Role of cognitive resources on everyday functioning among oldest-old physically frail

Translation and Psychometric Properties of the Portuguese Version of the Timed Instrumental Activities of Daily Living (TIADL)

(1) Background: to examine the psychometric properties of the Portuguese version of the Timed Instrumental Activities of Daily Living (TIADL) in nursing home residents. (2) Methods: Fifty-two participants (85.8 ± 4.2 years) were assessed on two occasions, 10-14 days apart. The same rater administered all assessments. Internal consistency was analysed through Cronbach's α. The reliability was estimated using the intraclass correlation coefficients (ICCs), and the standard error of the mean (SEM) was used to estimate the minimal detectable change (MDC). Construct validity was determined by Spearman's correlation coefficients. (3) Results: For internal consistency, Cronbach's α (0.81) revealed high internal reliability. All of the subtests demonstrated good or excellent reliability and also presented acceptable measurement precision, considering the criterion SEM < SD/2. According to Spearman's rho, correlations with the Portuguese version of the TIADL, the Useful Field of View test, and semantic and phonemic fluency tests were significant, with moderate positive and negative correlations (0.4 < rs < 0.69). (4) Conclusions: The Portuguese version of the TIADL had good to excellent test-retest reliability (ICC > 0.90) and acceptable measurement precision. This test could be a valuable clinical tool for assessing actual performance in instrumental activities of daily living in nursing home residents.

Can cochlear implantation prevent cognitive decline in the long-term follow-up?

Cognitive function and hearing are known to both decline in older adults. As hearing loss is proposed to be one modifiable risk factor for dementia, the impact of auditory rehabilitation on cognitive decline has been gaining increasing attention. Despite a large number of studies, long-term data are still rare. In a large prospective longitudinal monocentric study, 50 adults (aged ≥ 50 years) with severe postlingual bilateral hearing loss received a cochlear implant (CI). They underwent comprehensive neurocognitive testing prior to implantation (T1), at 12 months (T2) and up to 65 months (T3) after implantation. Various cognitive subdomains such as attention, inhibition, working memory, verbal fluency, mental flexibility and (delayed) recall were assessed by the computer-based non-auditory test battery ALAcog©. The observed trajectories of two exemplary cognitive subdomains (delayed recall and working memory) were then fitted over time using multilevel growth models to adjust for sociodemographic covariates and compared with 5-year longitudinal data from a sample of older adults from the representative Survey of Health, Aging and Retirement in Europe (SHARE) study. Postoperatively, auditory functions improved from 6.98% (SD 12.83) to 57.29% (SD 20.18) in monosyllabic speech understanding. Cognitive functions significantly increased from T1 to T3 in attention (p = 0.001), delayed recall (p = 0.001), working memory (OSPAN; p = 0.001), verbal fluency (p = 0.004), and inhibition (p = 0.002). A closer look at follow-up revealed that cognitive improvement could be detected between T1 and T2 and thereafter remained stable in all subtests (p ≥ 0.06). Additional longitudinal analysis confirmed these findings in a rigorous multilevel approach in two exemplary cognitive subdomains. In contrast to the SHARE data, there was no evidence for age-differential associations over time in CI recipients. This suggests that older adults benefit equally from cochlear implantation. CI users with worse preoperative cognitive skills experienced the most benefit (p < 0.0001). Auditory rehabilitation by cochlear implantation has a stimulating effect on cognitive functions beyond an improvement in speech understanding and an increased well-being. Large multicenter studies using standardized protocols have to be undertaken in the future to find out whether hearing restoration might help to prevent cognitive decline.

Associations of Age and Pain With 9-Year Functional Health Trajectories

Abstract. We investigated whether information-processing speed and accommodative coping moderate associations of age and pain with 9-year functional health trajectories. Our sample consisted of 5,254 participants of the German Ageing Survey aged 40 years and older ( M = 62.33 years) who participated in up to four measurement occasions. After controlling for sex, chronic diseases, and education, our longitudinal multilevel regression models revealed that the association of older age and higher pain severity with lower functional health was weaker in individuals with higher processing speed. The relationship between pain and functional health was weaker in individuals with higher scores on accommodative coping. Our findings suggest that processing speed and accommodative coping may be important compensatory resources buffering negative associations of age and pain with functional health.