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Song Y, Liu H, Gu K, Liu Y. Association between nighttime sleep duration, nap time, and mild cognitive impairment in Chinese older adults: a cross-sectional study. BMC Public Health 2024; 24:2381. [PMID: 39223492 PMCID: PMC11367814 DOI: 10.1186/s12889-024-19900-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE This study aims to investigate the relationship between midday nap time, nighttime sleep duration, and mild cognitive impairment (MCI) in Chinese older adults and determine the recommended sleep duration to provide a scientific basis for preventing and managing MCI in this population. METHODS Utilizing the 2020 China Health and Retirement Longitudinal Study database, the demographic data, health status, and lifestyle information of the study participants were collected. A total of 5,314 valid samples were included in the analysis. Logistic regression and restricted cubic spline plots were employed to explore the relationship between sleep patterns and MCI. RESULTS In the cross-sectional analysis, a linear relationship was observed between midday nap duration and MCI among Chinese elderly. The probability of MCI was lowest among those who napped for less than 30 min at noon. Compared with individuals who napped for30-90 min, those who did not nap were more likely to have MCI (OR = 1.30, 95% CI: 1.05-1.60). Older adults with napping duration < 30 min (OR = 0.73, 95% CI:0.56-0.95) also exhibited lower probability of MCI when compared those without napping habit, Nighttime sleep duration exhibited a U-shaped relationship with MCI. Individuals with less than approximately 6 h of nighttime sleep showed a gradual decrease in the probability of MCI with increasing sleep duration, whereas those with more than 7.5 h demonstrated an increase in the probability of MCI with longer sleep duration. Older adults who slept less than 6 h at night (OR = 1.22, 95% CI: 1.01 ~ 1.46) or more than 8 h (OR = 1.78, 95% CI: 1.35-2.33) were more likely to develop MCI compared with those who slept 6 to 8 h. CONCLUSION After controlling for potential confounding variables, both nighttime sleep duration and midday nap duration exhibited a nonlinear "U"-shaped relationship with MCI among the elderly. The probability of depression was lower with a nap duration of approximately 60 min, and the optimal nighttime sleep duration was 6-8 h, with around 7 h providing the greatest cognitive benefits.
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Affiliation(s)
- Yanliqing Song
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Haoqiang Liu
- College of Sports, Nanjing Tech University, Nanjing, China
| | - KeNan Gu
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Yue Liu
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China.
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Safarnavadeh M, Salehi L. Psychometric adequacy of the persian adapted version of the tilburg frailty indicator (P-TFI). BMC Geriatr 2024; 24:623. [PMID: 39034390 PMCID: PMC11265109 DOI: 10.1186/s12877-024-05161-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 06/18/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Frailty is identified as the primary goal of preventing the various consequences. The present study aimed to assess validity and reliability of the Persian adapted version of the Tilburg frailty indicator (TFI) in Iran. METHOD This cross-sectional study included three phases of translating the indicator to Persian, assessing the face and content validity, completing the P-TFI by older people, who helped assess the reliability and construct validity. For construct validity, convergent and divergent validity were used. It was expected that the TFI domain scores would show the highest correlations with their related measures of frailty (convergent construct validity) and the lowest correlations with measures of the other domains (divergent construct validity). The study population consisted of 400 older people, selected from six health care centers. RESULTS The mean age of the participants was 69.05 ± 7.28 years and the majority of the participants were married woman with less than a high school education. The total mean score of TFI was 8.26 ± 1.80, and 42.75% was classified as frail. The test-retest reliability was 0.88 for the total scale, 0.80 for physical, 0.65 for psychological, and 0.81 for social domains. The mean score of frailty and its dimensions (physical, psychological, and social) varied from 4.35 ± 1.78, 1.81 ± 1.33, 1.69 ± 0.73, and 0.86 ± 0.61, respectively. The total score of the TFI was correlated with each alternative measure and the convergent validity was proved. Further, the kappa values ranging from 535 to 0.967 were significant and test- retest reliability for total, physical, psychological, and social dimension were 0.88, 080, 065, and 081, respectively. Further, the convergent or divergent validity is being discussed for clarity. CONCLUSION The Persian version of the TFI is valid and easy scored tools among Iranian's older people.
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Affiliation(s)
- Maryam Safarnavadeh
- Vice Chancellery for Education, Iran Ministry of Health and Medical Education, Tehran, Iran
| | - Leili Salehi
- Department of Health Education & Promotion, School of Public Health,Research center for health,safety and environment,Karaj, Iran, Alborz University of Medical Sciences, P.O. Box 3146-883811, Karaj, Iran.
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Li X, Yin Y, Zhang H. Nonlinear association between self-reported sleep duration and cognitive function among middle-aged and older adults in China: The moderating effect of informal care. Sleep Med 2024; 115:226-234. [PMID: 38377839 DOI: 10.1016/j.sleep.2024.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/24/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Cognitive impairment is a major public health problem urgently to be solved. This study aims to examine the association between sleep duration and cognitive function and its two subdimensions: episodic memory and mental status, and to explore the moderating effects of informal care on these associations among middle-aged and older adults in China. METHODS Data was drawn from China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, 2015 and 2018 datasets. Sleep duration and informal care were self-reported. Cognitive function was measured using CHARLS Harmonized Cognitive Assessment Protocol. Effects of informal care on sleep duration-cognitive function were assessed using Generalized Estimating Equations models. RESULTS The relationships between sleep duration and cognitive function, episodic memory, and mental status were all found to follow an inverted U-shaped pattern. Spouse care weakened the adverse effects of extreme sleep duration on cognitive function while the children care amplified them. Further, we only observed the moderating effects of spouse and children care on the association between sleep duration and episodic memory, but not mental status. CONCLUSIONS The relationships between sleep duration and cognitive function, along with its different dimensions, are nonlinear in nature. The impacts of sleep duration on cognitive function and its dimensions are contingent upon the levels of informal care received and the sources of that care. We provide valuable insights into the complex interplay between sleep duration, informal care, and cognitive function.
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Affiliation(s)
- Xuezhu Li
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yujie Yin
- Department of Management, Marketing and Information Systems, Hong Kong Baptist University, Hong Kong, 999077, China
| | - Hui Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Blanco-Rambo E, Bandeira-Guimarães M, Rambo ES, Formighieri C, Steffens T, Cadore EL, Pietta-Dias C. Effects of social distancing provoked by COVID-19 pandemic in the functional capacity and cognitive function in nonagenarians and centenarians. J Bodyw Mov Ther 2024; 37:46-50. [PMID: 38432840 DOI: 10.1016/j.jbmt.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/02/2023] [Accepted: 11/11/2023] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Due to the rapid advance of coronavírus SARS-CoV-2 (COVID-19) pandemic in 2020, social distancing was the main way to reduce the transmission of the virus. Although this measure was efficient and necessary, the social distancing had severe consequences for physical function, mainly in older individuals. Thus, the aim of this study was to investigate the effects of social distancing in the functional and cognitive capacity of community-dwelling oldest-old adults. METHODS The present study is part of a larger prospective cohort study. Fifteen participants aged 90 years old or older were assessed in the 8-foot-timed-up-and-go test (8-footTUG), sit-to-stand-up test (STS), handgrip strength test (HGS), Mini Mental State Examination (MMSE), Katz Index and Lawton Scale before and after one year of social distancing. RESULTS A significant worsening in the 8-footTUG and MMSE score was observed, while there were no significant changes in the other variables. When analyzing the decreases in relation to previous functional capacity, it was observed that individuals categorized as dependent by STS cut-off points had the worst decreases in functional capacity. CONCLUSION The social distancing provoked by COVID-19 pandemic negatively affected the 8-footTUG and cognition. Moreover, individuals dependents showed greater decline in their functional capacity.
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Affiliation(s)
- Eduarda Blanco-Rambo
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Marcelo Bandeira-Guimarães
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Elias Scholl Rambo
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina Formighieri
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Tainara Steffens
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduardo Lusa Cadore
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Caroline Pietta-Dias
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Davies LE, Todd A, Sinclair DR, Robinson L, Kingston A. Is polypharmacy associated with difficulty taking medicines in people aged ≥85 living at home? Findings from the Newcastle 85+ Study. Br J Clin Pharmacol 2023; 89:3217-3227. [PMID: 37480194 DOI: 10.1111/bcp.15858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/23/2023] Open
Abstract
It is unclear whether polypharmacy is associated with difficulty taking medications amongst people aged ≥85 living at home. This is despite the projected decline in availability of family carers, who may support independent living. Using Newcastle 85+ Study data and mixed-effects modelling, we investigated the association between polypharmacy and difficulty taking medications amongst 85-year-olds living at home, over a 10-year time period. Polypharmacy was not associated with difficulty taking medications as either a continuous (OR = 0.99 [0.91-1.08]) or categorical variable (5-9 medications, OR = 0.69 [0.34-1.41]; ≥10 medications, OR = 0.85 [0.34-2.07]). The significant predictors included disability, visual impairment and cognitive impairment. Our results suggest that people aged ≥85 living at home with disability, visual impairment and/or cognitive impairment will have difficulty taking their medications, regardless of how many they are prescribed. Therefore, healthcare professionals should routinely ask about, assess and address problems that these patient groups may have with taking their medicines, independent of the number of drugs taken.
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Affiliation(s)
- Laurie E Davies
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Adam Todd
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK
| | - David R Sinclair
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Kingston
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Manna CK, Ranjan R, Kumar P, Ahmad S, Nath S. Effect of vortioxetine versus venlafaxine on cognitive functions in adults with major depressive disorder: A randomized-controlled trial. Indian J Psychiatry 2023; 65:815-824. [PMID: 37736222 PMCID: PMC10510634 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_160_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/26/2023] [Accepted: 07/12/2023] [Indexed: 09/23/2023] Open
Abstract
Background Vortioxetine and venlafaxine are antidepressants which have shown established efficacy to treat major depressive disorder (MDD). There are no studies that compared them for their efficacy in cognitive symptoms of depression. The study aimed to compare the effect of vortioxetine and venlafaxine on the change in cognitive scores in adults with MDD. Methods The present study was an open-label, active-controlled parallel design randomized clinical trial. After randomization, baseline clinical evaluations by Montgomery-Asberg Depression Rating Scale (MADRS) and Social and Occupational Functioning Assessment Scale (SOFAS) were done and coding (subset of WAIS-IV), WCST, TMT, Stroop test, PGI memory were used to assess cognition in 100 unmedicated MDD patients. They were reassessed after eight weeks of monotherapy with vortioxetine or venlafaxine. Results Primary cognitive measure (coding score) was found to be significantly higher (Mean Difference = 0.680; 95% CI:.202 to 1.158; P = 0.006) in vortioxetine in comparison with venlafaxine. Stroop test scores (word score, color score, color-word score) were also found to be significantly higher with vortioxetine. In other cognitive measures (WCST scores: total trials, total errors score, total perseverative responses score, total perseverative errors scores; TMT-A and B scores), a significant decrease in scores with vortioxetine in comparison with venlafaxine were observed. A significant decrease in MADRS and increase in SOFAS scores were observed with vortioxetine in comparison with venlafaxine. Both the drugs alleviated the symptoms of depression but vortioxetine was better tolerated. Conclusion Our study findings suggest that improvement in cognitive scores is significantly higher with vortioxetine than venlafaxine over the eight weeks of monotherapy. Clinical Trial registration number CTRI/2020/07/026819 (Registered with Clinical Trials Registry- India).
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Affiliation(s)
- Chayan K. Manna
- Department of Psychiatry, College of Medicine and JNM Hospital, Kalyani, West Bengal, India
| | - Rajeev Ranjan
- Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Pankaj Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Shamshad Ahmad
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Santanu Nath
- Department of Psychiatry, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
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Gómez-Soria I, Iguacel I, Aguilar-Latorre A, Peralta-Marrupe P, Latorre E, Zaldívar JNC, Calatayud E. Cognitive stimulation and cognitive results in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 104:104807. [PMID: 36116285 DOI: 10.1016/j.archger.2022.104807] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE The lack of cognitive activity accelerates age cognitive decline. Cognitive stimulation (CS) tries to enhance cognitive functioning. The purpose of this systematic review and meta-analysis was to evaluate the effects of CS on cognitive outcomes (general cognitive functioning and specific cognitive domains) in older adults (aged 65 years or older, cognitively healthy participants, or with mild cognitive impairment, or dementia). METHODS PubMed, Scopus and Web of Science databases were examined from inception to October 2021. A total of 1,997 studies were identified in these databases, and. 33 studies were finally included in the systematic review and the meta-analysis. Raw means and standard deviations were used for continuous outcomes. Publication bias was examined by Egger's Regression Test for Funnel Plot Asymmetry and the quality assessment tools from the National Institutes of Health. RESULTS CS significantly improves general cognitive functioning (mean difference=MD = 1.536, 95%CI, 0.832 to 2.240), memory (MD = 0.365, 95%CI, 0.300 to 0.430), orientation (MD = 0.428, 95%CI, 0.306 to 0.550), praxis (MD = 0.278, 95%CI, 0.094 to 0.462) and calculation (MD = 0.228, 95%CI, 0.112 to 0.343). CONCLUSION CS seems to increase general cognitive functioning, memory, orientation, praxis, and calculation in older adults.
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Affiliation(s)
- Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.
| | - Isabel Iguacel
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain; Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain.
| | | | - Patricia Peralta-Marrupe
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Eva Latorre
- Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Juan Nicolás Cuenca Zaldívar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), Madrid, Spain; Primary Health Center "El Abajon", 28231 Las Rozas de Madrid, Spain
| | - Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
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Shamoun CJ. Functional dependence among stroke survivors: A concept analysis. Nurs Forum 2022; 57:1472-1477. [PMID: 35809053 DOI: 10.1111/nuf.12779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
AIM To report an analysis of the concept of functional dependence among stroke survivors. BACKGROUND Functional dependence among stroke survivors is a focal stimulus that leads to caregiver burden and can be measured and applied to research and theory in different ways depending on the researcher's interpretation of the concept. DESIGN A concept analysis was conducted using the method described by Walker and Avant. DATA SOURCE A review of the literature was conducted using the CINAHL and PubMed databases. Lay literature, such as the Merriam-Webster dictionary was included. RESULTS Through the identification and analysis of definitions and uses of the concept, the defining attributes were found to be (1) inability to perform regular functions and (2) dependence on a caregiver to perform regular functions which form the conceptual and operational definitions. A model, borderline, and the related case of the conceptual definition are provided. One antecedent, two consequences, and four empirical referents are identified, alongside the instruments used to measure the empirical referents. CONCLUSIONS With functional dependence being so closely tied to caregiver burden, researchers and clinicians should take a dyadic approach to caring for this patient population to ensure both perspectives are considered, and optimal patient outcomes are achieved.
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Affiliation(s)
- Charles J Shamoun
- School of Nursing, Oakland University, Rochester, Michigan, USA.,Neurosurgical Intensive Care Unit, Detroit, Michigan, USA
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Early strong predictors of decline in instrumental activities of daily living in community-dwelling older Japanese people. PLoS One 2022; 17:e0266614. [PMID: 35381051 PMCID: PMC8982840 DOI: 10.1371/journal.pone.0266614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/23/2022] [Indexed: 11/19/2022] Open
Abstract
Objective Our aim is to determine the strong predictors of the onset of instrumental activities of daily living (IADL) decline in community-dwelling older people. Design A prospective cohort study with a two-year follow-up. Setting Kashiwa City, Chiba Prefecture, Japan and Toshima Ward, Tokyo Metropolitan, Japan. Participants The data were acquired from two cohorts. The final sample comprised 1,523 community-dwelling older people aged 65–94 years (681 men, 842 women). They were individuals who were independent in IADL at baseline and participated in follow-up IADL assessments two years later. Measurements At baseline, comprehensive assessments were performed including: health interview, gait function, hand-grip strength, skeletal muscle mass, balance function, oral function, dietary lifestyle, cognitive function, quality of life, mental status, and social network. When the two-year follow-up was performed, IADL declines were observed in 53 out of 1,523 people. The association of each Z-transformed parameter with the occurrence of IADL decline was examined by employing a binominal logistic regression model adjusting for age, gender, body weight, body height, and medical history. An odds ratio (OR) and a 95% confidence interval were calculated and compared between different parameters. Results A decrease in walking speed and one-legged stance time, whereas an increased timed up & go test time was associated with significant ORs for the occurrence of IADL decline. Conclusion Gait-related parameters appear to be the strong predictors of the onset of IADL decline in community-dwelling older people.
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Gómez-Soria I, Ferreira C, Oliván Blazquez B, Magallón Botaya RM, Calatayud E. Short-term memory, attention, and temporal orientation as predictors of the cognitive impairment in older adults: A cross-sectional observational study. PLoS One 2021; 16:e0261313. [PMID: 34928983 PMCID: PMC8687627 DOI: 10.1371/journal.pone.0261313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/30/2021] [Indexed: 11/19/2022] Open
Abstract
Late-life cognitive decline ranges from the mildest cases of normal, age-related change to mild cognitive impairment to severe cases of dementia. Dementia is the largest global burden for the 21st century welfare and healthcare systems. The aim of this study was to analyze the neuropsychological constructs (temporal orientation (TO), spatial orientation (SO), fixation memory (FM), attention (A), calculation (C), short-term memory (STM), language (L), and praxis (P)), semantic fluency, level of functionality, and mood that reveal the greatest deficit in the different stages ranging from normal cognition (NC) to cognitive impairment in older adults in a primary healthcare setting. The study included 337 participants (102 men, 235 women), having a mean age of 74 ± 6 years. According to their scores on the Spanish version of the Mini-Mental State Examination (MEC-35), subjects were divided into 4 groups: no deterioration (ND) (score 32-35), subtle cognitive impairment (SCI) (score 28-31), level deterioration (LD) (score 24-27) and moderate deterioration (MD) (score 20-23). The ND group revealed significant differences in TO, STM, C, A, L, P, and S-T as compared to the other groups. The MD group (in all the neuropsychological constructs) and the ND and SCI groups showed significant differences on the Yesavage geriatric depression scale (GDS-15). All except the FM neuropsychological construct were part of the MEC-35 prediction model and all of the regression coefficients were significant for these variables in the model. Furthermore, the highest average percentage of relative deterioration occurs between LD and MD and the greatest deterioration is observed in the STM for all groups, including A and TO for the LD and MD groups. Based on our findings, community programs have been implemented that use cognitive stimulation to prevent cognitive decline and to maintain the neuropsychological constructs.
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Affiliation(s)
- Isabel Gómez-Soria
- Faculty of Health Sciences, Department of Physiatry and Nursing,
University of Zaragoza, Zaragoza, Spain
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
| | - Chelo Ferreira
- Faculty of Veterinary Sciences, Department of Applied Mathematics and
IUMA, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván Blazquez
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
- Faculty of Social and Labor Sciences, Department of Psychology and
Sociology, University of Zaragoza, Zaragoza, Spain
| | - Rosa Mª Magallón Botaya
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
- Faculty of Medicine, Department of Medicine, Psychiatry and Dermatology,
University of Zaragoza, Zaragoza, Spain
| | - Estela Calatayud
- Faculty of Health Sciences, Department of Physiatry and Nursing,
University of Zaragoza, Zaragoza, Spain
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza,
Spain
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Gómez-Gallego M, Gómez-Gallego JC. Predictors of Caregiver Burden of Patients with Alzheimer Disease Attending Day-Care Centres. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010707. [PMID: 34682452 PMCID: PMC8535802 DOI: 10.3390/ijerph182010707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/01/2021] [Accepted: 10/07/2021] [Indexed: 11/29/2022]
Abstract
Nowadays, there are plenty of programs and resources to prevent caregiver burden of patients with Alzheimer’s disease. In spite of that, many caregivers suffer high levels of burden and stress, which leads to an earlier institutionalization of patients. This study aimed to explore the predictors of burden in relative caregivers of patients attending day-care centers and the moderating role of caregiver kinship in these associations. A sample of a hundred and two patient–caregiver dyads was recruited. Burden was measured with a Zarit Burden Interview. Measures of patients’ cognition, insight, depression, behavioral disturbances, functional ability and overall physical health were considered as predictors. We found that apathy, irritability and delusions and, patients’ mobility are the main determinants of caregivers’ burden. The strength of relationship between delusions and irritability was higher in spouse caregivers. Interventions to reduce burden should be adapted to the specific needs of a particular type caregiver.
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Affiliation(s)
- María Gómez-Gallego
- Clinical Neuroscience Research Group, Faculty of Health Sciences, Catholic University of Murcia, 30107 Murcia, Spain;
| | - Juan Cándido Gómez-Gallego
- Department of Applied Economics, Faculty of Economic, Espinardo Campus, University of Murcia, 30100 Murcia, Spain
- Correspondence:
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Barthold D, Marcum ZA, Chen S, White L, Ailabouni N, Basu A, Coe NB, Gray SL. Difficulty with Taking Medications Is Associated with Future Diagnosis of Alzheimer's Disease and Related Dementias. J Gen Intern Med 2021; 36:863-868. [PMID: 33037589 PMCID: PMC8041972 DOI: 10.1007/s11606-020-06279-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Medication management requires complex cognitive functioning, and therefore, difficulty taking medications might be an early sign of cognitive impairment and could be a risk factor for Alzheimer's disease and related dementias (ADRD). Accordingly, people with difficulty taking medications may benefit from more detailed cognitive screening, potentially aiding in the diagnosis of ADRD, which is underdiagnosed. We are unaware of evidence on medication management difficulties that precede a real-world ADRD diagnosis in the USA. OBJECTIVE Examine the association between difficulty taking medications and subsequent real-world ADRD diagnoses. DESIGN Case-control study, using Health and Retirement Study (HRS) survey data linked to Medicare claims. PARTICIPANTS A total of 1461 HRS respondents with an ADRD diagnosis observed from 1993 to 2012 (cases), matched by year of birth, wave of HRS entry, and sex to 3771 controls with no ADRD diagnosis. MAIN MEASURES We examined the association between diagnosis of ADRD and self-reported difficulty taking medications in the preceding years (1-2 and 3-4 years prior to case definition). Control individuals were assigned the index date from their matched case. Conditional logistic regressions adjusted for age, sex, race, education, and comorbidities. KEY RESULTS Compared with matched controls, cases had higher prevalence of difficulty taking medications 1-2 years prior to diagnosis (11.0% versus 2.3%), and 3-4 years prior to diagnosis (5.8% versus 2.3%). Adjusted analyses showed that compared with individuals without ADRD, those with an ADRD diagnosis had more than four times higher odds of difficulty taking medications 1-2 years prior (OR = 4.56 (CI 3.30-6.31)), and more than two times higher odds of difficulty taking medications 3-4 years prior (OR = 2.41 (CI 1.61-3.59)). CONCLUSIONS Odds of medication difficulty 1-2 years prior were more than four times greater for individuals with ADRD diagnoses compared with those without ADRD. Medication management difficulties may prompt further cognitive screening, potentially aiding in earlier recognition of ADRD.
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Affiliation(s)
- Douglas Barthold
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, WA, USA.
- The Plein Center for Geriatric Pharmacy Research, Education, and Outreach, School of Pharmacy, University of Washington, Seattle, WA, USA.
| | - Zachary A Marcum
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, WA, USA
- The Plein Center for Geriatric Pharmacy Research, Education, and Outreach, School of Pharmacy, University of Washington, Seattle, WA, USA
| | - Shuxian Chen
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, WA, USA
| | | | - Nagham Ailabouni
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, WA, USA
- The Plein Center for Geriatric Pharmacy Research, Education, and Outreach, School of Pharmacy, University of Washington, Seattle, WA, USA
- Quality Use of Medicine and Pharmacy Practice Centre, UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Anirban Basu
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, WA, USA
| | - Norma B Coe
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shelly L Gray
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, WA, USA
- The Plein Center for Geriatric Pharmacy Research, Education, and Outreach, School of Pharmacy, University of Washington, Seattle, WA, USA
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13
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Faronbi JO, Akinyoola OD, Faronbi GO, Ojo FT. Factors contributing to functional dependence among older adults in Ile–Ife, Nigeria. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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14
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Indahlastari A, Hardcastle C, Albizu A, Alvarez-Alvarado S, Boutzoukas EM, Evangelista ND, Hausman HK, Kraft J, Langer K, Woods AJ. A Systematic Review and Meta-Analysis of Transcranial Direct Current Stimulation to Remediate Age-Related Cognitive Decline in Healthy Older Adults. Neuropsychiatr Dis Treat 2021; 17:971-990. [PMID: 33824591 PMCID: PMC8018377 DOI: 10.2147/ndt.s259499] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/11/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) has been proposed as a possible method for remediating age-associated cognitive decline in the older adult population. While tDCS has shown potential for improving cognitive functions in healthy older adults, stimulation outcomes on various cognitive domains have been mixed. METHODS A systematic search was performed in four databases: PubMed, EMBASE, Web of Science, and PsychInfo. Search results were then screened for eligibility based on inclusion/exclusion criteria to only include studies where tDCS was applied to improve cognition in healthy older adults 65 years and above. Eligible studies were reviewed and demographic characteristics, tDCS dose parameters, study procedures, and cognitive outcomes were extracted. Reported effect sizes for active compared to sham group in representative cognitive domain were converted to Hedges' g. MAIN RESULTS A total of thirteen studies involving healthy older adults (n=532, mean age=71.2+5.3 years) were included in the meta-analysis. The majority of included studies (94%) targeted the prefrontal cortex with stimulation intensity 1-2 mA using various electrode placements with anodes near the frontal region. Across all studies, we found Hedges' g values ranged from -0.31 to 1.85 as reported group effect sizes of active stimulation compared to sham. CONCLUSION While observed outcomes varied, overall findings indicated promising effects of tDCS to remediate cognitive aging and thus deserves further exploration. Future characterization of inter-individual variability in tDCS dose response and applications in larger cohorts are warranted to further validate benefits of tDCS for cognition in healthy older adults.
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Affiliation(s)
- Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Stacey Alvarez-Alvarado
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Jessica Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Kailey Langer
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Department of Neuroscience, University of Florida, Gainesville, FL, USA
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15
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Johansen RH, Olsen K, Bergh S, Benth JŠ, Selbæk G, Helvik AS. Course of activities of daily living in nursing home residents with dementia from admission to 36-month follow-up. BMC Geriatr 2020; 20:488. [PMID: 33218298 PMCID: PMC7678321 DOI: 10.1186/s12877-020-01877-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 11/09/2020] [Indexed: 02/02/2023] Open
Abstract
Background Dementia is affecting both the person with the disease and the family members. It is associated with nursing home admission, and a reduced ability to perform personal activities of daily living (P-ADL). The aim of this study was to examine the association between the severity of dementia and P-ADL function, and to study if additional factors such as neuropsychiatric symptoms, type of nursing home unit, and use of medication were associated with P-ADL function. Methods A total of 582 nursing home residents with dementia, included at admission to the nursing home, were followed with biannual assessments for 36 months. P-ADL was assessed using the Physical Self-Maintenance scale, and severity of dementia was measured with the Clinical Dementia Rating scale. In addition, neuropsychiatric symptoms, general physical health, and use of medications were assessed at the same time points. Demographic information was collected at baseline. Linear mixed models were estimated. Results There was a significant (p < 0.05) non-linear decline in P-ADL function over time in analysis not adjusting for any characteristics. More severe dementia at baseline and at the follow-up assessments was associated with lower P-ADL function (p < 0.001), with the association being stable over time. A higher level of neuropsychiatric symptoms, not using anti-dementia medication, being in a regular care unit as compared to a special care unit and having poor/fair general physical health as compared to good/excellent, were associated with a lower P-ADL function. Conclusion The association between more severe dementia and lower P-ADL function was stable over a 36-month follow-up period of nursing home residents with dementia. Health care planners and clinicians should be aware of this when planning for and treating nursing home residents.
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Affiliation(s)
- Reidun Haarr Johansen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Karoline Olsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Research Centre for Age-related Functional decline and Disease, Innlandet Hospital Trust, Ottestad, Norway.,Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway.,Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Anne-Sofie Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,General Practice Research unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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16
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Hogan MJ, Stephens K, Smith E, Jalazo ER, Hendriksz CJ, Edwards LJ, Bjoraker KJ. Toileting Abilities Survey as a surrogate outcome measure for cognitive function: Findings from neuronopathic mucopolysaccharidosis II patients treated with idursulfase and intrathecal idursulfase. Mol Genet Metab Rep 2020; 25:100669. [PMID: 33101985 PMCID: PMC7578548 DOI: 10.1016/j.ymgmr.2020.100669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/12/2020] [Indexed: 10/31/2022] Open
Abstract
An outcome measure of toileting skills, the Toileting Abilities Survey or TAS, with sensitivity to detect change in a neurodegenerative disorder such as MPS II, was developed. The TAS was used in a research study of patients (n = 86) with the neuronopathic form of MPS II to measure treatment benefit of intrathecal idursulfase. Treatment with idursulfase and intrathecal idursulfase is associated with significantly higher individual and overall toileting skills versus treatment with idursulfase alone.
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Affiliation(s)
| | | | - Erin Smith
- Backpack Health, a Konica Minolta Service, Boston, MA, USA
| | - Elizabeth R Jalazo
- Division of Genetics and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christian J Hendriksz
- Department of Paediatrics and Child Health at the Steve Biko Academic Unit, University of Pretoria, South Africa
| | - Lloyd J Edwards
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
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17
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Kelly ME. The Potential of a Relational Training Intervention to Improve Older Adults' Cognition. Behav Anal Pract 2020; 13:684-697. [PMID: 32953397 PMCID: PMC7471216 DOI: 10.1007/s40617-020-00415-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Behavioral gerontology rarely focuses on improving older adults' cognitive function. This gap in the literature should be addressed, as our aging population means that greater numbers of older adults are experiencing cognitive decline and reduced functional independence. If cognitive training interventions are to be socially significant, they should target improvements in core executive functions (EFs) that are critical for everyday cognition and functioning independence. Evidence from the cognitive sciences suggests that a cognitive training intervention targeting "relational knowledge" and "cognitive flexibility," which are core EFs, could translate to improvements in cognition and functioning for older adults. Behavioral researchers, interested in the effects of relational training on cognition, have shown a relationship between complex and flexible arbitrarily applicable relational responding (AARRing) and improved performance on measures of intelligence in children and young adults. However, data examining the impact of AARRing on the cognition of older adults are lacking. This article suggests that complex and flexible AARRing may be synonymous with the aforementioned EFs of relational knowledge and cognitive flexibility, and that a behaviorally oriented relational training intervention might improve cognition and functioning for healthy older adults or those experiencing cognitive decline. The article initially presents a brief overview of research in behavioral gerontology and older adult cognition, followed by a detailed explanation of how training complexity and flexibility in AARRing could result in improvements in core EFs. Specific suggestions for designing a relational training intervention and assessing relevant outcomes are provided.
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Affiliation(s)
- Michelle E. Kelly
- National College of Ireland, Mayor Street Lower, IFSC, Dublin, Ireland
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18
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Thaung Zaw JJ, Howe PR, Wong RH. Long-term effects of resveratrol on cognition, cerebrovascular function and cardio-metabolic markers in postmenopausal women: A 24-month randomised, double-blind, placebo-controlled, crossover study. Clin Nutr 2020; 40:820-829. [PMID: 32900519 DOI: 10.1016/j.clnu.2020.08.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/08/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022]
Abstract
Ageing and menopause contribute to endothelial dysfunction, causing impaired cerebral perfusion, which is in turn associated with accelerated cognitive decline. In a 14-week pilot study, we showed that supplementation with low-dose resveratrol, a phytoestrogen that can enhance endothelial function, improved cerebrovascular and cognitive functions in postmenopausal women. We sought to confirm these benefits in a larger, longer-term trial. A 24-month randomized, placebo-controlled crossover trial was undertaken in 125 postmenopausal women, aged 45-85 years, who took 75 mg trans-resveratrol or placebo twice-daily for 12 months and then crossover to the alternative treatment for another 12 months. We evaluated within individual differences between each treatment period in measures of cognition (primary outcome), cerebrovascular function in the middle cerebral artery (cerebral blood flow velocity: CBFV, cerebrovascular responsiveness: CVR) and cardio-metabolic markers as secondary outcomes. Subgroup analyses examined effects of resveratrol by life stages. Compared to placebo, resveratrol supplementation resulted a significant 33% improvement in overall cognitive performance (Cohen's d = 0.170, P = 0.005). Women ≥65 years of age showed a relative improvement in verbal memory with resveratrol compared to those younger than 65 years. Furthermore, resveratrol improved secondary outcomes including resting mean CBFV (d = 0.275, P = 0.001), CVR to hypercapnia (d = 0.307, P = 0.027), CVR to cognitive stimuli (d = 0.259, P = 0.032), fasting insulin (d = 0.174, P = 0.025) and insulin resistance index (d = 0.102, P = 0.034). Regular supplementation with low-dose resveratrol can enhance cognition, cerebrovascular function and insulin sensitivity in postmenopausal women. This may translate into a slowing of the accelerated cognitive decline due to ageing and menopause, especially in late-life women. Further studies are warranted to observe whether these cognitive benefits of resveratrol can reduce the risk of dementia.
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Affiliation(s)
- Jay Jay Thaung Zaw
- University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, NSW, 2308, Australia
| | - Peter Rc Howe
- University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, NSW, 2308, Australia; University of Southern Queensland, Institute for Resilient Regions, Springfield Central, QLD, 4300, Australia; University of South Australia, School of Health Sciences, Adelaide, SA, 5000, Australia
| | - Rachel Hx Wong
- University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, NSW, 2308, Australia; University of Southern Queensland, Institute for Resilient Regions, Springfield Central, QLD, 4300, Australia.
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19
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Wang MC, Li TC, Li CI, Liu CS, Lin CH, Lin WY, Yang CW, Yang SY, Lin CC. Cognitive function and its transitions in predicting all-cause mortality among urban community-dwelling older adults. BMC Psychiatry 2020; 20:203. [PMID: 32375731 PMCID: PMC7201694 DOI: 10.1186/s12888-020-02618-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cognitive impairment is accompanied with high rates of comorbid conditions, leading ultimately to death. Few studies examine the relation between cognitive transition and mortality, especially in Asian population. This study evaluated baseline cognition and cognitive transition in relation to all-cause mortality among community-dwelling older adults. METHODS We conducted a community-based prospective cohort study among 921 participants of Taichung Community Health Study for Elders in 2009. Cognitive function was evaluated by the Mini-Mental State Examination. Cognitive impairment was considered if the total score is less than 27, 24, and 21 for a participant's educational level of more than 6 years, equal or less than 6 years, and illiteracy, respectively. One-year transition in cognitive function was obtained among 517 individuals who were assessed in both 2009 and 2010. Mortality was followed up until 2016. Cox proportional hazards models were applied to estimate the adjusted hazard ratios of mortality for baseline cognitive impairment and one-year transition in cognitive status. RESULTS After a follow-up of 6.62 years, 160 deaths were recorded. The multivariate adjusted hazard ratio (95% confidence interval) for baseline cognitive impairment was 2.08 (1.43, 3.01). Significantly increased mortality risk was observed for cognitively impaired-normal and impaired-impaired subgroups over 1 year as compared with those who remained normal [2.87 (1.25, 6.56) and 3.79 (1.64, 8.73), respectively]. The area under the receiver operating characteristic curves demonstrated that baseline cognition and one-year cognitive transition had no differential predictive ability for mortality. Besides, there was an interaction of cognitive impairment and frailty, with an additive mortality risk [5.41 (3.14, 9.35)] for the elders who presented with both. CONCLUSION Baseline cognitive impairment rather than one-year progression is associated with mortality in a six-year follow-up on older adults.
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Affiliation(s)
- Mu-Cyun Wang
- grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- grid.254145.30000 0001 0083 6092Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chia-Ing Li
- grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ,grid.411508.90000 0004 0572 9415Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ,grid.411508.90000 0004 0572 9415Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Yuan Lin
- grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chuan-Wei Yang
- grid.411508.90000 0004 0572 9415Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shing-Yu Yang
- grid.254145.30000 0001 0083 6092Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan. .,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. .,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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20
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Ding G, Zhao X, Wang Y, Song D, Chen D, Deng Y, Xing W, Dong H, Zhou Y, Li D, Hou H. Evaluation of the relationship between cognitive impairment and suboptimal health status in a northern Chinese population: a cross-sectional study. J Glob Health 2020; 10:010804. [PMID: 32257168 PMCID: PMC7101211 DOI: 10.7189/jogh.10.010804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Suboptimal health status (SHS) is an intermediate health status between ideal health and illness. As a determinant of cardiovascular disease and stroke, SHS is hypothesized to be associated with the development of cognitive impairment and dementia. This study aimed to investigate whether individuals with SHS have poor cognitive ability based on a community-based cohort in northern Chinese population. Methods 3524 participants who were enrolled in Jidong cohort 2015 in Tangshan City were investigated in this study. Cognitive function was measured with the Mini-Mental State Examination (MMSE). SHS level was evaluated using a self-reporting Suboptimal Health Status Questionnaire-25 (SHSQ-25). The relationship between SHS and cognitive function was analyzed with logistic regression analysis, by which odds ratio (OR) and 95% confidence interval (CI) were calculated. Results The prevalence of cognitive impairment was 3.4% (121/3524) in our study, with the prevalence rates of 1.9% (34/1750) among men and 4.9% (87/1774) in women. The medians of total score of MMSE were 28 (interquartile range (IQR) = 27-29) in the SHS group, and 29 (IQR = 27-30) in the ideal health group. Logistic regression analysis showed that SHS was significantly correlated with cognitive impairment (adjusted OR = 2.936, 95% CI = 1.428-6.033). With regard to gender, the OR was 5.067 (95% CI = 1.346-19.068) in men, which was higher than that in women (OR = 2.324, 95% CI = 1.130-4.779). Conclusions SHS might be a risk factor for cognitive function in northern Chinese population. Early screening of SHS individuals, as well as urgent treatment of SHS might contribute to the prevention of cognitive impairment.
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Affiliation(s)
- Guoyong Ding
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China.,Equal authorship
| | - Xuan Zhao
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China.,Equal authorship
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.,Equal authorship
| | - Daiyu Song
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Dongzhen Chen
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Yang Deng
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Weijia Xing
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Hualei Dong
- Taishan Hospital of Shandong Province, Taian, Shandong Province, China
| | - Yong Zhou
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Dong Li
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Haifeng Hou
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
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21
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Gracia-García P, López-Antón R, Santabárbara J, Quintanilla MÁ, De la Cámara C, Marcos G, Lobo E, Lobo A. Cognition and daily activities in a general population sample aged +55. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:270-283. [PMID: 32249666 DOI: 10.1080/13825585.2020.1745140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: We tested the association of individual cognitive domains measured with the Mini-Mental State Examination (MMSE) and disability. Method: Cross-sectional study in a population-based cohort aged ≥55 years (n = 4,803). Sample was divided into two groups: individuals with cognition within the normal range (CNR) (n = 4,057) and those with cognitive impairment (CI) (n = 746). Main outcome measures: The MMSE, the Katz Index (Basic Activities of Daily Living, bADL), the Lawton and Brody Scale (Instrumental Activities of Daily Living, iADL), and the Geriatric Mental State (GMS-AGECAT). Results: MMSE-orientation was associated with disability in bADL, iADL and a decrease in social participation, regardless of cognitive status. MMSE-attention was associated with disability in iADL, but only in CNR. MMSE-language was associated with disability in bADL, iADL and with reduced social participation, but only in CI. Conclusions: The associations observed between disability and orientation may have clinical and public health implications.
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Affiliation(s)
- Patricia Gracia-García
- Psychiatry Service, Hospital Universitario Miguel Servet , Zaragoza, Spain.,Department of Medicine and Psychiatry, Universidad de Zaragoza , Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain
| | - Raúl López-Antón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Department of Psychology and Sociology, Universidad de Zaragoza , Zaragoza, Spain
| | - Javier Santabárbara
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Department of Preventive Medicine and Public Health, Universidad de Zaragoza , Zaragoza, Spain
| | - Miguel Ángel Quintanilla
- Department of Medicine and Psychiatry, Universidad de Zaragoza , Zaragoza, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Psychiatry Service, Hospital Clínico Universitario , Zaragoza, Spain
| | - Concepción De la Cámara
- Department of Medicine and Psychiatry, Universidad de Zaragoza , Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Psychiatry Service, Hospital Clínico Universitario , Zaragoza, Spain
| | - Guillermo Marcos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Department of Preventive Medicine and Public Health, Universidad de Zaragoza , Zaragoza, Spain
| | - Elena Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain.,Department of Preventive Medicine and Public Health, Universidad de Zaragoza , Zaragoza, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza , Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation , Madrid, Spain.,Instituto Aragonés de Ciencias de la Salud (I+CS) , Zaragoza, Spain
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Chen YY, Wang CC, Kao TW, Wu CJ, Chen YJ, Lai CH, Zhou YC, Chen WL. The relationship between lead and cadmium levels and functional dependence among elderly participants. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:5932-5940. [PMID: 31863379 DOI: 10.1007/s11356-019-07381-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
The adverse impacts of lead and cadmium exposure on health outcomes have been reported in the past. Few studies have been conducted on the relationship between lead and cadmium exposures and disability. We evaluated whether lead and cadmium exposures were associated with functional dependence including the total number of disabilities, activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activities (GPA) in an elderly population. A total of 5513 eligible subjects were enrolled in the study from the National Health and Nutrition Examination Survey 2001-2006. Serum lead and cadmium exposure assessments were performed using atomic absorption spectrometry. Functional dependence was assessed by 19 structured questions. The relationships between lead and cadmium exposures and functional dependence were investigated using by multivariable linear regression models. Q2, Q3, and Q4 of lead exposure were significantly associated with the total number of disabilities, with β coefficients of - 0.62 (95% CI - 0.99, - 0.24), - 0.64 (95% CI - 1.02, - 0.26), and - 0.81 (95% CI - 1.19, - 0.42), respectively. This relationship remained significant in males. Furthermore, we analyzed the relationships between lead and cadmium exposure quartiles and various functional dependence metrics, and we determined that lead content was significantly associated with decreased ADL, LEM, and GPA (p < 0.05) and cadmium content was inversely associated with ADL (p < 0.05). Our study demonstrated a strong relationship between exposure to lead and cadmium and functional dependence in an elderly population.
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Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Department of General Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Ying-Jen Chen
- Department of Ophthalmology, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei, Republic of China
| | - Yi-Chao Zhou
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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23
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La Carpia D, Liperoti R, Guglielmo M, Di Capua B, Devizzi LF, Matteucci P, Farina L, Fusco D, Colloca G, Di Pede P, Ferrara ML, Hohaus S, Bernabei R, Ripamonti CI. Cognitive decline in older long-term survivors from Non-Hodgkin Lymphoma: a multicenter cross-sectional study. J Geriatr Oncol 2020; 11:790-795. [PMID: 32008957 DOI: 10.1016/j.jgo.2020.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/12/2019] [Accepted: 01/08/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare cognition in a group of older long-term survivors from Non-Hodgkin Lymphoma (NHL) and in a corresponding group of non-cancer controls of the same age. Functional status, polypharmacy and multimorbidity were also evaluated. METHODS A cross-sectional study was performed in a population of 63 outpatient long-term survivors from NHL, aged 65 or more and 61 non-cancer controls. Socio-demographic, clinical and functional data were collected. Cognitive function was assessed through neuropsychological tests. RESULTS NHL survivors showed a slightly worse functional status than controls, they were affected by more chronic conditions (3.4 vs 2.3; p = .003) and were taking a higher number of medications (3.4 vs 2.3; p = .03). The Mini Mental State Examination (MMSE) was not significantly different between the groups. NHL survivors performed worse than controls in executive functioning (Trail Making Test B-A 47.9 vs 32.1 p = .04, OR for Stroop test time over 75th percentile in survivors: 2.66; CI 95% 1.04-6.61; OR for Multiple Features Target Cancellation time over 75th percentile in survivors: 2.84; CI 95% 1.10-7.31). A small, statistically significant difference was also observed in verbal memory scores between the two groups. . CONCLUSIONS The findings of this study suggest that, compared with non-cancer controls, older survivors from NHL may have a lower cognitive performance, especially in the executive functioning and attention domains, regardless of multimorbidity and polypharmacy. Further evidence from larger samples is needed to confirm such findings and better characterize cognitive decline in NHL survivors.
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Affiliation(s)
| | - Rosa Liperoti
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mauro Guglielmo
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Beatrice Di Capua
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Paola Matteucci
- Haematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Lucia Farina
- Haematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Domenico Fusco
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Colloca
- Radiation Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Patricia Di Pede
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Stephan Hohaus
- Haematology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Roberto Bernabei
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carla Ida Ripamonti
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
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24
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Abstract
Activities of daily living (ADLs) is an important measure of the quality of care provided in home healthcare (HHC), but few studies describe the ADLs of HHC patients. The objectives of this study were to (1) describe the types and levels of ADL dependency among patients receiving home care, (2) identify the risk factors for severe ADL dependency at admission, and (3) identify the predictors of ADL improvement during an HHC stay. This was a secondary data analysis of a 5% random sample (n = 105,654) of the national Outcome and Assessment Information Set (OASIS-C) for the year 2013. The dependent variables were severe ADL dependency level at admission and ADL improvement from admission to discharge. About two thirds (65%) of the patients (n = 99,991) had severe ADL dependency (dependence in seven or more ADLs) at admission. Older age, female gender, and impaired decision-making were associated with severe ADL dependency on admission. Of the 105,654 patients, 58.1% (n = 89,997) experienced ADL improvement. ADL improvement was associated with increasing HHC length of stay, being female, and prior inpatient stay. Clinicians, policy makers, and agencies could focus on modifiable characteristics to achieve the goal of ADL improvement.
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25
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Marx W, Kelly JT, Marshall S, Cutajar J, Annois B, Pipingas A, Tierney A, Itsiopoulos C. Effect of resveratrol supplementation on cognitive performance and mood in adults: a systematic literature review and meta-analysis of randomized controlled trials. Nutr Rev 2019; 76:432-443. [PMID: 29596658 DOI: 10.1093/nutrit/nuy010] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Context The aim of this systematic review was to evaluate clinical trial data regarding the effect of resveratrol supplementation on cognitive performance and mood in populations that are healthy and in the clinical setting. Data Sources Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review of randomized controlled trials was conducted. Data Extraction A meta-analysis was also conducted to determine treatment effect on the following cognitive domains and mental processes: processing speed, number facility, memory, and mood. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool. Quality of the body of evidence was assessed by evidence for each outcome related to cognitive function for which data was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results Ten studies were included. Three studies found resveratrol supplementation significantly improved some measures of cognitive performance, 2 reported mixed findings, and 5 found no effect. When data were pooled, resveratrol supplementation had a significant effect on delayed recognition (standardized mean difference [SMD], 0.39; 95% confidence interval [CI], 0.08-0.70; I2 = 0%; P = 0.01; n = 3 studies; n = 166 participants) and negative mood (SMD, -0.18; 95%CI, -0.31 to -0.05; I2 = 0%; P = 0.006; n = 3 studies; n = 163 participants). Included studies generally had low risk of bias and were of moderate or high quality. Conclusions The results of this review indicate that resveratrol supplementation might improve select measures of cognitive performance; however, the current literature is inconsistent and limited.
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Affiliation(s)
- Wolfgang Marx
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Jaimon T Kelly
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Skye Marshall
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Jennifer Cutajar
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Brigitte Annois
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Audrey Tierney
- School of Allied Health, La Trobe University, Melbourne, Australia
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Zilbershlag Y, Josman N. The functional cognitive evaluation and model to assess older adults’ ability to function in their homes in the community. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2019. [DOI: 10.1080/02703181.2019.1622620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Y. Zilbershlag
- Department of Occupational Therapy, Faculty of Health Allied Professions, Ono Academic College, Kiryat Ono, Israel
| | - N. Josman
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
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27
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Chen YY, Kao TW, Wang CC, Chen YJ, Wu CJ, Lai CH, Chen WL. Exposure to polycyclic aromatic hydrocarbons and risk of disability among an elderly population. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:10719-10726. [PMID: 30778934 DOI: 10.1007/s11356-019-04498-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants. Exposure to PAHs is associated with several adverse health outcomes. However, no previous study has examined the relationship between PAH exposure and functional dependence in an elderly population. Our aim was to examine whether PAH exposure was associated with functional dependence including total disability, activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activities (GPA) in an elderly population. A total of 5816 elderly adults from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2006 were examined. PAH exposure was measured by urinary biomarkers. Functional dependence was assessed by 19 structured questions. The association between PAH exposures with functional dependence was performed by using a multivariable linear regression model. After adjusting for pertinent variables, positive associations were observed between the total number of disabilities and 2-naphthalene and 1-pyrene quartiles (all Ptrend < 0.05). There was a dose-dependent relationship between 1-pyrene quartiles and all functional dependence domains, and the higher quartile of 1-pyrene was more closely associated with functional impairment (all Ptrend < 0.05). PAH exposure is associated with functional dependence in American elderly adults. Future research is needed to bring to light the pathophysiological underlying mechanisms related to these findings.
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Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Number 325, Section 2, Chang-gong Rd, Nei-Hu District, 114, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Ying-Jen Chen
- Department of Ophthalmology, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Number 325, Section 2, Chang-gong Rd, Nei-Hu District, 114, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan.
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Number 325, Section 2, Chang-gong Rd, Nei-Hu District, 114, Taipei, Taiwan, Republic of China.
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28
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Abstract
BACKGROUND Virtual reality applications to assist older adult with cognitive and functional decline are fast growing. However, such technological developments face limitations such as due to limited constructs and ecological validity. This study was aimed at investigating age-related changes in functional abilities and their associated cognitive underpinnings during task performance in virtual and real environments. METHOD Twenty-two younger adults (university students) and 22 older adults (aged 58-74) performed a multiple errands task twice, once in the "Discoveries" section of the National Museum of Scotland and once in the same room as a virtual environment. Accuracy and distance traveled were measured in both groups. Cognitive and daily living abilities were recorded in older adults using standard and novel questionnaires. RESULTS The testing environment had a significant effect on how efficient individuals performed the task. Older and younger adults' performance was alike but older adults relied on more cognitive resources. Older adults struggled in the virtual but not in the real environment. Younger but not older adults could transfer knowledge between environments. CONCLUSION The use of technology to assist frail older adults and those affected by dementia is growing rapidly. For these novel tools to be theoretically valid, they need to incorporate knowledge of the challenges they pose to these vulnerable groups. Here we present evidence of such challenges and their cognitive underpinnings. This theory may be considered by future applications aimed at enhancing functional abilities in these populations.
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Affiliation(s)
- Mario A Parra
- a School of Social Sciences, Psychology , University Heriot-Watt , Edinburgh , UK.,b Human Cognitive Neuroscience , Edinburgh University , Edinburgh , UK.,c Alzheimer's Scotland Dementia Research Centre, University of Edinburgh , Edinburgh , UK.,d Neuroprogressive and Dementia Network , NHS Scotland , UK.,e Universidad Autónoma del Caribe, Programa de Psicología, Barranquilla , Colombia
| | - Rini I Kaplan
- b Human Cognitive Neuroscience , Edinburgh University , Edinburgh , UK
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29
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Zhang Q, Hu J, Wei L, Cao R, Ma R, Song H, Jin Y. Effects of traditional Chinese exercise on cognitive and psychological outcomes in older adults with mild cognitive impairment: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e14581. [PMID: 30762810 PMCID: PMC6408103 DOI: 10.1097/md.0000000000014581] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/28/2018] [Accepted: 01/24/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) can be a stage of pre-dementia. Although the traditional Chinese exercise (TCE) has benefits associated with cognitive functions, the effects of the TCE on cognitive functions of older patients with MCI remain controversial. This study performs a meta-analysis to quantify the efficiency of TCE for older individuals on cognitive and psychological outcomes. METHODS A comprehensive database search was conducted on PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), Web of Science, and four Chinese medical databases. We included trials published up to April 22, 2018, that fulfilled our inclusion and exclusion criteria. The literature was screened, the data were extracted and the methodological quality of the included trials was assessed. Meta-analyses were performed on the included data. RESULTS A total of 803 patients from 5 trials were included in our meta-analysis. Overall, there were no significant differences in global cognitive functions (P = .06), memory (P = .11), executive function (P = .74), Verbal fluency (P = .45) and depression (P = .89) between the TCE and the control groups. However, the TCE significantly improved the visuospatial function (SMD = 0.38, 95% CI = 0.22 to 0.54; P < .001) for individuals with MCI. CONCLUSIONS The findings of this study suggested that the TCE was associated with significant improvement in visuospatial function but did not affect the global cognitive functions, depression and other specific cognitive domains. There is a lack of clear evidence for effects of TCE; further large, rigorously designed studies are needed.
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Affiliation(s)
- Qi Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Jianan Hu
- The Department of Nursing, Children's Hospital of Shanxi/Woman Health Center of Shanxi, Taiyuan, Shanxi
| | - Lijiao Wei
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Ri Cao
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Ruishu Ma
- School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine
| | - Huimin Song
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Yi Jin
- The Department of Nursing, Tianjin Huanhu Hospital, Tianjin, China
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30
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Soleimani R, Shokrgozar S, Fallahi M, Kafi H, Kiani M. An investigation into the prevalence of cognitive impairment and the performance of older adults in Guilan province. J Med Life 2018; 11:247-253. [PMID: 30364719 PMCID: PMC6197520 DOI: 10.25122/jml-2018-0017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction: The escalating rate of old people with a functional impairment in Iran and the weakness of the family support due to the diminishing of family size have increased the demand for long-term care for the elderly with cognitive impairment (CI). Objective: The purpose of this research is to explore the frequency of cognitive impairment in the elderly and its association with their daily functional impairment and disability. Method: This is a cross-sectional and descriptive-analytic study conducted in 2016-2017. The study sample consisted of 393 elderly people who were 60 years old or older who live in of Guilan different counties. Samples were selected by using multi-stage cluster sampling. Subsequently, data were analyzed by using the Chi-square test and correlation and regression analysis conducted in SPSS 22. Results: It was observed that 4.3, 28.6, and 37% of the subjects suffered from severe, moderate, and mild cognitive impairment, respectively. Cognitive impairment had a significant relationship with daily functioning and activities requiring special tools. Moreover, cognitive impairment in women, people with low education, and those over 70 years old was more common, and the difference between them was significant (p <0.001). Also, disability was significantly greater in the elderly with cognitive impairment. Conclusion: Many old people need to be cared for after the appearance of cognitive impairment. Therefore, appropriate screening of cognitive impairments is conducive to early diagnosis and prevention of executive functioning problems.
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Affiliation(s)
- Robabeh Soleimani
- Psychiatry Department, Kavosh Cognitive Behaviour Sciences and Addiction Research Center, Shafa educational - remedial Hospital, Associate Professor, Guilan University of Medical Sciences, Rasht, Iran
| | - Somayeh Shokrgozar
- Psychiatry Department, Kavosh Cognitive Behaviour Sciences and Addiction Research Center, Shafa educational - remedial Hospital, Assistant Professor, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahnaz Fallahi
- Vice-chancellor for health, Guilan University of Medical Sciences, Rasht, Iran
| | - Hashem Kafi
- Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Kiani
- Guilan University of Medical Sciences, Rasht, Iran
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31
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Rosa TSM, Filha VAVDS, Moraes ABD. Prevalence and factors associated with cognitive impairments in the elderly of charity asylums: a descriptive study. CIENCIA & SAUDE COLETIVA 2018; 23:3757-3765. [PMID: 30427446 DOI: 10.1590/1413-812320182311.25212016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 10/23/2016] [Indexed: 11/22/2022] Open
Abstract
The current transversal and descriptive study evaluates the prevalence and factors associated with cognitive liabilities in a sample of 98 elderly people residents of philanthropic institutions. The sociodemographic and clinical data were retrieved from the patients´ clinical charts. The cognition was assessed by the Mental State Mini-Exam, while the maintenance of independence regarding basic activities (such as bathing, putting on clothes, and others) was evaluated using the Katz Index. The Short Physical Performance Battery exam assessed their physical performance. Non-parametric tests were employed for the statistical analysis. Cognitive impairment was registered in 27.6% of the elderlies and was not associated with sociodemographic variables, independence in basic activities, and physical performance. We verified a high prevalence of endocrine diseases, mental disorders, and psychiatric treatment in the elderlies with cognitive impairments. The percentage of elderly with cognitive alterations is similar to those found in the literature. We identified no significant risk factors associated with cognition among the evaluated variables.
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Affiliation(s)
- Tábada Samantha Marques Rosa
- Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria. Av. Roraima 1000, Camobi. 97119-900 Santa Maria RS Brasil.
| | | | - Anaelena Bragança de Moraes
- Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria. Av. Roraima 1000, Camobi. 97119-900 Santa Maria RS Brasil.
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32
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Eguchi Y, Tasato K, Nakajima S, Noda Y, Tsugawa S, Shinagawa S, Niimura H, Hirose N, Arai Y, Mimura M. Relationships between socio-clinico-demographic factors and global cognitive function in the oldest old living in the Tokyo Metropolitan area: Reanalysis of the Tokyo Oldest Old Survey on Total Health (TOOTH). Int J Geriatr Psychiatry 2018. [PMID: 29514399 DOI: 10.1002/gps.4873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Despite a steady increase in life expectancy, a few studies have investigated cross-sectional correlates and longitudinal predictors of cognitive function, a core domain of the successful aging, among socio-clinico-demographic factors in the oldest-old exclusively. OBJECTIVES The aims of this study were to examine socio-clinico-demographic characteristics associated with global cognition and its changes in the oldest-old. METHODS We reanalyzed a dataset of cognitively preserved community-dwelling subjects aged 85 years and older in the Tokyo Oldest Old Survey on Total Health, a 6-year longitudinal observational study. This study consisted of (1) baseline cross-sectional analyses examining correlates of global cognition (n = 248) among socio-clinico-demographic factors and (2) longitudinal analyses examining baseline predictors for changes of global cognition in 3-year follow-up (n = 195). The Mini-Mental State Examination was used as a screening test to assess global cognition. RESULTS At baseline, higher weights were related to higher cognitive function in the oldest-old. The baseline predictors of global cognitive decline in 3-year follow-up were higher global cognition, shorter education period, and lower sociocultural activities and lower instrumental activity of daily living, in this order. CONCLUSIONS The present study suggests that it is crucial to attain higher education during early life and avoid leanness or obesity, participate in sociocultural cognitive activities during late life, and maintain instrumental activity of daily living to preserve optimal cognitive function in the oldest-old, which will facilitate developing prevention strategies for cognitive decline and promoting successful aging in this increasing population.
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Affiliation(s)
- Yoko Eguchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kumiko Tasato
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Multimodal Imaging Group, Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Yoshihiro Noda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | | | - Hidehito Niimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Nobuyoshi Hirose
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Abstract
RATIONALE Poor functional status is common after critical illness, and can adversely impact the abilities of intensive care unit (ICU) survivors to live independently. Instrumental activities of daily living (IADL), which encompass complex tasks necessary for independent living, are a particularly important component of post-ICU functional outcome. OBJECTIVES To conduct a systematic review of studies evaluating IADLs in survivors of critical illness. METHODS We searched PubMed, CINAHL, Cochrane Library, SCOPUS, and Web of Science for all relevant English-language studies published through December 31, 2016. Additional articles were identified from personal files and reference lists of eligible studies. Two trained researchers independently reviewed titles and abstracts, and potentially eligible full text studies. Eligible studies included those enrolling adult ICU survivors with IADL assessments, using a validated instrument. We excluded studies involving specific ICU patient populations, specialty ICUs, those enrolling fewer than 10 patients, and those that were not peer-reviewed. Variables related to IADLs were reported using the Patient Reported Outcomes Measurement Information System (PROMIS). RESULTS Thirty of 991 articles from our literature search met inclusion criteria, and 23 additional articles were identified from review of reference lists and personal files. Sixteen studies (30%) published between 1999 and 2016 met eligibility criteria and were included in the review. Study definitions of impairment in IADLs were highly variable, as were reported rates of pre-ICU IADL dependencies (7-85% of patients). Eleven studies (69%) found that survivors of critical illness had new or worsening IADL dependencies. In three of four longitudinal studies, survivors with IADL dependencies decreased over the follow-up period. Across multiple studies, no risk factors were consistently associated with IADL dependency. CONCLUSIONS Survivors of critical illness commonly experience new or worsening IADL dependency that may improve over time. As part of ongoing efforts to understand and improve functional status in ICU survivors, future research must focus on risk factors for IADL dependencies and interventions to improve these cognitive and physical dependencies after critical illness.
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Yu STS, Yu ML, Brown T, Andrews H. Association between older adults’ functional performance and their scores on the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). IRISH JOURNAL OF OCCUPATIONAL THERAPY 2018. [DOI: 10.1108/ijot-07-2017-0020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The paper aims to investigate if the performance of older adults on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were associated or predictive of their functional performance in a geriatric evaluation and management (GEM) inpatient hospital setting. This will inform the occupational therapy assessment and management of older adults admitted to sub-acute GEM settings.
Design/methodology/approach
In all, 20 participants (11 men, 9 women, mean age 82 years, SD = 6.93) were recruited from a GEM ward in an Australian hospital. Participants’ cognitive abilities were assessed using the MMSE and MoCA, and their functional performance were assessed using the Functional Independence Measure (FIM). Spearman’s rho correlations and linear regression analyses were completed. Bootstrapping was applied to the regression analyses to accommodate the small study sample size.
Findings
No statistically significant correlations were obtained between the total and subscale scores of the MMSE and FIM or between the total and subscale scores of the MoCA and FIM. In other words, the cognitive and functional abilities of older adults admitted to a GEM setting were not significantly associated in this study.
Originality/value
The findings suggest that the MoCA and the MMSE were not predictive of participants’ functional performance as measure by the FIM in a sub-acute GEM setting. Occupational therapists should be cautious when interpreting participants’ MMSE, MoCA and FIM results and not depend solely on these results in the goal setting and intervention planning processes for clients on GEM wards. Further studies are recommended to confirm these findings.
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Siu MY, Lee DTF. Effects of tai chi on cognition and instrumental activities of daily living in community dwelling older people with mild cognitive impairment. BMC Geriatr 2018; 18:37. [PMID: 29394884 PMCID: PMC5797349 DOI: 10.1186/s12877-018-0720-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 01/22/2018] [Indexed: 12/31/2022] Open
Abstract
Background Cognitive impairment places older adults at high risk of functional disability in their daily-life activities, and thus affecting their quality of life. This study aimed to examine the effects of Tai Chi on general cognitive functions and instrumental activities of daily living (IADL) in community-dwelling older people with mild cognitive impairment (MCI) in Hong Kong. Methods The study adopted a multi-site nonequivalent control-group pretest-posttest design. 160 community-dwelling older people, aged ≥60, with MCI, from four community elderly centers participated in the study. The intervention group (IG, n = 80) received training in the Yang-style simple form of Tai Chi, at a frequency of two lessons per week for 16 weeks. Each lesson lasted for one hour. The control group (CG, n = 80) had no treatment regime and joined different recreational activity groups in community centers as usual within the study period. Outcome measures included measures of global cognitive status and IADL. The Chinese version of the Mini-Mental State Examination (CMMSE) was used for global cognitive assessment. The Hong Kong Chinese version of Lawton’s Instrumental Activities of Daily Living (IADL-CV) was used to assess the participants’ IADL levels. General Estimating Equations (GEE) was used to examine each of the outcome variables for the two groups at the two study time points (the baseline and at the end of the study). Meanwhile, minimum detectable change (MDC) was calculated to estimate the magnitude of changes required to eradicate the possibility of measurement error of outcome measures. Results Seventy four participants in the IG and 71 participants in the CG completed the study. With adjustments for differences in age, education, marital status and living conditions, the findings revealed that the participants in the IG scored significantly better on the CMMSE test (P = 0.001), and the instrumental ADL questionnaire (P = 0.004). However, those scores changes did not exceed the limits of the respective MDCs in the study, the possibility of measurement variation due to error could not be excluded. Conclusion Tai Chi may be an effective strategy to enhance cognitive health and maintain functional abilities in instrumental ADL in older people with MCI. Trial registration NCT03404765 (Retrospectively registered January 19, 2018) Electronic supplementary material The online version of this article (10.1186/s12877-018-0720-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mei-Yi Siu
- The School of Nursing, Tung Wah College, 31 Wylie Road, Homantin, Kowloon, Hong Kong, SAR, People's Republic of China.
| | - Diana T F Lee
- The Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong, SAR, People's Republic of China
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Voskou P, Douzenis A, Economou A, Papageorgiou SG. Testamentary Capacity Assessment: Legal, Medical, and Neuropsychological Issues. J Geriatr Psychiatry Neurol 2018; 31:3-12. [PMID: 29251179 DOI: 10.1177/0891988717746508] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The increase in the aging population and the number of patients with dementia led to the research in older adults' capacity assessment over the last 3 decades. Many cases of contested wills occur due to lack of testamentary capacity (TC), especially in cases of dementia. AIM Purpose of the present study was to overview the legal, medical, and neuropsychological aspects of TC as well as the instruments used for TC assessment. FINDINGS The testator/testatrix with intact TC has realistic perception of his or her property value, lack of psychopathology affecting contact with reality, and intact intention of how and to whom he or she will dispose his or her assets. It is frequent for the health practitioners to serve as "gold standards assessors" by examining an individual's ability to make a valid will and giving evidence to the court to support or not a will contest. The TC assessment is a complex process of clinical and legal practice requiring usually a variety of methods, that is, interviews, evaluation of clinical records, and administration of neuropsychological instruments. CONCLUSION The evaluation of TC is a multidimensional process that integrates both the legal and medical field, requiring a collaborative approach to its definition and assessment.
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Affiliation(s)
- Panagiota Voskou
- 1 Cognitive Disorders/Dementia Unit, 2nd Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Douzenis
- 2 2nd Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandra Economou
- 3 Department of Psychology, School of Philosophy, National and Kapodistrian University of Athens, Athens, Greece
| | - Sokratis G Papageorgiou
- 1 Cognitive Disorders/Dementia Unit, 2nd Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
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Functional impairment prior to major non-cardiac surgery is associated with mortality within one year in elderly patients with gastrointestinal, gynaecological and urogenital cancer: A prospective observational cohort study. J Geriatr Oncol 2017; 9:53-59. [PMID: 28888555 DOI: 10.1016/j.jgo.2017.07.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 06/21/2017] [Accepted: 07/27/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the prognostic value of elements of the Geriatric Assessment, in particular the Timed Up and Go (TUG) Test and the Barthel Index of Activities of Daily Living (ADL) for one-year post-operative mortality in elderly patients with cancer. MATERIALS AND METHODS This prospective cohort study included patients 65years of age or older undergoing elective major surgery for cancer between June 2008 and June 2010. Preoperative functional status was measured by the TUG Test and the Barthel Index of ADL Cognitive state was assessed by the Mini Mental State Examination (MMSE). Complications were recorded prospectively. The degree of resection was noted. RESULTS Data from 131 patients (56% women; median age, 71years) were analysed at 1year of follow-up. Mortality after 1year was 28.2%. Twenty-nine patients (22.3%) were dependent in ADLs, and 43 (35.2%) impaired in TUG. Thirteen patients (10.7%) were both, dependent in ADLs and impaired in TUG. Short-term complications after surgery occurred in 66% of patients, and major complications occurred in 29%. Patients who were dependent in ADLs and impaired in TUG had significantly higher 1-year mortality (OR, 4.5; 95% CI, 1.21-18.25; p=0.034). Lower scores on the MMSE (OR, 0.64; 95% CI, 0.43-0.95; p=0.048) and incomplete surgical resection (OR, 3.25; 95% CI, 1.15-9.20; p=0.026) were independently associated with higher 1-year mortality. CONCLUSION Functional assessments, such as ADL and TUG scores, as well as mild cognitive impairment, are predictors of long-term outcome in elderly cancer patients. TRIAL REGISTRATION German Clinical Trials Register (DRKS 00005150).
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Gracia-García P, López-Antón R, Santabárbara J, de la Cámara C, Saz P, Larraga L, Gonzalez-Torecillas J, Fernandez-Braso A, Quintanilla M. Disability in a memory clinic: Frequency and associations with low cognitive performance. EUROPEAN JOURNAL OF PSYCHIATRY 2017. [DOI: 10.1016/j.ejpsy.2017.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lorenzo-López L, Millán-Calenti JC, López-López R, Diego-Diez C, Laffon B, Pásaro E, Valdiglesias V, Maseda A. Effects of Degree of Urbanization and Lifetime Longest-Held Occupation on Cognitive Impairment Prevalence in an Older Spanish Population. Front Psychol 2017; 8:162. [PMID: 28243214 PMCID: PMC5303752 DOI: 10.3389/fpsyg.2017.00162] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/24/2017] [Indexed: 11/13/2022] Open
Abstract
Our aim was to estimate the prevalence of cognitive impairment in rural and urban elderly populations and to examine the relationship between lifetime occupation and general cognitive performance. A cross-sectional study was carried out covering a representative sample (n = 749) of adults aged ≥65 years. Two categories were created to define the degree of urbanization using a criterion of geographical contiguity in combination with a minimum population threshold: densely populated (urban) areas and intermediate-thinly populated (rural) areas. Occupational histories were ranked by skill level requirements according to the Spanish National Classification of Occupations. Prevalence estimates of cognitive impairment were measured with the Mini-Mental State Examination. Results show that rural residence was not significantly associated with higher risk of cognitive impairment. A protective effect of cognitive demands at work against age-related cognitive decline was observed. However, this effect was not independent of confounder factors, such as age and education. A low overall prevalence of cognitive impairment was observed (6.5%), compared with previous estimates, possibly due to the sample selection in senior centers. Occupation during active life is not an isolated protective factor against cognitive impairment, and it is closely related to educational level. In future geriatric programs, description of both factors should be taken into consideration in screening older adults at increased risk of cognitive impairment and dementia.
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Affiliation(s)
- Laura Lorenzo-López
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, A Coruña Spain
| | - José C Millán-Calenti
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, A Coruña Spain
| | - Rocío López-López
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, A Coruña Spain
| | - Clara Diego-Diez
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, A Coruña Spain
| | - Blanca Laffon
- Universidade da Coruña, DICOMOSA Group, Department of Psychology, Area of Psychobiology, Faculty of Education Sciences, Campus Elviña s/n, A Coruña Spain
| | - Eduardo Pásaro
- Universidade da Coruña, DICOMOSA Group, Department of Psychology, Area of Psychobiology, Faculty of Education Sciences, Campus Elviña s/n, A Coruña Spain
| | - Vanessa Valdiglesias
- Universidade da Coruña, DICOMOSA Group, Department of Psychology, Area of Psychobiology, Faculty of Education Sciences, Campus Elviña s/n, A Coruña Spain
| | - Ana Maseda
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, A Coruña Spain
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Quaglino V, Gounden Y, Lacot E, Couvillers F, Lions A, Hainselin M. Talk the talk and walk the walk. Evaluation of autonomy in aging and Alzheimer disease by simulating instrumental activities of daily living: the S-IADL. PeerJ 2016; 4:e2351. [PMID: 27672491 PMCID: PMC5028723 DOI: 10.7717/peerj.2351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/20/2016] [Indexed: 11/21/2022] Open
Abstract
Objective The autonomy of individuals is linked to the achievement of instrumental activities of daily living that require complex behavior. In the elderly, the assessment of autonomy is usually based on questionnaires that have strong subjective constraints. Considering this fact, we tested elderly healthy adults and Alzheimer disease patients using a new measure, the S-IADL (Simulation of Instrumental Activities for Daily Living), to assess the ability to perform effectively activities of daily living. Method The S-IADL shares many items with the well-known IADL questionnaire proposed by Lawton & Brody (1969). However, as opposed to the IADL, the assessment of autonomy is not based on the completion of a questionnaire but requires the realization or simulation of various activities of daily living. Eighty-three participants (69 healthy elderly, and 14 Alzheimer Disease patients) completed the IADL and performed the S-IADL assessment. Results Results revealed that, like the IADL, the S-IADL is able to identify AD patients who are likely to encounter difficulties in performing everyday activities, and no major differences were found between the IADL and the S-IADL. Conclusions We outlined some advantages for prefering, in certain situation, this new tool based on simulation of activities in functional evaluation. Finally, we discuss the main limits of the S-IADL that should be investigated prior to its utilization by clinicians.
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Affiliation(s)
| | - Yannick Gounden
- CRPCPO, EA, Université de Picardie Jules Verne , Amiens , France
| | - Emilie Lacot
- CRPCPO, EA, Université de Picardie Jules Verne, Amiens, France; Service de Génétique Clinique et Oncogénétique, Centre Hospitalier Universitaire d'Amiens Picardie, Amiens, France
| | - Frédérique Couvillers
- Services de Neurologie et de Gérontologie, Centre Hospitalier Universitaire d'Amiens Picardie , Amiens , France
| | - Amandine Lions
- IME Les Martinets, Adapei 36 l'Espoir , Saint Maur , France
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Durant J, Leger GC, Banks SJ, Miller JB. Relationship between the Activities of Daily Living Questionnaire and the Montreal Cognitive Assessment. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2016; 4:43-6. [PMID: 27489879 PMCID: PMC4961826 DOI: 10.1016/j.dadm.2016.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction The Activities of Daily Living Questionnaire (ADL-Q) is an informant report questionnaire assessing functional impairment in daily living skills. Previous research has demonstrated correlations between ADL-Q and cognitive screening measures among patients with dementia. This study examined the relationship between ADL-Q and the Montreal Cognitive Assessment (MoCA), a brief cognitive screening. Methods Records of 448 individuals from an outpatient neurology clinic were reviewed. Pearson correlations were calculated between ADL-Q scores and MoCA scores. Linear regression models were fit using demographic information to predict ADL-Q scores. MoCA scores were then added to the models to determine the increase in predictive value of the MoCA. Results Lower MoCA scores were associated with higher levels of functional impairment. For each model, adding the MoCA significantly improved model fit. Discussion Low scores on the MoCA, among patient's presenting for memory complaints, should raise concerns about functional decline and prompt for further assessment of functional ability.
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Affiliation(s)
- January Durant
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Gabriel C Leger
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Sarah J Banks
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Justin B Miller
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
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Winblad B, Amouyel P, Andrieu S, Ballard C, Brayne C, Brodaty H, Cedazo-Minguez A, Dubois B, Edvardsson D, Feldman H, Fratiglioni L, Frisoni GB, Gauthier S, Georges J, Graff C, Iqbal K, Jessen F, Johansson G, Jönsson L, Kivipelto M, Knapp M, Mangialasche F, Melis R, Nordberg A, Rikkert MO, Qiu C, Sakmar TP, Scheltens P, Schneider LS, Sperling R, Tjernberg LO, Waldemar G, Wimo A, Zetterberg H. Defeating Alzheimer's disease and other dementias: a priority for European science and society. Lancet Neurol 2016; 15:455-532. [DOI: 10.1016/s1474-4422(16)00062-4] [Citation(s) in RCA: 1001] [Impact Index Per Article: 125.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/06/2015] [Accepted: 02/09/2016] [Indexed: 12/15/2022]
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Guimarães FC, Amorim PRDS, Reis FFD, Bonoto RT, Oliveira WCD, Moura TADS, Assis CLD, Palotás A, Lima LM. Physical activity and better medication compliance improve mini-mental state examination scores in the elderly. Dement Geriatr Cogn Disord 2015; 39:25-31. [PMID: 25300502 DOI: 10.1159/000366413] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2014] [Indexed: 11/19/2022] Open
Abstract
In addition to hypertension, dyslipidemia, atherosclerosis, and diabetes, a sedentary lifestyle plays a pivotal role in cerebro- and cardiovascular disease and progressive cognitive decline, including vascular dementia and Alzheimer's disease. The present study investigated whether controlling the key risks and participating in physical activity have a beneficial impact on these disorders. Elderly volunteers were enrolled in a 3-month program that consisted of structured exercise three times per week. The daily routine, medical treatment, and vital parameters were evaluated and correlated with the subjects' neuropsychiatric status. High blood pressure was found in 40% of the participants, with no significant differences between the sexes. A higher proportion of females (55%) than males (18%) forgot to take their medication during the observation period. Significant negative correlations were found between Mini-Mental State Examination (MMSE) scores and age, lack of a caregiver, and increased pulse rate before or after exercise. These results suggest that the presence of home assistance and subsequent improvement in medication compliance, vital parameter optimization, and regular physical activity may yield better MMSE results and a lower risk for cerebro- and cardiovascular disease.
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Paraponaris A, Davin B. Economics of the Iceberg: Informal Care Provided to French Elderly with Dementia. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2015; 18:368-375. [PMID: 26091590 DOI: 10.1016/j.jval.2015.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 11/21/2014] [Accepted: 01/03/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Dementia has a substantial effect on patients and their relatives, who have to cope with medical, social, and economic changes. In France, most elderly people with dementia live in the community and receive informal care, which has not been well characterized. METHODS Using a sample of 4680 people aged 75 years and older collected in 2008 through a national comprehensive survey on health and disability, we compared the economic value of the care received by 513 elderly people with dementia to that received by a propensity score- matched set of older people without dementia. RESULTS More than 85% of elderly people with dementia receive informal care; the estimation of its economic value ranges from €4.9 billion (proxy good method) to €6.7 billion (opportunity cost method) per year. CONCLUSIONS The informal care provided to people with dementia has substantial annual costs; further work should be done to examine the social and economic roles foregone as a result of this care.
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Affiliation(s)
- Alain Paraponaris
- INSERM, UMR912 (SESSTIM), Marseille, France; Aix-Marseille University, UMR_S912, IRD, Marseille, France; ORS PACA, South-Eastern Health Observatory, Marseille, France; Aix-Marseille School of Economics (AMSE), Marseille, France.
| | - Bérengère Davin
- INSERM, UMR912 (SESSTIM), Marseille, France; ORS PACA, South-Eastern Health Observatory, Marseille, France
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Rodrigues V, Mota-Pinto A, de Sousa B, Botelho A, Alves C, de Oliveira CR. The aging profile of the Portuguese population: a principal component analysis. J Community Health 2015; 39:747-52. [PMID: 24519178 DOI: 10.1007/s10900-014-9821-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In the last 5 years the resident population of Portugal has increased 2.3%, along with a progressive ageing. This study aims assessing the social dependence and frailty, as well as social and familial support needs of the elderly. In an observational, cross-sectional community based study (EPEPP study), a total of 2,672 people, aged 55 or more, were submitted to an enquiry and several variables were studied among three age groups: 55-64 years old (37%), 65-74 years old (37%) and ≥ 75 years old (26%), encompassing a total of 57% women and 43% men. A questionnaire including items such as physical autonomy, locomotion, falls, health/medical complaints, instrumental autonomy, physical activity, health self-evaluation and emotional status was applied. The strong correlations among the studied scores allowed the identification of people groups with common characteristics when a principal component analysis was used: "autonomy" (scores of instrumental autonomy, locomotion and physical autonomy) and "perception of health and emotional status" (scores of health self-evaluation and emotional status), were present in the three age groups. The component analysis evidences that a good autonomy, a good perception of health and emotional status are determinant to a good quality of life in elderly. Although health status and self-rated health have a propensity to deteriorate with aging, older Portuguese consider their state of health satisfactory and tend to underestimate their decline. In what concerns the analysis of gender with the same age and in contrast to what has been reported, older women alike to men, experience a good mobility and health self-evaluation.
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Affiliation(s)
- Vitor Rodrigues
- Instituto de Higiene e Medicina Social, Faculdade de Medicina da, Universidade de Coimbra, Rua Larga, 3004-504, Coimbra, Portugal,
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Makizako H, Shimada H, Doi T, Tsutsumimoto K, Lee S, Hotta R, Nakakubo S, Harada K, Lee S, Bae S, Harada K, Suzuki T. Cognitive functioning and walking speed in older adults as predictors of limitations in self-reported instrumental activity of daily living: prospective findings from the Obu Study of Health Promotion for the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3002-13. [PMID: 25768239 PMCID: PMC4377948 DOI: 10.3390/ijerph120303002] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/23/2015] [Accepted: 03/04/2015] [Indexed: 12/21/2022]
Abstract
Our aim was to determine whether baseline measures of cognitive functioning, walking speed, and depressive status are independent predictors of limitations in instrumental activities of daily living (IADL) in older adults. The cross-sectional study involved 1329 community-dwelling adults, aged 75 years or older. At baseline, the Mini-Mental State Examination (MMSE), Symbol Digit Substitution Test (SDST), Geriatric Depressive Scale (GDS), and a word list memory task were completed, and self-reported IADLs and walking speed were recorded. The longitudinal study involved 948 participants without baseline IADL limitation, which was assessed at baseline and 15-month follow up, using the three Kihon Checklist subitems. In cross-sectional analyses, participants with IADL limitation demonstrated greater GDS scores, slower walking speeds, and lower MMSE, word list memory task, and SDST (only for women) scores relative to those without IADL limitation. In the longitudinal analyses, baseline walking speed (men: OR 0.98; women: OR 0.97, p < 0.05) and word list memory task scores (men: OR 0.84; women: OR 0.83, p < 0.05) in both sexes and SDST scores in women (OR 0.96, p = 0.04) were independent predictors of subsequent IADL limitation. Walking speed, memory, and processing speed may be independent predictors of IADL limitation in older adults.
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Affiliation(s)
- Hyuma Makizako
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Hiroyuki Shimada
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Takehiko Doi
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Kota Tsutsumimoto
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Sangyoon Lee
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Ryo Hotta
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Sho Nakakubo
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Kazuhiro Harada
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Sungchul Lee
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Seongryu Bae
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Kenji Harada
- Department of Functioning Activation, Center for Gerontology and Social Science, National Centerfor Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
| | - Takao Suzuki
- Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu,Aichi 474-8511, Japan.
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Cognitive frailty, a novel target for the prevention of elderly dependency. Ageing Res Rev 2015; 20:1-10. [PMID: 25555677 DOI: 10.1016/j.arr.2014.12.004] [Citation(s) in RCA: 197] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 12/12/2014] [Accepted: 12/16/2014] [Indexed: 01/10/2023]
Abstract
Frailty is a complex and heterogeneous clinical syndrome. Cognitive frailty has been considered as a subtype of frailty. In this study, we refine the definition of cognitive frailty based on existing reports about frailty and the latest progress in cognition research. We obtain evidence from the literature regarding the role of pre-physical frailty in pathological aging. We propose that cognitive impairment of cognitive frailty results from physical or pre-physical frailty and comprises two subtypes: the reversible and the potentially reversible. Reversible cognitive impairment is indicated by subjective cognitive decline (SCD) and/or positive fluid and imaging biomarkers of amyloid-β accumulation and neurodegeneration. Potentially reversible cognitive impairment is MCI (CDR=0.5). Based on the severity of cognitive impairment, it is possible to determine the primary and secondary preventative measures for cognitive frailty. We further determine whether SCD is a component of pre-clinical AD or the early stage of other neurodegenerative diseases, which is required for guiding personal clinical intervention.
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Maseda A, Balo A, Lorenzo-López L, Lodeiro-Fernández L, Rodríguez-Villamil JL, Millán-Calenti JC. Cognitive and affective assessment in day care versus institutionalized elderly patients: a 1-year longitudinal study. Clin Interv Aging 2014; 9:887-94. [PMID: 24940051 PMCID: PMC4051620 DOI: 10.2147/cia.s63084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Purpose Cognitive decline and depression are two common mental health problems that may create a need for long-term care among the elderly. In the last decade, the percentage of older adults who receive health care in nursing homes, day care centers, or home support services has increased in Europe. The objectives of this descriptive and nonrandomized longitudinal study were to evaluate and to compare the cognitive and affective evolution of day care versus institutionalized older patients through a 1-year period, and to assess the presence of cognitive and affective impairment as a function of the care setting. Patients and methods Ninety-four patients were assessed at baseline, and 63 (67.0%) were reassessed 1 year later. Neuropsychological assessment included measures of cognitive performance (general cognitive status, visuospatial, and language abilities) and affective status (depressive symptoms). Results Our findings indicated that the majority of the participants (day care and institutionalized patients) had mild–moderate cognitive impairment at baseline, which significantly increased in both groups after 1-year follow-up. However, the rate of change in global cognitive function did not significantly differ between groups over time. Regarding language abilities, naming function maintained among day care patients in comparison with institutionalized patients, who showed worse performance at follow-up. As regards to affective status, results revealed that institutionalized patients had a significant reduction in depressive symptoms at follow-up, when compared to day care patients. Results also highlight the high frequency of cognitive impairment and depressive symptoms regardless of the care setting. Conclusion Our findings revealed a similar global cognitive decline rate between patients receiving day care services and those residing in a nursing home at the 1-year follow-up, and slightly different trajectories in other outcomes such as naming function and depressive symptoms.
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Affiliation(s)
- Ana Maseda
- Gerontology Research Group, Faculty of Health Sciences, University of A Coruña, A Coruña, Spain
| | - Aránzazu Balo
- Gerontology Research Group, Faculty of Health Sciences, University of A Coruña, A Coruña, Spain
| | - Laura Lorenzo-López
- Gerontology Research Group, Faculty of Health Sciences, University of A Coruña, A Coruña, Spain
| | - Leire Lodeiro-Fernández
- Gerontology Research Group, Faculty of Health Sciences, University of A Coruña, A Coruña, Spain
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Koskas P, Henry-Feugeas MC, Feugeas JP, Poissonnet A, Pons-Peyneau C, Wolmark Y, Drunat O. The Lawton Instrumental Activities Daily Living/Activities Daily Living Scales: A Sensitive Test to Alzheimer Disease in Community-Dwelling Elderly People? J Geriatr Psychiatry Neurol 2014; 27:85-93. [PMID: 24578460 DOI: 10.1177/0891988714522694] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 10/09/2013] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To examine the diagnostic ability of the Lawton Instrumental Activities Daily Living (IADLs) scale and the Activities Daily Living (ADLs) scale as a sensitive tool to Alzheimer's disease (AD) in community-dwelling elderly people. DESIGN In an old age memory outpatient center, among patients with a clinical diagnosis of AD dementia or no dementia supported by at least 6 months of follow-up, we looked back at the baseline Lawton IADL scale (short version IADL-4 item), ADL scale, Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MOCA) values. RESULTS There were 109 patients with AD and 53 nondemented individuals (81.4 ± 4.6 years). The sensitivity of ADL scale or IADL-4 item or the MMSE was low (52%-57%). The most efficient AD classification used both the IADLs-4 item and the MOCA with a threshold score of 20. Besides age and memory scores, the main correlates of IADLs scale or ADLs scale were executive, neuropsychiatric, vascular, and extrapyramidal scores. CONCLUSION Our results suggest that the Lawton IADLs-4 item scale and ADLs scale lack sensitivity to AD dementia in elderly people and support a better sensitivity of MOCA rather than MMSE and IADLs-4 item/ADLs at the expense of specificity.
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Affiliation(s)
- Pierre Koskas
- Memory Center, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie Cécile Henry-Feugeas
- Department of Radiology, Bichat Claude Bernard University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean Paul Feugeas
- UMR U722 INSERM Faculté de Médecine Xavier Bichat, Paris Diderot University, Paris, France
| | - Aurore Poissonnet
- Department of Geriatrics, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Cécile Pons-Peyneau
- Department of Psycho-Geriatrics, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Yves Wolmark
- Department of Geriatrics, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Olivier Drunat
- Department of Psycho-Geriatrics, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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50
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Detecting everyday action deficits in Alzheimer's disease using a nonimmersive virtual reality kitchen. J Int Neuropsychol Soc 2014; 20:468-77. [PMID: 24785240 DOI: 10.1017/s1355617714000344] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Alzheimer's disease (AD) causes impairments affecting instrumental activities of daily living (IADL). Transdisciplinary research in neuropsychology and virtual reality has fostered the development of ecologically valid virtual tools for the assessment of IADL, using simulations of real life activities. Few studies have examined the benefits of this approach in AD patients. Our aim was to examine the utility of a non-immersive virtual coffee task (NI-VCT) for assessment of IADL in these patients. We focus on the assessment results obtained from a group of 24 AD patients on a task designed to assess their ability to prepare a virtual cup of coffee, using a virtual coffee machine. We compared performance on the virtual task to an identical daily living task involving the actual preparation of a cup of coffee, as well as to global cognitive, executive, and caregiver-reported IADL functioning. Relative to 32 comparable, healthy elderly (HE) controls, AD patients performed worse than HE controls on all tasks. Correlation analyses revealed that NI-VCT measures were related to all other neuropsychological measures. Moreover, regression analyses demonstrated that performance on the NI-VCT predicted actual task performance and caregiver-reported IADL functioning. Our results provide initial support for the utility of our virtual kitchen for assessment of IADL in AD patients.
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