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Vu TA, Fenwick E, Doshi K, Gupta P, Quek SY, Chen C, Ting S, Ng ASL, Yap P, Yeo D, Milea D, Lamoureux EL. Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in Singapore. BMJ Open 2023; 13:e070850. [PMID: 37816566 PMCID: PMC10565319 DOI: 10.1136/bmjopen-2022-070850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVES Current cognitive screening and diagnostic instruments rely on visually dependent tasks and are, therefore, not suitable to assess cognitive impairment (CI) in visually impaired older adults. We describe the content development of the VISually Independent test battery Of NeuroCOGnition (VISION-Cog)-a new diagnostic tool to evaluate CI in visually impaired older Singaporean adults. DESIGN The content development phase consisted of two iterative stages: a neuropsychological consultation and literature review (stage 1) and an expert-panel discussion (stage 2). In stage 1, we investigated currently available neuropsychological test batteries for CI to inform constructions of our preliminary test battery. We then deliberated this battery during a consensus meeting using the Modified Nominal Group technique (stage 2) to decide, via agreement of five experts, the content of a pilot neuropsychological battery for the visually impaired. SETTING Singapore Eye Research Institute. PARTICIPANTS Stakeholders included researchers, psychologists, neurologists, neuro-ophthalmologists, geriatricians and psychiatrists. OUTCOME MEASURE pilot VISION-Cog. RESULTS The two-stage process resulted in a pilot VISION-Cog consisting of nine vision-independent neuropsychological tests, including the modified spatial memory test, list learning, list recall and list recognition, adapted token test, semantic fluency, modified spatial analysis, verbal subtests of the frontal battery assessment, digit symbol, digit span forwards, and digit span backwards. These tests encompassed five cognitive domains-memory and learning, language, executive function, complex attention, and perceptual-motor abilities. The expert panel suggested improvements to the clarity of test instructions and culturally relevant test content. These suggestions were incorporated and iteratively pilot-tested by the study team until no further issues emerged. CONCLUSIONS We have developed a five-domain and nine-test VISION-Cog pilot instrument capable of replacing vision-dependent diagnostic batteries in aiding the clinician-based diagnosis of CI in visually impaired older adults. Subsequent phases will examine the VISION-Cog's feasibility, comprehensibility and acceptability; and evaluate its diagnostic performance.
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Affiliation(s)
- Tai Anh Vu
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Eva Fenwick
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Population Health Research, Singapore Eye Research Institute, Singapore
| | - Kinjal Doshi
- Department of Psychology, National University of Singapore, Singapore
| | - Preeti Gupta
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Population Health Research, Singapore Eye Research Institute, Singapore
| | - Shin Yi Quek
- Department of Psychology, Ng Teng Fong General Hospital, Singapore
| | - Christopher Chen
- Deaprtment of Pharmacology and Psychological Medicine, National University of Singapore, Singapore
| | - Simon Ting
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Adeline S L Ng
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Philip Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | - Donald Yeo
- KALL Psychological & Counselling Services Pte Ltd, Singapore
| | - Dan Milea
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Population Health Research, Singapore Eye Research Institute, Singapore
- Rothschild Foundation Hospital, Paris, France
| | - Ecosse Luc Lamoureux
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Department of Ophthalmology, The University of Melbourne, Melbourne, Victoria, Australia
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Vu TA, Fenwick E, Doshi K, Gupta P, Quek SY, Chen C, Ting S, Ng ASL, Yap P, Yeo D, Milea D, Lamoureux E. Feasibility, comprehensibility and acceptability of the VISION-Cog, a novel tool to assess cognitive impairment in visually impaired older adults: a cross-sectional pilot study in Singapore. BMJ Open 2023; 13:e072151. [PMID: 37657840 PMCID: PMC10476112 DOI: 10.1136/bmjopen-2023-072151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVES We pilot-tested the VISually Independent test battery Of NeuroCOGnition (VISION-Cog) to determine its feasibility, comprehensibility and acceptability in evaluating cognitive impairment (CI) in visually impaired older Asian adults. DESIGN The VISION-Cog was iteratively fine-tuned through pilot studies and expert-panel discussion. In the first pilot study (Stage 1), we recruited 15 visually impaired and cognitively normal participants aged ≥60 years to examine the pilot VISION-Cog's feasibility (length of time to administer), comprehensibility (clarity of instructions) and acceptability (participant burden). We then presented the pilot results to the expert panel (Stage 2) who decided via agreement on a revised version of the VISION-Cog. Subsequently, we conducted a second pilot study (Stage 3) on another four participants to ascertain improvement in feasibility, comprehensibility and acceptability of the revised version. SETTING Singapore Eye Research Institute. PARTICIPANTS Nineteen Asian adults aged ≥60 years with visual impairment (defined as near visual acuity worse than N8) were recruited. OUTCOME MEASURE Revised VISION-Cog. RESULT The VISION-Cog was deemed feasible, taking approximately 60 min to complete on average. All participants agreed that the test instructions were clear, and the battery did not cause undue discomfort or frustration. The data collector rated all tests as very user-friendly (score of 5/5). Minor modifications to the pilot VISION-Cog were suggested by the panel to improve its safety, clarity of instructions and content validity, which were incorporated and iteratively tested in the second pilot study until no further issues emerged. CONCLUSIONS Using an iterative mixed-methods process, we have developed a feasible, comprehensible and acceptable 5-domain and 9-item visually independent VISION-Cog test battery suitable to assist CI diagnosis in older adults with visual impairment. We will assess its diagnostic potential against clinician-based assessment of CI in subsequent phases.
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Affiliation(s)
- Tai Anh Vu
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Eva Fenwick
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Population Health Research, Singapore Eye Research Institute, Singapore
| | - Kinjal Doshi
- Department of Psychology, National University of Singapore, Singapore
| | - Preeti Gupta
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Population Health Research, Singapore Eye Research Institute, Singapore
| | - Shin Yi Quek
- Department of Psychology, Ng Teng Fong General Hospital, Singapore
| | - Christopher Chen
- Departments of Pharmacology and Psychological Medicine, National University of Singapore, Singapore
| | - Simon Ting
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Adeline S L Ng
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Philip Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | - Donald Yeo
- KALL Psychological & Counselling Services Pte Ltd, Singapore
| | - Dan Milea
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Population Health Research, Singapore Eye Research Institute, Singapore
- Rothschild Foundation Hospital, Paris, France
| | - Ecosse Lamoureux
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Department of Ophthalmology, The University of Melbourne, Melbourne, Victoria, Australia
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Chandrasekharan J, Joseph A, Ram A, Nollo G. ETMT: A Tool for Eye-Tracking-Based Trail-Making Test to Detect Cognitive Impairment. SENSORS (BASEL, SWITZERLAND) 2023; 23:6848. [PMID: 37571630 PMCID: PMC10422410 DOI: 10.3390/s23156848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
The growing number of people with cognitive impairment will significantly increase healthcare demand. Screening tools are crucial for detecting cognitive impairment due to a shortage of mental health experts aiming to improve the quality of life for those living with this condition. Eye tracking is a powerful tool that can provide deeper insights into human behavior and inner cognitive processes. The proposed Eye-Tracking-Based Trail-Making Test, ETMT, is a screening tool for monitoring a person's cognitive function. The proposed system utilizes a fuzzy-inference system as an integral part of its framework to calculate comprehensive scores assessing visual search speed and focused attention. By employing an adaptive neuro-fuzzy-inference system, the tool provides an overall cognitive-impairment score, allowing psychologists to assess and quantify the extent of cognitive decline or impairment in their patients. The ETMT model offers a comprehensive understanding of cognitive abilities and identifies potential deficits in various domains. The results indicate that the ETMT model is a potential tool for evaluating cognitive impairment and can capture significant changes in eye movement behavior associated with cognitive impairment. It provides a convenient and affordable diagnosis, prioritizing healthcare resources for severe conditions while enhancing feedback to practitioners.
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Affiliation(s)
- Jyotsna Chandrasekharan
- Department of Computer Science and Engineering, Amrita School of Computing, Amrita Vishwa Vidyapeetham, Bengaluru 560035, India;
- Department of Industrial Engineering, University of Trento, 38123 Trento, Italy;
| | - Amudha Joseph
- Department of Computer Science and Engineering, Amrita School of Computing, Amrita Vishwa Vidyapeetham, Bengaluru 560035, India;
| | | | - Giandomenico Nollo
- Department of Industrial Engineering, University of Trento, 38123 Trento, Italy;
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Kabanovski A, Shah B, D’Silva C, Ma J, Minotti SC, Qian J, Hatch W, Reid R, Chaudhary V, El-Defrawy S, Ahmed II, Schlenker MB. Multi-center validation of Catquest-9SF visual function questionnaire in Ontario, Canada. PLoS One 2023; 18:e0278863. [PMID: 37410799 PMCID: PMC10325044 DOI: 10.1371/journal.pone.0278863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 11/25/2022] [Indexed: 07/08/2023] Open
Abstract
PURPOSE To investigate the psychometric performance and responsiveness of Catquest-9SF, a patient-reported questionnaire developed to evaluate visual function as related to daily tasks, in patients referred for cataract surgery in Ontario, Canada. METHODS This is a pooled analysis on prospective data collected for previous projects. Subjects were recruited from three tertiary care centers in Peel region, Hamilton, and Toronto, Ontario, Canada. Catquest-9SF was administered pre-operative and post-operatively to patients with cataract. Psychometric properties, including category threshold order, infit/outfit, precision, unidimensionality, targeting, and differential item functioning were tested using Rasch analysis with Winsteps software (v.4.4.4) for Catquest-9SF. Responsiveness of questionnaire scores to cataract surgery was assessed. RESULTS 934 patients (mean age = 71.6, 492[52.7%] female) completed the pre- and post-operative Catquest-9SF questionnaire. Catquest-9SF had ordered response thresholds, adequate precision (person separation index = 2.01, person reliability = 0.80), and confirmed unidimensionality. The infit range was 0.75-1.29 and the outfit range was 0.74-1.51, with one item ('satisfaction with vision') misfitting (outfit value = 1.51). There was mistargeting of -1.07 in pre-operative scores and mistargeting of -2.43 in both pre- and post-operative scores, meaning that tasks were relatively easy for respondent ability. There was no adverse differential item functioning. There was a mean 1.47 logit improvement in Catquest-9SF scores after cataract surgery (p<0.001). CONCLUSION Catquest-9SF is a psychometrically robust questionnaire for assessment of visual function in patients with cataract in Ontario, Canada. It is also responsive to clinical improvement after cataract surgery.
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Affiliation(s)
- Anna Kabanovski
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Bindra Shah
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Chelsea D’Silva
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Julia Ma
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Simona C. Minotti
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Jenny Qian
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Wendy Hatch
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Robert Reid
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Varun Chaudhary
- Department of Eye Medicine and Surgery, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Sherif El-Defrawy
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Iqbal Ike Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Matthew B. Schlenker
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
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Yau PN, Foo CJE, Cheah NLJ, Tang KF, Lee SWH. The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis. Epidemiol Health 2022; 44:e2022058. [PMID: 35843601 PMCID: PMC9754909 DOI: 10.4178/epih.e2022058] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/12/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) independently. However, the prevalence of functional disability among older adults in the Association of Southeast Asian Nations (ASEAN) region is poorly documented. This study aimed to assess the prevalence of functional disability and its impact on older adults in the ASEAN region. METHODS A systematic literature search was performed on 4 databases from inception until March 2021 to identify studies examining individuals aged 60 years and above reporting functional disabilities in the ASEAN region. Information on the prevalence and impact of functional disability was extracted, assessed for bias, summarised, and analysed using a random-effects meta-analysis. RESULTS Thirty-four studies with 59,944 participants were included. The pooled prevalence of ADL disability was 21.5% (95% confidence interval [CI], 16.2 to 27.3) and that of IADL disability was 46.8% (95% CI, 35.5 to 58.3). Subgroup analyses showed higher prevalence among those of advanced age and women. Adverse impacts included increased years of life with disability and poor health-related quality of life. CONCLUSIONS Nearly a quarter of the older adult population in the ASEAN region experience functional disability. These findings highlight the need for further research on the burden and impact of functional disability within this region to allow decision-makers to gauge the severity of the issue, develop policies to reduce the risk of developing functional disabilities, and foster healthy ageing.
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Affiliation(s)
- Phei Nie Yau
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | | | | | - Kar Foong Tang
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia,School of Pharmacy, Taylor’s University, Subang Jaya, Malaysia,Correspondence: Shaun Wen Huey Lee School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Malaysia E-mail:
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Nesemann JM, Kandel RP, Byanju R, Poudyal B, Bhandari G, Bhandari S, O’Brien KS, Stevens VM, Melo JS, Keenan JD. Association of visual impairment with disability: a population-based study. Eye (Lond) 2022; 36:540-546. [PMID: 33731892 PMCID: PMC8873270 DOI: 10.1038/s41433-021-01498-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To determine the relationship between visual impairment and other disabilities in a developing country. METHODS In this cross-sectional ancillary study, all individuals 50 years and older in 18 communities in the Chitwan region of Nepal were administered visual acuity screening and the Washington Group Short Set (WGSS) of questions on disability. The WGSS elicits a 4-level response for six disability domains: vision, hearing, walking/climbing, memory/concentration, washing/dressing, and communication. The association between visual impairment and disability was assessed with age- and sex-adjusted logistic regression models. RESULTS Overall, 4719 of 4726 individuals successfully completed visual acuity and disability screening. Median age of participants was 61 years (interquartile range: 55-69 years), and 2449 (51.9%) were female. Participants with vision worse than 6/60 in the better-seeing eye were significantly more likely to be classified as having a disability in vision (OR 18.4, 95% CI 9.9-33.5), walking (OR 5.3, 95% CI 2.9-9.1), washing (OR 9.4, 95% CI 4.0-21.1), and communication (OR 5.0, 95% CI 1.7-13.0), but not in hearing (OR 0.6, 95% CI 0.006-2.2) or memory (OR 2.2, 95% CI 0.7-5.1). CONCLUSIONS Visually impaired participants were more likely to self-report disabilities, though causality could not be ascertained. Public health programs designed to reduce visual impairment could use the WGSS to determine unintended benefits of their interventions.
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Affiliation(s)
- John M. Nesemann
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA
| | | | | | | | | | | | - Kieran S. O’Brien
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA ,grid.47840.3f0000 0001 2181 7878Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA USA
| | - Valerie M. Stevens
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA
| | - Jason S. Melo
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA
| | - Jeremy D. Keenan
- grid.266102.10000 0001 2297 6811Francis I Proctor Foundation, University of California San Francisco, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Ophthalmology, University of California San Francisco, San Francisco, CA USA
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Zhao Y, Lu Y, Zhao W, Wang Y, Ge M, Zhou L, Yue J, Dong B, Hao Q. Long sleep duration is associated with cognitive frailty among older community-dwelling adults: results from West China Health and Aging Trend study. BMC Geriatr 2021; 21:608. [PMID: 34706663 PMCID: PMC8555015 DOI: 10.1186/s12877-021-02455-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/03/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To investigate the association between sleep duration and cognitive frailty among older adults dwelling in western China. METHODS We used the baseline data from West China Health and Aging Trend (WCHAT) study. Sleep duration was classified as short sleep duration (< 6 h), normal sleep duration (6-8 h) and long sleep duration (≥ 9 h). Fried frailty criteria and Short Portable Mental Status Questionnaire were used to measure cognitive frailty. Multinomial logistic regression was conducted to estimate odds ratio (OR) and 95% confidence interval (CI). RESULTS A total of 4093 older adults (age = 67.8 ± 5.9 years, 1708 males and 2385 females) were included in the analysis. The prevalence of cognitive frailty was 11.8% among older adults in western China. Approximately 11.9% participants had short sleep duration (< 6 h); 22.2% had a long sleep duration (≥ 9 h). After adjusting for covariates, only long sleep duration was significantly associated with high risk of cognitive frailty (OR = 2.07, 95%CI = 1.60-2.68, P < 0.001) in western China older adults compared to normal sleep duration. CONCLUSIONS Long sleep duration was significantly related to cognitive frailty in older adults. Intervention for long sleep duration may be helpful to prevent cognitive frailty. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR1800018895 .
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Affiliation(s)
- Yunli Zhao
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Ying Lu
- National Clinical Research Center for Geriatrics and Department of General Practice, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Wanyu Zhao
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Yanyan Wang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Meiling Ge
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Lixing Zhou
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Jirong Yue
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China. .,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China.
| | - Qiukui Hao
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu, China.,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, 610041, Sichuan, China
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McGrath C, Karsan I, Corrado AM, Lyons TA, Blue M. The impact of combined age-related vision loss and dementia on the participation of older adults: A scoping review. PLoS One 2021; 16:e0258854. [PMID: 34669752 PMCID: PMC8528328 DOI: 10.1371/journal.pone.0258854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/06/2021] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION There are a growing number of older adults with combined age-related vision loss (ARVL) and dementia. Existing literature shows the pervasive impact that both diagnoses have separately on the participation of older adults, however, little is known about the societal participation of older adults with both conditions. As such, the aim of this scoping review was to explore the combined impact of ARVL and dementia on the participation of older adults, with a specific focus on highlighting strategies that help mitigate the impact of ARVL and dementia on participation. METHODS This study utilized a scoping review, informed by the framework by Arksey and O'Malley [1]. Two researchers independently ran a total of 62 search terms across four categories in six databases (PubMed, CINAHL, Scopus, Embase, Medline, PsycINFO), with an initial yield of 2,053 articles. Grey literature was also included in this scoping review and was retrieved from organizational websites, brochures, conference proceedings, and a Google Scholar search. The application of study inclusion criteria resulted in a final yield of 13 empirical studies and 10 grey literature sources. RESULTS Following detailed thematic analysis of the empirical and grey literature sources, four themes emerged regarding the impact of combined ARVL and dementia on the participation of older adults including: 1) Managing the pragmatic aspects of a dual diagnosis; 2) Diverse approaches to risk assessment and management; 3) Adopting a multi-disciplinary approach to facilitate care and; 4) Using compensatory strategies to facilitate participation. CONCLUSIONS The four themes highlight the challenges older adults with these combined diagnoses experience, which limit their opportunities for meaningful participation. Given the scarcity of research on this topic, future research should identify the type of ARVL and dementia diagnoses of study participants, conduct qualitative research about the lived experiences of older adults with a dual diagnosis, and broaden the geographic scope of research.
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Affiliation(s)
- Colleen McGrath
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Inaara Karsan
- School of Occupational Therapy, Western University, London, Ontario, Canada
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Liu CJ, Chang PS, Griffith CF, Hanley SI, Lu Y. The Nexus of Sensory Loss, Cognitive Impairment, and Functional Decline in Older Adults: A Scoping Review. THE GERONTOLOGIST 2021; 62:e457-e467. [PMID: 34131697 DOI: 10.1093/geront/gnab082] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The prevalence of cognitive impairment and sensory loss in hearing or vision increases with age. Based on the Information Processing Model, cognitive impairment coupled with sensory loss may exacerbate disability in late life. Yet this issue has not been systematically studied. The purpose of this scoping review was to examine the literature that studied the relationship between cognitive impairment, sensory loss, and activities of daily living in older adults. RESEARCH DESIGN AND METHODS Two reviewers independently screened 1,410 studies identified from five electronic databases (Medline, EMBASE, PsycINFO, CINHAL, and the Web of Science). The search was completed in June 2020. A study was eligible if it included measurements of cognitive function, vision or hearing, and activities of daily living. Additionally, the data analyses must address how cognitive impairment and sensory loss are related to the performance of activities of daily living. RESULTS The final review included 15 studies. Findings show an additive effect of cognitive impairment and sensory loss on the activities of daily living. Cognitive impairment or vision loss independently relates to the decline in activities of daily living. Hearing loss relates to the decline only when the loss is severe, or if the daily task is hearing specific. DISCUSSION AND IMPLICATIONS Older adults with coexisting sensory loss and cognitive impairment have the highest risk or prevalence of disability, comparing to cognitive impairment or sensory loss alone. This finding highlights the importance of developing interventions to reduce the risk of disability for older adults experiencing multiple impairments.
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Affiliation(s)
- Chiung-Ju Liu
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Pei-Shiun Chang
- Department of Community and Health Systems, Indiana University School of Nursing, Bloomington, Indiana, USA
| | - Cheryl F Griffith
- Academic Affairs, Office of Clinical Education, Indiana University Health, Indianapolis, Indiana, USA
| | - Stephanie I Hanley
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Yvonne Lu
- Indiana University School of Nursing, Indianapolis, Indiana, USA
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Chiou GJ, Huang DS, Hu FR, Yang CM, Yang CH, Huang CW, Lin JW, Lin CW, Ho TC, Hsieh YT, Lai TT, Chen HM, Chen PL, Hsiao CK, Chen TC. Metabolic Syndromes as Important Comorbidities in Patients of Inherited Retinal Degenerations: Experiences from the Nationwide Health Database and a Large Hospital-Based Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2065. [PMID: 33672521 PMCID: PMC7923804 DOI: 10.3390/ijerph18042065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 01/05/2023]
Abstract
This study aimed to evaluate the medical and socioeconomic impacts of IRDs using the nationwide health database and a large hospital-based cohort. This retrospective cross-sectional cohort study used data from the nationwide National Health Insurance Research Database (NHIRD). All patients with IRD from January 2012 to December 2016 were selected from the NHIRD and matched with the general population at a ratio of 1:4. All variables, including comorbidities, medications, service utilization, and medical costs, within 1 year from the date of the IRD diagnosis, were analyzed. Disability data were retrieved from the Taiwan Inherited retinal degeneration Project (TIP), a medical center-based database. A total of 4447 and 17,788 subjects from the nationwide database were included in the IRD and control groups, respectively. The Charlson comorbidity index score was higher in the IRD group (0.74:0.52, p < 0.001). Yearly visits to the ophthalmology clinic were more frequent in the IRD group (6.80:1.06, p < 0.001), particularly to tertiary medical centers (p < 0.001). The IRD group showed greater odds ratios (OR) for metabolic syndrome-related comorbidities, including hypertension (OR = 1.18, 95% confidence interval (CI) 1.10 to 1.26) and diabetes (OR = 1.32, 95% CI 1.21 to 1.45), and double the average yearly medical cost (2104.3 vs. 1084.6 USD, p < 0.001) and ten times the yearly ophthalmology cost (369.1 vs. 36.1 USD, p < 0.001). The average disability level was 54.17% for all subjects. This study revealed the large medical and socioeconomic impacts of IRD on not only patients with IRD, but also their family members and the whole society.
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Affiliation(s)
- Guann-Jye Chiou
- Department of Medical Education, National Taiwan University Hospital, Taipei 100, Taiwan;
| | - Ding-Siang Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Chang-Hao Yang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Ching-Wen Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
| | - Jou-Wei Lin
- Cardiovascular Center, National Taiwan University Hospital (Yun-Lin Branch), Yunlin 632, Taiwan;
| | - Chao-Wen Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
| | - Tzyy-Chang Ho
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
| | - Yi-Ting Hsieh
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
| | - Tso-Ting Lai
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
| | - Ho-Min Chen
- Health Data Research Center, National Taiwan University, Taipei 100, Taiwan;
| | - Pei-Lung Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan;
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chuhsing Kate Hsiao
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100, Taiwan;
| | - Ta-Ching Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (D.-S.H.); (F.-R.H.); (C.-M.Y.); (C.-H.Y.); (C.-W.H.); (C.-W.L.); (T.-C.H.); (Y.-T.H.); (T.-T.L.)
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan;
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Elliott AF, Heskett M, Spiker C, McGwin G, Owsley C. Low rates of eye care utilization among visually impaired subsidized senior housing residents. Aging Ment Health 2021; 25:360-366. [PMID: 31694391 PMCID: PMC7202945 DOI: 10.1080/13607863.2019.1683813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine the rate of self-reported vision impairment, eye disease, and eye care utilization among residents of subsidized senior housing (SSH) communities. METHODS In this cross-sectional, observational study, residents of 14 SSH communities in Jefferson County, AL, USA self-reported their vision status and eye care utilization as part of vision screening events held in their community. RESULTS Two hundred and thirty-seven residents self-reported their vision status, presence of eye disease, and eye care utilization. A third of participants (33.3%) reported difficulty with distance vision while 38% reported difficulty with near vision. Rates of eye disease among this sample were as follows: 40.3% reported having cataracts, 13.6% reported having glaucoma, 4.2% reported having age-related macular degeneration, and 5.5% reported having diabetic retinopathy. The majority of participants (52.8%) had not been to see an eye care provider within the last year. Persons with vision impairment were less likely to report having seen an eye care provider within the last year than those without impairment (p = .03). CONCLUSION This study illuminates the low utilization of eye care among socioeconomically disadvantaged older adults residing in SSH, especially among those with vision impairment and eye disease. Vision-related health care is important in maintaining both physical and mental health in older adults.
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Affiliation(s)
| | | | - Christopher Spiker
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham
| | - Gerald McGwin
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham,Department of Epidemiology, School of Public Health, University of Alabama at Birmingham,Department of Surgery, School of Medicine, University of Alabama at Birmingham
| | - Cynthia Owsley
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham
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12
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Patel N, Stagg BC, Swenor BK, Zhou Y, Talwar N, Ehrlich JR. Association of Co-occurring Dementia and Self-reported Visual Impairment With Activity Limitations in Older Adults. JAMA Ophthalmol 2021; 138:756-763. [PMID: 32407444 DOI: 10.1001/jamaophthalmol.2020.1562] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance The number of older adults with visual impairment (VI) and dementia is projected to increase in the US because of the aging of the population. Dementia and VI commonly co-occur and are each independently associated with disability. To care for an aging population, it may be important to characterize the association of coexisting dementia and self-reported VI on daily functioning. Objective To evaluate the association of co-occurring dementia and self-reported VI on daily functioning. Design, Setting, and Participants This cross-sectional analysis of a nationally representative cohort study used data from the National Health and Aging Trends Study (NHATS), an annual study of US adults 65 years and older. Participants in the 2015 survey with complete data on outcomes, associated factors, and covariates were included in this study. Data analysis took place from January 2019 to November 2019. Main Outcomes and Measures Multivariable Poisson regression was used to model the independent associations and interaction of dementia and self-reported VI status on 3 functional activity scales (self-care, mobility, and household activities). Marginal predicted proportions were calculated. Analyses were adjusted for sociodemographic and medical factors and accounted for the complex survey design. Results A total of 7124 participants were included. The weighted proportion of female respondents was 55.3% (95% CI, 54.0%-56.6%), and 56.1% (95% CI, 54.1%-58.1%) were between 65 and 74 years old. Self-reported VI was present in 8.6% (95% CI, 7.8%-9.3%) of participants, while 8.3% (95% CI, 7.8%-8.9%) had possible dementia and 6.3% (95% CI, 5.7%-6.9%) had probable dementia. Self-reported VI was associated with an expected decrease in mobility score of 14.7% (functional scale scores: no VI, 10.82 vs VI, 9.23), self-care score of 9.5% (no VI, 14.54 vs VI, 13.16), and household activity score of 15.2% (no VI, 18.23 vs VI, 15.45), while probable dementia was associated with expected decreases of 27.8% (no dementia, 10.82 vs probable dementia, 7.81), 22.9% (no dementia, 14.54 vs probable dementia, 11.20), and 34.7% (no dementia, 18.23 vs probable dementia, 11.90), respectively. Among those with probable dementia and self-reported VI, there was an expected decrease in mobility score of 50.1% (functional ability scores: no VI and no dementia, 10.82 vs VI and probable dementia, 5.40), self-care score of 42.4% (no VI and no dementia, 14.54 vs VI and probable dementia, 8.38), and household activity score of 52.4% (no VI and no dementia, 18.23 vs VI and probable dementia, 8.68), suggesting that respondents with co-occurring dementia and self-reported VI had lower functional activity scores than would be associated with the independent contributions of these conditions. Conclusions and Relevance Older adults with both dementia and self-reported VI may be at high risk for disability, and their co-occurrence may potentiate this risk. These findings suggest that the growing population of older adults with both visual impairment and dementia may benefit from interventions to maximize vision and cognition and promote functioning and independence.
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Affiliation(s)
- Nish Patel
- University of Michigan Medical School, Ann Arbor.,Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Brian C Stagg
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City
| | - Bonnelin K Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Yunshu Zhou
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor
| | - Nidhi Talwar
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
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Luo S, Chen X, Hou L, Yue J, Liu X, Xia X, Dong B, Cao L. Comorbid Depressive Symptoms, Visual Impairment, and Sarcopenia among Middle-Aged and Older Women: Findings from the West China Health and Aging Trend study. J Nutr Health Aging 2021; 25:1131-1137. [PMID: 34725673 DOI: 10.1007/s12603-021-1687-2] [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] [Indexed: 02/05/2023]
Abstract
Previous reports have described close relationships between sarcopenia and either visual impairment or depression, but there have been few analyses investigating the association between sarcopenia and the coexistence of both visual impairment and depression. Herein, we sought to explore the associations between sarcopenia and comorbid depressive symptoms and visual impairment among older females. A cross-sectional analysis of females between the ages of 50 and 95 (n = 2454) from the West China Health and Aging Trend (WCHAT) study was conducted. Patient muscle mass was assessed via a bioimpedance-based approach using an InBody 770 device, while muscle strength was estimated based on handgrip strength as quantified with a digital grip strength dynamometer. Depressive systems were evaluated with the 15-item Geriatric Depression Scale (GDS-15), and a questionnaire was employed to evaluate patient visual functionality. Associations between sarcopenia and comorbid depressive status and visual impairment were explored through logistic regression analyses. Comorbid depressive symptoms and visual impairment were observed in 6.2% of the women included in this study, while 18.9% suffered from sarcopenia. Following adjustment for covariates, relative to normal controls, study subjects with only depression (OR=1.45, 95%CI=1.04-2.02), only visual impairment (OR=1.69, 95%CI=1.27-2.26), or comorbid depression and visual impairment (OR=1.76, 95% CI=1.16-2.67) exhibited a higher risk of sarcopenia. These results suggest that comorbid depression and visual impairment are linked to the prevalence of sarcopenia in older Chinese women. As such, further efforts to screen older women for these two comorbid conditions may thus be necessary.
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Affiliation(s)
- S Luo
- Birong Dong, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China, , Telephone: +86-028-85421550; Li Cao, Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China, of Missouri Sinclair School of Nursing, Columbia, Missouri, USA
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14
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Ge M, Zhang Y, Zhao W, Yue J, Hou L, Xia X, Zhao Y, Liu X, Dong B, Ge N. Prevalence and Its Associated Factors of Physical Frailty and Cognitive Impairment: Findings from the West China Health and Aging Trend Study (WCHAT). J Nutr Health Aging 2020; 24:525-533. [PMID: 32346692 DOI: 10.1007/s12603-020-1363-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Previous literature has reported that physical frailty (PF) closely associated with cognitive impairment (CI). In this study, we aim to describe and evaluate the prevalence and associated factors with different patterns of PF and cognitive impairment. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS Community-dwelling older adults aged ≥60 from the West China Health and Aging Trend (WCHAT) study were included in this study. MEASUREMENTS Participants were assessed the PF and cognitive impairment. PF was assessed using the physical phenotype as defined by Fried's criteria. Cognitive impairment was identified using the Short Portable Mental Status Questionnaire (SPMSQ). According different patterns of PF and cognitive impairment, participants were divided into 4 groups: not-PF and cognitive intact ( "neither" group), not-PF and cognitive impairment ("CI only" group), PF and cognitive intact ("PF only" group), and PF and cognitive impairment ("both" group). Multinomial logistic regression was used to explore the association between medical conditions and different patterns of PF and cognitive impairment after adjusting the demographic characteristics. RESULTS Among 4,103 participants (age 67.8 + 5.9 years, female 58.3%), 78.8%, 3.9%, 14.5% and 2.9% were "neither", "PF only", "CI only", and "both", respectively. The prevalence of "PF only", "CI only" and "both" were associated with age, lower education level and single status. In addition, there was substantial ethnicity heterogeneity in the prevalence of different patterns of PF and cognitive impairment. Comparing with "neither", PF and/or cognitive impairment had higher association with depression, ADLs impairment, and malnutrition. Of note, obesity was only significantly associated with "PF only", but not associated with "CI only" or "both". CONCLUSIONS We found the substantial demographic and medical conditions disparities in different patterns of PF and cognitive impairment. Further research should focus on the efficient and practical screen to predict the risk of "PF only", "CI only" and "both".
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Affiliation(s)
- M Ge
- Birong Dong, PhD, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, Chengdu, Sichuan, China, 610041; Ning Ge, PhD, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, Chengdu, Sichuan, China, 610041. E-mail address: (B. Dong), (Ning Ge), Fax: +86-028-85421550, Tel: +86-028-85421550
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15
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Chan A, Saito Y, Matchar DB, Østbye T, Malhotra C, Ang S, Ma S, Malhotra R. Cohort Profile: Panel on Health and Ageing of Singaporean Elderly (PHASE). Int J Epidemiol 2019; 48:1750-1751f. [DOI: 10.1093/ije/dyz172] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2019] [Indexed: 12/28/2022] Open
Affiliation(s)
- Angelique Chan
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
| | - Yasuhiko Saito
- College of Economics and Population Research Institute, Nihon University, Tokyo, Japan
| | - David B Matchar
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Internal Medicine (General Internal Medicine), Duke University, Durham, NC, USA
| | - Truls Østbye
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
- Family Medicine and Community Health, Duke University, Durham, NC, USA
| | - Chetna Malhotra
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Shannon Ang
- Department of Sociology, University of Michigan, Ann Arbor, MI, USA
- Sociology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Stefan Ma
- Epidemiology & Disease Control Division, Singapore Ministry of Health, Singapore
| | - Rahul Malhotra
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
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16
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Guo C, Wang Z, Li N, Chen G, Zheng X. Comorbid Visual and Psychiatric Disabilities Among the Chinese Elderly: A National Population-Based Survey. Curr Eye Res 2017; 42:1733-1737. [PMID: 29083235 DOI: 10.1080/02713683.2017.1315143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To estimate the prevalence of, and association between, co-morbid visual and psychiatric disabilities among elderly (>65 years-of-age) persons in China. METHODS Random representative samples were obtained using multistage, stratified, cluster sampling, with probabilities proportional to size. Standard weighting procedures were used to construct sample weights that reflected this multistage, stratified cluster sampling survey scheme. Logistic regression models were used to elucidate associations between visual and psychiatric disabilities. RESULTS Among the Chinese elderly, >160,000 persons have co-morbid visual and psychiatric disabilities. The weighted prevalence among this cohort is 123.7 per 100,000 persons. A higher prevalence of co-morbid visual and psychiatric disabilities was found in the oldest-old (p<0.001); women (65-79 years-of-age, p=0.001; ≥80 years-of-age, p=0.004); illiterate (65-79 years-of-age, p<0.001; ≥80 years-of-age, p=0.02); and single elders (65-79 years-of-age, p=0.01; ≥80 years-of-age, p=0.001). Presence of a visual disability was significantly associated with a higher risk of having a psychiatric disability among persons aged ≥80 years-of-age [adjusted odds ratio, 1.24; 95% confidence interval (CI), 1.03-1.54]. CONCLUSION A significant number of Chinese elderly persons were living with co-morbid visual and psychiatric disabilities. To address the challenge of these co-morbid disorders among Chinese elders, it is incumbent upon the government to implement additional and more comprehensive prevention and rehabilitation strategies for health-care systems, reinforce health promotion among the elderly, and improve accessibility to health-care services.
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Affiliation(s)
- Chao Guo
- a Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science , Peking University , Beijing , China.,b APEC Health Science Academy , Peking University (HeSAY) , Beijing , China.,c Freeman Spogli Institute for International Studies , Stanford University , CA , USA
| | - Zhenjie Wang
- a Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science , Peking University , Beijing , China
| | - Ning Li
- a Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science , Peking University , Beijing , China
| | - Gong Chen
- a Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science , Peking University , Beijing , China.,b APEC Health Science Academy , Peking University (HeSAY) , Beijing , China
| | - Xiaoying Zheng
- a Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science , Peking University , Beijing , China.,b APEC Health Science Academy , Peking University (HeSAY) , Beijing , China
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Gervais MÈ, Couture M, Le Blanc S, Blanchet S, Gagné MÈ, Ouellet MC. Evaluation of Cognitive Functioning in the Context of Rehabilitation for Visual Impairment in Older Adults: A Case Series. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2017. [DOI: 10.1080/02703181.2017.1339758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Marie-Ève Gervais
- Institut de réadaptation en déficience physique de Québec, Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Canada
| | - Mélanie Couture
- Institut de réadaptation en déficience physique de Québec, Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Canada
| | - Stéphanie Le Blanc
- Institut de réadaptation en déficience physique de Québec, Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Canada
| | - Sophie Blanchet
- Institut de réadaptation en déficience physique de Québec, Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Canada
- Université René Descartes - Paris 5, Paris, France
| | - Marie-Ève Gagné
- Institut de réadaptation en déficience physique de Québec, Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Canada
- School of Psychology, Université Laval, Québec, Canada
| | - Marie-Christine Ouellet
- Institut de réadaptation en déficience physique de Québec, Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, Canada
- School of Psychology, Université Laval, Québec, Canada
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Factors of nocturnal sleep and daytime nap durations in community-dwelling elderly: a longitudinal population-based study. Int Psychogeriatr 2017; 29:1335-1344. [PMID: 28434419 DOI: 10.1017/s104161021700062x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Durations of nocturnal sleep and daytime nap influence the well-being of older adults. It is thus essential to understand their determinants. However, much previous research did not assess sleep duration and nap duration individually, and longitudinal data is lacking. This study aimed at examining the impact of demographic, psychosocial, and health factors, including ethnicity, social networks outside the household, smoking and physical exercise on sleep duration and nap duration among community-dwelling elderly. METHODS Our study involved over 2,600 older adults (≥60 years) from a longitudinal, nationally representative survey - the Panel on Health and Ageing of Singaporean Elderly. Sleep and nap durations at Time 2 (two years later) were regressed on predictors measured at Time 1. RESULTS Time 2 short nocturnal sleep duration was predicted by Malay ethnicity (relative to Chinese and Indian), older age, lower education level, more depressive symptoms, and obesity, whereas future long nocturnal sleep duration was predicted by weaker social networks, older age, and more chronic diseases. Furthermore, smoking, obesity, Malay or Indian (relative to Chinese), older age, male gender, and cognitive impairment predicted longer daytime nap duration in the future. CONCLUSIONS Older adults' nocturnal sleep and daytime nap durations may be affected by different demographic, psychosocial, and health factors. Thus, it is important to differentiate these two attributes in this age group.
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Liu PL, Cohen HJ, Fillenbaum GG, Burchett BM, Whitson HE. Association of Co-Existing Impairments in Cognition and Self-Rated Vision and Hearing With Health Outcomes in Older Adults. Gerontol Geriatr Med 2016; 2. [PMID: 27054148 PMCID: PMC4820285 DOI: 10.1177/2333721415623495] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: The objective of this study was to assess the relationship of disability (activities of daily living [ADL] and instrumental ADL [IADL]), self-rated health (SRH), and 6-year mortality with co-existing impairments in vision (self-rated), hearing (self-rated), and/or cognition (Short Portable Mental Status Questionnaire) in older adults. Method: The study sample comprised of 3,871 participants from the North Carolina Established Populations for Epidemiologic Studies of the Elderly study (NC EPESE). Results: Persons with all three impairments had increased odds of ADL/IADL disability and low SRH. Participants with combined visual and cognitive impairments had increased odds of mortality. Whereas sensory impairments were associated with poor SRH, cognitive impairment was not unless both sensory impairments were present. Conclusion: Co-existent sensory and cognitive impairments were associated with higher risk of impaired functional status. Self-rated auditory impairment alone was not associated with higher odds of death, but mortality was linked to visual and, particularly, cognitive impairment, alone or combined.
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Affiliation(s)
- Phillip L Liu
- Center for the Study of Aging and Human Development, Duke University Durham, NC; Department of Medicine, Duke University, Durham, NC
| | - Harvey Jay Cohen
- Center for the Study of Aging and Human Development, Duke University Durham, NC; Department of Medicine, Duke University, Durham, NC; Durham VA Medical Center, Geriatrics Research Education and Clinical Center, Durham, NC
| | - Gerda G Fillenbaum
- Center for the Study of Aging and Human Development, Duke University Durham, NC
| | - Bruce M Burchett
- Center for the Study of Aging and Human Development, Duke University Durham, NC
| | - Heather E Whitson
- Center for the Study of Aging and Human Development, Duke University Durham, NC; Department of Medicine, Duke University, Durham, NC; Department of Ophthalmology, Duke University, Durham, NC; Durham VA Medical Center, Geriatrics Research Education and Clinical Center, Durham, NC
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