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Hollander M, Jariwala N, Sotelo L, Kiefer J, Gomez R. The impact of MIND diet consumption and physical activity on cognitive functioning in healthy aging older adults. Clin Neuropsychol 2024:1-19. [PMID: 39257328 DOI: 10.1080/13854046.2024.2399866] [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: 03/31/2024] [Accepted: 08/29/2024] [Indexed: 09/12/2024]
Abstract
Objective: Modifiable lifestyle factors evidence great promise in reducing cognitive decline in older adults. Greater consumption to the MIND diet (Morris et al.) and increased daily physical activity (Buchman et al.) are associated with higher cognitive functioning. The interactive effects of lifestyle factors on cognition in older adults has not been investigated extensively. The present study examined the interaction between MIND diet consumption and intensity of physical activity on cognition in community-dwelling older adults. Methods: The sample included 215 older adults (159 female, Mage=79.8; Medu=15.5) from the Memory and Aging Project (Bennet et al.). The measures included the food frequency questionnaire (FFQ, MIND diet consumption), a portable actigraph worn 24 h a day for ten days (activity intensity), and a neuropsychological battery (cognitive variables). Results: Controlling for age and education, multiple regression analyses revealed that MIND diet consumption significantly predicted global cognition (ps< .05). Physical activity significantly predicted global cognition (ps< .05), and processing speed (ps< .01). Interaction effects were significant in global cognition (ps< .05), and episodic memory (ps< .01) revealing a pattern that those with the lowest MIND diet consumption may experience greater cognitive benefits from physical activity in than those with higher diet consumption. Conclusions: Findings suggest that older adults who do not consume the MIND diet closely may experience greater benefit in cognitive functioning from exercise than individuals who more greatly consume the diet.
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Affiliation(s)
| | | | - Lizeth Sotelo
- Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Jamie Kiefer
- Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Rowena Gomez
- Psychology, Palo Alto University, Palo Alto, CA, USA
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2
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Budgett J. Setting individualised goals for people living with dementia and their family carers: A systematic review of goal-setting outcome measures and their psychometric properties. DEMENTIA 2024; 23:312-340. [PMID: 38105445 PMCID: PMC10807246 DOI: 10.1177/14713012231222309] [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] [Indexed: 12/19/2023]
Abstract
BACKGROUND Individualised goal-setting outcome measures can be a useful way of reflecting people living with dementia and family carers' differing priorities regarding quality-of-life domains in the highly heterogeneous symptomatology of the disease. Evaluating goal-setting measures is challenging, and there is limited evidence for their psychometric properties. AIM (1) To describe what goal-setting outcomes have been used in this population; (2) To evaluate their validity, reliability, and feasibility in RCTs. METHOD We systematically reviewed studies that utilised goal-setting outcome measures for people living dementia or their family carers. We adapted a risk of bias and quality rating system based on the COSMIN guidelines to evaluate the measurement properties of outcomes when used within RCTs. RESULTS Thirty studies meeting inclusion criteria used four different goal-setting outcome measures: Goal Attainment Scaling (GAS), Bangor Goal Setting Interview (BGSI), Canadian Occupational Performance Measure (COPM) and Individually Prioritized Problems Assessment (IPPA); other papers have reported study-specific goal-setting attainment systems. Only GAS has been used as an outcome over periods greater than 9 months (up to a year). Within RCTs there was moderate quality evidence for sufficient content validity and construct validity for GAS, COPM and the BGSI. Reliability was only assessed in one RCT (using BGSI); in which two raters reviewed interview transcripts to rate goals with excellent inter-rater reliability. Feasibility was reported as good across the measures with a low level of missing data. CONCLUSION We found moderate quality evidence for good content and construct validity and feasibility of GAS, BGSI and COPM. While more evidence of reliability of these measures is needed, we recommend that future trials consider using individualised goal setting measures, to report the effect of interventions on outcomes that are most meaningful to people living with dementia and their families.
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Affiliation(s)
- Jessica Budgett
- Division of Psychiatry, University College London, and Centre for Psychiatry and Mental Health, Wolfsen Institute of Population Health, Queen Mary University of London UK
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3
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Sergio J, Siedlecki KL. Which variables moderate the relationship between depressive symptoms and global neurocognition across adulthood? NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:145-173. [PMID: 36268987 DOI: 10.1080/13825585.2022.2131714] [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: 12/12/2021] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
The current study examined moderators of the relationship between depressive symptoms and global neurocognition in a large non-clinical community-dwelling sample spanning adulthood. Participants comprised 5,430 individuals between the ages of 18-99 years drawn from the Virginia Cognitive Aging Project. Depressive symptoms were measured via the Center for Epidemiologic Studies-Depression scale and neurocognition was operationalized as a composite variable comprising episodic memory, spatial visualization, processing speed, and reasoning tasks. Moderator variables included physical activity, cognitive activity, education, emotional stability, and openness. Hierarchical regressions were used to examine the influence of depressive symptoms and the moderators on neurocognition. Depressive symptoms significantly predicted neurocognition. Cognitive activity, years of education, and emotional stability moderated the depression-neurocognition relationship by buffering the impact of depressive symptoms on neurocognition. Cognitive activity engagement and level of education may function as a protective influence on those with higher levels of depressive symptoms, while emotional stability may be protective for individuals with lower levels of depressive symptoms. No differences in moderation were found across three age groups representing younger, middle, and older adults. Post-hoc analyses showed years of education and openness as moderators in a subsample excluding individuals with potentially clinically meaningful levels of depressive symptoms.
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Affiliation(s)
- Jordan Sergio
- Department of Psychology, Fordham University, New York, NY, USA
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4
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Stara V, Soraci L, Takano E, Kondo I, Möller J, Maranesi E, Luzi R, Riccardi GR, Browne R, Dacunha S, Palmier C, Wieching R, Ogawa T, Bevilacqua R. Intrinsic Capacity and Active and Healthy Aging Domains Supported by Personalized Digital Coaching: Survey Study Among Geriatricians in Europe and Japan on eHealth Opportunities for Older Adults. J Med Internet Res 2023; 25:e41035. [PMID: 37824183 PMCID: PMC10603559 DOI: 10.2196/41035] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/03/2022] [Accepted: 07/14/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND The worldwide aging trend requires conceptually new prevention, care, and innovative living solutions to support human-based care using smart technology, and this concerns the whole world. Enabling access to active and healthy aging through personalized digital coaching services like physical activity coaching, cognitive training, emotional well-being, and social connection for older adults in real life could offer valuable advantages to both individuals and societies. A starting point might be the analysis of the perspectives of different professionals (eg, geriatricians) on such technologies. The perspectives of experts in the sector may allow the individualization of areas of improvement of clinical interventions, supporting the positive perspective pointed out by the intrinsic capacity framework. OBJECTIVE The overall aim of this study was to explore the cross-national perspectives and experiences of different professionals in the field of intrinsic capacity, and how it can be supported by eHealth interventions. To our knowledge, this is the first study to explore geriatric care providers' perspectives about technology-based interventions to support intrinsic capacity. METHODS A survey involving 20 geriatricians or clinical experts in the fields of intrinsic capacity and active and healthy aging was conducted in Italy, France, Germany, and Japan between August and September 2021. RESULTS The qualitative findings pointed out relevant domains for eHealth interventions and provided examples for successful practices that support subjective well-being under the intrinsic capacity framework (the benefits offered by personalized interventions, especially by promoting health literacy but avoiding intrusiveness). Moreover, eHealth interventions could be used as a bridge that facilitates and enables social engagement; an instrument that facilitates communication between doctors and patients; and a tool to enrich the monitoring actions of medical staff. CONCLUSIONS There is an unexplored and significant role for such geriatric perspectives to help the development process and evaluate the evidence-based results on the effectiveness of technologies for older people. This is possible only when clinicians collaborate with data scientists, engineers, and developers in order to match the complex daily needs of older adults.
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Affiliation(s)
- Vera Stara
- Medical Direction, IRCCS, INRCA, Ancona, Italy
| | - Luca Soraci
- Unit of Geriatric Medicine, IRCCS, INRCA, Cosenza, Italy
| | - Eiko Takano
- National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Izumi Kondo
- National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Johanna Möller
- Diocesan Caritas Association for the Archdiocese of Cologne, Cologne, Germany
| | | | | | | | - Ryan Browne
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | | | - Cecilia Palmier
- Service de gériatrie 1&2, AP-HP, Hôpital Broca, Paris, France
| | - Rainer Wieching
- Institute for New Media & Information Systems, University of Siegen, Siegen, Germany
| | - Toshimi Ogawa
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
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Wittich W, Kröger E, Aubin G, Fadhlaoui A, Anderson ND, Ben Gaied N, Itzhak I, Belleville S. Using co-creation focus groups to customise a remote multidomain programme designed to increase dementia literacy. BMJ Open 2023; 13:e074555. [PMID: 37709333 PMCID: PMC10921908 DOI: 10.1136/bmjopen-2023-074555] [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: 04/10/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES To adapt the content and functionalities of Brain Health PRO, a web-based multidomain program designed to increase dementia literacy, to the context and needs of users, providers and community organisations across Québec, Canada. DESIGN Five consecutive qualitative co-creation focus group sessions 30-90 min in duration each, exploring potential barriers and facilitators to usability, accessibility, comprehensibility, participant recruitment and retention. SETTING Virtual meetings. PARTICIPANTS A 15-member team based in Québec and Ontario, Canada, consisting of 9 researchers (including a graduate student and the project coordinator), representing occupational therapy, sensory rehabilitation, neuropsychology, psychology, health science and research methods, 3 informal caregivers of older adults living with cognitive decline and 3 members of the Federation of Quebec Alzheimer Societies. DATA ANALYSIS Session recordings were summarised through both qualitative description and thematic analysis. RESULTS The synthesised recommendations included adjustments around diversity, the complexity and presentation styles of the materials, suggestions on refining the web interface and the measurement approaches; it influenced aspects of participant recruitment, retention efforts and engagement with the content of Brain Health PRO. CONCLUSIONS Co-creation in dementia prevention research is important because it involves collaboration between researchers, community support and service providers, and persons with lived experience as care providers, in the design and implementation of clinical studies. This approach helps to ensure that the content and presentation of educational material is relevant and meaningful to the target population and those involved in its delivery, and it leads to a greater understanding of their needs and perspectives.
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Affiliation(s)
- Walter Wittich
- School of Optometry, Universite de Montreal, Montreal, Québec, Canada
| | - Edeltraut Kröger
- Laval University Research Center on Primary Care and Services, Centre integre universitaire de sante et de services sociaux de la Capitale-Nationale, Quebec, Québec, Canada
| | - Gabrielle Aubin
- Department of Psychology, Universite de Montreal, Montreal, Québec, Canada
| | - Asma Fadhlaoui
- Institut Universitaire de Gériatrie de Montréal, Centre intégré universitairede santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, Québec, Canada
| | - Nicole D Anderson
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Academy of Research and Eduction, Toronto, Ontario, Canada
| | - Nouha Ben Gaied
- Fédération québécoise des Sociétés Alzheimer, Montreal, Québec, Canada
| | - Inbal Itzhak
- Lady Davis Institute, Centre intégré universitaire de santé et de services sociaux du Centre-Ouest-de-l'Île-de-Montréal, Montreal, Québec, Canada
| | - Sylvie Belleville
- Department of Psychology, Universite de Montreal, Montreal, Québec, Canada
- Institut Universitaire de Gériatrie de Montréal, Centre intégré universitairede santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, Québec, Canada
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6
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Noach S, Witteman B, Boss HM, Janse A. Effects of multidomain lifestyle interventions on cognitive decline and Alzheimer's disease prevention: A literature review and future recommendations. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 4:100166. [PMID: 37215433 PMCID: PMC10199401 DOI: 10.1016/j.cccb.2023.100166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/24/2023]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder with an increasing incidence and currently without a cure. It is speculated that targeting multiple modifiable risk factors (MRFs) could be a beneficial strategy for the prevention of cognitive decline and AD. This study provides an overview and discusses the existing literature on multidomain lifestyle interventions in relation to cognitive decline and the prevention of AD. A literature search was performed in PubMed and Scopus, for studies published in English up to 31 May 2021. We identified nine relevant studies on the effect of multidomain lifestyle interventions on cognition (n = 8) and/or AD incidence or risk scores (n = 4). The studies included a combination of the separate intervention components diet (n = 8), physical activity (n = 9), cognitive activity (n = 6), metabolic or cardiovascular risk factor reduction strategies (n = 8), social activity (n = 2), medication (n = 2), and/or supplementation (n = 1). Global cognition was improved significantly in four of the eight studies that had global cognition as the outcome. Moreover, significant improvements were shown for cognitive domains in two of the three studies with specific cognitive domains as an outcome. No effect on AD incidence was observed, although positive results were shown for AD risk scores. The results suggest that multidomain lifestyle intervention studies may be partially effective in preventing cognitive decline. However, studies were heterogeneous and limited in follow-up. Future research on the effect of multidomain lifestyle interventions on cognitive decline and AD incidence must be conducted with a longer follow-up period.
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Affiliation(s)
- Sasja Noach
- Division of Human Nutrition and Health, Wageningen University & Research, PO Box 17 6700 AA, Wageningen, the Netherlands
| | - Ben Witteman
- Division of Human Nutrition and Health, Wageningen University & Research, PO Box 17 6700 AA, Wageningen, the Netherlands
- Department of Geriatric Medicine, Hospital Gelderse Vallei, 6716 RP, Ede, the Netherlands
| | - H. Myrthe Boss
- Department of Neurology, Hospital Gelderse Vallei, 6716 RP, Ede, the Netherlands
| | - André Janse
- Department of Geriatric Medicine, Hospital Gelderse Vallei, 6716 RP, Ede, the Netherlands
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7
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Bevilacqua R, Soraci L, Stara V, Riccardi GR, Corsonello A, Pelliccioni G, Lattanzio F, Casaccia S, Möller J, Wieching R, Ogawa T, Watanabe S, Kokobun K, Kondo I, Takano E, Maranesi E. A systematic review of multidomain and lifestyle interventions to support the intrinsic capacity of the older population. Front Med (Lausanne) 2022; 9:929261. [PMID: 35911409 PMCID: PMC9335156 DOI: 10.3389/fmed.2022.929261] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/28/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction The focus on intrinsic capacity (IC) could help clinicians to design interventions to improve the health of the older population. This review aims to map the current state of the art in the field of multi-domain interventions based on the IC framework, to allow health professionals in identifying personalized clinical interventions, oriented to empower the older people with a holistic and positive approach. Methods A systematic review of the literature was conducted in July 2021 analyzing manuscripts and articles of the last 10.5 years from PubMed, Scopus, Embase, Google Scholar and Elsevier databases. A total of 12 papers were included. Results The majority of successful interventions are based on a goal setting approach where the older people are involved in the definition of the strategy to follow to remain active and independent. None of the study have used the IC as a framework to design a clinical intervention. Conclusion To the best of our knowledge, no other reviews are reported in the literature regarding the IC. Our study offers several research directions, which may take the existing debates to the next level.
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Affiliation(s)
| | - Luca Soraci
- Unit of Geriatric Medicine, IRCCS INRCA, Cosenza, Italy
| | - Vera Stara
- Scientific Direction, IRCCS INRCA, Ancona, Italy
| | | | - Andrea Corsonello
- Unit of Geriatric Medicine, IRCCS INRCA, Cosenza, Italy
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, Cosenza, Italy
| | | | | | - Sara Casaccia
- Department of Industrial Engineering and Mathematical Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Johanna Möller
- Department Elderly Care, Diocesan Caritas Association for the Archdiocese of Cologne, Cologne, Germany
| | - Rainer Wieching
- Universität Siegen, Wirtschaftsinformatik und Neue Medien, Siegen, Germany
| | - Toshimi Ogawa
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | | | - Keisuke Kokobun
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | - Izumi Kondo
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Eiko Takano
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
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8
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Vance DE, Lee Y, Batey DS, Li W, Chapman Lambert C, Nakkina SR, Anderson JN, Triebel K, Byun JY, Fazeli PL. Emerging directions of cognitive aging with HIV: practice and policy implications for social work. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022; 65:476-494. [PMID: 34511048 DOI: 10.1080/01634372.2021.1978028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
Cognitive impairments have been endemic to the HIV epidemic since its beginning and persist to this day. These impairments are attributed to HIV-induced neuroinflammation, the long-term effects of combination antiretroviral therapy, lifestyle factors (e.g., sedentary behavior, substance use), neuro-comorbidities (e.g., depression), age-associated comorbidities (e.g., heart disease, hypertension), and others causes. Normal aging and lifestyle also contribute to the development of cognitive impairment. Regardless of the etiology, such cognitive impairments interfere with HIV care (e.g., medication adherence) and everyday functioning (e.g., driving safely, financial management). With more than half of people with HIV (PWH) 50 years and older, and ~45% of all PWH meeting the criteria for HIV-Associated Neurocognitive Disorder (HAND), those aging PWH are more vulnerable for developing cognitive impairment. This article provides an update to a social work model to identify and monitor PWH for cognitive impairment. Within this update, the state of the science on protecting brain health and cognitive reserve within the context of neuroHIV is also presented. From this, implications for practice and policy to promote successful cognitive functioning in older PWH are provided.
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Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yookyong Lee
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David Scott Batey
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Wei Li
- Department of Clinical and Diagnostic Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Sai Rashmi Nakkina
- College of Arts and Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Joseph N Anderson
- School of Medicine, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kristen Triebel
- School of Medicine, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Brasser M, Frühholz S, Schneeberger AR, Ruschetti GG, Schaerli R, Häner M, Studer-Luethi B. A Randomized Controlled Trial Study of a Multimodal Intervention vs. Cognitive Training to Foster Cognitive and Affective Health in Older Adults. Front Psychol 2022; 13:866613. [PMID: 35795412 PMCID: PMC9251428 DOI: 10.3389/fpsyg.2022.866613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022] Open
Abstract
Research over the past few decades has shown the positive influence that cognitive, social, and physical activities have on older adults' cognitive and affective health. Especially interventions in health-related behaviors, such as cognitive activation, physical activity, social activity, nutrition, mindfulness, and creativity, have shown to be particularly beneficial. Whereas most intervention studies apply unimodal interventions, such as cognitive training (CT), this study investigates the potential to foster cognitive and affective health factors of older adults by means of an autonomy-supportive multimodal intervention (MMI). The intervention integrates everyday life recommendations for six evidence-based areas combined with psychoeducational information. This randomized controlled trial study compares the effects of a MMI and CT on those of a waiting control group (WCG) on cognitive and affective factors, everyday life memory performance, and activity in everyday life. Three groups, including a total of 119 adults aged 65-86 years, attended a 5- or 10-week intervention. Specifically, one group completed a 10-week MMI, the second group completed 5-week of computer-based CT followed by a 5-week MMI, whereas the third group paused before completing the MMI for the last 5 weeks. All participants completed online surveys and cognitive tests at three test points. The findings showed an increase in the number and variability of activities in the everyday lives of all participants. Post hoc analysis on cognitive performance of MMI to CT indicate similar (classic memory and attention) or better (working memory) effects. Furthermore, results on far transfer variables showed interesting trends in favor of the MMI, such as increased well-being and attitude toward the aging brain. Also, the MMI group showed the biggest perceived improvements out of all groups for all self-reported personal variables (memory in everyday life and stress). The results implicate a positive trend toward MMI on cognitive and affective factors of older adults. These tendencies show the potential of a multimodal approach compared to training a specific cognitive function. Moreover, the findings suggest that information about MMI motivates participants to increase activity variability and frequency in everyday life. Finally, the results could also have implications for the primary prevention of neurocognitive deficits and degenerative diseases.
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Affiliation(s)
- Maria Brasser
- Cognitive and Affective Neuroscience Unit, University of Zürich, Zürich, Switzerland
| | - Sascha Frühholz
- Cognitive and Affective Neuroscience Unit, University of Zürich, Zürich, Switzerland
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Andres R. Schneeberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, Zürich, Switzerland
| | | | - Rahel Schaerli
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Michèle Häner
- Department of Psychology, University of Bern, Bern, Switzerland
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10
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Mace RA, Greenberg J, Stauder M, Reynolds G, Vranceanu AM. My Healthy Brain: a multimodal lifestyle program to promote brain health. Aging Ment Health 2022; 26:980-991. [PMID: 33784902 DOI: 10.1080/13607863.2021.1904828] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Promoting brain health depends on sustaining healthy behaviors across the lifespan. Yet, public adoption of lifestyle behaviors and knowledge of cognitive decline (CD) prevention remains poor. Our multidisciplinary team developed My Healthy Brain (MHB) to promote a healthy lifestyle (e.g. diet, exercise, alcohol, sleep) and build cognitive reserve (e.g. memory compensatory strategies). Our objective was to demonstrate early proof-of-concept for MHB by exploring the feasibility, acceptability, and improvement in primary lifestyle outcomes as well as secondary outcomes of self-determination and subjective wellbeing. MATERIALS AND METHODS Older adults with subjective (self-report only) or objective (confirmed by cognitive testing) CD, referred by neurologists to modify lifestyle risk factors (e.g. sedentary), participated in a non-randomized open pilot of MHB (N = 24). Participants completed the 8-week MHB group (90 min each) and pre-post outcome measures. RESULTS MHB met all a-priori set benchmarks, including good feasibility of recruitment (71% of patients screened) and enrollment (75% completed baseline), and good acceptability of treatment (75% completed 6 of 8 sessions and post-testing). Program satisfaction was excellent (100% of participants) and no adverse events were reported. We also observed improvements in primary lifestyle outcomes as well as secondary outcomes of self-determination and subjective well-being. DISCUSSION While MHB demonstrated preliminary feasibility and the potential to modify lifestyle risk factors for CD, the program can be improved. Future work will explore the integration of mindfulness skills with behavioral principles to bolster multidomain lifestyle change, and the live video delivery format to bypass barriers to participation.
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Affiliation(s)
- Ryan A Mace
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Matthew Stauder
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Gretchen Reynolds
- Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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11
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Healthy Lifestyle Behaviors and Viewpoints Among Members of an Alzheimer Prevention Registry. Alzheimer Dis Assoc Disord 2022; 36:111-117. [PMID: 35288521 DOI: 10.1097/wad.0000000000000496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 01/03/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research on Alzheimer disease and related dementias is increasingly focused on preventative strategies to target modifiable risk factors (eg, exercise, diet, cognitive stimulation) to reduce risk of cognitive decline, though it remains difficult for adults to adopt and maintain these behaviors on their own. METHODS/PARTICIPANTS In this survey study, we examined knowledge about modifiable risk factors for dementia, engagement in healthy lifestyle behaviors, and associated barriers/facilitators in an Alzheimer disease prevention registry of at-risk, cognitively normal adults (n=135: 77% female; 96% Caucasian and non-Hispanic; mean age=66.1; 79% with family history of dementia; 46% with subjective memory decline). RESULTS Participants reported high levels of engagement in exercise (mean 3.4 d/wk), a healthy diet (60% with a healthy/balanced diet), and cognitive stimulation (52% engaging in cognitive stimulation 3 to 7 d/wk), and most (56% to 57%) reported moderate to high knowledge about dementia and modifiable risk factors. Family history of dementia was associated with greater knowledge of risk factors for dementia (P=0.017), but not with knowledge of lifestyle recommendations to reduce risk (P=0.85). Most participants (63%) reported a preference for walking/running over other types of aerobic exercise. On average, participants reported that they would be willing to increase healthy lifestyle behaviors to achieve "moderate" risk reduction for dementia (∼21% to 23%, on a scale from 0% to 40%, reflecting mildly to substantially reduced risk). CONCLUSION Results broaden our understanding of current habits and willingness to engage in healthy lifestyle behaviors, which may inform individualized lifestyle interventions and/or design of prevention trials, particularly among at-risk adults with subjective or mild cognitive concerns, who may be especially motivated and able to engage in lifestyle interventions, to optimize brain health and reduce risk of cognitive decline.
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Meng X, Fang S, Zhang S, Li H, Ma D, Ye Y, Su J, Sun J. Multidomain lifestyle interventions for cognition and the risk of dementia: A systematic review and meta-analysis. Int J Nurs Stud 2022; 130:104236. [DOI: 10.1016/j.ijnurstu.2022.104236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/12/2022] [Accepted: 03/14/2022] [Indexed: 11/15/2022]
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13
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Ngandu T, Lehtisalo J, Korkki S, Solomon A, Coley N, Antikainen R, Bäckman L, Hänninen T, Lindström J, Laatikainen T, Paajanen T, Havulinna S, Peltonen M, Neely AS, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. The effect of adherence on cognition in a multidomain lifestyle intervention (FINGER). Alzheimers Dement 2021; 18:1325-1334. [PMID: 34668644 DOI: 10.1002/alz.12492] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/02/2021] [Accepted: 09/07/2021] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Lifestyle interventions may prevent cognitive decline, but the sufficient dose of intervention activities and lifestyle changes is unknown. We investigated how intervention adherence affects cognition in the FINGER trial (pre-specified subgroup analyses). METHODS FINGER is a multicenter randomized controlled trial examining the efficacy of multidomain lifestyle intervention (ClinicalTrials.gov NCT01041989). A total of 1260 participants aged 60 to 77 with increased dementia risk were randomized to a lifestyle intervention and control groups. Percentage of completed intervention sessions, and change in multidomain lifestyle score (self-reported diet; physical, cognitive, and social activity; vascular risk) were examined in relation to change in Neuropsychological Test Battery (NTB) scores. RESULTS Active participation was associated with better trajectories in NTB total and all cognitive subdomains. Improvement in lifestyle was associated with improvement in NTB total and executive function. DISCUSSION Multidomain lifestyle changes are beneficial for cognitive functioning, but future interventions should be intensive enough, and supporting adherence is essential.
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Affiliation(s)
- Tiia Ngandu
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Jenni Lehtisalo
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
| | - Saana Korkki
- Department of Psychology, University of Cambridge, Cambridge, UK.,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Alina Solomon
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Stockholm, Sweden.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Nicola Coley
- Faculté de Médecine, INSERM-University of Toulouse UMR1295 (CERPOP), Toulouse, France.,Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Riitta Antikainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Lars Bäckman
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Tuomo Hänninen
- Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Jaana Lindström
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Joint municipal authority for North Karelia social and health services (Siun sote), Joensuu, Finland
| | - Teemu Paajanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Satu Havulinna
- Department of Public Health and Welfare, Functioning and Service Needs Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Markku Peltonen
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Anna Stigsdotter Neely
- Department of Social Psychological Sciences, Karlstad University, Karlstad, Sweden.,Engineering Psychology, Luleå University of Technology, Luleå, Sweden
| | - Timo Strandberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland.,Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.,South Ostrobothnia Central Hospital, Seinäjoki, Finland
| | - Hilkka Soininen
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Miia Kivipelto
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Stockholm, Sweden.,Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Theme Aging, Karolinska University Hospital, Solna, Sweden
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14
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Cox KL, Clare L, Cyarto EV, Ellis KA, Etherton-Beer C, Southam J, Ames D, Flicker L, Almeida OP, LoGiudice D, Liew D, Vlaskovsky P, Lautenschlager NT. A Randomized Controlled Trial on the Effects of a 6-Month Home-Based Physical Activity Program with Individual Goal-Setting and Volunteer Mentors on Physical Activity, Adherence, and Physical Fitness in Inactive Older Adults at Risk of Cognitive Decline: The INDIGO Study. J Alzheimers Dis 2021; 84:207-226. [PMID: 34511499 DOI: 10.3233/jad-210479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Increasing physical activity (PA) in those who have memory concerns requires innovative approaches. OBJECTIVE To compare in this randomized controlled trial (RCT) the effects on PA, adherence, and fitness of two approaches to deliver a 6-month home-based PA program in older, inactive individuals at risk of cognitive decline. METHODS Individuals (n = 52) aged 60-85 years, inactive with mild cognitive impairment or subjective cognitive decline were recruited from the community and memory clinics. Randomization was to 6 months of 150 min/week moderate intensity PA with either: goal-setting with mentor support; or education and peer contact. A subset of participants (n = 36) continued for a further 6 months. PA, moderate and vigorous PA, and secondary outcomes, fitness, goal performance/satisfaction and self-efficacy were assessed at baseline, 6 and 12 months. Modelling of primary and secondary outcomes was conducted with linear mixed models. RESULTS Participants were mean age (±sd) 70.1 (6.4) years. Six-month retention was 88.5%(n = 46). No significant between-group differences were observed for PA or fitness. Post-hoc combined group data showed a significant, moderate-large effect size increase in PA with time. PA increased by a mean 1,662 (943, 2383) steps/day (95%CI) and 1,320 (603, 2037) steps/day at 6 and 12 months (p < 0.001). Median (quartiles Q1-Q3) 6 and 6-12 month combined group adherence was 88.9 (74.4-95.7)%and 84.6 (73.9-95.4)%respectively. CONCLUSION In this target group, no differences were detected between groups both intervention strategies were highly effective in increasing PA and fitness.
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Affiliation(s)
- Kay L Cox
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, College of Medicine and Health, University ofExeter, UK
| | - Elizabeth V Cyarto
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Bolton Clarke Research Institute, Brisbane, Australia.,Faculty of Health and Behavioural Sciences, The University of Queensland, Qld, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Christopher Etherton-Beer
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
| | - Jenny Southam
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - David Ames
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,St George's Hospital, Kew, Victoria, Australia
| | - Leon Flicker
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
| | - Osvaldo P Almeida
- Medical School, University of Western Australia, Perth, Australia.,Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia
| | - Dina LoGiudice
- Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Philip Vlaskovsky
- Royal Perth Hospital Research Foundation Biostatistical Unit, Perth, Australia
| | - Nicola T Lautenschlager
- Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia.,Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,North Western Mental Health, Royal Melbourne Hospital, Melbourne, Australia
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Boyd B, McAlister C, Arrotta K, Schmitter-Edgecombe M. Self-Reported Behavior Change and Predictors of Engagement With a Multidomain Brain Health Intervention for Midlife and Older Adults: A Pilot Clinical Trial. J Aging Health 2021; 34:109-119. [PMID: 34266343 DOI: 10.1177/08982643211032483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study evaluated the efficacy of a multidomain brain health intervention on health behavior change and sought to understand whether health literacy or brain health knowledge predicted engagement with the intervention. METHODS One-hundred thirty midlife and older adults were assigned to one of three intervention conditions: brain fitness (B-Fit) utilizing education and goal setting, education-only, or waitlist. Questionnaires were completed at baseline and post-intervention. RESULTS Both B-Fit and education-only conditions reported improvements in health behaviors over time. Although effect size for the education-only condition was moderate, only the B-Fit condition differed significantly in health behaviors from the waitlist post-intervention. Lower baseline brain health knowledge predicted improvements in health behaviors for education-only condition. DISCUSSION The multidomain brain health intervention was successful in helping participants change their behaviors, but it was not more effective than the education-only condition. For those with lower brain health knowledge, an education-only intervention may be sufficient to encourage behavior change.
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Affiliation(s)
- Brenna Boyd
- 6760Washington State University, Pullman, WA, USA
| | | | - Kayela Arrotta
- Neurological Institute, Cleveland, OH, USA.,Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA
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Waldrop D, Irwin C, Nicholson WC, Lee CA, Webel A, Fazeli PL, Vance DE. The Intersection of Cognitive Ability and HIV: A Review of the State of the Nursing Science. J Assoc Nurses AIDS Care 2021; 32:306-321. [PMID: 33449578 PMCID: PMC8091162 DOI: 10.1097/jnc.0000000000000232] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Neurocognitive problems have been endemic to the HIV epidemic since its beginning. Four decades later, these problems persist, but currently, they are attributed to HIV-induced inflammation, the long-term effects of combination antiretroviral therapy, lifestyle (i.e., physical activity, drug use), psychiatric, and age-associated comorbidities (i.e., heart disease, hypertension). In many cases, persons living with HIV (PLWH) may develop cognitive problems as a function of accelerated or accentuated normal aging and lifestyle rather than HIV itself. Nonetheless, such cognitive impairments can interfere with HIV care, including medication adherence and attending clinic appointments. With more than half of PLWH 50 years and older, and 30%-50% of all PLWH meeting the criteria for HIV-associated neurocognitive disorder, those aging with HIV may be more vulnerable to developing cognitive problems. This state of the science article provides an overview of current issues and provides implications for practice, policy, and research to promote successful cognitive functioning in PLWH.
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Affiliation(s)
- Drenna Waldrop
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Crista Irwin
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - W. Chance Nicholson
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cheryl A. Lee
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Allison Webel
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L. Fazeli
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David E. Vance
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Wu CY, Rodakowski JL, Terhorst L, Karp JF, Fields B, Skidmore ER. A Scoping Review of Nonpharmacological Interventions to Reduce Disability in Older Adults. THE GERONTOLOGIST 2020; 60:e52-e65. [PMID: 31002312 DOI: 10.1093/geront/gnz026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Minimizing disability is critical to reduce the costly health care associated with disability and maintain quality of life into old age. We examined the effect sizes of nonpharmacological intervention studies in reducing disability and explored the active ingredients of interventions. RESEARCH DESIGN AND METHODS A scoping review was conducted via PubMed, PsycINFO, and CINAHL databases. Thirty-one randomized controlled trials were included. Eight active ingredients were identified by three experts (exercise, problem-solving, cognitive behavioral therapy, environmental modification, education, goal setting, comprehensive geriatric assessment, and cognitive training). RESULTS The range of Cohen's d was -0.85 to 1.76 across 31 studies (included 33 interventions); 67% studies (n = 22) obtained small-to-negative effect sizes (d = -0.85 to 0.18), accounting for 83% participants across studies. Interventions that incorporated exercise, problem-solving, cognitive behavior therapy, and environmental modification were associated with stronger effect sizes. Interventions that incorporated comprehensive geriatric assessment obtained small effect sizes. DISCUSSION AND IMPLICATIONS Majority of intervention studies found little or no effect in reducing disability for older adults. To optimize the effects of nonpharmacological interventions, we recommend researchers to (i) develop a screening tool for "risk of disability" to inform those who are early on the disability progression, yet not experience any difficulties in activities of daily living and instrumental activities of daily living; (ii) specify the active ingredients embedded in complex interventions to facilitate change in disability; and (iii) select sensitive tools to capture the progression of disability in late life.
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Affiliation(s)
- Chao-Yi Wu
- Department of Occupational Therapy, School of Health and Rehabilitation Science, Pennsylvania
| | - Juleen L Rodakowski
- Department of Occupational Therapy, School of Health and Rehabilitation Science, Pennsylvania.,Clinical and Translational Institute, School of Nursing, Pennsylvania
| | - Lauren Terhorst
- Department of Occupational Therapy, School of Health and Rehabilitation Science, Pennsylvania.,Clinical and Translational Institute, School of Nursing, Pennsylvania.,Department of Health and Community Systems, School of Nursing, Pennsylvania
| | - Jordan F Karp
- Department of Psychiatry, School of Medicine, Pennsylvania.,Department of Anesthesiology, School of Medicine, Pennsylvania
| | - Beth Fields
- Center for Caregiving Research, Education and Policy, Pennsylvania.,Center for Health Equity and Research Promotion, Veterans Affairs Pittsburgh Healthcare System, Pennsylvania
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, School of Health and Rehabilitation Science, Pennsylvania.,Clinical and Translational Institute, School of Nursing, Pennsylvania.,Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pennsylvania
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Effective implementation approaches for healthy ageing interventions for older people: A rapid review. Arch Gerontol Geriatr 2020; 92:104263. [PMID: 33010790 DOI: 10.1016/j.archger.2020.104263] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/16/2020] [Accepted: 09/19/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVES Systematic reviews on healthy ageing interventions have primarily focused on assessing their effectiveness, not the implementation processes underpinning them, and the factors influencing program effectiveness. This has created a knowledge gap about what are effective implementation approaches, and how to scale up such interventions at the population level. Our aim in this rapid review was to synthesise the evidence on implementation of effective healthy ageing interventions, and to identify the factors that influence population-level implementation of these interventions. DESIGN AND METHODS Following the PRISMA checklist, we searched for papers in six databases: Ovid Medline, Ovid Embase, CENTRAL, CINAHL, PsycArticles and PsycINFO. A narrative synthesis was used to summarise the results. RESULTS Twenty-nine articles reporting on 21 healthy ageing interventions (studies) were included in the review. The findings show that a wide range of approaches to implementation were used including collaborative partnership, co-design, use of volunteers, person centred-care, and self-directed/professional-led approaches. The key implementation drivers were the use of behavioural change techniques, social interaction, tailoring of interventions, booster sessions, and multi-component and multi-professional team approach to intervention design and delivery. CONCLUSION The effectiveness of healthy ageing interventions is contingent on a number of factors including the type of implementation approaches used, the context in which programs are implemented, and the specific mechanisms that may be at play at the individual older adult level.
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Cognitive Reserve Over the Lifespan: Neurocognitive Implications for Aging With HIV. J Assoc Nurses AIDS Care 2020; 30:e109-e121. [PMID: 30865059 DOI: 10.1097/jnc.0000000000000071] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Approximately 59% of adults living with HIV experience HIV-associated neurocognitive disorder, a collection of symptoms and cognitive deficits in various cognitive domains. As the HIV population ages, the prevalence and severity of such cognitive deficits are expected to grow. Understanding how these cognitive deficits manifest is important for nurses and health care providers. This article provides an overview of cognitive reserve and evidence of how it is compromised by HIV, aging, and individual characteristics. Within this context of cognitive reserve, the role of neuroinflammation, neurotoxicity, substance use, comorbidities, depression and anxiety, social isolation, and sedentary lifestyle is reviewed. From this, strategies used to address cognitive deficits are provided, including topics such as psychostimulants, cognitive training, multimodal lifestyle interventions, and compensation strategies. Scenarios of successful and unsuccessful cognitive aging are presented to provide a lifespan perspective of cognitive reserve. Implications for clinical practice and research are provided, as it relates to aging.
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Clare L, Kudlicka A, Oyebode JR, Jones RW, Bayer A, Leroi I, Kopelman M, James IA, Culverwell A, Pool J, Brand A, Henderson C, Hoare Z, Knapp M, Morgan-Trimmer S, Burns A, Corbett A, Whitaker R, Woods B. Goal-oriented cognitive rehabilitation for early-stage Alzheimer's and related dementias: the GREAT RCT. Health Technol Assess 2020; 23:1-242. [PMID: 30879470 DOI: 10.3310/hta23100] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cognitive rehabilitation (CR) is an individualised, person-centred intervention for people with mild to moderate dementia that addresses the impact of cognitive impairment on everyday functioning. OBJECTIVES To determine whether or not CR is a clinically effective and cost-effective intervention for people with mild to moderate Alzheimer's disease or vascular or mixed dementia, and their carers. DESIGN This multicentre randomised controlled trial compared CR with treatment as usual (TAU). Following a baseline assessment and goal-setting to identify areas of everyday functioning that could be improved or better managed, participants were randomised (1 : 1) via secure web access to an independent randomisation centre to receive either TAU or CR and followed up at 3 and 9 months post randomisation. SETTING Community. PARTICIPANTS Participants had an International Classification of Diseases, Tenth Edition, diagnosis of Alzheimer's disease or vascular or mixed dementia, had mild to moderate cognitive impairment (Mini Mental State Examination score of ≥ 18 points), were stable on medication if prescribed, and had a family carer who was willing to contribute. The exclusion criteria were people with a history of brain injury or other neurological disorder and an inability to speak English. To achieve adequate power, we needed 350 people to complete the trial, with 175 people in each trial arm. INTERVENTION Cognitive rehabilitation consisted of 10 therapy sessions over 3 months, followed by four maintenance sessions over 6 months, delivered in participants' homes. The therapists were nine occupational therapists and one nurse. OUTCOME MEASURES The primary outcome was self-reported goal attainment at 3 months. Goal attainment was also assessed at 9 months. Carers provided independent ratings of goal attainment at both time points. The secondary outcomes were participant quality of life, mood, self-efficacy and cognition, and carer stress, health status and quality of life. The assessments at 3 and 9 months were conducted by researchers who were blind to the participants' group allocation. RESULTS A total of 475 participants were randomised (CR arm, n = 239; TAU arm, n = 236), 427 participants (90%) completed the trial and 426 participants were analysed (CR arm, n = 208, TAU arm, n = 218). At 3 months, there were statistically significant large positive effects for participant-rated goal attainment [mean change in the CR arm: 2.57; mean change in the TAU arm: 0.86; Cohen'sd = 0.97, 95% confidence interval (CI) 0.75 to 1.19], corroborated by carer ratings (Cohen'sd = 1.11, 95% CI 0.89 to 1.34). These effects were maintained at 9 months for both the participant ratings (Cohen's d = 0.94, 95% CI 0.71 to 1.17) and the carer ratings (Cohen's d = 0.96, 95% CI 0.73 to 1.20). There were no significant differences in the secondary outcomes. In the cost-utility analyses, there was no evidence of cost-effectiveness in terms of gains in the quality-adjusted life-years (QALYs) of the person with dementia (measured using the DEMentia Quality Of Life questionnaire utility score) or the QALYs of the carer (measured using the EuroQol-5 Dimensions, three-level version) from either cost perspective. In the cost-effectiveness analyses, by reference to the primary outcome of participant-rated goal attainment, CR was cost-effective from both the health and social care perspective and the societal perspective at willingness-to-pay values of £2500 and above for improvement in the goal attainment measure. There was no evidence on the cost-effectiveness of the self-efficacy measure (the Generalized Self-Efficacy Scale) from either cost perspective. LIMITATIONS Possible limitations arose from the non-feasibility of using observational outcome measures, the lack of a general measure of functional ability and the exclusion of people without a carer or with rarer forms of dementia. CONCLUSIONS Cognitive rehabilitation is clinically effective in enabling people with early-stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy sessions. FUTURE WORK Next steps will focus on the implementation of CR into NHS and social care services and on extending the approach to people with rarer forms of dementia. TRIAL REGISTRATION Current Controlled Trials ISRCTN21027481. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 10. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Linda Clare
- Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - Aleksandra Kudlicka
- Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - Jan R Oyebode
- School of Dementia Studies, University of Bradford, Bradford, UK
| | - Roy W Jones
- Research Institute for the Care of Older People (RICE), Bath, UK
| | - Antony Bayer
- Division of Population Medicine, University Hospital Llandough, Cardiff University, Cardiff, UK
| | - Iracema Leroi
- Department of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Michael Kopelman
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, St Thomas' Hospital, King's College London, London, UK
| | - Ian A James
- Centre of the Health of the Elderly, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Alison Culverwell
- Kent and Medway NHS and Social Care Partnership Trust, St Martin's Hospital, Canterbury, UK
| | | | - Andrew Brand
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, UK
| | - Catherine Henderson
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Zoe Hoare
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, UK
| | - Martin Knapp
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | | | - Alistair Burns
- Department of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Anne Corbett
- Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | | | - Bob Woods
- Dementia Services Development Centre, Bangor University, Bangor, UK
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Whitty E, Mansour H, Aguirre E, Palomo M, Charlesworth G, Ramjee S, Poppe M, Brodaty H, Kales HC, Morgan-Trimmer S, Nyman SR, Lang I, Walters K, Petersen I, Wenborn J, Minihane AM, Ritchie K, Huntley J, Walker Z, Cooper C. Efficacy of lifestyle and psychosocial interventions in reducing cognitive decline in older people: Systematic review. Ageing Res Rev 2020; 62:101113. [PMID: 32534025 DOI: 10.1016/j.arr.2020.101113] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/20/2020] [Accepted: 06/08/2020] [Indexed: 01/06/2023]
Abstract
It is unclear what non-pharmacological interventions to prevent cognitive decline should comprise. We systematically reviewed lifestyle and psychosocial interventions that aimed to reduce cognitive decline in healthy people aged 50+, and people of any age with Subjective Cognitive Decline or Mild Cognitive Impairment. We narratively synthesised evidence, prioritising results from studies rated as at lower Risk of Bias (ROB) and assigning Centre for Evidence Based Medicine grades. We included 64 papers, describing: psychosocial (n = 12), multi-domain (n = 10), exercise (n = 36), and dietary (n = 6) interventions. We found Grade A evidence that over 4+ months: aerobic exercise twice weekly had a moderate effect on global cognition in people with/ without MCI; and interventions that integrate cognitive and motor challenges (e.g. dance, dumb bell training) had small to moderate effects on memory or global cognition in people with MCI. We found Grade B evidence that 4+ months of creative art or story-telling groups in people with MCI; 6 months of resistance training in people with MCI and a two-year, dietary, exercise, cognitive training and social intervention in people with or without MCI had small, positive effects on global cognition. Effects for some intervention remained up to a year beyond facilitated sessions.
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Promotion of Healthy Aging Within a Community Center Through Behavior Change: Health and Fitness Findings From the AgeWell Pilot Randomized Controlled Trial. J Aging Phys Act 2020; 29:80-88. [PMID: 32781433 DOI: 10.1123/japa.2019-0396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 11/18/2022]
Abstract
The purpose of this randomized controlled trial was to determine if behavior change through individual goal setting (GS) could promote healthy aging, including health and fitness benefits in older adults who attended a community "AgeWell" Center for 12 months. Seventy-five older adults were randomly allocated to either a control or a GS group. Health outcomes were measured at baseline and after 12 months of the participants' having access to the exception of Agewell Center facilities. The findings demonstrate that participation in the Center in itself was beneficial, with improved body composition and reduced cardiovascular risk in both groups (p < .05), and that this kind of community-based resource offers valuable potential for promoting protective behaviors and reducing health risk. However, a specific focus on identifying individual behavior change goals was required in order to achieve increased activity engagement (p < .05) and to bring about more substantial improvements in a range of health, diet, and physical function measures (p < .05).
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23
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Proud L, McLoughlin C, Kinghorn P. ICECAP-O, the current state of play: a systematic review of studies reporting the psychometric properties and use of the instrument over the decade since its publication. Qual Life Res 2019; 28:1429-1439. [PMID: 30666550 PMCID: PMC6522451 DOI: 10.1007/s11136-019-02114-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE A paper reporting the development of the ICECAP-O was published in 2006. Since then, there has been increasing interest in the use of capability-based measures within health economics and the ICECAP-O has been suggested for use in economic evaluation by decision-making bodies in the Netherlands and UK. METHODS A systematic review of studies published between January 2006 and October 2018 which have assessed the psychometric properties of ICECAP-O or utilised the measure within economic evaluation. RESULTS Twenty-four studies explored the psychometric properties of ICECAP-O and 21 have utilised the measure within economic evaluation; one study reported psychometric properties as well as utilising the measure within economic evaluation. The ICECAP-O has good construct validity and responsiveness, but there is evidence of some issues relating to content validity. In the context of economic evaluation, the ICECAP-O has, to date, mainly been included as a secondary economic measure and the reporting of results is brief with minimal detail and often no discussion. Five of the economic evaluation studies combined scores from ICECAP-O with time, but each used different terminology to describe this result. CONCLUSION Focus, in terms of publications, appears to have shifted now from assessment of psychometric properties to the utilisation of the ICECAP-O within economic evaluation. Further research is needed with respect to a decision-rule for the ICECAP measures. This additional research should also guide users in terms of appropriate analysis, terminology and presentation of results, which are in-keeping with the conceptual framework underpinning the ICECAP-O.
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Affiliation(s)
- Louise Proud
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, B15 2TT, Edgbaston, UK
| | - Carol McLoughlin
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, B15 2TT, Edgbaston, UK
| | - Philip Kinghorn
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, B15 2TT, Edgbaston, UK.
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24
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Jones CA, Siever J, Knuff K, Van Bergen C, Mick P, Little J, Jones G, Murphy MA, Kurtz D, Miller H. Walk, Talk and Listen: a pilot randomised controlled trial targeting functional fitness and loneliness in older adults with hearing loss. BMJ Open 2019; 9:e026169. [PMID: 30987987 PMCID: PMC6500300 DOI: 10.1136/bmjopen-2018-026169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Age-related hearing loss (HL) is a prevalent disability associated with loneliness, isolation, declines in cognitive and physical function and premature mortality. Group audiological rehabilitation (GAR) and hearing technologies address communication and cognitive decline. However, the relationship between loneliness, physical function and GAR among older adults with HL has not been studied. OBJECTIVES Explore the impact of a group exercise and socialisation/health education intervention and GAR on physical function and loneliness among older adults with HL. TRIAL DESIGN A Young Men's Christian Association (YMCA)-based, 10-week, single-blind, pilot randomised controlled trial (RCT). PARTICIPANTS Ambulatory adults aged 65 years or older with self-reported HL. INTERVENTIONS Seventy-one participants were screened. Thirty-five were randomised to intervention (strength and resistance exercise, socialisation/health education) and GAR (hearing education, communication strategies, psychosocial support) or control (n=31): GAR only. OUTCOMES Ninety-five per cent of eligible participants were randomised. GAR and exercise adherence rates were 80% and 85%, respectively. 88% of participants completed the study. Intervention group functional fitness improved significantly (gait speed: effect size: 0.57, 30 s Sit to Stand Test: effect size: 0.53). Significant improvements in emotional and social loneliness (effect size: 1.16) and hearing-related quality of life (effect size: 0.76) were related to GAR attendance and poorer baseline hearing-related quality of life. Forty-two per cent of participants increased social contacts outside the study. DISCUSSION Walk, Talk and Listen was feasible and acceptable. Exercise and socialisation/health education improved loneliness and key fitness measures but provided no additional benefit to GAR only for loneliness. This is the first preliminary evidence about the benefits of exercise on fitness and GAR on loneliness among older adults with HL. IMPLICATIONS This pilot trial provides key information on the sample size required for a larger, longer term RCT to determine the enduring effects of this holistic intervention addressing the negative psychosocial and musculoskeletal downstream effects of HL among older adults.
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Affiliation(s)
- Charlotte A Jones
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jodi Siever
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | - Kate Knuff
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | | | - Paul Mick
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jonathan Little
- Health and Exercise Science, University of British Columbia Okanagan Faculty of Health and Social Development, Kelowna, British Columbia, Canada
| | - Gareth Jones
- School of Health and Exercise Science, University of British Columbia, Kelowna, British Columbia, Canada
| | - Mary-Ann Murphy
- Social Work/Sociology, University of British Columbia, Kelowna, British Columbia, Canada
| | - Donna Kurtz
- Irving K Barber School of Arts and Social Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Harry Miller
- Medicine, University of British Columbia, Kelowna, British Columbia, Canada
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25
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Casadei GR, Silva ES, Oliveira LPD, Bennemann RM. Coaching as a strategy for the health promotion of the elderly: a systematic review. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2019. [DOI: 10.1590/1981-22562019022.190056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: To evaluate the effect of the application of coaching on the health promotion of the elderly. Method: A systematic review was performed in the PubMed, MEDLINE and SciELO databases. The selection of articles followed the PRISMA guidelines, and the articles were published from 2008 to July 2018. The following descriptors were used: aged (idoso, anciano), elderly (idoso, anciano), coaching (tutoria, tutoría), mentoring (tutoria, tutoría) and health promotion (promoção da saúde, promoción de la salud). Boolean operators were used for all databases: (coaching OR mentoring) AND (health promotion) AND (aged OR elderly); (idoso) AND (tutoria OR coaching) AND (promoção da saúde); (anciano) AND (tutoría OR coaching) AND (promoción de la salud). Results: The final analysis included three articles. These evaluated coaching tools for changes in lifestyle and the reduction of health risks for the elderly. The results were positive, with a significant improvement in the quality of life (mental and physical), health status, goal attainment, self-efficacy and increased immunization of the evaluated elderly persons. Conclusion: The use of coaching in health promotion in elderly is still incipient, however, based on the results, health coaching proved to be an effective strategy to enable the elderly to reach the maximum potential of self-management in health.
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26
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Seah B, Kowitlawakul Y, Jiang Y, Ang E, Chokkanathan S, Wang W. A review on healthy ageing interventions addressing physical, mental and social health of independent community-dwelling older adults. Geriatr Nurs 2019; 40:37-50. [DOI: 10.1016/j.gerinurse.2018.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/01/2018] [Indexed: 01/23/2023]
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Lehtisalo J, Levälahti E, Lindström J, Hänninen T, Paajanen T, Peltonen M, Antikainen R, Laatikainen T, Strandberg T, Soininen H, Tuomilehto J, Kivipelto M, Ngandu T. Dietary changes and cognition over 2 years within a multidomain intervention trial-The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Alzheimers Dement 2018; 15:410-417. [PMID: 30527596 DOI: 10.1016/j.jalz.2018.10.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/02/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Association between healthy diet and better cognition is well established, but evidence is limited to evaluate the effect of dietary changes adopted in older age. METHODS We investigated the role of dietary changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) with 1260 at-risk participants (60-77 years) who were randomized to intensive multidomain intervention (including dietary counseling) or regular health advice for 2 years. Parallel process latent growth curves of adherence to dietary recommendations and cognitive performance were analyzed. RESULTS Adherence to healthy diet at baseline predicted improvement in global cognition, regardless of intervention allocation (P = .003). Dietary improvement was associated with beneficial changes in executive function, especially in the intervention group (P = .008; P = .051 for groups combined). DISCUSSION Dietary changes initiated during the intervention were related to changes in executive function in 2 years. Long-term diet appeared more influential for global cognition.
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Affiliation(s)
- Jenni Lehtisalo
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Esko Levälahti
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Lindström
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Tuomo Hänninen
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Teemu Paajanen
- Research and Service Centre for Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Markku Peltonen
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Riitta Antikainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland; Oulu City Hospital, Oulu, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Joint Municipal Authority for North Karelia Social and Health Services, Joensuu, Finland
| | - Timo Strandberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland
| | - Hilkka Soininen
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland; Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; South Ostrobothnia Central Hospital, Seinäjoki, Finland; Department of Clinical Neurosciences and Preventive Medicine, Danube-University Krems, Krems, Austria; Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia; Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Miia Kivipelto
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Tiia Ngandu
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden
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Multidomain Lifestyle Intervention Strategies for the Delay of Cognitive Impairment in Healthy Aging. Nutrients 2018; 10:nu10101560. [PMID: 30347863 PMCID: PMC6212852 DOI: 10.3390/nu10101560] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/10/2018] [Accepted: 10/19/2018] [Indexed: 12/25/2022] Open
Abstract
Present demographic changes demonstrate that the number of elderly people is growing at a frenetic pace. This shift in population consequently results in many social and economic problems, which burden the social and economic systems of countries. The aging process is associated with age-related diseases, the most common of which are dementia and Alzheimer’s disease, whose main symptom is a decline in cognitive function, especially memory loss. Unfortunately, it cannot be cured. Therefore, alternative approaches, which are cost-effective, safe, and easy to implement, are being sought in order to delay and prevent cognitive impairment. The purpose of this review was to explore the effect of multidomain lifestyle intervention strategies on the delay and/or prevention of cognitive impairment in healthy older individuals. The methods are based on a literature review of available sources found on the research topic in three acknowledged databases: Web of Science, Scopus, and PubMed. The results of the identified original studies reveal that multidomain lifestyle interventions generate significant effects. In addition, these interventions seem feasible, cost-effective, and engaging. Thus, there is a call for the implementation of effective lifestyle prevention programs, which would involve goal-setting and would focus on the prevention of crucial risk factors threatening the target group of elderly people, who are at risk of cognitive decline and dementia.
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Klímová B, Vališ M. Nutritional Interventions as Beneficial Strategies to Delay Cognitive Decline in Healthy Older Individuals. Nutrients 2018; 10:nu10070905. [PMID: 30011956 PMCID: PMC6073697 DOI: 10.3390/nu10070905] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/08/2018] [Accepted: 07/13/2018] [Indexed: 11/16/2022] Open
Abstract
Current demographic trends indicate that the population is aging. The aging process is inevitably connected with cognitive decline, which manifests itself in worsening working memory, processing speed, and attention. Therefore, apart from pharmacological therapies, non-pharmacological approaches which can influence cognitive performance (such as physical activities or healthy diet), are being investigated. The purpose of this study is to explore the types of nutritional interventions and their benefits in the prevention and delay of cognitive delay in healthy older individuals. The methods used in this study include a literature review of the available studies on the research topic found in Web of Science, Scopus, and MEDLINE. The findings show that nutritional intervention has a positive impact on cognitive function in healthy older people. However, it seems that the interactions between more than one nutrient are most effective. The results reveal that specifically the Mediterranean diet appears to be effective in this respect. Moreover, the findings also indicate that multi-domain interventions including diet, exercise, cognitive training, and vascular risk monitoring have a far more significant effect on the enhancement of cognitive functions among healthy older individuals.
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Affiliation(s)
- Blanka Klímová
- Department of Applied Linguistics, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove 500 03, Czech Republic.
| | - Martin Vališ
- Department of Neurology, University Hospital Hradec Kralove, Sokolska 581, Hradec Kralove 500 05, Czech Republic.
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Nelis SM, Thom JM, Jones IR, Hindle JV, Clare L. Goal-setting to Promote a Healthier Lifestyle in Later Life: Qualitative Evaluation of the AgeWell Trial. Clin Gerontol 2018; 41:335-345. [PMID: 29308992 PMCID: PMC5942145 DOI: 10.1080/07317115.2017.1416509] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE We report a mixed method evaluation of the feasibility and implementation of the AgeWell goal-setting intervention to promote healthy ageing later life. METHOD Researcher field notes, goal-setting interview content, and semi-structured interviews with participants were content analysed to review trial implementation and participants' perspective on the goal-setting and mentoring intervention. RESULTS 75 people were recruited: 21 in the goal-setting and 22 in the goal-setting with mentoring arms of the intervention. Goal-setting was feasible in the main domains of interest. Adherence to the protocol was good and the mentoring schedule was adhered to. Participants reported satisfaction with their goal attainment, but barriers for non-achievement were also identified. Recommendations for small changes to the intervention included reducing the number of goals. CONCLUSIONS Participants understood the goal-setting process, and were able to set realistic and achievable lifestyle goals. The intervention and the procedures were acceptable but changes in how goal-setting is both introduced and monitored are needed for wider implementation. CLINICAL IMPLICATIONS Goal-setting can be a useful process to help people alter their lifestyle to allow them to age more successfully and reduce risk factors associated with dementia.
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Affiliation(s)
- Sharon M Nelis
- a Centre for Research in Ageing and Cognitive Health, College of Life and Environmental Sciences , University of Exeter , Exeter , UK.,b PenCLAHRC , Institute of Health Research, University of Exeter Medical School , Exeter , UK
| | - Jeanette M Thom
- c School of Medical Sciences , University of New South Wales , Syndey , Australia
| | - Ian Rees Jones
- d Wales Institute of Social and Economic Research, Data and Methods , Cardiff University , Cardiff , UK
| | - John V Hindle
- e College of Health and Behavioural Sciences , Bangor University , Bangor , UK
| | - Linda Clare
- a Centre for Research in Ageing and Cognitive Health, College of Life and Environmental Sciences , University of Exeter , Exeter , UK.,b PenCLAHRC , Institute of Health Research, University of Exeter Medical School , Exeter , UK
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Pasco JA, Holloway KL, Stuart AL, Williams LJ, Brennan-Olsen SL, Berk M. The subjective wellbeing profile of the ‘pretiree’ demographic: A cross-sectional study. Maturitas 2018; 110:111-117. [DOI: 10.1016/j.maturitas.2018.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/22/2017] [Accepted: 02/08/2018] [Indexed: 01/18/2023]
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Cox KL, Cyarto EV, Etherton-Beer C, Ellis KA, Alfonso H, Clare L, Liew D, Ames D, Flicker L, Almeida OP, LoGiudice D, Lautenschlager NT. A randomized controlled trial of physical activity with individual goal-setting and volunteer mentors to overcome sedentary lifestyle in older adults at risk of cognitive decline: the INDIGO trial protocol. BMC Geriatr 2017; 17:215. [PMID: 28903738 PMCID: PMC5597988 DOI: 10.1186/s12877-017-0617-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 09/08/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Increasing physical activity (PA) effectively in those who are inactive is challenging. For those who have subjective memory complaints (SMC) or mild cognitive impairment (MCI) this is a greater challenge necessitating the need for more engaging and innovative approaches. The primary aim of this trial is to determine whether a home-based 6-month PA intervention with individual goal-setting and peer mentors (GM-PA) can significantly increase PA levels in insufficiently active older adults at increased risk of developing Alzheimer's disease (AD). METHODS Community living 60-80 year olds with SMC or MCI who do not engage in more than 60 min per week of moderate intensity PA will be recruited from memory clinics and the community via media advertisements to participate in this randomized, single-blind controlled trial. All participants will receive an individually tailored home-based PA program of 150 min of moderate intensity walking/week for 6 months. The intervention group will undertake individual goal-setting and behavioral education workshops with mentor support via telephone (GM-PA). Those randomized to the control group will have standard education workshops and Physical Activity Liaison (PAL) contact via telephone (CO-PA). Increase in PA is the primary outcome, fitness, cognitive, personality, demographic and clinical parameters will be measured and a health economic analysis performed. A saliva sample will be collected for APOE e4 genotyping. All participants will have a goal-setting interview to determine their PA goals. Active volunteers aged 50-85 years will be recruited from the community randomized and trained to provide peer support as mentors (intervention group) or PALS (control group) for the 6-month intervention. Mentors and PALS will have PA, exercise self-efficacy and mentoring self-efficacy measured. Participants in both groups are asked to attend 3 workshops in 6 months. At the first workshop, they will meet their allocated Mentor or PAL who will deliver their respective programs and support via 6 telephone calls during the intervention. DISCUSSION If the GM-PA program is successful in increasing the PA levels of the target group it will potentially provide another strategy and community resource that can be translated into practice. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry ACTRN12613001181796 . (29/10/2013) retrospectively registered.
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Affiliation(s)
- Kay L. Cox
- School of Medicine, University of Western Australia, Perth, Australia
| | - Elizabeth V. Cyarto
- National Ageing Research Institute, Melbourne, Australia
- Royal District Nursing Service (RDNS) Institute, Melbourne, Australia
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Christopher Etherton-Beer
- School of Medicine, University of Western Australia, Perth, Australia
- Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia
| | - Kathryn A. Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | | | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, Exeter University, Exeter, UK
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - David Ames
- National Ageing Research Institute, Melbourne, Australia
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Leon Flicker
- School of Medicine, University of Western Australia, Perth, Australia
- Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia
| | - Osvaldo P. Almeida
- Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia
- School of Psychiatry and Neurosciences University of Western Australia, Perth, Australia
| | | | - Nicola T. Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia
- North Western Mental Health, Melbourne Health, Melbourne, Australia
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Vance DE, Gakumo CA, Childs GD, Enah C, Fazeli PL. Perceptions of Brain Health and Cognition in Older African Americans and Caucasians With HIV: A Focus Group Study. J Assoc Nurses AIDS Care 2017; 28:862-876. [PMID: 28802912 DOI: 10.1016/j.jana.2017.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 07/21/2017] [Indexed: 12/14/2022]
Abstract
As people age with HIV, cognitive problems may become more prevalent and severe, but lifestyle behaviors (i.e., physical activity) have been shown to protect brain health and cognition. We examined the perceptions that older adults living with HIV have about protecting and improving brain health and cognition through lifestyle behaviors. Qualitative data were analyzed from four focus groups (N = 30) of African Americans and Caucasians living with HIV and at least 50 years of age. An open-coding scheme using conventional content analysis was employed. Two results were found. First, many older adults with HIV in our study expressed a variety of cognitive complaints that interfered with daily function. Second, these participants reported few specific ideas about how such health behaviors were important to their own brain health and cognition. Education interventions may help older adults with HIV learn to improve and protect brain health and cognition as they age.
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Vance DE, Gakumo CA, Childs GD, Enah C, Fazeli PL. Feedback on a Multimodal Cognitive Intervention for Adults Aging With HIV: A Focus Group Study. J Assoc Nurses AIDS Care 2017; 28:685-697. [PMID: 28669770 DOI: 10.1016/j.jana.2017.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/01/2017] [Indexed: 12/30/2022]
Abstract
Nearly 50% of adult persons living with HIV (PLWH) experience HIV-associated neurocognitive disorder (HAND), which is associated with deteriorating brain health and cognitive functioning. Multimodal interventions that simultaneously improve physical activity, nutrition, and sleep hygiene may be of value for adult PLWH, especially as they age and become vulnerable to HAND. We used four focus groups of PLWH (N = 30; ages ≥ 50 years) to solicit feedback about Cognitive Prescriptions, a multimodal cognitive intervention. Lifestyle and health behaviors pertaining to Cognitive Prescriptions were assessed, including: (a) physical activity, (b) mental activity, (c) nutrition, (d) social engagement, (e) emotional health, (f) sleep hygiene, and (g) substance use. When presented a template of the intervention, participants expressed favorable opinions and remarked they would want to work with a clinician, paraprofessional, or peer to implement such a program into their own daily routines. From this, implications for practice and research are provided.
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Fessel MM, Mann M, Miyawaki CE, Rosenberg DE. Multi-Component Interventions and Cognitive Health: A Scoping Review. J Gerontol Nurs 2017; 43:39-48. [DOI: 10.3928/00989134-20170131-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/30/2016] [Indexed: 11/20/2022]
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Cutts J, Maxwell MV, Kushner RF, Mechanick JI. Community Engagement and Networks: Leveraging Partnerships to Improve Lifestyle. LIFESTYLE MEDICINE 2016. [DOI: 10.1007/978-3-319-24687-1_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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