Discourse performance and related cognitive function in mild cognitive impairment and dementia: A preliminary study

OBJECTIVES

This study applied the discourse task and related cognitive items of the Brief Test of Cognitive-Communication Disorders (BCCD) to normal, mild cognitive impairment (MCI), and moderate dementia groups and compared the scores of each area. In addition, the cognitive functions affecting the discourse performance were investigated by group.

PARTICIPANTS

117 normal adults, 38 MCI, and 31 patients with moderate dementia (DEM) conducted BCCD, including discourse and cognitive items.

DESIGN/SETTING

The discourse item included repeating an explanatory discourse, and the total discourse score was calculated by summing the scores for each of the four areas of coherence, cohesion, proposition, and pause. The cognitive areas of BCCD were attention, visuospatial ability, memory, organization, reasoning, problem-solving, and executive function. This study performed a one-way multivariate analysis of covariance to compare the scores of the three groups and multiple regression analysis determined the cognitive functions influencing the total discourse score.

MEASUREMENTS

The discourse scores reporting differences among all groups were the pause and the total discourse scores, with the normal group showing a higher performance than the patient groups in the cohesion score and the DEM group in the propositions score, respectively. In addition, the cognitive functions affecting discourse performance were attention, organization, and problem-solving in the normal group, and organization and problem-solving in the MCI group.

CONCLUSIONS

Organizing information into a series of semantic units related to each other is necessary for coherent and efficient utterances, and the ability to correctly recognize the task and establish a strategy to grasp the core content is necessary for pragmatic language.

Analysis of Factors Affecting the Mental Health Crisis of Coronavirus Disease Infection in Java Island

Introduction: Corona virus disease 2019 (COVID-19) is a health problem that is still a health emergency in the world and causes mental health crisis. The purpose of this study was to analyze the factors that influence the mental health crisis of COVID-19 infection on the island of Java.Methods: A cross sectional study between June-July 2020 in Java Island, Indonesia with 1.218 respondents selected using convenience sampling. The independent variable were demographic, individual internal, psychological factors and the dependent was mental health crisis. Data was measured by demographic information, knowledge and attitude questionnaires, depression anxiety stress score, the brief 28-item COPE Inventory, questionnaire on problem faces and crisis mental health emergencies. Analysis data is conducted by chi square and multivariate logistic regression.Results: The relation of demographic, individual internal and psychological factors were significant to crisis mental health and P <0.05. After adjusted with logistic regression, psychological factors have more significant relation and the highest relation was found in stress level with P = 0.000 and CI 95% was 1.064 – 2.131.Conclusion: The contributing factor that has the strongest relationship with a mental health crisis is the level of stress that people experience. The biggest contribution that causes disruption of psychologic conditions and mental health is psychological factors, which include levels of anxiety, stress, coping mechanisms and problems faced.

Erfolgreiches kognitives Altern: Zusammenhang der kognitiven Leistungen mit Aktivität und Zufriedenheit

Zusammenfassung. Für erfolgreiches Altern sind Kognition, Zufriedenheit und tägliche Aktivitäten relevante Faktoren. In dieser Studie werden Zusammenhänge zwischen diesen Faktoren aufgedeckt. Bei 167 Senioren (60 bis 98 Jahre) wurden Aktivität und Zufriedenheit in einem Interview, Kognition durch die Neuropsychological Assessment Battery (dt. Version) erfasst. Alle Faktoren zeigen eine negative Altersentwicklung. Aktivitäten korrelieren mit allen Faktoren; insbesondere stehen Alltagsaktivitäten und kognitive Aktivitäten positiv mit Kognition im Zusammenhang, soziale Aktivität ist davon unabhängig. Die kognitiven Funktionsbereiche Aufmerksamkeit, Sprache und exekutive Funktionen variieren mit Aktivität und Zufriedenheit, Gedächtnis nur mit kognitiven Aktivitäten, Wahrnehmung ist davon unabhängig. Dies könnte bedeuten, dass kognitive Aktivitäten spezifisch mit der kognitiven Leistung und soziale Aktivitäten spezifisch mit der emotionalen Bewertung zusammenhängen und als Schutzfaktoren während der Entwicklung wirken könnten.

Positive affect predicts everyday problem-solving ability in older adults

OBJECTIVES

Increased symptom endorsement on the short form of the Centre for Epidemiologic Studies Depression (CES-D) Scale has been previously associated with lower everyday problem-solving (EPS) ability in older adults. However, given the multifactorial and complex nature of depressive symptoms, it remains unclear whether certain symptoms/aspects of depression account for this relationship. We examined established factor scores on the full version of the CES-D to assess their utility as predictors of EPS in an older adult cohort.

METHODS

Community-dwelling older adults (n = 103; age: 51-91) were administered the CES-D along with a measure of EPS ability assessing both social and practical EPS. Regression analyses were used to determine the relationships between variables.

RESULTS

Analyses revealed that increased CES-D scores predicted worse EPS ability in older adults (β = -.17, p < .05) beyond the effects of age, gender, and education. Regression analyses examining each CES-D factor score revealed that decreased positive affect (loss of hope/enjoyment in life; β = -.21, p < .01) remained the only significant predictor of decreased overall EPS scores beyond demographic variables, while depressed affect, interpersonal, and somatic factors were not significant predictors. Positive affect predicted both practical, as well as social EPS scores.

CONCLUSIONS

Current results extend previous findings by showing that the relationship between increased depressive symptoms and decreased EPS ability in older age may be primarily driven by anhedonia as opposed to other depressive symptoms.

Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review

OBJECTIVES

Previous studies of older European populations have established that disability and morbidity vary with indicators of socio-economic position (SEP). We undertook a systematic narrative review of the literature to ascertain to what extent there is evidence of similar inequalities in the subjective health and well-being of older people in Europe.

METHOD

Relevant original research articles were searched for using Medline, Global Health, Embase, Social Policy and Practice, Cinahl, Web of Science and International Bibliography of the Social Sciences (IBSS). We included studies of SEP and indicators of subjective health and well-being (self-rated health; life satisfaction; quality of life) conducted since 1991 using population-based samples of older people in Europe and published 1995-2013.

RESULTS

A total of 71 studies were identified. Poorer SEP was associated with poorer subjective health and well-being. Associations varied somewhat depending on the SEP measure and subjective health and well-being outcome used. Associations were weaker when social support and health-related behaviours were adjusted for suggesting that these factors mediate the relationship between SEP and subjective health and well-being. Associations tended to be weaker in the oldest age groups. The patterns of associations by gender were not consistent and tended to diminish after adjusting for indicators of health and life circumstances.

CONCLUSION

The results of this systematic narrative review of the literature demonstrate the importance of social influences on later life subjective health and well-being and indicate areas which need further investigation, such as more studies from Eastern Europe, more longitudinal studies and more research on the role of mediating factors.

Age differences in everyday problem solving

Reductions in everyday problem solving (EPS) are often reported in older age, although it has been suggested that problem context may modify this effect. We evaluated the impact of two aspects of problem context: age appropriateness (age-neutral vs. older-age content) and problem type (interpersonal vs. practical) on EPS performance in 175 adults aged 18–87. Older adults generated fewer solutions to ill-structured EPS vignettes than younger and middle-aged adults. Middle-aged adults demonstrated an advantage on practical problems. While all age groups demonstrated a relative performance advantage for interpersonal content on older age problems, older adults showed the least relative benefit in this condition. Thus older adults do not exhibit relative performance gains on EPS problems designed to be most salient and relevant to this age group.

Cross-cultural evaluation of the French version of the LEIPAD, a health-related quality of life instrument for use in the elderly living at home

PURPOSE

To cross-culturally adapt a French version of the LEIPAD, a self-administered questionnaire assessing the health-related quality of life (HRQoL) in adults aged 65 years and over living at home, and to evaluate its psychometric properties.

METHODS

After having translated LEIPAD in accordance with guidelines, we studied psychometric properties: reliability and construct validity-factor analysis, relationships between items and scales, internal consistency, concurrent validity with the Medical Outcome Study Short-Form 36 and known-groups validity.

RESULTS

The results obtained in a sample of 195 elderly from the general population showed very good acceptability, with response rates superior to 93 %. Exploratory factor analysis extracted eight factors providing a multidimensionality structure with five misclassifications of items in the seven theoretical scales. Good internal consistency (Cronbach's alpha ranging from 0.73 and 0.86) and strong test-retest reliability (ICCs higher than 0.80 for six scales and 0.70 for one) were demonstrated. Concurrent validity with the SF-36 showed small to strong expected correlations.

CONCLUSION

This first evaluation of the French version of LEIPAD's psychometric properties provides evidence in construct validity and reliability. It would allow HRQoL assessment in clinical and common practice, and investigators would be able to take part in national and international research projects.

Everyday problem solving across the adult life span: solution diversity and efficacy

Everyday problem solving involves examining the solutions that individuals generate when faced with problems that take place in their everyday experiences. Problems can range from medication adherence and meal preparation to disagreeing with a physician over a recommended medical procedure or compromising with extended family members over where to host Thanksgiving dinner. Across the life span, research has demonstrated divergent patterns of change in performance based on the type of everyday problems used as well as based on the way that problem-solving efficacy is operationally defined. Advancing age is associated with worsening performance when tasks involve single-solution or fluency-based definitions of effectiveness. However, when efficacy is defined in terms of the diversity of strategies used, as well as by the social and emotional impact of solution choice on the individual, performance is remarkably stable and sometimes even improves in the latter half of life. This article discusses how both of these approaches to everyday problem solving inform research on the influence that aging has on everyday functioning.