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Paudel A, Boltz M, Kuzmik A, Resnick B, Liu W, Holmes S. The Association of Cognitive Impairment With Depressive Symptoms, Function, and Pain in Hospitalized Older Patients With Dementia. J Appl Gerontol 2023; 42:1974-1981. [PMID: 37072127 PMCID: PMC10466943 DOI: 10.1177/07334648231168446] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
This study examined the associations between cognition and depressive symptoms, function, and pain among hospitalized older patients with dementia. We utilized baseline data of 461 hospitalized older patients with dementia who participated in an intervention study implementing Family-centered Function-focused Care (Fam-FFC) and conducted stepwise linear regression. On average, the participants (males = 189; 41% and females = 272; 59%) were 81.64 years old (Standard Deviation, SD = 8.38). There was a statistically significant association of cognition with depressive symptoms (b = -0.184, p < .001), functional status (b = 1.324, p < .001), and pain (b = -0.045, p < .001) when controlling for covariates. This study utilized a large sample of a relatively underrepresented population, hospitalized older adults with dementia, and addressed a topic with great clinical significance. Specific focus on testing and implementing best practices or interventions to support the clinical outcomes, and the cognitive function of hospitalized older adults with dementia is warranted in both practice and research.
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Affiliation(s)
- Anju Paudel
- Ross and Carol Nese College of Nursing, Penn State University, University Park, PA, USA
| | - Marie Boltz
- Ross and Carol Nese College of Nursing, Penn State University, University Park, PA, USA
| | - Ashley Kuzmik
- Ross and Carol Nese College of Nursing, Penn State University, University Park, PA, USA
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Wen Liu
- The University of Iowa College of Nursing, Iowa City, IA, USA
| | - Sarah Holmes
- University of Maryland School of Nursing, Baltimore, MD, USA
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Kleinert S, Schuch F, Rapp P, Ronneberger M, Wendler J, Sternad P, Popp F, Bartz-Bazzanella P, von der Decken C, Karberg K, Gauler G, Wurth P, Späthling-Mestekemper S, Kuhn C, Englbrecht M, Vorbrüggen W, Adler G, Welcker M. Impairment in cognitive function in patients with axial spondyloarthritis and psoriatic arthritis. Rheumatol Int 2023; 43:89-97. [PMID: 36441274 DOI: 10.1007/s00296-022-05248-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
Abstract
Spondyloarthritis may contribute to deficits in cognition. The objective of this study was to compare cognitive abilities in patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) with matched reference groups. This investigator-initiated, cross-sectional, exploratory study of adults with axSpA or PsA was conducted at two German rheumatology centres (November 2018-September 2019). All data on patient and disease characteristics and cognitive abilities were collected at a single visit. Cognitive function was assessed by the previously validated Memory and Attention Test subscores of selective attention, episodic working memory, and episodic short-term memory and compared with subscores from healthy age-, sex-, and education-matched reference subjects. The mean patient age was 51.1 and 55.8 years in the axSpA (n = 101) and PsA (n = 117) groups, respectively, and mean symptom duration was 13.7 and 10.3 years. Compared with matched reference subjects, axSpA and PsA patients showed significant impairments in selective attention (mean difference of -6.5 and -4.5, respectively, on a 45-point scale; P < 0.001 for both) and no significant differences in episodic working memory. The PsA cohort, but not the axSpA cohort, had significantly better episodic short-term memory subscores compared with matched reference subjects (mean change of 2.0 on a 15-point scale; P < 0.001). Explorative subgroup analyses were unable to identify factors influencing cognitive changes, including disease activity, pain, and function, but may have been underpowered. We conclude that impairments in selective attention may impact the ability of axSpA and PsA patients to process information. These findings warrant additional studies, including longitudinal analyses, in patients with spondyloarthritis.
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Affiliation(s)
- Stefan Kleinert
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany.
- Universitätsklinik Würzburg, Med. Klinik 3, Rheumatologie/Klinische Immunologie, Würzburg, Germany.
| | - Florian Schuch
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany
| | - Praxedis Rapp
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany
| | - Monika Ronneberger
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany
| | - Joerg Wendler
- Praxisgemeinschaft Rheumatologie-Nephrologie (PGRN), Möhrendorferstr 1C, Erlangen, Germany
| | - Patrizia Sternad
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Planeg, Germany
| | - Florian Popp
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Planeg, Germany
| | | | | | - Kirsten Karberg
- Praxis Für Rheumatologie und Innere Medizin, Berlin, Germany
| | - Georg Gauler
- Rheumatologische Schwerpunktpraxis, Osnabrück, Germany
| | - Patrick Wurth
- Rheumatologische Schwerpunktpraxis, Osnabrück, Germany
| | | | | | | | | | - Georg Adler
- Institut für Studien zur Psychischen Gesundheit (ISPG), Mannheim, Germany
| | - Martin Welcker
- Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Planeg, Germany
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García C, Moreno L, Alacreu M, Muñoz FJ, Martínez LA. Addressing Psychosocial Factors in Cognitive Impairment Screening from a Holistic Perspective: The DeCo-Booklet Methodology Design and Pilot Study. Int J Environ Res Public Health 2022; 19:12911. [PMID: 36232215 PMCID: PMC9565987 DOI: 10.3390/ijerph191912911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Cognitive impairment (CI), an intermediate phase between the decline in physiological cognition and dementia, is known to be mediated by a variety of risk and protective factors, with age being the most influential of these. The multifactorial nature of CI and the worldwide phenomenon of an aging population makes decoupling old age from disease through the concept of healthy aging (HA) a matter of major interest. Focusing on psychosocial variables and psychological constructs, here we designed and piloted a data collection booklet (DeCo-B) to assess CI and HA from a holistic perspective. The DeCo-B comprises six sections: sociodemographic factors, CI, meaning in life, psychosocial factors, health problems, and lifestyle. The estimated prevalence of CI and HA in our cohort were 24.4% and 6.6%, respectively. Spearman correlations mainly identified pairwise associations between the meaning in life domains and psychosocial variables. Moreover, age, marital status, purpose in life, resilience, chronic pain, cognitive reserve, and obstructive sleep apnea were significantly associated with an increased risk of CI. Our results showed that DeCo-B is a suitable tool for researching how modifiable risk and protective factors influence cognitive status. The complex interrelationships between variables should be further investigated and, for practical reasons, the questionnaire should be optimized in future work.
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Affiliation(s)
- Cristina García
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
- Community Pharmacist, 02161 Albacete, Spain
| | - Lucrecia Moreno
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
| | - Mónica Alacreu
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
| | - Francisco J. Muñoz
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
| | - Luis A. Martínez
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Community Pharmacist, 02161 Albacete, Spain
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