scholarly journals Time-of-Day Could Affect Cognitive Screening Performance in Older Patients with TIA and Stroke

2017 ◽  
Vol 43 (5-6) ◽  
pp. 290-293 ◽  
Author(s):  
Sara Mazzucco ◽  
Linxin Li ◽  
Maria A. Tuna ◽  
Sarah T. Pendlebury ◽  
Rhoda Frost ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Older Patients ◽  
Time Of Day ◽  
Minor Stroke ◽  
Cognitive Screening ◽  
Repeated Testing ◽  
Cross Sectional ◽  
Ischemic Attack ◽  
The Impact ◽  
Moca Score

Background and Purpose: The impact of time-of-day on the cognitive performance of older patients with limited cognitive reserve after a transient ischemic attack (TIA) or stroke, and on short cognitive tests, such as the Montreal Cognitive Assessment (MoCA), is unknown. We retrospectively studied whether morning versus afternoon assessment might affect the classification of patients aged 70 or older as severe (SCI), mild (MCI), and no (NCI) cognitive impairment by the MoCA. Methods: Morning (12 p.m. or earlier) versus afternoon (later than 12 p.m.) proportions of SCI (MoCA score <20), MCI (MoCA score 25-20) and NCI (MoCA score ≥26) were compared in a cohort of patients aged ≥70, attending a rapid-access TIA/stroke clinic. Results: Of 278 patients, 113 (40.6%) were tested in the morning and 165 (59.4%) in the afternoon. The proportion with SCI was greater in the afternoon than in the morning (10.9 vs. 1.8%, respectively, p = 0.004), with no difference in age, education, diagnosis, disability, or vascular risk factors. Conclusions: Time-of-day appears to affect cognitive performance of older patients after they undergo TIA and minor stroke. If our cross-sectional findings are confirmed in cross-over studies with repeated testing, timing of assessments should be considered in clinical practice and in research studies.

Liver Fibrosis is Associated with a Decrease in Gait Speed in Older Men with Chronic Liver Disease: A Retrospective Cross-Sectional Study

2021 ◽  
Author(s):  
Kenichi Fudeyasu ◽  
Takuo Nomura ◽  
Toshihiro Kawae ◽  
Daisuke Iwaki ◽  
Yuki Nakashima ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Motor Function ◽  
Gait Speed ◽  
Older Patients ◽  
Knee Extension ◽  
Chronic Liver ◽  
Cross Sectional ◽  
The Impact

Abstract Background: Although it has already been reported that chronic liver disease (CLD) can induce sarcopenia, the impact of sarcopenia, especially on motor function, in older patients with CLD is still unclear. Therefore, we investigated the effects of liver fibrosis on motor function in these patients.Methods: In all, 117 older patients with CLD aged above 60 years (men, n=70; women, n=47) were included in this study. We examined the presence or absence of sarcopenia and checked motor functions such as muscle strength and walking speed. The results were compared between patients with FIB-4 index of >3.25, indicative of severe-degree liver fibrosis (SLF), and those with an index of <3.25, indicative of low-degree liver fibrosis (LLF). We also analyzed the factors related to the decrease in gait speed.Results: The decrease in gait speed (<1.0 m/s) was significantly higher (P = 0.027) and the knee extension force (KEF) was significantly lower (P = 0.010) in men with SLF than in those with LLF. In this study, liver fibrosis (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.56–0.90) and KEF (OR = 1.09, 95% CI = 1.02–1.16) were identified as factors associated with the decrease in gait speed.Conclusions: Older male patients with CLD have decreased motor function as the disease progresses. We found that the decrease in gait speed is related to liver fibrosis and KEF. It is necessary to focus on the motor function of older patients with CLD, especially the gait speed.

The Impact of Custodial Grandparenting on Cognitive Performance in a Longitudinal Sample of Grandparents Raising Grandchildren

2020 ◽  
pp. 0192513X2097672
Author(s):  
Ian T. McKay ◽  
Danielle K. Nadorff
Keyword(s):  
Cognitive Performance ◽  
Longitudinal Research ◽  
The United States ◽  
Word Recall ◽  
Grandparents Raising Grandchildren ◽  
Custodial Grandparents ◽  
Cross Sectional ◽  
Custodial Grandparenting ◽  
Sectional Analysis ◽  
The Impact

There are currently 2.7 million grandparents raising grandchildren in the United States. As grandparent caregiving has become more prevalent, concerns have surfaced regarding the effect of additional caregiving responsibilities placed on an aging population. The following study uses an existing dataset of individuals who graduated from Wisconsin high schools in 1957. The present study examined the impact of grandparenting on measures of cognition, both cross-sectionally and longitudinally. Findings from the cross-sectional analysis show that custodial grandparents outperformed their noncustodial grandparent counterparts on the cognitive tests of word recall, category fluency, letter fluency, and cognitive similarities. Findings from the longitudinal analysis show that though custodial grandparents had initially performed worse on the digit ordering task, their scores declined at a much slower rate than non-custodial grandparents. By using a cross-sectional and longitudinal research design, this study provides a unique opportunity to examine the impact of grandparenting on cognitive performance.

scholarly journals Montreal Cognitive Assessment in a 63- to 65-year-old Norwegian Cohort from the General Population: Data from the Akershus Cardiac Examination 1950 Study

2017 ◽  
Vol 7 (3) ◽  
pp. 318-327 ◽  
Author(s):  
Håkon Ihle-Hansen ◽  
Thea Vigen ◽  
Trygve Berge ◽  
Gunnar Einvik ◽  
Dag Aarsland ◽  
...  
Keyword(s):  
Higher Education ◽  
General Population ◽  
Cognitive Assessment ◽  
Population Data ◽  
Montreal Cognitive Assessment ◽  
Cross Sectional ◽  
Normal Cognitive Function ◽  
The Mean ◽  
The Impact ◽  
Moca Score

Aims: To investigate Montreal Cognitive Assessment (MoCA) test scores in a cohort aged 63–65 years from a general population in relation to the proposed cut-off score of 26 for mild cognitive impairment (MCI) and to explore the impact of education. Methods: MoCA scores were assessed in the Akershus Cardiac Examination 1950 Study, a cross-sectional cohort study of all men and women born in 1950 living in Akershus County, Norway. The participants were aged 63–65 at the time of data collection. Results: MoCA scores were available in 3,413 participants, of which 47% had higher education (>12 years). The mean MoCA score was 25.3 (95% confidence interval [CI] 25.2–25.4), and 49% had a score below the suggested cut-off of 26 points. Those with higher education had significantly higher scores (mean 26.2, 95% CI 26.1–26.3 vs. 24.4, 95% CI 24.3–24.6, p < 0.001). Conclusions: Approximately 50% scored below the cut-off score of 26 points, suggesting that the cut-off score may have been set too high to distinguish normal cognitive function from MCI. Educational level had a significant impact on MoCA scores.

scholarly journals INNV-11. GLIOBLASTOMA IN THE OLDER PERSON – HOW DO WE DECIDE ON TREATMENT?

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii118-ii118
Author(s):  
Cressida Lorimer ◽  
Anthony Chalmers ◽  
Margaret Johnson ◽  
Juliet Brock
Keyword(s):  
Screening Test ◽  
Older Patients ◽  
Performance Status ◽  
Treatment Options ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Clinical Factor ◽  
Cross Sectional ◽  
Multiple Treatment ◽  
The Impact

Abstract The incidence of glioblastoma (GBM) peaks in the 7th and 8th decades of life. Multiple treatment options exist for older patients with GBM however, the assessment of older patients prior to treatment decisions is poorly researched and lacks standardization. In order to address this issue we performed a cross-sectional electronic survey distributed to all full members of the Society for Neuro-Oncology. There were 116 respondents from a total of 1515 recipients (8% response rate). The survey was distributed during the peak of COVID-19 which undoubtedly affected response rates. 97% of respondents were clinicians with 86% academic. 72% had been in practice &gt; 10 years and the majority saw 5–10 new GBM cases per month. 95% of respondents were from the USA, with involvement from Japan, Australia, Canada and Italy. 37% of respondents routinely perform a cognitive or frailty screening test. Of these, MMSE and MoCA were the most commonly used. Of those who performed a screening test, the majority reported that the results changed their treatment decision in approximately 50% of cases. 50% of respondents have access to a multidisciplinary team during their clinic, with physical therapy being the most available. When making treatment decisions, participants ranked performance status as the most important clinical factor. Considering the heterogeneity of this patient population, we argue that performance status is a crude measure of vulnerability within this cohort. In the first survey of this kind, we have shown a disparity in assessment techniques across the international neuro-oncology field and the impact performing a cognitive screen has on decision making. Older patients with GBM represent a unique clinical scenario because of the complexity of distinguishing neuro- oncology related symptoms from general frailty. There is a need for specific geriatric assessment models tailored to the older neuro-oncology population in order to facilitate treatment decisions.

Awareness of the use of hyponatraemia-inducing medications in older adults with hyponatraemia: a study of their prevalent use and association with recurrent symptomatic or severe hyponatraemia

2020 ◽  
Author(s):  
Kwanghee Jun ◽  
Yujin Kim ◽  
Young-Mi Ah ◽  
Ju-Yeun Lee
Keyword(s):  
Older Patients ◽  
Case Control Study ◽  
Cross Sectional Study ◽  
Case Control ◽  
Thiazide Diuretics ◽  
Cross Sectional ◽  
Severe Hyponatraemia ◽  
Prescription Rates ◽  
The Impact ◽  
Control Study

Abstract Background Cautious use or avoidance of hyponatraemia-inducing medications (HIMs) is recommended in older patients with hyponatraemia. Objective To evaluate the use of HIMs after treatment for symptomatic or severe hyponatraemia and to investigate the impact of HIMs on the recurrence of symptomatic or severe hyponatraemia in older patients. Design and settings A cross-sectional and nested case–control study using data obtained from national insurance claims databases. Methods The rate of prescribing HIMs during the 3 months before and after the established index date was analysed in a cross-sectional analysis. Multivariable logistic regression was performed to investigate the association between HIM use and recurrence of symptomatic or severe hyponatraemia after adjusting for covariates in a case–control study. Results The cross-sectional study included 1,072 patients treated for symptomatic or severe hyponatraemia. The proportion of patients prescribed any HIMs after hyponatraemia treatment decreased from 76.9 to 70.1%. The prescription rates significantly decreased for thiazide diuretics (from 41.9 to 20.8%) and desmopressin (from 8.6 to 4.0%), but the proportion of patients prescribed antipsychotics increased from 9.2 to 17.1%. Of 32,717 patients diagnosed with hyponatraemia, 913 (2.8%) showed recurrent hyponatraemia. After adjusting for comorbid conditions, the use of any HIMs including proton pump inhibitors [adjusted odds ratio (aOR) 1.34, 95% confidence interval (CI) 1.15–1.57] and two or more HIMs (aOR 1.48, 95% CI 1.22–1.78) especially in combination with thiazide diuretics increased the likelihood of severe hyponatraemia recurrence. Conclusions Prevalent use of HIMs after treatment for symptomatic or severe hyponatraemia and multiple HIM use increase the risk of recurrent hyponatraemia in geriatric patients.

Effects of Illuminance and Correlated Color Temperature on Daytime Cognitive Performance, Subjective Mood, and Alertness in Healthy Adults

2017 ◽  
Vol 51 (2) ◽  
pp. 199-230 ◽  
Author(s):  
Yingying Zhu ◽  
Minqi Yang ◽  
Ying Yao ◽  
Xiao Xiong ◽  
Xiaoran Li ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Light Exposure ◽  
Bright Light ◽  
Time Of Day ◽  
Healthy Adults ◽  
Color Temperature ◽  
Future Research ◽  
Long Term Memory ◽  
Indoor Lighting ◽  
The Impact

This study investigated the impact of indoor illuminance and correlated color temperature (CCT) on healthy adults’ cognitive performance, subjective mood, and alertness during daytime office hours and differences in time-of-day effects. A 2(illuminance) × 2(CCT) × 2(morning vs. afternoon) mixed design ( N = 60) was employed. Participants felt less sleepy in the bright light exposure. The low “cool” lighting induced the least positive mood. The effects of illuminance and CCT on subjective feelings were not time-of-day dependent. The results demonstrated the slowest responses in inhibition, working memory, and recognition of facial expression tasks in the low “warm” lighting. The effect on long-term memory was most pronounced under the high “cool” light exposure, but only in the afternoon for recognition of neutral words. The findings suggest that future research on good indoor lighting should consider illuminance levels and CCT as well as other variables to optimize lighting effects during regular daytime hours.

scholarly journals Prevalence of Dementia Among Older Patients: A Hospital-Based Study in Iran

2019 ◽  
Vol 34 (7-8) ◽  
pp. 500-506
Author(s):  
Leila Kamalzadeh ◽  
Moein Moghaddamnia ◽  
Seyed Kazem Malakouti ◽  
Vahid Rashedi ◽  
Sara Bahrampour ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Health Hazard ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Prevalence Of Dementia

Background: Dementia constitutes a public health hazard in developing countries. The aim of this study was to evaluate the prevalence of dementia and its associated factors in older hospitalized patients. Methods: The participants of this cross-sectional study consisted of older patients admitted to medical wards in Rasoul-e Akram hospital in Tehran, Iran. Mini-Mental State Examination, Mini-Cog test, Geriatric Depression Scale, Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale, and socioeconomic questionnaires were used. Results: A total of 205 elderly inpatients were included. The mean age was 71.33 ± 7.35 years; 63.4% of the participants had normal cognitive function, while 36.6% had some degree of cognitive impairment. There was a statistically significant relationship between gender, age, number of children, and occupation and the prevalence of dementia. Conclusion: Appropriate cognitive screening of older patients upon admission to hospitals could help identify potential adverse events and enhance the quality of care for patients with comorbid dementia.

scholarly journals Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia

Geriatrics ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 52
Author(s):  
Khor ◽  
Ong ◽  
Tan ◽  
Low ◽  
Saedon ◽  
...  
Keyword(s):  
Older Patients ◽  
Altered Mental Status ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Assessment Tools ◽  
University Hospital ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Confusion Assessment ◽  
Severity Scores

The detection of delirium in acutely ill older patients is challenging with the lack of informants and the necessity to identify subtle and fluctuating signs. We conducted a cross-sectional study among older patients admitted to a university hospital in Malaysia to determine the presence, characteristics, and mortality outcomes of delirium. Consecutive patients aged ≥65years admitted to acute medical wards were recruited from August to September 2016. Cognitive screening was performed using the mini-mental test examination (MMSE) and the Confusion Assessment Method (CAM). The CAM-Severity (CAM-S) score was also performed in all patients. Of 161 patients recruited, 43 (26.7%) had delirium. At least one feature of delirium from the CAM-S short and long severity scores were present in 48.4% and 67.1%, respectively. Older age (OR: 1.07, 95% CI: 1.01–1.14), immobility (OR: 3.16, 95% CI: 1.18–8.50), cognitive impairment (OR: 5.04, 95% CI: 2.07–12.24), and malnutrition (OR: 3.37; 95% CI: 1.15–9.85) were significantly associated with delirium. Older patients with delirium had a higher risk of mortality (OR: 7.87, 95% CI: 2.42–25.57). Delirium is common among older patients in our setting. A large proportion of patients had altered mental status on admission to hospital although they did not fulfill the CAM criteria of delirium. This should prompt further studies on strategies to identify delirium and the use of newer, more appropriate assessment tools in this group of vulnerable individuals.

scholarly journals Differential effects of sex on longitudinal patterns of cognitive decline in Parkinson’s disease

2021 ◽  
Author(s):  
Megan C. Bakeberg ◽  
Anastazja M. Gorecki ◽  
Jade E. Kenna ◽  
Alexa Jefferson ◽  
Michelle Byrnes ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Repeated Measures ◽  
Cross Sectional ◽  
Domain Specific ◽  
Global Cognition ◽  
The Impact

Abstract Background Cognitive impairment is an important and diverse symptom of Parkinson’s disease (PD). Sex is a purported risk variable for cognitive decline in PD, but has not been comprehensively investigated. Objectives This cross-sectional and longitudinal study examined sex differences in global and domain-specific cognitive performance in a large PD cohort. Methods Cognitive function was evaluated using the Addenbrooke’s Cognitive Examination in 392 people with PD (PwP) from the Australian Parkinson’s Disease Registry. The influence of sex on domain-specific cognitive performance was investigated using covariate-corrected generalised linear models. In a repeated measures longitudinal subset of 127 PwP, linear mixed models were used to assess the impact of sex on cognition over time, while accounting for covariates. Results Cross-sectional-corrected modelling revealed that sex was significantly predictive of cognitive performance, with males performing worse than females on global cognition, and memory and fluency domains. Longitudinally, sex was significantly predictive of cognitive decline, with males exhibiting a greater reduction in global cognition and language, whereas females showed a greater decline in attention/orientation, memory and visuospatial domains, despite starting with higher baseline scores. At follow-up, a significantly higher proportion of males than females fulfilled criteria for mild cognitive impairment or PD dementia. Conclusions Sex was revealed as a significant determinant of overall cognitive performance as well as specific cognitive domains, with a differential pattern of decline in male and female participants. Such sex-specific findings appear to explain some of the heterogeneity observed in PD, warranting further investigation of mechanisms underlying this sexual dimorphism.

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