The IQCODE: Using Informant Reports to Assess Cognitive Change in the Clinic and in Older Individuals Living in the Community

2012 ◽  
pp. 165-182 ◽  
Author(s):  
Nicolas Cherbuin ◽  
Anthony F. Jorm
Keyword(s):  
Cognitive Change ◽  
Older Individuals

scholarly journals Association of β-amyloid level, clinical progression and longitudinal cognitive change in normal older individuals

Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011222
Author(s):  
Laura M. van der Kall ◽  
Thanh Truong ◽  
Samantha C Burnham ◽  
Vincent Doré ◽  
Rachel S Mulligan ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Cognitive Change ◽  
Cox Proportional Hazards ◽  
Imaging Biomarkers ◽  
Older Individuals ◽  
Mixed Effect ◽  
Preclinical Ad ◽  
Risk Of Progression ◽  
Very High

Objective:To determine the effect of Aβ level on progression risk to MCI or dementia and longitudinal cognitive change in cognitively normal (CN) older individuals.Methods:All CN from the Australian Imaging Biomarkers and Lifestyle study (AIBL) with Aβ PET and ≥3 years follow-up were included (n=534; age 72±6 yrs; 27% Aβ positive; follow-up 5.3±1.7 yrs). Aβ level was divided using the standardised 0-100 Centiloid scale: <15 CL negative, 15-25 CL uncertain, 26-50 CL moderate, 51-100 CL high, >100 CL very high, noting >25 CL approximates a positive scan. Cox proportional hazards analysis and linear mixed effect models were used to assess risk of progression and cognitive decline.Results:Aβ levels in 63% were negative, 10% uncertain, 10% moderate, 14% high and 3% very high. Fifty-seven (11%) progressed to MCI or dementia. Compared to negative Aβ, the hazard ratio for progression for moderate Aβ was 3.2 (95% CI 1.3-7.6; p<0.05), for high was 7.0 (95% CI 3.7-13.3; p<0.001) and for very high was 11.4 (95% CI 5.1-25.8; p<0.001). Decline in cognitive composite score was minimal in the moderate group (-0.02 SD/year, p=0.05) while the high and very high declined substantially (high -0.08 SD/year, p<0.001; very high -0.35 SD/year p<0.001).Conclusion:The risk of MCI or dementia over 5 years in older CN is related to Aβ level on PET, 5% if negative vs 25% if positive but ranging from 12% if 26-50 CL to 28% if 51-100 CL and 50% if >100 CL. This information may be useful for dementia risk counselling and aid design of preclinical AD trials.

scholarly journals Assessment of complex mental activity across the lifespan: development of the Lifetime of Experiences Questionnaire (LEQ)

2006 ◽  
Vol 37 (7) ◽  
pp. 1015-1025 ◽  
Author(s):  
MICHAEL J. VALENZUELA ◽  
PERMINDER SACHDEV
Keyword(s):  
Factor Analysis ◽  
Cognitive Decline ◽  
Test Performance ◽  
Leisure Activity ◽  
Cognitive Change ◽  
Mental Activity ◽  
Dominant Factor ◽  
Activity Levels ◽  
Older Individuals ◽  
Brain Reserve

Background. Brain reserve is a property of the central nervous system related to complex mental activity which may mediate the course and clinical expression of brain injury. Since there is no instrument that comprehensively assesses complex mental activity through the lifespan, we developed and tested the Lifetime of Experiences Questionnaire (LEQ) in a prospective study of healthy ageing.Method. The LEQ assesses educational, occupational and cognitive lifestyle activities at different stages through life. Test–retest, item analysis and Item Response Theory (IRT) were used to determine reliability. Dimensionality was evaluated using factor analysis. Validity was established through IRT analysis of test performance, correlation with an extant contemporaneous instrument (Cognitive Activities Scale; CAS) and prediction of global cognitive change over 18 months controlling for age, baseline cognition and hypertension.Results. In a sample of healthy older individuals (n=79) the LEQ was found to be consistent, coherent and discriminate between individuals with high and low mental activity levels. Factor analysis revealed a dominant factor which loaded heavily on education, occupation and leisure activity. Total LEQ was significantly correlated with the CAS. Furthermore, individuals with higher LEQ scores showed less cognitive decline over 18 months, independent of covariates (r=0·37, p=0·003).Conclusions. The LEQ is a reliable and valid instrument for assessing complex lifespan mental activity which is protective against cognitive decline. The LEQ is therefore proposed as a useful tool for estimating brain reserve in older individuals and further development is anticipated.

scholarly journals Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline

Neurology ◽  
2020 ◽  
Vol 95 (3) ◽  
pp. e320-e331 ◽  
Author(s):  
Joanne Ryan ◽  
Elsdon Storey ◽  
Anne M. Murray ◽  
Robyn L. Woods ◽  
Rory Wolfe ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Low Dose ◽  
Controlled Trial ◽  
Verbal Learning ◽  
Cognitive Change ◽  
Community Dwelling ◽  
Older Individuals ◽  
Dose Aspirin ◽  
Low Dose Aspirin

ObjectiveTo determine the effect of low-dose aspirin vs placebo on incident all-cause dementia, incident Alzheimer disease (AD), mild cognitive impairment (MCI), and cognitive decline in older individuals.MethodsAspirin in Reducing Events in the Elderly (ASPREE) was a double-blind, placebo-controlled trial of low-dose aspirin. In the United States and Australia, community-dwelling individuals aged ≥70 years (US minorities ≥65 years) and free of cardiovascular disease, physical disability, and diagnosed dementia were enrolled. Participants were randomized 1:1–100 mg daily aspirin or placebo. The Modified Mini-Mental State Examination, Hopkins Verbal Learning Test–Revised, Symbol Digit Modalities Test, and Controlled Oral Word Association Test assessed cognition at baseline and over follow-up. Additional cognitive testing was performed in participants with suspected dementia (“trigger”) based on within-study assessments or clinical history. Dementia was adjudicated according to DSM-IV criteria. National Institute on Aging–Alzheimer’s Association criteria were used for AD and MCI subclassification.ResultsA total of 19,114 participants were followed over a median 4.7 years and 964 triggered further dementia assessments. There were 575 adjudicated dementia cases, and 41% were classified as clinically probable AD. There was no substantial difference in the risk of all dementia triggers (hazard ratio [HR], 1.03; 95% confidence interval [CI], 0.91–1.17), probable AD (HR, 0.96; 95% CI, 0.74–1.24), or MCI (HR, 1.12; 95% CI, 0.92–1.37) between aspirin and placebo. Cognitive change over time was similar in the aspirin and placebo groups.ConclusionsThere was no evidence that aspirin was effective in reducing risk of dementia, MCI, or cognitive decline. Follow-up of these outcomes after initial exposure is ongoing.Classification of evidenceThis study provides Class II evidence that for healthy older individuals, low-dose aspirin does not significantly reduce the incidence of dementia, probable AD, MCI, or cognitive decline.Clinicaltrials.gov identifierNCT01038583.

“No Two Fields Ever Grow Grass the Same Way”: Assessment of Conservation Abilities in the Elderly

1983 ◽  
Vol 15 (3) ◽  
pp. 185-195 ◽  
Author(s):  
Pamela Roberts ◽  
Diane Papalia-Finlay ◽  
Elizabeth Socha Davis ◽  
James Blackburn ◽  
Mary Dellmann
Keyword(s):  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Older Persons ◽  
The Elderly ◽  
Cognitive Change ◽  
Older Individuals ◽  
Clinical Method ◽  
The Past ◽  
Problem Solving Strategies ◽  
Assessment Procedures

Within the past ten years, standard cognitive assessment procedures, including Piagetian tasks, have often been used with the elderly. The present paper examines several possible difficulties in interpreting the results of studies which employ Piagetian tasks, especially conservation tasks, with older individuals. First, it is noted that Piaget's clinical method allows more flexibility in the asesssment of competence than do the more quantifiable, American techniques. However, most of the research studies suggesting a cognitive decline with age have utilized rigid assessment procedures. Second, the paper examines the possibility of task misinterpretation by the elderly. Examples from recent research, in which older persons stressed reality-based problem solving strategies rather than the more abstract strategies traditionally associated with Piagetian tasks, are provided. The possibility of cognitive change instead of cognitive decline with age is discussed, and the importance of utilizing procedures which can measure this change is stressed.

Is Occupational Complexity Associated with Cognitive Performance or Decline? Results from the Australian Longitudinal Study of Ageing

Gerontology ◽  
2017 ◽  
Vol 63 (6) ◽  
pp. 550-559 ◽  
Author(s):  
Anna P. Lane ◽  
Tim D. Windsor ◽  
Ross Andel ◽  
Mary A. Luszcz
Keyword(s):  
Longitudinal Study ◽  
Cognitive Decline ◽  
Cognitive Functioning ◽  
Mental Status ◽  
Cognitive Change ◽  
Rate Of Change ◽  
Physical Work ◽  
Older Individuals ◽  
Australian Longitudinal Study ◽  
Occupational Complexity

Background: Long-term protective associations proposed between previous complex occupational tasks and cognitive functioning in later life point to work roles contributing to cognitive reserve. Objective: To examine occupational complexity involving data, people, and things in relation to the level of, and rate of change in, cognitive functioning. Methods: Participants were 1,290 members of the Australian Longitudinal Study of Ageing and initially aged 65-102 years (mean = 79). Information about main lifetime occupation was collected retrospectively. Cognition was assessed 4 times over a 13-year interval. Results: In multilevel models adjusted for demographics, medical conditions, and depressive symptoms, higher complexity involving data was associated with faster speed (β = 0.73, p < 0.001), better memory (β = 0.32, p < 0.05), and mental status (β = 0.40, p < 0.001) at baseline. These associations remained statistically reliable after adjusting for complexity with people and things, sedentary and heavy physical work, retirement age, and leisure activity. Complexity with things was associated with slower speed (β = -0.50, p < 0.001) and poorer mental status (β = -0.26, p < 0.01) and was not explained by other variables. There were no associations of occupational complexity with rates of cognitive decline over time. Conclusion: Older individuals retired from occupations characterized by higher complexity with data maintain their cognitive advantage over those with lower complexity into older adulthood, although without additional moderation of this advantage in terms of less postretirement cognitive decline. Complexity of work with things confers a negative relation to cognition whilst also not affecting postretirement cognitive change. Although the relative contributions of occupation or other early life influences for cognition remain to be established, it nevertheless may be beneficial to promote workplace design strategies and interventions that incorporate complex activities, particularly tasks involving data.

Perceived Voice Disorders in Older Adults and Impact on Social Interactions

2021 ◽  
pp. 1-8
Author(s):  
Connie K. Porcaro ◽  
Clare Singer ◽  
Boris Djokic ◽  
Ali A. Danesh ◽  
Ruth Tappen ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interactions ◽  
Social Engagement ◽  
Leisure Activities ◽  
Treatment Strategies ◽  
Voice Disorders ◽  
Community Dwelling ◽  
Vocal Performance ◽  
Older Individuals ◽  
Cross Sectional

Purpose Many aging individuals, even those who are healthy, report voice changes that can impact their ability to communicate as they once did. While this is commonly reported, most do not seek evaluation or management for this issue. The purpose of this study was to investigate the prevalence and differences in voice disorders in older adults, along with the effect of fatigue on their social interactions. Method This is a cross-sectional investigation of a community-dwelling sample of individuals aged 60 years or older. Participants completed the Questionnaire on Vocal Performance, the Social Engagement Index subset “Engagement in Social or Leisure Activities,” and the Fatigue Severity Scale. Results Results indicated 32.5% of the 332 participants reported symptoms of voice problems with no difference found between male and female respondents. A slight increase in report of voice problems was noted with each year of age. Participants who self-reported voice problems indicated less interaction in social activities involving communication than those who did not. Finally, as severity of self-reported voice problems increased, an increase was reported by the same individuals for signs of fatigue. Conclusions Voice problems and resulting decreased social interaction are commonly experienced by older individuals. Voice symptoms in older adults have been found to benefit from evidence-based treatment strategies. It is critical to provide education to encourage older individuals to seek appropriate evaluation and management for voice issues through a speech-language pathologist or medical professional.

Issues of Capacity and Decision-Making in the Context of Delirium

2015 ◽  
Vol 24 (4) ◽  
pp. 140-145
Author(s):  
Kevin R. Patterson
Keyword(s):  
Decision Making ◽  
Patient Autonomy ◽  
Care Setting ◽  
Cognitive Change ◽  
Treatment Team ◽  
Precipitating Factors ◽  
Term Care ◽  
Decision Making Capacity ◽  
Fundamental Consideration

Decision-making capacity is a fundamental consideration in working with patients in a clinical setting. One of the most common conditions affecting decision-making capacity in patients in the inpatient or long-term care setting is a form of acute, transient cognitive change known as delirium. A thorough understanding of delirium — how it can present, its predisposing and precipitating factors, and how it can be managed — will improve a speech-language pathologist's (SLPs) ability to make treatment recommendations, and to advise the treatment team on issues related to communication and patient autonomy.

Dual Task, Noise, and The Speech-Language Pathologist: A Clinical Guideline for Adult Multi-Tasking Intervention With Noise

2017 ◽  
Vol 2 (15) ◽  
pp. 32-41
Author(s):  
Jennine Harvey ◽  
Scott Seeman ◽  
Deborah von Hapsburg
Keyword(s):  
Dual Task ◽  
Clinical Guideline ◽  
Older Individuals ◽  
Speech Language Pathology ◽  
Speech Language Pathologist ◽  
Hearing In Noise ◽  
Hearing Function ◽  
Language Pathology ◽  
Relationship Of ◽  
The Relationship

The field of Cognitive Hearing Science examines the relationship between cognitive, linguistic, and hearing functions. Although these areas are of particular importance to speech-language pathology, few studies have investigated applications of cognitive hearing science to clinical practice. The purpose of this review article is to (1) explore and present a summary of cognitive hearing science techniques for dual-task and hearing-in-noise procedures and implications to speech-language pathology, and (2) provide a clinical guide for speech-language pathology in adult multitasking intervention with noise. It is well understood that areas of cognitive skill and hearing function decline with age; therefore, additional understanding of the relationship of these functions is of particular importance to speech-language pathologists working with older individuals. This article meets the American Speech-Language-Hearing Association's (ASHA's) Special Interest Group (SIG) 15's mission of “research-to-practice” professional development by “promoting understanding of the effects of normal and pathological aging on cognition, language […] and hearing” (ASHA, 2017), and is intended to be of interest to the SIG 15 readership.

Cubist Portrait of a Cognitive Change

1979 ◽  
Vol 24 (8) ◽  
pp. 645-646
Author(s):  
SUSAN F. CHIPMAN
Keyword(s):  
Cognitive Change
Sign in / Sign up

Export Citation Format

Share Document