Dementia severity among institutionalized elderly: Are there more unmet needs?

2016 ◽  
Vol 33 (S1) ◽  
pp. S187-S188
Author(s):  
A.R. Ferreira ◽  
S. Martins ◽  
C.C. Dias ◽  
L. Fernandes
Keyword(s):  
Cognitive Decline ◽  
Unmet Needs ◽  
The Elderly ◽  
Significant Negative Correlation ◽  
Cross Sectional Study ◽  
Active Management ◽  
Psychotic Symptoms ◽  
Ageing Population ◽  
Cross Sectional ◽  
Dementia Severity

IntroductionThe ageing population and the resulting increase in chronic diseases, including dementia, make the evaluation of their emergent needs a crucial step in psychogeriatric care. Unmet needs are found to be important clinical targets that should be followed by active management in order to improve health status and survival.ObjectivesTo analyze the relation between unmet needs and cognition, and explore the nature of these needs across dementia severity stages.MethodsA cross-sectional study was conducted in three nursing homes. Residents were excluded if they were terminally ill, unresponsive or presented delirium. All participants were assessed by Mini-Mental State Examination/MMSE (cognition) and Camberwell Assessment of Need for the Elderly/CANE (needs). Additionally, cognitive decline was staged as: absent (MMSE = 30), questionable (26–29), mild (21–25), moderate (11–20) and severe (≤ 10).ResultsThe study included 175 elderly with a mean age of 80.6 (SD = 10.1) years, of which 58.7% presented cognitive decline. For these, the mean number of unmet needs was greater than for those without (4 vs 3, P < 0.001), and they differed significantly in the domains of daytime activities (P < 0.001), memory (P < 0.001) and psychotic symptoms (P = 0.005). A significant negative correlation was found between MMSE and number of unmet needs (rs = −0.369, P < 0.001). Considering the severity stages, unmet needs also differed: more needs in early stages in daytime activities (73.3%), and in advanced ones in memory (63.9%) and psychotic symptoms (23%).ConclusionsGreater cognitive decline was related with more unmet needs, which agree with previous studies. The different nature of needs across severity stages also suggests that interventions should be tailored comprising this specificity and complexity, when effective care is planned.Disclosure of interestThe authors have not supplied their declaration of competing interest.

P4557Factors associated with treatment and control of hypertension in a healthy elderly population free of cardiovascular disease: a cross-sectional study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Chowdhury ◽  
M R Nelson ◽  
M E Ernst ◽  
K L Margolis ◽  
L J Beilin ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Elderly Population ◽  
Educational Status ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Uncontrolled Hypertension ◽  
Ageing Population ◽  
Cross Sectional ◽  
Healthy Elderly ◽  
And Control

Abstract Introduction Despite readily available treatments, control of high blood pressure (BP) in the ageing population remains suboptimal. Gaps in understanding the management of high BP amongst the elderly exist, as most studies have been in predominantly middle-aged populations. Purpose We explored pharmacological BP lowering treatment and control among elderly hypertensive participants free from overt cardiovascular disease (CVD), and identified factors related to both “untreated” and “treated but uncontrolled” high BP. Methods We analyzed baseline data from 19,114 individuals aged ≥65 years enrolled from Australia and the US in the ASPirin in Reducing Events in the Elderly (ASPREE) study. Hypertension was defined as an average systolic/diastolic BP ≥140/90 mmHg and/or use of any BP-lowering medication. `Controlled hypertensives” were those receiving BP-lowering medication and with BP <140/90 mmHg. Descriptive analyses were used to summarize hypertension control rates; logistic regression was used to investigate relationships with treatment and BP control. Results Overall, 74% (14,213/19,114) of participants were hypertensive, and of these 29% (4,151/14,213) were untreated. Among those treated, 47% (4,732/10,062) had BP <140/90 mmHg. Participants who were untreated were more likely to be men, have higher educational status, and be in good physical health, and less likely to have significant comorbidities. The factors related to “treated but uncontrolled” hypertension included older age, being men, Black race (versus White), using BP lowering monotherapy and residing in Australia (versus US) (Figure 1). Conclusion(s) There were high levels of “untreated” and “treated but uncontrolled” BP, in an otherwise healthy elderly population, suggesting that opportunities for better BP control exist through targeting intervention to high-risk individuals. Acknowledgement/Funding National Institute on Aging and the National Cancer Institute at NIH; NHMRC Australia, Monash University, Victorian Cancer Agency (Australia)

Behavioral and Psychological Symptoms: A Contribution for their Understanding Based on the Unmet Needs Model

2017 ◽  
Vol 41 (S1) ◽  
pp. S657-S657
Author(s):  
A.R. Ferreira ◽  
S. Martins ◽  
C. Dias ◽  
M.R. Simões ◽  
L. Fernandes
Keyword(s):  
Nursing Homes ◽  
Unmet Needs ◽  
Psychological Symptoms ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Final Sample ◽  
Camberwell Assessment Of Need ◽  
Competing Interest ◽  
Behavioral And Psychological Symptoms

IntroductionBehavioural and psychological symptoms (BPSD) are frequent in dementia and their contribution to poor health outcomes is well recognized. Four major frameworks attempt an explanation their aetiology: biological, behavioural, environmental vulnerability and unmet needs models. The latter states that BPSD are symptoms of needs that are not being met due to patients’ decreased ability to communicate/fulfil them. This model also implies that if needs were met, BPSD would improve.AimsTo explore the relation between needs and BPSD, and describe which unmet needs were contributing to BPSD in an elderly sample.MethodsA cross-sectional study was conducted in three Portuguese nursing homes. All residents were considered eligible. However, those unwilling or unable to participate were excluded. For each elderly patient, needs were assessed with camberwell assessment of need for the elderly/cane and BPSD with European Portuguese neuropsychiatric inventory/NPI.ResultsThe final sample included 166 elderly with an average of 80.9(sd = 10.2) years. Significant correlations between NPI and unmet and global needs were found (rs = 0.181,P = 0.020; rs = 0.254,P = 0.001, respectively). Additionally, the unmet needs of daytime activities (P = 0.019), company (P = 0.028) and behaviour (P = 0.001), presented significant correlations with NPI.ConclusionIn this sample, a high number of unmet needs were found. The absence of daytime activities, company and behaviour contributed to the identified BPSD, which is in line with other studies also highlighting the importance of these needs in nursing homes. This not only provides a framework for understanding BPSD, but also points to the identification of unmet needs as pivotal in prevention and treatment of these symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Cognitive performance and engagement in physical, social and intellectual activities in older adults: The FIBRA study

2015 ◽  
Vol 9 (3) ◽  
pp. 270-278 ◽  
Author(s):  
Giovana Sposito ◽  
Anita Liberalesso Neri ◽  
Mônica Sanches Yassuda
Keyword(s):  
Cognitive Decline ◽  
Cognitive Performance ◽  
Family Income ◽  
Linear Regression Analysis ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Multivariate Linear Regression Analysis ◽  
Cross Sectional ◽  
Cognitive Domains ◽  
Intellectual Activities

Cognitive decline in aging can negatively impact quality of life in the elderly. However, studies have shown that elderly engaged in advanced activities of daily living (AADLs) can maintain or enhance global cognitive function or specific domains. Objective: To investigate the relationship between engagement in AADLs and domains of cognition in elderly from seven different locations in Brazil. Methods: A cross-sectional study involving 2,549 elderly without cognitive deficits suggestive of dementia was conducted. Data were collected on sociodemographic characteristics, health status, the Mini-Mental State Exam (MMSE) by subdomain (orientation, memory, attention/calculus, language and constructional praxis), and engagement in AADL grouped under physical, social and intellectual activities. Results: Multivariate linear regression analysis revealed an association, albeit modest, between intellectual AADLs and the domains orientation, attention/calculus, language and constructional praxis (R2=0.005, 0.008, 0.021, and 0.021 respectively). Social AADLs were correlated with memory (R2=0.002) and language (R2=0.004) domains. No association was found between physical AADLs and MMSE domains. Schooling and family income were the sociodemographic variables exhibiting the strongest relationship with cognitive domains. Conclusion: The study found associations between intellectual and social AADLs with higher cognitive performance, suggesting that active aging can provide opportunities to attenuate cognitive decline in aging.

scholarly journals PROFIL PENURUNAN FUNGSI KOGNITIF PADA LANSIA DI YAYASAN-YAYASAN MANULA DI KECAMATAN KAWANGKOAN

e-CliniC ◽  
2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Rachel Mongisidi ◽  
Rizal Tumewah ◽  
Mieke A. H. N. Kembuan
Keyword(s):  
Cognitive Decline ◽  
Elderly People ◽  
Sex Education ◽  
Cognitive Functions ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Number Of Children ◽  
History Of ◽  
Descriptive Survey

Background: The cognitive impairment in elderly people is the major cause of the inability to execute the daily activity and of the major reason of the happening of care-dependence. There has not been any research about the profile of cognitive functions impairment in the District of Kawangkoan. Thus, the purpose of this research was to obtain the profile of cognitive functions impairment in the District of Kawangkoan. Methods: This was a descriptive survey with the design of cross-sectional study, which rolls out, the results of MMSE, TMT A, TMT B and CDT; the age, sex, education, occupations, family history of cognitive decline, marital status, the number of children, and the history of stroke and DM, and also the smoking profile of the participants. The subjects of this research were the elderly people that were the members of the old people foundations in the District of Kawangkoan. Results: There were 61 participants of this research, consisting of four males (6.6%) and 57 (94.4%) females participants. The result of this research shows that the MMSE scores were mostly normal (72.1%), the TMT A and the TMT B scores were both mostly abnormal (95.1% and the latter 72.1%), the CDT scores mostly normal (67.2%). In all these three instruments have the absolute result that was, the elderly people with older age has more numbers of participants with cognitive functions impairment than the younger age. The result also shows that the group of subjects with higher education has less numbers of cognitive decline subjects than the group of subjects with lower education. The subjects that had a former occupation as a teacher have the normal cognitive functions as the results of all the tests. Subjects that were married and have children, and do not have a history of stroke, DM and smoking got the score of normal cognitive functions. Conclusions: The cognitive functions of elderly people based on the MMSE and CDT scores, show that most of them have a normal cognitive functions where as the result of the TMT part A and the TMT part B show the opposite result that is most of the participants have an abnormal score. Key words: Cognitive functions impairment – Elderly peopleLatar Belakang: Penurunan fungsi kognitif pada lansia merupakan penyebab terbesar terjadinya ketidakmampuan dalam melakukan aktifitas normal sehari-hari, dan juga merupakan alasan tersering yang menyebabkan terjadinya ketergantungan terhadap orang lain untuk merawat diri sendiri. Belum pernah ada penelitian tentang profil penurunan fungsi kogntif di Kec. Kawangkoan. Tujuan dari penelitian ini untuk mengetahui profil penurunan fungsi kognitif pada lansia di Kecamatan Kawangkoan. Metode: Penelitian survey deskriptif dengan rancangan penelitian potong lintang, yang memaparkan data hasil pemeriksaan MMSE, TMT A, TMT B, CDT, umur, jenis kelamin; riwayat pendidikan, pekerjaan, keluarga dengan penurunan fungsi kognitif, status pernikahan dan jumlah anak, riwayat penyakit stroke, diabetes mellitus dan merokok. Subjek penelitian adalah para lansia yang menjadi anggota dari yayasan-yayasan manula yang ada di Kec. Kawangkoan. Hasil: Terdapat 61 sampel dari total 65 subjek penelitian. Sampel terdiri dari 4 orang berjenis kelamin laki-laki (6.6%) dan 57 perempuan (94.4%). Penelitian menunjukkan hasil pemeriksaan MMSE menunjukkan 72.1% normal, TMT A 95.1% tidak normal, pemeriksaan TMT B 72.1% tidak normal dan CDT67.2% normal. Pada hasil pemeriksaan ditemukan hasil absolut pada ketiga jenis pemeriksaan ini yaitu lebih banyak terdapat penurunan fungsi kognitif pada lansia dengan umur yang lebih tua. Profil fungsi kognitif berdasarkan riwayat pendidikan menunjukkan bahwa sampel dengan pendidikan kurang dari sembilan tahun sebagian besar mengalami penurunan fungsi kogntif. Riwayat pekerjaan guru seluruhnya memiliki hasil fungsi kognitif yang normal sedangkan sampel yang riwayat pekerjaannya petani lebih banyak mengalami penurunan fungsi kognitif. Sampel yang tidak menikah dan tidak memiliki anak memiliki hasil penurunan fungsi kognitif yang dominan daripada yang menikah dan memiliki anak. Pada hasil ditemukan bahwa sampel yang memiliki riwayat stroke, DM dan merokok positif memiliki hasil penurunan fungsi kognitif yang dominan disbanding yang tidak memiliki riwayat stroke, DM dan merokok. Kesimpulan: Hasil pemeriksaan fungsi kognitif berdasarkan pemeriksaan MMSE dan CDT menunjukkan bahwa sebagian besar lansia masih memiliki fungsi kogntif yang normal sedangkan pada TMT A dan TMT B ditemukan hasil sebaliknya di mana ditemukan hasil sebagian besar mengalami penurunan fungsi kognitif. Kata Kunci: Penurunan fungsi kognitif – Lansia

scholarly journals Is cognitive decline in the elderly associated with contextual income? Results of a population-based study in southern Brazil

2016 ◽  
Vol 32 (5) ◽  
Author(s):  
Ana Lúcia Danielewicz ◽  
Katia Jakovljevic Pudla Wagner ◽  
Eleonora d'Orsi ◽  
Antonio Fernando Boing
Keyword(s):  
Cognitive Decline ◽  
Skin Color ◽  
The Elderly ◽  
Population Based ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Income Quintile ◽  
Southern Brazil ◽  
Cross Sectional ◽  
Socioeconomic Environment

Abstract: The aim of this study was to estimate the association between contextual income and cognitive decline in the elderly in Florianópolis, a medium-sized city in southern Brazil. A nested cross-sectional study was performed in a cohort of elderly ≥ 60 years (n = 1,197), interviewed in the second wave (2013/2014) of the EpiFloripa cohort. Cognitive decline was assessed with the Mini Mental State Examination (MMSE) and contextual income was measured as the mean monthly income of the heads of households. Individual adjustment variables were sex, age, skin color, per capita household income, years of schooling, and time living in the neighborhood. The data were analyzed using multilevel logistic regression. The odds of cognitive decline were twice as high (OR = 1.99; 95%CI: 1.03; 3.87) in elderly living in census tracts with the lowest income quintile compared to those in the highest quintile, independently of individual characteristics. In conclusion, the socioeconomic environment is related to cognitive decline and should be considered in public policies with a focus on health of the elderly.

scholarly journals Effects of kidney function, serum albumin and hemoglobin on dementia severity in the oldest old people with newly diagnosed Alzheimer’s disease in a residential aged care facility: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jia-Jyun Wu ◽  
Shuo-Chun Weng ◽  
Chih-Kuang Liang ◽  
Chu-Sheng Lin ◽  
Tsuo-Hung Lan ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Cognitive Decline ◽  
Kidney Function ◽  
Oldest Old ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Old People ◽  
Cross Sectional ◽  
Dementia Severity ◽  
The Mean

Abstract Background Chronic kidney disease (CKD), low serum albumin, and anemia are known risk factors for cognitive decline in older people. We investigated the association between kidney function and cognitive impairment severity in oldest-old people with a diagnosis of Alzheimer’s disease (AD). Methods A cross-sectional study of patients aged 80 years and older was conducted at a veterans’ home in Taiwan between 2012 and 2016. Their estimated glomerular filtration rate (eGFR) was determined using the Modification of Diet in Renal Diseases (MDRD) equation. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Results A total of 84 patients (age mean ± SD, 86.6 ± 3.9 years) had MMSE scores of 10.1 ± 6.7, and CDR scores of 1.6 ± 0.7. The average eGFR was 61.7 ± 21.5 mL/min/1.73m2. The mean hemoglobin concentration was 12.7 ± 1.7 g/dl, and the mean albumin concentration was 4.5 ± 4.8 g/dl. Multivariate regression analyses showed that scores of CDR were significantly correlated with eGFR after adjustment for potential confounders. The scores of MMSE were significantly correlated with serum albumin and hemoglobin after adjustment for potential confounders. Conclusions We found dementia severity was significantly associated with kidney function, serum albumin, and hemoglobin in the oldest-old with AD. We recommend that oldest-old people with a diagnosis of AD be evaluated to determine kidney function, as well as nutritional and hematological status. Further study is needed to establish whether prevention of CKD deterioration, and correction of malnutrition and anemia may help to slow cognitive decline in oldest-old people with dementia.

A Cross-Sectional Study of Common Health Problems of the Elderly

2011 ◽  
Vol 4 (5) ◽  
pp. 509-511
Author(s):  
Pranay Gandhi ◽  
◽  
Sunita Sharma ◽  
Prateek Gandhi
Keyword(s):  
The Elderly ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Sectional Study ◽  
Cross Sectional

PHYSICAL, SOCIAL ACTIVITIES AND QUALITY OF LIFE OF THE ELDERLY LIVING IN TRUONG AN WARD, HUE CITY IN 2016

2019 ◽  
pp. 55-62
Author(s):  
Vuong Diem Khanh Doan ◽  
Ngoc Minh Chau Ho ◽  
Thi Van Ngo ◽  
Thi Bao Nga Phan ◽  
Thi Hong Phan Nguyen
Keyword(s):  
Quality Of Life ◽  
The Elderly ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Physical Activities ◽  
Social Activities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Elderly Living

Background: Vietnam is entering the stage of aging population; as a result, the quality of life (QOL) of the elderly is really a matter of concern. There is a great deal of research on the quality of life of the elderly while Vietnam witnesses a lack of research on this topic, especially on how physical and social activities have impact on QOL of the elderly. Objectives: (1) To describe the situation of participation in physical, social activities and QOL of the elderly residing in Truong An Ward, Hue city. (2) To examine the association between physical, social activities and QOL among participants. Methodology: This study used cross-sectional study design. A total sample of 420 people aged 60 and above in Truong An Ward, Hue city were interviewd. The SF36 was used to measure the QOL of participants. Results: Percentage of the elderly taking part in physical activity were 66%. 49% reported having the habit of taking part in social activities. The majority of the elderly get their QOL level in three health fields, namely physical, mental and general health at above average. (56.0, 60.7 and 60.8 respectively). There were significant associations between physical activities, social activities and QOL among participants. Conclusion: The percentage of the elderly taking part in physical and social activities were still low. Besides, QOL of the elderly at the research location was not really high. It’s important to encourage the elderly taking part in physical and social activities to improve their quality of life. Key words: Physical activities, social activities, QOL, the elderly

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