The Use and Cost of Community Care Services by Elders with Unimpaired Cognitive Function, with Cognitive Impairment/No Dementia and with Dementia

1997 ◽  
Vol 16 (4) ◽  
pp. 665-681 ◽  
Author(s):  
Evelyn Shapiro ◽  
Robert B. Tate
Keyword(s):  
Cognitive Impairment ◽  
Daily Living ◽  
Community Care ◽  
Independent Predictor ◽  
Living Arrangement ◽  
The Elderly ◽  
Mental Functioning ◽  
Care Services ◽  
Diagnosis Of Dementia ◽  
Cognitive Impairment No Dementia

ABSTRACTData from the Manitoba Study of Health and Aging were used to compare the utilization and direct costs of formal community care services among the elderly diagnosed as persons with no cognitive impairment, with cognitive impairment/no dementia and with dementia. The results of the analyses indicate that, in addition to living arrangement and limitation on basic and instrumental activities of daily living, mental function diagnosis is an independent predictor of community care use. A diagnosis of dementia increases the likelihood of community care use over those with unimpaired mental functioning, whereas cognitive impairment without dementia does not. The three diagnostic groups differ in the type of services used. Standardization by age, sex and the other variables which significantly affect the need for community care can help a program improve its ability to project realistic cost estimates.

scholarly journals Mild cognitive impairment in the elderly Relationship between communication and functional capacity

2018 ◽  
Vol 12 (2) ◽  
pp. 165-172 ◽  
Author(s):  
Ana Iza Gomes da Penha Sobral ◽  
Cláudia Marina Tavares de Araújo ◽  
Marcos Felipe Falcão Sobral
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Elderly People ◽  
Communication Skills ◽  
Social Communication ◽  
Daily Living ◽  
The Elderly ◽  
Intermediate Form ◽  
Instrumental Activities

Abstract Mild Cognitive Impairment is characterized as an intermediate form between age-related change and dementia. For the elderly, autonomy and independence are related to the ability to remain active in conducting their social activities and, for this to occur, communication is fundamental in this process. Objective: To assess the association between communication and the abilities of elderly people with mild cognitive impairment to perform instrumental activities of daily living. Methods: A cross-sectional, quantitative, analytical, correlational study was conducted at the Open University of the Third Age (UnATI), a program of the Federal University of Pernambuco. This study included 92 people, comprising 46 elderly with mild cognitive impairment and a caregiver or family member who met the inclusion criteria. The elderly were asked to complete a sociodemographic questionnaire and Lawton-Brody’s Instrumental Activities of Daily Living Scale. The caregivers were asked to complete the Functional Assessment of Communication Skills. The following variables were studied: social communication skills and instrumental activities of daily living. Data were stored in an Excel® 2007 spreadsheet, and the Pearson correlation test was used for the statistical analysis. Results: There were statistically significant correlations in four domains of social communication: referring to family members by name (p=0.0033); requesting information about people or events (p=0.0355); understanding conversations in a noisy environment (p=0.0448); and understanding what they watch on television or listen to on the radio (p=0.0127). Conclusion: Changes in the communication of elderly people with mild cognitive impairment interfere with their ability to perform instrumental activities autonomously and independently.

Informant-Reported Discrimination, Dementia, and Cognitive Impairment in Older Brazilians

2021 ◽  
pp. 1-9
Author(s):  
Jose M. Farfel ◽  
Lisa L. Barnes ◽  
Ana Capuano ◽  
Maria Carolina de Moraes Sampaio ◽  
Robert S. Wilson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sex Education ◽  
The Elderly ◽  
Structured Interview ◽  
Racially Diverse ◽  
Clinical Dementia Rating ◽  
Community Based ◽  
Poor Cognitive Function ◽  
Diagnosis Of Dementia ◽  
Everyday Discrimination

Background: Self-reported discrimination is a source of psychosocial stress that has been previously associated with poor cognitive function in older African Americans without dementia. Objective: Here, we examine the association of discrimination with dementia and cognitive impairment in racially diverse older Brazilians. Methods: We included 899 participants 65 years or older (34.3% Black) from the Pathology, Alzheimer’s and Related Dementias Study (PARDoS), a community-based study of aging and dementia. A structured interview with informants of the deceased was conducted. The interview included the Clinical Dementia Rating (CDR) Scale for the diagnosis of dementia and cognitive impairment proximate to death and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a second measure of cognitive impairment. Informant-reported discrimination was assessed using modified items from the Major and Everyday Discrimination Scales. Results: Discrimination was reported by informants of 182 (20.2%) decedents and was more likely reported by informants of Blacks than Whites (25.3% versus 17.6%, p = 0.006). Using the CDR, a higher level of informant-reported discrimination was associated with higher odds of dementia (OR: 1.24, 95% CI 1.08 –1.42, p = 0.002) and cognitive impairment (OR: 1.21, 95% CI: 1.06 –1.39, p = 0.004). Similar results were observed using the IQCODE (estimate: 0.07, SE: 0.02, p = 0.003). The effects were independent of race, sex, education, socioeconomic status, major depression, neuroticism, or comorbidities. Conclusion: Higher level of informant-reported discrimination was associated with higher odds of dementia and cognitive impairment in racially diverse older Brazilians.

scholarly journals Prevalence and Incidence Rates of Dementia and Cognitive Impairment No Dementia in the Mexican Population

2011 ◽  
Vol 23 (7) ◽  
pp. 1050-1074 ◽  
Author(s):  
Silvia Mejia-Arango ◽  
Luis Miguel Gutierrez
Keyword(s):  
Cognitive Impairment ◽  
Educational Level ◽  
Daily Living ◽  
Panel Study ◽  
Incidence Rates ◽  
Mexican Population ◽  
Future Burden ◽  
Cognitive Impairment No Dementia ◽  
Incidence Of Dementia

Objective: To estimate the prevalence and incidence of dementia and cognitive impairment without dementia (CIND) in the Mexican population. Method: The MHAS study is a prospective panel study of health and aging in Mexico with 7,000 elders that represent eight million participants nationally. Using measurements of cognition and activities of daily living of dementia cases and CIND were identified at baseline and follow-up. Overall incidence rates and specific rates for sex, age, and education were calculated. Results: Prevalence was 6.1% and 28.7% for dementia and CIND, respectively. Incidence rates were 27.3 per 1,000 person-years for dementia and 223 per 1,000 persons-year for CIND. Rates of dementia and CIND increased with advancing age and decreased with higher educational level; sex had a differential effect depending on the age strata. Hypertension, diabetes, and depression were risk factors for dementia but not for CIND. Discussion: These data provide estimates of prevalence and incidence of dementia and cognitive impairment in the Mexican population for projection of future burden.

Inhome Service Use by Caregivers and Their Elders: Does Cognitive Status Make a Difference?

2002 ◽  
Vol 21 (2) ◽  
pp. 257-271 ◽  
Author(s):  
Pamela Hawranik
Keyword(s):  
Cognitive Impairment ◽  
Functional Status ◽  
Service Use ◽  
Living Arrangement ◽  
Cognitive Status ◽  
Personal Care ◽  
Care Services ◽  
Significant Factors

ABSTRACTThe intent of this study was to examine the effect of cognitive status on the use of inhome services by caregivers and their elders. Data from the screening, clinical and community-caregiver phases of the Manitoba Study on Health and Aging (MSHA-1) were analysed utilizing a modified Andersen-Newman model. The findings indicated that those with dementia were more likely to use personal care services and use two or more inhome services than caregivers and their elders with no cognitive impairment and those with cognitive impairment but no dementia. Functional status of the elder and living arrangement of the caregiver and elder were strongly associated with the use of specific inhome services and with overall use. Policy and research implications of the findings including other significant factors such as caregiver employment, are presented.

The Office Assessment of Depression and Cognitive Impairment

2017 ◽  
Author(s):  
Martin Steinberg ◽  
Paul B. Rosenberg
Keyword(s):  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Clock Drawing Test ◽  
Atypical Symptoms ◽  
Cognitive Difficulties ◽  
Patient Health

Changes in mood and/or cognition are common complaints in the elderly population. This chapter uses case studies to illustrate insights to make clinical assessment more efficient. These include assessing for cognitive impairment when depression is present and vice versa, being mindful of assuming that patients reporting cognitive difficulties are “worried well,” avoiding overreaction to very mild symptoms, assessing the four key cortical cognitive domains (amnesia, aphasia, apraxia, agnosia), assessing for subcortical dysfunction, assessing Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), and understanding that depression in the elderly often presents with atypical symptoms. Brief cognitive instruments which can improve assessment include the Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ), Clock Drawing Test (CDT), and the Mini Cog. Brief depression instruments include the Geriatric Depression Scale (GDSS), and Cornell Scale for Depression in Dementia (CSDD).

Quality Improvement in Community-Based, Long-Term Care: Theory and Reality

1994 ◽  
Vol 20 (1-2) ◽  
pp. 59-77
Author(s):  
Eleanor D. Kinney ◽  
Jay A. Freedman ◽  
Cynthia A. Loveland Cook
Keyword(s):  
Daily Living ◽  
Long Term Care ◽  
Care Service ◽  
The Elderly ◽  
Community Based ◽  
Term Care ◽  
Care Theory ◽  
Care Services ◽  
Community Based Services

Community-based, long-term care has become an increasingly popular and needed service for the aged and disabled populations in recent years. These services witnessed a major expansion in 1981 when Congress created the Home and Community-Based Waiver authority for the Medicaid program. Currently, all states offer some complement of community-based, long-term care services to their elderly and disabled populations and nearly all states have Medicaid Home and Community-Based Services waivers which extend these services to their Medicaid eligible clients.An ever increasing proportion of the population is in need of community-based, long-term care services. Between nine and eleven million Americans of all ages are chronically disabled and require some help with tasks of daily living. In 1990, thirty percent of the elderly with at least one impaired activity of daily living used a community-based, long-term care service. Not surprisingly, expenditures for community-based, long-term care have increased.

scholarly journals Factors associated with the institutionalization of the elderly: a case-control study

2016 ◽  
Vol 19 (6) ◽  
pp. 1004-1014 ◽  
Author(s):  
Ezequiel Vitório Lini ◽  
Marilene Rodrigues Portella ◽  
Marlene Doring
Keyword(s):  
Cognitive Impairment ◽  
Elderly People ◽  
Daily Living ◽  
Long Term Care ◽  
The Elderly ◽  
Case Control ◽  
Term Care ◽  
Factors Associated ◽  
Care Facilities

Abstract Objective: to identify the factors associated with the institutionalization of the elderly. Method: a case-control, population-based study was performed with 387 elderly people. The study considered cases of elderly people (n=191) living in long-term care facilities, and a control group (n=196) who lived in homes in urban areas of the city. Both groups were identified from the records of the Family Health Strategy and were randomly selected. Institutionalization was considered a dependent variable, and sociodemographics, clinical factors, functional status, and cognitive impairment were considered independent variables. Comparison between groups was analyzed using the Chi-squared and Pearson tests and the logistic regression model was used in adjusted analysis, with measurements of effect expressed as odds ratio with a 95% confidence interval. Variables with p≤0.20 were considered for entry in the multiple model. Results: variables that remained associated with institutionalization in multiple analysis were: not having a partner (OR=9.7), not having children (OR=4.0), presenting cognitive impairment (OR=11.4), and depending on others to perform basic activities of daily living (OR=10.9). Conclusion: cognitive impairment and dependency for basic activities of daily living were more strongly associated with institutionalization. Home care strategies and preventive actions for risk factors should be stimulated to delay the referral of elderly people to Long Term Care Facilities for the Elderly, and to develop strategies that allow the elderly to remain socially active.

scholarly journals A Systematic Review of the Definitions of Vascular Cognitive Impairment, No Dementia in Cohort Studies

2016 ◽  
Vol 42 (1-2) ◽  
pp. 69-79 ◽  
Author(s):  
Stephanie L. Harrison ◽  
Eugene Y.H. Tang ◽  
Hannah A.D. Keage ◽  
John-Paul Taylor ◽  
Louise Allan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Cohort Studies ◽  
Daily Living ◽  
Vascular Cognitive Impairment ◽  
Cognitive Domain ◽  
Vascular Involvement ◽  
Operational Criteria ◽  
Single Set ◽  
Cognitive Impairment No Dementia

Background/Aims: No set operational criteria for vascular cognitive impairment, no dementia (VCI-ND) have yet been established. The aim of this study is to undertake a systematic review to compare definitions of VCI-ND that have been used in cohort studies. Methods: Medline, PsycINFO and Embase were searched from inception to October 13, 2015. Initially, 3,142 records were screened, and 30 were included in this review. Results: No single set of criteria for defining VCI-ND was identified. VCI-ND was broadly defined as an absence of dementia, cognitive impairment in at least one cognitive domain with signs of vascular involvement, and intact activities of daily living. Conclusion: Defining criteria will enable individuals with VCI-ND to be efficiently compared across cohort studies to more accurately determine the prevalence and risk of dementia.

scholarly journals Elderly Care: A Study on Community Care Services in Sleman, DIY, Indonesia

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Sumini ◽  
Sukamdi ◽  
Evita Hanie Pangaribowo ◽  
Yeremias T. Keban ◽  
Muhadjir Darwin
Keyword(s):  
Developing Countries ◽  
Home Care ◽  
Rapid Growth ◽  
Elderly Population ◽  
Community Care ◽  
Elderly Care ◽  
The Elderly ◽  
Home Care Services ◽  
Care Services ◽  
Local Initiatives

Elderly care services are important to provide in response to the rapid growth of the elderly population. In developing countries like Indonesia, the speed of growth of the elderly population does not simultaneously occur, so the needs for care services vary. This study discusses the emergence of home care services in response to the increase in elderly population. By taking the case of community home care services in Sleman, this study found the pattern and process of the emergence of local initiatives in home care services. This study also revealed an important factor affecting the implementation of community home care services, that is, leadership.

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