scholarly journals Predictors of financial capacity performance in older adults using the Financial Competence Assessment Inventory

2014 ◽  
Vol 26 (6) ◽  
pp. 921-927 ◽  
Author(s):  
Nancy A. Pachana ◽  
Gerard J. Byrne ◽  
Jill Wilson ◽  
Cheryl Tilse ◽  
Donna M. Pinsker ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Depression Scale ◽  
Later Life ◽  
The Elderly ◽  
Community Dwelling ◽  
Debt Management ◽  
Assessment Tools ◽  
Competence Assessment ◽  
Financial Capacity ◽  
Capacity Performance

ABSTRACTBackground:Declines in financial capacity in later life may arise from both neurocognitive and/or psychiatric disorders. The influence of socio-demographic, cognitive, health, and psychiatric variables on financial capacity performance was explored.Methods:Seventy-six healthy community-dwelling adults and 25 older patients referred for assessment of financial capacity were assessed on pertinent cognitive, psychiatric, and financial capacity measures, including Addenbrooke's Cognitive Examination – Revised (ACE-R), Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Geriatric Depression Scale (GDS), Geriatric Anxiety Inventory (GAI), selected Neuropsychiatric Inventory (NPI) items, Financial Competence Assessment Inventory (FCAI), and Social Vulnerability Scale (SVS).Results:The internal consistency of the debt management subscale of the FCAI was relatively poor in our sample. Financial capacity performance differed between controls and patients. In our sample, performance on the FCAI was predicted by Mini-Mental State Examination, IQCODE, and GAI, but not by ACE-R, GDS, NPI items, or SVS (adjusted R2 = 0.7059).Conclusions:Anxiety but not depression predicted financial capacity performance, possibly reflecting relatively low variance of depressive symptoms in this sample. Current cognitive decline as measured by the informant-rated IQCODE was more highly correlated to financial capacity than either educational attainment or ACE-R scores. Lack of significance of ACE-R data may reflect the instrument's decreased sensitivity to domains relevant to financial capacity, compared with more detailed neuropsychological assessment tools. The FCAI displayed fairly robust psychometric properties apart from the debt management subscale.

scholarly journals Is Depression or Apathy Playing a Key Role in Predicting Financial Capacity in Parkinson’s Disease with Dementia and Frontotemporal Dementia?

2021 ◽  
Vol 11 (6) ◽  
pp. 785
Author(s):  
Vaitsa Giannouli ◽  
Magda Tsolaki
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Frontotemporal Dementia ◽  
Cognitive Abilities ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Decisive Role ◽  
Financial Capacity ◽  
Capacity Performance

(1) Background: Depression and apathy both affect cognitive abilities, such as thinking, concentration and making decisions in young and old individuals. Although apathy is claimed to be a “core” feature of Parkinson’s disease (PD) and frontotemporal dementia (FTD), it may occur in the absence of depression and vice versa. Thus, the aim of this study is to explore whether depression or apathy better predict financial capacity performance in PD and FTD as well as in nondemented participants. (2) Methods: Eighty-eight participants divided into three groups (PD, FTD and non-demented participants) were examined with the Mini-Mental State Examination (MMSE) and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS)—Full and short form. The Geriatric Depression Scale informant version (GDS-15) and the Irritability-Apathy Scale (IAS) we completed by caregivers. (3) Results: The results indicated that both PD and FTD patients’ general cognitive functioning and financial capacity performance is negatively influenced by apathy and not by depression. (4) Conclusions: Differences in financial capacity performance indicate that apathy should not be disregarded in clinical assessments. Further studies on larger PD and FTD populations are necessary in order to investigate the decisive role of mood factors on financial capacity impairment.

scholarly journals Applying generalizability theory to examine assessments of subjective cognitive complaints: whose reports should we rely on – participant versus informant?

2021 ◽  
pp. 1-11
Author(s):  
Q. C. Truong ◽  
C. Choo ◽  
K. Numbers ◽  
A. G. Merkin ◽  
H. Brodaty ◽  
...  
Keyword(s):  
Predominantly White ◽  
Generalizability Theory ◽  
The Elderly ◽  
Community Dwelling ◽  
Assessment Tools ◽  
Sample Population ◽  
Cognitive Complaints ◽  
Longitudinal Measurement ◽  
Measurement Design ◽  
Subjective Cognitive Complaints

ABSTRACT Objectives: This study aimed to apply the generalizability theory (G-theory) to investigate dynamic and enduring patterns of subjective cognitive complaints (SCC), and reliability of two widely used SCC assessment tools. Design: G-theory was applied to assessment scales using longitudinal measurement design with five assessments spanning 10 years of follow-up. Setting: Community-dwelling older adults aged 70–90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study. Participants: The sample included 232 participants aged 70 years and older, and 232 associated informants. Participants were predominantly White Europeans (97.8%). The sample of informants included 76 males (32.8%), 153 females (65.9%), and their age ranged from 27 to 86 years, with a mean age of 61.3 years (SD = 14.38). Measurements: The Memory Complaint Questionnaire (MAC-Q) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Results: The IQCODE demonstrated strong reliability in measuring enduring patterns of SCC with G = 0.86. Marginally acceptable reliability of the 6-item MAC-Q (G = 0.77–0.80) was optimized by removing one item resulting in G = 0.80–0.81. Most items of both assessments were measuring enduring SCC with exception of one dynamic MAC-Q item. The IQCODE significantly predicted global cognition scores and risk of dementia incident across all occasions, while MAC-Q scores were only significant predictors on some occasions. Conclusions: While both informants’ (IQCODE) and self-reported (MAC-Q) SCC scores were generalizable across sample population and occasions, self-reported (MAC-Q) scores may be less accurate in predicting cognitive ability and diagnosis of each individual.

scholarly journals Applicability of a cognitive questionnaire in the elderly and proxy

2008 ◽  
Vol 2 (3) ◽  
pp. 228-232 ◽  
Author(s):  
Renata Areza Fegyveres ◽  
Ana Paula Formigoni ◽  
Cláudia Sellitto Porto ◽  
Maria Teresa Carthery Goulart ◽  
Mirna Lie Hosogi Senaha ◽  
...  
Keyword(s):  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Community Dwelling ◽  
Geriatric Depression ◽  
Community Group ◽  
Proxy Report ◽  
Proxy Responses ◽  
The Mean ◽  
State Examination

Abstract The Informant Questionnaire on Cognitive Decline in the Elderly with the Proxy (IQCODE) was developed as a screening tool for cognition alterations. Objectives: 1) To verify the applicability of IQCODE in the elderly with limited schooling, 2) To verify the reliability of the responses supplied by the aged and their proxies. Methods: Individuals of a Community Group were evaluated using the Mini-Mental State Examination (MMSE), IQCODE and Geriatric Depression Scale (GDS). The IQCODE was applied to informants and proxies. Results: We analyzed 44 individuals, aged between 58-82 years (M=66.8, SD=5.97) with mean elderly-schooling level of 3.75, SD=2.82 and 44 proxies aged 44.5 (SD=13.3), with mean schooling level of 8.25 (SD=4.3). The mean GDS was 8.22, SD=4.90 and 13 participants presented a score suggestive of depressive symptoms. The mean elderly IQCODE score was 3.26, SD=0.69 and 3.21, SD=0.65, for proxy responses. There was no statistical difference between these means. On the MMSE, the mean score was 24.20, SD=4.14 and 18 participants presented scores below the cut-off. The IQCODE answers by the elderly in this latter group were more congruent with MMSE than the answers of proxies. Conclusions: The applicability of the IQCODE in a population with little schooling was verified in that the proxy-report was similar to the elderly report. We can affirm that the elderly answers were more accurate than the proxies, as they were closer to MMSE score. The inclusion of a greater number of participants from community-dwelling settings is necessary to confirm the results obtained in this study.

scholarly journals Depressive symptoms in community-dwelling persons aged ≥60 years in Inanda, Ntuzuma and KwaMashu in eThekwini, KwaZulu-Natal

2015 ◽  
Vol 21 (1) ◽  
pp. 6 ◽  
Author(s):  
Jayalakshmi Narainsamy ◽  
Jennifer Chipps ◽  
Bilkish Cassim
Keyword(s):  
Logistic Regression ◽  
Depressive Symptoms ◽  
Univariate Analysis ◽  
Secondary Analysis ◽  
Depression Scale ◽  
The Elderly ◽  
Epidemiologic Studies ◽  
Household Size ◽  
Community Dwelling ◽  
Primary Study

<p><strong>Background. </strong>Physical and psychological ailments increase with age; while the physical ailments are well documented, mental health issues have received less attention. </p><p><strong>Objective.</strong> To determine the prevalence of depressive symptoms and associated risk factors in individuals aged <strong>≥</strong>60 years living in a low-resource peri-urban area in South Africa. </p><p><strong>Methods. </strong>Secondary analysis was performed on data obtained from a primary study conducted to determine the influence of socioeconomic and environmental factors on the health status and quality of life in older persons living in the Inanda, Ntuzuma and KwaMashu (INK) area. The Center for Epidemiologic Studies Short Depression Scale (CES-D 10) was used to screen for depressive symptoms in the week preceding the interview, and respondents were categorised as having no (score &lt;10), mild (10 - 14), or severe (&gt;14) depressive symptoms. Risk factor associations were tested using Pearson’s χ<sup>2</sup> tests and logistic regression. </p><p><strong>Results. </strong>There were 1 008 respondents (mean (standard deviation) age 68.9 (7.4) years), of whom 503 (49.1%) did not meet criteria for depressive symptoms. Of the 505 (50.1%) respondents who met the CES-D 10 criteria for depressive symptoms, 422 (41.9%) had mild and 83 (8.2%) had severe depressive symptoms. In the univariate analysis, significant associations were found with age (<em>p=</em>0.011), household size (<em>p=</em>0.007), income (<em>p=</em>0.033), disability (<em>p=</em>0.001), nutritional status (<em>p</em>≤0.001), the inability to count on family (<em>p=</em>0.008) and lack of mastery (<em>p</em>≤0.001). In direct binary logistic regression, there were significant associations with lack of mastery (<em>p≤</em>0.001), inability to count on family (<em>p=</em>0.027), malnutrition (<em>p</em>≤0.001) and household size (<em>p=</em>0.024).</p><p><strong>Conclusion. </strong>This study highlights the high prevalence of depressive symptoms in the elderly in the INK area, and the need to promote successful ageing of the elderly population in this area.</p>

scholarly journals The Relationship between Subjective Cognitive Decline and Health Literacy in Healthy Community-Dwelling Older Adults

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 567
Author(s):  
Akio Goda ◽  
Shin Murata ◽  
Hideki Nakano ◽  
Koji Nonaka ◽  
Hiroaki Iwase ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Literacy ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Depression Scale ◽  
Community Dwelling ◽  
Subjective Cognitive Decline ◽  
Healthy Community ◽  
Community Dwelling Older Adults ◽  
The Relationship

Few studies have examined the effects of health literacy on people at risk of developing dementia; its effects on the pathogenesis of subjective cognitive decline (SCD) are particularly unclear. This study aimed to clarify the relationship between health literacy and SCD in a population of healthy community-dwelling older adults. SCD status was assessed using the Cognitive Function domain of the Kihon Checklist (KCL-CF). Health literacy, in turn, was evaluated using the Communicative and Critical Health Literacy (CCHL) scale. Global cognitive function and depressive symptoms were evaluated using the Mini-Mental State Examination (MMSE) and a five-item version of the Geriatric Depression Scale (GDS-5), respectively. Participants who were suspected of having SCD were significantly older than their non-SCD peers, and scored significantly worse on the CCHL, MMSE, and GDS-5. In addition, SCD status was found to be associated with CCHL and GDS-5 scores, as well as age, according to a logistic regression analysis. These findings suggest that low health literacy is linked to SCD morbidity in healthy community-dwelling older adults and should prove useful in the planning of dementia prevention and intervention programs for this population.

scholarly journals Improving Dignity of Care in Community-Dwelling Elderly Patients with Cognitive Decline and Their Caregivers. The Role of Dignity Therapy

2020 ◽  
Vol 10 (12) ◽  
pp. 178
Author(s):  
Heifa Ounalli ◽  
David Mamo ◽  
Ines Testoni ◽  
Martino Belvederi Murri ◽  
Rosangela Caruso ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Early Stage ◽  
Psychosocial Interventions ◽  
The Elderly ◽  
Community Dwelling ◽  
Anticipatory Grief ◽  
Dignity Therapy ◽  
Existential Distress ◽  
Age Related

Demographic changes have placed age-related mental health disorders at the forefront of public health challenges over the next three decades worldwide. Within the context of cognitive impairment and neurocognitive disorders among elderly people, the fragmentation of the self is associated with existential suffering, loss of meaning and dignity for the patient, as well as with a significant burden for the caregiver. Psychosocial interventions are part of a person-centered approach to cognitive impairment (including early stage dementia and dementia). Dignity therapy (DT) is a therapeutic intervention that has been shown to be effective in reducing existential distress, mood, and anxiety symptoms and improving dignity in persons with cancer and other terminal conditions in palliative care settings. The aims of this paper were: (i) To briefly summarize key issues and challenges related to care in gerontology considering specifically frail elderly/elderly with cognitive decline and their caregivers; and (ii) to provide a narrative review of the recent knowledge and evidence on DT in the elderly population with cognitive impairment. We searched the electronic data base (CINAHL, SCOPUS, PSycInfo, and PubMed studies) for studies regarding the application of DT in the elderly. Additionally, given the caregiver’s role as a custodian of diachronic unity of the cared-for and the need to help caregivers to cope with their own existential distress and anticipatory grief, we also propose a DT-dyadic approach addressing the needs of the family as a whole.

Cognitive Decline, Body Mass Index, and Waist Circumference in Community-Dwelling Elderly Participants

2017 ◽  
Vol 30 (2) ◽  
pp. 67-76 ◽  
Author(s):  
Jorge Mario Rodríguez-Fernández ◽  
Emily Danies ◽  
José Martínez-Ortega ◽  
William C. Chen
Keyword(s):  
Body Mass Index ◽  
Waist Circumference ◽  
Cognitive Decline ◽  
Body Mass ◽  
Lean Mass ◽  
The Elderly ◽  
Community Dwelling ◽  
Increased Risk ◽  
Nationally Representative ◽  
Reduced Risk

Objective: The aim of this study was to explore the association of body mass index (BMI), waist circumference (WC), and BMI and WC changes over time with cognitive decline in a nationally representative sample. Methods: A total of 5239 participants (≥65 years) were followed for 3 years as part of the National Health and Aging Trends Study. Cox proportional hazard regression was applied to model the risk of cognitive decline. Results: BMI, after adjusting for WC and main confounders, was associated with reduced risk of cognitive decline (hazard ratio [HR] 0.97 for each unit BMI increase, 0.95-0.99). After stratifying by gender and age, this effect remained significant among females and young elders ≤80 years. A BMI decrease and WC increase >10% over the study period were associated with increased risk of cognitive decline (HR 1.98, 1.16-3.38; HR 1.30, 1.04-1.62, respectively). Conclusion: In the elderly individuals, lean mass, as measured by BMI adjusted for WC, was associated with reduced risk of cognitive decline. Loss of lean mass and gain of fat mass, as measured by WC adjusted for BMI, were associated with elevated risk of cognitive decline.

Enhancing precision of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) using Rasch methodology

2021 ◽  
pp. 1-11
Author(s):  
Quoc Cuong Truong ◽  
Carol Choo ◽  
Katya Numbers ◽  
Alexander G. Merkin ◽  
Perminder S. Sachdev ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Rasch Model ◽  
Interval Data ◽  
The Elderly ◽  
Community Dwelling ◽  
Model Fit ◽  
Level Scale ◽  
Clinical Conditions ◽  
Community Dwelling Older Adults

Abstract Objective: This study aimed to investigate psychometric properties and enhance precision of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) up to interval-level scale using Rasch methodology. Design: Partial Credit Rasch model was applied to the IQCODE-16 scores using longitudinal data spanning 10 years of biennial follow-up. Setting: Community-dwelling older adults aged 70–90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study (MAS). Participants: The sample included 400 participants of the MAS aged 70 years and older, 109 out of those were diagnosed with dementia 10 years after the baseline assessment. Measurements: The IQCODE-16. Results: Initial analysis indicated excellent reliability of the IQCODE-16, Person Separation Index (PSI) = 0.92, but there were four misfitting items and local dependency issues. Combining locally dependent items into four super-items resulted in the best Rasch model fit with no misfitting or locally dependent items, strict unidimensionality, strong reliability, and invariance across person factors such as participants’ diagnosis and relationship to their informants, as well as informants’ age and sex. This permitted the generation of conversion algorithms to transform ordinal scores into interval data to enhance precision of measurement. Conclusions: The IQCODE-16 demonstrated strong reliability and satisfied expectations of the unidimensional Rasch model after minor modifications. Ordinal-to-interval transformation tables published here can be used to increase accuracy of the IQCODE-16 without altering its current format. These findings could contribute to enhancement of precision in assessing clinical conditions such as cognitive decline in older people.

Sport and Recreational Physical Activities Attenuate the Predictive Association of Multimorbidity With Increased Geriatric Depressive Symptoms: A 14-Year Follow-Up Study of Community-Dwelling Older Adults

2021 ◽  
pp. 1-9
Author(s):  
Yonglin Liang ◽  
Francisco T.T. Lai ◽  
Joyce L.Y. Kwan ◽  
Wai Chan ◽  
Eng-Kiong Yeoh
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Physical Activities ◽  
Community Dwelling ◽  
Adjusted Relative Risk ◽  
Recreational Activities ◽  
Community Dwelling Older Adults

Multimorbidity is associated with increased depression risks. Little research examines how physical exercise moderates this association. From an existing cohort of community-dwelling older adults in Hong Kong recruited in 2001–2003, the authors included participants who were successfully interviewed after 14 years (2015–2017). Geriatric depressive symptoms were used as the primary outcome and measured by the 15-item Geriatric Depression Scale, while multimorbidity was operationalized using a list of 19 conditions. Subscores of the Physical Activity Scale for the Elderly measuring light, moderate, and strenuous sport/recreational activities were included as moderators. In total, 1,056 participants were included, of whom 50.7% were multimorbid. Multimorbidity was associated with 12% more geriatric depressive symptoms, but strenuous physical activities were associated with a smaller risk elevation only among multimorbid patients (adjusted relative risk = 0.99, 95% confidence interval [0.98, 0.99]; p = .001). In conclusion, strenuous sport and recreational activities may attenuate the association between multimorbidity and geriatric depressive symptoms.

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