Bias in discriminating very mild dementia for older adults with different levels of education in Hong Kong

2014 ◽  
Vol 26 (6) ◽  
pp. 995-1010 ◽  
Author(s):  
Jianfang Chang ◽  
Chi-Shing Tse ◽  
Grace Tak Yu Leung ◽  
Ada Wai Tung Fung ◽  
Kit-Tai Hau ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Hong Kong ◽  
Digit Span ◽  
Community Dwelling ◽  
Disease Assessment ◽  
Mild Dementia ◽  
Low Education ◽  
Education Groups ◽  
Different Levels

ABSTRACTBackground:Education has a profound effect on older adults’ cognitive performance. In Hong Kong, some dementia screening tasks were originally designed for developed population with, on average, higher education.Methods:We compared the screening power of these tasks for Chinese older adults with different levels of education. Community-dwelling older adults who were healthy (N = 383) and with very mild dementia (N = 405) performed the following tasks: Mini-Mental State Examination, Alzheimer's Disease Assessment Scale-Cognitive subscales, Verbal Fluency, Abstract Thinking, and Visual/Digit Span. Logistic regression was used to examine the power of these tasks to predict Clinical Dementia Rating (CDR 0.5 vs. 0).Results:Logistic regression analysis showed that while the screening power of the total scores in all tasks was similar for high and low education groups, there were education biases in some items of these tasks.Conclusion:The differential screening power in high and low education groups was not identical across items in some tasks. Thus, in cognitive assessments, we should exercise great caution when using these potentially biased items for older adults with limited education.

scholarly journals Indian older adults and the digit span A preliminary report

2019 ◽  
Vol 13 (1) ◽  
pp. 111-115 ◽  
Author(s):  
Ravikesh Tripathi ◽  
Keshav Kumar ◽  
Srikala Bharath ◽  
Marimuthu P ◽  
Vikram Singh Rawat ◽  
...  
Keyword(s):  
Older Adults ◽  
Ecological Validity ◽  
Digit Span ◽  
Structured Interview ◽  
Community Dwelling ◽  
Future Research ◽  
Low Literacy ◽  
Digit Span Test ◽  
Span Test ◽  
Low Education

ABSTRACT. The digit span test is widely used to assess attention and working memory. It is a portable, relatively culture-free and frequently used test. However, the cultural validity of this test, particularly in the Indian older population, is not well established. Objective: This study explores the usefulness of the digit span test for Indian older adults with different levels of education. Methods: Two hundred and fifty-eight community-dwelling healthy normal older adults formed the sample of this study. All study participants were screened using a semi-structured interview schedule, the modified MINI Screen, the Indian version of the Mini-Mental State Examination, a measure of activities of daily living and the digit span test administered verbally. Results: The results indicated that participants with higher educational level performed significantly better than low-educated participants on the digit span test. Participants with low education often struggled with the digit span test and resorted to guessing the digits. Conclusion: Our study clearly demonstrates that the digit span test can be useful for educated participants. However, its usefulness and ecological validity is questionable for those with low education and low literacy, warranting future research.

scholarly journals Prediction of 11-year incidence of psychophysically dependent status or death among community-dwelling younger elderlies: from an age-specified community-based cohort study (the NISSIN project)

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Satoe Okabayashi ◽  
Takashi Kawamura ◽  
Hisashi Noma ◽  
Kenji Wakai ◽  
Masahiko Ando ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cohort Study ◽  
Prediction Model ◽  
Nursing Care ◽  
Family Members ◽  
Limited Resource ◽  
Community Dwelling ◽  
Older Individuals ◽  
Regression Analyses

Abstract Background Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. Methods We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2005 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. Results Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714–0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699–0.771). Conclusions We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.

scholarly journals Relationship between Oral Hypofunction and Sarcopenia in Community-Dwelling Older Adults: The Otassha Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6666
Author(s):  
Yoshihiro Kugimiya ◽  
Masanori Iwasaki ◽  
Yuki Ohara ◽  
Keiko Motokawa ◽  
Ayako Edahiro ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cross Sectional Study ◽  
Albumin Level ◽  
Community Dwelling ◽  
Tongue Pressure ◽  
Swallowing Function ◽  
Cross Sectional ◽  
Community Dwelling Older Adults ◽  
The Relationship

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.

scholarly journals Effects of masticatory exercise on cognitive function in community-dwelling older adults

2021 ◽  
Vol 29 ◽  
pp. 125-131
Author(s):  
Tae-Hoon Kim
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Rehabilitation ◽  
Digit Span ◽  
Stroop Test ◽  
Community Dwelling ◽  
Healthy Older Adults ◽  
Digit Span Test ◽  
Span Test ◽  
Test Digit

BACKGROUND: Mastication improves cognitive function by activating cerebral cortical activity, and it is important to demonstrate the cognitive effects of masticatory training using a variety of different interventions. OBJECTIVE: This study aimed to evaluate the effects of masticatory exercise on cognitive function in healthy older adults living in the community. METHODS: For six weeks, twelve participants performed a masticatory exercise using a NOSICK exerciser device, and thirteen subjects performed daily life without masticatory exercises. Trail Making Test, Digit Span Test, and Stroop test were used to measure the cognitive function. RESULTS: The participants in the experimental group showed significant improvements in TMT-A/B (p= 0.001 and 0.004), DST-forward (p= 0.001), and ST-word (p= 0.001). The effect sizes after the intervention were calculated as (1.2 and 0.8) for TMT-A/B, (0.8 and 0.2) for Digit Span Test forward/backward, and (0.6 and 0.2) for Stroop test color/word. CONCLUSIONS: We suggest that the masticatory exercises improve cognitive function in healthy older adults. Therefore, masticatory exercises can be used as a therapeutic exercise during cognitive rehabilitation.

scholarly journals 10-Year Renal Function Trajectories in Community-Dwelling Older Adults: Exploring the Risk Factors for Different Patterns

2018 ◽  
Vol 7 (10) ◽  
pp. 373
Author(s):  
Chia-Ter Chao ◽  
Yung-Ming Chen ◽  
Fu-Hui Ho ◽  
Kun-Pei Lin ◽  
Jen-Hau Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Logistic Regression ◽  
Renal Function ◽  
Estimated Glomerular Filtration Rate ◽  
Community Dwelling ◽  
Multivariate Logistic Regression ◽  
Improve Risk Stratification ◽  
Leukocyte Counts ◽  
Community Dwelling Older Adults

Longitudinal changes of renal function help inform patients’ clinical courses and improve risk stratification. Rare studies address risk factors predicting changes in estimated glomerular filtration rate (eGFR) over time in older adults, particularly of Chinese ethnicity. We identified prospectively enrolled community-dwelling older adults (≥65 years) receiving annual health examinations between 2005 and 2015 with serum creatinine available continuously in a single institute, and used linear regression to derive individual’s annual eGFR changes, followed by multivariate logistic regression analyses to identify features associated with different eGFR change patterns. Among 500 elderly (71.3 ± 4.2 years), their mean annual eGFR changes were 0.84 ± 1.67 mL/min/1.73 m2/year, with 136 (27.2%) and 238 (47.6%) classified as having downward (annual eGFR change <0 mL/min/1.73 m2/year) and upward eGFR (≥1 mL/min/1.73 m2/year) trajectories, respectively. Multivariate logistic regression showed that higher age (odds ratio (OR) 1.08), worse renal function (OR 13.2), and more severe proteinuria (OR 9.86) or hematuria (OR 3.39) were predictive of a declining eGFR while greater waist circumference (OR 1.06) and higher leukocyte counts (OR 1.21) were predictive of an uprising 10-year eGFR. These findings elucidate important features associated with geriatric renal function variations, which are expected to improve their renal care.

scholarly journals Cognitive Outcomes during COVID-19 confiNemeNt in Elderly and their Caregivers using Technologies for DEMentia (CONNECT DEM): study protocol (Preprint)

2020 ◽  
Author(s):  
Jessica Marian Goodman-Casanova ◽  
Elena Dura-Perez ◽  
Gloria Guerrero-Pertiñez ◽  
Pilar Barnestein-Fonseca ◽  
Jose Guzman-Parra ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Social Isolation ◽  
Community Dwelling ◽  
Mild Dementia ◽  
Care Services ◽  
Health And Social Care ◽  
The Impact ◽  
Community Dwelling Older Adults

BACKGROUND Coronavirus disease 2019 has forced worldwide the implementation of unprecedented restrictions to control its rapid spread and mitigate its impact. The Spanish government has enforced social distancing, quarantine and home confinement. This restriction of daily life activities and separation from loved ones may lead to social isolation and loneliness with health-related consequences in community-dwelling older adults with mild cognitive impairment or mild dementia and their caregivers. Additionally, an inadequate access to healthcare and social support services may aggravate chronic conditions. Technology home-based interventions emerge for combating social isolation and loneliness preventing the risk of viral exposure. OBJECTIVE The aim of this cohort study is to explore, analyze and determine the impact of social isolation on: 1) cognition, quality of life, mood, technophilia and perceived stress of community-dwelling older adults with mild cognitive impairment or mild dementia, and on caregiver burden; 2) health and social care services access and utilization, and 3) cognitive, social and entertainment use of ICTs. METHODS This study will be conducted in the Spanish region of Andalucía (Málaga). In total 200 dyads, consisting of a person with mild cognitive impairment or mild dementia (PMCI/MD) and their informal caregiver will be contacted by telephone. Potential respondents will be participants of the SMART 4 MD (N=100) and TV-AssistDem (N=100) clinical trials. RESULTS The change in means in the variables will be analyzed comparing baseline results in the previous studies with those during and after confinement using the ANOVA test of repeated measures or the non-parametric Friedman test if appropriate. The performance of a multivariate analysis of variance (ANCOVA) to introduce possible covariates will also be contemplated. A 95% confidence level will be used. CONCLUSIONS If the hypothesis is proven, these findings will demonstrate the negative impact of social isolation due to the COVID-19 confinement on cognition, quality of life, mood, and perceived stress of community-dwelling older adults with mild cognitive impairment and mild dementia, the impact on technophilia, caregiver burden, and health and social care services access and utilization; and the cognitive, social and entertainment use of ICTs during the COVID-19 confinement and afterwards. CLINICALTRIAL NCT: 04385797

Heart Failure and Disability in Community-Dwelling Older Adults in the United States—1999 to 2018: Data From National Health and Nutrition Examination Survey

2021 ◽  
pp. 105477382110616
Author(s):  
Yaewon Seo ◽  
Jing Wang ◽  
Donelle Barnes ◽  
Surendra Barshikar
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Logistic Regression ◽  
National Health ◽  
The United States ◽  
Community Dwelling ◽  
Nutrition Examination Survey ◽  
Mediating Effects ◽  
Health And Nutrition ◽  
Community Dwelling Older Adults

To examine the associations of heart failure (HF) with five domains of disability while controlling for covariates. Subjects with HF and aged ≥ 50 years were selected from the 1999 to 2018 National Health and Nutrition Examination Survey data. Five domains of disability were measured with 19 physical tasks. Logistic regression with adjustment for covariates was conducted. The prevalence of HF in 27,185 adults aged ≥ 50 years was 6.37%. After controlling for demographics and smoking, logistic regression showed that HF was associated with 2.8 to 3.4 times increased odds of all domains of disability compared to adults without HF, but with additional adjustments of covariates, the association was attenuated indicating the mediating effects of covariates. The future study may examine the mediating effects of covariates when intervening difficulties with lower extremity mobility and activities of daily living while considering in community-dwelling older adults with HF.

scholarly journals QUADRICEPS STRENGTH IS ASSOCIATED WITH COGNITION IN OLDER ADULTS WITH CHRONIC STROKE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S655-S656
Author(s):  
Kimberly Bennett ◽  
Rachel A Crockett ◽  
Lisanne F ten Brinke ◽  
Jennifer C Davis ◽  
Teresa Liu-Ambrose
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Quadriceps Strength ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Total Variance ◽  
Disease Assessment ◽  
Lower Extremity Muscle ◽  
History Of ◽  
Variance Explained

Abstract Individuals who have suffered a stroke are at risk for developing cognitive impairment and dementia. Thus, it is important to identify modifiable risk factor for cognitive decline in this population. Among older adults without a history of stroke, greater muscle strength is associated with better cognitive function. Whether this relationship also exist in older adults with a history of stroke is not known. Thus, we aimed to examine whether cognition, as measured by both the Montreal Cognitive Assessment (MoCA) and the 13-item Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog 13), is associated with lower extremity muscle strength in adults with chronic stroke (&gt; 1 year post stroke). Ninety-one community-dwelling adults, aged 55 years and older, with chronic stroke were included in this analysis. Isometric strength of the quadriceps was measured bilaterally in kilograms. Two linear regression models were constructed to determine the independent association of quadriceps strength (mean kilograms of both legs) with: 1) MoCA; and 2) ADAS-Cog 13, after controlling for age, sex, and mood. Mean quadriceps strength was independently associated with both MoCA and ADAS-Cog scores, after accounting for age, sex, and mood. Specifically, quadriceps strength explained an additional 5.6% of the variable in MoCA scores; total variance explained by the model was 12.0%. For ADAS-Cog 13, quadriceps strength explained an additional 5.4% of the variance; total variance explained by the model was 16.5%. Our current cross-sectional results suggest that the maintenance of muscle strength may be important for cognitive health in older adults who have suffered a stroke.

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