The Dunedin dementia risk awareness project: pilot study in older adults

2019 ◽  
Vol 32 (2) ◽  
pp. 241-254 ◽  
Author(s):  
Yoram Barak ◽  
Andrew R. Gray ◽  
Charlene Rapsey ◽  
Kate Scott
Keyword(s):  
Older Adults ◽  
Physical Exercise ◽  
Protective Factors ◽  
Social Isolation ◽  
Protective Factor ◽  
Lifestyle Changes ◽  
Brain Health ◽  
Dementia Risk ◽  
The Usa ◽  
Postgraduate Qualification

ABSTRACTAims:The USA and UK governmental and academic agencies suggest that up to 35% of dementia cases are preventable. We canvassed dementia risk and protective factor awareness among New Zealand older adults to inform the design of a larger survey.Method:The modified Lifestyle for Brain Health scale quantifying dementia risk was introduced to a sample of 304 eligible self-selected participants.Results:Two hundred and sixteen older adults (≥50 years), with mean ± standard deviation age 65.5 ± 11.4 years (50–93 years), completed the survey (71% response rate). Respondents were mostly women (n = 172, 80%), European (n = 207, 96%), and well educated (n = 100, 46%, with a tertiary qualification; including n = 17, 8%, with a postgraduate qualification). Around half of the participants felt that they were at a future risk of living with dementia (n = 101, 47%), and the majority felt that this would change their lives significantly (n = 205, 95%), that lifestyle changes would reduce their risk (n = 197, 91%), and that they could make the necessary changes (n = 189, 88%) and wished to start changes soon (n = 160, 74%). Only 4 of 14 modifiable risk or protective factors for dementia were adequately identified by the participants: physical exercise (81%), depression (76%), brain exercises (75%), and social isolation (83%). Social isolation was the commonly cited risk factor for dementia, while physical exercise was the commonly cited protective factor. Three clusters of brain health literacy were identified: psychosocial, medical, and modifiable.Conclusion:The older adults in our study are not adequately knowledgeable about dementia risk and protective factors. However, they report optimism about modifying risks through lifestyle interventions.

Clusters of Dementia Literacy: Implications from a Survey of Older Adults

2021 ◽  
pp. 1-6
Author(s):  
Y. Barak ◽  
C. Rapsey ◽  
K.M. Scott
Keyword(s):  
Older Adults ◽  
Protective Factors ◽  
Protective Factor ◽  
Response Rate ◽  
Telephone Survey ◽  
Educational Interventions ◽  
Graduate Degree ◽  
Brain Health ◽  
Dementia Risk ◽  
Dementia Prevention

Clinicians and scientists suggest that up to 40% of dementia cases are potentially preventable. Data on awareness of dementia risk and protective factor among older adults can inform and facilitate designing educational interventions to prevent dementia. We aimed to quantify awareness of dementia risk and protective factors using a telephone survey. The modified Lifestyle for Brain Health scale was used to assess dementia risk and prevention knowledge. A representative sample of 1,005 older adults, mean age 64.02 (standard deviation + 1.4; range: 50-74 years) completed the survey (77% response rate). Under representation of non-European ethnicities was noted. Participants Respondents were all New Zealanders, more women (n=518, 51.5%), mostly European (n=921, 91.6%) and well educated (n=347, 34.5%, university or post-graduate degree). Only 6/14 modifiable risk or protective factors for dementia were adequately identified. Three clusters of dementia literacy were identified: psychosocial, medical and activities. These findings support personalizing dementia prevention efforts via targeted educational packages.

Intensity and Types of Physical Exercise in Relation to Dementia Risk Reduction in Community-Living Older Adults

2015 ◽  
Vol 16 (10) ◽  
pp. 899.e1-899.e7 ◽  
Author(s):  
Allen T.C. Lee ◽  
Marcus Richards ◽  
Wai C. Chan ◽  
Helen F.K. Chiu ◽  
Ruby S.Y. Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Exercise ◽  
Risk Reduction ◽  
Community Living ◽  
Dementia Risk

scholarly journals Benefit-finding buffers the effects of quarantine on older adults’ mental health during the COVID-19 pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 722-722
Author(s):  
Fan Zhang ◽  
Sheung-Tak Cheng
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Online Survey ◽  
Protective Factor ◽  
Negative Impact ◽  
Well Being ◽  
Benefit Finding ◽  
Anxiety Depression ◽  
Moderating Role

Abstract Objective Older adults’ health and well-being may suffer due to prolonged social isolation leading to loneliness and increased stress during the COVID-19 pandemic. The current study aimed to address the role of benefit-finding, defined as the capacity to derive meaning and positive aspects from stressful situations, in older adults’ adaptation to the effects of quarantine. Methods 421 participants aged 50 or above in China participated in an online survey to study the effects of quarantine on loneliness, stress, anxiety, depression and life satisfaction, and the moderating role of benefit-finding. Results The results showed that quarantine was basically unrelated to any outcome. Further analysis showed, however, that the effect of quarantine varied by levels of benefit-finding. Only people with lower benefit-finding reported a higher level of loneliness, perceived stress, anxiety and depression, but no relationships were found at higher benefit-finding. Conclusions The findings extended our understanding of the role of benefit-finding in buffering the negative impact of adversity on older people. By mitigating the effects of prolonged social isolation, benefit-finding served as a protective factor in older people’s adaptation to the sequelae of this pandemic.

scholarly journals Dual Trajectories of Social Isolation and Dementia in Older Adults: A Population-Based Longitudinal Study

2020 ◽  
pp. 089826432095369
Author(s):  
Xiaoling Xiang ◽  
Patrick Ho Lam Lai ◽  
Luoman Bao ◽  
Yihang Sun ◽  
Jieling Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Social Isolation ◽  
Late Onset ◽  
Population Based ◽  
Low Risk ◽  
Steady Increase ◽  
Steady Decrease ◽  
Dementia Risk

Objectives: To identify the interrelations between the trajectories of social isolation and dementia in older adults. Methods: Data came from the National Health and Aging Trends Study 2011–2018 surveys. Group-based dual trajectory modeling was used to examine trajectories and their interrelations. Results: Four trajectories of social isolation—rarely isolated (62.2%), steady increase (13.5%), steady decrease (7.4%), and persistently isolated (16.9%) and dementia risk—persistently low risk (80.4%), increasing with early onset (3.9%), increasing with late onset (4.5%), and persistently high risk (11.2%) emerged. Two-thirds of the low-risk dementia group were in the rarely isolated group. The high-risk dementia group had the most overlap with the decreasing social isolation group (47%), followed by the persistently isolated group (28%). Conclusions: Social isolation and dementia mostly evolved in the same direction. However, the pattern of associations between these trajectories is intricate and may be reversed among long-term dementia survivors.

Feasibility and Preliminary Efficacy of the Lifestyle, Exercise and Diet (LEAD) Study: A Cluster Randomized Controlled Trial of a Combined Exercise and Diet Intervention in Older Adults with Vascular Risk Factors and Early Dementia Risk

2021 ◽  
Author(s):  
Noah Koblinsky ◽  
Nicole Anderson ◽  
Fatim Ajwani ◽  
Matthew Parrott ◽  
Deirdre Dawson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Health Education ◽  
Healthy Eating ◽  
Vascular Risk ◽  
Brain Health ◽  
Dietary Counselling ◽  
Dementia Risk ◽  
Early Dementia ◽  
Cluster Randomized

Abstract Background: Healthy diet and exercise are associated with reduced risk of dementia in older adults. Evidence for the impact of clinical trials on brain health is less consistent, especially with dietary interventions which often rely on varying intervention approaches. Our objective was to evaluate the feasibility and preliminary efficacy of a 6-month intervention combining exercise with a novel dietary counselling approach among older adults with vascular risk factors (VRFs) and early dementia risk. Methods: Participants with VRF’s and SCD or early MCI were cluster randomized into the intervention (exercise + Baycrest Brain-healthy Eating Approach (EX+DIET)) or control group (exercise + brain health education (EX+ED)). Both groups participated in 1-hour of supervised exercise per week and were prescribed additional exercise at home. EX+DIET involved 1-hour per week of group-based dietary counselling comprising didactic education focused on brain healthy eating recommendations, goal setting and strategy training. Whereas, EX+ED involved 1-hour per week of group-based brain health education. The primary outcome was change in hippocampal volume from baseline to 6 months. Secondary outcomes included fitness, diet, cognition, and blood biomarkers. Recruitment challenges and early discontinuation of the trial due to COVID-19 necessitated a revised focus on feasibility and preliminary efficacy. Results: Of 190 older adults contacted, 14 (7%) were eligible and randomized, constituting 21% of our recruitment target. All participants completed the intervention and attended 90% of exercise and diet/education sessions on average. All 6-month follow-up assessments pre-COVID-19 were completed but disruptions to testing during the pandemic resulted in incomplete data collection. No serious adverse events occurred and all participants expressed positive feedback about the intervention. Mean improvements in peak oxygen consumption were observed in both EX+DIET (d = .98) and EX+ED (d =1.15) groups. Substantial improvements in diet and HbA1c were observed in the EX+DIET group compared to EX+ED (d = 1.75 and 1.07, respectively). Conclusions: High adherence and retention rates were observed among LEAD participants and preliminary findings illustrate improvements in cardiorespiratory fitness and diet quality. These results indicate that a larger trial is feasible if difficulties surrounding recruitment can be mitigated. Trial Registration: ClinicalTrials.gov identifier: NCT03056508

scholarly journals Dual Trajectories of Social Isolation and Dementia in Older Adults: A Population-Based Longitudinal Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 319-319
Author(s):  
Xiaoling Xiang ◽  
Patrick Ho Lam Lai ◽  
Yihang Sun ◽  
Ruth Dunkle
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Late Onset ◽  
Developmental Trajectories ◽  
Population Based ◽  
Steady Increase ◽  
Dual Model ◽  
Medicare Beneficiaries ◽  
Dementia Risk

Abstract The purpose of this study was to identify patterns of changes in social isolation and dementia and the interrelations between these developmental trajectories. The study sample included 7,609 Medicare beneficiaries age 65 and older from the National Health and Aging Trends Study 2011 through 2018 surveys. A group-based dual trajectory modeling approach was used to identify distinct groups of developmental trajectories for social isolation and dementia status over the 8-year period. The dual model provided estimates of conditional and joint probabilities linking the two sets of trajectory groups. Changes in social isolation over an 8-year period followed four trajectories: rarely isolated (62.2%), steady increase (13.5%), steady decrease (7.4%), and persistently isolated (16.9%). Changes in dementia risk also followed four trajectories: persistently low risk (80.4%), increasing with early onset (3.9%), increasing with late onset (4.5%), and persistently high risk (11.2%). Over two-third (68%) of the persistently low dementia group were also in the rarely isolated group. Both increasing dementia groups were composed mainly of individuals from the increasing social isolation group (40-43%) and persistently isolated group (24-29%). The persistently high dementia group had the most overlap with the decreasing social isolation group (47%), followed by the persistently isolated group (28%). For the most part, social isolation and dementia evolve in the same direction for older adults over an 8-year period. However, the pattern of associations between these developmental trajectories is complex and may be reversed among long-term dementia survivors.

scholarly journals Insight into the Feasibility and Acceptability of a Multi-lifestyle Dementia Risk Intervention

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 980-981
Author(s):  
Laura Dodds ◽  
Joyce Siette
Keyword(s):  
Older Adults ◽  
Lifestyle Change ◽  
Program Improvement ◽  
Brain Health ◽  
Dementia Risk ◽  
Innovative Program ◽  
Gender Education ◽  
Theoretical Sampling ◽  
Intervention Acceptability ◽  
English Speaking

Abstract Lifestyle interventions based on behaviour change principles may provide a useful mechanism in reducing dementia risk amongst older adults, however intervention acceptability remains relatively unexplored. We assessed the feasibility and acceptability of BRAIN BOOTCAMP, an Australian initiative aiming to improve dementia literary and reduce dementia risk by delivering a brain health box addressing multiple lifestyle factors through education, physical prompts and an individualised brain health profile. Semi-structured phone interviews were conducted with participants (N=94) at completion of the program (3-months) using a theoretical sampling approach to select a range of participants with varying brain health scores, age, gender, education and locality. Interview topics included participants’ overall experience and suggestions for program improvement. Interviews were transcribed and analysed using thematic analysis. Participants were mostly female (79%), with a mean age of 72.6 years (SD=5.4), from an English-speaking background (89.4%) and resided in metropolitan areas (76.6%). Participants positively perceived the program, resulting in high usability and acceptability. Valuable aspects included building dementia awareness in an innovative way, and having re-assessments which identified areas for personal improvement. Participants further discussed how the program prompted lifestyle change, including setting goals (e.g., physical activity) and facilitated a general awareness of their brain health. Suggested improvements included shorter surveys, regular check-ins, and specific tailoring of the program to be more inclusive for older adults with varying levels of health. Our study demonstrated that a simple, innovative program could be a promising medium for delivering comprehensive educational resources and induce lifestyle change for older adults.

scholarly journals Neighborhood greenspace exposure as a protective factor in dementia risk among U.S. adults 75 years or older: a cohort study

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Erik D. Slawsky ◽  
Anjum Hajat ◽  
Isaac C. Rhew ◽  
Helen Russette ◽  
Erin O. Semmens ◽  
...  
Keyword(s):  
Older Adults ◽  
Protective Factor ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Future Research ◽  
Cox Proportional Hazards Models ◽  
Linear Distance ◽  
Dementia Risk ◽  
Normalized Difference Vegetative Index ◽  
Multiple Covariates

Abstract Background Research suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults. Methods Greenspace exposure was computed for 3047 participants aged 75 years and older enrolled in the Gingko Evaluation of Memory Study (GEMS) across four U.S. sites that prospectively evaluated dementia and its subtypes, Alzheimer’s disease (AD), vascular dementia (VaD), and mixed pathologies, using neuropsychiatric evaluations between 2000 and 2008. After geocoding participant residences at baseline, three greenspace metrics—Normalized Difference Vegetative Index, percent park overlap within a 2-km radius, and linear distance to nearest park—were combined to create a composite residential greenspace measure categorized into tertiles. Cox proportional hazards models estimated the associations between baseline greenspace and risk of incident all-cause dementia, AD, and Mixed/VaD. Results Compared to low residential greenspace, high residential greenspace was associated with a reduced risk of dementia (HR = 0.76 95% CI: 0.59,0.98) in models adjusted for multiple covariates. After additional adjustment for behavioral characteristics, Apolipoprotein E ɛ4 status, and other covariates, the association was slightly attenuated (HR = 0.82; 95% CI:0.63,1.06). Those exposed to medium levels of greenspace also had 28% lower risk (HR = 0.72; CI: 0.55, 0.95) of dementia compared to those with low greenspace in adjusted models. Subtype associations between high residential greenspace and AD were not statistically significant. Greenspace was not found to be significantly associated with mixed/vascular pathologies. Conclusions This study showed evidence for an association between residential greenspace and all-cause dementia among older adults. Future research with larger sample size, precise characterization of different dementia subtypes, and assessment of residential greenspace earlier in life may help clarify the role between exposure to greenspace and dementia risk.

scholarly journals COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Emma Gabrielle Dupuy ◽  
Florent Besnier ◽  
Christine Gagnon ◽  
Thomas Vincent ◽  
Catherine-Alexandra Grégoire ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Trial ◽  
Physical Exercise ◽  
Physical Health ◽  
Social Isolation ◽  
Cognitive Training ◽  
Community Dwelling ◽  
Physical Exercises ◽  
Home Based ◽  
Physical Functions

Abstract Background In the context of the COVID-19 pandemic, lockdown and social distancing measures are applied to prevent the spread of the virus. It is well known that confinement and social isolation can have a negative impact on physical and mental health, including cognition. Physical activity and cognitive training can help enhance older adults’ cognitive and physical health and prevent the negative collateral impacts of social isolation and physical inactivity. The COVEPIC study aims to document the effects of 6 months of home-based physical exercise alone versus home-based physical exercise combined with cognitive training on cognitive and physical functions in adults 50 years and older. Methods One hundred twenty-two healthy older adults (> 50 years old) will be recruited from the community and randomized to one of the two arms for 6 months: (1) home-based physical exercises monitoring alone and (2) combined physical exercises monitoring with home-based cognitive training. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as executive functions, processing speed, and episodic memory (composite Z-scores based on validated neuropsychological tests and computerized tasks). The secondary outcome is physical functions, including balance (one-leg stance test), gait and mobility performance (Timed Up and Go, 4-meter walk test), leg muscle strength (5-time sit-to-stand), and estimated cardiorespiratory fitness (Matthews’ questionnaire). Exploratory outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported questionnaires (i.e., Geriatric depression scale-30 items, Perceived stress scale, State-trait anxiety inventory-36 items, Perseverative thinking questionnaire, Connor-Davidson Resilience Scale 10, and 12-item Short Form Survey). Discussion This trial will document the remote monitoring of home-based physical exercise alone and home-based physical combined with cognitive training to enhance cognitive and physical health of older adults during the COVID-19 pandemic period. Remote interventions represent a promising strategy to help maintain or enhance health and cognition in seniors, and potentially an opportunity to reach older adults in remote areas, where access to such interventions is limited. Trial registration Clinical trial Identifier NCT04635462. COVEPIC was retrospectively registered on November 19, 2020.

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