Decision-making profile in older adults: the influence of cognitive impairment, premorbid intelligence and depressive symptoms

2019 ◽  
Vol 32 (6) ◽  
pp. 697-703
Author(s):  
Marina Maria Biella ◽  
Alaise Silva Santos de Siqueira ◽  
Marcus Kiiti Borges ◽  
Elyse Soares Ribeiro ◽  
Regina Miksian Magaldi ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Aging ◽  
Multinomial Logistic Regression ◽  
Cognitive Disorders ◽  
Cross Sectional ◽  
Premorbid Intelligence

ABSTRACTObjective:Decision-making (DM) is a component of executive functioning. DM is essential to make proper decisions regarding important life and health issues. DM can be impaired in cognitive disorders among older adults, but current literature is scarce. The aim of this study was to evaluate the DM profile in participants with and without cognitive impairment.Design:Cross-sectional analysis of a cohort study on cognitive aging.Participants:143 older adults.Setting:University-based memory clinic.Methods:Patients comprised three groups after inclusion and exclusion criteria: healthy controls (n=29), mild cognitive impairment (n=81) and dementia (n=33). Participants were evaluated using an extensive neuropsychological protocol. DM profile was evaluated by the Melbourne Decision Making Questionnaire. Multinomial logistic regression was used to evaluate associations between age, sex, educational level, estimated intelligence quotient (IQ), cognitive disorders, depressive or anxiety symptoms, and the DM profiles.Results:The most prevalent DM profile was the vigilant type, having a prevalence of 64.3%. The vigilant profile also predominated in all three groups. The multinomial logistic regression showed that the avoidance profile (i.e. buck-passing) was associated with a greater presence of dementia (p=0.046) and depressive symptoms (p=0.024), but with less anxious symptoms (p=0.047). The procrastination profile was also associated with depressive symptoms (p=0.048). Finally, the hypervigilant profile was associated with a lower pre-morbid IQ (p=0.007).Conclusion:Older adults with cognitive impairment tended to make more unfavorable choices and have a more dysfunctional DM profile compared to healthy elders.

scholarly journals Is there an association between ageist attitudes and frailty?

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Douglas Salguero ◽  
Juliana Ferri-Guerra ◽  
Nadeem Y. Mohammed ◽  
Dhanya Baskaran ◽  
Raquel Aparicio-Ugarriza ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Multinomial Logistic Regression ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Frailty Status

Abstract Background Frailty is defined as a state of vulnerability to stressors that is associated with higher morbidity, mortality and healthcare utilization in older adults. Ageism is “a process of systematic stereotyping and discrimination against people because they are old.” Explicit biases involve deliberate or conscious controls, while implicit bias involve unconscious processes. Multiple studies show that self-directed ageism is a risk factor for increased morbidity and mortality. The purpose of this study was to determine whether explicit ageist attitudes are associated with frailty in Veterans. Methods This is a cross-sectional study of Veterans 50 years and older who completed the Kogan’s Attitudes towards Older People Scale (KAOP) scale to assess explicit ageist attitudes and the Implicit Association Test (IAT) to evaluate implicit ageist attitudes from July 2014 through April 2015. We constructed a frailty index (FI) of 44 variables (demographics, comorbidities, number of medications, laboratory tests, and activities of daily living) that was retrospectively applied to the time of completion of the KAOP and IAT. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multinomial logistic regression models with frailty status (robust, prefrail and frail) as the outcome variable, and with KAOP and IAT scores as the independent variables. Age, race, ethnicity, median household income and comorbidities were considered as covariates. Results Patients were 89.76% male, 48.03% White, 87.93% non-Hispanic and the mean age was 60.51 (SD = 7.16) years. The proportion of robust, pre-frail and frail patients was 11.02% (n = 42), 59.58% (n = 227) and 29.40% (n = 112) respectively. The KAOP was completed by 381 and the IAT by 339 participants. In multinomial logistic regression, neither explicit ageist attitudes (KAOP scale score) nor implicit ageist attitudes (IAT) were associated with frailty in community dwelling Veterans after adjusting for covariates: OR = .98 (95% CI = .95–1.01), p = .221, and OR:=.97 (95% CI = .37–2.53), p = .950 respectively. Conclusions This study shows that neither explicit nor implicit ageist attitudes were associated with frailty in community dwelling Veterans. Further longitudinal and larger studies with more diverse samples and measured with other ageism scales should evaluate the independent contribution of ageist attitudes to frailty in older adults.

scholarly journals Identifying the Factors Related to Depressive Symptoms Amongst Community-Dwelling Older Adults with Mild Cognitive Impairment

2019 ◽  
Vol 16 (18) ◽  
pp. 3449 ◽  
Author(s):  
Dan Song ◽  
Doris S.F. Yu ◽  
Polly W.C. Li ◽  
Qiuhua Sun
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Increased Risk ◽  
Community Dwelling Older Adults

High-level depressive symptoms have been reported in individuals with mild cognitive impairment (MCI), resulting in increased risk of progression to dementia. However, studies investigating the correlates of depressive symptoms among this population are scarce. This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, poor perceived positive social interaction, small social network, low level of physical activity, poor functional status, subjective memory complaint, and poor health perception were correlated with depressive symptoms. The findings highlight that depressive symptoms are sufficient to warrant evaluation and management in older adults with MCI. Addressing social isolation, assisting this vulnerable group in functional and physical activities, and cultivating a positive perception towards cognitive and physical health are highly prioritized treatment targets among individuals with MCI.

scholarly journals Atrial fibrillation and geriatric syndromes: an association beyond traditional risk factors

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D J C P Cataneo ◽  
A P N R Navarrete ◽  
L A L O Lasses ◽  
J E C A Cossio
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Functional Disability ◽  
Multivariate Logistic Regression Analysis ◽  
Geriatric Syndromes ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Severe Cognitive Impairment

Abstract Objectives Atrial fibrillation (AF) is particularly frequent in nonagenarian patients, in whom geriatric syndromes (GS) are also often present and may interfere with treatment decision-making and impact prognosis. Previous work has identified an association between AF and GS in older adults; however, available data is limited for nonagenarian patients and other possibly associated factors. Therefore, this study aims to describe the association between AF and GS in nonagenarian patients. Methods This is a cross-sectional study of 205 nonagenarian patients followed in a third-level hospital's Geriatric Cardiology Clinic. Sociodemographic factors, comorbidities, and GS were investigated. To determine the association between AF and GS, multivariate logistic regression analyses were carried out, taking into account other correlations. Results The mean age of participants was 92.56 (SD 2.39) years; 124 (60.5%) were women. AF was present in 30.7% of participants. Most common GS were sarcopenia (77.6%), risk of malnutrition or malnutrition (69.8%), frailty (52.2%), depressive symptoms (45.9%), cognitive impairment (27.3%), and severe disability for activities of daily living (25.4%). In the multivariate logistic regression analysis, AF was independently associated with frailty (OR 2.57; CI 95% 1.32–5.01; p=0.006), malnutrition (OR 1.95; CI 95% 1.3–8, p=0.045), moderate to severe cognitive impairment (OR 2.15; CI 95% 1.11–4.14; p=0.023), and depressive symptoms (OR 5.84; CI 95% 1.16–4.12, p=0.016). Conclusions AF is independently associated with frailty, malnutrition, depressive symptoms, moderate to severe cognitive impairment and severe functional disability in nonagenarian patients. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Association of Cognitive Impairment With Migrant Status Among Older Adults in India: A Cross-Sectional Study

2021 ◽  
Author(s):  
Shobhit Srivast ◽  
Ruchi Singh ◽  
Prem Shankar Mishra ◽  
Alok Aditya
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Total Sample ◽  
Health Concern ◽  
Bivariate Analysis ◽  
Migrant Status ◽  
Cross Sectional ◽  
Comprehensive Primary Health Care ◽  
Health Vulnerability

Abstract Introduction Among various health implications for older adult, cognitive impairment and related dementias are significant public health concern in many low and middle income countries, including India and lack due attention in policy arena. Socio-economic and health vulnerability are associated with cognitive impairment among older adults. Therefore the present study explores the prevalence and determinants of cognitive impairment among older adults in India with special reference to migrant status of older adults. MethodsData for this study was utilized from recent release of Longitudinal Ageing Study in India (LASI) wave 1 2017-19. The LASI is a nationally representative survey over 72000 older adults age 45 and above across all states and union territories of India. The present study is conducted on the eligible respondent’s age 60 years and above. The total sample size for the present study is 31,464 older adults aged 60 years and above (Male-15,068; Female-16,366). Descriptive and logistic regression analysis carried to fulfil the objective of the study. ResultsOverall, the prevalence of cognitive impairment among male older adults was 6.4% and female older adults 19.8%. Non-migrant status (6.8%) was more likely to face cognitive impairment than migrant status (5.7%) among older adults. The high prevalence of cognitive impairment were found with increasing socio-economic, demographic and multi-morbidities among older adults. Older adults (male 6.7% vs. female 20.2%) with no social participation were more likely to be face cognitive impairment. The result of logistic regression of our study is supported the bivariate analysis. Older adults with migrant status were more likely to be suffered from the cognitive impairment with unadjusted [UOR; 1.57, CI: 1.45-1.70] & after adjusting with covariates [AOR; 1.14, CI: 1.03-1.26] as compared to non-migrant status. Among the individual factors, odds of impairment was very high for the oldest-older adults age group [AOR: 2.95, CI: 2.59-3.36] as compared to young-older adults and further, female older adults were more likelihood to be cognitive impairment [AOR: 1.99, CI: 1.77-2.24] than their counterparts. Similar findings were also found with socio-economic and health vulnerability among older adults.Conclusion The study demonstrates that female older adults need more care and support from community and government as they face higher cognitive impairment. Further, the results significantly varied across different socio-economically, demographically, regionally in cognitive impairment and those who were suffering with co-morbidities. Comprehensive primary health care with community health approach may improve the health status of older adults in later period of life.

scholarly journals The Willingness for Downward Referral and Its Influencing Factors: A Cross-Sectional Study among Older Adults in Shandong, China

2020 ◽  
Vol 17 (1) ◽  
pp. 369
Author(s):  
Xiang Jing ◽  
Lingzhong Xu ◽  
Wenzhe Qin ◽  
Jiao Zhang ◽  
Lu Lu ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Influencing Factors ◽  
Treatment Effect ◽  
Multinomial Logistic Regression ◽  
Outpatient Service ◽  
Essential Medicines ◽  
Inpatient Service ◽  
Cross Sectional ◽  
Medical Institutions

Objectives: The aim of this study was to understand the willingness for downward referral among older adults who were hospitalized in the year before the survey and to explore its influencing factors. Methods: The sample was randomly selected by the multi-stage sampling method. A structural questionnaire was used to collect data from participants age 60 and above in Shandong, China, during August 2017. Data were analyzed by using descriptive statistics, one-way ANOVA, chi-square test, and multinomial logistic regression. Results: Of 1198 participants who were hospitalized in the year before the survey, 28.7% self-initiated downward referral, and 33.9% were willing to accept downward referral after a doctor’s advice. Multinomial logistic regression results showed that self-rated health, treatment effect in primary medical institutions, preference for outpatient service, choice of inpatient service, general understanding of essential medicines, the cost of essential medicines after zero-markup policy, and satisfaction with essential medicines’ reimbursement policy significantly correlated with older adults’ willingness for downward referral. Conclusions: The proportion of older adults who self-initiated downward referral was less than one-third. Doctors’ advice plays an important role in willingness for downward referral. More attention should be paid to improving the treatment effect of primary medical institutions, increasing the benefits of zero-markup policy, and ensuring a high reimbursement for the downward referral to work alongside doctors’ advice.

Fall Worry Restricts Social Engagement in Older Adults

2019 ◽  
Vol 32 (5-6) ◽  
pp. 422-431 ◽  
Author(s):  
Namkee G. Choi ◽  
Martha L. Bruce ◽  
Diana M. DiNitto ◽  
C. Nathan Marti ◽  
Mark E. Kunik
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Social Engagement ◽  
Regression Models ◽  
Multinomial Logistic Regression ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Health Related ◽  
Reported Health ◽  
Longitudinal Associations

Objective: To examine cross-sectional and longitudinal associations between (a) activity-limiting fall worry (ALW) and (b) self-reported health-related restrictions and social engagement among older adults. Method: The National Health and Aging Trends Study Waves 5 (T1) and 6 (T2) provided data ( n = 6,279). Binary and multinomial logistic regression models were used to examine association of T2 social engagement restrictions with T2 fall worry and association of T1–T2 changes in social engagement restrictions with T1–T2 changes in fall worry. Results: ALW was significantly associated with both informal and formal social engagement restriction at T2. Onset of ALW and continued ALW between T1 and T2 were also significantly associated with newly reported restrictions in both informal and formal social engagement at T2 even controlling for falls incidents and changes in health status and other covariates. Discussion: The findings underscore the importance of reducing fall worry and preventing social disengagement in late life.

scholarly journals Physical activity and depression in older adults with and without cognitive impairment

2018 ◽  
Vol 12 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Kornanong Yuenyongchaiwat ◽  
Khajonsak Pongpanit ◽  
Somrudee Hanmanop
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Older Individuals ◽  
Cross Sectional ◽  
Increased Risk

ABSTRACT Low physical activity and depression may be related to cognitive impairment in the elderly. Objetive: To determine depression and physical activity (PA) among older adults with and without cognitive impairment. Methods: 156 older adults, both males and females, aged ≥60 years, were asked to complete the Thai Mini-Mental State Examination (Thai-MMSE), a global cognitive impairment screening tool. Seventy-eight older adults with cognitive impairment and 78 older adults without cognitive impairment were then separately administered two questionnaires (i.e., the Thai Geriatric Depression Scale; TGDS and Global Physical Activity Questionnaire; GPAQ). Logistic regression analysis was used to determine the risk of developing cognitive impairment in the groups of older individuals with and without cognitive impairment. Results: A cross-sectional study of elderly with a mean age of 74.47 ± 8.14 years was conducted. There were significant differences on the depression scale and in PA between older adults with and without cognitive impairment. Further, participants with low PA and high level of depressive symptoms had an increased risk of cognitive impairment (Odds ratio = 4.808 and 3.298, respectively). Conclusion: Significant differences were noted in PA and on depression scales between older adults with and without cognitive impairment. Therefore, increased PA and decreased depressive symptoms (i.e., having psychological support) are suggested to reduce the risks of cognitive impairment in older adults.

scholarly journals Relationships between cognitive leisure activities and cognitive function in older adults with depressive symptoms: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032679 ◽  
Author(s):  
Min Ji Kim ◽  
Kota Tsutsumimoto ◽  
Takehiko Doi ◽  
Sho Nakakubo ◽  
Satoshi Kurita ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
Scale Score ◽  
Leisure Activities ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional

ObjectivesThe current study aimed to elucidate the associations between cognitive leisure activities and cognitive function in an older population stratified by having or not having depressive symptoms.DesignA retrospective cross-sectional study based on a self-report questionnaire.SettingAnnual health check-ups in a rural community in Japan.ParticipantsA total of 11 010 community-dwelling older adults aged ≥65 years (mean age: 74.0±5.4 years) was examined. Participants with missing data for the main outcome (n=1630) were excluded.Outcome measuresCognitive impairment was defined as at least 1.5 SD below the reference threshold (age-adjusted and education-adjusted score) on two of more of the tests in the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Depressive symptoms were defined by a 15-item Geriatric Depression Scale score ≥6. We assessed the frequency of participation in cognitive leisure activities using the validated scale (score: 0–42). A score of ≥8 points was defined as frequent participation in cognitive leisure activities.ResultsA total of 12.6% (n=1186) of the participants had depressive symptoms. There was a significant association between cognitive leisure activities and cognitive impairment in older adults (adjusted OR=0.77, 95% CI=0.65 to 0.94). In older adults with depressive symptoms, a higher frequency of cognitive leisure activities was negatively associated with cognitive impairment (adjusted OR=0.45, 95% CI=0.28 to 0.70). In contrast, there was no significant association in older adults without depressive symptoms (adjusted OR=0.85, 95% CI=0.70 to 1.02).ConclusionsEngaging in cognitive leisure activities in late life is associated with better cognitive function in older adults with depressive symptoms.

Prevalence, Incidence, and Progression of Cognitive Impairment, No Dementia Among Rural-Dwelling Chinese Older Adults

2021 ◽  
pp. 1-10
Author(s):  
Yifei Ren ◽  
Yi Dong ◽  
Tingting Hou ◽  
Xiaolei Han ◽  
Rui Liu ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Multinomial Logistic Regression ◽  
Chinese Older Adults ◽  
Multinomial Logistic Regression Analysis ◽  
Incident Dementia ◽  
Increased Risk ◽  
Cognitive Impairment No Dementia

Background: Few studies have examined occurrence and progression of cognitive impairment, no dementia (CIND) in rural China. Objective: To determine the prevalence and incidence of CIND in rural-dwelling Chinese older adults, and to examine risk and protective factors associated with progression to CIND and dementia. Methods: This population-based study included 2,781 dementia-free participants (age≥65 years) who were examined at baseline (2014) and followed in 2018. Demographic, epidemiological, clinical, and neuropsychological data were collected following a structured questionnaire. We defined CIND according to subjective cognitive complaints and the age- and education-specific Mini-Mental State Examination (MMSE) score. Data were analyzed with the multinomial logistic regression models. Results: The overall prevalence of CIND was 10.54% and the incidence was 28.26 per 1,000 person-years. CIND at baseline was associated with the multi-adjusted odds ratio (OR) of 2.06 (95% confidence interval = 1.23–3.47) for incident dementia. Multinomial logistic regression analysis suggested that compared with no CIND, the multi-adjusted OR of incident CIND was 2.21 (1.51–3.23) for women and 0.62 (0.38–0.99) for high social support, whereas the multi-adjusted OR of incident dementia was 1.14 (1.09–1.18) for older age, 0.29 (0.16–0.53) for high education, and 2.91 (1.47–5.74) for having a stroke history. Conclusion: CIND affects over one-tenth of older adults living in rural communities of western Shandong province. People with CIND are twice as likely to progress to dementia as people without CIND. Female sex, low education, stroke history, and low social support are associated with an increased risk of progression from normal cognition to CIND or dementia.

scholarly journals Depressive symptoms and associated factors in residents living in long-term care facilities from the metropolitan area of Belo Horizonte

2020 ◽  
Vol 14 (4) ◽  
pp. 252-258
Author(s):  
Poliana Fialho de Carvalho ◽  
Claudia Venturini ◽  
Tatiana Teixeira Barral de Lacerda ◽  
Marina Celly Martins Ribeiro de Souza ◽  
Lygia Paccini Lustosa ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Long Term Care ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Cross Sectional ◽  
Term Care ◽  
Self Rated Health ◽  
Care Facilities

OBJECTIVE: To identify the presence of depressive symptoms and its association with self-rated health among older adults living in Long-term Care Facilities. METHODS: This is a cross-sectional study in which institutionalized older adults were screened by using the Mental State Mini Exam. Standard questionnaires were used to collect the following data: 1) sociodemographic variables, 2) depressive symptoms, and 3) self-rated health. The descriptive statistical analysis by measures of central tendency and dispersion was performed to characterize the sample. The multinomial logistic regression analysis was performed to associate the variables. In all tests, the alpha value of 0.05 was considered. RESULTS: A total of 127 older adults living in 47 long-term care facilities were evaluated. Among those who presented depressive symptoms, 32.3% were classified as having mild symptoms and 13.4% had severe symptoms. Regarding self-rated health, 46.5% considered it poor/very poor. In the analysis of the association between mild and severe depressive symptoms and self-rated health, statistical significance (p = 0.004 and p = 0.001, respectively) was found. CONCLUSIONS: The results of this study suggest that more attention should be directed to institutionalized older adults who have symptoms of depression and to their impacts on the negative self-rated health.

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