scholarly journals Rates of Cognitive and Functional Impairments in Older Adults Residing in a Continuing Care Senior Housing Community

2021 ◽  
pp. 1-12
Author(s):  
Ryan Van Patten ◽  
Zanjbeel Mahmood ◽  
Tanya T. Nguyen ◽  
Jacqueline E. Maye ◽  
Ho-Cheol Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
Independent Living ◽  
Visual Learning ◽  
Cognitive Test ◽  
Continuing Care ◽  
Cognitive Screening ◽  
Functional Impairments ◽  
Senior Housing ◽  
The Mean

Abstract Objective: The current cross-sectional study examined cognition and performance-based functional abilities in a continuing care senior housing community (CCSHC) that is comparable to other CCSHCs in the US with respect to residents’ demographic characteristics. Method: Participants were 110 older adult residents of the independent living unit. We assessed sociodemographics, mental health, neurocognitive functioning, and functional capacity. Results: Compared to normative samples, participants performed at or above expectations in terms of premorbid functioning, attention span and working memory, processing speed, timed set-shifting, inhibitory control, and confrontation naming. They performed below expectation in verbal fluency and verbal and visual learning and memory, with impairment rates [31.4% (>1 SD below the mean) and 18.49% (>1.5 SD below the mean)] well above the general population (16% and 7%, respectively). Within the cognitive test battery, two tests of delayed memory were most predictive of a global deficit score. Most cognitive test scores correlated with performance-based functional capacity. Conclusions: Overall, results suggest that a subset of older adults in the independent living sector of CCSHCs are cognitively and functionally impaired and are at risk for future dementia. Results also argue for the inclusion of memory tests in abbreviated screening batteries in this population. We suggest that CCSHCs implement regular cognitive screening procedures to identify and triage those older adults who could benefit from interventions and, potentially, a transition to a higher level of care.

scholarly journals Performance-based instrument to assess functional capacity in community-dwelling older adults

2019 ◽  
Vol 13 (4) ◽  
pp. 386-393
Author(s):  
Ana Cláudia Becattini-Oliveira ◽  
Leonardo Cardoso Portela Câmara ◽  
Douglas de Farias Dutra ◽  
Antonia de Azevedo Falcão Sigrist ◽  
Helenice Charchat-Fichman
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
Independent Living ◽  
Community Dwelling ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Clock Drawing Test ◽  
Neuropsychological Functions ◽  
Figure Test ◽  
Community Dwelling Older Adults

ABSTRACT Functional capacity (FC) is a mediator between neuropsychological functions and real-world functioning, but there is a lack of evidence of its correlation in community-dwelling older adults. Objective: The study aim was to determine the FC level of community-dwelling older adults using the UCSD Performance-based Skills Assessment (UPSA) and to evaluate correlation with cognitive screening tests. Methods: Senior center participants were selected according to inclusion criteria: Portuguese fluency, age ≥60 years and self-reported independent living. The subject exclusion criteria were: dementia or other DSM-5 diagnoses, suicidal ideation or intent, non-completion of assessment battery, enrollment in another psychosocial intervention or pharmacotherapy study. FC level was determined by the UPSA, brief UPSA (UPSA-B) and Instrumental Activities of Daily Living scale (IADL’s). The Mini-Mental State Examination (MMSE), Memory of Figure Test (MFT), Verbal Fluency Test (VFT) and Clock Drawing Test (CDT) were used for cognitive assessment. A total of 35 subjects that had a mean age of 72 years, were predominantly females(88.6%) and had mean education level of 11.25 years were evaluated. Results: Mean UPSA and UPSA-B scores were 78.5 and 70, respectively. A statistically significant correlation was observed between the UPSA and IADL, MMSE and VFT. Conclusion: The UPSA serves as a screening assessment of FC in community-dwelling older adults, showing a positive correlation with cognitive screening tests.

scholarly journals HOUSING CONTEXT AND FUNCTIONAL HEALTH AMONG LOWER INCOME OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S968-S968
Author(s):  
Noah J Webster
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Independent Living ◽  
Functional Health ◽  
Assisted Living Facilities ◽  
Lower Income ◽  
Free Standing ◽  
Senior Housing ◽  
Multiunit Housing ◽  
Nationally Representative

Abstract The characteristics of where older adults live have strong links with disability. Although lower income older adults experience disability at higher rates, less is known about the link between housing characteristics and functional health in this group. A within group comparison among this population is needed to understand how aspects of this vulnerable subgroup’s housing context are associated with health outcomes. The present study examines the association between housing and functional health among a U.S. nationally representative sample of independent living (i.e., not living in nursing homes or assisted living facilities) lower income adults age 65+. Using data from round one of the National Health and Aging Trends Study, a sub-sample of N=2,865 lower income (<$15,000 in the past year) older adults was selected for analysis. Regression analyses indicate that lower income older adults living in multiunit buildings reported better functional health compared to those in other housing contexts (e.g., free-standing homes). This link also significantly varied by age and gender. Living in multiunit housing was associated with better functional health among those age 90+, not associated among those age 80-90, and was negatively associated among those age 65-79. In terms of gender, the link between multiunit housing and better functional health was only significant among women. Findings highlight variation in health across lower income older adults’ housing contexts. Potential explanatory mechanisms (e.g., social isolation) will be discussed. Such information can inform senior housing policy regarding best approaches to providing housing for older adults that optimizes and promotes independent living.

scholarly journals High prevalence of dementia among community dwelling older adults in receipt of state funded home care packages: implications for health care planning

2017 ◽  
Vol 36 (2) ◽  
pp. 139-144 ◽  
Author(s):  
I. O’Brien ◽  
K. Smuts ◽  
C. W. Fan ◽  
M. O’Sullivan ◽  
A. Warters
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Independent Living ◽  
Community Dwelling ◽  
Cognitive Screening ◽  
Health Care Planning ◽  
Cross Sectional ◽  
High Prevalence ◽  
Community Dwelling Older Adults ◽  
Prevalence Of Dementia

ObjectivesThe majority of people living with dementia in Ireland reside in their own homes, some supported by formal or informal home care. This audit aimed to estimate the prevalence of dementia and suspected cognitive impairment (CI) among older adults, 65+ years, in receipt of formal home care (domiciliary care) in a defined health service area in North Dublin. A secondary objective of the audit was to explore factors associated with dementia or CI in this cohort.MethodsA cross-sectional audit was conducted on all clients aged 65+ years actively receiving publicly funded home care packages (HCPs) during May 2016 in Healthcare Service Executive CHO9 Dublin North Central. A total of 935 urban community dwelling older adults were included in the study [mean age 83.7 (s.d. 7.4) years and 65% female]. Basic socio-demographic and health data were extracted from common summary assessment reports. Service users were categorised as having (a) dementia if a diagnosis of dementia or cognitive decline which impacts on independent living, was documented by a health professional or (b) suspected CI where a validated cognitive screening tool was applied and the score was indicative of mild CI.ResultsOverall, the estimated prevalence of dementia and suspected CI was 37.1% and 8.7%, respectively. Factors significantly associated with dementia and suspected CI were higher dependency and home care hours, communication difficulty and being non-self-caring (p<0.001). Notably, half (51.6%) of those with either dementia or suspected CI group lived alone.ConclusionsOur findings suggest a high prevalence dementia among HCP users, highlighting a need and opportunity for dementia-specific approaches to support older people in their homes.

scholarly journals Functional capacity assessment of long-lived older adults from Amazonas

2019 ◽  
Vol 72 (suppl 2) ◽  
pp. 49-55 ◽  
Author(s):  
Daiane de Souza Fernandes ◽  
Lucia Hisako Takase Gonçalves ◽  
Angela Maria Rodrigues Ferreira ◽  
Maria Izabel Penha de Oliveira Santos
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
High Energy ◽  
Capacity Assessment ◽  
Cognitive Screening ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

ABSTRACT Objective: To evaluate the functional capacity of long-lived older adults from Amazonas. Method: A cross-sectional epidemiological study was carried out with 116 older adults aged 80 years or older, registered in a primary health care unit in Belém, in the state of Pará, Brazil. The Functional Independence Measure (FIM) was used for functional capacity assessment and the Mini-Mental State Examination (MMSE) for cognitive screening. Univariate and bivariate analyses were carried out, in addition to the Pearson’s chi-square test. Results: The older adults presented modified independence in the self-care, sphincter control and locomotion dimensions, and needed supervision for mobility/transfers. In mobility, men presented complete independence. Modified independence was found in the 80-89 age group. It was observed that, the lower the education level, the worse the cognitive performance. Conclusion: In spite of their advanced age, long-lived older adults still present functional capacity for activities of daily living, even though they required supervision for high energy expenditure tasks, such as mobility and transfers.

scholarly journals Relationship of cognitive function and adjustment difficulties among children and adolescents with dissociative disorder

2016 ◽  
Vol 07 (02) ◽  
pp. 238-243 ◽  
Author(s):  
Rajeev Ranjan ◽  
Manju Mehta ◽  
Rajesh Sagar ◽  
Siddharth Sarkar
Keyword(s):  
Children And Adolescents ◽  
Learning And Memory ◽  
Sustained Attention ◽  
Visual Learning ◽  
Tertiary Care ◽  
Cognitive Test ◽  
Dissociative Disorder ◽  
Care Hospital ◽  
Adjustment Difficulties ◽  
The Mean

ABSTRACT Background and Aims: Although it has been suggested that children and adolescents with dissociative disorder have some cognitive deficits, the association of these cognitive impairments with adjustment difficulties has not been evaluated. The present study aimed to assess the relationship between cognitive functioning and adjustment difficulties in children and adolescents with dissociative disorder. Methods: This cross-sectional, descriptive assessment was carried out in the outpatient setting of child and adolescent psychiatric service in a tertiary care hospital. Fifty newly diagnosed children and adolescents with dissociative disorder were included. The cognitive functions were assessed by varied neuropsychological tests, and Bell’s adjustment inventory was used for assessing various domains of adjustment. Results: The mean age of the sample which comprised 40% males was 13.0 (±2.4) years. The mean intelligence quotient (IQ) of the sample was 90.6. Impairment in cognitive test was maximum for verbal working memory followed by sustained attention, visual learning and memory, and verbal retention and recall. Adjustment difficulties were greatest in the domains of self, followed by domains of health, school, and family. Significant association was found between the IQ and adjustment in school; visual learning and memory and adjustments in school and overall adjustment; and sustained attention and adjustment of health. Conclusions: Dissociative children have poor cognitive ability which may be related to poor adjustment scores.

Testing a Model of Overall Activity in Older Adults

2001 ◽  
Vol 9 (2) ◽  
pp. 142-160 ◽  
Author(s):  
Barbara Resnick
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Physical Health ◽  
Self Efficacy ◽  
Outcome Expectations ◽  
Retirement Community ◽  
Continuing Care ◽  
Efficacy Expectations ◽  
The Mean ◽  
Mental And Physical Health

The purpose of this study was to test a model of overall activity in older adults. It was hypothesized that (a) mental and physical health directly influence sell-efficacy expectations; (b) mental and physical health, age, and self-efficacy expectations influence outcome expectations; and (c) all of these variables directly or indirectly influence overall activity. The sample included 175 older adults living in a continuing care retirement community, and a one-time interview was conducted. The mean age of the participants was 86 ± 5.7 years, and the majority were Caucasian (n = 173, 99%), women (n = 136, 78%), and unmarried (widowed or single; n = 137, 78%). Seven of the 10 hypothesized paths were significant. The variables physical health, self-efficacy expectations. and outcome expectations directly influenced activity, and age and mental health indirectly influenced activity through self-efficacy and outcome expectations. The data fit the model, and combined, these variables accounted for 29% of the variance in activity.

scholarly journals Discontinued Information and Communication Technology Usage among Older Adults in Continuing Care Retirement Communities in the United States

Gerontology ◽  
2017 ◽  
Vol 64 (2) ◽  
pp. 188-200 ◽  
Author(s):  
R.V. Rikard ◽  
Ronald W. Berkowsky ◽  
Shelia R. Cotten
Keyword(s):  
Older Adults ◽  
Health Information ◽  
Independent Living ◽  
General Information ◽  
Retirement Communities ◽  
Continuing Care ◽  
Ict Use ◽  
Continuing Care Retirement Communities ◽  
Information And Communication ◽  
Ict Training

Background: Older adults are increasingly using information and communication technologies (ICTs). Recent studies show beneficial effects of using ICTs for older adults, particularly in terms of reducing loneliness and depression. However, little is known about the factors that may prevent discontinued ICT use in populations that may be at greater risk, such as those in continuing care retirement communities (CCRCs). Objectives: The purpose of this study is to examine a range of factors that may influence discontinued (1) ICT use, (2) searching for health information, and (3) searching for general information over time among CCRC residents. Methods: We use longitudinal data from a randomized controlled trial conducted with residents of 19 CCRCs. We use flexible parametric models to estimate the hazard ratio or hazard rate over 5 waves of data to determine what factors significantly predict discontinued (1) ICT use, (2) health information searching, and (3) general information searching. Results: The analysis reveals that independent living residents who took part in an 8-week ICT training intervention were less likely to stop using ICTs. Age and the number of instrumental activities of daily living (IADL) impairments significantly predicted an increased likelihood of stopping ICT use. When examining specific ICT-related activities, the analysis reveals that independent living residents who took part in the ICT training intervention were less likely to stop searching for health information and general information online. In addition, age and the number of IADL impairments were associated with increased likelihood of discontinued health information searches and discontinued general information searches. Conclusion: ICT training interventions may motivate residents of CCRCs to stay connected by increasing the ICT skill level and promoting confidence, thus decreasing the probability that they will discontinue using ICTs and searching for general information. However, the effects of ICT training on motivating continued ICT usage may be more pronounced among independent living residents. Limitations in the number of IADL impairments is a key factor leading to discontinued use of ICTs among CCRC residents, suggesting that designers of ICTs should be cognizant of the cognitive and physical limitations among this group.

scholarly journals Factors associated with the functional capacity of older adults with leprosy

2017 ◽  
Vol 70 (4) ◽  
pp. 711-718 ◽  
Author(s):  
Paula Sacha Frota Nogueira ◽  
Marilia Braga Marques ◽  
Janaina Fonseca Victor Coutinho ◽  
Juliana Cunha Maia ◽  
Maria Josefina da Silva ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
Family Income ◽  
Living Arrangement ◽  
Clinical Factors ◽  
Cross Sectional ◽  
Referral Service ◽  
Monthly Family Income ◽  
Katz Index ◽  
The Mean

ABSTRACT Objective: to investigate the association between socio-demographic and clinical factors and the functional capacity of older adults with leprosy. Method: cross-sectional analytical study conducted in Fortaleza, Ceará, Brazil, with 77 older adult patients with leprosy in a referral service, through interview, medical records and application of the Katz Index and the Lawton and Brody Scale. Results: the mean age was 68.23 years, with prevalence of men, in stable union/married, with mean monthly family income of 2.04 minimum wages, positive bacillary index, clinical dimorphic form and grade zero disability. In the Lawton and Brody scale, independence (58.5%) was predominant and associated to the variables "living arrangement" and "educational attainment". Total independence (87.0%) was predominant in the Katz Index and statistically associated to the variable monthly family income. Conclusion: most of the participants were classified as independent in the instruments used. Furthermore, the instruments pointed to a greater number of associations with socio-demographic and clinical factors not related to leprosy.

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