104 Sociodemographic, Cognitive & Physical Function Characteristics among Older Adult Fallers with and without Cognitive Frailty: Preliminary Results

Abstract Introduction Older adults with frailty and cognitive impairment are more susceptible to falls. The risk factor of falls and faller profiles among older adults in general has been established. However, information regarding potential risk factors and faller patterns among older adults with cognitive frailty is limited. Objective To examine the sociodemographic, cognitive and physical function characteristics of fallers with and without cognitive frailty. Methods A total of 133 community dwelling older adults aged 60 years and above were screened at three older adult activity centres in Kuala Lumpur. Sociodemographic details were obtained via interview. Cognitive Frailty was identified using the Clinical Dementia Rating Scale and Fried Frailty Index. Cognitive function was assessed using the Mini Mental State Examination (MMSE), Digit Span (DS) test and Ray Auditory Verbal Learning Test (RAVLT). The Senior Fitness test was used to asses physical function. Characteristics of falls were documented using a self-administered questionnaire. Data was descriptively analysed; independent T-test was used for continuous variables and chi-square test was used for categorical variables. Results Prevalence of falls was 21.1% (n=28). Within fallers, 42.9% (n=12) were cognitively frail and 57.1% (n=16) were not. Fallers with cognitive frailty were significantly older (mean age = 72.31±5.29) (p<0.001), had lower MMSE scores (p<0.01), lower 2 Minute Step test scores (p<0.001) and lower Lawton Instrumental Activities of Daily Living scores (p<0.05). Descriptively, fallers with cognitive frailty were mostly recurrent fallers (67%), sustained falls outdoors due to ‘slip and fall’ and majority sought medical attention after the fall(s). Conclusion Fallers with cognitive frailty were older and had lower physical and cognitive function as compared to those without. There is a need to further understand the relationship between falls and cognitive frailty in order to provide holistic fall prevention and management strategies. Acknowledgement of grant UKM(DCP-2017-002/2) and Ministry of Higher Education(LRGS/BU/2012/UKM-UKM/K/01).

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Relationship Between Dietary Lutein and Cognition in an Older Adult Population (P14-030-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz052.p14-030-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Krystle Zuniga ◽

Alexandria Turner ◽

Nicholas Bishop

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Older Adult ◽

Verbal Memory ◽

Adult Population ◽

Panel Study ◽

Community Dwelling ◽

Leafy Vegetables ◽

Cognitive Domain ◽

Word Recall

Abstract Objectives The dietary carotenoid lutein accumulates in the brain, and lutein supplementation has been demonstrated to improve cognitive function in older adults. The purpose of the study was to examine the association between dietary lutein intake and cognitive function in a recent and representative sample of the older adult U.S. population. Additionally, we aimed to identify the major contributors to dietary lutein intake in older adults. Methods Observations were drawn from the 2012 Health and Retirement Study (HRS), a nationally-representative panel study of older U.S. adults, and the 2013 Health Care and Nutrition Study (HCNS), which assessed dietary intake via food frequency questionnaire in a subsample of HRS respondents. The analytic sample included 7045 respondents age 50 and older. Cognitive function was evaluated on the cognitive domain of episodic verbal memory, assessed using immediate word recall (IWR) and delayed word recall (DWR). Quartiles of lutein intake were calculated then used to compare IWR and DWR scores in 2012. Descriptive statistics and bivariate comparisons were adjusted for the complex survey design of the HRS and HCNS with results representative of community-dwelling older Americans in 2013. Results The average age of the sample was 65.6 ± 10.3 years old. Leafy vegetables, cruciferous vegetables, dark yellow vegetables, eggs, fruit and other vegetables were significant predictors of dietary lutein intake. Lutein intake was significantly different between quartiles (P < 0.001) with lutein intakes of 720 ± 231 ug/day (Q1), 1468 ± 229 ug/day (Q2), 2394 ± 324 ug/day (Q3), and 5632 ± 3029 ug/day (Q4). Quartiles 3 and 4 had significantly higher IWR and DWR scores than quartiles 1 and 2 (P < 0.001). Conclusions Older adults may benefit from higher lutein intake through consumption of various vegetables, fruits, and eggs, as lutein may specifically protect episodic memory. Further research is needed to identify the mechanism of lutein's cognitive benefits. Funding Sources American Egg Board/Egg Nutrition Center.

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Going outdoors and cognitive function among community-dwelling older adults: Moderating role of physical function

Geriatrics and Gerontology International ◽

10.1111/ggi.12437 ◽

2015 ◽

Vol 16 (1) ◽

pp. 65-73 ◽

Cited By ~ 11

Author(s):

Kazuhiro Harada ◽

Sangyoon Lee ◽

Hyuntae Park ◽

Hiroyuki Shimada ◽

Hyuma Makizako ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Physical Function ◽

Community Dwelling ◽

Community Dwelling Older Adults ◽

Moderating Role

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Informant-Reported Cognitive Decline and Activity Engagement across Four Years in a Community Sample

Gerontology ◽

10.1159/000475594 ◽

2017 ◽

Vol 63 (5) ◽

pp. 469-478 ◽

Cited By ~ 2

Author(s):

Diane E. Hosking ◽

Da Jiang ◽

Kerry A. Sargent-Cox ◽

Kaarin J. Anstey

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Community Sample ◽

Verbal Learning ◽

Cognitive Change ◽

Mental Activity ◽

Community Dwelling ◽

Activity Engagement ◽

Change Scores

Background: Subtle age-related cognitive decline may be associated with the capacity to remain engaged in mental, physical, and social activities. Informant reports of cognitive decline potentially provide additional information to psychometric tests on change in everyday cognitive function relevant to activity engagement. Objective: To investigate relations between decline in everyday cognitive function as assessed by informant report and activity engagement in community-dwelling older adults. Methods: A sample of cognitively normal older adults was drawn from the 2 latest waves of the PATH Through Life Study (n = 1,391; mean age 74.5 ± 1.5, 48.4% female). PATH is a 16-year longitudinal cohort study set in the Canberra/Queanbeyan district, Australia. Assessments were carried out at baseline, and at 3 subsequent time-points 4 years apart. At wave-4, the IQCODE, an informant measure of 4-year cognitive decline was provided by a spouse, family member, or friend of each participant. Activity engagement was assessed by the abbreviated RIASEC Mental Activity List, self-reported frequency and duration of physical activity (Whitehall Questionnaire) and the Lubben Social Network Scale that assessed interaction with family/friends. Participants provided demographic information, self-reported health status (SF-12), and responses to the Goldberg Depression Scale. The Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test (CVLT) were used to measure objective 4-year cognitive change. Those with MMSE score of ≤27 were excluded. Results: IQCODE score predicted disengagement from mental activities over 4 years in cognitively healthy adults (β = -0.056, standard error [SE] = 0.019, p = 0.004). This association was robust to covariate control and change on the SDMT which was also significantly related to mental activity disengagement. In models adjusted for change scores on the SDMT and the CVLT, the IQCODE was associated with less physical (β = -0.692, SE = 0.24, p = 0.004) and social engagement (β -0.046, SE = 0.021, p = 0.032), but relationships were attenuated with the inclusion of covariates. Conclusion: Informant-reported cognitive decline in a non-clinical sample was linked to activities that support cognitive health. Associations were robust to adjustment for cognitive change scores. Utilising informant reports prior to the manifestation of clinically relevant decline may identify those who would benefit most from personalised activity interventions.

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Physical Frailty and Cognitive Functioning in Korea Rural Community-Dwelling Older Adults

Journal of Clinical Medicine ◽

10.3390/jcm7110405 ◽

2018 ◽

Vol 7 (11) ◽

pp. 405 ◽

Cited By ~ 4

Author(s):

Dong Yoon ◽

Su Hwang ◽

Dong Lee ◽

Chung Lee ◽

Wook Song

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Muscle Strength ◽

Cognitive Functioning ◽

Physical Function ◽

Rural Community ◽

Community Dwelling ◽

Physical Frailty ◽

Cognitive Domains ◽

Community Dwelling Older Adults

Cognitive frailty is a heterogeneous clinical manifestation characterized by the simultaneous presence of physical frailty and cognitive impairment. The objective of this study was to investigate the association between physical frailty and cognitive function in rural community-dwelling older Korean adults, taking four cognitive domains into account. We carried out a cross-sectional population-based study which enrolled 104 community-dwelling elderly. Physical frailty phenotype, as well as its individual criteria, were used. Cognitive functioning was examined in the four domains of memory, processing speed, cognitive flexibility, and working memory. Demographic data, lipid profile, muscle strength, physical function, and 25-hydroxyvitamin D (25[OH]D) concentration collected from questionnaire interviews and assessments were included. Of the 104 older adults (77% female), 24.3% were classified as robust, 49.6% as prefrail, and 16.5% as frail. Linear regression analyses showed that the severity of frailty index was associated with four cognitive domains Muscle strength (i.e., Grip strength, Knee extensor and flexor), physical function (i.e., SPPB and Gait speed), and 25[OH]D were associated with poorer cognitive function. Within our population of Korean rural community-dwelling older adults, physical frailty status, muscle strength, physical functions, and biochemical measurements were associated with poorer cognitive function. Synchronicity of physical frailty and cognitive dysfunction may contribute to the negative health-related effects associated with aging.

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Exploring the “Obesity Paradox” as a Correlate of Cognitive and Physical Function in Community-Dwelling Black and White Older Adults

Ethnicity & Disease ◽

10.18865/ed.27.4.387 ◽

2017 ◽

Vol 27 (4) ◽

pp. 387 ◽

Cited By ~ 7

Author(s):

Jeannine S. Skinner ◽

Willie Mae Abel ◽

Katryna McCoy ◽

Conseulo H. Wilkins

Keyword(s):

Older Adults ◽

Executive Function ◽

Cognitive Function ◽

Physical Function ◽

Performance Test ◽

Obesity Paradox ◽

Normal Weight ◽

Community Dwelling ◽

Future Research ◽

Cross Sectional

Objective: The obesity paradox has been documented in aged populations, yet it remains unclear if this paradox persists for physical and cognitive outcomes in community- dwelling older adult populations. Our study examines associations between body mass index (BMI) classification, cognitive function, and physical function. We also investigate whether these associations are modified by race or age. Design: Cross-sectional study. Settings: Senior residential sites and community centers in Saint Louis, Missouri. Participants: Study participants included 331 adults, aged >55 years. Age was stratified into young-old (aged 55-74 years) and older (aged ≥75 years). Outcome Measures: Physical function was measured using the mini-Physical Performance Test (mini-PPT) and grip strength. Cognitive function was assessed with the Short Blessed Test (SBT) and the Trail Making Tests (TMT-A and TMT-B) performance. Results: Older adults who were obese had significantly better cognitive flexibility (TMTB) performance than normal weight older adults (P=.02), and this association was not influenced by age or race. Adiposity was not associated with psychomotor speed (TMTA), general cognition (SBT), or measures of physical function (Ps>.05). Conclusion: In a diverse sample of community-dwelling older adults, we found partial support for the controversial obesity paradox. Our results suggest excess adiposity may be protective for executive function processes. Future research is needed to examine the underlying physiological processes linking adiposity to executive function in older adults. Ethn Dis. 2017;27(4):387-394; doi:10.18865/ed.27.4.387.

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Calf Circumference as a Screening Tool for Cognitive Frailty in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS)

Journal of Clinical Medicine ◽

10.3390/jcm7100332 ◽

2018 ◽

Vol 7 (10) ◽

pp. 332 ◽

Cited By ~ 4

Author(s):

Miji Kim ◽

Min Jeong ◽

Jinho Yoo ◽

Da Song ◽

Chang Won

Keyword(s):

Older Adults ◽

Cohort Study ◽

Cognitive Impairment ◽

Cognitive Function ◽

Frailty Index ◽

Community Dwelling ◽

Calf Circumference ◽

Cross Sectional ◽

Cognitive Frailty ◽

Community Dwelling Older Adults

The aim of this study was to examine calf circumference in relation to cognitive frailty in community-dwelling older adults. Cross-sectional analysis was performed on the first-year baseline data of 1559 adults aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study. The final analysis included 1221 adults who were non-dependent in terms of instrumental activities of daily living, who underwent frailty and cognitive function assessments. Physical frailty was defined using the Fried Frailty Index. Cognitive impairment was defined as a score 1.5 standard deviations below the age-, sex- and education-matched norms on any of four cognitive-function tests. The prevalence of cognitive frailty was 2.8% for men and 3.8% for women. After adjusting for potential confounders, in comparison to the “physically robust without cognitive impairment” group, the estimates of increased odds ratios (ORs) for low calf circumference (<32 cm) were much greater in the prefrail with cognitive impairment (OR 4.62, 95% confidence interval (CI): 2.02–10.61) and frail with cognitive impairment (OR 10.94, 95% CI: 2.87–41.68) groups in men but not in women. Low calf circumference was strongly related to cognitive frailty in men only, suggesting calf circumference can be used as an indicator of these outcomes.

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Do Communication Patterns Affect the Association between Cognitive Impairment and Hearing Loss among Older Adults in Vietnam?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041603 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1603

Author(s):

Tran Dai Tri Han ◽

Keiko Nakamura ◽

Kaoruko Seino ◽

Vo Nu Hong Duc ◽

Thang Van Vo

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Cognitive Impairment ◽

Cognitive Function ◽

Vision Loss ◽

Community Dwelling ◽

Cross Sectional ◽

Ordinal Logistic Regression Analysis ◽

Communication Devices ◽

Community Dwelling Older Adults

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.

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Accelerated Epigenetic Age in Normal Cognitive Aging of Korean Community-Dwelling Older Adults

Biological Research For Nursing ◽

10.1177/1099800420983896 ◽

2021 ◽

pp. 109980042098389

Author(s):

Jongmin Park ◽

Chang Won Won ◽

Leorey N. Saligan ◽

Youn-Jung Kim ◽

Yoonju Kim ◽

...

Keyword(s):

Older Adults ◽

Dna Methylation ◽

Cognitive Function ◽

Cognitive Aging ◽

Community Dwelling ◽

Test Results ◽

Cohen’S D ◽

Epigenetic Age ◽

Epigenetic Age Acceleration ◽

Community Dwelling Older Adults

Background: Epigenetic age acceleration has been studied as a promising biomarker of age-related conditions, including cognitive aging. This pilot study aims to explore potential cognitive aging-related biomarkers by investigating the relationship of epigenetic age acceleration and cognitive function and by examining the epigenetic age acceleration differences between successful cognitive aging (SCA) and normal cognitive aging (NCA) among Korean community-dwelling older adults (CDOAs). Methods: We used data and blood samples of Korean CDOAs from the Korean Frailty and Aging Cohort Study. The participants were classified into two groups, SCA (above the 50th percentile in all domains of cognitive function) and NCA. The genome-wide DNA methylation profiling array using Illumina Infinium MethylationEPIC BeadChip was used to calculate the following: the DNA methylation age, universal epigenetic age acceleration, intrinsic epigenetic age acceleration (IEAA), and extrinsic epigenetic age acceleration (EEAA). We also used Pearson correlation analysis and independent t-tests to analyze the data. Results: Universal age acceleration correlated with the Frontal Assessment Battery test results ( r = −0.42, p = 0.025); the EEAA correlated with the Word List Recognition test results ( r = −0.41, p = 0.027). There was a significant difference between SCA and NCA groups in IEAA ( p = 0.041, Cohen’s d = 0.82) and EEAA ( p = 0.042, Cohen’s d = 0.78). Conclusions: Epigenetic age acceleration can be used as a biomarker for early detection of cognitive decline in Korean community-dwelling older adults. Large longitudinal studies are warranted.

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Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00260-2 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Chisato Hayashi ◽

Soshiro Ogata ◽

Tadashi Okano ◽

Hiromitsu Toyoda ◽

Sonoe Mashino

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Physical Exercise ◽

Lower Extremity ◽

Physical Function ◽

Community Dwelling ◽

Group Exercise ◽

Community Based ◽

Lower Extremity Muscle

Abstract Background The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. Methods We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. Results A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. Discussion Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. Conclusion Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.

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Increasing Older Adult Involvement in Geriatric Assessment: A Mixed-Methods Process Evaluation

Journal of Aging and Health ◽

10.1177/0898264321993321 ◽

2021 ◽

pp. 089826432199332

Author(s):

Wanda Rietkerk ◽

Jannet de Jonge-de Haan ◽

Joris P. J. Slaets ◽

Sytse U. Zuidema ◽

Debby L. Gerritsen

Keyword(s):

Older Adults ◽

Behavior Change ◽

Older Adult ◽

Goal Setting ◽

Geriatric Assessment ◽

Well Being ◽

Community Dwelling ◽

Implementation Processes ◽

Adult Involvement ◽

Community Dwelling Older Adults

Objectives: Goal setting and motivational interviewing (MI) may increase well-being by promoting healthy behavior. Since we failed to show improved well-being in a proactive assessment service for community-dwelling older adults applying these techniques, we studied whether implementation processes could explain this. Methods: Goals set during the comprehensive geriatric assessment were evaluated on their potential for behavior change. MI and goal setting adherence wasassessed by reviewing audiotaped interactions and interviewing care professionals. Results: Among the 280 goals set with 230 frail older adults (mean age 77 ± 6.9 years, 59% women), more than 90% had a low potential for behavior change. Quality thresholds for MI were reached in only one of the 11 interactions. Application was hindered by the context and the limited proficiency of care professionals. Discussion: Implementation was suboptimal for goal setting and MI. This decreased the potential for improved well-being in the participating older adults.

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