A-150 Comparison of a Traditional and a Novel Measure of Executive Functioning in Predicting Daily Task Performance

2021 ◽  
Vol 36 (6) ◽  
pp. 1204-1204
Author(s):  
Stacey Brothers ◽  
Yana Suchy
Keyword(s):  
Executive Functioning ◽  
Independent Living ◽  
Time Frame ◽  
Community Dwelling ◽  
Valid Measure ◽  
Planning Time ◽  
Executive Skills ◽  
Daily Task ◽  
Healthy Community ◽  
At Home

Abstract Objective Executive functioning (EF) is known to be associated with performance of instrumental activities of daily living (IADLs). However, traditional EF assessment takes place in the lab under ideal circumstances, which does not take into account the complexity of daily life, such as the need to interleave tasks. The present study aimed to examine whether a novel ecologically valid measure of EF that requires interleaving of activities, the “Night Out Task” (NOT), better predicted daily at-home IADL performance than a traditional EF measure. Method Participants were 49 healthy, community-dwelling older adults aged 60–95 (Mage = 69.35, SD = 6.51, 63.3% female, 100% non-Hispanic White). Participants completed both a traditional (Delis Kaplan Executive Function System; D-KEFS) and a novel measure (Night Out Task; NOT) of EF. Over the course of the next 18 days, they completed IADL tasks at home daily as part of the Daily Assessment of Independent Living and Executive Skills (DAILIES) protocol. Results Planning time on the NOT predicted, above and beyond the D-KEFS (p = 0.007, CI = −0.053 to −0.009), whether the DAILIES tasks were completed at all and whether they were completed during a required time frame. NOT accuracy was predictive of how accurately daily tasks were completed, but not above and beyond the D-KEFS (p = 0.131, CI = −0.266 to 1.99). Conclusions The NOT is a novel ecologically valid measure of EF that demonstrated incremental utility beyond the D-KEFS. While the NOT and D-KEFS predicted task accuracy, only the NOT planning time predicted whether participants completed a task.

scholarly journals HOME AND COMMUNITY HEALTHCARE FOR FRAIL OLDER ADULTS: A PATIENT, CAREGIVER, AND PRACTITIONER PERSPECTIVE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S691-S691
Author(s):  
Andrew McDonald ◽  
Rowena Rizzotti ◽  
Joanna Rivera ◽  
Grace Park ◽  
Antonina Garm ◽  
...  
Keyword(s):  
Older Adults ◽  
Independent Living ◽  
Healthcare Providers ◽  
Community Dwelling ◽  
Community Healthcare ◽  
Use Of Technology ◽  
Age Related ◽  
Group Members ◽  
Tracking Devices ◽  
At Home

Abstract Frailty and the decline in ability to maintain independent living may be forestalled through discussions with healthcare providers and seniors about managing health at home. In addition, the use of technology in supplementing doctors’ visits to assess frailty progression may be easily adopted by some but not others. We conducted this qualitative study to elucidate the context in which seniors access care at home and current barriers to independent living, from the perspectives of both seniors and practitioners. Pre-approved discussion questions were administered to two audio-recorded focus group sessions of 14 participants. The first group were community-dwelling older adults and informal caregivers, while the second consisted of healthcare practitioners. Group members were sampled to include a range of health backgrounds and levels of technological expertise. Thematic analysis with NVivo Software was used to parse out key discussion topics from the audio transcripts. The caregiver/patient group emphasized the stigma of frailty and age-related isolation, desiring transparency and advocacy from care teams. Practitioners/researchers discussed the importance of a holistic biopsychosocial approach to frailty management and the need for standardized frailty measurement. Patients/caregivers used health-tracking devices at home and were more optimistic about telehealth/video-conferencing than practitioners. Awareness of contextual factors surrounding “aging in place” and what aspects of care are valued by patients and practitioners is key to advancing home health and paving the way for new evidence-based services in the home.

Daily Assessment of Executive Functioning and Expressive Suppression Predict Daily Functioning among Community-Dwelling Older Adults

2021 ◽  
pp. 1-10
Author(s):  
Stacey L. Brothers ◽  
Yana Suchy
Keyword(s):  
Older Adults ◽  
Executive Functioning ◽  
Past Research ◽  
Community Dwelling ◽  
Self Report ◽  
Expressive Suppression ◽  
Emotion Regulation Strategy ◽  
Ecological Momentary ◽  
The Impact ◽  
At Home

Abstract Objective: Executive functioning (EF) is known to be associated with performance of instrumental activities of daily living (IADLs). However, prior research has found that the degree to which EF fluctuates was more predictive of self-reported cognitive and IADL lapses than was average EF performance. One source of such EF fluctuations is engagement in an emotion regulation strategy known as expressive suppression (ES). Importantly, ES has also been shown to relate to IADL performance, presumably due to its impact on EF. However, past research is limited due to assessing IADLs only in the laboratory or via self-report. The present study examined (a) the association of daily EF and ES fluctuations with performance of actual IADL tasks in participants’ homes, and (b) whether any significant association between ES fluctuations and daily IADLs would be mediated by daily EF variability. Method: Participants were 52 older adults aged 60 to 95. Over the course of 18 days while at home, participants completed daily IADL tasks as well as daily measures of EF and ES via ecological momentary assessment. Results: Contrary to our hypothesis, average EF across days predicted at-home IADLs above and beyond daily EF variability, which itself was also predictive. ES variability also predicted daily IADLs, and this association was fully mediated by average daily EF. Conclusions: Daily fluctuations in ES appear to have a deleterious impact on performance of IADLs at home, likely due to the impact of such fluctuations on EF, although the average level of EF capacity is also important.

scholarly journals Robotics to Enable Older Adults to Remain Living at Home

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Alan J. Pearce ◽  
Brooke Adair ◽  
Kimberly Miller ◽  
Elizabeth Ozanne ◽  
Catherine Said ◽  
...  
Keyword(s):  
Older People ◽  
Independent Living ◽  
Social Connectedness ◽  
Relevant Literature ◽  
Critical Evaluation ◽  
Aged Care ◽  
Community Dwelling ◽  
Ageing Population ◽  
Robotic Devices ◽  
At Home

Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effective in enabling independent living in community dwelling older people? Following database searches for relevant literature an initial yield of 161 articles was obtained. Titles and abstracts of articles were then reviewed by 2 independent people to determine suitability for inclusion. Forty-two articles met the criteria for question 1. Of these, 4 articles met the criteria for question 2. Results showed that robotics is currently available to assist older healthy people and people with disabilities to remain independent and to monitor their safety and social connectedness. Most studies were conducted in laboratories and hospital clinics. Currently limited evidence demonstrates that robots can be used to enable people to remain living at home, although this is an emerging smart technology that is rapidly evolving.

scholarly journals The de Morton Mobility Index: Normative Data for a Clinically Useful Mobility Instrument

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
E. M. Macri ◽  
J. A. Lewis ◽  
K. M. Khan ◽  
M. C. Ashe ◽  
N. A. de Morton
Keyword(s):  
Assisted Living ◽  
Independent Living ◽  
Normative Data ◽  
Health Assessment ◽  
Reference Population ◽  
Community Dwelling ◽  
Mobility Spectrum ◽  
Cross Sectional ◽  
Retirement Village ◽  
Healthy Community

Determining mobility status is an important component of any health assessment for older adults. In order for a mobility measure to be relevant and meaningful, normative data are required for comparison to a healthy reference population. The DEMMI is the first mobility instrument to measure mobility across the spectrum from bed bound to functional levels of independent mobility. In this cross-sectional observational study, normative data were obtained for the DEMMI from a population of 183 healthy, community-dwelling adults age 60+ who resided in Vancouver, Canada and Melbourne, Australia. Older age categories had significantly lower DEMMI mobility mean scores (P<0.05), as did individuals who walked with a mobility aid or lived in semi-independent living (assisted living or retirement village), whereas DEMMI scores did not differ by sex (P=0.49) or reported falls history (P=0.21). Normative data for the DEMMI mobility instrument provides vital reference scores to facilitate its use across the mobility spectrum in clinical, research, and policymaking settings.

Alcohol Drinking and Brain Morphometry in Apparently Healthy Community-Dwelling Japanese Men

Alcohol ◽  
2020 ◽  
Author(s):  
Ali Haidar Syaifullah ◽  
Akihiko Shiino ◽  
Akira Fujiyoshi ◽  
Aya Kadota ◽  
Keiko Kondo ◽  
...  
Keyword(s):  
Alcohol Drinking ◽  
Community Dwelling ◽  
Japanese Men ◽  
Brain Morphometry ◽  
Healthy Community ◽  
Apparently Healthy

scholarly journals Physical Restraint of Older Adults at Home: Preliminary Analysis of a Prospective Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 683-683
Author(s):  
Asa Inagaki ◽  
Ayumi Igarashi ◽  
Maiko Noguchi-Watanabe ◽  
Mariko Sakka ◽  
Chie Fukui ◽  
...  
Keyword(s):  
Older Adults ◽  
Online Survey ◽  
Physical Restraint ◽  
Community Dwelling ◽  
Physical Restraints ◽  
Care Nurse ◽  
Factors Associated ◽  
Home Care Nurse ◽  
Community Dwelling Older Adults ◽  
At Home

Abstract Our study aimed to explore the prevalence and factors of physical restraints among frail to dependent older adults living at home. We conducted an online survey to ask about the physical/mental conditions, demographics, service utilization, and physical restraints of community-dwelling older adults. Either home care nurse or care managers who were responsible for the older adult answered the survey that were conducted at baseline and one month later. We obtained data from 1,278 individuals. Physical restraint was reported for 53 (4.1%) participants. Multiple logistic regression revealed the factors associated with physical restraints at home: having been restrained at baseline, having pneumonia or heart failure, receiving home bathing, or using rental assistive devices were associated with physical restraints at one month. The findings could be used to promote discussion about which services prevent physical restraints and what we should do to support clients and their family to stay at home safely.

scholarly journals Process evaluation of a reablement training program for homecare staff to encourage independence in community-dwelling older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teuni H. Rooijackers ◽  
G. A. Rixt Zijlstra ◽  
Erik van Rossum ◽  
Ruth G. M. Vogel ◽  
Marja Y. Veenstra ◽  
...  
Keyword(s):  
Older Adults ◽  
Training Program ◽  
Process Evaluation ◽  
Community Dwelling ◽  
Team Approach ◽  
Staff Members ◽  
Care Plans ◽  
Lump Sum ◽  
Community Dwelling Older Adults ◽  
At Home

Abstract Background Many community-dwelling older adults experience limitations in (instrumental) activities of daily living, resulting in the need for homecare services. Whereas services should ideally aim at maintaining independence, homecare staff often take over activities, thereby undermining older adults’ self-care skills and jeopardizing their ability to continue living at home. Reablement is an innovative care approach aimed at optimizing independence. The reablement training program ‘Stay Active at Home’ for homecare staff was designed to support the implementation of reablement in the delivery of homecare services. This study evaluated the implementation, mechanisms of impact and context of the program. Methods We conducted a process evaluation alongside a 12-month cluster randomized controlled trial, using an embedded mixed-methods design. One hundred fifty-four homecare staff members (23 nurses, 34 nurse assistants, 8 nurse aides and 89 domestic workers) from five working areas received the program. Data on the implementation (reach, dose, fidelity, adaptations and acceptability), possible mechanisms of impact (homecare staff's knowledge, attitude, skills and support) and context were collected using logbooks, registration forms, checklists, log data and focus group interviews with homecare staff (n = 23) and program trainers (n = 4). Results The program was largely implemented as intended. Homecare staff's average compliance to the program meetings was 73.4%; staff members accepted the program, and particularly valued its practical elements and team approach. They experienced positive changes in their knowledge, attitude and skills about reablement, and perceived social and organizational support from colleagues and team managers to implement reablement. However, the extent to which homecare staff implemented reablement in practice, varied. Perceived facilitators included digital care plans, the organization’s lump sum funding and newly referred clients. Perceived barriers included resistance to change from clients or their social network, complex care situations, time pressure and staff shortages. Conclusions The program was feasible to implement in the Dutch homecare setting, and was perceived as useful in daily practice. Nevertheless, integrating reablement into homecare staff's working practices remained challenging due to various personal and contextual factors. Future implementation of the program may benefit from minor program adaptations and a more stimulating work environment. Trial registration ClinicalTrials.gov (Identifier NCT03293303). Registered 26 September 2017.

A-11 Investigating Gene–Gene Interactions by Cognitive Domain in Healthy Older Adults

2021 ◽  
Vol 36 (6) ◽  
pp. 1051-1051
Author(s):  
Kendra L Pizzonia ◽  
Andrew M Bryant ◽  
Leatha A Clark ◽  
Brian C Clark ◽  
Julie A Suhr
Keyword(s):  
Executive Functioning ◽  
Cognitive Functioning ◽  
Verbal Fluency ◽  
Community Dwelling ◽  
Gene Interactions ◽  
Trail Making Test ◽  
Semantic Fluency ◽  
Immediate Memory ◽  
Trail Making ◽  
Main Effects

Abstract Objective ApoE is a well-known gene carrying risk for Alzheimer’s disease and is associated with memory performance while the COMT gene is associated with executive functioning but is understudied. The present study investigated these gene interactions across cognitive domains. Method A larger study on gait and aging recruited 89 healthy community-dwelling adults over the age of 60. The primary analyses included 82 participants (67% female, mean age = 74.61, SD = 6.71). The analyses on executive functioning included 72 participants (65% female, mean age = 73.02, SD = 4.99) who completed all measures of interest. ApoE status was defined as presence/absence of Ɛ4. The rs4680 gene on the COMT allele was classified into Val/Met, Val/Val, and Met/Met genotypes. Biological sex was included as a binary term (i.e., male/female). Index variables and age corrected standard scores on the Repeatable Battery for the Assessment of Neuropsychological Status, verbal fluency, and Trail Making Test were included. Results Gene–gene interactions were found for overall cognitive functioning, immediate memory, and semantic fluency. There were main effects of sex for overall cognitive functioning, immediate memory, delayed memory, and semantic fluency. There were main effects for COMT for delayed memory and a main effect for both COMT and ApoE for visuospatial functioning, coding, and verbal fluency (all p’s &lt; 0.05). There were no ApoE x COMT x Sex interactions and Trail Making Test B was not related to either gene or sex. Conclusion(s) Our findings suggest that both COMT and ApoE (and their interaction) influence cognition. Future research should investigate gene–gene interactions in larger samples with more comprehensive cognitive batteries.

EFFECTS OF COMPUTERIZED COGNITIVE TRAINING ON GAIT SPEED IN COMMUNITY DWELLING OLDER ADULTS, A PILOT STUDY

2016 ◽  
pp. 1-6
Author(s):  
J. Blackwood ◽  
T. Houston
Keyword(s):  
Older Adults ◽  
Cognitive Training ◽  
Gait Speed ◽  
Independent Living ◽  
Functional Decline ◽  
Community Dwelling ◽  
Computerized Cognitive Training ◽  
Home Based ◽  
Improved Function ◽  
Community Dwelling Older Adults

Background: In older adults declines in gait speed have been identified as predictors of functional decline and have been found in those with cognitive dysfunction. Cognitive training interventions that emphasize addressing executive function (EF) have resulted in a transfer effect from training cognitive processes into improved function. However research examining the effects of an EF specific computerized cognitive training (CCT) program on gait speed (GS) is limited. Objectives: To compare the effects of a six week EF specific CCT program on GS in community dwelling older adults using a pretest/posttest experimental design with subgroup comparisons based on a cutoff GS of 1.0m/s. Setting: Home based Participants: Forty independent living older adults (>65 years) without diagnosed cognitive impairment participated in either the intervention or control groups. Intervention: A six week long progressively challenging EF focused CCT program was performed at home. Measurements: Demographic variables, cognitive function (Trail-Making Test Part B) and GS were measured at baseline at week 7. Between group comparisons were completed for the whole sample initially with subgroup comparisons performed based on participants’ initial GS (Slow walkers: GS<1.0m/s; Fast Walkers: GS>1.0m/s). Results: No differences in GS were found for the whole population, but subgroup analyses restricted to slow walkers demonstrated a statistically significant improvement in GS after 6 weeks of CCT (µ =0.33 m/s, p = 0.03). Other outcomes measures were not statistically different at posttest. Conclusions: Older adults who walk at speeds <1.0m/s may benefit from a progressively challenging CCT program when self-administered in the home.

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