scholarly journals Multiple Chronic Condition Combinations and Cognitive Task Performance

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 479-479
Author(s):  
Aaron Ogletree ◽  
Benjamin Katz

Abstract A growing body of literature describes important advances in the study of chronic conditions, most notably a paradigm shift from the study of individual chronic conditions to the study of multiple chronic conditions (MCCs). Despite these advances, little research has explored MCC combinations, and almost no published research has explored how MCC combinations are related to cognitive outcomes in older adult populations. Using data from the Health and Retirement Study, we categorized 17,349 older adults into one of 32 groups using self-reports of five of the most commonly diagnosed conditions. These included arthritis, diabetes, heart problems, hypertension, and respiratory problems. We utilized ANOVA to examine the associations between combinations of MCCs and performance on two cognitive tasks associated with executive function and fluid intelligence: verbal fluency and verbal analogies. Results demonstrated that older adults with a greater number of health conditions performed more poorly on both the verbal fluency (p<.0001) and analogies (p<.0001) tasks than those with fewer conditions. Some MCC combinations were associated with poorer cognitive task performance than other combinations: for example, older adults in the Heart-Hypertension-Respiratory group had an average score of 488.73 (SD=24.96) on the verbal analogies task and 14.06 (SD=7.06) on the verbal fluency task. Conversely, adults in the Arthritis-Heart-Respiratory group had average scores of 503.69 (SD=27.89) and 16.45 (SD=7.03), respectively, suggesting differential additive effects of MCCs. These findings demonstrate the complex associations of specific MCC combinations with cognitive performance and highlight the importance of better understanding the unique needs of older people with MCCs.

2019 ◽  
Author(s):  
Debbie Marianne Yee ◽  
Sarah L Adams ◽  
Asad Beck ◽  
Todd Samuel Braver

Motivational incentives play an influential role in value-based decision-making and cognitive control. A compelling hypothesis in the literature suggests that the brain integrates the motivational value of diverse incentives (e.g., motivational integration) into a common currency value signal that influences decision-making and behavior. To investigate whether motivational integration processes change during healthy aging, we tested older (N=44) and younger (N=54) adults in an innovative incentive integration task paradigm that establishes dissociable and additive effects of liquid (e.g., juice, neutral, saltwater) and monetary incentives on cognitive task performance. The results reveal that motivational incentives improve cognitive task performance in both older and younger adults, providing novel evidence demonstrating that age-related cognitive control deficits can be ameliorated with sufficient incentive motivation. Additional analyses revealed clear age-related differences in motivational integration. Younger adult task performance was modulated by both monetary and liquid incentives, whereas monetary reward effects were more gradual in older adults and more strongly impacted by trial-by-trial performance feedback. A surprising discovery was that older adults shifted attention from liquid valence toward monetary reward throughout task performance, but younger adults shifted attention from monetary reward toward integrating both monetary reward and liquid valence by the end of the task, suggesting differential strategic utilization of incentives. Together these data suggest that older adults may have impairments in incentive integration, and employ different motivational strategies to improve cognitive task performance. The findings suggest potential candidate neural mechanisms that may serve as the locus of age-related change, providing targets for future cognitive neuroscience investigations.


2013 ◽  
Author(s):  
Laura K. Varner ◽  
Scott A. Crossley ◽  
Erica L. Snow ◽  
Danielle S. McNamara

2021 ◽  
Vol 111 ◽  
pp. 103882
Author(s):  
Rosleen Mansour ◽  
Anthony R. Ward ◽  
David M. Lane ◽  
Katherine A. Loveland ◽  
Michael G. Aman ◽  
...  

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 827-827
Author(s):  
Jaime Hughes ◽  
Susan Hughes ◽  
Mina Raj ◽  
Janet Bettger

Abstract Behavior change is an inherent aspect of routine geriatric care. However, most research and clinical programs emphasis how to initiate behavior change with less emphasis placed on skills and strategies to maintain behaviors over time, including after an intervention has concluded. This presentation will provide an introduction to the symposium, including a review of prior work and our rationale for studying the critical yet overlooked construct of maintenance in older adults. Several key considerations in our work include the impact of multiple chronic conditions, declines in cognitive and functional capacity over time, changes in environmental context and/or social support, and sustainability of community and population-level programs and services.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Jenny Ploeg ◽  
Marie-Lee Yous ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Sharon Kaasalainen ◽  
...  

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.


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