Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Subjective Cognitive Decline and Age

Abstract Home-based cognitive assessment (HBCA) services are emerging as a convenient alternative to in-clinic cognitive assessment and may aid in mitigating barriers to detecting cognitive impairment (CI). It is unknown which older adults would be likely to participate in HBCA. Here we investigated the role of age and Subjective Cognitive Decline (SCD). SCD has demonstrated an increased risk for progression to CI/dementia. A nation-wide community-dwelling sample of 494 adults age 50+ were recruited via Amazon Mechanical Turk to complete an online survey assessing perceptions around HBCA and SCD. Our sample was 91.9% White and 66.8% female. It consisted of 174 respondents aged 50-60, 265 aged 61- 70, and 55 aged 71-79. Age groups were comparable with respect to their acceptance of cognitive assessment (Range 4-20, higher score=higher acceptance, 7.9±3.3, 8.15±3.2, 8.05±3.43) and SCD-Q total (43.1±5.8, 43.2±5.7, 43.3±5.7). Correlation analysis revealed a relationship between SCD-QSCD total and perceived likelihood of participation in HBCA for those ages 61-70 (r(263) = .222 p = .000), but not for ages 50-60 or 71-79 (r(172) = .102 p = .152; r(53) = -.102 p = .458). Our findings suggest that SCD influences the likelihood of participation in HBCA for older adults’ transitioning to old age (61-70). Findings show that for adults transitioning into old age (61-70), perceived cognitive state influences their likelihood of participation in HBCA. Importantly, concerns about CI/dementia may generate more favorable perceptions of HBCA for this group.

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A-025 Subjective Cognitive Decline and Likelihood of Participation Across Home-Based Cognitive Assessment Modalities

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.025 ◽

2020 ◽

Vol 35 (6) ◽

pp. 815-815

Author(s):

Splonskowski M ◽

Smith S ◽

Jacova C

Keyword(s):

Cognitive Decline ◽

Cognitive Assessment ◽

Help Seeking ◽

Symptom Burden ◽

Community Dwelling ◽

Cognitive Testing ◽

Amazon Mechanical Turk ◽

Subjective Cognitive Decline ◽

Home Based ◽

The Relationship

Abstract Objective Individuals with subjective cognitive decline (SCD) are approximately twice as likely to develop dementia and less likely to seek cognitive assessment. Home-based cognitive assessment (HBCA) could reduce many practical and emotional barriers associated with in-person cognitive testing. We aimed to explore the relationship between SCD and likelihood of HBCA participation across various modalities. Method A nation-wide sample of 483 community-dwelling adults age 50 years and older (M = 63.61 ± 5.47) were recruited via Amazon Mechanical Turk, an online crowdsourcing website, to complete a survey. SCD was measured using the SCD-MyCog Questionnaire. A score of 7/24 endorsed symptoms classified respondents into SCD and non-SCD. Likelihood of participation in HBCA was measured using 4 likert-scale items (e.g., “How likely would you be to participate in HBCA via computer?”). Total likelihood was calculated by summing items. Results Regression revealed SCD symptom burden predicted likelihood of participation in HBCA [F(1, 481) = 12.42, B = .097, [.043–.150], p < .001, r^2 = .025]. Likelihood was higher in SCD (15.25 ± 3.3) than non-SCD (14.23 ± 3.5). When looking at specific HBCA modalities, SCD were more likely than non-SCD to participate in computer and videoconferencing modalities (1.36 ± 0.6 vs1.68 ± 0.87, p < .001; 2.26 ± 1.11 vs 2.58 ± 1.16, p < .001). There was no relationship with iPad or smartphone modalities. Conclusion SCD endorsement was associated with increased likelihood of engagement in HBCA. It is possible that HBCA can help overcome barriers to help-seeking in this group. SCD may prefer videoconferencing and computer modalities.

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Older Adults’ Subjective Cognitive Decline Correlated with Subjective but Not Objective Sleep: A Mediator Role of Depression

The International Journal of Aging and Human Development ◽

10.1177/00914150211024186 ◽

2021 ◽

pp. 009141502110241

Author(s):

Hai-Xin Jiang ◽

Xin Xie ◽

Yang Xu ◽

Rui Wang ◽

Xu Lei ◽

...

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

The Elderly ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Depression Symptoms ◽

Targeted Interventions ◽

Sleep Parameters ◽

The Relationship

This study examined the relationship between older adults’ subjective versus objective sleep and subjective cognitive decline (SCD), and explored the role of depression on this association. One hundred and four community-dwelling older adults underwent a week of actigraphic sleep monitoring, and completed a series of neuropsychological screeners. Older adults’SCD score was positively correlated with subjective insomnia, but not with objective sleep parameters. Further mediation modeling revealed that older adults’depression mediated the association between subjective insomnia and SCD. Subjective sleep, rather than objective sleep, may be a more sensitive indicator for older adults’ SCD, with depression symptoms appearing to account for most of the variance. These findings extend our perspective on the relationship between sleep disruption and cognitive decline, and highlight the necessity of early targeted interventions on sleep to reduce the risk of cognitive impairment in the elderly with SCD.

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The ACHIEVE Trial: Lessons Learned From Nesting a Randomized Controlled Trial Within an Observational Cohort Study

Innovation in Aging ◽

10.1093/geroni/igaa057.2950 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 811-811

Author(s):

Jennifer Deal ◽

Nicholas Reed ◽

David Couper ◽

Kathleen Hayden ◽

Thomas Mosley ◽

...

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Observational Study ◽

Cognitive Decline ◽

Controlled Trial ◽

Lessons Learned ◽

Community Dwelling ◽

Randomized Controlled ◽

Study Staff ◽

Increased Risk

Abstract Hearing impairment in older adults is linked to accelerated cognitive decline and a 94% increased risk of incident dementia in population-based observational studies. Whether hearing treatment can delay cognitive decline is unknown but could have substantial clinical and public health impact. The NIH-funded ACHIEVE randomized controlled trial of 977 older adults aged 70-84 years with untreated mild-to-moderate hearing loss, is testing the efficacy of hearing treatment versus health education on cognitive decline over 3 years in community-dwelling older adults (Clinicaltrials.gov Identifier: NCT03243422.) This presentation will describe lessons learned from ACHIEVE’s unique study design. ACHIEVE is nested within a large, well-characterized multicenter observational study, the Atherosclerosis Risk in Communities Study. Such nesting within an observational study maximizes both operational and scientific efficiency. With trial results expected in 2022, this presentation will focus on the benefits gained in design and recruitment/retention, including dedicated study staff, well-established protocols, and established study staff-participant relationships. Part of a symposium sponsored by Sensory Health Interest Group.

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Is the Discrimination of Subjective Cognitive Decline from Cognitively Healthy Adulthood and Mild Cognitive Impairment Possible? A Pilot Study Utilizing the R4Alz Battery

Journal of Alzheimer s Disease ◽

10.3233/jad-200562 ◽

2020 ◽

Vol 77 (2) ◽

pp. 715-732

Author(s):

Eleni Poptsi ◽

Despina Moraitou ◽

Emmanouil Tsardoulias ◽

Andreas L. Symeonidisd ◽

Magda Tsolaki

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Control ◽

Cognitive Decline ◽

Neurocognitive Disorders ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Working Memory Updating

Background: The early diagnosis of neurocognitive disorders before the symptoms’ onset is the ultimate goal of the scientific community. REMEDES for Alzheimer (R4Alz) is a battery, designed for assessing cognitive control abilities in people with minor and major neurocognitive disorders. Objective: To investigate whether the R4Alz battery’s tasks differentiate subjective cognitive decline (SCD) from cognitively healthy adults (CHA) and mild cognitive impairment (MCI). Methods: The R4Alz battery was administered to 175 Greek adults, categorized in five groups a) healthy young adults (HYA; n = 42), b) healthy middle-aged adults (HMaA; n = 33), c) healthy older adults (HOA; n = 14), d) community-dwelling older adults with SCD (n = 34), and e) people with MCI (n = 52). Results: Between the seven R4Alz subtasks, four showcased the best results for differentiating HOA from SCD: the working memory updating (WMCUT-S3), the inhibition and switching subtask (ICT/RST-S1&S2), the failure sets (FS) of the ICT/RST-S1&S2, and the cognitive flexibility subtask (ICT/RST-S3). The total score of the four R4Alz subtasks (R4AlzTot4) leads to an excellent discrimination among SCD and healthy adulthood, and to fare discrimination among SCD and MCI. Conclusion: The R4Alz battery is a novel approach regarding the neuropsychological assessment of people with SCD, since it can very well assist toward discriminating SCD from HOA. The R4Alz is able to measure decline of specific cognitive control abilities - namely of working memory updating, and complex executive functions - which seem to be the neuropsychological substrate of cognitive complaints in community dwelling adults of advancing age.

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The Relationship between Subjective Cognitive Decline and Health Literacy in Healthy Community-Dwelling Older Adults

Healthcare ◽

10.3390/healthcare8040567 ◽

2020 ◽

Vol 8 (4) ◽

pp. 567

Author(s):

Akio Goda ◽

Shin Murata ◽

Hideki Nakano ◽

Koji Nonaka ◽

Hiroaki Iwase ◽

...

Keyword(s):

Older Adults ◽

Health Literacy ◽

Cognitive Function ◽

Cognitive Decline ◽

Depression Scale ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Healthy Community ◽

Community Dwelling Older Adults ◽

The Relationship

Few studies have examined the effects of health literacy on people at risk of developing dementia; its effects on the pathogenesis of subjective cognitive decline (SCD) are particularly unclear. This study aimed to clarify the relationship between health literacy and SCD in a population of healthy community-dwelling older adults. SCD status was assessed using the Cognitive Function domain of the Kihon Checklist (KCL-CF). Health literacy, in turn, was evaluated using the Communicative and Critical Health Literacy (CCHL) scale. Global cognitive function and depressive symptoms were evaluated using the Mini-Mental State Examination (MMSE) and a five-item version of the Geriatric Depression Scale (GDS-5), respectively. Participants who were suspected of having SCD were significantly older than their non-SCD peers, and scored significantly worse on the CCHL, MMSE, and GDS-5. In addition, SCD status was found to be associated with CCHL and GDS-5 scores, as well as age, according to a logistic regression analysis. These findings suggest that low health literacy is linked to SCD morbidity in healthy community-dwelling older adults and should prove useful in the planning of dementia prevention and intervention programs for this population.

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Racial Differences in Cognitive Decline in a Sample of Community-Dwelling Older Adults: The Mediating Role of Education and Literacy

American Journal of Geriatric Psychiatry ◽

10.1176/appi.ajgp.13.11.968 ◽

2005 ◽

Vol 13 (11) ◽

pp. 968-975 ◽

Cited By ~ 2

Author(s):

N. Sachs-Ericsson

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Racial Differences ◽

Community Dwelling ◽

Mediating Role ◽

Community Dwelling Older Adults

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Are Adverse Childhood Experiences Associated with Worse Cognitive Function in Older Adults?

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721001272 ◽

2021 ◽

pp. 1-10

Author(s):

Amy B. Halpin ◽

Rebecca K. MacAulay ◽

Angelica R. Boeve ◽

Lisa M. D’Errico ◽

Sahvannah Michaud

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Adverse Childhood Experiences ◽

Community Dwelling ◽

Self Report ◽

Executive Attention ◽

Childhood Experiences ◽

Intellectual Function ◽

Adverse Childhood ◽

Increased Risk

Abstract Objectives: Adverse childhood experiences (ACE) are associated with an increased risk for dementia, but this relationship and modifying factors are poorly understood. This study is the first to our knowledge to comprehensively examine the effect of ACE on specific cognitive functions and measures associated with greater risk and resiliency to cognitive decline in independent community-dwelling older adults. Methods: Verbal/nonverbal intelligence, verbal memory, visual memory, and executive attention were assessed. Self-report measures examined depression, self-efficacy, and subjective cognitive concerns (SCC). The ACE questionnaire measured childhood experiences of abuse, neglect, and household dysfunction. Results: Over 56% of older adults reported an adverse childhood event. ACE scores were negatively associated with income and years of education and positively associated with depressive symptoms and SCC. ACE scores were a significant predictor of intellectual function and executive attention; however, these relationships were no longer significant after adjusting for education. Follow-up analyses using the PROCESS macro revealed that relationships among higher ACE scores with intellectual function and executive attention were mediated by education. Conclusions: Greater childhood adversity may increase vulnerability for cognitive impairment by impacting early education, socioeconomic status, and mental health. These findings have clinical implications for enhancing levels of cognitive reserve and addressing modifiable risk factors to prevent or attenuate cognitive decline in older adults.

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Cardiovascular biomarkers predict fragility fractures in older adults

Heart ◽

10.1136/heartjnl-2018-313741 ◽

2018 ◽

Vol 105 (6) ◽

pp. 449-454 ◽

Cited By ~ 3

Author(s):

Madeleine Johansson ◽

Fabrizio Ricci ◽

Giuseppe Di Martino ◽

Cecilia Rogmark ◽

Richard Sutton ◽

...

Keyword(s):

Older Adults ◽

Femoral Fractures ◽

Fragility Fractures ◽

Population Based ◽

Community Dwelling ◽

Increased Risk ◽

Longitudinal Association ◽

History Of ◽

Neuroendocrine Activation

ObjectiveTo assess the role of four biomarkers of neuroendocrine activation and endothelial dysfunction in the longitudinal prediction of fragility fractures.MethodsWe analysed a population-based prospective cohort of 5415 community-dwelling individuals (mean age, 68.9±6.2 years) enrolled in the Malmö Preventive Project followed during 8.1±2.9 years, and investigated the longitudinal association between C-terminal pro-arginine vasopressin (CT-proAVP), C-terminal endothelin-1 precursor fragment (CT-proET-1), the mid-regional fragments of pro-adrenomedullin (MR-proADM) and pro-atrial natriuretic peptide (MR-proANP), and incident vertebral, pelvic and extremity fractures.ResultsOverall, 1030 (19.0%) individuals suffered vertebral, pelvic or extremity fracture. They were older (70.7±5.8 vs 68.4±6.3 years), more likely women (46.9% vs 26.3%), had lower body mass index and diastolic blood pressure, were more often on antihypertensive treatment (44.1% vs 38.4%) and had more frequently history of fracture (16.3% vs 8.1%). Higher levels of MR-proADM (adjusted HR (aHR) per 1 SD: 1.51, 95% CI 1.01 to 2.28, p<0.001) and MR-proANP (aHR: 1.23, 95% CI 1.05 to 1.45, p<0.001) were independently associated with increased risk of any fracture. The fracture risk increased linearly across MR-proANP quartiles. Individuals who were in the top quartile of all four biomarkers had a significant higher risk of fracture at any site (aHR: 2.32, 95% CI 1.86 to 2.91), vertebral fracture (aHR: 3.16, 95% CI 1.97 to 5.07) and femoral fracture (aHR: 2.35, 95% CI 1.64 to 3.36).ConclusionsElevated levels of MR-proADM and MR-proANP independently predict fragility fractures in older adults. In subjects with top quartile levels of all four biomarkers there is a twofold to threefold increase in risk of vertebral and femoral fractures.

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A-026 Older Adults’ Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Age, Geographic Location, and Income

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.026 ◽

2020 ◽

Vol 35 (6) ◽

pp. 816-816

Author(s):

Splonskowski M ◽

Binng D ◽

Cooke H ◽

Jacova C

Keyword(s):

Older Adults ◽

Household Income ◽

Cognitive Assessment ◽

Online Survey ◽

Geographic Location ◽

Amazon Mechanical Turk ◽

Financial Resources ◽

Home Based ◽

The Relationship

Abstract Objective Recent implementations of teleneuropsychological services allow cognitive assessment to take place within the individual’s home. Geographic location and financial resources may influence older adults’ decision to access these services. Additionally, the likelihood of older adults’ participation in home-based cognitive assessment (HBCA) is unknown. We aimed to examine the relationship between age, geographic location, income, and likelihood of participation in HBCA. Method A nation-wide sample of 483 adults ages 50–79 completed an online survey via the crowdsourcing website Amazon Mechanical Turk. Respondents were asked about age, income and geographic location (e.g. rural, urban, suburban). Income was categorically measured in $20,000 increments. Likelihood of participation in HBCA was measured using 4 likert-scale items. Total likelihood was calculated by summing items. Results Perceived likelihood of participating in HBCA increased with greater household income, B = .087, p = .001 (0-20 K: M = 13.08 ± 4.19; 20-40 K: M = 14.76 ± 3.39; 40-60 K: M = 14.55 ± 3.49; 60–80 K: M = 14.55 ± 3.38; 80-100 K: M = 15.11 ± 2.83 and > 100 K: M = 15.48 ± 2.55). Likelihood decreased with age, B = −.061 p = .025 (50–59: M = 15.03 ± 3.56; 60–69: M = 14.31 ± 3.52, 70–79 M = 14.29 ± 3.27). Likelihood was not related to geographic location B = −.005, p = .933 (rural: M = 14.52 ± 3.84; suburban: M = 14.48 ± 3.31; urban: M = 14.48 ± 3.56). Conclusion Adults aged 50–59 with high income were the group most likely to participate in HBCA. Geographic location does not appear to play a role in acceptance of HBCA. However, this survey was conducted with online respondents. Different results may be obtained with in-person samples.

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