scholarly journals African-American Race Predicts 1-Year Cognitive Decline Among Adults Without Moderate Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 626-626
Author(s):  
Niser Babiker ◽  
Alan Gonzalez ◽  
Jovany Soto ◽  
Chengjian Shi ◽  
Andrey Rzhetsky ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Cognitive Decline ◽  
Racial Differences ◽  
Lean Mass ◽  
Depressed Mood ◽  
Community Dwelling ◽  
Antidepressant Use ◽  
The Impact ◽  
Moca Score

Abstract Previous literature shows conflicting conclusions about the association between race and cognitive decline, particularly in early impairment. In this study, we aimed to test whether race predicted 1-year change in Montreal Cognitive Assessment (MoCA) score among older adults without moderate-severe dementia. We secondarily explored whether multimorbidity, polypharmacy, depressed mood, antidepressant use, body composition, or frailty changed the association. We analyzed data (n=122) from predominantly African American (AfA, 78.7%) community-dwelling older adults from the south side of Chicago. Participants underwent baseline and 1-year MoCA testing. Age, gender, race, education, monthly income, co-morbidities (Charlson Comorbidity Index), medication use (<5 vs ≥5), depression (PHQ-2), proportion lean mass (DEXA), and the frailty phenotype (range 0-5) were collected at baseline. In a multivariate linear model, we regressed 1-year MoCA score on baseline MoCA score, race, and demographics and then evaluated the impact of each covariate added separately to the model on the race-cognition relationship. The mean MoCA score at baseline was 25.2+/-0.2 (range 18-30) and 41.0% of participants experienced ≥1 point MoCA decline at 1 year. After adjusting for demographics, AfAs experienced a greater 1-year MoCA decline (β= -1.3, p=0.04) compared to other races. The effect size was unchanged after adjusting for multimorbidity and polypharmacy (β= -1.3, p=0.04), attenuated slightly after adjusting for frailty (β= -1.2, p=0.06), depressed mood (β= -1.2, p=0.05), lean mass (β= -1.2, p=0.04), and attenuated notably after adjusting for antidepressant use (β= -1.0, p=0.11). Findings support the need to further explore racial differences in cognitive decline and potentially related anti-depressant underuse.

Racial Differences in the Influence of the APOE Epsilon 4 Allele on Cognitive Decline in a Sample of Community-Dwelling Older Adults

Gerontology ◽  
2008 ◽  
Vol 55 (1) ◽  
pp. 32-40 ◽  
Author(s):  
Kathryn Sawyer ◽  
Natalie Sachs-Ericsson ◽  
Kristopher J. Preacher ◽  
Dan G. Blazer
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Racial Differences ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Frailty as a Moderator of the Relationship Between Social Isolation and Health Outcomes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 269-270
Author(s):  
Fereshteh Mehrabi ◽  
François Béland
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Social Participation ◽  
Social Ties ◽  
Extended Family ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Cross Sectional ◽  
The Impact

Abstract Previous studies have reported that social isolation is a predictor of adverse outcomes, which is also closely associated with frailty. Very little is known about the moderating role of frailty on the impact of social isolation on health. We performed a cross-sectional analysis of the first wave of the FRéLE longitudinal study, consisting of 1643 Canadian community-dwelling older adults aged 65 years and over. Multivariate regression analysis was performed to examine the interaction between social isolation and frailty on health, controlling for socioeconomic characteristics and life habits. Social isolation was measured through social participation, social networks and support for different social ties namely, friends, children, extended family, and partner. In contrast to Berkman’s theory on the impact of social isolation on health, we found that frailty had no modifying role on the effects of social isolation on health. Frailty was significantly associated with all adverse outcomes. Less social participation was associated with ADLs, IADLs, depression and cognitive decline. The absence of friends was associated with depression and cognitive decline. Less support from children and having no children were associated with ADLs, comorbidity and depression. Fewer contact with extended family and having no family members were notably associated with ADLs and IADLs. Those who received less support from a partner or had no partner were more depressed and had more difficulties in performing IADLs. This study suggests that older adults who participate in social activities and have social ties, feel better with respect to physical health than those who feel isolated.

scholarly journals Disability in Community-Dwelling Older Adults: Exploring the Role of Stroke and Dementia

2019 ◽  
Vol 10 ◽  
pp. 215013271985250 ◽  
Author(s):  
Brian J. Stamm ◽  
James F. Burke ◽  
Chun Chieh Lin ◽  
Rory J. Price ◽  
Lesli E Skolarus
Keyword(s):  
Older Adults ◽  
Racial Differences ◽  
Daily Living ◽  
Cross Sectional Study ◽  
Race Differences ◽  
Community Dwelling ◽  
Cross Sectional ◽  
The Impact ◽  
Community Dwelling Older Adults

Objectives: We sought to determine the relative contributions of stroke, dementia, and their combination to disability and racial differences in disability among community-dwelling older adults. Methods: We performed a cross-sectional study of 6848 community-dwelling older adults. We evaluated the associations of stroke, dementia, and their combination with activities of daily living (ADL) limitations (range 0-7). We then explored the impact of stroke and dementia on race differences in ADL limitations using Poisson regression after accounting for sociodemographics and comorbidities. Results: After full adjustment, ADL limitations differed among older adults with stroke and dementia. Older adults without stroke or dementia had 0.32 (95% CI 0.29-0.35) ADL limitations compared to 0.64 (95% CI 0.54-0.73) with stroke, 1.36 (95% CI 1.20-1.53) with dementia and 1.84 (95% CI 1.54-2.15) with stroke and dementia. Overall, blacks had 0.27 (95%CI 0.19-0.36) more ADL limitations than whites. Models accounting for stroke led to a 3.7% (95%CI 2.98%-4.43%) reduction in race differences, while those for dementia led to a 29.26% (95%CI 28.53%-29.99%) reduction and the stroke-dementia combination −1.48% (95%CI −2.21% to −0.76) had little impact. Discussion: Older adults with stroke and dementia have greater disability than older adults with either of these conditions alone. However, the amount of disability experienced by older adults with stroke and dementia is less than the sum of the contributions from stroke and dementia. Dementia is likely a key contributor to race differences in disability.

Symptoms of depression among community-dwelling elderly African-American and White older adults

1998 ◽  
Vol 28 (6) ◽  
pp. 1311-1320 ◽  
Author(s):  
D. G. BLAZER ◽  
L. R. LANDERMAN ◽  
J. C. HAYS ◽  
E. M. SIMONSICK ◽  
W. B. SAUNDERS
Keyword(s):  
Older Adults ◽  
African American ◽  
African Americans ◽  
Racial Differences ◽  
Interpersonal Relations ◽  
Depressive Symptomatology ◽  
Community Sample ◽  
The Elderly ◽  
Community Dwelling ◽  
Bivariate Analysis

Background. Few studies have explored the variance in individual symptoms by race in older adults.Methods. Data were analysed from the Duke site of the Established Populations for Epidemiologic Studies of the Elderly (EPESE), a community sample of persons 65 years-of-age and older, 54% of whom were African-Americans. Of the 3401 subjects with adequate data on depressive symptomatology, confirmatory factor analysis and LISREL were first used to confirm the presence of the factor structure previously reported for the CES-D. Next, bivariate analysis was performed to determine the prevalence of individual symptoms by race. Finally, LISREL analysis was performed to control for potential confounding variables.Results. When bivariate comparisons of specific symptoms by race were explored, African-Americans were more likely to report less hope about the future, poor appetite, difficulty concentrating, requiring more effort for usual activities, less talking, feeling people were unfriendly, feeling disliked by others and being more ‘bothered’ than usual. When LISREL analyses were applied to these data (controlling for education, income, cognitive impairment, chronic health problems and disability and other factors) racial differences in somatic complaints and life satisfaction disappeared, yet differences in interpersonal relations persisted.Conclusions. This study confirms earlier findings of minimal overall differences in symptom frequency between African-American and non-African-American community-dwelling older adults in controlled studies.

scholarly journals Functional Constipation and Anorexia in Community-Dwelling Older Adults: Korean Frailty and Aging Cohort Study (KFACS)

2021 ◽  
Vol 18 (11) ◽  
pp. 5754
Author(s):  
Eunjin Jeong ◽  
Jung A Kim ◽  
Byung Sung Kim ◽  
Chang Kyun Lee ◽  
Miji Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Depressed Mood ◽  
Mmse Score ◽  
Univariate Analysis ◽  
Functional Constipation ◽  
Community Dwelling ◽  
Geriatric Syndrome ◽  
Female Sex ◽  
Community Dwelling Older Adults

Anorexia is a relevant geriatric syndrome because it accounts for most malnutrition in older adults. Constipation has been suggested as a risk factor for anorexia. This study aimed to examine the association between anorexia and functional constipation in community-dwelling older adults. Data on 899 subjects aged 72–86 years were obtained from a follow-up survey of the Korean Frailty and Aging Cohort Study in 2018. Anorexia was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ), while functional constipation was diagnosed based on Rome IV criteria. Anorexia and functional constipation were present in 30.9% and 19.6% of the participants, respectively. Age, female sex, chewing problems, malnutrition, polypharmacy, low Mini-Mental Status Examination (MMSE) score, depressed mood, low serum albumin, and functional constipation were associated with anorexia in the univariate analysis. In the multivariate logistic regression, functional constipation was associated with anorexia (OR 1.478, 95% CI 1.038–2.104) after adjusting for age, female sex, and MMSE score. However, after further adjusting for depressed mood (OR 2.568) and chewing problems (OR 2.196), the relationship was no longer significant. This study showed that functional constipation is associated with anorexia in community-dwelling older adults, but this association is confounded by depressed mood and chewing problems.

scholarly journals Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 407
Author(s):  
Laetitia Lengelé ◽  
Olivier Bruyère ◽  
Charlotte Beaudart ◽  
Jean-Yves Reginster ◽  
Médéa Locquet
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Performance ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
P Values ◽  
Student’S T ◽  
The Impact ◽  
Community Dwelling Older Adults

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).

scholarly journals Impact of the Outbreak of the COVID-19 Pandemic on Formal and Informal Care of Community-Dwelling Older Adults: Cross-National Clustering of Empirical Evidence from 23 Countries

2021 ◽  
Vol 13 (13) ◽  
pp. 7277
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Paolo Fabbietti ◽  
Giovanni Lamura
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Informal Care ◽  
Home Care Services ◽  
Community Dwelling ◽  
European Countries ◽  
Care Services ◽  
The Impact ◽  
Community Dwelling Older Adults ◽  
Informal Help

The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were reported. Seven clusters were identified, reflecting different combinations of changes in the formal/informal care provision. In most countries, informal care is more resilient than home care services that formal providers deliver. Since they are an essential source for sustainable care, their challenges related to care should be addressed. The impact of the pandemic does not follow the traditional characterization of welfare regimes. A clustering effort may yield more understanding of the priorities that future care policies should exhibit at the national level and may identify potential systems for policymakers to enhance sustainability of care for community-dwelling older adults.

scholarly journals Places Visited, Maintained, or Abandoned Outside Home: A Community Mobility Need of Older Adults With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 673-673
Author(s):  
Isabel Margot-Cattin ◽  
Sophie Gaber ◽  
Nicolas Kuhne ◽  
Camilla Malinowski ◽  
Louise Nygard
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Health Condition ◽  
Driving Cessation ◽  
Age In Place ◽  
Community Mobility ◽  
People With Dementia ◽  
The Uk ◽  
The Impact

Abstract For older adults to “age in place”, they need to keep engaged and mobile in their communities, whatever their health condition. The impact of age and cognitive decline on community mobility is a growing problem in Europe and worldwide. Engaging in occupations outside home implies being able to get to those places where activities are performed. Yet little is known regarding the types of places visited, maintained or abandoned for older adults with/without dementia. This study addresses community mobility needs through the places people visit, maintain or abandon. People with and without dementia, aged 55+, were interviewed using the Participation in ACTivities and Places OUTside the Home (ACT-OUT) questionnaire across Switzerland (n=70), Sweden (n=69) and the UK (n=128). Results show that people with dementia experience a higher rate of abandonment for more places than regular older adults. Insights about driving cessation and access to travel passes will be presented.

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