scholarly journals Effects of Caregiver Interventions for Informal Caregivers of Older Adults With Cognitive Decline

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 647-647
Author(s):  
Machiko Tomita
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Classification Accuracy ◽  
Informal Caregivers ◽  
Cognitive Status ◽  
Process Data ◽  
Physical Strain ◽  
Caregiver Support ◽  
Baseline Factors ◽  
Process Factors

Abstract Objectives To identify baseline factors and process factors, which indicate changes that are associated with caregiving confidence improvement attributed to caregiver support. Methods An intervention study using 35 informal caregivers (ICG) of older adults (≥65 years old) with cognitive decline. Recipients of ICGs belonged to the Programs of All Inclusive Care for the Elderly (PACE). Interventions were occupational therapy (OT) support or education about illness and effective caregiving methods, which took place in ICGs’ homes. OT interventions included training to reduce physical strain, and improve time and task organizations, and providing assistive devices). Caregiver confidence was measured using a Visual Analog Scale. Data were divided into two groups: improved confidence and decreased/no-change confidence. Eleven baseline data of care recipients (CRs) and ICGs as well as five process data were analyzed using logistic regression. Results Baseline factors that differentiated the two groups were ICG’s age, caregiving confidence level, and CR’s cognitive status, of which classification accuracy was 94.3%. Only Zarit Buren Interview (ZBI) score was associated with caregiving confidence change, of which classification accuracy was 74.3%. Younger ICGs, lower cognition, and lower caregiving confidence among baseline factors, and improved ZBI among the process factors were associated with improved confidence. Discussion Although our interventions prevented 65.7% of caregivers form declining their caregiving confidence, improving caregiving confidence was difficult while CRs’ cognition continued to decline. However, this positive change was possible even CRs had moderate dementia, on average. Personal interventions may be necessary to improve caregiving confidence and reduce ICG’s burden.

scholarly journals Aging, Cognitive Decline and Hearing Loss: Effects of Auditory Rehabilitation and Training with Hearing Aids and Cochlear Implants on Cognitive Function and Depression among Older Adults

2016 ◽  
Vol 21 (Suppl. 1) ◽  
pp. 21-28 ◽  
Author(s):  
Alessandro Castiglione ◽  
Alice Benatti ◽  
Carmelita Velardita ◽  
Diego Favaro ◽  
Elisa Padoan ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Decline ◽  
Cochlear Implants ◽  
Hearing Aids ◽  
Digit Span ◽  
Depression Scale ◽  
Cognitive Status ◽  
Long Term Memory ◽  
Auditory Rehabilitation

A growing interest in cognitive effects associated with speech and hearing processes is spreading throughout the scientific community essentially guided by evidence that central and peripheral hearing loss is associated with cognitive decline. For the present research, 125 participants older than 65 years of age (105 with hearing impairment and 20 with normal hearing) were enrolled, divided into 6 groups according to their degree of hearing loss and assessed to determine the effects of the treatment applied. Patients in our research program routinely undergo an extensive audiological and cognitive evaluation protocol providing results from the Digit Span test, Stroop color-word test, Montreal Cognitive Assessment and Geriatric Depression Scale, before and after rehabilitation. Data analysis was performed for a cross-sectional and longitudinal study of the outcomes for the different treatment groups. Each group demonstrated improvement after auditory rehabilitation or training on short- and long-term memory tasks, level of depression and cognitive status scores. Auditory rehabilitation by cochlear implants or hearing aids is effective also among older adults (median age of 74 years) with different degrees of hearing loss, and enables positive improvements in terms of social isolation, depression and cognitive performance.

scholarly journals IN-HOSPITAL NURSE CARE CONTINUITY: DOES IT MATTER?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S740-S740
Author(s):  
Orly Tonkikh ◽  
Anna Zisberg ◽  
Efrat Shadmi
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Interpersonal Relationship ◽  
Severity Of Illness ◽  
Cognitive Status ◽  
Cognitive Outcomes ◽  
Full Time ◽  
Hospital Nursing ◽  
Hospitalized Older Adults ◽  
Time Standard

Abstract In-hospital cognitive decline affects up to 40% of hospitalized older adults and is associated with post-hospitalization worsening of medical and functional status. Studies pointed to the substantial role of the interpersonal relationship between older adults with cognitive impairment and the nurses who care for them. We investigated the association between nursing interpersonal continuity and cognitive outcomes in a cohort of 646 older adults aged 70 or older admitted to internal units for non-disabling conditions. Cognitive decline was defined as at least one point decline in the Short Portable Mental Status Questionnaire from at admission to discharge assessments. Nursing interpersonal continuity was measured using continuity of care index (CoC). CoC assesses the extent of different nurses assigned to take care of each patient during the hospital stay (2 shifts per day) and ranges from 0 (none of the nurses is the same) to 0.4 (highest feasible score according to full time standard shift plan and length of stay (LOS)). Multivariate logistic regression showed that achieving 25% of the highest feasible in-hospital nursing CoC was associated with lower odds of cognitive decline (OR=0.67, 95% CI=0.47-0.97), controlling for age, sex, premorbid activities of daily living status, at admission cognitive status, comorbidities, severity of illness and LOS. This study shows that in-hospital nursing continuity is negatively associated with older adults’ cognitive decline, even in low-continuity levels. Future studies should investigate in-hospital continuity patterns and interventions maintaining continuity in larger and more heterogenic samples.

scholarly journals Health Trajectories in Swedish Centenarians

2020 ◽  
Vol 76 (1) ◽  
pp. 157-163
Author(s):  
Davide L Vetrano ◽  
Giulia Grande ◽  
Alessandra Marengoni ◽  
Amaia Calderón-Larrañaga ◽  
Debora Rizzuto
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Chronic Diseases ◽  
Care Delivery ◽  
Cognitive Status ◽  
National Study ◽  
Health Trajectories ◽  
Kungsholmen Project ◽  
Cognitively Intact

Abstract Background Longitudinal studies describing centenarians’ health trajectories are currently lacking. We compared health trajectories of older adults becoming centenarians and their shorter-living counterparts in terms of chronic diseases, disability, and cognitive decline. Methods We identified 3,573 individuals participating in the Kungsholmen Project and the Swedish National Study on Aging and Care in Kungsholmen who lived <100 years and 222 who survived to their 100th birthday. Trajectories of chronic diseases, disability (impaired activities of daily living), and cognitive status were obtained via linear mixed models over 13 years. Results Centenarians had fewer chronic diseases than noncentenarians. Before age 85, centenarians showed slower health changes. In centenarians, multimorbidity, disability, and cognitive impairment occurred 4 to 9 years later than in noncentenarians. After age 85, the speed of accumulation of chronic diseases, disabilities, and cognitive decline accelerated in centenarians. At age 100, 39% of the centenarians were cognitively intact and 55% had escaped disability. Only 5% were free of multimorbidity at age 100. When compared with their shorter lived counterparts, in terms of years spent in poor health, centenarians experienced more years with multimorbidity (9.4 vs 6.8 years; p < .001), disability (4.3 vs 3.1 years; p = .005), and cognitive impairment (6.3 vs 4.3 years; p < .001). Conclusions Older people who become centenarians present a delay in the onset of morbidity, but spend more years in this condition compared to their shorter lived peers. The observation of older adults’ health trajectories might help to forecast healthier aging, and plan future medical and social care delivery.

scholarly journals Transforming Aging: Increased Access to Care Minimizes Rural and Urban Differences in Cognitive Change

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 482-483
Author(s):  
Timothy Ly ◽  
Rebecca Allen ◽  
Barbara Jackson ◽  
Amy Albright ◽  
John Bell ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Cognitive Decline ◽  
Access To Care ◽  
Behavioral Health ◽  
Urban Areas ◽  
Cognitive Change ◽  
Cognitive Status ◽  
Cognitive Health ◽  
Rural And Urban

Abstract Rural-urban disparities in cognitive health outcomes, such as greater prevalence of cognitive decline among rural-dwelling older adults, have been linked to inequity in access to care. However, few studies have demonstrated whether longitudinal increased access to care may mitigate such disparities. This paper presents data from ongoing systematically collected behavioral health data on new and returning patients at an interdisciplinary geriatrics clinic at the University of Alabama Medical Center. The aim of this study was to determine baseline predictors of cognitive change across three annual visits (n = 42, mean age of 75.63 years (SD = 9.15)). Adjusting for baseline cognitive status, baseline subjective health literacy, and baseline depression and anxiety, results from a univariate ANCOVA showed that age at first visit (B = -.024, 95% CI [-.041, -.008], t(35) = -2.990, p = .005) and rural-urban status (B = .555, 95% CI [.123, .988], t(35) = 2.608, p = .013) predicted cognitive change at timepoint three (T3). Specifically, individuals from rural areas were less likely to experience cognitive decline and scored .555 points better than individuals from urban areas on cognitive screeners at T3 compared with baseline cognitive status. These results suggest that increased access to and utilization of care may ameliorate traditional disparate rates of cognitive decline between rural- and urban-dwelling older adults. Moreover, behavioral health screenings in primary geriatrics clinic care may help identify patient cognitive needs and facilitate integrated care through combined medical, pharmacological, and behavioral interventions to promote positive cognitive health outcomes.

scholarly journals Temporal context effects are associated with cognitive status in advanced age

2021 ◽  
Author(s):  
Sarah Maaß ◽  
Thomas Wolbers ◽  
Hedderik van Rijn ◽  
Martin Riemer
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Context Effects ◽  
Clinical Stage ◽  
Cognitive Status ◽  
Mixed Block ◽  
Diagnostic Tools ◽  
Temporal Context ◽  
Memory Functioning ◽  
Temporal Intervals

AbstractThe perception of temporal intervals changes during the life-span, and especially older adults demonstrate specific impairments of timing abilities. Recently, we demonstrated that timing performance and cognitive status are correlated in older adults, suggesting that timing tasks can serve as a behavioral marker for the development of dementia. Easy-to-administer and retest-capable timing tasks therefore have potential as diagnostic tools for tracking cognitive decline. However, before being tested in a clinical cohort study, a further validation and specification of the original findings is warranted. Here we introduce several modifications of the original task and investigated the effects of temporal context on time perception in older adults (> 65 years) with low versus high scores in the Montreal Cognitive Assessment survey (MoCA) and a test of memory functioning. In line with our previous work, we found that temporal context effects were more pronounced with increasing memory deficits, but also that these effects are stronger for realistic compared to abstract visual stimuli. Furthermore, we show that two distinct temporal contexts influence timing behavior in separate experimental blocks, as well as in a mixed block in which both contexts are presented together. These results replicate and extend our previous findings. They demonstrate the stability of the effect for different stimulus material and show that timing tasks can reveal valuable information about the cognitive status of older adults. In the future, these findings could serve as a basis for the development of a diagnostic tool for pathological cognitive decline at an early, pre-clinical stage.

scholarly journals Human anterolateral entorhinal cortex volumes are associated with preclinical cognitive decline

2016 ◽  
Author(s):  
RK Olsen ◽  
L-K Yeung ◽  
A Noly-Gandon ◽  
MC D’Angelo ◽  
A Kacollja ◽  
...  
Keyword(s):  
Older Adults ◽  
White Matter ◽  
Cognitive Decline ◽  
Entorhinal Cortex ◽  
Medial Temporal Lobe ◽  
Cognitive Status ◽  
Community Dwelling ◽  
White Matter Hyperintensity ◽  
Whole Brain ◽  
Community Dwelling Older Adults

AbstractWe investigated whether older adults without subjective memory complaints, but who present with cognitive decline in the laboratory, demonstrate atrophy in medial temporal lobe (MTL) subregions associated with Alzheimer's disease. Forty community-dwelling older adults were categorized based on Montreal Cognitive Assessment (MoCA) performance. Total grey/white matter, cerebrospinal fluid, and white matter hyperintensity load were quantified from whole-brain T1-weighted and FLAIR magnetic resonance imaging scans, while hippocampal subfields and MTL cortical subregion volumes (CA1, dentate gyrus/CA2/3, subiculum, anterolateral and posteromedial entorhinal, perirhinal, and parahippocampal cortices) were quantified using high-resolution T2-weighted scans. Cognitive status was evaluated using standard neuropsychological assessments. No significant differences were found in the whole-brain measures. However, MTL volumetry revealed that anterolateral entorhinal cortex (alERC) volume -- the same region in which Alzheimer's pathology originates -- was strongly associated with MoCA performance. This is the first study to demonstrate that alERC volume is related to cognitive decline in preclinical, community-dwelling older adults.

scholarly journals Neural Plastic Effects of Cognitive Training on Aging Brain

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Natalie T. Y. Leung ◽  
Helena M. K. Tam ◽  
Leung W. Chu ◽  
Timothy C. Y. Kwok ◽  
Felix Chan ◽  
...  
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Cognitive Decline ◽  
Cognitive Training ◽  
Training Group ◽  
Cognitive Status ◽  
Control Group ◽  
Aging Brain ◽  
Visual Spatial ◽  
Significant Difference

Increasing research has evidenced that our brain retains a capacity to change in response to experience until late adulthood. This implies that cognitive training can possibly ameliorate age-associated cognitive decline by inducing training-specific neural plastic changes at both neural and behavioral levels. This longitudinal study examined the behavioral effects of a systematic thirteen-week cognitive training program on attention and working memory of older adults who were at risk of cognitive decline. These older adults were randomly assigned to the Cognitive Training Group (n=109) and the Active Control Group (n=100). Findings clearly indicated that training induced improvement in auditory and visual-spatial attention and working memory. The training effect was specific to the experience provided because no significant difference in verbal and visual-spatial memory between the two groups was observed. This pattern of findings is consistent with the prediction and the principle of experience-dependent neuroplasticity. Findings of our study provided further support to the notion that the neural plastic potential continues until older age. The baseline cognitive status did not correlate with pre- versus posttraining changes to any cognitive variables studied, suggesting that the initial cognitive status may not limit the neuroplastic potential of the brain at an old age.

Isolation, Not Loneliness or Cynical Hostility, Predicts Cognitive Decline in Older Americans

2018 ◽  
Vol 32 (1-2) ◽  
pp. 52-60 ◽  
Author(s):  
Sarah C. Griffin ◽  
Briana Mezuk ◽  
Allison Baylor Williams ◽  
Paul B. Perrin ◽  
Bruce D. Rybarczyk
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Functional Limitations ◽  
Cognitive Status ◽  
Older Americans ◽  
Frequency Of Contact ◽  
Cynical Hostility ◽  
Reported Health ◽  
Retirement Study

Objective: To jointly examine isolation, loneliness, and cynical hostility as risk factors for cognitive decline in older adults. Method: Data came from the 2006 to 2012 waves of the Health and Retirement Study (HRS), a longitudinal study of U.S. older adults (age ⩾ 65 years, n = 6,654). Measures included frequency of contact with social network (objective isolation), the Hughes Loneliness Scale (loneliness), a modified version of the Cook–Medley Hostility Inventory (cynical hostility), and a modified version of the Telephone Interview for Cognitive Status (cognitive function). Multilevel modeling (random slope + intercept) was used to examine the association between these factors and trajectories of cognitive function. Results and Discussion: After controlling for demographic characteristics, self-reported health, and functional limitations, loneliness (β = −.34, 95% confidence interval [CI] = [−0.56, −0.11), and cynical hostility (β = −.14, 95% CI = [−0.24, −0.04) correlated with lower cognitive function, but none predicted change in cognitive function. Objective social isolation was associated with lower cognitive function (β = −.27, 95% CI = [−0.41, −0.12]) and steeper decline in cognitive function (β = −.09, 95% CI = [−0.16, −0.01]).

scholarly journals Association of Adherence to a Healthy Diet with Cognitive Decline in European and American Older Adults: A Meta-Analysis within the CHANCES Consortium

2017 ◽  
Vol 43 (3-4) ◽  
pp. 215-227 ◽  
Author(s):  
Agnes A.M. Berendsen ◽  
Jae H. Kang ◽  
Ondine van de Rest ◽  
Nicole Jankovic ◽  
Ellen Kampman ◽  
...  
Keyword(s):  
Older Adults ◽  
Fatty Acids ◽  
Cognitive Decline ◽  
Repeated Measures ◽  
Fruits And Vegetables ◽  
Meta Analysis ◽  
Saturated Fatty Acids ◽  
Cognitive Status ◽  
Healthy Diet ◽  
Health Study

Aim: To examine the association between a healthy diet, assessed by the Healthy Diet Indicator (HDI), and cognitive decline in older adults. Methods: Data from 21,837 participants aged ≥55 years from 3 cohorts (Survey in Europe on Nutrition and the Elderly, a Concerted Action [SENECA], Rotterdam Study [RS], Nurses' Health Study [NHS]) were analyzed. HDI scores were based on intakes of saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, fruits and vegetables, and fiber. The Telephone Interview for Cognitive Status in NHS and Mini-Mental State Examination in RS and SENECA were used to assess cognitive function from multiple repeated measures. Using multivariable-adjusted, mixed linear regression, mean differences in annual rates of cognitive decline by HDI quintiles were estimated. Results: Multivariable-adjusted differences in rates in the highest versus the lowest HDI quintile were 0.01 (95% CI -0.01, 0.02) in NHS, 0.00 (95% CI -0.02, 0.01) in RS, and 0.00 (95% CI -0.05, 0.05) in SENECA with a pooled estimate of 0.00 (95% CI -0.01, 0.01), I2 = 0%. Conclusions: A higher HDI score was not related to reduced rates of cognitive decline in European and American older adults.

scholarly journals Plasma neurofilament light chain is associated with cognitive decline in non-dementia older adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lingxiao He ◽  
John E. Morley ◽  
Geetika Aggarwal ◽  
Andrew D. Nguyen ◽  
Bruno Vellas ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Light Chain ◽  
Cognitive Functions ◽  
Linear Models ◽  
Cognitive Status ◽  
Neurofilament Light Chain ◽  
Cross Sectional ◽  
Neurofilament Light ◽  
State Examination

AbstractNeurofilament light chain (NfL) has been associated with cognitive status in multiple neurodegenerative conditions. Studies about plasma NfL and cognitive decline in older adults are still limited. 504 older adults (median age 75 years) who expressed memory complaints were selected from the Multidomain Alzheimer’s Preventive Trial (MAPT) and were classified as normal cognition (NC) or mild cognitive impairment (MCI). Cognitive functions were measured as mini mental state examination (MMSE) and composite cognitive score (CCS) over a 4-year period. Plasma NfL was measured at the first or the second year of the MAPT. Mixed-effects linear models were performed to evaluate cross-sectional and longitudinal associations. In the whole population, higher plasma NfL was cross-sectionally associated with lower cognitive functions (MMSE: β =  − 0.007, 95% CI [− 0.013, − 0.001]; CCS: β =  − 0.003, 95% CI [− 0.006, − 0.001]). In adults with MCI, but not NC, higher plasma NfL was associated with lower CCS at the cross-sectional level (β =  − 0.003, 95% CI [− 0.005, − 0.0002]). The upper quartile NfL group further demonstrated more over time decline in CCS (β =  − 0.07, 95% CI [− 0.12, − 0.01]) under the MCI status. Plasma NfL can be a promising biomarker of progressive cognition decline in older adults with MCI.

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