scholarly journals Involvement in Decision-Making for Daily Care and Cognitive Decline among Older Adults Who Need Care in Japan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 706-706
Author(s):  
Ayane Komatsu ◽  
Takeshi Nakagawa ◽  
Taiji Noguchi ◽  
Tami Saito
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Cognitive Decline ◽  
Mmse Score ◽  
Care Quality ◽  
Multivariable Logistic Regression Analysis ◽  
Term Care ◽  
Daily Care ◽  
Japanese Adults

Abstract Effective decision-making regarding daily care for older adults with needs could reduce the risk of dementia by preventing loss of motivation and improving care quality. However, empirical studies are scarce, particularly in non-Western countries with different socio-cultural backgrounds. By using 2-year longitudinal data of older Japanese adults aged 65 years and above who were receiving care at home, as well as of their family caregivers, we examined the association of involvement in decision-making with the onset of cognitive decline among older Japanese adults requiring care. The analysis included 219 cases of individuals with normal cognition and no missing variables at baseline and responded to the follow-up survey. An MMSE score of 23 or lower at follow-up was defined as the onset of cognitive decline. The level of involvement in decision-making was assessed by one item and dichotomized (not involved/involved). The covariates were age, gender, education, MMSE score, eligibility level for long-term care, and others at baseline. At baseline, 67.1% were 75 years or older, 58.9% were female, and 91.8% responded being “involved” in the decision-making. The incidence of cognitive decline at follow-up was 30.6%. The multivariable logistic regression analysis showed that involvement in decision-making (OR=0.298 [95% CI: 0.10-0.88], p=0.029) was negatively and significantly associated with the onset of cognitive decline. Our findings show the importance of involvement in the decision-making for daily care to reduce the risk of subsequent cognitive decline in older adults requiring care, even in a culture of familism.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

scholarly journals Cognitive decline and alcohol consumption adjusting for functional status over a 3-year period in French speaking community living older adults

2018 ◽  
Vol 41 (2) ◽  
pp. e177-e184 ◽  
Author(s):  
Helen-Maria Vasiliadis ◽  
Marie-Christine Payette ◽  
Djamal Berbiche ◽  
Sébastien Grenier ◽  
Carol Hudon
Keyword(s):  
Older Adults ◽  
Alcohol Consumption ◽  
Cognitive Decline ◽  
Functional Status ◽  
Repeated Measures ◽  
Service Use ◽  
High Functioning ◽  
French Speaking ◽  
Changing Patterns

AbstractBackgroundThe effect of alcohol consumption on cognitive decline is not clear. We aimed to study the association between alcohol consumption and cognitive functioning controlling for functional heath status.MethodsA total of 1610 older adults with a score ≥26 on the Mini-Mental State Examination (MMSE) were followed to assess the change in scores at the 3-year follow-up. Information on alcohol consumption as well as socio-demographic, lifestyle, psychosocial and clinical factors, as well as health service use were assessed at baseline and 3-year follow-up interviews. Linear mixed models with repeated measures were used stratifying by functional status.ResultsClose to 73% reported consuming alcohol in the past 6 months, of which 11% were heavy drinkers (≥11 and ≥16 drinks for women and men). A significant decrease in MMSE scores was observed in low functioning non-drinkers (−1.48; 95% CI: −2.06, −0.89) and light to moderate drinkers (−0.99; 95% CI: −1.54, −0.44) and high functioning non-drinkers (−0.51; 95% CI: −0.91, −0.10).ConclusionsAlcohol consumption did not contribute to cognitive decline. Cognitive decline was greater in individuals reporting low functional status. Research should focus on the interaction between changing patterns of alcohol consumption and social participation in individuals with low and high functioning status.

Effect of the Fungus Isaria japonica from the Silkworm on Cognitive Function in Older Adults with Mild Cognitive Decline: A Pilot Study

2021 ◽  
Vol 19 (4) ◽  
pp. 383-387
Author(s):  
Daisuke Furushima ◽  
Yuri Takashima ◽  
Toshiji Miyagawa ◽  
Hiroshi Fujita ◽  
Yuzuki Nomura ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Blood Test ◽  
Mmse Score ◽  
Protective Role ◽  
In Vivo Studies ◽  
Serious Adverse Events ◽  
Silkworm Pupae

Several in vivo studies report that the fungus Isaria japonica grown on silkworm pupae, classified as a Cordycipitaceae, plays a role in preventing memory deficits and may have a protective role against cognitive impairment. The present study investigated the cognitive effects and safety of I. japonica in older adults with mild cognitive decline. Intervention trial was conducted in subjects over 60 years of age with mild cognitive decline (Mini-Mental State Examination [MMSE] score: 20-27). The subjects consumed the I. japonica supplements twice per day for 12 weeks. The outcome measures included the MMSE score and blood test values before and after the intervention. A total of 25 subjects (aged 64-94 years) were eligible for the study. After the intervention, the MMSE score (mean ± standard deviation) significantly increased from 25.5 ± 1.6 to 27.1 ± 2.4 (P < 0.0001). The blood test revealed no change in any of the hematological and biochemical parameters evaluated. Also, no serious adverse events were reported. Despite several limitations in the study design, the findings of the present study suggest that the fungus I. japonica is safe to consume and it may improve cognitive function in older adults with mild cognitive decline.

scholarly journals Delirium and post-discharge dementia: results from a cohort of older adults without baseline cognitive impairment

2019 ◽  
Vol 48 (6) ◽  
pp. 845-851 ◽  
Author(s):  
Flavia Barreto Garcez ◽  
Daniel Apolinario ◽  
Flavia Campora ◽  
Jose Antonio Esper Curiati ◽  
Wilson Jacob-Filho ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Clinical History ◽  
University Hospital ◽  
Proportional Hazard ◽  
Post Discharge ◽  
Preventable Risk Factor ◽  
Admission Data ◽  
Incident Dementia

Abstract Objectives to investigate the association between delirium occurrence in acutely ill older adults and incident dementia after hospital discharge. Methods retrospective cohort study examining acutely ill older adults aged +60 years and consecutively admitted to the geriatric ward of a tertiary university hospital from 2010 to 2016. Inclusion criteria were absence of baseline cognitive decline on admission and documented clinical follow-up of +12 months after discharge. Admission data were collected from our local database, including results from a standardized comprehensive geriatric assessment completed for every patient. Pre-existing cognitive decline was identified based on clinical history, CDR and IQCODE-16. Delirium was diagnosed using short-CAM criteria, while post-discharge dementia after 12 months was identified based on medical records’ review. We used competing-risk proportional-hazard models to explore the association between delirium and post-discharge dementia. Results we included 309 patients. Mean age was 78 years, and 186 (60%) were women. Delirium was detected in 66 (21%) cases. After a median follow-up of 24 months, 21 (32%) patients who had experienced delirium progressed with dementia, while only 38 (16%) of those without delirium had the same outcome (P = 0.003). After adjusting for possible confounders, delirium was independently associated with post-discharge dementia with a sub-hazard ratio of 1.94 (95%CI = 1.10–3.44; P = 0.022). Conclusion one in three acutely ill older adults who experienced delirium in the hospital developed post-discharge dementia during follow-up. Further understanding of delirium as an independent and potentially preventable risk factor for cognitive decline emphasizes the importance of systematic initiatives to fight it.

scholarly journals Depressive symptoms and cognitive decline in elderly people

2002 ◽  
Vol 181 (5) ◽  
pp. 406-410 ◽  
Author(s):  
Sabrina Paterniti ◽  
Marie-Hélène Verdier-Taillefer ◽  
Carole Dufouil ◽  
Annick Alpérovitch
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Elderly People ◽  
Depressive Symptomatology ◽  
Mmse Score ◽  
Epidemiologic Study ◽  
Depression Scale ◽  
Depressive Episodes ◽  
State Examination

BackgroundDepressive symptoms are associated with cognitive decline in elderly people, but the nature of their temporal relationship remains equivocal.AimsTo test whether depressive symptoms predict cognitive decline in elderly people with normal cognition.MethodThe Center for Epidemiologic Study depression scale (CES – D) and the Mini-Mental State Examination (MMSE) were used to evaluate depressive symptomatology and cognitive functioning, respectively. A sample of 1003 persons aged 59–71 years and with a MMSE score of 26 or over was selected. Cognitive decline was defined as a drop of at least 3 points on the MMSE at 4-year follow-up.ResultsBaseline high levels of depressive symptoms predicted a higher risk of cognitive decline at 4-year follow-up. The MMSE score of participants with depression was more likely to fall below 26 at 2-year follow-up and to remain below at 4-year follow-up than the MMSE score of those without depressive symptoms. Persistent but not episodic depressive episodes were associated with cognitive decline.ConclusionsHigh levels of depressive symptoms, when persistent, are associated with cognitive decline in a sample of elderly people.

scholarly journals Functional network integrity presages cognitive decline in preclinical Alzheimer disease

Neurology ◽  
2017 ◽  
Vol 89 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Rachel F. Buckley ◽  
Aaron P. Schultz ◽  
Trey Hedden ◽  
Kathryn V. Papp ◽  
Bernard J. Hanseeuw ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Connectivity ◽  
Alzheimer Disease ◽  
Cognitive Decline ◽  
Cognitive Networks ◽  
Rate Of Change ◽  
Control Networks ◽  
Clinically Normal ◽  
And Control

Objective:To examine the utility of resting-state functional connectivity MRI (rs-fcMRI) measurements of network integrity as a predictor of future cognitive decline in preclinical Alzheimer disease (AD).Methods:A total of 237 clinically normal older adults (aged 63–90 years, Clinical Dementia Rating 0) underwent baseline β-amyloid (Aβ) imaging with Pittsburgh compound B PET and structural and rs-fcMRI. We identified 7 networks for analysis, including 4 cognitive networks (default, salience, dorsal attention, and frontoparietal control) and 3 noncognitive networks (primary visual, extrastriate visual, motor). Using linear and curvilinear mixed models, we used baseline connectivity in these networks to predict longitudinal changes in preclinical Alzheimer cognitive composite (PACC) performance, both alone and interacting with Aβ burden. Median neuropsychological follow-up was 3 years.Results:Baseline connectivity in the default, salience, and control networks predicted longitudinal PACC decline, unlike connectivity in the dorsal attention and all noncognitive networks. Default, salience, and control network connectivity was also synergistic with Aβ burden in predicting decline, with combined higher Aβ and lower connectivity predicting the steepest curvilinear decline in PACC performance.Conclusions:In clinically normal older adults, lower functional connectivity predicted more rapid decline in PACC scores over time, particularly when coupled with increased Aβ burden. Among examined networks, default, salience, and control networks were the strongest predictors of rate of change in PACC scores, with the inflection point of greatest decline beyond the fourth year of follow-up. These results suggest that rs-fcMRI may be a useful predictor of early, AD-related cognitive decline in clinical research settings.

scholarly journals Association Between Urate-Lowering Therapies and Cognitive Decline in Community-Dwelling Older Adults: A Post-Hoc Analysis of the MAPT Study.

2021 ◽  
Author(s):  
Luc MOLET-BENHAMOU ◽  
Kelly VIRECOULON GIUDICI ◽  
Philipe BARRETO ◽  
Yves ROLLAND
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Composite Score ◽  
Cognitive Score ◽  
Using Data ◽  
Community Dwelling Older Adults

Abstract Introduction Long-term use of urate-lowering therapies (ULT) may reduce inflammaging and thus prevent cognitive decline during aging. This article examined the association between long-term use of ULT and cognitive decline among community-dwelling older adults with spontaneous memory complaints. Material and methods We performed a secondary observational analysis using data of 1,673 participants ≥ 70 years old from the Multidomain Alzheimer Preventive Trial (MAPT Study), a randomized controlled trial assessing the effect of a multidomain intervention, the administration of polyunsaturated fatty acids (PUFA), both, or placebo on cognitive decline. We compared cognitive decline during the 5-year follow-up between three groups according to ULT use: participants treated with ULT during at least 75% of the study period (PT ≥ 75; n = 51), less than 75% (PT < 75; n = 31), and non-treated participants (PNT; n = 1,591). Cognitive function (measured by a composite score) was assessed at baseline, 6 months and every year for 5 years. Linear mixed models were performed and adjusted for age, sex, body mass index (BMI), diagnosis of arterial hypertension or diabetes, baseline composite cognitive score, and MAPT intervention groups. Results After the 5-year follow-up, only non-treated participants presented a significant decline in the cognitive composite score (mean change − 0.173, 95%CI -0.212 to -0.135; p < 0.0001). However, there were no differences in change of the composite cognitive score between groups (adjusted between-group difference for PNT vs. PT < 75: 0.089, 95%CI -0.160 to 0.338, p = 0.484; PNT vs. PT ≥ 75: 0.174, 95%CI -0.042 to 0.391, p = 0.115). Conclusion Use of ULT was not associated with reduced cognitive decline over a 5-year follow-up among community-dwelling older adults at risk of dementia.

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