scholarly journals Employers ’ Response to Workers With Progressive Cognitive Impairment: A Review of Policy in Canada

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 717-717
Author(s):  
Josephine McMurray ◽  
Kristina Kokorelias ◽  
AnneMarie Levy ◽  
Krista James ◽  
Logan Reis ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Grey Literature ◽  
Case Law ◽  
Professional Organizations ◽  
Cognitive Changes ◽  
Policy Makers ◽  
Early Onset Dementia ◽  
Gig Economy ◽  
Age Related ◽  
Progressive Cognitive Impairment

Abstract Longer lifespans, the gig economy, eligibility for government pensions, and more testing for age-related cognitive changes, increase the potential for workers developing mild cognitive impairment and/or early onset dementia (MCI|EOD) “on the job”. This critical analysis assesses Canada’s policy environment for employers when employees are diagnosed with MCI|EOD. Our search for policy literature included: a scoping review of academic literature involving Canadian-focused articles, and countries where novel or innovative policy had been evaluated and published; a search for Canadian court judgements and tribunal decisions; and a grey literature search in both Canadian and international sources, as innovation will often happen “at the margin” and updated policy may take years to be enacted and formalized. We used participatory research to obtain feedback from a broad group of stakeholders including employers, industry, professional organizations, and government, as well as people living with MCI/dementia, to ensure outputs were reflective of current policy. We found that: 1) Canadian federally-regulated employers are governed by similar Acts & Codes as the provinces and territories, with some notable exceptions, 2) Disability discrimination and accommodation case law in Canada is settled, however there are few cognitive impairment cases to provide specific guidance, 3) Scant empirical research in the scientific literature addresses policy that incents employers to build workspaces for employees with MCI|EOD that help them stay on the job longer. We conclude that engaging with employers to better understand their needs will help policy-makers to support them build workspaces that encourage productive engagement of all workers.

scholarly journals The age-related effect on cognitive performance in cognitively healthy elderly is mainly caused by underlying AD pathology or cerebrovascular lesions: implications for cutoffs regarding cognitive impairment

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Emma Borland ◽  
Erik Stomrud ◽  
Danielle van Westen ◽  
Oskar Hansson ◽  
Sebastian Palmqvist
Keyword(s):  
Cognitive Impairment ◽  
Age Effect ◽  
Cognitive Test ◽  
Cognitive Tests ◽  
Test Results ◽  
Cognitive Changes ◽  
Cerebrovascular Lesions ◽  
Cerebrovascular Pathology ◽  
Healthy Elderly ◽  
Age Related

Abstract Background As research in treatments for neurocognitive diseases progresses, there is an increasing need to identify cognitive decline in the earliest stages of disease for initiation of treatment in addition to determining the efficacy of treatment. For early identification, accurate cognitive tests cutoff values for cognitive impairment are essential. Methods We conducted a study on 297 cognitively healthy elderly people from the BioFINDER study and created subgroups excluding people with signs of underlying neuropathology, i.e., abnormal cerebrospinal fluid [CSF] β-amyloid or phosphorylated tau, CSF neurofilament light (neurodegeneration), or cerebrovascular pathology. We compared cognitive test results between groups and examined the age effect on cognitive test results. Results In our subcohort without any measurable pathology (n = 120), participants achieved better test scores and significantly stricter cutoffs for cognitive impairment for almost all the examined tests. The age effect in this subcohort disappeared for all cognitive tests, apart from some attention/executive tests, predominantly explained by the exclusion of cerebrovascular pathology. Conclusion Our study illustrates a new approach to establish normative data that could be useful to identify earlier cognitive changes in preclinical dementias. Future studies need to investigate if there is a genuine effect of healthy aging on cognitive tests or if this age effect is a proxy for higher prevalence of preclinical neurodegenerative diseases.

A Systematic Review of Cognitive Impairments Associated With Kidney Failure in Adults Before Natural Age-Related Changes

2018 ◽  
Vol 25 (1) ◽  
pp. 101-114 ◽  
Author(s):  
Julia Brodski ◽  
Susan L. Rossell ◽  
David J. Castle ◽  
Eric J. Tan
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Kidney Disease ◽  
Short Term Memory ◽  
Early Stage ◽  
Cumulative Effect ◽  
Cognitive Changes ◽  
Cross Sectional ◽  
Age Related ◽  
Age Related Changes

AbstractObjectives: Recognition of cognitive impairment in chronic kidney disease (CKD) and its impact on functioning in adults is growing. The vast majority of studies to date have been conducted in older populations where CKD is more pronounced; however, the degree to which age-related cognitive changes could be influencing these findings remains unaddressed. This current study thus aimed to review cognitive impairment findings by stage in non-elderly CKD samples. Methods: PubMed and Medline via Scopus were searched for cross-sectional or cohort studies and randomized controlled trials that assessed cognitive function in individuals with CKD in any research setting. CKD studies including patients at any illness stage were included providing participants were below 65 years old, were not on peritoneal dialysis and had not undergone a kidney transplant. Results: Fifteen studies, with a total of 9304 participants, were included. Cognitive function broadly deteriorated from stage 1 to stage 5. Early stage CKD was associated with a drop in speed of processing, attention, response speed, and short-term memory abilities. Moderate stage CKD was associated with deficits in executive functioning, verbal fluency, logical memory, orientation and concentration. People with end stage kidney disease manifested significant deficits in all previous cognitive domains, along with cognitive control, delayed and immediate memory, visuospatial impairment, and overall cognitive impairment. Conclusions: Cognitive impairment is evident across the stages of CKD, independent of age-related changes, for both lower-order and higher-order cognitive abilities. These impairments also increase between the stages, suggesting a cumulative effect. Future directions for research are discussed. (JINS, 2019, 25, 101–114)

Information Practices of Baby Boomers as Caregivers

2013 ◽  
Author(s):  
Khuan Seow ◽  
Nadia Caidi
Keyword(s):  
Social Policy ◽  
Baby Boomers ◽  
Information Needs ◽  
Family Members ◽  
Age Groups ◽  
Maladie D’Alzheimer ◽  
Policy Makers ◽  
Age Related ◽  
The Family ◽  
Growing Age

Canada has an aging population with the fastest growing age groups (80 and 45-64 years old) vulnerable to age-related diseases such as Alzheimer’s disease. Caregiving responsibilities often fall to the family members of the afflicted without much attention and consideration being placed on the information needs of these caregivers. We call for a better understanding of these caregivers' information needs and uses by social policy makers as well as information providers.La population du Canada a tendance à vieillir considérablement, avec la hausse la plus rapide dans les groupes d’âge (80 et 45 à 64 ans). Les personnes âges sont très vulnérables à toute sorte de maladies, telles que la maladie d’Alzheimer. La responsabilité revient souvent aux membres de la famille qui doivent prendre soin des personnes atteintes de cette maladie. Or, nous ne connaissons que peu de chose sur les besoins en information des personnes qui prennent soin de ces malades de l’Alzheimer : qui sont-ils ? Quelles sont leurs sources... 

Language and Aging

2019 ◽  
pp. 294-316
Author(s):  
Jonathan E. Peelle
Keyword(s):  
Language Processing ◽  
Brain Function ◽  
Neural Systems ◽  
Language Abilities ◽  
Physiological Mechanisms ◽  
Cognitive Changes ◽  
Older Adulthood ◽  
Neural Organization ◽  
Age Related ◽  
High Level

Language processing in older adulthood is a model of balance between preservation and decline. Despite widespread changes to physiological mechanisms supporting perception and cognition, older adults’ language abilities are frequently well preserved. At the same time, the neural systems engaged to achieve this high level of success change, and individual differences in neural organization appear to differentiate between more and less successful performers. This chapter reviews anatomical and cognitive changes that occur in aging and popular frameworks for age-related changes in brain function, followed by an examination of how these principles play out in the context of language comprehension and production.

Can housing rights be applied to modern housing systems?

2010 ◽  
Vol 2 (2) ◽  
pp. 103-117 ◽  
Author(s):  
Padraic Kenna
Keyword(s):  
International Law ◽  
Case Law ◽  
Epistemic Communities ◽  
Policy Makers ◽  
Content Type ◽  
Housing Systems ◽  
Effective Implementation ◽  
Housing Rights ◽  
The World ◽  
Effective Translation

PurposeThe purpose of this paper is to outline and examine the growing corpus of housing rights and assess their relevance and applicability to complex contemporary housing systems across the world.Design/methodology/approachThe paper sets out the principal instruments and commentaries on housing rights developed by the United Nations, regional and other bodies. It assesses their relevance in the context of contemporary analysis of housing systems, organized and directed by networks of legal and other professionals within particular domains.FindingsHousing rights instruments are accepted by all States across the world at the level of international law, national constitutions and laws. The findings suggest that there are significant gaps in the international law conception and framework of housing rights, and indeed, human rights generally, which create major obstacles for the effective implementation of these rights. There is a preoccupation with one element of housing systems, that of subsidized or social housing. However, effective housing rights implementation requires application at meso‐, micro‐ and macro‐levels of modern, dynamic housing systems as a whole. Epistemic communities of professionals develop and shape housing law and policy within these domains. The housing rights paradigm must be further fashioned for effective translation into contemporary housing systems.Research limitations/implicationsThe development of housing rights precedents, both within international and national law, is leading to a wide and diffuse corpus of legislation and case law. More research is needed on specific examples of effective coupling between housing rights and elements of housing systems.Originality/valueThis paper offers housing policy makers and lawyers an avenue into the extensive jurisprudence and writings on housing rights, which will inevitably become part of the lexicon of housing law across the world. It also highlights the limitations of housing rights implementation, but offers some new perspectives on more effective application of these rights.

scholarly journals Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry

2021 ◽  
Author(s):  
Marjolein Bonthuis ◽  
Enrico Vidal ◽  
Anna Bjerre ◽  
Özlem Aydoğ ◽  
Sergey Baiko ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Cox Regression ◽  
Patient Survival ◽  
Healthcare Providers ◽  
Resource Planning ◽  
Policy Makers ◽  
Age Related ◽  
Kidney Replacement Therapy ◽  
Over Time ◽  
Related Population

Abstract Background For 10 consecutive years, the ESPN/ERA-EDTA Registry has included data on children with stage 5 chronic kidney disease (CKD 5) receiving kidney replacement therapy (KRT) in Europe. We examined trends in incidence and prevalence of KRT and patient survival. Methods We included all children aged <15 years starting KRT 2007–2016 in 22 European countries participating in the ESPN/ERA-EDTA Registry since 2007. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age-related population (pmarp) and time trends studied with JoinPoint regression. We analyzed survival trends using Cox regression. Results Incidence of children commencing KRT <15 years remained stable over the study period, varying between 5.5 and 6.6 pmarp. Incidence by treatment modality was unchanged over time: 2.0 for hemodialysis (HD) and peritoneal dialysis (PD) and 1.0 for transplantation. Prevalence increased in all age categories and overall rose 2% annually from 26.4 pmarp in 2007 to 32.1 pmarp in 2016. Kidney transplantation prevalence increased 5.1% annually 2007–2009, followed by 1.5% increase/year until 2016. Prevalence of PD steadily increased 1.4% per year over the entire period, and HD prevalence started increasing 6.1% per year from 2011 onwards. Five-year unadjusted patient survival on KRT was around 94% and similar for those initiating KRT 2007–2009 or 2010–2012 (adjusted HR: 0.98, 95% CI:0.71–1.35). Conclusions We found a stable incidence and increasing prevalence of European children on KRT 2007–2016. Five-year patient survival was good and was unchanged over time. These data can inform patients and healthcare providers and aid health policy makers on future resource planning of pediatric KRT in Europe.

Elevated Inflammatory Markers and Arterial Stiffening Exacerbate Tau but Not Amyloid Pathology in Older Adults with Mild Cognitive Impairment

2021 ◽  
pp. 1-13
Author(s):  
Alexandra L. Clark ◽  
Alexandra J. Weigand ◽  
Kelsey R. Thomas ◽  
Seraphina K. Solders ◽  
Lisa Delano-Wood ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Inflammatory Markers ◽  
Memory Performance ◽  
Cognitive Testing ◽  
Interactive Effects ◽  
Protein Biomarkers ◽  
Age Related ◽  
T Tau

Background: Age-related cerebrovascular and neuroinflammatory processes have been independently identified as key mechanisms of Alzheimer’s disease (AD), although their interactive effects have yet to be fully examined. Objective: The current study examined 1) the influence of pulse pressure (PP) and inflammatory markers on AD protein levels and 2) links between protein biomarkers and cognitive function in older adults with and without mild cognitive impairment (MCI). Methods: This study included 218 ADNI (81 cognitively normal [CN], 137 MCI) participants who underwent lumbar punctures, apolipoprotein E (APOE) genotyping, and cognitive testing. Cerebrospinal (CSF) levels of eight pro-inflammatory markers were used to create an inflammation composite, and amyloid-beta 1–42 (Aβ 42), phosphorylated tau (p-tau), and total tau (t-tau) were quantified. Results: Multiple regression analyses controlling for age, education, and APOE ɛ4 genotype revealed significant PP x inflammation interactions for t-tau (B = 0.88, p = 0.01) and p-tau (B = 0.84, p = 0.02); higher inflammation was associated with higher levels of tau within the MCI group. However, within the CN group, analyses revealed a significant PP x inflammation interaction for Aβ 42 (B = –1.01, p = 0.02); greater inflammation was associated with higher levels of Aβ 42 (indicative of lower cerebral amyloid burden) in those with lower PP. Finally, higher levels of tau were associated with poorer memory performance within the MCI group only (p s <  0.05). Conclusion: PP and inflammation exert differential effects on AD CSF proteins and provide evidence that vascular risk is associated with greater AD pathology across our sample of CN and MCI older adults.

scholarly journals A Preliminary Analysis of Hearing Loss and Its Association With Mild Cognitive Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 451-452
Author(s):  
Mary Caroline Yuk ◽  
Rebecca Allen ◽  
Marcia Hay-McCutcheon ◽  
Dana Carroll ◽  
Anne Halli-Tierney
Keyword(s):  
Hearing Loss ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Emotional Health ◽  
Medical Center ◽  
Pearson Correlation ◽  
Well Being ◽  
Hearing Screening ◽  
Community Dwelling ◽  
Age Related

Abstract Age related hearing loss, or presbycusis, is a global condition that is increasing in its prevalence. Despite being one of the most common chronic conditions among the older population, there is much more to understand about its association with other aspects of physical and emotional health and well-being. Current research is suggesting that hearing loss is more prevalent in those with cognitive impairment compared to those without cognitive impairment. This study analyzed the incidence of hearing loss and its linkage to mild cognitive impairment in a community-dwelling geriatric population. With the increasing prevalence of this condition in both rural and urban communities of Alabama, it becomes a more pressing matter to understand comorbidities and risk factors for future decline in functioning. This study was conducted in an interdisciplinary geriatrics primary care outpatient clinic in a Family, Internal, and Rural Medicine department affiliated with a university medical center in the Deep South. Ninety-one participants completed the Montreal Cognitive Assessment (MoCA) and a hearing screening. Hearing screenings were conducted in quiet rooms in the medical center using Phonak hearing screening cards. Detection of 500, 1000, 2000, and 4000 Hz tones was assessed. Pearson correlation analyses demonstrated an association between hearing loss mild cognitive impairment. Poorer hearing was significantly associated with lower scores on the MoCA. Conducting behavioral health screenings like this in other primary geriatrics clinics and community settings could improve care and identification of patient needs by integrating important data regarding comorbidities and independent living.

scholarly journals Pharmacological rescue of cognitive function in a mouse model of chemobrain

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lien D. Nguyen ◽  
Tom T. Fischer ◽  
Barbara E. Ehrlich
Keyword(s):  
Cognitive Impairment ◽  
Prefrontal Cortex ◽  
Calcium Oscillations ◽  
Neuronal Morphology ◽  
Post Injection ◽  
Object Recognition Test ◽  
Cognitive Changes ◽  
Memory Acquisition ◽  
Underlying Mechanisms ◽  
Trisphosphate Receptor

Abstract Background After chemotherapy, many cancer survivors suffer from long-lasting cognitive impairment, colloquially known as “chemobrain.” However, the trajectories of cognitive changes and the underlying mechanisms remain unclear. We previously established paclitaxel-induced inositol trisphosphate receptor (InsP3R)-dependent calcium oscillations as a mechanism for peripheral neuropathy, which was prevented by lithium pretreatment. Here, we investigated if a similar mechanism also underlay paclitaxel-induced chemobrain. Method Mice were injected with 4 doses of 20 mg/kg paclitaxel every other day to induced cognitive impairment. Memory acquisition was assessed with the displaced object recognition test. The morphology of neurons in the prefrontal cortex and the hippocampus was analyzed using Golgi-Cox staining, followed by Sholl analyses. Changes in protein expression were measured by Western blot. Results Mice receiving paclitaxel showed impaired short-term spatial memory acquisition both acutely 5 days post injection and chronically 23 days post injection. Dendritic length and complexity were reduced in the hippocampus and the prefrontal cortex after paclitaxel injection. Concurrently, the expression of protein kinase C α (PKCα), an effector in the InsP3R pathway, was increased. Treatment with lithium before or shortly after paclitaxel injection rescued the behavioral, cellular, and molecular deficits observed. Similarly, memory and morphological deficits could be rescued by pretreatment with chelerythrine, a PKC inhibitor. Conclusion We establish the InsP3R calcium pathway and impaired neuronal morphology as mechanisms for paclitaxel-induced cognitive impairment. Our findings suggest lithium and PKC inhibitors as candidate agents for preventing chemotherapy-induced cognitive impairment.

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