scholarly journals ENHANCE: The Center for Enhancing Neurocognitive Health, Abilities, Networks, & Community Engagement

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 193-194
Author(s):  
Sara Czaja ◽  
Walter Boot ◽  
Michelle Bourgeois
Keyword(s):  
Cognitive Impairment ◽  
Community Engagement ◽  
Cognitive Impairments ◽  
Instructional Support ◽  
Target Population ◽  
Development Project ◽  
Technology Support ◽  
Support Tool ◽  
Transportation Services ◽  
Aging Adults

Abstract Approximately 9 % of those aged 65 and over have a cognitive impairment due to a variety of causes including Alzheimer’s disease and other forms of dementia, Mild Cognitive Impairment (MCI), Parkinson’s disease, traumatic brain injury (TBI), and stroke. Few technology solutions have been directed towards supporting older adults with cognitive impairments and the literature regarding the efficacy of these solutions is sparse. In this symposium, we describe our new Center called ENHANCE (Enhancing Neurocognitive Health, Abilities, Networks, and Community Engagement), which is focused on developing technology support for aging adults with a cognitive impairment due to MCI, TBI, and Stroke. Sara Czaja will provide an overview of the conceptual framework, goals, and structure of ENHANCE, and describe the STRUMM project, that focuses on the design and evaluation of an innovative intelligent adaptive software package aimed at providing cognitive and social support to aging adults with cognitive impairments. Wendy Rogers will discuss the ENACT project, a longitudinal needs assessment focusing on understanding the needs, challenges, and support preferences of our target population and informal caregivers. Neil Charness will describe the AUGMENT development project, which is concerned with developing an instructional support tool for mobility activities, such as wayfinding, locating, and using transportation services. Finally, Walter Boot will discuss the DREAM development project, which is focused on developing a technology-based cognitive aid to support prospective memory activities. Michelle Bourgeois will serve as the discussant for the symposium and highlight the unique opportunities and challenges associated with ENHANCE.

scholarly journals AUGMENT: Navigation Apps Instruction for Older Adults With Cognitive Impairment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 194-194
Author(s):  
Walter Boot ◽  
Sara Czaja ◽  
Wendy Rogers ◽  
Nicholas Gray ◽  
Dorota Kossowska-Kuhn ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Control Sample ◽  
Development Project ◽  
Community Dwelling ◽  
Engineering Research ◽  
Testing Performance ◽  
Aging Adults ◽  
Community Dwelling Older Adults ◽  
Instructional Package

Abstract Augmenting User Geocordinates and Mobility by ENhanced Tutorials (AUGMENT) is a development project in the ENHANCE Rehabilitation Engineering Research Center aiming to promote community engagement for aging adults with cognitive impairment (CI) from stroke, traumatic brain injury, and mild cognitive impairment. AUGMENT aims include 1) providing proof of concept that a robust instructional package can support successful use of existing, complex navigation apps, Google maps and rideshare app Uber, by a diverse set of people with CI; and 2) providing proof of product by testing performance with and without instruction. We discuss the needs assessment phase and development of new tests to assess wayfinding abilities and reported difficulties with navigation, using a control sample of 384 community-dwelling older adults. We found that self-reported navigation difficulties are predicted (R-square = .28) by gender, a spatial orientation test, self-reported memory ability, and severity of memory difficulty.

scholarly journals STRUMM: An Intelligent, Adaptive Software Package for Older Adults With a Cognitive Impairment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 194-194
Author(s):  
Sara Czaja ◽  
Marco Ceruso ◽  
Walter Boot ◽  
Neil Charness ◽  
Wendy Rogers
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Software Package ◽  
Technology Support ◽  
Adaptive Software ◽  
Site Development ◽  
User Groups ◽  
Perceived Usability ◽  
Aging Adults ◽  
Cross Site

Abstract Many older adults have a cognitive impairment (CI), which negatively impacts on their quality of life and threatens their independence. In this presentation, we provide an overview of the conceptual framework, structure, and processes of our multi-site Center, ENHANCE, which is focused on developing technology support for aging adults with a CI. ENHANCE has two cross-site research projects, two cross-site development projects, training, and dissemination components. A core battery of measures is collected across all projects. We also discuss the Supportive Technology Resources through Usability & Machine-learning Methods (STRUMM) research project, which focuses on an innovative intelligent adaptive software package aimed at providing cognitive and social support, and support for resource access to aging adults with a CI. STRUMM is designed to meet the user’s varying cognitive needs. Finally, we present preliminary data regarding the perceived usability and value of STRUMM from our clinical partners and potential user groups.

Association of Circulating Cholesterol Level with Cognitive Function and Mild Cognitive Impairment in the Elderly: A Community-based Population Study

2020 ◽  
Vol 17 (6) ◽  
pp. 556-565
Author(s):  
Yujie Guo ◽  
Pengfei Li ◽  
Xiaojun Ma ◽  
Xiaochen Huang ◽  
Zhuoheng Liu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Cholesterol Level ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cross Sectional ◽  
Increased Risk ◽  
Aging Adults ◽  
Female Subjects

Background: The present study was designed to examine the association of circulating cholesterol with cognitive function in non-demented community aging adults. Methods: This was a cross-sectional study including 1754 Chinese adults aged 55-80 years. The association between serum cholesterol levels and cognitive function was examined. Participants were categorized into four groups according to the quartile of circulating TC (total cholesterol), High Density Lipoprotein Cholesterol (HDL-c), Low Density Lipoprotein Cholesterol (LDL-c) levels and HDLc/ LDL-c ratio. The difference in cognitive performance among the groups was compared. Logistic regression model was used to determine the association of circulating cholesterol level with the risk of Mild Cognitive Impairment (MCI). Results: Mild increase of serum LDL-c level correlated with better visual and executive, language, memory and delayed recall abilities. Higher circulating TC and HDL-c levels were found to be associated with poorer cognitive function, especially in aging female subjects. Higher circulating TC, HDL-c and HDL/LDL ratio indicated an increased risk of MCI, especially in female subjects. Conclusion: Slight increase in circulating LDL-c level might benefit cognitive function in aging adults. However, higher circulating TC and HDL-c levels might indicate a decline of cognitive function, especially in aging female subjects.

scholarly journals Adopt, adapt, or abandon technology-supported person-centred care initiatives: healthcare providers’ beliefs matter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Dyb ◽  
Gro Rosvold Berntsen ◽  
Lisbeth Kvam
Keyword(s):  
Information Technologies ◽  
Scale Up ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Analytical Framework ◽  
Development Project ◽  
Technology Support ◽  
Care Needs ◽  
Term Care

Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.

Assessment of the neuronal underpinnings of cognitive impairment in bipolar disorder with a picture encoding paradigm and methodological lessons learnt

2021 ◽  
pp. 026988112110085
Author(s):  
JZ Petersen ◽  
J Macoveanu ◽  
HL Kjærstad ◽  
GM Knudsen ◽  
LV Kessing ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Neuronal Activity ◽  
Cognitive Impairments ◽  
Hierarchical Cluster ◽  
Small Region ◽  
Middle Temporal Gyrus ◽  
Recall Accuracy ◽  
Fmri Study

Background: Mood disorders are often associated with persistent cognitive impairments. However, pro-cognitive treatments are essentially lacking. This is partially because of poor insight into the neurocircuitry abnormalities underlying these deficits and their change with illness progression. Aims: This functional magnetic resonance imaging (fMRI) study investigates the neuronal underpinnings of cognitive impairments and neuronal change after mood episodes in remitted patients with bipolar disorder (BD) using a hippocampus-based picture encoding paradigm. Methods: Remitted patients with BD ( n=153) and healthy controls ( n=52) were assessed with neuropsychological tests and underwent fMRI while performing a strategic picture encoding task. A subgroup of patients ( n=43) were rescanned after 16 months. We conducted data-driven hierarchical cluster analysis of patients’ neuropsychological data and compared encoding-related neuronal activity between the resulting neurocognitive subgroups. For patients with follow-up data, effects of mood episodes were assessed by comparing encoding-related neuronal activity change in BD patients with and without episode(s). Results: Two neurocognitive subgroups were revealed: 91 patients displayed cognitive impairments while 62 patients were cognitively normal. No neuronal activity differences were observed between neurocognitive subgroups within the dorsal cognitive control network or hippocampus. However, exploratory whole-brain analysis revealed lower activity within a small region of middle temporal gyrus in impaired patients, which significantly correlated with poorer neuropsychological performance. No changes were observed in encoding-related neuronal activity or picture recall accuracy with the occurrence of mood episode(s) during the follow-up period. Conclusion: Memory encoding fMRI paradigms may not capture the neuronal underpinnings of cognitive impairment or effects of mood episodes.

Development of a decision-making tool for reporting drivers with mild dementia and mild cognitive impairment to transportation administrators

2017 ◽  
Vol 29 (9) ◽  
pp. 1551-1563 ◽  
Author(s):  
Duncan H. Cameron ◽  
Carla Zucchero Sarracini ◽  
Linda Rozmovits ◽  
Gary Naglie ◽  
Nathan Herrmann ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Delphi Study ◽  
Qualitative Interviews ◽  
Decision Support Tool ◽  
Driving Safety ◽  
Decision Tool ◽  
Computerized Decision Support ◽  
Support Tool ◽  
Mild Dementia

ABSTRACTBackground:Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators.Methods:A multi-faceted, computerized decision support tool was developed, using a systematic literature and guideline review, expert opinion from an earlier Delphi study, as well as qualitative interviews and focus groups with physicians, caregivers of former drivers with dementia, and transportation administrators. The tool integrates inputs from the physician-user about the patient's clinical and driving history as well as cognitive findings, and it produces a recommendation for reporting to transportation administrators. This recommendation is translated into a customized reporting form for the transportation authority, if applicable, and additional resources are provided for the patient and caregiver.Conclusions:An innovative approach was needed to develop the DD-DT. The literature and guideline review confirmed the algorithm derived from the earlier Delphi study, and barriers identified in the qualitative research were incorporated into the design of the tool.

scholarly journals Older Adults in Hospitals: Health Promotion When Hospitalized

2021 ◽  
pp. 287-301
Author(s):  
Anne-S. Helvik
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Cognitive Impairment ◽  
Nursing Care ◽  
Cognitive Impairments ◽  
Clinical Nursing ◽  
Older Inpatients ◽  
Health Promoting ◽  
To Come ◽  
Age Range

AbstractThe population of older adults (≥60 years) is currently growing. Thus, in the years to come it is expected that a high proportion of patients hospitalized will be in the older age range. In western countries, the proportion of older inpatients is about 40% in the medical and surgical hospitals units. Older people with illness is vulnerable to both physical and cognitive impairments as well as depression. Therefore, a health-promoting perspective and approach are highly warranted in clinical nursing care of older adults in medical hospitals. This chapter focuses on health promotion related to depressive symptoms, impairment in activities of daily living, and cognitive impairment in older hospitalized adults.

scholarly journals Aerobic or strength training and flexibility activities and mild cognitive impairment: CETI cohort

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Dupré ◽  
B Bongue ◽  
L Fruteau de Laclos ◽  
J Blais ◽  
M-J Sirois
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Neurodegenerative Diseases ◽  
Cognitive Impairments ◽  
Cognitive Status ◽  
Physical Activities ◽  
Community Dwelling ◽  
Different Types ◽  
Initiative Program ◽  
The Impact

Abstract Background Previous studies have been notably criticized for not studying the different types of physical activity. The objective of this work was to examine the association between types of physical activity and cognitive decline in older people. Methods This is a sub-group analysis from the CETI cohort, a multicenter prospective study conducted by the Canadian Emergency Team Initiative Program (CETIE), between 2011 and 2016. Participants were community-dwelling seniors aged ≥ 65 years, consult emergency services for minor injuries with follow-up at 3 and 6 months. Physical activity was assessed by the RAPA (Rapid assessment of Physical activity), which describes the level of aerobic activities and the overall level of muscle strength and flexibility activities. The cognitive status was assessed with the Montreal Cognitive Assessment (MoCA) and the Telephone Interview for Cognitive Status (TICS), using their current cut-offs (MoCA <26/30 and TICS < = 35/50) for mild cognitive impairments (MCI). Logistic regression, COX models and splines were used to examine the association between the type of physical activities and the onset of cognitive impairment. Results At inclusion, 281 individuals were free of MCI, or 43.8% of the total sample, with an average age of 73 years. During follow-ups, MCI appeared in 31.7% of participants initially free of it. The risk of MCI was lower with higher muscular strength & flexibility physical activities (HR = 0.84 [0.70-0.99]), while the relationship with aerobic physical activities was not significant. Conclusions These results showed a potential link between strength & flexibility activities and cognitive impairments, but not with aerobic physical activities. Further analyses are needed to examine whether these relationships persist as a function of the adjustment variables, or statistical methods. This study contributes to the debate on the evaluation of physical activity in the elderly, and its link with neurodegenerative diseases. Key messages This study analyzed the link between types of physical activity and mild cognitive disorders. The aim is to put in place preventive policies of aging, specially in neurodegenerative diseases. The work allowed us to see the effect of the different types of physical activity and the impact of the statistical method on the results.

scholarly journals Web Accessibility Interventions for Citizens Living with Cognitive Impairment: A Rapid Evidence Assessment

2021 ◽  
Author(s):  
Paul Flynn ◽  
Sara Gartland ◽  
Joe Cullen ◽  
Maria Ana Carneiro ◽  
Jose de Sousa Fialho ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Policy Development ◽  
Research Team ◽  
Literature Search ◽  
Cognitive Impairments ◽  
Cognitive Disabilities ◽  
Grey Literature ◽  
Web Accessibility ◽  
Flow Diagram ◽  
Rapid Review

Abstract BackgroundThere is a clear and pressing need to understand the barriers to technology user experience, particularly in relation to people with cognitive disabilities. The COVID-19 pandemic and subsequent expansion of digital technologies associated with education, wellness and employment only makes the need to understand how people with cognitive disabilities interact with such technologies, within the naturalistic context of their lifeworld, increasingly urgent. Therefore a necessary first step is to develop a baseline understanding of the current state of web accessibility for people with cognitive disabilities. Thus, the purpose of this review is to conduct baseline research to understand the factors and processes that inhibit access to online content and services for people with cognitive impairments.MethodsThis systematic, rapid evidence assessment, review will employ a search strategy using defined terms within agreed search strings in the following databases: Web of Science, SCOPUS, EBSCOhost, ERIC and ProQuest. Internet searching through Google Scholar will be carried out as well as forward and backward tracking of citations from studies that are included in the review. All results, screening process results will be documented in tabular form and communicated in a PRISMA flow diagram. In addition, the research team consider it necessary to carry out a grey literature search due to the nature of the work being investigated. The expertise within the research team indicated that many programmes that support people with cognitive impairments do not formally report their work through academic dissemination pathways. Consequently it is intended that a grey literature search will be carried out to supplement that findings of study. In contrast to the focus on studies published in English for peer review returns, the grey literature search will actively seek out returns across all languages of the European Union.DiscussionThis rapid review protocol will focus on citizens ages 9 and up who live with cognitive impairment and establish a baseline for best practice in supporting web accessibility for people with cognitive impairments. It will achieve this by providing a time limited state-of-the-art evidence report, specific to the challenges people with cognitive impairment, that will help those involved in policy development, policy response initiatives and localised activity. It is intended that, depending on the outcome of the review process, additional opportunities for innovation and/or research may be communicated to relevant stakeholders and policy makers.Systematic Review RegistrationThis protocol has been submitted to the International Prospective Register for Systematic Reviews - PROSPERO, and is currently under review. Reference No. 269245.

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