scholarly journals IMPACT OF ELDER ABUSE ON SUBSEQUENT COGNITIVE DETERIORATION IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S287-S287
Author(s):  
Boye FANG ◽  
Elsie Yan
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Physical Abuse ◽  
Elder Abuse ◽  
Psychological Abuse ◽  
Neuropsychiatric Symptoms ◽  
Outcome Variable ◽  
Cognitive Deterioration ◽  
The Impact ◽  
Observation Period

Abstract Objectives: Considering the rapidly increasing older population, elder abuse has become a major public health problem. Using longitudinal data, this study examines the impact of elder abuse on subsequent cognitive deterioration. Methods: At baseline, one-thousand-and-two older adults (aged≥55 years) with a clinically valid diagnosis of mild-to-moderate cognitive impairment were consecutively recruited from the geriatric and neurological departments of three Grade-A hospitals in Guangdong Province of People’s Republic of China from 2015 to 2016 and 958 of them have completed the present follow-up study after two years. The major independent variables were psychological abuse, physical abuse, caregiver neglect, and financial exploitation experienced at baseline. The outcome variable was cognitive deterioration defined by repeated measures using the Mini-Mental State Examination. Covariates included demographic characteristics, neuropsychiatric symptoms, depression, and IADL impairment. Results: According to the mixed-effect model, elder abuse at baseline did not have significant association with baseline cognitive impairment. However, experience of physical abuse (coefficient 0.11; 95% CI 0.06-0.15), psychological abuse (coefficient 0.28; 95% CI 0.09-0.47), and caregiver neglect (coefficient 0.03; 95% CI 0.01-0.05) at baseline predicted greater cognitive deterioration over the two-year observation period. Other contributing factors for greater cognitive deterioration included neuropsychiatric symptoms and depression. Discussion: Although no significant cross-sectional association between elder abuse and cognitive impairment was observed, physical abuse, psychological abuse, and caregiver neglect at baseline was found to have a long-term prominent effect on subsequent cognitive deterioration over the two-year observation period. The present results su

scholarly journals ASSOCIATION BETWEEN ELDER ABUSE AND TELOMERE LENGTH IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S490-S490
Author(s):  
Boye FANG ◽  
Elsie Yan ◽  
Keith Tung ◽  
Gengzhen Chen
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Telomere Length ◽  
Physical Abuse ◽  
Elder Abuse ◽  
Domestic Abuse ◽  
Psychological Abuse ◽  
Previous Experience ◽  
Outcome Variable ◽  
Current Experience

Abstract Objectives: Elder abuse is a stressful event that can lead to compromised psychological and physical health consequences. This study examines the association between elder abuse and telomere length (TL), a biomarker reflecting cellular aging and disease pathogenesis. Methods: Between 2015 and 2016, 1,002 older adults (aged≥55 years) with cognitive impairment were consecutively recruited from the geriatric and neurological departments of three Grade-A hospitals in Guangdong Province of People’s Republic of China. At two-year follow-up, 958 of these participants were reassessed and 600 of them were randomly selected for this study. The outcome variable is TL (measured in blood cells using a multiplex quantitative polymerase chain reaction) and the major independent variables were current experience of overall abuse, psychological abuse, physical abuse, caregiver neglect, and previous experience of domestic abuse in the past two years. Potential confounding variables include demographic variables and increased severity of cognitive impairment, neuropsychiatric symptoms, sleep disorders, and depressive symptoms. Results: Multivariate regression models show that current experience of overall domestic abuse (t= -5.116, β= -0.376, confidence interval[CI] -20.231–-9.006), psychological abuse (t= -4.431, β= -0.231, [CI] -13.023–-5.023), physical abuse (t= -2.474, β= -0.151, CI -14.116–-1.621), and caregiver neglect were associated with shorter TL (t= -4.470, β= -0.185, CI -10.457–-4.072). Other predictors of shorter TL were previous experience of domestic abuse and increased severity of depression. Discussion: Both current and previous experiences of elder abuse are associated with shorter TL. Multidisciplinary efforts were needed to prevent and intervene elder abuse.

scholarly journals Social and Behavioral Factors, Oral Health, and Dental Care Utilization

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 799-800
Author(s):  
Bei Wu ◽  
Stephen Shuman ◽  
Elisa Ghezzi
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Oral Health ◽  
Health Outcomes ◽  
Dental Care ◽  
Care Utilization ◽  
Behavioral Factors ◽  
Dental Care Utilization ◽  
The Impact ◽  
The U.S

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.

scholarly journals Cognitive Outcomes during COVID-19 confiNemeNt in Elderly and their Caregivers using Technologies for DEMentia (CONNECT DEM): study protocol (Preprint)

2020 ◽  
Author(s):  
Jessica Marian Goodman-Casanova ◽  
Elena Dura-Perez ◽  
Gloria Guerrero-Pertiñez ◽  
Pilar Barnestein-Fonseca ◽  
Jose Guzman-Parra ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Social Isolation ◽  
Community Dwelling ◽  
Mild Dementia ◽  
Care Services ◽  
Health And Social Care ◽  
The Impact ◽  
Community Dwelling Older Adults

BACKGROUND Coronavirus disease 2019 has forced worldwide the implementation of unprecedented restrictions to control its rapid spread and mitigate its impact. The Spanish government has enforced social distancing, quarantine and home confinement. This restriction of daily life activities and separation from loved ones may lead to social isolation and loneliness with health-related consequences in community-dwelling older adults with mild cognitive impairment or mild dementia and their caregivers. Additionally, an inadequate access to healthcare and social support services may aggravate chronic conditions. Technology home-based interventions emerge for combating social isolation and loneliness preventing the risk of viral exposure. OBJECTIVE The aim of this cohort study is to explore, analyze and determine the impact of social isolation on: 1) cognition, quality of life, mood, technophilia and perceived stress of community-dwelling older adults with mild cognitive impairment or mild dementia, and on caregiver burden; 2) health and social care services access and utilization, and 3) cognitive, social and entertainment use of ICTs. METHODS This study will be conducted in the Spanish region of Andalucía (Málaga). In total 200 dyads, consisting of a person with mild cognitive impairment or mild dementia (PMCI/MD) and their informal caregiver will be contacted by telephone. Potential respondents will be participants of the SMART 4 MD (N=100) and TV-AssistDem (N=100) clinical trials. RESULTS The change in means in the variables will be analyzed comparing baseline results in the previous studies with those during and after confinement using the ANOVA test of repeated measures or the non-parametric Friedman test if appropriate. The performance of a multivariate analysis of variance (ANCOVA) to introduce possible covariates will also be contemplated. A 95% confidence level will be used. CONCLUSIONS If the hypothesis is proven, these findings will demonstrate the negative impact of social isolation due to the COVID-19 confinement on cognition, quality of life, mood, and perceived stress of community-dwelling older adults with mild cognitive impairment and mild dementia, the impact on technophilia, caregiver burden, and health and social care services access and utilization; and the cognitive, social and entertainment use of ICTs during the COVID-19 confinement and afterwards. CLINICALTRIAL NCT: 04385797

scholarly journals 85 A Cross-Sectional Study Assessing Agreement Between Self-Reported and General Practice Recorded Health Conditions Among Community Dwelling Older Adults

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i27-i27
Author(s):  
M D Hale ◽  
G Santorelli ◽  
C Brundle ◽  
A Clegg
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Older Adults ◽  
General Practice ◽  
Cognitive Impairment ◽  
Visual Impairment ◽  
Community Dwelling ◽  
Health Conditions ◽  
Kappa Statistics ◽  
The Impact

Abstract Introduction Self-reported data regarding health conditions are utilised in both clinical practice and research, however, their agreement with general practice records is variable. The extent of this variability is poorly studied among older adults, particularly among those with multiple health conditions, cognitive impairment or frailty. This study investigates the agreement between self-reported and general practice recorded data among such patients and the impact of participant factors on this agreement. Methods Data on health conditions was collected from participants in the Community Ageing Research 75+ (CARE75+) study (n=964) by self-reporting during face to face assessment and interrogation of the participants’ practice health records. Agreement between self-report and practice records was assessed using Kappa statistics and the effect of participant demographics using logistic regression. Results Agreement ranged from K=0.25-1.00. The presence of ≥2 health conditions modified agreement for cancer (odds ratio, OR:0.62, 95% confidence interval, CI:0.42-0.94), diabetes (OR:0.55, 95%CI:0.38-0.80), dementia (OR:2.82, 95%CI:1.31-6.13) and visual impairment (OR:3.85, 95%CI:1.71-8.62). Frailty reduced agreement for cerebrovascular disease (OR:0.45, 95%CI:0.23-0.89), heart failure (OR:0.40, 95%CI:0.19-0.84) and rheumatoid arthritis (OR:0.41, 95%CI:0.23-0.75). Cognitive impairment reduced agreement for dementia (OR:0.36, 95%CI:0.21-0.62), diabetes (OR:0.47, 95%CI:0.33-0.67), heart failure (OR:0.53, 95%CI:0.35-0.80), visual impairment (OR:0.42, 95%CI:0.25-0.69) and rheumatoid arthritis (OR:0.53, 95%CI:0.37-0.76). Conclusions Significant variability exists for agreement between self-reported and general practice recorded comorbidities. This is further affected by individuals’ baseline demographics. This study is the first to assess frailty as a factor modifying agreement and highlights the importance of utilising the general practice records as the gold standard for data collection from older adults.

scholarly journals Geriatric Resource Teams: Equipping Primary Care Practices to Meet the Complex Care Needs of Older Adults

Geriatrics ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. 59 ◽  
Author(s):  
Gwendolen Buhr ◽  
Carrissa Dixon ◽  
Jan Dillard ◽  
Elissa Nickolopoulos ◽  
Lynn Bowlby ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Assessment Process ◽  
Complex Care ◽  
Care Needs ◽  
Care Practices ◽  
Primary Care Practices ◽  
Complex Care Needs ◽  
The Impact

Primary care practices lack the time, expertise, and resources to perform traditional comprehensive geriatric assessment. In particular, they need methods to improve their capacity to identify and care for older adults with complex care needs, such as cognitive impairment. As the US population ages, discovering strategies to address these complex care needs within primary care are urgently needed. This article describes the development of an innovative, team-based model to improve the diagnosis and care of older adults with cognitive impairment in primary care practices. This model was developed through a mentoring process from a team with expertise in geriatrics and quality improvement. Refinement of the existing assessment process performed during routine care allowed patients with cognitive impairment to be identified. The practice team then used a collaborative workflow to connect patients with appropriate community resources. Utilization of these processes led to reduced referrals to the geriatrics specialty clinic, fewer patients presenting in a crisis to the social worker, and greater collaboration and self-efficacy for care of those with cognitive impairment within the practice. Although the model was initially developed to address cognitive impairment, the impact has been applied more broadly to improve the care of older adults with multimorbidity.

scholarly journals MP34: Elder abuse in the emergency department: a systematic scoping review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S54-S55
Author(s):  
E. Mercier ◽  
A. Nadeau ◽  
A. Brousseau ◽  
M. Emond ◽  
J. Lowthian ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Physical Abuse ◽  
Health Care Providers ◽  
Scoping Review ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Screening Tools ◽  
Care Providers

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

scholarly journals The Independent Contributions of Cognitive Impairment and Neuropsychiatric Symptoms to Everyday Function in Older Adults

2014 ◽  
Vol 28 (2) ◽  
pp. 215-236 ◽  
Author(s):  
Lauren A. Rog ◽  
Lovingly Quitania Park ◽  
Danielle J. Harvey ◽  
Chun-Jung Huang ◽  
Scott Mackin ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Neuropsychiatric Symptoms ◽  
Everyday Function
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