scholarly journals CHRONIC DISEASES IN MIDDLE-AGED ADULTS WITH SUBJECTIVE COGNITIVE DECLINE: UNITED STATES, 2015-2017

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S815-S816
Author(s):  
Christopher A Taylor ◽  
Erin D Bouldin ◽  
Lisa C McGuire
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Cognitive Decline ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Cognitive Status ◽  
Subjective Cognitive Decline ◽  
Middle Aged ◽  
Memory Problems ◽  
Middle Aged Adults

Abstract While adults aged 65 years and older are most at risk for chronic conditions, studies show that middle-aged adults aged 45–64 years also have growing numbers of comorbid chronic diseases. Regardless of age, managing chronic conditions requires decision-making abilities to manage treatments effectively. Symptoms of memory loss and confusion may impair a person’s ability to manage their health. This study examined chronic conditions in persons with subjective cognitive decline (SCD), defined as the self-reported experience of increased memory problems or confusion. Behavioral Risk Factor Surveillance System data from 2015–2017 were used to define SCD and disease status for eight chronic conditions (heart disease, stroke, cancer, arthritis, asthma, depression, diabetes, and chronic obstructive pulmonary disease) for adults 45–64 years from 49 states, District of Columbia, and Puerto Rico that collected data on cognitive decline. Among adults aged 45–64 years, 10.8% reported SCD. Among those with SCD, 77.4% had at least one chronic disease compared to 47.1% of those without SCD. Those with SCD had a higher prevalence for all eight conditions compared to those similarly-aged without SCD. Adults with at least one chronic condition were more likely to discuss their symptoms of SCD with a health care professional (54.2%) compared to those with no chronic conditions (30.3%). Poor management of chronic conditions can result in increased health care costs and might worsen existing symptoms of confusion and memory problems. Self-care interventions for chronic disease management should consider the importance of an individual’s cognitive status, including SCD.

scholarly journals The influence of primary health care organizational models on patients’ experience of care in different chronic disease situations

2011 ◽  
Vol 31 (3) ◽  
pp. 109-120 ◽  
Author(s):  
R Pineault ◽  
S Provost ◽  
M Hamel ◽  
A Couture ◽  
JF Levesque
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Chronically Ill ◽  
Organizational Models ◽  
Experience Of Care ◽  
Primary Health

Objectives To examine the extent to which experience of care varies across chronic diseases, and to analyze the relationship of primary health care (PHC) organizational models with the experience of care reported by patients in different chronic disease situations. Methods We linked a population survey and a PHC organizational survey conducted in two regions of Quebec. We identified five groups of chronic diseases and contrasted these with a no–chronic-disease group. Results Accessibility of care is low for all chronic conditions and shows little variation across diseases. The contact and the coordination-integrated models are the most accessible, whereas the single-provider model is the least. Process and outcome indices of care experience are much higher than accessibility for all conditions and vary across diseases, with the highest being for cardiovascular-risk-factors and the lowest for respiratory diseases (for people aged 44 and under). However, as we move from risk factors to more severe chronic conditions, the coordination-integrated and community models are more likely to generate better process of care, highlighting the greater potential of these two models to meet the needs of more severely chronically ill individuals within the Canadian health care system.

scholarly journals Interventions to Support Behavioral Self-Management of Chronic Diseases

2019 ◽  
Vol 40 (1) ◽  
pp. 127-146 ◽  
Author(s):  
John P. Allegrante ◽  
Martin T. Wells ◽  
Janey C. Peterson
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Health Care Expenditures ◽  
Self Management ◽  
Management Interventions ◽  
Wide Range

A majority of the US adult population has one or more chronic conditions that require medical intervention and long-term self-management. Such conditions are among the 10 leading causes of mortality; an estimated 86% of the nation's $2.7 trillion in annual health care expenditures goes toward their treatment and management. Patient self-management of chronic diseases is increasingly essential to improve health behaviors, health outcomes, and quality of life and, in some cases, has demonstrated effectiveness for reducing health care utilization and the societal cost burden of chronic conditions. This review synthesizes the current state of the science of chronic disease self-management interventions and the evidence for their effectiveness, especially when applied with a systematic application of theories or models that account for a wide range of influences on behavior. Our analysis of selected outcomes from randomized controlled trials of chronic disease self-management interventions contained in 10 Cochrane systematic reviews provides additional evidence to demonstrate that self-management can improve quality of life and reduce utilization across several conditions.

scholarly journals Racial and ethnic disparities in subjective cognitive decline: a closer look, United States, 2015–2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sangeeta Gupta
Keyword(s):  
Health Care ◽  
Cognitive Decline ◽  
Ethnic Groups ◽  
Chronic Conditions ◽  
Functional Limitations ◽  
Population Based ◽  
Subjective Cognitive Decline ◽  
Sociodemographic Characteristics ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Background Subjective cognitive decline (SCD), characterized by self-experience of deterioration in cognitive performance may be a precursor to Alzheimer’s disease (AD). Given the association of AD with dependence and disability for a long duration, earlier the detection, the sooner people and their families can receive information regarding better management. It is critical to explore disparities amongst racial and ethnic populations with SCD in order to facilitate targeted interventions. The primary objective was to identify disparities in prevalence of SCD amongst Whites, Blacks and Hispanics by select sociodemographic characteristics and functional limitations in a U.S. population-based sample of non-institutionalized adults aged 45 and older. The secondary objective was to assess the association between SCD and select chronic conditions (angina, heart attack, stroke, diabetes, high blood pressure and high cholesterol) by race/ethnicity. Methods Combined data (2015–2018) were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) to conduct a population -based study. Analyses included 179,852 respondents aged 45 years or older who answered the SCD screening question as “yes” (n = 19,276) or “no” (n = 160,576). Descriptive statistics examined sociodemographic characteristics including functional limitations amongst racial/ethnic groups with SCD. Association of SCD with chronic conditions by race/ethnicity was also calculated. Results Overall, 10.8% (CI: 10.6–11.1) of adults aged 45 years or older reported SCD.10.7% Whites, 12.3% Blacks and 9.9% Hispanics experienced SCD. Blacks and Hispanics with SCD were more likely to be in the younger age group (45–54 years), less educated, low income, without access to health care, living alone and with functional limitations. Only half had discussed cognitive decline with a health care professional. Prevalence of selected chronic conditions was significantly higher in all racial/ethnic groups with SCD. Conclusions Demographic trends predict a larger proportion of Hispanics and Blacks with SCD in the coming years. This information can lead to identification of opportunities for addressing negative SCD outcomes in minorities affected by inequitable conditions.

scholarly journals The Effect of CAG Repeats within the Non-Pathological Range in the HTT Gene on Cognitive Functions in Patients with Subjective Cognitive Decline and Mild Cognitive Impairment

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1051
Author(s):  
Valentina Bessi ◽  
Salvatore Mazzeo ◽  
Silvia Bagnoli ◽  
Giulia Giacomucci ◽  
Assunta Ingannato ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Spatial Ability ◽  
Cognitive Status ◽  
Cag Repeat ◽  
Cag Repeats ◽  
Subjective Cognitive Decline ◽  
Visual Spatial ◽  
Premorbid Intelligence

The Huntingtin gene (HTT) is within a class of genes containing a key region of CAG repeats. When expanded beyond 39 repeats, Huntington disease (HD) develops. Individuals with less than 35 repeats are not associated with HD. Increasing evidence has suggested that CAG repeats play a role in modulating brain development and brain function. However, very few studies have investigated the effect of CAG repeats in the non-pathological range on cognitive performances in non-demented individuals. In this study, we aimed to test how CAG repeats’ length influences neuropsychological scores in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). We included 75 patients (46 SCD and 29 MCI). All patients underwent an extensive neuropsychological battery and analysis of HTT alleles to quantify the number of CAG repeats. Results: CAG repeat number was positively correlated with scores of tests assessing for executive function, visual–spatial ability, and memory in SCD patients, while in MCI patients, it was inversely correlated with scores of visual–spatial ability and premorbid intelligence. When we performed a multiple regression analysis, we found that these relationships still remained, also when adjusting for possible confounding factors. Interestingly, logarithmic models better described the associations between CAG repeats and neuropsychological scores. CAG repeats in the HTT gene within the non-pathological range influenced neuropsychological performances depending on global cognitive status. The logarithmic model suggested that the positive effect of CAG repeats in SCD patients decreases as the number of repeats grows.

scholarly journals Promoting Conversations About Cognitive Decline Between Older Adults and Primary Care Providers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 157-158
Author(s):  
Benjamin Olivari ◽  
Christopher Taylor ◽  
Nia Reed ◽  
Lisa McGuire
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Chronic Conditions ◽  
Memory Loss ◽  
Primary Care Providers ◽  
Subjective Cognitive Decline ◽  
Care Providers

Abstract Alzheimer’s disease and related dementias often begin with symptoms of mild memory loss, eventually leading to more severe cognitive impairment, functional impairment, and ultimately, death. Data from the Behavioral Risk Factor Surveillance System core questions related to chronic diseases and from the cognitive decline optional module on subjective cognitive decline (SCD) from the years 2015-2018 were aggregated across the participating 50 states, D.C., and Puerto Rico for this analysis. Among U.S. adults aged 65 years and older, only 39.8% (95%CI=37.6-42.1) of those experiencing SCD reported discussing their SCD symptoms with a healthcare provider. The prevalence of discussing SCD symptoms with a provider was higher among those with at least one chronic condition than among those with no chronic conditions. 30.7% (28.6-32.8) of those aged 65 years and older reported that their SCD led to functional limitations and 28.8% (26.5-31.2) needed assistance with day-to-day activities. For patients aged 65 years and older, Welcome to Medicare visits and Medicare Annual Wellness Visits are critically underutilized primary care access points. Primary care providers can manage chronic conditions, cognitive health, and initiate referrals for testing. Efforts to promote the use of toolkits and diagnostic codes that are available to primary care providers to initiate conversations about memory loss with patients may be utilized to improve detection, diagnosis, and planning for memory problems. Discussions may lead to earlier detection and diagnosis of cognitive impairment, such as Alzheimer’s disease, or other treatable conditions such as delirium or pressure in the brain and avoid costly hospitalizations.

scholarly journals The impact of chronic disease and disability on the elderly

1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Health Care Systems ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Elderly Persons ◽  
Care Systems ◽  
And Function ◽  
The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

Differences in quantitative methods for measuring subjective cognitive decline – results from a prospective memory clinic study

2016 ◽  
Vol 28 (9) ◽  
pp. 1513-1520 ◽  
Author(s):  
Asmus Vogel ◽  
Lise Cronberg Salem ◽  
Birgitte Bo Andersen ◽  
Gunhild Waldemar
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Quantitative Methods ◽  
Cognitive Status ◽  
Cognitive Test ◽  
Subjective Cognitive Decline ◽  
Linear Regression Models ◽  
Memory Clinic ◽  
Subjective Memory ◽  
Wide Range

ABSTRACTBackground:Cognitive complaints occur frequently in elderly people and may be a risk factor for dementia and cognitive decline. Results from studies on subjective cognitive decline are difficult to compare due to variability in assessment methods, and little is known about how different methods influence reports of cognitive decline.Methods:The Subjective Memory Complaints Scale (SMC) and The Memory Complaint Questionnaire (MAC-Q) were applied in 121 mixed memory clinic patients with mild cognitive symptoms (mean MMSE = 26.8, SD 2.7). The scales were applied independently and raters were blinded to results from the other scale. Scales were not used for diagnostic classification. Cognitive performances and depressive symptoms were also rated. We studied the association between the two measures and investigated the scales’ relation to depressive symptoms, age, and cognitive status.Results:SMC and MAC-Q were significantly associated (r = 0.44, N = 121, p = 0.015) and both scales had a wide range of scores. In this mixed cohort of patients, younger age was associated with higher SMC scores. There were no significant correlations between cognitive test performances and scales measuring subjective decline. Depression scores were significantly correlated to both scales measuring subjective decline. Linear regression models showed that age did not have a significant contribution to the variance in subjective memory beyond that of depressive symptoms.Conclusions:Measures for subjective cognitive decline are not interchangeable when used in memory clinics and the application of different scales in previous studies is an important factor as to why studies show variability in the association between subjective cognitive decline and background data and/or clinical results. Careful consideration should be taken as to which questions are relevant and have validity when operationalizing subjective cognitive decline.

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