scholarly journals A TYPICAL WEEK WITH MILD COGNITIVE IMPAIRMENT: A PHOTO-ELICITATION STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S849-S849
Author(s):  
Jenny Wool ◽  
Brenna N Renn

Abstract Mild cognitive impairment (MCI) is an important precursor to dementia syndromes and carries with it both public and personal health significance, yet affected individuals may experience stigma, fear, and reluctance to participate in research or access services. Identifying the experience of people with MCI may help develop research agendas, interventions, and other supports to better match patients’ needs. To this end, we conducted photo-elicitation interviews with 11 community-dwelling adults aged 57-79 years with diagnosed MCI. Interviews took place remotely using teleconferencing software to reduce access barriers. Each semi-structured interview used 5-10 participant-generated photographs to elicit the experience of living with MCI, barriers to daily activities, and facilitators and supports. Interviews were transcribed, coded, and analyzed using Dedoose software. Qualitative analysis revealed themes of important activities, including physical activity, social engagement, and cognitive stimulation. Barriers presented by MCI included difficulty with former routines (e.g., cooking, finances), reduction of activities, and perceived stigma or fear of disclosure. Facilitators of daily activities included increased use of new strategies and environmental supports (e.g., calendars, smartphones), in addition to social and familial support. Multiple participants noted that the diagnosis of MCI led to opportunities for inner reflection and seeking a sense of inner calmness. Incorporating participant-generated images aided in data collection and facilitated discussion of sensitive topics with a cognitively impaired sample. Clinicians and researchers should support engagement in meaningful activities, assess barriers to important daily activities, and consider support to match the experience and needs of those with MCI.

2021 ◽  
Author(s):  
Brenna N Renn ◽  
Jenny L Wool ◽  
Basia Belza

Abstract Background and Objectives Identifying the experience of people with mild cognitive impairment (MCI) may help develop research agendas, interventions, and other supports to better match individuals’ needs. The purpose of this study was to explore the subjective experience of a “typical week” living with MCI to document (a) important activities, (b) barriers to usual activities, and (c) facilitators and supports. Research Design and Methods We conducted remote individual photo-elicitation interviews with 11 community-dwelling adults aged 55 years or older with MCI. Participants each provided 5–10 photographs of daily life taken over 1 week to facilitate a semistructured qualitative interview. Interview transcriptions were coded in Dedoose software and analyzed using thematic analysis. Results Participants shared photos and narratives highlighting the important activities in a typical week, in which physical activity, social engagement, spiritual and religious practice, hobbies, and cognitive stimulation were central. Many also shared disruptions to former routines and reduction of activities alongside increased use of new strategies and environmental supports (e.g., calendars, smartphones). Finally, emergent themes centered on disclosure of their diagnosis and reflections about the future. Discussion and Implications Participant-generated images aided data collection and facilitated discussion of sensitive topics with individuals with MCI. Such narratives may illustrate the needs and opportunities to promote well-being in individuals with MCI, including engagement in meaningful and health-promoting activities, assessing barriers to important daily activities, and considering supports that match the experience and needs of those with MCI.


Author(s):  
Jessica Marian Goodman-Casanova ◽  
Elena Dura-Perez ◽  
Jose Guzman-Parra ◽  
Antonio Cuesta-Vargas ◽  
Fermin Mayoral-Cleries

BACKGROUND The public health emergency of coronavirus disease (COVID-19) is rapidly evolving worldwide; some countries, including Spain, have implemented restrictive measures. Populations that are vulnerable to this outbreak and its physical and mental health effects include community-dwelling older adults with mild cognitive impairment or mild dementia. Telehealth is a potential tool to deliver health care and decrease exposure risk. OBJECTIVE The aims of this study were to explore the impact of confinement on the health and well-being of community-dwelling older adults with mild cognitive impairment or mild dementia, to provide television-based and telephone-based health and social support, and to study the effects of a television-based assistive integrated technology, TV-AssistDem (TeleVision-based ASSistive Integrated Service to supporT European adults living with mild DEMentia or mild cognitive impairment). METHODS A telephone-based survey was administered in Spain to 93 participants in the TV-AssistDem clinical trial from March 25 to April 6, 2020. RESULTS Of the respondents, 60/93 (65%) were women. The mean age was 73.34 (SD 6.07), and 69/93 (74%) lived accompanied. Lockdown measures forced 17/93 respondents (18%) to change their living arrangements. Health status was found to be optimal in 89/93 respondents (96%), with no COVID-19 symptoms. Grocery and pharmacy outings were performed by family members of 68/93 participants (73%); 57 (61%) reported overall well-being, and 65 (70%) maintained their sleep quality. However, participants living alone reported greater negative feelings and more sleeping problems. Regarding leisure activities, 53/93 respondents (57%) took walks, 32 (35%) played memory games, 55 (60%) watched television, and 91 (98%) telephoned relatives. 58/93 (64%) respondents reported accessing moderate or too much COVID-19 information, 89 (97%) received it from television, and 56 (62%) stated that their understanding of the information was extreme. 39/93 (39%) respondents had contacted health and social services, while 29 (31%) requested information regarding these services during the telephone call. There were no significant differences in health and well-being between the intervention and control groups. Respondents with TV-AssistDem performed more memory exercises (24/93, 52% vs 8/93, 17.4%; <i>P</i>&lt;.001) than control respondents. CONCLUSIONS Our findings suggest that during COVID-19 confinement, the physical and mental health and well-being was optimal for the majority of our vulnerable population. However, those living alone reported greater negative psychological effects and sleeping problems. Measures adopted to address the negative experiences of confinement included keeping informed about the situation, accessing health and social services, having a support network that prevents risk of exposure to COVID-19 and guarantees food and medical supplies, a daily routine with maintained sleeping habits and leisure activities, staying physically and mentally active with cognitive stimulation exercises, and ensuring social connectedness using technology. Television sets were preferred technological devices to access COVID-19 information, watch television as a recreational activity, and perform memory exercises as an intellectual activity. Television-based telehealth support using TV-AssistDem demonstrated potential for cognitive stimulation. CLINICALTRIAL ClinicalTrials.gov NCT03653234; https://clinicaltrials.gov/ct2/show/NCT03653234


2020 ◽  
Vol 14 (1) ◽  
pp. 28-34
Author(s):  
Maria dos Anjos Dixe ◽  
Mônica Braúna ◽  
Timóteo Camacho ◽  
Filipa Couto ◽  
João Apóstolo

ABSTRACT Mild cognitive decline is a feared aspect of aging associated with frailty experienced by individuals. Objective: To determine the number of elderly people with mild cognitive impairment (MCI); to determine the relationship of sociodemographic and clinical variables by group of individuals with or without MCI and to determine the relationship between MCI assessed by 6CIT and the cognitive domains assessed by the MoCA. Methods: A correlational study was conducted of 44 elderly individuals attending a day-care center or residing in a care home, with an average age of 88.9 ± 8.8 years who answered a structured interview collecting sociodemographic and clinical data. Results: The elderly living at home had higher average body mass index and number of pathologies than those living in an institution for the elderly (p < 0.01). 63.6% of the elderly did not have MCI, and no differences were found between residential settings. The comparison between 6CIT and MoCA yielded differences in the general domain and in visual, attention, abstraction and, orientation subdomains. Conclusion: Cognitive stimulation interventions should be optimized according to the residential setting at the level of comorbidities and nutrition.


10.2196/19434 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e19434 ◽  
Author(s):  
Jessica Marian Goodman-Casanova ◽  
Elena Dura-Perez ◽  
Jose Guzman-Parra ◽  
Antonio Cuesta-Vargas ◽  
Fermin Mayoral-Cleries

Background The public health emergency of coronavirus disease (COVID-19) is rapidly evolving worldwide; some countries, including Spain, have implemented restrictive measures. Populations that are vulnerable to this outbreak and its physical and mental health effects include community-dwelling older adults with mild cognitive impairment or mild dementia. Telehealth is a potential tool to deliver health care and decrease exposure risk. Objective The aims of this study were to explore the impact of confinement on the health and well-being of community-dwelling older adults with mild cognitive impairment or mild dementia, to provide television-based and telephone-based health and social support, and to study the effects of a television-based assistive integrated technology, TV-AssistDem (TeleVision-based ASSistive Integrated Service to supporT European adults living with mild DEMentia or mild cognitive impairment). Methods A telephone-based survey was administered in Spain to 93 participants in the TV-AssistDem clinical trial from March 25 to April 6, 2020. Results Of the respondents, 60/93 (65%) were women. The mean age was 73.34 (SD 6.07), and 69/93 (74%) lived accompanied. Lockdown measures forced 17/93 respondents (18%) to change their living arrangements. Health status was found to be optimal in 89/93 respondents (96%), with no COVID-19 symptoms. Grocery and pharmacy outings were performed by family members of 68/93 participants (73%); 57 (61%) reported overall well-being, and 65 (70%) maintained their sleep quality. However, participants living alone reported greater negative feelings and more sleeping problems. Regarding leisure activities, 53/93 respondents (57%) took walks, 32 (35%) played memory games, 55 (60%) watched television, and 91 (98%) telephoned relatives. 58/93 (64%) respondents reported accessing moderate or too much COVID-19 information, 89 (97%) received it from television, and 56 (62%) stated that their understanding of the information was extreme. 39/93 (39%) respondents had contacted health and social services, while 29 (31%) requested information regarding these services during the telephone call. There were no significant differences in health and well-being between the intervention and control groups. Respondents with TV-AssistDem performed more memory exercises (24/93, 52% vs 8/93, 17.4%; P<.001) than control respondents. Conclusions Our findings suggest that during COVID-19 confinement, the physical and mental health and well-being was optimal for the majority of our vulnerable population. However, those living alone reported greater negative psychological effects and sleeping problems. Measures adopted to address the negative experiences of confinement included keeping informed about the situation, accessing health and social services, having a support network that prevents risk of exposure to COVID-19 and guarantees food and medical supplies, a daily routine with maintained sleeping habits and leisure activities, staying physically and mentally active with cognitive stimulation exercises, and ensuring social connectedness using technology. Television sets were preferred technological devices to access COVID-19 information, watch television as a recreational activity, and perform memory exercises as an intellectual activity. Television-based telehealth support using TV-AssistDem demonstrated potential for cognitive stimulation. Trial Registration ClinicalTrials.gov NCT03653234; https://clinicaltrials.gov/ct2/show/NCT03653234


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 451-452
Author(s):  
Mary Caroline Yuk ◽  
Rebecca Allen ◽  
Marcia Hay-McCutcheon ◽  
Dana Carroll ◽  
Anne Halli-Tierney

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.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 558-558
Author(s):  
Chantal Kerssens ◽  
Maribeth Gandy ◽  
Kara Cohen ◽  
Laura Levy ◽  
Cecile Janssens ◽  
...  

Abstract Mild cognitive impairment (MCI) affects millions of older Americans and progression to dementia is common. Although people with MCI may experience impairments, they are often highly verbal, able, and eager to uphold beloved routines. Moreover, many seek opportunities to stay active, physically and mentally, to support their brain health. Some forms of cognitive training and social engagement potentially delay the onset and progression of disease, including dementia. This 12-month project used mixed methods to co-design and test an accessible version of well-known board games for people with MCI and a care partner without MCI. The overall goal was to foster a meaningful, joyous, social activity for players with differing capabilities using adapted game mechanics to create a compelling experience for both players. Coping strategies of care partners were studied to learn ways to foster positive interactions. Findings inform recommendations for game design and clinical interventions. Part of a symposium sponsored by Technology and Aging Interest Group.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 598-598
Author(s):  
Ruixue Zhaoyang ◽  
Stacey Scott ◽  
Eric Cerino ◽  
Martin Sliwinski

Abstract Social relationships play an important role in cognitive health and aging. However, it is unclear how older adult’s cognitive function affects their everyday social interactions, especially for those with mild cognitive impairment (MCI). This study examined whether older adults with intact cognition vs. MCI differed in their daily social interactions. Community-dwelling older adults from the Einstein Aging Study (N=244, 70-91 yrs) reported their social interactions five times daily for 14 consecutive days using smartphones. Compared to those with normal cognitive function, older adults with MCI reported less frequent positive social interactions (p=0.012) and in-person social activities (p=0.006) on a daily basis. These two groups, however, did not show significant differences in their social relationships assessed by a conventional global questionnaire. The results support that, relative to global social relationships, daily social interactions are more sensitive, ecologically valid social markers that can facilitate the early detection of MCI.


2021 ◽  
Vol 18 ◽  
Author(s):  
Huilian Duan ◽  
Changqing Sun ◽  
Yun Zhu ◽  
Qian Liu ◽  
Yue Du ◽  
...  

Background: Recent findings suggest a possible role of diet, particularly nutrient in- takes and dietary patterns, in the prevalence of mild cognitive impairment (MCI); few studies, how- ever, have been explicitly devoted to the relationship between dietary habits and MCI. Objectives: We aimed to explore the association between dietary habits, including meal timing, and MCI among older Chinese adults. Methods: This cross-sectional study involved data collected at the baseline of the Tianjin Elderly Nutrition and Cognition Cohort (TENCC) study, in which 3,111 community-dwelling older adults (326 MCI patients and 2,785 non-MCIs) from a rural area of Tianjin, China, were recruited. In March 2018 to June 2019, all participants underwent a detailed neuropsychological evaluation that allowed for psychometric MCI classification. Information on self-reported dietary behaviors was gathered via face-to-face interviews. Crude and multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models. Results: In the multivariable-adjusted models, eating breakfast 4 to 6 times per week (vs. ≤3 times per week, OR: 0.45; 95% CI: 0.26, 0.75), drinking water before breakfast (yes vs. no, OR: 0.64; 95% CI: 0.51, 0.82), consuming water ≥1.5L per day (vs. <1.5L per day, OR: 0.64; 95% CI: 0.51, 0.82), and having lunch after 12:00 (vs. before 12:00, OR: 0.59; 95% CI: 0.47, 0.75) were associat- ed with decreased risk of MCI. Participants who consumed higher amounts of cooking oil were at a higher risk of MCI (moderate vs. low, OR: 1.42; 95% CI: 1.04, 1.92; high vs. low, OR: 1.40; 95% CI: 1.07-1.83). Conclusion : This study suggests that dietary habits, including breakfast frequency, daily water consumption, cooking oil consumption, and meal timing, may be associated with the risk of MCI. If replicated, these findings would open new possibilities of dietary interventions for MCI.


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