The Association Between Patterns of Social Engagement and Conversion From Mild Cognitive Impairment to Dementia

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.

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Association between Poor Sleep Quality and Subsequent Peptic Ulcer Recurrence in Older Patients with Mild Cognitive Impairment: Examining the Role of Social Engagement

Scientific Reports ◽

10.1038/s41598-019-38715-3 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 4

Author(s):

Boye Fang ◽

Shuyan Yang ◽

Ruirui Xu ◽

Gengzhen Chen

Keyword(s):

Peptic Ulcer ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sleep Quality ◽

Social Engagement ◽

Older Patients ◽

Ulcer Recurrence ◽

Poor Sleep ◽

Poor Sleep Quality

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The Association Between Social Engagement, Mild Cognitive Impairment, and Falls Among Older Primary Care Patients

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2019.01.020 ◽

2019 ◽

Vol 100 (8) ◽

pp. 1499-1505 ◽

Cited By ~ 2

Author(s):

Lien T. Quach ◽

Rachel E. Ward ◽

Mette M. Pedersen ◽

Suzanne G. Leveille ◽

Laura Grande ◽

...

Keyword(s):

Primary Care ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Social Engagement ◽

Primary Care Patients

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Midlife Long-Hour Working and Later-life Social Engagement Are Associated with Reduced Risks of Mild Cognitive Impairment among Community-Living Singapore Elderly

Journal of Alzheimer s Disease ◽

10.3233/jad-180605 ◽

2019 ◽

Vol 67 (3) ◽

pp. 1067-1077 ◽

Cited By ~ 5

Author(s):

Jing-Huan Deng ◽

Kai-Yong Huang ◽

Xiao-Xiao Hu ◽

Xiao-Wei Huang ◽

Xian-Yan Tang ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Social Engagement ◽

Later Life ◽

Community Living

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State of the science on mild cognitive impairment (MCI)

CNS Spectrums ◽

10.1017/s1092852918001347 ◽

2019 ◽

Vol 24 (1) ◽

pp. 78-87 ◽

Cited By ~ 7

Author(s):

Nicole D. Anderson

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Social Engagement ◽

Medial Temporal Lobe ◽

Healthy Aging ◽

Cognitive Screening ◽

Symptoms Of Depression ◽

Preclinical Ad ◽

Positron Emission ◽

State Of The Science

Mild cognitive impairment (MCI) represents a transitional stage between healthy aging and dementia, and affects 10–15% of the population over the age of 65. The failure of drug trials in Alzheimer’s disease (AD) treatment has shifted researchers’ focus toward delaying progression from MCI to dementia, which would reduce the prevalence and costs of dementia profoundly. Diagnostic criteria for MCI increasingly emphasize the need for positive biomarkers to detect preclinical AD. The phenomenology of MCI comprises lower quality-of-life, greater symptoms of depression, and avoidant coping strategies including withdrawal from social engagement. Neurobiological features of MCI are hypoperfusion and hypometabolism in temporoparietal cortices, medial temporal lobe atrophy particularly in rhinal cortices, elevated tau and phosphorylated tau and decreased Aβ42in cerebrospinal fluid, and brain Aβ42deposition. Elevated tau can be identified in MCI, particularly in the entorhinal cortex, using positron emission tomography, and analysis of signal complexity using electroencephalography or magnetoencephalography holds promise as a biomarker. Assessment of MCI also relies on cognitive screening and neuropsychological assessment, but there is an urgent need for standardized cognitive tests to capitalize on recent discoveries in cognitive neuroscience that may lead to more sensitive measures of MCI. Cholinesterase inhibitors are frequently prescribed for MCI, despite the lack of evidence for their efficacy. Exercise and diet interventions hold promise for increasing reserve in MCI, and group psychoeducational programs teaching practical memory strategies appear effective. More work is needed to better understand the phenomenology and neurobiology of MCI, and how best to assess it and delay progression to dementia.

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A Typical Week With Mild Cognitive Impairment

The Gerontologist ◽

10.1093/geront/gnab008 ◽

2021 ◽

Author(s):

Brenna N Renn ◽

Jenny L Wool ◽

Basia Belza

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Social Engagement ◽

Subjective Experience ◽

Well Being ◽

Religious Practice ◽

Community Dwelling ◽

Cognitive Stimulation ◽

Photo Elicitation ◽

Design And Methods

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.

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Patterns of Social Engagement Among Older Adults With Mild Cognitive Impairment

The Journals of Gerontology Series B ◽

10.1093/geronb/gbz051 ◽

2019 ◽

Vol 75 (7) ◽

pp. 1361-1371 ◽

Cited By ~ 2

Author(s):

Takashi Amano ◽

Nancy Morrow-Howell ◽

Sojung Park

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Social Engagement ◽

Latent Class ◽

Multinomial Logistic Regression ◽

Health Condition ◽

Social Activities ◽

Personal Factors ◽

Icf Model ◽

Engagement Factors

Abstract Objectives Promoting engagement in social activities may be an intervention that prevents or delays cognitive impairment. Nevertheless, little is known about social engagement among people with mild cognitive impairment (MCI). We aim to examine patterns of social engagement among people with MCI and to assess whether factors under 4 domains of the WHO’s ICF model (personal factors, environmental factors, body functions and structure, and health condition) associate with different patterns of social engagement. Method Data were drawn from the 2010 Health and Retirement Study. The final sample comprised 1,227 people with cognitive impairment no dementia (CIND). Latent class analysis and multinomial logistic regression were utilized. Results Three patterns of social engagement were identified: informal social engagement only, formal and informal social engagement, and low social engagement. Factors in each of the 4 ICF model domains were associated with the probability of class membership. Discussion Our findings suggest that social engagement is heterogeneous among people with CIND and that some groups of people with CIND have possibilities of engaging in more social activities, especially in formal social activities. Results also indicate that providing informal social resources may be essential for social programs designed specifically for people with CIND to promote their formal social engagement. Future study is needed to examine possible differences in outcomes across groups with similar patterns of social engagement.

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An Integrative Framework to Guide Social Engagement Interventions and Technology Design for Persons With Mild Cognitive Impairment

Frontiers in Public Health ◽

10.3389/fpubh.2021.750340 ◽

2022 ◽

Vol 9 ◽

Author(s):

Elizabeth A. Lydon ◽

Lydia T. Nguyen ◽

Qiong Nie ◽

Wendy A. Rogers ◽

Raksha A. Mudar

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Physical Health ◽

Social Isolation ◽

Cognitive Aging ◽

Social Engagement ◽

Emotional Health ◽

Integrative Framework ◽

Increased Risk

Social isolation and loneliness in older adults are associated with poor health outcomes and have been linked to an increased risk of cognitive impairment and incident dementia. Social engagement has been identified as a key factor in promoting positive health behaviors and quality of life and preventing social isolation and loneliness. Studies involving cognitively healthy older adults have shown the protective effects of both in-person and technology-based social engagement. However, the benefits of social engagement for people who are already at-risk of developing dementia, namely those with mild cognitive impairment (MCI), have yet to be elucidated. We present a narrative review of the literature, summarizing the research on social engagement in MCI. First, we identified social networks (quality, size, frequency, and closeness) and social activities (frequency, format, purpose, type, and content) as two overarching dimensions of an integrative framework for social engagement derived from literature examining typical cognitive aging. We then used this framework as a lens to examine studies of social engagement in MCI to explore (i) the relationship between in-person and technology-based social engagement and cognitive, emotional, and physical health, and (ii) interventions that target social engagement including technology-based approaches. Overall, we found that persons with MCI (PwMCI) may have different levels of social engagement than those experiencing typical cognitive aging. Moreover, in-person social engagement can have a positive impact on cognitive, emotional, and physical health for PwMCI. With respect to activity and network dimensions in our framework, we found that cognitive health has been more widely examined in PwMCI relative to physical and emotional health. Very few intervention studies have targeted social engagement, but both in-person and technology-based interventions appear to have promising health and well-being outcomes. Our multidimensional framework of social engagement provides guidance for research on characterizing the protective benefits of social engagement for PwMCI and informs the development of novel interventions including technology-based approaches.

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EFFECTS OF A STRENGTHS-BASED DYADIC PROGRAM ON THE HEALTH OF PERSONS WITH MILD COGNITIVE IMPAIRMENT AND THEIR FAMILY

Innovation in Aging ◽

10.1093/geroni/igz038.420 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S113-S114

Author(s):

Doris Yu ◽

Sheung-Tak Cheng ◽

Polly Li ◽

Fan Zhang

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Health Outcomes ◽

Social Engagement ◽

Symptom Management ◽

Psychiatric Symptoms ◽

Control Group ◽

Self Image ◽

Strength Based ◽

Post Test

Abstract Mild cognitive impairment (MCI) is characterized by cognitive impairment cognition, neuro-psychiatric symptoms particularly depressed mood, and compromised self-image. This RCT evaluated the effects of a strength-based dyadic program, which supported MCI care dyads for effective symptom and disease management and active social engagement, on the dyadic health outcomes. From Dec 2017-Jan 2019, 103 care dyads were recruited in an elderly community center. By adopting the strength-based and person-centered approach, this 14-week program worked out a dyadic biographies for care dyads to increase identification and recognition of their own strengths. Then, six interactive educative-counseling sessions focusing on cognitive and behavioral symptom management, social interaction and gauge capability were delivered, with four sessions for the MCI clients in small groups and two sessions for the care dyads in their home environment. The control group received usual care. Dyadic health outcomes were measured at baseline, upon program completion and three months thereafter. The results of Generalized Estimating Equations showed that the strength-based dyadic program significantly improved the objective memory (post-test: β=-0.179, p=0.001), and subjective memory (post-test: β=7.542. p=0.007; 3-month: β=7.842. p=0.012), neuro-psychiatric symptoms (post-test: β=2.822, p=0.001; 3-month: β=3.038. p=0.007), and depression (post-test: β=2.665, p=0.017; 3-month: β=3.556. p=0.007). It also improved the caregiver stress in symptom management at post-test (β=2.822. p=0.001) and depression at the 3-month endpoint (β=1.510. p=0.015). Identifying and mobilizing the strengths of the clients with MCI and their family caregivers not only promote a more assertive coping experience and positive self-image for the care dyads, but also improve their health outcomes.

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