scholarly journals Prevalence of cognitive impairment among hill-tribe older people in the Northern part of Thailand

2018 ◽  
Vol 32 (6) ◽  
pp. 478-484
Author(s):  
Supaporn Trongsakul ◽  
Thapakorn Ruanjai ◽  
Wilawan Chaiut ◽  
Ratipark Tamornpark ◽  
Tawatchai Apidechkul

Purpose The purpose of this paper is to investigate the prevalence and factors related to cognitive impairment among hill-tribe older people in Chiang Rai province, Thailand. Design/methodology/approach A cross-sectional study was carried out amongst 459 hill-tribe older people aged 60 years and above. A Mini Mental State Examination (MMSE) Thai 2002 version was used for cognitive screening. A questionnaire and medical records were used for demographic and clinical data collection while descriptive statistics were used to analyze characteristic data. Potential factors related to cognitive impairment were analyzed by using univariate logistic regression analysis. Findings The prevalence of cognitive impairment amongst the participants was 49.89 percent (95% CI 45.32%, 53.47 percent). Factors related to cognitive decline included no occupation (OR=1.49, 95% CI 1.10–2.03, p<0.04) and a history of amphetamine use (OR=1.57, 95% CI 1.09–2.33, p<0.04). Originality/value Cognitive decline should be a cause for concern amongst Thai hill-tribe older people, especially amongst those in the group with a history of amphetamine use. However, Thai health care professionals need to be aware of the potential cultural bias in the MMSE Thai 2002 version as a cognition test targeted at the hill-tribe population as the questionnaire may not provide a true reflection of their cultural experience and background.

2019 ◽  
Vol 12 (4) ◽  
pp. 200-208
Author(s):  
Rahul Rao

Purpose The assessment of patterns in risky drinking and its association with dual diagnosis in community services for older people remains under-explored. The paper aims to discuss this issue. Design/methodology/approach Drinking risk using the Alcohol Use Disorders Identification Test (AUDIT) and the presence of co-existing mental disorders was examined in 190 people aged 65 and over. Findings In total, 24 per cent of drinkers drank above lower risk levels and 22 per cent reported binge drinking over the past 12 months. Those scoring 1 or more on the AUDIT were more likely to be male and to have greater cognitive impairment than non-drinkers and those reporting no past problems with alcohol. Research limitations/implications Given the limitations of the Mini Mental State Examination in the detection of alcohol related cognitive impairment (ARCI), the use of other cognitive screening instruments in larger study populations is also warranted. Practical implications Greater attention needs to be paid to the assessment of risky drinking in older male drinkers and those with cognitive impairment. Originality/value There is considerable scope for the routine detection of cognitive impairment and dementia in older people with alcohol use within mainstream mental health services, particularly in those with binge drinking. As ARCI is associated with loss of function and independence, early detection and intervention can improve health and social outcomes.


2019 ◽  
Vol 23 (4) ◽  
pp. 241-250
Author(s):  
Alessandra Merizzi

Purpose The purpose of this paper is to explore how supervision is applied in the context of National Health Service services for older adults, with particular regard to the profession of clinical psychology and psychotherapy. Design/methodology/approach The clinical supervision theories that are considered in this exploration are the Seven-Eyed Model (Hawkins and Shohet, 2012) and the Cyclical Model (Page and Wosket, 2015). The discussion also integrates an overview of psychological dynamics as presented by the existing literature with the author’s reflections on the influence of ageing stereotypes in the therapeutic work with older adults. Findings The theoretical models of clinical supervision considered can offer a robust framework and pathway for supervisory work in psychology and psychotherapy for older people. However, this alone seems insufficient and needs to be combined with the supervisor’s knowledge on psychology of ageing as well as their own self-reflection on internalised ageing stereotypes. Practical implications The paper suggests a need for health care professionals, providing clinical supervision on older adult therapeutic work, to be familiar with the aspects analysed. Originality/value Clinical supervision handbooks overlook aspects related to age as an issue of difference. This paper adds value to the clinical work with older people through a novel attempt to link implications of ageing stereotypes with the therapeutic and supervisory practice.


Author(s):  
Bruno Kusznir Vitturi ◽  
Enrico Stefano Suriano ◽  
Ana Beatriz Pereira de Sousa ◽  
Dawton Yukito Torigoe

ABSTRACT:Background:Little is known about the potential systemic effects of ankylosing spondylitis (AS) on the nervous system. We designed a study aiming to assess the frequency and clinical predictors of cognitive impairment in AS patients.Methods:We carried out a cross-sectional case–control study composed of consecutive patients with AS. Trained and blinded interviewers registered clinical-epidemiological data and applied a standardized neurological assessment for each subject of the study. At baseline, functional limitations were characterized using the Health Assessment Questionnaire. Cognitive impairment was evaluated with the Brief Cognitive Screening Battery, the Montreal Cognitive Assessment, and the Clinical Dementia Rating, while neuropsychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale. Healthy controls were matched for age, educational attainment, sex, and comorbidities. We compared the neurological outcomes between case and controls, and we determined the clinical predictors of cognitive decline.Results:We included 40 patients (mean: 49.3 years) with AS and 40 healthy controls (mean: 48.8 years) in our study. In Brief Cognitive Screening Battery, patients with AS presented a statistically significant poor performance in the clock drawing test and in the verbal fluency. The mean Montreal Cognitive Assessment (MoCA) scores were significantly lower in AS subjects compared to the control group. Also, the prevalence of subjects classified as cognitively impaired according to MoCA was significantly higher in the AS group (90.0% vs. 57.5%, p = 0.02). Moreover, neuropsychiatric symptoms were more prevalent in AS patients. Worse functional limitations were associated with poor cognitive performance as well.Conclusions:Patients with AS might be more vulnerable to cognitive decline.


Author(s):  
A.J. Sinclair ◽  
B. Vellas

The recent addition of the Diabetes and Cognitive Decline section to JPAD marks a milestone in the history of this progressive journal as it recognises the important contribution that Diabetes makes to the aetiology of both vascular and neurodegenerative dementia syndromes (1-3). It has been observed that diabetes in the presence of hypertension leads to a more pronounced cognitive decline (4) and that at an early stage of cognitive decline (mild cognitive impairment ( MCI)), diabetes accelerates the progression of MCI to dementia (5).


2012 ◽  
Vol 24 (10) ◽  
pp. 1700-1701 ◽  
Author(s):  
K. Bloomfield ◽  
N. John

Over recent years in the UK, emphasis has been placed on appropriate diagnosis and referral of patients with dementia. In guidelines published by the British Geriatrics Society (BGS) and Faculty of Old Age Psychiatrists consensus group (Forsyth et al., 2006), a cognitive screening algorithm was developed, which consists of initial screening for cognitive impairment with the Mini-Mental State Examination (MMSE) and CLOX1 (an executive clock drawing task). If the scores meet cut-off points indicated in the algorithm (MMSE <24 or CLOX1 <11), further assessments with the Confusion Assessment Method (CAM) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) are applied with the aim to differentiate between delirium (CAM positive, IQCODE negative), delirium and chronic impairment (CAM positive, IQCODE positive), or chronic cognitive impairment (CAM negative, IQCODE positive).


Author(s):  
Alyssa M. Lanzi ◽  
James M. Ellison ◽  
Matthew L. Cohen

Purpose Persons with dementia and mild cognitive impairment (MCI) are major consumers of services provided by speech-language pathologists (SLPs). These services include not only direct assessment and treatment of communication and swallowing but also counseling, collaboration, prevention, and wellness. These “counseling+” activities can be especially challenging for SLPs to deliver because of the lack of evidence, as well as the complex nature of Alzheimer's disease (AD) and other conditions that cause MCI and dementia. Method This tutorial is written by a speech-language pathologist, a neuropsychologist, and a geriatric psychiatrist to provide education, resources, and recommendations for SLPs delivering counseling+ activities to patients with MCI and dementia from AD and related disorders. Results and Conclusions We describe counseling+ activities across the continuum of care ranging from educating and conducting cognitive screenings with adults experiencing age-related cognitive decline to supporting end-of-life wishes. Because of their expertise in communication, SLPs can provide an array of important leading and supporting services to patients, their family, and other health care professionals on the care team, such as providing patients with appropriate feedback following a cognitive screening and helping caregivers identify the communicative intent of a responsive behavior. The demand for SLP services for patients with MCI and dementia will grow significantly over the next few decades, necessitating more systematic research and clinical evidence in this area.


2021 ◽  
Vol 79 (7) ◽  
pp. 565-570
Author(s):  
Sérgio Ferreira de Ferreira-Filho ◽  
Wyllians Vendramini Borelli ◽  
Rodrigo Mantovani Sguario ◽  
Gustavo Fiorentin Biscaia ◽  
Vitória Schneider Müller ◽  
...  

ABSTRACT Background: Cognitive decline is a common condition, but is still underrepresented in studies conducted in developing countries. Objective: To calculate the prevalence of cognitive decline and depression in an elderly community-dwelling population in a city in southern Brazil. Methods: We calculated the prevalences of dementia, cognitive impairment with no dementia (CIND) and symptoms of depression in an elderly population relying on the public healthcare system. This epidemiological study in Pelotas, Brazil, was conducted within the primary care setting. It included 299 older adults (mean age = 69.75 ± 7.6 years) who presented low levels of education (mean = 4.16 ± 3.17 years of education). They underwent cognitive screening and their medical records were analyzed. Results: Among these older adults, 142 (47.5%) presented cognitive decline: 104 (34.8%) matching the cognitive criteria for CIND and 38 (12.7%) matching the cognitive criteria for dementia. Among all the individuals who completed the cognitive screening, 141 (48.4%) were positive for symptoms of depression, of whom 99 (34%) did not have any previous diagnosis in their medical records. Conclusion: There was high prevalence of cognitive impairment among these older adults in a primary care setting. A large number of older adults were found to have symptoms of depression without any diagnosis.


2019 ◽  
Vol 37 (2) ◽  
pp. 139-147
Author(s):  
Anyuan Shen

Purpose Electronic communication technology can facilitate communications with family, friends and health-care professionals and deliver products and services that can significantly raise quality of life for the aging population. However, technology use by older Americans lags behind that of younger Americans. This paper aims to explore physiological decline and cognitive decline as underlying causes or antecedents that may uniquely contribute to predicting perceived ease of use (PEOU) and actual use of technology over and beyond chronological age among older adults. Design/methodology/approach Data were collected by University of Michigan’s 2012 Health and Retirement Study from a national sample of 1,686 respondents age 50 or older. Data were analyzed with the Mplus software package. The conceptual framework was estimated with a path analysis model. Findings Results indicated that physiological decline (vision, hearing and health) and cognitive decline (memory) made a significant unique contribution to predicting PEOU and actual use of technology above and beyond chronological age. Implications for marketing technology-based products and services to older Americans were discussed. Originality/value This research has identified and empirically tested how variability in physiological decline and cognitive decline could uniquely predict use of communication technologies, directly and indirectly via PEOU, above and beyond chronological age.


2020 ◽  
Vol 24 (2) ◽  
pp. 137-142
Author(s):  
Watchara Tabootwong ◽  
Frank Kiwanuka

Purpose Partnership is both a goal and an approach to family-centered care (FCC). Family members play an important role alongside the health-care team when an older family member is admitted to the hospital. Family involvement in care for an older person forms a partnership approach where health professionals and the family engage collaboratively in care. This enhances the quality of care and family satisfaction with care. The purpose of this paper is to highlight the potential areas of partnerships of family members with health-care professionals while caring for older people based on the perspective of FCC. Design/methodology/approach A literature review was carried out. Findings The findings of this study focus on how healthcare professionals can listen to, respect the perspectives of family members, and share useful information with the family while caring for an older person. Family participation in providing care and collaboration between healthcare professionals and families is a seminal goal strategy in caring for older people during hospitalization. It is helpful to family members as a way of training and preparing them to assist their loved one after hospital discharge. Furthermore, it can establish a good relationship between healthcare professionals and families. Originality/value Partnership between health-care professionals and families helps and supports the older people and the family in managing the health condition the following discharge from the hospital.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kenny Xu ◽  
Catherine Dong ◽  
Christopher Chen

Objective: We aimed to establish the association of decline in cognitive screening tests scores, the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE), with the decline in neuropsychological diagnostic status from 3-6 months to a year later. Method: Patients with ischemic stroke/ Transient Ischemic Attack (TIA) received the MoCA and MMSE within 14 days after stroke, then 3-6 months and 1 year later. The decline in MoCA and MMSE scores were defined by reduction of 2 points or more in total scores, while stable/improved MoCA scores referred to reduction of MoCA scores less than 2 or improved scores. The decline in neuropsychological diagnostic status was defined by category transition from no cognitive impairment to any cognitive impairment (≥1 domain), from mild cognitive impairment (impairment in 1-2 domains) to moderate cognitive impairment (impairment >2 domains) and dementia (i.e., functional loss associated with cognitive impairment, DSM-IV criteria), as well as from moderate cognitive impairment to dementia. Results: At baseline, most patients were Chinese (70.3%) and males (69.8%) with age of 59.8 ± 11.6 years and education of 7.7 ± 4.3 years. 327 out of 400 stroke/TIA patients completed neuropsychological assessments at 3-6 months and 275 completed at 1 year after their index cerebrovascular events. Of these, 31 (11.3%) had decline in neuropsychological diagnostic status. Logistic regression was used to model the association between probability of decline in neuropsychological diagnostic status and the decline in MMSE or MoCA scores. There were not significant associations between the decline of neuropsychological diagnostic status and the decline in MMSE scores. Controlling baseline MoCA scores and the change scores of MoCA from baseline to 3-6 months, patients with decline in MoCA scores (reduction of 2 points or more) were associated with higher risks of decline in neuropsychological diagnostic status, relative to those with stable/ improved MoCA scores (odd ratio=3.21, p=0.004). Conclusion: The decline in MoCA scores are associated with a higher risks for decline in neuropsychological diagnostic status from 3-6 months to 1 year, therefore may be used to detect post-stroke cognitive decline.


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