Picture‐Based Memory Impairment Screen: A Major Achievement for Cognitive Assessment of Older Adults in Developing Countries

Abstract Background Delirium is a common geriatric problem associated with poor outcomes. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium yet, not satisfying the definition of full-blown delirium, defined by categorical elements, and is usually referred to as the presence of one or more symptoms in the confusion assessment method (CAM). This study aimed to investigate the prevalence and risk factors of delirium and SSD in older adults admitted to the hospital. Five hundred eighty-eight elderly (above 65 years) Egyptian patients were recruited from January 2019 to February 2020. After explaining the purpose of the study and assuring the confidentiality of all participants, an informed consent was obtained from the participant or a responsible care giver for those who were not able to give consent. All patients were subjected ‘on admission’ to thorough history taking, clinical examination, and comprehensive geriatric assessment including confusion assessment tools, mini-mental state examination, and functional assessment using Barthel index score. Results The current study showed that 19.6% of patients had delirium and 14.1% of patients had SSD with combined prevalence of 33.7%. Most common causes included metabolic, infection, organic brain syndrome, and dehydration. The current study reported significant proportionate relation between cognitive assessment and functional ability, so patients with a score of 23 MMSE had good functional ability, while cognitive assessment using mini-mental score shows inversed relation to delirium and SSD using CAM score. Conclusion Delirium is independently associated with adverse short-term and long-term outcomes, including an increase in mortality, length of hospital stay, discharge to an institution, and functional decline on discharge. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium, not yet satisfying the definition of full-blown delirium but it can identify patients with early cognitive and functional disabilities, and because of high prevalence of delirium and SSD. Efforts to prevent or early detection may identify patients who warrant clinical attention.

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The bicaudate index inversely associates with performance in the Montreal Cognitive Assessment (MoCA) in older adults living in rural Ecuador. The Atahualpa project

International Journal of Geriatric Psychiatry ◽

10.1002/gps.4419 ◽

2016 ◽

Vol 31 (8) ◽

pp. 944-950 ◽

Cited By ~ 13

Author(s):

Oscar H. Del Brutto ◽

Robertino M. Mera ◽

Victor J. Del Brutto ◽

Mark J. Sedler

Keyword(s):

Older Adults ◽

Cognitive Assessment ◽

Montreal Cognitive Assessment ◽

Atahualpa Project

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Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Subjective Cognitive Decline and Age

Innovation in Aging ◽

10.1093/geroni/igaa057.940 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 293-294

Author(s):

Moriah Splonskowski ◽

Holly Cooke ◽

Claudia Jacova

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Old Age ◽

Cognitive Assessment ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Cognitive State ◽

Home Based ◽

Increased Risk

Abstract Home-based cognitive assessment (HBCA) services are emerging as a convenient alternative to in-clinic cognitive assessment and may aid in mitigating barriers to detecting cognitive impairment (CI). It is unknown which older adults would be likely to participate in HBCA. Here we investigated the role of age and Subjective Cognitive Decline (SCD). SCD has demonstrated an increased risk for progression to CI/dementia. A nation-wide community-dwelling sample of 494 adults age 50+ were recruited via Amazon Mechanical Turk to complete an online survey assessing perceptions around HBCA and SCD. Our sample was 91.9% White and 66.8% female. It consisted of 174 respondents aged 50-60, 265 aged 61- 70, and 55 aged 71-79. Age groups were comparable with respect to their acceptance of cognitive assessment (Range 4-20, higher score=higher acceptance, 7.9±3.3, 8.15±3.2, 8.05±3.43) and SCD-Q total (43.1±5.8, 43.2±5.7, 43.3±5.7). Correlation analysis revealed a relationship between SCD-QSCD total and perceived likelihood of participation in HBCA for those ages 61-70 (r(263) = .222 p = .000), but not for ages 50-60 or 71-79 (r(172) = .102 p = .152; r(53) = -.102 p = .458). Our findings suggest that SCD influences the likelihood of participation in HBCA for older adults’ transitioning to old age (61-70). Findings show that for adults transitioning into old age (61-70), perceived cognitive state influences their likelihood of participation in HBCA. Importantly, concerns about CI/dementia may generate more favorable perceptions of HBCA for this group.

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Concerns and difficulties associated with the COVID-19 pandemic among older adults with cancer in Mexico.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.12042 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 12042-12042

Author(s):

Sofia Sánchez-Román ◽

Yanin Chavarri Guerra ◽

Andrea Morales Morales Alfaro ◽

Daniela Ramirez Maza ◽

Andrea de la O Murillo ◽

...

Keyword(s):

Older Adults ◽

Developing Countries ◽

Medical Care ◽

Cancer Care ◽

Significant Proportion ◽

Stage Iv ◽

Well Being ◽

Public Hospitals ◽

The Individual

12042 Background: The COVID-19 pandemic has impacted the well-being of people not only due to the disease but also because of stay-at-home orders, social distancing, unemployment, and different kinds of loses. Older adults have particularly suffered during the pandemic, with increased health-related concerns and anxiety leading to increased vulnerability. However, little is known about the effects of the pandemic on older adults with cancer living in developing countries. They are facing issues related to their diagnosis and treatment, as well as the effects of the pandemic on their care and on the well-being of their families. To improve care for this vulnerable population, we studied the concerns and difficulties associated with COVID-19 among older Mexican adults with cancer. Methods: We included patients age ≥65 with the 10 most common tumors in Mexico according to GLOBOCAN and within 3-24 months of cancer diagnosis at two public hospitals in Mexico City. Patients were contacted telephonically and asked to complete a survey reporting the difficulties encountered during the COVID-19 pandemic and to rate their concerns associated with cancer care management using a 0-10 Likert-type scale, with higher ratings meaning increased concerns. Focused interviews were used to describe the individual experience of selected patients and their relatives related to COVID-19 and cancer care. Results: Between April 20, 2020 and December 1, 2021, 67 patients (mean age 71.9, min 65, max 90; 35.8% female; 62.7% living with a partner) were included. The most common tumors were prostate (43%), colon (16%), and lung (12%). 46% had Stage IV disease, and 61% had a life expectancy of more than a year. Twenty-five percent of patients reported encountering at least one difficulty in obtaining cancer care due to the COVID-19 pandemic. 43% of the patients reported difficulties with accessing follow-up cancer care; 39% reported issues with obtaining medications, including chemotherapy; and 34% reported problems obtaining medical care in general, including oncology visits. Regarding concerns, 33% of the patients reported being “very worried” or “extremely worried” about the COVID-19 pandemic. The most relevant concerns were related to getting infected with COVID-19 (or having a family member who became infected) (mean rating 7.9, SD 2.9); not being able to pay for cancer treatments or medical care (mean rating 6.9, SD 3.5); and worsening of cancer due to delayed care during the pandemic (mean rating 6.6, SD 3.7). Conclusions: A significant proportion of older adults with cancer in Mexico faced difficulties obtaining cancer treatment and follow-up care during the COVID-19 pandemic. Their most relevant concerns included getting infected, financial losses, and progression of disease. Creating systems to provide continued cancer care for vulnerable populations in developing countries is essential to face the COVID-19 pandemic.

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Can Virtual Assistants Perform Cognitive Assessment in Older Adults? A Review

Medicina ◽

10.3390/medicina57121310 ◽

2021 ◽

Vol 57 (12) ◽

pp. 1310

Author(s):

Carmen Moret-Tatay ◽

Isabel Iborra-Marmolejo ◽

María José Jorques-Infante ◽

José Vicente Esteve-Rodrigo ◽

Carla H. A. Schwanke ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Language Processing ◽

Cognitive Assessment ◽

Chronic Conditions ◽

Community Dwelling ◽

Screening Process ◽

Digital Devices ◽

The Given ◽

Community Dwelling Older Adults

Community-dwelling older adults have raised the scientific community’s interest during the COVID-19 era as their chronic conditions might be aggravated by the consequences of confinement. Digital devices in this field to monitor cognitive impairment are an emerging reality of an innovative nature. However, some groups may not have benefited from these developments as much as, for example, younger people. The aim of this manuscript is to carry out a review on the development of digital devices, and specifically virtual assistants, for the detection of cognitive impairment in older adults. After a screening process, eight studies were found under the given criteria, and this number was even smaller for those using virtual assistants. Given the opportunities offered by virtual assistants through techniques such as natural language processing, it seems imperative to take advantage of this opportunity for groups such as older adults.

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Refining sleep measurement using the Motionwatch8©: How many days of monitoring do we need to get reliable estimates of sleep quality for older adults with Mild Cognitive Impairment?

10.21203/rs.2.20676/v2 ◽

2020 ◽

Author(s):

Ryan S. Falck ◽

Cindy K. Barha ◽

Patrick C.Y. Chan ◽

Teresa Liu-Ambrose

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sleep Duration ◽

Older Adult ◽

Cognitive Assessment ◽

Cognitive Status ◽

Field Methods ◽

Sleep Measurement ◽

Reliability Coefficients

Abstract Background Mild cognitive impairment (MCI) is a transition stage between healthy cognition and dementia, and is linked to poorer sleep. Objective, reliable, and low-burden field methods to measure older adult sleep are also currently needed. The MotionWatch8© (MW8) wrist-worn actigraph provides estimates of sleep with 14 days of observation; however, there may be underlying differences in the reliability of sleep estimates based on MCI status. We therefore investigated the number of MW8 monitoring days required to estimate sleep in older adults with MCI and without. Methods Older adults (55+ years; N=151) wore the MW8 for ≥14 days. The Montreal Cognitive Assessment was used to categorize participants with probable MCI (scores of <26/30) and participants without MCI (≥26/30). We calculated intra-class reliability coefficients for 1-, 7-, and 14-days of wear-time, and performed Spearman-Brown predictions to determine the number of monitoring days needed for an ICC=0.80. Results Older adults with MCI were older ( p <0.01), more likely to be male ( p =0.03), and had shorter sleep duration ( p <0.01). Spearman-Brown analyses indicated that the number of monitoring days needed for an ICC=0.80 in older adults with probable MCI was 7 days for sleep duration, 4 days for fragmentation, and 4 days for efficiency; adults without MCI required 4 days for duration, 6 days for fragmentation, and 3 days for efficiency. Conclusions Our results indicate that while the reliability of MW8 estimates of sleep differs based on cognitive status, 7 days of MW8 monitoring provides reliable estimates of sleep for adults with MCI and those without.

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