scholarly journals Health and social interventions to restore physical function of older adults post-hip fracture: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053992
Author(s):  
Abeer Omar ◽  
Alexia Cumal ◽  
Shirin Vellani ◽  
Alexandra Krassikova ◽  
Julie Lapenskie ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Hip Fracture ◽  
Outcome Measures ◽  
Scoping Review ◽  
Inpatient Rehabilitation ◽  
Community Dwelling ◽  
Inpatient Setting ◽  
Social Interventions ◽  
Community Dwelling Older Adults

ObjectivesDespite inpatient rehabilitation, many older adults post-hip fracture have difficulty returning to their prefracture levels of function and activity. This scoping review aims to identify interventions for community-dwelling older adults discharged from inpatient rehabilitation and examine the function and activity outcomes associated with these interventions.DesignThis scoping review followed Arksey and O’Malley’s five-stage framework.Data sourcesWe searched MEDLINE, CINAHL, PsycINFO, EMBASE and Ageline electronic databases for English-language articles published between January 1946 and January 2020.Eligibility criteriaWe included studies with health and social interventions involving community-dwelling older adults and their caregivers after hip fracture and inpatient rehabilitation. The interventions were selected if initiated within 60 days post-hip fracture surgery.Data extraction and synthesisTwo independent reviewers screened abstracts and full texts and extracted the data based on the inclusion criteria. A third reviewer adjudicated any disagreement and collated the extracted data.ResultsOf the 24 studies included in the review, most studies (79%) used exercise-based interventions, over half (63%) included activities of daily living training and/or home assessment and environment modification as intervention components, and three studies used social intervention components. Over half of the interventions (58%) were initiated in the inpatient setting and physiotherapists provided 83% of the interventions. Only seven studies (29%) involved tailored interventions based on the older adults’ unique needs and progress in exercise training. Six studies (25%) enrolled patients with cognitive impairment, and only one study examined caregiver-related outcomes. Exercise-based interventions led to improved function and activity outcomes. 29 different outcome measures were reported.ConclusionWhile exercise-based multicomponent interventions have evidence for improving outcomes in this population, there is a paucity of studies, including social interventions. Further, studies with standardised outcome measures are needed, particularly focusing on supporting caregivers and the recovery of older adults with cognitive impairment.

scholarly journals Mindfulness Awareness Practice (MAP) to Prevent Dementia in Older Adults with Mild Cognitive Impairment: Protocol of a Randomized Controlled Trial and Implementation Outcomes

2021 ◽  
Vol 18 (19) ◽  
pp. 10205
Author(s):  
Ted Kheng Siang Ng ◽  
Lei Feng ◽  
Johnson Fam ◽  
Iris Rawtaer ◽  
Alan Prem Kumar ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Randomized Controlled ◽  
Community Dwelling Older Adults

Background: With an aging population, developing non-pharmacological interventions (NPIs) to delay dementia has become critical. Apart from cognitive decline, dementia is associated with multiple pathophysiology, including increased oxidative stress, dysregulated gene expressions, cytokine, neurotrophin, and stress markers, telomere shortening, and deteriorations in brain connectivity. Although mindfulness practices have been proposed to ameliorate these biological changes, no empirical studies were conducted. We thus aimed to investigate the effects of mindfulness awareness practice (MAP) to prevent cognitive decline and improve peripheral biomarkers in community-dwelling older adults diagnosed with mild cognitive impairment (MCI). Methods/Design: This was a single-blinded and parallel-group randomized controlled trial with two arms (intervention and active control arms), conducted over nine months. A total of 60 consenting community-dwelling older adults diagnosed with MCI were planned to be randomized in a 1:1 ratio to either the MAP or the Health Education Program (HEP). Interventions were performed weekly for the initial 12 weeks, and monthly for the subsequent six months. Outcome measures were assessed at baseline, 3-month, and 9-month post-intervention by blinded assessors. Primary outcomes were neurocognitive tests, comprehensive peripheral biomarkers, and brain imaging scans. Secondary outcomes included basic health screening measures, affective symptoms, and measures of physical functions. Linear-mixed models were used to examine the effects of MAP on these outcome measures. Significance: This is the first randomized controlled trial to systematically investigate the effects of a mindfulness intervention in improving cognitive functions and various biomarkers in community-dwelling older adults diagnosed with MCI. Our findings have the potential to inform mindfulness intervention as a novel approach to delay dementia.

scholarly journals Do Communication Patterns Affect the Association between Cognitive Impairment and Hearing Loss among Older Adults in Vietnam?

2021 ◽  
Vol 18 (4) ◽  
pp. 1603
Author(s):  
Tran Dai Tri Han ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Vo Nu Hong Duc ◽  
Thang Van Vo
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Vision Loss ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Ordinal Logistic Regression Analysis ◽  
Communication Devices ◽  
Community Dwelling Older Adults

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.

scholarly journals Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049926
Author(s):  
Sandra Angelika Mümken ◽  
Paul Gellert ◽  
Malte Stollwerck ◽  
Julie Lorraine O'Sullivan ◽  
Joern Kiselev
Keyword(s):  
Older Adults ◽  
Construct Validity ◽  
Outcome Measures ◽  
Total Sample ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Life Space ◽  
Cross Sectional ◽  
The Past ◽  
Community Dwelling Older Adults

ObjectivesTo develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.DesignCross-sectional validation study.SettingTwo study centres in urban and rural German outpatient hospital settings.ParticipantsIn total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).Primary and secondary outcome measuresThe final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.ResultsIn the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=−0.26; 95% CI=−0.42 to −0.08), Timed Up and Go Test (β=−0.37; 95% CI=−0.68 to −0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=−0.22; 95% CI=−0.41 to −0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=−0.19; 95% CI=−0.42 to 0.03) and male gender (β=0.15; 95% CI=−0.04 to 0.35) were not significant.ConclusionThe LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.Trial registration numberDRKS00019023.

Anxiety, Depression, and 1-Year Incident Cognitive Impairment in Community-Dwelling Older Adults

2011 ◽  
Vol 59 (8) ◽  
pp. 1421-1428 ◽  
Author(s):  
Olivier Potvin ◽  
Hélène Forget ◽  
Sébastien Grenier ◽  
Michel Préville ◽  
Carol Hudon
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Community Dwelling ◽  
Anxiety Depression ◽  
Community Dwelling Older Adults

The Brief Odor Detection Test (B-ODT) for Very Early Diagnosis of Cognitive Decline: A Preliminary Study

2017 ◽  
Vol 18 (2) ◽  
pp. 197-210
Author(s):  
Dimitra Savvoulidou ◽  
Efthymia Totikidou ◽  
Chariklia Varvesiotou ◽  
Magda Iakovidou ◽  
Ourania Sfakianaki ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Adult Population ◽  
Detection Threshold ◽  
Community Dwelling ◽  
Odor Detection ◽  
Olfactory Impairment ◽  
Older Adult Population ◽  
Community Dwelling Older Adults

Olfactory impairment in older adults is associated with cognitive decline. This study describes the development of a Brief Odor Detection Test (B-ODT), and its pilot administration in community-dwelling older adults. The study aimed at examining whether the test could differentiate older adults with very mild cognitive impairment from their cognitively healthy counterparts. The sample consisted of 34 older adults (22 women), aged from 65 to 87 years. Participants were divided into two groups according to their general cognitive functioning. Odor detection was measured via vanillin solutions at the following concentrations: 150 mg/L, 30 mg/L, 15 mg/L, 3 mg/L, and .03 mg/L. The first condition of the test involved a scale administration of vanillin solutions. The second condition examined the change in air odour and it required vanillin solution of 30 mg/L and a metric ruler of 30 cm. The examiner had to place the solution at a specific distance point from each nostril. Odour identification sensitivity was secondarily measured. The results showed statistically significant differences in odour detection threshold between the two groups. In the unirhinal testing, left nostril differences of the two groups were definite. Hence, the B-ODT seems a promising instrument for very early cognitive impairment screening in older adult population.

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

Medicina ◽  
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.

scholarly journals Cognitive Outcomes during COVID-19 confiNemeNt in Elderly and their Caregivers using Technologies for DEMentia (CONNECT DEM): study protocol (Preprint)

2020 ◽  
Author(s):  
Jessica Marian Goodman-Casanova ◽  
Elena Dura-Perez ◽  
Gloria Guerrero-Pertiñez ◽  
Pilar Barnestein-Fonseca ◽  
Jose Guzman-Parra ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Social Isolation ◽  
Community Dwelling ◽  
Mild Dementia ◽  
Care Services ◽  
Health And Social Care ◽  
The Impact ◽  
Community Dwelling Older Adults

BACKGROUND Coronavirus disease 2019 has forced worldwide the implementation of unprecedented restrictions to control its rapid spread and mitigate its impact. The Spanish government has enforced social distancing, quarantine and home confinement. This restriction of daily life activities and separation from loved ones may lead to social isolation and loneliness with health-related consequences in community-dwelling older adults with mild cognitive impairment or mild dementia and their caregivers. Additionally, an inadequate access to healthcare and social support services may aggravate chronic conditions. Technology home-based interventions emerge for combating social isolation and loneliness preventing the risk of viral exposure. OBJECTIVE The aim of this cohort study is to explore, analyze and determine the impact of social isolation on: 1) cognition, quality of life, mood, technophilia and perceived stress of community-dwelling older adults with mild cognitive impairment or mild dementia, and on caregiver burden; 2) health and social care services access and utilization, and 3) cognitive, social and entertainment use of ICTs. METHODS This study will be conducted in the Spanish region of Andalucía (Málaga). In total 200 dyads, consisting of a person with mild cognitive impairment or mild dementia (PMCI/MD) and their informal caregiver will be contacted by telephone. Potential respondents will be participants of the SMART 4 MD (N=100) and TV-AssistDem (N=100) clinical trials. RESULTS The change in means in the variables will be analyzed comparing baseline results in the previous studies with those during and after confinement using the ANOVA test of repeated measures or the non-parametric Friedman test if appropriate. The performance of a multivariate analysis of variance (ANCOVA) to introduce possible covariates will also be contemplated. A 95% confidence level will be used. CONCLUSIONS If the hypothesis is proven, these findings will demonstrate the negative impact of social isolation due to the COVID-19 confinement on cognition, quality of life, mood, and perceived stress of community-dwelling older adults with mild cognitive impairment and mild dementia, the impact on technophilia, caregiver burden, and health and social care services access and utilization; and the cognitive, social and entertainment use of ICTs during the COVID-19 confinement and afterwards. CLINICALTRIAL NCT: 04385797

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