Prevalence Estimates and Health-Related Correlates of Cognitive Impairment From a Probability Sample of Community-Residing Latino Elders

Introduction: Continued evaluation of Transition Care Programs (TCP) is essential to improving older adults' outcomes and can guide which older adults may benefit from undertaking TCP. The aim of this study was to audit a transition care service to identify the association between the characteristics of older adults undertaking a facility-based TCP and (i) discharge destination and (ii) functional improvement.Materials and methods: An audit (n = 169) of older adults aged 60 years and above who completed a facility-based TCP in Australia was conducted. Outcomes audited were performance of activities of daily living (ADL) measured using the Modified Barthel Index (MBI) and discharge destination. Data were analyzed using logistic regression and linear mixed modeling.Results: Older adults [mean age 84.2 (±8.3) years] had a median TCP stay of 38 days. Fifty-four older adults (32.0%) were discharged home, 20 (11.8%) were readmitted to hospital and 93 (55%) were admitted to permanent residential aged care. Having no cognitive impairment [OR = 0.41 (95% CI 0.18-0.93)], being independent with ADL at admission [OR = 0.41 (95% CI 0.16-1.00)] and a pre-planned team goal of home discharge [OR = 24.98 (95% CI 5.47-114.15)] was significantly associated with discharge home. Cases discharged home showed greater improvement in functional ability [MBI 21.3 points (95% CI 17.0-25.6)] compared to cases discharged to other destinations [MBI 9.6 points (95% CI 6.5-12.7)].Conclusion: Auditing a facility-based TCP identified that older adults who were independent in ADL and had good cognitive levels were more likely to be discharged home. Older adults with cognitive impairment also made clinically significant functional improvements.

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Health-Related Resource Use and Costs in Elderly Adults with and without Mild Cognitive Impairment

Journal of the American Geriatrics Society ◽

10.1111/jgs.12132 ◽

2013 ◽

Vol 61 (3) ◽

pp. 396-402 ◽

Cited By ~ 30

Author(s):

Carolyn W. Zhu ◽

Mary Sano ◽

Steven H. Ferris ◽

Peter J. Whitehouse ◽

Marian B. Patterson ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Resource Use ◽

Elderly Adults ◽

Health Related

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The influence of cognitive impairment on health-related quality of life in neurological disease

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2009.00439.x ◽

2010 ◽

Vol 22 (1) ◽

pp. 2-13 ◽

Cited By ~ 63

Author(s):

Alex J. Mitchell ◽

Steven Kemp ◽

Julián Benito-León ◽

Markus Reuber

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Deficits ◽

Neurological Disorders ◽

Neurological Disease ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Mitchell AJ, Kemp S, Benito-León J, Reuber M. The influence of cognitive impairment on health-related quality of life in neurological disease.Background:Cognitive impairment is the most consistent neurological complication of acquired and degenerative brain disorders. Historically, most focus was on dementia but now has been broadened to include the important construct of mild cognitive impairment.Methods:Systematic search and review of articles linked quality of life (QoL) and cognitive complications of neurological disorders. We excluded QoL in dementia.Results:Our search identified 249 publications. Most research examined patients with brain tumours, stroke, epilepsy, head injury, Huntington's disease, motor neuron disease, multiple sclerosis and Parkinson's disease. Results suggested that the majority of patients with epilepsy, motor neuron disease, multiple sclerosis, Parkinson's disease, stroke and head injury have subtle cognitive deficits early in their disease course. These cognitive complaints are often overlooked by clinicians. In many cases, the cognitive impairment is progressive but it can also be relapsing-remitting and in some cases reversible. Despite the importance of severe cognitive impairment in the form of dementia, there is now increasing recognition of a broad spectrum of impairment, including those with subclinical or mild cognitive impairment. Even mild cognitive difficulties can have functional and psychiatric consequences–especially when they are persistent and untreated. Specific cognitive deficits such an inattention, dysexecutive function and processing speed may affect a number of quality of life (QoL) domains. For example, cognitive impairment influences return to work, interpersonal relationships and leisure activities. In addition, fear of future cognitive decline may also impact upon QoL.Conclusions:We recommend further development of simple tools to screen for cognitive impairments in each neurological condition. We also recommend that a thorough cognitive assessment should be a part of routine clinical practice in those caring for individuals with neurological disorders.

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Mild cognitive impairment in combination with comorbid diabetes mellitus and hypertension is negatively associated with health-related quality of life among older persons in Taiwan

Quality of Life Research ◽

10.1007/s11136-019-02101-3 ◽

2019 ◽

Vol 28 (5) ◽

pp. 1281-1291 ◽

Cited By ~ 4

Author(s):

Hsin-Yun Liu ◽

Wen-Che Tsai ◽

Ming-Jang Chiu ◽

Li-Yu Tang ◽

Huey-Jane Lee ◽

...

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Older Persons ◽

Health Related Quality ◽

Negatively Associated ◽

Related Quality ◽

Health Related

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Cognition, coping, and outcome in Parkinson's disease

International Psychogeriatrics ◽

10.1017/s1041610212000749 ◽

2012 ◽

Vol 24 (10) ◽

pp. 1656-1663 ◽

Cited By ~ 23

Author(s):

Catherine S. Hurt ◽

Sabine Landau ◽

David J. Burn ◽

John V. Hindle ◽

Mike Samuel ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Coping Strategies ◽

Latent Variable ◽

Rating Scale ◽

Depression Scale ◽

Equation Modeling ◽

Health Related ◽

Task Oriented

ABSTRACTBackground: Cognitive impairment and depression are common and disabling non-motor symptoms of Parkinson's disease (PD). Previous studies have shown associations between them but the nature of the relationship remains unclear. In chronic illness, problem- or task-oriented coping strategies are associated with better outcome but often require higher level cognitive functioning. The present study investigated, in a sample of patients with PD, the relationships between cognitive function, choice of coping strategies, and a broad index of outcome including depression, anxiety, and health-related quality of life (QoL). It was hypothesized that the coping strategy used could mediate the association between cognition and outcome.Methods: 347 participants completed the Coping Inventory for Stressful Situations, the Hospital Anxiety and Depression Scale, the Parkinson's Disease Questionnaire-8, the Unified Parkinson's Disease Rating Scale, and the Addenbrooke's Cognitive Examination–Revised. Structural Equation Modeling was used to test the hypothesized model of cognition, coping, and outcome based on a direct association between cognition and outcome and an indirect association mediated by coping.Results: Overall, poorer cognition predicted less use of task-oriented coping, which predicted worse outcome (a latent variable comprised of higher depression and anxiety and lower QoL). The analyses suggested a small indirect effect of cognition on outcome mediated by coping.Conclusions: The findings suggest that patients who fail to employ task-oriented coping strategies may be at greater risk of depression, anxiety, and poor health-related QoL. Even mild to moderate cognitive impairment may contribute to reduced use of task-oriented coping. Suitably adapted cognitive–behavioral approaches may be useful to enable the use of adaptive coping strategies in such patients.

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