A Longitudinal Study of Cognitive and Instrumental Activities of Daily Living Disablement Among the Oldest Mexican Americans

2021 ◽  
pp. 089826432110375
Author(s):  
Jiwon Kim ◽  
Jacqueline L. Angel ◽  
Sunshine M. Rote
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Mexican Americans ◽  
Daily Living ◽  
Oldest Old ◽  
Epidemiologic Study ◽  
Mobility Limitations ◽  
Limited Mobility ◽  
Community Activities ◽  
Instrumental Activities

Objectives Mexican Americans live longer on average than other ethnic groups, but often with protracted cognitive and physical disability. Little is known, however, about the role of cognitive decline for transitions in instrumental activities of daily living (IADL) disability and tertiary outcomes of the IADL disablement for the oldest old (after 80 years old). Methods We employ the Hispanic Established Populations for the Epidemiologic Study of the Elderly (2010–2011, 2012–2013, and 2016, N = 1,078) to investigate the longitudinal patterns of IADL decline using latent transition analysis. Results Three IADL groups were identified: independent (developing mobility limitations), emerging dependence (limited mobility and community activities), and dependent (limited mobility and household and community activities). Declines in cognitive function were a consistent predictor of greater IADL disablement, and loneliness was a particularly salient distal outcome for emerging dependence. Discussion These results highlight the social consequences of cognitive decline and dependency as well as underscore important areas of intervention at each stage of the disablement process.

scholarly journals Living Beyond 80: A Longitudinal Study of Cognitive and IADL Disablement Among the Oldest Mexican Americans

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 479-479
Author(s):  
Jacqueline Angel ◽  
Sunshine Rote ◽  
Jiwon Kim
Keyword(s):  
Cognitive Decline ◽  
Mexican Americans ◽  
Oldest Old ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Social Consequences ◽  
Mobility Limitations ◽  
Transition Analysis ◽  
Limited Mobility ◽  
Community Activities

Abstract Mexican Americans live longer on average than other ethnic groups, but often with protracted cognitive and physical disability. Little is known, however, about the role of cognitive decline for transitions in IADL disability and tertiary outcomes of the IADL disablement for the oldest old. We employ the Hispanic Established Populations for the Epidemiologic Study of the Elderly (2010-2011, 2012-2013, 2016, N=1,078) to investigate the longitudinal patterns of IADL decline using Latent Transition Analysis. Three IADL groups were identified: independent (developing mobility limitations), emerging dependence (limited mobility and community activities), and dependent (limited mobility and household and community activities). Declines in cognitive function were a consistent predictor of greater IADL disablement, and loneliness was a particularly salient distal outcome for emerging dependence. These results highlight the social consequences of cognitive decline and dependency as well as underscore important areas of intervention at each stage of the disablement process.

ASSESSMENT OF INSTRUMENTAL ACTIVITIES OF DAILY LIVING IN OLDER ADULTS WITH SUBJECTIVE COGNITIVE DECLINE USING THE VIRTUAL REALITY FUNCTIONAL CAPACITY ASSESSMENT TOOL (VRFCAT)

2018 ◽  
pp. 1-9
Author(s):  
A.S. Atkins1 ◽  
A. Khan ◽  
D. Ulshen ◽  
A. Vaughan ◽  
D. Balentin ◽  
...  
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Functional Capacity ◽  
Daily Living ◽  
Assessment Tool ◽  
Subjective Cognitive Decline ◽  
Capacity Assessment ◽  
Instrumental Activities

Background: Continuing advances in the understanding of Alzheimer’s disease progression have inspired development of disease-modifying therapeutics intended for use in preclinical populations. However, identification of clinically meaningful cognitive and functional outcomes for individuals who are, by definition, asymptomatic remains a significant challenge. Clinical trials for prevention and early intervention require measures with increased sensitivity to subtle deficits in instrumental activities of daily living (IADL) that comprise the first functional declines in prodromal disease. Validation of potential endpoints is required to ensure measure sensitivity and reliability in the populations of interest. Objectives: The present research validates use of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) for performance-based assessment of IADL functioning in older adults (age 55+) with subjective cognitive decline. Design: Cross-sectional validation study. Setting: All participants were evaluated on-site at NeuroCog Trials, Durham, NC, USA. Participants: Participants included 245 healthy younger adults ages 20-54 (131 female), 247 healthy older adults ages 55-91 (151 female) and 61 older adults with subjective cognitive decline (SCD) ages 56-97 (45 female). Measures: Virtual Reality Functional Capacity Assessment Tool; Brief Assessment of Cognition App; Alzheimer’s Disease Cooperative Study Prevention Instrument Project – Mail-In Cognitive Function Screening Instrument; Alzheimer’s Disease Cooperative Study Instrumental Activities of Daily Living – Prevention Instrument, University of California, San Diego Performance-Based Skills Assessment – Validation of Intermediate Measures; Montreal Cognitive Assessment; Trail Making Test- Part B. Results: Participants with SCD performed significantly worse than age-matched normative controls on all VRFCAT endpoints, including total completion time, errors and forced progressions (p≤0001 for all, after Bonferonni correction). Consistent with prior findings, both groups performed significantly worse than healthy younger adults (age 20-54). Participants with SCD also performed significantly worse than controls on objective cognitive measures. VRFCAT performance was strongly correlated with cognitive performance. In the SCD group, VRFCAT performance was strongly correlated with cognitive performance across nearly all tests with significant correlation coefficients ranging from 0.3 to 0.7; VRFCAT summary measures all had correlations greater than r=0.5 with MoCA performance and BAC App Verbal Memory (p<0.01 for all). Conclusions: Findings suggest the VRFCAT provides a sensitive tool for evaluation of IADL functioning in individuals with subjective cognitive decline. Strong correlations with cognition across groups suggest the VRFCAT may be uniquely suited for clinical trials in preclinical AD, as well as longitudinal investigations of the relationship between cognition and function.

Is function in instrumental activities of daily living a useful feature in predictingAlzheimer's disease dementia in subjective cognitive decline?

2018 ◽  
Vol 34 (1) ◽  
pp. 193-203 ◽  
Author(s):  
Susanne Roehr ◽  
Steffi G. Riedel‐Heller ◽  
Hanna Kaduszkiewicz ◽  
Michael Wagner ◽  
Angela Fuchs ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Daily Living ◽  
Subjective Cognitive Decline ◽  
Instrumental Activities

scholarly journals Instrumental Activities of Daily Living Difficulties Predict Cognitive Decline in Older Puerto Rican Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 238-239
Author(s):  
Caitlin Pope ◽  
Tyler Bell ◽  
Brian Downer ◽  
Sadaf Milani ◽  
Lauren Roach ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Puerto Rican ◽  
Daily Living ◽  
The United States ◽  
Community Dwelling ◽  
Instrumental Activities ◽  
Bidirectional Association ◽  
Bidirectional Associations

Abstract Given the hypothesized bidirectional association between functional and cognitive decline, further characterization of the temporal association between the two is needed, especially in Latinx samples as they are the most rapidly growing demographic in the United States and at greater risk for Alzheimer’s disease. This study assessed bidirectional associations between instrumental activities of daily living (IADL) difficulty and cognition in older Puerto Rican adults. Participants included 2,840 community-dwelling adults (60+ years) without cognitive impairment who completed baseline and a four-year follow-up in the Puerto Rican Elderly: Health Conditions (PREHCO) project. At each wave, cognition (using the Mini-Mental Cabán) and self-reported IADL difficulty (a sum score of 10 everyday tasks) were measured. Covariates included age, gender, education, comorbidities, and depressive symptoms. Bidirectional associations were tested using a path model with concurrent and cross-lagged paths between cognition and IADL difficulty adjusting for covariates. Lower baseline cognition related to more baseline IADL difficulty (B=-0.08, SE=0.02, p&lt;.001). Cognitive decline at follow-up related to greater IADL difficulty at follow-up (B=-0.06, SE=0.02, p=.012). Looking at cross-lagged associations, greater baseline IADL difficulty associated with more cognitive decline at follow-up (B=-0.10, SE=0.04, p=.012). However, baseline cognition was not significantly associated with change in IADL difficulty at follow-up (B=-0.003, SE=0.02, p=.869). Findings support the growing body of literature that IADL difficulties can predict future cognitive decline in samples of community-dwelling older adults. More research into both functional and cognitive decline in Latinx samples will provide a more generalizable view of aging.

scholarly journals Type and Severity of Cognitive Decline in Older Adults after Noncardiac Surgery

2008 ◽  
Vol 108 (1) ◽  
pp. 8-17 ◽  
Author(s):  
Catherine C. Price ◽  
Cynthia W. Garvan ◽  
Terri G. Monk
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Daily Living ◽  
Noncardiac Surgery ◽  
Future Research ◽  
Equal Distribution ◽  
Memory Decline ◽  
Instrumental Activities

Background The authors investigated type and severity of cognitive decline in older adults immediately and 3 months after noncardiac surgery. Changes in instrumental activities of daily living were examined relative to type of cognitive decline. Methods Of the initial 417 older adults enrolled in the study, 337 surgery patients and 60 controls completed baseline, discharge, and/or 3-month postoperative cognitive and instrumental activities of daily living measures. Reliable change methods were used to examine three types of cognitive decline: memory, executive function, and combined executive function/memory. SD cutoffs were used to grade severity of change as mild, moderate or severe. Results At discharge, 186 (56%) patients experienced cognitive decline, with an equal distribution in type and severity. At 3 months after surgery, 231 patients (75.1%) experienced no cognitive decline, 42 (13.6%) showed only memory decline, 26 (8.4%) showed only executive function decline, and 9 (2.9%) showed decline in both executive and memory domains. Of those with cognitive decline, 36 (46.8%) had mild, 25 (32.5%) had moderate, and 16 (20.8%) had severe decline. The combined group had more severe impairment. Executive function or combined (memory and executive) deficits involved greater levels of functional (i.e., instrumental activities of daily living) impairment. The combined group was less educated than the unimpaired and memory groups. Conclusion Postsurgical cognitive presentation varies with time of testing. At 3 months after surgery, more older adults experienced memory decline, but only those with executive or combined cognitive decline had functional limitations. The findings have relevance for patients and caregivers. Future research should examine how perioperative factors influence neuronal systems.

scholarly journals NATIVITY AND DISABILITY TRAJECTORIES AMONG TWO COHORTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S481-S481
Author(s):  
Elizabeth Vasquez ◽  
Weihui Zhang ◽  
Anda Botoseneanu
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Mexican Americans ◽  
Daily Living ◽  
Epidemiologic Study ◽  
Self Report ◽  
Quadratic Growth ◽  
Foreign Born ◽  
Rate Of Increase ◽  
Iadl Disability

Abstract Nativity is an important characteristic in the context of disability in older adults, as it may influence attitudes and behaviors that can delay or accelerate the disability process. This study aims to assess trajectories of disability (defined as lower-body functional limitations, limitations in daily and instrumental activities of daily living, and gross mobility) in foreign-born and US-born Mexican Americans between 1993 and 2013. We used eight waves (1993 -2013) from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE; N=3050, mean age at baseline=73.6 (±6.8). Disability was assessed using self-reported limitations in activities of daily living (ADL /IADL). Nativity and age-at-migration were collected by self-report. We used linear and quadratic growth curve models to evaluate the trajectory of ADL/IADL disability over a period of 20 years and assessed variations by nativity status while adjusting for potential confounders. Approximately 19% of foreign-born and 17% of US-born reported having at least one ADL, while 51.5% natives and 58.7% of foreign-born had at least one IADL. Our results showed that after controlling for age at baseline, sex, marital status, self-reported health, chronic conditions, and education, foreign-born older adults were less likely to have ADL/IADL disability at baseline, but exhibited a faster rate of increase in disability over time (β =0.31 for ADL, β=0.07 for IADL). Our findings show that foreign-born older adults are accumulating disability at faster compared with their native peers, highlighting the importance of evaluating nativity differences in the health outcomes of Hispanic population at old age.

scholarly journals Nativity, Family, Disability: Results from the Hispanic Established Populations for the Epidemiologic Study of the Elderly

2021 ◽  
Vol 31 (2) ◽  
pp. 253-262
Author(s):  
Elizabeth Vasquez ◽  
Weihui Zhang ◽  
Joanna Dreby ◽  
Sunghee Lee ◽  
Anda Botoseneanu
Keyword(s):  
Activities Of Daily Living ◽  
Family Support ◽  
Mexican Americans ◽  
Daily Living ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Foreign Born ◽  
Cohort Differences ◽  
And Migration ◽  
Over Time

Objectives: Nativity and family support may influence attitudes and behaviors that delay or accelerate the disability process in older adults. The objectives of this study were twofold: 1) to evaluate nativity and migration cohort differences in trajecto­ries of disability (assessed by activities of daily living [ADL]) among older Mexican Americans; and 2) to determine the role of objectively measured family support in the association between nativity, migration cohort, and disability changes over time.Methods: This is a longitudinal study with up to 18 years follow-up (1993-2011) using data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (N=2,785, mean age =72.4 years). Disability was assessed using self-reported limitations in activities of daily living (ADL). Nativity and migration cohort were self-reported. Family support was as­sessed by marital status and the number of their children participants saw each month. Linear growth curve models evaluated the trajectory of ADL disability over 18 years and assessed variations by nativity status, migration cohort and family support.Results: Foreign-born respondents who migrated before age 20 had more starting ADL limitations (β= .36, P<.001) and ac­cumulated disability faster (β=.04, P<.01) compared with their US-born counterparts. In contrast, foreign-born respondents who migrated at later ages showed disability trajectories similar to US-born respondents. Married respondents had a lower level of disability (β= -.14, P<.01) and a lower rate of accumulation over time (β= -.02, P=.001) compared with participants who were not married.Discussion: Mexican Americans who migrate at younger ages may experience greater disability over time; however, family support may help mitigate the accumula­tion of disability among older Mexican Americans.Ethn Dis. 2021;31(2):253-262; doi:10.18865/ed.31.2.253

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