scholarly journals “What would you like to achieve?” Goal-Setting in Patients with Dementia in Geriatric Rehabilitation

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ilona Dutzi ◽  
Michael Schwenk ◽  
Marietta Kirchner ◽  
Jürgen M. Bauer ◽  
Klaus Hauer
Keyword(s):  
Cognitive Impairment ◽  
Goal Setting ◽  
Well Being ◽  
Cognitive Status ◽  
Geriatric Rehabilitation ◽  
Functional Impairments ◽  
Empirical Examination ◽  
Handling Stress ◽  
Clinical Assessments ◽  
Rehabilitation Needs

Abstract Background Setting meaningful, individualized rehabilitation goals is an essential part of the rehabilitation process. Even though patients with dementia are a drastically increasing patient group in geriatric rehabilitation, empirical data about meaningful rehabilitation goals and collaborative goal-setting in this target group is missing. Cognitive impairment and lack of insight in current deficits have been discussed as barriers for participation in goal-setting, but require empirical examination. This study investigated the feasibility of a semi-structured versus a structured goal-setting approach and the types of goals, rehabilitation patients with mild to moderate dementia perceive as personally relevant. Insights in acute functional and motor deficits, differentiated by cognitive status were explored. Methods Cohort study in a geriatric rehabilitation center. Semi-structured and ICF-based, structured interviews were applied to explore patients` rehabilitation goals. Patients` insight in deficits was operationalized as the relationship of self-ratings and objective measures of linked clinical assessments for the same functional construct. Results Patients (n = 101, MMSE 22 ± 2.6, age 83.9 ± 5.9 years) stated the improvement of mobility-related functions and self-care activities (> 70%) but also psychological well-being such as handling stress or mood (> 38%) as most important rehabilitation goals. The structured interview facilitated goal-setting and provided a broader view of rehabilitation needs. Correlations between self-ratings and clinical assessments were medium to high (rho = 0.29 to 0.83) with highest associations for key motor features. Trend tests identified a significant trend between values of the clinical assessment and categories of self-ratings (p ≤ 0.01) with lower cognitive status derogating this relationship. Conclusions Collaborative goal-setting was feasible, especially when supported by a structured approach and yielded a large spectrum of functional but also psychological rehabilitation needs from the patients` perspective. Patients showed sustained insight in their actual functional impairments, limited in a subgroup of patients with more advanced cognitive impairment.

Caregiving burden and out-of-home mobility of cognitively impaired care-recipients based on GPS tracking

2012 ◽  
Vol 24 (11) ◽  
pp. 1836-1845 ◽  
Author(s):  
Shirli Werner ◽  
Gail K. Auslander ◽  
Noam Shoval ◽  
Tamar Gitlitz ◽  
Ruth Landau ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Caregiver Burden ◽  
Well Being ◽  
Cognitive Status ◽  
Gps Tracking ◽  
Emotional States ◽  
Caregiving Burden ◽  
Positioning Systems ◽  
Care Recipients ◽  
The Relationship

ABSTRACTBackground: Out-of-home mobility refers to the realization of trips outside the home, by foot or by other means of transportation. Although out-of-home mobility is important for the well-being of older people with cognitive impairment, its importance for their caregivers is not clear. This study aims to clarify the relationship between caregiving burden and out-of-home mobility of care-recipients using Global Positioning Systems (GPS) technology.Methods: Seventy-six dyads (care-recipients and caregivers) were recruited from a psychogeriatric center, where they underwent cognitive assessment, followed by psychosocial interviews at home. Care-recipients received GPS tracking kits to carry for a period of four weeks, whenever they left home. Mobility data and diagnostic and psychosocial data were examined in relation to caregiver burden.Results: The strongest predictors of burden were care-recipients’ lower cognitive status and more time spent walking out-of-home. An interaction was found between cognitive status and time spent walking in relation to caregiver burden. The relationship between walking and burden was stronger among caregivers of care-recipients with dementia than caregivers of care-recipients with no cognitive impairment or mild cognitive impairment. Care-recipients’ behavioral and emotional states were also positively related to caregiver burden.Conclusions: The findings stress the importance of maintaining older persons’ out-of-home mobility during cognitive decline.

scholarly journals An Ecological Model of Care for Older Adults With Cognitive Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 154-155
Author(s):  
Elizabeth Rhodus ◽  
Graham Rowles ◽  
Shani Bardach ◽  
Elizabeth Hunter ◽  
Gregory Jicha
Keyword(s):  
Cognitive Impairment ◽  
Theoretical Model ◽  
Ecological Model ◽  
Participant Observation ◽  
Well Being ◽  
Cognitive Status ◽  
Limited Information ◽  
Environmental Interactions ◽  
Political Environments ◽  
Contextual Environment

Abstract Living with dementia causes increasing dependence on the surrounding physical and social environment. There is limited information on environmental interactions of persons with cognitive impairment. Based on participant observation and repeated interviews with both members of nine dyads (primary care partner and person with cognitive impairment) in situ in their homes, a theoretical model depicting environmental interaction was developed. The model illustrates parallel and interwoven environmental experiences of each member of the dyad as they negotiate progressive cognitive impairment. Evolution of the dyad is situated within nested layers of the physical and contextual environment including physical structures, social norms, and political environments. Experiential elements for each member of the dyad are described. Elements include cognitive status, trial and error associated with care provision, adverse behavior linked with onset of caregiver burden, onset of a significant event leading to altered living situations, and maximum dependence on environmental factors prior to end of life. Evidence collected suggests that both persons of the dyad become increasingly susceptible to environmental influences with progression of the disorder. Implication of these findings offer a theoretical framework describing dyadic experiences of environmental interactions when living with dementia. This theoretical model provides a basis for clinical and social intervention to enhance the well-being of both members of the dyad. Interventions associated with environmental interactions may slow socially discordant behavioral manifestations associated with dementia and significantly improve quality of life for both members of the dyad.

scholarly journals The CoGenT3 Study: Cognition and Gender Trends in Three American Generations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 817-817
Author(s):  
Shana Stites
Keyword(s):  
Cognitive Impairment ◽  
Quantitative Methods ◽  
Cognitive Testing ◽  
Library Science ◽  
Sexual And Gender Minorities ◽  
Functional Impairments ◽  
Gender Minorities ◽  
Wide Range ◽  
And Gender ◽  
New Research

Abstract Many studies find gender differences in how older adults’ report on their memory, perform on cognitive testing, and manage functional impairments that can accompany cognitive impairment. Thus, understanding gender’s effects in aging and Alzheimer’s research is key for advancing methods to prevent, slow, manage, and diagnosis cognitive impairment. Our study, CoGenT3 – The study of Cognition and Gender in Three Generations – seeks to disambiguate the effects of gender on cognition in order to inform a conceptual model, guide innovations in measurement, and support future study. To accomplish this ambitious goal, we have gathered an interdisciplinary team with expertise in psychology, cognition, sexual and gender minorities, library science, measurement, quantitative methods, qualitative methods, and gender and women’s studies. The team benefits from the intersections of expertise in being able to build new research ideas, gain novel insights, and evaluate a wide-range of actions and re-actions but this novelty can also raise challenges.

scholarly journals Association of Cognitive Function Screening Results with Adherence and Performance in a Pedometer-Based Intervention

2021 ◽  
pp. 1-9
Author(s):  
Anoop Sheshadri ◽  
Piyawan Kittiskulnam ◽  
Cynthia Delgado ◽  
Rebecca L. Sudore ◽  
Jennifer C. Lai ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Physical Performance ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Controlled Trial ◽  
Cognitive Status ◽  
Dialysis Patients ◽  
Exercise Interventions ◽  
And Performance

<b><i>Introduction:</i></b> A randomized, controlled trial of a pedometer-based walking intervention with weekly activity goals led to increased walking among dialysis patients. We examined whether impairment per cognitive function screening is associated with adherence and performance in the intervention. <b><i>Methods:</i></b> Thirty dialysis patients were randomly assigned to a 3-month pedometer-based intervention with weekly goals. Participants were administered the Telephone Interview of Cognitive Status (TICS), a test of global mental status. We examined the association of levels of impairment on the TICS (≥33: unimpaired, 26–32: ambiguous impairment, 21–25: mild cognitive impairment [MCI]) with adherence, achieving weekly goals, and increasing steps, physical performance (Short Physical Performance Battery, SPPB), and self-reported physical function (PF) through multivariable linear mixed-model and logistic regression analyses adjusted for age, sex, BMI, dialysis modality, baseline steps, baseline SPPB, and stroke status. <b><i>Results:</i></b> One-third of participants were unimpaired, and 13% had MCI. Participants with worse results on cognitive function screening missed more calls and completed fewer weekly goals than participants with better results. During the intervention, a worse result on cognitive function screening was associated with smaller increases in steps compared to those without impairment: (ambiguous: −620 [95% CI −174, −1,415], MCI: −1,653 [95% CI −120, −3,187]); less improvement in SPPB (ambiguous: −0.22 points [95% CI −0.08, −0.44], MCI: −0.45 [95% CI −0.13, −0.77]); and less improvement in PF (ambiguous: −4.0 points [95% CI −12.2, 4.1], MCI: −14.0 [95% CI −24.9, −3.1]). During the postintervention period, a worse result on cognitive function screening was associated with smaller increases in SPPB (ambiguous: −0.54 [95% CI −1.27, 0.19], MCI: −0.97 [95% CI −0.37, −1.58]) and PF (ambiguous: −3.3 [95% CI −6.5, −0.04], MCI: −10.5 [95% CI −18.7, −2.3]). <b><i>Discussion/Conclusion:</i></b> Participants with worse results on cognitive function screening had worse adherence and derived less benefit from this pedometer-based intervention. Future exercise interventions should be developed incorporating methods to address cognitive impairment, for example, by including caregivers when planning such interventions.

scholarly journals Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Shobhit Srivastava ◽  
T. V. Sekher
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Psychological Health ◽  
Daily Living ◽  
Basic Needs ◽  
Well Being ◽  
Asset Ownership ◽  
Increased Risk

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.

scholarly journals Frequency of But Not Capacity for Participation in Everyday Activities Is Associated With Cognitive Impairment in Late Life

2021 ◽  
pp. 073346482098428
Author(s):  
Chao-Yi Wu ◽  
Juleen Rodakowski ◽  
Lauren Terhorst ◽  
Mary Amanda Dew ◽  
Meryl Butters ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Late Life ◽  
Cognitive Status ◽  
Computerized Adaptive Test ◽  
Time Points ◽  
Everyday Activities ◽  
Neuropsychological Status ◽  
Activity Frequency ◽  
Test Version ◽  
Life Function

We examined features of everyday activities (capacity and frequency) between older adults with and without cognitive impairment over 12 months. Participants aged ≥60 years and at risk for depression were included (n = 260); 26% ( n = 69) had an acquired cognitive impairment at baseline. Cognitive impairment was defined as one standard deviation below norms on the Repeatable Battery for the Assessment of Neuropsychological Status. Features of everyday activities were measured by a computerized adaptive test version of Late-Life Function and Disability Instrument (LLFDI) at six time points (baseline, 6 weeks, 3, 6, 9, 12 months). There were significant between-group differences in activity frequency ( p = .04), but not activity capacity ( p = .05). The group difference in activity frequency exceeded minimal detectable changes (MDC90 = 3.7) and reached moderate clinical meaningfulness (∆ at six time points = 3.7–4.7). Generalized linear mixed models revealed no Group × Time interactions on activity capacity and frequency ( p = .65 and p = .98). Practitioners may assess changes in activity frequency to monitor cognitive status of clients even when there is no loss of activity capacity.

scholarly journals Relationship Between Patient and Informant Assessment of Personality and Cognitive Status

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 260-260
Author(s):  
Magdalena Tolea ◽  
James Galvin
Keyword(s):  
Cognitive Impairment ◽  
Personality Traits ◽  
Caregiver Burden ◽  
Disease Onset ◽  
Cognitive Status ◽  
Cognitively Normal ◽  
Psychotherapeutic Interventions ◽  
State Measure ◽  
Personality Ratings ◽  
Neuropsychological Evaluations

Abstract Personality has been linked to risk of dementia. Most studies ask individuals to rate their own personality traits or for a knowledgeable informant to perform the rating; few collect data from both. When informants are asked to give an estimate of the patient’s lifelong personality traits, they often describe personality before disease onset. When asked to self-rate, patients may instead assess their personality as they see themselves, providing a personality-state measure. The goal of this study was to assess agreement between two independent measures of personality and evaluate whether stage of cognitive impairment and characteristics of patients or caregivers impact concordance. In 79 consecutive patient-caregiver dyads presenting to our center (mean age:76.8±8.4; 44.1% female; 6% cognitively normal, 41% MCI; and 53% dementia) with in-depth psychosocial and neuropsychological evaluations, we found informants rated patients lower on openness (O) (ICC=0.434; 95%CI: 0.235-0.598) and agreeableness (A) (ICC=0.491; 95%CI: 0.302-0.643) and higher on extraversion (O) (ICC=0.396; 95%CI: 0.191-0.568) and neuroticism (N) (ICC=0.444; 95%CI: 0.247-0.607). Greater discordance was observed in established dementia (ICCE=0.497; 95%CI: 0.222-0.700; ICCA=0.337; 95%CI:0.031-0.586; ICCN=0.422; 95%CI: 0.191-0.683), compared with MCI (ICCO=0.568; 95%CI: 0.282-0.762). We explored the effect of patient and caregiver mood and caregiver burden on personality ratings. Although personality is typically described as a trait, we present evidence that in the eyes of patients, personality ratings may represent a state that changes across the spectrum of cognitive impairment. Understanding how patients and caregivers differentially perceive personality may assist in developing novel psychotherapeutic interventions and approaches dealing with behavioral manifestations of dementia.

scholarly journals The Congregational Character Questionnaire: An Initial Empirical Examination of the Significance of Collective Church Character Traits

2021 ◽  
pp. 009164712110219
Author(s):  
T. Ryan Byerly ◽  
Keith J. Edwards ◽  
Peter C. Hill
Keyword(s):  
Meaning In Life ◽  
Satisfaction With Life ◽  
Empirical Studies ◽  
Well Being ◽  
Character Traits ◽  
Academic Disciplines ◽  
Future Research ◽  
Religious Congregations ◽  
Empirical Examination ◽  
Christian Churches

Researchers in several academic disciplines have begun to take an interest in group character traits, including the character traits of religious congregations. This article reports the first empirical studies of congregational virtues. The Congregational Character Questionnaire was developed for measuring 12 different virtues of Christian churches: clinging to apostolic teaching, honoring teachers, prayerfulness, hopefulness, discipleship, emotional supportiveness, material supportiveness, spiritual equality, unity, submission, peace with the world, and spreading the faith. The instrument was then used with an online sample ( N = 530) to study how congregants’ perceptions of their congregation’s virtuousness related to congregants’ evaluations of their congregation, participation in their congregation, as well as congregants’ satisfaction with life, presence of meaning in life, and religious well-being. Results indicated that congregants’ overall perceptions of congregational virtuousness were significantly positively related to all of these dependent variables. These results help to reveal the important role that congregational character may play in the experience of congregants. Directions for future research in this area are outlined.

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