scholarly journals No association between rheumatoid arthritis and cognitive impairment in a cross-sectional national sample of older U.S. adults

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Michael J. Booth ◽  
Mary R. Janevic ◽  
Lindsay C. Kobayashi ◽  
Daniel J. Clauw ◽  
John D. Piette
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Cognitive Impairment ◽  
National Sample ◽  
Cognitive Status ◽  
Neuropsychological Battery ◽  
Cross Sectional ◽  
Icd 10 ◽  
Nationally Representative ◽  
National Probability Sample

Abstract Background Studies suggest an increased prevalence of cognitive impairment (CI) among people with rheumatoid arthritis (RA). However, most prior studies have used convenience samples which are subject to selection biases or have failed to adjust for key confounding variables. We thus examined the association between CI and RA in a large national probability sample of older US adults. Methods Data were from interviews with 4462 participants in the 2016 wave of the nationally representative U.S. Health and Retirement Study with linked Medicare claims. RA diagnoses were identified via a minimum of two ICD-9CM or ICD-10 codes in Medicare billing records during the prior 2 years. The Langa-Weir Classification was used to classify cognitive status as normal, cognitively impaired non-dementia (CIND), or dementia based on a brief neuropsychological battery for self-respondents and informant reports for proxy respondents. We compared the odds of CI between older adults with and without RA using logistic regression, adjusted for age, education, gender, and race. Results Medicare records identified a 3.36% prevalence of RA (150/4462). While age, gender, education, and race independently predicted CI status, controlling for these covariates we found no difference in CI prevalence according to RA status (prevalent CI in 36.7% of older adults with RA vs. 34.0% without RA; adjusted OR = 1.08, 95% CI 0.74–1.59, p = .69). Conclusion There was no association between RA and CI in this national sample of older U.S. adults.

A path to early diagnosis of mild cognitive impairment and dementia: validity and reliability of the myMemCheck® self-administered screening tool

2020 ◽  
Vol 37 (4) ◽  
pp. 561-567
Author(s):  
William E Mansbach ◽  
Ryan A Mace ◽  
Melissa A Tanner ◽  
Steven P Simmons
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Cognitive Status ◽  
Diagnostic Process ◽  
Validity And Reliability ◽  
Characteristic Analysis ◽  
Cross Sectional

Abstract Background Barriers to the early detection of mild cognitive impairment (MCI) and dementia can delay diagnosis and treatment. myMemCheck® was developed as a rapid free cognitive self-assessment tool that can be completed at home to identify older adults that would benefit from a more comprehensive cognitive evaluation. Objective Two prospective cross-sectional studies were conducted to examine the psychometric properties and clinical utility of myMemCheck®. Methods In Study 1, participants were independent living residents referred to an outpatient memory clinic (N = 59); older adults in the community and post-acute nursing home residents (N = 357) comprised Study 2. Results Psychometric analyses were performed on cognitive and psychological testing data, including myMemCheck®. myMemCheck® evidenced adequate reliability and strong construct validity. Receiver operating characteristic analysis evidenced an optional myMemCheck® cut score for identifying older adults at risk for MCI or dementia. myMemCheck® explained 25% of cognitive status beyond basic patient information. Conclusions myMemCheck® may help fast-track the diagnostic process, facilitate appropriate referrals for cognitive and neuropsychological evaluation, reduce assessment burden in health care and prevent negative outcomes associated with undetected cognitive impairment.

scholarly journals Social Participation and Elder Mistreatment in a National Sample of Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 153-153
Author(s):  
Emmy Yang ◽  
Nadra Lisha ◽  
Ashwin Kotwal ◽  
Jaclyn Wong ◽  
Alison Huang
Keyword(s):  
Older Adults ◽  
Social Participation ◽  
Social Engagement ◽  
National Sample ◽  
Community Dwelling ◽  
Social Activities ◽  
Elder Mistreatment ◽  
Cross Sectional ◽  
National Probability Sample ◽  
Sectional Analysis

Abstract Little is known about how social participation influences older adults' susceptibility to elder mistreatment. We conducted a cross-sectional analysis of a national probability sample of community-dwelling U.S. adults from 2015-2016 (1,268 women and 973 men; mean age 75 and 76 years, respectively; 82% non-Hispanic white). Frequency of participation in formal activities (community meetings, religious services, and volunteering) and informal social activities (socializing with friends and family) was assessed by questionnaire. Additional measures assessed emotional, physical, and financial mistreatment since age 60. Multivariable logistic regression examined associations between social participation and elder mistreatment, adjusting for age, race/ethnicity, education, and comorbidity. Forty percent of women and 22% of men reported at least one form of mistreatment (emotional, physical, or financial). Women reporting at least monthly formal social participation were more likely to report emotional mistreatment (adjusted odds ratio (AOR) 1.57, 95% confidence interval (CI) 1.08-2.29) and financial mistreatment (AOR 1.56, 95% CI 1.02-2.38) than women with less frequent engagement. Older women who socialized at least weekly were more likely to report emotional mistreatment (AOR 0.59, 95% CI 0.44-0.78) and financial mistreatment (AOR 0.59, 95% CI 0.42-0.85). These associations were not seen among older men. Frequent social engagement in the community does not preclude risk for elder mistreatment, and informal socializing may be associated with decreased exposure to certain forms of mistreatment. Assessment of older adults’ social activities may help guide strategies for detecting and mitigating elder mistreatment in the community.

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 Low Back Pain and Substance Use: Diagnostic and Administrative Coding for Opioid Use and Dependence Increased in U.S. Older Adults with Low Back Pain

Pain Medicine ◽  
2021 ◽  
Author(s):  
Beth B Hogans ◽  
Bernadette C Siaton ◽  
Michelle N Taylor ◽  
Leslie I Katzel ◽  
John D Sorkin
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
Low Back Pain ◽  
Back Pain ◽  
National Sample ◽  
Cross Sectional Study ◽  
Diagnostic Code ◽  
Low Back ◽  
Opioid Use ◽  
Cross Sectional

Abstract Objective Low back pain (LBP) is a leading cause of pain and disability. Substance use complicates the management of LBP, and potential risks increase with aging. Despite implications for an aging, diverse U.S. population, substance use and LBP comorbidity remain poorly defined. The objective of this study was to characterize LBP and substance use diagnoses in older U.S. adults by age, gender, and race. Design Cross-sectional study of a random national sample. Subjects Older adults including 1,477,594 U.S. Medicare Part B beneficiaries. Methods Bayesian analysis of 37,634,210 claims, with 10,775,869 administrative and 92,903,649 diagnostic code assignments. Results LBP was diagnosed in 14.8±0.06% of those more than 65 years of age, more in females than in males (15.8±0.08% vs. 13.4±0.09%), and slightly less in those more than 85 years of age (13.3±0.2%). Substance use diagnosis varied by substance: nicotine, 9.6±0.02%; opioid, 2.8±0.01%; and alcohol, 1.3±0.01%. Substance use diagnosis declined with advancing age cohort. Opioid use diagnosis was markedly higher for those in whom LBP was diagnosed (10.5%) than for those not diagnosed with LBP (1.5%). Most older adults (54.9%) with an opioid diagnosis were diagnosed with LBP. Gender differences were modest. Relative rates of substance use diagnoses in LBP were modest for nicotine and alcohol. Conclusions Older adults with LBP have high relative rates of opioid diagnoses, irrespective of gender or age. Most older adults with opioid-related diagnoses have LBP, compared with a minority of those not opioid diagnosed. In caring for older adults with LBP or opioid-related diagnoses, health systems must anticipate complexity and support clinicians, patients, and caregivers in managing pain comorbidities. Older adults may benefit from proactive incorporation of non-opioid pain treatments. Further study is needed.

Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Diego Urrunaga-Pastor ◽  
Diego Chambergo-Michilot ◽  
Fernando M. Runzer-Colmenares ◽  
Josmel Pacheco-Mendoza ◽  
Vicente A. Benites-Zapata
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
High Altitude ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Language Restriction ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Ottawa Scale

<b><i>Introduction:</i></b> Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. <b><i>Methods:</i></b> We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. <b><i>Results:</i></b> Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, <i>I</i><sup>2</sup>: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, <i>I</i><sup>2</sup>: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, <i>I</i><sup>2</sup>: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. <b><i>Conclusions:</i></b> The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.

scholarly journals The Association Between Recent Family Death and Self-Perceptions of Aging Among Middle-Aged and Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 450-450
Author(s):  
Shu Xu
Keyword(s):  
Older Adults ◽  
Child Death ◽  
Parental Death ◽  
Middle Aged ◽  
Cross Sectional ◽  
Self Perceptions ◽  
Perceptions Of Aging ◽  
Nationally Representative ◽  
And Gender ◽  
Family Loss

Abstract The loss of a family member may have a significant influence on one’s aging experience in life. Self-perceptions of aging, which are an individual’s beliefs or evaluation of their experiences of aging, have been described as an important factor for one’s health and daily life. However, there is little research on the association between family death and self-perceptions of aging. This study examines the relationships between recent family death, self-perceptions of aging, and gender of the bereaved among middle-aged and older adults. Using nationally representative data from the Health and Retirement Study (HRS), we conducted cross-sectional analysis on adults age 50 years and older (n=1,839). Self-perceptions of aging were accessed by 8 items derived from the Attitudes Toward Own Aging subscale of the Philadelphia Geriatric Center Morale Scale and the Berlin Aging Study, and we considered recent family death (i.e., parental death, spousal death, sibling death and child death), as well as gender of the bereaved. Multiple linear regression analyses revealed that respondents who experienced recent family death report less positive self-perceptions of aging compared to those who did not experience recent family death (t = 12.40, p &lt; .01). Recent parental death was more negatively related with self-perceptions of aging for bereaved women than for bereaved men (χ2 = 4.28, p &lt; .05). Findings suggest that middle-aged and older adults experiencing recent family loss have less positive self-perceptions of aging, and gender of the bereaved plays an important role in the relationship between parental death and self-perceptions of aging.

scholarly journals Validation of Self‐Reported Rheumatoid Arthritis Using Medicare Claims: A Nationally Representative Longitudinal Study of Older Adults

2021 ◽  
Vol 3 (4) ◽  
pp. 239-249
Author(s):  
Michael J. Booth ◽  
Daniel Clauw ◽  
Mary R. Janevic ◽  
Lindsay C. Kobayashi ◽  
John D. Piette
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Longitudinal Study ◽  
Medicare Claims ◽  
Nationally Representative

scholarly journals Effect of Demographic and Health Dynamics on Cognitive Status in Mexico between 2001 and 2015: Evidence from the Mexican Health and Aging Study

Geriatrics ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 63
Author(s):  
Silvia Mejia-Arango ◽  
Jaqueline Avila ◽  
Brian Downer ◽  
Marc A. Garcia ◽  
Alejandra Michaels-Obregon ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Cardiovascular Diseases ◽  
Educational Attainment ◽  
Access To Health Care ◽  
Sociodemographic Factors ◽  
Cognitive Status ◽  
Access To Health ◽  
Mexican Adults

Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how sociodemographic factors, cardiovascular diseases, and their treatment relate to changes in cognitive function of Mexican adults aged 60 and older between 2001 and 2015. Self and proxy respondents were classified as dementia, cognitive impairment no dementia (CIND), and normal cognition. We use logistic regression models to examine the trends in dementia and CIND for men and women aged 60 years or older using pooled national samples of 6822 individuals in 2001 and 10,219 in 2015, and sociodemographic and health variables as covariates. We found higher likelihood of dementia and a lower risk of CIND in 2015 compared to 2001. These results remain after adjusting for sociodemographic factors, cardiovascular diseases, and their treatment. The improvements in educational attainment, treatment of diabetes and hypertension, and better access to health care in 2015 compared to 2001 may not have been enough to counteract the combined effects of aging, rural residence disadvantage, and higher risks of cardiovascular disease among older Mexican adults.

scholarly journals Memory-Related Frontal Brainwaves Predict Transition to Mild Cognitive Impairment in Healthy Older Individuals Five Years Before Diagnosis

2020 ◽  
pp. 1-11
Author(s):  
Yang Jiang ◽  
Juan Li ◽  
Frederick A. Schmitt ◽  
Gregory A. Jicha ◽  
Nancy B. Munro ◽  
...  
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Memory Performance ◽  
Memory Task ◽  
Cognitive Status ◽  
Older Individuals ◽  
Increased Risk ◽  
Differentiation Pattern

Background: Early prognosis of high-risk older adults for amnestic mild cognitive impairment (aMCI), using noninvasive and sensitive neuromarkers, is key for early prevention of Alzheimer’s disease. We have developed individualized measures in electrophysiological brain signals during working memory that distinguish patients with aMCI from age-matched cognitively intact older individuals. Objective: Here we test longitudinally the prognosis of the baseline neuromarkers for aMCI risk. We hypothesized that the older individuals diagnosed with incident aMCI already have aMCI-like brain signatures years before diagnosis. Methods: Electroencephalogram (EEG) and memory performance were recorded during a working memory task at baseline. The individualized baseline neuromarkers, annual cognitive status, and longitudinal changes in memory recall scores up to 10 years were analyzed. Results: Seven of the 19 cognitively normal older adults were diagnosed with incident aMCI for a median 5.2 years later. The seven converters’ frontal brainwaves were statistically identical to those patients with diagnosed aMCI (n = 14) at baseline. Importantly, the converters’ baseline memory-related brainwaves (reduced mean frontal responses to memory targets) were significantly different from those who remained normal. Furthermore, differentiation pattern of left frontal memory-related responses (targets versus nontargets) was associated with an increased risk hazard of aMCI (HR = 1.47, 95% CI 1.03, 2.08). Conclusion: The memory-related neuromarkers detect MCI-like brain signatures about five years before diagnosis. The individualized frontal neuromarkers index increased MCI risk at baseline. These noninvasive neuromarkers during our Bluegrass memory task have great potential to be used repeatedly for individualized prognosis of MCI risk and progression before clinical diagnosis.

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