scholarly journals Bewildered and alone: supporting people with cognitive impairment on COVID isolation wards

2021 ◽  
pp. 1-2
Author(s):  
Martha Finnegan ◽  
Elaine Greene
Keyword(s):  
Cognitive Impairment ◽  
The Elderly ◽  
Cognitively Impaired ◽  
Pharmacological Interventions ◽  
Specific Group ◽  
Liaison Psychiatry ◽  
Professional Boundaries ◽  
Off Label ◽  
New Challenges

SUMMARY Managing isolation protocols for distressed, cognitively impaired COVID-19-positive patients presented a range of new challenges to our liaison psychiatry for the elderly service. In this article we present some of the scenarios we have experienced, our own reflections on the needs of this specific group and how this has challenged us in terms of tolerating risk, prescribing off-label, collaborating with distressed colleagues, professional boundaries and being creative in non-pharmacological interventions.

scholarly journals Vitamin B12 supplementation and cognitive scores in geriatric patients having Mild Cognitive Impairment

2016 ◽  
Vol 6 (9) ◽  
pp. 578 ◽  
Author(s):  
Komal Chauhan ◽  
Aditika Agarwal
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Vitamin B12 ◽  
Neurological Disorders ◽  
Geriatric Patients ◽  
Serum Vitamin ◽  
The Elderly ◽  
Cognitively Impaired ◽  
Vitamin B12 Supplementation ◽  
Young Old

Background: The Neurodegenerative diseases are increasingly affecting the elderly with a severe impact on their brain health. There is a wide gap in supplementation based studies for increasing the cognition levels of the geriatric population especially in the developing countries like India, which are at extreme risk of developing neurological disorders. Vitamin B12 herein has caught much attention lately for improving the cognitive status. Literature has linked the possibility of alleviating neurological disorders in the elderly with effective vitamin B12 management. Abundant animal and human models have proved that supplementation of vitamin B12 is beneficial for the restoration of cognitive functions. Objective: To supplement vitamin B12 deficient mild cognitively impaired geriatric patients with injectable doses of vitamin B12 followed by impact evaluation. Methods: Screening of the mild cognitively impaired patients was carried out using the Mini-Mental State Examination and Yamaguchi Fox Pigeon Imitation test. Baseline information was elicited from the patients residing in urban Vadodara (a district in the state of Gujarat), India. This included socio-demographic, medical and drug history, anthropometric and physical activity pattern as well as biochemical parameters comprising of serum vitamin B12 and glycated haemoglobin profile. A sub-sample of 60 patients with mild cognitive impairment (MCI) demonstrating severe vitamin B12 deficiency were conveniently enrolled for injectable doses of Vitamin B12 in the dosage of 1,000 μg every day for one week, followed by 1,000 μg every week for 4 weeks & finishing with 1,000 μg for the remaining 4 months. Post six months intervention all the parameters were elicited. Results: Vitamin B12 supplementation resulted in a significant (p<0.001) improvement in the MMSE scores of the patients with a rise of 9.63% in the total patients. Gender-wise division also highlighted a significant increase (p<0.001) in the scores by 6.79% and 12.46% in overall males and females and a 10.20% and 8.24% rise for young-old (60-69 yrs) and old- old (70-85 yrs) categories, respectively. As a result, 27 patients progressed towards the category from the MCI state being assessed by MMSE scores. In the same manner, YGFPIT too demonstrated a 38% increase in normal with 35% males, 42% females, 41% young–old and 31% old-old moving to normal status. Thus, a total number of 28 patients progressed to the normal condition as per YGFPIT.Conclusion: Hence, vitamin B12 supplementation was found significantly effective in placing the serum vitamin B12 of MCI patients from the deficiency state to sufficient levels and in turn increased their performance in MMSE and YFPIT scores. Keywords: Mild Cognitive Impairment, vitamin B12, geriatrics, cognition

Serum Immunoglobulins and Cognitive Status in the Elderly: 1. A Population Study

1980 ◽  
Vol 136 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Donna Cohen ◽  
Carl Eisdorfer
Keyword(s):  
Cognitive Impairment ◽  
Population Study ◽  
Elevated Serum ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Immunological Factors ◽  
A Current ◽  
Age And Sex

SummaryFifty-seven cognitively impaired elderly had significantly elevated serum IgG (P $0.005) and IgA (P $0.01) levels and similar IgM levels, compared to a population of 65 elderly matched for age and sex, who did not manifest cognitive impairment. These findings are compatible with a current hypothesis that immunological factors may be important in the cognitive disorders observed with increasing frequency among the aged.

scholarly journals Association between Physical Activity and Cognitive Function among the Elderly in the Health and Social Centers in Kenitra, Rabat, and Sidi Kacem City (Morocco)

2021 ◽  
Vol 14 ◽  
pp. 117863882110267
Author(s):  
Abdeljalil Talhaoui ◽  
Youssef Aboussaleh ◽  
Ahmed Ahami ◽  
Rachid Sbaibi ◽  
Naima Agoutim ◽  
...  
Keyword(s):  
Physical Activity ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Protective Factor ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Cognitively Impaired ◽  
Gender Education ◽  
Global Physical Activity Questionnaire

Objective: The aim of this study was to determine the link between the physical activity (PA) and cognitive function among the elderly in the health and social centers in Kenitra, Rabat, and Sidi Kacem city (Morocco). Materials and methods: This study was conducted among 172 elderly (56.4% men) aged above 60 years (67.53 ± 7.53) in the health and social centers in Kenitra, Rabat, and Sidi Kacem city (Morocco). Cognitive functions were assessed by the Mini-Mental State Examination (MMSE) (Normal: MMSE’s score >24 and cognitive impairment (CI): MMSE’s score ⩽ 24). The physical activity (PA) was evaluated using the GPAQ (Global Physical Activity Questionnaire), ranking the elderly by high, moderate, and limited level of PA. The binary logistic regression was performed by the cognitive function (dependent variable), and PA level (independent variable). Results: The elderly people with cognitive impairment (MMSE score <24 tend to practice less walking and cycling activities ( P  =  .005). However no difference was found between normal and cognitively impaired subjects for all other subtypes of PA ( P > .05). The binary logistic regression adjusted for gender, education, profession, pension, depression, and nutritional status reveled that only the moderate level of PA was a protective factor against cognitive impairment compared to limited level (ORa = 0.136, 95% CI: 0.04-0.41) (ORa: Adjusted Odd Ratio; 95% CI: 95% of Confidence Interval). Conclusion: Our finding demonstrates that moderate PA specially walking or cycling is associated with lower risk of cognitive impairment. This indicates that a regular practice of walking or cycling as PA can play an important role for cognitive impairment prevention. And the necessity for further researches to more understands this association.

scholarly journals Screening of cognitive impairment by general internists using two simple instruments

2012 ◽  
Vol 6 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Alessandro Ferrari Jacinto ◽  
Sonia Maria Dozzi Brucki ◽  
Claudia Sellitto Porto ◽  
Milton de Arruda Martins ◽  
Ricardo Nitrini
Keyword(s):  
Cognitive Impairment ◽  
High Sensitivity ◽  
The Elderly ◽  
University Hospital ◽  
Cognitively Impaired ◽  
Screening Instruments ◽  
Outpatient Services ◽  
Functional Activities ◽  
General Internists ◽  
Combined Use

ABSTRACT General internists (GIs) tend to overlook cognitive impairment in the elderly. Lack of time to diagnose and/or poor knowledge on how to use screening instruments may be the reasons for this shortcoming. Objectives: To verify the efficacy of simple instruments in the screening of cognitive impairment in elders. Methods: In a previous study, 248 patients aged ≥65 that had been assisted by GIs within outpatient services of a public university hospital in São Paulo, Brazil, were evaluated. The Mini-Mental State Examination and/or the Informant Questionnaire on Cognitive Decline in the Elderly (short-IQCODE) were employed to classify patients into probable cognitively impaired cases or otherwise. Other tests and questionnaires were also applied, but were not used to perform this classification. After full assessment and consensus meetings, cases were classified into dementia, cognitively impaired not demented, and without cognitive impairment. In this study, the sensitivity and specificity of the combined use of the category fluency test (CFT) and the Functional Activities Questionnaire (FAQ) was evaluated as if used as screening instruments for the whole sample. Results: The combined use of the CFT and/or FAQ showed sensitivity of 88.3% and specificity of 76.5% in the screening of cognitive impairment for the whole sample. Conclusions: Two simple and easy-to-apply instruments showed high sensitivity and reasonable specificity, and are probably useful for the screening of cognitive impairment in the elderly in outpatient services.

scholarly journals Evaluation Of Motor Performance In Cognitively Impaired Elderly Patients With Berg Test: A pilot study

2020 ◽  
Author(s):  
Annamaija Sutela ◽  
Timo Kauppila
Keyword(s):  
Cognitive Impairment ◽  
Motor Performance ◽  
Motor Program ◽  
The Elderly ◽  
Cognitively Impaired ◽  
Care Hospital ◽  
Verbal Instructions ◽  
Primary Care Hospital ◽  
Quasi Experimental ◽  
Normal Cognition

Abstract Objectives We studied whether we can determine a degree of cognitive impairment in which the testing for need of physiotherapy cannot be evaluated without continuous non-verbal instructions in the elderly patients.Present study was a retrospective observational quasi-experimental cohort study performed with patients of geriatric primary care hospital. Fifty-seven aged (>65 years) patients who are aiming to be rehabilitated to home-like facilities participated this study. We compared groups of different levels of cognitive performance (normal cognition, mild, moderate, and severe cognitive impairment) as determined with MiniMental(MMSE)-test by using their motor performance in Berg test.ResultsSeverely cognitively impaired patients (MMSE≤11) were equally able to perform the Berg test as their less cognitively compromised controls if they were continuously advised non-verbally. However, standing without support, sitting without support, reaching forward, watching backwards by turning as well as turning around 360° were too difficult tasks for these patients to be performed without continuous extra assistance given by the physiotherapists. Even the most cognitively impaired patients may be able to perform a motor program in physiotherapy. However, with these patients autonomous exercise is likely to fail and excessive work by physiotherapists is thereby required for their training.

Easy Screening for Mild Alzheimer's Disease and Mild Cognitive Impairment from Elderly Speech

2018 ◽  
Vol 15 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Shohei Kato ◽  
Akira Homma ◽  
Takuto Sakuma
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Characteristic Curve ◽  
Linear Regression Analysis ◽  
Speech Sound ◽  
The Elderly ◽  
Speech Sounds ◽  
Mel Frequency Cepstral Coefficients

Objective: This study presents a novel approach for early detection of cognitive impairment in the elderly. The approach incorporates the use of speech sound analysis, multivariate statistics, and data-mining techniques. We have developed a speech prosody-based cognitive impairment rating (SPCIR) that can distinguish between cognitively normal controls and elderly people with mild Alzheimer's disease (mAD) or mild cognitive impairment (MCI) using prosodic signals extracted from elderly speech while administering a questionnaire. Two hundred and seventy-three Japanese subjects (73 males and 200 females between the ages of 65 and 96) participated in this study. The authors collected speech sounds from segments of dialogue during a revised Hasegawa's dementia scale (HDS-R) examination and talking about topics related to hometown, childhood, and school. The segments correspond to speech sounds from answers to questions regarding birthdate (T1), the name of the subject's elementary school (T2), time orientation (Q2), and repetition of three-digit numbers backward (Q6). As many prosodic features as possible were extracted from each of the speech sounds, including fundamental frequency, formant, and intensity features and mel-frequency cepstral coefficients. They were refined using principal component analysis and/or feature selection. The authors calculated an SPCIR using multiple linear regression analysis. Conclusion: In addition, this study proposes a binary discrimination model of SPCIR using multivariate logistic regression and model selection with receiver operating characteristic curve analysis and reports on the sensitivity and specificity of SPCIR for diagnosis (control vs. MCI/mAD). The study also reports discriminative performances well, thereby suggesting that the proposed approach might be an effective tool for screening the elderly for mAD and MCI.

scholarly journals Use radiography rarely, not routinely, for hip hemiarthroplasty

2021 ◽  
Author(s):  
Lucy Clare Maling ◽  
John Martin Lynch ◽  
Robert William Walker ◽  
Mark Ross Norton ◽  
Rory George Middleton
Keyword(s):  
Patient Safety ◽  
Cognitive Impairment ◽  
Limited Resources ◽  
Cognitively Impaired ◽  
Clinical Change ◽  
Index Procedure ◽  
Hip Hemiarthroplasty ◽  
Operative Care ◽  
Fluoroscopic Imaging ◽  
Retrospective Database

Abstract Purpose Hip hemiarthroplasty (HA) is a commonly performed operation. A post-operative radiograph forms part of the routine hip fracture pathway, although patients are often mobilised prior to this investigation. This study seeks to provide evidence for a pragmatic clinical change to optimise patient safety and allocate limited resources within the National Health Service (NHS). Methods We undertook a retrospective database review of 1563 HA procedures to assess whether the routine ordering of check radiographs played an important role in a patient’s post-operative care. Results 18 (1.2%) mechanical complications led to a return to theatre within 6 weeks of the index procedure. All were dislocations. Ten had a normal post-operative radiograph and five had documented suspicion of dislocation prior to radiography. The post-operative check radiograph was the sole identifier of dislocation in only three patients (0.2%). All three of these patients were pre-morbidly bed bound and non-communicative due to cognitive impairment (AMTS 0/10). Conclusion Unless a patient is pre-morbidly bed bound and cognitively impaired, routine post-operative radiography following HA surgery is of little clinical benefit, yet may carry considerable risk to the patient and cost to the NHS. A pragmatic compromise is to perform intra-operative fluoroscopic imaging.

Post-stroke Cognitive Impairment and Malnutrition in the Elderly (PCIME): study design and protocol

2021 ◽  
Author(s):  
Zahra Vahabi ◽  
M. Reza Azarpazhooh ◽  
Shima Raeesi ◽  
Shahram Oveisgharan ◽  
Farnaz Etesam ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Study Design ◽  
The Elderly ◽  
Post Stroke
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