scholarly journals Performance-based instrument to assess functional capacity in community-dwelling older adults

2019 ◽  
Vol 13 (4) ◽  
pp. 386-393
Author(s):  
Ana Cláudia Becattini-Oliveira ◽  
Leonardo Cardoso Portela Câmara ◽  
Douglas de Farias Dutra ◽  
Antonia de Azevedo Falcão Sigrist ◽  
Helenice Charchat-Fichman
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
Independent Living ◽  
Community Dwelling ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Clock Drawing Test ◽  
Neuropsychological Functions ◽  
Figure Test ◽  
Community Dwelling Older Adults

ABSTRACT Functional capacity (FC) is a mediator between neuropsychological functions and real-world functioning, but there is a lack of evidence of its correlation in community-dwelling older adults. Objective: The study aim was to determine the FC level of community-dwelling older adults using the UCSD Performance-based Skills Assessment (UPSA) and to evaluate correlation with cognitive screening tests. Methods: Senior center participants were selected according to inclusion criteria: Portuguese fluency, age ≥60 years and self-reported independent living. The subject exclusion criteria were: dementia or other DSM-5 diagnoses, suicidal ideation or intent, non-completion of assessment battery, enrollment in another psychosocial intervention or pharmacotherapy study. FC level was determined by the UPSA, brief UPSA (UPSA-B) and Instrumental Activities of Daily Living scale (IADL’s). The Mini-Mental State Examination (MMSE), Memory of Figure Test (MFT), Verbal Fluency Test (VFT) and Clock Drawing Test (CDT) were used for cognitive assessment. A total of 35 subjects that had a mean age of 72 years, were predominantly females(88.6%) and had mean education level of 11.25 years were evaluated. Results: Mean UPSA and UPSA-B scores were 78.5 and 70, respectively. A statistically significant correlation was observed between the UPSA and IADL, MMSE and VFT. Conclusion: The UPSA serves as a screening assessment of FC in community-dwelling older adults, showing a positive correlation with cognitive screening tests.

scholarly journals High prevalence of dementia among community dwelling older adults in receipt of state funded home care packages: implications for health care planning

2017 ◽  
Vol 36 (2) ◽  
pp. 139-144 ◽  
Author(s):  
I. O’Brien ◽  
K. Smuts ◽  
C. W. Fan ◽  
M. O’Sullivan ◽  
A. Warters
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Independent Living ◽  
Community Dwelling ◽  
Cognitive Screening ◽  
Health Care Planning ◽  
Cross Sectional ◽  
High Prevalence ◽  
Community Dwelling Older Adults ◽  
Prevalence Of Dementia

ObjectivesThe majority of people living with dementia in Ireland reside in their own homes, some supported by formal or informal home care. This audit aimed to estimate the prevalence of dementia and suspected cognitive impairment (CI) among older adults, 65+ years, in receipt of formal home care (domiciliary care) in a defined health service area in North Dublin. A secondary objective of the audit was to explore factors associated with dementia or CI in this cohort.MethodsA cross-sectional audit was conducted on all clients aged 65+ years actively receiving publicly funded home care packages (HCPs) during May 2016 in Healthcare Service Executive CHO9 Dublin North Central. A total of 935 urban community dwelling older adults were included in the study [mean age 83.7 (s.d. 7.4) years and 65% female]. Basic socio-demographic and health data were extracted from common summary assessment reports. Service users were categorised as having (a) dementia if a diagnosis of dementia or cognitive decline which impacts on independent living, was documented by a health professional or (b) suspected CI where a validated cognitive screening tool was applied and the score was indicative of mild CI.ResultsOverall, the estimated prevalence of dementia and suspected CI was 37.1% and 8.7%, respectively. Factors significantly associated with dementia and suspected CI were higher dependency and home care hours, communication difficulty and being non-self-caring (p<0.001). Notably, half (51.6%) of those with either dementia or suspected CI group lived alone.ConclusionsOur findings suggest a high prevalence dementia among HCP users, highlighting a need and opportunity for dementia-specific approaches to support older people in their homes.

scholarly journals Rates of Cognitive and Functional Impairments in Older Adults Residing in a Continuing Care Senior Housing Community

2021 ◽  
pp. 1-12
Author(s):  
Ryan Van Patten ◽  
Zanjbeel Mahmood ◽  
Tanya T. Nguyen ◽  
Jacqueline E. Maye ◽  
Ho-Cheol Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
Independent Living ◽  
Visual Learning ◽  
Cognitive Test ◽  
Continuing Care ◽  
Cognitive Screening ◽  
Functional Impairments ◽  
Senior Housing ◽  
The Mean

Abstract Objective: The current cross-sectional study examined cognition and performance-based functional abilities in a continuing care senior housing community (CCSHC) that is comparable to other CCSHCs in the US with respect to residents’ demographic characteristics. Method: Participants were 110 older adult residents of the independent living unit. We assessed sociodemographics, mental health, neurocognitive functioning, and functional capacity. Results: Compared to normative samples, participants performed at or above expectations in terms of premorbid functioning, attention span and working memory, processing speed, timed set-shifting, inhibitory control, and confrontation naming. They performed below expectation in verbal fluency and verbal and visual learning and memory, with impairment rates [31.4% (>1 SD below the mean) and 18.49% (>1.5 SD below the mean)] well above the general population (16% and 7%, respectively). Within the cognitive test battery, two tests of delayed memory were most predictive of a global deficit score. Most cognitive test scores correlated with performance-based functional capacity. Conclusions: Overall, results suggest that a subset of older adults in the independent living sector of CCSHCs are cognitively and functionally impaired and are at risk for future dementia. Results also argue for the inclusion of memory tests in abbreviated screening batteries in this population. We suggest that CCSHCs implement regular cognitive screening procedures to identify and triage those older adults who could benefit from interventions and, potentially, a transition to a higher level of care.

EFFECTS OF COMPUTERIZED COGNITIVE TRAINING ON GAIT SPEED IN COMMUNITY DWELLING OLDER ADULTS, A PILOT STUDY

2016 ◽  
pp. 1-6
Author(s):  
J. Blackwood ◽  
T. Houston
Keyword(s):  
Older Adults ◽  
Cognitive Training ◽  
Gait Speed ◽  
Independent Living ◽  
Functional Decline ◽  
Community Dwelling ◽  
Computerized Cognitive Training ◽  
Home Based ◽  
Improved Function ◽  
Community Dwelling Older Adults

Background: In older adults declines in gait speed have been identified as predictors of functional decline and have been found in those with cognitive dysfunction. Cognitive training interventions that emphasize addressing executive function (EF) have resulted in a transfer effect from training cognitive processes into improved function. However research examining the effects of an EF specific computerized cognitive training (CCT) program on gait speed (GS) is limited. Objectives: To compare the effects of a six week EF specific CCT program on GS in community dwelling older adults using a pretest/posttest experimental design with subgroup comparisons based on a cutoff GS of 1.0m/s. Setting: Home based Participants: Forty independent living older adults (>65 years) without diagnosed cognitive impairment participated in either the intervention or control groups. Intervention: A six week long progressively challenging EF focused CCT program was performed at home. Measurements: Demographic variables, cognitive function (Trail-Making Test Part B) and GS were measured at baseline at week 7. Between group comparisons were completed for the whole sample initially with subgroup comparisons performed based on participants’ initial GS (Slow walkers: GS<1.0m/s; Fast Walkers: GS>1.0m/s). Results: No differences in GS were found for the whole population, but subgroup analyses restricted to slow walkers demonstrated a statistically significant improvement in GS after 6 weeks of CCT (µ =0.33 m/s, p = 0.03). Other outcomes measures were not statistically different at posttest. Conclusions: Older adults who walk at speeds <1.0m/s may benefit from a progressively challenging CCT program when self-administered in the home.

Bingocize®: Utilizing a mobile application to improve gait in community-dwelling older adults

2018 ◽  
Vol 17 (2) ◽  
pp. 9
Author(s):  
Dustin Falls, MS ◽  
Matthew Shake, PhD ◽  
Elizabeth Norris, PhD, PT, OCS ◽  
Scott Arnett, PhD, CSCS,*D ◽  
Jenn Taylor, MS, CTRS ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Gait Speed ◽  
Independent Living ◽  
Mixed Model ◽  
Community Dwelling ◽  
Health Promotion Program ◽  
Post Intervention ◽  
Gait Performance ◽  
Community Dwelling Older Adults

Physical activity (PA) can improve older adults’ gait performance and decrease fall risks, yet adherence to PA programs is low. The purpose of this study was to evaluate the efficacy of a game-centered mobile health promotion application (app) to improve gait performance in community-dwelling older adults. Participants (N = 38; age 72.42 ± 12.58) from four independent living facilities were randomly assigned to experimental (n = 20; app with exercise) or control (n = 18; app without exercise) conditions. Each condition completed a 10-week intervention using an inclusive evidence-based health promotion program that combines bingo and exercise, Bingocize®. The investigators collected baseline/post gait assessments 1 week prior and 1-week post intervention. Data were analyzed using a mixed-model ANOVA (p < 0.05). There were no main effects; however, significant interactions (group × time) were observed, and interactions for gait speed (>5 cm/s) were observed in the experimental condition. Research supports this increase as a meaningful clinical change in gait speed, which may potentially reduce the risk of falls.

scholarly journals A Scoping Review of Digital Solutions that Might be Used as Cognitive Screening Instruments of Community-Dwelling Older Adults

2022 ◽  
Vol 196 ◽  
pp. 956-963
Author(s):  
Rute Bastardo ◽  
João Pavão ◽  
Ana Isabel Martins ◽  
Anabela G. Silva ◽  
Nelson Pacheco Rocha
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Community Dwelling ◽  
Screening Instruments ◽  
Cognitive Screening ◽  
Community Dwelling Older Adults

scholarly journals Stress and Adjustment During the COVID-19 Pandemic: A Qualitative Study on the Lived Experience of Older Adults

2021 ◽  
Author(s):  
Alexandra J. Jasmine Fiocco ◽  
Charlie Gryspeerdt ◽  
Giselle Franco
Keyword(s):  
Older Adults ◽  
Lived Experience ◽  
Social Isolation ◽  
Independent Living ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Behavioral Strategies ◽  
Increased Risk ◽  
The Impact ◽  
Community Dwelling Older Adults

In response to the COVID-19 pandemic, social distancing measures were put into place to flatten the pandemic curve. It was projected older adults were at increased risk for poor psychological and health outcomes resulting from increased social isolation and loneliness. However, little re-search has supported this projection among community-dwelling older adults. While growing body of research has examined the impact of the COVID-19 pandemic on older adults, there is a paucity of qualitative research that captures the lived experience of community-dwelling older adults. The current study aimed to better understand the lived experience of community-dwelling older adults during the first six months of the pandemic. Semi-structured one on one interviews were conducting with independent living older adults aged 65 years and older. After achieving saturation, 22 interview were analyzed using inductive thematic analysis. Following a recursive process, two overarching themes emerged from the data: perceived threat and challenges of the pandemic and coping with the pandemic. Specifically, participants reflected on the threat of contracting the virus and challenges associated with living arrangement, social isolation, and financial insecurity. Participants shared their coping strategies to maintain health and wellbeing, including behavioral strategies, emotion-focused strategies, and social support. Overall, this re-search highlights resilience among older adults during the first six months of the pandemic.

scholarly journals Longitudinal Association of Executive Function and Balance in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 700-700
Author(s):  
Jennifer Blackwood ◽  
Reza Amini ◽  
Gerry Conti ◽  
Quinn Hanses ◽  
Rebekah Taylor ◽  
...  
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Best Practice ◽  
Secondary Data ◽  
Community Dwelling ◽  
Balance Performance ◽  
Cross Sectional ◽  
Clock Drawing Test ◽  
Single Leg Stance ◽  
Community Dwelling Older Adults

Abstract Declines in Executive Function (EF) are associated with balance in community-dwelling older adults with Mild Cognitive Impairment (MCI). While this has been examined in cross-sectional studies, no longitudinal studies describe change over time. The purpose of this study was to examine how performance on the components of the Short Physical Performance Battery (SPPB) are associated with EF in community-dwelling older adults who transition into MCI. This secondary data analysis employed eight years of data from the National Health and Aging Trends Study dataset (2011 – 2018) with 1,225 participants in all eight waves (balanced). EF was measured with the Clock Drawing Test and SPPB balance tests included side-by-side, semi-tandem, full tandem, and single leg stance with eyes open or closed. Longitudinal ordered logistic regression was used to examine associations between each balance measure and EF while controlling for comorbidity, function, depression, gender, age, and ethnicity. EF was significantly associated with tandem, semi-tandem, and single leg stance after controlling for covariates. One point increase in SPPB can reduce the risk of EF impairment by 8.2% (Odds Ratio (OR)=0.918, p&lt;0.001). Among SPPB components, semi-tandem (OR=0.468) and side-by-side (OR=0.472) were the strongest predictors of EF impairment. Declines in both EF and balance performance occurred over an eight-year period in adults. This may reflect common neural processes shared between the cognitive and motor areas of the central nervous system. Best practice suggests screening both balance (tandem, semi-tandem, or single leg stance) and EF in the clinical assessment of community-dwelling older adults.

Influence of Frailty Phenotype Items on Functional Capacity and Falls Occurrence in Frail Community-Dwelling Older Adults

2016 ◽  
Vol 32 (2) ◽  
pp. 74-80
Author(s):  
Silvia Lanziotti Azevedo da Silva ◽  
Joana Ude Viana ◽  
Anita Liberalesso Neri ◽  
Eduardo Ferriolli ◽  
Roberto Alves Lourenço ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
Community Dwelling ◽  
Frailty Phenotype ◽  
Community Dwelling Older Adults

Impaired Higher-Level Functional Capacity as a Predictor of Stroke in Community-Dwelling Older Adults

Stroke ◽  
2016 ◽  
Vol 47 (2) ◽  
pp. 323-328 ◽  
Author(s):  
Keiko Murakami ◽  
Megumi Tsubota-Utsugi ◽  
Michihiro Satoh ◽  
Kei Asayama ◽  
Ryusuke Inoue ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

Screening to Assessment Pathways in Evaluating Functional Cognition in Older Adults

2021 ◽  
pp. 153944922110218
Author(s):  
Timothy S. Marks ◽  
Gordon M. Giles ◽  
Muhammad O. Al-Heizan ◽  
Dorothy F. Edwards
Keyword(s):  
Older Adults ◽  
Cognitive Assessment ◽  
Screening Test ◽  
Discriminant Validity ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Screening Tests ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Community Dwelling Older Adults

Identification of functional cognitive deficits can facilitate intervention to improve outcomes among older adults. We aimed to determine if impairments on screening tests of cognition are associated with deficits in performance on a more extensive functional cognitive assessment. Using a cross-sectional study design we administered the Montreal Cognitive Assessment (MoCA), the Mini-Cog, the Menu Task, and Weekly Calendar Planning Activity (WCPA) to a convenience sample of 277 community-dwelling older adults (55–93 years old). We created impaired and unimpaired groups using an established cut-off score for each screening test and compared each group on WCPA scores. The WCPA scores that demonstrated significant differences across screening measures were: Accuracy, Efficiency, Strategies, Rules, and Appointments Entered. Effect sizes for the WCPA scores Accuracy and Efficiency were large. Each screening test demonstrated discriminant validity on select WCPA scores and appear to be appropriate for use as screening tests of functional cognition.

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