The virtual cognitive health (VC Health) study: design, recruitment, and baseline characteristics of a fully remote single-arm pre-post study to prevent or delay cognitive impairment in older adults (Preprint)

BACKGROUND A growing body of evidence supports the use of lifestyle interventions for preventing or delaying the onset of Alzheimer’s disease (AD) and other forms of dementia in at-risk individuals. The development of virtually delivered programs would increase the scalability and reach of these interventions, but requires validation to ensure similar efficacy to brick and mortar options. OBJECTIVE The aims of this study are to describe the study design, recruitment process, and baseline participant characteristics of the sample in the virtual cognitive health (VC Health) study. Future analyses will assess the impact of the remotely delivered lifestyle intervention on (1) cognitive function, (2) depression and anxiety, and (3) various lifestyle behaviors, including diet, exercise, and sleep in a cohort of older adults with subjective memory decline. Additional analyses will explore feasibility outcomes, as well as the participants’ engagement patterns with the program. METHODS Older adults (age 60-75) with subjective memory decline as measured by the Subjective Cognitive Decline (SCD-9) questionnaire, and who reported feeling worried about their memory decline, were eligible to participate in this single-arm pre-post study. All participants enrolled in the year-long virtual intervention, which consists of health coach-guided lifestyle change for improving diet, exercise, sleep, stress, and cognition. All components of this study were conducted virtually, including the collection of data and the administration of the intervention. Participants were assessed at baseline, 12 weeks, 24 weeks, and 52 weeks with online surveys and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test. Intention-to-treat analysis will be conducted on all outcomes. RESULTS A total of 85 participants enrolled in the intervention and 82 are included in the study sample (3 participants withdrew). The study cohort is 74% female, 88% Caucasian, 78% overweight or obese, and 67% have at least a college degree. The average baseline RBANS score was 95.9±11.1, which is within age-adjusted norms. The average SCD-9 score was 6.0±2.0, indicating minor subjective cognitive impairment at the beginning of the study. Average baseline Generalized Anxiety Disorder (GAD-7) scores were 6.2±4.5 and Patient Health Questionnaire (PHQ-9) scores were 8.5±4.9, indicating mild levels of anxiety and depression at baseline. CONCLUSIONS Virtually delivered lifestyle interventions may represent a scalable solution for the prevention or delay of AD. The results of this study will provide the first evidence for the efficacy of a fully remote intervention and lay the groundwork for future investigations. CLINICALTRIAL NCT02969460

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Fear of memory decline predicts lower quality of life and increased memory failures in older adults: Preliminary findings from a novel fear-avoidance of memory decline scale.

10.31234/osf.io/vugny ◽

2020 ◽

Author(s):

Francesca Farina ◽

Marc Patrick Bennett ◽

James William Griffith ◽

Bert Lenaert

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Memory Performance ◽

Fear Avoidance ◽

Subjective Memory ◽

Memory Decline ◽

General Anxiety ◽

Quality Of Life Scale ◽

The Impact

Evidence concerning the impact of fear of memory decline on health-related outcomes is limited. To determine the relationship between fear-avoidance of memory decline, quality of life and subjective memory in older adults using a novel scale to measure fear of memory decline. Sixty-seven older adults (59-81 years) completed a 23-item self-report questionnaire designed to capture experiential, cognitive and behavioral components of fear of memory decline, known as the fear and avoidance of memory decline (FAM) scale. Memory performance was assessed using the Wechsler Memory Scale (WMS-IV) and the Memory Failures Scale (MFS). General anxiety was assessed using the Depression, Anxiety and Stress Scales (DASS) and the Geriatric Anxiety Inventory (GAI). Quality of life was assessed using the Older Person’s Quality of Life scale (OPQOL-35). The FAM scale demonstrated good reliability and validity. Three latent factors were observed including: (1) fear-avoidance, (2) problematic beliefs and (3) resilience. After adjusting for age, education, memory performance and general anxiety, higher fear-avoidance predicted lower quality of life (p=.021) and increased memory failures (p=.022). Increased fear of memory decline predicts lower quality of life and subjective memory failures in healthy older adults. Based on these findings, we propose a preliminary fear-avoidance model that explains the development and maintenance of dementia-related functional disability in terms of psychological processes.

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Preventing Loss of Independence through Exercise (PLIÉ): A Pilot Trial in Older Adults with Subjective Memory Decline and Mild Cognitive Impairment

Journal of Alzheimer s Disease ◽

10.3233/jad-210159 ◽

2021 ◽

pp. 1-15

Author(s):

Linda L. Chao ◽

Jennifer A. Lee ◽

Steven Martinez ◽

Cody Barlow ◽

Margaret A. Chesney ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Functional Connectivity ◽

Social Isolation ◽

Self Regulation ◽

Pilot Trial ◽

Well Being ◽

Subjective Memory ◽

Memory Decline

Background: Preventing Loss of Independence through Exercise (PLIÉ) is a group movement program initially developed for people with mild-to-moderate dementia that integrates principles from several well-established traditions to specifically addresses the needs of people with cognitive impairment. Objective: To investigate whether PLIÉ would benefit cognitive and behavioral outcomes and functional brain connectivity in older adults with milder forms of cognitive impairment. Methods: Participants (≥55 y) with subjective memory decline (SMD) or mild cognitive impairment (MCI) were assessed with tests of cognitive and physical function, self-report questionnaires, and resting state functional magnetic resonance imaging (rs-fMRI) on a 3 Tesla scanner before and after participating in twice weekly PLIÉ classes for 12 weeks at the San Francisco Veterans Affairs Medical Center. Results: Eighteen participants completed the pre-post intervention pilot trial. We observed significant improvements on the Alzheimer’s Disease Assessment Scale cognitive subscale (ADAS-cog; effect size 0.34, p = 0.002) and enhanced functional connections between the medial prefrontal cortex (mPFC) and other nodes of the default mode network (DMN) after PLIÉ. Improvements (i.e., lower scores) on ADAS-cog were significantly correlated with enhanced functional connectivity between the mPFC and left lateral parietal cortex (Spearman’s ρ= –0.74, p = 0.001) and between the mPFC and right hippocampus (Spearman’s ρ= –0.83, p = 0.001). After completing PLIÉ, participants reported significant reductions in feelings of social isolation and improvements in well-being and interoceptive self-regulation. Conclusion: These preliminary findings of post-PLIÉ improvements in DMN functional connectivity, cognition, interoceptive self-regulation, well-being and reduced feelings of social isolation warrant larger randomized, controlled trials of PLIÉ in older adults with SMD and MCI.

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A Remote Intervention to Prevent or Delay Cognitive Impairment in Older Adults: Design, Recruitment, and Baseline Characteristics of the Virtual Cognitive Health (VC Health) Study

JMIR Research Protocols ◽

10.2196/11368 ◽

2018 ◽

Vol 7 (8) ◽

pp. e11368 ◽

Cited By ~ 10

Author(s):

Nicholas Bott ◽

Shefali Kumar ◽

Caitlyn Krebs ◽

Jordan M Glenn ◽

Erica N Madero ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Health Study ◽

Cognitive Health ◽

Baseline Characteristics

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Social and Behavioral Factors, Oral Health, and Dental Care Utilization

Innovation in Aging ◽

10.1093/geroni/igaa057.2899 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 799-800

Author(s):

Bei Wu ◽

Stephen Shuman ◽

Elisa Ghezzi

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Oral Health ◽

Health Outcomes ◽

Dental Care ◽

Care Utilization ◽

Behavioral Factors ◽

Dental Care Utilization ◽

The Impact ◽

The U.S

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.

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Qualitative Evaluation Informs Understanding of Motor Cognition and Therapies in Older Adults with Mild Cognitive Impairment

Journal of Alzheimer s Disease ◽

10.3233/jad-210617 ◽

2021 ◽

pp. 1-13

Author(s):

David Lazris ◽

Molly M. Perkins ◽

Allison A. Bay ◽

Madeleine E. Hackney

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Black Women ◽

Qualitative Evaluation ◽

Social Benefit ◽

Lifestyle Changes ◽

Cognitive Integration ◽

Subjective Memory ◽

Predominantly Black

Background: 10%to 20%of Americans aged 65 and older have mild cognitive impairment (MCI) with 10%progressing to Alzheimer’s disease (AD) each year. Underserved groups, including African Americans (AAs), are among the most vulnerable to MCI and AD. Although evidence continues to amass, the benefits of exercise and movement for AD is still understudied in AD. Objective: Understanding the attitudes, perceptions, and beliefs about motor-cognitive integration and examining the physical activity of a sample of predominantly Black women community members with self-reported memory problems will allow improved recruitment and refinement of multimodal interventions designed to improve motor-cognitive and cognitive function. Methods: We conducted focus groups with older adults who reported subjective memory complaints (n = 15; Black: n = 12, White: n = 3, mean age 71.7±5.8). Results: Findings from thematic analysis showed most participants knew of benefits of exercise. However, most participants reported not getting adequate exercise due to factors such as pain, increased responsibilities, and fears of injury. Despite barriers, participants expressed enthusiasm for multimodal interventions designed to target body and brain health and provided several suggestions to improve or enhance the proposed interventions. Conclusion: Results provide useful insights regarding improving participation among historically under-represented groups in clinical movement-based research. Participants’ discussion focused primarily on the way motor-cognitive integration prevents falls, maintains memory, and provides a social benefit. The reported perceived benefits and limitations of exercise, as this population understands it, can help researchers and physicians better engage the community for lifestyle changes that will support greater motor-cognitive health.

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Memory and Cognitive Function of Older Adults according to Subjective Memory Decline, Depression

Indian Journal of Science and Technology ◽

10.17485/ijst/2016/v9is1/109913 ◽

2016 ◽

Vol 9 (S1) ◽

Author(s):

Hye Sun Byun ◽

Yongsuk Kim ◽

Ho Jin Lee

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Subjective Memory ◽

Memory Decline

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Cognitive Outcomes during COVID-19 confiNemeNt in Elderly and their Caregivers using Technologies for DEMentia (CONNECT DEM): study protocol (Preprint)

10.2196/preprints.26431 ◽

2020 ◽

Author(s):

Jessica Marian Goodman-Casanova ◽

Elena Dura-Perez ◽

Gloria Guerrero-Pertiñez ◽

Pilar Barnestein-Fonseca ◽

Jose Guzman-Parra ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Social Isolation ◽

Community Dwelling ◽

Mild Dementia ◽

Care Services ◽

Health And Social Care ◽

The Impact ◽

Community Dwelling Older Adults

BACKGROUND Coronavirus disease 2019 has forced worldwide the implementation of unprecedented restrictions to control its rapid spread and mitigate its impact. The Spanish government has enforced social distancing, quarantine and home confinement. This restriction of daily life activities and separation from loved ones may lead to social isolation and loneliness with health-related consequences in community-dwelling older adults with mild cognitive impairment or mild dementia and their caregivers. Additionally, an inadequate access to healthcare and social support services may aggravate chronic conditions. Technology home-based interventions emerge for combating social isolation and loneliness preventing the risk of viral exposure. OBJECTIVE The aim of this cohort study is to explore, analyze and determine the impact of social isolation on: 1) cognition, quality of life, mood, technophilia and perceived stress of community-dwelling older adults with mild cognitive impairment or mild dementia, and on caregiver burden; 2) health and social care services access and utilization, and 3) cognitive, social and entertainment use of ICTs. METHODS This study will be conducted in the Spanish region of Andalucía (Málaga). In total 200 dyads, consisting of a person with mild cognitive impairment or mild dementia (PMCI/MD) and their informal caregiver will be contacted by telephone. Potential respondents will be participants of the SMART 4 MD (N=100) and TV-AssistDem (N=100) clinical trials. RESULTS The change in means in the variables will be analyzed comparing baseline results in the previous studies with those during and after confinement using the ANOVA test of repeated measures or the non-parametric Friedman test if appropriate. The performance of a multivariate analysis of variance (ANCOVA) to introduce possible covariates will also be contemplated. A 95% confidence level will be used. CONCLUSIONS If the hypothesis is proven, these findings will demonstrate the negative impact of social isolation due to the COVID-19 confinement on cognition, quality of life, mood, and perceived stress of community-dwelling older adults with mild cognitive impairment and mild dementia, the impact on technophilia, caregiver burden, and health and social care services access and utilization; and the cognitive, social and entertainment use of ICTs during the COVID-19 confinement and afterwards. CLINICALTRIAL NCT: 04385797

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