Assessing the Reliability of Reported Medical History in Older Adults

Background: Age-associated increases in medical complexity, frailty, and cognitive impairment may compromise reliable reporting of medical history. Objective: To evaluate the influence of increasing age and cognitive impairment on concordance between reported history of stroke and cerebral infarction, and reported history of diabetes and elevated hemoglobinA1c in community-dwelling older adults. Methods: The association between participant-specific factors and accurate reporting of stroke or diabetes was evaluated using multivariable logistic regression in 1,401 participants enrolled in longitudinal studies of memory and aging, including 425 participants with dementia (30.3%). Stroke and diabetes were selected as index variables as gold standard measures of both were obtained in all participants: magnetic resonance neuroimaging for cerebral infarcts and hemoglobinA1c (≥6.5%) for diabetes. Results: Concordance between reported history of stroke and imaging-confirmed cerebral infarction was low (sensitivity: 17.4%, 8/46; specificity: 97.9%, 799/816). Small infarcts were strongly associated with inaccurate reporting (OR = 265.8; 95% CI: 86.2, 819.4), suggesting that occult/silent infarcts contributed to discordant reporting. Reporting accuracy was higher concerning diabetes (sensitivity: 83.5%, 147/176; specificity: 96.2%, 1100/1143). A history of hypertension (OR = 2.3; 95% CI: 1.3, 4.2), higher hemoglobinA1c (OR = 1.9; 95% CI: 1.5, 2.4), and hemoglobinA1c compatible with impaired glucose tolerance (OR = 3.1; 95% CI 1.8, 5.3) associated with increased odds of discordant reporting. Cognitive impairment and increased age were not independently associated with reliable reporting. Conclusion: Factors beyond advancing age and cognitive impairment appear to drive discordance in reported medical history in older participants. Objective testing for cerebral infarcts or diabetes should be performed when relevant to diagnostic or therapeutic decisions in clinical and research settings.

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Chronic Health Conditions as a Risk Factor for Falls among the Community-Dwelling US Older Adults: A Zero-Inflated Regression Modeling Approach

BioMed Research International ◽

10.1155/2017/5146378 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 22

Author(s):

Yoshita Paliwal ◽

Patricia W. Slattum ◽

Scott M. Ratliff

Keyword(s):

Older Adults ◽

Risk Factor ◽

Medical History ◽

Community Dwelling ◽

Chronic Health Conditions ◽

Health Conditions ◽

Health Concern ◽

Chronic Health ◽

History Of ◽

First Time

Falls are an important health concern among older adults due to age-related changes in the body. Having a medical history of chronic health condition may pose even higher risk of falling. Only few studies have assessed a number of chronic health conditions as risk factor for falls over a large nationally representative sample of US older adults. In this study, Behavioral Risk Factor Surveillance System (BRFSS) 2014 participants aged 65 years and older (n = 159,336) were evaluated. It was found that 29.7% (n=44,550) of the sample experienced at least one fall and 16.3% (n=20,444) experienced more than one fall in the past 12 months. According to the study findings, having a medical history of stroke, CKD, arthritis, depression, and diabetes independently predict the risk of first-time falling as well as the risk of recurrent falling in older adult population while controlling for other factors. On the other hand, having a medical history of the heart attack, angina, asthma, and COPD did not predict the risk of first-time falling, but did predict the risk of recurrent falling after experiencing the first fall in this population.

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Usability and acceptability of technology for community-dwelling older adults with mild cognitive impairment and dementia: a systematic literature review

Clinical Interventions in Aging ◽

10.2147/cia.s154717 ◽

2018 ◽

Vol Volume 13 ◽

pp. 863-886 ◽

Cited By ~ 36

Author(s):

Torhild Holthe ◽

Liv Halvorsrud ◽

Dag Karterud ◽

Kari-Anne Hoel ◽

Anne Lund

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Literature Review ◽

Systematic Literature Review ◽

Community Dwelling ◽

Community Dwelling Older Adults

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Do Communication Patterns Affect the Association between Cognitive Impairment and Hearing Loss among Older Adults in Vietnam?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041603 ◽

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.

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Exploring the Association between Multimorbidity and Cognitive Impairment in Older Adults Living in the Community: A Review of the Literature

Home Health Care Management & Practice ◽

10.1177/10848223211030468 ◽

2021 ◽

pp. 108482232110304

Author(s):

Grace F. Wittenberg ◽

Michelle A. McKay ◽

Melissa O’Connor

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Assessment Tool ◽

Adult Population ◽

Home Health ◽

Adverse Outcomes ◽

Community Dwelling ◽

Cognitive Screening ◽

Review Of The Literature ◽

Increased Risk

Two-thirds of older adults have multimorbidity (MM), or co-occurrence of two or more medical conditions. Mild cognitive impairment (CI) is found in almost 20% of older adults and can lead to further cognitive decline and increased mortality. Older adults with MM are the primary users of home health care services and are at high risk for CI development; however, there is no validated cognitive screening tool used to assess the level of CI in home health users. Given the prevalence of MM and CI in the home health setting, we conducted a review of the literature to understand this association. Due to the absence of literature on CI in home health users, the review focused on the association of MM and CI in community-dwelling older adults. Search terms included home health, older adults, cognitive impairment, and multimorbidity and were applied to the databases PubMed, CINAHL, and PsychInfo leading to eight studies eligible for review. Results show CI is associated with MM in older adults of increasing age, among minorities, and in older adults with lower levels of education. Heart disease was the most prevalent disease associated with increased CI. Sleep disorders, hypertension, arthritis, and hyperlipidemia were also significantly associated with increased CI. The presence of MM and CI was associated with increased risk for death among older adults. Further research and attention are needed regarding the use and development of a validated cognitive assessment tool for home health users to decrease adverse outcomes in the older adult population.

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A Modified CAIDE Risk Score as a Screening Tool for Cognitive Impairment in Older Adults

Journal of Alzheimer s Disease ◽

10.3233/jad-210269 ◽

2021 ◽

pp. 1-14

Author(s):

Magdalena I. Tolea ◽

Jaeyeong Heo ◽

Stephanie Chrisphonte ◽

James E. Galvin

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Impairment ◽

Risk Score ◽

Clinical Sample ◽

Community Sample ◽

Community Dwelling ◽

Cognitive Testing ◽

Risk Scores ◽

Predictive Values

Background: Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today’s US population, and requires laboratory biomarkers, which are not always available. Objective: Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. Methods: Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. Results: Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by > 85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.

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The Role of Daily Social Interactions in Detecting Mild Cognitive Impairment

Innovation in Aging ◽

10.1093/geroni/igaa057.2013 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 598-598

Author(s):

Ruixue Zhaoyang ◽

Stacey Scott ◽

Eric Cerino ◽

Martin Sliwinski

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Social Interactions ◽

Social Relationships ◽

Daily Basis ◽

Community Dwelling ◽

Normal Cognitive Function ◽

Social Markers

Abstract Social relationships play an important role in cognitive health and aging. However, it is unclear how older adult’s cognitive function affects their everyday social interactions, especially for those with mild cognitive impairment (MCI). This study examined whether older adults with intact cognition vs. MCI differed in their daily social interactions. Community-dwelling older adults from the Einstein Aging Study (N=244, 70-91 yrs) reported their social interactions five times daily for 14 consecutive days using smartphones. Compared to those with normal cognitive function, older adults with MCI reported less frequent positive social interactions (p=0.012) and in-person social activities (p=0.006) on a daily basis. These two groups, however, did not show significant differences in their social relationships assessed by a conventional global questionnaire. The results support that, relative to global social relationships, daily social interactions are more sensitive, ecologically valid social markers that can facilitate the early detection of MCI.

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Anxiety, Depression, and 1-Year Incident Cognitive Impairment in Community-Dwelling Older Adults

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2011.03521.x ◽

2011 ◽

Vol 59 (8) ◽

pp. 1421-1428 ◽

Cited By ~ 49

Author(s):

Olivier Potvin ◽

Hélène Forget ◽

Sébastien Grenier ◽

Michel Préville ◽

Carol Hudon

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Community Dwelling ◽

Anxiety Depression ◽

Community Dwelling Older Adults

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The Brief Odor Detection Test (B-ODT) for Very Early Diagnosis of Cognitive Decline: A Preliminary Study

Brain Impairment ◽

10.1017/brimp.2017.7 ◽

2017 ◽

Vol 18 (2) ◽

pp. 197-210

Author(s):

Dimitra Savvoulidou ◽

Efthymia Totikidou ◽

Chariklia Varvesiotou ◽

Magda Iakovidou ◽

Ourania Sfakianaki ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Adult Population ◽

Detection Threshold ◽

Community Dwelling ◽

Odor Detection ◽

Olfactory Impairment ◽

Older Adult Population ◽

Community Dwelling Older Adults

Olfactory impairment in older adults is associated with cognitive decline. This study describes the development of a Brief Odor Detection Test (B-ODT), and its pilot administration in community-dwelling older adults. The study aimed at examining whether the test could differentiate older adults with very mild cognitive impairment from their cognitively healthy counterparts. The sample consisted of 34 older adults (22 women), aged from 65 to 87 years. Participants were divided into two groups according to their general cognitive functioning. Odor detection was measured via vanillin solutions at the following concentrations: 150 mg/L, 30 mg/L, 15 mg/L, 3 mg/L, and .03 mg/L. The first condition of the test involved a scale administration of vanillin solutions. The second condition examined the change in air odour and it required vanillin solution of 30 mg/L and a metric ruler of 30 cm. The examiner had to place the solution at a specific distance point from each nostril. Odour identification sensitivity was secondarily measured. The results showed statistically significant differences in odour detection threshold between the two groups. In the unirhinal testing, left nostril differences of the two groups were definite. Hence, the B-ODT seems a promising instrument for very early cognitive impairment screening in older adult population.

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Self-Perceived Hearing Loss, Hearing-Help Seeking and Hearing Aid Adoption Among Older Adults in Malaysia

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418795982 ◽

2018 ◽

Vol 127 (11) ◽

pp. 798-805 ◽

Cited By ~ 1

Author(s):

Siti Zamratol Mai Sarah Mukari ◽

Wan Fazlina Wan Hashim

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Help Seeking ◽

Hearing Aid ◽

Pure Tone Audiometry ◽

Cognitive Status ◽

Community Dwelling ◽

Hearing Level ◽

Low Sensitivity ◽

Single Question

Introduction: The aims of this study were to examine the validity of self-perceived hearing loss in detecting hearing loss and factors associated with self-perceived hearing loss and hearing-help seeking and to report hearing aid adoption among a group of community-dwelling older adults in Malaysia. Methods: A total of 301 older adults (⩾60 years of age) participating in a study on aging had their hearing tested using pure-tone audiometry. Self-perceived hearing loss was assessed using a single question. Sociodemographic profile, otologic history, and general cognitive status were also obtained. Results: A single question had low sensitivity in detecting actual hearing loss: 31.3% for 4-frequency average > 25 dBHL and 48.8% for 4-frequency average > 40 dBHL. Besides hearing level, history of otorrhea and tinnitus were factors that were associated with self-perceived hearing loss among older adults with at least mild hearing loss. Hearing-help-seeking behavior was not associated with any of the tested variables. The hearing aid adoption rate was 2.7% and 7.3% among participants with 4-frequency averages > 25 dBHL and > 40 dBHL, respectively. Conclusion: The underestimation of hearing loss in the majority of older adults in this study poses a potential barrier to hearing loss intervention.

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