scholarly journals Cognitive decline, functional dependency and sociodemographic characteristics in elderly patients with bone fractures

2015 ◽  
Vol 5 (2) ◽  
pp. 221-232
Author(s):  
Ana R. Ortega ◽  
Mª José Calero
Keyword(s):  
Elderly Patients ◽  
Cognitive Decline ◽  
Bone Fractures ◽  
Functional Decline ◽  
The Elderly ◽  
Structured Interview ◽  
Demographic Variables ◽  
Cognitive Status ◽  
Functional Dependency ◽  
Functional Gain

The objective of this paper was to study the evolution of cognitive status and of functional dependency in patients over 65 and how these relate to different demographic variables. The sample consisted of 259 elderly people admitted to the Hospital Neurotraumatológico in Jaen (Spain) with a diagnosis of bone fracture. Sociodemographic data was obtained through a semi-structured interview. Furthermore, the following tests were also administered: Barthel Index, Lawton and Brody’s Scale, Phototest, and Informant Questionnaire on Cognitive Decline in the Elderly. According to the results of this study, elderly patients show increased dependency during hospitalization and a mild recovery at discharge, but without regaining their dependency values prior to hospitalization. There is a differential incidence of functional decline as a function of gender, where women have significantly lower functional dependency at home than men and they do not decline as much as men do from their status prior to hospitalization. Also, we have encountered significant inverse relations between the different levels of dependency and cognitive status, and the age of the elderly patient. Moreover, married patients experienced greater functional gain than did the widowed patients, regardless of gender.

scholarly journals Cognitive decline, functional dependency and sociodemographic characteristics in elderly patients with bone fractures

2015 ◽  
Vol 5 (2) ◽  
pp. 221-232
Author(s):  
Ana R. Ortega ◽  
Mª José Calero
Keyword(s):  
Elderly Patients ◽  
Cognitive Decline ◽  
Bone Fractures ◽  
Functional Decline ◽  
The Elderly ◽  
Structured Interview ◽  
Demographic Variables ◽  
Cognitive Status ◽  
Functional Dependency ◽  
Functional Gain

The objective of this paper was to study the evolution of cognitive status and of functional dependency in patients over 65 and how these relate to different demographic variables. The sample consisted of 259 elderly people admitted to the Hospital Neurotraumatológico in Jaen (Spain) with a diagnosis of bone fracture. Sociodemographic data was obtained through a semi-structured interview. Furthermore, the following tests were also administered: Barthel Index, Lawton and Brody’s Scale, Phototest, and Informant Questionnaire on Cognitive Decline in the Elderly. According to the results of this study, elderly patients show increased dependency during hospitalization and a mild recovery at discharge, but without regaining their dependency values prior to hospitalization. There is a differential incidence of functional decline as a function of gender, where women have significantly lower functional dependency at home than men and they do not decline as much as men do from their status prior to hospitalization. Also, we have encountered significant inverse relations between the different levels of dependency and cognitive status, and the age of the elderly patient. Moreover, married patients experienced greater functional gain than did the widowed patients, regardless of gender.

scholarly journals Post-infection cognitive impairments in a cohort of elderly patients with COVID-19

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu-Hui Liu ◽  
Ye-Ran Wang ◽  
Qing-Hua Wang ◽  
Yang Chen ◽  
Xian Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Cognitive Decline ◽  
Post Infection ◽  
Elderly Population ◽  
The Elderly ◽  
Cognitive Status ◽  
Increased Risk

Abstract Background Understanding the long-term effects of coronavirus disease 2019 (COVID-19) on cognitive function is essential for monitoring the cognitive decline in the elderly population. This study aims to assess the current cognitive status and the longitudinal cognitive decline in elderly patients recovered from COVID-19. Methods This cross-sectional study recruited 1539 COVID-19 inpatients aged over 60 years who were discharged from three COVID-19-designated hospitals in Wuhan, China, from February 10 to April 10, 2020. In total, 466 uninfected spouses of COVID-19 patients were selected as controls. The current cognitive status was assessed using a Chinese version of the Telephone Interview of Cognitive Status-40 (TICS-40) and the longitudinal cognitive decline was assessed using an Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cognitive assessments were performed 6 months after patient discharge. Results Compared with controls, COVID-19 patients had lower TICS-40 scores and higher IQCODE scores [TICS-40 median (IQR): 29 (25 to 32) vs. 30 (26 to 33), p < 0.001; IQCODE median (IQR): 3.19 (3.00 to 3.63) vs. 3.06 (3.00 to 3.38), p < 0.001]. Severe COVID-19 patients had lower TICS-40 scores and higher IQCODE scores than non-severe COVID-19 patients [TICS-40 median (IQR): 24 (18 to 28) vs. 30 (26 to 33), p < 0.001; IQCODE median (IQR): 3.63 (3.13 to 4.31) vs. 3.13 (3.00 to 3.56), p < 0.001] and controls [TICS-40 median (IQR): 24 (18 to 28) vs. 30 (26 to 33), p < 0.001; IQCODE median (IQR) 3.63 (3.13 to 4.31) vs. 3.06 (3.00 to 3.38), p < 0.001]. Severe COVID-19 patients had a higher proportion of cases with current cognitive impairment and longitudinal cognitive decline than non-severe COVID-19 patients [dementia: 25 (10.50 %) vs. 9 (0.69 %), p < 0.001; Mild cognitive impairment (MCI): 60 (25.21 %) vs. 63 (4.84 %), p < 0.001] and controls [dementia: 25 (10.50 %) vs. 0 (0 %), p < 0.001; MCI: 60 (25.21 %) vs. 20 (4.29 %), p < 0.001)]. COVID-19 severity, delirium and COPD were risk factors of current cognitive impairment. Low education level, severe COVID-19, delirium, hypertension and COPD were risk factors of longitudinal cognitive decline. Conclusions Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with an increased risk of long-term cognitive decline in elderly population. COVID-19 patients, especially severe patients, should be intensively monitored for post-infection cognitive decline.

Relation between cognitive disorders and type of physical activity: Results of the FréLE cohort

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Dupré ◽  
N Barth ◽  
A El Moutawakkil ◽  
F Béland ◽  
F Roche ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Decline ◽  
Proportional Hazards ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Cognitive Status ◽  
Global Test ◽  
Professional Activities ◽  
Beneficial Effects ◽  
The Impact

Abstract Background Few previous cohorts have studied the different type of physical activities and the degree of cognitive decline. The objective of this work was to analyze the leisure, domestic and professional activities with mild and moderate cognitive disorders in older people living in community. Methods The study used data from the longitudinal and observational study, FrèLE (FRagility: Longitudinal Study of Expressions). The collected data included: socio-demographic variables, lifestyle, and health status (frailty, comorbidities, cognitive status, depression). Cognitive decline was assessed by using: MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment). MoCA was used with two cut-offs (26 and 17) so as to define mild and moderate cognitive disorders Physical activity was assessed by the PASE (Physical Activity Scale for the Elderly), structured in three sections: leisure, domestic and professional activities. Spline and proportional hazards regression models (Cox) were used to estimate the risk of cognitive disorders. Results At baseline, 1623 participants were included and the prevalence of cognitive disorders was 6.9% (MMSE) and 7.2% (MoCA), mild cognitive disorders was 71.3%. The mean age was 77 years, and 52% of the participants were women. After a 2 years long follow-up, we found 6.9% (MMSE) and 6% (MoCA) cognitive disorders on participants. Analyses showed that domestic activities were associated to cognitive decline (HR = 0.52 [0.28-0.94] for MMSE and HR = 0.48 [0.28-0.80] for MoCA). No association were found with leisure and professional activities, and no spline were significant with mild cognitive disorders. Conclusions Analysis showed a relationship between cognitive disorders and type of physical activity, thanks to the use of specific questionnaire of elderly and two global test of cognition. These findings will contribute to the debate on the beneficial effects of physical activity on cognition. Key messages This work allowed to compare two test of cognition and their link with physical activity. It contributes to the debate on the beneficial effects of physical activity on cognition. The work allowed us to see the effect of the different types of physical activity and the impact of the statistical method on the results.

scholarly journals The impact of cognitive impairment at admission on short-term functional outcome of elderly hip fracture patients

2010 ◽  
Vol 138 (5-6) ◽  
pp. 319-322 ◽  
Author(s):  
Emilija Dubljanin-Raspopovic ◽  
Dragana Matanovic ◽  
Marko Bumbasirevic
Keyword(s):  
Cognitive Impairment ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Functional Outcome ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Short Term ◽  
Functional Gain ◽  
The Impact ◽  
Cognitively Intact

Introduction The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome. Objective To assess the relationship between cognitive status on admission and functional gain during an early rehabilitation period in elderly hip fracture patients. Methods Forty-five elderly patients with surgically treated hip fracture were examined. Cognitive status was assessed by the Mini Mental State Examination (MMSE) at admission; functional status was assessed by the motor subscale of Functional Independence Measure (FIM) at admission and before discharge, while absolute functional gain was determined by the motor FIM gain (FIM discharge - FIM admission). Absolute functional gain was analyzed in respect to cognitive status. Results Both cognitively impaired and cognitively intact hip fracture patients exhibited overall FIM motor improvements, as well as functional gains in specific FIM motor areas (p<0.01). Absolute functional gain, however, was higher in 1) cognitively intact compared to cognitively impaired patients (p<0.01), and 2) cognitively moderately impaired patients compared to severely cognitively impaired patients (p<0.01). No difference in functional gain was detected between the patients with moderately cognitively impaired compared to the cognitive intact patients (p>0.05). Conclusion The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favorable short term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best achievable outcome to be reached.

scholarly journals The influence of schooling on cognitive screening test in the elderly

2007 ◽  
Vol 1 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Gustavo Christofoletti ◽  
Merlyn Mércia Oliani ◽  
Florindo Stella ◽  
Sebastião Gobbi ◽  
Lílian Teresa Bucken Gobbi
Keyword(s):  
Cognitive Decline ◽  
Educational Level ◽  
Screening Test ◽  
Neuropsychological Tests ◽  
Formal Education ◽  
The Elderly ◽  
Cognitive Status ◽  
Cognitive Screening ◽  
Screening Battery ◽  
Cognitive Screening Test

Abstract Introduction: Tests for screening cognitive functions are gaining importance with the increasing incidence and prevalence of demential syndromes. For our elderly population, the challenge is to develop neuropsychological tests independent from the influence of educational level. Objective: To compare the influence of education on the elderly with or without cognitive decline, on the Brief Cognitive Screening Battery (BCSB). Methods: We studied 176 elderly people: 60 with cognitive decline (aged 73.6±9.3 years and with 5.7±0.7 years of education) and 116 without cognitive impairments (aged 73.4±0.6 years and with 5.6±0.5 years of education). The BCSB was applied in all subjects. The data were submitted to descriptive statistics and analyzed by Independent Student test with 95% confidence intervals. Results: The data showed that the BCSB is an appropriate battery for identifying cognitive status in normal elderly individuals, as well as cognitive decline in our elderly sample. The BCSB items were not significantly influenced by schooling years, making this test favorable for different groups characterized by illiterate individuals, as well as by those with low or high levels of formal education. Conclusion: The BCSB proved to be a useful cognitive screening test for old people with or without cognitive decline independent of their educational level.

scholarly journals Prevalence of Dry Mouth and Associated Demographic, Behavioral and Clinical Factors: A Hospital-based Study among the Elderly in Dar Es Salaam

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Anna Joseph Lyimo ◽  
Makoye Mang'oma Ndalahwa ◽  
Irene Kida Minja
Keyword(s):  
Elderly Patients ◽  
Systemic Disease ◽  
The Elderly ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Referral Hospital ◽  
Dry Mouth ◽  
Chi Square ◽  
Cross Sectional

Aim: This study aimed at determining the prevalence of self-reported and clinically determined dry mouth among elderly patients attending a referral hospital in Dar es Salaam; and to assess factors associated with the condition. Methodology: This cross-sectional study included elderly patients aged 60 years and above who were attending Mwananyamala referral hospital in Dar es Salaam between January and February 2017. Data was collected using structured interview questionnaire, followed by clinical oral examination. Chi-square test was used to check for bivariate associations between variables; and multiple logistic regressions to determine relative contribution of demographic, behavioral and clinical variables on dry mouth. Results: Information was obtained from a total number of 334 elderly patients aged 60-90 years, response rate 86%. The prevalence of self-reported dry mouth (xerostomia) was 65.3% and clinically determined dry mouth 64.1%. Multiple logistic regression analyses revealed that elderly participants who were 70+ years old (OR=2.0, CI=1.1-3.6 and OR=2.5, CI=1.5-4.4); those who used tobacco (OR=2.1; C.I=1.2-3.5 and OR=2.9; CI=1.5-5.6,); those having at least one tooth with cervical caries (OR=1.7, CI=1.0-2.9 and OR=2.9; C.I=1.7-5.1) and poor oral hygiene (OR=2.7; C.I=1.6-4.5 and OR=4.3; C.I=2.5-7.3) were significantly at higher odds for xerostomia and clinically determined dry mouth, respectively. Level of education, systemic disease, and use of systemic medication showed no statistically significantly association with dry mouth i.e xerostomia and clinically determined dry mouth. Conclusions: The results of this study revealed that, the prevalence of complaints of xerostomia and clinically determined dry mouth were high among elderly patients attending Mwananyamala referral hospital. The condition was significantly associated with socio demographic, clinical and behavioral factors showing the need for multi-disciplinary oral health care for this group of population.

Impact of Age and Comorbidity in Myelodysplastic Syndromes

2008 ◽  
Vol 6 (9) ◽  
pp. 927-934 ◽  
Author(s):  
Reinhard Stauder ◽  
Thomas Nösslinger ◽  
Michael Pfeilstöcker ◽  
Wolfgang R. Sperr ◽  
Friedrich Wimazal ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Elderly Patients ◽  
Myelodysplastic Syndromes ◽  
Intensive Therapy ◽  
Functional Decline ◽  
Surrogate Marker ◽  
Scoring Systems ◽  
The Elderly ◽  
Western World ◽  
Comorbidity Scores

Myelodysplastic syndromes (MDS) represent a heterogeneous group of myeloid neoplasms that are preferentially diagnosed in the elderly. With the increase in older patients with MDS in the Western world and the availability of more therapeutic options, new strategies and algorithms for optimal management and treatment of these patients must be developed. Although age is recognized as an important adverse variable affecting survival, most scoring systems have not included age in score risk calculations. Comorbidity is of particular importance and a frequent covariable in elderly patients with MDS. However, although comorbidity scores have been established and used for risk assessment in younger high-risk patients scheduled to undergo intensive therapy, these scores are only just being applied to elderly patients, with relevant results. Advanced age should not exclude a patient with MDS from appropriate treatment, and age alone should not be considered a surrogate marker for functional decline or comorbidities. This article discusses the need to improve scoring systems, individualized risk-assessment, and treatment algorithms for elderly patients with MDS by including age and comorbidities.

scholarly journals Cognition, functionality and depression indicative among elderly

Rev Rene ◽  
2016 ◽  
Vol 17 (1) ◽  
pp. 103
Author(s):  
Winnie Andaki Nunes ◽  
Flavia Aparecida Dias ◽  
Janaína Santos Nascimento ◽  
Nayara Cândida Gomes ◽  
Darlene Mara dos Santos Tavares
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Daily Living ◽  
Functional Disability ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Cognitive Status ◽  
Chi Square ◽  
Chi Square Test

to describe the socioeconomic characteristics of the elderly according to cognitive status, and, to associate the cognitive decline with functional disability and depression indicative among the elderly. Methods: this is a quantitative, retrospective and observational study with 92 elderly. The used instruments were: Mini Examination of Mental State; Katz Index; Lawton and Brody Scale and Abbreviated Geriatric Depression Scale. Statistical analysis and chi-square test (p<0.05) were used. Results: elderly with a cognitive decline for females were predominant, 80 years and older, widowed and living with children, with one to three years of study, individual income up to a minimum wage. The proportion of elderly with a dependent cognitive decline in basic activities of daily living (p=0.043) and instrumental activities of daily living (p=0.008) was higher than independent. There were no significant differences in the depression indicative (p=0.437). Conclusion: the proportion of dependent elderly was higher in those with cognitive decline.

scholarly journals Elevated Procalcitonin and Depression As Risk Factors For Postoperative Delirium In The Elderly After Cardiac Surgery – A Prospective Observational Study.

2020 ◽  
Author(s):  
Anna Kupiec ◽  
Barbara Adamik ◽  
Natalia Kozera ◽  
Waldemar Gozdzik
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Inflammatory Marker ◽  
Functional Decline ◽  
The Elderly ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Multivariable Logistic Regression Model

Abstract Background One of the most common complications after cardiac surgery is delirium. Determining the origin of this complication from possible pathomechanisms is difficult. The activation of an inflammatory response during surgery has been suggested as one possible mechanism of delirium. The usefulness of the inflammatory marker procalcitonin (PCT) as a predictor of delirium after cardiac surgery with cardiopulmonary bypass (CBP) has not yet been investigated. Methods The purpose of this study was to prospectively investigate the risk of developing postoperative delirium in a group of elderly patients using a multivariate assessment of preoperative (PCT, comorbidities, functional decline, depression) and intraoperative risk factors. 149 elderly patients were included. Delirium was assessed using the Confusion Assessment Method for the ICU. Results Thirty patients (20%) developed post-operative delirium: hypoactive in 50%, hyperactive in 33%, mixed in 17%. Preoperative PCT above the reference range (> 0.05 ng/mL) was recorded more often in patients who postoperatively developed delirium than in the non-delirium group (50% vs. 27%, p=0.019). After surgery, PCT was significantly higher in the delirium than the non-delirium group: ICU admission after surgery: 0.08 ng/mL, IQR 0.03-0.15 vs. 0.05 ng/mL, IQR 0.02-0.09, p=0.011), and for consecutive days (day 1: 0.59 ng/mL, IQR 0.25-1.55 vs. 0.25 ng/mL, IQR 0.14-0.54, p=0.003; day 2: 1.21 ng/mL, IQR 0.24-3.29 vs. 0.36 ng/mL, IQR 0.16-0.76, p=0.006; day 3: 0.76 ng/mL, IQR 0.48-2.34 vs. 0.34 ng/mL, IQR 0.14-0.66, p=0.001). Patients with delirium were older (74 years, IQR 70 – 76 vs. 69 years, IQR 67 – 74; p=0.038) and more often had functional decline (47% vs. 28%, p=0.041). There was no difference in comorbidities with the exception of anaemia (43% vs. 19%, p=0.006). Depression was detected in 40% of patients with delirium and in 17% without delirium (p=0.005). In a multivariable logistic regression model of preoperative procalcitonin (OR= 3.05; IQR 1.02-9.19), depression (OR=5.02, IQR 1.67-15.10), age (OR=1.14; IQR 1.02-1.26), functional decline (OR=0.76; IQR 0.63-0.91) along with CPB time (OR=1.04; IQR 1.02-1.06) were significant predictors of postoperative delirium. Conclusion A preoperative PCT test and assessment of functional decline and depression may help identify patients at risk for developing delirium after cardiac surgery.

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