scholarly journals Pilot Study to Assess the Feasibility of a Mobile Unit for Remote Cognitive Screening of Isolated Elderly in Rural Areas

2021 ◽  
Vol 18 (11) ◽  
pp. 6108
Author(s):  
Radia Zeghari ◽  
Rachid Guerchouche ◽  
Minh Tran Duc ◽  
François Bremond ◽  
Maria Pascale Lemoine ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Cognitive Testing ◽  
Cognitive Screening ◽  
Mobile Unit ◽  
Mobile Clinic ◽  
Face To Face ◽  
Comparison Results ◽  
Quantitative Manner ◽  
Telemedical System

Background: Given the current COVID-19 pandemic situation, now more than ever, remote solutions for assessing and monitoring individuals with cognitive impairment are urgently needed. Older adults in particular, living in isolated rural areas or so-called ‘medical deserts’, are facing major difficulties in getting access to diagnosis and care. Telemedical approaches to assessments are promising and seem well accepted, reducing the burden of bringing patients to specialized clinics. However, many older adults are not yet adequately equipped to allow for proper implementation of this technology. A potential solution could be a mobile unit in the form of a van, equipped with the telemedical system which comes to the patients’ home. The aim of this proof-of-concept study is to evaluate the feasibility and reliability of such mobile unit settings for remote cognitive testing. Methods and analysis: eight participants (aged between 69 and 86 years old) from the city of Digne-Les-Bains volunteered for this study. A basic neuropsychological assessment, including a short clinical interview, is administered in two conditions, by telemedicine in a mobile clinic (equipped van) at a participants’ home and face to face in a specialized clinic. The administration procedure order is randomized, and the results are compared with each other. Acceptability and user experience are assessed among participants and clinicians in a qualitative and quantitative manner. Measurements of stress indicators were collected for comparison. Results: The analysis revealed no significant differences in test results between the two administration procedures. Participants were, overall, very satisfied with the mobile clinic experience and found the use of the telemedical system relatively easy. Conclusion: A mobile unit equipped with a telemedical service could represent a solution for remote cognitive testing overcoming barriers in rural areas to access specialized diagnosis and care.

The Impact of Subjective and Objective Hearing Loss on Cognition and Memory in Older Adults

2015 ◽  
Vol 20 (2) ◽  
pp. 49-57 ◽  
Author(s):  
Yvonne Rogalski ◽  
Amy Rominger
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Reading Aloud ◽  
Cognitive Testing ◽  
Professional Collaboration ◽  
Cognitive Screening ◽  
Speech Language Pathologist ◽  
Text Passage ◽  
The Impact ◽  
Audiologic Evaluation

For this exploratory cross-disciplinary study, a speech-language pathologist and an audiologist collaborated to investigate the effects of objective and subjective hearing loss on cognition and memory in 11 older adults without hearing loss (OAs), 6 older adults with unaided hearing loss (HLOAs), and 16 young adults (YAs). All participants received cognitive testing and a complete audiologic evaluation including a subjective questionnaire about perceived hearing difficulty. Memory testing involved listening to or reading aloud a text passage then verbally recalling the information. Key findings revealed that objective hearing loss and subjective hearing loss were correlated and both were associated with a cognitive screening test. Potential clinical implications are discussed and include a need for more cross-professional collaboration in assessing older adults with hearing loss.

scholarly journals Association Between Happiness and Objective/Subjective Economic Status Among Older Adults in Myanmar

2020 ◽  
Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Urban Areas ◽  
Economic Status ◽  
Wealth Index ◽  
Economic Indicator ◽  
Sampling Procedure ◽  
Household Asset ◽  
Face To Face ◽  
Urban And Rural Areas

Abstract BackgroundFew studies have examined whether objective or subjective economic status (ES) has a greater effect on the happiness of older adults in developing countries with ageing populations. This study examined whether objective/subjective economic status (ES) is associated with happiness in older adults in Myanmar.MethodA multistage, random sampling procedure and face-to-face interviews were conducted in urban and rural areas in Myanmar. The happiness of 1,200 participants aged 60+ was evaluated using a single happiness score of 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective economic indicator, was calculated from household asset items. Subjective economic status was assessed by asking “Which of the following best describes your current financial situation in light of general economic conditions?” The possible responses ranged from (1) very difficult to (5) very comfortable. ResultsThe mean happiness score was lower among participants with low objective and subjective ES than among those with medium or high objective ES (6.24 versus 6.80 points, p < 0.001) and average or higher subjective ES (5.62 versus 6.83 points, p < 0.001), respectively. Both low objective and subjective ES were negatively associated with happiness after adjusting for confounding variables (B: -0.41, 95% confidence interval [CI]: -0.69, -0.13 and B: -0.71, 95% CI: -1.00, -0.42, respectively) and stratification by region (low objective ES, urban: B: -0.52, 95% CI: -1.03, -0.02; low subjective ES, urban: B: -0.50, 95% CI: -0.96, -0.03; low objective ES, rural: B: -0.37, 95% CI: -0.73, -0.02; and low subjective ES, rural: B: -0.80, 95% CI: -1.18, -0.41). ConclusionsIn Myanmar, both objective and subjective ES might influence happiness among older adults. Although they had a similar impact on happiness in urban areas, subjective ES had a stronger impact in rural areas. Interventions for promoting happiness in older adults should consider differences in how objective/subjective ES impacts happiness in different regions, and focus should be placed not only on improving objective ES but also subjective ES in society.

Perceptions Toward Internet-Based Delivery of Hearing Aids among Older Hearing-Impaired Adults

2016 ◽  
Vol 27 (06) ◽  
pp. 441-457
Author(s):  
Navshika Chandra ◽  
Grant D. Searchfield
Keyword(s):  
Older Adults ◽  
Hearing Aids ◽  
Rural Areas ◽  
Psychological Functioning ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Fine Tuning ◽  
Face To Face ◽  
General Lack ◽  
Internet Sales

Background: Despite evidence that hearing aids can improve the social and psychological functioning of older hearing-impaired adults, hearing aid uptake is low. High cost of hearing aids and poor access to audiology services in rural areas are potential barriers to hearing aid acquisition. Methods of hearing aid delivery deviating from the traditional clinician-based model have been available to consumers for many years. One such method is Internet hearing aid sales. However, research exploring Internet-based hearing aid delivery, as a method to improve hearing aid uptake in this population, is limited. Purpose: The purpose of this study was to explore the perceptions of older hearing aid users (aged ≥65 yr) toward Internet-based hearing aid delivery. Research Design: A qualitative approach was adopted to investigate older adults’ perceptions of buying hearing aids online. Study Sample: The sample consisted of 18 participants aged between 64 and 81 yr. Fourteen men and four women participated in this study. Participants were all experienced hearing aid users. Data Collection and Analysis: Face-to-face semistructured interviews were conducted. An interview schedule guided the interview. Interviews were recorded with a voice recorder and transcribed verbatim. Thematic analysis of the data was carried out. Results: Seven main themes emerged from the data. A general lack of awareness, but willingness to learn more about Internet hearing aid sales, was found. Two perceived benefits of Internet-based hearing aid delivery were identified: lower cost of hearing aids and greater convenience or physical accessibility. Numerous concerns and limitations were communicated. Concerns regarding the availability of clinical procedures, such as hearing tests, obtaining the correct-sized earmolds, and fine-tuning of hearing aids, were expressed. Participants conveyed distrust in online retailers. However, trust in and a preference for audiologists’ expertise, which was not perceived to be available online, was found. Participants further conveyed a preference for face-to-face contact. Finally, in this sample, a general lack of familiarity and confidence in using the Internet was communicated. Conclusions: Internet sales of hearing aids is a controversial topic in audiology. Although Internet-based delivery of hearing aids was perceived by older adults to be potentially beneficial, several shortcomings and concerns were conveyed. Irrespective of opinion of the role of Internet sales, audiologists should consider the opinions of the elderly as to how different service models may improve hearing aid uptake.

scholarly journals The Nordic @geing Online project: Co-creating a social application together with older adults

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Nordmyr ◽  
A K Forsman
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Social Participation ◽  
Rural Areas ◽  
New Technologies ◽  
Psychosocial Health ◽  
Design Approach ◽  
Online Services ◽  
Online Application ◽  
Development Fund

Abstract Background Online resources present various possibilities for health promotion, also in the growing older adult population. Tailored online services aiming to support social participation among users could potentially promote older adults’ psychosocial health. In the @geing Online project an online application is developed, focusing on access to meaningful social activities among older adults in rural areas in Finland and Sweden. The innovation project (2017-2020) is funded by the Interreg Botnia-Atlantica programme (European Regional Development Fund). Methods A collaborative, user-centred design approach is applied when developing the online application, allowing older potential users and personnel groups from the social and health care sector to evaluate application features in a step-wise process. The inclusion of personnel groups allows for the exploration of the feasibility of introducing the tool in home care services and similar relevant contexts from an organizational perspective. Further, the inclusion of regional IT-companies presents opportunities for them to develop their competence regarding eHealth tools and older adults as a target group. Results An advanced prototype of the application and its core features is presented. Promising approaches and outcomes regarding the co-creation methods applied to ensure the involvement of stakeholders in the development process are elaborated upon. Challenging issues related to the project theme, such as stereotypical and negative views of older adults’ competences and motivation related to application use are also discussed. Conclusions The project highlights possibilities - but also challenges - when co-creating a social application together with older adults, some of whom have no experience in internet use. The gathered project outcomes will provide lessons on the potential of new technologies for delivering health promotion initiatives among older adults. Key messages Tailored online services aiming to support social participation among users provide possibilities for promoting psychosocial health in the growing population of older adults. Application development utilizing a user-centered design approach can be implemented even if the end-users are not familiar with the internet or application use.

scholarly journals Sex disparities in cardiovascular health metrics among rural-dwelling older adults in China: a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaolei Han ◽  
Ziying Jiang ◽  
Yuanjing Li ◽  
Yongxiang Wang ◽  
Yajun Liang ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Cardiovascular Health ◽  
Rural China ◽  
Descriptive Analysis ◽  
Population Based ◽  
Baseline Survey ◽  
Chinese Older Adults ◽  
Face To Face ◽  
Sex Disparities

Abstract Background Cardiovascular health (CVH) metrics among Chinese older adults are poorly understood. We investigated sex disparities in CVH metrics and their management among rural-dwelling older adults in China. Methods This community-based study included 5026 participants (age ≥ 65 years; 57.2% women) in the baseline survey of a multimodal intervention study in rural China. In March–September 2018, data were collected through face-to-face interviews, clinical examinations, and laboratory tests. We defined six CVH metrics (three behavioral factors—smoking, body mass index, and physical activity; three biological factors—blood pressure, total cholesterol, and blood glucose) following the modified American Heart Association’s recommendations. We performed descriptive analysis separately for men and women. Results Of all participants, only 0.8% achieved ideal levels in all six CVH metrics. Men were more likely than women to have ideal levels in all CVH metrics but smoking. Women had higher prevalence of ideal global (9.7% vs. 7.8%) and behavioral (18.3% vs. 9.5%) CVH metrics (p < 0.001), whereas men had higher prevalence of ideal biological CVH metrics (5.4% vs. 3.5%, p < 0.001). The prevalence of ideal global and behavioral CVH metrics increased with age in both women and men (p for trend< 0.001). Women were more likely to be aware of their hypertension and diabetes, and to receive antihypertensive treatment, while men were more likely to achieve the goal of high cholesterol treatment (p < 0.05). Conclusions The CVH metrics among older adults living in the rural communities in China are characterized by an extremely low proportion of optimal global CVH metrics and distinct sex differences, alongside poor management of major biological risk factors. Trial registration ChiCTR1800017758 (Aug 13, 2018).

scholarly journals Impact of Pain and Discomfort on the Lives of Cognitively Impaired Older Adults and Their Informal Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 786-787
Author(s):  
Hyunjin Noh
Keyword(s):  
Older Adults ◽  
Cognitively Impaired ◽  
Community Settings ◽  
Adult Age ◽  
Face To Face ◽  
Disease Trajectory ◽  
Care Recipients ◽  
Home Based ◽  
The Impact ◽  
Future Program

Abstract This qualitative study explored the impact of pain and discomfort on the lives of cognitively impaired older adults and their caregivers from the caregiver perspective. Forty-three individuals of age 19+, who identified themselves as primary caregiver to a chronically or seriously ill older adult (age 50+) with cognitive impairment, such as Alzheimer’s Disease and Related Dementia, were recruited at various community settings. Individual, face-to-face interviews were conducted to ask participants how they thought their care-recipient’s pain and discomfort affected the care-recipient’s and the caregiver’s life respectively. Inductive, thematic analysis of interview transcripts revealed several key themes: compromised mobility, limited social interaction or activities, and depressive symptoms in both care-recipients and caregivers; aggravated cognitive decline in care-recipients; and poorer physical health in caregivers. Participants wanted more information on the disease trajectory and available services, particularly home-based therapies and social activities for care-recipients, which provides future program/practice implications.

scholarly journals Rural–Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

2021 ◽  
Vol 18 (6) ◽  
pp. 2818
Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  
Keyword(s):  
Older Adults ◽  
Middle School ◽  
Depressive Symptoms ◽  
Rural Areas ◽  
Urban Areas ◽  
Depression Scale ◽  
Wealth Index ◽  
School Level ◽  
Cross Sectional ◽  
Middle School Level

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

Elevated Inflammatory Markers and Arterial Stiffening Exacerbate Tau but Not Amyloid Pathology in Older Adults with Mild Cognitive Impairment

2021 ◽  
pp. 1-13
Author(s):  
Alexandra L. Clark ◽  
Alexandra J. Weigand ◽  
Kelsey R. Thomas ◽  
Seraphina K. Solders ◽  
Lisa Delano-Wood ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Inflammatory Markers ◽  
Memory Performance ◽  
Cognitive Testing ◽  
Interactive Effects ◽  
Protein Biomarkers ◽  
Age Related ◽  
T Tau

Background: Age-related cerebrovascular and neuroinflammatory processes have been independently identified as key mechanisms of Alzheimer’s disease (AD), although their interactive effects have yet to be fully examined. Objective: The current study examined 1) the influence of pulse pressure (PP) and inflammatory markers on AD protein levels and 2) links between protein biomarkers and cognitive function in older adults with and without mild cognitive impairment (MCI). Methods: This study included 218 ADNI (81 cognitively normal [CN], 137 MCI) participants who underwent lumbar punctures, apolipoprotein E (APOE) genotyping, and cognitive testing. Cerebrospinal (CSF) levels of eight pro-inflammatory markers were used to create an inflammation composite, and amyloid-beta 1–42 (Aβ 42), phosphorylated tau (p-tau), and total tau (t-tau) were quantified. Results: Multiple regression analyses controlling for age, education, and APOE ɛ4 genotype revealed significant PP x inflammation interactions for t-tau (B = 0.88, p = 0.01) and p-tau (B = 0.84, p = 0.02); higher inflammation was associated with higher levels of tau within the MCI group. However, within the CN group, analyses revealed a significant PP x inflammation interaction for Aβ 42 (B = –1.01, p = 0.02); greater inflammation was associated with higher levels of Aβ 42 (indicative of lower cerebral amyloid burden) in those with lower PP. Finally, higher levels of tau were associated with poorer memory performance within the MCI group only (p s <  0.05). Conclusion: PP and inflammation exert differential effects on AD CSF proteins and provide evidence that vascular risk is associated with greater AD pathology across our sample of CN and MCI older adults.

scholarly journals Increased Glucose Activity in Subgenual Anterior Cingulate and Hippocampus of High Performing Older Adults, Despite Amyloid Burden

2021 ◽  
pp. 1-10
Author(s):  
Wyllians Vendramini Borelli ◽  
Eduardo Leal-Conceição ◽  
Michele Alberton Andrade ◽  
Nathalia Bianchini Esper ◽  
Paula Kopschina Feltes ◽  
...  
Keyword(s):  
Older Adults ◽  
Anterior Cingulate Cortex ◽  
Cognitive Aging ◽  
Cingulate Cortex ◽  
Amyloid Deposition ◽  
Cognitive Testing ◽  
Anterior Cingulate ◽  
High Performing ◽  
Potential Biomarker ◽  
Definition Of

Background: Individuals at 80 years of age or above with exceptional memory are considered SuperAgers (SA), an operationalized definition of successful cognitive aging. SA showed increased thickness and altered functional connectivity in the anterior cingulate cortex as a neurobiological signature. However, their metabolic alterations are yet to be uncovered. Objective: Herein, a metabolic (FDG-PET), amyloid (PIB-PET), and functional (fMRI) analysis of SA were conducted. Methods: Ten SA, ten age-matched older adults (C80), and ten cognitively normal middle-aged (C50) adults underwent cognitive testing and multimodal neuroimaging examinations. Anterior and posterior regions of the cingulate cortex and hippocampal areas were primarily examined, then subregions of anterior cingulate were segregated. Results: The SA group showed increased metabolic activity in the left and right subgenual anterior cingulate cortex (sACC, p <  0.005 corrected, bilateral) and bilateral hippocampi (right: p <  0.0005 and left: p <  0.005, both corrected) as compared to that in the C80 group. Amyloid deposition was above threshold in 30% of SA and C80 (p >  0.05). The SA group also presented decreased connectivity between right sACC and posterior cingulate (p <  0.005, corrected) as compared to that of the C80 group. Conclusion: These results support the key role of sACC and hippocampus in SA, even in the presence of amyloid deposition. It also suggests that sACC may be used as a potential biomarker in older adults for exceptional memory ability. Further longitudinal studies measuring metabolic biomarkers may help elucidate the interaction between these areas in the cognitive aging process.

Sign in / Sign up

Export Citation Format

Share Document