scholarly journals Nursing protocol: management of older adults with sensory deficits

2021 ◽  
pp. 116-118
Author(s):  
O. N. Tkacheva ◽  
N. K. Runikhina ◽  
Yu. V. Kotovskaya ◽  
N. V. Sharashkina ◽  
E. I. Lesina
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Functional Impairment ◽  
Older Patients ◽  
Sensory Systems ◽  
Sensory Deficits ◽  
Leading Role ◽  
Adequate Care ◽  
Sensory Impairments

The prevalence of sensory deficits in older patients is high and is associated with falls, cognitive impairment, depression, functional impairment, disability, and mortality. Regularly assessing sensory systems and organizing adequate care measures is an essential task of nursing elderly patients. Nurses who are most in contact with patients can play a leading role in screening for sensory impairments and ensuring timely corrections.

scholarly journals Lower Skeletal Muscle Mass at Admission Independently Predicts Falls and Mortality 3 Months Post-discharge in Hospitalized Older Patients

2018 ◽  
Vol 74 (10) ◽  
pp. 1650-1656 ◽  
Author(s):  
Esmee M Reijnierse ◽  
Sjors Verlaan ◽  
Vivien K Pham ◽  
Wen Kwang Lim ◽  
Carel G M Meskers ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Muscle Mass ◽  
Older Patients ◽  
Test Score ◽  
Handgrip Strength ◽  
Bed Rest ◽  
Post Discharge ◽  
Male Sex ◽  
Prospective Longitudinal

Abstract Background Approximately 10% of older adults are annually admitted to a hospital. Hospitalization is associated with a higher risk of falls and mortality after discharge. This study aimed to identify predictors at admission for falls and mortality 3 months post-discharge in hospitalized older patients. Methods The Evaluation of Muscle parameters in a Prospective cohort of Older patients at clinical Wards Exploring Relations with bed rest and malnutrition (EMPOWER) study is an observational, prospective longitudinal inception cohort of 378 patients aged 70 years and older who were subsequently admitted to a tertiary hospital (the Netherlands). Potential predictors for falls and mortality 3 months post-discharge were tested using univariate and multivariate logistic regression analyses and included the following domains: demographic (age, sex, living independently), lifestyle (alcohol, smoking), nutrition (SNAQ score), muscle mass (absolute, relative), physical function (handgrip strength, Katz ADL score), cognition (six-item cognitive impairment test score), and disease (medications, diseases). Results The mean age was 79.6 years (standard deviation 6.23) and 50% were male. Within 3 months post-discharge, 19% reported a fall and 13% deceased. Univariate predictors for falls were higher age, lower absolute muscle mass and higher six-item cognitive impairment test score. Lower absolute muscle mass independently predicted falls post-discharge (multivariate). Univariate predictors for mortality were higher age, male sex, no current alcohol use, higher SNAQ score, lower absolute and higher relative muscle mass, higher Katz ADL score and higher number of diseases. Male sex, higher SNAQ score, and lower absolute muscle mass independently predicted mortality post-discharge (multivariate). Conclusions In hospitalized older adults, muscle mass should be measured to predict future outcome. Future intervention studies should investigate if increasing muscle mass prevent short-term falls and mortality.

scholarly journals Reliability and validity of a quick test of cognitive speed (AQT) in screening for mild cognitive impairment and dementia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pouya Farokhnezhad Afshar ◽  
Elisabeth H. Wiig ◽  
Seyed Kazem Malakouti ◽  
Behnam Shariati ◽  
Sara Nejati
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sensitivity And Specificity ◽  
Older Patients ◽  
Reliability And Validity ◽  
Quick Test ◽  
Significant Difference ◽  
Cognitive Speed ◽  
Color Form

Abstract Background Cognitive disorders are one of the important issues in old age. There are many cognitive tests, but some variables affect their results (e.g., age and education). This study aimed to evaluate the reliability and validity of A Quick Test of Cognitive Speed (AQT) in screening for mild cognitive impairment (MCI) and dementia. Methods This is a psychometric properties study. 115 older adults participated in the study and were divided into three groups (46 with MCI, 24 with dementia, and 45 control) based on the diagnosis of two geriatric psychiatrists. Participants were assessed by AQT and Mini-Mental State Examination (MMSE). Data were analyzed using Pearson correlation, independent t-test, and ROC curve by SPSS v.23. Results There was no significant correlation between AQT subscales and age and no significant difference between the AQT subscales in sex, educational levels. The test-retest correlations ranges were 0.84 from 097. Concurrent validity was significant between MMSE and AQT. Its correlation was with Color − 0.78, Form − 0.71, and Color-Form − 0.72. The cut-off point for Color was 43.50 s, Form 52 s, and Color-Form 89 s were based on sensitivity and specificity for differentiating older patients with MCI with controls. The cut-off point for Color was 62.50 s, for Form 111 s, and Color-Form 197.50 s based on sensitivity and specificity measures for differentiating older patients with dementia and MCI. Conclusion The findings showed that AQT is a suitable tool for screening cognitive function in older adults.

Cancer-specific mortality and competing causes of death in older adults: A prospective, multicenter cohort study (ELCAPA-19).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11547-11547 ◽  
Author(s):  
Deborah Assouan ◽  
Elena Paillaud ◽  
Philippe Caillet ◽  
Emmanuelle Kempf ◽  
Helene Vincent ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cancer Mortality ◽  
Older Patients ◽  
Rating Scale ◽  
Mortality Rates ◽  
Test Time ◽  
Cancer Death ◽  
Multicenter Cohort Study ◽  
Patients With Cancer

11547 Background: Among older adults with cancer, comorbidities compete with cancer as the cause of death. The objectives were to quantify the proportion and rate of cancer-specific death in older patients with cancer, and to analyze the associations between geriatric factors and cancer death. Methods: Between January 2007 and December 2014, older patients with cancer were prospectively included by the ELCAPA cohort study’s eight investigating centers. Competing risk methods were used to estimate 6-month and 3-year cancer mortality rates and to probe associations between geriatric factors and cancer death. Results: A total of 1678 patients were included (mean ± standard deviation age: 81.3 ± 5.8; women: 49%). The most common cancers were colorectal (19%), breast (17%) and urinary (15%) cancers and 49% had metastasis. After a median follow-up period of 34 months, a total of 948 deaths were observed. Of the 282 deaths in non-metastatic patients, 203 (72%; 95% confidence interval (CI): [66%-77%]) were attributable to cancer. This proportion was 92% (89–94; N = 448/498) for metastatic patients. The 6-month and 3-year cancer mortality rates was respectively 12% (9–15) and 34% (29-38) for non-metastatic tumors and 45% (41–49) and 83% (80–87) for metastatic stage tumors. At 6 months, the geriatric factors independently associated with cancer death were a dependency in activities of daily living (ADL) score ≤ 5 (adjusted subhazard ratio: 2.11 (95%CI: [1.68–2.64]), mobility impairment (Timed Get Up and Go (TGUG) test time > 20 s (1.40 [1.05–1.87]) or inability to perform the TGUG (2.41 [1.67–3.48])) and comorbidities (total Cumulative Index Rating Scale-Geriatric score ≥13) (1.59 [1.23–2.06]). At 3 years, the independently associated factors were ADL ≤ 5 (1.60, [1.34–1.91]), TGUG > 20 s (1.28, [1.04–1.59]) or inability to perform TGUG (2.02 [1.47–2.79]), and cognitive impairment (1.23 [1.01–1.50]). Conclusions: Most older adults with cancer die from this disease and not from other comorbidities. However, geriatric parameters (dependency, impaired mobility, comorbidities, and cognitive impairment) are independently associated with cancer death. These geriatric impairments should be taken into account when assessing the cancer patient’s prognosis in clinical practice. Clinical trial information: NCT02884375.

scholarly journals Considering the Technological and Sensory Needs of Patients With Cognitive Impairment in the Era of Telehealth

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 86-86
Author(s):  
Esther Oh ◽  
Julie Yi ◽  
Corrine Pittman ◽  
Carrie Price ◽  
Carrie Nieman
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Routine Care ◽  
Support Staff ◽  
Care Partners ◽  
Sensory Impairments ◽  
Memory Care ◽  
Important Means

Abstract During the COVID-19 pandemic, telehealth has become an important means of delivering memory care. Telehealth that is responsive to the technological abilities and preferences as well as the sensory needs of persons living with dementia is critical to advancing access to care. We conducted a systematic review to investigate the use of telehealth among older adults with cognitive impairment. The search yielded 3,551 titles and abstracts that led to 17 full-text articles. Studies showed that telehealth can be used for routine care, cognitive assessment and telerehabilitation with good efficacy and satisfaction. Three studies investigated telemedicine delivery in the home and 16/17 studies relied on support staff and care partners to navigate technology. No studies reported adaptations to account for sensory impairments and 5/17 studies excluded individuals with sensory impairments. This talk will review barriers and facilitators totelehealth for older adults with cognitive impairment and adaptations to address sensory needs.

scholarly journals Gender Differences in the Association between Frailty, Cognitive Impairment, and Self-Care Behaviors Among Older Adults with Atrial Fibrillation

2019 ◽  
Vol 16 (13) ◽  
pp. 2387 ◽  
Author(s):  
Youn-Jung Son ◽  
Kyounghoon Lee ◽  
Bo-Hwan Kim
Keyword(s):  
Atrial Fibrillation ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Older Patients ◽  
Linear Regression Analysis ◽  
Self Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Plans ◽  
Individualized Care

Atrial fibrillation (AF), common in older adults, increases the risk of heart failure, stroke, and all-cause mortality. Self-care behaviors help avoid adverse events in older patients with AF. However, while frailty and cognitive impairment can contribute to poor self-care behaviors, few studies have explored these relationships in older adults with AF. This cross-sectional study aims to determine associations between frailty, cognitive impairment, and self-care behaviors among older adults with AF by gender. A total of 298 patients with AF aged 60 and over were assessed with a self-reported questionnaire consisting of the Korean version of the FRAIL scale, modified mini-mental state examination, and self-care scale for AF. Prevalence of frailty and prefrailty in men and women was around 11% and 48.4% and 28% and 47.4%, respectively. According to the hierarchical linear regression analysis, in men, prefrailty (β = −2.874, p = 0.013) and frailty (β = −7.698, p < 0.001) were associated with self-care behaviors; in women, frailty (β = −5.476, p = 0.003), and cognitive impairment (β = −3.350, p = 0.044) were associated with self-care behaviors. Developing individualized care plans will require periodic screening of older patients with AF to determine their frailty status and cognitive function.

Traumatic Stress in Older Adults

2020 ◽  
Author(s):  
Joan M. Cook ◽  
Vanessa Simiola
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Healthcare Utilization ◽  
Functional Impairment ◽  
Stress Disorder ◽  
Acute Stress ◽  
Age Groups ◽  
Accelerated Aging ◽  
Older Individuals ◽  
The Impact

This chapter focuses on older adult trauma survivors. Information is presented on prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD); course, functional impairment, suicide risk, cognitive impairment, accelerated aging, healthcare utilization in older adults with PTSD, and the impact of demographic factors such as gender, ethnicity, and race on PTSD in older individuals. In general, rates of ASD and PTSD are lower in older adults compared to other age groups. PTSD in older adults has been linked to suicidal ideation and attempts, functional impairment, physical health, cognitive impairment, accelerated aging, and increased healthcare utilization. Although delayed onset of PTSD has been empirically verified in some military samples with veterans and younger adult civilians, it is rare in the absence of any prior symptoms and might more accurately be labeled “delayed recognition.” More information on trauma and PTSD in diverse populations of older adults is needed, such as racial/ethnic as well as sexual and gender minorities, those with severe physical or mental impairment, non–community-residing groups, and those from non-industrialized countries.

scholarly journals ASSOCIATION OF SENSORY AND COGNITIVE IMPAIRMENT WITH HEALTHCARE UTILIZATION AND COST IN MEDICARE BENEFICIARIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S44-S44
Author(s):  
William Deardorff ◽  
Phillip liu ◽  
Richard Sloane ◽  
Courtney Van Houtven ◽  
Susan N Hastings ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Healthcare Cost ◽  
Functional Disability ◽  
Hospital Admissions ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Vision Impairment ◽  
Increased Risk ◽  
Sensory Impairments

Abstract The combination of sensory and cognitive impairment is increasingly prevalent among older adults and may be an important driver of healthcare cost due to functional disability and reduced self-care. This presentation focuses on the relationship between hearing and/or vision impairment and cognitive impairment with hospital admissions and healthcare cost using data from the Medicare Current Beneficiary Survey, a nationally representative sample of community-dwelling adults. We show that the presence of sensory impairment is associated with increased risk of hospitalization regardless of dementia status. In adjusted models, annual total healthcare costs were generally higher among those with sensory impairments compared to those without sensory impairments. We will also discuss work related to the development of a prognostic model that provides estimates of hospitalization risk among older adults with self-reported hearing and/or vision impairment. This model may help inform allocation of health care resources to those at highest risk for adverse outcomes.

Risk factors for falls in older patients with cancer

2017 ◽  
Vol 8 (1) ◽  
pp. 34-37 ◽  
Author(s):  
Xiaotao Zhang ◽  
Ming Sun ◽  
Suyu Liu ◽  
Cheuk Hong Leung ◽  
Linda Pang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Support ◽  
Older Adults ◽  
Logistic Regression ◽  
Major Depression ◽  
Functional Impairment ◽  
Older Patients ◽  
Patients With Cancer ◽  
Number Of Patients ◽  
Risk Factors For Falls

ObjectivesA rising number of patients with cancer are older adults (65 years of age and older), and this proportion will increase to 70% by the year 2020. Falls are a common condition in older adults. We sought to assess the prevalence and risk factors for falls in older patients with cancer.MethodsThis is a single-site, retrospective cohort study. Patients who were receiving cancer care underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, falls in the prior 6 months and comorbidity assessment. Vitamin D and bone densitometry were performed.AnalysisDescriptive statistics and multivariable logistic regression.ResultsA total of 304 patients aged 65 or above were enrolled in this study. The mean age was 78.4±6.9 years. They had haematological, gastrointestinal, urological, breast, lung and gynaecological cancers. A total of 215 patients with available information about falls within the past 6 months were included for final analysis. Seventy-seven (35.8%) patients had at least one fall in the preceding 6 months. Functional impairment (p=0.048), frailty (p<0.001), dementia (p=0.021), major depression (p=0.010) and low social support (p=0.045) were significantly associated with the fall status in the univariate analysis. Multivariate logistic regression analysis identified frailty and functional impairment to be independent risk factors for falls.ConclusionsFalls are common in older patients with cancer and lead to adverse clinical outcomes. Major depression, functional impairment, frailty, dementia and low social support were risk factors for falls. Heightened awareness and targeted interventions can prevent falls in older patients with cancer.

Recommencing lithium in Older Adults with Bipolar I Disorder

2017 ◽  
Vol 25 (6) ◽  
pp. 571-573 ◽  
Author(s):  
Lara Gallur ◽  
Alice Powell ◽  
Patrick Flynn
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Case Reports ◽  
Relevant Literature ◽  
Lithium Therapy ◽  
Medical Comorbidity ◽  
Bipolar I Disorder

Objectives: This paper addresses considerations in recommencing lithium in elderly patients with Bipolar I Disorder and medical comorbidity. We focus on nephrotoxicity and cognitive impairment. Methods: Case reports and review of relevant literature. Results: Three elderly psychogeriatric inpatients admitted with severe manic relapse following lithium cessation are described. In all cases, lithium was recommenced safely with good response. Conclusions: Even with medical comorbidity it may be possible to recommence modified lithium therapy.

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