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Rahman A, Schmitter-Edgecombe M, Krishnan A, Cunningham R, Pare N, Beadle J, Warren DE, Rabin L. Concurrent Validity of Performance-Based Measures of Daily Functioning with Cognitive Measures and Informant Reported Everyday Functioning. Arch Clin Neuropsychol 2024:acae077. [PMID: 39342453 DOI: 10.1093/arclin/acae077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 08/23/2024] [Accepted: 09/11/2024] [Indexed: 10/01/2024] Open
Abstract
OBJECTIVE Despite the substantial need for reliable and valid assessment of functional ability in older adults, there is currently limited research on the emergence of early functional declines during prodromal dementia stages, such as subjective cognitive decline (SCD) and mild cognitive impairment (MCI). This study uses novel performance-based assessments to characterize subtle, yet clinically meaningful, changes in functional ability. METHOD A sample of 93 older adults classified as cognitively unimpaired (CU; n = 30, Mage = 73.57 ± 6.66), SCD (n = 34, Mage = 72.56 ± 6.43), or MCI (n = 29, Mage = 78.28 ± 7.55) underwent neuropsychological testing along with an informant-rated daily functional skills measure (Assessment of Functional Capacity Interview). Participants also completed the Night Out Task (NOT), an open-ended performance-based measure of functional assessment, and the Financial Capacity Instrument-Short Form (FCI-SF) that assesses financial skills. RESULTS The MCI group performed worse on the NOT and FCI-SF relative to SCD and CU. NOT and FCI scores were associated with measures of global cognitive function, executive function, processing speed, language and memory, and FCI-SF overall score was correlated with informant-rated functional ability. The NOT and FCI-SF were also predictive of informant-reported daily functioning over and above traditional cognitive data and demographics. CONCLUSIONS Performance-based measures of IADL may allow for earlier detection of subtle functional changes that might not be adequately captured by traditional measures. The measurement of early functional changes is an important global outcome to evaluate the efficacy of interventions in dementia research.
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Affiliation(s)
- Aneela Rahman
- Department of Psychology, The Graduate Center, City University of New York, New York, NY 10016, USA
- Department of Psychology, Queens College, City University of New York, Queens, NY 11367, USA
| | | | - Anjali Krishnan
- Department of Psychology, Brooklyn College, City University of New York, Brooklyn, NY 11210, USA
| | - Reanne Cunningham
- Department of Psychology, Washington State University, Pullman, WA 99163, USA
| | - Nadia Pare
- Gaylord Specialty Hospital, Wallingford, CT 06492, USA
| | - Janelle Beadle
- Department of Gerontology, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - David E Warren
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Laura Rabin
- Department of Psychology, Brooklyn College, City University of New York, Brooklyn, NY 11210, USA
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Rivas-Fernández MA, Varela-López B, Zurrón M, Lindín M, Díaz F, Galdo-Alvarez S. Subjective Cognitive Decline is associated with altered patterns of brain activity and connectivity during performance of an old/new recognition memory task. Biol Psychol 2024:108882. [PMID: 39332662 DOI: 10.1016/j.biopsycho.2024.108882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 08/30/2024] [Accepted: 09/24/2024] [Indexed: 09/29/2024]
Abstract
INTRODUCTION Subjective Cognitive Decline (SCD) is considered a preclinical stage within the AD continuum. Knowledge about the functional changes in the brain associated with episodic memory retrieval and novelty recognition in people with SCD is currently very limited. METHOD The study aimed to evaluate behavioural and neurofunctional changes in individuals with SCD, measured relative to a control group, during successful episodic memory retrieval and novelty recognition, as well as to compare the functional connectivity patterns related to these cognitive processes within the Default Mode Network (DMN) in both groups. Participants performed an old/new recognition memory task with words while the BOLD signal was acquired. RESULTS No between-group differences were observed in the performance of the episodic memory task. However, during the successful recognition of old words, the SCD group showed brain hypoactivity in the right rolandic operculum and reduced functional connectivity between the DMN and the fronto-parietal control network (FPCN). During the correct identification of new words, the SCD group also showed reduced connectivity between the DMN and the FPCN, and lower connectivity within the DMN. CONCLUSION Despite the absence of objective evidence of cognitive impairment, people with SCD display several changes in brain activity and connectivity associated with episodic memory retrieval and novelty recognition.
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Affiliation(s)
- M A Rivas-Fernández
- Division of Endocrinology, Diabetes and Metabolism, Children's Hospital of Los Angeles, California, USA
| | - B Varela-López
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Applied Cognitive Neuroscience and Psychogerontology Research Group, Instituto de Psicoloxía, USC (IPsiUS), Santiago de Compostela, Spain; Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - M Zurrón
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Applied Cognitive Neuroscience and Psychogerontology Research Group, Instituto de Psicoloxía, USC (IPsiUS), Santiago de Compostela, Spain; Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - M Lindín
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Applied Cognitive Neuroscience and Psychogerontology Research Group, Instituto de Psicoloxía, USC (IPsiUS), Santiago de Compostela, Spain; Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - F Díaz
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Applied Cognitive Neuroscience and Psychogerontology Research Group, Instituto de Psicoloxía, USC (IPsiUS), Santiago de Compostela, Spain; Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - S Galdo-Alvarez
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Applied Cognitive Neuroscience and Psychogerontology Research Group, Instituto de Psicoloxía, USC (IPsiUS), Santiago de Compostela, Spain; Cognitive Neuroscience Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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Schrempft S, Baysson H, Graindorge C, Pullen N, Hagose M, Zaballa ME, Preisig M, Nehme M, Guessous I, Stringhini S. Biopsychosocial risk factors for subjective cognitive decline among older adults during the COVID-19 pandemic: a population-based study. Public Health 2024; 234:16-23. [PMID: 38924819 DOI: 10.1016/j.puhe.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/07/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES There have been concerns that the COVID-19 pandemic and the measures used to contain it impacted the cognitive health of older adults. We therefore examined the prevalence of subjective cognitive decline, and its associated risk factors and health consequencs, among dementia-free older adults 2 years into the pandemic in Switzerland. STUDY DESIGN Population-based cohort study. METHODS Prevalence of SCD was estimated using the cognitive complaint questionnaire administered to adults aged ≥65 years in June-September 2022 (Specchio-COVID19 cohort, N = 1414), and compared to prepandemic values from 2014 to 2018 (CoLaus|PsyCoLaus cohort, N = 1181). Associated risk factors and health consequences were assessed using logistic and/or linear regression. RESULTS Prevalence of SCD in 2022 (18.9% [95% CI, 16.2-21.9]) was comparable to prepandemic levels in 2014-2018 (19.5% [17.2-22.1]). Risk factors included established risks for dementia-namely health issues, health behaviours, and depressive symptoms. Self-reported post-COVID, perceived worsening of mental health since the start of the pandemic, less frequent social club attendance, and increased loneliness were also risk factors for SCD. In turn, SCD was associated with poorer objective cognitive performance, difficulty performing instrumental activities of daily living, greater risk of falls, and lower well-being at one-year follow-up. CONCLUSIONS While the overall prevalence of SCD in 2022 was comparable to prepandemic levels, we identified several pandemic-related risk factors for SCD, including perceived worsening of mental health and increased isolation since the start of the pandemic. These findings highlight the importance of mental health promotion strategies in reducing cognitive complaints and preventing cognitive decline.
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Affiliation(s)
- S Schrempft
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland.
| | - H Baysson
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland; Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - C Graindorge
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - N Pullen
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - M Hagose
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - M-E Zaballa
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - M Preisig
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - M Nehme
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland; Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - I Guessous
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - S Stringhini
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland; University Centre for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Rivan NFM, Ludin AFM, Clark BC, Shahar S. Predictors for the development of motoric cognitive risk syndrome in older adults. BMC Geriatr 2024; 24:575. [PMID: 38961342 PMCID: PMC11223433 DOI: 10.1186/s12877-024-05179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/25/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Motoric cognitive risk (MCR) syndrome refers to a condition where both slow gait and memory complaints coexist, which heightens their vulnerability to developing dementia. Considering that the risk factors of MCR are elucidated from cross-sectional studies and also likely vary based on socioeconomic status, we conducted a community-based longitudinal study to determine the predictors of MCR among older adults in Malaysia. METHODS Out of 1,249 older participants (aged 60 years and above) without MCR at baseline (Wave II of LRGS-TUA cohort study), 719 were successfully followed up after 3.5 years to identify predictors of subsequent MCR development. A comprehensive interview-based questionnaire was administered for sociodemographic information, cognitive function, psychosocial, functional status, and dietary intake. Anthropometric measurements, body composition, and physical performance were assessed. Univariate analyses were performed for each variable, followed by a hierarchical logistic regression analysis to identify the predictors of MCR that accounted for confounding effects between the studied factors. RESULTS The incidence rate of MCR was 4.0 per 100 person-years. Smoking (Adjusted Odd Ratio (Adj OR) = 1.782; 95% Confidence Interval (CI):1.050-3.024), hypertension (Adj OR = 1.725; 95% CI:1.094-2.721), decreased verbal memory as assessed by the lower Rey Auditory Verbal Learning Test (RAVLT) (Adj OR = 1.891; 95% CI:1.103-3.243), and decreased functional status measured using instrumental activity of daily living (IADL) (Adj OR = 4.710; 95% CI:1.319-16.823), were predictors for MCR incidence. CONCLUSIONS Our study results provide an initial reference for future studies to formulate effective preventive management and intervention strategies to reduce the growing burden of adverse health outcomes, particularly among Asian older adults.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Biomedical Science Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI) and Department of Biomedical Sciences, Ohio University, Athens, OH, USA
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Komalasari R, Thiamwong L, Wangi K, Ng BP. Subjective Functional Difficulties Were Associated With Subjective Cognitive Decline Among U.S. Older Adults: Mentally Unhealthy Days Mediation and Income Level Moderation Effects. SAGE Open Nurs 2024; 10:23779608231226065. [PMID: 38268951 PMCID: PMC10807341 DOI: 10.1177/23779608231226065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/20/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Subjective cognitive decline (SCD) is a self-perceived decline in cognition that may progress to mild cognitive impairment or Alzheimer's disease. SCD may be associated with difficulties in daily functioning and psychological distress. Previous research has shown the association between functional difficulties and SCD via mentally unhealthy days (MUDs). However, whether income levels influence the mediation effect of MUDs is less understood. Objectives This study examined the association between subjective functional difficulties and the odds of SCD through MUDs, and whether the mediation effect was moderated by income levels. Methods Cross-sectional data were obtained from the 2019 Behavioral Risk Factor Surveillance System (N = 13,160 older adults aged 65+; 7,370 women). SCD was assessed by more frequent or worse memory loss and confusion in the past 12 months. Subjective functional difficulties represented difficulties with daily activities. MUDs denoted the days that a person felt mentally unwell within the past 30 days. We used path analysis with 5,000 bootstrapped confidence intervals and logistic regression to classify the risks of SCD based on subjective functional difficulties and MUDs. Results Subjective functional difficulties were positively associated with SCD through mediation by MUDs (b = 0.119, 95% CI 0.102, 0.137). After accounting for covariates, we found that greater subjective functional difficulties were associated with 2.50 times the odds of SCD (AOR = 2.50; 95% CI: 2.14, 2.91); MUDs were related to 1.06 times the odds of SCD reporting (AOR = 1.06; 95% CI: 1.05, 1.07). Income levels moderated the indirect effect of MUDs in the subjective functional difficulties-SCD relationship, with an income of <$15,000 showing the most prominent effect. Those earning ≥$50,000 self-reported a lower SCD than those earning <$15,000. Conclusions Our study extends previous findings by demonstrating that greater subjective functional difficulties are associated with higher odds of SCD through more frequent MUDs, with higher income levels being associated with more SCD reporting.
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Affiliation(s)
- Renata Komalasari
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Ladda Thiamwong
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, USA
| | - Karolus Wangi
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Boon Peng Ng
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, USA
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Bohn L, Drouin SM, McFall GP, Rolfson DB, Andrew MK, Dixon RA. Machine learning analyses identify multi-modal frailty factors that selectively discriminate four cohorts in the Alzheimer's disease spectrum: a COMPASS-ND study. BMC Geriatr 2023; 23:837. [PMID: 38082372 PMCID: PMC10714519 DOI: 10.1186/s12877-023-04546-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Frailty indicators can operate in dynamic amalgamations of disease conditions, clinical symptoms, biomarkers, medical signals, cognitive characteristics, and even health beliefs and practices. This study is the first to evaluate which, among these multiple frailty-related indicators, are important and differential predictors of clinical cohorts that represent progression along an Alzheimer's disease (AD) spectrum. We applied machine-learning technology to such indicators in order to identify the leading predictors of three AD spectrum cohorts; viz., subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and AD. The common benchmark was a cohort of cognitively unimpaired (CU) older adults. METHODS The four cohorts were from the cross-sectional Comprehensive Assessment of Neurodegeneration and Dementia dataset. We used random forest analysis (Python 3.7) to simultaneously test the relative importance of 83 multi-modal frailty indicators in discriminating the cohorts. We performed an explainable artificial intelligence method (Tree Shapley Additive exPlanation values) for deep interpretation of prediction effects. RESULTS We observed strong concurrent prediction results, with clusters varying across cohorts. The SCI model demonstrated excellent prediction accuracy (AUC = 0.89). Three leading predictors were poorer quality of life ([QoL]; memory), abnormal lymphocyte count, and abnormal neutrophil count. The MCI model demonstrated a similarly high AUC (0.88). Five leading predictors were poorer QoL (memory, leisure), male sex, abnormal lymphocyte count, and poorer self-rated eyesight. The AD model demonstrated outstanding prediction accuracy (AUC = 0.98). Ten leading predictors were poorer QoL (memory), reduced olfaction, male sex, increased dependence in activities of daily living (n = 6), and poorer visual contrast. CONCLUSIONS Both convergent and cohort-specific frailty factors discriminated the AD spectrum cohorts. Convergence was observed as all cohorts were marked by lower quality of life (memory), supporting recent research and clinical attention to subjective experiences of memory aging and their potentially broad ramifications. Diversity was displayed in that, of the 14 leading predictors extracted across models, 11 were selectively sensitive to one cohort. A morbidity intensity trend was indicated by an increasing number and diversity of predictors corresponding to clinical severity, especially in AD. Knowledge of differential deficit predictors across AD clinical cohorts may promote precision interventions.
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Affiliation(s)
- Linzy Bohn
- Department of Psychology, University of Alberta, P217 Biological Sciences Building, Edmonton, AB, T6G 2E9, Canada.
- Neuroscience and Mental Health Institute, University of Alberta, 2-132 Li Ka Shing Center for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada.
| | - Shannon M Drouin
- Department of Psychology, University of Alberta, P217 Biological Sciences Building, Edmonton, AB, T6G 2E9, Canada
- Neuroscience and Mental Health Institute, University of Alberta, 2-132 Li Ka Shing Center for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada
| | - G Peggy McFall
- Department of Psychology, University of Alberta, P217 Biological Sciences Building, Edmonton, AB, T6G 2E9, Canada
- Neuroscience and Mental Health Institute, University of Alberta, 2-132 Li Ka Shing Center for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada
| | - Darryl B Rolfson
- Department of Medicine, Division of Geriatric Medicine, University of Alberta, 13-135 Clinical Sciences Building, Edmonton, AB, T6G 2G3, Canada
| | - Melissa K Andrew
- Department of Medicine, Division of Geriatric Medicine, Dalhousie University, 5955 Veterans' Memorial Lane, Halifax, NS, B3H 2E1, Canada
| | - Roger A Dixon
- Department of Psychology, University of Alberta, P217 Biological Sciences Building, Edmonton, AB, T6G 2E9, Canada
- Neuroscience and Mental Health Institute, University of Alberta, 2-132 Li Ka Shing Center for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada
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Santos Henriques RPD, Tomas-Carus P, Filipe Marmeleira JF. Association Between Neuropsychological Functions and Activities of Daily Living in People with Mild Cognitive Impairment. Exp Aging Res 2023; 49:457-471. [PMID: 36242522 DOI: 10.1080/0361073x.2022.2133292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/03/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The aim of this study was to explore the relationship between performance in neurocognitive variables and daily functioning (basic or b- and instrumental or i-ADL) in people with mild cognitive impairment (MCI). METHODS A sample of 157 participants with MCI (73.65 ± 7.58 years) completed a battery of tests for assessing ADL and cognitive functions. t-test, Pearson's correlation and multiple linear regression (backward stepwise selection) were used for data analyses. RESULTS Significant correlations were found between b- and i-ADL, and several neuropsychological tests (p < .01). Multivariate analysis showed that difficulties in Blessed Rating Scales (BLS) explained 33.2% of the variation in b-ADL and that this variation rises to 42.9% when BLS is associated with Frontal Assessment Battery Flexibility, Trail Making Test A (TMT-A) and BLS Personality. For i-ADL, BLS and Dementia Rating Scale Total (DRS-T) explained 47.7% of the variation and the inclusion in the model of BLS, DRS-IP (Initiation/Perseveration), TMT-A and BLS Personality explained 53.5% of this variation. Executive functions explained 24.8% of the variation in i-ADL. CONCLUSIONS Cognitive functions are related to i- and b-ADL in people with MCI. The general indicators and those that assess executive functions and verbal- or visual-spatial memory should be considered to predict i-ADL.
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Affiliation(s)
- Rogério Paulo Dos Santos Henriques
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais, Portugal
| | - Pablo Tomas-Carus
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais, Portugal
| | - José Francisco Filipe Marmeleira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais, Portugal
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Molina-Donoso M, Parrao T, Meillon C, Thumala D, Lillo P, Villagra R, Ibañez A, Cerda M, Zitko P, Amieva H, Slachevsky A. Assessing subjective cognitive decline in older adults attending primary health care centers: what question should be asked? J Clin Exp Neuropsychol 2023; 45:313-320. [PMID: 37403327 PMCID: PMC11195299 DOI: 10.1080/13803395.2023.2221399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 05/26/2023] [Indexed: 07/06/2023]
Abstract
INTRODUCTION Subjective Cognitive Decline (SCD) refers to a self-perceived experience of decreased cognitive function without objective signs of cognitive impairment in neuropsychological tests or daily living activities. Despite the abundance of instruments addressing SCD, there is no consensus on the methods to be used. Our study is founded on 11 questions selected due to their recurrence in most instruments. The objective was to determine which one of these questions could be used as a simple screening tool. METHODS 189 participants aged 65 and over selected from Primary Care centers in Santiago de Chile responded to these 11 questions and were evaluated with the MiniMental State Examination (MMSE), the Free and Cued Selective Reminding Test (FCSRT), the Pfeffer functional scale, and the Geriatric Depression Scale (GDS). An Item ResponseTheory (IRT) method was performed to assess the contribution of each of the 11 questions to the SCD latent trait and its discrimination ability. RESULTS Based on the results of the exploratory factor analysis showing very high/low saturation of several questions on the factors, and the high residual correlation between some questions, the IRT methods led to select one question ("Do you feel like your memory has become worse?") which revealed to be the most contributive and discriminant. Participants who answered yes had a higher GDS score. There was no association with MMSE, FCSRT, and Pfeffer scores. CONCLUSION The question "Do you feel like your memory has become worse?" may be a good proxy of SCD and could be included in routine medical checkups.
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Affiliation(s)
- Matías Molina-Donoso
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
- INSERM, Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Teresa Parrao
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Faculty of Psychology, University Alberto Hurtado, Santiago, Chile
| | - Céline Meillon
- INSERM, Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Daniela Thumala
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Faculty of Psychology, University of Chile, Santiago, Chile
| | - Patricia Lillo
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neurology Department (South Division), Faculty of Medicine, University of Chile, Santiago, Chile
- Unit of Neurology, Hospital San José, Santiago, Chile
| | - Roque Villagra
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), University Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center (CNC), University de San Andrés & CONICET, Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, US; and Trinity College, Dublin, Ireland
| | - Mauricio Cerda
- Biomedical Neuroscience Institute, Santiago, Chile
- Integrative Biology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
- Center for Medical Informatics and Telemedicine, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Pedro Zitko
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Hélène Amieva
- INSERM, Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Neurology Department, Hospital del Salvador and Faculty of Medicine, Universityof Chile, Santiago, Chile
- Neurology Service, Department of Medicine, Clínica Alemana-University of Desarrollo, Santiago, Chile
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Giebel C, Halpin K, Tottie J, O'Connell L, Carton J. The digitalisation of finance management skills in dementia since the COVID-19 pandemic: A qualitative study. DEMENTIA 2023; 22:783-806. [PMID: 36803284 PMCID: PMC9944462 DOI: 10.1177/14713012231159156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVES Engaging with finances has become increasingly digitalised in recent years, particularly since the COVID-19 pandemic, yet it is unknown how finance management has been affected in people living with dementia. The aim of this qualitative study was therefore to explore how digitalisation and the recent pandemic have affected finance management skills in people with dementia. METHODS Semi-structured interviews were conducted remotely with people with dementia and unpaid carers living in the UK via phone or Zoom between February and May 2022. Transcripts were coded by one of four different research team members, including two unpaid carers who were public advisers on the project. Data were analysed using inductive thematic analysis. RESULTS Thirty carers and people with dementia participated, and five overarching themes were identified. Managing finances has been both simplified and made more complicated by digitalising how money is spent and managed, with people with dementia and unpaid carers reporting advantages of using direct debits and debit cards, as well as digital illiteracy barriers for older relatives with dementia. Unpaid carers have received no support in managing their relative's finances, and were found to be burdened by the additional caring duties. CONCLUSIONS Carers need to be supported in managing their relative's finances as well as with their general well-being due to taking on additional caring duties. Digital systems for finance management need to be user-friendly for people with cognitive impairment, with a need for digital literacy training for middle-aged and older adults to avoid difficulties if they develop dementia, and improved access to a computer/tablet/smart phone.
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Affiliation(s)
- Clarissa Giebel
- Clarissa Giebel, Department of Primary Care
& Mental Health, University of Liverpool, 1-5 Brownlow Street, Liverpool L69
3GL, UK.
| | - Kath Halpin
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Jean Tottie
- TIDE (Together In Dementia Everyday), Liverpool, UK
| | - Lena O'Connell
- Department of Primary Care and Mental Health, 4591University of Liverpool, Liverpool, UK; NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Joan Carton
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
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10
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Komalasari R, Mpofu E, Prybutok G, Ingman S. Subjective Functional Difficulties and Subjective Cognitive Decline in Older-Age Adults: Moderation by Age Cohorts and Mediation by Mentally Unhealthy Days. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1606. [PMID: 36674359 PMCID: PMC9860596 DOI: 10.3390/ijerph20021606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 06/17/2023]
Abstract
Background and Objectives: Despite the expected positive association between subjective functional difficulties (SFD) and subjective cognitive decline (SCD), their mediation by mentally unhealthy days (MUDs) is under-studied. Moreover, few SCD studies have examined affective reactivity to functional difficulties by age cohort. This study examined the mediation effect of MUDs on the association between SFD and SCD by age cohorts' moderation among older adults. Methods: Using a cross-sectional design approach, we used the 2019 BRFSS dataset on 13,377 older adults aged 65 to ≥80 (44% males and 56% females). Results: The bias-corrected percentile bootstrap with 5000 samplings revealed that MUDs partially mediate the relationship between SFD and SCD (14.12% mediation effect), controlling depressive symptoms, education, income levels, and race. Age cohorts moderated the relationship between SFD and SCD and between SFD and SCD but not between MUDs and SCD. The predictive effects of the path from SFD to MUDs and from MUDs to SCD were stronger in the younger-old (65-69) than the middle-old (70-79) and oldest-old (≥80) age cohorts. Worse SCD was associated with being Asian, in female older adults, and in those with lower education and income levels. Conclusions: These findings extend the chronic stress theory predictions that accentuated emotional vulnerability to subjective functional difficulties may magnify SCD, particularly in the younger-old age group. By implication, preventive SCD interventions should seek to support younger-old adults in their activities of daily life for successful aging transitioning into older-age cohorts.
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Affiliation(s)
- Renata Komalasari
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX 76201, USA
| | - Elias Mpofu
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX 76201, USA
- School of Health Sciences, University of Sydney, Camperdown, NSW 2050, Australia
- Educational Psychology, Faculty of Education, University of Johannesburg, Johannesburg P.O. Box 524, South Africa
| | - Gayle Prybutok
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX 76201, USA
| | - Stanley Ingman
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX 76201, USA
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11
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Ikeda Y, Maruta M, Han G, Miyata H, Nakamura A, Shimokihara S, Tabira T. Implications of refrigerator management on subjective memory complaints among Japanese community-dwelling older adults. Psychogeriatrics 2023; 23:3-10. [PMID: 36210329 DOI: 10.1111/psyg.12893] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/29/2022] [Accepted: 08/23/2022] [Indexed: 01/05/2023]
Abstract
AIM Older adults with subjective memory complaints (SMC) may experience very minor difficulties in daily activities. Although caregivers and occupational therapists who support community-dwelling older adults are aware of the existence of characteristic behaviours related to refrigerator management, no specific studies have been conducted. This study aimed to examine the implications of refrigerator management for older adults with SMC. METHODS A self-administered questionnaire was sent to 3000 randomly selected members of Consumer's Co-operative Kagoshima. Of the returned responses, a total of 282 older adults were analyzed. Analyzed subjects were divided into two groups: SMC (+) group (n = 74) and SMC (-) group (n = 192). A questionnaire was created by four occupational therapists and used to assess the characteristics of analyzed subjects and their abilities to manage the refrigerator. The observation list for early signs of dementia was also utilised. A multiple logistic analysis was performed to examine the association between SMC and refrigerator management. RESULTS The SMC (+) group had a significantly higher number of refrigerator management errors than the SMC (-) group (P = 0.008). The SMC (+) group had more errors than the SMC (-) group in the following four items regarding refrigerator management; the refrigerator has a lot of the same foods / expired food, the person does not know what's in the refrigerator, the person cannot find what he/she needs in the refrigerator. Moreover, SMC was associated with the item 'the person does not know what is in the refrigerator' (odds ratio 7.44, 95% CI 1.51-43.8, P = 0.02). CONCLUSIONS Our results showed that older adults with SMC had several problems regarding refrigerator management. Evaluating refrigerator management among older adults with SMC may help consider multifaceted support.
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Affiliation(s)
- Yuriko Ikeda
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Michio Maruta
- Visiting Researcher, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.,Unit of Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Gwanghee Han
- Visiting Researcher, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.,Department of Occupational Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - Hironori Miyata
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.,Division of Occupational Therapy, Department of Rehabilitation, Faculty of Health Science, Kumamoto Health Science University, Kumamoto, Japan
| | | | - Suguru Shimokihara
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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12
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Sex differences in risk factors that predict progression from mild cognitive impairment to Alzheimer's dementia. J Int Neuropsychol Soc 2022; 29:360-368. [PMID: 35968841 DOI: 10.1017/s1355617722000297] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To evaluate whether cerebrospinal fluid biomarkers, apolipoprotein e4, neuroimaging abnormalities, and neuropsychological data differentially predict progression from mild cognitive impairment (MCI) to dementia for men and women. METHODS Participants who were diagnosed with MCI at baseline (n = 449) were classified as either progressing to Alzheimer's dementia at follow-up or as not progressing. Men and women were first compared using bivariate analyses. Sex-stratified Cox proportional hazard regressions were performed examining the relationship between baseline data and the likelihood of progressing to dementia. Sex interactions were subsequently examined. RESULTS Cox proportional hazard regression controlling for age and education indicated that all variables significantly predicted subsequent progression to dementia for men and women. Sex interactions indicated that only Rey Auditory Verbal Learning Test (RAVLT) delayed recall and Functional Activities Questionnaire (FAQ) were significantly stronger risk factors for women. When all variables were entered into a fully adjusted model, significant risk factors for women were Aβ42, hippocampal volume, RAVLT delayed recall, Boston Naming Test, and FAQ. In contrast, for men, Aβ42, p-tau181, p-tau181/Aβ42, hippocampal volume, category fluency and FAQ were significant risk factors. Interactions with sex were only significant for p-tau181/Aβ42 and RAVLT delayed recall for the fully adjusted model. CONCLUSIONS Men and women with MCI may to differ for which factors predict subsequent dementia although future analyses with greater power are needed to evaluate sex differences. We hypothesize that brain and cognitive reserve theories may partially explain these findings.
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13
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Wion RK, Hill NL, Bell TR, Mogle J, Yates J, Bhang I. The Role of Cognitive Self-Report Measure Type in Predicting Cognitive Decline Among Older Adults: A Systematic Review. J Geriatr Psychiatry Neurol 2022; 35:487-511. [PMID: 34151643 PMCID: PMC8688580 DOI: 10.1177/08919887211023591] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Many types of items are used to measure self-reported cognition, resulting in heterogeneity across studies. Certain cognitive self-report measure types may be more predictive of future decline. Therefore, the purpose of this systematic review was to compare whether specific types of cognitive self-report measures better predict risk for cognitive decline over time when measures are directly compared within the same study. The PRISMA criteria guided the review. Eligibility criteria included: longitudinal studies, outcome of cognitive decline, at least 2 different cognitive self-report measures, and no cognitive impairment at baseline. Nineteen studies were included in the final review. A narrative synthesis of results was completed, resulting in 3 thematic groups of comparisons across self-reported measure types. Self-reported memory decline with worry and peer perceptions of memory were associated with the highest risk for cognitive decline. Future longitudinal investigations of self-reported cognitive problems should focus on using measures that may be most sensitive to predicting cognitive decline risk.
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Affiliation(s)
| | - Nikki L. Hill
- College of Nursing++, Pennsylvania State University, University Park, PA
| | - Tyler R. Bell
- Department of Psychology, University of California San Diego, San Diego, CA
| | - Jacqueline Mogle
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, PA
| | - Jennifer Yates
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Iris Bhang
- College of Nursing, Pennsylvania State University, University Park, PA
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14
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Rotenberg S, Dawson DR. Characterizing Cognition in Everyday Life of Older Adults With Subjective Cognitive Decline. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:269-276. [PMID: 35499254 PMCID: PMC9459355 DOI: 10.1177/15394492221093310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Subjective cognitive decline (SCD), the subjective experience of
worsening cognition with no objective cognitive impairment, poses a
heightened risk for dementia. This study aimed to characterize
cognition in the everyday life of people with SCD, is crucial for
understanding and preventing further functional and cognitive decline.
One hundred and thirty-five older adults (age 70.7±6.7) with SCD were
assessed using functional-cognition measures: Multifactorial Memory
Questionnaire (MMQ), Behavior Rating Inventory of Executive
Function–Adult version (BRIEF-A), and Multiple Errands Test (MET). The
resulted showed that older adults with SCD reported lower memory
satisfaction (Hedges’s g = 0.41) on the MMQ, and
worse metacognition on the BRIEF-A (Hedges’s g =
0.63) compared with published normative data. They completed an
average of only 6/12 required tasks on the MET. The findings show
functional difficulties related to SCD and inform the development of
occupational therapy intervention for this population.
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Affiliation(s)
- Shlomit Rotenberg
- University of Toronto, Ontario, Canada
- Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Deirdre R. Dawson
- University of Toronto, Ontario, Canada
- Baycrest Health Sciences, Toronto, Ontario, Canada
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15
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Tahami Monfared AA, Byrnes MJ, White LA, Zhang Q. The Humanistic and Economic Burden of Alzheimer's Disease. Neurol Ther 2022; 11:525-551. [PMID: 35192176 PMCID: PMC9095804 DOI: 10.1007/s40120-022-00335-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/03/2022] [Indexed: 02/07/2023] Open
Abstract
Alzheimer's disease (AD) is the leading cause of cognitive impairment and dementia in older individuals (aged ≥ 65 years) throughout the world. As a result of these progressive deficits in cognitive, emotional, and physical function, AD dementia can cause functional disability and loss of independence. To gain a deeper understanding of the recent literature on the burden of AD, including that of mild cognitive impairment (MCI) due to AD, we conducted a comprehensive targeted review of the PubMed-indexed literature (2014 to 2021) to examine the humanistic and economic burden of AD (including MCI) in North America, Europe, and Asia. Our literature review identified a range of factors associated with quality of life (QoL): some factors were positively associated with QoL, including caregiver relationship, religiosity, social engagement, and ability to engage in activities of daily living (ADL), whereas other factors such as neuropsychiatric symptoms were associated with poorer QoL. While patient- and proxy-rated QoL are highly correlated in patients with early AD dementia, proxy-rated QoL declines more substantially as severity worsens. The maintenance of self-reported QoL in patients with more severe AD dementia may be due to lack of awareness or to adaptation to circumstances. Compared to persons with normal cognition, MCI is associated with a greater cost burden, and individuals with MCI exhibit worse QoL. Key drivers of the societal economic burden of AD include disease severity, dependence level, institutionalization, and comorbidity burden. Evaluation of the impact of a hypothetical disease-modifying treatment delaying the progression from MCI to AD has suggested that such a treatment may result in cost savings.
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Affiliation(s)
- Amir Abbas Tahami Monfared
- Eisai, 200 Metro Blvd, Nutley, NJ, 07110, USA. .,McGill University, Epidemiology, Biostatistics and Occupational Health, Montreal, QC, Canada.
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16
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Mogle J, Turner JR, Rabin LA, Sliwinski MJ, Zhaoyang R, Hill NL. Measuring Memory Lapses and Their Impact on Daily Life: Results From Two Daily Diary Studies. Assessment 2022:10731911221077962. [PMID: 35189724 DOI: 10.1177/10731911221077962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Memory lapses (e.g., forgetting a medication) are common for most people, yet past methods of assessment relied upon retrospective reports from long recall windows. Recently, researchers have incorporated daily diary methods to capture memory lapse frequency closer to the experience in real-world environments. This study describes the utility of the Daily Memory Lapses Checklist using data from two 14-day diary studies (Combined Sample = 467; 66% women). Frequency and impact (i.e., irritation and interference) of prospective and retrospective memory lapses were assessed at both individual- and daily levels. Across studies, memory lapses occurred on more than one-third of assessment days. Retrospective lapses were reported more frequently than prospective; however, both lapses had a similar impact. The Daily Memory Lapses Checklist represents a flexible measure that separates the occurrence of a memory lapse from its impact on daily life: metrics that will enhance our understanding of daily experiences of cognitive functioning.
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Affiliation(s)
| | | | | | | | | | - Nikki L Hill
- The Pennsylvania State University, University Park, USA
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17
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Pacifico D, Sabatini S, Fiordelli M, Albanese E. The role of disability and depressive symptoms in the relation between objective cognitive performance and subjective cognitive decline. Front Psychiatry 2022; 13:963703. [PMID: 36506437 PMCID: PMC9729556 DOI: 10.3389/fpsyt.2022.963703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Subjective cognitive decline (SCD) and subjective memory decline (SMD) are common among older people. Evidence linking SCD and SMD with cognitive and memory impairment is inconsistent. Moreover, little is known about the associations of SCD and SMD with disability. We aimed to explore the associations of SCD and SMD with objective cognitive and memory performance, disability, and depressive symptoms. MATERIALS AND METHODS In a cross-sectional study we conducted face to face interviews in a randomized sample of people aged ≥65 years living in the Canton of Ticino, southern Switzerland, between May 2021 and April 2022. We measured subjective cognitive decline with the MyCog, a subsection of the Subjective Cognitive Decline Questionnaire (SCD-Q); cognitive functioning with the Community Screening Instrument for Dementia; memory with the consortium to establish a registry for alzheimer's disease (CERAD) 10-word list learning task; and disability and depressive symptoms with the world health organization disability assessment schedule 2.0 (WHO-DAS 2.0) and the Euro-Depression (EURO-D) scales, respectively. RESULTS Of the 250 participants 93.6% reported at least one cognitive difficulty, and 40.0% SMD. Both SCD and SMD were associated with poorer objective cognitive/memory performance, and independently with greater disability, and more depressive symptoms. But in participants with high disability and depressive symptoms subjective and objective cognition were no longer associated. Disability fully mediated the associations of poorer objective cognitive and memory performance with subjective cognitive and memory decline. CONCLUSION Routine clinical assessments of cognitive function should include formal enquires about SCD and SMD, and also account for disability and depressive symptoms.
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Affiliation(s)
- Deborah Pacifico
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Serena Sabatini
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
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18
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Yu Y, Yuan C, Zhang Q, Song C, Cui S, Ye J, Zhang X, Chen C. Longitudinal association between home and community-based services provision and cognitive function in Chinese older adults: Evidence from the Chinese Longitudinal Healthy Longevity Survey. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e288-e298. [PMID: 33761178 DOI: 10.1111/hsc.13353] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 09/24/2020] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
Few studies have assessed the impact of home and community-based services (HCBSs) provision on cognitive function among older adults over time. This study examined the longitudinal association between HCBSs provision and cognitive function in Chinese older adults. The study included 5,134 participants aged 65 years and older in the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014. The Mini-Mental State Examination (MMSE) was used to evaluate cognitive function over the same time period. Participants were asked what kind of HCBSs were provided in his or her community. However, they were not asked whether services were utilised. The study used the number of HCBSs provided each wave to represent the strength of HCBSs, and used the MMSE score of each wave to represent the older adults' cognitive function status. A latent growth model was used to explore the relationship between HCBSs provision and cognitive function of older adults. The number of HCBSs provided was positively associated with older adults' cognitive function (2008: β = 0.03, p = 0.031; 2011: β = 0.06, p < 0.001; 2014: β = 0.06, p < 0.001) after controlling for gender, age, residence, education, income, medical insurance, activities of daily living disability, instrumental activities of daily living disability, serious illness, living arrangement and marital status. Results provided longitudinal evidence that an increase in HCBSs provision at a national level can result in better cognitive function in Chinese older adults.
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Affiliation(s)
- Yushan Yu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Changzheng Yuan
- Department of Big Data in Health Science, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qi Zhang
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA, USA
| | - Chao Song
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Shichen Cui
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Jun Ye
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xiangyang Zhang
- First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chun Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Center for Health Assessment, Wenzhou Medical University, Wenzhou, China
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19
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Sapkota S, Ramirez J, Yhap V, Masellis M, Black SE. Brain atrophy trajectories predict differential functional performance in Alzheimer's disease: Moderations with apolipoprotein E and sex. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12244. [PMID: 34692981 PMCID: PMC8515221 DOI: 10.1002/dad2.12244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/09/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION We examine whether distinct brain atrophy patterns (using brain parenchymal fraction [BPF]) differentially predict functional performance and decline in Alzheimer's disease (AD), and are independently moderated by (1) a key AD genetic risk marker (apolipoprotein E [APOE]), (2) sex, and (3) high-risk group (women APOE ɛ4 carriers). METHODS We used a 2-year longitudinal sample of AD patients (baseline N = 170; mean age = 71.3 [9.1] years) from the Sunnybrook Dementia Study. We applied latent class analysis, latent growth modeling, and path analysis. We aimed to replicate our findings (N = 184) in the Alzheimer's Disease Neuroimaging Initiative. RESULTS We observed that high brain atrophy class predicted lower functional performance and steeper decline. This association was moderated by APOE, sex, and high-risk group. Baseline findings as moderated by APOE and high-risk group were replicated. DISCUSSION Women APOE ɛ4 carriers may selectively be at a greater risk of functional impairment with higher brain atrophy.
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Affiliation(s)
- Shraddha Sapkota
- Hurvitz Brain Sciences Research ProgramSunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Joel Ramirez
- Hurvitz Brain Sciences Research ProgramSunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Vanessa Yhap
- Hurvitz Brain Sciences Research ProgramSunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Mario Masellis
- Hurvitz Brain Sciences Research ProgramSunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoOntarioCanada
- Department of Medicine (Neurology)University of TorontoTorontoOntarioCanada
| | - Sandra E. Black
- Hurvitz Brain Sciences Research ProgramSunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoOntarioCanada
- Department of Medicine (Neurology)University of TorontoTorontoOntarioCanada
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20
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Dashwood M, Churchhouse G, Young M, Kuruvilla T. Artificial intelligence as an aid to diagnosing dementia: an overview. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2021. [DOI: 10.1002/pnp.721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Mark Dashwood
- Dr Dashwood and Dr Churchhouse are Advanced Trainees in Old Age Psychiatry; Dr Young is a CT2, and Dr Kuruvilla is a Consultant in Old Age Psychiatry, all at Gloucestershire Health & Care NHS Foundation Trust, Cheltenham
| | - Gabrielle Churchhouse
- Dr Dashwood and Dr Churchhouse are Advanced Trainees in Old Age Psychiatry; Dr Young is a CT2, and Dr Kuruvilla is a Consultant in Old Age Psychiatry, all at Gloucestershire Health & Care NHS Foundation Trust, Cheltenham
| | - Matilda Young
- Dr Dashwood and Dr Churchhouse are Advanced Trainees in Old Age Psychiatry; Dr Young is a CT2, and Dr Kuruvilla is a Consultant in Old Age Psychiatry, all at Gloucestershire Health & Care NHS Foundation Trust, Cheltenham
| | - Tarun Kuruvilla
- Dr Dashwood and Dr Churchhouse are Advanced Trainees in Old Age Psychiatry; Dr Young is a CT2, and Dr Kuruvilla is a Consultant in Old Age Psychiatry, all at Gloucestershire Health & Care NHS Foundation Trust, Cheltenham
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21
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Rotenberg S, Leung C, Quach H, Anderson ND, Dawson DR. Occupational performance issues in older adults with subjective cognitive decline. Disabil Rehabil 2021; 44:4681-4688. [PMID: 33989108 DOI: 10.1080/09638288.2021.1916626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To describe and categorize difficulties in daily activities of older adults with subjective cognitive decline (SCD) compared to individuals with mild cognitive impairment (MCI). METHODS Deductive quantitative content analysis was used to classify reported issues in the performance of meaningful daily activities, in older adults with SCD (n = 67; age= 70 ± 6.3) or MCI (n = 42; age= 72 ± 6.6). The occupational performance issues were identified using the Canadian Occupational Performance Measure, a semi-structured interview, and categorised using the International Classification of Functioning, Disability and Health (ICF). RESULTS Both groups identified issues in all nine ICF "Activities and Participation" domains, with no significant group effects on seven of them. The most frequently affected "Activities and Participation" domains in both groups were "Self-care" (e.g. exercise and diet); "Community, social and civic life" (e.g. social-leisure activities); and "General tasks and demands" (e.g. time management). Over 90% of the issues in both groups were described in the context of difficulties in "Mental functions" (e.g. memory and higher-level cognitive functions). CONCLUSIONS Older adults with SCD, although independent, identified a variety of daily activities that they are not performing satisfactorily, remarkably similar in nature to the occupational performance issues described by older adults with MCI.Implications for RehabilitationOlder adults with SCD identified difficulties in performing social and leisure activities, maintaining healthy lifestyle behaviours, and managing multiple daily tasks.The daily challenges described by older adults with SCD are similar in nature to those identified by those with MCI.Older adults with SCD and MCI describe their daily challenges are related not only to memory problems, but also to executive dysfunction.Interventions for older adults with SCD should aim to improve self-identified problems in everyday functioning.
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Affiliation(s)
- Shlomit Rotenberg
- Rotman Research Institute, Baycrest, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Calvin Leung
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Henry Quach
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest, Toronto, Canada.,Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | - Deirdre R Dawson
- Rotman Research Institute, Baycrest, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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22
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Olivari BS, Baumgart M, Taylor CA, McGuire LC. Population measures of subjective cognitive decline: A means of advancing public health policy to address cognitive health. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12142. [PMID: 33681450 PMCID: PMC7919133 DOI: 10.1002/trc2.12142] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022]
Abstract
Subjective cognitive decline (SCD) is receiving increasing attention as studies have suggested that SCD status is associated with risk of future cognitive decline and dementia. Population-based measures of SCD can be extremely useful to the public health community, health-care providers, researchers, and policymakers. A large population-based SCD measure now exists through the state-based Behavioral Risk Factor Surveillance System (BRFSS). All 50 states have included the cognitive decline module, which asks about SCD, to their BRFSS survey one or more times. Population measures of SCD can aid researchers in designing clinical studies by better estimating the populations that may be at risk for more severe cognitive decline based on their SCD status to ensure that the optimal groups are targeted. Population-level estimates of SCD can also help to inform health-care providers' decisions about initiating cognitive assessments, managing other conditions among those with memory problems, and identifying the needs of caregivers.
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Affiliation(s)
- Benjamin S Olivari
- Division of Population Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
| | | | - Christopher A Taylor
- Division of Population Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
| | - Lisa C McGuire
- Division of Population Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
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Röhr S, Pabst A, Riedel-Heller SG, Jessen F, Turana Y, Handajani YS, Brayne C, Matthews FE, Stephan BCM, Lipton RB, Katz MJ, Wang C, Guerchet M, Preux PM, Mbelesso P, Ritchie K, Ancelin ML, Carrière I, Guaita A, Davin A, Vaccaro R, Kim KW, Han JW, Suh SW, Shahar S, Din NC, Vanoh D, van Boxtel M, Köhler S, Ganguli M, Jacobsen EP, Snitz BE, Anstey KJ, Cherbuin N, Kumagai S, Chen S, Narazaki K, Ng TP, Gao Q, Gwee X, Brodaty H, Kochan NA, Trollor J, Lobo A, López-Antón R, Santabárbara J, Crawford JD, Lipnicki DM, Sachdev PS. Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: a COSMIC study. ALZHEIMERS RESEARCH & THERAPY 2020; 12:167. [PMID: 33339532 PMCID: PMC7749505 DOI: 10.1186/s13195-020-00734-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/26/2020] [Indexed: 12/20/2022]
Abstract
Background Subjective cognitive decline (SCD) is recognized as a risk stage for Alzheimer’s disease (AD) and other dementias, but its prevalence is not well known. We aimed to use uniform criteria to better estimate SCD prevalence across international cohorts. Methods We combined individual participant data for 16 cohorts from 15 countries (members of the COSMIC consortium) and used qualitative and quantitative (Item Response Theory/IRT) harmonization techniques to estimate SCD prevalence. Results The sample comprised 39,387 cognitively unimpaired individuals above age 60. The prevalence of SCD across studies was around one quarter with both qualitative harmonization/QH (23.8%, 95%CI = 23.3–24.4%) and IRT (25.6%, 95%CI = 25.1–26.1%); however, prevalence estimates varied largely between studies (QH 6.1%, 95%CI = 5.1–7.0%, to 52.7%, 95%CI = 47.4–58.0%; IRT: 7.8%, 95%CI = 6.8–8.9%, to 52.7%, 95%CI = 47.4–58.0%). Across studies, SCD prevalence was higher in men than women, in lower levels of education, in Asian and Black African people compared to White people, in lower- and middle-income countries compared to high-income countries, and in studies conducted in later decades. Conclusions SCD is frequent in old age. Having a quarter of older individuals with SCD warrants further investigation of its significance, as a risk stage for AD and other dementias, and of ways to help individuals with SCD who seek medical advice. Moreover, a standardized instrument to measure SCD is needed to overcome the measurement variability currently dominant in the field.
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Affiliation(s)
- Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany. .,Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Yuda Turana
- Department of Neurology, School of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Yvonne S Handajani
- Center for Health Research, School of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Carol Brayne
- Cambridge Public Health, Cambridge University, Cambridge, UK
| | - Fiona E Matthews
- MRC Biostatistics Unit, Institute of Public Health, Cambridge University, Cambridge, UK.,Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Blossom C M Stephan
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.,Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Maëlenn Guerchet
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France
| | - Pierre-Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,CHU, Department of Medical Information & Evaluation, Clinical Research and Biostatistic Unit, Limoges, France
| | - Pascal Mbelesso
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Neurology, Amitié Hospital, Bangui, Central African Republic
| | - Karen Ritchie
- INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, Université de Montpellier, Montpellier, France.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Marie-Laure Ancelin
- INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, Université de Montpellier, Montpellier, France
| | - Isabelle Carrière
- INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, Université de Montpellier, Montpellier, France
| | - Antonio Guaita
- Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy
| | - Annalisa Davin
- Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy
| | - Roberta Vaccaro
- Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seung Wan Suh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Suzana Shahar
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah C Din
- Centre for Rehabilitation Science and Special Needs, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Divya Vanoh
- School of Health Science, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Martin van Boxtel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Erin P Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kaarin J Anstey
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia.,Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Shuzo Kumagai
- Center for Health Science and Counseling, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
| | - Sanmei Chen
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kenji Narazaki
- Faculty of Socio-Environmental Studies, Department of Socio-Environmental Studies, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka, 811-0295, Japan
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia.,Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia.,Department of Developmental Disability Neuropsychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Medicine and Psychiatry, Universidad de Zaragoza and Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Raúl López-Antón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Santabárbara
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - John D Crawford
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia.,Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
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Kim S, Choe K, Lee K. Depression, Loneliness, Social Support, Activities of Daily Living, and Life Satisfaction in Older Adults at High-Risk of Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249448. [PMID: 33348548 PMCID: PMC7767125 DOI: 10.3390/ijerph17249448] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022]
Abstract
As the number of older adults with dementia increases, early diagnosis and intervention are crucially important. The purpose of this study was to conduct dementia screening on older adults to determine whether there are differences in depression, loneliness, social support, daily activities of living, and life satisfaction between older adults at high-risk for dementia compared with low-risk older adults. We hypothesized a negative relationship between high-risk older adults and these factors. This study also hypothesized a moderating effect for social support on the relationship between daily living activities and life satisfaction. This study used a cross-sectional design with survey data. Participants were recruited at 15 public community health centers in South Korea. A total of 609 older adults (male 208, female 401) living in the community were screened for early dementia, and 113 participants (18.9%) were assigned to the high-risk group. As hypothesized, participants in the high-risk group showed significantly more negative results in terms of activities of daily living, depression, loneliness, social support, and life satisfaction compared with participants in the low-risk group. The findings of this study provide a theoretical basis for the importance of early screening for dementia and policies for effective dementia prevention.
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25
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Alshammari SA, Alhamdan AA, Bindawas SM, Al-Amoud MM, Al-Orf SM, Al-Muammar MN, Calder PC. Assessing the cognitive status of older adults attending primary healthcare centers in Saudi Arabia using the Mini-Mental State Examination. Saudi Med J 2020; 41:1315-1323. [PMID: 33294888 PMCID: PMC7841595 DOI: 10.15537/smj.2020.12.25576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To assess the cognitive status of older adults in Saudi Arabia. METHODS This was a cross-sectional, multistage, stratified study of older individuals (≥60 years of age) attending primary healthcare centres in Riyadh, Saudi Arabia between January 2015 and April 2017. We collected data using a structured questionnaire, which incorporated questions regarding demographic and anthropometric variables, the Arabic version of Mini-Mental State Examination, the Mini-Nutritional Assessment tool, and the Modified Katz Index of Independence in activities of daily living. RESULTS Of the 1299 participants, 914 (70.4%) were male, with a mean age of 66.2 ± 5.9 years. Approximately 79.1% of the participants had intact cognitive function, 17.1 had mild cognitive impairment, and 3.8% had severe cognitive impairment. Impaired cognitive function was associated with increased age, female gender, low education, unmarried status, and unemployed (p less than 0.001). Reduced cognitive impairment was significantly associated with functional impairment and malnutrition (p less than 0.001). CONCLUSION Cognitive impairment affected around 21% of the participants. The reduced cognitive function was associated with increased age, female gender, low education level, unmarried, low income, dependency on others, functional impairment, and malnutrition. Such information could motivate health-policy makers to introduce appropriate measures to improve older adults' existing healthcare services in primary care, including cognitive function assessment.
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Affiliation(s)
- Sulaiman A Alshammari
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Marshall GA, Sikkes SAM, Amariglio RE, Gatchel JR, Rentz DM, Johnson KA, Langford O, Sun C, Donohue MC, Raman R, Aisen PS, Sperling RA, Galasko DR. Instrumental activities of daily living, amyloid, and cognition in cognitively normal older adults screening for the A4 Study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12118. [PMID: 33163609 PMCID: PMC7596668 DOI: 10.1002/dad2.12118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION We examined the associations among instrumental activities of daily living (IADL), cortical amyloid, and cognition in cognitively normal (CN) older adults. METHODS CN participants screening for the A4 Study (n = 4486) underwent florbetapir (amyloid) positron emission tomography. IADL were assessed using the Alzheimer's Disease Cooperative Study Activities of Daily Living Prevention Instrument. Separate logistic regression models were run with cortical amyloid or cognition as independent variable and IADL as dependent variable, adjusting for age and sex. RESULTS IADL difficulties were endorsed infrequently (≤16%). Overall IADL and four select IADL item difficulties ("remembering appointments," "finding belongings," "following TV programs," and "remembering current events") reported by both participant and study partner were significantly associated with greater amyloid burden and worse cognition. DISCUSSION Although IADL deficits were infrequent in this CN cohort, greater participant and study partner report of overall IADL deficits and subtle difficulties in specific IADL items were associated with mildly higher amyloid burden and worse cognition.
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Affiliation(s)
- Gad A. Marshall
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Sietske A. M. Sikkes
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- VUmc Alzheimer CenterVU University Medical CenterAmsterdamthe Netherlands
| | - Rebecca E. Amariglio
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Jennifer R. Gatchel
- Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Division of Geriatric PsychiatryMcLean HospitalHarvard Medical SchoolBelmontMassachusettsUSA
| | - Dorene M. Rentz
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Keith A. Johnson
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Oliver Langford
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Chung‐Kai Sun
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Michael C. Donohue
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Rema Raman
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Paul S. Aisen
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Reisa A. Sperling
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Douglas R. Galasko
- Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of CaliforniaSan Diego Health—La JollaSan DiegoCaliforniaUSA
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Geddes MR, O'Connell ME, Fisk JD, Gauthier S, Camicioli R, Ismail Z. Remote cognitive and behavioral assessment: Report of the Alzheimer Society of Canada Task Force on dementia care best practices for COVID-19. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12111. [PMID: 32999916 PMCID: PMC7507991 DOI: 10.1002/dad2.12111] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Despite the urgent need for remote neurobehavioral assessment of individuals with cognitive impairment, guidance is lacking. Our goal is to provide a multi-dimensional framework for remotely assessing cognitive, functional, behavioral, and physical aspects of people with cognitive impairment, along with ethical and technical considerations. METHODS Literature review on remote cognitive assessment and multidisciplinary expert opinion from behavioral neurologists, neuropsychiatrists, neuropsychologists, and geriatricians was integrated under the auspices of the Alzheimer Society of Canada Task Force on Dementia Care Best Practices for COVID-19. Telephone and video approaches to assessments were considered. RESULTS Remote assessment is shown to be acceptable to patients and caregivers. Informed consent, informant history, and attention to privacy and autonomy are paramount. A range of screening and domain-specific instruments are available for telephone or video assessment of cognition, function, and behavior. Some neuropsychological tests administered by videoconferencing show good agreement with in-person assessment but still lack validation and norms. Aspects of the remote dementia-focused neurological examination can be performed reliably. DISCUSSION Despite challenges, current literature and practice support implementation of telemedicine assessments for patients with cognitive impairment. Convergence of data across the clinical interview, reliable and brief remote cognitive tests, and remote neurological exam increase confidence in clinical interpretation and diagnosis.
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Affiliation(s)
- Maiya R. Geddes
- Department of Neurology and NeurosurgeryMontreal Neurological InstituteMcGill UniversityMontrealCanada
- McGill Center for Studies in AgingMcGill UniversityVerdunCanada
- Departments of Psychiatry and NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonUSA
| | - Megan E. O'Connell
- Department of PsychologyUniversity of SaskatchewanSaskatoonCanada
- Canadian Center for Health & Safety in AgricultureMedicineUniversity of SaskatchewanSaskatoonCanada
| | - John D. Fisk
- Department of PsychiatryDalhousie UniversityHalifaxCanada
- Department of Psychology and NeuroscienceDalhousie UniversityHalifaxCanada
- Department of MedicineDalhousie UniversityHalifaxCanada
| | - Serge Gauthier
- McGill Center for Studies in AgingMcGill UniversityVerdunCanada
| | - Richard Camicioli
- Neuroscience and Mental Health Institute and Department of MedicineDivision of NeurologyUniversity of AlbertaEdmontonCanada
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteO'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
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Lai FHY, Yan EWH, Tsui WS, Yu KKY. A randomized control trial of activity scheduling for caring for older adults with dementia and its impact on their spouse care-givers. Arch Gerontol Geriatr 2020; 90:104167. [DOI: 10.1016/j.archger.2020.104167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/14/2020] [Accepted: 06/28/2020] [Indexed: 01/05/2023]
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Cavedoni S, Chirico A, Pedroli E, Cipresso P, Riva G. Digital Biomarkers for the Early Detection of Mild Cognitive Impairment: Artificial Intelligence Meets Virtual Reality. Front Hum Neurosci 2020; 14:245. [PMID: 32848660 PMCID: PMC7396670 DOI: 10.3389/fnhum.2020.00245] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/02/2020] [Indexed: 01/16/2023] Open
Abstract
Elderly people affected by Mild Cognitive Impairment (MCI) usually report a perceived decline in cognitive functions that deeply impacts their quality of life. This subtle waning, although it cannot be diagnosable as dementia, is noted by caregivers on the basis of their relative’s behaviors. Crucially, if this condition is also not detected in time by clinicians, it can easily turn into dementia. Thus, early detection of MCI is strongly needed. Classical neuropsychological measures – underlying a categorical model of diagnosis - could be integrated with a dimensional assessment approach involving Virtual Reality (VR) and Artificial Intelligence (AI). VR can be used to create highly ecologically controlled simulations resembling the daily life contexts in which patients’ daily instrumental activities (IADL) usually take place. Clinicians can record patients’ kinematics, particularly gait, while performing IADL (Digital Biomarkers). Then, Artificial Intelligence employs Machine Learning (ML) to analyze them in combination with clinical and neuropsychological data. This integrated computational approach would enable the creation of a predictive model to identify specific patterns of cognitive and motor impairment in MCI. Therefore, this new dimensional cognitive-behavioral assessment would reveal elderly people’s neural alterations and impaired cognitive functions, typical of MCI and dementia, even in early stages for more time-sensitive interventions.
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Affiliation(s)
- Silvia Cavedoni
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Alice Chirico
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.,Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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Blanchette R, Khojandi A, Cox D, Oliver M, Fernandez R. Predicting Alzheimer's Disease Using Driving Simulator Data. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5432-5435. [PMID: 33019209 DOI: 10.1109/embc44109.2020.9176118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Early detection of Alzheimer's Disease (AD) is critical in creating better outcomes for patients. Performance in complex tasks such as vehicular driving may be a sensitive tool for early detection of AD and serve as a good indicator of functional status. In this study, we investigate the classification of AD patients and controls using driving simulator data. Our results show that machine learning algorithms, especially random forest classifier, can accurately discriminate AD patients and controls (AUC = 0.96, Sensitivity = 87%, and Specificity = 93%). The model-identified most important features include Pothole Avoidance, Road Signs Recalled, Inattention Measurements, Reaction Time, and Detection Times, among others, all of which closely align with previous studies about cognitive functions that are affected by AD.
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32
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Si T, Xing G, Han Y. Subjective Cognitive Decline and Related Cognitive Deficits. Front Neurol 2020; 11:247. [PMID: 32508729 PMCID: PMC7248257 DOI: 10.3389/fneur.2020.00247] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 03/13/2020] [Indexed: 12/21/2022] Open
Abstract
Since late stage dementia, including Alzheimer's disease (AD), cannot be reversed by any available drugs, there is increasing research interest in the preclinical stage of AD, i.e., subjective cognitive decline (SCD). SCD is characterized by self-perceptive cognitive decline but is difficult to detect using objective tests. At SCD stage, the cognitive deficits can be more easily reversed compared to that of mild cognitive impairment (MCI) and AD only if accurate diagnosis of SCD and early intervention can be developed. In this paper, we review the recent progress of SCD research including current assessment tools, biomarkers, neuroimaging, intervention and expected prognosis, and the potential relevance to traumatic brain injury (TBI)-induced cognitive deficits.
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Affiliation(s)
- Tong Si
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guoqiang Xing
- The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
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33
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Rotenberg S, Maeir A, Dawson DR. Changes in Activity Participation Among Older Adults With Subjective Cognitive Decline or Objective Cognitive Deficits. Front Neurol 2020; 10:1393. [PMID: 32010049 PMCID: PMC6974583 DOI: 10.3389/fneur.2019.01393] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/19/2019] [Indexed: 12/25/2022] Open
Abstract
Participation in daily activities is crucial for healthy aging. There is limited research on participation of older adults with subjective cognitive decline (SCD), defined as the experience of cognitive deficits with no evidence of objective cognitive deficits. Therefore, this study examined perceived changes in participation in this population, and compared it to perceived changes reported by individuals with objective cognitive deficits. The study aimed to: (1) examine the reported changes in activity participation of older with SCD; (2) investigate differences in the reported changes in participation between individuals with SCD and those with mild or severe objective cognitive deficits; (3) examine the relationship between activity participation, subjective memory, and objective cognitive status; and (4) explore whether subjective memory explains additional variance in activity participation after accounting for age and objective cognitive deficits. Participants were 115 older adults (60+), divided into three groups based on their Montreal Cognitive Assessment (MoCA) scores: (1) SCD (MoCA≥26; n = 66); (2) mild objective cognitive deficits (MoCA = 20-25; n = 34); and (3) severe objective cognitive deficits (MoCA ≤ 19; n = 15). The Activity Card Sort was used to measure participation in instrumental activities of daily living, social, and leisure activities. The Multifactorial Memory Questionnaire-Ability subscale was used to assess subjective memory. We found that individuals with SCD, mild cognitive deficits and severe cognitive deficits reported participation withdrawal to a level of 80, 70, and 58% of their past participation, respectively. A significant between group difference was found on participation [χ2(2) = 16.44, p < 0.01], with the SCD group reporting higher participation than the other two groups. Participation significantly correlated with both cognitive status (r = 0.40, p < 0.01) and subjective memory (r = 0.45, p < 0.05). A regression analysis revealed that subjective memory contributed significantly to the explained variance in participation, beyond that accounted for by objective cognitive deficits and age. Our findings demonstrate the important role of subjective memory problems in activity participation of older adults, even in the absence of objective cognitive deficits.
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Affiliation(s)
- Shlomit Rotenberg
- Dawson Lab, Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | - Adina Maeir
- Cog-Fun Lab, School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Deirdre R. Dawson
- Dawson Lab, Rotman Research Institute, Baycrest, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
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Yi Y, Ding L, Wen H, Wu J, Makimoto K, Liao X. Is Barthel Index Suitable for Assessing Activities of Daily Living in Patients With Dementia? Front Psychiatry 2020; 11:282. [PMID: 32457659 PMCID: PMC7225343 DOI: 10.3389/fpsyt.2020.00282] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 03/23/2020] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To evaluate application of the Barthel Index (BI) in assessing basic activities of daily living (ADL) of patients with dementia using Rasch analysis. DESIGN A multi-country cross-sectional study. SETTING AND PARTICIPANTS Nineteen long-term care facilities located in China, Japan, South Korea, and Thailand. A total of 644 patients with dementia were included. METHODS Unidimensionality, global and item fit, local dependence, person-item targeting, threshold disordering, and differential item functioning (DIF) were examined. Negative correlations between scores for DIF items and Neuropsychiatric Inventory Nursing Home version (NPI-NH) were evaluated. RESULTS Item reliability (1.0) and person reliability (.88) were acceptable. The Rasch dimension explained 72.9% of the variance (Eigenvalue = 27), while the first contrast explained 6.6% (Eigenvalue = 2.4). The "mobility" was misfitting to the Rasch model (infit mean square = 1.86). The overall difficulty of the BI exceeded patients' ability (person location = -2.27 logits). The "stairs climbing" and "mobility" showed narrow category thresholds (< 1.4 logits). The location of "controlling bladder" and "toilet use" overlapped. Removing "stairs climbing", collapsing categories with narrow threshold widths in "mobility", and combining "controlling bowel" and "controlling bladder" into one item, improved unidimensionality, and item fit of the scale. Only three items ("grooming", "dressing", and "toilet use") were free from DIF across countries. The scores for "feeding" were negatively related to scores for "disinhibition" (r = -0.46, P < 0.01), and scores for "controlling bowel" were negatively related to scores for "disinhibition" (r = -0.44, P < 0.01), "agitation" (r = -0.32, P < 0.05), and "aggression" (r = -0.27, P < 0.01) in Japanese samples. CONCLUSIONS AND IMPLICATIONS The performance of the BI for assessing patients with dementia might be compromised by misfit items, person-item mistargeting, measurement gaps, redundant items, narrow threshold width, and item bias. Mobility ability might not be helpful for determining capability of basic ADL in the patients. Comparisons of BI scores between countries should be undertaken with caution due to item bias. Neuropsychiatric symptoms might interact with basic ADL abilities of the patients. We will not suggest using the instrument in patients with dementia, without future refining to improve its performance.
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Affiliation(s)
- Yayan Yi
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lin Ding
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Huangliang Wen
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jialan Wu
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Kiyoko Makimoto
- Department of Nursing, School of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Xiaoyan Liao
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Tseng YC, Gau BS, Lou MF. Validation of the Chinese version of the Life-Space Assessment in community-dwelling older adults. Geriatr Nurs 2019; 41:381-386. [PMID: 31818502 DOI: 10.1016/j.gerinurse.2019.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/23/2019] [Accepted: 11/27/2019] [Indexed: 11/29/2022]
Abstract
The Life-Space Assessment (LSA) is a comprehensive tool for assessing mobility in older adults, but the evidence of its psychometric properties in Chinese older adults is lacking. The aim was to adapt and validate the psychometric properties of the Chinese version of the Life-Space Assessment (LSA-C) in community-dwelling older adults. A cross-sectional study was designed with 225 community-dwelling older adults. The content validity of the LSA-C was satisfactory. The criterion validity was supported by significant correlation between the LSA-C and the Multidimensional Functional Assessment Questionnaire (MFAQ). Additionally, the LSA-C was negatively correlated with the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) and positively correlated with the General Health subscale of the Short-Form-36 Health Survey (GH of the SF-36), implying good construct validity. Finally, the LSA-C showed excellent stability (intraclass correlation coefficient = 0.88). The LSA-C demonstrates adequate psychometric properties, supporting its use in future research in the Chinese context.
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Affiliation(s)
- Ya-Chuan Tseng
- School of Nursing, College of Medicine, National Taiwan University, No.1, Jen-Ai Rd. Sec. 1, Taipei 10051, Taiwan.
| | - Bih-Shya Gau
- School of Nursing, College of Medicine, National Taiwan University, No.1, Jen-Ai Rd. Sec. 1, Taipei 10051, Taiwan.
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University, No.1, Jen-Ai Rd. Sec. 1, Taipei 10051, Taiwan.
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Noh HM, Roh YK, Song HJ, Park YS. Severe Fear of Falling Is Associated With Cognitive Decline in Older Adults: A 3-Year Prospective Study. J Am Med Dir Assoc 2019; 20:1540-1547. [DOI: 10.1016/j.jamda.2019.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022]
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Wang J, Zhu WH, Li YF, Zhu WW. Temporal precedence of cognitive function and functional abilities: A latent difference score model of the Chinese community-dwelling elders. Int J Geriatr Psychiatry 2019; 34:1892-1899. [PMID: 31469190 DOI: 10.1002/gps.5206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/24/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Little research has explored how cognitive function and activities of daily living (ADL) affect each other over time. In addition, no current finding provides a clear hint to the temporal precedence between them. The present study tries to address these limitations of prior studies by utilizing a longitudinal data and advanced statistical modeling. METHODS This study analyzed the data from the China Health and Retirement Longitudinal Study (CHARLS), a prospective observational study performed every 2 years for a total of three waves between 2011 and 2015 using a multistage probability sampling. Cognitive function was measured on the basis of three aspects of cognitive performance. Functional abilities were assessed using six types of activities of ADL and five types of instrumental ADL (IADL). Latent difference score modeling was employed to investigate the temporal precedence between cognitive function and ADL. RESULTS The best fitting model indicates poor cognitive function precede worsening in ADL function, whereas the current findings did not support that poor ADL predate the cognition decline or reciprocal influence hypotheses. CONCLUSIONS The elderly with poor cognitive function may be more vulnerable to deterioration in ADL. Findings underscore the importance of early screening for cognitive function among the elderly as the key strategy to prevent further ADL impairment and keep independence.
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Affiliation(s)
- Juan Wang
- School of Public Health, Guangzhou Medical University, Guangzhou, China.,Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-Heng Zhu
- College of information science and technology, Jinan University, Guangzhou, China
| | - You-Fu Li
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-Wen Zhu
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Ikeda Y, Ogawa N, Yoshiura K, Han G, Maruta M, Hotta M, Tabira T. Instrumental Activities of Daily Living: The Processes Involved in and Performance of These Activities by Japanese Community-Dwelling Older Adults with Subjective Memory Complaints. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142617. [PMID: 31340466 PMCID: PMC6678870 DOI: 10.3390/ijerph16142617] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/19/2019] [Accepted: 07/20/2019] [Indexed: 11/19/2022]
Abstract
Subjective memory complaints (SMCs) may predict the onset of dementia. The purpose of this study was to clarify characteristics of performance of activities of daily living (ADL) for older adults with SMCs and to offer support options that enable them to maintain their community-based lifestyle. A self-administered questionnaire was sent to 2000 randomly selected members of CO-OP Kagoshima, and 621 responded. 270 responders answered all questions were categorized into SMC (+) group and SMC (−) group (n = 133). Participants were evaluated the Process Analysis of Daily Activity for Dementia. A 2-sample t-test or the Chi-square test were used to compare the averages of continuous variables or the proportions of categorical variables. The results showed the SMC (+) group ranked significantly lower in ability to use the telephone, shop, cook, do housekeeping, manage finances, and manage medications compared with the SMC (−) group. In addition, the SMC (+) group was significantly less independent than the SMC (−) group in many processes requiring the use of tools, operation of machines, management of goods, selection of tools, and monitoring. To enable continued independence of older adults’ experiencing SMCs, it may be important to analyze their performance of ADL and to develop plans for supporting their strengths.
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Affiliation(s)
- Yuriko Ikeda
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University 8-35-1, Sakuragaoka Kagoshima 890-8544, Japan.
| | - Noriyuki Ogawa
- Faculty of Health Science, Kyoto Tachibana University 34, Yamada-cho, Oyake Yamashina-Ku, Kyoto 607-8175, Japan
| | - Kazuhiro Yoshiura
- Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Gwanghee Han
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University 8-35-1, Sakuragaoka Kagoshima 890-8544, Japan
| | - Michio Maruta
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University 8-35-1, Sakuragaoka Kagoshima 890-8544, Japan
| | - Maki Hotta
- Department of Psychiatry, Graduate School of Medicine, Osaka University 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takayuki Tabira
- Graduate School of Health Science, Kagoshima University, 8-35-1, Sakuragaoka Kagoshima 890-8544, Japan
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