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Shi J, Zhang D, Liu X. Intergenerational Caregiving Patterns and Cognitive Health among the Sandwich Generation Within Four-Generation Families. Int J Aging Hum Dev 2024:914150241235088. [PMID: 38436083 DOI: 10.1177/00914150241235088] [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: 03/05/2024]
Abstract
This study aims to investigate whether generational differences in intergenerational caregiving patterns (caring for parents only, caring for grandchildren only, and caring for parents and grandchildren simultaneously) are associated with cognitive health disparities among the sandwich generation within four-generation families, drawing upon the theories of intergenerational solidarity and intergenerational stake. Moreover, this study seeks to identify mediators that help explain these disparities. A nationally representative sample of 8,065 respondents was drawn from the 2011 and 2018 waves of the China Health and Retirement Longitudinal Study. The findings reveal that the sandwich generation caring for grandchildren only, as well as those caring for grandchildren and parents simultaneously, exhibit better cognitive health. However, caregiving for parents only is not significantly related to their cognitive health. This study identifies the inability to reduce depressive symptoms as a mediator explaining the insignificant association between caregiving for parents only and the cognitive health of the sandwich generation. The findings underscore the importance of offering support to the sandwich generation within four-generation families to enhance their cognitive health. Moreover, it is imperative to distinguish between different intergenerational caregiving patterns based on generational differences among the sandwich generation, with a specific emphasis on allocating public resources aimed at promoting cognitive health for those engaged in caring for parents.
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Affiliation(s)
- Jiaming Shi
- Department of Social Security, School of Public Administration, Southwestern University of Finance and Economics, Chengdu, China
| | - Denghao Zhang
- School of Marxism, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoting Liu
- School of Public Affairs, Zhejiang University, Hangzhou, China
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2
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Bhattacharyya KK, Gupta DD, Schwartz S, Molinari V, Fauth EB. Protective roles of meditation practice and self-esteem on cognitive functions over time: findings from the Midlife in the United States study. Psychogeriatrics 2024; 24:94-107. [PMID: 37994673 DOI: 10.1111/psyg.13046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Cognitive function is an important component of healthy ageing. However, it is unclear whether relaxation/meditation practices provide cognitive benefits, particularly in midlife and early late life. Meditative practices are associated with higher self-esteem, and self-esteem serves as a general protective factor for many health outcomes. The current study examines associations between meditation practice, self-esteem, and change over 10 years in midlife cognitive performance. METHODS Data were from waves 2 (2003-2004) and 3 (2013-2014) of the Midlife in the United States (MIDUS) study. We used structural equation modelling to examine whether persistent meditation practice at both waves or episodic practice at one wave is associated with better cognitive function over 10 years, compared to no meditation practice, while controlling for prior cognitive function and covariates (baseline socio-demographics, health, and functional status). Additionally, we assessed if self-esteem mediates the above associations. RESULTS We included 2168 individuals (Mage = 65 ± 11). After controlling for covariates, the findings revealed that persistent meditation practice in both waves was associated with significantly less decline in episodic memory; however, no such effects were found for executive function. Further, although participants' higher self-esteem was significantly associated with less decline in executive function and episodic memory, it did not mediate the associations between meditation practice and cognitive functions. CONCLUSIONS While both persistent meditation practice and self-esteem have associations with cognitive outcomes for middle-aged and older adults in MIDUS, self-esteem as a mediator was not supported. Thus, future investigations should examine mechanisms that underlie these protective factors on cognitive performances across adulthood.
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Affiliation(s)
| | - Debasree Das Gupta
- Alzheimer's Disease and Dementia Research Center, Utah State University, Logan, Utah, USA
- Department of Kinesiology and Health Science, Utah State University, Logan, Utah, USA
| | - Sarah Schwartz
- Alzheimer's Disease and Dementia Research Center, Utah State University, Logan, Utah, USA
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Victor Molinari
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Elizabeth B Fauth
- Alzheimer's Disease and Dementia Research Center, Utah State University, Logan, Utah, USA
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
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3
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Fearn K, Bhattacharyya KK. Is Use of Psychedelic Drugs a Risk or Protective Factor for Late-Life Cognitive Decline? Gerontol Geriatr Med 2024; 10:23337214241250108. [PMID: 38694265 PMCID: PMC11062230 DOI: 10.1177/23337214241250108] [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: 12/15/2023] [Revised: 03/11/2024] [Accepted: 04/09/2024] [Indexed: 05/04/2024] Open
Abstract
Objectives: Common age-related health conditions can lead to poor mental health outcomes and deteriorate cognition. Additionally, commonly prescribed medications for various mental/physical health conditions may cause adverse reactions, especially among older adults. Psychedelic therapy has shown positive impacts on cognition and has been successful in treating various mental health problems without long-lasting adversities. The current study examines the association between psychedelic drug usage and cognitive functions in middle-aged and older adults. Methods: Data were from wave 3 (2013-2014) of the Midlife in the United States (MIDUS) study. We used multiple linear regression models examining associations between psychedelic usage and cognitive functions, controlling for covariates of sociodemographic and health factors. Results: We included 2,503 individuals (Mage = 64 ± 11). After controlling for covariates, the finding revealed that psychedelic usage was independently associated with more favorable changes in executive function (β = .102, SE = 0.047, p = .031) and less depressive symptoms (β = -.090, SE = 0.021, p < .001). The same effect was not found for episodic memory (β = .039, SE = 0.066, p = .553). Discussion: Addressing the mental health implications of physical health conditions in older adults are vital for preventing neurocognitive deterioration, prolonging independence, and improving the quality of life. More longitudinal research is essential utilizing psychedelics as an alternative therapy examining late-life cognitive benefits.
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Bhattacharyya KK, Liu Y, Das Gupta D, Molinari V, Fauth EB. The Healthy Caregiver? A Positive Impact of Informal Caregiving Status on Cognitive Functions Over Time From the Midlife in the United States Study. J Aging Health 2023:8982643231209482. [PMID: 37864504 DOI: 10.1177/08982643231209482] [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: 10/23/2023]
Abstract
OBJECTIVES The current study examined whether informal caregivers performed worse, better, or similar to non-caregivers on cognitive tests of executive functioning and episodic memory over 10 years. Methods: Data were from waves 2 (2003-04) and 3 (2013-14) of the Midlife in the United States (MIDUS) study (N = 2086). Multiple linear regression models examined whether caregiving at both waves 2 and 3 predicted better cognitive functioning at wave 3, than caregiving at only one time point or no caregiving (reference) while controlling for baseline covariates (i.e., sociodemographic, health, and functional status). RESULTS After controlling for covariates, caregiving at both waves was independently associated with better performance in episodic memory (b = .24, SE = .10, p = .013) but not executive function (b = -.06, SE = .05, p = .246). Discussion:The findings partially supported both healthy caregiver and stress process models, indicating caregiving may be associated with better episodic memory but not executive functioning over time among the middle-aged and older adults.
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Affiliation(s)
| | - Yin Liu
- Alzheimer's Disease and Dementia Research Center, Utah State University, Logan, UT, USA
- Department of Human Development and Family Studies, Utah State University, Logan, UT, USA
| | - Debasree Das Gupta
- Alzheimer's Disease and Dementia Research Center, Utah State University, Logan, UT, USA
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, USA
| | - Victor Molinari
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Elizabeth B Fauth
- Alzheimer's Disease and Dementia Research Center, Utah State University, Logan, UT, USA
- Department of Human Development and Family Studies, Utah State University, Logan, UT, USA
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5
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Risk Factors of Cognitive Decline in Older Caregivers With HIV: An Emerging Hypothesis. J Assoc Nurses AIDS Care 2022; 33:676-681. [PMID: 35878046 DOI: 10.1097/jnc.0000000000000349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT People with HIV (PWH) are living longer and healthier lives; thanks to combination antiretroviral therapy. As many PWH age, they find themselves providing care to family members and friends, just as their counterparts without HIV. The literature indicates that becoming a caregiver creates conditions that compromise one's cognitive function. Additionally, nearly 45% of all PWH experience HIV-associated neurocognitive disorder and are already vulnerable to cognitive impairment due to HIV, aging, and accompanying health conditions, and lifestyle factors. Given what is known, we assert that caregivers with HIV, especially as they age, are at additional risk for developing cognitive impairments. The purpose of this commentary was to briefly examine the juxtaposition between cognitive vulnerability of caregiving and the cognitive vulnerability of aging with HIV. Potential factors contributing to impaired cognition include stress, lack of social support, stigma, lifestyle, and comorbidities. Implications for clinical practice and research are provided.
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García-Castro FJ, Bendayan R, Dobson RJB, Blanca MJ. Cognition in informal caregivers: evidence from an English population study. Aging Ment Health 2022; 26:507-518. [PMID: 33719753 DOI: 10.1080/13607863.2021.1893270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES The relationship between caregiving and cognition remains unclear. We investigate this association comparing four cognitive tasks and exploring the role of potential explanatory pathways such as healthy behaviours (healthy caregiver hypothesis) and depression (stress process model). RESEARCH DESIGN AND METHODS Respondents were from English Longitudinal Study of Ageing (ELSA) (N = 8910). Cognitive tasks included immediate and delayed word recall, verbal fluency and serial 7 subtraction. Series of hierarchical linear regressions were performed. Adjustments included socio-demographics, health related variables, health behaviours and depression. RESULTS Being a caregiver was positively associated with immediate and delayed recall, verbal fluency but not with serial 7. For immediate and delayed recall, these associations were partially attenuated when adjusting for health behaviours, and depression. For verbal fluency, associations were partially attenuated when adjusting for depression but fully attenuated when adjusting for health behaviours. No associations were found for serial 7. DISCUSSION AND IMPLICATIONS Our findings show that caregivers have higher level of memory and executive function compared to non-caregivers. For memory, we found that although health behaviours and depression can have a role in this association, they do not fully explain it. However, health behaviours seem to have a clear role in the association with executive function. Public health and policy do not need to target specifically cognitive function but other areas as the promotion of healthy behaviours and psychological adjustment such as preventing depression and promoting physical activity in caregivers.
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Affiliation(s)
- F Javier García-Castro
- Department of Psychobiology and Behavioral Sciences Methodology, University of Malaga, Malaga, Spain
| | - Rebecca Bendayan
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King's College London, London, UK
| | - Richard J B Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King's College London, London, UK
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK London, University College London, London, UK
- NIHR Biomedical Research Centre at University College London Hospitals NHS Foundation Trust, London, UK
| | - María J Blanca
- Department of Psychobiology and Behavioral Sciences Methodology, University of Malaga, Malaga, Spain
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Wu-Chung EL, Leal SL, Denny BT, Cheng SL, Fagundes CP. Spousal caregiving, widowhood, and cognition: A systematic review and a biopsychosocial framework for understanding the relationship between interpersonal losses and dementia risk in older adulthood. Neurosci Biobehav Rev 2022; 134:104487. [PMID: 34971701 PMCID: PMC8925984 DOI: 10.1016/j.neubiorev.2021.12.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 01/18/2023]
Abstract
Accumulating research suggests that stressful life events, especially those that threaten close intimate bonds, are associated with an increased risk of dementia. Grieving the loss of a spouse, whether in the form of caregiving or after the death, ranks among 'life's most significant stressors', evoking intense psychological and physiological distress. Despite numerous studies reporting elevated dementia risk or poorer cognition among spousal caregivers and widow(er)s compared to controls, no review has summarized findings across cognitive outcomes (i.e., dementia incidence, cognitive impairment rates, cognitive performance) or proposed a theoretical model for understanding the links between partner loss and abnormal cognitive decline. The current systematic review summarizes findings across 64 empirical studies. Overall, both cross-sectional and longitudinal studies revealed an adverse association between partner loss and cognitive outcomes. In turn, we propose a biopsychosocial model of cognitive decline that explains how caregiving and bereavement may position some to develop cognitive impairment or Alzheimer's disease and related dementias. More longitudinal studies that focus on the biopsychosocial context of caregivers and widow(er)s are needed.
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Affiliation(s)
| | | | - Bryan T. Denny
- Department of Psychological Sciences, Rice University, Houston, TX
| | | | - Christopher P. Fagundes
- Department of Psychological Sciences, Rice University, Houston, TX,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX,Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX
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Brewster GS, Molinari V, McCrae C, Beckstead J, D'Aoust R, Rowe M. Cognitive Function and Sleep in Caregivers of Persons Living with Dementia. West J Nurs Res 2021; 44:260-268. [PMID: 34467789 DOI: 10.1177/01939459211041163] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Poor sleep is prevalent among caregivers of persons living with dementia and increases their risk for cognitive impairment and decline. In this cross-sectional, correlational study, we compared the cognitive function scores of caregivers with poor sleep with the demographically adjusted normed scores of the National Institutes of Health Toolbox Cognition Battery. Caregivers completed a 14-day sleep diary. On average, caregivers (n = 28) were 65.14 (±10.08) years, female, and White. Their average crystallized cognitive function composite score was significantly higher and their average fluid cognitive function composite score was significantly lower than the normative scores. Caregivers performed significantly worse on the processing speed domain measure. Poor sleep may affect how caregivers, including highly educated caregivers, process and respond to information, thus can influence how they safely perform complex caregiving tasks. Health care providers should consistently assess caregivers' sleep and cognitive abilities to promptly identify changes and provide timely interventions.
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Affiliation(s)
- Glenna S Brewster
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Victor Molinari
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | | | - Jason Beckstead
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Rita D'Aoust
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Meredeth Rowe
- College of Nursing, University of South Florida, Tampa, FL, USA
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9
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Yuan J, Grühn D. Time Effects of Informal Caregiving on Cognitive Function and Well-Being: Evidence From ELSA. THE GERONTOLOGIST 2021; 61:341-351. [PMID: 32840611 DOI: 10.1093/geront/gnaa114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES As informal caregiving becomes prevalent, its consequences for caregivers' cognitive and socioemotional functioning gain more importance for society. There are inconsistent findings regarding the direction of the impact of caregiving-whether caregiving maintains or compromises functioning-and the impact of time-whether the effects accumulate or are stable. In this study, we elucidated 3 time effects of caregiving-concurrent, cumulative, and lagged effects-on cognitive and socioemotional functioning. RESEARCH DESIGN AND METHODS We used data from Wave 1 (2002-2003) to Wave 8 (2016-2017) in the English Longitudinal Study of Ageing (ELSA) and latent growth curve models with the time-varying predictor to investigate 3 time effects of caregiving on cognitive function (memory and executive function) and well-being (life satisfaction and quality of life). RESULTS Over and beyond age effects, current caregiving (concurrent effect) was related to worse well-being and better delayed recall. Little robust cumulative effect was found on cognition and well-being. In addition, there were significant and differential lagged effects of caregiving after controlling for concurrent and cumulative effects; that is, caregiving was related to worse well-being and better memory functioning 2-4 years later. DISCUSSION AND IMPLICATIONS The differential concurrent and lagged effects of caregiving on cognitive and socioemotional functioning suggest separate mechanisms for different domains of functioning. The nonsignificant cumulative effects but significant lagged effects imply that even one-time caregiving has long-term (2-4 years) consequences for the caregiver's future functioning, and the mechanism of long-term caregiving effects may be more qualitative than quantitative.
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Affiliation(s)
- Jing Yuan
- Department of Psychology, North Carolina State University, Raleigh
| | - Daniel Grühn
- Department of Psychology, North Carolina State University, Raleigh
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Falzarano F, Siedlecki KL. Differences in cognitive performance between informal caregivers and non-caregivers. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2021; 28:284-307. [PMID: 32270735 PMCID: PMC7544647 DOI: 10.1080/13825585.2020.1749228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
Extensive literature exists documenting the relationship between stress and cognition. Caregiving for an individual with Alzheimer's disease can be aunique and chronic stress experience due to the increasing dependency of the care-recipient as the disease progresses. The current study examines the relationship between stress and cognitive performance in 47 dementia caregivers compared to 47 noncaregiver control participants matched on age, gender, and education. Participants completed measures assessing stress (measured via the Perceived Stress Scale) and seven domains of cognition including episodic memory, working memory, executive functioning, attention, visuospatial processing, processing speed, and implicit memory. Results showed that caregivers had poorer performance than non-caregivers on certain measures of episodic memory, working memory, and executive functioning; while no significant differences were observed on measures of attention, visuospatial processing, processing speed, or implicit memory. In addition, when controlling for general stress, caregiver performance on measures of processing speed and visuospatial processing was also poorer than non-caregivers. By controlling for levels of general stress that may not be related to caregiving, these results show that differences in cognitive performance are unlikely to be explained by general stress alone.
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Affiliation(s)
| | - Karen L Siedlecki
- Department of Psychology, Fordham University , Bronx, NY, United States
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Walsh S, Pertl M, Gillespie P, Lawlor B, Brennan S, O'Shea E. Factors influencing the cost of care and admission to long-term care for people with dementia in Ireland. Aging Ment Health 2021; 25:512-520. [PMID: 31847539 DOI: 10.1080/13607863.2019.1699901] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To explore the factors associated with the cost of care and admission to long-term care (LTC) for people with dementia living at home in Ireland. METHODS Data on formal and informal resource use for people with dementia, and their LTC admission, were obtained from a national study of spousal dementia caregivers. Functional status was measured using the Bristol Activities of Daily Living Scale, while behavioural and psychiatric symptoms were evaluated using the Neuropsychiatric Inventory. Multivariable regression analysis was used to model costs and the predictors of LTC admission. RESULTS Physical and cognitive symptoms were significantly associated with costs. Severely impaired functional ability was associated with a €2,308 increase in mean total 30-day monthly costs. Psychosis was associated with a €335 increase in primary and community 30-day monthly care costs. These factors also make it more likely that a person with dementia is admitted to LTC. Having an older caregiver also increases the risk of admission to LTC, while living in a rural area and having a female caregiver reduce the likelihood of admission. CONCLUSIONS Dependency matters for the cost of care. Physical and cognitive symptoms, caregiver age and gender, and geographic location are significant predictors of admission to LTC.
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Affiliation(s)
- Sharon Walsh
- Centre for Economic and Social Research on Dementia, Discipline of Economics, National University of Ireland Galway, Galway, Ireland
| | - Maria Pertl
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paddy Gillespie
- Health Economic and Policy Analysis Centre, Discipline of Economics, National University of Ireland Galway, Galway, Ireland
| | - Brian Lawlor
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Sabina Brennan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Eamon O'Shea
- Centre for Economic and Social Research on Dementia, Discipline of Economics, National University of Ireland Galway, Galway, Ireland
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Bissig D, Kaye J, Erten‐Lyons D. Validation of SATURN, a free, electronic, self-administered cognitive screening test. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12116. [PMID: 33392382 PMCID: PMC7771179 DOI: 10.1002/trc2.12116] [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: 07/14/2020] [Revised: 10/19/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognitive screening is limited by clinician time and variability in administration and scoring. We therefore developed Self-Administered Tasks Uncovering Risk of Neurodegeneration (SATURN), a free, public-domain, self-administered, and automatically scored cognitive screening test, and validated it on inexpensive (<$100) computer tablets. METHODS SATURN is a 30-point test including orientation, word recall, and math items adapted from the Saint Louis University Mental Status test, modified versions of the Stroop and Trails tasks, and other assessments of visuospatial function and memory. English-speaking neurology clinic patients and their partners 50 to 89 years of age were given SATURN, the Montreal Cognitive Assessment (MoCA), and a brief survey about test preferences. For patients recruited from dementia clinics (n = 23), clinical status was quantified with the Clinical Dementia Rating (CDR) scale. Care partners (n = 37) were assigned CDR = 0. RESULTS SATURN and MoCA scores were highly correlated (P < .00001; r = 0.90). CDR sum-of-boxes scores were well-correlated with both tests (P < .00001) (r = -0.83 and -0.86, respectively). Statistically, neither test was superior. Most participants (83%) reported that SATURN was easy to use, and most either preferred SATURN over the MoCA (47%) or had no preference (32%). DISCUSSION Performance on SATURN-a fully self-administered and freely available (https://doi.org/10.5061/dryad.02v6wwpzr) cognitive screening test-is well-correlated with MoCA and CDR scores.
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Affiliation(s)
- David Bissig
- Department of NeurologyUniversity of California–DavisSacramentoCaliforniaUSA
| | - Jeffrey Kaye
- Department of NeurologyOregon Health and Science UniversityPortlandOregonUSA
| | - Deniz Erten‐Lyons
- Department of NeurologyVeterans Affairs Medical CenterPortlandOregonUSA
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Pavarini SCI, Bregola AG, Luchesi BM, Oliveira D, Orlandi FDS, de Moura FG, Silva HRO, de Oliveira NA, Zazzetta MS, Dos Santos-Orlandi AA, Ottaviani AC. Social and health-related predictors of family function in older spousal caregivers: a cross-sectional study. Dement Neuropsychol 2020; 14:372-378. [PMID: 33354290 PMCID: PMC7735050 DOI: 10.1590/1980-57642020dn14-040007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Given the benefits of adequate family function for the health and well-being of older adults, it is important to understand what factors predict adequate family function in older people who care for their spouses.
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Affiliation(s)
- Sofia Cristina Iost Pavarini
- Department of Gerontology, Universidade Federal de São Carlos - São Carlos, SP, Brazil.,Graduate Program in Nursing, Universidade Federal de São Carlos - São Carlos, SP, Brazil
| | | | - Bruna Moretti Luchesi
- Graduate Program in Nursing, Universidade Federal de Mato Grosso do Sul - Três Lagoas, MS, Brazil
| | - Déborah Oliveira
- School of Medicine, Department of Psychiatry, Universidade Federal de São Paulo - São Paulo, SP, Brazil
| | - Fabiana de Souza Orlandi
- Department of Gerontology, Universidade Federal de São Carlos - São Carlos, SP, Brazil.,Graduate Program in Nursing, Universidade Federal de São Carlos - São Carlos, SP, Brazil
| | - Fernanda Gomez de Moura
- Universidade do Vale do Paraíba, Graduate Program in Gerontology - São José dos Campos, SP, Brazil
| | | | | | - Marisa Silvana Zazzetta
- Department of Gerontology, Universidade Federal de São Carlos - São Carlos, SP, Brazil.,Graduate Program in Nursing, Universidade Federal de São Carlos - São Carlos, SP, Brazil
| | - Ariene Angelini Dos Santos-Orlandi
- Department of Gerontology, Universidade Federal de São Carlos - São Carlos, SP, Brazil.,Department of Nursing, Universidade Federal de São Calos - São Carlos, SP, Brazil
| | - Ana Carolina Ottaviani
- Graduate Program in Nursing, Universidade Federal de São Carlos - São Carlos, SP, Brazil
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14
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Jütten LH, Mark RE, Sitskoorn MM. Episodic memory and executive functioning in informal dementia caregivers. Aging Ment Health 2020; 24:1681-1689. [PMID: 31116020 DOI: 10.1080/13607863.2019.1617242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objectives: Informal dementia caregivers are thought to experience high levels of depression and burden, which can contribute to worse cognitive functioning. However, poorer cognitive functioning in caregivers is not always found. The current study explored whether caregivers perform better, worse, or similar to non-caregivers on tasks for executive functioning and memory. Whether sociodemographic and psychosocial characteristics are associated with caregivers' performance was also assessed.Methods: One hundred forty-five caregivers completed the Letter Fluency and Category Fluency, the Logical Memory test from the WMS-III, and five questionnaires assessing psychological characteristics. Standardized z-scores (based on age, education, and sex) were calculated using data from a matched control group (187 non-caregivers). One sample z-tests were executed to examine if the caregivers' standardized mean z-score significantly deviated from the population mean of z = 0. The z-scores were used as dependent variables in multivariable regression analyses.Results: The caregivers performed significantly better on Logical Memory - Immediate Recall than non-caregivers (z = 2.92, p = .004). The obtained z-scores on the other tasks did not deviate significantly from 0. Male sex and social reliance predicted higher scores on Category Fluency, but the F-test was non-significant, and the explained variance was low (adjusted R2 = .068).Conclusions: We found no evidence for poorer cognitive performance among informal caregivers compared to non-caregivers. Our results suggest that caregiving for a loved one with dementia does not impair the caregivers' episodic memory or executive functioning when measured cross-sectionally.
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Affiliation(s)
- Linda Helena Jütten
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Ruth Elaine Mark
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
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Ottaviani AC, Bregola AG, Terassi M, Luchesi BM, Souza ÉN, de Oliveira NA, Fraga FJ, Pavarini SCI. Comparison of cognitive performance and aspects of the care context in elderly caregivers in Brazil: A follow-up study. Dement Neuropsychol 2020; 14:159-164. [PMID: 32595885 PMCID: PMC7304268 DOI: 10.1590/1980-57642020dn14-020009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Cognitive health is important for the quality of life and well-being of elderly caregivers. Cognitive impairments can negatively affect the ability to care for oneself and others.
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Affiliation(s)
| | | | | | - Bruna Moretti Luchesi
- Federal University of Mato Grosso do Sul, Três Lagoas Campus, Graduate Program in Nursing, Três Lagoas, MS, Brazil
| | - Érica Nestor Souza
- Federal University of São Carlos, Graduate Program in Nursing, São Carlos, SP, Brazil
| | | | - Francisco José Fraga
- Federal University of ABC (UFABC), Engineering, Modeling and Applied Social Sciences Center (CECS), Santo André, SP, Brazil
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Romero-Martínez Á, Hidalgo-Moreno G, Moya-Albiol L. Neuropsychological consequences of chronic stress: the case of informal caregivers. Aging Ment Health 2020; 24:259-271. [PMID: 30450952 DOI: 10.1080/13607863.2018.1537360] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Introduction: Caring for a family member with a long-term illness is a significant source of chronic stress that might significantly accelerate the cognitive ageing of informal caregivers. Nevertheless, the absence of a defined theoretical body of literature on the neuropsychology of this population makes it difficult to understand what the characteristic neuropsychological deficits of these caregivers are.Aims: The main aim of this study is to carry out a systematic review of studies of cognitive deficits present in informal caregivers of people with several chronic pathologies, and analyse the effects of cognitive-behavioural interventions on caregivers' cognition.Methods: The scientific literature was reviewed following the PRISMA quality criteria for reviews using the following digital databases: PubMEd, PsycINFO, and Dialnet.Results: Identification of 2046 abstracts and retrieval of 211 full texts led to the inclusion of 38 papers. The studies showed heterogeneous results, but most of the cross-sectional studies reviewed that employed neuropsychological assessments concluded that informal caregivers reported a generalized cognitive deterioration, especially memory dysfunctions (i.e. learning verbal, visuospatial, and digit information). Moreover, they also presented low selective attention and capacity for inhibition, along with slow processing speed. Longitudinal studies confirmed that caregivers whose care situation was more prolonged showed a marked deterioration in their overall cognitive state, memory, processing speed, and vocabulary richness. However, although the patient's death does not seem to reverse the neuropsychological alterations in caregivers, cognitive-behavioural interventions that employ techniques to reduce stress levels, cognitive biases, and inadequate adaptation schemas seem to improve some of the aforementioned cognitive abilities.Conclusions: Results from this synthesis and critical analysis of neuropsychological deficits in informal caregivers offer guidelines for diagnosing caregivers' cognitive status by including a test battery covering all the domains considered relevant. Finally, given the ability of cognitive behavioural interventions to improve cognition in caregivers, further studies on their long-term effects on caregivers are warranted.Chronic stress entails an acceleration of the cognitive ageingCross-sectional studies concluded that informal caregivers reported a generalized cognitive deteriorationCognitive-behavioural interventions seem to improve cognitive abilities of caregivers.
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Pertl MM, Sooknarine-Rajpatty A, Brennan S, Robertson IH, Lawlor BA. Caregiver Choice and Caregiver Outcomes: A Longitudinal Study of Irish Spousal Dementia Caregivers. Front Psychol 2019; 10:1801. [PMID: 31456713 PMCID: PMC6700469 DOI: 10.3389/fpsyg.2019.01801] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/19/2019] [Indexed: 11/17/2022] Open
Abstract
Background The perception of choice in becoming a caregiver may impact on caregiver psychological and physical health. We determined the proportion of spousal dementia caregivers who felt they had a choice, and examined whether lack of choice in taking up the caregiving role and the perceived degree of choice in caregiving predicted caregiver health and wellbeing and care-recipient placement in long-term care at 1-year follow-up. Methods We performed secondary analyses of data from DeStress, a longitudinal study of 251 spousal dementia caregivers in Ireland. We used multivariate logistic and linear regression analyses to examine whether lack of choice (a dichotomous item) and/or the perceived degree of choice (a 9-point scale) at baseline predicted caregiver health (number of chronic health conditions; self-reported health) and wellbeing (e.g., burden, anxiety, depression, stress, and positive aspects of caregiving) and care status (continued care at home or placement in long-term care) at follow-up. Results The vast majority of caregivers (82%) reported that they had no choice in taking up the caregiving role. Nevertheless, nearly three-quarters (74%) responded above the midpoint on the rating scale (Mean = 6.82, SD = 3.22; Median = 9; Mode = 9), indicating they provided care voluntarily. Caregivers who reported a greater degree of choice were more likely to still be providing care at home at follow-up and to identify benefits from providing care. Neither choice nor degree of choice predicted any other caregiver outcomes. Conclusion For the vast majority of spousal dementia caregivers, taking up the caregiving role is not perceived as a choice; yet, most report performing this role voluntarily. Thus, facilitating greater choice may not necessarily diminish the key contribution family caregivers make to the care system. Although we found no evidence that caregiver choice predicted more positive caregiver health and wellbeing, the perception of choice is important in and of itself, and may benefit caregivers by facilitating the identification of positive aspects of care and be a factor in delaying care-recipient placement in long-term care. Future research should be especially mindful of how caregiver choice is assessed and how this may affect the resulting prevalence of choice.
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Affiliation(s)
- Maria M Pertl
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Sabina Brennan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Ian H Robertson
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Brain A Lawlor
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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