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Holmqvist SL, Jobson K, Desalme D, Simone SM, Tassoni M, McKniff M, Yamaguchi T, Olson I, Martin N, Giovannetti T. Preliminary validation of the Virtual Kitchen Challenge as an objective and sensitive measure of everyday function associated with cerebrovascular disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12547. [PMID: 38318469 PMCID: PMC10840367 DOI: 10.1002/dad2.12547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/27/2023] [Accepted: 01/12/2024] [Indexed: 02/07/2024]
Abstract
Preliminary validity of a computer-based test of everyday function (Virtual Kitchen Challenge [VKC]) was examined against brain-imaging markers of cerebrovascular disease and in contrast to conventional neuropsychological and self-report measures. Twenty community-dwelling older adults (n = 6 mild cognitive impairment) performed simulated breakfast and lunch tasks using a computer touchscreen (VKC). Automated measures (completion time, proportion time off screen, etc.) were computed during training and test conditions. White matter hyperintensity (WMH) volumes from brain magnetic resonance imaging and conventional measures of cognition and function also were obtained. VKC completion time and proportion time off screen improved significantly from training to test and were significantly associated with WMH volume (r > 0.573). VKC measures and WMH were not significantly correlated with conventional cognitive or self-report measures. The VKC holds promise as a valid measure of subtle functional difficulties in older adults that is sensitive to change and cerebrovascular pathology, highlighting its potential for clinical trials. Highlights Virtual Kitchen Challenge (VKC) scores showed significant improvement from training to test conditions.VKC scores (completion time and proportion of time off screen) were associated with a neuroimaging biomarker of brain health (white matter hyperintensities).
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Affiliation(s)
- Sophia L. Holmqvist
- Department of Psychology and NeuroscienceTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Katie Jobson
- Department of Psychology and NeuroscienceTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Dennis Desalme
- Department of Communication Sciences and DisordersEleanor M. Saffran Center for Cognitive NeuroscienceTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Stephanie M. Simone
- Department of Psychology and NeuroscienceTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Molly Tassoni
- Department of Psychology and NeuroscienceTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Moira McKniff
- Department of Psychology and NeuroscienceTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Takehiko Yamaguchi
- Department of Applied Information EngineeringSuwa University of ScienceNaganoJapan
| | - Ingrid Olson
- Department of Psychology and NeuroscienceTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Nadine Martin
- Department of Communication Sciences and DisordersEleanor M. Saffran Center for Cognitive NeuroscienceTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Tania Giovannetti
- Department of Psychology and NeuroscienceTemple UniversityPhiladelphiaPennsylvaniaUSA
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Koblinsky ND, Anderson ND, Ajwani F, Parrott MD, Dawson D, Marzolini S, Oh P, MacIntosh B, Middleton L, Ferland G, Greenwood CE. Feasibility and preliminary efficacy of the LEAD trial: a cluster randomized controlled lifestyle intervention to improve hippocampal volume in older adults at-risk for dementia. Pilot Feasibility Stud 2022; 8:37. [PMID: 35139918 PMCID: PMC8826667 DOI: 10.1186/s40814-022-00977-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 01/11/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Healthy diet and exercise are associated with reduced risk of dementia in older adults. The impact of diet and exercise interventions on brain health is less consistent, especially with dietary interventions which rely on varying approaches. Our objective was to evaluate the feasibility and preliminary efficacy of a 6-month intervention combining exercise with a novel dietary counseling approach to improve hippocampal volume among older adults at-risk for dementia. METHODS Participants with vascular risk factors and subjective cognitive decline or early mild cognitive impairment were cluster randomized in groups of 3-4 to the diet intervention (DIET) or control education (ED) group. All participants engaged in 1 h of supervised exercise per week and additional exercise at home. DIET involved 1 h per week of group-based dietary counseling comprising education, goal setting, and strategy training. ED involved 1 h per week of group-based brain health education classes. Our primary outcome was change in hippocampal volume from baseline to 6 months. Secondary outcomes included changes in cognitive function, blood biomarkers, diet, and fitness. Recruitment challenges and early discontinuation of the trial due to COVID-19 necessitated a revised focus on feasibility and preliminary efficacy. RESULTS Of 190 older adults contacted, 14 (7%) were eligible and enrolled, constituting 21% of our recruitment target. All participants completed the intervention and attended 90% of exercise and DIET/ED sessions on average. All 6-month assessments prior to COVID-19 were completed but disruptions to in-person testing resulted in incomplete data collection. No serious adverse events occurred and all participants expressed positive feedback about the study. Preliminary findings did not identify any significant changes in hippocampal volume; however, substantial improvements in diet and HbA1c were observed with DIET compared to ED (d = 1.75 and 1.07, respectively). CONCLUSIONS High adherence and retention rates were observed among participants and preliminary findings illustrate improvements in diet quality and HbA1c. These results indicate that a larger trial is feasible if difficulties surrounding recruitment can be mitigated. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03056508 .
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Affiliation(s)
- N D Koblinsky
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - N D Anderson
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada.
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada.
| | - F Ajwani
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- KITE, Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - M D Parrott
- PERFORM Centre, Concordia University, Montreal, Canada
| | - D Dawson
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Occupational Sciences and Occupational Therapy and Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - S Marzolini
- KITE, Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - P Oh
- KITE, Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - B MacIntosh
- Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | | | - G Ferland
- Montreal Heart Institute Research Centre, Montreal, Canada
- Department of Nutrition, Université de Montréal, Montreal, Canada
| | - C E Greenwood
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
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3
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McDougall GJ, McDonough IM, LaRocca M. Memory training for adults with probable mild cognitive impairment: a pilot study. Aging Ment Health 2019; 23:1433-1441. [PMID: 30303394 PMCID: PMC6458094 DOI: 10.1080/13607863.2018.1484884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background & Objectives: This pilot study aimed to evaluate the efficacy of memory training and health training intervention over a 24-month period in people with probable mild cognitive impairment (MCI). Research Design & Methods: Based on the accepted criteria, and the neuropsychiatric measures used in the trial, MCI was defined as a subjective change in cognition, impairment in episodic memory, preservation of independence of functional abilities, and no dementia. Without a neurological assessment, laboratory tests, and psychometric evaluation combined, some of our participants may have had dementia that we were unable to detect through neuropsychological testing. Of the 263 total participants, 39 met criteria for a diagnosis of MCI. There were 19 adults in the memory and 20 in health training conditions. Both groups received twenty hours of classroom content that included eight hours of booster sessions at three months post intervention. Hierarchical linear models (HLM) and standardized regression-based (SBR) analyses were used to test the efficacy of the intervention on immediate recall, delayed recall, subjective memory complaints, and memory self-efficacy. Age, education, depression, racial group, ethnic group, MMSE score, and baseline performance were included as covariates. Results: Over 24 months, the MCI group in the memory training condition showed better objective and subjective memory outcomes compared with the MCI group in the health training condition. Conclusions: Senior WISE Memory training delivered to individuals with MCI was able to forestall the participants' declining cognitive ability and sustain the benefit over two years in both subjective and objective memory function.
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Affiliation(s)
| | | | - Michael LaRocca
- Veterans Administration Palo Alto Health Care System, War Related Illness and Injury Study Center
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McDougall GJ, Han A, Staggs VS, Johnson DK, McDowd JM. Predictors of instrumental activities of daily living in community-dwelling older adults. Arch Psychiatr Nurs 2019; 33:43-50. [PMID: 31711593 PMCID: PMC10613508 DOI: 10.1016/j.apnu.2019.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/22/2019] [Accepted: 08/18/2019] [Indexed: 10/26/2022]
Abstract
Psychiatric mental health clinicians often rely on proxy and self-report evaluations to determine the cognitive function of older adults however, performance measures have greater accuracy and predictive ability for everyday function. This study tested physical and cognitive predictors of functional abilities in fifty-one community residing older adults. We administered a computerized battery of executive function tasks, a performance-based measure of instrumental activities of daily living (IADL), and three physical function measures (grip strength, 30-second Chair Stand Test, and 8-foot Up and Go). Regression models assessed the associations of three components of executive function (updating, shifting, and inhibition) with IADLs and physical functions. Updating was a significant predictor of the Medications and Financial DAFS scores and of grip strength. Shifting also predicted grip strength. In conclusion, different executive functions predict different domains of IADL functioning. Working memory was a robust predictor of IADL functioning in older adults, especially medication management skills.
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Affiliation(s)
- Graham J McDougall
- Florida State University, College of Nursing, Tallahassee, FL 32306-4310, USA.
| | - Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL 35294-1212, USA
| | - Vincent S Staggs
- Health Services & Outcomes Research, Children's Mercy Hospitals and Clinics, and School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - David K Johnson
- Department of Psychology, University of Kansas, Lawrence, KS 66045, USA
| | - Joan M McDowd
- Department of Psychology, University of Missouri - Kansas City, Kansas City, MO 64110, USA
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Burke SL, Naseh M, Rodriguez MJ, Burgess A, Loewenstein D. Dementia-Related Neuropsychological Testing Considerations in Non-Hispanic White and Latino/Hispanic Populations. PSYCHOLOGY & NEUROSCIENCE 2019; 12:144-168. [PMID: 31649798 PMCID: PMC6812579 DOI: 10.1037/pne0000163] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hispanic individuals are at greater risk for health disparities, less than optimal health care, and are diagnosed at later stages of cognitive impairment than white non-Hispanics. Acculturation and different attitudes toward test-taking may result in decrements in performance, especially on unfamiliar measures that emphasize speed and accuracy. Non-Hispanic individuals often outperform Hispanic individuals on cognitive and neuropsychological measures in community and clinical populations. Current neuropsychological testing may not provide accurate data related to monolingual and bilingual individuals of Hispanic descent. Testing instruments were identified by searching academic databases using combinations of relevant search terms. Neuropsychological instruments were included if they were designed to detect cognitive impairment, had an administration time of less than 45 minutes, and were available in English. Validity studies were required to employ gold standard comparison diagnostic criteria. Twenty-nine instruments were evaluated in dementia staging, global cognition, memory, memory and visual abilities, working memory and attention, verbal learning and memory, recall, language, premorbid intelligence, literacy/cognitive reserve, visuospatial, attention, problem-solving, problem solving and perception, functional assessment, and mood/daily functioning domains. Spanish-language neuropsychological instruments need to be made widely available and existing instruments to be normed in Spanish to best serve and assess diverse populations. Psychometric data were reported for neuropsychological instruments, which may be administered to Hispanic older adults presenting for evaluation related to dementia-spectrum disorders. This is one of the few reviews to provide an overview of the sensitivity and specificity of available Spanish translated neuropsychological instruments.
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Affiliation(s)
- Shanna L Burke
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University
| | - Mitra Naseh
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University
| | | | - Aaron Burgess
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University
| | - David Loewenstein
- Center on Aging as the Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami
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Belleville S, Moussard A, Ansaldo AI, Belchior P, Bherer L, Bier N, Bohbot VD, Bruneau MA, Cuddy LL, Gilbert B, Jokel R, Mahalingam K, McGilton K, Murphy KJ, Naglie G, Rochon E, Troyer AK, Anderson ND. Rationale and protocol of the ENGAGE study: a double-blind randomized controlled preference trial using a comprehensive cohort design to measure the effect of a cognitive and leisure-based intervention in older adults with a memory complaint. Trials 2019; 20:282. [PMID: 31118095 PMCID: PMC6532200 DOI: 10.1186/s13063-019-3250-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 02/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Leisure activities can be both enjoyable and cognitively stimulating, and participation in such activities has been associated with reduced age-related cognitive decline. Thus, integrating stimulating leisure activities in cognitive training programs may represent a powerful and innovative approach to promote cognition in older adults at risk of dementia. The ENGAGE study is a randomized controlled, double-blind preference trial with a comprehensive cohort design that will test the efficacy and long-term impact of an intervention that combines cognitive training and cognitively stimulating leisure activities. METHODS One hundred and forty-four older adults with a memory complaint will be recruited in Montreal and Toronto. A particular effort will be made to reach persons with low cognitive reserve. Participants will be randomly assigned to one of two conditions: cognitive + leisure training (ENGAGE-MUSIC/SPANISH) or active control (ENGAGE-DISCOVERY). The ENGAGE-MUSIC/SPANISH training will include teaching of mnemonic and attentional control strategies, casual videogames selected to train attention, and classes in music or Spanish as a second language. The ENGAGE-DISCOVERY condition will comprise psychoeducation on cognition and the brain, low-stimulating casual videogames and documentary viewing with discussions. To retain the leisure aspect of the activities, participants will be allowed to exclude either music or Spanish at study entry if they strongly dislike one of these activities. Participants randomized to ENGAGE-MUSIC/SPANISH who did not exclude any activity will be assigned to music or Spanish based on a second random assignment. Training will be provided in 24 2-h sessions over 4 months. Outcomes will be measured at baseline, at 4-month follow-up, and at 24-month follow-up. The primary outcome will be cognitive performance on a composite measure of episodic memory (delayed recall scores for words and face-name associations) measured at baseline and at the 4-month follow-up. Secondary outcomes will include a composite measure of attention (speed of processing, inhibition, dual tasking, and shifting), psychological health, activities of daily living, and brain structure and function and long-term maintenance measured at the 24-month follow-up. Information on cognitive reserve proxies (education and lifestyle questionnaires), sex and genotype (apolipoprotein (Apo)E4, brain-derived neurotrophic factor (BDNF), and catechol-O-methyltransferase (COMT)) will be collected and considered as moderators of training efficacy. DISCUSSION This study will test whether a program combining cognitive training with stimulating leisure activities can increase cognition and reduce cognitive decline in persons at risk of dementia. TRIAL REGISTRATION NCT03271190 . Registered on 5 September 2017.
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Affiliation(s)
- S Belleville
- Université de Montréal, Montreal, Canada. .,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada.
| | - A Moussard
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - A I Ansaldo
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - P Belchior
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada.,McGill University, Montreal, Canada
| | - L Bherer
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - N Bier
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - V D Bohbot
- McGill University, Montreal, Canada.,Douglas Mental Health University Institute, Montreal, Canada
| | - M-A Bruneau
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - L L Cuddy
- Queen's University, Kingston, Canada
| | - B Gilbert
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - R Jokel
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
| | | | - K McGilton
- University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - K J Murphy
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
| | - G Naglie
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
| | - E Rochon
- University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - A K Troyer
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
| | - N D Anderson
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
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7
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Book S, Luttenberger K, Stemmler M, Meyer S, Graessel E. The Erlangen test of activities of daily living in persons with mild dementia or mild cognitive impairment (ETAM) - an extended validation. BMC Psychiatry 2018; 18:308. [PMID: 30249231 PMCID: PMC6154426 DOI: 10.1186/s12888-018-1886-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 09/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ability to perform activities of daily living (ADLs) is a central marker in the diagnosis and progression of the dementia syndrome. ADLs can be identified as basic ADLs (BADLs), which are fairly easy to perform, or instrumental ADLs (IADLs), which involve more complex activities. Presently, the only performance-based assessment of IADL capabilities in persons with cognitive impairment is the Erlangen Test of Activities of Daily Living in Persons with Mild Dementia or Mild Cognitive Impairment (ETAM). The aim of the present study was to revalidate the ETAM in persons with mild cognitive impairment (MCI) or mild dementia and to analyze its application to persons with moderate dementia. METHODS We used baseline data from a cluster randomized controlled trial involving a sample of 443 users of 34 day-care centers in Germany. We analyzed groups of persons with MCI, mild dementia, and moderate dementia, categorized on the basis of the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). An item analysis was performed, and new discriminant validities were calculated. We computed a confirmatory factor analysis (CFA) to examine the postulated theoretical model of the ETAM with all six items loading on a single IADL factor. This was the first time that the ETAM's sensitivity to change was analyzed after a time period of 6 months. RESULTS The overall sample scored on average 17.3 points (SD = 7.2) on the ETAM (range: 0-30 points). Persons with MCI scored on average 23.2 points, persons with mild dementia scored 18.4 points, and persons with moderate dementia scored 12.9 points, p < .001 (ANOVA). The item analysis yielded good difficulty indices and discrimination powers. The CFA indicated a good fit between the model and the observed data. After 6 months, both the ETAM score at baseline and the change in MMSE score (t0-t1) were significant predictors of the ETAM score at t1. CONCLUSIONS The ETAM is a valid and reliable instrument for assessing IADL capabilities in persons with MCI or mild dementia. It is sensitive to changes in cognitive abilities. The test parameters confirm its application to persons with moderate dementia. TRIAL REGISTRATION Identifier: ISRCTN16412551 (Registration date: 30 July 2014, registered retrospectively).
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Affiliation(s)
- Stephanie Book
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Katharina Luttenberger
- 0000 0001 2107 3311grid.5330.5Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Mark Stemmler
- 0000 0001 2107 3311grid.5330.5Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nägelsbachstr. 49c, 91052 Erlangen, Germany
| | - Sebastian Meyer
- 0000 0001 2107 3311grid.5330.5Institute of Medical Informatics, Biometry, and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 6, 91054 Erlangen, Germany
| | - Elmar Graessel
- 0000 0001 2107 3311grid.5330.5Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany
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8
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Ashendorf L, Alosco ML, Bing-Canar H, Chapman KR, Martin B, Chaisson CE, Dixon D, Steinberg EG, Tripodis Y, Kowall NW, Stern RA. Clinical Utility of Select Neuropsychological Assessment Battery Tests in Predicting Functional Abilities in Dementia. Arch Clin Neuropsychol 2018; 33:530-540. [PMID: 29126099 PMCID: PMC6116785 DOI: 10.1093/arclin/acx100] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 08/21/2017] [Accepted: 10/02/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Neuropsychological test performance can provide insight into functional abilities in patients with dementia, particularly in the absence of an informant. The relationship between neuropsychological measures and instrumental activities of daily living (IADLs) is unclear due to hetereogeneity in cognitive domains assessed and neuropsychological tests administered. Practical and ecologically valid performance-based measures of IADLs are also limited. The Neuropsychological Assessment Battery (NAB) is uniquely positioned to provide a dual-purpose assessment of cognitive and IADL function, as it includes Daily Living tests that simulate real-world functional tasks. We examined the utility of select NAB tests in predicting informant-reported IADLs in mild cognitive impairment and dementia. METHODS The sample of 327 participants included 128 normal controls, 97 individuals with mild cognitive impairment, and 102 individuals with Alzheimer's disease dementia from the Boston University Alzheimer's Disease Center research registry. Informants completed the Lawton Brody Instrumental Activities of Daily Living Scale, and study participants were administered selected NAB tests that were complementary to the existing protocol. RESULTS ROC curves showed strongest prediction of IADL (AUC > 0.90) for memory measures (List Learning delayed recall and Daily Living Memory delayed recall) and Daily Living Driving Scenes. At a predetermined level of specificity (95%), List Learning delayed recall (71%) and Daily Living Memory delayed recall (88%) were the most sensitive. The Daily Living Memory and Driving Scenes tests strongly predicted IADL status, and the other Daily Living tests contributed unique variance. CONCLUSIONS NAB memory measures and Daily Living Tests may have clinical utility in detecting informant-rated functional impairment in dementia.
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Affiliation(s)
- Lee Ashendorf
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA
| | - Michael L Alosco
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Hanaan Bing-Canar
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kimberly R Chapman
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Brett Martin
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Christine E Chaisson
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Diane Dixon
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Eric G Steinberg
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Yorghos Tripodis
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Neil W Kowall
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Pathology, Boston University School of Medicine, Boston, Massachusetts, USA
- Neurology Service, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Robert A Stern
- Boston University Alzheimer’s Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Departments of Neurosurgery, and Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA
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9
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Chen B, Huang Y, Wang D, Deng W. Comparison of Performance-Based Observed Assessment, Self-Report, and Paper–Pencil Measures of Everyday Problem Solving in Chinese Older Adults. JOURNAL OF ADULT DEVELOPMENT 2018. [DOI: 10.1007/s10804-018-9305-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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10
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Marroni SP, Radaelli G, Silva Filho IGD, Portuguez MW. Instruments for evaluating financial management capacity among the elderly: an integrative literature review. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2017. [DOI: 10.1590/1981-22562017020.160207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To identify tools available in literature for assessing the financial management capacity of elderly persons with and without cognitive deficit or impairment. Methods: An integrative literature review was performed. Scientific publications indexed in the PubMed, LILACS (Latin American and Caribbean Health Sciences Literature), Psychology Index and Cochrane Library databases by November 2015 were evaluated. Results: Of the 609 articles obtained from the databases, 29 were considered eligible for this review, and involved 11 instruments for the evaluation of financial management capacity, the most cited of which was the Financial Capacity Instrument (FCI). Conclusion: There are several scales and instruments available which are used to investigate both daily and instrumental activities of daily living, which allow the independence and effective functioning of the elderly on a day to day basis to be verified. Non-Brazilian literature also describes specific instruments for the assessment of financial management capacity. However, no references to a specific scale that evaluates this construct and which has been validated and adapted for the Brazilian population were identified.
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Affiliation(s)
| | - Graciane Radaelli
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Universidade Federal de São Paulo, Brazil
| | - Irenio Gomes da Silva Filho
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
| | - Mirna Wetters Portuguez
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
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11
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Bentvelzen A, Aerts L, Seeher K, Wesson J, Brodaty H. A Comprehensive Review of the Quality and Feasibility of Dementia Assessment Measures: The Dementia Outcomes Measurement Suite. J Am Med Dir Assoc 2017; 18:826-837. [PMID: 28283381 DOI: 10.1016/j.jamda.2017.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 01/11/2017] [Indexed: 12/19/2022]
Abstract
The diagnosis of dementia and the management of its associated symptoms are aided by high-quality assessment tools. However, there is disagreement on the optimal tools among abundant alternatives and lack of consistent quality standards across the different domains of dementia-related change (ie, cognition, severity, function, behavioral and psychological symptoms, delirium, quality of life). Standardization is difficult because the relevance of a measurement tool for health professionals may depend on the clinical setting and on the dementia type and severity. To address this need, we conducted a comprehensive and clinically relevant evidence-based review of dementia-related tools and present a set of recommended tools, the Dementia Outcomes Measurement Suite. The review revealed that considerable development has occurred in terms of assessment of persons with mild cognitive impairment, executive dysfunction, cognitively mediated functional change, and apathy. More research is needed to develop and validate tools to assess health-related quality of life and specific symptoms of dementia including anxiety, wandering, and repetitive vocalizations. This extensive overview of the quality of different measures may serve as a guide for health professionals clinically and for researchers developing new or improved dementia assessment tools.
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Affiliation(s)
- Adam Bentvelzen
- Dementia Collaborative Research Center (DCRC) Network, University of New South Wales Australia, Sydney, Australia
| | - Liesbeth Aerts
- Dementia Collaborative Research Center (DCRC) Network, University of New South Wales Australia, Sydney, Australia
| | - Katrin Seeher
- Dementia Collaborative Research Center (DCRC) Network, University of New South Wales Australia, Sydney, Australia
| | - Jacqueline Wesson
- Aging Work and Health Research Unit, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Henry Brodaty
- Dementia Collaborative Research Center (DCRC) Network, University of New South Wales Australia, Sydney, Australia; Center for Healthy Brain Aging (CHeBA), University of New South Wales Australia, Sydney, Australia.
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Advinha AM, Lopes MJ, de Oliveira-Martins S. Assessment of the elderly's functional ability to manage their medication: a systematic literature review. Int J Clin Pharm 2016; 39:1-15. [PMID: 27942949 DOI: 10.1007/s11096-016-0409-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 12/03/2016] [Indexed: 12/13/2022]
Abstract
Background The evaluation of the elderly's ability to manage medication through the use of a validated tool can be a significant step in identifying inabilities and needs, with the objective of increasing their self-care skills, and promoting successful aging. Aim of the review To identify studies assessing the elderly's functional ability to manage their own medication. Method For the search strategy, the PICO method was used: P-Population (elderly), I-Instruments (tools for assessing medication management ability), C-Context (community) and O-Outcomes (functional ability to manage medication). The final search query was run in MEDLINE/PubMed, CINAHL Plus, ISI Web of Science and Scopus. The whole process was developed according to the PRISMA statement. Results The search retrieved 8051 records. In each screening stage, the selection criteria were applied to eliminate records where at least one of the exclusion criteria was verified. At the end of this selection, we obtained a total of 18 papers (17 studies). The results allow the conclusion to be drawn that studies use several different instruments, most of them not validated. The authors agree that medication management abilities decrease as cognitive impairment increases, even if a lot of studies assess only the physical dimension. DRUGS was the instrument most often used. Conclusion Older adults' ability to manage their medication should be assessed using tools specifically built and validate for the purpose. DRUGS (which uses the real regimen taken by the elderly) was the most widely used assessment instrument in the screened studies.
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Affiliation(s)
- Ana Margarida Advinha
- Faculty of Pharmacy, University of Lisbon, Avenida Professor Gama Pinto, 1649-003, Lisbon, Portugal.
| | - Manuel José Lopes
- Nursing School S. João de Deus, University of Évora, Largo do Senhor da Pobreza, 7000-811, Évora, Portugal
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Quaglino V, Gounden Y, Lacot E, Couvillers F, Lions A, Hainselin M. Talk the talk and walk the walk. Evaluation of autonomy in aging and Alzheimer disease by simulating instrumental activities of daily living: the S-IADL. PeerJ 2016; 4:e2351. [PMID: 27672491 PMCID: PMC5028723 DOI: 10.7717/peerj.2351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/20/2016] [Indexed: 11/21/2022] Open
Abstract
Objective The autonomy of individuals is linked to the achievement of instrumental activities of daily living that require complex behavior. In the elderly, the assessment of autonomy is usually based on questionnaires that have strong subjective constraints. Considering this fact, we tested elderly healthy adults and Alzheimer disease patients using a new measure, the S-IADL (Simulation of Instrumental Activities for Daily Living), to assess the ability to perform effectively activities of daily living. Method The S-IADL shares many items with the well-known IADL questionnaire proposed by Lawton & Brody (1969). However, as opposed to the IADL, the assessment of autonomy is not based on the completion of a questionnaire but requires the realization or simulation of various activities of daily living. Eighty-three participants (69 healthy elderly, and 14 Alzheimer Disease patients) completed the IADL and performed the S-IADL assessment. Results Results revealed that, like the IADL, the S-IADL is able to identify AD patients who are likely to encounter difficulties in performing everyday activities, and no major differences were found between the IADL and the S-IADL. Conclusions We outlined some advantages for prefering, in certain situation, this new tool based on simulation of activities in functional evaluation. Finally, we discuss the main limits of the S-IADL that should be investigated prior to its utilization by clinicians.
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Affiliation(s)
| | - Yannick Gounden
- CRPCPO, EA, Université de Picardie Jules Verne , Amiens , France
| | - Emilie Lacot
- CRPCPO, EA, Université de Picardie Jules Verne, Amiens, France; Service de Génétique Clinique et Oncogénétique, Centre Hospitalier Universitaire d'Amiens Picardie, Amiens, France
| | - Frédérique Couvillers
- Services de Neurologie et de Gérontologie, Centre Hospitalier Universitaire d'Amiens Picardie , Amiens , France
| | - Amandine Lions
- IME Les Martinets, Adapei 36 l'Espoir , Saint Maur , France
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Wesson J, Clemson L, Brodaty H, Reppermund S. Estimating functional cognition in older adults using observational assessments of task performance in complex everyday activities: A systematic review and evaluation of measurement properties. Neurosci Biobehav Rev 2016; 68:335-360. [DOI: 10.1016/j.neubiorev.2016.05.024] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 04/19/2016] [Accepted: 05/23/2016] [Indexed: 12/01/2022]
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Chandler MJ, Parks AC, Marsiske M, Rotblatt LJ, Smith GE. Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2016; 26:225-251. [PMID: 27632385 PMCID: PMC5048589 DOI: 10.1007/s11065-016-9330-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 08/22/2016] [Indexed: 01/13/2023]
Abstract
Cognitive interventions in Mild Cognitive Impairment (MCI) seek to ameliorate cognitive symptoms in the condition. Cognitive interventions may or may not generalize beyond cognitive outcomes to everyday life. This systematic review and meta-analysis sought to assess the effect of cognitive interventions compared to a control group in MCI on generalizability outcome measures [activities of daily living (ADLs), mood, quality of life (QOL), and metacognition] rather than cognitive outcomes alone. PRISMA guidelines were followed. MEDLINE and PsychInfo were utilized as data sources to locate references related to cognitive interventions in individuals with MCI. The cognitive intervention study was required to have a control or alternative treatment comparison group to be included. Thirty articles met criteria, including six computerized cognitive interventions, 14 therapist-based interventions, and 10 multimodal (i.e., cognitive intervention plus an additional intervention) studies. Small, but significant overall median effects were seen for ADLs (d = 0.23), mood (d = 0.16), and metacognitive outcomes (d = 0.30), but not for QOL (d = 0.10). Computerized studies appeared to benefit mood (depression, anxiety, and apathy) compared to controls, while therapist-based interventions and multimodal interventions had more impact on ADLs and metacognitive outcomes than control conditions. The results are encouraging that cognitive interventions in MCI may impact everyday life, but considerably more research is needed. The current review and meta-analysis is limited by our use of only PsychInfo and MEDLINE databases, our inability to read full text non-English articles, and our reliance on only published data to complete effect sizes.
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Affiliation(s)
- M J Chandler
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
| | - A C Parks
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - M Marsiske
- University of Florida, Gainesville, FL, USA
| | | | - G E Smith
- University of Florida, Gainesville, FL, USA
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Elliott RA, Goeman D, Beanland C, Koch S. Ability of older people with dementia or cognitive impairment to manage medicine regimens: a narrative review. ACTA ACUST UNITED AC 2016; 10:213-21. [PMID: 26265487 PMCID: PMC5396255 DOI: 10.2174/1574884710666150812141525] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 08/07/2011] [Indexed: 12/12/2022]
Abstract
Impaired cognition has a significant impact on a person’s ability to manage their medicines. The aim of this paper is to provide a narrative review of contemporary literature on medicines management by people with dementia or cognitive impairment living in the community, methods for assessing their capacity to safely manage medicines, and strategies for supporting independent medicines management. Studies and reviews addressing medicines management by people with dementia or cognitive impairment published between 2003 and 2013 were identified via searches of Medline and other databases. The literature indicates that as cognitive impairment progresses, the ability to plan, organise, and execute medicine management tasks is impaired, leading to increased risk of unintentional non-adherence, medication errors, preventable medication-related hospital admissions and dependence on family carers or community nursing services to assist with medicines management. Impaired functional capacity may not be detected by health professionals in routine clinical encounters. Assessment of patients’ (or carers’) ability to safely manage medicines is not undertaken routinely, and when it is there is variability in the methods used. Self-report and informant report may be helpful, but can be unreliable or prone to bias. Measures of cognitive function are useful, but may lack sensitivity and specificity. Direct observation, using a structured, standardised performance-based tool, may help to determine whether a person is able to manage their medicines and identify barriers to adherence such as inability to open medicine packaging. A range of strategies have been used to support independent medicines management in people with cognitive impairment, but there is little high-quality research underpinning these strategies. Further studies are needed to develop and evaluate approaches to facilitate safe medicines management by older people with cognitive impairment and their carers.
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Affiliation(s)
| | - Dianne Goeman
- Royal District Nursing Service, 31 Alma Rd, St Kilda, Victoria 3182, Australia.
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Luttenberger K, Reppermund S, Schmiedeberg-Sohn A, Book S, Graessel E. Validation of the Erlangen Test of Activities of Daily Living in Persons with Mild Dementia or Mild Cognitive Impairment (ETAM). BMC Geriatr 2016; 16:111. [PMID: 27229937 PMCID: PMC4882865 DOI: 10.1186/s12877-016-0271-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 04/29/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND There are currently no valid, fast, and easy-to-administer performance tests that are designed to assess the capacities to perform activities of daily living in persons with mild dementia and mild cognitive impairment (MCI). However, such measures are urgently needed for determining individual support needs as well as the efficacy of interventions. The aim of the present study was therefore to validate the Erlangen Test of Activities of Daily Living in Persons with Mild Dementia and Mild Cognitive Impairment (ETAM), a performance test that is based on the International Classification of Functioning and Health (ICF), which assesses the relevant domains of living in older adults with MCI and mild dementia who live independently. METHODS The 10 ICF-based items on the research version of the ETAM were tested in a final sample of 81 persons with MCI or mild dementia. The items were selected for the final version in accordance with 6 criteria: 1) all domains must be represented and have equal weight, 2) all items must load on the same factor, 3) item difficulties and item discriminatory powers, 4) convergent validity (Bayer Activities of Daily Living Scale [B-ADL]) and discriminant validity (Mini Mental State Examination [MMSE], Geriatric Depression Scale 15 [GDS-15]), 5) inter-rater reliabilities of the individual items, 6) as little material as possible. Retest reliability was also examined. Cohen's ds were calculated to determine the magnitudes of the differences in ETAM scores between participants diagnosed with different grades of severity of cognitive impairment. RESULTS The final version of the ETAM consists of 6 items that cover the five ICF domains communication, mobility, self-care, domestic life (assessed by two 3-point items), and major life areas (specifically, the economic life sub-category) and load on a single factor. The maximum achievable score is 30 points (6 points per domain). The average administration time was 35 min, 19 of which were needed for pure item performance. The internal consistency was α = .71. The three-week test-retest reliability was r = .78, and the inter-rater reliability was r = .97. The ETAM also provided satisfactory discrimination between healthy individuals and persons with MCI or mild dementia as well as between persons with mild and moderate dementia. CONCLUSIONS The 6-item final version of the ETAM shows satisfactory psychometric characteristics and can be administered quickly. It is therefore suitable for use in both clinical practice and research.
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Affiliation(s)
- Katharina Luttenberger
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany.
| | - Simone Reppermund
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, University of New South Wales/ UNSW Medicine, 34 Botany Street, UNSW, Sydney, NSW, 2052, Australia
| | - Anke Schmiedeberg-Sohn
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
| | - Stephanie Book
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
| | - Elmar Graessel
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, 91054, Germany
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Bier N, Belchior PDC, Paquette G, Beauchemin É, Lacasse-Champagne A, Messier C, Pellerin ML, Petit M, Mioshi E, Bottari C. The Instrumental Activity of Daily Living Profile in Aging: A Feasibility Study. J Alzheimers Dis 2016; 52:1361-71. [PMID: 27079703 DOI: 10.3233/jad-150957] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dysfunctions in complex activities of daily living (ADLs) are a normal part of the aging process. However, differentiating functional decline associated with healthy aging from the subtle decline experienced by individuals with mild cognitive impairment and early dementia constitutes a challenge. Finding an appropriate tool that can capture these subtle but important functional changes represents a priority. OBJECTIVES The aims of this study were to evaluate the feasibility of using the Instrumental Activities of Daily Living Profile (IADL Profile) with elderly participants and to describe their level of difficulty encountered in each task. METHODS The tool was administered to a group of 40 elderly participants living in the community. RESULTS The IADL Profile was found to be feasible to use in older individuals; the tool also showed sensitivity to the difficulties experienced by this population in everyday functioning. CONCLUSION The IADL Profile is a promising ecological tool to evaluate independence in aging and may help to identify individuals with MCI. This tool may also contribute to the development of tailored interventions to enhance everyday functioning in the older population.
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Affiliation(s)
- Nathalie Bier
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada.,Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Patricia da Cunha Belchior
- Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Guillaume Paquette
- Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Émilie Beauchemin
- School of Rehabilitation, Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Chantal Messier
- School of Rehabilitation, Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Line Pellerin
- School of Rehabilitation, Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marisol Petit
- School of Rehabilitation, Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Eneida Mioshi
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Carolina Bottari
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada.,Centre de Recherche Interdisciplinaire en Réadaptation - site Lucie-Bruneau, Montreal, QC, Canada
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Abstract
Previous tests of the SeniorWISE intervention with community-residing older adults that were designed to improve affect and cognitive performance were successful and positively affected these outcomes. In this study, we tested whether adding yoga to the intervention would affect the outcomes. Using a quasiexperimental pre-post design, we delivered 12 hours of SeniorWISE memory training that included a 30-minute yoga component before each training session. The intervention was based on the four components of self-efficacy theory: enactive mastery experience, vicarious experience, verbal persuasion, and physiologic arousal. We recruited 133 older adults between the ages of 53 and 96 years from four retirement communities in Central Texas. Individuals were screened and tested and then attended training sessions two times a week over 4 weeks. A septuagenarian licensed psychologist taught the memory training, and a certified yoga instructor taught yoga. Eighty-three participants completed at least 9 hours (75%) of the training and completed the posttest. Those individuals who completed made significant gains in memory performance, instrumental activities of daily living, and memory self-efficacy and had fewer depressive symptoms. Thirteen individuals advanced from poor to normal memory performance, and seven improved from impaired to poor memory performance; thus, 20 individuals improved enough to advance to a higher functioning memory group. The findings from this study of a memory training intervention plus yoga training show that the benefits of multifactorial interventions had additive benefits. The combined treatments offer a unique model for brain health programs and the promotion of nonpharmacological treatment with the goals of maintaining healthy brain function and boosting brain plasticity.
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McDougall GJ, Simpson G, Friend ML. Strategies for research recruitment and retention of older adults of racial and ethnic minorities. J Gerontol Nurs 2015; 41:14-23; quiz 24-5. [PMID: 25849063 DOI: 10.3928/00989134-20150325-01] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 02/20/2015] [Indexed: 11/20/2022]
Abstract
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.4 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Strategies for Research Recruitment and Retention of Older Adults of Racial and Ethnic Minorities" found on pages 14-23, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until April 30, 2018. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVE 1. Identify strategies and barriers for the recruitment and retention of older adults of racial and ethnic minorities in cognitive aging research. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. The numbers of Hispanic and African American older adults in the United States are expected to increase by 86% and more than 31%, respectively. African American and Hispanic American individuals are more likely than Caucasian individuals to have chronic health conditions, and researchers have argued that these health disparities may contribute to their higher rates of dementia-related illnesses. The current article explores strategies to improve participation in cognitive aging research by older adults, particularly minority older adults. The cultural aspects of cognitive aging are examined, especially the role of stigma and stereotype threat. The perceptions of cognitive aging of African American and Hispanic older adults are also described. Specific strategies are presented that have been successfully implemented to improve recruitment and retention in research targeting minority older adults. Strategies that yielded retention of minority older adults included advertising and marketing a randomized clinical trial, media relations, intervention tailoring, and adaptation of psychometric instruments.
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Schmiedeberg-Sohn A, Graessel E, Luttenberger K. A Direct Performance Test for Assessing Activities of Daily Living in Patients with Mild Degenerative Dementia: The Development of the ETAM and Preliminary Results. Dement Geriatr Cogn Dis Extra 2015; 5:74-84. [PMID: 25873929 PMCID: PMC4376934 DOI: 10.1159/000369550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There are currently only a few performance tests that assess the capacity to perform activities of daily living. These measures frequently require a long time to administer, are strongly cognition oriented, or have not been adequately validated. METHODS The Erlangen Test of Activities of Daily Living in Mild Dementia (ETAM) was developed in a 4-phase process that was based on the International Classification of Functioning, Disability, and Health (ICF). A pilot study was conducted on 30 subjects with mild dementia with a mean age of 80 years. The subjects' mean score on the MMSE was 21.5. Twenty-one of the 30 subjects were women. RESULTS Ten items were developed and tested in the pilot study. The mean time required to complete the test was 26 min. The item analysis showed difficulties that ranged primarily from r = 0.28 to r = 0.79. The ETAM had a moderate correlation with the MMSE (rMMSE = 0.310) and a low correlation with the Geriatric Depression Scale-15 (GDS-15; rGDS-15 = 0.149). CONCLUSION The preliminary version of the ETAM is quick and easy to use and has predominantly satisfactory item characteristics. There still is the need to revise the items 'giving directions' and 'making tea' with regard to standardisation.
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Affiliation(s)
| | | | - Katharina Luttenberger
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische und Psychotherapeutische Klinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Lindbergh CA, Puente AN, Gray JC, MacKillop J, Miller LS. Discounting preferences and response consistency as markers of functional ability in community-dwelling older adults. J Clin Exp Neuropsychol 2014; 36:1112-23. [DOI: 10.1080/13803395.2014.983464] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Luttenberger K, Schmiedeberg A, Gräßel E. Activities of daily living in dementia: revalidation of the E-ADL Test and suggestions for further development. BMC Psychiatry 2012; 12:208. [PMID: 23176536 PMCID: PMC3605268 DOI: 10.1186/1471-244x-12-208] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 11/19/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The everyday practical capabilities of dementia patients have a direct influence on a patient's independence and thus on the person's quality of life and on the amount of care needed. These capabilities are therefore important as therapeutic goals and are also important from a health-economic point of view. To date, no economical and valid performance test is available. The E-ADL-Test developed by Gräβel et al. in 2009 is a short performance test that has, however, only been validated on a small sample thus far. The objective of the present study is to re-validate the E-ADL-Test and explore possibilities for further development. METHODS The data were obtained from an RCT with a sample of 139 dementia patients in 5 nursing homes in Bavaria (Germany). The internal consistency was calculated as a measure of reliability. An item analysis was performed for the sample and subgroups with various degrees of dementia. Criterion and construct validity were tested based on five hypotheses. For validation, the residents' capabilities were examined using the Barthel-Index (BI), the Nurses' Observation Scale for Geriatric Patients (NOSGER), the Alzheimer's Disease Assessment Scale (ADAS), and the Mini-Mental Status Examination (MMSE). RESULTS The internal consistency was .68 for the sample and .73 for the subgroup with severe dementia. The item analysis yielded good difficulty indices and discrimination power for moderate and severe dementia. The tasks were found to be too easy for mild dementia. The predictive criterion-related validity was confirmed by a correlation of r = .54 with the care level after 22 months and significant mean differences in the E-ADL-Test between persons with and without an increase in the care level. A differentiated correlation profile supported the three hypotheses on construct validity. CONCLUSIONS The E-ADL-Test in its current form is a valid and reliable instrument for assessing the ADL capabilities of patients with moderate and severe dementia. More difficult items should be developed for use with mild dementia. TRIAL REGISTRATION http://www.isrctn.com Identifier: ISRCTN87391496.
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Affiliation(s)
- Katharina Luttenberger
- Medical Psychology and Medical Sociology, Clinic for Psychiatry and Psychotherapy, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen Nürnberg, Erlangen, Germany.
| | - Anke Schmiedeberg
- Medical Psychology and Medical Sociology, Clinic for Psychiatry and Psychotherapy, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Elmar Gräßel
- Medical Psychology and Medical Sociology, Clinic for Psychiatry and Psychotherapy, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany
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Mitchell MB, Miller LS, Woodard JL, Davey A, Martin P, Burgess M, Poon LW. Regression-based estimates of observed functional status in centenarians. THE GERONTOLOGIST 2010; 51:179-89. [PMID: 20974657 DOI: 10.1093/geront/gnq087] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE OF THE STUDY There is lack of consensus on the best method of functional assessment, and there is a paucity of studies on daily functioning in centenarians. We sought to compare associations between performance-based, self-report, and proxy report of functional status in centenarians. We expected the strongest relationships between proxy reports and observed performance of basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). We hypothesized that the discrepancy between self-report and observed daily functioning would be modified by cognitive status. We additionally sought to provide clinicians with estimates of centenarians' observed daily functioning based on their mental status in combination with subjective measures of activities of daily living (ADLs). DESIGN AND METHODS Two hundred and forty-four centenarians from the Georgia Centenarian Study were included in this cross-sectional population-based study. Measures included the Direct Assessment of Functional Status, self-report and proxy report of functional status, and the Mini-Mental State Examination (MMSE). RESULTS Associations between observed and proxy reports were stronger than between observed and self-report across BADL and IADL measures. A significant MMSE by type of report interaction was found, indicating that lower MMSE performance is associated with a greater discrepancy between subjective and objective ADL measures. IMPLICATIONS Results demonstrate associations between 3 methods of assessing functional status and suggest proxy reports are generally more accurate than self-report measures. Cognitive status accounted for some of the discrepancy between observed and self-reports, and we provide clinicians with tables to estimate centenarians' performance on observed functional measures based on MMSE and subjective report of functional status.
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Affiliation(s)
- Meghan B Mitchell
- Geriatric Research Education and Clinical Center, Edith Nourse Memorial Veterans Hospital, Bedford, MA 01730, USA.
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McDougall GJ, Becker H, Pituch K, Acee TW, Vaughan PW, Delville CL. Differential benefits of memory training for minority older adults in the SeniorWISE study. THE GERONTOLOGIST 2010; 50:632-45. [PMID: 20203096 DOI: 10.1093/geront/gnq017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Cognitive training improves mental abilities in older adults, but the benefit to minority elders is unclear. We conducted a subgroup analysis of subjects in the SeniorWISE (Wisdom Is Simply Exploration) trial to examine this issue. DESIGN AND METHODS SeniorWISE was a Phase 3 randomized trial that enrolled 265 nondemented community-dwelling older adults aged 65 years and older between 2001 and 2006. Participants were randomly assigned to 12 hr of either memory or health training. RESULTS The sample was 79% female, 71% Caucasian, 17% Hispanic, and 12% African American. On the Rivermead Behavioural Memory Test (RBMT), 28% of the sample scored normal, 47% scored poor, and 25% impaired. Memory performance changed differently over time depending on the demographic characteristics of participants. Both Hispanics and Blacks performed better than Whites on visual memory, and Blacks performed better over time on instrumental activities of daily living. On all performance measures, lower pretest scores were associated with relatively greater improvements over time. IMPLICATIONS Our analyses suggested that minority participants received differential benefits from the memory training; however, this remains speculative because the 3 ethnic groups in the sample were not equivalent in size. The question of why Black and Hispanic participants often made greater improvements needs further exploration.
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Affiliation(s)
- Graham J McDougall
- School of Nursing, The University of Texas at Austin, Austin, TX 78701, USA.
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