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Tabira T, Hotta M, Maruta M, Ikeda Y, Shimokihara S, Han G, Yamaguchi T, Tanaka H, Ishikawa T, Ikeda M. Characteristic of process analysis on instrumental activities of daily living according to the severity of cognitive impairment in community-dwelling older adults with Alzheimer's disease. Int Psychogeriatr 2024; 36:188-199. [PMID: 35838312 DOI: 10.1017/s1041610222000552] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To clarify the characteristic of impaired and unimpaired Instrumental Activities of daily living (IADL) processes with the severity of cognitive impairment in community-dwelling older adults with Alzheimer's disease (AD) using the Process Analysis of Daily Activity for Dementia (PADA-D). DESIGN Cross-sectional study. SETTING 13 medical and care centers in Japan. PARTICIPANTS 115 community-dwelling older adults with AD. METHODS The severity of cognitive impairment was classified by Mini-Mental State Examination (20 ≥ mild group, 20 < moderate group ≥ 10, 10 < severe group), and IADL scores and eight IADL items in PADA-D were compared among three groups after adjusting for covariates. Rate of five feasible processes included in each IADL of PADA-D was compared. RESULTS IADL score showed a decrease in independence with the severity of AD except for Use modes of transportation and Managing finances, which was especially pronounced in Shopping (F = 25.58), Ability to use the telephone (F = 16.75), and Managing medication (F = 13.1). However, when the PADA-D was examined by process, some processes that were impaired and unimpaired with the severity of cognitive impairment were clear. For example, Plan a meal was impaired (ES = 0.29) with the severity, but Prepare the food was not in Cooking performance. CONCLUSIONS We suggested that detailed process analysis in IADLs can clarify the characteristic of processes that are impaired and unimpaired with the severity of cognitive impairment in older adults with AD living in the community. Our findings may be useful for rehabilitation and care in IADL to continue living at home.
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Affiliation(s)
- Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Maki Hotta
- Department of Psychiatry, Osaka University, 2-2, Yamadaoka, Osaka, 565-0871, Japan
| | - Michio Maruta
- Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Yuriko Ikeda
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Suguru Shimokihara
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Gwanghee Han
- Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Tomoharu Yamaguchi
- Department of Rehabilitation, Gunma University of Health and Welfare, 2-12-2, Honmachi, Maebashi, Gunma, 371-0023, Japan
| | - Hiroyuki Tanaka
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Osaka, 583-8555, Japan
| | - Tomohisa Ishikawa
- Department of Psychiatry, Arao Kokoronosato Hospital, 1992, Arao-city, Kumamoto, 864-0041, Japan
- Department of Neuropsychiatry, Kumamoto University Hospital, 1-1-1, Chuo-ku, Honjo, Kumamoto, 860-8566, Japan
- Faculty of Life Sciences, Kumamoto University, 1-1-1, Chuo-ku, Kuhonji, Kumamoto, 862-0976, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University, 2-2, Yamadaoka, Osaka, 565-0871, Japan
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Gagnon-Roy M, Bier N, Le Dorze G, Boulé-Riley S, Paquette G, Couture M, Bottari C. Cognitive assistance to support individuals with traumatic brain injury using a minimal and personalised approach: A conversion mixed methods study using video analysis. Aust Occup Ther J 2024; 71:35-51. [PMID: 37799014 DOI: 10.1111/1440-1630.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Individuals with traumatic brain injury (TBI) frequently need assistance to manage complex everyday activities. However, little is known about the types of cognitive assistance that can be used to facilitate optimal independence. A conversion mixed method study using video analysis was conducted to describe assistance provided by trained occupational therapists during three everyday tasks carried out in the participants' homes and surrounding environments. METHODS Forty-five people with moderate and severe TBI were tested by three occupational therapists using the Instrumental Activities of Daily Living Profile, an observation-based assessment that documents independence in complex everyday activities and the minimal assistance required to attain task goals. Using video analysis, difficulties experienced by the people with TBI during a meal preparation and grocery shopping task, and the cognitive assistance provided by the occupational therapists in response to these difficulties, were documented. Statistical analyses were also completed to identify the main difficulties and types of cognitive assistance provided during the evaluation, for the whole group and depending on their level of independence. RESULTS Nine types of cognitive assistance were used by occupational therapists, including implicit (stimulating thought processes), and more explicit assistance (cueing), to facilitate task performance. When needed, motivational assistance, which consisted of encouraging participants to think for themselves, was also used. Stimulating thought processes was mostly used to support goal formulation and planning, whereas cueing was used in numerous instances. Participants with lower levels of independence received more assistance of almost all types to support them. CONCLUSION Using these findings, training could be developed for caregivers and occupational therapists to support them in providing minimal and personalised cognitive assistance. Further research is needed to examine the extent to which all types of cognitive assistance are effective in helping various cognitive profiles of people with TBI attain optimal independence.
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Affiliation(s)
- Mireille Gagnon-Roy
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Nathalie Bier
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
| | - Guylaine Le Dorze
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- School of Speech-Language Pathology and Audiology, Université de Montréal, Montréal, Québec, Canada
| | - Stéphanie Boulé-Riley
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Guillaume Paquette
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | | | - Carolina Bottari
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
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Filiou RP, Brambati SM, Lussier M, Bier N. Speech Acts as a Window to the Difficulties in Instrumental Activities of Daily Living: A Qualitative Descriptive Study in Mild Neurocognitive Disorder and Healthy Aging. J Alzheimers Dis 2024; 97:1777-1792. [PMID: 38339927 DOI: 10.3233/jad-230031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Background Executive functions (EF) are central to instrumental activities of daily living (IADL). A novel approach to the assessment of the impact of EF difficulties on IADL may be through the speech acts produced when performing IADL-inspired tasks in a laboratory-apartment. Speech acts may act as a window to the difficulties encountered during task performance. Objective We aim to 1) qualitatively describe the speech acts produced by participants with mild neurocognitive disorder (mild NCD) and healthy controls (HC) as they performed 4 IADL-inspired tasks in a laboratory-apartment, and to then 2) compare their use in both groups. Methods The participants' performance was videotaped, and speech acts produced were transcribed. Qualitative description of all speech acts was performed, followed by a deductive-inductive pattern coding of data. Statistical analyses were performed to further compare their use by mild NCD participants and HC. Results Twenty-two participants took part in the study (n mild NCD = 11; n HC = 11). Meta-categories of data emerged from pattern coding: strategies, barriers, reactions, and consequences. Mild NCD participants used significantly more strategies and barriers than did HC. They were more defensive of their performance, and more reactive to their difficulties than HC. Mild NCD participants' verification of having completed all tasks was less efficient than controls. Conclusions An assessment of speech acts produced during the performance of IADL-inspired tasks in a laboratory-apartment may allow to detect changes in the use of language which may reflect EF difficulties linked to cognitive decline.
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Affiliation(s)
- Renée-Pier Filiou
- Research Center, Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-del'Île-de-Montréal, Montréal, QC, Canada
- Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Simona Maria Brambati
- Research Center, Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-del'Île-de-Montréal, Montréal, QC, Canada
- Département de Psychologie, Université de Montréal, Montréal, QC, Canada
| | - Maxime Lussier
- Research Center, Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-del'Île-de-Montréal, Montréal, QC, Canada
| | - Nathalie Bier
- Research Center, Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-del'Île-de-Montréal, Montréal, QC, Canada
- École de Réhabilitation, Université de Montréal, Montréal, QC, Canada
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Zhang H, Hu W, Yuan M, Lu D, Gao Y, Dai Q. The association between erector spinae muscle content and chronic heart failure and its severity. ESC Heart Fail 2023; 10:2982-2989. [PMID: 37522384 PMCID: PMC10567664 DOI: 10.1002/ehf2.14482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/11/2022] [Accepted: 07/04/2023] [Indexed: 08/01/2023] Open
Abstract
AIMS Previous studies have shown a significant reduction in skeletal muscle content in patients with chronic heart failure (CHF). The present study focused on the erector spinae muscle (ESM) to determine whether ESM content is associated with the development and severity of CHF. METHODS AND RESULTS A total of 652 patients were included in this trial for the study. According to the diagnostic criteria of CHF, 652 patients were divided into two groups, namely, the control group (268 patients) and the CHF group (384 patients). Meanwhile, to assess whether the ESM is associated with the severity of CHF, patients in the CHF group were divided into two groups according to left ventricular ejection fraction (LVEF) values: heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%, 256 patients) and heart failure with reduced ejection fraction (HFrEF, LVEF ≤40%, 68 patients). Receiver operating curve analysis was performed to assess whether ESM content could predict CHF and determine its severity. Compared with the control group, the patients in the CHF group were older, the prevalence of coronary heart disease (CHD) and atrial fibrillation was higher, the colour ultrasound results showed that LVEF decreased significantly, and the left ventricular end-diastolic internal diameter and left ventricular end-systolic internal diameter increased significantly. Besides, patients in the CHF group had significantly lower ESM content, and ESM is an independent predictor of heart failure, with an odds ratio of 0.713 (CHF group vs. control group, 95% confidence interval 0.626-0.811, P < 0.001). Compared with the HFpEF group, the HFrEF group has a lower prevalence of CHD, LVEF decreased significantly, the left ventricular end-diastolic internal diameter and left ventricular end-systolic internal diameter increased significantly, also patients in the HFrEF group had significantly lower ESM content compared with patients in the HFpEF group, and ESM is an independent predictor of the severity of heart failure, with an odds ratio of 0.514 (HFrEF group vs. HFpEF group, 95% confidence interval (0.418-0.633, P < 0.05). The results of receiver operating curve analysis showed that the sensitivity and specificity of ESM content for the diagnosis of CHF were 65.6% and 71.6%, respectively, while the sensitivity and specificity of ESM content for predicting the severity of CHF were 47.1% and 89.1%, respectively. CONCLUSIONS The ESM is of great value in predicting the onset and severity of CHF.
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Affiliation(s)
- Hao Zhang
- Department of CardiologyZhongda Hospital, School of Medicine, Southeast UniversityNanjingPR China
| | - Weiwei Hu
- Department of CardiologyZhongda Hospital, School of Medicine, Southeast UniversityNanjingPR China
| | - Mengxuan Yuan
- Department of CardiologyAffiliated Hospital of Yangzhou UniversityYangzhouPR China
| | - Dasheng Lu
- Department of CardiologyThe Second Affiliated Hospital of Wannan Medical CollegeWuhuPR China
| | - Yang Gao
- Department of CardiologyAffiliated Hospital of Yangzhou UniversityYangzhouPR China
| | - Qiming Dai
- Department of CardiologyZhongda Hospital, School of Medicine, Southeast UniversityNanjingPR China
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Li D, Chen X, Li F, Jia Y, Li Z, Liu Y, Ye L, Gao Y, Zhang W, Li H, Zeng R, Wan Z, Zeng Z, Cao Y. Evaluation of risk stratification program based on trajectories of functional capacity in patients with acute coronary syndrome: The REACP study. Front Cardiovasc Med 2022; 9:1020488. [PMID: 36606276 PMCID: PMC9808036 DOI: 10.3389/fcvm.2022.1020488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background As a validated assessment tool for functional disability (activities of daily living), the Barthel index (BI) assessed initially at admission has the potential to stratify patients with high-risk acute coronary syndrome (ACS). Dynamic trajectory evaluation of functional capacity in hospitals may provide more prognostic information. We aimed to establish a novel dynamic BI-based risk stratification program (DBRP) during hospitalization to predict outcomes among ACS patients. Methods A total of 2,837 ACS patients were included from the Retrospective Multicenter Study for Early Evaluation of Acute Chest Pain. The DBRP rating (low, medium, and high-risk categories) was calculated from dynamic BI at admission and discharge. The primary outcome was all-cause mortality, and the secondary outcome was cardiac mortality. Results Of all the included patients, 312 (11%) died during a median follow-up period of 18.0 months. Kaplan-Meier analysis revealed that the cumulative mortality was significantly higher in patients in the higher risk category according to the DBRP. Multivariable Cox regression analysis indicated that, compared to the low-risk category, the higher risk category in the DBRP was an independent strong predictor of all-cause mortality after adjusting for confounding factors (medium-risk category: hazard ratio [HR]: 1.756, 95% confidence interval [95% CI]: 1.214-2.540; P = 0.003; high-risk category: HR: 5.052, 95% CI: 3.744-6.817; P < 0.001), and the same result was found for cardiac mortality. Conclusion The DBRP was a useful risk stratification tool for the early dynamic assessment of patients with ACS. Clinical trial registration [http://www.chictr.org.cn], identifier [ChiCTR1900024657].
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Affiliation(s)
- Dongze Li
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiaoli Chen
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Fanghui Li
- Department of Cardiology, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Yu Jia
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Zhilin Li
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Yi Liu
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Lei Ye
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Yongli Gao
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Wei Zhang
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Hong Li
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Rui Zeng
- Department of Cardiology, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Zhi Wan
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Zhi Zeng
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China,Zhi Zeng,
| | - Yu Cao
- Department of Emergency Medicine and West China School of Nursing, Laboratory of Emergency Medicine, Disaster Medical Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China,*Correspondence: Yu Cao,
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Yao S, Zheng P, Ji L, Ma Z, Wang L, Qiao L, Wan Y, Sun N, Luo Y, Yang J, Wang H. The effect of comprehensive assessment and multi-disciplinary management for the geriatric and frail patient: A multi-center, randomized, parallel controlled trial. Medicine (Baltimore) 2020; 99:e22873. [PMID: 33181655 PMCID: PMC7668452 DOI: 10.1097/md.0000000000022873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND A comprehensive geriatric assessment (CGA) of elderly patients is useful for detecting the patients vulnerabilities. Exercise and early rehabilitation, nutritional intervention, traditional Chinese medicine (TCM), standardized medication guidance, and patient education can, separately, improve and even reverse the physical frailty status. However, the effect of combining a CGA and multi-disciplinary management on frailty in elderly patients remains unclear. The present study assessed the effects of a CGA and multi-disciplinary management on elderly patients with frailty in China. METHODS In this study, 320 in patients with frailty ≥70 years old will be randomly divided into an intervention group and a control group. The intervention group will be given routine management, a CGA and multi-disciplinary management involving rehabilitation exercise, diet adjustment, multi-drug evaluation, acupoint massage in TCM and patient education for 12 months, and the control group will be followed up with routine management for basic diseases. The primary outcomes are the Fried phenotype and short physical performance battery (SPPB). The secondary outcomes are the clinical frailty scale (CFS), non-elective hospital readmission, basic activities of daily living (BADL), 5-level European quality of life 5 dimensions index (EQ-5D), nutrition risk screening-2002 (NRS-2002), medical insurance expenses, fall events, and all-cause mortality. In addition, a cost-effectiveness study will be carried out. DISCUSSION This paper outlines the protocol for a randomized, single-blind, parallel multi-center clinical study. This protocol, if beneficial, will demonstrate the interaction of various intervention strategies, will help improve elderly frailty patients, and will be useful for clinicians, nurses, policymakers, public health authorities, and the general population. TRIAL REGISTRATION Chinese Clinical Trials Register, ChiCTR1900022623. Registered on April 19, 2019, http://www.chictr.org.cn/showproj.aspx?proj=38141.
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Affiliation(s)
- Simin Yao
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
- Peking University Fifth School of Clinical Medicine, Dong Dan, Beijing
| | - Peipei Zheng
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
- Peking University Fifth School of Clinical Medicine, Dong Dan, Beijing
| | | | - Zhao Ma
- Department of Rehabilitation
| | | | - Linlin Qiao
- Department of TCM, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Yuhao Wan
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
| | - Ning Sun
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
| | - Yao Luo
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
| | - Jiefu Yang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
| | - Hua Wang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences
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Li F, Li D, Yu J, Jia Y, Jiang Y, Chen T, Gao Y, Wan Z, Cao Y, Zeng Z, Zeng R. Barthel Index as a Predictor of Mortality in Patients with Acute Coronary Syndrome: Better Activities of Daily Living, Better Prognosis. Clin Interv Aging 2020; 15:1951-1961. [PMID: 33116449 PMCID: PMC7568594 DOI: 10.2147/cia.s270101] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/27/2020] [Indexed: 02/05/2023] Open
Abstract
Background The Barthel index (BI) is a widely used assessment tool for evaluating physical performance in activities of daily living (ADL). The association between BI scores and mortality in hospital and during follow-up of acute coronary syndrome (ACS) patients remains unclear. The present study investigated whether the BI score could be used as a predictor for mortality of ACS. Methods We investigated ACS patients from the multi-center Retrospective Evaluation of Acute Chest Pain (REACP) study. The association between BI scores and all-cause mortality of patients with ACS was analyzed by Cox proportional hazards models. The primary endpoint was all-cause death and the secondary endpoint was cardiac death during follow-up. Results Among 2908 patients with ACS enrolled, 277 (9.5%) patients died within a median follow-up time of 10.6 months. Patients with lower BI had higher risks of mortality, compared with those with higher BI in ACS patients. Kaplan–Meier analysis revealed that patients with lower BI had worse survival rates than patients with higher BI (P < 0.001). After adjustment for potential influencing factors, multivariate Cox regression analysis showed that the BI was independently associated with all-cause mortality and cardiac mortality, respectively. Conclusion The BI at admission has the powerful potential to provide useful prognostic information of early risk stratification, and routine recording of the BI at the ED visit may help in decision-making and health care planning for patients with ACS.
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Affiliation(s)
- Fanghui Li
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China
| | - Dongze Li
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China
| | - Jing Yu
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yu Jia
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China
| | - Ying Jiang
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China
| | - Tengda Chen
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China
| | - Yongli Gao
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China
| | - Zhi Wan
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China
| | - Yu Cao
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China
| | - Zhi Zeng
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China
| | - Rui Zeng
- Department of Emergency Medicine and Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, People's Republic of China.,Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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García-García-Patino R, Benito-León J, Mitchell AJ, Pastorino-Mellado D, García García R, Ladera-Fernández V, Vicente-Villardón JL, Perea-Bartolomé MV, Cacho J. Memory and Executive Dysfunction Predict Complex Activities of Daily Living Impairment in Amnestic Multi-Domain Mild Cognitive Impairment. J Alzheimers Dis 2020; 75:1061-1069. [PMID: 32390622 DOI: 10.3233/jad-191263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Specific cognitive alterations could be one of the predictors that lead to the complex activities of daily living (CADL) impairment in mild cognitive impairment (MCI) and, hence, help to explain the continuum between MCI and dementia. OBJECTIVE We aimed to reevaluate the existing uncertainty regarding the impact of memory and executive functions on CADL in patients with MCI. METHODS Caregivers of 161 patients with amnestic multi-domain MCI and of 150 patients with incipient Alzheimer's disease as well as 100 age-, sex-, and education-matched controls, completed the Interview for Deterioration in Daily Living Activities in Dementia, a suitable instrument for the description and discrimination of CADL. In addition, all patients and controls were assessed with a neuropsychological battery to measure explicit memory and executive functions performance. RESULTS Multiple regression analyses showed that in the group of patients with amnestic multi-domain MCI, 67.4% of the variability of the CADL impairment was explained by worse performance on executive functions tests (p < 0.0001) and 41.8% by different explicit memory components impairment (p < 0.0001). Further, in patients with incipient AD, 44.0% of the variability of CADL impairment was explained by worse performance on executive functions tests (p < 0.0001) and 39.9% by different explicit memory components worsening (p < 0.0001). CONCLUSIONS Memory and executive functions alterations impact similarly on the CADL in both amnestic multi-domain MCI and incipient Alzheimer's disease. Given the continuum that exists between both conditions, we conclude that CADL impairment may be an important early step in the evolution towards Alzheimer's disease from amnestic multi-domain MCI.
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Affiliation(s)
| | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Complutense University, Madrid, Spain
| | - Alex J Mitchell
- Department of Psychooncology, Leicestershire Partnership Trust and University of Leicester, Leicester, UK
| | - Damián Pastorino-Mellado
- Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - Ricardo García García
- Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - Valentina Ladera-Fernández
- Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - Jose Luis Vicente-Villardón
- Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - María Victoria Perea-Bartolomé
- Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - Jesús Cacho
- Department of Neurology, University Clinic Hospital of Salamanca, Salamanca, Spain
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9
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Lussier M, Adam S, Chikhaoui B, Consel C, Gagnon M, Gilbert B, Giroux S, Guay M, Hudon C, Imbeault H, Langlois F, Macoir J, Pigot H, Talbot L, Bier N. Smart Home Technology: A New Approach for Performance Measurements of Activities of Daily Living and Prediction of Mild Cognitive Impairment in Older Adults. J Alzheimers Dis 2019; 68:85-96. [DOI: 10.3233/jad-180652] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Maxime Lussier
- Research Center of Institut universitaire de gériatrie de Montréal, Montreal, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Stéphane Adam
- Faculty of Psychology, Speech therapy and Education Sciences, Université de Liège, Liège, Belgique
| | - Belkacem Chikhaoui
- Department of Science and Technology, Université Téluq, 5800, rue Saint-Denis, Montreal, Canada
| | - Charles Consel
- Bordeaux Institute of Technology & Inria, Université de Bordeaux, Bordeaux, France
| | - Mathieu Gagnon
- Faculty of Sciences and Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Canada
| | - Brigitte Gilbert
- Research Center of Institut universitaire de gériatrie de Montréal, Montreal, Canada
| | - Sylvain Giroux
- Faculty of Sciences and Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Canada
| | - Manon Guay
- Faculty of Sciences and Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Canada
| | - Carol Hudon
- Faculty of Social Sciences and Faculty of Medicine, Université Laval, Québec city, Canada
- CERVO Brain Research Centre, Quebec city, Canada
| | - Hélène Imbeault
- CSSS-Institut universitaire de gériatrie de Sherbrooke, Sherbrooke, Canada
| | - Francis Langlois
- CSSS-Institut universitaire de gériatrie de Sherbrooke, Sherbrooke, Canada
| | - Joel Macoir
- Faculty of Social Sciences and Faculty of Medicine, Université Laval, Québec city, Canada
- CERVO Brain Research Centre, Quebec city, Canada
| | - Hélène Pigot
- Faculty of Sciences and Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Canada
| | - Lise Talbot
- Faculty of Sciences and Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Canada
| | - Nathalie Bier
- Research Center of Institut universitaire de gériatrie de Montréal, Montreal, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Canada
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10
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Koyfman I, Finnell D. A Call for Interfacing Measures of Instrumental Activities of Daily Living Across the Transition of Care. Home Healthc Now 2019; 37:44-49. [PMID: 30608467 DOI: 10.1097/nhh.0000000000000715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The ability to maintain functional status is an essential aspect of self-care for older adults. Instrumental activities of daily living (IADLs) decline within hours of hospitalization and are often overlooked, underassessed, and underreported. The aim of this integrative review was to examine and compare methods used to assess IADLs to determine the best measure for use across the care continuum, especially during transitions of care. A literature search without date restrictions was conducted using PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Embase databases. Twelve studies of moderate quality were included in this review. More than half (58%) of the studies utilized the Lawton and Brody Scale to measure IADL among home-based and hospitalized patients. Implementation of this scale as standard practice and sharing the results with healthcare providers would encourage continuity of care with the goal of supporting older adults aging in place and preventing rehospitalization. In turn, this communication process may improve the transition from the inpatient to home setting, where, since 1999, the Outcome and Assessment Information Set has been mandated.
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Affiliation(s)
- Irina Koyfman
- Irina Koyfman, MSN, RN, NP-C, is a Doctor of Nursing Practice Student, Johns Hopkins School of Nursing, Baltimore, Maryland. Deborah Finnell, DNS, CARN-AP, FAAN, is a Professor, Johns Hopkins School of Nursing, Baltimore, Maryland
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11
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Bier N, El-Samra A, Bottari C, Vallet G, Carignan M, Paquette G, Brambati S, Demers L, Génier-Marchand D, Rouleau I. Posterior cortical atrophy: Impact on daily living activities and exploration of a cognitive rehabilitation approach. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1634911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- N. Bier
- School of rehabilitation, Université de Montréal, Montréal, Canada
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - A. El-Samra
- School of rehabilitation, Université de Montréal, Montréal, Canada
| | - C. Bottari
- School of rehabilitation, Université de Montréal, Montréal, Canada
- Centre de recherche en réadaptation du Montréal Métropolitain (CRIR), Montreal, Canada
| | - G.T. Vallet
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - M. Carignan
- Centre de recherche en réadaptation du Montréal Métropolitain (CRIR), Montreal, Canada
- Institut Nazareth et Louis Braille, CISSS de la Montérégie-Centre, Montreal, Canada
| | - G. Paquette
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
- Centre de recherche en réadaptation du Montréal Métropolitain (CRIR), Montreal, Canada
| | - S. Brambati
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
- Department of psychology, Université de Montréal, Montreal, Canada
| | - L. Demers
- School of rehabilitation, Université de Montréal, Montréal, Canada
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - D. Génier-Marchand
- Department of psychology, Université du Québec à Montréal, Montreal, Canada
| | - I. Rouleau
- Department of psychology, Université du Québec à Montréal, Montreal, Canada
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12
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Lussier M, Lavoie M, Giroux S, Consel C, Guay M, Macoir J, Hudon C, Lorrain D, Talbot L, Langlois F, Pigot H, Bier N. Early Detection of Mild Cognitive Impairment With In-Home Monitoring Sensor Technologies Using Functional Measures: A Systematic Review. IEEE J Biomed Health Inform 2018; 23:838-847. [PMID: 29994013 DOI: 10.1109/jbhi.2018.2834317] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aging of the world population is accompanied by a substantial increase in neurodegenerative disorders, such as dementia. Early detection of mild cognitive impairment (MCI), a clinical diagnostic that comes with an increased chance to develop dementias, could be an essential condition for promoting quality of life and independent living, as it would provide a critical window for the implementation of early pharmacological and nonpharmacological interventions. This systematic review aims to investigate the current state of knowledge on the effectiveness of smart home sensors technologies for the early detection of MCI through the monitoring of everyday life activities. This approach offers many advantages, including the continuous measurement of functional abilities in ecological environments. A systematic search of publications in MEDLINE, EMBASE, and CINAHL, before November 2017, was conducted. Seventeen studies were included in this review. Thirteen studies were based on real-life monitoring, with several sensors installed in participants' actual homes, and four studies included scenario-based assessments, in which participants had to complete various tasks in a research lab apartment. In real-life monitoring, the most used indicators of MCI were walking speed and activity/motion in the house. In scenario-based assessment, time of completion, quality of activity completion, number of errors, amount of assistance needed, and task-irrelevant behaviors during the performance of everyday activities predicted MCI in participants. Despite technological limitations and the novelty of the field, smart home technologies represent a promising potential for the early screening of MCI and could support clinicians in geriatric care.
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13
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Parsons TD, Barnett M. Validity of a Newly Developed Measure of Memory: Feasibility Study of the Virtual Environment Grocery Store. J Alzheimers Dis 2017; 59:1227-1235. [DOI: 10.3233/jad-170295] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Thomas D. Parsons
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Michael Barnett
- Department of Psychology, University of North Texas, Denton, TX, USA
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14
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Giebel CM, Sutcliffe C, Challis D. Hierarchical Decline of the Initiative and Performance of Complex Activities of Daily Living in Dementia. J Geriatr Psychiatry Neurol 2017; 30:96-103. [PMID: 28073326 DOI: 10.1177/0891988716686835] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES While basic activities of daily living hierarchically decline in dementia, little is known about the decline of individual instrumental activities of daily living (IADLs). The objective of this study was to assess initiative and performance deficits in IADLs in dementia. METHODS A total of 581 carers completed the revised Interview for Deterioration in Daily Living Activities in Dementia 2 to rate their relative's everyday functioning. RESULTS Initiating and performing IADLs deteriorated hierarchically, while people with dementia were consistently most impaired in initiating using the computer and managing finances. Initiating preparing a cold or hot meal and managing finances were more impaired than their performance, whereas performing maintaining an active social life for example were more impaired than their initiative. CONCLUSION Findings can help identify the severity of dementia by understanding deficits in initiative and performance. This study has implications for the development of targeted interventions depending on the stage of dementia.
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Affiliation(s)
- Clarissa M Giebel
- 1 School of Health Sciences, University of East Anglia, Norwich, United Kingdom.,2 Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, United Kingdom
| | - Caroline Sutcliffe
- 3 Personal Social Services Research Unit, The University of Manchester, Manchester, United Kingdom
| | - David Challis
- 3 Personal Social Services Research Unit, The University of Manchester, Manchester, United Kingdom
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