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Li A, Li J, Chai J, Wu W, Chaudhary S, Zhao J, Qiang Y. Detection of Mild Cognitive Impairment Through Hand Motor Function Under Digital Cognitive Test: Mixed Methods Study. JMIR Mhealth Uhealth 2024; 12:e48777. [PMID: 38924786 PMCID: PMC11237787 DOI: 10.2196/48777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 03/07/2024] [Accepted: 04/22/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Early detection of cognitive impairment or dementia is essential to reduce the incidence of severe neurodegenerative diseases. However, currently available diagnostic tools for detecting mild cognitive impairment (MCI) or dementia are time-consuming, expensive, or not widely accessible. Hence, exploring more effective methods to assist clinicians in detecting MCI is necessary. OBJECTIVE In this study, we aimed to explore the feasibility and efficiency of assessing MCI through movement kinetics under tablet-based "drawing and dragging" tasks. METHODS We iteratively designed "drawing and dragging" tasks by conducting symposiums, programming, and interviews with stakeholders (neurologists, nurses, engineers, patients with MCI, healthy older adults, and caregivers). Subsequently, stroke patterns and movement kinetics were evaluated in healthy control and MCI groups by comparing 5 categories of features related to hand motor function (ie, time, stroke, frequency, score, and sequence). Finally, user experience with the overall cognitive screening system was investigated using structured questionnaires and unstructured interviews, and their suggestions were recorded. RESULTS The "drawing and dragging" tasks can detect MCI effectively, with an average accuracy of 85% (SD 2%). Using statistical comparison of movement kinetics, we discovered that the time- and score-based features are the most effective among all the features. Specifically, compared with the healthy control group, the MCI group showed a significant increase in the time they took for the hand to switch from one stroke to the next, with longer drawing times, slow dragging, and lower scores. In addition, patients with MCI had poorer decision-making strategies and visual perception of drawing sequence features, as evidenced by adding auxiliary information and losing more local details in the drawing. Feedback from user experience indicates that our system is user-friendly and facilitates screening for deficits in self-perception. CONCLUSIONS The tablet-based MCI detection system quantitatively assesses hand motor function in older adults and further elucidates the cognitive and behavioral decline phenomenon in patients with MCI. This innovative approach serves to identify and measure digital biomarkers associated with MCI or Alzheimer dementia, enabling the monitoring of changes in patients' executive function and visual perceptual abilities as the disease advances.
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Affiliation(s)
- Aoyu Li
- School of Software, Taiyuan University of Technology, Jinzhong, China
| | - Jingwen Li
- School of Computer Science, Xijing University, Xian, China
| | - Jiali Chai
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Jinzhong, China
| | - Wei Wu
- Shanxi Provincial People's Hospital, Taiyuan, China
| | - Suamn Chaudhary
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Jinzhong, China
| | - Juanjuan Zhao
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Jinzhong, China
| | - Yan Qiang
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Jinzhong, China
- School of Software, North University of China, Taiyuan, China
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Cai Z, Ma Y, Li L, Lu GZ. Effects of exergaming in older individuals with mild cognitive impairment and dementia: A systematic review and meta-analysis. Geriatr Nurs 2023; 51:351-359. [PMID: 37099867 DOI: 10.1016/j.gerinurse.2023.03.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Non-pharmaceutical interventions have been implemented for people with dementia or mild cognitive impairment (MCI). Researchers have used exergaming in dementia to alleviate cognitive decline in patients with dementia. AIMS We assessed the effects of exergaming interventions on MCI and dementia. METHODS We conducted a systematic review and meta-analysis (PROSPERO [CRD42022347399]). PubMed, Cochrane Library, Web of Science, CINAHL, and Embase electronic databases were searched for randomized controlled trials (RCTs). The impact of exergaming on cognitive function, physical performance, and quality of life in patients with MCI and dementia was investigated. RESULTS Ten RCTs met the eligibility criteria and were included in our systematic review. The results of the meta-analysis demonstrated a statistically significant difference in the Mini-mental State Examination, Montreal Cognitive Assessment, Trail Making Test, Chinese version of the Verbal Learning Test, Berg Balance Scale, Short Physical Performance Battery, and Physical Activity Scale for the Elderly in people with dementia and MCI who participated in exergaming. However, there were no significant improvements in the Activities of Daily Living, Instrumental Activity of Daily Living or Quality of Life. CONCLUSION Although there were significant differences in cognitive and physical functions, these results should be interpreted with caution because of heterogeneity. The additional benefits of exergaming remain to be confirmed in future studies.
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Affiliation(s)
- Zhi Cai
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
| | - Yanling Ma
- West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Lei Li
- Sichuan Vocational college of Health and rehabilitation, Zigong, Sichuan, China.
| | - Gui-Zhi Lu
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
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Hausman HK, Dai Y, O’Shea A, Dominguez V, Fillingim M, Calfee K, Carballo D, Hernandez C, Perryman S, Kraft JN, Evangelista ND, Van Etten EJ, Smith SG, Bharadwaj PK, Song H, Porges E, DeKosky ST, Hishaw GA, Marsiske M, Cohen R, Alexander GE, Wu SS, Woods AJ. The longitudinal impact of the COVID-19 pandemic on health behaviors, psychosocial factors, and cognitive functioning in older adults. Front Aging Neurosci 2022; 14:999107. [PMID: 36506467 PMCID: PMC9732386 DOI: 10.3389/fnagi.2022.999107] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Older adults are at a greater risk for contracting and experiencing severe illness from COVID-19 and may be further affected by pandemic-related precautions (e.g., social distancing and isolation in quarantine). However, the longitudinal impact of the COVID-19 pandemic on older adults is unclear. The current study examines changes in health behaviors, psychosocial factors, and cognitive functioning in a large sample of older adults using a pre-pandemic baseline and longitudinal follow-up throughout 9 months of the COVID-19 pandemic. Methods: One hundred and eighty-nine older adults (ages 65-89) were recruited from a multisite clinical trial to complete additional virtual assessments during the COVID-19 pandemic. Mixed effects models evaluated changes in health behaviors, psychosocial factors, and cognitive functioning during the pandemic compared to a pre-pandemic baseline and over the course of the pandemic (i.e., comparing the first and last COVID-19 timepoints). Results: Compared to their pre-pandemic baseline, during the pandemic, older adults reported worsened sleep quality, perceived physical health and functioning, mental health, slight increases in depression and apathy symptoms, reduced social engagement/perceived social support, but demonstrated better performance on objective cognitive tasks of attention and working memory. Throughout the course of the pandemic, these older adults reported continued worsening of perceived physical health and function, fewer depression symptoms, and they demonstrated improved cognitive performance. It is important to note that changes on self-report mood measures and cognitive performance were relatively small regarding clinical significance. Education largely served as a protective factor, such that greater years of education was generally associated with better outcomes across domains. Conclusions: The present study provides insights into the longitudinal impact of the COVID-19 pandemic on health behaviors, psychosocial factors, and cognitive functioning in a population disproportionately affected by the virus. Replicating this study design in a demographically representative older adult sample is warranted to further inform intervention strategies targeting older adults negatively impacted by the COVID-19 pandemic.
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Affiliation(s)
- Hanna K. Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Yunfeng Dai
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL,, United States
| | - Andrew O’Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Vanessa Dominguez
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Matthew Fillingim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Kristin Calfee
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Daniela Carballo
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Cindy Hernandez
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Sean Perryman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Jessica N. Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicole D. Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Emily J. Van Etten
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Samantha G. Smith
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Pradyumna K. Bharadwaj
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Hyun Song
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Eric Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Steven T. DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Georg A. Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer’s Disease Consortium, Tucson, AZ, United States
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Gene E. Alexander
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States,Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer’s Disease Consortium, Tucson, AZ, United States
| | - Samuel S. Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL,, United States
| | - Adam J. Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States,*Correspondence: Adam J. Woods
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Peng W, Miyawaki CE, Okoye SM, Wang W, Luo Y, Mo C, Liu M. Mediating role of homebound status between depressive symptoms and cognitive impairment among community-dwelling older adults in the USA: a cross-sectional analysis of a cohort study. BMJ Open 2022; 12:e065536. [PMID: 36316068 PMCID: PMC9628545 DOI: 10.1136/bmjopen-2022-065536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Depressive symptoms are known modifiable factors of cognitive impairment in older adults. However, the pathway through which depressive symptoms lead to cognitive impairment is not well understood. This study aimed to investigate whether homebound status (defined as usually unable to leave home unassisted) mediates the association between depressive symptoms and cognitive impairment in community-dwelling older adults in the USA. DESIGN A secondary analysis of cross-sectional data. SETTINGS Communities in the USA. PARTICIPANTS Community-dwelling older adults (N=7537) from the 2011 National Health and Aging Trends Study, a nationally representative survey of Medicare Beneficiaries in the USA. MAIN OUTCOME MEASURES Participants' cognitive impairment status was classified using a composite measure. Depressive symptoms were assessed using Patient Health Questionnaire-2. Homebound status was determined by the frequency, difficulty and needing help in getting outdoors. We used logistic regression and the Paramed command in STATA to analyse whether homebound mediated the association between depressive symptoms and cognitive impairment. RESULTS Participants were on average, 77.7 years old, female (58.3%) and non-Hispanic white (68.1%). About 26% of the participants were classified as having cognitive impairment, 16% reported depressive symptoms and 25% were homebound. Depressive symptoms (adjusted OR, 1.60; 95% CI 1.36 to 1.89) and homebound status (adjusted OR, 1.58; 95% CI 1.34 to 1.86) were independently associated with cognitive impairment. Homebound significantly mediated 12.5% of the total effect between depressive symptoms and cognitive impairment, with significant indirect effect (OR, 1.07; 95% CI 1.04 to 1.10), direct effect (OR, 1.61; 95% CI 1.36 to 1.91) and total effect (OR, 1.72; 95% CI 1.46 to 2.03). CONCLUSIONS This study supports a mediating role of homebound status in the relationship between depressive symptoms and cognitive impairment. Interventions to promote outdoor mobility should be studied for their ability to delay cognitive impairment for older adults with depressive symptoms.
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Affiliation(s)
- Wenting Peng
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | | | - Safiyyah M Okoye
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yuqian Luo
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Cen Mo
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
| | - Minhui Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China
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5
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Jiao Y, Liu C, Chang J, Zhou S, Ji Y. Self-management preferences in patients with mild cognitive impairment: A qualitative study. Front Psychol 2022; 13:955960. [DOI: 10.3389/fpsyg.2022.955960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
PurposePatients with mild cognitive impairment (MCI) require self-management, yet current self-management compliance is low. Taking patients’ preferences into account can improve the self-management situation. The purpose of this study is to look into MCI patients’ preferences for self-management in China.MethodsA qualitative research was conducted using semi-structured in-depth interviews with 21 patients recently diagnosed with MCI who were chosen by purposive sampling. These interviews were analyzed through thematic analysis and identified emerging themes.ResultsFive themes of self-management preference were identified: (1) Preference for acquiring disease knowledge; (2) Preference for participating in drug therapy; (3) Preference for participating in exercise; (4) Preference for applying memory compensation strategy; (5) Preferences for emotional expression and response.ConclusionOur study identified the specific preferences of MCI patients in China for the main self-management items. The findings are valuable insights for knowing MCI patients’ self-management content and preferences and provide better guidance for health practitioners to improve self-management compliance.
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Augustine CA, Keikhosrokiani P. A Hospital Information Management System With Habit-Change Features and Medial Analytical Support for Decision Making. INTERNATIONAL JOURNAL OF INFORMATION TECHNOLOGIES AND SYSTEMS APPROACH 2022. [DOI: 10.4018/ijitsa.307019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A hospital information management system (Doctive) with habit-change features and medial analytical support for decision making is developed in this study to reduce the risks of heart diseases. Doctive is targeted for hospital authorities to monitor patients’ habits and to prescribe medication and advice accordingly. Furthermore, this system provides emergency assistance for patients based on their current location. The proposed system would be beneficial for monitoring and organizing patients’ information to ease data entry, data management, data access, data retrieval and finally decision making. Doctive is tested and evaluated by 41 people who are either medical experts or professionals in the field of data analytics and visualization. The results indicate a high acceptance rate towards using Doctive system in hospitals and very good usability of the system. Doctive can be useful for healthcare providers and developers to track users’ habits for reducing the risk of heart disease. In the future.
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Martin E, Velayudhan L. Neuropsychiatric Symptoms in Mild Cognitive Impairment: A Literature Review. Dement Geriatr Cogn Disord 2021; 49:146-155. [PMID: 32289790 DOI: 10.1159/000507078] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/07/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) in dementia have received much attention due to their high prevalence and their significant implications. NPS in mild cognitive impairment (MCI), a clinical concept proposed as an intermediate state between normal aging and dementia, is now gradually gaining in interest. We aimed to conduct a selective review to examine the prevalence rate of NPS in MCI and associations of NPS symptoms with disease progression. SUMMARY We searched the PubMed database for articles on NPS in MCI and included articles that fulfilled the inclusion criteria. NPS was present in 35-85% of MCI patients. The most common symptoms were depression, irritability, apathy, anxiety, agitation, and sleep problems. Although the associated risk for disease progression of some symptoms, such as apathy and anxiety, was more consistent across studies, evidence was conflicting for symptoms like depression and sleep problems. NPS tend to co-occur, and certain combinations of NPS had a mutual or cumulative effect on disease progression. Late-onset NPS, even in a mild form (mild behavioural impairment) were found to be associated with an increased risk of dementia, even in the absence of cognitive impairment. Key Messages: NPS are highly prevalent in MCI patients and associated with subsequent cognitive deterioration. Late-onset NPS should raise suspicions of neurodegeneration. Future studies with improvised methodology are required to understand the interrelations of NPS and the role they play in the prognosis for patients with MCI.
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Affiliation(s)
- Evangelia Martin
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Latha Velayudhan
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom,
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Perez-Lasierra JL, Casajús JA, Casasnovas JA, Arbones-Mainar JM, Lobo A, Lobo E, Moreno-Franco B, Gonzalez-Agüero A. Can Physical Activity Reduce the Risk of Cognitive Decline in Apolipoprotein e4 Carriers? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7238. [PMID: 34299687 PMCID: PMC8303365 DOI: 10.3390/ijerph18147238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 12/16/2022]
Abstract
Physical activity (PA) reduces the risk of cognitive decline (CD) in the general population. However, little is known about whether the presence of the apolipoprotein E epsilon 4 allele (APOE e4) could modify this beneficial effect. The aim of this systematic review was to analyze and synthetize the scientific evidence related to PA levels and CD risk in cognitively healthy APOE e4 carriers. Four electronic databases were analyzed. Only original articles with longitudinal study design were selected to analyze the relationship between PA and CD in APOE e4 carriers. Five studies were included in the systematic review. All studies except one stated that PA is a protective factor against CD in APOE e4 carriers. Moreover, partial support was found for the hypothesis that a greater amount and intensity of PA are more beneficial in CD prevention. The results support the idea that PA is a protective factor against CD in APOE e4 carriers. Nevertheless, it would be necessary to carry out further studies that would allow these findings to be contrasted.
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Affiliation(s)
- Jose Luis Perez-Lasierra
- Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (J.L.P.-L.); (J.A.C.)
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
| | - Jose Antonio Casajús
- Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (J.L.P.-L.); (J.A.C.)
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- CIBEROBN Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - José Antonio Casasnovas
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERCV Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jose Miguel Arbones-Mainar
- CIBEROBN Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- Adipocyte and Fat Biology Laboratory (AdipoFat), 50009 Zaragoza, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERSAM Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Elena Lobo
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERSAM Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Microbiology, Pediatrics, Radiology and Public Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Belén Moreno-Franco
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERCV Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Microbiology, Pediatrics, Radiology and Public Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Alejandro Gonzalez-Agüero
- Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (J.L.P.-L.); (J.A.C.)
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- CIBEROBN Instituto de Salud Carlos III, 28029 Madrid, Spain;
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Wu VX, Chi Y, Lee JK, Goh HS, Chen DYM, Haugan G, Chao FFT, Klainin-Yobas P. The effect of dance interventions on cognition, neuroplasticity, physical function, depression, and quality of life for older adults with mild cognitive impairment: A systematic review and meta-analysis. Int J Nurs Stud 2021; 122:104025. [PMID: 34298320 DOI: 10.1016/j.ijnurstu.2021.104025] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Mild cognitive impairment is an age-related cognitive disorder which is associated with frequent memory lapses, impaired judgement, and progressive functional decline. If untreated early, 39.2% of people with mild cognitive impairment could progress to develop dementia. However, there are currently no approved pharmacological interventions to treat the condition, which lead researchers to explore non-pharmacological options, such as dance therapy. OBJECTIVES This systematic review aimed to examine the effectiveness of dance interventions on cognition, neuroplasticity, physical function, depression, and quality of life in older adults with mild cognitive impairment. METHODS Seven databases were systematically searched from their respective inception dates to 31 March 2020. Relevant randomized controlled trials (RCTs) were screened and assessed for risk of bias. Eight RCTs evaluating dance interventions were included. RESULTS Results showed that dance interventions had a significant moderate effect on global cognition (SMD=0.54, Z = 3.55, p<0.001), significantly improved memory (SMD=0.33, Z = 3.97, p<0.001), visuospatial function (SMD=0.42, Z = 2.41, p = 0.02), and language (SMD=0.39, Z = 2.69, p = 0.007). We found that dance interventions produced a significant moderate effect on physical function (SMD=0.55, Z = 3.43, p<0.001), and a significant effect on quality of life (SMD=0.93, Z = 5.04, p<0.0.001). CONCLUSION Dance is a non-pharmacological and inexpensive intervention that can be implemented for older adults on a large scale. It can slow down the cognitive deterioration of older adults with mild cognitive impairment. However, the findings should be interpreted with caution due to the heterogeneity in intervention designs. Rigorous design studies with long-term follow-ups, neuroimaging, biological markers, and comprehensive neuropsychological assessment are required to understand the mechanism of dance interventions and demonstrate its efficacy for older adults with mild cognitive impairment. The protocol was registered on PROSPERO (CRD42020173659).
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Affiliation(s)
- Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Yuchen Chi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Jeong Kyu Lee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Y, Singapore 117549, Singapore.
| | - Hongli Sam Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Delphine Yu Mei Chen
- General Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore.
| | - Gørill Haugan
- Norwegian University of Science and Technology, Department of Public Health and Nursing, Address: Postbox 8905, 7491 Trondheim, Norway.
| | - Felicia Fang Ting Chao
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
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10
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Kurmyshev MV, Zakharova NV, Bravve LV. [Neuropsychiatric symptoms in patients with mild cognitive impairment]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:68-74. [PMID: 34184481 DOI: 10.17116/jnevro202112105168] [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: 11/18/2022]
Abstract
OBJECTIVE To study the prevalence of neuropsychiatric symptoms (NPS) in patients with mild cognitive impairment (MCI) who asked for help in memory clinics. MATERIAL AND METHODS We analysed data on 729 patients with MCI (average age 76.6 years, average MMSE score 25.3), who underwent a course of cognitive neurorehabilitation in a specialized department - a memory clinic. A Russian version of Neuropsychiatric Inventory (NPI) was used. We compared the indicators for the main psychometric scales for the diagnosis of MCI in comparison with the dynamics of NPS. RESULTS The prevalence rates for NPS differed in part from those reported in the literature. The most common symptom was anxiety (54.7%) and irritability (56.5%), while euphoria, as well as delusions and hallucinations were not detected. All disorders significantly reduced at the end of the rehabilitation program. CONCLUSION MCI influences the level of functioning and social interaction in older patients and mediates the quality of life. Thus, given the increase in life expectancy, it is necessary to introduce new methods of examination applicable in the practice of psychiatrists to diagnose and rehabilitate such patients. NPS turned out to be widespread in MCI, but may reduce during the course of complex neurorehabilitation.
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Affiliation(s)
- M V Kurmyshev
- Alexeev Psychiatric Clinical Hospital No. 1, Moscow, Russia
| | - N V Zakharova
- Alexeev Psychiatric Clinical Hospital No. 1, Moscow, Russia
| | - L V Bravve
- Alexeev Psychiatric Clinical Hospital No. 1, Moscow, Russia
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Bartels SL, van Knippenberg RJM, Malinowsky C, Verhey FRJ, de Vugt ME. Smartphone-Based Experience Sampling in People With Mild Cognitive Impairment: Feasibility and Usability Study. JMIR Aging 2020; 3:e19852. [PMID: 33064084 PMCID: PMC7600012 DOI: 10.2196/19852] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/16/2020] [Accepted: 07/28/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Daily functioning of people with cognitive disorders such as mild cognitive impairment (MCI) is usually depicted by retrospective questionnaires, which can be memory-biased and neglect fluctuations over time or contexts. OBJECTIVE This study examines the feasibility and usability of applying the experience sampling method (ESM) in people with MCI to provide a detailed and dynamic picture of behavioral, emotional, and cognitive patterns in everyday life. METHODS For 6 consecutive days, 21 people with MCI used an ESM app on their smartphones. At 8 semi-random timepoints per day, participants filled in momentary questionnaires on mood, activities, social context, and subjective cognitive complaints. Feasibility was determined through self-reports and observable human-technology interactions. Usability was demonstrated on an individual and group level. RESULTS Of the 21 participants, 3 dropped out due to forgetting to carry their smartphones or forgetting the study instructions. In the remaining 18 individuals, the compliance rate was high, at 78.7%. Participants reported that momentary questions reflected their daily experiences well. Of the 18 participants, 13 (72%) experienced the increase in awareness of their own memory functions as pleasant or neutral. CONCLUSIONS Support was found for the general feasibility of smartphone-based experience sampling in people with MCI. However, many older adults with MCI are currently not in possession of smartphones, and study adherence seems challenging for a minority of individuals. Momentary data can increase the insights into daily patterns and may guide the person-tailored development of self-management strategies in clinical settings.
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Affiliation(s)
- Sara Laureen Bartels
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
- Division of Occupational Therapy, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Rosalia J M van Knippenberg
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
| | - Camilla Malinowsky
- Division of Occupational Therapy, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
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Sabatini S, Ukoumunne OC, Ballard C, Brothers A, Kaspar R, Collins R, Kim S, Corbett A, Aarsland D, Hampshire A, Brooker H, Clare L. International relevance of two measures of awareness of age-related change (AARC). BMC Geriatr 2020; 20:359. [PMID: 32957978 PMCID: PMC7507664 DOI: 10.1186/s12877-020-01767-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/10/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND A questionnaire assessing awareness of positive and negative age-related changes (AARC gains and losses) was developed in the US and Germany. We validated the short form of the measure (AARC-10 SF) and the cognitive functioning subscale from the 50-item version of the AARC (AARC-50) questionnaire in the UK population aged 50 and over. METHODS Data from 9410 participants (Mean (SD) age = 65.9 (7.1)) in the PROTECT cohort were used to explore and confirm the psychometric properties of the AARC measures including: validity of the factor structure; reliability; measurement invariance across men and women, individuals with and without a university degree, and in middle age, early old age, and advanced old age; and convergent validity with measures of self-perception of aging and mental, physical, and cognitive health. We explored the relationship between demographic variables (age, sex, marital status, employment, and university education) and AARC. RESULTS We confirmed the two-factor structure (gains and losses) of the AARC-10 SF and the AARC-50 cognitive functioning subscale. Both scales showed good reliability and good convergent validity for AARC losses, but weak convergent validity for AARC gains. For both scales metric invariance was held for the two subgroups defined by education level and age. For the AARC-50 subscale, but not for the AARC-10 SF, strong invariance was also held for the two subgroups defined by sex. Age, sex, marital status, employment, and university education predicted AARC gains and losses. CONCLUSIONS The AARC-10 SF and AARC-50 cognitive functioning subscale identify UK individuals who perceive age-related changes in their mental, physical, and cognitive health.
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Affiliation(s)
- Serena Sabatini
- College of Medicine and Health, REACH, University of Exeter, South Cloisters, St Luke's Campus, Exeter, EX12LU, UK.
| | - Obioha C Ukoumunne
- NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Clive Ballard
- College of Medicine and Health, REACH, University of Exeter, South Cloisters, St Luke's Campus, Exeter, EX12LU, UK
| | - Allyson Brothers
- College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Roman Kaspar
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany
| | - Rachel Collins
- College of Medicine and Health, REACH, University of Exeter, South Cloisters, St Luke's Campus, Exeter, EX12LU, UK
| | - Sarang Kim
- Wicking Dementia Research & Education Centre, University of Tasmania, Hobart, Australia
| | - Anne Corbett
- College of Medicine and Health, REACH, University of Exeter, South Cloisters, St Luke's Campus, Exeter, EX12LU, UK
| | - Dag Aarsland
- Department of Medicine, Imperial College London, London, UK
| | - Adam Hampshire
- Department of Brain Sciences, Imperial College London, London, UK
| | - Helen Brooker
- College of Medicine and Health, REACH, University of Exeter, South Cloisters, St Luke's Campus, Exeter, EX12LU, UK
| | - Linda Clare
- College of Medicine and Health, REACH, University of Exeter, South Cloisters, St Luke's Campus, Exeter, EX12LU, UK
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Lovett RM, Curtis LM, Persell SD, Griffith JW, Cobia D, Federman A, Wolf MS. Cognitive impairment no dementia and associations with health literacy, self-management skills, and functional health status. PATIENT EDUCATION AND COUNSELING 2020; 103:1805-1811. [PMID: 32197929 PMCID: PMC7864102 DOI: 10.1016/j.pec.2020.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/19/2020] [Accepted: 03/11/2020] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To determine the prevalence of cognitive impairment no dementia (CIND) among a diverse, community-based population, and establish associations between CIND and health literacy, chronic disease self-management and functional health status. METHODS 863 primary care adults without dementia aged 55-74. Adjusted logistic and linear regressions were used to assess associations between CIND (None, Mild, Moderate/Severe) and outcomes. RESULTS 36 % participants exhibited CIND. It was strongly associated with limited health literacy (Newest Vital Signs: Mild [OR 3.25; 95 % CI 1.93, 5.49], Moderate/Severe [OR 6.45; 95 % CI 3.16, 13.2]; Test of Functional Health Literacy in Adults: Mild [OR 3.46; 95 % CI 2.08, 5.75], Moderate/Severe [OR 8.82; 95 % CI 4.87, 16.0]; all p's < 0.001) and poor chronic disease self-management (Mild [B = -11.2; 95 % CI -13.5, -8.90], Moderate/Severe CI [B = -21.0; 95 % CI -23.6, -18.4]; both p's < 0.001). Associations between CIND and functional health status were non-significant. CONCLUSIONS CIND was prevalent in this cohort, and strongly associated with requisite skills for managing everyday health needs. PRACTICE IMPLICATIONS Attention to subtle declines in chronic disease self-care may assist with CIND identification and care management within this population. When CIND is observed, clinicians should also expect and address difficulties with self-management.
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Affiliation(s)
- Rebecca M Lovett
- Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA.
| | - Laura M Curtis
- Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA.
| | - Stephen D Persell
- Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA.
| | - James W Griffith
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave. #822, Chicago, IL, USA.
| | - Derin Cobia
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA.
| | - Alex Federman
- General Internal Medicine, Icahn School of Medicine, Mount Sinai Hospital, 17 E 102nd St, 7th Floor, New York, NY, USA.
| | - Michael S Wolf
- Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA.
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Barbosa R, Midão L, Almada M, Costa E. Cognitive performance in older adults across Europe based on the SHARE database. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:584-599. [PMID: 32741311 DOI: 10.1080/13825585.2020.1799927] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
With ageing mental health issues, as age-related cognitive decline, increase. This study aims to evaluate the prevalence of cognitive impairment among older European adults and to evaluate its association with clinical and sociodemographic variables, using SHARE. Numeracy, temporal orientation, verbal fluency, and memory were the measures used to evaluate cognitive performance. From 44 963 individuals included, mean age was 70.0±9.0 years old and 56.3% were female. Overall prevalence of impairment was of 13.0% (temporal orientation), 24.8% (numeracy), 27.6% (verbal fluency) and 50.5% (memory). Men showed higher impairment prevalence in temporal orientation and memory and lower in numeracy and verbal fluency. Age, fewer years of education, difficulties performing iADLs, physical inactivity, and poor self-perceived health were independently associated with impairment in all cognitive abilities. These results showed the burden of cognitive impairment across Europe. Factors identified as associated should be taken in consideration to develop effective interventions to prevent cognitive decline.
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Affiliation(s)
- Rui Barbosa
- UCIBIO REQUIMTE, Faculty of Pharmacy, Competences Center on Active and Healthy Ageing, University of Porto , Porto, Portugal
| | - Luís Midão
- UCIBIO REQUIMTE, ICBAS, Competences Center on Active and Healthy Ageing, University of Porto , Porto, Portugal
| | - Marta Almada
- UCIBIO REQUIMTE, Faculty of Pharmacy, Competences Center on Active and Healthy Ageing, University of Porto , Porto, Portugal
| | - Elísio Costa
- UCIBIO REQUIMTE, Faculty of Pharmacy, Competences Center on Active and Healthy Ageing, University of Porto , Porto, Portugal
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Cheng DL, Thompson L, Snyder PJ. A Potential Association Between Retinal Changes, Subjective Memory Impairment, and Anxiety in Older Adults at Risk for Alzheimer's Disease: A 27-Month Pilot Study. Front Aging Neurosci 2019; 11:288. [PMID: 31736739 PMCID: PMC6830450 DOI: 10.3389/fnagi.2019.00288] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 10/07/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction The utility of subjective memory impairment (SMI) as a risk marker for preclinical Alzheimer's disease (AD) remains unclear; however, recent studies have identified a correlation between retinal biomarkers and onset of preclinical disease. This study examines the relationship between retinal biomarkers that have been associated with cerebral amyloid, an early hallmark of AD, and SMI scores in patients at risk for developing AD. Methods Forty-nine cognitively normal subjects were followed over 27 months and evaluated using a combination of neuropsychological, psychological, and retinal imaging instruments. Subjective memory testing was conducted using the memory assessment clinic questionnaire (MACQ) and Depression, Anxiety, and Stress Scales (DASS). Multivariate linear analysis was conducted using STATA software. Results Positive correlations were found between retinal nerve fiber layer (RNFL) volume and scores obtained from the MAC-Q at 27 months (MAC-Q_27), the DASS questionnaire for anxiety at 27 months (DASS-A_27), and the change in DASS-A over 27 months (dDASSA). There was also a significant positive correlation between these variables and the change in RNFL thickness over 27 months (dRNFL). MACQ_27, DASSA_27, and dDASS-A accounted for 35.7% of RFNL variance at 27 months and 21.5% of dRFNL variance. Discussion These findings suggest that worse subjective memory complaints and anxiety scores may be associated with one of the most commonly used structural anatomical retinal markers of early disease burden in AD. If so, these results lend support to SMI as a valid risk marker for later cognitive decline.
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Affiliation(s)
- Derrick L Cheng
- The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Louisa Thompson
- Department of Neurology, Alpert Medical School, Brown University, Providence, RI, United States
| | - Peter J Snyder
- Department of Neurology, Alpert Medical School, Brown University, Providence, RI, United States.,The Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, RI, United States
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Chen C, Hu Z, Jiang Z, Zhou F. Prevalence of anxiety in patients with mild cognitive impairment: A systematic review and meta-analysis. J Affect Disord 2018; 236:211-221. [PMID: 29747139 DOI: 10.1016/j.jad.2018.04.110] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/12/2018] [Accepted: 04/08/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Prevalence rates of anxiety in patients with mild cognitive impairment (MCI) varied widely across studies and may confer a higher likelihood of progression to dementia. Our aim was to estimate the prevalence of anxiety in MCI and identify reasons for heterogeneity in the reported results. METHODS A computerized search in PubMed, EMBASE, and Psyc INFO for studies on anxiety in MCI was performed up to March 2017. The overall prevalence of anxiety in patients with MCI was pooled using a random-effects model. Heterogeneity was explored using stratification (recruitment resource; method of anxiety diagnosis; method of MCI diagnosis; and region) and random-effects meta-regression. RESULTS Of 2494 unique abstracts, 290 were selected for full-text review, and 39 studies, representing 10,587 patients, met all inclusion criteria. The overall pooled prevalence of depression in patients with MCI was 21.0% (95% CI, 16.2-26.7) with significant heterogeneity present (I2 = 97.2%, p < 0.001). When stratified by source, the prevalence of anxiety in patients with MCI in community-based samples was 14.3% (95% CI, 9.7-20.5) and was 31.2% (95% CI, 23.6-40.0) in clinic-based samples, which was significantly different (p < 0.01). The prevalence of anxiety estimates also differed significantly, when stratification by the method of anxiety diagnosis (p < 0.01). However, the criteria used for MCI diagnosis and geographical region did not significantly influence the prevalence estimate. LIMITATIONS We did not consider the usage of anti-anxiety drugs and language bias. CONCLUSIONS The prevalence of anxiety in patients with MCI was common and variability in prevalence of anxiety across studies can be attributed partly to the source of the sample and method of anxiety diagnosis. Further research is needed to identify sources of heterogeneity.
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Affiliation(s)
- Chunli Chen
- Department of Neurology, Second Xiangya Hospital, Hunan, PR China
| | - Zhiping Hu
- Department of Neurology, Second Xiangya Hospital, Hunan, PR China
| | - Zheng Jiang
- Department of Neurology, Second Xiangya Hospital, Hunan, PR China.
| | - Fangfang Zhou
- Department of Neurology, Second Xiangya Hospital, Hunan, PR China
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Liang Y, Xu X, Yin M, Li Y, Zhang Y, Huang L, Ni J. A more comprehensive investigation of disability and associated factors among older adults receiving home-based care in rural Dongguan, China. BMC Geriatr 2018; 18:158. [PMID: 29976138 PMCID: PMC6034336 DOI: 10.1186/s12877-018-0852-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 06/27/2018] [Indexed: 12/19/2022] Open
Abstract
Background No previous study has evaluated disability in older persons according to the International Classification of Functioning, Disability and Health Framework guidelines. We conducted a more comprehensive investigation of disability and associated factors among older adults receiving home-based care in rural Dongguan, a city in the central Guangdong Province of Southern China. Methods A total of 819 individuals aged ≥60 years were recruited from Dongguan home-based care system of via a two-stage selection process. We interviewed participants and assessed their ability level using the Ability Assessment for Older Adults, which defined by a combination of activity of daily living, sensory perception, mental status and social involvement. Conditional probability and Logistic regression approaches were used to assess the strength of association between each pair of conditions. Factors significantly associated with disability were identified via χ2 tests and multinomial ordinal logistic regression. Results Of the 819 included participants (mean age 87 ±4.7 years), 75.5% were female, 76.7% had any disability, and 62.3% had a mild disability. The occurrence of any deficits significantly increased the likelihood of the co-occurrence of other deficits (odds ratio [OR] > 1, P < 0.05), with the lowest prevalence odds ratio observed among individuals with sensory and communication deficiency (OR: 2.99; 95% confidence interval [CI]: 2.21–4.05). Multivariable ordinal logistic regression analysis indicated that physical activity (OR: 0.96; 95% CI: 0.93–0.99), sedentary behavior (OR: 1.25; 95% CI: 1.13–1.38), not watching television (OR: 1.7; 95% CI: 1.07–2.72) and age (OR: 1.09; 95% CI: 1.02–1.17) were significantly associated with disability. Conclusions Impairment of ADL, sensory perception, mental status or social involvement increased the likelihood of risk of the co-occurrence of other deficits. Comprehensive disability among older adults receiving home-based care is associated with age, sedentariness, physical activity and TV viewing. Electronic supplementary material The online version of this article (10.1186/s12877-018-0852-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yaping Liang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xiaojia Xu
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Mingjuan Yin
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Yulian Li
- Da Lang Community Health Service Center, Dongguan, China
| | - Yan Zhang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Lingfeng Huang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jindong Ni
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China.
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Lindroth H, Bratzke L, Purvis S, Brown R, Coburn M, Mrkobrada M, Chan MTV, Davis DHJ, Pandharipande P, Carlsson CM, Sanders RD. Systematic review of prediction models for delirium in the older adult inpatient. BMJ Open 2018; 8:e019223. [PMID: 29705752 PMCID: PMC5931306 DOI: 10.1136/bmjopen-2017-019223] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To identify existing prognostic delirium prediction models and evaluate their validity and statistical methodology in the older adult (≥60 years) acute hospital population. DESIGN Systematic review. DATA SOURCES AND METHODS PubMed, CINAHL, PsychINFO, SocINFO, Cochrane, Web of Science and Embase were searched from 1 January 1990 to 31 December 2016. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and CHARMS Statement guided protocol development. INCLUSION CRITERIA age >60 years, inpatient, developed/validated a prognostic delirium prediction model. EXCLUSION CRITERIA alcohol-related delirium, sample size ≤50. The primary performance measures were calibration and discrimination statistics. Two authors independently conducted search and extracted data. The synthesis of data was done by the first author. Disagreement was resolved by the mentoring author. RESULTS The initial search resulted in 7,502 studies. Following full-text review of 192 studies, 33 were excluded based on age criteria (<60 years) and 27 met the defined criteria. Twenty-three delirium prediction models were identified, 14 were externally validated and 3 were internally validated. The following populations were represented: 11 medical, 3 medical/surgical and 13 surgical. The assessment of delirium was often non-systematic, resulting in varied incidence. Fourteen models were externally validated with an area under the receiver operating curve range from 0.52 to 0.94. Limitations in design, data collection methods and model metric reporting statistics were identified. CONCLUSIONS Delirium prediction models for older adults show variable and typically inadequate predictive capabilities. Our review highlights the need for development of robust models to predict delirium in older inpatients. We provide recommendations for the development of such models.
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Affiliation(s)
- Heidi Lindroth
- Department of Anesthesiology, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
- School of Nursing, University of Wisconsin Madison, Madison, Wisconsin, USA
| | - Lisa Bratzke
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Suzanne Purvis
- Department of Nursing, University Hospital, Madison, Wisconsin, USA
| | - Roger Brown
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Mark Coburn
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Marko Mrkobrada
- Department of Medicine, Western University, London, Ontario, Canada
| | - Matthew T V Chan
- Anesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Daniel H J Davis
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Pratik Pandharipande
- Division of Anesthesiology Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Cynthia M Carlsson
- Department of Anesthesiology, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Medicine, Division of Geriatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Geriatric Research, Education, and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Institute, Madison, Wisconsin, USA
| | - Robert D Sanders
- Department of Anesthesiology, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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