Relationship between Cognitive Reserve and Cognitive Impairment in Autonomous and Institutionalized Older Adults

Automated vehicles for older adults with cognitive impairment: a survey study

As the population is ageing, the number of older adults with cognitive impairment (CI) is increasing. Automated vehicles (AVs) can improve independence and enhance the mobility of these individuals. This study aimed to: (1) understand the perception of older adults (with and without CI) and stakeholders providing services and supports regarding care and transportation about AVs, and (2) suggest potential solutions to improve the perception of AVs for older adults with mild or moderate CI. A survey was conducted with 435 older adults with and without CI and 188 stakeholders (e.g. caregivers). The results were analysed using partial least square - structural equation modelling and multiple correspondence analysis. The findings suggested relationships between older adults' level of cognitive impairment, mobility, knowledge of AVs, and perception of AVs. The results provided recommendations to improve older adults' perception of AVs including education and adaptive driving simulation-based training.Practitioner summary: This study investigated the perception of older adults and other stakeholders regarding AVs. The findings suggested relationships between older adults' level of cognitive impairment, mobility, knowledge of AVs, and perception of AVs. The results provided guidelines to improve older adults' perception of AVs.

[Cognitive, Emotional and Dependency Level on Institutionalized Older Adults]

INTRODUCTION

It is necessary to analyze the aging process in institutionalized older people. For this purpose, a descriptive and analytical epidemiological study was carried out in nursing homes for older adults before the COVID-19 pandemic.

OBJECTIVE

Provide an in-depth insight into cognitive (MEC), emotional (Geriatric Depression Scale), and functional (Barthel Scale) status within the older adult participants.

METHOD

A sample of 973 participants analyzed the relationship between cognitive status, vulnerability to depression, and autonomous performance in Daily Day Activities (DDA) to predict the impact of the comorbidity of these variables. Therefore, in addition to the general distribution of the sample in the previously mentioned dimensions, differences were analyzed according to gender, age, educational level, and geographic area.

RESULTS

The results confirm the hypothesis that a more impaired cognitive state is associated with higher levels of depression and lower functional capacity. The MEC scores have positive and highly significant correlations with Barthel and Yesavage. The relationship between dementia and autonomy is observed for both sexes, while the relationship between dementia and depression is only observed in women. The educational level influences the MEC scores (the more education, the better performance) and the Barthel scores (the less education, the greater dependency). Statistically significant differences were also found depending on the area of residence location.

CONCLUSIONS

The more deteriorated cognitive state will be associated with a higher level of depression and lower functional capacity in daily life activities.

Tele neuropsychological exploratory assessment of indicators of mild cognitive impairment and autonomy level in Mexican population over 60 years old

Due to the cognitive decline associated with aging, it is necessary to determine the variables involved in this process to implement preventive actions to avoid or help slow the progression of cognitive decline to dementia in older adults. This is a priority in the current pandemic situation, due to the consequences of periods of confinement due to COVID-19. To address these challenges, this study was conducted through Information and Communication Technologies (ICTs), by adapting an in-person assessment protocol into an online Tele neuropsychological consultation. The correlation between autonomy and cognitive performance variables is analyzed in 47 Mexican subjects over 60 years of age. The results of the statistical analyses suggest a moderate correlation between the level of autonomy and cognitive performance (with MOCA and Clock Drawing Test), significant correlation values are outlined in some of the variables reviewed, and interesting data were found in the correlation of cognitive reserve with cognitive decline and the educational level from the participants. Finally, future analysis is proposed of the sensitivity of screening tests (CDT) to find indicators of Mild Cognitive Impairment (MCI) in this population that is not detected in classical tests (MOCA). Developing ICT-based screening protocols for the elderly may be a key tool in these coronavirus times or under any given circumstances.

Cognitive status and its risk factors in patients with hypertension and diabetes in a low-income rural area of China: A cross-sectional study

OBJECTIVES

The proportion of older people with dementia in China is gradually increasing with the increase in the aging population over recent years. Hypertension and diabetes are common non-communicable diseases among rural populations in China. However, it remains unclear whether these conditions affect the occurrence and development of cognitive impairment as there is limited research on cognitive status and its risk factors among residents of rural areas.

METHODS

A multi-stage stratified cluster random sampling method was used to select 5400 participants from rural permanent residents. A self-designed structured questionnaire was used to investigate demographic data of the participants. Cognitive function was assessed using the Montreal Cognitive Function Assessment Scale (MoCA). The results were analyzed using chi-square test, ANOVA and multiple linear regression analysis.

RESULTS

A total of 5028 participants returned the survey, giving a response rate of 93.1%. Higher education (odds ratio (OR) = 3.2, 95% confidence interval (CI) 2.87-3.54, p < 0.001), higher income (OR = 1.61, 95% CI 1.16-2.07, p < 0.001), and dietary control (OR = 0.66, 95%CI 0.34-0.98, p < 0.001) were protective factors. A visual representation of the relationship between annual income and MoCA score showed an inverted U-curve, the group with an annual income of 6000-7999 RMB had a maximum OR of 1.93 (95%CI 0.12-2.74, p < 0.001). While difficulty in maintaining sleep were risk factors for cognitive impairment (OR = -2.28, 95% CI-4.18-0.39, p = 0.018).

CONCLUSIONS

Participants with middle incomes had better cognitive status than those with the highest incomes. Higher education, proper diet control and good sleep are beneficial to the cognitive status of residents in rural areas.

Impact of Family Function on the Quality of Life and Health Perception of Non-Institutionalized Dementia Patients

BACKGROUND

Dementia is one of the pathologies that has increased the most among the older population (mainly Alzheimer's disease), and it has a direct impact on the quality of life (QoL), cognitive performance, and health of these patients. Family functionality can play a role in this QoL if these patients are not institutionalized.

OBJECTIVE

To analyze the role of family function in the QoL and health perception of non-institutionalized dementia patients, as well as related variables such as anxiety, depression, optimism, or pessimism.

METHODS

Cross-sectional study with a sample of 54 patients diagnosed with some type of dementia, non-institutionalized, or in outpatient care, from different centers in the province of Valencia (Spain). The EQ-5D, MMSE, Apgar Family or general health, and Goldberg anxiety and depression questionnaires were utilized.

RESULTS

The correlation of the Apgar Family with the General Health Questionnaire-new onset problems variable (GHQ) and Chronicity and General Health Questionnaire-chronic problems (CGHQ) of the Goldberg Quality of Life questionnaire was statistically significant and negative (GHQ r = -0.310; p = 0.034. CGHQ r = -0.363; p = 0.012); as well as between Apgar Family and Anxiety-Depression (r = -0.341; p = 0.020). The correlation of the Apgar Family with the Life Orientation Test-Pessimism variable (LOT) was statistically significant and negative (r = -0.270; p = 0.061). Finally, severe dysfunction of Apgar Family has a negative correlation with self-perception of health (p = 0.036 B = -16.589) determined by the Visual Analogue Scale (VAS).

CONCLUSION

Family functionality directly influences anxiety, depression, optimism, and pessimism. This could explain why family function is related to the QoL of patients and their self-perception of health.

Mediation effects of cognitive, physical, and motivational reserves on cognitive performance in older people

Introduction

We study from a multidimensional perspective the different factors that help prevent the development of cognitive impairment in old aging.

Methods

This study analyzed in 300 elderly subjects the relationship between cognitive reserve (CR), physical reserve (PR) and motivational reserve (MR) with cognitive impairment. This study also takes into consideration different variables (sex, age, educational level, and institutionalization) that might affect the results in the different types of reserves (CR, physical and MR) and cognitive impairment.

Results

The results show that people with a higher cognitive reserve, physical reserve and motivational reserve have less cognitive impairment.

Discussion

Therefore, it is important to consider measuring the CR as a variable to diagnose neurodegenerative illnesses but it is also essential to consider the physical state and physical activity, as well as the motivational dimension. With the cognitive reserve and sex variables no significant differences were observed. Age had a negative effect on strategic flexibility, but those with higher CR had better cognitive flexibility and the educational.

Cognitive abilities of institutionalized older persons with depressive symptoms

ABSTRACT Objective To determine the level of association between depressive symptoms and cognitive abilities of institutionalized older adults. Methods This is a cross-sectional study that enrolled 69 older adults, living in a long-term care facility. Investigation of depressive symptoms in all individuals was performed using the geriatric depression scale. Cognitive verbal fluency, digit span forward (DSF) and backward (DSB) tests, and two-minute stationary gait, sit-to-stand test, and six-minute walk test were performed to assess their association with depressive symptoms. Results Depressive symptoms were identified in 35 individuals. Worse cognition and physical performances were associated with the presence of depressive symptoms – Mini-Mental State Examination [t (61) = 2.36; p < 0.05] and Stationary gait test of two minutes [t (53) = 3.12; p < 0.05]. Short-term memory and working memory tests presented worse results in individuals with depressive symptoms (DSF: U = 402.00; p < 0.05 e DSB: U = 341,00; p < 0.05). Older adults with scores below normal in DSF were 5 times more likely to exhibit depressive symptoms. Conclusion The importance of physical, cognitive and social intervention strategies in long-term care facilities for the older adults is highlighted, in order to privilege autonomy. Notably, there is an association between deficits in short-term memory and the presence of depressive symptoms in older adults. Therefore, prospective studies are suggested to investigate the cause-effect relationship of this association with the institutionalization of older adults.

Physical and Cognitive Functioning of Institutionalized Elderly People in Rural Areas. Preventive Actions Using Physical Activity and Music Therapy

Background: Comprehensive geriatric evaluation should include a functional and cognitive assessment to guide the intervention of interdisciplinary teams. The aim of this study was to analyze the physical capacities of institutionalized elderly people and to describe the preventive actions of physical activity and music therapy as non-invasive preventive pharmacological treatments given their importance for the cognitive and functional performance of elderly people. An observational and descriptive cross-sectional study was carried out. The participants in the study were 109 elderly people institutionalized in three residential centers with a mean age of 83.41 years (SD = 8.72). Findings: Most of the residents had very impaired physical faculties. However, cognitive impairment was not very high. Most residents (55.04%) had some form of dementia and/or high blood pressure (54.12%) followed by pathologies such as diabetes (27.52%), heart failure (17.43%), Parkinson’s disease (9.17%) and chronic obstructive pulmonary disease (8.25%). There were no differences in cognitive or physical capacity among the residents according to sex, age, or education and only those who had worked in the service sector had less cognitive capacity than those who had worked in the agricultural sector or as housewives. Applications: Facilitate the creation and development of programs based on physical activity and music therapy in residential centers that can prevent and improve pathologies on the elderly.

Physical Activity and Life Satisfaction: An Empirical Study in a Population of Senior Citizens

Objective: The specialised literature indicates that the two key aspects in active ageing are performing physical activity and life satisfaction. Regarding physical activity, this not only improves physical aspects of senior citizens, but also has a positive impact on mental well-being and satisfaction with one’s own life. The aim is to demonstrate the relationship between these two variables to explain healthy ageing.

Method: In a sample of 300 senior citizen subjects, the influence of various sociodemographic variables (age, sex, institutionalisation, and level of education) on the performance of physical activity and life satisfaction, is analysed. The research design is a non-experimental study with two unique cross-sectional and correlational measurement groups.

Results: An analysis of the results indicates that people with a higher level of education present differences in physical and motivational reserves. Furthermore, age and institutionalisation have an impact on physical reserves. Analysis using structural equation models allows key relationships between the variables analysed to be predicted, which can guide the implementation of active ageing.

Conclusion: Motivational reserves affect healthy cognitive ageing through their positive impact on cognitive and physical reserves.

Impact of Cognitive Reserve and Premorbid IQ on Cognitive and Functional Status in Older Outpatients

The study aimed to investigate cross-sectionally the associations of cognitive reserve (CR) and premorbid IQ with cognitive and functional status in a cohort of older outpatients. Additionally, we evaluated the association of CR and premorbid IQ with the worsening of patients' cognitive status at one-year follow-up. We originally included 141 outpatients (mean age 80.31 years); a telephone-based cognitive follow-up was carried out after one year, including 104 subjects (mean age 80.26 years). CR (β = 0.418), premorbid IQ (β = 0.271) and handgrip strength (β = 0.287) were significantly associated with the MMSE score. The cognitive worsening at follow-up was associated with lower CR, lower MMSE score, reduced gait speed and frailty exhibited at baseline. Univariate linear regressions showed that CR was associated with handgrip strength (β = 0.346), gait speed (β = 0.185), autonomy in basic (β = 0.221) and instrumental (β = 0.272) daily activities, and frailty (β = -0.290); premorbid IQ was significantly associated with autonomy in instrumental daily activities (β = 0.211). These findings highlight the need for integrating CR and premorbid IQ with physical and motor measures when appraising predictors of cognitive decline in the elderly population. The study also newly extends the link of CR and premorbid IQ to the functional status in older adults.