Cognitive reserve and mental health in cognitive frailty phenotypes: Insights from a study with a Portuguese sample

Background

Research on prevalence of cognitive frailty phenotypes in community-dwelling older adults in different countries is important to estimate their prevalence and to determine the influence of cognitive reserve and mental health in order to prevent frailty. The aims of this study were to estimate the prevalence of reversible and potentially reversible cognitive frailty (R-CF, PR-CF) in a Portuguese sample of old adults and explore the associations between these phenotypes and demographic, comorbidity, social support, cognitive reserve and mental health factors.

Methods

We assessed frailty (Fried criteria) in 250 community-dwelling older adults (179 women) aged 60 years or over (mean 71.04 years) without dementia, neurological or psychiatric disorders. Subjective cognitive decline and Mild cognitive impairment were diagnosed according to standard criteria. The questionnaires Charlson Index, Medical Outcomes Study Social Support, Cognitive Reserve Index and General Health were used for assessing comorbidity, social support, cognitive reserve and mental health, respectively.

Results

Prevalence of R-CF was 14%, and that of PR-CF, 15.2%. Cognitive frailty profiles differed significantly in relation to education, comorbidity, mental health, and cognitive reserve, but not in age or sex. Multivariate logistic regression showed that age, sex, comorbidity, social support, mental health, and cognitive reserve together predicted R-CF and PR-CF (90% specificity 75% sensitivity) with significant OR for mental health and cognitive reserve.

Discussion

Cognitive reserve and mental health are important factors predicting R-CF and PR-CF. We recommend assessing these factors for early detection of cognitive frailty and promoting psychological well-being and lifestyles that increase cognitive reserve in adults.

Precompetitive anxiety and self-confidence in athletes with disability

This study examined the precompetition temporal patterning of competitive anxiety components in 42 athletes with disability who participated at the national level and at the national trials for the Paralympic Games in a variety of sports. All subjects completed a modified version of the Competitive State Anxiety Inventory-2 which measures intensity and direction of the competitive anxiety response on three occasions before competition (1 wk., 2 hr., and 20 min.). Analysis suggested that for cognitive and somatic dimensions athletes with disabilities show a similar precompetition anxiety response to athletes without disability. However, there appear to be some differences, particularly in the intensity of self-confidence, as athletes with disability reported a reduction of self-confidence just prior to competition.

Water intake of nursing home residents

This study describes the adequacy of water intake among nursing home residents and identifies variables associated with the adequacy of water intake. Ninety-nine nursing home residents were observed for two 24-hour periods to record food and fluid ingested, ingestion behaviors, and function. Mean water intake (based on food and fluid) was 1,968 mL per day, ranging from 597 mL to 2,988 mL. Only eight subjects met their standard water requirement of 1,600 mL/m2 body surface area. Subjects with inadequate water intake were older, more independent, had few ingestion sessions per day, had intact speech, were semidependent with eating, did not drool, and had inadequate nutrient intake.

Comparison of psychotropic agent use among rural elderly caregivers and noncaregivers

OBJECTIVE

To determine the prescription and over-the-counter (OTC) psychotropic medication and social drug (alcohol and caffeine) use patterns of community-based elderly caregivers of patients with dementia and elderly noncaregivers.

DESIGN

Cross-sectional study design in which characteristics of psychotropic medication and social drug use were collected including the specific agent, frequency, dose, and reason for use.

SETTING

A rural, sparsely populated agricultural area in the midwest region of the US.

SAMPLE

Thirty elderly caregivers of patients with dementia were recruited through a public health agency and homemaker health aid service. Thirty elderly noncaregivers were recruited through the senior citizens center in a neighboring rural community. Data were collected by interview.

RESULTS

A significantly greater number of caregivers used OTC psychotropic agents (43%) than did noncaregivers (3%; p < 0.001). In all cases these agents were used for sleep. The combined number of caregivers using prescription and OTC psychotropic products (63%) also achieved statistical significance compared with the control group (10%; p < 0.001). Caffeine was used by all members of both groups and alcohol was consumed by eight caregivers and seven noncaregivers.

CONCLUSIONS

A greater percentage of rural caregivers of patients with dementia in this study took psychotropic agents compared with the noncaregiver group. OTC products for sleep were the most frequently used agents.