Editorial

4 pages, 178 KiB

Open AccessEditorial

New Trends in Cognitive Aging and Mild Cognitive Impairment

by David Facal, Carlos Spuch and Sonia Valladares-Rodriguez

Geriatrics 2022, 7(4), 80; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics7040080 - 01 Aug 2022

Cited by 1 | Viewed by 1746

In this editorial, we aim to highlight some lessons learned in our field and to discuss some open questions regarding the continuum between healthy cognitive aging and dementia [...] Full article

(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

Research

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9 pages, 276 KiB

Open AccessCommunication

Feasibility of a Small Group Otago Exercise Program for Older Adults Living with Dementia

by Julie D. Ries and Martha Carroll

Geriatrics 2022, 7(2), 23; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics7020023 - 24 Feb 2022

Cited by 3 | Viewed by 2978

Abstract

Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people [...] Read more.

Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people with dementia. We sought to explore the feasibility of group delivery of OEP in an adult day health center (ADHC) for people with dementia. We collected demographic data, Functional Assessment Staging Tool (FAST), and Mini Mental State Exam (MMSE) scores for seven participants with dementia. Pre- and post-test data included: Timed-Up-and-Go (TUG), 30-Second Chair-Stand (30s-CST), Four-Stage-Balance-Test (4-SBT), and Berg Balance Scale (BBS). We implemented a supervised group OEP, 3x/week × 8 weeks. Most participants required 1:1 supervision for optimal challenge and participation. Five participants completed the program. All had moderately severe to severe dementia based upon FAST; MMSE scores ranged from mild to severe cognitive impairment. Four of five participants crossed the threshold from higher to lower fall risk in at least one outcome (TUG, 30s-CST, 4-SBT, or BBS), and four of five participants improved by >Minimal Detectible Change (MDC₉₀) score in at least one outcome. The group delivery format of OEP required significant staff oversight for optimal participation, making the program unsustainable. Full article

(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

29 pages, 3837 KiB

Open AccessFeature PaperArticle

SART and Individual Trial Mistake Thresholds: Predictive Model for Mobility Decline

by Rossella Rizzo, Silvin Paul Knight, James R. C. Davis, Louise Newman, Eoin Duggan, Rose Anne Kenny and Roman Romero-Ortuno

Geriatrics 2021, 6(3), 85; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics6030085 - 31 Aug 2021

Cited by 5 | Viewed by 2983

Abstract

The Sustained Attention to Response Task (SART) has been used to measure neurocognitive functions in older adults. However, simplified average features of this complex dataset may result in loss of primary information and fail to express associations between test performance and clinically meaningful [...] Read more.

The Sustained Attention to Response Task (SART) has been used to measure neurocognitive functions in older adults. However, simplified average features of this complex dataset may result in loss of primary information and fail to express associations between test performance and clinically meaningful outcomes. Here, we describe a new method to visualise individual trial (raw) information obtained from the SART test, vis-à-vis age, and groups based on mobility status in a large population-based study of ageing in Ireland. A thresholding method, based on the individual trial number of mistakes, was employed to better visualise poorer SART performances, and was statistically validated with binary logistic regression models to predict mobility and cognitive decline after 4 years. Raw SART data were available for 4864 participants aged 50 years and over at baseline. The novel visualisation-derived feature bad performance, indicating the number of SART trials with at least 4 mistakes, was the most significant predictor of mobility decline expressed by the transition from Timed Up-and-Go (TUG) < 12 to TUG ≥ 12 s (OR = 1.29; 95% CI 1.14–1.46; p < 0.001), and the only significant predictor of new falls (OR = 1.11; 95% CI 1.03–1.21; p = 0.011), in models adjusted for multiple covariates. However, no SART-related variables resulted significant for the risk of cognitive decline, expressed by a decrease of ≥2 points in the Mini-Mental State Examination (MMSE) score. This novel multimodal visualisation could help clinicians easily develop clinical hypotheses. A threshold approach to the evaluation of SART performance in older adults may better identify subjects at higher risk of future mobility decline. Full article

(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

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17 pages, 300 KiB

Open AccessArticle

Evaluating the Consistency of Subjective Activity Assessments and Their Relation to Cognition in Older Adults

by Cassandra R. Hatt, Christopher R. Brydges, Jacqueline A. Mogle, Martin J. Sliwinski and Allison A. M. Bielak

Geriatrics 2021, 6(3), 74; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics6030074 - 28 Jul 2021

Cited by 5 | Viewed by 4192

Abstract

(1) Background: Research examining whether activity engagement is related to cognitive functioning in older adults has been limited to using retrospective reports of activity which may be affected by biases. This study compared two measurements (estimated weekly versus reported daily), and whether these [...] Read more.

(1) Background: Research examining whether activity engagement is related to cognitive functioning in older adults has been limited to using retrospective reports of activity which may be affected by biases. This study compared two measurements (estimated weekly versus reported daily), and whether these activity assessments were related to cognition in older adults; (2) Methods: Participants from US (n = 199) and Australian (n = 170) samples completed a weekly estimate of activity, followed by 7 consecutive days of daily reporting. Differences between weekly estimates and daily reports were found, such that estimations at the weekly level were lower than self-reported daily information. Multivariate multiple regression was used to determine whether total activity, activity domains and the discrepancy between assessment types (i.e., weekly/daily) predicted cognitive performance across three cognitive domains (fluid, verbal, memory); (3) Results: When activity assessments were totaled, neither predicted cognition; however, when activity was grouped by domain (cognitive, social, physical), different domains predicted different cognitive outcomes. Daily reported cognitive activity significantly predicted verbal performance (β = 1.63, p = 0.005), while weekly estimated social activity predicted memory performance (β = −1.81, p = 0.050). Further, while the magnitude of discrepancy in total activity did not significantly predict cognitive performance, domain specific differences did. Differences in physical activity reported across assessments predicted fluid performance (β = −1.16, p = 0.033); (4) Conclusions: The significant discrepancy between the measurement types shows that it is important to recognize potential biases in responding when conducting activity and cognition research. Full article

(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

14 pages, 930 KiB

Open AccessFeature PaperArticle

Effect of Demographic and Health Dynamics on Cognitive Status in Mexico between 2001 and 2015: Evidence from the Mexican Health and Aging Study

by Silvia Mejia-Arango, Jaqueline Avila, Brian Downer, Marc A. Garcia, Alejandra Michaels-Obregon, Joseph L. Saenz, Rafael Samper-Ternent and Rebeca Wong

Geriatrics 2021, 6(3), 63; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics6030063 - 25 Jun 2021

Cited by 12 | Viewed by 3714

Abstract

Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how [...] Read more.

Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how sociodemographic factors, cardiovascular diseases, and their treatment relate to changes in cognitive function of Mexican adults aged 60 and older between 2001 and 2015. Self and proxy respondents were classified as dementia, cognitive impairment no dementia (CIND), and normal cognition. We use logistic regression models to examine the trends in dementia and CIND for men and women aged 60 years or older using pooled national samples of 6822 individuals in 2001 and 10,219 in 2015, and sociodemographic and health variables as covariates. We found higher likelihood of dementia and a lower risk of CIND in 2015 compared to 2001. These results remain after adjusting for sociodemographic factors, cardiovascular diseases, and their treatment. The improvements in educational attainment, treatment of diabetes and hypertension, and better access to health care in 2015 compared to 2001 may not have been enough to counteract the combined effects of aging, rural residence disadvantage, and higher risks of cardiovascular disease among older Mexican adults. Full article

(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

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15 pages, 1437 KiB

Open AccessArticle

“It Makes You Feel That You Are There”: Exploring the Acceptability of Virtual Reality Nature Environments for People with Memory Loss

by Noreen Orr, Nicola L. Yeo, Sarah G. Dean, Mathew P. White and Ruth Garside

Geriatrics 2021, 6(1), 27; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics6010027 - 12 Mar 2021

Cited by 11 | Viewed by 3680

Abstract

Aim: To report on the acceptability of virtual reality (VR) nature environments for people with memory loss at memory cafes, and explore the experiences and perceptions of carers and staff. Methods: A qualitative study was conducted between January and March 2019. Ten adults [...] Read more.

Aim: To report on the acceptability of virtual reality (VR) nature environments for people with memory loss at memory cafes, and explore the experiences and perceptions of carers and staff. Methods: A qualitative study was conducted between January and March 2019. Ten adults with memory loss, eight carers and six volunteer staff were recruited from two memory cafes, located in Cornwall, UK. There were 19 VR sessions which were audio recorded and all participants were interviewed at the end of the sessions. Framework analysis was used to identify patterns and themes in the data. Results: During the VR experience, participants were engaged to varying degrees, with engagement facilitated by the researcher, and in some cases, with the help of a carer. Participants responded positively to the nature scenes, finding them soothing and evoking memories. The VR experience was positive; many felt immersed in nature and saw it as an opportunity to ‘go somewhere’. However, it was not always positive and for a few, it could be ‘strange’. Participants reflected on their experience of the VR equipment, and volunteer staff and carers also shared their perceptions of VR for people with dementia in long-term care settings. Conclusions: The VR nature experience was an opportunity for people with memory loss to be immersed in nature and offered the potential to enhance their quality of life. Future work should build on lessons learned and continue to work with people with dementia in developing and implementing VR technology in long-term care settings. Full article

(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

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Other

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11 pages, 273 KiB

Open AccessCase Report

A Case Study on Polypharmacy and Depression in a 75-Year-Old Woman with Visual Deficits and Charles Bonnet Syndrome

by José Caamaño-Ponte, Martina Gómez Digón, Mercedes Pereira Pía, Antonio de la Iglesia Cabezudo, Margarita Echevarría Canoura and David Facal

Geriatrics 2022, 7(1), 5; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics7010005 - 28 Dec 2021

Cited by 3 | Viewed by 2898

Abstract

Depression is one of the most prevalent pathologies in older adults. Its diagnosis and treatment are complex due to different factors that intervene in its development and progression, including intercurrent organic diseases, perceptual deficits, use of drugs, and psycho-social conditions associated with the [...] Read more.

Depression is one of the most prevalent pathologies in older adults. Its diagnosis and treatment are complex due to different factors that intervene in its development and progression, including intercurrent organic diseases, perceptual deficits, use of drugs, and psycho-social conditions associated with the aging process. We present the case of a 75-year-old woman (who lives in the community) with a diagnosis of major depression with more than 10 years of history, analyzing her evolution and therapeutic approach. Full article

(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

8 pages, 506 KiB

Open AccessCase Report

Behavioral Interventions in Long-Term Care Facilities during the COVID-19 Pandemic: A Case Study

by Carlos Dosil-Díaz, David Facal and Romina Mouriz-Corbelle

Geriatrics 2022, 7(1), 1; https://0-doi-org.brum.beds.ac.uk/10.3390/geriatrics7010001 - 21 Dec 2021

Cited by 2 | Viewed by 2413

Abstract

During the COVID-19 pandemic, long-term care (LTC) centers have adopted a series of measures that have affected the physical and cognitive health of patients. The routines of the patients, as well as the interventions of professionals, have been altered. In the case presented [...] Read more.

During the COVID-19 pandemic, long-term care (LTC) centers have adopted a series of measures that have affected the physical and cognitive health of patients. The routines of the patients, as well as the interventions of professionals, have been altered. In the case presented here, our aim was to explain the effect that the strong confinement due to the spread of the first COVID-19 wave in Spain had on a 75-year-old resident in an LTC center, with cognitive and behavioral symptomatology compatible with a diagnosis of mixed dementia, as well as the measures that the center adopted to manage the lockdown situation in the best possible way, including personalized attention protocols and a video call program. Different nosological hypotheses are also raised using a semiological analysis, including the analysis of the initial and continuation diagnostic protocols, as well as the therapeutic options. Full article

(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

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8 pages, 1941 KiB

Open AccessCase Report

Cognitive and Behavior Deficits in Parkinson’s Disease with Alteration of FDG-PET Irrespective of Age

by Fulvio Lauretani, Livia Ruffini, Crescenzo Testa, Marco Salvi, Mara Scarlattei, Giorgio Baldari, Irene Zucchini, Beatrice Lorenzi, Chiara Cattabiani and Marcello Maggio

Geriatrics 2021, 6(4), 110; https://doi.org/10.3390/geriatrics6040110 - 10 Nov 2021

Cited by 1 | Viewed by 2525

Abstract

Significant progress has been made in our understanding of the neurobiology of Parkinson’s disease (PD). Post-mortem studies are an important step and could help to comprehend not only the progression of motor symptoms, but also the involvement of other clinical domains, including cognition, [...] Read more.

Significant progress has been made in our understanding of the neurobiology of Parkinson’s disease (PD). Post-mortem studies are an important step and could help to comprehend not only the progression of motor symptoms, but also the involvement of other clinical domains, including cognition, behavior and impulse control disorders (ICDs). The correlation of neuropathological extension of the disease with the clinical stages remains challenging. Molecular imaging, including positron emission tomography (PET) and single photon computed tomography (SPECT), could allow for bridging the gap by providing in vivo evidence of disease extension. In the last decade, we have observed a plethora of reports describing improvements in the sensitivity of neuroimaging techniques. These data contribute to increasing the accuracy of PD diagnosis, differentiating PD from other causes of parkinsonism and also obtaining a surrogate marker of disease progression. FDG-PET has been used to measure cerebral metabolic rates of glucose, a proxy for neuronal activity, in PD. Many studies have shown that this technique could be used in early PD, where reduced metabolic activity correlates with disease progression and could predict histopathological diagnosis. The aim of this work is to report two particular cases of PD in which the assessment of brain metabolic activity (from FDG-PET) has been combined with clinical aspects of non-motor symptoms. Integration of information on neuropsychological and metabolic imaging allows us to improve the treatment of PD patients irrespective of age. Full article

(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

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