Search results for ‘Subject term:"cognitive impairment"’ Sort:
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Preferences for routines in older people: associations with cognitive and psychological vulnerability
- Authors:
- BERGUA Valerie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(10), October 2006, pp.990-998.
- Publisher:
- Wiley
Although routine activities are important to normal functioning across all phases of life, their expression in older people may be associated with cognitive and psychological vulnerability. The relationship between these variables was explored in 235 elderly French participants from the PAQUID cohort study. Cross-sectional positive associations were found between preferences for routines, anxiety and depression levels, and cognitive complaints. General cognitive decline over a three-year time span was also associated with a greater desire for routines at the end of this period. The progressive routinization of behaviours and activities in older people is discussed as a marker of affective and cognitive vulnerability, and its understanding has potential for improving the early detection of adaptation difficulties and overall care in this population.
Topographical recognition memory sensitive to amnestic mild cognitive impairment but not to depression
- Authors:
- RITTER Emilie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(10), October 2006, pp.924-929.
- Publisher:
- Wiley
Amnestic mild cognitive impairment (aMCI) involves episodic memory. The person who presents aMCI has a high risk of developing Alzheimer's disease (AD). However, prediction of deterioration to dementia in cases of aMCI can be confounded with depression due to lack of specificity on selective memory tests. Finding a test sensitive to aMCI but not to depression would be potentially most useful to subsequent longitudinal studies researching the neuropsychological markers of preclinical AD. We hypothesized that the performance on a topographical memory task would be sensitive to the aMCI condition, while depression would not influence such a performance. A group of 137 community-dwelling French-speaking subjects between 55 and 70 years old was administered a topographical recognition memory task. Based on aMCI and depression criteria, 45 subjects were selected and divided into four groups: 11 patients with aMCI without depression, nine depressive patients with aMCI, ten depressive patients without cognitive impairment and 15 control subjects. The remaining non-selected participants did not belong to any of the previous interest groups. The aMCI factor had a significant effect on the topographical recognition memory task scores, while the depression factor did not. The aMCI patients performed worse than the non-aMCI. Although these results were found with relatively small groups, deficits in topographical recognition memory were observed in aMCI patients and did not seem to be sensitive to depression. Further longitudinal studies are needed to examine whether deficits in topographical recognition memory are a neuropsychological marker of preclinical AD.
Predictors of rapid cognitive decline among demented subjects aged 75 or more: (Sujet Agé Fragile - Evaluation et Suivi Cohort - SAFES)
- Authors:
- VIATONOU Saturnin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(7), July 2009, pp.709-715.
- Publisher:
- Wiley
This study aimed to identify factors predictive of rapid cognitive decline (RCD) among elderly subjects aged 75 or over suffering from dementia. The analysis concerned 250 patients drawn from the Sujet Agé Fragile - Evaluation et Suivi (SAFES) cohort, presenting a dementia syndrome at inclusion and followed-up for at least 1 year. RCD was defined as the loss of at least 3 points on the Mini-Mental State Examination (MMSE) in the follow-up period of 12 months. All patients underwent a standardised geriatric evaluation. Logistic regression was used to identify factors predictive of RCD. In the study sample, 84 patients (33.6%) presented RCD. The factors identified in multivariate analysis as predictive of RCD were: high level of education, risk of depression, and the initial MMSE score. Among subjects with a main caregiver (n = 177), the predictive factors were malnutrition or risk thereof, risk of a fall, caregiver burden and initial MMSE score. The authors conclude that as soon as dementia is diagnosed in elderly subjects, information should be collected about the subject's socioeconomic status, nutritional status, risk of falling, mood state, and caregiver burden. This would enable the provision of appropriate therapeutic care, and make it possible to adapt follow-up in case of a risk of accelerated cognitive deterioration.
Older patients undergoing dialysis treatment: cognitive functioning, depressive mood and health-related quality of life
- Authors:
- TYRRELL J., et al
- Journal article citation:
- Aging and Mental Health, 9(4), July 2005, pp.374-379.
- Publisher:
- Taylor and Francis
An increasing number of older patients receive dialysis treatment to compensate for deficient kidneys due to end-stage renal disease (ESRD). Ethical questions arise about the benefits of dialysis when a patient appears unwilling or unable to comply with this treatment procedure. Such attitudes and behaviour may be due to psychological factors, but these are not routinely assessed. The purpose of this study was to evaluate levels of cognitive impairment, depressive mood and self-reported quality of life in older dialysis patients (>70 years). A total of 51 outpatients receiving dialysis were assessed by psychologists, using a depression scale (MADRS), two cognitive tests (MMSE and BEC 96), and a quality of life questionnaire (NHP). Sixty percent of the patients were depressed, and between 30–47% had cognitive impairment. Almost half of the depressed patients were also cognitively impaired. The scores for self-reported quality of life varied widely within the sample. Cognitive impairment and depressive mood are often overlooked and underestimated in this population. Regular assessments of depressive mood, cognitive ability and quality of life are recommended, given the prevalence of problems in these domains for older dialysis patients. The information obtained should assist staff as they reflect on individual cases where the benefits of continuing treatment are being examined.
The detection of mild cognitive impairment in the general practice setting
- Authors:
- ATERO S, RITCHIE K.
- Journal article citation:
- Aging and Mental Health, 7(4), July 2003, pp.251-258.
- Publisher:
- Taylor and Francis
Results from a general practice study of cognitive impairment are used to construct guidelines for the detection of mild cognitive impairment (MCI) in general practice. The role of the general practitioner in the diagnosis of MCI is discussed and the potential feasibility of general practice screening is evaluated with data from a two-year prospective study conducted in the Montpellier region of France. Neuropsychological tests with the highest predictive value for dementia conversion and suitable for use in general practice, were determined by logistic regression modelling. An examination comprising three tests (delayed auditory verbal recall, verbal fluency and visuospatial construction), were found to give a specificity of 99% and sensitivity of 73%. Reports from other research centres suggest that MCI detection should not be limited to cognitive performance alone. It is suggested that proxy observations of behavioural change and information relating to loss of ability to perform activities of daily living should also be used to improve sensitivity and also to provide information needed in patient management. It may be potentially feasible for the family practitioner to verify cognitive complaints and to screen for MCI with a high degree of accuracy using a brief test battery derived from empirical observations in population studies.