Search results for ‘Subject term:"cognitive impairment"’ Sort:
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Collaborative stretching: a research agenda for enhancing the quality of lives of people with severe cognitive impairments
- Authors:
- LYONS Gordon Stuart, ARTHUR-KELLY Michael
- Journal article citation:
- Journal of Care Services Management, 7(3), 2013, pp.107-115.
- Publisher:
- Taylor and Francis
This paper explains and demonstrates the early application of collaborative stretching: a new and practical technique for enhancing the quality of lives of people in care – particularly those who have severe cognitive impairments. An introduction explains severe cognitive impairment and the notion of quality of life. This is followed by an explanation of the nature of, theory behind, and the key steps of collaborative stretching. An illustrative vignette is then presented to demonstrate its application, utility, and value in one care setting. The paper concludes with a discussion around advancing a research agenda for this technique, and its potential implications for care service managers. (Publisher abstract)
Is it possible to conceptualise and measure quality of life for people with severe Alzheimer's disease?
- Author:
- THOMPSON Lauren
- Journal article citation:
- Generations Review, 15(1), January 2005, pp.22-24.
- Publisher:
- British Society of Gerontology
States that the experience and natural history of Alzheimer's varies considerably between individuals but it develops in stages common to all sufferers varying from mild cognitive impairment to severe dementia. Discusses conceptualisation and measurement of quality of life (QoL) measures, problems associated with assessing QoL using observer reported measures, and alternatives.
Time effects of informal caregiving on cognitive function and well-being: evidence from ELSA
- Authors:
- YUAN Jing, GRUHN Daniel
- Journal article citation:
- Gerontologist, 61(3), 2021, pp.341-351.
- Publisher:
- Oxford University Press
Background and Objectives: As informal caregiving becomes prevalent, its consequences for caregivers’ cognitive and socioemotional functioning gain more importance for society. There are inconsistent findings regarding the direction of the impact of caregiving—whether caregiving maintains or compromises functioning—and the impact of time—whether the effects accumulate or are stable. In this study, we elucidated 3 time effects of caregiving—concurrent, cumulative, and lagged effects—on cognitive and socioemotional functioning. Research Design and Methods: We used data from Wave 1 (2002–2003) to Wave 8 (2016–2017) in the English Longitudinal Study of Ageing (ELSA) and latent growth curve models with the time-varying predictor to investigate 3 time effects of caregiving on cognitive function (memory and executive function) and well-being (life satisfaction and quality of life). Results: Over and beyond age effects, current caregiving (concurrent effect) was related to worse well-being and better delayed recall. Little robust cumulative effect was found on cognition and well-being. In addition, there were significant and differential lagged effects of caregiving after controlling for concurrent and cumulative effects; that is, caregiving was related to worse well-being and better memory functioning 2–4 years later. Discussion and Implications: The differential concurrent and lagged effects of caregiving on cognitive and socioemotional functioning suggest separate mechanisms for different domains of functioning. The nonsignificant cumulative effects but significant lagged effects imply that even one-time caregiving has long-term (2–4 years) consequences for the caregiver’s future functioning, and the mechanism of long-term caregiving effects may be more qualitative than quantitative. (Edited publisher abstract)
Activities people with cognitive deficits want to continue mastering – a scoping study
- Authors:
- LINDQVIST Eva, et al
- Journal article citation:
- British Journal of Occupational Therapy, 79(7), 2016, pp.399-408.
- Publisher:
- Sage
Introduction: To date, potential difficulties that people with cognitive deficits meet in everyday life are relatively well known, but in which activities mastery is desired, and why, is less researched. The aim of this study was to develop deeper knowledge about activities that people with cognitive deficits want to continue mastering in everyday life and the reasons why these activities were desired. Method: In the frame of a scoping study, articles were gathered and charted. Sixteen qualitative studies were selected as meeting the aim of the study and analysed with a descriptive-interpretative method. Findings: The analysis of the studies showed that the desired activities conveyed social values or independence, supported significant roles, diminished negative influence on other people, and increased health and safety. Linkages, in the form of dependencies between the desired activities, were also identified. Conclusion: When planning for interventions for facilitating everyday activities, for example with technology, it is beneficial to consider both safety and values that are more closely related to meaningfulness and wellbeing. Most difficult activities were identified as hindering outdoor activities, and targeting those activities might be most valuable for enabling active everyday lives for this group. (Publisher abstract)
Quality of life in dementia: a systematically conducted narrative review of dementia-specific measurement scales
- Authors:
- BOWLING Ann, et al
- Journal article citation:
- Aging and Mental Health, 19(1), 2014, pp.13-31.
- Publisher:
- Taylor and Francis
Objectives: Ascertaining the quality of life (QoL) in people with dementia is important for evaluating service outcomes and cost-effectiveness. This paper identifies QoL measures for people with dementia and assesses their properties. Method: A systematic narrative review identified articles using dementia QoL measures. Electronic databases searched were AMED, CINAHL, EMBASE, Index to Theses, IBSS, MEDLINE, PsycINFO, Sociological Abstracts, and Web of Science. All available years and languages (if with an English language abstract) were included. Results: Searches yielded 6806 citations; 3043 were multiple duplicates (759 being true duplicates). Abstracts were read; 182 full papers were selected/obtained, of which 126 were included as relevant. Few measures were based on rigorous conceptual frameworks. Some referenced Lawton's model (Dementia Quality of Life [DQOL] and Quality of Life in Alzheimer's Disease [QOL-AD]), though these tapped part of this only; others claimed relationship to a health-related QoL concept (e.g. DEMQOL), though had less social relevance; others were based on limited domains (e.g. activity, affect) or clinical opinions (Quality of Life in Late-Stage Dementia [QUALID]). Many measures were based on proxy assessments or observations of people with dementia's QoL, rather than their own ratings. The Bath Assessment of Subjective Quality of Life in Dementia (BASQID) was developed involving people with dementia and caregivers, but excluded some of their main themes. All measures were tested on selective samples only (ranging from community to hospital clinics, or subsamples/waves of existing population surveys), in a few sites. Their general applicability remains unknown, and predictive validity remains largely untested. Conclusion: The lack of consensus on measuring QoL in dementia suggests a need for a broader, more rigorously tested QoL measure. (Publisher abstract)
The double burden of age and disease on cognition and quality of life in bipolar disorder
- Authors:
- WEISENBACK Sara L., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(9), 2014, pp.952-961.
- Publisher:
- Wiley
Objective: Bipolar disorder (BPD) and normal aging are known to impact cognitive skills and health-related quality of life (HRQOL). This study investigated how ageing and disease interact in predicting cognitive and psychosocial outcomes. Methods: Eight cognitive and ten subjective HRQOL domain ratings were measured. Subjects included 80 young (18–29 years) and late middle-aged (50–65 years) BPD patients in the euthymic phase and 70 age-equivalent healthy comparison participants. Results: An age X disease interaction was detected in three domains of cognitive functioning that reflect emotion processing, processing speed, and executive functioning skills, with BPD patients in the older group performing most poorly. There was a double burden of ageing and disease on reported ability to perform physical tasks. However, regardless of age, disease status was associated with lower ratings of HRQOL in the psychosocial/affective sphere and the majority of cognitive domains. Post hoc analyses revealed that number of years ill was positively associated with select HRQOL ratings in older, but not younger BPD adults. Conclusions: These findings may stimulate future longitudinal study of cognition and quality of life in BPD patients across the life span, focusing on additive and interactive effects of aging and disease burden, which could culminate in developing more effective treatment and rehabilitation strategies for this traditionally challenging to treat population. (Publisher abstract)
Does cognitive impairment influence quality of life among nursing home residents?
- Authors:
- ABRAHAMSON Kathleen, et al
- Journal article citation:
- Gerontologist, 52(5), October 2012, pp.632-640.
- Publisher:
- Oxford University Press
This study explored the relationship between cognitive status and quality of life (QOL) in Minnesota nursing home (NH) residents. It also looked at the relationship between conventional or Alzheimer’s special care unit (SCU) placement and QOL. The data for analysis came from face-to-face interviews with a representative sample of 13,130 NH residents collected as part of the 2007 Minnesota NH Resident Quality of Life and Consumer Satisfaction survey. Seven QOL domains were examined: comfort, meaningful activities, privacy, environment, individuality, autonomy, relationships, and a positive mood scale. Multilevel models (resident and facility) were used to examine the relationship between the resident’s score on each QOL domain and their cognitive impairment (CI) and SCU placement after controlling for covariates, such as activities of daily living dependency, pain, depression or psychiatric diagnosis, and length of stay. Residents with more severe CI reported higher QOL in the domains of comfort and environment and lower QOL in activities, individuality, privacy and meaningful relationships, and the mood scale. Residents on SCU reported higher QOL in the meaningful activities, comfort, environment, and autonomy domains but had lower mood scores. These findings point to significant variation in QOL domains by CI and may be of value in improving dementia care and developing NH quality indicators that more accurately represent the QOL of NH residents with CI.
Characteristics of help-seeking behaviour in subjects with subjective memory complaints at a memory clinic: a case-control study
- Authors:
- RAMAKERS Inez H.G.B., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(2), February 2009, pp.190-196.
- Publisher:
- Wiley
Memory complaints in the absence of objective test impairments are common. Only a subset of these subjects seeks medical attention for these complaints. The aim of the present study was to investigate which factors determine why people with subjective memory complaints (SMC) seek medical attention. Thirty-three cases with SMC from a memory clinic in the Netherlands were compared to 85 control subjects with SMC from a population-based study who did not seek help for their complaints. The study investigated whether cases differed from controls with respect to the following: depressive and anxiety symptoms (SCL-90), extraversion and neuroticism (EPQ), meta-memory (MIA), quality of life (SF-36), changes in memory and daily functioning according to a relative (DECO), life-changing events, and a family history of dementia. Cases with SMC who seek medical attention, scored lower on memory self-efficacy and quality of life. They were more often worried due to a positive family history of dementia by comparison to the control subjects. Relatives of cases reported more deterioration in daily functioning than relatives of controls. Both the cases and control subjects had similar levels of depressive and anxiety symptoms, as well as levels of extraversion and neuroticism.
Health utilities in mild cognitive impairment and dementia: a population study in Sweden
- Authors:
- EKHAM Mattias, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(7), July 2007, pp.649-655.
- Publisher:
- Wiley
To collect new primary data on community-based health utilities (time trade-off values) in different stages of mild cognitive impairment and dementia from a general population sample. A cross-sectional study including 1,800 randomly selected members of the Swedish public aged 45-84 was performed through a postal survey; 42% response rate. The Clinical Dementia Rating scale was used for describing progressive stages of dementia in vignettes that were used in combination with time trade-off questions for valuing the perceived quality of life in these stages. The time-trade off values varied considerably across the progressive disease stages. The mean score was 0.82 for mild cognitive impairment, 0.62 for mild dementia, 0.40 for moderate dementia, and 0.25 for severe dementia. In multiple regression analyses, the scores were relatively insensitive to demographic factors like age, gender and self-assessed health. The results showed that the average time trade-off values declined sharply from mild cognitive impairment to progressing stages of dementia. Since there are many methodological challenges involved in measuring health state utilities in mild cognitive impairment and dementia, more research that evaluates different methods would be welcome.
Measuring psychological well-being in cognitively impaired persons
- Authors:
- BURGENER Sandy C., TWIGG Prudence, POPOVICH Ann
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 4(4), November 2005, pp.463-485.
- Publisher:
- Sage
An objective measure of psychological well-being (a previously understudied outcome for persons with dementia) was developed and tested as part of a longitudinal study (n= 96 participant pairs; n= 73 pairs remaining at 18 months). The reliability and validity of the Psychological Well-being in Cognitively Impaired Persons (PWB-CIP) scale was examined as a measure of one dimension of quality of life (QoL) as persons progress in the disease. The original 16-item PWB-CIP Likert-type scale required only five to 10 minutes to complete and was reduced to 11 items following factor analysis. Cronbach's alpha for the total scale was .79 at baseline and .82 at 18 months. Two subscales were identified: positive affect/interaction and negative affect/interaction. One item ('involved in a single activity for > five minutes') loaded on a different subscale at baseline (early disease stages) compared to 18 months (reflecting disease progression). The internal consistency of the two subscales remained acceptable across the two measurement intervals. Controlling for mental status, the PWB-CIP's construct validity was supported through significant relationships with depression, personal characteristics (personality), and the behavioral competence QoL dimensions at baseline and at 18 months. Because both rural (55%) and urban populations were sampled and the PWB-CIP was used across care settings, the findings support the PWB-CIP as a psychometrically sound measure of psychological well-being for diverse populations of persons with dementia.