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The relationship between age and neurocognitive and daily functioning in adults with hoarding disorder
- Authors:
- DOZIER Mary E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(12), 2016, pp.1329-1336.
- Publisher:
- Wiley
Objective: Given the increase in hoarding symptoms with age, there is a pressing need for understanding the clinical features as they relate to potential interventions for older adults with hoarding disorder (HD). The aim of the current investigation was to explore age-related differences in the level of functional and cognitive impairment in individuals with HD. Methods: The current study utilized the baseline assessments of 122 adults with HD. Age-related differences in the raw scores of psychiatric, cognitive, and daily functioning were analyzed using a series of multiple regression models controlling for the possible age-related differences in premorbid IQ. Results: The results suggested that older adults with HD may experience increased levels of impairment in skills related to executive functioning and everyday functioning when compared with younger adults with HD. Conclusions: Given these difficulties with neurocognitive functioning, older HD patients may require interventions that focus more on behavioural and functional skills, rather than focusing on changing thought processes. (Edited publisher abstract)
Cognitive impairment in older people with alcohol use disorders in a UK community mental health service
- Author:
- RAO Rahul
- Journal article citation:
- Advances in Dual Diagnosis, 9(4), 2016, pp.154-158.
- Publisher:
- Emerald
Purpose: The assessment of cognitive impairment in community services for older people remains under-explored. The paper aims to discuss this issue. Design/methodology/approach: Cognitive impairment was examined in 25 people aged 65 and over with alcohol use disorders, on the caseload of community mental health services over a six-month period. All subjects assessed using Addenbrooke’s Cognitive Assessment (ACE-III). Findings: In total, 76 per cent of the group scored below the cut-off point for likely dementia but only 45 per cent of people scored below the cut-off point for tests of language, compared with 68-84 per cent people in other domains. Research limitations/implications: This finding has implications for the detection of alcohol-related brain cognitive impairment in clinical settings. Practical implications: Standardised cognitive testing is common within mental health services for older people, but may also have utility within addiction services. Social implications: The early detection of alcohol-related cognitive impairment can improve social outcomes in both drinking behaviour and the social consequences of alcohol-related dementia. Originality/value: This may be the first published study of cognitive impairment in patients under a mental team for older people with alcohol use disorders and offers some unique findings within this sampling frame. (Publisher abstract)
Cognitive performance in depressed older persons: the impact of vascular burden and remission. A two-year follow-up study
- Authors:
- ZUIDERSMA Marij, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(9), 2016, pp.1029-1039.
- Publisher:
- Wiley
Objectives: Depression is associated with an increased risk of cognitive decline. The present study compared two-year change in cognitive performance between depressed older persons and a non-depressed control group, between remitted and non-remitted patients, and evaluated whether vascular burden at baseline was associated with more cognitive decline in depressed older persons. Methods: Depressed patients (n = 378) aged ≥60 were recruited from mental healthcare institutes and general practices, and a non-depressed control group (n = 132) was recruited from general practices. A DSM-IV depressive episode was established with the Composite International Diagnostic Interview, and processing speed, working memory, verbal memory and interference control were evaluated with three neurocognitive tasks at baseline and 2 years later. A modified Framingham Risk Score, ankle-brachial index, and history of a vascular event defined vascular burden at baseline. Results: After adjusting for baseline cognitive performance, age, sex, and education level, depressed older persons had worse processing speed and verbal memory scores at follow-up than controls but did not differ in the other two-cognitive outcomes. In the sample of depressed patients, remission status at 2 years follow-up and baseline vascular burden did not predict cognitive performance at follow-up, after adjustment for baseline cognitive performance, age, sex and education level. Conclusions: The findings suggest that cognitive deficits in depressed older persons are not just a manifestation of depression. In addition, vascular burden was not associated with worse cognitive decline in a sample of depressed older persons. (Edited publisher abstract)
Course of cognitive impairment following attempted suicide in older adults
- Authors:
- GUJRAL Swathi, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(6), 2016, pp.592-600.
- Publisher:
- Wiley
Objective: Cognitive impairment has been associated with late-life suicidal behaviour. Without longitudinal data it is unclear whether these are transient features of a depressive state or stable impairments. We examined longitudinally the course of cognitive impairment in older adults with depression and a history of suicide attempt. Methods: The authors investigated the persistence of cognitive impairment over time in 198 depressed older adults (age >60); 91 suicide attempters, 39 depressed individuals with suicidal ideation (ideators), and 68 non-suicidal depressed adults assessed over a 2-year period at four time points. The authors used linear mixed effects modelling to examine group differences in trajectories of cognitive decline over 2 years, using the Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale (DRS), and Executive Interview (EXIT). Results: Over the 2-year period, suicide attempters performed significantly worse than both suicide ideators and non-suicidal depressed older adults on the MMSE (mean difference: from ideators: −0.88, p = 0.02; from non-suicidal depressed: −1.52, p < 0.01), while on the EXIT and DRS, suicide attempters performed significantly worse than non-suicidal depressed older adults (mean difference: in EXIT: −1.75, p = 0.01; in DRS: 3.04, p < 0.01; in MMSE: 1.15, p < 0.01). Cognitive impairment in suicide attempters partly resolved, as indicated by a group × time interaction on the DRS (p = 0.039), but not the EXIT (p = 0.58) or the MMSE (p = 0.08). Conclusions: Cognitive impairment in late-life suicidal behavior appears to involve both a stable and a state-related component. (Edited publisher abstract)
Managing ageing and cognitive decline: challenges and opportunities for financial services: report on World Economic Forum (WEF) Global Agenda Council on Ageing Symposium
- Author:
- AGE UK
- Publisher:
- Age UK
- Publication year:
- 2016
- Pagination:
- 26
- Place of publication:
- London
This report summarises the second symposium of the WEF Global Agenda Council on Ageing on the implications of ageing and cognitive decline for financial services, which was hosted by Age UK in London, 3-4 February 2016. The presentations, panel discussions and workshops covered: the particular challenges and opportunities of Japan’s ageing society; cognitive vulnerability and resilience in later life; how ageing and dementia affect the capacity to manage money; challenges and opportunities for financial services; building resilience and reducing risk; changing technologies in financial services: opportunity or threat for people with cognitive decline; financial planning for an uncertain future; and how people living with cognitive decline can remain financially included. (Edited publisher abstract)
Daytime somnolence as an early sign of cognitive decline in a community-based study of older people
- Authors:
- TSAPANOU Angeliki, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(3), 2016, p.247–255.
- Publisher:
- Wiley
Objective: This study aimed to examine the association between self-reported sleep problems and cognitive decline in community-dwelling older people. The authors hypothesised that daytime somnolence predicts subsequent cognitive decline. Methods: This is a longitudinal study in a 3.2-year follow-up, with 18-month intervals. The setting is the Washington Heights-Inwood Community Aging Project. There were 1098 participants, who were over 65 years old and recruited from the community. Sleep problems were estimated using five sleep categories derived from the RAND Medical Outcome Study Sleep Scale: sleep disturbance, snoring, awaken short of breath/with a headache, sleep adequacy, and daytime somnolence. Four distinct cognitive composite scores were calculated: memory, language, speed of processing, and executive functioning. The authors used generalised estimating equations analyses with cognitive scores as the outcome, and time, sleep categories and their interactions as the main predictors. Models were initially unadjusted and then adjusted for age, gender, education, ethnicity, depression, and apolipoprotein E-ε4 genotype. Results: Increased daytime somnolence (including feeling drowsy/sleepy, having trouble staying awake, and taking naps during the day) was linked to slower speed of processing both cross-sectionally (B = −0.143, p = 0.047) and longitudinally (B = −0.003, p = 0.027). After excluding the demented participants at baseline, the results remained significant (B = −0.003, p = 0.021). Conclusions: Findings suggest that daytime somnolence may be an early sign of cognitive decline in the older population (Edited publisher abstract)
Knowingly not wanting to know: discourses of people diagnosed with mild cognitive impairment
- Author:
- PEARCE Sian
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 15(5), 2016, pp.1246-1259.
- Publisher:
- Sage
Mild cognitive impairment is a heterogeneous clinical state whereby assessed cognitive changes over time may progress to dementia, remain stable or revert to back to normal. This study aimed to identify, through discourse analysis, how people with a diagnosis of mild cognitive impairment used language in order to reveal the societal views and shared meanings of the diagnosis, and the positions taken by people. Seven people with mild cognitive impairment were interviewed, and three discourses emerged during analysis. One of the discourses revealed was ‘Not Knowing’ about mild cognitive impairment. Furthermore, in the absence of a coherent discourse related to mild cognitive impairment, participants went on to position themselves between two more familiar discourse; ‘Knowing’ about ageing and dying and ‘Not Wanting to Know’ about dementia. Clinicians must consider how information is presented to people about mild cognitive impairment, including where mild cognitive impairment is positioned in respect to normal ageing and dementia. (Publisher abstract)
The brain-body connection: GCBH recommendations on physical activity and brain health
- Author:
- GLOBAL COUNCIL ON BRAIN HEALTH
- Publisher:
- Global Council on Brain Health
- Publication year:
- 2016
- Pagination:
- 17
Based on an examination of existing evidence and consensus of experts from a variety of disciplines, this paper presents key points on the relationship between exercise and brain health as we age. It also provides four recommendations, together with practical tips to help individuals put the recommendations into practice. The experts reached consensus on five points: physical activity has a positive impact on brain health; people can change their behaviour to become more physically active at any age; based on randomised controlled trials, people who participate in purposeful exercise show beneficial changes in brain structure and function; based on epidemiological evidence, people who lead a physically active lifestyle have lower risk of cognitive decline; and that there is not yet sufficient scientific evidence that physical activity can reduce risk of brain diseases that cause dementia. (Edited publisher abstract)
Retirement and memory in Europe
- Authors:
- BIANCHINI Laura, BORELLA Margherita
- Journal article citation:
- Ageing and Society, 36(7), 2016, pp.1434-1458.
- Publisher:
- Cambridge University Press
The authors investigate the effect of retirement on memory using the Survey on Health, Ageing and Retirement in Europe (SHARE). The availability of a panel data-set allows individual heterogeneity to be controlled for when estimating the effect of transitions into retirement on a commonly employed memory measure, word recall. Control for endogeneity of the retirement decision is made by applying an instrumental variable technique to fixed-effects transformation. The authors' main finding is that, conditional on the average non-linear memory age path of the typical individual, time spent in retirement has a positive effect on word recall.
How dementia differs from normal ageing
- Author:
- GINESI Laura
- Journal article citation:
- Nursing Times, 112(24), 2016, pp.12-15.
- Publisher:
- Nursing Times
Dementia is the collective name for as set of mood changes, confusion and increasing difficulty with everyday tasks.. This four part series provides an overview of dementia and it's treatment, from its causes a pathophysiology to diagnosis and the nurse's role in its management. This, first article reviews the main forms of dementia and how research is shedding new light on the differences between dementia and normal ageing. (Publisher abstract)