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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)
Doing memory work with older men: the practicalities, the process, the potential
- Authors:
- BLAKE Vic, et al
- Journal article citation:
- Working with Older People, 20(4), 2016, pp.209-213.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to describe the process of setting up and participating in a collective memory work group of older men, with a focus on the making and unmaking of older men and masculinities through age, ageing, gender, gendering, and other intersections. Design/methodology/approach: Participant review and reflection on collective of memory work group of older men. Findings: Memory work is located in relation to related but different forms of writing and group work, emphasizing how in this method everyone becomes a writer, an author, a listener, a reader, a discussant, and a commentator. This provides a novel way to explore the constructions and intersections of ageing, gender, men, and masculinities. Social implications: The potential of memory work, both for working with older men, and more generally is outlined. Key issues are: genuine and collective commitment to substantive change, not just at a personal level, but also at wider social/political/cultural levels; willingness to trust in the other members of the group, an issue that may be difficult for some men; and commitment for caring for one another especially in their moments of greatest vulnerability. Originality/value: There is little, if any, other writing on this approach to ageing, men, and masculinities. The paper is therefore of great value, and may stimulate wider application of this approach. (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.
Materialising memories: exploring the stories of people with dementia through dress
- Authors:
- BUSE Christina E., TWIGG Julia
- Journal article citation:
- Ageing and Society, 36(6), 2016, pp.1115-1135.
- Publisher:
- Cambridge University Press
In this article, the authors use clothes as a tool for exploring the life stories and narratives of people with dementia, eliciting memories through the sensory and material dimensions of dress. The article draws on an Economic and Social Research Council-funded study, ‘Dementia and Dress’, which explored everyday experiences of clothing for carers, care workers and people with dementia, using qualitative and ethnographic methods including: ‘wardrobe interviews’, observations, and visual and sensory approaches. In this analysis, the authors use three dimensions of dress as a device for exploring the experiences of people with dementia: kept clothes, as a way of retaining connections to memories and identity; discarded clothes, and their implications for understanding change and loss in relation to the ‘dementia journey’; and absent clothes, invoked through the sensory imagination, recalling images of former selves, and carrying identity forward into the context of care. The article contributes to understandings of narrative, identity and dementia, drawing attention to the potential of material objects for evoking narratives, and maintaining biographical continuity for both men and women. The paper has larger implications for understandings of ageing and care practice; as well as contributing to the wider Material Turn in gerontology, showing how cultural analyses can be applied even to frail older groups who are often excluded from such approaches. (Edited publisher abstract)
Patients' and carers' experiences of UK memory services
- Authors:
- HAILEY Emma, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(6), 2016, pp.676-680.
- Publisher:
- Wiley
Objective: The objective of this study is to test the validity of an accreditation programme for memory services in the UK by investigating whether different levels of accreditation status (excellent compared with accredited) are reflected in patients' and carers' reported satisfaction. Method: A comparison of survey data from patient and carer feedback questionnaires collected from services as part of the accreditation process. Results: Five hundred and eighty-three patient questionnaires and 663 carer questionnaires were returned from 41 services. Patients and carers who attended memory services which were later ‘accredited as excellent’, were more likely than those who had visited ‘accredited’ services to have: been given written information about a variety of topics; been asked for feedback about using the memory service; and had found it easier to get to their appointments. Carers attending services accredited as excellent were more likely to have been offered an assessment of their needs. Conclusion: Patients and carers had very good experiences of memory services overall whether they had standard or excellent accreditation. However, ‘excellent’ services were consistently better on a number of factors. This provides further support that the accreditation process is an important indicator of the quality of memory services (Publisher abstract)
Protecting cognition from aging and Alzheimer's disease: a computerized cognitive training combined with reminiscence therapy
- Authors:
- BARBAN Francesco, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(4), 2016, pp.340-348.
- Publisher:
- Wiley
Objective: The aim of this paper was to assess the efficacy of process-based cognitive training (pb-CT) combined with reminiscence therapy (RT) in patients with mild Alzheimer's disease (mAD) and mild cognitive impairment (MCI) and in healthy elderly (HE) subjects. Methods: This multicentre, randomised, controlled trial involved 348 participants with mAD, MCI, and HE from four European countries. Participants were randomly assigned to two arms of a crossover design: those in arm A underwent 3 months of computerised pb-CT for memory and executive functions combined with RT and 3 months of rest; those in arm B underwent the reverse. The primary outcome was the effect of the training on memory and executive functions performance. The secondary outcome was the effect of the training on functional abilities in mAD assessed with the instrumental activities of daily living. Results: The study found a significant effect of the training for memory in all three groups on delayed recall of the Rey Auditory Verbal Learning Test and for executive functions in HE on the phonological fluency test. MCI and HE participants maintained these effects at follow-up. MCI and mAD participants also showed a significant effect of the training on the Mini-mental state examination scale. Participants with mAD showed more stable instrumental activities of daily living during the training versus the rest period. Conclusions: The results corroborate the positive effect of pb-CT and its maintenance primarily on memory in HE and MCI participants that did not seem to be potentiated by RT. Moreover, our results are very promising for the mAD participants. (Edited publisher abstract)
Self-awareness of memory impairment in Parkinson’s disease: a review of the literature
- Authors:
- BLOOMFIELD Jacqueline, WOODS Damith Thushara, LUDINGTON Jason
- Journal article citation:
- Working with Older People, 20(1), 2016, pp.57-64.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to review and provide information on the small but growing body of literature that demonstrates that some people with Parkinson’s disease (PD) are unaware of the memory impairment, and this has clinical implications for how family members care for their loved one, and how clinical staff and others may interact with them on a day-to-day perspective. Design/methodology/approach: The approach takes the form of a general review. Findings: People with PD experience a variety of cognitive impairment including deficits in memory and higher level executive processes. Impairment in these areas can occur early in the disease course and result in adverse consequences including distractibility, trouble recalling information, and problems remembering to execute planned actions like adhering to medication regimes. The literature also suggests heterogeneity in both the memory performance of people with PD and in the definition of awareness used to investigate this phenomenon. Practical implications: Strategies for remembering may be of practical importance for people with PD, and/or caregivers should be introduced and educated to the nature of memory impairment in PD, as well as its likely course and natural progression in a non-threatening way before they are later instructed on “tips” for maximising daily functioning as more severe cognitive deficits begin to appear. Originality/value: This paper adds to the small body of literature that investigates patients’ awareness of memory impairment in PD and advocates for ongoing research within the area. (Publisher abstract)
Conversational assessment in memory clinic encounters: interactional profiling for differentiating dementia from functional memory disorders
- Authors:
- JONES Danielle, et al
- Journal article citation:
- Aging and Mental Health, 20(5), 2016, pp.500-509.
- Publisher:
- Taylor and Francis
Objectives: In the UK dementia is under-diagnosed, there is limited access to specialist memory clinics, and many of the patients referred to such clinics are ultimately found to have functional (non-progressive) memory disorders (FMD), rather than a neurodegenerative disorder. Government initiatives on ‘timely diagnosis’ aim to improve the rate and quality of diagnosis for those with dementia. This study seeks to improve the screening and diagnostic process by analysing communication between clinicians and patients during initial specialist clinic visits. Establishing differential conversational profiles could help the timely differential diagnosis of memory complaints. Method: This study is based on video- and audio recordings of 25 initial consultations between neurologists and patients referred to a UK memory clinic. Conversation analysis was used to explore recurrent communicative practices associated with each diagnostic group. Results: Two discrete conversational profiles began to emerge, to help differentiate between patients with dementia and functional memory complaints, based on (1) whether the patient is able to answer questions about personal information; (2) whether they can display working memory in interaction; (3) whether they are able to respond to compound questions; (4) the time taken to respond to questions; and (5) the level of detail they offer when providing an account of their memory failure experiences. Conclusion: The distinctive conversational profiles observed in patients with functional memory complaints on the one hand and neurodegenerative memory conditions on the other suggest that conversational profiling can support the differential diagnosis of functional and neurodegenerative memory disorders. (Publisher abstract)
Memory care and wellness services: efficacy of specialized dementia care in adult day services
- Authors:
- LOGSDON Rebecca G., et al
- Journal article citation:
- Gerontologist, 56(2), 2016, pp.318-325.
- Publisher:
- Oxford University Press
Purpose of the Study: This investigation evaluated participant and caregiver outcomes of a programme of specialised dementia adult day services (ADS; Memory Care and Wellness Services: MCWS). Design and Methods: One hundred eighty-seven participant–caregiver dyads were enrolled in a quasiexperimental research investigation; 162 attended MCWS and 25 were comparison dyads that met eligibility criteria but did not have access to ADS within their communities. The objectives of this investigation were to evaluate whether MCWS improved quality of life, mood, behaviour, or functional status for participants with dementia and whether caregivers experienced decreased stress, burden, or depression, compared with comparison dyads. Results: No significant differences were seen between MCWS and comparison dyads at 3 months. However, after 6 months, MCWS participants exhibited significantly fewer depressive behaviours (p < .05) and a trend toward fewer total behaviour problems (p < .10) than comparison participants, and MCWS caregivers exhibited significantly less distress over behaviour problems (total behaviour problems, memory problems, depressive problems, all p < .05) than comparison caregivers. Implications: Although modest, outcomes represent a reversal of the typical direction of change in both behaviour problems and caregiver distress, despite the progression of cognitive and functional impairment. Caregivers were highly satisfied with the services. The MCWS programme provides a model of a community-based dementia ADS and results provide support for further development of the programme. (Edited publisher abstract)
Does targeted cognitive training reduce educational disparities in cognitive function among cognitively normal older adults?
- Authors:
- CLARK Daniel O., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 31(7), 2016, pp.809-817.
- Publisher:
- Wiley
Objective: The aim of this study was to investigate educational differences in treatment responses to memory, reasoning, and speed of processing cognitive training relative to no-contact control. Methods: Secondary analyses of the Advanced Cognitive Training for Independent and Vital Elderly trial were conducted. Two thousand eight hundred older adults were randomized to memory, reasoning, or speed of processing training or no-contact control. A repeated-measures mixed-effects model was used to investigate immediate post-training and 1-year outcomes with sensitivity analyses out to 10 years. Outcomes were as follows: (1) memory composite of Hopkins Verbal Learning Test, Rey Auditory Verbal Learning Test, and Rivermead Behavioral Memory Test; (2) reasoning composite of letter series, letter sets, and word series; and (3) speed of processing measured using three trials of useful field of view and the digit symbol substitution test. Results: The effects of reasoning and memory training did not differ by educational attainment. The effect of speed of processing training did. Those with fewer than 12 years of education experienced a 50% greater effect on the useful field of view test compared with those with 16 or more years of education. The training advantage for those with fewer than 12 years of education was maintained to 3 years post-training. Conclusion: Older adults with less than a secondary education are at elevated risk of dementia, including Alzheimer's disease. The analyses here indicate that speed of processing training is effective in older adults with low educational attainment. (Publisher abstract)