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Identifying individuals with subtle cognitive decline

Dementia is a devastating neurological disease that may be better managed if diagnosed earlier when subclinical neurodegenerative changes are already present, including subtle cognitive decline and mild cognitive impairment. In a new study published in the journal Neuropsychology, researchers used item-level performance on the Montreal Cognitive Assessment (MoCA) to identify individuals with subtle cognitive decline. Method: Individual MoCA item data from the Alzheimer’s Disease Neuroimaging Initiative was grouped using k-modes cluster analysis. These clusters were validated and examined for association with convergent neuropsychological tests. The clusters were then compared and characterized using multinomial logistic regression. Results: A three-cluster solution had 77.3% precision, with Cluster 1 (high performing) displaying no deficits in performance, Cluster 2 (memory deficits) displaying lower memory performance, and Cluster 3 (compound deficits) displaying lower performance on memory and executive function. Age at MoCA (older in compound deficits), gender (more females in memory deficits), and marital status (fewer married in compound deficits) were significantly different among clusters. Age was not associated with increased odds of membership in the high-performing cluster compared to the others. Conclusions: We identified three clusters of individuals classified as cognitively unimpaired using cluster analysis. Individuals in the compound deficits cluster performed lower on the MoCA and were older and less often married than individuals in other clusters. Demographic analyses suggest that cluster identity was due to a combination of both cognitive and clinical factors. Identifying individuals at risk for future cognitive decline using the MoCA could help them receive earlier evidence-based interventions to slow further cognitive decline. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

For the abstract

Predicting Alzheimers

Alzheimer’s, or so-called dementia, is one of the types of diseases that affects brain cells and causes memory loss, difficulty in thinking, and forgetfulness. Thus far, there is no effective treatment for AD, but treatment could be helpful in impeding the progression of the disease. Therefore, early AD diagnosis is effective in limiting the disease from progressing to advanced and dangerous stages. Physicians and radiologists face difficulties in diagnosing healthy nerve cells from soft tissue, and it requires substantial expertise and a long time to decipher the MRI images. Thus, artificial intelligence techniques can play a key role in diagnosing MRI images for early detection of AD. In a study published in Connection Science, four proposed systems with different methodologies and materials for tracking the stages of AD development are presented. The first proposed system is to classify a data set using artificial neural networks (ANNs) and feed-forward neural networks (FFNN) based on the features extracted in a hybrid manner by using a combination of Local Binary Pattern (LBP), Discrete Wavelet Transform (DWT), and Gray Level Co-occurrence Matrix (GLCM) algorithms. The second proposed system is to classify the data set using two deep learning models—ResNet-18 and AlexNet—that are pre-trained based on deep feature map extraction. The third proposed system is to diagnose the data set using a hybrid technology between ResNet-18 and AlexNet models to extract feature maps and machine learning (SVM) to classify feature maps. The fourth proposed system diagnoses the data set using ANN and FFNN algorithms based on the hybrid features of ResNet-18 and AlexNet deep learning models and traditional algorithms (LBP, DWT, and GLCM). All the proposed techniques achieved superior results in the diagnosis of MRI images for early detection of AD. The FFNN algorithms based on the hybrid features extracted by ResNet-18 with features extracted using traditional algorithms achieved an accuracy of 99.8%, precision of 99.9%, sensitivity of 99.75%, specificity of 100%, and AUC of 99.94%. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

For the abstract

Internet-delivered therapy for family carers of people with dementia (iACT4CARERS)

A new paper in the International Journal of Qualitative Studies on Health and Well-being examined the impact of internet-delivered, therapist-guided, self-help Acceptance and Commitment Therapy (ACT) for family carers of people with dementia (iACT4CARERS).  A qualitative approach with semi-structured interviews was employed with family carers (N = 23) taking part in a feasibility study of iACT4CARERS. The interviews were audiorecorded, transcribed and analysed using thematic analysis. Results showed that four overarching themes were identified: 1) usefulness and relevance of the content of the sessions, 2) sense of connectedness, 3) the impact of the intervention on participants and 4) acceptability of the online delivery. Positive carer experiences and intervention acceptability were facilitated by learning helpful ACT skills, perceiving the content of the session as relatable to the carers’ needs, feeling connected to other carers and the therapist during the intervention, noticing the benefits of the intervention and the user-friendliness of the online platform. Recommendations for a full-scale trial were identified, such as the inclusion of some “face-to-face” interactions (e.g., via video call) between carers and therapists to facilitate a bidirectional interaction and the provision of an additional aide-memoire to improve the learning experiences. Conclusion: Overall, the intervention was acceptable to the family carers. The proposed recommendations should be considered in a full-scale trial.

For the abstract (open access)

Are Older Adults "Risky Readers?"

According to an influential account of aging effects on reading, older adults (65+ years) employ a more “risky” reading strategy compared to young adults (18–30 years), in which they attempt to compensate for slower processing by using lexical and contextual knowledge to guess upcoming (i.e., parafoveal) words more often. Consequently, while older adults may read more slowly, they might also skip words more often (by moving their gaze past words without fixating them), especially when these are of higher lexical frequency or more predictable from context. However, this characterization of aging effects on reading has been challenged recently following several failures to replicate key aspects of the risky reading hypothesis, as well as evidence that key effects predicted by the hypothesis are not observed in Chinese reading. To resolve this controversy, a recent study presents in the journal Psychology and Aging presented the results of  a meta-analysis of 102 eye movement experiments comparing the reading performance of young and older adults. Researchers focused on the reading of sentences displayed normally (i.e., without unusual formatting or structures, or use of gaze-contingent display-change techniques), conducted using an alphabetic script or Chinese, and including experiments manipulating the frequency or predictability of a specific target word. Meta-analysis confirmed that slower reading by older compared to younger adults is accompanied by increased word-skipping, although only for alphabetic scripts. Meta-analysis additionally showed that word-skipping probabilities are unaffected by age differences in word frequency or predictability effects, casting doubt on a central component of the risky reading hypothesis. We consider implications for future research on aging effects on reading. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

For the abstract

Do People With Mental Illness Age Faster?

A new study in the Psychiatric Rehabilation Journal compared physical functional measures of people with severe mental illness (SMI) to standardized geriatric values. Method: Retrospective analysis of physical functioning sample data of middle-aged people with SMI was compared to standardized older adult data. Compared: Sit to Stand Test (STS; n = 68), 6 min Walk Test (6MWT; n = 71), and Single Legged Stance Test (SLS; n = 55). One sample t tests were computed, using standardized values for older adult healthy populations, to identify differences for the group. Results: STS (M = 11.3 SD = 5.36), for the sample were comparable to 80–89 year old. The 6MWT values were significantly worse than 80–89-year-old range for women, t(28) = −2.88, p < .01, and men, t(40) = −5.32, p =. 00. SLS values for women and men were comparable to the 70–79-year-old range in the general population. Conclusions and Implications for Practice: People with SMI have functional fitness levels that are older than chronological age, and should be assessed regularly for physical functioning to support independent living. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

For the abstract

How Is Late-Life Depression Linked to Dementia?

Late-life depression (LLD) increases risk for dementia and brain pathology, but possibly this is only true for one or more symptom profiles of LLD. In 4354 participants (76 ± 5 years; 58% female) from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, recently published in the journal Neurobiology of Aging, researchers identified five LLD symptom profiles, based on the Geriatric Depression Scale-15 (no LLD (57%); apathy (31%); apathy with emptiness (2%), mild LLD (8%) and severe LLD (2%)). Cox regression analyses showed that severe LLD, mild LLD and apathy increased risk of dementia up to 12 years, compared to no LLD. Additionally, hippocampal volume loss and white matter lesion increase, were assessed on 1.5 T MR images, at baseline and after 5 years follow-up. Only severe LLD showed increased WML volume over time, but not on hippocampal volume loss. WML increase over time mediated partially the relation between mild LLD and dementia but not for the other symptom profiles. It appears that hippocampal atrophy and LLD are independent predictors for dementia incidence, whereas for mild LLD the risk for dementia is partially mediated by WML changes. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

For the abstract

The effectiveness of positivism training on suicide ideation and death anxiety in the elderly.

Aging appears to be a biological process experienced by all living beings including humans. Hence, it seems crucial to pay particular attention to the elderly and prevent disorders such as suicide ideation and death anxiety among them. A new study in the journal Aging Psychology explored the effectiveness of positivism training on suicide ideation and death anxiety in the elderly. It was a quasi-experimental study with pretest-posttest and control group design. The statistical population included all the elderly men living in Dezful, Iran in 2020. The sample consisted of 30 elderly men (60 to 70 years old) selected using the convenience sampling method and considering the inclusion and exclusion criteria. The experimental group underwent eight 90-minute weekly sessions. Applied in the study were the Beck’s suicide ideation scale and Collet–Lester’s fear of death scale. Data were analyzed using univariate analysis in SPSS-22 software. The results indicated that there is a significant difference between experimental and control groups in terms of suicide ideation and death anxiety in the posttest (P<.001). That is, the positivism training resulted in the deacres of suicide ideation and death anxiety. According to the findings of the present study, the positivism training can be suggested as an efficient method in the reduction of suicide ideation and death anxiety in the elderly men. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

For the abstract

 

Dementia Linked to Two Murder-Suicides in Iowa

When deputies in Iowa's Pottawattamie County on November 7 of this year, they were told that a domestic disturbance was in progress.  They were also warned that 86-year-old Harvey Rankin was suffering from dementia and family members worried about his welfare as well as that of his wife, 83-year-old Bonnie Rankin.   Upon arriving, they discovered that Harvey Rankin had shot and killed his wife and, despite pleas from the deputies for him to give himself up, shot himself as well.   Despite being transported to a local hospital, he died on November 16.

"All the evidence so far leads to an apparent murder-suicide,” said Sgt. Jim Doty, Pottawattamie County Sheriff's Office. "Going to the scene and seeing that it’s an elderly couple and hearing the reports of dementia, it was heartbreaking, because you can't believe that he was in his right mind to do something that horrific,” Doty added. 

The case bears a striking resemblance to an earlier murder that occurred in Lincoln, Nebraska in June of this year.  On June 20, 80-year-0ld JohnKotopka shot and killed his 78-year-old wife, Janet.  Now facing a first-degree murder charge, Kotopka told authorities that he killed his wife of 57 years due to the exhaustion of caring for.   She had been diagnosed with dementia two years earlier and he had been acting as her primary caregiver with little real relief.  

While caregiver stress remains a major problem for spouses of dementia patients, Nebraska Alzheimer’s Association executive director Julie Chytil said there is help available for people in need.  "Knowledge is going to be your friend in this situation so you know what’s coming and how to prepare,” she said. “Your loved one will change, and the way you used to communicate with them must also change. Learning how to care for them can help you plan.”  Many organizations for dementia sufferers have extensive online and local resources which can be invaluable in avoiding tragedies such as these.

 

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Experiences of becoming widowed in old age—A cross-countries study with qualitative interviews from Denmark and quantitative measures of association in a Swedish sample.

Becoming widowed is a stressful health-threatening event causing major life changes. In a study recently published in the International Journal of Qualitative Studies on Health and Well-being, we explored how widowed people experience becoming widowed and examined if these experiences are quantitatively associated with widowhood.  A multi-methods study using an exploratory sequential mixed-methods approach including a qualitative descriptive study with widowed people from Denmark and a Swedish cohort study. Qualitative interviews (n = 9) were analysed using qualitative content analysis, describing experiences as explained by the widowed people. The quantitative association of the experiences was examined by identifying proxies for the qualitative experiences of widowhood in the cohort study and examining the occurrence in widowed people compared to married people (n = 1,095). Results showed that six categories of experiences emerged: the circumstances around spousal death, mental health and well-being, physical health, social relations, activities and practicalities. The quantitative examination showed a significant association with widowhood regarding mental and physical health problems. In conclusion, the circumstances around spousal death and the time before spousal death, in general, were important to how participants felt being widowed. Being ill negatively affected mental health and well-being, partly because of the inability to participate in activities and social relations. This is important, as health problems are more common among widowed people than married people. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

For the abstract (Open Access) 

Is There a "COVID-19" Effect for Aging?

As older adults have frequently been portrayed as one homogeneous and vulnerable risk group in public debates and in the media immediately after the outbreak of the Coronavirus disease (COVID-19) pandemic, a general shift toward less favorable attitude toward own aging (ATOA) might have resulted. In contrast, individuals may feel younger than before the pandemic, reflecting a psychological mechanism to avoid identifying themselves with the old age “risk group.” A new study in the journal Psychology and Aging examines e 12-year trajectories of ATOA and subjective age among middle-aged and older German adults based on assessments between 2008 and Summer 2020 (N = 7,730; age in 2008: 40–93 years, M = 62.41). Based on longitudinal multilevel regression models, we found that for ATOA, a model including a potentially “pandemic-driven” change component between 2017 and 2020 in addition to an overall linear change between 2008 and 2020 revealed a better fit than a linear change model without that additional change component. Mean-level decline in ATOA between 2017 and 2020 was five times steeper in such a model than in a linear change model that did not include an additional 2017–2020 change component. The extent of intraindividual ATOA change between 2017 and 2020 varied interindividually, but for more than 99% of the sample, particularly among those with poorer self-rated health, ATOA became less favorable. There was very limited evidence for a pandemic-specific change in subjective age. In conclusion, our findings suggest that the early phase of the pandemic might have caused a change toward less favorable ATOA, whereas it did not affect subjective age. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

For the abstract

Charting Cognitive Functioning in Seniors Across Europe

With ageing mental health issues, as age-related cognitive decline, increase. A study recently published in the journal Aging, Neuropsychology, and Cognition aims to evaluate the prevalence of cognitive impairment among older European adults and to evaluate its association with clinical and sociodemographic variables, using SHARE. Numeracy, temporal orientation, verbal fluency, and memory were the measures used to evaluate cognitive performance. From 44 963 individuals included, mean age was 70.0 ± 9.0 years old and 56.3% were female. Overall prevalence of impairment was of 13.0% (temporal orientation), 24.8% (numeracy), 27.6% (verbal fluency) and 50.5% (memory). Men showed higher impairment prevalence in temporal orientation and memory and lower in numeracy and verbal fluency. Age, fewer years of education, difficulties performing iADLs, physical inactivity, and poor self-perceived health were independently associated with impairment in all cognitive abilities. These results showed the burden of cognitive impairment across Europe. Factors identified as associated should be taken in consideration to develop effective interventions to prevent cognitive decline. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

 

For the abstract