Cognitive Aging and Cognitive Impairment

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: closed (30 April 2019) | Viewed by 41420

Special Issue Editors


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Guest Editor
Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
Interests: longitudinal process of cognitive aging; early signs of cognitive impairment; mild cognitive impairment and mild dementia; the role of cognitive reserve in early manifestation of the disease; the development computerized cognitive interventions to prevent dementia and other age-related diseases
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Co-Guest Editor
Department Special Didactics, Faculty of Education and Sport Sciences, University of Vigo, 36005 Pontevedra, Spain
Interests: dementia; physical activity; physical exercise
Special Issues, Collections and Topics in MDPI journals

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Co-Guest Editor
1. Galicia Sur Health Research Institute, Vigo, Galicia, Spain
2. Coordinator of Rede Galega de Investigación en Demencias (Galician Dementia Research Network), Galicia, Spain
Interests: dementia; nutrition; physical activity; biomarkers

Special Issue Information

Dear Colleagues,

The huge impact of cognitive impairment and dementia has turned cognitive aging in a public health concern from many perspectives and requiring actions from many sectors. It is increasingly relevant to fully understand age-related neurocognitive changes observed in both normal and pathologic development.

Research on cognitive aging is concerned with language, learning, memory, and other intellectual abilities responsible for daily adjustment, and with explaining the mechanism of cognitive changes with advancing age. These changes range from subtle cognitive complaints associated with normal aging to mild cognitive impairment and dementia. Research on cognitive impairment is currently focused in identifying risk factors and mechanism of age-related impairment, with a strong focus on early detection of dementia and early interventions. New trends in the study of cognitive impairment include new diagnostic labels, such as Mild Behavioral Impairment and Subjective Cognitive Decline. In this context, early intervention and preventive approaches are gaining relevance, including cognitive training and cognitive stimulation, physical exercise, nutritional and technology-based interventions.

This Special Issue on Geriatrics will focus on current advances in the study of cognitive aging and the age-related risk factors of cognitive impairment, with a special emphasis on preventive interventions. The Special Issue provides an open access opportunity to publish research articles, reviews, opinions, letters, and case reports related to this important field of research. I encourage you and your colleagues to submit for publication in this Special Issue.

Prof. Dr. David Facal
Prof. Dr. José Mª Cancela Carral
Dr. Carlos Spuch
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Cognitive aging
  • Cognitive impairment
  • Dementia
  • Cognitive reserve
  • Cognitive training
  • Cognitive frailty
  • Prevention

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Published Papers (15 papers)

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Editorial

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4 pages, 178 KiB  
Editorial
New Trends in Cognitive Aging and Mild Cognitive Impairment
by David Facal, Carlos Spuch and Sonia Valladares-Rodriguez
Geriatrics 2022, 7(4), 80; https://doi.org/10.3390/geriatrics7040080 - 1 Aug 2022
Cited by 1 | Viewed by 1844
Abstract
In this editorial, we aim to highlight some lessons learned in our field and to discuss some open questions regarding the continuum between healthy cognitive aging and dementia [...] Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)

Research

Jump to: Editorial, Other

9 pages, 276 KiB  
Communication
Feasibility of a Small Group Otago Exercise Program for Older Adults Living with Dementia
by Julie D. Ries and Martha Carroll
Geriatrics 2022, 7(2), 23; https://doi.org/10.3390/geriatrics7020023 - 24 Feb 2022
Cited by 3 | Viewed by 3149
Abstract
Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people [...] Read more.
Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people with dementia. We sought to explore the feasibility of group delivery of OEP in an adult day health center (ADHC) for people with dementia. We collected demographic data, Functional Assessment Staging Tool (FAST), and Mini Mental State Exam (MMSE) scores for seven participants with dementia. Pre- and post-test data included: Timed-Up-and-Go (TUG), 30-Second Chair-Stand (30s-CST), Four-Stage-Balance-Test (4-SBT), and Berg Balance Scale (BBS). We implemented a supervised group OEP, 3x/week × 8 weeks. Most participants required 1:1 supervision for optimal challenge and participation. Five participants completed the program. All had moderately severe to severe dementia based upon FAST; MMSE scores ranged from mild to severe cognitive impairment. Four of five participants crossed the threshold from higher to lower fall risk in at least one outcome (TUG, 30s-CST, 4-SBT, or BBS), and four of five participants improved by >Minimal Detectible Change (MDC90) score in at least one outcome. The group delivery format of OEP required significant staff oversight for optimal participation, making the program unsustainable. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
29 pages, 3837 KiB  
Article
SART and Individual Trial Mistake Thresholds: Predictive Model for Mobility Decline
by Rossella Rizzo, Silvin Paul Knight, James R. C. Davis, Louise Newman, Eoin Duggan, Rose Anne Kenny and Roman Romero-Ortuno
Geriatrics 2021, 6(3), 85; https://doi.org/10.3390/geriatrics6030085 - 31 Aug 2021
Cited by 5 | Viewed by 3069
Abstract
The Sustained Attention to Response Task (SART) has been used to measure neurocognitive functions in older adults. However, simplified average features of this complex dataset may result in loss of primary information and fail to express associations between test performance and clinically meaningful [...] Read more.
The Sustained Attention to Response Task (SART) has been used to measure neurocognitive functions in older adults. However, simplified average features of this complex dataset may result in loss of primary information and fail to express associations between test performance and clinically meaningful outcomes. Here, we describe a new method to visualise individual trial (raw) information obtained from the SART test, vis-à-vis age, and groups based on mobility status in a large population-based study of ageing in Ireland. A thresholding method, based on the individual trial number of mistakes, was employed to better visualise poorer SART performances, and was statistically validated with binary logistic regression models to predict mobility and cognitive decline after 4 years. Raw SART data were available for 4864 participants aged 50 years and over at baseline. The novel visualisation-derived feature bad performance, indicating the number of SART trials with at least 4 mistakes, was the most significant predictor of mobility decline expressed by the transition from Timed Up-and-Go (TUG) < 12 to TUG ≥ 12 s (OR = 1.29; 95% CI 1.14–1.46; p < 0.001), and the only significant predictor of new falls (OR = 1.11; 95% CI 1.03–1.21; p = 0.011), in models adjusted for multiple covariates. However, no SART-related variables resulted significant for the risk of cognitive decline, expressed by a decrease of ≥2 points in the Mini-Mental State Examination (MMSE) score. This novel multimodal visualisation could help clinicians easily develop clinical hypotheses. A threshold approach to the evaluation of SART performance in older adults may better identify subjects at higher risk of future mobility decline. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
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17 pages, 300 KiB  
Article
Evaluating the Consistency of Subjective Activity Assessments and Their Relation to Cognition in Older Adults
by Cassandra R. Hatt, Christopher R. Brydges, Jacqueline A. Mogle, Martin J. Sliwinski and Allison A. M. Bielak
Geriatrics 2021, 6(3), 74; https://doi.org/10.3390/geriatrics6030074 - 28 Jul 2021
Cited by 5 | Viewed by 4295
Abstract
(1) Background: Research examining whether activity engagement is related to cognitive functioning in older adults has been limited to using retrospective reports of activity which may be affected by biases. This study compared two measurements (estimated weekly versus reported daily), and whether these [...] Read more.
(1) Background: Research examining whether activity engagement is related to cognitive functioning in older adults has been limited to using retrospective reports of activity which may be affected by biases. This study compared two measurements (estimated weekly versus reported daily), and whether these activity assessments were related to cognition in older adults; (2) Methods: Participants from US (n = 199) and Australian (n = 170) samples completed a weekly estimate of activity, followed by 7 consecutive days of daily reporting. Differences between weekly estimates and daily reports were found, such that estimations at the weekly level were lower than self-reported daily information. Multivariate multiple regression was used to determine whether total activity, activity domains and the discrepancy between assessment types (i.e., weekly/daily) predicted cognitive performance across three cognitive domains (fluid, verbal, memory); (3) Results: When activity assessments were totaled, neither predicted cognition; however, when activity was grouped by domain (cognitive, social, physical), different domains predicted different cognitive outcomes. Daily reported cognitive activity significantly predicted verbal performance (β = 1.63, p = 0.005), while weekly estimated social activity predicted memory performance (β = −1.81, p = 0.050). Further, while the magnitude of discrepancy in total activity did not significantly predict cognitive performance, domain specific differences did. Differences in physical activity reported across assessments predicted fluid performance (β = −1.16, p = 0.033); (4) Conclusions: The significant discrepancy between the measurement types shows that it is important to recognize potential biases in responding when conducting activity and cognition research. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
14 pages, 930 KiB  
Article
Effect of Demographic and Health Dynamics on Cognitive Status in Mexico between 2001 and 2015: Evidence from the Mexican Health and Aging Study
by Silvia Mejia-Arango, Jaqueline Avila, Brian Downer, Marc A. Garcia, Alejandra Michaels-Obregon, Joseph L. Saenz, Rafael Samper-Ternent and Rebeca Wong
Geriatrics 2021, 6(3), 63; https://doi.org/10.3390/geriatrics6030063 - 25 Jun 2021
Cited by 12 | Viewed by 3857
Abstract
Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how [...] Read more.
Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how sociodemographic factors, cardiovascular diseases, and their treatment relate to changes in cognitive function of Mexican adults aged 60 and older between 2001 and 2015. Self and proxy respondents were classified as dementia, cognitive impairment no dementia (CIND), and normal cognition. We use logistic regression models to examine the trends in dementia and CIND for men and women aged 60 years or older using pooled national samples of 6822 individuals in 2001 and 10,219 in 2015, and sociodemographic and health variables as covariates. We found higher likelihood of dementia and a lower risk of CIND in 2015 compared to 2001. These results remain after adjusting for sociodemographic factors, cardiovascular diseases, and their treatment. The improvements in educational attainment, treatment of diabetes and hypertension, and better access to health care in 2015 compared to 2001 may not have been enough to counteract the combined effects of aging, rural residence disadvantage, and higher risks of cardiovascular disease among older Mexican adults. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
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15 pages, 1437 KiB  
Article
It Makes You Feel That You Are There”: Exploring the Acceptability of Virtual Reality Nature Environments for People with Memory Loss
by Noreen Orr, Nicola L. Yeo, Sarah G. Dean, Mathew P. White and Ruth Garside
Geriatrics 2021, 6(1), 27; https://doi.org/10.3390/geriatrics6010027 - 12 Mar 2021
Cited by 11 | Viewed by 3799
Abstract
Aim: To report on the acceptability of virtual reality (VR) nature environments for people with memory loss at memory cafes, and explore the experiences and perceptions of carers and staff. Methods: A qualitative study was conducted between January and March 2019. Ten adults [...] Read more.
Aim: To report on the acceptability of virtual reality (VR) nature environments for people with memory loss at memory cafes, and explore the experiences and perceptions of carers and staff. Methods: A qualitative study was conducted between January and March 2019. Ten adults with memory loss, eight carers and six volunteer staff were recruited from two memory cafes, located in Cornwall, UK. There were 19 VR sessions which were audio recorded and all participants were interviewed at the end of the sessions. Framework analysis was used to identify patterns and themes in the data. Results: During the VR experience, participants were engaged to varying degrees, with engagement facilitated by the researcher, and in some cases, with the help of a carer. Participants responded positively to the nature scenes, finding them soothing and evoking memories. The VR experience was positive; many felt immersed in nature and saw it as an opportunity to ‘go somewhere’. However, it was not always positive and for a few, it could be ‘strange’. Participants reflected on their experience of the VR equipment, and volunteer staff and carers also shared their perceptions of VR for people with dementia in long-term care settings. Conclusions: The VR nature experience was an opportunity for people with memory loss to be immersed in nature and offered the potential to enhance their quality of life. Future work should build on lessons learned and continue to work with people with dementia in developing and implementing VR technology in long-term care settings. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
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6 pages, 199 KiB  
Article
Neurocognitive Function and Quality of Life Outcomes in the ONTRAC Study for Skin Cancer Chemoprevention by Nicotinamide
by Andrew J. Martin, Haryana M. Dhillon, Janette L. Vardy, Robyn A. Dalziell, Bonita Choy, Pablo Fernández-Peñas, Ann Dixon, Corrinne Renton, Gayathri St George, Niranthari Chinniah, Gary M. Halliday, Diona L. Damian and Andrew C. Chen
Geriatrics 2019, 4(1), 31; https://doi.org/10.3390/geriatrics4010031 - 25 Mar 2019
Cited by 4 | Viewed by 6577
Abstract
Nicotinamide (vitamin B3) has photoprotective effects and reduces skin cancer incidence in high risk patients. Nicotinamide also improves cognition in animal models. As part of the ONTRAC (Oral Nicotinamide To Reduce Actinic Cancer) phase III placebo-controlled, randomized trial to assess nicotinamide’s efficacy in [...] Read more.
Nicotinamide (vitamin B3) has photoprotective effects and reduces skin cancer incidence in high risk patients. Nicotinamide also improves cognition in animal models. As part of the ONTRAC (Oral Nicotinamide To Reduce Actinic Cancer) phase III placebo-controlled, randomized trial to assess nicotinamide’s efficacy in skin cancer prevention, we included clinical neurocognitive function and patient-reported quality of life assessments at baseline and after 12 months of intervention in individuals with previous skin cancer in order to assess any effect of oral nicotinamide (500 mg po twice daily) on cognitive function and quality of life. In our sample of 310 participants who completed neurocognitive function testing at baseline and at 12 months, we were not able to detect any significant effect of oral nicotinamide on cognitive function nor on quality of life. Further studies of nicotinamide’s effects on cognition in humans might include individuals with pre-existing mild cognitive impairment, and it may be that higher doses of nicotinamide are required to significantly influence cognitive function compared to doses required to reduce skin cancer. Full article
(This article belongs to the Special Issue Cognitive Aging and Cognitive Impairment)
6 pages, 227 KiB  
Article
Characterisation of Benzodiazepine Use in an Older Population Registered in Family Health Units in the Region of Minho, Portugal
by Ana Vilaça, Ana Vieira, André Fernandes, Daniela Ribeiro and Inês Esteves
Geriatrics 2019, 4(1), 27; https://doi.org/10.3390/geriatrics4010027 - 1 Mar 2019
Cited by 4 | Viewed by 5791
Abstract
Benzodiazepines are the most frequently consumed psychotropic drugs among older persons. This pharmacological class has been advised against in this group, due to the various risks associated with its use in an older population. This study seeks to determine the prevalence of benzodiazepine [...] Read more.
Benzodiazepines are the most frequently consumed psychotropic drugs among older persons. This pharmacological class has been advised against in this group, due to the various risks associated with its use in an older population. This study seeks to determine the prevalence of benzodiazepine use in a non-institutionalized older population over the age of 75 that is registered in Family Health Units (USF) in the region of Minho, Portugal, as well as to characterize these patients and understand the link between benzodiazepine use and chronic medication use, risk of falls, and level of physical and functional dependence. The data extracted from the clinical records registered in the SAM® were analyzed using the Statistical Package for the Social Sciences (SPSS). A sample of 700 patients was obtained. These patients presented a mean age of 82.3 years, 62.7% were female, 95.3% were physically independent, and 38.0% were functionally independent. Almost half of the elder persons presented a moderate (36.9%) or high (11.4%) risk of falls. 37.9% of the patients were chronic benzodiazepines users, using between 1 and 3 active substances belonging to this pharmacological class, with a higher rate of use among women (p < 0.001) and elder persons. There was a statistically significant association among the use of benzodiazepines, a functional independence, and a higher risk of falls. These pioneering findings in Portugal reveal a high prevalence of benzodiazepine use in the population studied and warn about the specific characteristics of said population and the importance in reducing the risks associated with the inappropriate prescription of these drugs. Full article
(This article belongs to the Special Issue Cognitive Aging and Cognitive Impairment)
11 pages, 447 KiB  
Communication
Rehabilitative Support for Persons with Dementia and Their Families to Acquire Self-Management Attitude and Improve Social Cognition and Sense of Cognitive Empathy
by Yohko Maki and Hideyuki Hattori
Geriatrics 2019, 4(1), 26; https://doi.org/10.3390/geriatrics4010026 - 25 Feb 2019
Cited by 7 | Viewed by 6935
Abstract
People with dementia are often inevitably confronted with various difficulties with social interaction and communication, which is a core problem that can be improved with rehabilitative support, thus improving their quality of life. The authors propose rehabilitative support using communication via activities; co-beneficial [...] Read more.
People with dementia are often inevitably confronted with various difficulties with social interaction and communication, which is a core problem that can be improved with rehabilitative support, thus improving their quality of life. The authors propose rehabilitative support using communication via activities; co-beneficial relationship-based rehabilitation, which emphasizes the following 3 points: support for people with dementia to improve social reserves, which is the ability to overcome the decline in social cognition; support for family members for improving cognitive empathy, which is the ability to analyze the background of others’ behaviors and speech; and the involvement of the practitioner to supervise and empower them. The process of intervention is as follows: (1) selecting activities for collaboration; (2) sharing information on their current situation including declined abilities; (3) enhancing cognitive empathy through dementia education; (4) designing the intervention measures together; and (5) practice and feedback. Living with dementia involves a continuous process of coping with various challenges in daily living, however, the process of effectively managing these challenges is one of the ways to improve the quality of life of people with dementia and their family members. Full article
(This article belongs to the Special Issue Cognitive Aging and Cognitive Impairment)
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9 pages, 646 KiB  
Article
Dementia in an Acute Hospital Setting: Health Service Research to Profile Patient Characteristics and Predictors of Adverse Clinical Outcomes
by Inderpal Singh, Chris Edwards, Daniel Duric, Aman Rasuly, Sabdat Oziohu Musa and Anser Anwar
Geriatrics 2019, 4(1), 7; https://doi.org/10.3390/geriatrics4010007 - 2 Jan 2019
Cited by 5 | Viewed by 7339
Abstract
Introduction: Patients with dementia often have other associated medical co-morbidities resulting in adverse outcomes. The National Audit of Dementia (NAD) in the UK showed a wide variation in the quality and clinical care for acute dementia patients. This study aims to record the [...] Read more.
Introduction: Patients with dementia often have other associated medical co-morbidities resulting in adverse outcomes. The National Audit of Dementia (NAD) in the UK showed a wide variation in the quality and clinical care for acute dementia patients. This study aims to record the clinical profile and benchmark clinical outcomes of acute dementia patients admitted within Aneurin Bevan University Health Board, Wales (UK). Methods: This was a retrospective observational study based on analysis of the existing data for all acute dementia patients. Ethical approval was not required for this service evaluation. Results: In 2016, a total of 1770 dementia patients had 2474 acute admissions. We studied 1167 acute admissions (953 dementia patients) from 1st January 2016–30th June 2016. The mean age was 84.5 ± 7.8 years (females = 63.5%). Mean Charlson comorbidity index and the number of drugs were 6.0 ± 1.5 and 5.1 ± 2.1. 15.4% (147/953) patients were on antipsychotics. Overall mean hospital stay was 19.4 ± 27.2 days. 30-days readmission rate was 17.2% (138/800) with a mean hospital stay of 14.6 ± 17.9 days. 3.4% (32/953) patients were excluded due to a coding error. 70.3% (n = 670/953) were previously living in their own homes and only 26.3% (n = 251/953) were admitted from care homes. 59.5% patients (n = 399/670) were discharged back to their homes and 21.6% (145/670) were discharged to a new care home, which represents an approximately 1.68 times higher rate of new care home occupancy than the patients being originally admitted from a care home. Overall inpatient was 16.0% (153/953). 30-days and one-year mortality were 22.3% (213/953) and 49.2% (469/953) respectively. The observed mortality rates between patients admitted from home or from a care home were highly significant for one-year mortality (p < 0.001). The inpatient falls rate was significantly higher (1.8 times) as compared to overall general medical inpatient falls rate. Conclusion: Acute patients with dementia have a higher risk of adverse outcomes and the impact of hospitalisation. Prompt comprehensive geriatric assessment and quality improvement initiatives are needed to improve clinical outcomes and to enhance the quality of care. Full article
(This article belongs to the Special Issue Cognitive Aging and Cognitive Impairment)
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Other

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11 pages, 273 KiB  
Case Report
A Case Study on Polypharmacy and Depression in a 75-Year-Old Woman with Visual Deficits and Charles Bonnet Syndrome
by José Caamaño-Ponte, Martina Gómez Digón, Mercedes Pereira Pía, Antonio de la Iglesia Cabezudo, Margarita Echevarría Canoura and David Facal
Geriatrics 2022, 7(1), 5; https://doi.org/10.3390/geriatrics7010005 - 28 Dec 2021
Cited by 3 | Viewed by 2989
Abstract
Depression is one of the most prevalent pathologies in older adults. Its diagnosis and treatment are complex due to different factors that intervene in its development and progression, including intercurrent organic diseases, perceptual deficits, use of drugs, and psycho-social conditions associated with the [...] Read more.
Depression is one of the most prevalent pathologies in older adults. Its diagnosis and treatment are complex due to different factors that intervene in its development and progression, including intercurrent organic diseases, perceptual deficits, use of drugs, and psycho-social conditions associated with the aging process. We present the case of a 75-year-old woman (who lives in the community) with a diagnosis of major depression with more than 10 years of history, analyzing her evolution and therapeutic approach. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
8 pages, 506 KiB  
Case Report
Behavioral Interventions in Long-Term Care Facilities during the COVID-19 Pandemic: A Case Study
by Carlos Dosil-Díaz, David Facal and Romina Mouriz-Corbelle
Geriatrics 2022, 7(1), 1; https://doi.org/10.3390/geriatrics7010001 - 21 Dec 2021
Cited by 2 | Viewed by 2451
Abstract
During the COVID-19 pandemic, long-term care (LTC) centers have adopted a series of measures that have affected the physical and cognitive health of patients. The routines of the patients, as well as the interventions of professionals, have been altered. In the case presented [...] Read more.
During the COVID-19 pandemic, long-term care (LTC) centers have adopted a series of measures that have affected the physical and cognitive health of patients. The routines of the patients, as well as the interventions of professionals, have been altered. In the case presented here, our aim was to explain the effect that the strong confinement due to the spread of the first COVID-19 wave in Spain had on a 75-year-old resident in an LTC center, with cognitive and behavioral symptomatology compatible with a diagnosis of mixed dementia, as well as the measures that the center adopted to manage the lockdown situation in the best possible way, including personalized attention protocols and a video call program. Different nosological hypotheses are also raised using a semiological analysis, including the analysis of the initial and continuation diagnostic protocols, as well as the therapeutic options. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
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8 pages, 1941 KiB  
Case Report
Cognitive and Behavior Deficits in Parkinson’s Disease with Alteration of FDG-PET Irrespective of Age
by Fulvio Lauretani, Livia Ruffini, Crescenzo Testa, Marco Salvi, Mara Scarlattei, Giorgio Baldari, Irene Zucchini, Beatrice Lorenzi, Chiara Cattabiani and Marcello Maggio
Geriatrics 2021, 6(4), 110; https://doi.org/10.3390/geriatrics6040110 - 10 Nov 2021
Cited by 1 | Viewed by 2587
Abstract
Significant progress has been made in our understanding of the neurobiology of Parkinson’s disease (PD). Post-mortem studies are an important step and could help to comprehend not only the progression of motor symptoms, but also the involvement of other clinical domains, including cognition, [...] Read more.
Significant progress has been made in our understanding of the neurobiology of Parkinson’s disease (PD). Post-mortem studies are an important step and could help to comprehend not only the progression of motor symptoms, but also the involvement of other clinical domains, including cognition, behavior and impulse control disorders (ICDs). The correlation of neuropathological extension of the disease with the clinical stages remains challenging. Molecular imaging, including positron emission tomography (PET) and single photon computed tomography (SPECT), could allow for bridging the gap by providing in vivo evidence of disease extension. In the last decade, we have observed a plethora of reports describing improvements in the sensitivity of neuroimaging techniques. These data contribute to increasing the accuracy of PD diagnosis, differentiating PD from other causes of parkinsonism and also obtaining a surrogate marker of disease progression. FDG-PET has been used to measure cerebral metabolic rates of glucose, a proxy for neuronal activity, in PD. Many studies have shown that this technique could be used in early PD, where reduced metabolic activity correlates with disease progression and could predict histopathological diagnosis. The aim of this work is to report two particular cases of PD in which the assessment of brain metabolic activity (from FDG-PET) has been combined with clinical aspects of non-motor symptoms. Integration of information on neuropsychological and metabolic imaging allows us to improve the treatment of PD patients irrespective of age. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
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9 pages, 219 KiB  
Commentary
Giving Them a Voice: Challenges to Narrative Agency in People with Dementia
by Feliciano Villar, Rodrigo Serrat and Stephany Bravo-Segal
Geriatrics 2019, 4(1), 20; https://doi.org/10.3390/geriatrics4010020 - 12 Feb 2019
Cited by 12 | Viewed by 6853
Abstract
In this paper, we argue that the capacity for narrative agency is significantly compromised in individuals with dementia due to at least three factors: (a) Dementia itself, which causes increasing difficulties in constructing and articulating coherent and meaningful stories, and sharing them with [...] Read more.
In this paper, we argue that the capacity for narrative agency is significantly compromised in individuals with dementia due to at least three factors: (a) Dementia itself, which causes increasing difficulties in constructing and articulating coherent and meaningful stories, and sharing them with others; (b) cultural narratives about dementia, which promote an extremely negative and pessimistic view of those with the disease; and (c) the convergence of these two last factors, which can lead to caregiving interactions that do not support storytelling and can even stop people with dementia from telling stories. We highlight the importance of narrative care, which involves interventions that focus on the person and their unique life narrative. In narrative care, people with dementia are treated not as impaired patients defined by the disease, but as human beings. In doing so, people with dementia can have their own voices back, which is silenced and discredited so many times. Full article
(This article belongs to the Special Issue Cognitive Aging and Cognitive Impairment)
10 pages, 252 KiB  
Case Report
Dementia and Challenging Behaviors in Gerontological Centers. A Case Report
by Romina Mouriz, José Caamaño Ponte, Laura García Tuñas, Carlos Dosil and David Facal
Geriatrics 2019, 4(1), 15; https://doi.org/10.3390/geriatrics4010015 - 22 Jan 2019
Cited by 1 | Viewed by 6287
Abstract
Among the main challenges in geriatric and gerontological centers, we consider, central, the individualized attention to those elderly persons with challenging behaviors, to the extent that it is possible to design preventive strategies that delay cognitive deterioration and minimize consequences of behavior disorders. [...] Read more.
Among the main challenges in geriatric and gerontological centers, we consider, central, the individualized attention to those elderly persons with challenging behaviors, to the extent that it is possible to design preventive strategies that delay cognitive deterioration and minimize consequences of behavior disorders. The first step will be to develop the correct interpretation of symptoms and deficits as a guarantee of a correct diagnosis which, in addition to not always being easy, has to be adapted to the progression of the disease. We present the case of a 68-year-old institutionalized individual, with an initial diagnosis of diffuse Lewy bodies dementia, analyzing his cognitive and behavioral evolution, and the pharmacological and non-pharmacological approach to the case. Full article
(This article belongs to the Special Issue Cognitive Aging and Cognitive Impairment)
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