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Cognitive dispersion is related to subtle objective daily functioning changes in older adults with and without cognitive impairment.

ABSTRACT: Early detection of cognitive and functional decline is difficult given that current tools are insensitive to subtle changes. The present study evaluated whether cognitive dispersion on neuropsychological testing improved prediction of objectively assessed daily functioning using unobtrusive monitoring technologies. Hierarchical linear regression was used to evaluate whether cognitive dispersion added incremental information beyond mean neuropsychological performance in the prediction of objectively assessed IADLs (i.e., computer use, pillbox use, driving) in a sample of 104 community-dwelling older adults without dementia (M_age = 74.59, 38.5% Female, 90.4% White). Adjusting for age, sex, education, and mean global cognitive performance, cognitive dispersion improved prediction of average daily computer use duration (R² Δ = 0.100, F Change, p = 0.005), computer use duration variability (R² Δ = 0.089, F Change p = 0.009), and average daily duration of nighttime driving (R² Δ = 0.072, F Change p = 0.013). These results suggest cognitive dispersion may improve prediction of objectively assessed functional changes in older adults without dementia.

SUBMITTER: De Vito AN

PROVIDER: S-EPMC10835082 | biostudies-literature | 2024 Jan-Mar

REPOSITORIES: biostudies-literature

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Cognitive dispersion is related to subtle objective daily functioning changes in older adults with and without cognitive impairment.

De Vito Alyssa N AN Ju Catherine H CH Lee Samuel Y SY Cohen Anael Kuperwajs AK Trofimova Alexandra D AD Liu Yan Y Eichten Alyssa A Hughes Adriana A

Alzheimer's & dementia (Amsterdam, Netherlands) 20240101 1

Early detection of cognitive and functional decline is difficult given that current tools are insensitive to subtle changes. The present study evaluated whether cognitive dispersion on neuropsychological testing improved prediction of objectively assessed daily functioning using unobtrusive monitoring technologies. Hierarchical linear regression was used to evaluate whether cognitive dispersion added incremental information beyond mean neuropsychological performance in the prediction of objectiv ...[more]

PMID: 38312515

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Project description:BackgroundThe presence of cognitive impairment (CI) among hospitalized older adults (aged 85 years and older) could interfere with the identification and treatment of other important symptoms experienced by these patients. Little is known, however, about the nursing care provided to this group. Contrasting the nursing care provided to patients with and without CI may reveal important insights about symptom treatment in the CI population.ObjectiveThe aim of this study was to examine the relationship of CI to nursing care provided and length of stay for hospitalized older adults using standardized nursing data retrieved from electronic health records.MethodsWe conducted a comparative secondary data analysis. A data set of standardized nursing plan of care data retrieved from electronic health record data of nine units at four hospitals was analyzed. The plan of care data for this study were previously transformed into one of eight categories (family, well-being, mental comfort, physical comfort, mental, safety, functional, and physiological care). Fisher exact tests were used to compare the differences in the nursing care for hospitalized older adults with and without CI. Mixed-effects models were used to examine associations of patient's cognitive status and nursing care, and cognitive status and length of stay.ResultsWe identified 4,354 unique patients; 746 (17%) had CI. We observed that older adults with CI were less likely to receive physical comfort care than those without CI for seven of nine units. Older adults' cognitive status was associated with the delivery of mental comfort care. In addition, a worsening in cognitive status was associated with an increase in length of stay for older adults with CI.DiscussionOlder adults with CI appeared to be undertreated for symptoms of pain when compared to those without CI across units. There is a need for further research to improve symptom recognition and management for this population. The presence of CI was associated with variation in nursing care provided and length of stay. Future studies that include the analysis of nursing data merged with elements stored in the electronic health record representing the contributions of other health professions are expected to provide additional insights into this gap.

Dataset Information

Cognitive dispersion is related to subtle objective daily functioning changes in older adults with and without cognitive impairment.

Publications

Cognitive dispersion is related to subtle objective daily functioning changes in older adults with and without cognitive impairment.

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