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1.
J Neuropsychiatry Clin Neurosci ; 36(2): 110-117, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37849313

RESUMO

OBJECTIVE: Recent studies suggest that psychosocial factors can have an impact on brain health. Yet, it is unclear whether psychosocial stress affects aging of the brain. The aim of the study was to investigate the association between psychosocial stress and brain aging. METHODS: Data from the German population-based cohort Study of Health in Pomerania (N=991; age range 20-78 years) were used to calculate a total psychosocial stress score by combining subscores from five domains: stress related to the living situation, the occupational situation, the social situation, danger experiences, and emotions. Associations with brain aging, indicated by an MRI-derived score quantifying age-related brain atrophy, were estimated by using regression models adjusted for age, gender, education, diabetes, problematic alcohol consumption, smoking, and hypertension. RESULTS: The relative risk ratio for advanced brain aging was 1.21 (95% CI=1.04-1.41) for stress related to emotions in fully adjusted models. The interactions between stress related to emotions and mental health symptoms were also significantly associated with advanced brain aging. The association between higher total psychosocial stress and brain aging was not statistically significant. CONCLUSIONS: These findings highlight that high stress related to emotions is associated with advanced brain aging. To protect brain health in older age, more research is needed to explore the role of emotional distress.


Assuntos
Consumo de Bebidas Alcoólicas , Encéfalo , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Estudos de Coortes , Encéfalo/diagnóstico por imagem , Envelhecimento , Estresse Psicológico/epidemiologia
2.
J Asthma ; 61(11): 1477-1487, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38805388

RESUMO

OBJECTIVE: To assess the associations of asthma status or age at asthma diagnosis with cognition using the Telephone Survey of Cognitive Status from a large population-based sample. Further, we investigated the possibility that asthma treatment mediates these associations. METHODS: This is a cross-sectional study from the Indonesian Family Life Survey Fifth Wave (IFLS-5) collected in 2014-2015. A weighted linear regression model was used to examine the associations between asthma and cognitive functioning scores in adults aged 50 years or older. Of the 6660 total samples included in this study, 176 participants had asthma (2.6%). We controlled for age, sex, and urbanicity with further adjustments for adult covariates or childhood covariates, as appropriate. RESULTS: There was no association between overall asthma status and cognitive functioning scores. However, asthma diagnosed at 0-19 years was associated with significantly higher cognitive functioning scores (Beta coefficient = 2.24, 95% CI: 0.62 - 0.87), compared to those without asthma. In the analysis involving current treatment status (restricted analysis), the significant association disappeared among those under current asthma treatment status, indicating that asthma treatment may mediate the association. CONCLUSION: Asthma might not be a risk factor for cognitive impairment. Observations of a significant association of pediatric asthma with higher cognitive scores need further investigation. Understanding cognitive functioning among older adults with asthma may improve the surveillance of cognitive decline inthis age group.


Assuntos
Asma , Cognição , Humanos , Asma/epidemiologia , Asma/diagnóstico , Asma/complicações , Asma/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Transversais , Idoso , Fatores Etários , Indonésia/epidemiologia , Adolescente , Adulto Jovem , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/diagnóstico , Criança , Pré-Escolar , Adulto
3.
Age Ageing ; 53(3)2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38497234

RESUMO

BACKGROUND: The aim of this study was to investigate the role of support from the social environment for the life expectancy in people with dementia beyond well-established individual demographic and clinical predictors over a period of up to 8 years. METHODS: The analyses are based on data from 500 community-dwelling individuals in Germany who tested positive for dementia and were followed up for up to 8 years. Life expectancy was examined in relation to perceived social support as well as well-established socio-demographic (age, sex) and clinical predictors (cognitive status, functional status, comorbidities), using Cox regressions. RESULTS: Greater support from the social environment reduced the risk of mortality (hazard ratio [HR]: 0.78; 95% confidence interval [CI]: 0.63-0.98), with the role of emotional support being particularly important. Furthermore, higher age was associated with an increased mortality risk (HR: 1.08; 95% CI: 1.05-1.11), while female sex (HR: 0.64; 95% CI: 0.48-0.85) and higher cognitive (HR: 0.96; 95% CI: 0.93-0.98) and functional status (HR: 0.91; 95% CI: 0.86-0.97) were associated with higher life expectancy. CONCLUSION: Our study provides novel evidence that less support from the social environment, especially emotional support, is a risk factor for shorter life expectancy in people with dementia-beyond known clinical factors. Not only the clinical and caregiving needs but also their psychosocial needs of individuals with dementia should be emphasised.


Assuntos
Demência , Humanos , Feminino , Demência/diagnóstico , Fatores de Proteção , Apoio Social , Modelos de Riscos Proporcionais , Expectativa de Vida
4.
Psychogeriatrics ; 24(1): 108-116, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38014476

RESUMO

BACKGROUND: People with dementia experience severe problems in their daily lives. However, little is known about self-perceived problems in the course of dementia. The aim of our study was to assess self-perceived problems with daily activities as well as individually developed strategies of older people of different cognitive status. METHODS: Semi-structured interviews were conducted with 25 participants (mean age 67.6 years, 56% female, 24% healthy, 28% mild dementia, 48% severe dementia). Questions addressed problems in daily activities, their occurrence and the behaviour toward them, and their developed strategies. Information was summarized quantitatively and evaluated using the chi-squared and Kruskal-Wallis tests. RESULTS: Self-perceived problems included awareness of physical and cognitive deficits in managing daily life, disturbing factors, and lost autonomy. Increased cognitive impairment was associated with more problems in daily life, even though people with severe dementia seemed not to recognize them. The most frequently reported strategies included orderliness, doing things immediately, and the use of external aids. While healthy people and those with mild dementia developed strategies, those with severe dementia reported only few strategies. CONCLUSION: Our findings indicate that self-perceived problems in daily life and strategy development are strongest in mild dementia, while people with more severe dementia tend to perceive no problems at all while correctly reflecting their current state of dependency. Importantly, despite memory loss during early stages of dementia, strategies are still being developed. Accordingly, strategies for daily living should be taught in early dementia to sustain an independent lifestyle.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Demência , Humanos , Feminino , Idoso , Masculino , Demência/diagnóstico , Demência/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Amnésia , Nível de Saúde , Atividades Cotidianas/psicologia
5.
Int J Geriatr Psychiatry ; 38(8): e5989, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37594395

RESUMO

BACKGROUND: Memory problems are common in advanced age. Memory strategies can be used to manage such challenges. To assist older people facing memory problems, we conducted a pilot study to evaluate the usability of a memory aid handbook that we developed specifically for this purpose. METHOD: A memory aid handbook with a 7-week program was developed based on a systematic review. A total of 19 older people with self-reported memory problems (mean age: 76.11 years, female: 73.68%) tested the memory aid handbook and completed the System Usability Scale (SUS), a checklist on the relevance of the strategies in the handbook, and questionnaires on daily life functioning and self-efficacy. Further, they participated in cognitive tests. In a pre-post design, within-subject differences were determined using paired t-tests. RESULTS: The usability of the memory aid handbook scores as were high (mean SUS score: 99.21). The checklist indicated that the handbook was perceived as beneficial for confirming already established memory strategies and stimulating new ones, such as self-acceptance, visualizing and verbalizing daily routines, and asking for help. In addition, the checklist revealed that using a calendar was considered the most helpful strategies for daily living, followed closely by taking notes, having specific places for certain items and creating routines in daily life. After the 7 weeks, participants scored significantly better in the cognitive and self-efficacy tests. The exploratory nature of the study combined with the small sample size should be considered when interpreting the results. CONCLUSION: The usability of the handbook was high, reflecting the relevance of the strategies it contains. Teaching memory strategies can be a useful, inexpensive method to foster independence among those at risk for cognitive impairment.


Assuntos
Disfunção Cognitiva , Humanos , Feminino , Idoso , Projetos Piloto , Cabeça , Transtornos da Memória , Testes Neuropsicológicos
6.
Int Psychogeriatr ; : 1-14, 2023 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-37039457

RESUMO

OBJECTIVE: Previous studies have shown that socioeconomically deprived groups exhibit higher lesion load of the white matter (WM) in aging. The aim of this study was to (i) investigate to what extent education and income may contribute to differences in white matter hyperintensities (WMHs) and (ii) identify risk profiles related to a higher prevalence of age-associated WMH. DESIGN AND SETTING: Population-based adult study of the Leipzig Research Centre for Civilization Diseases (LIFE) in Leipzig, Germany. PARTICIPANTS: Dementia-free sample aged 40-80 years (n = 1,185) derived from the population registry. MEASUREMENTS: Information was obtained in standardized interviews. WMH (including the derived Fazekas scores) were assessed using automated segmentation of high-resolution T1-weighted anatomical and fluid-attenuated inversion recovery (FLAIR) MRI acquired at 3T. RESULTS: Despite a significant association between income and WMH in univariate analyses, results from adjusted models (age, gender, arterial hypertension, heart disease, and APOE e4 allele) indicated no association between income and WMH. Education was associated with Fazekas scores, but not with WMH and not after Bonferroni correction. Prevalence of some health-related risk factors was significantly higher among low-income/education groups. After combining risk factors in a factor analysis, results from adjusted models indicated significant associations between higher distress and more WMH as well as between obesity and more deep WMH. CONCLUSIONS: Previously observed differences in WMH between socioeconomically deprived groups might stem from differences in health-related risk factors. These risk factors should be targeted in prevention programs tailored to socioeconomically deprived individuals.

7.
BMC Geriatr ; 23(1): 160, 2023 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-36949404

RESUMO

BACKGROUND: It is well known that older age is associated with losses in cognitive functioning. Less is known about the extent to which creativity is changing with age or dementia. Aim of the current study was to gain more insights into psychometric aspects of creativity in younger and older people as well as people with dementia. METHOD: Our sample comprised three groups, (1) participants between age 18-30 years (n = 24), (2) participants 65 + years without cognitive impairment (n = 24), and (3) participants 65 + years with cognitive impairment / dementia (n = 23). Cognitive abilities were assessed via the Standard Progressive Matrices Test (SPM), Montreal Cognitive Assessment Test (MoCa), and Trail Making Test (TMT). Creativity was assessed via the Creative Reasoning Task (CRT), Test of Creative Thinking-Drawing Production (TCT-DP), and Alternate Uses Task (AUT). RESULTS: Compared to younger people, older people scored significantly lower in only two out of eleven creativity sub-scores (one in the CRT and one in the TCT-DP). Performance in the SPM was significantly associated with these two sub-scores and age. Cognitively impaired older people had significantly lower scores in the creativity task AUT compared to cognitively healthy older people and younger people. The associations between MoCa and AUT scores were also significant. CONCLUSION: Creativity appears relatively stable in older age, with exception of those creativity skills that are affected by abstract reasoning (SPM), which appear susceptible to aging. As our findings suggest, cognitive impairment in older age might impair only some aspects of creativity with other creativity aspects being comparable to cognitively healthy people. The age-related and the cognitive status-related effects seem to be independent. The preserved creative abilities can be used in dementia care programs.


Assuntos
Disfunção Cognitiva , Criatividade , Demência , Idoso , Humanos , Cognição , Demência/diagnóstico , Longevidade
8.
Int J Psychol ; 58(5): 465-475, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37248624

RESUMO

Musical stimuli are widely used in emotion research and intervention studies. However, reviews have repeatedly noted that a lack of pre-evaluated musical stimuli is stalling progress in our understanding of specific effects of varying music. Musical stimuli vary along a plethora of dimensions. Of particular interest are emotional valence and tempo. Thus, we aimed to evaluate the emotional valence of a set of slow and fast musical stimuli. N = 102 (mean age: 39.95, SD: 13.60, 61% female) participants rated the perceived emotional valence in 20 fast (>110 beats per minute [bmp]) and 20 slow (<90 bpm) stimuli. Moreover, we collected reports on subjective arousal for each stimulus to explore arousal's association with tempo and valence. Finally, participants completed questionnaires on demographics, mood (profile of mood states), personality (10-item personality index), musical sophistication (Gold-music sophistication index), and sound preferences and hearing habits (sound preference and hearing habits questionnaire). Using mixed-effect model estimates, we identified 19 stimuli that participants rated to have positive valence and 16 stimuli that they rated to have negative valence. Higher age predicted more positive valence ratings across stimuli. Higher tempo and more extreme valence ratings were each associated with higher arousal. Higher educational attainment was also associated with higher arousal reports. Pre-evaluated stimuli can be used in future musical research.


Assuntos
Música , Humanos , Feminino , Adulto , Masculino , Música/psicologia , Emoções , Nível de Alerta , Afeto , Percepção , Percepção Auditiva
9.
Artigo em Inglês | MEDLINE | ID: mdl-35362220

RESUMO

OBJECTIVES: Dealing with memory loss is a major challenge for older people. Coping strategies for memory problems could enable cognitively impaired people to live independently for longer. We conducted a systematic review to summarize evidence on coping strategies for older people and people with cognitive impairment to stabilize everyday life functioning. METHODS: We systematically searched the databases PubMed, PsychInfo, Scopus and WebofScience using a well-defined search string. Studies were included if they were published between January 1990 and February 2021 and written in English, German, Spanish, French, or Swedish language. Two blind researchers independently checked the studies for inclusion and exclusion criteria and evaluated the quality of the studies using Critical Appraisal Skills Programme-checklists. Evidence was summarized in a narrative synthesis. RESULTS: A total of 16 relevant studies with adequate quality were identified. These studies reported on three categories of strategies: external, internal, and behavioral coping strategies. External strategies included reminder systems and integrated features in the environment and were used by people with and without cognitive impairments. Internal strategies such as visualization, verbalization, active remembering, and systematic thinking were reported less often by people with cognitive impairment than those without cognitive impairment. Behavioral strategies such as reducing expectations and acceptance of support was most frequently reported by people with cognitive impairment. CONCLUSIONS: The findings of our systematic review show a great number of coping strategies, which seem to depend on cognitive status. Appropriate training tools incorporating these strategies should be developed.


Assuntos
Disfunção Cognitiva , Transtornos da Memória , Adaptação Psicológica , Idoso , Amnésia , Disfunção Cognitiva/psicologia , Humanos
10.
Artigo em Inglês | MEDLINE | ID: mdl-34571579

RESUMO

OBJECTIVE: Interventions to reduce the risk of cognitive decline and dementia largely focus on individual-level strategies. To maximize risk reduction, it is also necessary to consider the environment. With the majority of older people living in cities, we explored how urban environments could support risk reduction. MATERIALS AND METHODS: In our qualitative study, we conducted semi-structured interviews with community members aged ≥65 years and stakeholders, all living in Leipzig, Germany. Interview guides were informed by the framework on modifiable risk factors for dementia of the Lancet Commission on Dementia Prevention, Intervention, and Care. Interviews were audio-recorded, verbatim-transcribed, and thematically analysed. RESULTS: Community members (n = 10) were M = 73.7 (SD = 6.0) years old and 50% were women. Stakeholders (n = 10) were aged 39-72 years, and 70% were women. Stakeholders' fields included architecture, cultural/arts education, environmental sciences, geriatrics, health policy, information and technology, philosophy, psychology, public health, and urban sociology. Across interviews with both older individuals and stakeholders, three main themes were identified: (i) social participation and inclusion (emphasizing social contacts, social housing, intergenerationality, neighbourhood assistance, information and orientation, digital and technological literacy, lifelong learning, co-creation/co-design), (ii) proximity and accessibility (emphasizing proximity and reachability, mobility, affordability, access to health care, access to cultural events, public toilets), (iii) local recreation and wellbeing (emphasizing safety in traffic, security, cleanliness and environmental protection, urban greenery, climate change and heat waves, outdoor physical activity). DISCUSSION: The design of urban environments holds large potential to create favourable conditions for community-dwelling individuals to practice lifestyles that promote brain health. Public policy should involve community members in co-creating such environments.


Assuntos
Demência , Vida Independente , Idoso , Demência/prevenção & controle , Feminino , Humanos , Pesquisa Qualitativa , Características de Residência , Comportamento de Redução do Risco
11.
Int J Geriatr Psychiatry ; 36(7): 1085-1094, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33860548

RESUMO

OBJECTIVES: Social deprivation, i.e. the relative deprivation in socioeconomic domains, is known to exacerbate disease risk. Less is known about its role in cognitive functioning and decline in older adults. This study aimed to investigate the association between social deprivation and cognitive status as well as rate of decline. METHODS: We analysed data from the nationally representative Health and Retirement study (HRS) of individuals aged 50 and older. The analysis sample contained 11,101 respondents (mean age at baseline: 69.4, SD: 8.6%, 55% female) with at least two cognitive assessments (mean follow up: 11.2, SD: 5.4). To quantify social deprivation we constructed a social deprivation index (SDI) with structural equation modelling. Multiple growth curve modelling was used to model cognitive status and decline as predicted by SDI. RESULTS: After adjusting for covariates, greater social deprivation was associated with poorer cognitive status (ß = -0.910, p < 0.001; 95% CI: -0.998-0.823) and faster cognitive decline (ß = -0.005, p = 0.002; 95% CI:-0.009-0.002). Of the covariates, depressive symptoms, chronic disease burden, belonging to a racial or ethnical minority, and male gender were also associated with poorer cognitive status. Marriage statuses other than being married or partnered had a positive association with cognitive status. CONCLUSIONS: Our findings indicate that greater social deprivation was associated with significantly poorer cognitive status implying that preventing social deprivation can contribute to raising cognitive functioning in the older population and help reduce the incidence of dementia. Policy that facilitates early intervention in social deprivation will be key.


Assuntos
Disfunção Cognitiva , Idoso , Cognição , Disfunção Cognitiva/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Aposentadoria
12.
Int J Geriatr Psychiatry ; 36(12): 1908-1921, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34378818

RESUMO

OBJECTIVES: Previous studies have shown that higher education promotes cognitive health. This effect, however, is embedded in the living conditions of a particular country. Since it is not clear to what extent the country and its specific living standards are necessary preconditions for the observed effect, we investigated whether the impact of education and income on cognitive functioning differs between countries. METHODS: Analyses were based on harmonized data from the World Health Organization's multi-country Study on global AGEing and adult health, the Health and Retirement Study, and the Survey of Health, Ageing and Retirement in Europe of over 85,000 individuals aged 50 years and older. Analyses were conducted via multivariate regression analyses and structural equation modeling adjusted for age, gender, marital status, health status, and depression. RESULTS: The effect of education was twice as large as the effect of income on cognitive functioning and indirectly moderated the effect of income on cognitive functioning. The effect sizes varied strongly between countries. The country's gross domestic product per capita seems to influence cognitive functioning. CONCLUSIONS: Our findings indicate that education has a dominant effect on cognitive functioning in people aged 50 years and older, which might even offset the adverse implications of living with low income on cognitive health. Therefore, expanding efforts to achieve universal education are essential to mitigate health disparities due to low income and early life disadvantages, including chances for good cognitive functioning over the life-span.


Assuntos
Cognição , Renda , Idoso , Envelhecimento , Escolaridade , Humanos , Pessoa de Meia-Idade , Fatores Socioeconômicos
13.
Int J Geriatr Psychiatry ; 36(1): 152-162, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32819031

RESUMO

OBJECTIVES: Previous studies have observed protective effects of high mental demands at work on cognitive functioning and dementia risk. However, it is unclear what types of demands drive this effect and whether this effect is subject to a person's genetic risk. We investigated to what extent eight different types of mental demands at work together with the APOE e4 allele, a major risk gene for late-onset Alzheimer's disease, affect cognitive functioning in late life. METHODS/DESIGN: The population-based German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe, n = 2 154) followed cognitively healthy individuals aged 75 years and older in seven assessment waves. Cognitive functioning was assessed via the mini-mental status examination. RESULTS: Mixed-effects modeling (adjusted for education, gender, marital status, stroke, depression, and diabetes) indicated that participants who had an occupational history of working in jobs with high compared to low demands in "Language & Knowledge", "Pattern detection", "Information processing", and "Service" had a slower cognitive decline. APOE e4-allele carriers had an accelerated cognitive decline, but this decline was significantly smaller if they had a medium compared to a low level of demands in contrast to non-carriers. CONCLUSIONS: Our longitudinal observations suggest that cognitive decline could be slowed by an intellectually enriched lifestyle even in risk gene carriers. Fostering intellectual engagement throughout the life-course could be a key prevention initiative to promote better cognitive health in old age.


Assuntos
Disfunção Cognitiva , Demência , Idoso , Envelhecimento , Alelos , Apolipoproteína E4/genética , Apolipoproteínas E/genética , Cognição , Disfunção Cognitiva/genética , Demência/genética , Humanos , Idioma , Atenção Primária à Saúde
14.
Int Psychogeriatr ; 33(12): 1309-1320, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34494514

RESUMO

OBJECTIVES: Previous work using a US sample has shown that an index of social deprivation (SoDep Index) is associated with cognitive functioning and decline in older adults. This study aimed to replicate these findings using a European sample (Survey of Health, Ageing and Retirement in Europe, SHARE). DESIGN: We analyzed data of 51,630 respondents aged 50 years and older (M: 63.5 years, standard deviation [SD]: 9.1) with at least two cognitive assessments (follow-up M: 6.06 years, SD: 3.86). Cognitive scores were transformed to Z-scores. Multiple growth curve modeling was used to model cognitive status and decline as predicted by the SoDep Index. In a sensitivity analysis, we constructed a new SoDep Index (SoDep Indexnew) including further social deprivation domains. RESULTS: Adjusting for covariates, a unit increase in SoDep Index was associated with a cognitive score of 0.037 SDs smaller (p < .001) and a decline 0.003 SDs per year faster (p < .001). Of the covariates, depressive symptoms, chronic disease burden, male gender, and widowhood were also associated with poorer cognition. Being divorced was associated with better cognition. Sensitivity analysis confirmed findings. Compared to the SoDep Index, the SoDep Indexnew showed a more pronounced association with both cognition and cognitive decline. CONCLUSIONS: We were able to replicate results showing an association between SoDep Index and cognitive function and decline. The sensitivity analysis further emphasizes the relevance of financial security. This strengthens the implication that preventing social deprivation can contribute to reducing the dementia burden by raising cognitive functioning in the older population. The findings are relevant to policy-makers and health care practitioners.


Assuntos
Disfunção Cognitiva , Privação Social , Idoso , Cognição , Disfunção Cognitiva/diagnóstico , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Aposentadoria
15.
Int Psychogeriatr ; 33(7): 715-726, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-32434623

RESUMO

OBJECTIVES: Research shows that mental demands at work affect later-life cognitive functioning and dementia risk, but systematic assessment of protective mental work demands (PMWDs) is still missing. The goal of this research was to develop a questionnaire to assess PMWDs. DESIGN: The instrument was developed in accordance with internationally recognized scientific standards comprising conceptualization, pretesting, and validation via confirmatory factor analysis (CFA), principal component analysis (PCA), and multiple regression analyses. PARTICIPANTS: We included 346 participants, 72.3% female, with an average age of 56.3 years. MEASUREMENT: Item pool, sociodemographic questions, and cognitive tests: Trail-Making Test A/B, Word List Recall, Verbal Fluency Test, Benton Visual Retention Test, Reading Minds in the Eyes Test. RESULTS: CFAs of eight existing PMWD-concepts revealed weaker fit indices than PCA of the item pool that resulted in five concepts. We computed multivariate regression analyses with all 13 PMWD-concepts as predictors of cognitive functioning. After removing PMWD-concepts that predicted less than two cognitive test scores and excluding others due to overlapping items, the final questionnaire contained four PMWD-concepts: Mental Workload (three items, Cronbach's α = .58), Verbal Demands (four, Cronbach's α = .74), Information Load (six, Cronbach's α = .83), and Extended Job Control (six, Cronbach's α = .83). CONCLUSIONS: The PMWD-Questionnaire intends to assess protective mental demands at the workplace. Information processing demands and job control make up the primary components emphasizing their relevance regarding cognitive health in old age. Long-term follow-up studies will need to validate construct validity with respect to dementia risk.


Assuntos
Cognição , Fatores de Proteção , Medição de Risco , Inquéritos e Questionários , Local de Trabalho/psicologia , Demência/diagnóstico , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores Sociológicos
16.
Aging Ment Health ; 25(9): 1649-1658, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-32347107

RESUMO

OBJECTIVES: Previous work has shown that high mental demands are associated with better cognitive functioning in old age. As there is a lack of a general conceptual framework for this association, the aim of the study was to investigate how mental demands and other work-related factors relate to cognitive functioning as a foundation for developing such a framework. METHODS: An expert panel discussion was conducted with the aim of determining relevant work-related factors, which were then tested in a survey with 346 employees aged 50+ years, who were actively working. Assessment of cognitive functioning comprised complex attention, executive function, learning/memory, language, perceptual-motor, and social cognition. Confirmatory factor analysis was conducted to confirm factor belonging. Associations with cognitive functioning were analyzed using structure equation modelling to confirm associations and to identify additional direct and indirect paths. RESULTS: Only 42.3% (22/52) of the work-related factors and 19.0% (4/21) of the mediating paths suggested by the experts were significant with respect to cognitive functioning. Factor analysis and structural equation modeling indicated that high mental demands are only associated with better cognitive functioning in old age to the extent that they are intellectually stimulating and this effect is embedded in individual capacities and the social context. CONCLUSION: Based on the panel discussion and the empirical testing, we propose the Conceptual Framework of Social Dependency of Intellectual Stimulation on Cognitive Health. We recommend researchers and workplace health experts to pay attention to the component of this theory when assessing workplace risk.


Assuntos
Cognição , Local de Trabalho , Função Executiva , Humanos , Idioma , Inquéritos e Questionários
17.
Psychogeriatrics ; 21(1): 3-13, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33263217

RESUMO

BACKGROUND: Since dementia is a result of cognitive rather than physical impairment, cognitive aspects are important for care planning. This mixed-model study aims to understand how the loss of cognitive functioning affects mental representations of daily activities. METHODS: Mental representations were assessed via the script generation task of daily activities (grocery shopping, dentist appointment, doing laundry, leaving the house, car accident) and a qualitative semi-structured interview from 25 people (age (mean: 67.64; SD: 23.625), gender (f: 14 (56%); m: 17 (68%)). Cognitive status was assessed via the Montreal Cognitive Assessment. RESULTS: Mental representations of daily activities loose content and get inaccurate throughout the disease (i.e. number of actions, abstractions, unemotional content) with poorer cognitive status. People with mild dementia report the most strategies and extend their mental representation by including strategies to circumvent experienced problems. Overall, mental representations of daily activities seem to be largely intact throughout the course of dementia (i.e. sequencing, personalisations, intrusions, examples, emotional content). CONCLUSION: This study outlines that even though the content of mental representations decreases with dementia, the mental representations themselves remain in good order. Performance of daily activities throughout dementia may be hampered by the loss of content of the generated actions.


Assuntos
Disfunção Cognitiva , Demência , Atividades Cotidianas , Humanos , Testes de Estado Mental e Demência
18.
BMC Geriatr ; 20(1): 540, 2020 12 29.
Artigo em Inglês | MEDLINE | ID: mdl-33375944

RESUMO

BACKGROUND: The outbreak of the Corona virus is a challenge for health care systems worldwide. The aim of this study is to analyze a) knowledge about, and feelings related to the Corona-pandemic. Describe b) loneliness, depression and anxiety and, c) the perceived, immediate impact of the lockdown on frequency of social contacts and quality of health care provision of people with cognitive impairment during social distancing and lockdown in the primary care system and living at home in Germany. METHODS: This analysis is based on data of a telephone-based assessment in a convenience sample of n = 141 people with known cognitive impairment in the primary care setting. Data on e.g. cognitive and psychological status prior to the pandemic was available. Attitudes, knowledge about and perceived personal impact of the pandemic, social support, loneliness, anxiety, depression, change in the frequency of social activities due to the pandemic and perceived impact of the pandemic on health care related services were assessed during the time of lockdown. RESULTS: The vast majority of participants are sufficiently informed about Corona (85%) and most think that the measures taken are appropriate (64%). A total of 11% shows one main symptom of a depression according to DSM-5. The frequency of depressive symptoms has not increased between the time before pandemic and lockdown in almost all participants. The sample shows minimal (65.0%) or low symptoms of anxiety (25%). The prevalence of loneliness is 10%. On average seven activities have decreased in frequency due to the pandemic. Social activities related to meeting people, dancing or visiting birthdays have decreased significantly. Talking with friends by phone and activities like gardening have increased. Utilization of health care services like day clinics, relief services and prescribed therapies have been reported to have worsened due to the pandemic. Visits to general practitioners decreased. CONCLUSIONS: The study shows a small impact of the pandemic on psychological variables like depression, anxiety and loneliness in the short-term in Germany. There is a decrease in social activities as expected. The impact on health care provision is prominent. There is a need for qualitative, in-depth studies to further interpret the results.


Assuntos
COVID-19 , Disfunção Cognitiva , Idoso , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Alemanha/epidemiologia , Humanos , Pandemias , SARS-CoV-2
19.
Aging Ment Health ; 24(7): 1064-1070, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31129995

RESUMO

Objectives: Mental demands at the workplace can be preventive against cognitive decline. However, personality shapes the way information is processed and we therefore assume that Neuroticism, Extraversion, Openness, Agreeableness and Conscientiousness, would moderate the beneficial effects of workplace stimulation on cognitive outcomes.Methods: We analyzed data from the population-based LIFE-Adult-Study (n = 6529). Cognitive outcomes were assessed via the Trail-Making Test (TMTA, TMTB) and the Verbal Fluency Test. Personality was assessed via the Personality Adjective List (16 AM). Mental demands were classified with the indices Verbal and Executive based on the O*NET database.Results: Multivariate regression analyses showed only two significant moderation effects of personality, i.e. in individuals with low scores on Conscientiousness/Openness, index Verbal was connected to better TMTB performance, while this effect disappeared for individuals with high values on the personality trait. However, the additional explained variance remained marginal.Conclusion: The findings suggest that personality does not modify associations between high mental demands at work and better cognitive functioning in old age; however, there is a tendency that high levels of Openness and Conscientiousness may offset effects of mental demands.


Assuntos
Cognição , Extroversão Psicológica , Local de Trabalho , Humanos , Neuroticismo , Personalidade
20.
Dement Geriatr Cogn Disord ; 47(4-6): 335-344, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31466060

RESUMO

BACKGROUND: The capacity to mitigate dementia symptomology despite the prevailing brain pathology has been attributed to cognitive reserve. OBJECTIVES: This study aimed to investigate how psychometric performance differs between individuals with a high school versus college education (surrogate measures for medium and high cognitive reserves) given the same level of brain pathology assessed using quantitative structural MRI. METHODS: We used data from the Aging Brain: Vasculature, Ischemia, and Behavior Study (ABVIB). Cognition was assessed using a neuropsychological battery that included those contained in the National Alzheimer's Coordinating Center (NACC) uniform data set. Participants with a medium and high cognitive reserve were matched by level of structural MRI changes, gender, and age. RESULTS: Matched-pair regression analyses indicated that individuals with a higher education had a significantly better performance in recognition and verbal fluency animals, working memory, and processing speed in complex tasks. Moreover, they had a better performance in interference trails compared to individuals with a high school education (medium cognitive reserve). CONCLUSIONS: Our findings suggest that, given the same level of brain pathology, individuals with a higher education (cognitive reserve) benefit from a superior performance in semantic memory and executive functioning. Differences in these cognitive domains may be key pathways explaining how individuals with a high cognitive reserve are able to diminish dementia symptomatology despite physical changes in the brain.


Assuntos
Envelhecimento/psicologia , Cognição/fisiologia , Reserva Cognitiva/fisiologia , Escolaridade , Psicometria , Idoso , Idoso de 80 Anos ou mais , Encéfalo/diagnóstico por imagem , Estudos de Coortes , Função Executiva , Feminino , Envelhecimento Saudável , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Memória de Curto Prazo , Testes Neuropsicológicos , Estudos Prospectivos , Tempo de Reação
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