Risk of Cognitive and Functional Impairment in Spouses of People With Dementia: Evidence From the Health and Retirement Study.

Caring for a spouse with dementia is a chronic stressor that may compromise caregivers' own cognitive functioning and capacity to provide adequate care. We examined whether having (i) a spouse with dementia and (ii) a spouse who requires assistance with activities of daily living predicted cognitive and functional impairments in respondents to the Health and Retirement Study (n = 7965). Respondents who had a spouse who requires care had poorer cognitive functioning, whereby this relationship was significantly stronger for male respondents. Having a spouse with dementia moderated the relationship between income and cognition and predicted caregiver functional impairment, though not when depression was controlled. Although we found no significant differences on any individual cognitive domains between 179 dementia caregivers and sociodemographically matched noncaregivers, our findings suggest that caregivers, especially men, and low-income individuals who have a spouse with dementia are more vulnerable to adverse cognitive outcomes. Targeting depression in spouses of people with dementia may help to prevent functional impairments.

Reliability and validity of the Automatic Cognitive Assessment Delivery (ACAD).

IN THIS STUDY WE EVALUATED RELIABILITY AND VALIDITY OF THE AUTOMATIC COGNITIVE ASSESSMENT DELIVERY (ACAD): a short computerized battery composed by memory and attention tests, delivered online, and designed primarily for the elderly. Reliability was examined with a test-retest design and validity was assessed by means of comparison with standard neuropsychological tests. Older (N = 32) and young adult participants (N = 21) were involved. We found that the ACAD is free from any practice effect. Test-retest reliability was confirmed via significant correlations and high percentage agreements between the scores of three repeated assessments. ACAD scores were lower for older than for young adult participants and correlated significantly with the standardized measures of memory and attention. Results demonstrate that the ACAD battery provides a reliable and valid measure of both immediate and delayed recognition memory and sustained attention, and may be useful for convenient and efficient cognitive assessment and monitoring in older adults.

Cognitive function is preserved in older adults with a reported history of childhood sexual abuse.

Childhood sexual abuse (CSA) is associated with mood and cognitive deficits in children and young adults. Evidence suggests that the effects of early-life adversity persist throughout adulthood; however, the impact of CSA on cognition in older adults is largely unknown. This study investigated cognitive function in older adults with a reported history of CSA. Data are from a population-based study (The Irish Longitudinal Study on Ageing) of 6,912 adults aged 50 years and older. Participants answered questions about CSA as part of a stressful life events questionnaire. Global cognition, executive function, memory (both objective and self-rated), attention, and processing speed were measured via a comprehensive battery of tests. Anxiety and depression, other childhood adversity, health behaviours, chronic disease, and medication use were also assessed. Of the total sample, 6.5% reported CSA. These individuals were more likely to have experienced other forms of childhood adversity and to exhibit poor mental health compared to those who reported no history of CSA. Multivariate regression analyses revealed, however, that CSA was associated with better global cognition, memory, executive function, and processing speed, despite poorer psychological health in this group. Future studies should aim to investigate possible reasons for this finding.

A study into the automation of cognitive assessment tasks for delivery via the telephone: lessons for developing remote monitoring applications for the elderly.

BACKGROUND: Cognitive assessments are valuable tools in assessing neurological conditions. They are critical in measuring deficits in cognitive function in an array of neurological disorders and during the ageing process. Automation of cognitive assessments is one way to address the increasing burden on medical resources for an ever increasing ageing population. OBJECTIVE: This study investigated the suitability of using automated Interactive Voice Response (IVR) technology to deliver a suite of cognitive assessments to older adults using speech as the input modality. METHODS: Several clinically valid and gold-standard cognitive assessments were selected for implementation in the IVR application. The IVR application was designed using human centred design principles to ensure the experience was as user friendly as possible. Sixty one participants completed two IVR assessments and one face to face (FF) assessment with a neuropsychologist. Completion rates for individual tests were inspected to identify those tests that are most suitable for administration via IVR technology. Interclass correlations were calculated to assess the reliability of the automated administration of the cognitive assessments across delivery modes. RESULTS: While all participants successfully completed all automated assessments, variability in the completion rates for different cognitive tests was observed. Statistical analysis found significant interclass correlations for certain cognitive tests between the different modes of administration. Analysis also suggests that an initial FF assessment reduces the variability in cognitive test scores when introducing automation into such an assessment. CONCLUSION: [corrected] This study has demonstrated the functional and cognitive reliability of administering specific cognitive tests using an automated, speech driven application. This study has defined the characteristics of existing cognitive tests that are suitable for such an automated delivery system and also informs on the limitations of other cognitive tests for this modality. This study presents recommendations for developing future large scale cognitive assessments.

The effects of visuomotor feedback training on the recovery of hemispatial neglect symptoms: assessment of a 2-week and follow-up intervention.

In patients suffering from left unilateral neglect, their right-biased attention to the phenomenal world can be ameliorated, short-term, by making motor responses to left-right extended objects (rods) that immediately reveal to them that their phenomenal world is in fact skewed. In this study the extent to which more intensive experiences of this type produced enduring and useful improvements in neglect, was assessed by first examining the effect of a 3-day experimenter-administered practice of rod lifting, then by examining the effects of a self-administered practice for a further 2-week period and a further 1 month post-training. Despite the fact that by the time the patients were able to undergo the intervention they had progressed to the chronic neglect stage, significant improvements of the intervention over the control group were found for a third of the tests given after the 3-day practice. Additionally, at the 1-month follow-up the intervention group again showed significantly better results in 46% of the direct neglect tests. As far as we are aware this is the first time that significant long-term improvements have been shown in a rehabilitation approach with neglect patients with a mean time of more than 12 months post-stroke and visuomotor feedback training can thus be seen as a most encouraging paradigm for future attempts.