Multiple Sensory Impairment Is Associated With Increased Risk of Dementia Among Black and White Older Adults.

BACKGROUND: Few studies have examined impairment in multiple senses (multisensory impairment) and risk of dementia in comparison to having a single or no sensory impairment. METHODS: We studied 1,810 black and white nondemented participants from Health, Aging, and Body Composition (Health ABC) Study aged 70-79 years at enrollment. Sensory impairment was determined at our study baseline (Year 3-5 of Health ABC) using established cut points for vision (Bailey-Lovie visual acuity and Pelli-Robson contrast sensitivity test), hearing (audiometric testing), smell (12-item Cross-Cultural Smell Identification Test), and touch (peripheral nerve function tests). Incident dementia over 10 years of follow-up was based on hospitalization records, dementia medications, or at least 1.5 SD decline in Modified Mini-Mental State Examination score (race-specific). Cox proportional hazard models with adjustment for demographics, health behaviors, and health conditions evaluated the relationship between risk of dementia and increasing number of sensory impairments. RESULTS: Sensory impairments were common: 28% had visual impairment, 35% had hearing loss, 22% had poor smell, 12% had touch insensitivity; 26% had more than two impairments, and 5.6% had more than three sensory impairments. Number of impairments was associated with risk of dementia in a graded fashion (p < .001). Compared to no sensory impairments, the adjusted hazard ratio was 1.49 (95% CI: 1.12, 1.98) for one sensory impairment, 1.91 (95% CI: 1.39, 2.63) for two sensory impairments, and 2.85 (95% CI: 1.88, 4.30) for more than three sensory impairments. CONCLUSIONS: Multisensory impairment was strongly associated with increased risk of dementia. Although, the nature of this relationship needs further investigation, sensory function assessment in multiple domains may help identify patients at high risk of dementia.

The effect of a whole-body vibration therapy on the sitting balance of subacute stroke patients: a randomized controlled trial.

BACKGROUND: The use of a whole-body vibration (WBV) therapy has recently been applied and investigated as a rehabilitation method for subacute stroke patients. OBJECTIVE: To evaluate the effects of a WBV therapy on recovery of balance in subacute stroke patients who were unable to gain sitting balance. METHODS: The conventional rehabilitation group (CG) received conventional physical therapy, including sitting balance training by a physical therapist, for 30 min a one session, for twice a day for five days a week for two weeks. The whole-body vibration group (VG) received one session of conventional physical therapy, and received WBV therapy instead of conventional physical therapy for 30 min a day for five days a week for two weeks. RESULTS: There were 15 patients in the CG and 15 patients in the VG who completed the two-week therapy. After the two-week therapy, both groups showed functional improvement. Patients in the VG improved functional ambulation categories, Berg balance scale, trunk impairment scale scores. But, no statistically significant correlations between the therapeutic methods and outcomes were observed in either group. CONCLUSION: Our results suggest that WBV therapy led to improvement of the recovery in balance recovery for subacute stroke patients. Because the WBV therapy was as effective as conventional physical therapy, we can consider a WBV therapy as a clinical method to improve the sitting balance of subacute stoke patients.

Prevalence of sensory modulation disorder among Puerto Rican preschoolers: an analysis focused on socioeconomic status variables.

The purposes of this study were to determine the prevalence of sensory modulation disorder (SMD) in a sample of Puerto Rican preschoolers and to examine differences in the prevalence of SMD based on socioeconomic status (SES) variables. Caregivers of children from Head Start programs and private preschools were recruited from three regions in Puerto Rico (PR) to participate in the study. Each caregiver completed a Short Sensory Profile (SSP) and a demographic data sheet. Total scores on the SSP were used to establish diagnosis of SMD. The total sample included 141 participants (response rate of 64%). Prevalence of SMD among the total PR sample (19.9%) was higher than previously reported estimates on the US mainland (5-16%). Statistical results indicated no difference in the overall prevalence of SMD based on SES. However, significant differences in scores based on caregivers' educational degree were found on the SSP sub-domain of Movement sensitivity and Under-responsive/seeks sensation; differences in scores based on caregiver household income were also found for the SSP sub-domain of Under-responsive/seeks. Although SMD appears to be prevalent in preschoolers in PR, variables associated with SES do not appear to contribute to an overall SMD diagnosis. However, additional research linking specific sub-domains of SMD to SES variables may be warranted.

The prevalence of sensory deficits, functional limitations, and disability among older Southeast Asians in the United States.

OBJECTIVE: This study described the prevalence of and risk factors for sensory deficits, cognitive and physical functional limitations, and disability among older Southeast Asian refugees in the United States. METHODS: Data for the regression analyses were drawn from the 2003-2007 American Community Surveys. The sample included foreign-born persons aged 55 and older who were classified as Hmong, Cambodian, Laotian, and Vietnamese. RESULTS: Hmong, Cambodian, and Laotian persons were more likely to report a sensory deficit, functional limitation and disability than Vietnamese persons. Year of arrival, English language proficiency and education were important risk factors. Hmong and Cambodian groups had the most negative health profiles. DISCUSSION: Previous studies found that Vietnamese were the most health disadvantaged when compared to other Asian American groups and Whites. When compared to other refugee populations, the Vietnamese were actually the advantaged group. Our results indicated additional research on the disablement process among Southeast Asians is warranted.

Re-examining the epidemiology of sensory regulation dysfunction and comorbid psychopathology.

The aims of this study were threefold: (1) to compare prevalence of sensory regulation dysfunction based on previously established criteria to rates established with a more representative community sample of 796 4-year-olds; (2) to examine ethnic/racial and gender differences in prevalence according to the different criteria; and (3) to examine the co-occurrence of sensory regulation dysfunction and preschool psychiatric disorders. Prevalence rates ranged from 3.4% (current criteria) to 15.6% (previous criteria). In contrast to previous studies with less representative samples, there were no significant ethnic or racial differences using the current criteria. Boys were more likely to have sensory regulation dysfunction than girls according to all criteria. Depending upon impairment criteria used, 33-63% of children meeting criteria for sensory dysregulation also had a psychiatric disorder; 37-67% had only a sensory dysregulation disorder, indicating that sensory regulation dysfunction exists independent of psychiatric disorder, and is also a significant risk factor for disorder.

Aging among persons with intellectual disability in Israel in relation to type of residence, age, and etiology.

This study was conducted to compare aging phenomena of persons with intellectual and developmental disability (ID) aged 40 years and older living in community residence (N = 65) with those living with their families (N = 43) in Jerusalem, Israel. All 108 persons and care givers were interviewed to ascertain health problems, sensory impairment, activity of daily living (ADL), cognitive skills, and leisure activities. Health problem had already developed by age 40 years. The most frequent were visual (33%), hearing impairments (20%) and dental problems (30%). The community residence group displayed more medical problems, whereas individuals living at home had more dental problems. Health problems in persons with Down syndrome were significantly higher. ADL functioning for all participants was high, but persons with Down syndrome and cerebral palsy had more dependence. A decline in functioning in both residential groups was observed concerning leisure time, but scores for social life leisure activities were better for the community residential group. The data provided in this study can serve as information to develop geriatric services for persons with ID and provide a basis for comparison with peers in the general population in Israel. Dental service to persons with ID living at home should be improved.

Regulatory disorders in Israeli infants: epidemiologic perspective.

The concept of regulatory disorders has been clinically defined. However, epidemiologic validity has not yet been investigated. Children between the ages of 6 and 36 months (N = 450) were included in the study. Two age groups were analyzed separately: 6 to 17 months (53%) and 18 to 36 months (47%). A specially designed questionnaire in Arabic and Hebrew pertaining to the physiologic and behavioral aspects of regulatory disorders was administered at the mother and child health clinics in northern Israel. It was established in the present study that a minimum of four regulatory items should be reported for the diagnosis of a regulatory disorder, as perceived by parents. Factor analysis revealed 6 and 10 different aggregates of regulatory items in the young and older age groups, respectively. The general prevalence of regulatory disorder as defined in the present study was found to be 18%. Age, maternal education, and sex were found to be significantly related to the prevalence of regulatory disorders. No difference in the prevalence of regulatory disorders between Arab and Jewish infants was found. Further validations of the concept of regulatory disorder as well as devising appropriate measurements in well-designed studies are warranted.

Pica and olfactory craving of pregnancy: how deep are the secrets?

The practice of pica during pregnancy is described in contemporary literature as the ingestion of nonfood substances and food staples in response to craving. A previously unnamed practice, olfactory craving of pregnancy, is the smelling by pregnant women of selected substances in response to craving, which may occur alone or with pica. Observations and descriptions of women's experiences of pica and olfactory craving were documented during individualized postpartum bedside instruction of 300 women at a midwestern hospital between 1992 and 1994. Most women were African American and low income. Eight themes about pica of pregnancy were keeping practices secret, singularity of the experience, obtaining the craved substance, fears for effects on the fetus, yielding or not yielding to cravings, use of substances as medication, pica and food intake, and sensory experiences other than taste. Three themes about olfactory craving of pregnancy were changes in sense of smell during pregnancy, types of craved substances and settings, and escalation in use during pregnancy. The clinical stages of pica and olfactory craving require further investigation, and perinatal caregivers have to seek and remove the barriers that cause pregnant women to isolate themselves with the practices that stem from these cravings.