Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: a COSMIC study.

BACKGROUND: Subjective cognitive decline (SCD) is recognized as a risk stage for Alzheimer's disease (AD) and other dementias, but its prevalence is not well known. We aimed to use uniform criteria to better estimate SCD prevalence across international cohorts. METHODS: We combined individual participant data for 16 cohorts from 15 countries (members of the COSMIC consortium) and used qualitative and quantitative (Item Response Theory/IRT) harmonization techniques to estimate SCD prevalence. RESULTS: The sample comprised 39,387 cognitively unimpaired individuals above age 60. The prevalence of SCD across studies was around one quarter with both qualitative harmonization/QH (23.8%, 95%CI = 23.3-24.4%) and IRT (25.6%, 95%CI = 25.1-26.1%); however, prevalence estimates varied largely between studies (QH 6.1%, 95%CI = 5.1-7.0%, to 52.7%, 95%CI = 47.4-58.0%; IRT: 7.8%, 95%CI = 6.8-8.9%, to 52.7%, 95%CI = 47.4-58.0%). Across studies, SCD prevalence was higher in men than women, in lower levels of education, in Asian and Black African people compared to White people, in lower- and middle-income countries compared to high-income countries, and in studies conducted in later decades. CONCLUSIONS: SCD is frequent in old age. Having a quarter of older individuals with SCD warrants further investigation of its significance, as a risk stage for AD and other dementias, and of ways to help individuals with SCD who seek medical advice. Moreover, a standardized instrument to measure SCD is needed to overcome the measurement variability currently dominant in the field.

Factors associated with odour identification in older Indonesian and white Australian adults.

BACKGROUND AND AIMS: Among older adults, olfactory dysfunction is associated with cognitive impairment, lower quality of life, and increased mortality. While age is a risk factor for olfactory dysfunction, other risk factors are less well understood, and may vary between ethno-regional groups. This study investigated how associations between odour identification (OI) and various risk factors, as well as cognition and language ability, differed or were similar in two distinct ethno-regional groups of older adults. METHODS: This cross-sectional study used data from two cohorts: 470 Indonesians (aged 67.4 ± 7.4 years) and 819 white Australians (aged 78.7 ± 4.8 years). Univariate and multivariate analyses explored whether OI test scores were associated with age, sex, education, cholesterol levels, apolipoprotein E ε4 status, smoking, diabetes, hypertension and depression scale scores, or with Mini-Mental State Examination (MMSE) and language test performance. RESULTS: Univariate analyses identified some factors associated with OI scores in both Indonesians and white Australians, including older age and smoking with lower scores, and MMSE and language test performance with higher scores. Multivariate analyses yielded different and mutually exclusive patterns of associations in the two ethno-regional groups, with language test scores significantly associated with higher OI scores in Indonesians, and age, being male, smoking, having diabetes and higher depression scale scores significantly associated with lower OI scores in white Australians. CONCLUSION: Ethno-regional differences may need consideration in the attempt to fully understand associations between OI and negative outcomes like dementia and mortality, and interventions for olfactory dysfunction might need to be tailored to specific ethno-regional groups. However, the difference in mean age between cohorts is a limitation of this study, and future studies should aim to compare populations with similar age distributions.

Nursing home research: the first International Association of Gerontology and Geriatrics (IAGG) research conference.

The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations.

Quality of life people living with HIV/AIDS: outpatient in Kramat 128 Hospital Jakarta.

AIM: to provide an overview of the quality of life (OQL) for people living with HIV/AIDS (PLWHA) in Jakarta, particularly in the Kramat 128 Hospital, based on CD4 and viral load (VL) levels and the length of antiretroviral (ARV) treatment. METHODS: a cross-sectional study performed at Kramat 128 Hospital Jakarta Outpatient Clinic from November 2010 to January 2011. Quality of life was assessed with the WHOQOL-BREF instrument. The data were analyzed using Chi-Square test, independent T-test, and One-Way Analysis of Variance (ANOVA) test. RESULTS: the mean score in four domains of QOL in descending order were psychological (72.27), physical health (70.10), environment (65.59), and social relationships (64.44). There were a significant differences in overall QOL (p=0.000) and general health (p=0.001) between lower and higher CD4 levels. Patients who were interviewed look healthy physically and psychologically, have a good QOL based on statistical analysis. Patients with undetectable VL levels had better in general health (p=0.012), and those with longer ARV therapy (>1 year) had better overall QOL (p=0.024) and general health (p=0.003). Analysis with four domains of QOL showed a significant relationship of CD4 levels with the physical health (p=0.001) and psychological domain (p=0.043). VL levels showed significant relationships with the four domains of QOL (p<0.05). Duration of ARV therapy showed a significant association only with physical health domain (p=0.015). CONCLUSION: higher CD4 levels, undetectable VL, and longer ARV therapy will increase patient's QOL. Higher QOL will make the patient have ability to cope with illness. So, a better QOL can be taken as indicator of successful ARV treatment.