Is there a common latent cognitive construct for dementia estimation across two Chinese cohorts?

Introduction: It is valuable to identify common latent cognitive constructs for dementia prevalence estimation across Chinese aging cohorts. Methods: Based on cognitive measures of 12015 Chinese Longitudinal Healthy Longevity Survey (CLHLS; 13 items) and 6623 China Health and Retirement Longitudinal Study (CHARLS; 9 items) participants aged 65 to 99 in 2018, confirmatory factor analysis was applied to identify latent cognitive constructs, and to estimate dementia prevalence compared to Mini-Mental State Examination (MMSE) and nationwide estimates of the literature. Results: A common three-factor cognitive construct of orientation, memory, and executive function and language was found for both cohorts with adequate model fits. Crude dementia prevalence estimated by factor scores was similar to MMSE in CLHLS, and was more reliable in CHARLS. Age-standardized dementia estimates of CLHLS were lower than CHARLS among those aged 70+, which were close to the nationwide prevalence reported by the COAST study and Global Burden of Disease. Discussion: We verified common three-factor cognitive constructs for both cohorts, providing an approach to estimate dementia prevalence at the national level. Highlights: Common three-factor cognitive constructs were identified in Chinese Longitudinal Healthy Longevity Survey (CLHLS) and China Health and Retirement Longitudinal Study (CHARLS).Crude dementia estimates using factor scores were reliable in both cohorts.Estimates of CHARLS were close to current evidence, but higher than that of CLHLS.

Analyses and identification of ICD codes for dementias in the research based on the NHIRD: a scoping review protocol.

INTRODUCTION: Studies based on health claims data (HCD) have been increasingly adopted in medical research for their strengths in large sample size and abundant information, and the Taiwan National Health Insurance Research Database (NHIRD) has been widely used in medical research across disciplines, including dementia. How the diagnostic codes are applied to define the diseases/conditions of interest is pivotal in HCD-related research, but the consensus on the issue that diagnostic codes most appropriately define dementias in the NHIRD is lacking. The objectives of this scoping review are (1) to investigate the relevant characteristics in the published reports targeting dementias based on the NHIRD, and (2) to address the diversity by a case study. METHODS AND ANALYSIS: This scoping review protocol follows the methodological framework of the Joanna Briggs Institute Reviewer's Manual and the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. The review will be performed between 1 March and 31 December 2022 in five stages, including identifying the relevant studies, developing search strategies, individually screening and selecting evidence, collecting and extracting data, and summarising and reporting the results. The electronic databases of MEDLINE, EMBASE, CENTRAL, CINAHL, and PsycINFO, Airiti Library Academic Database, the National Health Insurance Administration's repository, and Taiwan Government Research Bulletin will be searched. We will perform narrative syntheses of the results to address research questions and will analyse the prevalence across the included individual studies as a case study. ETHICS AND DISSEMINATION: Our scoping review is a review of the published reports and ethical approval is not required. The results will provide a panorama of the dementia studies based on the NHIRD. We will disseminate our findings through peer-reviewed journals and conferences, and share with stakeholders by distributing the summaries in social media and emails.

Effect and quality of couple-based interventions of middle-aged and older adults with type 2 diabetes mellitus: a scoping review.

BACKGROUND: Studies have shown the existence of health concordance between patients with type 2 diabetes mellitus (T2DM) and their spouses, and also that spouses could influence the effect of self-management, benefiting patients' health. However, these studies are heterogeneous and the evidence is inconclusive. OBJECTIVE: To synthesize evidence from published randomized controlled trials: the interventional effects and the quality of study performance, also to identify the research gap and the directions for future studies. METHODS: We performed the scoping review by following the PRISMA-ScR guidance. We searched and examined the reports from MEDLINE, EMBASE, PsychInfo, CINAHL Plus by the pre-specified criteria. Key characteristics and information of eligible reports were extracted, analysed and synthesized comprehensively, and the results were presented in the form of words and diagrams. RESULTS: We identified 5 reports from 4 studies out of 3479 records included. Qualified studies indicated a positive effect of couple-based interventions on couples' distress. Insufficient evidence on physiological health or health behaviours was identified owing to the small number of included studies and inconsistent assessment outcomes. The methodological quality across these studies was generally low due to inadequate reporting of study process and substantial biases. CONCLUSIONS: Couple-based interventions for patients with T2DM showed small effects on the couple's distress while the effects of other outcomes were inconclusive. Future studies should strengthen methodologies by using standard measures of core diabetic outcomes, including detailed assessments of implementation process, and taking a dyadic approach to systematically examine the effects.

Multiyear Square Dancing Is Associated With Superior Mental Processing Capacity But Not Memory in Middle-Aged and Older Chinese Women: A Cross-Sectional Propensity Score Matching Analysis.

BACKGROUND: Evidence suggests the importance of physical activity and social engagement in cognitive preservation. Group-based dancing combining exercise and prosocial features may generate physical and cognitive benefits. OBJECTIVES: To investigate the association between multiyear habitual square dancing and domain-specific cognitive function, and assess the relative importance and joint impact of physical activity and social activity on cognition. METHODS: Using the cross-sectional propensity score matching method, the study compared the mental status, episodic memory, and overall cognitive performances of 145 amateur female square-dancing participants (aged ≥45 y) to their sociodemographic- and health-status-matched 222 nondancing counterparts, selected from the China Health and Retirement Longitudinal Study. RESULTS: The authors found a positive association between multiyear square dancing (average 8 y) and overall cognitive performances (mean difference = 2.84; 95% confidence interval [CI], 1.65 to 4.02), which was apparent in processing capacity (2.29; 95% CI, 1.51 to 3.07) but not in memory (0.55; 95% CI, -0.13 to 1.23). The hypothesized synergic effect of physical activity and social activity on cognition was only observed in group-based exercises embodying these 2 components simultaneously. CONCLUSIONS: Long-term square dancing as one type of physically and socially engaging activities may preserve cognition. Future longitudinal and interventional studies are needed to further clarify the causal relationship.

Couple-based collaborative management model of type 2 diabetes mellitus for community-dwelling older adults in China: protocol for a hybrid type 1 randomized controlled trial.

BACKGROUND: China's limited health care resources cannot meet the needs of chronic disease treatment and management of its rapid growing ageing population. The improvement and maintenance of patient's self-management is essential to disease management. Given disease management mainly occurs in the context of family, this study proposes to validate a Couple-based Collaborative Management Model of chronic diseases that integrates health professionals and family supporters; such as to empower the couples with disease management knowledge and skills, and to improve the couples' health and quality of life. METHODS: The proposed study will validate a couple-based collaborative management model of Type 2 Diabetes Mellitus (T2DM) in a community-based multicenter, two-arm, randomized controlled trial of block design in Guangzhou, China. Specifically, 194 T2DM patients aged ≥55 and their partners recruited from community health care centers will be randomized at the patient level for each center at a 1:1 ratio into the couple-based intervention arm and the individual-based control arm. For the intervention arm, both the patients and their spouses will receive four-weekly structured group education & training sessions and 2 months of weekly tailored behavior change boosters; while these interventions will be only provided to the patients in the control group. Behavior change incentives will be targeted at the couples or only at the patient respectively. Treatment effects on patients' hemoglobin, spouses' quality of life, alongside couples' behavior outcomes will be compared between arms. Study implementation will be evaluated considering its Reach, Effectiveness, Adoption, Implementation and Maintenance following the RE-AIM framework. DISCUSSION: This study will generate a model of effective collaboration between community health professionals and patients' family, which will shield light on chronic disease management strategy for the increasing ageing population. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900027137, Registered 1st Nov. 2019.

A Social Group-Based Information-Motivation-Behavior Skill Intervention to Promote Acceptability and Adoption of Wearable Activity Trackers Among Middle-Aged and Older Adults: Cluster Randomized Controlled Trial.

BACKGROUND: Wearable activity trackers offer potential to optimize behavior and support self-management. To assist older adults in benefiting from mobile technologies, theory-driven deployment strategies are needed to overcome personal, technological, and sociocontextual barriers in technology adoption. OBJECTIVE: To test the effectiveness of a social group-based strategy to improve the acceptability and adoption of activity trackers by middle-aged and older adults. METHODS: A cluster randomized controlled trial was conducted among 13 groups of middle-aged and older adults (≥45 years) performing group dancing (ie, square dancing) as a form of exercise in Guangzhou from November 2017 to October 2018. These dancing groups were randomized 1:1 into two arms, and both received wrist-worn activity trackers and instructions at the baseline face-to-face assessment. Based on the Information-Motivation-Behavior Skill framework, the intervention arm was also given a tutorial on the purpose of exercise monitoring (Information), encouraged to participate in exercise and share their exercise records with their dancing peers (Motivation), and were further assisted with the use of the activity tracker (Behavior Skill). We examined two process outcomes: acceptability evaluated by a 14-item questionnaire, and adoption assessed by the uploaded step count data. Intention-to-treat analysis was applied, with the treatment effects estimated by multilevel models. RESULTS: All dancing groups were followed up for the postintervention reassessment, with 61/69 (88%) participants of the intervention arm (7 groups) and 56/80 (70%) participants of the control arm (6 groups). Participants' sociodemographic characteristics (mean age 62 years, retired) and health status were comparable between the two arms, except the intervention arm had fewer female participants and lower cognitive test scores. Our intervention significantly increased the participants' overall acceptability by 6.8 points (95% CI 2.2-11.4), mainly driven by promoted motivation (adjusted group difference 2.0, 95% CI 0.5-3.6), increased usefulness (adjusted group difference 2.5, 95% CI 0.9-4.1), and better perceived ease of use (adjusted group difference 1.2, 95% CI 0.1-2.4), whereas enjoyment and comfort were not increased (adjusted group difference 0.9, 95% CI -0.4-2.3). Higher adoption was also observed among participants in the intervention arm, who were twice as likely to have valid daily step account data than their controlled counterparts (adjusted incidence relative risk [IRR]=2.0, 95% CI 1.2-3.3). The average daily step counts (7803 vs 5653 steps/day for the intervention and control, respectively) were similar between the two arms (adjusted IRR=1.4, 95% CI 0.7-2.5). CONCLUSIONS: Our social group-based deployment strategy incorporating information, motivation, and behavior skill components effectively promoted acceptability and adoption of activity trackers among community-dwelling middle-aged and older adults. Future studies are needed to examine the long-term effectiveness and apply this social engagement strategy in other group settings or meeting places. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR-IOC-17013185; https://tinyurl.com/vedwc7h.

Personal and Social Environmental Correlates of Square Dancing Habits in Chinese Middle-Aged and Older Adults Living in Communities.

This study aimed to examine personal and social environmental correlates of the physical activity habit of middle-aged and older adults, using Chinese square dancing as a natural exploratory example. Participants were 385 adults aged ≥45 years (93% female), who habitually danced on squares or parks of three old districts of Guangzhou. Multinomial logistic regression was used to identify personal, social, psychological, and behavioral correlates of multiyear dance. Old age, high education, sufficient leisure time, and stable social environmental factors were associated with persistent dancing, whereby education (relative risk ratio [RRR] = 1.64, 95% confidence interval [1.05, 2.57]) and social engagement (RRR = 1.66, 95% confidence interval [1.05, 2.63]) showed the largest effects. Participants dancing ≤1 year were least satisfied with their social relationships than their counterparts dancing 1-5 years (RRR = 0.68) or over 5 years (RRR = 0.58). Physical activity promotion for older adults should adapt from culturally appropriate group activities and leverage community social resources to encourage voluntary participation, particularly for low-educated older women.

[A nursing experience using the props-integrated communicative approach to ameliorate aggression in a frontotemporal dementia patient].

This report introduces the nursing caring experience with a male patient with frontotemporal dementia (FTD) who was hospitalized in an acute psychiatric ward from March 5th to April 30th, 2012 due to the clinical manifestations of verbally expressive impairment, aggression, and subsequent caregiver burden. The patient was assessed according to the guidelines of clinical competencies for mental health nursing assessments developed by the Psychiatric Mental Health Nurses Association. Three clinical diagnoses were identified after this assessment, including (1) impaired verbal communication, (2) chronic confusion, and (3) caregiver role strain. The current report focuses only on the clinical issue of impaired verbal communication. We adopted a props-integrated communicative approach by integrating props and physical motions with communicative strategies. This approach enabled us to formulate a patient-centered communicating model and prompt for active expression and adequate communication, which ultimately resolved the patient's aggression problem. In addition, we provided psychoeducation to the family members in order to teach them the relevant knowledge, skills, and approaches that caregivers may use to enhance their caring capabilities and reduce the burden of caregiving. This successful experience may be used as a reference in caring for FTD patients with communicative impairments. Our proposed approach integrates props with simple language and develops an appropriate communicating model to provide high quality care for patients.