Objective: Since vitamin D is an important regulator of muscle function, the effect of vitamin D deficiency on frailty syndrome has been recently studied. This cross-sectional study aimed to ...determine the association between 25(OH)-vitamin D levels and frailty status in Mexican community-dwelling elderly.
Methods: Sample of 331 community-dwelling elderly aged 70 or older, a subset of those included in the "Coyoacán cohort" were included. 25(OH)-vitamin D assay and frailty status were measured.
Results: Mean age was 79.3 years and 54.1% were women. Those classified as frail were more likely to have lower Mini-Mental State Examination score (p = 0.015), more disability for instrumental activities of daily living (p < 0.001) and for activities of daily living (p < 0.001). Serum 25(OH)-vitamin D levels were lower in the frail subgroup when compared with the non-frail one (p < 0.001). Multivariate logistic regression analyses showed a significant association between intermediate tertile odds ratios (OR) = 4.13; 95% confidence intervals (CI) 2.00-8.56 or insufficient tertile (OR = 8.95; 95% CI 2.41-33.30) of vitamin D levels and frailty even after adjusting for potential confounders.
Conclusion: These results suggest that older adults with low 25(OH)-vitamin D levels are associated with the probability to being frail compared with those with sufficient vitamin D levels.
The Mini-Mental State Examination (MMSE), the Free and Cued Selective Reminding Test (FCSRT), and the Isaacs Set Test (IST) are useful instruments in the neuropsychological assessment of older ...individuals. Several versions of these tests exist in Spanish but normative data specifically set up for Mexican older adult population are missing although Mexico is the country containing the largest population of Spanish speakers and is undergoing a demographic transition with its aging population. Therefore, the aim of the present work was to produce age, educational level, and gender-adjusted normative scores for these tests for the population of older adults living in Mexico. Methods: Data were collected from a sample of 1047 subjects aged 70 years and over who participated in the Coyoacán cohort study, a population-based cohort study conducted in Mexico City. Results: Normative scores, presented in percentiles, were calculated according to age (70-79 and 80 years and over), educational level (0 years of schooling vs. 1-5 years of schooling vs. 6 and more years of schooling), and gender. Conclusion: This work provides norms for the MMSE, the FCSRT, and the IST which should be useful in clinical practice and helpful to better interpret the performances of Mexican older people consulting for memory troubles.
In 2015 in France, 585,560 people were nursing home residents. A large body of studies has identified predictors of poor quality of life and poor adaptation in institution, mostly for residents ...without dementia. With 42 to 72% of these residents diagnosed with dementia, it is crucial to identify what factors prior to admission might have an impact on quality of life once the admission is finalized, in order to target specific domains of intervention, while the person still lives at home and after his/her admission.
QOL-EHPAD is a prospective, multi-centred, observational cohort study. At baseline, we will collect retrospective data on the life of 150 persons with dementia and their caregivers. These data will refer to the conditions of admission to a nursing home (emergency admission, involvement in the decision, admission from home or from the hospital) and to the 6 months prior to the admission of the person with dementia: sociodemographic and medical data, psychological tests, information on quality of life, satisfaction, behaviour, and nutrition. Similar data about life in the nursing home will be collected after 6 months, along with information on adaptation of the person with dementia to his/her new living environment. We will use univariate regression analyses followed by stepwise linear regression models to identify which factors pertaining to life at home are associated with quality of life and adaptation after 6 months.
This study will provide data on the impact of institutionalization on quality of life and the determinants of a successful institutionalization in people with dementia. This could be helpful in setting up targeted interventions to prepare admission into a nursing home before the actual admission and to accompany both the caregiver and the person with dementia throughout this process.
The latest version of the State-Trait Anxiety Inventory (STAI-Y) is commonly used in older adults, even though this anxiety scale was developed in and for young adults. Norms and associated factors ...of the STAI-Y are lacking for older adults in the general population. The objectives of the present study were to produce norms on the STAI-Y State scale for older adults using a large sample of older adults selected from a general population and to examine the sociodemographic and health-related factors associated with the STAI-Y State score.
993 community-dwelling individuals aged 66 years and over from the PAQUID study were evaluated at home by a psychologist for the following variables: age, education, marital status, proximity of relatives, self-assessment of income sufficiency, occupation during active life, depressive symptomatology, objective and subjective health, objective and subjective cognitive functioning, adverse life events, activities of daily living, drug use, and cigarette consumption.
Norms were stratified for age, sex, and education and were produced separately for older adults with and without depressive symptomatology. Multivariate analyses revealed that younger age (66-79 years), female sex, lower education, perception of income insufficiency, depressive symptomatology, poor subjective health, subjective cognitive complaints, psychotropic drugs use, and recent adverse life events were independently associated with higher STAI-Y State score.
This study provides norms for the STAI-Y State anxiety inventory in a general population of older adults and indicates the specific factors linked with state anxiety. Such factors should be taken into account by clinicians in order to better understand state anxiety in older adults.
Introduction:
The literature draws a mitigated picture of the psychosocial effects of the lockdown in older adults. However, the studies conducted so far are mainly based on web surveys which may ...involve selection bias. The PACOVID survey relies on a population-based design and addresses the attitudes, psychological and social experiences of the oldest old regarding the pandemic and lockdown and their impact.
Material and Methods:
Cross-sectional phone survey involving 677 persons. Baseline report on attitudes, psychological, and social experiences of the oldest old, regarding the pandemic and lockdown measures.
Results:
The mean age was 87.53 (SD 5.19). About 46% were living alone during the lockdown. Concerning difficulties, “
none
” was the most frequent answer (35.6%). For questions addressing how often they had felt sad, depressed, or lonely (CESD-scale), the most frequent answers were “
never/very rarely
” (58.7, 76.6, 60.8%) and 27.1% had anxious symptomatology (STAI scale). Most (92.9%) felt socially supported. Engaging in leisure activities was the most frequent coping strategy, and for numerous participants the lockdown did not represent much of a change in terms of daily routine. A very good knowledge and awareness of COVID-19 and the safety measures was observed. Comparisons with measures collected before the pandemic showed low changes in subjective health and the CES-D questions.
Discussion:
With a methodological design limiting selection bias, our results claim for a weakened psychosocial impact even though the participants are concerned and aware of the pandemic issues. These results highlight the resources and resilience abilities of older persons including in advancing age.
High level of preferences for routines is an indicator of psychological vulnerability in older adults. However, the psychometric properties of the Preferences for Routines Scale (PRS) initially ...validated in a small selected sample of older adults revealed a low Cronbach’s α (.50) in the general elderly population. The present study aims to improve the PRS using the data from the “AMI” and “PAQUID” population-based studies. Among 718 older persons, the most discriminative items are identified using item response theory methodology. A short form of the PRS (PRS-S) included five of the ten items of the original scale and showed improved internal consistency and test–retest reliability. The factors associated with the PRS-S are similar to those found in previous studies. Norms are provided according to gender and educational level. The reduction of the number of items tends to facilitate its administration and promote its use in both clinical and epidemiologic research contexts.
Objectives:The objective of this longitudinal study was to compare the trajectory of subjective quality of life in 2 groups of older adults: those who entered a nursing home and those who remained ...living in the community with similar clinical conditions.Method:PAQUID is a prospective population-based study. It included, at baseline, 3777 community-dwelling participants aged 65 years and over. Participants were followed-up for up to 27 years. Among people living at home at baseline, 2 groups were compared: participants who entered a nursing home over a 20-year follow-up (n = 528) and those who remained community dwellers (n = 2273). We used latent process mixed models to estimate the relationship between mean trajectory of subjective quality of life and admission into a nursing home. We computed univariate and multivariate models taking into account potential confounders (age, gender, education, income, comorbidities, dementia, disability and depression).Results:Nursing home placement was significantly associated with a drop in quality of life between the last visit before and after institutionalization. Nevertheless, we found no difference in quality of life trajectory after this initial drop.Conclusion:Older adults exhibit an acute drop in quality of life after nursing home admission, probably reflecting the associated psychological distress. Even though their quality of life does not go back to pre-admission levels, the residents do not show a steeper decline when compared to the “natural” evolution of quality of life in older adults living in the community, which suggests a relative adaptation to their new living conditions.
There is an obvious lack of validated norms for elderly persons aged 85 and older for the large majority of the neuropsychological tests used in clinical practice. Yet this range of "oldest-old" ...individuals drastically increases worldwide and is the more likely to develop dementia. Providing clinicians validated and updated norms to accurately evaluate cognitive functioning in this population is an important issue in geriatrics. This study provides normative scores for 7 neuropsychological tests commonly used in clinical practice. Data were collected in a sample of 283 subjects aged 85 and older, included in the PAQUID study, a population-based cohort conducted in France. Normative scores were calculated according to 2 age ranges and 2 educational levels, and are presented in percentiles. The norms provided in the present study involve 7 tests that are widely used in the neuropsychological assessment of geriatrics populations and should be of help for clinicians.
ObjectivesTo determine the impact of both individual psychosocioeconomic precariousness and geographical deprivation on risk of dementia in older adults followed-up for 25 years.MethodThe sample ...consisted of 3,431 participants aged 65 years or over from the PAQUID cohort study. Individual psychosocioeconomic precariousness was measured computing eight economic and psychosocial indicators. Geographical deprivation was assessed by the FDep99 index, consisting of four community socioeconomic variables. For both measures, the fourth quartile of the distribution was considered as the more precarious or deprived category, while the first quartile was considered as the less precarious or deprived one. Clinical dementia diagnosis was assessed all along study follow-up. The association between individual psychosocioeconomic precariousness, geographical deprivation and risk of dementia was assessed using illness-death regression models adjusted for age, sex, depression, psychotropic drug consumption, comorbidities, disability, and body mass index, while accounting for death as a competing event.ResultsThe risk of dementia was higher for the more psychosocioeconomic precarious participants (HR = 1.51; 95% CI: 1.24–1.84). No increased risk of dementia was found for those living in communities with high index of deprivation.DiscussionPsychosocioeconomic precariousness, but not geographical deprivation, is associated with a higher risk of dementia.
BACKGROUND AND PURPOSE:Neuropsychological testing plays a key role in various clinical contexts. Even though a substantial number of adults suffer neurological disorders such as early-onset dementia, ...stroke, traumatic brain injury or multiple sclerosis, most normative data do not include persons below 65. The aim of this study was to produce updated norms for the Mini-Mental State Examination, the Free and Cued Selective Reminding Test, the Trail Making Test, verbal fluency tasks and the Digit Symbol Substitution Test for middle-aged and older adults.METHODS:The sample consisted of 51 879 participants aged 45-70 years from the CONSTANCES study. Norms are presented in percentiles stratified on age, education and gender.RESULTS:The results illustrated the effect of age in all tests considered. For tests involving speed processing, the impact of age was observed including in tight age range categories (5 years). The results also showed the well-known effect of education and an effect of gender in tests involving verbal memory and speed processing.CONCLUSIONS:The norms provided allow the variability of the cognitive performances of middle-aged to older populations to be understood, with a high precision in age categories. The tests considered are broadly used in neuropsychological practice and should be helpful in a variety of clinical contexts.
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