Abstract
In this study, functional near-infrared spectroscopy (fNIRS) was used to record brain activation during cognitive testing in older individuals (88±6yo; N = 19) living in residential care communities. This population, which is often associated with loss of personal independence due to physical or cognitive decline associated with aging, is also often under-represented in neuroscience research because of a limited means to participate in studies which often take place in large urban or university centers. In this study, we demonstrate the feasibility and initial results using a portable 8-source by 4-detector fNIRS system to measure brain activity from participants within residential care community centers. Using fNIRS, brain signals were recorded during a series of computerized cognitive tests, including a Symbol Digit Coding test (SDC), Stroop Test (ST), and Shifting Attention Test (SAT). The SDC and SAT elicited greater activity in the left middle frontal region of interest. Three components of the ST produced increases in the right middle frontal and superior frontal, and left superior frontal regions. An association between advanced age and increased activation in the right middle frontal region was observed during the incongruent ST. Although none of the participants had clinical dementia based on the short portable mental status questionnaire, the group performance was slightly below age-normed values on these cognitive tests. These results demonstrate the capability for obtaining functional neuroimaging measures in residential settings, which ultimately may aid in prognosis and care related to dementia in older adults.
Highlights
In 2014, approximately 830,000 older adults in the US lived in a residential care community (RCC), which is one type of long-term care facility [1]
The primary findings of this study indicated increased activation above baseline for channels overlying the left Brodmann areas (BA-)10 region-of-interest (ROI) during the Symbol Digit Coding test and Shifting Attention Test
During all versions of the Stroop test, increased activity was observed in the channels above the right BA-10 and BA-45 and left BA-10 ROIs
Summary
In 2014, approximately 830,000 older adults in the US lived in a residential care community (RCC), which is one type of long-term care facility [1]. Residential care communities serve individuals with cognitive impairment, dementia, or Alzheimer’s disease. Of residents had some form of cognitive impairment, consisting of 18% without dementia and 42% with Alzheimer’s disease or other dementia [2]. These residents with cognitive impairment had more emergency department visits, required greater assistance with activities of daily living, greater care for urinary incontinence, and more skilled nursing care, resulting in an additional $7,000 of care per year. The overall cost for individuals with cognitive impairment residing in RCCs was $17 billion [2]. About 6% of RCCs are part of facilities that provide a continuum of care that include skilled nursing, assisted living, independent, and dementia units [2]. Assessment of cognitive function using simple, portable tools may provide some benefit for facilities to provide the optimum care and manage costs
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