Mental Status Questionnaire Research Articles

The ability of peripheral neurophysiological biomarkers to predict future psychological conditions among geriatric populations

ObjectiveThough the association between peripheral neurophysiological biomarkers and psychological conditions is widely discussed, there is still limited evidence about the ability of peripheral biomarkers to predict psychological outcomes, especially among geriatric populations. MethodsThe study is designed as a prospective cohort study. We collected information from participants aged over 55 years. The participants were evaluated at the start of the study (T0) and 6–9 months later (T1). Information about demographic profiles, peripheral neurophysiological biomarker recordings (including heart rate variability, finger temperature, skin conductance, and electromyogram), and psychological measurements (including Brief Symptom Rating Scale-5, Chinese Happiness Inventory, and Short Portable Mental Status Questionnaire) were collected at T0. At T1, participants reported self-rated questionnaires for psychological outcomes (Patient Health Questionnaire-15, health anxiety questionnaire, Beck Depression Inventory-II, and Beck Anxiety Inventory) and were evaluated with Mini-Mental State Examination by the staff. The association between the peripheral biomarkers and psychological outcomes was evaluated via multiple regression models. ResultsA total of 385 participants were included in the study and the average age was 74.49 ± 7.34 years. Both stepwise multiple linear and logistic models showed a significant association between decreased skin conductance and increased/presence of depression at T1. The receiver operating characteristic (ROC) curve analysis of skin conductance for depression was fair (area under curve = 0.812). ConclusionsThe ability of skin conductance to predict depression among geriatric populations may facilitate the detection of geriatric depression and future research on the pathophysiology.

Physical activity modifies cognitive impairment-associated mortality risks among chronic kidney disease

BackgroundOlder chronic kidney disease (CKD) patients frequently face unrecognized cognitive impairment and excess mortality. Physical activity (PA) reduces cognitive decline but whether PA modifies cognitive impairment-associated mortality remains unknown. MethodsFrom 2005 to 2011, 30,561 older Taiwanese CKD patients were enrolled. Patients were divided into intact cognition (≥8 scores), mild (6–7 scores), and severe (≤5 scores) cognitive impairment groups by the Short Portable Mental Status Questionnaire (SPMSQ), and were also categorized into high-PA (≥60 min/week of moderate-intensity PA), low-PA (20–60 min/week) or inactive (<20 min/week) groups. Cox regression was conducted to evaluate the individual and joint associations of cognitive impairment and PA on all-cause and cardiovascular mortality. ResultsAfter a median follow-up of 4.52 years, the all-cause mortality were higher in CKD patients with severe (multivariable-adjusted hazard ratio [aHR] 2.31; 95% confidence interval [CI] 2.05–2.60) and mild (aHR 1.74; CI 1.51–1.99) cognitive impairment than cognitively intact ones. Remarkably, decreased PA amount interacted and amplified the cognitive impairment-associated mortality risks. Notably, the high-PA status linked to lower overall mortality risks both in mild (aHR 0.65; CI 0.45–0.93) and severe (aHR 0.73; CI 0.54–0.99) cognitively-impaired patients as compared to inactivity. Survival tree analysis indicated the least mortality in those with high PA and >8 SPMSQ scores. Similar associations were found in the cardiovascular mortality. LimitationsResidual confounding and single ethnicity. ConclusionsCognitive impairment defined by SPMSQ was progressively associated with higher mortality among elderly CKD. Higher PA linked to lower cognitive impairment-associated death risks, and could be promoted for longevity benefits.

Associations of parity and cognitive decline, depression, and chronic comorbidity in West China: Results from WCHAT study.

To investigate the associations between parity (the number of offspring a female has borne) and cognitive function, depression, and chronic comorbidity in Western China. A total of 846 women aged 50-55 years were included in the current analysis. Cognitive status was measured using a 10-item short portable mental status questionnaire (SPMSQ). Depressive symptoms were assessed using the 15-item geriatric depression scale (GDS-15). Other characteristics were self-reported. The associations between parity and cognitive decline, depression, and chronic comorbidity were analyzed using univariable and multivariable models. Multivariable models were adjusted for age, ethnic group, occupation, marital status, educational level, lifestyle factors, and sleeping time. Among the enrolled women, 26.71% were either childless or had one child, 47.40% had two children, 18.32% had three children, and 7.57% had ≥4 children. Compared to women with low parity, women with two or more children exhibited a higher risk of cognitive decline. Moreover, having four or more children was significantly associated with depression and chronic comorbidity. After adjusting covariates, women with three or more children exhibited a higher risk of cognitive decline than those with low parity. However, high parity was not significantly associated with depression or chronic comorbidity after adjustment for covariates. Our study showed that ≥3 children was associated with cognitive decline in women. Longitudinal studies are needed to evaluate this conclusion and to investigate the mechanisms involved. More importantly, families and societies should pay more attention to women's long-term health outcomes related to fertility.

Predictors of outcomes after internal fixation of periprosthetic femoral hip fractures Subgroup analysis of the peri-implant and peri-prosthetic fractures Spanish registry (PIPPAS)

To identify risk factors predisposing patients to poor outcomes after fixation of periprosthetic hip fractures around femoral stems. Prospective multicentre cohort study of fractures around a hip replacement stem managed by internal fixation. The primary outcome was one-year mortality, while secondary outcomes were local complications and healthcare burden-related outcomes (nursing facility utilization and hospital length of stay). One-year mortality was 16.2%. Age-adjusted Charlson Comorbidity Index score (OR=1.17; 95%CI=1.03-1.33)), Pfeiffer Short Portable Mental Status Questionnaire (SPMSQ) score (OR=1.16; 1.06-1.28), prosthetic dysfunction (OR=1.90; 1.00-3.61), and postoperative medical complications (OR=1.97; 1.06-3.68) were predictors of mortality. Patients with prior prosthetic dysfunction, lower Pfeiffer SPMSQ scores, Vancouver A fractures, and fractures fixed only using cerclages were at higher risk of local complications, which occurred in 9.3% of cases. Medical (OR=1.81; 1.05-3.13) and local complications (OR=5.56; 2.42-3.13) emerged as consistent risk factors for new institutionalization. Average hospitalization time was 13.9±9.2 days. Each day of fixation delay led to an average 1.4-day increase in total hospitalization. Frail periprosthetic hip-fracture patients with poorer functional status, dysfunctional replacements, and postoperative complications are at increased risk of mortality. Postoperative complications are more common in patients with dysfunctional arthroplasties, Vancouver A fractures, and fixation using cerclages alone. Postoperative complications were the most consistent predictor of higher healthcare resource utilization.

Machine vision-based gait scan method for identifying cognitive impairment in older adults.

Early identification of cognitive impairment in older adults could reduce the burden of age-related disabilities. Gait parameters are associated with and predictive of cognitive decline. Although a variety of sensors and machine learning analysis methods have been used in cognitive studies, a deep optimized machine vision-based method for analyzing gait to identify cognitive decline is needed. This study used a walking footage dataset of 158 adults named West China Hospital Elderly Gait, which was labelled by performance on the Short Portable Mental Status Questionnaire. We proposed a novel recognition network, Deep Optimized GaitPart (DO-GaitPart), based on silhouette and skeleton gait images. Three improvements were applied: short-term temporal template generator (STTG) in the template generation stage to decrease computational cost and minimize loss of temporal information; depth-wise spatial feature extractor (DSFE) to extract both global and local fine-grained spatial features from gait images; and multi-scale temporal aggregation (MTA), a temporal modeling method based on attention mechanism, to improve the distinguishability of gait patterns. An ablation test showed that each component of DO-GaitPart was essential. DO-GaitPart excels in backpack walking scene on CASIA-B dataset, outperforming comparison methods, which were GaitSet, GaitPart, MT3D, 3D Local, TransGait, CSTL, GLN, GaitGL and SMPLGait on Gait3D dataset. The proposed machine vision gait feature identification method achieved a receiver operating characteristic/area under the curve (ROCAUC) of 0.876 (0.852-0.900) on the cognitive state classification task. The proposed method performed well identifying cognitive decline from the gait video datasets, making it a prospective prototype tool in cognitive assessment.

A psychometric study of validation and cross-cultural adaptation of the Holden Communication Scale for elderly with dementia in care homes

Purpose This paper aims to validate and adapt the Arabic version of Holden Communication Scale (HCS) for assessing communication skills among old people with dementia in care home. Design/methodology/approach A study involving 210 elderly residents from Jordanian care homes was conducted, where they completed the Arabic version of the HCS. Internal consistency and factor analysis techniques were precisely used to assess the scale's reliability. Additionally, cognitive function evaluation used the Arabic iteration of the Saint Louis University Mental Status (SLUMS) questionnaire, while communication skills were comprehensively appraised using the HCS. Findings The Arabic HCS has strong content validity, with a one-component structure accounting for 60% of the variation and a three-factor structure accounting for 77.2% of the variance. The original three-subgroup structure of the scale was recreated, and internal consistency varied from 0.85 to 0.87, indicating good reliability. Originality/value This study aimed to assess the reliability and validity of the Arabic version of the HCS among old people with dementia residing in care homes. The authors conducted examination of its psychometric properties within this unique population.

Impact effects of COVID-19 pandemic on chronic disease patients: A longitudinal prospective study.

To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper. A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened. COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term.

Cognitive assessment to optimize prediction of functional outcome in subacute hip fracture: a short-term prospective study.

Cognitive impairment is a long-known negative prognostic factor after hip fracture. Cognition is usually screened by a single easy-to-administer bedside tool, but recent studies have shown that screening tests may be not enough to rule out cognitive impairment with an unfavorable prognostic role. Unfortunately, data on outcome prediction by further cognitive assessments is sparse. We focused on patients with subacute hip fracture defined cognitively intact or mildly impaired on the screening evaluation performed by the Short Portable Mental Status Questionnaire (SPMSQ). We hypothesized that each of 3 further cognitive tests could independently predict activities of daily living, with optimal prediction of function obtained by performing all three the tests. Short-term prospective study. Rehabilitation ward. Inpatients with subacute hip-fracture. Three cognitive tests were performed on admission to rehabilitation in the patients who made ≤4 errors on the SPMSQ: Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning Test (RAVLT, immediate and delayed recall) and Frontal Assessment Battery (FAB). We assessed activities of daily living by the Barthel index. Successful rehabilitation was defined with a Barthel Index Score ≥85. Each of the three cognitive tests assessed before rehabilitation significantly predicted the Barthel index scores measured at the end of the rehabilitation course in our sample of 280 inpatients. However, only the MoCA score retained its significant predictive role when the scores from the three tests were included together as independent variables in a multiple regression model, with adjustments for a panel of potential confounders (P=0.007). The adjusted odds ratio to achieve successful rehabilitation for a seven-point change in MoCA score was 1.98 (CI 95% from 1.02 to 3.83; P=0.042). Contrary to our hypothesis, MoCA but not RAVLT and FAB retained the prognostic role when the scores from the three tests were evaluated together as potential predictors of functional ability in activities of daily living. In the presence of a normal (or mildly altered) score on the SPMSQ in subacute hip fracture, MoCA scores improve prediction of activities of daily living and should be routinely performed.

The impact of ketamine on delayed neurocognitive recovery in elderly patients undergoing spinal anaesthesia for orthopaedic procedures, a pilot study.

Delayed neurocognitive recovery is an objectively measurable decline in the cognitive status at varying intervals after surgery under both general and spinal anaesthesia. In this study, we used the Short Portable Mental Status Questionnaire to evaluate the protective effect of ketamine infusion on cognitive function of elderly patients undergoing spinal anaesthesia for orthopaedic procedures. A randomised, double-blinded placebo-controlled trial. Forty-two geriatric patients listed for elective orthopaedic surgery under spinal anaesthesia were randomly assigned to receive an intravenous infusion of either ketamine (0.3mg/kg) or isotonic saline (control group) after receiving spinal anaesthesia, which continued throughout the procedure. Cognitive performance was evaluated, as a primary outcome, with Short Portable Mental Status Questionnaire. Baseline cognitive performance was comparable in both groups. Patients in the ketamine group showed statistically significant fewer errors in the postoperative Short Portable Mental Status Questionnaire compared with the baseline evaluations (p = 0.038). Patients in the ketamine group showed significantly lower verbal numerical scale scores than the control group (p = 0.04) at six hours after surgery. Elderly patients undergoing spinal anaesthesia showed a better cognitive status after receiving an intravenous infusion of 0.3mg/kg ketamine. However, further research with a larger sample size and different assessment tools might be required to verify our results.

Risk of Obstructive Sleep Apnea and its Relation to Cognitive Functions Among Saudi Older Adults.

The association between obstructive sleep apnea (OSA) and cognitive decline among older adults is a still a topic of debate. Objective: The aim of this study was to determine the association between risk of OSA and cognitive function among Saudi older adults. This was a cross-sectional community-based study conducted between July and October 2022. Participants were recruited from gathering areas where older adults are likely attending such as district centers, waiting areas of shopping malls, and mosques. Questionnaires were completed using face-to-face interviews. The questionnaire included questions of sociodemographics, sleep pattern and health status. A validated Arabic version of Athens insomnia scale, STOP-BANG questionnaire, and St. Louis University mental status (SLUMS) questionnaire were used. A multi-Linear regression model was used to determine the association between cognitive functions and OSA. A total of 343 participants were recruited in this study, of which 86% were male. The mean age was 65±9 years. 65% of participants with high risk of sleep apnea were diagnosed with either dementia or mild cognitive impairment (MCI). Most of the participants who were illiterate (83%) had dementia, while only 4% of participants with higher education had dementia. Dementia and mild cognitive impairment is prevalent among Saudi older adults with high risk of OSA. Clinicians and patients should be aware of the risk of developing dementia in patients with OSA, especially if remain untreated.

Incidence of Postoperative Delirium among Elderly Patients after Elective Surgeries under Anesthesia in the Charity Services of the Philippine General Hospital.

Due to the increasing number of elderly patients being referred to anesthesia for surgical procedures, there is a growing interest with regard to the incidence of postoperative delirium and its contributing factors. The primary objective of this study is to determine the incidence of postoperative delirium in the charity elderly patients at the Philippine General Hospital (PGH). The incidence of postoperative delirium was assessed in an analytic prospective study conducted at the PGH among elderly patients undergoing elective surgeries. Through interviews and chart reviews, the collected data focused on baseline intellectual status, age, gender, ASA classification, level of education, comorbidities, vices, previous surgeries, maintenance medications, preoperative diagnostics, duration of surgery, duration of anesthesia, type of anesthetic technique, and pain scores at the recovery room and 24 hours postoperatively. Responses to the Short Portable Mental Status Questionnaire (SPMSQ), the Preoperative and Postoperative assessment forms and the Confusion Assessment Method (CAM) instrument were analyzed. It was observed that there was a 2.5% incidence of postoperative delirium in the study population and among the risk factors assessed, polypharmacy and presence of moderate to severe pain scores on the first day following surgery were significant contributors in its occurrence. In this preliminary study, the incidence of postoperative delirium as well as the significant contributing factors were described. In succeeding investigations, it is recommended to extend the observation and follow-up periods.

Evaluation of the psychometric properties of the Brazilian version of the Short Portable Mental Status Questionnaire (SPMSQ) by Pfeiffer

Resumo Objetivo Avaliar as propriedades psicométricas, contemplando validade, confiabilidade, sensibilidade e especificidade do SPMSQ-BR. Método A análise foi realizada em 93 idosos, avaliados com a versão brasileira do SPMSQ, Mini-Exame do Estado Mental (MEEM), Teste do Desenho do Relógio (TDR) e Teste de Fluência Verbal (TFV). A consistência interna foi estimada pelo coeficiente alfa de Cronbach. Para avaliar a estabilidade intra-avaliador e a reprodutibilidade inter-avaliador, utilizou-se o coeficiente de correlação intraclasse (CCI) com intervalo de confiança de 95%. Para a validade concorrente e convergente, utilizou-se o coeficiente de correlação de Spearman. A acurácia para estabelecer o ponto de corte do SPMSQ-BR para rastreamento da sensibilidade e especificidade realizou-se através da curva ROC. Resultado: O SPMSQ-BR demonstrou excelente consistência interna (α=0,803), alta confiabilidade intra e inter-avaliador (CCI-0,977) e (CCI-0,973) respectivamente. Na validade concorrente apresentou forte correlação linear com o MEEM (-0,799 p&lt;0,001), já com TDR (-0,584 p&lt;0,01) e TFV (-0,569 p&lt;0,01) foram encontradas correlações moderadas. O SPMSQ-BR mostrou-se capaz de discriminar o comprometimento cognitivo com ponto de corte a partir de 3 erros, conforme a escala original. A área sob a curva considerando a escolaridade foi de AUC=0,905 (S=81,3% e E=76,9%) e sem considerar a escolaridade AUC=0,927 (S=87,5% e E=80,8%) apresentando uma boa sensibilidade e especificidade em ambos os casos. Conclusão O estudo demonstrou que a versão brasileira do SPMSQ estabelecida como Breve Escala de Capacidade Cognitiva apresentou-se estável, reprodutível, válida e confiável para avaliar a capacidade cognitiva de idosos, além de ser sensível na identificação de comprometimento cognitivo.

Avaliação das propriedades psicométricas da versão brasileira do Short Portable Mental Status Questionnaire (SPMSQ) de Pfeiffer

Abstract Objective To evaluate the psychometric properties, including validity, reliability, sensitivity, and specificity of the SPMSQ-BR. Method The analysis was conducted on 93 older adults, assessed with the Brazilian version of the SPMSQ, Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), and Verbal Fluency Test (VFT). Internal consistency was estimated using Cronbach's alpha coefficient. In order to assess intra-rater stability and inter-rater reproducibility, the intraclass correlation coefficient (ICC) with a 95% confidence interval was employed. For concurrent and convergent validity, Spearman's correlation coefficient was utilized. Accuracy in establishing the cutoff point for the SPMSQ-BR to screen sensitivity and specificity was assessed through ROC curve analysis. Result The SPMSQ-BR demonstrated excellent internal consistency (α=0.803), high intra-rater and inter-rater reliability (ICC=0.977 and ICC=0.973), respectively. In terms of concurrent validity, it showed a strong negative linear correlation with the MMSE (-0.799, p&lt;0.001), while moderate correlations were found with the CDT (-0.584, p&lt;0.01) and VFT (-0.569, p&lt;0.01). The SPMSQ-BR proved capable of discriminating cognitive impairment with a cutoff point of 3 errors, following the original scale. The area under the curve (AUC) considering education level was 0.905 (sensitivity=81.3%, specificity=76.9%), and without considering education level, the AUC was 0.927 (sensitivity=87.5%, specificity=80.8%), indicating good sensitivity and specificity in both cases. Conclusion The study demonstrated that the Brazilian version of the SPMSQ, established as a Brief Cognitive Capacity Scale, proved to be stable, reproducible, valid, and reliable for assessing the cognitive capacity of older adults. Furthermore, it showed sensitivity in identifying cognitive impairment.

Demographic, functional and clinical characteristics in hip fracture patients according to mental status of the Spanish National Hip Fracture Registry

ObjectiveTo describe the differences according to mental status at admission on the care process and 30-day outcomes in hip fracture patients, mainly regarding the use of rehabilitation resources and anti-osteoporotic medication, by analysing data from the Spanish National Hip Fracture Registry (RNFC, “Registro Nacional de Fracturas de Cadera” in Spanish). MethodsWe analysed prospectively collected data from a cohort of patients admitted participating in the Spanish National Hip Fracture Registry (RNFC) in 76 Spanish hospitals between 2017 and 2019. We classified participants using Short Portable Mental Status Questionnaire (SPMSQ), defining two groups: patients with ≤2 SPMSQ score and patients with >2 SPMSQ score. ResultsOf 21,254 patients was recorded SPMSQ in 17,242 patients, 9052 were >2 SPMSQ score (52.6%). These were older (87.7 vs. 85.3 years; p<0.001), had worse mobility (no-independent walking ability 26.0% vs. 4.5%; p<0.001) and were more likely to be living in nursing homes (35.3% vs. 9.6%; p<0.001). They were more likely to be treated nonoperatively (3.8% vs. 1.5%; p>0.001), less early mobilisation (57.5% vs. 68.9%; p<0.001) and suffered higher in-hospital mortality (5.2% vs. 2.7%; p<0.001). At discharge, they received less anti-osteoporotic medication (37.9% vs. 48.9%; p<0.001) and returned home less often (29.8%% vs. 51.2%; p<0.001). One month after fracture, patients with >2 SPMSQ score had poorer mobility (no-independent walking ability 44.4% vs. 24.9%; p<0.001) and were newly institutionalised in a nursing home more (12.6% vs. 12.0%; p<0.001) and were more likely to die by one-month post-fracture (9.5% vs. 4.6%; p<0.001). ConclusionRNFC patients with >2 SPMSQ score were more vulnerable and had poorer outcomes than patients with ≤2 SPMSQ score, suggesting that they need specialised care in-hospital and in the recovery phase.

High Nutritional Risk Is Associated with Poor Functional Status and Prognostic Biomarkers in Stroke Patients at Admission to a Rehabilitation Unit.

Considering that malnutrition (undernutrition) is common in stroke patients and may negatively impact body function, the aim of this study was to determine the relationship between nutritional risk and functional status in stroke patients at admission to a rehabilitation unit. Nutritional risk was assessed using the Geriatric Nutritional Risk Index (GNRI), the Prognostic Nutritional Index (PNI) and the Controlling Nutritional Status (CONUT) score. Functional status was assessed using the Barthel Index, the modified Rankin Scale, the Trunk Control Test and the Sitting Balance Scale, and cognitive function was assessed using the Short Portable Mental Status Questionnaire. C-reactive protein, fibrinogen and D-dimer were also evaluated as established prognostic biomarkers. Stroke patients (n = 245; age 69.7 ± 12.8 years; 47%, women; 82% ischemic stroke) at admission to a rehabilitation unit were included in this study. A high prevalence of nutritional risk was detected with each tool and was found to be greater using the GNRI and in patients aged ≥75 years. Multiple logistic regression analysis showed that age and dysphagia were independent predictors of high nutritional risk. High risk groups performed worse on all functional tests compared to the low-risk groups (p < 0.05). Nutritional risk with each tool was associated with functional and cognitive statuses (with the highest correlation being with the Trunk Control Test). Significant associations were also found with C-reactive protein, fibrinogen and D-dimer. In conclusion, a high nutritional risk, as evaluated with the GNRI, the PNI and the CONUT score, was detected in stroke patients at admission to a rehabilitation unit. High nutritional risk was associated with functional status and with predictors of clinical outcomes (and specifically in older patients).

Health factors associated with cognitive frailty in older adults living in the community.

This study aims to investigate the health factors associated with cognitive frailty in frail and pre-frail older adults living in the community. A total of 233 older adults meeting Fried's criteria for pre-frailty or frailty were included. Cognitive status was evaluated using the Short Portable Mental Status Questionnaire. Health factors encompassed nutritional status (evaluated using the Mini Nutritional Assessment tool, body mass index, and waist, arm, and leg circumferences), physical function (assessed with the Short Physical Performance Battery), quality of life (measured with the total index of the EuroQoL 5-Dimension 5-Level questionnaire - EQoL-Index -, and the Visual-Analogue Scale - QoL-VAS - for today's health state), as well as sleep, physical activity, and inactivity estimated through wrist-worn accelerometers. Multivariable logistic regression analyses were conducted to identify potential predictors of cognitive frailty, considering age as a confounding factor. Cognitive frail participants exhibited advanced age, heightened self-reported exhaustion, diminished overall physical performance, reduced leg perimeter, decreased engagement in moderate-to-vigorous physical activity, and higher levels of inactivity (all p<0.05). However, after adjusting for age, only QoL-VAS emerged as a cognitive frailty risk factor (Odds ratio: 1.024), while the EQoL-Index, calf perimeter, and levels of moderate-to-vigorous physical activity were identified as protective factors (Odds ratios: 0.025, 0.929, and 0.973, respectively). This study highlights the complex relationship between non-modifiable factors such as age, and modifiable factors including quality of life, nutritional status, and physical activity in the development of cognitive frailty among older adults with a frailty phenotype living in the community.

Effect of Tooth Loss on Cognitive Function among Older Adults in Singapore

Evidence suggests a longitudinal association between tooth loss and cognitive function. However, the temporality of this association is not well understood. We investigated the effect of several emulated tooth loss prevention scenarios on cognitive function. We used data from 3 waves (baseline: 2009, second wave: 2011–2012, and third wave: 2015) of the Panel on Health and Ageing of Singaporean Elderly (PHASE). PHASE targeted older adults, aged ≥60 y, in Singapore. Number of teeth was used as a time-varying exposure (baseline, second wave). Cognitive function (Short Portable Mental Status Questionnaire score) in the third wave was assessed as the outcome. Multiple time-invariant (baseline) and time-varying (baseline and second wave) covariates were included. The “longitudinal modified treatment policy approach” combined with targeted minimum loss–based estimation was used to define and estimate additive effects of emulated tooth loss prevention scenarios. Emulated scenarios were the following: what if edentate people retained 1 to 4 teeth (scenario 1), what if those with <5 teeth retained 5 to 9 teeth (scenario 2), what if those with <10 teeth retained 10 to 19 teeth (scenario 3), and what if everyone retained ≥20 teeth (scenario 4)? A total of 1,516 participants, excluding those with severe cognitive impairment, were included (male: 41.6%). The mean age at baseline was 70.6 y (SD = 7.1). The mean SPMSQ score at baseline was 2.06 (SD = 0.02) for edentulous, 1.55 (SD = 0.04) for 1 to 4 teeth, 1.61 (SD = 0.03) for 5 to 9 teeth, 1.73 (SD = 0.02) for 10 to 19 teeth, and 1.71 (SD = 0.02) for ≥20 teeth. Additive effect of hypothetical intervention gradually increased with intensity of prevention from scenario 1 to scenario 4 (scenario 1: −0.02 [95% CI, −0.08 to 0.04], scenario 2: −0.05 [95% CI, −0.11 to −0.00], scenario 3: −0.07 [95% CI, −0.14 to −0.00], scenario 4: −0.15 [95% CI, −0.23 to −0.06]). Emulated tooth loss prevention interventions were associated with better cognitive function score. Therefore, preventing tooth loss could potentially benefit maintenance of cognitive function among older adults.

Gait speed according to cognitive status in older adults: a cross-sectional study in a resource-limited country

Objective We aimed to investigate the association between gait speed and cognitive status in outpatient older adults from a resource-limited setting in Peru. Methods We performed a cross-sectional study including older adults aged ≥60 years attending a geriatrics outpatient clinic between July 2017 and February 2020. Gait speed was measured over a 10-meters distance without considering the first and last meter traveled. Cognitive status was assessed through the Short Portable Mental Status Questionnaire (SPMSQ) and the Mini-Mental State Examination (MMSE). We used a multivariate binomial logistic regression to conduct both an epidemiological and fully adjusted models. Results We included 519 older adults (mean age: 75 years; IQR = 10), of whom 95 (18.3%) and 151 (31.5%) were cognitively impaired according to the SPMSQ and MMSE, respectively. Gait speed was slower among patients with poorer cognitive status as assessed by both tools (p < 0.001). Malnutrition (PR: 1.74; CI: 1.45–2.08) and functional dependency (PR: 4.35; CI: 2.68–7.08) were associated with a greater prevalence of cognitive impairment according to the SPMSQ, whereas a faster gait speed (PR: 0.27, CI: 0.14–0.52) and longer years of education (PR: 0.83, CI: 0.77–0.88) were associated with a less prevalence. Conclusions Slower gait speed was associated with poorer cognitive status in outpatient older adults. Gait speed may be a complementary tool in the cognitive assessment of older adults from resource-limited settings.

Effects of a Multiple-Intervention Program on the Depressive Tendencies, Social Support, and Life Satisfaction of Older Adults in Taiwan

ABSTRACT Purpose This study evaluated the effectiveness of a multiple-intervention program (MIP) on the life satisfaction, social support, and depressive tendencies of older adults. Design A cross-sectional, pretest-posttest design involving a questionnaire survey was adopted. Methods Thirty-seven older adults were recruited from 2 daycare centers for an 8-week MIP comprising 60-min sessions conducted once a week. The questionnaire comprised the Short Portable Mental Status Questionnaire, Geriatric Depression Short Form-15 (GDS-SF15), Life Satisfaction Scale (LSS), and Inventory of Social Support Scale (ISSB). Findings The participants’ average GDS-SF15 score decreased considerably (by 35.3%), their average ISSB score increased from 61.9% to 80.9%, and their average LSS score increased from 48% to 64%. Conclusions The outcomes for depressive tendencies, social support, and life satisfaction were measured before and after the intervention, and the participants successfully engaged in the MIP throughout its duration and exhibited improvement. The MIP can serve as a basis for planning group activities for older adults. Clinical Evidence The MIP benefits older adults at daycare centers. Incorporating multiple activities into daily care can help increase the diversity, uniqueness, and innovativeness of a daycare center.

Automated Video Analysis of Audio-Visual Approaches to Predict and Detect Mild Cognitive Impairment and Dementia in Older Adults.

Early identification of different stages of cognitive impairment is important to provide available intervention and timely care for the elderly. This study aimed to examine the ability of the artificial intelligence (AI) technology to distinguish participants with mild cognitive impairment (MCI) from those with mild to moderate dementia based on automated video analysis. A total of 95 participants were recruited (MCI, 41; mild to moderate dementia, 54). The videos were captured during the Short Portable Mental Status Questionnaire process; the visual and aural features were extracted using these videos. Deep learning models were subsequently constructed for the binary differentiation of MCI and mild to moderate dementia. Correlation analysis of the predicted Mini-Mental State Examination, Cognitive Abilities Screening Instrument scores, and ground truth was also performed. Deep learning models combining both the visual and aural features discriminated MCI from mild to moderate dementia with an area under the curve (AUC) of 77.0% and accuracy of 76.0%. The AUC and accuracy increased to 93.0% and 88.0%, respectively, when depression and anxiety were excluded. Significant moderate correlations were observed between the predicted cognitive function and ground truth, and the correlation was strong excluding depression and anxiety. Interestingly, female, but not male, exhibited a correlation. The study showed that video-based deep learning models can differentiate participants with MCI from those with mild to moderate dementia and can predict cognitive function. This approach may offer a cost-effective and easily applicable method for early detection of cognitive impairment.