Aspects of cognition that impact aging‐in‐place and long‐term care planning

Abstract

Background Older adults frequently defer decisions about their aging‐in‐place/long‐term care (AIP‐LTC) needs. As a result, when older adults experience worsening Alzheimer's disease, family members/friends become surrogate decision makers. We sought to understand what aspects of cognition impact older adult AIP‐LTC planning. Methods As part of the PlanYourLifespan (PYL)‐LitCog study, we longitudinally examined AIP‐LTC decision‐making among a cohort (LitCog) of community‐based older adults (65 years and older) recruited from hospital‐associated primary care clinics in Chicago, Illinois, with extensive cognitive testing. PlanYourLifespan.org (PYL) is an evidence‐based online intervention that facilitates AIP‐LTC planning. Subjects underwent baseline testing, received the PYL online intervention, and then were surveyed at 1, 6, and 12 months about AIP‐LTC decision‐making. Cross‐sectional logistic regression analysis was conducted examining cognitive variables that impacted AIP‐LTC decision‐making. Results Of the 293 older adults interviewed (mean age 73.0 years, 40.4% non‐White), subjects were more likely to have made AIP‐LTC decisions if they had adequate inductive reasoning (ETS letter sets total—OR = 1.14 (95% CI = 1.03–1.27; p < 0.05)) and adequate working memory (size judgment span total—OR = 1.76 (95% CI = 1.13–2.73; p < 0.05)). There were no differences in decision‐making observed in verbal abilities, long‐term memory, or processing speed. All analyses were adjusted for participant gender, race, age, and decision‐making response at baseline. Conclusion Inductive reasoning and working memory are critical to AIP‐LTC decision‐making. Screening routinely for these specific cognitive domains is important in targeting and helping older adults prepare in time for their future AIP‐LTC needs.

Clock Drawing Test Common Errors in Older People with Cancer

“…On the other hand, we added to the evidence that some types of errors in the CDT (neglect of left hemi-space, numbers written counterclockwise) that suggest the need for a deeper cognitive evaluation even if the overall (quantitative) score classifies the patient as normal, are present among older cancer patients even before starting treatment. Adequate working memory has been associated with decision-making ability [35], which is of paramount importance when dealing with a cancer diagnosis and treatment possibilities, as well as when navigating medical services. Thus, the detection of those individuals with cognitive problems and their timely referral for a complete evaluation could be carried out with the CDT, both to find modifiable causes (polypharmacy, vitamin deficiencies, lack of control of comorbidities) and to appoint substitutes and representatives in decision-making.…”

Subjective cognitive decline and missed aging‐in‐place/long‐term care planning

“…The Plan Your Lifespan (PYL) longitudinal research study evaluates AIP planning and decision-making, specifically with AD. [7][8][9][10] Subjects were recruited from the LitCog study (n = 800); a cohort of older adults 65+ who participate in extensive neuropsychological cognitive testing every 2.5 years. Cognitive testing was grouped into three categories: no impairment, mild cognitive impairment, and moderate dementia.…”

Desarrollo y validación de una tarea experimental de Memoria Episódica verbal en español

“…La evidencia aportada por estudios conductuales ha demostrado que proporcionar AA durante la codificación produce efectos positivos en el recuerdo (13)(14)(15) . El AA se entiende entonces como un soporte externo de rendimiento que actúa manipulando las demandas de una tarea cognitiva para favorecer un procesamiento más eficaz de la información (12) .…”