Cognitive Decline After Entering a Nursing Home: A 22-Year Follow-Up Study of Institutionalized and Noninstitutionalized Elderly People

Harmand, Magali González‐Colaço; Meillon, Céline; Rullier, Laetitia; Ávila-Funes, José Alberto; Bergua, Valérie; Dartigues, Jean‐François; Amieva, Hélène

doi:10.1016/j.jamda.2014.02.006

Cited by 86 publications

(65 citation statements)

References 37 publications

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“…The finding that elderly who enter a nursing home demonstrate more rapid cognitive decline compared to those who remain in the community 31 , together with the findings of this study, raise questions into the effect of novel environments for people with AD on disease progression. Moreover, the findings presented here bring into question cognitive interventions for the elderly, and for people living with AD in particular.…”

Section: Discussionmentioning

confidence: 71%

Environmental novelty exacerbates stress hormones and Aβ pathology in an Alzheimer’s model

Stuart

King

Fernández-Martos

et al. 2017

Sci Rep

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Cognitive stimulation has been proposed as a non-pharmacological intervention to be used in primary, secondary and tertiary prevention approaches for Alzheimer’s disease. A common familial Alzheimer’s disease transgenic model showed heightened levels of the stress hormone, corticosterone. When exposed to periodic enhanced cognitive stimulation, these animals demonstrated further heightened levels of corticosterone as well as increased Aβ pathology. Hence, Alzheimer’s disease may be associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction, causing stimulatory environments to become stress-inducing, leading to a glucocorticoid-pathology cycle contributing to further Aβ release and plaque formation. This finding suggests that stimulation-based interventions and local environments for people with Alzheimer’s disease need to be designed to minimise a stress response that may exacerbate brain pathology.

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Section: Discussionmentioning

confidence: 71%

Environmental novelty exacerbates stress hormones and Aβ pathology in an Alzheimer’s model

Stuart

King

Fernández-Martos

et al. 2017

Sci Rep

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“…However, these findings can potentially be explained by pre‐existing differences between patients, since dementia is one of the main risk factors associated with institutionalization (Gnjidic et al., ), González‐Colaço Harmand et al. () showed that even after exclusion of the patients who developed dementia during the follow‐up examination, their results indicating a cognitive decline as a result of institutionalization remained unchanged. Furthermore, our sample only consists of dementia patients suggesting that the risk of being institutionalized was similar for all the patients.…”

Section: Discussionmentioning

confidence: 99%

“…Moving to a nursing home where the older people no longer permanently live with their relatives is stressful for them (An & Jo, 2009;Givens et al, 2012). Furthermore, institutionalization aggravates cognitive decline, probably due to the impoverished environment of nursing homes, defined by Volkers and Scherder (2011) as an environment with limited possibilities for physical and social activity (González-Colaço Harmand et al, 2014;Scocco, Rapattoni, & Fantoni, 2006;Wilson, McCann, et al, 2007;Winocur & Moscovitch, 1990). Indeed, a sample of research revealed a negative association between social isolation and cognitive functioning (Conroy, Golden, Jeffares, O'Neill, & McGee, 2010;O'Luanaigh et al, 2012;Tilvis et al, 2004).…”

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confidence: 99%

Living condition, weight loss and cognitive decline among people with dementia

Harsányiová

Prokop

2018

Nursing Open

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AimsThe aim of this study was to investigate cognitive performance and BMI of patients with dementia living in their own homes with family members, nursing homes and alone.DesignA prospective observational cohort study with a quantitative design.MethodMini–mental state examination (MMSE) scores and BMI were examined with a sample of Slovak patients (N = 428). Patients were followed up 12 months later after the first examination.ResultsCognitive decline was significantly faster for patients living in nursing homes and for solitary patients. BMI consistently decreased in the follow‐up examination and this drop was stronger in patients living alone and in nursing homes. Patients with VaD manifested a stronger BMI decline as compared with AD patients. This study suggests that impoverished conditions such as nursing homes or social isolation of solitary people contribute to stronger progress in dementia. Healthcare professionals need to implement meaningful activities for institutionalized people and for people who are living alone to eliminate the negative impact of an impowerished environment on patient's cognitive functioning.

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“…Sabemos que idosos institucionalizados são mais suscetíveis a doenças psiquiátricas, e vulneráveis à depressão (Runcan, 2012), apresentando de igual modo um maior declínio cognitivo comparativamente aos que permanecem na comunidade (Akdag, Telci, & Cavlak, 2013;Harmand et al, 2014). Estas condições são comuns e ocorrem frequentemente em conjunto (Korostiy & Dubenko, 2012), sendo notório o impacto negativo sobre a saúde (Ford, 2014).…”

Section: Procedimentosunclassified

“…Os baixos níveis de alfabetização (Teixeira, Vasconcelos-Raposo, Fernandes, & Brustad, 2013), a progressiva perda do papel do idoso na sociedade, o luto, o sentimento de isolamento social, assim como a institucionalização são considerados como fatores adjuvantes ao desenvolvimento de sintomatologia depressiva (Carmen, 2013;Runcan, 2012), apresentando um maior declínio cognitivo (Akdag, Telci, & Cavlak, 2013;Harmand et al, 2014), com implicações negativas ao nível da saúde (Ford, 2014), especialmente em idades mais avançadas (Gustafson et al, 2013).…”

Section: Introductionunclassified

Interação entre a idade, escolaridade, tempo de institucionalização e exercício físico na função cognitiva e depressão em idosos

2016

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RESUMOO objetivo deste estudo foi verificar o efeito e interação entre a idade, escolaridade, institucionalização e exercício físico na função cognitiva e depressão em Idosos. Foi utilizada uma amostra constituída por 39 idosos institucionalizados (33 mulheres e 6 homens), com idades compreendidas entre os 64-96 anos (82.13±6.66). Os instrumentos de avaliação utilizados foram: Mini Mental State Examination, Escala de Depressão Geriátrica, Matrizes Progressivas Coloridas de Raven e um questionário sociodemográfico. Para verificar o efeito e a interação entre variáveis, foi aplicado o modelo geral linear, introduzindo como covariável o tempo de institucionalização, e como variáveis fator a idade (<85 anos; ≥85 anos), a escolaridade (analfabetos; 1ºciclo) e a prática de exercício. Os resultados demonstraram um efeito significativo do tempo de institucionalização (p= 0.003) na depressão; e da escolaridade na função cognitiva (p= 0.030). Os resultados da interação escolaridade x idade foram significativos na função cognitiva (p= 0.010) e na capacidade intelectual (p= 0.032). Os indivíduos mais velhos e com nível de escolaridade superior apresentaram resultados mais elevados na função cognitiva e na capacidade intelectual. Podemos concluir que em idosos mais velhos, a escolaridade é a variável mais determinante da função cognitiva, enquanto a depressão depende do tempo de institucionalização.Palavras-chaves: idosos, função cognitiva, depressão, escolaridade, institucionalização, exercício físico ABSTRACT The purpose of this study was verifying the effect and interaction between age, schooling, institutionalisation and physical exercise in the cognitive function and depression in the elderly. The study comprised 39 institutionalized senior citizens (33 females and 6 males) aged between 64 and 96 (82.13±6.66). We used as evaluation tools: Mini Mental State Examination, Geriatric Depression Scale, Raven's Coloured Progressive Matrices and a socio-demographic questionnaire. In order to understand the effect and interaction between variables we used the General Linear Model, introducing the time of institutionalization as a co-variable, and age (<85 years; ≥85 years), schooling (illiterate; 1st cycle of basic education) and physical exercise as variables. The results revealed a statistically significant difference regarding the time of institutionalization when dealing with depression (p= 0.003); and regarding schooling in the cognitive function (p= 0.030). Also, results concerning schooling versus age were significantly different in the cognitive function (p= 0.010) and intellectual ability (p= 0.032). Older individuals with higher levels of education presented superior results regarding the cognitive function and intellectual ability. We can thus infer that when it comes to older seniors schooling is the most decisive variable of the cognitive function, while depression depends on the time of institutionalization.

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Cognitive Decline After Entering a Nursing Home: A 22-Year Follow-Up Study of Institutionalized and Noninstitutionalized Elderly People

Cited by 86 publications

References 37 publications

Environmental novelty exacerbates stress hormones and Aβ pathology in an Alzheimer’s model

Environmental novelty exacerbates stress hormones and Aβ pathology in an Alzheimer’s model

Living condition, weight loss and cognitive decline among people with dementia

Interação entre a idade, escolaridade, tempo de institucionalização e exercício físico na função cognitiva e depressão em idosos

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