Comorbidity in Aging and Dementia: Scales Differ, and the Difference Matters

Borson, Soo; Scanlan, James M.; Lessig, Mary; DeMers, Shaune M.

doi:10.1097/jgp.0b013e3181d695af

Cited by 25 publications

(19 citation statements)

References 25 publications

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“…In certain communities, more than 80% of the elderly people do not read or write. The Mini Mental State Examination (MMSE) has been translated into many languages and its use as an initial screening tool was settled [5,6].…”

Section: Introductionmentioning

confidence: 99%

The Use of the Mini-Mental State Examination and the Clock-Drawing Test for Dementia in a Tertiary Hospital

Sallam

Amr²

2013

JCDR

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Section: Introductionmentioning

confidence: 99%

The Use of the Mini-Mental State Examination and the Clock-Drawing Test for Dementia in a Tertiary Hospital

Sallam

Amr²

2013

JCDR

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“…The CIRS has been shown to correlate with medication use and disability, and to predict mortality, hospitalization, and disability (e.g., Borson, Scanlan, Lessig, & DeMers, 2010; Parmelee, Thuras, Katz, & Lawton, 1995). In our study, the CIRS-G was completed by a licensed registered nurse with training and supervision from one of the study physicians (JS).…”

Section: Methodsmentioning

confidence: 99%

Psychological and social resources relate to biomarkers of allostasis in newly admitted nursing home residents

Meeks

Haitsma

Mast

et al. 2015

Aging & Mental Health

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Objectives This paper presents preliminary baseline data from a prospective study of nursing home adaptation that attempts to capture the complexity of residents’ adaptive resources by examining psychological, social, and biological variables from a longitudinal conceptual framework. Our emphasis was on validating an index of allostasis. Method In a sample of 26 long-term care patients, we measured 6 hormone and protein biomarkers to capture the concept of allostasis as an index of physiological resilience, related to other baseline resources, including frailty, hope and optimism, social support, and mental health history, collected via interview with the resident and collaterals. We also examined the performance of self-report measures reflecting psychosocial and well-being constructs, given the prevalence of cognitive impairment in nursing homes. Results Our results supported both the psychometric stability of our self-report measures, and the preliminary validity of our index of allostasis. Each biomarker was associated with at least one other resilience resource, suggesting that our choice of biomarkers was appropriate. As a group, the biomarkers showed good correspondence with the majority of other resource variables, and our standardized summation score was also associated with physical, social, and psychological resilience resources, including those reflecting physical and mental health vulnerability as well as positive resources of social support, optimism, and hope. Conclusion Although these results are based on a small sample, the effect sizes were large enough to confer some confidence in the value of pursuing further research relating biomarkers of allostasis to psychological and physical resources and well-being.

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“…Patient variables included demographic descriptors, a defined set of 5 behavioral problems (27) reported by caregivers and/or observed during interview (anger/hostility, visual/auditory hallucinations, irritability, suspiciousness/paranoia, severe social withdrawal), dementia stage (Clinical Dementia Rating [CDR]) (28), and burden of chronic disease (Cumulative Illness Rating Scale, 13 item modification for medical conditions comorbid with cognitive disorders [CIRS-G-13]) (31). Caregiver variables included relationship to the care recipient (spouse or other relative); living situation (together or apart) and the caregiver’s current level of perceived stress using a single question (“Overall, how stressful is your caregiving situation at this time?” scored 1 [not at all] to 5 [extremely]).…”

Section: Methodsmentioning

confidence: 99%

Dementia Services Mini-Screen: A Simple Method to Identify Patients and Caregivers in Need of Enhanced Dementia Care Services

Borson

Scanlan

Sadak

et al. 2014

The American Journal of Geriatric Psychiatry

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Objective The National Alzheimer’s Plan calls for targeted health system change to improve outcomes for persons with dementia and their family caregivers. We explored whether dementia-specific service needs and gaps could be predicted from simple information that can be readily acquired in routine medical care settings. Method Primary family caregivers for cognitively impaired older adults (n=215) were asked about current stress, challenging patient behaviors, and prior-year needs and gaps in 16 medical and psychosocial services. Demographic data, caregiver stress, and patient clinical features were evaluated in regression analyses to identify unique predictors of service needs and gaps. Results Caregiver stress and patient behavior problems together accounted for an average of 24% of the whole-sample variance in total needs and gaps. Across all analyses, including total, medical, and psychosocial services needs and gaps, all other variables combined (comorbid chronic disease, dementia severity, age, caregiver relationship, and residence) accounted for an accounted for a mean of 3%, with no variable yielding more than 4% in any equation. We combined stress and behavior problem indicators into a simple screen. In early/mild dementia dyads (n=111) typical in primary care settings, the screen identified gaps in total and psychosocial care in 84% and 77%, respectively, of those with high stress/high behavior problems vs. 25% and 23%, respectively, of those with low stress/low behavior problems. Medical care gaps were dramatically higher in high stress/high behavior problem dyads (66%) than all others (12%). Conclusion A simple tool (likely completed in 1–2 minutes) which combines caregiver stress and patient behavior problems, the Dementia Services Mini-Screen, could help clinicians rapidly identify high need, high gap dyads. Health care systems could use it to estimate population needs for targeted dementia services and facilitate their development.

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Comorbidity in Aging and Dementia: Scales Differ, and the Difference Matters

Abstract: Background-Accurate assessment of dementia's impact on health care utilization and costs requires separation of the effects of comorbid conditions, often poorly accounted for in existing claims-based studies.

Cited by 25 publications

References 25 publications

The Use of the Mini-Mental State Examination and the Clock-Drawing Test for Dementia in a Tertiary Hospital

The Use of the Mini-Mental State Examination and the Clock-Drawing Test for Dementia in a Tertiary Hospital

Psychological and social resources relate to biomarkers of allostasis in newly admitted nursing home residents

Dementia Services Mini-Screen: A Simple Method to Identify Patients and Caregivers in Need of Enhanced Dementia Care Services

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