Development of classification models for early identification of persons at risk for persistent cognitive decline

Kommer, Tessa N. van den; Comijs, Hannie C.; Dik, Miranda G.; Jonker, Cees; Deeg, Dorly J. H.

doi:10.1007/s00415-008-0942-3

Cited by 16 publications

(4 citation statements)

References 46 publications

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“…with higher age, diabetes mellitus) and individuals at risk of a missed dementia diagnosis (e.g. living alone), based on risk factors readily available in primary care (van den Kommer et al , ; Pentzek et al , ; Kamat et al , ). Another area deserving further attention is the development of educational interventions with more emphasis on FPs' perceptions of their own suitability and capability to diagnose dementia, their skills to communicate the diagnosis and the importance of early diagnosis (Iliffe et al , ; Koch and Iliffe, ).…”

Section: Discussionmentioning

confidence: 99%

The accuracy of family physicians' dementia diagnoses at different stages of dementia: a systematic review

Dungen

Marwijk

Horst

et al. 2011

Int J Geriat Psychiatry

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Section: Discussionmentioning

confidence: 99%

The accuracy of family physicians' dementia diagnoses at different stages of dementia: a systematic review

Dungen

Marwijk

Horst

et al. 2011

Int J Geriat Psychiatry

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“…Additional covariates derived from LASA data were highest education level, type of housing, partner status, multimorbidity, persistent cognitive decline, depressive symptoms, and interview mode (supplementary texts available from authors). A dichotomous variable distinguished Period 2 from Period 1, the latter of which was the reference category.…”

Section: Methodsmentioning

confidence: 99%

Decreasing Hospital Length of Stay: Effects on Daily Functioning in Older Adults

Vliet

Huisman

Deeg

2017

J American Geriatrics Society

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OBJECTIVES:To examine the effects of decreasing hospital length of stay (HLOS) on change in functioning from prehospital admission to posthospital discharge in older cohorts. DESIGN: Cohort-sequential design. SETTING: Nationwide, older population-based Longitudinal Aging Study Amsterdam (LASA). PARTICIPANTS: Individuals aged 68 and older with any hospital admission according to national medical registry data: two 10-year age groups (68-77 (younger-old) and 78-87 (older-old)) in two periods (1996-99 (Period 1) and 2006-09 (Period 2)) (N = 1,212). MEASUREMENTS: HLOS was the main independent variable in multinomial logistic models, dichotomized as 1 to 5 days (short) and 6 days or longer (long). Outcomes were change scores in mobility and activities in daily living (ADLs). Respondents who died during the 3-year period were assigned to a third outcome category. RESULTS: Results for both age groups showed more hospital admissions and shorter median HLOS in Period 2 than Period 1 (P < .05). Lower odds of decline in physical functioning were found in respondents with short HLOS than in those with long HLOS (for mobility: odds ratio (OR) = 0.36, 95% confidence interval (CI) = 0.23-0.54 (younger-old) and OR = 0.47, 95% CI = 0.30-0.72 (older-old); for ADLs: OR = 0.30, 95% CI = 0.19-0.48 (younger-old) and OR = 0.30, 95% CI = 0.18-0.53 (older-old)). Adjusting for confounders did not significantly change these estimates. Period did not modify these associations. CONCLUSION: Because the associations of HLOS with change in mobility and ADLs were the same in both periods, hospitalized older adults had neither advantage nor disadvantage from the decrease in HLOS. In addition, in both age groups, a greater percentage experienced the better functional outcomes and lower mortality associated with short admissions, which suggests an advantage of the decrease in HLOS. J Am Geriatr Soc 65:1214-1221, 2017.Key words: hospital length of stay; functional decline; cohort study; older adults; mortality H ospitalization often results in a decline in functioning for older adults due to interactions of aging, disease, and hospital factors.1-3 Hospital length of stay (HLOS) has been shown to predict functional decline for older adults, with longer HLOS associated with a greater likelihood of decline.4-6 HLOS has been decreasing in recent decades. Severely ill individuals are admitted to hospitals for increasingly shorter periods, and individuals with less-severe conditions are receiving increasingly more day care and outpatient treatment. 7,8 A decrease in HLOS may be positive for older adults if the time needed for diagnostic and curative processes is shortened and functional decline during the admission is less severe. Conversely, recovery from functional decline may be adversely affected if the in-hospital recovery period is shorter and posthospital rehabilitation care is not adequately allocated or applied after discharge. The effects of the decrease in HLOS on older adults' daily functioning are unclear. To study the association of the dec...

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“…We restricted both samples to dementia-free participants [14, 15] aged 65 and older at baseline with valid vitamin D assessment and ≥2 cognitive assessments. In the CHS, dementia status was adjudicated according to the National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) criteria [14] whereas in the LASA probable dementia (persistent cognitive decline of more than two standard deviations (SD) below the mean decline with continued decline during follow-up) was identified based on available data as previously described [15]. We also excluded those with baseline memory scores that precluded substantial decline defined as ≥1 SD decrease greater than the mean change score from baseline to final assessment [16] (scores <3 and <8 in the CHS and LASA respectively).…”

Section: Methodsmentioning

confidence: 99%

Vitamin D and Memory Decline: Two Population-Based Prospective Studies

Kuźma

Soni

Littlejohns

et al. 2016

JAD

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Background Vitamin D deficiency has been linked with dementia risk, cognitive decline and executive dysfunction. However, the association with memory remains largely unknown. Objective To investigate whether low serum 25-hydroxyvitamin D (25(OH)D) concentrations are associated with memory decline. Methods We used data on 1,291 participants from the US Cardiovascular Health Study (CHS) and 915 participants from the Dutch Longitudinal Aging Study Amsterdam (LASA) who were dementia-free at baseline, had valid vitamin D measurements and follow-up memory assessments. The Benton Visual Retention Test (in the CHS) and Rey’s Auditory Verbal Learning Test (in the LASA) were used to assess visual and verbal memory respectively. Results In the CHS, those moderately and severely deficient in serum 25(OH)D changed −0.03 SD (95% CI: −0.06 to 0.01) and −0.10 SD (95% CI: −0.19 to −0.02) per year respectively in visual memory compared to those sufficient (p = 0.02). In the LASA, moderate and severe deficiency in serum 25(OH)D was associated with a mean change of 0.01 SD (95% CI: −0.01 to 0.02) and −0.01 SD (95% CI: −0.04 to 0.02) per year respectively in verbal memory compared to sufficiency (p = 0.34). Conclusions Our findings suggest an association between severe vitamin D deficiency and visual memory decline but no association with verbal memory decline. They warrant further investigation in prospective studies assessing different memory subtypes.

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Development of classification models for early identification of persons at risk for persistent cognitive decline

Cited by 16 publications

References 46 publications

The accuracy of family physicians' dementia diagnoses at different stages of dementia: a systematic review

The accuracy of family physicians' dementia diagnoses at different stages of dementia: a systematic review

Decreasing Hospital Length of Stay: Effects on Daily Functioning in Older Adults

Vitamin D and Memory Decline: Two Population-Based Prospective Studies

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