Severity of memory impairment in the elderly: Association with health care resource use and functional limitations in the United States

Aigbogun, Myrlene Sanon; Stellhorn, Robert; Krasa, Holly B.; Kostić, Dušan

doi:10.1016/j.dadm.2017.04.001

Cited by 21 publications

(21 citation statements)

References 15 publications

(32 reference statements)

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“…1 Behavioral and psychological symptoms of dementia-especially agitation, aggressiveness, and personality changes-are significant drivers of ER visits and inpatient hospitalizations. [21][22][23][24] Consistent with these previously published data, the overall severity of dementia was found to be a predictor of ER utilization in the present study. In contrast, the MNC cohort did not have an increase in hospitalizations or ER visits compared with the NPE group.…”

Section: Discussionsupporting

confidence: 92%

Acute Healthcare Utilization of a Multidisciplinary Neurocognitive Dementia Patient Cohort

et al. 2020

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Background and Purpose Upon referral from the primary care provider (PCP), dementia is diagnosed either by a neuropsychological evaluation (NPE) or at a multidisciplinary neurocognitive clinic (MNC). Following the NPE, patients continue receiving care from their PCP. In contrast, patients at the MNC are followed by a multidisciplinary care team that provides expertise across specialties in dementia care and education for the patient, family members, and care providers. The purpose of the study was to determine the utilization of acute healthcare services during the 2 years following a diagnosis of dementia in patients from the MNC and NPE. Methods A retrospective review was performed of 581 electronic medical records from January 2010 through December 2014 for 2 cohorts of patients diagnosed with dementia 1) by a neuropsychologist or 2) in a MNC. Acute-care hospital admissions, emergency room (ER) visits, and nonroutine PCP visits were identified. Categorical demographics and utilization variables were summarized by frequency. Chi-square analysis was used to analyze demographic characteristics and overall utilization between MNCs and NPE. Utilization in comparison with various demographic characteristics was analyzed using Spearman correlation coefficients and negative binomial regressions. Results Patients evaluated in the MNC were older, more severely impaired, and lived alone more often compared with NPE patients, but there was no increase in hospital admissions and ER visits. Patients who underwent NPE were 1.58 times more likely to have a nonroutine PCP office visit than patients evaluated in the MNC (p=0.0093). Conclusions Performing follow-up in multidisciplinary clinics provides patients with more education and may help to reduce the utilization of healthcare services.

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Section: Discussionsupporting

confidence: 92%

Acute Healthcare Utilization of a Multidisciplinary Neurocognitive Dementia Patient Cohort

et al. 2020

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“…Dysregulation of cAMP-PKA signaling and alterations in CREB activity have been associated with age-related cognitive impairments and neurodegenerative diseases [ 7 ]. In recent US National Health Surveys, more than 46% of respondents over age 65 reported memory impairments [ 8 ]. Currently, many countries around the world, including the USA, are experiencing demographic shifts towards older populations.…”

Section: Introductionmentioning

confidence: 99%

The CBP KIX domain regulates long-term memory and circadian activity

et al. 2020

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Background CREB-dependent transcription necessary for long-term memory is driven by interactions with CREB-binding protein (CBP), a multi-domain protein that binds numerous transcription factors potentially affecting expression of thousands of genes. Identifying specific domain functions for multi-domain proteins is essential to understand processes such as cognitive function and circadian clocks. We investigated the function of the CBP KIX domain in hippocampal memory and gene expression using CBPKIX/KIX mice with mutations that prevent phospho-CREB (Ser133) binding. Results We found that CBPKIX/KIX mice were impaired in long-term memory, but not learning acquisition or short-term memory for the Morris water maze. Using an unbiased analysis of gene expression in the dorsal hippocampus after training in the Morris water maze or contextual fear conditioning, we discovered dysregulation of CREB, CLOCK, and BMAL1 target genes and downregulation of circadian genes in CBPKIX/KIX mice. Given our finding that the CBP KIX domain was important for transcription of circadian genes, we profiled circadian activity and phase resetting in CBPKIX/KIX mice. CBPKIX/KIX mice exhibited delayed activity peaks after light offset and longer free-running periods in constant dark. Interestingly, CBPKIX/KIX mice displayed phase delays and advances in response to photic stimulation comparable to wildtype littermates. Thus, this work delineates site-specific regulation of the circadian clock by a multi-domain protein. Conclusions These studies provide insight into the significance of the CBP KIX domain by defining targets of CBP transcriptional co-activation in memory and the role of the CBP KIX domain in vivo on circadian rhythms. Graphical abstract

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“…Dysregulation of cAMP-PKA signaling and alterations in CREB activity have been associated with agerelated cognitive impairments and neurodegenerative diseases (7). In recent U.S. National Health Surveys, more than 46% of respondents over age 65 reported memory impairments (8). Currently many countries around the world, including the United States, are experiencing demographic shifts towards older populations.…”

Section: Introductionmentioning

confidence: 99%

The CBP KIX domain regulates long-term memory and circadian activity

Chatterjee

Angelakos

Bahl

et al. 2020

Preprint

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CREB-dependent transcription necessary for long-term memory is driven by interactions with CREB-binding protein (CBP), a multi-domain protein that binds numerous transcription factors. Identifying specific domain functions for multi-action proteins is essential to understand processes necessary for healthy living including cognitive function and a robust circadian clock. We investigated the function of the CBP KIX domain in hippocampal memory and gene expression using CBP KIX/KIX mice with mutations that prevent phospho-CREB (Ser133) binding. We found that CBP KIX/KIX mice were impaired in long-term, but not short-term spatial memory in the Morris water maze. Using an unbiased analysis of gene expression after training for hippocampus-dependent memory, we discovered dysregulation of CREB and CLOCK target genes and downregulation of circadian genes in CBP KIX/KIX mice.With our finding that the CBP KIX domain was important for transcription of circadian genes, we profiled circadian activity in CBP KIX/KIX mice. CBP KIX/KIX mice exhibited delayed activity peaks after light offset and longer free-running periods in constant dark, although phase resetting to light was comparable to wildtype. These studies provide insight into the significance of the CBP KIX domain by defining targets of CBP transcriptional co-activation in memory and the role of the CBP KIX domain in vivo on circadian rhythms.

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Severity of memory impairment in the elderly: Association with health care resource use and functional limitations in the United States

Cited by 21 publications

References 15 publications

Acute Healthcare Utilization of a Multidisciplinary Neurocognitive Dementia Patient Cohort

Acute Healthcare Utilization of a Multidisciplinary Neurocognitive Dementia Patient Cohort

The CBP KIX domain regulates long-term memory and circadian activity

The CBP KIX domain regulates long-term memory and circadian activity

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