Clinical assessments for legal competence of older adults.

2004 ◽  
pp. 119-139 ◽  
Author(s):  
Thomas Grisso
Keyword(s):  
Older Adults ◽  
Clinical Assessments ◽  
Legal Competence

scholarly journals Evaluation of Concurrent Validity between a Smartphone Self-Test Prototype and Clinical Instruments for Balance and Leg Strength

Sensors ◽  
2021 ◽  
Vol 21 (5) ◽  
pp. 1765
Author(s):  
Linda Mansson ◽  
Pernilla Bäckman ◽  
Fredrik Öhberg ◽  
Jonas Sandlund ◽  
Jonas Selling ◽  
...  
Keyword(s):  
Older Adults ◽  
Concurrent Validity ◽  
Test Validity ◽  
Strength Test ◽  
Test Procedures ◽  
Balance Test ◽  
Clinical Assessments ◽  
Leg Strength ◽  
Test Application ◽  
Self Test

The evolving use of sensors to objectively assess movements is a potentially valuable addition to clinical assessments. We have developed a new self-test application prototype, MyBalance, in the context of fall prevention aimed for use by older adults in order to independently assess balance and functional leg strength. The objective of this study was to investigate the new self-test application for concurrent validity between clinical instruments and variables collected with a smartphone. The prototype has two test procedures: static standing balance test in two positions, and leg strength test performed as a sit-to-stand test. Thirty-one older adults were assessed for balance and functional leg strength, in an outpatient physiotherapy setting, using seven different clinical assessments and three sensor-tests. The results show that clinical instruments and sensor measurements correlate to a higher degree for the smartphone leg strength test. For balance tests, only a few moderate correlations were seen in the Feet Together position and no significant correlations for the Semi Tandem Stance. This study served as a first step to develop a smartphone self-test application for older adults to assess functional balance at home. Further research is needed to test validity, reliability, and user-experience of this new self-test application.

Home and Clinical Assessments of Instrumental Activities of Daily Living: What Could Explain the Difference between Settings in Frail Older Adults, If Any?

2009 ◽  
Vol 72 (8) ◽  
pp. 339-348 ◽  
Author(s):  
Véronique Provencher ◽  
Louise Demers ◽  
Isabelle Gélinas
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Occupational Therapists ◽  
Frail Older Adults ◽  
Clinical Assessments ◽  
Instrumental Activities ◽  
Current Content ◽  
The Difference ◽  
Discharge From Hospital

Background: Older patients are usually assessed by occupational therapists in hospital before going home. However, for many frail older adults, this assessment in an unfamiliar environment might not be as representative of their functional abilities as an assessment at home. The aim of this literature review was to determine if differences exist between home and clinical instrumental activities of daily living (IADL) assessments of frail older adults and identify factors that might explain those differences, if any. Method: The sources of the review data were Medline, CINAHL, AMED, PsycINFO, Embase and Current Content from 1988 to 2008. As few relevant studies concerning frail people were found, the search was extended to mixed-age and older adult populations. Ten articles were retained. Main findings: The results suggest differences in IADL assessment between settings for older adults without dementia. Some factors, such as familiarity with the environment and coping skills, might explain those differences. Based on this review, similar results might be expected with frail older people. Implications for practice: Given the dearth of literature on this topic, further research is needed to compare home and clinical assessments and measure relevant factors in a frail population. Helping occupational therapists to identify frail patients, who may show different abilities in unfamiliar settings, could mean more appropriate services after discharge from hospital.

scholarly journals Characteristic patterns of emergency ambulance assignments for older adults compared with adults requiring emergency care at home in Sweden: a total population study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Hjalmarsson ◽  
Mats Holmberg ◽  
Margareta Asp ◽  
Gunnel Östlund ◽  
Kent W. Nilsson ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Priority Level ◽  
Clinical Assessments ◽  
Emergency Medical ◽  
Emergency Ambulance ◽  
Care At Home ◽  
To Receive ◽  
Priority Levels

Abstract Background Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18–69 years requiring emergency care at home in Sweden. Methods A descriptive retrospective study was performed using anonymized registry data from the emergency medical services in a region of Sweden during 2017–2018. One-sample χ2 test, one-way analysis of variance, and binary logistic regression models were used for investigating group differences. Variables for analysis were age, gender, clinical assessments, on-scene time, priority levels, result of response, and temporal patterns. Results Of all included emergency ambulance assignments (n = 28,533), 59.9% involved older adults, of which 53.8% were women. The probability for older adults to receive the highest priority was decreased for both dispatch (p < 0.001, odds ratio [OR] 0.63, 95% confidence interval [CI] 0.59–0.66), and transport priorities (p < 0.001, OR 0.74, 95% CI 0.68–0.80). Older adults were more likely to receive dispatch priority levels 2 (p < 0.001, OR 1.48, 95% CI 1.40–1.56), and 3 (p < 0.001, OR 1.73, 95% CI 1.46–2.06). The older adults were similarly more likely to receive transport priority level 3 (p < 0.001, OR 1.40, 95% CI 1.28–1.52) compared with adults. Age had a small but additive effect in relation to on-scene time (p < 0.001, R2 = 0.01, F = 53.82). Distinguishing initial clinical assessments for older adults were circulatory, respiratory, trauma, infection, and nonspecific assessments. Emergency ambulance assignments for older adults were more frequently occurring on Mondays (p < 0.001, χ2 = 232.56), and in the 08:00–11:59 interval (p < 0.001, χ2 = 1224.08). Conclusion The issues of the lower priority level preponderance, and the decreased probability for receiving the highest priority warrant further attention in future research and clinical practice.

scholarly journals Loneliness, Circulating Endocannabinoid Concentrations, and Grief Trajectories in Bereaved Older Adults: A Longitudinal Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Minhi Kang ◽  
Luisa Bohorquez-Montoya ◽  
Timothy McAuliffe ◽  
Stacy A. Claesges ◽  
Nutta-On Blair ◽  
...  
Keyword(s):  
Mental Health ◽  
Mass Spectrometry ◽  
Older Adults ◽  
Symptom Severity ◽  
Rating Scales ◽  
Liquid Chromatography Mass Spectrometry ◽  
Clinical Assessments ◽  
Symptom Trajectories ◽  
Depressive Symptom Severity

Background: Loneliness is one of the most distressing grief symptoms and is associated with adverse mental health in bereaved older adults. The endocannabinoid signaling (ECS) system is stress-responsive and circulating endocannabinoid (eCB) concentrations are elevated following bereavement. This study examined the association between loneliness and circulating eCB concentrations in grieving older adults and explored the role of eCBs on the association between baseline loneliness and grief symptom trajectories.Methods: A total of 64 adults [grief with high loneliness: n = 18; grief with low loneliness: n = 26; and healthy comparison (HC): n = 20] completed baseline clinical assessments for the UCLA loneliness scale. In grief participants, longitudinal clinical assessments, including the Inventory of Complicated Grief and 17-item Hamilton Depression Rating scales, were collected over 6 months. Baseline circulating eCB [N-arachidonoylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG)] concentrations were quantified in the serum using isotope dilution, liquid chromatography-mass spectrometry; cortisol concentrations were measured in the same samples using radioimmunoassay.Results: Circulating AEA concentrations were higher in severely lonely grieving elders than in HC group; cortisol concentrations were not different among the groups. Cross-sectionally, loneliness scores were positively associated with AEA concentrations in grievers; this finding was not significant after accounting for depressive symptom severity. Grieving individuals who endorsed high loneliness and had higher 2-AG concentrations at baseline showed faster grief symptom resolution.Conclusions: These novel findings suggest that in lonely, bereaved elders, increased circulating eCBs, a reflection of an efficient ECS system, are associated with better adaptation to bereavement. Circulating eCBs as potential moderators and mediators of the loneliness-grief trajectory associations should be investigated.

Measuring hand sensory function and force control in older adults: Are current hand assessment tools enough?

2021 ◽  
Author(s):  
Rachel N Logue ◽  
Elana R Goldenkoff ◽  
Michael Vesia ◽  
Susan H Brown
Keyword(s):  
Older Adults ◽  
Pattern Recognition ◽  
Young Adults ◽  
Force Control ◽  
Assessment Tools ◽  
Sensory Function ◽  
Sensorimotor Function ◽  
Healthy Older Adults ◽  
Clinical Assessments ◽  
Tactile Pattern

Abstract Background The ability to grasp and manipulate objects is essential for performing activities of daily living. However, there is limited information regarding age-related behavioral differences in hand sensorimotor function due, in part, to the lack of assessment tools capable of measuring subtle but important differences in hand function. The purpose of this study was to demonstrate performance differences in submaximal force control and tactile pattern recognition in healthy older adults using two custom-designed sensorimotor assessment tools. Methods Sensorimotor function was assessed in 13 healthy older adults (mean age 72.2 ±5.5y, range: 65-84y) and 13 young adults (mean age 20 ±1.4y, range: 19-23y). Clinical assessments included the Montreal Cognitive Assessment (MoCA), monofilament testing, maximum voluntary contraction (MVC), and Grooved Pegboard Test. Sensorimotor assessments included submaximal (5, 20% MVC) grip force step-tracking and tactile pattern recognition tasks. Results Clinical assessments revealed no or minimal group differences in MVC, monofilament thresholds, and MoCA. However, sensorimotor assessments showed that older adults took longer to discriminate tactile patterns and had poorer accuracy than young adults. Older adults also produced submaximal forces less smoothly than young adults at the 20% force level while greater variability in force maintenance was seen at 5% but not 20% MVC. Conclusions These results demonstrate the ability to integrate higher-order tactile information and control low grip forces is impaired in older adults despite no differences in grip strength or cognition. These findings underscore the need for more sensitive evaluation methods that focus on sensorimotor ability reflective of daily activities.

scholarly journals Reliability of Clinical Assessments in Older Adults With Syncope or Near Syncope

2016 ◽  
Vol 23 (9) ◽  
pp. 1014-1021 ◽  
Author(s):  
Daniel K. Nishijima ◽  
Amber L. Laurie ◽  
Robert E. Weiss ◽  
Annick N. Yagapen ◽  
Susan E. Malveau ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Assessments

scholarly journals Nurse Practitioner’s Role as 3D Team Leader

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 745-745
Author(s):  
Kathleen Obuchon
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Older Adult ◽  
Home Visit ◽  
Cognitive Vulnerability ◽  
Care Physician ◽  
Intervention Period ◽  
Clinical Assessments ◽  
Inappropriate Medications ◽  
Reconciliation Process

Abstract The nurse practitioner’s (NP) clinical activities during the 12-month intervention period include 4 monthly in-home visits and 8 monthly telephone contacts. This presentation will detail the clinical assessments and activities conducted during the initial home visit, and how subsequent home visit activities and interventions are structured for older adults and their informal caregivers depending on whether older adults have dementia, depression, and/or recent delirium. Because the potential for medication-related problems is a critical concern for older adults with cognitive vulnerability, this presentation also will detail how the NP works with the 3D Team pharmacist to determine potential inappropriate medications through a review and reconciliation process, and how the NP and pharmacist summarize these results and correspond accordingly with the older adult’s primary care physician. Finally, this presentation will explain how the NP manages communication among members of the 3D Team who provide interventions to the same older adult and caregiver.

Cognitive control constrains memory attributions

2019 ◽  
Vol 42 ◽  
Author(s):  
Colleen M. Kelley ◽  
Larry L. Jacoby
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Control

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

Cognitive Load Affects Speech Motor Performance Differently in Older and Younger Adults

2019 ◽  
Vol 62 (5) ◽  
pp. 1258-1277 ◽  
Author(s):  
Megan K. MacPherson
Keyword(s):  
Older Adults ◽  
Cognitive Load ◽  
Motor Performance ◽  
Age Groups ◽  
Incongruent Condition ◽  
Sentence Production ◽  
Movement Duration ◽  
Production Task ◽  
Younger Adults ◽  
Speech Motor

PurposeThe aim of this study was to determine the impact of cognitive load imposed by a speech production task on the speech motor performance of healthy older and younger adults. Response inhibition, selective attention, and working memory were the primary cognitive processes of interest.MethodTwelve healthy older and 12 healthy younger adults produced multiple repetitions of 4 sentences containing an embedded Stroop task in 2 cognitive load conditions: congruent and incongruent. The incongruent condition, which required participants to suppress orthographic information to say the font colors in which color words were written, represented an increase in cognitive load relative to the congruent condition in which word text and font color matched. Kinematic measures of articulatory coordination variability and movement duration as well as a behavioral measure of sentence production accuracy were compared between groups and conditions and across 3 sentence segments (pre-, during-, and post-Stroop).ResultsIncreased cognitive load in the incongruent condition was associated with increased articulatory coordination variability and movement duration, compared to the congruent Stroop condition, for both age groups. Overall, the effect of increased cognitive load was greater for older adults than younger adults and was greatest in the portion of the sentence in which cognitive load was manipulated (during-Stroop), followed by the pre-Stroop segment. Sentence production accuracy was reduced for older adults in the incongruent condition.ConclusionsIncreased cognitive load involving response inhibition, selective attention, and working memory processes within a speech production task disrupted both the stability and timing with which speech was produced by both age groups. Older adults' speech motor performance may have been more affected due to age-related changes in cognitive and motoric functions that result in altered motor cognition.

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