Feasibility and Acceptance of Telerehabilitation among Older Adults with Mild Cognitive Impairment or Cognitive Frailty: A Scoping Review (Preprint)

2021 ◽  
Author(s):  
Nurul Hidayah Md Fadzil ◽  
Suzana Sahar ◽  
Roslee Rajikan ◽  
Devinder Kaur Ajit Singh ◽  
Arimi Fitri Mat Ludin ◽  
...  

BACKGROUND Older adults are vulnerable towards cognitive frailty that can lead to adverse health outcomes such as cognitive frailty, falls, disabilities, hospitalizations and increased morbidity. With advancement of healthcare technology, there is a potential to manage and reverse cognitive frailty among older adults using a multi-domain intervention programme via telerehabilitation. OBJECTIVE In this review, we aimed to identify the feasibility and acceptance towards telerehabilitation and the common technology used for delivering telerehabilitation among older adults with mild cognitive impairment or cognitive frailty. METHODS Five research databases were searched: PubMed (EMBASE), Embase (Science Direct), Cochrane Database of Systematic Review, IEEE Xplore and Scopus. Articles published from January 2015 until October 2020 were selected. A hand search of JMIR Publications journals was also included RESULTS Of the 1758 articles retrieved, six studies were identified that involved implementation of telerehabilitation targeting older adults with cognitive frailty. Two articles were randomized controlled trials, one pilot study and three were qualitative studies. Telerehabilitation can improve quality of life among participants with mild cognitive impairment and cognitive frailty and found to be feasible as supportive digital platform in digital health care. Some types of technologies commonly used in the studies were smartphone or telephone with Internet, television-based assistive integrated technology, mobile application and videoconference. CONCLUSIONS Telerehabilitation utilization in managing cognitive frailty among older adults is still limited and more research is required to evaluate its feasibility and acceptability. Although telerehabilitation appears to be feasible and accepted among older adults with cognitive frailty, some social support in place is required. Future research should focus on evaluation of acceptance and cost effectiveness of multi-domain intervention via telerehabilitation among older adults with cognitive frailty.

2016 ◽  
Vol 2 (2) ◽  
Author(s):  
Maurizio Gallucci

Dementia is one of the most disabling health conditions for older people. Increasing attention is paid to the preclinical phase such as cognitive frailty and mild cognitive impairment, and to the prevention programs designed to reduce the number of patients in the future. The aims of this brief report are therefore: i) to illustrate an action plan currently active in Treviso and that is aimed at secondary prevention in cognitive frailty subjects on the Treviso Dementia (TREDEM) Registry; ii) to highlight the results achieved by the TREDEM Registry up to now and how these can be used in future research.


2020 ◽  
Vol 7 ◽  
pp. 205566832090907 ◽  
Author(s):  
Amel Yaddaden ◽  
Mélanie Couture ◽  
Mireille Gagnon-Roy ◽  
Patricia Belchior ◽  
Maxime Lussier ◽  
...  

Introduction Occupational therapists promote safety and autonomy of older adults with cognitive impairments. A technology, named COOK, offers support on a touch screen installed next to the stove to support task performance while correcting risky behaviors. We aimed to document (1) the functional profiles according the diagnosis (2) the types of interventions used to increase autonomy in the kitchen (3) the facilitators and obstacles to the implementation of COOK with this clientele. Methods Four focus groups were conducted with occupational therapists ( n = 24) and were transcribed and analyzed using thematic analysis, including coding and matrix building. Results Occupational therapists identified different (1) functional profiles and (2) interventions for both diagnoses. The use of COOK (3) could be more beneficial in mild cognitive impairment, as many barriers occur for the use in Alzheimer’s disease. Some parameters, such as digital control of the stove and complex information management, need to be simplified. Discussion According to occupational therapists, this technology is particularly applicable to people with mild cognitive impairment, because this population has better learning abilities. Conclusion This study documented the specific needs of older adults with cognitive impairments as well as interventions used by occupational therapists. The perspectives of caregivers should be captured in future research.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 442-442
Author(s):  
Yoonjung Ji ◽  
TaeWha Lee ◽  
Eunkyung Kim

Abstract Cognitive frailty is a condition where physical frailty and mild cognitive impairment (MCI) co-exist without dementia. It occurs in 1.8%-8.9% of the general older population, and older people with depression have a higher risk of frailty. However, the relationship between cognitive frailty and depression is still unclear. This study aimed to determine the relationship between cognitive frailty and depression of older adults by time using comparative group analysis. A secondary analysis was conducted using the Korean Longitudinal Study of Aging (KLoSA) dataset from 2010 to 2018. A sample was 981 older adults who were 65 years old and without dementia over residing in the community. Cognitive frailty was defined as having a mini-mental state examination score of 18-23 and 3 or more of the Fried frailty indexes. Generalized Estimating Equation model and chi-square test were employed. Of the 981 subjects, the cognitive frailty(CF) was 28.5%, followed by robust (37.7%), physical frailty (PF, 29.4%), mild cognitive impairment (MCI, 4.4%) at baseline. The group differences on depression measured by the Center for Epidemiological Studies Depression (CESD) were statistically significant in the PF (F=4.70, p<.001) and the CF (F=4.95, p<.001) group compared to the robust group. The time difference effect (F=.09, p=.05) and a group-by-time interaction effect were observed (p<.001). This study confirmed that cognitive frailty is strongly associated with depression. Effective approaches to managing psychological wellbeing, including dementia, are essential for older adults with cognitive frailty.


2019 ◽  
Vol 34 (6) ◽  
pp. 936-936
Author(s):  
J Quattlebaum ◽  
P Martin ◽  
A Moltisanti ◽  
H Clark ◽  
R Schroeder

Abstract Objective The current study sought to examine the specificity of Digit Span (DS) scaled score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) as a performance validity test (PVT) in older adults with Mild Cognitive Impairment (MCI) or dementia. Method Archival data were utilized and included 195 patients (mean age = 72.8; mean education = 13.2) who underwent outpatient neuropsychological evaluations. Cases that had missing data, did not meet criteria for a neurocognitive disorder, or whose performance was deemed invalid were excluded. Participants were classified according to their evaluation diagnosis of MCI (n = 72; mean RBANS total score = 86.8) or dementia. Those diagnosed with dementia were divided by MoCA performance and categorized as mild dementia (n = 90; MoCA≥15; mean RBANS Total Score = 71.0) or moderate dementia (n = 33; MoCA < 15; mean RBANS Total Score = 55.9). Scaled score frequencies were analyzed to calculate specificity for each group. Results An RBANS DS scaled score of ≤4 occurred infrequently in older adults with MCI and mild dementia, resulting in specificity values of 0.93 and 0.90, respectively. In moderate dementia, specificity fell to 0.68 when using a scaled score of ≤4, with a cutoff of ≤2 required to maintain adequate specificity. Conclusions Findings suggest utility of RBANS DS scaled score as a PVT in dementia evaluations provided use of appropriate cutoffs. A more stringent cutoff was required in examinees with moderate dementia relative to patients with MCI and mild dementia. Future research should examine the RBANS DS sensitivity to invalid performance, as well as DS specificity across specific etiologies of MCI and dementia.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 908-909
Author(s):  
Zuyun Liu ◽  
Chen Chen ◽  
Juyoung Park ◽  
Chenkai Wu ◽  
Qian-Li Xue ◽  
...  

Abstract Cognitive frailty was proposed in 2013 by an (I.A.N.A./I.A.G.G.) international consensus group; however, little is known about its status and associations with adverse health outcomes in China. The objectives of this study were to evaluate: 1) the associations of cognitive frailty with various health outcomes including disability, hospitalization, and death; 2) whether the associations differed by multimorbidity in Chinese older adults. We included 5113 Chinese older adults (aged 60+ years) who had baseline (2011 wave) cognition and physical frailty assessments and follow-up for 4 years from the China Health and Retirement Longitudinal Study. We found that about 16.0% had cognitive impairment; 6.7% had physical frailty; and 1.6% met criteria for cognitive frailty (having both cognitive impairment and physical frailty). Both cognitive impairment (odds ratios (ORs) range: 1.41 to 2.11) and physical frailty (ORs range: 1.51 to 2.43) were independently associated with basic activities of daily living (BADL), instrumental ADL (IADL), mobility disability, hospitalization, and death among participants without that corresponding outcome at baseline, even after accounting for covariates. Relative to participants who had normal cognition and were nonfrail, those with cognitive frailty had the highest risk for IADL disability (OR=3.40, 95% CI, 1.23–9.40) and death (OR=3.89, 95% CI, 2.25–6.47). We did not find significant interaction effects between cognitive frailty and multimorbidity (P for interactions&gt;0.05). Overall, cognitive frailty was associated with disability and death, independent of multimorbidity. This highlights the importance of assessing cognitive frailty in the community to promote primary and secondary preventions for healthy aging.


2020 ◽  
Author(s):  
Bess Yin-Hung Lam ◽  
Daniel W.L. Lai ◽  
Jessica Li ◽  
Zhi Zou ◽  
Chetwyn C. H. Chan

Abstract Background Positive ageing amid of age-related neurodegeneration is a global challenge. The present study examined whether psychological resilience can be a protective factor among older adults. Methods The participants were 233 community-dwelling older individuals with or without mild cognitive impairment (MCI). They completed testing on resilience and the cognitive reserve proxies. Hierarchical logistic regression was conducted to test the hypotheses of the present study. Results After controlling for age and the cognitive reserve proxies, resilience (b= -0.38) and resilience × visuospatial function significantly predicted MCI group membership (ps < 0.05). There are two new findings. First, higher level of resilience in addition to the conventional cognitive reserve proxies predicted lower MCI risks. Second, MCI participants with higher level of resilience had significantly higher visuospatial ability than their lower level counterparts. Conclusions These findings raise the question of whether resilience should be considered as a cognitive reserve proxy. It also calls for future research to enhance the level of resilience in older adults for healthy ageing.


2017 ◽  
Vol 2 (2) ◽  
pp. 110-116
Author(s):  
Valarie B. Fleming ◽  
Joyce L. Harris

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.


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