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Associations between unmet palliative care needs and cognitive impairment in a sample of diverse, community-based older adults

Published online by Cambridge University Press:  25 June 2020

Elissa Kozlov Open the ORCID record for Elissa Kozlov [Opens in a new window] ,
Matthew J. Wynn ,
M. Carrington Reid ,
Charles R. Henderson Jr. ,
XinQi Dong  and
Jo Anne Sirey
Elissa Kozlov*
Affiliation:
Rutgers University, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA
Matthew J. Wynn
Affiliation:
Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA
M. Carrington Reid
Affiliation:
Department of Geriatrics and Palliative Care, Weill Cornell Medicine, New York, NY, USA
Charles R. Henderson Jr.
Affiliation:
Cornell University, College of Human Ecology, Ithaca, NY, USA
XinQi Dong
Affiliation:
Rutgers University, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA
Jo Anne Sirey
Affiliation:
Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
*
Author for correspondence: Elissa Kozlov, Institute for Health, 12 Patterson St, New Brunswick, NJ 08901, USA. E-mail: [email protected]
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Abstract

Objective

Given a large number of community-based older adults with mild cognitive impairment, it is essential to better understand the relationship between unmet palliative care (PC) needs and mild cognitive impairment in community-based samples.

Method

Participants consisted of adults ages 60+ receiving services at senior centers located in New York City. The Montreal Cognitive Assessment (MoCA) and the Unmet Palliative Care Needs screening tool were used to assess participants’ cognitive status and PC needs.

Results

Our results revealed a quadratic relationship between unmet PC needs and mild cognitive impairment, controlling for gender, living status, and age. Participants with either low or high MoCA scores reported lower PC needs than participants with average MoCA scores, mean difference of the contrast (low and high vs. middle) = 2.15, P = 0.08.

Significance of results

This study is a first step toward elucidating the relationship between cognitive impairment and PC needs in a diverse community sample of older adults. More research is needed to better understand the unique PC needs of older adults with cognitive impairment living in the community.

Keywords

Advanced care planningCommunity-based older adultsGoals of careMild cognitive impairmentPalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 1 , February 2021 , pp. 41 - 45
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

REFERENCES

Ahn, IS, Kim, J-H, Kim, S, et al. (2009) Impairment of instrumental activities of daily living in patients with mild cognitive impairment. Psychiatry Investigation 6(3), 180–184. https://doi.org/10.4306/pi.2009.6.3.180CrossRefGoogle ScholarPubMed
Arkin, S (2007) Language-enriched exercise plus socialization slows cognitive decline in Alzheimer's disease. American Journal of Alzheimer's Disease and Other Dementias. https://doi.org/10.1177/1533317506295377CrossRefGoogle ScholarPubMed
Carson, N, Leach, L and Murphy, KJ (2017) A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores. International Journal of Geriatric Psychiatry. https://doi.org/10.1002/gps.4756Google ScholarPubMed
Cecato, JF, Martinelli, JE, Izbicki, R, et al. (2016) A subtest analysis of the Montreal Cognitive Assessment (MoCA): Which subtests can best discriminate between healthy controls, mild cognitive impairment and Alzheimer's disease’. International Psychogeriatrics. https://doi.org/10.1017/S1041610215001982CrossRefGoogle Scholar
Dodge, HH, Kadowaki, T, Hayakawa, T, et al. (2005) Cognitive impairment as a strong predictor of incident disability in specific ADL-IADL tasks among community-dwelling elders: The Azuchi study. The Gerontologist 45(2), 222–230. https://doi.org/10.1093/geront/45.2.222CrossRefGoogle ScholarPubMed
Ghesquiere, A, Gardner, DSDS, McAfee, C, et al. (2018) Development of a community-based palliative care screening tool for underserved older adults with chronic illnesses. American Journal of Hospice and Palliative Medicine. https://doi.org/10.1177/1049909117749467CrossRefGoogle ScholarPubMed
Jedrziewski, MK, Ewbank, DC, Wang, H, et al. (2014) The impact of exercise, cognitive activities, and socialization on cognitive function: Results from the national long-term care survey. American Journal of Alzheimer's Disease and Other Dementias. https://doi.org/10.1177/1533317513518646CrossRefGoogle ScholarPubMed
Kozlov, E, Cai, A, Sirey, JA, et al. (2018) Identifying palliative care needs among older adults in nonclinical settings. American Journal of Hospice and Palliative Medicine. https://doi.org/10.1177/1049909118777235CrossRefGoogle ScholarPubMed
Lepore, M, Ferrell, A and Wiener, JM (2017). Living arrangements of people with Alzheimer's disease and related dementias: Implications for services and supports. Research Summit on Dementia Care: Building Evidence for Services and Supports. Washington DC: Office of the Assistant Secretary for Planning and Evaluation Disability, Aging, and Long-Term Care Policy.Google Scholar
Manly, JJ, Tang, M-X, Schupf, N, et al. (2008) Frequency and course of mild cognitive impairment in a multiethnic community. Annals of Neurology 63(4), 494–506. https://doi.org/10.1002/ana.21326CrossRefGoogle Scholar
Milani, SA, Marsiske, M, Cottler, LB, et al. (2018) Optimal cutoffs for the Montreal Cognitive Assessment vary by race and ethnicity. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring 10, 773–781. https://doi.org/10.1016/J.DADM.2018.09.003CrossRefGoogle ScholarPubMed
Mitchell, AJ and Shiri-Feshki, M (2009) Rate of progression of mild cognitive impairment to dementia - Meta-analysis of 41 robust inception cohort studies. Acta Psychiatrica Scandinavica. https://doi.org/10.1111/j.1600-0447.2008.01326.xCrossRefGoogle ScholarPubMed
Nasreddine, ZS, Phillips, NA, Bédirian, V, et al. (2005) The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2005.53221.xCrossRefGoogle ScholarPubMed
Porter, KE and Cahill, S (2015) A state-level review of diversity initiatives in congregate meal programs established under the older Americans act. Research on Aging. https://doi.org/10.1177/0164027514552330CrossRefGoogle ScholarPubMed
Ritchie, K (2004) Mild cognitive impairment: An epidemiological perspective. Dialogues in Clinical Neuroscience 6(4), 401–408.Google Scholar
Small, GW (2008) Beyond standard anti-dementia therapies: Diet, exercise, socialization, and supplements. CNS Spectrums 13(S16), 31–33. https://doi.org/10.1017/S1092852900027036CrossRefGoogle ScholarPubMed
Tinetti, ME, Speechley, M and Ginter, SF (1988) Risk factors for falls among elderly persons living in the community. New England Journal of Medicine 319(26), 1701–1707. https://doi.org/10.1056/NEJM198812293192604CrossRefGoogle ScholarPubMed
Wilson, RS, Boyle, PA, Segawa, E, et al. (2013) The influence of cognitive decline on well-being in old age. Psychology and Aging 28(2), 304–313. https://doi.org/10.1037/a0031196CrossRefGoogle ScholarPubMed