Memory and Cognition Problems Affect Recovery in Rehabilitation Facilities

Journal of the American Geriatrics Society Research Summary

After a hospital stay, many older adults will be discharged to a skilled nursing facility to recover. The goal of this type of short-term nursing care is to help patients regain their ability to function and perform their daily activities to the best of their ability so they can return home, if possible.

Cognitive impairment is when you have difficulties with memory and your ability to think and make decisions. Some studies have examined how cognitive impairment can affect recovery for nursing home residents. But recently, the Centers for Medicare and Medicaid Services (CMS) added new ways to measure patients’ abilities to perform their daily routines in nursing facilities and other after-care settings.

So far, studies have not examined how skilled nursing care residents who have cognitive difficulties perform on the new self-care and mobility measurements. Researchers designed a new study to fill that knowledge gap. Using new measurements, it examines changes in residents’ self-care and their ability to get around. The study was published in the Journal of the American Geriatrics Society. Continue reading

New Study Estimates the Caregiving Costs for Families

Journal of the American Geriatrics Society Research Summary

“Informal care” is the term used in medicine to describe unpaid care provided by family and friends. It’s an important lifeline for millions of older adults in the U.S. who need day-to-day help with shopping, cooking, cleaning, eating, taking medicine, looking after their own daily well-being, and many other activities essential to our health and quality of life as we age.

In the U.S., more than 35 million people provided informal care to someone 50-years-old and older in 2015. We usually understand the costs associated with a doctor, nurse, or other healthcare worker providing professional care to older adults. However, we don’t understand what the true costs are when older adults are cared for by family members or friends. In part, that’s because most studies have focused on “direct” healthcare costs (the expenses associated with professional help/treatment). However, these studies have ignored the “indirect” costs associated with informal care.

When the costs of informal care are accounted for, most studies usually multiply the hours of informal care by the wage that a formal home healthcare provider would earn. But this doesn’t reflect the true cost of informal care. Informal caregivers often give up other activities such as leisure or employment, for example. Studies haven’t examined the value of leisure time and the other important aspects of life people may give up when they care for a friend or family member.

In a new study, researchers focused on one of the most common caregiving arrangements: daughters between the ages of 40 and 70 who were likely to need to provide informal care to their mothers at some point in the near future. Participants were identified using the Health and Retirement Study, a survey conducted by the University of Michigan since 1992. Findings from this new analysis were published in the Journal of the American Geriatrics Society.

Continue reading

Can Special Training Improve Memory and Thinking Abilities in Older Adults with Mild Cognitive Impairment?

JAGS graphicJournal of the American Geriatrics Society Research Summary

Cognition is the ability to think and make decisions. Medication-free treatments that maintain cognitive health as we age are attracting the attention of medical experts. Maintaining the ability to think clearly and make decisions is crucial to older adults’ well-being and vitality.

Mild cognitive impairment (MCI) is a condition that affects people who are in the early stages of dementia or Alzheimer’s disease. People with MCI may have mild memory loss or other difficulties completing tasks that involve cognitive abilities. MCI may eventually develop into dementia or Alzheimer’s disease. Depression and anxiety also can accompany MCI. Having these conditions can increase the risk of mental decline as people age.

A new, first-of-its-kind study was published in the Journal of the American Geriatrics Society by scientists from research centers in Montreal and Quebec City, Canada. They designed a study to learn whether cognitive training, a medication-free treatment, could improve MCI. Studies show that activities that stimulate your brain, such as cognitive training, can protect against a decline in your mental abilities. Even older adults who have MCI can still learn and use new mental skills.

For their study, researchers recruited 145 older adults around the age of 72 from Canadian memory clinics. The participants had been diagnosed with MCI, and were assigned to one of three groups. Each group included four or five participants, and met for eight weekly sessions for 120 minutes.

The three groups were:

  • Cognitive training group. Members of this group participated in the MEMO program (MEMO stands for a French phrase that translates to “training method for optimal memory”). They received special training to improve their memory and attention span.
  • Psycho-social group. Participants in this group were encouraged to improve their general well-being. They learned to focus on the positive aspects of their lives and find ways to increase positive situations.
  • Control group. Participants had no contact with researchers and didn’t follow a program.

During the time the training sessions took place, 128 of the participants completed the project. After six months, 104 completed all the sessions they were assigned.

People in the MEMO group increased their memory scores by 35 to 40 percent, said Sylvie Belleville, PhD, a senior author of the study. “Most importantly, they maintained their scores over a six-month period.”

What’s more, the improvement was the largest for older adults with “delayed recall.” This means memory for words measured just 10 minutes after people have studied them. Because delayed memory is one of the earliest signs of Alzheimer’s disease, this was a key finding.

Those who participated in the MEMO group said they used the training they learned in their daily lives. The training gave them different ways to remember things. For example, they learned to use visual images to remember names of new people, and to use associations to remember shopping lists. These lessons allowed them to continue maintaining their memory improvements after the study ended.

The people in the psycho-social group and the control group didn’t experience memory benefits or improvement in their mood.

This summary is from “MEMO+: efficacy, durability and impact of cognitive training and psychosocial intervention in MCI.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Sylvie Belleville, PhD; Carol Hudon, PhD; Nathalie Bier, PhD; Catherine Brodeur, MD; Brigitte Gilbert, PhD; Sébastien Grenier, PhD; Marie-Christine Ouellet, PhD; Chantal Viscogliosi, PhD; and Serge Gauthier, MD.