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From Brain Health to Good Health
International Journal of Gerontology 11 (2017) 1
Contents lists available at ScienceDirect
International Journal of Gerontology journal homepage: www.ijge-online.com
Editorial
From Brain Health to Good Health
Cognitive function as an integrated assessment incorporating both anatomic (structural) and a variety of functional alterations may include several important components, including the ability to learn, to solve problems in real-world, and to remember or to appropriately use stored data or relevant information. The integrity of cognition has been proposed to be a key to successful health, especially during aging process. While approximately more than half of persons with cognitive dysfunction identified from population studies may have Alzheimer disease (AD), efforts have been made to screen early cognitive impairment and to establish the minimum workup/advice that a care provider should achieve in early cognitive impairment1. A potentially interaction and synergistic effects between physical and cognitive failure may possible exist, based on the findings that both psychological and social problems may accelerate the development of disability. The reasons can be complex, or simply based on the conditions that they may share common and similar pathophysiological processes accelerating both sides2. In this issue, we appreciate the study conducted by HM Chen et al3, which examined and the link among several disability scorings (such as ADL, DALY, and IADL), burden of comorbid conditions (Charlson Comorbidity Index: CCI) and early cognitive functional changes by using Alzheimer disease-8 (AD8) in 115 elderly participants. The authors further explored the associations of these components with a probably more comprehensive measure by quality of life (QoL), with a more focused topic between risk for disability and QoL. AD-8 had been consistently shown to be associated with several common dementing disorders and actually is relatively sensitive to early cognitive changes from common dementing illness. Interestingly, the authors observed strong relationship between total QoL score and AD-8, indicating the link between early cognitive changes and life quality of multi-facets. This result may not be surprising, given the fact that several dimensions of mental health contained in AD-8 including memory
ability, temporal orientation, judgment, and relevant functional performance could overlap some main domains of QoL, which may become more pronouncedly related when facing multiple chronic diseases, for example, during senescence process. HM Chen et al's study demonstrated insights into the understanding how cognitive failure may somewhat play a role, or at least by exerting its influences via mutual interactions, from mental health inside to physical or social life outside in an elderly population. More positive steps toward early detection of individuals at risk for specific disability category in a wide range of clinical applications by using such scoring system are encouraged with caution in the future. References 1. Morley JE, Morris JC, Berg-Weger M, et al. Brain health: the importance of recognizing cognitive impairment: an IAGG consensus conference. J Am Med Dir Assoc. 2015;16:731e739. 2. Malmstrom TK, Morley JE. Frailty and cognition: linking two common syndromes in older persons. J Nutr Health Aging. 2013;17:723e725. 3. Chen HM, Chen CM. Factors associated with quality of life among older adults with chronic disease in Taiwan. Int J Gerontol. 2017;11:12e15.
Chung-Lieh Hung, MD, MSc
*
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan * Correspondence to: Dr Chung-Lieh Hung, Department of Psychiatry, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Taipei 10449, Taiwan. E-mail address: [email protected].
Available online 6 March 2017
http://dx.doi.org/10.1016/j.ijge.2017.02.001 1873-9598/Copyright © 2017, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Contents lists available at ScienceDirect
International Journal of Gerontology journal homepage: www.ijge-online.com
Editorial
From Brain Health to Good Health
Cognitive function as an integrated assessment incorporating both anatomic (structural) and a variety of functional alterations may include several important components, including the ability to learn, to solve problems in real-world, and to remember or to appropriately use stored data or relevant information. The integrity of cognition has been proposed to be a key to successful health, especially during aging process. While approximately more than half of persons with cognitive dysfunction identified from population studies may have Alzheimer disease (AD), efforts have been made to screen early cognitive impairment and to establish the minimum workup/advice that a care provider should achieve in early cognitive impairment1. A potentially interaction and synergistic effects between physical and cognitive failure may possible exist, based on the findings that both psychological and social problems may accelerate the development of disability. The reasons can be complex, or simply based on the conditions that they may share common and similar pathophysiological processes accelerating both sides2. In this issue, we appreciate the study conducted by HM Chen et al3, which examined and the link among several disability scorings (such as ADL, DALY, and IADL), burden of comorbid conditions (Charlson Comorbidity Index: CCI) and early cognitive functional changes by using Alzheimer disease-8 (AD8) in 115 elderly participants. The authors further explored the associations of these components with a probably more comprehensive measure by quality of life (QoL), with a more focused topic between risk for disability and QoL. AD-8 had been consistently shown to be associated with several common dementing disorders and actually is relatively sensitive to early cognitive changes from common dementing illness. Interestingly, the authors observed strong relationship between total QoL score and AD-8, indicating the link between early cognitive changes and life quality of multi-facets. This result may not be surprising, given the fact that several dimensions of mental health contained in AD-8 including memory
ability, temporal orientation, judgment, and relevant functional performance could overlap some main domains of QoL, which may become more pronouncedly related when facing multiple chronic diseases, for example, during senescence process. HM Chen et al's study demonstrated insights into the understanding how cognitive failure may somewhat play a role, or at least by exerting its influences via mutual interactions, from mental health inside to physical or social life outside in an elderly population. More positive steps toward early detection of individuals at risk for specific disability category in a wide range of clinical applications by using such scoring system are encouraged with caution in the future. References 1. Morley JE, Morris JC, Berg-Weger M, et al. Brain health: the importance of recognizing cognitive impairment: an IAGG consensus conference. J Am Med Dir Assoc. 2015;16:731e739. 2. Malmstrom TK, Morley JE. Frailty and cognition: linking two common syndromes in older persons. J Nutr Health Aging. 2013;17:723e725. 3. Chen HM, Chen CM. Factors associated with quality of life among older adults with chronic disease in Taiwan. Int J Gerontol. 2017;11:12e15.
Chung-Lieh Hung, MD, MSc
*
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan * Correspondence to: Dr Chung-Lieh Hung, Department of Psychiatry, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Taipei 10449, Taiwan. E-mail address: [email protected].
Available online 6 March 2017
http://dx.doi.org/10.1016/j.ijge.2017.02.001 1873-9598/Copyright © 2017, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).