- Email: [email protected]
HELP-SEEKING FOR NEUROPSYCHIATRIC SYMPTOMS IN OLDER ADULTS
Poster Presentations: Monday, July 17, 2017
convey and interpret meaning in art. Our aim is to study the impact of neurodegenerative disease on creativity and creative expression in visual artists. We aim to study if there is a correlation between symptoms experienced by the patient, perceived by their caregivers and the medical professionals examining, testing and evaluating them, and the way the patient continue to create within their visual art form. Methods: Case study of a, now deceased, well-known Swedish visual artist who suffered from Alzheimer’s disease. Medical records as well as interviews with caregivers and family, along with interviews from television and newspapers articles throughout his life, is used to map his symptoms and progress of disease which is then compared to a similar mapping of his creative output before and after he was diagnosed. In this comparison we are studying such factors as use of colour, choice of motif, evocation of emotion, and if there is any correlation between physical or cognitive dysfunction and the artwork produced when these symptoms where present (such as hemispatial neglect, loss of depth perception or perseveration, to name a few). Results: Since current tests and tools for cognitive assessment are limited in their ability to assess complex brain functions case studies of patients utilizing such functions on a regular basis, such as through creative expression in visual arts even when suffering from cognitive diseases, could expand the knowledge of how these functions of the brain are influenced by cognitive disease. Conclusions: Any correlation or discrepancy found in the case study could add valuable insight into, not only how these functions are affected, but also, how patients suffering from neurocognitive disease experience their situation. P2-589
WITHDRAWN
P2-590
CONTRIBUTION OF COGNITIVE IMPAIRMENT, DEPRESSION AND CHRONIC ILLNESS TO FUNCTIONAL IMPAIRMENT INCIDENCE IN THE MEXICAN HEALTH AND AGING STUDY
Claudia I. Astudillo-Garcia1, Gilberto Isaac Acosta-Castillo2,3, Ana Luisa Sosa-Ortiz4, 1Dementia Laboratory, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 2National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 3National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 4Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico. Contact e-mail: [email protected] Background: Functional impairment is an important public health
issue in elderly population. The identification and understanding of their risk factors is key for implementing prevention, care plans, and health policies. This study aims to estimate the contribution of cognitive impairment, depression and chronic illness to functional impairment in a follow-up study from the Mexican Health and Aging Study (MHAS). Methods: We analysed a cohort study of 3633 participants aged 60 an over, with a median follow-up of 11.5 years. Baseline socio-demographic characteristics, cognitive impairment, depression, and self-reported chronic illness (hypertension, diabetes, cancer, respiratory illness, heart attack, stroke, arthritis or rheumatism, vision and hearing impairments) were evaluated. Functional impairment was considered when at least one limitations in basic activities of daily living was present at baseline and follow up. We classified cognitive impairment if alterations in 3 or more cognitive tasks were present: verbal memory (coding), verbal memory (recall), visual-constructional abilities, visual memory (recall of the two figures previously copied) and attention through a visual-scanning task.
P873
Depression was measured with the Center for Epidemiologic Studies Depression Scale Center (CESD). We used a competing-risks regression model to estimate the effects of cognitive impairment, depression and illness on functional impairment incidence, adjusted for age, sex, marital status, and educational attainment. We also estimated the population-attributable risk of each condition for functional impairment at follow-up. Results: Cognitive impairment was not associated with functional impairment incidence with a sub-hazard ratio (subHR) of 1.10(CI 95%: 0.91-1.34), but depression (subHR: 1.35, CI 95%: 1.16-1.58), and chronic illness (subHR: 1.08, CI: 1.02-1.14) were associated, even when adjusted for age, sex, marital status, and educational attainment. 8.6% cases of functional impairment could be avoided if depression cases were treated or prevented, and 11.8% (3.8-19.10) if chronic illness cases were treated. Conclusions: Cognitive impairment was not found to be associated with functional impairment after 11 years of follow-up. Limitations in the evaluation of this condition in older adults should be taken into consideration. Strategies to prevent or treat depression and chronic illness could reduce the incidence of functional impairment among older adults. P2-591
HELP-SEEKING FOR NEUROPSYCHIATRIC SYMPTOMS IN OLDER ADULTS
Gilberto Isaac Acosta-Castillo1,2, Gabriela Rojas de la Torre2, Airam Campos2, Loreli Alvarez2, Ana Luisa Sosa-Ortiz3, 1 National Autonomous University of Mexico, Mexico City, Mexico; 2National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 3Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico. Contact e-mail: [email protected] Background: Is wide accepted that the presence of neuropsychiatric symptoms (NPS) in patients with dementia promotes the deterioration of cognitive impairments and functionality. Some reports describe NPS as a major cause of stress in caregivers. Estimating the impact of SNPs is not a simple task due to the multi-causality that characterize them and the potential factors involved, the way that they are evaluated, whether they are reported by the caregivers or clinician’s observations. The present study aims to analyze the caregiver’s seek related to NPS in Mexican older adults with and without dementia. Methods: We analysed the search for help associated to clinically significant neuropsychiatric symptoms NPS-CS (symptoms with moderate and high severity), evaluated by the Neuropsychiatric Inventory (NPI). Our study’s sample, were 1,355 Mexican elderlies, residents in urban and rural settings, evaluated within the 10/66 Dementia Research Group’s protocols. Results: Of the 1,355 elderly evaluated: 56.1% register cero NPSCS; 37.3% had one to three SNP-CS and 6.6% 4 SNP-CS. Only 11.1% of older adult’s caregivers without dementia, sought help for SNP-CS and 16.5% in dementias cases. The seeking for help was associated with more SNP-CS and dementia. Conclusions: Despite the significant burden of NPS, in our country the seeking for care is low and only increases it, in cases of dementia or with the increment in the number of symptoms, even when symptoms of moderate and severe severity are considered.
P2-592
EXPLORING FAMILIARITY IN OUT-OF-HOME PARTICIPATION OF PEOPLE WITH DEMENTIA
Isabel Margot-Cattin1,2, Nicolas K€uhne1, Annika Ohman3, Louise Nygard2, 1University of Applied Sciences and Arts of
convey and interpret meaning in art. Our aim is to study the impact of neurodegenerative disease on creativity and creative expression in visual artists. We aim to study if there is a correlation between symptoms experienced by the patient, perceived by their caregivers and the medical professionals examining, testing and evaluating them, and the way the patient continue to create within their visual art form. Methods: Case study of a, now deceased, well-known Swedish visual artist who suffered from Alzheimer’s disease. Medical records as well as interviews with caregivers and family, along with interviews from television and newspapers articles throughout his life, is used to map his symptoms and progress of disease which is then compared to a similar mapping of his creative output before and after he was diagnosed. In this comparison we are studying such factors as use of colour, choice of motif, evocation of emotion, and if there is any correlation between physical or cognitive dysfunction and the artwork produced when these symptoms where present (such as hemispatial neglect, loss of depth perception or perseveration, to name a few). Results: Since current tests and tools for cognitive assessment are limited in their ability to assess complex brain functions case studies of patients utilizing such functions on a regular basis, such as through creative expression in visual arts even when suffering from cognitive diseases, could expand the knowledge of how these functions of the brain are influenced by cognitive disease. Conclusions: Any correlation or discrepancy found in the case study could add valuable insight into, not only how these functions are affected, but also, how patients suffering from neurocognitive disease experience their situation. P2-589
WITHDRAWN
P2-590
CONTRIBUTION OF COGNITIVE IMPAIRMENT, DEPRESSION AND CHRONIC ILLNESS TO FUNCTIONAL IMPAIRMENT INCIDENCE IN THE MEXICAN HEALTH AND AGING STUDY
Claudia I. Astudillo-Garcia1, Gilberto Isaac Acosta-Castillo2,3, Ana Luisa Sosa-Ortiz4, 1Dementia Laboratory, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 2National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 3National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 4Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico. Contact e-mail: [email protected] Background: Functional impairment is an important public health
issue in elderly population. The identification and understanding of their risk factors is key for implementing prevention, care plans, and health policies. This study aims to estimate the contribution of cognitive impairment, depression and chronic illness to functional impairment in a follow-up study from the Mexican Health and Aging Study (MHAS). Methods: We analysed a cohort study of 3633 participants aged 60 an over, with a median follow-up of 11.5 years. Baseline socio-demographic characteristics, cognitive impairment, depression, and self-reported chronic illness (hypertension, diabetes, cancer, respiratory illness, heart attack, stroke, arthritis or rheumatism, vision and hearing impairments) were evaluated. Functional impairment was considered when at least one limitations in basic activities of daily living was present at baseline and follow up. We classified cognitive impairment if alterations in 3 or more cognitive tasks were present: verbal memory (coding), verbal memory (recall), visual-constructional abilities, visual memory (recall of the two figures previously copied) and attention through a visual-scanning task.
P873
Depression was measured with the Center for Epidemiologic Studies Depression Scale Center (CESD). We used a competing-risks regression model to estimate the effects of cognitive impairment, depression and illness on functional impairment incidence, adjusted for age, sex, marital status, and educational attainment. We also estimated the population-attributable risk of each condition for functional impairment at follow-up. Results: Cognitive impairment was not associated with functional impairment incidence with a sub-hazard ratio (subHR) of 1.10(CI 95%: 0.91-1.34), but depression (subHR: 1.35, CI 95%: 1.16-1.58), and chronic illness (subHR: 1.08, CI: 1.02-1.14) were associated, even when adjusted for age, sex, marital status, and educational attainment. 8.6% cases of functional impairment could be avoided if depression cases were treated or prevented, and 11.8% (3.8-19.10) if chronic illness cases were treated. Conclusions: Cognitive impairment was not found to be associated with functional impairment after 11 years of follow-up. Limitations in the evaluation of this condition in older adults should be taken into consideration. Strategies to prevent or treat depression and chronic illness could reduce the incidence of functional impairment among older adults. P2-591
HELP-SEEKING FOR NEUROPSYCHIATRIC SYMPTOMS IN OLDER ADULTS
Gilberto Isaac Acosta-Castillo1,2, Gabriela Rojas de la Torre2, Airam Campos2, Loreli Alvarez2, Ana Luisa Sosa-Ortiz3, 1 National Autonomous University of Mexico, Mexico City, Mexico; 2National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 3Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico. Contact e-mail: [email protected] Background: Is wide accepted that the presence of neuropsychiatric symptoms (NPS) in patients with dementia promotes the deterioration of cognitive impairments and functionality. Some reports describe NPS as a major cause of stress in caregivers. Estimating the impact of SNPs is not a simple task due to the multi-causality that characterize them and the potential factors involved, the way that they are evaluated, whether they are reported by the caregivers or clinician’s observations. The present study aims to analyze the caregiver’s seek related to NPS in Mexican older adults with and without dementia. Methods: We analysed the search for help associated to clinically significant neuropsychiatric symptoms NPS-CS (symptoms with moderate and high severity), evaluated by the Neuropsychiatric Inventory (NPI). Our study’s sample, were 1,355 Mexican elderlies, residents in urban and rural settings, evaluated within the 10/66 Dementia Research Group’s protocols. Results: Of the 1,355 elderly evaluated: 56.1% register cero NPSCS; 37.3% had one to three SNP-CS and 6.6% 4 SNP-CS. Only 11.1% of older adult’s caregivers without dementia, sought help for SNP-CS and 16.5% in dementias cases. The seeking for help was associated with more SNP-CS and dementia. Conclusions: Despite the significant burden of NPS, in our country the seeking for care is low and only increases it, in cases of dementia or with the increment in the number of symptoms, even when symptoms of moderate and severe severity are considered.
P2-592
EXPLORING FAMILIARITY IN OUT-OF-HOME PARTICIPATION OF PEOPLE WITH DEMENTIA
Isabel Margot-Cattin1,2, Nicolas K€uhne1, Annika Ohman3, Louise Nygard2, 1University of Applied Sciences and Arts of