ABSTRACT
Background COVID‐19‐restrictions impact the lifestyle and mental health of people, which then might affect brain health and increase risk of cognitive decline particularly in older adults. Thereby, COVID‐19 might indirectly contribute to cognitive decline. We aimed to investigate changes in modifiable risk factors related to brain health in older adults after one year of COVID‐19‐restrictions. Method An online questionnaire was disseminated between February and March 2021 to registrants of the Dutch Brain Research Registry, aged ≥50, without a self‐reported diagnosis of mild cognitive impairment or dementia. Participants reported potential changes in behaviors during COVID‐19 pandemic concerning modifiable risk factors in eight domains (physical activity, sleep, memory, stress, feeling of loneliness, diet, alcohol consumption and smoking) compared to before the COVID‐19‐outbreak. We counted the number of reported detrimental and beneficial changes, and used multiple regression analyses to relate (socio)demographics, subjective memory complaints and COVID‐19 related aspects to increasing number of reported detrimental and beneficial changes, separately. Result 3943 participants (66±8 years old, 76% female) completed the questionnaire. After one year of COVID‐19‐restrictions, 74% reported one or more detrimental changes and 60% reported at least on beneficial change. More specifically, participants reported more often detrimental changes for loneliness, sleep, physical activities, stress, memory complaints and smoking, while beneficial changes were more often reported for diet and alcohol consumption. More detrimental changes was associated lower age, (B = 0.02;95%confidence interval = ‐0.03‐ ‐0.01), female sex (0.28;0.15–0.41), living alone (0.35;0.22–0.48), the presence of subjective memory complaints (0.69;0.54–0.84), a current or past COVID‐19 infection (0.35;0.14–0.56) and a fear of a COVID‐infection (0.54;0.42–0.65). In addition, those who were less satisfied with their income were more likely to report more detrimental changes (0.66;0.34‐1.00). More beneficial changes were only associated with female sex (0.16;0.06‐0.27). Conclusion The COVID‐19 pandemic appears to have a differentially impact on older adults in the Netherlands, with people who are relatively younger, female, living alone, experiencing subjective memory complaints and those with a past or current or fear of a COVID‐19‐infection seem more vulnerable for more detrimental changes in modifiable risk factors related to brain health. Thus providing an opportunity for targeted prevention and health education.
ABSTRACT
Introduction: Clear communication of diagnostic test results and dementia diagnosis is challenging yet important to empower patients and care partners. A personalized diagnostic report could support the communication of dementia diagnostics and aid patients' understanding of diagnosis. In this study, we aimed to design a diagnostic report in co-creation with patients and care partners. Methods: We used a mixed-methods approach, combining surveys with focus groups in iteration. Phase 1 consisted of an international survey assessing needs among patients (n = 50) and care partners (n = 46), and phase 2 consisted of focus group meetings (n = 3) to co-create the content and to hands-on co-design the layout of the diagnostic report with patients (n = 7) and care partners (n = 7). Phase 3 validated results from phase 2 in a survey among patients (n = 28) and care partners (n = 12), and phase 4 comprised final feedback by dementia (care) experts (n = 5). Descriptive statistics were used to report quantitative results and directed content analysis was used to analyze qualitative data. Results: Most patients (39/50, 78%) and care partners (38/46, 83%) positively valued a diagnostic report to summarize test results. The report should be brief, straightforward, and comprise results of the diagnostic tests, including brain imaging and information on future expectations. Despite a clear preference for visual display of test results, several visualization options were deemed best and were equally comprehended. Discussion: In this study, we developed a prototype of a personalized patient report through an iterative design process and learned that co-creation is highly valuable to meet the specific needs of end-users.
ABSTRACT
Background: The COVID-19 pandemic has major influence on lifestyle and mental health, which might affect brain-health and increase the risk of cognitive decline, particularly in older adults. We aimed to describe changes in modifiable risk factors related to brain-health in older adults after one year of COVID-19 restrictions. Methods: An online survey was disseminated between February and March 2021 to 17,773 registrants of the Dutch Brain Research Registry, aged ≥50, without a self-reported diagnosis of mild cognitive impairment or dementia. Participants were asked to report potential changes in behaviors during the COVID-19 pandemic, compared to pre-pandemic, in eight domains related to brain health: physical activity, sleep, feeling of memory decline, perceived stress, feeling of loneliness, diet, alcohol consumption, and smoking. We used negative binomial regression analyses to relate (socio)demographics, subjective memory complaints and COVID-19 related aspects (fear of, or current/past COVID-19 infection) to the number of reported detrimental and beneficial changes as dependent variable. Results: 3,943 participants (66 ± 8 years old; 76% female; 71% highly educated) completed the survey. After one year of COVID-19-restrictions, 74% reported at least one detrimental lifestyle change unfavorable for their brain health, most frequently reported were feelings of loneliness, sleep problems, and less physical activity. 60% of participants reported at least one beneficial change, which were most often more physical activity, healthier dietary habits, and less alcohol consumption. Individuals who are younger [incidence rate ratio (IRR) = 0.99, 95% CI = 0.98-0.99], female (1.20, 1.11-1.30), living alone (1.20, 1.11-1.28) and in urban environments (1.18, 1.08-1.29), who are less satisfied with their income (1.38, 1.17-1.62), experiencing subjective memory complaints (1.40, 1.28-1.52) and those with a past or current (1.19, 1.06-1.34) or fear of a COVID-19 infection (1.33, 1.25-1.42) reported higher numbers of detrimental changes. Discussion: The COVID-19 pandemic has influenced lifestyle in both positive and negative ways. We identified (socio)demographic factors associated with more detrimental changes in modifiable risk factors related to brain health, suggesting that some individuals are more vulnerable for the impact of the COVID-19 pandemic. These findings provide an opportunity for targeted prevention and education to promote a healthy lifestyle during and after the pandemic.
ABSTRACT
BACKGROUND: Heightened public awareness about Alzheimer's disease and dementia increases the need for at-home cognitive self-testing. We offered Cognitive Online Self-Test Amsterdam (COST-A) to independent groups of cognitively normal adults and investigated the robustness of a norm-score formula and cutoff. METHODS: Three thousand eighty-eight participants (mean age ± standard deviation = 61 ± 12 years, 70% female) completed COST-A and evaluated it. Demographically adjusted norm scores were the difference between expected COST-A scores, based on age, gender, and education, and actual scores. We applied the resulting norm-score formula to two independent cohorts. RESULTS: Participants evaluated COST-A to be of adequate difficulty and duration. Our norm-score formula was shown to be robust: ≈8% of participants in two cognitively normal cohorts had abnormal scores. A cutoff of -1.5 standard deviations proved optimal for distinguishing normal from impaired cognition. CONCLUSION: With robust norm scores, COST-A is a promising new tool for research and clinical practice, providing low cost and minimally invasive remote assessment of cognitive functioning.