Identifying predictors of cognitive decline in long-term care: a scoping review
Abstract Background Cognitive impairment can cause social, emotional, and financial burdens on individuals, caregivers, and healthcare providers. This is especially important in settings such as long-term care (LTC) homes which largely consist of vulnerable older adults. Thus, the objective of this...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-04193-6 |
| _version_ | 1827708484688281600 |
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| author | Gaurav Arora Christina Milani Peter Tanuseputro Patrick Tang Ahwon Jeong Daniel Kobewka Colleen Webber |
| author_facet | Gaurav Arora Christina Milani Peter Tanuseputro Patrick Tang Ahwon Jeong Daniel Kobewka Colleen Webber |
| author_sort | Gaurav Arora |
| collection | DOAJ |
| description | Abstract Background Cognitive impairment can cause social, emotional, and financial burdens on individuals, caregivers, and healthcare providers. This is especially important in settings such as long-term care (LTC) homes which largely consist of vulnerable older adults. Thus, the objective of this study is to review and summarize current research examining risk factors of cognitive decline in older adults within LTC. Methods This scoping review includes primary observational research studies assessing within-person change in cognition over time in LTC or equivalent settings in high resource countries. A mean participant age of ≥ 65 years was required. Searches were conducted in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PyscInfo on June 27th, 2022 and included articles published during or after the year 2000. Title, abstract, and full-text screening was performed by two independent reviewers using Covidence. Specific predictors along with their associated relation with cognitive decline were extracted by a team of reviewers into a spreadsheet. Results Thirty-eight studies were included in this review. The mean sample size was 14 620. Eighty-seven unique predictors were examined in relation to cognitive decline. Dementia was the most studied predictor (examined by 9 of 38 studies), and the most conclusive, with eight of those studies identifying it as a risk factor for cognitive decline. Other predictors that were identified as risk factors included arterial stiffness (identified by 2 of 2 studies), physical frailty (2 of 2 studies), sub-syndromal delirium (2 of 2 studies), and undergoing the first wave of COVID-19 lockdowns (2 of 2 studies). ADL independence was the most conclusive protective factor (3 of 4 studies), followed by social engagement (2 of 3 studies). Many remaining predictors showed no association and/or conflicting results. Conclusions Dementia was the most common risk factor, while ADL independence was the most common protective factor associated with cognitive decline in LTC residents. This information can be used to stratify residents by risk severity and provide better personalized care for older adults through the targeted management of cognitive decline. |
| first_indexed | 2024-03-10T17:04:17Z |
| format | Article |
| id | doaj.art-c8844397ac074126a879d1ab8d5610eb |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-10T17:04:17Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-c8844397ac074126a879d1ab8d5610eb2023-11-20T10:51:27ZengBMCBMC Geriatrics1471-23182023-09-012311910.1186/s12877-023-04193-6Identifying predictors of cognitive decline in long-term care: a scoping reviewGaurav Arora0Christina Milani1Peter Tanuseputro2Patrick Tang3Ahwon Jeong4Daniel Kobewka5Colleen Webber6University of OttawaOttawa Hospital Research InstituteUniversity of OttawaOttawa Hospital Research InstituteWestern UniversityUniversity of OttawaOttawa Hospital Research InstituteAbstract Background Cognitive impairment can cause social, emotional, and financial burdens on individuals, caregivers, and healthcare providers. This is especially important in settings such as long-term care (LTC) homes which largely consist of vulnerable older adults. Thus, the objective of this study is to review and summarize current research examining risk factors of cognitive decline in older adults within LTC. Methods This scoping review includes primary observational research studies assessing within-person change in cognition over time in LTC or equivalent settings in high resource countries. A mean participant age of ≥ 65 years was required. Searches were conducted in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PyscInfo on June 27th, 2022 and included articles published during or after the year 2000. Title, abstract, and full-text screening was performed by two independent reviewers using Covidence. Specific predictors along with their associated relation with cognitive decline were extracted by a team of reviewers into a spreadsheet. Results Thirty-eight studies were included in this review. The mean sample size was 14 620. Eighty-seven unique predictors were examined in relation to cognitive decline. Dementia was the most studied predictor (examined by 9 of 38 studies), and the most conclusive, with eight of those studies identifying it as a risk factor for cognitive decline. Other predictors that were identified as risk factors included arterial stiffness (identified by 2 of 2 studies), physical frailty (2 of 2 studies), sub-syndromal delirium (2 of 2 studies), and undergoing the first wave of COVID-19 lockdowns (2 of 2 studies). ADL independence was the most conclusive protective factor (3 of 4 studies), followed by social engagement (2 of 3 studies). Many remaining predictors showed no association and/or conflicting results. Conclusions Dementia was the most common risk factor, while ADL independence was the most common protective factor associated with cognitive decline in LTC residents. This information can be used to stratify residents by risk severity and provide better personalized care for older adults through the targeted management of cognitive decline.https://doi.org/10.1186/s12877-023-04193-6Long-term careNursing homesAssisted-livingCognitive declineCognitive impairmentCognitive dysfunction |
| spellingShingle | Gaurav Arora Christina Milani Peter Tanuseputro Patrick Tang Ahwon Jeong Daniel Kobewka Colleen Webber Identifying predictors of cognitive decline in long-term care: a scoping review BMC Geriatrics Long-term care Nursing homes Assisted-living Cognitive decline Cognitive impairment Cognitive dysfunction |
| title | Identifying predictors of cognitive decline in long-term care: a scoping review |
| title_full | Identifying predictors of cognitive decline in long-term care: a scoping review |
| title_fullStr | Identifying predictors of cognitive decline in long-term care: a scoping review |
| title_full_unstemmed | Identifying predictors of cognitive decline in long-term care: a scoping review |
| title_short | Identifying predictors of cognitive decline in long-term care: a scoping review |
| title_sort | identifying predictors of cognitive decline in long term care a scoping review |
| topic | Long-term care Nursing homes Assisted-living Cognitive decline Cognitive impairment Cognitive dysfunction |
| url | https://doi.org/10.1186/s12877-023-04193-6 |
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