Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA92093, USA.
Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA92093, USA.
J Int Neuropsychol Soc. 2022 Jan;28(1):62-73. doi: 10.1017/S1355617721000163. Epub 2021 Mar 22.
The current cross-sectional study examined cognition and performance-based functional abilities in a continuing care senior housing community (CCSHC) that is comparable to other CCSHCs in the US with respect to residents' demographic characteristics.
Participants were 110 older adult residents of the independent living unit. We assessed sociodemographics, mental health, neurocognitive functioning, and functional capacity.
Compared to normative samples, participants performed at or above expectations in terms of premorbid functioning, attention span and working memory, processing speed, timed set-shifting, inhibitory control, and confrontation naming. They performed below expectation in verbal fluency and verbal and visual learning and memory, with impairment rates [31.4% (>1 SD below the mean) and 18.49% (>1.5 SD below the mean)] well above the general population (16% and 7%, respectively). Within the cognitive test battery, two tests of delayed memory were most predictive of a global deficit score. Most cognitive test scores correlated with performance-based functional capacity.
Overall, results suggest that a subset of older adults in the independent living sector of CCSHCs are cognitively and functionally impaired and are at risk for future dementia. Results also argue for the inclusion of memory tests in abbreviated screening batteries in this population. We suggest that CCSHCs implement regular cognitive screening procedures to identify and triage those older adults who could benefit from interventions and, potentially, a transition to a higher level of care.
本横断面研究考察了一个持续护理老年住房社区（CCSHC）中的认知和基于表现的功能能力，该社区在居民人口统计学特征方面与美国其他 CCSHC 相当。
参与者为独立生活单元的 110 名老年居民。我们评估了社会人口统计学、心理健康、神经认知功能和功能能力。
与常模样本相比，参与者在以下方面的表现达到或超过预期：预患病功能、注意力广度和工作记忆、处理速度、定时转换、抑制控制和对抗命名。他们在言语流畅性、言语和视觉学习记忆方面的表现低于预期，损伤率[31.4%（低于平均值 1 个标准差）和 18.49%（低于平均值 1.5 个标准差）]远高于普通人群（分别为 16%和 7%）。在认知测试组合中，两个延迟记忆测试最能预测整体缺陷评分。大多数认知测试分数与基于表现的功能能力相关。
总体而言，结果表明，CCSHC 独立生活部门的一部分老年人在认知和功能上受损，并且有患痴呆症的风险。结果还表明，在该人群中，应将记忆测试纳入简化筛查组合中。我们建议 CCSHC 实施定期认知筛查程序，以识别和甄别那些可能受益于干预措施、并可能过渡到更高护理水平的老年人。
