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Aboriginal experiences of aging and dementia in a context of sociocultural change: qualitative analysis of key informant group interviews with Aboriginal seniors.

https://arctichealth.org/en/permalink/ahliterature137393
Source
J Cross Cult Gerontol. 2011 Mar;26(1):103-17
Publication Type
Article
Date
Mar-2011
Author
Shawnda Lanting
Margaret Crossley
Debra Morgan
Allison Cammer
Author Affiliation
Department of Psychology, University of Saskatchewan, Arts Building, 9 Campus Drive, S7N 5A5 Saskatoon, SK, Canada. shawnda.lanting@usask.ca
Source
J Cross Cult Gerontol. 2011 Mar;26(1):103-17
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - ethnology - psychology
Cultural Evolution
Dementia - ethnology - psychology
Family
Female
Health Knowledge, Attitudes, Practice
Humans
Indians, North American - psychology
Interviews as Topic
Neuropsychological Tests
Qualitative Research
Saskatchewan
Abstract
Examining the role of culture and cultural perceptions of aging and dementia in the recognition, diagnosis, and treatment of age-related cognitive impairment remains an understudied area of clinical neuropsychology. This paper describes a qualitative study based on a series of key informant group interviews with an Aboriginal Grandmothers Group in the province of Saskatchewan. Thematic analysis was employed in an exploration of Aboriginal perceptions of normal aging and dementia and an investigation of issues related to the development of culturally appropriate assessment techniques. Three related themes were identified that highlighted Aboriginal experiences of aging, caregiving, and dementia within the healthcare system: (1) cognitive and behavioural changes were perceived as a normal expectation of the aging process and a circular conception of the lifespan was identified, with aging seen as going back "back to the baby stage", (2) a "big change in culture" was linked by Grandmothers to Aboriginal health, illness (including dementia), and changes in the normal aging process, and (3) the importance of culturally grounded healthcare both related to review of assessment tools, but also within the context of a more general discussion of experiences with the healthcare system. Themes of sociocultural changes leading to lifestyle changes and disruption of the family unit and community caregiving practices, and viewing memory loss and behavioural changes as a normal part of the aging process were consistent with previous work with ethnic minorities. This research points to the need to understand Aboriginal perceptions of aging and dementia in informing appropriate assessment and treatment of age-related cognitive impairment and dementia in Aboriginal seniors.
PubMed ID
21287400 View in PubMed
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Does executive function explain the IQ-mortality association? Evidence from the Canadian study on health and aging.

https://arctichealth.org/en/permalink/ahliterature153739
Source
Psychosom Med. 2009 Feb;71(2):196-204
Publication Type
Article
Date
Feb-2009
Author
Peter A Hall
Joel A Dubin
Margaret Crossley
Maxine E Holmqvist
Carl D'Arcy
Author Affiliation
Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada. pahall@healthy.uwaterloo.ca
Source
Psychosom Med. 2009 Feb;71(2):196-204
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - psychology
Canada - epidemiology
Cognition
Comprehension
Educational Status
Female
Follow-Up Studies
Humans
Intelligence
Intelligence Tests
Kaplan-Meier Estimate
Male
Mortality
Neuropsychological Tests
Proportional Hazards Models
Reference Values
Symbolism
Abstract
To assess the robustness of the association between intelligence quotient (IQ) and mortality in older adults and to examine whether or not the association can be explained by more specific cognitive processes, including individual differences in executive functioning.
We examined the associations among Full Scale IQ, individual IQ subtest scores, and 10-year mortality among older community-dwelling, adult participants in the Canadian Study of Health and Aging, who were verified as disease and cognitive-impairment free at baseline via comprehensive medical and neurological evaluation (n = 516). Survival analysis including Cox proportional hazards regression models were used to examine mortality risk as a function of Full Scale IQ and its specific subcomponents.
An inverse association was found between IQ and mortality, but this did not survive adjustment for demographics and education. The association between IQ and mortality seemed to be predominantly accounted for by performance on one specific IQ subtest that taps executive processes (i.e., Digit Symbol (DS)). Performance on this subtest uniquely and robustly predicted mortality in both unadjusted and adjusted models, such that a 1-standard deviation difference in performance was associated with a 28% change in risk of mortality over the 10-year follow-up interval in adjusted models.
The association between IQ and mortality in older adults may be predominantly attributable to individual differences in DS performance.
PubMed ID
19073749 View in PubMed
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Improving access to dementia care: development and evaluation of a rural and remote memory clinic.

https://arctichealth.org/en/permalink/ahliterature152756
Source
Aging Ment Health. 2009 Jan;13(1):17-30
Publication Type
Article
Date
Jan-2009
Author
Debra G Morgan
Margaret Crossley
Andrew Kirk
Carl D'Arcy
Norma Stewart
Jay Biem
Dorothy Forbes
Sheri Harder
Jenny Basran
Vanina Dal Bello-Haas
Lesley McBain
Author Affiliation
University of Saskatchewan, Canadian Centre for Health and Safety in Agriculture, Saskatoon, Saskatchewan, Canada. debra.morgan@usask.ca
Source
Aging Ment Health. 2009 Jan;13(1):17-30
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Alzheimer Disease - diagnosis - therapy
Dementia
Female
Health Services Accessibility
Humans
Longitudinal Studies
Male
Memory
Middle Aged
Patient care team
Patient satisfaction
Program Development
Questionnaires
Remote Consultation
Rural Health Services
Saskatchewan
Videoconferencing
Abstract
The availability, accessibility and acceptability of services are critical factors in rural health service delivery. In Canada, the aging population and the consequent increase in prevalence of dementia challenge the ability of many rural communities to provide specialized dementia care. This paper describes the development, operation and evaluation of an interdisciplinary memory clinic designed to improve access to diagnosis and management of early stage dementia for older persons living in rural and remote areas in the Canadian province of Saskatchewan. We describe the clinic structure, processes and clinical assessment, as well as the evaluation research design and instruments. Finally, we report the demographic characteristics and geographic distribution of individuals referred during the first three years.
Notes
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PubMed ID
19197686 View in PubMed
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Informal caregivers' hopes and expectations of a referral to a memory clinic.

https://arctichealth.org/en/permalink/ahliterature104913
Source
Soc Sci Med. 2014 Feb;102:111-8
Publication Type
Article
Date
Feb-2014
Author
Debra G Morgan
Sheena Walls-Ingram
Allison Cammer
Megan E O'Connell
Margaret Crossley
Vanina Dal Bello-Haas
Dorothy Forbes
Anthea Innes
Andrew Kirk
Norma Stewart
Author Affiliation
University of Saskatchewan, Canada. Electronic address: debra.morgan@usask.ca.
Source
Soc Sci Med. 2014 Feb;102:111-8
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Ambulatory Care Facilities
Canada
Caregivers - psychology - statistics & numerical data
Dementia - diagnosis - therapy
Female
Follow-Up Studies
Health Services Accessibility
Hope
Humans
Male
Prospective Studies
Qualitative Research
Referral and Consultation
Retrospective Studies
Rural Health Services
Abstract
Although only 20-50% of individuals with dementia are diagnosed, early diagnosis enables patients and families to access interventions and services, and plan for the future. The current study explored the experiences of rural family caregivers in the period leading up to a diagnostic assessment at a Canadian memory clinic, their hopes and expectations of the assessment, and their experiences in the six months following diagnosis. Using a longitudinal, retrospective and prospective qualitative research design, caregivers of 30 patients referred to the clinic were interviewed during the diagnostic assessment process and again six months after the diagnosis. Most caregivers reported first noticing symptoms two years prior to diagnosis. The pre-diagnostic interviews revealed a prevalent 'need to know' among caregivers that drove the help-seeking process. Caregivers hoped that the diagnosis would have the benefits of 'naming it,' 'accessing treatment,' 'knowing what to expect,' and 'receiving guidance.' When asked six months later about the impact of the diagnosis, the main theme was 'acceptance and moving forward.' Caregivers reported that the diagnosis provided 'relief,' 'validation,' and 'improved access to services.' These findings can inform care practices of primary health care providers who represent the first point of contact regarding expectations and experiences of dementia-related diagnoses.
PubMed ID
24565148 View in PubMed
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Mental alternation test: administration mode, age, and practice effects.

https://arctichealth.org/en/permalink/ahliterature140537
Source
J Clin Exp Neuropsychol. 2011 Feb;33(2):234-41
Publication Type
Article
Date
Feb-2011
Author
Erin McComb
Holly Tuokko
Paul Brewster
Pak Hei Benedito Chou
Katja Kolitz
Margaret Crossley
Martine Simard
Author Affiliation
Centre on Aging, University of Victoria, Victoria, British Columbia, Canada.
Source
J Clin Exp Neuropsychol. 2011 Feb;33(2):234-41
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging - psychology
Canada
Data Interpretation, Statistical
Educational Status
Executive Function - physiology
Female
Humans
Male
Neuropsychological Tests
Practice (Psychology)
Psychomotor Performance - physiology
Reproducibility of Results
Sex Factors
Telephone
Abstract
Administration mode, age, education, and practice effects were examined for the Mental Alternation Test (MAT), a brief orally administered measure of executive function. Participants (N = 135) between the ages of 65 and 85 years completed the MAT twice in person, twice over the telephone, or once in person and once over the telephone. MAT scores did not differ across administration modes. Furthermore, the MAT detected normative decreases in executive ability in later life. The correlation between MAT performance and educational attainment was small. Finally, practice effects, which were influenced by age, were found between administration times. These findings provide important implications for both research and clinical applications of the MAT in older populations.
PubMed ID
20865619 View in PubMed
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Nursing aide reports of combative behavior by residents with dementia: results from a detailed prospective incident diary.

https://arctichealth.org/en/permalink/ahliterature131831
Source
J Am Med Dir Assoc. 2012 Mar;13(3):220-7
Publication Type
Article
Date
Mar-2012
Author
Debra G Morgan
Allison Cammer
Norma J Stewart
Margaret Crossley
Carl D'Arcy
Dorothy A Forbes
Chandima Karunanayake
Author Affiliation
Canadian Centre for Health & Safety in Agriculture (CCHSA), Royal University Hospital, University of Saskatchewan, Saskatoon, SK, Canada. debra.morgan@usask.ca
Source
J Am Med Dir Assoc. 2012 Mar;13(3):220-7
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Aggression - physiology
Dementia
Female
Focus Groups
Humans
Male
Middle Aged
Nurses' Aides
Nursing Homes
Occupational Exposure - statistics & numerical data
Professional-Patient Relations
Prospective Studies
Saskatchewan
Self Report
Violence - statistics & numerical data
Abstract
This study examined nursing aides' (NAs) perspectives of specific incidents of combative behavior from nursing home residents with dementia, particularly their attributions for the behaviors.
This research is part of a larger mixed-method study exploring combative behavior as experienced by NAs. The data for this component were collected using a cross-sectional survey design. NAs used a prospective event-reporting log or "diary" to record consecutive incidents of combative resident behaviors.
Eleven rural nursing homes located in a mid-Western Canadian province.
Eighty-three full-time, part-time, and casual NAs.
NAs used the diary instrument to document details of each incident of combative behavior over a 144-hour period. Findings from the diaries were explored in subsequent focus groups (reported elsewhere).
The 83 NAs reported 409 incidents linked to residents with dementia, with a range of 1 to 28 incidents per aide. The frequency of incidents in the preceding month was reported as follows: none (11.1%), 1-5 times (58.7%), 6-10 times (11.1%), more than 10 times (19.0%). Most incidents occurred in residents' rooms (65%) during personal care, with the most frequent behaviors reported as slapping, squeezing, punching or hitting, and shoving. The main perceived causes of the behavior were cognitive impairment and residents not wanting care. NAs reported they could control or modify the cause in only 3% of incidents, and they were not optimistic about preventing future combative behaviors. They continued to provide care in 89% of incidents.
In the diaries, NAs identified resident-related factors (cognitive impairment and not wanting care) as the main causes of combative behavior, and they reported having no control over these factors. In the focus groups conducted to explore diary findings, NAs reported system-level factors, also beyond their control, which affected their practices and increased their risk of exposure to combative behavior. Taken together, the results of this research program suggest a need for a broad multifaceted strategy aimed at addressing the modifiable risk factors, which includes recognizing NAs as equal partners in a team process backed by strong organizational support and commitment.
Notes
Comment In: J Am Med Dir Assoc. 2012 Mar;13(3):195-621945459
PubMed ID
21872535 View in PubMed
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Partial measurement equivalence of French and English versions of the Canadian Study of Health and Aging neuropsychological battery.

https://arctichealth.org/en/permalink/ahliterature151265
Source
J Int Neuropsychol Soc. 2009 May;15(3):416-25
Publication Type
Article
Date
May-2009
Author
Holly A Tuokko
Pak Hei Benidito Chou
Stephen C Bowden
Martine Simard
Bernadette Ska
Margaret Crossley
Author Affiliation
Department of Psychology, University of Victoria, Victoria, British Columbia, Canada. htuokko@uvic.ca
Source
J Int Neuropsychol Soc. 2009 May;15(3):416-25
Date
May-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - physiology
Canada
Cognition Disorders - diagnosis
Cross-Cultural Comparison
Factor Analysis, Statistical
Female
Humans
Language
Male
Models, Statistical
Neuropsychological Tests
Translating
Abstract
Neuropsychological batteries are often translated for use across populations differing in preferred language. Yet, equivalence in construct measurement across groups cannot be assumed. To address this issue, we examined data from the Canadian Study of Health and Aging, a large study of older adults. We tested the hypothesis that the latent variables underlying the neuropsychological battery administered in French or English were the same (invariant). The best-fitting baseline model, established in the English-speaking Exploratory sample (n = 716), replicated well in the English-speaking Validation sample (n = 715), and the French-speaking sample (FS, n = 446). Across the English- and FSs, two of the factors, Long-term Retrieval and Visuospatial speed, displayed invariance, that is, reflected the same constructs measured in the same scales. In contrast, the Verbal Ability factor showed only partial invariance, reflecting differences in the relative difficulty of some tests of language functions. This empirical demonstration of partial measurement invariance lends support to the continued use of these translated measures in clinical and research contexts and illustrates a framework for detailed evaluation of the generality of models of cognition and psychopathology, across groups of any sort.
PubMed ID
19402928 View in PubMed
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Reliability of the MMSE administered in-person and by telehealth.

https://arctichealth.org/en/permalink/ahliterature152470
Source
Can J Neurol Sci. 2008 Nov;35(5):643-6
Publication Type
Article
Date
Nov-2008
Author
Wendaline McEachern
Andrew Kirk
Debra G Morgan
Margaret Crossley
Carol Henry
Author Affiliation
College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Source
Can J Neurol Sci. 2008 Nov;35(5):643-6
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cognition Disorders - diagnosis
Data Collection
Female
Health status
Humans
Male
Mental Disorders - diagnosis - epidemiology
Middle Aged
Neuropsychological Tests - statistics & numerical data
Psychiatric Status Rating Scales
Psychometrics
Remote Consultation - methods - statistics & numerical data
Reproducibility of Results
Rural Population
Saskatchewan
Telemedicine - methods - statistics & numerical data
Videoconferencing - statistics & numerical data
Abstract
Recent advances in telehealth have improved access to health care for those in rural areas. It is important that examinations conducted via telehealth are comparable to in-person testing. A rural and remote memory clinic in Saskatoon provided an opportunity to compare scores on the Mini-Mental State Examination (MMSE) administered in-person and via telehealth.
After an initial one day assessment in Saskatoon, patients were seen in follow-up at 6 and 12 weeks. Individual patients were randomly assigned to either in-person follow-up assessment in Saskatoon or telehealth assessment in their home community. Patients who initially received in-person assessments were seen by telehealth for their next follow-up visit and vice-versa. The same neurologist administered MMSEs at all visits. The first 71 patients with both 6 and 12 week follow-up assessments were included in this study. The scores of in-person and telehealth MMSE administrations were compared using the methods of Bland and Altman as well as a paired t-test.
MMSE scores did not differ significantly between telehealth (22.34 +/- 6.35) and in-person (22.70 +/- 6.51) assessments.
Telehealth provides an acceptable means of assessing mental status of patients in remote areas.
PubMed ID
19235450 View in PubMed
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