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To address the issue of falls, which are increasing as the population ages, an intelligent video-monitoring system is being developed. The aim of the study is to explore caregivers’ perceptions of and receptiveness to a prototype of this fall detection system. A cross-sectional mixed-method study was carried out with individual interviews of 18 caregivers. Statistical frequencies and content analysis were conducted (SPSS and N’Vivo). The results show that most participants (n = 15/18) liked the intelligent video-monitoring system and were willing to use it. They would worry less if they could be alerted if a care recipient fell, but they were concerned about privacy and cost. Participants had a positive perception of the system and expressed their wishes regarding the kind of alert and the person to contact in case of a fall.

Background: Socio-demographic features such as age and education are the strongest influences on cognitive and communicative performance in every culture. However, there are few neuropsychological tests adapted to Brazilian society, culture, and language, especially for evaluating the communication of individuals with right hemisphere damage.Aims: This study was designed to describe age and education effects on the communicative performance of non-brain-damaged Brazilian adults on the Brazilian Montreal Communication Evaluation Battery (MAC Battery), which was created to evaluate components of communication usually overlooked by aphasia tests.Methods & Procedures: The sample was composed of 240 adults, divided into two education and three age groups. The influence of these variables on the Brazilian MAC Battery performance was assessed.Outcomes & Results: Communicative performance is influenced by educational level. Age also partially impacts performance, but to a lesser degree, and there is an interactio...

The purpose of this study was to determine: (i) the proportion of frail older adults who demonstrate (a) statistically significant and (b) clinically meaningful differences between home and clinic cooking task performance; and (ii) factors associated with a better performance in each environment.Thirty-seven participants were evaluated with the Assessment of Motor and Process Skills (AMPS) in home and clinic environments using a counterbalanced design. Demographic, physical, cognitive, psychological, and environmental characteristics were also collected.Thirty-three participants were retained for analysis. A statistically significant difference (±2 standard errors of measurement) between environments was found in 33% of the participants on the motor scale and the same proportion on the process scale. A clinically meaningful difference (based on cut-off scores predicting need for assistance) was noted in 30% of the participants. Better performance at home on the process scale was associated with a decrease in some executive functions, while better performance in the clinic on the motor scale was mostly related to a decline in grip strength.Our findings may help occupational therapists identify frail patients for whom home assessments would be advisable prior to discharge so that assistance provided meets their needs at home.

A psycho-educational intervention focused on communication was conceived for caregivers of family members in the early stage of Alzheimer’s disease (i.e., persons with dementia), and tested on five proximal outcome variables: caregiver knowledge, perceptions of communication difficulties and degree of perceived disturbance related to these difficulties, self-efficacy and skills. Guided by a theoretical framework that encompassed geragogy, the McGill model of nursing and self-efficacy theory, the intervention was evaluated via an experimental design with pre-post tests. Fifty family caregivers were randomly assigned to an experimental group (intervention program), or to a control group (information flier on communication and memory). Statistically significant effects were found on four dependent variables: caregiver knowledge, degree of disturbance related to communication difficulties, self-efficacy and skills. No significant effects were observed in regard to the perceived presence of communication difficulties. This communication program serves as a useful tool to prepare caregivers for their new role.

We explored the perception and receptivity of elderly people regarding the introduction of an intelligent videomonitoring system (IVS) at home. Using a mixed methods design, 25 elderly people with a history of falls completed a structured interview (two questionnaires). In the year preceding the interview, 72% of the participants fell as many as seven times. Open-ended questions (qualitative data) were used to supplement the quantitative data. A content analysis (qualitative data) and a descriptive analysis (quantitative data) were carried out. The participants were 84% favourable or partially favourable to technologies which ensured home security and 96% favourable or partially favourable to the IVS. About half (48%) said that they would use it. The other participants did not wish to use it unless they had been left to live alone or if their health condition worsened. Thus the living conditions of the elderly appear to influence their perception and receptivity regarding the acceptance and use of an IVS.

The lack of standardized instruments to evaluate communication disorders related to the right hemisphere was verified. A new evaluation tool was developed: Protocole Montréal d'Évaluation de la Communication – Protocole MEC, adapted to Brazilian Portuguese – Bateria Montreal de Avaliação da Comunicação – Bateria MAC (Montreal Evaluation of Communication Battery). The purpose was to present stratified normative data by age and educational level, and to verify the reliability parameters of the MEC Battery. 300 individuals, between the ages of 19 and 75 years, and levels of formal education between 2 and 35 years, participated in this study. They were divided equally into six normative groups, according to three age categories (young adults, intermediary age, and seniors) and two educational levels (low and high). Two procedures were used to check reliability: Cronbach alpha and reliability between evaluators. Results were established at the 10th percentile, and an alert point per task for each normative group. Cronbach's alpha was, in general, between .70 and .90 and the average rate of agreement between evaluators varied from .62 to .94. Standards of age and education were established. The reliability of this instrument was verified. The psychometric legitimization of the MEC Battery will contribute to the diagnostic process for communicative disorders.

This one-year longitudinal study carried out on a sample of 232 older husband caregivers sought to describe changes in psychological distress and self-perceived health, and to examine relationships between factors drawn primarily from Pearlin's model of caregiving and changes in these two health outcomes. Prediction analyses shows that nearly two thirds of the husbands have unsuccessful outcomes with respect to these two dimensions, that is, most husbands obtain either steadily poor scores at both times of the study or worse scores on one or both outcomes. Higher levels of education and informal instrumental support at time 1, as well as an increase in role overload, are predictive of unsuccessful outcome for psychological distress, whereas an increase in self-efficacy predicts successful outcome for self-perceived health. Overall, husband caregivers vary in their response to caregiving over time. The findings support previous study results showing subjective stressors, rather than objective stressors, and caregiver resources to be significant predictors of caregiving outcomes.

Background: It is estimated that approximately 50% of individuals who incur right‐hemisphere damage (RHD) have subsequent communication disorders. Lexical‐semantic, discourse, prosodic, and pragmatic deficits have been reported following RHD, but the co‐occurrence of these deficits within the same individual has not yet been systematically investigated. Therefore clinical profiles of communication impairments in individuals with RHD still have to be identified and described in order to appreciate their communication impairment and provide strategies for rehabilitation. Aims: The goal of the present study was to explore the clinical profiles of communication impairments subsequent to a right hemisphere lesion. Methods and Procedures: A total of 28 French‐speaking individuals with a right‐hemisphere lesion were evaluated using the Protocole MEC (Joanette, Ska, & Cote, 2004), a normalised battery allowing the assessment of communication deficits after RHD. A hierarchical cluster analysis was used to group pa...

To field test the applicability of a multidimensional toolkit for geriatric rehabilitation outcomes which includes nine standardized tools. Applicability is defined as context- and population-specific pragmatic qualities of an assessment tool such as respondent and examiner burden, score distribution and format compatibility.A sample of 48 older adults representing four diagnostic groups, as well as 26 caregivers, were assessed at home in the first month after discharge from intensive rehabilitation (T1) and 2 months later (T2). Pre-determined qualitative and quantitative applicability criteria were coded and compared at T1 and T2, as well as responsiveness.A higher respondent burden was found for three self-report tools, as well as a ceiling effect on social functioning tools. Respondent burden, examiner burden and score distribution remained stable or diminished at T2. Format compatibility deteriorated only for the mobility test due to a higher proportion of non ambulatory participants (17%). Low to moderate associations between the tools corroborated that they were not redundant (rPearsonor= 0.77). Responsiveness estimates confirmed that mean scores were stable between T1 and T2.Overall, the toolkit was found to be applicable at home after geriatric rehabilitation. Modifications are proposed to further improve its applicability. This study highlighted practical aspects that could alleviate the burden on research participants and facilitate the use of those tools for community follow-up for clinical and research purposes.

This study examined individual and collective factors as predictors of change in global diet quality (DQ). Subjects were 373 older adults (57 % female) aged 68–82 years at recruitment (T1) into the NuAge Cohort Study, and followed for three years. Data were collected by questionnaires, physical performance tests and anthropometric measurements. Diet was assessed at T1 and T4 using three non-consecutive 24-h diet recalls (24HR) and DQ (Canadian Healthy Eating Index), and was computed on the means of the 24HR. DQ change over three years was determined as “DQT4-DQT1”. Baseline (T1) measures significantly correlated with DQ at T1 were entered into backward stepwise linear regression analyses along with selected theoretical constructs and controlled for baseline DQ to determine predictors of change in DQ over 3 years. Among men, education (p = .009) and sensations of hunger (p = .01) were positive predictors of DQ change over time, while DQ at T1 (p

The purpose of this randomized study was to test the persistent and delayed effects of an intervention program entitled "Taking Care of Myself " on selected mental health outcomes of daughter caregivers of a relative with dementia living in a long-term care setting. One group of caregivers took part in the experimental program (EG, n = 45), one in a comparison program offered by an Alzheimer Society (AG, n = 51), and another constituted a control group (CG, n = 41). Effects were verified at the end of the program and 3 months later. Results from prediction analyses reveal that competence dealing with healthcare staff and use of the coping strategy of reframing were persistent effects unique to the EG condition, whereas perceived availability of informal and formal support was a persistent effect in the EG and in the AG. A delayed effect was observed in the AG regarding competence dealing with healthcare staff. These results underline the importance of follow-up assessments of intervention programs and suggest avenues to support caregivers of institutionalized seniors.

The purpose of this randomized study was to test the efficacy of an intervention programme entitled ‘Taking Care of Myself’ on selected indicators of mental health of daughter caregivers of elderly parents with dementia living in a long-term care setting. The programme is based on an empowerment perspective and on a stress and coping theoretical framework. Three groups of caregivers were compared: one took part in the experimental programme (EG, N= 45), one in a comparison programme offered by a Quebec Alzheimer Society (AG, N = 51), and another was a control group (CG, N = 41). Two successful outcomes are unique to the EG condition, that is, competence dealing with health care staff and perceived challenge of the caregiver role. Prediction analyses also provide statistical support for the efficacy of the EG and AG conditions to produce successful outcomes with respect to common indicators (perceived threat and role overload, control by self, informal/formal social support, and use of the coping strategy of reframing). These results provide avenues of intervention for promoting the mental health of caregivers of an institutionalized relative.

This study examines the specificity of the contribution of the right hemisphere to the processing of metaphoric meaning of words. Ten right- and 10 left-hemisphere-damaged subjects, and 20 normal control subjects were submitted to: (1) a word-triad task where they had to associate alternative metaphoric and non-metaphoric words to a target word, and to (2) a word-dyad task where they had to decide whether or not there was a semantic relationship between two words. The two tasks aimed at differentiating between the subjects' preference for a given semantic meaning versus a genuine semantic deficit for a particular meaning. Results revealed that both right- and left-hemisphere-damaged groups presented a genuine semantic deficit for the processing of metaphoric meaning. The absence of a double dissociation between the two brain-damaged groups does not support the hypothesis of a specific contribution of the right-hemisphere to the processing of metaphoric meaning of words.

Acoustic measures of (1) syllable duration, (2) voice onset time, (3) fundamental frequency (F0) and (4) the first three formant frequencies (F1, F2, F3) of vowels were provided for a speech corpus produced by 10 French-speaking children (five boys, five girls, with an average age of 9;4 years) with profound hearing impairment (i.e. pure tone averages of more than 100 dB HL.) These data were then compared with previously published data for children with moderate-to-severe hearing impairment (i.e. pure tone averages of more than 60 dB HL) and normally hearing children. The children with profound hearing loss were significantly different in all measures from peers with moderate-to-severe hearing loss and normally hearing peers, while children with moderate-to-severe hearing impairment were not significantly different from their normally hearing peers.

Head injuries are the third leading cause of neurological disability for adults aged 35 and under in the United States. The government of Quebec has elaborated a rehabilitation model for the head-injured population. Unfortunately, the state of this population after discharge from acute care settings is not known, nor what they have become after their reintegration in society. A feasibility project was developed with three objectives: (1) to determine the percentage of persons and their relatives who could be traced and who would accept to be interviewed; (2) to identify the instruments that would best describe their biopsychosocial state; and (3) to evaluate the Quality of Life of the participant in the community and compare it with the perception of a respondent.

Joanette and Goulet ( Neuropsychologia , 1986, 24, 875–879) reported that right-handed patients suffering from a right-hemisphere stroke were impaired on semantic but not on orthographic criteria when they were submitted to a word fluency task. The interpretation of this dissociation was that the right hemisphere would subtend a particular contribution to the semantic component of word processing in right handers. The goal of the research reported here was to challenge this dissociation. In contrast with the first study, the production criteria were presented randomly and their level of productivity was a controlled factor. The semantic-orthographic dissociation was not replicated under these conditions.

The Functional Independence Measure (FIM) was developed to assess the burden of care of persons receiving rehabilitation services in regard to self-care activities and social and cognitive skills. Until now, no study has evaluated the validity of the FIM with the elderly without distinction of diagnosis. The purpose of this study was to examine the MIF's factorial structure using a principal components analysis. As a secondary goal, the predictive validity and the internal consistency of the instrument were also examined. Data collected from 120 subjects generated a solution consisting of three factors accounting for 67.6 per cent of the total variance. The first factor (46.6%) represents the handicap concept, the second factor (14.7%) measures disability and the third factor (6.3%) represents disability with a major component of physical involvement of lower extremities. The results of this analysis confirm the multidimensional structure of the FIM and reveal the possibility of a third factor for the elderly. With this population, internal consistency of the instrument, obtained from admission and discharge data, is estimated at 0.92 and 0.96 with Cronbach's alpha. Total FIM score at discharge as well as items related to the handicap factor as measured on admission allow us to correctly predict place of discharge in a proportion of 72.9 per cent of the cases. These results indicate that the FIM bears an interesting potential for measuring rehabilitation outcomes for the elderly.

Patients in lone term care units are susceptible to the development of contractures because of immobility. One method advocated by physiotherapists in order to prevent the formation or progression of contractures is the use of passive range of motion exercises. An ABA study on 35 subjects was undertaken over a period of six months in order to observe any changes in amplitude at the knee and/or elbow when applying a passive range of motion exercise program. The results revealed that, when considered as a group, there was no significant change in the joint amplitudes over the six-month period. When subdividing these joints according to the muscular tonus, statistical analyses demonstrated similar results over time. Physiotherapists are encouraged to monitor closely each patient as this type of intervention may not be necessary for all long term care patients. Further studies are needed to assess the benefits of this form of treatment.

The study of the neural basis of syntactic processing has greatly benefited from neuroimaging techniques. Research on syntactic processing in bilinguals has used a variety of techniques, including mainly functional magnetic resonance imaging (fMRI) and event-related potentials (ERP). This paper reports on a functional near-infrared spectroscopy (fNIRS) study on syntactic processing in highly proficient young adult speakers of Portuguese (mother tongue) (L1) and French (second language) (L2). They made a syntactic judgment of visually presented sentences, which either did or did not contain noun–verb agreement violations. The results showed that syntactic processing in both languages resulted in significant activation in anterior frontal regions of the left hemisphere and in the temporal superior posterior areas of the right hemisphere, with a more prominent activation for L2 in some areas. These findings corroborate previously reported neuroimaging evidence, showing the suitability of fNIRS for the study of syntactic processing in the bilingual brain.

Relatively few studies have analyzed the mechanisms underlying the cognitive changes that affect language in the elderly, and fewer have done so for narrative discourse. The goal of this study was to explore the neurofunctional changes associated with aging for different components of narrative discourse. Functional near-infrared spectroscopy (fNIRS) and behavioral data on 10 younger adults and 10 healthy elderly participants were collected. Ten younger adults in a non-proficient second language condition were included to explore the possibility that the age-related neurofunctional reorganization partly expresses demanding resource allocation. Results show within- and across-hemispheric differences in the neurofunctional pattern of activation in the older participants with reference to the younger ones, partially shared with the low-proficiency young adults, providing support for the recognized mechanisms underlying neural reserve and compensation. fNIRS was shown to be appropriate for studying the age-related neurofunctional reorganization of complex cognitive abilities.

The purpose of this study was to investigate transitions over time in the functional status of disabled community-living elderly. The study explored clinical and socio-demographic predictors of functional status decline. Data from the SIPA 3-year longitudinal study were analyzed (n = 1164). Three categories of functional status were defined: no important disability, significant IADL disability and significant ADL disability. At baseline, results show that the prevalence rates were 26.9%, 58.6% and 14.5% for the three categories of functional status. After 12 months, about 50–60% of participants had remained in the same status, while some 10–15% of those with baseline significant disability had improved. The patterns of transitions between 12 and 36 months of follow-up were slightly different. The results indicated more deterioration (13–38%) and less improvement (6–9%). After controlling for baseline functional status, the best predictors for functional decline at 36 months were prior disability, functional limitations, cognitive impairment and comorbidity burden. We found that older adults’ functional status may decline or improve even if the participants are disabled. Disabled conditions play a crucial role in the development of future disability and preventive actions need to be implemented.

Aging brings cognitive changes. Language is not immune to these changes. The use of compensation strategies may permit older adults to achieve a performance level identical to the one obtained by younger adults. This research aims to study text comprehension in aging and the reading strategies used for by older and younger adults. Kintsch's cognitive model (1988) allows the identification of different levels of representation within text treatment (linguistic form, macrostructure, microstructure and situation model) and predicts the underlying cognitive components. Eye-tracking analyses during reading permit inference about the moments of reading treatment and detection of reading strategies. Sixty highly educated participants were assessed. They were divided in two age groups (20-40 and 60-80 years old). Participants were asked to read and understand three texts constructed to highlight the features of text comprehension within each one of the different levels of text representation. The amount of detail and the necessity of updating the situation model varied for each text. Eye movements were registered by an eye-tracker (Cambridge research) during the reading process. Specific complementary tasks were administered to evaluate working memory, long-term memory, and executive functions. Variances analyses showed significantly lower performance by older adults regarding: 1) recall of the microstructure of the two texts with a high degree of detail, 2) macrostructure of the text with fewer details, and 3) performance on all tasks that evaluated cognitive components. Aging influenced treatment of levels of text representation depending on text characteristics. However, cluster analysis of the text comprehension and eye-tracker data revealed a group of older adults whose performance in reading comprehension was identical to the performance of younger adults, with the same reading profile. This result seems to show that use of compensation strategies by older adults at the onset of signs of cognitive deterioration is not necessary in reading.

Background The majority of older persons in Lebanon live with their family, which provides the help and care required when their relative is functionally impaired. Knowing that taking care of an older impaired relative is considered a source of enrichment for the caregiver and an act of gratitude towards the older person in Lebanon. However, there are few formal resources to support these families. This study is informed by a theoretical framework of stress. Objective Identify the dimensions of the caring context related to the health of Lebanese family caregivers living with an older impaired relative. Design Exploratory correlational study. Participants Convenience sample \( N = 319 \) drawn from all the regions of Lebanon according to predetermined quotas on the basis of relative demographic weight and socio-economic class. The inclusion criteria are: aged 18 years or over; primary caregiver; provided help with at least one ADL or IADL once a week; lived with the older impaired person. 13.5% refused to participate in the study. The caregivers recruited were female (84%), adult children (48%) or spouses (22.6%) with a mean age of 46 years. Almost half of them reported a post-compulsory level of education and a low monthly household income and no medical coverage for 68% of them. Methods The data were collected during a face-to-face interviews with the caregivers in their homes. Results The results from regression analyses indicate that the degree of functional impairment, the frequency of depressive and disruptive behaviours of cared-for relative are linked to at least one of three caregiver health indicators \( p . 01 \) . Also, caregiver cognitive appraisal of these stressors is associated with either role strain or feeling of helplessness \( p . 05 \) . The informal emotional support received by caregivers is positively related to well-being \( p . 001 \) , whereas interpersonal conflicts with family and friends diminish caregiver well-being and increase role strain \( p . 001 \) . Sufficiency of emotional support received is negatively associated with role strain \( p . 001 \) . Conclusion Many stressors proved associated with one or other of the health indicators under study and the resources emerged as significant factors related to caregiver's health.

This study describes discourse patterns produced by 46 Alzheimer disease (AD) patients and 53 normal elderly subjects in two picture-supported narratives. Nine measures derived from a cognitive model of discourse processing were obtained and submitted to cluster analysis. Results indicate that discourse patterns elicited from both stimuli were heterogeneous. Further, they fail to clearly differentiate between normal aging and AD in half of the AD patients. Discourse patterns are examined in light of various sources of heterogeneity including severity of cognitive impairment, subject characteristics, and task demands. The usefulness of discourse as a diagnostic and therapeutic tool is discussed.

The rights of families of an institutionalized elderly relative with dementia have yet to be recognized. The results of our pilot study based on a participatory approach show, among other things, that family caregivers, women for the most part, have little input in the decisions regarding their relative's care and are uneasy to express their opinions to health care staff. As part of the pilot study, caregivers developed a group intervention program entitled "Taking Care of Myself" geared, among other things, towards increasing their competence in expressing their viewpoint to health care staff and in taking part in care-related decisions. According to an efficacy study conducted after the pilot study, the program produced successful outcomes in terms of caregiver competence in dealing with the health care staff and of perceived challenge of the caregiver situation. Recommendations are made aimed at giving caregivers recognition, that is their due.

Background and Purpose. Physical therapists working with elderly people require an instrument that provides reliable force measurements and can be used in a clinical setting. The modified sphygmomanometer has been identified as potentially fulfilling these requirements, yet there is an absence of research on the reliability of measurements taken with this instrument on elderly patients. This study was undertaken to investigate the interrater reliability of force measurements, in a group of elderly subjects, using a modified sphygmomanometer. Subjects. Thirty-six hospitalized subjects (mean age=75.28 years, SD=9.43, range=62–95) participated in the study. Methods. With the modified sphygmamanometer, 3 examiners evaluated the isometric force of the elbow extensors and hip extensors using a break test and a make test, respectively. Results. Intraclass correlation coefficients (2,1) reflecting reliability were .87 for the elbow extensors and .65 for the hip extensors. The estimation of the components of variance for hip extensors revealed that these results were due in part to the raters but that random error contributed to a much larger extent. Conclusion and Discussion. The modified sphygmomanometer appears to be practical to use, and the high correlations found in this study for the elbow extensors suggest that reliable measurements can be obtained with this instrument. Further research is needed, however, to specify the manner in which the modified sphygmomanometer can be used when assessing different muscle groups.

Os autores relatam e discutem aspectos neuro-psicológicos relacionados à organização funcional do cérebro ligados à cognição em 81 pacientes com doença de Alzheimer. Confrontam aspectos clínicos da homogeneidade com os da heterogeneidade, dentro da organização funcional do cérebro. Foram utilizados para diagnóstico os critérios do NINCDS-ADRDA. Todos os pacientes estavam no início da evolução, nos estágios 3 ou 4 de Reisberg (Functional Assessement Staging-FAST). A conclusão mostra que existem dois perfis cognitivos: o perfil não recorrente formado da maioria dos pacientes, o qual testemunha a heterogeneidade dependente dos fatores genéticos e ambientais de cada indivíduo; e o outro, perfil recorrente formado por grupo menor de pacientes, retrata alterações na heterogeneidade de formas clínicas, nosológicas, patológicas e senescentes. The authors describe and discuss neuropsichological aspects related to the functional organization of the brain connected to cognition in 81 Alzheimer's disease patients in the Laboratoire Théophile-Alajouanine du Centre de Recherche du Centre hospitalier Côte-des-Neiges in the University of Montreal. They confront the clinical of homogeneity against the heterogeneity within functional organization of the brain. The criteria used for diagnosis were those of the NINCDS-ADRDA. All of the patients were in the begining of the evolution, in stages 3 and 4 of Reiberg (Functional Assessement Staging, FAST). The conclusion shows that there are two cognitive profiles: a non-recurrent profile, made up by the majority of the patients, and the heterogeneity depends on the genetic background of each individual; a recurrent profile, made up by a small group of patients that show changes in the heterogeneity of clinical, nosological, pathological and normal aging forms.