Frailty, comorbidity, disability and poor self-rated health: prevalence of overlaps amongst the oldest-old adults from the Hong Kong Centenarian Study.

Posters - Scientific Research (Epidemology)INTRODUCTION: The frailty phenotype includes five characteristics: fatigue, weakness, poor endurance, physical illness and weight loss. Frailty correlates strongly with comorbidity and disability, but their interaction with selfrated health (SRH) amongst the oldest-old adults remains unclear. We examined the prevalence of overlap between frailty, comorbidity, disability and poor SRH amongst the oldest-old adults …published_or_final_versio

Comprehensive Index of Frailty: a multi-dimensional construct from the Hong Kong Centenarian Study

This journal suppl. entitled: 20th Medical Research Conference; Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong KongINTRODUCTION: Frailty is a global epidemiological and clinical phenomenon that can lead to poor long-term outcome. A better understanding of its components is essential for future developments of management strategies. We sought to assess the incremental validity of a new Comprehensive Index of Frailty over Frailty …published_or_final_versio

Identifying the earliest sign of pathological cognitive decline by using magnetic resonance imaging structural brain connectivity analysis

PosterINTRODUCTION: With the increasing understanding of subjective cognitive decline (SCD) as a possible precursor of mild cognitive impairment (MCI) and Alzheimer’s disease (AD), the early identification of those with truly pathological SCD, and distinguish them from normal aging, is of great clinical importance. We investigated this prodromal stage by studying the structural brain connectivity of subjective cognitive impairment (SCI) patients as compared to MCI and healthy subjects …published_or_final_versio

Oral treatment with herbal formula B307 alleviates skeletal muscle atrophy from hind-limb unloading

PosterINTRODUCTION: Muscle atrophy can result from physical inactivity, chronic bedrest, and ageing. Traditional Chinese herbal formula B307 is a health supplement with multiple potential protective functions of organs. We investigated the effects of herbal formula B307 on muscle atrophy using the hind-limb unloading (HU) model in mice …published_or_final_versio

Event-related potential using task-based electroencephalogram may differentiate between mild cognitive impairment and normal controls

BACKGROUND: New non-invasive biomarkers to diagnose early Alzheimer’ disease are needed. We investigated the role of event-related potential (ERP) using task-based electroencephalogram (EEG) in differentiating patients with mild cognitive problems from cognitive-normal healthy controls …published_or_final_versio

Magnetic resonance spectroscopy demonstrates neuronal loss and altered glutamatergic neurotransmission in Alzheimer's Disease

BACKGROUND: The role of the anterior cingulate cortex (ACC) is involved in the default mode network during resting state, and is dysfunctional in ageing and Alzheimer’s disease (AD). We used magnetic resonance spectroscopy (MRS) to study the biochemical and metabolite profile in patients with AD, and compared with cognitive-normal healthy controls (HC) with no cognitive complaints …published_or_final_versio

Comprehensive Index of Frailty: a multi-dimensional construct from the Hong Kong Centenarian Study

Posters - Scientific Research (Biology and Social Gerontology)INTRODUCTION: Frailty is a global epidemiological and clinical phenomenon that can lead to poor long-term outcome. A better understanding of its components is essential for future developments of management strategies. We sought to assess the incremental validity of a new Comprehensive Index of Frailty over Frailty Index in predicting self-rated health and functional dependency amongst the oldest-old adults …published_or_final_versio

Depression, not lethargy, moderates the frailty-subjective health relationship among centenarians

Platform Presentations: Friday, Clinical Quality - Scientific Research (Psychiatry and Mental Health)INTRODUCTION: Very old people may be physically frail, but they may not necessarily experience poor subjective health after taking into account other dimensions of health, e.g. psychological well-being. We hypothesized that the frailty-subjective health relationship is moderated by depression and/or lethargy in very-old adults …published_or_final_versio

Diurnal cortisol slope mediates the association between affect and memory retrieval in older adults with mild cognitive impairment: a path-analytical study

Background: Memory deficits are linked to dysfunctional HPA axis activity and negative affect in older adults. This study evaluated the mediating effect of the diurnal cortisol pattern on the relationship between affect and memory in older people with mild cognitive impairment (MCI). Methods: This longitudinal study recruited 189 Chinese older adults with MCI from elderly centers in Hong Kong. The participants completed assessments of affect, salivary cortisol, and digit spans at baseline; neurocognitive assessments on verbal fluency, memory retrieval, and digit spans at 6-month follow-up; and instrumental activities of daily living (IADL) at 1-year follow-up. Structural equation modeling examined the direct and indirect effects of negative affect on memory and IADL via diurnal cortisol pattern. Results: Controlling for covariates, negative affect significantly predicted flattened diurnal cortisol slopes (β = 0.17, p < 0.05) but not memory or IADL (p = 0.23 – 0.91) directly. Diurnal cortisol slopes negatively predicted memory retrieval (β = −0.20, p < 0.05), which in turn positively predicted IADL (β = 0.22, p < 0.01). The indirect effect from negative affect to IADL via cortisol slope and memory retrieval was significant and negative (αβγ = −0.05, 95% bootstrapped CI = −0.248 to −0.001). Discussion: The present study established certain temporal linkages among affect and cortisol slopes at baseline, memory retrieval at 6 months, and functional decline 1 year later in older adults with MCI. Flattened diurnal cortisol slopes might mediate the detrimental effects of negative affect on memory retrieval and functioning across 1 year

Psychometric properties of the caregiver inventory for measuring caregiving self-efficacy of caregivers of patients with palliative care needs

Taking care of patients with palliative care needs could be a stressful event. While caregiving was associated with decreases in psychological health in caregivers, increased caregiving self-efficacy associated with reduced burden. Yet, there is no instrument available in Chinese for assessing caregiving self-efficacy in the palliative care setting. This study aimed to examine the psychometric properties of a Chinese version of Caregiver Inventory (CGI) in Chinese caregivers of patients with palliative care needs. The CGI was translated to the Chinese language, validated by an expert panel, and tested. A convenience sample of 232 patient-caregiver dyads recruited from three hospitals in Hong Kong was included in the analysis. A high completion rate of 95.5% in caregivers and no floor or ceiling effects were noted for the CGI. In contrast to the four-factor structure identified in the original 21- item CGI, our EFA produced an 18-item solution accounting for 57% of the total variation comprising three factors: (1) Care of the care recipient, (2) Managing information and self-care, and (3) Managing emotional interaction with care recipient (C-CGI-18). Separate dimensions for Managing information and Self-care were not supported. For the three domains of the C-CGI-18, Cronbach’s alphas ranged from 0.84 to 0.90 and 2-week testretest reliability ranged from 0.71 to 0.76. Correlations of the three domains with caregiver strain (r: -0.31 to -0.42, p-values<0.01) and total scores in perceived social support (r: 0.24 to 0.36, p-values<0.01). Correlation between the Care of the care recipient domain and patient’s physical functioning (r=0.17, p-value<0.05) indicated acceptable construct validity. In conclusion, the C-CGI-18 has suitable factor structure and psychometric properties for use in assessing caregiving self-efficacy among Chinese caregivers of patients with palliative care needs. It is simply and easy to use and can be recommended for clinical and research practice for the Hong Kong Chinese populations