Cognitive Functioning and Vitality among the Oldest Old: Implications for Well-Being

This chapter clarifies and differentiates changes in cognitive functioning among the oldest old at the group and individual levels. Cross-sectionally, the oldest old demonstrate normative differences of being more physically and cognitively frail compared to younger groups. More variation and successful aging is observed at the individual level. Some oldest-old individuals can perform at the same levels as adults 20 to 40 years younger. Recent literature has recognized that the concept of cognitive vitality transcends the absence of dementia or dementing processes. We seek to clarify the concept of cognitive vitality because it has not been well defined in the literature either theoretically or operationally. This chapter addresses the following questions: 1) What is cognitive vitality and how does it contribute to the well-being of older adults? 2) What factors or resources contribute to cognitive vitality among the oldest old? and 3) What new directions can be identified for future research

Dementia beyond 2025: knowledge and uncertainties

International audienceGiven that there may well be no significant advances in drug development before 2025, prevention of dementia/AD through the management of vascular and lifestyle-related risk factors may be a more realistic goal than treatment. Level of education and cognitive reserve assessment in neuropsychological testing deserve attention, as well as cultural, social and economic aspects of caregiving. Assistive technologies for dementia care remain complex. Serious games are emerging as virtual educational and pleasurable tools, designed for individual and cooperative skill-building. Public policies are likely to pursue improving awareness and understanding of dementia; providing good quality early diagnosis and intervention for all; improving quality of care from diagnosis to the end of life, using clinical and economic endpoints; delivering dementia strategies quicker, with an impact on more people. Dementia should remain presented as a stand-alone concept, distinct from frailty or loss of autonomy. The basic science of sensory impairment and social engagement in people with dementia needs to be developed. E-learning and serious games programmes may enhance public and professional education. Faced with funding shortage, new professional dynamics and economic models may emerge through coordinated, flexible research networks. Psychosocial research could be viewed as an investment in quality of care, rather than an academic achievement in a few centres of excellence. This would help provide a competitive advantage to the best operators. Stemming from care needs, a logical, systems approach to dementia care environment through organizational, architectural and psychosocial interventions may be developed, to help reduce symptoms in people with dementia and enhance quality of life. Dementia-friendly environments, culture and domesticity are key factors for such interventions

Supporting stimulation needs in dementia care through wall-sized displays

Beside reminiscing, the increasing cognitive decline in dementia can also be addressed through sensory stimulation allowing the immediate, nonverbal engagement with the world through one’s senses. Much HCI work has prioritized cognitive stimulation for reminiscing or personhood often on small screens, while less research has explored sensory stimulation like the one enabled by large displays. We describe a year-long deployment in a residential care home of a wall-sized display, and explored its domestication through 24 contextual interviews. Findings indicate strong engagement and attachment to the display which has inspired four psychosocial interventions using online generic content. We discuss the value of these findings for personhood through residents’ exercise of choices, the tension between generic/personal content and its public/private use, the importance of participatory research approach to domestication, and the infrastructure-based prototype, illustrated by the DementiaWall and its generative quality

Who is informed and who uninformed? Addressing the legal barriers to progress in dementia research and care

Abstract Conduct of research is an essential tool for the evaluation and improvement of health services. In Israel, research on persons with dementia is very limited, with the largest portion of such research involving a few surveys and examining risk factors for dementia. Very few studies describe clinical research, and those that do either include participants at early stages of dementia, or rely completely on caregivers’ perceptions and experiences, often without reference to any individual with dementia. This dearth of research is due, to a substantial extent, to Ministry of Health regulations which do not permit family proxy consent for research involving persons with dementia. Alternative models for regulation of consent for research exist in other countries, including the U.S., and these allow for proxy consent under certain conditions. This paper presents such a model and its underlying ethical principles. It contends that the current state of affairs, which stands in the way of clinical research concerning persons with advanced dementia, is contrary to the interests of such persons, their caregivers, and Israeli society. Therefore, this paper calls for a change in the present regulations and/or law in the cause of advancing knowledge and improving care for persons with dementia

The impact of group activities and their content on persons with dementia attending them

Abstract Background Individuals suffering from dementia and residing in nursing homes often feel lonely and bored. This study examined the engagement and mood of people with dementia in group activities, and how personal characteristics, such as cognitive function, may impact on an individual’s responses to group activities. Methods The study included 102 participants, who took part in group activities while their mood and engagement levels were observed. Participants were invited to attend 10 different types of group activities, each of which was offered twice. Results Results found improved engagement and mood during group activities as compared to control no-group times. Significant relationships between the type of activity and ratings of engagement and mood were also found. Although participants with higher levels of cognitive functioning manifested greater responsiveness to groups, the pattern of response to different contents did not differ by cognitive function. Conclusions This study shows the potential utility of group activities for improving quality of life of persons with dementia and demonstrates a methodology that can be used for quality improvement to optimize group contents. Future research should expand the range of contents of group activities in order to enhance the options for improving mood and engagement of individuals with dementia

Recollections of a jewish mathematician in Germany

Abraham A. Fraenkel was a world-renowned mathematician in pre–Second World War Germany, whose work on set theory was fundamental to the development of modern mathematics. A friend of Albert Einstein, he knew many of the era’s acclaimed mathematicians personally. He moved to Israel (then Palestine under the British Mandate) in the early 1930s. In his autobiography Fraenkel describes his early years growing up as an Orthodox Jew in Germany and his development as a mathematician at the beginning of the twentieth century. This memoir, originally written in German in the 1960s, has now been translated into English, with an additional chapter covering the period from 1933 until his death in 1965 written by the editor, Jiska Cohen-Mansfield. Fraenkel describes the world of mathematics in Germany in the first half of the twentieth century, its origins and development, the systems influencing it, and its demise. He also paints a unique picture of the complex struggles within the world of Orthodox Jewry in Germany. In his personal life, Fraenkel merged these two worlds during periods of turmoil including the two world wars and the establishment of the state of Israel. Including a new foreword by Menachem Magidor Foreword to the 1967 German edition by Yehoshua Bar-Hillel

Motivation to Participate in Intergenerational Programs: A Comparison across Different Program Types and Generations

Much research has attested to the benefits of intergenerational programs (IGPs) for older and younger participants, but there is a lack of understanding about what motivates them to participate and to persevere. We conducted structured interviews with 83 older (mean age = 77) and 96 younger (mean age = 23) participants who participated in 13 IGPs in Israel, some involving specific topics, and some providing assistance to older adults. Using a mixed-methods approach, we analyzed differences in motivation across generations and program types and compared initial and ongoing motivation to participate. We found differences regarding motivation by age group and program type: Among older participants, interest in the specific subject was a more prevalent motivation in topic-focused groups, while receiving support was more common in assistance groups. Among young persons, motivations relating to obligation, such as receipt of a financial scholarship, and the wish to help others were the most prevalent motivators. Ongoing motivation was often explained by positive intergenerational relationships and enjoyment. For older adults, offering more diverse topic-focused activities may motivate greater participation. For young adults, integrating IGPs within more and different settings, and promoting IGPs as opportunities to help others are potential motivators