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Cognition, Everyday Function and Driving Performance in Old Age
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.ORCID iD: 0000-0002-5289-8831
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The population of people aged 80 years and older is the fastest growing population in the world. Age is the main risk factor for many diseases and to be able to investigate and help old people when they have symptoms or increased difficulties in their everyday lives, there is a need of knowledge of normal functions and abilities in this population. The main aim of this thesis is to present normative data for established cognitive tests from cognitively healthy old persons, and to describe and investigate predictors of everyday function and driving performance in old age. The results are based on two projects, The Elderly in Linköping Screening Assessment and The Normative Study of Driving Ability in Old Swedes.

Paper I presents normative data for four established cognitive tests measuring processing speed, attention and executive function, from participants that were longitudinally tested at 85, 90 and 93 years of age. There was no clinically important difference in test results due to gender, but educational level affected test results at 85 years of age. Age-related decline was present for most of the examined tests.  

Paper II presents normative data for age 85, 90 and 93 years for two tests of naming ability and verbal comprehension and investigate age-related changes from 85 to 93 years of age. Higher educational level was associated with better test results. Naming ability was found to be more sensitive to aging than verbal comprehension.  

Paper III describes difficulties and changes of everyday function between 85 and 90 years of age. Difficulties in everyday function increased significantly over the five-year period. Decline in everyday function was partly shown to be predicted by concurrent decline in processing speed and self-rated health.  

Paper IV describes driving characteristics of drivers aged 75 years and older and examines associations between driving performance and results on cognitive tests and driving habits. There was a large variation in driving performance among the older drivers and combined results on cognitive tests were found to be a more robust predictors of driving performance than age, although age was still a significant predictor.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2024. , p. 118
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1924
Keywords [en]
Aged, Aging, Cognition, Neuropsychological tests, Normative, Everyday function, Automobile Driving
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-208532DOI: 10.3384/9789180756990ISBN: 9789180756983 (print)ISBN: 9789180756990 (electronic)OAI: oai:DiVA.org:liu-208532DiVA, id: diva2:1905922
Public defence
2024-11-22, Berzeliussalen, building 463, Campus US, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2024-10-16 Created: 2024-10-16 Last updated: 2024-10-16Bibliographically approved
List of papers
1. Normative data for the oldest old: Trail Making Test A, Symbol Digit Modalities Test, Victoria Stroop Test and Parallel Serial Mental Operations
Open this publication in new window or tab >>Normative data for the oldest old: Trail Making Test A, Symbol Digit Modalities Test, Victoria Stroop Test and Parallel Serial Mental Operations
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2020 (English)In: Aging, Neuropsychology and Cognition, ISSN 1382-5585, E-ISSN 1744-4128, Vol. 27, no 4, p. 567-550Article in journal (Refereed) Published
Abstract [en]

Normative data for evaluating cognitive function in the oldest old, aged 85 years and above, are currently sparse. The normative values used in clinical practice are often derived from younger old persons, from small sample sizes or from broad age spans (e.g. amp;gt;75 years) resulting in a risk of misjudgment in assessments of cognitive decline. This longitudinal study presents normative values for the Trail Making Test A (TMT-A), the Symbol Digit Modalities Test (SDMT), the Victoria Stroop Test (VST) and the Parallel Serial Mental Operations (PaSMO) from cognitively intact Swedes aged 85 years and above. 207 participants, born in 1922, were tested at 85, 90 (n = 68) and 93 (n = 35) years of age with a cognitive screening test battery. The participants were originally recruited for participation in the Elderly in Linkoping Screening Assessment. Normative values are presented as mean values and standard deviations, with and without adjustment for education. There were no clinically important differences between genders, but education had a significant effect on test results for the 85-year-olds. Age effects emerged in analyses of those participants who completed the entire study and were evident for TMT-A, SDMT, VST1 and PaSMO. When comparisons can be made, our results are in accordance with previous data for TMT-A, SDMT and VST, and we present new normative values for PaSMO.

Place, publisher, year, edition, pages
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2020
Keywords
Neuropsychological tests; aged; 80 and over; executive function; attention; normative
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-159866 (URN)10.1080/13825585.2019.1648747 (DOI)000480134100001 ()31382824 (PubMedID)
Note

Funding Agencies|Linkoping University [LIO-696631, LIO 602761, LIO 537591]; Linkopings Universitet [LIO- 696631, LIO- 602761, LIO- 537591]

Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2024-10-16
2. Swedish normative data and longitudinal effects of aging for older adults: The Boston Naming Test 30-item and a short version of the Token Test
Open this publication in new window or tab >>Swedish normative data and longitudinal effects of aging for older adults: The Boston Naming Test 30-item and a short version of the Token Test
2022 (English)In: Applied neuropsychology. Adult, ISSN 2327-9095, E-ISSN 2327-9109Article in journal (Refereed) Epub ahead of print
Abstract [en]

Naming ability and verbal comprehension are cognitive functions that may be affected both by normal aging and by disease. Neuropsychological testing is crucial to evaluate changes in language ability and reliable normative data for all ages are needed. We present clinically useful test norms, together with subsample analysis of longitudinal effects of aging, for two robust and well-known tests that evaluate naming ability and verbal comprehension where the present norms for older adults (aged 85 and older) are sparse or missing. Participants (n = 338) from a Swedish population-based study, the Elderly in Linkoping Screening Assessment, were cognitively evaluated with a cognitive screening battery at the age of 85 years and followed to the age of 93 years. Normative data at age 85 years were calculated from a sample (n = 207) that was determined as cognitively healthy after application of rigorous exclusion criteria. Effects of normal aging were investigated by analyzing follow-up performance at age 90 and 93 years for the subsample of cognitively healthy that completed the entire study. The evaluated tests in this study are Swedish versions of the Boston Naming Test 30-item Odd Version (BNT-30) and a short form of the Token Test, Part V (TokV). Analyzes of effects of aging showed that performance decreased with age for BNT-30, but not for TokV. Higher education was associated with better performance in both tests and men performed better than women on the BNT-30. Results also showed naming ability to be more sensitive to aging than verbal comprehension.

Place, publisher, year, edition, pages
Routledge; Taylor & Francis, 2022
Keywords
80 and over; aged; language test; naming ability; neuropsychological tests; verbal comprehension
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-190634 (URN)10.1080/23279095.2022.2148106 (DOI)000889200700001 ()
Available from: 2022-12-19 Created: 2022-12-19 Last updated: 2024-10-16
3. Relations between Concurrent Longitudinal Changes in Cognition, Depressive Symptoms, Self-Rated Health and Everyday Function in Normally Aging Octogenarians
Open this publication in new window or tab >>Relations between Concurrent Longitudinal Changes in Cognition, Depressive Symptoms, Self-Rated Health and Everyday Function in Normally Aging Octogenarians
2016 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 8, p. e0160742-Article in journal (Refereed) Published
Abstract [en]

Ability to predict and prevent incipient functional decline in older adults may help prolong independence. Cognition is related to everyday function and easily administered, sensitive cognitive tests may help identify at-risk individuals. Factors like depressive symptoms and self-rated health are also associated with functional ability and may be as important as cognition. The purpose of this study was to investigate the relationship between concurrent longitudinal changes in cognition, depression, self-rated health and everyday function in a well-defined cohort of healthy 85 year olds that were followed-up at the age of 90 in the Elderly in Linkoping Screening Assessment 85 study. Regression analyses were used to determine if cognitive decline as assessed by global (the Mini-Mental State Examination) and domain specific (the Cognitive Assessment Battery, CAB) cognitive tests predicted functional decline in the context of changes in depressive symptoms and self-rated health. Results showed deterioration in most variables and as many as 83% of these community-dwelling elders experienced functional difficulties at the age of 90. Slowing-down of processing speed as assessed by the Symbol Digits Modality Test (included in the CAB) accounted for 14% of the variance in functional decline. Worsening self-rated health accounted for an additional 6%, but no other variables reached significance. These results are discussed with an eye to possible preventive interventions that may prolong independence for the steadily growing number of normally aging old-old citizens.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2016
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-131502 (URN)10.1371/journal.pone.0160742 (DOI)000381768800016 ()27551749 (PubMedID)
Note

Funding Agencies|Health Research Council of the South-East of Sweden [FORSS-8888, FORSS-11636, FORSS-31811]; County of Ostergotland [LIO-11877, LIO-31321, LIO-79951, LIO-430341]; Janne Elgqvist Family Foundation

Available from: 2016-09-26 Created: 2016-09-23 Last updated: 2024-10-16

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