Hispanic/Latino ethnicity moderates the plasma P‐tau217 and memory relationship in older adults across the cognitive continuum.

Background: Plasma P‐tau217 demonstrates strong sensitivity and specificity for Alzheimer’s disease (AD) neuropathological change, but existing studies are often ethnically homogeneous. Assumptions about how well plasma P‐tau217 relates to key AD‐related cognitive outcomes like memory may not generalize. We assessed whether the association between plasma P‐tau217 and memory depended on ethnicity in a sample of Hispanic/Latino and non‐Hispanic/Latino White older adults.

Poor Colonoscopy Bowel Prep in 69‐Year‐old with Mild Neurocognitive Disorder: A Case Example.

Introduction: Colonoscopies are medical procedures used to identify colon abnormalities and remove polyps to decrease the incidence of colorectal cancer. Prior to this exam, patients must undergo bowel preparation to ensure proper cleansing of the colon and maximize outcomes (e.g.

Poor Colonoscopy Bowel Prep in Cognitively Impaired 85‐Year‐Old with Low Education: Another Case Example.

Introduction: Colonoscopies are routine procedures performed primarily on adults over the age of 50; however, there is little known about the influence of social determinants of health on successful completion of colonoscopies. Inadequate at‐home bowel preparation can result in increased procedure duration, decreased cancer detection, and may necessitate a repeated colonoscopy, putting undue stress on the patient. Research suggests neurocognitive disorder is a risk factor for poor bowel preparation in older adults; however, lower education may confound neurocognitive findings, independently contributing to risk of incomplete colonoscopies.

Adaptation, calibration, and validation of a cognitive assessment battery for telephone and video administration.

Background: Events such as global pandemics can force rapid adoption of new modes of assessment. We describe the evaluation of a modified neuropsychological assessment for web and telephone administration.

Methods: Telephone and video conferencing-based neuropsychological assessment procedures were developed and implemented within an ongoing observational study, the Successful Aging following Elective Surgery II (SAGES) study (N = 420 persons).

Characterizing Spanish-speaking patients' patient-centered care experiences in the emergency department.

Background: Patient-centered care (PCC) is an essential component of high-quality health, yet patients with non-English language preferences (NELP) experience worse PCC outcomes. Additionally, there are likely unique aspects to PCC for patients with NELP in the emergency department (ED). To inform the development of strategies to improve PCC for NELP in the ED, we sought to understand how Spanish-speaking ED patients experience care and the factors that influenced their perceptions of the patient-centeredness of that care.

Nonpharmacological treatment for older adults with mild cognitive impairment: Considerations for culturally informed clinical practice and research.

Objective: Numerous nonpharmacological treatments (NPTs) have been developed for older adults with mild cognitive impairment (MCI). Two forms of cognition-focused NPTs, cognitive rehabilitation (CR) and cognitive training (CT), demonstrate cognitive benefit, but limitations remain regarding the contribution of cultural and demographic factors to study outcome heterogeneity, generalizability to diverse populations, and feasibility. This article aimed to review demographic and culturally informed NPTs and provides recommendations for culturally informed clinical practice and research.

Electroencephalographic Measures of Delirium in the Perioperative Setting: A Systematic Review.

Postoperative delirium (POD) is frequent in older adults and is associated with adverse cognitive and functional outcomes. In the last several decades, there has been an increased interest in exploring tools that easily allow the early recognition of patients at risk of developing POD. The electroencephalogram (EEG) is a widely available tool used to understand delirium pathophysiology, and its use in the perioperative setting has grown exponentially, particularly to predict and detect POD.

Plasma p-tau217 concordance with amyloid PET among ethnically diverse older adults.

Introduction: Commercially available plasma p-tau217 biomarker tests are not well studied in ethnically diverse samples.

Methods: We evaluated associations between ALZPath plasma p-tau217 and amyloid-beta positron emission tomography (Aβ-PET) in Hispanic/Latino (88% of Cuban or South American ancestry) and non-Hispanic/Latino older adults. One- and two-cutoff ranges were derived and evaluated to assess agreement with Aβ-PET.

Association of Loneliness With Change in Physical and Emotional Health of Older Adults During the COVID-19 Shutdown.

Objectives: To examine factors influencing loneliness and the effect of loneliness on physical and emotional health, in the context of the COVID-19 pandemic.

Design: Prospective, observational cohort.

Setting: Community-dwelling participants.

Social determinants of health and incident postoperative delirium: Exploring key relationships in the SAGES study.

Background: Examining the associations of social determinants of health (SDOH) with postoperative delirium in older adults will broaden our understanding of this potentially devastating condition. We explored the association between SDOH factors and incident postoperative delirium.

Methods: A retrospective study of a prospective cohort of patients enrolled from June 18, 2010, to August 8, 2013, across two academic medical centers in Boston, Massachusetts.

Plasma Alzheimer's biomarkers and brain amyloid in Hispanic and non-Hispanic older adults.

Introduction: Alzheimer's disease studies often lack ethnic diversity.

Methods: We evaluated associations between plasma biomarkers commonly studied in Alzheimer's (p-tau181, GFAP, and NfL), clinical diagnosis (clinically normal, amnestic MCI, amnestic dementia, or non-amnestic MCI/dementia), and Aβ-PET in Hispanic and non-Hispanic older adults. Hispanics were predominantly of Cuban or South American ancestry.

Shared Decision Making for Elective Surgical Procedures in Older Adults with and without Cognitive Insufficiencies.

Purpose: Older adults are prone to cognitive impairment, which may affect their ability to engage in aspects of shared decision making (SDM) and their ability to complete surveys about the SDM process. This study examined the surgical decision-making processes of older adults with and without cognitive insufficiencies and evaluated the psychometric properties of the SDM Process scale.

Methods: Eligible patients were 65 y or older and scheduled for a preoperative appointment before elective surgery (e.

Culturally and Linguistically Informed Neuropsychological Evaluation Protocol for Primarily Spanish-Speaking Adults.

Objective: The Latina(o)/Hispanic (L/H) population represents the largest and fastest-growing ethnic group in the United States. Migration patterns have evolved and greater diversity (i.e.

Paternal Occupation and Delirium Risk in Older Adults: A Potential Marker of Early-Life Exposures.

Background And Objectives: Delirium is a common disorder among older adults following hospitalization or major surgery. Whereas many studies examine the risk of proximate exposures and comorbidities, little is known about pathways linking childhood exposures to later-life delirium. In this study, we explored the association between paternal occupation and delirium risk.

Parental Education and Delirium Risk after Surgery in Older Adults.

Objectives: Efforts to conceptualize risk factors for postoperative delirium in older adults have focused on the time proximate to the episode, but how early-life exposures influence delirium risk is poorly understood.

Methods: An observational cohort of 547 patients aged 70+undergoing major non-cardiac surgery at two academic medical centers in Boston. Demographic characteristics, cognition, parental education, health, and participation in cognitively stimulating activities were assessed prior to surgery.

Neuropsychological evaluation in American Sign Language: A case study of a deaf patient with epilepsy.

In high-stake cases (e.g., evaluating surgical candidacy for epilepsy) where neuropsychological evaluation is essential to care, it is important to have culturally and linguistically appropriate and accessible neuropsychological instruments and procedures for use with deaf individuals who use American Sign Language (ASL).

Identifying Delirium in Persons With Moderate or Severe Dementia: Review of Challenges and an Illustrative Approach.

Delirium and dementia are common causes of cognitive impairment among older adults, which often coexist. Delirium is associated with poor clinical outcomes, and is more frequent and more severe in patients with dementia. Identifying delirium in the presence of dementia, also described as delirium superimposed on dementia (DSD), is particularly challenging, as symptoms of delirium such as inattention, cognitive dysfunction, and altered level of consciousness, are also features of dementia.

Underrepresentation of diverse populations and clinical characterization in opioid agonist treatment research: A systematic review of the neurocognitive effects of buprenorphine and methadone treatment.

Introduction: The relative neurocognitive effects of the two most common opioid agonist treatments (OAT; buprenorphine and methadone) for opioid use disorder (OUD) are poorly understood. The aim of this systematic review is to examine the neurocognitive effects of OAT (buprenorphine and methadone) and the clinical and sociodemographic characteristics of study samples.

Methods: The research team queried PubMed, PsycINFO and Cochrane Reviews for articles (01/1980-01/2020) with terms related to neurocognitive testing in adults (age ≥ 18) prescribed OAT.

A framework of social determinants of health for delirium tailored to older adults.

Delirium is a debilitating medical condition that disproportionately affects hospitalized older adults and is associated with adverse health outcomes, increased mortality, and high medical costs. Efforts to understand delirium risk in hospitalized older adults have focused on examining medical comorbidities, pre-existing cognitive deficits, and other clinical and demographic factors present in the period proximate to the hospitalization. The contribution of social determinants of health (SDOH), including social circumstances, environmental characteristics, and early-life exposures, referred as the social exposome, to delirium risk is poorly understood.

Neurocognitive, psychiatric, and substance use characteristics in a diverse sample of persons with OUD who are starting methadone or buprenorphine/naloxone in opioid treatment programs.

Background: Medications for opioid use disorder such as opioid agonist treatment (OAT, including methadone, buprenorphine) are the gold standard intervention for opioid use disorder (OUD). Persons with OUD have high rates of neurocognitive impairment and psychiatric and substance use disorders, but few studies have examined these characteristics in diverse patients initiating OAT in opioid treatment programs (OTPs). Additionally, in these individuals, poor neurocognitive functioning and psychiatric/other substance use disorders are associated with poor OUD treatment outcomes.

Predictors of Caregiver Burden in Delirium: Patient and Caregiver Factors.

The current study examined the association of patient factors, patient/caregiver relationships, and living arrangements with caregiver burden due to delirium. The sample included a subset ( = 207) of hospitalized medical and surgical patients (aged >70 years) enrolled in the Better Assessment of Illness Study and their care-givers. The majority of caregivers were female (57%) and married (43%), and 47% reported living with the patient.

Teleneuropsychology for Monolingual and Bilingual Spanish-Speaking Adults in the Time of COVID-19: Rationale, Professional Considerations, and Resources.

Objective: Neuropsychological assessments with monolingual Spanish and bilingual Spanish/English-speaking adults present unique challenges. Barriers include, but are not limited to, the paucity of test norms, uncertainty about the equivalence of translated neuropsychological tests, and limited proficiency in the provision of culturally competent services. Similar issues generalize to telephone- and video-based administration of neuropsychological tests or teleneuropsychology (TeleNP) with Hispanics/Latinos (as), and few studies have examined its feasibility and validity in this group.

Neighborhood-Level Social Disadvantage and Risk of Delirium Following Major Surgery.

Background/objectives: Delirium is a common postoperative complication associated with prolonged length of stay, hospital readmission, and premature mortality. We explored the association between neighborhood-level characteristics and delirium incidence and severity, and compared neighborhood- with individual-level indicators of socioeconomic status in predicting delirium incidence.

Design: A prospective observational cohort of patients enrolled between June 18, 2010, and August 8, 2013.

Education differentially contributes to cognitive reserve across racial/ethnic groups.

Introduction: We examined whether educational attainment differentially contributes to cognitive reserve (CR) across race/ethnicity.

Methods: A total of 1553 non-Hispanic Whites (Whites), non-Hispanic Blacks (Blacks), and Hispanics in the Washington Heights-Inwood Columbia Aging Project (WHICAP) completed structural magnetic resonance imaging. Mixture growth curve modeling was used to examine whether the effect of brain integrity indicators (hippocampal volume, cortical thickness, and white matter hyperintensity [WMH] volumes) on memory and language trajectories was modified by education across racial/ethnic groups.