Page 52 - Encyclopedia of Nursing Research

APPLiED RESEARCH n 19

informants reported memory loss, 30% of with Alzheimer pathology plus clinical diag-
participants were found not to have a cogni- noses of dementia.
tive loss. Among participants in whom fam- A review of 23 studies of alcohol use A
ily informants reported no memory loss, 75% found that alcohol use during adulthood in
were diagnosed with dementia or cognitive moderation may protect the individuals from
impairment. Mexican Americans were 2.2 developing dementia in later life (Peters,
times more likely than European Americans Peters, Warner, Beckett, & Bulpitt, 2008).
to have MMSE scores less than 24, indicat- in conclusion, the findings from a state
ing cognitive impairment (Watson, Lewis, & of the science consensus conference on AD
Fillenbaum, 2005). convened by the National institutes of Health
Prevention of cognitive decline has was recently published (Daviglus et al., 2010).
ongoing merit for health promotion research. The risk factors identified were current
Aspects of lifestyle and SES, including diet, tobacco use, apolipoprotein E ε4 genotype,
emotional state, and use of drugs, are of high and certain medical conditions, which were
interest to nurse scientists (Karlamangla associated with increased risk (Plassman,
et al., 2009). Williams, Burke, Holsinger, & Benjamin,
Whether or not diabetic Hispanics are at 2010). Although the identification of protec-
an increased risk for cognitive impairment tive factors was limited, as reported by the
is uncertain. Cognitive aging studies have authors, the quality of research from obser-
failed to assess the overall health and phys- vational studies (N = 122) was low.
ical functioning in older subjects. Recently, The major outcome from the conference
investigators found decreasing serum anti- was a change in the criteria for diagnosing AD
oxidant levels to be negatively associated toward an earlier diagnosis using biomarkers,
with memory performance in a multiethnic such as brain scans and spinal taps. Another
sample of elderly (N = 4,809). Hispanic elders’ change is categorizing AD into three stages:
memory complaints may be misclassified as preclinical disease, mild cognitive impair-
cognitive impairment or dementia with the ment, and Alzheimer’s dementia. Complaints
MMSE if other sociodemographic and med- and problems with everyday memory are
ical conditions such as diabetes are ignored primary determinants of whether an individ-
(Perkins et al., 1999; Wu et al., 2003). ual seeks medical attention or is motivated
Data from the Baltimore Longitudinal to participate in cognitive aging research
Study on Aging illuminated the association and/or engage in activities such as mental
between depression and cognitive decline stimulation, social engagement, or lifestyle
(Bierman, Comijs, Jonker, & Beekman, 2005). adjustment. The AD research funding at the
Four groups of individuals were compared: (1) National institutes of Health for fiscal year
cognitively normal controls with no Alzheimer 2011 is estimated at $480 million.
pathology, (2) cognitively normal individu-
als with Alzheimer pathology, (3) individu- Graham J. McDougall Jr.
als with mild cognitive impairment plus
Alzheimer pathology, and (4) individuals with
clinical diagnoses of dementia plus Alzheimer
pathology. Depressive symptoms were APPlied reSeArch
assessed using the Center for Epidemiologic
Studies Depression Scale. individuals with
Alzheimer pathology but no cognitive decline in an attempt to differentiate between vari-
before death had significantly lower rates of ous types of research, the scientific commu-
depression than cognitively normal controls nity uses a myriad of terms, which, however,
with no Alzheimer pathology and individuals tend to fall into a discrete classification. on