Memory Loss and Cognitive Impairment of the Elderly

CHAPTER V

DISCUSSION, SUMMARY, CONCLUSION, IMPLICATIONS

LIMITATIONS AND RECOMENDATIONS

This chapter deals with discussion, summary and conclusion drawn. It also clarifies the limitation of the study, the implications and recommendations given for different areas such as nursing practice, nursing education, nursing administration and research.

Memory loss is unusual forgetfulness. May not able to remember the new incidents, recall more memories of the past or both .Memory loss can be distressing for the person affected as well as for their family.

Mild cognitive impairment is a syndrome defined as cognitive decline greater than expected for an individual’s age and education levels but that does not interfere notably with activities of daily life. Age related changes in cognitive function vary considerably across individuals. Some cognitive functions appearing more susceptible than others to the effect of aging.

DISCUSSION:

The present study was designed to assess the memory loss and cognitive impairment for the elder peoples. The investigator adopted descriptive research design. The data collected for the study were analyzed statistically and discussed below based on objectives.

i) Demographic Description: Demographic variables included Age , Sex , Education , Monthly income before coming to the old age home , Marital status , Occupation before coming to the old age home , Duration of stay in the old age home , Family history of mental illness , Source of income .

Out of 60 elderly majority of the people 26 ( 43.33%) were between the age group of 76 – 80 yrs , regarding the sex 36 ( 60%) people are males ,regarding the educational status 50 ( 83.33 %) people had primary education , regarding the monthly income 46( 76.66%) people are getting RS ,3000-5000, 39 ( 65%) people married , 24 ( 40%) people are in private job , 30 ( 50%) people are staying 1-2 years in the old age home , 55( 91.66% ) people are not having family history of mental illness , 20 ( 33.33%) people are having source of income from the children.

1) The first objective of the study was to assess the memory loss and cognitive impairment among elder people.

Among 60 samples 1 (1.66%) of them scored between 61-80 (Mild memory loss), 19 (31.66%) of them scored between 41- 60 (Moderate memory loss), 40 (66.66%) of them scored between 21- 40 (Severe memory loss), and there is no people in very severe memory loss among elderly.

This study was supported by Chips .J Pillai., et al (2009), conducted a early assessment of memory impairment in people over 65 years old . Tests used for the early diagnosis with memory loss are Wechsler memory scale. They recorded 74.5 % of memory complaints for old age people. Memory consultations were assessed at clinical settings and improve the access to early medical and behavioral support.

Among 60 samples 3(5%) of them scored between 21-25 (Mild cognitive impairment), 56 (93.33%) of them scored between 11- 20 (Moderate cognitive impairment), 1 (1.66%) of them scored between 0-10 (Severe cognitive impairment) among elderly.

This study was supported by Cynthia Thomas et al ( 2005 ) , conducted the study on cognitive assessment for elderly ; A brief screening test for mild cognitive impairment. Mini mental status examination administered to all the participants. 94 Participants meeting mild cognitive impairment clinical criteria. The study concluded that 55%people detect mild cognitive impairment.

2) The second objective of the study was association between the memory loss with demographic variables:

The chi square value for the association of age and memory loss among elderly is significant 0.001 levels. Hence, a significant association between age and memory loss.

There is no significant association between memory loss with sex , education , occupation before coming to the old age home , marital status , income before coming to the old age home , duration of stay in the old age home , family history of mental illness , source of income among elderly.

This study was supported by Gary .J Kennedy (2008), assessed the age associated memory impairment. 160 participants were selected with the age group of 70 -80 years. Used 4 computerized & 3 non computerized memory tests. The participants score was low on two memory test. The data suggest that 80 % subjects had memory impairment.

3) The third objective was to associate the cognitive impairment with demographic variables.

There is no significant association between cognitive impairment with demographic variables such as age , sex , education , occupation before coming to the old age home , marital status , income before coming to the old age home , duration of stay in the old age home , family history of mental illness , and source of income among elderly.

This study was supported by John .M Starr et al (1999) conducted a study on age associated cognitive decline in healthy older people. Results were the study fails to support the hypothesis that cognitive decline can be attributed to age alone in healthy older people. They detected 57% older people had moderate cognitive impairment.

4) The fourth objective was to assess the correlation between memory loss and cognitive impairment.

Mean value for memory loss is 38.3 and standard deviation value is 5.60, and mean value for cognitive impairment is 15.5 and standard deviation value is 2.89. Correlation of memory loss and cognitive impairment score is 0.407. It is evident that there is a positive correlation between memory loss and cognitive impairment among elderly.

This study was supported by Noboru Habu., et al (2010). Conducted a cross sectional study on relationship between mild memory impairment and cognitive impairment. Results were the study there is a correlation of coefficient of memory loss and cognitive impairment(r = 0.391). There is a positive correlation between memory loss and cognitive impairment among elderly.

SUMMARY

The present study aimed to assess the memory loss and cognitive impairment among elderly at ST. JOSEPH old age home in Coimbatore.

The objectives were to:

1) Assess the memory loss and cognitive impairment among elderly.

2) Associate the memory loss with demographic variables among elderly

3) Associate the cognitive impairment with demographic variables among elderly.

4) Correlate the memory loss and cognitive impairment among elderly.

Review of literature facilitated the investigator to collect the relevant information to support the study. The researcher adopted descriptive research design for conducting this study. The conceptual frame work was based on Modified bio psychosocial model 1999. The researcher to identify the memory loss and cognitive impairment among elderly. 60 elderly were selected by convenient sampling technique .The tool used for data collection consists of Wechsler memory scale, mini mental status examination.

The data was collected for a period of 6 weeks in ST. JOSEPH OLD AGE HOME Coimbatore. Based on the objectives, data were analyzed using both descriptive and inferential statistics.

MAJOR FINDINGS OF THE STUDY:

• According to statistical analysis, 1(1.66%) elderly had mild memory loss.
• 19(31.66%) elderly had moderate memory loss.
• 40(66.66%) elderly had severe memory loss.
• 3(5%) elderly had mild cognitive impairment.
• 56(93.33%) elderly had moderate cognitive impairment.
• 1(1.66%) elderly had severe cognitive impairment.
• Chi square value for the association of age with memory loss is significant at 0.001 levels. So these findings indicated that as age progress the memory will get decreased.
• Chi square value for the association of cognitive impairment with demographic variables is not significant.
• Mean value for memory loss is 38.3 and standard deviation is 5.60.
• Mean value for cognitive impairment is 15.5 and standard deviation is 2.89.
• The findings indicated that the Correlation value of memory loss and cognitive impairment is 0.407. It was evident that there is positive correlation between memory loss and cognitive impairment. It can be assumed when memory loss get increased the cognitive impairment also will increase.

CONCLUSION:

That it is concluded that elderly are suffers from memory loss and cognitive impairment, there is a significant association between age and memory loss. As the age progress the memory will get decreased. And there is no significant association between cognitive impairment with demographic variables. There is a positive correlation between memory loss and cognitive impairment among elderly.

IMPLICATIONS:

The present study findings have several implications in nursing practice, nursing education, nursing administration and nursing research. Nurse can assess the problems of elderly and prevent further complication.

Nursing practice:

• Increased attention towards family members regarding care of elderly.

• Nurses can provide memory training for the elderly.

• Nurses can advice the elderly to maintain the diary for remembering important matters.
• Nurses can provide counselling for psychological problems of the elderly.

Nursing Education:

• Nursing educator plays an important role for preparing the nurses for caring the elderly and meets the psychological and physical needs of the elderly.
• Nursing educator Involve the students in memory training program.
• Nursing educator ways to improve and maintain cognitive health.

Nursing Administration:

• Nursing administrator can plan and organizing community based classes to the community people regarding improving memory and cognitive impairment among elderly.
• Nursing administrator can encourage students to participate in health education and counselling programme for the family members.
• Nursing administrator can conduct in-service education, workshop, continuing nursing education to the nursing students and update their knowledge about needs (physical & psychological) for the elderly.

Nursing Research:

• This study can be baseline for future studies to build on.

• Nursing research provides evidence based clinical practice.

LIMITATIONS:

• This study was limited to single setting.
• This study was limited to the sample size of 60 elderly.
• This study was limited to only assessment of memory loss and cognitive impairment among elderly.

RECOMMENDATIONS:

• A study can be conducted to find out the needs of the elderly
• A study can be conducted in various settings.
• A study can be conducted to psychological and physical problems of elderly.
• A study can be conducted to compare the memory loss and cognitive impairment of elderly staying in old age home and staying in home.
• A study can be conducted in community settings.
• A study can be conducted memory loss and cognitive impairment can affect the activities of daily living and occupational functions of the elderly.

ABSTRACT

The present study entitled, study to ASSESS THE MEMORY LOSS AND COGNITIVE IMPAIRMENT AMONG ELDERLY AT ST. JOSEPH OLD AGE HOME COIMBATORE. The objectives of the study were to assess the memory loss and cognitive impairment among elderly, associate the memory loss with demographic variables among elderly, associate the cognitive impairment with demographic variables among elderly, and correlate the memory loss and cognitive impairment among elderly. Descriptive research design was adopted for this study. This study was conducted in ST.JOSEPH old age home, Coimbatore. The sample size was 60 elderly. The Conceptual frame work adopted for this study was Modified bio psychosocial model (1999). The study was conducted for a period of six weeks. The tools used to assess the memory loss and cognitive impairment is Wechsler memory scale and Mini mental status examination. The results of the study were Among 60 samples, 1.66% elderly had mild memory loss, 31.66% elderly had moderate memory loss, and 66.66% elderly had severe memory loss. In cognitive impairment 5% elderly had mild cognitive impairment, 93.33% elderly had moderate cognitive impairment, and 1.66% elderly had severe cognitive impairment. There is a significant association between age and memory loss .There is no significant association between cognitive impairment with demographic variables. Positive correlation between memory loss and cognitive impairment among elderly. The study concluded that as the age progress the memory will get decreased.