COPE
Coatomer subunit epsilon (Epsilon-coat protein) (Epsilon-COP)
Publications[править]
The prevalence of impaired cognitive functioning in older patients with end stage kidney disease (ESKD) is high. We aim to describe patterns of memory, executive function or psychomotor speed and to identify nephrologic, geriatric and neuroradiologic characteristics associated with cognitive impairment in older patients approaching ESKD who have not yet started with renal replacement therapy (RRT). The COPE-study (Cognitive Decline in Older Patients with ESRD) is a prospective cohort study including 157 participants aged 65 years and older approaching ESKD (eGFR ≤20 ml/min/1.73 m ) prior to starting with RRT. In addition to routinely collected clinical parameters related to ESKD, such as vascular disease burden and parameters of metabolic disturbance, patients received a full geriatric assessment, including extensive neuropsychological testing. In a subgroup of patients (n = 93) a brain MRI was performed. The median age was 75.3 years. Compared to the normative data of neuropsychological testing participants memory performance was in the 24th percentile, executive function in the 18th percentile and psychomotor speed in the 20th percentile. Independent associated characteristics of impairment in memory, executive and psychomotor speed were high age, low educational level and low functional status (all p-values < 0.003). A history of vascular disease (p = 0.007) and more white matter hyperintensities on brain MRI (p = 0.013) were associated with a lower psychomotor speed. Older patients approaching ESKD have a high prevalence of impaired memory, executive function and psychomotor speed. The patterns of cognitive impairment and brain changes on MRI are suggestive of vascular cognitive impairment. These findings could be of potentially added value in the decision-making process concerning patients with ESKD.
Keywords
- Cognitive function
- End stage renal disease
- Geriatric assessment
- Geriatrics
- Older patients
ABSTRACTBackground:A cognitive behavioral model predicts that coping responses mediate the relationship between falls related psychological concerns and falls incidence, in community-dwelling older people. If empirical support could be found for this pathway then interventions could be developed to reduce falls risk by targeting coping strategies. Therefore, this study aimed to begin the process of testing whether coping responses mediate the association between falls self-efficacy (a principal element of falls related psychological concerns) and falls incidence, in community-dwelling older people. In a cross-sectional design, 160 community-dwelling older people (31 male, 129 female; mean age 83.47 years) completed the Falls Efficacy Scale-International, the Revised-Ways of Coping Questionnaire, the Turning to Religion subscale of the COPE, and a falls questionnaire. Data were analyzed via mediation analysis using a bootstrapping approach. Lower falls self-efficacy was associated with higher falls incidence, and more self-controlling coping was found to be a partial mediator of this association, with a confidence interval for the indirect effect of (0.003, 0.021) and an effect size of κ2 = 0.035. The association was not mediated by the other measured coping responses; namely, turning to religion, distancing, seeking social support, accepting responsibility, escape-avoidance, planful problem-solving, and positive reappraisal. Self-controlling coping may mediate the association between falls self-efficacy and falling. If longitudinal studies confirm this finding then coping could be targeted in interventions to reduce falls.
MeSH Terms
- Accidental Falls
- Adaptation, Psychological
- Aged
- Aged, 80 and over
- Aging
- Cross-Sectional Studies
- Female
- Humans
- Incidence
- Male
- Postural Balance
- Quality of Life
- Self Efficacy
- Surveys and Questionnaires
- United Kingdom
Keywords
- community-dwelling older people
- coping
- falls
- falls related psychological concerns
To examine age-related differences in the relationship between personality and coping strategies in an Australian population of psychiatric inpatients. Consenting eligible adults (N=238) from 18-100 years of age consecutively admitted to inpatient psychiatry units were assessed using the SCID I and II, the Coping Orientations to Problems Experienced Scale (COPE), the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning Scale (GAF), the Social and Occupational Functioning Assessment Scale (SOFAS), the 12 Item Short-Form Heath Survey (SF12), the Sarason Social Support Questionnaire, and the NEO Five Factor Inventory (NEO-FFI) (cognitively impaired, and non-English speaking patients were excluded). Older adults reported less symptomatology than younger patients and younger patients described more personality dysfunction than older patients. As assessed by the COPE, older adults reported lower levels of dysfunctional coping strategies than younger adults. Personality traits, social supports, gender, and age predicted coping strategies, while Axis I diagnosis, education, personality disorder, and symptom severity were not significant predictors of coping strategies. This study found that influences on coping were multifactorial and moderated by age. These factors have implications for interventions designed to enhance coping strategies.
MeSH Terms
- Adaptation, Psychological
- Adolescent
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Aging
- Australia
- Female
- Hospitals, Psychiatric
- Humans
- Male
- Middle Aged
- Multivariate Analysis
- Personality Disorders
- Prospective Studies
- Regression Analysis
- Sex Factors
- Social Support
The way people cope with stressors of day to day living has an important influence on health. The aim of the present study was to explore whether genetic and environmental variations in stress-coping differ over time during adulthood. The brief COPE was mailed to a large sample of the UK female twins (N = 4,736) having a wide range of age (20-87 years). Factor analyses of the items of the brief COPE yielded three coping scales: 'Problem-Solving', 'Support Seeking', and 'Avoidance'. Monozygotic and dizygotic twin correlations tended to become lower with age for all three scales, suggesting that unique environmental factors may become more important with age during adulthood. Model-fitting results showed that relative influences of unique environmental factors increased from 60 % at age 20 years to 74% at age 87 years for 'Problem-Solving' and 56 % at age 20 years to 76% at age 87 years for 'Avoidance'. During the same age period, genetic factors decreased from 40 to 26 % for 'Problem-Solving' and from 44 to 24 % for 'Avoidance'. For 'Seeking Support', the magnitude of genetic and unique environmental factors was not significantly different across the adulthood. For all three scales, shared environmental effects were negligible. Overall, our findings implicate that the effects of environment that stem from idiosyncratic experience of stressful life events accumulate and become increasingly important in adulthood.
MeSH Terms
- Adaptation, Psychological
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Aging
- Defense Mechanisms
- Environment
- Factor Analysis, Statistical
- Female
- Humans
- Middle Aged
- Models, Genetic
- Problem Solving
- Stress, Psychological
- Twins, Dizygotic
- Twins, Monozygotic
1) To describe the illness representations of older persons with Mild Cognitive Impairment (MCI); 2) to describe how older adults cope with MCI; 3) to examine the relationships between illness representations and coping. Sixty-three older adults with MCI completed questionnaires on demographic and health information, beliefs about MCI (Illness Perception Questionnaire-MCI), and coping with MCI (brief COPE and Self-care Behaviors Checklist). Participants endorsed an average of 7 symptoms that they experienced and believed were related to MCI and an average of 7 potential causes of MCI. Participants tended to believe MCI was chronic, not cyclic, and controllable, but they differed in their beliefs about the consequences, understandability and emotional impact of MCI. Participants used many dementia prevention behaviors and memory aids, some problem-focused and emotion-focused coping strategies, and few dysfunctional coping strategies. Cluster analysis identified three clusters of beliefs about MCI: "few symptoms and positive beliefs," "moderate symptoms and positive beliefs," and "many symptoms and negative beliefs." Those in the "many symptoms and negative beliefs" cluster had significantly more negative beliefs about the consequences, unpredictability (cyclic timeline), and emotional impact of MCI than those in the other clusters. Participants in the "few symptoms and positive beliefs" cluster used significantly fewer memory aids, problem-focused coping strategies, emotion-focused coping strategies, and dysfunctional coping than those in the other two clusters. As suggested by the Common Sense Model, older adults with MCI have beliefs about their MCI and these beliefs are associated with how older adults cope with MCI.
MeSH Terms
- Adaptation, Psychological
- Aged
- Aged, 80 and over
- Aging
- Attitude to Health
- Cognitive Dysfunction
- Emotions
- Female
- Health Behavior
- Humans
- Male
- Middle Aged
- Self Care
- Self Concept
- Stress, Psychological
- Surveys and Questionnaires
This study collected data on demographic factors, heart failure physical limitations, perception of heart failure intrusiveness, coping mechanisms, locus of control, self-efficacy and social support for 104 older veterans with heart failure (HF) to determine the factors' relative importance in predicting depressive symptoms. Participants were veterans at least 60 years of age with HF who were screened for depression and anxiety with the Geriatric Depression Scale and Geriatric Anxiety Inventory, respectively, so that the final sample consisted of equal numbers with and without significant levels of anxiety and depression. Other measures included the Kansas City Cardiomyopathy Questionnaire, Heart Failure Illness Intrusiveness Rating Scale, Brief-COPE, Multidimensional Health Locus of Control Scale, Chronic Disease Self-Efficacy and Multidimensional Scale of Perceived Social Support. Correlational analyses indicated that depressive symptoms were significantly associated with physical limitations from HF, HF perceptions of intrusiveness, maladaptive coping, attributing locus of control to chance and HF self-efficacy. Including these variables in one regression equation predicting depressive symptoms indicated that perceptions of intrusiveness from HF and attributing locus of control to chance were the only variables to predict depressive symptoms independent of the influence of other significant bivariate predictors. Even if physical limitations, maladaptive coping and self-efficacy are held constant, decreasing perceptions of HF intrusiveness and locus of control to chance reduce depressive symptoms. These two cognitive/perceptual factors may play a salient role in treatment of depression among older HF patients.
MeSH Terms
- Aged
- Aged, 80 and over
- Aging
- Depression
- Female
- Geriatric Assessment
- Heart Failure
- Humans
- Internal-External Control
- Male
- Middle Aged
- Predictive Value of Tests
- Self Efficacy
- Severity of Illness Index
- Social Support
- Socioeconomic Factors
- Surveys and Questionnaires
- United States
- Veterans
Older minority immigrant groups in the United States may be at increased risk for traumatic stress in an age of terrorism and of civil and political unrest. This exploratory study investigated how older Hispanic immigrants in New York City coped in response to current traumatic stressors, and whether they differed from a comparison group of older US-born non-Hispanics. We administered the Impact of Events Scale-Revised (IES-R) and the Brief COPE instruments to 24 older Hispanic immigrants and 15 older non-Hispanics, born in the United States, at 2 senior centers. Hispanic immigrants showed greater symptomatic response to current stressors as measured by significantly higher scores on the hyperarousal and avoidance subscales of the IES-R. Both groups used passive coping strategies. Older Hispanic immigrants may be at increased risk for negative psychological consequences caused by a current stressor. Practitioners should encourage older Hispanic immigrants to use active coping strategies to deal with those stressors.
MeSH Terms
- Adaptation, Psychological
- Aged
- Emigrants and Immigrants
- Female
- Geriatrics
- Hispanic Americans
- Humans
- Life Change Events
- Male
- New York City
- Social Work
- Socioeconomic Factors
- Stress Disorders, Post-Traumatic
Previous studies have shown that taking care of elderly, demented patients carries a high cost to caregivers' health, and is associated with negative consequences for physical and mental health. The aim of this study is to investigate which socio-demographic and clinical variables are significantly associated with higher levels of distress in caregivers, and the relationship between caregivers' levels of distress and the coping strategies they adopt. The study samples 112 caregivers of demented patients, consecutively admitted to the Department of Neurology of San Raffaele-Turro Hospital (Milan, Italy). Caregivers were asked to complete the CBI and the COPE. Caregivers with the highest levels of distress are characterised by an impaired physical health status. Avoidance coping may represent a risk factor associated with higher levels of distress; conversely, an active and problem-focused approach to stressful situations may act as a protective factor.
MeSH Terms
- Adaptation, Psychological
- Adult
- Aged
- Aged, 80 and over
- Aging
- Caregivers
- Cost of Illness
- Cross-Sectional Studies
- Data Collection
- Dementia
- Female
- Health Status
- Humans
- Male
- Middle Aged
- Neuropsychological Tests
- Prevalence
- Risk Factors
- Sex Distribution
- Socioeconomic Factors
- Stress, Psychological
- Surveys and Questionnaires
This study examines rural-urban differences in informal caregivers' perceptions of caregiving. The study's theoretical framework is based on the two-factor model of caregiving, which views caregiving as having both positive and negative impact. Data were collected in personal interviews with 126 rural and 127 urban caregivers in the Bialystok region. The COPE-Index was used to assess caregivers. Rural caregivers reported a greater negative impact of caregiving than their urban counterparts, controlling for caregiver socio-demographic characteristics and care-recipient disability level. There was no difference in caregivers' perceptions of positive aspects of caregiving. These findings are consistent with previous research, which suggests that rural caregivers experience greater caregiver burden. Better understanding of rural-urban differences in caregiving outcomes can be useful in designing supportive services for informal caregivers in Poland.
MeSH Terms
- Caregivers
- Delivery of Health Care
- Female
- Geriatrics
- Humans
- Interviews as Topic
- Male
- Middle Aged
- Models, Theoretical
- Personal Satisfaction
- Poland
- Professional-Patient Relations
- Rural Health
- Rural Health Services
- Urban Health
- Urban Health Services