B - 32 Grief in Neuropsychological Assessment among Culturally Diverse Middle-Old Older Adults.
Academic Article
Overview
abstract
OBJECTIVE: Bereavement, exacerbated by losses stemming from the COVID-19 pandemic, contributes to high rates of grief and associated mood disturbances among older adults, potentially impacting neurocognition. Middle-old cohorts (ages 75-84) are particularly vulnerable, due to elevated levels of baseline depression, complicated grief, and perceived lower quality of life. The contributory role of grief and culturally-relevant manifestations of bereavement should be carefully considered as potential confounds or performance contributors. METHOD: Four cases seen for neuropsychological assessment in the Department of Neurological Surgery: A 75-year-old bilingual (Russian, English) patient with a meningioma who noticed cognitive changes following spouse's death from COVID-19; A 77-year-old monolingual (English) patient with Parkinson's disease undergoing a pre-surgical work-up prior to Deep Brain Stimulator insertion. Mood reportedly worsened sharply since spouse's recent death; An 81-year-old monolingual (Cantonese) patient undergoing a pre-surgical work-up prior to DBS insertion. Shared grieving the recent death of younger sibling from COVID-19; An 84-year-old, monolingual (English) patient who was evaluated due to longstanding cognitive challenges in the context of cerebrovascular disease (monitored by Neurological Surgery). Cognitive deficits reportedly precipitously worsened following spouse's death. RESULTS: While levels of neurocognitive and adaptive dysfunction varied, mood disturbance and affective distress likely reduced engagement in the testing process. Reluctance to disclose depressive and anxious symptomatology on questionnaires as a function of culture was noted. Thorough, culturally-sensitive, clinical interviewing and metrics are needed to elicit nuanced information. CONCLUSIONS: Grief and associated mood disturbances are to be prioritized and carefully considered in the evaluation and treatment plan with middle-old older adults.
