Digital Commons Network^™

Genetic Vulnerability To Diabetes And Obesity: Does Education Offset The Risk?, Sze Yan Liu, Stefan Walter, Jessica Daniel, David H. Rehkopf, Laura E. Kubzansky, M Maria Glymour

Sze Yan Liu

The prevalence of type 2 diabetes (T2D) and obesity has recently increased dramatically. These common diseases are likely to arise from the interaction of multiple genetic, socio-demographic and environmental risk factors. While previous research has found genetic risk and education to be strong predictors of these diseases, few studies to date have examined their joint effects. This study investigates whether education modifies the association between genetic background and risk for type 2 diabetes (T2D) and obesity. Using data from non-Hispanic Whites in the Health and Retirement Study (HRS, n = 8398), we tested whether education modifies genetic risk for obesity …

Risk Factors For Falls In Homebound Community-Dwelling Older Adults, Yunchuan (Lucy) Zhao, Jenny Alderden, Bonnie Lind, Jennifer Stibrany

Nursing Faculty Publications and Presentations

Objective: To examine risk factors associated with falls among homebound community-dwelling older adults, a vulnerable population often possessing functional disabilities and chronic conditions.

Design and Sample: The study was a cross-sectional study utilizing round 6 data of the National Health and Aging Trend Study (NHATS). Descriptive statistics and multiple logistic regression analyses were conducted. A total of 1,356 homebound community-dwelling older adults aged 65 and above participated in the NHATS.

Measures: The outcome variable was falls within the last month reported in NHATS. Independent variables were selected based on the NHATS disability conceptual model and literature review, including personal conditions, …

Using Participant Observation To Enable Critical Understandings Of Disability In Later Life: An Illustration Conducted With Older Adults With Low Vision, Colleen E. Mcgrath

Occupational Therapy Publications

Research with older adults aging with vision loss has typically been informed by a biomedical theoretical framework. With a growing focus, however, on critical disability perspectives, which locates disability within the environment, new methods of data collection, such as participant observation, are needed. This article, which reports on the findings from a critical ethnographic study conducted with older adults with age-related vision loss (ARVL), aims to share those insights gained through participant observation and to demonstrate the utility of this method. Three insights were gained including the adaptive strategies tacitly employed to navigate the physical environment, a grounded understanding of …

Electrocardiographic Findings During Standard Hands Only Cpr And Hands Only Cpr Plus Pedal Cpr In Senior Rescuers, Laura Melany Yassa

Master's Theses

The standard first aid for a heart attack resulting in cardiopulmonary arrest is effective cardiopulmonary resuscitation (CPR). Chest compressions are most commonly performed on a flat surface with the rescuer kneeling next to the victim with one hand on top of the other on the sternum and elbows straight. This technique of being on the ground may be challenging for those without the mobility and strength to get up and down from the ground. In 2005, the American Heart Association (AHA) Guidelines listed “pedal”, or heel, compression as an acceptable alternative to standard chest compressions (Trenkamp & Perez, 2015). That …

Semi-Recumbent Vibration Exercise In Older Adults: A Pilot Study Of Methodology, Feasibility, And Safety, Murad Taani, Ellen Siglinsky, Jessie Libber, Diane Krueger, Neil Binkley, Christine R. Kovach, Bjoern Buehring

Nursing Faculty Articles

Objectives: Older adults with impaired physical function are at risk for further functional decline in part due to limited ability to engage in regular exercise. Effective approaches to exercise in this vulnerable population are needed to improve functional capacity and optimize independence.

Methods: Thirty-two residential care apartment complex (RCAC) residents, age ≥70, with low short physical performance battery (SPPB) scores were recruited and randomly assigned to a crossover-design study exploring feasibility and safety of semi-recumbent vibration exercise in older adults living in one RCAC. The primary outcomes were retention and adherence rates and adverse events.

Results: The retention rate was …

Age-Related Smell Changes And Their Effects On The Health Status Of Older Americans, Emily Duran Frontera

Electronic Theses and Dissertations

Olfactory impairment is a prevalent but underreported condition among older adults in the United States (U.S.). In the elderly, this impairment is associated with a host of adverse health conditions and issues that affect the quality of life. This study investigated the prevalence of smell disorders in older adults over 60 years of age, the potential risk factors for smell deterioration, and the influence of smell dysfunction on health status using the data collected through the National Health and Nutrition Examination Survey (NHANES) 2013-2014 questionnaires and examination components.

Participants were categorized as smell impaired (‘SI Present’) if they were unable …

Older Adult Hospital Readmission Outcomes Of Transitional Care Model Compared With Home Based Primary Care Practice, Kellie L. Kahveci

Nursing Dissertations

Background: Thirty-day hospital readmission is a significant quality of care and economic problem for adults aged 65 years and older in the United States. The diagnoses most commonly problematic include heart failure (HF), pneumonia (PNE), and chronic obstructive pulmonary disease (COPD). Review of Literature: Multiple factors have been found to influence thirty-day hospital readmissions. Patient specific contributing factors include: depression, cognitive function, level of functional mobility, socioeconomic forces, and race. Exogenous factors include: patient education, pharmacologic agents, and health care providers quality of care. Interventions most effective in decreasing thirty-day hospital readmission include utilization of a team approach and a …

Resedent Study- Reducing Sedentary Behaviour May Slow Cognitive Decline In Older Adults With Mild Cognitive Impairment: A Pilot Study, Kirsten B. Dillon

Electronic Thesis and Dissertation Repository

Physical activity (PA) has been shown to slow down dementia. Unfortunately, older adults spend most of their day in sedentary behaviours (SB). Breaking up prolonged bouts of sitting with intermittent bouts of light intensity PA may reduce glycemic variability in the brain; potentially mitigating cognitive decline. This study investigated how interrupting SB with 10 min bouts of light intensity PA 3x a day would affect mild to moderate cognitive impairment progression (primary outcome) in older adults residing in an assisted living facility. Participants (n=25) were assigned in clusters into a two arm 10-week single site pilot randomized controlled trial. Secondary …

Mostly White, Christian, And Straight: Informational And Institutional Erasure Of Lgbtq And Ethnoculturally Diverse Older Adults On Long-Term Care Homes Websites, Ferzana Chaze, Sulaimon Giwa, Nellie Groenenberg, Bianca Burns

Publications and Scholarship

The website of a long-term care home is the face of the organization, providing not only a snapshot view of the home’s programs and services, but also an insight into the organization’s vision, mission, policies, and culture. The website provides information—either purposefully or inadvertently—about the manner in which the organization responds to diversity among its residents. Guided by an intersectional analysis, this study uses content analysis to examine websites of long-term care homes run by companies, municipalities, and not-for-profit organizations in two provinces in Canada to understand how these websites demonstrate inclusion towards ethnoculturally diverse and LGBTQ older adults. Findings …

Testing An Implementation Strategy Bundle On Adoption And Sustainability Of Evidence To Optimize Physical Function In Community-Dwelling Disabled And Older Adults In A Medicaid Waiver: A Multi-Site Pragmatic Hybrid Type Iii Protocol, Sandra L. Spoelstra, Monica Schueller, Alla Sikorskii

Funded Articles

Background: In partnership with a state Medicaid home and community-based waiver program, this study tests implementation strategies for adoption and sustainability of an evidence-based intervention to support disabled and older adults who have difficulty with physical function and daily living tasks. A multi-level implementation strategy bundle will be directed at relationship, coalition, and team building; readiness to implement, leadership, and clinician attitude toward evidence assessments; intervention and facilitation training; interdisciplinary coordination; facilitation; and audit and feedback to support practice change.

Methods: Knowledge-to-Action model underpins this 2-arm, 3-year pragmatic mixed method randomized hybrid type III trial in 18 waiver program sites …

Healthy Aging In The Community Initiative, Didem Kadriye Unver

Master's Projects and Capstones

In 2016 the Sequoia Health Care partnering with Peninsula Family Services developed a non-profit and free program called 70 Strong. It is a personal resource guide for the 60 and above client base for activities and services from Redwood City to Foster City to encourage independence amongst the older population. It includes a wide array of categories, such as fitness and social activities, volunteer opportunities, transportation, enrichment, and support groups. This is not an acute healthcare provider; however, it is a primary prevention effort by Sequoia Healthcare District to increase wellness among the older population in the county. The purpose …

Older Adults’ Implementation Of Discharge Instructions Following An Acute Care Hospital Stay, Brenda Miller

Dissertations

Discharge instructions are a self-care guide for patients after discharge from an acute care hospitalization. The discharge process starts on admission to the hospital and continues until discharged. Many patients rely on informal caregivers to provide support after a discharge. However, it is often unclear whether the patients or caregivers completely understand instructions provided during the discharge process. Key concepts related to how discharge instructions were implemented following discharge to home have been understudied from the patient’s and informal caregivers’ perspectives. Developing effective discharge instructions based on study findings may assist in reducing 30-day hospital readmission rates.
This study was …

The Impact Of Fall Efficacy On Occupational Performance In Community-Dwelling Older Adults, Michelle Fong, Araya Moua, Erin Denola, Merit Franklin

Occupational Therapy | Graduate Capstone Projects

Falls are a major health concern in the older adult (OA) population. While there is research on falls and their prevention, research on how low fall efficacy (FE) impacts the occupational engagement of the OA population is limited. FE is defined as the confidence a person has in his/her ability to complete a task without falling (Tinetti & Powell, 1993). A qualitative study was conducted using a phenomenological approach to explore the lived experiences of OAs with low FE and the impact on occupational performance. Participants who scored ≤ 6 on the Modified Fall Efficacy Scale (MFES) engaged in a …

Testing A Musical Game Activity For Community-Dwelling Older Adults, Jordan Riggins, Susan Mclennon Phd Arnp

Chancellor’s Honors Program Projects

No abstract provided.

Looking For Age Differences In Self-Driving Vehicles: Examining The Effects Of Automation Reliability, Driving Risk, And Physical Impairment On Trust, Ericka Rovira, Anne Collins Mclaughlin, Richard Pak, Luke High

Publications

Purpose

Self-driving cars are an extremely high level of autonomous technology and represent a promising technology that may help older adults safely maintain independence. However, human behavior with automation is complex and not straightforward (Parasuraman and Riley, 1997; Parasuraman, 2000; Rovira et al., 2007; Parasuraman and Wickens, 2008; Parasuraman and Manzey, 2010; Parasuraman et al., 2012). In addition, because no fully self-driving vehicles are yet available to the public, most research has been limited to subjective survey-based assessments that depend on the respondents’ limited knowledge based on second-hand reports and do not reflect …

A Protocol Paper On The Preservation Of Identity: Understanding The Technology Adoption Patterns Of Older Adults With Age-Related Vision Loss (Arvl), Colleen E. Mcgrath

Occupational Therapy Publications

There are a growing number of older adults with age-related vision loss (ARVL) for whom technology holds promise in supporting their engagement in daily activities. Despite the growing presence of technologies intended to support older adults with ARVL, there remains high rates of abandonment. This phenomenon of technology abandonment may be partly explained by the concept of self-image, meaning that older adults with ARVL avoid the use of particular technologies due to an underlying fear that use of such technologies may mark them as objects of pity, ridicule, and/or stigmatization. In response to this, the proposed study aims to understand …

Observation And Self-Report Of Fun And Social Engagement Of Nursing Home Residents During Bingocize®, Lauren Rene Stevens

Masters Theses & Specialist Projects

Individuals in certified nursing facilities (CNF) often experience social isolation and have limited opportunities to exercise. Bingocize®, an evidence-based healthpromotion program, is a combination of exercise and Bingo and provides opportunities for CNF resident interaction. Limited tools are available to quantify social engagement displayed by nursing home residents. Research suggests that intergenerational programming can positively affect social engagement. The present pilot study focused on the implementation of the Fun and Social Engagement (FUSE) evaluation to measure social engagement displayed by nursing home residents during Bingocize® sessions. The FUSE combined observation and self-report measures to yield a total social engagement score. …

Association Between Perceived Physical Activity And Cognitive Function In Older Adults, Paul D. Loprinzi, Emily Frith

Faculty and Student Publications

© The Author(s) 2018. There is irrefutable evidence that regular participation in physical activity is favorably associated with numerous positive health outcomes, including cognitive function. Emerging work suggests that perceived physical activity, independent of actual physical activity behavior, is inversely associated with mortality risk. In this study, we evaluate whether perceived physical activity, independent of actual physical activity, is associated with cognitive function, a robust indicator of mortality risk. Data from the cross-sectional 1999–2002 National Health and Nutrition Examination Survey were employed (N = 2352; 60+ years of age). Actual physical activity was assessed via a validated survey. Perceived physical …

Emergency Medicine Palliative Care Access (Empalla): Protocol For A Multicentre Randomised Controlled Trial Comparing The Effectiveness Of Specialty Outpatient Versus Nurse-Led Telephonic Palliative Care Of Older Adults With Advanced Illness, Corita R. Grudzen, Deborah J. Shim, Abigail M. Schmucker, Jeanne Cho, Keith S. Goldfeld

Student Papers, Posters & Projects

Introduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.

Methods and analysis This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of …

Effects Of Generic Group-Based Versus Personalized Individual-Based Exercise Programs On Balance, Gait, And Functional Performance Of Older Adults With Mild Balance Dysfunction And Living In Residential Care Facilities - A Randomized Controlled Trial, Varatharajan Lingam

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background and Purpose: To investigate the effect of an individualized exercise program versus a generic group-based exercise program on balance, gait, and functional performance of older adults categorized as having mild balance dysfunction and living in residential care facilities. Methods: Single blind randomized control design. One hundred-twenty residents fulfilled screening criteria for mild balance dysfunction based on the BioSwayTM balance and the Multi-Directional Reach Test (MDRT) primary outcome measures. Secondary assessment was completed using the Modified Physical Performance Test (PPT), hand-held dynamometer (lower-limb muscle strength testing), and gait speed analysis. Sixty subjects received individualized treatment from physical therapists (8 weeks). …

Understanding The Utilization Of Community-Based Services In Late Old Age: A Participatory Approach For Connecting Through The Communication Ecology, Carrie Leach

Wayne State University Dissertations

As the pool of eligible recipients continues to grow, understanding service system utilization and barriers can help ensure very old adults can access support from their communities when needed. Mounting research demonstrates that investment in community-based services to ensure seniors remain independent translates to saved government dollars. As a contributing researcher of a multi-year county-wide older adult needs assessment in Monroe County, Michigan, data collected from 1,870 people revealed a communication disjuncture between seniors and service providers. In response, officials convened a post assessment working group that focused on communication and outreach. Along with members of the Community Advisory Group …

Older Adult Spouses’ Emotional Responses To Reminiscing About Their First Encounter: Associations With Mental Health, Marital Satisfaction, And Cardiovascular Reactivity, Hanzhen Lan

Public Health Theses

Objectives: While there has been growing interest in how close relationships affect older adults’ health, not much research has examined how emotional experiences in older married couples’ positive interactions relate to individual and relational well-being and physical health. The present study hypothesizes that positive emotional responses to older couples reminiscing about first encounter are associated with each spouse’s higher marital satisfaction, fewer depressive symptoms, and healthier cardiovascular reactivity (blood pressure and heart rate variability).

Method: One hundred and one couples completed a background questionnaire at home and then participated in a laboratory session in which they discussed how they first …

National And Local Antibiotic Prescribing Trends And Prescribing Appropriateness In Older Adults, Fawaz M. Alotaibi

Theses and Dissertations

Background: Antibiotic overuse/misuse has been documented in several reports to increase the risk of Clostridioides difficile (C.diff) infection and antibiotic resistance. The older adult population is more prone to use antibiotic medications than any other age group due to decreased immune function, use of urinary catheters, ventilation during hospitalization and other factors. Antibiotic resistance and C.diff are major public health problems. However, studies examining the trends of antibiotic use and the association between the antibiotic use and negative health outcomes among older adults in the outpatient and emergency department settings are limited.

Objectives: The main objectives of this …

Unmet Support Needs Of Informal Caregivers Of Older Adults, Julie Ann Smith Hinders

Walden Dissertations and Doctoral Studies

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival …

Fear Of Falling Assessment And Interventions In Community-Dwelling Older Adults: A Mixed Methods Case Study, Amanda S. Cappleman

Honors Undergraduate Theses

Background: Fear of falling has significant adverse physical and psychological effects for the community-dwelling older adult. Objective: The purpose of this study was to assess fear of falling in community-dwelling older adults and explore participant perceptions of fear of falling assessments and interventions. Methods: A mixed methods case study was utilized to gain an in-depth understanding of older adults' perceptions. It consisted of quantitative data collection by objective measures and qualitative data collection by four individual in-depth interviews. A sample of four community-dwelling adults aged 65 years and older and living in Orlando, Florida, completed the study in their home …

Validity Of The Falls Risk For Older People In The Community (Frop‑Com) Tool To Predict Falls And Fall Injuries For Older People Presenting To The Emergency Department After Falling, Marlon Mascarenhas, Keith D. Hill, Anna Barker, Elissa Burton

Health Sciences Papers and Journal Articles

The aims of this study were to (1) externally validate the accuracy of the Falls Risk for Older People in the Community (FROP-Com) falls risk assessment tool in predicting falls and (2) undertake initial validation of the accuracy of the FROPCom to predict injurious falls (requiring medical attention) in people aged ≥ 60 years presenting to emergency departments (EDs) after falling. Two hundred and thirteen participants (mean age = 72.4 years; 59.2% women) were recruited (control group of a randomised controlled trial). A FROP-Com assessment was completed at a home visit within 2 weeks of ED discharge. Data on falls …

Health Outcomes For Low-Income Older Adults With Diabetes Who Receive Services From Meals On Wheels, Monyca Johnson

Senior Honors Theses and Projects

INTRODUCTION: As the population continues to age and healthcare costs steadily increase, identifying what factors possibly add to the risk of hospitalization will help find effective solutions targeting these issues. HYPOTHESIS: We hypothesized that Medicaid and Medicare dual eligibility, membership in a racial minority, and female gender would increase the risk of hospitalizations in the past year. We further hypothesized that receipt of food assistance would decrease the risk of hospitalization for older adults with diabetes. METHODS: For this study, we conducted a secondary analysis of data from the National Health and Aging Trends Study (NHA TS) to test the …

Implicit Attitudes Of Asian American Older Adults Toward Aging, Anita Ho

Scripps Senior Theses

Greenwald, McGhee, and Schwartz (1998) developed the Implicit Association Test (IAT), a measure of mental associations between target pairs and positive or negative attributes. Highly associative categories yield faster responses than the reverse mental associations, which is thought to reflect implicit attitudes toward stereotypes. The present study investigated the effect of ethnic group on one’s implicit attitudes toward aging and gender stereotypes by comparing two groups of older adults, Asian Americans and Caucasian Americans, that likely hold different culture values. Past qualitative studies have established the existence of mental health stigma in Asian American populations, including negative Asian American perceptions …

Attitudes And Factors Involved In Decision-Making Around Complementary And Alternative Medicines (Cams) By Older Australians: A Qualitative Study, Gisselle Gallego, Saira Gugnani, Mike Armour, Caroline A. Smith, Esther Chang

Medical Papers and Journal Articles

Introduction: Recent evidence has indicated that older Australians are increasingly turning to complementary and alternative medicines (CAMs) to address a variety of health issues. This qualitative study aimed to explore the attitudes and factors involved in decision-making around CAMs by older Australians upon the completion of a CAM educational intervention.

Methods: Men and women aged over 65 years living in New South Wales, Australia were invited to participate in semi-structured interviews after taking part in a randomised control trial. Interviews were analysed using the framework approach.

Results: A total of 20 participants aged over 65 years were interviewed. Themes captured …

The Role Of Neck Musculature In Traumatic Brain Injuries In Older Adults: Implications From Sports Medicine, Tyler A. Wood, Steven Morrison, Jacob J. Sosnoff

Rehabilitation Sciences Faculty Publications

Traumatic brain injuries (TBIs) are common and serious injuries to older adults. The majority of TBIs in older adults are sustained when the head impacts the ground or other surface during a fall. While several non-modifiable risk factors have been identified for fall-related TBIs in older adults, there still remains a dearth of knowledge surrounding modifiable risk factors. Thus, this significant knowledge gap warrants an investigation into research across disciplines. The sports medicine literature has examined several modifiable risk factors to prevent a mild form of TBI known as concussion. While this research has identified several risk factors, one particular …