Medicine and Health Sciences Commons^™

Goals Of Family Caregivers Of Persons With Dementia Across The Caregiving Career, Shalane R. Basque

Electronic Thesis and Dissertation Repository

Understanding goals of family caregivers of persons with dementia is critical to provide effective education and support. However, there is little understanding about family caregivers’ goals. This study investigated goals set by family caregivers prior to an education and training program and whether their goals varied across the caregiving career. Phases of the caregiving career were measured by relationship identity; the extent to which participants viewed their relationship in terms of familial and caregiver roles. Conventional content analysis on goals of 30 family caregivers yielded five categories which varied by relationship identity. Enhancing relationships reflected goals for the familial role …

Improving Transitions In Care For People With Dementia: The Cared Tool, Yuwen Deng, Jamie Bisset, Silk Lim, Maryssa Edwards

Community Engaged Learning Final Projects

Transitions in Care are challenging for people with dementia due to impairments in communication and disorientation from being in a foreign environment. Transitions in care have lead to incidents of unnecessary physical and chemical restraints of this vulnerable population. To investigate how to optimize care transitions, qualitative descriptive information was collected through three personal interviews to gain a broader understanding of mechanisms of care transitions in London, ON. After conducting interviews and literature review, the CARED Tool was developed. The CARED Tool promotes social inclusion of patients with dementia through recognizing that people with dementia have complex needs, thereby allowing …

Endocytic Trafficking Of The Amyloid Precursor Protein In Rat Cortical Neurons, Sahily Reyes

Dissertations & Theses (Open Access)

Amyloid-beta (Aβ) aggregation and deposition into extracellular plaques is a hallmark of the most common forms of dementia, including Alzheimer’s disease. The Aβ-containing plaques result from pathogenic cleavage of amyloid precursor protein (APP) by secretases resulting in intracellular production of Aβ peptides that are secreted and accumulate extracellularly. Despite considerable progress towards understanding APP processing and Aβ aggregation, the mechanisms underlying endosomal production of Aβ peptides and their secretion remain unclear. Using endosomes isolated from cultured primary neurons, we determined that the trafficking of APP from the endosomal membrane into internal vesicles of late endosome/multivesicular bodies (MVB) is dependent on …

The Correlation Of Size Of Core Network And Frequency Of Contacts With Agitation And Positive Affect In Elderly With Dementia, Amal Ali Al Ghassani

Theses and Dissertations

In the country of Oman, care needs of older adults are primarily provided by family members in the home. The study was guided by socioemotional selectivity theory, the environmental vulnerability hypothesis, and the need-driven dementia-compromised behavior theories. The central premise was that the size of the person’s activities of daily living (ADL) core network and frequency of contact with the ADL core network would predict agitation and affect. A smaller core network with a higher frequency of contact may be better at identifying and treating the person’s unmet needs. A secondary premise was that the emotional closeness of the core …

Does Music Therapy Intervention Have An Effect On The Emotional Behavior Of Alzheimer Patients?, Alexandra P. Lahurd

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy intervention have an effect on emotional behavior of Alzheimer patients. Behavior variables measuring are agitation and anxiety.

STUDY DESIGN: Systematic review of two randomized, controlled trials published in 2009 and 2014, respectively, and one randomized control case study published in 2006.

DATA SOURCE: Three published studies comparing music therapy intervention on behavioral modifications with Alzheimer patients were found using PubMed and Medline

OUTCOMES MEASURES: All three studies measure behavior in Alzheimer patients based on a variety of well validated …

Dementia Survey Among Attendees Of A Dementia Awareness Event In Karachi, Pakistan, Qurat Ul Ain Khan, Yusra Hanif Khan, Mohammad Zaman Khan, Shireen Najam

Pakistan Journal of Neurological Sciences (PJNS)

There is little information available about peoples'knowledgeregarding symptoms of dementia, dementia diagnosis, and care arrangementsfor dementia patients in Pakistan. Aims: We aimed to find out if patients with dementia and their caregivers were aware of diagnosis, the most common and most distressing symptoms, and care arrangement for these patients.

Cognitive Trajectory Changes Over 20 Years Before Dementia Diagnosis: A Large Cohort Study., Ge Li, Eric B Larson, Jane B Shofer, Paul K Crane, Laura E Gibbons, Wayne Mccormick, J D Bowen, Mary Lou Thompson

Articles, Abstracts, and Reports

BACKGROUND/OBJECTIVES: Longitudinal studies have shown an increase in cognitive decline many years before clinical diagnosis of dementia. We sought to estimate changes, relative to "normal" aging, in the trajectory of scores on a global cognitive function test-the Cognitive Abilities Screening Instrument (CASI).

DESIGN: A prospective cohort study.

SETTING: Community-dwelling members of a U.S. health maintenance organization.

PARTICIPANTS: Individuals aged 65 and older who had no dementia diagnosis at baseline and had at least two visits with valid CASI test score (N = 4,315).

MEASUREMENTS: Average longitudinal trajectories, including changes in trajectory before clinical diagnosis in those who would be diagnosed …

An Exploration Of Dementia Friendly Communities From The Perspective Of Persons Living With Dementia, Catherine Hebert

Electronic Theses and Dissertations

The growing global prevalence of dementia coupled with a shift in public perception from a hopeless disease to the possibility of living well with dementia has led to the formation of dementia friendly communities (DFC). DFCs are a new phenomenon in the United States, with a gap in knowledge on input from people living with dementia (PLWD). This study investigated DFCs from the perspective of PLWD in Western North Carolina, with the following research questions:

1. How are interactions and relationships experienced by persons living with dementia in the community?
2. How is community engagement experienced by PLWD?
3. To what extent and …

The Feasibility Of Square-Stepping Exercise As A Universal Intervention For Older Adults With Chronic Disease To Improve Cognitive And Physical Function, Erin M. Shellington

Electronic Thesis and Dissertation Repository

Square-stepping exercise (SSE) is a cognitive training program with a physical component. An instructor demonstrates a stepping pattern across a gridded mat and participants are required to memorize and repeat the patterns on their own. In community-dwelling older adults, SSE has demonstrated some benefits on global cognitive functioning (GCF), balance, functional fitness, and social interaction.

Aims: to investigate the feasibility and efficacy of SSE in varied populations and settings to improve mobility and cognition. Populations included older adults with: knee osteoarthritis (OA), type 2 diabetes mellitus (T2DM) and self-reported cognitive complaints (sCC), and those living in long-term care (LTC) …

Memory Care Residents And Indoor Ecotherapy, Robert C. Rados, Jun Kim

ASA Multidisciplinary Research Symposium

The positive benefits of this study support the use of “indoor ecotherapy” as an intervention, and as an alternative to use of medications, for resident residing in a memory care facility.

Evaluating The Effectiveness Of Abilities Care Approach™ Training, Michelle E. D'Amato, Sophie E. Miller, April Perez, Carmen Joaquin, Louiza Alexandria Villarina

Student Research Posters

Approximately 50% of US nursing home residents have a diagnosis of dementia. Abilities Care Approach® was created by occupational therapists (OTs) to promote quality dementia care for residents in skilled nursing facilities (SNFs). Certified nursing assistants (CNAs) are often the primary caregiver for residents with dementia. To ensure carryover of ACA principles, ACE dementia training was targeted towards CNAs. The purpose of this study was to evaluate Abilities Care Experts®(ACE) training program which provides CNAs with an occupation-based dementia care approach by focusing on the importance of occupational engagement and knowledge of dementia stages. Results indicated that ACE trained CNAs …

Cognitive And Neurobiological Degeneration Of The Mental Lexicon In Primary Progressive Aphasia, Jet M. J. Vonk

Dissertations, Theses, and Capstone Projects

The ease with which we use the thousands of words in our vocabulary stands in stark contrast to our difficulty establishing how they are organized in our mind and brain. The breakdown of language due to cortical atrophy in primary progressive aphasia (PPA) creates conditions to study this organization at a cognitive and neurobiological level in that the three variants of this disease, namely non-fluent, logopenic, and semantic PPA, each bear their own signature of language-specific decline and cortical atrophy. As the impaired regions in each variant are linked to different lexical and semantic attributes of words, lexical decision performance …

Reduction Of Cognitive Decline In Patients With Or At High Risk For Diabetes, Gladys E. Maestre

School of Medicine Publications and Presentations

Purpose of review—The incidence of Alzheimer’s disease and related disorders is expected to triple by 2050. People with type 2 diabetes and prediabetes have a higher risk of cognitive dysfunction, including Alzheimer’s disease and vascular dementia. Controversy remains about when and how to prevent and treat cognitive dysfunction in people with or at high risk of diabetes.

Recent findings—In our review of ongoing clinical trials, we have found that there has been an increase in the number of studies assessing the efficacy of pharmacological and non-pharmacological approaches to prevent or slow down cognitive impairment among people with or …

Challenges And Considerations Related To Studying Dementia In Blacks/African Americans, Eseosa T. Ighodaro, Peter T. Nelson, Walter A. Kukull, Frederick A. Schmitt, Erin L. Abner, Allison M. Caban-Holt, Shoshana H. Bardach, Derrick C. Hord, Crystal M. Glover, Gregory A. Jicha, Linda J. Van Eldik, Alexander X. Byrd, Anita Fernander

Neuroscience Faculty Publications

Blacks/African Americans have been reported to be ~2–4 times more likely to develop clinical Alzheimer’s disease (AD) compared to Whites. Unfortunately, study design challenges (e.g., recruitment bias), racism, mistrust of healthcare providers and biomedical researchers, confounders related to socioeconomic status, and other sources of bias are often ignored when interpreting differences in human subjects categorized by race. Failure to account for these factors can lead to misinterpretation of results, reification of race as biology, discrimination, and missed or delayed diagnoses. Here we provide a selected historical background, discuss challenges, present opportunities, and suggest considerations for studying health outcomes among racial/ethnic …

Prospective Studies Of Cardiovascular Risk Factors And Mild Cognitive Impairment, Kevin Sullivan

Electronic Theses and Dissertations

The association of cardiovascular risk factors including hypertension, diabetes, cholesterol, kidney function, and arterial stiffness with cognitive impairment in older adults is a well-studied phenomenon. However, there is considerably less evidence relating cardiovascular health specifically to a diagnosis of Mild Cognitive Impairment (MCI). As a precursor state of dementia, MCI is characterized by a decline in cognitive function from previous level, but not to the degree that activities of daily living are impaired. Not everyone who is diagnosed with MCI will eventually transition to dementia, but the transition rates are much higher compared to the general population (5-15% per year …

Alzheimer's Disease, Kirstin Fortune

Nursing Student Class Projects (Formerly MSN)

This presentation is an overview on Alzheimer's disease. Signs, symptoms, pathophysiology and pharmaceuticals are all incorporated in this poster. The United States is planning to address the possible crisis of Alzheimer's with many initiatives.

Speech Processing Approach For Diagnosing Dementia In An Early Stage, Roozbeh Sadeghian, J. David Schaffer, Stephen A. Zahorian

Faculty Works

The clinical diagnosis of Alzheimer’s disease and other dementias is very challenging, especially in the early stages. Our hypothesis is that any disease that affects particular brain regions involved in speech production and processing will also leave detectable finger prints in the speech. Computerized analysis of speech signals and computational linguistics have progressed to the point where an automatic speech analysis system is a promising approach for a low-cost non-invasive diagnostic tool for early detection of Alzheimer’s disease.

We present empirical evidence that strong discrimination between subjects with a diagnosis of probable Alzheimer’s versus matched normal controls can be achieved …

Association Of A Communication Training Program With Use Of Antipsychotics In Nursing Homes, Jennifer Tjia, Jacob N. Hunnicutt, Laurie Herndon, Carolyn R. Blanks, Kate L. Lapane, Susan Wehry

Jennifer Tjia

Importance: Off-label antipsychotic prescribing in nursing homes (NHs) is common and is associated with increased risk of mortality in older adults. Prior large-scale, controlled trials in the NH setting failed to show meaningful reductions in antipsychotic use.

Objective: To quantify the influence of a large-scale communication training program on NH antipsychotic use called OASIS.

Design, Setting, and Participants: This investigation was a quasi-experimental longitudinal study of NHs in Massachusetts enrolled in the OASIS intervention. Participants were residents living in NHs between March 1, 2011, and August 31, 2013. The data were analyzed from December 2015, to March 2016, and from …

Milder Alzheimer's Disease Pathology In Heart Failure And Atrial Fibrillation, Luciano A. Sposato, Estefania Ruiz Vargas, Patricia M. Riccio, Jon B. Toledo, John Q. Trojanowski, Walter A. Kukull, Lauren E. Cipriano, Antonia Nucera, Shawn N. Whitehead, Vladimir Hachinski

Anatomy and Cell Biology Publications

Introduction:Heart failure (HF) and atrial fibrillation (AF) have been associated with a higher risk of Alzheimer’s disease (AD). Whether HF and AF are related to AD by enhancing AD neuropathological changes is unknown.

Methods:We applied network analyses and multiple logistic regression models to assess the association between HF and AF with severity of AD neuropathology in patients from the National Alzheimer’s Coordinating Center database with primary neuropathological diagnosis of AD.

Results:We included 1593 patients, of whom 129 had HF and 250 had AF. HF and AF patients were older and had milder AD pathology. In the network …

Selection Of Memory Book Content: Agreement In Content As A Function Of Informant Relationship To Memory Book Recipient, Rebecca J. Allen

USF Tampa Graduate Theses and Dissertations

This study was designed to determine to what extent provision of personally relevant information and sensory cues would agree between Recipient and Informant for selection of memory book content. Six dyads married to each other an average of 29.17 years (SD = 10.03), between the ages of 43 and 70 years (Mean = 57; SD = 8.39), and cognitively competent (i.e., no diagnosis of cognitive impairment) participated. Participants completed questionnaires independently and provided personally relevant information/memories, aversions towards select memories/topics, and sensory cues on behalf of themselves (as “Recipient) and their spouse (as “Informant”). For provision of personally relevant information/memories, …

Calcineurin/Nfat Signaling In Activated Astrocytes Drives Network Hyperexcitability In AΒ-Bearing Mice, Pradoldej Sompol, Jennifer L. Furman, Melanie M. Pleiss, Susan D. Kraner, Irina A. Artiushin, Seth R. Batten, Jorge E. Quintero, Linda A. Simmerman, Tina L. Beckett, Mark A. Lovell, M. Paul Murphy, Greg A. Gerhardt, Christopher M. Norris

Sanders-Brown Center on Aging Faculty Publications

Hyperexcitable neuronal networks are mechanistically linked to the pathologic and clinical features of Alzheimer's disease (AD). Astrocytes are a primary defense against hyperexcitability, but their functional phenotype during AD is poorly understood. Here, we found that activated astrocytes in the 5xFAD mouse model were strongly associated with proteolysis of the protein phosphatase calcineurin (CN) and the elevated expression of the CN-dependent transcription factor nuclear factor of activated T cells 4 (NFAT4). Intrahippocampal injections of adeno-associated virus vectors containing the astrocyte-specific promoter Gfa2 and the NFAT inhibitory peptide VIVIT reduced signs of glutamate-mediated hyperexcitability in 5xFAD mice, measured in vivo with …

Activity Trackers: Are They The Answer, Connor Ogden, Neil Peterson

Journal of Undergraduate Research

Physical inactivity in young adults leads to a 40% greater chance of cancer mortality, 50% greater risk of dementia, 60% greater risk of stroke, type 2 diabetes, obesity, and a number of other health related issues1. In our country in which sedentary jobs have increased by 83% since 1950, and 69%2 of all adults are obese or overweight, these health related factors due to inactivity become a real concern. Many companies have created these activity trackers as a solution to solving physical inactivity. The purpose of this project was to evaluate what aspects of the Microsoft Band that young adults …

Transitional Care For Older Adults With Dementia: Variation Across Patients And Providers, Patricia Prusaczyk

Arts & Sciences Electronic Theses and Dissertations

Older adults with dementia are particularly vulnerable to negative outcomes and adverse events when they transition between healthcare settings such as being discharged from the hospital. However, little is known about how healthcare providers help patients prepare for a care transition – known as transitional care – among older adults with dementia. Therefore, this study sought to understand the transitional care currently delivered by hospital healthcare providers to older adults with dementia, how it compared to that received by older adults without dementia, and how it varied across different patient and provider characteristics. Guided by key provider/informant interviews and theory, …

De-Prescribing, A Solution To The Issue Of Polypharmacy, Megan R. Kampa

Nursing Capstones

No abstract provided.

Linking Key Factors Of Quality Dementia Care: Knowledge And Self-Efficacy, Sophie E. Miller

Honors Theses

Dementia-related changes in cognition, memory, and personality can have wide-ranging impacts on individuals, families, and healthcare systems (Plassman et al., 2007); including caregiver burnout, disruption of family life, and costly care requirements (Graneheim, Johansson, & Lindgren, 2014). Dementia has become a global issue; 46 million people worldwide have dementia and $600 billion are spent on dementia-related care every year (Farina al., 2016). Certified nursing assistants (CNAs) generally assume the majority of day-to-day care and are a vital component of providing quality, person-centered services to patients with dementia in residential care (Burke & Orlowski, 2015). The purpose of this study was …

Gait And Balance In Alzheimer's Disease: A Retrospective Analysis Across Varying Levels Of Cognitive Impairment, Diana Contreras, Jessica Heim, Jun Nelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: It was once thought that Alzheimer’s disease (AD) affected mostly cognition with minor motor impairment; however, it is becoming apparent that motor impairment may also be a prominent feature. Determining the extent of motor impairments throughout the continuum of cognitive impairment is critical in developing timely interventions for this population. Purpose/Hypothesis: The aim of this study was to gain a greater understanding of motor impairment in AD by exploring the relationships among gait, balance, and falls. Specifically, we explored the association of fall history to measures of cognition and performance-based balance measures in individuals with AD. We hypothesized that …

Buspirone For The Treatment Of Dementia With Behavioral Disturbance, Maria R. Santa Cruz, Priscilla Hidalgo, Meredith Lee, Cornelius Thomas, Suzanne Holroyd

Psychiatry

Behavioral disturbances are common but serious symptoms in patients with dementia. Currently there are no FDA approved drugs for this purpose. There have been case reports and small case series of the use of buspirone. In this retrospective study, we review 179 patients prescribed buspirone for treatment of behavioral disturbance in dementia to better characterize the efficacy and potential side effects. All patients prescribed buspirone for behavioral disturbance due to dementia from a geropsychiatric outreach program were reviewed. Data was collected and analyzed using SPSS. One hundred-seventy-nine patients met criteria for the study with a mean age of 83.8 + …

The Attentional Demands Of Ambulating With An Assistive Device In Older Adults With Alzheimer's Disease, Susan W. Hunter, M Montero-Odasso

Physical Therapy Publications

Ambulation with a mobility aid is a unique real-life situation of multi-tasking. These simultaneous motor tasks place increased demands on executive function in healthy young and older adults, but the demands have not been evaluated in people with Alzheimer's disease (AD). Mobility problems are common among adults with AD, leading to provision of a mobility aid to optimize independent activity. The study objectives were: (i) to determine the dual-task cost (DTC) associated with the use of a mobility aid in straight and complex path walking, and (ii) to evaluate the association between executive function and ambulation with a mobility aid …

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Georgia Southern Collaborates on Examination of Vigilance in Decision-Making among Dementia Family Caregivers

Exploring Memory Impairment In A Rural Community In Tanzania: Trends And Reflections, Amanda Barry

Student Symposium

The researchers traveled to Tanzania in January of 2017. For two weeks they traveled to various Masaai villages around the town of Arusha. Mini-mental status exams were administered to 46 individuals ranging in age from 40-101 years. For those participants whose scores reflected possible memory impairment, family members or close friends were then administered a semi-structured interview to develop a more comprehensive understanding of the individual's life and cognitive function. The data collection process was directly affected by cultural differences between the United States (where the materials were developed) and Tanzania (where the materials were applied). This effect, although it …