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Magnitude And Impact Of Multiple Chronic Conditions With Advancing Age In Older Adults Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Hoa L. Nguyen, Jerry H. Gurwitz, David D. McManus, Joel M. Gore, Sonal Singh, Jorge L. Yarzebski, Robert J. Goldberg 2018 University of Massachusetts Medical School

Magnitude And Impact Of Multiple Chronic Conditions With Advancing Age In Older Adults Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Hoa L. Nguyen, Jerry H. Gurwitz, David D. Mcmanus, Joel M. Gore, Sonal Singh, Jorge L. Yarzebski, Robert J. Goldberg

Open Access Articles

BACKGROUND: To examine age-specific differences in the frequency and impact of cardiac and non-cardiac conditions among patients aged 65years and older hospitalized with acute myocardial infarction (AMI).

METHODS: Study population consisted of 3863 adults hospitalized with AMI at 11 medical centers in central Massachusetts on a biennial basis between 2001 and 2011. The presence of 11 chronic conditions (five cardiac and six non-cardiac) was based on the review of hospital medical records.

RESULTS: Participants' median age was 79years, 49% were men, and had an average of three chronic conditions (average of cardiac conditions: 2.6 and average of non-cardiac conditions ...


The Impact Of The Bundled Hospital Elder Life Program© (Help And Help At Home) On 30-Day Hospital Readmission, Michelle Simpson, Rebecca Weeks, Amy Driscoll, Jonny A. Macias Tejada, Maharaj Singh, Michael L. Malone 2018 Aurora Health Care

The Impact Of The Bundled Hospital Elder Life Program© (Help And Help At Home) On 30-Day Hospital Readmission, Michelle Simpson, Rebecca Weeks, Amy Driscoll, Jonny A. Macias Tejada, Maharaj Singh, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Background: Prevention and early identification of vulnerable older adults’ risk for delirium and functional decline is critical to improving quality of care across the continuum. To our knowledge there are no known studies that examine the impact of a model of care that spans across health care settings (inpatient to skilled home care) on unplanned 30-day readmissions.

Purpose: To examine the impact of the adapted model of care (Bundled HELP) on 30-day unplanned hospital readmission among patients 65 and older who received inpatient hospital care and skilled home care in two rural hospitals and home care in Wisconsin.

Methods: A ...


Hospital Elder Life Program: A Retrospective Quality Improvement Project Of A Delirium Prevention Program, Jonny A. Macias Tejada, Marianne Klumph, Regina Manansala, Jessica J.F. Kram, Candice R. LeGros, Ariba Khan 2018 Aurora St. Luke's Medical Center

Hospital Elder Life Program: A Retrospective Quality Improvement Project Of A Delirium Prevention Program, Jonny A. Macias Tejada, Marianne Klumph, Regina Manansala, Jessica J.F. Kram, Candice R. Legros, Ariba Khan

Journal of Patient-Centered Research and Reviews

Background: Delirium is an acute change in mental status commonly seen in hospitalized older adults. Although the occurrence of delirium is serious and is associated with adverse outcomes, patients with delirium may be prescribed antipsychotics/benzodiazepines, which may lead to potential side effects and other complications. The Hospital Elder Life Program (HELP) is a national evidence-based program designed to prevent delirium and functional decline. Research demonstrates that HELP decreases the onset and/or length of delirium episodes, functional decline in hospitalized older adults, and readmission rates, promotes nonpharmacological interventions, and is a cost-effective method for improving outcomes.

Purpose: To evaluate ...


Conference Proceedings: Aurora Scientific Day 2018, 2018 Aurora Health Care

Conference Proceedings: Aurora Scientific Day 2018

Journal of Patient-Centered Research and Reviews

This journal supplement includes selected abstracts from among the more than 50 presented at the 44th annual Aurora Scientific Day research symposium. Held May 25, 2018, in Milwaukee, Wisconsin, Aurora Scientific Day provides a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system with hospitals and clinics in Wisconsin and Illinois.


Using Virtual Reality In Medical Education To Teach Empathy, Elizabeth Dyer, Barbara Swartzlander, Marilyn R. Gugliucci 2018 University of New England

Using Virtual Reality In Medical Education To Teach Empathy, Elizabeth Dyer, Barbara Swartzlander, Marilyn R. Gugliucci

Library Services Faculty Publications

Objective: The project adopted technology that teaches medical and other health professions students to be empathetic with older adults, through virtual reality (VR) software that allows them to simulate being a patient with age-related diseases, and to familiarize medical students with information resources related to the health of older adults.

Methods: The project uses an application that creates immersive VR experiences for training of the workforce for aging services. Users experience age-related conditions such as macular degeneration and high-frequency hearing loss from the patient’s perspective. Librarians and faculty partner to integrate the experience into the curriculum, and students go ...


Intergenerational Adult Day Services Needs Assessment Project Final Report, University of Maine School of Social Work, Eastern Area Agency on Aging, University of Maine Center on Aging 2018 The University of Maine

Intergenerational Adult Day Services Needs Assessment Project Final Report, University Of Maine School Of Social Work, Eastern Area Agency On Aging, University Of Maine Center On Aging

Maine Center on Aging Research and Evaluation

Focus group research conducted in the Greater Bangor, Maine area in 2016 identified respite services and intergenerational programming as important factors for supporting a more livable community.

This report outlines findings from a 2018 needs assessment of adult day services (ADS), funded by Maine Health Access Foundation. The needs assessment utilized a survey of local caregivers (N=84) and key informant interviews (N=10) with staff at Maine adult day service programs or service providers that could utilize adult day services for their clients.

Key survey findings indicate that lack of financial resources (identified by 20% of the survey sample ...


Humanin Prevents Age-Related Cognitive Decline In Mice And Is Associated With Improved Cognitive Age In Humans., Kelvin Yen, Junxiang Wan, Hemal H Mehta, Brendan Miller, Amy Christensen, Morgan E Levine, Matthew P Salomon, Sebastian Brandhorst, Jialin Xiao, Su-Jeong Kim, Gerardo Navarrete, Daniel Campo, G Jean Harry, Valter Longo, Christian J Pike, Wendy J Mack, Howard N Hodis, Eileen M Crimmins, Pinchas Cohen 2018 Department of Translational Molecular Medicine, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA

Humanin Prevents Age-Related Cognitive Decline In Mice And Is Associated With Improved Cognitive Age In Humans., Kelvin Yen, Junxiang Wan, Hemal H Mehta, Brendan Miller, Amy Christensen, Morgan E Levine, Matthew P Salomon, Sebastian Brandhorst, Jialin Xiao, Su-Jeong Kim, Gerardo Navarrete, Daniel Campo, G Jean Harry, Valter Longo, Christian J Pike, Wendy J Mack, Howard N Hodis, Eileen M Crimmins, Pinchas Cohen

Journal Articles and Abstracts

Advanced age is associated with a decline in cognitive function, likely caused by a combination of modifiable and non-modifiable factors such as genetics and lifestyle choices. Mounting evidence suggests that humanin and other mitochondrial derived peptides play a role in several age-related conditions including neurodegenerative disease. Here we demonstrate that humanin administration has neuroprotective effects in vitro in human cell culture models and is sufficient to improve cognition in vivo in aged mice. Furthermore, in a human cohort, using mitochondrial GWAS, we identified a specific SNP (rs2854128) in the humanin-coding region of the mitochondrial genome that is associated with a ...


Comprehensive Geriatric Assessment: A Primer, Thomas M. Meuser 2018 University of New England

Comprehensive Geriatric Assessment: A Primer, Thomas M. Meuser

Social Work Faculty Publications

Comprehensive Geriatric Assessment is an integrative approach to diagnosis, treatment and management of older adults that takes the whole person into account. While deficits may be a primary focus, strengths are also considered.


Life Review In Aging: A Primer, Thomas M. Meuser 2018 University of New England

Life Review In Aging: A Primer, Thomas M. Meuser

Social Work Faculty Publications

Humans are narrative beings. We understand and speak of ourselves and the events of our lives in the context of stories. The stories we tell are influenced by our lived experiences, the quality of our memories (what’s recalled and forgotten), relationships, personality styles, values, accomplishments, regrets, spiritual beliefs, and a host of other factors. Telling our stories from the vantage point of old age is reflective of a maturational process of introspection and discovery called life review.


Working Memory And Falls Risk In Older Adults: An Event-Related Potential Study, Yee (Michelle) S. Wong 2018 The University of Western Ontario

Working Memory And Falls Risk In Older Adults: An Event-Related Potential Study, Yee (Michelle) S. Wong

Electronic Thesis and Dissertation Repository

BACKGROUND: The aging population is rapidly increasing, where currently in North America, the population of older adults (ages 60+) outnumbers the population of children. Falls are a major concern for older adults and their quality of life. Cognitive impairment has been shown to be declined in older adults at-risk for falls, but working memory has not been thoroughly investigated within this population. PURPOSE: To examine differences in Non-Fallers, Moderate Risk for Falls, and Fallers in a working memory task using electroencephalography (EEG). METHODS: Older adults (n=44, female=27) aged 60 – 80 years (m=68.8, SD=4.7) completed ...


The Conceptual Relevance Of Assessment Measures In Patients With Mild/Mild-Moderate Alzheimer's Disease, Ann Hartry, Natalie V.J. Aldhouse, Tamara Al-Zubeidi, Myrlene Sanon, Richard G. Stefanacci, Sarah L. Knight 2018 Lundbeck, Deerfield, IL

The Conceptual Relevance Of Assessment Measures In Patients With Mild/Mild-Moderate Alzheimer's Disease, Ann Hartry, Natalie V.J. Aldhouse, Tamara Al-Zubeidi, Myrlene Sanon, Richard G. Stefanacci, Sarah L. Knight

College of Population Health Faculty Papers

Introduction: This study aims to evaluate the conceptual relevance of four measures of disease activity in patients with mild/mild-moderate Alzheimer's disease (AD): (1) the Alzheimer's Disease Assessment Scale–Cognitive Subscale; (2) the Alzheimer's Disease Cooperative Study–Activities of Daily Living Inventory; (3) the Neuropsychiatry Inventory; and (4) the Dependence Scale. Methods: A conceptual model depicting patient experience of mild AD was developed via literature review; concepts were compared with the items of the four measures. Relevance of the concepts included in the four measures was evaluated by patients with mild AD in a survey and follow-up ...


Prevalence Rates Of Arthritis Among Us Older Adults With Varying Degrees Of Depression: Findings From The 2011 To 2014 National Health And Nutrition Examination Survey, Jessica L. Brooks, Alexander J. Titus, Courtney A. Polenick, Nicole M. Orzechowski, Manney Carrington Reid, Todd A. MacKenzie, Stephen J. Bartels, John A. Batsis 2018 Dartmouth College

Prevalence Rates Of Arthritis Among Us Older Adults With Varying Degrees Of Depression: Findings From The 2011 To 2014 National Health And Nutrition Examination Survey, Jessica L. Brooks, Alexander J. Titus, Courtney A. Polenick, Nicole M. Orzechowski, Manney Carrington Reid, Todd A. Mackenzie, Stephen J. Bartels, John A. Batsis

Open Dartmouth: Faculty Open Access Articles

Arthritis and depressive symptoms often interact and negatively influence one another to worsen mental and physical health outcomes. Better characterization of arthritis rates among older adults with different levels of depressive symptoms is an important step toward informing mental health professionals of the need to detect and respond to arthritis and related mental health complications. The primary objective is to determine arthritis rates among US older adults with varying degrees of depression. Using National Health and Nutrition Examination Survey 2011 to 2014 data (N = 4792), we first identified participants aged ≥50 years. Measures screened for depressive symptoms and self‐reported ...


A Retrospective Analysis Of Fall Patients And The Potential Contribution Of Opioids, Stephanie Adjei, Jake Muha, Jana Sanders, Annette Chard, Lisa Hollister, Deborah McMahan MD 2018 Parkview Health

A Retrospective Analysis Of Fall Patients And The Potential Contribution Of Opioids, Stephanie Adjei, Jake Muha, Jana Sanders, Annette Chard, Lisa Hollister, Deborah Mcmahan Md

MAHE Student Research

Background: The leading cause of death due to unintentional injuries amidst individuals 65 years and older is falls, and there is increasing evidence of an association between opioid use and falls in older adults. Objective: The aim of this study was to observe the rate at which patients admitted to trauma centers had opioids listed on their current medications list or present in their urine drug screen. Methods & Design: This study conducted a retrospective, descriptive, correlational study of 2,873 patients aged 15 years and older who were admitted to Allen County trauma centers as a result of a fall between 01/01/2017 and 04/30/2018. Data regarding if the patient had an opioid or benzodiazepine medication on their current medications list and if they were discharged with an opioid were gathered via chart review. The age groups were divided into two groups to observe differences between younger and older adults. Associations were evaluated via univariate and multivariate logistic regression tests. Odds ratios (ORs) were utilized to demonstrate the results with 90% confidence intervals (90% CI). Additional sub-analyses for length of stay (LOS), patient status at time of discharge, and injury severity score (ISS) were also performed. Results: Of all the patients who were admitted to a trauma center for a fall, 30.0% had an existing opioid prescription in their medical records. Of those that had a documented opioid prescription in their current medications list, 87.2% were in the older adult age group. Overall, older adults with an opioid prescription comprised 31.2% of the total fall population (Odds Ratio [OR]=0.71; 90% CI 0.59-0.86). Conclusion: This study demonstrates that the proportion of patients on opioid medications prior to their fall may have been underestimated, compared to the previous literature.


Multimodal Pain Management For Older Adults In Primary Care, Bina Solanky 2018 The University of San Francisco

Multimodal Pain Management For Older Adults In Primary Care, Bina Solanky

DNP Qualifying Manuscripts

Persistent pain affects 50% to 75% of adults of the age of 65 and it is often underreported and undertreated in primary care. This manuscript discusses how nurse practitioners and other primary care providers can manage persistent pain in older adults utilizing nonpharmacological methods in addition to standard pharmacological treatments.


Implementation Of A Volunteer-Based Hospital Program For Older Adults, Elizabeth Collins, MD, Kristine Swartz, MD 2018 Thomas Jefferson University

Implementation Of A Volunteer-Based Hospital Program For Older Adults, Elizabeth Collins, Md, Kristine Swartz, Md

House Staff Quality Improvement and Patient Safety Posters

Background

  • A multi-faceted, volunteer-led, hospital-based program1has been shown to: •Reduce the incidence of delirium •Decrease hospital length of stay •Reduce hospital costs.
  • Implementation of such a program requires upfront investment.
  • A smaller, volunteer-based visitation program for older adults may provide support for the allocation of more hospital resources in delirium prevention and establishment of a formal Hospital Elder Life Program1in this institution.
  • This research aims to investigate: •If the implementation of a visitation program is feasible at this hospital •Volunteer experience with the program.


Massoptions Transforms The Way Elderly And People With Disabilities Get Much Needed Long-Term Services And Supports In Massachusetts, Jeff A. Auger, Kerrie Topi 2018 University of Massachusetts Medical School

Massoptions Transforms The Way Elderly And People With Disabilities Get Much Needed Long-Term Services And Supports In Massachusetts, Jeff A. Auger, Kerrie Topi

Commonwealth Medicine Publications

Some of the Commonwealth’s most underserved populations—the elderly, people with disabilities, and their caregivers— now have simplified access to the long-term services and supports (LTSS) they need, thanks to MassOptions, an innovative collaboration between UHealthSolutions, the nonprofit business affiliate of UMass Medical School, and the Massachusetts Executive Office of Elder Affairs.


Cognitive Impairment, Vulnerability, And Mortality Post Ischemic Stroke: A Five-Year Follow-Up Of The Action On Secondary Prevention Interventions And Rehabilitation In Stroke (Aspire-S) Cohort, Eva Gaynor, Daniela Rohde, Margaret Large, Lisa Mellon, Patricia Hall, Linda Brewer, Orla Conway, Anne Hickey, Kathleen Bennett, Eamon Dolan, Elizabeth Callaly, David Williams 2018 Royal College of Surgeons in Ireland

Cognitive Impairment, Vulnerability, And Mortality Post Ischemic Stroke: A Five-Year Follow-Up Of The Action On Secondary Prevention Interventions And Rehabilitation In Stroke (Aspire-S) Cohort, Eva Gaynor, Daniela Rohde, Margaret Large, Lisa Mellon, Patricia Hall, Linda Brewer, Orla Conway, Anne Hickey, Kathleen Bennett, Eamon Dolan, Elizabeth Callaly, David Williams

Psychology Articles

Background

The aim of this study was to examine predictors of mortality in patients 5 years after ischemic stroke, focusing on cognitive impairment, vulnerability, and vascular risk factors assessed at 6 months post stroke.

Materials and Methods

Patients from the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) cohort were followed up 5 years post ischemic stroke. Vascular risk factors, cognitive impairment, and vulnerability were assessed at 6 months post stroke. Cognitive impairment was assessed using a cutoff score lower than 26 on the Montreal Cognitive Assessment (MoCA). Vulnerability was defined as a score of 3 or higher ...


The Aging Initiative Experience: A Call For Sustained Support For Team Science Networks, Tullika Garg, Kathryn Anzuoni, Valentina Landyn, Alexandra Hajduk, Stephen Waring, Leah R. Hanson, Heather E. Whitson 2018 Geisinger Health System, Danville, PA

The Aging Initiative Experience: A Call For Sustained Support For Team Science Networks, Tullika Garg, Kathryn Anzuoni, Valentina Landyn, Alexandra Hajduk, Stephen Waring, Leah R. Hanson, Heather E. Whitson

Open Access Articles

Team science, defined as collaborative research efforts that leverage the expertise of diverse disciplines, is recognised as a critical means to address complex healthcare challenges, but the practical implementation of team science can be difficult. Our objective is to describe the barriers, solutions and lessons learned from our team science experience as applied to the complex and growing challenge of multiple chronic conditions (MCC). MCC is the presence of two or more chronic conditions that have a collective adverse effect on health status, function or quality of life, and that require complex healthcare management, decision-making or coordination. Due to the ...


Lgbt Senior Health Disparities: Information Resources To Bridge The Gap, Gregg A. Stevens, Tony Nguyen, Francisco J. Fajardo 2018 SUNY Stony Brook

Lgbt Senior Health Disparities: Information Resources To Bridge The Gap, Gregg A. Stevens, Tony Nguyen, Francisco J. Fajardo

Library Faculty Publications

As the senior population in the United States increases, the aging LGBT (lesbian, gay, bisexual, transgender) population should also see comparable growth rates. Health care providers and social service organizations will care for more LGBT seniors with special needs beyond the general population of older adults as they are more at risk for certain conditions. This article identifies some specific health disparities and examines several organizations that work to improve LGBT senior health by providing critical health information to LGBT older adults, caregivers, and health care professionals.


Resilience And Protective Factors In Older Adults, Jessica McClain, Katelyn Gullatt, Caroline Lee 2018 Dominican University of California

Resilience And Protective Factors In Older Adults, Jessica Mcclain, Katelyn Gullatt, Caroline Lee

Master's Theses and Capstone Projects

Evidence suggests resilience promotes successful aging in place and protective factors promote resilience. This study sought to investigate whether or not the combination of three protective factors, physical health, social support, and self-efficacy are all of equal importance in predicting resilience among Marin County older adults, or if some individual protective factors have a greater impact on resilience than the others. Fifty-eight participants ages 62 and higher were recruited from senior community programs and personal contacts. Four self-report questionnaires were completed by the participants in this exploratory, cross-sectional, quantitative design. SPSS was used for a descriptive and multivariate analyses to ...


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