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Awareness, Knowledge, And Motivations About Lifespan, Healthspan, And Healthy Longevity Medicine In The General Population: The Healthy Longevity (Helo) Conceptual Framework, Belinda Wang, Anna Szucs, Elena Sandalova, E. J. Horberg, Paul A. O'Keefe, Louis Island, Hans J. Meij, Sonny Rosenthal, Andrea B. Maier

Research Collection College of Integrative Studies

The global population is ageing and the gap between lifespan (total years lived) and healthspan (years lived free of diseases) is increasing. Healthy Longevity Medicine (HLM) is an approach to optimise health and healthspan, and it has substantial public health implications. Despite those implications, the understanding of public perspectives on this field is lacking. The HEalthy LOngevity (HELO) framework was developed through a literature review guided by expert discussions across disciplines to include evidence-based concepts of health-related decision-making, ageing, and HLM. The framework organises concepts into three components. The first two components, awareness and knowledge, explore public perception and understanding …

Comparing The Performance Of 3 Sarcopenia Definitions For Predicting Adverse Events Prior To Liver Transplant, Heidi E Johnston, Hannah L Mayr, Melita Andelkovic, Tahnie G Takefala, Yanyan Chen, Aaron P Thrift, Graeme A Macdonald, Ingrid J Hickman

Faculty, Staff and Students Publications

Background: Sarcopenia is a syndrome of severe muscle wasting, associated with adverse outcomes related to liver transplantation (LT). There are several approaches used to identify sarcopenia. We aimed to investigate the prevalence of sarcopenia using 3 different criteria and determine how these performed in relation to clinical outcomes.

Methods: The cohort study included 237 adults with cirrhosis referred for LT. Sarcopenia was identified using (1) CT-defined; and the (2) original and (3) updated European Working Group on Sarcopenia in Older People criteria (EWGSOP1 and 2). Logistic regression was used to estimate OR and 95% CI for the relationships between sarcopenia …

Linking Symptom Inventories Using Semantic Textual Similarity, Eamonn Kennedy, Shashank Vadlamani, Hannah M Lindsey, Kelly S Peterson, Kristen Dams O'Connor, Ronak Agarwal, Houshang H Amiri, Raeda K Andersen, Talin Babikian, David A Baron, Erin D Bigler, Karen Caeyenberghs, Lisa Delano-Wood, Seth G Disner, Ekaterina Dobryakova, Blessen C Eapen, Rachel M Edelstein, Carrie Esopenko, Helen M Genova, Elbert Geuze, Naomi J Goodrich-Hunsaker, Jordan Grafman, Asta K Håberg, Cooper B Hodges, Kristen R Hoskinson, Elizabeth S Hovenden, Andrei Irimia, Neda Jahanshad, Ruchira M Jha, Finian Keleher, Kimbra Kenney, Inga K Koerte, Spencer W Liebel, Abigail Livny, Marianne Løvstad, Sarah L Martindale, Jeffrey E Max, Andrew R Mayer, Timothy B Meier, Deleene S Menefee, Abdalla Z Mohamed, Stefania Mondello, Martin M Monti, Rajendra A Morey, Virginia Newcombe, Mary R Newsome, Alexander Olsen, Nicholas J Pastorek, Mary Jo Pugh, Adeel Razi, Jacob E Resch, Jared A Rowland, Kelly Russell, Nicholas P Ryan, Randall S Scheibel, Adam T Schmidt, Gershon Spitz, Jaclyn A Stephens, Assaf Tal, Leah D Talbert, Maria Carmela Tartaglia, Brian A Taylor, Sophia I Thomopoulos, Maya Troyanskaya, Eve M Valera, Harm Jan Van Der Horn, John D Van Horn, Ragini Verma, Benjamin S C Wade, Willian C Walker, Ashley L Ware, J Kent Werner, Keith Owen Yeates, Ross D Zafonte, Michael M Zeineh, Brandon Zielinski, Paul M Thompson, Frank G Hillary, David F Tate, Elisabeth A Wilde, Emily L Dennis

Faculty, Staff and Students Publications

An extensive library of symptom inventories has been developed over time to measure clinical symptoms of traumatic brain injury (TBI), but this variety has led to several long-standing issues. Most notably, results drawn from different settings and studies are not comparable. This creates a fundamental problem in TBI diagnostics and outcome prediction, namely that it is not possible to equate results drawn from distinct tools and symptom inventories. Here, we present an approach using semantic textual similarity (STS) to link symptoms and scores across previously incongruous symptom inventories by ranking item text similarities according to their conceptual likeness. We tested …

Managing Hypercholesterolemia In Adults Older Than 75 Years Without A History Of Atherosclerotic Cardiovascular Disease: An Expert Clinical Consensus From The National Lipid Association And The American Geriatrics Society, Vera Bittner, Sunny A Linnebur, Dave L Dixon, Daniel E Forman, Ariel R Green, Terry A Jacobson, Ariela R Orkaby, Joseph J Saseen, Salim S Virani

Faculty, Staff and Students Publications

The risk of atherosclerotic cardiovascular disease increases with advancing age. Elevated LDL-cholesterol and non-HDL-cholesterol levels remain predictive of incident atherosclerotic cardiovascular events among individuals older than 75 years. Risk prediction among older individuals is less certain because most current risk calculators lack specificity in those older than 75 years and do not adjust for co-morbidities, functional status, frailty, and cognition which significantly impact prognosis in this age group. Data on the benefits and risks of lowering LDL-cholesterol with statins in older patients without atherosclerotic cardiovascular disease are also limited since most primary prevention trials have included mostly younger patients. Available …

From Industrial Building To Affordable Senior Housing: An Idea Book Beyond Code, Weiyi Ma

Masters Theses

This thesis envisions a proposal to adaptively re-purpose Rhode Island’s extant industrial building stock into affordable housing tailored to the needs of its older and more vulnerable citizens. Architectural dignity, in terms of older citizens amidst this housing crisis, is the creation of living environments that honor their autonomy, comfort, and identity through design interventions that provide accessible, luminous, breathable, and socially enriching spaces, reaffirming their rightful place within the community. With humanistic care and logical rigor, it establishes a mathematical framework for assessment and execution, anchored in five criteria: light, air, space, accessibility, and livability, and presents itself in …

Investigating The Associations Of Cognitive Health, Health Behaviors, And Personality In Older Community-Dwelling Adults, Yan-Jhu Su

Graduate Doctoral Dissertations

Cognitive decline poses a significant public health challenge, with profound implications for aging populations. This dissertation investigates the associations between health behaviors, leisure activities, personality traits, and cognitive function in older U.S. adults, using data from the Health and Retirement Study (HRS) and the Consumption and Activities Mail Survey (CAMS). This work comprises three studies that explore both cross-sectional and longitudinal perspectives on cognitive aging.

Study 1 examines the complex interactions between personality traits, education, health behaviors, and cognitive function. The study is divided into two parts: Study 1a explores the role of health behaviors—smoking, alcohol use, and physical activity—as …

Factors Associated With Caregivers' Concern In Maintaining The Oral Function Of Elderly Living In Long-Term Care Facilities, Susiana Nugraha, Tri Budi Wahyuni Rahardjo, Misako Higashijima, Yuko Hirano

Kesmas

This study investigated the attentiveness of elderly caregivers in long-term care facilities in maintaining oral function. A cross-sectional approach was used to achieve the study's purpose. The sample size formula accounted for 213 caregivers randomly selected from 18 long-term care facilities in 4 provinces. A self-reported questionnaire of sociodemographic characteristics and an adapted Leopold’s oral care checklist was distributed. The average age of study participants was 35.24 (±11.2 SD; aged 18–70 years), dominated by females (62.9%), and only 39% had experienced long-term care training. Multiple linear regression analysis indicated that younger caregivers likely pay more attention in the swallowing periods …

From Childhood To Adult Cognitive Health: Analyzing Adverse Experiences And Subjective Cognitive Decline Using Brfss 2020-2023 Dataset, Kyaolin Rajbhandary

NYMC Student Theses and Dissertations

The chronic impact of early-life experiences on long-term health is a critical area of investigation, especially regarding cognitive health in adulthood. Adverse childhood experiences (ACEs) have been linked to an increased risk of developing various health issues in adulthood, including mental health disorders, substance abuse, and chronic diseases. The connection between ACEs, substance abuse and cognitive health, particularly subjective cognitive decline (SCD), remains relatively underexplored. The aim of this study is to examine the intricate relationships between ACEs, alcohol abuse, and SCD in adulthood. This study draws on trauma theory and the biopsychosocial model to conceptualize the long-term impact of …

Music As Medicine: The Impact Of Music On Pain Reported After Surgery, Anastasia Pike, Gregory T. Chesnut

Journal of Global Awareness

The impact of music on subjective reporting of pain and anxiety has been increasingly described in medical literature. Multimodal methods of alleviating postoperative pain and anxiety, including the use of live or recorded music in perioperative settings, have been shown to improve patient-reported pain levels and, in some studies, to result in decreased opioid usage. The overprescription of opioids after surgery can contribute to long-term abuse or trafficking of medications, and the use of non-opioid medications, alternative methods of pain relief, and environmental/auditory stimuli offer new mechanisms to promote safe opioid prescribing while improving both pain control and patient wellbeing. …

A Systematic Review Of Brief Cognitive Test Used Among The Veteran Population, Joel Mcpherson

Walden Dissertations and Doctoral Studies

The practice problem this DNP project addressed was the lack of a of consensus for a brief cognitive screening (BCS) tool that can be most predictive of mild cognitive disorder (MCI) and dementia in a Veteran Affairs (VA) outpatient clinic. Addressing this gap in practice is important because the veteran population may be at increased risk of MCI and dementia due to age, a history of traumatic brain injury, and posttraumatic stress disorder. This DNP project was a systematic review of the literature. A population, exposure, outcome (PEO) framework and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) theory guided …

Staff Education To Increase Knowledge And Education Of Urinary Tract Infection To Reduce Rehospitalization, Yia Lor

Walden Dissertations and Doctoral Studies

Urinary tract infections (UTIs) are considered the most common infections in healthcare, particularly in nursing homes. If appropriate preventive measures are taken, infection rates will be reduced. The DNP project aimed to enhance clinicians' knowledge to reduce and prevent UTIs in nursing homes. This knowledge expansion also significantly has potential to reduce the risk of unnecessary hospitalizations. A knowledge gap was identified that focused on the necessary preventive measures to impact patient outcomes positively. Addressing this in nursing is essential because it can help reduce mortality risks. The participants consisted of six registered nurses and six certified nurse assistants who …

Staff Education To Prevent Falls In Long-Term Care Facilities, Shekinah Gleason

Walden Dissertations and Doctoral Studies

In this staff education initiative, I focused on fall prevention in long-term care facilities (LTCFs) by reinforcing the Morse Fall Scale fall risk assessment tool. Falls in LTCFs are a significant concern, leading to injuries, hospitalization, and declining residents' quality of life. The practice problem stems from insufficient staff training, contributing to inadequate patient care and an increased risk of falls. The practice-focused question was used to explore whether education about fall prevention measures and guidelines improves long-term care nurses’ knowledge and intent to follow these guidelines; a total of 23 participants were involved in this project. Pre- and post-education …

Staff Education On Medicaid And Medicare Programs, Angela R. Smith

Walden Dissertations and Doctoral Studies

Case managers at the practice site are responsible for helping older and disabled clients receive services from Medicare and Medicaid. The gap in practice was that case managers were failing to recognize the benefit and eligibility differences between these federal and state-run programs. Case managers must be well-informed regarding these programs to effectively manage their clients’ care. The goal of this project was to plan, implement, and evaluate a staff education program on Medicare and Medicaid services. The practice-focused question centered on whether participants demonstrated increased knowledge about Medicare and Medicaid services available to Waiver Program clients. The theoretical framework …

Utilizing A Clinical Resource Hub To Improve Access And Workflow For Retinopathy Screenings In The Veteran Population, Erin Kelly Pope

Doctor of Nursing Practice Final Manuscripts

Abstract

Utilizing a Clinical Resource Hub to Improve Access and Workflow for Retinal Screenings in the Veteran Population

Erin K. Pope, MSN, RN, AGCNS-BC, AMB-BC

Scot Nolan, DNP, RN, CNS, PHN, CCRN, CNRN, SCRN, FCNS

Background: Diabetic retinopathy (DR), a progressive complication of diabetes mellitus (DM), is the leading cause of blindness among working-age adults. As DR can remain asymptomatic until advanced stages, annual screenings are critical for early detection and management. Teleretinal imaging is an evidence-based method for DR screening, offering cost efficiency and reduced demand on ophthalmology clinics. At the Veterans Administration’s (VA) Loma Linda Healthcare System …

Life In The Fast Lane: Improving Patient Intermittent Fasting Compliance, William C. Moreo

Doctor of Nursing Practice Final Manuscripts

Background: In the United States, 2 in 5 adults are obese. The U.S. spends approximately $147 billion annually on healthcare related to obesity. Intermittent Fasting (IF) has emerged as an evidence-based, safe, and cost-effective approach to weight loss. When instructed correctly, it has been shown to improve patient BMI and total weight over a short-term duration.

Purpose of the Project: The purpose of this study was to determine the effectiveness of a standardized time-restricted eating (TRE) intermittent fasting education protocol for primary care providers (PCP) and its impact on their confidence levels in managing patients. This project aims to enhance …

Staff Education To Improve Quality Of Life For Patients With Dementia, Vanessa Ann Soda

Walden Dissertations and Doctoral Studies

Dementia is a chronic neurodegenerative disease that is incurable and unpredictable. Patients with dementia experience a decline in functional abilities, communication, and social skills. Fifty-five million people worldwide live with dementia with over 6.9 million people over 65 years of age diagnosed in the United States. The practice problem identified by a 25-bed assisted living facility in the north-central United States was staff’s lack of knowledge of dementia diagnosis, person-centered care approaches, and optimal care strategies supporting a positive quality of life for patients with dementia. The practice-focused question addressed whether an education program consisting of evidence-based practices using the …

Improving Patients' Confidence In Self-Care Management And Preventing Hospital Readmission Within 30 Days Of Discharge In The Heart Failure Population, Kelly Carroll

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Heart failure (HF) is a chronic, progressive condition and a leading cause of hospital admissions nationwide. The 30-day readmission rate for HF patients is approximately 23.4%, contributing to increased morbidity, mortality, and significant healthcare costs. Each HF-related readmission is estimated to result in a financial loss of $15,789 per patient due to reduced reimbursement from both private and public insurers. This underscores the critical need for timely follow-up care, particularly within the first 30 days post-discharge.Without adequate follow-up and patient education, many individuals lack the confidence and knowledge necessary for safe and effective self-management in the outpatient setting, …

The Joint Association Of Diet Quality And Sleep Regularity With Incident Cardiovascular Disease In The Multi-Ethnic Study Of Atherosclerosis, Kaitlin S Potts, Claire Veldkamp, Alexis C Wood, Erin D Michos, Raymond Noordam, Tianyi Huang, Susan Redline, Heming Wang

Children’s Nutrition Research Center Staff Publications

Background/objectives: Diet quality and sleep regularity both influence cardiovascular disease (CVD) risk and may influence each other, but there is scarce evidence for their joint or interacting associations in relation to CVD. We assessed these associations in the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods: Participants free of CVD with valid diet and sleep measures in 2010-2013 were included and followed through 2020 for detection of incident CVD (188 events detected over 8.8 years among 1782 participants; 55% women). Sleep timing and duration regularity were assessed via the intra-individual SD of sleep onset time and duration across 5- to 7-day actigraphy. …

It Is Not Clear How Well Physical Activity Promotion Materials Are Understood: Findings From A Rapid Literature Review, Jafra D. Thomas, Jasmine C. Wong, Regina F. Hockert, Yi Sheng Wu, Winston Kennedy

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 6: Issue 1, Article 6, 2025. Efforts to promote physical activity and other health-related behaviors are more effective when resource materials are understood by a wide and diverse audience. Before our lab’s previous investigations (Thomas et al., 2024), only one study seemed to use the cloze procedure to directly test the comprehension (i.e., readability) of physical activity promotion material (Cardinal & Seidler, 1995). Thus, this rapid literature review sought to (a) determine the extent the cloze procedure has been used to study physical activity promotion material comprehension in lay adults and (b) collate …

Interprofessional Collaboration Between Primary Care And Occupational Therapy, Ellen Modlin, Phd, Otr/L, Bcp, Caps, Deana Shevit Goldin, Phd, Dnp, Arnp, Fnp-Bc

Journal of Interprofessional Practice and Collaboration

Purpose: This article explores the utilization of occupational therapy (OT) in interprofessional health care teams in adult populations. Primary care settings are typically the first point of contact for individuals seeking health care services; therefore, primary care practitioners (PCPs) are in a unique position to initiate collaboration with specialty clinicians to optimize the use of health care resources.

Method: Peer- reviewed literature from primary care and OT research was reviewed and summarized. The search focused on barriers and potential opportunities for collaboration between primary care and occupational therapy in adult populations.

Results: Occupational therapy (OT) is underutilized, as lack of …

Enhancing Physical Therapy Practice Through Interprofessional Collaboration: Addressing Elderly Self-Neglect Via Pt And Behavioral Health Integration, Alexia Stamas, Feroze Sio, Jodi Thomasian, Kate Jansen, Margaret R. Klausing

Journal of Interprofessional Practice and Collaboration

Purpose: This article examines the role of interprofessional collaboration between Physical Therapy (PT) and Behavioral Health (BH) services in identifying and supporting elderly individuals at risk of self-neglect. Through a case study, we explore the benefits of integrating interprofessional collaboration and APS reporting processes into PT practice.

Problem: Self-neglect among older adults is a critical public health issue often overlooked in healthcare settings. PTs, as mandated reporters, frequently encounter patients exhibiting signs of self-neglect but may lack training in psychosocial and cognitive assessment skills necessary for effective intervention.

Significance: Interprofessional collaboration enables PTs to address both physical …

The Impact Of Functional Disabilities On The Quality Of Life Of Older U.S. Adults, Bernadette Lavender

Walden Dissertations and Doctoral Studies

Among older U.S. adults, functional disabilities are critical determinants of quality of life (QoL), influencing mobility, social engagement, and independence. Despite growing evidence of these impacts, limited research examines how healthcare access, social support, and socioeconomic factors moderate this relationship. This quantitative study explored the effects of functional disabilities on QoL, operationalized through self-reported health, while examining the moderating roles of key social determinants. Using a cross-sectional design, secondary data from the Health and Retirement Study (HRS) were analyzed. The sample included 42,405 participants aged 60 years and above from all 50 states. Multiple regression analyses and ANOVA were employed …

Analyzing The Effectiveness Of Dance Movements In Enhancing Activities Of Daily Living For Geriatric Patients And Relevant Implications For Nursing Care, Rachel Bruce

Undergraduate Theses and Capstone Projects

Within the healthcare industry, the geriatric population holds a unique set of patient-care needs due to a myriad of physical and cognitive challenges that are not present in other subcategories of the population (Cremer et al., 2023). The presentation of these challenges can negatively impact a patient’s quality of life and their overall independence, which in turn decreases their overall quality of life (Cremer et al., 2023). One specific challenge healthcare providers must consider when caring for elderly patients is the reduced range of mobility typically associated with growing older (Machacova et al., 2015; Hartigan, 2007; Sinoff & Ore, 1997; …

Healthy Bytes: Enhancing Health Literacy In Older Adults Through Technology Services, Gianna M. Susa

Master's Projects and Capstones

This quality improvement project aimed to enhance health literacy among senior residents through interactive technology workshops. Aim During a twelve-week period from January 22, 2025, to March 31, 2025, this project aimed to increase technology proficiency among senior residents from 0% to 75%. Methods A 5P Microsystem assessment and preliminary survey revealed residents' interest in technology workshops. Based on this feedback technology workshops were implemented once a week for a twelve-week period. Each session provided one on one support to help residents navigate online health portals, communicate with providers, and interpret health information. A SWOT analysis and Fishbone analysis were …

The Impact Of The Mediterranean Diet On Depression: A Narrative Review, Emma Kate Schaaf

Honors Theses

Background. The Western diet has extensive negative ramifications on physical health and emotional well-being. The Mediterranean diet, widely regarded as one of the healthiest eating patterns in the world, may have the ability to improve psychological conditions. This study aims to examine existing research from randomized control trials (RCTs) on the association between depression prevalence and the Mediterranean diet.

Methods. The following review was conducted using PRISMA guidelines and the Google Scholar and PsycInfo databases. The criteria for inclusion were that studies: 1) were randomized control trials (RCTs) examining the Mediterranean diet; 2) included samples of adults (i.e., > 18 years …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

Cognitive Interviews With Emergency Physicians To Understand Disposition Decisions With People With Dementia With Borderline Cases, Anita N Chary, Annika R Bhananker, Rebecca Franks, Adrian Haimovich, Aanand D Naik, Maura Kennedy, Kei Ouchi

Faculty, Staff and Students Publications

People with dementia are often hospitalized from the emergency department (ED) for "borderline cases," where outpatient or inpatient management may be clinically reasonable. We sought to investigate how ED physicians make and communicate about decisions in borderline cases. Through cognitive interviews, we asked attending ED physicians from an academic hospital to share their approach to scenarios representing borderline cases with people with dementia and verbalize communication about ED disposition with patients and care partners. We deductively coded responses related to patient/care partner engagement and key features of communication and then elucidated themes related to content and phrasing of communication. Of …

Associations Of Muscular And Cardiovascular Fitness Variables With Cardiovascular Disease In Older Adult Athlete Populations, Lauren T. Zick

Honors Thesis

This data analysis examined associations between cardiovascular and muscular fitness indicators and the presence of cardiovascular disease (CVD) in older adult athletes. Using cross-sectional data from 1,110 participants aged 50 and older who completed the Sustained Athlete Fitness Exam (SAFE) at state-level Senior Games events, we evaluated both objective performance metrics and self-reported exercise behaviors. Cardiovascular measures included systolic blood pressure (SBP), waist circumference (WC), waist-to-hip ratio (WHR), and body mass index (BMI). Muscular fitness was assessed through grip strength, maximum walking speed, and chair stand time. CVD status was defined as the presence of two or more self-reported cardiovascular …

Overconfidence And Financial Risk Tolerance In Older Age, Colleen C Frank, Gary R Mottola, Meiru Chen, Lei Yu, Patricia A Boyle, Gregory R Samanez-Larkin, Kendra L Seaman

Faculty, Staff and Student Publications

Objectives: Excessive financial risk-taking in older age can have harmful consequences as opportunities to recover lost wealth are limited. Understanding financial risk-taking in older age is important for identifying vulnerabilities and developing interventions to empower aging investors to make wise financial choices. In this paper, we explore how overconfidence in financial knowledge affects financial risk-taking among older adults.

Methods: We examine this research question in older adults aged 58-101 (N = 1,242) using data from the Rush Memory and Aging Project (MAP).

Results: After controlling for demographics, overconfidence was associated with self-reported financial risk tolerance such that those who were …

Empathy And Psychological Outcomes In Informal Caregivers Of Community-Dwelling Older Adults: A Systematic Review And Meta-Analysis, Meng Huo, Thi Vu, Tomiko Yoneda, Jingkai Wei, Bruce Abbott, Joan K Monin

Faculty, Staff and Student Publications

Objectives: Scholars have increasingly recognized the crucial role that empathy plays as informal caregivers provide unpaid care to their older family and friends (i.e., care recipients). Yet, the existing literature exhibits substantial variability in study approaches and results, which limits the extent to which this literature can inform interventions intended to benefit informal caregivers. We sought to address this critical gap by synthesizing research that examined how caregivers' and care recipients' empathy were associated with caregivers' psychological health.

Methods: We conducted a literature search using PubMed, PsycInfo, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE, and Scopus databases …