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Early Detection Of Alcohol Related Dementia Across The Lifespan: An Integrative Literature Review For Primary Care Providers, Kaylee A. Chapman

University Honors Theses

Introduction: Alcohol related dementia (ARD) is a long-term, heterogeneous cognitive impairment that can develop in the course of excessive and prolonged use of alcohol. This integrative literature review evaluated the relevant research, preventative measures, and early detection of brain changes leading to memory impairment as a result of the chronic consumption of alcohol. Widespread prevention and detection of ARD can be achieved through the support of healthcare professiona ls in understanding, observing, and catching behavioral patterns ahead of time to properly direct treatment. The risk factors associated with an early diagnosis of dementia include, but are not limited to, abnormal …

Mental-Somatic Multimorbidity In Trajectories Of Cognitive Function For Middle-Aged And Older Adults, Siting Chen, Corey L. Nagel, Ruotong Liu, Anda Botoseneanu, Heather G. Allore, Jason T. Newsom, Stephen Thielke, Jeffrey Kaye, Ana R. Quiñones

Psychology Faculty Publications and Presentations

Multimorbidity may confer higher risk for cognitive decline than any single constituent disease. This study aims to identify distinct trajectories of cognitive impairment probability among middle-aged and older adults, and to assess the effect of changes in mental-somatic multimorbidity on these distinct trajectories.

It Takes A Village: An Examination Of Social Relationships And Mental Health, Em Francis Trubits

Dissertations and Theses

Social relationships are impactful to mental health and well-being, both positively and negatively. Different sources of support vary in their ability to meet our needs and ultimately influence our well-being. While research has examined aspects of supportive and harmful social relationships and mental health, much of this work is cross-sectional or limited to a single source of support. This dissertation aimed to better elucidate the relationship between social relationships and mental health by integrating multiple theoretical perspectives and multiple sources of support, in a series of three empirical studies in order to inform theory and interventions targeting mental health of …

2024 Community-Based Care. Resident And Community Characteristics Report On Assisted Living, Residential Care, And Memory Care Communities, Ozcan Tunalilar, Sarah Dys, Yuliana Levchenko, Diana Jacoby, Minju Kim, Wafi Albalawi, Paula Carder

Institute on Aging Publications

This report marks the 10th anniversary of the Resident and Community Characteristics Report on Assisted Living (AL), Residential Care (RC), and Memory Care (MC) Communities as part of the Oregon Community Based Care project. This study includes rotating questions that focus on emerging areas of interest in the AL/RC/MC settings based on feedback from ODHS and interested parties alongside a core set of questions that are asked every year or every other year to allow comparisons over time. In this year’s study, we included information about various resident, community, and staff characteristics, including:

• Residents: sociodemographic characteristics (e.g., age, sex, …

2024 Adult Foster Home: Resident And Community Characteristics Report On Adult Foster Homes, Ozcan Tunalilar, Sarah Dys, Diana Jacoby, Wafi Albalawi, Minju Kim, Yuliana Levchenko, Paula C. Carder

Institute on Aging Publications

This year marks the 10th anniversary of the Resident and Community Characteristics Report on Adult Foster Homes as part of the Oregon Community Based Care project. The first of these reports was published in 2014 and looking back, one gets a sense of both stability and change. In this year’s report, we describe the results based on data we collected from AFHs licensed and monitored by the Aging and People with Disabilities program of the Oregon Department of Human Services (ODHS/APD). These are small residential settings that provide personal and health-related services for up to five residents. They are primarily …

Raps Sheet, January 2024, Retirement Association Of Portland State

RAPS Sheet: Monthly Newsletter

No abstract provided.

Sequence Analysis Of Cardiometabolic Multimorbidity And Association With Subsequent Dementia, Corey Nagel, Heather Allore, Anda Botoseneanu, Jeffrey Kaye, Jason Newsom, Nicholas Bishop, Ana Quinones

Psychology Faculty Publications and Presentations

Sequence analysis is used in the social sciences to examine patterns of events occurring across the life course, but there are few examples of its use in multimorbidity research among older adults. We used sequence analysis to identify longitudinal patterns of cardiometabolic multimorbidity over a five-year period among participants in the National Health and Aging Trends Study (N=5,218). Multimorbidity sequences were constructed using self-reported diagnosis of diabetes, heart disease, stroke, and myocardial infarction (MI) assessed annually. Death was included as an absorbing state, yielding a total of 281 distinct sequences. We calculated sequence dissimilarity using optimal matching then used hierarchical …

Raps Sheet, December 2023, Retirement Association Of Portland State

RAPS Sheet: Monthly Newsletter

No abstract provided.

Transportation Planning In An Aging Society, Shengxiao (Alex) Li

PSU Transportation Seminars

By 2030, all Baby Boomers (those born between 1946 and 1964) will be 65 and older in the U.S. However, the understanding of how Baby Boomers travel differently from the previous generations, and the opportunities and challenges of older people's travel, do not keep pace with the increasing number of older people. This presentation starts with an overview of transportation policies for older people and challenges, followed by several empirical studies investigating older people's generational travel differences, vehicle ownership over the life course, and the interaction of technology usage and travel among older people. It concludes with a policy agenda …

Supporting Care Partners Of People Living With Dementia, Sherril Gelmon, Walter Dawson, Jenn Hollandsworth Reed

OHSU-PSU School of Public Health Faculty Publications and Presentations

This report addresses the need to better support care partners of people living with dementia, including a proposal for a new Dementia Care Partner Hub (the “Hub”) that will facilitate care partner access to information, supports, services and activities. This work is the culmination of the “Supporting Care Partners of People Living with Alzheimer’s Disease and Related Dementias (ADRD)” project funded by the Portland State University Institute on Aging’s “Gerontology Education & Research Initiative” (GERI) faculty grant, conducted from June 2022 to October 2023. The project focused on addressing concerns and needs of care partners and people living with dementia …

Musculoskeletal Pain, A Possible Indicator Of Central Sensitization, Is Positively Associated With Lower Urinary Tract Symptom Progression In Community-Dwelling Older Men, Angela Senders, Scott Bauer, Yiyi Chen, Barry Oken, Howard A. Fink, Nancy E. Lane, Kamran P. Sajadi, Lynn M. Marshall

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Musculoskeletal pain, a possible marker of central sensitization, is associated with higher prevalence of lower urinary tract symptoms (LUTS) among older men. We investigated whether musculoskeletal pain is associated with LUTS progression.

Methods

Participants were 5 569 men age ≥65 years enrolled in the prospective, multicenter Osteoporotic Fractures in Men (MrOS) Study. Self-reported musculoskeletal pain within 12 months before baseline was categorized as any pain and multilocation pain. Pain interference within 4 weeks of baseline was assessed with the SF-12 questionnaire. LUTS were assessed repeatedly with the American Urological Association Symptom Index (AUA-SI). Men with severe LUTS at baseline …

Extreme Heat Vulnerability Among Older Adults: A Multi-Level Risk Index For Portland, Oregon, Jacklyn N. Kohon, Katsuya Tanaka, Dani Himes, Paula Carder, Eiji Toda, Bryant Carlson

Institute on Aging Publications

Background and Objectives

Extreme heat is an environmental health equity concern disproportionately impacting low-income older adults and people of color. Exposure factors, such as living in rental housing and lack of air conditioning, and sensitivity factors, such as chronic disease and social isolation, increase mortality risk among older adults. Older persons face multiple barriers to adaptive heat mitigation, particularly for those living in historically temperate climates. This study measures two heat vulnerability indices to identify areas and individuals most vulnerable to extreme heat and discusses opportunities to mitigate vulnerability among older adults.

Research Design and Methods

We constructed two heat …

Paperwork, Paradox, And Prn: Psychotropic Medication Deficiencies In Assisted Living, Sarah Dys, Paula Carder

Institute on Aging Publications

Individual state approaches to assisted living/residential care (AL/RC) licensing and oversight in the United States result in different practice standards and requirements, including psychotropic medication use. We examined 170 psychotropic medication deficiency citations issued to 152 Oregon AL/RC settings from 2015 to 2019. Applied thematic analysis resulted in the following themes: (1) documentation issues are primarily responsible for noncompliance, (2) unclear parameters place direct care workers in a role paradox, and (3) there is a persistent disconnect about when to seek qualified expertise before requesting psychotropic medications. AL/RC-specific mechanisms for medication prescription and administration are necessary to improve the structure …

Climate Change Policies And Older Adults: An Analysis Of States’ Climate Adaptation Plans, Bryant Carlson, Jacklyn N. Kohon, Paula Carder, Dani Himes, Eiji Toda, Katsuya Tanaka

Institute on Aging Publications

Background and Objectives

As climate change drives more frequent and intense weather events, older adults face disproportionate impacts, including having the highest mortality rates from storms, wildfires, flooding, and heat waves. State governments are critical in deploying local resources to help address climate change impacts. This policy study analyzes states’ climate adaptation plans to assess the methods through which they address the impact of climate change on older adults.

Research Design and Methods

This study uses content analysis to analyze available climate change adaptation plans for all U.S. states for strategies designed to increase resilience of older adults to impacts …

International Comparison Of Literature On Home Health: Taiwan And The United States, Jaden Gloden

University Honors Theses

Taiwan is one of the world's fastest-aging societies and in 1994 implemented its universal National Health Insurance program which would later include a comprehensive long-term care system. The United States is also an aging society and a growing number of Americans are in need of long-term care services that the government has yet to provide or finance. Aging in place, the desire of older adults to stay in their homes as they age has consistently remained popular among Americans 50+ resulting in the popularity of home-based medical care. Taiwan society also values aging in place and an emphasis on Confucian …

Raps Sheet, May 2023, Retirement Association Of Portland State

RAPS Sheet: Monthly Newsletter

No abstract provided.

Longitudinal Changes In Alzheimer’S-Related Plasma Biomarkers And Brain Amyloid, Murat Bilgel, Abhay Moghekar, Henrik Zetterberg, Bruno Jedynak, Multiple Additional Authors

Mathematics and Statistics Faculty Publications and Presentations

Introduction Understanding longitudinal plasma biomarker trajectories relative to brain amyloid changes can help devise Alzheimer’s progression assessment strategies.

Methods We examined the temporal order of changes in plasma amyloid-β ratio (Aβ42/Aβ40), glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), and phosphorylated tau ratios (p-tau181/Aβ42, p-tau231/Aβ42) relative to 11C-Pittsburgh compound B (PiB) positron emission tomography (PET) cortical amyloid burden (PiB−/+). Participants (n = 199) were cognitively normal at index visit with a median 6.1-year follow-up.

Results PiB groups exhibited different rates of longitudinal change in Aβ42/Aβ40 (β = 5.41 × 10-4, SE = 1.95 × 10-4, p = 0.0073). …

Defining Dementia-Friendly Communities From The Perspective Of Those Affected, Iris Alexandra Wernher

Dissertations and Theses

More and more communities across the globe are pledging to become more "dementia friendly," yet many initiatives lack direction as to what this pledge might entail. The intent of this qualitative study, conducted in the metropolitan area of Portland and several other cities in Oregon, was to better understand how communities can increase their dementia friendliness – from the perspective of people living with dementia and their care partners. The study further aimed to clarify if and how age- and dementia-friendly efforts can be integrated.

Twenty-five community-dwelling individuals living with dementia and their 25 informal carers participated separately in semi-structured …

Wage And Cost Study Of Oregon Assisted Living And Residential Care Providers, 2022, Ozcan Tunalilar, Sarah Dys, Paula Carder, Diana Jacoby

Institute on Aging Publications

Senate Bill 703 directed Oregon Department of Human Services (ODHS) to conduct a study of licensed residential care (RCF) and assisted living (ALF) facilities, including those with a memory care (MC) endorsement, to evaluate: a) Total cost to provide care to residents, b) the sufficiency of the Medicaid reimbursement paid to facilities to meet the total cost of care, and c) the average compensation paid to direct care workers by the facilities by geographic region. ODHS contracted with the Institute on Aging (IOA) at Portland State University (PSU) to conduct a study to achieve these three objectives. In the fall …

Older Adults In Action: Using Action Research To Address Neighborhood Change, Amie Thurber

School of Social Work Faculty Publications and Presentations

Older adults face distinct challenges amidst changing neighborhood conditions, yet also bring distinct resources to aid their communities. After considering the literature related to well-being in older adulthood, the effects of neighborhood change on older adults, and older adults and social action, this paper explores the experiences of older adults in the Neighborhood Story Project. This action research project engages a group of neighbors to identify a set of research questions about their community, conduct place-based inquiry, and take action based on their learning. This study considers the degree to which the Neighborhood Story Project constitutes a macro therapeutic intervention. …

Direct Care Staff Experiences In Oregon Assisted Living, Residential Care And Memory Care Communities, 2022, Paula Carder, Sarah Dys, Lindsay Schwartz, Diana Jacoby, Jacklyn N. Kohon, Dani Himes, Madeleine Fox, Sheryl Elliott, Lauren Bouchard, Portland State University Institute On Aging

Institute on Aging Publications

Resident care assistants (e.g., direct care workers, caregivers, personal care aides) provide the majority of services to assisted living, residential care and memory care-endorsed (ALF/RCF) residents. They faced significant burdens during the COVID-19 pandemic, which amplified existing challenges in some ALF/RCF communities, yet little is known about their work experiences. This qualitative study collected data through focus group and individual interviews with 21 resident care assistants and 12 external colleagues who have experience hiring, training or managing resident care assistants and other ALF/RCF staff, including registered nurse consultants, staffing agency operators, state policy staff, ALF/RCF community operations managers, and advocates. …

The Resident View In Community- Based Care Residential Settings, Diana L. White, Ozcan Tunalilar, Serena Hasworth, Jaclyn Winfree

Institute on Aging Publications

The Resident VIEW is a measure of person-centered care (PCC) from residents’ perspectives and was previously studied in nursing homes. The current study presents descriptive data for the Resident VIEW in community-based care settings including assisted living, residential care (AL/RC), and adult foster homes (AFH). Using a two-stage sampling design, we recruited 31 AL/RC and 119 AFH in Oregon and completed face-to-face structured interviews with 227 and 195 residents, respectively. Residents provided ratings for both the importance of and their experience with 66 items that tapped into PCC practices in eight domains. Results are provided for each item, many of …

Beyond The Medication Pass: Attitudes, Ethics, Agency, And Antipsychotic Medications In Assisted Living/Residential Care, Sarah Dys, Paula Carder

Institute on Aging Publications

Background and Objectives

As-needed (PRN) antipsychotic medication use (APU) among assisted living/residential care (AL/RC) residents is a controversial health policy issue. AL/RC care staff, families, clinicians, researchers, and policymakers disagree about PRN APU to manage behavioral expressions associated with residents’ dementia or cognitive impairment.

Research Design and Methods

Semistructured interviews among eleven direct care staff (n = 3), licensed nurses (n = 2), administrators/executive directors (n = 4), and consultant pharmacists (n = 2) currently working in Oregon AL/RC. Using situational analysis, we identify, describe, and visualize positions and ideologies by job role to theorize PRN …

In Favor Of Bringing Game Theory Into Urban Studies And Planning Curriculum: Reintroducing An Underused Method For The Next Generation Of Urban Scholars, Brian Mcdonald Gardner

Dissertations and Theses

By looking at some historical examples of Urban Studies literature and theory (and a detailed dive into Neil Smith's "Toward a theory of gentrification…") this thesis makes the case that Game Theory has valid insights to add to the foundation of Urban Studies and Planning and should be included in Masters and Doctorate level curriculums. As a discipline Game Theory has revolutionized multiple other fields, and can be used both mathematically and/or non-mathematically. It is postulated below that the inclusion of Game Theory would help scholars and practitioners arrive at better outcomes. This case is made by reviewing various areas …

Association Between State Regulations Supportive Of Third-Party Services And Likelihood Of Assisted Living Residents In The Us Dying In Place, Emmanuelle Belanger, Nicole Rosendaal, Joan M. Teno, David M. Dosa, Pedro L. Gozalo, Paula Carder, Kali S. Thomas

Institute on Aging Publications

Importance Older adults are increasingly residing in assisted living residences during their last year of life. The regulations guiding these residential care settings differ between and within the states in the US, resulting in diverse policies that may support residents who wish to die in place.

Objective To examine the association between state regulations and the likelihood of assisted living residents dying in place. The study hypothesis was that regulations supporting third-party services, such as hospice, increase the likelihood of assisted living residents dying in place.

Design, Setting, and Participants This retrospective cohort study combined data about assisted living residences …

Raps Sheet, October 2022, Retirement Association Of Portland State

RAPS Sheet: Monthly Newsletter

No abstract provided.

Enhancing Grant-Writing Expertise In Build Institutions: Building Infrastructure Leading To Diversity, Robert A. Hiatt, Yazmin P. Carrasco, Alan L. Paciorek, Lauren Kaplan, Marc B. Cox, Carlos J. Crespo, Andrew Feig, Karsten Hueffer, Harris Mcferrin, Multiple Additional Authors

Community Health Faculty Publications and Presentations

Background

The lack of race/ethnic and gender diversity in grants funded by the National Institutes of Health (NIH) is a persistent challenge related to career advancement and the quality and relevance of health research. We describe pilot programs at nine institutions supported by the NIH-sponsored Building Infrastructure Leading to Diversity (BUILD) program aimed at increasing diversity in biomedical research.

Methods

We collected data from the 2016–2017 Higher Education Research Institute survey of faculty and NIH progress reports for the first four years of the program (2015–2018). We then conducted descriptive analyses of data from the nine BUILD institutions that had …

Fall Prediction Based On Instrumented Measures Of Gait And Turning In Daily Life In People With Multiple Sclerosis, Ishu Arpan, Vrutangkumar Shah, James Mcnames, Graham Harker, Patricia Carlson-Kuhta, Rebecca I. Spain, Mahmoud El-Gohary, Martina Mancini, Fay Horak

Electrical and Computer Engineering Faculty Publications and Presentations

This study investigates the potential of passive monitoring of gait and turning in daily life in people with multiple sclerosis (PwMS) to identify those at future risk of falls. Seven days of passive monitoring of gait and turning were carried out in a pilot study of 26 PwMS in home settings using wearable inertial sensors. The retrospective fall history was collected at the baseline. After gait and turning data collection in daily life, PwMS were followed biweekly for a year and were classified as fallers if they experienced >1 fall. The ability of short-term passive monitoring of gait and turning, …

Reflecting On Resilience: Insight Into Resiliency Development And Utilization In Oregon's Older Adults From 2020 To 2022, Riley A. Wilton

University Honors Theses

The events of the last 2 years have complicated the lives of older adults throughout the world. For many, their survival can be traced back to one key trait: resilience. In the state of Oregon, the years 2020-2022 came with a host of issues that expanded past the COVID-19 pandemic. These events provide context for the world our storytellers discuss.

Using a snowball recruitment strategy through the efforts of community organizations and senior centers, 4 storytellers sat down to describe their resilience in different ways. They were asked to reflect on their own life experiences, how it influenced their resilience, …

Testing The Ls/Cmi For Predictive Accuracy: Does Age Matter?, Sandra Stephanie Lawlor

Dissertations and Theses

The Level of Service/Case Management Inventory (LS/CMI) is one of the most widely used instruments for assessing recidivism risk and treatment needs in correctional settings. The predictive validity of the measure and its predecessor (LSI-R) has been established in meta-analytic studies and research finds that the scale's accuracy is largely independent of sex, race, and ethnicity. Whether the LS/CMI works equally well for different age groups remains in question. The current study assessed the predictive accuracy of the LS/CMI from a sample of 14,940 adults in custody (AIC) released from an Oregon prison between 2011 and 2017 for three age …