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How Speech-Language Pathologists Account For Self-Determination Across The Progression Of Dementia, Emilee Mcgahee

Master's Theses

Dementia diagnoses are continuing to increase, with the number of diagnoses expected to reach 231 million globally by 2050 (World Alzheimer’s Report, 2019). With this comes a greater need for Speech-Language Pathologists (SLPs) who are able to best treat those who are diagnosed. Providing person-centered and strengths-based treatment approaches for people with dementia (PWD) has been proven to increase positive engagement responses while decreasing negative engagement responses (Skrainer et al., 2007). The primary objective of this research study was to assess treatment approaches used by SLPs in dementia care setting, along with how SLPs provide person-centered dementia treatment throughout the …

Updating Data On Cognitive Impairment In Stroke Patients, Denisa Floriana Vasilica Pîrșcoveanu, Carmen Valeria Albu, Elena-Anca Târtea, Iulia Cristina Mărginean, George Alexandru Iacob, Elena Pinoșanu, Anca Maria Țucă, Cristina Maria Mărginean, Raluca Elena Sandu, Mircea Pîrșcoveanu

Journal of Mind and Medical Sciences

Vascular cognitive impairments are the expression of complex interactions between vascular etiology, risk factors (brain diseases, white matter lesions, etc.) and cellular changes at the brain level. Consequently, vascular cognitive impairment is highly dependent on the location, extent (volume of brain tissue affected) and number of lesions. Memory impairment is not necessarily characteristic of vascular cognitive decline, usually having an evolution with episodic exacerbations and multiple cerebrovascular attacks (cumulative effect), thus producing a gradual deterioration. In recent years, the concept of mild cognitive impairment has emerged as a potential form of predementia, but which can progress to different types of …

Factors Influencing Driving Confidence In Older Adults, Jill Linder, Beth Ann Walker, Elizabeth Moore, Anne Hegberg

The Open Journal of Occupational Therapy

Background: It has been determined that both confidence and cognition impact driving performance and self-regulation. While it is known that cognitive decline impacts driving safety and that decreases in driving confidence can lead to self-driving regulation, further research is needed to determine whether cognition, demographics, and driving routines are associated with driving confidence.

Method: A non-experimental, cross-sectional design study using a convenience sample of 100 older adults was conducted to determine if individual factors are related to daytime and nighttime driving confidence.

Results: Multiple regression indicated that four variables predicted daytime driving confidence, including cognition, driving at …

Positive Communication Strategies And Approaches To Improve Quality Of Care For Those Living With Dementia, Tiffany M. Wright

MOT Student Capstones

The number of people living with dementia (PL WD) is growing exponentially each year. As the number increases, skilled nursing facilities (SNF) will be faced with the challenge of caring for more residents living with dementia. This project investigates the benefits of providing education to healthcare professionals in SNF who care for PL WD to improve the quality of care provided. Historically, pharmacological interventions have been overused in SNF. This project investigates the most effective evidence-based approaches to providing high-quality dementia care to manage behaviors and improve active participation in occupations. To address this topic, a literature review was conducted, …

Improving Dementia Symptoms Through Personalized Music, Lindsay Grainger

SC Upstate Research Symposium

Alzheimer's disease and related dementia (ADRD) is a prevalent, costly, and complicated disease. With over 6 million Americans affected and the cost of treatment soaring to over $320 billion dollars annually, there is a growing need for low-cost interventions to treat symptoms. Routinely listening to personalized music selections has been shown to reduce agitation—the most common symptom of Alzheimer’s disease and related dementia. The purpose of this study was to provide a personalized music listening (PML) intervention of thirty minutes to 10 nursing home residents with dementia. Thirty-minute PML sessions occurred multiple times a week over six weeks. The inclusion …

Stigma And Its Implications For Dementia In South Africa: A Multi-Stakeholder Exploratory Study, R Jacobs, M Schneider, N Farina, Toit P Du, S Evans-Lacko

Peninsula Medical School

Stigma and discrimination in relation to dementia has a range of implications for people living with dementia and their families worldwide, including help-seeking, quality of life, social rejection and isolation. Few studies consider the perceptions and stigma towards dementia from multiple perspectives, such as people living with dementia, carers, general public and health-care workers. South Africa has limited evidence on the stigmatisation of people living with dementia, with responses to people living with dementia being driven by poor understanding of the condition, cultural beliefs about causes and social interaction problems associated with memory and cognitive impairment. This study explored the …

Social Participation Program For Older Adults With Dementia Residing In Long Term Care Facilities, Keri Mcclelland

Student Capstone Papers

Social participation is characterized by activities that involve social interaction with others and supports social interdependence; individuals engage in this occupation through a variety of contexts including with their community, family, friends, and peers (American Occupational Therapy Association, 2020). Social participation has been discovered to influence general health and well-being, cognitive health, risk of dementia, and stress (Sommerlad et al., 2023). Dementia is a prevalent disease affecting approximately 50 million individuals worldwide (Sommerlad et al., 2023) causing increased dependence and disability among the older adult population and is shown to be growing as the aging population increases in number (Wang …

Does A Reduction In Receiving Assistance With Daily Activities Among Older Adults In Mexico Indicate An Increase In Unmet Needs Or A Decrease In Needs For Care?, Brian Downer, Rafael Samper-Ternent, Philip Cantu, Matthew Miller, Rebeca Wong

Faculty, Staff and Student Publications

OBJECTIVES: The percentage of older adults in Mexico with difficulty completing activities of daily living (ADL) who receive assistance from family appears to be decreasing. We compared 2 birth cohorts of older adults in Mexico to investigate whether this trend reflects an increase in unmet caregiving needs or a decrease in the need for care.

METHODS: We selected Mexican Health and Aging Study participants aged 60-76 in 2001 (n = 4,805) and 2018 (n = 6,494). ADL tasks were dressing, walking, bathing, getting in and out of bed, and toileting. Participants who reported difficulty with an ADL were asked if …

The Dementia Care Study (D-Care): Recruitment Strategies And Demographic Characteristics Of Participants In A Pragmatic Randomized Trial Of Dementia Care, Mia Yang, Rafael Samper-Ternent, Elena Volpi, Aval-Na'ree Green, Maya Lichtenstein, Katy Araujo, Pamela Borek, Peter Charpentier, James Dziura, Thomas M Gill, Rebecca Galloway, Erich J Greene, Kristin Lenoir, Peter Peduzzi, Can Meng, Jordan Reese, Amy Shelton, Eleni A Skokos, Jenny Summapund, Erin Unger, David B Reuben, Jeff D Williamson, Alan B Stevens

Faculty, Staff and Student Publications

INTRODUCTION: Pragmatic research studies that include diverse dyads of persons living with dementia (PLWD) and their family caregivers are rare.

METHODS: Community-dwelling dyads were recruited for a pragmatic clinical trial evaluating three approaches to dementia care. Four clinical trial sites used shared and site-specific recruitment strategies to enroll health system patients.

RESULTS: Electronic health record (EHR) queries of patients with a diagnosis of dementia and engagement of their clinicians were the main recruitment strategies. A total of 2176 dyads were enrolled, with 80% recruited after the onset of the pandemic. PLWD had a mean age of 80.6 years (SD 8.5), …

Recollection-Based Occupational Therapy: An Activities Program For Catholic Dominican Sisters With Dementia, Alyssa J. Visockis

Capstone Projects

Recollection-based occupational therapy is a nonpharmacological approach to dementia, involving five categories of activities: horticultural, physical, art, musical, and instrumental activities of daily living (IADLs). The purpose of this approach is to incorporate memories of a person’s childhood, adulthood, and older adulthood before dementia in activities. Furthermore, the Grand Rapids Catholic Dominican sisters at Aquinata Hall needed a method to gather psychosocial history on their residents as well as new activity programming on the dementia- care unit that had meaningful purpose. Therefore, during this capstone experience, a psychosocial history assessment was created and conducted with the sisters. Using the results …

What Factors Increase Risk Of Alzheimer's Disease And Related Dementia?, Elizabeth Vásquez, Kai Zhang

Population Health Research Brief Series

Alzheimer’s disease is the most common form of dementia and ranks 7th in the leading causes of death in the United States (U.S.). This data slice uses nationwide data from 3,155 counties in the U.S. to identify the factors that best predict county-level rates of Alzheimer’s Disease and Related Dementias (ADRDs) in 2018. The results indicate that insufficient sleep, consuming less than one serving of fruits and vegetables per day, having no high school diploma, Black population percentage, and social vulnerability were among the leading factors predicting county-level ADRD prevalence.

Poor Oral Health Is Associated With Inflammation, Aortic Valve Calcification, And Brain Volume Among Forager-Farmers, Benjamin C. Trumble, Matthew Schwartz, Andrew T. Ozga, Gary T. Schwartz, Christopher M. Stojanowski, Carrie L. Jenkins, Thomas Kraft, Angela R. Garcia, Daniel K. Cummings, Paul L. Hooper, Daniel Eid Rodriguez, Kenneth Buetow, Bret Beheim, Andrei Irimia, Gregory S. Thomas, Randall C. Thompson, Horus Team, Margaret Gatz, Jonathan Stieglitz, Caleb E. Finch, Michael Gurven, Hillard Kaplan

ESI Publications

Poor oral health is associated with cardiovascular disease and dementia. Potential pathways include sepsis from oral bacteria, systemic inflammation, and nutritional deficiencies. However, in post-industrialized populations, links between oral health and chronic disease may be confounded because the lower socioeconomic exposome (poor diet, pollution, low physical activity) often entails insufficient dental care. We assessed tooth loss, caries, and damaged teeth, in relation to cardiovascular and brain aging among the Tsimane, a subsistence population living a relatively traditional forager-horticulturalist lifestyle with poor dental health, but minimal cardiovascular disease and dementia. Dental health was assessed by a physician in 739 participants aged …

How Marital Stress May Affect The Onset Of Dementia In Older Adults, Khunza Asma

All Graduate Theses, Dissertations, and Other Capstone Projects

Marital stress has been identified as a significant factor influencing the cognitive health of older adults, with emerging evidence suggesting a potential link between marital discord and the risk of developing dementia. This study will review the existing literature on the relationship between chronic stress, depression, marital discord, and the development of cognitive impairment which can increase the risk of developing dementia in older adults. However, the purpose of studying how marital stress affects the onset of dementia is to deepen our understanding of the complex interplay between psychosocial factors and cognitive health in older adults, with the ultimate goal …

Perceptions Of Acute Care Telemedicine Among Caregivers For Persons Living With Dementia: A Qualitative Study, Anita Chary, Norvin Hernandez, Ana Paulina Rivera, Vivian Ramont, Tracey Obi, Ilianna Santangelo, Christine Ritchie, Hardeep Singh, Emily Hayden, Aanand D Naik, Shan Liu, Maura Kennedy

Faculty, Staff and Student Publications

Persons living with dementia (PLWD) have high emergency department (ED) utilization. Little is known about using telemedicine with PLWD and caregivers as an alternative to ED visits for minor acute health problems. This qualitative interview-based study elicited caregivers' perspectives about the acceptability of telemedicine for acute complaints. We performed telephone interviews with 28 caregivers of PLWD from two academic EDs, one in the Northeast and another in the South. Using a combined deductive-inductive approach, we coded interview transcripts and elucidated common themes by consensus. All caregivers reported they would need to participate in the telemedicine visit to help overcome communication …

Effective Communication With People With Dementia: An Exploratory Study Of Pre-Registration Occupational Therapy Students, Samita Kirve, Lucy Perkins

Journal of Occupational Therapy Education

Dementia is a major global concern, with 50 million people already affected worldwide in 2018, and this number is expected to triple by 2050. Healthcare practitioners, specifically occupational therapists, are responsible for providing care and ensuring the well-being of people with dementia. However, occupational therapy students may not always have the necessary knowledge and skills to effectively communicate and support dementia patients, which could negatively impact the quality of care they provide. To explore this issue, a study was conducted with final-year pre-registration occupational therapy students at a public university in England. The study used a qualitative methodology, with semi-structured …

Dementia Education Opportunities For Pre-Registration Occupational Therapy And Physiotherapy Students- A Scoping Review, Samita Kirve, Alice Teague

Journal of Occupational Therapy Education

The number of dementia diagnoses is ever-increasing in the aging population, meaning that healthcare staff need to be equipped with the appropriate knowledge, attitudes, and skills to care for people with dementia. However, recent research suggests that globally, both healthcare workers and students require greater dementia education opportunities to meet the needs of people with dementia. There seems to be limited research exploring dementia education opportunities within occupational therapy (OT) and physiotherapy (PT) programs. A scoping review methodology was chosen to explore the literature about dementia education in global OT and PT programs. There was limited literature in this area …

Refinement Of An Emergency Department-Based, Advance Care Planning Intervention For Patients With Cognitive Impairment And Their Caregivers, Kei Ouchi, Christopher Joshi, Jenson Kaithamattam, Seth A Gale, Gad A Marshall, Alison Pietras, Wei Wang, Edward W Boyer, James A Tulsky, Susan D Block, Dorene Rentz, Mara A Schonberg

Faculty, Staff and Student Publications

Background and objectives: Advance care planning (ACP) conversations are important to provide goal-concordant care (i.e., the care that matches the patient's previously stated goals) near end of life. While 31% of older adults presenting to the emergency department (ED) have dementia, only 39% have previously had ACP conversations. We refined and piloted an ED-based, motivational interview designed to stimulate ACP conversations (ED GOAL) for patients living with cognitive impairment and their caregivers.

Research design and methods: We systematically refined ED GOAL and then conducted an acceptability study in an urban, academic medical center. We prospectively enrolled adults aged 50+ with …

Subjective Cognitive Decline: Examining The Contributions Of Adverse Childhood Experiences And Social Determinants Of Health, Amber Victoria Rusch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Subjective cognitive decline is one’s awareness of their own consistent memory loss or confusion that interrupts their day-to-day activities (CDC, 2022; Roehr et al., 2017). Several risk factors for subjective cognitive decline, such as demographic social determinants of health (SDOH) and adverse childhood experiences (ACEs) have been identified through previous research (Alzheimer’s Association, 2016; Dening & Sandilyan, 2015); however, less is known about the interaction between demographic SDOH and ACEs on subjective cognitive decline. The current study sought to examine how demographic SDOH (i.e., age, sex, race, and education) (research question 1) and ACEs (i.e., physical abuse, sexual abuse, and …

Psychosocial Factors Associated With Physical Activity In People With Dementia: A Pilot Cross-Sectional Study, Nicolas Farina, Uzma Niazi, Riona Mc Ardle, Johanna Eronen, Ruth Lowry, Sube Banerjee

Peninsula Medical School

Objectives: To understand how psychosocial factors associated with physical activity differ based on disease severity in people with dementia, and how these factors are associated with physical activity participation. Methods: Eighty-seven people with dementia, alongside their family carer were asked to complete a series of questions related to physical activity participation, including barriers, motivators, and facilitators. Regression models were developed to understand how psychosocial factors were associated with physical activity participation in the cohort. Results: In the final models, only the absence of intrapersonal barriers was associated with overall physical activity and regular moderate-to-vigorous physical activity. Feelings of relatedness were …

The Experiences Of Older Immigrants Living With Dementia In Australia: A Multi-Method Secondary Analysis, Pelden Chejor

Theses: Doctorates and Masters

The ageing immigrant population and rising dementia cases underscores the need for culturally appropriate dementia care services. However, accessing dementia care services can be challenging for immigrants due to cultural and linguistical differences including their health beliefs. Understanding the experiences and concerns of older immigrants living with dementia is imperative for the planning and delivery of culturally and linguistically appropriate care. The aim of this thesis was to explore and describe the experiences of older immigrants living with dementia, as well as to describe and compare (against non-immigrants living with dementia) the characteristics (neuropsychiatric symptoms and pain characteristics) of older …

Association Of Circulating Ketone Bodies With Cognitive Performance And Dementia In The Multi-Ethnic Study Of Atherosclerosis (Mesa), Parag Anilkumar Chevli, Christopher L Schaich, Alexis C Wood, Luqman A Tk, Anurag Mehta, Vardhmaan Jain, Margery Connelly, Suzanne Craft, Elad Shemesh, José A Luchsinger, Kathleen M Hayden, Bonnie Colleen Sachs, Timothy M Hughes, Michael D Shapiro

Faculty, Staff and Students Publications

Introduction

Growing interest centers on the association between circulating ketone bodies (KB) and cognitive function, notably in aging and neurodegenerative diseases.

Methods

Associations of plasma KB with incident dementia and cognitive performances were examined among Multi‐Ethnic Study of Atherosclerosis (MESA) participants. KB were measured using plasma samples collected following an overnight fasting at Exam 1 (2000–02) and detailed cognitive testing at Exam 5 (2010–2012, N = 4392), Exam 6 (2016–2018, N = 1838), and in MESA‐MIND (2019–2021, N = 2060).

Results

Over 16.7 years, a doubling of total KB was associated with a greater risk of incident dementia (hazard ratio …

Outcomes From An Interprofessional, Dementia-Focused, Telementoring Program: A Brief Report, Julianna Fernandez, Kathryn S Agarwal, Amber B Amspoker, Kyler M Godwin, Erial Green, Sabrina Pickens, Jasmin Lindo, Ali Abbas Asghar-Ali

Faculty, Staff and Students Publications

Despite a burgeoning older-adult population, the number of healthcare professionals with geriatric expertise continues to lag behind. In 2014, the American Geriatrics Society’s position statement encouraged interprofessional training for healthcare professionals. Telementoring remotely connects clinicians with specialists for education and group mentoring. This dementia-focused, 11-month, 1-hour each, telementoring program was modeled on the Alzheimer’s Association ECHO. Our interprofessional expert panel consisted of a geriatrician, a geriatric psychiatrist, an adult nurse practitioner (with geriatrics expertise), 2 geriatric pharmacists, a licensed social worker (coordinating a dementia day program), and a project coordinator. Learners were residents in family medicine and general psychiatry, physician …

Parkinson's Disease And Other Alzheimer's Disease And Related Dementia Pathologies And The Progression Of Parkinsonism In Older Adults, Aron S Buchman, Lei Yu, Shahram Oveisgharan, Andrea R Zammit, Tianhao Wang, Joshua M Shulman, Veronique Vanderhorst, Sukrit Nag, David A Bennett

Faculty, Staff and Students Publications

BACKGROUND: The interrelationship of parkinsonism, Parkinson's disease (PD) and other Alzheimer's disease (AD) and Alzheimer's disease and related dementias (ADRD) pathologies is unclear.

OBJECTIVE: We examined the progression of parkinsonian signs in adults with and without parkinsonism, and their underlying brain pathologies.

METHODS: Annual parkinsonian signs were based on a modified Unified Parkinson's Disease Rating Scale. We used linear mixed effects models to compare the progression of parkinsonian signs in 3 groups categorized based on all available clinical evaluations: Group1 (never parkinsonism or clinical PD), Group2 (ever parkinsonism, but never clinical PD), Group3 (ever clinical PD). In decedents, we examined …

Hearing Loss As A Risk Factor For Cognitive Decline In The Elderly: A Rapid Review, Natalie Large, Nannette Nicholson

Internet Journal of Allied Health Sciences and Practice

Purpose: The aim of this rapid review was to identify and evaluate evidence exploring hearing loss as a risk factor for cognitive decline in the elderly population. Methods: A literature search was performed in three databases: CINAHL, Cochrane Central, and PubMed. The PRISMA template was used to record the search and selection process. Search criteria included older adults aged 65 and up with diagnosed or self-reported hearing loss and no previous diagnosis of dementia or Alzheimer’s disease. Participants were excluded if they had been diagnosed with dementia or tested for it before the study began. Hearing loss was categorized using …

Bridging The Gaps: Characterizing Alzheimer's Disease In Native Hawaiian And Pacific Islander Populations, Justina P. Tavana

Theses and Dissertations

This dissertation addresses critical gaps in dementia research in Native Hawaiian and Pacific Islander (NHPI) communities. Focusing on Samoan and Tongan communities, the study successfully adapted and validated the AD8 informant interview and the Clinical Dementia Rating (CDR) scale in native languages, establishing these instruments as reliable tools for detecting cognitive impairment in these populations. The research process prioritized meaningful community engagement and forged partnerships with indigenous professionals, ensuring alignment with and responsiveness to the specific needs of the community. These invaluable connections were the foundation of making this difficult work possible. Subjects assessed with these adapted instruments were enrolled …

Dementia Diagnosis And Personality Change, Molly Pavek

Counselor Education Capstones

The diagnosis of dementia is typically overlooked when thinking about mental health. It has been around for over a century, yet there have been minimal breakthroughs in research. This diagnosis is quite complicated, given the unexpected and sometimes abrupt nature of symptoms. There is still no cure and there are no medications that stop, slow down, or reverse the diagnosis. Several cognitive and behavioral symptoms accompany a dementia diagnosis; a change in personality being one of the most apparent. Researching personality changes over time, allows researchers discover patterns among the diagnosed and medical professionals, the diagnosed, and caregivers of the …

The Mex-Cog Cognitive Assessment Battery: Discriminant Analysis Of The Cognitive Performance Profile In Older Adults, Silvia Mejia-Arango, Sara Aguilar-Navarro, Alberto José Mimenza-Alvarado

School of Medicine Publications

Objective. To analyze the cognitive profile of a clinical sample using the Mex-Cog cognitive battery and establish which cognitive measures and domains contribute most to group separation.

Materials and methods. A group of 145 older adults previously diagnosed with dementia (n= 47), mild cognitive impairment MCI (n= 47), or as cognitively normal (n= 51) were assessed with the Mex-Cog cognitive battery. Six linear discriminant analyses (LDA) were estimated to compare dementia vs. cognitively normal, MCI vs. cognitively normal, and MCI vs. dementia, using ten individual measures and six cognitive domains. We used a leave-one-out cross-validation procedure to evaluate the predictive …

Implementing An Alzheimer’S And Dementia Library Outreach Program: A Partnership Between The Nebraska Chapter Of The Alzheimer’S Association And Nebraska Libraries, Casey Wilkinson

Theses/Capstones/Creative Projects

This paper focuses on the establishment of an Alzheimer’s and dementia library outreach program in Nebraska, initiated by the Nebraska Chapter of the Alzheimer’s Association. The program aims to address the lack of community resources and support for individuals affected by dementia-related diseases in Nebraska. Extensive research, including interviews with successful library outreach programs globally, informed the program's foundation. A survey distributed to Nebraska libraries had a stellar response rate, with 57 libraries expressing interest in collaborating. An in-depth guide was created and distributed to the interested libraries, outlining program components such as educational programming, support groups, and a designated …

Shared Disposition Decision Making In The Emergency Department For Persons Living With Dementia, Justine Seidenfeld, Fernanda Bellolio, Anita Vashi, Courtney Van Houtven, Susan Hastings

Journal of Geriatric Emergency Medicine

N/A

Shared Care Networks Assisting Older Adults: New Insights From The National Health And Aging Trends Study, Mengyao Hu, Vicki A Freedman, Sarah E Patterson, Nora Lewis

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: Caregiving research often assumes older adults receiving care have a primary caregiver who provides the bulk of care. Consequently, little is known about the extent to which care responsibilities are shared more evenly within a care network, the characteristics associated with sharing, or the consequences for meeting older adults' care needs.

RESEARCH DESIGN AND METHODS: We analyze a sample of U.S. older adults receiving care from the 2011 National Health and Aging Trends Study (n = 2,398). Based on variables reflecting differences in care hours, activities, and care provided by the whole network, we create network typologies …