Digital Commons Network^™

Towards A Remote Patient Monitoring Platform For Comprehensive Risk Evaluations For People With Diabetic Foot Ulcers, Gozde Cay, M G Finco, Jason Garcia, Jill L Mcnitt-Gray, David G Armstrong, Bijan Najafi

Center on Aging Staff Publications

Diabetic foot ulcers (DFUs) significantly affect the lives of patients and increase the risk of hospital stays and amputation. We suggest a remote monitoring platform for better DFU care. This system uses digital health metrics (scaled from 0 to 10, where higher scores indicate a greater risk of slow healing) to provide a comprehensive overview through a visual interface. The platform features smart offloading devices that capture behavioral metrics such as offloading adherence, daily steps, and cadence. Coupled with remotely measurable frailty and phenotypic metrics, it offers an in-depth patient profile. Additional demographic data, characteristics of the wound, and clinical …

Mapping Brain Function In Adults And Young Children During Naturalistic Viewing With High-Density Diffuse Optical Tomography, Kalyan Tripathy, Morgan Fogarty, Alexandra M Svoboda, Mariel L Schroeder, Sean M Rafferty, Edward J Richter, Christopher Tracy, Patricia K Mansfield, Madison Booth, Andrew K Fishell, Arefeh Sherafati, Zachary E Markow, Muriah D Wheelock, Ana María Arbeláez, Bradley L Schlaggar, Christopher D Smyser, Adam T Eggebrecht, Joseph P Culver

2020-Current year OA Pubs

Human studies of early brain development have been limited by extant neuroimaging methods. MRI scanners present logistical challenges for imaging young children, while alternative modalities like functional near-infrared spectroscopy have traditionally been limited by image quality due to sparse sampling. In addition, conventional tasks for brain mapping elicit low task engagement, high head motion, and considerable participant attrition in pediatric populations. As a result, typical and atypical developmental trajectories of processes such as language acquisition remain understudied during sensitive periods over the first years of life. We evaluate high-density diffuse optical tomography (HD-DOT) imaging combined with movie stimuli for high …

Academic Detailing As A Health Information Technology Implementation Method: Supporting The Design And Implementation Of An Emergency Department-Based Clinical Decision Support Tool To Prevent Future Falls, Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson

Faculty, Staff and Student Publications

BACKGROUND: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation.

OBJECTIVE: This study aimed to assess academic detailing as a method for simultaneously ensuring the correct …

Fedfsa: Hybrid And Federated Framework For Functional Status Ascertainment Across Institutions, Sunyang Fu, Heling Jia, Maria Vassilaki, Vipina K Keloth, Yifang Dang, Yujia Zhou, Muskan Garg, Ronald C Petersen, Jennifer St Sauver, Sungrim Moon, Liwei Wang, Andrew Wen, Fang Li, Hua Xu, Cui Tao, Jungwei Fan, Hongfang Liu, Sunghwan Sohn

Faculty, Staff and Student Publications

Introduction: Patients' functional status assesses their independence in performing activities of daily living, including basic ADLs (bADL), and more complex instrumental activities (iADL). Existing studies have discovered that patients' functional status is a strong predictor of health outcomes, particularly in older adults. Depite their usefulness, much of the functional status information is stored in electronic health records (EHRs) in either semi-structured or free text formats. This indicates the pressing need to leverage computational approaches such as natural language processing (NLP) to accelerate the curation of functional status information. In this study, we introduced FedFSA, a hybrid and federated NLP framework …

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), …

Shaping The Future Of Vascular Care: The Evolution Of Advanced Practice Providers (Apps)., Alexandra Moran Baird, Katherine Hays, Danielle Vlazny

Medical Education Articles

No abstract provided.

Physical Activity Patterns Within Dementia Care Dyads, N Farina, R Mcardle, Rg Lowry, S Banerjee

Peninsula Medical School

Previous research has explored the physical activity habits of people with dementia and their family carers separately, with little consideration of how physical habits are associated within dyads. In this observational study, we sought to explore the relationship between people with dementia and their carers' physical activity, at a group level and at a dyadic level. Twenty-six participant dyads (persons with dementia and their carer spouses) were asked to wear an accelerometer for 30 days continuously. Comparisons were made at a group level and a dyadic level. People with dementia did not participate in significantly more moderate to vigorous physical …

Mitochondrial Involvement In Sarcopenia, Charles Affourtit, Jane E. Carré

School of Biomedical Sciences

Sarcopenia lowers the quality-of-life for millions of people across the world, as accelerated loss of skeletal muscle mass and function contributes to both age- and disease-related frailty. Physical activity remains the only proven therapy for sarcopenia to date, but alternatives are much sought after to manage this progressive muscle disorder in individuals who are unable to exercise. Mitochondria have been widely implicated in the etiology of sarcopenia and are increasingly suggested as attractive therapeutic targets to help restore the perturbed balance between protein synthesis and breakdown that underpins skeletal muscle atrophy. Reviewing current literature, we note that mitochondrial bioenergetic changes …

The Application Of Digital Frailty Screening To Triage Nonhealing And Complex Wounds, Ram Kinker Mishra, Rasha O Bara, Alejandro Zulbaran-Rojas, Catherine Park, Malindu E Fernando, Jeffrey Ross, Brian Lepow, Bijan Najafi

Center on Aging Staff Publications

Objective: We investigated the association between the complexity of diabetic foot ulcers (DFUs) and frailty.

Research design and methods: Individuals (n = 38) with Grade 2 Wagner DFU were classified into 3 groups based on the Society for Vascular Surgery risk-stratification for major limb amputation as Stage 1 at very low risk (n = 19), Stage 2 at low risk (n = 9), and Stage 3 to 4 at moderate-to-high risk (n = 10) of major limb amputation. Frailty status was objectively assessed using a validated digital frailty meter (FM). The FM works by quantifying weakness, slowness, rigidity, and exhaustion …

The Conceptual Definition Of Sarcopenia: Delphi Consensus From The Global Leadership Initiative In Sarcopenia (Glis), Ben Kirk, Ellen F Binder, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Sarcopenia, the age-related loss of muscle mass and strength/function, is an important clinical condition. However, no international consensus on the definition exists.

OBJECTIVE: The Global Leadership Initiative in Sarcopenia (GLIS) aimed to address this by establishing the global conceptual definition of sarcopenia.

DESIGN: The GLIS steering committee was formed in 2019-21 with representatives from all relevant scientific societies worldwide. During this time, the steering committee developed a set of statements on the topic and invited members from these societies to participate in a two-phase International Delphi Study. Between 2022 and 2023, participants ranked their agreement with a set of …

Improving Safety And Preventing Falls Using An Evidence-Based, Front-Line Staff Huddling Practice: Protocol For A Pragmatic Trial To Increase Quality Of Care In State Veterans Homes, Princess Nash, Valerie Clark, Eleanor Mcconnell, Whitney Mills, Robert Morgan, Camilla Pimentel, Katherine Ritchey, Cari Levy, A Lynn Snow, Christine Hartmann

Faculty, Staff and Student Publications

Introduction: Falls in nursing homes are a major cause for decreases in residents' quality of life and overall health. This study aims to reduce resident falls by implementing the LOCK Falls Programme, an evidence-based quality improvement intervention. The LOCK Falls Programme involves the entire front-line care team in (1) focusing on evidence of positive change, (2) collecting data through systematic observation and (3) facilitating communication and coordination of care through the practice of front-line staff huddles.

Methods and analysis: The study protocol describes a mixed-methods, 4-year hybrid (type 2) effectiveness-implementation study in State Veterans Homes in the USA. The study …

Risk Factors For Post-Discharge Adverse Outcomes Following Hospitalization Among Older Adults Diagnosed With Elder Mistreatment, Monique R Pappadis, Leila Wood, Allen Haas, Jordan Westra, Yong-Fang Kuo, Charles P Mouton

Faculty, Staff and Student Publications

Using 100% Medicare data files, this study explored whether primary elder mistreatment (EM) diagnosis, EM type, and facility type were associated with 3-year mortality and 1-year unplanned hospital readmission among older patients diagnosed with EM with hospital discharge from 10/01/2015 through 12/31/2018 (n = 11,023). We also examined outcome differences between older patients diagnosed with EM and matched non-EM patient controls. Neglect by others was the most common EM diagnosis. Three-year mortality was 56.7% and one-year readmission rate was 53.8%. Compared to matched non-EM patient controls, older EM patients were at an increased risk of mortality and readmission. Among …

Intracranial Volume Is Driven By Both Genetics And Early Life Exposures: The Sol-Inca-Mri Study, Tamar Sofer, Einat Granot-Hershkovitz, Wassim Tarraf, Paola Filigrana, Carmen R Isasi, Shakira F Suglia, Robert Kaplan, Kent Taylor, Martha L Daviglus, Fernando D Testai, Donglin Zeng, Jianwen Cai, Myriam Fornage, Hector M González, Charles Decarli

Faculty, Staff and Student Publications

Intracranial volume (ICV) reflects maximal brain development and is associated with later-life cognitive abilities. We quantified ICV among first- and second-generation Hispanic and Latino adults from the Study of Latinos-Investigation of Cognitive Aging - MRI (SOL-INCA-MRI), estimated ICV heritability, and tested its associations with previously reported genetic variants, both individually and as a genetic risk score (GRS). We also estimated the association of ICV with early life environmental measures: nativity or age of immigration and parental education. The estimated heritability of ICV was 19% (95% CI, 0.1%-56%) in n=1781 unrelated SOL-INCA-MRI individuals. Four of 10 tested genetic variants were associated …

Calorie Restriction Reduces Biomarkers Of Cellular Senescence In Humans, Zaira Aversa, Susan B Racette, Et Al.

2020-Current year OA Pubs

Calorie restriction (CR) with adequate nutrient intake is a potential geroprotective intervention. To advance this concept in humans, we tested the hypothesis that moderate CR in healthy young-to-middle-aged individuals would reduce circulating biomarkers of cellular senescence, a fundamental mechanism of aging and aging-related conditions. Using plasma specimens from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE™) phase 2 study, we found that CR significantly reduced the concentrations of several senescence biomarkers at 12 and 24 months compared to an ad libitum diet. Using machine learning, changes in biomarker concentrations emerged as important predictors of the change …

Core Requirements Of Frailty Screening In The Emergency Department: An International Delphi Consensus Study, Elizabeth Moloney, Christopher R Carpenter, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Frailty is associated with adverse outcomes among patients attending emergency departments (EDs). While multiple frailty screens are available, little is known about which variables are important to incorporate and how best to facilitate accurate, yet prompt ED screening. To understand the core requirements of frailty screening in ED, we conducted an international, modified, electronic two-round Delphi consensus study.

METHODS: A two-round electronic Delphi involving 37 participants from 10 countries was undertaken. Statements were generated from a prior systematic review examining frailty screening instruments in ED (logistic, psychometric and clinimetric properties). Reflexive thematic analysis generated a list of 56 statements …

Effect Of Testosterone Replacement Therapy On Sexual Function And Hypogonadal Symptoms In Men With Hypogonadism, Karol M Pencina, Thomas G Travison, Glenn R Cunningham, A Michael Lincoff, Steven E Nissen, Mohit Khera, Michael G Miller, Panagiotis Flevaris, Xue Li, Kathleen Wannemuehler, Shalender Bhasin

Faculty, Staff and Students Publications

Context: Few long-term randomized trials have evaluated the efficacy of testosterone replacement therapy (TRT) in improving sexual function and hypogonadal symptoms in men with hypogonadism and whether effects are sustained beyond 12 months.

Objective: The Testosterone Replacement therapy for Assessment of long-term Vascular Events and efficacy ResponSE in hypogonadal men (TRAVERSE) study evaluated the effect of TRT on major adverse cardiovascular events in middle-aged and older men with hypogonadism. The Sexual Function Study, nested within the parent trial, determined testosterone's efficacy in improving sexual activity, hypogonadal symptoms, libido, and erectile function among men reporting low libido.

Methods: Among 5204 men, …

Aging Fly Cell Atlas Identifies Exhaustive Aging Features At Cellular Resolution, Kenneth A Wilson, Sudipta Bar, Eric B Dammer, Enrique M Carrera, Brian A Hodge, Tyler A U Hilsabeck, Joanna Bons, George W Brownridge, Jennifer N Beck, Jacob Rose, Melia Granath-Panelo, Christopher S Nelson, Grace Qi, Akos A Gerencser, Jianfeng Lan, Alexandra Afenjar, Geetanjali Chawla, Rachel B Brem, Philippe M Campeau, Hugo J Bellen, Birgit Schilling, Nicholas T Seyfried, Lisa M Ellerby, Pankaj Kapahi

Faculty, Staff and Students Publications

Dietary restriction (DR) delays aging, but the mechanism remains unclear. We identified polymorphisms in mtd, the fly homolog of OXR1, which influenced lifespan and mtd expression in response to DR. Knockdown in adulthood inhibited DR-mediated lifespan extension in female flies. We found that mtd/OXR1 expression declines with age and it interacts with the retromer, which regulates trafficking of proteins and lipids. Loss of mtd/OXR1 destabilized the retromer, causing improper protein trafficking and endolysosomal defects. Overexpression of retromer genes or pharmacological restabilization with R55 rescued lifespan and neurodegeneration in mtd-deficient flies and endolysosomal defects in fibroblasts from patients with lethal loss-of-function …

Ageannomo: A Knowledgebase Of Multi-Omics Annotation For Animal Aging, Kexin Huang, Xi Liu, Zhaocan Zhang, Tiangang Wang, Haixia Xu, Qingxuan Li, Yuhao Jia, Liyu Huang, Pora Kim, Xiaobo Zhou

Faculty, Staff and Student Publications

Aging entails gradual functional decline influenced by interconnected factors. Multiple hallmarks proposed as common and conserved underlying denominators of aging on the molecular, cellular and systemic levels across multiple species. Thus, understanding the function of aging hallmarks and their relationships across species can facilitate the translation of anti-aging drug development from model organisms to humans. Here, we built AgeAnnoMO (https://relab.xidian.edu.cn/AgeAnnoMO/#/), a knowledgebase of multi-omics annotation for animal aging. AgeAnnoMO encompasses an extensive collection of 136 datasets from eight modalities, encompassing 8596 samples from 50 representative species, making it a comprehensive resource for aging and longevity research. AgeAnnoMO characterizes …

Digital Clock Drawing As An Alzheimer's Disease Susceptibility Biomarker: Associations With Genetic Risk Score And Apoe In Older Adults, L I Thompson, M Cummings, S Emrani, David J. Libon, A Ang, C Karjadi, R Au, C Liu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Alzheimer's disease (AD) is the leading cause of dementia in older adults, but most people are not diagnosed until significant neuronal loss has likely occurred along with a decline in cognition. Non-invasive and cost-effective digital biomarkers for AD have the potential to improve early detection.

OBJECTIVE: We examined the validity of DCTclockTM (a digitized clock drawing task) as an AD susceptibility biomarker.

DESIGN: We used two primary independent variables, Apolipoprotein E (APOE) ε4 allele carrier status and polygenic risk score (PRS). We examined APOE and PRS associations with DCTclockTM composite scores as dependent measures.

SETTING: We used existing data …

A Modified Nucleoside O6-Methyl-2'-Deoxyguanosine-5'-Triphosphate Exhibits Anti-Glioblastoma Activity In A Caspase-Independent Manner., Zi-Hui Wang, Jin Li, Qian Liu, Jian-Chang Qian, Qing-Qing Li, Qing-Yu Wang, Lv-Tao Zeng, Si-Jia Li, Xin Gao, Jia-Xin Pan, Xu-Fan Gao, Kun Wu, Guo-Xin Hu, Tomoo Iwakuma, Jian-Ping Cai

Manuscripts, Articles, Book Chapters and Other Papers

Resistance to temozolomide (TMZ), the frontline chemotherapeutic agent for glioblastoma (GBM), has emerged as a formidable obstacle, underscoring the imperative to identify alternative therapeutic strategies to improve patient outcomes. In this study, we comprehensively evaluated a novel agent, O6-methyl-2'-deoxyguanosine-5'-triphosphate (O6-methyl-dGTP) for its anti-GBM activity both in vitro and in vivo. Notably, O6-methyl-dGTP exhibited pronounced cytotoxicity against GBM cells, including those resistant to TMZ and overexpressing O6-methylguanine-DNA methyltransferase (MGMT). Mechanistic investigations revealed that O6-methyl-dGTP could be incorporated into genomic DNA, disrupting nucleotide pools balance, and inducing replication stress, resulting in S-phase arrest and DNA damage. The compound exerted its anti-tumor properties …

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 …

The Relationship Of Neighborhood Disadvantage, Biological Aging, And Psychosocial Risk And Resilience Factors In Heart Failure Incidence Among Black Persons: A Moderated Mediation Analysis, Ganga S Bey, James R Pike, Anthony S Zannas, Qian Xiao, Bing Yu, Amil M Shah, Priya Palta

Faculty, Staff and Student Publications

Objectives: Deprived living environments contribute to greater heart failure (HF) risk among non-Hispanic Black persons, who disproportionately occupy disadvantaged neighborhoods. The mechanisms for these effects are not fully explicated, partially attributable to an insufficient understanding of the individual factors that contribute additional risk or resilience to the impact of neighborhood disadvantage on health. The objective of this study was, therefore, to clarify the complex pathways over which such exposures act to facilitate more targeted, effective interventions. Given the evidence for a mediating role of biological age and a moderating role of individual psychosocial characteristics in the neighborhood disadvantage-HF link, we …

Developing A National Implementation Strategy To Accelerate Uptake Of Evidence-Based Family Caregiver Support In Us Cancer Centers, J Nicholas Odom, Heather M Young, Katherine Sterba, Timothy S Sannes, Susan Reinhard, Chandylen L Nightingale, Diane Meier, Tamryn F Gray, Betty Ferrell, Maria E Fernandez, Heidi Donovan, Kayleigh Curry, Erin R Currie, Tara Bryant, Marie A Bakitas, Allison J Applebaum

Faculty, Staff and Student Publications

OBJECTIVE: Characterize key factors and training needs of U.S. cancer centers in implementing family caregiver support services.

METHODS: Sequential explanatory mixed methods design consisting of: (1) a national survey of clinicians and administrators from Commission-on-Cancer-accredited cancer centers (N = 238) on factors and training needed for establishing new caregiver programs and (2) qualitative interviews with a subsample of survey respondents (N = 30) to elicit feedback on survey findings and the outline of an implementation strategy to facilitate implementation of evidence-based family caregiver support (the Caregiver Support Accelerator). Survey data was tabulated using descriptive statistics and transcribed interviews were analyzed …

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 …

The Contribution Of Amyloid Deposition In The Aortic Valve To Calcification And Aortic Stenosis, Romeesa Khan, Claudia M Di Gesù, Juneyoung Lee, Louise D Mccullough

Faculty, Staff and Student Publications

Trillions of microbes live symbiotically in the host, specifically in mucosal tissues such as the gut. Recent advances in metagenomics and metabolomics have revealed that the gut microbiota plays a critical role in the regulation of host immunity and metabolism, communicating through bidirectional interactions in the microbiota-gut-brain axis (MGBA). The gut microbiota regulates both gut and systemic immunity and contributes to the neurodevelopment and behaviors of the host. With aging, the composition of the microbiota changes, and emerging studies have linked these shifts in microbial populations to age-related neurological diseases (NDs). Preclinical studies have demonstrated that gut microbiota-targeted therapies can …

Optimizing Delirium Care In The Era Of Age-Friendly Health System, Min Ji Kwak, Sharon K Inouye, Donna M Fick, Alice Bonner, Terry Fulmer, Emily Carter, Victor Tabbush, Kerri Maya, Nicholas Reed, Christine Waszynski, Esther S Oh

Faculty, Staff and Student Publications

Delirium is a significant geriatric condition associated with adverse clinical and economic outcomes. The cause of delirium is usually multifactorial, and person-centered multicomponent approaches for proper delirium management are required. In 2017, the John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI) launched a national initiative, Age-Friendly Health System (AFHS), promoting the use of a framework called 4Ms (what matters, medication, mentation, and mobility). The 4Ms framework's primary goal is to provide comprehensive and practical person-centered care for older adults and it aligns with the core concepts of optimal delirium management. In this special article, we demonstrate how …

The Cost Of Providing Care By Family And Friends (Informal Care) In The Last Year Of Life: A Population Observational Study, Miriam J. Johnson, David C. Currow, Jade Chynoweth, Helen Weatherly, Gamze Keser, Ann Hutchinson, Annie Jones, Laurie Dunn, Victoria Allgar

Peninsula Medical School

Introduction: Little is known about replacement costs of care provided by informal carers during the last year of life for people dying of cancer and non-cancer diseases. Aim: To estimate informal caregiving costs and explore the relationship with carer and decedent characteristics. Design: National observational study of bereaved carers. Questions included informal end-of-life caregiving into the 2017 Health Survey for England including estimated recalled frequency, duration and intensity of care provision. We estimated replacement costs for a decedent’s last year of life valuing time at the price of a substitutable activity. Spearman rank correlations and multivariable linear regression were used …

Harnessing Speech-Derived Digital Biomarkers To Detect And Quantify Cognitive Decline Severity In Older Adults, Gozde Cay, Valeria A Pfeifer, Myeounggon Lee, Mohammad Dehghan Rouzi, Adonay S Nunes, Nesreen El-Refaei, Anmol Salim Momin, Md Moin Uddin Atique, Matthias R Mehl, Ashkan Vaziri, Bijan Najafi

Center on Aging Staff Publications

Introduction: Current cognitive assessments suffer from floor/ceiling and practice effects, poor psychometric performance in mild cases, and repeated assessment effects. This study explores the use of digital speech analysis as an alternative tool for determining cognitive impairment. The study specifically focuses on identifying the digital speech biomarkers associated with cognitive impairment and its severity.

Methods: We recruited older adults with varying cognitive health. Their speech data, recorded via a wearable microphone during the reading aloud of a standard passage, were processed to derive digital biomarkers such as timing, pitch, and loudness. Cohen's d effect size highlighted group differences, and correlations …

Assessing The Acceptability And Effectiveness Of A Novel Therapeutic Footwear In Reducing Foot Pain And Improving Function Among Older Adults: A Crossover Randomized Controlled Trial, M G Finco, Abderrahman Ouattas, Nesreen El-Refaei, Anmol Salim Momin, Mehrnaz Azarian, Bijan Najafi

Center on Aging Staff Publications

Introduction: Nearly, a quarter of older adults suffer from frequent foot pain, impacting their quality of life. While proper footwear can alleviate this, design issues often hinder regular use. This study evaluated novel therapeutic footwear, designed for aesthetics and custom fit, to reduce foot pain. We hypothesized that older adults would experience less foot pain and favor the new footwear over their own.

Methods: This 12-week crossover randomized controlled trial evaluated the effectiveness of OrthoFeet therapeutic footwear on reducing foot pain in older adults (n = 50, age = 65 ± 5, 18% male) with moderate to severe pain. Participants …