Medicine and Health Sciences Commons^™

Risk Factors For Falls In Homebound Community-Dwelling Older Adults, Yunchuan (Lucy) Zhao, Jenny Alderden, Bonnie Lind, Jennifer Stibrany

Nursing Faculty Publications and Presentations

Objective: To examine risk factors associated with falls among homebound community-dwelling older adults, a vulnerable population often possessing functional disabilities and chronic conditions.

Design and Sample: The study was a cross-sectional study utilizing round 6 data of the National Health and Aging Trend Study (NHATS). Descriptive statistics and multiple logistic regression analyses were conducted. A total of 1,356 homebound community-dwelling older adults aged 65 and above participated in the NHATS.

Measures: The outcome variable was falls within the last month reported in NHATS. Independent variables were selected based on the NHATS disability conceptual model and literature review, including personal conditions, …

Using Participant Observation To Enable Critical Understandings Of Disability In Later Life: An Illustration Conducted With Older Adults With Low Vision, Colleen E. Mcgrath

Occupational Therapy Publications

Research with older adults aging with vision loss has typically been informed by a biomedical theoretical framework. With a growing focus, however, on critical disability perspectives, which locates disability within the environment, new methods of data collection, such as participant observation, are needed. This article, which reports on the findings from a critical ethnographic study conducted with older adults with age-related vision loss (ARVL), aims to share those insights gained through participant observation and to demonstrate the utility of this method. Three insights were gained including the adaptive strategies tacitly employed to navigate the physical environment, a grounded understanding of …

Semi-Recumbent Vibration Exercise In Older Adults: A Pilot Study Of Methodology, Feasibility, And Safety, Murad Taani, Ellen Siglinsky, Jessie Libber, Diane Krueger, Neil Binkley, Christine R. Kovach, Bjoern Buehring

Nursing Faculty Articles

Objectives: Older adults with impaired physical function are at risk for further functional decline in part due to limited ability to engage in regular exercise. Effective approaches to exercise in this vulnerable population are needed to improve functional capacity and optimize independence.

Methods: Thirty-two residential care apartment complex (RCAC) residents, age ≥70, with low short physical performance battery (SPPB) scores were recruited and randomly assigned to a crossover-design study exploring feasibility and safety of semi-recumbent vibration exercise in older adults living in one RCAC. The primary outcomes were retention and adherence rates and adverse events.

Results: The retention rate was …

An Interdisciplinary Framework For Impacting Older Adults Health And Physical Activity, Christopher J. Dondzila, Elaine Vandoren

Funded Articles

The exploration of feasible and cost-effective strategies is warranted to mitigate rising healthcare costs and lessen the impact of chronic diseases, functional decline, and disability in older adults. The overwhelming sedentariness of older adults is accompanied by a lack of expertise by healthcare professionals in exercise programming that acknowledge factors influencing physical activity (PA) patterns. We present a framework for a nursing/exercise science interdisciplinary effort to increase PA and improve health in older adults via the delivery of individually tailored exercise programming for an 8-week intervention. Results from this study will be integral in translating effective interdisciplinary efforts across diverse …

Association Of Fish Oil And Physical Activity On Mobility Disability In Older Adults, Anoop T. Balachandran

Publications and Research

Purpose: This study aimed to examine whether long-term fish oil (FO) supplementation is associated with a lower risk of mobility disability and enhances benefits of physical activity (PA). Methods: A total of 1635 sedentary adults age 70 to 89 yr from the Lifestyle Interventions and Independence for Elders single-blinded randomized,multicenter clinical trial, which compared a structured PA program to a health education program. Primary outcome was incident major mobility disability (MMD), defined by loss of ability to walk 400 m, measured every 6 months for an average of 2.6 yr. Secondary outcomes included persistent mobility disability, Short Physical Performance Battery, …

Primary Care Providers' Attitudes And Practices Regarding Cancer Screening In Older Adults., Randa Sifri, Brooke Salzman, Amy Cunningham, Alexis Silverio, Madalene Zale, Christine Talerico

Department of Family & Community Medicine Faculty Papers

Introduction: Cancer-screening decisions for older adults should be individualized. However, conducting such complex shared decisions may be challenging for primary care providers (PCPs). Additionally, there is little information on how PCPs make these decisions. This study consisted of a provider survey and chart review to assess current PCP approaches to breast and colorectal cancer (CRC) screening with patients age ≥75.

Methods: PCP survey questions: panel age, comfort with discussion of screening harms and benefits, screening decision-making process, and discussion style. One Hundred charts were chosen from a random sample of male and female patients ≥75 with a recent office …

Mostly White, Christian, And Straight: Informational And Institutional Erasure Of Lgbtq And Ethnoculturally Diverse Older Adults On Long-Term Care Homes Websites, Ferzana Chaze, Sulaimon Giwa, Nellie Groenenberg, Bianca Burns

Publications and Scholarship

The website of a long-term care home is the face of the organization, providing not only a snapshot view of the home’s programs and services, but also an insight into the organization’s vision, mission, policies, and culture. The website provides information—either purposefully or inadvertently—about the manner in which the organization responds to diversity among its residents. Guided by an intersectional analysis, this study uses content analysis to examine websites of long-term care homes run by companies, municipalities, and not-for-profit organizations in two provinces in Canada to understand how these websites demonstrate inclusion towards ethnoculturally diverse and LGBTQ older adults. Findings …

Whey Protein Supplementation Post Resistance Exercise In Elderly Men Induces Changes In Muscle Mirna's Compared To Resistance Exercise Alone, Randall F. D'Souza, Nina Zeng, James F. Markworth, Vandre C. Figueiredo, Christopher P. Hedges, Aaron C Petersen, Paul A Della Gatta, David Cameron-Smith, Cameron J. Mitchell

Center for Muscle Biology Faculty Publications

Progressive muscle loss with aging results in decreased physical function, frailty, and impaired metabolic health. Deficits in anabolic signaling contribute to an impaired ability for aged skeletal muscle to adapt in response to exercise and protein feeding. One potential contributing mechanism could be exerted by dysregulation of microRNAs (miRNAs). Therefore, the aim of this study was to determine if graded protein doses consumed after resistance exercise altered muscle miRNA expression in elderly men. Twenty-three senior men (67.9 ± 0.9 years) performed a bout of resistance exercise and were randomized to consume either a placebo, 20 or 40 g of whey …

Testing An Implementation Strategy Bundle On Adoption And Sustainability Of Evidence To Optimize Physical Function In Community-Dwelling Disabled And Older Adults In A Medicaid Waiver: A Multi-Site Pragmatic Hybrid Type Iii Protocol, Sandra L. Spoelstra, Monica Schueller, Alla Sikorskii

Funded Articles

Background: In partnership with a state Medicaid home and community-based waiver program, this study tests implementation strategies for adoption and sustainability of an evidence-based intervention to support disabled and older adults who have difficulty with physical function and daily living tasks. A multi-level implementation strategy bundle will be directed at relationship, coalition, and team building; readiness to implement, leadership, and clinician attitude toward evidence assessments; intervention and facilitation training; interdisciplinary coordination; facilitation; and audit and feedback to support practice change.

Methods: Knowledge-to-Action model underpins this 2-arm, 3-year pragmatic mixed method randomized hybrid type III trial in 18 waiver program sites …

Looking For Age Differences In Self-Driving Vehicles: Examining The Effects Of Automation Reliability, Driving Risk, And Physical Impairment On Trust, Ericka Rovira, Anne Collins Mclaughlin, Richard Pak, Luke High

Publications

Purpose

Self-driving cars are an extremely high level of autonomous technology and represent a promising technology that may help older adults safely maintain independence. However, human behavior with automation is complex and not straightforward (Parasuraman and Riley, 1997; Parasuraman, 2000; Rovira et al., 2007; Parasuraman and Wickens, 2008; Parasuraman and Manzey, 2010; Parasuraman et al., 2012). In addition, because no fully self-driving vehicles are yet available to the public, most research has been limited to subjective survey-based assessments that depend on the respondents’ limited knowledge based on second-hand reports and do not reflect …

A Protocol Paper On The Preservation Of Identity: Understanding The Technology Adoption Patterns Of Older Adults With Age-Related Vision Loss (Arvl), Colleen E. Mcgrath

Occupational Therapy Publications

There are a growing number of older adults with age-related vision loss (ARVL) for whom technology holds promise in supporting their engagement in daily activities. Despite the growing presence of technologies intended to support older adults with ARVL, there remains high rates of abandonment. This phenomenon of technology abandonment may be partly explained by the concept of self-image, meaning that older adults with ARVL avoid the use of particular technologies due to an underlying fear that use of such technologies may mark them as objects of pity, ridicule, and/or stigmatization. In response to this, the proposed study aims to understand …

Observation And Self-Report Of Fun And Social Engagement Of Nursing Home Residents During Bingocize®, Lauren Rene Stevens

Masters Theses & Specialist Projects

Individuals in certified nursing facilities (CNF) often experience social isolation and have limited opportunities to exercise. Bingocize®, an evidence-based healthpromotion program, is a combination of exercise and Bingo and provides opportunities for CNF resident interaction. Limited tools are available to quantify social engagement displayed by nursing home residents. Research suggests that intergenerational programming can positively affect social engagement. The present pilot study focused on the implementation of the Fun and Social Engagement (FUSE) evaluation to measure social engagement displayed by nursing home residents during Bingocize® sessions. The FUSE combined observation and self-report measures to yield a total social engagement score. …

Association Between Perceived Physical Activity And Cognitive Function In Older Adults, Paul D. Loprinzi, Emily Frith

Faculty and Student Publications

© The Author(s) 2018. There is irrefutable evidence that regular participation in physical activity is favorably associated with numerous positive health outcomes, including cognitive function. Emerging work suggests that perceived physical activity, independent of actual physical activity behavior, is inversely associated with mortality risk. In this study, we evaluate whether perceived physical activity, independent of actual physical activity, is associated with cognitive function, a robust indicator of mortality risk. Data from the cross-sectional 1999–2002 National Health and Nutrition Examination Survey were employed (N = 2352; 60+ years of age). Actual physical activity was assessed via a validated survey. Perceived physical …

Mindfulness-Based Stress Reduction Intervention For The Treatment Of Chronic Pain In The Elderly, Austin Roadarmel, Diane Reibel, Phd, Aleeze Moss, Phd, Andrew Newberg, Md

Phase 1

One of the most common complaints of adults in their 80s and above, a growing portion of our population, is chronic pain and it is often inadequately treated. A secular mindfulness-based stress reduction (MBSR) program was developed by Jon Kabat-Zinn in 1979 and has since shown measurable benefits to individuals in decreasing depression, pain, and anxiety. Considering the significant risk of side effects and age-associated changes of pharmacodynamics and pharmacokinetics in the traditional pharmacologic approach to chronic pain in the elderly, non-pharmacologic intervention such as MBSR may be particularly effective for the elderly population.

Methods: We conducted a 6 week, …

Emergency Medicine Palliative Care Access (Empalla): Protocol For A Multicentre Randomised Controlled Trial Comparing The Effectiveness Of Specialty Outpatient Versus Nurse-Led Telephonic Palliative Care Of Older Adults With Advanced Illness, Corita R. Grudzen, Deborah J. Shim, Abigail M. Schmucker, Jeanne Cho, Keith S. Goldfeld

Student Papers, Posters & Projects

Introduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.

Methods and analysis This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of …

The Effect Of Volunteers’ Care And Support On The Health Outcomes Of Older Adults In Acute Care: A Systematic Scoping Review, Rosemary Saunders, Karla Seaman, Renée Graham, Angela Christiansen

Research outputs 2014 to 2021

Aim: To examine the available evidence on the effects of care and support provided by volunteers on the health outcomes of older adults in acute care services.

Background: Acute hospital inpatient populations are becoming older, and this presents the potential for poorer health outcomes. Factors such as chronic health conditions, polypharmacy and cognitive and functional decline are associated with increased risk of health care‐related harm, such as falls, delirium and poor nutrition. To minimise the risk of health care‐related harm, volunteer programmes to support patient care have been established in many hospitals worldwide.

Design: A systematic scoping review.

Methods: The …

Association Of Depressive Symptoms With Incident Cardiovascular Diseases In Middle-Aged And Older Chinese Adults, Haibin Li, Deqiang Zheng, Zhiwei Li, Zhiyuan Wu, Wei Feng, Xue Cao, Jiaxin Wang, Qi Gao, Xia Li, Wei Wang, Brian J. Hall, Yu-Tao Xiang, Xiuhua Guo

Research outputs 2014 to 2021

Importance: The prevalence of depressive symptoms among older adults has become an increasingly important public health priority. Elevated depressive symptoms are well documented among elderly people with cardiovascular disease (CVD), but studies conducted among Chinese adults are scarce. Objective: To estimate the association between depressive symptoms and incident CVD among middle-aged and older Chinese adults. Design, Setting, and Participants: The China Health and Retirement Longitudinal Study is an ongoing nationally representative prospective cohort study that was initiated in 2011. This cohort study included 12 417 middle-aged and older Chinese adults without heart disease and stroke at baseline. Statistical analysis was …

Validity Of The Falls Risk For Older People In The Community (Frop‑Com) Tool To Predict Falls And Fall Injuries For Older People Presenting To The Emergency Department After Falling, Marlon Mascarenhas, Keith D. Hill, Anna Barker, Elissa Burton

Health Sciences Papers and Journal Articles

The aims of this study were to (1) externally validate the accuracy of the Falls Risk for Older People in the Community (FROP-Com) falls risk assessment tool in predicting falls and (2) undertake initial validation of the accuracy of the FROPCom to predict injurious falls (requiring medical attention) in people aged ≥ 60 years presenting to emergency departments (EDs) after falling. Two hundred and thirteen participants (mean age = 72.4 years; 59.2% women) were recruited (control group of a randomised controlled trial). A FROP-Com assessment was completed at a home visit within 2 weeks of ED discharge. Data on falls …

Complementary Medicine Use And Health Literacy In Older Australians, Caroline A. Smith, Esther Chang, Gisselle Gallego

Medical Papers and Journal Articles

Objectives: To investigate whether complementary medicine (CAM) use is associated with health literacy levels and decision self-efficacy.

Design: A cross-sectional survey was distributed to men and women aged 65 years and older who participated in a randomised control trial (N = 153) in Sydney, Australia.

Results: One hundred and fifty-three people completed the survey of those 66% were females and the mean age was 76 years. Most participants used or were currently using CAM in the past 12 months (75%). The most common source of CAM information were GPs. Participants with higher levels of social support were found more likely …

Attitudes And Factors Involved In Decision-Making Around Complementary And Alternative Medicines (Cams) By Older Australians: A Qualitative Study, Gisselle Gallego, Saira Gugnani, Mike Armour, Caroline A. Smith, Esther Chang

Medical Papers and Journal Articles

Introduction: Recent evidence has indicated that older Australians are increasingly turning to complementary and alternative medicines (CAMs) to address a variety of health issues. This qualitative study aimed to explore the attitudes and factors involved in decision-making around CAMs by older Australians upon the completion of a CAM educational intervention.

Methods: Men and women aged over 65 years living in New South Wales, Australia were invited to participate in semi-structured interviews after taking part in a randomised control trial. Interviews were analysed using the framework approach.

Results: A total of 20 participants aged over 65 years were interviewed. Themes captured …

The Role Of Neck Musculature In Traumatic Brain Injuries In Older Adults: Implications From Sports Medicine, Tyler A. Wood, Steven Morrison, Jacob J. Sosnoff

Rehabilitation Sciences Faculty Publications

Traumatic brain injuries (TBIs) are common and serious injuries to older adults. The majority of TBIs in older adults are sustained when the head impacts the ground or other surface during a fall. While several non-modifiable risk factors have been identified for fall-related TBIs in older adults, there still remains a dearth of knowledge surrounding modifiable risk factors. Thus, this significant knowledge gap warrants an investigation into research across disciplines. The sports medicine literature has examined several modifiable risk factors to prevent a mild form of TBI known as concussion. While this research has identified several risk factors, one particular …

Nursing Students' Willingness To Care For Older Adults, Insun Jang, Younglee Kim, Phoebe (Yeon) S. Kim

Nursing Faculty Publications

The older adult population has increased and is projected to grow. This population usually has chronic disorders that need continuous care. However, it has been reported nurses and nursing students have negative attitude towards older adults. This descriptive study aimed at investigating factors influencing nursing students’ willingness to care for older adults. This study was conducted among 270 nursing students at the university in the United States from February 1 to February 28, 2017. Study participants answered the survey about quality and frequency of contact with older adults, anxiety about aging, empathy, attitude, and willingness to care for older adults. …