Medicine and Health Sciences Commons^™

Mental Health Benefits Of Physical Activity In Older Adults, Adrian Kurt Zitzmann

Master of Science in Nursing Family Nurse Practitioner

Physical activity is the fountain of youth, strengthening both the physical body as well as the mind, leading to better emotional stability and a general sense of well-being. The population over age 65 is nearing retirement age and are transitioning from a high paced work and family life to a slower and less active “empty nest” lifestyle. Among adults over age 65, will implementing an exercise program for 30 minutes per day increase mental well-being? The benefits of physical activity will be supported by gathering a group of older adults ages 65 and up from a local retirement community to …

Rural Health Action Network Enhanced Outreach Initiative. Year One Final Report, Mary Lindsey Smith Phd, Karen Pearson Mlis, Ma, Evelyn Ali Bs

Substance Use Research & Evaluation

Healthy Community Coalition (HCC), in coordination with the Rural Health Action Network (RHAN) of greater Franklin County, is implementing a multi-faceted outreach program to improve health outcomes among the rural poor living with chronic conditions in greater Franklin County, Maine.

The goals of the Franklin County Rural Health Action Network Enhanced Outreach Initiative (RHAN-EOI) include:

• Expand access to quality services;
• Expand training for community health extenders;
• Decrease hospital admissions, emergency department use, and costs; and
• Improve communication and care coordination across project partners

This report highlights the implementation and progress of HCC RHAN in Year 1. For more information, please …

A Qualitative Systematic Review On The Experiences Of Homelessness Among Older Adults, Phuntsho Om, Lisa Whitehead, Caroline Vafeas, Amanda Towell-Barnard

Research outputs 2022 to 2026

Adults who experience homelessness for an extended period of time also experience accelerated ageing and other negative impacts on their general health and wellbeing. Homelessness amongst older adults is on the rise, yet there are few systematic reviews investigating their experiences. Thus, this review classifies and synthesises qualitative research findings of studies published between 1990 to 2020 that have examined the needs and challenges of homeless older adults to elucidate their journey of homelessness. Seven papers met the requirements for inclusion. Three main themes were identified in the review: - (1) Pathways to homelessness, (2) Impact of homelessness, and (3) …

Feasibility And Acceptability Of A Remotely Delivered, Home-Based, Pragmatic Resistance ‘Exercise Snacking’ Intervention In Community-Dwelling Older Adults: A Pilot Randomised Controlled Trial, Jackson J. Fyfe, Jack Dalla Via, Paul Jansons, David Scott, Robin M. Daly

Research outputs 2022 to 2026

Background: Very few older adults meet current muscle strengthening exercise guidelines, and several barriers exist to supervised, community-based resistance exercise programs. Older adults therefore require access to feasible resistance exercise modalities that may be performed remotely. This pilot study assessed the feasibility and acceptability of undertaking a four-week home-based resistance ‘exercise snacking’ intervention (performed either once, twice, or thrice daily) when delivered and monitored remotely in older adults. Methods: Thirty-eight community-dwelling older adults [mean ± SD age 69.8 ± 3.8 y, 63% female] were randomised to complete resistance ‘exercise snacks’ (9-minute sessions) either once (n = 9), twice (n = …

The Role Of Dysfunctional Sleep Beliefs In Mediating The Outcomes Of Web-Based Cognitive Behavioral Therapy For Insomnia In Community-Dwelling Older Adults: Protocol For A Single-Group, Nonrandomized Trial, Yvonne Kutzer, Lisa Whitehead, Eimear Quigley, Mandy Stanley

Research outputs 2022 to 2026

Background: Sleeping well is an essential part of good health. Older adult populations report a high rate of sleep problems, with recent studies suggesting that cognitive processes as well as behavioral and hyperarousal-related mechanisms could be important factors in the development and maintenance of insomnia. Individuals who have an asynchronous or uncoupled sleep pattern and sleep appraisal-those who complain about their sleep but do not have poor sleep quality, and vice versa-might show differences in subjective sleep and sleep perceptions and other characteristics that could impact their treatment outcomes following cognitive behavioral therapy for insomnia (CBT-I). Objective: The purpose of …

A Systematic Review And Meta-Analysis: Assessment Of Hospital Walking Programs Among Older Patients, Christine Loyd, Yue Zhang, Tara Weisberg, James Boyett, Elizabeth R. Huckaby, Jeri Grundhoefer, Steve Otero, Lisa Roberts, Samantha Giordano-Mooga, Carmen Capo-Lugo, Catherine H. Smith, Richard E. Kennedy, Barbara J. King, Cynthia J. Brown

School of Medicine Faculty Publications

Aim: The aim of this study is to assess effect of hospital walking programs on outcomes for older inpatients and to characterize hospital walking dose reported across studies. Design: A systematic review and meta-analysis examining impact of hospital walking and/or reported walking dose among medical-surgical inpatients. For inclusion, studies were observational or experimental, published in English, enrolled inpatients aged ≥ 65 yrs hospitalized for medical or surgical reasons. Methods: Searches of PubMed, CINAHL, Embase, Scopus, NICHSR, OneSearch, ClinicalTrials.gov, and PsycINFO were completed in December 2020. Two reviewers screened sources, extracted data, and performed quality bias appraisal. Results: Hospital walking dose …

The Association Of Gabapentin Initiation And Neurocognitive Changes In Older Adults With Normal Cognition, Gyeon Oh, Daniela Claudia Moga, David W. Fardo, Erin L. Abner

Sanders-Brown Center on Aging Faculty Publications

Background: Gabapentin is increasingly prescribed to older adults, which raises concerns about its potential to cause neurocognitive changes. Therefore, we aimed to examine the association of gabapentin use with neurocognitive changes (i.e., cognitive decline, functional status decline, and motor function change) in older adults.

Methods: We conducted a retrospective cohort study using the National Alzheimer’s Coordinating Center Uniform Data Set (UDS; September 2005-March 2021 data freeze). From the eligible sample (≥age 65 years), we identified cognitively normal new-users of gabapentin and the visit they initiated gabapentin (i.e., index visit). Initiators were matched to randomly selected nonusers on year …

Older Adults Access To Mental Health And Social Care Services During Covid-19 Restrictions In Western Australia, Claire Adams, Eyal Gringart, Daniel Mcaullay, Moira Sim, Brigitta Scarfe, Amy Budrikis, Natalie Strobel

Research outputs 2022 to 2026

Objective: This study aimed to understand the impact of COVID-19 on access to mental health and social services among older adults in Western Australia. Method: A cross-sectional study was conducted with 194 adults aged ≥ 70 years or ≥ 60 years with chronic conditions. A questionnaire co-developed by a consumer reference group was used to collect data on social networks and service access. Frequency analyses were used to assess quantitative data. Qualitative data were assessed using thematic analyses. Results: 62.7 % of participants reported being not at all/slightly affected by COVID-19; 40.7 % reported having three/four people to chat with. …

From 'Pandemic' To 'Endemic' And Beyond: Key Aspects Of Research On Older Singaporeans In A Year Of Transition, Nadya Haifan, Jane Tan, Rachel Wen Yi Ngu, Mindy Eiko Tadai, Yan Er Tan, Grace Cheong, Micah Tan, Wensi Lim

ROSA Research Briefs

The past year has been one marked by transition – as a country we have moved from treating COVID-19 as a pandemic to living with it as an endemic disease. Research conducted by the Centre for Research on Successful Ageing (ROSA) has taken a similar trajectory, expanding the scope of investigations from COVID-19 topics to other areas that are important for the general well-being of older adults in Singapore. This report showcases ROSA’s research involving older Singaporeans and the partnerships that have been forged in the past year. These developments will be presented in two sections. The first outlines the …

Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph

Access / Insurance

The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:

1. socioeconomic and health characteristics that may inform health care use;
2. trends in health care use, including use of inpatient and emergency department (ED) care; …

Likeability And Perceived Effectiveness Of Messages Designed To Encourage Physical Activity Participation Among Older Adults, Michelle I. Jongenelis, Ben Jackson, Robert U. Newton, Simone Pettigrew

Research outputs 2022 to 2026

Issue addressed: Older adults are significantly less likely than their younger counterparts to engage in physical activity. Comprehensive policies to support healthy ageing thus need to include components encouraging greater participation in physical activity in later life. This study tested potential messages for use in health communication campaigns aimed at increasing physical activity among older adults. Methods: Twelve written messages designed to encourage older adults to increase their levels of physical activity were rated by Australians aged 60-92 years (n = 369; 54 % female) on the variables of likeability and perceived effectiveness. Results: Ratings for all the tested messages …

Prevalence And Factors Associated With Mild Depressive And Anxiety Symptoms In Older Adults Living With Hiv From The Kenyan Coast, Patrick N. Mwangala, Carophine Nasambu, Ryan G. Wagner, Charles R. Newton, Amina Abubakar

Institute for Human Development

Introduction: Empirical research on the burden and determinants of common mental disorders (CMDs), especially depression and anxiety, among older adults living with HIV (OALWH) in sub-Saharan Africa is inadequate. To bridge the gap in Kenya we: (1) determined the prevalence of CMDs among OALWH on routine HIV care compared to HIV-negative peers; (2) investigated HIV status as an independent predictor of CMDs in older adults; and (3) investigated CMD determinants.

Methods: In a cross-sectional study conducted between 2020 and 2021, the prevalence of CMDs and associated determinants were investigated at the Kenyan coast among 440 adults aged ≥50 …

A Smartwatch Step-Counting App For Older Adults: Development And Evaluation Study, George Boateng, Curtis L. Petersen, David Kotz, Karen L. Fortuna, Rebecca Masutani, John A. Batsis

Dartmouth Scholarship

Background: Older adults who engage in physical activity can reduce their risk of mobility impairment and disability. Short amounts of walking can improve quality of life, physical function, and cardiovascular health. Various programs have been implemented to encourage older adults to engage in physical activity, but sustaining their motivation continues to be a challenge. Ubiquitous devices, such as mobile phones and smartwatches, coupled with machine-learning algorithms, can potentially encourage older adults to be more physically active. Current algorithms that are deployed in consumer devices (eg, Fitbit) are proprietary, often are not tailored to the movements of older adults, and have …

Results Of A Multi-Site Pragmatic Hybrid Type 3 Cluster Randomized Trial Comparing Level Of Facilitation While Implementing An Intervention In Community-Dwelling Disabled And Older Adults In A Medicaid Waiver, Sandra Spoelstra, Monica Schueller, Viktoria Basso, Alla Sikorskii

Peer Reviewed Articles

Background: Evidence-based interventions that optimize physical function for disabled and older adults living in the community who have difficulty with daily living tasks are available. However, uptake has been limited, particularly in resource-constrained (Medicaid) settings. Facilitation may be an effective implementation strategy. This study’s aim was to compare internal facilitation (IF) versus IF and external facilitation (EF) on adoption and sustainability of an intervention in a Medicaid home and community-based waiver.

Methods: In a hybrid type 3 trial, waiver sites (N = 18) were randomly assigned to implement the intervention using a bundle of strategies with either IF or IF …

Life In An Endemic Covid-19: Older Adults' Well-Being, Activity, And Perceptions, Rachel Ngu, Micah Tan, Jia Ying Low

ROSA Research Briefs

The current research brief provides a preliminary examination of whether older adults have been able to ‘return’ to the pre-pandemic way of life in an endemic COVID-19. To do this, we look at several key indicators, including (1) tracking older adults’ overall life satisfaction, activity levels, and trust in government over the past 3 years, (2) older adults’ confidence to resume activities, as well as subjective perceptions about their safety when leaving the home in an endemic COVID-19, and (3) older adults’ ability to adhere to the Home Recovery Program (HRP), where individuals with COVID-19 are able to recover from …

From Caregiver To Care Partner: A View From The Other Side, Centre For Elder Research, Tyze Networks

From Caregiver to Care Partner: A view from the other side

Background As the trend towards aging in place continues to grow, unpaid caregivers are facing challenges that include access to relevant and meaningful resources, systemic barriers to efficient two-way communication with healthcare and service organizations, navigating the healthcare system, time management, financial strain, and difficult family dynamics.

Objective This project was designed to help Tyze Networks broaden their understanding of how unpaid caregivers, and supportive healthcare and service organizations, perceive the value of formal managed care coordination.

Methods This project began with a comprehensive environmental scan of existing research, policies, pathways, and best practices. This was followed by an online …

Nurses’ Attitudes Towards Hospitalized Older Adults In A Tertiary Care Setting In Ghana, Yakubu H. Yakubu, Abdul-Ganiyu Fuseini, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

Introduction: The increasing population of older adults and rapid increases in co- morbidities globally has necessitated the need for a healthcare delivery system that meets the multifaceted needs of the growing population of older adults. Concurrent with these rising complex health needs is the importance of positive, non-judgmental attitudes of health services providers towards older adults. Moreover, this is particu-larly important in the nursing profession, given nurses' significant and crucial roles in healthcare settings.

Aim: The study aimed to evaluate nurses’ attitudes towards older adults in a tertiary hospital in Ghana.

Design: It employed a descriptive cross-sectional …

Social Isolation During The Covid-19 Pandemic And Its Impact On Maine's Nursing Homes, Tanya Roy

Honors College

The COVID-19 pandemic has created several challenges within the healthcare industry and has highlighted the impact of social isolation on older adults in Maine’s nursing homes. The older adult population, defined as individuals 65 years and older, has been identified with increased risk in contracting the SARS-CoV-2 virus during the COVID-19 pandemic. Therefore, older adults were placed on strict isolation precautions and confined within their nursing home setting, many residing only in their rooms. With Maine having the oldest population in the United States, this created a need for further investigation into how the COVID-19 pandemic has impacted the lived …

Reducing Medication Non-Adherence With Improved Health Literacy Interventions: An Evidence-Based Practice Quality Improvement Project, Unity Wiles

DNP Projects

Introduction

Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate healthcare decisions and follow instructions for treatment. Patients with low health literacy have been predicted to have poor health outcomes. The inclusion of the single-item literacy tool into the admission process of this project involved the patient-centered-care characteristics of improved patient experience, lower health cost, improved clinical experience, and better outcomes.

Purpose

The National Action Plan to improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked multi-sector effort to improve health literacy. Low …

Implementation Of A Polypharmacy Deprescribing Protocol Among Older Adults In A Community-Based Care Organization, Johanne Cazeau

Doctor of Nursing Practice Scholarly Projects

Background: Polypharmacy, defined as the use of five or more medications, has the potential to increase morbidity, mortality and decrease quality of life. Older adults are disproportionately affected by polypharmacy. Decreasing polypharmacy could prevent morbidity and mortality while saving millions of dollars annually. The use of the ARMOR tool has been shown to decrease polypharmacy and the prescribing of inappropriate medications among the elderly.

Local problem: There is a high prevalence of polypharmacy among older adult patients at the managed care organization where this quality improvement project was implemented. Among a panel of 30 members, almost all (n=29) were taking …

Barriers And Enablers For Older Adults Participating In A Home-Based Pragmatic Exercise Program Delivered And Monitored By Amazon Alexa: A Qualitative Study, Paul Jansons, Jackson Fyfe, Jack Dalla Via, Robin M. Daly, Eugene Gvozdenko, David Scott

Research outputs 2022 to 2026

Background: The remote delivery and monitoring of individually-tailored exercise programs using voice-controlled intelligent personal assistants (VIPAs) that support conversation-based interactions may be an acceptable alternative model of digital health delivery for older adults. The aim of this study was to evaluate the enablers and barriers for older adults participating in a home-based exercise program delivered and monitored by VIPAs. Method: This qualitative study used videoconferencing to conduct semi-structured interviews following a 12-week, prospective single-arm pilot study in 15 adults aged 60 to 89 years living alone in the community. All participants were prescribed an individualized, brief (10 min, 2–4 times …

Information Trust And Covid-19 Vaccine Hesitancy Amongst Middle-Aged And Older Adults In Singapore: A Latent Class Analysis Approach, Micah Tan, Paulin Tay Straughan, Grace Cheong

Research Collection School of Social Sciences

Rationale: COVID-19 vaccine hesitancy presents significant challenges for public health. Objective: Vaccine hesitancy among middle-aged and older adults has been a significant barrier in Singapore’s battle against COVID-19. We hypothesize that the trust middle-aged and older adults place in various sources of information influences vaccine hesitancy, and that distinct typologies of trust can be identified to better inform targeted health communication efforts. Method: Data from a nationally representative panel survey of Singaporeans aged 56–75 (N = 6094) was utilized. Modules fielded in August and November 2020, and June 2021 were analyzed, assessing social networks, trust in sources of information, and …

Older Adults' Perceptions Of Government Handling Of Covid-19: Predictors Of Protective Behaviors From Lockdown To Post-Lockdown, Savannah Kiah Hui Siew, Jonathan Louis Chia, Rathi Mahendran, Junhong Yu

Research Collection School of Social Sciences

Background: Distrust, and more broadly, public perception of government's handling of a crisis, has been a widely studied topic within health crisis research and suggests that these perceptions are significantly associated with the behavior of its citizens. Purpose: To understand which aspects of the public's perception of government handling of the COVID-19 pandemic predicted engagement of protective behaviors among older adults, who are the most vulnerable to COVID-19.Methods: Participants were recruited from an ongoing biopsychosocial study on aging amongst community-dwelling older adults. There were two rounds of data collection, during the national lockdown and post-lockdown. The average length of follow-up …

Is It Possible To Predict Mgmt Promoter Methylation From Brain Tumor Mri Scans Using Deep Learning Models?, Numan Saeed, Shahad Hardan, Kudaibergen Abutalip, Mohammad Yaqub

Computer Vision Faculty Publications

Glioblastoma is a common brain malignancy that tends to occur in older adults and is almost always lethal. The effectiveness of chemotherapy, being the standard treatment for most cancer types, can be improved if a particular genetic sequence in the tumor known as MGMT promoter is methylated. However, to identify the state of the MGMT promoter, the conventional approach is to perform a biopsy for genetic analysis, which is time and effort consuming. A couple of recent publications proposed a connection between the MGMT promoter state and the MRI scans of the tumor and hence suggested the use of deep …

Nutrition Policy: Developing Scientific Recommendations For Food-Based Dietary Guidelines For Older Adults Living Independently In Ireland, Oonagh C. Lyons, Mary A.T. Flynn, Clare A. Corish, Eileen R. Gibney, Maeve A. Kerr, Malachi J. Mckenna, Helene Mcnulty, Emeir M. Mcsorley, Anne P. Nugent, Claire O'Brien, Mary Ward, Katherine Younger, Ita Saul

Conference Papers

Older adults (≥65 years) are the fastest growing population group. Thus, ensuring nutritional well-being of the ‘over-65s’ to optimise health is critically important. Older adults represent a diverse population – some are fit and healthy, others are frail and many live with chronic conditions. Up to 78% of older Irish adults living independently are overweight or obese. The present paper describes how these issues were accommodated into the development of food-based dietary guidelines for older adults living independently in Ireland. Food-based dietary guidelines previously established for the general adult population served as the basis for developing more specific recommendations appropriate …

Understanding A Low Vitamin D State In The Context Of Covid-19, James Bernard Walsh, Daniel Mccartney, Eamon Laird, Kevin Mccarroll, Declan G. Byrne, Martin Healy, Paul O'Shea, Rose Anne Kenny, John L. Faul

Articles

While a low vitamin D state has been associated with an increased risk of infection by SARS-CoV-2 in addition to an increased severity of COVID-19 disease, a causal role is not yet established. Here, we review the evidence relating to i) vitamin D and its role in SARS-CoV-2 infection and COVID-19 disease ii) the vitamin D status in the Irish adult population iii) the use of supplemental vitamin D to treat a deficient status and iv) the application of the Bradford-Hill causation criteria. We conclude that reverse causality probably makes a minimal contribution to the presence of low vitamin D …

Nurses Leading Volunteer Support For Older Adults In Hospital: A Discussion Paper, Rosemary Saunders, Kate Crookes, Karen Gullick, Olivia Gallagher, Karla L. Seaman, Debra Scaini, Seng G.M. Ang, Caroline Bulsara, Beverley Ewens, Jeff Hughes, Beverly O'Connell, Christopher Etherton-Beer

IHR Papers and Journal Articles

Background

The ageing population has led to growing numbers of older adults in hospital. Given the increased care needs of older adult patients, hospitals are facing resource challenges to ensure patient safety and quality of care. Support from trained volunteers focussed on older adults needs, such as eating, drinking, ambulation and cognitive stimulation have been found to improve patient outcomes.

Aim

This discussion paper describes a novel nurse-led model of volunteer support providing individualised supportive care for hospitalised older adults.

Methods

Discussion paper.

Findings

Nurses’ clinical expertise, 24 hour care and leadership skills makes them ideally placed to guide support …

Nurse-Led Volunteer Support Care Plan, Rosemary Saunders, Kate Crookes, Karen Gullick, Olivia Gallagher, Karla Seaman, Debra Scaini, Seng Giap Marcus Ang, Caroline Bulsara, Bev Ewens, Jeff Hughes, Bev O'Connell, Christopher Etherton-Beer

Research outputs 2022 to 2026

The Nurse-Led Volunteer Support Care Plan described in “Nurses leading volunteer support for older adults in hospital: A discussion paper” is made available. This care plan is designed for nurses to develop a plan to direct volunteer support to better meet the individual needs of patients.

Perspectives On Wider Integration Of The Health-Assistive Smart Home, Gordana Dermody, Jenna Mikus, Davina Porock, Dov Sugarman, Naeem K. Janjua, Christopher How, Roschelle Fritz

Research outputs 2022 to 2026

Most older adults desire to be as independent as possible and remain living in their ancestral home as they age. Aging-in-place maximizes the independence of older adults, enhancing their wellbeing and quality of life while decreasing the financial burden of residential care costs. However, due to chronic disease, multimorbidity, and age-related changes, appropriate conditions are required to make aging-in-place possible. Remote monitoring with smart home technologies could provide the infrastructure that enables older adults to remain living independently in their own homes safely. The health-assistive smart home shows great promise, but there are challenges to integrating smart homes on a …