Medicine and Health Sciences Commons^™

Genetic Vulnerability To Diabetes And Obesity: Does Education Offset The Risk?, Sze Yan Liu, Stefan Walter, Jessica Daniel, David H. Rehkopf, Laura E. Kubzansky, M Maria Glymour

Sze Yan Liu

The prevalence of type 2 diabetes (T2D) and obesity has recently increased dramatically. These common diseases are likely to arise from the interaction of multiple genetic, socio-demographic and environmental risk factors. While previous research has found genetic risk and education to be strong predictors of these diseases, few studies to date have examined their joint effects. This study investigates whether education modifies the association between genetic background and risk for type 2 diabetes (T2D) and obesity. Using data from non-Hispanic Whites in the Health and Retirement Study (HRS, n = 8398), we tested whether education modifies genetic risk for obesity …

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 …

Electrocardiographic Findings During Standard Hands Only Cpr And Hands Only Cpr Plus Pedal Cpr In Senior Rescuers, Laura Melany Yassa

Master's Theses

The standard first aid for a heart attack resulting in cardiopulmonary arrest is effective cardiopulmonary resuscitation (CPR). Chest compressions are most commonly performed on a flat surface with the rescuer kneeling next to the victim with one hand on top of the other on the sternum and elbows straight. This technique of being on the ground may be challenging for those without the mobility and strength to get up and down from the ground. In 2005, the American Heart Association (AHA) Guidelines listed “pedal”, or heel, compression as an acceptable alternative to standard chest compressions (Trenkamp & Perez, 2015). That …

Interventions To Improve Older Driver Safety, Bernadette A. Fausto

USF Tampa Graduate Theses and Dissertations

Increased longevity coupled with age-related declines that compromise driving safety and fragility render older adults as vulnerable road users (Oxley & Whelan, 2008). To address this public health concern, researchers continue to investigate interventions to improve older driver safety. The current dissertation consists of two papers examining: a) the state of the literature on older driver interventions and b) the efficacy of one approach, Useful Field of View cognitive training, to reduce at-fault crash involvement. The first paper sought to identify and quantify the effects of different interventions among older adults on outcomes of crashes, on-road driving performance, self-reported outcomes …

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, …

Age-Related Smell Changes And Their Effects On The Health Status Of Older Americans, Emily Duran Frontera

Electronic Theses and Dissertations

Olfactory impairment is a prevalent but underreported condition among older adults in the United States (U.S.). In the elderly, this impairment is associated with a host of adverse health conditions and issues that affect the quality of life. This study investigated the prevalence of smell disorders in older adults over 60 years of age, the potential risk factors for smell deterioration, and the influence of smell dysfunction on health status using the data collected through the National Health and Nutrition Examination Survey (NHANES) 2013-2014 questionnaires and examination components.

Participants were categorized as smell impaired (‘SI Present’) if they were unable …

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 …

Resedent Study- Reducing Sedentary Behaviour May Slow Cognitive Decline In Older Adults With Mild Cognitive Impairment: A Pilot Study, Kirsten B. Dillon

Electronic Thesis and Dissertation Repository

Physical activity (PA) has been shown to slow down dementia. Unfortunately, older adults spend most of their day in sedentary behaviours (SB). Breaking up prolonged bouts of sitting with intermittent bouts of light intensity PA may reduce glycemic variability in the brain; potentially mitigating cognitive decline. This study investigated how interrupting SB with 10 min bouts of light intensity PA 3x a day would affect mild to moderate cognitive impairment progression (primary outcome) in older adults residing in an assisted living facility. Participants (n=25) were assigned in clusters into a two arm 10-week single site pilot randomized controlled trial. Secondary …

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 …

Implementation Of A Volunteer Based Hospital Visitation Program For Older Adults, Mariana R. Kuperman, Md, Mph, Kristine Swartz, Md, Elizabeth Collins, Md, Jennifer Kim, Bs

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background

Hospital Elder Life Program (HELP)¹: a multi faceted, volunteer led, hospital based program has been shown to:

• Reduce the incidence of delirium
• Decrease length of stay
• Reduce hospital costs

Implementation of such a program requires upfront investment.

A smaller, volunteer based visitation program for older adults was started to provide support for the allocation of hospital resources in delirium prevention and establishment of HELP in this institution.

This research aims to investigate the program’s implementation and impact on delirium specific outcomes.

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 …

Healthy Aging In The Community Initiative, Didem Kadriye Unver

Master's Projects and Capstones

In 2016 the Sequoia Health Care partnering with Peninsula Family Services developed a non-profit and free program called 70 Strong. It is a personal resource guide for the 60 and above client base for activities and services from Redwood City to Foster City to encourage independence amongst the older population. It includes a wide array of categories, such as fitness and social activities, volunteer opportunities, transportation, enrichment, and support groups. This is not an acute healthcare provider; however, it is a primary prevention effort by Sequoia Healthcare District to increase wellness among the older population in the county. The purpose …

The Relationship Of Risk Of Falls And Activities Of Daily Living To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes, Sanath Shetty, Shmilah Choudhary, Meet Shah, Terrie Ginsberg D.O., Matthew H. Mclaughlin

Rowan-Virtua Research Day

Introduction: Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes (T2DM) would help identify patients at risk of rehospitalization.

Objective: The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM. Factors to be investigated are: patient demographics, whether patients were at risk for falling, and patients’ activities of daily living (ADL) at discharge.

Methods: …

The Impact Of Fall Efficacy On Occupational Performance In Community-Dwelling Older Adults, Michelle Fong, Araya Moua, Erin Denola, Merit Franklin

Occupational Therapy | Graduate Capstone Projects

Falls are a major health concern in the older adult (OA) population. While there is research on falls and their prevention, research on how low fall efficacy (FE) impacts the occupational engagement of the OA population is limited. FE is defined as the confidence a person has in his/her ability to complete a task without falling (Tinetti & Powell, 1993). A qualitative study was conducted using a phenomenological approach to explore the lived experiences of OAs with low FE and the impact on occupational performance. Participants who scored ≤ 6 on the Modified Fall Efficacy Scale (MFES) engaged in a …

Older Adults’ Implementation Of Discharge Instructions Following An Acute Care Hospital Stay, Brenda Miller

Dissertations

Discharge instructions are a self-care guide for patients after discharge from an acute care hospitalization. The discharge process starts on admission to the hospital and continues until discharged. Many patients rely on informal caregivers to provide support after a discharge. However, it is often unclear whether the patients or caregivers completely understand instructions provided during the discharge process. Key concepts related to how discharge instructions were implemented following discharge to home have been understudied from the patient’s and informal caregivers’ perspectives. Developing effective discharge instructions based on study findings may assist in reducing 30-day hospital readmission rates.
This study was …

Testing A Musical Game Activity For Community-Dwelling Older Adults, Jordan Riggins, Susan Mclennon Phd Arnp

Chancellor’s Honors Program Projects

No abstract provided.

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. …

Aging-In-Community: The Influence Of Social Capital On Accessory-Dwelling Unit Access And Utilization Among Older Americans, Travis M. Gagen

Doctoral Dissertations

Accessory-Dwelling Units (ADUs) are one form of the built-environment in which the field of public health law can intervene to improve population aging. Modifying the built-environment to incorporate ADUs allows older adults to utilize a higher level of smart home technologies (SHT) to age-in-community. Under Massachusetts law MGL c. 40A, the state gives authority to cities and towns to adopt ordinances and bylaws to regulate the use of land, buildings and structures. A mixed-methods research design was used to examine the access and utilization of ADU and SHT among older adults. Of the 351 Massachusetts town and cities, 66.5% were …

Scores For The Modified Functional Movement Screen In Active Older Adults, Martin S. Dietze-Hermosa, Samuel Montalvo, Lance Gruber, Lizette Terrazas, Matthew Gonzalez, Sandor Dorgo

International Journal of Exercise Science: Conference Proceedings

The modified Functional Movement Screen^TM (mFMS), an adapted form of the traditional FMS for older adults, consists of a battery of tests aiming at identifying areas of movement deficiency. Prompt identification of movement deficiency can help exercise practitioners create a tailored program to improve these limitations. PURPOSE: To establish normative values for the mFMS in healthy active older adults. METHODS: There were 141 individuals (56 males and 85 females; mean age ± SD: age 69.51 ± 7.41 years) who participated in the study. Participants performed an 8-10 minute warm-up at a self-selected pace on a treadmill …

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 …

Improving Screening For Depression And Fall Risk In Community Dwelling Older Adults, Devan C. Lucier

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose. Falls and depressive symptoms are common in the older adult population and are associated with significant morbidity and mortality. The relationship between depression and falls is bidirectional. Given that community health nurses are critical health care personnel in assessing risk for depression and falls in the older adult population, the purpose of this project was to implement screening measures for depression and falls in an older adult population.

Methods:Nurses from a community health outreach team implemented depression and fall risk screening assessment with an older adult population 65 years and older in their homes. The Geriatric Depression Scale, …

Resiliency And Proactive Coping Methods Targeting Perceived Stress Levels In Older Adults, Katie Holmes

OT Student Capstones

Stress, or perceived stress, has the potential to be life-threatening to those that experience it on a regular basis. Community-dwelling older adults may be particularly vulnerable to perceived stress and its effects due to stressors such as negative life events, chronic disease or declining health, loss of loved ones experienced with the aging process, and social isolation. Stress and mental health and well-being are not being adequately addressed in independent and assisted living communities for older adults. An eight-week stress management program focusing on the concepts of resiliency and proactive coping was implemented at a local retirement community. An overall …