Geriatrics Commons^™

Animal-Assisted Therapy And Quality Of Life Of Patients With Dementia, Karissa D. Thomson, Kayla Collins, Mary P. Shotwell

Spring 2020 Virtual OTD Capstone Symposium

The aim of this quantitative study was to examine the effects animal-assisted therapy (AAT) had on people diagnosed with dementia living in a nursing home. The study examined the effects AAT had on depression, blood pressure, social interaction and how these factors impact quality of life (QOL). The study was conducted once a week for one hour on Thursdays for 6 weeks. 7 participants were included in the study and further broken down into two groups based upon their level of cognition as measured by the Mini Mental State Examination. The Beck’s depression inventory (BDI) and the World Health Organization …

The Health Benefits Of Visual Art Activities In The Geriatric Population, Melody Au-Yeung, Abraham Avila, Jason Bandong, Hy Ia, Naureen Imam, Kayla Wilcox

San Marcos, Spring 2020

Purpose: The purpose of this poster presentation is to assess the efficacy of visual art therapy on the physical and mental health of the geriatric population.

Description: The potential impact of art therapy on cognition and dementia is a growing field of research in the rehabilitative world. Some researchers have found support for certain mediums, such as ceramic painting, while others have explored multimodal treatment programs that integrate art into physical activities. Combining physical activity with an arts and crafts program could posit a significant impact on ADL function and quality of life in older adults. As a …

First-In-Human Studies Of Mw01-6-189wh, A Brain-Penetrant, Antineuroinflammatory Small-Molecule Drug Candidate: Phase 1 Safety, Tolerability, Pharmacokinetic, And Pharmacodynamic Studies In Healthy Adult Volunteers, Linda J. Van Eldik, Lumy Sawaki, Karen Bowen, Daniel T. Laskowitz, Robert J. Noveck, Byron Hauser, Lynn Jordan, Tracy G. Spears, Huali Wu, Kevin Watt, Shruti Raja, Saktimayee M. Roy, D. Martin Watterson, Jeffrey T. Guptill

Sanders-Brown Center on Aging Faculty Publications

MW01-6-189WH (MW189) is a novel central nervous system-penetrant small-molecule drug candidate that selectively attenuates stressor-induced proinflammatory cytokine overproduction and is efficacious in intracerebral hemorrhage and traumatic brain injury animal models. We report first-in-human, randomized, double-blind, placebo-controlled phase 1 studies to evaluate the safety, tolerability, and pharmacokinetics (PK) of single and multiple ascending intravenous doses of MW189 in healthy adult volunteers. MW189 was safe and well tolerated in single and multiple doses up to 0.25 mg/kg, with no clinically significant concerns. The most common drug-related treatment-emergent adverse event was infusion-site reactions, likely related to drug solution acidity. No clinically concerning changes …

Compassion And Suppression In Caregivers: Twin Masks Of Tragedy And Joy Of Caring, Emanuele Maria Merlo, Sean M. Mcnabney, Fabio Frisone, Federica Sicari, Mihai Paunica, Catalina Motofei, Salvatore Settineri

Journal of Mind and Medical Sciences

Background: Compassionate caregiving is a critical skill for workers among the helping professions, but the degree of empathy required by caregivers can place high demands on their mental and emotional resources. While many professionals employ successful coping strategies to mitigate these stressors, others experience compassion fatigue or burnout from emotional exhaustion. The objective of this research was to evaluate the relationships between caregivers’ demographic/career variables, compassion satisfaction, compassion fatigue, and psychodynamic defense mechanisms such as suppression, repressive function, regression in the service of the Ego, and rationalization. Methods: Participants were 250 caregivers with 178 (71,2%) women and 72 men (28,8%) …

Reliability And Validity Of An Assessment Of Engagement In Nursing Home Residents During Bingocize®, Elizabeth Batson Apelt

Masters Theses & Specialist Projects

Research suggests nursing home residents are often socially isolated and physically inactive despite overwhelming evidence that both social engagement and physical activity are crucial for healthy aging (Jones, Sung, & Moyle, 2018; Yen & Lin, 2018; Ice, 2002; Jansson et al., 2017). Bingocize® is a program that combines exercise and the game of Bingo to improve the quality of life, physical health, and social engagement of certified nursing facility (CNF) residents. The purpose of this study is to determine the level of social engagement displayed by CNF residents during Bingocize® using the Fun and Social Engagement Evaluation (FUSE). Reliability and …

The Effects Of Saido Learning On The Cognition Of Patients With Dementia: A Retrospective Study, Stephanie N. Laduke

Honors Projects

SAIDO Learning is a cognitive and social intervention developed by the Kumon Institute in 2004 to slow the progress of symptoms in patients diagnosed with dementia. Today, twenty-three nursing facilities nationwide utilize SAIDO Learning. The data in this retrospective study compare the baseline Mini-Mental State Exam (MMSE) scores to the MMSE scores obtained six months after SAIDO Learning is implemented from patients diagnosed with dementia at Waterford Place in Jenison, Michigan. These scores are reassessed every 6 months as a standard of care. The data was deidentified by the staff of Waterford Place before given to the research team. A …

State Variability In The Prevalence And Healthcare Utilization Of Assisted Living Residents With Dementia, Kali S. Thomas, Wenhan Zhang, Portia Y. Cornell, Lindsey Smith, Brian Kaskie, Paula C. Carder

Institute on Aging Publications

Objectives: Almost 1 million older and disabled adults who require long‐term care reside in assisted living (AL), approximately 40% of whom have a diagnosis of Alzheimer's disease and related dementias (ADRD). States vary in their regulations specific to dementia care that may influence the presence of residents with ADRD in AL and their outcomes. The objectives of this study were to describe the state variability in the prevalence of ADRD among Medicare beneficiaries residing in larger (25+ bed) ALs and their healthcare utilization.

Design: Retrospective observational national study.

Participants: National cohort of 293,336 Medicare fee‐for‐service enrollees residing in larger (25+ …

Sleeping Time Is Associated With Functional Limitations In A National Sample Of Older Americans, Brenda M. Vincent, Nathaniel Johnson, Grant R. Tomkinson, Ryan Mcgrath, Brian C. Clark, Bong-Jin Choi

Education, Health & Behavior Studies Faculty Publications

Background: Engaging in healthy behaviors may help to preserve function during aging; however, it is not well understood how sleeping time is associated with functional capacity in older adults.

Aims: We sought to determine the association of sleeping time on functional limitation in a national sample of older Americans.

Methods: The analytical sample included 6,020 adults aged at least 65 years who participated in the 2007-2016 waves of the National Health and Nutrition Examination Survey. Respondents indicated their hours of sleep/week night and were categorized as <5, 5-6.5, 7-8, 8.5-9, and >9 hours of sleep/week night. Ability to complete 19 functional tasks …

Why I Brought My Mother Home, Barbara L. Gracious

HCA Healthcare Journal of Medicine

According to the Alzheimer’s Association, in the United States more than 16 million adult family members provide care for a relative with Alzheimer’s disease or other dementia. The economic value contributed by unpaid caregivers is $234 billion dollars. Such caregivers are vital to the ability of the U.S. to meet caretaking needs, as the projected number of individuals suffering from dementia will nearly triple over the next 30 years. A meta-analysis found that decisions to provide family caretaking are rooted in long-standing family relationships. This essay explores one family’s decision to move from long-term institutional care back to family-based care …

“But I’Ve Always Lived Here”: Evidence Informed Analysis On Aging In Place, Roxanne Mueller, Allison Paris, Holly Olsen, Lindsey Valentine, Chris Childers

Physical Therapy Collection

Purpose: The purpose of this poster/presentation is to provide an exploration and analysis of aging in place. To ensure the success of the older adult to remain in their home it is essential to determine and meet the changing needs of the aging population in a way that preserves lifelong health and wellness.

Description: The global trend of population aging is on the continual rise due to longer life expectancy and lower fertility rates.¹ It is predicted that by the year 2036 one in every four individuals will be a senior citizen. In some areas, the availability of …

Pills And Spills: An Assessment Of Medications And Fall Risk In Older Patients, Kelly L. Covert, Courtney D. Hall

ETSU Faculty Works

No abstract provided.

Hierarchical Clustering Analyses Of Plasma Proteins In Subjects With Cardiovascular Risk Factors Identify Informative Subsets Based On Differential Levels Of Angiogenic And Inflammatory Biomarkers, Zachary Winder, Tiffany L. Sudduth, David W. Fardo, Qiang Cheng, Larry B. Goldstein, Peter T. Nelson, Frederick A. Schmitt, Gregory A. Jicha, Donna M. Wilcock

Sanders-Brown Center on Aging Faculty Publications

Agglomerative hierarchical clustering analysis (HCA) is a commonly used unsupervised machine learning approach for identifying informative natural clusters of observations. HCA is performed by calculating a pairwise dissimilarity matrix and then clustering similar observations until all observations are grouped within a cluster. Verifying the empirical clusters produced by HCA is complex and not well studied in biomedical applications. Here, we demonstrate the comparability of a novel HCA technique with one that was used in previous biomedical applications while applying both techniques to plasma angiogenic (FGF, FLT, PIGF, Tie-2, VEGF, VEGF-D) and inflammatory (MMP1, MMP3, MMP9, IL8, TNFα) protein data to …

Rivastigmine Modifies The Α-Secretase Pathway And Potentially Early Alzheimer's Disease, Balmiki Ray, Bryan Maloney, Kumar Sambamurti, Hanuma K. Karnati, Peter T. Nelson, Nigel H. Greig, Debomoy K. Lahiri

Sanders-Brown Center on Aging Faculty Publications

Rivastigmine (or Exelon) is a cholinesterase inhibitor, currently used as a symptomatic treatment for mild-to-moderate Alzheimer’s disease (AD). Amyloid-β peptide (Aβ) generated from its precursor protein (APP) by β-secretase (or BACE1) and γ-secretase endoproteolysis. Alternative APP cleavage by α-secretase (a family of membrane-bound metalloproteases– Adamalysins) precludes the generation of toxic Aβ and yields a neuroprotective and neurotrophic secreted sAPPα fragment. Several signal transduction pathways, including protein kinase C and MAP kinase, stimulate α-secretase. We present data to suggest that rivastigmine, in addition to anticholinesterase activity, directs APP processing away from BACE1 and towards α-secretases. We treated rat neuronal PC12 cells …

A Retrospective Matched-Cohort Study Of 3994 Lower Extremity Wounds Of Multiple Etiologies Across 644 Institutions Comparing A Bioactive Human Skin Allograft, Theraskin, Plus Standard Of Care, To Standard Of Care Alone, Geoff C Gurtner, Aimee D Garcia, Katie Bakewell, Jason B Alarcon

Faculty, Staff and Students Publications

Most chronic wounds are related to comorbidities, for which no clinical trials are performed. This retrospective propensity matched-cohort study examined data from 2 074 000 lower extremity wounds across 644 institutions to determine the effectiveness of TheraSkin plus standard of care (SOC; n = 1997) versus SOC alone (n = 1997). Multivariate modelling comparing outcomes such as healing rates, percent area reductions (PARs), amputations, recidivism, treatment completion, and medical transfers were evaluated. A higher proportion of wounds in the treatment group compared with the controls were more likely to close (68.3% versus 60.3%), particularly wounds with exposed structures (64% versus …

Older Adults Hospitalized For Pneumonia In The United States: Incidence, Epidemiology, And Outcomes., Forest W. Arnold, Andrea Reyes-Vega, Vidyulata Salunkhe, Stephen P. Furmanek, Christian Furman, Laura Morton, Anna Johan Faul, Pam Yankeelov, Julio A. Ramirez

Faculty and Staff Scholarship

OBJECTIVES: To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. DESIGN: This was a secondary analysis of older adults (aged ≥65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. SETTING: The study took place in all nine acute care hospitals for adults in Louisville, …

The Benefits Of Physical Activity On Depression, Edward F. Ansello

Director's Editorials from Age in Action

Physical exercise can be an effective counter-measure against depression. Activity need not be strenuous and it may reduce the risk for depression, even among those with a family history or genetic disposition for depression. And depression in itself may not cause a reduction in physical activity. It could be that we will see health care providers increasingly prescribing doses of physical activity for our mental health.

Creating Covid-19 Work-Arounds For Vulnerable Older Adults, Edward F. Ansello

Director's Editorials from Age in Action

In response to disruptions in care due to the COVID-19 pandemic, the Geriatrics Workforce Enhancement Program (GWEP) has decided to focus energies on vulnerable populations, specifically: low income older adults in the Richmond Health and Wellness Program (RHWP), which delivers healthcare coordination at rental assistance housing complexes in Richmond, who had been receiving regular in-person help from interprofessional teams of faculty and students; residents with dementia and staffs of long-term care facilities who’d been intended to participate on-site in a non-pharmacological dementia care intervention called TimeSlips, as well as family caregivers of individuals in the community with dementia; and older …

Finding Light In The Darkness: The Role Of Humor, Edward F. Ansello

Director's Editorials from Age in Action

The human story of confrontations with darkness can be lightened with the aid of humor and laughter.

Ageism In The Age Of Covid-19, Edward F. Ansello

Director's Editorials from Age in Action

Greater awareness of biases in health care and protective services are needed. Ageism is not going away but at least COVID-19 has unveiled some of its manifestations.

A Multifaceted Approach To Address Food Insecurity In Urban Dwelling Older Adults, Ana Diallo, Katherine Falls

Case Studies from Age in Action

Educational Objectives

1. Identify and discuss concepts of food insecurity as a social determinant of health in older adults.

2. Explain the health benefits of participation in a nutrition initiative, Healthy Meals Program, to address food insecurity among low-income older adults living in an urban food desert.

3. Describe the use of motivational interviewing and goal setting techniques for nutrition-related behavior in the management of chronic disease.

4. Summarize the lessons learned and implications for clinical practice.

Two Professionally Led Choir Programs: Empowering People With Dementia And Their Care Partners, Helen Kivnick, Debra Sheets

Case Studies from Age in Action

Educational Objectives

Identify the benefits of participation in a community-based choir for persons with dementia (PwD) and their care partners.

1. Describe the work of the choirs to show the potential of living well with dementia.

2. Identify the ways in which the choirs address stigma and social isolation.

3. Highlight lessons learned

The Agony Of Da Feet: Reexamining The Foundation To Fitness, Amanda M. Lutter, Christopher B. Stewart

Case Studies from Age in Action

Educational Objectives

1. Explain the role of podiatry in helping older adults maintain wellbeing.

2. Provide an overview of common foot and ankle conditions that older adults should be concerned about.

3. Discuss newer services and techniques provided by podiatrists.

4. Review several cases in which podiatry supported patients’ health through early interventions.

The Health Empowerment Program: A Primary Care – Area Agency On Aging Partnership, Daniel Bluestein, Brad Lazernick, Britt Gnilka

Case Studies from Age in Action

Educational Objectives

1. Appreciate the benefits of a primary care-area agency on aging collaboration.

2. Identify strategies for enhancing this cross-organizational partnership.

Age And Functional Outcomes Post-Neurologic Insult In Patients Attending Inpatient Rehabilitation, Jonathan Bowman Spt, Elena Crooks Pt, Dpt, Phd, Doug Weeks Phd, Kimberly Honn Phd

2020 Symposium Posters

Introduction

Neurologic insults such as strokes and traumatic brain injuries (TBI) affect over 1 million Americans every year. The lack of current knowledge informing accurate prognoses causes victims and their loved ones distress, and is a focus of much research. The purpose of this study was to determine whether patient age at time of insult could predict change in functional outcomes during inpatient rehabilitation.

Methods

Subjects were patients of an inpatient rehabilitation facility (IRF) post-stroke or TBI. The Functional Independence Measure (FIM) assessed functional independence and cognitive status at admission and discharge from the IRF. The Montebello Rehabilitation Factor Score …

The Covid-19 Pandemic: Experiences Of A Geriatrician-Hospitalist Caring For Older Adults, L. Sinvani

Journal Articles

No abstract provided.

What A Difference A Disaster Makes: The Telehealth Revolution In The Age Of Covid-19 Pandemic, Jr Maese, D Seminara, Z Shah, A Szerszen

Journal Articles

No abstract provided.

“Palliative Pandemic Plan,” Triage And Symptoms Algorithm As A Strategy To Decrease Providers’ Exposure, While Trying To Increase Teams Availability And Guidance For Goals Of Care (Goc) And Symptoms Control, S. Lopez, G. Decastro, K. M. Van Ogtrop, S. Weiss-Domis, S. R. Anandan, C. J. Magalee, R. Roofeh, T. A. Liberman

Journal Articles

No abstract provided.

Helping Continuing Care Retirement Communities Determine The Best Level Of Care For Each Patient, Nicholas Safian, Grant Schultheis, Sopuru Ezeonu, Austin Klein, Danielle Snyderman, Md

Phase 1

Background: Continuing Care Retirement Communities (CCRC’s) are long-term care facilities for senior adults where residents can live in different “levels of care” (LOC)––Independent, Assisted, Nursing––depending on their needs. It is beneficial for the CCRC administration to have residents in the appropriate LOC for their given needs. However, the current process for determining which LOC is appropriate for a given resident lacks structure and provides a challenge for administrators. This project seeks to provide CCRC administrators an efficient, structured way for determining which level of care is most appropriate based on the needs of the resident and the resources available from …

Motor Performance And Quality Of Life In A Community Exercise Program For Parkinson Disease, Elizabeth A. Stiles, Karen M. Jaffe, Catherine E. Schwartz, Benjamin M. Rossi, David E. Riley

2020 Faculty Bibliography

We investigated the effect of a comprehensive community program composed of exercise, mindfulness practice, and education on motor function and quality of life in individuals with Parkinson disease (PD). Thirty-six participants completed physical and quality-of-life assessments independently at baseline and 12 months. Physical assessments showed stability or improvement in functional mobility, integrated strength, and walking ability over the 1-year interval. PDQ-39 measures showed improvement in 6 of 8 indices: mobility, activities of daily living, emotional well-being, stigma reduction, social support, and bodily discomfort. Our results demonstrate the effectiveness of exercise, mindfulness, and education in community and group settings.

Helping Continuing Care Retirement Communities Determine The Best Level Of Care For Each Patient, Austin Klein, Nicholas Safian, Grant Schultheis, Sopuru Ezeonu, Danielle Snyderman, Md

Phase 1

Background: The vast majority of healthcare costs are spent on the last decade of life. Older patients often have complex medical histories complicated further by physical, mental and social limitations. High levels of hospital readmittance and nonadherence further complicate care for senior adult patients. Continuing Care Retirement Communities (CCRCs) are long term care facilities that attempt to support this diverse array of problematic patients. Residents can live in several different groupings called “Levels of Care” (LOC). To maximize safety, quality of care, and patient satisfaction, it is important to place residents in the right context. This project seeks to drive …