Geriatrics Commons^™

Diagnosing Dementia In The Dental Office, Stuart Segelnick Dds, Ms

The New York State Dental Journal

What to do when you no longer recognize the patient you’ve treated for years.

Effect Of Antipsychotic Medication Use And Type On Mortality And Cardiovascular Risks In Nursing Home Patients With Dementia, Hamid R. Okhravi, Fang Fang, Melissa P. Hunter, Brynn E. Sheehan

Glennan Center for Geriatrics and Gerontology Faculty Publications

Introduction

Antipsychotic medication (APM) use in nursing home (NH) patients with dementia is common but carries risks. This study assessed the association between APM use and mortality, stroke, and myocardial infarction (MI) compared to non-use, as well as differences between first- and second-generation APMs.

Methods

A serial cross-sectional study using Medicare data examined outcomes from 2012 to 2015 in a national sample of 328,138 US NH residents aged 50 and older with dementia. Multivariate logistic regressions were used to analyze risk.

Results

APM use was associated with increased mortality in all years (odds ratio [OR] range: 2.39 to 1.23, all …

Development And Evaluation Of The Agitation In Alzheimer's Screener For Caregivers (Aasc): A Clinical Tool To Screen For Agitation., Carolyn Clevenger, W Clay Jackson, Jared Stroud, Malaak Brubaker, Mehul Patel, Iwona Bucior, Emily Bratlee-Whitaker, T Michelle Brown, Sheri Fehnel, Sue Peschin, Jeffrey Cummings, George Grossberg

Ambulatory and Primary Care Articles

OBJECTIVE: Although agitation is a common neuropsychiatric symptom in Alzheimer's dementia, it can be challenging to recognize and diagnose. Caregivers of individuals with Alzheimer's dementia are often the first to encounter agitation behaviors but may struggle to recognize and communicate symptoms to healthcare professionals (HCPs). Here, we describe the development and evaluation of the Agitation in Alzheimer's Screener for Caregivers (AASC), a practical screening tool to identify agitation symptoms and facilitate caregiver-HCP communication.

METHODS: The AASC was developed based on the International Psychogeriatric Association (IPA) criteria for agitation in cognitive disorders, input from multidisciplinary experts, and qualitative interviews with caregivers …

Incident Hearing Loss And Subsequent Risk Of Dementia: The Health And Retirement Study 2010-2018, Jingkai Wei, Youngran Kim, Yike Li, Donglan Zhang, Casey Crump

Faculty, Staff and Student Publications

Background and Objectives

Research Design and Methods

Training To Move An Evidence-Based Dementia Caregiver Support Program Into Practice: A Pragmatic, Randomized, Non-Inferiority Trial Protocol, Nancy A. Hodgson, Miranda V. Mcphillips, Karen B. Hirschman, Emily Summerhayes, Catherine Verrier Piersol, Laura N. Gitlin

Department of Occupational Therapy Faculty Papers

Background

Objective

Gait Variability As A Marker Of White Matter Integrity In Individuals With Down Syndrome, Elizabeth M. Leach, David K. Powell, Amanda C. Glueck, Elizabeth Head, Moaz W. Ibrahim, Amelia J. Anderson-Mooney, Kathryn L. Van Pelt, Jordan P. Harp, Frederick A. Schmitt, Ahmed A. Bahrani

Sanders-Brown Center on Aging Faculty Publications

Introduction: Individuals with Down syndrome (DS) face a significant risk of neurodegeneration, and gait variability may serve as a clinical biomarker of neurological health. This longitudinal parent substudy aimed to explore relationships between gait, white matter (WM) integrity, and cognitive function in DS.

Methods: The associations were investigated between magnetic resonance imaging diffusion tensor imaging (DTI), cognition, and self-paced gait data from 22 DS participants (mean age ± SD 37 ± 7.5 years).

Results: DTI measures, such as lower fractional anisotropy (FA) and higher mean diffusivity, were correlated with greater step time variability but not normalized velocities. Lower cognitive scores …

Enhancing Dignity Amongst Persons With Dementia Through Occupational Engagement, Habeeba Ahmed, Amy Lyons-Brown Ms, Otd, Otr/L

Fall 2024 OTD Capstone Symposium

Dementia is a cognitive impairment that impacts an individual's memory, judgement, safety awareness, and emotions which can interfere with their activities of daily living. As the condition progresses, the person living with dementia (PLWD) may require a care partner to help them complete their daily tasks. Having a care partner and being a care partner can be challenging for both, the PLWD and their care partner, as there begins to be a shift in their independence. The PLWD must rely on their care partner to help them throughout their day, leading to a decrease in independence and occupational engagement. When …

Training Staff Members And Caregivers On Utilizing Allen Cognitive Levels To Aid Individuals Living With Alzheimer's And Dementia To Maintain Activities Of Daily Living, Kristy Boyd, Cassandra Nelson, Jennifer Summers

Fall 2024 OTD Capstone Symposium

This capstone project is about training staff members and caregivers on utilizing the Allen's cognitive levels to aid individuals living with Alzheimer's and dementia to maintain their activities of daily living by creating a program that consists of modules, physical demonstration, and a deliverable for staff members and caregivers as well as therapeutic activities and sensory regulation activities for the participants.

Initiation Of Hearing Aids Use And Incident Dementia Among Mid-To-Late Life Adults: The Health And Retirement Study 2010-2018, Jingkai Wei, Kun Li, Youngran Kim, Rahul Ghosal, Donglan Zhang, Anwar T Merchant, Casey Crump

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: Hearing aids may reduce the risk of dementia among individuals with hearing loss. However, no evidence is available from randomized controlled trials (RCTs) on the effectiveness of hearing aids use in reducing incident dementia. Using target trial emulation, we leveraged an existing longitudinal cohort study to estimate the association between hearing aids initiation and risk of dementia.

RESEARCH DESIGN AND METHODS: The Health and Retirement Study was used to emulate target trials among non-institutionalized participants aged ≥50 years with self-reported hearing loss, without dementia at baseline, and without use of hearing aids in the previous 2 years. …

Cerebrovascular Disease Is Associated With Alzheimer's Plasma Biomarker Concentrations In Adults With Down Syndrome, Andreas Engvig, Karl Trygve Kalleberg, Lars T. Westlye, Esten Høyland Leonardsen, Alzheimer’S Disease Neuroimaging Initiative Consortium

Neurology Faculty Publications

DNA methylation age (MA), brain age (BA), and frailty index (FI) are putative aging biomarkers linked to dementia risk. We investigated their relationship and combined potential for prediction of cognitive impairment and future dementia risk using the ADNI database. Of several MA algorithms, DunedinPACE and GrimAge2, associated with memory, were combined in a composite MA alongside BA and a data-driven FI in predictive analyses. Pairwise correlations between age- and sex-adjusted measures for MA (aMA), aBA, and aFI were low. FI outperformed BA and MA in all diagnostic tasks. A model including age, sex, and aFI achieved an area under the …

A Genome-Wide Association Meta-Analysis Of All-Cause And Vascular Dementia, Mega Vascular Cognitive Impairment And Dementia (Megavcid) Consortium

Faculty, Staff and Students Publications

INTRODUCTION: Dementia is a multifactorial disease with Alzheimer's disease (AD) and vascular dementia (VaD) pathologies making the largest contributions. Yet, most genome-wide association studies (GWAS) focus on AD.

METHODS: We conducted a GWAS of all-cause dementia (ACD) and examined the genetic overlap with VaD. Our dataset includes 800,597 individuals, with 46,902 and 8702 cases of ACD and VaD, respectively. Known AD loci for ACD and VaD were replicated. Bioinformatic analyses prioritized genes that are likely functionally relevant and shared with closely related traits and risk factors.

RESULTS: For ACD, novel loci identified were associated with energy transport (SEMA4D), neuronal excitability …

Factors Associated With Increased Health Care Utilization For Patients With Dementia With Lewy Bodies: A Narrative Review, Kathryn A. Wyman-Chick, Matthew J. Barrett, Michael J. Miller, Jennifer L. Kuntz, Ella A. Chrenka, Rebecca C. Rossom

Journal of Patient-Centered Research and Reviews

Numerous studies have demonstrated that dementia is associated with increased utilization of health care services, which in turn results in increased costs of care. Dementia with Lewy bodies (DLB) is associated with greater costs of care relative to other forms of dementia due to higher rates of hospitalization and nursing home placement directly related to neuropsychiatric symptoms, parkinsonism, increased susceptibility to delirium, and elevated rates of caregiver burden. There is a critical need for researchers to identify potentially modifiable factors contributing to increased costs of care and poor clinical outcomes for patients with DLB, which may include comorbidities, polypharmacy/contraindicated medications, …

Bilateral Corneal Perforations Due To Elder Neglect, Jaclyn Jordan, Katherine Selman, Richard Byrne

Journal of Geriatric Emergency Medicine

Introduction: Atraumatic corneal melting and perforation is a rare etiology of eye pain and visual loss in the Emergency Department (ED), and xerophthalmia from vitamin A deficiency is primarily described as a cause of blindness in pediatric patients.

Case: A 68-year-old female presented to the ED with worsening eye pain and months of clouding and vision loss. History was limited by cognitive impairment and was provided by spouse. On exam, she was found to have a body mass index of 13.7 kg/m², dry mucous membranes, purulent discharge from both eyes, and opacification and erosion of both corneas. She …

Improving Occupational Therapy Student Utilization Through A Community Engagement Program For Individuals With Dementia, Andrew Stevenson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The contents of this doctoral project include an introduction to some of the difficulties people with dementia face in regard to engaging in the community, and how that may impact their health. It goes on to support how occupational therapists (OTs) have the skills to provide treatment addressing this issue but have faced difficulty entering settings such as memory care. A literature review demonstrates some of the positive benefits that can result from providing people with dementia opportunities for community engagement and reveals some of the difficulties associated with providing quality dementia care. This helps to explain the purpose of …

Does A Reduction In Receiving Assistance With Daily Activities Among Older Adults In Mexico Indicate An Increase In Unmet Needs Or A Decrease In Needs For Care?, Brian Downer, Rafael Samper-Ternent, Philip Cantu, Matthew Miller, Rebeca Wong

Faculty, Staff and Student Publications

OBJECTIVES: The percentage of older adults in Mexico with difficulty completing activities of daily living (ADL) who receive assistance from family appears to be decreasing. We compared 2 birth cohorts of older adults in Mexico to investigate whether this trend reflects an increase in unmet caregiving needs or a decrease in the need for care.

METHODS: We selected Mexican Health and Aging Study participants aged 60-76 in 2001 (n = 4,805) and 2018 (n = 6,494). ADL tasks were dressing, walking, bathing, getting in and out of bed, and toileting. Participants who reported difficulty with an ADL were asked if …

Perceptions Of Acute Care Telemedicine Among Caregivers For Persons Living With Dementia: A Qualitative Study, Anita Chary, Norvin Hernandez, Ana Paulina Rivera, Vivian Ramont, Tracey Obi, Ilianna Santangelo, Christine Ritchie, Hardeep Singh, Emily Hayden, Aanand D Naik, Shan Liu, Maura Kennedy

Faculty, Staff and Student Publications

Persons living with dementia (PLWD) have high emergency department (ED) utilization. Little is known about using telemedicine with PLWD and caregivers as an alternative to ED visits for minor acute health problems. This qualitative interview-based study elicited caregivers' perspectives about the acceptability of telemedicine for acute complaints. We performed telephone interviews with 28 caregivers of PLWD from two academic EDs, one in the Northeast and another in the South. Using a combined deductive-inductive approach, we coded interview transcripts and elucidated common themes by consensus. All caregivers reported they would need to participate in the telemedicine visit to help overcome communication …

Depression And Anxiety Of Care Partners During The Emergency Department Visit Of Older Adults With Cognitive Impairment, Nancy Glober, Anthony Perkins, Joshua Chodosh, Karen Connor, Sujuan Gao, Frank Messina, Malaz Boustani, Soo Borson, Nicole R. Fowler

Journal of Geriatric Emergency Medicine

Background: Older adults with cognitive impairment (CI) are more likely to visit the emergency department (ED) than those without CI. They are also more likely to suffer poor outcomes after an ED visit. Family and friends who serve as care partners contribute significant time and resources to the care of these patients and may need particular attention to their emotional needs during and after the ED encounter. In this study, we examined the association between patient and care partner characteristics on care partner depression and anxiety at the time of the ED visit.

Methods: Baseline data from 640 patient-care partner …

Hearing Health And Dementia - Authors' Reply, Dongshan Zhu, Shiva Raj Mishra, Salim S. Virani, Nipun Shrestha, Fan Jiang

Office of the Provost

No abstract provided.

Critical Reflection In Practice: Generating Knowledge From The Interactions With Promotores For Engagement In Neurocognitive Disorders, Noe Garza, Ney Alliey-Rodriguez, Rosa V. Pirela, Gladys E. Maestre

Research Symposium

Background: Colonias are underserved areas along the Texas-Mexico border, with high incidences of neurocognitive disorders, dementia, and Alzheimer's disease (AD). Our goal is to build capacity to reduce risk, facilitate treatment for affected individuals, and provide caregiver support. Our aim was to construct an approach that was reflective and would reveal the rich and diverse ways in which people make meaning of their experiences and interactions with scientists, faculty, staff and students.

Methods: We examined our work with local community health workers. (CHWs), promotores in Spanish, to establish contact with, engage, mobilize, and educate the Hispanic communities of the Lower …

Shared Disposition Decision Making In The Emergency Department For Persons Living With Dementia, Justine Seidenfeld, Fernanda Bellolio, Anita Vashi, Courtney Van Houtven, Susan Hastings

Journal of Geriatric Emergency Medicine

N/A

Association Of Type 2 Diabetes Subgroups With Cognitive Status Without Modification From Lifestyle Intervention, Michael P Bancks, James Lovato, Ashok Balasubramanyam, Mace Coday, Karen C Johnson, Medha Munshi, Candida Rebello, Lynne E Wagenknecht, Mark A Espeland

Faculty, Staff and Students Publications

CONTEXT: Type 2 diabetes is a risk factor for incident dementia but whether risk and treatment/prevention strategies differ by diabetes subgroup is unknown.

OBJECTIVE: We assessed (1) whether specific type 2 diabetes (T2D) subgroups are associated with mild cognitive impairment (MCI) or probable dementia (PD), and (2) whether T2D subgroups modified the association of the Action for Health in Diabetes (Look AHEAD) multidomain intensive lifestyle intervention (ILI) with MCI/PD.

METHODS: We included 3760 Look AHEAD participants with T2D and overweight or obesity randomly assigned to 10 years of ILI or diabetes support and education. We used k-means clustering techniques with …

Hearing, Cognitive Decline, And The Value Of Hearing Interventions, Lisa Price, Jennifer Ren, Victoria Wong Murray, Dylan Trawinski, Ethan Zerpa-Blanco, Sheam Jahan

Rowan-Virtua Research Day

The term “dementia” includes a wide array of diseases. Millions of Americans are affected by these diseases, especially with aging. Its prevalence makes dementia a candidate for exploratory research in understanding its various etiologies and cause-effect relationships in hopes of developing treatment. Numerous studies have been conducted in an attempt to discern whether a causal relationship exists between hearing loss and dementia, as hearing loss frequently precedes dementia. Some publications have reported a correlation between hearing loss treatment and a decreased dementia incidence rate. This review seeks to investigate the associations between hearing loss and dementia, the efficacy of hearing …

Patterns Of Care Partner Communication For Persons Living With Dementia In The Emergency Department, Adrian D. Haimovich, Aidan Gilson, Evangeline Gao, Ling Chi, Cameron J. Gettel, Mara Schonberg, Ula Hwang, Richard A. Taylor

Journal of Geriatric Emergency Medicine

Abstract

Background:

Nearly half of all persons living with dementia (PLwD) will visit the emergency department (ED) in any given year and ED visits by PLwD are associated with short-term adverse outcomes. Care partner engagement is critical in the care of PLwD, but little is known about their patterns of communication with ED clinicians.

Methods:

We performed a retrospective electronic health record (EHR) review of a random sampling of patients ≥ 65 years with a historical diagnosis code of dementia who visited an ED within a large

regional health network between 1/2014 and 1/2022. ED notes within the EHRs were …

Examination Of Geriatric Care Processes Implemented In Level 1 And Level 2 Geriatric Emergency Departments, Ilianna Santangelo, Surriya Ahmad, Shan Liu, Lauren Southerland, Christopher Carpenter, Ula Hwang, Adriane Lesser, Nicole Tidwell, Kevin Biese, Maura Kennedy

Journal of Geriatric Emergency Medicine

Background: Older adults constitute a large and growing proportion of the population and have unique care needs in the emergency department (ED) setting. The geriatric ED accreditation program aims to improve emergency care provided to older adults by standardizing care provided across accredited geriatric EDs (GED) and through implementation of geriatric-specific care processes.

Objective: The purpose of this study was to evaluate select care processes at accredited level 1 and level 2 GEDs.

Methods: This was a cross-sectional analysis of a cohort of level 1 and level 2 GEDs that received accreditation between May 7, 2018 and …

‘Can You See What I See?’: An Art Project Promoting Living Well With Dementia, Jennifer K. Fortuna

The Open Journal of Occupational Therapy

Caroline Hyland, an illustrator and former occupational therapist based in Dublin, Ireland, provided the cover art for the Winter 2023 edition of The Open Journal of Occupational Therapy (OJOT). “Can You See What I See?” is an acrylic painting on black textured paper. The piece was inspired by Caroline’s grandmother Kathleen Duhig, her love of flowers, and the song “The Dutchman.” Kathleen and three of her sisters lived with dementia. This painting, and several others, are featured in a book Caroline wrote to support living well with dementia. By combining her artistic talents and training as an occupational therapist, Caroline …

Estimating Dementia Risk In An African American Population Using The Dctclock, Marissa Ciesla, Jeff Pobst, Joyce Gomes-Osman, Melissa Lamar, Lisa L Barnes, Russell Banks, Ali Jannati, David Libon, Rodney Swenson, Sean Tobyne, David Bates, John Showalter, Alvaro Pascual-Leone

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The prevalence of Alzheimer's disease (AD) and related dementias (ADRD) is increasing. African Americans are twice as likely to develop dementia than other ethnic populations. Traditional cognitive screening solutions lack the sensitivity to independently identify individuals at risk for cognitive decline. The DCTclock is a 3-min AI-enabled adaptation of the well-established clock drawing test. The DCTclock can estimate dementia risk for both general cognitive impairment and the presence of AD pathology. Here we performed a retrospective analysis to assess the performance of the DCTclock to estimate future conversion to ADRD in African American participants from the Rush Alzheimer's Disease Research …

Home-Based Primary Care In Patients With Dementia: Impact On Cost, Medication Use, And Patient Satisfaction, Megan O'Leary

Theses and Graduate Projects

Background: Individuals living with dementia deserve affordable, accessible, and effective healthcare. These patients often face barriers that make it difficult to consistently access traditional in office primary care. Home-based primary care (HBPC) holds the opportunity to bridge the gap between individuals with dementia and preventative healthcare resources.

Purpose: Dementia rates are increasing as the population ages, and additional research is needed to determine the optimal treatment model for individuals with dementia. This literature review evaluates if patients with dementia receive improved care with HBPC vs in office primary care through examining cost, medication use and compliance, and patient satisfaction.

Methods: …

Dead End: Challenges In Healthcare Delivery To Older Adults With History Of Dementia And Incarceration- A Case Report, Shruti Anand, Saket Saxena

Journal of Geriatric Emergency Medicine

No abstract provided.

Comorbidities And Risk Factors Associated With Insomnia In The Elderly Population, Neil Mookerjee, Nicole Schmalbach, Gianna Antinori, Subhadra Thampi, Dylan Windle-Puente, Amy Gilligan, Ha Huy, Megha Andrews, Angela Sun, Roshni Gandhi, William Benedict, Austin Chang, Ben Sanders, Justin Nguyen, Maanika Reddy Keesara, Janet Aliev, Aneri Patel, Isaiah Hughes, Ian Millstein, Krystal Hunter, Satyajeet Roy

Faculty, Staff and Student Publications

INTRODUCTION/OBJECTIVES: Sleep disorders affect around 50 to 70 million Americans, with chronic insomnia being the most common, especially in the elderly population. With an 11-fold increase in the US office visits due to insomnia, from 0.8 to 9.4 million, between 1993 and 2015, it is imperative to identify the modifiable risk factors. The aim of our study was to examine the association of risk factors and comorbid medical conditions with insomnia in patients 65 years, and older.

METHODS: We performed a retrospective electronic medical record review of the patients aged 65 years and older, who visited our suburban internal medicine …

The Impact Of The Progresses Of Knowledge And Technologies In Pediatrics, Kristofer Harris, Yaobin Ling, Avram S Bukhbinder, Luyao Chen, Kamal N Phelps, Gabriela Cruz, Jenna Thomas, Yejin Kim, Xiaoqian Jiang, Paul E Schulz

Faculty, Staff and Student Publications

Background:

Accumulating evidence suggests that adult vaccinations can reduce the risk of developing Alzheimer’s disease (AD) and Alzheimer’s disease related dementias.

Objective:

To compare the risk for developing AD between adults with and without prior vaccination against tetanus and diphtheria, with or without pertussis (Tdap/Td); herpes zoster (HZ); or pneumococcus.

Methods:

A retrospective cohort study was performed using Optum’s de-identified Clinformatics® Data Mart Database. Included patients were free of dementia during a 2-year look-back period and were≥65 years old by the start of the 8-year follow-up period. We compared two similar cohorts identified using propensity score matching (PSM), one vaccinated …