Geriatrics Commons^™

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. Medicaid is a major source of funding for long term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional, …

Cx3cl1 Reduces Neurotoxicity And Microglial Activation In A Rat Model Of Parkinson's Disease, Mibel M. Pabon, Adam D. Bachstetter, Charles E. Hudson, Carmelina Gemma, Paula C. Bickford

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Parkinson's disease is characterized by a progressive loss of dopaminergic neurons in the substantia nigra. The cause of the neurodegeneration is unknown. Neuroinflammation has been clearly shown in Parkinson's disease and may be involved in the progressive nature of the disease. Microglia are capable of producing neuronal damage through the production of bioactive molecules such as cytokines, as well as reactive oxygen species (ROS), and nitric oxide (NO). The inflammatory response in the brain is tightly regulated at multiple levels. One form of immune regulation occurs via neurons. Fractalkine (CX3CL1), produced by neurons, suppresses the activation of microglia. CX3CL1 …

Forever Young, Edward F. Ansello

Director's Editorials from Age in Action

Gerontologists theorize that each of us is shaped by the influences of cohort and historical time. If there's a oneness of who we were and who we are, then Bob Dylan's music is in many of us. Forever Young is not a paean to age denial. Rather, it seems to invoke virtues or characteristics that never grow old: charity to others, acceptance of kindness, hope, righteousness, courage, fortitude, industriousness, and joy.

Falls, Edward F. Ansello

Director's Editorials from Age in Action

Falls are common, affecting about one third of community-dwelling adults over age 65 and about half over age 80. The risk factors for falling are complex, and falls may themselves be a signal for other troubling conditions. When fear of falling emerges as an issue for some elders, they are likely to reduce their activities, thinking that this will reduce their risk, and isolation and depression can ensue. There are teaching roles for nurses, physicians, and physical therapists in sharing with other professions how to assess gait, vision, or dizziness.

Baby Boomers And Stereotypes, Edward F. Ansello

Director's Editorials from Age in Action

With age we become more and more like ourselves. This would mean millions and millions of individual Baby Boomers, each with his or her own characteristics and life trajectory. Stereotyping would, therefore, be wrong, but it is happening.

The Most Terrible Poverty, Edward F. Ansello

Director's Editorials from Age in Action

Caring, private individuals and agency employees and volunteers in "direct" or "human" services regularly deliver what can be called love, the antidote to the poverty of loneliness. Let's acknowledge the essential importance of people in various forms of human services who reach out to others who are alone.

The Impact Of Providing Rehab Mobility Equipment To Those In Need, Bruce Stelmack, Brian Leitten

Case Studies from Age in Action

Educational Objectives

1. Discuss the need to provide rehabilitation mobility equipment at no cost to those who have no other means to obtain it.

2. Assess the impact on a community when mobility equipment for underinsured impaired persons (“at risk”) cannot be secured.

3. Describe a successful recycling program that provides free rehabilitation mobility equipment.

4. Explain the importance of a community- based model to provide rehabilitation equipment.

Universal Design In Housing, Steve Hansler, Beth Glas

Case Studies from Age in Action

Educational Objectives

1. Show how an aging population increases the need for housing that is accessible and adaptable.

2. Define visitability, universal design, and accessible design.

3. Explain ways to approach universal design including key factors.

4. Illustrate how universal design can be used in both renovation and new construction.

Alcohol, Medications, And Older Adults, Mailtreyee Mohanty, Patricia Slattum

Case Studies from Age in Action

Educational Objectives

1. Describe patterns of simultaneous use of alcohol and Central Nervous System (CNS) - acting medications among older adults.

2. Understand the mechanisms of interaction between alcohol and CNS-acting medications and their consequences.

3. Identify strategies to prevent alcohol-medication interactions among older adults.

4. Recommend resources for older adults and service providers for identifying and managing problematic alcohol and medication use.

Habilitation Therapy In Dementia Care, Paul Raia

Case Studies from Age in Action

Educational Objectives

1. To describe the goal of Habilitation Therapy and how it differs from other methods of dementia care, including rehabilitation.

2. To identify areas or domains in which we have opportunities to bring about and sustain positive emotions.

3. To discuss four communication strategies to use with mid- to laterstage Alzheimer’s patients.

Is Thrombolytic Therapy Safe When Used To Treat Elderly Patients?, Daniel Yaeger

The Science Journal of the Lander College of Arts and Sciences

Recently, research has been conducted to determine if thrombolytic therapy works to dissolve clots and if it is a safe treatment option. The specific purpose of this study is to determine if thrombolytic therapy is safe for use in the elderly. This study was conducted by reviewing the relevant literature that has been published from the time that research began to test the usefulness of thrombolytic therapy. Numerous journals were examined to ensure impartiality and emerge with an unbiased conclusion. The journals were discovered using PubMed article finder, using Google as a search engine, and by scrutinizing relevant references found …

Nitric Oxide And Osteoporosis: What A Gas!, Sophie Jamal

Canadian Centre for Activity and Aging Presentations

No abstract provided.

Residency Corner, Tamara Gravano

Physical Therapy Faculty Research

The new Residency Corner will feature articles written by residents that describe topics such as in-depth case analysis, problem solving, and practice as nonphysician primary care providers. Here residents will get to discuss their findings and thought-processes with an audience of their peers--those clinicians and academics interested in the advancement of geriatric health care. Also, for those who may be interested to see what geriatric residency education is really all about, these clinical snapshots can help remove the veil and provide a glimpse into the level of practice our residents are experiencing. Yet, this is only one half of the …

Evaluation Of Verbal Behavior In Older Adults, Amy Gross

Dissertations

Older adults make up a large and increasing portion of the population (U.S. apply those assessments to the evaluation of verbal behavior in older adults with and without dementia. The research addressed two questions. First, in what way do verbal behavior problems differ between older adults with and without dementia? Second, does language deteriorate in a pattern compatible with Skinner's analysis of functionally independent verbal operants? Thirty-one participants were categorized into Control (n=15) and Dementia (n=16) Groups based on their score on the Dementia Rating Scale-2. Verbal behavior assessments were administered to participants on two occasions, separated by one week. …

Attention-Deficit/Hyperactivity Disorder In Childhood Is Associated With Cognitive Test Profiles In The Geriatric Population But Not With Mild Cognitive Impairment Or Alzheimer's Disease, N. Ivanchak, Erin L. Abner, S. A. Carr, S. J. Freeman, A. Seybert, John Ranseen, Gregory A. Jicha

Sanders-Brown Center on Aging Faculty Publications

The frequency of ADHD in the aging population and its relationship to late-life cognitive decline has not been studied previously. To address this gap in our understanding, the Wender-Utah ADHD Rating scale (WURS) was administered to 310 geriatric subjects with cognitive status ranging from normal cognition to mild cognitive impairment to overt dementia. The frequency of WURS-positive ADHD in this sample was 4.4%. WURS scores were not related to cognitive diagnoses, but did show nonlinear associations with tasks requiring sustained attention. The frequency of ADHD appears stable across generations and does not appear to be associated with MCI or dementia …

Preference Assessments For Older Adults With Dementia: Utility Of The Mswo Procedure And Assessment Of The Stability Of Preference, Paige B. Raetz

Dissertations

Individuals with dementia suffer from a variety of cognitive deficits that can lead to a lack of engagement in activities. In recent years, researchers have begun to look at ways to assess preferences in hopes that increased identification of leisure items may lead to increases in engagement. Due to the decline in cognitive status a simple questionnaire may not be sufficient to assess preference for this population. As a result, several recent studies have incorporated the use of systematic preference assessments to assess preference for leisure activities with adults with dementia using a paired stimulus format. The purpose of the …

Risk Factors For Driving Cessation Vary By Race And Ethnicity, Elizabeth Dugan, Frank Porell, Chae Man Lee

Gerontology Institute Publications

Driving is related to our identity and independence as well as allowing us to get needed goods, services, and social opportunities that enrich daily life. Yet with increasing age, the risk for developing threats to medical fitness to drive increases. Driving cessation is related to a long list of negative outcomes, such as: depression, social isolation, diminished access to health care, and diminished quality of life. We investigated risks for driving cessation, paying close attention to racial differences. This study used data from the Health and Retirement Study (HRS), 1998-2008. The study included N=46, 528 older people (age 65 and …

What Is The Safety And Efficacy Of Tarenflurbil (R-Flurbiprofen) In Mild To Moderate Alzheimer’S Disease?, Lauren Viscount

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine what is the safety and efficacy of Tarenflurbil (R-flubiprofen) in mild to moderate Alzheimer’s Disease.

Does Beta Amyloid Immunization Reduce Amyloid Plaques And Preserve Cognitive Function In Patients With Alzheimer’S Disease?, Andrea Sasin

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to examine the efficacy of beta amyloid immunization in reducing amyloid plaques and preserving cognitive function in patients with Alzheimer’s disease (AD).

The Cultural Context Of Alzheimer’S Disease: The Impact Of Perception And Knowledge On Willingness To Seek Medcial [I.E., Medical] Help Among Ghanaian Immigrants In The United States., Olivia Owusu-Boakyewaah

Theses and Dissertations

This correlational study explored the knowledge, perceived seriousness, and willingness to seek medical help for Alzheimer’s Disease (AD) among Ghanaian Immigrants currently residing in the Unites States. Study participants were 163 Ghanaian Immigrants between the ages of 45 and 90, attending Ghanaian community churches in Virginia and Maryland. Significant results include a positive correlation between knowledge and perceived seriousness of the disease, perceived seriousness of the disease was negatively correlated with caregiving experience. These results as well as several seemingly counterintuitive findings are discussed in terms of the Health Disparities and Psychometric challenges. Specifically, these results points to the necessity …

Physical Activity And Cognitive-Health Content In Top-Circulating Magazines, 2006–2008, Anna E. Greer, Sara J. Corwin, Daniela B. Friedman

All PTHMS Faculty Publications

Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90–300 min of …

Dementia Caregiving Outcomes: The Impact Of Caregiving Onset, Role Occupancy, And Care-Recipient Decline, Katherina Nikzad-Terhune

University of Kentucky Doctoral Dissertations

Dementia is characterized as a progressive loss of brain function that results in the deterioration of many cognitive and physical abilities. Alzheimer’s disease (AD) is the most common form of dementia, causing steady declines in memory, functional abilities, and mental functioning. With a projected increase of degenerative illnesses, such as AD, family caregiving for individuals with the disease is also steadily increasing. Caring for an individual with AD has been characterized as a “career,” and within this career are a number of key transitions, including the onset of caregiving. Preexisting caregiving research reveals a number of negative consequences for AD …

Improving The Quality Of Information Sent To Primary Care Physicians For Patients Discharged From Nursing Facilities, Catherine M. Glew Bm, Bs, Cmd, Anne M. Yawman Md

Department of Medicine

No abstract provided.

Conformation Dependent Monoclonal Antibodies Distinguish Different Replicating Strains Or Conformers Of Prefibrillar Aβ Oligomers, Rakez Kayed, Isabel Canto, Leonid Breydo, Suhail Rasool, Tamas Lukacsovich, Jessica Wu, Ricardo Albay, Anna Pensalfini, Stephen Yeung, Elizabeth Head, J. Lawrence Marsh, Charles Glabe

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Age-related neurodegenerative diseases share a number of important pathological features, such as accumulation of misfolded proteins as amyloid oligomers and fibrils. Recent evidence suggests that soluble amyloid oligomers and not the insoluble amyloid fibrils may represent the primary pathological species of protein aggregates.

RESULTS: We have produced several monoclonal antibodies that specifically recognize prefibrillar oligomers and do not recognize amyloid fibrils, monomer or natively folded proteins. Like the polyclonal antisera, the individual monoclonals recognize generic epitopes that do not depend on a specific linear amino acid sequence, but they display distinct preferences for different subsets of prefibrillar oligomers. Immunological …

Deficient Liver Biosynthesis Of Docosahexaenoic Acid Correlates With Cognitive Impairment In Alzheimer's Disease, Giuseppe Astarita, Kwang-Mook Jung, Nicole C. Berchtold, Vinh Q. Nguyen, Daniel L. Gillen, Elizabeth Head, Carl W. Cotman, Daniele Piomelli

Sanders-Brown Center on Aging Faculty Publications

Reduced brain levels of docosahexaenoic acid (C22:6n-3), a neurotrophic and neuroprotective fatty acid, may contribute to cognitive decline in Alzheimer's disease. Here, we investigated whether the liver enzyme system that provides docosahexaenoic acid to the brain is dysfunctional in this disease. Docosahexaenoic acid levels were reduced in temporal cortex, mid-frontal cortex and cerebellum of subjects with Alzheimer's disease, compared to control subjects (P = 0.007). Mini Mental State Examination (MMSE) scores positively correlated with docosahexaenoic/α-linolenic ratios in temporal cortex (P = 0.005) and mid-frontal cortex (P = 0.018), but not cerebellum. Similarly, liver docosahexaenoic acid content was lower in Alzheimer's …

Polymorphisms In The Macrophage Migration Inhibitory Factor Gene And Bone Loss In Postmenopausal Women, George A. Kuchel, Anne M. Kenny

UCHC Articles - Research

Osteoporosis is a severe condition in postmenopausal women and a common cause of fracture. Osteoporosis is a complex disease with a strong genetic impact, but susceptibility is determined by many genes with modest effects and environmental factors. Only a handful of genes consistently associated with osteoporosis have been identified so far. Inflammation affects bone metabolism by interfering with the interplay between bone resorption and formation, and many inflammatory mediators are involved in natural bone remodeling. The cytokine macrophage migration inhibitory factor (MIF) has been shown to affect bone density in rodents, and polymorphisms in the human MIF promoter are associated …

Program Evaluation Of A Community-Based Door-Through-Door Medical Escort Service, Lauren A. Martin

Gerontology Institute Publications

This report summarizes the program evaluation findings of a Boston-based organization’s Medical Escort program. This “door-through-door” service strives to provide medical transportation, physical assistance, and emotional support to elders on their way to the doctor’s office, during medical appointments and on the way back home again. By offering added assistance the program attempts to remove environmental barriers associated with access to health care. This evaluation combines previously collected program statistics with surveys (32) from program volunteers and phone interviews (78) with recipients.

Hip Power Asymmetry In Older Adult Fallers And Non-Fallers, Lauren Grace Mcdonald

Boise State University Theses and Dissertations

The purpose of this study was to determine if a difference exists in hip power asymmetry between community-dwelling older adult fallers and non-fallers. Hypothesis: fallers would be more asymmetrical than non-fallers. Participants: 21 non-fallers (10 females, 11 males) and 18 fallers (14 females, 4 males) over the age of 65 (76.5 ± 6.9yrs). Method: Isokinetic peak torque during flexion, extension, abduction, and adduction at four velocities was recorded as measures of leg power. Asymmetry equaled the percent of power difference between each leg. Data analysis: Differences in age, physical activity, height, weight, and BMI were assessed …

Effect Of Calcium Supplements On Risk Of Myocardial Infarction And Cardiovascular Events: Meta-Analysis, Mark J. Bolland, Allison Avenell, John A. Baron, A. Grey

Dartmouth Scholarship

Objective: To investigate whether calcium supplements increase the risk of cardiovascular events.

Osteoporosis is a major cause of morbidity and mortality in older people. Calcium supplements margin- ally reduce the risk of fracture, and most guidelines recommend adequate calcium intake as an integral part of the prevention or treatment of osteoporosis. Consequently, calcium supplements are commonly used by people over the age of 50. Observational stu- dies suggest that high calcium intake might protect against vascular disease, and the findings are consis- tent with those of interventional studies of calcium sup- plements thatshow improvementin some vascular risk factors. In contrast, …

Designing For An Aging Population, Allison Shives

Undergraduate Research Conference

Aging starts at birth and continues throughout life. As people age, they need to continue to live a happy life. A designer’s job is to design a facility that will encourage an independent lifestyle while providing the help and community involvement aging requires. The design solution should meet the aging population’s desire to age in place. An assisted living facility allows older adults to live independently while being surrounded by a support group and events that promote an active lifestyle which is conducive to physical and mental wellbeing.