Other Medical Specialties Commons^™

The Relationship Between Physical Activity And Cognitive Performance In African American Older Adults, Rio S. Tate

USF Tampa Graduate Theses and Dissertations

The number of older adults in the United States is expected to increase in the years to come. As we age, cognitive performance is noted to decline. African American older adults are more likely than non-Hispanic Whites to experience cognitive impairment and dementia. It is known that physical activity is a modifiable risk factor for dementia. It is not known the extent to which physical activity engagement is related to cognitive performance in African American older adults, and which variables, if any, moderate this association. To answer this question, the authors examined the association between three intensities of physical activity …

A Life Course Approach To Understanding Preserved Cognition In Late Life, Cassidy E. Doyle

USF Tampa Graduate Theses and Dissertations

Some level of cognitive decline is generally expected with advanced age. However, a subgroup of individuals – commonly labeled as ‘SuperAgers’ – maintain youthful memory abilities into their 80s and beyond. Relatively little is known about factors across the life course related to this phenotype. This dissertation used population-based data from the Health and Retirement Study (HRS) to investigate lifestyle factors related to the most youthful cognitive trajectory in the United States and assess how their cognition fares over time. Three research questions were addressed: (1) Can samples of youthful cognitive agers be identified longitudinally in a population-based dataset? (2) …

Understanding The Coping Mechanisms Used By Older Formerly Incarcerated Persons During Reentry, Sayla Victores

USF Tampa Graduate Theses and Dissertations

The current study investigated the coping mechanisms employed by older formerly incarcerated individuals during reentry. While there is research on the reentry experiences of older formerly incarcerated individuals, less is known about how they cope with the strains of reentry. As such, this study fills this gap in the literature by exploring both adaptive and maladaptive coping mechanisms employed by this population during reentry. Using in-depth interviews with 20 older, formerly incarcerated individuals, I found that older formerly incarcerated persons experienced challenges related to securing stable housing, finding employment and economic security, community supervision, stigma and judgment, and overall reintegration. …

Contribution Of Contextual Factors And Neuropathology To Dementia, Monica E. Nelson

USF Tampa Graduate Theses and Dissertations

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that has extensive biological heterogeneity. It is not clear the extent to which this heterogeneity may be detected in participants without dementia, how it relates to incident AD dementia, and whether contextual factors may change how neuropathology relates to incident AD dementia. Therefore, this dissertation was completed using data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI; n = 1,703) and the Czech Brain Aging Study (CBAS; n = 385) to address the following aims: to assess biological heterogeneity in participants without dementia, to relate this heterogeneity to incident AD dementia, and to …

Complaint Patterns In Us Nursing Homes: 2013-2017, Kallol Kumar Bhattacharyya

USF Tampa Graduate Theses and Dissertations

Complaints provide valuable information to consumers about nursing homes (NHs). Complaints that are substantiated often lead to an investigation and potentially a deficiency citation. In recent years, Nursing Home Quality data show mixed results. According to some Federal reports, one of the four data sets that measure residents’ quality of care in NHs, consumer complaints, suggest that residents’ concerns over quality have increased. In contrast, the other three datasets, i.e., deficiencies through annual recertification surveys, staffing levels, and clinical quality measures, reveal potential improvement in NH quality of services. The purpose of this dissertation is to carry out analyses of …

Stressors, Resources, And Psychological Well-Being Among Working Black And White Caregivers In The United States, Maureen E. Templeman

USF Tampa Graduate Theses and Dissertations

By the year 2060 in the United States (U.S.), not only will the number of adults aged 65 and older double, non-Hispanic Whites (Whites), who currently constitute 77% of the older adult population, will constitute just slightly more than half of older adults. As the older adult population diversifies, so will their caregivers. Over 60% of informal caregivers of older adults (caregivers) are employed, and the majority of these are employed full time. Little is known about the unique experiences of working Black or African American (Black/AA) and White caregivers and non-caregivers in the U.S. This dissertation consists of three …

Serious Mental Illness In Nursing Homes: Quality Concerns, Dylan J. Jester

USF Tampa Graduate Theses and Dissertations

Objective: This dissertation is made of two academic papers followed by a chapter discussing policy implications of the findings. The objective of this dissertation is to better understand if high-serious mental illness (SMI) nursing homes (NHs) provide poorer quality of care (e.g., operationalized as staffing levels, NH Compare quality star ratings, and health deficiencies) and whether quality in high-SMI NHs is confounded by payer mix (e.g., the proportion of residents who are Medicaid-reimbursed). A modified Donabedian Structure, Process, Outcome (SPO) Model was used as the main theoretical framework.

Methods: Data came from the Certification and Survey Provider Enhanced Reports (CASPER) …

Evaluation Of Aging And Genetic Mutation Variants On Tauopathy, Amber M. Tetlow

USF Tampa Graduate Theses and Dissertations

Alzheimer’s disease (AD) is characterized by amyloid β plaques and neurofibrillary tau tangles (NFTs). While research has demonstrated amyloid pathology occurs prior to tau pathology, or tauopathy, tau has proven to be more toxic. Tauopathy is associated with cognitive declines and neurodegeneration. These findings have highlighted the importance of further understanding tauopathy. In the progression of tauopathy, there is an observable immune response that can be measured by glial cells such as microglia. Activated microglia are known to exacerbate tauopathy rather than reducing the pathology. Research has indicated that with increased age there is an increased risk for AD-related tauopathy …

The Left Behind Generation: Instructional Practices To Increase The Technological Literacy Of Older Adults, Daphne Pace Phillips

USF Tampa Graduate Theses and Dissertations

This study sought to explore the utilization and perception of best practices by community-based technology training programs when instructing older adults to become technologically literate. The target population included adults age 55 years and older of the Baby Boomer generational cohort who ranged academically from possessing a high school diploma or General Education Diploma (GED) through a college degree and had enrolled in a local technology training program to improve their technological skill level with the goal of obtaining employment and/or to remain functionally independent. This study was conducted at three community technology training centers located in the southeast that …

Widow Narratives On Film And In Memoirs: Exploring Formula Stories Of Grief And Loss Of Older Women After The Death Of A Spouse, Jennifer R. Bender

USF Tampa Graduate Theses and Dissertations

This dissertation analyzes narratives (written and mediated) about widows’ post-loss experiences—specifically the ways in which these women embody and adjust/adhere to their post-loss widow identities—and whether or not the canonical/formula stories about widows reflect current experiences of widowhood. I look at older widowed women—both those in well-read widow memoirs and also in media portrayals of widows on film. The canonical view of widows as not attractive, not useful, and not interesting needs to be reexamined in light of changing ideas about gender roles and increased longevity. Surely older women have experiences, desires, and goals that encompass more than being socially …

Supporting Persons With Dementia In Communicating Their Care Preferences, Vanessa L. Burshnic

USF Tampa Graduate Theses and Dissertations

Person-centered care is important to the quality of life of nursing home residents with dementia. Preference assessments enable person-centered care by documenting residents’ preferred activities. Residents with severe dementia are less likely to have a role in preference assessment due to communication challenges associated with the disease. External supports (visual and text cues) are effective in improving the communication of residents with dementia, but these cues are often not used in practice. Standard assessment (verbal questioning) places greater demands on short-term memory and attention, which are known deficits in dementia.

Applying a within-subjects design, this study evaluated two conditions (standard …

Using A Stress Process Model To Examine Longitudinal Racial Differences In Well-Being And Health: Results From A Population-Based Study Of Caregiving, Adrian N. S. Badana

USF Tampa Graduate Theses and Dissertations

As the older adult population of the United States increases over the next decade, many family caregivers will be needed to provide care for aging loved ones. The growing diversity of the population may also mean that more racial/ethnic minority caregivers will be providing care to older family members. Most of the studies examining race and caregiving have focused on racial differences in stress, coping, well-being and health among White and Black family caregivers. However, previous research examining racial differences in caregiving has often been limited to smaller convenience samples of caregivers, which limit generalizability of study findings. In this …

Broadening The Lens: A Systems Approach To Nursing Home Quality Improvement, Kelly M. Smith

USF Tampa Graduate Theses and Dissertations

The National Quality Award Program, sponsored by the American Healthcare Association National Center for Assisted Living, was implemented to cultivate continuous quality improvement in nursing homes and assisted living facilities. Based upon the Baldridge Criteria for Performance Excellence, the program utilizes a systems-based or Big “Q” approach to quality and requires applicants to examine seven categories of their organizational environment including: 1) leadership, 2) strategy, 3) customers, 4) measurement, analysis, and knowledge management, 5) workforce, 6) operations, and 7) results. The subsequent dissertation examines whether award status is associated with better performance on publicly reported quality measures and financial performance …

The Relationship Between Sleep Quality And Motor Function In Hospitalized Older Adult Survivors Of Critical Illness, Maya N. Elías

USF Tampa Graduate Theses and Dissertations

The primary, descriptive aim of this dissertation was to describe the nighttime sleep quality of previously mechanically ventilated older adult patients within 24-48 hours of transfer out of the intensive care unit (ICU) to a medical-surgical floor. The secondary, exploratory aim was to examine the relationships between post-ICU sleep efficiency (SE) and wake after sleep onset (WASO) with grip strength in previously mechanically ventilated older adult patients within 24-48 hours of transfer out of the ICU.

The study included 30 adults ages 65 and older (11 women, 19 men; age 71.37 ± 5.35, range 65-86 years), who were functionally independent …

Pain And Physical Function In A Socioeconomically Diverse Sample Of Black And White Adults, Angela Sardina

USF Tampa Graduate Theses and Dissertations

Musculoskeletal pain alters physiological function and these changes may be evidenced as early as middle age. Previous research has concluded that middle-aged adults are a high-risk group for chronic pain and report functional limitations similar to older adults. However, few studies have explored the unique individual factors (e.g., sociodemographic, health, and psychosocial characteristics) that may drive the pain experience; and more research is needed that examines the relationships between musculoskeletal pain and physical function, using objective performance measures, in a sample of racially and socioeconomically diverse adults.

Data from the Healthy Aging in Neighborhoods of Diversity across the Life Span …

Improving Dementia Care Through Online Training Programs: A Systematic Review And Evaluation, Michelle L. Pleasant

USF Tampa Graduate Theses and Dissertations

Over the next thirty years, Alzheimer’s disease rates will increase alongside global aging. To handle the anticipated increase in demand, knowledgeable and skilled dementia caregivers are in need throughout the long-term care spectrum. Online training programs have emerged as a viable and convenient platform to educate both formal and informal caregivers. The first and second study systematically reviewed online dementia training programs and evaluated the CARES® Dementia Basics Training Program among formal and informal caregivers.

The first study is a systematic review of online dementia-based training programs for both formal and informal caregivers conducted using the Preferred Reporting Items for …

Reducing Caregiver Burden: Fostering Healthy Aging And Social Support, Maria A. Rodriguez

USF Tampa Graduate Theses and Dissertations

Over 43.5 million Americans provide informal care to a fast-growing elderly population in the United States. Informal care allows care-recipients to remain functional members of society. However, research suggests that the demands of informal care can negatively impact the health of caregivers. For example, caregiver burden increases the risk for poor health in caregivers compared to non-caregivers. Caregiving research is on the rise, but the dynamics of informal care in active retirement communities remains widely unexplored. To provide adequate services to lessen caregiver burden and improve the Quality of Life (QoL) of informal caregivers, the various settings in which informal …

Moderation Analysis Of Bowel Function Among Nutrients And Physical Function Or Depression, As Well As Whether Bowel Function Is Related To Cognition In Older Adults, Jessie Alwerdt

USF Tampa Graduate Theses and Dissertations

As we age, the risk for gut issues, such as smooth muscle tone, may be an underlying indirect or direct cause or risk factor for many age-related issues, such as frailty. Consequences of decreased motility and depleted epithelial barrier may result in nutrient deficiencies that may increase the risk for malnutrition (Brownie, 2006). Further, there is increasing evidence that there is a gut-brain-axis relationship that may influence cognition and mental health issues, such as depression and anxiety. While there are relationships established, the interconnections of these factors have yet to be fully understood.

This dissertation examined several relationships specific to …

Care Setting Of The Last Resort: Care Transitions For Nursing Home Residents Directly Admitted From The Community, Amanda A. Holup

USF Tampa Graduate Theses and Dissertations

Since the late 1980s, policymakers have attempted to reduce the institutional bias of their long-term services and supports by investing in more accessible home and community-based services for older adults with long-term care needs and adults with disabilities. To further advance rebalancing discussions, this study examined the resident, facility, and state characteristics associated with the admission of community-dwelling older adults to the nursing home and the subsequent discharge of this population back to community settings. Data from the Minimum Data Set (MDS) 2.0 were used to construct episodes of care for all newly-admitted residents aged 65 and older to any …

Using Instructions And Behavioral Skills Training To Teach Facebook Skills To Seniors, Alison Ann Oconnell

USF Tampa Graduate Theses and Dissertations

The senior population is growing faster than any other population group, and life expectancy is increasing. E-mail and social media enable people of all ages to stay in touch, and find information, resources, and entertainment. Positive effects are associated with computer and internet use for older adults, but not all seniors have embraced technology and some seniors feel negatively about it. Several different methods have been used to teach seniors computer skills, including mentoring, lecturing, and providing instructions, but not many procedures have been evaluated for effectiveness. In the current study, we recruited three to five seniors, taught them to …

Lipoproteins And Health Outcomes: Cognitive And Physical Function In Older Adults, Marianne Chanti-Ketterl

USF Tampa Graduate Theses and Dissertations

Cardiovascular health is a major determinant of quality of life and mortality, especially in older adulthood. With the world’s oldest population increasing at expedited rates, challenges from cardiovascular conditions and its implications are spawning. Although it is well known that dyslipidemia may lead to cardiac events, less is known about the effects on cognitive and physical function in older adults. Epidemiological studies show that optimizing current preventive strategies even at older ages may reduce the incidence of cardiovascular comorbidity (e.g. hypertension, stroke) and increase quality of life. Determining the association between lipoproteins and cognitive and functional performance in older adults …

Keeping Up With The Grandkids: Using Tagteach To Train Baton Twirling Skills In Older Adults, Sarah Elizabeth Hester

USF Tampa Graduate Theses and Dissertations

Exercise has many physical, cognitive, and social benefits, but the majority of older adults do not meet the recommended level of physical activity (Centers for Disease Control and Prevention, 2014). TAGteach, which combines elements of both behavioral coaching and acoustical feedback, has been demonstrated as an effective way to teach athletic skills (Fogel, Weil, & Burris, 2010; Quinn, Miltenberger, & Fogel, 2015; Stokes, Luiselli, Reed, & Fleming 2010). However, none of the current research on teaching athletic skills targeted an older population. This study evaluated TAGteach in a multiple baseline across behaviors design as a method of teaching 4 basic …

Analyzing The Effect Of Complaints, Investigation Of Allegations, And Deficiency Citations On The Quality Of Care In United States Nursing Homes (2007 – 2012), Kevin E. Hansen

USF Tampa Graduate Theses and Dissertations

The quality of care in nursing homes has been evaluated from many varying perspectives, but few studies have analyzed quality in light of complaints made to state survey agencies by residents, their family members, or other individuals interacting with the nursing home. This study analyzed complaints, investigation of complaint allegations, and complaint-related deficiency citations to determine their effect, if any, on the quality of care in nationwide nursing homes. Using the Online Survey Certification and Reporting (OSCAR) survey dataset for facility characteristics and the complaint investigation dataset for outcomes of complaint investigation, analyses conducted included descriptives, correlations, conceptual mapping for …

Sleep, Depressive Symptoms And Cognition In Older Adults And Caregivers Of Persons With Dementia, Glenna Shemida Brewster

USF Tampa Graduate Theses and Dissertations

Caregivers of persons with dementia, who are often older adults, report sleep disturbance, high rates of depressive symptoms and may be at risk for impaired cognition. This dissertation examined sleep, depressive symptoms, and cognition in older adults and caregivers of persons with dementia. The aims of the review of literature were to understand, in community dwelling adults 60 years and older, the relationships among sleep parameters (sleep onset latency, wake after sleep onset, sleep efficiency, total sleep time, and general sleep complaints), and the domains of cognition (Executive Function, Attention, Episodic Memory, Working Memory, Processing Speed), and global cognition. Based …

The Effects Of The A Matter Of Balance Program On Falls, Physical Risks Of Falls, And Psychological Consequences Of Falling Among Older Adults, Tuo Yu Chen

USF Tampa Graduate Theses and Dissertations

The effectiveness of the A Matter of Balance (MOB) program, a multifactorial falls prevention intervention, is uncertain. Although targeting multiple risk factors of falling at the same time seems reasonable and desirable, in that falls are often caused by several risk factors, results from previous studies investigating the effects of multifactorial falls prevention interventions are inconsistent. In addition, research shows that single factor interventions (e.g., exercise) can produce the same effects. The cost-effectiveness of multifactorial falls prevention interventions has varied across studies (e.g., Jenkyn, Hoch, & Speechley, 2012; Tinetti, Baker, et al., 1994). Despite the fact that the American Geriatrics …

Daily Experiences Of Older Adults With Mild Cognitive Impairment, Elizabeth Hahn

USF Tampa Graduate Theses and Dissertations

Rationale and study aims: Persons with mild cognitive impairment (MCI) experience declines in everyday functioning and cognitive performance greater than what is experienced in normal aging but less than that of dementia. Daily stress and daily memory complaints associated with cognitive deficits may contribute to greater psychological distress in the day-to-day experiences of persons with MCI. However, research examining the occurrence of daily stressors, daily memory complaints and psychological distress in MCI is limited, and it is not clear how the daily processes of stress and affect in persons with MCI compare to cognitively healthy older adults. This dissertation examined …

Bereavement Outcomes Among Spousal Hospice Caregivers: The Role Of Rumination, Feelings Of Relief, And Perceived Suffering, Jessica Y. Allen

USF Tampa Graduate Theses and Dissertations

Background: The death of a spouse is among the most distressing life events faced by older adults and frequently follows long periods of providing extensive care and support. Although many spouses are resilient following loss, a number of bereaved spousal caregivers have poor psychological well-being and may benefit from clinical services. However, it can be difficult to determine who may most benefit from bereavement services and why some individuals are at greater risk for poor bereavement; thus, there is a need for greater understanding of the process of bereavement. Therefore, the purpose of this dissertation was to investigate a number …

The Impact Of Hospice And Dementia Special Care Units On End-Of-Life Care For Individuals With Dementia, Catherine Elizabeth Mccarty

USF Tampa Graduate Theses and Dissertations

ABSTRACT

Hospice and Dementia Special Care Units (DSCUs) have been shown to be gold standards of care for individuals who are dying and for those with dementia in nursing homes. Using a retrospective administrator and family survey, this study investigated whether the processes of care used in hospice and DSCUs are associated with increased quality of end of life (EOL) care for individuals with dementia. A convenience sample of 17 facilities in four states (FL, PA, MD and MA) was included in the study. Nursing home administrators were surveyed between September 2008 and October 2009. The administrators identified 116 family …

The Role Of Lipoproteins/Cholesterol In Genomic Instability And Chromosome Mis-Segregation In Alzheimer's And Cardiovascular Disease, Antoneta Granic

USF Tampa Graduate Theses and Dissertations

Several lines of evidence link Alzheimer's disease (AD) to atherosclerosis (CVD), including that elevated low density lipoprotein (LDL)-cholesterol is a common risk factor. Development of genomic instability could also link the two diseases. Previous fluorescence in situ hybridization (FISH) analyses revealed a clonal expansion of aneuploid smooth muscle cells underlying atherosclerotic plaques. Likewise, cellular and mouse models of AD revealed tau-dependent mitotic defects and subsequent aneuploidy partly resulting from amyloid-beta (A&beta) interference with microtubule (MT) stability, and specific MT motors function. Moreover, AD patients develop aneuploid/hyperploid cells in brain and peripheral tissues, implicating similar mechanism that may lead to apoptosis …

Patient Safety In Nursing Homes, Kali Thomas

USF Tampa Graduate Theses and Dissertations

Safety of residents has gained increased popularity in recent years following a report from the Institute of Medicine attributing 98,000 hospital deaths each year to errors by staff. As a result, regulatory agencies, advocates, and health care providers have shifted their focus to understanding patient safety and developing a culture that promotes safety. However, nursing homes lag behind other health care providers in their adoption of a patient safety culture and understanding what factors affect safety in resident care. These insights are needed to ensure that nursing home residents receive the safe care.

The purpose of this dissertation is to …