Geriatrics Commons^™

Nonpharmacological Practices For Reducing Agitation In Persons With Dementia, Meghan L. Farkas

Commonwealth Scholars Program

1 in 11 people aged 45 years and older experience subjective cognitive decline, with nearly a third identifying a decline in the ability to participate in social activities, work, or volunteering. There are twelve modifiable risk factors that can either increase or decrease an individual's possibility of developing Dementia. This can include excessive alcohol consumption, head injury, air pollution, lower education level, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and infrequent social contact. These modifiable risk factors may prevent or delay up to 40% of dementias. Furthermore, many risk factors cluster around inequalities, which occur particularly in Black, …

What Matters Most: Cna Perspectives On Workforce Education, Professional Identity And Age-Friendly Care, Shannon Arnette, Annie Rhodes, Kimberly Ivey, Christian Bergman, Leland "Bert" Waters

Case Studies from Age in Action

Learning Objectives

1. Identify the gaps in current Certified Nursing Assistant (CNA) training in relation to Delirium, Dementia(s), and Depression (3D’s).

2. Identify CNA learning preferences.

3. Review the constructed tele-education training sessions that incorporate age-friendly care and What Matters Most (WMM) to participants in regards to the 3D’s.

4. Increase the CNAs’ competency and level of comfort working with individuals living with the 3D’s.

Recognizing And Responding To Abuse In Later Life: Feedback From Virginia’S Frontline, Sarah A. Marrs, Courtney O'Hara

Case Studies from Age in Action

Learning Objectives

1. To describe a research project aimed at understanding the recognition of and response to abuse in later life in the greater Richmond area

2. To discuss the structural factors that contribute to underidentification and under-resourcing of services that address abuse in later life

3. To discuss the relationship between ageism and abuse in later life

Coping With Macular Degeneration: Three Case Studies, Ajit D. Tiwari

Case Studies from Age in Action

Educational Objectives

1. Learn about the diagnosis and available treatments for Age Related Macular Degeneration (AMD).

2. Explain the differences between Dry and Wet AMD.

3. Understand the impact of vision loss on the lives of older adults.

Sound And Silence For Patients With Dementia, Jess Porteous

Theses and Graduate Projects

Dementia, a condition that causes cognitive and physical impairments in the aging population, is becoming a global health issue as life expectancy continues to rise. Ineffective and inhumane interventions, such as physical and chemical restraints, are often used in acute hospitalizations due to safety concerns stemming from behavioral and psychological symptoms of dementia. Nurses often feel overwhelmed by the complex needs of patients with dementia and may suffer from moral injury while trying to care for them with limited interventions. Fortunately, integrative therapies such as mindfulness meditation, energy therapies, and sound healing, show promising results for patients with dementia. Resonant …

Comparison Of Maintenance Gains From Two Treatment Approaches For Patients Diagnosed With Apraxia Of Speech And Broca’S Aphasia: A Critically Appraised Topic, Kalli B. Whiting

The Graduate Review

Three peer-reviewed research articles demonstrated benefits in using the articulatory-kinematic approaches of sound production treatment (SPT) and speech motor learning (SML) for intervention of patients diagnoses with apraxia of speech (AOS) concomitant with aphasia over the age of 50. This CAT was intended to review and compare the treatment maintenance between the two approaches using a specific search question; however, there was limited evidence for the specified population in that question. Although both approaches warranted positive outcomes, the SML approach may demonstrate a stronger linkage to the underlying features of apraxia of speech based on the method’s rationale. Through the …

Dysphagia Is Associated With Worse Clinical Outcomes In Geriatric Trauma Patients, Heather R Kregel, Mina Attia, Claudia Pedroza, David E Meyer, Michael W Wandling, Shah-Jahan M Dodwad, Charles E Wade, John A Harvin, Lillian S Kao, Thaddeus J Puzio

Faculty, Staff and Student Publications

INTRODUCTION: Dysphagia is associated with increased morbidity, mortality, and resource utilization in hospitalized patients, but studies on outcomes in geriatric trauma patients with dysphagia are limited. We hypothesized that geriatric trauma patients with dysphagia would have worse clinical outcomes compared with those without dysphagia.

METHODS: Patients with and without dysphagia were compared in a single-center retrospective cohort study of trauma patients aged ≥65 years admitted in 2019. The primary outcome was mortality. Secondary outcomes included intensive care unit (ICU) length of stay (LOS), hospital LOS, discharge destination, and unplanned ICU admission. Multivariable regression analyses and Bayesian analyses adjusted for age, …

Effect Of Living Arrangements On Cognitive Function In Chinese Elders: A Longitudinal Observational Study, Yanwei Lin, Qi Zhang, Tingxian Wang, Zhirong Zeng

Community & Environmental Health Faculty Publications

Objective To examine how living arrangement as a social contextual factor can affect Chinese elders’ cognitive function.

Setting and participants Our sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China’s 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80–112 in China.

Outcome measures Cognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement …

Effect Of Auricular Acupressure On Acute Pain In Nursing Home Residents With Mild Dementia: A Single-Blind, Randomized, Sham-Controlled Study, Jun Jun Zhang, Li Yu, Jun Hui Mei, Hong Xin Wang, Hai Xiang Gao, Ju Fang Fu, Ye Cheng, Lu Lu Gao, Lei Bu, Jian Qiang Yu, Carol Chunfeng Wang, Yu Xiang Li

Research outputs 2022 to 2026

Introduction. Acute pain is a prevalent problem for dementia residents in nursing homes. A variety of intervention strategies have been applied to address this problem. However, there remains an issue of inadequate pain control. This study aims to explore the analgesic efficacy of auricular acupressure (AA) for dementia residents with acute pain in nursing homes. Methods. A multicenter, single-blind, randomized, and sham-controlled clinical trial was performed in three nursing homes in Yinchuan, China. All of the 206 eligible patients with acute pain were randomly divided into two groups for real AA therapy or sham AA (at sham point stimulation) therapy. …

Medication Usage In Independent Living: A Continuing Care Retirement Community Aging In Place Initiative, Aarti Deshpande, Carrie B Rubenstein, Ruth Benfield, Lee Burnside

All Poster Presentations

Purpose: The purpose of the study was to identify medication use concerns in this community.

Background: In this study, Swedish Geriatric Medicine Fellow partnered with this community to identify medication use concerns in this population.

Continuing Care Retirement Communities (CCRCs) are intended to support residents as they age in place. These communities tend to be well resourced but less studied. This survey attempts to identify medication use concerns in this population. Mirabella CCRC has 324 Independent living (IL) residents, 82 of which are couples. The average age is 85 years. The current cost of an IL unit is from $4673- …

Comorbidities, Health-Related Quality Of Life, Health-Care Utilization In Older Persons With Hemophilia-Hematology Utilization Group Study Part Vii (Hugs Vii), Randall Curtis, Marilyn Manco-Johnson, Barbara A Konkle, Roshni Kulkarni, Joanne Wu, Judith R Baker, Megan Ullman, Duc Quang Tran, Michael B Nichol

Faculty, Staff and Student Publications

PURPOSE: We compare the impact of hemophilia on comorbidities, joint problems, health-related quality of life (HRQoL) and health-care utilization between two age groups: 40-49 years and ≥50 years.

PATIENTS AND METHODS: The HUGS VII study recruited persons with hemophilia A or B age ≥40 years. Participants completed surveys to collect data on sociodemographic and clinical characteristics, hemophilia treatment regimen, pain, joint problems, comorbidities, HRQoL, depression and anxiety, at baseline and 6-months later. Clinical chart reviews documented hemophilic severity and treatment.

RESULTS: The sample includes 69 males, 65.2% aged ≥50 years, 75.4% with hemophilia A. Individuals ≥50 years were more likely …

An Asian Case Of Combined 17Α-Hydroxylase/17,20-Lyase Deficiency Due To Homozygous Pr96q Mutation: A Case Report And Review Of The Literature, Qian Liao, Rufei Shen, Mingyu Liao, Chenxi Ran, Ling Zhou, Yuling Zhang, Guiliang Peng, Zheng Sun, Hongting Zheng, Min Long

Center on Aging Staff Publications

Background: Combined 17α-hydroxylase/17,20-lyase deficiency (17-OHD) is a very rare form of congenital adrenal hyperplasia (CAH) caused by mutations in the CYP17A1 gene. Almost 100 different mutations of the CYP17A1 gene have been reported, including p.R96Q mutation, but no case of p.R96Q mutation has been described in Asian populations.

Case presentation: We describe a 22-year-old female patient of 46,XY karyotype, who presented with pseudohermaphrodism, primary amenorrhea, underdeveloped secondary sexual characteristics, delayed epiphyseal healing, hypertension, and hypokalemia. The diagnosis of 17-OHD was reached by measurement of steroid hormones and abdominal CT scan and confirmed by genetic sequencing, which revealed a homozygous p.R96Q …

Safety And Efficacy Of Electrical Stimulation For Lower-Extremity Muscle Weakness In Intensive Care Unit 2019 Novel Coronavirus Patients: A Phase I Double-Blinded Randomized Controlled Trial, Alejandro Zulbaran-Rojas, Ramkinker Mishra, Naima Rodriguez, Rasha O Bara, Myeounggon Lee, Amir Behzad Bagheri, James P Herlihy, Muhammad Siddique, Bijan Najafi

Center on Aging Staff Publications

Background: Intensive care unit (ICU) prolonged immobilization may lead to lower-extremity muscle deconditioning among critically ill patients, particularly more accentuated in those with 2019 Novel Coronavirus (COVID-19) infection. Electrical stimulation (E-Stim) is known to improve musculoskeletal outcomes. This phase I double-blinded randomized controlled trial examined the safety and efficacy of lower-extremity E-Stim to prevent muscle deconditioning.

Methods: Critically ill COVID-19 patients admitted to the ICU were randomly assigned to control (CG) or intervention (IG) groups. Both groups received daily E-Stim (1 h) for up to 14 days on both gastrocnemius muscles (GNMs). The device was functional in the IG and …

Developing A Community-Based Rehabilitation Programs In Elderly Nursing Home: A Brief Descriptive Analysis, Melinda Harini, Dosmaria Dosmaria, Herry Herry, Lisa Emilda, Listyani Herman, Nelfidayani Nelfidayani, Putu K. Mahardini, Shynta D. Hantogo, Widya Meiliana, Ikhsan Johnson, Peggy Peggy, Wanarani Aries, Widjajalaksmi Kusumaningsih, Luh K. Wahyuni

ASEAN Journal of Community Engagement

The need for rehabilitation services in nursing homes (NH) for the elderly is increasing each year, and this need is fulfilled both with ordinary clinical rehabilitation center visits, as well as community-based rehabilitation (CBR) inside the facility. However, a proper situation analysis is needed to establish a well-delivered CBR program in the NH, a niche to be fulfilled in this study. This study used a descriptive measurement and cross-sectional design to target the elderly who are living in the NHs. Consecutive sampling was done in the largest NH in Jakarta, in Cipayung District. Participants who were dependently ambulated were assessed …

Caring For Older Adults In The Hallway Of A Crowded Emergency Department, Rebecca Weeks, Kathy Sawasky, Michael Malone

Journal of Geriatric Emergency Medicine

This paper describes strategies for emergency department providers to address the needs of older adults when facilities are overcrowded and care extends into the hallway.

The Role Of Physical Activity In Older Adults And Practical Intervention, Se Won Lee, Rebecca Patel, Bryan Werner, Ji Won Yoo, Timothy Tiu

HCA Healthcare Journal of Medicine

Physical inactivity (PI), defined as not meeting guidelines for physical activity beyond baseline daily living activities, is common among older adults (age 65 and older) and contributes to increased morbidity, increased mortality and increased health care spending. Understanding the clinical impact of PI on common medical conditions among older adults will help primary care physicians (PCPs) to educate these patients successfully. Physical activity and exercise are effective in the primary and secondary prevention of chronic diseases that can lead to physical impairments, disability and/or premature death. Physical activity and exercise have been shown to improve cognitive dysfunction and painful musculoskeletal …

Late-Life Exercise Mitigates Skeletal Muscle Epigenetic Aging, Kevin A. Murach, Andrea L. Dimet-Wiley, Yuan Wen, Camille R. Brightwell, Christine M. Latham, Cory M. Dungan, Christopher S. Fry, Stanley J. Watowich

Center for Muscle Biology Faculty Publications

There are functional benefits to exercise in muscle, even when performed late in life, but the contributions of epigenetic factors to late-life exercise adaptation are poorly defined. Using reduced representation bisulfite sequencing (RRBS), ribosomal DNA (rDNA) and mitochondrial-specific examination of methylation, targeted high-resolution methylation analysis, and DNAge™ epigenetic aging clock analysis with a translatable model of voluntary murine endurance/resistance exercise training (progressive weighted wheel running, PoWeR), we provide evidence that exercise may mitigate epigenetic aging in skeletal muscle. Late-life PoWeR from 22–24 months of age modestly but significantly attenuates an age-associated shift toward promoter hypermethylation. The epigenetic age of muscle …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Persistent Polypharmacy And Fall Injury Risk: The Health, Aging And Body Composition Study, Lingshu Xue, Robert M. Boudreau, Julie M. Donohue, Janice C. Zgibor, Zachary A. Marcum, Tina Costacou, Anne B. Newman, Teresa M. Waters, Elsa S. Strotmeyer

Health Management and Policy Faculty Publications

Background

Older adults receive treatment for fall injuries in both inpatient and outpatient settings. The effect of persistent polypharmacy (i.e. using multiple medications over a long period) on fall injuries is understudied, particularly for outpatient injuries. We examined the association between persistent polypharmacy and treated fall injury risk from inpatient and outpatient settings in community-dwelling older adults.

Methods

The Health, Aging and Body Composition Study included 1764 community-dwelling adults (age 73.6 ± 2.9 years; 52% women; 38% black) with Medicare Fee-For-Service (FFS) claims at or within 6 months after 1998/99 clinic visit. Incident fall injuries (N = 545 in …

Deletion Of Sa Β-Gal+ Cells Using Senolytics Improves Muscle Regeneration In Old Mice, Cory M. Dungan, Kevin A. Murach, Christopher J. Zdunek, Zuo Jian Tang, Georgia L. Vonlehmden, Camille R. Brightwell, Zachary Hettinger, Davis A. Englund, Zheng Liu, Christopher S. Fry, Antonio Filareto, Michael Franti, Charlotte A. Peterson

Physical Therapy Faculty Publications

Systemic deletion of senescent cells leads to robust improvements in cognitive, cardiovascular, and whole-body metabolism, but their role in tissue reparative processes is incompletely understood. We hypothesized that senolytic drugs would enhance regeneration in aged skeletal muscle. Young (3 months) and old (20 months) male C57Bl/6J mice were administered the senolytics dasatinib (5 mg/kg) and quercetin (50 mg/kg) or vehicle bi-weekly for 4 months. Tibialis anterior (TA) was then injected with 1.2% BaCl₂ or PBS 7- or 28 days prior to euthanization. Senescence-associated β-Galactosidase positive (SA β-Gal+) cell abundance was low in muscle from both young and old mice …