Geriatrics Commons^™

Preventing Falls-Interventions In Geriatric Psychiatry Patients: An Overview Of Current Literature, Samantha Beckwith

MaineHealth Maine Medical Center

PREVENTING FALLS-INTERVENTIONS IN GERIATRIC PSYCHIATRY PATIENTS: AN OVERVIEW OF CURRENT LITERATURE

Samantha Beckwith, BSN, RN, PMH-BC, P6

Background: The Inpatient Psychiatry unit at Maine Medical Center (P6) is a 21-bed unit specializing in geriatric and medical psychiatry. The majority of patients have a primary diagnosis of Dementia with Behavioral Disturbance. The unit features 12 double occupancy rooms and one single occupancy room, as well as a large activity room. Patients participate in a therapeutic milieu in which they are encouraged to interact with other patients in common areas and ambulate around the unit. The average number of patients is 19.6 …

Tdp-43 Mediated Blood-Brain Barrier Permeability And Leukocyte Infiltration Promote Neurodegeneration In A Low-Grade Systemic Inflammation Mouse Model, Frank Zamudio, Anjanet R. Loon, Shayna Smeltzer, Khawla Benyamine, Nanda K. Navalpur Shanmugam, Nicholas J. F. Stewart, Daniel C. Lee, Kevin Nash, Maj-Linda B. Selenica

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Neuronal cytoplasmic inclusions containing TAR DNA-binding protein 43 (TDP-43) are a neuropathological feature of several neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and Alzheimer's Disease (AD). Emerging evidence also indicates that systemic inflammation may be a contributor to the pathology progression of these neurodegenerative diseases.

METHODS: To investigate the role of systemic inflammation in the progression of neuronal TDP-43 pathology, AAV9 particles driven by the UCHL1 promoter were delivered to the frontal cortex of wild-type aged mice via intracranial injections to overexpress TDP-43 or green fluorescent protein (GFP) in corticospinal motor neurons. Animals were then subjected …

An Approach To Classifying Subjective Cognitive Decline In Community-Dwelling Elders, Laura A. Rabin, Cuilling Wang, Jacqueline A. Mogle, Richard B. Lipton, Carol A. Derby, Mindy J. Katz

Publications and Research

Introduction: Subjective cognitive decline (SCD) may be an early symptomatic man- ifestation of Alzheimer’s disease, though published research largely neglects how to classify SCD in community-based studies.

Methods: In neuropsychologically intact Einstein Aging Study participants (n = 1115; meanage=78;63%female;30%non-White),weusedCoxmodelstoexaminetheasso- ciation between self-perceived cognitive functioning at baseline (using three different approaches) and incident amnestic mild cognitive impairment (aMCI) with covariates of age, sex, education, race/ethnicity, general (objective) cognition, depressive symp- toms, and four other SCD-related features.

Results: After a median of 3 years, 198 participants developed aMCI. In models that included all the variables, self-perceived cognitive functioning was consistently asso- ciated …

Microglial-Associated Responses To Comorbid Amyloid Pathology And Hyperhomocysteinemia In An Aged Knock-In Mouse Model Of Alzheimer's Disease, David J. Braun, Edgardo R. Dimayuga, Josh M. Morganti, Linda J. Van Eldik

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Elevated blood homocysteine levels, termed hyperhomocysteinemia (HHcy), is a prevalent risk factor for Alzheimer's disease (AD) in elderly populations. While dietary supplementation of B-vitamins is a generally effective method to lower homocysteine levels, there is little if any benefit to cognition. In the context of amyloid pathology, dietary-induced HHcy is known to enhance amyloid deposition and certain inflammatory responses. Little is known, however, about whether there is a more specific effect on microglia resulting from combined amyloid and HHcy pathologies.

METHODS: The present study used a knock-in mouse model of amyloidosis, aged to 12 months, given 8 weeks of …

Social Inequality And Type 2 Diabetes Management Among Older Latinx Immigrants, Jasmin Tahmaseb-Mcconatha, Frauke Schnell

Psychology Faculty Publications

Being an immigrant in the contemporary U.S. is stressful. During the pandemic of 2020, these stressors are amplified for all populations. At the same time, Latinx immigrants are also disproportionately affected by the pandemic. They are more vulnerable, face greater economic challenges, and are more likely to die from the virus. In addition to these difficult realities, regardless of status, Latinx immigrants are often perceived as illegal and subjected to discriminatory treatment [1]. Type 2 diabetes is also an illness that disproportionately affects minorities and immigrant populations. In 2018, there were almost 60 million Latinos-18% of the U.S. population (more …

Understanding The Impact Of Social Distancing On Older Adults And Senior Centers To Better Adapt Towards A New Normal, Salina Jivan

Student Capstone Papers

COVID-19 brought about social distancing mandates that posed as a new barrier to meaningful social participation in the community. The purpose of this project was to understand the impact of social distancing on older adults and senior organizations to better inform the role of OT in helping seniors adapt towards a new normal within the community. A qualitative study and needs assessment were performed through phone interviews with seniors and organizations that support them from around the United States. Themes highlighted seniors desire for social contact and cautious return to the community once mandates are lifted. Both seniors and organizations …

Mitochondrial Oxidative And Nitrosative Stress And Alzheimer Disease, D. Allan Butterfield, Debra Boyd-Kimball

Chemistry Faculty Publications

Oxidative and nitrosative stress are widely recognized as critical factors in the pathogenesis and progression of Alzheimer disease (AD) and its earlier stage, amnestic mild cognitive impairment (MCI). A major source of free radicals that lead to oxidative and nitrosative damage is mitochondria. This review paper discusses oxidative and nitrosative stress and markers thereof in the brain, along with redox proteomics, which are techniques that have been pioneered in the Butterfield laboratory. Selected biological alterations in—and oxidative and nitrosative modifications of—mitochondria in AD and MCI and systems of relevance thereof also are presented. The review article concludes with a section …

Integrating Affect Perception Tasks From The New York Emotion Battery Into A Comprehensive Measure Of Neuropsychological Change Across The Lifespan, Melinda A. Cornwell

Dissertations, Theses, and Capstone Projects

Background: The ability to perceive others’ emotions is a vital skill for social competency, impacting the success of personal and professional relationships (Brinton & Fujiki, 2011; Cassidy et al., 1992; Côté & Miners, 2006). According to Socioemotional Selectivity Theory (SST; Carstensen, 1991), human motivation develops to become more discerning in choosing milieus that yield the most gratifying return on the investment of personal resources (e.g., time, attention, and effort), perhaps explaining why some research findings indicate that older adults may demonstrate an affect perception (AP) bias described as a positivity effect (Reed et al., 2014). Moreover, AP predicts cognitive and …

Hypusination Of Eif5a Regulates Cytoplasmic Tdp-43 Aggregation And Accumulation In A Stress-Induced Cellular Model, Shayna Smeltzer, Zainuddin Quadri, Abraian Miller, Frank Zamudio, Jordan Hunter, Nicholas J.F. Stewart, Sheba Saji, Daniel C. Lee, Dale Chaput, Maj-Linda B. Selenica

Sanders-Brown Center on Aging Faculty Publications

TAR DNA-binding protein 43 (TDP-43) is a nuclear RNA/DNA binding protein involved in mRNA metabolism. Aberrant mislocalization to the cytoplasm and formation of phosphorylated/aggregated TDP-43 inclusions remains the hallmark pathology in a spectrum of neurodegenerative diseases, including frontotemporal disorders and Alzheimer's disease. Eukaryotic Translation Initiation Factor 5A undergoes a unique post-translation modification of lysine to hypusine (K50), which determines eIF5A binding partners. We used a sodium arsenite-induced cellular stress model to investigate the role of hypusinated eIF5A (eIF5A^HypK50) in governing TDP-43 cytoplasmic mislocalization and accumulation in stress granule. Our proteomics and functional data provide evidence that eIF5A interacts …

Cardiorespiratory Fitness Diminishes The Effects Of Age On White Matter Hyperintensity Volume, Nathan F. Johnson, Ahmed A. Bahrani, David K. Powell, Gregory A. Jicha, Brian T. Gold

Physical Therapy Faculty Publications

White matter hyperintensities (WMHs) are among the most commonly observed marker of cerebrovascular disease. Age is a key risk factor for WMH development. Cardiorespiratory fitness (CRF) is associated with increased vessel compliance, but it remains unknown if high CRF affects WMH volume. This study explored the effects of CRF on WMH volume in community-dwelling older adults. We further tested the possibility of an interaction between CRF and age on WMH volume. Participants were 76 adults between the ages of 59 and 77 (mean age = 65.36 years, SD = 3.92) who underwent a maximal graded exercise test and structural brain …

Feasibility Of Dual-Task Gait To Estimate Alzheimer's Related Cognitive Decline In Down Syndrome, Kathryn L. Van Pelt, Lisa Mason Koehl, Allison M. Caban-Holt, Amelia J. Anderson-Mooney, Elizabeth Head, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Introduction: The striatum and frontal lobes have been shown to have early Alzheimer's disease (AD) neuropathology and are critical for motor and cognitive function. We hypothesized gait would be associated with early-stage dementia in Down syndrome (DS), a cohort at risk for AD.

Methods: Twenty-eight participants with DS were enrolled in the study. Participants walked at their self-selected pace and while completing a dual task (counting, obstacle, or counting+obstacle).

Results: All participants were able to complete the self-paced condition and 78.57-96.42% completed the dual-task conditions. There was a trend for greater dual-task effects on gait velocity based on dementia diagnosis. …

Limbic-Predominant Age-Related Tdp-43 Encephalopathy Differs From Frontotemporal Lobar Degeneration, John L. Robinson, Sílvia Porta, Filip G. Garrett, Panpan Zhang, Sharon X. Xie, Eunran Suh, Vivianna M. Van Deerlin, Erin L. Abner, Gregory A. Jicha, Justin M. Barber, Virginia M-Y Lee, Edward B. Lee, John Q. Trojanowski, Peter T. Nelson

Epidemiology and Environmental Health Faculty Publications

TAR-DNA binding protein-43 (TDP-43) proteinopathy is seen in multiple brain diseases. A standardized terminology was recommended recently for common age-related TDP-43 proteinopathy: limbic-predominant, age-related TDP-43 encephalopathy (LATE) and the underlying neuropathological changes, LATE-NC. LATE-NC may be co-morbid with Alzheimer’s disease neuropathological changes (ADNC). However, there currently are ill-defined diagnostic classification issues among LATE-NC, ADNC, and frontotemporal lobar degeneration with TDP-43 (FTLD-TDP). A practical challenge is that different autopsy cohorts are composed of disparate groups of research volunteers: hospital- and clinic-based cohorts are enriched for FTLD-TDP cases, whereas community-based cohorts have more LATE-NC cases. Neuropathological methods also differ across laboratories. Here, …

Understanding The Impact Of Social Distancing On Older Adults And Senior Organizations To Better Adapt Towards A New Normal, Salina Jivan

San Marcos, Summer 2020

COVID-19 brought about social distancing mandates that posed as a new barrier to meaningful social participation in the community. The purpose of this project was to understand the impact of social distancing on older adults and senior organizations to better inform the role of OT in helping seniors adapt towards a new normal within the community. A qualitative study and needs assessment were performed through phone interviews with seniors and organizations that support them from around the United States. Themes highlighted seniors desire for social contact and cautious return to the community once mandates are lifted. Both seniors and organizations …

Impact And Mortality Of Covid-19 On People Living With Dementia: Cross-Country Report, Aida Suárez-González, Gill Livingston, Lee Fay Low, Suzanne Cahill, Niamh Hennelly, Walter D. Dawson, Wendy Weidner, Martina Bocchetta, Cleusa P. Ferri, Jordi A. Matias-Guiu, Multiple Additional Authors

Institute on Aging Publications

This report brings together international evidence on the impact of the COVID-19 pandemic on people living with dementia and an overview of international policy and practice measures to mitigate the impact of COVID-19 among people living with dementia.

Key Findings

• We have collected data on impact and mortality of COVID-19 in people living with dementia in 9 countries: The United Kingdom (UK), Spain, Ireland, Italy, Australia, the United States (US), India, Kenya and Brazil.
• The share of people whose deaths were linked to COVID-19 in care homes who had dementia ranges from 29% to 75% across those countries. Within countries, …

Therapeutic Trem2 Activation Ameliorates Amyloid-Beta Deposition And Improves Cognition In The 5xfad Model Of Amyloid Deposition, Brittani R. Price, Tiffany L. Sudduth, Erica M. Weekman, Sherika Johnson, Danielle Hawthorne, Abigail E. Woolums, Donna M. Wilcock

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Triggering receptor expressed on myeloid cell-2 (TREM2) is a lipid and lipoprotein binding receptor expressed by cells of myeloid origin. Homozygous TREM2 mutations cause early onset progressive presenile dementia while heterozygous, point mutations triple the risk of Alzheimer's disease (AD). Although human genetic findings support the notion that loss of TREM2 function exacerbates neurodegeneration, it is not clear whether activation of TREM2 in a disease state would result in therapeutic benefits. To determine the viability of TREM2 activation as a therapeutic strategy, we sought to characterize an agonistic Trem2 antibody (AL002a) and test its efficacy and mechanism of action …

Involuntary Treatment In Dementia Care At Home: Results From The Netherlands And Belgium, Angela M. H. J. Mengelers, Vincent R. A. Moermans, Michel H. C. Bleijlevens, Hilde Verbeek, Elizabeth Capezuti, Frans Tan, Koen Milisen, Jan P. H. Hamers

Publications and Research

Aims and objectives: To gain insight into the request, use and associated factors of involuntary treatment in people with dementia (PwD) receiving professional home care in the Netherlands and Belgium.

Background: Most of the PwD remain living at home as long as possible. Due to complex care needs, this can result in an increased risk for care provided against the wishes of the client and/or to which the client resists, referred to as involuntary treatment.

Design: Secondary data analyses of two cross-sectional surveys.

Methods: Dementia case managers and district nurses filled in a questionnaire for each PwD in their …

Gwep Goals Of Care, Audrey Dunstan, Nyann Biery Ms

Research Scholars Poster Presentation

No abstract provided.

Investigating A Multimodal Approach To Clinical Diagnosis Of Mild Cognitive Impairment And Alzheimer’S Disease, Sean M. Flannery

Psychology Theses & Dissertations

An estimated 5.8 million Americans suffer from dementia due to Alzheimer’s disease (AD), with that number projected to grow to 13.8 million by mid-century (Alzheimer’s Association, 2019). Mild cognitive impairment (MCI) describes the stage between normal cognitive decline that comes with aging and a dementia diagnosis (Peterson, 1999). Due to a lack of a cure or particularly effective treatment, a major goal of treatment is to focus on improving quality of life (Budson & Solomon, 2016). An early and accurate diagnosis can address this goal in a variety of ways. Despite the high prevalence and immense amount of research in …

Sexually Transmitted Infections And The 65 And Older Population: Knowledge And Perceived Risk, Alexus Miranda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sexually transmitted infections (STI) can impact all persons. Since 2000, the number of STIs has steadily increased among persons aged 50 years and older in the United States (Purpora, 2012). Persons over the age of 60 accounted for the biggest increase of in-office treatments of STIs between 2014 and 2017 (Howley, 2018). The purpose of this study was to use the Sexual Health Model to examine the relationship between various predictors and these persons’ perceived risk of STIs, their STI knowledge, and other barriers that impact the sexual health of persons 65 years of age and older. This study used …

Machine Learning Approaches For Fracture Risk Assessment: A Comparative Analysis Of Genomic And Phenotypic Data In 5130 Older Men, Qing Wu, Fatma Nasoz, Jongyun Jung, Bibek Bhattarai, Mira V. Han

School of Public Health Faculty Research

The study aims were to develop fracture prediction models by using machine learning approaches and genomic data, as well as to identify the best modeling approach for fracture prediction. The genomic data of Osteoporotic Fractures in Men, cohort Study (n = 5130), were analyzed. After a comprehensive genotype imputation, genetic risk score (GRS) was calculated from 1103 associated Single Nucleotide Polymorphisms for each participant. Data were normalized and split into a training set (80%) and a validation set (20%) for analysis. Random forest, gradient boosting, neural network, and logistic regression were used to develop prediction models for major osteoporotic fractures …