Geriatrics Commons^™

Neuroimaging Biomarkers Of Mtor Inhibition On Vascular And Metabolic Functions In Aging Brain And Alzheimer’S Disease, Jennifer Lee, Lucille M. Yanckello, David Ma, Jared D. Hoffman, Ishita Parikh, Scott Thalman, Bjoern Bauer, Anika M. S. Hartz, Fahmeed Hyder, Ai-Ling Lin

Pharmacology and Nutritional Sciences Faculty Publications

The mechanistic target of rapamycin (mTOR) is a nutrient sensor of eukaryotic cells. Inhibition of mechanistic mTOR signaling can increase life and health span in various species via interventions that include rapamycin and caloric restriction (CR). In the central nervous system, mTOR inhibition demonstrates neuroprotective patterns in aging and Alzheimer’s disease (AD) by preserving mitochondrial function and reducing amyloid beta retention. However, the effects of mTOR inhibition for in vivo brain physiology remain largely unknown. Here, we review recent findings of in vivo metabolic and vascular measures using non-invasive, multimodal neuroimaging methods in rodent models for brain aging and AD. …

Ca2+, Astrocyte Activation And Calcineurin/Nfat Signaling In Age-Related Neurodegenerative Diseases, Pradoldej Sompol, Christopher M. Norris

Sanders-Brown Center on Aging Faculty Publications

Mounting evidence supports a fundamental role for Ca²⁺ dysregulation in astrocyte activation. Though the activated astrocyte phenotype is complex, cell-type targeting approaches have revealed a number of detrimental roles of activated astrocytes involving neuroinflammation, release of synaptotoxic factors and loss of glutamate regulation. Work from our lab and others has suggested that the Ca²⁺/calmodulin dependent protein phosphatase, calcineurin (CN), provides a critical link between Ca²⁺ dysregulation and the activated astrocyte phenotype. A proteolyzed, hyperactivated form of CN appears at high levels in activated astrocytes in both human tissue and rodent tissue around regions of amyloid and …

Multimodal Pain Management For Older Adults In Primary Care, Bina Solanky

DNP Qualifying Manuscripts

Persistent pain affects 50% to 75% of adults of the age of 65 and it is often underreported and undertreated in primary care. This manuscript discusses how nurse practitioners and other primary care providers can manage persistent pain in older adults utilizing nonpharmacological methods in addition to standard pharmacological treatments.

Implementation Of A Volunteer-Based Hospital Program For Older Adults, Elizabeth Collins, Md, Kristine Swartz, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background

• A multi-faceted, volunteer-led, hospital-based program1has been shown to: •Reduce the incidence of delirium •Decrease hospital length of stay •Reduce hospital costs.
• Implementation of such a program requires upfront investment.
• A smaller, volunteer-based visitation program for older adults may provide support for the allocation of more hospital resources in delirium prevention and establishment of a formal Hospital Elder Life Program1in this institution.
• This research aims to investigate: •If the implementation of a visitation program is feasible at this hospital •Volunteer experience with the program.

Agreement Between Clinician-Rated Versus Patient-Reported Outcomes In Huntington Disease, Noelle E Carlozzi, Nicholas R Boileau, Joel S Perlmutter, Kelvin L Chou, Julie C Stout, Jane S Paulsen, Michael K Mccormack, David Cella, Martha A Nance, Jin-Shei Lai, Praveen Dayalu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Clinician-rated measures of functioning are often used as primary endpoints in clinical trials and other behavioral research in Huntington disease. As study costs for clinician-rated assessments are not always feasible, there is a question of whether patient self-report of commonly used clinician-rated measures may serve as acceptable alternatives in low risk behavioral trials.

AIM: The purpose of this paper was to determine the level of agreement between self-report and clinician-ratings of commonly used functional assessment measures in Huntington disease.

DESIGN: 486 participants with premanifest or manifest Huntington disease were examined. Total Functional Capacity, Functional Assessment, and Independence Scale assessments …

Lgbt Senior Health Disparities: Information Resources To Bridge The Gap, Gregg A. Stevens, Tony Nguyen, Francisco J. Fajardo

Library Faculty Publications

As the senior population in the United States increases, the aging LGBT (lesbian, gay, bisexual, transgender) population should also see comparable growth rates. Health care providers and social service organizations will care for more LGBT seniors with special needs beyond the general population of older adults as they are more at risk for certain conditions. This article identifies some specific health disparities and examines several organizations that work to improve LGBT senior health by providing critical health information to LGBT older adults, caregivers, and health care professionals.

The Correlation Between Quality Of Care And Type Of Room In Long-Term Care Facilities In The Shenandoah Valley Of The Commonwealth Of Virginia, Hannah Twomey

Senior Honors Projects, 2010-2019

The purpose of this study was to examine if there was a present correlation the quality of care a resident in a long-term care facility received and the type of room they resided in. The researcher conducted a quantitative, cross-sectional research study of direct care healthcare providers (n=77) in four long-term care facilities in the Shenandoah Valley of Virginia through the documentation of a paper survey. The survey questions were adapted from Nursing Home Survey on Patient Safety Culture and participants responded according to their personal habits regarding the quality of care they gave residents and feelings about their place …

Age-Related Changes In Visual Processing Speed: A Pilot Study Using The Motor Free Visual Perception Test- 4, Amber Zadravecz, Kassidy Ha, Lauren Gollnick, Stephanie Pawek, Zoe Studer

Dissertations, Masters Theses, Capstones, and Culminating Projects

Older adults are at a significantly increased risk of being involved in motor vehicle accidents. Evidence reveals that visual processing speed decreases with age, which may impact driving. The Motor-Free Visual Perception Test- Third Edition (MVPT-3) is used as a pre-driving assessment and has an age-normed Response Time Index that measures visual processing speed. In 2015, a new version, the new Motor-Free Visual Perception Test- Fourth Edition (MVPT-4), was published. The new MVPT-4 does not yet demonstrate its utility in measuring visual processing speed. The purpose of this study was to explore if differences in visual processing speed between younger …

Survey Of Sensory Diet Use Among California Occupational Therapy Practitioners, Morganne Peterson, Allison Hunt, Emily White

Dissertations, Masters Theses, Capstones, and Culminating Projects

The purpose of this study was to examine the use of sensory diets in the field of occupational therapy. This study investigated the use of sensory diets among California occupational therapy practitioners. A mixed-methods design was used to collect data through an online survey. The survey was sent out to members of the Occupational Therapy Association of California (OTAC) and received 98 respondents within one month. Participants worked among various clinical settings and implemented sensory diets with various client populations. Practitioners reported using terms such as “sensory strategies,” “sensory tools,” and “sensory supports” which indicates an overall misunderstanding associated with …

Evaluating The Effectiveness Of A Formal Dementia Care Training Program: Abilities Care Experts™, Carmen Joaquin, Michelle D'Amato, April Perez, Louiza Alexandria Villarina, Sophie E. Miller

Dissertations, Masters Theses, Capstones, and Culminating Projects

Overview: Abilities Care Experts™ (ACE™) is an educational training program for nursing staff who care for individuals with dementia in skilled nursing facilities (SNF). The objective of the program is to provide the nursing staff with knowledge, and methods to engage residents’ remaining abilities in order to maximize occupational participation using a stage-specific dementia care approach. ACE™ training has yet to be evaluated for effectiveness in a controlled study design.

Objectives: This study sought to evaluate the effectiveness of the ACE™ training.

Design: The study employed a quantitative, cross-sectional, quasi-experimental design.

Participants: A total of 29 CNAs, 13 ACE™ trained …

Resilience And Protective Factors In Older Adults, Jessica Mcclain, Katelyn Gullatt, Caroline Lee

Dissertations, Masters Theses, Capstones, and Culminating Projects

Evidence suggests resilience promotes successful aging in place and protective factors promote resilience. This study sought to investigate whether or not the combination of three protective factors, physical health, social support, and self-efficacy are all of equal importance in predicting resilience among Marin County older adults, or if some individual protective factors have a greater impact on resilience than the others. Fifty-eight participants ages 62 and higher were recruited from senior community programs and personal contacts. Four self-report questionnaires were completed by the participants in this exploratory, cross-sectional, quantitative design. SPSS was used for a descriptive and multivariate analyses to …

Individualized Music Improves Social Interaction Of Women, But Not Men, With Dementia, Emily Farrer, Diana Hilycord

Butler Journal of Undergraduate Research

Dementia is tragic both for patients with the disease and for their family members. As this neurodegenerative disorder progresses, cognitive functions deteriorate, agitation and aggression increase, and mood worsens (McDermott, Orrell, et al., 2014; Spiro, 2010; Vasionyté & Madison, 2013). Non-pharmacological approaches, such as active music therapy or passive music listening, can be effective in reducing these symptoms. However, no past studies have examined how music listening affects the social interactions of patients with dementia. As such, this study examined whether nursing home residents with dementia are more engaged and interactive if they listen to individually selected music for 15 …

The Interprofessional Management Of Geriatric Patients Undergoing Head And Neck Cancer Treatment In U.S. Nursing Homes, Rashida Wiley, Vidushi Gupta, Riddhi A. Daftary, Jessfor Baugh, Anh H. Tran, Dorothy Lynne Cataldo, Yang Kang, Takashi Komabayashi

Dental Medicine Faculty Publications

A dental approach toward interprofessional management, treatment planning and rehabilitation of diagnosed individuals undergoing cancer therapies is essential. Literature review focuses on presurgery oral hygiene instructions, pre-radiography/chemotherapy dental clearance, complications and management during radiotherapy/chemotherapy; post-radiotherapy/ chemotherapy oral healthcare; and adjunctive measures.

Assessing Dementia And Mild Cognitive Impairment Within The Home, Kate Sobanik, Melinda Blais

Thinking Matters Symposium Archive

What are useful assessments which can be administered by occupational therapists for homebound adults with dementia or mild cognitive impairment that will influence practice patterns?

“Older Adults And Their Experiences With Home Care And Assisted Living”, Faith Robinson

Thinking Matters Symposium Archive

As the state of Maine and the U.S. population at large continues to age, discussion about future care and living arrangements for older adults has become an increasingly relevant issue. Older adults are often faced with a range of options for housing, including staying in their home in their community while receiving home care services, or moving to an assisted living facility.

Currently a gap in the research exists as to the attitudes, perceptions, and lived experiences of the older adults themselves around these decisions, experiences, and the meaning of “home” in our older years. This study aims to provide …

Evaluation Of Group Movement Programs (Plié And Paired Plié) For People With Memory Loss, Alzheimer’S Disease Or Dementia, Martin Blanco, Deborah Barnes

GW Research Days 2016 - 2020

Today, one in ten people ages 65 and older have Alzheimer’s dementia. This serious condition often causes great suffering among affected individuals and their families, and there are no medications that stop or slow the disease. It is therefore important to evaluate alternative interventions that may benefit both patients and their care partners. Preventing Loss of Independence through Exercise (PLIÉ) and Paired PLIÉ are group movement programs that combine neuroscience and integrative medicine for individuals with dementia. We analyzed data from [N=39] anonymous evaluation surveys performed as part of two ongoing randomized control trials. Survey data included general questions on …

Comparison Of Existing Methods For Algorithmic Classification Of Dementia In The Health And Retirement Study, Kan Z. Gianattasio, Qiong Wu, M Maria Glymour, Melinda C. Power

GW Research Days 2016 - 2020

Background: Dementia ascertainment is difficult and costly, hindering the use of large, representative studies such as the Health and Retirement Study (HRS) to monitor trends or disparities in dementia. To address this issue, multiple groups of researchers have developed algorithms to classify dementia status in HRS participants using data from HRS and the Aging, Demographics, and Memory Study (ADAMS), an HRS sub-study that systematically ascertained dementia status. However, the relative performance of each algorithm has not been systematically evaluated.

Objective: To compare the performance of five existing algorithms, overall and by sociodemographic subgroups.

Methods: We created two standardized datasets: (a) …

(Video) Barriers To Implementing Advance Care Planning In The Healthcare Setting, Dona Occhipinti, Matias Attene Ramos

GW Research Days 2016 - 2020

Objectives: Current barriers to implementing Advanced Care Planning (ACP) will be examined as applied to the healthcare system.

Methods: A literature review was performed looking at the current practices of ACP (e.g. filling out advanced directives (AD), Medical Orders for Life Sustaining Treatment (MOLST)/ Physician Orders for Life Sustaining Treatment (POLST), etc.), physician comfort level with having end-of-life discussion (EOL), successful/unsuccessful interventions to increase ACP/EOL discussions among health care providers (HCP), and the current political environment with respect to physicians’ ability to implement ACP/EOL discussions. Cochrane, Pubmed, and Google Scholar were searched for papers written in English after …

Hospital-Based Physicians' Intubation Decisions And Associated Mental Models When Managing A Critically And Terminally Ill Older Patient., Shannon Haliko, Julie Downs, Deepika Mohan, Robert Arnold, Amber E Barnato

Articles, Abstracts, and Reports

BACKGROUND: Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences.

OBJECTIVE: We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant.

METHODS: Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter. We used an "expert" model to code the …

Identification Of Risk Factors Associated With Falls In The Long Term Care Setting, Jacqueline L. Patel, Dnp, Ms, Anp-Bc

Doctor of Nursing Practice Projects

Background: Falls threaten the safety of older adults in long term care (LTC).

Objectives: To assess environmental, clinical and pharmacological causes of falls as well as compare Fall Risk Assessment Score, Brief Interview of Mental Status (BIMS) score, Activities of Daily Living (ADL) scores, age and gender of residents with one fall, recurrent falls, and no falls.

Methods: Using a descriptive-comparative design, we included a convenience sample of 290 adults ≥50 years old at our LTC facility. Fall and recurrent fall groups were matched to those with no falls. We assessed environmental, clinical and pharmacological variables, Fall Risk Assessment Scores, …