Geriatrics Commons^™

The Famous Names Discrimination Task As A Biomarker Of Alzheimer's Disease Risk: An Erp Study, Elizabeth Rose Paitel

Master's Theses (2009 -)

Current ERP research emphasizes age- and pathology-related declines in neural processing in the form of attenuated amplitudes and prolonged latencies. Notably, there is a gap in the ERP literature regarding neural processing trajectories in the time between healthy young adulthood and clinical MCI/AD samples. fMRI research, however, has demonstrated periods of increased, compensatory activation in healthy, cognitively intact APOE ɛ4 carriers both during resting state and event-related tasks (Bondi, Houston, Eyler, & Brown, 2005; Evans et al., 2014; Filippini et al., 2009; Rao et al., 2015), consistent with compensatory theories of cognitive aging (Cabeza, 2002; Park & Reuter-Lorenz, 2009; Reuter-Lorenz …

Mechanisms Of Fatigue With Aging: Evidence From The Whole-Limb To The Single Cell In Humans, Christopher W. Sundberg

Dissertations (1934 -)

Aging is accompanied by a loss of muscle mass and increased fatigability of limb muscles making it difficult for old adults to generate the force and power necessary to perform daily activities, such as ascending a flight of stairs. The mechanisms for the age-related increase in fatigability in old and very old adults (≥80 yrs) and whether there are differences between men and women are unknown. The purpose of this dissertation was to determine the mechanisms for the age-related increase in fatigability in men and women by studying fatigue at the level of the whole-limb and within the muscle cells. …

The Impact Of Advance Directives On The Intensity Of Care Received In The Acute Care Setting In Older Adults, Marsha Helen Tyacke

Dissertations (1934 -)

The proportion of older adults in the U.S. is rapidly increasing. One-third of Medicare expenditures occur in the final year of life, with nearly half resulting from acute exacerbations of chronic, progressive diseases(Riley & Lubitz, 2010). Older adults prefer comfort over life-sustaining care, and decreased intensity of care is associated with improved quality of life at the end-of-life (EOL). Advance directives (ADs) have been proposed as mechanisms to improve congruence between patient wishes and EOL care; however, the impact of ADs on care delivered in the acute care setting at the EOL for this population is unclear. A retrospective, correlation …

Biomarker And Clinical Trial Design Support For Disease-Modifying Therapies: Report Of A Survey Of The Eu/Us: Alzheimer's Disease Task Force, Jeffrey Cummings, Nick Fox, Bruno Vellas, Paul Aisen, Guogen Shan

Environmental & Global Health Faculty Research

BACKGROUND: Disease-modifying therapies are urgently needed for the treatment of Alzheimer’s disease (AD). The European Union/United States (EU/US) Task Force represents a broad range of stakeholders including biopharma industry personnel, academicians, and regulatory authorities. OBJECTIVES: The EU/US Task Force represents a community of knowledgeable individuals who can inform views of evidence supporting disease modification and the development of disease-modifying therapies (DMTs). We queried their attitudes toward clinical trial design and biomarkers in support of DMTs. DESIGN/SETTING/PARTICIANTS: A survey of members of the EU/US Alzheimer’s Disease Task Force was conducted. Ninety-three members (87%) responded. The details were analyzed to understand what …

Factors Associated With End-Of-Life Planning In Huntington Disease., Nancy R Downing, Siera Goodnight, Sena Chae, Joel S Perlmutter, Michael Mccormack, Elizabeth Hahn, Stacey K Barton, Noelle Carlozzi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: Knowledge of one's gene status for adult onset conditions provides opportunity to make advance end-of-life (EOL) plans. The purposes of these analyses were to (1) determine the prevalence of EOL plans, including advance directives (ADs) among persons across 3 stages of Huntington disease (HD) and (2) examine factors associated with having ADs in this sample.

METHODS: Data are from 503 participants in the HD Quality of Life study. Participants completed an online health-related quality-of-life survey that included questions regarding EOL planning and self-reported HD symptoms. Frequencies were calculated for EOL planning by the HD stage. Bivariate analysis and logistic …

Conserved Brain Myelination Networks Are Altered In Alzheimer's And Other Neurodegenerative Diseases., Mariet Allen, Xue Wang, Jeremy D Burgess, Jens Watzlawik, Daniel J Serie, Curtis S Younkin, Thuy Nguyen, Kimberly G Malphrus, Sarah Lincoln, Minerva M Carrasquillo, Charlotte Ho, Paramita Chakrabarty, Samantha Strickland, Melissa E Murray, Vivek Swarup, Daniel H Geschwind, Nicholas T Seyfried, Eric B Dammer, James J Lah, Allan I Levey, Todd E Golde, Cory Funk, Hongdong Li, Nathan D Price, Ronald C Petersen, Neill R Graff-Radford, Steven G Younkin, Dennis W Dickson, Julia R Crook, Yan W Asmann, Nilüfer Ertekin-Taner

Articles, Abstracts, and Reports

INTRODUCTION: Comparative transcriptome analyses in Alzheimer's disease (AD) and other neurodegenerative proteinopathies can uncover both shared and distinct disease pathways.

METHODS: We analyzed 940 brain transcriptomes including patients with AD, progressive supranuclear palsy (PSP; a primary tauopathy), and control subjects.

RESULTS: We identified transcriptional coexpression networks implicated in myelination, which were lower in PSP temporal cortex (TCX) compared with AD. Some of these associations were retained even after adjustments for brain cell population changes. These TCX myelination network structures were preserved in cerebellum but they were not differentially expressed in cerebellum between AD and PSP. Myelination networks were downregulated in …

Adult Day Service Providers: Untapped Potential For Care Coordination, Nicole Ruggiano, Ellen L. Brown, Karen L. Fortuna

Nursing & Health Sciences Research Journal

Adult Day Services (ADS) have become increasingly available for community-dwelling older adults who are often experiencing multiple chronic conditions and/or dementia. ADS providers spend a significant amount of time with their clients and offer the opportunity for a wealth of clinical information that can be used by primary care providers and specialists for decision-making about patient care. There are also opportunities for hospitals to coordinate care transitions with ADS providers by involving them with discharge planning with appropriate patients who require post-hospital care. However, ADS providers are often viewed as social service providers, and there is little known about the …

Exploring The Use Of The Timed Up And Go Test To Identify Patient Fall Risk In An Inpatient Geriatric Psychiatry Unit, Danielle Struble-Fitzsimmons

Seton Hall University Dissertations and Theses (ETDs)

Background: Patient falls during hospitalization influence healthcare costs and quality, and hospitals are mandated to complete fall risk assessments on all patients. Inpatient geriatric psychiatry units have the highest fall rates in the acute care setting, and most falls in this population occur during the mobility tasks of transfers and ambulation. The Timed Up and Go (TUG) test includes these two specific functional tasks, and has been used to predict falls in other geriatric populations, but has never been tested in an inpatient geriatric psychiatry unit. The purpose of this study was to determine if the TUG is a predictive …

Word-List Intrusion Errors Predict Progression To Mild Cognitive Impairment, Kelsey R Thomas, Joel Eppig, Emily C Edmonds, Diane M Jacobs, David J Libon, Rhoda Au, David P Salmon, Mark W Bondi, Alzheimer’S Disease Neuroimaging Initiative

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: Preclinical Alzheimer's disease (AD) defined by a positive AD biomarker in the presence of normal cognition is presumed to precede mild cognitive impairment (MCI). Subtle cognitive deficits and cognitive inefficiencies in preclinical AD may be detected through process and error scores on neuropsychological tests in those at risk for progression to MCI.

METHOD: Cognitively normal participants (n = 525) from the Alzheimer's Disease Neuroimaging Initiative were followed for up to 5 years and classified as either stable normal (n = 305) or progressed to MCI (n = 220). Cox regressions were used to determine whether baseline process scores on …

Fighting Frailty With The Mediterranean Diet, Edward F. Ansello

Director's Editorials from Age in Action

It’s appropriate for each of us to examine our eating habits, not just our nutrition intake. The various aspects of the Mediterranean Diet hold potential benefits beyond the important feature of helping to reduce frailty.

Lewy Body Dementia, Edward F. Ansello

Director's Editorials from Age in Action

While Alzheimer’s disease is the most common and widely known cause of dementia, it is not the only cause. Dementia with Lewy Bodies (DLB), in fact, may be the second most common cause of progressive dementia but it is certainly less well known.

Our Anniversary, Edward F. Ansello

Director's Editorials from Age in Action

The Virginia Center on Aging celebrates 40 years.

Addressing The Spiritual Needs Of People Aging With Dementia And/Or Lifelong Disabilities, Kathy Fogg Berry

Case Studies from Age in Action

Educational Objectives

1. Present the need for spiritual care as part of holistic care for people living with dementia and/or lifelong disabilities.

2. Distinguish the difference between spirituality and religion.

3. Discuss how to assess the spiritual needs of people living with dementia and/or lifelong disabilities.

4. Show through case study examples specific ways to address the spiritual needs of people living with dementia and/or lifelong disabilities.

Gerontology Theory Communicated In The Primary Grades Through Picture Books, Edward F. Ansello

Case Studies from Age in Action

Educational Objectives

1. To recognize children’s first literature as a means of socialization to aging and older people.

2. To identify children’s books that reflect basic principles of gerontology theory.

3. To help primary school teachers, grandparents, and others interested in human development use books and activities to capture children’s attention.

4. To identify a unit of six brief, overlapping modules, each with objectives, activities, and recommended readings.

Into The Elder Law Trenches At Wake Forest University School Of Law, Kate Mewhinney

Case Studies from Age in Action

Educational Objectives:

1. Examine the benefits of a medical-legal partnership for training law students how to represent older clients.

2. Review common legal issues in the field of elder law.

3. Explore broader policy concerns facing an aging population.

Silver Saddles: An Equestrian Intervention For Older Adults With Dementia, Christine Jensen, Jessica Lyon, Tina Thomas, Rachel Scrivano

Case Studies from Age in Action

Educational Objectives

1. Demonstrate the encouraging outcomes therapeutic horseback riding programs can have for older adults with memory loss.

2. Describe the importance of trained volunteers and staff at both the riding center and the long-term care community for aiding older adults with memory loss during the therapeutic riding program.

3. Showcase the research process and pilot results.

4. Highlight lessons learned and future directions for Silver Saddles.

Suicidal Ideation Assessment In Individuals With Premanifest And Manifest Huntington Disease., Melissa Wesson, Nicholas R Boileau, Joel S Perlmutter, Jane S Paulsen, Stacey K Barton, Michael K Mccormack, Noelle E Carlozzi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Huntington disease (HD) is associated with increased risk of suicide.

OBJECTIVE: This study compares suicide ideation in HD to the general population, assesses factors associated with increased prevalence of suicidal thoughts, and compares clinician-rated to self-reported assessments of suicidal ideation.

METHODS: We examined 496 participants with premanifest or manifest HD. Clinician-rated suicidal ideation was measured using the Problem Behaviors Assessment - short form. Self-reported ideation was measured using two items from the HDQLIFE Concern with Death and Dying item bank. Independent sample t-tests were conducted to compare the prevalence of suicidal thoughts between our HD sample and the U.S. …

The Year In The Rear-View Mirror, Edward F. Ansello

Director's Editorials from Age in Action

The year 2018 is the Virginia Center on Aging's 40th anniversary. Our programs and activities have evolved over time but we have remained true to the charges given us in the Code of Virginia, essentially to conduct interdisciplinary studies, including training practitioners and offering educational opportunities for older adults, conducting research on and advancing knowledge about dementia, and serving as an information resource to those committed to the well-being of older adults. Our current operations feature four program areas: abuse in later life (domestic violence and elder abuse); dementia research; geriatrics and gerontology education; and lifelong learning.

A New Measure For End Of Life Planning, Preparation, And Preferences In Huntington Disease: Hdqlife End Of Life Planning, Noelle E Carlozzi, E A Hahn, S A Frank, J S Perlmutter, N D Downing, M K Mccormack, S Barton, M A Nance, S G Schilling, Hdqlife Site Investigators And Coordinators

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Huntington disease is a fatal inherited neurodegenerative disease. Because the end result of Huntington disease is death due to Huntington disease-related causes, there is a need for better understanding and caring for individuals at their end of life.

AIM: The purpose of this study was to develop a new measure to evaluate end of life planning.

DESIGN: We conducted qualitative focus groups, solicited expert input, and completed a literature review to develop a 16-item measure to evaluate important aspects of end of life planning for Huntington disease. Item response theory and differential item functioning analyses were utilized to examine …

Baseline White Matter Hyperintensities And Hippocampal Volume Are Associated With Conversion From Normal Cognition To Mild Cognitive Impairment In The Framingham Offspring Study., Katherine J Bangen, Sarah R Preis, Lisa Delano-Wood, Philip A Wolf, David J Libon, Mark W Bondi, Rhoda Au, Charles Decarli, Adam M Brickman

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: We examined associations between magnetic resonance imaging (MRI) markers of cerebrovascular disease and neurodegeneration with mild cognitive impairment (MCI) diagnosis at baseline and conversion from normal cognition to MCI at follow-up.

METHODS: Framingham Offspring participants underwent brain MRI and neuropsychological assessment at baseline (n=1049) and follow-up (n=561). Participants were classified at baseline and at follow-up as cognitively normal or MCI using sensitive neuropsychological criteria. White matter hyperintensity (WMH) volume, covert brain infarcts, hippocampal volume, and total cerebral brain volume were quantified.

RESULTS: Baseline measures of WMH and hippocampal volume were associated with MCI status cross-sectionally and also with conversion …