Journal articles on the topic 'Older adults (OAs)'
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1
Rahardjo, Anton, Fakhira Hanna Safira Firdaus, Peter Andreas, Yuniardini Septorini Wimardhani, and Diah Ayu Maharani. "Awareness and Attitudes of Dental Students toward Older Adults in Indonesia." Dentistry Journal 10, no. 10 (September 29, 2022): 183. http://dx.doi.org/10.3390/dj10100183.
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In this study, we aimed to analyse the awareness and attitudes of dental students (DS) toward older adults (OAs) in Indonesia. Compromised oral health (OH) among OAs is a significant public health problem that is a global health burden. Furthermore, appropriate education can provide DS with information about strategic and efficient treatments for OAs. An online invitation was provided to every dental student in Indonesia in the third to sixth year of study to answer a web-based questionnaire as a part of a survey on awareness and attitudes (14 questions) towards OAs. From 1288 valid forms submitted, it was evident that most students (87%) expressed a positive attitude toward OAs. Female students showed a more positive attitude compared to males, with an odds ratio of 1.539 (p = 0.036), and students who had a connection to an older adult demonstrated a more positive attitude than those who did not (OR = 2.076; p < 0.001). The majority of the DS (98%) were conscious of the importance of geriatrics in dentistry, with female students showing more awareness than their male counterparts (OR = 2.553; p = 0.033). Positive awareness and attitudes must be accompanied by knowledge so that DS can offer appropriate and effective oral care to geriatric patients.
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Chen, Linlin, and Xin Zhang. "EASILY ACCESSIBLE EVALUATIVE INFORMATION COULD FACILITATE OLDER ADULTS’ (BUT NOT ALL) TRUSTWORTHINESS JUDGEMENT." Innovation in Aging 3, Supplement_1 (November 2019): S855. http://dx.doi.org/10.1093/geroni/igz038.3144.
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Abstract Facial appearance served great function in social interactions, especially for older adults in making trustworthiness judgements. Previous literatures have consistently shown that when making trustworthiness judgements older adults tended to rely more on facial cues rather than behaviors, due to declines in cognition. However, one question remains unsolved, whether older adults could make accurate trustworthiness judgements if evaluative information (with minimal memory load) is easily accessible. Sixty younger adults (YAs) and sixty older adults (OAs) were recruited, and asked to make investment decisions for different brokers in ninety-six trials. In each trial, brokers’ facial appearance (trustworthy and untrustworthy looking) and different behavioral evaluative information (good: Ninety percent positive evaluations, neutral: Fifty percent positive evaluations, bad: Ninety percent negative evaluations) were displayed simultaneously on screen to facilitate investment decisions. Brokers’ facial appearances and behaviors were set to be independent to each other. The results indicated that YAs’ and the majority of OAs’ proportions of correct investment increase, gradually reaching a stable high correction rate, although OAs needed more trials than did YAs. The findings extended prior work by suggesting that both OAs and YAs had similar abilities to distinguish different brokers according to easily accessible evaluative information. However, and surprisingly, a small subgroup of OAs (with low economic status) still had a lower correction rate even after ninety-six trials, suggesting that they could not distinguish brokers based on their evaluations at all, who might be at risk for fraud.
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Hamilton, Lucas, and Eric Allard. "Older and Younger Adults Reappraise Negative Life Events in Different Ways." Innovation in Aging 4, Supplement_1 (December 1, 2020): 893–94. http://dx.doi.org/10.1093/geroni/igaa057.3294.
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Abstract Past reappraisal studies have been equivocal regarding age and reappraisal efficacy potentially due to the use of laboratory-generated stimuli. We examined reappraisal in a more self-relevant context: negative autobiographical events. 49 younger adults (YA) and 47 older adults (OA) generated 50 negative memories and provided negativity, positivity, and vividness ratings. One to two weeks later, participants underwent the reappraisal task during which physiological data were collected. Participants implemented one of three instructions for 30 seconds: remember naturally, increase negative reactions, or decrease negative reactions via a “positivizing” tactic. Each instruction was provided for 10 unique memories with negativity, positivity, and vividness ratings collected after each trial. 2 (Age; YA, OA) × 3 (Instruction; Remember, Increase, Decrease) mixed ANOVAs uncovered no differences in negativity or vividness ratings before reappraisal. However, OAs rated all memories more positively than YAs. This age difference persisted after reappraisal; however, OAs rated all memories more negatively and vividly than YAs, although both decreased compared to pre-reappraisal levels. Cardiorespiratory data were tested via 2 × 3 mixed ANOVAs, uncovering only a main effect of age on average heart rate. A multilevel model revealed significant variability in the time-course of pupillary responses. 2 × 3 mixed ANOVAs illustrated that reappraisal brought about faster and more frequent spikes in pupil diameter, particularly for OAs. We conclude that OAs and YAs may achieve reappraisal in different ways. Contrary to strict hedonic orientations, OAs simultaneously maintain higher negativity and positivity than YAs challenging existing propositions regarding age-related prioritization of hedonic goals.
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Dube, Victoria, Mollie George, Sarah Hubner, and Julie Blaskewicz Boron. "COMMUNICATION DURING COVID-19: A COMPARISON BETWEEN INSTITUTIONALIZED AND COMMUNITY DWELLING OLDER ADULTS." Innovation in Aging 6, Supplement_1 (November 1, 2022): 459. http://dx.doi.org/10.1093/geroni/igac059.1788.
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Abstract COVID-19 has created communication and socialization challenges for many older adults (OAs) living in community or institutional settings (CECs, IECs respectively) and their essential contacts (ECs). An essential contact is someone who provides emotional, physical, and social support for an older adult. While social distancing measures have decreased the spread and infection rate, these measures have placed strain upon communication and socialization needed for wellbeing which may increase the risk of loneliness and subsequently depression, cognitive functioning, and mortality among OAs. This study compared how general, in-person, and distanced communication between CECs and IECs has changed due to COVID-19. Self-identified ECs to OAs (N=546) completed a Qualtrics questionnaire via Amazon Mechanical Turk. Respondents (Age Range: 19-77; Mean=44.3; SD=14.2) were generally female (54.8%), white (81.0%), and CECs (57.3%). Pearson chi-square was used to evaluate the association between EC and communication type. Phi and Cramer’s V were used to measure effect size. IECs were significantly more likely than CECs to report much less general (41.6% vs. 10.7; medium effect) and in-person (60.0% vs. 22.4%; medium effect) social interaction due to COVID-19. IECs were significantly more likely to report much more distanced communication than CECs (42.8% vs 5.2%; small effect). Overall, this suggests community dwelling OAs’ communication and socialization were less impacted by COVID-19 distancing than institutionalized OAs. Thus, institutionalized OAs may be at greater risk for negative effects of social distancing. Future efforts need to focus on prioritizing ways for institutionalized adults to communicate with their ECs if social distancing is needed.
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Yeo, Hyesu, and Elisa Childs. "ACCESS TO HOSPITAL-BASED PALLIATIVE CARE SERVICES FOR OLDER ADULTS IN IOWA." Innovation in Aging 6, Supplement_1 (November 1, 2022): 686. http://dx.doi.org/10.1093/geroni/igac059.2519.
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Abstract Background U.S. Medicare covers many palliative services; however, Iowa’s rurality and high rate of older adults (OAs) aged 65 or over make it unclear whether older Iowans have equitable service access. Hospital-based palliative care services (HBPCSs) include curative treatment, whereas other providers of palliative care may not. Thus, this study only examined OAs’ geographic access to HBPCSs in Iowa. Methods This study used the American Hospital Association and U.S. Census Bureau estimate in 2017. The geographical distribution of hospitals and HBPCSs was examined using a county-level approach, considering rural/urban status (using the Office of Management and Budget’s definitions) and OA population proportion. Results Of the 99 counties in Iowa, 89 were rural. Of the 116 hospitals statewide, one urban county and nine rural counties had no hospital. A total of 52 hospitals provided HBPCSs in 43 counties across nine urban and 34 rural counties. HBPCSs were primarily located in central Iowa, with northern and southern Iowa having the lowest access to HBPCSs. The OA population ratio was higher in counties without HBPCSs (19%) than HBPCSs (15.7%). All 54 counties with over a 20% OA population were concentrated in rural counties, while only 37% of these rural counties had HBPCSs. Conclusion This study suggests a regional imbalance of HBPCS providers for OAs in Iowa. Results showed that rural communities with a high ratio of OAs lack HBPCSs and suggest HBPCSs should be expanded at hospitals in northern and southern Iowa counties where many OAs live.
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Glass, Anne, and Lauretta Lawlor. "The First COVID-19 Stay-at-Home Restrictions: An Intergenerational Comparison of the Impacts." Innovation in Aging 4, Supplement_1 (December 1, 2020): 958–59. http://dx.doi.org/10.1093/geroni/igaa057.3504.
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Abstract “Social distancing” and stay-at-home orders were enacted in many states in response to the spread of COVID-19. We sought to understand intergenerational differences in the impact of the initial COVID-19 restrictions on interactions, loneliness, and stress. Data was collected via online survey from individuals ages 18 and above during the period April 7-May 8, 2020. The predominantly female, White, and well-educated sample (n = 962) included 245 younger adults (YAs) ages 18-34, 374 middle-aged adults (MAs) ages 35-64, and 343 older adults (OAs) ages 65+, with overall mean age 51.67 (SD=20.257; range 18-96). Before the restrictions, 41% of these OAs infrequently/never interacted face-to-face with children, increasing to 74% after restrictions. Three quarters (77%) of YAs reported seeing OAs less often, but 42% reported increasing their connections with OAs via technology. About a third of MAs (35%) and OAs (36%) were lonely, compared to 48% of YAs (p = .003), and a higher percentage of YAs (57%) reported being “more lonely” now, compared to MAs (36%) and OAs (41%). OAs reported the least stress; 42% reported low/very low levels of stress compared to YAs (9%) and MAs (20%). All generations most often identified “being able to go places” as the thing they missed most, but it increased significantly with age (p < .001), from YAs (32%), MAs (37%), to OAs (44%). More YAs (20%) than OAs (7%) reported missing “structure to their day.” Results of these intergenerational comparisons suggest the resilience of older adults is helping them during the current pandemic.
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Swanson, Clayton W., and Brett W. Fling. "Discriminative Mobility Characteristics between Neurotypical Young, Middle-Aged, and Older Adults Using Wireless Inertial Sensors." Sensors 21, no. 19 (October 6, 2021): 6644. http://dx.doi.org/10.3390/s21196644.
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Age-related mobility research often highlights significant mobility differences comparing neurotypical young and older adults, while neglecting to report mobility outcomes for middle-aged adults. Moreover, these analyses regularly do not determine which measures of mobility can discriminate groups into their age brackets. Thus, the current study aimed to provide a comprehensive analysis for commonly performed aspects of mobility (walking, turning, sit-to-stand, and balance) to determine which variables were significantly different and furthermore, able to discriminate between neurotypical young adults (YAs), middle-aged adults (MAAs), and older adults (OAs). This study recruited 20 YAs, 20 MAAs, and 20 OAs. Participants came into the laboratory and completed mobility testing while wearing wireless inertial sensors. Mobility tests assessed included three distinct two-minute walks, 360° turns, five times sit-to-stands, and a clinical balance test, capturing 99 distinct mobility metrics. Of the various mobility tests assessed, only 360° turning measures demonstrated significance between YAs and MAAs, although the capacity to discriminate between groups was achieved for gait and turning measures. A variety of mobility measures demonstrated significance between MAAs and OAs, and furthermore discrimination was achieved for each mobility test. These results indicate greater mobility differences between MAAs and OAs, although discrimination is achievable for both group comparisons.
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Ju, Catherine, Meghan McDarby, Matthew Picchiello, and Brian Carpenter. "Experiences and Perceived Origins of Compassionate Ageism Among Older Adults During the COVID-19 Pandemic." Innovation in Aging 5, Supplement_1 (December 1, 2021): 937. http://dx.doi.org/10.1093/geroni/igab046.3389.
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Abstract During the COVID-19 pandemic, there was a rise in media messages (MMs) and interpersonal behaviors (IBs) that could have been considered as reflecting compassionate ageism (i.e., ageism that stems from perceptions of older adults [OAs] as warm but incompetent). However, it is unclear how OAs experienced these MMs and IBs during the pandemic. The current study examined how OAs perceived pandemic-related MMs and IBs. We recruited 74 community-dwelling OAs (Mage = 73.18, 58% female). Participants completed a survey in which they reported the extent to which they had encountered five MMs and nine IBs throughout the COVID-19 pandemic. Then, participants rated whether they believed each MM and IB was motivated by care and how offended they were by it. Nearly all participants had encountered MMs about OAs’ vulnerability to COVID-19 (e.g., more likely to contract COVID-19, 97%; more likely to die from COVID-19, 97%). Furthermore, most participants experienced IBs emphasizing their vulnerability to COVID-19 (e.g., told by another person they had a higher likelihood of contracting COVID-19, 64%; someone had checked in on them unprompted, 63%). However, across MMs and IBs, most participants (59–100%) perceived them as motivated by care and concern, and a relatively small proportion (0–20%) reported being offended by them. Our findings underscore the importance of understanding nuances of ageism from the perspective of OAs themselves. Different forms of ageism (i.e., compassionate ageism, hostile ageism) rooted in certain stereotypes about older adults (i.e., high warmth-low competence) may uniquely shape the lived experiences of OAs.
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Sunderaraman, Preeti, Ziqian Dong, Santhoshkumar Sampath, Silvia Chapman, Jillian Joyce, Yaakov Stern, and Stephanie Cosentino. "Development of the Online Money Management Credit Card Task." Innovation in Aging 4, Supplement_1 (December 1, 2020): 801. http://dx.doi.org/10.1093/geroni/igaa057.2906.
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Abstract Older adults (OAs), a wealthy but vulnerable segment of our population, are at risk to make compromised financial decisions. Evidence suggests that OAs increasingly use technology to perform everyday financial transactions, such as to manage their credit card statements. However, current tools are lacking in terms of assessing how older adults navigate and handle the online financial milieu. We will discuss the development of a novel, simulated online money management (OMM) credit card statement task. OMM examines OAs performance on several indices including reaction time, nature and frequency of errors, and their ability to comprehend and trouble shoot problems. Psychometric properties related to the reliability and validity will be discussed. Ultimately, by examining the longitudinal performance of OMM in OAs, we can better characterize the natural course of OMM. Such an approach will enable clinicians to accurately and objectively examine OMM and identify those at risk for making financial errors.
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Smalls, Brittany, Myles Moody, Matthew Rutledge, and Amy Cowley. "MEASURING QUALITY OF LIFE IN OLDER ADULTS LIVING WITH T2DM: A COMPARISON WITH YOUNGER ADULTS USING 2015 BRFSS DATA." Innovation in Aging 3, Supplement_1 (November 2019): S258—S259. http://dx.doi.org/10.1093/geroni/igz038.966.
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Abstract Challenges due to burden of disease can affect adherence to self-care behaviors and optimal health outcomes in those living with T2DM. This study utilized state- and national-level data from the 2015 BRFSS to compare QoL measured by the prevalence of physical and mental burden days among older adults (OAs) compared to younger adults living with T2DM. The results of our analysis showed that OAs living in the US were significantly less likely to experience at least one mental burden day when compared to their younger counterparts (OR =0.61, 95% CI: 0.58, 0.64), while gender, education, race, BMI, and depression, CVD, or another chronic condition were significantly associated with the odds of experiencing at least one mental burden day. Whereas, in Kentucky OAs were less likely to experience at least one mental burden day when compared to their younger counterparts (OR= 0.48, 95% CI: 0.35, 0.66). Gender, education, BMI, and depression were significantly associated with the odds of experiencing at least one mental burden day or one physical burden day. The findings of this study suggests that the questions used by BRFSS to measure QoL may not be the most suitable for OAs who likely have different criteria for self-reported mental or physical burden days. When assessing QoL or burden of disease among the aging at a population level, considerable thought should be given into the questions asked and if they appropriately examine patient-level QoL in this population.
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Tinlin, Rowan &., and Ray Cabrera. "‘Making space’: Exploring staff attitudes and experiences of working with LGBT+ older adults." FPOP Bulletin: Psychology of Older People 1, no. 153 (January 2021): 38–45. http://dx.doi.org/10.53841/bpsfpop.2021.1.153.38.
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Compared to their heterosexual and cisgender peers, older adults (OA) identifying as LGBT+ experience increased levels of emotional distress and associated mental health conditions such as depression, anxiety and panic. Additionally, due to generational effects such as historical legal and medical discrimination, LGBT+ OAs face additional barriers to accessing mental health services. The OA pathway within Cumbria, Northumberland and Tyne and Wear NHS Foundation trust (CNTW) works clinically with LGBT+ OAs within the community, care and inpatient settings. The trust delivers LGBT+ awareness and ally training, however, the experiences and attitudes of clinical staff have not been previously explored. Therefore the current evaluation used qualitative methodology and thematic analysis to examine staff confidence and experiences working with this population. Following analysis five themes with multiple subordinate themes were identified; (1) staff emotions and thoughts; (2) compassionate attitudes; (3) awareness of LGBT+ history; (4) adaptations to practice; (5) support for staff. The themes informed a model of ‘best practice working with LGBT+ OAs’ and service recommendations for training, resources and signposting, and LGBT+ specific supervision.
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Cathers, Rebecca, and Fionnuala Edgar. "GPs’ perceptions of the barriers to referring older adult patients to mental health services in NHS Dumfries & Galloway." FPOP Bulletin: Psychology of Older People 1, no. 124 (October 2013): 44–50. http://dx.doi.org/10.53841/bpsfpop.2013.1.124.44.
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Older adults (OAs) have been found to be under-represented relative to working-aged adults in referrals received by Dumfries & Galloway’s psychology service (Robson & Higgon, 2010). Previous research has suggested various reasons why OAs may not be referred on to psychology services which can be grouped into two main categories: OAs not discussing their problems with general practitioners (GPs) and GPs failing to refer on. Given GPs important role as gatekeepers to services, this study aimed to investigate this underrepresentation by exploring GPs’ opinions of the barriers to OAs accessing mental health services locally. An online survey was distributed to all GPs in the region investigating presentation rates and routine treatment options for memory problems, depression and anxiety and the perceived barriers to onward referrals to mental health services. Thirty-one per cent of GPs completed the survey. The majority of GPs reported being ‘unlikely’ to refer to mental health services if the main complaint was anxiety and ‘somewhat likely’ or ‘unlikely’ to refer on if this was depression. ‘Preoccupation with physical explanations for symptoms’ was perceived to be the main barrier to OAs accessing services. ‘Waiting lists’ were also seen as a significant barrier. Overall, the results suggest that improved communication between GPs and mental health services may have a positive influence on access to mental health services for OAs.
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Stewart, Brittany, Paige Hanke, Megan Kucemba, Diane L. Levine, Jennifer Mendez, and Aline H. Saad. "A Qualitative Analysis of Older Adults’ Views of Healthcare Provider Attributes and Communication Skills." Journal of Patient Experience 9 (January 2022): 237437352210925. http://dx.doi.org/10.1177/23743735221092564.
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Understanding factors that improve patients’ healthcare experiences are essential for healthcare providers (HCPs) caring for older adults (OAs). Previous data supports that effective patient-centered care leads to a better understanding of patients’ experiences, values, and preferences. The aim of this study was to evaluate OAs views of HCPs attributes and communication skills to better understand patient's views about their HCP interactions. Qualitative analysis of the data revealed five key themes that emerged: professionalism, patient rapport, patient-centered care, empathy, and communication. Addressing and optimizing performance in these areas could improve patient experiences and support enhanced training for healthcare students.
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Yang, Chun, Daniel W. L. Lai, Yi Sun, Chun-Yin Ma, and Anson Kai Chun Chau. "Mobile Application Use and Loneliness among Older Adults in the Digital Age: Insights from a Survey in Hong Kong during the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 19, no. 13 (June 23, 2022): 7656. http://dx.doi.org/10.3390/ijerph19137656.
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Existing literature on the associations between use of mobile applications (i.e., mobile apps) and loneliness among older adults (OAs) has been mainly conducted before the outbreak of the COVID-19 pandemic. Since mobile apps have been increasingly used by OAs during the pandemic, subsequent effects on social and emotional loneliness need updated investigation. This paper examines the relationship between mobile app use and loneliness among Hong Kong’s OAs during the pandemic. In our research, 364 OAs with current use experience of mobile apps were interviewed through a questionnaire survey conducted during July and August 2021, which assessed the use frequency and duration of 14 mobile app types and levels of emotional and social loneliness. The survey illustrated communication (e.g., WhatsApp) and information apps were the most commonly used. Emotional loneliness was associated with the use of video entertainment (frequency and duration), instant communication (duration), and information apps (duration). Association between video entertainment apps’ use and emotional loneliness was stronger among older and less educated OAs. Our findings highlight the distinctive relationships between different types of apps and loneliness among Hong Kong’s OAs during the pandemic, which warrant further exploration via research into post-pandemic patterns and comparative studies in other regions.
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Kurti, Stephanie P., William S. Wisseman, Molly E. Miller, Hannah L. Frick, Steven K. Malin, Sam R. Emerson, David A. Edwards, and Elizabeth S. Edwards. "Acute Exercise and the Systemic and Airway Inflammatory Response to a High-Fat Meal in Young and Older Adults." Metabolites 12, no. 9 (September 10, 2022): 853. http://dx.doi.org/10.3390/metabo12090853.
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The purpose of the present study was to determine fasting and high-fat meal (HFM)-induced post-prandial systemic inflammation and airway inflammation (exhaled nitric oxide (eNO)) in older adults (OAs) compared to younger adults (YAs) before and after acute exercise. Twelve YAs (23.3 ± 3.9 y n = 5 M/7 F) and 12 OAs (67.7 ± 6 y, n = 8 M/4 F) completed two HFM challenges. After an overnight fast, participants underwent an HFM session or pre-prandial exercise (EX, 65% VO2Peak to expend 75% of the caloric content of the HFM) plus HFM (EX + HFM) in a randomized order. Systemic inflammatory cytokines were collected at 0, 3, and 6 h, while eNO was determined at 0, 2, and 4 h after the HFM (12 kcal/kg body weight: 61% fat, 35% CHO, 4% PRO). TNF-α was higher in OAs compared to YAs (p = 0.005) and decreased across time from baseline to 6 h post-HFM (p = 0.007). In response to the HFM, IL-6 decreased from 0 to 3 h but increased at 6 h regardless of age or exercise (p = 0.018). IL-8 or IL-1β did not change over the HFM by age or exercise (p > 0.05). eNO was also elevated in OAs compared to YAs (p = 0.003) but was not altered by exercise (p = 0.108). There was a trend, however, towards significance post-prandially in OAs and YAs from 0 to 2 h (p = 0.072). TNF-α and eNO are higher in OAs compared to YAs but are not elevated more in OAs post-prandially compared to YAs. Primary systemic inflammatory cytokines and eNO were not modified by acute exercise prior to an HFM.
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Brand, Yonatan E., Dafna Schwartz, Eran Gazit, Aron S. Buchman, Ran Gilad-Bachrach, and Jeffrey M. Hausdorff. "Gait Detection from a Wrist-Worn Sensor Using Machine Learning Methods: A Daily Living Study in Older Adults and People with Parkinson’s Disease." Sensors 22, no. 18 (September 19, 2022): 7094. http://dx.doi.org/10.3390/s22187094.
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Remote assessment of the gait of older adults (OAs) during daily living using wrist-worn sensors has the potential to augment clinical care and mobility research. However, hand movements can degrade gait detection from wrist-sensor recordings. To address this challenge, we developed an anomaly detection algorithm and compared its performance to four previously published gait detection algorithms. Multiday accelerometer recordings from a wrist-worn and lower-back sensor (i.e., the “gold-standard” reference) were obtained in 30 OAs, 60% with Parkinson’s disease (PD). The area under the receiver operator curve (AUC) and the area under the precision–recall curve (AUPRC) were used to evaluate the performance of the algorithms. The anomaly detection algorithm obtained AUCs of 0.80 and 0.74 for OAs and PD, respectively, but AUPRCs of 0.23 and 0.31 for OAs and PD, respectively. The best performing detection algorithm, a deep convolutional neural network (DCNN), exhibited high AUCs (i.e., 0.94 for OAs and 0.89 for PD) but lower AUPRCs (i.e., 0.66 for OAs and 0.60 for PD), indicating trade-offs between precision and recall. When choosing a classification threshold of 0.9 (i.e., opting for high precision) for the DCNN algorithm, strong correlations (r > 0.8) were observed between daily living walking time estimates based on the lower-back (reference) sensor and the wrist sensor. Further, gait quality measures were significantly different in OAs and PD compared to healthy adults. These results demonstrate that daily living gait can be quantified using a wrist-worn sensor.
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Huisingh-Scheetz, Megan, Roscoe Nicholson, Chelsea Smith, Saira Shervani, Yadira Montoya, and Louise Hawkley. "EngAGE via Alexa for Older Adults and Caregivers: Design, Utilization, and Impact of Socially Motivated Exercise." Innovation in Aging 4, Supplement_1 (December 1, 2020): 645. http://dx.doi.org/10.1093/geroni/igaa057.2219.
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Abstract EngAGE is a technology-based program leveraging Alexa that encourages older adult (OA) activity and socialization from home while empowering caregivers to support them. EngAGE delivers daily, in-home, NIA Go4Life exercise routines with instructions, pictures and music via Alexa Echo Shows or Fire Tablets to OAs. Caregivers use EngAGE to view scheduled exercises, follow progress, and send encouraging messages that are read aloud to OAs by Alexa. We will discuss the strategic co-design of EngAGE with OAs and caregivers and the utilization and functional impact of EngAGE over a 12-week feasibility and usability study (n=10 OA + caregiver pairs). Preliminary analyses revealed improvement in upper (mean grip strength change = +1.3 kg, paired t-test p=0.34) and lower (5-repeated chair stand time change = -2.3 seconds, paired t-test p=0.02) body strength. Discussion of focus group data will cover themes of perceived benefits, user experience, drivers/barriers to usage and desired features for EngAGE.
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Erlenbach, Emily, Revati Malani, Edward McAuley, and Neha Gothe. "FEASIBILITY AND ACCEPTABILITY OF A HYBRID AEROBIC EXERCISE PROGRAM FOR OLDER ADULTS DURING THE COVID-19 PANDEMIC." Innovation in Aging 6, Supplement_1 (November 1, 2022): 800–801. http://dx.doi.org/10.1093/geroni/igac059.2889.
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Abstract The COVID-19 pandemic and ensuing lockdowns, physical distancing and mask mandates exacerbated the challenges older adults (OAs) face towards exercise engagement. We present data on the feasibility, safety, and acceptability of a hybrid (in-person and virtual) aerobic exercise program for OAs. Nf39 (30 females, Mage=64.10) low-active OAs completed an aerobics-based exercise program as part of a larger ongoing RCT. Participants exercised 3x/week by attending one in-person and two Zoom-based exercise classes. Attendance, attrition, format preferences, and adverse events were documented. Participants also completed an anonymous survey to detail their experiences with the hybrid delivery model. Thirty participants completed the program. Total average attendance of 83.64%; 58.93% and 24.71% of the attended sessions were on Zoom and in-person, respectively. On post-program surveys, 36.67% reported preferring Zoom sessions, followed by 33.33% preferring both formats equally. No adverse events were reported. From the anonymous program feedback surveys, common reasons for preferring the Zoom sessions included convenience; not having to wear a mask; not worrying about COVID exposure; and not feeling self-conscious about exercising with others. Commonly reported reasons for preferring the in-person sessions were increased motivation from group energy; social support; more space to move around; and better engagement with instructors. Collectively, these findings show a hybrid aerobic exercise program is feasible and safe for OAs to engage in and is overall well-accepted. Findings are encouraging for the design of future exercise programs for OAs, who continue to remain a vulnerable population during the pandemic but need a structure to remain sufficiently active.
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Sanders, Edie, and Jane Berry. "Evidence for an Age-Related Positivity Effect in Metacognitive Confidence Judgments." Innovation in Aging 4, Supplement_1 (December 1, 2020): 363–64. http://dx.doi.org/10.1093/geroni/igaa057.1170.
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Abstract We examined age differences in metacognitive monitoring of emotionally-valenced stimuli. If older adults (OAs) are more focused on emotionally meaningful goals in late life (Carstensen, 2006), then they should demonstrate attentional and memory biases for positive stimuli over neutral and negative stimuli and, arguably, these cognitive biases should be reflected in their metacognitive judgments of learning. Judgments of learning (JOLs) for memory of positive, negative, and neutral words were collected. Younger adults (YAs) aged 18-23 years and OAs aged 65-90 years (N = 85) studied words in each valence category and made immediate JOLs, followed by a two-alternative forced choice (2AFC) recognition memory task. Analyses of JOLs revealed evidence for a positivity effect (Mather & Carstensen, 2005) in metacognitive confidence for OAs and an emotional salience effect in YAs (Tauber & Dunlosky, 2012; Zimmerman & Kelley, 2010). Predictably, YAs recognized more words than OAs, but valence did not affect number of words recognized and valence did not moderate age differences in recognition memory (p = .055). Memory monitoring as measured by resolution accuracy was equivalent in YAs and OAs (Hertzog & Dunlosky, 2011). Positive affect was higher and negative affect was lower in OAs relative to YAs (Gallant, Spaniol, & Yang, 2019), lending additional evidence to an orientation toward the positive in older adulthood. These results are novel in that they demonstrate an age-related positivity effect that extends beyond the domains of memory and emotion to the domain of metacognitive aging. Discussion will focus on theoretical, methodological, and applied implications.
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Heyn, Patricia, and Amber Watts. "A New Lens on Physical Activity Promotion: Can Technology Boost Exercise Prescription and Adherence?" Innovation in Aging 4, Supplement_1 (December 1, 2020): 842–43. http://dx.doi.org/10.1093/geroni/igaa057.3089.
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Abstract Adherence to exercise prescription for older adults (OAs) is a significant problem and can have a detrimental effect on key health outcomes. Exercise adherence for OAs is a multifactorial problem encompassing many factors affecting adherence such as socioeconomic status, education, physical fitness, and mental and health status. Improving exercise adherence could have a significant impact on longevity, quality of life, and health care costs. This symposium brings multiple perspectives to closely examine promising technology approaches, both in the form of models and programs. We will also discuss gaps regarding adherence to physical activity (PA) and exercise prescription for OA and the application of current publicly available technologies to boost PA adherence and compliance accordingly to the U.S. Department of Health and Human Services national standards for promoting health and preventing disease. The symposium includes five novel presentations addressing several key factors related to successful implementation of technology approaches to exercise program delivery and adherence for OAs. In addition, we will have one presentation highlighting the key factors that impact exercise prescription, compliance, and adherence. The speakers will present and address important components related to technology use with the goal to increase older adult’s PA participation. The exercise programs will target key areas affecting older adult’s health such as cognitive function, falls, obesity, gender, environments, and self-efficacy. Technology user-usability perspective will be presented. Current challenges and recommendations for future research will be comprehensively discussed to properly address the exercise adherence and compliance needs of our OA populations.
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Rogalski, Yvonne, and Amy Rominger. "The Impact of Subjective and Objective Hearing Loss on Cognition and Memory in Older Adults." Perspectives on Gerontology 20, no. 2 (May 2015): 49–57. http://dx.doi.org/10.1044/gero20.2.49.
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For this exploratory cross-disciplinary study, a speech-language pathologist and an audiologist collaborated to investigate the effects of objective and subjective hearing loss on cognition and memory in 11 older adults without hearing loss (OAs), 6 older adults with unaided hearing loss (HLOAs), and 16 young adults (YAs). All participants received cognitive testing and a complete audiologic evaluation including a subjective questionnaire about perceived hearing difficulty. Memory testing involved listening to or reading aloud a text passage then verbally recalling the information. Key findings revealed that objective hearing loss and subjective hearing loss were correlated and both were associated with a cognitive screening test. Potential clinical implications are discussed and include a need for more cross-professional collaboration in assessing older adults with hearing loss.
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Strong, Jessica, and Kirsten Graham. "Ageism Across Cultures and Interest in Geropsychology Among International Students." Innovation in Aging 4, Supplement_1 (December 1, 2020): 594–95. http://dx.doi.org/10.1093/geroni/igaa057.1997.
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Abstract Ageist attitudes are concerning when considering who will enter the geriatric workforce. The impact of ageism on intent to work with older adults (OAs) between North American and non-North American individuals is unclear. We collected data from N=186 students (n=153 N. American, n=33 non-N. American), examining ageist attitudes and intent to work with OAs. We found significant differences between groups in ageist attitudes; North American students had more positive views of aging (M=88.64, SE=0.72) than non-North American students (M=85.33, SE = 1.42; t (167) = 2.04, p = 0.04, d=0.39), but there were no differences between groups for intent to work with OAs (t (174) = 0.09, p = 0.93). Ageist attitudes predicted intent to work with OAs for North American students only (F (2, 112) = 8.82, p < 0.001, R2 = 0.14). We discuss implications of ageism and intent to work with OAs from a cross-cultural lens.
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Morris, Ashley O., Jamie A. Stone, Ka Xiong, Robert Breslow, Denise Walbrandt Pigarelli, Lauren Welch, and Michelle A. Chui. "A Field Study: Partnering with Pharmacists to Develop a Tool for Evaluating Misuse of Over-the-Counter Medications among Older Adults in the Community Pharmacy." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 66, no. 1 (September 2022): 2122–26. http://dx.doi.org/10.1177/1071181322661266.
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Safe over the counter (OTC) medication use by older adults (OAs, aged 65+) is difficult to achieve because of age-related physiologic complexities, and millions of OAs in the US who are at risk of experiencing a major adverse drug event linked to an OTC medication. Our interdisciplinary team studies how we can improve OTC safety in OAs by developing human factors-based, community pharmacy interventions. Testing the effectiveness of our interventions on improving OTC safety necessitated the development of a framework that captures the ways OTC medication misuse can occur and designing and implementing a tool that can be used to evaluate for potential misuse, which can be used by researchers and healthcare professionals to understand misuse in OAs. This paper shares the results of our efforts and discusses the implications of our work for other HF practitioners that may be interested applying our approach to their research.
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Pierpaoli-Parker, Christina. "The Senior Sex Education Experience Study: Qualitative Data From Developing an Adult Sex Education Program." Innovation in Aging 4, Supplement_1 (December 1, 2020): 500. http://dx.doi.org/10.1093/geroni/igaa057.1615.
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Abstract Older adults (OAs) account for an unprecedented proportion of STDs but receive limited sex education. We present preliminary data from the SEXEE study developing a sex education intervention for OAs 50+. The sample consisted of 17 OAs, ages 53 to 77, (M = 65, SD = 7.6; 64.7% female; 94.1% Caucasian) and seven primary care physicians, geriatricians, and other specialists (e.g. gynecologists), sampled purposively. Physicians completed a semi-structured interview to describe their experiences discussing sexual health with OAs, identify barriers to those discussions, and elicit recommendations for an educational curriculum. OAs participated in three separate focus groups to determine their interest in and suggestions for the intervention. Qualitative data underwent thematic coding separately by two researchers, with a third researcher resolving any discrepancy. One physician (14%) reported routinely assessing adults’ sexual health; others only in the context of a specific presenting concern (e.g. ED). Though the physicians considered sexuality important component of QoL, many reported barriers to assessment and treatment, including insufficient time, training, and knowledge; concerns about personal and patient discomfort; and patient complexity. Of the OAs interviewed, 15 (88%) endorsed high interest in attending a sex education program. The most commonly recommended educational topics among physicians and OAs included: sexual changes with aging and management strategies; STDs and risk factors; tools for enlarging the sexual repertoire, myths about late life-sexuality; masturbation, and dating. Findings extend previous observations about clinical barriers to sexual health discussions and provide new insights for developing a sex ed intervention for this population.
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Hughes, Mary, and Fionnuala Edgar. "‘Beating the Lows in Later Life’: Evaluation of a mental health awareness raising campaign aimed at OAs." FPOP Bulletin: Psychology of Older People 1, no. 125 (January 2014): 58–65. http://dx.doi.org/10.53841/bpsfpop.2014.1.125.58.
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Prevalence rates for mental health difficulties among Older Adults (OAs) are high, with over a third experiencing symptoms of mental illness (Age Concern, 2007). Within Dumfries and Galloway OAs are under-represented, relative to working-age adults, in referrals to the psychology service. Under-referral has been suggested to arise as a consequence of direct and indirect stigma and ageist attitudes towards mental health problems in OAs. This study aimed to explore perceptions of OAs in relation to mental health stigma and barriers to treatment. We also aimed to evaluate the impact of a pilot local mental health awareness raising campaign: ‘Beating the Lows in Later Life’ on referral rates to Psychology and Guided Self-Help services. Surveys were made available in both an electronic and print format to community-dwelling OAs, via general practitioner (GP) surgery waiting rooms, public libraries and electronic distribution to members of two local branches of the University of the Third Age (U3A: a national organisation supporting life-long learning). Referral rates in the period following the awareness raising campaign (May-July 2013) were compared with those in the same period the previous year. Thirty-two respondents completed the survey. Despite no significant difference in referral rates following the campaign, respondents reported increased confidence in help-seeking and decreased perceptions of mental health stigma. Lack of awareness about services available, acceptance of anxiety/depression as normal, mobility issues and stigma were reported as being key barriers to treatment-seeking by OAs.
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Nathwani, Nitya, Supriya Gupta Mohile, Brea Lipe, Karen Carig, Laura DiGiovanni, Agnes Davis, Debra Wujcik, Arti Hurria, and Tanya Marya Wildes. "Integrating a touchscreen-based brief geriatric assessment in older adults with multiple myeloma." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e21703-e21703. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e21703.
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e21703 Background: Multiple myeloma (MM) is a disease of older adults (OAs) with > 60% of diagnoses and nearly 75% of deaths occurring in patients > 65 years old (YO). Geriatric Assessment (GA) is associated with toxicity and survival in OAs with MM, but not routinely used in practice. This project pilot tests a tablet-based modified Geriatric Assessment (mGA) that presents compiled GA results, including (the Palumbo) frailty score, to clinicians at a treatment decision-making visit in a single screen dashboard. Methods: In this multisite ongoing study, 210 patients with MM ≥65 YO facing a decision point for care will complete a mGA that includes the Charlson Comorbidity Index (CCI), Katz Activity of Daily Living (ADL) Score, and Lawton Instrumental Activity of Daily Living (IADL) Score prior to meeting with a physician. mGA results, including composite frailty score, are provided to physicians at the start of a visit. Results: Thirty-six patients have been enrolled to date; enrollment continues. Participants are 69% (n = 25) white, 64% (n = 23) male, and mean age of 72 YO (range 65-87). Most (74%, n = 20) currently receive ≥1 therapy and have few co-morbidities (CCI median 1, SD 1.95, range 0-8); 57% require assistance with IADLs and 37% require assistance with ADLs. Based on Palumbo score, 36% of participants were frail (n = 13), 33% intermediate (n = 12), and 31% fit (n = 11). Providers report mGA results influenced treatment decision (54%, n = 28) and frailty score was the most frequently cited result to impact treatment decision-making (61%, n = 39). The most common way the mCGA influenced decision-making was to reduce dose/dose intensity (25%, N = 8). Clinicians on average spent 5 minutesreviewing the mGA results. Patients reported an average of 7 minutes to complete the survey, most independently (83%, n = 30), and were satisfied with the electronic program overall (80%, n = 29), including how easy it was to use (88%, n = 32). Conclusions: Preliminary data support feasibility, usability, and acceptability of the tablet-based mGA and that frailty score influences provider decision-making ≥50% of the time. Future analyses will explore the relationship of the mGA with toxicity, dose modification and/or treatment discontinuation in OAs with MM.
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Sánchez-Arenas, Rosalinda, Svetlana V. Doubova, Mariela Bernabe-Garcia, Michel A. Gregory, Laura Alejandra Mejía-Alonso, Oscar Orihuela-Rodríguez, Carlos Paredes-Manjarrez, et al. "Double-task exercise programmes to strengthen cognitive and vascular health in older adults at risk of cognitive decline: protocol for a randomised clinical trial." BMJ Open 10, no. 12 (December 2020): e039723. http://dx.doi.org/10.1136/bmjopen-2020-039723.
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IntroductionCognitive and physical declines are frequent causes of disability among older adults (OAs) in Mexico that imposes significant burden on the health system and OAs’ families. Programmes to prevent or delay OAs’ cognitive and physical decline are scarce.Methods and analysisA double-blind randomised clinical trial will be conducted. The study will aim to evaluate two 24-week double-task (aerobic and cognitive) square-stepping exercise programmes for OAs at risk of cognitive decline—one programme with and another without caregiver participation—and to compare these with an aerobic-balance-stretching exercise programme (control group). 300 OAs (100 per group) affiliated with the Mexican Institute of Social Security (IMSS) between 60 and 65 years of age with self-reported cognitive concerns will participate. They will be stratified by education level and randomly allocated to the groups. The intervention will last 24 weeks, and the effect of each programme will be evaluated 12, 24 and 52 weeks after the intervention. Participants’ demographic and clinical characteristics will be collected at baseline. The outcomes will include: (1) general cognitive function; (2) specific cognitive functions; (3) dual-task gait; (4) blood pressure; (5) carotid intima–media thickness; (6) OAs’ health-related quality of life; and (7) caregiver burden. The effects of the interventions on each outcome variable will be examined using a repeated-measures analysis of variance (ANOVA), with study groups as the between-subjects variable and time as the within-subject variable.Ethics and disseminationThe study was approved by the IMSS Ethics and Research Committees (registration number: 2018-785-095). All participants will sign a consent form prior to their participation. The study results will be disseminated to the IMSS authorities, healthcare providers and the research community.Trial registration numberClinicalTrials.gov (NCT04068376).
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Bedin, Maria Grazia, Fabien Capelli, and Marion Droz-Mendelzweig. "Explicitation Interview: A Method for Collecting First Person Perspectives on Living Alone in Old Age." International Journal of Qualitative Methods 18 (January 1, 2019): 160940691986584. http://dx.doi.org/10.1177/1609406919865840.
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How can older adults (OAs) live at home alone when they have health problems? Growing numbers of OAs live with chronic health problems and yet are determined to remain in their homes as long as possible. The risks associated with living alone are a source of grave concern not only for OAs but also for those around them. Knowing how OAs cope with the risks they face is a central issue for home care and support services. The present article describes the advantages of coupling an existential anthropology approach with an explicitation interview (EI) methodology as a means of understanding the details of how OAs manage their lives at home alone. Using this introspective methodology, we encouraged 20 participants aged 80 years or older to share very detailed elements of their subjective daily life experiences of coping with the risks inherent to their solitary lifestyles. Different types of risk coexisted with one another; some risks were physical, while others were existential. Physical risks appeared to be subordinate to other major fears: loss of identity, disintegration of one’s internal coherence, lack of autonomy and control over one’s personal situation, and decline in self-esteem and self-image. These fears acted as incentives for developing various practical coping mechanisms for their daily lives, including measures that involved taking risks with regard to their physical safety. Using our existential anthropology approach, supported by the EI methodology, we closely examined the details of interviewees’ realities.
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Spradley, Laura. "Community Collaborations & Technology Successfully Connect Isolated Older Adults to Education & Activities." Innovation in Aging 5, Supplement_1 (December 1, 2021): 923. http://dx.doi.org/10.1093/geroni/igab046.3342.
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Abstract Providing programs, activities and education to older adults (OA) is a challenge under normal circumstances. The Arkansas Geriatric Education Collaborative (AGEC) is a HRSA Geriatric Workforce Enhancement Program with a mission to “provide high quality programs that support healthy aging in Arkansas.” Prior to the pandemic, AGEC educators provided face-to-face programs to OA’s through senior centers, places of worship and other public venues. The pandemic changed all that. In-person programs were replaced with zoom presentations, social media events and pre-recorded programs placed on websites and patient-learn platforms for 24/7 viewing. Gaining viewership proved difficult and after collaborative research, it was determined the major barrier was a digital divide between access, usage and knowledge of digital platforms. To overcome this barrier, AGEC utilized TV, radio, libraries, digital infographics, newsletters and video tips addressing Wi-Fi and technology training. Videos, distributed via multiple routes, addressed basic topics such as “Creating and Utilizing Zoom and Facebook accounts” and “how to improve telehealth visits”. After establishment of a regular audience, AGEC engaged new and established partners and hosted a plethora of educational programs and activities further expanding the viewing audiences. In addition, with personalized emails and targeted marketing, AGEC engaged OA audiences in caregiving workshops, on-line caregiver support groups, telephone check-ins and exercise programs. Many OAs have found ways to bridge the digital divide and are engaged and active with educational and program activities and have used their new skills to connect with other OAs, grandkids, friends and even their spiritual communities.
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Acquaye, Alvina, Kathleen Wall, Mark Gilbert, and Terri Armstrong. "QOLP-08. UNDERSTANDING THE EXPERIENCE OF YOUNG ADULTS (YAS) DIAGNOSED WITH AN EPENDYMOMA FROM THE ADULT EPENDYMOMA OUTCOMES PROJECT AND RARE CNS OUTCOMES AND RISK STUDY." Neuro-Oncology 21, Supplement_6 (November 2019): vi199. http://dx.doi.org/10.1093/neuonc/noz175.828.
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Abstract Research in young adult (YA) patients is novel, particularly in central nervous system tumors like ependymomas. Stagnant survival outcomes in YAs are concerning compared to improvements within pediatric and older adults. Additionally, uncertainty of the impact of treatment on psychosocial and behavioral outcomes during an essential developmental stage warrants attention. The purpose of this report is to explore ependymoma YA outcomes data to inform care. Adult ependymoma (n=191) patients participating in a web-based outcomes study completed clinical data and validated questionnaires (EQ-5D, MDASI-BT). YAs 18–39 (n= 58) were compared to older adults (OAs) >40 (n=133). Participants were predominantly female (68%), with tumor location in brain (29%) or spine (71%). The majority of YAs (67%) reported seeing a physician within 6 months from symptom onset, whereas OAs were more likely to delay for 7 months or longer. Headaches (brain tumor 70%) and numbness (spine tumor73%) were common presenting symptoms for both age groups. 76% of YAs were working before diagnosis, however 27% stopped work, 18% reduced hours, 7% switched jobs and 2% lost their job after diagnosis. At time of participation, most participants were not on active treatment (61%), but both YA and OA frequently endorsed use of pain medication (37%). Tumor recurrence was more common in YAs (30%) compared to OAs (19%). Common moderate to severe symptoms in YAs included distress (27%) and fatigue/sadness (18%) with brain tumors compared to fatigue (56%) and distress/disturbed sleep/drowsiness (36%) with spine tumors. Over a third of YAs reported some impact on general health (usual activities, pain/discomfort, and anxiety/depression). Despite stable disease, YAs with ependymoma experienced mood and lifestyle challenges and reported significant symptoms and use of pain medication. Further exploration is needed on the impact of cancer-related effects on YAs to gain insight on appropriate management and care.
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Becker, Todd, John Cagle, and Paul Sacco. "The Prevalence of Prior Mental Health and Substance Use Problems in Older Persons and Their Families." Innovation in Aging 4, Supplement_1 (December 1, 2020): 170–71. http://dx.doi.org/10.1093/geroni/igaa057.552.
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Abstract Although research has shown mental health and substance use problems (MHSUPs) are fairly prevalent in older adults (OAs), less research has considered MHSUPs in hospice beneficiaries and their families. This secondary analysis filled this gap using the Health and Retirement Study’s Core survey wave from 2014 and Exit wave data from 2016. These data are nationally-representative of OAs aged 50+. Each biennial wave introduces an experimental module to a random 10% of Core survey participants. One Core 2014 experimental module included self-report indicators assessing past MHSUPs, like depression and anxiety, using single items. Exit 2016 proxy-reported information about respondent deaths was used to create a decedent subsample. Descriptive statistics established MHSUP prevalence rates in OAs and their family. The self-report depression indicator was validated against the 8-item Center for Epidemiological Studies Depression Scale (CESD-8) at the ≥3, ≥4, and ≥5 cut points using χ2 analyses. The full sample’s (N=1,461) average age was 68 years. Participants were mostly non-Hispanic (87.5%), White (72.8%), and female (59.7%). The decedent subsample (n=64) was bifurcated by hospice (54.7%) versus nonhospice (45.3%) utilization. Most participants in the full sample (63.9%), hospice decedent subsample (77.1%), and nonhospice decedent subsample (75.9%) endorsed at least one MHSUP. Depression and anxiety were the most common MHSUPs in each study sample. The CESD-8 was associated with the self-report depression indicator across all cut points (p<.001). Practitioners, policymakers, and researchers should consider the high prevalence rates of MHSUPs found in OAs and their families when designing programs, policies, and research.
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Tobey, Leah, and Robin McAtee. "Implementation of 4M Age-Friendly Care in Arkansas Rural Primary Care Clinics Led to Improved Advance Care Planning." Innovation in Aging 5, Supplement_1 (December 1, 2021): 822. http://dx.doi.org/10.1093/geroni/igab046.3016.
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Abstract The 4Ms Age-Friendly Framework has been introduced and implemented into nearly 2,000 primary care practices across the United States by Geriatric Workforce Enhancement Program’s (GWEP) educational efforts. The AR Geriatric Education Collaborative, the GWEP in Arkansas, has provided monthly trainings to a rural federally qualified healthcare clinic system and educated clinicians about how to complete a Medicare Annual Wellness Visit (AWV) that was inclusive of an advance care plan. Specific educational training including the two main components of an ACP: living will preferences and medical power of attorney were reviewed as their role into “What Matters” was explained. Before 4Ms Age Friendly training, baseline data showed only 7% of older adults (OAs) had an established ACP in site 1 and 33% in site 2. After training, the rate of ACP rose to 47% in site 1 and 59% in site 2. During the training, not only were the two main components reviewed but case studies were provided about what questions to ask surrounding the “What Matters” question as a guide to further discuss an OAs wishes, priorities and end-of-life care. This project demonstrated that implementation of 4Ms Age-Friendly Care not only improves the completion of advance care plans but also further enhances the overall care of the older adult when “what matters” most to the older adults is known and communicated.
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Salzman, Talia, Tabassum Rahman, Nadia Polskaia, Gabrielle St-Amant, Diana Tobón Vallejo, Yves Lajoie, and Sarah Fraser. "Neural Inhibition Task Elicits Age-Associated Changes in Prefrontal Cerebral Oxygenation." Innovation in Aging 4, Supplement_1 (December 1, 2020): 365. http://dx.doi.org/10.1093/geroni/igaa057.1175.
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Abstract Certain cognitive tasks, such as those involving inhibition, can influence an older adult’s dual-tasking ability more than others. This study aimed to manipulate cognitive task difficulty to evaluate age-associated differences in brain activity and behaviour during walking. Nineteen younger (M=21.3, SD=3.9) and 20 older (M=71.8, SD=6.4) adults completed four cognitive-auditory tasks: simple reaction time (SRT; processing speed), Go-no-Go (GNG; neural inhibition), N-back (NBK; working memory) and Double number sequence (DNS; working memory) with or without self-paced walking. Trials took place under single cognitive (SC), single motor (SM) and dual-task (walking with a cognitive task; DT) conditions. Throughout each condition, cerebral oxygenation changes (ΔHbO2) in the prefrontal cortex were acquired using functional near-infrared spectroscopy (fNIRS). Behavioural measures including response time (ms), accuracy (%) and gait speed (m/s) were also calculated. Repeated measures ANOVAs revealed that OAs exhibited greater ΔHbO2 than YAs in the left hemisphere during the GNG inhibition task (p = 0.04). Activation in the right hemisphere also increased compared to the left during DNS DT (p = 0.05). Response times increased with increasing task difficulty and YAs were faster than OAs during NBK SC (p = 0.09). Neural findings revealed age-associated changes in prefrontal activation at the GNG inhibition difficulty level. Behavioural results indicated poorer performance with increasing task difficulty including slower response times in OAs. Moreover, gait speed and accuracy only decreased within task and difficulty. Therefore, understanding the neural and behavioural changes across task difficulty may help monitor cognitive decline and distinguish normal aging from disease states.
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Fraser, Sarah, Talia Salzman, Hyejun Kim, Hawazin Badawi, Diana Tobon Vallejo, Yves Lajoie, Lara Pilutti, and John Farrell. "Using fNIRS to Capture Cerebral Oxygenation in Older Adults Navigating Stairs." Innovation in Aging 4, Supplement_1 (December 1, 2020): 792. http://dx.doi.org/10.1093/geroni/igaa057.2870.
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Abstract Navigating stairs is a complex motor activity and while it provides health benefits it can also increase the risk of falls in older adults (OA). The prefrontal cortex (PFC) contributions to stairclimbing (with or without a cognitive task) remain unknown. Using functional near infra-red spectroscopy (fNIRS) and wireless insoles, this study evaluated cerebral oxygenation changes (∆HbO2) in the PFC, gait parameters (speed) and cognitive performance (reaction time(RT)/accuracy) during stair ascent and descent in single (SMup/SMdown) and dual task (DTup/DTdown) conditions. OAs navigated stairs with or without a simple reaction time task. Participants had longer RTs in DTup (p < .001) and DTdown (p <.001) in comparison to standing, with no significant differences in accuracy or walk speed. ∆HbO2 was significantly different (p = .003) between SMdown and DTdown. Findings suggest that despite the simplicity of the cognitive task, dual-tasking on stairs resulted in increased cerebral oxygenation and slowed cognitive responses.
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Naudé, Bérangère, Anne-Sophie Rigaud, Laila Kamali, and Maribel Pino. "Barriers and Enablers for the Use of Digital Interactive Television in Nursing Home Settings: An Interview Case Study with Older Adults and Professionals." International Journal of Environmental Research and Public Health 20, no. 3 (January 18, 2023): 1813. http://dx.doi.org/10.3390/ijerph20031813.
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Increasingly, public health programs are recommending the use of information and communication technologies to address the psychosocial needs of Older Adults (OAs). Recently, several applications that allow access to communication and stimulation functionalities using digital interactive television (DiTV) have been developed. The use of the television interface to access digital services seems to help meet several accessibility and usability needs of OAs. However, its use entails other challenges related to different dimensions (organizational, technological, ethical, etc.). This study aims to identify the factors that enable or hinder the use of DiTV by OAs living in geriatric institutions. A qualitative interview case study was conducted in three French geriatric facilities. A total of 25 semi-structured interviews were carried out with residents and care professionals, between February and April 2022, to identify enablers and barriers to DiTV use. Data were processed using a thematic deductive analysis inspired by a multidimensional Health Technology Assessment model. The analysis showed that DiTV use may be limited by organizational (e.g., workload), technological (e.g., ergonomic issues), human (e.g., health issues), ethical (e.g., privacy), and safety factors (e.g., frustration due to technical problems). A summary of these factors and five recommendations for DiTV implementation in geriatric settings are presented in this paper.
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Ekwonye, Angela U., Abigail Malek, Tenzin Chonyi, Stephanie Nguyen, Valerie Ponce-Diaz, Lisa Lau Lau Haller, Iqra Farah, and Mary Hearst. "“Pandemic Fatigue! It’s Been Going On since March 2020”: A Photovoice Study of the Experiences of BIPOC Older Adults and Frontline Healthcare Workers during the Pandemic." Healthcare 10, no. 10 (October 8, 2022): 1967. http://dx.doi.org/10.3390/healthcare10101967.
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The coronavirus disease 2019 (COVID-19) pandemic intensified the stressful and already difficult circumstances of communities of color. Yet, there is no current photovoice research highlighting the lived experiences of these communities from two perspectives—the older adults (OAs) and the frontline healthcare workers (FLHWs). This qualitative study used photovoice to visually portray the struggles of Black, Indigenous, and persons of color (BIPOC) OAs (n = 7) and younger FLHWs (n = 5) who worked with older adults during the pandemic and how they coped and recovered from the challenges of the pandemic. The investigators conducted a three-day training of ten research assistants (RAs) who were paired with either an OA or an FLHW for the photovoice sessions conducted in four stages. Upon examination of the narratives, focus group transcriptions, and photo stories, it became clear that participants faced different challenges during the pandemic, such as the fear of COVID-19 exposure, struggles to adopt COVID-19 mitigation strategies, workplace challenges, and social isolation. Amid this crisis of suffering, isolation, and sadness, participants employed two major strategies to deal with the challenges of the pandemic: positive reappraisal and self-care practices. The findings have implications for clinical social workers, mental health counselors, faith communities, nurse managers and administrators, and policymakers.
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Chu, Charlene H., Renée K. Biss, Lara Cooper, Amanda My Linh Quan, and Henrique Matulis. "Exergaming Platform for Older Adults Residing in Long-Term Care Homes: User-Centered Design, Development, and Usability Study." JMIR Serious Games 9, no. 1 (March 9, 2021): e22370. http://dx.doi.org/10.2196/22370.
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Background Older adults (OAs) residing in long-term care (LTC) homes are often unable to engage in adequate amounts of physical activity because of multiple comorbidities, including frailty and severe cognitive impairments. This level of physical inactivity is associated with declines in cognitive and functional abilities and can be further compounded by social isolation. Exergaming, defined as a combination of exercise and gaming, has the potential to engage OAs in exercise and encourage social interaction. However, previously used systems such as the Nintendo Wii are no longer commercially available, and the physical design of other exergames is not suitable for OAs (ie, fall risks, accessibility issues, and games geared toward a younger population) with diverse physical and cognitive impairments. Objective This study aims to design and develop a novel, user-centered, evidence-based exergaming system for use among OAs in LTC homes. In addition, we aim to identify facilitators and barriers to the implementation of our exergaming intervention, the MouvMat, into LTC homes according to staff input. Methods This study used a user-centered design (UCD) process that consisted of 4 rounds of usability testing. The exergame was developed and finalized based on existing evidence, end user and stakeholder input, and user testing. Semistructured interviews and standardized and validated scales were used iteratively to evaluate the acceptability, usability, and physical activity enjoyment of the MouvMat. Results A total of 28 participants, 13 LTC residents, and 15 staff and family members participated in the UCD process for over 18 months to design and develop the novel exergaming intervention, the MouvMat. The iterative use of validated scales (System Usability Scale, 8-item Physical Activity Enjoyment Scale, and modified Treatment Evaluation Inventory) indicated an upward trend in the acceptability, usability, and enjoyment scores of MouvMat over 4 rounds of usability testing, suggesting that identified areas for refinement and improvement were appropriately addressed by the team. A qualitative analysis of semistructured interview data found that residents enjoyed engaging with the prototype and appreciated the opportunity to increase their PA. In addition, staff and stakeholders were drawn to MouvMat’s ability to increase residents’ autonomous PA. The intended and perceived benefits of MouvMat use, that is, improved physical and cognitive health, were the most common facilitators of its use identified by study participants. Conclusions This study was successful in applying UCD to collaborate with LTC residents, despite the high number of physical and sensory impairments that this population experiences. By following a UCD process, an exergaming intervention that meets diverse requirements (ie, hardware design features and motivation) and considers environmental barriers and residents’ physical and cognitive needs was developed. The effectiveness of MouvMat in improving physical and cognitive abilities should be explored in future multisite randomized controlled trials.
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Clark, Phoebe, Vanessa Cuppari, Matthew Picchiello, Michiko Iwasaki, and Andrew Futterman. "Perceptions on Own Aging: Comparisons between Young Adults with and without Caregiving Experience." Innovation in Aging 5, Supplement_1 (December 1, 2021): 1041–42. http://dx.doi.org/10.1093/geroni/igab046.3722.
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Abstract Although informal caregiving for older adults (OAs) can increase knowledge and awareness about one’s own aging (Pope, 2013), it can also negatively impact caregivers’ physical health and emotional wellbeing (AARP & NAC, 2020) and have spillover effects on school, work, and marriage (Dellmann-Jenkins & Blankemeyer, 2009). Despite the recent trend of family caregiving for OAs by young adults (YAs), research about these young caregivers is scarce. The present study focused on YAs’ perceptions on aging. We hypothesized that YAs who provided at least three months of caregiving tasks for OAs would hold more awareness and negative perceptions on their own aging, as measured by a modified version of the Brief Aging Perceptions Questionnaire (Sexton et al., 2014), compared to those who did not. We recruited 234 YAs between the ages of 18 - 40 (Mage = 29.78, SD, age = 4.83; 59% White; 65.4% male) and had them complete a survey via Amazon Mechanical Turks. About one third (32.1%) had caregiving experience. Results of independent t-tests revealed that caregivers scored higher on awareness of aging [t(229) = 6.950., p < .001, d = .865] and negative consequences/control [t(231) = 6.528., p < .001, d = .927]. Scores of positive consequences/control did not differ between the two groups. Our findings indicate the need for psychological interventions designed to help young caregivers integrate their caregiving experiences with less negative aging perceptions. Future research should examine the direct effects of caregiving experience on perceptions of aging between young and middle-aged adults.
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Gauthier, Adèle, Cécile Lagarde, France Mourey, and Patrick Manckoundia. "Use of Digital Tools, Social Isolation, and Lockdown in People 80 Years and Older Living at Home." International Journal of Environmental Research and Public Health 19, no. 5 (March 2, 2022): 2908. http://dx.doi.org/10.3390/ijerph19052908.
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The COVID-19 crisis and associated lockdowns have exposed the extent of social isolation among older adults (OAs). Currently, the French government and medical, social, and charitable organizations are working to find means of limiting the multiple psychological and physical consequences of social isolation on the health of OAs. One proposal is to help the elderly become more comfortable using digital tools (DTs). However, the ability of DTs to reduce social isolation is disputed in the literature. This study aimed to collect the views of OAs on social isolation; to identify the determinants of the use or not of DTs, in particular in the context of a lockdown; and the role of DTs in the strategy to reduce social isolation. This qualitative study was based on 27 semi-structured individual interviews with OAs ≥ 80 years, in Côte-d’Or and Haute-Marne (French departments), from March to May 2021. A total of 96.3% of participants had already owned one or more DTs (mobile phone, tablet, or computer) for several years. The lockdown had not prompted the population to equip themselves more. The most common reason for using DTs was to maintain contact with relatives, and 63% of the participants said that DTs have a positive impact in reducing social isolation. However, there is a significant need for assistance and training in their use, especially since many services are now offered online. The participants suggested that the key to minimizing social isolation remained the maintenance of social contacts. In conclusion, DTs appear to be useful for helping the elderly maintain social links with relatives and, therefore, have a strategic place in the reduction of social isolation. However, these tools should not replace in-person interactions.
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Ghneim, Mira H., Joseph A. Kufera, Jaclyn Clark, Melike N. Harfouche, Cheralyn J. Hendrix, and Jose J. Diaz. "Emergency General Surgery Procedures and Cost of Care for Older Adults in the State of Maryland." American Surgeon 88, no. 3 (November 3, 2021): 439–46. http://dx.doi.org/10.1177/00031348211048838.
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Background Older adults (OAs) ≥ 65 years of age, representing the fastest growing segment in the United States, are anticipated to require a greater percentage of emergency general surgery procedures (EGSPs) with an associated increase in health care costs. The aims of this study were to identify the frequency of EGSP and charges incurred by OA compared to their younger counterparts in the state of Maryland. Methods A retrospective review of the Maryland Health Services Cost Review Commission from 2009 to 2018 was undertaken. Patients undergoing urgent or emergent ESGP were divided into 2 groups (18-64 years and ≥65 years). Data collected included demographics, APR-severity of illness (SOI), APR-risk of mortality (ROM), the EGSP (partial colectomy [PC], small bowel resection [SBR], cholecystectomy, operative management of peptic ulcer disease, lysis of adhesions, appendectomy, and laparotomy), length of stay (LOS), and hospital charges. P-values ( P < .05) were significant. Results Of the 181,283 patients included in the study, 55,401 (38.1%) were ≥65 years of age. Older adults presented with greater APR-SOI (major 37.7% vs 21.3%, extreme 5.2% vs 9.3%), greater APR-ROM (major 25.3% vs 8.7%, extreme 22.3% vs 5.3%), underwent PC (24.5% vs 10.9%) and SBR (12.8% vs 7.0%) more frequently, and incurred significantly higher median hospital charges for every EGSP, consistently between 2009 and 2018 due to increased LOS and complications when compared to those ≤65 years of age. Conclusion These findings stress the need for validated frailty indices and quality improvement initiatives focused on the care of OAs in emergency general surgery to maximize outcomes and optimize cost.
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Croff, Raina, L. Kris Gowen, Allison Lindauer, Sabrina Shofner, Kim Brown, and Elizabeth Eckstrom. "Including older rural adults in research: Practical guidance for addressing the NIH Inclusion Across the Lifespan policy." Journal of Clinical and Translational Science 4, no. 5 (February 13, 2020): 431–36. http://dx.doi.org/10.1017/cts.2020.12.
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AbstractIntroduction:The NIH Inclusion Across the Lifespan policy has implications for increasing older adult (OA) participation in research. This study aimed to understand influential factors and facilitators to rural OA research participation.Methods:Thirty-seven rural adults aged ≥66 years participated in focus groups in community centers in four Oregon “non-metro” counties. Transcribed discussions were coded using open-axial coding by an interdisciplinary analytical team.Results:Ages were 66–96 (mean 82.2) years. Majority were women (64%) and white (86%). Primary, interrelated discussion themes were Motivation and Facilitators, Perceptions of Research, and Barriers to Research Participation. Participants were motivated to engage in research because they believed research had implications for improved longevity and quality of life and potentially benefited future generations. Motivational factors influencing participation included self-benefit and improving others’ lives, opportunities to socialize and learn about current research, research transparency (funding, time commitment, and requirements), and financial compensation. Perceptions influencing trustworthiness in research included funding source (industry/non-industry) and familiarity with the research institution. Barriers to research participation included transportation and concern about privacy and confidentiality. Suggestions for making research participation easier included researchers coming to rural communities and meeting participants in places where OAs gather and providing transportation and hotel accommodations.Conclusion:Lessons learned offer practical guidance for research teams as they address the new NIH Inclusion Across the Lifespan policy. Including OAs in research in ways that motivate and facilitate participation will be critical for a robust representation across the lifespan and in tailoring treatments to the specific needs of this population.
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Kim, So-Yeon, and Kelly S. Giovanello. "The Effects of Attention on Age-related Relational Memory Deficits: fMRI Evidence from a Novel Attentional Manipulation." Journal of Cognitive Neuroscience 23, no. 11 (November 2011): 3637–56. http://dx.doi.org/10.1162/jocn_a_00058.
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Numerous studies have documented that older adults (OAs) do not perform as well as young adults (YAs) when task demands require the establishment or retrieval of a novel link between previously unrelated information (relational memory: RM). Nonetheless, the source of this age-related RM deficit remains unspecified. One of the most widely investigated factors is an age-related reduction in attentional resources. To investigate this factor, previous researchers have tested whether dividing YAs' attention during encoding equated their RM performance to that of OAs. However, results from these studies failed to replicate the age-related RM impairment observed in aging. The current study investigated whether a reduction in attentional resources for processing of relational information (i.e., relational attention) underlies age-related RM deficits. Using fMRI, we examined whether the effect of reduced attentional resources for processing of relational information is similar to that observed in aging at both behavioral and neural levels. The behavioral results showed that reduced attentional resources for relational information during encoding equated YAs RM performance to that of OAs. Furthermore, the fMRI results demonstrated that both aging, as well as reductions in relational attention in YAs, significantly reduced activity in brain areas associated with successful RM formation, namely, the ventrolateral and dorsolateral PFC, superior and inferior parietal regions, and left hippocampus. Such converging evidence from behavioral and neuroimaging studies suggests that a reduction in attentional resources for relational information is a critical factor for the RM deficit observed in aging.
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Mullins, Lindsay. "HEALTHY AGING TALK AROUNDS: NEAR AND FAR." Innovation in Aging 6, Supplement_1 (November 1, 2022): 706. http://dx.doi.org/10.1093/geroni/igac059.2583.
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Abstract BackgroundLoneliness and chronic health conditions are the two most cited ailments among older adults (OAs) that deter independent living. Community-tailored health programs increase feelings of connectivity to neighbors and link OAs to healthcare resources. MethodsDesign. The Healthy Aging Talk Around program is product of CAB formation, input, and a series of talks in-person (near) and virtually (far). Using qualitative methods, data was collected to determine significant health issues for OAs and qualitative data were collected through surveys to evaluate knowledge, access, and feelings of connectivity related to series gatherings. Setting and Population. Inner-city and rural OAs in the deep south from various communities (2 FBOs, 1 Assisted Living, 2 neighborhood groups). Series was held in community and later online. Attendance ranged between 75-130 OAs. Measures. Qualitative measures included pre and post series surveys (n=110; n = 91) with questions to determine the impact of the series. Analysis. Content analysis was conducted with the qualitative data to determine the impact of the series on 1.) knowledge of health issue(s), 2.) likelihood of accessing health resources, and 3.) feelings of connectivity and isolation. ResultsThe qualitative data analysis suggested the series as relatable because information was tailored linked to local community resources. Discussion of independent living challenges fostered connectivity with neighbors. Once virtual, knowledge and access were similar, feelings of connectivity were less prevalent. ConclusionA community-tailored health program series can increase knowledge of health issues, access to resources, and create neighborly connectivity potentially influencing ability to age in place.
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Van Patten, Ryan, Ellen E. Lee, Sarah A. Graham, Colin A. Depp, Ho-Cheol Kim, Dilip V. Jeste, and Elizabeth W. Twamley. "The Utility of the Timed Up-and-Go Test in Predicting Cognitive Performance: A Cross-Sectional Study of Independent Living Adults in a Retirement Community." Journal of Applied Gerontology 39, no. 10 (September 6, 2019): 1163–68. http://dx.doi.org/10.1177/0733464819872636.
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Physical, emotional, and cognitive changes are well documented in aging populations. We administered a comprehensive battery of mental and physical health measures and the Montreal Cognitive Assessment (MoCA; a cognitive screening tool) to 93 independently living older adults (OAs) residing in a Continuing Care Senior Housing Community. Performance on the Timed Up-and-Go (TUG) test (a measure of functional mobility) correlated more strongly with the MoCA total score than did measures of aging, psychiatric symptoms, sleep, and both self-report and objective physical health. Furthermore, it was associated with MoCA Attention, Language, Memory, and Visuospatial/Executive subscales. The MoCA-TUG relationship remained significant after controlling for demographic and physical/mental health measures. Given that the TUG explained significantly more variance in broad cognitive performance than a comprehensive battery of additional physical and mental health tests, it may function as a multimodal measure of health in OAs, capturing physical changes and correlating with cognitive measures.
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Skemp, Lisa. "COMMUNITY CONTEXT OF OLDER ADULT CARE: A CASE STUDY DURING THE COVID-19 PANDEMIC." Innovation in Aging 6, Supplement_1 (November 1, 2022): 25. http://dx.doi.org/10.1093/geroni/igac059.093.
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Abstract Introduction Expectations for older adults (OA) to live in the community and prevent costly long-term care assume OAs’ informal network members are available, able, and willing to fill this need. Yet, little is known about the processes whereby OAs construct care networks, especially during COVID-19. Methods A longitudinal case study of one OA male who participated in the ethnographic community Older Adult Care study in one urban Chicago neighborhood is described. The OA male described his network on three occasions: 2/2018, 1/2021 and 9/2021. The care networks were described by size, density, and transitivity. Data analysis was performed using the R programming language. Adjacency networks were constructed using the network package, then visualized using the sna package. Results The OA’s network went from 23 members pre-pandemic in time one to 13 in time two and 8 members in time three. As network size contracted, the network density increased from 25% in time two to 46% at time three, indicating a more interconnected network. Clustering varied over time and was at its lowest in time 2 (27%) and increased by time 3 (67%). Friends and church connections were 72% of his network in time one, whereas 71% of his network were family and neighbors in time three. Conclusions Our OA’s large, relatively disconnected social network tightened to fewer, more closely connected members during COVID-19 months. Contextual variables (environment, health guidelines, fear, pets) influenced the networks. It is essential to understand OA care networks to promote healthy aging in community.
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Barragan, Cassandra, and Stephanie Wladkowski. "AFU PRINCIPLES IN ACTION: ENGAGING STUDENTS THROUGH HANDS-ON AGE-RELATED ACTIVITIES." Innovation in Aging 3, Supplement_1 (November 2019): S832. http://dx.doi.org/10.1093/geroni/igz038.3066.
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Abstract The Age-Friendly University (AFU) Initiative is a global network of universities working to embrace and promote the growing population of older adults (OAs) on campuses. Integrating inter-generational learning is a proven benefit to share knowledge (Gerpott, Lehmann-Willenbrock, & Velopel, 2017) and to mutually benefit both older and more traditional learners (Pstross, Corrigan, Knopf, et al., 2017). To thoughtfully develop AFU initiatives on their campus, one midwestern university created an educational activity for students to better understand the needs of OAs. This presentation will cover results of this activity and offer suggestions for aging-focused learning activities. In winter 2019, 23 undergraduate students from 5 disciplines participated in a guided sensory activity with 5 Masters in Social Work (MSW) students that simulated impaired vision, hearing, and dexterity. Afterwards, using the AARP walking audit, they walked campus to understand challenges those with limitations might face. Students then completed a guided reflection and thought of ways to advocate for anyone with physical challenges, both off and on campus. This activity resulted in several successful learning outcomes and provided concrete experiences, establishing grounds to think about advocacy in a practical way. First, the undergraduate students presented their experiences at a campus-wide activism and advocacy event. They aimed to 1) increase awareness of the challenges those with visual and physical challenges and 2) promote the AFU initiatives. MSW students further analyzed their experience from a policy perspective and presented to the AFU steering committee with recommendations to influence policy in alignment with the AFU principles.
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Cortés, Sandra, Cinthya Leiva, María José Ojeda, Natalia Bustamante-Ara, Wanjiku Wambaa, Alan Dominguez, Carlos Pasten Salvo, et al. "Air Pollution and Cardiorespiratory Changes in Older Adults Living in a Polluted Area in Central Chile." Environmental Health Insights 16 (January 2022): 117863022211071. http://dx.doi.org/10.1177/11786302221107136.
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One recognized cause of cardiorespiratory diseases is air pollution. Older adults (OA) are one of the most vulnerable groups that suffer from its adverse effects. The objective of the study was to analyze the association between exposure to air pollution and changes in cardiorespiratory variables in OA. Observational prospective cohort study. Health questionnaires, blood pressure (BP) measurements, lung functions, respiratory symptoms, physical activity levels, and physical fitness in high and low exposure to air pollution were all methods used in evaluating OAs in communes with high contamination rates. Linear and logistic models were created to adjust for variables of interest. A total of 92 OA participated in this study. 73.9% of the subjects were women with 72.3 ± 5.6 years. 46.7% were obese, while 12.1% consumed tobacco. The most prevalent diseases found were hypertension, diabetes, and cardiovascular disease. Adjusted linear models maintained an increase for systolic BP of 6.77 mmHg (95% CI: 1.04-12.51), and diastolic of 3.51 mmHg (95% CI: 0.72-6.29), during the period of high exposure to air pollution. The adjusted logistic regression model indicated that, during the period of high exposure to air pollution increase the respiratory symptoms 4 times more (OR: 4.43, 95% CI: 2.07-10.04) in the OA. The results are consistent with an adverse effect on cardiorespiratory variables in periods of high exposure to air pollution in the OA population.
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Bhatt, Tanvi, Savitha Subramaniam, Spyros Kitsiou, Lakshmi Kannan, and Edwina Wilson. "COGNITIVE-MOTOR GAMING IN OLDER ADULTS: FEASIBILITY OF TELEASSESSMENT AND TELEREHABILITATION ON FALL RISK." Innovation in Aging 6, Supplement_1 (November 1, 2022): 713. http://dx.doi.org/10.1093/geroni/igac059.2605.
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Abstract There is limited guidance for clinically relevant tele-assessment, and access to a comprehensive physical-activity (PA) based telerehabilitation paradigm to enhance physical function, and slow progression of frailty among older adults (OA). In this we first examined the usability, safety, and feasibility of tele-assessment and telerehabilitation program on physical, and CV function. Subsequently evaluated its compliance and effectiveness. Healthy OAs (n=23,>65 years) participated a custom-designed exergaming-based tele-exercise program (EG-BTxP) delivered in home-setting for 4 weeks (3 sessions/week) consisting of 4 exercise modules: Dancing, aerobics, cognitive-motor gaming and mind-body exercises (yoga and tai-chi) in groups of 5. Pre- and post-training, a real-time online teleassessment was performed and change in lower limb strength, endurance (30-second chair stand test), static balance (one-legged stand test, Romberg test), and dynamic balance (4-step square test), aerobic endurance (2-minute step in place test) were assessed. Participants were provided with wearable sensors and education to self-monitor heart rate during exercise and report back to health coach after each module. Participants responded positively on the qualitative usability survey and there were no adverse events . All participants were able to tolerate the teleassessment and tele-intervention with a compliance of >90%. Post-training, there were improvements in 30-second chair stand test; (p< 0.01), one-legged stand test, Romberg test, and 4-step square test, (p< 0.05). Further, number of steps in the 2-minute step-in-place test increased (p < 0.05). These findings suggest that gaming-based tele-exercise programs could be safely implemented in community-based settings to increase compliance with participation for improved physical rehabilitation outcomes.
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Tinlin, Rowan, and Kayleigh Purvis. "Working psychologically with older adults with hoarding disorder: A scoping review of psychological assessment, formulation and intervention." FPOP Bulletin: Psychology of Older People 1, no. 157 (January 2022): 45–54. http://dx.doi.org/10.53841/bpsfpop.2022.1.157.45.
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IntroductionHoarding disorder (HD) is characterised by excessive acquisition and difficulty discarding possessions, resulting in heightened distress and significant clutter. Associated social isolation, reports of heightened shame, mistrust of professionals, and risk of falls or problems with hygiene make it difficult for professionals to successfully assess and intervene. The progression of hoarding symptoms is chronic in nature, with older adult (OA) services seeing an increasing number of individuals with HD.MethodA systematic search of several databases was conducted. Following title, abstract and full text screening, and the exclusion of research focussing on an OCD sample or hoarding within the context of dementia or psychosis, 12 primary research papers were identified for inclusion in this review. These described the assessment, formulation and intervention of OA’s with hoarding.ResultsDespite there being several psychometric measures of hoarding severity, symptoms and beliefs, only two are validated for use with older adults. Moreover, there is little evidence of the efficacy of formulation and CBT interventions for HD in an OA population. There is however, useful documented adaptations to psychological work with OAs.DiscussionMore research is required documenting the efficacy of psychological intervention with OA’s with HD, as well as adaptations for assessment tools and formulation models for HD. These should account for the transitional life stage of OAs, possible physical health and cognitive functioning barriers, time constraints, increased need for motivational interviewing, relational approaches and emphasis on social activity.
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Puts, Martine, Schroder Sattar, Kara McWatters, Katharine Lee, Michael Kulik, Mary Ellen Macdonald, Raymond Woo-Jun Jang, et al. "What is the role of comorbidity, frailty, and functional status in the decision-making process for older adults with cancer and their family members, oncologists, and family physician?" Journal of Clinical Oncology 34, no. 3_suppl (January 20, 2016): 92. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.92.
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92 Background: Little is known about the treatment decision making process (TDMP) in older adults (OA) with cancer. The objective of this study is to develop a theoretical framework with the aim to improve the TDMP for this population. Methods: This is a mixed methods multi-perspective longitudinal study. OAs aged > 70 years with advanced prostate, breast, colorectal, or lung cancer, their family members, oncologists and family physicians are invited to participate in individual, semi-structured interviews. Each OA also completes a short survey to characterize their health, functional status, frailty level, decision-making preferences, and satisfaction with the TDMP. The sample is stratified on age (70-79 and 80+) to obtain data saturation for the oldest old. All interviews will be analyzed using the grounded-theory approach. Results: To date, 32 first interviews and 15 second interviews have been completed with 32 older adults, 21 family members and 12 family physicians and 7 cancer specialists. Interviews lasted between 10-60 minutes. Most older adults felt that they should have the final say in the treatment decision, but strongly valued their physician’s opinion. Most participants felt they received enough information, time and support from the oncologist to make their decision. About half the participants went to see their family physician to talk about the diagnosis and plan. Comorbidity and potential side-effects did not play a major role in the decision-making processes for patients and families but it did for oncologists. Family physicians reported they were not involved in treatment decisions, and they preferred more timely information about the patient. Conclusions: This study-in-progress is examining the TDMP from four different perspectives and examining changes over time in the TDMP. Patients and family members were generally satisfied with the treatment decision making process. Final results will be presented at the conference.