scholarly journals Effects of the JC JoyAge Stepped-Care Model Are Differentially Associated With Older Adults’ Baseline Profiles

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 305-305
Author(s):  
Tianyin Liu ◽  
Gloria Hoi Yan Wong ◽  
Shiyu Lu ◽  
Terry Lum
Keyword(s):  
Older Adults ◽  
Depressive Symptom ◽  
Preventive Care ◽  
Intervention Group ◽  
Symptom Clusters ◽  
Stepped Care ◽  
Care Model ◽  
Affective Symptoms ◽  
Patient Health ◽  
The Impact

Abstract Depression is a multidimensional construct consists of different symptom clusters. This paper aims to investigate if the impact of a stepped-care model, JC JoyAge, differs for older adults with different baseline depressive symptom clusters. Data came from 702 older people aged 65 and over who completed the JoyAge program. Their depression (measured by Patient Health Questionnaire-9 [PHQ-9]), anxiety, loneliness, and cognition were assessed by social workers at baseline and 12-months follow-up. Among them 609 were at risk or with mild symptoms and received group-based preventive care (prevention group), and 93 had moderate or above symptoms and received intensive intervention (intervention group). Their responses to PHQ-9 were coded to indicate affective, cognitive, behavioral, and somatic symptom clusters. It was found that somatic complaints had the highest prevalence (91%), followed by affective (83%), behavioral (60%), and cognitive symptoms (41%). Logistic regressions were used to estimate the effects of the program. For the prevention group, the JoyAge preventive care is more effective among those who reported behavioral symptoms (b=0.44, p<0.05, OR=1.55, 95% CI: 1.01, 2.40), but less so in those who had cognitive appraisal issues (b=-0.42, p<0.05, OR=0.66, 95% CI: 0.46, 0.96). For the intervention group, the JoyAge intervention was more effective in treatment among those who reported more affective symptoms (b=0.46, p<0.05, OR=1.59, 95% CI: 1.05, 2.42). The benefits of JC JoyAge stepped-care are differentially associated with participants’ baseline profile. Participants’ overall depressive symptom severity and the presentation of symptom clusters need to be taken into consideration when delivering the services.

scholarly journals The Impact of Learning Multiple Real-World Skills on Cognitive Abilities and Functional Independence in Healthy Older Adults

2019 ◽  
Vol 75 (6) ◽  
pp. 1155-1169 ◽  
Author(s):  
Shirley Leanos ◽  
Esra Kürüm ◽  
Carla M Strickland-Hughes ◽  
Annie S Ditta ◽  
Gianhu Nguyen ◽  
...  
Keyword(s):  
Older Adults ◽  
Real World ◽  
Cognitive Abilities ◽  
Intervention Group ◽  
Functional Independence ◽  
Skill Learning ◽  
Control Group ◽  
Healthy Older Adults ◽  
The Impact ◽  
Multiple Skills

Abstract Objective The natural learning experience from infancy to emerging adulthood, when considerable cognitive and functional growth is observed, mandates learning multiple real-world skills simultaneously. The present studies investigated whether learning multiple real-world skills simultaneously is possible in older adults and also whether it improves both their cognitive abilities (working memory, episodic memory, and cognitive control) and functional independence. Method Over two studies (15 and 27 participants), older adults learned at least three new skills (e.g., Spanish, drawing, music composition) simultaneously for 3 months. Participants completed cognitive and functional assessments before, during, and after the intervention in both studies. Participants were recruited sequentially for an intervention or no-contact control group in Study 1, and Study 2 included only an intervention group, who also completed assessments 4–6 weeks prior to the start of the intervention (i.e., they served as their own control group). Results Results from both studies show that simultaneously learning multiple skills is feasible and potentially beneficial for healthy older adults. Learning multiple skills simultaneously increased cognitive abilities in older adults by midpoint of the intervention, to levels similar to performance in a separate sample of middle-aged adults, 30 years younger. Discussion Our findings demonstrate the feasibility and potential of conducting a real-world skill-learning intervention involving learning three novel skills with older adults. Our multiskill intervention may provide broad cognitive gains, akin to the benefits experienced earlier in the life span.

scholarly journals The Effect of Exercise on the Older Adult’s Blood Pressure Suffering Hypertension: Systematic Review and Meta-Analysis on Clinical Trial Studies

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Mohsen Kazeminia ◽  
Alireza Daneshkhah ◽  
Rostam Jalali ◽  
Aliakbar Vaisi-Raygani ◽  
Nader Salari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Older Adults ◽  
Treatment Plan ◽  
Meta Analysis ◽  
Intervention Group ◽  
The Elderly ◽  
Before And After ◽  
Cochran Test ◽  
The Impact

Background. Senescence refers to spontaneous and progressive irreversible degenerative changes in which both the physical and psychological power diminish significantly. Hypertension is the most common cardiovascular disease in the elderly. Several studies have been conducted regarding the effect of exercise on reducing the blood pressure of the elderly, which have found contradictory results. One of the uses of meta-analysis study is responding to these assumptions and resolving the discrepancies. Accordingly, the aim of the present study is to determine the impact of exercise on the blood pressure of older adults. Method. In this research, in order to find electronic published papers from 1992 to 2019, the papers published in both domestic and foreign databases including SID, MagIran, IranMedex, IranDox, Gogole Scholar, Cohrane, Embase, Science Direct, Scopus, PubMed, and Web of Science (ISI) were used. Heterogeneity index between the studies was determined based on Cochran test Q(c) and I2. Considering existence of heterogeneity, random effects model was employed to estimate the standardized subtraction of the mean exercise test score for reduction of blood pressure in the older adults across the intervention group before and after the test. Results. In this meta-analysis and systematic review, eventually 69 papers met the inclusion criteria. The total number of participants was 2272 in the pre- and postintervention groups when examining the systolic changes and 2252 subjects in the pre- and postintervention groups when inspecting the diastolic changes. The standardized mean difference in examining the systolic changes before the intervention was 137.1 ± 8.09 and 132.98 ± 0.96 after the intervention; when exploring the diastolic changes, the pre- and postintervention values were 80.3 ± 0.85 and 76.0 ± 6.56, respectively, where these differences were statistically significant (P<0.01). Conclusion. The results of this study indicated that exercise leads to significant reduction in both systolic and diastolic blood pressure. Accordingly, regular exercise can be part of the treatment plan for hypertensive elderly.

scholarly journals Nutritional supplementation alters associations between one-carbon metabolites and cardiometabolic risk profiles in older adults: a secondary analysis of the Vienna Active Ageing Study

2021 ◽  
Author(s):  
Nicola A. Gillies ◽  
Bernhard Franzke ◽  
Barbara Wessner ◽  
Barbara Schober-Halper ◽  
Marlene Hofmann ◽  
...  
Keyword(s):  
Older Adults ◽  
Resistance Training ◽  
Mixed Model ◽  
Cardiometabolic Risk ◽  
Intervention Group ◽  
Nutritional Supplementation ◽  
Cardiometabolic Health ◽  
Active Ageing ◽  
Model Interaction ◽  
The Impact

Abstract Purpose Cardiovascular diseases and cognitive decline, predominant in ageing populations, share common features of dysregulated one-carbon (1C) and cardiometabolic homeostasis. However, few studies have addressed the impact of multifaceted lifestyle interventions in older adults that combine both nutritional supplementation and resistance training on the co-regulation of 1C metabolites and cardiometabolic markers. Methods 95 institutionalised older adults (83 ± 6 years, 88.4% female) were randomised to receive resistance training with or without nutritional supplementation (Fortifit), or cognitive training (control for socialisation) for 6 months. Fasting plasma 1C metabolite concentrations, analysed by liquid chromatography coupled with mass spectrometry, and cardiometabolic parameters were measured at baseline and the 3- and 6-month follow-ups. Results Regardless of the intervention group, choline was elevated after 3 months, while cysteine and methionine remained elevated after 6 months (mixed model time effects, p < 0.05). Elevated dimethylglycine and lower betaine concentrations were correlated with an unfavourable cardiometabolic profile at baseline (spearman correlations, p < 0.05). However, increasing choline and dimethylglycine concentrations were associated with improvements in lipid metabolism in those receiving supplementation (regression model interaction, p < 0.05). Conclusion Choline metabolites, including choline, betaine and dimethylglycine, were central to the co-regulation of 1C metabolism and cardiometabolic health in older adults. Metabolites that indicate upregulated betaine-dependent homocysteine remethylation were elevated in those with the greatest cardiometabolic risk at baseline, but associated with improvements in lipid parameters following resistance training with nutritional supplementation. The relevance of how 1C metabolite status might be optimised to protect against cardiometabolic dysregulation requires further attention.

Depressive symptom clusters are differentially associated with atherosclerotic disease

2010 ◽  
Vol 41 (7) ◽  
pp. 1419-1428 ◽  
Author(s):  
B. A. A. Bus ◽  
R. M. Marijnissen ◽  
S. Holewijn ◽  
B. Franke ◽  
N. Purandare ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Symptom Clusters ◽  
Symptom Cluster ◽  
Cardiac Patients ◽  
Depression Symptom ◽  
Vascular Events ◽  
Affective Symptom ◽  
Affective Symptoms ◽  
Sum Score

BackgroundDepression increases the risk of subsequent vascular events in both cardiac and non-cardiac patients. Atherosclerosis, the underlying process leading to vascular events, has been associated with depression. This association, however, may be confounded by the somatic-affective symptoms being a consequence of cardiovascular disease. While taking into account the differentiation between somatic-affective and cognitive-affective symptoms of depression, we examined the association between depression and atherosclerosis in a community-based sample.MethodIn 1261 participants of the Nijmegen Biomedical Study (NBS), aged 50–70 years and free of stroke and dementia, we measured the intima–media thickness (IMT) of the carotid artery as a measure of atherosclerosis and we assessed depressive symptoms using the Beck Depression Inventory (BDI). Principal components analysis (PCA) of the BDI items yielded two factors, representing a cognitive-affective and a somatic-affective symptom cluster. While correcting for confounders, we used separate multiple regression analyses to test the BDI sum score and both depression symptom clusters.ResultsWe found a significant correlation between the BDI sum score and the IMT. Cognitive-affective, but not somatic-affective, symptoms were also associated with the IMT. When we stratified for coronary artery disease (CAD), the somatic-affective symptom cluster correlated significantly with depression in both patients with and patients without CAD.ConclusionsThe association between depressive symptoms and atherosclerosis is explained by the somatic-affective symptom cluster of depression. Subclinical vascular disease thus may inflate depressive symptom scores and may explain why treatment of depression in cardiac patients hardly affects vascular outcome.

scholarly journals 128 Getting Healthcare Students to be More Empathatic for Geriatric Patients: The Impact of Simulation Suit on Pharmacy Students

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Shaun Lee ◽  
Pei-Lee Teh
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Professionals ◽  
Intervention Group ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Controlled Study ◽  
Future Research ◽  
Ageing Population ◽  
The Impact

Abstract Introduction The world’s population worldwide is greying, and it is important that health care professionals such as pharmacists are able to gain proficiency in working with older adults who may be suffering from both physical and mental illnesses. One of the challenges for many schools that offer healthcare related courses is the need to support continued empathy towards this ageing population so that they can offer better healthcare services. Recently, ageing suits which are an immersive simulation suit designed to simulate the effects of ageing have been introduced to enable nursing students to experience what older adults face in health care situation. Method In this randomised controlled study, all year 1 students enrolled in the Bachelor of Pharmacy course (n=120) at our institution were assigned to either a polypharmacy only workshop or use an ageing suit together with polypharmacy workshop (intervention). The intervention group was tasked to perform a series of exercises, including walking a flight of stairs, picking up a coin as well as filling up a form. All participants completed the Jefferson Empathy Scale and semi-structured questionnaire. Results At the end of exercise, intervention group participants had a marginal improvement in their self-reported empathy levels, with an improvement of 1.7 +14.5 points compared to 1.2 + 9.4 points in control (p=0.81). Participants in the intervention reported changes in physical performance consistent with the expected changes associated with ageing. They also reported a change in attitude and were able to empathize better with older adults especially on issues related to patient communication. Conclusion As such, future research should also include and involve a wider range of students to ensure that they become health advocates for the health care needs of older adults. This will enable them to deliver better healthcare services to meet the needs of the older adults.

scholarly journals EFFECTS OF A SITTING REDUCTION INTERVENTION FOR OBESE OLDER ADULTS WITH DEPRESSION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Sarita A Hemmady ◽  
Dori Rosenberg ◽  
Peggy Hannon ◽  
Jing Zhou
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Depressed Mood ◽  
Sitting Time ◽  
Linear Regression Models ◽  
Social Barriers ◽  
Patient Health ◽  
Mental Health Effects ◽  
Post Hoc ◽  
The Impact

Abstract Background: Little is known about the impact of sedentary behavior (SB) reduction interventions on older adults with obesity and depressed mood. An exploratory analysis examined behavioral and mental health effects of a SB reduction among participants with depressed moods. Methods: Participants were obese older adults (n=30, mean age=66, 77% female, 23% male, mean PHQ-8-Score=13.67) that were randomized to receive a sitting reduction intervention ( I-STAND); N=16) or a control condition (N=14) as part of a larger trial. Participants wore activPAL devices to assess sitting time at baseline and 12-weeks; they also completed the Patient-Health Questionnaire-8 (PHQ-8) to assess depressive symptoms. Linear regression models compared baseline and 12-week measures between groups adjusting for baseline values. A post-hoc qualitative analysis assessed ISTAND participant interview data. Results: I-STAND participants had greater reductions in sitting time than control participants by 57-minutes (p=0.04), as well as greater reductions in percent sitting time by 5.89-percent (p=0.03). Mean PHQ-8 scores were decreased by 0.14-points among the I-STAND group compared to the control (P=0.90). Qualitative themes included physical and social barriers to standing; varying perceptions of the presence of depression; physical health improvements (i.e. mood improvement) and perceptions of physical activity (i.e. feasibility to exercise). Conclusion: We found significant associations between sitting reduction and a SB intervention among older adults with obesity and depression, however this did not impact depressive symptoms. Further research should examine whether sitting reduction can improve mood or standing time among older adults with obesity and depressed mood.

scholarly journals Predictive analytics and tailored interventions improve clinical outcomes in older adults: a randomized controlled trial

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Sara Bersche Golas ◽  
Mariana Nikolova-Simons ◽  
Ramya Palacholla ◽  
Jorn op den Buijs ◽  
Gary Garberg ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Clinical Outcomes ◽  
Predictive Analytics ◽  
Controlled Trial ◽  
Stepped Care ◽  
Control Group ◽  
Randomized Controlled ◽  
Tailored Interventions ◽  
The Impact

AbstractThis study explored the potential to improve clinical outcomes in patients at risk of moving to the top segment of the cost acuity pyramid. This randomized controlled trial evaluated the impact of a Stepped-Care approach (predictive analytics + tailored nurse-driven interventions) on healthcare utilization among 370 older adult patients enrolled in a homecare management program and using a Personal Emergency Response System. The Control group (CG) received care as usual, while the Intervention group (IG) received Stepped-Care during a 180-day intervention period. The primary outcome, decrease in emergency encounters, was not statistically significant (15%, p = 0.291). However, compared to the CG, the IG had significant reductions in total 90-day readmissions (68%, p = 0.007), patients with 90-day readmissions (76%, p = 0.011), total 180-day readmissions (53%, p = 0.020), and EMS encounters (49%, p = 0.006). Predictive analytics combined with tailored interventions could potentially improve clinical outcomes in older adults, supporting population health management in home or community settings.

scholarly journals The Effect of Partnership Care Model on Mental Health of Patients with Thalassemia Major

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Afzal Shamsi ◽  
Fardin Amiri ◽  
Abbas Ebadi ◽  
Musab Ghaderi
Keyword(s):  
Mental Health ◽  
Intervention Group ◽  
Public Health Problem ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Care Model ◽  
Poor Countries ◽  
Beta Thalassemia Major ◽  
Before And After ◽  
The Impact

Background. Thalassemia major has become a public health problem worldwide, particularly in developing and poor countries, while the role of educating the family and community has not been considered enough in patients’ care.Objectives. This study examines the impact of partnership care model on mental health of patients with beta-thalassemia major.Materials and Methods. This experimental study, with pretest and posttest design, was performed on patients with beta-thalassemia major in Jiroft city. 82 patients with beta-thalassemia major were allocated randomly into two groups of intervention (41 patients) and control (n=41) groups. Mental health of the participants was measured using the standard questionnaire GHQ-28 before and after intervention in both groups. The intervention was applied to the intervention group for 6 months, based on the partnership care model.Results. There were significant differences between the scores of mental health and its subscales between two groups after the intervention (P<0.05).Conclusions. The findings of the study revealed the efficacy and usefulness of partnership care model on mental health of patients with beta-thalassemia major; thus, implementation of this model is suggested for the improvement of mental health of patients with beta-thalassemia major.

Sign in / Sign up

Export Citation Format

Share Document