scholarly journals RACIAL DIFFERENCES IN PHYSICAL ACTIVITY IN NURSING HOME RESIDENTS WITH COGNITIVE IMPAIRMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S168-S168
Author(s):  
Nicole A Viviano ◽  
Elizabeth Galik ◽  
Barbara Resnick
Keyword(s):  
Physical Activity ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Light Intensity ◽  
Racial Differences ◽  
Nursing Home Residents ◽  
Moderate Level ◽  
Future Research ◽  
Cognitively Impaired ◽  
Significant Difference

Abstract INTRODUCTION: Nursing home residents with moderate to severe cognitive impairment are mostly sedentary. It is more likely that African-American (AA) older adults tend to be more sedentary than their white counterparts. The purpose of this study was to examine racial differences in overall time spent in physical activity (PA), time in sedentary, light intensity, and moderate levels of PA, and participation in activities of daily living (ADLs) among cognitively impaired nursing home residents. METHODS: This was a secondary data analysis from the Function and Behavior Focused Care Intervention study. The sample included 336 cognitively impaired residents from 12 nursing homes. RESULTS: The mean age of the residents was 86.2 (SD=10.1) with an average MMSE score of 7.8 (SD=5.0) where 41% were AA and 59% white. White and AA participants engaged in only 51.2 and 46.1 minutes of light and 1.5 and 1.1 minutes of moderate level PA, respectively. There was a significant difference in time spent in light-intensity PA with whites spending more time in this level of activity [F(4, 242) = 3.360, p = .01]. Conversely, AAs had better functional ability than white residents [F(4, 242) = 4.754, p < .001]. There were no significant racial differences in time in sedentary, or moderate level PA. DISCUSSION: These findings are consistent with prior research showing that AAs had lower PA levels compared to their white counterparts. Future research should focus on increasing PA among nursing home residents and consider specific interventions to increase activity among AA residents.

An Observational Study of Agitation in Agitated Nursing Home Residents

1989 ◽  
Vol 1 (2) ◽  
pp. 153-165 ◽  
Author(s):  
Jiska Cohen-Mansfield ◽  
Perla Werner ◽  
Marcia S. Marx
Keyword(s):  
Nursing Home ◽  
Observational Study ◽  
Nursing Home Residents ◽  
Future Research ◽  
Cognitively Impaired ◽  
High Frequencies ◽  
Direct Observations ◽  
Very High Frequencies ◽  
Very High

Direct observations of 24 highly agitated, cognitively impaired nursing home residents were performed during each hour of the 24-hour day for 2–3 months. Results showed that agitated behaviors (in particular, strange noises, requests for attention, repetitious mannerisms, picking at things, strange movements, and pacing) were manifested at very high frequencies. The data also showed that daytime agitation was positively related to nighttime agitation. Patterns of agitation were specific to each resident, an important finding for future research and intervention.

scholarly journals Optimizing Physical Activity and Decreasing Care-Resistant Behaviors Among Nursing Home Residents With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 630-630
Author(s):  
Elizabeth Galik ◽  
Barbara Resnick ◽  
Erin Vigne ◽  
Sarah Holmes
Keyword(s):  
Physical Activity ◽  
Nursing Home ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Cognitively Impaired ◽  
Repeated Measures Design ◽  
Randomized Controlled ◽  
Resistiveness To Care ◽  
And Behavior

Abstract The purpose of this study was to test the effectiveness of the Function and Behavior Focused Care (FBFC) intervention on function, physical activity and behavioral symptoms among nursing home residents with dementia. This study was a clustered, randomized controlled trial with a repeated measures design in 12 nursing homes. The participants (N=336) were 82.6 (SD=10.1) years of age, mostly female and were moderate to severely cognitively impaired (MMSE of 7.8, SD=5.1). There were a statistically significant improvements in time spent in light, moderate and overall physical activity based on actigraphy and a decrease in resistiveness to care at 4 months among participants in the treatment group. There was no change in mood, agitation, and the use of psychotropic medications. This study provides some support for the use of the FBFC intervention to increase time spent in physical activity and decrease resistive behaviors during care among nursing home residents with dementia. Part of a symposium sponsored by Nursing Care of Older Adults Interest Group.

scholarly journals Diagnostic Failure of Cognitive Impairment in Nursing Home Residents May Lead to Impaired Medical Care

2019 ◽  
Vol 47 (4-6) ◽  
pp. 209-218 ◽  
Author(s):  
Björn Westerlind ◽  
Carl Johan Östgren ◽  
Patrik Midlöv ◽  
Jan Marcusson
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Medical Care ◽  
Nursing Home Residents ◽  
Control Group ◽  
Cognitively Impaired ◽  
Dementia Diagnosis ◽  
Laboratory Findings ◽  
Group A ◽  
The Impact

Background/Objectives: Dementia and cognitive impairment are common in nursing homes. Few studies have studied the impact of unnoted cognitive impairment on medical care. This study aimed to estimate the prevalence of diagnostic failure of cognitive impairment in a sample of Swedish nursing home residents and to analyze whether diagnostic failure was associated with impaired medical care. Method: A total of 428 nursing home residents were investigated during 2008–2011. Subjects without dementia diagnosis were grouped by result of the Mini Mental State Examination (MMSE), where subjects with <24 points formed a possible dementia group and the remaining subjects a control group. A third group consisted of subjects with diagnosed dementia. These three groups were compared according to baseline data, laboratory findings, drug use, and mortality. Results: Dementia was previously diagnosed in 181 subjects (42%). Among subjects without a dementia diagnosis, 72% were cognitively impaired with possible dementia (MMSE <24). These subjects were significantly older, did not get anti-dementia treatment, and had higher levels of brain natriuretic peptide compared to the diagnosed dementia group, but the risks of malnutrition and pressure ulcers were similar to the dementia group. Conclusions: Unnoted cognitive impairment is common in nursing home residents and may conceal other potentially treatable conditions such as heart failure. The results highlight a need to pay increased attention to cognitive impairment among nursing home residents.

scholarly journals OPTIMISM, QUALITY OF LIFE, AND COGNITION IN RECENT NURSING HOME RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S113-S113
Author(s):  
Diana DiGasbarro ◽  
Kimberly Van Haitsma ◽  
Suzanne Meeks ◽  
Benjamin T Mast
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Home Residents ◽  
Dispositional Optimism ◽  
Well Being ◽  
Future Research ◽  
The Relationship

Abstract Dispositional optimism may be an important resource for well-being across the lifespan. However, the relationship between optimism and quality of life in recent nursing home residents with and without cognitive impairment has not been examined. The aim of this study is to fill this gap in a sample of 66 older adults with a mean age of 74.59 years old (SD=10.37) who were admitted to a nursing home within the previous 30 days. Sixty older adults completed measures of cognition, quality of life, and optimism, and thus were included in analysis for the current study. Participants were split into groups based on the presence or absence of cognitive impairment, and linear regressions were conducted to examine the relationship between optimism and quality of life. In recent nursing home residents without cognitive impairment (n=30), optimism did not predict quality of life and accounted for a very small amount of variance (R2=.042, p=.280). However, in recent nursing home residents with cognitive impairment (n=32), optimism accounted for 20.9% of the variance in quality of life (R2=.209, p=.009). Higher levels of optimism were associated with better quality of life. Future research should explore why a stable trait like dispositional optimism is a stronger predictor of quality of life in recent nursing home residents with cognitive impairment compared to those without cognitive impairment. This line of research would be synergistic with emerging research on the identification and encouragement of strengths in older adults with cognitive impairment.

Educational intervention to improve palliative care knowledge among informal caregivers of cognitively impaired older adults

2020 ◽  
pp. 1-9
Author(s):  
Hyunjin Noh ◽  
Lewis H. Lee ◽  
Chorong Won
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Cognitive Impairment ◽  
Educational Intervention ◽  
Test Scores ◽  
Informal Caregivers ◽  
Cognitively Impaired ◽  
Significant Difference ◽  
Post Test ◽  
Seriously Ill

Abstract Objective Lack of palliative care knowledge among caregivers may pose an access barrier for cognitively impaired older adults, who may benefit from the specialized care. Therefore, this study aims to examine the effectiveness of an educational intervention in improving palliative care knowledge among informal caregivers of cognitively impaired older adults. Method Using a one-group, pre- and post-test intervention design, this study implemented an individual, face-to-face educational intervention with an informational brochure for 43 informal caregivers of chronically or seriously ill older adults (50+) with cognitive impairment, recruited from communities in West Alabama. Their level of knowledge about palliative care was assessed by the Palliative Care Knowledge Scale (PaCKS). The pre- and post-test scores were compared by the Wilcoxon signed-ranks test, and the racial subgroup (Whites vs. Blacks) comparison was made by the Mann–Whitney U test. Results There was a statistically significant difference between the pre- and post-test scores (z = 5.38, p < 0.001), indicating a statistically significant effect of the educational intervention in improving palliative care knowledge among participants. There was a significant difference (U = 143, p < 0.05) between Whites and Blacks in the pre-test, which, however, disappeared in the post-test (U = 173.50, p > 0.05), suggesting that the amount of increased PaCKS scores were significantly greater for Blacks (Mdn = 9.50) than for Whites (Mdn = 4.00, U = 130.50, p < 0.05). Significance of results This study demonstrated that a one-time educational intervention can improve the level of palliative care knowledge among informal caregivers of chronically or seriously ill older adults with cognitive impairment, particularly among Black caregivers. Therefore, further educational efforts can be made to promote palliative care knowledge and reduce racial disparities in palliative care knowledge and its use.

scholarly journals Physical Activity Patterns After Retirement: The REGARDS Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 528-529
Author(s):  
Eric Shiroma ◽  
J David Rhodes ◽  
Aleena Bennet ◽  
Monika M Safford ◽  
Leslie MacDonald ◽  
...  
Keyword(s):  
Physical Activity ◽  
Light Intensity ◽  
Racial Differences ◽  
Activity Patterns ◽  
Accelerometer Data ◽  
Tv Viewing ◽  
Major Life Events ◽  
Major Life ◽  
Physical Activity Patterns ◽  
Regards Study

Abstract Major life events, such as retirement, may lead to dramatic shifts in physical activity (PA) patterns. However, there are limited empirical data quantifying the magnitude of these changes. Our aims were to objectively measure PA before and after retirement and to describe changes in participation in various types of PA. Participants were employed black and white men and women enrolled in REGARDS (REasons for Geographic and Racial Differences in Stroke), a national prospective cohort study (n=581, mean age 64 years, 25% black, 51% women). Participants met inclusion criteria if they retired between their first and second accelerometer wearing (2009-2013 and 2017-2018, respectively) and had valid accelerometer data (&gt;4 days with &gt;10 hours/day pre- and post-retirement). Accelerometer-based PA was categorized into average minutes per day spent in sedentary, light-intensity, and moderate-to-vigorous PA. Participants reported changes (less, same, more) in 12 types of PA. After retirement, participants decreased both sedentary time (by 36.3 minutes/day) and moderate-to-vigorous PA (by 5.6 minutes/day). Conversely, there was an increase in light-intensity PA (+18.1 minutes/day) after retirement. Participants reported changes in their participation level in various PA activities. For example, 41% reported an increased amount of TV viewing, 42% reported less walking, and 31% reported increased participation in volunteer activities. Findings indicate that retirement coincides with a change in the time spent in each intensity category and the time spent across a range of activity types. Further research is warranted to examine how these changes in physical activity patterns influence post-retirement health status.

Disruptive Vocalization and Depression in Older Nursing Home Residents

2000 ◽  
Vol 12 (4) ◽  
pp. 463-471 ◽  
Author(s):  
Michael Dwyer ◽  
Gerard J. A. Byrne
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Nursing Home Residents ◽  
Confounding Variables ◽  
The Relationship ◽  
State Examination ◽  
Age And Sex

Screaming and other types of disruptive vocalization are commonly observed among nursing home residents. Depressive symptoms are also frequently seen in this group, although the relationship between disruptive vocalization and depressive symptoms is unclear. Accordingly, we sought to examine this relationship in older nursing home residents. We undertook a controlled comparison of 41 vocally disruptive nursing home residents and 43 non-vocally-disruptive nursing home residents. All participants were selected to have Mini-Mental State Examination (MMSE) scores of at least 10. Participants had a mean age of 81.0 years (range 63-97 years) and had a mean MMSE score of 17.8 (range 10-29). Nurse ratings of disruptive vocalization according to a semioperationalized definition were validated against the noisy behavior subscale of the Cohen-Mansfield Agitation Inventory. Subjects were independently rated for depressive symptoms by a psychiatrist using the Dementia Mood Assessment Scale, the Cornell Scale for Depression in Dementia, and the Depressive Signs Scale. Vocally disruptive nursing home residents scored significantly higher than controls on each of these three depresion-in-dementia scales. These differences remained significant when the effects of possible confounding variables of cognitive impairment, age, and sex were removed. We conclude that depressive symptoms are associated with disruptive vocalization and may have an etiological role in the generation of disruptive vocalization behaviors in elderly nursing home residents.

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