Uncertainty Management Among Older Adults with Heart Failure: Responses to Receiving Implanted Device Data using a Fictitious Scenario Interview Method

Heart failure (HF) is a complex chronic illness that affects the older adult population, requiring medical therapy and day-to-day management to prevent worsening and exacerbation. Patients with HF are often treated with cardiac implanted electronic devices (CIEDs) which capture diagnostic and predictive parameters for HF. In this work we explore how patients would respond to receiving data from an implanted device, using a fictitious scenario interview method with 24 older adults with HF. We applied an uncertainty management lens to better understand how patients face uncertain outcomes and integrate novel data into their decision making. The findings provide insight into how patients would engage and respond to a technology which provides an indicator of their HF status from an implanted device.

Download Full-text

Frailty transitions and cognitive function among South Korean older adults

Scientific Reports ◽

10.1038/s41598-021-90125-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Fatima Nari ◽

Bich Na Jang ◽

Hin Moi Youn ◽

Wonjeong Jeong ◽

Sung-In Jang ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Daily Living ◽

Mini Mental State Examination ◽

Adult Population ◽

Geriatric Syndrome ◽

South Korean ◽

Adl Disability ◽

Older Adult Population ◽

State Examination

AbstractFrailty is considered a multidimensional geriatric syndrome, manifested by the accumulation of age-associated deficits. The consequences of frailty transitions are still understudied. This study evaluated the influence of frailty transitions on cognitive function in the older adult population. We used data derived from the Korean Longitudinal Study of Aging (KLoSA) (2008–2018) on older adults aged ≥ 65 years. Frailty was assessed using a validated Korean frailty measure known as the frailty instrument (FI), and cognitive function was measured using the Korean version of the Mini-Mental State Examination (K-MMSE). Transitions in frailty and their relationship with cognitive function were investigated using lagged generalized estimating equations (GEE), t-tests, and ANOVA. Respondents who experienced frailty transitions (those with ameliorating frailty), those who developed frailty, and whose frailty remained constant, were more likely to have a lower cognitive function than those who were consistently non-frail. Older age, activities of daily living (ADL) disability, and instrumental ADL disability were more negatively associated with declining cognitive function, especially in the “frail → frail” group. Changes in all individual components of the frailty instrument were significantly associated with impaired cognitive function. The results suggest an association between frailty transitions and cognitive impairment. Over a 2-year span, the remaining frail individuals had the highest rate of cognitive decline in men, while the change from non-frail to frail state in women was significantly associated with the lowest cognitive function values. We recommend early interventions and prevention strategies in older adults to help ameliorate or slow down both frailty and cognitive function decline.

Download Full-text

The Brief Odor Detection Test (B-ODT) for Very Early Diagnosis of Cognitive Decline: A Preliminary Study

Brain Impairment ◽

10.1017/brimp.2017.7 ◽

2017 ◽

Vol 18 (2) ◽

pp. 197-210

Author(s):

Dimitra Savvoulidou ◽

Efthymia Totikidou ◽

Chariklia Varvesiotou ◽

Magda Iakovidou ◽

Ourania Sfakianaki ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Adult Population ◽

Detection Threshold ◽

Community Dwelling ◽

Odor Detection ◽

Olfactory Impairment ◽

Older Adult Population ◽

Community Dwelling Older Adults

Olfactory impairment in older adults is associated with cognitive decline. This study describes the development of a Brief Odor Detection Test (B-ODT), and its pilot administration in community-dwelling older adults. The study aimed at examining whether the test could differentiate older adults with very mild cognitive impairment from their cognitively healthy counterparts. The sample consisted of 34 older adults (22 women), aged from 65 to 87 years. Participants were divided into two groups according to their general cognitive functioning. Odor detection was measured via vanillin solutions at the following concentrations: 150 mg/L, 30 mg/L, 15 mg/L, 3 mg/L, and .03 mg/L. The first condition of the test involved a scale administration of vanillin solutions. The second condition examined the change in air odour and it required vanillin solution of 30 mg/L and a metric ruler of 30 cm. The examiner had to place the solution at a specific distance point from each nostril. Odour identification sensitivity was secondarily measured. The results showed statistically significant differences in odour detection threshold between the two groups. In the unirhinal testing, left nostril differences of the two groups were definite. Hence, the B-ODT seems a promising instrument for very early cognitive impairment screening in older adult population.

Download Full-text

COLAEVA: Visual Analytics and Data Mining Web-Based Tool for Virtual Coaching of Older Adult Populations

Sensors ◽

10.3390/s21237991 ◽

2021 ◽

Vol 21 (23) ◽

pp. 7991

Author(s):

Jon Kerexeta Sarriegi ◽

Andoni Beristain Iraola ◽

Roberto Álvarez Sánchez ◽

Manuel Graña ◽

Kristin May Rebescher ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Visual Analytics ◽

Web Application ◽

Adult Population ◽

Research Area ◽

Web Based ◽

Virtual Coaching ◽

Evolution Analysis ◽

Older Adult Population

The global population is aging in an unprecedented manner and the challenges for improving the lives of older adults are currently both a strong priority in the political and healthcare arena. In this sense, preventive measures and telemedicine have the potential to play an important role in improving the number of healthy years older adults may experience and virtual coaching is a promising research area to support this process. This paper presents COLAEVA, an interactive web application for older adult population clustering and evolution analysis. Its objective is to support caregivers in the design, validation and refinement of coaching plans adapted to specific population groups. COLAEVA enables coaching caregivers to interactively group similar older adults based on preliminary assessment data, using AI features, and to evaluate the influence of coaching plans once the final assessment is carried out for a baseline comparison. To evaluate COLAEVA, a usability test was carried out with 9 test participants obtaining an average SUS score of 71.1. Moreover, COLAEVA is available online to use and explore.

Download Full-text

Communicating with the Older Adult Cancer Patient

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0085 ◽

2021 ◽

pp. 678-684

Author(s):

Patricia A. Parker ◽

Smita C. Banerjee ◽

Beatriz Korc-Grodzicki

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Impairment ◽

Psychological Distress ◽

Cancer Patients ◽

Older Adult ◽

Adult Population ◽

Healthcare Providers ◽

Multiple Morbidity ◽

Older Adult Population

The older adult population continues to increase. Among all known risk factors for developing cancer, the most important is growing old. Thus, caring for older adults with cancer is of increasing importance. This chapter describes important considerations involved in communicating with cancer patients including sensory impairment, cognitive impairment, multiple morbidity, polypharmacy, and psychological distress. It also describes how stereotyping and ageism affect communication with older adults with cancer. Finally, the chapter discusses ways to facilitate communication with older adult cancer patients and their families and provides an example of a training program that was created specifically to enhance communication between healthcare providers and older adult cancer patients and their families.

Download Full-text

Applying the Pikes Peak Model of Treatment Competency to the Use of Cognitive-Behavioral Therapies with Older Adults

Specialty Competencies in Geropsychology ◽

10.1093/med:psych/9780195385670.003.0006 ◽

2011 ◽

pp. 67-83

Author(s):

Forrest Scogin ◽

Andrew Presnell

Keyword(s):

Older Adults ◽

Behavioral Therapy ◽

Adult Population ◽

Cognitive Behavioral ◽

Problem Solving Therapy ◽

Evidence Based Treatments ◽

Behavioral Therapies ◽

Cognitive Behavioral Therapies ◽

Older Adult Population ◽

Peak Model

Chapter 6 examines specifically the application of Beck’s cognitive-behavioral therapy (CBT) and problem-solving therapy (PST), an adaptation of cognitive-behavioral techniques, with the older adult population. It also uses the Pikes Peak Model to identify the focal areas needed for competent delivery of these treatments with older adults. It also covers the Pikes Peak Model, which outlines six areas to be considered in the competent application of treatment: applying interventions with appropriate modifications, using evidence-based treatments, developing appropriate treatments when there is a lack of evidence available, proficiently employing common late-life intervention, using interventions to enhance the health of diverse elderly persons, and intervening across settings.

Download Full-text

Inadequacy of Protein Intake in Older UK Adults

Geriatrics ◽

10.3390/geriatrics5010006 ◽

2020 ◽

Vol 5 (1) ◽

pp. 6 ◽

Cited By ~ 2

Author(s):

Susan Morris ◽

James D. Cater ◽

Mark A. Green ◽

Alexandra M. Johnstone ◽

Jeffrey M. Brunstrom ◽

...

Keyword(s):

Older Adults ◽

Protein Synthesis ◽

Protein Intake ◽

Muscle Protein ◽

Muscle Protein Synthesis ◽

Adult Population ◽

Specific Recommendation ◽

Food Diaries ◽

The Uk ◽

Older Adult Population

The current dietary recommendation for protein intake in the UK is 0.75 g/kg/day, however, this population-wide recommendation does not necessarily reflect altered requirements for older adults to maintain muscle protein synthesis, nor does it encompass the potential impact of intake timing. Optimal muscle protein synthesis in older adults requires both higher intake requirements and a distribution of protein intake above a 25 g threshold, three times across the day. This study aimed to describe the protein intake of older adults in a UK region and compare the results to recommendations. The study re-assessed two existing datasets with rich diet information for older adults in the South Yorkshire area. Data were extracted from food diaries of 256 adults aged between 65 and 89 years old (mean ± SD 72.4 ± 5.3 years). Quantity and timing of intake were coded using Nutritics software and compared to recommendations. The relationship between body mass index (BMI), age, and protein intake was explored. Fewer than 50% of the participants met current UK recommendations (0.75 g/kg/day) and fewer than 15% met the ESPEN 1.2 g/kg/day age-specific recommendation. Only one participant met the 25 g/meal recommendation across three meals. These findings suggest that the older adult population is not achieving recommendations to maintain muscle protein synthesis. Nonetheless it identifies several straightforward opportunities for improvement, notably elevation of morning intake.

Download Full-text

Developing a model of resilience in older adulthood: a qualitative meta-synthesis

Ageing and Society ◽

10.1017/s0144686x20000112 ◽

2020 ◽

pp. 1-23

Author(s):

Claire A. Wilson ◽

Deanna Walker ◽

Donald H. Saklofske

Keyword(s):

Older Adults ◽

Protective Factors ◽

Older Adult ◽

Factor Model ◽

Adult Population ◽

Theoretical Models ◽

Older Individuals ◽

Older Adulthood ◽

Older Adult Population ◽

Qualitative Literature

Abstract The study of resilience in an older adult population is expanding rapidly. However, most theoretical models of resilience have been developed with children or young to middle-aged adults. The objective of the present study was to review systematically the qualitative literature examining resilience in older adults, and to develop a comprehensive model of resilience in older adulthood. A qualitative meta-synthesis was conducted to review the qualitative literature examining resilience from older adults’ perspectives. An exhaustive search of the literature revealed 1,752 articles. From these articles, 34 studies meeting inclusion criteria were selected for analysis. Across the 34 studies analysed, eight themes were revealed as important for achieving resilience later in life: perseverance and determination, self-efficacy and independence, purpose and meaning, positive perspective, social support, faith and prayer, previous experience and being proactive. These themes can be organised into a four-factor model: (a) Intrapersonal Protective Factors; (b) Interpersonal Protective Factors; (c) Spiritual Protective Factors; and (d) Experiential Protective Factors. This study presents a new model of resilience in older adulthood that is grounded in qualitative literature and is relevant and appropriate for an older adult population. This research may be useful for clinicians, support workers and researchers working with older individuals through improving our understanding of what contributes to resilience later in life.

Download Full-text

VISIBILITY OF PROGRAMS AND SERVICES ON HOSPITAL WEBSITES: GERIATRICS COMPARED WITH OBSTETRICS

Innovation in Aging ◽

10.1093/geroni/igz038.1675 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S446-S446

Author(s):

Brenda P Johnson ◽

MyoungJin Kim ◽

Emily E McMahon ◽

Ali Mojadam

Keyword(s):

Older Adults ◽

Adult Population ◽

Descriptive Analysis ◽

Binary Matrix ◽

Digital Platform ◽

Geographical Regions ◽

Sample Proportion ◽

Specialized Services ◽

Older Adult Population ◽

Functional Areas

Abstract Hospitals increasingly use a digital platform to market their services as well as reflect the values and mission of the organization. As payment incentives and national initiatives grow for making hospitals more “age friendly” in both the quality and extent of specialized services for older adults, the visibility of these services on a digital platform is of interest. This exploratory, descriptive analysis of hospital websites was to illuminate the ease with which a consumer could identify that a hospital has specialized services in geriatrics as compared with obstetrics. A proportionate stratified random sampling based on the five geographical regions of the country was used to select 220 hospitals with 5% margin of error, 95% confidence interval and 50% sample proportion with no prior information from a population of over 600 hospitals known to have implemented at least one quality initiative specific to older adults (NICHE). A binary matrix was developed for collecting data related to the visibility of services in three main areas of hospital websites: 1) images and terms on the homepage 2) identification of programs in the “Services” function and 3) availability of the specialty in the “Search for Doctor” function. Data show that the frequency of all key words used to identify obstetrical services was greater than those used to describe geriatric services across all functional areas explored in this study. Implications are that hospital websites may be an underutilized resource for marketing services as well as accurately reflecting specialized services for the older adult population.

Download Full-text

Association between the Use of Proton Pump Inhibitors and Cognitive Impairment in Older Adults

Universitas Médica ◽

10.11144/javeriana.umed60-1.inhi ◽

2018 ◽

Vol 60 (1) ◽

Author(s):

Camilo Gómez ◽

Miguel German Borda Borda ◽

Mario Ulises Pérez ◽

Pamela Tella Vega ◽

Carlos Alberto Cano Gutiérrez

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Adult Population ◽

Cross Sectional ◽

Adjusted Risk ◽

Risk Increase ◽

Older Adult Population ◽

State Examination

Objective: The objective was to describe the association between the presence of cognitive impairment and the use of proton pump inhibitors (PPI) in the older adult population in Bogotá, Colombia. Methods: We analyzed the SABE Bogotá study. This study included 2,000 people over 60 years, in a cross-sectional sample. The variable of interest was the alteration in the modified Mini-Mental State Examination (MMSE-M). It was related to the use of PPI. This analysis was adjusted for factors such as sex, age, years of schooling and marital status. Results: The average age was 71.17±8.05 years, 63.4% were women. We found that 20.7% used PPIs, with an average duration of use of 74.8±93.76 months. 12.6% of older adults had altered MMSE-M, with a higher prevalence in PPI users (25.4% vs. 20.02%; p: 0.049). In the multivariate analysis, an association of adjusted risk increase was found between cognitive impairment and the use of PPIs for ≥24 months (OR: 1.90; CI: 1.11-3.24; p = 0.018). Conclusions: This study shows an association of a significant increase in the risk between using PPIs for ≥ 24 months and developing cognitive impairment. More studies are needed to conclude a direct causality relationship.

Download Full-text

BMI, waist-to-height ratio and body fat mass in older adults: results from the Pronutrisenior project

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001706 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Flora Correia ◽

Bruno M. P. M. Oliveira ◽

Rui Poínhos ◽

Anzhela Sorokina ◽

Cláudia Afonso ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Body Fat ◽

Fat Mass ◽

Adult Population ◽

Body Fat Mass ◽

Height Ratio ◽

Waist To Height Ratio ◽

Older Adult Population ◽

Geographical Characteristics

AbstractNear 20% of the Portuguese population is aged 65 years or above, a value similar to most developed countries. This older adult population also suffers from obesity and obesity-related pathologies. The environment encompasses a set of obesity determinants and knowing the associations between the environment and obesity may help health professionals and caregivers to provide for the older adults.In this study, we aimed to relate anthropometric measures with socio-demographic data in older adults.This is a cross-sectional study using data from the Pronutrisenior project, collected in Vila Nova de Gaia, Portugal. The sample consists of 456 older adults, aged 65 to 92 years without cognitive impairment. The sample consisted of older adults living at their homes. Socio-demographic, clinical, geographical, and anthropometric data was collected. The statistical analysis used IBM-SPSS-22.0 and consisted on descriptive statistics, Pearson correlations and UniANOVA. Significantly results (p < 0.05) are reported.These older adults were mostly females (54.2%) with a mean age of 73.8 years (sd = 6.3), mean body mass index (BMI) of 29.1kg/m2 (sd = 4.8), mean waist-to-height ratio (WHtR) of 0.623 (sd = 0.073) and mean percentage of body fat mass (%BFM) of 40.7% (sd = 8.9%) for females and 30.2% (sd = 8.5%) for males. BMI, WHtR and %BFM were positively correlated. In this sample of older adults, higher values of these measures were associated to being female, younger, less educated; to having articular pains and respiratory problems, and not having insomnia, hypertension, chewing problems nor hearing problems; to drink more liquids but not consuming dairy products daily; to not take nutritional supplements but to take more medicines; to be without somebody to talk to and to be more dependent; and to live in a house without stairs to climb and to live near other older adults, and in a more urbanized area with streets with steeper slopes.In this sample of older adults, obesity is related with health characteristics and those are related with socio-demographic and geographical characteristics of the area of residence. Besides the identification of risk factors for the older adult population, this information may help designing health care policies that takes in consideration the physical and geographical characteristics of the neighbourhood of the area of residence of the older adults.

Download Full-text