Beneficial effects of multisensory and cognitive stimulation on age-related cognitive decline in long-term-care institutions

A variety of environmental factors contribute significantly to age-related cognitive decline and memory impairment in Alzheimer’s Disease (AD) and other neurodegenerative diseases. Nutrition can alter epigenetics, improving health outcomes, which can be transmitted across generations; this process is called epigenetic inheritance. We investigate the beneficial effects of maternal resveratrol supplementation in the direct exposed F1 generation and the transgenerational F2 generation. The offspring was generated from females Senescence Accelerated Mouse-Prone (SAMP8) fed a resveratrol-enriched diet for two months prior to mating. Object novel recognition and Morris Water Maze (MWM) demonstrated improvements in cognition in the 6-month-old F1 and F2 generations from resveratrol fed mothers. A significant increase in global DNA methylation with a decrease in hydroxymethylation in F1 and F2 were found. Accordingly, Dnmt3a/b and Tet2 gene expression changed. Methylation levels of Nrf2 and NF-kβ genes promoters raised in offspring, inducing changes in target genes expression, as well as hydrogen peroxide levels. Offspring that resulted from a resveratrol fed mother showed increase AMPKα activation, mTOR inhibition, and an increase in Pgc-1α gene expression and Beclin-1 protein levels. Endoplasmic reticulum stress sensors were found changed both in F1 and F2 generations. Overall, our results demonstrated that maternal resveratrol supplementation could prevent cognitive impairment in the SAMP8 mice offspring through epigenetic changes and cell signaling pathways.

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Oral medicine modification for older adults: a qualitative study of nurses

BMJ Open ◽

10.1136/bmjopen-2017-018151 ◽

2017 ◽

Vol 7 (12) ◽

pp. e018151 ◽

Cited By ~ 3

Author(s):

Aoife Mc Gillicuddy ◽

Abina M Crean ◽

Maria Kelly ◽

Laura Sahm

Keyword(s):

Older Adults ◽

Qualitative Study ◽

Acute Care ◽

Long Term Care ◽

Oral Medicine ◽

Term Care ◽

Ethical Implications ◽

Age Related ◽

Medicine Administration

ObjectiveOral medicines are frequently modified (eg, tablets crushed) for older adults. However, these modifications can have clinical, legal and/or ethical implications. Nurses bear responsibility for medicine administration and hence, perform these modifications. The aim of this study was to investigate the knowledge, attitudes and beliefs of nurses about oral medicine modification for older adults.DesignA qualitative study was conducted using semi-structured, face-to-face interviews with nurses providing care to older adults in acute and long-term care settings. Interviews were audio-recorded, transcribed verbatim and analysed thematically.SettingsSixteen purposively selected care settings; 4 acute-care and 12 long-term care settings were included. Nurses were recruited by convenience sampling at these sites.ParticipantsEighteen nurses participated (83% female, 67% long-term care, 33% acute-care, median age (IQR) 38 years (32.5–52.0)).ResultsThree major themes: modifying—a necessary evil, nurses’ role as patient advocate and modifying—we are working very much as a teamand two minor themes: fractional dosing, and covert administration emerged from the data. Nurses viewed oral medicine modifications as being a routine and necessary occurrence in geriatric patient care due to limitations of available formulations and the presence of age-related challenges in drug administration. Nurses’ knowledge of residents’ requirements ensured that they advocate for those with individualised formulation needs, however, nurses rely on pharmacists for information about modifications. Nurses expressed a desire for supports including increased education and ward-specific, pharmacist-developed recommendations on common modifications.ConclusionsThis study has provided useful insights into the views of nurses regarding oral medicine modification for older adults. The unique and varied formulation requirements of older adults must be acknowledged. Increased engagement by healthcare professionals, the pharmaceutical industry, regulatory agencies and policy-makers is required to facilitate the development of age-appropriate formulations. In the interim, practical interventions, informed by the findings of this study, are required.

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Arts, Narrative, and Creativity: Enhancing Connection, Communication, and Health

Innovation in Aging ◽

10.1093/geroni/igaa057.2344 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 675-675

Author(s):

Jacqueline Eaton

Keyword(s):

Mental Health ◽

Long Term Care ◽

Social Activity ◽

Health Condition ◽

Creative Expression ◽

Adult Health ◽

Term Care ◽

Age Related ◽

Innovative Solutions

Abstract Older adults will comprise17% of the world’s population by2050. Meeting the unique challenges of an aging society requires innovative solutions to enhance the aging experience, reduce the pressures placed on the current infrastructure, and inspire future generations to see that aging matters. Shifts in multi and transdisciplinary approaches to research in aging have contributed to an increasing surge in the development and evaluation of arts-based strategies to find innovative solutions to the challenges associated with aging. This symposium examines the use of creative expression as a tool to enhance older adult health and quality of life through five different approaches targeting1) workforce training,2) mental health self-support,3) perceptions of peer loss and death in long-term care and,4) social activity for persons with dementia. Cox and Maguire enhance undergraduate gerontology courses with guided autobiography, portfolios, and creative collaging processes. Eaton et al. report findings from a study testing the use of arts-based caregiving techniques by certified nursing assistants to improve resident care. Fortuna and Brooks describe the use of narrative and storytelling to share lived experiences of aging with a mental health condition while promoting age-related self-management skills development. Olson presents findings from her work using expressive arts to explore perceptions of death and peer loss by residents in long-term care. Finally, Mittelman and Harris share outcomes from the program, A Place For Us, which provides creative expression opportunities for persons with dementia.

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Cognitive Stimulation for Individuals with Parkinson’s Disease Dementia Living in Long-Term Care: Preliminary Data from a Randomized Crossover Pilot Study

Parkinson s Disease ◽

10.1155/2018/8104673 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Ann-Kristin Folkerts ◽

Miriam E. Dorn ◽

Mandy Roheger ◽

Marco Maassen ◽

Janneke Koerts ◽

...

Keyword(s):

Pilot Study ◽

Effect Size ◽

Long Term Care ◽

Neuropsychiatric Symptoms ◽

Cognitive Stimulation ◽

Term Care ◽

Moderate Effect Size ◽

Global Cognition ◽

Moderate Effect

Background. While the efficacy of cognitive stimulation (CS) has been demonstrated in patients with dementia, no study has included patients with Parkinson’s disease dementia (PDD). Objective. For the first time, this randomized crossover pilot study examined the feasibility and potential effects of CS in PDD. Methods. All residents of a PDD-specific long-term care unit in the Netherlands that were eligible for the study (n=12) were randomly allocated to group A (n=6) receiving CS (eight weeks, twice weekly for 60 minutes) or group B (n=6) receiving usual care (control group, CG). The CG participated in CS afterwards, resulting in an experimental group (EG), consisting of n=12. Pre- and postassessments and a six-week follow-up (FU) were conducted for cognition, neuropsychiatric symptoms, quality of life (QoL), and activities of daily living (ADL) outcomes. Results. Between-group analysis with difference scores from pre- to posttest revealed a group difference for global cognition (CERAD total score) favoring the EG, with a moderate effect size and a p value just failing to reach statistical significance (p=0.067; r = 0.43). A further statistical trend was observed for neuropsychiatric symptoms, again with a moderate effect size (p=0.075; r = 0.42). Within-group analyses indicated improvement only in the EG with large effects also just failing to reach significance for global cognition (short term, p=0.060; r = 0.70) as well as for depression (long term, p=0.072; r = 0.61). ADL deteriorated significantly at FU in the EG (p=0.014; r = 0.71). Conclusions. Although our data are preliminary due to the small sample size, this study shows that CS is feasible and potentially effective for cognitive and noncognitive outcomes in PDD patients. Randomized controlled trials with larger sample sizes are needed to confirm these promising results.

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