875 Works

IMPACT OF NUTRITIONAL RISK ON SELF-CARE CAPACITY: SOCIAL SUPPORT AS A SOURCE OF PROTECTION FOR COMMUNITY-DWELLING OLDER ADULTS LIVING IN A RURAL AREA

S.E. Jung , J.R. Hermann & A. Bishop
Background: Loss of independence is a major concern for rural older adults. Older adults living in rural areas are at an increased nutritional risk, which can lead to functional impairments in self-care capacity. Identifying factors, which have a role in sustaining rural older adults’ self-care capacity, could help with maintaining independence as long as possible. Objective: The objective of this study was to examine the effect of social support as a moderator between nutritional risk...

Identifying Better Outcome Measures to Improve Treatment of Agitation in Dementia: A Report from the EU/US/CTAD Task Force

M. Sano , M. Soto , M. Carrillo , J. Cummings , S. Hendrix , J. Mintzer , A. Porsteinsson , P. Rosenberg , L. Schneider , J. Touchon , P. Aisen , B. Vellas , C. Lyketsos & And The EU/US/CTAD Task Force Members
For the second time in the past 3 years, the EU-US CTAD Task Force addressed challenges related to designing clinical trials for agitation in dementia, which is one of the most disruptive aspects of the condition for both patients and caregivers. Six recommendations emerged from the Task Force meeting: 1 – Operationalizing agitation criteria established by the IPA; 2 – Combining clinician- and caregiver-derived outcomes as primary outcome measures; 3 – Using global ratings to...

Effect of Punicalagin and Resveratrol on Methionine Sulfoxide Reductase: a possible protective contribution against Alzheimer Disease

M.E. Clementi , B. Sampaolese , G. Lazzarino & B. Giardina
Methionine sulfoxide reductase A (MsrA) has been postulated to act as a catalytic antioxidant system involved in the protection of oxidative stress-induced cell injury. MsrA has recently turned attention in coupling with the neurodegenerative disorders and in particular with Alzheimer disease. In fact this neurodegenerative disorder depends to a deposit of beta amyloid a peptide with an oxidizable methionine in position 35 which is proved able to modulate the expression to MsrA in neuronal cells....

Does tailored nutritional guidance encourage older caregivers to increase their protein intake? The CareNutrition trial (RCT)

S. Kunvik , R. Valve , M. Salonoja & M.H. Suominen
Background: Older caregivers, males especially, are vulnerable to nutritional problems. Low intake of protein is common and can affect their nutrition and health. Objectives: The aim in this RCT was to investigate the effect of tailored nutritional guidance on protein intake among caregivers aged ≥65 years with protein intake under recommendations (≤1.2 g/kgBW/d). Subgroup analysis were made with male caregivers. Design: Data from the CareNutrition randomized controlled trial (RCT). Setting: Community-dwelling caregivers from the Western...

Concurrent use of dietary supplements and medications in long-term care facility residents with advanced dementia

S. Goorang , L.U. Thorpe , A. Baillod & S.J. Whiting
Seniors residing in long-term care (LTC) facilities may suffer from nutrient deficiencies, yet supplementation may increase burden with little benefit, especially in advanced dementia with reduced life expectancy. A multidisciplinary team examined the clinical context and prescription of medications and dietary supplements to 29 LTC residents in the latest stages of dementia. All except one had problems with oral intake, and almost half had problems taking medications/supplements. The mean likelihood of death at 6 months...

Nursing homes characteristics according to the rate of emergency department transfer: a retrospective study

K. El Haddad , X. Dubusc , C. Cool , F. Nourhashémi , P. De Souto Barreto & Y. Rolland
Background: Despite comparable clinical characteristics of nursing home residents, the rate of emergency department transfer is highly variable from one nursing home to another, suggesting that structural characteristic and organizational factors may influence the rate of nursing home resident’s transfer to the emergency department. Objectives: To identify structural characteristics and medical care organization of nursing homes according to the rate of emergency department transfers of nursing home residents. Design: We conducted a cross-sectional analysis using...

Resistance training and co-supplementation with creatine and protein in older subjects with frailty

J. Collins , G. Longhurst , H. Roschel & B. Gualano
Background: Studies assessing the effects co-supplementation with creatine and protein, along with resistance training, in older individuals with frailty are lacking. Objectives: This is an exploratory trial from the Pro-Elderly study (“Protein Intake and Resistance Training in Aging”) aimed at gathering knowledge on the feasibility, safety, and efficacy of co-supplementation with creatine and protein supplementation, combined with resistance training, in older individuals with frailty. Design: A 14-week, double-blind, randomized, parallel-group, placebo controlled exploratory trial. Setting,...

PHYSICAL ACTIVITY IN HOSPITALIZED OLD MEDICAL PATIENTS; HOW ACTIVE ARE THEY, AND WHAT

M. Holst , P.L. Hansen , L.A. Pedersen , S. Paulsen , C.D. Valentinsen & M. Kohler
Objective: To examine how physically active Danish old medical patients are during hospitalization and to achieve knowledge of motivation and barriers to physical activity. Background: Functional decline in frail old patients during hospitalization is an important clinical problem with potential long-lasting undesirable outcomes and complications. Design: A mixed methods study including qualitative and quantitative methods. Methods: Patients >60 years of age were recruited at two medical departments during one week. Three SenseWear armband monitors were...

Nutritional status in frail cirrhotic patients undergoing liver transplantation

D. Azzolino , S. Damanti & M. Cesari
The liver is the largest and most important metabolic organ, playing a pivotal role in the integration of biochemical pathways of carbohydrates, fats, proteins, and vitamins (1). End-stage liver disease (ESLD) has an important negative effect on nutritional status (2) and malnutrition is a common problem in patients waiting for liver transplantation (LT). The mean weight loss during ESLD is about 9 Kg and this contributes to further morbidities and mortality (3).

Role of Anti-inflammatory Cytokines on Muscle Mass and Performance Changes in Elderly Men and Women

A.P. Rossi , S. Budui , E. Zoico , C. Caliari , G. Mazzali , F. Fantin , M. D’Urbano , R. Paganelli & M. Zamboni
Objectives: investigate the presence of a correlation between systemic inflammatory profile of community-dwelling individuals and the loss of muscular mass and performance in old age over a 4.5y follow-up, focusing on the role of anti-inflammatory cytokines in muscular changes in elderly. Design: Longitudinal clinical study. Setting: Subjects were randomly selected from lists of 11 general practitioners in the city of Verona, Italy. Partecipants: The study included 120 subjects, 92 women and 28 men aged 72.27±2.06...

Ginkgo Biloba Extract Consumption and Long-term Occurrence of Death and Dementia

J.F. Dartigues , L. Grasset , C. Helmer , C. Féart , L. Letenneur , H. Jacqmin-Gadda , P. Joly & H. Amieva
Objectives: To study the benefit of Ginkgo Biloba Extract (GBe) consumption on the long term risk of dementia and death in elderly people.Design: The Paquid study is a population-based cohort with regular follow-up screenings up to twenty-two years and systematic detection of incident cases of dementia. Statistical analysis was conducted with an illness-death model dealing with interval censoring of dementia and competing risk of death. Setting: The sample was randomly selected from electoral rolls in...

Global Alzheimer’s Platform Trial Ready Cohorts for the Prevention of Alzheimer’s Dementia

R. Sperling , J. Cummings , M. Donohue3 & P. Aisen
With the now widely accepted view that preventing Alzheimer’s disease likely will require treatment in the earliest stages of disease, a number of secondary prevention trials have been launched. Recruiting sufficient numbers of participants for these trials represents a major roadblock. To address this barrier, the Global Alzheimer’s Platform Trial Ready Cohorts for Preclinical and Prodromal Alzheimer’s Dementia (GAP TRC-PAD) has created an efficient and sustainable recruitment system for upcoming secondary prevention trials. The initial...

Computerized Cognitive Testing for Use in Clinical Trials: A Comparison of the NIH Toolbox and Cogstate C3 Batteries

R.F. Buckley , K.P. Sparks , K.V. Papp , M. Dekhtyar , C. Martin , S. Burnham , R.A. Sperling & D.M. Rentz
Background: As prevention trials for Alzheimer’s disease move into asymptomatic populations, identifying older individuals who manifest the earliest cognitive signs of Alzheimer’s disease is critical. Computerized cognitive testing has the potential to replace current gold standard paper and pencil measures and may be a more efficient means of assessing cognition. However, more empirical evidence about the comparability of novel computerized batteries to paper and pencil measures is required. Objectives: To determine whether two computerized IPad...

Living with Family yet Eating Alone is Associated with Frailty in Community-Dwelling Older Adults: The Kashiwa Study

U. Suthutvoravut , T. Tanaka , K. Takahashi , M. Akishita & K. Iijima
Objectives: Eating alone is related to depression, nutritional risk, and mortality. These effects are also influenced by living status. However, little is known about the relationship between eating alone despite living with family and frailty. This study explores the relationship of eating alone and living status with frailty in community-dwelling older adults. Design: Cross-sectional study. Setting and Participants: Kashiwa city, Chiba prefecture, Japan; randomly selected community-dwelling older adults (aged 65 years and over). Measurements: Eating...

Effects of fermented papaya preparation (FPP) on safety outcomes in older adults – a short report of a placebo-controlled clinical trial

R.T. Mankowski , C. Leeuwenburgh , T.M. Manini , A.J. Woods , S.D. Anton & J.E. Martinelli
Fermented Papaya Preparation (FPP®) has shown antioxidative and anti-inflammatory effects in preclinical and clinical aging studies. However, clinical trials are needed to fully evaluate the safety of FPP® in moderate-functioning, generally healthy older adults. In this randomized (9g/day of FPP® or placebo), crossover design study, we enrolled 30 older moderate-functioning older adults (70-100 years old). The participants completed both a treatment and a placebo condition. After eight (8) weeks on each of these regimens (with...

POOR DENTAL HEALTH AND CRUSHED DRUGS IN NURSING HOME RESIDENTS

S. Pasqualini , A.M. Barisic , M. Serris , C. Rio & I. Prêcheur
Some older adults with a poor dental state, but not suffering from swallowing disorders (dysphagia), could be given crushed drugs unnecessarily, just because they are given texture modified food. Thirty-nine residents were included in this analysis of nursing home practices: mainly women (28/39); mean age 86.8 +/-7.7; Groupe Iso-Ressource (GIR) 1.7 +/- 0.6; Mini Mental State (MMS) 16.5 +/- 6.0; crushed drugs 26/38; swallowing disorders 14/39; mixed and mashed food 25/38. Crushed drugs were associated...

Low rates of vitamin D screening: concern for aging with poor skeletal health in the older minorities

N.J. Rianon , K.P. Murphy , C.B. Dyer & B.J. Selwyn
Background: Regardless of discussion about vitamin D deficiency in minority population, there is a scarcity of information on vitamin D screening practice in older minority patients by their PCPs. Screening for risk factors does improve diagnosis and treatment of compromised skeletal health. Objective: To compare vitamin D screening rates between older patients from Caucasian and other non-Caucasian backgrounds including Blacks and Hispanics who were being treated by their PCPs for osteopenia, osteoporosis or related fractures....

Fear of choking and fear of falling in Huntington’s disease: study protocol for a multi-center observational cross-sectional study

K. Kalkers , J.M.G.A Schols , J.C.L. Neyens & R.A.C. Roos
Background: Dysphagia and accidental falls are common in patients with Huntington’s disease; they can have serious consequences and may, therefore lead to fear of choking and fear of falling. Objectives: In this article, a protocol is described to explore the prevalence of fear of choking and fear of falling in patients with Huntington’s disease, to identify the relationship between fear of choking and fear of falling and, respectively, anxiety, awareness and cognitive functioning and to...

Predicting 30-day mortality and 30-day re-hospitalization risks in Medicare patients with heart failure discharged to skilled nursing facilities: development and validation of models using administrative data

L. Li , J. Baek , B.M. Jesdale , A.L. Hume , G. Gambassi , R.J. Goldberg & K.L. Lapane
Background: Despite the growing importance of skilled nursing facility care for Medicare patients hospitalized with heart failure, no risk prediction models for these patients. Objectives: To develop and validate separate predictive models for 30-day all-cause mortality and 30-day exist all-cause re-hospitalization. Design: Retrospective cohort study using nationwide Medicare claims data cross-linked with Minimum Data Set 3.0. Setting: 11,529 skilled nursing facilities in the United States (2011-2013). Participants: 77,670 hospitalized heart failure patients discharged to skilled...

Frailty Is a Geriatric Syndrome Characterized by Multiple Impairments: A Comprehensive Approach Is Needed

L.-K. Chen , A.-C. Hwang , L.-K. Liu , W.-J. Lee & L.-N. Peng
Objective: To evaluate the prevalence of frailty and the associated multimorbidity and functional impairments among community-dwelling middle-aged and elderly people in Taiwan. Design: a cross-sectional study. Setting: communities in I-Lan County of Taiwan. Participants: 1839 community-dwelling people aged 50 years and older. Intervention: None. Measurements: Frailty defined by Fried’s criteria, Charlson’s comorbidity index (CCI), Functional Autonomy Measurement System (SMAF), Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Nutrition Assessment (MNA), Mini–Mental State Examination (MMSE), and Short...

Dentition and Malnutrition Risk in Community-Dwelling Older Adults

R. Zelig , L. Byham-Gray , S.R. Singer , E.R. Hoskin , A. Fleisch Marcus , G. Verdino , D.R. Radler & R. Touger-Decker
Background and Objective: Older adults are at risk for both impaired oral health and suboptimal nutritional status. The objective of this study was to explore the relationships between malnutrition risk and missing teeth in community-dwelling older adults. Design: This was a retrospective cross-sectional analysis of data obtained from the electronic health records of 107 patients aged 65 and older who attended an urban northeast US dental school clinic between June 1, 2015 and July 15,...

The 2018 Revised FDA Guidance for Early Alzheimer’s Disease: Establishing the Meaningfulness of Treatment Effects

C.J. Edgar , G. Vradenburg & J. Hassenstab
The present report reviews the revised 2018 FDA guidance for early AD, with an emphasis on meaningfulness of clinical outcome assessments (COAs). A radical shift is evident in the importance given to establishing the meaningfulness of COAs in the 2018 draft versus the 2013 draft. The implications of this shift include the assertion that cognition is clinically meaningful, but that a persuasive effect on cognition, depending upon disease stage of the participants in the trial,...

The Value of Pre-screening in the Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease Trial

S. Rios-Romenets , M. Giraldo-Chica , H. López , F. Piedrahita , C. Ramos , N. Acosta-Baena , C. Muñoz , P. Ospina , C. Tobón , W. Cho , M. Ward , J.B. Langbaum , P.N. Tariot , E.M. Reiman & F. Lopera
The Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease (ADAD) trial evaluates the anti-amyloid-β antibody crenezumab in cognitively unimpaired persons who, based on genetic background and age, are at high imminent risk of clinical progression, and provides a powerful test of the amyloid hypothesis. The Neurosciences Group of Antioquia implemented a pre-screening process with the goals of decreasing screen failures and identifying participants most likely to adhere to trial requirements of the API ADAD trial...

ESTABLISHING COMPOSITE COGNITIVE ENDPOINTS FOR USE IN PRECLINICAL ALZHEIMER’S DISEASE TRIALS

J.B. Langbaum, S. Hendrix, N. Ayutyanont, D. A. Bennett, R.C. Shah, L.L. Barnes, F. Lopera, E.M. Reiman & P.N. Tariot
Traditional cognitive outcomes developed for clinical trials in mild cognitive impairment (MCI) or Alzheimer’s disease (AD) dementia are not well-suited for preclinical AD trials due to the psychometric properties of the tests (e.g., ceiling effects). Rather than selecting a single cognitive assessment that has been reported to measure change in preclinical AD, or individually examining multiple cognitive assessments and treating each as an individual outcome thereby potentially inflating Type I error, we and other groups...

How Do Work Hierarchies and Strict Divisions of Labour Impact Care Workers’ Experiences of Health and Safety? Case Studies of Long Term Care in Toronto

I. Syed , T. Daly , P. Armstrong , R. Lowndes , M. Chadoin & V. Naidoo
Background: According to the Canadian Health Care Association (1), there are 2,577 long-term care (“LTC”) facilities across Canada, with the largest proportion (33.4%) located in Ontario. Most studies focus on residents’ health, with less attention paid to the health and safety experiences of staff. Given that the work performed in Ontario LTC facilities is very gendered, increasingly racialized, task-oriented, and with strict divisions of labour, this paper explores in what ways some of these factors...

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