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Browsing by Author "Jones, Richard N."
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Item The ACTIVE cognitive training trial and predicted medical expenditures(BioMed Central, 2009-06-29) Wolinsky, Fredric D.; Mahncke, Henry W.; Kosinski, Mark; Unverzagt, Frederick W.; Smith, David M.; Jones, Richard N.; Stoddard, Anne; Tennstedt, Sharon L.; Medicine, School of MedicineBackground Health care expenditures for older adults are disproportionately high and increasing at both the individual and population levels. We evaluated the effects of the three cognitive training interventions (memory, reasoning, or speed of processing) in the ACTIVE study on changes in predicted medical care expenditures. Methods ACTIVE was a multisite randomized controlled trial of older adults (≥ 65). Five-year follow-up data were available for 1,804 of the 2,802 participants. Propensity score weighting was used to adjust for potential attrition bias. Changes in predicted annualmedical expenditures were calculated at the first and fifth annual follow-up assessments using a new method for translating functional status scores. Multiple linear regression methods were used in this cost-offset analysis. Results At one and five years post-training, annual predicted expenditures declinedby $223 (p = .024) and $128 (p = .309), respectively, in the speed of processing treatment group, but there were no statistically significant changes in the memory or reasoning treatment groups compared to the no-contact control group at either period. Statistical adjustment for age, race, education, MMSE scores, ADL and IADL performance scores, EPT scores, chronic condition counts, and the SF-36 PCS and MCS scores at baseline did not alter the one-year ($244; p = .012) or five-year ($143; p = .250) expenditure declines in the speed of processing treatment group. Conclusion The speed of processing intervention significantly reduced subsequent annual predicted medical care expenditures at the one-year post-baseline comparison, but annual savings were no longer statistically significant at the five-year post-baseline comparison.Item Acute Changes in Sleep Duration on Eating Behaviors and Appetite-Regulating Hormones in Overweight/Obese Adults(Taylor & Francis, 2015) Hart, Chantelle N.; Carskadon, Mary A.; Demos, Kathryn E.; Van Reen, Eliza; Sharkey, Katherine M.; Raynor, Hollie A.; Considine, Robert V.; Jones, Richard N.; Wing, Rena R.; Department of Medicine, IU School of MedicineThere is considerable interest in the role of sleep in weight regulation, yet few studies have examined this relationship in overweight/obese (OW/OB) adults. Using a within-subject, counterbalanced design, 12 OW/OB women were studied in lab with two nights of short (5 hr time in bed [TIB]) and two nights of long (9 hr TIB) sleep. Hunger, consumption at a buffet, and fasting hormone levels were obtained. Significant polysomnographic differences occurred between conditions in total sleep time and sleep architecture (ps < .001). Percent energy from protein at the buffet increased following short sleep. No differences were observed for total energy intake or measured hormones. Further research is needed to determine how lengthening sleep impacts weight regulation in OW/OB adults.Item Delirium Severity Trajectories and Outcomes in ICU Patients. Defining a Dynamic Symptom Phenotype(American Thoracic Society, 2020-09) Lindroth, Heidi; Khan, Babar A.; Carpenter, Janet S.; Gao, Sujuan; Perkins, Anthony J.; Khan, Sikandar H.; Wang, Sophia; Jones, Richard N.; Boustani, Malaz A.; School of NursingRationale: Delirium severity and duration are independently associated with higher mortality and morbidity. No studies to date have described a delirium trajectory by integrating both severity and duration. Objectives: The primary aim was to develop delirium trajectories by integrating symptom severity and duration. The secondary aim was to investigate the association among trajectory membership, clinical characteristics, and 30-day mortality. Methods: A secondary analysis of the PMD (Pharmacologic Management of Delirium) randomized control trial (ClinicalTrials.gov Identifier: NCT00842608; N = 531) was conducted. The presence of delirium and symptom severity were measured at least daily for 7 days using the Confusion Assessment Method for the intensive care unit (CAM-ICU) and CAM-ICU-7 (on a scale of 0-7, with 7 being the most severe). Delirium trajectories were defined using an innovative, data-driven statistical method (group-based trajectory modeling [GBTM]) and SAS v9.4.Results: A total of 531 delirious participants (mean age 60 yr [standard deviation = 16], 55% female, and 46% African American) were analyzed. Five distinct delirium trajectories were described (CAM-ICU-7: mean [standard deviation]); mild-brief (CAM-ICU-7: 0.5 [0.5]), severe-rapid recovers (CAM-ICU-7: 2.1 [1.0]), mild-accelerating (CAM-ICU-7: 2.2 [0.9]), severe-slow recovers (CAM-ICU-7: 3.9 [0.9]), and severe-nonrecovers (CAM-ICU-7: 5.9 [1.0]). Baseline cognition and race were associated with trajectory membership. Trajectory membership independently predicted 30-day mortality while controlling for age, sex, race, cognition, illness severity, and comorbidities. Conclusions: This secondary analysis described five distinct delirium trajectories based on delirium symptom severity and duration using group-based trajectory modeling. Trajectory membership predicted 30-day mortality.Item Linking Self-Perceived Cognitive Functioning Questionnaires Using Item Response Theory: The Subjective Cognitive Decline Initiative(American Psychological Association, 2023) Rabin, Laura A.; Sikkes, Sietske A. M.; Tommet, Douglas; Jones, Richard N.; Crane, Paul K.; Elbulok-Charcape, Milushka M.; Dubbelman, Mark A.; Koscik, Rebecca; Amariglio, Rebecca E.; Buckley, Rachel F.; Boada, Mercè; Chételat, Gaël; Dubois, Bruno; Ellis, Kathryn A.; Gifford, Katherine A.; Jefferson, Angela L.; Jessen, Frank; Johnson, Sterling; Katz, Mindy J.; Lipton, Richard B.; Luck, Tobias; Margioti, Eleni; Maruff, Paul; Molinuevo, Jose Luis; Perrotin, Audrey; Petersen, Ronald C.; Rami, Lorena; Reisberg, Barry; Rentz, Dorene M.; Riedel-Heller, Steffi G.; Risacher, Shannon L.; Rodriguez-Gomez, Octavio; Sachdev, Perminder S.; Saykin, Andrew J.; Scarmeas, Nikolaos; Smart, Colette; Snitz, Beth E.; Sperling, Reisa A.; Taler, Vanessa; van der Flier, Wiesje M.; van Harten, Argonde C.; Wagner, Michael; Wolfsgruber, Steffen; Alzheimer’s Disease Neuroimaging Initiative; Canadian Longitudinal Study on Aging; Health and Aging Brain Study; Health Disparities (HABS-HD) Study Team; Radiology and Imaging Sciences, School of MedicineObjective: Self-perceived cognitive functioning, considered highly relevant in the context of aging and dementia, is assessed in numerous ways-hindering the comparison of findings across studies and settings. Therefore, the present study aimed to link item-level self-report questionnaire data from international aging studies. Method: We harmonized secondary data from 24 studies and 40 different questionnaires with item response theory (IRT) techniques using a graded response model with a Bayesian estimator. We compared item information curves to identify items with high measurement precision at different levels of the self-perceived cognitive functioning latent trait. Data from 53,030 neuropsychologically intact older adults were included, from 13 English language and 11 non-English (or mixed) language studies. Results: We successfully linked all questionnaires and demonstrated that a single-factor structure was reasonable for the latent trait. Items that made the greatest contribution to measurement precision (i.e., "top items") assessed general and specific memory problems and aspects of executive functioning, attention, language, calculation, and visuospatial skills. These top items originated from distinct questionnaires and varied in format, range, time frames, response options, and whether they captured ability and/or change. Conclusions: This was the first study to calibrate self-perceived cognitive functioning data of geographically diverse older adults. The resulting item scores are on the same metric, facilitating joint or pooled analyses across international studies. Results may lead to the development of new self-perceived cognitive functioning questionnaires guided by psychometric properties, content, and other important features of items in our item bank.