IU Indianapolis ScholarWorks :: Browsing by Subject "older adults"

Browsing by Subject "older adults"

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"Alexa is a Toy": Exploring Older Adults' Reasons for Using, Limiting, and Abandoning Echo
(ACM, 2020-04) Trajkova, Milka; Martin-Hammond, Aqueasha; Human-Centered Computing, School of Informatics and Computing
Intelligent voice assistants (IVAs) have the potential to support older adults' independent living. However, despite a growing body of research focusing on IVA use, we know little about why older adults become IVA non-users. This paper examines the reasons older adults use, limit, and abandon IVAs (i.e., Amazon Echo) in their homes. We conducted eight focus groups, with 38 older adults residing in a Life Plan Community. Thirty-six participants owned an Echo for at least a year, and two were considering adoption. Over time, most participants became non-users due to their difficulty finding valuable uses, beliefs associated with ability and IVA use, or challenges with use in shared spaces. However, we also found that participants saw the potential for future IVA support. We contribute a better understanding of the reasons older adults do not engage with IVAs and how IVAs might better support aging and independent living in the future.
Change in Depression, Confidence, and Physical Function Among Older Adults With Mild Cognitive Impairment
(Wolters Kluwer, 2019-09-01) Ellis, Jennifer L.; Altenburger, Peter; Lu, Yvonne; Physical Therapy, School of Health and Rehabilitation Sciences
Background and Purpose Nearly a quarter of those in the US over age 71 experience mild cognitive impairment (MCI). Persons with MCI (PwMCI) battle depression and progressive disengagement from daily activities, which contribute to participation restriction and activity limitation. Daily engagement in meaningful activity (DEMA) is a tailored intervention designed to benefit PwMCI and their caregivers through preserved engagement and supported adjustment to cognitive changes. This secondary analysis was guided by the International Classification of Functioning, Disability and Health (ICF) model. Aims were to (i) explore the extent to which change in self-rated activity performance and physical function can predict change in depressive symptoms, (ii) evaluate for difference in confidence and depressive symptoms at ICF levels of activity and participation, and (iii) quantify the impact of daily engagement at the ICF level of participation on physical function. Methods A secondary analysis was conducted using data from the parent study, which was a two-group randomized trial involving PwMCI and their informal caregivers participating in the Indiana Alzheimer Disease Center DEMA program. Quantitative analysis (dyads: DEMA N = 20, Information Support N = 20) examined outcomes at posttest and follow-up. Analysis employed linear regression to model the relationship between explanatory and dependent variables and independent t-test to examine for difference in confidence, depression, and physical function. Results and Discussion At posttest, change in self-rated performance predicted change in depressive symptoms. Those in the DEMA group who engaged in activity at the ICF level of participation demonstrated a significant increase in confidence and physical function. Although not significant, the control group posttest results showed a mean decrease in confidence. Conclusions Results demonstrate a positive impact of DEMA on depressive symptoms, confidence, and physical function. Change in occupational performance predicted change in depressive symptoms. Confidence significantly improved among those who engaged at the ICF participation level. A larger, randomized controlled longitudinal trial is needed to better assess the impact of DEMA on physical function, activity, participation restriction and quality of life.
Cognitive Dysfunction in Older Breast Cancer Survivors
(2020-09) Crouch, Adele Deborah Lenae; Von Ah, Diane; Champion, Victoria; Pressler, Susan J.; Unverzagt, Frederick; Huber, Lesa
Up to 75% of the more than 3.5 million breast cancer survivors (BCS) living in the United States report cognitive dysfunction. However, little is known about cognitive dysfunction among older BCS, who may be at greater risk. Therefore, the purpose of this dissertation was to characterize cognitive dysfunction in older BCS. Specific aims included: (1) synthesize the literature regarding cognitive dysfunction in older BCS; and (2) examine the relationships between a) objective cognitive function (immediate memory, delayed memory, attention, executive function-working memory, verbal fluency) and subjective cognitive function (attention); b) demographic factors, medical factors, treatment factors, and cancer-related symptoms (depressive symptoms, anxiety, fatigue, sleep disturbance) and cognitive function; and c) comorbidity and cognitive function and physical functioning, and quality of life (QoL) in older BCS. In an integrative review, to address aim 1, 12 studies were identified. Up to 41% of older BCS showed objective cognitive dysfunction on neuropsychological assessment, up to 64% reported subjective cognitive dysfunction concerns pre-treatment, and 50% incurred cognitive decline from pre- to post-treatment. Cognitive dysfunction was associated with older age, multiple comorbidities, chemotherapy, sleep disturbance, neuropsychological symptom cluster, frailty, and poorer QoL. To address aim 2, data were leveraged from a large, nationwide, QoL in younger versus older BCS study (PI: Champion), which included 335 older BCS who were ≥60 years of age, had breast cancer (stage I-IIIa), received chemotherapy, and were 3-8 years post-diagnosis without recurrence. Findings included up to 19% of older BCS had mild-moderate objective cognitive dysfunction on at least one neuropsychological assessment, with 26% reporting poor-moderate subjective attention function. BCS, who were older, had less education and more depressive symptoms had greater cognitive dysfunction. Objective attention and executive function-working memory significantly and positively correlated with subjective attention. In turn, subjective cognitive dysfunction and increased number of comorbidities were related to poorer physical functioning. Subjective cognitive dysfunction was also related to poorer QoL. The findings from this study highlights the prevalence and complexity of cognitive dysfunction in older BCS. Further research is needed to better understand the intersection of aging, cancer, comorbidities and cognitive dysfunction and the negative implications in older BCS.
Does Targeted Cognitive Training Reduce Educational Disparities in Cognitive Function among Cognitively Normal Older Adults?
(Wiley, 2016-07) Clark, Daniel O.; Xu, Huiping; Unverzagt, Frederick W.; Hendrie, Hugh; Department of Medicine, IU School of Medicine
Objective The aim of this study was to investigate educational differences in treatment responses to memory, reasoning, and speed of processing cognitive training relative to no-contact control. Methods Secondary analyses of the Advanced Cognitive Training for Independent and Vital Elderly trial were conducted. Two thousand eight hundred older adults were randomized to memory, reasoning, or speed of processing training or no-contact control. A repeated-measures mixed-effects model was used to investigate immediate post-training and 1-year outcomes with sensitivity analyses out to 10 years. Outcomes were as follows: (1) memory composite of Hopkins Verbal Learning Test, Rey Auditory Verbal Learning Test, and Rivermead Behavioral Memory Test; (2) reasoning composite of letter series, letter sets, and word series; and (3) speed of processing measured using three trials of useful field of view and the digit symbol substitution test. Results The effects of reasoning and memory training did not differ by educational attainment. The effect of speed of processing training did. Those with fewer than 12 years of education experienced a 50% greater effect on the useful field of view test compared with those with 16 or more years of education. The training advantage for those with fewer than 12 years of education was maintained to 3 years post-training. Conclusion Older adults with less than a secondary education are at elevated risk of dementia, including Alzheimer's disease. The analyses here indicate that speed of processing training is effective in older adults with low educational attainment.
Engaging Older Adults in the Participatory Design of Intelligent Health Search Tools
(ACM, 2018-05) Martin-Hammond, Aqueasha; Vemireddy, Sravani; Rao, Kartik; BioHealth Informatics, School of Informatics and Computing
Engaging older adults (adults 65+) in technology design can be challenging. At the same time, it is becoming ever more important to ensure inclusion of diverse perspectives in design research. Several strategies currently exist for successfully recruiting and engaging older adults in design. However, there is still much to learn about how to effectively engage older adults in the design process. In this position paper, we reflect on our experiences engaging older adults in participatory design of "smart" tools for health information search. We share our study design, including our recruitment process and procedures. We then discuss the strategies we used in the design process and challenges we encountered when designing and implementing our research protocol. We contribute our experiences in an effort to facilitate discussion of strategies and opportunities for including older adults in design research.
Evaluating the Implementation of Virtual Reality to Improve the Quality of Life of Individuals with Dementia
(2023-05) Long, Ryane; Sego, Daniel; Department of Occupational Therapy, School of Health and Human Sciences; Smith, Jessica
Falls are the leading cause of morbidity and disability in the geriatric population. Although falls and fall-related injuries are highly prevalent, they are preventable. Through research, virtual reality has been identified as a promising tool used in cognitive and physical assessments and therapeutic interventions. The goal of the capstone project was to gain clinical knowledge and hands-on experience related to program development and the implementation of novel therapeutic technology, consisting of virtual reality (VR) during therapy treatment sessions. Additionally, the student analyzed and addressed cultural and economical facility specific barriers to the implementation of facility-wide programming with the goal of decreasing falls and improving the quality of life of the residents with cognitive deficits. Although the product quality and logistical barriers observed limited the use of MyndVR as a clinical tool, the project results found the use of virtual reality with the geriatric population to have positive outcomes. The capstone student led an in-service where the project findings were presented and the therapists were educated on other virtual reality devices and important features offered on more established systems. Additionally, a quick-start guide was created to increase the competence and confidence of staff members while operating the MyndVR system. The therapists at Heritage Pointe were receptive to the information presented and the resource created based on the increased confidence demonstrated through the survey results.
Fall Prevention at a Local Fitness Center
(2022-05-01) Parker, Kirsten; Bednarski, Julie; Department of Occupational Therapy, School of Health and Human Sciences; Armstrong, Isabel
Abstract Falls are the leading cause of fatal and nonfatal injuries in adults over the age of 65 with 1 in 4 experiencing a fall in their lifetime (Stark et al., 2018). With a growing number of community-dwelling older adult clientele returning to the gym following the Covid-19 pandemic, the leadership at a fitness center in Fishers, IN found a gap in their services. A collaboration began between an Indiana University Doctor of Occupational Therapy capstone student and this a fitness center in Fishers, IN club to develop and implement an evidence-based fall prevention program through an occupational therapy lens to meet the needs of the older adult clients at a fitness center in Fishers, IN An eight-week program was administered, and results suggest an increase in group members’ balance-related self-confidence scores utilizing the Activities-specific Balance Confidence (ABC) Scale as a pre and posttest. Program satisfaction was measured through use of a nonstandardized survey and analyzed for sustainability purposes of the program.
Greater functional aerobic capacity predicts more effective pain modulation in older adults
(Office of the Vice Chancellor for Research, 2016-04-08) Ohlman, Tom; Naugle, Keith; Keith, NiCole; Riley, Zachary; Naugle, Kelly M.
Endogenous pain inhibitory and facilitory function deteriorates with age, potentially placing older adults at greater risk for chronic pain. Prior research shows that self-reported physical activity predicts endogenous pain inhibitory capacity and facilitation of pain on quantitative sensory tests (QST) in healthy adults. Purpose: To investigate whether functional aerobic capacity and lower extremity strength in older adults cross-sectionally predicts pain sensitivity, pain inhibition following isometric exercise, and facilitation of pain during heat pain temporal summation (TS) tests. Methods: 42 subjects (10 male, 32 female, age=67.5±5.1) completed the 6-minute walk test (6MWT), 30-second chair stand test, and several QSTs. QSTs included: 1) Pain ratings (0-100 scale) during the submersion of the hand in a cold water bath (CWB), 2) heat pain threshold tests, 3) the amount of pain reduction following submaximal isometric exercise, and 4) degree of pain facilitation during temporal summation tests conducted at 44, 46, and 48°C. Responses on the QSTs were analyzed using hierarchical linear regression with meters on 6MWT and number of chair stands as final predictors. Results: After controlling for demographic and psychological factors, aerobic capacity on 6MWT significantly predicted CWB pain ratings (R2 change= 22.5%, Beta= -0.491), pain facilitation during TS trials at 44°C (R2 change= 16.7%, Beta= -0.446), and the amount of pain reduction following isometric exercise (R2 change= 20.7%, Beta= 0.393). All other analyses were not significant (P>0.05). Conclusions: Older adults exhibiting greater functional aerobic capacity displayed reduced cold pain sensitivity, reduced pain facilitory function, and increased pain inhibition following exercise. These findings suggest that increased aerobic fitness in older adults may be associated with more effective endogenous modulation of pain. This study was funded by the IUPUI School of PETM Faculty Research Opportunity Grant.
How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement
(Karger, 2020) Paris, Sebastian; Banerjee, Avijit; Bottenberg, Peter; Breschi, Lorenzo; Campus, Guglielmo; Doméjean, Sophie; Ekstrand, Kim; Giacaman, Rodrigo A.; Haak, Rainer; Hannig, Matthias; Hickel, Reinhard; Juric, Hrvoje; Lussi, Adrian; Machiulskiene, Vita; Manton, David; Jablonski-Momeni, Anahita; Santamaria, Ruth; Schwendicke, Falk; Splieth, Christian H.; Tassery, Hervé; Zandona, Andrea; Zero, Domenick; Zimmer, Stefan; Opdam, Niek; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
Aim: To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. Methods: A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. Results: Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient’s individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual.
Increased Sensitivity to Physical Activity in Healthy Older Adults Predicts Worse Pain and Functional Outcomes
(Office of the Vice Chancellor for Research, 2016-04-08) Miller, Leah K.; Naugle, Kelly M.
Prior research indicates older adults with knee osteoarthritis (OA) have increased sensitivity to physical activity (SPA) and respond to physical activities of stable intensity with increases in pain. SPA predicted self-reported pain and function in older adults with knee OA. It is unknown whether SPA is present in healthy older adults without chronic pain and predicts functional outcomes. The purpose of this study was to determine if SPA in response to a standardized 6-minute Walk Test cross-sectionally predicted selfreported pain, physical function, and physical activity behaviors in healthy older adults. Forty-two older adults (age=67.5±5 years) completed the Pain subscale of the Quality of Well Being scale (QWB–measures the frequency and severity of pain during common daily activities), the Short Form Health Survey (SF-36–measure of physical function), the 6-Minute Walk Test (6MWT), and wore an accelerometer on the hip for 7 days. Subjects rated overall bodily discomfort (0-100 scale) prior to and during each minute of the 6MWT. RPE was recorded at the end of the walk. An SPA index was created by subtracting the initial bodily discomfort ratings from the peak ratings. Average moderate to vigorous physical activity/day (MVPA) and steps/day were recorded from the accelerometer. Dependent variables were analyzed with hierarchical linear regressions with SPA as the final predictor. Sixty percent of older adults experienced SPA (SPA=9.5±15.6). After accounting for age, sex, BMI, and meters walked on the 6MWT, SPA significantly predicted steps and MVPA per day, RPE on the 6MWT, and severity and frequency of activity related pain on the QWB scale. These results revealed that increased SPA in healthy older adults was associated with fewer steps and MVPA per day, greater exertion on 6MWT, and greater self-reported activity-related pain. This study was funded by the IUPUI School of PETM Faculty Research Opportunity Grant.

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