Clinical Gerontologist最新文献

{"title":"The Effect of Cannabidiol 3% on Neuropsychiatric Symptoms in Dementia - Six-Month Follow-Up.","authors":"Foteini Alexandri, Lydia Papadopoulou, Anthoula Tsolaki, Georgia Papantoniou, Loukas Athanasiadis, Magda Tsolaki","doi":"10.1080/07317115.2023.2209563","DOIUrl":"10.1080/07317115.2023.2209563","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the beneficial outcomes of giving cannabidiol (CBD) 3% over a six-month period in the BPSD, the management of which is a crucial issue for everyday clinical praxis and to compare the progress in BPSD of patients who receive Cannabidiol 3% with those who follow usual medical treatment (UMT) in everyday clinical praxis.</p><p><strong>Methods: </strong>A total of 20 PwD with severe BPSD were recruited from the database of Alzheimer Hellas with NPI score >30. Ten of them were assigned to UMT, while ten were assigned to a six-month treatment with CBD drops. The follow-up assessment was performed with NPI, both clinically and by structured telephone interview.</p><p><strong>Results: </strong>The follow-up assessment with NPI showed significant improvement of the BPSD in all our patients who received CBD, and no or limited improvement in the second group, regardless of the underlying neuropathology of dementia.</p><p><strong>Conclusions: </strong>We suggest that CBD may be a more effective and safe choice for managing BPSD than the typical intervention. Future large randomized clinical trials are needed to re-assure these findings.</p><p><strong>Clinical implications: </strong>Healthcare professionals should consider incorporating CBD 3% into their practices to reduce BPSD in PwD. Regular assessments are necessary to ensure long-term effectiveness.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"800-807"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9486710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dementia, Caregiving, and Long-Term Care.","authors":"Jennifer Moye","doi":"10.1080/07317115.2024.2387916","DOIUrl":"https://doi.org/10.1080/07317115.2024.2387916","url":null,"abstract":"","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":"47 5","pages":"661-664"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of the Effectiveness of Educational Interventions in Promoting Person-Centred Care in Dementia Services.","authors":"Chiara Carparelli, Christopher Jones, Jan R Oyebode, Gerard A Riley","doi":"10.1080/07317115.2022.2152515","DOIUrl":"10.1080/07317115.2022.2152515","url":null,"abstract":"<p><strong>Objectives: </strong>To review evidence about the effectiveness of educational programmes in promoting the delivery of person-centered care by staff in dementia services.</p><p><strong>Methods: </strong>Several databases were searched, and the methodological quality of identified studies systematically evaluated. A summary mean effect size was calculated for several types of outcome (direct knowledge, applied knowledge, attitudes, self-reported and observed working practices).</p><p><strong>Results: </strong>Eighteen studies were identified. Results were mixed, with findings of no change, significant improvement, and (in attitude) significant deterioration. Effect size was modest for direct knowledge (standardized mean difference = 0.6), but small or negligible for applied knowledge (0.29) and self-reported (0.06) and observed (0.25) working practices. There was a negative effect for attitudes (-0.17).</p><p><strong>Conclusions: </strong>The quality of evidence was poor. Apart from attitudes, the effect sizes are likely to be overestimates. There was little evidence that education programmes can reliably produce substantial improvements in working practices.</p><p><strong>Clinical implications: </strong>Education alone is unlikely to be sufficient for establishing high standards of person-centered care in services. It needs to be supplemented by steps to ensure that staff develop skills in delivering such care in practice, and by organizational support to ensure staff have sufficient motivation, cues and opportunities for implementation.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"665-683"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10418070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General and Specific Quality of Life Course of Individuals with Different Levels of Stroke Severity: A One-Year Prospective Longitudinal Study.","authors":"Marcela Aline Fernandes Braga, Iza Faria-Fortini, Kênia Kiefer Parreiras de Menezes, Jéssica Melo Santos, Nathália Aparecida Gravito Rodrigues, Edvânia Andrade de Moura Silva, Christina Danielli Coelho de Morais Faria","doi":"10.1080/07317115.2024.2366833","DOIUrl":"10.1080/07317115.2024.2366833","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the course of generic and specific health-related quality of life (HRQOL) of individuals with stroke, and its physical, mental, and social domains, at three, six, and 12 months after hospital discharge, considering the levels of stroke severity.</p><p><strong>Methods: </strong>This is a longitudinal study, in stroke individuals, assessed during hospital admission by the National Institutes of Health Stroke Scale (NIHSS), and divided into mild (NIHSS ≤3) or moderate/severe (NIHSS ≥4) disease. At three, six, and 12 months after hospital discharge, the individuals were assessed for generic (Short Form Health Survey-36: total score and physical and mental domains) and specific (Stroke Specific Quality of Life Scale: total score and social domain) HRQOL. A 2 × 2 repeated measures analysis of variance (ANOVA) with post-hoc was applied.</p><p><strong>Results: </strong>146, 122, and 103 individuals were assessed at three, six and 12 months, respectively HRQOL courses showed different behaviors according to stroke severity (3.37≤<i>F</i> ≤ 4.62; 0.010≤<i>p</i> ≤ .036). Individuals with mild stroke showed significant changes in the physical domain, with a reduction between three and six months, and an increase between six and 12. Moderate/severe individuals showed a significant increase in all HRQOL variables between three and six months, and a maintenance of values for almost all variables, except for physical domain, which improved significantly between three and six months, and got significantly worse between six and 12.</p><p><strong>Conclusions: </strong>HRQOL during the first year after stroke showed distinct trajectories, being stroke severity an important factor in identifying stroke subjects at risk of HRQOL decline.</p><p><strong>Clinical implications: </strong>These results demonstrate the importance of considering not only the phase of the stroke, the severity, and the general and specific HRQOL, but also the physical, social, and mainly the mental domain, which has long been neglected, when assessing this population.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"1008-1020"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging Sexual and Gender Minority Older Adults to Elicit Concerns and Recommendations for Communicating Care Preferences in Long-Term Care: Focus Group Findings.","authors":"Kristin G Cloyes, Gail L Towsley","doi":"10.1080/07317115.2023.2213682","DOIUrl":"10.1080/07317115.2023.2213682","url":null,"abstract":"<p><strong>Objectives: </strong>1) Describe sexual and gender minority (SGM) older adults' current practices and concerns for communicating end-of-life (EOL) and daily care preferences in long-term care (LTC); 2) Elicit ideas about adapting a video-based intervention to facilitate communication.</p><p><strong>Methods: </strong>After consulting a community advisory board, we conducted two focus groups with SGM older adults ≥55 years of age recruited from a community-based service organization (<i>n</i> = 4) and a continuing care retirement community (<i>n</i> = 9). We audio-recorded, transcribed, and coded data using directed content analysis methods and summarized results descriptively.</p><p><strong>Results: </strong>Most participants were cisgender (<i>n</i> = 12), female (<i>n</i> = 11), lesbian (<i>n</i> = 10), White and non-Hispanic (<i>n</i> = 13); mean age was 70.62. Participants' concerns included discrimination, autonomy, chosen family, and community; they linked daily care preferences with personhood and quality of life. They advocated for building intentional community-based support networks to help peers discuss preferences and produce videos before LTC transition and ensure compliance after.</p><p><strong>Conclusions: </strong>For SGM older adults, asserting and protecting their full personhood, through daily care preferences, is essential to quality of life in LTC.</p><p><strong>Clinical implications: </strong>Video-recorded statements of daily preferences, facilitated and supported by a peer network, could promote culturally competent, person- and community-centered care for SGM older adults in LTC settings.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"950-961"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9524745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Photo Captioning Cognitive Empathy Intervention for Dementia Caregivers.","authors":"James K Rilling, Minwoo Lee, Julie McIsaac, Sophie Factor, Paige Gallagher, Joseph H Kim, Jiajin Zhang, Carolyn Zhou, Thomas W McDade, Kenneth Hepburn, Molly M Perkins","doi":"10.1080/07317115.2024.2317972","DOIUrl":"10.1080/07317115.2024.2317972","url":null,"abstract":"<p><strong>Objectives: </strong>The goal of this study was to develop and evaluate an intervention aimed at increasing cognitive empathy, improving mental health, and reducing inflammation in dementia caregivers, and to examine the relevant neural and psychological mechanisms.</p><p><strong>Methods: </strong>Twenty dementia caregivers completed an intervention that involved taking 3-5 daily photographs of their person living with dementia (PLWD) over a period of 10 days and captioning those photos with descriptive text capturing the inner voice of the PLWD. Both before and after the intervention, participants completed questionnaires, provided a blood sample for measures of inflammation, and completed a neuroimaging session to measure their neural response to viewing photographs of their PLWD and others.</p><p><strong>Results: </strong>87% of enrolled caregivers completed the intervention. Caregivers experienced pre- to post-intervention increases in cognitive empathy (i.e. Perspective-Taking) and decreases in both burden and anxiety. These changes were paralleled by an increased neural response to photographs of their PLWD within brain regions implicated in cognitive empathy.</p><p><strong>Conclusion: </strong>These findings warrant a larger replication study that includes a control condition and follows participants to establish the duration of the intervention effects.</p><p><strong>Clinical implications: </strong>Cognitive empathy interventions may improve caregiver mental health and are worthy of further investigation.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"832-845"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139899443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Transition of Older Adults into Residential Aged Care: A Scoping Review.","authors":"Stacey Scott, Annette Raynor, Julie Dare, Jennifer Grieve, Leesa Costello","doi":"10.1080/07317115.2023.2274042","DOIUrl":"10.1080/07317115.2023.2274042","url":null,"abstract":"<p><strong>Objectives: </strong>The transition into residential aged care (RAC) is often associated with loss, grief, isolation and loneliness. This scoping review aimed to identify quantitative research which focused on reducing the negative effects associated with transition, thereby improving the transition experience.</p><p><strong>Methods: </strong>A scoping review, which concentrated on quantitative research, was conducted. MEDLINE, CINAHL andPSYCHINFO databases were searched using the initial search terms \"olderadults\", \"residential aged care\" and \"transition\".</p><p><strong>Results: </strong>From the 457 original citations identified, four met the inclusion criteria. The interventions used a range of professionals and clinicians, diverse content, and a mixture of outcomes. The content of the more successful studies were underpinned by mental wellness themes and helped to reduce depressive symptoms among new residents.</p><p><strong>Conclusions: </strong>Our review provides a summary of interventions aimed at improving the transition experience for older adults moving into RAC and highlights gaps in the literature. This review is limited by the paucity of quantitative research in this area. Further research is required to address the negative psychosocial effects associated with transition into RAC.</p><p><strong>Clinical implications: </strong>Assessing which of the transition phases an individual is in can help individualize interventions to reduce negative symptoms relating to transition.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"746-759"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver Preparedness: A Therapeutic Mechanism and Moderating Factor on Outcomes for the Savvy Caregiver Program.","authors":"Daniel Paulson, Nicole McClure, Tracy Wharton, Edith Gendron, Quinn Allen, Hanya Irfan","doi":"10.1080/07317115.2023.2242357","DOIUrl":"10.1080/07317115.2023.2242357","url":null,"abstract":"<p><strong>Objectives: </strong>Evidence-based interventions for dementia caregivers, such as the Savvy Caregiver Program (SC), seek to address skills and knowledge deficits, caregiver burden, depressive symptoms, and grief. Little research has examined mechanisms by which these interventions accomplish their goals. Caregiver preparedness may be a possible mechanism by which caregiver interventions may confer benefits.</p><p><strong>Methods: </strong>The sample included 76 dementia caregivers who completed the 6-session SC. Participants completed the Anticipatory Grief Scale, Center for Epidemiological Studies-Depression Scale, the Preparedness for Caregiving Scale, and the Zarit Burden Interview-Short Form.</p><p><strong>Results: </strong>A repeated measures ANOVA was utilized to determine the interaction between baseline scores and pre-post change in caregiver preparedness. Analysis significantly predicted caregiver burden, (<i>F</i>₍₁₎ = 6.68, <i>p</i>=.012, <i>partial η</i>^<i>2</i>=.10), depressive symptom endorsement, (<i>F</i>₍₁₎ = 6.41, <i>p</i>=.014, <i>partial η</i>^<i>2</i>=.09, and anticipatory grief, (<i>F</i>₍₁₎ = 6.22, <i>p</i>=.02, <i>partial η</i>^<i>2</i>=.1), post-treatment.</p><p><strong>Conclusions: </strong>Pre-post change in caregiver preparedness significantly predicted pre-post change across measures of caregiver burden, depressive symptom endorsement, and anticipatory grief. Findings suggest that caregiver preparedness may be one mechanism by which the SC confers positive outcomes. These findings provide an empirical and theoretical basis for tailoring future dementia caregiver interventions.</p><p><strong>Clinical implications: </strong>Clinical Interventions may seek to improve caregiver preparedness and subsequent outcomes through utilization of programs like SC.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"870-884"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10296230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the Person-Centered Care to Manage Responsive Behaviors in Clients with Major Neurocognitive Disorders: A Qualitative Single Case Study.","authors":"Sareh Zarshenas, Carmela Paulino, Isabelle Sénéchal, Josianne Décary, Audrey Dufresne, Anne Bourbonnais, Chloé Aquin, Marie-Andrée Bruneau, Nathalie Champoux, Patricia Belchior, Melanie Couture, Nathalie Bier","doi":"10.1080/07317115.2022.2162468","DOIUrl":"10.1080/07317115.2022.2162468","url":null,"abstract":"<p><strong>Objectives: </strong>Our study aimed to describe \"how\" and \"why\" the person-centered care (PCC) approach was applied within a long-term care (LTC) community to manage responsive behaviors (RBs) in individuals with major neurocognitive disorders.</p><p><strong>Methods: </strong>A descriptive holistic single case study design was employed in the context of an LTC community in Quebec, using semi-structured interviews and non-participatory observations of experienced care providers working with clients with RBs, photographing the physical environment, and accessing documents available on the LTC community's public website. A thematic content analysis was used for data analysis.</p><p><strong>Results: </strong>The findings generated insight into the importance of considering multiple components of the LTC community to apply the PCC approach for managing RBs, including a) creating a homelike environment, b) developing a therapeutic relationship with clients, c) engaging clients in meaningful activities, and d) empowering care providers by offering essential resources.</p><p><strong>Conclusions: </strong>Applying and implementing the PCC approach within an LTC community to manage clients' RBs is a long-term multi-dimensional process that requires a solid foundation.</p><p><strong>Clinical implications: </strong>These findings highlight the importance of considering multiple factors relevant to persons, environments, and meaningful activities to apply the PCC approach within LTC communities to manage RBs.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"922-934"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10465500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Impacts of Social Participation Activities on Cognitive and Psychopathological Statuses in Community-Dwelling Older Adults.","authors":"Kai-Chieh Chang, Hsin-Shui Chen, Chi-Shin Wu, Chin-Kai Chang, Juey-Jen Hwang, Su-Hua Huang, Yung-Ming Chen, Bor-Wen Cheng, Min-Hsiu Weng, Chih-Cheng Hsu, Wei-Lieh Huang","doi":"10.1080/07317115.2024.2374518","DOIUrl":"10.1080/07317115.2024.2374518","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the impact of social activities on cognitive functioning and psychopathological symptoms.</p><p><strong>Methods: </strong>Participants aged 55 or older were enrolled through communities. Initial measures assessed demographic data, neuropsychological functioning, psychopathological state, and happiness. Social activities were evaluated using a modified 12-item tool, with 3-4 activities as the cutoff. Follow-up after 6-9 months included Mini-Mental State Examination (MMSE), Beck Depression Inventory - II (BDI-II), Beck Anxiety Inventory (BAI), Health Assessment Questionnaire (HAQ), and Patient Health Questionnaire-15 (PHQ-15) measurements. Predictive models for psychiatric and cognitive statuses were built using multiple linear regression, adjusting for baseline conditions.</p><p><strong>Results: </strong>Initially, 516 older individuals enrolled, with 403 undergoing follow-up. During follow-up, the low participation group reported lower MMSE scores, higher BAI scores, and increased PHQ-15 risk. Negative correlations between social activity numbers and PHQ-15 results were found. Engagement in social clubs correlated positively with higher MMSE scores, while regular interactions with one's adult child(ren) were linked to decreased BAI scores.</p><p><strong>Conclusions: </strong>The quantity of social activities was associated with lower somatic distress. Social club engagement positively influenced cognition, and regular interactions with one's adult child(ren) mitigated anxiety among older individuals.</p><p><strong>Clinical implications: </strong>Enough types of social activities, participating in social clubs, and adequate interactions with children protected against psychopathologies.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"996-1007"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}