ABSTRACT
OBJECTIVE: The aim of this study was to understand the relationships among depressive symptoms, cognition, and functional performance in a community-based sample of older adults. METHOD: Older adults ( N = 885) from the Staying Keen in Later Life study completed tests of executive function, speed of processing, and memory. The Center for Epidemiologic Depression Scale assessed depressive symptoms. The Timed Instrumental Activities of Daily Living Test assessed participants' everyday functional performance. RESULTS: Depressive symptoms had significant associations with measures of executive function, speed of processing, memory, and everyday functional performance. Cognitive performance completely mediated the association between depressive symptoms and everyday function. DISCUSSION: Among community-dwelling older adults, depressive symptoms were associated with impaired cognition across multiple domains, which detrimentally affected everyday function. Health care providers should be aware of these associations to monitor and manage changes in depressive symptoms and cognitive performance and thereby potentially mitigate functional decline.
Subject(s)
Activities of Daily Living , Cognition , Depression/physiopathology , Independent Living , Aged , Executive Function , Female , Geriatric Assessment , Humans , Male , Neuropsychological Tests , Self ReportABSTRACT
OBJECTIVES: Antipsychotic medications have been federally regulated since 1987, yet research suggests they continue to be used inappropriately to alleviate behavioral symptoms associated with dementia. In 2012, the Centers of Medicare and Medicaid launched a new initiative to reduce antipsychotic medication in nursing homes by 15% nationally. The aim of this study was to examine qualitative data to explore strategies that have been implemented, to assess which strategies are evidence-based, and to make recommendations to improve upon practices to reduce antipsychotic medication use. METHOD: A convenience sample of 276 nursing home professional staff members were surveyed about these topics using open-ended questions. RESULTS: Theme-based content analysis yielded three main themes. The themes related to changes in practice included the following: (1) increased review of resident behavior and antipsychotic medication regimens; (2) reduction in antipsychotic medications or dosage; and (3) increased use of nonpharmacological interventions. The main themes relevant to needed assistance included the following: (1) education; (2) clinical support; and (3) increased financial resources and reimbursement. DISCUSSION: Overall findings indicate that the majority of facilities are actively responding to the initiative, but challenges remain in education, finding mental health support, and in reimbursement.
Subject(s)
Antipsychotic Agents/therapeutic use , Dementia/drug therapy , Health Care Surveys , Homes for the Aged/organization & administration , Inappropriate Prescribing , Nursing Homes/organization & administration , Attitude of Health Personnel , Florida , Health Knowledge, Attitudes, Practice , Humans , Insurance, Health, Reimbursement/statistics & numerical data , Male , Medicaid/economics , Medicaid/statistics & numerical data , Medicare/statistics & numerical data , Middle Aged , Practice Patterns, Physicians' , Qualitative Research , Surveys and Questionnaires , United StatesABSTRACT
OBJECTIVE: Cognitive deficits pose serious problems for older adults with heart failure (HF). Cognitive speed of processing training improves cognition among older adults but has not been examined among older adults with HF. METHOD: Data from the ACTIVE study were used to examine the effects of cognitive speed of processing training on cognitive and functional performance among older adults with HF. RESULTS: Of the 54 participants included in the analyses, 23 who were randomized to cognitive training performed significantly better on a composite of everyday speed of processing from pre- to post-training compared with 31 participants who were randomized to the control group, F(1, 51) = 28.67, p ≤ .001, [Formula: see text] = .360. DISCUSSION: Results indicate that speed of processing training may improve everyday cognitive performance among older adults with HF. Future studies should investigate the longitudinal effects of cognitive training with HF patients.
ABSTRACT
The University of South Florida's master's degree in gerontology is a long-established program that focuses on a multidisciplinary approach to population aging. This study identifies graduate students' needs in preparation for a professional career in gerontology. An online survey was distributed to graduates and those currently enrolled (N = 56) in order to better understand expectations for the program, identify outcomes of graduation, and obtain program recommendations for future students. The program's 40 year history was well represented with participants ranging from the first graduating class to current students. Results indicated high satisfaction in students' expectations of the program, educational experience, and assessment of faculty. Further, 68% of graduates reported success in gaining age-related employment shortly after graduation. However, students echoed well-known barriers in gerontology, reporting tough competition for jobs versus those with licensure, and challenges in promoting their nonclinical gerontology degree to employers. Respondents recommended more applied coursework and assistance with career planning to enhance employment opportunities upon graduation. Implications of these findings are discussed in further detail.
