Resilience, Mental Health, Sleep, and Smoking Mediate Pathways Between Lifetime Stressors and Multiple Sclerosis Severity.

Introduction: Lifetime stressors (e.g., poverty, violence, discrimination) have been linked to features of multiple sclerosis (MS); yet mechanistic pathways and relationships with cumulative disease severity remain nebulous.

Resilience, mental health, sleep, and smoking mediate pathways between lifetime stressors and Multiple Sclerosis severity.

Intro: Lifetime stressors (e.g., poverty, violence, discrimination) have been linked to Multiple Sclerosis (MS) features; yet mechanistic pathways and relationships with cumulative disease severity remain nebulous.

Fatigue, pain interference, and psychiatric morbidity in multiple sclerosis: The role of childhood stress.

Background: Multiple sclerosis (MS) is a progressive, autoimmune disease of the central nervous system that affects nearly one million Americans. Despite the existence of immunomodulatory therapies to slow physical and cognitive disability progression, interventions to ameliorate common symptoms of MS, including fatigue and pain, remain limited. Poor understanding of risk factors for these symptoms may contribute to treatment challenges.

Changes in Care Use and Financial Status Associated With Dementia in Older Adults.

Importance: Estimating the effects of dementia on care use and financial outcomes is timely, as the population with dementia will more than double in the next few decades.

Objective: To determine the incremental changes associated with dementia in regard to older adults' care use and assess financial consequences for individuals, families, and society.

Design, Setting, And Participants: This population-based cohort study included propensity score matching on national, longitudinal data using extensive baseline variables of sociodemographic characteristics, economic status, family availability, health conditions, disability status, and outpatient care use among 2 groups of US adults aged 55 years or older who did not have dementia.

Associations among stressors across the lifespan, disability, and relapses in adults with multiple sclerosis.

Introduction: Stress and adversity during childhood, adolescence, and adulthood could impact the present and future health and well-being of people with multiple sclerosis (PwMS); however, a lifespan approach and nuanced stressor data are scarce in this nascent area of research. Our aim was to examine relationships among comprehensively measured lifetime stressors and two self-reported MS outcomes: (1) disability and (2) relapse burden changes since COVID-19 onset.

Methods: Cross-sectional data were collected from a nationally distributed survey of U.

Heart Disease Self-management for African American Older Adults: Outcomes of an Adapted Evidence-Based Intervention.

Background And Objectives: To assess the impact of an evidence-based self-management intervention adapted through a community-engaged process for African American midlife and older adults with heart disease and/or cardiovascular risk factors.

Research Design And Methods: Adults 50 years and over, living in or near Detroit, MI, with diagnosed heart disease or greater or equal to two major risk factors for heart disease, were randomized to a 7-week group-format program called , or a usual-care control group. included education about heart disease and support for behavioral lifestyle change, using a goal-setting process based on self-regulation theory.

Mood Lifters for Seniors: Development and Evaluation of an Online, Peer-Led Mental Health Program for Older Adults.

Effective, scalable mental health programs are greatly needed for older adults. In this study, Mood Lifters-a peer-led, community-based program promoting mental well-being-was adapted to more specifically address the needs of older adults. Two groups completed the 14-week program via Zoom.

Exploring dementia care in acute care settings: Perspectives of nurses and social workers on caring for patients with behavioral and psychological symptoms.

This qualitative study compares perspectives of nurses (n = 5) and social workers (n = 12) about their role in caring for patients with dementia with behavioral and psychological problems in an acute care setting. A thematic qualitative analysis was conducted using the Rigorous and Accelerated Data Reduction Technique (RADaR). Three themes emerged: engagement of the patient and coordination with family and professionals, treatment and medical management of behavioral and psychological symptoms of dementia (BPSD) in the hospital, and barriers to care.

Family Care Availability And Implications For Informal And Formal Care Used By Adults With Dementia In The US.

Despite the important role that family members can play in dementia care, little is known about the association between the availability of family members and the type of care, informal (unpaid) or formal (paid), that is actually delivered to older adults with dementia in the US. Using data about older adults with dementia from the Health and Retirement Study, we found significantly lower spousal availability but greater adult child availability among women versus men, non-Hispanic Blacks versus non-Hispanic Whites, and people with lower versus higher socioeconomic status. Adults with dementia and disability who have greater family availability were significantly more likely to receive informal care and less likely to use formal care.

The Role of Pets in Supporting Cognitive-Behavioral Chronic Pain Self-Management: Perspectives of Older Adults.

Cognitive-behavioral self-management strategies are recommended for older adults with chronic pain. The goal of this study was to explore how pet ownership promotes use of these strategies in everyday life. We conducted four focus groups ( = 25) with dog and cat owners aged ≥70 years with persistent pain.

Dementia Care Across a Tertiary Care Health System: What Exists Now and What Needs to Change.

Objectives: This study explored the process of care for persons living with dementia (PLWDs) in various care settings across a tertiary care system and considers challenges and opportunities for change.

Design: Aimed at quality improvement, qualitative interviews were conducted with key stakeholders in dementia care across geriatric outpatient clinics, medical and psychiatric emergency departments, and the main hospital in 2016.

Setting And Participants: Forty-nine interactive interviews were conducted with a purposive and snowball sampling of health care professionals (physicians, nurses, social workers, administrators) and families in a large, academic health care system.

Comparison of Recruitment Strategies for Engaging Older Minority Adults: Results From Take Heart.

Background: Few published studies report lessons learned for recruiting older adults from racial/ethnic minority, low SES communities for behavioral interventions. In this article, we describe recruitment processes and results for Take Heart, a randomized controlled trial testing the effectiveness of an adapted heart disease self-management program for primarily African American, urban, low SES adults 50 years or older living in Detroit.

Methods: Older adults were recruited via community-based (CB), electronic medical record (EMR), and in-person hospital clinic (HC) methods.

Retaining identity: Creativity and caregiving.

Arts programming for people living with dementia and their caregivers has gained popularity as a way to provide opportunities for social interaction, expression, and continual learning. The goal of the present study, referred to as Retaining Identity: Creativity & Caregiving is to: (1) describe the process of designing and implementing a structured art experience for people living with memory loss and their co-residing caregiver; and (2) to summarize feedback provided by caregivers at the conclusion of the program. Retaining Identity is an eight-week program offered by professional artists who instructed dementia caregivers in four visual art activities, which they then taught to their care recipient.

Using the Replicating Effective Programs Framework to Adapt a Heart Health Intervention.

Heart disease is the leading cause of death in the United States. African Americans and people of low socioeconomic status suffer disproportionately from heart disease-related morbidity and mortality. In Detroit, Michigan, a primarily African American and low-income urban area, heart disease mortality is at twice the national rate.

The Influence of Psychosocial and Cognitive Factors on Perceived Threat of Alzheimer's Disease.

This study explored psychosocial and cognitive predictors of perceived threat of Alzheimer's disease (AD). Respondents were 1641 adults (mean age: 64.4; 54% female; 82% white) who completed a module in the Health and Retirement Study, a nationally representative survey of adults aged ≥50.

How Efficacious Are Patient Education Interventions to Improve Bowel Preparation for Colonoscopy? A Systematic Review.

Background: Bowel preparation is inadequate in a large proportion of colonoscopies, leading to multiple clinical and economic harms. While most patients receive some form of education before colonoscopy, there is no consensus on the best approach.

Aims: This systematic review aimed to evaluate the efficacy of patient education interventions to improve bowel preparation.

Paradox of Prescribing Late Chemotherapy: Oncologists Explain.

Purpose: The value of chemotherapy for patients with cancer in the last weeks of life warrants examination. Late chemotherapy may not improve survival or quality of life but typically precludes hospice enrollment and may result in additional symptoms, increased use of other aggressive treatments, and worsening quality of life. Few studies have explored oncologists' rationales for administering chemotherapy near death.

The Influence of the Transportation Environment on Driving Reduction and Cessation.

Purpose Of The Study: Driving is by far the most common mode of transportation in the United States, but driving ability is known to decline as people experience age-related functional declines. Some older adults respond to such declines by self-limiting their driving to situations with a low perceived risk of crashing, and many people eventually stop driving completely. Previous research has largely focused on individual and interpersonal predictors of driving reduction and cessation (DRC).

Oncologists' End of Life Treatment Decisions.

Background: Optimal treatment decisions for older end-stage cancer patients are complicated, and are influenced by oncologists' attitudes and beliefs about older patients. Nevertheless, few studies have explored oncologists' perspectives on how patient age affects their treatment decisions.

Methods: In-depth interviews were conducted with 17 oncologists to examine factors that influence their chemotherapy decisions for adults with incurable cancer near death.

Gender Differences in Trajectories of Physical Activity Among Older Americans With Diabetes.

Objective: The primary objective of this study was to examine gender differences in engagement in physical activity over time among older U.S. adults with diabetes.

Older adults' driving reduction and cessation: perspectives of adult children.

Purpose Of The Study: Adult children are often directly affected by aging parents' decision to limit or stop driving. This qualitative study examined the process of driving reduction and cessation (DRC) from the perspective of adult children, with a focus on family communication.

Design And Methods: Four focus group interviews were conducted with 37 adult children (29/37 female; mean age = 45.

Public beliefs and knowledge about risk and protective factors for Alzheimer's disease.

Background: The purpose of this study was to assess public beliefs and knowledge about risk and protective factors for Alzheimer's disease (AD).

Methods: A brief survey module was added to the Health and Retirement Study, a longstanding national panel study of the U.S.

Current and potential support for chronic disease management in the United States: the perspective of family and friends of chronically ill adults.

Family members and friends can be an important source of self-management support for older adults with chronic diseases. We characterized the U.S.

The association of diabetes complications with physical activity in a representative sample of older adults in the United States.

OBJECTIVE Most adults with diabetes do not engage in the level of physical activity recommended for optimal disease management. Diabetes complications are not generally considered a clinical contraindication to exercise. No prior national studies have examined the associations of these complications with physical activity.