Changes in Physical and Cognitive Function Predict Sedentary Behavior in Older Adults With Mild Cognitive Impairment.

The current longitudinal study examined the influence of cognitive and lower extremity function on sedentary behavior continuously over 6 months in community-dwelling older adults with mild cognitive impairment (MCI). Multilevel models examined Montreal Cognitive Assessment (MoCA) change scores and the Short Physical Performance Battery (SPPB) on percent time in sedentary behavior among 17 older adults with MCI (50 to 74 observations for analysis). Sedentary behavior was measured daily and averaged monthly using wrist-worn actigraphy.

Letters from the pandemic: Nursing student narratives of change, challenges and thriving at the outset of COVID-19.

Aim: The aim of this study is to explore the experience of third year baccalaureate nursing students during the outbreak of the COVID-19 pandemic.

Design: Research design is a narrative analysis of archived letters written by nursing students in Spring 2020.

Methods: Letters and other media were written between 1 April and 20 May 2020.

Factors Associated With Health Service Use Among Older Adults in a Mobile Veterans Program.

The current retrospective, longitudinal study applied Andersen's Behavioral Model of Health Services Use to examine how demographic characteristics (age), available resources (e.g., a caregiver, the Mobile Veterans Program [MVP]) and health needs (e.

An observational study of antipsychotic medication use among long-stay nursing home residents without qualifying diagnoses.

Unlabelled: WHAT IS KNOWN ON THE SUBJECT?: In the United States, 15.5% of nursing home residents without qualifying diagnoses of schizophrenia, Huntington's' Disease, and/or Tourette Syndrome receive antipsychotic medications. Antipsychotic medications are used off-label (i.

Physical Function, Relocation, and Mortality Outcomes in Residential Care and Assisted Living Residents.

This study aimed to identify predictors of 6-month physical function and 12-month relocation or death in 272 residents of 34 residential care/assisted communities. Measures collected at baseline, 6, and 12 months included health and demographic characteristics; self-reported pain, fatigue, and depressive symptoms; exercise self-efficacy, barriers, and expectations; attitudes on aging; performance-based physical function and physical activity; and community demographics, programs, and policies. GLIMMIX procedures for regression analyses with community as a random effect were run.

Randomized Trial of Intelligent Sensor System for Early Illness Alerts in Senior Housing.

Objectives: Measure the clinical effectiveness and cost effectiveness of using sensor data from an environmentally embedded sensor system for early illness recognition. This sensor system has demonstrated in pilot studies to detect changes in function and in chronic diseases or acute illnesses on average 10 days to 2 weeks before usual assessment methods or self-reports of illness.

Design: Prospective intervention study in 13 assisted living (AL) communities of 171 residents randomly assigned to intervention (n=86) or comparison group (n=85) receiving usual care.

Assessment of Fall Characteristics From Depth Sensor Videos.

Falls are a major source of death and disability in older adults; little data, however, are available about the etiology of falls in community-dwelling older adults. Sensor systems installed in independent and assisted living residences of 105 older adults participating in an ongoing technology study were programmed to record live videos of probable fall events. Sixty-four fall video segments from 19 individuals were viewed and rated using the Falls Video Assessment Questionnaire.

The Effectiveness of Simulation on Recognizing and Managing Clinical Deterioration: Meta-Analyses.

The purpose of these meta-analyses was to quantitatively synthesize the effectiveness of simulation on student nurses' and registered nurses' ability to recognize and manage clinical deterioration in the acute care setting. A search of the literature resulted in 22 reports and 19 studies meeting inclusion criteria. Four random-effects analyses were conducted to examine two-group posttest and single-group pre-posttest intervention effect sizes for knowledge and performance.

Exploring Path Models of Disablement in Residential Care and Assisted Living Residents.

This study examined the relationships between individual and environmental factors and physical activity, and between physical activity and functional limitations and disability in residential care/assisted living (RC/AL) residents. Participants completed questionnaires and physical performance tests, and wore the Fitbit Motion Tracker® to capture physical activity. Model fit was analyzed using two-level path models with residents nested within RC/AL settings.

Using Embedded Sensors in Independent Living to Predict Gait Changes and Falls.

This study explored using Big Data, totaling 66 terabytes over 10 years, captured from sensor systems installed in independent living apartments to predict falls from pre-fall changes in residents' Kinect-recorded gait parameters. Over a period of 3 to 48 months, we analyzed gait parameters continuously collected for residents who actually fell ( n = 13) and those who did not fall ( n = 10). We analyzed associations between participants' fall events ( n = 69) and pre-fall changes in in-home gait speed and stride length ( n = 2,070).

Enhanced registered nurse care coordination with sensor technology: Impact on length of stay and cost in aging in place housing.

Background: When planning the Aging in Place Initiative at TigerPlace, it was envisioned that advances in technology research had the potential to enable early intervention in health changes that could assist in proactive management of health for older adults and potentially reduce costs.

Purpose: The purpose of this study was to compare length of stay (LOS) of residents living with environmentally embedded sensor systems since the development and implementation of automated health alerts at TigerPlace to LOS of those who are not living with sensor systems. Estimate potential savings of living with sensor systems.

A Comparison of Accelerometer Accuracy in Older Adults.

Older adults' gait disorders present challenges for accurate activity monitoring. The current study compared the accuracy of accelerometer-detected to hand-tallied steps in 50 residential care/assisted living residents. Participants completed two walking trials wearing a Fitbit® Tracker and waist-, wrist-, and ankle-mounted Actigraph GT1M.

A New Paradigm of Technology-Enabled ‘Vital Signs’ for Early Detection of Health Change for Older Adults.

Environmentally embedded (nonwearable) sensor technology is in continuous use in elder housing to monitor a new set of ‘vital signs' that continuously measure the functional status of older adults, detect potential changes in health or functional status, and alert healthcare providers for early recognition and treatment of those changes. Older adult participants' respiration, pulse, and restlessness are monitored as they sleep. Gait speed, stride length, and stride time are calculated daily, and automatically assess for increasing fall risk.

Lipid outcomes from supervised exercise interventions in healthy adults.

Objectives: To meta-analyze lipid outcomes from supervised exercise interventions among healthy adults.

Methods: Comprehensive search strategies identified trials testing supervised exercise interventions in samples of healthy adults. Data were coded and analyzed using random effects meta-analysis methods.

Impact of physical activity interventions on anthropometric outcomes: systematic review and meta-analysis.

Considerable research has tested physical activity (PA) interventions to prevent and treat overweight and obesity. This comprehensive meta-analysis synthesized the anthropometric effects of supervised exercise interventions and motivational interventions to increase PA. Eligible intervention studies included healthy participants with reported anthropometric outcomes [e.

The continued success of registered nurse care coordination in a state evaluation of aging in place in senior housing.

Older adults prefer to age in place, remaining in their home as their health care needs intensify. In a state evaluation of aging in place (AIP), the University of Missouri Sinclair School of Nursing and Americare System Inc, Sikeston, MO, developed an elder housing facility to be an ideal housing environment for older adults to test the AIP care delivery model. An evaluation of the first 4 years (2005-2008) of the AIP program at TigerPlace (n = 66) revealed that the program was effective in restoring health and maintaining independence while being cost-effective.

Retirement community residents' physical activity, depressive symptoms, and functional limitations.

This study examined the types of physical activity (PA) retirement community residents report and the effects of PA and depressive symptoms on functional limitations. Elders (N=38) enrolled in a 2-year sensor technology study in senior housing completed regular assessments of functional limitations and depressive symptoms with the Short Physical Performance Battery and Geriatric Depression Scale, respectively. Evaluation of reported PA using the Physical Activity Scale for the Elderly coincided with 12-month functional limitation testing.

Insulin Sensitivity Following Exercise Interventions: Systematic Review and Meta-Analysis of Outcomes Among Healthy Adults.

Objective: Although exercise can improve insulin sensitivity, no adequate synthesis exists of exercise intervention studies with regard to their effect on insulin sensitivity. This comprehensive meta-analysis synthesized the insulin sensitivity outcomes of supervised exercise interventions.

Method: Extensive literature searching located published and unpublished intervention studies that measured insulin sensitivity outcomes.

Using meta-analyses for comparative effectiveness research.

Comparative effectiveness research seeks to identify the most effective interventions for particular patient populations. Meta-analysis is an especially valuable form of comparative effectiveness research because it emphasizes the magnitude of intervention effects rather than relying on tests of statistical significance among primary studies. Overall effects can be calculated for diverse clinical and patient-centered variables to determine the outcome patterns.

Perspectives and experiences related to physical activity of elders in long-term-care settings.

This qualitative study investigated individual and situational factors influencing physical activity (PA) practices of elders in residential-care/assisted-living (RC/AL) communities. This article describes the results of focus-group interviews involving 47 residents across 6 RC/AL settings. Thematic analysis revealed 6 themes: staying active, past PA experiences, value of PA, barriers to PA, strategies to facilitate PA, and support needs to promote PA.

Physical activity interventions with healthy minority adults: meta-analysis of behavior and health outcomes.

This meta-analysis is a systematic compilation of research focusing on various exercise interventions and their impact on the health and behavior outcomes of healthy African American, Hispanic, Native American, and Native Hawaiian adults. Comprehensive searching located published and unpublished studies. Random-effects analyses synthesized data to calculate effect sizes (ES) as a standardized mean difference (d) and variability measures.

Evolution of an Early Illness Warning System to Monitor Frail Elders in Independent Living.

This paper describes the evolution of an early illness warning system used by an interdisciplinary team composed of clinicians and engineers in an independent living facility. The early illness warning system consists of algorithms which analyze resident activity patterns obtained from sensors embedded in residents' apartments. The engineers designed an automated reasoning system to generate clinically relevant alerts which are sent to clinicians when significant changes occur in the sensor data, for example declining activity levels.

Measuring symptoms of depression: comparing the Cornell Scale for Depression in Dementia and the Patient Health Questionnaire-9-Observation Version.

The purpose of this study was to extend available psychometric data on the Patient Health Questionnaire-9-Observation Version (PHQ-9-OV) by comparing it with the Cornell Scale for Depression in Dementia (CSDD) in a new sample of long-term care residents. Data were collected post intervention in a quasi-experimental storytelling study across six communities. The sample (N = 54) was 87% women with mean age of 84.