Browsing by Subject "Older Adults"

Now showing 1 - 4 of 4
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    Fall Prevention
    (2009-09-16) Christ, Amanda
    Everyone should be safe in their homes, but sometimes it can be a dangerous place. This pamphlet will give you tips on how to make your home safer to get around in.
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    Informing medication discontinuation decisions among older adults with relapsing-onset multiple sclerosis
    (2018-11) Schwehr, Natalie
    Multiple sclerosis (MS) is a chronic neurological condition that persists throughout the life course after onset and has no known cure. Relatively little is known about aging with MS. Medications that target the immune system (disease-modifying treatments [DMDs]) are often burdensome for people with relapsing-onset MS. DMDs are more effective in people who are younger and who have higher disease activity, including relapses, which decreases with age. The potential benefits of DMDs may be low among older adults with relapsing-onset MS. We projected the long-term outcomes of discontinuing DMDs among older adults with relapsing-onset MS. We developed a decision-analytic model that incorporates an age-related decline in relapses and underlying disease heterogeneity (different rates of relapse and disability progression) among simulated individuals. In Paper 1, we estimated the age-related decrease in the annualized relapse rate (ARR) and examined a range of assumptions about the initial ARR at MS symptom onset and the relationship between changes in the ARR, age, and changes in disability status. In Paper 2, we examined the impact of underlying population heterogeneity on the expected outcomes for relapse and disability among older adults who were relapse-free for at least 5 years. Among these cohorts, in Paper 3 we projected the long-term outcomes of continuing versus discontinuing DMDs (interferon beta, fingolimod, or natalizumab) among older adults. We examined different assumptions about treatment efficacy. Outcomes included quality-adjusted life expectancy (QALE), and the percent of a cohort with a relapse or reaching EDSS 6 within the next 10 years.
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    The Relationship of Resting Cardiopulmonary Function to Peak and Submaximal Cardiopulmonary Exercise Testing in Older Adults with Heart Failure
    (2016-12) Webb, Marjorie
    Background: Heart failure (HF) is a challenging disease that affects more than five million people, half of whom are at least 75 years old. Peak oxygen consumption (VO2peak), the minute ventilation/carbon dioxide production (VE/VCO2) slope, and the 6MWT are powerful prognostic indicators of all-cause mortality and cardiovascular-related mortality. VO2peak and the VE/VCO2 slope, obtained during CPX, have been shown to be useful for monitoring the efficacy of symptom and therapeutic management. Peak cardiac output (Qpeak) would also be an excellent prognostic indicator but traditionally it has been difficult to measure since the measurement is usually highly invasive. At the University of Minnesota, we are able to measure Qpeak noninvasively using the acetylene washin method. Despite the body of evidence supporting these measures, CPX and the 6MWT are not routinely performed on an outpatient basis as a part of HF symptom assessment and management. Additionally, older patients with HF often do not recognize worsening symptoms which frequently lead to hospitalization. In order for nurses to maximize quality of life for patients with HF and affect morbidity and mortality, usable methods for the evaluation of therapeutic efficacy of symptom management and prescribed treatments must be available. N-terminal prohormone brain natriuretic peptide (NT-pro BNP), New York Heart Association (NYHA) classification, and inspiratory capacity, are all obtainable in an office visit and may explain enough variance in peak Q, VO2, the VE/VCO2 slope, 6MWT distance, or all three measurements to be useful in the outpatient setting. Objective: The purpose of this study was to explore the potential of a model that incorporates resting measures, NT-Pro BNP, NYHA classification, and inspiratory capacity, for the evaluation of therapeutic efficacy of symptom management and prescribed treatments for older patients with HF. We hypothesized that there is a relationship between Qpeak, VO2peak, the VE/VCO2 slope, and/or 6MWT distance with NT-pro BNP, NYHA classification, and inspiratory capacity. Method: Twenty-three older patients (mean age 73.6 + 4.5 years old) with HF underwent venipuncture, inspiratory capacity measurement, and performed the 6MWT and CPX per standardized protocol. Qpeak, VO2 peak and the VE/VCO2 slope measurements were recorded during the CPX. NYHA classification was obtained from chart review and assessment. Results: The strongest relationships were between inspiratory capacity and Qpeak (R = 0.77, p <0.0001), and between NT-pro BNP and the VE/VCO2 slope (R = 0.71, p <0.001). Additionally, there was a moderate relationship between NT-pro BNP and VO2peak (R = -0.47, p <0.03) and between inspiratory capacity and VO2peak (R = 0.51, p <0.02). Due to the lack of variance NYHA classification was not included in the regression analysis. The 6MWT distance did not correlate with NT-pro BNP or inspiratory capacity. NT-pro BNP accounted for 22% of variance in VO2peak and 50% of variance in the VE/VCO2 slope. Mean inspiratory capacity accounted for 59% of variance in Qpeak and 26% of variance in VO2peak. The combined measurements of inspiratory capacity and NT-pro BNP explained 42% of the variance in VO2peak (adjusted R2 = 0.42, F (2, 20) = 8.82, p < 0.002). A model of prediction for either Qpeak or the VE/VCO2 slope could not be constructed since only one predictor variable for each outcome variable was statistically significant.
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    Representational elements of nature's effect on seniors' self-perceived well-being
    (2014-05) Kieffer, Sheena Marie
    Humans evolved in a natural habitat, and thus, have an innate preference for nature, as stated by the biophilia hypothesis (Wilson, E.O., 1984). Attention Restoration Theory stresses nature's incredible ability to restore ones' mind (Kaplan, S., 1995). Consequently, spending time in nature improves humans' well-being. It is reasonable to assume that nature's benefits could be extended to viewing nature in interior space, referred to as biophilic design (Kellert, 2008). Incorporating nature into interior space is critical for older adults who may no longer be able to experience the outdoors. This study examined the possible effects on seniors from their observation of representational elements of nature (REN) in the interior of senior living communities to determine if they would strengthen their self-perceived connectedness to nature, and therefore, support their self-perceived well-being. This exploratory mixed methods study surveyed 20 residents at a market rate independent senior living community. Individually, participants viewed four pairs of photographs of senior living communities' main public lounges. The four REN variables reviewed were water, fire, natural materials, and botanical motifs. It was found that natural materials, followed by fire, had the most significant influence on seniors' well-being. Findings related to botanical motifs and water's influence on well-being is less clear. Plants, color, and nature-based artwork were also identified as design elements that influenced participants' preference for the lounges shown in the photographs, though not REN variables measured in this study. This exploratory research lays a foundation for future researchers to examine the significance of incorporating REN into interior space occupied by seniors in independent living communities.