3 Tests Show Near-Perfect AD Prediction
In a paper published in Neurology, a team of physicians and scientists describe using a combination of broadly available medical tests to produce a much-improved predictive picture of the likelihood of impending Alzheimer’s disease (AD) in patients with mild cognitive impairment. To determine the likelihood of developing AD, researchers compared risk factors based on magnetic resonance imaging (MRI), cerebrospinal fluid (CSF), and neuropsychological testing. Unlike other efforts that have evaluated the predictive capabilities of research-based biomarkers, MRI, CSF, and neuropsychological tests are all technologies widely available to clinicians.
The researchers found that these available biomarkers significantly improved accuracy in predicting near-term conversion to dementia. In combination, their prediction rate was almost perfect: None of the individuals who tested negative on all three measures went on to develop AD in the 3-year follow up. By comparison, almost 90% of individuals who tested positive on all three measures had dementia at the end of 3 years.
The presence of medial temporal atrophy, determined by automated analysis of MRI using a software package approved by the U.S. Food and Drug Administration, was associated with the likeliest chance of near-term dementia, with a median dementia-free survival time of only 15 months.
Source.“Test Combination Helps Predict Alzheimer’s Disease Risk.” (2011, October 20). Retrieved November 30, 2011, from http://www.newswise.com/articles/test-combination-helps-predict-alzheimer-s-disease-risk.
Edna Stilwell Writing Award Presented at GSA
Journal of Gerontological Nursing (JGN) author Alicia J. Curtin, PhD, GNP-BC, was selected as the 14th annual recipient of the Edna Stilwell Writing Award for her article, “Individualized Skills Training Program for Community-Dwelling Adults with Mild Alzheimer’s Disease,” published in the October 2011 issue of JGN (Vol. 37, No. 10, pp. 20–31). The article detailed the applicability and effectiveness of an individualized skills training program that drew on the preserved memory of individuals with Alzheimer’s disease (AD) to improve their performance of a specific meal task in the home setting. Curtin found that adults with mild AD who were once dependent in meal preparation were able to make pudding, pancakes, poached eggs and toast, blueberry muffins, and oatmeal with minimal verbal prompting.
Journal of Gerontological Nursing Editor Emerita Kathleen C. Buckwalter, RN, PhD, FAAN (left), presents Alicia J. Curtin, PhD, GNP-BC, with a plaque for the Edna Stilwell Writing Award for her October 2011 article.
The Award, which includes a plaque and a $500 cash prize, was established by SLACK Incorporated, publisher of JGN, in recognition of the contributions of Edna M. Stilwell, PhD, RN, C, as Editor of JGN from 1974 to 1997. The purpose of the Award is to continue Stilwell’s tradition of mentoring and recognizing authors in the field of gerontological nursing.
All authors published in JGN are eligible for this Award, given to the author or group of authors of the best article published each year. Entrants are nominated by Editorial Board and Review Panel members during blind peer review, and the winner is selected by a committee.
Dr. Curtin accepted the award in November at the Gerontological Society of America’s annual meeting in Boston. JGN congratulates the author on her outstanding contribution.
Study Examines Pain Treatment Trends
Seventeen percent of adults with chronic pain who have tried to reach their primary pain care providers with questions face difficulties doing so, according to survey results from the American Pain Foundation. The national survey conducted online among 2,118 adults 18 and older, of which 619 currently live with chronic pain, also found that nearly half (43%) of those who have sought out pain treatment options had questions about their treatment after they left their provider’s office. Among these, the top three questions relate to treatment side effects (62%), duration of treatment (55%), and cost (41%).
The survey found that of those who reached out to their health care providers with questions about treatment, almost everyone (99%) eventually received a response, the same day (83%) or 1 or more days later (16%). Also, nearly everyone (98%) reported that the responses to their questions were “at least somewhat helpful.”
Unfortunately, 14% of adults living with chronic pain who have questions about their pain treatment have not tried to reach out to their providers. Reasons cited among these 52 people for not contacting their providers included: not wanting to “bother” their health care provider (11%), fear of looking like a “complainer” (8%), and fear of looking like a “drug seeker” or “drug addict” (7%).
Of people who reported pain, 92% have sought treatment of any kind for their pain; among those, 72% have ever been treated by a health care provider, but this varies greatly by age. Younger people (ages 18 to 34) are less inclined to seek treatment, with only 45% saying they have ever sought treatment from a health care provider, while 76% of those ages 55 to 64 say they have ever sought treatment from a health care provider for their pain. This increases to 88% in adults 65 and older.
Source.“American Pain Foundation Survey Uncovers Treatment Questions and Concerns Among People with Pain.” (2011, September 21). Retrieved October 31, 2011, from http://www.painfoundation.org/media/press-releases/2011/survey-uncovers-concerns.pdf.
Older Cancer Patients Open to Web-Based Survey System
When cancer patients are given the choice, they are significantly more likely to use web-based technology to answer questions about their quality of life 6 months after treatment as opposed to a paper survey, according to a study presented at the annual meeting of the American Society for Radiation Oncology.
This finding challenges the perception that older cancer patients do not have access to or are not comfortable using Internet technology. Investigators found that a significant proportion of cancer patients (mean age = 64) who participated in the study were computer savvy and preferred using a keyboard to a pen or pencil to fill out a questionnaire.
The prospective study is part of a larger Radiation Therapy Oncology Group randomized trial for early-stage prostate cancer patients that included a quality-of-life questionnaire. Findings showed that while 90% of patients completed the paper survey at the end of treatment, only 52% did so 6 months after treatment. The most common reason cited for nonadherence was “institutional error.”
Researchers wanted to find a new approach to increase participation in its quality-of-life questionnaire. The goal of the companion study was to determine whether the adherence rate could increase from 52% to 75% using a web-based system. Investigators used the secure VisionTree Optimal Care, which can be accessed from any computer and offers e-mail reminders to further increase adherence rates.
From September 2008 to December 2009, 49 prostate cancer patients who had an e-mail address were involved in the study. Researchers found that the survey adherence rate 6 months after treatment increased from 52% to 90% (15% higher than their goal) when the web-based technology was offered to patients.
The technology almost eliminated institutional error as a reason for nonadherence, since the system sent automatic e-mail reminders to patients to encourage survey completion. A survey of research associates found that the system saved them an average of 10 minutes per quality-of-life form.
Source.“Cancer Patients in Their 60s Are Tech-Savvy.” (2011, October 3). Retrieved November 30, 2011, from http://www.newswise.com/articles/cancer-patients-in-their-60s-are-tech-savvy.
Stroke Risk Shown to Increase with Depression
An analysis of nearly 30 studies including more than 300,000 patients has found that depression is associated with a significantly increased risk of developing and dying from stroke, according to an article in the Journal of the American Medical Association.
Researchers conducted a systematic review and meta-analysis of prospective cohort studies to describe the association between depression and risk of total and subtypes of stroke. The researchers conducted a search of the medical literature and identified 28 prospective cohort studies that met criteria for inclusion in the analysis. The studies, which included 317,540 participants, reported 8,478 stroke cases during a follow-up period ranging from 2 to 29 years.
The researchers found that when the data from the studies were pooled, analysis indicated that depression was associated with a 45% increased risk for total stroke, a 55% increased risk for fatal stroke, and a 25% increased risk for ischemic stroke. Depression was not associated with an increased of hemorrhagic stroke.
The corresponding absolute risk difference associated with depression based on the most recent stroke statistics for the United States was estimated to be (per 100,000 individuals per year) 106 cases for total stroke, 53 cases for ischemic stroke, and 22 cases for fatal stroke.
The researchers speculate that depression may contribute to stroke through a variety of mechanisms, including having known neuroendocrine and immunological/inflammation effects; poor health behaviors (e.g., smoking, physical inactivity, poor diet, lack of medication adherence) and obesity; having other major comorbidities, such as diabetes and hypertension; and antidepressant medication use, which may contribute to the observed association.
Source.“Depression Associated with Increased Risk of Stroke and Stroke-Related Death.” (2011, September 16). Retrieved November 30, 2011, from http://www.newswise.com/articles/depression-associated-with-increased-risk-of-stroke-and-stroke-related-death.
Home Health Care Patients Placed at Higher Risk for PIMs
Nearly 40% of older adults receiving medical care from a home health agency are taking at least one prescription medication that is considered potentially inappropriate, a study in the Journal of General Internal Medicine has revealed.
The study’s researchers found that home health care patients 65 and older are prescribed potentially inappropriate medications (PIM) at rates three times higher than patients who visit a medical office. The researchers’ data show that home health care patients are taking 11 medications on average, and that concurrent use of multiple medications is a strong indicator of the presence of PIMs.
The study used data from the National Home and Hospice Care Survey, conducted in 2007 by the Centers for Disease Control and Prevention, which is the most recent nationally representative epidemiological survey of home health patients. The 2002 Beers Criteria, an expert-panel-generated list that itemizes 77 medications or groups of medications considered inappropriate for older adults, was the basis for the PIMs chosen.
In their review of data of 3,124 home health patients 65 and older, the researchers found that 38% were taking at least one PIM. Patients taking 15 or more medications were five to six times as likely to be prescribed PIMs as patients taking 7 or fewer medications. Of those taking at least one PIM, 21%were taking 15 or more medications.
Source.“Older Adults in Home Health Care at Elevated Risk for Unsafe Meds.” (2011, November 21). Retrieved December 5, 2011, from http://www.newswise.com/articles/older-adults-in-home-health-care-at-elevated-risk-for-unsafe-meds.
MU Sinclair School of Nursing Professor Receives National Award
The American Academy of Nursing (AAN), in partnership with the John A. Hartford Foundation, has selected Marilyn Rantz, PhD, RN, FAAN, as recipient of the 2011 Nurse Leader in Aging Award. Rantz, a professor in the University of Missouri Sinclair School of Nursing (MUSSON), was selected for her “exemplary leadership achievements, contributions, productivity, and mentorship in the field of gerontological nursing,” said Catherine Gilliss, DNSc, RN, FAAN, past president of the AAN.
© University of Missouri Sinclair School of Nursing
Affiliated with MUSSON since 1992, Rantz is professor and Helen E. Nahm Chair, University Hospitals and Clinics professor of nursing, executive director of Aging in Place, and associate director of the MU Interdisciplinary Center on Aging. She specializes in gerontological nursing, nursing administration, and chronic illness management. Rantz was instrumental in developing TigerPlace, an independent living facility by Americare and the SSON using the Aging in Place (AIP) model to improve older adults’ quality of life in a home-type setting by providing health care where they live. TigerPlace residents live in private apartments featuring sensor technology to detect early changes in health conditions, which helps residents avoid or delay hospitalizations; several articles detailing such endeavors have been published in the Journal of Gerontological Nursing’s Technology Innovations section. In 2008, Dr. Rantz earned the AAN’s Edge Runner distinction for the AIP project. Her 2011 funded grants total more than $6 million.
Source.University of Missouri, Sinclair School of Nursing. (2011, November 29). MU Sinclair School of Nursing Professor Receives National Award for Nursing Research and Practice [Press release]. Columbia, MO: Author.
Alzheimer’s Risk Study Now Enrolling Participants
In a first-of-its kind study, University of Michigan researchers will provide genetic testing and Alzheimer’s disease risk estimates for people who are already experiencing mild cognitive impairment (MCI). Researchers hope to learn how people with MCI and their caregivers respond to health education and genetic testing.
The research team will look specifically at how the information affects the participants’ psychological adjustment and any behavior changes and evaluate how well the participants understand the study’s genetic testing and Alzheimer’s disease risk assessment materials. After receiving their risk estimate, participants will be followed for 12 months.
The study, called the Risk Evaluation and Education for Alzheimer’s Disease, is a multi-centered research project funded by the National Institutes of Health. Participants will have the opportunity to learn what it means to have MCI, what their chances are of developing Alzheimer’s disease, and how to cope with problems related to memory loss.
Study investigators hope to enroll individuals ages 55 to 90 who have been diagnosed with MCI and have a study partner willing to participate with them. Recruitment will continue through spring 2012. Those interested in enrolling in the study may contact Lan Le at (734) 615-2422 or email@example.com.
Source.“Study Will Test for Alzheimer’s Risk.” (2011, November 10). Retrieved December 5, 2011, from http://www.newswise.com/articles/u-m-study-will-test-for-alzheimer-s-risk.