Journal of Gerontological Nursing

News Free

News

Compound May Halt Clinical Progression of Alzheimer’s

AFFiRiS AG has released the results of a clinical Phase II study of its proprietary compound AD04, a therapeutic drug against Alzheimer’s disease (AD). Results showed an impressive therapeutic effect of AD04, thus making it the first compound to ever demonstrate clinical and biomarker evidence consistent with disease modification of AD.

Specifically, 47% of study patients stabilized regarding their cognitive/functional status. In addition, the effect was statistically significantly correlated with the rescue of the hippocampus (i.e., the region of the brain locating the cognitive/memory functions) (p = 0.0016). This correlation of significant clinical and biomarker effects meets the U.S. Food and Drug Administration’s definition of disease modification in the context of a compound with a consistent mode of action.

In addition, a stabilization of the cognitive/functional endpoint found in patients who were treated with AD02 occurred. AD02 is the company’s lead compound in AD to date.

Dependent on dosage and formulation of AD02 in three different study arms, 24% to 31% of patients showed cognitive/functional stabilization or improvement. However, statistically significant correlation with biomarker hippocampus volume could not be demonstrated within the observation period of 18 months. Altogether, 332 patients were treated in an international multicentric clinical trial in five different study arms, and more than 85% of patients completed the study.

As a result of these findings, the company has decided to focus on AD04 for further clinical development.

Source.“Breakthrough in Alzheimer’s Disease: AFFiRiS Halted Clinical Progression in Alzheimer Patients Upon Treatment With AD04 in a Phase II Clinical Study.” (2014, June 4). Retrieved July 17, 2014, from http://on.mktw.net/UejnXa.

Alzheimer’s May Be More Prevalent Among African Americans

A new study has reviewed research that suggests the risk for developing Alzheimer’s disease (AD) among older adult African Americans may be two to three times greater than in the non-Hispanic White population, and that risk factors and disease manifestation in the older adult African American population differ from those in the non-Hispanic White population as well. Study results were published in Health Affairs.

Research suggests that a combination may exist of biological, cultural, health systems-based, and other factors that may be contributing to the risk of developing AD in older adult African Americans when compared to non-Hispanic White older adults. Researchers maintain that cognitive tests conducted over time actually indicate small or no differences in performance among these populations and that studies on risk factors have produced useful, yet insufficient, explanations of the disparities—largely due to the lack of African American participation in research studies.

To understand why AD is more prevalent among African American older adults and why it manifests itself differently, researchers said that they would need more African American individuals to participate in AD studies and would need to look at a range of risk factors and their effects on cognition over time.

In 2010, the U.S. Census Bureau indicated that 20% of the population 65 and older was a racial or ethnic minority member. Current projections suggest that by 2050, 42% of the nation’s older adults will be members of minority groups.

Source.“Alzheimer’s Disease May Be More Prevalent And Manifests Itself Differently Among African Americans.” (2014, April 3). Retrieved July 18, 2014, from http://bit.ly/UfomXK.

Study Shows Community-Living Older Adults with Dementia More Likely to Be Hospitalized Than Those Without Dementia

Older adults living in the community who have dementia are more likely to be hospitalized and visit the emergency department than those who do not have dementia, according to a new study published in Health Affairs. However, the research showed only little difference in the number of hospitalizations among nursing home residents with and without dementia.

The study examined Medicare claims linked to the Health and Retirement Study data to examine hospital and emergency department use (both potentially avoidable and overall) among Medicare beneficiaries with and without dementia across community and institutional settings.

Researchers found significant differences in the likelihood of these events among older adult fee-for-service Medicare beneficiaries in the community, with 26.7% of adults with dementia versus 18.7% of adults without dementia experiencing hospitalization, and 34.5% versus 25.4%, respectively, experiencing an emergency department visit each year.

In contrast, researchers found only a small difference in hospital and emergency department use between nursing home residents with and without dementia. The study found that 45.8% of nursing home residents with dementia versus 41.9% of residents without dementia experienced hospitalization, and 55.3% compared with 52.7%, respectively, experienced an emergency department visit annually.

However, the study found hospitalization and emergency department visits increased significantly for both community and nursing home residents in the last year of life, whether or not they had dementia.

This research suggests that the high rate of hospitalization and emergency department use among older adult community residents may be attributable to factors such as deficiencies in primary and other medical care available to these patients, as well as fewer programs designed to reduce these events among community residents with dementia. In comparison, nursing home providers may be more equipped to provide care to patients with dementia due to the high prevalence of dementia in nursing homes.

Source.“Community-Living Seniors With Dementia More Likely to be Hospitalized Than Those Without Dementia; Little Difference Found Among Nursing Home Residents.” (2014, April 7). Retrieved July 17, 2014, from http://bit.ly/1tX47OG.

New Glasses May Increase Fall Risk in Older Adults

Optometrists can help prevent falls by avoiding overaggressive vision correction in older patients at risk, according to a recent review.

Falls in older adults are often not accidental—most of the time, they are related to a wide range of risk factors, including older age, disabilities, muscle weakness, and various medical conditions.

Reduced vision is also an important risk factor, suggesting that interventions to correct vision—particularly glasses and cataract surgery—would reduce the risk of falling. However, most studies have shown little or no reduction in falls among older adults receiving a new vision correction.

According to researchers, magnification from new glasses may contribute to the increase in fall risk. Frail older adults may have greater difficulty adapting to such changes and be at increased risk of falling during this adaptation period. Unaccustomed magnification may cause objects to appear closer or farther than they really are, thus affecting the reflexes linking the vestibular (i.e., balance) system with eye movements.

In addition, for older patients who are not used to bifocals and progressive lenses, switching to these types of lenses may cause distortion in peripheral vision.

So if maximizing vision correction is not the answer, what can optometrists do to help prevent the risk of falls in elderly patients? According to the review, an important first step is to assess risk factors, including history of falls, medical conditions, and medications used.

In addition, optometrists should take a conservative approach to prescribing new glasses for older adults with a history of falls or risk factors for falling. It is also suggested that optometrists keep the same type of lens (e.g., bifocals, progressive), unless a significant reason for change exists.

Falls are a major cause of accidental death and nonfatal injuries in older adults in the United States. At least one third of healthy adults 65 or older fall at least once per year. For those 90 or older, the risk increases to approximately 60%.

Source.“New Glasses May Increase the Risk of Falls in Older Adults, Suggests Review in Optometry and Vision Science.” (2014, May 23). Retrieved July 18, 2014, from http://bit.ly/RoXoet.

Moderate-Intensity Physical Activity May Reduce Mobility Problems in Older Adults

According to a study published in the Journal of the American Medical Association, participation in a structured moderate-intensity physical activity program, compared with a health education intervention, significantly reduced the risk of major mobility disability (i.e., the loss of ability to walk 400 meters, or approximately one-quarter mile) in older adults.

Researchers randomly assigned sedentary men and women (ages 70 to 89) who were able to walk 400 meters to a structured, moderate-intensity physical activity program (n = 818) conducted in a center and at home that included aerobic, resistance, and flexibility training activities, or to a health education program (n = 817), consisting of workshops on topics relevant to older adults and upper extremity stretching exercises. The older adults participated for an average of 2.6 years. Participants were enrolled at eight centers across the country.

Major mobility disability was experienced by 246 participants (30.1%) in the physical activity group and 290 participants (35.5%) in the health education group. Persistent mobility disability (i.e., two consecutive major mobility disability assessments or major mobility disability followed by death) was ex perienced by 14.7% of participants in the physical activity group and 19.8% of participants in the health education group.

A subgroup with lower physical function at study entry, representing 45% of the study population, received considerable benefit from the physical activity intervention.

Serious adverse events were reported by 49.4% of participants in the physical activity group and 45.7% of participants in the health education group.

Mobility (i.e., the ability to walk without assistance) is a critical characteristic for functioning independently. Reduced mobility is common in older adults and is an independent risk factor for illness, hospitalization, disability, and death.

Source.“Moderate-Intensity Physical Activity Program For Older Adults Reduces Mobility Problems.” (2014, May 22). Retrieved July 18, 2014, from http://bit.ly/WhZvnm.

Physical Work Environment in Hospitals May Affect Nurses’ Job Satisfaction

A new study published in Research in Nursing & Health has found that a physical work environment that facilitates RNs’ efficiency, teamwork, and interprofessional communication is related to higher job satisfaction.

The study is based on a 98-question survey of 1,141 RNs, which is part of RN Work Project, a nationwide, 10-year, longitudinal survey of RNs that began in 2006.

Researchers found that although physical environment had no direct influence on job satisfaction, it did have a significant indirect influence because the environment affected whether nurses could complete tasks without interruptions, communicate easily with other nurses and physicians, and/or do their jobs efficiently.

In addition, they found that RNs who gave their physical work environments higher ratings were also more likely to report better work-group cohesion, nurse–physician relations, workload, and other factors associated with job satisfaction. Researchers measured job satisfaction in terms of procedural justice, autonomy, nurse–physician relationships, distributive justice, opportunities for promotion, workgroup cohesion, and variety in one’s job.

Physical environment was assessed based on the architectural, ambient, and design features of the workspace, including crowdedness, ventilation, lighting, arrangement of furniture, colors and decorations, aesthetic appearance, and the need for remodeling.

Source.New York University College of Nursing. (2014). Physical Work Environment in Hospitals Affects Nurses’ Job Satisfaction, With Implications for Patient Outcomes, Health Care Costs [Press release]. New York; NY: Author.

10.3928/00989134-20140818-03

Sign up to receive

Journal E-contents