DIMENSIONS Winter 2004

ADRC Research at the Gerontological Society of America Annual Scientific Meeting

photo of Dr. Susan McCurry and poster

The University of Washington ADRC was well-represented at the annual scientific meeting of the Gerontological Society of America (GSA) held in November in San Diego. The GSA meeting was attended by over 3,400 gerontological researchers and practitioners from around the world. Dr. George Martin, founding director of the UW ADRC and current GSA President, opened the meeting with a Presidential Symposium: The Economics, Culture, and Biology of Intergenerational Research.

One of the goals of GSA is to foster interdisciplinary interactions among clinical, administrative, and research professionals. Conferences like GSA help disseminate research findings and educational information to geriatric health care professionals so that the care of older adults is optimized. Below are summaries of some of the topics that were presented by UW ADRC researchers at the meeting:

Treatment of Depression and Anxiety in Dementia Patients: Issues in Treatment Development and Measurement

Depression and anxiety can be significant problems for individuals with dementia and their caregivers. They often lead to decreased quality of life, increased caregiver burden and stress, and eventual nursing home placement. This symposium featuring Drs. Linda Teri, Susan McCurry, Laura Gibbons, and Rebecca Logsdon, presented new data on a treatment program called STAR-C, designed specifically to reduce depression and anxiety in community-residing dementia patients. Presentations provided information about the treatment program and its effects on patient and caregiver well-being and quality of life.

Evidence-Based Behavioral Training for Staff in Long-Term Care

Millions of older adults live in long-term care. They rely on staff for much, if not all, of their day-to-day physical, emotional, and social care. Consequently, there is a tremendous need for systematic, empirically validated, practical programs to train staff members how to provide the best possible care for these residents. This symposium, organized by Dr. Linda Teri, presented four training programs from around the country that have been scientifically evaluated and shown to enhance long-term care resident outcomes. Symposium participants included: Drs. Teri (University of Washington), Lou Burgio (University of Alabama), Cornelia Beck (University of Arkansas), and Ronald Toseland (State University of New York at Albany).

Sleep Disturbances in Dementia Patients: Inter-actions Between Patient and Caregiver Mood, Health and Behavior

Caregivers frequently report sleep problems in their loved ones with dementia, and treatment is based on these reports. Dr. Susan McCurry, along with collaborators Drs. Rebecca Logsdon, Laura Gibbons, Michael Vitiello, and Linda Teri, presented results of a study evaluating the relationship between caregiversí reports of sleep disturbances in the person with dementia with actual recordings of patient sleep-wake activity. Results indicated that caregiversí own physical health and mood influence their appraisal of sleep problems in community-dwelling AD patients, and that treatments to improve sleep should address the needs of both the person with dementia and the caregiver, rather than focusing on patient symptoms alone.

A Comparison of Resident Outcomes in Special Dementia Care and Traditional Care Boarding Home Residences

Dr. Rebecca Logsdon, along with colleagues Drs. Laura Gibbons, Susan McCurry, and Linda Teri, from the UW ADRC, and Lynne Korte and Marta Acedo, from Washington Stateís Aging and Disability Services Administration, presented results of an investigation comparing two types of community-based residential care programs for Medicaid clients with dementia: special dementia care (SDC) and traditional boarding home care (TC). Results of this study indicated that family members were more satisfied with SDC than TC boarding homes, and residents in SDC were less likely than TC residents to be moved into a nursing home over an 18- month time period, despite greater cognitive impairment and behavioral disturbance. Thus specialized dementia care in boarding homes may provide an acceptable, less costly residential care option for many individuals with dementia.

Bias With Respect to Education in the MMSE, and the Two-Stage Sampling Design: The Granarolo, Italy Study

Dr. Paul Crane, along with colleagues Drs. Laura Gibbons, Lance Jolley, Gerald van Belle,Riccardo Selleri, Edoardo Dalmonte, and Diana De Ronchi presented a poster describing the Italian version of the Mini Mental State Exam (MMSE). Researchers were interested in whether the MMSE was valid in persons with varying levels of education, age, gender, and occupation. All elderly residents in Granarolo, Italy, were screened for cognitive difficulties as part of an epidemiological study of dementia. The Italian MMSE was found to have possible bias with respect to education and age. This finding is consistent with studies in the United States, and suggests that further work needs to be done to improve our measurement of cognitive function, especially for those with little or no formal education.

Nursing Assistantsí Responses to a Dementia Care Training Program in the Assisted Living Setting

The assisted living (AL) setting requires nursing assistants to demonstrate highly effective communication and problem solving skills in order to complete their daily tasks of helping residents with their day-to-day activities. Effective training is crucial for nursing assistants to deliver quality resident care. The STAR program, developed by Dr. Linda Teri and colleagues at the UW ADRC, is the first training program to target dementia-related behaviors in the AL setting. Piruz Huda, Dr. Teri, and Dr. Heather Young presented the STAR program, focusing on teaching other professionals how to make training accessible and user-friendly to nursing assistants, how to correct prior misinformation about dementia care, and how to clarify and promote the nursing assistantís role in improving resident quality of life.†

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