PennAI Tech funds pilot grants focused on technology and AI development to advance the science of care management and aging in place for vulnerable older adults or those with AD/ADRD receiving ...skilled home and community-based services (https://www.pennaitech.org). Dr. Suchi Saria is John C. Malone Associate Professor of Computer Science and Statistics and Health Policy at Johns Hopkins University, Director of the Machine Learning and Healthcare Lab and Malone Center for Engineering in Health Care, and Chief Executive Officer of Bayesian Health (an adaptive AI company that uses health care data to provide actionable clinical insights to improve patient outcomes Bayesian Health, 2024). According to Dr. Saria, medicine's complexity and the translation gap between testing new ideas, gaining clinical and community adoption, as well as the complexity of successful commercialization, should not be underestimated (a2 Collective, 2024).
Objectives
To examine the cross‐sectional associations between self‐reported postlunch napping and structured cognitive assessments in Chinese older adults.
Design
Cross‐sectional cohort study.
...Setting
China.
Participants
Individuals aged 65 and older from the baseline national wave of the China Health and Retirement Longitudinal Study (CHARLS) (N = 2,974).
Measurements
Interview‐based cognitive assessments of orientation and attention, episodic memory, visuospatial abilities, and a combined global cognition score incorporating these assessments. Other self‐reported or interview‐based assessments included postlunch napping duration, nighttime sleep duration, demographic characteristics, health habits, comorbidities, functional status and social activities. According to reported napping duration, older adults were categorized as non‐nappers (0 minutes), short nappers (<30 minutes), moderate nappers (30–90 minutes), and extended nappers (>90 minutes).
Results
Postlunch napping was reporting in 57.7% of participants for a mean of 63 minutes. Cognitive function was significantly associated with napping (P < .001). Between‐group comparisons showed that moderate nappers had better overall cognition than nonnappers (P < .001) or extended nappers (P = .01). Nonnappers also had significantly poorer cognition than short nappers (P = .03). In multiple regression analysis, moderate napping was significantly associated with better cognition than non‐ (P = .004), short (P = .04), and extended napping (P = .002), after controlling for demographic characteristics, body mass index, depression, instrumental activities of daily living, social activities, and nighttime sleep duration.
Conclusion
A cross‐sectional association was found between moderate postlunch napping and better cognition in Chinese older adults. The cross‐sectional design and self‐reported measures of sleep limited the findings. Longitudinal studies with objective napping measures are needed to further test this hypothesis.
Scoping reviews have now been around for approximately 18 years with the growing use of this methodology. In a recent scoping review of scoping reviews, from 1999 to 2012, almost 70% of the scoping ...reviews were found from 2009 to 2012. This scoping review pointed out that there are a variety of terms used to describe scoping reviews in the literature including but not limited to scoping study, scoping project, literature mapping, scoping exercise, scoping report, evidence mapping, systematic mapping, and rapid review. Here, Cacchione examines the extent range and nature of research activity around a particular topic, determines the value for undertaking a systematic review, summarizes and disseminates research findings, and discovers research gaps in the literature.
The aging demographic shift occurring world-wide is creating an opportunity for innovative care models to address the burgeoning care needs of the expanding population of older adults. Nursing and ...advanced practice nursing as well as interprofessional models past and present hold insights into how to meet the needs of older adults across the continuum of care. A review of past and present models of care is provided. These models across settings emphasize maximizing the role of nurses and advanced practice nurses. The models reviewed include: On LOK and Programs of All-inclusive Care for the Elderly (PACE); Community Aging in Place, Advancing Better Living for Elders (CAPABLE); Teaching Nursing Homes; Interventions to Reduce Acute Care Transfers (INTERACT); Missouri Quality Initiative (MOQI); Evercare/Optum; Nurses Improving Care for Health System Elders (NICHE); Acute Care for the Elderly Unit (ACE Unit); Hospital Elder Life Program (HELP); Age-Friendly Health Systems; and the Transitional Care Model. Each model emphasizes education on the special needs of older adults, providing easy access to evidence-based tools and interventions, as well as strong interprofessional collaboration. Sustainable evidence-based nursing and interprofessional innovations are present across health care settings from the community, long-term care and the acute care setting to address the complex needs of older adults.
In 2021, 11.3 million unpaid caregivers of persons with Alzheimer's disease/Alzheimer's disease and related dementias (AD/ADRD) provided 16 billion hours of unpaid caregiving worth $271.6 billion. ...This study aimed to fully capture the contextual complexities of the caregiving role acquisition articulated by female family caregivers of those with AD/ADRD, emphasizing assigned meaning to one's lived experience with a critical focus on how family power structures influence caregiving practices. Recorded open structured interview transcripts (N = 30) from two qualitative studies with the same two opening questions resulted in a corpus of 481 pages of pooled textual data. The data were analyzed using Utrecht's descriptive and interpretive thematic analysis approach. The interpretive thematic analysis uncovered the theme of intervening to protect and its subthemes of financial exploitation, mistreatment, and endangerment. Based on the evolving analysis, we reanalyzed the data using critical discourse analysis (CDA), drawing from Foucault and feminist CDA to explore the complex but subtle nuances of gender, power, and ideologies. CDA uncovered the theme of compulsory altruism. Ambiguity about violating personhood delayed responses to potentially dangerous behavior and actual harm. Using interpretive thematic and critical discourse analysis, we discovered a deeper understanding of female caregivers' contextual complexities, their journey to becoming a caregiver of a family member with AD/ADRD, and the power structures that relegated caregiving to female family members. This research identified a substantial policy gap in supporting female family caregivers who provide the majority of care to persons with AD/ADRD risking their health and financial security.
PDF
