Jason is an Assistant Professor with the Institute for Health & Aging, University of California San Francisco. Previously, he was a postdoctoral fellow at the University of Pittsburgh, School of Medicine in the Department of Epidemiology and the Clinical and Translational Science Institute. He earned is PhD in Behavioral and Community Health Sciences at the University of Pittsburgh Graduate School of Public Health, where he explored the relationship between cognitive health and the social environment of older adults.
Background: Falls result in devastating problems for older adults and lead to increased morbidity... more Background: Falls result in devastating problems for older adults and lead to increased morbidity, mortality and health care costs. One in three community-dwelling older adults fall each year, and close to half of older adults aged 80 and older fall each year. Several community-based fall prevention programs have been shown to reduce fall risks and fall-related injuries. Purpose: Describe the personal characteristics of participants who attend two statewide fall prevention programs in Pennsylvania. Methods: Participants were recruited from local Area Agencies on Aging and partnering senior centers that offer fall prevention programming to seniors. Results: Currently, 193 participants have been recruited from 33 senior centers/providers in eight counties in Pennsylvania. The mean age is 78, 45% of participants are 80 years or older, 82% female and 18% are African American. Seventy-eight percent live in a home or apartment in the community and only 6% receive homemaker or nursing serv...
Purpose: To describe persons with Alzheimer's (AD) and their caregivers' subjective views... more Purpose: To describe persons with Alzheimer's (AD) and their caregivers' subjective views and experiences regarding participation in an art engagement activity. Methods: Four focus groups were conducted with participants in a novel art engagement activity at the Andy Warhol Museum. Immediately following the completion of the activity, we recruited 10 persons with AD or cognitive impairment and 10 caregivers to share their views and experiences. Open-ended questions were asked in each focus group and we used the qualitative method of grounded theory to analyze the data. Participants also completed a brief satisfaction survey and associations were examined using nonparametric statistics. Findings: Three key themes were identified that described the aspects that participants' enjoyed overall: cognitive stimulation, social connections, and a sense of self. In addition, we identified programmatic issues such as participant characteristics, activity-specific concerns and progr...
WalkWorks is a large scaled, community-based health improvement initiative based at the Universit... more WalkWorks is a large scaled, community-based health improvement initiative based at the University of Pittsburgh Graduate School of Public Health. The initiative is operated in partnership with the Pennsylvania Department of Health, the Centers for Disease Control and Prevention, and local organizations in six rural counties in Western Pennsylvania. Funding originates with the American Recovery and Reinvestment Act. WalkWorks seeks to increase physical activity by establishing community-based walking initiatives. Through WalkWorks, access to local walking routes and social support of individuals wanting to improve their activity habits is enhanced. Specifically, WalkWorks identifies, maps and promotes safe walking routes that are accessible to people of all ages and abilities, establishes and promotes guided community-based walking groups, and advocates for local policy related to pedestrian transportation in the built environment. The initiative was designed by the Pennsylvania Dep...
This paper examines the prevalence and correlates of depressive symptoms among older persons of P... more This paper examines the prevalence and correlates of depressive symptoms among older persons of Punjab, the largest Province of Pakistan. Data were gathered from 4191 older persons aged 60+ using Probability Proportional to Size (PPS) of population. A version of the CES-D Scale adapted for low-literate populations was used to measure self reported depressive symptoms. Various independent factors, including socioeconomic factors, self-reported health conditions, and functional impairments were examined to see their net effect on depressive symptoms among older persons. Results of logistic regression analysis showed that region, area, living index, independent source of income, self-reported health conditions, and functional impairment were significant factors affecting self-reported depressive symptoms among older persons in Punjab. An important cross-cultural difference was a lower risk of depressive symptoms among older women, which may reflect the buffering effects of family co-residence and the position of seniors in extended families.
Purpose: The purpose of this study was to describe humor and laughter in persons with cognitive i... more Purpose: The purpose of this study was to describe humor and laughter in persons with cognitive impairment (PWCI) and caregivers who were recalling a shared experience in a focus group. Design: Twenty participants attended an Art Engagement Activity at the Andy Warhol Art Museum, which included a guided tour and an art project. All PWCI had medically diagnosed cognitive disorders and all caregiver participants did not. Four focus groups were conducted and transcripts of audio-recorded sessions were transferred to a qualitative software program. Method: Words, phrases, and episodes of humor and laughter were used to construct codes, which were refined during group analysis using constant comparison. Findings: Humor and laughter were present in all four focus groups. Emerging themes of humor included silliness, sarcasm, and commenting about hardships of dementia. Laughter was identified in segments with and without humor. Some PWCI were unable to follow social cues. Conclusions: Humor and laughter played a role in creating a safe social environment. PWCI were able to engage in humor during social interactions, yet some had difficulty recognizing social cues. Further study may reveal roles of humor and laughter in adaptation to cognitive decline and holistic interventions for improved quality of life.
Objective: To describe the subjective experiences of older adults with early-stage Alzheimer’s d... more Objective: To describe the subjective experiences of older adults with early-stage Alzheimer’s disease or related cognitive disorders (ADRDs) and their family caregivers who participated in an art museum engagement activity.
Methods: Four focus groups were conducted with 10 persons with ADRD and 10 family caregivers following the completion of a 1-time, 3-hour engagement activity. Participants also completed a brief satisfaction survey, and associations were examined using nonparametric statistics.
Results: Three key themes were identified: cognitive stimulation, social connections, and self-esteem. In addition, we identified programmatic issues such as activity-specific concerns and program logistics that could help improve future art program offerings. Past experience with art and perceived social cohesion were correlated with participants’ overall satisfaction with the program.
Discussion: Efforts aimed at improving the quality of life of those with Alzheimer’s disease and their family caregivers should consider the potential role of art museums.
Background. Disparities in breast and cervical cancer screening by socioeconomic status persist i... more Background. Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose. This study examines the association between social support and compliance with mammogram and Pap test screening guidelines, and whether social support provides added value for women of low education. Method. Data were from a countywide 2009-2010 population-based survey, which included records of 2,588 women 40 years and older (mammogram) and 2,123 women 21 to 65 years old (Pap test). Compliance was determined using the guidelines in effect at the time of data collection. Results. Social support was significantly related to mammogram (adjusted odds ratio = 1.43; 95% confidence interval [1.16, 1.77]) and Pap test (adjusted odds ratio = 1.71; 95% confidence interval [1.27, 2.29]) compliance after controlling for age, race, having a regular health care provider, and insurance status. The interaction between social support and education had a significant effect on Pap test compliance only among women younger than 40; the effect was not significant for mammogram compliance. Conclusion. Social support is associated with breast and cervical cancer screening compliance. The association between education and cancer screening behavior may be moderated by social support; however, results hold only for Pap tests among younger women. Practitioners and researchers should focus on interventions that activate social support networks as they may help increase both breast and cervical cancer screening compliance among women with low educational attainment.
Current approaches to falls prevention mostly rely on secondary and tertiary prevention and targe... more Current approaches to falls prevention mostly rely on secondary and tertiary prevention and target individuals at high risk of falls. An alternative is primary prevention, in which all seniors are screened, referred as appropriate, and educated regarding falls risk. Little information is available on research designs that allow investigation of this approach in the setting of aging services delivery, where randomization may not be possible. Healthy Steps for Older Adults, a statewide program of the Pennsylvania (PA) Department of Aging, involves a combination of education about falls and screening for balance problems, with referral to personal physicians and home safety assessments. We developed a non-randomized statewide trial, Falls Free PA, to assess its effectiveness in reducing falls incidence over 12 months. We recruited 814 seniors who completed the program (503 first-time participants, 311 people repeating the program) and 1,020 who did not participate in the program, from the same sites. We assessed the quality of this non-randomized design by examining recruitment, follow-up across study groups, and comparability at baseline. Of older adults approached in senior centers, 90.5 % (n = 2,219) signed informed consent, and 1,834 (82.4 %) completed baseline assessments and were eligible for follow-up. Attrition in the three groups over 12 months was low and non-differential (<10 % for withdrawal and <2 % for other loss to follow-up). Median follow-up, which involved standardized monthly assessment of falls, was 10 months in all study groups. At baseline, the groups did not differ in measures of health or falls risk factors. Comparable status at baseline, recruitment from common sites, and similar experience with retention suggest that the non-randomized design will be effective for assessment of this approach to primary prevention of falls
Background: It is of considerable public health importance to prevent or delay the progression of... more Background: It is of considerable public health importance to prevent or delay the progression of mild cognitive impairment (MCI) to more severely impaired cognitive states. This study examines the risk of progression from mild to severe cognitive impairment in relation to engagement in social activities while mildly impaired and the concurrence of subsequent change in engagement with MCI progression.
Methods: Participants were 816 older adults with cognitively defined MCI (mean age 78.0 (standard deviation or SD = 7.4) years) from the Monongahela–Youghiogheny Healthy Aging Team (MYHAT) Study – a prospective cohort study of MCI in the community. Over three years of follow-up, 78 individuals progressed from MCI to severe cognitive impairment, while 738 did not progress. Risk of progression was estimated using discrete time survival analyses. The main predictors were standardized composite measures of the variety and frequency of engagement in social activities.
Results: Lower risk of progression from mild to severe cognitive impairment was associated with both a greater level of frequency of engagement in social activities while mildly impaired (OR = 0.72, 95% CI: 0.55–0.93, p = 0.01) and also with a slower rate of decline in the variety of activities over time (OR = 0.01, 95% CI: <0.001–0.38, p = 0.02).
Conclusions: Greater engagement in social activities may potentially be beneficial for preventing or delaying further cognitive decline among older adults with MCI. Alternatively, lesser engagement in social activities may be a marker of impending cognitive decline in MCI.
Objective
We evaluated the feasibility of a trial of Wii interactive video gaming, and its pot... more Objective
We evaluated the feasibility of a trial of Wii interactive video gaming, and its potential efficacy at improving cognitive functioning compared with health education, in a community sample of older adults with neuropsychologically defined mild cognitive impairment.
Methods
Twenty older adults were equally randomized to either group-based interactive video gaming or health education for 90 min each week for 24 weeks. Although the primary outcomes were related to study feasibility, we also explored the effect of the intervention on neuropsychological performance and other secondary outcomes.
Results
All 20 participants completed the intervention, and 18 attended at least 80% of the sessions. The majority (80%) of participants were “very much” satisfied with the intervention. Bowling was enjoyed by the most participants and was also rated the highest among the games for mental, social, and physical stimulation. We observed medium effect sizes for cognitive and physical functioning in favor of the interactive video gaming condition, but these effects were not statistically significant in this small sample.
Studies have demonstrated that regularly participating in activities with others may be important... more Studies have demonstrated that regularly participating in activities with others may be important for cognitive health. However, less is known about why social activities are beneficial to cognitive health. This review will highlight several important concepts to consider when studying social activities and the cognitive health of older adults. The potential psychological and physiological mechanisms linking social activities to cognitive health will be discussed, with special attention to enjoyment and the elements important for enjoyment. Little is known about enjoyment in later life and if it is important for cognitive health. A deeper understanding of the mechanisms by which enjoyment in later life may affect cognitive health could help to inform future clinical and public health interventions.
Purpose/Objectives: To explore (a) how women who were diagnosed with breast cancer (BC) defined t... more Purpose/Objectives: To explore (a) how women who were diagnosed with breast cancer (BC) defined themselves as survivors and when this occurred, and (b) the types of benefits they derived from their experiences.
Research Approach: An exploratory, qualitative approach.
Participants: 112 women who had BC (response rate = 70%).
Setting: Participants were recruited from two cancer survivor organizations in a northeastern U.S. city.
Methodologic Approach: Responses to open-ended questions in telephone interviews were examined by age at diagnosis using thematic analysis. Chi squares were used to conduct analyses by age (younger than 51 years; aged 51 years or older).
Main Research Variables: Meaning of survivorship, defining moment, benefits derived from surviving from breast cancer.
Findings: Participants' perceptions of survivorship included two main components, a defining moment and the meaning attached to being a survivor. Becoming a survivor is an active process, except in the case of those participants who realized they were survivors when informed by a third party. Meanings differed by age at diagnosis. Most participants listed at least one benefit from surviving cancer.
Conclusions: The definitions of survivorship and benefits outlined here suggest that many positive aspects of the survivorship experience exist that may inform future interventions' designs.
Implications for Practice: Providers should acknowledge the strength survivors show in the process of meaning-making and finding benefits in their adverse experiences. The use of expressive and supportive interventions may hold promise for women facing difficulties in coping with their diagnosis.
A common network phenomenon, homophily, involves developing relationships with others who are sim... more A common network phenomenon, homophily, involves developing relationships with others who are similar to you. The intent of this study was to determine if older adults' health behaviors were shared within social networks. We interviewed older adults from low-income senior housing (egos) on egocentric social network characteristics and key health behaviors for themselves and for named social ties (alters). Findings suggest strong effects for homophily, especially for those who smoked and were physically inactive. Public health interventions for older adults should consider the influence that social relationships have on personal health behaviors. Network-based interventions may be required.
Background: Falls result in devastating problems for older adults and lead to increased morbidity... more Background: Falls result in devastating problems for older adults and lead to increased morbidity, mortality and health care costs. One in three community-dwelling older adults fall each year, and close to half of older adults aged 80 and older fall each year. Several community-based fall prevention programs have been shown to reduce fall risks and fall-related injuries. Purpose: Describe the personal characteristics of participants who attend two statewide fall prevention programs in Pennsylvania. Methods: Participants were recruited from local Area Agencies on Aging and partnering senior centers that offer fall prevention programming to seniors. Results: Currently, 193 participants have been recruited from 33 senior centers/providers in eight counties in Pennsylvania. The mean age is 78, 45% of participants are 80 years or older, 82% female and 18% are African American. Seventy-eight percent live in a home or apartment in the community and only 6% receive homemaker or nursing serv...
Purpose: To describe persons with Alzheimer's (AD) and their caregivers' subjective views... more Purpose: To describe persons with Alzheimer's (AD) and their caregivers' subjective views and experiences regarding participation in an art engagement activity. Methods: Four focus groups were conducted with participants in a novel art engagement activity at the Andy Warhol Museum. Immediately following the completion of the activity, we recruited 10 persons with AD or cognitive impairment and 10 caregivers to share their views and experiences. Open-ended questions were asked in each focus group and we used the qualitative method of grounded theory to analyze the data. Participants also completed a brief satisfaction survey and associations were examined using nonparametric statistics. Findings: Three key themes were identified that described the aspects that participants' enjoyed overall: cognitive stimulation, social connections, and a sense of self. In addition, we identified programmatic issues such as participant characteristics, activity-specific concerns and progr...
WalkWorks is a large scaled, community-based health improvement initiative based at the Universit... more WalkWorks is a large scaled, community-based health improvement initiative based at the University of Pittsburgh Graduate School of Public Health. The initiative is operated in partnership with the Pennsylvania Department of Health, the Centers for Disease Control and Prevention, and local organizations in six rural counties in Western Pennsylvania. Funding originates with the American Recovery and Reinvestment Act. WalkWorks seeks to increase physical activity by establishing community-based walking initiatives. Through WalkWorks, access to local walking routes and social support of individuals wanting to improve their activity habits is enhanced. Specifically, WalkWorks identifies, maps and promotes safe walking routes that are accessible to people of all ages and abilities, establishes and promotes guided community-based walking groups, and advocates for local policy related to pedestrian transportation in the built environment. The initiative was designed by the Pennsylvania Dep...
This paper examines the prevalence and correlates of depressive symptoms among older persons of P... more This paper examines the prevalence and correlates of depressive symptoms among older persons of Punjab, the largest Province of Pakistan. Data were gathered from 4191 older persons aged 60+ using Probability Proportional to Size (PPS) of population. A version of the CES-D Scale adapted for low-literate populations was used to measure self reported depressive symptoms. Various independent factors, including socioeconomic factors, self-reported health conditions, and functional impairments were examined to see their net effect on depressive symptoms among older persons. Results of logistic regression analysis showed that region, area, living index, independent source of income, self-reported health conditions, and functional impairment were significant factors affecting self-reported depressive symptoms among older persons in Punjab. An important cross-cultural difference was a lower risk of depressive symptoms among older women, which may reflect the buffering effects of family co-residence and the position of seniors in extended families.
Purpose: The purpose of this study was to describe humor and laughter in persons with cognitive i... more Purpose: The purpose of this study was to describe humor and laughter in persons with cognitive impairment (PWCI) and caregivers who were recalling a shared experience in a focus group. Design: Twenty participants attended an Art Engagement Activity at the Andy Warhol Art Museum, which included a guided tour and an art project. All PWCI had medically diagnosed cognitive disorders and all caregiver participants did not. Four focus groups were conducted and transcripts of audio-recorded sessions were transferred to a qualitative software program. Method: Words, phrases, and episodes of humor and laughter were used to construct codes, which were refined during group analysis using constant comparison. Findings: Humor and laughter were present in all four focus groups. Emerging themes of humor included silliness, sarcasm, and commenting about hardships of dementia. Laughter was identified in segments with and without humor. Some PWCI were unable to follow social cues. Conclusions: Humor and laughter played a role in creating a safe social environment. PWCI were able to engage in humor during social interactions, yet some had difficulty recognizing social cues. Further study may reveal roles of humor and laughter in adaptation to cognitive decline and holistic interventions for improved quality of life.
Objective: To describe the subjective experiences of older adults with early-stage Alzheimer’s d... more Objective: To describe the subjective experiences of older adults with early-stage Alzheimer’s disease or related cognitive disorders (ADRDs) and their family caregivers who participated in an art museum engagement activity.
Methods: Four focus groups were conducted with 10 persons with ADRD and 10 family caregivers following the completion of a 1-time, 3-hour engagement activity. Participants also completed a brief satisfaction survey, and associations were examined using nonparametric statistics.
Results: Three key themes were identified: cognitive stimulation, social connections, and self-esteem. In addition, we identified programmatic issues such as activity-specific concerns and program logistics that could help improve future art program offerings. Past experience with art and perceived social cohesion were correlated with participants’ overall satisfaction with the program.
Discussion: Efforts aimed at improving the quality of life of those with Alzheimer’s disease and their family caregivers should consider the potential role of art museums.
Background. Disparities in breast and cervical cancer screening by socioeconomic status persist i... more Background. Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose. This study examines the association between social support and compliance with mammogram and Pap test screening guidelines, and whether social support provides added value for women of low education. Method. Data were from a countywide 2009-2010 population-based survey, which included records of 2,588 women 40 years and older (mammogram) and 2,123 women 21 to 65 years old (Pap test). Compliance was determined using the guidelines in effect at the time of data collection. Results. Social support was significantly related to mammogram (adjusted odds ratio = 1.43; 95% confidence interval [1.16, 1.77]) and Pap test (adjusted odds ratio = 1.71; 95% confidence interval [1.27, 2.29]) compliance after controlling for age, race, having a regular health care provider, and insurance status. The interaction between social support and education had a significant effect on Pap test compliance only among women younger than 40; the effect was not significant for mammogram compliance. Conclusion. Social support is associated with breast and cervical cancer screening compliance. The association between education and cancer screening behavior may be moderated by social support; however, results hold only for Pap tests among younger women. Practitioners and researchers should focus on interventions that activate social support networks as they may help increase both breast and cervical cancer screening compliance among women with low educational attainment.
Current approaches to falls prevention mostly rely on secondary and tertiary prevention and targe... more Current approaches to falls prevention mostly rely on secondary and tertiary prevention and target individuals at high risk of falls. An alternative is primary prevention, in which all seniors are screened, referred as appropriate, and educated regarding falls risk. Little information is available on research designs that allow investigation of this approach in the setting of aging services delivery, where randomization may not be possible. Healthy Steps for Older Adults, a statewide program of the Pennsylvania (PA) Department of Aging, involves a combination of education about falls and screening for balance problems, with referral to personal physicians and home safety assessments. We developed a non-randomized statewide trial, Falls Free PA, to assess its effectiveness in reducing falls incidence over 12 months. We recruited 814 seniors who completed the program (503 first-time participants, 311 people repeating the program) and 1,020 who did not participate in the program, from the same sites. We assessed the quality of this non-randomized design by examining recruitment, follow-up across study groups, and comparability at baseline. Of older adults approached in senior centers, 90.5 % (n = 2,219) signed informed consent, and 1,834 (82.4 %) completed baseline assessments and were eligible for follow-up. Attrition in the three groups over 12 months was low and non-differential (<10 % for withdrawal and <2 % for other loss to follow-up). Median follow-up, which involved standardized monthly assessment of falls, was 10 months in all study groups. At baseline, the groups did not differ in measures of health or falls risk factors. Comparable status at baseline, recruitment from common sites, and similar experience with retention suggest that the non-randomized design will be effective for assessment of this approach to primary prevention of falls
Background: It is of considerable public health importance to prevent or delay the progression of... more Background: It is of considerable public health importance to prevent or delay the progression of mild cognitive impairment (MCI) to more severely impaired cognitive states. This study examines the risk of progression from mild to severe cognitive impairment in relation to engagement in social activities while mildly impaired and the concurrence of subsequent change in engagement with MCI progression.
Methods: Participants were 816 older adults with cognitively defined MCI (mean age 78.0 (standard deviation or SD = 7.4) years) from the Monongahela–Youghiogheny Healthy Aging Team (MYHAT) Study – a prospective cohort study of MCI in the community. Over three years of follow-up, 78 individuals progressed from MCI to severe cognitive impairment, while 738 did not progress. Risk of progression was estimated using discrete time survival analyses. The main predictors were standardized composite measures of the variety and frequency of engagement in social activities.
Results: Lower risk of progression from mild to severe cognitive impairment was associated with both a greater level of frequency of engagement in social activities while mildly impaired (OR = 0.72, 95% CI: 0.55–0.93, p = 0.01) and also with a slower rate of decline in the variety of activities over time (OR = 0.01, 95% CI: <0.001–0.38, p = 0.02).
Conclusions: Greater engagement in social activities may potentially be beneficial for preventing or delaying further cognitive decline among older adults with MCI. Alternatively, lesser engagement in social activities may be a marker of impending cognitive decline in MCI.
Objective
We evaluated the feasibility of a trial of Wii interactive video gaming, and its pot... more Objective
We evaluated the feasibility of a trial of Wii interactive video gaming, and its potential efficacy at improving cognitive functioning compared with health education, in a community sample of older adults with neuropsychologically defined mild cognitive impairment.
Methods
Twenty older adults were equally randomized to either group-based interactive video gaming or health education for 90 min each week for 24 weeks. Although the primary outcomes were related to study feasibility, we also explored the effect of the intervention on neuropsychological performance and other secondary outcomes.
Results
All 20 participants completed the intervention, and 18 attended at least 80% of the sessions. The majority (80%) of participants were “very much” satisfied with the intervention. Bowling was enjoyed by the most participants and was also rated the highest among the games for mental, social, and physical stimulation. We observed medium effect sizes for cognitive and physical functioning in favor of the interactive video gaming condition, but these effects were not statistically significant in this small sample.
Studies have demonstrated that regularly participating in activities with others may be important... more Studies have demonstrated that regularly participating in activities with others may be important for cognitive health. However, less is known about why social activities are beneficial to cognitive health. This review will highlight several important concepts to consider when studying social activities and the cognitive health of older adults. The potential psychological and physiological mechanisms linking social activities to cognitive health will be discussed, with special attention to enjoyment and the elements important for enjoyment. Little is known about enjoyment in later life and if it is important for cognitive health. A deeper understanding of the mechanisms by which enjoyment in later life may affect cognitive health could help to inform future clinical and public health interventions.
Purpose/Objectives: To explore (a) how women who were diagnosed with breast cancer (BC) defined t... more Purpose/Objectives: To explore (a) how women who were diagnosed with breast cancer (BC) defined themselves as survivors and when this occurred, and (b) the types of benefits they derived from their experiences.
Research Approach: An exploratory, qualitative approach.
Participants: 112 women who had BC (response rate = 70%).
Setting: Participants were recruited from two cancer survivor organizations in a northeastern U.S. city.
Methodologic Approach: Responses to open-ended questions in telephone interviews were examined by age at diagnosis using thematic analysis. Chi squares were used to conduct analyses by age (younger than 51 years; aged 51 years or older).
Main Research Variables: Meaning of survivorship, defining moment, benefits derived from surviving from breast cancer.
Findings: Participants' perceptions of survivorship included two main components, a defining moment and the meaning attached to being a survivor. Becoming a survivor is an active process, except in the case of those participants who realized they were survivors when informed by a third party. Meanings differed by age at diagnosis. Most participants listed at least one benefit from surviving cancer.
Conclusions: The definitions of survivorship and benefits outlined here suggest that many positive aspects of the survivorship experience exist that may inform future interventions' designs.
Implications for Practice: Providers should acknowledge the strength survivors show in the process of meaning-making and finding benefits in their adverse experiences. The use of expressive and supportive interventions may hold promise for women facing difficulties in coping with their diagnosis.
A common network phenomenon, homophily, involves developing relationships with others who are sim... more A common network phenomenon, homophily, involves developing relationships with others who are similar to you. The intent of this study was to determine if older adults' health behaviors were shared within social networks. We interviewed older adults from low-income senior housing (egos) on egocentric social network characteristics and key health behaviors for themselves and for named social ties (alters). Findings suggest strong effects for homophily, especially for those who smoked and were physically inactive. Public health interventions for older adults should consider the influence that social relationships have on personal health behaviors. Network-based interventions may be required.
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Papers by Jason Flatt
Methods: Four focus groups were conducted with 10 persons with ADRD and 10 family caregivers following the completion of a 1-time, 3-hour engagement activity. Participants also completed a brief satisfaction survey, and associations were examined using nonparametric statistics.
Results: Three key themes were identified: cognitive stimulation, social connections, and self-esteem. In addition, we identified programmatic issues such as activity-specific concerns and program logistics that could help improve future art program offerings. Past experience with art and perceived social cohesion were correlated with participants’ overall satisfaction with the program.
Discussion: Efforts aimed at improving the quality of life of those with Alzheimer’s disease and their family caregivers should consider the potential role of art museums.
Methods: Participants were 816 older adults with cognitively defined MCI (mean age 78.0 (standard deviation or SD = 7.4) years) from the Monongahela–Youghiogheny Healthy Aging Team (MYHAT) Study – a prospective cohort study of MCI in the community. Over three years of follow-up, 78 individuals progressed from MCI to severe cognitive impairment, while 738 did not progress. Risk of progression was estimated using discrete time survival analyses. The main predictors were standardized composite measures of the variety and frequency of engagement in social activities.
Results: Lower risk of progression from mild to severe cognitive impairment was associated with both a greater level of frequency of engagement in social activities while mildly impaired (OR = 0.72, 95% CI: 0.55–0.93, p = 0.01) and also with a slower rate of decline in the variety of activities over time (OR = 0.01, 95% CI: <0.001–0.38, p = 0.02).
Conclusions: Greater engagement in social activities may potentially be beneficial for preventing or delaying further cognitive decline among older adults with MCI. Alternatively, lesser engagement in social activities may be a marker of impending cognitive decline in MCI.
We evaluated the feasibility of a trial of Wii interactive video gaming, and its potential efficacy at improving cognitive functioning compared with health education, in a community sample of older adults with neuropsychologically defined mild cognitive impairment.
Methods
Twenty older adults were equally randomized to either group-based interactive video gaming or health education for 90 min each week for 24 weeks. Although the primary outcomes were related to study feasibility, we also explored the effect of the intervention on neuropsychological performance and other secondary outcomes.
Results
All 20 participants completed the intervention, and 18 attended at least 80% of the sessions. The majority (80%) of participants were “very much” satisfied with the intervention. Bowling was enjoyed by the most participants and was also rated the highest among the games for mental, social, and physical stimulation. We observed medium effect sizes for cognitive and physical functioning in favor of the interactive video gaming condition, but these effects were not statistically significant in this small sample.
Conclusion
Interactive video gaming is feasible for older adults with mild cognitive impairment, and medium effect sizes in favor of the Wii group warrant a larger efficacy trial. Copyright © 2014 John Wiley & Sons, Ltd.
Research Approach: An exploratory, qualitative approach.
Participants: 112 women who had BC (response rate = 70%).
Setting: Participants were recruited from two cancer survivor organizations in a northeastern U.S. city.
Methodologic Approach: Responses to open-ended questions in telephone interviews were examined by age at diagnosis using thematic analysis. Chi squares were used to conduct analyses by age (younger than 51 years; aged 51 years or older).
Main Research Variables: Meaning of survivorship, defining moment, benefits derived from surviving from breast cancer.
Findings: Participants' perceptions of survivorship included two main components, a defining moment and the meaning attached to being a survivor. Becoming a survivor is an active process, except in the case of those participants who realized they were survivors when informed by a third party. Meanings differed by age at diagnosis. Most participants listed at least one benefit from surviving cancer.
Conclusions: The definitions of survivorship and benefits outlined here suggest that many positive aspects of the survivorship experience exist that may inform future interventions' designs.
Implications for Practice: Providers should acknowledge the strength survivors show in the process of meaning-making and finding benefits in their adverse experiences. The use of expressive and supportive interventions may hold promise for women facing difficulties in coping with their diagnosis.
Methods: Four focus groups were conducted with 10 persons with ADRD and 10 family caregivers following the completion of a 1-time, 3-hour engagement activity. Participants also completed a brief satisfaction survey, and associations were examined using nonparametric statistics.
Results: Three key themes were identified: cognitive stimulation, social connections, and self-esteem. In addition, we identified programmatic issues such as activity-specific concerns and program logistics that could help improve future art program offerings. Past experience with art and perceived social cohesion were correlated with participants’ overall satisfaction with the program.
Discussion: Efforts aimed at improving the quality of life of those with Alzheimer’s disease and their family caregivers should consider the potential role of art museums.
Methods: Participants were 816 older adults with cognitively defined MCI (mean age 78.0 (standard deviation or SD = 7.4) years) from the Monongahela–Youghiogheny Healthy Aging Team (MYHAT) Study – a prospective cohort study of MCI in the community. Over three years of follow-up, 78 individuals progressed from MCI to severe cognitive impairment, while 738 did not progress. Risk of progression was estimated using discrete time survival analyses. The main predictors were standardized composite measures of the variety and frequency of engagement in social activities.
Results: Lower risk of progression from mild to severe cognitive impairment was associated with both a greater level of frequency of engagement in social activities while mildly impaired (OR = 0.72, 95% CI: 0.55–0.93, p = 0.01) and also with a slower rate of decline in the variety of activities over time (OR = 0.01, 95% CI: <0.001–0.38, p = 0.02).
Conclusions: Greater engagement in social activities may potentially be beneficial for preventing or delaying further cognitive decline among older adults with MCI. Alternatively, lesser engagement in social activities may be a marker of impending cognitive decline in MCI.
We evaluated the feasibility of a trial of Wii interactive video gaming, and its potential efficacy at improving cognitive functioning compared with health education, in a community sample of older adults with neuropsychologically defined mild cognitive impairment.
Methods
Twenty older adults were equally randomized to either group-based interactive video gaming or health education for 90 min each week for 24 weeks. Although the primary outcomes were related to study feasibility, we also explored the effect of the intervention on neuropsychological performance and other secondary outcomes.
Results
All 20 participants completed the intervention, and 18 attended at least 80% of the sessions. The majority (80%) of participants were “very much” satisfied with the intervention. Bowling was enjoyed by the most participants and was also rated the highest among the games for mental, social, and physical stimulation. We observed medium effect sizes for cognitive and physical functioning in favor of the interactive video gaming condition, but these effects were not statistically significant in this small sample.
Conclusion
Interactive video gaming is feasible for older adults with mild cognitive impairment, and medium effect sizes in favor of the Wii group warrant a larger efficacy trial. Copyright © 2014 John Wiley & Sons, Ltd.
Research Approach: An exploratory, qualitative approach.
Participants: 112 women who had BC (response rate = 70%).
Setting: Participants were recruited from two cancer survivor organizations in a northeastern U.S. city.
Methodologic Approach: Responses to open-ended questions in telephone interviews were examined by age at diagnosis using thematic analysis. Chi squares were used to conduct analyses by age (younger than 51 years; aged 51 years or older).
Main Research Variables: Meaning of survivorship, defining moment, benefits derived from surviving from breast cancer.
Findings: Participants' perceptions of survivorship included two main components, a defining moment and the meaning attached to being a survivor. Becoming a survivor is an active process, except in the case of those participants who realized they were survivors when informed by a third party. Meanings differed by age at diagnosis. Most participants listed at least one benefit from surviving cancer.
Conclusions: The definitions of survivorship and benefits outlined here suggest that many positive aspects of the survivorship experience exist that may inform future interventions' designs.
Implications for Practice: Providers should acknowledge the strength survivors show in the process of meaning-making and finding benefits in their adverse experiences. The use of expressive and supportive interventions may hold promise for women facing difficulties in coping with their diagnosis.