Allison Lindauer

TELE-STAR FOR CAREGIVERS: FIDELITY ASSESSMENT METHODS AND EARLY FINDINGS

approach to the intervention design combines advances from three fields: (a) the “task-sharing model” from global mental health research, in which trained community health workers, supervised by health professionals, deliver health care as a strategy to overcome the lack of adequately trained care specialists in LMICs; (b) evidence-based interventions developed in non-LMIC countries including exercise / activity programs used successfully with caregiver/ care recipient dyads in the US, and (c) the Getting-to-Outcomes (GTO) implementation support model. This is a promising approach for Thailand because it builds on prior, similar research in that country and potentially will help to improve efficient intervention implementation strategies. This work is innovative in that it will be the first government–university partnership to address growing needs for infrastructure to assist elderly persons with significant cognitive impairment in Thailand. We anticipate that this model, if successful, will be scaled-up in Thailand and exported to other Asian countries in the future. Results:Contextual data on policy environments, service settings, and financing mechanisms have been collected. These data are informative for addressing three basic challenges: How to tailor evidence-based exercise interventions to fit the local social and cultural context? How to build capacity at local service sites to enhance their readiness for new services? How to provide implementation support using a culturallyadapted GTO model? Conclusions: Contextual data are critical to inform the adaptation and implementation approaches for the randomized controlled trial to identify the most effective strategies for advancing and scaling up evidence-based dementia care services in a developing country.

SOCIAL ENGAGEMENT AND COGNITIVE FUNCTION ARE RELATED IN OLDER AFRICAN AMERICANS

Mustafa M. Ahmed, Allison Lindauer, Andr e Pruitt, Nora Mattek, Jeffrey A. Kaye, Oregon Health & Science University, Portland, OR, USA; NIA-Layton Aging and Alzheimer’s Disease Center, Portland, OR, USA; Portland State University, Portland, OR, USA; Oregon Center for Aging & Technology (ORCATECH), Portland, OR, USA; NIA-Layton Aging and Alzheimer’s Disease Center, Portland, OR, USA. Contact e-mail: ahmedmu@ohsu.edu

‘YOU DON'T NEED TO DO THINGS FACE-TO-FACE ANYMORE...’: STAR-C-TELEMEDICINE

(MCI) or mild dementia, even though it is used in this population. Methods: We enrolled 28 older adults ( 50 years) to a randomized parallel-group trial of center-based versus home-based exercise. Participants were diagnosed with MCI or mild dementia (MoCA 17 or MMSE 22), were safe to exercise, and were currently exercising 2x/wk. At baseline, participants reported physical activity levels using the PASE and had physical activity assessed using an accelerometer (Actigraph GT3x+) over 7 days. Physical function was assessed using the 6-min walk, 5x sit-stand, and gait speed. Spearman’s rank correlation coefficient (rs) was calculated between PASE scores and accelerometer (% time in moderate-vigorous physical activity [MVPA], step count) and physical function scores. Results: Participants’ average age (SD) was 75.5 (8.2) years and education was 15.0 (3.5) years; they were 18% (n1⁄45) female. There were no significant relationships between the PASE score and either accelerometer scores (% time in moderate-vigorous physical activity, step count) or physical function (sit-stand, 6min walk, gait speed) (p>0.07). However, rs were in the expected direction. Non-significant, positive rs occurred between PASE score and % MVPA (rs1⁄40.31, p1⁄40.13), step count (rs1⁄40.30, p1⁄40.14), and 6-min walk time (rs1⁄40.23, p1⁄40.16). Negative rs occurred between PASE score and gait speed (rs1⁄4-0.34, p1⁄40.06). Conclusions: Our results are insufficient to support the validation of the PASE of among individuals with MCI or mild dementia. Further work is needed to support use of the PASE in this group. With additional participants enrolled to the trial through late 2018, it is possible that the expanded sample will clarify the validity of the PASE in this population.

STAR-C-TELEMEDICINE: COST ANALYSIS

generated much interest are locating systems. Such systems allow to locate persons with dementia (PwD) via global positioning system technology. The aim of this study is to investigate the usefulness and potential benefits of locating systems for PwD and their caregivers (CG). Methods:We conducted a two month longitudinal user study with 20 dyads of PwD and CG (dementia severity: n1⁄410 mild and n1⁄410 moderate). Outcome measures were three times determined. We implemented a cross-over design with two similar available locating system watches (Himatic and ReSOS), followed by detailed analyses focusing on user experience. Our primary outcome measures were usability and acceptability. Secondary outcome measures comprised caregiver burden, activities of daily living and quality of life. Covariates were technological affinity and group membership. Results: 18 dyads completed the study. Overall usability ratings decreased after two months of use, from 75.7% to 65.2% (t(35)1⁄41.88,p1⁄4.067,n1⁄436). Surprisingly, technological affinity scores also decreased over time, from 76.8% to 61% (t(35)1⁄47.33,p1⁄4.000,n1⁄436). No changes were detected regarding caregiver burden, activities of daily living and quality of life. Multiple regression analysis revealed four factors predicting participants’ usability ratings at baseline (R1⁄4.92,F(8,11)1⁄4 16.31,p1⁄4.000). PwD had lower usability ratings than CG (b1⁄4.30,p1⁄4.026) and low usability scores were associated with more pronounced dementia (b1⁄4-.72,p1⁄4.000). As expected, lower technological affinity negatively predicted usability (b1⁄4.36,p1⁄4.006). Evaluating Himatic predicted lower usability than rating ReSOS (b1⁄4.57,p1⁄4.001). Educational sessions and handbooks were essential for all dyads. Conclusions:Our study investigates two locating systems and which factors might influence their potential benefit. More impaired PwD as well as participants with low technological affinity seem to experience less usability indicating the importance of educational sessions and professional advice. Usability ratings and technological affinity dropped over time reflecting technical dysfunction and stressful effects. More detailed analyses implicate recommendations for professionals and developers. Finally, data from our study suggest that usability of assistive technology has to improve and has only started on a long way to facilitate dementia care.

DISTANCE AND INTIMACY: AN ETHNOGRAPHIC ANALYSIS OF THE STRENGTHS AND LIMITATIONS OF VIDEO TELEMEDICINE CARE FOR DEMENTIA

TD-P-001 DISTANCE AND INTIMACY: AN ETHNOGRAPHIC ANALYSIS OF THE STRENGTHS AND LIMITATIONS OF VIDEO TELEMEDICINE CARE FOR DEMENTIA Bayard Lyons, Allison Lindauer, Adriana Seelye, Katherine Mincks, Jeff A. Kaye, Deniz Erten-Lyons, NIA-Layton Aging and Alzheimer’s Disease Center, Oregon Health & Science University, Portland, OR, USA; 2 Oregon Center for Aging and Technology (ORCATECH), Oregon Health & Science University, Portland, OR, USA; Oregon Health & Science University, Portland, OR, USA; Oregon Center for Aging and Technology (ORCATECH), Portland, OR, USA; 5 NIA-Layton Aging and Alzheimer’s Disease Center, Portland, OR, USA; 6 NIA-Layton Aging and Alzheimer’s Disease Center, Oregon Health & Science University, Portland, OR, USA; Oregon Health & Science University, Portland, OR, USA; 8 NIA-Layton Aging and Alzheimer’s Disease Center, Portland, OR, USA. Contact e-mail: lyonsb@ohsu.edu