Brian D. Carpenter

Computer use among older adults in a naturally occurring retirement community

Though computers and the Internet offer an opportunity to enhance the lives of older adults, rates of computer use among older adults are low relative to other age groups. This study examined patterns of computer use and barriers to use among 324 residents living in a suburban naturally occurring retirement community (NORC). One-third (36%) of the residents were actively using computers. Residents currently using computers were more likely to be younger, with more education, fewer functional impairments, and greater social resources. Results from a multidimensional scaling analysis suggested that common uses fell along two dimensions: a solitary-social dimension and an obligatory-discretionary dimension. Barriers to more frequent use included cost, complexity, ergonomic impediments, and a lack of interest. Results from this study could inform the development of services by taking into account how older adults prefer to use computers and their perceptions of the technology. We include practical recommendations for program developers.

The Alzheimer's Disease Knowledge Scale: Development and Psychometric Properties

PURPOSE This study provides preliminary evidence for the acceptability, reliability, and validity of the new Alzheimers Disease Knowledge Scale (ADKS), a content and psychometric update to the Alzheimers Disease Knowledge Test. DESIGN AND METHODS Traditional scale development methods were used to generate items and evaluate their psychometric properties in a variety of subsamples. RESULTS The final 30-item, true/false scale takes approximately 5-10 min to complete and covers risk factors, assessment and diagnosis, symptoms, course, life impact, caregiving, and treatment and management. Preliminary results suggest that the ADKS has adequate reliability (test-retest and internal consistency) and validity (content, predictive, concurrent, and convergent). IMPLICATIONS The ADKS is designed for use in both applied and research contexts, capable of assessing knowledge about Alzheimers disease among laypeople, patients, caregivers, and professionals.

Reaction to a Dementia Diagnosis in Individuals with Alzheimer's Disease and Mild Cognitive Impairment

OBJECTIVES: To examine short‐term changes in depression and anxiety after receiving a dementia diagnosis.

Directive and Nondirective E-Coach Support for Weight Loss in Overweight Adults

BackgroundAlthough e-coach support increases the effectiveness of Internet weight loss interventions, no studies have assessed influence of type of e-coach support.PurposeThe effects of nondirective (collaborative, flexible) and directive (prescriptive, protocol driven) e-coach support on weight loss, dietary behavior, physical activity, and engagement were assessed in a 12-week weight loss e-coaching program.ProceduresOverweight adults (N = 104) were randomly assigned to nondirective, directive, or minimal support. All received weekly lessons and feedback graphs via e-mail. Participants in the nondirective and directive support conditions received individualized nondirective or directive weight loss support.ResultsFor females, weight loss (η2 = 0.10) and changes in waist circumference (η2 = 0.07) were greater in the directive than in the nondirective and minimal support conditions.ConclusionsDifferences in type of e-coach support are salient to participants. Directive support is beneficial to females in a 12-week e-coach weight loss program.

Family, peer, and staff social support in nursing home patients: Contributions to psychological well-being

This study examined whether nursing home patients identified social support as coming from institutional peers and staff as well as family members. Associations among social support from those three sources, psychological well-being, and motivation to participate in treatment were explored in 32 patients. A majority described peer and staff support networks that were as large as or larger than their family support network. Subjective perceptions of support, but not size of network, were associated with well-being. Perceived support from peers was associated with less depression, greater positive affect, and greater motivation. Perceived support from staff and family was less consistently associated with well-being and motivation. Results suggest that peer and staff support contribute to the well-being of older adults and may complement family support during inpatient admissions or residential stays. Clinical and programmatic interventions that facilitate peer and staff support might enhance patient well-being and stimulate participation in self-care.

Anticipating relocation: concerns about moving among NORC residents.

Summary Most older adults prefer to live at home as long as possible, requiring supports and services to help them age in place. This study examines the relocation concerns of a group of older adults in a suburban naturally-occurring retirement community (NORC). Twenty-six percent of the 324 residents interviewed expressed concern about having to move in the next few years. Residents who were worried differed from those who did not worry on a number of demographic and biopsychosocial characteristics. Overall, residents present a profile of vulnerability that calls for preemptive action to help them stay in their homes. A NORC is an ideal setting in which to provide supportive services.

Demographic and Contextual Factors Related to Knowledge About Alzheimer's Disease

Accurate knowledge about Alzheimer’s disease (AD) is essential to address the public health impact of dementia. This study examined AD knowledge in 794 people who completed the Alzheimer’s Disease Knowledge Scale and questions about their background and experience with AD. Whereas overall knowledge was fair, there was significant variability across groups. Knowledge was highest among professionals working in the dementia field, lower for dementia caregivers and older adults, and lowest for senior center staff and undergraduate students. Across groups, respondents knew the most about assessment, treatment, and management of AD and knew the least about risk factors and prevention. Greater knowledge was associated with working in the dementia field, having family members with AD, attending a related class or support group, and exposure to dementia-related information from multiple sources. Understanding where gaps in dementia knowledge exist can guide education initiatives to increase disease awareness and improve supportive services.

Measuring treatment fidelity in a rehabilitation intervention study.

ABSTRACTAttaining and demonstrating treatment fidelity is critical in the development and testing of evidence-based interventions. Treatment fidelity refers to the extent to which an intervention was implemented in clinical testing as it was conceptualized and is clearly differentiable from control or standard-of-care interventions. In clinical research, treatment fidelity is typically attained through intensive training and supervision techniques and demonstrated by measuring therapist adherence and competence to the protocol using external raters. However, in occupational and physical therapy outcomes research, treatment fidelity methods have not been used, which, in our view, is a serious gap that impedes novel treatment development and testing in these rehabilitation fields. In this article, we describe the development of methods to train and supervise therapists to attain adequate treatment fidelity in a treatment development project involving a novel occupational and physical therapy–based intervention. We also present a data-driven model for demonstrating therapist adherence and competence in the new treatment and its differentiation from standard of care. In doing so, we provide an approach that rehabilitation researchers can use to address treatment fidelity in occupational and physical therapy–based interventions. We recommend that all treatment researchers in rehabilitation disciplines use these or similar methods as a vital step in the development and testing of evidence-based rehabilitation interventions.

Black and White Adult Family Members' Attitudes Toward a Dementia Diagnosis

OBJECTIVES: To examine potential benefits of and barriers to diagnosis from the perspective of black and white adults directly affected by Alzheimers disease (AD).

Preferences and life evaluations of older adults with and without dementia: reliability, stability, and proxy knowledge.

This study assessed the reliability and stability of care preferences and life evaluations among older adults with and without dementia. The study also examined spouse proxy predictions of partner responses. Test-retest reliability over 1 week, stability over 1 year, and proxy knowledge were all moderate to good, but lower for people with dementia. In all 3 areas, however, there was broad interindividual variability. People with dementia may become less reliable and stable in their self-reports, and some spouse proxies may have flawed knowledge about their partner, but dementia status alone is not sufficient to presume poor reliability or knowledge.