Sally Miller

Effects of Tai Chi on cognitive function in community-dwelling older adults: A review

As the population of the United States ages, activities to maintain or improve cognitive function will become increasingly important to preserve functional ability, independence and health-related quality of life. This article is a review of recent research on Tai Chi and cognitive function in community-dwelling older adults. Of the 12 studies reviewed, 10 reported improvement in measures of executive function, language, learning, and/or memory. Several design features make comparisons across studies challenging. As a moderate-intensity, low-impact form of exercise, Tai Chi is appropriate for older adults and seems to offer positive cognitive benefits. Recommendations for future research are provided.

The association of physical activity, cognitive processes and automobile driving ability in older adults: A review of the literature

As the number of older adults in the United States grows, the number of automobile drivers over the age of 65 will also increase. Several cognitive processes necessary for automobile driving are vulnerable to age-related decline. These include declines in executive function, working memory, attention, and speed of information processing. The benefits of physical activity on physical, psychological and particular cognitive processes are well-documented; however few studies have explored the relationship between physical activity and driving ability in older adults or examined if cognitive processes mediate (or moderate) the effect of physical activity on driving ability. The purpose of this paper is to review the existing literature regarding physical activity, cognition and automobile driving. Recommendations for further research and utility of the findings to nursing and the health care team are provided.

Journal writing: a teaching strategy for gerontology nursing courses.

Journal writing, recognized as a valuable method to augment and enrich learning, has been used in adult education, higher education, and in the health care professions. Journal writing promotes reflective thought and increases awareness. This article describes how journal writing was used in the gerontology rotation of an associate degree nursing program to engage students in the content, encourage examination of personal beliefs, recognize biases, and reflect on perceptions about older adults.

The association between Tai Chi exercise and safe driving performance among older adults: An observational study

Background Age-related cognitive and physical decline can impair safe driving performance. Tai Chi exercise benefits cognitive and physical function and may influence safe driving performance in older adults. The primary aim of this observational study was to compare cognitive processes and physical function related to safe driving performance among older adult Tai Chi practitioners to normative reference values. Secondary aims were to examine relationships between Tai Chi exercise habits, cognitive processes, and physical function related to safe driving performance and to explore potential predictors of safe driving performance. Methods The DrivingHealth Inventory, the Driving Scenes Test, other driving-related cognitive and physical measures, and self-reported measures including the Mindful Attention Awareness Scale (MAAS) and the Vitality Plus Scale (VPS) were collected from current Tai Chi practitioners (n = 58; age 72.9 ± 5.9 years, mean ± SD) with median >3 years Tai Chi practice. Results Compared to normative reference values, participants performed better on numerous cognitive measures including the Driving Scenes Test (p < 0.001, d = 1.63), maze navigation (p = 0.017, d = 0.27), the Useful Field of View Test (p < 0.001, r = 0.15), and on physical measures including the Rapid Walk Test (p < 0.001, r = 0.20), and the Right Foot Tapping Test, (p < 0.001, r = 0.35). Participants scored higher than normative reference values on MAAS and VPS (p < 0.001, d = 0.75; p = 0.002, d = 0.38, respectively). Statistically significant correlations were found between several study measures. The digit span backward test was the strongest predictor of safe driving performance (β = 0.34, p = 0.009). Conclusion Tai Chi exercise has the potential to impact cognitive processes and physical function related to safe driving performance. Further study using randomized controlled trials, structured Tai Chi exercise doses, and driving simulator or on-road driving performance as outcome measures are warranted.

Geriatric Syndromes: Meeting a Growing Challenge

The world is aging. The older adult population is growing rapidly in the United States and worldwide. It is estimated that older adults will represent 20% of the US population by 2030, at which time they will exceed the number of the young for the first time in history. Given advancements in medical care, life expectancy in this country is increasing. Current life expectancy at birth is 78.8 years. Those who survive to age 65 can be expected to live, on average, until age 84, and those who survive to age 85 are expected to live to age 91. “Old-old” adults, those aged 85, is the fastest growing age group in the United States andwill represent 4.5% of American population by 2030. Old-old adults have more health conditions than their younger counterparts. Along with a growing percentage of older adults is a growing public concern about the ability to adequately care for their unique and complex physical and psychosocial needs. Normal changes of aging combined with accrued diseases and conditions increase an older adult’s vulnerability. More than two-thirds of all Medicare beneficiaries have two or more chronic conditions, and more than 15% have six or more. The occurrence of at least one chronic medical condition is associated with the presence of at least one geriatric syndrome. Geriatric syndromes are clinical conditions commonly found in older adults and are associated with increased morbidity and mortality. They share underlying contributing factors and involve multiple organ systems, but they do not fit into specific disease categories. Common geriatric syndromes include urinary incontinence, cognitive impairment, delirium, falls, pressure ulcers, polypharmacy, and weight loss. Geriatric syndromes contribute to poor health outcomes, including disability, institutionalization, and dependence. In their various clinical roles, nurses have the opportunity to identify geriatric syndromes through screening and thorough assessments. Furthermore, nurses are in a position to refer to, and collaborate with, appropriate disciplines, family, and

Geriatric Simulation: Practicing Management and Leadership in Care of the Older Adult

According to the Centers for Disease Control and Prevention, patients age 65 and older account for 43% of hospital days. The complexity of caring for older adults affords nursing students opportunities to assess, prioritize, intervene, advocate, and experience being a member of an interdisciplinary health care team. However, these multifaceted hospital experiences are not consistently available for all students. Nursing clinical simulation (NCS) can augment or replace specific clinical hours and provide clinically relevant experiences to practice management and leadership skills while caring for older adults. This article describes a geriatric management and leadership NCS.