Tamara Cadet

Neuropsychiatric symptoms and Apolipoprotein E: Associations with eventual Alzheimer's disease development.

OBJECTIVE Alzheimers disease (AD) is the result of neurodegeneration, which manifests clinically as deficits in memory, thinking, and behavior. It was hypothesized that neuropsychiatric symptoms and the apolipoprotein E genotype increase the likelihood of Alzheimers disease development. METHODS Utilizing data from the National Alzheimers Coordinating Center, information from evaluations of 11,453 cognitively intact participants was analyzed. Survival analysis was used to explore relationships between individual neuropsychiatric symptoms as determined by the Neuropsychiatric Inventory Questionnaire, apolipoprotein E, and eventual AD diagnosis. Cox proportional hazard models were utilized to explore the main effects and synergistic (additive and multiplicative) interactions. RESULTS This study provided evidence for an increased hazard of developing AD among participants with any of the symptoms assessed by the NPI-Q. The hazard of developing AD was almost thirteen times higher for ε4 carriers with delusions and eleven times greater for those with apathy and disinhibition. Statistically significant hazards (p>0.001) were also realized by ε4 carriers with hallucinations; agitation; depression; anxiety; elation; apathy; irritability; and motor, sleep, and appetite disturbances. CONCLUSIONS Findings suggest that neuropsychiatric symptoms are associated with eventual AD diagnosis among a group of cognitively asymptomatic participants at baseline. Many studies begin with a group of participants already impacted by AD diagnosis. The longitudinal analysis of a group of participants who, at baseline, demonstrated no observable signs of AD was a strength of this study. This investigation contributes to the literature exploring an increased hazard of AD due to potential modifiable risk factors and genetic biomarkers such as apolipoprotein E.

Reflections on a Quantitative, Group-Based Mindfulness Study with Social Work Students

Emerging research demonstrates that mindfulness is effective in reducing health care worker burnout. The aim of this quantitative pilot study was to examine the effectiveness of a mindfulness intervention on social work students. The investigation utilized a pretest/posttest design. Findings from the study demonstrated an increase in knowledge (p < .001), self-efficacy (p < .001), and beliefs (p < .005) related to mindfulness following a group-based mindfulness intervention. Reflections on the first author’s need to resist her group work instincts to test the effectiveness of the mindfulness intervention are shared.

Interdisciplinary Medical Social Work: A Working Taxonomy

Findings from a year-long exploratory study aimed at describing universal functions of medical social work with interdisciplinary teams in acute care settings are reported here. A universal taxonomy of interdisciplinary social work skills and competencies was empirically identified through a participatory action research framework. Findings support previous conceptual descriptions of medical social work’s overarching and historical role to help interdisciplinary teams in acute care to consider patients’ home environment, knowledge, beliefs, culture, and resources during assessment, treatment, and discharge planning. The empirically determined taxonomy reported is intended to provide social workers a framework with which to articulate and evaluate their core competencies on interdisciplinary medical teams.

Exploring the Relationship Between Fear of Cancer Recurrence and Sleep Quality in Cancer Survivors

Fear of cancer recurrence (FCR) and sleep disturbance are identified as top psychosocial concerns in cancer survivorship, yet few studies have explored the association between these two factors. Using data from a study of 67 cancer survivors, hierarchical logistic regression models examined the relationships between socio-demographic characteristics, FCR, and sleep disturbance. More than half of survivors reported poor sleep quality; those with some college education and those with higher levels of FCR were at greater risk for poor sleep. These findings provide formative data for oncology social workers to implement interventions that target FCR as a strategy for improving sleep.

Cancer screening barriers for community-based older Hispanics and Caucasians.

Despite advances in screening and early detection, ethnic minority populations, ages 65 and older, are less likely than Caucasians to participate in cancer screening services. Empirical research indicates that older ethnic minorities have cultural values that influence their behaviors. Addressing culturally relevant communication to better understand those values may increase participation in cancer screening. The study reported is a secondary analysis of qualitative data gathered from focus groups. Utilizing an interdisciplinary analytical lens, we compared older Hispanic and Caucasians cultural values and their screening behaviors. Suggested psychosocial interventions are discussed to assist providers in their ongoing efforts to promote cancer screening.

Decreasing hazards of Alzheimer's disease with the use of antidepressants: mitigating the risk of depression and apolipoprotein E

Alzheimers disease (AD) is a neurodegenerative disease, manifesting in clinically observable deficits in memory, thinking, and behavior that disproportionately affects older adults. Susceptibility genes, such as apolipoprotein ε4, have long been associated with an increased risk of AD diagnosis. Studies have shown associations between depression and increased risk of AD development. Furthermore, findings from previous investigations suggest mixed effects in the use of psychotropic medication in older adults. The hypothesis for this study is that antidepressant use modifies the increased hazard of depression or such that a non‐significant hazard will result with respect to eventual AD development.

Breast care screening for underserved African American women: Community-based participatory approach

ABSTRACT Traditional health promotion models often do not take into account the importance of shared cultural backgrounds, beliefs, and experiences unique to underserved African American women when designing community-based cancer screening and prevention programs. Thus, the purpose of this study was the development, implementation, and evaluation of a community-based participatory research (CBPR) program designed to increase breast cancer screening awareness in an underserved African American population by providing culturally appropriate social support and information. The study includes 357 African American women who participated in the program and completed the 6-month follow-up questionnaire. The program consisted of a 45-minute play, using community members and storytelling to honor and incorporate five different cultural experiences (skits) with breast care and cancer. Overall, findings indicate that the educational intervention was effective. In addition, these findings are consistent with the literature that suggests that educational interventions that include knowledge to alleviate concerns, dispel myths, and create awareness can increase breast cancer screening participation rates. Furthermore, these findings confirm the importance of CBPR in health promotion activities in reducing health and cancer disparities.

The Paradoxical Impact of Companionship on the Mental Health of Older African American Men

Objectives African Americans comprise 9% of the 46 million U.S. adults over age 65. Two thirds of older African American men (AAM) reside with companions. This study investigated the assumption that frequent contact with companions confers mainly health-related benefits for AAM. Methods Utilizing secondary data from the National Alzheimers Coordinating Center, the relationship between older AAMs mental health and related conditions (depression, anxiety, and sleep disturbances), companion living arrangements, and frequency of contact with the participants for 3,423 older AAM and their 1,161 companions, was examined. Results The mean age of participants and companions was 74 years and 90% of AAM lived in a private residence. Logistic regression models indicated that an increased risk for anxiety was found when companions lived in (OR = 1.66), called daily (OR = 1.089), or visited daily (OR = 1.079). Finally, AAM had an increased likelihood of nonmedical sleep disturbances when companions lived in (OR = 1.67), called daily (1.105), or visited daily (1.078). Discussion The frequency of contact with companions may be consequential for select mental health outcomes and associated physiological conditions for older AAM; the timing of contact requires further investigation.

Mental health and breast cancer screening utilization among older Hispanic women

ABSTRACT Considerable racial and ethnic differences exist in the way the burden of cancer is experienced in the United States for older Hispanic women. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the mental health factors associated with older Hispanic women’s participation in breast cancer screening services. Logistic regression models were used. Findings indicated that anxiety and positive affect were associated with a greater likelihood of participating in breast cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population.

Home Modifications among Community-Dwelling Older Adults: A Closer Look at Race and Ethnicity

ABSTRACT This study investigated racial and ethnic differences in home modification use. Data from the 2011 National Health and Aging Trends Study were used (n=6,764). Compared with non-Hispanic Whites, Hispanics were less likely to have a grab bar (odds ratio (OR) = 0.6), bath seat (OR = 0.8), or raised toilet (OR = 0.6). Non-Hispanic Blacks were less likely to have a grab bar (OR = 0.7) or bath seat (OR = 0.7) than non-Hispanic Whites, but more likely to have a raised toilet (OR = 1.3). English proficiency largely explained ethnic differences, while health status partially accounted for racial disparities.