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Background and Objectives Insufficient ethnoracial diversity is a pervasive challenge in Alzheimer's disease (AD) research. The Recruitment Innovations for Diversity Enhancement (RIDE) is grounded in the premise that culturally informed narratives of research participation can inspire individuals from a given culture-sharing group to consider research enrollment. This study examines factors associated with interest in AD research among Black or African American adults following exposure to RIDE narrative campaign materials. Research Design and Methods A community-based sample of 500 Black or African American adults viewed RIDE narrative materials online and completed a survey of perceptions about research, AD risk, and likelihood of enrolling in AD research. Logistic regression examined predictors and mediators of self-reported likelihood of participating in AD research. Results Most (72%) participants reported interest in being contacted for AD research opportunities. After controlling for key variables, prior experience with clinical research and trust in medical researchers emerged as independent predictors of likelihood of enrolling in AD research. Perceived burden of AD research partially mediated the effects of prior research experience and trust on likelihood of enrollment. Perceived benefits of AD research also played a mediating role, accounting for over one third of the effect of trust on likelihood of enrollment. Discussion and Implications This study advances the field's understanding of how narrative may function to enhance diversity in AD research. Findings suggest that participant narratives should address experiences regarding the burdens and potential benefits of AD research participation as these factors may influence decisions leading to subsequent research enrollment. [ABSTRACT FROM AUTHOR]

Background: Deciding to learn one's Alzheimer's disease (AD) biomarker status requires comprehending and deliberating about complex and nuanced information. Assessing capacity to consent to AD biomarker testing and disclosure is further complicated when candidates have cognitive impairment and present with family care partners. The objective of this analysis was to identify predictors of decisional capacity for an amyloid PET disclosure study among persons with Mild Cognitive Impairment (PwMCI) and their care partners (CPs). Method: This investigation was a secondary analysis, using baseline data of a randomized controlled trial of amyloid PET results disclosure. Multiple linear regression modeling was used to examine predictors of decisional capacity, measured by the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). Focusing on PwMCI (n = 82), the predictor variables of interest were sociodemographic characteristics, and level of knowledge on MCI/AD and normal aging, global cognition measured by Mini Mental Status Exam (MMSE), and neuropsychological tests of language and executive functioning. Dyadic analyses were conducted with CP data (n = 82), using the Actor Partner Interdependence Model (APIM) to assess for presence of partner effects among key variables. Result: Participants and CPs were mostly White (91.5%, 90.2%), highly educated (16.5, 15.5 years on average), with mean age 72.7 and 66.8 years, respectively. CPs tended to be female, and spouses of the participants (70.7%). MMSE scores (b = 0.215, SE = 0.082, p = 0.011) and MCI/AD knowledge scores (b = 0.241, SE = 0.101, p = 0.020) positively predicted decisional capacity for PwMCI. Dyadic analysis using APIM showed that level of MCI/AD knowledge (p = 0.019) and level of education (p<0.001) were highly correlated within the dyad. Furthermore, analyses revealed significant positive correlations for MCI/AD knowledge for actor relations for decisional capacity for both the participant (a11 = 0.328, p = 0.005) and the CP (a22 = 0.262, p = 0.025). CP's level of MCI/AD knowledge had a negative association for partner effects for decisional capacity (p21 = ‐0.207, p = 0.043) of the PwMCI. Conclusion: Assessment of decisional capacity is imperative when considering participation in AD research, including biomarker studies involving results disclosure. Our findings highlight that not only do individual characteristics put PwMCI at risk for lower decisional capacity, but dyadic effects from their CPs may also be present. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies suggest that Alzheimer's disease (AD) biomarker disclosure has no discernable psychological impact on cognitively healthy persons. Far less is known about how such results affect symptomatic individuals and their caregivers. Methods: Randomized controlled trial of 82 mild cognitive impairment (MCI) patient and caregiver dyads (total n = 164) to determine the effect of receiving amyloid positron emission tomography results on understanding of, and perceived efficacy to cope with, MCI over 52 weeks of follow‐up. Results: Gains in the primary outcomes were not consistently observed. Amyloid negative patients reported greater perceived ambiguity regarding MCI at follow‐up, while moderate and sustained emotional distress was observed in patients, and to a lesser extent, caregivers, of those who were amyloid positive. There was no corresponding increase in depressive symptoms. Discussion: These findings point to the possibility that both MCI patients and caregivers may need emotional support after the disclosure of amyloid scan results. [ABSTRACT FROM AUTHOR]

Older adults with memory loss often require assistance from caregivers to manage their medications. This study examined the efficacy of a problem-solving-based intervention focused on caregiver medication management, problem solving, self-efficacy, and daily hassles. Caregiver health-related quality of life (HRQoL) and patient health care utilization were secondary outcomes. Totally, 83 patients (age 79.9±8.8 years) and their informal caregivers (age 66.9±12 years, female 69.9%, White 85.5%) were randomized; data collection occurred at baseline, 8, 16, and 24 weeks. Linear mixed modeling showed significant decreases in medication deficiencies which were sustained over time. No significant changes in caregiver problem solving, daily hassles, or patient health care utilization occurred between groups or over time. In addition, caregiver self-efficacy and mental HRQoL decreased in both groups. Physical HRQoL decreased in the intervention group, yet increased in the usual care group. Future research should investigate these outcomes in larger and more diverse samples. [ABSTRACT FROM AUTHOR]

Background: Insufficient racial and ethnic diversity is a pervasive challenge in clinical research on Alzheimer's disease (AD). The Recruitment Innovations for Diversity Enhancement (RIDE) in AD research study is grounded in the premise that culturally informed narratives of research participation can inspire other individuals from a given culture‐sharing group (in this case, African Americans) to consider enrolling in research. RIDE involved developing and disseminating narrative materials to share the research participation experiences of African American adults who are enrolled in AD research with those who are not. The current analysis aims to examine factors associated with interest in AD research following exposure to RIDE narrative campaign materials. Method: A community‐based sample of 500 individuals, primarily in mid to late life, identifying as Black or African American adults were invited to view a RIDE study video (∼2 minute story of AD research participation) online and complete a survey of perceptions about research and researchers, AD risk, and likelihood of enrolling in AD research. Logistic regression models were used to identify predictors of self‐reported likelihood of participating in AD research and potential mediators were tested to examine the causal pathway between predictors and likelihood of enrollment. Result: Most (n = 376; 72%) participants reported interest in being contacted to learn more about local AD research opportunities. After controlling for demographic variables and perceived AD risk, prior experience with clinical research and trust in medical researchers emerged as independent predictors of likelihood of enrolling in AD research. Mediation analysis revealed that perceived burdens of AD research mediated 40.5% of the effect of prior research experience and 25.3% of the effect of trust on likelihood of enrollment (P<0.05). Perceived benefits of AD research also played a mediating role, accounting for 35.3% of the effect of trust on likelihood of enrollment (P = 0.006). Conclusion: This study is a first step to understand the mechanisms by which narrative may function to enhance diversity in AD research. Findings suggest that participant narratives should address experiences that speak to the burdens and potential benefits of AD research participation as these factors may influence decisions leading to subsequent research enrollment. [ABSTRACT FROM AUTHOR]

Background: Amyloid PET scans allow for the visualization of amyloid plaque in the brain, which, in the context of mild cognitive impairment (MCI), signal heightened risk for progression to Alzheimer's dementia (AD). Disclosure of such results can profoundly impact patients as well as their family care partners. The purpose of this study was to examine the role and perspectives of family care partners during and after the return of amyloid PET results. Method: We used qualitative description to analyze transcripts of audio‐recorded results disclosure sessions and 4‐week follow‐up interviews of participants with MCI and their care partners who were randomized to the disclosure arm of the Return of Amyloid Imaging Scan Results (RAISR) trial. Focusing on care partners (n = 36), we conducted line by line coding and thematic analysis with the goals of 1) categorizing the frequency and nature of the questions raised by care partners during the open‐ended segment of the disclosure sessions, and 2) describing care partners' perceptions of their loved one's results in the month following disclosure. Result: At disclosure, 13 families received positive for amyloid, and 21 received negative scan results. Care partners of those learning of amyloid positivity asked approximately twice as many questions as those receiving negative results (averaging 5.6 vs. 2.8 questions per session). Seven themes were identified in the questions: study logistics, AD/AD care, result clarification, next steps given result, outside resources, requests for scan images, and "other." The vast majority of questions fell under AD/AD care (n = 47), followed by questions about study logistics (n = 24). The overarching theme of the week 4 interviews was a general sense of acceptance of the scan results. However, instances of inadequate comprehension of the scans' implications were noted, particularly among partners of amyloid negative patients, some of whom interpreted the result to mean that their loved one's MCI was nonprogressive. Conclusion: Family care partners play active roles in eliciting information and clarification during amyloid PET results disclosure. However, our findings regarding care partners of amyloid negative patients affirm that disclosing clinicians should not assume that those who ask fewer questions have an adequate understanding of the information presented. [ABSTRACT FROM AUTHOR]

Caring for an older adult with memory loss is stressful. Caregiver stress could produce negative outcomes such as depression. Previous research is limited in examining multiple intermediate pathways from caregiver stress to depressive symptoms. This study addresses this limitation by examining the role of self-efficacy, social support, and problem solving in mediating the relationships between caregiver stressors and depressive symptoms. Using a sample of 91 family caregivers, we tested simultaneously multiple mediators between caregiver stressors and depression. Results indicate that self-efficacy mediated the pathway from daily hassles to depression. Findings point to the importance of improving self-efficacy in psychosocial interventions for caregivers of older adults with memory loss. [ABSTRACT FROM AUTHOR]

Increasingly, family members are assisting with the complex task of medication management when patients are experiencing cognitive decline. To date, limited published research addresses caregiver-mediated medication management of patients with impaired cognition. Thus, the purpose of this study was to describe the characteristics and correlates of caregiver-mediated medication management in community-dwelling patients with memory loss. We used baseline data from the 91 patient-caregiver dyads participating in a randomized controlled trial designed to assist caregivers of patients with memory loss with medication management. The patient's level of cognitive impairment was not related to medication errors; however, the number of medications that patients were prescribed and taking was related to medication errors. Important factors to consider when discussing medication management with caregivers of patients with memory loss include the caregiver's age, cognitive ability, and depressive symptoms, as well as the caregiver's perception of the impact of the patient's behavioral problems. [ABSTRACT FROM AUTHOR]

We used meta-analysis to examine recent studies of sex differences in coping. Women were more likely than men to engage in most coping strategies. The strongest effects showed that women were more likely to use strategies that involved verbal expressions to others or the self-to seek emotional support, ruminate about problems, and use positive self-talk. These sex differences were consistent across studies, supporting a dispositional level hypothesis. Other sex differences were dependent on the nature of the stressor, supporting role constraint theory. We also examined whether stressor appraisal (i.e., women's tendencies to appraise stressors as more severe) accounted for sex differences in coping. We found some support for this idea. To circumvent this issue, we provide some data on relative coping. These data demonstrate that sex differences in relative coping are more in line with our intuitions about the differences in the ways men and women cope with distress. [ABSTRACT FROM AUTHOR]

Background: The relation between mood or emotions and concurrent ambulatory blood pressure responses holds both fundamental and clinical interest.Methods: The primary sample consisted of 69 normotensive or borderline hypertensive but otherwise healthy adult males. The validation sample consisted of 85 healthy male undergraduate college students. Both samples underwent half-hourly 24-hour ambulatory blood pressure measurements on four separate workdays, 1 week apart. At each ambulatory measurement, subjects recorded their behavior, environment, and mood. The circular mood scale, a circular visual analogue scale based on the circumplex model of mood, was used to reflect the totality of a participant's affective state space. Longitudinal random effects regression models were applied in the data analysis.Results: The results for both samples were quite similar. Sleep and posture had the greatest influence on ambulatory blood pressure and heart rate. The effects of the environmental setting, social setting, and consumption were modest but statistically significant. Independent of these covariates, mood exerted a significant effect on blood pressure and heart rate. Relative to the "mellow" default category, blood pressure increased both for "anxious/annoyed" and "elated/happy" and decreased during "disengaged/sleepy" mood. The range of mood-related blood pressure estimates was 6.0/3.7 mm Hg.Conclusions: The pattern of blood pressure responses suggests that they were related to the degree of engagement of a mood rather than the degree of unpleasantness. The hypothesis that posits that negative affect-related cardiovascular reactivity mediates the observed correlation between negative affect and disease risk should be reconsidered. [ABSTRACT FROM AUTHOR]

Background and Purpose: This study examined the psychometric properties of a 9-item Morisky Medication Adherence Scale (MMAS-9) adapted specifically for patients with HIV/AIDS. Methods: We used data from two randomized controlled trials investigating telephone-delivered interventions for improving adherence to antiretroviral therapy to assess reliability (Cronbach’s α and Pearson’s product correlation) and validity (convergent and concurrent) of the MMAS-9. Results: The internal consistency (Cronbach’s α) of the MMAS-9 was.66 (study 1) and.69 (study 2); 3-month test–retest reliability (Pearson’s correlation) ranged from.50 to.74. Validity was supported by associations with electronic event monitored adherence, social support, depressive symptoms, self-efficacy, stigma, regimen complexity, and impact of side effects in the hypothesized direction. Conclusions: The adapted MMAS-9 demonstrated good convergent validity but somewhat lower internal consistency reliability than other reports. [ABSTRACT FROM AUTHOR]