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8. Feasibility of Telehealth Occupational Therapy for Behavioral Symptoms of Adults With Dementia: Randomized Controlled Trial

Author

Rhodus, Elizabeth K., primary, Baum, Carolyn, additional, Kryscio, Richard, additional, Liu, Changrui, additional, George, Rosmy, additional, Thompson, MaryEllen, additional, Lowry, Kimberly, additional, Coy, Beth, additional, Barber, Justin, additional, Nichols, Heather, additional, Curtis, Alexandra, additional, Holloman, Angela, additional, and Jicha, Gregory A., additional

Published
2023
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10. Occupational Therapy Practice Guidelines for Adults Living With Alzheimer's Disease and Related Neurocognitive Disorders.

Author

Smallfield, Stacy, Metzger, Lizabeth, Green, Melissa, Henley, Laura, and Rhodus, Elizabeth K.

Subjects
ALZHEIMER'S disease treatment, MENTAL illness treatment, TREATMENT of dementia, SERVICES for caregivers, CAREGIVERS, SENSORIMOTOR integration, SOCIAL support, COUNSELING, DANCE therapy, FUNCTIONAL status, BEHAVIOR therapy, COGNITION, EVIDENCE-based medicine, PATIENT-centered care, MEDICAL protocols, OCCUPATIONAL therapy, MUSIC therapy, TREATMENT effectiveness, OCCUPATIONAL therapy services, EXERCISE, MEDICAL practice, DECISION making in clinical medicine, REMINISCENCE therapy, GOAL (Psychology), COGNITIVE therapy, PAIN management, PSYCHOTHERAPY, ADULTS
Abstract

Importance: There are currently 55 million adults living with declining functional cognition—altered perception, thoughts, mood, or behavior—as the result of Alzheimer's disease (AD) and related neurocognitive disorders (NCDs). These changes affect functional performance and meaningful engagement in occupations. Given the growth in demand for services, occupational therapy practitioners benefit from consolidated evidence of effective interventions to support adults living with AD and related NCDs and their care partners. Objective: These Practice Guidelines outline effective occupational therapy interventions for adults living with AD and related NCDs and interventions to support their care partners. Method: We synthesized the clinical recommendations from a review of recent systematic reviews. Results: Twelve systematic reviews published between 2018 and 2021 served as the foundation for the practice recommendations. Conclusion and Recommendations: Reminiscence, exercise, nonpharmacological behavioral interventions, cognitive therapy, sensory interventions, and care partner education and training were found to be most effective to support adults living with AD and related NCDs. Plain-Language Summary: These Practice Guidelines provide strong and moderate evidence for occupational therapy practitioners to support adults living with Alzheimer's disease (AD) and related neurocognitive disorders (NCDs) and their care partners. They provide specific guidance for addressing the decline in cognition, behavioral and psychological symptoms of dementia, and pain experience of adults living with AD and related NCDs. The guidelines also describe interventions to support care partners. With support from the evidence, occupational therapy practitioners are better equipped to address the unique needs of adults living with AD and related NCDs and their care partners. These Practice Guidelines provide strong and moderate evidence for occupational therapy practitioners to support adults living with Alzheimer's disease and related neurocognitive disorders and their care partners. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Global rural health disparities in Alzheimer's disease and related dementias: State of the science

Author

Wiese, Lisa Ann Kirk, primary, Gibson, Allison, additional, Guest, Marc Aaron, additional, Nelson, Amy R., additional, Weaver, Raven, additional, Gupta, Aditi, additional, Carmichael, Owen, additional, Lewis, Jordan P., additional, Lindauer, Allison, additional, Loi, Samantha, additional, Peterson, Rachel, additional, Radford, Kylie, additional, Rhodus, Elizabeth K., additional, Wong, Christina G., additional, Zuelsdorff, Megan, additional, Saidi, Ladan Ghazi, additional, Valdivieso‐Mora, Esmeralda, additional, Franzen, Sanne, additional, Pope, Caitlin N., additional, Killian, Timothy S., additional, Shrestha, Hom L., additional, Heyn, Patricia C., additional, Ng, Ted Kheng Siang, additional, Prusaczyk, Beth, additional, John, Samantha, additional, Kulshreshtha, Ambar, additional, Sheffler, Julia L., additional, Besser, Lilah, additional, Daniel, Valerie, additional, Tolea, Magdalena I., additional, Miller, Justin, additional, Musyimi, Christine, additional, Corkey, Jon, additional, Yank, Veronica, additional, Williams, Christine L, additional, Rahemi, Zahra, additional, Park, JuYoung, additional, Magzamen, Sheryl, additional, Newton, Robert L., additional, Harrington, Candace, additional, Flatt, Jason D., additional, Arora, Sonakshi, additional, Walter, Sarah, additional, Griffin, Percy, additional, and Babulal, Ganesh M., additional

Published
2023
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19. Harmony at HOME (Help Online Modifying the Environment): Proof‐of‐concept clinical trial of an innovative telehealth intervention for adults with Alzheimer’s disease with behavioral symptoms

Author

Rhodus, Elizabeth K., primary, George, Rosmy, additional, Thompson, MaryEllen, additional, Lowry, Kimberly, additional, Coy, Beth, additional, Johnson, Julia, additional, Parsons, Kelly, additional, Barber, Justin M, additional, Nichols, Heather, additional, Hunter, Alexandra, additional, Holloman, Angela, additional, Kryscio, Richard J, additional, Baum, M. Carolyn, additional, and Jicha, Gregory A, additional

Published
2022
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21. sj-pdf-1-ggm-10.1177_23337214211068290 ��� Supplemental Material for Sensory Processing Abnormalities in Community-Dwelling Older Adults with Cognitive Impairment: A Mixed Methods Study

Author

Rhodus, Elizabeth K., Hunter, Elizabeth G., Rowles, Graham D., Bardach, Shoshana H., Parsons, Kelly, Barber, Justin, Thompson, MaryEllen, and Jicha, Gregory A.

Subjects
FOS: Clinical medicine, 110308 Geriatrics and Gerontology
Abstract

Supplemental Material, sj-pdf-1-ggm-10.1177_23337214211068290 for Sensory Processing Abnormalities in Community-Dwelling Older Adults with Cognitive Impairment: A Mixed Methods Study by Elizabeth K. Rhodus, Elizabeth G. Hunter, Graham D. Rowles, Shoshana H. Bardach, Kelly Parsons, Justin Barber, MaryEllen Thompson, and Gregory A. Jicha in Gerontology and Geriatric Medicine

Published
2022
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25. Exploring older adults' experiences using technology during a viral pandemic

Author

Barber, Justin M, primary, Scherer, Sally, additional, Rhodus, Elizabeth K, additional, Kelly, Parsons R, additional, Johnson, Julia, additional, Hall, Megan, additional, Snyder, Katherine, additional, Coy, Beth, additional, Boggess, Bailee, additional, Lowry, Kimberly, additional, Shaffer, Andrea, additional, McRoberts, Tyler, additional, Jicha, Gregory A, additional, Gibson, Allison, additional, and Bardach, Shoshana H, additional

Published
2021
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27. Being in Place: Toward a Situational Perspective on Care.

Author

Rhodus, Elizabeth K and Rowles, Graham D

Subjects
*HOME environment, *SOCIAL support, *MATHEMATICAL models, *PHYSICIAN-patient relations, *THEORY, *PATIENT care, *ELDER care
Abstract

An optimum focus in any care situation is creating and sustaining environments that facilitate an ongoing sense of "being in place" for all involved. Using this rationale, we propose a Situational Model of Care for exploring dynamic relationships among aging persons receiving care, the convoy of persons offering this care and support, and the place where this occurs, as evolving situations throughout the course of a disease. The model is grounded in extant literature and illustrated through a case study derived from in-home observations and interviews. Emphasizing an underlying goal of fostering a sense of being in place as a desirable outcome facilitates situationally nuanced directions in research and clinical care. [ABSTRACT FROM AUTHOR]

Published
2023
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29. sj-pdf-1-jag-10.1177_0733464821996864 – Supplemental material for Older Adults’ Adaptations to the Call for Social Distancing and Use of Technology: Insights From Socioemotional Selectivity Theory and Lived Experiences

Author

Bardach, Shoshana H., Rhodus, Elizabeth K., Parsons, Kelly, and Gibson, Allison K.

Subjects
FOS: Clinical medicine, 111799 Public Health and Health Services not elsewhere classified, FOS: Health sciences, 110306 Endocrinology, 110308 Geriatrics and Gerontology
Abstract

Supplemental material, sj-pdf-1-jag-10.1177_0733464821996864 for Older Adults’ Adaptations to the Call for Social Distancing and Use of Technology: Insights From Socioemotional Selectivity Theory and Lived Experiences by Shoshana H. Bardach, Elizabeth K. Rhodus, Kelly Parsons and Allison K. Gibson in Journal of Applied Gerontology

Published
2021
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34. Comparison of behaviors characteristic of autism spectrum disorder behaviors and behavioral and psychiatric symptoms of dementia.

Author

Rhodus, Elizabeth K., Barber, Justin, Abner, Erin L., Bardach, Shoshana H., Gibson, Allison, and Jicha, Gregory A.

Subjects
ALZHEIMER'S disease, CROSS-sectional method, REGRESSION analysis, MENTAL health, COMPARATIVE studies, NEUROPSYCHOLOGICAL tests, AUTISM, DEMENTIA, PSYCHOSOCIAL factors, LONGITUDINAL method, NEURODEGENERATION, SYMPTOMS
Abstract

Similarities exist in behavioral expression of autism spectrum disorder (ASD) and Alzheimer's disease and related dementias (ADRD). The purpose of this study was to assess presence of behavioral and psychiatric symptoms of dementia (BPSD) and ASD-like behaviors in adults with ADRD. Using a cross-sectional design, data from University of Kentucky Alzheimer's Disease Center participant cohort were used. Hierarchical linear regression was used to assess (1) the relationship between ASD-like behaviors (measured by the Gilliam Autism Rating Scale-Second Edition, GARS-2) and BPSD measured by the Neuropsychiatric Inventory (NPI), and (2) the relationship between ASD-like behaviors and dementia severity (measured by the Clinical Dementia Rating [CDR] sum of boxes), when controlling for BPSD. Complete data were available for 142 participants. Using α of 0.05, analyses identified ASD behaviors were significantly associated with BPSD severity ratings (r = 0.47; p < 0.001) and dementia severity (r = 0.46; p < 0.001). GARS-2 explained 6.1% (p < 0.001) of variance in CDR sum of boxes when controlling for NPI and other covariates. There is significant overlap in behaviors characteristic of ASD and BPSD as assessed by the NPI and GARS-2, despite the use of these instruments in disparate developmental vs. aging settings. ASD behaviors appear to not be solely present in early childhood as a manifestation of ASD but are also present in older adults with neurodegenerative cognitive impairment. Such associations warrant additional research into causation, assessment, and behavioral interventions to further enable new therapeutic approaches targeting ASD behaviors across the lifespan. [ABSTRACT FROM AUTHOR]

Published
2022
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39. TOWARD AN UNDERSTANDING OF BEHAVIORAL AND SENSORY EXPERIENCES WHEN LIVING WITH DEMENTIA AND RELATED DISORDERS: AN ENVIRONMENTAL GERONTOLOGY PERSPECTIVE

Author

Rhodus, Elizabeth K.

Subjects
Gerontology, Dementia, Environment, Sensory Processing
Abstract

Behavioral and psychological symptoms of dementia create challenges for those living with neurodegenerative cognitive impairment and their care partners. Pharmacological approaches for treatment of challenging behaviors seen in dementia have limited success and serious side effects. Because of this, nonpharmacological approaches are being investigated with increasing frequency. Of particular interest are nonpharmacological approaches involving environmental stimulation to change behaviors. Success of such approaches relies on sensory processing systems, personal preferences, and environmental congruence. There is limited evidence describing behaviors of persons with cognitive impairment in relation to these components. Currently, there is no guiding model for implementation of environmental and sensory-based strategies with this population. The overall goal of this project is to elaborate on an emerging model describing the relationship among environment, behavior, sensation, and cognitive impairment for community-dwelling adults with mild cognitive impairment or dementia. Three studies allow for deeper understanding of this relationship. Study one compared behaviors seen in autism spectrum disorder (ASD) with exhibited behaviors of individuals with mild cognitive impairment or dementia. Of neurological conditions similar to dementia, ASD has been chosen as an exemplar for comparison of behavioral expression because evidence supports sensory-based theory and interventions to improve behaviors for those with ASD. Results indicate that ASD behaviors are reported in those assessed, with highest rates of behaviors in those with young age of onset and advanced cognitive impairment severity. Study two described presentation of behavior, sensory processing, and environment for community-dwelling adults with cognitive impairment in the context of the caregiver situation. Findings reflect dyadic experiences for the person with cognitive impairment and the primary care partner. Emergent themes included consideration of the passage of time, environmental contexts, behavioral adjustments while aging, and overall influences of living with cognitive impairment. Sensory processing assessment using the Adult Sensory Profile identified that all participants had some atypical sensory processing patterns, highlighting a need for attention to environmental congruence to promote adaptive behaviors. Using data collected in study one and study two, a model was created describing interactions among the person with cognitive impairment, sensation, and the environment as these interactions evolve over time. Areas for future research are conceptualized for implementation of the model. Future research is needed for assessment of the model to test for validity and reliability. Creation of an instrument is needed to place individuals within the model given their behavior and cognitive impairment progression. And, future research is needed to create and test interventions in order to aid in environmental congruence. Long-term goals are to improve care for adults with cognitive impairment and dementia via environmental interventions.

Published
2019

40. Will "social distancing" lead to future "research distancing": A reflection on COVID-19 impacts on Alzheimer's disease research.

Author

Bardach SH, Gibson AK, Rhodus EK, and Jicha GA

Abstract

Coronavirus disease 19 (COVID-19) has dramatically altered everyday life, including the field of Alzheimer's disease (AD) research. This perspective article explores some of the ways in which COVID-19 has already impacted the field, anticipates some of the long-lasting effects, and explores strategies for addressing current and future needs. Areas of impact include study integrity, regulatory and industry issues, and participant engagement. Proposed strategies for addressing these challenges include analytic methods to deal with large degrees of missing data and development of patient-centered, user-friendly, remote data collection tools and assessments. We also highlight the importance of maintaining participant well-being as a first and constant priority., (© 2020 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals, Inc. on behalf of Alzheimer's Association.)

Published
2020
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