Search PubMed⌕ Search

Biomedical subjects

Ann M Kolanowski

Publications and source records attributed to Ann M Kolanowski.

9 recordsLinked to original sources
PubMed2006

Improving cognition and function through exercise intervention in Alzheimer's disease.

PURPOSE: To analyze the effects of cognition on function and to explore the potential of aerobic exercise for promoting cognitive and functional capacities. DESIGN: Integrative review of literature. METHODS: Studies were selected based on an extensive search of electronic databases and manual cross-referencing for 1980 to 2006, using the combination of key words: Alzheimer's disease (AD), dementia, or cognitive impairment with function or activities of daily living. FINDINGS: Three broad themes were identified from the literature analysis. First, global cognition has mainly been used to examine the effect of cognition on function, indicating an assumption that functional decline progresses in a hierarchical manner in AD. Second, specific cognitive domains affect functional decline in different ways. Executive functioning might have more effect on function than does memory. Third, aerobic exercise might promote cognitive and functional capacities in people with AD by modifying neuropathological changes in the brain. CONCLUSIONS: Specific cognitive domains such as executive functioning are important for understanding function in people with AD and are potentially modifiable by aerobic exercise.

Activities of Daily Living↗
PubMed2006

The association of physical function with agitation and passivity in nursing home residents with dementia.

The purpose of this article is to examine the association of physical function with agitation and passivity in nursing home residents with dementia using direct observational measures. Data were analyzed using mixed model analysis of variance. This study was a secondary data analysis using baseline data yielded from a crossover experimental study. Univariate analyses showed that physical function, cognitive status, and education explained a significant amount of variance in agitation. When controlled for cognitive status and education, physical function lost significance and only explained 2.6% of the variance in agitation. It was found that physical function was not related to passivity. Environmental factors may be more salient antecedents for agitation and passivity in nursing home residents with moderate to severe cognitive impairment.

Activities of Daily Living↗
PubMed2005

Delirium superimposed on dementia in a community-dwelling managed care population: a 3-year retrospective study of occurrence, costs, and utilization.

BACKGROUND: Dementia is a growing public health problem and a well-described risk factor for delirium. Yet little is known about delirium superimposed on dementia in community-dwelling populations. The purpose of this study was to examine the 3-year occurrence, healthcare utilization, and costs associated with delirium superimposed on dementia in community-dwelling persons. METHODS: We used a 3-year cross-sectional, retrospective design with an administrative database from a large managed care organization. Four individually matched samples of 699 individuals each were selected for comparison purposes: delirium superimposed on dementia (DSD), dementia alone, delirium alone, and a control group with neither delirium nor dementia. The occurrence rate of DSD was calculated by measuring those individuals with a dementia diagnosis that were also coded with an International Classification of Diseases, Ninth Edition Clinical Modification (ICD-9 CM) code for delirium or delirium with dementia. RESULTS: Of the total sample of 76,688 persons aged 65 years or older in the managed care organization, 7347 (10%) were coded as having dementia, and an additional 763 (1%) as having delirium alone. Among the 7347 with dementia, 976 (13%) had DSD, representing 1.3% of the total sample. After log transformation of total costs and adjustment for multiple covariates, the adjusted mean total health care costs remained significantly higher for the DSD group than for all other groups. CONCLUSIONS: This study is the first to report the occurrence rate of DSD in a community-dwelling population, and to demonstrate the substantial health care costs and utilization associated with DSD.

Aged↗
PubMed2004

Spouses of persons with dementia: their healthcare problems, utilization, and costs.

Spouses of persons with dementia (PWD) often experience poor health outcomes related to the experience of living with the afflicted spouse. Using the Anderson and Aday Healthcare Utilization Model, we conducted a retrospective review of an administrative database from a private healthcare insurer to compare health problems that precipitate utilization, patterns of utilization, and costs of care of spouses of PWD (n = 979) to those of spouses of persons without dementia (n = 979). Spouses of PWD were treated for more anxiety disorders (OR = 2.97; 95% CI = 1.63-5.44), falls (OR = 7.72; 95% CI = 2.73-21.84), rheumatologic diseases (OR = 2.5; 95% CI = 1.24-5.06), and diabetes with no complications (OR = 1.53; 95% CI = 1.06-2.22), but less pneumonia (OR =.55; 95%; CI =.35-.88) than comparison spouses. Spouses of PWD had a higher number of emergency room (ER) visits (p =.01). There were no differences in costs between the groups. The findings can be used to develop interventions for spouses of PWD.

Accidental Falls↗
PubMed2002

Theory-based intervention for dementia behaviors: a within-person analysis over time.

The historic "black-box" approach to treatment effectiveness research has hampered the development of effective activity interventions for persons with dementia. The purpose of this case study is to test the effectiveness of activities derived from the Need-Driven Dementia-Compromised Behavior Model. Activities that matched skill level and personality style of interest resulted in a pattern of greater time on task (p =.0012), participation (p =.004), and positive mood (p =.0001) and fewer dementia-related behaviors (p =.009) compared with activities matched to skill level only. Practitioners may improve behavioral outcomes for persons with dementia by prescribing activities based on an assessment of skill level and style of interest.

Aged↗
PubMed2002

Emotional well-being in a person with dementia.

Self-reported mood and observations of affect are often used as indicators of emotional well-being. The purpose of this case study was to (a) describe the self-reported mood and affective pattern of an older man with severe cognitive impairments, (b) assess consistency in his responses to mood state, (c) compare mood pattern to premorbid personality, and (d) determine the concordance between self-reported mood and observed affect. Observations of mood and affect were taken three times per day for 35 days. There was concordance between self-reported mood and observed affect. The participant was consistent in his responses to mood 75% of the time. The pattern of self-reported mood reflected the participant's long-standing personality traits of extraversion and neuroticism. Results, although not generalizable, demonstrate the need to consider the perspective of the person with dementia when addressing quality-of-life issues in research and practice.

Activities of Daily Living↗
PubMedDate not supplied

Efficacy of theory-based activities for behavioral symptoms of dementia.

BACKGROUND: Agitation and passivity are behavioral symptoms exhibited by 90% of nursing home residents with dementia. They account for many poor health outcomes, caregiver burden, and increased costs of long-term care. OBJECTIVES: This study tested the efficacy of recreational activities derived from the Need-driven Dementia-compromised Behavior (NDB) model: activities matched to skill level only; activities matched to style of interest only; and a combination of both (NDB-derived) for responding to the behavioral symptoms of dementia. METHODS: Thirty participants were randomly assigned to 1 of 6 possible order-of-condition presentations in this crossover experimental design with repeated measures of dependent variables. Trained research assistants, blind to condition match, implemented each condition for 12 consecutive days. Measures of engagement (time on task and participation), affect, and behavioral symptoms (agitation and passivity) were taken from videotape recordings of each session. Mood was measured with the Dementia Mood Picture Test. The primary analysis method was mixed-model analysis of variance. RESULTS: Significantly more time on task, greater participation, more positive affect, and less passivity were found under NDB-derived and matched to interest only treatments compared with the matched to skill level only treatment or baseline. Agitation and negative affect improved under all treatments compared with baseline. There was no significant change in mood. DISCUSSION: The NDB-derived activities are tailored to meet individual needs and improve behavioral symptoms associated with dementia. These findings help to explain factors that produce behavioral symptoms and the mechanisms that underlie their successful treatment.

Activities of Daily Living↗