Characterizing Elder Mistreatment Among Older Adults with Dementia

患有痴呆症的老年人中虐待老年人的特征

基本信息

批准号：
10590808
负责人：
Kristin Lees Haggerty
金额：
$ 14.22万
依托单位：
EDUCATION DEVELOPMENT CENTER, INC.
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-01-15 至 2027-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10590808
关键词：
Active Learning Address Affect Aging Alzheimer&apos s Disease Alzheimer&apos s disease patient Alzheimer&apos s disease related dementia Applied Psychology Area Basic Science Behavioral Model Behavioral Symptoms Caregivers Caring Characteristics Clinical Clinical Trials Design Code Cross-Sectional Studies Data Data Set Databases Dementia Dementia caregivers Dependence Development Doctor of Philosophy Education Elder Abuse Elderly Ethics Family Focus Groups Frequencies Future Generations Goals Grant Health Health Policy Health Professional Health Psychology High Prevalence Impaired cognition Intervention Knowledge Lead Logistic Regressions Managed Care Manuscripts Measures Medical Records Mental Depression Mentors Mentorship Methodology Modeling Modification Outcome Patient Care Patients Persons Policy Making Population Positioning Attribute Prevalence Primary Care Productivity Provider Public Health Records Research Research Personnel Research Project Grants Risk Risk Factors Safety Sampling Science Screening procedure Severities Severity of illness Specialist Subgroup Training United States United States National Institutes of Health Work Writing care providers caregiver strain caregiving community setting cost dementia care demographics design evidence base experience implementation science improved insight longitudinal dataset loved ones maltreatment modifiable risk patient health information population health prevent primary care provider programs protective factors response screening skills sociodemographics therapy development tool

项目摘要

Project Summary/Abstract This mentored research project focuses on the intersection between two urgent and related threats to older adults’ health and safety: Alzheimer’s disease and related dementias (ADRD) and elder mistreatment (EM). Elder mistreatment (EM) prevalence estimates for older adults with cognitive impairment range from 27.5%- 55%. High prevalence of EM among persons with dementia (PWD) is unsurprising considering that many of the risk factors for EM are related to dependency and caregiving. However, logistical and methodological challenges as well as the high costs associated with studying mistreatment among PWD have contributed to a dearth of research on the topic. Existing research has relied on small, cross-sectional studies and have not provided the data required to produce evidence-based tools for EM screening and intervention tailored to the growing population of PWD. This project will fill critical knowledge gaps by leveraging an already existing large longitudinal dataset from UCLA’s Alzheimer’s and Dementia Care Program (ADC Program) to describe the phenomenon of EM and identify modifiable risk factors for EM among PWD that can be applied in subsequent intervention generation, refinement, and adaptation. Aim 1 is a qualitative study of expert dementia care specialists (DCS) experiences with EM to inform revisions to a data abstraction tool used in Aim 2. Focus groups with DCS from 16 clinical settings across the US will be conducted to examine: perspectives on EM frequency, severity, and triggers; barriers and facilitators to identifying EM in patients with varying levels of dementia severity; and ethical and practical implications of addressing EM. Aim 2 will describe EM type and frequencies among a well-defined sample of PWD from the ADC program. To conduct the analyses, EM data will be extracted from patient medical records and combined with existing sociodemographic and clinical measures. Aim 3 will utilize the same ADC program dataset to characterize EM risk and protective factors among patient/caregiver dyads using hierarchical logistic regression modeling comparing PWD who experienced EM to those who did not. Kristin Lees Haggerty, PhD, a Project Director and researcher at Education Development Center (EDC), is in an ideal position to lead this work. Dr. Lees Haggerty has an academic background in population health and applied psychology, demonstrated productivity in aging research, and a strong network of collaborators and mentors in academic, clinical, and community settings. Dr. Lees Haggerty has developed a comprehensive training and mentorship plan that will prepare her to become an independent investigator devoted to improving older adults’ health and safety. The training plan includes course work and experiential learning opportunities addressing four key areas: ADRD research; clinical trial design and implementation science; health care policy making; and manuscript and grant writing. The interdisciplinary mentorship team includes national leaders with expertise in the identified training areas and extensive experience mentoring junior investigators who are strongly committed to supporting Dr. Lees Haggerty’s development into an independent investigator.

项目概要/摘要这个指导研究项目的重点是对老年人的两个紧急且相关的威胁之间的交叉点成年人的健康和安全：阿尔茨海默病和相关痴呆症 (ADRD) 和虐待老年人 (EM)。患有认知障碍的老年人中虐待老人 (EM) 的患病率估计范围为 27.5%- 考虑到许多痴呆症患者 (PWD) 的 EM 患病率高达 55%，这一点并不令人意外。 EM 的危险因素与依赖性和护理有关，但与后勤和方法有关。挑战以及研究残疾人虐待行为相关的高额费用导致了缺乏关于该主题的研究。现有的研究依赖于小型的横断面研究。提供了生产针对 EM 筛查和干预的循证工具所需的数据该项目将利用现有的大量人口来填补关键的知识空白。来自加州大学洛杉矶分校阿尔茨海默氏症和痴呆症护理计划（ADC 计划）的纵向数据集，用于描述 EM 现象，并确定残疾人中 EM 的可改变风险因素，可应用于后续干预措施的产生、完善和适应目标 1 是对痴呆症专家护理的定性研究。专家 (DCS) 的 EM 经验为目标 2 中使用的数据抽象工具的修订提供信息。重点来自美国 16 个临床机构的 DCS 小组将进行检查：对 EM 的看法识别不同程度患者 EM 的频率、严重程度和触发因素；痴呆症的严重程度；以及解决 EM 的伦理和实际影响目标 2 将描述 EM 的类型和情况。 ADC 程序中明确定义的 PWD 样本中的频率为了进行分析，EM 数据。将从患者病历中提取并与现有的社会人口统计和临床相结合目标 3 将利用相同的 ADC 程序数据集来描述 EM 风险和保护因素。使用分层逻辑回归模型在患者/护理人员二人组中比较残疾人 Kristin Lees Haggerty 博士是 EM 项目的项目总监和研究员。教育发展中心 (EDC) 的 Lees Haggerty 博士是领导这项工作的理想人选。人口健康和应用心理学的学术背景，在老龄化方面表现出生产力研究，以及学术、临床和社区环境中强大的合作者和导师网络。 Lees Haggerty 制定了一项全面的培训和指导计划，帮助她做好成为该培训计划包括一位致力于改善老年人健康和安全的独立调查员。课程作业和体验式学习机会涉及四个关键领域：ADRD 研究；设计和实施科学；医疗保健政策制定；以及手稿和拨款写作。跨学科指导团队包括在确定的培训领域具有专业知识的国家领导人指导坚定致力于支持 Lees 博士的初级研究人员的丰富经验哈格蒂成长为一名独立调查员。