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.

项目摘要/摘要该修改研究项目的重点是对较老的两个紧急威胁和相关威胁之间的交集成人的健康与安全：阿尔茨海默氏病和相关痴呆症（ADRD）和老年虐待（EM）。认知障碍的老年人的老年虐待（EM）患病率估计值范围为27.5％ - 55％。 EM在痴呆症患者中的高度患病率（PWD）并不奇怪，许多人都认为许多 EM的危险因素与依赖和照料有关。但是，后勤和方法论挑战以及与研究PWD虐待有关的高昂成本已导致关于该主题的研究的缺乏。现有的研究依赖于小型的横断面研究，但没有提供了生产基于证据的工具进行EM筛查和量身定制干预措施所需的数据 PWD人口不断增长。该项目将利用已经存在的大型知识来填补关键知识差距加州大学洛杉矶分校的阿尔茨海默氏症和痴呆症护理计划（ADC计划）的纵向数据集以描述 EM的现象并确定PWD中EM的可修改风险因素，可以在随后应用干预，改进和适应。 AIM 1是针对专家痴呆症护理的定性研究 EM的专家（DC）经验为AIM 2中使用的数据抽象工具提供了信息。将进行来自美国16个临床环境的DC组，以检查：有关EM的观点频率，严重性和触发因素；在不同水平的患者中识别EM的障碍和促进者痴呆症的严重程度；解决EM的道德和实际含义。 AIM 2将描述EM类型和 ADC程序中定义明确的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学和临床结合措施。 AIM 3将利用相同的ADC程序数据集来表征EM风险和保护因素在患者/护理人员中，使用层次逻辑回归模型比较PWD 向那些没有的人经历了em。克里斯汀·李斯·哈格蒂（Kristin Lees Haggerty）博士，项目总监兼研究员教育发展中心（EDC）处于领导这项工作的理想位置。 Lees Haggerty博士有人口健康和应用心理学的学术背景表现出衰老的生产力研究，以及在学术，临床和社区环境中的合作者和导师的强大网络。博士 Lees Haggerty制定了一项全面的培训和指导计划，这将使她做好准备一位独立的研究人员致力于改善老年人的健康和安全。培训计划包括课程工作和经验丰富的学习机会，解决四个关键领域：ADRD研究；临床试验设计和实施科学；医疗保健政策制定；以及手稿和赠款写作。这跨学科心态团队包括在已确定的培训领域具有专业知识的国家领导人，强烈致力于支持Lees博士的丰富经验经验的初级调查员哈格蒂（Haggerty）发展成为独立调查员。