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Author: Jiska Cohen-Mansfield (149)


Jan
2018

Loneliness is common among older persons and is associated with adverse health and wellbeing outcomes. We investigated a theory-based intervention that addresses barriers to social contacts and aims at increasing social self-efficacy. Individuals that met pre-assessment criteria of cognitive function, physical health, and loneliness levels were randomly assigned either to the I-SOCIAL intervention that combined both individual and group sessions to address individuals' unique social challenges, or to the control group.

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Jan
2017

Objectives The aims of this study are (1) to describe the types of leisure activities preferred by persons with dementia in the past and present, as reported by family members and therapeutic recreation staff members, and (2) to examine the influence of demographic and functional abilities variables on the perceived current interest of persons with dementia. Method Family members of persons with dementia and therapeutic recreation staff involved in the care of those persons completed an activities preference assessment concerning the persons with dementia. Participants were recruited from a nursing home and a senior day center.

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Nov
2017

As more older persons opt to age in place, there is a growing trend to hire migrant workers as live-in caregivers to care for them. This raises the need to examine the quality of care they receive within this unique care setting. The objective of this pilot study was to establish the components of quality of care as provided by migrant live-in caregivers.

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Sep
2017

Neuropsychiatric symptoms (NPSs) are hallmarks of Alzheimer's disease (AD), causing substantial distress for both people with dementia and their caregivers, and contributing to early institutionalization. They are among the earliest signs and symptoms of neurocognitive disorders and incipient cognitive decline, yet are under-recognized and often challenging to treat. With this in mind, the Alzheimer's Association convened a Research Roundtable in May 2016, bringing together experts from academia, industry, and regulatory agencies to discuss the latest understanding of NPSs and review the development of therapeutics and biomarkers of NPSs in AD.

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Oct
2017

As the population lives longer, end of life (EOL) is emerging as a distinct life phase, about which there is still limited understanding. Characterizing this important period is vital for clarifying issues regarding trajectory and decline at EOL and for health service planning on an institutional, communal, and societal level. In this paper we aim to characterize the EOL period, examining the duration and number of EOL stages, as well as the functional, attitudinal and emotional trajectories.

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Jul
2017

Because End of life (EOL) is becoming an increasingly long life stage, this paper aims to describe the delineation of EOL by reviewing studies which examine (a) terminal decline (TD), the timing of change in slope of decline in specific abilities; and (b) trajectories of decline in areas such as function, health care expenditures, and well-being according to cause of death.
Studies were identified through Google Scholar, PsycNET, and PubMed.
TD was identified in diverse domains.

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Nov
2017

This study examined the relationship between personal characteristics and attendance, engagement, sleep, and mood outcomes of persons with dementia participating in group activities. The purpose of this study is to examine which persons with dementia benefit most from group interventions. Sixty-nine persons with dementia were observed by research and therapeutic recreation staff during 10 types of group activities (reading aloud with discussion, choral-singing, baking, creative storytelling, brain games, active games, exercise, reminiscence poetry, holiday newsletter, and holiday discussions) on multiple outcomes (attendance duration, sleep, engagement, active participation, attitude, and positive mood).

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Sep
2017

Older age, male gender, and poor socioeconomic status have been found to predict mortality. Studies have also documented an elevation in health services standardized costs (HSSC) and expenditures in the last years of life. We examined the contribution of HSSC in the last years of life in predicting mortality beyond predictors that have been established in the literature, and whether the impact of HSSC on mortality is linear.

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Dec
2017

Investigating complaints concerning end-of-life (EoL) care is a necessary step for improving the quality of life at its final stage.
We aimed to classify and quantify the aspects of EoL care that require improvement by analyzing caregivers' feedback on the care their relatives received before death.
A survey of primary family caregivers of deceased patients.

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Dec
1969

Transitional care units aim to assist caregivers who cannot manage the care for persons with dementia who manifest behavioral and psychological symptoms of dementia (BPSD). However, there is a dearth of research on such care units.
The current study reviewed one specialized transitional unit to better understand the characteristics of the persons with dementia and behavioral symptoms entering such unit.

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May
2017

To describe social engagement care (SEC) provided by live-in migrant caregivers for frail older adults compared with care recipients' and families' wishes for such care.
Interviews with care recipients, family members, and migrant caregivers assessed preferences for and provision of five types of SEC activities: knowing the older person as a person, knowing their main concerns, having personal conversations, going for walks, and sharing social or leisure activities.
Care recipients and family proxies reported a moderate desire for SEC from migrant caregivers, except for sharing leisure activities, for which there was only a slight preference.

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Aug
2017

An in-depth analysis of qualitative data regarding antecedents, consequences, and descriptions of delusions of persons with dementia (PwD) provided by family caregivers is presented. Three broad classifications of reasons given behind types of delusions are included, namely environmental factors, personal factors, and dementia, with dementia being the most prominent factor. We observed an overlap between known cognitive symptoms of dementia and the characteristics of the reported "delusions" in dementia.

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May
2017

Although a few papers documented benefits of group therapeutic activities for individuals with dementia, there is a dearth of studies that have investigated the effects of group activities on persons with dementia. This paper introduces a theoretical framework of studying group therapeutic recreational activity, the Comprehensive Process Model of Group Engagement, and an assessment tool, the Group Observational Measurement of Engagement (GOME). We also report the psychometric properties of this assessment.

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Jul
2017

People with dementia (PwD) attending dementia day care often experience the death of others. Little research exists regarding whether PwD should be informed of the death, and if so, how? In this qualitative research, the authors explored, through semistructured interviews, the beliefs and practices of 52 staff members of adult day centers for PwD about these issues. Themes that emerged are that many staff members feel their clients have emotional capacity to mourn, despite their cognitive impairments.

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Dec
2016

Knowledge of individual-level trajectories of Health Services Consumption (HSC) at End-of-Life (EoL) is scarce. Such research is needed for understanding and planning health expenditures.
To explore individual-level EoL trajectories in the Israeli population.

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Dec
1969

Changes in Religiosity in Old Age: An Exploratory Study.

Int J Aging Hum Dev 2016 09 9;83(3):256-73. Epub 2016 Jun 9.
Jiska Cohen-Mansfield, Dov Shmotkin, Haim Hazan
Changes in religious identity and predictors of change in religiousness are explored in a sample of 1,191 self-respondent Jewish Israeli participants, aged 75 to 94. Data were drawn from two waves of a national survey. Assessments included measures of religious identity, reported change in religiousness, religious practice, functional status, cognitive functioning, and depression.

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Mar
2016

To portray the emotional and behavioral reactions of persons with dementia to the delusions and hallucinations they experience, according to the reports of their family caregivers. The article also explores the relationship between those reactions and background variables.
Study participants were family caregivers of 74 older persons with a diagnosis of dementia (aged ≥ 65) residing in the community recruited from adult day centers and support groups for caregivers of persons with dementia and by advertising online.

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Dec
1969

Predictors of Smoking Cessation in Old-Old Age.

Nicotine Tob Res 2016 07 17;18(7):1675-9. Epub 2016 Jan 17.
Jiska Cohen-Mansfield
There is a dearth of knowledge on smoking cessation in older adults. This study examined predictors of smoking cessation in persons over age 75.
This study is a secondary analysis of a prospective longitudinal study.

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Apr
2016

Older persons are particularly vulnerable to loneliness because of common age-related changes and losses. This paper reviews predictors of loneliness in the older population as described in the current literature and a small qualitative study.
Peer-reviewed journal articles were identified from psycINFO, MEDLINE, and Google Scholar from 2000-2012.

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Aug
2015

A systematic review was conducted to identify, categorize and summarize available research on planned care transitions or relocations for persons with dementia (PWD) in order to help guide best practice. Articles were identified by keyword searches of electronic databases, and a soft search of references of relevant articles. The review found that planned care transitions in PWD are associated with an increase in undesirable outcomes, particularly immediately post-transition, and that caregivers are often underutilized in care planning and underprepared for care transitions.

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Dec
1969

The Sources of Discomfort Scale (SODS) assesses discomfort manifestations based on source of discomfort, thus making it both distinct from and complementary to pain assessments for persons with dementia. Sources were categorized as pertaining to physical discomfort, to body position, and to environmental sources. Body position sources of discomfort were related to poor functional status and to pain.

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Jul
2015

The Unmet Needs Model states that problem behaviors of people with dementia result from unmet needs stemming from a decreased ability to communicate those needs and to provide for oneself. The purpose of this study is to describe the unmet needs of persons with dementia exhibiting behavior problems. Eighty-nine residents with dementia from six Maryland nursing homes were assessed by research assistants and nursing assistants for their unmet needs using multiple assessment tools.

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Jan
2016

Given that there may well be no significant advances in drug development before 2025, prevention of dementia-Alzheimer's disease through the management of vascular and lifestyle-related risk factors may be a more realistic goal than treatment. Level of education and cognitive reserve assessment in neuropsychological testing deserve attention, as well as cultural, social, and economic aspects of caregiving. Assistive technologies for dementia care remain complex.

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Mar
2017

Intergenerational Programs in Schools.

J Appl Gerontol 2017 Mar 9;36(3):254-276. Epub 2016 Jul 9.
Jiska Cohen-Mansfield, Barbara Jensen
This study examined the prevalence, types, and perceived impact of intergenerational programs in schools. Programs involving senior volunteers assisting children, or children participating in activities with older people were considered. Of the schools reached, 47% reported intergenerational programming.

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Jul
2014

Research is needed to determine specific factors that contribute to the success of nonpharmacologic interventions. In this study, we examined the influence of personal characteristics (demographic, medical, and functional variables) and possible barriers (eg, staff or family barriers) on the efficacy of nonpharmacological interventions in reducing agitation.
Agitation was systematically observed at baseline and intervention stages using the Agitation Behavior Mapping Instrument (ABMI) in a sample of 89 residents from 6 Maryland nursing homes (mean age = 85.

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Feb
2015

This study compares different nonpharmacological interventions for persons with behavioral symptoms and dementia on frequency of use and perceived efficacy in terms of change in behavior and interest.
Participants were 89 nursing home residents from six Maryland nursing homes with a mean age of 85.9 years (SD: 8.

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May
2015

The objective of this study is to compare three different interventions for persons who report memory difficulties: health promotion, cognitive training, and a participation-centered course, using a single-blind, randomized controlled design.
Participants were 44 Israeli adults with memory complaints, aged 65 years or older. The main outcome variable was the Global Cognitive Score assessed using the MindStreams(®) mild cognitive impairment assessment, a computerized cognitive assessment.

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Aug
2014

Whose responsibility is it to make life worth living?

Int Psychogeriatr 2014 Aug 2;26(8):1231-3. Epub 2014 Jun 2.
Jiska Cohen-Mansfield, Colleen A Ray

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Dec
1969

This paper challenges the assumptions underlying many reviews and offers alternative criteria for examining evidence for nonpharmacological interventions. We evaluated 27 reviews examining interventions for persons with dementia as they relate to the issues of selection based on randomized controlled trial (RCT) design. Reviews were described by type of intervention, level of cognitive function, and criteria for inclusion.

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Dec
1969

Loneliness is common among older persons and has been associated with health and mental health risks. This systematic review examines the utility of loneliness interventions among older persons.
Thirty-four intervention studies were used.

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Jun
2014

This is a qualitative and quantitative study examining institutional staff members' reactions to delusions experienced by nursing home residents. Participants were 38 nursing home residents aged 65 and older, diagnosed with dementia. Data were collected from 8 nursing homes in Israel between June 2007 and January 2009.

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Dec
2013

This study compares formal and informal caregivers' perceptions of delusions and hallucinations in older persons with dementia (PWDs). The study population consisted of 151 community-dwelling PWDs aged 65 and older, 90 formal caregivers, and 151 informal caregivers residing in Israel. Assessments included the Behavioral Pathology in Alzheimer's Disease Rating Scale, Neuropsychiatric Inventory, Etiological Assessment of Psychotic Symptoms in Dementia, Activities of Daily Living, and Mini-Mental State Examination.

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Dec
2013

Dementia symptoms are often complicated by behavioral disorders such as repetitive verbalizations, aggressive behavior, and pacing. In clinical practice, the most common responses to behavioral disorders are pharmacologic, mostly using antipsychotic medication, or ignoring the behavior. However, multiple research studies support the notion that these behavioral disorders in dementia are related to unmet needs that can be addressed by nonpharmacologic interventions.

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Dec
2013

We compared regulation and working and living conditions of foreign home attendants in 7 countries (Canada, Germany, Israel, Singapore, Spain, United Kingdom, United States). We conducted a literature search in the PSYCinfo, MEDLINE, and Google Scholar databases for 2002 to 2012. We found substantial between-country differences in the legal status of migrant caregivers and regulations regarding working and living conditions and drew 3 conclusions.

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Dec
1969

This study aims to examine whether old age, old-old age, and oldest-old age comprise distinct categories via comparing persons aged 75-84, 85-94, and 95+ on demographics, health, function, and wellbeing. The sample was drawn from a representative longitudinal cohort of older persons in Israel. Matched cohort comparisons found a significant decline in Activities of Daily Living (ADL), instrumental ADL, cognitive function, percent of participants who go outside their home, and physical activity, with an increase in physical and mobility difficulties, and no difference in depressed affect or loneliness.

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Jul
2014

Behavioral disturbances and pain are common in nursing home (NH) patients with dementia. An association between pain and increased agitation has been suggested, and recently a significant reduction of agitation has been demonstrated by pain treatment in patients with moderate to severe dementia. We now examined which specific agitated behaviors respond to individualized pain treatment.

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Mar
2013

Smoking and mortality among persons aged 75-94.

Prev Med 2013 Mar 26;56(3-4):185-9. Epub 2012 Dec 26.
Jiska Cohen-Mansfield
Examine the effect of current level of smoking and lifetime tobacco consumption on mortality in persons 75-94 years of age.
Data were from a representative sample of older Jewish persons in Israel, which included 1,200 self-respondent participants aged 75-94 (Mean=83.1, SD=5.

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Feb
2013

To clarify physicians' actual practice in treating agitation in the nursing home and to elucidate the relationship between background factors, familiarity with interventions, and practice.
A survey of actual practice for agitation in persons with dementia was administered to 67 physicians aged 31-70+ working in nursing homes in Israel. Questionnaires were administered by personal interview, self-completed, or a combination of the two.

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Sep
2012

A randomized, placebo-controlled clinical trial was undertaken to determine the efficacy of nonpharmacologic individualized interventions (individualized to address unmet needs such as boredom or pain) in decreasing agitation in persons with dementia.
Agitated nursing home residents with advanced dementia (from 9 nursing homes in 5 locations in Maryland, United States) were randomized into an intervention group (n = 89) and a placebo control group (n = 36). On the basis of data from baseline assessment, a systematic methodology for individualizing nonpharmacologic interventions, Treatment Routes for Exploring Agitation (TREA), was used with the intervention group: an unmet need was hypothesized, a corresponding treatment category was identified, and specifics of the treatment were chosen to fit the person's need, past identity, preferences, and abilities.

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Jul
2012

To examine the effect of nighttime sleep duration on mortality and the effect modification of daytime napping on the relationship between nighttime sleep duration and mortality in older persons.
Prospective survey with 20-yr mortality follow-up.
The Cross-Sectional and Longitudinal Aging Study, a multidimensional assessment of a stratified random sample of the older Jewish population in Israel conducted between 1989-1992.

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Jun
2012

This study investigated the meanings and etiologies of hallucinations in persons with dementia. Participants were 74 nursing home residents aged ≥ 65 diagnosed with dementia. Most of the reported visual and auditory hallucinations involved talking to persons who are not present, a phenomenon described as either a visual or auditory hallucination, or both.

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Apr
2012

Many elderly people experience pain and regularly take analgesic medication. Pain is also frequent in people with dementia, particularly those with severe disease. As no robust clinical guidelines are available for the treatment of pain in the context of dementia, the risk of inadequate treatment in individuals with this condition is high.

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Jan
2012

This study aimed to examine changes in the practice of health behaviors (smoking, physical activity, and alcohol consumption) via comparing two Israeli cohorts of persons aged 75 to 94 over a 10-year period. Data collection was conducted during 1989-1992 for the first cohort (N=1,200) and during 2000-2002 for the second (N=421). Decreases in smoking indices (rates of current smokers, total nicotine consumption, years of smoking), increase in physical activity levels, and decreases in alcohol consumption of liquor and whiskey were found in the more recent cohort compared to the earlier one.

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May
2012

Affect, behavior, and cognition can be considered as basic constructs that dictate human functioning, with intricate and bi-directional relationships among them. Prior to the present study, relationships among these constructs have not been systematically examined within the context of dementia.
Sample 1 contained 185 nursing home residents with a diagnosis of dementia.

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