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• The number of adults in the U.S. aged 65 years and older living with Alzheimer Disease and related dementias (ADRD) is projected to increase significantly in the coming decades. • ADRD informal caregivers are essential resources, providing for the care recipient to remain at home from diagnosis to end-of-life. • Current ADRD caregiving intervention research prioritizes burden and distress, with variable effects. • The Remembering Warmth and Safeness Intervention advances a new perspective, engaging safety signals in memories of warmth and safeness to cultivate feeling safe and contribute to well-being in older ADRD caregivers. • Using a within-subjects pre-post design, this study provides support for the feasibility and empirical promise of the Remembering Warmth and Safeness Intervention in older ADRD caregivers. The number of older adults in the U.S. living with ADRD is projected to increase dramatically by 2060. As older adults increasingly assume informal caregiving responsibilities, community-based intervention to sustain caregiver well-being is a dementia research priority. To evaluate the feasibility of the RWSI among older ADRD caregivers. The RWSI is informed by the Neurovisceral Integration Model, in which memories that engage safety signals cultivate feelings of safety and well-being. A within-subjects pre/post-intervention design with older ADRD caregivers to evaluate feasibility (acceptability, demand, fidelity) and empirical promise (well-being). The feasibility of the RWSI, implemented with fidelity, was strongly endorsed, as participants attended each intervention session, after which reported experiencing feelings of warmth and safeness, and provided the highest possible acceptability ratings. Participant narratives provided corroboration. Findings support the feasibility of the RWSI in older ADRD caregivers, providing the basis for continued research. [ABSTRACT FROM AUTHOR]

In this secondary analysis we tested whether 12 h of Senior WISE (Wisdom Is Simply Exploration) memory or health training with older adults would produce better outcomes by gender in perceptions of anxiety and bodily pain and whether the effects of the Senior WISE training on pain were mediated by anxiety. An implemented Phase III randomized clinical trial with follow up for 24 months in Central Texas. The sample was mostly female (79%), 71% Caucasian, 17% Hispanic, and 12% African American with an average age of 75 and 13 years of education. The effects of the memory intervention on anxiety were consistent across time, with effects present for males but not females at post-treatment and end-of-study. Although males had more anxiety in the health promotion group, the memory training reduced males' anxiety such that no gender difference was present in this group. The Senior WISE intervention reduced pain for both males and females at post-intervention but not at end-of-study. Although gender differences did not depend on the treatment group for pain, females reported somewhat, but not significantly, less pain at post-treatment and end-of-study. Mediation analysis indicated that, for males, the memory intervention indirectly affected pain at post-treatment, in part, by reducing anxiety, which lowered pain. However, at end-of-study, no indirect effect was present. Males responded to memory training. Training tailored to gender may increase the efficacy of the programs and "buy-in" from male participants, especially if tailored to anxiety and pain. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) disproportionately affects Mexican Americans, however, reasons underlying this health disparity remain unknown. Type 2 diabetes (T2D) is a risk factor for AD and may contribute to AD pathogenesis. The purpose of this study was to examine the associations between T2D and AD blood biomarkers among Mexican Americans and non‐Hispanic Whites. Methods: This study analyzed baseline data from the Health and Aging Brain Study: Health Disparities (HABS‐HD) that investigated AD differences among Mexican Americans and non‐Hispanic White. HABS‐AD participants were excluded from this study if they had missing data or were outliers (z‐scores >|4|) on a given AD biomarker (N = 1,552 for Aβ42/40 ratio, 1,570 for t‐tau, and 1,553 for NfL). AD biomarkers included plasma Aβ42/42 ratio, total tau (t‐tau), and neurofilament light (NfL) analyzed using Simoa. Predictors were blood glucose, HbA1c, and T2D diagnosis. Data were analyzed with regression analyses controlling for covariates (e.g., demographics, smoking, BMI, health status, diseases, cognition) and treating missing predictor data using Bayesian MCMC estimation. Results: Mexican Americans differed significantly from non‐Hispanic Whites in age (66.6±8.7 vs. 69.5±8.6), sex (64.9% female vs. 55.1%), education (9.5±4.6 vs. 15.6±2.5), blood glucose (113.5±36.6 vs. 99.2±17.0), HbA1c (6.33±1.4 vs. 5.51±0.6), T2D diagnosis (35.3% vs. 11.1%), Aβ42/40 ratio (.051±.012 vs..047±.011), t‐tau (2.56±.95 vs. 2.33±.90), and NfL (16.3±9.5 vs. 20.3±10.3). The models with the covariates and predictors accounted for 6% (p<.001), 15% (p<.001), and 36% (p<.001) of the variation in Aβ42/40 ratio, t‐tau, and NfL, respectively. Blood glucose, HbA1c, and T2D diagnosis were not related to Aβ42/40 ratio and t‐tau but explained 3.7% of the variation in NfL (p<.001). Among non‐Hispanic Whites, blood glucose, HbA1c, and T2D diagnosis were negatively (b = ‐0.09, p<.01, β = ‐0.26), not (b = 0.34, p =.71, β = 0.04), and positively (b = 3.32, p<.01, β = 0.33) associated with NfL, respectively. In contrast, blood glucose and T2D diagnosis were not, while HbA1c was positively (b = 2.31, p<.001, β = 0.26), associated with NfL among Mexican Americans. Conclusion: Blood glucose, HbA1c, and T2D may contribute to differences in NfL levels, but not Aβ42/40 ratio and t‐tau, in an ethnicity‐specific manner. Future studies are needed to corroborate our findings in longitudinal cohorts. [ABSTRACT FROM AUTHOR]

Objective: When several continuous outcome measures of interest are collected across time in experimental studies, the use of standard statistical procedures, such as multivariate analysis of variance or growth curve modeling, can be properly used to assess treatment effects. However, when data consist of mixed responses (e.g., continuous and ordered categorical [ordinal] responses), traditional modeling approaches are no longer appropriate. The purpose of this article is to illustrate the use of a more suitable modeling procedure when mixed responses are collected in longitudinal intervention studies. Method: Problems with traditional analyses of such data are discussed, as are potential advantages provided by the proposed modeling approach. The application of the multiple-domain latent growth modeling approach with mixed responses is illustrated for experimental designs with data from the SeniorWISE study (McDougall et al., 2010). This multisite randomized trial assessed memory functioning of 265 elderly adults across a 26-month period after receiving either a memory or health promotion training program. Results: The latent growth models illustrated allow one to examine treatment effects on the growth of multiple mixed outcomes while incorporating associations among multiple responses, which allows for better missing data treatment, greater power, and more accurate control of Type I error. The interpretation of parameters of interest and treatment effects is discussed using the SeniorWISE data. Conclusions: Multiple-domain latent growth modeling with mixed responses is a flexible statistical modeling tool that can have substantial benefits for applied researchers. As such, the use of this modeling approach is expected to increase. [ABSTRACT FROM AUTHOR]

Abstract: We designed an Internet survey to identify the educational priorities that parents have for their children with autism spectrum disorders and to examine the relation between these priorities and the children''s level of adaptive behavior functioning. The survey listed 54 skills/behaviors (e.g., toileting, expressing wants and needs, and tantrums) representing 10 adaptive behavior domains (e.g., self-care, communication, and problem behavior). Parents rated their child''s current level of ability/performance with respect to each skill/behavior and indicated the extent to which training/treatment was a priority. Ninety surveys were completed during the 8-month data collection period. The top 10 treatment priorities represented skills/behaviors from six different domains. Results supported the view that parent priorities tended to be higher in areas where children have the greatest deficits or show emerging skills. The results suggest there may be value in targeting the assessment of children''s deficits and emergent skills for treatment planning. [Copyright &y& Elsevier]

We tested whether at-risk older adults receiving memory training showed better memory self-efficacy, metamemory, memory performance, and function in instrumental activities of daily living than participants receiving a health promotion training comparison condition. We followed participants for 26 months. The sample was mostly female (79%) and Caucasian (71%), with 17% Hispanics and 12% African Americans; average age was 75 years, and average education was 13 years. The memory training group made greater gains on global cognition and had fewer memory complaints, but both groups generally maintained their performance on the other cognitive measures and instrumental activities of daily living (IADLs) throughout the 24-month study period. Black and Hispanic participants made greater gains than Whites did on some memory performance measures but not on memory self-efficacy. The unexpected finding that minority elders made the largest gains merits further study. This study contributed to the knowledge base of geropsychiatric nursing by providing evidence for an effective psychosocial intervention that could be delivered by advanced practice nurses. [Copyright &y& Elsevier]

This article describes the outcomes of a psychosocial intervention that tested whether health training could improve health and functional ability in a group of community-residing elderly persons. The health-training intervention consisted of eight 90-minute lecture and discussion classes conducted twice a week for 1 month. In 3 months following the posttest, an additional four booster sessions were delivered once per week for 1 month. Participants received a total of 20 hours of health training. The National Institutes of Health-funded SeniorWISE (Wisdom is Simply Exploration) study was advertised in the community as a program to learn strategies for successful aging. We describe the health curriculum and the health and functional outcomes for a 6-month period at preintervention, postintervention, and postbooster sessions. Complete data were available for 110 individuals. There was a statistically significant change on the Direct Assessment of Functional Status, F(2, 107) = 4.69, P < .012. Health variables remained stable over time. This intervention demonstrated that health training has the potential for noticeable improvement in Instrumental Activities of Daily Living function. [Copyright &y& Elsevier]

Abstract: The Behavior Flexibility Rating Scale (BFRS) is designed to assess insistence on sameness or lack of behavioral flexibility, which is often associated with autism and other developmental disabilities. This study was designed to assess the factor structure of this scale for a sample of 968 individuals with autism, Asperger''s syndrome, and Down syndrome. To establish factorial validity, an exploratory factor analysis (EFA) was conducted with half of the sample, with a confirmatory factor analysis (CFA) conducted with the remaining cases to cross-validate the model obtained with the EFA. The factor analyses supported the presence of two factors—Interruption/Disruption and Position/Location. However, further analysis suggested the presence of a third factor, Interpersonal Mishaps, for the Asperger''s syndrome group. [Copyright &y& Elsevier]