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The COVID-19 pandemic and subsequent social distancing guidelines and restrictions brought on changes in the everyday experiences of older adults. It is not clear, however, to what extent the pandemic has impacted the importance of everyday preferences for persons with cognitive impairment (CI) or the proxy ratings of those preferences. The sample of this study included 27 dyads of persons with CI and their care partners. The Preferences for Everyday Living Inventory was used to assess importance of preferences among persons with CI; care partners completed concurrent proxy assessments. Mixed random and fixed effects longitudinal models were used to evaluate changes in ratings and concordance levels between persons with CI and care partners prior to and during the COVID-19 pandemic. Persons with CI rated autonomous choice preferences as significantly more important during the COVID-19 pandemic than before; there was no association between the COVID-19 pandemic and change in other everyday preferences domains or discrepancy in proxy assessments of everyday preferences. Identifying avenues to support and provide for autonomy in the decision-making of older adults with CI may offer a way forward in mitigating the psychological and behavioral impacts of the COVID-19 pandemic in this population.
Agitation is a common complication of Alzheimer’s dementia (Agit-AD) associated with substantial morbidity, high healthcare service utilization, and adverse emotional and physical impact on care partners. There are currently no FDA-approved pharmacological treatments for Agit-AD. We present the study design and baseline data for an ongoing multisite, three-week, double-blind, placebo-controlled, randomized clinical trial of dronabinol (synthetic tetrahydrocannabinol [THC]), titrated to a dose of 10 mg daily, in 80 participants to examine the safety and efficacy of dronabinol as an adjunctive treatment for Agit-AD. Preliminary findings for 44 participants enrolled thus far show a predominately female, white sample with advanced cognitive impairment (Mini Mental Status Examination mean 7.8) and agitation (Neuropsychiatric Inventory-Clinician Agitation subscale mean 14.1). Adjustments to study design in light of the COVID-19 pandemic are described. Findings from this study will provide guidance for the clinical utility of dronabinol for Agit-AD. ClinicalTrials.gov Identifier: NCT02792257.
For centuries, the sea and those who sail upon it have inspired the imaginations of British musicians. Generations of British artists have viewed the ocean as a metaphor for the mutable human condition - by turns calm and reflective, tempestuous and destructive - and have been influenced as much by its physical presence as by its musical potential. But just as geographical perspectives and attitudes on seascapes have evolved over time, so too have cultural assumptions about their meaning and significance. Changes in how Britons have used the sea to travel, communicate, work, play, and go to war have all irresistibly shaped the way that maritime imagery has been conceived, represented, and disseminated in British music. By exploring the sea's significance within the complex world of British music, this book reveals a network of largely unexamined cultural tropes unique to this island nation. The essays are organised around three main themes: the Sea as Landscape, the Sea as Profession, and the Sea as Metaphor, covering an array of topics drawn from the seventeenth century to the twenty-first. Featuring studies of pieces by the likes of Purcell, Arne, Sullivan, Vaughan Williams, and Davies, as well as examinations of cultural touchstones such as the BBC, the Scottish fishing industry, and the Aldeburgh Festival, The Sea in the British Musical Imagination will be of interest to musicologists as well as scholars in history, British studies, cultural studies, and English literature.
ERIC SAYLOR is Associate Professor of Musicology at Drake University.
CHRISTOPHER M. SCHEER is Assistant Professor of Musicology at Utah State University.
CONTRIBUTORS: Byron Adams, Jenny Doctor, Amanda Eubanks Winkler, James Brooks Kuykendall, Charles Edward McGuire, Alyson McLamore, Louis Niebur, Jennifer Oates, Eric Saylor, Christopher M. Scheer, Aidan J. Thomson, Justin Vickers, Frances Wilkins
Among older people with cognitive impairment and mild dementia, relatively little is known about the factors that predict preferences for everyday living activities and experiences and that influence the relative importance of those activities and experiences.
Design:
Cross-sectional study.
Setting:
Participants were recruited from the Massachusetts Alzheimer’s Disease Research Center (MADRC) Clinical Core longitudinal cohort.
Participants:
The sample included 62 community-dwelling older adults with cognitive impairment (Clinical Dementia Rating global score ≥ 0.5).
Measurements:
We used the Preferences for Everyday Living Inventory (PELI) to assess preferences for activities and lifestyle experiences among persons with cognitive impairment. Within-subjects analysis of variance was used to test for significant differences in the mean ratings of importance for four domains of the PELI (“autonomous choice,” “social engagement,” “personal growth,” and “keeping a routine”). Multiple regression models were used to relate predictors, including neuropsychiatric symptoms, to importance ratings for each domain.
Results:
Significant differences were noted in the mean importance ratings of the preferences domains: “social engagement” preferences were rated as most important, followed by “autonomous choice,” “personal growth,” and “keeping a routine.” For the “social engagement” preferences domain, female sex was significantly associated with higher importance of “social engagement,” while depressive symptoms (Geriatric Depression Scale-15 scores) were significantly associated with lower importance.
Conclusions:
This study adds novel insight into the everyday preferences of community-dwelling older adults with cognitive impairment and highlights the impact of a number of factors, particularly level of depression, on how important various everyday experiences are perceived.
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
Edited by
Eric Saylor, Associate Professor, musicology (Drake University),Christopher M. Scheer, Associate Professor, musicology (Utah State University)
