Center for Excellence in Aging Pilot Grants

The goal of the pilot grants are to support members across cores of the Center and disciplines in collaborating to collect pilot data for projects that advance the mission of the Center and are likely to lead to an extramural grant to RUSH from a foundation, State, or Federal government agency (e.g., National Institutes of Health [NIH], Health Resources & Services Administration [HRSA]).

2022-2023 Award

Cognitive Health in Cantonese-Speaking Older Adults: A Feasibility and Acceptability Study

Joyce W. Tam, PhD & Lisa L. Barnes, PhD

The number of Asian older adults with Alzheimer’s disease and related dementias (ADRD) is expected to increase as Asians are the fastest growing ethnic group in Illinois and in the United States. However, our understanding of unique factors that may affect cognitive functioning amongst Asian subgroups is lacking as cognitive aging studies in this population are mostly done in Asia or comprised of culturally and linguistically diverse Asian individuals. Chinese is the largest Asian subgroup in Chicago and Cantonese is one of the two most spoken Chinese dialects. To better understand factors important for cognitive aging in minoritized groups, the goal of this project is to demonstrate the acceptability and feasibility of recruiting and enrolling Cantonese-speaking older adults (cOA) for a research study that assesses cognitive functioning as well as psychosocial and cultural factors that may affect cognition. Exploratory analyses will be conducted to evaluate the association between these factors and to characterize the cognitive profile of cOA. Participants will complete a 2-hour session consisting of objective cognitive measures and self-report questionnaires. Findings from this study will provide a foundation for understanding factors affecting cognitive health in Cantonese-speaking older adults.

2021-2022 Award

Feasibility and Acceptability of Implementing Dignity Therapy as a Supportive Intervention for Individuals with Advanced Neurodegenerative Disease

Dirk Labuschagne, MDiv, MPH; George Fitchett, DMin, PhD; Jori Fleisher, MD, MSCE

Age-friendly care is important for the management of advanced neurodegenerative diseases, such as Parkinson’s Disease (PD) and related disorders. PD is the fastest growing neurological disorder worldwide. Consistent with age-friendly care’s emphasis on what matters and prioritizing mentation, the value of interdisciplinary approaches and spiritual well-being are increasingly appreciated in PD clinical and research settings. Dignity Therapy (DT) is a life-review intervention that includes the production of a legacy document that can be shared with loved ones. The value of DT for improving well-being and preserving dignity for patients with advanced illness such as cancer has been demonstrated. DT appears ideally suited to address the impact on memory and identity of neurodegenerative diseases but research about DT in this population is limited. Under the leadership of Dr. Jori Fleisher, the Advanced Interdisciplinary Movement Disorders Supportive Care (AIMS) clinic provides interdisciplinary, comprehensive care to patients with neurological diseases at RUSH University Medical Center. The primary aim of the present pilot study is to determine the feasibility and acceptability of implementing DT in the AIMS clinic. The secondary aim is to determine its preliminary efficacy. Procedures involve recruiting a convenience sample of 25 AIMS patients age 65 and older who will receive DT from a trained therapist. They will complete self-report measures pre- and post-intervention to investigate the study aims. With the growing demand for innovative, interdisciplinary approaches in providing supportive care to complex, aging patient populations, DT may serve as a valuable resource to offer in this advanced setting.

2020-2021 Award

Age-Friendly Adult Centered Telehealth Training (A-FACTT) to Promote Competency and Confidence in the Use of Telehealth

Steven J. Taylor, OTD; Grisel Rodriguez-Morales, MSW, LCSW; Jan Odiaga, DNP, CPNP-PC; Theresa Gierlowski, MPM; Lauren Little PhD, OTR/L

Telehealth is a promising emerging technology to support independent living amongst older adults and the management of their chronic conditions, however several barriers influence its use among this population. These primarily include limited confidence with employing this resource, as well as a lack of accessible training and technology specific knowledge. To mitigate these barriers, this pilot study will evaluate the extent to which Telehealth Electronic Modules (TEMs) contribute to the competency and confidence of older adults in the use of Telehealth. Specifically, this investigation will develop an age-friendly virtual website (Age-Friendly Adult Centered Telehealth Training: A-FACTT) to serve as a repository of resources that provide training to increase competence and confidence among older adults in Telehealth by means of TEMs. These will be developed and refined through consultation with older adults to be universally accessible and meet the diverse needs of this population. Efficacy of both A-FACTT and TEMs to increase competency and confidence among this population will be evaluated through community participants participating with RUSH University’s Interprofessional Education Course through a series of telehealth consultations with student-lead interprofessional teams. Following this trial, modules will be freely available to the public via the newly developed A-FACTT website.

2019-2020 Award

Creation of a FAIR (Frailty Assessments & Individualized Report) Clinic Model and Centralized Research Database for Vulnerable Older Adults

Magdalena Bednarczyk, MD; Alexander Rackman, MD; Ashley Okray, PA; Lydia Royeen, OT; Alan L. Landay, PhD; Anneke Flannick, LCSW

The multi-disciplinary FAIR clinic will identify and help guide the most vulnerable older adult population at highest risk for adverse health outcomes. Assessments will focus on measures of physical function, cognition, mood, polypharmacy, and social support. Patients will receive an individualized report to classify their risk category based on established frailty criteria. Each patient will also receive individualized treatment plans based on their goals and likely trajectories, especially prior to a high-risk intervention or procedure. Patients will be encouraged to donate serum samples for collection and analysis of a panel of frailty biomarkers in order to create a central research database.

2018-2019 Award

Physical function promotion in midlife and beyond

Brittney Lange-Maia, PhD, MPH; Elizabeth Lynch, PhD; Grisel Rodriguez-Morales, LCSW; Sheila Dugan, MD

Physical function has been long studied in older adults, and the prevalence of functional impairments is rising among midlife adults. The need for community-based programs focused on physical function is high, especially in underserved communities. In this project we expanded a church-based health screening program focused in West Side communities to include a measure of physical function. We also conducted focus groups to assess perceptions of functional limitations and to gain insight into strategies for developing a new program aimed at improving physical function delivered through churches. In total, 804 individuals age 40+ were screened. Approximately 1/3 of participants had evidence of limitations as assessed by the Short Physical Performance Battery (scores of ≤9 of a possible 12 points), with the prevalence rising sharply with age (19% in those age 40-49; 72% in those age 70-79). In focus groups (N=41 participants reporting difficulty with mobility), a major theme was that physical function limitations keep participants from living a full life and being active in their community, church, and family. Participants had a strong desire to learn how to move better—like learning about how to climb stairs when experiencing pain and ways to reduce fall risk—and were interested in programs focused on improving physical function through their church. This study indicated that functional limitations are common and that interventions for improving function are needed, but also helped to elucidate specific elements to include in a new intervention that would appeal to the community members. We used feedback gained through the focus groups, insights from the quantitative study, and existing scientific evidence, to develop a novel program aimed at improving physical function that will be appropriate for delivery in churches. Since the completion of this pilot, we have secured further funds to test this proposed intervention in the community.