powerpoint presentation - brain health lifestyle pilot study€¦ · ppt file · web...
TRANSCRIPT
Brain Health Lifestyle Study Brain Health Lifestyle Study TeamTeam
Jack Burt - Lead Study Coordinator Jack Burt - Lead Study Coordinator • Assistant Executive Director, Summerville at Farm PondAssistant Executive Director, Summerville at Farm Pond
Maria Hanley - Activities Coordinator Maria Hanley - Activities Coordinator • Business Office Director, Summerville at Farm PondBusiness Office Director, Summerville at Farm Pond
Mike Dee - Nutrition & Dietary Coordinator Mike Dee - Nutrition & Dietary Coordinator • Dining Services Director, Summerville at Farm PondDining Services Director, Summerville at Farm Pond
Kelly Scott - Study Advisor Kelly Scott - Study Advisor • Program Specialist, Emeritus Senior LivingProgram Specialist, Emeritus Senior Living
Chris Guay - Study AdvisorChris Guay - Study Advisor• N.E. Vice President of Operations, Emeritus Senior LivingN.E. Vice President of Operations, Emeritus Senior Living
Dr. Paul Nussbaum - Principle Investigator and Consultant to Dr. Paul Nussbaum - Principle Investigator and Consultant to EmeritusEmeritus
Rationale for Pilot StudyRationale for Pilot Study Brain Health is a major focus of interest.Brain Health is a major focus of interest. NO STUDY has looked at a proactive-NO STUDY has looked at a proactive-
comprehensive lifestyle approach to brain comprehensive lifestyle approach to brain health.health.
First empirical investigation of Dr. First empirical investigation of Dr. Nussbaum’s Four Factor Brain Health Nussbaum’s Four Factor Brain Health Lifestyle on Cognition, Mood, Medical Lifestyle on Cognition, Mood, Medical Measures, and Quality of Life.Measures, and Quality of Life.
Emeritus and Dr. Nussbaum hope to refine Emeritus and Dr. Nussbaum hope to refine the Brain Health Lifestyle Program and the Brain Health Lifestyle Program and replicate it across the entire company.replicate it across the entire company.
Methods of Pilot StudyMethods of Pilot Study 16 randomly selected subjects in brain health 16 randomly selected subjects in brain health
study groupstudy group 10 randomly selected subjects in control group10 randomly selected subjects in control group 5 subjects dropped out (4 in Brain Health Group 5 subjects dropped out (4 in Brain Health Group
and 1 in Control Group)and 1 in Control Group) 6 WEEK STUDY – Brain Health subjects engaged 6 WEEK STUDY – Brain Health subjects engaged
in one daily activity for each of the five factors of in one daily activity for each of the five factors of the Brain Health Lifestyle.the Brain Health Lifestyle.
The Brain Health Group also consumed a special The Brain Health Group also consumed a special diet.diet.
The Control Group was not involved in any of the The Control Group was not involved in any of the Brain Health program.Brain Health program.
Measures Used in StudyMeasures Used in Study DemographicsDemographics
• AgeAge• EducationEducation• Marital StatusMarital Status• GenderGender
Measures of Cognition -Pre and PostMeasures of Cognition -Pre and Post• Folstein Mini Mental State ExamFolstein Mini Mental State Exam• Hopkins Verbal Learning TestHopkins Verbal Learning Test
Measures of Mood -Pre and PostMeasures of Mood -Pre and Post• Geriatric Depression ScaleGeriatric Depression Scale
Medical Measures -Pre and PostMedical Measures -Pre and Post• Total CholesterolTotal Cholesterol• LDL and HDLLDL and HDL• Total Cholesterol / HDL RatioTotal Cholesterol / HDL Ratio• Blood PressureBlood Pressure• WeightWeight• Blood GlucoseBlood Glucose
Quality of Life -self & staff ratings Post onlyQuality of Life -self & staff ratings Post only Knowledge of Brain Health Scale -Pre and PostKnowledge of Brain Health Scale -Pre and Post
Content of Brain Health LifestyleContent of Brain Health Lifestyle
Five factors from Dr. NussbaumFive factors from Dr. Nussbaum• SocializationSocialization• Mental StimulationMental Stimulation• Physical ActivityPhysical Activity• SpiritualitySpirituality• NutritionNutrition
Each program activity was selected based Each program activity was selected based on research findings and its fit within one on research findings and its fit within one of the five factors of brain health.of the five factors of brain health.
So, what did the participants do?So, what did the participants do? Each and every day throughout the six week Each and every day throughout the six week
study the subjects would complete between study the subjects would complete between three and five hours of various activities. These three and five hours of various activities. These activities included:activities included:• Tai Chi (Physical)Tai Chi (Physical)• Mind & Body Relaxation (Spiritual)Mind & Body Relaxation (Spiritual)• Creative Visualization (Social, Spiritual, & Mental)Creative Visualization (Social, Spiritual, & Mental)• Journaling & Creative Writing (Mental)Journaling & Creative Writing (Mental)• Group Exercise (Physical)Group Exercise (Physical)• Basic Portuguese (Mental)Basic Portuguese (Mental)• Sign Language (Mental)Sign Language (Mental)• Yoga (Physical & Spiritual)Yoga (Physical & Spiritual)• Meditation (Spiritual)Meditation (Spiritual)• Group Socials (Social)Group Socials (Social)• Word puzzles (Mental)Word puzzles (Mental)
So, what did the participants do?So, what did the participants do?
The subjects also ate a controlled diet The subjects also ate a controlled diet consisting of foods that are outlined as consisting of foods that are outlined as “Brain Healthy Foods” in the lifestyle “Brain Healthy Foods” in the lifestyle program. This was the case for all three program. This was the case for all three meals a day, seven days a week, for the meals a day, seven days a week, for the entire six week program.entire six week program.
ResultsResults
DEMOGRAPHICSDEMOGRAPHICS
Mean (SD) Treatment
(n=12)
Control(n=9)
STAT p-value
Age 86.9 (3.2) 83.4 (6.0) t=1.70 NS
Education 14.2 (3.0) 14.4 (2.7) t=0.16 NS
Marital Status (% W) 91.7 55.6 FET NS
Gender (% Female) 66.7 33.3 FET NS
DemographicsDemographics
0
20
40
60
80
100
Age EducationMarital Status (% W)Gender (% Female)
Demographic's Between Brain Health & Control Group
Brain Health GroupControl Group
COMPLETERS vs. NON COMPLETERS vs. NON COMPLETERSCOMPLETERS
Mean (SD) Completers(n=21)
Non-Completers(n=5)
STAT p-value
Age 85.4 (4.8) 85.2 (11.5) t=0.04 NS
Education 14.3 (2.8) 13.6 (1.5) t=0.56 NS
Marital Status (% W) 76.2 100 FET NS
Gender (% Female) 52.4 100 FET NS
DEMOGRAPHICS
DemographicsDemographics
0
20
40
60
80
100
Age Education Marital Status (% W)Gender (% Female)
Demographics Between Completers & Non-Completers
CompletersNon-Completers
Pre Study Completers vs. Non-Pre Study Completers vs. Non-CompletersCompleters
Mean (SD) Completers
(n=21)
Non-Completers(n=5)
STAT p-value
Folstein 25.4 (2.5) 21.8 (4.0) t=2.62 .02Hopkins Total 15.0 (4.2) 13.6 (2.3) t=0.68 NSHopkins Trial 1 3.8 (1.6) 3.4 (1.3) t=0.53 NSHopkins Trial 2 5.4 (1.4) 5.2 (0.8) t=0.28 NSHopkins Trial 3 5.8 (1.8) 5.0 (1.9) t=0.84 NSHopkins Delay 4.1 (2.5) 3.6 (2.1) t=0.41 NSRecognition 9.3 (2.4) 8.2 (3.6) t=0.82 NSGeriatric Depression
Scale 5.9 (5.9) 3.0 (2.1) t=1.06 NS
Knowledge of Brain Health (n=16) 1.3 (1.2) 1.0 (0.0) t=0.56 NS
Completers vs Non CompletersCompleters vs Non Completers
20
25
30
Completers vs Non-Completers
Folstien Mini Mental State Exam Results
CompletersNon-Completers
Cognitive Measures Within Study Cognitive Measures Within Study GroupGroup
Mean (SD) Pre Post Change STAT p-value
Folstein 25.3 (2.7) 25.7 (3.1) 0.3 (1.6) t=0.74 NSHopkins Total 14.5 (4.8) 15.9 (6.0) 1.4 (5.1) t=0.96 NSHopkins Trial 1 3.8 (1.7) 4.5 (1.6) 0.8 (1.5) t=1.68 NSHopkins Trial 2 5.2 (1.6) 5.6 (2.6) 0.4 (2.3) t=0.62 NSHopkins Trial 3 5.6 (1.8) 5.8 (2.3) 0.2 (1.8) t=0.48 NSHopkins Delay 3.8 (2.6) 5.3 (3.0) 1.6 (2.0) t=2.71 p=.02Recognition 8.8 (3.0) 9.3 (3.3) 0.5 (1.9) t=0.90 NSGeriatric
Depression Scale 5.5 (6.4) 4.5 (6.9) -1.0 (2.6) t=1.34 NS
Knowledge of Brain Health 1.3 (1.2) 6.9 (1.9) 5.6 (1.9) t=10.28 p<.001
Hopkins Verbal Learning TestHopkins Verbal Learning Test
0
5
10
Delay Recall
Pre StudyPost Study
Knowledge of Brain HealthKnowledge of Brain Health
0
5
10
Knowledge of Brain Health
Pre StudyPost Study
Medical Measures Within Study Medical Measures Within Study GroupGroup
Mean (SD) Pre Post Change STAT p-value
Total Cholesterol
169.2 (37.3) 181.9 (44.4) 12.7 (14.1) t=3.12 p=.01
HDL 47.4 (17.0) 46.8 (16.1) -0.6 (6.7) t=0.30 NS
LDL 103.3 (29.9) 112.4 (35.1) 9.2 (12.8) t=2.39 p=.04
Total/HDL 3.8 (1.1) 4.1 (1.1) 0.3 (0.4) t=2.38 p=.04
Blood Glucose 101.9 (15.7) 105.6 (9.6) 3.7 (19.1) t=0.67 NS
Systolic BP 132.3 (10.0) 133.3 (9.2) 1.0 (15.3) t=0.23 NS
Diastolic BP 73.3 (8.0) 74.8 (5.5) 1.5 (8.2) t=0.64 NS
Weight 146.4 (23.4) 145.0 (22.0) -1.4 (2.3) t=2.16 p=.054
Medical MeasuresMedical Measures
160
165
170
175
180
185
Total Cholesterol
Pre Study Post Study
95
100
105
110
115
LDL
Pre Study Post Study
3.6
3.8
4
4.2
Total Cholesterol / HDL
Pre Study Post Study
144
145
146
147
Total Weight
Pre Study Post Study
Medical Data RangesMedical Data Ranges CholesterolCholesterol
• Desirable: Below 200 mg/dLDesirable: Below 200 mg/dL• Borderline: 200-239 mg/dLBorderline: 200-239 mg/dL• High: 240 mg/dL and aboveHigh: 240 mg/dL and above
HDLHDL• High: 60 mg/dL and aboveHigh: 60 mg/dL and above• Low: 40 mg/dL and belowLow: 40 mg/dL and below
LDLLDL• Desirable: 129 mg/dL and belowDesirable: 129 mg/dL and below• Borderline: 130-159 mg/dLBorderline: 130-159 mg/dL• High: 160-189 mg/dLHigh: 160-189 mg/dL• Very High: 190 mg/dL and aboveVery High: 190 mg/dL and above
Staff Perception ScaleStaff Perception Scale
0204060
SignificantlyMore Negative
SomewhatMore Negative
No Change SomewhatMore Positive
SignificantlyMore Positive
The Resident's Overall Demeanor Over The Past Six Weeks
Staff Perception ScaleStaff Perception Scale
0
2040
60
SignificantlyMore
Depressed
SomewhatMore
Depressed
No Change SomewhatMore Happy
SignificantlyMore Happy
The Resident's General Mood Over The Past Six Weeks
Staff Perception ScaleStaff Perception Scale
0
20
40
60
Significantly
Reduced
Somew hat
Reduced
No
Changed
Somew hat
Increased
Significantly
Increased
The Resident's Tendency to Engage in Activities
Staff Perception ScaleStaff Perception Scale
0
50
100
Decreased
Significantly
Decreased
Som ew hat
No Change Increased
Som ew hat
Increased
Significantly
The Resident's Functional Ability with Daily Tasks
Staff Perception ScaleStaff Perception Scale
0
20
40
60
Decreased
Significantly
Decreased
Somew hat
No Change Increased
Somew hat
Increased
Significantly
The Resident's Desire to Socialize
Staff Perception ScaleStaff Perception Scale
0
20
40
60
Declined
Significantly
Declined
Somew hat
No Change Improv ed
Somew hat
Improv ed
Significantly
The Resident's Mental Alertness and Thinking Abilities
Staff Perception ScaleStaff Perception Scale
020
4060
DeclinedSignificantly
DeclinedSomewhat
No Change ImprovedSomewhat
ImprovedSignificantly
The Resident's Energy Level
Staff Perception ScaleStaff Perception Scale
01020304050
Declined
Significantly
Declined
Somew hat
No Change Improv ed
Somew hat
Improv ed
Significantly
The Resident's Physical Status Appears to Have
Staff Perception ScaleStaff Perception Scale
0
20
40
60
Absolutely Not Probably Not No Change Probably Has
Dem onstrated
Benefit
Absolutely Has
Dem onstrated
Benefit
My Overall Impression is That The Resdent Has Benefited From The Brain Health Program
Quality of Life ScaleQuality of Life Scale1. Prior to this study my knowledge of the brain or brain health was:
N (%) Post
0. No knowledge 5 (41.7)
1. Very little knowledge 5 (41.7)
2. Some knowledge 2 (16.7)
3. Adequate knowledge 0
4. More knowledge than most 0
2. As a result of my participation in this study my knowledge of my brain and brain health has:
N (%) Post
0. Decreased 0
1. Remained the same 1 (8.3)
2. Increased somewhat 6 (50.0)
3. Increased significantly 5 (41.7)
3. My participation in this study has helped me feel better about myself:
N (%) Post
True 9 (75.0)
False 3 (25.0)
4. My participation in this study has provided me a new motivation to engage in a lifestyle that may promote my brain health:
N (%) Post
True 10 (83.3)
False 2 (16.7)
Quality of Life ScaleQuality of Life Scale5. My greatest strength of the Brain Health Pie prior to starting the study was:
N (%) Post
A. Physical activity 2 (16.7)
B. Mental Stimulation 4 (33.3)
C. Spirituality 2 (16.7)
D. Socialization 3 (25.0)
E. Nutrition 0
Missing 1 (8.3)
6. As a result of this study I now recognize my weakest area of the Brain Health Pie is:
N (%) Post
A. Physical activity 4 (33.3)
B. Mental Stimulation 3 (25.0)
C. Spirituality 5 (41.7)
D. Socialization 0
E. Nutrition 0
7. My participation in this study has changed my quality of life:
N (%) Post
0. Reduced quality of life 0
1. No change in quality of life 3 (25.0)
2. Minimal positive change in quality of life 4 (33.3)
3. Moderate positive change in quality of life 3 (25.0)
4. Significant positive change in quality of life 2 (16.7)
8. My participation in this study has changed my ability to think and remember:
N (%) Post
0. Reduced thinking and memory ability 0
1. No change in thinking and memory ability 7 (58.3)
2. Minimal positive change in thinking and memory ability 2 (16.7)
3. Moderate positive change in thinking and memory ability 1 (8.3)
4. Significant positive change in thinking and memory ability 2 (16.7)
Quality of Life ScaleQuality of Life Scale9. I have noticed improved daily functioning after this study:
N (%) Post
True 6 (50.0)
False 5 (41.7)
Missing 1 (8.3)
10. My mood has changed after my participation in this study:
N (%) Post
0. Mood has changed in a negative direction 0
1. My mood has not changed 2 (16.7)
2. Mood has changed minimally in a positive direction 3 (25.0)
3. Mood has changed moderately in a positive direction 5 (41.7)
4. Mood has changed significantly in a positive direction 2 (16.7)
11. I now know more about the basics of my brain and how to keep it healthy:
N (%) Post
True 11 (91.7)
False 1 (8.3)
12. I have a more positive overall sense of esteem and well being after the study:
N (%) Post
True 9 (75.0)
False 3 (25.0)
Quality of Life ScaleQuality of Life Scale13. I am a more confident person after the study:
N (%) Post
True 8 (66.7)
False 4 (33.3)
14. I am motivated to continue my Brain Health Lifestyle:
N (%) Post
True 9 (75.0)
False 3 (25.0)
15. I believe the Brain Health Lifestyle I learned can help other people:
N (%) Post
True 12 (100.0)
False 0
SummarySummary First Empirical Measure (to our knowledge) of effects First Empirical Measure (to our knowledge) of effects
of comprehensive lifestyle approach on measures of of comprehensive lifestyle approach on measures of Brain Health.Brain Health.
Lifestyle has positive effects on Delayed Recall, Lifestyle has positive effects on Delayed Recall, knowledge of Brain Health and Quality of Life knowledge of Brain Health and Quality of Life Measures.Measures.
Brain Health diet needs to be refined for next step in Brain Health diet needs to be refined for next step in development of the program.development of the program.
Residents report enthusiasm for their participation Residents report enthusiasm for their participation and desire to remain involved.and desire to remain involved.
Emeritus and Dr. Nussbaum will now:Emeritus and Dr. Nussbaum will now:• Implement a similar program with a larger sample.Implement a similar program with a larger sample.• Customize the program for Assisted Living and Dementia Customize the program for Assisted Living and Dementia
Care.Care.• Open the program for residents.Open the program for residents.• Continue to refine and lead the Brain Health Lifestyle Continue to refine and lead the Brain Health Lifestyle
Approach.Approach.