- Email: [email protected]
DEMENTIA HEALTH LITERACY AMONG FIRST NATIONS PEOPLE IN ONTARIO: INTEGRATING WESTERN AND INDIGENOUS UNDERSTANDINGS
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Poster Presentations: Tuesday, July 26, 2016
each potential user, which could further enhance the experience of chatting with Harlie. P3-405
COMPARISON OF A NOVEL, NATURALISTIC DRIVING ASSESSMENT SYSTEM WITH SELFREPORTED DRIVING BEHAVIOR IN A SAMPLE OF COGNITIVELY NORMAL OLDER ADULTS
Ganesh M. Babulal1, Cindy Traub2, Mollie M. Webb2, Sarah Holtz Stout1, Aaron Addison2, John C. Morris1,3, Cathy Roe2, 1Washington University School of Medicine, St. Louis, MO, USA; 2Washington University School of Medicine (St. Louis), St. Louis, MO, USA; 3Washington University in St. Louis, St. Louis, MO, USA. Contact e-mail: [email protected] Background: Changes in driving behavior among older drivers has
participated). Harlie was programmed to randomly choose one topic at a time out of a repertoire of six total topics, including the specialised topic and five generic topis, such as ‘music’ or ‘good memories’. Participants were seated individually and shown how to chat with Harlie on a smartphone. Headphones were used and each participant spoke to Harlie for approximately 5 minutes. Audio and text recordings were securely saved to an online server for analysis by the research team and participants were encouraged to share feedback on the experience during a group discussion. Results: The feedback on the experience of using Harlie was positive in both groups. While the knitting module was successful in prolonging conversational engagement, the woodworking module was not eliciting longer engagement for this specialised topic. Conclusions: All community members were able to successfully use the Harlie application, feedback was positive and differential chat preferences could be identified. This is a promising finding with potential future applications for using this chatbot with isolated older adults including those with dementia. By following the approach described here, individual chat preferences can be explored for
become an increasing area of public and research interest as older adults continue to drive longer. Controlled conditions like on-theroad tests and driving simulators evaluate driving ability in clinical populations and older adults, but are limited in understanding daily driving behavior. Existing research that measure naturalistic driving behavior are often expensive, obtrusive, require extensive modifications to a vehicle and involve cumbersome download procedures. To address this gap in research technology, we developed a new methodology including, data acquisition, curation and archiving procedures, and wrote custom computer codes (using R and ArcGIS) to modify a commercial off the shelf global positioning system (GPS) solution for our own use. We then conducted a pilot study to assess the degree to which our naturalistic driving system was associated with self-reported driving behavior among older adults with and without preclinical Alzheimer’s disease (AD). Methods: Participants (N¼20) with normal cognition (Clinical Dementia Rating, 0), aged 65 years and older were recruited from the Knight Alzheimer Disease Research Center. Participants completed a clinical assessment and psychometric battery, brain amyloid imaging, and cerebrospinal fluid (CSF) collection. Driving behavior was evaluated using the self-report, Driving Habits Questionnaire (DHQ) and by our system, which incorporated, a GPS device plugged into participant’s vehicle. We examined correlations between five main outcomes collected by both methods: speeding, driving space, total miles driven, total number of trips, and number of days-per-week driven. Group differences were also examined on the five outcomes between those with lower and higher biomarker variables. Results: There were statistically significant correlation (p .05) between both instruments on total miles driven (r¼.83), between number of trips and total miles driven (r¼.57) and number of trips and days-per-week driven (r¼.48). Participants with lower amyloid imaging biomarkers had a higher number of trips with speeding, total miles driven, total number of trips and number of days-per-week driven. Conclusions: Participants more accurately report global driving behavior but less so for specific day-to-day driving behaviors. Further work is needed to determine the association between biomarkers of preclinical AD, self-report driving behavior and, naturalistic driving outcomes.
P3-406
DEMENTIA HEALTH LITERACY AMONG FIRST NATIONS PEOPLE IN ONTARIO: INTEGRATING WESTERN AND INDIGENOUS UNDERSTANDINGS
Sharlene Christina Mary Webkamigad1, Kristen Jacklin2, Shiela CoteMeek1, Birgit Pianosi3, 1Laurentian University, Sudbury, ON, Canada; 2 Northern Ontario School of Medicine, Sudbury, ON, Canada; 3Huntington University, Sudbury, ON, Canada. Contact e-mail: swebkamigad@ laurentian.ca
Poster Presentations: Tuesday, July 26, 2016 Background: Dementia in Indigenous peoples is expected to be an increasing challenge for health care systems at all levels. Our research team’s previous work resulted in the development of evidence-based culturally grounded health promotion material for First Nations people in Canada. Our current project aims to understand the implications of Indigenous cultural diversity on the effectiveness of the materials. To do this we undertook a process of refinement of the materials from a national level focus to a regional focus with the goal of improving cultural relevance at the local level. Methods: Our approach was community-based and participatory. Working with the N’Swaakamok Native Friendship Centre, an Aboriginal advisory group was developed to guide the research. We conducted a qualitative study including 2 focus groups (n¼8) with older adults aged 55 and over and 4 one-onone interview sessions with caregivers of a person with Alzheimer’s disease or age-related dementia. An iterative, thematic data analysis utilizing NVIVO 10 software to organize the data assisted in making meaning. Member checking through transcript reviews and a larger group session was completed to validate the thematic analysis. Results: A significant finding suggests that Aboriginal caregivers and older adults prefer developing a connection with an educated health care professional in order to receive dementia education. This can be done through face-to-face contact by means of family-centred group sessions. These sessions should be supplemented by dementia health promotion material that is organized into the Medicine Wheel. We draw upon the Seven Grandfather Teachings to exemplify how individuals can apply this knowledge in their lives. This research study resulted in two culturally relevant dementia health promotion fact sheets that are locally-specific for the Aboriginal peoples of the City of Greater Sudbury. Aboriginal people have contributed to evidence-based research and knowledge translation. Conclusions: Developing health promotion materials for Indigenous populations requires evidence-informed approaches. While it is desirable to have tools and resources that can be shared nationally, it is important that those tools leave room for local adaptation in order to improve uptake and effectiveness. Culturallygrounded tools hold the potential to improve dementia health literacy and increase cultural safety.
P3-407
EDUCATING PATIENTS AND CARE PARTNERS ABOUT MILD COGNITIVE IMPAIRMENT, APOE, AND ALZHEIMER’S DISEASE: FINDINGS FROM THE REVEAL STUDY
Lan Q. Le1, Natalie J. Bartnik1, Kurt D. Christensen2, Wendy R. Uhlmann3, Jason Karlawish4, Robert C. Green2, J. Scott Roberts1 and the REVEAL Study Group, 1University of Michigan School of Public Health, Ann Arbor, MI, USA; 2Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; 3University of Michigan Medical School, Ann Arbor, MI, USA; 4University of Pennsylvania, Philadelphia, PA, USA. Contact e-mail: [email protected] Background: Biomarkers such as the APOE gene can be used in
combination with other risk factors to predict rates of conversion from mild cognitive impairment (MCI) to Alzheimer’s disease (AD). However, little is known about how best to educate patients and potential care partners about the implications of a MCI diagnosis for risk of progressing to AD. Methods: A multi-site clinical trial enrolled 110 dyads of patients with diagnoses of amnestic-
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MCI (mean age 74, range: 57-89; 49% female; 82% white) and their cognitively normal study partners (SP) (mean age 67, range: 22-93; 72% female; 82% white; 58% significant other). Dyads were randomized to receive an education and risk assessment intervention either with or without disclosure of APOE genotype. An 11-item measure assessing general knowledge of MCI and AD was administered to all participants at baseline, risk disclosure, and 6 weeks. The 73 dyads in the genotype disclosure arm were additionally administered a 4-item measure of knowledge of APOE and AD risk after disclosure. These measures included items from validated instruments and novel survey items customized for this educational intervention. Results: A comparison of knowledge scores demonstrated an improvement from baseline (MCI patient: 70%, SP: 77% correct) to risk disclosure (MCI patient: 83%, SP: 90% correct) and 6 weeks (MCI patient: 80%, SP: 85% correct). Following risk disclosure, the majority of MCI patients and SP correctly identified e4 as a risk allele (MCI patient: 77%, SP: 96% correct), understood the magnitude of its impact on AD risk (MCI patient: 78%, SP: 93% correct), and recognized that non-e4 carriers could still develop AD (MCI patient: 96%, SP: 95% correct). SP scored higher than MCI patients on both study knowledge measures across all time points (p<.05). Conclusions: Our findings confirm the efficacy of a novel intervention for educating patients and care partners about MCI diagnoses and the impact of APOE on risk for AD. Both MCI patients and SP showed good understanding of MCI and genetic risk information, and maintained educational gains over time. Evidence-based approaches to dementia education will be increasingly important as biomarkers are integrated into the treatment of MCI and pre-clinical AD.
P3-408
INVESTIGATIONS ON CLASSIFICATION ACCURACY AND EFFECTIVE MANAGEMENT OF STAGES OF DEMENTIA OF ALZHEIMER’S TYPE EMPLOYING MACHINE LEARNING AND DATA MINING METHODS
Sandhya P1, Deepa Shenoy P2, 1Visveswaraya Technological University, Gulbarga, India; 2Department of Computer Science and Engineering, University Visvesvaraya College of Engineering, Bangalore, India. Contact e-mail: [email protected] Background: There has been a steady rise in the number of patients suffering from Alzheimer’s disease (AD) all over the world. Medical diagnosis is an important but complicated task that should be performed accurately and efficiently and its automation would be very useful. Methods: The patient’s records are collected from DIMHANS, India. The Sample consisted of initial visits of 1027 subjects seen either as control or as patients. Patients were concerned about their memory at DIMAHANS. It also consisted of patients and caregiver interviews. This research work presents different models for the classification of different stages of Alzheimer’s disease using various machine learning methods such as Neural Networks, Multilayer Perceptron, Bagging, Decision tree, CANFIS and Genetic algorithms. Results: The classification accuracy for CANFIS was found to be 99.55% which was found to be better when compared to other classification methods. It was observed that Donepezil hydrochloride, Galantamine, Rivastigmine tartrate, Rivastigmine, Memantine are the most prescribed drugs for the treatment of Mild, Moderate and Severe Alzheimer’s
Poster Presentations: Tuesday, July 26, 2016
each potential user, which could further enhance the experience of chatting with Harlie. P3-405
COMPARISON OF A NOVEL, NATURALISTIC DRIVING ASSESSMENT SYSTEM WITH SELFREPORTED DRIVING BEHAVIOR IN A SAMPLE OF COGNITIVELY NORMAL OLDER ADULTS
Ganesh M. Babulal1, Cindy Traub2, Mollie M. Webb2, Sarah Holtz Stout1, Aaron Addison2, John C. Morris1,3, Cathy Roe2, 1Washington University School of Medicine, St. Louis, MO, USA; 2Washington University School of Medicine (St. Louis), St. Louis, MO, USA; 3Washington University in St. Louis, St. Louis, MO, USA. Contact e-mail: [email protected] Background: Changes in driving behavior among older drivers has
participated). Harlie was programmed to randomly choose one topic at a time out of a repertoire of six total topics, including the specialised topic and five generic topis, such as ‘music’ or ‘good memories’. Participants were seated individually and shown how to chat with Harlie on a smartphone. Headphones were used and each participant spoke to Harlie for approximately 5 minutes. Audio and text recordings were securely saved to an online server for analysis by the research team and participants were encouraged to share feedback on the experience during a group discussion. Results: The feedback on the experience of using Harlie was positive in both groups. While the knitting module was successful in prolonging conversational engagement, the woodworking module was not eliciting longer engagement for this specialised topic. Conclusions: All community members were able to successfully use the Harlie application, feedback was positive and differential chat preferences could be identified. This is a promising finding with potential future applications for using this chatbot with isolated older adults including those with dementia. By following the approach described here, individual chat preferences can be explored for
become an increasing area of public and research interest as older adults continue to drive longer. Controlled conditions like on-theroad tests and driving simulators evaluate driving ability in clinical populations and older adults, but are limited in understanding daily driving behavior. Existing research that measure naturalistic driving behavior are often expensive, obtrusive, require extensive modifications to a vehicle and involve cumbersome download procedures. To address this gap in research technology, we developed a new methodology including, data acquisition, curation and archiving procedures, and wrote custom computer codes (using R and ArcGIS) to modify a commercial off the shelf global positioning system (GPS) solution for our own use. We then conducted a pilot study to assess the degree to which our naturalistic driving system was associated with self-reported driving behavior among older adults with and without preclinical Alzheimer’s disease (AD). Methods: Participants (N¼20) with normal cognition (Clinical Dementia Rating, 0), aged 65 years and older were recruited from the Knight Alzheimer Disease Research Center. Participants completed a clinical assessment and psychometric battery, brain amyloid imaging, and cerebrospinal fluid (CSF) collection. Driving behavior was evaluated using the self-report, Driving Habits Questionnaire (DHQ) and by our system, which incorporated, a GPS device plugged into participant’s vehicle. We examined correlations between five main outcomes collected by both methods: speeding, driving space, total miles driven, total number of trips, and number of days-per-week driven. Group differences were also examined on the five outcomes between those with lower and higher biomarker variables. Results: There were statistically significant correlation (p .05) between both instruments on total miles driven (r¼.83), between number of trips and total miles driven (r¼.57) and number of trips and days-per-week driven (r¼.48). Participants with lower amyloid imaging biomarkers had a higher number of trips with speeding, total miles driven, total number of trips and number of days-per-week driven. Conclusions: Participants more accurately report global driving behavior but less so for specific day-to-day driving behaviors. Further work is needed to determine the association between biomarkers of preclinical AD, self-report driving behavior and, naturalistic driving outcomes.
P3-406
DEMENTIA HEALTH LITERACY AMONG FIRST NATIONS PEOPLE IN ONTARIO: INTEGRATING WESTERN AND INDIGENOUS UNDERSTANDINGS
Sharlene Christina Mary Webkamigad1, Kristen Jacklin2, Shiela CoteMeek1, Birgit Pianosi3, 1Laurentian University, Sudbury, ON, Canada; 2 Northern Ontario School of Medicine, Sudbury, ON, Canada; 3Huntington University, Sudbury, ON, Canada. Contact e-mail: swebkamigad@ laurentian.ca
Poster Presentations: Tuesday, July 26, 2016 Background: Dementia in Indigenous peoples is expected to be an increasing challenge for health care systems at all levels. Our research team’s previous work resulted in the development of evidence-based culturally grounded health promotion material for First Nations people in Canada. Our current project aims to understand the implications of Indigenous cultural diversity on the effectiveness of the materials. To do this we undertook a process of refinement of the materials from a national level focus to a regional focus with the goal of improving cultural relevance at the local level. Methods: Our approach was community-based and participatory. Working with the N’Swaakamok Native Friendship Centre, an Aboriginal advisory group was developed to guide the research. We conducted a qualitative study including 2 focus groups (n¼8) with older adults aged 55 and over and 4 one-onone interview sessions with caregivers of a person with Alzheimer’s disease or age-related dementia. An iterative, thematic data analysis utilizing NVIVO 10 software to organize the data assisted in making meaning. Member checking through transcript reviews and a larger group session was completed to validate the thematic analysis. Results: A significant finding suggests that Aboriginal caregivers and older adults prefer developing a connection with an educated health care professional in order to receive dementia education. This can be done through face-to-face contact by means of family-centred group sessions. These sessions should be supplemented by dementia health promotion material that is organized into the Medicine Wheel. We draw upon the Seven Grandfather Teachings to exemplify how individuals can apply this knowledge in their lives. This research study resulted in two culturally relevant dementia health promotion fact sheets that are locally-specific for the Aboriginal peoples of the City of Greater Sudbury. Aboriginal people have contributed to evidence-based research and knowledge translation. Conclusions: Developing health promotion materials for Indigenous populations requires evidence-informed approaches. While it is desirable to have tools and resources that can be shared nationally, it is important that those tools leave room for local adaptation in order to improve uptake and effectiveness. Culturallygrounded tools hold the potential to improve dementia health literacy and increase cultural safety.
P3-407
EDUCATING PATIENTS AND CARE PARTNERS ABOUT MILD COGNITIVE IMPAIRMENT, APOE, AND ALZHEIMER’S DISEASE: FINDINGS FROM THE REVEAL STUDY
Lan Q. Le1, Natalie J. Bartnik1, Kurt D. Christensen2, Wendy R. Uhlmann3, Jason Karlawish4, Robert C. Green2, J. Scott Roberts1 and the REVEAL Study Group, 1University of Michigan School of Public Health, Ann Arbor, MI, USA; 2Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; 3University of Michigan Medical School, Ann Arbor, MI, USA; 4University of Pennsylvania, Philadelphia, PA, USA. Contact e-mail: [email protected] Background: Biomarkers such as the APOE gene can be used in
combination with other risk factors to predict rates of conversion from mild cognitive impairment (MCI) to Alzheimer’s disease (AD). However, little is known about how best to educate patients and potential care partners about the implications of a MCI diagnosis for risk of progressing to AD. Methods: A multi-site clinical trial enrolled 110 dyads of patients with diagnoses of amnestic-
P1007
MCI (mean age 74, range: 57-89; 49% female; 82% white) and their cognitively normal study partners (SP) (mean age 67, range: 22-93; 72% female; 82% white; 58% significant other). Dyads were randomized to receive an education and risk assessment intervention either with or without disclosure of APOE genotype. An 11-item measure assessing general knowledge of MCI and AD was administered to all participants at baseline, risk disclosure, and 6 weeks. The 73 dyads in the genotype disclosure arm were additionally administered a 4-item measure of knowledge of APOE and AD risk after disclosure. These measures included items from validated instruments and novel survey items customized for this educational intervention. Results: A comparison of knowledge scores demonstrated an improvement from baseline (MCI patient: 70%, SP: 77% correct) to risk disclosure (MCI patient: 83%, SP: 90% correct) and 6 weeks (MCI patient: 80%, SP: 85% correct). Following risk disclosure, the majority of MCI patients and SP correctly identified e4 as a risk allele (MCI patient: 77%, SP: 96% correct), understood the magnitude of its impact on AD risk (MCI patient: 78%, SP: 93% correct), and recognized that non-e4 carriers could still develop AD (MCI patient: 96%, SP: 95% correct). SP scored higher than MCI patients on both study knowledge measures across all time points (p<.05). Conclusions: Our findings confirm the efficacy of a novel intervention for educating patients and care partners about MCI diagnoses and the impact of APOE on risk for AD. Both MCI patients and SP showed good understanding of MCI and genetic risk information, and maintained educational gains over time. Evidence-based approaches to dementia education will be increasingly important as biomarkers are integrated into the treatment of MCI and pre-clinical AD.
P3-408
INVESTIGATIONS ON CLASSIFICATION ACCURACY AND EFFECTIVE MANAGEMENT OF STAGES OF DEMENTIA OF ALZHEIMER’S TYPE EMPLOYING MACHINE LEARNING AND DATA MINING METHODS
Sandhya P1, Deepa Shenoy P2, 1Visveswaraya Technological University, Gulbarga, India; 2Department of Computer Science and Engineering, University Visvesvaraya College of Engineering, Bangalore, India. Contact e-mail: [email protected] Background: There has been a steady rise in the number of patients suffering from Alzheimer’s disease (AD) all over the world. Medical diagnosis is an important but complicated task that should be performed accurately and efficiently and its automation would be very useful. Methods: The patient’s records are collected from DIMHANS, India. The Sample consisted of initial visits of 1027 subjects seen either as control or as patients. Patients were concerned about their memory at DIMAHANS. It also consisted of patients and caregiver interviews. This research work presents different models for the classification of different stages of Alzheimer’s disease using various machine learning methods such as Neural Networks, Multilayer Perceptron, Bagging, Decision tree, CANFIS and Genetic algorithms. Results: The classification accuracy for CANFIS was found to be 99.55% which was found to be better when compared to other classification methods. It was observed that Donepezil hydrochloride, Galantamine, Rivastigmine tartrate, Rivastigmine, Memantine are the most prescribed drugs for the treatment of Mild, Moderate and Severe Alzheimer’s