Evacuation planning to reduce resident stress for senior adult facilities

Podium Presentations: Tuesday, July 21, 2015

use mix. APOE ε4 carriers showed larger increases in ventricle volume and decreases in right-hippocampal volumes if living in neighborhoods with low street intersection density and land use mix, respectively. Significant increases in amyloid b burden were found only in APOE ε4 carriers from areas with below-average dwelling and intersection densities (Table 2). Conclusions: These preliminary findings indicate possible associations of urban environment characteristics with brain imaging measures, especially in those with a higher genetic risk. Further investigations are warranted. O3-03-05

EVACUATION PLANNING TO REDUCE RESIDENT STRESS FOR SENIOR ADULT FACILITIES

Sally Curtis, Fielding Graduate University, Santa Barbara, CA, USA. Contact e-mail: [email protected] Background: Evacuation plans are a required element of generalized disaster planning for residential facilities but do not address the issues of keeping nursing home residents safe in a natural disaster. Methods: Many nursing homes do not have emergency plans in place that met federal guidelines, regardless of the recommendations found in literature. A review of current emergency plan development and implementation during Hurricane Katrina is presented. The complications that resulted in those evacuations are presented along with suggestions for future natural disasters. Results: For a majority of nursing home administrative directors, resident medical conditions including mobility issues, visual and auditory difficulties, and cognitive impairments influenced the decision to evacuate. A primary element of developing a national model for nursing home evacuations involved using systems already in place and refining those systems to be accessed during evacuations. Conclusions: A national model for evacuation plans would keep evacuation routes to appropriate facilities viable and medical concerns of the residents up to date. Logistical issues concerning what residents are able to do for themselves and what residents need additional assistance would be identified. Accessible medical information ensures that care does not stall because the resident cannot remember the correct diagnosis or medication list. Either in the form of regional databases or digital medical dog tags, medical providers would know how to accurately treat a patient transported out of their local area. O3-03-06

MEDICATION RECONCILIATION: A VITAL PROCESS TO CORRECT MEDICATION MISMANAGEMENT

Judith A. Erlen, Jennifer Lingler, Lisa Tamres, Susan M. Sereika, Martin Houze, Robert Kaufman, University of Pittsburgh, Pittsburgh, PA, USA. Contact e-mail: [email protected] Background: Community-dwelling patients with memory loss can potentially mismanage their medications requiring assistance from their informal caregivers. Medication reconciliation is one means of reviewing medications to identify and correct errors. This study describes the medication reconciliation process used to assess accuracy of medication taking and explores the association of potential caregiver risk factors and errors identified through medication reconciliation. Methods: Medication reconciliation was conducted prior to randomizing dyads into our problem solving intervention study to improve medication management. During the initial home visit research staff examined the patient’s pill bottles to verify drug, dosage, and route and interviewed the caregiver about the medications. The completed medication verification form was sent to the patient’s for confirmation. Providers were asked to review the form noting any discrepancies. If discrepancies were identified, research staff followed up requesting that the patient’s informal caregiver contact the provider for direction. Our goal was to assure that our interventionists focused on the correct

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medications. Results: The sample, 83 randomized caregiver-patient dyads, included 70% female and 88% white caregivers; patients were 60% female and 86% white with a mean MMSE score of 17.3(SD¼7.9). Medication reconciliation findings showed that over half (n¼46) of the sample had at least one discrepancy (range was 06). Exploring caregiver factors revealed trends for associations between number of discrepancies and years of caregiver formal education (r¼.206;p¼.065) and number of correct answers on the Newest Vital Sign measure of health literacy (r¼-.203;p¼.069). There was no significant association between caregiver cognitive status as measured by the Blessed and number of discrepancies (r¼.183;p¼.101). Of the 69 dyads who resided together, there was an average of 1.52 discrepancies; of the 12 dyads residing in different locations, there was an average of 1.42 discrepancies. Conclusions: These results suggest that medication reconciliation discrepancies are common among community dwelling persons with memory loss receiving medication-taking assistance from informal caregivers. The finding that more the half showed at least one discrepancy lends support to recent calls for making medication reconciliation a routine practice in geriatric care settings. Additional research is needed to identify risk factors for medication reconciliation discrepancies in this population. TUESDAY, JULY 21, 2015 ORAL SESSIONS O3-04 PRECLINICAL: PRECLINICAL TAU THERAPEUTICS O3-04-01

TARGETING A STRESS-ASSOCIATED HSP90 COMPLEX AS A NOVEL THERAPEUTIC STRATEGY TO DOWNREGULATE TOXIC TAU IN ALZHEIMER’S DISEASE

Gabriela Chiosis, Sloan Kettering Institute, New York, NY, USA. Contact e-mail: [email protected] Background: Alzheimer’s disease (AD), as well as other neurodegenerative disorders, are caused by the aberrant accumulation of proteins. While mechanisms exist to promote and enforce protein turnover, such mechanisms for the clearance of proteins are overcome, ineffective, or are inhibited during the genesis and progression of these diseases. Hsp90, a molecular chaperone tasked with maintaining cellular proteostasis, has been identified as a protective factor of the microtubule associating protein tau, as well as of several other proteins linked to neurodegeneration. In vitro studies have demonstrated that a loss of Hsp90 activity ablates this protection and allows for normal healthy clearance of tau and associated toxic tau species. While expression levels of Hsp90 remain relatively unchanged between AD and the normal brain, Hsp90 in the diseased brain has traits which are therapeutically targetable. In conditions similar to those identified in cancer cells, the stressed environment generated by the transformation of the normal brain into the diseased AD incites an increased affinity of Hsp90 to the enzymatic regulator ATP. This enhanced affinity creates a drug-targetable pool of Hsp90 distinct from the Hsp90 in normal tissues; we term this as stress-associated Hsp90. This selection advantage and direct regulatory capacity on an accumulating toxic AD protein makes stress Hsp90 an intriguing therapeutic target. Its in vivo targeting however has been hampered by the difficulty of developing an inhibitor that acts selectively on the stress Hsp90 complexes leaving normal Hsp90 unharmed. Methods: We disclose the in vivo activity of the first reported inhibitor of Hsp90 that acts specifically on stress Hsp90 complexes in the brain. The talk will detail the mechanism of action and the therapeutic effect of the compound in tau transgenic mice. Results: We will present how the use of this compound under systemic chronic administration is non-toxic to mice and ameliorates