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LEVERAGING NURSING ASSESSMENT DATA TO IDENTIFY FRA

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Abstract citation ID: igad104.2987
Abstract citation ID: igad104.2988
PARO ROBOT INTERACTION DECREASES PAIN
AND AGITATION SCORES IN HOSPITALIZED OLDER
ADULTS WITH ADRD AND/OR DELIRIUM
Pamela Cacchione1, Ellen Munsterman2, Lisa Walke2,
Lisa Triantos3, Michelle Johnson2, and Jodi Cheeks3,
1. University of Pennsylvania School of Nursing; Penn
Presbyterian Medical Center, Philadelphia, Pennsylvania,
United States, 2. University of Pennsylvania, Philadelphia,
Pennsylvania, United States, 3. Penn Presbyterian Medical
Center, Philadelphia, Pennsylvania, United States
Hospitals are stressful for persons with Alzheimer’s
Disease and Related Disorders (ADRD) and/or delirium.
Therapeutic robotic animals, used in long-term care, are
gaining traction in hospitals to decrease agitation. The
purpose of this RCT was to 1) test the effectiveness of the
PARO Robot in decreasing agitation (CMAI-OT) and pain,
(PAINAD); 2) quantify the interactions (SIT) with PARO
over 2 visits in persons with ADRD and/or delirium. We enrolled 45 intervention and 42 attention control (2 one-hour
PARO interactions vs. research assistant interactions) participants. The CMAI-OT and PAINAD were completed at baseline and every 20 minutes X 3 in both groups. No differences
between groups on age (M=83.7), gender (63% female), race
(77 % Black) number of antipsychotics prescribed [M=1.2 vs
M1.5, p=0.14], or baseline CMAI-OT scores PARO vs control [M=9.3 vs M=9.4, p=0.94]. CMAI-OT decreased at 20
minutes in the PARO group [M=3.9 vs. M=7.0, p= .004] and
remained lower for the hour but not significantly. PAINAD
scores were similar at baseline [M=2.0 vs M=2.2, p=0.65].
PAINAD scores decreased for PARO vs. control [M= 1.64
vs. M= 2.28, p=0.02; M=0.9 vs. M= 1.8, p=0.03] at 20 & 60
minutes day one without differences day two. Participants
held PARO; engaged physically; talked to; smiled; and agreed
to have PARO return. We demonstrated improved agitation
for first 20 minutes of PARO interaction as well as lower
pain over the first 60 minutes day one. Findings did not persist through day two. Next steps are to measure emotional
responses to PARO.
SESSION 7870 (POSTER)
MICROBIOME AND AGING
Abstract citation ID: igad104.2989
A NEW ROLE FOR KYNURENINE METABOLISM IN
THE AGE-ASSOCIATED DECLINE OF THE BACTERIAL
IMMUNE RESPONSE
George Sutphin, and Luis Espejo, University of Arizona,
Tucson, Arizona, United States
Tryptophan metabolism through the kynurenine pathway
becomes dysregulated during normal aging and is implicated
in age-associate disease, including chronic inflammation,
atherosclerosis, neurodegeneration, and cancer. Kynurenine
pathway enzymes and metabolites influence a range of molecular processes critical to healthy aging, including regulation of inflammatory and immune responses. Kynurenine
metabolism is active in immune cells and activated in response to proinflammatory cytokine signaling. We previously determined that elevating physiological levels of the
kynurenine pathway metabolite 3-hydroxyanthranilic acid
(3HAA) via either direct supplementation or inhibition
of the enzyme that degrades 3HAA, 3HAA dioxygenase
(HAAO), extends lifespan and delays age-associated health
decline in Caenorhabditis elegans. Published work suggests
that 3HAA is anti-inflammatory in mammals, for example
by reducing the ratio of activated to regulatory T cells and
inhibiting pathological activation of macrophages. In recent
work, we find that elevating physiological 3HAA can beneficially enhance the immune response of C. elegans to bacterial
pathogens during aging. 3HAA is sufficient to kill bacterial
and inhibit bacterial growth in culture. When HAAO is inhibited in C. elegans, 3HAA accumulates in lysosome related
organelles (LROs) in the intestinal cells, the same subcellular
compartment that contains engulfed bacteria. LROs are a
cellular repository for both iron and zinc, and we further find
that iron chelation or zinc supplementation dramatically enhances the bactericidal properties of 3HAA. Here we present
a mechanistic model in which age-dependent accumulation
of 3HAA in intestinal LROs combines with zinc to enhance
bacterial resistance with age in C. elegans.
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LEVERAGING NURSING ASSESSMENT DATA TO
IDENTIFY FRAILTY INDICATORS OF HOSPITAL
DISCHARGE DISPOSITION
Sarah Ser1, Laurence Solberg2, Ragnhildur Bjarnadottir1,
Robert Lucero3, Mattia Prosperi1, Urszula Snigurska4, and
Brian Celso5, 1. University of Florida, Gainesville, Florida,
United States, 2. NF/SG VHS, Newberry, Florida, United
States, 3. University of California, Los Angeles, Los Angeles,
California, United States, 4. University of Florida College of
Nursing, Gainesville, Florida, United States, 5. University of
Florida Jacksonville, Jacksonville, Florida, United States
Frailty among older adults is associated with higher morbidity and mortality rates and poorer hospital outcomes.
Although frailty is not routinely assessed in the hospital setting, elements of frailty are captured in nursing assessments.
The purpose of this study was to examine components of
the Risk Analysis Index (RAI) captured in electronic health
record (EHR) assessment data and their associations with
discharge disposition. This was a retrospective observational
study of EHR assessment data which included encounters
of older adult patients (≥ 65 years) who were admitted
from home to a medical/surgical unit of an academic hospital in North Central Florida between January 2012 and
May 2021. The components of the RAI included in the study
were sex, age, cancer, renal failure, heart failure, cognitive
decline, unintentional weight loss, poor appetite, and shortness of breath at rest. Descriptive statistics were generated
and compared between patients discharged to home versus
those who were discharged to Post-Acute Care (PAC) facilities. Unadjusted associations were assessed using univariate
logistic regression. Consistent with existing literature on
frailty, all but one of the included RAI components (i.e., male
sex) exhibited higher odds of discharge to a PAC facility with
strong statistical support. Recognizing functional decline
due to frailty is integral to the mission of improving patient
safety. This study provides a preliminary proof of concept for
leveraging existing assessment data in the EHR to capture
frailty in older adults. Future studies of the overall predictive
value of RAI with disposition are warranted.
Innovation in Aging, 2023, Vol. 7, No. S1
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