Improved outcomes for depressed elder abuse victims with video-delivered psychotherapy during COVID-19.

OBJECTIVE: There is a lack of evidence-based scalable therapies for elder abuse victims, with no current remotely delivered tailored psychotherapy. The purpose of this manuscript is to (a) examine the effectiveness of a brief therapy for depression for elder abuse victims, and (b) to compare remote intervention delivery via phone or video to the traditional in-person delivery. METHOD: PROTECT, Providing Options to Elderly Clients Together, is a brief therapy developed in collaboration with partners at the Department for the Aging (DFTA) of New York City. During the COVID-19 outbreak, PROTECT delivery shifted from in-person to phone or video delivery. Depression severity was tracked using the Patient Health Questionaire-9 (PHQ-9). Reduction in depression severity was evaluated using a linear mixed effects model with non-inferiority test to compare the effectiveness of video vs in-person delivery of PROTECT. RESULTS: PROTECT reduced depression (average 5.15 PHQ-9 points). Video and phone delivery were non-inferior to in-person delivery. The video group completed therapy more quickly than the in-person group and had a more rapid improvement in depression symptoms. CONCLUSIONS: PROTECT therapy delivered remotely reduces depression among diverse elder abuse victims. Video delivery of PROTECT could increase reach and scalability to serve more vulnerable older depressed victims.

The invisible gap: Older adults' communication with health care providers about concomitant use of alcohol and medications.

The purpose of this study was to assess the impact of a new educational intervention, Communicating with your Health Care Providers, which was designed to assist older adults in communicating with their physicians and other health care providers and improving their knowledge about concomitant alcohol and medication risks. A randomized control trial was conducted in older adult centers in an urban community. Participants were assigned to either the intervention group or a control group that received traditional services. The intervention group received educational material about health, physical and other aging changes, medication use and possible adverse interactions between alcohol and medications, as well as strategies to initiate communication with physicians and other health care providers. The outcomes measured were: (1) interest in communicating with physicians and health care providers; (2) perception of the importance of communication; and (3) knowledge about concomitant alcohol and medication use. MANCOVA tests indicated that the intervention group had greater knowledge about the risks of combining alcohol with prescription medications than the control group, as well as greater interest in having health care discussions with their physicians and other health care providers. These findings may be translated into future educational programming for community centers.

Change in Depression Severity Among Depressed Older Crime Victims.

The crime rates in urban centers are rising. The psychological impact of crime can range from distress to longstanding mental health impairment. Despite the rising crime rates and psychological impact on victims, little research has been conducted on older adult crime victims' mental health. In this manuscript we describe the profile of older adult crime victims in New York City referred for mental health services, their rates of depression, and the preliminary outcome data from a brief therapy intervention (PROTECT) targeting depression among victims. Building on prior research demonstrating the efficacy of PROTECT for depressive symptom reduction in elder abuse victims, the present study hypothesized elder crime victims who completed PROTECT therapy would demonstrate clinically meaningful depression symptom reduction as measured by the Patient Health Questionnaire-9 (PHQ-9). Additionally, it was hypothesized that these clinically significant depression symptom reductions would be demonstrated regardless of sex, gender, victimization type, victimization frequency, or living status. The results demonstrate that 67.7% (21/31) of participants had a clinically significant reduction in PHQ-9 scores (≥5 points) upon completion of PROTECT. There were no significant group differences in clinically significant depression symptom reduction, suggesting that PROTECT is an effective intervention for a diverse sample of elder crime victims. Future research should focus on the mental health impact of crime against older adults and explore reductions in anxiety and PTSD symptoms among crime victims. Through our partnerships we aim to bridge the divide between victim service providers, and mental health service providers to assist victims to recover, heal, and thrive.

Acceptance of technology-based tools in a sample of Parkinson's patients.

Objectives Parkinson's disease is the second most common neurodegenerative movement disorder in the United States. Patients' opinions of technology-based tools for education and communication as related to Parkinson's disease are unclear with little documented research addressing the issue. The goal of this research was to investigate patient opinions about technology-based tools with a focus on differences between patients of different age groups. Methods A cross-sectional survey was used to assess views on using multiple different electronic methods for receiving instructions and communicating with healthcare providers in 109 Parkinson's disease patients. Results Approximately 28% (n = 28) of the subjects reported having unmet needs related to Parkinson's disease. Those 65 and over were less likely to believe that using technology to communicate with the healthcare center would result in themselves having a better understanding of their care (odds ratio = 0.36, 95% confidence interval: 0.14, 0.95). Those over 75 had a lower odds of being willing to use electronic methods (odds ratio = 0.33, 95% confidence interval: 0.14, 0.79), a lower odds of believing that technology would result in better self-understanding of medical needs (odds ratio = 0.27, 95% confidence interval: 0.12, 0.63) and a lower odds of believing that technology would result in their healthcare providers better understanding their needs (odds ratio = 0.32, 95% confidence interval: 0.14, 0.73). Discussion The results of this study indicate that older Parkinson's disease patients report a less favorable view regarding the role of technology in communicating with healthcare providers and for understanding their care.

Automatic identification of solid-phase medication intake using wireless wearable accelerometers.

We have proposed a novel solution to a fundamental problem encountered in implementing non-ingestion based medical adherence monitoring systems, namely, how to reliably identify pill medication intake. We show how wireless wearable devices with tri-axial accelerometer can be used to detect and classify hand gestures of users during solid-phase medication intake. Two devices were worn on the wrists of each user. Users were asked to perform two activities in the way that is natural and most comfortable to them: (1) taking empty gelatin capsules with water, and (2) drinking water and wiping mouth. 25 users participated in this study. The signals obtained from the devices were filtered and the patterns were identified using dynamic time warping algorithm. Using hand gesture signals, we achieved 84.17 percent true positive rate and 13.33 percent false alarm rate, thus demonstrating that the hand gestures could be used to effectively identify pill taking activity.