PowerPoint Presentation - BRAIN HEALTH LIFESTYLE Pilot Study€¦ · PPT file · Web...

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


3.6

3.8

4

4.2

Total Cholesterol / HDL


144

145

146

147

Total Weight


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


0

2040

60

SignificantlyMore

Depressed

SomewhatMore

Depressed

No Change SomewhatMore Happy

SignificantlyMore Happy

The Resident's General Mood Over The Past Six Weeks


0

20

40

60

Significantly

Reduced

Somew hat

Reduced

No

Changed

Somew hat

Increased

Significantly

Increased

The Resident's Tendency to Engage in Activities


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


0

20

40

60

Decreased

Significantly

Decreased

Somew hat

No Change Increased

Somew hat

Increased

Significantly

The Resident's Desire to Socialize


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


020

4060

DeclinedSignificantly

DeclinedSomewhat

No Change ImprovedSomewhat

ImprovedSignificantly

The Resident's Energy Level


01020304050

Declined

Significantly

Declined

Somew hat

No Change Improv ed

Somew hat

Improv ed

Significantly

The Resident's Physical Status Appears to Have


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.

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