The NIA-funded study focuses on those who care for people with dementia and Alzheimer’s disease at home

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Tampa, FL (July 9, 2013) – The University of South Florida College of Nursing is conducting research to improve sleep in those caring for people with dementia and Alzheimer’s disease, with the aim of determining if better sleep affects heart health. The $1.9-million, four-year study funded by National Institute on Aging (NIA), “Improving Dementia Caregiver Sleep and the Effect on Heart Disease Biomarkers,” is led by USF College of Nursing Professor and Endowed Chair Meredeth Rowe, RN, PhD, FGSA, FAAN.

Fifteen million Americans provided an estimated 17.5 billion hours of unpaid care to people with Alzheimer’s disease and other dementias in 2012, according to the Alzheimer’s Association. Recent studies indicate that caregivers, unpaid family members or friends who assist people with Alzheimer’s with daily activities, may experience sleep loss from the constant demands of caregiving.

The College of Nursing study tests the relationship between caregiver sleep and heart disease to help understand what negatively affects caregiver health.

USF College of Nursing’s Dr. Meredeth Rowe places one of the monitoring device’s sensors beneath the mattress. The sensor detects movement and sounds an alarm to alert the caregiver if the person with Alzheimer’s disease starts to get out of bed.

“Caregiving and lack of sleep each separately increase the risk of heart disease,” Dr. Rowe said. “We want to discover whether improving sleep in caregivers lowers that risk.”

According to the 2006 Institute of Medicine (IOM) report “Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem,” the cumulative effects of sleep loss and sleep disorders have been associated with a wide range of adverse health consequences including increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke.

“The College of Nursing at the University of South Florida is transforming lives through research to improve the health of patients and their caregivers,” said Dianne Morrison-Beedy, PhD, RN, WHNP-BC, FNAP, FAANP, FAAN, senior associate vice president of USF Health and dean of the College of Nursing. “We’re making life better by transforming the health care of the family members who provide essential home care for persons with dementia. These caregivers fill an often unrecognized role in the healthcare system.”

The primary focus of Dr. Rowe’s research is finding an effective and easy-to-use treatment that can improve sleep in Alzheimer’s caregivers to increase their overall health and reduce the nursing home placement of people with dementia.

“When I was working on ways to provide caregivers better quality of sleep, I looked for technologies that might help and there were none,” Dr. Rowe said. “I realized that unless I invented a system that allowed them to sleep well, I was never going to have an impact on improving their sleep.”

Dr. Rowe explains to a caregiver how the integrated nighttime monitoring system tracks the bed occupancy and movement patterns around the house of a loved one with dementia. The goal is to allow the caregiver to rest easier through the night while maintaining the safety of the person with dementia.

A number of sensors can be placed around the house, including doorways, to analyze movement patterns and provide customized, specific alerts.

CareAlert, a new night monitoring system designed by Dr. Rowe and Caregiver Watch, LLC, provides reliable alerts to caregivers whenever a person with dementia leaves the bed and wanders through the house. The system helps the caregiver rest easier through the night, and improves the overall safety of the person with dementia. The findings of a study testing the effectiveness of CareAlert were published by Dr. Rowe and colleagues in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, in 2009. The researchers reported that use of CareAlert reduced nighttime injuries and unattended home exits by 85 percent over a period of 12 months.

“Dr. Rowe’s research seeks not only to improve caregiver sleep, but also to better understand the relationships between sleep and changes in heart health,” said Cindy L. Munro, PhD, RN, ANP-BC, FAAN, professor and associate dean for research and innovation at the USF College of Nursing.

In the latest research, Dr. Rowe is evaluating whether a combined intervention using  CareAlert and cognitive-behavioral therapy for insomnia improves sleep in individuals who care for people with dementia and Alzheimer’s who wake up at night. The study, conducted in the USF College of Nursing Caregiving Laboratory, will include as many as 100 participants. All will receive the CareAlert device and one of two sleep therapies assigned at random.

Dr. Rowe, a national expert in caregiver-related issues, worked with a company to design an evidence-based monitoring system with technology responsive to caregiver needs.

Rita F. D’Aoust, PhD, ACNP, ANP-BC, CNE, FAANP, FNAP, associate professor and associate dean of academic affairs and interprofessional initiatives at the USF College of Nursing, and Maureen E. Groer, RN, PhD, FAAN, Gordon Keller professor, are study co-investigators. Dr. D’Aoust studies the associations between vigilance and sympathetic nervous system activity, and Dr. Groer leads the design and analysis of biologic markers for heart disease. Others contributing to this research project include Brandi Mallek, research project manager; Taujihana Brown, research assistant; Glenna Brewster, predoctoral fellow; Milora Morley, undergraduate public health honors student.

The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation’s medical research agency and the leading supporter of biomedical research in the world. NIA, one of the 27 institutes and centers at NIH, helps understand the nature of aging and supports the health and well-being of older adults. Dr. Rowe has received many NIH grants throughout her research career to study people with Alzheimer’s disease or dementia and their caregivers. The USF College of Nursing ranks first in Florida and 24th in the nation in NIH funding, for both public and private schools of nursing.

Dr. Maureen Groer, a co-investigator for the caregiver sleep and heart disease risk study, watches as research lab technician Nicole Williams drops processed blood into a machine that will identify biomarkers of heart disease.

Dr. Rowe is currently enrolling participants for this study. For more information, contact USF College of Nursing Research Project Manager Brandi Mallek, at (813) 974-1827 or bmallek@health.usf.edu.

USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities. For more information, visit www.health.usf.edu.

Media contact:
Ashlea Bailey, College of Nursing Communications 
(813)396-9642 or  ahudak@health.usf.edu

All photos with Dr. Rowe taken at the USF Health Byrd Alzheimer’s Institute’s Center for Memory C.A.R.E  by Eric Younghans, USF Health Communications
Video by Andy Faza, USF College of Nursing Communications & Marketing

The study, led by USF Nursing, has implications for the development of Silver Alert-type programs

Tampa, FL (Dec. 14, 2012)— A new study focusing on how people with dementia become lost while driving, how missing drivers are found, and the role of public notification systems like Silver Alert in these discoveries suggests techniques that may help recover drivers with dementia and prevent potentially harmful incidents.

The study was led by principal investigator Meredeth A. Rowe, RN, PhD, FGSA, FAAN, professor and endowed chair at the University of South Florida College of Nursing. The findings were published online last month in the Journal of the American Geriatrics Society:  Missing Drivers with Dementia: Antecedents and Recovery.

Based on the study results, the research team reported several recommendations to help guide local policies and training for Silver Alert-type programs that broadcast information about missing seniors with Alzheimer’s disease, dementia or other cognitive deficits, including:

–          Rapid, direct notification of law enforcement agencies as well as equipping officers a mechanism for quickly assessing the cognitive status of drivers is critical.  Law enforcement officers are more likely than citizens or family members to discover missing drivers with dementia.

–          More detailed information about a missing individual, not just a description of the car being driven, may better assist law enforcement officers and citizens in rescuing lost drivers who have left their vehicles to wander on foot.

–          State and federal agencies planning a Silver Alert program need to develop policies and procedures that recognize the distinct differences between those missing while driving and those lost while walking.

–          Retirement from driving is the only preventive option when individuals can no longer safely operate a motor vehicle because dementia interferes with their ability to retain and use new information.

“With the baby-boomer generation getting older, the number of the people living with Alzheimer’s disease is on the rise,” Dr. Rowe said. “Most Americans depend on driving their own car to meet their transportation needs, even for the most basic needs such as food.  It will be critical to identify other means of transportation for people with dementia (PWD) to facilitate driving retirement.  This strategy will be the most effective intervention to reduce and prevent incidents of missing PWDs.  Strategies commonly recommended, such a hiding the car keys, are potentially protective only in a small number of cases.” 

According to Alzheimer’s Association, 5.4 million Americans live with Alzheimer’s disease, including 800,000 who live alone. One in eight older Americans lives with the memory-robbing disease, including 450,000 Floridians age 65 or older.  These statistics highlight the need to find more effective ways to search for missing drivers with dementia and reduce missing incidents.

The study was led by Meredeth Rowe, PhD, of the University of South Florida College of Nursing.

Dr. Rowe and her colleagues analyzed 156 law enforcement records for missing drivers who had a Silver Alert issued for October 2008 through May 2010. These alerts are issued on digital highway signs and news broadcasts in Florida to assist law enforcement officials and the general public in identifying and safely returning cognitively impaired drivers.

The researchers found that most missing drivers were men, ages 58 to 94, who were cared for by a spouse. Most got lost on routine, caregiver-sanctioned trips to usual locations. Only 15 percent were found while driving, with most discovered in or near a parked car — and law enforcement officers recovered the large majority of drivers with dementia.

In addition, only 40 percent were found in the county where they were reported missing, and 10 percent were found in a different state. Another 15 percent were found in dangerous situations such as stopped on railroad tracks.  There was a 5 percent mortality rate in the study population, with those living alone more likely to be found dead than alive.

“While some PWDs may continue to drive safely, it is imperative that we identify individuals who will get lost, determine predictors of modifiable outcomes, and establish policies that will improve location of those individuals who get lost,” said study co-author James E. Galvin, MD, MPH, professor of neurology and psychiatry New York University Langone Medical Center.

A comprehensive Silver Alert program that includes law enforcement and community education as well as rapid alerts is critical to finding missing drivers, the researchers conclude. Their findings led to recommendations for an additional study on how notifications be more effectively delivered to facilitate increased recoveries from “Good Samaritan” citizens.  

The researchers emphasize that getting cognitively impaired people to retire from driving may be the single most effective measure for prevent missing incidents that may lead to injury or death.

“Important aspects of successful driving retirement include a partnership between the healthcare practitioner and caregiver to support the decision for driving retirement, the identification of

local and state programs… and assistance in finding alternative forms of transportation in the community,” they report.

                                                                                                                                                                                                           -USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of PublicHealth, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities.

-About NYU Langone Medical Center-

NYU Langone Medical Center, a world-class, patient-centered, integrated, academic medical center, is one on the nation’s premier centers for excellence in clinical care, biomedical research and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals – Tisch Hospital, its flagship acute care facility; the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology; Hassenfeld Pediatric Center, a comprehensive pediatric hospital supporting a full array of children’s health services; and the Rusk Institute of Rehabilitation Medicine, the world’s first university-affiliated facility devoted entirely to rehabilitation.

Written by Guy Engelhardt and Vjollca Hysenlika, USF College of Nursing

Media contact:
Ashlea Hudak, College of Nursing Communications
(813) 396-9642 or ahudak@health.usf.edu