Date Presented 3/31/2017 Despite much reporting on the association between neuropsychiatric symptoms (NPS) of dementia and caregiver burden, little preparatory work has informed whether the type of NPS influences burden level. This exploratory factor analysis with 569 dyads reports clinically meaningful findings. Primary Author and Speaker: Paul Arthur Contributing Authors: John Kairalla, William C. Mann, Laura Gitlin

Date Presented 4/7/2016 This study examines how child, family, and health care satisfaction affect families of children with rare diseases. The findings may contribute to building an evidence-based approach and providing diverse therapy options for children with rare diseases and their families. Primary Author and Speaker: Yoonjeong Lim Contributing Authors: Roxanna Bendixen, William C. Mann

Date Presented 4/18/2015 In this study, we explore habits, routines, and schedules of university students with learning disabilities and attention disorders. Findings highlight the importance of establishing habits and routines that support participation and performance. Findings expand the understanding of holistic collegiate demands.

OBJECTIVE. We determined differences in driving errors between combat veterans with mild traumatic brain injury and posttraumatic stress disorder and healthy control participants. METHOD. We compared 18 postdeployed combat veterans with 20 control participants on driving errors in a driving simulator. RESULTS. Combat veterans were more likely to be male; were younger; and had more racial diversity, less formal education, and lower cognitive scores than control participants. Control participants made more signaling errors (t [19] = −2.138, p = .046, SE = 0.395), but combat veterans made more overspeeding (t [17.3] = 4.095, p = .001, SE = 0.708) and adjustment-to-stimuli (t [17] = 2.380, p = .029, SE = 0.140) errors. Young age was related to overspeeding. CONCLUSION. Combat veterans made more critical driving errors than did control participants. Such errors made on the road may lead to crashes or injuries. Although limited in generalizability, these findings provide early support for developing safe driving interventions for combat veterans.

OBJECTIVE. We conducted a literature review of assessment tools predicting driving performance for people with traumatic brain injury (TBI). METHOD. Data sources were Web of Science, EBSCOhost, PubMed, and recently published literature from experts and team members not yet catalogued in the databases. We used the American Academy of Neurology's classification criteria to extract data from 13 studies, and we assigned a class (I–IV, with I being the highest level of evidence) to each study. We grouped primary studies into categories of driving assessment (neuropsychological; simulator; off-road; self-report, other report, and postinjury disability status; and comprehensive driving evaluation) and synthesized the predictability of these tools as it relates to driving performance for people with TBI. CONCLUSIONS. To assist clinicians and researchers in making decisions regarding testing the driving performance of people with TBI, we provide recommendations for neuropsychological tests; off-road tests; self-report, other report, and postinjury disability status; and comprehensive driving evaluation.

OBJECTIVE. We sought to understand how functional status, impairment level, and use of assistive devices change over 3 years for older adults with depressive symptoms. We further explored factors that predict change in severity of depressive symptoms. METHOD. This study used data from the Rehabilitation Engineering Research Center on Aging Consumer Assessment Study, a longitudinal study of coping strategies of elders with disabilities. Seventy-three participants with depressive symptoms were interviewed at baseline and 3 years later. RESULTS. During 3 years, participants experienced increased physical disability (p = .001), a decline in severity of depressive symptoms (p = .03), and an increase in the total number of assistive devices owned. CONCLUSION. A significant number of older adults will experience a decrease in depressive symptoms over 3 years, despite an increase in physical disability. They also will obtain more assistive devices as they age.

OBJECTIVE. Dressing is an important activity of daily living, yet many older adults have difficulty due to impairments. The purpose of this study was to explore the use of assistive devices for dressing by older persons with impairments, and to look at differences among frail elders with no dressing difficulty, upper-extremity-only dressing difficulty, lower-extremity-only dressing difficulty, and both upper- and lower-extremity dressing difficulty. METHOD. We conducted in-home interviews and functional assessments with 1,101 elderly persons with activities of daily living and/or instrumental activities of daily living limitations in Western New York and Northern Florida. Participants were assigned to one of four groups based on Functional Independence Measure™ item scores for upper-extremity dressing and lower-extremity dressing. Descriptive statistics were used to report results. RESULTS. Compared to women, there were relatively more men with lower-extremity dressing difficulty than with upper-extremity dressing difficulty. The group with both upper- and lower-extremity dressing difficulty reported the highest level of pain and scored lowest on all measures of functional status and mental status. The most commonly used dressing devices were associated with lower-extremity dressing. CONCLUSION. There are differences in gender, health status, functional status, and mental status among elderly persons grouped by upper- or lower-extremity dressing difficulty. Results suggest that therapists should consider such differences as gender and type of difficulty (upper- or lower-extremity dressing) in both therapeutic approaches and recommendations for assistive devices. Pain is another important consideration, but it can often be reduced during dressing by using assistive devices.

Objective. This study examined the effectiveness of microwave ovens in assisting elderly persons with disabilities with cooking food. Method. The participants were five elderly persons who had gross motor, fine motor, or vision impairments but no cognitive impairments. Before the study, none of the participants owned or operated a microwave oven. In this single-subject design off our phases (ABAB), training in microwave oven use was provided between the first A (baseline) and first B (intervention) phases. Participants had access to the microwave oven in their homes only during the B phases. Each phase lasted for 3 weeks, for a total of 12 weeks. The frequency of using cooking appliances, the number of food items prepared, and the time spent preparing meals were recorded through daily self-reports. Results. All participants showed an increase in the frequency of using cooking appliances for at least one of the two B phases, although they showed different patterns. The number of food items prepared increased in the B phases, except for two participants who were ill. With the introduction of the microwave oven, time spent preparing meals decreased for all five participants, and their participation in meal preparation increased. Although not measured as a study variable, results suggest that the quality of diet also improved with microwave oven use. Conclusion. Occupational therapy practitioners who serve elderly clients might consider recommending microwave ovens for those who do not have cognitive impairments but who are having difficulty with cooking because of vision impairments or physical disabilities.

Objective. This article examines assistive device use by home-based elderly persons with arthritis. Method. Sixty-six persons were interviewed for the State University of New York at Buffalo (University at Buffalo) Rehabilitation Engineering Research Center Consumer Assessment Study, which sought information on need for and current use of assistive devices. Subjects were assigned to a moderate or a severe arthritis group according to the impact of arthritis on their activities. Results. Subjects in the severe arthritis group had more chronic diseases, a higher level of pain, and a lower level of independence in self-care activities than subjects in the moderate arthritis group. Similarities between the groups included relatively poor health, high rate of medication use, depression, use of a high number of assistive devices (about 10 per person), and an expressed need for additional devices, such as reachers, magnifiers, grab bars, jar openers, and bearing aids. Generally, there was a high rate of satisfaction with the assistive devices used. Most subjects missed being able to participate in at least one activity; most of these activities were active and many related to leisure time. Conclusion. Findings also revealed that subjects had inadequate information on assistive devices, which suggests the importance of more occupational therapy involvement with elderly persons in selecting devices.

This paper examined assistive device use by noninstitutionalized older persons with visual, cognitive, and physical impairments. One hundred fifty seven persons over 60 years of age (M = 75.5 years) were interviewed in their homes for the University at Buffalo Rehabilitation Engineering Research Center Consumer Assessments Study. Subjects were assigned to one of seven groups according to types of impairment: minimal, physical, visual, visual and physical, cognitive, cognitive and physical, and cognitive and visual. Group assignments were based on scores on the Sickness Impact Profile (physical), Older Americans Resources and Services Program Multidimensional Functional Assessment Questionnaire (vision), and Mini Mental State Exam (cognitive). Overall, subjects owned a mean of 13.7 devices, used 10.8 devices (79% of the devices they own), and were satisfied with 9.8 devices (72% of the devices they own). There were significant differences among the impairment groups in numbers of devices owned and used, and in satisfaction with devices. Subjects expressed the need for more devices, especially devices for increasing mobility and assisting with balance. Results suggest a stronger role for occupational therapists in the assessment of assistive device needs of older persons, and in recommending devices and training persons in their use.