Cathleen M Connell

University of Michigan, Ann Arbor, MI, United States

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Publications (47)136.35 Total impact

  • J. Scott Roberts, Sara J. McLaughlin, Cathleen M Connell
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    ABSTRACT: Background The purpose of this study was to assess public beliefs and knowledge about risk and protective factors for Alzheimer's disease (AD). Methods A brief survey module was added to the Health and Retirement Study, a longstanding national panel study of the U.S. population over the age of 50. Results Respondents were 1641 adults (mean age = 64.4 years, 53.6% female, 81.7% White). Most (60.1%) indicated interest in learning their AD risk, with 29.4% expressing active worry. Many failed to recognize that medications to prevent AD are not available (39.1%) or that having an affected first-degree relative is associated with increased disease risk (32%). Many respondents believed that various actions (e.g., mental activity, eating a healthy diet) would be effective in reducing AD risk. Conclusion Older and middle-aged adults are interested in their AD risk status and believe that steps can be taken to reduce disease risk. Tailored education efforts are needed to address potential misconceptions about risk and protective factors.
    Alzheimer's & dementia: the journal of the Alzheimer's Association 10/2014; DOI:10.1016/j.jalz.2013.07.001 · 17.47 Impact Factor
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    ABSTRACT: Purpose of the Study. Adult children are often directly affected by aging parents' decision to limit or stop driving. This qualitative study examined the process of driving reduction and cessation (DRC) from the perspective of adult children, with a focus on family communication. Design and Methods. Four focus group interviews were conducted with 37 adult children (29/37 female; mean age = 45.5) of older parents using a structured protocol. Transcripts were analyzed by two independent coders to identify major themes. Results. Themes represented three aspects of the DRC process: family communication and dynamics (i.e., discussion, negotiation, and planning; avoidance and side stepping; resignation and refusal), taking action to end a parent's driving career (i.e., engaging a third party; taking away the car), and post-cessation reflection (i.e., relief; social benefits; resentment and guilt). Implications. Despite the potential benefits of planning for DRC, families are unsure about how best to approach this topic. Adult children worry about assuming responsibility for their parents' transportation needs and their parents' reactions to restricted mobility. Despite a reluctance to communicate openly about DRC, adult children and their parents share similar and significant concerns that merit increased attention.
    Journal of Applied Gerontology 12/2013; 32(8):975-96. DOI:10.1177/0733464812448962 · 0.97 Impact Factor
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    ABSTRACT: Family members and friends can be an important source of self-management support for older adults with chronic diseases. We characterized the U.S. population of potential and current "disease management supporters" for people with chronic illness who are independent in activities of daily living, the help that supporters could provide, and barriers to increasing support. We used a nationally representative survey of U.S. adults (N = 1,722). Forty-four percent of respondents (representing 100 million US adults) help a family member or friend with chronic disease management; another 9% (representing 21 million U.S. adults) are willing to start. Most are willing to assist with key tasks such as medication use and communicating with providers, although they feel constrained by privacy concerns and a lack of patient health information. The majority of U.S. adults already helps, or would be willing to help, one of their family members or friends with chronic illness care. Supporters' specific concerns could be addressed through innovative programs. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Families Systems & Health 06/2013; 31(2):119-131. DOI:10.1037/a0031535 · 1.04 Impact Factor
  • Mary R Janevic, Sara J McLaughlin, Cathleen M Connell
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    ABSTRACT: OBJECTIVE: Most adults with diabetes do not engage in the level of physical activity recommended for optimal disease management. Diabetes complications are not generally considered a clinical contraindication to exercise. No prior national studies have examined the associations of these complications with physical activity. METHODS: Data are from the 2003 Diabetes Supplement to the nationally representative US Health and Retirement Study (n = 1811; age >50 years). Multiple logistic regression was used to examine the association between diabetes complications and the odds of meeting physical activity guidelines. RESULTS: Forty-three percent of the sample met physical activity guidelines. Adjusting for sociodemographic variables, retinopathy (odds ratios (OR) OR = 0.54, 95% confidence intervals (CI) = 0.36-0.81), nephropathy (OR = 0.70, 95% CI = 0.50-0.99), neuropathy (OR = 0.75, 95% CI = 0.59-0.95), and heart disease (OR = 0.69, 95% CI = 0.51-0.94) were all independently associated with reduced odds of meeting guidelines. A borderline significant association was observed for stroke. DISCUSSION: Adults with diabetes with complications of the eyes, kidneys, or nerves and those with heart disease are less likely to meet physical activity guidelines compared to those without these complications. These individuals may require additional support from health professionals to achieve recommended amounts of physical activity. More studies are needed to clarify the barriers and benefits to engaging in physical activity in the presence of diabetes complications.
    Chronic Illness 05/2013; DOI:10.1177/1742395313475461
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    ABSTRACT: Background: Blacks have higher hypertension rates than whites, but the reasons for these disparities are unknown. Differential vulnerability, through which stress alters vulnerability to the effects of environmental hazards, is an emergent notion in environmental health that may contribute to these disparities. Objectives: We examined whether blacks and whites exhibit different associations between blood lead (BPb) and blood pressure (BP) and whether depressive symptoms may play a role. Methods: Using the National Health and Nutrition Examination Survey 2005–2008, we regressed BP on the three-way interaction among race/ethnicity, BPb, and depressive symptoms in blacks and whites ≥ 20 years of age. Results: Blacks but not whites showed a positive association between BPb and systolic blood pressure (SBP). The disparity in this association between blacks and whites appeared to be specific to the high depressive symptoms group. In the low depressive symptoms group, there was no significant black–white disparity (βinteraction = 0.9 mmHg; 95% CI: –0.9, 2.7). However, of those with high depressive symptoms, blacks and whites had 5.6 mmHg (95% CI: 2.0, 9.2) and 1.2 mmHg (95% CI: –0.5, 2.9) increases in SBP, respectively, in association with each doubling of BPb (βinteraction = 4.4 mmHg; 95% CI: 0.5, 8.3). The pattern of results was similar for diastolic blood pressure. Conclusions: Our results suggest that depressive symptoms may contribute to the black–white disparity in the association between BPb and BP. Depressive symptoms may result, in part, from psychosocial stress. Our results support the notion that stress increases vulnerability to the health effects of environmental hazards and suggest that stress-related vulnerability may be an important determinant of racial/ethnic health disparities.
    Environmental Health Perspectives 10/2012; 121(2). DOI:10.1289/ehp.1104517 · 7.03 Impact Factor
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    ABSTRACT: Objectives. We explored the notion that social disadvantage increases vulnerability to the health effects of environmental hazards. Specifically, we examined (1) whether race modifies the association between blood lead and blood pressure and (2) whether socioeconomic status (SES) plays a role in this modifying effect. Methods. Using the National Health and Nutrition Examination Survey (2001-2008) and linear regression, we estimated the association between blood lead and blood pressure. Using interactions among race, SES, and lead, we estimated this association by levels of social disadvantage. Results. Black men and women showed a 2.8 (P < .001) and 4.0 (P < .001) millimeters mercury increase in SBP, respectively, for each doubling of blood lead. White adults showed no association. This lead-SBP association exhibited by Blacks was primarily isolated to Blacks of low SES. For example, poor but not nonpoor Black men showed a 4.8 millimeters mercury (P < .001) increase in SBP for each doubling of blood lead. Conclusions. Our results suggest that social disadvantage exacerbates the deleterious health effects of lead. Our work provides evidence that social and environmental factors must be addressed together to eliminate health disparities. (Am J Public Health. Published online ahead of print October 18, 2012: e1-e8. doi:10. 2105/AJPH.2012.300774).
    American Journal of Public Health 10/2012; 102(12). DOI:10.2105/AJPH.2012.300774 · 4.23 Impact Factor
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    ABSTRACT: To describe how comorbid depression in chronically ill adults affects the willingness of their family and friends to provide them with illness management support. We identified a national sample of U.S. adults (n=1027), all of whom had a close relative or friend with a chronic physical illness. We examined whether respondents were less willing to help their relatives/friends with disease management when they reported that these relatives/friends were also diagnosed with depression. In multivariate models, the odds of respondents being willing to provide disease-management support doubled when the relative/friend was depressed (adjusted odds ratio (AOR)=1.99; 95% C.I.=1.31, 3.02). Respondents were willing to perform an equal number of illness support tasks for relatives/friends with and without depression. However, respondents reported 30% more difficulties discussing health issues (incidence rate ratio (IRR)=1.30; 95% C.I.=1.11, 1.53), and 44% more barriers to providing support (IRR=1.44; 95% C.I.=1.18, 1.75) to depressed relatives/friends. U.S. adults are more willing to provide disease-management support for chronically ill relatives/friends with depression. However, helping depressed relatives/friends is also more challenging. By providing resources for potential supporters, health providers could mobilize an important source of disease-management support for patients with chronic illness and depression.
    Patient Education and Counseling 06/2012; 89(1):191-8. DOI:10.1016/j.pec.2012.05.009 · 2.60 Impact Factor
  • Sara J McLaughlin, Alan M Jette, Cathleen M Connell
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    ABSTRACT: Although the notion of healthy aging has gained wide acceptance in gerontology, measuring the phenomenon is challenging. Guided by a prominent conceptualization of healthy aging, we examined how shifting from a more to less stringent definition of healthy aging influences prevalence estimates, demographic patterns, and validity. Data are from adults aged 65 years and older who participated in the Health and Retirement Study. We examined four operational definitions of healthy aging. For each, we calculated prevalence estimates and examined the odds of healthy aging by age, education, gender, and race-ethnicity in 2006. We also examined the association between healthy aging and both self-rated health and death. Across definitions, the prevalence of healthy aging ranged from 3.3% to 35.5%. For all definitions, those classified as experiencing healthy aging had lower odds of fair or poor self-rated health and death over an 8-year period. The odds of being classified as "healthy" were lower among those of advanced age, those with less education, and women than for their corresponding counterparts across all definitions. Moving across the conceptual continuum--from a more to less rigid definition of healthy aging--markedly increases the measured prevalence of healthy aging. Importantly, results suggest that all examined definitions identified a subgroup of older adults who had substantially lower odds of reporting fair or poor health and dying over an 8-year period, providing evidence of the validity of our definitions. Conceptualizations that emphasize symptomatic disease and functional health may be particularly useful for public health purposes.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 02/2012; 67(7):783-9. DOI:10.1093/gerona/glr234 · 4.98 Impact Factor
  • Mary R Janevic, Sara J McLaughlin, Cathleen M Connell
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    ABSTRACT: Using data from the national Health and Retirement Study, we sought to: (a) estimate the proportion of the US adults with diabetes above the age of 50 who do not meet physical activity guidelines but believe they are sufficiently active; and (b) examine demographic and health-related correlates of such "overestimation." Respondents who were classified as underactive according to a detailed activity inventory but reported exercising at least the "right amount," were designated as overestimating their physical activity. Multiple logistic regression was used to examine the association of demographic and health-related correlates with the odds of overestimation. Fifty-four percent of the survey sample did not meet physical activity guidelines, and one quarter of this underactive group overestimated their physical activity. The adjusted odds of overestimation were higher among respondents who held the perception that they were about the right weight or underweight [odds ratio (OR)=2.42; 95% confidence interval (CI), 1.49-3.94), who had good or better self-assessed diabetes control (OR=1.84; 95% CI, 1.12-3.04), and who were Black or Hispanic (OR=1.89; 95% CI, 1.13-3.16). Experiencing shortness of breath reduced the odds of overestimation (OR=0.34; 95% CI, 0.19-0.61). Overestimation of physical activity is common among adults with diabetes, and is associated with the perceptions that one is about the right weight and that one has good control of diabetes, and with being Black or Hispanic. Clinicians should be aware that these factors may affect their patients' beliefs about how much physical activity is adequate.
    Medical care 12/2011; 50(5):441-5. DOI:10.1097/MLR.0b013e3182422a52 · 2.94 Impact Factor
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    ABSTRACT: Despite the potential of the internet for informing clinical practice, little is know about physicians' use of and attitudes about internet use for dementia care. We surveyed 373 physicians to inform development of on-line dementia education resources. Two thirds reported using internet-based resources in their clinical practices at least three times per week; 61% participated in on-line continuing medical education. Three fourths agreed that internet-based resources are helpful in clinical care but most expressed mixed views about quality of available information. Respondents reported limited awareness and use of dementia-specific internet resources, but expressed an interest in such information regarding screening, treatment, community resources, and patient education. National Institute on Aging-funded Alzheimer's Disease Centers are in a unique position to disseminate on-line resources for physicians on dementia diagnosis, treatment, and care. Our study suggests that such a resource would be well received and utilized by physicians.
    Journal of Applied Gerontology 08/2011; 30(4):513-523. DOI:10.1177/0733464810363894 · 0.97 Impact Factor
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    ABSTRACT: To determine if older women with both heart disease and diabetes experience worse physical and psychosocial functioning and higher symptom burden over an 18-month period compared with those with heart disease alone. Data from older women with heart disease (≥60 years, n = 1008, 18% with diabetes) were used to assess the impact of diabetes on physical functioning (Sickness Impact Profile [SIP]-Physical and Six-Minute Walk test [6MWT]), psychosocial functioning (SIP-Psychosocial and depressive symptoms), and physical symptom burden (cardiac and general) at baseline and 4, 12, and 18 months later. Generalized estimating equation models compared trends in outcomes over time between groups with and without diabetes. Across all four time points, women with heart disease and diabetes had greater functional impairment, as indicated by higher SIP scores, than those without diabetes (43%-71% higher SIP-Physical scores and 32%-65% higher SIP-Pyschosocial scores; all p ≤ 0.002). 6MWT distance was 17%-30% less in the diabetes group across time points (all p ≤ 0.002). Depressive symptoms were 27%-39% higher in the diabetes group (all p < 0.03) except at month 4. Women with diabetes scored 15%-29% higher on a physical symptom index across time points (all p < 0.05) than those without diabetes; no significant differences were observed in cardiac symptoms until month 18 (diabetes group 29% higher, p = 0.02). Subgroups with and without diabetes in this sample experienced significantly different trends over time in SIP-Physical scores (p = 0.02) and 6MWT distance (p = 0.05), such that the disadvantage of the diabetes group at baseline was greater 18 months later. Women with comorbid diabetes and heart disease are vulnerable to poor health-related quality of life, particularly in terms of physical functioning and symptoms, and require special efforts from clinical care providers to ameliorate a potential downward trend in these outcomes over time.
    Journal of Women's Health 01/2011; 20(1):107-15. DOI:10.1089/jwh.2010.2123 · 1.90 Impact Factor
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    ABSTRACT: To estimate the prevalence of successful aging in the United States, with the broad aim of contributing to the dialogue on Rowe and Kahn's concept of successful aging. Using data from the Health and Retirement Study, the prevalence of successful aging was calculated for adults aged 65 years and older at four time points: 1998, 2000, 2002, and 2004. Successful aging was operationalized in accordance with Rowe and Kahn's definition, which encompasses disease and disability, cognitive and physical functioning, social connections, and productive activities. No greater than 11.9% of older adults were aging "successfully" in any year. The adjusted odds of successful aging were generally lower for those of advanced age, male gender, and lower socioeconomic status. Between 1998 and 2004, the odds of successful aging declined by 25%, after accounting for demographic changes in the older population. Few older adults meet the criteria put forth in Rowe and Kahn's definition of successful aging, suggesting the need for modification if the concept is to be used for broad public health purposes. Disparities in successful aging were evident for socially defined subgroups, highlighting the importance of structural factors in enabling successful aging.
    The Journals of Gerontology Series B Psychological Sciences and Social Sciences 12/2009; 65B(2):216-26. DOI:10.1093/geronb/gbp101 · 2.85 Impact Factor
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    ABSTRACT: To examine potential benefits of and barriers to diagnosis from the perspective of black and white adults directly affected by Alzheimer's disease (AD). Telephone survey. Convenience sample recruited from two U.S. metropolitan areas. One hundred seventy-eight family members of people with AD, including current and former AD caregivers and immediate blood relatives of someone with AD. Respondents were asked to rate the importance of eight benefits of and 16 barriers to obtaining a diagnosis. Family members strongly endorse several benefits of obtaining a diagnosis, including getting information, finding out what is wrong with their relative, and prompting future planning. A majority of survey respondents did not endorse any barriers examined. Lack of a cure for AD and the belief that little can be done for someone with AD were the most frequently endorsed barriers. Black respondents endorsed five of the eight benefits more frequently than white respondents. Black and white adults with a family member who has received an diagnosis of AD perceive a range of benefits and few barriers to the diagnostic process examined in this study. Their positive experiences might be instructive to families considering pursuing a diagnosis and to physicians who may be reluctant to offer screening or referral because of the belief that families have little to gain.
    Journal of the American Geriatrics Society 09/2009; 57(9):1562-8. DOI:10.1111/j.1532-5415.2009.02395.x · 4.22 Impact Factor
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    ABSTRACT: Inadequate recruitment into Alzheimer disease clinical trials is an important threat to the validity and generalizability of the studies. The majority of dementia patients are first evaluated by community-based physicians; however, physician perceptions of clinical research are largely unknown. A survey was distributed to 3123 physicians in 3 states; 370 were returned. Survey items assessed attitudes, perceived benefits of and barriers to referral to clinical research, and physicians use of the internet for medical information. The mean age of the respondents was 50.6+/-10.8 years; 70% were male, 78% white, 61% were primary care providers; 63% used the internet > or =3 times/week. No demographic or medical specialty differences existed between those who were likely (n=193) and unlikely (n=162) to refer patients to clinical trials. Differences were discovered in perceived benefits reported by physicians who were more likely to refer, whereas differences in perceived barriers existed in primary care compared with specialists. Referral to clinical trials is predicted by close proximity to a research center [odds ratio (OR): 4.0; 95% confidence interval (CI), 1.1-15.6] and availability of internet information regarding diagnostic evaluation (OR: 2.3; 95% CI, 1.1-4.7). Primary barriers included concerns about exposure of patients to uncomfortable procedures (OR: 4.7; 95% CI, 1.2-18.7) and lack of time to discuss research participation (OR: 6.8; 95% CI, 1.4-32.3). Proximity to a research center and availability of diagnostic clinical tools are strong predictors of clinical trial referral. Concern over risks to patients and lack of time are strong barriers. These results suggest that dementia outreach education targeted to physicians should emphasize the importance of clinical trials with a focus on discussing research participation in a time-efficient manner and increasing awareness of risk reduction and the safety of research protocols. Providing easy access to up-to-date, user-friendly educational materials on dementia diagnosis and research via the internet are likely to improve referrals of patients to Alzheimer disease clinical trials from community physicians.
    Alzheimer disease and associated disorders 07/2009; 23(4):352-6. DOI:10.1097/WAD.0b013e31819e0cac · 2.69 Impact Factor
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    Cathleen M Connell, Mary R Janevic
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    ABSTRACT: Despite the importance of self-care for dementia caregivers, few interventions have included a focus on health behaviors. The current study reports outcomes of a telephone-based exercise intervention designed for women caring for a spouse with dementia. Caregivers (N = 137) were randomized to intervention or control conditions. Participants with at or below-median exercise scores at baseline had a significantly greater increase in exercise at six-month follow-up compared to their control counterparts. At 6 months, participants had greater reductions in perceived stress relative to controls. Participants also reported significantly greater increases in exercise self-efficacy than caregivers in the control group at both follow-up points. . Results indicate that spouse caregivers are able to increase their physical activity and that a focus on exercise in multi-component interventions may be beneficial. Debate and discussion is needed to inform expectations for program impacts and their maintenance and to explore the interface between enhanced self-care and caregiving perceptions.
    Journal of Applied Gerontology 04/2009; 28(2):171-194. DOI:10.1177/0733464808326951 · 0.97 Impact Factor
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    ABSTRACT: Alzheimer disease (AD) is a growing public health problem that disproportionately affects racial and ethnic minorities, including African Americans. Given that the perceptions of illness can influence response to treatment options and coping with disease burden, we examined differences between African Americans and whites with regard to their attitudes, beliefs, and knowledge about AD. A total of 301 participants (mean age = 57 y; 80% female; 47% African American) were surveyed by telephone, with overrepresentation of caregivers and first-degree relatives of people with AD (62% of sample). After controlling for potentially confounding covariates, the 2 groups differed in terms of the following: (1) their knowledge about the disease (eg, recognizing that AD is not a part of normal aging); (2) concern about AD (eg, worry about developing the disease); (3) beliefs about putative causes of AD (eg, stress); and 4) beliefs about the effectiveness of various options for reducing risk of and treating AD (eg, physical activity). Findings suggest that AD outreach and education efforts may do well to take into account divergent illness perceptions across racial and ethnic groups. Further research is needed to confirm these findings in more representative samples and to identify factors that explain these racial differences.
    Alzheimer disease and associated disorders 01/2009; 23(2):110-6. DOI:10.1097/WAD.0b013e318192e94d · 2.69 Impact Factor
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    ABSTRACT: Current asthma guidelines encourage the use of an asthma diary for patients whose symptoms are not under control, who are being introduced to new treatments, or who need help in identifying environmental or occupational exposures. Despite the potential benefit of diaries in asthma management, gaps in the understanding of their use exist. Our objective was to identify demographic and clinical characteristics predictive of diary use by women with asthma as women patients predominate in asthma among adults and have higher rates of associated asthma management problems. Demographic and clinical characteristics associated with the use of a structured asthma diary were examined using data collected from 424 women with asthma over 18 years of age taking part in a randomized controlled study. Data were analyzed using chi-square statistics and logistic regression. Data reported are for women randomized to the intervention arm (N = 424) who were assigned the diary as part of the educational intervention. Older age (OR = 1.614; p < 0.05) and higher education (OR = 1.835; p < 0.05) were associated with diary use. More severe asthma (OR = 0.479; p < 0.01) and a history of smoking (OR = 0.495; p < 0.05) were associated with nonuse of the diary. Both demographic and clinical characteristics are associated with asthma diary use. Clinicians and researchers should anticipate potential differences in use of an asthma diary according to demographic and/or clinical characteristics of female patients.
    Journal of Asthma 07/2008; 45(5):357-61. DOI:10.1080/02770900801956405 · 1.83 Impact Factor
  • Alzheimer's and Dementia 07/2008; 4(4). DOI:10.1016/j.jalz.2008.05.1349 · 17.47 Impact Factor
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    ABSTRACT: The authors examined exercise behaviors among family caregivers and the degree to which aspects of the caregiving role influenced exercise behaviors. Understanding factors associated with caregiver physical activity provides practitioners the means to design and tailor interventions to be effective for caregivers. Caregivers (N = 208) participating in a self-care intervention to promote caregiving skills were surveyed at baseline, prior to training. Measures included caregiver characteristics, care recipient characteristics, attitudes and intentions toward exercise, and levels of physical activity. Mental health variables and self-efficacy for exercise were significantly related to exercise levels in bivariate analyses. Regression analyses revealed that caregiver and care recipient characteristics accounted for a small percentage of the variance in exercise behavior. Caregiver vitality and self-efficacy for exercise were key variables most significantly related to exercise behaviors. Findings suggest that mental health factors and attitudes about exercise may be more important predictors of exercise than caregiving factors.
    Journal of Applied Gerontology 06/2008; 27(3):350-367. DOI:10.1177/0733464808315276 · 0.97 Impact Factor
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    ABSTRACT: In studies that have explored pet ownership in families affected by dementia, reported benefits have ranged from improvements in patient behavior to reduction in caregiver blood pressure. In this exploratory study, the impact of dementia on relationships among pets, caregivers, and care recipients was examined using content analysis of open-ended questions included in a telephone survey. Female spouse caregivers who owned pets were asked how their (and their husband's) relationship with their pets changed since they started caring for their husband. Most caregivers reported that they felt closer and more attached to their pets than previously. However, some caregivers reported that their pets created an additional burden and that they and their spouse had less time to care for the pets since the onset of illness. Findings highlight the need for further research to explore the unique benefits and burdens of owning a pet for families affected by dementia.
    Journal of Applied Gerontology 11/2007; 26(5):472-485. DOI:10.1177/0733464807305180 · 0.97 Impact Factor

Publication Stats

1k Citations
136.35 Total Impact Points

Institutions

  • 1992–2013
    • University of Michigan
      • • Center for Managing Chronic Disease
      • • Department of Health Behavior and Health Education
      • • School of Public Health
      • • School of Social Work
      Ann Arbor, MI, United States
  • 2008
    • Concordia University–Ann Arbor
      Ann Arbor, Michigan, United States
  • 1997
    • University at Albany, The State University of New York
      New York City, New York, United States
  • 1995–1996
    • University of South Carolina
      • Department of Health Promotion, Education & Behavior
      Columbia, SC, United States