Measures Of Social Engagement Research Articles

Prior Negative Experience Biases Activity of Medial Amygdala during Interstrain Social Engagement in Male Rats.

Social recognition is an essential part of social function and often promotes specific social behaviors based on prior experience. Social and defensive behaviors in particular often emerge with prior experiences of familiarity or novelty/stress, respectively. This is also commonly seen in rodents toward same-strain and interstrain conspecifics. Medial amygdala (MeA) activity guides social choice based on age and sex recognition and is sensitive to social experiences. However, little is known about whether the MeA exhibits differential responses based on strain or how this is impacted by experience. Social stress impacts posterior MeA (MeAp) function and can shift measures of social engagement. However, it is unclear how stress impacts MeAp activity and contributes to altered social behavior. The primary goal of this study in adult male Sprague Dawley rats was to determine whether prior stress experience with a different-strain (Long-Evans) rat impacts MeAp responses to same-strain and different-strain conspecifics in parallel with a change in behavior using in vivo fiber photometry. We found that MeAp activity was uniformly activated during social contact with a novel same-strain rat during a three-chamber social preference test following control handling but became biased toward a novel different-strain rat following social stress. Socially stressed rats also showed initially heightened social interaction with novel same-strain rats but showed social avoidance and fragmented social behavior with novel different-strain rats relative to controls. These results indicate that heightened MeAp activity may guide social responses to novel, threatening, rather than non-threatening, social stimuli after stress.

P038 Measuring social engagement in rheumatic and musculoskeletal diseases

Abstract Background/Aims Rheumatic and musculoskeletal diseases (RMDs) result in reduced social well-being and social engagement (SE). Despite being an important outcome for patients, SE is rarely measured in studies or clinical practice. Furthermore, social media and COVID-19 has changed how we interact with society. We aimed to evaluate existing SE measures used in RMD populations. Methods A systematic review of the qualitative literature and thematic analysis identified key impacts of RMDs and associated treatments on SE [unrestricted date -February 2023]. A systematic review of the quantitative literature [unrestricted date-February 2022] identified existing SE measures validated for use within RMDs, their constructs and compared these to themes identified from the qualitative literature. Results From 2601 records screened, we identified 30 eligible qualitative papers. Thematic analysis highlighted barriers and facilitators of SE in RMDs:. Barriers to SE included: 1) Direct effects of RMDs 2) Practicalities of undertaking SE 3) Social networks and roles. Facilitators of SE included: 1) Benefits of SE 2) Resilience & Acceptance 3) Activity Adjustment. From 7772 records screened we identified 15 specific SE measures validated in RMD populations. These measures focused on measuring frequency, satisfaction, difficulty, and modification of SE. Table 1 shows how many of the existing SE measures validated for use in RMDs identified in the quantitative systematic review measure the key impacts of RMDs on SE as identified in the qualitative thematic analysis. Conclusion Existing measures of SE do not assess the wide range of impacts identified as important to patients. There is a need for a new SE measure to inform interventions to improve health and social outcomes for people with RMDs. Focus groups involving individuals with RMDs, and key stakeholders are planned to present the findings from the systematic reviews and facilitate discussion to help inform development of a new measure of SE. Disclosure A. Maciver: None. G. Macfarlane: None. R.J. Hollick: None.

SOCIAL ENGAGEMENT AMONG COMMUNITY-DWELLING OLDER ADULTS: A QUALITY-OF-LIFE ANALYSIS

Abstract Older adults are living longer without sufficient efforts from health and social service systems to improve their quality of life (QoL). QoL is a nuanced, dynamic aspect to analyze. Literature shows that higher levels of social engagement provide a range of benefits to physical, mental, and cognitive health, all broad indicators of overall QoL. Social engagement comprises the person’s subjective experience of the richness of their relationships. The purpose of this study was to examine empirically the connection among this richness of relationships — specifically social engagement and perceived quality of relationships — and overall QoL among older adults. The study used a large sample (N=746) of non-institutionalized adults, ages 65 and older, from the nationally representative, AARP Social Engagement and Brain Health Survey. Two primary independent variables (IVs) were quantifiable measures of social engagement and perceived quality of social relationships; covariance controlled for several demographic factors (e.g., sex, ethnicity, income) and general health measures of physical, mental, and emotional health. The outcome variable was a composite score from a popular QoL measure. Analyses involved bivariate regression for the primary IVs, then multivariate OLS regression with each IV to predict quality of life. Results showed that QoL significantly regressed with predictors of social engagement (positively); each health variable (positively); unmarried status; ethnicity of Black/African American or Asian; and male gender. These results enhance our understanding of the relationship between social engagement, relationship quality, and QoL in older adults, particularly those who identify within the aforesaid demographic brackets. Implications are discussed.

INFLUENCES OF HAVING COGNITIVE IMPAIRMENT OR DEMENTIA ON SOCIAL ENGAGEMENT AMONG OLDER ADULTS: A SYSTEMATIC REVIEW

Abstract Studies have suggested that promoting and maintaining social engagement are positively associated with various well-being outcomes in later life. One notable barrier to sustaining social engagement in later life is development of cognitive impairment (CI) and/or Alzheimer’s disease and related dementias (ADRD). This study aims to synthesize existing literature exploring the impact of CI and ADRD on social engagement among older adults. We conducted a search of studies written in English language in the following databases: PsychInfo, PubMed, MEDLINE, CINAHL, and The Cochrane Library. Inclusion criteria included: observational studies that were conducted outside of residential long-term care facilities, included social engagement as an outcome variable, and examined the impact of cognitive impairment and/or ADRD on social engagement. Eighteen studies were included for qualitative synthesis. The majority of studies used author-developed scales to measure social engagement. Three utilized formal clinical diagnosis to measure cognitive impairment and ADRD. Twenty unique social activities were included, such as volunteering, attending community groups, and religious services. Four primary themes emerged regarding the relationship between CI/ADRD and social engagement: decreased levels of social engagement, reduced variety of social activities, lowered motivation, and heterogeneity in social engagement. Results suggest that people with CI/ADRD have reduced social engagement, but the evidence is limited due to the inconsistent use of measures for social engagement and CI/ADRD. Future research is needed to develop valid and reliable measures of social engagement that can be used among individuals living with CI/ADRD.

NOT ALL CREATED EQUAL: THE IMPACTS OF POSITIVE, NEGATIVE, AND PARTNER RELATIONSHIPS ON COGNITION IN LATELIFE

Abstract Background Social engagement has been linked to higher cognitive function in later life and it is a well evidenced protective factor against dementia and cognitive decline. However, far less is understood about how the type, quality and quantity of social engagement differentially affects cognitive health outcomes in older adults. Methods The sample consisted of 1972 participants aged 68-74 (M = 70.60, SD = 1.49) from a large population-based study in Australia, Personality and Total Health Through Life (PATH). The constructs underlying nine observed measures of social engagement were first identified through exploratory and confirmatory factor analysis (CFA). A Latent Variable Path Model (LVPA) was then employed to examine the relationships between positive, negative and partner social engagement on memory and executive function, as measured by six validated cognitive tests. Results The CFA identified partner relationship as a distinct social engagement construct, separate to positive and negative relationships. The main analysis demonstrated that negative relationships and partner relationship were positively associated with better memory and executive function, with the former twice the strength of the latter. Discussion These findings provide support that more frequent social interactions and larger support structures contribute to better cognitive function in later life, with partner relationship making a significant and distinct contribution. Positive or high-quality social engagement, however, appears to be a less critical factor in bolstering cognitive health. Close and cognitively demanding relationships may promote cognitive health via frequent cognitive stimulation, but more research is required to confirm the mechanisms underpinning observed effects.

Eye-tracking measures of social versus nonsocial attention are related to level of social engagement during naturalistic caregiver-child interactions in autistic children.

Eye-tracking (ET) measures indexing social attention have been proposed as sensitive measures related to autism, but less is known about the relationship between social and nonsocial attention and naturalistic measures of social engagement and whether sex moderates this relationship. This study investigated ET measures of social attention as predictors of social engagement during a naturalistic caregiver-child interaction (CCI). Participants included 132, 2-7-year-old autistic children (77% male) and their caregivers. Participants engaged in a CCI and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. Pearson correlations and multiple regression analyzes revealed that ET measures correlated with social engagement behaviors, including degree of attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement. Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor's mouth were more likely to engage in coordinated play with and without language. Sex moderated the relationship between time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play. Overall, ET measures of social and nonsocial attention correlated with the level of social engagement during naturalistic play, with some sex differences. Eye-tracking measures that predict interaction patterns may provide insight into promoting social engagement between caregivers and their autistic children and can inform outcome monitoring and intervention development.

3.40 Eye-Tracking Biomarkers of Social Attention Are Related to Naturalistic Social Interactions in Children With ASD

Eye-tracking (ET) measures indexing social attention have been proposed as sensitive biomarkers of ASD. However, less is known about the relationship between social attention biomarkers and naturalistic measures of social engagement. This study investigated ET biomarkers of social attention as predictors of social engagement during a naturalistic parent-child interaction. Sex was included as a moderator due to known sex differences in prevalence and behavioral features of ASD.

Social engagement and cognitive decline in older African‐Americans: The Minority Aging Research Study

AbstractBackgroundSocial engagement in later life is associated with lower rates of cognitive decline and dementia, but most research has been conducted in primarily White cohorts. Little is known about this relationship in older African Americans, and some promoters of cognitive reserve in Whites may not have the same benefits in African Americans.MethodsWe used data from the Minority Aging Research Study (MARS), a study of community‐dwelling African American older adults in Chicago. Social activity was measured using an 8‐item scale assessing frequency of participation in activities involving social interaction (mean=2.5, SD=0.5). Social network size was assessed as the number of children, family, and friends seen at least once a month (mean=6.4, SD=6.0). Loneliness was measured with a 5‐item Likert scale assessing perceived emotional isolation (mean=2.1, SD=0.6). Life space is a measure of spatial movement through 6 zones of the environment from bedroom (smallest) to out of town (largest) (mean=5.5, SD=0.9). Global cognitive function was the average of z‐scores for 19 standard cognitive tests. Linear mixed models were used to test for associations with level and rate of change in cognitive function, with terms for each social engagement variable at baseline, age at baseline, sex, education, time since baseline, and interactions with time.ResultsParticipants (n=768; mean age=73.5, SD=6.3) were followed for an average of 6.3 years (SD=4.6). Higher social activity was related to slower cognitive decline (est=0.021, SE=0.008, p=0.011), but not to level of cognitive function (est=0.052, SE=0.036, p=0.15). Alternately, loneliness and a larger life space were not related to cognitive decline (est=0.003, SE=0.007, p=0.64; and est=0.001, SE=0.005, p=0.82, respectively), but were related to level of cognitive function (est=‐0.104, SE=0.029, p<0.001; and est=0.062, SE=0.020, p=0.002, respectively). Social network size was not related to level or rate of change in cognition.ConclusionsIn older African Americans, social activity was related to less cognitive decline, while other measures of social engagement were related to level but not rate of change in cognitive function.

Law Enforcement Pathways to Mental Health: Secondary Traumatic Stress, Social Support, and Social Pressure.

The mental health of law enforcement officers (LEO) is critical to the safety and well-being of the officers and the public they serve. However, LEO face significant on-the-job stressors that undermine mental health, and there is a lot to be learned about when and how LEO seek and enter mental health services. The present study sought to explore variables related to mental health seeking behavior, the role of social engagement and social pressure in the decision to seek mental health services, and the most common pathways into mental health utilized by LEO. A small sample of 86 LEO were recruited from the social media page of a law enforcement nonprofit support organization to take several self-report measures on past mental health service usage and intentions to seek future services, the Inventory of Attitudes Toward Seeking Mental Health Services, the Professional Quality of Life Survey, and a measure of social engagement on mental health topics. Results indicate that while a number of factors are associated with intentions to seek future services, the primary factor in past mental health seeking behavior was secondary traumatic stress. Those who sought mental health services reported higher social engagement and social pressure to seek help. LEO entered mental health services for a variety of reasons and through a variety of provider options, such that no one provider source was preferred. Though the present study was limited by a small sample size, reliance on self-report measures, and occurred during a time of civil unrest that sparked the “defund the police” movement, the results serve as a starting point for understanding the pathways into mental health services for LEO and the roles of secondary trauma and prior mental health service experience.

Toward an Automated Measure of Social Engagement for Children With Autism Spectrum Disorder-A Personalized Computational Modeling Approach.

Social engagement is a key indicator of an individual's socio-emotional and cognitive states. For a child with Autism Spectrum Disorder (ASD), this serves as an important factor in assessing the quality of the interactions and interventions. So far, qualitative measures of social engagement have been used extensively in research and in practice, but a reliable, objective, and quantitative measure is yet to be widely accepted and utilized. In this paper, we present our work on the development of a framework for the automated measurement of social engagement in children with ASD that can be utilized in real-world settings for the long-term clinical monitoring of a child's social behaviors as well as for the evaluation of the intervention methods being used. We present a computational modeling approach to derive the social engagement metric based on a user study with children between the ages of 4 and 12 years. The study was conducted within a child-robot interaction setting that targets sensory processing skills in children. We collected video, audio and motion-tracking data from the subjects and used them to generate personalized models of social engagement by training a multi-channel and multi-layer convolutional neural network. We then evaluated the performance of this network by comparing it with traditional classifiers and assessed its limitations, followed by discussions on the next steps toward finding a comprehensive and accurate metric for social engagement in ASD.

A Robotic Framework to Facilitate Sensory Experiences for Children with Autism Spectrum Disorder: A Preliminary Study.

The diagnosis of Autism Spectrum Disorder (ASD) in children is commonly accompanied by a diagnosis of sensory processing disorders. Abnormalities are usually reported in multiple sensory processing domains, showing a higher prevalence of unusual responses, particularly to tactile, auditory and visual stimuli. This paper discusses a novel robot-based framework designed to target sensory difficulties faced by children with ASD in a controlled setting. The setup consists of a number of sensory stations, together with two different robotic agents that navigate the stations and interact with the stimuli. These stimuli are designed to resemble real world scenarios that form a common part of one's everyday experiences. Given the strong interest of children with ASD in technology in general and robots in particular, we attempt to utilize our robotic platform to demonstrate socially acceptable responses to the stimuli in an interactive, pedagogical setting that encourages the child's social, motor and vocal skills, while providing a diverse sensory experience. A preliminary user study was conducted to evaluate the efficacy of the proposed framework, with a total of 18 participants (5 with ASD and 13 typically developing) between the ages of 4 and 12 years. We derive a measure of social engagement, based on which we evaluate the effectiveness of the robots and sensory stations in order to identify key design features that can improve social engagement in children.

Social engagement after stroke – is it relevant to cognitive function? A cross-sectional analysis of UK Biobank data

Background: Findings from studies in older adult populations suggest that measures of social engagement may be associated with health outcomes, including cognitive function. Plausibly the magnitude and direction of this association may differ in stroke. The disabling nature of stroke increases the likelihood of social isolation and stroke survivors are at high risk of cognitive decline. We assessed the association between social engagement and cognitive function in a sample of stroke survivors. Methods: We included available data from stroke survivors in the UK Biobank (N=8776; age range: 40-72; 57.4% male). In a series of regression models, we assessed cross-sectional associations between proxies of social engagement (frequency of family/friend visits, satisfaction with relationships, loneliness, opportunities to confide in someone, participation in social activities) and performance on domain specific cognitive tasks: reaction time, verbal-numerical reasoning, visual memory and prospective memory. We adjusted for demographics, health-, lifestyle-, and stroke-related factors. Accounting for multiple testing, we set our significance threshold at p<0.003. Results: After adjusting for covariates, we found independent associations between faster reaction times and monthly family visits as compared to no visit (standardised beta=-0.32, 99.7% CI: -0.61 to -0.03, N=4,930); slower reaction times and religious group participation (standardised beta=0.25, 99.7% CI 0.07 to 0.44, N=4,938); and poorer performance on both verbal-numerical reasoning and prospective memory tasks with loneliness (standardised beta=-0.19, 99.7% CI: -0.34 to -0.03, N=2,074; odds ratio=0.66, 99.7% CI: 0.46 to 0.94, N=2,188; respectively). In models where all proxies of social engagement were combined, no associations remained significant. Conclusions: We found limited task-specific associations between cognitive performance and proxies of social engagement, with only loneliness related to two tasks. Further studies are necessary to confirm and improve our understanding of these relationships and investigate the potential to target psychosocial factors to support cognitive function in stroke survivors.

Social engagement after stroke – is it relevant to cognitive function? A cross-sectional analysis of UK Biobank data

Background: Findings from studies in older adult populations suggest that measures of social engagement may be associated with health outcomes, including cognitive function. Plausibly the magnitude and direction of this association may differ in stroke. The disabling nature of stroke increases the likelihood of social isolation and stroke survivors are at high risk of cognitive decline. We assessed the association between social engagement and cognitive function in a sample of stroke survivors. Methods: We included available data from stroke survivors in the UK Biobank (N=8776; age range: 40-72; 57.4% male). In a series of regression models, we assessed cross-sectional associations between proxies of social engagement (frequency of family/friend visits, satisfaction with relationships, loneliness, opportunities to confide in someone, participation in social activities) and performance on domain specific cognitive tasks: reaction time, verbal-numerical reasoning, visual memory and prospective memory. We adjusted for demographics, health-, lifestyle-, and stroke-related factors. Accounting for multiple testing, we set our significance threshold at p<0.003. Results: After adjusting for covariates, we found independent associations between faster reaction times and monthly family visits as compared to no visit (standardised beta=-0.32, 95% CI: -0.51 to -0.13, p=0.001, N=4,930); slower reaction times and religious group participation (standardised beta=0.25, 95% CI 0.13 to 0.38, p<0.001, N=4,938); and poorer performance on both verbal-numerical reasoning and prospective memory tasks with loneliness (standardised beta=-0.19, 95% CI: -0.29 to -0.08, p<0.001, N=2,074; odds ratio=0.66, 95% CI: 0.52 to 0.84, p=0.001, N=2,188; respectively). In models where all proxies of social engagement were combined, no associations remained significant. Conclusions: We found limited task-specific associations between cognitive performance and proxies of social engagement, with only loneliness related to two tasks. Further studies are necessary to confirm and improve our understanding of these relationships and investigate the potential to target psychosocial factors to support cognitive function in stroke survivors.

Psychological benefits of attending the theatre associated with positive affect and well-being for subscribers over age 60

Objectives: Although late adulthood may be a time of greater well-being, optimal aging still characterizes a minority of older adults. Understanding how individuals achieve well-being across adulthood is important for intervention and social policy. We focused on how attending live theatre might enhance the well-being of a sample of 53 season ticket holders aged 60 and older. Based on a previously tested conceptual framework, we hypothesized that post-performance reports of social-cognitive experience while at the play would predict post-performance positive affect, which in turn would predict well-being.Method: The sample was a subset of volunteers from a large survey study of theatre ticket purchasers. They completed baseline and two-year follow-up measures of well-being, and questionnaires immediately after attending seven plays across two seasons: measures of social engagement, belonging, flow, positive affect, and their reactions to the plays.Results: We found that sense of belonging, social engagement, and flow were associated with positive affect after performances, as hypothesized. We also found that the cumulative positive affect experienced after plays in the two seasons predicted change in well-being between baseline and follow-up.Conclusion: Our findings suggest that attending performances is a combined social, cognitive, and affective experience that transcends entertainment. Future research might investigate whether the psychological benefit model we assessed will generalize to other leisure activities that create similar engagement. The findings have implications for individuals seeking to promote their own well-being, and, possibly more importantly, for policies that support enriching cultural opportunities, particularly in the arts.

Effect of Antidepressant Medication Use and Social Engagement on the Level of Depressive Symptoms in Community-Dwelling, Older African Americans and Whites With Dementia.

Objective: This study examines the effect of antidepressant medication use and social engagement on the level of depressive symptoms at the time of initially meeting criteria for dementia. Method: Measures of social engagement, medication use, and depressive symptoms from 402 participants with incident dementia were utilized for the study. Proportional odds models adjusted for demographics were constructed with depressive symptoms as the outcome and social network size, perceived social isolation, and antidepressant medication use as independent variables. Results: Each additional person in the social network was associated with a lower depressive symptom score, odds ratio (OR) = 0.93, 95% confidence interval (CI) = [0.90, 0.97], p ≤ .01, and each unit increase in perceived social isolation was associated with a higher depressive symptom score (OR = 4.14, 95% CI = [2.94, 5.85], p ≤ .01). No association was found between antidepressant medication use and depressive symptom score. Discussion: Depression management at the time of dementia diagnosis should probably be directed toward increasing social engagement in older adults.

Social engagement and the elderly in rural Indonesia

Rural areas in Indonesia are older relative to urban areas. This paper questions how levels of social engagement vary across among the elderly in rural Indonesia. A sample of 2750 respondents aged 60 and over was drawn from 10 purposely-selected relatively “old” villages. Our three measures of social engagement are: participation in income-generating activities, in communal activities, and in care work. While there are notable village-level differences in patterns of social engagement, the majority of our respondents are actively engaged in productive activities in their old age until they can no longer be so. A negative educational gradient in the likelihood of work participation suggests that needs for income security is a driver of the elderly's work participation. The notion of promoting active ageing, as typically understood in the Western and/or urban contexts, is of secondary importance to health care provision and managing old-age disability in these ageing rural communities.

Objectively Measured Social Integration Is Associated With an Immune Risk Phenotype Following Marital Separation

Close relationships play an integral role in human development, and robust evidence links marital separation and divorce to poor health outcomes. Social integration may play a key role in this association. In many ways, the study of marital separation and divorce provides an ideal model system for a more complete understanding of the association between life stress and physical health. The current study investigated associations among objectively measured social integration, psychological distress, and biomarkers of immune health in recently separated adults (N = 49). We collected four measures of immune functioning-interleukin-6, C-reactive protein, and antibody titers to latent cytomegalovirus and Epstein-Barr virus-that were combined to yield a viral-Immune Risk Profile. To assess how variability in social integration is associated with immunological correlates following the end of a marriage, we incorporated observational ecological momentary assessment data using a novel methodology (the Electronically Activated Recorder). We found that objectively measured social behaviors are associated with concurrent viral-Immune Risk Profile scores over and above the effects of psychological distress and that psychological distress may be linked to biomarkers of immune health through social integration. This research expands current knowledge of biomarkers of immune health after divorce and separation and includes a new methodology for objective measures of social engagement.

Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences

ABSTRACTIn this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers’ self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers’ self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers’ self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.

DOES SOCIAL ENGAGEMENT MITIGATE DECLINES IN COGNITIVE FUNCTIONING OVER TIME?

We investigated whether social engagement mitigates declines in cognitive functioning in older adults over time. We used a nationally representative sample of 6,902 Medicare beneficiaries age 65 and older who completed the 2011 National Health and Aging Trends Study (NHATS). We used multilevel mixed effect models (growth curve models) to examine effects of social engagement on both initial levels and change in cognitive functioning over 4 annual surveys, controlling for age, gender, race, education, vigorous physical activity and social network size. We used two measures of social engagement: an aggregate sum of number of types of social activities completed in the past month (e.g., visiting with family, going out for enjoyment; range 0–6) and the effect of each of these considered separately. Cognitive functioning was a summed measure of immediate and delayed word recall (range 0–19). Results showed that both measures of social engagement were positively correlated with level of cognitive functioning, with baseline activities having a stronger effect than changes in engagement between survey waves. However, their effects on the rate of cognitive decline were not significant, with the exception of the effect of visiting friends and family (b=0.48 on the measure of cognitive function over all years; overall model pseudo R2= 15.8%). That there are (only) modest effects of social engagement on amelioration of cognitive decline add to debates about both the tractability of cognitive decline in older adults, as well as ongoing debates about what measures and study designs will be most helpful in understanding these processes.

Enhancing Communication in Adults with Dementia and Age-Related Hearing Loss.

For many adults with dementia, age-related hearing loss is undiagnosed and/or untreated. Untreated hearing loss can exacerbate common dementia-related behavioral symptoms, such as depression, apathy, agitation. Despite the potential benefits to the individual and the family, pursuing and adopting hearing aids for persons with dementia presents with many challenges. As such, this group of vulnerable older adults is well suited for alternative approaches that adopt an interventional audiology framework. This article reviews alternative hearing care models that we have tested when working with older adults with cognitive impairments. We have found that some individuals show improvements in dementia-related problem behaviors and/or in measures of social engagement after brief aural rehabilitation interventions that provide non-custom amplification. We have developed simple training materials to help family and professional caregivers use communication strategies and non-custom amplification. Providing services that can be integrated into the person's broader dementia care has the potential to improve communication and quality of life for individuals and families. There are opportunities in this population to provide basic, simple strategies and make substantial improvements as long as we adopt approaches that bring the services to the people, instead of bringing the people to us in the audiology clinic.