Ann Mayo ‘90 (MSN), ‘98 (DNSc) is a professor and researcher in the Hahn School of Nursing and Health Science. She answered questions from Inside USD about her interest and research in gerontology and cognitive impairment and the role nursing can play in these areas as the U.S. population ages. Professor Mayo received the Author E. Hughes Award for Career Achievement from the School of Nursing in 2006.
I have been interested in cognitive science and decision-making my entire career. Being in health care I was curious about differences I would see among patients in terms of their decision-making abilities. The largest group of patients potentially impacted by compromised cognition and loss of decision-making abilities is older adults. Normal aging cognitive changes can cause slight changes in decision-making. But older adults at risk for significant changes in decision-making are those with dementia, including Alzheimer’s disease and the other dementia subtypes such as frontotemporal dementia.
Once patients receive a diagnosis of dementia, their families and health care providers make assumptions about their decision-making abilities and typically leave them out of making decisions, many times prematurely. Being able to participate in our own decision-making is fundamental to being human. We need research to map decision-making abilities across the dementia subtypes and time so that patients can remain involved in making their own decisions for as long as possible. My program of research is mapping these decision-making abilities and studying them in relation to cognitive variables such as memory and attention.
Q: What role do you think nursing can play in dealing with issues such as Alzheimer’s Disease and cognitive impairment that affect the aging U.S. population?
Alzheimer’s disease and the related dementia subtypes are under the direct purview of the nursing profession. There are no cures for these diseases to date; and, therefore the nursing ‘caring’ model is most appropriate for these patients and their family members. In this model of care, the primary nursing role is to promote function and quality of life among these patients.
This community-centered collaborative project was a unique research project because co-investigators were from the community center, rather than from a traditional academic setting or research center, and participants were recruited from the local community, rather than an academic research center. The study measured cognition, functional status, and social integration among older adults and there were a number of valuable learnings obtained from this study.
First, the research team learned that community members from an ethnically diverse area of San Diego would readily volunteer for a study that examined cognitive impairment. For my field of cognitive science in the context of Alzheimer’s disease and the related dementia, the majority of research has been conducted in large National Institutes of Health (NIH) funded academic research centers. These research centers tend to attract research volunteers who are white, Caucasian, and highly educated professionals. Therefore, most of the research generated to date in this field is not representative of disease progression across other races or ethnicities.
Second, not only would ethically diverse community members volunteer for such research, they volunteered in numbers that I have never experienced before. For example, in large academic research centers it may take 12 months to recruit 50 volunteers. In a matter of two months, we had recruited over 100 volunteers using the Bayside Community Center.
Finally, Bayside Community Center research participants possessed variability across the primary study variables that were used to measure cognition, functional status, and social integration. Variability is an important phenomenon so that scientists can explain why scientific interventions may or may not work. Therefore, this community setting is a valuable source of volunteers to help researchers advance science.
Q: Are you at work on other research?
I belong to a number of professional nursing organizations in which I am working on research projects with nursing colleagues across California and the United States. For example, as the primary investigator and with team members we are developing a nursing leadership development instrument for the Association of California Nurse Leaders. We are in the first phase of a psychometric instrumentation study examining the reliability, validity, sensitivity and specificity of the instrument.
I am also involved in a number of studies examining clinical nurse specialist outcomes with other collaborators. Clinical nurse specialists (CNSs) are advanced practice nurses prepared with a graduate degree in nursing (master or doctoral degree) and who typically work in hospital settings. For years we have had anecdotal evidence that their role promotes hospital safety for patients and high quality work environments for nurses. Our current research is describing the outcomes of CNSs, including how they monitor those outcomes and what facilitates or hinders their important role.
Q: How long have you lived in San Diego and what hobbies and activities do you enjoy outside of work?
My husband Ron and I first came to San Diego on vacation from Sacramento in 1981 and we were back as new residents within two weeks. We built a home in Mission Beach the following year and have lived in that home now for over 30 years. I love living in Mission Beach which is a surprisingly eclectic community comprised of college students, surfers, families, and retired older adults. I also enjoy rode trips to locations “off the beaten path” in the U.S. And when I visit Florida, which I do on a regular basis, I enjoy swimming in the warm ocean water.
– Liz Harman