bluuebunny/crossref_metadata_2025 huggingface dataset:
HEALTH ACROSS BORDERS: A CROSS-NATIONAL COMPARISON OF IMMIGRANT HEALTH IN EUROPE
Authors: Sheftel Mara , Margolis Rachel , Verdery Ashton
Published: December 2022

Although older immigrants are a growing share of the total population in many countries, evidence regarding health differentials by nativity in older adulthood remains underdeveloped. We examine whether foreign-born adults 50 and older in Europe are disadvantaged in terms of multiple health domains, what drives the potential immigrant health disadvantage, and whether such differences are contextually dependent or a general feature of the immigrant experience in Europe. We use the Survey of Health, Aging and Retirement in Europe (SHARE) to estimate physical, mental, and social health of middle age and older adults by nativity in 19 countries. We examine whether nativity-based health disparities can be attributed to demographic composition, socioeconomic factors, family and social support, and life course timing of migration. Last, we examine regional differences in nativity-based health disparities. We find that immigrants aged 50 and above in Europe are more likely to report fair/poor physical health, score worse on EURO-D depression scale, and are more likely to be lonely than the native-born. Socioeconomic status and age at migration partially explain these health differences, although immigrant health disparities remain after accounting for these and other factors. We document some contextual variation within Europe. Immigrants in Eastern, Western and Northern Europe are disadvantaged compared to native-born adults in those regions, while immigrants in Southern Europe are in comparable health to their native-born peers. This article offers new insights into the ways that aging immigrant populations will reshape older adult health profiles in a diverse array of countries.
THEORETICAL IMPLICATIONS AND IMPACT OF SELF-COMPASSION IN CAREGIVERS OF PEOPLE LIVING WITH DEMENTIA
Authors: Grant Claire , Judge Katherine
Published: December 2022

Caregivers of people living with dementia often report greater symptoms of depression, anxiety, and burden. Guided by the Stress Process Model, the study examined the impact of self-compassion on these key psychosocial well-being outcomes in a sample of dementia caregivers (N=99). Participants were 66.7% female, 67.7% White, and 74% were children/in law or grandchildren/in law, with a mean age of 38.61. Findings indicated self-compassion was a significant and unique predictor of symptoms of depression (β = -.25, p = .03), anxiety (β = -.36, p = .01), and burden (β = -.25, p = .02). Additional analyses found support for dysfunctional coping meditating the relationship between self-compassion and caregiver burden ((B = -.20, SE = .06, 95%CI[-.3242, -.0924] dysfunctional coping mediating the relationship between self-compassion and anxiety (B = -.16, SE = .05, 95%CI[-.2257, -.0302] and emotion-focused coping meditating the relationship between self-compassion and depression (B = -.06, SE = .03, 95%CI[-.1388, -.0045]. Results demonstrate the important role of self-compassion along with the impact of coping style on psychosocial well-being outcomes. Discussion will highlight the theoretical implications of these findings along with how these results can be used to develop efficacious interventions for caregivers of persons with dementia. Specifically, tailoring an intervention for dementia caregivers grounded in self-compassion theory as well as Compassion Focused Therapy and Mindful Self-Compassion Therapy may assist caregivers in developing a self-compassionate mindset and skills to more effectively cope with caregiving challenges.
DEMENTIA FAMILY CAREGIVERS EXPERIENCES USING COMMUNITY-BASED AND HEALTHCARE SERVICES DURING COVID-19
Authors: Leggett Amanda , Baker Elaina , Lee Hannah , Webber Anna , Wallace Sarah , Fang Tyson , Johnson Florence
Published: December 2022

Family caregivers are key medical decision makers for persons living with dementia (PLwD) and play a critical role in interfacing with community-based services and the health care system. The COVID-19 pandemic, however, had dramatic impact on service utilization, with many suspended, delayed, or moved to telehealth. Emerging data suggests the pandemic posed challenges to service use for family caregivers, yet how this impacted caregiver’s care practice is unknown. An in-depth qualitative interview was conducted with 100 primary family caregivers for PLwD in 2021 on care management during the COVID-19 pandemic. Watkins’ rigorous and accelerated data reduction technique was used to analyze qualitative data through open and focused coding and identify themes specific to family caregiver’s access to and use of community-based and health care services. Themes emerged regarding challenges and benefits of service use during the pandemic. Caregivers struggled with not being allowed to attend medical appointments with the PLwD or to speak confidentially with the physician over a PLwD’s telehealth appointment. Caregivers felt physicians couldn’t always read the care situation over telehealth, but appreciated not having to leave the house. Losing the consistency of in-home caregivers or respite programs put additional strain on caregivers, but many found virtual programming engaging. Grocery delivery/pickup was a new service used by many caregivers and found to be supportive of in-home care. As the pandemic evolves, finding ways to support caregivers through continued involvement in health care visits and as they access community services is critical to caregiver and PLwD health and well-being.
WORSENING OF DEPRESSIVE SYMPTOMATOLOGY SINCE BEFORE COVID-19 AMONG CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Authors: Smith Matthew , Kew Chung Lin , Han Gang , Wilson Lucas , Lee Shinduk , Fitch John , Ory Marcia
Published: December 2022

This study examines factors associated with self-reported worsening of depressive symptomatology since before the COVID-19 pandemic among caregivers of persons living with dementia (PLWD). Cross-sectional baseline survey data were analyzed from 76 paid and unpaid caregivers of PLWD participating in a larger NIH-funded study assessing the feasibility of using a novel in-situ sensor system. Using the PHQ-2, caregivers were asked to report their depressive symptomatology twice: (1) retrospectively before the COVID-19 pandemic started; and (2) since the COVID-19 pandemic. A change score was calculated, and whether or not caregivers’ depressive symptomatology worsened since before the pandemic served as the dependent variable. A logistic regression model was fitted, controlling for contextual items related to the caregiver, care recipient, and caregiving logistics. On average, caregivers were age 58.09(±16.92) and the majority was female (84.2%). Thirty percent of caregivers reported worse depressive symptomatology since the COVID-19 pandemic than before the COVID-19 pandemic started. Caregivers who were female (OR=25.86, P=0.028), not paid for caregiving (OR=14.59, P=0.047), had lower annual household incomes (OR=0.50, P=0.032), and whose care recipients had higher Mini-Mental State Exam scores (OR=1.78, P=0.005) were more likely to report worse depressive symptomatology since the COVID-19 pandemic. Results suggest that the COVID-19 pandemic intensified depressive symptomatology for many caregivers, and unpaid, female caregivers with fewer financial resources have been especially impacted. As the pandemic continues, support for caregivers of PLWD should be tailored to specifically meet their needs and circumstances.
SPOUSAL ASSOCIATIONS BETWEEN GRANDPARENT CAREGIVING AND WELL-BEING: FINDINGS FROM THE HEALTH AND RETIREMENT STUDY
Authors: Chan Athena Chung Yin , Sneed Rodlescia
Published: December 2022

Numerous studies document the impact of grandparent caregiving on the health and well-being of grandparents; however, there has been little dyadic research on how the caregiving and health-related outcomes of one grandparent influence partner couples The purpose of this study was to determine the interdependence of grandparents’ intensity of caregiving and well-being (i.e., depressive symptoms and self-rated health) over time. Participants were 7,133 dyads of American grandparents aged ≥ 50 who participated in the Health and Retirement Study, a population-based study of community-dwelling adults, in 2010 and 2012. Data on hours of grandparent caregiving in the past two years, depressive symptoms, and self-rated health were obtained via self-report. Two longitudinal, dyadic path analyses were conducted using the Actor-Partner Interdependence Model. Within individuals (actor effects), greater depressive symptoms and better self-rated health at baseline, predicted greater depressive symptoms and better self-rated health two years later. Between spouses (partner effects), an individuals’ greater depressive symptoms predicted the spouses’ greater depressive symptoms. However, grandfathers’ better self-rated health predicted subsequent better grandmothers’ self-rated health, but not vice versa. Further, greater depressive symptoms among grandmothers predicted lower subsequent caregiving intensity among both grandmothers and grandfathers. Additionally, better self-rated health among grandfathers predicted better self-rated health and lower subsequent self and spousal grandparenting caregiving intensity. Our findings demonstrate that depressive symptoms, self-rated health, and caregiving intensity are interrelated among grandparent couples. Interventions for improving well-being and caregiving outcomes that focus on couples may be more effective than those that focus on individuals.
SCREENING OF US VETERANS AT HIGH RISK FOR OUTCOMES FOLLOWING COVID-19 BY FRAILTY STATUS
Authors: Park Catherine , Naik Aanand , Horstman Molly , Seligman Benjamin , Orkaby Ariela , Intrator Orna , Lynch Kristine , Razjouyan Javad
Published: December 2022

Frailty increases risk of adverse outcomes in the presence of stressors such as COVID-19 infection. We examined the association between different levels of frailty and outcomes following COVID-19 infection. This is a retrospective cohort study of US Veterans aged ≥50 years, active Veterans Health Administration (VHA) care users, and tested positive for COVID-19 between 02/15/2020 and 09/30/2021. VHA frailty index (VA-FI) was calculated from one year prior to the COVID-19 testing and divided into three groups: robust (≤0.1), prefrail (0.1-0.2), and frail (>0.2). The risk of hospitalization, ICU admission, ventilator use, and in-hospital mortality were calculated using logistic regression adjusted by age, sex, body-mass-index, and race. The performance of VA-FI in predicting outcomes was compared to age or Charlson comorbidity index (CCI) using area under the curve (AUC). Of 204,426 COVID-19 positive Veterans, 32,965 were hospitalized (age: 71.4±10.4 years, BMI: 29.5±7.1 kg/m2). We observed higher odds of hospitalization (frail, adjusted odds ratio (aOR)=8.64; prefrail, aOR=2.57), ICU admission (frail, aOR=1.58; prefrail, aOR=1.32), ventilator use (frail, aOR=1.97; prefrail, aOR=1.57), and mortality (frail aOR=2.15; prefrail, aOR=1.55) in frail and prefrail compared to robust Veterans. We observed that VA-FI had higher AUC in predicting hospitalization (AUC 0.75) independent of age (0.59) and CCI (0.63). Veterans with COVID-19 who were frail and prefrail had a higher risk of hospitalization, ICU admission, ventilator use, mortality compared to robust. VA-FI may be a useful tool at the time of COVID-19 diagnosis to triage patients at risk for adverse outcomes.
BLOOD-BASED BIOMARKER CHANGES IN A PHASE 2B TRIAL ASSESSING LOMECEL-B IN OLDER ADULTS WITH FRAILTY
Authors: Ramdas Kevin , Mehranfard Danial , Naioti Eric , Green Geoff , McClain-Moss Lisa , Gincel Dan , Hare Joshua , Oliva Anthony
Published: December 2022

Aging frailty (AF) is a multidimensional geriatric syndrome that is characterized by physical and cognitive symptoms, increasing the vulnerability of affected older adults to adverse health outcomes. Mechanistically, a low-grade chronic inflammatory state (inflammaging), endothelial dysfunction, and decreased regenerative capacity are thought to be major contributors to AF pathophysiology. Lomecel-B is an allogenic medicinal signaling cell(MSC) formulation that can potentially ameliorate AF through pleiotropic mechanisms, including anti-inflammatory, pro-vascular, and pro-regenerative activities. We completed a Phase 2b randomized, double-blinded, placebo-controlled trial designed to assess Lomecel-B benefits for AF via change versus placebo in the six-minute walk test(6MWT), to assess the dose-response relationship, and to evaluate bioactivity via changes in blood-based biomarkers. Enrolled subjects were aged 70–85 years with mild-to-moderate AF, a reduced 6MWT of 200-400m, and Tumor Necrosis Factor-α of ≥ 2.5pg/mL indicative of inflammaging. In total, 143 subjects received a single intravenous infusion of Lomecel-B at doses of 2.5 x 107 cells (25M, N=35), 5.0 x 107 cells (50M, N=30), 1.0 x 108 cells (100M, N=33), or 2.0 x 108 cells (200M, N=16), or placebo (N=29). Safety and efficacy assessments were performed at 1, 3, 6, and 9 months post-infusion. Increases in 6MWT and decreases in serum levels of the blood-based biomarker Soluble-Tie-2 were observed at 9 months in the Lomecel-B groups versus placebo. Notably, both observations were seen in a dose dependent fashion with 200M showing the highest effect. Based on the findings, a next-phase trial is being developed to advance this clinical program and will be presented.
POLYPHARMACY, FRAILTY, AND DISABILITY-FREE SURVIVAL IN COMMUNITY-DWELLING HEALTHY OLDER INDIVIDUALS
Authors: Ekram A R M Saifuddin , Woods Robyn , Ryan Joanne , Espinoza Sara , Gilmartin-Thomas Julia , Shah Raj , Nelson Mark , Ernst Michael
Published: December 2022

BACKGROUND

Polypharmacy and frailty are two common geriatric syndromes. We examined the association between polypharmacy and frailty and if, together, they predicted disability-free survival (DFS), defined as time to the first event of dementia, persistent physical disability or death.

METHODS

We included 19,114 participants from the "ASPirin in Reducing Events in the Elderly" (ASPREE) clinical trial. Polypharmacy was defined as regular, concomitant use of five or more prescription medications. Frailty was assessed using a modified Fried phenotype and a deficit accumulation frailty index (FI) of 66 items. The association between polypharmacy and frailty was assessed by multinomial logistic regression. In addition, Cox regression was used to determine the association between polypharmacy-exposed frailty and DFS.

RESULTS

Individuals with polypharmacy (vs. < 5 medications) were 55% more likely to be pre-frail (Relative Risk Ratio or RRR: 1.55; 95%Confidence Interval or CI:1.44, 1.68) and three times more likely to be frail (RRR: 3.34; 95%CI: 2.64, 4.22) according to Fried phenotype. Frail individuals had a two-fold reduction in their survival free of dementia/disability (Hazard ratio or HR: 2.16; 95%CI: 1.56, 2.99), whereas frail individuals with polypharmacy had a four-fold reduction (HR: 4.24; 95%CI: 3.28, 5.47). Effect sizes were more prominent when frailty was assessed using the FI than when assessed by Fried phenotype.

CONCLUSION

Polypharmacy was significantly associated with pre-frailty/frailty. Polypharmacy-exposed pre-frailty/frailty increased the risk of death, dementia or physical disability among older adults. Addressing polypharmacy in older people could ameliorate the impact of frailty on individuals’ functional status, cognition and survival.
POETRY AND UNCOVERING THE MYSTERY OF SOCIAL PROBLEMS: AN ARTS-BASED INQUIRY TO AGING CARE
Authors: Wu Heng , Szto Peter
Published: December 2022

This research focuses on a current social welfare problem: unemployment and the loss of employer-based health insurance among non-elderly adults aged 18 to 64. The literature covers this social problem in terms of health status, access to medical care, employed versus unemployed working-age adults, mitigating the risks of unemployment, and loss of health insurance via the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). As good as the findings are, they are methodologically limited by looking at only half the story. This research asks a different question: how might the humanities and arts-based perspective address the social problem? It aims at answering why the employment status is related to health and health insurance. Chinese poetry has a long rich tradition of expressing insights about the inner life since antiquity to the present. These reflections include practice wisdom and keen observations on aging. This poster presents case findings on the use of Chinese poetics to inform aging care in the West. Each case provides discussions on why social welfare system comes up short to solve the problem and how the social welfare system can be effectively changed. Researchers use survey data to compliment Chinese poetic insights about employment status and insurance status to illustrate the correlation between respondents’ health status with versus without employment. Findings are hoped to interpret the role of family as a social unit where it consists in social welfare along with the speculative inquiry of poetry.
ESPO AND BUTLER-WILLIAMS SCIENTIFIC SYMPOSIUM: CAREER DEVELOPMENT TO PROMOTE DIVERSITY, DISCOVERY, AND AGING
Authors: Johnson Kalisha Bonds , Morgan Brianna , Jones Patricia
Published: December 2022

The NIA’s Butler-Williams Scholars Program and GSA’s ESPO Section are united in providing career development opportunities in a manner that promotes leadership, diversity, and inclusivity. This year’s theme challenges our emerging scholars to embrace diversity and discovery while thinking—or rethinking—about the perspectives of older adults. Disparities in health associated with race/ethnicity, experience, sociocultural and socioeconomic factors, as well as access to and provision of health care are chief concerns of our aging population. GSA’s early career professionals and 2021 alumni of the prestigious NIA Butler-Williams Scholars Program address these issues. Dr. Matthew Farina will present on the importance of identifying life course pathways in understanding the lived experiences of older adults from underrepresented racial groups. Dr. Kacie Deters will discuss how both demographics and genetic factors contribute to cognitive performance. Dr. Mirna Arroyo-Miranda will present findings on social isolation and cognition in Hispanic/Latino older adults. The final speaker, Dr. Jamaine Davis will present on the genetic factors that may contribute to dementia in African American older adults. The featured talks by rising stars deepen our understanding of the influence of diversity and key discoveries so we can reimagine aging research.
MINNESOTA’S 2021 LGBTQ AGING NEEDS ASSESSMENT
Authors: Moone Rajean
Published: December 2022

Every decade Minnesota embarked on a needs assessment of lesbian, gay, bisexual, transgender and queer (LGBTQ) older adults which has provided important insights into aging within these communities. In 2021, a research team replicated these past monumental studies into this Minnesota 2021 LGBTQ Aging Needs Assessment. 485 individuals responded to the survey, either online or by paper. Of those, 354 met the inclusion criteria and are included in the results. Like the 2012 study, LGBTQ older adults who participated in the study were more likely to be a caregiver than compared to the general population. At the same time they were less likely to have a caregiver and less likely to have children. Half of the participants experienced some form of discrimination and the vast majority more knew someone who experienced discrimination due to their sexual orientation or gender identity. Positively, study participants were more likely to have completed a health care directive and more likely to volunteer than the general population. Possibly one of the most striking changes over the last two decades is that 85% of respondents were confident they would receive sensitive services. In 2012 only 18% and 2002 only 9% expressed the same confidence. In congruence with the past studies, the majority of respondents continue to desire LGBTQ welcoming senior services rather than LGBTQ segregated services.
VOLUNTEERING AND RISK OF HEART ATTACK IN LATER LIFE: THE MODERATING ROLE OF PURPOSE IN LIFE?
Authors: Bell Mallory , Ferraro Kenneth
Published: December 2022

Background and Objectives

Although research on the health benefits of volunteering has proliferated in recent decades, most studies are cross-sectional, and none prospectively examine the relationship between volunteering engagement, purpose in life, and heart attack.

Research design and methods

This study uses seven waves of data (2006-2018) from the Health and Retirement study--a nationally representative survey of adults over age 50 (N=5,093). Event history analysis using Cox proportional hazards were used to examine if volunteering engagement in later life reduced the risk of first heart attack and if the effects of volunteering vary by level of purpose in life.

Results

Results reveal that volunteering, and doing so at a low time commitment, reduces the risk of first heart attack in later life. Additionally, the effect of volunteering varies by sense of purpose in life, such that volunteers with a strong sense of purpose in life had the lowest risk of heart attack. Implications: The findings of this study will inform public health and policy interventions dedicated to extending and improving later life health.
TIME-VARYING ASSOCIATIONS BETWEEN SOCIAL INTERACTION MODALITY AND POSITIVE AFFECT DURING TIMES OF CHALLENGE
Authors: Broen Tiana , Choi Yoonseok , Pauly Theresa , Garza Elizabeth Zambrano , Gerstorf Denis , Hoppmann Christiane
Published: December 2022

The COVID-19 pandemic compromised psychological wellbeing, especially given public health guidance that restricted social contact. Engaging in daily social interactions is especially important for maintaining wellbeing, and virtual interactions may be a surrogate for face-to-face interactions when in-person contact is not possible. Embracing the idea that virtual communication may facilitate social connectedness, this project seeks to better understand the potential of virtual social interactions for supporting wellbeing. Using repeated-daily-life-assessments from an adult lifespan sample (N=164, Mage=42.53 years), we examined how number of virtual and face-to-face social interactions were associated with positive affect in individuals’ daily lives. We expected that face-to-face interactions would have a stronger relationship with positive affect than virtual social interactions, but that engaging in virtual interactions would be positively related to affect during these unprecedented times. In line with our hypotheses, number of daily in-person (r(812)=0.14, p<.001) and total number of social interactions (r(812)=0.14, p<.001) were associated with higher positive affect at the bivariate level; number of daily virtual social interactions showed a positive trend with affect (r(812)=0.06, p=.07). Multilevel models including quantity of face-to-face and virtual interactions indicate that only face-to-face interactions were associated with concurrent elevations in positive affect (b=0.58, p=.03) and overall higher positive affect (b=0.72, p<.001). Future analyses will examine whether social interactions involving close ties are more powerful drivers of positive affect than distal ties, whether everyday closeness to others mediates the relationship between social interaction modality and positive affect, and we will unpack age as a moderator in these relationships.
ATIP LEVELS ARE ASSOCIATED WITH LESS AMYLOID-Β BURDEN IN POSTMORTEM BRAINS OF OLDER ADULTS WITH ALZHEIMER’S DEMENTIA
Authors: Cosarderelioglu Caglar , Plaza-Rodriguez Alma , Iglesias Pablo , Talbot C Conover , Foster D Brian , Cole Robert N , Walston Jeremy , Abadir Peter M
Published: December 2022

Angiotensin system, aging, and Alzheimer's disease are tightly linked. Of the brain angiotensin receptors, the subtype 2 receptor (AT2R) is relatively less studied. Canonically, the AT2R functions through nitric oxide release, and its activation has been linked to vasodilatation and neurite outgrowth as well as anti-inflammation. How AT2R signals is not known, however, an AT2R-binding protein (ATIP) has been recently described. Controversies exist on the link between ATIP and AT2R functions. Here, we describe the development of the first non-antibody based ultra-sensitive and specific quantitative mass spectrometry assay for ATIP. Using a technique that permits targeted analysis of multiple peptides across multiple samples in a single mass spectrometry run, known as TOMAHAQ, we have identified specific human tryptic peptides that permit quantification of ATIP abundance. We have used this method to quantify ATIP in postmortem frontal cortex samples of older adults (n= 60) with Alzheimer’s dementia (AD). We correlated levels of ATIP to brain RAS receptors, and biomarkers of AD pathogenesis including oxidative stress, inflammation, mitochondrial dysfunction as well as amyloid-β, and tau burden. Our results show that ATIP expression (ANLKNPQIMYLEQELESLK sequence of ATIP) is positively correlated with neuronal nitric oxide synthase (nNOS) (p = 0.009, r = 0.337). Furthermore, expression of ATIP is negatively correlated with amyloid-β load in several brain regions including hippocampus (p= 0.014, r= -0.317), entorhinal cortex (p= 0.010, r= -0.331), frontal cortex (p= 0.023, r= -0.294), and overall (p= 0.004, r= -0.365). These results highlight a potential protective role for ATIP in Alzheimer’s disease.
INTEGRATIVE MULTI-OMICS ANALYSIS REVEALS THE CRITICAL ROLE OF PBXIP1 GENE IN AGING-RELATED ALZHEIMER'S DISEASE
Authors: Liu Zuyun , Zhang Jingyun , Sun Xiaoyi
Published: December 2022

Alzheimer’s disease (AD) is a neurodegenerative disorder, and its strongest risk factor is aging. A few studies have explored the relationship between aging and AD, while the underlying mechanism remains unclear. We assembled data cross multi-omics (i.e., epigenetics, transcriptomics, and proteomics, based on frozen tissues from the dorsolateral prefrontal cortex) and neuropathological and clinical traits from the Religious Orders Study and Rush Memory and Aging Project (ROSMAP). Aging was assessed using six epigenetic clocks (including Horvath clock, Hannum clock, Levine clock, Horvathskin clock, Lin clock, and Cortical clock) that capture mortality risk in literature. After accounting for age, we first identified a gene module (including 263 genes) that was related to most epigenetic clocks (e.g., P=3.61×10−5 for Levine clock) and three neuropathological traits of AD (i.e., β-amyloid, Tau tangles, and tangle density). Interestingly, among 20 key genes with top intramodular connectivity of the module, PBXIP1 was the only one that was significantly associated with all three neuropathological traits of AD at the protein level after Bonferroni correction. Furthermore, PBXIP1 was associated with clinical diagnosis of AD in both ROSMAP and two independent datasets. The results suggest the critical role of PBXIP1 in aging-related AD and support the potential and feasibility of using multi-omics data to investigate mechanisms of complex diseases. However, more validations in different populations and experiments in vitro and in vivo are required in the future.
SPATIALLY RESOLVED MAPPING OF CELL-SPECIFIC SENESCENT PROFILES IN AGING MOUSE BRAIN
Authors: Carver Chase , Schafer Marissa
Published: December 2022

Cellular senescence is a conserved mechanism of aging characterized by cell cycle arrest and secretion of a senescence-associated secretory phenotype comprised of proinflammatory cytokines, chemokines, proteases, and growth factors that disrupt cellular homeostasis by promoting sterile inflammation and aberrant tissue remodeling. Tissue microenvironment, induction mechanism, and duration since senescence onset contribute to senescent cell heterogeneity, making identification challenging. Senescent cell contribution to age-related cognitive decline suggests that the hippocampus may be a key brain region for uncovering functional identities of senescence. Therefore, our goal is to contextually and spatially map senescent cells in comparison of cell-type specific morphological, transcriptional, and functional features that distinguish them among highly-ordered brain microenvironments. GeoMx Digital Spatial profiling was used to investigate cell identity and senescence markers in the aging brain to develop transcriptomic profiles from 22-24-month old mice. We also adapted Imaging Mass Cytometry with a curated panel of antibody-labeled proteins in fixed brain sections. We observed that senescent-like phenotypes of cells from myeloid and non-myeloid origin accumulate in the hippocampus and cortex, whereas CD45+ immune cells primarily accumulate in the white matter regions, in close proximity to microglia and GAL3+ cells. We profiled differences in ramified and ameboid microglia, in comparison of young and old mice, with emphasis on the chemotactic microenvironment involving activation of inflammatory signals. These advanced, multi-plex imaging modalities enable in-depth characterization of senescent cell features in the aging brain. Beyond morphological profiling, we demonstrate enhanced resolution and detection of individualized senescence in the aging brain.
DEVELOPMENT OF A MOBILE INTERVENTION TO SUPPORT HEALTHY EATING IN PERSON WITH CO-OCCURRING FRAILTY AND DEMENTIA
Authors: Zaslavsky Oleg , Wu Kuan-Ching , Chien Shao-Yun , Domoto-Reilly Kimiko
Published: December 2022

New behavioral solutions are needed to improve health in persons with co-occurring frailty and dementia. Using dementia-specific principles of human-centered design, we developed a mobile intervention that includes a patient-facing app and clinician interface to promote a Mediterranean-style eating plan in this population. Our design processes were as follows. We first solicited iterative input from experts in dementia, accessible design, and technology concerning language, cognitive load, and overall accessibility needs in persons with early dementia. Next, we recruited seven people with mild dementia and their partners for interviews, experience sampling, and usability studies. Our primary findings were: 1) participants have basic knowledge of healthy eating tenets and want to learn more; 2) participants are unaware of anything specific to improve in their diet; 3) participants value simple meals with few ingredients; 4) participants strongly rely on physical cookbooks. Based on the results, we developed a high-fidelity prototype of the patient-facing mobile app, divided into tasks: 1) First time onboarding; 2) Setting the first dietary goal; 3) Finding a recipe; 4) Filter/sort for recipes; 5) Food tracking tool; 6) Mastering a dietary goal and starting a new one; 7) Reviewing progress. The resultant product was iterated in usability studies and informed a final prototype for further testing. In parallel, a web-based clinician interface was developed through individual interviews, a survey of potential end-users (n=24), and two rounds of usability studies (n=3 in each round). The online clinician product features these interactive modules: dashboard, tracking manager, patient portal, and individual patient page
ACCEPTABILITY OF ANIMATRONIC PETS AMONG COMMUNITY-DWELLING VETERANS LIVING WITH DEMENTIA AND THEIR CAREGIVERS
Authors: Harris Melissa , Alcorn Edwin , Davagnino Judith
Published: December 2022

Animatronic pets can improve psychosocial outcomes among older adults, but little is known about in-home use by Veterans living with dementia and the perceptions of informal caregivers regarding these tools. This quality improvement project examined the usability and acceptability of animatronic pets by community dwelling Veterans living with dementia from the perspective of informal caregivers. Usability and acceptability were examined through a structured telephone interview with 17 caregivers. Usability was operationalized as frequency of: pet use by the Veteran (1=Not at all, 4=Daily or all of the time), and reminders provided by caregivers (1=Not at all, 4=Daily or all of the time). Acceptability was defined as perceived benefit (measured using an acceptability tool; 0= Not at all, 2=A great deal beneficial) and satisfaction (measured using acceptability tool with close and open-ended response items) as reported by caregivers. Results indicated high usability (71% of Veterans used the pet daily with reminders provided by 30% of caregivers) and acceptability (Benefit: (M=1.5/2, SD=0.7); Satisfaction: 94% of caregivers would continue to encourage use of the animatronic pet by the Veteran and recommend one to others). Open-ended responses suggest that they may be less satisfying to those who lost a real pet or did not have an affinity for pets earlier in life. Animatronic pets can be used with minimal assistance by Veterans with dementia and are acceptable to informal caregivers. As VA initiatives support provision of these pets, additional research is needed to examine their broader impact on Veterans living with dementia specifically.
IMPROVING HOME-CARE SERVICES FOR HIGH-RISK OLDER ADULTS USING PEER-LED VIDEO VISITS TO HOME
Authors: Lamba Shiv , Garcia Sandra , Bast Elizabeth , Penney Lauren , Palacio Ana , Madera Sonia , Intrator Orna , Dang Stuti
Published: December 2022

Older Veterans at high-risk for institutionalization often require home- and community-based services (HCBS). Yet, current HCBS delivery often fails to meet the needs of high-risk Veterans due to decreased veteran engagement in outpatient programs and limited HCBS capacity. A promising approach to address these gaps is the use of Veteran-Peers to make home-visits. Peer-2-PACT is a peer-led needs-assessment intervention for high-risk older veterans. Two trained peers conducted a checklist-guided virtual and/or in-person home-assessment to identify unmet needs and home-safety concerns. Veterans with access, acceptance and ability for video-capable technology were offered video-visits. We report on the feasibility of video home-visits in this high-risk group, and the experience of the video-visits using the visit-data and interviews with peers.Eight of 27 Peer-2-PACT Veterans successfully completed initial video-visit to home. The video-visit participants (n=8) were age 74±9; Non-Hispanic Black (50%); males (100%), compared to initial in-person home-visit participants (n=19), age 75.3±10.8; Non-Hispanic Black (47%); males (89%). The commonest needs identified during video-home-visits were home-safety devices 5(62.5%), housing assistance 4(50%), and medication refills 2(25%). Peers report that identifying veterans suitable for video-visits was challenging. During video-visits, depth-perception by peers is limited and sometimes needed in-person follow-up. Main advantages of video-visits was ability to identify unmet needs, engage veterans, provide care during COVID, and tele-present to remote clinicians. Preliminary data suggest that peer-conducted video home-visits is a feasible way to identify unmet needs in some high-risk older adults. This is particularly important improve care of Veterans who live at a distance from the facility.
FEASIBILITY AND ACCEPTABILITY OF A WEB-BASED COGNITIVE TRAINING PLATFORM FOR OLDER ADULTS: THE BREAKFAST TASK
Authors: Simon Sharon Sanz , Ben-Eliezer Daniel , Pondikos Maria , Stern Yaakov , Gopher Daniel
Published: December 2022

Background

Developing efficient cognitive training for the older population is a major public health goal due to its potential cognitive benefits. A promising cognitive training target is executive control, critical for multitasking in everyday life. The aim of this pilot study was to establish the feasibility and acceptability of the Breakfast Task in older adults, a new web-based cognitive training platform that simulates real-life multitasking demands. Research Design and

Methods

A community-based sample of 24 cognitively healthy participants aged between 60 and 75 (M = 69.12, SD = 3.83) underwent an online 5-session training protocol. Each session lasted 40 minutes and occurred twice a week at participant’s homes. Game performance was recorded, and participants completed questionnaires at baseline and after the intervention.

Results

Feasibility metrics showed overall high recruitment (82.7%), adherence and retention rates (100%). Acceptability was considered good based on participant`s quantitative and qualitative responses. On average, participants rated the game as interesting, enjoyable and did not report difficulties in accessing the game online or in understanding the instructions. Moreover, participants showed a learning curve across sessions, improvement in most game outcomes and benefits from the emphasis change approach. Discussion and Implications: The findings provide preliminary support for the feasibility and acceptability of the Breakfast Task training platform with community-dwelling older adults and demonstrate potential cognitive benefits. Results suggest the value of further research investigating the Breakfast Task features and dose-response relationship, as well as its efficacy in older adults via larger randomized controlled trials.
FINANCIAL AND TIME HELP FROM ADULT CHILDREN DURING THE COVID-19 PANDEMIC
Authors: Wiemers Emily , Lin I-Fen , Chin Janecca , Strauss Anna
Published: December 2022

Pandemic-induced challenges to health and economic well-being for older adults likely increased the need for help from adult children, disrupted the help children provided for needs unrelated to COVID-19, and changed interactions among time help, financial help, and shared housing. This paper uses data from the Health and Retirement Study Core and COVID-19 Module to assess whether adult children’s transfers of time, money, and coresidence with parents responded to the pandemic-related challenges older adults faced. Because of unequal health and economic impacts of the pandemic, non-White and less-educated older adults, and those living in areas hard-hit by the pandemic may have been less likely to receive help from family members, their children may have been less able to substitute financial support for time or in-kind help, and older adults may have experienced greater disruptions in existing help arrangements so we examine differences by socioeconomic status, race-ethnicity, and local pandemic severity.
RECOMMENDATIONS TO IMPROVE NURSING HOME QUALITY: A DISCUSSION OF THE 2022 NASEM REPORT
Authors: Travers Jasmine
Published: December 2022

Every year approximately four million persons receive care in approximately 15,000 nursing homes across the U.S. The costs of this care exceed $168 billion per year and are projected to grow to $274 billion by 2024. Nursing homes have long been plagued by problems with quality of care.In 1986, the Institute of Medicine released, Improving the Quality of Care in Nursing Homes, a landmark report that fundamentally changed the nation’s approach to nursing home operation and regulation. However, three decades later, significant challenges with nursing home quality remain, many of which were brought to light during the COVID-19 pandemic. As a result, in 2020, the National Academies of Sciences, Engineering, and Medicine (NASEM) convened a panel of 17 experts in nursing home care to examine our nation’s approach to nursing home care, including clinical care, staffing, financing and payment, and regulation, with the goal of making recommendations for improving the quality of care in today’s nursing homes and ensuring the safety and well-being of nursing home residents and staff. Expert members represented areas of diversity, policy, regulation, education, technology, quality measurement and reporting, and clinical practice. The release of this report is April 2022.In this symposium, four committee members will present the main findings and recommendations from the forthcoming and highly-anticipated report, with a particular focus on care delivery, workforce, quality assurance & policy, and equity. During this session, an emphasis will be placed on how the presented recommendations can be incorporated into policy and practice.
THE EQUIVALENCE OF CANTAB AS A COGNITIVE FUNCTION MEASURE FOR CHINESE STROKE SURVIVORS: A PILOT STUDY
Authors: Li Fanfan , Zhu Huanzhi , Wu Bei , Xu Hanzhang , Wang Jing , Li Juan
Published: December 2022

This study aims to investigate the equivalence between Cambridge Neuropsychological Test Automated Battery (CANTAB) and Montreal Cognitive Assessment, Changsha version (MoCA-CS) as cognition measures for Chinese stroke survivors. Sixteen stroke survivors were recruited from stroke center in Shanghai, China. Participants completed Paired Associates Learning (PAL) task in CANTAB, MoCA-CS and questionnaire about demo-social characteristics. Pearson correlation and hierarchical regression were used for equivalence analysis. CANTAB-PAL task performances（PAL First Attempt Memory Score, PALFAMS, PAL Total Attempts 2 Patterns, PALTA2）were significantly associated with score of MoCA-CS and delayed recall (β=0.528, p=0.014; β=0.198, p=0.043; β= -3.885，p=0.017; β= -1.600,p=0.026, respectively）after controlling for age, gender and education. The results suggest CANTAB-PAL is a reliable tool for measuring Chinese stroke survivors’ cognitive function. Future studies are needed to establish the equivalence of CANTAB in multi-tasks in larger sample of Chinese stroke survivors.
COPING WITH COGNITIVE DECLINE AMONG OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT OR MILD DEMENTIA: A SCOPING REVIEW
Authors: Cho Youngmin , Kamkhoad Donruedee , Beeber Anna
Published: December 2022

As cognitive impairment progresses, Persons with Mild Cognitive Impairment or Mild Dementia (PwMCI or MD) have trouble in adapting to changes in their cognitive functioning and, as a result, develop challenges in daily activities. If these challenges are not appropriately addressed, PwMCI or MD can experience poor health outcomes and quality of life. Coping, behavioral and cognitive efforts to regulate the distress from a certain stressful situation, is widely regarded as a fundamental determinant of health outcomes. We conducted a scoping review to understand what coping strategies PwMCI or MD used, and facilitators and barriers of the use of these coping strategies. Using the PRISMA-ScR guideline, we reviewed peer-reviewed empirical studies exploring coping experiences for cognitive impairment among community-dwelling PwMCI or MD. We used thematic synthesis to generate themes relevant to the coping strategies and the facilitators and barriers. Of 1267 studies identified, 12 qualitative studies were reviewed. Under three dimensions of coping strategy (i.e., problem-solving, emotional, and maladaptive coping strategies), six themes were identified: independent coping (e.g., use of reminder and practice of cognitive activities), collaborative/dependent coping (e.g., asking help as needed), reframing, expression of unpleasant feelings, comparing self to others, and avoidance. The themes for facilitators and barriers were social response to one’s cognitive impairment, assistance from informal care partners, and support from professionals. These findings can provide not only a better understanding of how people cope with their cognitive impairment but can also provide rationale for developing interventions to maximize the use of coping strategies.
ASSOCIATIONS BETWEEN PRESCRIPTION OPIOID AVAILABILITY AND LONGITUDINAL CHANGES IN COGNITION IN OLDER ADULTS
Authors: Warner Nafisseh , Hanson Andrew , Schulte Phillip , Habermann Elizabeth , Warner David , Mielke Michelle
Published: December 2022

Opioids are frequently prescribed to alleviate pain symptoms in older adults, yet the relationships between prescription opioid availability and long-term cognitive function are incompletely defined. We evaluated the associations between prescription opioid availability and neuropsychological function and incident mild cognitive impairment (MCI) by performing a secondary analysis of the Mayo Clinic Study of Aging (MCSA), a longitudinal population-based observational cohort study with participants enrolled between 11/1/2004 and 4/1/2019 aged 65 years or older at the time of enrollment and without dementia. A total of 4,218 participants (51% male) were included with median age of 76 (interquartile range 72, 82) years. In multivariable analyses, each receipt of an opioid prescription, regardless of duration, resulted in an additional -0.007 (95% CI: -0.009, -0.005) change in global cognitive z-score (p< 0.001), with significant effects seen in the domains of memory (-0.005, 95% CI: -0.007, -0.003; p< 0.001), language (-0.002, 95% CI -0.003, 0.000; p=0.024) and attention (-0.004, 95% CI: -0.006, -0.002; p< 0.001) but not visual-spatial function (0.000, 95% CI: -0.001, 0.001; p=0.897). Among 2,963 cognitively unimpaired subjects with longitudinal follow-up, 769 (26%) developed incident MCI. Receipt of any opioid prescription during follow-up was associated with incident MCI in adjusted analysis (hazard ratio 1.21, 95% CI: 1.04, 1.42; p=0.014). In conclusion, prescription opioid availability was associated with cognitive decline across multiple domains and with incident MCI. These findings suggest that prescription opioid availability may have long-term effects on cognitive function.
EMPOWERING SENIORS TO RECOGNIZE ELDER MISTREATMENT THROUGH PEER SUPPORT: RESULTS FROM A COMMUNITY OUTREACH PROJECT
Authors: Hsieh Jessica , Tan Sharon , Pang Celeste , Mirza Raza , Klinger Christopher
Published: December 2022

Elder mistreatment, often understood in the context of abuse and neglect, is a growing concern for the health and wellbeing of seniors and their families. A 2015 Canadian prevalence study by the National Initiative for the Care of the Elderly (NICE) found that seniors who are mistreated are more willing to talk to other seniors, rather than clinicians, police or family. However, a lack of knowledge, access to resources, and community stigma may limit seniors’ abilities to address mistreatment.This study evaluated the impact on knowledge, attitudes, and behaviours of having seniors deliver workshops on mistreatment to other seniors. A Seniors’ Advisory Committee developed content for these workshops, delivered by seniors in sixteen communities across Ontario, Canada. Participants completed pre/post-surveys assessing changes in knowledge, attitudes, and behaviours. Results indicate that workshops effectively increased awareness of mistreatment issues among participants, on average, by 37%. Participants experienced a 44% increase in their perceived preparation to provide information to another older adult asking about mistreatment. Barriers to help-seeking among seniors include finding trustworthy sources, fear of retaliation, and a lack of legal protection. Prior to the training, healthcare providers were the main sources of information for participants (58%); depending on the severity of the situation, 60% of participants indicated eventually reporting to police, who are not the preferred source of information. Senior-led workshops about mistreatment appear to be effective for increasing knowledge and encouraging disclosure and help-seeking behaviours. Results support prevention models that empower seniors to educate other seniors on issues around mistreatment.