bluuebunny/crossref_metadata_2025 huggingface dataset:
Tippu Tip
Authors: Laing Stuart
Published: December 2022

Hamad bin Muhammad al-Murjabi, usually known by his nickname Tippu Tip, was an ivory and slave trader based in Zanzibar, who in the second half of the 19th century, built up wide influence and a strong trading empire in the “Arab Zone” west of Lake Tanganyika. He accompanied and assisted a number of European explorers in the region and was recruited by Leopold II, king of the Belgians, to be governor of Stanley Falls, supervising the area that became the eastern province of the Congo Free State. He was contracted by Stanley to supply men and guns for the Emin Pasha Relief Expedition but had a falling out with him when the expedition ran into difficulties. In his closing years, having accumulated wealth from his ivory trading, he lived in comfort in Zanzibar but had to watch from the sidelines in retirement, as the sultan was deprived of his mainland possessions by the British and the Germans, Zanzibar itself became a British protectorate, and the Arabs were ejected from their Zone by the acquisitive (Belgian) Congo Free State.

Tippu Tip’s life covered a period witnessing huge changes in East and Central Africa, as well as touching on aspects of East African and Indian ocean trading (notably, the ivory, slave, and cloves trades), and of exploration and discovery.
Kelly, Michael S.
Authors: Menon Goutham
Published: December 2022

Michael Stokely Kelly (1968–2021), who served as Lucian Welch and Carol Matusak Endowed Chair at Loyola University, has left a lasting legacy in the students and colleagues whom he has inspired and mentored. He was an innovative, forward-thinking, master teacher-scholar in the field of school social work.
Impact of perioperative steroid administration in patients undergoing elective liver resection: meta-analysis
Authors: Jötten Laila , Steinkraus Kira C , Traub Benno , Graf Sandra , Mihaljevic André L , Kornmann Marko , Michalski Christoph W , Hüttner Felix J
Published: December 2022

Background

Perioperative steroid administration may improve postoperative outcomes in major abdominal surgery by reducing the systemic inflammatory response. The aim of this systematic review was to evaluate the impact of perioperative steroid administration on outcomes after elective liver resection.

Methods

PubMed, Cochrane Library, and Web of Science were systematically searched for randomized clinical trials (RCTs) comparing perioperative steroid administration with placebo, standard of care, or no steroids with respect to postoperative outcomes, particularly postoperative complications. Two independent reviewers critically appraised the studies and extracted data. Meta-analyses were performed using a random-effects model with ORs calculated for dichotomous outcomes and mean differences (MDs) for continuous outcomes.

Results

Ten RCTs comprising 930 patients were included. Perioperative steroid administration significantly reduced the overall postoperative complication rate (OR 0.61, 95 per cent c.i. 0.43 to 0.87; P = 0.006; I2 = 26 per cent). No significant differences were shown for individual complications. Several postoperative laboratory parameters were positively affected, like total serum bilirubin (MD −0.46; 95 per cent c.i. −0.74 to −0.18; P = 0.001; I2 = 80 per cent), interleukin 6 (MD −48.99; 95 per cent c.i. −60.72 to −37.27; P < 0.001; I2 = 0 per cent) and C-reactive protein (MD −5.20; 95 per cent c.i. −7.62 to −2.77; P < 0.001; I2 = 71 per cent). There were no signs of an increase in potential steroid-induced adverse events, namely infectious complications, thromboembolic events, or bleeding.

Conclusions

Perioperative steroid administration significantly reduces the overall complication rate after elective liver resection without an increased risk of adverse effects.
Is perioperative fast-track management the future of proximal aortic repair?
Authors: Haunschild Josephina , van Kampen Antonia , Misfeld Martin , Von Aspern Konstantin , Ender Jörg , Zakhary Waseem , Borger Michael A , Etz Christian D
Published: December 2022

OBJECTIVES

The Bentall procedure is the gold standard for patients with combined aortic root dilation and valve dysfunction. Over the past decade, fast-track (FT) perioperative anaesthetic management protocols have progressively evolved. We reviewed our results for selected patients undergoing Bentall surgery under an FT protocol.

METHODS

We retrospectively analysed a consecutive cohort of patients who underwent elective Bentall procedures at our institution between 2000 and 2018. Complex aortic root repair (i.e. David and Ross procedure, redo surgery, major concomitant procedures, emergency repair for acute dissections) was excluded. Patients who underwent conventional perioperative treatment and those treated according to our institutional FT concept were compared following 1:1 propensity score matching.

RESULTS

Of 772 patients who fit the in- and exclusion criteria, 565 were treated conventionally post-surgery, while 207 were treated using the FT protocol. Propensity score matching resulted in 197 pairs, with no differences in baseline characteristics after matching. In-house mortality, 30-day mortality and overall all-cause long-term mortality were comparable between the FT and the conventionally treated cohort. Postoperative anaesthetic care unit/intensive care unit length-of-stay (6.2 vs 20.6 h, P = 0.03) and postoperative ventilation times (158.9 vs 465.5 min, P < 0.001) were significantly shorter in the FT cohort. There were no differences in rates of postoperative adverse events.

CONCLUSIONS

In centres with experienced anaesthesiologists, perioperative FT management is non-inferior to conventionally treated patients undergoing elective Bentall procedures without compromising patient safety.
DECIPHERING RACIAL AND ETHNIC DISPARITIES IN DEMENTIA AND COGNITIVE FUNCTION: A POLYSOCIAL SCORE APPROACH
Authors: Wu Chenkai , Ping Yongjing , Chen Xi , Odden Michelle , Prina Matthew
Published: December 2022

The burden of dementia has been increasing rapidly in the US and huge racial/ethnic disparities exist. We examined whether social environment, measured in a comprehensive way (polysocial score approach), could modify the racial and ethnic differences in dementia. Data are from the Health and Retirement Study; 12,836 adults aged at least 65 years were included in the analysis. We assessed cognitive function by a modified version of the telephone interview for cognitive status. We included 24 social factors from five categories (economic stability, neighborhood environment, education, community/social context, and healthcare system) and used forward stepwise regression to screen for important ones. Polysocial score was created using 11 social factors and was classified as low (< 25), intermediate (25-31), and high (32+). We used the multivariable Poisson regression to estimate the incidence rate of dementia by three polysocial score categories and evaluate the interaction between race/ethnicity (non-Hispanic white, non-Hispanic Black, and Hispanic) and the polysocial score. Higher polysocial score is associated with a lower dementia rate in the overall sample and each racial/ethnic group. We found an additive interaction between race/ethnicity and polysocial score categories. In the low polysocial score group, Whites and Hispanics had substantially higher dementia rates than non-Hispanic Blacks (difference was 20.3 and 15.8 per 1,000 persons-years, respectively). These differences significantly attenuated and were no longer significant in the high polysocial score group (4.9 and 5.5 per 1,000 persons-years, respectively). The polysocial score approach offers a new opportunity to explain the racial/ethnic disparities in cognitive function among older adults.
GEOGRAPHIC DISPARITIES IN INCIDENCE AND MORTALITY OF ALZHEIMER’S DISEASE
Authors: Akushevich Igor , Yashkin Arseniy , Kravchenko Julia
Published: December 2022

Our estimates showed that geographic patterns of incidence rates extracted from Medicare data and mortality rates calculated using Multiple-Cause-of-death data are significantly different. The significant gap in mortality rates between the East and West parts of the U.S. present in death certificate data is not observed when Medicare data is used. In addition, high incidence rates of Alzheimer’s Disease (AD) identified in the stroke-belt states when using Medicare data is not fully reproduced when death certificates are used. Therefore, we used 5%-Medicare data linked to the National Death Index to resolve this inconsistency in findings using both types of data for the same individuals. We found that the excess rates of AD in the stroke-belt states cannot be attributed to higher proportions of vulnerable populations as the associated differences hold across race- and gender-specific subgroups: 1,717 (1,704-1,731) vs. 1,280 (1,275-1,286) for Whites; 2,052 (2,017-2,086) vs. 1,821 (1,795-1,848) for Blacks; 1,538 (1,520-1,556) vs. 1,156 (1,140-1,164) for males; and 1,878 (1,861-1,894) vs. 1,383 (1,376-1,391) for females. We evaluated the sensitivity and specificity for having AD as an underlying cause of death in all these regions and developed a predictive model that predicts occurrence of AD in death certificate based on information in individual Medicare records. Our findings show that underrepresentation of AD in death certificates is a strong contributor to geographic disparities in AD mortality. Predictive quality of occurrence of AD in death certificates can be improved by advancing the predictive model and using a broader set of predictors from Medicare records.
BEHAVIORAL AND SOCIAL IMPACTS ON DAILY VARIABILITY IN HEALTH AND FUNCTIONING IN OLD AND VERY OLD AGE
Authors: Lücke Anna Jori , Schilling Oliver , Hofer Scott
Published: December 2022

In recent years, research has shown that people experience substantial variability in domains such as cognition, health, or social interactions from day-to-day or even moment-to-moment. This variability carries relevant information above and beyond an individual’s mean levels of functioning, revealing, for instance, potential risk factors for healthy aging. Thus, aging research increasingly examined such variations in older adults’ daily lives, aiming to further the understanding of aging processes with insights into short- and long-term predictors of daily health and functioning. In this symposium, we introduce research using repeated daily life assessments from older participants to elucidate behavioral and social impacts on variations in working memory performance, pain and self-rated health, as well as social interaction quality. Luo et al. show that diverse daily activities were linked with higher working memory performance one the same day. Regarding long-term prediction, Schilling et al. found that patterns of alcohol consumption across two decades were only weakly predictive of subsequent short-term variability in daily working memory performance. Turning from cognitive functioning to health, Lücke et al. observed bidirectional links of variations in daily sleep quality with variations in daily pain and health perceptions across several days. Finally, Hülür et al. addressed the role of communication technologies for older persons’ social interactions and found that daily social interaction quality differs with the interaction modalities. Scott Hofer will discuss the implications of the presented findings for our understanding of variability in everyday functioning in old age, considering challenges and opportunities for future research in this field.
PERCEIVED QUALITY OF DAILY SOCIAL INTERACTIONS: THE ROLE OF INTERACTION MODALITY
Authors: Hueluer Gizem , Luo Minxia , Macdonald Birthe , Grünjes Carlotta
Published: December 2022

Older adults increasingly use digital technologies to communicate with others. In the present study, we examine the role of interaction modality (face-to-face, telephone, digital) for perceived quality of social interactions. We use data from 118 participants (age: M = 72 years, SD = 5, range = 65 to 94; 40% women), who reported on their social interactions over 21 days in an event-contingent experience sampling study. Relative to face-to-face interactions, participants reported feeling more accepted and calmer, but also less happy in telephone interactions. They perceived telephone interactions as more meaningful, but also as less pleasant. Relative to face-to-face interactions, participants felt less accepted, less close to their interaction partner, and less happy in digital interactions and they perceived digital interactions as less pleasant. In summary, our findings suggest that the modality of daily social interactions is related to their quality. We discuss implications of these findings for future research.
POSITIVE ASPECTS OF CAREGIVING AND LOWER RISK OF FRAILTY AND SLEEP DISRUPTION IN THE NATIONAL STUDY OF CAREGIVING
Authors: Wennberg Alexandra , Anderson Loretta , Chen-Edinboro Lenis , Cagnin Annachiara , Pini Lorenzo
Published: December 2022

Older adult caregivers have compounded risk for adverse health outcomes; however, evidence investigating the association between the spectrum of the caregiving experience and frailty has been limited. In the National Study of Caregiving, we examined the cross-sectional association between caregiving experiences and both frailty and sleep disruption outcomes among caregivers. We included 621 caregivers aged 65+ who completed a phone interview, including 36 items about caregiving. Using principal component analysis, we identified three caregiving components: general burden, financial burden, and positive emotions. Frailty was assessed via low energy, shrinking, weakness, reduced activity, and poor self-rated health. Sleep disruption was assessed with two questions regarding sleep interruption and trouble falling back asleep. In age- and sex-adjusted ordinal regression models, general burden was associated with frailty (OLO=1.21, 95% CI 1.12, 1.30) and trouble falling back asleep (OLO=1.08, 95% CI 1.00, 1.17); financial burden (OLO=1.15, 95% CI 1.02, 1.31) was associated with frailty. General (OLO=1.99, 95% CI 1.38, 2.88) and financial (OLO=1.98, 95% CI 1.25, 3.14) burden were associated with sleep interruption in the fully adjusted model. Positive emotions were associated with lower odds of both frailty (OLO=0.86, 95% CI 0.74, 0.99) and sleep interruption (OLO=0.75, 95% CI 0.58, 0.98). Caregiver burden was associated with greater risk of frailty in age- and sex- adjusted models and sleep interruption when further accounting for sociodemographic and health factors. Positive emotions of caregiving were associated with decreased risk of these outcomes.
CAREGIVER PARTICIPATION IN VIDEO VISITS: CHALLENGE OR OPPORTUNITY?
Authors: Gately Megan , Moo Lauren
Published: December 2022

Rapid expansion of telehealth in response to COVID revealed a digital divide for many patients, particularly older adults. Given the technical complexity of video visits (which may include downloading novel software and enabling a camera and microphone), video visits may be out of reach for older patients with less technological experience or with age and condition-related changes such as sensory loss or cognitive impairment. Involving caregivers in video visits (particularly technical set-up) may not only increase patient access but also enhance clinical care by allowing for collaboration with family. Caregivers may themselves benefit from video visits, given that video offers increased options for caregiver support. Though caregivers are often identified as critical components to older adults’ accessing telehealth and may also benefit from telehealth services, caregivers’ own technical needs are not well-understood. This symposium discusses caregivers’ involvement in telehealth from multiple perspectives. The first presentation includes findings from a national clinician survey about caregivers’ support role in occupational therapy video visits, including barriers and benefits (Gately et al). The second presentation includes findings from a regional survey of interprofessional clinicians about telehealth modalities to provide dementia family caregiver support during COVID-19 (Quach et al). The third presentation includes family caregivers’ technology assistance requirements before and during a virtual, seven-session group skills training program, including benefits of individualized assistance (Moo et al). The fourth presentation includes caregiver perspectives about tele-geriatrics visits, highlighting caregivers’ support role and enhancements of video versus phone (Boudreau et al).
TECHNICAL SUPPORTS TO BRIDGE THE DIGITAL DIVIDE FOR OLDER ADULTS PARTICIPATING IN TELEMEDICINE
Authors: Moo Lauren , Nguyen Andrew , Pugh Kendra , McLaren Jaye , Shirk Steven , O'Connor Maureen
Published: December 2022

Older adults’ relative lack of technological literacy is a barrier to telemedicine, including participation in virtual caregiver support programs. Details of technology assistance required before and during a virtual, seven-session group skills training program for family caregivers were recorded. A majority of participants, all older adults, had difficulty using videoconferencing technology that ranged from finding meeting links in emails to difficulty with basic device use. Personalized support was provided to each caregiver as needed. None required any support by the final session. Those with initial technology challenges felt a sense of accomplishment and increased tech comfort by the end of the sessions. While some older adults had difficulty using telemedicine technology, they were eager to learn and educable with personalized help. Infrastructure to provide this personalized help is necessary to support older adults’ desire to engage in telemedicine and to reduce the digital divide.
NEIGHBORHOOD GREENSPACE AND GRAY MATTER MICROSTRUCTURAL INTEGRITY: THE HEALTH ABC STUDY
Authors: Godina Sara , Shaaban C , Rosano Caterina , Aizenstein Howard , Rosso Andrea
Published: December 2022

Neighborhood greenspace is positively associated with cognition and macrostructural indicators of brain health. Microstructural damage may be a sensitive marker for dementia-related neurodegeneration that precedes such macrostructural changes. We aimed to examine cross-sectional associations between neighborhood (census tract) greenspace and gray matter (GM) microstructure in 265 community-sampled adults (mean age=83, 57% women, 39% Black). Linear mixed effects regression models tested associations between quartiles of percent greenspace derived from the normalized vegetation index and mean diffusivity (MD) quantified using magnetic resonance imaging with diffusion tensor. Greater greenspace was related to higher MD in 4 regions: left calcarine (Q3 vs. Q1 stβ=0.38, p=0.0348), left thalamus (Q2 vs. Q1 stβ=0.35, p=0.0443; Q3 vs. Q1 stβ=0.49, p=0.0061), and bi-lateral precuneus (left Q2 vs. Q1 stβ=0.46, p=0.0096; right Q2 vs. Q1 stβ=0.36, p=0.0385). The relationship between greenspace and cognition may be through paths other than GM microstructure; future research should explore other potential mechanisms.
SHARESTART: A NEW PEDAGOGY TO PROMOTE LEARNING IN DIVERSE CLASSROOMS
Authors: Su YanJhu
Published: December 2022

Diverse classrooms are nightly valued. The role of teachers is not limited to imparting knowledge. Nor are students only limited to gaining knowledge from their teachers. In this symposium session, the speaker would like to introduce a new pedagogy — Sharestart, which is specifically designed for comprehensive student learning. This pedagogy was proposed by a senior high school teacher in Taiwan. It is a long-term and stable teaching method that integrates a diversity of abilities by enabling students to self-learn, read, think, discuss, analyze, summarize, express and compose in every class session. In this symposium presentation, the speaker will introduce the core values of Sharestart pedagogy, discuss the advantages and disadvantages, and present an application scenario applying the Sharestart pedagogy.
CURRICULUM MAPPING AS A STRATEGY TO TEACH DIVERSITY IN GERONTOLOGY PROGRAMS
Authors: Liu Darren , Burston Betty
Published: December 2022

Curriculum mapping is a process where instructors, program leaders and other instructional designers come together to prepare learning objectives for students throughout a learning journey. The concepts of diversity may be introduced at all levels of a gerontology curriculum. A curriculum that desires to integrate diversity education is especially imperative as it needs to be built upon a guiding principle of a didactic program within which its individual courses, learning objectives, and assessments all together serve the same purpose. This presentation provides insight to the curriculum mappings for diversity education in gerontology programs. While the current programs introduce diversity topics such as race, racism, implicit bias, etc., how and when each topic being introduced in bringing about maximum learning outcomes may be related to a well thought out curriculum mapping. Specifically, this session will go over a few examples of methods for the mappings of diversity topics in different courses.
REMINISCENCE AND DIGITAL STORYTELLING TO IMPROVE WELL-BEING OF OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Xu Ling , Fields Noelle , Daniel Kathryn , Troutman Brooke , Cipher Daisha
Published: December 2022

To address the growing concern about loneliness and diminished well-being among persons with cognitive impairment, an intergenerational intervention based on reminiscence and digital storytelling was offered by trained college student volunteers to older adults living in the community. A randomized controlled trial was used to assess the effects of the intervention. Younger and older adult participants were randomly paired and assigned to reminiscence (n=20) or control (social wellness, n=16) groups. Data were collected at baseline, mid-intervention, and at the end of the intervention. Friedman tests for non-normally distributed outcome variables and one-way repeated measures ANOVA for normally distributed outcome variables were conducted. Results showed that emotional loneliness, total social and emotional loneliness, quality of life, and positive affect significantly improved among older adults in the reminiscence group, especially between baseline and posttest. Results suggest that weekly intergenerational engagements with young adults benefit older adults with psychological well-being.
MIGRATION ACROSS THE LIFE COURSE AMONG OLDER ADULTS FROM PUERTO RICO
Authors: Rivera-Hernandez Maricruz
Published: December 2022

The prior literature regarding migration among Hispanics to US states has largely focused on younger migrants and often excluded people from Puerto Rico (e.g., Hispanic Paradox; Bostean, 2013). However, older Puerto Ricans appear to be moving to the US mainland (US Census Bureau, 2020, 2021). Therefore, the primary objective of this research was to examine migration among Medicare beneficiaries from Puerto Rico. Using data from Medicare, our results showed that migration trends among Medicare beneficiaries from Puerto Rico have increased over the past decade, including those with special needs. There were 5,593 (1%) Medicare beneficiaries who migrated in 2009 compared to 12,382 (~2%) beneficiaries who migrated in 2018. Among those who migrated, 3,679 were 65 and older in 2009 compared to 8,805 in 2018. The majority of older adults who moved to US states were female (59%), about 75 years old and were enrolled in Medicare Advantage. Destination states among Medicare beneficiaries from Puerto Rico included Florida, New York and New Jersey (comparable to those reported for the general population of Puerto Rico in the US Census). This research has policy implications. Although people from Puerto Rico have different reasons for migrating, those with long term care needs may have multiple varying reasons to move to the mainland. However, migration to the US may have additional challenges for people with high needs (Mellgard et al., 2019). For instance, Medicare coverage/network may not transfer to the US and plan switching/disenrolling may not be a straightforward process for people leaving Puerto Rico.
PHYSICAL ACTIVITY AT THE INTERSECTIONS OF AGING AND DISABILITY
Authors: Na Annalisa , Na Annalisa
Published: December 2022

Physical activity is beneficial for older adults to maintain health and help manage chronic diseases but relies on routine participation. Some older adults continue with physical activity behaviors as they age, whereas others are negatively affected by impaired functional abilities, physical disabilities, and unmet psychosocial needs. This symposium presents quantitative and qualitative data on physical and psychosocial factors that can influence physical activity among older adults with varying levels and types of physical abilities. The first presentation will focus on aging into the disability associated with knee osteoarthritis, the leading cause of mobility decline among older adults that generally onsets after the fifth decade of life. The second presentation will focus on aging with a disability, specifically how health perspectives evolve when aging with a spinal cord injury. The third presentation will highlight how the COVID-19 pandemic has influenced outdoor physical activity among older adults when indoor activities became limited. The fourth presentation shifts perspectives to clinicians, specifically physical therapists, to explore the needs for addressing physical activity in the clinic. The fifth presentation outlines a physical activity intervention program and its implementation for community-dwelling older adults. Together, these presentations will provide practical insights for designing a person-centered program to improve physical activity for older adults including those aging into disability or aging with disability.
OUTDOOR PHYSICAL ACTIVITY AMONG OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Sefcik Justine , Panicker Amina , Katsev Danielle , Na Annalisa , Greenberg Sherry , DiMaria-Ghalili Rose Ann
Published: December 2022

There is a gap in understanding how the current pandemic is affecting older adults’ outdoor physical activity. This study aimed to explore older adults’ perceptions of their outdoor physical activity during the current pandemic. A qualitative descriptive approach was taken with a conventional content analysis. Participants were primarily recruited through ResearchMatch. Eighteen community-dwelling older adults were individually interviewed from geographical locations across the United States; 61.1% female, 88.9% White, mean age 76.4 (range 68-92), 5 ambulated with a cane or walker. We identified an overarching theme of Benefits and Motivation in which older adults conveyed wanting to maintain and improve their health and used the outdoors to continue physical activity since indoor activities decreased during the pandemic. Walking was expressed as the most frequent outdoor physical activity. Implications of these findings will be discussed which include supporting community improvements to facilitate older adults’ ease of maintaining a walking routine.
SOCIAL ISOLATION, SLEEP DISTURBANCE, AND COGNITIVE HEALTH: A LONGITUDINAL MEDIATION STUDY
Authors: Qi Xiang , Pei Yaolin , Malone Susan , Wu Bei
Published: December 2022

Research indicates that social isolation is associated with dementia, but the role of sleep on this association is less known. We aimed to examine the impact of social isolation on cognitive function, and how sleep disturbance mediated the association. Data came from the 2006, 2010, and 2014 waves of the Health and Retirement Study. Participants aged 50+ who completed the Psychosocial and Lifestyle Questionnaire in 2006 were included (n=5,036). Measures include the Social Isolation Index, modified Jenkins Sleep Scale, and Telephone Interview of Cognitive Status. Cross-lagged panel models were used in the analysis. After controlling socio-demographics, lifestyle, and loneliness, social isolation predicted subsequent sleep disturbance (β=0.05; P<0.01), which in turn predicted worse cognitive functioning (β=-0.02; P<0.01). The reverse pathways from cognitive function to social isolation were also statistically supported. Public health initiatives could reduce sleep disturbance by facilitating social integration and participation in community activities, thereby protecting against cognitive decline.
INVESTIGATION OF BIOLOGICAL DETERMINANTS OF FRAILTY IN MALE AND FEMALE MICE
Authors: Kane Alice , Griffin Patrick , Arnold Matthew , McNamara Maeve , Vera Daniel , Vogel David , Sinclair David
Published: December 2022

Frailty is quantified as the accumulation of health deficits over an organism’s lifetime and gives a measure of the overall health of an organism. Preliminary studies have found an association between frailty and some of the hallmarks of aging including inflammation and senescence. However, the molecular underpinnings of frailty, and whether the mechanisms of frailty are distinct from or overlap those of aging is unknown. Previously we developed clocks based on frailty assessments that accurately predict age and lifespan in older male mice. Here, we expand these clocks to predict age, lifespan and frailty itself in younger, and also female mice. Additionally, we incorporate molecular measures including blood cell composition, plasma metabolomics, PBMC DNA methylation and stool microbial diversity measures into the clocks. These clocks provide important tools for the field, and also provide an indication of the molecular underpinnings of frailty and sex differences in these.
SYSTEMS AGING AND REJUVENATION
Authors: Gladyshev Vadim
Published: December 2022

What is aging? When does it begin? How to control lifespan? Can we rejuvenate organisms in addition to slowing down the aging process? There is no consensus on these questions, but recent developments in the field may allow to address these questions. In particular, DNA methylation of defined sets of CpG dinucleotides emerged as a critical and precise biomarker of the aging process. Multi-variate machine learning models, known as epigenetic clocks, exploit quantitative changes in the methylome to predict the age of bulk tissue with remarkable accuracy. Additionally, the first epigenetic aging clock that works at the level of single cells has been developed. Together with advances in genomics, transcriptomic longevity signatures and intervention strategies, these tools support quantification and manipulation of the aging process. Moreover, these tools may also be used to assess the possibility of age reversal. Several types of rejuvenation have been described, including the recently discovered process of early embryonic rejuvenation, culminating in ground zero, marking the beginning of organismal aging.
INVESTIGATING PHYSICAL EXERCISE-RELATED MEDIATING VARIABLES IN THE RDAD-NW TRANSLATIONAL STUDY
Authors: Li Jingyi , Cochrane Barbara
Published: December 2022

Declining physical function significantly worsens quality of life in dementia care dyads. Caring for people living with dementia (PLWD) at home is both physically demanding and emotionally stressful. Physical exercise is strongly recommended as a way of sustaining or improving overall function in dementia care dyads. However, little is known regarding the impact of home-based dyadic exercise interventions. We present results from a secondary analysis of data from a multicomponent translational study, Reducing Disability in Alzheimer's Disease – North West (RDAD-NW). We report results from an examination of the mediating role of exercise on the trajectory of change in physical function over time for both PLWD and their care partners.
CARE COORDINATION, HEALTH OUTCOMES, AND HEALTHCARE UTILIZATION AMONG ADULTS WITH MULTIMORBIDITY
Authors: Mezuk Briana , Qin Weidi , Dang Linh , Sneed Rodlescia
Published: December 2022

Care coordination is a vehicle for improving patient-provider and provider-provider communication to improve outcomes and reduce unnecessary healthcare utilization, particularly for adults with multimorbidity. However, the clinical effectiveness of coordination at the population level remains unknown. This study examined the association between experiences of care coordination with subsequent health and healthcare outcomes among US adults over age 50. The analytic sample (n=695) included respondents from the Health and Retirement Study who had at least two chronic conditions, completed an Experimental Module on Coordinated Care in 2016, and were re-interviewed in 2018. Three domains of care coordination were examined as predictors: perceptions of coordination; using tangible supports (e.g., seeing a care coordinator); and using technical supports (e.g., patient portal). A range of outcomes related to health (i.e., self-rated health, functioning, pain) and healthcare (i.e., medication adherence, visits, hospitalizations, care satisfaction) were assessed in 2018. Weighted linear and logistic regression models, adjusted for demographic and socioeconomic characteristics, were fit for each lagged outcome. Higher engagement with tangible supports was positively associated with subsequent hospitalization (OR: 1.08, 95%CI: 1.01-1.15), greater pain (OR: 1.11 , 95%CI: 1.03-1.20), and marginally worse self-rated health (B=-0.02, p< 0.063). Better perceptions of coordination were also positively associated with care satisfaction (B=0.03, p< 0.020). Care coordination was not associated with functioning, adherence, or number of medical visits. Findings indicate the salience of tangible support for coordination among older adults with multi-morbidity, and that positive perceptions of coordination contribute to healthcare satisfaction.
PATIENT AND CAREGIVER PERCEPTIONS OF MOBILITY AFTER DISCHARGE FROM SKILLED NURSING FACILITIES TO HOME
Authors: Bankole Ayomide , Preisser John , Zang Ying , Toles Mark
Published: December 2022

Functional outcomes of older adults in post-acute care is poorly understood. The purpose of this study was to describe skilled nursing facility (SNF) patient or caregiver perceptions of patient mobility and factors associated with patient mobility in 30 days after discharge from SNF to home. We conducted a secondary analysis of data from a stepped-wedge cluster randomized trial of the Connect-Home intervention set in 6 SNFs in North-Carolina. The sample included SNF patients (N=249) and their caregivers (N=249). In 30 days after discharge, SNF patients or their caregivers (as proxies) rated patient mobility using the Life-Space Assessment (LSA). LSA total-scores (range= 0-120), with higher scores indicating greater mobility. Linear mixed models, with random effects to adjust for clustering in SNFs, were used to describe associations between LSA total-score and patient, caregiver, and health-system factors. Participants were typically female (63%), White (74%), and average age of 76.3 years. In 30 days after discharge, LSA total-scores ranged from 0-90 with a mean score of 22 (SD=16.01). Most (85%) required caregiver and/or assistive devices to transfer inside and outside of their homes. In the mixed models, lower LSA scores were associated with older age [-0.232(0.108), p< 0.05], lower cognition score [1.182(0.384), p< 0.005], diagnosis of dementia [-6.863(3.057), p< 0.05], lower baseline mobility in the SNF [0.296(0.142), p< 0.05] and longer SNF stay [-0.200(0.068), p< 0.005]. Low LSA scores in this sample suggest the need for caregiver support to continue rehabilitation and promote functional ability at home. Studies are needed to augment transitional care and address these care needs.
USING RESEARCH TO ADVANCE THE DEMENTIA-FRIENDLY COMMUNITY MOVEMENT AT THE LOCAL, NATIONAL, AND INTERNATIONAL LEVEL
Authors: Scher Clara , Greenfield Emily , Gaugler Joseph
Published: December 2022

It is estimated that more than 55 million people worldwide are living with dementia. To address the social and health needs of individuals living with dementia and their care partners, researchers, policymakers and advocates have championed dementia-friendly communities (DFCs) as a population-level response. DFCs promote the well-being of those living with dementia, empower all members of the community to celebrate the capabilities of persons with dementia, and encourage individuals living with dementia to engage in their communities. The objective of this symposium is to describe the ways in which research can help to advance the dementia-friendly movement at the local, national, and international levels. First, Scher & Greenfield will describe the dimensions of implementation of DFCs in Massachusetts with implications for program monitoring and process evaluation. Second, Epps & colleagues will discuss the process of developing a person-centered tool to evaluate the impact of dementia-friendly programs in faith-based communities. Third, Somerville & colleagues will present findings from a study of community and organizational factors related to dementia-friendly readiness in community-based senior centers. Finally, Sun & colleagues will discuss the barriers and facilitators to implementation of DFCs in the USA during the COVID-19 pandemic. Taken together, these studies demonstrate the utility of quantitative and qualitative research methodologies to elucidate how and to what extent DFCs are implemented. Findings have implications for examining the population health impact of DFC efforts, as well as for attending to issues of health disparities and aging equity in the uptake, implementation, and sustainability of DFC initiatives.
EARLY DETECTION AND MANAGEMENT OF FRAILTY IN PRIMARY CARE: VALIDATION OF THE EFI-CGA WITH ELECTRONIC HEALTH RECORDS
Authors: Song Xiaowei , Park Grace , Clarke Barry , Rockwood Kenneth
Published: December 2022

Background

Frailty is common in older adults and associated with many adverse outcomes. To promote early detection and management of frailty outside specialized geriatric services, we developed an electronic Frailty Index based on a Comprehensive Geriatric Assessment (eFI-CGA) in electronic health records. Here, we compare the eFI-CGA assessments between family physicians (FP) and geriatricians (GM).

Methods

Data from community-dwelling older adults were collected as part of the collaborative effort between Fraser Health and Nova Scotia Health to validate the eFI-CGA. The eFI-CGA was created following a standard procedure based on understanding deficit accumulation. A FP and a GM assessed each patient independently. Characteristics of the eFI-CGA were examined for each physician group using descriptive statistics and correlation analysis. FP-GM inter-rater reliability was tested using Cohen’s Kappa.

Results

The first 30 cases were aged 80.8±5.2 years; 7% were women; with 12.9±2.8 years of education; 17% lived alone. Mild cognitive impairment or dementia was present in 20% participants. The mean clinical frailty scale (CFS) was 3 and the mean eFI-CGA was 0.20 by both FP and GM ratings. The CFS and eFI-CGA were closely correlated (r=0.76 for FP and r=0.71 for GM, p<.001). The eFI-CGA also showed an age correlation (r values >0.37, p values <.050). The average intraclass correlation coefficient was 0.79 for CFS and 0.90 for eFI-CGA (each p<.001).

Conclusion

Frailty data collected in primary care are highly comparable with geriatrician assessments. Ongoing work will test the generalizability of these findings using a larger sample with follow-up and outcomes evaluations.
EXPERIENCES OF INNER STRENGTH AT THE TIME OF MILD COGNITIVE IMPAIRMENT DIAGNOSIS
Authors: Morgan Brianna , Massimo Lauren , Ravitch Sharon , Karlawish Jason , Hodgson Nancy
Published: December 2022

Inner strength is a person’s internal process of moving through challenging circumstances, such as receiving a diagnosis of Mild Cognitive Impairment (MCI). This study describes experiences of inner strength using qualitative methodologies to identify themes within semi-structured dyadic and individual interviews with persons diagnosed with MCI within 12 months at a Memory Center and their care partners. We analyzed data in NVivo using reflexive thematic analysis methods. Trustworthiness was maintained through vetted interview guides, verbatim transcription, field notes, peer group analysis, and audit trails. One overarching theme and three subthemes explained inner strength. An overarching theme, Finding Ways to Live with It, described how participants live within the circumstances of MCI. Three subthemes were Defining Strength by Recalling the Past, Seeking Relief and Dwelling in It, and Finding Purpose & Meaning. Implications include supporting inner strength at the time of MCI diagnosis through reminiscence therapy and meaning making interventions.
OUTDOOR ENVIRONMENTAL RISK FACTORS FOR FALLS AND FEAR OF FALLING: A SYSTEMATIC REVIEW
Authors: Dunlap Pamela , Hubbard Zachary , Fan Erica , Strotmeyer Elsa , Rosso Andrea
Published: December 2022

The purpose of this systematic review was to identify outdoor environmental risk factors associated with falls and/or fear of falling among older adults. PubMed, EMBASE, and CINAHL were searched through February 19, 2021. Studies were included if they measured outdoor environment, falls or fear of falling as an outcome, and included adults aged ≥ 45 years. Excluded studies were not published in English and/or did not include original results. Two study-team members completed abstract screening. For full text reviews, a third reviewer resolved conflicts. A total of 5,727 abstracts were screened and 462 full texts were reviewed. After full-text review, approximately 25 studies will be assessed for risk of bias and data extracted by two independent reviewers. Based on the initial review, uneven outdoor surfaces, busy traffic areas, and neighborhood disorder were associated with falls/fear of falling among older adults. Modifiable outdoor environmental factors may be targets for fall prevention.
WHAT PANDEMIC RECOVERY WILL LOOK LIKE FOR OLDER, MULTICULTURAL WORKERS
Authors: Burton Cassandra , Bridges Katherine , Cozad Aisha
Published: December 2022

It is no surprise to many that the impact of Covid-19 on older adults, particularly LGBTQ and people of color has been detrimental, not just physically, but mentally, socially, and economically. Many African American/Black adults have suffered disproportionately during the pandemic. In terms of Social Security more than nine in 10 (93%) older Black Americans report that having adequate Social Security benefits is important, but for the many who were forced to retire early due to the pandemic, they will be at a disadvantage. LGBTQ older adults experience persistent discrimination due to sexual orientation or gender identity. When the LGBTQ individual was African American/Black, experiences of discrimination were higher and often occurred in the workplace. These forms of discrimination are directly impacts ones earning potential both during active work years and in retirement savings. AARP has a long history of being an advocate for marginalized and vulnerable adults. AARP staff will discuss policy needs and what the post pandemic workplaces needs to ensure that older LGBTQ people can thrive in the workplace with dignity and respect. The 2021 AARP’s Vital Voices research will be used to showcase the economic impact the pandemic has had on older adults, African American communities, Hispanic/Latino communities, Asian Pacific Islander communities and LGBTQ communities. AARP staff will discuss strategies and tactics needed to ensure that opportunities for economic recovery for older adults. The survey gathers information to gauge opinions on a range of topics as well as breaking and current issues.
DIRECTIONS UNCLEAR: DEMYSTIFYING AGING AND FINDING OUR FUTURE GERONTOLOGISTS
Authors: Guest Aaron
Published: December 2022

When did you first learn about gerontology? Becoming a gerontologist is rarely at the top of any student’s potential career list. How many of us only found the prospect of a gerontological career in graduate school – or after entering the workforce. We often hear that too few students show interest in jobs working with older persons. In turn, dedicated homes for gerontological degrees are threatened with closure and consolidation. Rather than students being uninterested, I believe the perceived ambiguity of careers and lack of exposure to aging content prevent many from seeking out these careers. In this lecture, I will share my own experience in navigating the ambiguity of a career in aging and how I now use it as a strength to recruit students. I aim to emphasize the unique role of gerontological education and the transdisciplinary approaches and interprofessional strengths that it provides for our aging society.
CHRONIC CONDITIONS DURING THE COVID PANDEMIC: MORTALITY PATTERNS IN THE UNITED STATES
Authors: Kravchenko Julia , Hoque Masudul , Akushevich Igor
Published: December 2022

Patients with chronic diseases, especially the older adults, are at increased risk of death during the COVID pandemic. We analyzed monthly patterns of mortality rates for patients with diabetes, arterial hypertension, cerebrovascular disease, heart failure, and kidney disease using the provisional Multiple Cause of Death data (2018-2022), for age-, gender, and race/ethnicity-specific population groups. Since population is available at annual basis, we used interpolation of population at risk to have the estimates of population at monthly basis. For all studied diseases, there were substantial increases in mortality among patients that peaked in late-Spring 2020 and Winter 2020/2021. Increases of COVID-related deaths were greater in older (aged 65+) than in younger (55-64) patients. For majority of diseases, Black patients predominantly had their maximum/peaks of COVID-related mortality in late-Spring 2020, while White, American Indian, and Hispanic patients had their max in Winter 2020/2021, and Asian patients had both peaks. Additionally to increased COVID-related deaths, higher mortality rates were also observed among patients with above diseases who did not have COVID in their death records. These increases were more pronounced in younger (55-64) than in older (65+) age groups, and they varied by the studied disease. Increased mortality not directly related to COVID could be due to the relocations of medical resources, lower access to medical care (e.g., limited use of telemedicine), non-COVID related complications caused by the earlier COVID infection, undiagnosed and/or unregistered COVID cases in patients with chronic disease, or other causes. Disease-specific differences in mortality patterns were analyzed and discussed.
DELIRIUM SUPERIMPOSED ON DEMENTIA IN POST-ACUTE CARE: NURSE DOCUMENTATION OF SYMPTOMS AND INTERVENTIONS
Authors: Sillner Andrea , Berish Diane , Mailhot Tanya , Sweeder Logan , Fick Donna , Kolanowski Ann
Published: December 2022

Delirium is common in older adults and across settings of care, including post-acute care (PAC). Nurses have an important role in identifying, preventing and managing delirium. Even though best practice guidelines highlight the need to accurately document delirium and to deliver non-pharmacological, nurse-driven interventions, it is unclear how this is done in PAC. The aim of this research was two-fold: 1) to describe how nurses document DSD symptoms in PAC nursing notes and 2) to determine if appropriate non-pharmacological nursing interventions are included in their documentation when DSD is present. The sample (N=281) was drawn from a large, single-blinded randomized controlled trial (Recreational Stimulation For Elders As A Vehicle To Resolve DSD (Reserve-DSD) across 8 facilities. Participants tended to be white, female, and had a high-school education. A total of 115 participants (40.6%) had full delirium per the CAM upon admission to PAC, while the remainder 168 (59.4%) had subsyndromal delirium. All had a baseline of dementia. Symptoms of ‘Confusion or Acute Confusion’ were reported for more than 50% of patients. Approximately 90% of had the symptom ‘Confusion or Acute Confusion’ documented and this was also the most commonly documented symptom for which a nursing-driven intervention was provided. Overall delirium symptoms and interventions were poorly documented by nurses. Implications for future research and practice include understanding how the pandemic and subsequent resource deprivations impacted delirium documentation and intervention in this setting. Also there is a need for expanded nurse and other healthcare provider education.