bluuebunny/crossref_metadata_2025 huggingface dataset:
TARGETING P21CIP1-HIGHLY-EXPRESSING SENESCENT CELLS TO IMPROVE HEALTHSPAN IN PROGEROID MICE
Authors: Wang Binsheng , Wang Lichao , Xu Ming
Published: December 2023

Aging is the leading risk factor for a variety of chronic diseases. Emerging evidence suggests that modulating fundamental aging processes such as cellular senescence may delay the onset of most chronic conditions as a group and increase healthy lifespan. Cellular senescence refers to the essentially irreversible growth arrest that occurs when cells experience stress. One common feature of senescent cells is the high expression level of p16Ink4a and/or p21Cip1. We and others have demonstrated the causal roles of p16Ink4a-highly-expressing (p16high) senescent cells in various age-related conditions. However, the role of p21high senescent cells in aging remains largely unknown. To address these questions, we have generated and validated a novel p21-Cre mouse model containing p21 promoter driving inducible Cre. By crossing with floxed mice, we managed to monitor, sort, image, eliminate, or modulate p21high cells in vivo. We investigated the maximal walking speed and grip strength of klotho (kl)-/- progeroid mice weekly starting from 5 weeks old until death. We showed that clearance of p21high cells can improve physical function in kl-/- mice for a long time period. Additionally, inactivation of NF-κB specifically in p21high cells also can improve tissue function in kl-/- mice. This study will provide invaluable research tools and pinpoint the role of cellular senescence in age-related tissue dysfunction.
TEKIBEN --- DIGITAL DISIMPACTION AT HOME CARE IN JAPAN
Authors: Miyagawa Shoko , Seong Young Ah
Published: December 2023

Though this may not be the case worldwide, in Japan, digital disimpaction (Tekiben in Japanese) is one of the most frequently performed care procedures done by home-visit nurses. This study aimed to clarify the status of digital disimpaction at home care in Japan by interviewing nurses skilled in disimpaction. The interviews were conducted during the process of developing a simulator for digital disimpaction training and were conducted with seven nurses who provide home care. The interviews lasted between 50 and 75 minutes each. The interview data were transcribed, and descriptions of the frequency and target audience for digital disimpaction were extracted. The frequency with which each nurse performed digital disimpaction ranges from 10 to 30 times per month. The clients who require digital disimpaction include those who require the procedure regularly due to conditions such as cerebral infarction or neuropathy, as well those who are in the terminal stages of cancer or other conditions and require the procedure when assessed as necessary. Digital disimpaction techniques are not taught in educational courses at universities or vocational schools but are learned through on-the-job training at hospitals or in-home nursing. The reason for performing routine digital disimpaction is that it is difficult for family members to assist with defecation. The importance of passing stool at the time of digital disimpaction is pointed out, as it is difficult for family members to handle bowel movements in the absence of a nurse.
THE “DOUBLE JEOPARDY” OF MIDLIFE AND OLD AGE MORTALITY TRENDS IN THE UNITED STATES
Authors: Abrams Leah , Mehta Neil , Myrskyla Mikko
Published: December 2023

Since 2010, U.S. life expectancy growth has stagnated. Much research on U.S. mortality has focused on working age adults given adverse trends in drug overdose deaths, other external causes of death, and cardiometabolic deaths in midlife. We show that the adverse mortality trend at retirement ages (65+ years) has in fact been more consequential to the U.S. life expectancy stagnation since 2010, as well as excess deaths and years of life lost in 2019, than adverse mortality trends at working ages. These results reveal that the U.S. is experiencing a “double jeopardy” that is driven by both mid-life and older-age mortality trends, but more so by older-age mortality. Understanding and addressing the causes behind the worsening mortality trend in older ages will be essential to returning to the pace of life expectancy improvements that the U.S. had experienced for decades.
THE ASSOCIATIONS OF HANDGRIP STRENGTH AND ANTHROPOMETRIC MEASUREMENTS WITH UPPER LIMB BODY FAT MASS IN OLDER ADULTS
Authors: Suarez Jethro Raphael , Park Joon-Hyuk , Choudhury Renoa , Stout Jeffrey , Banarjee Chitra , Thiamwong Ladda
Published: December 2023

Body Fat Mass (BFM) is a crucial body composition measurement serving as a predictor for various health conditions and mortality in older adults. However, limited research has been conducted to investigate how upper limb BFM associates with anthropometric measurements and handgrip strength (HGS) in older adults. In this cross-sectional study, 119 older adults, ranging from 60 to 96 years of age (93 women, 26 men; mean age 74.71 ± 7.35 years), were assessed. Body composition was evaluated using the portable Bioelectrical Impedance Analysis (BIA) device, InBody S10, and average HGS was measured on each side using a hand grip dynamometer (JAMAR 5030J1). Multiple linear regression analysis was performed and found a significant, positive association for age (β = 0.048 , p = 0.024), height (β = 0.649, p = 0.024), and BMI (β = 1.371, p < 0.001) with left arm BFM, while weight and left HGS showed a negative association (β = -0.152, p = 0.007; β = -0.070 , p = 0.004, respectively). Similar trends were seen for the right arm. However, height and right HGS became statistically insignificant (β = 0.536, p = 0.069; β = -0.046 , p = 0.054, respectively) for right arm BFM only. These results show that the independent variables may have the ability to predict upper limb BFM in older adults without the need for body composition measurement methods (e.g., BIA). Further research is warranted to examine the true predictive capacity of the independent variables in relation to upper limb BFM.
THE FEASIBILITY OF TAICHI WITH MUSIC FOR HEALTH IN INDIVIDUALS LIVING WITH ADRD AND THEIR CAREGIVERS
Authors: Du Yan , Blackmon Emma , Smith Christina , Robles Cindy , Subramanian Sandeep , Jee Sue , Meyer Kylie , Roberts Penny
Published: December 2023

Caregiving demands associated with cognitive and physical function decline in care recipients (CRs) living with Alzheimer’s disease and related dementias (ADRD) contribute to compromised health and quality of life among ADRD caregivers. In turn, the affected health of caregivers affects the care quality of CR and their health. TaiChi or music is evidenced to be beneficial for the generation population and those with various health conditions. This pilot project assessed the feasibility and preliminary efficacy of an 8-week TaiChi with music (TCM) program on individuals with ADRD (e.g., physical and cognitive function) and their family caregivers (e.g., caregiver distress and quality of life). Outcomes were compared between baseline and post-intervention using paired t-tests. Qualitative interview data exploring the perceptions of participating in TCM program were analyzed using content analysis. Five dyads were enrolled in this study (CR age=77.4±6.8; Caregiver age=62.6±6.7). The overall class attendance rate is 65%. Among the small but diverse sample, adult child care dyads had higher class attendance (93%); spousal care and CR with severe cognitive impairment dyads had lower attendance (46%). Improvements were found in assessed health outcomes for both CR and caregivers, and CR’s physical function significantly improved at 8-week (p=0.016). Qualitative data revealed perceived balance improvements; Caregivers perceived calmness and peace, and expressed their interest in participating in TCM in the future. TCM may be more feasible in ADRD individuals with mild to moderate cognitive impairment. Future research will evaluate the efficacy of this intervention in a larger sample with a longer follow-up period.
THE INFLUENCE OF SPIRITUALITY AND RELIGION ON NURSING HOME SOCIAL WORKERS PROFESSIONAL IDENTITY AND RESILIENCE
Authors: Garrison Brianna , Myers Dennis
Published: December 2023

The complexities of social workers’ behavioral integration of personal spirituality within nursing homes, where a highly regulated, stressful environment marginalizes professional identity and challenges retention, remains largely unexplored and untested. The paucity of data limits the profession’s commitment to resourcing current and future practitioners with evidence-informed integration of spirituality with professional identity, ethical practice, and continuation in the role. This qualitative study addresses this gap by interviewing and analyzing narratives authored by experienced NHSWs who daily navigate the spirituality-at-work opportunity and challenge. Researchers collected a purposive sample of licensed NHSWs working within these settings and consenting to participate. All respondents held a social work license at the baccalaureate or master’s level (LBSW, LMSW, or LCSW) and were employed as a social worker full time for an average of 3.2 years in their current nursing facility and their overall experience in nursing facility social work averaged 8.8 years, with a range of 2 to 30 years’ experience. Twenty NHSWs were interviewed and 80% (n=16) associated their role, at some level, with a higher power (God, Christ, Holy Spirit, unnamed) and religious beliefs and practices. Fifteen percent (n=3) stated faith and religious ideology had no impact or was irrelevant for practice, and one (5%) did not respond. It became clear that religion, spirituality, and faith practices matter for a majority of the respondents in how they view and enact their practice.
THE POTENTIAL OF MULTIDOMAIN MOBILE PROGRAMS IN SUPPORTING COGNITIVE HEALTH OF SENIORS IN RESIDENTIAL FACILITIES
Authors: Kim Junhyoung , Kim Yongseop , Cho Jeff , Ko Myungjin , Ory Marcia
Published: December 2023

This study pilot tested the efficacy of a mobile-based multidomain application, Silvia Program, on cognitive functioning of residents in assisted living facilities (ALFs). After a 12-week randomized pilot trial using a two-group pretest-posttest design (Silvia group vs. usual care group), we assessed the cognitive functioning using the Montreal Cognitive Assessment (MoCA). Results are that the total MoCA scores of the Silvia group showed significant improvement while the total scores of the control group declined. The present study provides suggestive evidence for an overall positive effect of the use of the Silvia Program on the cognitive functioning among residents in ALFs.
THE RELATIONSHIP BETWEEN ALLOSTATIC LOAD AND PROGRESS OF MULTIMORBIDITY AMONG OLDER AMERICANS
Authors: Mira Rolla Saud
Published: December 2023

To examine the relationship between allostatic load and progress of multimorbidity over 10 years among older Americans and whether it mediates socioeconomic inequalities in multimorbidity.

Methods Six Waves of Health and Retirement Study (HRS), a longitudinal survey of older American adults from 2006 -2016. Multimorbidity was indicated by 5 chronic conditions: diabetes, heart conditions, lung diseases, cancer, and stroke. Socioeconomic factors were education, total wealth, poverty-income ratio (income), and race/ethnicity. Behavioural factors were smoking, excessive alcohol consumption, physical activity, and body mass index (BMI). Allostatic load was used as a biomarker of stress and was indicated by a combination of total cholesterol, high-density lipoprotein, glycosylated hemoglobin, c-reactive protein, waist circumference, and high blood pressure. Two Multilevel mixed effects generalized linear models were constructed to assess the association between allostatic load and progress of multimorbidity and whether allostatic load explained socioeconomic inequalities in the progress of multimorbidity. All variables included in the analysis were time-varying except gender, race/ethnicity, and education.

Results Allostatic load was significantly associated with the progress of multimorbidity even after adjusting for socioeconomic and behavioural factors with a rate ratio (RR) of 1.12 (95%CI: 1.11, 1.13). The association between socioeconomic factors and multimorbidity was slightly attenuated after adjusting for allostatic load. Socioeconomic factors were also associated with changes in allostatic load.

Conclusion Biological markers of stress indicated by allostatic load were associated with the progress of multimorbidity. Allostatic load appears to be induced by adverse socioeconomic factors and mediates the relationship between socioeconomic factors and progress of multimorbidity.
THE ROLE OF SENSE OF PURPOSE IN HEALTH NAVIGATION AMONG MARGINALIZED OLDER ADULTS
Authors: Narine Ameesha , Mroz Emily , Sharma Shubam
Published: December 2023

A sense of purpose is a central, self-organizing life aim that guides choices and behaviors . In older adulthood, having a sense of purpose is linked with positive health. Understanding how older adults who identify as socially marginalized (e.g., racially/ ethnically diverse, LGBTQ+) leverage purpose to navigate their health, for example, when setting health values, making health decision, or adapting to health challenges may support development of tailored resources to combat social disparities embedded in healthcare systems.. This study used qualitative thematic analysis (Braun & Clarke, 2012). to explore the role of purpose in marginalized older adults’ current health navigation and including how purpose and health navigation change across adulthood. Nineteen older men and women who identified as socially marginalized (Mage = 66.5) participated in semi-structured interviews Analyses revealed that older adults draw on purpose to guide health by maintaining personally meaningful, health-related (e.g., health education, caregiving) vocations into late life and by modeling positive health behaviors for others . Further, the role of purpose in health navigation changed across their adulthoods: participants described shifts from adversity-driven purpose to wellness-focused purpose, translating early adversity into current health motivation, and finding space for their authentic purpose when health was considered to stabilize. Findings demonstrate that, for marginalize older adults, their relationship with their own health may improve across the lifespan as they overcome adversity and health becomes enmeshed in purpose. Findings support refining health interventions to account for the role of purpose for older adults who have faced undue social hardship.
THE SOCIAL RELATIONSHIP OF OLD ADULTS ACCORDING TO THE USE OF ASSISTIVE APPLIANCES IN SOUTH KOREA.
Authors: Yoon Yeojin
Published: December 2023

This study aims to examine the differences in the social relationship of the old adults between the use of assistive appliances. For the analysis, the data were obtained from “2020 National Data on the Elderly” published by the Ministry of Health and Welfare and the Korea Institute for Health and Social Affair. Data was a survey of people aged 65 and older conducted between June and August 2020, which included data from 10,097 people. The variables used for the use of assistive appliances were vision aids, hearing aids, chewing aids. The variables used to measure older adults’ social relationship resource are the frequency of visits and contact with non-resident children, grandchildren and children with whom they have the most contact, and the frequency of visits and contact with relatives, friends, neighbors, and acquaintances. The analysis used multiple regression analysis and t-test for comparison of means between groups, and the main findings were as follows. First, there is no statistical correlation between assistive appliances use and older adults’ social relationships. Second, there is no significant difference in the mean of the social relationships of older adults with and without assistive appliances use. In this paper, we overlooked the ease with which the elderly can use assistive appliances with support if they have functional difficulties. These findings confirm that there is no direct relationship between the use of assistive appliances and the social relationships of older adults, and suggest the need for further research on the social relationships of older adults.
TRIALS AND TRIBULATIONS OF CONDUCTING A GEROSCIENCE TRIAL
Authors: Millar Courtney , Baldyga Kathryn , Iloputaife Ikechukwu , Wolfe Alex , Kuo Jasmin , Lipsitz Lewis
Published: December 2023

Emerging trials of geroscience interventions show great promise in preventing age-related diseases and disabilities. However, there are many challenges that need to be considered when conducting such trials. Our objective is to describe the major challenges when conducting a geroscience intervention, utilizing the STAMINA study as an example. The STAMINA (Senolytics To Alleviate Mobility Issues and Neurological Impairments in Aging) study is a single-arm geroscience-motivated pilot study in which 12 older adults with mild cognitive impairment and slow gait speed are asked to take 12 doses of two senolytic agents (Quercetin and Dasatinib) over 12 weeks. Study challenges were identified and recorded by the study team and categorized into 3 groups: Regulatory, Recruitment, and Unexpected. This is a descriptive analysis and no formal statistical tests were conducted. Eleven major challenges were identified. The Regulatory Challenges included obtaining the IND from the FDA, hiring a clinical research organization (CRO) to monitor compliance with FDA regulations, and establishing FDA compliant data management tools and procedures. The Recruitment Challenges include drug-drug interactions, comorbidities, need for transportation to and from study visits, and fear of drug side effects. Unexpected Challenges included exorbitant drug costs (Dasatinib costs $500 per dose); requirements for drug storage, dispensing, and destruction; multiple safety lab tests; transportation; biomarker processing, transport, and assays; equipment failure; and intercurrent vaccinations and medicines (e.g., COVID-19 and flu vaccines) which may impact biomarker levels. Conducting a geroscience trial has numerous challenges that need to be considered when developing a budget, hiring staff, and assuring compliance.
TRYPTOPHAN: A POTENTIAL BIOMARKER DISTINGUISHING CHRONIC VENOUS LEG ULCERS HEALING IN OLDER ADULTS
Authors: Kim Jung Lyun , Stechmiller Joyce , Weaver Michael , Lyon Debra , Garrett Timothy , Kelly Debra
Published: December 2023

Chronic venous leg ulcers (CVLUs) affect 2 million persons annually, including 4% of people over age 65 years. Chronic wound healing is a complex process that is still not well understood. Indoleamine 2,3-dioxygenase (IDO) activity is highly active in chronic wounds. The study aims to examine the tryptophan (TRP) L-Kynurenine (KYN) metabolic pathway as a biomarker of CVLUs healing. We collected 60 serum samples from 30 older adult patients with CVLUs receiving weekly sharp debridement at a university wound clinic. Serum samples were collected at baseline, week 4, and week 8 until wound closure. Liquid chromatography-mass spectrometry (LC-MS) metabolomics was utilized to examine targeted metabolites. A robust Bayesian approach was employed to examine correlations between change of metabolites and linear healing slope. The mean age was 71.13 (±9.46); 25 (83.3%) were white; the mean wound area was 2823.54 (±6002.93) mm2; the mean wound duration was 341.67 (±538.29) days. A total of 11 participants had healed wounds during the study period. Those with healing CVLUs had higher levels of mean TRP at baseline and over time compared to individuals with non-healing CVLUs. Change in Kynurenic Acid (r:-0.36, Bayes factor: 3.70, 95% Credibility Interval [-0.62, -0.06]) was associated with a linear healing slope. Serum tryptophan may serve as a candidate biomarker for predicting wound healing trajectories, which can guide clinicians in making treatment decisions. Specifically, decreasing metabolites associated with the downstream activity of the kynurenine pathway, a pathway for tryptophan metabolism may be an indicator of healing under sharp debridement in CVLUs.
WHERE IS THE DIGITAL DIVIDE? INTRA-GENERATIONAL DIVIDE ON APP USAGE IN POST-PANDEMIC HONG KONG
Authors: Lau Bobo Hi-po , Shum Eric Ngai Yin , Lui Fan Yin-Fong , Lam Gigi , Kwok Alex Pak-Ki , Tsang Chung-Kin
Published: December 2023

The COVID pandemic has evoked extensive digitalization of our daily lives. This paper reports two studies conducted in the June/July 2023 that evaluated smartphone usage among Hong Kong middle-aged and older adults after 13 months of smartphone-based compulsory track-and-trace COVID policy. A focus group study with 145 adults aged 55 years or above (Max = 92) found that smartphones are used primarily for instant but asynchronous communication, thus, WhatsApp and WeChat are the most popular. Divisive usage is the most salient with apps that involve monetary transactions (e.g., mobile banking, online shopping) with participants having more trust towards the security provided by the device, the network, and the financial institutions as well as higher socio-economic status (SES) being more receptive. Higher SES was also related to a broader repertoire of app use. These findings corroborate with those from a concurrent survey with 750 smartphone users aged 45 or older (Max = 78). Using latent class analysis, we found two classes of users based on their usage on 18 categories of apps. Class 1 (64.3%) were more likely to use all categories of apps than Class 2 (35.7%), with the largest Chi-square values reported on apps for small-sum transactions, online shopping, private hire cab/courier, and mobile banking – all related to monetary transactions. Class 1 were younger, with higher SES, owning more smart devices, more proficient with mobile devices, and more optimistic with technologies than Class 2. Our findings elucidate directions for narrowing the digital divide within the older adult population.
MOBILE-BASED COGNITIVE TRAINING IN CHINESE AMERICANS: PERSPECTIVES FROM OLDER ADULTS AND ADULT CHILDREN
Authors: Xue Tingzhong (Michelle) , McConnell Eleanor , Wu Bei , Xu Hanzhang
Published: December 2023

The population of older Chinese Americans is growing rapidly. However, their access to culturally responsive dementia prevention services is very limited. Cognitive training may delay cognitive decline in older adults, but such training has not been widely accessible to older Chinese Americans. This study explored perspectives of older Chinese Americans and their adult children on dementia prevention and cognitive stimulating activities to inform co-design of a culturally appropriate, mobile-based cognitive training for this population. We conducted five focus groups in Mandarin using Zoom video conferencing, with four groups of older Chinese Americans (n=21) and one group of adult children (n=6). We applied rapid qualitative analysis, guided by the Health Belief Model. We identified seven themes. Overall, participants had modest knowledge of dementia, and viewed health care professionals as credible information sources for dementia prevention. Some participants thought any social activity would provide cognitive stimulation. Both older adults and adult children expressed strong interest in cognitive training but were concerned about losing interest over time and transportation and language barriers. Both groups noticed similar advantages (e.g. benefits for cognition, interesting exercises), and disadvantages (e.g. eyestrain, addiction) of mobile-based cognitive training but had different perspectives on acquiring health information online. Adult children were eager to provide support for older adults to participate in cognitive training, whereas older adults preferred to engage in cognitive training autonomously. Knowledge generated from this study forms the foundation for designing of a tailored mobile-based intervention to prevent cognitive decline among older Chinese Americans.
NOT ALL CREATED EQUAL: THE IMPACTS OF POSITIVE, NEGATIVE, AND PARTNER RELATIONSHIPS ON COGNITION IN LATELIFE
Authors: Ee Nicole , Matthews Fiona , Peters Ruth , Anstey Kaarin
Published: December 2023

Background

Social engagement has been linked to higher cognitive function in later life and it is a well evidenced protective factor against dementia and cognitive decline. However, far less is understood about how the type, quality and quantity of social engagement differentially affects cognitive health outcomes in older adults.

Methods

The sample consisted of 1972 participants aged 68-74 (M = 70.60, SD = 1.49) from a large population-based study in Australia, Personality and Total Health Through Life (PATH). The constructs underlying nine observed measures of social engagement were first identified through exploratory and confirmatory factor analysis (CFA). A Latent Variable Path Model (LVPA) was then employed to examine the relationships between positive, negative and partner social engagement on memory and executive function, as measured by six validated cognitive tests.

Results

The CFA identified partner relationship as a distinct social engagement construct, separate to positive and negative relationships. The main analysis demonstrated that negative relationships and partner relationship were positively associated with better memory and executive function, with the former twice the strength of the latter.

Discussion

These findings provide support that more frequent social interactions and larger support structures contribute to better cognitive function in later life, with partner relationship making a significant and distinct contribution. Positive or high-quality social engagement, however, appears to be a less critical factor in bolstering cognitive health. Close and cognitively demanding relationships may promote cognitive health via frequent cognitive stimulation, but more research is required to confirm the mechanisms underpinning observed effects.
VISION IMPAIRMENT AND COGNITION IN INDIA: ASSOCIATIONS AFTER ADJUSTMENT FOR POTENTIAL BIAS
Authors: Nichols Emma , Chen Yizhou , Hazzouri Adina Zeki Al , Gross Alden , Nagarajan Niranjani , Lee Jinkook , Ehrlich Joshua
Published: December 2023

Increasing evidence suggests that vision impairment may be an important modifiable risk factor for dementia, particularly in low- and middle-income settings where the prevalence of uncorrected vision impairment is high. Although prior studies in various settings, including India, have found strong associations between vision impairment and cognition, this work has not considered potential bias in cognitive testing due to vision impairment. We evaluated and adjusted for measurement differences by vision impairment status using data from the Longitudinal Aging Study in India–Diagnostic Assessment of Dementia (LASI-DAD) study (N=3780). We used Multiple Indicators Multiple Causes models to assess differential item functioning (DIF) (e.g. bias) in cognitive testing by objective near and distance vision impairment. We estimated associations between vision impairment and cognition adjusting for hypothesized confounders before and after DIF adjustment. Although there was statistical evidence of DIF (near vision: 3/10 items, distance vision: 4/10 items), differences between DIF-unadjusted and -adjusted scores were small compared to the standard error of measurement, indicating no evidence of clinically meaningful measurement differences. Both near and distance vision impairment were associated with cognition before and after DIF-adjustment; after DIF-adjustment, severe near and distance vision impairment were associated with -0.43 [95% CI -0.53--0.33] and -0.60 [-0.76--0.43] standard deviation units lower cognitive scores compared to those with normal vision, respectively. In well-conducted large-scale surveys, bias in cognitive testing due to vision impairment is likely minimal, even in low- and middle-income settings. Findings strengthen the evidence base on vision impairment as a risk factor for dementia.
OLDER ADULTS’ PERSPECTIVES ON USING TECHNOLOGY TO ASSESS SOCIAL ISOLATION AT THE ONSET OF COVID-19
Authors: Nanthakumar Jarshini , Patel Karishma , Aratia Shahrose , Thakkar Priyanka , Wang Rosalie , Khan Shehroz
Published: December 2023

Social isolation (SI) among older adults (OA) is a global health issue that was exacerbated by the pandemic. This study examines OA’s perspectives on technology use (i.e., home-based ambient sensor or wearable technology) to assess SI, with consideration of understanding these perspectives in relation to the pandemic. Two questions were examined: (i) How familiar are OA with technology that can be used to assess SI? and (ii) Are OA agreeable to using technology to assess SI? Online surveys (n=4379) and semi-structured interviews were completed by community-dwelling OA at the onset of COVID-19. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using content analysis. From survey responses, 16.79% indicated they would be agreeable to using technology to assess SI, whereas 40.37% and 42.83% indicated no and maybe/not sure, respectively. Although most participants were familiar with some technologies that could be used as part of an SI assessment tool, interviews suggested they were unfamiliar with this application of technologies. Preliminary analysis of the interviews (n=31) revealed three broad categories addressing the research questions: (1) perceived barriers to sensor-based technology adoption, (2) user experience and acceptance, and (3) changing social norms. Our study is one of the first to examine the views of OA regarding familiarity and openness to technology use for SI assessment that emerged with COVID-19. Technology developers and healthcare providers need to address ethical concerns around sensor-based technology use and increase opportunities to improve OA’s digital literacy and accessibility to support technology acceptance for SI assessment.
INVESTIGATING THE RELATIONSHIP BETWEEN HABITUAL ACTIVITY AND COGNITIVE DOMAINS AMONG PEOPLE LIVING WITH DEMENTIA
Authors: Pottayil Faheem , Dong Yanbin , Zhu Haidong , Sams Richard , Young Lufei , Jehu Deborah
Published: December 2023

Habitual activity preserves cognitive function in people without dementia, but the relationship between habitual activity and cognitive domains among people living with dementia is unclear. The purpose of this study was to explore the association between habitual activity and cognition domains among people living with dementia. Participants living with dementia in residential care facilities (complete case analysis: n=24/42) completed a battery of cognitive tests (global cognition: Montreal Cognitive Assessment; executive function: Trail-Making Test, Digit Span Forward Test; perception and orientation: Benton Judgement of Line Orientation Test; language: Boston Naming Test; learning and memory: Rey Auditory Verbal Learning Test; complex attention: Digit Symbol Substitution Test). Participants wore an actigraphy monitor on their non-dominant wrist over seven days. We conducted a linear regression for total habitual activity (independent variable) with race (white/black), fall risk (Morse Fall Scale), and the number of comorbidities (Functional Comorbidities Index) as covariates, and cognitive tests as variables of interest. Participants were primarily male (75%), white (87.5%), and 50% had unspecified dementia (Alzheimer’s disease: 33%). Greater habitual activity was associated with poorer global cognition, better executive function, and better learning and memory (ps< 0.05). Habitual activity was not related to visuospatial perception, language, or complex attention. Habitual activity may preserve executive function and learning and memory among people living with dementia. Wandering is more common in later stages of dementia, which may explain greater habitual activity observed with lower global cognition. Regularly assessing habitual activity may be useful in screening and monitoring cognitive changes.
PSYCHOSOCIAL WELL-BEING AND COGNITION AMONG OLDER ADULTS IN A LATE LIFE LEARNING PROGRAM IN LEBANON
Authors: Lu Peiyi , Elbejjani Martine , Chehabeddine Lara , Arabi Hana , Chahine Maya Abi , Kezios Katrina , Hazzouri Adina Zeki Al , Sibai Abla
Published: December 2023

Growing evidence suggests that engaging in cognitively stimulating activities across the lifecourse is associated with improved health. However, very few studies have evaluated the benefits of late life learning (LLL), especially in the low- and middle-income country setting. We designed a prospective cohort study to evaluate whether LLL is associated with better cognition among older Lebanese and related underlying mechanism. The University for Seniors (UfS) is an established and ongoing LLL program at the American University of Beirut, since 2012, providing cognitively and socially enriching activities (e.g., lectures, study groups, social and cultural events) to older adults, aged 50 and above. Our study will select 700 members (both previous longer-term members and new enrollees) and recruit a comparison group composed of 700 age-, sex-, and education-matched non-UfS-participating community residents. Participants will be interviewed on various topics at baseline and at a two-year follow-up visit. Older Lebanese are exposed to a host of lifecourse psychosocial adversities. We developed a questionnaire to capture their life history such as war-related exposures and economic changes due to recent financial crises. We will also measure participants’ psychological well-being including social network and support, ageism, resilience, hopelessness, loneliness. The challenges of adapting psychosocial scales and capturing lifecourse collective and individual adversities in a particularly burdened low-resourced settings and contextual complexity will be presented. With comprehensive data on LLL and lifecourse adversities, we will be able to examine the potential for scalable low-cost LLL programs to mitigate the impacts of earlier and accumulated psychosocial adversities on cognition.
USE OF CHRONIC CARE MANAGEMENT SERVICE AMONG MEDICARE BENEFICIARIES IN 2015-2019
Authors: Jang Jieun , Kim Dae Hyun
Published: December 2023

The Centers for Medicare and Medicaid Services (CMS) introduced Chronic Care Management (CCM) services in 2015 for patients with multiple chronic diseases. Few studies examined the use of CCM services by demographic, geographic, and clinical characteristics. We used 2014-2019 Medicare claims data from a 5% random sample of fee-for-service beneficiaries aged 65 years or over and enrolled Medicare Part B. Of the approximately 1.4 million beneficiaries annually, approximately 75% were potentially eligible beneficiaries of CCM services who had been diagnosed with two or more chronic conditions before the year (2015: 1,073,729; 2016: 1,094,277; 2017: 1,106,929; 2018: 1,118,386; 2019: 1,130,523). The primary outcome was the rate of patients receiving CCM services among potentially eligible beneficiaries using CPT codes 99490, 99491, and 99487 in each year. Among the potentially eligible beneficiaries, the rate of patients receiving CCM services increased from 1.1% in 2015 to 3.4% in 2019 (2015: 11,480; 2016: 22,154; 2017: 31,890; 2018: 37,341; 2019: 38,863). CCM use was concentrated in the South (2015: Georgia: 1.4%; Vermont: 0.1%; 2019: Georgia: 6.1%; Vermont: 0.1%). The increase was higher in beneficiaries with ten or more chronic diseases than in those with two to five chronic diseases (2015: 2-5 chronic diseases: 0.7%; 10 + chronic diseases 2.0%; 2019: 2-5 chronic diseases: 2.1%; 10 chronic diseases: 7.0%), and higher in severely frail beneficiaries than in robust beneficiaries (2015: robust: 0.6%; severely frail: 3.3%; 2019: robust: 1.9%; severely frail: 9.4%). Variations were observed in the utilization of CCM services across demographic, geographic, and clinical characteristics.
SOCIAL DETERMINANTS OF BRIDGE EMPLOYMENT: DO BIRTH COHORTS MATTER?
Authors: Choi Gayoung , Lee Haena
Published: December 2023

A growing number of retirees now engage in bridge employment, a term referring to their continued participation in the workforce post-retirement. The generation in South Korea born between 1945 and 1955, a period marked by leading industrialization and experiencing economic crises during their working age, exhibits unique socioeconomic characteristics distinct from later generations. Consequently, their retirement trajectories diverge significantly from those of later cohorts, including the Baby Boomer generation (born between 1956 and 1965). In this paper, we investigate whether social, demographic, psychological, and health factors are associated with bridge employment and whether this association differs across birth cohorts. Data were drawn from seven waves of the Korean Longitudinal Study of Aging, conducted between 2008 and 2020. We employ an integrative framework that considers socioeconomic status, health status, and psychological factors as the main variables to explain the odds of continuing to work after retirement. Retirement status includes three categories: employed, bridge, and total retirement. Results from a multinomial logit model reveal birth cohort differences in the relationship between social/psychological predictors and bridge employment. Additionally, higher educational attainment, a private pension, and poor mental health are associated with decisions regarding bridge employment for the industrialization generation, but not for Baby Boomers. Furthermore, females are more likely to participate in bridge employment than males for the industrialization generation, but not for Baby Boomers. Our findings contribute to the current literature on bridge employment by identifying the social determinants of bridge employment and highlighting the importance of cohort differences in bridge employment.
FACTORS ASSOCIATED WITH A FOUR-YEAR SARCOPENIA TRANSITION IN CHINESE OLDER ADULTS
Authors: Lin Shujing , He Lingxiao , Yang Jinzhu , Fang Ya
Published: December 2023

Background

Previous studies have reported a dynamic change of sarcopenia status while factors associated with such status changes remained unexplored. This study aimed to identify factors associated with sarcopenia status transitions based on Chinese older adults.

Methods

6065 older adults (aged 66.8±6.2) with complete data at baseline and at least one follow-up (2 years) were included from the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia was determined based on AWGS2019 criteria. Multistage Markov model was used to explore potential sociodemographic, behavioral, psychological and disease-related factors associated with sarcopenia transitions.

Results

At baseline, 59.1% of participants were non-sarcopenic, 24.7% had probable sarcopenia and 16.2% were diagnosed with sarcopenia. Participants with non-probable sarcopenia had 1-year transition probability of developing probable sarcopenia (0.101) or sarcopenia (0.056). Overweight (HR=1.89, 95%CI: 1.55-2.30), obesity (HR=1.85, 95%CI:1.37-2.48) and presence of chronic diseases (HR=1.26, 95%CI: 1.03-1.56) increased the risk of progression from non-sarcopenia to probable sarcopenia. Older age (HR=1.10, 95%CI:1.08-1.13), female sex (HR=1.38, 95%CI: 1.08-1.75), shorter sleep duration (HR=1.42, 95%CI:1.12-1.80), depression (HR=1.27, 95%CI:1.01-1.59) and presence of chronic diseases (HR=1.35, 95%CI: 1.05-1.74) were associated with transition towards sarcopenia from non-sarcopenia. Higher cognitive function (HR=1.03, 95CI:1.01-1.05), rural dwelling(HR=1.25, 95%CI: 1.00-1.55) and alcohol consumption (HR=1.41, 95%CI:1.15-1.73) were associated with reversed status from probable sarcopenia to non-sarcopenia. Higher cognitive function increased the conversion from sarcopenia to probable sarcopenia (HR=1.21, 95%CI:1.06-1.37) and non-sarcopenia (HR=1.03, 95%CI:1.00-1.06) .

Conclusions

Sarcopenia is a dynamic condition in older adults. Possible interventions should focus on improving cognitive functions, sleep quality and better controlling on chronic conditions.
RCT OF A BEHAVIORAL, TELEHEALTH WELLNESS PROMOTION PROGRAM FOR MIDDLE-AGED ADULTS WITH DISABILITIES
Authors: Molton Ivan , Rivera Donovan , Singsank Katie , Flaster Aaron , Munroe Leah , Humbert Andrew
Published: December 2023

For people aging with physical disabilities, there is a striking need for evidence-based approaches to promote positive health behaviors and to support active community participation. This is especially true in midlife, which is a period of significant health and social vulnerability for this population. This study describes a 3-arm, randomized controlled trial of a telehealth, motivational-interviewing based health promotion program (EnhanceWellness, EW) adapted for people with physical disability. 505 individuals with long-term physical disability were randomized to 8 sessions of individual EW coaching over 6 months, or to one of two control conditions (health education or treatment as usual). Primary outcomes included self-report of ability to participate in social activities, satisfaction with community participation, and mood, using validated NIH PROMIS scales. Participants completed assessments before randomization, at 7 and 12 months post-randomization. Statistical analysis included linear mixed-effects modeling with random intercepts. Participants were on average 56 years old (SD=5.6), were mostly women (77%) and had lived with a medical condition causing ADL impairment (disability) for an average of 23 years. Results demonstrated significant group by time interaction terms (p’s < .01), underlying statistically significant improvements in the EW group in both ability to participate and satisfaction with community participation, relative to either control condition. These changes tended to increase or maintain over time. There were no significant intervention effects on mental health outcomes. Results emphasize the applicability of individualized health behavior change coaching in supporting community participation among adults aging with disability.
UNDERSTANDING OLDER ADULTS’ MOTIVATIONS TO ADOPT DIGITAL HEALTH PORTALS
Authors: Trinh Mimi , Hattakitjamroen Varitnan , Rogers Wendy
Published: December 2023

Older adults are likely to develop chronic illnesses (e.g., hypertension or high cholesterol), resulting in the need to manage their symptoms. Self-management often involves tracking symptoms, medication taking, nutrition, or exercise. Digital health portals (DHPs) have the potential to fulfill these tracking needs by viewing records of symptoms, doctor’s notes relating to diet or exercise, and reviewing medication regimens. However, DHPs are often not used to their full potential. The goal of this study was to understand what motivates older adults to utilize their DHPs, and what features are needed for health self-management. We conducted a qualitative study consisting of surveys and semi-structured interviews to elicit the thoughts of 26 older participants. Following Self Determination Theory and Unified Theory of Acceptance and Use of Technology Integrated Model, we organized their responses into motivation factors of autonomy, competence, and relatedness as well as facilitators such as perceived usefulness, perceived ease of use, social influence, and facilitating conditions. Using this integrated analysis approach, we identified themes related to health portal experience, motivation, barriers and facilitators, health provider support, and ideal design. These themes provide insights into how the DHPs were used and perceived; why older adults use DHPs; and their overall positive experiences using them. The participants generally found the DHPs to be convenient due to features related to self-management. They also shared their core needs and what could be improved for a better and easier experience. The Integrated Model helps in understanding the foundation needed to motivate the acceptance of DHPs.
A pharmacy-led sore throat test and treat (STTT) service: antigen testing and antibiotic supply rates during the period of heightened public awareness of Group A Streptococcus infections
Authors: Mantzourani Efi , Ahmed Haroon , Evans Andrew , Gunnarsson Ronny , Cannings-John Rebecca
Published: December 2023

Background

Community pharmacies in Wales delivered an NHS-funded sore throat test and treat (STTT) service during the period of increased invasive Group A Streptococcus (iGAS) incidents in winter 2022–23. Service users were screened using FeverPAIN/CENTOR scores, offered GAS rapid antigen detection tests (RADT) if appropriate, and antibiotics if indicated.

Objectives

To evaluate the service’s response to a substantial rise in sore throat presentations during a period of heightened public anxiety.

Methods

Cross-sectional study with anonymized individual-level data from electronic pharmacy records of all eligible STTT service users, between January 2022 and March 2023.

Results

Antibiotics were supplied to 24% (95% CI: 23–24) of people who used the STTT service and 31% (95% CI: 31–32) of those who met the threshold for an RADT. Of 27 441 STTT consultations, 9308 (33.9%) occurred during December 2022. In the week commencing 2 December 2022, following the announcements of increased iGAS incidents, we observed a statistically significant increase of 1700 consultations (95% CI: 924–2476) and a statistically significant decrease in supply rate of 13.9 antibiotics per 100 RADT (95% CI: −18.40 to −9.40). Antibiotic supply rates increased thereafter to those observed before the announcements of iGAS incidents. Referral rates to other primary care or emergency settings remained below 10% throughout the study period.

Conclusions

Our findings suggest that, despite a dramatic increase in sore throat consultation rates in response to media reports, the pre-specified pathway followed by pharmacists ensured appropriate use of antibiotics, and absorbed a substantial workload that would otherwise end up in other healthcare settings.
Technical note: ShinyAnimalCV: open-source cloud-based web application for object detection, segmentation, and three-dimensional visualization of animals using computer vision
Authors: Wang Jin , Hu Yu , Xiang Lirong , Morota Gota , Brooks Samantha A , Wickens Carissa L , Miller-Cushon Emily K , Yu Haipeng
Published: December 2023

Computer vision (CV), a non-intrusive and cost-effective technology, has furthered the development of precision livestock farming by enabling optimized decision-making through timely and individualized animal care. The availability of affordable two- and three-dimensional camera sensors, combined with various machine learning and deep learning algorithms, has provided a valuable opportunity to improve livestock production systems. However, despite the availability of various CV tools in the public domain, applying these tools to animal data can be challenging, often requiring users to have programming and data analysis skills, as well as access to computing resources. Moreover, the rapid expansion of precision livestock farming is creating a growing need to educate and train animal science students in CV. This presents educators with the challenge of efficiently demonstrating the complex algorithms involved in CV. Thus, the objective of this study was to develop ShinyAnimalCV, an open-source cloud-based web application designed to facilitate CV teaching in animal science. This application provides a user-friendly interface for performing CV tasks, including object segmentation, detection, three-dimensional surface visualization, and extraction of two- and three-dimensional morphological features. Nine pre-trained CV models using top-view animal data are included in the application. ShinyAnimalCV has been deployed online using cloud computing platforms. The source code of ShinyAnimalCV is available on GitHub, along with detailed documentation on training CV models using custom data and deploying ShinyAnimalCV locally to allow users to fully leverage the capabilities of the application. ShinyAnimalCV can help to support the teaching of CV, thereby laying the groundwork to promote the adoption of CV in the animal science community.