bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECTS OF AN AGE SUIT SIMULATION ON NURSING STUDENTS’ PERSPECTIVES ON PROVIDING CARE TO OLDER PERSONS
Authors: Hallgren Jenny , Stjernetun Björn Bouwmeester , Gillsjö (Gillsjo) Catharina
Published: December 2023

Background

Nursing students are important future health care providers to the growing number of older persons in society. However, two barriers are their common ageist attitudes and lack of interest in geriatrics. This is a concern in light of the global demand for more nurses. Method: This study investigated the effects of ageing simulation with an age suit as a part of experiential learning in a nursing programme among 471 nursing students. The simulation allowed the students to experience specific and common health problems from the patient’s point of view in a controlled environment and a relevant context of care provision for future nurses: a home with welfare technology and other aids. The learning process involves a continuous cycle of doing and reflecting resulting in knowledge that also becomes “ingrained” in the body of the learner. Data on the Perspectives on Caring for Older Patients – Short Form (PCOP-SF) scale were collected using a quasi-experimental pretest–posttest design with a control group.

Results

The results showed that the intervention had a positive effect on various aspects of nursing students’ perspectives on caring for older persons. Work experience was associated with more positive attitudes. The control group was more negative towards geriatrics as a career choice than the intervention group.

Conclusion

Age suit simulation can be an innovative intervention in nurse education as it raises awareness and understanding of aging and the health challenges of older persons, which are important in combatting ageism among future nurses.
ORAL HEALTH: THE MOST UNMET HEALTH CARE NEED FOR MEDICALLY VULNERABLE ELDERLY WITH OR WITHOUT DEMENTIA
Authors: Tabrizi maryam , Lee Wei-Chen
Published: December 2023

Individuals aged 65 and older are living longer with multiple chronic conditions, leading to a larger population of medically vulnerable elderly with or without dementia. Consequently, only an interdisciplinary health system can meet the comprehensive health needs for older adults. Historically, Oral Health (OH) is the most unmet need in healthcare, particularly in older adults. This is due to several barriers including Interprofessional Education (IPE) and Interprofessional Collaboration (IPC). Therefore, there is a growing gap between OH and overall health. We conducted two studies in the past 4 years. The first study included pre-doctorate healthcare students (Medical, Nursing, Dental and Pharmacy) evaluating their IPE during their educational training and the influence of their education later as practitioners. The result of this study revealed an unsatisfactory IPE that would lead to minimum or no interdisciplinary collaboration. The second study (2019 to 2022) included dental residents in a one year post graduate program “Advanced Education in General Dentistry” (AEGD). In each year we collected a survey at the beginning of the residency program asking the level of comfort treating medically vulnerable elderly as a provider in a health team. We then exposed them to a comprehensive geriatric oral health both didactics and clinical skills. The same survey was again conducted at the end of the residency. The study revealed adequate training increased the level of residents’ ability to provide care within a health team. Interdisciplinary health services require interdisciplinary educational training to close the gap between oral health and overall health.
SPOUSAL MULTIMORBIDITY AND DEPRESSIVE SYMPTOMS AMONG OLDER INDIAN COUPLES: DOES ONE’S OWN HEALTH AND GENDER MATTER?
Authors: Ko Soohyeon , Kim Rockli
Published: December 2023

With the aging population, increases in non-communicable diseases that require chronic management pose economic and social burdens to individuals with multimorbid conditions and their spousal caregivers. However, little is known about the crossover effect of spousal multimorbidity on mental health outcomes in the context of low-and middle-income countries, and whether it depends on one’s own health status and gender. We used data on 6,158 older couples (12,316 individuals aged 60 years or above) from the Longitudinal Aging Study in India (LASI) 2017-18 to examine the association between spousal multimorbidity and depressive symptoms. Overall, 23.4% of the sample were multimorbid and 27.0% reported having depressive symptoms in the past week. Multivariate logistic regression models showed that spousal multimorbidity was associated with depressive symptoms, even after accounting for one’s own multimorbidity status (adjusted odds ratio(aOR)=1.23; 95% confidence interval (CI)=1.06-1.44). However, this association was gender-specific. Among men, when jointly considered, spousal multimorbidity was no longer statistically significant whereas their own multimorbidity was associated with 60% higher odds of having depressive symptoms (aOR=1.60; 95% CI=1.28-2.00). Furthermore, the association between spousal multimorbidity and depressive symptoms was contingent upon the presence of their own multimorbidity for men. Among women, spousal multimorbidity was significantly associated with depressive symptoms, regardless of their own multimorbidity status. Our findings indicate that interventions to promote healthy aging should expand the formal caregiving system and consider family-based approaches to minimize the crossover health consequences of morbidity in conjugal relationships, especially for women.
DEPRESSION AMONG OLDER ADULTS WITH ACUTE CORONARY SYNDROME ASKING FOR EMERGENCY HELP
Authors: Hayajneh Audai
Published: December 2023

Acute coronary syndrome (ACS) has been associated with urgent cardiac symptoms, which require an emergent medical care by the healthcare providers (HCPs), including nurses. These cardiac emergency events may cause disturbance to daily life for older adults with ACS. The purpose of this study was to identify the occurrence of depression and examine its correlates among those patients with ACS asking for emergency help. This is secondary data analysis of data collected from a convenient sample of 300 older adults with ACS asking for emergency help. Correlation and multivariate analyses were utilized in this study. Depression was found to be significantly, positively associated with each of hospital length of stay (LOS), intensive care unit (ICU) LOS, and frailty. The level of depression among older adults with ACS asking for emergency help was 65.7%. The level of depression among older adults asking for emergency help had significant predictors, as follows: Age (t=3.06), troponin (t=2.98), hemoglobin alpha 1C (HbA1c) (t=3.18), and frailty (t=5.77). These factors utilized in the linear regression model explained 56.6% (Adjusted R²=0.566, p=0.017) of the variation in the level of depression. The rate of depression is high among older adults asking for emergency help. Thus, the HCPs, including nurses, should pay a high attention to those at-risk patients for the occurrence of depression, as well as be well-prepared to manage correspondingly. Depression among older adults with ACS asking for emergency help requires emergency intervention protocol to combat depression among those patients by HCPs, including nurses.
DEPRESSION AND LONELINESS IN BLACK WOMEN WITH HYPERTENSION: A SYSTEMATIC LITERATURE REVIEW
Authors: Hutto Lashawn , Odlum Michelle , Dowling Maritza , Theeke Laurie
Published: December 2023

Hypertension occurs more frequently in Black women than men. Over 50% of Black women have hypertension, compared to 39% of non-Hispanic white women and 38% of Hispanic women. Black women with hypertension are more likely to report depressive symptoms which are associated with hypertension, a known risk for cardiovascular diseases including myocardial infarction, heart failure, and stroke. This paper presents a synthesis of findings from quantitative studies that measured depression and loneliness in black women with hypertension. The literature search used EbscoHost with the following databases: Medline Complete, Academic Search Complete, Medline, Pub-Med, Scopus, APA PsycArticles, APA PsycINFO, and CINAHL. Twelve articles were included. Loneliness and social isolation are predictive of depression in black women ages 40 and older. The issue is further confounded by cultural norms that include not seeking therapy, discussing symptoms, and displaying vulnerability, leading to loneliness and disconnection. Loneliness is increased in middle age black women who’ve experienced traumatic events. In an intervention trial, the associations between blood pressure control and living arrangements were examined. Middle- aged black women living alone were reported to have a higher prevalence of uncontrolled blood pressure, cardiovascular events, and mortality compared to those living with others. There are limited studies of loneliness and depression in black women with hypertension. Additional studies are needed that include variables reflective of cultural norms. A culturally sensitive clinical environment that facilitates discussion about feelings of depression and loneliness could be foundational to the development of new more precise interventions for black women with hypertension.
DOES HEARING LOSS MODERATE THE RELATIONSHIP BETWEEN COGNITION AND DEPRESSION?
Authors: Lister Jennifer , Bush Aryn Harrison , O’Brien Jennifer , Conover Laura , Sadeq Nasreen
Published: December 2023

Hearing loss, depression, and cognitive impairment are common, co-occurring conditions experienced by older adults, but the nature of the relationship among these conditions remains unclear. Both depression and hearing loss have been identified as risk factors for dementia, but for different stages of life (e.g., Singh-Manoux et al., 2017; Livingston et al., 2020). Hearing loss is described as the strongest modifiable risk factor in mid-life, and depression is second only to smoking as the strongest modifiable risk factor in late-life (Livingston et al., 2020). The association between hearing loss and depression is well documented in the literature (e.g., Lawrence et al., 2015). It is possible that hearing loss, as an earlier risk factor, moderates the relationship between depression and cognition. Therefore, as part of an ongoing longitudinal study of early indicators of cognitive decline, we examined the moderating effect of two measures of hearing (pure-tone hearing threshold average, Dichotic Sentence Identification test) on the relationship between depression (Geriatric Depression Scale) and cognition (Montreal Cognitive Assessment, Digit Symbol Substitution test) for a group of 65 older adults (mean age 74). Although none of the hearing or cognitive measures were significant predictors of depression scores on their own, there was a significant negative interaction between the Montreal Cognitive Assessment and pure-tone hearing threshold average, p = 0.048. These results may be interpreted to suggest that individuals with higher (poorer) hearing thresholds show a decrease in depression as their cognitive scores improve, whereas individuals with lower (better) hearing thresholds show the opposite pattern.
MYOGENIC CONTRIBUTORS TO PHYSICAL FUNCTION IN OLDER ADULTS WITH SYMPTOMATIC KNEE OSTEOARTHRITIS
Authors: Johnson Alisa , Nichols Jennifer , Vincent Heather , Fillingim Roger , Cruz-Almeida Yenisel
Published: December 2023

Knee osteoarthritis (OA) is a leading cause of mobility disability among middle-aged and older adults, and contributes to significant global disease burden. The impact of knee OA on physical function varies widely across individuals, and the factors contributing to this heterogeneity are poorly understood. Recent compelling research suggests that myogenic factors, including muscle quality (MQ), may underly symptoms in knee OA. While MQ is gaining attention in aging research, the role of MQ on functional outcomes in persons with knee OA remains unknown. This pilot study examined morphological and neuromuscular biomarkers of MQ among adults aged 50 years and older (N=44) who met clinical criteria for symptomatic knee OA. Physical performance was assessed using the Short Physical Performance Battery (SPPB). MQ was quantified using B-mode ultrasound (echo intensity) and isokinetic strength measures (force/body mass). Associations between MQ and physical performance were determined, with consideration for clinical pain, age, sex, and body mass index. Pearson correlation analysis indicated SPPB scores were associated with clinical pain, strength, and MQ (r values ranged -.42 – 0.60, p’s< 0.05). Multivariable backward stepwise linear regression analysis demonstrated that MQ biomarkers contributed 39% to variance for SPPB score independent of clinical pain and strength, after adjustment for age, sex, and BMI (b’s = -0.32 – 0.45; p’s < 0.05). MQ is an important consideration for physical function in older adults with chronic knee OA pain, regardless of pain severity, and represents a potentially potent treatment target for disability prevention.
PSYCHOSOCIAL CHARACTERISTICS BY PAIN PRESENCE AND LIMITATIONS AMONG OLDER ADULTS
Authors: Holmes Ashleigh , Wang Weijun , Chang Yu-Ping
Published: December 2023

Older adults experience high rates of pain, which is linked to physical disability, poorer mental health, reduced social engagement, cognitive impairment, and increased health care costs. Due to the heterogeneous nature of pain, further research is needed to identify psychosocial characteristics in older adults grouped by pain experience. Using the nationally representative National Health and Aging Trends Study Round 11 (2021) dataset, we performed ten multiple regression models (controlling for age, gender, and race/ethnicity) examining various psychosocial variables in 3,381 older adults divided into three pain groups: no pain within the last month, pain without activity limitations, and activity-limiting pain. The results showed that older adults with activity-limiting pain compared to those without pain had significantly higher depression (b=0.724, p<.001), anxiety (b=0.675, p<.001), fear of falling (b=1.078, p<.001), difficulty initiating and maintaining sleep (b=0.906, p<.001), and use of sleep medications (b=0.448, p<.001), as well as reduced positive affect (b=-1.812, p<.001), self-realization (b=-0.204, p<.001), self-efficacy (b=-0.041, p=.012), resilience (b=-0.101, p<.001), and social participation (b=-0.205, p<.001). In older adults with non-activity-limiting pain compared to those without pain, all relationships remained significant except for self-realization (p=.366), self-efficacy (p=.122) and resilience (p=.123). Furthermore, older adults with non-activity-limiting pain reported higher levels of self-realization (b=0.173, p<.001) and self-efficacy (b=0.068, p<.001) than those with activity-limiting pain. The findings suggest that pain is strongly associated with all psychosocial outcomes, especially in older adults with activity-limiting pain. Future research should examine the impact of self-realization and self-efficacy on pain experiences in older adults with activity-limiting pain.
SELF-REPORTED MENTAL AND PHYSICAL HEALTH IN OLDER PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Anim-Koranteng Comfort , Eun Yong , Opoku-Agyemang Christfelly
Published: December 2023

Rheumatoid arthritis (RA) is the most common autoimmune arthritis with a prevalence of 1% among the American population. RA significantly impacts mortality and is associated with worse quality of life among older adults. Management of RA in older patients is challenging due to comorbidities and frailty. This study compared RA patients’ self-reported mental and physical health between older (65 and over) and younger (18-64) individuals. In the study, we included participants from the All of Us dataset version 6, which includes survey data collected between May 6, 2018, and January 1, 2022, who had one or more diagnosis codes (ICD9/ICD10) of RA and at least one medication exposure for RA. Total of 2904 patients with RA - 1577 older and 1327 younger - were included in the analysis. PROMIS-PH (Patient-Reported Outcomes Measurement System - Physical Health) and MH (Mental Health) score were calculated from the survey result, from 2 to 10: higher score representing better outcome. Average PROMIS-PH score was 6.5 in older patients and 5.9 in younger patients (P< 0.05). Average PROMIS-MH score was 7.2 in older patient and 6.4 in younger patients (P< 0.05). The findings of this study suggest that older patients with RA may have better self-reported mental and physical health than younger individuals. This could be attributed to better disease management, increased resilience, and adaptability. Further research is warranted to understand the underlying causes of the study’s findings.
THE FACTORS RELATED TO KENDO PRACTICE THAT AFFECT IKIGAI-KAN OF MIDDLE-AGED AND OLDER KENDO PRACTITIONERS
Authors: Matsumoto Daisuke , Uchida Hayato
Published: December 2023

The purpose of this study was to clarify the factors related to kendo practice that affect Ikigai-Kan and actual conditions of generativity, mental health of middle-aged and elderly Kendo practitioners. We selected 97 middle-aged and older Kendo practitioners who are practicing at Dojos in Osaka and Hyogo prefectures as research participants. Items that are basic attributes were grouped into two groups, and the values of each survey item were compared between groups. In addition, correlation analysis was performed to grasp the mutual relationship between the basic attributes and each survey item value. Furthermore, in order to clarify the factors related to the practice of kendo that affect Ikigai-Kan, multiple regression analysis was performed. Each item value indicating the practice status of kendo was used as independent variable. As a result, it was confirmed that the frequency of practice with young people (β=0.384, p< 0.01) affected Ikigai-Kan. These results show that the collaboration between the school and the community, the creation of an environment where the skills and experience of middle-aged and elderly people such as club activity instructors and local sports organizers can be enhanced, and opportunities to interact with or practice with young people would lead to Ikigai.
USER PERCEPTION OF TECHNOLOGICAL INTERVENTIONS FOR PARKINSON’S DISEASE: A SYSTEMATIC REVIEW
Authors: Lau Terence , Leung Angela Y M
Published: December 2023

With the growing number of Parkinson’s disease technological intervention studies available, it is uncertain what and how people with Parkinson’s disease (PWP) respond to these interventions. This systematic review aims to study the user perception and perceived psychosocial gain of technological interventions among the Parkinson’s disease population, and it included 27 eligible studies from 6 databases. Through thematic synthesis, qualitative evidence suggests technological interventions could benefit the psychosocial well-being of people with Parkinson’s disease (PWP) under appropriate implementation. Coping with technological interventions was identified as the overarching theme. The theme is closely related to participants’ technological literacy and could lead to perceived psychosocial gain. The discrepancy between the implemented technology and PWP’s technological literacy level dictated how well PWP coped with the interventions. Ineffective coping attempts could induce undesirable emotions within PWP and tamper with their psychosocial health. In contrast, successful coping attempts reduced initial adverse effects, resulting in psychosocial growth such as increased autonomy and interpersonal relationships. To facilitate PWP’s coping process and design a Parkinson’s disease-friendly technological intervention. Scholars should include an adjustable, progressive module design and provide sufficient training and technical support to participants during implementation.
VASOMOTOR SYMPTOMS AND DIET QUALITY
Authors: Thangwaritorn Pilar , Perales-Puchalt Jaime , Meister Melanie , Schwasinger-Schmidt Tiffany , Billinger Sandra , Bright Briana , Watts Amber
Published: December 2023

During the menopausal transition, women report a variety of physical changes including hot flashes and nights sweats, known as vasomotor symptoms, which are associated with later life health outcomes including vascular disease and Alzheimer’s risk. Previous studies suggest that maintaining a healthy diet may alleviate vasomotor symptoms, however, few studies have investigated this association. We examined the potential association between diet quality and vasomotor symptoms in women ages 40-60 years. Recruitment is ongoing and currently consists of N = 44 women (Mage = 50.59, SD = 5.96) from the Kansas City and Wichita areas. We assessed vasomotor symptoms using two questions from the Greene Climacteric Scale and measured diet quality with the Rapid Eating Assessment for Participants-shortened version. We evaluated the association between diet quality and vasomotor symptoms using linear regression. Overall, women in our sample reported moderate diet quality and were moderately bothered by hot flashes and night sweats. The association of diet and vasomotor symptoms was not statistically significant accounting for covariates, possibly related to sample size (β = 6.024, p = .307). However, lower education levels are associated with a greater degree of vasomotor symptoms (β = -0.876, p = .011). Future research could investigate specific types of foods (e.g., vegetables, proteins, etc.) that influence vasomotor symptoms and the associated health outcomes in women who are post-menopausal, including vascular disease and cognitive decline. Lifestyle factors such as diet may be an intervention strategy to reduce disease that emerges during the menopausal transition.
DIFFERENCES IN PHYSICAL PERFORMANCE MEASURES BETWEEN BLACK AND WHITE OLDER ADULTS
Authors: Windham William , Windham B Gwen , Sylvester Hunter , Palta Priya , Skow Laura , Sharrett A Richey , Kucharska-Newton Anna , Griswold Michael
Published: December 2023

Older Black adults are reported to have poorer physical function relative to White older adults. Cardiovascular risk factors and disease are associated with physical function and are more prevalent in Black adults. We examined objective physical function cross-sectionally using the Short Physical Performance Battery (SPPB, scored 0-12; 0.5 is considered clinically meaningful) in the Atherosclerosis Risk in Communities Study among Black and White participants during Visit 5 (2011-2013). Marginal standardization following generalized linear modelling (log-link, negative-binomial) was used to investigate whether cardiovascular features (hypertension, diabetes, BMI, smoking, heart disease, heart failure, stroke) helped explain race differences by comparing unadjusted (total effect) versus adjusted (direct effect) results. Among 5,836 participants (>65 years, mean age=75.9, 42% men, 22% Black), Black participants scored 1.3 points lower than White participants; unadjusted: 8.2 versus 9.5; relative difference of 0.86 (0.84, 0.88). After accounting for cardiovascular features, Black participants scored 1.4 points lower than White participants; adjusted: 8.2 versus 9.6; relative difference of 0.85 (0.84, 0.87). Cardiovascular risk factors and disease alone did not appear to account for substantial cross-sectional physical performance race differences in this population. Future research should examine additional factors potentially contributing to observed functional differences typically attributed to race such as cumulative vascular risk factors, geographic, social, cultural, and other systemic influences.
EFFICACY OF COMBINED THERAPEUTIC EXERCISE AND PSYCHOLOGICAL INTERVENTIONS ON DISABILITY OUTCOMES: A SCOPING REVIEW
Authors: Rose Grace , Bruni Pietra , Wingood Mariana , Kallmi Selmi , Finer Elizabeth , Bamonti Patricia
Published: December 2023

The goal of therapeutic exercise (i.e., physical activity/exercise programs, physical therapy, rehabilitation), restoring and maintaining function in older adults (≥60 years), is hindered by personal factors (e.g., low self-efficacy) impacting exercise engagement. Combining therapeutic exercise with psychological interventions is a promising solution for maximizing treatment benefits. The purpose of this scoping review is to systematically synthesize the knowledge of randomized controlled trials (RCTs) testing combined therapeutic exercise and psychological interventions targeting disability outcomes in older adults. A comprehensive review of the literature, searching four databases, was performed following PRISMA-ScR guidelines. Articles (n=4,995) underwent iterative screening, resulting in 31 RCTs. The World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) model was utilized as a conceptual framework. Studies assessed at least one major domain of the ICF model: Body Function and Structure was an outcome in 67.74% of RCTs and both Activity and Participation were an outcome in 77.42% of RCTs. Personal factors were assessed in 64.52% of RCTs. Psychological interventions utilized were cognitive-behavioral (32.26%), motivational interviewing (29.03%), meditation (12.90%), or other (32.26%). Combined interventions compared to either therapeutic exercise alone (25.81%) or control (74.19%) demonstrated greater efficacy on at least one major ICF outcome in 77.42% of RCTs. This review indicates that incorporating psychological interventions within therapeutic exercise can maximize treatment benefits in older adults across diagnoses and setting. Future research is needed to better understand which psychological interventions demonstrate greatest efficacy when paired with therapeutic exercise within certain patient subgroups, in order to guide best practice guidelines.
GAIT ANALYSIS OF ELDERLY PEOPLE IN ANGOLA: COMPARISON BETWEEN ESTABLISHED ROUTE AND VIRTUAL REALITY AND TIME UP AND GO
Authors: Barbara Rita , Luanda Natália
Published: December 2023

Background

Aging limits physical and mental abilities, particularly gait, compromising quality of life and increasing the risk of falls, which is a public health challenge in Angola. Technologies, such as virtual reality, may offer a promising alternative for treatment and prevention of these limitations. Objective: This study aimed to analyze the gait of elderly individuals in Angola by comparing gait on an established course and in a virtual environment, using motion analysis software and SPSS for statistical analysis with a p>0.05.

Methods

Seven elderly individuals, aged 60-80, participated in the study. Gait was evaluated using the Timed Up and Go (TUG) test, an established course, and gait in a virtual environment.

Results

Statistically significant differences were found between gait on the established course and in virtual reality, with elderly individuals showing slower and more variable gait in the virtual environment. There were also significant correlations between gait and TUG, highlighting the importance of motor coordination and balance in elderly gait.

Conclusion

Gait analysis in elderly individuals can be performed precisely and stably through virtual reality technology. The results of this study suggest that virtual reality may be an interesting alternative for the treatment and prevention of falls in the elderly. The findings also emphasize the importance of motor coordination and balance in gait and the need for further research on the use of virtual reality technology in this population.
MEASURING ANKLE FLEXIBILITY IN OLDER HOME CARE RECIPIENTS WITH DISABILITIES IN THEIR HOME SETTING
Authors: Skowronski Jordan
Published: December 2023

Ankle flexibility is critical for daily activities, such as climbing stairs. Ankle range of motion (AROM), or the range through which the ankle joint can bend up and down, decreases with age. Thus, interventions to improve or maintain AROM is an important goal in geriatric rehabilitation. Evaluating the outcome of such interventions requires AROM measures. However, existing measures either require large equipment or for the participant to stand and lunge, and so are not appropriate nor practical for home-bound older adults. This paper aims to (1) describe how we developed an AROM measure for frail, older adults as part of the Promoting Seniors’ Health with Home Care Aides (Pro-Home) Study, and (2) examine the convergent and discriminant validity of the AROM measure. Data came from the baseline assessment of older home care participants’ physical function (N=115). AROM was moderately correlated with lower extremity function as measured by the Short Physical Performance Battery, r(113) = 0.30, p< 0.01 and the gait speed component scores, r(113) = 0.33, p< 0.01, and AROM was not correlated with self-reported upper extremity function. Results from the robust regression analyses are that 1 standard error unit greater averaged AROM is associated with 0.06 points higher SPPB score (p< 0.00) and 0.06 greater Gait Speed Score (p< 0.00), after adjusting for age, gender, and ambulatory device use. The significant associations between AROM and SPPB and AROM and gait speed indicate that the AROM measure has convergent validity, while the nonsignificant associations among AROM and upper extremity function show its discriminant validity.
FROM MISFIT TO FIT: THE IMPACT OF NURSING PRACTICE ON COMPLEX NURSING INTERVENTION DEVELOPMENT
Authors: ten Cate Debbie , Schuurmans Marieke , Schoonhoven Lisette , Ettema Roelof
Published: December 2023

Nurses have a key role in providing nutritional care to older adults to prevent and treat malnutrition, and stimulate health and well-being. However, evidence for nursing activities regarding nutritional care is often lacking. Therefore, intervention development is necessary. From earlier studies, an evidence-based nutritional intervention carried out by nurses appeared the best solution. The aim of this study was to outline the steps taken to develop a complex nursing intervention to prevent and treat malnutrition in older adults and the challenges faced during this stage. Following the phase of intervention development of the Medical Research Council (MRC) Framework, a systematic review, a questionnaire survey, semi-structured interviews, focus groups and participant observation were carried out. The purpose was to gather information about current nursing practice and context, the needs of future users and providers, and gain insight into the problem. The studies showed that nurses had moderate knowledge of (mal)nutrition. They gave nutritional care low prioritization during daily nursing activities. These results provided insight that the intended nursing nutritional intervention would most likely lead to a misfit with the context. To fit the intervention properly into nursing practice, it was decided to develop an educational intervention targeting nurses instead of a nutritional intervention carried out by nurses. Building proofs in context leads to challenges but is essential to prevent a misfit between complex nursing interventions and nursing practice. As an element of rigorous intervention development following systematic steps, it increases the chance of successful implementation.
EDUCATION AS A MEDIATOR OF GENDER DIFFERENCES IN COGNITION IN OLDER ADULTS
Authors: Rijnhart Judith , Valente Matthew , Kok Almar , Huisman Martijn
Published: December 2023

Although dementia is more prevalent in women than in men, studies on the socio-cultural mechanisms that cause and sustain gender differences in dementia remain scarce. Historic gender differences in education may explain why older women are at higher risk of dementia nowadays. This study aimed to investigate education as a mediator of gender differences in cognitive function, as measured with the Mini-Mental State Examination (MMSE). We used data from the Longitudinal Aging Study Amsterdam. The analytical sample consisted of 2,909 older adults aged 55-85, of whom 1,601 were women and 1,506 were men. We used causal mediation analysis to estimate total, indirect, and direct effects of gender on MMSE. Effect estimates were adjusted for confounding by age, parental education, and childhood adversity. The total effect was -0.60 (95% CI: -0.90; -0.32), indicating that women on average had a 0.60 lower MMSE score than men. The indirect effect was -0.84 (95% CI: -1.11; -0.59), indicating that women on average had a 0.84 lower MMSE score compared to men, because women completed fewer years of education. The direct effect was 0.24 (95% CI: 0.04; 0.44), indicating that if women had the same number of education years as men, their MMSE score would on average be 0.24 points higher than the average MMSE score in men. These findings indicate that education is an important mediator of gender differences in cognitive function. Future studies are needed to explore whether gender differences in cognitive function decrease as gender equality in education increases.
HOW THE PATIENT-CENTERED MEDICAL HOME MODEL IMPACTS OLDER ADULTS’ ACCESS TO HEALTH CARE IN RURAL GEORGIA
Authors: Childs Elisa
Published: December 2023

Rural Americans face several healthcare access barriers, including limited providers and driving further distances to receive care. Georgia healthcare access is especially problematic given its high rurality, hospital closure rate, number of medically underserved areas, and older adult population. The government promotes the Patient-Centered Medical Home (PCMH) model to improve healthcare access. This study supports a better understanding of older Georgian’s access to care by exploring PCMH’s ability to improve healthcare access. Older adults were surveyed using a modified version of the Healthcare Quality Survey (N=746). Analyses included univariate, bivariate (t-test, ANOVA, chi-square, and a crosstabulation), and multivariate (multiple linear regression). Healthcare access was statistically significantly different depending on care source type, with significant associations between PCMH users and income, age, urban/rural status, and health status. Access was also statistically significantly different based on annual household income, educational attainment, age, and health status. Further, a significant relationship was found between access and age, income, and health status. PCMH users were primarily Caucasian and most often had an advanced degree and income of $60,000 or more. PCMH users most often reported living in Three Rivers, Atlanta Region, Northeast Georgia, and the Georgia Mountains. Finally, urban and rural residents with a regular care source reported “always” receiving needed care more often than PCMH users and those with no care source. The National Committee for Quality Assurance and other accreditation agencies should target low-income rural areas with high older adult populations when implementing the PCMH model to increase older adults’ healthcare access.
MALE BREAST CANCER IN OLDER ADULTS BELONGING TO THE LOWER-INCOME GROUP
Authors: Chakravarty Esha
Published: December 2023

Male breast cancer is a rare type of cancer constituting around 1% of male malignancies. Cases of 21 elderly (aged>60) patients diagnosed with breast cancer were studied with respect to age of onset, treatment choices, access to care, ability to perform activities of daily living (ADL) from CMIG, resource centre on ageing in east India. All 21 patients belonged to lower income group in society and the study was conducted over a 5 year period of 2018-2022. Primary symptom leading to diagnosis was self-detection of lump and the median time of diagnosis from onset of symptoms was 6 months. Twenty of the 21 patients were diagnosed with Stage III or Stage IV breast cancer and 1 patient was diagnosed with Stage I cancer. The average age of diagnosis of the patients was found to be 69 years. The main method of treatment was surgery for patient diagnosed in Stage I and surgery followed by chemotherapy and radiation therapy for the rest. None of the patients underwent hormone therapy and information regarding presence of hormone receptors was not available in all cases. Five of the 21 cases reported metastasis- 4 in bone and 1 in lung. Spouse or adult children were found to be caregivers with no access to trained caregivers or counsellors. All patients showed moderate decline in motor function and ADL after surgery alongwith susceptibility to fall or injury. Free hand exercises showed slight improvement. Further studies can attract state funding and influence heath policies for lower income groups.
RELATIONSHIP BETWEEN INFORMAL AND FORMAL HELP-SEEKING BEHAVIORS FOR ELDER MISTREATMENT AMONG CHINESE IMMIGRANTS
Authors: Chao Ying-Yu , Seo Jin Young , Chang Yu-Ping
Published: December 2023

Purpose

Help-seeking minimizes the consequences from elder mistreatment (EM). However, formal help-seeking could be challenging for older immigrants due to cultural and linguistic barriers. Informal supporters have been shown to promote formal help-seeking among EM victims. This study aimed to examine whether informal help facilitates U.S. Chinese EM victims with seeking help from formal sources.

Methods

Data were derived from the Population Study of Chinese Elderly in Chicago. EM measurements included psychological, physical, sexual mistreatment, financial exploitation, and caregiver neglect. Seeking help from informal and formal sources were evaluated. Descriptive statistics and multinominal logistic regression were conducted.

Results

Among 450 EM victims, 53.48% of them sought informal help, 31.75% did not seek any help, 11.42% sought both informal and formal help, and 3.34% sought formal help. The most common informal sources were adult children, partners, and friends/neighbors. The most common formal sources were community social services organizations, followed by legal criminal justice systems. Compared to those who did not seek any help, victims who reported more emotional closeness within their social network and experienced financial exploitation were more likely to seek help from formal sources. However, informal help-seeking was not significantly associated with formal help-seeking. Conclusion/implication: The findings suggest that most U.S. Chinese older adults who experienced EM did not seek formal help. Higher levels of contact with social networks could increase seeking help from formal sources. However, future research is needed to explore why informal supporters did not facilitate seeking help from formal sources in Chinese EM victims.
DNA METHYLATION-BASED BIOLOGICAL AGING, PLASMA PROTEINS, AND INCIDENT FRAILTY AND PHYSICAL DISABILITY
Authors: Phyo Aung Zaw Zaw , Espinoza Sara , Murray Anne , Fransquet Peter , Wrigglesworth Jo , Woods Robyn , Ryan Joanne
Published: December 2023

Decline in physical function occurs with advanced age, and biological aging may be a useful marker of decline in physical function, beyond chronological age. This study investigated the associations between DNA methylation-based biological aging (DNAm-based age acceleration (AA)) and plasma proteins and the risk of frailty (based on Fried phenotype and a frailty deficit accumulation index (FI)), and persistent physical disability (defined as loss of ability to perform one or more Katz ADL), among community-dwelling people aged ≥70 years enrolled in the ASPREE study. Five AA indices (Horvath, Hannum, Pheno, Grim, and DunedinPACE) and seven plasma proteins (including plasminogen activation inhibitor-1 (PAI-1), growth differentiation factor-15 (GDF-15), and leptin) were measured in blood from 560 participants (50.7% women). Incident health events were captured over a mean of 5.2 years. Cox proportional-hazard regression adjusted for gender, education, and cell counts. One-standard deviation (SD) increase in AA was associated with an increased risk of frailty (FI) (GrimAA: HR=1.48 (95% CI, 1.19 – 1.84), and DunedinPACE: HR=1.39 (95% CI, 1.11 – 1.73)) and physical disability (GrimAA: HR=1.78 (95% CI, 1.15 – 2.77)). One-SD increase in plasma proteins except for leptin was associated with a higher risk of frailty (both Fried phenotype and FI) (range HR: 1.26 to 2.14). In conclusion, accelerated Grim age and DunedinPACE appear as markers of physical impairments, even in initially healthy individuals. Variations in plasma protein levels might be helpful for the identification of pathophysiological pathways associated with the increased risk of physical impairment in later life.
GENES FROM PEROXISOME AND INTEGRATED STRESS RESPONSE IN REGULATION OF HUMAN LONGEVITY
Authors: Yashin Anatoliy , Wu Deqing , Arbeev Konstantin , Duan Hongzhe , Akushevich Igor , Yashkin Arseniy , Holmes Rachel , Ukraintseva Svetlana
Published: December 2023

Dietary/caloric restriction shares pathways with peroxisome, a cellular organelle that regulates the synthesis and turnover of complex lipids. PEX3, a peroxisomal biogenesis factor involved in selective type of autophagy. EIF2AK4, a sensor of amino acid deprivation in the integrated stress response (ISR) involved in lifespan regulation. We hypothesize that interplay between EIF2AK4 and PEX3 is associated with human survival. We applied logistic regression model with the interaction term to the analysis of Health and Retirement Study (HRS) and UK Biobank (UKB) parents data to test whether interactions of SNPs from the EIF2AK4 and SNPs from the PEX3 are associated with the dichotomous survival trait (ST) with case group defined as: lifespan ≥ 85; and control as: 75 ≤ (lifespan or age at last follow-up) < 85. Analyses of HRS data showed that interactions between SNPs rs4924405, rs2250402, rs8031319, rs16970049, rs3816899, rs16970112, rs2412459 from the EIF2AK4 gene and SNP rs161070 from the PEX3 gene are significantly associated with ST. In the UKB data, interactions of rs161070 from the PEX3 gene and rs7176881 and rs117778159 SNPs from the EIF2AK4 gene showed nominally significant associations with ST. Analyses of linkage disequilibrium (LD) between the EIF2AK4 SNPs detected in HRS and UKB data showed that their LD are close to the highest values for SNPs with allele frequencies specific for detected variants. Our results confirm association of interplay between EIF2AK4 and PEX3 with human longevity. They also show how information from experimental studies could be transformed to the form useful for human applications.
TRANSCRIPTOMIC SIGNATURES FOR AGING AND EXTREME OLD AGE IDENTIFIED IN LONG LIFE FAMILY STUDY
Authors: Li Mengze , Song Zeyuan , Karagiannis Tanya , Monti Stefano , Sebastiani Paola , Perls Thomas , Brent Michael
Published: December 2023

Transcriptional studies of blood have previously identified changes in gene expression profiles associated with age. Centenarians, a rare population of individuals that reach 100 years of age, experience delays in aging-related diseases and mortality. Thus, the analysis of their blood transcriptome may help shed light on mechanisms contributing to healthy aging and extreme longevity, as well as enable the discovery of candidate molecular therapeutic targets. In this project, we analyzed RNAseq-based blood transcriptomic data and genetic data from 1,286 participants in the Long Life Family Study age ranged from 25 to 108. To identify transcripts with different abundances at different ages, we used linear mixed-effect models and included relevant covariates to control for genetic, socioeconomic, and technical confounders. We also estimated a genetic relationship matrix (GRM) from the genotype data to account for familial relatedness. We used the same models and covariates to compare transcripts’ abundance between the extreme old and younger participants to discover markers of extreme old age. Among the 11k RNA transcripts tested, we identified 5,249 aging markers (FDR ≤ 0.01) and 761 extreme old age markers (FDR ≤ 0.01). We successfully replicated our aging signature with previously published aging signature in another cohort with comparable Z-scores. Currently, further investigation is ongoing to distinguish markers that contribute to extreme longevity from markers that represent extreme old age. This study found large signatures of age and extreme old age and will serve as a valuable reference for future research to identify molecular mechanisms of healthy aging.
CROSS-COUNTRY COMPARISONS OF FUNCTIONING AND CARDIOVASCULAR RISKS IN OLDER ADULTS
Authors: Zhang Mutian , Zhang Yuan , Ailshire Jennifer , Crimmins Eileen
Published: December 2023

Life expectancy at birth in China has increased more than 20 years over the past 50 years and is one year higher than in the US in 2021. Whether the rapid improvement in Chinese life expectancy has been accompanied by similar changes in other aspects of the aging process compared to the US remains unclear. In this study, we focus on measured physical functioning and cardiovascular risk factors which signify disability and disease processes, and address how age and gender differences and change with age in these indicators are similar for the two countries. We use data from the 2015 China Health and Retirement Longitudinal Study (n=8,303) and the 2016/18 Health and Retirement Study (n=10,804) on performance-based functioning (e.g., walking speed) and cardiovascular biomarkers (e.g., systolic blood pressure) for those over age 60. We first examine the distribution of each measure by gender and age and conduct t-tests on mean differences. Then we conducted regression analyses to examine cross-country differences. In both countries functioning worsens with age (e.g., mean scores of walking speed for CHARLS females decreased from 0.76 to 0.47 m/s). In contrast, only among older Chinese does cardiovascular risk increase with age while in the US risk is flat (e.g., mean scores of systolic blood pressure for CHARLS females increased from 129.59 to 142.39 mm hg). Although life expectancy is nearly equivalent in these two countries, there are large gaps in health and functioning between China and the US, especially in cardiovascular disease risk.
DESCRIPTIVE EPIDEMIOLOGY ON THE TRENDS OF SUICIDAL ATTEMPTS AMONG OLDER ADULTS IN KOREA FROM 2007–2020
Authors: Lee Seoyoon , Shin Hyung Eun , Lee SeungCheor , Oh In-Hwan
Published: December 2023

When a suicide attempt results in the act of suicide, personal and social losses increase to a degree that is difficult to quantify. It is urgent to evaluate the status of suicide attempts in Korea accurately. This study is to examine a 14-year time series of older adults who have engaged in suicidal behavior or attempted suicide. We used claim data from Health Insurance Review and Assessment Service. A total of 3,440 individuals with a diagnosis code, 768 individuals with a primary diagnosis, and 2,672 individuals with a secondary diagnosis, were included in the analysis. Suicide attempts were defined by intentional self-harm(X60-X84), harmful biological control agent(X87), and personal history of self-harm(Z91.5). To analyze the frequency of suicide attempts by age, a chi-squared test was conducted. Among those over 60 years with a primary diagnosis of suicide attempt, personal history of self-harm was the most common, accounting for 92.4%, followed by intentional self-harm with a rate of 7.5%. No subjects had a primary diagnosis as code of X87. A similar trend was observed for those under the age of 60. In the case of those with a secondary diagnosis of suicide attempt, personal history of self-harm was the highest at 93.5%. Subsequently, intentional self-harm accounted for about 6.4%, and each code was evenly distributed except for alcohol addiction and exposure(X65) in 2007 and X87 in 2020. Conclusively, this study reported the trend of suicide attempts in Korea, which can provide the basis for preparing effective short- and long-term health policies.