bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduced Muscle Oxidative Capacity During and After Exercise in Older Adults With Obesity
Authors: Zhao Fei , Dutta Anirban , Tomita Machiko
Published: December 2021

Objective: Obesity and physical activity are two major factors affecting aerobic performance in older adults. The underlying mechanisms of the causes are still unknown. Oxidative capacity, muscles’ maximal capacity to utilize oxygen, is a part of aerobic performance. Muscle oxygen level (SmO2), a measure of oxidative capacity, reflects the balance between oxygen delivery and oxygen demand. When oxygen delivery surpasses oxygen demand, SmO2 increases, which indicates higher oxidative capacity. This study aimed to identify the influence of obesity and physical activity level on SmO2 changes during and after short exercise. Methods: This is a cross-sectional study. SmO2 changes during and after a bilateral heel-raise (BHR) test were measured in 60 community-dwelling older adults (≥ 60 years old) in four groups: inactive obese, active obese, inactive non-obese, and active non-obese. Inactive is defined as performing less than 150 minutes/week moderate-intensity activity. Results: The inactive obese group took a longer time for SmO2 drop during the BHR test, had a lower SmO2 level at the end, and recovered slower after the test than all other groups. Especially, compared with the active non-obese group, this group exhibited significantly poorer SmO2 recovery one minute after the test, 5.3% less (p=.036). The active obese group’s oxidative capacity was similar to the inactive non-obese group, although lower than the active non-obese group. Discussion: To prevent physical decline in older adults with obesity, regular exercise has been recommended. This study substantiated this from a hemodynamics viewpoint. Older adults with obesity need 150+ minutes/week moderate-intensity exercise.
Reducing Methylglyoxal Rescues Obesity Related Phenotypes and Lifespan in a Leptin Receptor Deficient Mouse Model
Authors: Wimer Lauren , Contreras Martin Valdearcos , Shanmugam Muniesh Muthaiyan , Ramirez Jessica , Beck Jennifer , Koliwad Suneil , Kapahi Pankaj
Published: December 2021

Obesity remains one of the leading risk factors for aging and age-related diseases such as Alzheimer’s and type II diabetes, and effects 40% of the US population. The occurrence of obesity has been closely tied to an increase in sugar consumption with chronic hyperglycemia enhancing glycolysis. One of the byproducts of glycolysis is methylglyoxal (MGO), a reactive precursor for advanced glycation end-products (AGEs), which drives type II diabetes and its complications. We hypothesize that an MGO-derived AGE, MG-H1, affects hypothalamic regulation of food consumption and metabolism parallel to the leptin pathway in mice fed a high carbohydrate diet. Exogenous supplementation of MG-H1 increased food consumption rates and weight gain. Conversely, glycation byproduct lowering compounds (GLY-LOW), a customized chemical cocktail that blocks the production of MGO, rescued over-feeding phenotypes in wild-type mice. Furthermore, GLY-LOW treatment in a leptin receptor deficient mouse model rescued weight gain, diabetic phenotypes and lifespan. RNA sequencing of the hypothalamus of leptin receptor deficient mice treated with GLY-LOW showed significant downregulation of Rax, a gene responsible for tanycyte differentiation, and several genes involved in feeding and aging. We propose that specific cells in the hypothalamus both make and respond to MG-H1. We will also discuss evidence for the potential of GLY-LOW as a new class of therapeutics that reduce the effects of glycation to reduce food intake and slow aging.
Targeting cellular senescence with novel senotherapeutics by design to extend healthspan
Authors: Zhang Lei , Hughes Brian , Angelini Luise , O’Kelly Ryan , Yousefzadeh Matthew , Kamenecka Ted , Niedernhofer Laura , Robbins Paul
Published: December 2021

Senescent cells accumulate with age in various tissues and organs, leading to the decline in tissue function and deterioration of many age-related diseases and aging. Senolytics have emerged as an effective therapeutic approach to eliminate senescent cells to improve aging phenotypes and associated co-morbidities. Despite their promising potential, only a handful of senolytics have been reported, including a natural flavonoid fisetin discovered by our group. Fisetin has been shown to reduce senescence, suppress age-related pathology, and extend healthspan in aged mice. However, its moderate potency, potential mutagenic risk and poor bioavailability have limited its further clinical applications. By leveraging drug design, medicinal chemistry and high-content imaging analysis, we have successfully optimized the senolytic activity of fisetin, leading to the identification of two improved fisetin senolytic analogs (FAs) with reduced toxicity in non-senescent cells. The improved senolytic activity of these FAs was demonstrated in murine and human senescent cell models as well as in accelerated aging and naturally aged mouse models. The analysis of the senolytic activity of the FAs as well as several other recently identified senolytics, including a senolytic lipid, will be presented.
The Interaction of Osmotic and Heavy Metal Stress in C. elegans
Authors: Turner Emily , Furtmann Amanda , Dang Hope , DeNicola Destiny , Sutphin George
Published: December 2021

Cellular stress is an ever-present aspect of aging and a primary driver of many common age-associated diseases such as cancer, diabetes, or neurodegenerative diseases. As we age, stress-induced damage accumulates over time, along with reduced efficacy of stress response pathways at combatting such damage. Molecular stress response pathways are well studied in the context of individual stressors, but there is a lack of understanding of how these responses change when multiple stressors are encountered at the same time. The goal of our work is to explore the impact of multiple simultaneous stressors on health and survival, and to investigate the underlying molecular pathways involved. To accomplish this, we utilize the nematode Caenorhabditis elegans to monitor lifespan changes in response to various stressors. We simultaneously exposed C. elegans to high concentrations of sodium chloride and cadmium chloride, known to induce osmotic and heavy metal stress, respectively. We found that lifespan is drastically decreased by the combined stress, significantly more so than the reduction in lifespan caused by either individual stress. Our results show that glycerol levels, which are normally increased in response to osmotic stress, are significantly lowered when the two stresses are combined compared to levels detected for osmotic stress alone. This suggests that the presence of cadmium may sensitize worms to sodium and other osmotic stressors by blunting cells’ ability to mount an appropriate molecular response. In ongoing work, we will continue to dissect the mechanisms through which cadmium influences glycerol production and other aspects of osmotic stress response.
Older Breast Cancer Survivors’ Cognitive Response to Qigong/Tai Chi Easy: An Exploratory Analysis
Authors: James Dara , Larkey Linda , Han SeungYong
Published: December 2021

Increasing rates of breast cancer coupled with improvements in treatment means the number of breast cancer survivors (BCSs) is growing. BCSs frequently report persistent cognitive deficits (i.e., “cancer-related cognitive impairment”) that impacts QOL and treatment compliance. Older (≥65 years old) BCSs are more likely to experience cognitive decline and impairment, partly due to the biological process of senescence. In the context of a larger RCT of BCSs (ages 45-75; stages 0-III), we evaluated cognitive function/performance effects on among the older participants (ages 65-75) of 8-weeks Qigong/Tai Chi Easy (QG/TCE) compared to education control (EdC). Cognitive function was measured using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-COG), including: perceived cognitive impairment (PCI), and perceptions of effects of cognitive function on quality of life (PCQOL). Cognitive performance was measured using the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III): Digit Span (DS) and Letter-Number Sequencing (LNS). A multilevel model with random intercept was used to examine GroupXTime interactions: The majority of participants (N= 32) (M age= 69.7) were white (84%). Changes in WAIS-III DS, LNS and FACT-COG PCI were not statistically significant, but effect sizes were small to medium. The interaction between group and time was significant for FACT-COG PCQOL (p= 0.033) with a medium effect size, 0.14. Findings from this exploratory analysis of the larger study suggests that older BCSs’ participation in QG/TCE may improve perceptions of effects of cognitive function on quality of life. Such improvements may increase cognitive-related self-efficacy, overall QOL and treatment compliance among older BCSs.
Internalized age stereotypes as a mediator between volunteering and psychosocial health for adults 50+
Authors: Steward Andrew , Hasche Leslie , Laser-Maira Julie Anne
Published: December 2021

The productive aging literature describes a wide range of psychosocial benefits of volunteerism for older adults. A growing, compelling body of literature drawing from stereotype embodiment theory identifies significant, negative public health impacts of internalized age stereotypes. Yet, little research has explored which activities may reduce internalized ageism and enhance psychosocial health as people age. This cross-sectional study examined whether internalized age stereotypes mediate the relationship between volunteering and social connectedness for adults 50+. A convenience sample of volunteers (n = 112) 50+ years of age residing in the U.S. Mountain West were recruited. A 15-minute, online survey was utilized. The independent variable was number of volunteer hours per week (mean = 6.25, SD = 4.85). The dependent variable was social connectedness measured by five items positively worded from the five-point, Likert-type UCLA loneliness scale (α = .85; mean = 4.26, SD = 0.59). Drawing from the self-stereotypes of aging scale, the indirect effects of five internalized positive (e.g., “wise” and “capable”) and five negative (e.g., “grumpy” and “helpless”) age stereotypes were tested. Results indicate that increased internalized positive, not negative, age stereotypes partially mediated the relationship between volunteer hours and increased social connectedness, while holding constant age, gender, race, functional limitation, education, employment, length of volunteering, and previous volunteer experience. Although positive age stereotypes have long been considered a form of ageism, the results of this study suggest that internalizing positive age stereotypes may function as a form of esteem to promote enhanced psychosocial health as people age.
The relationship of Careers with People Interactions and Volunteering Between Gender-racial Groups in Late-life
Authors: Lai Patrick Ho Lam
Published: December 2021

Prior research showed that ethnic minorities in late-life tended to participate less in volunteering, compared to Whites. Older women, in general, spent more time volunteering than older men in the United States. Previous studies showed that occupational statuses, but have not yet discussed occupation categories, affected older adults' volunteering. The Current Population Survey dataset was utilized in this study to explore the relationship between careers with or without people interactions and volunteering of Americans aged 50 to 85 in an intersectionality lens. Regarding races, older African Americans who worked in occupations requiring human interactions, had almost double volunteering rate than those occupations not requiring these interactions. In respect of genders, compared to older men who worked in jobs requiring human interactions, the volunteer rate of those not requiring human interactions was 81% less. Either older African Americans or older men had more associations between their human interactions in career and their volunteering rate, than other racial groups or gender groups individually. Considering races and genders together, comparing to older Asian men who worked in fields needed interactions with others, the volunteering rate of those who did not work in these fields was 52% less. The association of older Asian men between fields requiring human interactions and volunteering rate was the least, among various gender-racial subgroups. Older adults with different racial-gender identities may face varying experiences in different types of occupations. Social and cultural factors among these identities are discussed to better understand the relationships between careers and volunteering in late-life.
Relationship Between Type 2 Diabetes Control and Cognition in Older Adults: Findings From NHANES
Authors: Jiwani Rozmin , Espinoza Sara , Wang Jing , Serra Monica
Published: December 2021

Cognitive health has emerged as an important public health concern for America’s aging population. Type 2 Diabetes (T2D) may be associated with an exacerbated decline in cognitive performance. This study aimed to examine the relationship between T2D control and cognitive performance in older adults (≥60 years) using the 2013-2014 National Health and Nutrition Examination Surveys. Participants who completed the following cognitive assessments were included: 1) Consortium to Establish a Registry for Alzheimer’s Disease Word List (CERAD-WL), 2) Animal Fluency (AF), 3) Digit Symbol Substitution Test (DSST) (higher scores associated with better cognition). Participants were stratified by four groups: no T2D (N=557), treated/controlled T2D (controlled; N=41), treated/uncontrolled T2D (uncontrolled; N=120), untreated T2D (N=86), based on self-reported T2D treatment, fasting plasma glucose, and hemoglobin A1c. Logistic regression was used to examine the relationship between T2D control and cognition. We observed that those with uncontrolled and untreated T2D each had ~15% lower DSST than those with no T2D (P<0.01). CERAD-WL and AF were similar across all groups. Unadjusted analyses showed that individuals with 1) lower CERAD-WL were more likely to have controlled and untreated T2D, 2) lower AF were more likely to have controlled and uncontrolled T2D, and 3) lower DSST were more likely to have uncontrolled and untreated T2D (P’s<0.05). After adjusting for significant demographics and cardiovascular risk factors, only having uncontrolled T2D was associated with lower DSST (β=-3.164, P=0.04). These data indicate the need for longitudinal studies to further explore dynamic relationship and causal pathway between T2D control and cognitive impairment.
Risk factors for dementia onset in older adults with metastatic renal cell carcinoma
Authors: Miller Samuel , Wilson Lauren , Greiner Melissa , Pritchard Jessica , Zhang Tian , Kaye Deborah , Cohen Harvey , Dinan Michaela
Published: December 2021

Renal dysfunction is a driver of dementia. It is also associated with renal cell carcinoma, possibly the result of the tumor itself or from cancer treatment. This study evaluates metastatic renal cell carcinoma (mRCC) as a risk factor for developing mild cognitive impairment or dementia (MCI/D) as well as the impact of RCC-directed therapies on the development of MCI/D. We identified all patients diagnosed with mRCC in SEER-Medicare from 2007-2015. The main outcome was incident MCI/D within one year of mRCC diagnosis or cohort entry. Exclusion criteria included age <65 at mRCC diagnosis and diagnosis of MCI/D within preceding year of mRCC diagnosis. Patients with mRCC (n=2,533) were matched to non-cancer controls (n=7,027) on age, sex, race, comorbidities and year. Cox proportional hazards regression showed that having mRCC (HR 8.52, 95% MCI/D 6.49-11.18, p<0.001) and being older (HR 1.05 for 1-year age increase, 95% MCI/D 1.03-1.07, p<0.001) were predictive of developing MCI/D. A second Cox proportional hazards regression of only patients with mRCC revealed that neither those initiating treatment with oral anticancer agents (OAAs) nor those who underwent nephrectomy were more likely to develop MCI/D. Black patients had a higher risk of dementia compared to white patients (HR 1.92, 95% MCI/D 1.02-3.59, p=0.047). In conclusion, patients with mRCC were more likely to develop MCI/D than those without mRCC. The medical and surgical therapies evaluated were not associated with increased incidence of MCI/D. The increased incidence of MCI/D in older adults with mRCC may be the result of the pathology itself.
Does HbA1c Influence the Relationship between Stress and Cognition? Findings from the VA Normative Aging Study
Authors: Brockmann Austin , Aldwin Carolyn , Spiro Avron
Published: December 2021

Type 2 diabetes has increased in prevalence globally, with potential adverse effects on cognition. Both high levels of hemoglobin A1c (HbA1c) and stressful life events (SLEs) are associated with impaired cognitive performance, but few studies have examined their synergistic effects. The present study examined direct effects of stress and HbA1c on several cognitive outcomes, and whether HbA1c moderated the relationship between SLEs and cognition. Utilizing a sample of 527 older men from the VA Normative Aging Study (Mage = 74.3, SD = 6.5), stress was inversely related to MMSE, verbal fluency, and pattern recognition; HbA1c was only inversely associated with MMSE. The moderation model was supported only for pattern recognition (β = 1.64, p < .05), with stress having worse effects in those high in HbA1c. Stratifying analyses by age group (<75, 75+) showed that stress predicted cognition only in the young-old, while HbA1c was inversely related to cognition only in old-old participants. Further, these age-group analyses yielded different effects of demographics on cognition. In the young-old, age was consistently inversely related to all cognitive outcomes, but in the old-old only with MMSE and word list recall. Among the young-old, education was associated with only word list recall but improved performance for most scales among the old-old. Finally, HbA1c intensified the effect of stress moderation on verbal fluency only in old-old (β = 2.78, p < .05). In summary, stress was more important for cognition in the young-old, while education and health status were more important in the old-old.
Effects of Age and Self-Performance on Memory for the Actions of Other People
Authors: Kersten Alan , Earles Julie , Brymer Jennifer
Published: December 2021

This research tested whether performing an action themselves leads young and older adults to have difficulty remembering which of a number of other people had performed that same action. It also tested whether observing another person perform an action leads to false memory for self-performance of that action. Young adults and healthy older adults 62 to 88 years of age viewed videos of actors performing actions. After viewing some of the actions, participants were instructed to perform those same actions themselves. Participants were tested one week later on their memory for their own actions and for the actions of the actors in the videos. Older adults were more strongly influenced by self-performance than were young adults when asked whether the actor in a test item had performed the same action previously. Young adults performed better than older adults at discriminating the correct and incorrect actors in the videos, although both groups showed reduced discrimination for actions that they had also performed themselves. The two groups were equally likely to falsely remember having performed an action that had only appeared in the videos, but young adults were better able than older adults to correctly identify the actions that they had in fact performed. Older adults thus have greater difficulty than young adults at distinguishing self-performed actions from actions performed by other people. This suggests the existence of common representations for the actions of oneself and others that must be bound to identity information to specify the correct source of the actions.
Neuroanatomical Moderators of the Impact of Mild Behavioral Impairment on Cognition
Authors: Rouse Hillary , Small Brent
Published: December 2021

Older adults with mild behavioral impairment (MBI), or the presence of late-life neuropsychiatric symptoms, have a unique cognitive phenotype. However, the neural correlates associated with MBI-related cognitive changes is not well understood. The goal of this study is to examine if specific regions of the brain moderate the relationship between the presence of MBI and performance on tasks of cognition. Data from the National Alzheimer’s Coordinating Center was utilized for this study. Participants (N=1,451) were included in our analyses if they were cognitively healthy or had mild cognitive impairment (MCI). Multiple domains of cognitive performance were evaluated. The neuroanatomical regions included hippocampus, caudal anterior cingulate (ACC), rostral ACC, entorhinal, and parahippocampal gray matter volume; and caudal ACC, rostral ACC, entorhinal, and parahippocampal mean cortical thickness. Hippocampal, entorhinal, and parahippocampal cortical gray matter volume moderated the relationship between MBI and performance on tasks of episodic memory. Left rostral ACC cortical gray matter volume and entorhinal and parahippocampal mean cortical thickness moderated the relationship between MBI and performance on language tasks. Hippocampi cortical gray matter volume also moderated the relationship between MBI and performance on processing speed tasks. Persons with smaller brain sizes in these areas were more negatively affected in these cognitive domains if they had MBI. These results suggest that the association between smaller brain volumes and cognition was stronger among persons with MBI. These findings suggest that older adults with MBI may perform worse on these tasks due to neurodegeneration that is present.
Technology Supporting Cognitively Impaired Older Adults: A Scoping Review for the ENHANCE Center
Authors: Sanders Edie , Stuart Robin , Exum Alexander , Boot Walter
Published: December 2021

Cognitive impairments (CIs) result in difficulties with a wide range of daily activities. Older adults are especially at risk for CIs, and as the older adult population increases, so does the importance of understanding and supporting the needs of those with CIs. The Enhancing Neurocognitive Health, Abilities, Networks, and Community Engagement (ENHANCE) Center was established with a focus on developing technology-based support for socialization, transportation, and prospective memory needs of older adults with CIs due to mild cognitive impairment (MCI), traumatic brain injury (TBI), and stroke. The extent to which relevant literature in these domains existed was unknown. We conducted a scoping review to identify existing research meeting the following criteria: participants aged 50+ years classified as having a CI due to MCI, TBI, or stroke; and a focus on technology-based support for socialization, transportation, and/or prospective memory needs. Using PRISMA guidelines, we searched three electronic databases, and reviewers screened citations for inclusion and completed data charting. Following screening, only 11 studies met our inclusion criteria. Qualitative and quantitative data are reported for each study. In addition to few studies available, it was common for studies to include 20 or fewer participants. Most assessed technology interactions at one time and few studies examined longitudinal use and benefits. While each paper examined one aspect of user-centered design, no technologies were reported that underwent all stages of the user-centered design process, from needs assessment to iterative design and usability testing, to efficacy trial. Such gaps highlight the important role ENHANCE can play.
Voice Biomarkers as Possible Indicators of Cognitive Aging
Authors: Mahon Elizabeth , Lachman Margie
Published: December 2021

There is emerging evidence that measures of voice prosody are related to diagnoses of Alzheimer’s Disease and Related Disorders. The goal of this study was to examine whether voice prosody measures (pitch, pulse, voice breaks, jitter, shimmer, and amplitude) are also related to individual differences in normal cognitive aging. Data are from the Midlife in the United States Wave 2 (M2) and Wave 3 (M3) for 2693 participants (ages 42-92 at M3) who completed the M2 and M3 Brief Test of Adult Cognition by Telephone (BTACT) and had M3 voice recordings. Voice variables were measured from cognitive interviews using three cognitive tests and averaged to create a composite for each voice variable. Voice prosody was related to age, sex, education, and health, which were included as covariates. Older adults, men, and those with more health conditions had higher jitter and shimmer. Older adults, women, and those with higher education and better health had more voice breaks. Hierarchical regression models, controlling for the covariates, examined the voice composites as predictors of each cognitive measure at M3 and change over 9 years from M2 to M3. As hypothesized, higher jitter predicted lower performance and greater decline on memory, category fluency, and attention. Contrary to predictions, a lower number of voice breaks predicted worse performance and greater declines on all cognitive tests. The results suggest that voice biomarkers are related to cognitive performance and decline, and they may offer a promising approach for identifying early signs of cognitive impairment or dementia.
Association Between Diet And Cognitive Performance In Adults Aged 60 And Over: NHANES, 2011–2014
Authors: Alam Md Towfiqul , Vasquez Elizabeth , Echeverria Sandra
Published: December 2021

There is limited evidence examining associations between diet and cognitive performance (CP) in older adults. We used the 2011-2014 National Health and Nutrition Examination Survey to determine if meeting dietary recommendations was associated with CP in adults 60+ years of age. Diet was based on the healthy eating index (HEI) 2015 and categorized into quintiles (higher quintiles indicating healthier diet). CP was based on word list learning, animal naming, and digit symbol substitution test, with scores above 25th percentile indicating adequate performance. Multivariate logistic regression modeling was conducted and adjusted for potential cofounders. A total of 3,068 participants completed the CP tests. A slightly higher percentage of participants were female (54.0%), predominantly White (80.5%) and the largest percentage (54.7%) was 60 to 69 years of age. The mean HEI-2015 score (0-100) was 54.89 (SE = 0.56). High CP scores increased with healthier dietary quintiles. However, results were only significant (p for trend <0.05) for digit symbol substitution test when comparing those in the highest quintile (82.53%) to those in the lowest (70.23%). Compared with participants in the lowest quintile of HEI-2015, participants in the highest quintile had a two-fold increased odds of better digit symbol substitution test scores, after adjusting for confounders (Odds Ratio [OR]: 1.96, 95% Confidence Interval [CI]: 1.28-3.01). Results showed that meeting healthy diet recommendations is associated with improved digit symbol substitution test, a marker of attention, processing speed and executive function. Future research should consider the role of diet in older adults to improve cognitive performance.
Education Differences in Older Adults' Performance on Online Assessments of Inductive Reasoning and Verbal Memory
Authors: Caskie Grace , Voelkner Abigail
Published: December 2021

Paper-and-pencil measures of inductive reasoning and verbal memory administered in-person are well-established methods for measuring cognitive ability in adults. However, given recent increases in the use of online surveys, particularly during the COVID-19 pandemic when in-person research with older adults became difficult, we investigated whether these cognitive measures could be administered effectively online and whether older adults’ performance on these measures of inductive reasoning and verbal memory might differ by education level. Data were collected online between mid-May and mid-June of 2020 from 292 individuals aged 66-90 years (M=69.1, SD=3.3). The sample was primarily White (91%) and had more women (62%) than men; 83 participants had a graduate-level education (master’s/doctoral degree), 101 had an associate’s or bachelor’s degree, and 108 had less than an associate’s degree. Three measures of inductive reasoning (Number Series, Letter Sets, and Word Series) and two measures of verbal memory (Immediate Recall and Delayed Recall of a list of 20 words) were completed by participants on an online platform. One-way MANOVA found a significant main effect for education group on the inductive reasoning measures (Wilks’ lambda=.93, p=.001). However, follow-up univariate ANOVAs indicated significant differences by education group only for Number Series, with Tukey post hoc tests showing that the graduate-level and college-degree groups performed significantly better than the group with less than an associate’s degree. Factorial repeated-measures ANOVA found a significant decline between immediate and delayed recall (p<.001) and that this difference varied by education group (p=.003). Implications of these findings will be discussed.
Modifiable Lifestyle Factors Associated with Cognitive Recovery from MCI: A 12-Year Longitudinal Study
Authors: Li Bingyu
Published: December 2021

Introduction: Many studies have investigated the risk factors associated with progression from mild cognitive impairment (MCI) to cognitive impairment, while it is unclear which lifestyle factors are associated with cognitive recovery among those who have mild cognitive impairment. Methods: The study includes 7,422 participants above 65 years old with MCI from The Chinese Longitudinal Healthy Longevity Survey (CLHLS). Cox regression analysis was adopted to investigate the association between cognitive recovery and selected lifestyle factors. LASSO was applied to select the variables. Results: Daily consumption of fresh fruits is associated with higher possibility of cognitive recovery (HR: 1.28, 95% CI: 1.15-1.42) while daily consumption of meat show opposite influence (HR: 0.90, 95% CI: 0.80-0.99). Smoking (HR: 0.99, 95% CI: 0.98-1.00) and alcohol consumption (HR: 1.00, 95% CI: 0.99-1.00) are both negatively associated with cognitive recovery. Daily engagement in reading (HR: 1.24, 95% CI: 1.00-1.54), housework (HR: 1.21, 95% CI: 1.08-1.35) as well as mahjong and other card games (HR: 1.23, 95% CI: 1.08-1.39) are associated with higher possibility of cognitive recovery. Conclusion: This study has identified important modifiable lifestyle factors associated with natural cognitive recovery from MCI. The findings have considerable implications for dementia prevention.
Racial and Ethnic Diversities in Cognitive Health Appraisals: Findings from the HCAP
Authors: Jang Yuri , Choi Eunyoung , Franco Yujin , Park Nan Sook , Chiriboga David , Kim Miyong T
Published: December 2021

The aims of the study were: (1) to investigate the relationship between cognitive performance and cognitive health appraisals across non-Hispanic White, non-Hispanic Black, and Hispanic older adults in the United States and (2) to explore within-group variations by examining interactions between cognitive performance and background and health variables. The sample (N = 3,099) included 2,260 non-Hispanic White, 498 non-Hispanic Black, and 341 Hispanic adults aged 65 or older, from the 2016–2017 Harmonized Cognitive Assessment Protocol. Regression models of cognitive health appraisals, indicated by self-rated cognitive health, were examined in the entire sample and in racial and ethnic subgroups to test direct and interactive effects of cognitive performance, indicated by the Mini-Mental State Examination (MMSE). The regression model for the entire sample showed direct effects of cognitive performance and race/ethnicity on cognitive health appraisals, as well as a significant interaction between cognitive performance and being non-Hispanic Black. Cognitive performance and cognitive health appraisals were positively associated in non-Hispanic Whites but not significantly associated in non-Hispanic Blacks. Our subsequent analysis within each racial/ethnic group showed that the effect of cognitive performance in non-Hispanic Blacks and Hispanics became either reversed or nonsignificant when background and health variables were considered. Modification by age or chronic medical conditions in each racial and ethnic group was also observed. Overall, these findings suggest that perceptions and appraisals of cognitive health vary by race and ethnicity and hold implications for how these differences should be considered in research and practice with diverse groups of older adults.
The Effect of Childhood Emotional Adversity and Later Life Friend Solidarity on Cognition
Authors: Odd Kaleena , Boron Julie Blaskewicz , Turiano Nicholas , Santo Jonathan
Published: December 2021

Early life experiences can influence later life outcomes such as physical, mental, and cognitive health. Previous research investigated the effect of childhood socioeconomic status in relation to mid-to-later life cognition (Liu & Lachman, 2019); however, the effects of childhood emotional adversity on cognition have not been examined. Controlling for age, education, sex, and race, the current study investigated the influence of childhood emotional adversity and later life friend solidarity on change in later life episodic memory, executive functioning, and subjective memory (i.e., perceived memory compared to others same age). Utilizing the Midlife in the United States (MIDUS) database, we studied 2,752 participants (50-75 years, M=60.09, SD=6.97, 53% female, 84% White) with completed measures on MIDUS 1 retrospective childhood adversity, MIDUS 2 friend solidarity, and MIDUS 2/3 cognition. Multilevel modeling (Mplus) was used. Higher friend solidarity was associated with higher executive functioning (b=0.122, p<.01) and higher subjective memory (b=0.267, p<.001), suggesting the positive impact of supportive friendships. Higher childhood emotional adversity was associated with lower perceived subjective memory (b=-0.037, p<.05). There was no significant friend solidarity by emotional adversity interaction. Together, these findings suggest that later life friend solidarity may be important for objective and subjective cognition; whereas, childhood emotional adversity may play a role in subjective cognition. Given the associations in prior research between lower perceptions of memory and lower mental well-being and quality of daily life, experiencing childhood emotional adversity may increase risk of lower perceptions of well-being, including cognitive functioning.
Employers ’ Response to Workers With Progressive Cognitive Impairment: A Review of Policy in Canada
Authors: McMurray Josephine , Kokorelias Kristina , Levy AnneMarie , James Krista , Reis Logan , Boger Jennifer , Astell Arlene
Published: December 2021

Longer lifespans, the gig economy, eligibility for government pensions, and more testing for age-related cognitive changes, increase the potential for workers developing mild cognitive impairment and/or early onset dementia (MCI|EOD) “on the job”. This critical analysis assesses Canada’s policy environment for employers when employees are diagnosed with MCI|EOD. Our search for policy literature included: a scoping review of academic literature involving Canadian-focused articles, and countries where novel or innovative policy had been evaluated and published; a search for Canadian court judgements and tribunal decisions; and a grey literature search in both Canadian and international sources, as innovation will often happen “at the margin” and updated policy may take years to be enacted and formalized. We used participatory research to obtain feedback from a broad group of stakeholders including employers, industry, professional organizations, and government, as well as people living with MCI/dementia, to ensure outputs were reflective of current policy. We found that: 1) Canadian federally-regulated employers are governed by similar Acts & Codes as the provinces and territories, with some notable exceptions, 2) Disability discrimination and accommodation case law in Canada is settled, however there are few cognitive impairment cases to provide specific guidance, 3) Scant empirical research in the scientific literature addresses policy that incents employers to build workspaces for employees with MCI|EOD that help them stay on the job longer. We conclude that engaging with employers to better understand their needs will help policy-makers to support them build workspaces that encourage productive engagement of all workers.
The Role of Socioeconomic Inequalities In Transitioning to Neurocognitive Disorders in English Population
Authors: Gireesh Aswathikutty , Sacker Amanda , McMunn Anne , Cadar Dorina
Published: December 2021

The association between socioeconomic position (SEP) and dementia is well studied. However, scant attention has been given to the relationship with mild cognitive impairment (MCI), often considered a transient state between normal cognition and dementia. The purpose of this study was to determine the role of various SEP markers such as education and wealth on transitioning to MCI and dementia over a four-year period using data from the English Longitudinal Study of Ageing, a national representative sample of the English population aged 50+. We ascertained MCI and dementia over four years, using a validated algorithm based on physician diagnosis and lower cognitive performance (1 standard deviation below the mean) on multiple standardised tests adjusted for age and education. A Multistate Markov survival model was utilised to investigate whether different SEP markers increased the risk of specific transitions between normal cognitive performance and MCI or dementia, with the latter being considered an absorbing state. During the study period, a quarter of participants progressed to MCI from the normal state. Being in the lowest quintile of wealth was associated with a lower probability of transitioning back to a normal cognitive state from MCI, compared with those in the highest quintile. Greater wealth was weakly associated with a lower risk of transitioning from normal cognitive state to MCI and from MCI to dementia. The overall results imply that socioeconomic advantage might be protective against rapid progression from mild to more severe neurocognitive disorders such as dementia in later life.
Shifting Information-Seeking Behaviors of Rural Older Americans During the Era of the COVID-19 Pandemic
Authors: Lund Brady
Published: December 2021

This session reports findings on how older rural adults in the Midwest United States adapted their information seeking behaviors in the face of the COVID-19 pandemic. A series of nearly three-dozen interviews conducted during late-summer 2020 capture the experiences of members of this population in their own words. Findings indicate that the experiences of the rural older American during this period were often unique to each individual and cannot be easily explained by a single social or demographic factor. Those participants with greater educational attainment were more likely to use a variety of digital technologies (smartphones, tablets, at-home personal computers) prior to the pandemic and thus experienced fewer challenges finding reliable information when the pandemic began. Those who were married felt less socially-isolated, but were often more reliant on others to find information for them. Women were more likely than people with other gender identities to use social media to connect and find information, which helped abate feelings of isolation but also made them feel more susceptible to misinformation and information overload. All participants expressed some level of fear or concern that motivated them to seek health information, while many expressed the same motivation in seeking political and economic information. These findings suggest that the information seeking behaviors of rural older adults were dramatically altered by the COVID-19 pandemic, with most becoming more reliant on digital technology to find information, and all being motivated by fear, concern, and/or curiosity to find information about the pandemic.
Personality and change in perceived control across the first four months of the coronavirus pandemic
Authors: Sesker Amanda , Lee Ji Hyun , Luchetti Martina , Aschwanden Damaris , Stephan Yannick , Terracciano Antonio , Sutin Angelina
Published: December 2021

Objective. This study examined change in perceived control (PC) across the first four months of the global coronavirus pandemic and whether change varied significantly by age and personality traits during the first four months of the pandemic. Methods. Personality was assessed prior to the pandemic in a large national sample of 2,455 American adults (18-100 years) from a preregistered online survey (https://osf.io/q8cpd), first conducted between January 31, 2020 and February 10, 2020. Three additional follow-up waves were conducted: mid-March 2020 (following the World Health Organization declaration of the coronavirus a pandemic), late April 2020 (toward the end of the White House’s 30 Days to Slow the Spread guidance), and late July 2020 (when patient deaths in the U.S. reached 132,918). PC was assessed in Waves 2-4. Results. There were age differences in the trajectory of PC such that PC increase for middle-aged and older adults, whereas younger adults had lower PC and did not increase over the follow-ups. All personality traits but Openness were associated with PC at the first assessment. Conscientiousness, Extraversion, and Agreeableness positively predicted PC change over time. The association between Conscientiousness and Extraversion and increased PC over time was stronger at older ages. Conclusion. Pre-pandemic personality predicted PC and PC change during the first four months of the pandemic, with middle-aged and older adults showing better adaption than younger adults. This study provides new evidence for PC change and associations between personality and PC during the COVID-19 pandemic.
Physical Activity, Social Support, and Mood in Older Adults during the COVID-19 Pandemic
Authors: Inman Morgan , Murphy Clare , Strong Jessica
Published: December 2021

Research shows that increased physical activity is associated with improved mood and reduced symptoms of depression in older adults. Prior research has also found that loneliness and social isolation have a significant impact on the mental and physical well-being of older adults, with higher amounts of social connectedness and social activity associated with more frequent positive mood states. Overall social isolation is increased due to the COVID-19 pandemic and this could have a large impact on the physical and mental health of older adults. A group of 36 community dwelling older adults (Mean age = 70.5) completed questionnaires measuring physical activity, social activity, and social support, during the COVID-19 pandemic. Analyses found that perceived social support and average social network size significantly predicted positive mood states (F(2,33)=3.32, p<0.05) accounting for 16.7% of the variance, with a large effect. After adding average number of hours of sedentary activity the model was not significant. Perceived social support was more predictive of positive mood (β=0.32) compared to network size (β=0.17). There was a trend for the same three variables to predict negative mood (F(3,32)=2.76, p=0.06) accounting for 22% of the variance. Sedentary behaviour was the most predictive (t=2.68, p<0.05, β= 0.49). This suggests that perceived social support is most predictive of positive mood, and sedentary behaviour is predictive of negative mood during the COVID-19 pandemic.
The mediating role of rumination and personal growth on pandemic depression: a longitudinal study
Authors: Paniagua Teresa , Fernández-Fernández Virginia , Molina Martínez MªÁngeles
Published: December 2021

Introduction: The experience of recent months, caused by COVID-19 pandemic including strict home confinement, has required older people to implement coping strategies to combat the harmful effects of depression and associated loneliness. Method: longitudinal study, including functionally and cognitively independent people over 65, three temporal evaluation measures: WAVE1 (6 months pre-COVID-19, N=305; M=73.63; 58.9% women), WAVE2 (during home confinement; N=151; M=73.14; 59.6% women) and WAVE3 (8 months post-WAVE2; N = 85; M=72.62; 64.70% women). Bivariate correlations and a multiple hierarchical regression model are performed to explain the variance of depression in WAVE3 from rumination and growth on general life events (in WAVE1) and rumination and personal growth associated with COVID-19, both in WAVE2 and WAVE3. Results: statistically significant correlations are obtained between all the variables. The regression model explains 65.7% of the variance of depression (all steps significant). Both rumination (B=0.45;p=0.00) and growth (B=-0.40;p=0.00) on general life events (WAVE1) explain 54.5% of the depression in WAVE3. Rumination on COVID (B=.310;p≤0.01) in WAVE2 and the growth over COVID (B=-0.24;p≤0.01) in WAVE3, allow a significant explanation of 6.8 and 4.4% of the proposed model, respectively. Conclusions: it seems clear the impact that emotional regulation strategies have on life events over time. In addition, rumination is an emotional process of maladaptive coping also in the face of the pandemic. However, the growth capacity of the person is a useful tool to combat the damaging effects of negative life events. In the elderly, it seems necessary to influence and bet on positive coping strategies.
Early Documentation of Life-Sustaining Treatment Orders Prior to Diagnosis of COVID-19 in Nursing Home Residents
Authors: Henkin David , Harris Brande , Espinoza Sara , Caliz Hazel , Oakman Kimberly , Sanchez-Reilly Sandra , Restrepo Marcos
Published: December 2021

Coronavirus disease 2019 (COVID-19) has had a devastating impact on older adult nursing home residents (NHR). NHRs comprise greater than one-third of COVID-19 U.S. deaths, emphasizing the importance of engaging in end-of-life discussions. At South Texas Veterans Health Care System (STVHCS), we implemented early documentation of patient’s Life-Sustaining Treatment (LST) or end-of-life goals-of-care preferences prior COVID-19 infection. We now aim to examine the association between early LST documentation (prior to COVID-19 diagnosis) and hospital admissions for COVID-19 by conducting a retrospective cohort study of Veteran NHRs at STVHCS from March 2020-January 2021. Inclusion criteria were NHRs with COVID-19 diagnosis, LST documentation, and clear timing of whether the LST documentation occurred before or after COVID-19 diagnosis. Logistic regression was used to determine the likelihood of hospitalization by whether LST was documented before or after COVID-19 diagnosis. 208 NHRs were diagnosed with COVID-19 and 160 (76.9%) had LST documentation. Of these, 148 were included in the analysis: 84 (56.8%) had a completed LST note prior to diagnosis and 64 (43.2%) after diagnosis. The hospitalization rate was 46% for those with LST prior to diagnosis compared to 78% in those with LST after diagnosis (OR = 0.24, 95% CI: 0.12-0.50, P<0.001), showing that early LST documentation was associated with 76% lower likelihood of hospitalization. Early interventions for LST documentation can reduce hospitalization in high-risk populations. These findings may have implications for reducing unnecessary hospitalizations, diminishing healthcare costs, and resolving ethical dilemmas related to potential resource allocation during a pandemic.