bluuebunny/crossref_metadata_2025 huggingface dataset:
Six-Month Lower-Leg Sensory Stimulation Augments Neural Network Connectivity Associated With Improved Gait
Authors: Hsu Chun Liang , Iloputaife Ikechukwu , Oddsson Lars , Manor Brad , Lipsitz Lewis
Published: December 2021

Foot sole somatosensory impairment associated with peripheral neuropathy (PN) is prevalent and a strong independent risk factor for gait disturbance and falls in older adults. A lower-limb sensory prosthesis providing afferent input related to foot sole pressure distributions via lower-leg vibrotactile stimulation has been demonstrated to improve gait in people with PN. The effects of this device on brain function related to motor control, however, remains equivocal. This study aimed to explore changes in brain network connectivity after six months of daily use of the prosthesis among individuals with diagnosed PN and balance problems. Functional Gait Assessment (FGA) and resting-state functional magnetic resonance imaging were completed before and after the intervention. Preliminary analysis on participants who have completed the study to date (N=5; mean age 76 years) indicated altered connectivity of the sensorimotor network (SMN), frontoparietal network (FPN), and the default mode network (DMN) post-intervention (Z>3.11, unadjusted p<0.05). Participants displayed an average improvement of 5.5 point in the FGA (Minimal Clinically Important Differences>4 for community-dwelling older adults) that was correlated with connectivity changes (unadjusted p<0.05). Specifically, improved FGA was associated with: 1) increased connectivity between the SMN, cerebellum, and occipital cortex; 2) increased connectivity between the FPN, cerebellum, calcarine and intracalcarine; and 3) decreased connectivity between DMN and intracalcarine. These early findings suggest that long-term use of a lower-limb sensory prosthesis may induce neuroplastic changes in brain network connectivity reflecting enhanced bottom-up sensory-attentional processing and suppression of the DMN that are relevant to gait improvements among older adults with PN.
What works and what doesn’t: Gerontology focused PhD/ DSW graduates speak out
Authors: Myrick Matthew , Snedeker Lauren
Published: December 2021

Lin et al. (2015) projected there would be a shortage of approximately 195,000 social workers in the United States by 2030. In the next twenty years, it is estimated that Americans over the age of 65 will actually outnumber children under the age of 18 (US Census, 2018). With a longstanding reputation for being less “glamorous”, social work with older adults will continue to experience deficits in the amount of those who commit to this field of practice unless more lasting change occurs (Cummings et al., p. 645, 2005). We must take a closer look at what takes place in the classroom at schools of social work to understand why social workers are not interested in working with older adults (Scharlach et al., 2000). Berkman et al. (2016) described in their work that a critical shortage of gerontology-focused social work faculty exists in schools of social work. Thus, we cannot expect more social workers to work with older adults unless they are exposed to this work in their educational programs. The purpose of this study is to report on the academic experience, research agenda, professional experiences (practice and teaching), and future goals of social work PhD/ DSW graduates. Ten social work doctoral graduates were interviewed in order to understand the impact their academic programs had on their commitment to older adults in their field and to learn their recommendations for schools of social work in an effort to sustain and grow the gerontological workforce.
A Platform to Study the Effects of Home Environment on Health and Wellbeing of Older Adults
Authors: Baniassadi Amir , Manor Brad , Yu Wanting , Lipsitz Lewis , Pascual-Leone Alvaro
Published: December 2021

While older adults’ living environment is rarely well-tuned to their specific needs, technological advances provide new opportunities to understand, and ultimately optimize, the relationship between the home environment and health outcomes. We aimed to establish proof-of-concept and feasibility of a platform enabling real-time, high-frequency, and simultaneous monitoring of environment, biological variables, and outcomes related to health and wellbeing in older adults. We recruited 7 participants (6 females, 1 male, aged 78-90, MoCA scores 14–28), installed environmental sensors measuring temperature, humidity, and CO2 inside their homes, provided them with wearables that measure sleep, activity, body temperature, and heart rhythms, and asked them to use a tablet to complete four sets of questionnaires and cognitive tests per day for three consecutive weeks. Environmental sensors collected data with no disruption or complaint from participants. Average compliance with the wearables was 81% (ring) and 60% (watch). All participants preferred the ring due to ease-of-use. Compliance was better in those with higher MoCA scores. Three participants were able to use the tablet successfully and completed 90% of prescribed questionnaires and cognitive tests. Cognitive and/or motor issues prevented the other participants from using the tablet. Exit interviews revealed that participants would prefer to complete a maximum of two sets of daily questionnaires and cognitive tests (five minutes each) in longer-term studies. These results suggest that it is feasible to study the impact of the environment on biological rhythms, cognition, and other outcomes in older adults and provide recommendations for ensuring long-term compliance with the protocol.
Age-related Changes in Ongoing Thought Relate to External Context and Individual Cognition
Authors: Turnbull Adam , Poerio Giulia , Lin Feng , Smallwood Jonathan
Published: December 2021

Understanding how age-related changes in cognition manifest in the real world is an important goal for aging research. One means of capturing these changes involves “experience sampling” participant’s self-reported thoughts as they go about their daily lives. Previous research using this method has shown age-related changes in ongoing thought: e.g., older adults have fewer thoughts unrelated to the here-and-now. However, it is currently unclear how these changes reflect cognitive aging or lifestyle changes. 78 younger adults and 35 older adults rated their thought contents along 20 dimensions and the difficulty of their current activity in their daily lives. They also performed cognitive tasks in the laboratory. In a set of exploratory analyses using Principal Component Analysis (PCA), we found that older adults spent more time thinking positive, wanted thoughts, particularly in demanding contexts, suggesting they may use different strategies to regulate their emotions. In line with previous research, older adults spent less time mind wandering about their future selves. Past-related thought related to episodic memory differently in older and younger adults. Additionally, PCA analyses performed separately in older and younger adults showed high similarity to an analysis performed on the combined sample, suggesting a similar structure to ongoing daily life thought in older and younger adults. These findings inform the use of experience sampling to understand cognitive aging, highlighting the need to consider content along multiple dimensions as well as the context in which thoughts are reported when analyzing aging ongoing thought.
An Online Community Intervention for Older Persons with Pre-Frailty and Frailty: Pilot Studies
Authors: Zaslavsky Oleg , Chu Frances , Ge Shaoqing , Teng Andrew , Lin Shih-Yin , Demiris George , Chen Annie
Published: December 2021

Online community interventions can support self-management in older populations but have rarely targeted symptomology of pre-frailty and frailty. To support older adults’ pre-frailty/frailty symptom management, we iteratively refined an approach entitled Virtual Online Community for Aging Life Experience (VOCALE) in three consecutive pilot studies (2018-2020). These studies employed asynchronous online discussions in which participants were asked to respond to weekly prompts. A study facilitator moderated the discussion, encouraging participants to respond to both the prompts and comments of other participants. In the first pilot (n=8), participants engaged in a collective exploration of different symptoms of pre-frailty and frailty. The second (n=10) and third (n=10) pilots employed a hybrid approach including collaborative exploration and learning of different problem-solving therapy skills over eight weeks. The mean age of participants of the three pilots combined was 80.6 (SD = 7.0). Most participants were female (71%). Participant attrition ranged from 20-25%. Many participants who completed the study noted that they enjoyed the discussions. The participants also found the moderators' follow-up questions and support timely and engaging. Additionally, we observed small but positive changes in self-efficacy measures. These pilot studies have confirmed that older adults with pre-frailty and frailty are interested, and can successfully engage in online community interventions, with the technical support and moderation provided, even during the initial stages of the COVID-19 pandemic, when lockdown policies were rolled out. Participation in the intervention was also associated with increased awareness of the need to be proactive in self-management concerning frailty-related symptoms.
Association of Dual Sensory Impairment with Incident Mobility and ADL Difficulty
Authors: Armstrong Nicole , Teixeira Camila Vieira Ligo , Brenowitz Willa , Swenor Bonnielin , Simonsick Eleanor , Jones Richard , Gendron Colby
Published: December 2021

Hearing and vision impairment are each independently associated with incident mobility disability and disability in activities of daily living (ADL). Whether dual sensory impairment (DSI) in both hearing (pure-tone average >25 dB) and vision (impaired visual acuity and/or impaired contrast sensitivity) is associated with greater risk of incident mobility and ADL difficulty, as compared to single or no sensory impairments, has not been well-studied. To examine these associations, we used data from 2,020 Health Aging and Body Composition Study participants aged 70-79 years without mobility limitations. Incident mobility difficulty was defined as the first instance of a lot of problems or inability to walk ¼ mile and/or climb 10 steps, and incident ADL difficulty was defined as the first instance of problems with any ADL. Cox proportional hazards models adjusted by demographic covariates, diabetes, hypertension, and depressive symptoms were used to model these associations. Approximately 22.7% of the study had DSI. DSI was associated with increased risk of both incident mobility (Hazard Ratio [HR]=2.43, 95% Confidence Interval [CI]: 1.60, 3.69) and ADL difficulty (HR=2.39, 95% CI: 1.60, 3.56). Vision impairment only was associated with risk of incident mobility difficulty (HR=1.74, 95% CI: 1.09, 2.78), but not incident ADL difficulty (HR=1.45, 95% CI: 0.91, 2.32). Hearing impairment only was not associated with risk of either outcome. Synergistic effects of DSI on the additive scale were present. Sex and race did not modify associations. Monitoring of DSI may be beneficial in delaying incident difficulty.
Dementia Risk in Older Veterans With Frailty: A Cross-Sectional Study
Authors: Hernandez Christian Gomez , Diaz Alma , Sow Ahmadou , Athouriste Gauty , Ijaopo Ezekiel , Ruiz Jorge
Published: December 2021

Frailty, a clinical syndrome characterized by vulnerability to stressors resulting from multisystemic loss of physiological reserve, predicts future cognitive decline. However, frailty has also been proposed as a dementia risk factor, predicting future cognitive impairment. The study aim was to determine frailty in older veterans and its association with risk of dementia. Community-dwelling Veterans ≥50 years completed a mailed socio-demographic questionnaire and Self-Administered Gerocognitive Examination (SAGE), July 2019-May 2020. The information was complemented with EHR data. We calculated the CAIDE score, a validated tool predicting dementia (≥6 points= high risk 20 years later) and the 31-item VA frailty index data (frail ≥.20, non-frail ≤.20). After adjusting for socio-demographic characteristics, smoking, alcohol/substance abuse, OSA and anticholinergic use, odds ratio (OR) and 95% CI were calculated using BLR to assess the cross-sectional association between frailty and dementia risk (CAIDE ≥6 points and MCI). The survey response rate was 19.75% (1,073 of 5,432). Participants mean age was 68.38 (SD=8.49) years, 57.50% (n=617) Caucasian, 69.34% (n=744) non-Hispanic, 95.81% (n=1,028) male, and 36.72% (n=394) frail. 11.84%(n=127) screened positive for MCI and 15.38% (n=165) for dementia. 689 (75.88%) veterans were at high risk for dementia of whom 426 (61.83%) were non-frail and 263 (38.17%) were frail. Frailty was cross-sectionally associated with higher risk for dementia in older Veterans, adjusted OR:1.45 (95%CI:1.016-2.070), p=.041. The mailed screening was a feasible and practical approach to screen for dementia risk. Early identification of patients with frailty can help in the implementation of interventions aimed at preventing or delaying dementia.
Depression Mediates the Causal Effect of Food Insecurity Transition on Cognitive Function
Authors: Lu Peiyi , Kezios Katrina , Hazzouri Adina Zeki Al
Published: December 2021

Despite substantial evidence on the relationship between food insecurity and worse cognition, few studies have examined the underlying mechanisms. This study examined whether and to what extent depression mediated the casual effect of food insecurity on cognition in midlife. Longitudinal data from the Coronary Artery Risk Development in Young Adults Study were used. The 2000 survey was used as our study’s baseline, when respondents aged 33-45. We lagged the explanatory and mediator variables to set up temporality. Food insecurity transition from 2000-2005 surveys was recoded (persistent food secure, persistent food insecure, became food insecure, and became food secure). Depression was measured in 2010, while cognitive functions were measured in 2015. Causal mediation analysis examined and decomposed the direct and indirect effect. Compared to persistent food security, both persistent and became food insecure were linked to worse cognition, after adjusting demographic and cardiovascular risk factors. Further, for both exposure groups, depression had significant and strong mediation effects (natural indirect effect ranged from -0.037 to -0.018). Specifically, as respondents experienced persistent food insecurity or became food insecure, their depression increased, which, in turn, reduced their cognition. The proportion of the total effect of food insecurity transition on cognition mediated by depression ranged from 7-24% for processing speed, verbal memory, cognitive, and language functions. Persistent and became food insecure reduced cognitive function directly or indirectly through increasing depression among middle-aged adults. Interventions targeting either food insecurity or treatment of depression among food insecure individuals may have the potential to slow premature cognitive aging.
Do Inflammation Markers Moderate Associations Between Caregiving and Quality of Life, Health, and Depression?
Authors: Orsega-Smith Elizabeth , Kuczmarski Marie , Davey Adam , Wolfle Brianna , Zonderman Alan , Evans Michele
Published: December 2021

Caregiving responsibilities can put stress and strain on older adults including emotional distress, depression, decline in physical functioning, and decreased self- reported quality of life. Chronic stress such as from caregiving may be related to chronic inflammation, but this has been less widely examined. Therefore, the purpose of this study is to examine whether the association between caregiving and outcomes including quality of life indicators, self-rated health, and depressive symptoms are moderated by physical activity, stress coping, diet quality inflammatory index, and selected biomarkers of inflammation. We used data from waves 3 and 4 of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. In wave 3, 733 reported caregiving for grandchildren. They were mostly African American (59%) and female (55%) with a mean age was 47.7 years at the start of the study. In linear regression models, caregiving for grandchildren (CGC) predicted higher depressive symptoms and lower quality of life and self-rated health. Results demonstrated that the association between erythrocytes sedimentation rate (ESR) was a significant moderator between CGC and quality of life, self-rated health, and depressive symptoms (p<0.05). In a separate analysis of wave 4 data (152 reported caregiving for elders), serum magnesium was a significant moderator between caregiving for elders and both quality of life and self-rated health (p<0.05). These results suggest that inflammatory factors may influence the health of diverse older adult caregivers. Further (or Future) research may evaluate the effect of these moderators over time.
Does Frailty influence Inhospital Management and Outcomes of COVID-19 in Older Adults in the US?
Authors: Setoguchi Soko , Madhira Vithal , Bergquist Timothy , Kuhrt Nathaniel , Islam Jessica , Spratt Heidi , Siu Joseph , Kennedy Richard
Published: December 2021

Older age has been consistently associated with adverse COVID-19 outcomes. Frailty, a syndrome characterized by declining function across multiple body systems is common in older adults and may increase vulnerability to adverse outcomes among COVID-19 patients. However, the impacts of frailty on COVID-19 management, severity, or outcomes have not been well characterized in a large, representative US population. Using the National COVID Cohort Collaborative, a multi-institutional US repository for COVID-19 research, we calculated the Hospital Frailty Risk Score (HFRS), a validated EHR-based frailty score, among COVID-19 inpatients age ≥ 65. We examined patient demographics and comorbidities, length of stay (LOS), systemic corticosteroid and remdesivir use, ICU admission, and inpatient mortality across subgroups by HFRS score. Among 58,964 inpatients from 53 institutions (51% male, 65% White, 18% Black, 9% Hispanic, mean age 75, mean Charlson comorbidity count 3.0, and median LOS 7 days), 38,692 (66%), 4,180 (7%), 3,531 (6%), 3,525 (6%) and 7,862 (13%) had HFRS scores of 0-1, 2, 3, 4, and >=5 , respectively. Frailty was only moderately correlated with age and comorbidity (ρ=0.178 and 0.348, respectively, p<0.001). Overall, 34% received systemic corticosteroid and 19% received remdesivir. We observed 4% ICU admissions and 16% inpatient death. Among non-ICU admissions, after adjusting for demographics and comorbidities, frailty (HFRS ≥ 2) was associated with 79% greater systemic corticosteroid use and 22% greater remdesivir use, whereas a higher HRFS score was marginally associated with higher rates of severe COVID disease, inpatient death, or ICU admission.
Duration of Reproductive Period and Risk of Transitioning to Mild Cognitive Impairment and Dementia
Authors: Yoneda Tomiko , Knight Jamie , Lewis Nathan , Muniz-Terrera Graciela , Bennett David , Piccinin Andrea
Published: December 2021

Decreasing estrogen levels have been hypothesized to be associated with increased risk of dementia, yet the current literature reveals conflicting results. This study aimed to determine whether a longer reproductive period, as an indicator of longer exposure to endogenous estrogens, is associated with risk of transitioning to MCI and dementia. Women 65 and over (N=1507) from the Rush Memory and Aging Project met eligibility for the current analysis. The average length of reproductive period (menopause age minus menarche age) was 35 years (range=16-68 years), and 64% had natural menopause. Multistate survival modeling (MSM) was used to estimate the influence of reproductive period on risk of transitioning through cognitive states including mild cognitive impairment (MCI) and clinically diagnosed dementia, as well as death. Multinomial regression models estimated total and cognitively unimpaired life expectancies based on the transition probabilities estimated by the MSM. Results suggest that women with more reproductive years were less likely to transition from no cognitive impairment (NCI) to MCI, and were more likely to return to NCI from MCI. Analyses also suggest two additional years free of cognitive impairment for women with 45 vs 25 years of reproduction, though reproduction period did not significantly impact overall life expectancy. This study suggests that the number of years of reproductive duration is not associated with the transition to dementia, but is possibly associated with delayed cognitive decline, reduced risk of MCI, increased likelihood of returning to NCI from MCI, and increased lifespan free of cognitive impairment.
Effects of Tinnitus on Cognition and Depressive Symptoms Over Time
Authors: De Anda Jennifer , Warren Teresa , Bell Tyler , Kremen William , Franz Carol
Published: December 2021

Evidence suggests links among tinnitus, depression, and cognition. We examined these associations over time. We hypothesized baseline tinnitus would predict poorer cognitive performance and more depressive symptoms an average of 11.4 years later. We examined 839 men at two timepoints (baseline age M=55.94; follow-up age M=67.56). At each time point participants responded yes/no if they had tinnitus. We created three tinnitus status groups – no tinnitus at either time, tinnitus at both, and no tinnitus at baseline but tinnitus at follow-up. At both time points we measured cognitive performance with tests of episodic memory, processing speed, executive function, and verbal fluency. Depressive symptoms were based on the Center for Epidemiological Studies Depression scale. There was no association between tinnitus and any measure of cognitive performance. Depressive symptoms declined from baseline to follow-up. In separate mixed models predicting depressive symptoms, there was a significant main effect for tinnitus status at baseline (p = .003) and follow-up (p < .001). Those with tinnitus at both times had significantly higher depressive symptoms than the “No tinnitus” group (p < .001). This association remained significant after accounting for baseline depressive symptoms (p = .011) at follow-up. Results did not support the hypothesis that tinnitus would be associated with poorer cognitive function. However, depressive symptoms declined among those with no tinnitus than the other groups. The relationship between tinnitus and depressive symptoms may have implications for future cognitive performance among older adults, given previous evidence that depressive symptoms are risk factors for cognitive decline.
Engaging with Aging: A Qualitative Study of Age-Related Changes and Adaptations
Authors: Ge Shaoqing , Wu Kuan-Ching , Frey Hillary , Saudagaran Maryam , Welsh Derick , Primomo Janet , Belza Basia
Published: December 2021

Engaging with Aging is an emerging framework proposed by Carnevali which provides a new lens to understand an active, conscious daily living process of coping with age-related changes (ARCs) taken on by older adults. Study aims were to 1) describe the ARCs experienced by community-dwelling older adults; 2) identify the strategies and resources used by older adults to accommodate the daily living challenges caused by the associated ARCs; and 3) evaluate the framework of EWA based on findings from aims 1 and 2. We conducted semi-structured interviews with 29 participants aged 64 to 98 online due to COVID-19 restrictions. We used a virtual card sort to assist data gathering. Fifteen ARCs (e.g., changes in hearing, changes in stability, changes in sleep, etc.) were mentioned by participants and their corresponding adaptations were discussed. We found that older adults linked their adaptations to their ARCs based on their changing capacities and needs. Commonly used adaptations included conserving energy, utilizing tools or technology, and being more conscious before and while taking actions. The challenges caused by COVID-19 in implementing the adaptations were also discussed (e.g., increased difficulty in understanding others due to mask-wearing). Our study substantiates the EWA framework by showing the commonality among older adults in linking ARCs with adaptations. Implications for clinicians and researchers include using EWA to help older adults identify personalized solutions that fit their capacities. Our study is late-breaking as we recently finished data analysis and the information included was not yet available by the previous submission deadline.
Experiences of African American Dementia Caregivers During the COVID-19 Pandemic
Authors: Oliver Sloan , Alexander Karah , Epps Fayron
Published: December 2021

African American caregivers are often confronted with the complexities of caregiving through the lens of race and associated health disparities. The COVID-19 pandemic has both exacerbated the systemic disparities and deeply rooted inequities experienced by African Americans and laid bare their effects on the community of caregivers. The purpose of this project was to explore the experiences of African American dementia caregivers during the COVID-19 pandemic. Nineteen African American caregivers of persons living with dementia were recruited by primary investigators and community partners with purposeful sampling techniques to participate in semi-structured focus groups that were held April 2021. Four overarching themes were constructed during thematic analysis: social isolation, decreased well-being, the good and bad of telehealth, and challenges in fulfilling the caregiver role. Caregivers expressed that they became socially isolated from family and friends, which led to them becoming depressed and mentally strained. Several caregivers felt they could not carry out their caregiver duties due to the constraints surrounding the pandemic. The varying levels of interaction with and the comfort level of physicians utilizing telehealth led to caregivers having mixed reviews on the popularized service. The results of this study will be used to culturally adapt caregiving education courses and programs promoting mastery and competency during a pandemic. In preparations for future public health crises, healthcare professionals will be able to use the results of this study to address the specific needs and improve the experiences of African American dementia caregivers.
Fake News Detection in Aging During the Era of Infodemic
Authors: Pehlivanoglu Didem , Lin Tian , Chi Kevin , Perez Eliany , Polk Rebecca , Cahill Barian , Lighthall Nichole , Ebner Natalie
Published: December 2021

Increasing misinformation spread, including news about COVID-19, poses a threat to older adults but there is little empirical research on this population within the fake news literature. Embedded in the Changes in Integration for Social Decisions in Aging (CISDA) model, this study examined the role of (i) analytical reasoning; (ii) affect; and (iii) news consumption frequency, and their interplay with (iv) news content, in determining fake news detection in aging during the COVID-19 pandemic. Young (age range 18-35 years, M = 20.24, SD = 1.88) and older (age range 61-87 years, M = 70.51, SD = 5.88) adults were randomly assigned to view COVID or non-COVID news articles, followed by measures of analytical reasoning, affect, and news consumption frequency. Comparable across young and older adults, fake news detection accuracy was higher for news unrelated to COVID, and non-COVID fake news detection was predicted by individual differences in analytic reasoning. Examination of chronological age effects further revealed that detection of fake news among older adults aged over 70 years depended on interactions between individual CISDA components and news content. Collectively, these findings suggest that age-related susceptibility to fake news may only be apparent in later stages of older adulthood, but vulnerabilities are context dependent. Our findings advance understanding of psychological mechanisms in fake news evaluation and empirically support CISDA in its application to fake news detection in aging.
Feasibility, Acceptability, and Impact of a Self-guided e-Learning Memory Program for Older Adults
Authors: D'Amico Danielle , Yusupov Iris , Zhu Lynn , Lass Jordan , Plunkett Cindy , Levine Brian , Troyer Angela , Vandermorris Susan
Published: December 2021

Clinician-led memory interventions have been shown to increase knowledge, reduce anxiety, promote memory-strategy use, and increase brain-healthy lifestyle behaviours in older adults with normal age-related memory changes. A self-guided, e-learning version of the Baycrest Memory and Aging Program® was recently developed to increase accessibility to memory interventions. The objectives of the current study were to assess program feasibility (retention rate), acceptability (satisfaction), and participant-reported impact (memory concerns, behaviour change, goal attainment). As part of a larger study, participants were 139 healthy older adults (mean age: 73±7, 73% female). Ninety-two individuals completed the program (retention rate=66%). Anonymous feedback data indicated a high level of satisfaction with the program overall (98%), the pace and clarity of the learning modules (100%), and the organization and navigation of the interface (92%). Suggested improvements included offering more interaction with others and addressing minor platform glitches. There was a decrease in the level of concern about memory change, with 64% expressing concern at a level consistent with the Jessen et al. (2014) criteria for Subjective Cognitive Decline at baseline, and 23% expressing the same at post-test. The majority of participants reported increases in using memory-strategies (63-97%) and lifestyle-promoting behaviours (40-72%). All participants reported moderate to high satisfaction with personal goal attainment. Results support feasibility, acceptability, and impact of a self-guided e-learning adaptation of memory intervention. E-learning tools may be a promising avenue to deliver accessible brain health promotion in later life, especially in the context of the shift to virtual care during and beyond COVID-19.
Insight into the Feasibility and Acceptability of a Multi-lifestyle Dementia Risk Intervention
Authors: Dodds Laura , Siette Joyce
Published: December 2021

Lifestyle interventions based on behaviour change principles may provide a useful mechanism in reducing dementia risk amongst older adults, however intervention acceptability remains relatively unexplored. We assessed the feasibility and acceptability of BRAIN BOOTCAMP, an Australian initiative aiming to improve dementia literary and reduce dementia risk by delivering a brain health box addressing multiple lifestyle factors through education, physical prompts and an individualised brain health profile. Semi-structured phone interviews were conducted with participants (N=94) at completion of the program (3-months) using a theoretical sampling approach to select a range of participants with varying brain health scores, age, gender, education and locality. Interview topics included participants’ overall experience and suggestions for program improvement. Interviews were transcribed and analysed using thematic analysis. Participants were mostly female (79%), with a mean age of 72.6 years (SD=5.4), from an English-speaking background (89.4%) and resided in metropolitan areas (76.6%). Participants positively perceived the program, resulting in high usability and acceptability. Valuable aspects included building dementia awareness in an innovative way, and having re-assessments which identified areas for personal improvement. Participants further discussed how the program prompted lifestyle change, including setting goals (e.g., physical activity) and facilitated a general awareness of their brain health. Suggested improvements included shorter surveys, regular check-ins, and specific tailoring of the program to be more inclusive for older adults with varying levels of health. Our study demonstrated that a simple, innovative program could be a promising medium for delivering comprehensive educational resources and induce lifestyle change for older adults.
Pleiotropy of Alzheimer’s Disease and Educational Attainment: Insights from the Summary Statistics
Authors: Loika Yury , Loiko Elena , Culminskaya Irina , Kulminski Alexander
Published: December 2021

Epidemiological studies report beneficial associations of higher educational attainment (EDU) with Alzheimer’s disease (AD). Prior genome-wide association studies (GWAS) also reported variants associated with AD and EDU separately. The analysis of pleiotropic predisposition to these phenotypes may shed light on EDU-related protection against AD. We examined pleiotropic predisposition to AD and EDU using Fisher’s method and omnibus test applied to summary statistics for single nucleotide polymorphisms (SNPs) associated with AD and EDU in large-scale univariate GWAS at suggestive-effect (5×10-8
The relationship between protein intake and gut microbiota in community-dwelling older men from the MrOS study.
Authors: Farsijani Samaneh , Cauley Jane , Peddada Shyamal , Langsetmo Lisa , Shikany James , Ensrud Kristine , Orwoll Eric , Newman Anne
Published: December 2021

Despite growing evidence supporting the role of protein consumption in promoting muscle health, the possible mediation by gut microbiota remains unclear. Here, we determined the association between the quantity of dietary protein and gut microbiome composition in community-dwelling older adults. We performed a cross-sectional analysis on 775 older men from the Osteoporotic Fractures in Men (MrOS) study with available dietary information and stool samples at visit 4 (2014-16). Protein intake extracted from a brief Food Frequency Questionnaire and adjusted to total energy intake using the residual method. Gut microbial taxa were determined by 16S (v4) sequencing (Greengenes references). 11,534 Operational Taxonomic Units were identified and assigned to 21 phyla with dominance of Firmicutes (45%) and Bacteroidetes (43%). We performed distribution-based analysis (α-diversity), distance-based Permutation Multivariate Analysis of Variance (β-diversity), and taxa abundance (by ANCOM-BC R-package) to determine associations between protein intake and gut microbiome. Mean energy-adjusted protein intake was 62.0±10.8 g/d [0.8±0.3 g/kgBW/d]. Participants with higher protein intake had higher Shannon and Chao1 α-diversity indices (P<0.05). For β-diversity analysis, participants with higher protein intake had a different center in weighted and unweighted UniFrac PCoA vs. those with lower intake (P<0.05) adjusted for age, race, clinical center, energy intake, weight, height, and medications. Tenericutes phylum and several genus-level OTUs, including Klebsiella, Tyzzerella, Christensenellaceae, Ruminococcaceae, Blautia, and Veillonella were differentially abundant between quartiles of protein intake (FDR corrected P<0.05). Our data support an association between dietary protein and gut microbiota diversity, a relationship that could potentially influence physical function and sarcopenia development.
Trehalose Enhances Long-term Recovery in 18-month-old Mice by Increasing Autophagy after Traumatic Brain Injury
Authors: Ritzel Rodney , Li Yun , Carter Jordan , Khan Niaz , He Junyun , Allen Samantha , Faden Alan , Wu Junfang
Published: December 2021

Older patients with traumatic brain injury (TBI) have higher mortality and poorer long-term outlook compared to younger individuals. This may contribute to the assumption that aggressive management of geriatric TBI is futile. The present study examined the long-term recovery potential and underlying mechanisms associated with advanced age in male C57BL/6 mice using a controlled cortical impact model of TBI. Older (18 mos) mice had higher mortality compared to younger (10 wks) mice at 12 weeks post-injury. While aging alone had a profound impact on behavioral ability, the recovery slope in some, but not all, neurobehavioral tests was relatively similar between young and old injured mice. NanoString analysis identified several age- and injury-specific genes that were differentially expressed, including those involved with the complement, phagocytosis, and autophagy pathways. Flow cytometry demonstrated dysregulation of autophagic function in microglia with normal aging which was exacerbated after TBI. Given the critical role for autophagy in promoting the cellular degradation of cytoplasmic materials, we reasoned that treatment with the autophagic inducer, trehalose, may be a viable therapeutic strategy. Trehalose was administered in the drinking water (3%) starting at d1 post-injury up to 8 weeks. Older TBI mice treated with trehalose exhibited either delayed deficits or enhanced recovery in cognitive and motor tasks. Trehalose modified expression of autophagy markers and reprogrammed the microglial response to TBI. Our data indicate that microglia undergo chronic changes in autophagic regulation that are associated with poor outcome. Boosting autophagy may be a promising therapeutic strategy for older TBI patients.
Understanding Older Adults Motivations and Preferences for a Medication Adherence App
Authors: Kupiec Olivia , Harris Maurita , Rogers Wendy
Published: December 2021

As the percentage of older adults with hypertension continues to increase, medication adherence remains low. However, medication adherence can potentially be improved through the use of medication reminder apps. Medication reminder apps contain numerous features that enable older adults to remember to take their medication, such as providing alerts to take their medication, reminding them when to refill their prescription, and more. Despite being aware of these apps, many older adults lack the motivation needed to use them continuously. We recruited 9 participants (60 years or older) who currently take medication for a chronic condition. Using a mixed-methods approach, we gathered quantitative survey data using the TechSAge Demographic Background, Motivation, and Behavior Change Technique Questionnaires). Qualitative data were gathered through a semi-structured interview that asked questions about general motivations and preferences in addition to engaging participants in co-designing a medication adherence app. Results from the interview were analyzed through a thematic analysis that identified comprehension and preferences of older adults in medication reminder app usage. We tested five different intrinsic motivation factors, and results indicate older adults are most motivated intrinsically due to perceived choice, perceived competence, value/usefulness, effort/importance, and pressure/tension. We also tested five factors of extrinsic motivation, and results indicate older adults are most motivated extrinsically due to introjected regulation, reward-driven, external regulation, compliance, and identification. These data provide insights to guide the design of medication reminder apps to support older adults in the self-management of their chronic conditions.
Using Diagnostic Ultrasound to Support the Diagnose Sarcopenia in Older Adults: A Systematic Review
Authors: Vieira Edgar , Charles Lily , Cortes Monica , Lees Tabitha
Published: December 2021

Dual-energy x-ray absorptiometry (DXA) is currently the gold standard for diagnosing loss of muscle mass in older adults (a component of sarcopenia diagnosis). Magnetic resonance imaging (MRI) and computed tomography (CT) have also been used successfully. Due to elevated costs, limited access, exposure to radiation, and increased difficulty of operation, other methods have been explored as alternatives. We reviewed the literature on the use of diagnostic ultrasound to assist in the diagnose sarcopenia in older adults by searching MEDLINE, Embase, and CINAHL using a variation of terms related to “ultrasound”, “sarcopenia”, and “older adults”. We included studies that included older adults over the age of 60. Eighteen studies were included after screening for eligibility and conducting full-text reviews. The most common transducer head frequency utilized in the studies were 5-12 and 8 MHz (three studies each), followed by 5, 6, and 7.5 MHz (two studies each). The most common musculature examined was anterior thigh musculature, followed by muscles of the lower leg, upper extremity, abdominals, and head/neck. Measurements most taken were muscle thickness/cross sectional area (18 studies), followed by muscle echogenicity (9 studies), and pennation angle (3 studies). Ultrasound is a reliable and valid tool to examine muscle thickness to assist in diagnosing sarcopenia. However, echogenicity measures of a muscle were not reliable. Further research is needed with increased sample size and variance amongst subjects to generalize and create normative data. In addition, standardized protocols for the use of ultrasound to assist in the diagnosing sarcopenia need to be established.
Growth Mindset and Older Adults’ Well-Being During the COVID-19 Pandemic
Authors: Kyeong Yena , Sheffler Pamela , Kürüm Esra , Ferguson Leah , Davis Elizabeth , Strickland-Hughes Carla , Wu Rachel
Published: December 2021

Growth mindset, the belief that abilities and attributes are improvable, may help buffer against older adults’ feelings of social isolation during the COVID-19 pandemic, as it may foster effective self-regulation and resilience. This study examined the effects of growth mindset on older adults’ well-being and adjustment, compared to younger and middle-aged adults. Participants self-reported on their growth mindset, depression, well-being, and daily habits amid the pandemic. For older adults (N = 178, 82% female, M age = 70.42, SD age = 6.50, range 60-90), regression analyses (controlling for gender, education, income, and age) revealed that growth mindset was associated with decreased depression (β = -.29, p = .001) and increased well-being (β = .38, p < .001). In addition, a logistic regression showed that older adults with a higher growth mindset were more likely to adjust their daily tasks during the pandemic (e.g., using technology to remotely socialize; OR = 1.77, p = .012). The same set of analyses in samples of younger (N = 235, 72% female, M age = 29.84, SD age = 5.89, range 18-39) and middle-aged adults (N = 188, 74% female, M age = 50.02, SD age = 6.10, range 40-59) revealed that growth mindset was associated with decreased depression and increased well-being. However, in these groups, growth mindset did not predict the likelihood of adjusting daily tasks. Findings suggest that while growth mindset is linked to enhanced well-being during the pandemic, its effect on adjusting to new circumstances might be salient in older adulthood.
Age Differences in Anticipated Use of Virtual Healthcare Services After the Pandemic
Authors: Murphy Matthew , Hills William , Hills Karen
Published: December 2021

Healthcare has undergone a significant transformation during the pandemic, with virtual services being rapidly developed and implemented to keep pace with societal needs. This study documented this change in healthcare by examining access and use of video-based, virtual service use before and during the pandemic. Participants for the study (n = 685) included three groups, including retirement-aged persons, middle-aged adults, and traditional college-aged students. Measures for the study included access to and utilization of physical and mental health services, satisfaction with services accessed, and anticipated access and use of virtual services following the pandemic. Results showed that most participants (94.2%) believed that virtual healthcare would persist after the pandemic; three-quarters of adults (75.2%) but only half of college-aged (52.8%) and retirement-aged (57.6%) participants anticipated using virtual healthcare in the future. Prior use and satisfaction with virtual healthcare services mediated anticipated future use for retirement-aged participants (p < .001), but only satisfaction with virtual healthcare was a marginal predictor for college-aged participants (p = .051), and neither were predictors for adult-aged participants. These results support that people believe virtual healthcare will persist after the end of the pandemic, but that there are age-related differences in who anticipates using these services in the future, and which factors will make the most difference in attracting clients. These differences can impact how healthcare providers market and develop further tele-health services to increase the likelihood of use by retirement-aged participants, and suggests that client satisfaction is a key mediator for different age groups.
Associations between Visual, Hearing Functioning and Cognitive Functioning among Hispanics/Latinos
Authors: Lee David , Zheng D Diane , McClure Laura , Cruickshanks Karen , Joslin Charlotte , Gonzalez Hector , Schneiderman Neil , Lam Byron L
Published: December 2021

Findings that visual impairment (VI) and hearing impairment (HI) are associated with cognitive functioning are drawn from studies that involved few Hispanic/Latino participants. We utilized data from the Miami Ocular SOL ancillary study to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) with 1056 participants aged 45 and older. The outcomes were neurocognitive performances assessed by the Digit Symbol Substitution Test (DSST, executive function), Word Frequency Test (verbal fluency), Brief Spanish-English Verbal Learning Test-recall (B-SEVLT recall, episodic memory), and the Six-Item Screener (global cognitive functioning). Visual functioning was measured by National Eye Institute Visual Function Questionnaire (NEI-VFQ). Hearing function which was measured by Hearing Handicap Inventory for Adults and Elderly (HHIA/HHIE) was available for all HCHS/SOL participants (n=9343). Multiple regression was performed for each cognitive outcome while controlling for age, gender, education, Hispanic/Latino ethnicity background, cardiovascular risk factors, depression and complex design. NEI-VFQ was associated with 3 of the 4 cognitive outcomes: DSST (β =0.14, se=0.027, p<0.01), Word Frequency Test (β=0.042, se=0.016, p<0.01), B-SEVLT-recall (β=0.021, se=0.007, p<0.03). HHIA/HHIE was not associated with any of the cognitive measures examined. The HHIA/HHIE analysis was repeated using data from all sites; similar results were observed. Visual functioning but not hearing functioning is associated with worse cognition in Hispanics/Latinos, although previous HCHS/SOL analysis indicated that hearing loss as assessed by pure tone audiometry was associated with worse cognitive functioning. Longitudinal assessment of both clinical and functional measures is needed to understand the impact of sensory impairment on cognition in Hispanics/Latinos.