bluuebunny/crossref_metadata_2025 huggingface dataset:
A NOVEL FRAMEWORK LINKING MNEMONIC AND HIPPOCAMPAL INTEGRATION TO LATE-LIFE REAPPRAISAL EFFICACY
Authors: Martins-Klein Bruna , Orlovsky Irina , Heideman Kristin
Published: December 2022

Socioemotional theories suggest that surviving challenging experiences enhances emotional resilience with age, yet the role of memories is overlooked in most models of emotion regulation. In parallel, cognitive accounts focus on age-related memory deficits associated with overlapping hippocampal neural representations across unique memories (neural dedifferentiation). We propose a novel framework supporting enhanced late-life reappraisal via hippocampal dedifferentiation of memory representations across current and past experiences. We review classic studies supporting mood benefits from integrated positive narratives following adverse autobiographical events. We also discuss multivariate neuroimaging evidence supporting overlapping hippocampal representations and ventromedial prefrontal cortex (vmPFC) involvement in meaning-making processes. We posit that greater hippocampal dedifferentiation across life memories may facilitate associative binding of current and past stressors as well as reappraisals in vmPFC. This process may provide avenues for generalizing past reappraisals to novel contexts and reducing cognitive demands of reappraisal. In addition, we discuss the possible age-related facilitation of this process, as a greater number of life experiences may become increasingly integrated with one another over the lifespan. These integrated neural associations may serve to make reappraisals from the past more readily accessible and applicable in new contexts over time, increasing routes to positive narratives following stress. We discuss future directions for testing components of the proposed model using multivariate neuroimaging methods. We conclude by briefly reviewing the possible clinical impact of mnemonic emotion regulation in promoting emotional well-being among older adults, using a strengths-based approach that leverages wisdom from experience and neural processes facilitated with age.
SLEEP, COGNITION, AND BRAIN FUNCTION IN OLDER ADULTS WITH CHRONIC KIDNEY DISEASE AND MILD COGNITIVE IMPAIRMENT
Authors: Jeamjitvibool Thanakrit , Hannan Mary , Bronas Ulf
Published: December 2022

Older adults with chronic kidney disease (CKD) are at risk for cognitive impairment and commonly report sleep disturbances. The association between sleep and brain function remains unclear. This cross-sectional study investigated the relationship between sleep, cognition, and brain function in older adults with CKD and mild cognitive impairment (MCI). Older adults with CKD and MCI (n=37, age=68 + 4.93, eGFR=43.7 + 10.98, 73%=Black, 70%=Female), were evaluated via a comprehensive cognitive function battery and brain MR-imaging. Seven-day actigraphy was scored utilizing the Cole-Kripke algorithm to evaluate sleep quality and duration. Ordinary least square regression controlling for age and education quality indicated that >9 hours of sleep, as compared to < 7 hours of sleep, was associated with worse executive function (unstandardized beta=-6.86, 95% CI:-13.19, -0.53, p=.04). Less sleep (< 8 hours) was associated with better learning/memory (unstandardized beta=2.61, 95% CI: 0.84, 4.38, p=.01). Better sleep efficiency was associated with increased global cerebral blood flow (unstandardized beta=3.30, 95% CI: 0.65, 5.95, p=.02). Longer sleep time (>9 hours), as compared to shorter sleep time (< 7 hours), was associated with worse mean diffusivity (unstandardized beta=0.12, 95% CI: 0.03, 0.20, p=.01). Shorter sleep time (< 8 hours, compared to >=8 hours) was associated with better fractional anisotropy of the cingulum (unstandardized beta=0.03, 95% CI: 0.01, 0.05, p=<.001). Sleep duration and quality may be related to cognition and brain function in older adults with CKD and MCI providing a possible avenue for interventions to improve cognitive outcomes in this population.
ARE PAIN APPS USABLE? MHEALTH LITERACY FRAMEWORK
Authors: Milidonis Mary , Menges Carolyn
Published: December 2022

Older adults are at risk for low health literacy and not adhering to self-care. Health professionals are shifting their practices to emphasize wellbeing through health promotion. Mobile pain applications may be a tool to improve health communication and individualize care. Mobile health apps do not always consider the needs of the older adult who may be less comfortable and confident with technology. The purpose of this qualitative review is to explore mobile pain applications for adults with a health literacy framework, and identify facilitators and barriers to usability. Databases that reviewed apps included Google, Google Scholar, ScienceDirect, PubMed, CINAHL plus full text, APTA EBP database, MEDline, and SportDiscus. Fifty-three apps found. Excluded criteria: if there was a cost, targeted for children, and without pain diary. Six apps identified to be specifically relevant to pain intensity, location quality, and impact on life. Mobile Application Rating System (MARS) tool assessed engagement, functionality, aesthetics, information quality, and subjective quality. All apps were engaging, allowed for tracking symptoms and life impact over time. Some apps were difficult to navigate, did not offer education support. Two of the apps individualized pain. Two apps are on only accessible on one app platform. One app allowed for feedback about the app design. Pain mobile health applications can improve tracking, managing and understanding pain for improved mobility and social engagement for older adults. The use of health literacy frameworks with mobile health applications may increase accessibility to care.
IMPACT OF VIBRATION ON TREMOR IN OLDER ADULTS WITH PARKINSON’S DISEASE
Authors: Pretzer-Aboff Ingrid , Elswick R K , Watson Amanda , Sun Minglong , Jung Woosub , Koltermann Ken , Zhou Gang , Cloud Leslie
Published: December 2022

This was a randomized trial to explore the safety and efficacy of the RMBand (Resonate Forward LLC, Delaware) device to alleviate Parkinson’s Disease (PD) tremors. The RMBand applies vibration to the proximal arm and was worn on the side of tremor dominance. Thirty subjects with PD and associated tremors were randomized to receive high vs. low-frequency vibration. Tremor assessments occurred for 20 minutes before, during 20 minutes of continuous vibration, and for 20 minutes immediately post-vibration in a single 60-minute session. Assessments (MDS-UPDRS part 3 and FTM tremor scale) were performed during each of the 3 phases by blinded raters. A quantitative assessment of tremor was performed throughout the session using wearable sensors on the distal arms. Linear mixed models were used for group comparisons. No significant difference was observed between the high and low dose groups in the MDS-UPDRS part 3 or FTM tremor scale (p=0.83 and 0.48 respectively), which may be due to the crude nature of these scales. Quantitative wearable sensor data were used to assess total time with tremors during the pre-vibration, vibration, and post-vibration periods. Time with tremor during the pre-vibration period was significantly greater than that during and post-vibration (p< 0.0001) for both dose groups, suggesting that vibration therapy applied to the proximal arm may suppress PD tremor. No significant adverse events related to vibration therapy occurred. In conclusion, the RMBand appears safe and possibly effective for suppressing PD tremor. Further study is warranted.
FINDINGS FROM HIGH USERS OF VIDEO TELEHEALTH TO DELIVER OCCUPATIONAL THERAPY SERVICES DURING COVID-19
Authors: Gately Megan , Waller Dylan , Metcalf Emily , Moo Lauren
Published: December 2022

Occupational therapy (OT) helps older adults improve their ability to perform day-to-day tasks. Veterans Health Administration (VHA) is the single largest employer of occupational therapy (OT) practitioners in the United States and a forerunner in telehealth. As a result of COVID, OT video visits increased by nearly 2000% from 2019 to 2020. To ascertain barriers and facilitators to this shift in care delivery, we conducted interviews between January and April 2021 with OT practitioners (N=27) who were high users of VA Video Connect (VVC), VHA’s videoconferencing software. OT participants were from rural and urban settings, and had completed an average of 536 VVC appointments each in 2020. Participants used VVC to deliver a variety of OT services, including mental health groups and home safety interventions. Facilitators to VVC included, a) Patient characteristics, such as positive perceptions of VVC and technological skill, b) OT clinician characteristics, like flexibility, level of experience, and desire to increase patient access to care, and, c) VHA’s telehealth infrastructure. Barriers included, a) Patients’ lack of familiarity or skills with technology, particularly older patients, b) challenges translating traditionally hands-on care to video, and c) unreliable internet connectivity, particularly for rural patients. This study broadens our understanding of video telehealth service delivery for care which has historically been delivered in brick-and-mortar settings. Understanding challenges and enablers to video telehealth highlights opportunities to increase access to those who face barriers, such as older, rural patients.
FACTORS INFLUENCING CANCER SURVIVORSHIP AMONG NIGERIAN WOMEN
Authors: Esiaka Darlingtina , Nwakasi Candidus , Chidebe Runcie , Fatai Khadijat Banwo , Orji Gloria
Published: December 2022

Breast cancer is the most common cancer globally and among Nigerian women. With technological and medical advancements, especially in the early detection of chronic illnesses, there is a reduction in cancer deaths, and more women are living as cancer survivors in Nigeria. Despite the increase in the number of cancer survivors, many survivors struggle with life after cancer diagnoses. In this study, we interviewed 30 Nigerian women (Mage = 42.00) who completed cancer therapy in the past 12 months and above, to explore how women who underwent cancer therapy perceive their healing, health, and quality of life. An example of one of the interview questions is “How did cancer diagnoses affect your normal way of life?” Each interview lasted an average of 1 hour. Participant responses were transcribed, and theme coded for analysis. We found that fear of reoccurrence, loss of sense of purpose, shame from physical mutilation related to mastectomy, poor psychological health, social isolation, and ill-treatment from other members of the community were recurring themes across all of the women’s responses. The presence of cancer survivors' support groups and religiosity were important for the experience of life after a cancer diagnosis. Our findings draw attention to the need for interventions targeting cancer survivors. The result further indicates that addressing community perceptions of breast cancer is imperative to ensure the health of breast cancer survivors, especially in low-resource countries.
THE ROLE OF VIRTUAL PEER HEALTH SUPPORT IN ALTERNATIVE ILLNESS APPRAISALS AND PATIENT SELF-REAPPRAISAL AFTER CANCER
Authors: Seckin Gul
Published: December 2022

Technology is transforming how older adults find health-related support and get connected with others who cope with similar healthproblems. This study examined the relationship between virtual peer health support and alternative appraisals of illness experience in old age among people who use the Internet for cancer related support (N=157, Age Range: 50-79, Mean = 57). Regression models with interaction terms examined whether and to what extent virtual peer health support was associated with differential illness appraisal as well as and post-diagnosis self-reappraisal. Results demonstrated that a) perceived benefits of virtual peer health support is a significant predictor of self-reported self-reappraisal (β = .24, p < .01) b) appraisals of illness experience as a traumatic event and/or as a life challenge are both significantly associated with virtual peer health support (β = .18, p < .05 and β = .23, p < .01), and c) appraisal of illness experience as a personal growth growth opportunity is not significantly associated with virtual peer health support (β = .10, p < .23). These results suggest the statistical interactions of the virtual peer health support with illness appraisals are significant predictors of self-reappraisal post-diagnosis. Specifically, those who appraised cancer to have been a traumatic experience and/or life challenge for them perceived virtual peer support to be positively influential on their self-perception after cancer diagnosis, which is in contrast to those who perceived cancer experience as an opportunity for personal growth and thus possibly not deriving further significant additional benefits from virtual peer support.
DEVELOPMENT AND EVALUATION OF A WEB-BASED DECISION AID FOR LUNG CANCER SCREENING FOR OLDER CHINESE AMERICANS
Authors: Li Chien-Ching , Matthews Alicia K , Gao Xiaojun , Cheung Krystal
Published: December 2022

Low dose computed tomography (LDCT) lung cancer screening is effective in reducing lung cancer mortality. In the United States, Chinese Americans are disproportionately impacted by lung cancer compared to other Asian subgroups. Our prior study showed that over 25% of older Chinese male smokers met eligibility for LDCT screening based on the CMS guidelines. However, in general, cancer screening rates among Chinese Americans are lower compared to other Americans. Therefore, we developed a culturally and logistically web-based decision aid (DA) for LDCT screening “Lung Decision Coaching Tool (LDC-T)” to improve the older Chinese American's knowledge of lung cancer and screening and to facilitate the decision making with the physician. Compared to traditional paper-based DA, the LDC-T DA has key elements including video, pack-year calculator, eligibility determination, and visual aids to support comprehension and shared decision-making. We conducted acceptability and usability tests among 22 older Chinese American smokers. The tool was highly received by participants for its usefulness and ease to use. Over 80% reported the way of information presented in LDC-T is "good or very good" and the length of the information is "just right". Overall, the majority were satisfied with the LDC-T DA (95%) and agreed that the tool includes sufficient information for people to make the screening decision (90%) and prepare shared decision making with their healthcare providers (81%). Our study results will inform strategies for reducing lung cancer disparities among Chinese Americans and other underserved smokers thus filling important gaps in the literature.
THE HOPES AND FEARS OF OLDER ADULT, LONG-TERM CANCER SURVIVORS: RACIAL AND GENDER DIFFERENCES
Authors: Deimling Gary , Ciaralli Spencier , Burnham Dyanna , Kavanagh Colleen
Published: December 2022

Understanding the impact of cancer on the hopes and fears of older adult (age 60+), long-term (5 years +) survivors is important for assessing their quality of life after cancer. Prior quantitative research has shown the important role that cancer plays in the health and psycho-social well-being of survivors in the years and even decades after diagnosis and treatment. This presentation extends that research by examining both quantitative data and survivors’ narratives revealing important issues survivors face such as altered sense of self/identity, feelings of social isolation, key sources of social support as well as cancer and other health-related concerns. These are examined in the context of broader existential issues related to their hopes and fears for the future and differences by race, gender and cancer type are also presented. The data analyzed are from an NCI funded, 10-year longitudinal study based on in-person interviews with 321 survivors of breast, colorectal and prostate cancer to document how cancer-related factors have affected their aspirations for the future. The findings are discussed in the context of how the issues that survivors identified as affecting their hopes and fears may be integrated into the dialogue clinical staff can have with older survivors and their families as part of after-cancer care.
ASSOCIATION OF PSYCHOSOCIAL FACTORS WITH MORTALITY IN OLDER FEMALE SURVIVORS OF CANCER
Authors: King Jennifer , Lind Kimberly , Morrill Kristin , Thomson Cynthia
Published: December 2022

Understanding factors associated with survival after a cancer diagnosis among older adults is critical as the population ages and cancer survivorship increases. The purpose of this study was to: (1) identify clusters of postmenopausal cancer survivor characteristics by demographic and lifestyle factors; 2) describe the characteristics of each cluster; and 3) evaluate the association of cluster assignment with survival. Participants from the Women’s Health Initiative (WHI) who reported either a prevalent cancer diagnosis at baseline (n=14294) or were diagnosed with a first primary incident cancer within the first 10 years of WHI (n=12934) were included. Latent class analysis was used to identify survivor clusters using psychosocial variables. Clusters were characterized using descriptive statistics. We tested for differences in cluster characteristics using ANOVA and Chi-square tests as appropriate. Cox proportional hazards regression was used to evaluate the association between cluster and mortality. Prevalent (n=7) and incident (n=9) cancer survivors clusters were identified. Among both (prevalent and incident) sets of clusters, age at WHI baseline, age at menopause, race, ethnicity, income, education, body mass index, diet quality, smoking, alcohol consumption and exercise all differed by cluster (p<.0001 for all). The most racially and ethnically diverse cluster had higher mortality rates compared to the largest most homogenous cluster; hazard ratio (95%CI) 1.30 (1.15, 1.48) and 1.33 (1.16, 1.53), respectively. Understanding how clusters of risk factors influence cancer survival in postmenopausal women will inform future interventions to improve outcomes and reduce health disparities for cancer survivors.
COGNITIVE RESERVE, PHYSICAL HEALTH, AND COGNITIVE FUNCTIONING IN OLDER ADULTS
Authors: MacLean Alyssa , Strong Jessica
Published: December 2022

Prior research has shown positive relationships between cognitive reserve (CR), physical health, and cognition, meaning that higher levels of physical health and CR are associated with higher cognitive functioning and vice versa. A group of community-dwelling older adults (N = 45, mean age = 70.5 years) completed a measure of CR (Life Experiences Questionnaire; LEQ), as well as cognitive tests, with number of physician diagnosed health conditions and number of medications measuring physical health. Initially, we ran correlations with the intention of running a mediation model (physical health factor as the independent variable, LEQ as the mediator, and cognitive test scores as dependent variables). Significant correlations were found between physical health and CR (r = -0.44, p = .01) with a medium effect size, and between CR and some test scores. However, there were no correlations between physical health and cognitive scores. Therefore, using linear regression analyses, the LEQ significantly predicted scores on some tests of executive functioning (DKEFS: Colour-Word Interference Test; Trial 3: F(1,39) = 7.42, p = .010), and processing speed (DKEFS: combined colour naming/reading: F(1,32) = 4.32, p = .046). However, the LEQ did not significantly predict verbal fluency, any set-switching tests, or a set-switching and inhibition test. Additionally, when physical health was added to the model, there was no significant improvement. The results suggest that CR may predict some types of executive functioning test scores, but not other executive functioning tests. Additionally, physical health did not predict cognitive test scores in this sample.
COHORT SHIFTS IN POPULATION COGNITIVE AGING
Authors: O'Keefe Patrick , Hofer Scott , Voll Stacey , Terrera Graciela Muniz , Wänström Linda , Clousten Sean , Rodgers Joeseph
Published: December 2022

Declines in cognitive functioning with increased age, on average and individually, is well documented and demonstrated to be related to genetics and a variety of life course risk factors, many of which are modifiable. Related to population cognitive aging is the phenomenon of the Flynn effect, the finding of increasing cognitive test scores across successive cohorts of young adults (e.g., Flynn 1987). This cohort effect has been repeatedly observed, in a wide variety of contexts, for over 30 years, with evidence that it has been occurring for at least a century. Our research looks at the interaction of the population cognitive aging and the Flynn effect. Using data from the English Longitudinal Survey of Ageing (ELSA) we show that, indeed, later born cohorts show significant (and meaningful) differences from earlier born cohorts. Using nonlinear Bayesian modeling we find that, on certain measures, later born cohorts have higher initial ability. This higher ability leads to a persistent advantage for later born cohorts, even as they experience (or will experience) cognitive decline. Additionally, we find that the advantage for later born cohorts is not present for every measure. Later born cohorts show an advantage for verbal fluency and episodic memory, however there is no cohort advantage on orientation scores. The lack of measurable differences on orientation is likely due to ceiling effects on orientation, which suggests that any substantial decline on that measure is indicative of pathology. We discuss the potential factors underlying both population cognitive aging and recent birth cohort trends.
EARLY LIFE ADVERSITY, ALLOSTATIC LOAD, AND COGNITIVE FUNCTION AMONG MIDDLE-AGED AND OLDER ADULTS
Authors: D'Amico Danielle , Amestoy Maya , Fiocco Alexandra
Published: December 2022

Early life adversity (ELA) is consequential for poor cognitive health in mid to late life. ELA is associated with higher allostatic load (AL), a biological indicator of physiological dysregulation due to cumulative wear-and-tear from chronic stress. Higher AL is also associated with poorer cognitive function across the lifespan. To date, however, a paucity of research has investigated AL as a mechanism through which ELA impacts cognition. Using cross-sectional data from the Midlife in the United States (MIDUS) Study, the objective of this study was to investigate the mediating role of AL in the relationship between ELA and cognitive performance (global cognition, episodic memory, executive function) among middle-aged and older adults without cognitive impairment (n=1541, mean age=53±12, 53% female). ELA, including physical, emotional, and sexual experiences, was measured retrospectively using the Childhood Trauma Questionnaire. AL was composed of 20 biomarker proxies of neuroendocrine, metabolic, inflammatory, and cardiovascular systems, stratified by sex. Cognitive performance was evaluated using a battery of neuropsychological tests from the Brief Test of Adult Cognition by Telephone. Controlling for age, education, and ethnicity, AL significantly mediated the relationship between ELA and global cognition (ß=-0.01,95%CI[-0.02,-0.003]) and executive function (ß=-0.01,95%CI[-0.02,-0.003]) such that higher ELA was associated with higher AL, and higher AL was associated with poorer global cognition and executive function. No such effects were found for episodic memory. Consistent with the biopsychosocial lifespan model of cognitive aging, findings suggest that ELA may become biologically embedded over time to negatively impact cognitive function in later adulthood in a domain-specific manner.
PHYSIOLOGICAL DYSREGULATION AS A PREDICTOR OF COGNITIVE DECLINE
Authors: Mahon Elizabeth , Merkin Sharon Stein , Lachman Margie , Karlamangla Arun , Seeman Teresa
Published: December 2022

Preclinical indicators of disease such as inflammation, cortisol and glucose dysregulation, and multisystem dysregulation (allostatic load) are related to individual differences in the level of cognitive functioning across adulthood. This study examined whether individual biological systems and allostatic load are related to differential patterns of change in cognitive functioning over 9 years. Data are from the Midlife in the United States (MIDUS) study second (biomarker and cognitive) and third waves (cognitive). The sample includes 863 men and women who ranged in age from 35 to 85 when the data were first collected. MIDUS biomarkers include a comprehensive range of biological and anthropometric measurements reflecting cardiovascular functioning, glucose metabolism, lipid metabolism, inflammation, HPA axis function, as well as sympathetic and parasympathetic nervous system function. Summary indices of dysregulation in each of these major systems as well as an overall index of multi-system dysregulation, or allostatic load were examined in relation to 9-year changes in episodic memory and executive functioning from the Brief Test of Adult Cognition by Telephone. Regression analyses, controlling for preexisting diseases and medications, showed that higher allostatic load was associated with decreased executive functioning over time for those who started out with higher cognitive performance at baseline, after adjusting for age, gender, race, English language, education, neurological conditions, medication use and smoking. Identifying biomarkers as antecedents of cognitive changes in midlife and old age, can potentially aid in the early detection of cognitive impairments and increase the possibilities for preventive interventions.
PREFRONTAL BLOOD FLOW DURING DUAL-TASK WALKING IN ADULTS WITH AND WITHOUT MILD COGNITIVE IMPAIRMENT
Authors: Argilaga Cristina Udina , Avtzi Stella , Durduran Turgut , Rosso Andrea , Mota Miriam , Ars Joan , Inzitari Marco
Published: December 2022

Background

Blood flow differences in the prefrontal cortex (PFC) during dual-task walking are thought to indicate various degrees of neural efficiency. Individuals with poorer neural resources might need higher activation to meet behavioral performance. We aim to assess PFC cerebral blood flow (CBF) among older adults with and without mild cognitive impairment (MCI) during dual-task using functional Diffuse Correlation Spectroscopy (fDCS).

Methods

We assessed PFC CBF with DCS during dual-task paradigm: 1)Normal Walk(NW); 2)Forward-count(FWC); 3)Backward-count(BWC); 4)Obstacle negotiation(WWO). We assessed demographics, clinical variables, physical and cognitive function in those with MCI vs normal cognition (NC). Linear mixed effects models assessed changes of CBF across the tests in the dual-task paradigm and differences between MCI and NC.

Results

49 older adults (median age=78 years, 51% women, 34 MCI) were included. MCI were older, with higher frailty, polypharmacy and comorbidity. Compared to NC, MCI showed worse cognitive and physical performance scores and lower Gait Speed (GS) during NW and WWO but not during FWC and BWC. N=12 were unable to perform BWC. CBF change from NW to FWC was higher in MCI compared to NC (estimate=0.35, 95%CI [0.03, 0.67], p=0.03). CBF change from NW to BWC and WWO was not different between groups. There was no effect of age or clinical covariates.

Conclusions

Higher NW-FWC CBF change seems due to the cognitive load of FWC in MCI. Higher activation in MCI compared to healthier counterparts could be explained by compensatory mechanisms. Further research should focus on better understanding dual-task related neural mechanisms.
PREVALENCE AND FACTORS ASSOCIATED WITH MOTORIC COGNITIVE RISK IN A COMMUNITY-DWELLING OLDER SCOTTISH POPULATION
Authors: Mullin Donncha , Stirland Lucy , Russ Tom , Luciano Michelle , Terrera Graciela Muniz
Published: December 2022

Motoric Cognitive Risk (MCR) syndrome combines slow walking and self-reported cognitive complaints. It is a quick and simple way of identifying individuals at high risk of developing dementia. MCR has not been described in a Scottish population to date. This study describes the prevalence and associated factors of MCR in a community-dwelling sample of older Scottish people. The MCR concept was derived in the Lothian Birth Cohort 1936 (LBC1936) - a highly phenotyped cohort of over 1000 people followed up every 3 years since 2004. Uniquely, participants in LBC1936 had their IQ measured at age 11 in 1936. Authors found MCR prevalence of approximately 5.4% at baseline. Using logistic and linear regression analysis, as appropriate, they found that participants' age, depressive symptoms and cognitive measures of executive function were significantly associated with an increased likelihood of have MCR, but that IQ aged 11 was not associated. This study found rates of MCR in Scotland are within the typical range for this age group, albeit on the lower end. Interestingly, IQ at age 11 was not significantly associated with MCR, which was unexpected given MCR's prognostic value for dementia. That tests of executive function were associated with MCR adds further credence to the hypothesis that walking speed and executive function are linked. This points to further important work to ascertain if increasing walking speed can improve executive function.
SEX DIFFERENCES IN THE ASSOCIATION BETWEEN BODY COMPOSITION AND 2-YEAR CHANGE IN COGNITIVE FUNCTION
Authors: Lee Daehyun , Kim Miji , Shin Hyung Eun , Jang Jae Young , Won Chang Won
Published: December 2022

In the process of aging, the loss of lean mass and increase in fat mass are associated with cognitive decline. This study investigated sex differences in the association between body composition and changes in cognitive function in community-dwelling older adults in Korea. A total of 1,420 participants (aged 70–84 years, 54.2% men) of the Korean Frailty and Aging Cohort Study with data from baseline and 2-year follow-up surveys were included. Body composition was measured using dual-energy X-ray absorptiometry and cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet. The total fat mass was lower in men than in women (p< 0.001), whereas total lean mass was higher in men than in women (p< 0.001). Total body fat mass was positively associated with the time taken to finish the Trail Making Test-A only in women (standardized beta coefficient [ß]= -1.371, p=0.018), and a negative association was observed between trunk fat mass and digit span total only in men (ß= -0.092, p=0.039). Appendicular lean mass was significantly positively associated with word list recognition only in women (ß=0.087, p=0.010) and was significantly positively associated with digit span total (ß=0.108, p=0.027) and digit span forward (ß=0.081, p=0.025) only in men. The results of this study indicated that higher fat mass was associated with the protection of decline in cognitive function only in women, while lean mass was positively associated with a change in cognitive function in both sexes.
SKELETAL MUSCLE ADIPOSITY IS ASSOCIATED WITH LOWER COGNITION IN AFRICAN CARIBBEAN WOMEN
Authors: Acevedo-Fontanez Adrianna , Cvejkus Ryan , Kuipers Allison , Zmuda Joseph , Rosano Caterina , Miljkovic Iva
Published: December 2022

Objective

Skeletal muscle adiposity (SMA) increases with aging and is recognized as a major risk factor for cardiometabolic diseases, disability, and mortality among older adults. Obesity is related to dementia and cognitive decline yet the relationship between SMA and cognition remains ill defined. The objective of this study was to assess SMA and cognitive function among African Caribbean women.Design and

Methods

Cross-sectional analysis of 448 African Caribbean women in the Tobago Health Study (mean age, 55 years; range, 39-84 years). Cognition was assessed by the Digit Symbol Substitution Test (DSST), a test of information processing speed with a range of 0-90; higher scores suggest better cognitive function (faster information processing speed). Calf SMA (muscle density) was assessed with computed tomography (Stratec XCT-2000). Linear regression was used to assess the association of SMA with DSST adjusted for age, education, muscle area, waist circumference, alcohol intake, smoking, physical activity, diabetes, and hypertension.

Results

Participants had a BMI of 30.7 kg/m2. Mean (SD) DSST scores and SMA were 39.2 (13.1) and 71.7 (5.3) mg/cm3, respectively. After full adjustment, we found that one SD greater skeletal muscle adiposity was associated with a 1.40 lower DSST score (p-value=0.025).

Conclusions

Our findings suggest that in African Caribbean women, greater SMA is associated with slower information processing speed, an early indicator of future dementia risk. Future studies using an expanded battery of cognitive tests and longitudinal follow-up should further advance our understanding of the role of SMA and dementia risk among African ancestry populations.
PERSON-CENTERED LANGUAGE-BASED STRATEGIES USED BY HOME CARE WORKERS WHO CARE FOR PERSONS LIVING WITH DEMENTIA
Authors: Mundadan Reanne , Savundranayagam Marie , Orange Joseph , Murray Laura
Published: December 2022

Several studies recommend language-based strategies for communication with persons living with dementia. Language-based strategies improve coherence, clarity, reciprocity, and continuity of interactions. Person-centered communication (PCC) strategies are the gold standard, including facilitation, recognition, validation, and negotiation. Only one study has examined the overlap between language-based strategies and PCC in long-term care. Little is known about which language-based strategies support PCC in home care. Accordingly, this study investigated the overlap between language-based strategies and PCC in home care interactions. Conversation analysis of 30 audio-recorded routine care interactions between home care workers and persons living with dementia was conducted. The overlap between communication-units coded for PCC and 33 language-based strategies was analyzed. Of 11,347 communication-units, 2,664 overlapped with PCC. For facilitation, 21% were yes/no questions and 15% were announcements of action/intent. For recognition, 25% were yes/no questions and 22% were affirmations. For validation, the majority (81%) of communication-units were affirmations and positive feedback. Finally, for negotiation, 60% of communication-units were yes/no questions. This is the first study examining naturalistic interactions between home care workers and persons living with dementia. The findings highlight the person-centeredness of language-based strategies. Yet only six of 33 language -based strategies occurred in the top 50% of overlapping communication-units. Home care workers in this study use a uniform set of person-centered language-based strategies, illustrated by the frequent use of yes/no questions overlapping with most PCC indicators. Our findings emphasize the need for training among home care workers in the use of diverse language-based strategies that are potentially person-centered.
PREVALENCE AND USE OF ADVANCED DRIVER ASSISTANCE SYSTEMS IN THE OLDER DRIVER POPULATION
Authors: Louis Renee St , Eby David , Kostyniuk Lidia , Molnar Lisa , Zakrajsek Jennifer , Zanier Nicole , Yung Raymond , Nyquist Linda
Published: December 2022

Research on advanced driver assistance systems (ADAS) in the older driver population has suggested the potential for ADAS to improve safety and driving comfort by helping aging drivers overcome functional declines commonly experienced in later-life. However, attaining anticipated ADAS benefits is dependent upon drivers’ awareness, understanding, and use of ADAS in their own vehicles. Questionnaire data from 2,374 older drivers enrolled in the AAA LongROAD study were analyzed to investigate changes in the prevalence and use of 15 ADAS and how participants learned to use these technologies. From baseline to Year 3, the prevalence of each ADAS significantly increased, with the greatest percentage point increase being for backup/parking assist technology (from 41.5% to 58.8%). The prevalence of one or more ADAS in participants’ vehicles increased from 59.0% to 72.0%, and the average number of ADAS per vehicle increased from 2.0 to 3.3. At both baseline and Year 3, approximately one-third of participants reported always using the ADAS available in their vehicle, but nearly one-quarter reported never using their ADAS. The largest proportion of participants at both baseline and Year 3 reported learning to use ADAS by figuring it out by themselves (45.5% and 50.8%, respectively), yet approximately 12.0% of participants at both time points reported never learning to use ADAS. To achieve the expected benefits of ADAS for older drivers, research is needed to better understand why ADAS are not being use more frequently when available, and to develop acceptable and accessible programs for training older adults to use ADAS.
THE ROLE OF RELATIONSHIP FACTORS IN HARMFUL CAREGIVER BEHAVIORS: OLDER CHILDREN CARING FOR PARENTS WITH DEMENTIA
Authors: Gallagher Elizabeth , Boerner Kathrin , Kim Yijung , Kim Kyungmin , Jopp Daniela
Published: December 2022

Elder abuse by family caregivers is an often-overlooked phenomenon that affects many older adults. Especially, retirement-aged children caring for their oldest-old parents with dementia may be at greater risk of engaging in harmful or abusive behaviors, given their own age-related health issues and other competing caregiving demands. Most of the elder abuse literature has focused on general demographic predictors of elder abuse, regarding the caregiver, care recipient, and the care environment. Less attention has been paid towards relationship factors, which may play a large role among these parent-child dyads. This study examined how relationship factors are associated with potentially harmful caregiver behaviors (PHCB; e.g., screaming), which have been identified as “early warning signs” for elder abuse. Relationship factors of interest include positive and negative relationship quality measured by caregivers’ mean scores on the support and conflict subscales on the Quality of Relationship Inventory (QRI). We conducted in-depth interviews with 88 caregivers (65+) who are caring for their parents with dementia (90+) as the part of the Boston Aging Together Study. Regression models revealed that relationship conflict was significantly associated with higher levels of PHCB, accounting for caregiver, care recipient, and care environment characteristics. The creation of screeners to identify “high conflict” care dyads could prove useful in the early detection and intervention of potential elder abuse cases, given that caregivers may be more willing to report negative aspects of their relationship (e.g., fighting) than more obviously harmful or abusive behaviors.
PSYCHOMETRIC PROPERTIES OF A NOVEL MEASURE OF FINANCIAL ABUSE OF OLDER ADULTS
Authors: Hancock David , Pillemer Karl , Burnes David , Czaja Sara , Lachs Mark
Published: December 2022

Background and Objectives

Elder abuse, or mistreatment affects at least 1 in 10 older adults. Financial abuse, or exploitation, of older adults is among the most commonly reported forms of abuse. Few validated measures exist to measure this construct. We aim to present a new psychometrically validated measure of financial abuse of older adults.Research Design and

Methods

Classical test theory and item response theory methodologies were used to examine a five-item measure of financial abuse of older adults, administered as part of the New York State Elder Mistreatment Survey.

Results

Factor analysis revealed a single factor best fits the data, which we labeled as financial abuse. Moreover, IRT analyses revealed that these items discriminated well between abused and non-abuse persons and provided information at high levels of the latent trait θ, as is expected in cases of abuse. Discussion and Implications: The FIVE has acceptable psychometric properties and has been used successfully in large scale survey research. We recommend this measure as an indicator of financial abuse in elder abuse, or mistreatment prevalence research studies.
COGNITIVE EFFECTS OF PM2.5 EXPOSURE FROM MID-LIFE TO EARLY OLD AGE
Authors: Franz Carol , Tu Xin , Qin Yongmei , Elman Jeremy , Fennema-Notestine Christine , DeAnda Jaden , Wu Tsung-Chin , Kremen William
Published: December 2022

Air pollution exposure is a notable public health hazard with adverse effects on multiple health outcomes as well as with increased risk of developing cognitive impairment, Alzheimer’s disease, and related dementias. Few studies examine associations between air pollution exposure in midlife or the transition from midlife to old age. We examined associations between exposure in midlife and cognitive functioning in early old age in ~800 men from the Vietnam Era Twin Study of Aging. Measures included PM2.5 and NO2 exposure in the three years prior to the time 1 (mean age 56; range 51-61) assessment, and cognitive performance in 5 domains at time 1 and time 2 (mean age 68; range 65-72). Analyses adjusted for multiple health and lifestyle covariates. Cognitive performance in all domains was worse at age 68 than at age 56. There was a main effect of midlife PM2.5 on verbal fluency; greater PM2.5 exposure was associated with worse fluency. This association was at a trend level for NO2. In addition, we found significant PM2.5-by-APOE genotype interactions. Increased exposure to PM2.5 in midlife was related to lower executive function and working memory performance in APOE-ε4 carriers, but not non-carriers. Both early executive deficits and APOE-ε4 status have been associated with increased risk for progression to mild cognitive impairment and Alzheimer’s disease. The present results indicate that midlife PM2.5 exposure in men is an additional factor contributing to poorer frontal-executive function, and that APOEε4 carriers are more susceptible to the deleterious effects of PM2.5.
ROLE OF HOME ENVIRONMENT IN LTSS USE AMONG OLDER ADULTS IN THE US
Authors: Sahoo Shalini
Published: December 2022

Older adults have shown increasing preference towards having help and health care in the comfort of their own homes rather than in an institutional setting. Research suggests that about 1 in 5 older adults with limitations in activities of daily living report needing more help than they receive. There is insufficient research examining how home inaccessibility and disorder relates to LTSS use for community-dwelling older adults in the U.S. This study addresses a gap in the literature by directly examining the relationship between home environment quality and LTSS use for a national sample of older adults. Data was analyzed from round eight (2018) of the National Health and Aging Trends Study (NHATS), an epidemiological panel study of nationally representative Medicare beneficiaries ages 65 and older living in the communities (n = 4,806). The final analytic sample included respondents with valid data on all variables (n = 4,265). Community dwelling adults with greater home accessibility had lower odds of having two or more LTSS caregivers, compared to the counterpart with lower home accessibility (OR = 0.246, SE = 0.094, p < 0.01). However, poor housing conditions had lower odds of having two or more LTSS caregivers (OR = 0.333, SE = 0.156, p < 0.05). Community-dwelling older adults who have accessible and organized homes are more likely to be independent and are less likely to depend on LTSS caregiving. Policies to improve home environment quality could benefit both older adults and those who care for them.
THE IMPACTS OF WILDFIRES ON OLDER ADULTS: A SCOPING REVIEW
Authors: De Fries Carson , Melton Colleen , Smith Rebecca , Mason Lisa Reyes
Published: December 2022

Climate change is leading to worsening disasters that disproportionately impact certain populations, including older adults (Benevolenza & DeRigne, 2019). Older adults are more likely to encounter life-threatening challenges during disaster evacuation, less likely to receive disaster warnings, and more likely to experience greater financial losses following disasters (Acierno et al., 2006). While research has begun to measure these disparities, there is a gap in examining the effects of wildfire-specific disasters, which are increasing in intensity and severity (Hoover & Hanson, 2020). To examine this gap, scoping review methodology was used to analyze peer-reviewed studies of how wildfires affect older adults by looking at impacts and the disaster recovery cycle (i.e., preparedness, response, recovery, and mitigation). Authors screened 263 titles and abstracts, and 138 were reviewed in full. Eighty-one studies were included for data extraction and analysis. Preliminary findings illustrate that most literature focuses on the health impacts that older adults endure during and following wildfires, with a specific focus on the short and long-term effects of smoke and poor air quality on respiratory health. While previous literature has cited a need for community response strategies that incorporate the needs of older adults, few findings addressed firsthand experiences of older adults during a wildfire event. However, one unique finding was the incorporation of Aboriginal and Indigenous Elders’ knowledge into fire management strategies. While recommendations for incorporating the needs of older adults into policy planning were briefly mentioned, most articles focused on problem scope rather than evaluating potential solutions.
ADAPTING STAKEHOLDER WALKABILITY/WHEELABILITY AUDIT TOOL IN NEIGHBORHOOD FOR SENSORY AND COGNITIVE DISABILITIES
Authors: Seetharaman Kishore , Mahmood Atiya , Disini Bridget , Jenkins Hailey-Thomas , Prescott Mike , Rikhtehgaran Farinaz , Mortensen W Ben
Published: December 2022

Neighbourhood accessibility influences health, social inclusion, and overall wellbeing of older adults. It is important to assess neighbourhood accessibility in relation to the diverse needs and challenges brought on by the intersection of aging and disability, particularly sensory and cognitive disabilities. Given the paucity of neighbourhood audit tools tailored for this population, The user-led Stakeholders’ Walkability/Wheelability Audit in Neighbourhoods (SWAN) tool was originally created for people with mobility disabilities and is now being adapted for seniors with sensory and cognitive disabilities to evaluate functionality, safety, appearance, supportive features, and social aspects in their neighbourhoods. In this paper, we present highlights and key takeaways from the process of adapting the SWAN tool for three user groups: people living with 1) Blindness or low vision, 2) Deafness and hearing loss, and 3) Dementia. Key steps in the iterative tool adaptation process include 1) identifying access needs/challenges for the three user groups based on a literature review, 2) online consultation with stakeholders with lived and/or professional experience (N = 4) to prioritize key access needs/challenges that will be captured through the SWAN tool and review draft versions of the tool, and 3) in-person pilot testing of tools with persons with lived experience (N = 2) in two urban/suburban neighbourhoods in British Columbia, Canada. Reflections of team members and input from stakeholders and pilot participants revealed issues that were addressed in tool development, namely 1) length of audit and participant fatigue, 2) legibility of tool, and 3) tailoring audit to participants’ context and needs.