bluuebunny/crossref_metadata_2025 huggingface dataset:
MAILED SURVEYS WITH NONAGENARIANS - CHALLENGES AND LESSONS FROM THE VITALITY 90+ STUDY
Authors: Jylha Marja , Raitanen Jani , Tiainen Kristina , Halonen Pauliina , Enroth Linda
Published: November 2019

Reliable population-based data on health, functioning and quality of life among very old people are scarce because only during the last decades this age group has grown to be an important segment of population, and because data collection among the oldest old is challenging. Due to poor health, problems in hearing and vision, cognitive decline, and institutionalization, very old individuals may not be able to participate in research studies, or, the information they give may not be reliable. In the Vitality 90+ Study, the whole population aged 90+ in the Tampere area, Finland, has been investigated six times since 2001. Mailed surveys have been conducted in years 1995, 1996, 1998, 2001, 2003, 2007, 2010, 2014, and 2018. In each data collection, the response rate has been ca 80%. The questionnaires and the wording of the questions have been identical in each survey round, which provides data for investigating time trends in health, functioning, and quality of life. Linkages with national population and care registers are used for studying mortality and care use. In this poster, we analyze the impact of 1) exhaustive base data, 2) the questionnaire, 3) including institutionalized individuals and proxy answers, on the findings and on the quality and reliability of the data. We conclude that mailed surveys can be a feasible method of data collection among very old people, but only in favorable local circumstances and with great efforts from the research group.
ATTACHMENT SECURITY AND VIEWS TOWARD AGING IN OLDER COUPLES: A DYADIC PERSPECTIVE
Authors: Chang E-Shien , Goktas Seline O , Monin Joan K
Published: November 2019

Research has shown that attachment security–feelings of emotional safety from interpersonal closeness and responsiveness– is associated with better appraisal of stressful situations. Individuals’ views toward aging could be one avenue such appraisals are expressed that in turn contribute to better health in late life. However, no studies to our knowledge have examined the dyadic associations between attachment security and views towards aging in the context of close relationships. We hypothesized that attachment insecurity would be associated with individuals’ own and partners’ negative views toward aging in older married couples. The study sample was comprised of 77 older persons with a self-reported musculoskeletal condition and their caregiving spouses. The Experiences in Close Relationships Scale and the open-ended Image of Aging questions were used to measure attachment security and views toward aging. Data were analyzed with SPPS mixed models using the Actor Partner Interdependence Model. Mean age of care-recipients were 65.9 and 64.8 for their spouses. Contrary to our hypothesis, results showed no significant associations between each individual’s attachment security and their own views toward aging. However, care-recipients reported particularly positive views toward aging when caregivers had low attachment anxiety (p=.03), and caregivers reported more negative views toward aging when care-recipients had low attachment avoidance (p=.02). Findings suggest that having a close partner who is securely attached may be protective of one’s own views of aging, which may in turn have positive effects on health.
TRANSCRIPTOME ALTERATIONS ASSOCIATED WITH AGE-RELATED DECLINE IN PHYSICAL FUNCTION.
Authors: Graber Ted G , Marota Rosario , Thompson Jill , Widen Steve , Rasmussen Blake
Published: November 2019

One inevitable consequence of the effect of age on our bodies is the graduated deterioration of physical function and exercise capacity, driven, in part by the adverse effect of age on muscle tissue. Our primary purpose was to determine the relationship between patterns of gene expression in skeletal muscle and loss of physical function. We hypothesized that some genes that change expression with age would correlate with functional decline, or conversely with preservation of function. Male C57Bl/6 mice [adults (6-7 months old, n=9), older (24-25 months old, n=9), and elderly (28+ months of age, n=9) were tested for physical ability using a comprehensive functional assessment battery [CFAB, a composite scoring system: comprised of the rotarod (overall motor function), grip strength (fore-limb strength), inverted cling (4-limb strength/endurance), voluntary wheel running (activity rate/volitional exercise), and treadmill tests (endurance)]. We extracted RNA from the tibialis anterior muscles, ran RNAseq to examine the transcriptome using an Illumina NextSeq 550, comparing adults (n=7) to older (n=7) and elderly mice (n=9). Age resulted in gene expression differences of 1.5 log2 fold change or greater (p<0.01) in 46 genes in the older mice and in 252 genes in the elderly (both compared to adults). Current ongoing work is examining the physiological relevance of these genes to age-related loss of physical function. We are in the process of using linear regression to determine which of the genes with age-related changes in expression are associated (R>0.5 and p<0.05) with functional status as measured by CFAB.
SOCIABILITY AMONG PERSONS LIVING WITH DEMENTIA IN A CREATIVE GROUP STORYTELLING CONTEXT
Authors: Chee Kyong Hee , Kim Seoyoun , Gerhart Olga , Caldwell Sara
Published: November 2019

Considering healthcare costs related to Alzheimer’s Disease and related dementias, shifting attention to the relatively malleable abilities of persons living with dementia holds promise for improving their well-being while reducing care burden. Defined as the ability to successfully interact with others, social intelligence is found to benefit well-being. Nevertheless, no known prior study has examined social intelligence among persons living with dementia. The purpose of this study is, therefore, to fill this gap by identifying the themes of social intelligence in this group. We used video-recorded data from an arts-based, creative group storytelling program (TimeSlips) that we implemented at Silverado Onion Creek Memory Care Community (currently, The Auberge) in Austin. The program is designed for persons living with dementia and involves a facilitator encouraging participants to use their imagination to collectively create a story from a staged picture. We offered 6 weekly sessions with 4 small groups of their residents (N = 26) in fall 2018 and spring 2019, and videotaped the sessions. Three researchers open-coded how participants interacted during storytelling sessions, and then met to reach consensus concerning verbal and non-verbal indicators of social intelligence. Major themes that emerged from our analysis are social awareness, initiating social interactions, and social diplomacy. Our findings suggest that those with lower cognitive function scores do not necessarily lack sociability. These findings add to social intelligence and dementia literatures, with potential implications for future research that can investigate the relationship between sociability and well-being among persons living with dementia.
THE ASSOCIATION OF MORTALITY WITH DEMENTIA IN VETERANS ENROLLED IN A MEMORY DISORDERS CLINIC: THE EFFECT OF FRAILTY
Authors: Shah Aakashi , Apracio-Ugarriza Raquel , Morani Amar , Rodriguez-Suarez Mercedes , Ruiz Jorge G
Published: November 2019

Dementia is a syndrome of deterioration in cognition and ability to perform everyday activities. Frailty, a state of vulnerability to stressors leading to increased morbidity, mortality and utilization is a determinant of dementia. The aim was to determine if dementia leads to increased mortality in Veterans and whether frailty affects this association. We conducted a retrospective cohort study of 308 Veterans enrolled in VA memory disorders clinic during 2016-2019. Dementia was diagnosed based on complete clinical assessments, brain imaging and neuropsychological testing. A 44–item frailty index (FI) was constructed using demographics, comorbidities, medications, laboratory tests, and activities of daily living. Patients were divided into non-Frail (FI<0.21) and Frail (FI≥0.21). After adjusting for age, race, ethnicity, income, education, substance abuse, BMI, comorbidities, hospitalizations, medication use, the association of dementia with mortality was assessed using Cox proportional hazards regression. Patients were 55.2% White, 74% non-Hispanic, and the mean age was 74.4 ± 8.3 years. 113 patients were diagnosed with dementia out of which 27 died. Over a median follow-up period of 526 days (Interquartile Range: 431.5 days), there were 27 deaths. There was a significant and positive association of dementia with mortality significant even after all adjustments, HR=2.65 (95% CI: 1.02-6.92), p: 0.045. After subgroup analysis, there was no significant association between mortality and dementia according to frailty status. Our study results suggest that dementia is associated with a higher risk for mortality in Veterans at a Memory Disorders clinic. Frailty did not modify the effect.
COST-EFFECTIVENESS ANALYSIS OF THE COLLABORATIVE STEPPED CARE INTERVENTION FOR LATE-LIFE DEPRESSION
Authors: Lu Shiyu , Wong Gloria H Y , Lum Terry , Liu Tianyin
Published: November 2019

Late-life depression is a burden on society because it is costly and have a significant adverse effect on the quality of life. The aim of this study is to evaluate the cost-effectiveness of the collaborative stepped care intervention for depression among community-dwelling older adults compared to care as usual from a societal perspective. The intervention was piloted from 2016-2019 in Hong Kong. The study used a two-armed quasi-experimental design. Eventually, 412 older people were included (314 collaborative stepped care, 98 care as usual). Baseline measures and 12-month follow-up measures were assessed using questionnaires. We applied the 5-level EQ-5D version (EQ-5D-5L) and the Client Service Receipt Inventory (CSRI) respectively measuring quality-adjusted life-year (QALY) and health care utilization. The average annual direct medical cost in the intervention group was USD 6,589 (95% C.I., 4,979 to 8,199) compared to US$ 6,167 (95% C.I., 3,702 to 8,631) in the care as usual group. The average QALYs gained was 0.036 higher in the collaborative stepped care group, leading to an incremental cost-effectiveness ratio (ICER) of US$ 11,722 per QALY, lower than the cost-effectiveness threshold suggested by The National Institute for Health and Clinical Excellence. The study showed that collaborative stepped care was a cost-effective intervention for late-life depression over service as usual.
PREDICTORS OF HEALTH-RELATED QUALITY OF LIFE AND RECOVERY AMONG OLDER ADULTS WITH SERIOUS MENTAL ILLNESS
Authors: Muralidharan Anjana , Brown Clayton H , Goldberg Richard W
Published: November 2019

Older adults with serious mental illness (i.e., schizophrenia spectrum disorders and affective psychoses) exhibit marked impairments across medical, cognitive, and psychiatric domains. The present study examined predictors of health-related quality-of-life and mental health recovery in this population. Participants (N=211) were ages 50 and older with a chart diagnosis of serious mental illness and a co-occurring medical condition, engaged in outpatient mental health services at a study site. Participants completed a battery of assessments including subtests from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the 24-Item Behavior and Symptom Identification Scale (BASIS-24), the 12-Item Short-Form Health Survey (SF-12), and the Maryland Assessment of Recovery Scale (MARS). Multiple linear regression analyses, with age, race, gender, and BMI as covariates, examined number of current medical conditions, RBANS, and BASIS as predictors of quality-of-life and recovery. Significant predictors of physical health-related quality-of-life (R-squared=.298, F(9,182)=8.57, p<.0001) were number of medical conditions (β=-1.70, p<.0001), BASIS-Depression/Functioning (β=-4.84, p<.0001), and BASIS-Psychosis (β=2.39, p<.0008). Significant predictors of mental health-related quality-of-life (R-squared=.575, F(9,182)=27.37, p<.0001) were RBANS (β=0.03, p=.05), BASIS-Depression/Functioning (β=-6.49, p<.0001), BASIS-Relationships (β=-3.17, p<.0001), and BASIS-Psychosis (β=-1.30, p=.03). Significant predictors of MARS (R-squared=.434, F(9,183)=15.56, p<.0001) were BASIS-Depression/Functioning (β=-4.68, p=.002) and BASIS-Relationships (β=-9.44, p<.0001). To promote holistic recovery among older adults with serious mental illness, integrated interventions are required. For example, to improve physical health-related quality-of-life, one should target depression and psychotic symptoms as well as medical illness burden. To improve mental health-related quality-of-life, depression symptoms and interpersonal functioning may be key targets, as well as neurocognitive function.
DISPARITIES IN DEPRESSION AMONG CHINESE OLDER ADULTS WITH NEURODEGENERATIVE DISEASES
Authors: Hao Zhichao , Li qingyi , Ruggiano Nicole
Published: November 2019

Depression is a major health issue among older adults, and it exerts negative impacts on them physically and mentally. In turn, various factors facilitate or impede the occurrence of depression, socially, economically and culturally. At the same time, neurodegenerative diseases have become a leading cause of death and disability worldwide. In China, the incidence rate of Parkinson’s disease among older adults aged 65 and older is 1.7%, which means 100,000 new cases occur each year, more than 2.5 million in total. Meanwhile, 3.21% of incidence rate, more than 8 million older adults aged 65 and older with Alzheimer’s Disease and Related Dementia (AD/RD) makes China become the largest and fastest-growing area of AD/RD in the world. Around 2050, Chinese older adults with AD/RD will exceed 20 million. However, little is known about the extent that to which older adults with Parkinson’s or AD/RD in China will suffer from depression. This study was conducted on the latest wave (2011-2014) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 1998-2014). The sample included 334 Chinese older adults aged 65 and older with neurodegenerative diseases (Parkinson’s or AD/RD). A univariate and binomial hierarchical logistic regression were performed. Result showed that 13.5% (n = 45) participants reported depression. Several covariates were significantly correlated with the occurrence of depression, including: co-residence of interviewee, activity level, level of chronic diseases, self-reported health status and Instrumental Activity of Daily Life. Implications for research, policy, and practice are discussed.
AGE-RELATED ELEVATED CD4+ T HELPER 17 CELL RESPONSE PROMOTES PROSTATE CANCER CELL GROWTH, MIGRATION, AND INVASION
Authors: Zhang Qiuyang , Liu Sen , Zhang Bing , Norton Elizabeth , Jazwinski S Michal , Sartor Oliver , Steele Chad , Abdel-Mageed Asim B
Published: November 2019

Age is the most important risk factor for prostate cancer (PCa). But, how age contributes to PCa remains unknown. Interleukin-17 (IL-17) -producing CD4+ T helper 17 (Th17) cells play a critical role in inflammatory diseases. It is often elevated in aging humans and mice, however, whether aging affects Th17 cell function and subsequent PCa risk increase is unclear. In this study, we investigated the role of CD4+ T cells in PCa cell growth during the aging process. Splenic T cells were isolated and purified into CD4+CD25- T cells from young and old mice, then cultured in the presence of plate-bound anti-CD3/anti-CD28. Four days later, the cells were re-stimulated with PMA and ionomycin in the presence of brefeldin A for 4 hours and then were collected and used for flow cytometry and/or qPCR. The supernatant (conditioned media) from young and old cultures was collected and used in subsequent experiments. Flow and qPCR results showed that 17-producing T cells and associated cytokines were significantly increased in old mice compared to young mice. When PCa cell lines (LNCaP, DU-145, and PC3) were treated by the conditioned media for 48 and 72 hours. The cell proliferation, migration, and invasion, as well as the activation of NF-B signaling in PCa cells, were significantly increased after exposure to the conditioned media from aged mice, compared to that from young mice. These results indicated that age-related CD4+ Th17 cell responses are elevated in mice in the aging process and play an important role in PCa growth.
SEPARATED KIN: RURAL-URBAN MIGRATION AND MENTAL HEALTH TRAJECTORIES OF OLDER ADULTS LEFT BEHIND IN RURAL CHINA
Authors: Lin Zhiyong
Published: November 2019

As the processes of urbanization and globalization have intensified across the world, a burgeoning literature has documented the impact of emigration on the health of family members left behind in emigrant communities. Although the association between children’s migration and parental well-being is well documented, few have examined the health implications of children’s migration in the milieu of multiple children and further differentiated between children’s short-term and long-term migration. Therefore, I argue that it is not the geographic locality of a single child but the composition of all children’s location that matters. I further suggest that the impact of children’s migration on parental wellbeing is conditioned on the duration of children’s migration. Using a six waves longitudinal data (2001-2015) collected in rural China, this paper compares mental health (measured as depressive symptoms) trajectories of old adults (aged 60 and older) across different compositions of local and migrant children over a 14-year span. Results from growth curve models show that parents having more migrant children relative to local children experience a more rapid increase in depressive symptoms. In addition, older adults who have their most children migrate away for three or more waves of data have experienced the steepest rate of increase in depressive symptoms. These findings provide new evidence to support the life course processes of mental health disparities among older adults from the perspective of intergenerational proximity.
RELATIONSHIP OF DEMENTIA AND MEDICAID ELIGIBILITY WITH FACILITY ADMISSIONS IN MEDICARE HOME HEALTH PATIENTS
Authors: Wang Jinjiao , Caprio Thomas V , Temkin-Greener Helena , Cai Xueya , Shang jingjing , Li Yue
Published: November 2019

This study was a secondary analysis of the Outcome and Assessment Information Set (OASIS) and administrative billing records of 6,153 adults ≥ 65 years old who received home health (HH) from a not-for-profit HH agency in upstate New York between 01/01/2017 and 12/31/2017. We examined the relationships of dementia and Medicare-Medicaid dual eligibility with unplanned institutional admission (i.e. to hospital, nursing home, or inpatient rehabilitation facility) among these HH recipients. Dementia was identified by ICD-10 codes and OASIS items (M1700, M1710, M1740). We also used OASIS record to identify dual eligible status (M0150) and unplanned facility admission (M2410 [occurrence], M0906 [date], M2430 [reason]). Time-to-facility admission was defined as the number of days from HH start date to the facility admission date. The rate of having an unplanned facility admission was 14.2% among Medicare-only patients without dementia, 15.8% among dual eligible patients without dementia, 16.7% among Medicare-only patients with dementia, and 39.3% among dual eligible patients with dementia (p<0.001). In the multivariable Cox proportional hazard model of time-to-facility admission adjusting for patient covariates, dually eligible patients with dementia were more than twice as likely as Medicare-only patients without dementia to have an unplanned facility admission (Hazard Ratio=2.35, p=0.006). This is the first study that identified synergistic effects of having both dementia and Medicare-Medicaid dual eligibility on increasing the risk of healthcare facility admission in the Medicare HH population in the United States. Policies should ensure that appropriate and sufficient HH services be provided for dually eligible patients with dementia.
DEMENTIA IMMERSION SIMULATION EXPERIENCE (DISE): ELICITING EMPATHY, IMPROVING COMMUNICATION SKILLS IN DEMENTIA
Authors: Zaragoza Gabriela , Cruz-Martinez Jaime , Reilly Paula , Ross Jeanette , Mader Michael J , Arevalo-Flechas Lyda C
Published: November 2019

Dementia awareness training alone does not improve care or outcomes for patients living with dementia. Effective dementia education programs for family caregivers and healthcare providers can lead to improved care practices and patient outcomes. The Dementia Immersion Simulation Experience (DISE) is a face-to-face 2-hour educational program that includes simulation, videos, a virtual reality station, group debriefing, and a didactic session delivered by faculty with dementia caregiving expertise. The purpose of this project was to evaluate the effectiveness of DISE in a group of 48 interdisciplinary healthcare providers, trainees and administrative staff. A program evaluation and pre and post knowledge questionnaires were administered. Prior to the activity, the mean score of all participants was 8.85. After the activity, the mean score was 10.1 (p<0.0001). 35.4% of all participants were well informed on dementia before DISE and 70.8% were well informed after the activity (p <0.0005). Qualitative analysis of the comments section of the program evaluation showed that 95% of the participants mentioned empathy for those living with dementia. Participants rated DISE on a scale of 1 (Strongly Disagree) to 5 (Strongly Agree) across ten categories, covering objectives, relevance, effectiveness, and value of the learning experience. Over 95% of respondents agreed or better (score = 4 or 5) with each evaluation statement and at least 85% strongly agreed with each statement. The evaluation scores are further evidence of an effective program. DISE is an effective tool to teach and support family caregivers, healthcare workers, and healthcare professionals and trainees.
FAMILY CONFLICT: A WELL KEPT SECRET IN LATINO DEMENTIA CAREGIVING
Authors: Zaragoza Gabriela , Arevalo-Flechas Lyda C , Flores Bertha E , Lesser Janna
Published: November 2019

The number of Latino older adults living with Alzheimer’s disease and related dementias (ADRD) could increase more than six-fold, from fewer than 200,000 in 2004 to more than 1.3 million by 2050 . One-third of Hispanic households report having at least one family caregiver (36%). 63% of Latino family caregivers are in high burden situations compared to 51% of non-Latino caregivers. Although in recent years research with Latino caregivers has increased, studies examining the family as a unit in a culture in which familismo is a central value, remain limited. The purpose of this study was to describe the experience of Latino families caring for loved ones living with ADRD along the illness trajectory. Group interviews were conducted with families caring for individuals in different stages of dementia. Interviews were conducted in English or Spanish, transcribed verbatim, and analyzed in the source language by bilingual investigators. In contrast to the numerous positive aspects of caregiving reported by individual Latino caregivers in previous studies, preliminary analysis of family group interviews revealed predominantly negative perceptions of the family caregiving experience. Families reported conflict between family members, feelings of resentment, lack of family member involvement, and uneven distribution of caregiving duties. The complex nature of fulfilling family duties as dictated by familismo appears to have idealistic and realistic consequences for families. Further exploration of Latino family dynamics in the context of dementia caregiving is needed.
METABOLOMICS IN MEN WITH DISTINCT INFLAMMATION TRAJECTORIES FOLLOWING HIP FRACTURE REVEAL RESPONSE MECHANISMS
Authors: Salimi Shabnam , Ryan Alice , Orwig Denise , Gruber-Baldini Ann , Guralnik Jack , Magaziner Jay S , Hochberg March
Published: November 2019

Introduction: Following hip fracture, men exhibit different trajectories of inflammation: high (HiInf) vs. low (LoInf). The purpose of this analyses was to compare metabolomics Between these groups. Methods: Seven men with HiInf and 7 with LoInf were randomly selected to quantify serum metabolites at baseline, 2, and 6 months following hip fracture in Baltimore Hip Study-7. We performed analysis of variance and mixed effects models. A p <0.05 was considered significant. Results: At baseline, men with HiInf had higher oxidative stress, lipid-related inflammatory markers, and antioxidant compounds compared to LoInf group. These markers were reduced in both groups at follow-up, consistent with reduced stress. However, the attenuation level was significantly different between the two groups. Kynurenate, that indicates activation of the immune system, was higher in HiInf group and remained elevated over 6 months follow-up. Polyamines with antioxidant activity and boosting autophagy activities were declined more significantly in the LoInf group presumably indicating more response to bodily anti-oxidant activity compared to the HiInf group. Arachidonic acid-derived eicosanoids, mediators of the immune response, were significantly elevated at baseline in the LoInf while oxidative stress markers were increased more in HiInf group. Branched-chain amino acids (BCAAs), the essential amino acids abundant in muscle, were elevated at baseline in the LoInf compared to HiInf group. Conclusion: Both groups showed an increase in anti-oxidative stress while LoInf group showed more reduction in oxidative stress and immune cell activity. Reduced intermediate compounds of BCCA suggest that their catabolism was attenuated following hip fracture in LoInf.
PARENTING ALL OVER AGAIN : HISPANIC “ABUELITAS” RAISING GRANDCHILDREN IN THE CONTEXT OF SUBSTANCE ABUSE DISORDERS
Authors: Flores Bertha E , Arevalo-Flechas Lyda C , Martinez Martha
Published: November 2019

Around 7 million grandparents in the U.S live with grandchildren under 18 and 39% have primary caregiving responsibilities. In Texas, more than 313,499 children under age 18 live with a grandparent who is responsible for them. Hispanic grandparents are disproportionately more likely to care for grandchildren compared to non-Hispanic whites. In San Antonio, Texas, 36.6 % of grandparents are the primary caregivers for their grandchildren. Parental substance abuse disorders have been identified as one of the causes prompting child removal from parental custody. To understand the experience of custodial Hispanic grandmothers raising their grandchildren, three focus groups were conducted in English and Spanish by three bilingual investigators. Twenty-three grandmothers, mean age 60, caring for an average of 3.2 children, 2 months to 17 years of age participated in the focus groups. The narratives were transcribed and analyzed in the source language. The following overarching themes were identified: Family is family, parenting all over again, this is a struggle but a blessing, what did I do wrong? , fear of losing the children to foster care, I do not trust anybody with my children, financial and legal challenges, role captivity, aging as a limitation, and hope for the future. The findings from the study contribute to the body of knowledge necessary to foster urgent policy changes aimed at supporting these grandparents who feel unjustly treated by human services agencies and the legal system. Programs to support custodial Hispanic grandmothers need to be linguistically congruent and culturally competent.
AUTOMATED MEASUREMENT OF MUSCLE DENSITY ON COMPUTED TOMOGRAPHY (CT) PREDICTS ALL-CAUSE MORTALITY IN OLDER ADULTS
Authors: Lenchik Leon , Barnard Ryan , Boutin Robert D , Kritchevsky Stephen B , Weaver Ashley A , Hsu Fang-Chi
Published: November 2019

The purpose was to examine the association of paraspinous muscle density (CT surrogate of myosteatosis) with all-cause mortality in 6803 men and 4558 women, age 60-69 years (mean age 63.6) in the National Lung Screening Trial. Our fully-automated machine learning algorithm: 1) selected the appropriate CT series, 2) chose a single CT image at the level of T12 vertebra, 3) segmented the left paraspinous muscle, and 4) recorded the muscle density in Hounsfield Units (HU). Association between baseline muscle density and all-cause mortality was determined using Cox proportional hazards models, adjusted for age, race, body mass index, pack years of smoking, and presence of diabetes, lung disease, cardiovascular disease, and cancer at enrollment. After a mean 6.44 ± 1.06 years of follow-up, 635 (9.33%) men and 265 (5.81%) women died. In men, lower muscle density on baseline CT examinations was associated with increased all-cause mortality (HR per SD = 0.90; CI = 0.83, 0.99; p=0.03). Each standard deviation (7.8 HU) decrease in muscle density was associated with a 10% increase in mortality. In women, the association did not reach significance.
NATURALISTIC DRIVING BEHAVIOR AS A NEUROBEHAVIORAL MARKER OF PRECLINICAL ALZHEIMER’S DISEASE
Authors: Babulal Ganesh
Published: November 2019

Decline in driving skills begins in preclinical AD, when an older adult remains cognitively normal, but the underlying disease process has begun. Preclinical AD is detectable among cognitively normal individuals using molecular biomarkers: positron emission tomography (PET) imaging and cerebrospinal fluid (CSF). The aim of this prospective, longitudinal study is to determine whether naturalistic driving behavior using in-vehicle dataloggers can distinguish older adults with (n=36) and without preclinical AD (n=134). Driving data was calculated as mean/month for several variables (number of trips/day, trip length, trip time, speeding, and hard-braking) for participants followed between one to 46 months. Using stepwise logistic regression, the area under the receiver operating curve (AUC) and 95% confidence interval for these five variables was 0.73 (0.63-0.79) in distinguishing those with and without preclinical AD via amyloid imaging. When age, gender, race, and education were added, the model improved: 0.80 (0.72-0.88). Finally, when apolipoprotein ε4 allele (APOε4), obtained via blood or saliva, was added to the model, accuracy improved: 0.84 (0.77-0.89). Similar results were found using CSF biomarker tau/Aβ42: AUCs (95% CI) were 0.68 (0.58-0.79) for driving variables alone, 0.77 (0.69-0.86) for driving variables and demographics, and 0.87 (0.80-0.94) driving variables, demographics, and apolipoprotein ε4 allele. These promising findings suggest that naturalistic driving behavior can predict those with and without preclinical AD. The AUC is further improved with demographics and APOε4, an easily obtainable genetic biomarker. This model may be used in clinical/research settings as a screen or adjunct for diagnostics and prognostics purposes.
INFLUENCE OF DEPRESSION, SOCIAL SUPPORT AND MEANING IN LIFE ON SUICIDAL IDEATION OF OLD ADULTS HEMODIALYSIS PATIENTS
Authors: Sim Hyebeen , Shin Jinhee
Published: November 2019

Purpose: This study is to identify how depression, social support and meaning in life influence to suicidal ideation of home based Korean old adult renal dialysis patients and the relating factors according to their general characteristics. Methods: This descriptive correlative study was conducted through a organized and structured self-administrated questionnaire and 120 sampled home based old adult renal dialysis patients. Collected data was analyzed by t-tests, ANOVA, Pearson’s correlation coefficient and multiple regression analysis using SPSS/WIN 24.0. Results: Findings revealed that; 1) The degrees of suicidal ideation were significantly different among groups according to the marital status, drinking and smoking history. 2) Pearson’s correlation coefficient revealed a significant association among the suicidal ideation, depression, social support and meaning in life. 3) Multiple regression analysis showed depression, social support and meaning in life were related to factors. Conclusion: Based on the findings of this study, health professionals should provide home based Korean old adult renal dialysis patients with proper management of suicidal ideation as well as its relating factors, depression, social support and meaning in life. Especially, it needs to implement suicidal ideation management and self-help group program to home based old adult renal dialysis patients.
SOCIAL NETWORK INFLUENCES ON SENSE OF CONTROL AND ATTRIBUTED DIGNITY IN OLDER AGE: RESEARCH RESULTS
Authors: LeBlanc Raeann G , Jacelon Cynthia
Published: November 2019

The purpose of this study was to explore the relationship between the functions of individual social networks, defined here as social support, and the outcomes of sense of control and attributed dignity among a sample of older people living with multiple chronic conditions. This study integrated an explanatory sequential (Quan/Qual) mixed methods design. Descriptive statistics were used to describe social networks. Bivariate correlations and regression statistics were used to examine the relationships of social network support (MOS-Social Support Scale) with the dependent variables of sense of control (Wallhagen Revised PCQ Questionnaire) and attributed dignity (Jacelon Attributed Dignity Scale). Open-ended interviews and thematic analysis were used to expand understanding of the quantitative findings. A cross-sectional sample of eighty-nine community dwelling older people living with multiple chronic health conditions participated. Social support, as a function of one’s social network, predicted the outcome of sense of control (β = .33, p ≤ .01) and attributed dignity (β = .44, p ≤ .001). Correlation statistics and regression models substantiated positive relationships of social supports’ influence on perceived sense of control and attributed dignity. Thematic analysis, based on open-ended interviews (n=12), expanded on the nuances of social influences on sense of control and attributed dignity in managing chronic health conditions through the themes “learning to ask for help”, “only a phone call away” and “smaller circles”. This research proposes new ways of understanding the relationships between perceptions of social support, sense of control and attributed dignity in later life in managing health.
AGING ALTERS STEROID HORMONE METABOLISM AND EXACERBATES LOWER URINARY TRACT DYSFUNCTION IN MICE
Authors: Liu Teresa T , Ricke William A
Published: November 2019

Benign prostatic hyperplasia (BPH) is a disease of aging that impacts 50% of men in their 50s and 90% of men in their 80s. While rodent models have been invaluable in the study of lower urinary tract dysfunction (LUTD) associated with human disease, many studies recapitulate aspects of aging, steroid hormone fluctuations, and/or inflammation without using aged mice that would better correspond to the age range of patients. In this study, we examine the impact of age in the hormone-induced mouse model of LUTD, so we can better understand the contribution of age to disease initiation and progression. We’ve discovered that aged mice exhibit a level of LUTD that is further exacerbated by hormone implantation when compared to both treated and untreated younger mice. Examination of circulating levels of androgens and estrogens indicate an alteration in steroid hormone metabolism with age, suggesting an altered nuclear receptor activation within disease. Epigenetic modifications have been associated with normal aging, including an increase in DNA methylation to alter gene expression. Examination of the proximal promoter of a steroid enzyme gene, CYP7B1, responsible for the degradation of 3β-diol (an ERβ ligand) within the prostate shows an age-mediated increase in methylation. With this, there is a corresponding decrease in CYP7B1 gene expression in the aged mice. Taken together, this suggests the altered steroid hormone environment seen in LUTD is further exacerbated due to normal aging-related epigenetic modifications that need to be considered for better treatment efficacy.
THE PROBLEM OF INTEGRATING OF BIOLOGICAL AND CLINICAL MARKERS OF AGEING
Authors: Mitnitski Arnold , Rockwood Kenneth
Published: November 2019

The number of potential biological markers of ageing increases dramatically especially with the development omics technologies. These biomarkers are not generally independent from each other and also related to clinical markers of aging that also could be markers of some illnesses. We discuss three ways of integrating biological and clinical markers of ageing: a frailty index (FI), indices of biological age, and a statistical distance as a measure of physiological dysregulation. We shows that FI has a strong theoretical support in the complex dynamical network model of the ageing process. The theory allows to explain why the interdependence of variables (representing the attributes of health) is essential for understanding of the basic properties both of the FI and of ageing such as a Gompertz law of mortality. Further progress in the field will go hand-in-hand with the development of new technologies that allow more data to be collected and interpreted.
ART TO LIFE: THE IMPACT OF AN EXPERIENTIAL ARTS PROGRAM ON ENGAGEMENT IN PERSONS LIVING WITH DEMENTIAS
Authors: Reel Candice
Published: November 2019

The Art to Life (ATL) program aims to improve the quality of life for persons living with dementia (PWD) through art therapy, intergenerational contact with college students, and life story preservation within an adult day service. This poster will present the results of an ongoing program evaluation to determine the effects of the intervention on PWDs’ engagement in (1) communication with others and (2) art/creative activity. A two-member analysis team independently coded ethnographic field notes utilizing operational definitions of PWDs’ observed behavior during momentary time sampling, and recording events of communication and art engagement using the modified ENGAGE measure (Hartmann et. al, 2017). Results across sessions (N=97) reveal communication engagement (M=28.30, SD=13.36) significantly exceeded art engagement (M=9.86, SD=5.56), t (96)=20.85, p=0.001). These results suggest that engagement in reminiscence via intergenerational contact is a fundamental feature in comparison to art and creative activity within the ATL program. Exploratory qualitative content analysis of ethnographic field notes by a three-member coding team identified two key themes within the communication engagements. These emergent themes included validation of personhood and reminiscence of family ties. More studies are needed to determine if the scope and reach of intergenerational interventions may be increased through the nationwide translation of the ATL program.
SOCIAL MEDIA RESOURCES FOR BILINGUAL CAREGIVERS OF STROKE SURVIVORS
Authors: Sanchez-Reilly Sandra , Reilly-Sanchez Laura M , Restrepo Valeria , Restrepo Marcos I , Ross Jeanette , Mader Michael J
Published: November 2019

Background: Stroke survivors experience long-term disability also affecting informal caregivers (ICG). With current technology, social media might be the only way for ICG to gain training/access support. What resources are available for ICG of older adults who survived stroke (OASS)? Objective: To identify/analyze types of bilingual social media resources available to ICG of OASS Methods: Facebook data was bilingually collected (Spanish), including most popular groups and pages based on search engines containing terms such as stroke, CVA, caregiver. Similar numbers of groups (35 English vs. 52 Spanish) and pages (32 English vs. 34 Spanish) were analyzed. Data included pages and groups’ information, numbers-of-likes, type-of-organization and resources provided. Results: English-Facebook resources were more popular for pages and groups (3820/2010 vs. 190/7; p<0.001), Spanish resources were present, but with little activity among ICG. Majority of Spanish posts came from experts and English posts related to offering services or raising community awareness. Among both languages, pages provided resources related to social support (81%), improving caregiver skills (35%), advocacy (100%-English vs.56%-Spanish, p<0.001) and research news (84%-English vs.41%-Spanish, p<0.001). For English-ICG, more opportunities for live chats, messaging and inspirational messages were found (22-44% vs.3-9%, p<0.001). Conclusions: ICG of OASS could access Facebook resources to support multiple areas of caregiving including retrieving social support, gaining skills, learning new stroke-science findings and encountering live chats while getting inspired. Some resources are more available to English-ICG. Stroke-supporting organizations must consider using social media as crucial platforms to access bilingual resources and improve quality-of-life for ICG and OASS.
THE ASSOCIATION OF FRAILTY WITH MCI AND DEMENTIA IN A MEMORY DISORDERS CLINIC FOR OLDER VETERANS
Authors: Shah Aakashi , Morani Amar , Rodriguez-Suarez Mercedes , Apracio-Ugarriza Raquel , Ruiz Jorge G
Published: November 2019

Frailty, a state of increased vulnerability to stressors due to multiple physiological dysfunction is associated with mild cognitive impairment (MCI) as well as dementia and may moderate its progression. Frailty and cognitive decline are highly prevalent in the Veteran population. The aim of our study was to determine whether frailty is associated with MCI and dementia in older Veterans at a Memory Disorders Clinic. We performed a cross-sectional study of 308 Veterans enrolled in VA Memory Disorders Clinic during 2016-2019. MCI and dementia were diagnosed based on complete clinical assessment including cognitive testing, brain imaging and neuropsychological testing. A 44–item frailty index (FI) was constructed using potential variables (demographics, comorbidities, number of medications, laboratory tests, and activities of daily living). Binomial logistic regression was run using MCI and dementia as outcome variable and frailty status (frail and non-frail) as independent variable. Age, race, marital status, ethnicity, median household income, education, comorbidities, BMI, history of substance abuse, smoking, alcohol, hospitalizations, anticholinergic use, and utilization were considered as covariates. The mean age was 74.43± 8.31 years. 43.2% population was frail (FI>0.21) and 56.8% was non-frail (FI≤0.21). The number of Veterans with MCI and dementia was 114 and 113 respectively. Frailty was significantly and positively associated with dementia (OR: 2.29 95%CI:1.25-4.21, p=0.007) but there was no association with MCI (OR: 1.06 95%CI: 0.605-1.886, p=0.820). Our study results suggest that frailty might not be associated with MCI but has significant association with dementia in a group of Veterans at a Memory Disorder Clinic.
DYNAMIC, BIDIRECTIONAL LONGITUDINAL RELATIONSHIP BETWEEN LEISURE ACTIVITY ENGAGEMENT AND COGNITIVE PERFORMANCE
Authors: Armstrong Nicole , Tom Sarah , Renteria Miguel Arce , Casaletto Kaitlin , Weuve Jennifer , Simonsick Eleanor M , Manly Jennifer , Zahodne Laura B
Published: November 2019

Engagement in leisure activities, i.e., intellectual, social, and physical activities, may reduce the risk of incident dementia, yet little is known about the longitudinal, dynamic relationship between overall leisure activity engagement and cognition in older adulthood. Using data from a survey measure of 13 leisure activities, e.g., doing unpaid volunteer work and playing cards, games, or bingo, and a neuropsychological battery collected concurrently over 14 years from 2,259 multi-ethnic participants (mean age of 76.0 years) in the Washington Heights-Inwood Columbia Aging Project, we used a parallel process latent growth curve model of trajectories of both leisure activity engagement and cognitive z-scores (global cognitive performance, language, memory, and visuospatial ability). Estimates were adjusted for baseline age, years of education, sex, race/ethnicity, recruitment year, occupation (unskilled, skilled, and housewife), and baseline income. More baseline activity engagement (range, 0-13, higher indicating more engagement) was associated with higher baseline cognitive performance, i.e., global cognitive performance (estimate=0.129, standard error, SE=0.017, p<0.001), language (estimate=0.146, SE=0.020, p<0.001), memory (estimate=0.141, SE=0.025, p<0.001), and visuospatial ability (estimate=0.111, SE=0.020, p<0.001). Decline in leisure activity engagement were associated with decline in global cognitive performance (estimate=0.002, SE=0.000, p<0.001), language (estimate=0.002, SE=0.000, p<0.001), memory (estimate=0.002, SE=0.001, p<0.001), and visuospatial ability (estimate=0.001, SE=0.000, p=0.001). While both level and change in overall leisure activity engagement and cognitive performance were correlated, level of one did not predict change in the other. Similar relationships were found when examining leisure activity categories. This suggests a dynamic, bidirectional relationship between leisure activity engagement and cognitive performance among older adults.
FACTORS INFLUENCING EPISODIC MEMORY IN SUBJECTIVE COGNITIVE DECLINE: AN IMPLICATION FOR DEMENTIA PREVENTION
Authors: Ahn Sangwoo
Published: November 2019

Episodic memory is typically affected early in the process of Alzheimer’s disease. Little is known about factors affecting episodic memory in subjective cognitive decline (SCD). The purpose of this study was to identify vascular and neuropsychiatric risk factors associated with episodic memory changes in older adults with SCD. Using the National Alzheimer’s Coordinating Center-Uniform Data Set, the relationship between baseline modifiable risk factors and episodic memory changes was analyzed using linear mixed-effects regression models. The study included a total of 1,401 subjects with SCD (mean ages: 74.0±8.2 years, 67.5% females, 84.2% White, mean follow-up period: 4.1±2.4 years). In univariate adjusted model, statistically significant coefficients on main effect or interaction with time were selected and entered into multivariate model, which was adjusted mutually for chosen independent variables and for all covariates. Reference in the final model was subjects without 1) hypercholesterolemia, 2) cigarette smoking history, and 3) depression. Those with hypercholesterolemia and former smokers had 0.024 and 0.035 points higher episodic memory scores than reference at baseline with similar rate of score changes between each group and reference over time, respectively. Current smokers scored 0.081 points lower than reference at baseline with similar rate of change over time between groups. Despite no difference at baseline, the score of depressed subjects decreased by 0.014 points a year compared to reference. It is important to manage current smoking and depression for older adults with SCD. Further research needs to identify which levels of cholesterol and smoking have a protective effect on episodic memory.