bluuebunny/crossref_metadata_2025 huggingface dataset:
Multimorbidity among Diverse Communities in New England: Findings from the Healthy Aging Data Reports
Authors: Karakida Maki , Lee Chae Man , Jansen Taylor , Xu Shu , Porell Frank , Silverstein Nina , Dugan Elizabeth
Published: December 2021

The risk for multimorbidity increases with age. Community burden of comorbidities in New England (NE) was assessed by comparing state and community rates of two measures (having no comorbidities and having 4 or more) among Medicare beneficiaries age 65+ in CT, MA, NH, and RI. Data sources were the Medicare Current Beneficiary Summary File (2014-2017) and the American Community Survey (2014-2018). Small area estimation techniques were used to calculate age-sex adjusted community rates. Multimorbidity was measured as people with zero or with 4 or more of the following chronic conditions: Alzheimer’s disease, asthma, atrial fibrillation, cancer (breast, colorectal, lung, and prostate), kidney disease, COPD, depression, diabetes, congestive heart failure, hypertension, hyperlipidemia, ischemic heart disease, osteoporosis, arthritis, and stroke. Rates for 4+ conditions: RI 63.8% (45.76-70.69%), CT 61.8% (47.82-70.05%), MA 60.7% (40-74.96%), NH 54.4% (36.67-62.99%). Results were mapped, showing the statewide and regional distribution of rates. Rates were much higher for having 4+ chronic conditions than not having any comorbidities. RI had the highest rates of 4+ and in MA the highest chronic disease rates were found in lower socioeconomic communities. CT has the highest number of diverse older residents and dual-eligible beneficiaries for Medicare and Medicaid in NE. The rates show late-life health disparities that have implications for independent living, quality of life, and mortality suggesting the need for policies to provide equitable access to care and resources to disadvantaged NE communities.
Angiotensin Receptor Blockers Upregulate Angiotensin Type 4 Receptor in Brains of Cognitively Intact Individuals
Authors: Cosarderelioglu Caglar , George Claudene J , Xue Qian-Li , Oh Esther , Ferrucci Luigi , Bennett David , Walston Jeremy , Abadir Peter M
Published: December 2021

The primary dementia-protective benefits of Angiotensin receptor type 1 (AT1R) blockers (ARBs) are believed to arise from systemic effects on blood pressure. However, there is a brain-specific renin-angiotensin system (b-RAS) that acts mainly through three receptor subtypes: AT1R, AT2R, and AT4R. AT1R promotes inflammation and oxidative stress (OS). AT2R increases nitric oxide. AT4R is essential for dopamine release and mediates memory consolidation. Here, we aimed to investigate the effects of ARBs on b-RAS, OS, inflammation, PHF-tau, and beta-amyloid load. Postmortem frontal-cortex brains of age- and sex-matched cognitively intact (CI) individuals using (n=30) and not using ARBs (n=30) and Alzheimer's disease (AD) patients using (n=30) and not using ARBs (n=30) were studied. Protein levels of receptors were measured by Western blot. Protein carbonyl (PC) and cytokine levels were measured by ELISA. Tangle and amyloid-β scores were used as outcomes. In CI individuals, our data shows that ARB treatment was associated with higher protein levels of AT4R (median(range) 0.69(1.92) vs 0.17(1.18) CI+ARBs vs CI, p=0.02), lower level of OS marker PC (10.60(8.32) vs 11.26(7.44), CI+ARBs vs CI, p=0.03) and lower hippocampal and overall amyloid scores (0(5.45) vs 1.15(4.21) p=0.03, 0.79(12.75) vs 3.41(13.36) p=0.04, CI+ARBs vs CI, respectively). In AD group, ARB treatment was associated with lower AT1R protein levels (0.47(1.15) vs 0.59(1.99), AD+ARBs vs AD, p=0.02). No significant changes were observed in OS, inflammation, or PHF-tau and amyloid load in AD brains treated with ARBs. Our results highlight the impact of ARBs on the brains of cognitively intact and AD older individuals.
Choosing Unwisely: Dissemination Needs of Primary Care Providers of Patients with Alzheimer’s Disease
Authors: Lindquist Lee , Madore Aylin , Miller Stephanie , Rowe Theresa , Bradley Sara
Published: December 2021

Choosing Wisely is a well-known campaign to disseminate evidence-based clinical practices to providers and patients to drive care decisions, with geriatrics recommendations released in 2013. In December 2019, we aimed to determine what the dissemination needs of primary care providers were towards these recommendations. We developed common clinical scenarios with follow-up survey questions, relative to the care of people with Alzheimer’s disease (AD) and utilizing Choosing Wisely geriatrics recommendations. The survey was distributed online to a national cohort of providers. Providers were also asked to rate their confidence level and rationale for clinical choices. Results were analyzed used mixed methodology, with constant comparative analysis utilized for qualitative responses. Nationally from 41/50 states, 211 providers responded, 72% female, with occupations of physician (36%, 77), advanced practice nurse (50%, 106) and physician assistant (13%, 28), with family practice (63%, 142) and internal medicine (20%, 43) the most prominent fields. Results revealed erroneous geriatric practices, including 1.)checking urinalysis for mental-status changes (55%, 116), 2.)treating asymptomatic bacteria with unnecessary antibiotics (59%, 124), 3.)placement of gastric tubes in end-stage dementia (11%, 23). Qualitative analysis of rationale for incorrect responses revealed knowledge misconceptions (e.g.feeding tube would help avoid aspiration). Confidence levels were high among providers as 75.9% rated themselves as above average, yet did not correlate to clinical errors. Choosing Wisely geriatrics recommendations are not being followed by some providers. Highly confident providers made errors similar to lower confident providers. New ways to disseminate geriatric recommendations are needed to improve the care of patients with AD.
Effects of Caregiver Interventions for Informal Caregivers of Older Adults With Cognitive Decline
Authors: Tomita Machiko
Published: December 2021

Objectives: To identify baseline factors and process factors, which indicate changes that are associated with caregiving confidence improvement attributed to caregiver support. Methods: An intervention study using 35 informal caregivers (ICG) of older adults (≥65 years old) with cognitive decline. Recipients of ICGs belonged to the Programs of All Inclusive Care for the Elderly (PACE). Interventions were occupational therapy (OT) support or education about illness and effective caregiving methods, which took place in ICGs’ homes. OT interventions included training to reduce physical strain, and improve time and task organizations, and providing assistive devices). Caregiver confidence was measured using a Visual Analog Scale. Data were divided into two groups: improved confidence and decreased/no-change confidence. Eleven baseline data of care recipients (CRs) and ICGs as well as five process data were analyzed using logistic regression. Results: Baseline factors that differentiated the two groups were ICG’s age, caregiving confidence level, and CR’s cognitive status, of which classification accuracy was 94.3%. Only Zarit Buren Interview (ZBI) score was associated with caregiving confidence change, of which classification accuracy was 74.3%. Younger ICGs, lower cognition, and lower caregiving confidence among baseline factors, and improved ZBI among the process factors were associated with improved confidence. Discussion: Although our interventions prevented 65.7% of caregivers form declining their caregiving confidence, improving caregiving confidence was difficult while CRs’ cognition continued to decline. However, this positive change was possible even CRs had moderate dementia, on average. Personal interventions may be necessary to improve caregiving confidence and reduce ICG’s burden.
Machine Learning-Based Predictive Models of Behavioral and Psychological Symptoms of Dementia
Authors: Cho Eunhee , Kim Sujin , Heo Seok-Jae , Shin Jinhee , Ye Byoung Seok , Lee Jun Hong , Kang Bada
Published: December 2021

Models predicting the occurrence of specific types of behavioral and psychological symptoms of dementia (BPSD) can be highly beneficial for its early intervention and individualized care planning. Using a machine learning approach, this study developed and validated predictive models of the occurrence of BPSD, categorized into seven subsyndromes, among community-dwelling older adults with dementia in South Korea. BPSD dairy was used to measure BPSD and the state of unmet needs daily. We measured sleep and activity levels using actigraphy, and stress and fatigue using a portable heart rate variability analyzer. We developed predictive models and conducted cross-validation using training data that consisted of the first two wave dataset, and then validated the models using wave 3 test data. To deal with imbalanced datasets, we used Synthetic Minority Oversampling Technique (SMOTE), an over-sampling method. Categorical variables were pre-processed using target encoding. We then compared the machine-learning models with logistic regression. The area under the receiver operating characteristic curve (AUC) scores of the support vector machine (SVM) models for the wave 3 test data showed a similar or greater value than logistic regression models across all BPSD subsyndromes. The SVM model (AUC = 0.899) had an AUC value greater than that of the logistic regression model (AUC = 0.717), particularly for hyperactivity symptoms. Machine learning algorithms, especially SVM models, can be used to develop BPSD prediction models to help identify at-risk individuals and implement symptom-targeted individualized interventions.
Music Interventions for Early-Stage Cognitive Decline: A Systematic Review and Meta-Analysis
Authors: Dorris Jennie , Neely Stephen , Rodakowski Juleen
Published: December 2021

Older adults in the early stages of Alzheimer’s and dementia deserve effective modalities that support their cognition, emotional well-being, and social engagement. Music has demonstrated potential to support these critical outcomes through its ability to simultaneously stimulate multiple areas of the brain and induce neuroplasticity. We reviewed randomized controlled trials for studies that specifically utilized active music-making interventions for older adults with early-stage cognitive decline to assess their effects on cognition, emotional well-being, and social engagement. Additionally, this review categorized the specific music activities employed by each intervention. We conducted searches on Medline (Ovid), APA PsycInfo (Ovid) CINAHL (Ebsco), and Embase (Elsevier). Our search yielded 285 potential studies. We analyzed 19 studies with 1,387 participants for potential effect sizes and intervention ingredients. Of the 19 studies, eight studies, recruiting a total of 460 participants, were used to conduct a random-effects meta-analysis to assess the effect of music on cognition. Meta-analytic aggregration of effect sizes showed that music had a modest positive effect on cognition compare with the control conditions (SMD= 0.26; P= 0.008; 95% confidence interval, 0.07, 0.45; I2= 5%). The musical activities of 1) singing and/or playing pre-composed songs and/or 2) creating music in the moment were utilized in the protocols. This research demonstrates that active music-making supports cognition for older adults with early-stage cognitive decline. Future music programs should consider inclusion of pre-composed songs, as well as music creation, to better understand the power for music to provide critical support for a rapidly growing segment of the population.
Family Caregivers as Advocates
Authors: Whiting C Grace
Published: December 2021

This presentation discusses the growing influence of family caregiver advocacy and its prospects for impacting policy under the Biden administration, at both the federal and states levels. In particular, it will describe the National Alliance for Caregiving’s 50-state unified strategy for establishing the caregiver support infrastructure that is needed to coordinate efforts and to support caregivers across the nation and the lifespan. Historically, family caregivers have had difficulty acting as effective advocates, given the multiple roles they often play and their widely divergent interests, based on the varying needs of their care recipient and their divergent life circumstances. However, the Biden administration has indicated receptivity to caregiver issues, and the public has become increasingly aware of the caregiver role (in part, due to the pandemic), resulting in improved prospects for policy action at both the state and federal levels. This presentation reviews recent developments and discusses strategies for moving forward.
Aging Across the Life Course: Research Collections Available from the National Archive of Computerized Data on Aging
Authors: McNally James
Published: December 2021

The creation and maintenance of sustainable data archives can be challenging, but it offers clear advantages. Properly curated data can be used by multiple researchers, testing a variety of hypotheses, and increasing the return on investment to the expensive process of data collection. Having an internally managed archival system also provides greater control and autonomy in the equitable distribution of data resources. This process ensures all researchers will have full use of the data for original research, teaching, and new directions once the data leaves the control of the local investigator’s control. This poster reviews the advantages of having a local strategy geared toward the preservation and sharing of gerontological research data. Using the National Archive of Computerized Data on Aging (NACDA) as a working example, the poster offers an overview of collections at NACDA. Using our metadata tools and variable search database, NACDA can identify studies in its collections that examine aspects of aging and health among adults during their lifecourse. Many of the studies are longitudinal or repeat measure cross-sectional studies. We are also able to identify studies that focus on aging that are not maintained by NACDA but which are available to interested researchers. Using a strategy of archival preservation combined with a strong focus on productive research Innovation in Aging, NACDA has amassed data and metadata covering a wide array of studies worldwide that address the aging lifecourse. Because our collections are multinational, we share these data at no cost to interested users worldwide
Human Factors Linked with Initial and Continuous Trust in Autonomous Systems: A Literature Review
Authors: Pena Maria , Carrillo Jared , Milyavskaya Nonna , Chan Thomas
Published: December 2021

Many autonomous systems are being developed to assist older adults to age in place. However, there is little research related to the human factors associated with why older adults may initially and continuously trust these autonomous systems. More research in this area on older adults and trust in autonomy is needed to facilitate the technologies better everyday use. The current study conducted a literature review on the prevalent human factors that enable people to trust their interactions with smart technologies (e.g., artificial intelligence, navigational structures). Articles were collected from various disciplines on concepts such as trust in autonomy, human-computer interactions and teamwork. Thematic analysis revealed two convergent areas that were associated with initial and continuous trust: human and technological characteristics. Human characteristics are defined by a person’s ability to understand and use autonomous systems. Generally, people with higher competency and abilities with autonomous systems demonstrated the ease of use to carry out desired actions with smart technology. Technological characteristics are defined by the system’s performance, explainability, and its intended purpose between trust. Essentially, people were less critical of autonomous systems that were perceived to be useful, transparent, and predictable. Overall, the autonomous system's ability to perform its intended purpose and the users knowledge and technical qualifications dominate the relationship between initial and continuous trust with autonomous systems. These are the prevalent factors that need to be considered for the creation of trusted autonomous technologies for older adults to help them age in the approaching more advanced technological world.
Links of Sleep Duration with Biomarkers of Accelerated Aging: the Baltimore Longitudinal Study of Aging
Authors: Smail Emily , Maher Brion , Moore Ann , Kuo Pei-Lun , Wu Mark , Low Dominique , Stone Katie , Spira Adam
Published: December 2021

Sleep disorders and sleep deprivation have been linked to markers of biological aging, including methylation change and increases in white blood cell and neutrophil counts. However, little is known regarding the association of sleep duration with biological markers of aging. We investigated links of self-reported sleep duration with biological aging markers in 615 participants in the Baltimore Longitudinal Study of Aging (BLSA) aged ≥50 years (mean = 71.0 ± 11.2, 49.6% women, 68.8% white) with data on self-reported sleep duration in hours (i.e., ≤6 (n=131), >6 to 7 (n=234), >7 (n=250)), demographics, and genetic and methylation data (mDNA). Our aging biomarker outcomes were four epigenetic clocks (Horvath, Hannum, PhenoAge, and GrimAge), mDNA-estimated PAI1, and estimated granulocyte count. After adjustment for age, sex, and race, compared to those sleeping ≤6 hours, those reporting >7 hours of sleep had faster biological aging according to Hannum age-acceleration, PhenoAge, GrimAge, mDNA-estimated PAI1, and granulocyte count. In addition, sleep duration interacted with age, such that compared to individuals reporting ≤6 hours of sleep, individuals reporting >6 to 7 hours showed lower GrimAge with increasing age, and with sex, such that males with longer sleep duration (>6 to 7 and >7 hours) showed a lower granulocyte count compared to females. Findings suggest that both short and long sleep duration are associated with and may contribute to accelerated aging. Prospective studies in larger samples are needed to examine whether changes in sleep duration precede changes in aging biomarkers.
A novel probiotics therapy for aging-related leaky gut and inflammation
Authors: Wang Shaohua , Wang Bo , Mishra Sidharth , Jain Shalini , Ding Jingzhong , Krtichevsky Stephen , Kitzman Dalane , Yadav Hariom
Published: December 2021

Inflammaging characterized with increased low grade inflammation in older adults is common determinant of unhealthy aging; and is a major risk factor of morbidity and mortality in older adults. The precise origin of inflammation in older adults is not known, however, emerging evidence indicate that increased intestinal epithelial permeability (leaky gut) and abnormal (dysbiotic) gut microbiota could be one of the key source. However, no preventive and treatment therapies are available to reverse the leaky gut and microbiome dysbiosis in older adults. Here, we presented the evidence that a human-origin probiotics cocktail containing 5 Lactobacillus and 5 Enterococcus strains isolated from healthy human infant gut can ameliorate aging-related metabolic, physical and cognitive dysfunctions in older mice. We show that the Feeding this probiotic cocktail prevented high-fat diet–induced (HFD-induced) abnormalities in glycose metabolism and physical functions in older mice and reduced microbiota dysbiosis, leaky gut, inflammation. Probiotic-modulated gut microbiota reduced leaky gut by increasing tight junctions on intestinal epithelia, which in turn reduced inflammation. Mechanistically, probiotics increased bile salt hydrolase activity in older microbiota, which in turn increased taurine deconjugation from bile acids to increase free taurine abundance in the gut. We further show that taurine stimulated tight junctions and suppressed gut leakiness. Further, taurine increased life span, reduced adiposity and leaky gut, and enhanced physical function in Caenorhabditis elegans. Whether this novel human origin probiotic therapy could prevent or treat aging-related leaky gut and inflammation in the elderly by reversing microbiome dysbiosis requires evaluation.
Mammalian Co-methylation Network Analysis of Species Characteristics
Authors: Haghani Amin , Horvath Steve
Published: December 2021

The comparative cross-species analysis is a powerful tool to resolve the mysteries of evolution and phenotypic disparities among animals. This is the first network analysis of 10,000 DNA methylome data from 176 mammalian species to identify co-methylation modules that relate to individual (age, sex, tissue type) and species characteristics (e.g. phylogenetic order, maximum lifespan, adult weight). The unexpected correlation between DNA methylation and species were sufficiently strong to allow the construction of phyloepigenetic trees that parallel the phylogenetic tree. Weighted correlation network analysis identified 55 distinct co-methylation modules, i.e. sets of highly correlated CpGs. 31 of these modules are readily interpretable in terms of their relationship to age, maximum lifespan, tissue type etc. An age-related module was perturbed by gold standard anti-aging interventions in mice such as caloric restriction or growth hormone receptor knock outs. Our module-based analysis greatly enhances our biological understanding of age-related changes in DNA methylation across many species.
Widespread Cortical Demyelination in Geriatric Cases of Mild Traumatic Brain Injury and in Alzheimer’s Disease
Authors: Irimia Andrei , Chowdhury Nahian , Wang Shania , Mahoney Sean , Van Ngo  , Rostowsky Kenneth , Hacker Benjamin , Chaudhari Nikhil
Published: December 2021

Cortical demyelination is related to neurodegeneration after mild traumatic brain injury (mTBI) and Alzheimer’s disease (AD). The ratio R of T1-to-T2-weighted magnetic resonance image (MRI) intensities is proportional to myelin content, and allows myelin changes to be mapped in vivo. T1 and T2 MRIs were acquired from mTBI patients (N = 97, age μ = 41 y; σ = 19 y, range: 21-79) both acutely and chronically (~1 week and ~6 months post-injury, respectively), from AD patients (N = 80, age μ = 76 y; σ = 8 y, range: 55-88), and from cognitively normal (CN) adults (N = 78, age μ = 75 y; σ = 5 y, range: 12-90). AD and CN subjects’ data were acquired less than a year apart. MRIs were analyzed using 3DSlicer’s BRAINSfit (registration), FreeSurfer (segmentation), SPM12 (bias field correction) and custom MATLAB scripts to calculate myelin content and demyelination. The null hypothesis of no myelin change was tested at each cortical location for each pair of groups (α = 0.05), after accounting for age, sex and interscan interval. Compared to HCs, AD subjects featured significantly greater myelin loss in dorsolateral prefrontal cortex, lateral and medial temporal lobes (~52% of the cortex, p < 0.05). mTBI participants experienced significantly greater myelin loss across ~96% of the cortex (p < 0.05), suggesting that mTBI has dramatic impact upon cortical myelin content. Myelin loss magnitude was comparable across mTBI and AD, particularly within temporal lobes. Future research should study whether post-traumatic demyelination increases the AD risk.
Association between Serum 25-hydroxyvitamin D Levels and Incidences of Infection in Long-Term Care
Authors: Robbins Ronna , Serra Monica , Briley Margaret
Published: December 2021

Insufficient serum 25-hydroxyvitamin D (25(OH)D) concentrations are associated with increased respiratory tract infections, influenza, and other infectious diseases. As the world deals with the COVID-19 pandemic, the interest of adequate serum levels to reduce the risk of infection has surfaced. This study determined if the number of infections per year are associated with serum 25(OH)D concentrations in long-term care (LTC). Participants (≥ 65 years) in a cross-sectional study were recruited across five LTC communities in Texas. Medical records were used to collect a one-year medical history using double-blind protocols. Blood draws were collected to measure serum 25(OH)D concentrations. Medical records were used to classify infections based upon documentation of signs and symptoms of infection concurrent with either a physician’s note or antibiotic/antiviral medication prescription. Race, BMI, sex, age, and liver and renal disease diagnoses were used as confounders. Of the 177 participants (89% Caucasian, 63% female, mean age 83 years) 69% had ≥1 infection over year and 55% had insufficient serum 25(OH)D concentrations <30 mg/mL (mean 32.6 ng/mL). Linear regression did not show a significant association between serum 25(OH)D concentrations and number of infections (β 0.003; 95% CI -0.014, 0.018; p=0.760). Additionally, insufficient serum concentration did not increase the odds of having an infection (OR 1.02; 95% CI 0.05, -19.34; p=0.987). This study did not show a significant association between infection rates and serum 25(OH)D concentrations. However, further research is needed to determine if vitamin D supplementation could be an effective therapeutic intervention to reduce infection rates, including COVID-19.
Combating Age-Associated Immune Decline Using Kynurenine Pathway Interventions
Authors: Espejo Luis , DeNicola Destiny , Freitas Sam , Dang Hope , Turner Emily , Castro-Portuguez Raul , Haskins Anne , Sutphin George
Published: December 2021

Select kynurenine pathway interventions extend lifespan in invertebrate models and are of interest in treating age-associated diseases. Kynurenine pathway activity is responsive to inflammatory signaling, and we are evaluating the potential for these interventions to increase pathogen resistance and curtail age-associated immune decline in Caenorhabditis elegans and mammals. The kynurenine pathway facilitates the catabolism of tryptophan to nicotinamide adenine dinucleotide (NAD). Our lab has found that supplementing the kynurenine metabolite 3-hydroxyanthranilic acid (3HAA) or inhibiting the enzyme 3HAA dioxygenase (HAAO) extends lifespan in C. elegans. 3HAA has demonstrated pro/anti-inflammatory properties in mammals, suggesting a potential role in immune function. C. elegans have a primitive immune system that lacks an adaptive element, but it recapitulates aspects of innate immune signaling and pathogen response. I hypothesize kynurenine pathway interventions that impact C. elegans’ lifespan similarly improve pathogen resistance and immunity. Interventions within the kynurenine pathway are capable of differentially impacting pathogenesis and lifespan of C. elegans challenged with Psuedomonas aeruginosa. C. elegans subjected to select lifespan-extending kynurenine pathway interventions fared better when challenged with P. aeruginosa at older ages. Additionally, fluorescent infection tracking has displayed decreased infection rates in worms with elevated 3HAA. Our data suggests pro-immune activity is facilitated by 3HAA acting downstream of the dbl-1 pathway in addition to directly inhibiting bacterial growth. Our goal is to discover the mechanism(s) through which the kynurenine pathway interacts with immune function in animals and identify potential targets for clinical therapy in aging populations.
Association Between Meeting Physical Activity Guidelines with Ambulation and Quality of Life in Claudication
Authors: Gardner Andrew , Montgomery Polly , Wang Ming , Shen Biyi , Zhang Shangming , Pomilla William
Published: December 2021

We determined if meeting the 2018 physical activity guidelines was associated with better ambulatory function, health-related quality of life, and inflammation than failing to meet the guidelines in patients with peripheral artery disease and claudication. Secondly, we determined the optimal number of total daily steps that are needed to meet the physical activity guidelines. Five hundred seventy-two patients were assessed on their daily ambulatory activity for one week with a step activity monitor, and were grouped according to whether they achieved less than 150 minutes of moderate intensity physical activity per week (Group 1=Do Not Meet Guidelines; n=397), or whether they were above this threshold (Group 2=Meet Guidelines; n=175). Treadmill peak walking time (mean±SD) was significantly higher (p<0.001) in Group 2 (709±359 sec) than in Group 1 (427±281 sec). The health-related quality of life score for physical function was significantly higher (p<0.001) in Group 2 (61±22%) than in Group 1 (44±21%). High sensitivity C-reactive protein was significantly lower (p<0.001) in Group 2 (3.6±4.5 mg/L) than in Group 1 (5.9±6.1 mg/L). Finally, 7,675 daily steps was the optimal threshold associated with meeting the physical activity guidelines, with a sensitivity of 82.9% and a specificity of 88.4%. In conclusion, patients with claudication who meet the 2018 physical activity guidelines for US adults had better ambulation, HRQoL, and inflammation outcomes than those who failed to meet the guidelines. From a practical standpoint, patients with claudication best achieved the physical activity guidelines by taking a total of 7,675 daily steps.
Social Disengagement and Cognitive Function: Does the Association Vary by Gender?
Authors: Kang Bada , Cho Eunhee , Oh Sarah
Published: December 2021

Although social disengagement is considered to be a predictor of cognitive decline, and increase risk of Alzheimer’s and related dementias, little is known regarding the gender-specific association between social disengagement and cognition among Korean middle-aged and older adults. Korea’s Confucianism-based gender roles provide unique contexts to examine gender differences in the influence of social disengagement on cognition. This study investigated the association between social disengagement and cognitive function in a nationally representative sample of Koreans aged 45 years or older (N = 5,196 women and 2,707 men), using data from the Korean Longitudinal Study of Aging (2008-2018). Results from the generalized estimating equation model showed that compared to consistent social engagement, consistent non-engagement was significantly associated with lower cognitive function among both genders. Transitioning from social engagement to non-engagement was significant for males only. Of various types of social activities (religious, senior center, sport, reunion, voluntary, political), consistent non-engagement in a senior center was most associated with lower cognitive function among both genders, while consistent non-engagement in religious activities was significant for females only. While household arrangements were not associated with cognition in men, widowed women had increased risk of cognitive decline than married women, as did women living in households of three or more people. Depression was a predictor of cognitive decline among males only. In this gender-specific study, we found that consistent participation in social activities, especially via membership in a senior community center, is beneficial in preventing cognitive decline among both genders.
Multitasking in Older Adults’ Daily Activities: A Preliminary Investigation
Authors: Stephan Abigail , Tian Junyan , Ross Lesley
Published: December 2021

The ability to multitask, defined as conducting two or more activities simultaneously, is important in daily life. The majority of prior work has examined multitasking in laboratory settings. However, less is known about how multitasking in daily activities is related to older adults’ executive functioning and perceptions of aging. The current study investigated these relationships in a sample of 33 older adults aged 65-81 (M=70.0, SD=3.6). Participants were asked to describe activities they did each day and estimate time spent in each activity across fourteen days; multiple activities reported in the same time frame were considered multitasking. Executive function was measured at baseline using the Trail Making Test Part B (TMTB), with higher scores indicating worse performance. Expectations regarding aging were measured at baseline using the Expectations Regarding Aging (ERA-12) survey, with higher scores indicating more positive perceptions. Twenty-seven participants (81.82%) reported at least one instance of multitasking in the fourteen-day period. Participants were divided into three groups based on the median number of reported multitasks: no multitasking (n=6), low multitasking (≤4; n=15), and high multitasking (>4; n=12). Although there were no significant differences within the ANOVA, participants who reported low multitasking trended towards poorer executive function and more positive expectations of aging (M_TMTB=100.28, M_ERA= 64.88) than both no multitasking (M_TMTB=82.12, M_ERA=50.46) and high multitasking groups (M_TMTB=94.90, M_ERA= 54.29). Additional research should investigate these possible relationships in larger samples and explore how covariates, such as gender and age, may moderate possible relationships.
Does Cognitive Status Moderate the Relationship between Environmental Factors and Self-Reported Health?
Authors: Cheung Ethan Siu Leung , Mui Ada
Published: December 2021

Using data from NHATS Round 9, the present study examines the relationships between environmental factors and self-reported health among older adults with dementia, mild cognitive impairment (MCI), and normal cognition. Based on neighborhood stress process theory, we investigate the following questions: 1) Are there associations between dwelling safety hazards and neighborhood environments and self-reported health? 2) Is cognitive status a moderator between the relationship? 3) How do these associations differ between older adults with varying cognitive status (i.e., dementia, MCI, and normal cognition)? A hierarchical linear regression analyses are conducted. Results indicate that better quality of sidewalk surface and neighborhood social cohesion are associated with better self-reported health, after taking into account sociodemographic, health, and social factors. Interaction terms are then used to examine the moderating effects of cognitive status on the associations; four interactions terms are found to be statistically significant. Lastly, separate linear regression analyses are implemented for the dementia, MCI, and normal cognition groups. Findings show that the predicting power of environmental factors vary by cognitive status of older adults. For individuals with dementia, tripping hazards, cluttered home, and community disconnectedness are associated with poor self-reported health. However, no significant relationship was found for older adults with MCI. For older adults with normal cognition, better quality of sidewalk surface and neighborhood social cohesion predict better self-rated health scores. Findings of this study illuminate the important role of a hazard-free home, community walkability, and socially cohesive neighborhood environments in predicting better health status of older adults.
DNR Linked to Reduced Depressive Symptoms in Nursing Home Residents During COVID-19 Illness
Authors: Mak Wingyun , Burack Orah , Reinhardt Joann , Weerahandi Himali , Canter Benjamin , Boockvar Kenneth
Published: December 2021

Prior work shows that older adults who establish future care plans have a lower risk of depression. Residents in long-term care may benefit from establishing a do-not-resuscitate (DNR) order when cardiopulmonary resuscitation is unlikely to provide medical benefit. The current study examines whether having a DNR order in place prior to COVID-19 diagnosis was associated with fewer depressive symptoms during the illness course. Residents at a NYC skilled nursing facility with a positive COVID-19 PCR test between 3/1/2020 – 6/1/2020 were included (N=338). The Minimum Data Set (3.0) was used to examine residents’ Patient Health Questionnaire-9 (PHQ-9) scores 1-30 days after diagnosis, functional status, cognition, age, and sex. A retrospective chart review was conducted to determine whether participants had an established DNR, DNI, and/or DNH order before developing COVID-19. Forty-eight percent, 46%, and 12% of participants had a DNR, DNI, or DNH order prior to COVID-19 illness, respectively. Average PHQ-9 score was 1.65 (SD=2.37). A hierarchical regression showed that after controlling for age (β=-.13, p=.06), sex (β=-.08, p=.28), cognition (β=.14, p=.04), and functional status (β=.23, p=.001; R2=.10, p=.001), having a DNR (β=-.22, p=.006) order in place prior to COVID illness was associated with lower endorsement of depressive symptoms during illness (ΔR2=.04, p=.01). Results suggest that establishing a DNR in long-term care residents when appropriate may potentially buffer depressive symptoms during illness in nursing home residents regardless of their age, sex, cognitive abilities, and functional status. Future examination of the underlying mechanism is warranted.
Protective and Risk Factors of Depression Among Older Adults During the COVID-19 Pandemic
Authors: Lee Yeonjung , Terada Tyran
Published: December 2021

The coronavirus disease 2019 (COVID-19) pandemic adversely impacted the mental health of older adults. This study aims to explore the associations between protective/risk factors of depression during the pandemic and to examine the differences in these associations by marital status. Data from the Health and Retirement Study 2020 COVID-19 module, released in February, 2021, were used. The level of resilience during the pandemic was selected as a protective factor. The level of COVID-19 pandemic concern was selected as a risk factor. Among older adults aged 51 years and older, the weighted regression model found that higher levels of COVID-19 concern were associated with higher levels of depressive symptoms (p<0.05), whereas higher levels of resilience were associated with lower levels of depressive symptoms (p<0.05). Marital status moderated the association between COVID-19 concern and depressive symptoms. Never-married people were at higher risk of depressive symptoms than married people when COVID-19 concerns increased. It is important to enhance support for never-married people during the pandemic to protect their psychological well-being.
The Impact of COVID-19 Concerns on the Mental Health of Older Adults: A Rapid Review
Authors: Perez Sophia , Nuccio Alexandria , Stripling Ashley
Published: December 2021

The Coronavirus (COVID-19) Pandemic continues to drastically impact older adults. Despite COVID-19 being linked to increased social isolation and loneliness, more research is needed on the psychological effects associated with older adults’ concerns of the pandemic. The current review explores associations between the COVID-19 Pandemic and older adults’ mental health to increase awareness and understanding. For this rapid review, empirical peer-reviewed source documents were identified through a computerized search using APA PsycInfo and Google Scholar bibliographical databases covering the years 2019 to 2021. The following keywords and combinations were used: “older adults,” “COVID-19,” and “mental health effects.” Relevant exclusion criteria were applied, and all related English-language journal articles were read. 47 articles met inclusion criteria. Eight associated COVID-19 stress with loneliness, anxiety, depression, sleep disturbances, and poor psychological well-being, with three additional articles reporting elevations in women. Three articles revealed mixed findings regarding the impact of age on psychological variables. 13 articles evaluated changes among those with psychological/psychiatric diagnoses, and six explored physical activity and depression. Of the remaining articles, two concentrated on nutrition; seven examined routines, behaviors, and societal or risk perceptions; two evaluated coping mechanisms; and three examined emotional distress changes. Understanding COVID-19’s psychological impact on older adults will take time. This rapid review revealed mixed findings regarding COVID-19 related concerns on older adults’ psychological well-being, with multiple demographic variables uniquely impacting these outcomes. It is imperative that future research explore older adults’ risks and develop interventions related to the psychological impact of COVID-19.
No Visitors Allowed! The Impact of Covid-19 Restrictions on the Psychosocial Well-being of Nursing Home Residents
Authors: Shaw Shanae , Csikai Ellen
Published: December 2021

The COVID-19 coronavirus pandemic changed life for everyone, but especially for nursing home residents. In March 2020, the Centers for Medicare and Medicaid Services enacted nursing home restrictions in response to the pandemic regarding visitation from outside family/friends and changes to facility activity programs. Despite the public health concern prompting these restrictions to prevent virus spread, these sudden changes affected nursing home residents’ relationships with their spouses/partners. As part of a larger study to identify the nursing home policies and practices that preserve relationships among nursing home residents with spouses/partners, participants shared facilities’ restrictions, social connection practices, and effect of coronavirus restrictions on residents’ relationships with spouses/partners. The study utilized both an online survey (81 respondents) and ten telephone interviews with nursing home social workers in four Southern states. Twenty-eight percent of participants reported that no visitors were allowed; while 25% allowed couples to visit with one another as usual was reported by 25%. The most noted practices to maintain social connections were phone calls, video calls, and ‘window’ visits between residents and families/friends; however, “it’s just not the same. It’s affected them greatly”. The interviews revealed further details about the detrimental effect of the COVID-19 restrictions on nursing home residents’ overall mental health and attachment relationships with spouses/partners. These results highlight the importance of maintaining social connections between residents and spouses/partners. Nursing home social workers can develop policies and practices that enhance relationships and connections under all circumstances and work with other health care team members to ensure implementation.
Alzheimer’s Prevention Lifestyle Risk Coaching in Low-income Older Adults
Authors: Zanjani Faika , Rhodes Annie
Published: December 2021

Prevention, with widespread lifestyle risk reduction at the community-level, is currently considered an effective method to decrease Alzheimer’s disease (AD). As part of the Virginia Commonwealth University iCubed Health and Wellness in Aging Core, diverse older adults (60+) living in Richmond, VA, with incomes below $12,000/year and managing either diabetes/cardiovascular symptoms, were offered weekly lifestyle telephone-health coaching for 12-weeks, providing education, motivations, self-efficacy, and referral services for AD lifestyle risk. The study sample (n=40, mean age 68 years (range: 60-77 years) was 88% African American/Black (n=35), 100% Non-Hispanic, and 45% males (n=18)). Thirty-nine (95%) of subjects successfully participated in coaching sessions; on average 91.9% (11) sessions/subject were completed. On a scale of 0-100 (higher scores more positivity), rated their experience 93.3. On a scale of 0-10 (higher scores more improvement), rated their health improved 8.36. Pre/post-test analyses indicated lifestyle improvement trends over 4-months for total lifestyle risk (F=4.69;p=.037;effect=.12), social activity (F=4.63;p=.063;effect =.09), and improvement in certain psychological domains: AD knowledge (F=4.49;p=.041;effect=.11); cognitive functioning (short-term memory (F=4.99;p=.038;effect= .21); delayed memory (F=2.26;p=.154;effect=.11); Trails A (F=5.60;p=.0294;effect=.24); and Trails B (F=2.22;p=.154;effect=.11). Participants provided positive anecdotal feedback and the need for continued health coaching. In conclusion, this preliminary work creates the impetus for future large-scale lifestyle AD prevention investigations to improve the lives of AD-risk, low-income, diverse older adults. These findings demonstrate that telephone-based health coaching is feasible, based on participant engagement, and effective, based on positive trends in reducing AD risk factors.
Behavioral correlates of subjective cognitive decline in the Canadian Longitudinal Study on Aging (CLSA)
Authors: Hopper Shawna , Hammond Nicole , Stinchcombe Arne
Published: December 2021

Subjective cognitive decline (SCD) is a self-reported decline in cognition among otherwise cognitively healthy older adults. It is believed that SCD may be a precursor to Alzheimer’s Disease (AD). Analyzing data from the Canadian Longitudinal Study on Aging (CLSA), a large national sample of participants aged 45-85 at baseline, we sought to identify prospective relationships between health-related behaviors and SCD. Exposures were measured at baseline and SCD was measured three years later, with the question: “Do you feel like your memory is becoming worse?”. A multivariable logistic regression model was used to estimate odds of SCD (analytic sample: n=35,680). Alcohol consumption was associated with increased odds of SCD, with regular drinkers (OR=1.13, 95% CI: 1.04, 1.22) and frequent drinkers (OR=1.17, 95% CI: 1.08, 1.27) more likely to report SCD than never drinkers. Compared to participants who never smoked, former smokers had increased odds of SCD (OR=1.13, 95% CI: 1.08, 1.18), whereas current smokers had reduced odds of SCD (OR=0.90, 95% CI: 0.83, 0.98). Participants who consumed five or more servings of fruits/ vegetables had reduced odds of SCD (OR=0.95, 95% CI: 0.91, 0.99), when compared to those who consumed <5 servings. Lastly, we did not observe any associations between walking and SCD. This study identifies relationships between various health-related behaviors and SCD in a large population-based sample of older Canadians. Identification of modifiable risk factors may help with early prevention and intervention of SCD.
Older Adults' Perceptions of College Campus Accessibility
Authors: Ermer Ashley , Verna Nadine
Published: December 2021

The emerging Age-Friendly University Global Network encourages universities to engage older adults in university activities (Gerontological Society of America, 2019). As such, attention should be devoted to the accessibility of campus facilities to older adults as a potential mechanism to increase age diversity. Intergenerational interactions, which may take place on college campuses, promote better perceptions of other generations (Bertram et al., 2017), making campus accessibility for all age groups a priority. The present study sought to uncover older adults’ perceptions of campus accessibility via an online survey. Participants were recruited through local newsletters, word of mouth, and included 81 community members (Age mean=71.58 years; 79% female; 89% White; 43% traveled to campus every few months). Descriptive analyses were conducted for closed-ended responses and two members of the research team used a constant comparative method (Corbin & Strauss, 2015) to code open-ended responses. Participants felt that campus was somewhat accessible (M = 2.72;1(very inaccessible) to 5(very accessible)), moderately easy to walk around (M=3.79;1(extremely difficult) to 7(extremely easy)), and felt somewhat welcome on campus (M=3.27; 1(strongly disagree) to 7(strongly agree). The following general themes emerged in the open-ended responses: 1)inaccessibility on campus was due to parking, drop-off locations, and topography (e.g., due to stairs, distance, hills) constraints; 2)feeling welcome on campus was due to people being helpful; and 3)difficulty in attending events was due to parking and lack of knowledge about events. Implications for campus initiatives that aim to attract older adults, especially for campuses that have topography constraints, will be discussed.