bluuebunny/crossref_metadata_2025 huggingface dataset:
MAP GERIATRICS CLERKSHIP LEARNING OBJECTIVES WITH GERIATRICS 5MS
Authors: Cheng Huai
Published: December 2023

Background

Minimum Geriatrics Competencies (MGC) are used to guide teaching geriatrics for medical students in a required geriatrics clerkship since 2011. These learning objectives can be mapped to Entrustable Professional Activities (EPA). Since 2017, Geriatrics 5Ms (mind, mobility, medication, multi-complexities, and what matters most) was developed to guide teaching geriatrics for medical students and to promote a Geriatrics 4Ms Age-friendly health care system as well. The aim of this study is to examine whether an MGC-based geriatrics clerkship is consistent with geriatrics 5Ms by mapping its learning objectives with geriatrics 5Ms.

Methods

This geriatrics clerkship is a two-weeks required rotation for all fourth-year medical students. It includes didactic classroom teaching and clinical rotation in different geriatrics practice, palliative care, and physical medicine rehabilitation. This clerkship has a total of 50 learning objectives with corresponding MGC teaching methods/strategies, assessment, and evaluation. The author will map each learning objective with Geriatrics 5Ms. Results 13 learning objectives are mapped to “Mind”. 9 learning objectives are mapped to “Mobility”. 10 learning objectives are mapped to “Medications”. 14 learning objectives are mapped to “multi-complexity”. 6 learning objectives are mapped to “Matters most”. 12 learning objectives are not mapped to any of geriatric 5Ms. Conclusion and discussion The majority of 50 learning objectives in a required geriatrics clerkship can be mapped to geriatrics 5Ms. This MGC-based learning objective can be adopted to teach medical students geriatric 5Ms and geriatric 4M Age-friendly health care system. Take-home message MGC-based learning objectives are aligned with geriatrics 5Ms.
MEDIATING EFFECTS OF QUALITY OF LIFE IN THE ASSOCIATION OF DEBTS AND LATER MEMORY FUNCTION IN CHINA, ENGLAND, AND THE US
Authors: Cho Tsai-Chin , Choi HwaJung , Langa Kenneth , Adar Sara , Kobayashi Lindsay
Published: December 2023

Non-mortgage debts were linked to negative cognitive health outcomes in later-life older adults. It is unclear how they may be associated with later-life memory function through psychosocial pathways, and whether the associations vary by health care system and policy environment. We examined the mediating effects of depressive symptoms and dissatisfaction with life in the association between non-mortgage debts and subsequent memory function among adults aged 65-101 years in the US, China, and England. Data were from harmonized, nationally representative longitudinal studies of aging in the US (Health and Retirement Study; n=8,388), China (China Health and Retirement Longitudinal Study; n=1,180), and England (English Longitudinal Study of Aging; n=3,390). Non-mortgage debt burden was defined as any pre-existing or new non-mortgage debts in two years (2010-2012 for the US and England; 2011-2013 for China). Memory function was measured by 20-point immediate and delayed word recall summary scores over a subsequent 5- or 6-year follow-up period. Within each country, we used sampling-weighted, multivariable-adjusted causal mediation analysis (product method) to estimate the total and direct effects of non-mortgage debts on memory function, and the indirect effects mediated by depressive symptoms and dissatisfaction with life. We observed significant mediating effects of depressive symptoms on the association between non-mortgage debts and memory function in China only. Dissatisfaction with life had a significant mediating effect on this association in US and China, not in England. Although more investigation is needed, the relationships between non-mortgage debts and later-life memory function through psychosocial pathways may differ across macro-level socioeconomic structures.
TOBACCO USE AND COGNITIVE FUNCTION AMONG OLDER ADULTS IN MEXICO AND BRAZIL
Authors: Avila Jaqueline , Goncalves Natalia Gomes , Saenz Joseph , Suemoto Claudia , Wong Rebeca
Published: December 2023

Older adults in Brazil and Mexico have high lifetime tobacco exposure, which is an important modifiable dementia risk factor. They also have lower levels of education, which is associated with lower cognitive reserve. This study examines how tobacco use is associated with cognition and how this association differs by education among older adults in Brazil and Mexico. Data included adults 50 and older in the 2015 waves of the Mexican Health and Aging Study (MHAS, n=14,018) and the Brazilian Longitudinal Study of Aging (ELSI, n=9,409). The outcome was a global cognitive score, calculated with standardized cognitive tasks. Tobacco use was defined as current, former, and never smoker. Linear regression models were used to test differences in cognitive function by tobacco use, adjusted by sex, educational level, rural/urban area, chronic disease and included the interaction between smoking and education. Current and former smokers represented 17% and 37% of the sample in Brazil and 13.4% and 27.4% in Mexico, respectively. Current smokers in both countries were more likely to be men and be younger. However, current smokers in Brazil were more likely to have lower educational levels whereas those in Mexico were more likely to have 8+ years of education. In Brazil, current smokers had lower cognitive scores than never smokers (B= -0.06; 95%CI: -0.11; -0.01). In Mexico, current and former smokers had higher cognitive scores than never smokers (B=0.09 ; 95%CI: [0.05; 0.13] and B=0.10 [0.07;0.13], respectively). Cognitive scores for current smokers were significantly lower as education increased in Mexico.
DYADS’ POSITIVE AND NEGATIVE AFFECT ASSOCIATION WITH MENTAL HEALTH AND PERCEIVED GENERAL HEALTH
Authors: de Rosa Cristina , Wang Weijun , Chang Yu-Ping
Published: December 2023

Positive and negative affect may impact health in older adults and their family caregivers. However, how members of a caregiving dyad may influence each other’s health outcomes is not well understood. The purpose of this analysis was to simultaneously examine whether both dyad members’ positive and negative affect were associated with their own and each other’s mental health (depression and anxiety) and perceived general health. Dyadic data were obtained from the National Health and Aging Trends Study (NHATS) (2021) linked to the National Study of Caregiving (NSOC) IV (2021). The sample consisted of 1,209 pairs of adults aged 71 and older and their respective primary caregivers, defined as the family member or friend who provided the greatest number of hours of care in the preceding month. Actor-partner interdependence models were used to examine associations between positive and negative affect, mental health, and perceived general health, controlled for dyad members’ own gender, age, and race/ethnicity. Results indicated that positive and negative affect significantly predicted caregivers’ and older adults’ own mental health and perceived general health. Furthermore, older adults’ negative affect significantly predicted caregivers’ expressing little interest or pleasure in doing things (b = 0.033 (0.016), p = .046). Our results suggest that an individual’s mood influences their mental health and perceived general health even when considering partner effects. Caregivers’ interest or pleasure is particularly impacted by older adults’ negative affect. Dyadic supportive strategies to improve mood could be beneficial for both older adults and their family caregivers.
ELECTROCONVULSIVE THERAPY FOR TREATMENT OF TACTILE HALLUCINATIONS
Authors: Kummerlowe Megan , Utter Kierstin , Maria Lapid
Published: December 2023

Tactile hallucinations can be highly distressing and lead to psychiatric morbidities and functional impairments. There are no established treatments for tactile hallucinations that occur outside of primary psychotic disorders, and available pharmacologic and nonpharmacologic therapies may have limited effectiveness. We present a case of a 75-year-old female with treatment-refractory tactile hallucinations successfully treated with electroconvulsive therapy (ECT). She endorsed 13 months of distressing tactile hallucinations described as slimly substances on her skin. Symptoms started insidiously, became more severe with time and refractory to multiple antipsychotic medications. She became so severely distressed from the tactile hallucinations that she developed a major depressive episode and became suicidal. Relevant medical history included one prior depressive episode, occipital lobe stroke, restless legs syndrome, and obstructive sleep apnea. She was hospitalized in an inpatient psychogeriatric unit and treated with ECT for 12 sessions over 3.5 weeks. Hallucinations responded well to ECT. Patient experienced some mild memory impairment from treatment. Treatment was optimized with duloxetine titration, addition of mirtazapine and repletion of B6 vitamin. Following the acute course of ECT, she reported an 80 % improvement in tactile hallucinations. Depressive symptoms improved, and suicidal thoughts resolved. She was able to discharge from the hospital and continued with maintenance ECT. Our case illustrates the potential therapeutic role of brain stimulation in the treatment of refractory cases of tactile hallucinations. Further studies are needed to determine effective treatment strategies for treatment-refractory tactile hallucinations to prevent progression to severe psychiatric disturbances and improve quality of life.
GENDERED TRAJECTORIES OF DEPRESSIVE SYMPTOMS IN OLDER KOREAN PARENTS BEREAVED OF AN ADULT CHILD
Authors: Park Sujeong , Kim Jinho
Published: December 2023

Despite the existing body of research on the impact of child bereavement, little is known about whether time to the death of an adult child is associated with changes in depressive symptoms among older Korean parents. This study examines (a) trajectories of depressive symptoms before and after the loss of an adult child and (b) whether these trajectories differ across parent-child pairs (father-son, father-daughter, mother-son, and mother-daughter). Using eight waves of the Korean Longitudinal Study of Ageing (KLoSA), the study employs fixed effects models to mitigate potential bias due to unobserved individual-level heterogeneity. The result of this study revealed that depressive symptoms increased within the first year following the loss of an adult child among bereaved parents. Considering the gender of both the parent and the deceased child, differences in psychological adjustment to bereavement were observed in different dyads. Depressive symptoms surged within the first year and persisted even beyond the fourth year of loss among daughter-bereaved fathers, while only an immediate rise in depressive symptoms within the first year of loss occurred for other pairs. Given prevailing gender role socialization in the Korean context, men’s conformity to masculinity norms and the traditional expectation for daughters to provide emotional support may contribute to the long-term increase in depressive symptoms for fathers who have lost a daughter. Thus, in societies where Confucian gender culture is ingrained as a social norm, policies for the psychological support of older parents who have lost adult children must consider the different trajectories of parent-child relationships.
INTEGRATING GEROPSYCHOLOGY SERVICES INTO MEDICAL SETTINGS
Authors: Pearman Ann
Published: December 2023

Integrating behavioral health into medical settings, such as primary care clinics, has been shown to have a positive impact on the well-being and health of patients. Increased access to mental health services as well as increased identification of psychological issues is an important goal for all patients but may be of particular importance for geriatric patients who often have multiple chronic conditions along with an increased risk of neurocognitive disorders. This paper is intended to describe the process of starting an integrated geriatric behavioral health service line into geriatric and internal medicine clinics at a large urban hospital that serves a primarily underserved population of patients. MetroHealth Medical Centers serves over 300,000 patients, 75% of whom are uninsured or covered exclusively by Medicare and/or Medicaid. The system has one centralized geriatric medicine clinic as well as geriatric providers throughout the system. In 2021, a geropsychologist was brought on board to create a geriatric mental health service for the system. Three different models of integrated care are being used – within-clinic collaborative care, co-location of services, and referrals – and will be described further. There have been over 1200 referrals to the service since its inception, many of whom are receiving mental health care for the first time. This presentation will highlight the types of patients being referred and the efforts put forth to reach as many patients as possible. Finally, the development of Geropsychology-specific training opportunities for psychology and medical residents and fellows will be described.
TAILORED INTERVENTION PROGRAM USING HUMANOID AI MINI-ROBOT FOR OLDER ADULTS WITH DEPRESSION IN RURAL AREAS
Authors: Lim Young Mi , Kim Jungsug , Lim Junghee , Sun Minjung
Published: December 2023

Loneliness, and social isolation have worsened because most mental health centers were forced to suspend elderly-centric programs due to COVID-19. Recently, with the demand for a frail elderly-care model that enables non face-to-face interactions, strategies to utilize various technologies using robots for depression prevention are emerging. This pilot study aimed to develop and analyze a tailored intervention program using humanoid AI mini-robot for older adults with depression in rural areas. An experimental group of eight depressed elders participated daily in a tailored intervention program using humanoid AI mini-robot involving physical (stretching exercise) and emotional activities (listening to music) for ten weeks. A control group of ten depressed older adults received routine case management with non face-to-face at a mental health center. We compared the grip strengths and levels of depression and mental well-being between the experimental and control groups before and after the intervention, using Mann-Whitney U test and Wilcoxon signed rank test Statistically significant difference (U =12.0, p < 0.05) was observed between the mental well-being levels of the two groups; by contrast, grip strengths and depression levels did not differ significantly. The experimental group exhibited a significant difference (Z = –2.038, p < 0.05) between pre- and post-intervention grip strengths. The number of subjects was too small and the intervention period was not long enough to draw a meaningful conclusion. However, the findings have implications for the need of potential tailored interventions using humanoid AI mini-robot for mental well-being of community dwelling frail older adults.
DEALING WITH INJURED OR REPAIRED ANKLES IN OLDER ADULTS: ASSESSING ANKLE IMMOBILIZATION METHODS DURING LOCOMOTION
Authors: Dickin Clark
Published: December 2023

Orthopedic walking boots (OWB) are an alternative to casting and immobilizing an injured ankle. Unfortunately, OWB causes a change in leg-length and pelvis angle which alters gait and postural stability and can lead to chronic back pain. Immobilizing the ankle without changing leg-length would be beneficial, especially for individuals with impaired gait and postural stability. The purpose of this study was to assess level-ground walking and stair negotiation in healthy older adults across three ankle support conditions (1) OWB, (2) TayCo ankle brace (TAB) and (3) athletic footwear (SHOD). Sixteen older adults (69+/-7.0 years) performed 2-3 trials of walking, stair ascent, and stair descent using each of the three ankle support conditions. Ankle motion in all three planes was monitored using 3D motion capture cameras to assess differences during walking and stair negotiation. For all tasks, significant differences were revealed between the SHOD and both ankle support methods for all three planes (p < .001). Significant differences were also revealed between OWB and TAB during walking in the transverse plane (abd/adduction) (p = .036 OWB>TAB) and for stair descent in the sagittal plane (dorsi/plantarflexion) (p = .001 TAB>OWB). No other differences were observed between the OWB and TAB for walking or stair negotiation. Ankle motion was similarly controlled with both the OWB and TAB indicating that either method would be appropriate to immobilize an injured ankle, however the TAB does not alter leg length or pelvic tilt since it fits over the individual’s footwear.
POOR ACTIVITIES OF DAILY LIVING PREDICT FUTURE WEIGHT LOSS IN OLDER ADULTS AFTER HOSPITAL DISCHARGE
Authors: Ramel Alfons
Published: December 2023

The aim was to investigate whether older adults with poor activities of daily living (ADL) at hospital discharge had increased weight loss after six months of follow-up and whether nutrition therapy can prevent this weight loss. This was a secondary analysis of the HOMEFOOD dietary intervention trial (N=104) investigating community dwelling older adults (66-95 years) discharged from hospital and at risk for malnutrition, receiving either 6 months nutrition therapy or standard care without any further nutrition intervention. ADL were assessed using seven questions on self-care including mobility.Of the participants, 45 (43%) had good ADL at discharge, 36 (35%) had medium ADL and 23 (22%) had poor ADL with no differences between control and intervention group. During the study period, 79% of the control group lost more than 1 kg body weight with a mean weight loss of -3.5 ± 3.9 kg, whereas only 2% of the intervention group lost more than 1 kg with a mean weight gain of 1.7 kg ± 2.5 kg. According to general linear models, participants in the control roup with poor ADL had significantly higher weight loss than participants with good ADL (estimated and adjusted: 3.6 kg (95%CI: 1.0-6.1 kg, P=0.007). No such difference was observed in the intervention group. In our study, participants with poor ADL at hospital discharge develop lower body weight by around 3.5 kg six months later when compared to participants with good ADL. Receiving nutrition therapy post discharge can nullify these differences in body weight between ADL categories.
PREVALENCE AND SOCIOECONOMIC DETERMINATES OF FOOD INSECURITY IN VETERANS: FINDINGS FROM NHANES
Authors: Robbins Ronna , Addison Odessa , Parker Elizabeth , Wherry Sarah , Serra Monica
Published: December 2023

Objective

Determine predictors of the association between being a Veteran and adult food security, as well as to examine the relation of potential covariates to this relationship.

Methods

Data collected during 2011-2012, 2013-2014, and 2015-2016 National Health and Nutrition Examination Survey (NHANES) were pooled for analyses. 1,227 self-reported Veterans (mean age: 57 years) were matched to 2,432 non-Veterans (mean age: 53 years) on age, race/ethnicity, sex, and education. Adjusted logistic regression was used to determine the odds of Veterans having high food security vs. the combination of marginal, low, and very low food security compared to non-Veterans.

Results

Veteran-status had no effect on the proportion of food insecurities between Veterans and non-Veterans reporting high (Veterans vs. non-Veteran: 79% vs. 80%), marginal (9% vs. 8%), low (5% vs 6%), and very low (8% vs. 6%) food security (p=0.11). However, after controlling for covariates (age, race, education, diabetes, cardiovascular disease, hypertension, and depression), Veterans tended to be less likely to have high food security (OR: 0.82 (95% CI: 0.66, 1.02), p=0.07). Further, non-Hispanic Veterans (OR: 0.72 (95% CI: 0.55, 0.95), p=0.02) and Veterans completing some college (OR: 0.71 (95% CI: 0.50, 0.99), p< 0.05), were significantly less likely to experience high food security compared to non-Veterans.

Conclusion

This study supports previous research findings that after controlling for covariates, Veterans tend to be less likely to have high food security. It also highlights ethnicity and level of education as important socioeconomic determinates of food security status in Veterans.
BRAIN HEALTH COMMUNITY REGISTRY: DEVELOPMENT OF A MODEL FOR CONNECTING PARTICIPANTS TO COMMUNITY-BASED SUPPORTS
Authors: Block Laura , Haas Meghan , Kay Lilli , Benson Clark , Gilmore-Bykovskyi Andrea
Published: December 2023

Growing evidence demonstrates social and economic factors (e.g. socioeconomic status, level of education) contribute to risk for Alzheimer’s disease and related dementia (ADRD). These factors also serve as barriers to research participation, contributing to systematic under-inclusion in ADRD research. The Participant and Relationship-Oriented Research Engagement (PRORE) Model outlines mechanisms through which socioeconomic determinants and reciprocal relationships may shape research participation; however, scalable protocols that address these mechanisms are lacking. Our objective was to develop and pilot the feasibility and acceptability of a research-based resource-matching protocol. The Brain Health Community Registry (BHCR) recruits adults ages 40 and above with and without changes in memory, and caregivers of individuals experiencing memory changes. BHCR connects participants with research opportunities and conducts a needs assessment to match individuals with community-based services and supports. Of 168 participants enrolled in BHCR, 33 (20%) report changes in memory, 93 (55%) do not, and 42 (25%) are caregivers. More than half (n=91, 58%) requested resource matching. Resource matching took 1.8 hours per participant (range 0.5-4.5 hours). Challenges included navigating rural counties with limited resources and effective follow-up; strategies included an interdisciplinary approach, offering multiple modes of contact, and a strengths and relation-based approach. Participants who responded to follow-up at two and six weeks (45% of total), and at annual review (100%, N=6) described resource-matching as instrumental for successful connection to supports, general knowledge/preparation, or on behalf of a friend or family member. Future work must ascertain whether needs assessment and resource matching change study participant perceptions of research.
CONTRIBUTION OF CHRONIC CONDITIONS TO MORTALITY: DIFFERENCES BY RACE AND ETHNICITY
Authors: Quiñones Ana , Elman Miriam , McAvay Gail , Wyk Brent Vander , Nagel Corey , Allore Heather
Published: December 2023

Health disparities exist in the timing, order, and accumulation of chronic somatic and neurodegenerative conditions, which are associated with increased health care utilization, expenditure, and mortality. We assessed the contribution of coexisting conditions to mortality among Hispanic, non-Hispanic (NH) White, and NH Black older adults in the United States to measure their burden. We used nationally-representative data from the Health and Retirement Study (HRS) from 1998-2016 (n=11,532). This analysis estimates the absolute additive contributions of seven somatic and two mental/neurodegenerative conditions using a longitudinal average attributable fraction derived from a survey-weighted multivariable discrete survival model adjusted for sociodemographic characteristics (sex, education, net worth, body-mass index, coupled, insured, and any of six ADLs lasting three or more months “because of physical, mental, emotional, or memory problems”). Conditions accounted for over 60% of mortality in each racial/ethnic group (64.0%, 62.2%, and 70.5% in Hispanic, NH White, and NH Black adults, respectively). Although we found that cardiovascular diseases (heart disease and hypertension) were the greatest contributor to morality in each racial/ethnic group, the impact of other conditions varied by race/ethnicity. Leading contributors to mortality were diabetes (12.0%) and dementia (7.2%) for Hispanic participants; cancer (13.0%) and lung disease (10.7%) for NH White participants; and diabetes (11.5%), lung disease (7.4%), and dementia (7.3%) in NH Black participants. This study provides insights into racial and ethnic differences in the contribution of chronic somatic and neurodegenerative conditions to mortality and may help target efforts for specific preventative care services to populations most impacted by them.
SOCIAL CHARACTERISTICS OF RACIAL MINORITY STROKE SURVIVORS AND PERCEIVED DISCRIMINATION: A SECONDARY ANALYSIS
Authors: Williams Lilcelia , Antoan Jordann , Harris Tina , Hammel Joy , Leland Natalie , Skidmore Elizabeth
Published: December 2023

African American and Black persons experience significant disability after stroke. They also experience high external stressors, including discrimination, which may attenuate stroke recovery. Further understanding of the associations among external stressors, disability severity, and attenuated recovery are important to reduce healthcare disparities and improve patient outcomes. However, persons of the same race may not have the same lived experiences due to variations in social characteristics such as age or education. Associations between these social characteristics and perceived discrimination may offer insights into the recovery of older adult African American and Black stroke survivors. We conducted a secondary analysis of 11 poststroke patients who were recruited to participate in the Black Lived Experiences of Stroke Study (female=10, age=67±11, ≥2 years post-secondary education=63%) to assess the frequency of perceived discrimination. Perceived discrimination was measured with the Everyday Discrimination Scale survey. We examined correlations between age and education and perceived discrimination using Cramer’s V tests. Semi-structured participant interviews were also examined for examples of perceived discrimination during poststroke healthcare. Nine participants reported perceived discrimination post-stroke. Analyses revealed a clinically meaningful but not statistically significant relationship between chronological age and perceived discrimination (Cramer’s V=0.62, p=0.12). There was no meaningful relationship between educational level and perceived discrimination. All participants reported challenges with communication, missed diagnoses and poor delivery of care poststroke. Findings support the need for additional research to examine the relationships between participants’ social characteristics and perceived discrimination among Black and African American stroke survivors, and the impact on stroke recovery.
THE GRAYING RAINBOW: TRACING LGBTQI AGING IN SCANDINAVIAN LITERATURE
Authors: Christiansen Mats , Handelsman-Nielsen Mika , Mehdiyar Manijeh
Published: December 2023

Background: There have been several international reviews about aging LGBTQI health and living conditions, but where policy, social insurance, and services differ. The Public Health Agency of Sweden was given a government assignment to review the literature on LGBTI, emphasizing Scandinavian literature. Method: This scoping review includes peer-reviewed literature published in English or Scandinavian languages from January 1, 2012, to May 2022. Literature was searched in PsycINFO, PubMed, Web of Science, CINAHL, International Bibliography of the Social Sciences (IBSS), Social Science Database, Applied Social Sciences Index & Abstracts (ASSIA), and Sociological Abstracts, Sociology Database. Initially, 11,428 articles were found. After removing duplicates using Rayyan and reviewing titles and abstracts, 54 articles were read in full. After the final review, 16 articles remained. Thematic analysis was used to produce themes from the reviewed literature. Findings: The following two themes were identified: Aspects of health and Living conditions. Studies were primarily interpretive. There is a lack of studies about some subgroups of older LGBTQ people in this context; for instance, there are insufficient studies on older lesbian women and gay men. Furthermore, there is a lack of studies on somatic health for older LGBTQ people, generally. Comparatively, albeit in small samples, we better understand trans descriptions of aging than lesbian women and gay men. There were no studies found on intersex individuals. Implications: There remains a paucity of literature regarding the life and living conditions for LGBTQI older adults in Nordic countries.
THE INFLUENCE OF RURALITY AND FRAILTY ON HEALTH OUTCOMES IN OLDER ADULTS
Authors: Spangler Hillary , Mitchell Emma , Lynch David , Haaland Perry , Batsis John
Published: December 2023

Background

Frailty is a syndrome representing a decline in physical function and an increased vulnerability to stressors. Older adults in rural areas may be at increased risk for frailty and adverse outcomes due to worse overall health. Our aim was to identify how rural/urban residence can influence frailty status.

Methods

We used National Health and Aging Trend Study (2011-2020) data, a cohort of Medicare beneficiaries. Participants were categorized as robust, pre-frail, and frail (Fried’s frailty phenotype). Rural residence included counties outside of a metropolitan statistical area (Office of Management and Budget). Participants were excluded if frailty components or geographical status were incomplete. We used logistic regression analyses for the relationship between adverse outcomes (death, nursing home placement over 2011-2020), rural/urban, and frailty status.

Results

Of 7,393 participants (57.2% female), median age range was 75-80 years and 19.4% were rural residents. Rates of robust, pre-frailty, and frailty were 41.4%, 48.4%, and 10.2%, respectively. There was no difference of frailty status by rural status nor was there a frailty x rural interaction. Older adults with pre-frailty (OR=1.18; 1.05-1.34) and frailty (OR=1.01; 0.82-1.24) had higher risk of residing in rural than urban areas. Rural residence (OR=1.75;1.33-2.24), pre-frailty (OR=1.87;1.54-2.28) and frailty (OR=3.62; 2.79-4.71) had higher risk of adverse outcomes.

Conclusion

Participants with pre-frailty had higher odds of living in a rural area. Similarly, participants in rural areas had higher odds of adverse outcomes. These findings may highlight health care disparities in rural areas and opportunities for system- and individual-level interventions to prevent frailty development.
A GENETICALLY INFORMED STUDY ON THE ETIOLOGICAL ASSOCIATIONS AMONG EPIGENETIC CLOCKS
Authors: Penichet Eric , Beam Christopher , Bakulski Kelly , Turkheimer Eric , Higdon Kristin , Ryan Lesa , Sikes Kendra , Davis Deborah
Published: December 2023

Epigenetic clocks are believed to capture the molecular footprints of biological programs that subserve innate aging processes. Although epigenetic clocks can predict disease phenotypes and mortality with a high degree of accuracy, little is known about the extent to which they capture the same (or different) developmental and maintenance mechanisms. Quantitative genetic studies may provide useful information on the etiological links between epigenetic clocks, particularly pertaining to the question of whether they are influenced by a common set of genetic and environmental factors. Using preliminary data from the Louisville Twin Study, this study used a multivariate independent pathway model to examine the shared and unique genetic and environmental influences of three epigenetic clocks (GrimAge, HannumAge, PhenoAge). Participants consisted of 43 monozygotic pairs and 30 (18 same-sex) dizygotic twin pairs with a mean age of 54.5 years (sd = 5.27). Phenotypic analyses revealed significant correlations among the clocks (r = 0.63 - 0.78). Subsequent multivariate biometric analyses showed that there were common genetic and nonshared environmental influences across all three clocks (p < 0.001), with unique genetic and nonshared environmental influences specific to GrimAge and HannumAge (p < 0.001). To examine the sources of covariation between these variables, biometric regression models were used to decompose the covariance between each of the clocks (GrimAge and Hannum, Hannum and PhenoAge, PhenoAge and GrimAge) into genetic and environmental components. These analyses revealed large, significant genetic correlations (rg = 0.80-0.86) and medium to large, significant nonshared environmental correlations (re = 0.37-0.73) among the clocks.
ALTERED GENE EXPRESSION PROFILE OF AGING BONE MARROW MESENCHYMAL STEM CELLS
Authors: Su Yun , Chen Jie , Isales Carlos , Shi Xingming
Published: December 2023

Aging is a complex process that affects many physiological systems, including bone metabolism. To gain insight into the molecular mechanisms underlying age-related bone loss, we conducted RNA-seq analysis of mesenchymal stem cells (MSCs) isolated from the bone marrow of 6-month and 24-month-old C57Bl/6 mice. We identified 5857 differentially expressed genes, out of 19,324 genes, with an absolute fold change greater than 1.4 and FDR q-value less than 0.05. These genes are involved in a variety of biological processes, including metabolism, immune response, and signal transduction. KEGG pathway enrichment analysis revealed 28 significantly enriched pathways, suggesting that multiple pathways contribute to age-related bone loss. Our findings provide a foundation for future studies aimed at elucidating the molecular mechanisms underlying age-related bone loss and identifying potential therapeutic targets for the prevention and treatment of osteoporosis.
ANALYSIS OF CIRCADIAN TRANSCRIPTION ACTIVATOR BMAL1 AND CLOCK BINDING TARGETS IN YOUNG AND OLD MOUSE SKELETAL MUSCLE
Authors: Zhang Xiping , Viggars Mark , Esser Karyn
Published: December 2023

Circadian rhythms play important roles in many physiological processes and circadian rhythm disturbances are often observed in older people. Circadian rhythms are regulated by a molecular clock mechanism that is found in virtually all cells of the body. The core clock mechanism consists of transcriptional activators (BMAL1 and CLOCK) and the feedback negative regulators (PER and CRY). Beyond keeping daily time, the core clock factors regulate a daily gene expression program and this daily program is diminished with age. Skeletal muscle is critical in supporting systemic metabolism and mobility. Loss of muscle strength in older people are related to increased morbidity and mortality. Our previous studies have shown a significant decline of circadian genes with age in skeletal muscle and there are very few circadian genes in common between young and old mouse muscle. To understand the mechanism of the diminished circadian gene expression with age, we performed ChIPseq to determine BMAL1 and CLOCK binding and ATACseq to determine chromatin accessibility with muscle from young (6 months) and old (27 months) mouse. The ChIPseq result showed that BMAL1 and CLOCK shared more than 8,000 binding peaks in young muscle and less than 200 binding peaks in old muscle. The ATACseq identified that chromatin accessibility altered in more than 7000 sites with age and BMAL1:CLOCK binding sites were less accessible with age. In conclusion, our research has demonstrated that muscle chromatin accessibility changes with age and the core clock factors are important regulators of gene expression in skeletal muscle.
CAN ACUTE MUSCLE DAMAGE LEAD TO OSTEOARTHRITIS?
Authors: Awad Kamal , Moore Logan , Huang Jian , Brotto Leticia , Brotto Marco
Published: December 2023

Skeletal muscles are crucial for maintaining musculoskeletal homeostasis, as they provide mechanical support, joint stability, and biochemical functions via myokine secretion. We investigated whether acute muscle damage or weakness could contribute to the development of osteoarthritis (OA). Using a chemical damage model, we induced muscle damage by injecting 1.2% barium chloride into the tibialis anterior muscle, resulting in an immune response characterized by a significant increase in the concentration of Prostaglandin E2 (PGE2) and other lipid mediators derived from the EPA and DHA signaling pathways, as quantified using our innovative lipidomics methods. The muscle damage was confirmed and visualized by muscle histomorphometry. The damage resulted in muscle weakness, detected by a significant decrease in grip strength at 4-days post-injury, but without changes in mice activity measured with force-plate actimeter. After 1-month post-injury, grip strength and muscle histology returned to normal, but histological changes were observed in the articulating cartilage, indicating surface erosion and cartilage matrix loss (OARSI grade 4). We used Raman Spectroscopy and micro-CT to confirm the joint alterations observed in the changes in subchondral bone and increased bone volume fraction in the cortical shell of the subchondral bone, respectively, features characteristic of OA in rodents and humans. These findings suggest that muscle weakness or imbalance due to injury can contribute to joint degeneration. This study highlights the significance of muscles in preventing OA and provides a novel approach for exploring the relationship between muscle damage and OA development. This new model could prove valuable for aging research.
EPIGENETIC AGE DYNAMICS AND EMBRYONIC MORTALITY POINT TO GASTRULATION AS AGING GROUND ZERO IN XENOPUS LAEVIS
Authors: Zhang Bohan , Gladyshev Vadim
Published: December 2023

Recent studies on embryonic development revealed a natural rejuvenation event followed by epigenetic aging. Here, we developed a frog aging clock based on the DNA methylation profile in the African clawed frog Xenopus laevis. Application of this clock to Xenopus laevis early embryonic development identified a decrease in epigenetic age during early embryogenesis, with the minimal epigenetic age reached around gastrulation. We further examined the individual developmental trajectories of 6,457 embryos and found that this minimum age is also accompanied by a higher incidence of disrupted development. Taken together, our data point to gastrulation as a critical stage for aging and natural rejuvenation, characterized by the lowest epigenetic age and increased mortality, defining aging ground zero as the basepoint where rejuvenation ends and the aging process begins.
EPIGENETIC AGING AND RHEUMATOID ARTHRITIS
Authors: Mukherjee Nandini , Harrison Tracie
Published: December 2023

Indicators of biological aging with rheumatoid arthritis (RA), a chronic autoimmune disease, are not yet fully known. In this cross-sectional study, we tested associations between plasma indicators of epigenetic aging using online data (GSE42861) regarding RA and DNA methylation from the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA). Peripheral blood DNA methylation of participants 18-70 years old was assessed using Illumina HumanMethylation450 arrays. Horvath’s online DNA Methylation Age Calculator determined DNAm estimate of Telomere length (DNAmTL), Hannum’s, Horvath’s 2013 and 2018 epigenetic ages, PhenoAge and GrimAge and the respective age accelerations. Association of RA prevalence with epigenetic age were determined using linear regression, correcting for false discovery rate. We identified significant associations of RA with age acceleration measures of Horvath 2013 (Estimate:-1.34 ; FDR p-value: 1.0 × 10-2) and Horvath 2018 (Estimate:-1.32; FDR p-value: 4.0 × 10-5), extrinsic age acceleration (Estimate: 1.34 ; FDR p-value: 1.0 × 10-2), PhenoAge acceleration (Estimate: 2.31; FDR p-value: 1.1 × 10-5), GrimAge (Estimate: 2.54; FDR p-value: 1.0 × 10-2) and GrimAge acceleration (Estimate: 3.15 ; FDR p-value: 1.7 × 10-17), adjusting for sex and smoking (FDR p-value<=0.05). In sex stratified analyses, first-generation clocks were associated only in women, but no sex specific effects for PhenoAge or GrimAge accelerations were identified. The second generation ‘biological’ clocks PhenoAge, GrimAge and its components showed higher epigenetic age acceleration in RA cases compared to healthy controls. We conclude that second generation indicators of epigenetic aging provide promise as markers of biological aging in people with RA.
EVIDENCE THAT CONSERVED ESSENTIAL GENES ARE ENRICHED FOR PRO-LONGEVITY FACTORS
Authors: Kaya Alaattin
Published: December 2023

At the cellular level, many aspects of aging are conserved across species. This has been demonstrated by numerous studies in simple model organisms like Saccharomyces cerevisiae, Caenorhabdits elegans, and Drosophila melanogaster. Functional genomic studies in these models have contributed enormously to our understanding of conserved genetic pathways influencing aging in evolutionarily divergent organisms. From this perspective, essential genes that are evolutionarily constrained and functionally conserved should be more relevant to the regulation and evolution of aging. However, because most genetic screens examine loss of function mutations or decreased expression of genes through reverse genetics, essential genes have often been overlooked as potential modulators of the aging process. By taking the approach of increasing the expression level of conserved essential genes, we found that 23% of these genes resulted in increased replicative lifespan in S. cerevisiae. This is greater than the ~3.5% of genes found to affect lifespan upon deletion, suggesting that activation of essential genes may have a relatively disproportionate effect on increasing lifespan. These essential prolongevity genes function in a variety of pathways and complexes highlighting both known and previously unknown longevity pathways and their previously unknown essential components. The results of our experiments demonstrate that essential gene overexpression is a rich, relatively unexplored means of increasing eukaryotic lifespan.
EXPRESSION OF THE TARDIGRADE DAMAGE SUPPRESSOR PROTEIN IN THE YEAST SACCHAROMYCES CEREVISIAE
Authors: Su Wei-Hsuan , Smith Jessica , Cheng Evien , Schriner Samuel
Published: December 2023

Tardigrades are resilient organisms that can tolerate extremes in temperature, pH, pressure, and salinity. They are also exceptionally resistant to starvation, dehydration, and irradiation. The damage suppressor (Dsup) protein is thought to be unique to tardigrades and may act by coating and protecting nuclear DNA, particularly the nucleosomes. Nuclear DNA damage and mutation may be one of the driving forces of the aging process. In addition, there has been demonstrated a clear relationship between stress tolerance and aging. In this study, we are asking whether Dsup, when expressed in the yeast Saccharomyces cerevisiae, can afford yeast with an enhanced tolerance to environmental stresses, lowered spontaneous and induced mutation rates, and extended chronological lifespan. Yeast were constructed expressing Dsup with the strong promoter TEF on a high copy plasmid containing the 2 micron origin of replication. Preliminary results show that Dsup is able to enhance yeast survival against hydrogen peroxide, but surprisingly appeared to compromise survival to the DNA damaging agent ethyl methanesulfonate (EMS). Excessive expression of Dsup may explain the unexpected toxicity to EMS. We are therefore planning to test the expression of Dsup with a lower copy plasmid. We then plan to challenge the Dsup-expressing yeast to a variety of stresses, including extremes in temperature, high salt, and heavy metals. Induced mutant frequencies and spontaneous mutations rates at the CAN1 locus will be evaluated. Ultimately, we intend to determine whether Dsup can extend yeast chronological lifespan as a direct test of nuclear DNA damage in the regulation of lifespan.
PLACENTAL MUTATIONAL BURDEN NEGATIVELY CORRELATES WITH GESTATIONAL AGE IN EARLY-ONSET PREECLAMPSIA
Authors: Chavez Hector , Guo Nicholas , Huang Molly , Meads Morgan , Aisagbonhi Omonigho , Parast Mana , Horii Mariko , Fisch Kathleen
Published: December 2023

The placenta exists in a hypoxic environment during early pregnancy, making it susceptible to somatic genetic mutations caused by oxidative stress and rapid cell proliferation. Oxidative stress is one of the leading factors involved in cellular aging causing genetic mutations, cellular senescence, and mitochondria dysfunction over time. While it has been demonstrated that healthy placentas accumulate somatic mutations as they develop, we hypothesize that diseased placentas display an accelerated aging phenotype through the accumulation of somatic mutations. To address this, we analyzed RNA-seq data from 84 human placentas throughout gestation from healthy (N=33) and preeclamptic pregnancies (N=51). We identified rare single nucleotide variants, insertions and deletions using GATK Best practices Workflow for RNA-seq short variant discovery using bcbio-nextgen and annotated with VEP and LOFTEE. Mutational burden, defined as the total number of rare mutations per megabase, was calculated after strict quality control and filtering for rare (gnomADg< 0.05) variants using maftools in R. Linear regression models were employed to determine the association between mutational burden and gestational age. Differences in mean values were computed with a pairwise t-test . This study revealed that mutational burden in early-onset preeclampsia placentas is negatively correlated to gestational age (R^2=0.256; p-value=0.032). The early-onset preeclampsia group had a higher mutational burden relative to the other groups (p-value< 0.05). This study revealed a significant correlation of mutational burden with gestational age in early-onset preeclampsia, paving the way for additional investigation of accelerated aging in placentas and its contribution to the development of preeclampsia.
SIRTUIN 1 ISOFORMS DIFFERENTIALLY IMPACT MITOCHONDRIAL GENE EXPRESSION AND FUNCTION IN MUSCLE CELLS
Authors: Zhang Xiaomin , Patyal Pankaj , Verma Ambika , Sharma Shakshi , Azhar Gohar , Ameer Fathima , Che Yingni , Wei Jeanne
Published: December 2023

Background

Alternative splicing (AS) is a mechanism that generates multiple mRNA transcripts and protein isoforms from a single gene, thereby increasing transcriptomic and proteomic diversity. The spliced isoforms commonly lack one or more exons, which may have similar or even opposite functions. Alternatively spliced isoforms tend to increase during aging. The sirtuin-1 gene contains multiple exons and undergoes alternative splicing, which generates multiple isoforms. In this study, we assessed the impact of three sirtuin-1 isoforms on mitochondrial gene expression and function in muscle cells.

Methods

Three sirtuin-1 isoforms (V1, V2, V3) were subcloned into expression vectors. Muscle cell lines (H9C2 and C2C12) were transfected with sirtuin-1 isoforms, respectively. Microscopic images were obtained using a Nikon microscope. Gene expression was determined by quantitative RT-PCR and Western blotting. The mitochondrial function was determined with a Seahorse XFe96 Analyzer. Results and conclusions The sirtuin-1 V1 isoform significantly increased the oxygen consumption rate (OCR) and decreased glycolysis (ECAR) in muscle cells, while V2 and V3 isoforms had slight or no significant effect on OCR and ECAR. V1 isoform was localized in the nucleus, whereas V2 and V3 were localized in the cytoplasm. Sirtuin-1 isoforms differentially impacted mitochondrial complex genes, including NDUFS1, NDUFV1, NDUFV2, NDUFA5. Our data indicate that the domain loss changed sirtuin-1 isoform subcellular localization, differentially impacted mitochondrial gene expression, and affected mitochondrial function. The age-related change in the expression of sirtuin-1 isoforms could affect cardiac and skeletal muscle function in aging and senescence. Further exploration of the sirtuin-1 isoforms’ functions is warranted.