bluuebunny/crossref_metadata_2025 huggingface dataset:
GENDER DIFFERENCES IN ASSOCIATIONS BETWEEN LIVING ARRANGEMENTS AND HEALTH OF OLDER ADULTS IN VIETNAM
Authors: Takagi Emiko , Saito Yasuhiko , Vu Nguen Cong
Published: January 2025

This study examined gender differences in the variation of physical and psychological well-being measures across four types of living arrangements among older adults in Vietnam. We analyzed the initial wave data of a nationally representative sample of self-reporting adults 60 years and older with at least one living child (n=5,306) from the Longitudinal Study of Health and Aging in Vietnam (LSHAV). The four types of living arrangements in the analysis included: living alone, living with a spouse, living with a spouse, adult children, and/or grandchildren, and living with adult children and/or grandchildren but without a spouse. The well-being measures included physical health indicators regarding the difficulties with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), disability status, and self-rated health. Psychological well-being was assessed based on the CESD depression scores and the UCLA 3-item loneliness scores. The descriptive statistics showed that overall, the poorer health conditions tended to be more prevalent in the household where older adults lived with their adult children and/or grandchildren and without a spouse, compared to counterpart types of living arrangements. The regression analyses on well-being measures showed that men who either live alone or live with children or grandchildren but without a spouse were especially more likely to report emotional loneliness. We discuss gender differences in physical and psychological well-being in conjunction with late-life intergenerational living arrangements and life transitions such as widowhood.
MEASURING INTERGENERATIONAL AMBIVALENCE TOWARD OLDER ADULTS IN THE FAMILY CONTEXT: A SCOPING REVIEW
Authors: Chan Athena Chung Yin , Lee Sophia , Li Shuwen , Duckett Jacquelyn , Sneed Rodlescia
Published: January 2025

Informal family caregivers may frequently feel ambivalent toward taking care of older family members. Ambivalence is the simultaneously held conflicting emotions, cognitions and/or behavioral tendencies due to countervailing expectations about how individual should act within the cultural norms. Most existing measurements directly or indirectly measuring caregiving or intergenerational ambivalence were developed from the West. Less is known how ambivalence is understood across distinctive sociocultural context globally. This scoping review examines the dimensions of existing instruments in measuring caregiver ambivalence toward older adults. Peer-reviewed articles were identified in five electronic databases. A keyword search was performed associated with ambivalence, caregiver or family, and measure development. Ten instruments were included. These instruments used different terms to represent caregiver ambivalence, not limited to intergenerational ambivalence and filial maturity. Existing measure items primarily capture the simultaneously held conflicting emotions toward older family members but limited to the domains of behaviors or cognitions. Moreover, existing measures are not inclusive of family caregiving to capture ethnic minorities who provide support to older family members motivated by filial responsibility beliefs. The scoping review uncovers the gaps between conceptual understanding and measurement of caregiver ambivalence toward older adults in the family. Findings will inform the direction of future research and the development of a culturally relevant measure that captures the intergenerational ambivalence experienced by ethnic minority who provide family support to older adults. The review will likely inform practice policy, and research in caregiving in a culturally sensitive manner.
CAREGIVING INTENSITY AND LABOR FORCE PARTICIPATION AMONG CAREGIVERS: THE ROLES OF INCOME AND PAID HELP
Authors: Qu Shan , Burr Jeffrey
Published: January 2025

Framed within Role Theory, this study examined the association between caregiving intensity and labor force participation among caregivers and whether income and paid help moderated this relationship. We used data from the National Health and Aging Trends Study and the National Study of Caregiving. Caregiving intensity was measured by days and hours of caregiving in the last month. Care was considered high-intensity if a respondent provided an average of 21 hours or more of care per month. Low-intensity caregivers provided 20 hours of care or less per month. Labor force participation was divided into three categories: ‘1=unemployed/retired,’ ‘2=worked less than 35 hours,’ and ‘3=worked 35 hours or more.’ Compared to those with low-intensity caregiving, high-intensity caregivers had a lower likelihood of working part-time than those who were not working. Compared to not having a paid helper, having a paid helper was associated with an increased likelihood of working part-time and full-time compared to those who were not working. As household income increased, the likelihood of being a part-time worker and the likelihood of being a full-time worker increased. The moderation model results showed the likelihood of working part-time compared to being unemployed or retired was lower when caregiving intensity was higher. No other moderation effect was found for paid work. In addition, the likelihood of working part-time or full-time increased as annual income increased. We believe the findings contribute to policies that increase access to paid help and may ultimately assist caregivers to remain active in the job market.
PHYSICAL AND MENTAL HEALTH OF GRANDPARENTS CARING FOR GRANDCHILDREN IN CHINA: A SYSTEMATIC REVIEW
Authors: Wang Shuangshuang
Published: January 2025

Guided by role strain and role enhancement perspectives, this study systematically reviewed the effects of providing grandchild care on the physical and mental health of Chinese grandparents, aiming to identify research gaps and offer insights for future studies and the enhancement of Chinese grandparents’ well-being. Utilizing a thematic search method, we conducted searches in PubMed, Web of Science, CNKI, Wan Fang Data, and CQVIP databases for relevant literature spanning from January 1st, 2012, to March 1st, 2024. Ninety-one articles were ultimately included, and their content was analyzed to systematically review the impacts on physical and mental health. Factors such as grandparents’ gender, age, and residential areas affected their participation in intergenerational care. Mental health outcomes primarily focused on depressive symptoms, cognition, loneliness, and life satisfaction, while physical health was assessed through self-assessed health, daily-life abilities, and instrumental self-care abilities. However, the literature lacked consensus on the effects of providing grandchild care on Chinese grandparents’ physical and mental health. Negative outcomes mainly due to role conflicts, high care demands, feelings of isolation, while positive outcomes were achieved through social more social activities, companionship, and family network support. In conclusion, Chinese grandparents’ well-being appears to be influenced by a multitude of factors, with current exploration in its nascent stages. Opportunities for improvement lie in data collection methods, research design, and areas of investigation. Further research is warranted to better understand the complexities of this relationship and to develop interventions aimed at promoting the health and well-being of Chinese grandparents.
SLEEP BARRIERS AND FACILITATORS IN AFRICAN AMERICAN FAMILY CAREGIVERS
Authors: Aldossary Heba , Brewster Glenna , Griggs Stephanie , Irani Elliane
Published: January 2025

Cultural and historical experiences of African American family caregivers influence their overall health outcomes and can compound their risk for poor sleep health. Since there is inadequate representation of African American individuals in caregiving research, the existing literature is limited as it pertains to informing sleep intervention targets to address the unique needs of African American caregivers. This study aims to explore the barriers and facilitators to sleep health in African American family caregivers. To be eligible for this study, caregivers were required to provide care to an adult family member or friend with a chronic or disabling condition for a minimum of 6 months and self-identify as Black or African American. Twenty-four participants were recruited via community-based methods and participated in semi-structured in-person, telephone, or videoconference interviews. Transcribed interviews were analyzed using conventional content analysis. Participants were on average 58.0 (SD=10.1) years old, mostly female (83.3%) and caring for a parent (79.2%). Main sleep barriers included being alert to care recipient’s needs, general and caregiving-specific stress, existing health conditions such as anxiety or sleep apnea, and environmental factors such as room temperature and noise within and outside the home. Sleep facilitators included caregiving support, daytime activities for the care recipient and the caregiver, natural or pharmacological sleep aids, and relaxing activities at bedtime such as meditation, journaling, reading, and art-based activities. Half of our participants perceived the television before and/or during sleep as a facilitator. Our findings can inform the cultural adaptation of behavioral interventions to optimize sleep health.
THE HOSPITAL ENVIRONMENT’S INFLUENCE ON THE INCLUSION OF CARE PARTNERS OF HOSPITALIZED PLWD
Authors: Still Catherine , Hoel Sydney , Strayer Andrea , Werner Nicole , Fields Beth
Published: January 2025

Federal initiatives like the National Strategy to Support Family Caregivers advocate for the inclusion of care partners into their family member or friends care teams. Yet, care partners of hospitalized people living with dementia (PLWD) often report feeling left out of the hospital care. This feeling of exclusion may be related to the hospital’s physical environment. Prior research has explored dementia care partners’ perceptions of the hospital space, but there is little research examining how the hospital environment can facilitate or hinder care partner inclusion. Therefore, this study sought to explore how the physical environment of the hospital influences care partner inclusion practices. Our team used a descriptive qualitative approach and collected data from two sources: direct observations (27 hours) in a large academic hospital and interviews with care partners (15) and clinicians/administrators (23) representing hospital experiences across the country. Observational data were analyzed using a framework analysis, and interview data were analyzed using a team-based inductive content analysis. Observational data revealed an underutilization of environmental resources, including communication tools and family-dedicated spaces. Interview data revealed three aspects of the physical environment that influence care partner inclusion: space for both the PLWD and their care partner, room personalization, and parking. Health systems should ensure adequate space for care partners in the hospital, allow care partners to personalize patient rooms, and designate dementia-friendly parking spaces. Modification of the physical environment may promote the inclusion of care partners into hospital care, which could potentially improve the health outcomes for hospitalized PLWD.
EFFECTS OF EXERCISE WITH MUSIC IN FRAIL OLDER ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Kim Namhee , Kim Gwang Suk , Park Min Kyung , Kim Layoung , Lee Jae Jun
Published: January 2025

Accumulating research on the impact of exercise with music on the health of frail older adults emphasized the necessity of a comprehensive analysis that encompasses physical and emotional health outcomes. Consequently, this study aimed to identify the contents and characteristics of exercising with music and to evaluate the effects of exercising with music on the physical and emotional health of frail community-dwelling older adults. This was a systematic literature review and a meta-analysis. All searches were conducted from April 12, 2022, to March 2, 2024, with no restrictions on language or publication date. Seven electronic databases were searched: MEDLINE, CINAHL, Embase, Cochrane Library, PsyINFO, Google Scholar, and the Virginia Henderson International Nursing Library. PRISMA guidelines for systematic reviews were followed. After screening the initial 1409 studies, 17 studies, including 13 randomized controlled trials and four quasi-experimental studies, were analyzed. The findings indicate that exercise with music has positive effects on reducing frailty (SMD = -0.43, 95% CI = -0.81 – -0.05), improving Timed Up and Go test results (MD = -3.76, 95% CI = -6.67 – -0.85), increasing handgrip strength (MD = 2.01, 95% CI = 0.36 – 3.65), and decreasing depression levels (SMD = -0.34, 95% CI = -0.56 – -0.11) among frail older adults. By addressing both physical and emotional health, exercise with music can significantly contribute to enhancing older adults’ quality of life and reducing the burden of frailty. In conclusion, this review emphasizes musical exercises’ potential as a multifaceted intervention for frail older adults.
EXPLORING THE RELATIONSHIP BETWEEN MULTIDOMAINS OF FRAILTY AND MORTALITY IN OLDER ADULTS LIVING IN COMMUNITY
Authors: Li Yuelin , Song Rhayun , Seo Jisu
Published: January 2025

The global population’s aging presents health challenges. This study aimed to explore the relationship between various domains of frailty (physical, cognitive, social, and multidimensional) on all-cause mortality in community-dwelling older adults. Studies were searched in five databases up to December 5, 2023. Quality and Risk of Bias assessment were assessed using the ROBINS-E tool. A meta-analysis was performed to synthesize pooled mortality risk estimates by using the random-effects model. A total of 53 studies were included for systematic review, with 49 eligible for meta-analysis, involving 153,237 participants and over 31,021 deaths. The quality assessment revealed that 10 were low risk (18.9%), 7 had some concerns (13.2%), 34 were high risk (64.2%), and 2 were considered very high risk (3.7%). Results indicated that frail older adults had a significantly higher mortality risk than robust ones, consistent across frailty domains (physical HR=1.72, 95 CI%:1.50-1.97; social HR=1.17, 95 CI%:1.04-1.31; multidimensional HR=2.37, 95 CI%: 2.10-2.68; cognitive HR=1.48, 95 CI%:1.09-2.01). Our findings highlight that various domains of frailty are strongly and robustly associated with all-cause mortality in older adults. This relationship between multidimensional frailty and mortality is stronger than that of a single type of frailty. Therefore, although focusing on a single frailty can improve the well-being of the older population, interventions targeting multiple aspects of frailty are more effective in improving the quality of life and longevity of this population.
JOINT TRAJECTORIES OF FRAILTY AND COGNITIVE FUNCTION IN OLDER KOREANS: A 14-YEAR ANALYSIS WITH NATIONAL-LEVEL DATA
Authors: Jung Yunkyung , Lyu Jiyoung
Published: January 2025

Despite the evidence on the link between frailty and cognitive function, less is known about the joint developments of these two multidimensional indexes. The present study aimed to identify distinct trajectories of frailty and cognitive function and examine the influence of sociodemographic and lifestyle factors on the co-development of frailty and cognitive function in older Koreans. A nationally representative sample of 2,766 adults aged ≥65 years from the first (2006) to the eighth (2020) waves of the Korean Longitudinal Study of Aging (KLoSA) was analyzed. Frailty was measured with a Frailty Index with 33 deficit-related indicators. Cognitive function was measured using the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to fit the developments of frailty and cognitive function. A multinomial logistic regression was conducted to assess the predictors for each trajectory group. Three joint trajectories were identified, including cognitive frailty (13.2%), cognitive decline and progressive frailty (33.0%), and no cognitive frailty (53.7%). Compared to individuals in the no cognitive frailty group, those in the cognitive frailty group were more likely to be unemployed and current smokers; while those in the cognitive decline and progressive frailty group were more likely to be women, have low income, and not current drinkers. Significant heterogeneity in the co-development of frailty and cognitive function in older Koreans was identified. Findings suggest that different sociodemographic and lifestyle factors determined the trajectory membership.
PLASMA PROTEOMIC SIGNATURE OF DEVELOPMENT AND PROGNOSIS OF PHYSICAL FRAILTY
Authors: Xu Jianhong , Liu jingyun , Liao Jinhui , Wu Chenkai
Published: January 2025

The complete understanding of biological mechanisms behind frailty remains elusive. We aimed to investigate the proteomic signature associated with the development and prognosis of frailty. Data from 43,895 participants (aged 39-70 years) in the UK Biobank were analyzed, with 2,920 proteins assayed using Olink. Participants were split into development and validation cohorts based on geographic location. Multinomial logistic models identified proteins cross-sectionally associated with baseline prefrailty and frailty (Bonferroni-corrected p-value < 0.05). Cox models identified proteins associated with mortality among initially prefrail and frail participants. LASSO regression was used to construct protein-based prediction models for death among prefrail and frail participants, respectively. Protein importance was ranked using the light gradient boosting machine classifier. We identified 210 and 268 proteins cross-sectionally associated with prefrailty and frailty at baseline, respectively. Additionally, 109 and 80 proteins were associated with mortality among initially prefrail and frail individuals, respectively. LASSO regression model selected 60 and 21 proteins predicting survival in prefrail and frail participants, respectively. Protein-based prediction models demonstrated satisfactory discrimination, calibration, and reclassification in the development and validation cohorts. GDF15 (WFDC2) and PLAUR emerged as the top two proteins in prefrailty (frailty) development, demonstrating robust connections with overall survival in prefrail (frail) individuals. Differentially expressed proteins were enriched in pathways involving protein metabolism, cellular signaling in disease, apoptosis, and inflammation. Exploring novel proteins and pathways provides insights into the biological mechanisms and potential therapeutic targets associated with the onset and progression of frailty.
TOWARD DEVELOPING PATIENT-ORIENTED WEBSITES FOR EARLY DETECTION AND MANAGEMENT OF FRAILTY
Authors: Chung Seohyeon , Song Xiaowei
Published: January 2025

Understanding frailty status of older adults before a doctor’s visit can result in more effective care planning, where web technology can play role. We conducted a study engaging community-dwelling older adults and caregivers to better understand their perspectives about developing patient-oriented frailty websites. Our objectives are to describe the project activities and share the insights learned from potential end-users of the website. We first organized an online educational symposium consisting of six invited talks on patient-oriented frailty management given by experts of frailty and older adult care. Audience of the symposium was recruited through newsletters and academic, community, and patient association platforms. Clinicians, researchers, caregivers, and community-dwelling older adults across Canada participated (n=300). Members from the symposium (n=14) participated in two virtual discussion sessions with open-ended questions. Discussions highlighted aspects, including the function, usage, and feasibility of a frailty website; security and privacy of online health data; patient-physician interactions; and existing technologies and resources supporting patient-oriented frailty management for successful aging in place. Our findings revealed the needs, barriers, and possible solutions with developing patient-oriented frailty websites. The effort towards building frailty websites that patients can use will benefit future development and implementation to identify people at risk of frailty and facilitate real-time monitoring for personalized and preventative care.
REGIONAL POLICY SCAN: POLICIES TO ADDRESS AGING IN SUB-SAHARAN AFRICA
Authors: Osae-Oppong Edward
Published: January 2025

This paper presenting a regional policy scan focused on aging in sub-Saharan Africa. The study aims to provide an overview of policy responses to aging in the region, identifying key challenges, opportunities, and recommendations for addressing the needs of the aging population. The methodology involves conducting a critical essay reviewing articles on public policy related to mental health and well-being in older populations across databases such as PubMed, Google Scholar, and Science Direct. This review analyzes policies addressing healthcare needs and identifies demographic, economic, and social trends to understand the aging population comprehensively. Findings from the policy scan reveal a growing aging population in sub-Saharan Africa, with existing policies and strategies in place to address their needs. However, challenges persist in implementing effective policies, social protection systems, and engaging the private sector. Key recommendations include advocating for a comprehensive and coordinated approach to aging, improving access to healthcare and social services, incentivizing employers to hire older workers, and increasing public awareness of aging issues. The study concludes that sub-Saharan Africa faces significant challenges and opportunities concerning its aging population. It underscores the importance of developing and implementing effective policies and strategies to address the healthcare needs of older populations, strengthen social protection systems, and engage the private sector. By investing in the health and well-being of older adults, sub-Saharan Africa can achieve sustainable economic development and enhance the quality of life for its aging population.
THE ICHANGE PROJECT: AN HRSA SPNS INITIATIVE TO ADVANCE HIV AND AGING CARE
Authors: Burk-Leaver Erin , Sanner Haley , Saenz Janette Romero , Abraham Alison , Erlandson Kristine M
Published: January 2025

With the advent of antiretroviral therapy (ART), improvements in life expectancy of people living with HIV (PLWH) are now nearing that of populations living without HIV. As a result, over 50% of PLWH within the United States – over 55% in Colorado – are now aged 50 years and older. While this shift highlights how ART has drastically improved the life expectancy of PLWH, aging with HIV is associated with unique issues and challenges that impact quality of life. In response to these challenges, the Health Resources and Services Administration (HRSA) Ryan White HIV/AIDS Program (RWHAP) Part F: Special Projects of National Significance (SPNS) funded the design, implementation, and evaluation of emerging strategies to improve the well-being of people with HIV ages 50 and older served by RWHAP. Colorado Health Network (CHN), serving as one of ten national demonstration sites under the HRSA SPNS HIV and Aging Initiative, developed the iCHANGE (Integrative Care for Healthy Aging and Navigation of Geriatric Effects) Project, an integrated healthcare model designed to comprehensively assess comorbidities and geriatric conditions among older PLWH, with the overarching goal of improving health outcomes. Drawing on concepts such as the Public Health Prevention model, Geriatric 5M’s framework, and implementation science methodology, CHN’s iCHANGE strategy enhances the ongoing efforts to develop holistic healthcare programs to support and navigate the unique challenges faced by older PLWH. This presentation aims to provide insight and a comprehensive overview into the evolving landscape of supportive healthcare delivery for people living and aging with HIV.
NURSING FACILITY RESPONSES TO GROWING CONSUMER COMPLAINTS
Authors: Applebaum Robert , Bowblis John , Nelson Matt , Dikhtyar Oksana
Published: January 2025

Nursing home consumers can file a complaint to regulators regarding such areas as quality of care or resident rights. The number of formal complaints filed has increased at dramatically. Between 2016 and 2021, Ohio saw a 40% increase in the number of complaints. A number of factors are associated with complaints including staffing levels and staff and leadership turnover. The increase in complaints is an indicator that residents and families do not feel satisfied with their nursing home experience, and it is also a huge strain on the nursing home inspection process. Last year in Ohio fewer than 40% of required nursing home recertification surveys were completed in the required window. The critical question then becomes, are there things that can be done by facilities to reduce the number of complaints filed with regulators. Using data from the 2023 Biennial Survey of Long-Term Care Facilities completed in Ohio on all licensed nursing homes, this paper examines the strategies used by nursing homes to respond to the growing number of complaints. Approaches examined include such areas as having a dedicated staff member to examine complaints or building a review of complaints into the facility quality improvement process. The survey also presents findings about the interactions with the Department of Health survey teams. Data suggest there is a long lag between a complaint visit and an adjudication of the complaint. The paper concludes with recommendations for facilities and states as they respond to the growing number of complaints experienced across the nation.
RELATED FACILITY AND RESIDENT FACTORS ON STANDARDIZED NURSING LANGUAGES FOR NURSING HOME NURSES IN KOREA
Authors: shin Juh Hyun , Park Chung Hyuk , Lee Myungeun , Park Suhyun
Published: January 2025

Standardized nursing languages play a crucial role in facilitating holistic nursing care, but their full benefits are still being realized. However, the implementation of NNN linkages and their impact on nursing processes and nursing home (NH) residents’ outcomes, as well as the identification of facility and resident factors, remain unexplored. The purpose of this study was to examine (a) frequently occurring NNN linkages and (b) related facility and resident factors on the use of NANDA, NIC, and NOC for NH residents. Data were collected from 273 residents in 19 NHs in Korea 19 NHs in Korea, with structured questionnaires administered to NH registered nurses using a newly developed smartphone application. Descriptive statistics, ANOVA, and ANCOVA were used for the data analysis. We identified that factors, such as case mix index (resident acuity), age of resident, year of facility establishment, facility ownership status, and admission period of residents, are related to the use of NANDA, NIC, and NOC. Nine NNN linkages were newly identified in this study, mostly centered on fall prevention. The findings provide various approaches to address the risk of falls in NHs considering environmental, physical, and psychological factors. This study contributes to the foundation of evidence related to NHs by collecting specific data on the nursing process for the physiological, behavioral, safety, family, health system, and community areas applied to the residents of long-term care facilities at the national level. Future research in different settings and tailored population is needed.
EXPLORING ASSISTIVE TECHNOLOGY ACCESS AND USE AMONG OLDER ADULTS THROUGH SELF-DIRECTED HOME TOURS
Authors: Mortenson Ben , Tsai Chih-TIng (Gina) , Yu Chin Wing , Huot Suzanne , Hurd Laura
Published: January 2025

Assistive technology (AT) and home modifications play a crucial role in enhancing independence and quality of life for individuals with disabilities. Our aim was to explore access and use of AT for older adults through an innovative research methodology, virtual self-directed home tours. These interviews were held across three groups of participants (A) first-generation Chinese-speaking immigrants to Canada, (B) second and subsequent generations of Chinese-speaking immigrants, and (C) native-born English-speaking Canadian citizens of European descent. A total of 17 interviews were conducted (Group A=8, Group B=3, and Group C=6) through Zoom Video Communications. Participants were demographically diverse adults with disabilities living in Metro Vancouver, British Columbia (Age= 59 ± 15 years; 11 female and 6 male). Most participants had assistance from their caregivers to complete the interview. Three main themes were identified. (1) Enabling Participation described the transformative role of AT in optimizing participants’ ability to engage in activities that are meaningful to them independently. (2) User-Driven Do-It-Yourself Adaptations explored how participants developed cost effective alternatives by creatively adding their own modifications to existing AT. (3) Navigating Complexities and Hurdles encompassed the challenges with accessing and incorporating AT in their homes due to lack of adequate knowledge transfer from healthcare professionals, financial circumstances, and other systemic barriers that further delayed the implementation of home modifications. Chinese-speaking immigrants faced compound challenges due to language barriers. The insights gained from this study may inform strategies for improving the experiences of older adults accessing and using AT and home modifications.
LIFE SPACE MOBILITY IS ASSOCIATED WITH DISTINCT FACTORS BELOW AND ABOVE THE AGE OF 75 YEARS
Authors: Khalil Samar Assadi , Kizony Rachel , Gil Efrat , Tzemah-Shahar Roy , Agmon Maayan
Published: January 2025

Life-space mobility (LSM) is associated with the quality of life and well-being of older adults, and it is influenced by individual and environmental factors. However, age-related differences are ignored. This study aimed to explore which factors are associated with LSM in community-dwelling older adults from two age groups (< 75 and≥75 years). This cross-sectional study included older adults aged 65 and over, independently mobile, without neurologic conditions or dementia. LSM, the dependent variable, was assessed using the Life-Space Assessment-(LSA). Independent variables were assessed using Timed Up and Go-(TUG) for mobility, Montreal Cognitive Assessment-(MoCA) for cognition, Activities-specific Balance Confidence Scale-(ABC) for fear of falling, Hospital Anxiety and Depression Scale-(HADS) for depression, and four-functional mobility tasks for participation. Additionally, functional status and number of medications were assessed. Two separate stepwise regression models were conducted for older adults aged< 75 and≥75 years. Two-hundred forty-two older adults (28.9% men) were included [mean(SD) age: 73.7(6.4) years], of whom 40.9% were≥75 years. Results revealed that different factors were associated with LSM in each age group. For those< 75 years, participation and TUG explained 33% and 9.4% of the variance in LSM, respectively. Conversely, for the older group, ABC, MoCA, and TUG explained 33.5%, 4.1% and 5.2% of the variance in LSM, respectively. Our finding shows that distinct factors are associated with LSM in each group, particularly mobility in the younger and fear of falling in the older. By highlighting these specific factors, interventions can be tailored more effectively to enhance the quality of life and well-being of older adults.
LONGEVITY POLYGENIC RISK IN MULTIDOMAIN AGING AND LONG-TERM SURVIVAL AMONG OLDER WHITE AND BLACK ADULTS
Authors: Chen Siting , Nagel Corey L , Lapidus Jodi , Quiñones Ana
Published: January 2025

This study aims to identify genetic characteristics of multi-dimensional aging and longevity by examining the association of longevity polygenic risk scores with multi-domain aging trajectories and long-term survival in older Non-Hispanic White and Non-Hispanic Black adults. We studied 7,287 older adults (≥ 65 years, 14.0% Non-Hispanic Black) from the Health and Retirement Study (HRS, 1998-2016). Group-based trajectory modeling was performed to identify distinct groups of older adults following similar joint trajectories of aging across four domains (multimorbidity burden, functional status, cognitive performance, and depressive symptomatology). We identified four distinct multi-domain trajectory groups: minimal impairment with low multimorbidity (34.1%), minimal impairment with high multimorbidity (37.1%), multidomain impairment with intermediate multimorbidity (16.7%), and multidomain impairment with high multimorbidity (12.1%). Longevity polygenic risk scores (categorized as low, medium, medium-high, and high) were compared between long-term survival groups (long-lived group and controls) across the identified trajectory groups in Non-Hispanic White and Black adults. The proportion of long-lived group was significantly higher in minimal impairment with low multimorbidity group in both Non-Hispanic White (23.3%,p< 0.01) and Non-Hispanic Black adults (19.6%,p< 0.01). The long-lived group had greater proportions of Non-Hispanic White participants with high longevity polygenic risk scores in all trajectory groups. The long-lived group had lower proportions of Non-Hispanic Black participants with low longevity polygenic risk scores in all trajectory groups except for the multi-domain impairment with high multimorbidity group. Our study highlights the need to examine the constellation of genetic and socioeconomic factors on aging-related health domains and longevity among diverse groups of older adults.
SOCIOECONOMIC STATUS AND THE RELATIONSHIP OF PHYSICAL PERFORMANCE WITH ACTIVITIES OF DAILY LIVING
Authors: Chang Grace , Malhotra Rahul , Seligman Benjamin
Published: January 2025

The translation of reduced intrinsic capacity, assessed through physical performance such as gait speed and grip strength, to diminished functional ability, such as limitations in activities of daily living (ADLs), can be modified by one’s environment. Socioeconomic status (SES), linked with access to resources, may thus modify the relationship between physical performance and ADL limitations. We study this question in a cohort of older adults, using data from the 2016 wave of the Health and Retirement Study. Performance was measured using gait speed and grip strength, adjusted for sex and height/BMI respectively. ADL limitation was assessed using five Katz ADLs: bathing, toileting, eating, dressing, and transferring from bed. We considered three SES measures: highest education level, household wealth, and household income. Analysis was by negative binomial regression of the number of ADL limitations on performance and/or SES with adjustment for age and sex. Individually, each performance and SES measure was associated with ADL limitations. In regressions including grip strength, SES was associated with ADL limitations, and wealth and income had interactions with grip strength. For gait speed, only wealth was associated with ADL limitations, though education had an interaction with gait speed. Our mixed results for effect modification by SES of the association between physical performance and ADL limitations do suggest the role of SES as an effect modifier, contingent on the measures being used for assessing physical performance and SES. However, they also suggest that performance may mediate the relationship between SES and ADL limitations.
MODELING TRAUMATIC BRAIN INJURY (TBI)–INDUCED NEURODEGENERATION USING HIPSC-CORTICAL ORGANOIDS
Authors: Duckworth Alyssa , Venugopal Surya , Coelho Luisa , Kwon Ester , Shah Sameer , Almenar-Queralt Angels
Published: January 2025

Traumatic Brain Injury (TBI) is a serious injury that affects millions of people worldwide and has significant effects on neural pathways in the brain, making it a risk factor for neurodegenerative diseases. Most research that examines the link between TBI and neurodegeneration uses rodent models, however they do not fully recapitulate disease pathology and cannot capture human specific features including the effect of genetic variations. Human induced pluripotent stem cells (hiPSC)-derived cortical organoids have become the gold standard to model neurological disorders. They recapitulate certain aspects of physiological and neural pathways of the human brain and are easily reproducible, making them a better model. To understand the effects of TBI-induced neurodegeneration and explore potential treatment therapies, we model TBI in cortical hiPSC organoids through inducing mechanical injury. We assess AD-related morphological, biochemical, and functional downstream effects with a battery of assays. Among them, we measure the impact on neuronal activity using fluorescent Ca2+ indicators to measure Ca flux at a single-cell level post injury. Together, these assays will help us establish a human-based system to model in vitro TBI-induced neurodegeneration. We hope it can help contribute to evaluate specific therapies and diagnostic tools to stop progression of neurodegeneration after mechanical injury.
SELF-COMPASSION IN CAREGIVERS OF NEURODEGENERATIVE DISEASES: DEMENTIA CARE CONTEXTS AND BEYOND
Authors: Lero Christi , Park Soobin , Mroz Emily
Published: January 2025

Informal caregivers of those with neurodegenerative disease (ND) manage increasingly complex symptoms which impact their own wellbeing. Self-compassion can promote maintenance of wellbeing during challenging life experiences, including caregiving. There is little guidance for studying self-compassion observationally or targeting self-compassion through intervention for this population. Our objective was to complete a scoping review of research describing self-compassion in the context of wellbeing of informal caregivers of those living with ND. In this review, following PRISMA-ScR guidelines, three online databases identified 350 peer-reviewed articles, 18 of which were included in this study. Eligibility included being written in English, targeting informal caregivers of a care recipient living with ND, and examination of self-compassion. Findings showed that study samples most often included informal caregivers of persons living with Alzheimer’s and related dementias. Across study types (e.g., hypothesis generating, intervention) self-compassion appeared as a theoretical concept, emerging theme from participant interviews, variable associated with other outcomes, and a main outcome variable. Self-compassion is often measured using the Self-Compassion Scale or short form version of this measure. Based on this review, we will discuss how study of self-compassion as useful for informal caregivers of individuals living with ND is in a growth period. The classification of ND is broad, however the range of common NDs among care recipient diagnosis was not represented by existing work. Future research should explore the nuances of self-compassion when caregiving for persons living with other NDs, as symptomology, disease trajectory, treatments, care provision, and outcomes vary across these caregiving contexts.
XBP-1S TRANSCRIPTIONAL TARGETS IN THE ER UNFOLDED PROTEIN RESPONSE RESCUE AGING-RELATED TAUOPATHY PROTEOSTASIS
Authors: Kraemer Brian
Published: January 2025

Proteostasis mechanisms fail with aging, promoting toxic protein accumulation. Neurons are particularly vulnerable to proteostatic disruption leading to aging related neurodegeneration. Abnormal activation of the endoplasmic reticulum unfolded protein response (UPRER) is implicated in tauopathies, a group of neurodegenerative diseases characterized by pathological accumulation of the microtubule-associated protein tau. Previous work showed neuronal overexpression of UPRER transcription factor XBP-1s suppresses tauopathy in C. elegans. Whole-genome RNA sequencing of C. elegans overexpressing XBP-1s showed upregulation of the following genes with human homologs compared to non-transgenic controls: csp-1, F42G8.7, F41E7.6, Y19D10A.16, C01B4.6, dnj-28, hsp-4, ckb-2, mct-2, lipl-3, and eol-1. Surprisingly, each one of these genes is required for xbp-1s-mediated suppression of tauopathy, suggesting that XBP-1s activates a broad and non-redundant network of cellular mechanisms to reduce tau pathology. Of these, we examined the critical UPRER regulator BiP/hsp-4, the ER resident HSP70 homolog. Hsp-4 loss of function, but not loss of the cognate ER resident DNAJ protein dnj-28, eliminates xbp-1s-mediated suppression of tauopathy. While hsp-4 loss of function exacerbates tau-induced behavioral deficits, tau protein level and phosphorylation are unaffected. High level overexpression of hsp-4 exacerbates tau-induced behavioral deficits and protein accumulation, while moderated hsp-4 overexpression ameliorates this phenotype. Furthermore, caspases also appear to play an important role downstream of XBP-1s: both the XBP-1s target csp-1 and its non-XBP-1s target gene family member ced-3 are required for xbp-1s-mediated suppression of tauopathy. In summary, this data set provides new therapeutic ideas that may be leveraged into novel treatments for tauopathy disorders further development against tauopathy.
AGE DIFFERENCES IN POSTPRANDIAL AMINO ACID PROFILES ARE DETERMINED BY PROTEIN CONTENT OF THE MEAL
Authors: Herpich Catrin , Li Donna , Weber Daniela , Norman Kristina
Published: January 2025

Amino acid availability after a meal differs between older and younger adults and the macronutrient composition of the meal affects postprandial amino acid availability as well. In this analysis, we examined postprandial amino acid response of healthy older and younger study participants to test meals with varying protein contents. The test meal either had normal protein (16 E% (energy percent) protein, 68 E% carbohydrates) or a high-protein content (HP, 77 E% protein (whey), 17% carbohydrates; 450 kcal each). Postprandial plasma amino acid concentrations were quantified at different timepoints (0, 30, 60, 120, 240 min) using UPLC-MS/MS. Amino acids were grouped into essential (EAA), dispensable (NEAA), and branched-chain amino acids (BCAA). Time and group differences of amino acid profiles were examined by repeated measures ANOVA and by comparing the incremental area under the curve (iAUC) using Mann-Whitney test. In older (n=40, 72.8±5.05 years) and younger adults (n=30, 25.5±3.94 years), EAA, NEAA and BCAA concentrations increased after both test meals over four hours (all p< 0.005), with a higher increase in response to HP. After the HP meal, significantly higher BCAA and EAA concentrations were found in older adults at 60 min. In addition, iAUC of BCAA, EAA and NEAA was significantly higher only in older participants following HP (all p< 0.05). After a meal containing high amounts of fast-absorbed protein, healthy older adults show higher postprandial amino acid concentrations that might result from delayed tissue uptake. Whereas in response to normal protein content no age-differences were seen.
VALIDATION OF A COMBINED SARCOPENIA AND NUTRITION SCREENING TOOL FOR COMMUNITY-LIVING OLDER ADULTS
Authors: Saffel-Shrier Susan , Covington Amy , Wang Jing
Published: January 2025

Malnutrition and sarcopenia are major intersecting conditions of the frailty syndrome. Both have similar symptoms to include reduced energy and protein intake along with losses of muscle and strength. These losses can lead to decreased functionality and independence culminating in poor health outcomes. When both conditions are present, community-living older adults have a potential for a more direct negative health effect. Appropriate screening tools for malnutrition and sarcopenia are frequently underutilized impairing diagnosis and treatment in this population. Furthermore, there is a lack of validated community-based nutrition screening tools compared against the Nutrition-Focused Physical Exam (NFPE), the gold standard for malnutrition diagnosis. The purpose of this study was to determine if combining two screening tools, the nutrition SCREEN II and sarcopenia SARC-F would yield higher malnutrition diagnostic accuracy compared to using each tool individually. Utilizing the NFPE tool as a reference, the combined SCREEN II plus SARC-F accurately diagnosed malnutrition in 103 participants (84.4%), surpassing the individual diagnoses of 72 (59%) by SCREEN II and 66 (54%) by SARC-F. This result underscores the superior accuracy of the combined tool. The internal consistency reliability of the combined tool, assessed through Cronbach’s alpha, yielded a coefficient of 0.73, indicating satisfactory internal consistency reliability. The convergent validity, assessed using the Phi coefficient, was 0.67, suggesting that the combined scores from the two tools are positively correlated with diagnoses of malnutrition based on the NFPE. These results support utilization of the combined screening tools in diagnosing malnutrition therefore improving the health of older adults.
DISTINCTIVE NEURONAL RESPONSES TO VARIOUS ANTICHOLINERGICS IN THE ACT COHORT HIPSC-DERIVED NEURONS
Authors: Pranoto Inez , Schwarze-Taufiq Tiara , Hui Katherine , Zhu Ruowei , Ogg Jordan , Crane Paul , Gray Shelly , Young Jessica
Published: January 2025

Anticholinergic medications remain widely used among older adults despite evidence of safety concerns, including dementia risk. Clinical cohort studies have linked certain anticholinergic classes, such as antidepressants and bladder antimuscarinics, to higher dementia risk. However, distinguishing whether this association stems from individuals’ predisposed conditions or drug-induced neuronal dysfunctions remains challenging. To address this, we used human induced pluripotent stem cell-derived neurons (hiPSC-Ns) from participants in the Adult Changes in Thought Study (ACT) aging study. We treated ACT hiPSC-Ns with four anticholinergic classes: antidepressants, antihistamines, bladder antimuscarinics, and antispasmodics. We evaluated drug-induced neuronal responses at a cellular and molecular level by measuring cytotoxicity, synaptic gene expression, and secreted amyloid-beta, a hallmark of Alzheimer’s disease. We found that exposure to antidepressants and bladder antimuscarinics induced neurotoxicity, while antihistamines and antispasmodics did not compromise cell viability at the concentrations tested. Despite inducing neurotoxicity, antidepressants and bladder antimuscarinic treatments upregulated the expression of various genes involved in synaptic plasticity, synaptic vesicle trafficking/release, and synaptic inhibition. Notably, treatment with a bladder antimuscarinic drug increased the secreted A𝛃-42/A𝛃-40 ratio, indicating a higher production of pathogenic amyloid isoform. Our preliminary findings reveal a consistent elevation in neurotoxicity, synaptic gene expression, and secreted amyloid-beta following exposure to antidepressants and bladder antimuscarinics across hiPSC-Ns from multiple ACT participants. We aim to further investigate the distinct molecular mechanisms of different anticholinergic compounds and their potential impact on declining neuronal functions. Our ongoing investigation provides cellular and molecular evidence to discern the source of dementia risk observed in cohort studies.