bluuebunny/crossref_metadata_2025 huggingface dataset:
DEMENTIA STATUS AND PERCEIVED IMPORTANCE OF RELIGIOUS SERVICES OF OLDER ADULTS OVER 11 YEARS
Authors: Tu Yufang , O’Connor Melissa
Published: January 2025

Religious/spiritual activities positively impact older adults’ health and well-being, and are associated with reduced cognitive decline and dementia progression. The current study explored the connection between dementia status and changes in the perceived importance of religious service participation (RSP) over an 11-year period. We used data from 12 longitudinal waves (2011-2022) of the National Health and Aging Trends Study (NHATS). NHATS is nationally representative of Medicare beneficiaries in the United States. The current study included 41,567 participants at baseline. The outcome variable measured the self-rated perceived importance of RSP on a 3-point scale. Longitudinal multilevel modeling was conducted with dementia diagnosis as a time-invariant predictor (yes/no). Covariates included sex, age group, education level, and self-rated health. The interaction between time and dementia status was also examined. Individuals with dementia had a lower baseline perceived importance of RSP by 0.28 points (estimate = -0.28, p < 0.001) compared to those without dementia. The average trajectory of the perceived importance of RSP significantly declined over time for both individuals without dementia (p < 0.001) and those with dementia (p < 0.001). Notably, individuals with dementia exhibited a faster decline, decreasing by 0.05 points for every 1 unit/year increase, in contrast to 0.01 points (estimate = -0.01) for those without dementia. This study demonstrated that older adults with dementia perceive RSP as less important compared to those without dementia. However, spiritual/religious engagement has been shown to help individuals with dementia cope with their symptoms.
DEPRESSIVE SYMPTOMS MEDIATE THE LONGITUDINAL ASSOCIATION OF RELIGIOUSNESS WITH SLEEP HEALTH AMONG OLDER ADULTS
Authors: Domingo Divine , Chen Tuo Yu , Mgabhi Philile , Lim Kian Lee
Published: January 2025

Although previous research shows that religiousness is significantly associated with better sleep health, their underlying mechanisms are unclear. We examined whether psychological distress and healthy behaviors mediated the association of baseline religiousness with multidimensional sleep health at 4-year follow-up among community-dwelling older adults. Data were from the Taiwan Longitudinal Study on Aging (2011-2015; N=2182). Multidimensional sleep health was conceptualized using the SATED model (satisfaction, alertness, timing, efficiency, duration; total score: 0-5), with a higher score indicating better sleep health. Religiousness was operationalized using the average frequency of five religious activities (praying, studying the sutra or bible, going to temple or church, watching or listening to religious programs, and making donations for religious purposes). Mediators at baseline included depressive symptoms (the Center for Epidemiological Studies-Depression Scale), self-reported frequencies of exercise and drinking, and number of cigarettes smoked per day. We used PROCESS macro to test the mediational relationship adjusting for age, sex, education, and chronic conditions at baseline. The results from bootstrapping showed that baseline depressive symptoms significantly mediated the effects of baseline religiousness on multidimensional sleep health at follow-up (indirect effect: B=.01, SE =.004, 95%CI=.0004-.02). Exercise frequency, drinking frequency, and number of cigarettes smoked per day at baseline were not significant mediators. Our finding provided further insights on the link between religiousness and multidimensional sleep health by showing that religiousness was associated with better sleep health through decreased depressive symptoms but not by increased exercise frequency, reduced drinking frequency, and fewer number of cigarettes smoked per day.
GENDER DIFFERENCES IN THE RELATIONSHIP BETWEEN SEXUAL SATISFACTION AND SPIRITUAL WELL-BEING
Authors: Lou Vivian Weiqun , Cheng Clio Yuen Man
Published: January 2025

Recognizing the significance of sexual activity in the holistic health of older adults, this research is the first to explore how sexual satisfaction contributes to the broader well-being dimensions, particularly spiritual well-being. Guided by an integration of the attachment theory and the spiritual well-being of Chinese older adults’ framework, we conducted a longitudinal study with 290 married young-olds aged 50 to 75 years. Participants completed self-reported measures assessing sexual satisfaction at baseline and three dimensions of spiritual well-being at 1-year follow-up. Linear regression analysis results indicate gender differences emerged in the associations between sexual satisfaction and these components of spiritual well-being. For the meaning of life, while males did not exhibit a significant association with sexual satisfaction, females demonstrated a positive association, suggesting that higher sexual satisfaction was linked to a greater sense of meaning in life (β =.728, SE =.365, t(1) = 1.997, p = 0.047). In terms of transcendence, no significant associations were found between sexual satisfaction and this component of spiritual well-being for either gender. Regarding overall spiritual well-being, males did not show a significant association with sexual satisfaction, while females displayed a positive association, indicating that higher sexual satisfaction was associated with higher levels of spiritual well-being (β = 1.175, SE = 0.410, t(1) = 2.868, p = 0.004). The findings underscore the significance of considering sexual satisfaction as a factor influencing spiritual well-being in older adults. Moreover, considering gender-specific patterns in future studies and interventions development for holistic well-being is warranted.
ROLES OF LONELINESS, STRESS, AND RELIGIOSITY IN SUICIDE IDEATION IN A SAMPLE OF SUB-SAHARAN AFRICAN OLDER ADULTS
Authors: Ebulum Genevieve , Eze John , Ezeihuoma Obinna , Njoku Crystal , Chukwuorji JohnBosco
Published: January 2025

Suicidal behaviour in older adults is a fundamental public health problem globally and the highest suicide rates occur in the low- and middle-income countries (LMICs). However, there is limited research on suicidality among older adults especially in sub-Saharan Africa. We sought to find out whether loneliness, stress and religiosity would significantly predict suicide ideation among Nigerian older adults (N = 500). They completed a questionnaire form comprising the Beck Suicidal Ideation Scale, the UCLA Loneliness Scale – version 3, Perceived Stress Scale and Religiosity Scale. While including age, educational qualification, and number of children as covariates, regression results showed that loneliness (β =.23) and stress (β =.10) were positively associated with suicide ideation while religiosity (β = -.16) exhibited a negative association with suicide ideation. The models substantially improved with the addition of each predictor. This suggests that whereas suicide ideation could be exacerbated by loneliness and stress, more religious older adults were less likely to report suicidal ideation. Interventions aimed at managing and protecting the mental health of older adults during their transition to late adulthood should guard them against loneliness and buffer their resilience and coping strategies with the connectedness that religiosity offers.
CO-PRODUCED IDEAS FOR SMART HOME TECHNOLOGIES TO SUPPORT ENGAGEMENT IN MEANINGFUL ACTIVITIES
Authors: Galanza William Son , Schmidt Steven , Jonsson Oskar , Offerman Jens , Malesevic Nebojsa , Iwarsson Susanne , Fristedt Sofi
Published: January 2025

While research in the field of technology is surging, research on older adults playing an active role in designing and developing smart home technology (SHT) to enhance usability and adoption is lacking. It is important to co-develop products with potential users to better match their needs and desires. This study aims to generate ideas about SHT that can enhance the use and adoption of SHT that can support engagement in meaningful activities while ageing. The research circle methodology was utilized to elicit co-produced ideas for SHT and their functions with participants from different generations (30-39, 50-59 and 70-79 years old; n=9), together with two professionals with expertise in SHT and four researchers. The strength of research circle methodology is knowledge translation through the collaborative effort of participants. The findings revealed that the participants preferred SHT which can support independence, engagement in social experiences, and participation in meaningful activities while ageing, rather than smart home appliances or full home automation. Moreover, SHT which can create a stimulating environment to positively impact physical, cognitive, and psychosocial factors were highlighted. Some ideas generated were multi-purpose functions and a system that can analyze patterns for monitoring activities and prevention of disability or its progression. Non-technology support such as informal carers and neighborhood and community support were also prioritized. Our study highlights the benefits of collaboration among diverse stakeholders (older adults, informal carers, technology professionals and researchers) to generate ideas about preferences for SHT that can better support the needs and desires of older adults.
LONGITUDINAL RELATIONS OF INTERNET USE FREQUENCY WITH COGNITIVE AND SOCIAL FUNCTIONING AMONG OLDER ADULTS
Authors: Toh Wei Xing , Ho Chin Wei , Khoo Shuna Shi Ann
Published: January 2025

Given the increasing reliance on the Internet in our daily lives, understanding the role of Internet use in cognitive and social functioning among older adults is crucial for promoting successful aging. However, the directionality of these relations remains inconclusive owing to methodological limitations in past studies (e.g., Mariano et al., 2021; Szabo et al., 2019), such as (a) reliance on cross-sectional and limited (two-wave) longitudinal data and (b) failure to disaggregate stable, between-person differences from temporal, within-person dynamics. Drawing from four waves of the English Longitudinal Study of Aging (N = 12,264; Mean age = 66.01 years), we used random-intercept cross-lagged panel modelling to investigate the directionality of Internet use frequency with cognitive functioning (i.e., verbal fluency and episodic memory) and social functioning (i.e., perceived social support, social-interaction frequency, and perceived social closeness). At the between-person level, older adults with higher Internet use frequency reported greater cognitive and social functioning (rs >.11, ps <.001). At the within-person level, greater-than-average cognitive functioning unidirectionally predicted subsequently higher Internet use frequency (βs >.06, ps <.035), thereby indicating that more cognitively intact older adults may face fewer difficulties with Internet use. Conversely, Internet use frequency was bidirectionally associated with social functioning (βs >.11, ps <.001). Specifically, engagement with the Internet supports social networks, and improved social functioning likely enhances the perceived usefulness and usage behavior of the Internet. These findings underscore the importance of considering cognitive and social factors when promoting Internet use among older adults.
MOBILE TEXT MESSAGE AS AN ADJUNCTIVE STRATEGY TO SUPPORT HOME-BASED EXERCISE IN OLDER ADULTS
Authors: Kidd Bethany , Jennings Stephen , Abbate Lauren , Tayade Arti , Hall Katherine
Published: January 2025

Lack of physical activity is associated with increased comorbidities, falls, frailty and healthcare usage. Several clinical and community-based exercise programs exist to provide guided exercise to older adults, however, staffing and space allotment often create barriers to providing sufficient opportunities. Puget Sound Gerofit sessions are held both in person and virtually. Both classes take place twice a week for 45 minutes. The Gerofit program in Seattle Washington implemented a structured text-based messaging protocol to provide additional exercise opportunities in support of meeting public health guidelines for physical activity. Twenty-six veterans were enrolled using mobile test messaging to provide an additional day of exercise. These veterans were texted 1x a week an automated message asking if they would like to exercise. Positive responses were sent a randomized link from a digital library of pre-recorded exercise videos featuring Gerofit instructors. Follow-up messages were sent to quantify minutes of activity participation. Twenty-six Veterans were messaged, over an average of 24 weeks. Participating veterans were on average 73.7 years old, predominately male (87.0%), and White race (82.6%). Of the 634 messages sent, 145 responses were gathered (22.8%). Veterans who engaged positively (61.5%) in exercise reported an average activity of 33.5 minutes/day. Participating older adults reported high satisfaction with the text-based protocol. Supplementation of a virtual group exercise program is feasible with text messaging and on-demand pre-recorded videos. This format allows a flexible option for participants as well as providing a lower resource option for exercise programs.
POWER ASSIST ADD-ONS FOR OLDER ADULT MANUAL WHEELCHAIR USERS: A SCOPING REVIEW
Authors: Atoyebi Oladele , Wister Andrew , Mattie Johanne , Gutman Gloria , Chaudhury Habib , O’Dea Eireann , Hosseini Sogol Haji , Borisoff Jaimie
Published: January 2025

Manual wheelchairs can promote independence among users of all ages. However, there are age-related differences in the level of disability, strength, stamina, and the environmental conditions within which the wheelchair is used. Using power assist add-ons may mitigate these limitations and help individuals in independent mobility. A gap in the literature is an understanding of the ways in which aging may limit the functionality of power assists on wheelchairs and the impact on independence and active aging. This scoping review analyzes scientific and gray literature to examine the use of power assist add-ons among older adults who use manual wheelchairs, as well as their advantages, limitations, and potential benefits in promoting independence and active aging. This review was guided by the PRISMA checklist for scoping reviews, and the Arksey and O’Malley review methodology. The literature search was carried out in two phases: 1) a keyword and MeSH search of electronic databases, proceedings, as well as symposia for relevant titles/abstracts; and 2) a search of Google and Google Scholar, as well as hand searches. After applying the inclusion and exclusion criteria, we included 20 publications with a focus on power-assist wheelchair technology for full review. Results indicate that power-assist add-ons for manual wheelchairs show promise in improving mobility and reducing user exertion for older adults. However, concerns regarding safety, indoor maneuverability, and user preferences highlight the need for specialized training and retrofitting power assist add-ons, especially among older users. Further research on user-centered design, and adherence to safety standards are warranted.
THE RELATIONSHIP BETWEEN TECHNOLOGY USE, EMPLOYMENT STATUS, AND SOCIAL ENGAGEMENT IN OLDER AMERICANS
Authors: Lee Jaesung , O’Shields Jay , Dunnigan Allison
Published: January 2025

Previous studies have explored the relationship between technology use or employment status among older adults and social engagement. However limited knowledge exists regarding the relationship between technology use, employment status, and social engagement. This study analyzes the relationship between older adults’ information and technology (ICT) use and employment status on social engagement. The 2022 (wave 12) National Health & Aging Trends Study (NHATS) was used. The sample population includes US Medicare beneficiaries aged 65 years and older who were community dwellers (N = 5,195). Multivariate regression analysis indicates that ICT use is associated with social engagement (b=-1.52, t=-11.86, p< 0.001), with ICT users having the highest level of social engagement followed by CT users, IT users, and nonusers. Employment status is also associated with social engagement (b=-0.46, t=-5.14, p< 0.001), with the employed being the most socially engaged, and the retired/do not work anymore group having higher levels of social engagement compared to the unemployed group. An interaction was tested but was not significant. Additionally, sociodemographic factors including age (b=0.05, t=2.50, p=0.015), gender (b=0.31, t=5.71,p< 0.001), race (b=-0.78, t=-9.52, p< 0.001), education(b=0.24, t=3.70, p< 0.001), and living arrangements (b=0.31, t=6.84, p< 0.001) have a statistically significant relationship with social engagement. In conclusion, this study emphasizes the importance of considering both technology use and employment status in understanding social engagement among older Americans. These findings suggest the need for further research to explore the complex interaction of these factors in older adults’ social engagement.
TRAINING OLDER ADULTS IN THE USE OF INTERNET TECHNOLOGY
Authors: Case Donna , Groden Sheryl , Sahli Michelle
Published: January 2025

This study was conducted to investigate whether small group (2:1) technology training increases the frequency of technology use among older adults and how these older adults perceived this training. Graduate occupational therapy students, under faculty supervision, provided 4 weekly technology tutoring sessions to older adults at a senior center and an independent living facility located in Genesee County, MI. Participants received training in pairs. This training consisted of internet safety and additional instruction centered on participants’ interests. When requested, participants were offered assistive devices to help them use technology. Pre and post surveys were administered to participants to examine their independent technology use and attitudes towards the training sessions. Students provided training to 31 older adults with only 3 participants requesting assistive devices. The surveys showed an increase in the proportion of participants independently using technology for 10 out of 11 activities; however, these results were not statistically significant. Analysis of qualitative data revealed that most participants felt comfortable using technology post intervention and that they learned more about technology. Participants also liked the frequency and length of the sessions and reported forming relationships with others during the sessions. Although not statistically significant, perhaps due to small sample size, these findings provide evidence that training in small groups provided by students may increase technology use by older adults and that this type of training is acceptable to older adults. Future studies should be conducted in larger samples and with other populations to further explore this type of training program.
DRIVING RISK TOLERANCE AS A PREDICTOR OF OLDER ADULTS’ ABILITY TO DRIVE
Authors: Curl Angela
Published: January 2025

Driving is critical to mobility, autonomy, freedom of choice, and engagement for older adults, but many eventually stop driving. Evaluation of fitness to drive, risks related to driving, and personal preferences about driving all can play a role in driving cessation. Using 2022 data from the Health and Retirement Study (HRS; N=2,209), this study examined the relationship between driving risk tolerance and driving cessation for White and Black adults over age 65. Risk tolerance (key predictor) was measured as willingness to take risks while driving (0=“unwilling to take any risks” to 10=”fully prepared to take risks”). Self-reported ability to drive (yes/no) assessed driving cessation. Model 1 consisted of driving risk tolerance, controlling for education, gender, race, ethnicity and age, while Model 2 tested whether the relationship was mediated by self-rated eyesight, health, and memory (3 single-item measures, 0=poor to 4=excellent). Logistic regression results indicated that higher driving risk tolerance was associated with greater likelihood of ability to drive in Model 1 (OR=1.08, p=.01). Addition of health factors (Model 2) only weakly mediated this relationship, with driving risk tolerance having a slightly stronger impact on driving ability (OR=1.10, p<.01). Better eyesight (OR=1.76, p<.01) and health (OR=1.45, p<.01) were associated with greater likelihood self-reported ability to drive. As driving involves potential risks (e.g., traffic tickets, accidents), driving assessments should include perceptions of level of risk in discussions about driving cessation. Interventions designed to help older adults accurately assess their driving risk and how to minimize risks could promote driving ability/driving cessation.
COGNITIVE IMPAIRMENT, DEMENTIA, AND FALLS IN RACIALLY/ETHNICALLY DIVERSE OLDER AMERICANS
Authors: Malatyali Ayse , Thiamwong Ladda , Cidav Tom , Xie Rui , Wiese Lisa
Published: January 2025

Older adults with cognitive impairment (CI) and dementia are prone to falls as they have at least twice as much risk than their cognitively normal peers. The relationship between falls and cognitive decline is bidirectional. However, evidence regarding the effects of falls on CI and dementia is limited. This study describes the association of falls, repeated falls, and related risk factors with CI and dementia among older Americans. This cross-sectional study used datasets from the 2020 interviews of the Health and Retirement Study. The sample included 7,663 participants (age>64). Participants who had fallen in the last two years were 15% more likely to have CI and 34% more likely to have dementia. Increased number of falls was significantly associated with CI (OR=1.03) and dementia (OR=1.04). Having depressive symptoms was also associated with CI (OR=1.64) and dementia (OR=1.99). Participants living in rural areas were 17% more likely to have CI and 53% more likely to have dementia than those living in urban areas. Furthermore, living alone increased the odds of having CI (OR: 1.22) and dementia (OR=1.15). We also observed a significant association of ethnicity and race with cognitive stages: Hispanic participants were 1.7 times more likely, and Black participants were 2.4 times more likely to have CI. The likelihood of having dementia was also higher in Hispanics (OR: 2.36) and Blacks (OR= 5.21) compared to non-Hispanic Whites. Falls prevention interventions should be tailored across cognitive stages in older adults with the consideration of ethnic, racial, and environmental diversities.
EFFECTS OF MENOPAUSE MODELING ON AUTOPHAGIC AND LYSOSOMAL FUNCTION IN ALZHEIMER’S DISEASE MICE
Authors: Osborne Danielle , Dorn Adrianah
Published: January 2025

Alzheimer’s disease (AD) is denoted by strong sex differences, whereby females are significantly more likely to develop AD and often experience more rapid progression and cognitive decline. This difference in risk is often attributed to menopause, however the underlying molecular mechanisms are unknown. In humans and animal models, autophagic and lysosomal dysfunction are among the earliest known cellular changes that occur in AD susceptible brain regions, like the hippocampus. Our goal was to first characterize how key autophagic and lysosomal gene transcripts changed due to sex, ovariectomy (OVX) and estrogen replacement in wildtype mice, then investigate in female AD mice how these cellular processes change due to OVX and estrogen replacement. In wildtype mice, across 22 genes investigated, three transcripts, Atg12, Atg5, and Map1LC3b showed a baseline sex difference. Using the 5xFAD model of AD, we observed the expected genotype difference in cognition, with transgenics having a significant impairment in Morris watermaze performance. Probe measures indicate decreased performance due to OVX, but that 5xFAD mice may be further hindered by the addition of estrogen. Molecular measures will include western blot analysis of phosphorylated proteins involved in autophagic/lysosomal signaling (pAkt, pAMPK, pRPS6), and qPCR (Atg5, Atg12, Map1LC3b, Tfe3, Tfeb, among others) in the hippocampus, and immunohistochemistry (GFAP, Iba1, amyloid-beta, reelin) in the hippocampus and entorhinal cortex. These studies will provide valuable information on how cessation of female hormones at menopause affect the vital cellular functions of autophagy and lysosomal degradation in key cognitive and disease susceptible brain regions in AD.
EVALUATION OF A LATINO BRAIN HEALTH FAIR FOR ALZHEIMER’S DISEASE EDUCATION AND RESEARCH RECRUITMENT
Authors: Kehne Theresa , Rojina Janet , Ko Linda , Bishop Sonia , Pascoe Kelley , Domoto-Reilly Kimiko , Anaya-Carmona Israel , Torres Karen
Published: January 2025

Hispanic/Latino individuals are at higher risk of developing Alzheimer’s disease (AD) than non-Hispanic White individuals, yet risk factors in the Hispanic/Latino community are not well understood due to barriers impacting research participation. This study, in partnership with a community advisory board, developed and evaluated a novel “Brain Health Fair” (BHF) intervention for increasing AD knowledge and willingness to participate in AD research among Hispanic/Latino individuals. The BHF involved an educational presentation and interactive stations run by language-concordant health professionals that provided information about AD, health promotion and the importance of research participation to improve health equity in a culturally grounded context. Participant knowledge, attitudes, and willingness to participate in AD research were assessed in an anonymous assessment administered pre and post intervention. Participants were also given the option to enroll in the local University of Washington Alzheimer’s Disease Research Center (ADRC). Participants (n=26) demonstrated a significant change in knowledge of AD in the Latino community pre and post intervention (M pre; post=1.4;3.6, SD pre; post=1.5;1.5, Z=-3.5, p=0.001), preventative behaviors for AD (M=1;3.3, SD=1.4;1.7, Z=-3.6, p=0), what ADRC participation entails (M=0.9;3.5, SD=1.6;1.7, Z=-3.8, p=0) and benefits of research participation (M=1.2;3.9, SD=1.8;1.6, Z=-3.5, p=0.001) (two-sided Wilcoxon signed-rank test, p=0.001). After the intervention, 85% reported being satisfied and found it culturally appropriate and 81% signed consent forms to enroll in the ADRC. The BHF showed great promise for improving knowledge of AD and readiness of Hispanic/Latino individuals to participate in research and was a successful method for recruiting participants into AD research.
MEASURING LIGHTING USING AN INDIVIDUAL WEARABLE LIGHT SENSOR IN NURSING HOME RESIDENTS WITH DEMENTIA
Authors: Jao Ying-Ling , Wang Julian , Beiglary Shevvaa , Liao Yo-Jen
Published: January 2025

More research has examined the light effect in dementia. Lighting exposure varies widely across times and people. Individual light sensors allow more precise measurements. Yet, their feasibility has not been established. This study examined the feasibility of using individual light sensors (LYS Button) in a clinical trial for nursing home residents with dementia. This study enrolled 27 residents with dementia. The LYS Button is a small, lightweight sensor clipped on residents’ collar/shoulder area. The sensor measured lighting every 15 seconds all day, 7 days a week, every other week for 13 weeks. Several strategies were implemented. First, instructions on sensor use were provided, and a reminder sign was posted in the residents’ bedrooms. Second, a computer station on site enabled data monitoring. If a sensor disconnected from the server, the team was alerted, and on-site staff were contacted to check/replace sensors. Third, the research team checked the sensor on-site twice weekly. To examine the feasibility, the number of sensors was tallied, sensor data were analyzed, and individual interviews were conducted with 22 healthcare workers. Results showed that 52 sensors were lost or broken. The average missing data per resident per day were 1.13 (SD=0.99) and 6.84 hours (SD=2.28) during daytime and nighttime, respectively. Despite some missing data, the intense data collection allowed sufficient data for analysis. The results support the feasibility of using the wearable sensor to measure daytime lighting. Wearing methods and strategies during nighttime need modification to improve the use of individual lighting sensors in people with dementia.
PREVALENCE AND CHARACTERISTICS OF HEALTH CARE–RELATED TASKS BY INFORMAL DEMENTIA CAREGIVERS: A SYSTEMATIC REVIEW
Authors: Zuber Mohammed , Borate Samruddhi Nandkumar , Tan Chia Jie , Li Niying
Published: January 2025

Healthcare-related tasks (e.g. making appointments, talking to providers) performed by informal caregivers caring for older adults with dementia have become increasingly common. This is a systematic review of the prevalence and characteristics of healthcare related tasks performed by informal caregivers. Articles were searched in PubMed, Embase, PsychInfo and CINAHL until September 2023. Studies that were based in the United States and reported the prevalence of healthcare related tasks performed by informal dementia caregivers were included. Tasks identified were grouped into health and medical care, advocacy and care coordination, and surrogate tasks. Caregiver characteristics were reported. Of 6,284 articles screened, we included 12 studies. All the studies were cross-sectional and the majority of them were nationally representative. Majority of caregivers were female and spousal caregivers. Only four studies included racial and ethnic minority caregivers. Medication management, including keeping track of medications, was the most common health and medical care task reported in eight studies ranging from 41% to 86%, followed by five studies reporting 7% to 47% caregivers being involved in wound and skin care. Two studies reported caregivers performing advocacy and care coordination tasks (27 to 73%) such as making appointments, managing insurance, and one study reported surrogate tasks such as participating in medical/treatment decisions (41%). Informal dementia caregivers were involved in a wide range of complex healthcare related tasks. The healthcare system and healthcare professionals need to provide training and support to informal dementia caregivers in performing these tasks.
THE ROLE OF TREATMENT CHOICE IN CONFOUNDING ASSOCIATIONS BETWEEN HASHIMOTO AND ALZHEIMER’S DISEASE
Authors: Gorbunova Galina , Yashkin Arseniy , Nikitin Stanislav Kolpakov , Ukraintseva Svetlana , Yashin Anatoliy , Akushevich Igor
Published: January 2025

Alzheimer’s disease (AD) is a neurodegenerative disorder, most prevalent at the advanced ages. The increased risk of cognitive decline and the onset of AD and related dementia have recently been associated with hyperthyroidism while the results for hypothyroidism-AD association have been inconclusive. We hypothesized that hypothyroidism treatment modalities may cause variability in the available evidence of a hypothyroidism-AD association. We used Medicare administrative claims data from 2006-2022 to test this hypothesis by assessing how the association between Hashimoto’s disease, which is the most common form of hypothyroidism, and a clinical diagnosis of AD dementia changes as information about treatment modality is entered into the model. As was expected, non-treatment-enabled models were unable to find a statistically significant association between Hashimoto’s disease and AD. These findings were consistent across sex/gender and race/ethnicity-specific groups. The introduction of treatment modalities into the model, such as T-4 hormone replacement therapy, Liothyronine (and its generic equivalents), Levothyroxine (and its generic equivalents), surgery, and supplementary metformin use, modified the observed non-treatment-aware relationships. However, due to stratification, the prediction power of our treatment-aware models accounting for treatment modality was substantially weaker.
ACTIVITY INTENSITY AND HEALTH DECLINES IN OLDER ADULTS WITH PROSTATE CANCER VIA THE OPEN-SOURCE GERI PLATFORM
Authors: Mir Nabiel , Che Yan , Szmulewitz Russell , Huisingh-Scheetz Megan
Published: January 2025

Wearable sensors may facilitate remote monitoring of patient vulnerability during cancer treatment but the associations between the technology measures and clinically meaningful measures have not been established. The Geriatric Remote Initiative (GeRI) is a remote data collection platform that employs a Bangle.js 2 wrist accelerometer alongside a WiFi-enabled Raspberry Pi tablet to collect and transmit free-living physical activity in older adults with cancer. The objective of this analysis was to relate mean activity levels collected in a pilot sample of 10 advanced prostate cancer patients aged ≥65 years over a period of ≥12 weeks to baseline self-rated health and 12-week adverse events. All participants were currently or previously exposed to androgen deprivation therapy. Participants wore the accelerometer weekly for 48-hours; activity indices were recorded and averaged every 15 minutes. Records with at least 12 hours of activity, two or more measurement periods, and ≥50% wear compliance were included. Mean day time (7am-7pm) activity indices were calculated across wear periods. Data from two devices were omitted due to insufficient activity data capture, resulting in 8 evaluable patients. The participant with the lowest mean day time activity (mean activity index=45,803.2) had the lowest baseline self-rated health and was the only participant to develop new high-grade vascular comorbidities at 12 weeks. The mean activity index for the rest of the sample ranged from 80,454.0 to 154,898.3 (mode of five instances of wear, range 3-6 wear instances). Remote monitoring using platforms like GeRI may offer novel methods for detecting vulnerability throughout cancer treatment.
DEVELOPMENT AND VALIDATION OF A SOCIAL FRAILTY INDEX AMONG OLDER ADULTS IN THE PHILIPPINES
Authors: Tan Edina , Xu Hanzhang , Malhotra Rahul , Paguirigan Mark Ryan , Cruz Grace , Saito Yasuhiko , Østbye Truls
Published: January 2025

The potential of social frailty, known to be associated with adverse health outcomes among older adults, for risk assessment can be maximized if the development of a scale to measure it considers the sociocultural context in which it will be applied. No social frailty scales have been developed for use in the Philippines, a Southeast Asian country with distinctive sociocultural characteristics such as an emphasis on religious life, family caregiving, and a generally positive view of aging. We developed and validated a Social Frailty Index-Philippines (SFI-Phil), using 4-year mortality as an outcome, for use among older adults in the Philippines. We also evaluated its performance across age, gender, and urban-rural residence. Data on 5153 older adults, aged 60 years and older, from the nationally representative Longitudinal Study of Ageing and Health in the Philippines (LSAHP) was analyzed. Applying LASSO regression on 33 candidate variables selected using a conceptual framework for social frailty, the SFI-Phil included six variables: (1) education, (2) religious activity participation, (3) caring for grandchildren, (4) employment, (5) hanging out with friends and neighbors, and (6) feeling left out. Evaluation of SFI-Phil in a validation sample demonstrated satisfactory accuracy in predicting mortality (C-statistic 0.640, 95% CI: 0.608-0.673). It also performed adequately across demographic strata, although better amongst 60–69 year olds (C-statistic 0.642, 95% CI: 0.606-0.673), males (0.670, 0.650-0.694), and urban residents (0.660, 0.637-0.684). SFI-Phil, developed considering the country’s sociocultural context, can be used to assess social frailty among older adults in the Philippines.
DISCORD BETWEEN SELF-REPORT AND PERFORMANCE-BASED ADL MEASURES AMONG PREFRAIL OR FRAIL OLDER ADULTS
Authors: Liu Chiung-ju (C J) , Chang Wen-Pin , Wang Inga
Published: January 2025

Prefrail and frail older adults face an increased risk of late-life disability. Detecting the decline in activities of daily living is essential to mitigate or reverse the progression of disability in this population. However, self-report and performance-based measures of activities of daily living do not always coincide because the magnitude of decline could be too subtle to detect or be aware of. This study examined the correlation between the two evaluation approaches and compared the characteristics of participants who overestimated with those who underestimated their performance. The baseline data of 71 prefrail or frail, community-living older adults (Mean age = 74 years) from previous clinical trials were analyzed. There was no statistically significant correlation between the self-reported measure in activities of daily living (assessed by the Performance Score of the Canadian Occupational Performance Measure) and the performance-based measure (assessed by the Motor Skills Score of the Assessment of Motor and Process Skills), rs =.01, p =.94. Approximately half of the participants showed a discrepancy between the two measures. Those who overestimated (n = 12) tended to be older and had poorer physical functioning than those who underestimated (n = 20), all ps <.05. Additionally, those who overestimated were more satisfied with their performance of activities of daily living than those who underestimated it, Z = 35.55, p <.05. Overestimation and underestimation may reflect different coping mechanisms adopted by prefrail and frail older adults in response to functional decline. Research to further investigate these mechanisms is encouraged.
IDENTIFYING UNMET NEEDS: THE RELATIONSHIP BETWEEN FRAILTY MEASURES AND PATIENT PRIORITIES CARE
Authors: Thomas Amy , Bernacki Gwen , Brown Karl , May Terri , Williams Kirk , Martinez Erica , Ritchey Katherine
Published: January 2025

Patient Priorities Care (PPC) is an effective approach to identifying and aligning ‘what matters’ (i.e., values) with healthcare for patients with multimorbidity and frailty. VA metrics [i.e., Jen Frailty Index (JFI); Care Assessment Need (CAN)] predict mortality and institutionalization but may not correlate with the number and complexity of healthcare needs of veterans with multimorbidity. For patients referred to a VA Geriatric PPC Consultation clinic, recommendations and alignment of care were guided by a veteran-derived health outcome goal. Recommended changes to healthcare plans including rehabilitative or social service referrals were identified from electronic health records. Multiple linear regression was used to correlate total number of recommendations (outcome) with frailty (JFI) and multimorbidity (CAN) scores; interaction between frailty/multimorbidity scores with rurality was also explored. Rural/non-rural groups were demographically similar and had four recommendation subtypes per patient (mean). Median CAN was 85 (out of 99) and JFI 6 (out of 13). CAN or JFI scores had no effect on number of recommendations for both rural (p = 0.32 for CAN, p = 0.85, respectively) and non-rural (p = 0.09, p = 0.35, respectively) groups. There was no difference in the effect of CAN or JFI on the recommendations between rural vs. non-rural groups (p = 0.45, p = 0.43). JFI and CAN scores may not identify which older veterans have rehabilitative or social needs. Future work is needed to clarify how frailty and multimorbidity measures can guide referral to geriatric services and/or resource allocation to prevent disability.
ACCELERATED PACE OF BIOLOGICAL AGING IN PARTICIPANTS WITH LOW LEVELS OF SELENIUM BIOMARKERS IN BERLIN AGING STUDY II
Authors: Vetter Valentin , Demircan Kamil , Homann Jan , Mülleder Michael , Ralser Markus , Bertram Lars , Schomburg Lutz , Demuth Ilja
Published: January 2025

Low levels of selenium in blood were shown to be associated with adverse health outcomes and are discussed as anti-aging interventions by some investigators. Inter-individual differences in the aging process can be quantified by epigenetic clocks (DNA methylation age, DNAmA). In this study, we analyzed 1,568 participants of the Berlin Aging Study II (BASE-II, mean age +/- SD: 68.8 +/- 3.7 years, 51% women). DNAmA, and its deviation from chronological age, DNAmA acceleration (DNAmAA), were measured from DNA methylation data derived from Illumina’s “MethylationEPIC” array via the Horvath, GrimAge, and DunedinPACE clock algorithms. Selenium was measured in serum samples via total reflection X-ray fluorescence (TXRF) spectroscopy. Selenoprotein P (SELENOP) was measured with ELISA. GPX3 was assessed as part of a larger set of proteins by mass spectrometry. A statistically significantly higher pace of ageing (using the DunedinPACE clock) was observed for participants with deficient selenium levels (< 90 μg/L). This association persisted after adjustment for age, sex, BMI, smoking, and genetic ancestry in linear regression (β=-0.02, SE=0.01, p= 0.012; n=757). Similarly, participants in the highest quartile of SELENOP levels showed a statistically significantly lower pace of ageing compared to the lowest quartile (DunedinPACE, β=-0.03, SE=0.01, p=0.007; n=740). Participants within the lowest quartile of GPX3 levels showed statistically significantly higher rates of biological ageing compared to the participants in the third quartile (HorvathDNAmAA, p=0.04), the fourth quartile (GrimAgeDNAmAA, p=0.003) or both quartiles combined (DunedinPACE, p=0.002). In conclusion, our findings support previous reports of potentially detrimental effects of low levels of selenium biomarkers.
AGE-RELATED CHANGES IN BODY WEIGHT AS DETERMINANTS OF EXTREME LONGEVITY
Authors: Ukraintseva Svetlana , Duan Hongzhe , Holmes Rachel , Arbeev Konstantin , Yashin Anatoliy
Published: January 2025

Age-related changes in body weight may mirror fundamental processes of aging and ontogeny that contribute to determining human longevity limits. We estimated the mean age trajectories of weight, along with their key characteristics, such as the age at which maximum weight values (AgeMax) are reached, and the slope of weight decline (Slope) thereafter, and tested whether they can predict extreme longevity in the Framingham Heart Study participants. We compared weight trajectories over a period of approximately 50 years between those who survived beyond age 95 (longevity group) and those who died before age 85 (conventional lifespan). We also estimated survival trajectories after age 80 for individuals who had different AgeMax and Slope. We found that individuals who lived beyond the age of 95 reached AgeMax about 15 years later (around age 75), and experienced a slower decline in weight, compared to participants with a conventional lifespan. The older AgeMax and flatter Slope were both significant predictors of better survival after age 80 and increased chances of extreme longevity. Our findings suggest that patterns of long-term changes in body weight can be informative biomarkers of aging and longevity. A slower or postponed decline in weight at the oldest old ages may indicate better physical resilience contributing to an organism’s ability to reach longevity limits.
AGING MARKERS IN CONTEXT OF MORBIDITY, FRAILTY, AND GERIATRIC ASSESSMENTS: LONGITUDINAL RESULTS FROM BASE-II
Authors: Vetter Valentin , Drewelies Johanna , Homann Jan , Düzel Sandra , Kühn Simone , Bertram Lars , Gerstorf Denis , Demuth Ilja
Published: January 2025

Several markers are available that aim at the quantification of inter-individual differences in biological age. While many of these markers have been evaluated individually, there are few comparisons in terms of their association with age-related outcomes within the same dataset available. In this study, we compare 13 different aging markers in relation to morbidity, frailty and geriatric assessments in 1,671 participants of the Berlin Aging Study II (BASE-II). Participants were on average 68.8 years old at baseline (SD = 3.7 years) and 51.6% of the participants were women. A follow-up examination of 1,083 participants was conducted on average 7.4 years later. Biological age was assessed as epigenetic age using DNA methylation (7-CpG, Horvath, Hannum, PhenoAge, GrimAge, DunedinPACE), telomere length, BioAge, BrainAge, SkinAge, Subjective Age, Subjective Life Expectancy, and Subjective Health Horizon. Aging markers were analyzed in the context of morbidity (overall morbidity, diabetes and diabetes associated complications, cardiovascular risk scores), frailty (Fried), Tinetti Mobility Test, falls in past 12 months, finger-floor distance, mini mental state examination, Center for Epidemiologic Studies-Depression scale, activities of daily living (ADL), and mini nutritional assessment (MNA). Associations between ageing markers and outcomes were assessed with regression analyses adjusted for known confounders (age, sex, smoking, BMI). Preliminary results revealed strengths and limitations of the biomarkers analyzed with respect to the different domains of aging represented by the investigated age-associated outcomes. Cross-sectional and longitudinal results will be presented at the meeting and discussed in the context of the literature.
EFFECTS OF FASTING STATUS ON BLOOD-BASED INFLAMMATORY BIOMARKERS IN OLDER ADULTS
Authors: Engeland Christopher , Tennyson Robert , Wright Molly , Knight Erik , Mousavi Seyedeh Leila , Buxton Orfeu , Graham-Engeland Jennifer
Published: January 2025

To determine the effects of fasting status on blood-based biomarker concentrations, 30 older adults (Mage = 67.52; 70% women) fasted from midnight onwards prior to two morning laboratory visits. Each visit included 4 blood draws, spaced 1 hour apart. The visits (counterbalanced by order) were differentiated by a meal being provided after either the 2nd or 4th blood draw. This design enabled examination of fasting versus post-prandial effects, accounting for circadian variation of biomarkers. Plasma levels of cytokines (interleukin [IL]-1β, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor [TNF]-α), soluble urokinase-type plasminogen activator receptor (suPAR), and C-reactive protein (CRP) were quantified at each timepoint. Separate subsets of whole blood were stimulated with 1µg/ml lipopolysaccharide and incubated for 2h or 24h at 37ºC (5% CO2) to examine cytokine responsivity to immunogenic challenge. Bayesian multilevel models (minimally informative priors, Stan MCMC sampler) compared all pre-prandial (6 timepoints) vs. post-prandial (2 timepoints) concentrations (covariates: time-of-blood-draw, visit order, age, gender, BMI). Results provided strong to very strong evidence for no changes in basal cytokines, CRP, or suPAR by fasting status. However, there was strong evidence that eating decreased stimulated TNF-α levels (2h and 24h incubation) and weak evidence that eating decreased stimulated IL-6 (2h incubation only). These findings indicate that levels of basal inflammation are not affected by eating, but that stimulated levels of TNF-α are susceptible to post-prandial effects. This implies that studies assessing stimulated TNF-α should have participants fast. Further research is needed for stimulated IL-6, which exhibited uncertain (weak) evidence of change.