bluuebunny/crossref_metadata_2025 huggingface dataset:
POEMS syndrome causing left ventricular hypertrophy, myocardial dysfunction, and pericardial effusion: a case report
Authors: Wang Shanshan , Wu Xuejie , Li Hui
Published: December 2021

Background

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) is a paraneoplastic syndrome caused by a plasma cell proliferative disorder. Characteristics of POEMS syndrome include elevated pro-inflammatory and angiogenic cytokine levels that lead to multi-organ dysfunction. Patients have a variety of initial symptoms, but cardiac involvement is not common.

Case summary

We report a case of a 31-year-old Chinese woman with chief complaints of chest pain and dyspnoea who was diagnosed with POEMS syndrome. The cardiovascular system in the case study patient was characterized by pericardial effusion, enlarged left atria, abnormal myocardial segmental deformation, left ventricular hypertrophy, pulmonary hypertension, and increased glucose metabolism in the left and right ventricular myocardium. The pericardial effusion diminished, while cardiac function, left ventricular wall thickness, and pulmonary hypertension gradually returned to normal with dexamethasone and bortezomib treatment.

Discussion

This case suggests that cardiovascular system damage may be related to systemic diseases. Cardiovascular system damage caused by POEMS syndrome is recoverable after chemotherapy treatment. Echocardiography readily visualizes the changes in the heart of a patient with POEMS syndrome, clearly reflecting the changes in the structure and function of the heart before and after treatment.
Social relationships and the risk of incident heart failure: results from a prospective population-based study of older men
Authors: Coyte Aishah , Perry Rachel , Papacosta Anna Olia , Lennon Lucy , Whincup Peter Hynes , Wannamethee Sasiwarang Goya , Ramsay and Sheena Esther
Published: December 2021

Aims

Limited social relationships, particularly in older adults, have been implicated as a risk factor for cardiovascular disease. However, little is known about the associations between poor social relationships and heart failure incidence.

Methods and results

Prospective study of socially representative men aged 60–79 years drawn from general practices in 24 British towns and followed up for a maximum of 18 years. A total of 3698 participants with no previous diagnosis of heart failure were included. Information on social relationships was based on a combination of marital status, living circumstances, and social contacts with friends and family. These provided information on contact frequency, contact satisfaction, and a social relationship score (low to high) combining frequency and satisfaction with contact. Heart failure included both incidents non-fatal heart failure and death from heart failure. Among 3698 participants, 330 developed heart failure. Men with low compared to high frequency of contact with family and friends had an increased risk of incident heart failure [hazard ratio (HR) 1.59, 95% confidence interval (CI) 1.15–2.18]; this remained statistically significant after adjustment for social class, behavioural, and biological risk factors. Low compared to high scores for satisfaction with contacts was associated with increased risk of heart failure (adjusted HR = 1.54; 95% CI 1.14–2.07). Lower social relationship scores (combining frequency and satisfaction with contact) were associated with greater risk of incident heart failure (adjusted HR = 1.38, 95% CI 1.02–1.87). Marital status and living alone were not significantly associated with heart failure.

Conclusion

Weaker social relationships appear to increase the risk of developing heart failure in older age. Further research is needed to investigate pathways underlying these associations and to test whether interventions to strengthen social relationships can reduce the risk of heart failure.
Midterm results of arch augmentation with autologous vascular patch in interrupted aortic arch
Authors: Lee Sang On , Shin Hong Ju , Jun Tae-Gook , Kang I-Seok , Huh June , Song Jinyoung , Yang Ji-Hyuk
Published: December 2021

OBJECTIVES

Aortic arch reconstruction of interrupted aortic arch remains challenging, and subsequent problems, including arch and airway stenosis, may occur. Thus, we investigated midterm results of an augmentation technique using autologous vascular patch.

METHODS

This retrospective study included 24 patients who underwent arch reconstruction with an autologous vascular patch for interrupted aortic arch with biventricular physiology from 2006 to 2018. The median age and body weight at operation were 10 days (range 4–77 days) and 3 kg (range 2.5–5.1 kg), respectively. The reconstructed arch was supplemented in the lesser curvature with an autologous vascular patch that was harvested from main pulmonary artery (n = 19), left subclavian artery (n = 3) or aberrant right subclavian artery (n = 1). One patient used patches from both the main pulmonary and left subclavian artery.

RESULTS

There was 1 early death due to right heart failure. All survivors were discharged 15 days (range 9–58 days) after surgery without residual arch stenosis. Late death occurred in 1 patient with Cri-du-chat syndrome and airway stenosis. Two reoperations and 1 intervention for arch stenosis were performed. The 1-, 5- and 10-year survival was 92%. Freedom from reoperation or intervention for arch stenosis was 86% 1, 5 and 10 years after surgery. No occurrence of arch aneurysm formation, left main bronchial stenosis and significant hypertension was found during a median follow-up period of 5.5 years (range 0.3–13.3 years).

CONCLUSIONS

Augmenting the lesser curvature with an autologous vascular patch during arch reconstruction resulted in reasonable midterm outcomes.
Gender differences in lifestyle management among coronary patients and the association with education and age: results from the ESC EORP EUROASPIRE V registry
Authors: Vynckier Pieter , Ferrannini Giulia , Kotseva Kornelia , Gevaert Sofie , De Bacquer Dirk , De Smedt Delphine
Published: December 2021

Background

Lifestyle management is essential in the secondary care of coronary heart disease (CHD) patients. Little evidence is available about gender differences in lifestyle counselling and lifestyle compliance. This study aimed to provide an overview on potential gender differences in lifestyle advice provided by a healthcare professional and patients’ lifestyle compliance.

Methods and results

Analyses were based on the cross-sectional ESC EORP EUROASPIRE V survey including data on CHD patients across 27 European countries. Consecutive patients <80 years, hospitalized for a first or recurrent coronary event, were included in the study. Information on lifestyle management was collected from medical records, medical examination, and structured questionnaires during patient interviews (≥6 months to <2 years after hospitalization). Data were available for 8261 patients of whom 25.8% women. Overall, no gender differences were observed in lifestyle advice provided by a healthcare professional for smoking cessation advice, dietary advice, advice on losing weight, and physical activity advice (P > 0.05). However, a closer look at the particular actions to adopt a healthy diet revealed that women reported more frequently a reduction of their salt (68.6% vs. 73.7%; P = 0.002), fat (70.8% vs. 74.7%; P = 0.003), and calorie intake (56.8% vs. 60.5%; P = 0.004) compared to men. In contrast, women were less likely to increase their physical activity levels (55.5% vs. 48.0%; P < 0.001).

Conclusion

Despite little gender differences in lifestyle advice provided by a healthcare professional, lifestyle compliance for physical activity is worse in CHD women. Further actions are needed to increase physical activity levels in female CHD patients.
Associations Between Changes in Loneliness and Social Connections, and Mental Health During the COVID-19 Pandemic: The Women’s Health Initiative
Authors: Goveas Joseph S , Ray Roberta M , Woods Nancy F , Manson JoAnn E , Kroenke Candyce H , Michael Yvonne L , Shadyab Aladdin H , Meliker Jaymie R , Chen Jiu-Chiuan , Johnson Lisa , Mouton Charles , Saquib Nazmus , Weitlauf Julie , Wactawski-Wende Jean , Naughton Michelle , Shumaker Sally , Anderson Garnet L
Published: December 2021

Background

Older women have faced significant disruptions in social connections during the coronavirus disease 2019 pandemic. Whether loneliness increased or whether a change in loneliness from pre- to intrapandemic period was associated with mental health during the pandemic is unknown.

Methods

Older women (n = 27 479; mean age 83.2 [SD: 5.4] years) completed surveys in mid-2020, including questions about loneliness, living arrangements, changes in social connections, and mental health. Loneliness was also previously assessed in 2014–2016. We examined whether loneliness changed from the pre- to intrapandemic period and explored factors associated with this change. In multivariable models, we investigated the association of changes in loneliness and social connections with mental health.

Results

Loneliness increased from pre- to intrapandemic levels. Factors associated with worsening loneliness included older age, experiencing stressful life events, bereavement, histories of vascular disease and depression, and social connection disruptions. Factors associated with a decrease in loneliness included identifying as Black, engaging in more frequent physical activity, being optimistic, and having a higher purpose in life. A 3-point increase in loneliness scores was associated with higher perceived stress, higher depressive, and higher anxiety symptoms. Social connection disruptions showed modest or no associations with mental health.

Conclusions

Loneliness increased during the pandemic in older women and was associated with higher stress, depressive, and anxiety symptoms. Our findings point to opportunities for interventions targeting lifestyle behaviors, well-being, disrupted social connections, and paying closer attention to those with specific medical and mental health histories that may reduce loneliness and improve mental health.
Validation of Claims Algorithms to Identify Alzheimer’s Disease and Related Dementias
Authors: McCarthy Ellen P , Chang Chiang-Hua , Tilton Nicholas , Kabeto Mohammed U , Langa Kenneth M , Bynum Julie P W
Published: December 2021

Background

Using billing data generated through health care delivery to identify individuals with dementia has become important in research. To inform tradeoffs between approaches, we tested the validity of different Medicare claims-based algorithms.

Methods

We included 5 784 Medicare-enrolled, Health and Retirement Study participants aged older than 65 years in 2012 clinically assessed for cognitive status over multiple waves and determined performance characteristics of different claims-based algorithms.

Results

Positive predictive value (PPV) of claims ranged from 53.8% to 70.3% and was highest using a revised algorithm and 1 year of observation. The tradeoff of greater PPV was lower sensitivity; sensitivity could be maximized using 3 years of observation. All algorithms had low sensitivity (31.3%–56.8%) and high specificity (92.3%–98.0%). Algorithm test performance varied by participant characteristics, including age and race.

Conclusion

Revised algorithms for dementia diagnosis using Medicare administrative data have reasonable accuracy for research purposes, but investigators should be cognizant of the tradeoffs in accuracy among the approaches they consider.
Geriatric Interprofessional Education Theoretical Framework
Authors: Drost Jennifer
Published: December 2021

The literature is lacking in theoretically grounded techniques to teach interprofessional skills specific to caring for older adults. This presentation details how Wagner’s Chronic Care Model and the Constructivist/Active Learning theoretical frameworks were used in the design of an interprofessional education. The content of the education was modeled after Wagner’s chronic illness care model that advocates changes in processes and organizational structures to promote interprofessional team practice. The educational intervention follows a Constructivist/Active learning framework delivered in a simulation format. Constructivist approaches encompass active learning and guided experiential learning procedures, methods well-suited to our scaffolded simulation educational experience.
Geriatric Interprofessional Simulation Education Results and Rapid Cycle Quality Improvement
Authors: Kropp Denise
Published: December 2021

Following a geriatric interprofessional education event, we measured learner progression in interprofessional collaborative competencies using the Interprofessional Socialization and Valuing Scale (ISVS). We also measured student satisfaction with an investigator generated assessment tool. Through Rapid Cycle Quality Improvement (RCQI) processes, we implemented a number of variations of both the in-person and the virtual events. Variations included differences in case studies, pre work requirements, geriatric didactic topics, poster topics and presentation format, facilitator training, standardized patient or patient presence, huddle format, and demonstration of how to effectively perform teamwork. Results showed gains in interprofessional collaborative competencies between pre- and post-education using this geriatric simulation model. Learner satisfaction was high for all simulation variations. Results of education variations and comparisons of the delivery methods will be presented.
A DNAmCULTURE Epigenetic Fingerprint Recapitulates Physiological Aging
Authors: Minteer Christopher , Morselli Marco , Meer Margarita , Cao Jian , Lang Sabine , Pellegrini Matteo , Yan Qin , Levine Morgan
Published: December 2021

Aging elicits dramatic changes to DNA methylation (DNAm), however the causes and consequences of such alterations to the epigenome remain unclear. The utility of biomarkers of aging based on DNAm patterns would be greatly enhanced if in vitro models existed that recapitulated physiological phenotypes such that modulation could garnish mechanistic insights. Using DNAm from serially passaged mouse embryonic fibroblasts, we developed a marker of culture aging and asked if culture phenotypes, like exhaustive replication, are epigenetically analogous to physiological aging. Our measure, termed DNAmCULTURE, accurately estimated passage number and was shown to strongly increase with age when examined in multiple tissues. Furthermore, we observed epigenetic alterations indicative of early cultured cells in animals undergoing caloric restriction and in lung and kidney fibroblasts re-programmed to iPSCs. This study identifies culture-derived alterations to the methylome as physiologically relevant and implicates culture aging as an important feature in known epigenetic aging phenomena.
Navigating COVID-19 and Long-Term Care: Dementia Caregivers' Challenges and Strengths
Authors: Mitchell Lauren , Albers Elizabeth , Birkeland Robyn , Stabler Henry , Cha Jinhee , Gaugler Joseph
Published: December 2021

Persons with dementia living in long-term care settings have been especially affected by the COVID-19 pandemic, and their family caregivers have had to cope with numerous additional stressors during this time. We conducted 20 semi-structured interviews and gathered open-ended survey data from N=104 caregivers participating in an ongoing intervention trial at the start of the COVID-19 pandemic. Open-ended questions explored the difficulties caregivers have experienced in caring for and supporting a relative in long-term residential care. Caregivers provided their perspectives about services and supports that have facilitated coping with uncertainty, anxiety, and loss during the pandemic, and identified resources and strengths they have found helpful in caring for their relatives. Thematic analysis was used to identify themes reflecting the key challenges and supports that have emerged for caregivers, and to highlight caregivers' recommendations for promoting their and their relatives' well-being during this crisis.
Assessing Personality in Daily Life: Variability Between and Within Persons
Authors: Ferguson Giselle , Pasquini Giancarlo , Neubauer Andreas , Scott Stacey
Published: December 2021

Trait personality measures may not be able to detect subtle personality changes and fluctuations which may be indicative of cognitive impairment. Measuring personality in daily life may allow sufficient sensitivity to capture this within-person variability. Eighty-six older adults from the Einstein Aging Study completed items assessing daily extraversion and neuroticism for a median of 17 days. Using separate unconditional models, we calculated the proportions of variance in daily extraversion and neuroticism that were due to between-person and within-person variability. Variability in daily extraversion was relatively evenly related to between-person differences and within-person fluctuation (Intra-Class Correlation [ICC] = 0.576), but the majority of variability in daily neuroticism was at the between-person level (ICC = 0.730). Thus, although these daily assessments were sensitive enough to capture within-person variability in personality in daily life, different traits may exhibit more or less of this variability.
Personality and Socioeconomic Predictors of Midlife Cognitive Functioning in Mexican-Origin Adults
Authors: Lawson Katherine , Sutin Angelina , Robins Richard
Published: December 2021

The present study aims to identify personality and socioeconomic (e.g., education, per capita income, economic stress) factors that contribute to midlife cognitive functioning across middle adulthood. Specifically, we examined how the growth trajectories of personality and socioeconomic factors across 12 years predict subsequent cognitive functioning, using data from a large sample of Mexican-origin adults (N=1,110; median age at Time 1=37 years, age range at Time 1=26-65). Personality was assessed using the Big Five Inventory, which assesses the Big Five domains as well as specific facets of each domain; economic stress was assessed using measures of negative economic events (e.g., job loss) and economic hardship (e.g., difficulty paying bills). Cognitive functioning was assessed using the NIH Cognitive Toolbox with measures of memory, language, and executive function. Findings from this work will help identify intervention targets for promoting healthy cognitive aging in midlife and beyond in Mexican-origin adults.
Toward a Model of Age Inclusivity in Higher Education
Authors: Whitbourne Susan
Published: December 2021

The AFU principles clearly state the aspiration of promoting age inclusivity in higher education within the context of the UN Sustainability Development Goals. With these principles as a starting point, the Age-Friendly Campus Climate Inventory and Survey were developed to assess the extent to which AFU principles are put into practice (Inventory) and how campus constituencies perceive these practices. Based on social ecological models, a framework for measuring age inclusivity was developed in which practices ("objective environment") are compared to perceptions ("subjective environment"). Participating campuses (N=29) completed the inventory for each major executive unit, providing scores that were grouped by major campus functions, including research, teaching, community engagement, and support. By comparing these scores with perceptions of each function by samples of constituencies of faculty, staff, and students, it is possible to test the person-environment match as conceptualized by social ecological models providing important clarification for the AFU principles.
Observations and Recommendations Toward Increasing Age-Inclusivity
Authors: Silverstein Nina
Published: December 2021

Some areas of current campus practice better align with AFU principles than others. It may be that age-friendly practices already implemented by campus administrators are either not sufficiently publicized or that the campus constituents are not aware that these accommodations are in place. Specifically, staff members in these institutions appear to have markedly different perceptions of an institutions’ overall age-friendliness than did students and faculty. Lower ratings of age-friendliness by staff suggest that the experiences of ageism could contribute to negative outcomes such as stress and burnout. In line with Sustainable Development Goals (SDGs) in the evaluation of campus sustainability efforts, aging should be addressed along with other elements of diversity, equity, and inclusion. There is also a need to support faculty development for designing courses and materials for age-diverse learners. Finally, campuses might organize age-inclusivity task forces and regularly reassess their age-friendly progress.
Plasma Long Chain Fatty Acids and Cognitive Function in Older Adults: A Comparison of Statistical Analyses
Authors: Duchaine Caroline , Carmichael Pierre-Hugues , Presse Nancy , Fiocco Alexandra , Gaudreau Pierrette , Ferland Guylaine , Laurin Danielle
Published: December 2021

Omega-3 fatty acids (FAs) have been suggested as modifiable protective factors for cognitive decline because of their neuroprotective properties. However, the evidence is still inconsistent regarding types of omega-3 FAs, and the probable interrelation with other circulating long chain FAs (LCFAs). This study aimed to evaluate associations between 14 plasma LCFAs and four cognitive domains using a principal component analysis (PCA) and to compare results with those obtained using standard methods. A group of 386 healthy older adults aged 77 ± 4 years (53% women), selected from the NutCog Study, a sub-study from the Québec cohort on Nutrition and Successful Aging (NuAge), underwent a cognitive evaluation and fasting blood sampling. Verbal and non-verbal episodic memory, executive functioning, and processing speed were evaluated using validated tests. LCFAs circulating concentrations were measured by high-performance liquid chromatography using published procedures. Linear regressions adjusted for age, sex, education, and BMI were used to evaluate cross-sectional associations between LCFAs, using PCA or a more standard grouping (omega-3, omega-6, monounsaturated, and saturated LCFAs), and cognitive performance. Higher scoring on the omega-3 PCA factor and higher concentrations of total omega-3 FAs were both associated with better episodic non-verbal memory and processing speed. Higher eicosapentaenoic acid (EPA omega-3) was also associated with these two cognitive domains and with episodic verbal memory. The associations with total omega-3 FAs taken separately were of smaller magnitude than those with PCA. These results suggest that omega-3 FAs should be considered in combination with other LCFAs when evaluating the association with cognitive function.
Factors Associated With Nursing Home Residents’ COVID-19 Infections: A Systematic Review of Literature
Authors: Yin Cheng , Li Xiaoli , Zhan Rongfang , ONeill Liam
Published: December 2021

Background: Nursing homes were impacted disproportionately by the coronavirus because of their resident’s vulnerabilities and settings. Even many previous studies illustrated factors related to nursing home residents’ Covid-19 infections, there’s no such study epitomizing those factors systematically, while some factors were controversial in different studies. The article aims to summarize major types of factors and provide crucially influential implications for nursing homes to prevent and manage their resident infections. Methods: All articles published between 01 January 2020 - 15 January 2021 in English version were searched through three electronic databases (PubMed, Web of Science, and Scopus). Two authors screened and evaluated a total of 121 studies independently based on selection and extraction criteria. Results: Seventeen identified studies were included in the research, which involved five major types of factors (nursing home’s residence, nursing home, staff, resident, and others). Conclusion: nursing home’s county infection rate, size, and staff residence were the strongest significant factors in many studies. Per-capital income, symptom-based screening and testing, and asymptomatic individuals have impacted resident’s infections variously since the beginning of the pandemic. Nursing home’s star rating and a total count of fines became factors when considered its locations. Other factors, including nursing home’s type, historical health deficiencies, staffing level, and staff working different facilities, etc., were also significant factors. The value of factors suggests healthcare systems reflect appropriate measures and allocate more resources to nursing homes in high prevalence counties on the basis of universal allocation.
Rich and Balanced Experiences of Daily Emotions Are Associated With Activity Diversity Across Adulthood
Authors: Lee Soomi , Urban-Wojcik Emily , Charles Susan , Almeida David
Published: December 2021

We examined whether the diversity of daily activities (“activity diversity”) is associated with the diversity of daily emotions (“emodiversity”) and if the association differs by age. Two samples of adults from the Midlife in the United States Study provided activity and emotion data for eight days. Greater activity diversity was associated with greater positive and negative emodiversity in each sample. Age moderated the association between activity diversity and positive emodiversity in an older sample, such that association was stronger for younger adults than for older adults. Results from data combining the two samples revealed that the associations of activity diversity with positive or negative emodiversity were significant when age < 70, 71 years, respectively. Broad and even participation of daily activities may provide more opportunities to experience rich and balanced emotions in adulthood. The weaker associations in older age may suggest the need to promote active lifestyles in later life.
A Comparative Assessment of Long-Term Care Financing and Service Delivery Models
Authors: Polivka Larry , Polivka-West LuMarie
Published: December 2021

The face of public long term care (LTC) funded largely through the Medicaid program is changing rapidly in the U.S. Over the last decade, most states have moved to managed LTC programs in various forms, with a growing number transferring all their programs, home and community based (HCBS) and nursing home services, to a Medicaid (MLTC) model. The amount of rigorously conducted and reported evaluation results on these programs are still very limited. Enough information is available, however, from other sources for at least preliminary comparison of relative cost-effectiveness of MLTC vs. traditional, non-profit models of public LTC services delivery and financing, as discussed in this paper. This comparison will show that, at this point, the MLTC programs are not more cost-effective than the traditional model of LTC administration. In fact, these initial assessments seem to indicate that the traditional model may be superior to the corporate for-profit MLTC model.
Information Seeking During the Pandemic: The Role of Age, Agency, and Fake News Concerns
Authors: Pearman Ann , Hughes MacKenzie , Coblenz Clara
Published: December 2021

COVID-19 brought rapid changes to the way in which people understand and process news, including both information and misinformation about the pandemic. This cross-sectional study was designed to examine persons’ experiences during the earliest months of the pandemic. The sample included 871 adults ages 20-79 (M=38.27 years, SD=11.40). Online surveys were collected between March and May, 2020 using Amazon Mechanical Turk. Participants completed a series of questionnaires, including a measure of agency from the Midlife Development Inventory, a questionnaire that assessed level of skepticism about the COVID-19 pandemic (i.e. fake news beliefs), a depression scale, a question about their level of anxiety about developing COVID-19, and questions about the frequency in which they sought information about the pandemic from different sources (e.g., TV, social media). A multiple regression using information seeking frequency as the outcome variable revealed several significant relationships. Specifically, younger adults, people with higher agency, and people with higher fake news beliefs all reported higher levels of COVID-19-related information seeking. In addition, there was a significant 3-way interaction between age, agency, and fake news beliefs. Disentangling this interaction revealed that older adults with low agency were least likely to engage in information seeking. There were, however, no age differences in information seeking in participants with high agency and fake news beliefs, but large age differences in participants with low agency but high fake news beliefs. Findings suggest agency is an important predictor of information seeking behavior, particularly for older adults with high levels of skepticism about the pandemic.
A Community-Based System Dynamics Study of the Senior Community Service Employment Program
Authors: Halvorsen Cal , Werner Kelsey , McColloch Elizabeth
Published: December 2021

The Senior Community Service Employment Program (SCSEP), the only federal workforce-training program that targets older adults, engages people aged 55 years and older with incomes at or below 125% of the federal poverty level with multiple barriers to employment. This study examined SCSEP’s role in participant financial, physical, and mental well-being. To do so, we held five sessions (four virtual, one telephone) over a combined nine hours in August and September 2020 using a form of participatory research called community-based system dynamics with 15 Massachusetts SCSEP participants and case managers. Through structured activities, respondents identified how program, policy, and organizational factors influence and are influenced by participant well-being (e.g., SCSEP participation results in less social isolation, decreased isolation subsequently increases desire to participate) as well as program and policy recommendations to strengthen the program (e.g., reconsider benchmarks of success). These findings highlight the benefits and potential of this long-running program.
Geriatric Oncology in the Instagram Era: PhotoVoice to Enable Patient-Centered Care and Shared Decision Making
Authors: Blackberry Irene , Steer Christopher , Rasekaba Tshepo , Young Kim , Webb Nicole , Jayasuriya Darren , Owen Kylie , Kapur Mira
Published: December 2021

Evidence shows that multidimensional assessment of older adults with cancer yields more holistic care and results in better communication about age-related concerns; as well as enables personalised, patient-centered supportive care. Geriatric assessment (GA) captures clinical, physical and psychological factors, with limited opportunity to gather information about the patient’s environment, personal contexts and priorities. We trialed the feasibility and acceptability of geriatric assessment (GA)-guided enhanced supportive care (ESC) among 20 adults aged over 70 years in a regional cancer center. We then studied the impact of the integration of four patient-derived photographs (with PhotoVoice analysis) to this ESC on patient satisfaction with communication with the oncologist regarding age-related concerns and on facilitating empowerment, patient-centered care and shared decision making. The use of PhotoVoice analysis of patient-derived photographs is a novel strategy that can facilitate gathering patient-centered information during the assessment process.
Driving Habits of Older Adults in Massachusetts: Variations by Sex, Age, Race, Income, Housing Density, and Health
Authors: Li Wenjun , ProcterGray Elizabeth , Kane Kevin , Cheng Jie , Clarke Anthony
Published: December 2021

Maintaining ability to drive is critical to independent living among older adults residing in suburban and rural communities. We administrated structured questionnaire about driving behaviors to 370 persons age 65 and older living in Central Massachusetts between 2018 and 2020. Of them, 307 were active drivers. Driving in the past year was strongly associated with being male, White race, higher income, non-urban resident, and good-to-excellent health. Advancing age was associated with lower frequency of driving, less miles driven, lower percentage of the day spent in transportation. Men and women drove with nearly equal frequency (~26 days/month), but men drove significantly more miles. Non-White drivers were significantly more likely to avoid driving out of town or in difficult conditions, even after controlling for age, sex, income, and density of residential area. In conclusion, driving behaviors differed significantly by age, sex, income, race, and housing density. Further investigation is warranted.
Race, Ethnicity, and Social Engagement Among Community-Dwelling Older Adults: The Health and Retirement Study
Authors: Quach Lien
Published: December 2021

Social engagement is crucial for older adults. This study examines the relationship between race, ethnicity, and social engagement among community-dwelling older adults using data came from the Health and Retirement Study (2014) (n=6221). Race and ethnic status were categorized as: non-Hispanic white (NHW), non-Hispanic black (NHB), non-Hispanic “Asians and other race” (NHA) and Hispanic (any race). Social engagement was based on self-report and included keeping in touch with friends, family and participating in social activities. Covariates included age, sex, education, number of comorbidities, physical function, and alcohol consumptions. The mean age was 74.6, 60% were female. Race and ethnicity distribution were 78.6% NHW, 11.9% NHB, 7.89% Hispanics, and 1.7% NHA. The social engagement (SE) score averaged 3.3. Hispanics, Asians and other races had a lower SE score compared with NHW (b=-0.29, p<.0001; b=-0.27, p=0.04). Understanding racial and ethnic disparities in SE can help target appropriate social intervention.
Adding Person-Centered Measures to Research on Detection and Diagnosis of Dementia
Authors: Maslow Katie
Published: December 2021

In the United States, numerous studies on detection and diagnosis of dementia show that large proportions of subjects refuse initial screening tests. Moreover, among those who accept the tests, score poorly, and are therefore referred for a diagnostic evaluation, large proportions do not follow up to get the evaluation. Available data on characteristics of subjects who refuse initial screening and follow-up evaluation suggest that incorporating procedures based on person-centered concepts and practices, such as procedures that acknowledge individuals’ unique characteristics and attempt to involve, enable, and empower them, could lead to more effective detection and diagnosis. Based on results of an analysis of measures used in studies conducted in the U.S. and elsewhere, this presentation will describe frequently used measures and identify person-centered measures that could be added to studies of alternate procedures intended to increase detection and diagnosis.
Person-Centered Assessment: Evaluating Positive Psychosocial Measures in Dementia Research
Authors: Mast Benjamin , Molony Sheila
Published: December 2021

Person-centered principles continue to redefine the nature of dementia care, but less attention has been given to integration of person-centered principles into clinical assessment and dementia research. As a result, identification of deficits and cognitive impairment tends to dominate clinical and research efforts, whereas strengths and positive characteristics need more research. This paper examines existing positive psychosocial measures of psychological wellbeing, hope, spirituality, resilience, social relationship, dignity, and at-homeness. Many of these measures demonstrate strong psychometric properties and have been identified as promising outcome measures for strengths-based studies and approaches to care. This paper will evaluate the extent to which these measures used a person-centered approach to item development and testing, and whether item content is consistent with person-centered principles. Future directions for instrument development require greater inclusion of people living with dementia and family caregivers.
Factors Affecting Cognitive Dysfunction Screening for Latinx Adults With Type 2 Diabetes
Authors: Cuevas Heather , Zuñiga Julie , Morgan Stephanie
Published: December 2021

Before development of overt type 2 diabetes (T2DM), changes in brain structure and activation patterns are found in insulin resistance, indicating many with T2DM may already have alterations in cognitive function. How best practices are met for screening for cognitive dysfunction, specifically Latinx adults with T2DM who are at higher risk, remains unclear. The purpose of this study was to examine aspects influencing screening Latinx adults with T2DM for cognitive problems by identifying patient-, clinician- and clinic- level factors. This was a mixed methods study which used semi-structured interviews with Latinx adults with T2DM (n=30; mean age: 68; 57% Mexican American); surveys and interviews with health care providers (n = 15); and inventories of four outpatient clinics to identify factors (e.g. time, clinic policies) influencing screening. Data were analyzed via thematic analysis (interviews) and descriptive statistics (surveys and inventories). For patients, screening was important, but inability to work related to a possible diagnosis of dementia was a concern. Providers and patients agreed other health issues (e.g. hyperglycemia) took precedence to screening. Providers (96.7%) were expected to screen but did not have support/time from clinics and relied on patients for initial prompts. Only one clinic reported staff education on cognitive screening with an emphasis on potential cultural differences in test results and adequate resources related to dementia for Latinx adults. Clinics serving Latinx adults have a responsibility to deliver appropriate care. Leadership should consider innovative practices such creation, with patients, of educational materials for screening -a need highlighted by most participants.
Benefits and Barriers to Emerging Technologies to Promote Health, Well-Being, and Independence of Older Adults
Authors: Boot Walter
Published: December 2021

Emerging technologies, such as voice assistant systems and artificial companion robots, hold a great deal of promise for improving the health, wellbeing, and independence of older adults. However, these solutions will likely be ineffective in the absence of research to understand barriers to the adoption and use of these technologies and without an exploration of the needs and preferences of older adults. This symposium focuses on both the potential of such technologies and factors that may affect their success. H. Spangler will present a detailed analysis of privacy concerns of older adults, with and without cognitive impairment, related to the use of Voice Assistant Systems (VAS). R. Nicholson will discuss the potential of a VAS app for promoting exercise among older adults and their caregivers to enhance mobility independence, with a focus on perceived benefits and dislikes about the app that may impact use. Finally, C. Berridge will present an exploration of perceptions of and attitudes toward artificial companion (AC) robots across the lifespan, before and after the start of the COVID-19 pandemic, including concerns about privacy. Together, these talks will highlight novel methods through which emerging technologies can support older adults and issues to consider if these methods are to produce meaningful change.
Overview of NIA Budget
Authors: Hodes Richard
Published: December 2021

Dr. Hodes will discuss budget and overall research priorities for the National Institute on Aging.
Using Administrative Claims to Model Health-Related Behaviors: Measures of Screening and Medication Adherence
Authors: Yashkin Arseniy
Published: December 2021

We demonstrate how administrative claims records can be used to model certain behavioral patterns and associated health effects. The inability of administrative claims, which are in essence a billing record, to account for differences in behavior is a major limitation of such data which usually requires an externally linked source to overcome. However, for certain diseases, for which well-defined and accepted guidelines on screening and medication use exist, the claims themselves can provide a way for modeling health-related behavior. A practical application to screening and medication adherence for type ii diabetes mellitus is presented. Diverse methods of the calculation of such indexes with their pros, cons and variation in identified effects are discussed and demonstrated using results based on administrative claims drawn from a 5% sample of Medicare beneficiaries.
Differences in the Racial Contribution of Dementia and Chronic Conditions to Hospitalization, SNF Admission
Authors: Allore Heather
Published: December 2021

We estimate the contribution for experiencing hospitalization, skilled nursing facility admission and mortality using a measure of attributable fraction that incorporates both the prevalence, incidence and risk called Longitudinal Extension of the Average Attributable Fraction (LE-AAF). We estimate the LE-AAF for Non-Hispanic whites and Non-Hispanic Blacks for dementia and 10 chronic conditions, for three outcomes. This approach analyses the temporal relationships among conditions to estimate their population-level average attributable fractions. Unlike standard measures of attributable fraction, the sum of the contribution of each condition based on the LE-AAF will not exceed 100 percent, enabling us to compute the contribution of pairs, triads or any combination of conditions. Furthermore, in studying multimorbidity, the LE-AAF has the desirable feature of being based on all combinations of the risk factors and covariates present in the data with final values for the individual LE-AAFs obtained by averaging across these observed combinations of predictors.
Longitudinal Effects of Stress and Cognitive Fusion in Anxiety and Depressive Symptoms of Family Caregivers
Authors: Barrera-Caballero Samara , Carlos Vara-García Rosa Romero Moreno , Olazarán Javier , Pedroso Chaparro María del Sequeros , Jiménez-Gonzalo Lucía , Fernandes-Pires José Adrián , Losada-Baltar Andrés
Published: December 2021

Dementia caregiving has been commonly associated with negative psychological consequences in caregivers. Cognitive fusion, that is, the tendency for been overly influenced by cognition, has been linked to psychological distress in caregivers in cross-sectional studies. Female caregivers and those who are exposed to more stressors such as behavioral and psychological symptoms of dementia report higher levels of distress. However, longitudinal analysis of predictors of caregivers levels of distress are sparse, with no available study analyzing the longitudinal effect of cognitive fusion. The aim of this study is to analyze the longitudinal effect of cognitive fusion in depressive and anxiety symptoms of family dementia caregivers, after controlling for other relevant variables. Face to face interviews were conducted each year through a two-year period (three assessments) with 143 caregivers. Linear mixed models analysis were used to analyze the associations between time-varying values for cognitive fusion, frequency and reaction to care-recipient behavioral problems and depressive and anxiety symptoms, after controlling for caregivers’ age and gender, daily hours and time caring, care-recipient functional capacity and caregivers’ transitions (cessation of caregiving). Results suggest that increases in cognitive fusion and in reaction to behavioral problems, being a female caregiver and being younger, significantly predicted increases in anxiety symptoms over time. Also, increases in cognitive fusion and in reaction to behavioral problems, decreases in care-recipient’s functional capacity and ending of the caregiving role significantly predicted increases in depressive symptoms. Psychological strategies aimed at reducing cognitive fusion and stress levels may be especially helpful for reducing caregivers’ distress.
Met and Unmet Needs of Cognitively Impaired Older Adults and Burden and Benefits of Their Caregivers
Authors: Sung Pildoo , Suen Johan , Hashim Nawal , Malhotra Rahul , Chan Angelique
Published: December 2021

Previous studies typically assess caregiver needs when trying to interpret caregiver burden. We propose that both met and unmet needs of care recipients translate into different caregiving experiences with varying levels of benefits and burden combined. We use data on 263 caregivers of community-dwelling Singaporean older adults with cognitive impairment who participated in a community-based dementia care study conducted in 2018-2020. Our analysis produces three major findings. First, latent class analysis identifies three distinct types of caregiving experience based on caregiver-reported burden and benefits of caregiving: intensive (high burden and high benefits, 11% of caregivers), satisfied (low burden and high benefits; 54%), and dissatisfied (low burden and low benefits; 35%). Second, multinomial logistic regression shows that both met and unmet needs of care recipients are positively associated with the intensive caregiving experience, while only met needs are positively associated with the satisfied caregiving experience, in comparison to dissatisfied caregiving experience. Third, met needs in the areas of daytime activities, memory assistance, and mobility are positively related to the satisfied caregiving experience, compared to the dissatisfied caregiving experience. In other words, caregivers are more likely to be satisfied in their caregiving experiences (i.e., low burden and high benefits) if their care recipients’ problems with memory, mobility, and finding suitable and adequate daytime activities are properly managed. Our findings thus call for interventions to fulfill care recipients’ needs in a more tailored manner in order to increase satisfaction among caregivers.
Preliminary Findings of a National Survey of Black ADRD Family Caregivers
Authors: Robinson-Lane Sheria , Johnson Florence , Mazzara Nicholas , DeMarco Kayla , Dinov Ivaylo
Published: December 2021

The National Caregiver Survey aims to capture a representative sample of Black Alzheimer’s disease and/or related dementias (ADRD) family caregivers who are 55+ to better understand the relationships between adaptation to caregiving, coping, and health. Following targeted social media marketing, ADRD family caregivers (n=60) completed an electronic survey capturing over 200 data elements. Analysis was completed using Spearman correlation coefficients. Preliminary results suggest that 55% of participants were hypertensive (n=33) and 27% (n=16) had diabetes. Participants were generally overweight with an average BMI of 29. 28% (n=17) of the sample were smokers. A negative correlation was identified between the level of care needs of the recipients (IADLs) and alcohol use (p=0.037). There was also a correlation between identifying positive aspects of caregiving and adaptive coping (p=0.045). Caregiver support programs should facilitate development of effective coping strategies for new family caregivers, with particular attention on smoking cessation, brain-healthy diet, and exercise.