bluuebunny/crossref_metadata_2025 huggingface dataset:
THE GENERALIST RESOURCE TO INTEGRATE DRIVING: MEASURING THE CLINICAL UTILITY OF THE GRID TOOL
Authors: Dickerson Anne , Cassidy Terri , Touchinsky Susan
Published: January 2025

Cut-off scores for driving evaluations are based on the concept that a score indicates whether the individual is likely to pass or fail a driving evaluation. Cut-off scores should be derived from research over multiple studies used with diverse populations. Assessments develop scores based on specific populations (e.g., dementia) which may not be valid for other populations (e.g., stroke). Thus, when using scores, it is critical to understand the population and range of scores upon which it is based. The Generalist’s Resource to Integrate Driving (GRID) is a resource for practitioners to integrate driving into their practice and use scores appropriately. The tool is designed to provide specific guidelines to evaluate, create and implement intervention plans using the schematic of red (stop driving), green (ok to drive) and yellow (needs further evaluation). The aim of this study was to evaluate the utility of the GRID by practitioners who used it. Results of the IRB approved Qualtrics survey with 70 respondents showed 79% indicated they used while 21% had not, although 10% plan to use it. Also, 69% of users found it easy-to-use, 73% indicated it was easy to understand, and 63% felt it was comprehensive. and use scores appropriately 51% respondents indicated the most important use was screening for driving risk although planning a referral to a driving evaluation was a close second. This presentation will briefly explain the use of the GRID, the model upon which it is based and discuss the results of the utility study.
THE RELATIONSHIP BETWEEN LONELINESS AND PUBLIC TRANSPORTATION CARDS FOR OLDER PEOPLE
Authors: Mercan Murat , Yigit Oykum , Yurekli Hulya , Aslan Ilker
Published: January 2025

Active aging is critical to combating social isolation and loneliness. Scientific studies have found that even small increases in activity can reduce the risk of disease in the older people. One method that can be used to achieve these goals is providing discounted and free transportation cards for seniors. However, the number of studies measuring the effect of these cards on isolation and loneliness is very limited. This article aims to fill that gap. The paper consists of two parts. The first part is based on big data analysis. It investigates the daily transportation data provided by the Istanbul Metropolitan Municipality to examine how discounted (for individuals aged 60-65) and free (for those aged 65 and over) transportation cards affect the frequency of public transportation usage among individuals aged 50 and over between 2019 and 2022. The analysis, utilizing more than 400 million observations, holds tremendous original value. In the second part of the project, a representative survey is conducted among individuals aged 50 and over in Istanbul. This survey aims to measure the relationship between discounted and free transportation cards and social isolation and loneliness. Regression discontinuity, exploratory and confirmatory factor analyses, and logistic regression analysis methods will be employed for the analyses. The findings indicate an inverse relationship between loneliness and public transportation usage among the older people.
A WALK-THROUGH DEMENTIA: UNDERSTANDING ALZHEIMER’S DISEASE OR RELATED DEMENTIA THROUGH YOUTUBE VR VIDEOS
Authors: Li Xiaoli , Liu Xiaoyu , Alanazi Eman , Goss Arianna
Published: January 2025

Emerging research has highlighted the potential of Virtual Reality (VR) as a tool for raising awareness of Alzheimer’s disease or related dementia (ADRD) among healthcare students and professionals. However, there is limited VR research focused on engaging the general public. This research aimed to examine the issues faced by YouTube users who interacted with the VR application “A Walk-Through Dementia” by analyzing their posts. We collected 12,754 comments from VR videos ‘A Walk-Through Dementia’, which simulate the everyday challenges faced by individuals with ADRD, providing viewers with an immersive experience on the condition. We conducted topic modeling to gauge viewer opinions and reactions to the videos. A pre-trained BERT model was utilized to transform YouTube comments into high-dimensional vector embeddings, enabling systematic identification and detailed analysis of principal topics and their intrinsic thematic structures within the dataset. Our analysis identified five distinct topics. The predominant topic, reflected in 2,917 comments, focused on users’ personal experiences regarding the impact of ADRD on patients and caregivers. The other topics were organized into four main categories: support and empathy for individuals affected by ADRD, the absence of caregiver, unfriendly environment, and positive reactions to the VR experience. With the technique of topic modeling, the present study indicated that the VR application is an engaging and experiential learning tool that can provide public with deeper awareness of living with ADRD. Future research need explore more VR applications on social media as it has the potential to reach broader audiences that disseminate knowledge of ADRD.
CULTURE AND COGNITION: RISK FACTORS FOR ALZHEIMER’S DISEASE IN US HONOR CULTURES
Authors: Harrington Erin , Bock Jarrod
Published: January 2025

Alzheimer’s disease is the sixth leading cause of death among all Americans. As the prevalence of Alzheimer’s disease and related dementias (ADRD) continues to grow, researchers and clinicians are ever cognizant of cultural predictors that may contribute to ADRD risk. One cultural approach not yet examined within the context of ADRD is honor cultures (i.e., primarily southern and western states), where reputation management and defense are paramount. Normative behaviors within honor cultures (e.g., risk taking, military involvement, intimate partner violence) may heighten ADRD risk, particularly related to traumatic brain injury (TBI) and subjective cognitive decline (SCD). Further, the lack of general and mental health resources and stigma toward help-seeking in honor cultures likely leave these outcomes untreated. As such, the present study used statewide data collected between 2009-2019 to examine links between statewide honor-orientation and unintentional TBI death rates, frequency of SCD, and AD death rates. Honor-orientation was a significant predictor of unintentional TBI death rates (ß =.44, p <.001), SCD frequency (ß =.58, p =.004), and AD death rates (ß =.41, p =.048), over-and-above state-level covariates (i.e., rurality, temperature, economic conditions, healthcare access). Taken together, individuals in honor cultures appear to be more likely to experience TBI, SCD, and heightened AD mortality, which might confer greater risk for ADRD. Additional research is required in this area to further assess ADRD risk within honor cultures, as individuals living within these cultures may benefit from culturally specific education and prevention efforts to reduce risk.
ENGAGING OLDER ADULTS AND CAREGIVERS IN THE DEVELOPMENT OF A COUNTYWIDE DEMENTIA STRATEGIC PLAN
Authors: Reyes Mariana , Barragan Noel , Craypo Lisa , Schwarte Liz , Jeffroy-Meynard Anne-Celine , Kuo Tony
Published: January 2025

In 2021, the Los Angeles County Department of Public Health launched the CDC-funded Los Angeles County BOLD Initiative (LA BOLD), the primary outcome of which is a strategic plan focused on improving dementia infrastructure and supports in Los Angeles County. To ensure that the plan aligns with concerns and priorities of older adults and caregivers impacted by dementia, LA BOLD partnered with Ad Lucem Consulting to conduct a series of 10 listening sessions with 92 participants to share their perspectives, experiences, and concerns related to dementia awareness and care between September and October 2022. To ensure inclusion of a diverse cross-section of community voices, sessions were held either virtually or in-person and conducted in English, Spanish, Korean, and English/Samoan. Sessions were held in strategic partnerships with multiple community organizations spanning the county’s Supervisorial Districts. Session topics were organized around the three strategic plan focus areas: Hypertension Prevention & Management, Early Detection, and Advance Care Planning. Overall, participants were appreciative of the opportunity to discuss dementia and related health issues. Key findings point to disparities in knowledge and accessible services (e.g., culturally appropriate messaging, inconsistent detection/referral, stigma, insufficient caregiver supports). A number of actionable recommendations emerging from the findings can be addressed in the strategic plan, offering valuable insights for policymakers and public health professionals on how to address this condition in the county and other communities. This presentation will highlight key findings and provide suggested solutions to facilitating equitable services/resources for dementia prevention and management.
MOTIVATIONS FOR AND EXPERIENCES OF UNDERGOING AN AMYLOID SCAN: A SYSTEMATIC REVIEW OF QUALITATIVE STUDIES
Authors: Couch Elyse
Published: January 2025

Amyloid positron emission tomography (PET) scans are a tool that could improve the accuracy of dementia diagnoses. The FDA approval of new amyloid targeting monoclonal antibodies makes it increasingly likely that amyloid scans will be implemented into routine clinical care. This systematic review aimed to identify and summarize qualitative studies exploring patient and care partner experiences of undergoing an amyloid scan. Seven papers were included in this review. We identified four themes related to patient and care partner experiences of receiving an amyloid scan. 1) motivations for undergoing an amyloid scan, 2) experiences of receiving the result, 3) emotional responses to the result, and 4) actions in light of the scan result. Participants reported undergoing the scan to learn more about the patient’s condition. They described the information gained from the scan as helpful but, in some cases, struggled to recall the terminology used by the clinicians or the meaning of the scan result. Emotional responses to the scan varied depending on the scan result and those with “elevated” scan results were more likely to express feelings of distress. The most common action following the scan result was making advanced plans. Aside from determining eligibility for prescribing monoclonal antibodies, amyloid scans provide patients and their care partners with useful and actionable information. However, learning the scan result could be distressing. Future research is needed to understand how to balance the potential benefits and harms of amyloid scans in light of novel dementia treatments.
RELATIONSHIP BETWEEN PHYSIOLOGICAL MEASURES AND COGNITIVE FUNCTION IN OLDER ADULTS WITH DEMENTIA
Authors: Zeng Derong
Published: January 2025

This study explores the interrelationships among physiological indicators in dementia patients, focusing on the correlation between Mini-Mental State Examination (MMSE) scores and indicators like blood pressure, heart rate, and body temperature, aiming to contribute new insights for early dementia diagnosis and treatment. Research involved 337 dementia patients, employing descriptive statistical analysis, correlation analysis, multivariate linear regression, and principal component analysis, with ethical approval from Kyoto University Hospital Ethics Committee (R3258). Findings reveal an average MMSE score of 21.69 (SD=5.33), highlighting a significant positive correlation between diastolic blood pressure (DBP) and MMSE scores (r=0.139, p=0.0030), while associations with systolic blood pressure, pulse rate, and body temperature were not significant. The first principal component accounted for 40.51% of variance, indicating that DBP may significantly impact cognitive function in dementia patients, suggesting blood pressure management’s potential in cognitive function maintenance. However, weak associations with other physiological indicators underscore dementia’s complexity, influenced by multiple factors.
TRANSITIONAL CARE TRENDS IN BENEFICIARIES WITH HEART FAILURE AND DEMENTIA
Authors: Bayer Thomas , Varma Hiren , Hollmann Peter , Gozalo Pedro
Published: January 2025

Medicare Transitional Care Management (TCM) has grown since its introduction in 2013, but we know little about utilization among beneficiaries with dementia (BWD) undergoing the complex care transition from hospital to skilled nursing facility to home (hospital-SNF-home). We studied trends in TCM among BWD discharged to various care settings after heart failure hospitalization, given heart failure’s high readmission risk and amenability to care management. We selected a sample of BWD heart failure hospitalizations in years 2013-2018 using the Chronic Conditions Warehouse algorithm for Alzheimer’s Disease and Related Dementias and principal diagnostic codes of hospital claims. Next, we excluded all except hospital-home and hospital-SNF-home discharges. We then fit a linear regression with TCM as the dependent variable and discharge year, discharge type, interaction of year and discharge type, race, age, dual status, and sex as predictors. TCM after hospital-home discharges grew from 521 (5.3%) of the 9,930 eligible discharges in 2013 to 2,015 (15.9%) of the 12,706 eligible discharges in 2018. In contrast, TCM after hospital-SNF-home discharges grew from 80 (4.0%) of the 1,990 eligible discharges in 2013 to 207 (9.9%) of the 2,095 eligible discharges in 2018. The P-value for the interaction between year and discharge type was <.001. The proportion of BWD utilizing TCM after heart failure hospitalization grew less among hospital-SNF-home discharges than hospital-home discharges. Further study is needed to understand why TCM utilization in hospital-SNF-home discharges has lagged behind hospital-home discharges and to estimate TCM’s effect on the success of discharge from SNF to home.
AD-RISK FACTORS AND TIMED UP AND GO TASKS IN IMPAIRED AND UNIMPAIRED OLDER ADULTS
Authors: Price Ashley , Stradtman Megan , Alber Jessica , Durkin Maeve
Published: January 2025

The Timed Up and Go (TUG) is a clinical assessment tool evaluating mobility and dual-task function. This study examined TUG performance in a sample of cognitively unimpaired (CU) older adults at low risk (LR)/high risk (HR) for Alzheimer’s disease (AD) and a group of mild cognitive impairment (MCI) patients. 194 older adults aged 55-80 (82 M, 112 F) comprised 3 groups: 75 CU LR, 76 CU HR, and 32 MCI. Having at least one copy of the APOE E4 allele designated CU participants as high risk for AD. The TUG is a 20-foot walking task, and TUG-DT adds serial subtractions to the original task to determine dual-task cost (DTC). Both TUG and TUG-DT tasks were completed (2 runs each) during clinical assessment. DTC was calculated for both number of steps and time to completion to determine the change in performance from single to dual task. Univariate ANOVA assessed the group differences in key TUG outcome variables (number of steps, time to completion). Though the completion time for TUG-run1 was as expected (LR< HR< MCI), practice effects were suspected in TUG-run2 as group completion times were not significantly different. Additionally, significant differences were identified in TUG-DT time between LR and MCI (p=< 0.001) and HR and MCI (p=0.003). There were significant differences in TUG/TUG-DT steps between the LR and HR groups and LR and MCI. This suggests improved gait efficiency in the LR CU group, compared to both the HR and the patient group. DTC for time or steps showed no significant group differences.
AGING TRAJECTORY OF THE JAPAN SCIENCE AND TECHNOLOGY AGENCY INDEX OF COMPETENCE (JST-IC): THE OTASSHA STUDY
Authors: Kawai Hisashi , Imamura Keigo , Ejiri Manami , Sasai Hiroyuki , Fujiwara Yoshinori , Ihara Kazushige , Hirano Hirohiko , Obuchi Shuichi
Published: January 2025

The Japan Science and Technology Agency Index of Competence (JST-IC) was developed to measure higher levels of competence than measured by the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), which evaluates higher-level functional capacity necessary for independent daily life. This study compared the aging trajectory between the JST-IC and TMIG-IC among community-dwelling older Japanese individuals. The participants were 775 adults who participated in the health check-up of the Otassha study three or more times between 2014 and 2019. Three patterns of aging trajectories of the JST-IC and TMIG-IC were identified using group-based trajectory modeling. Each subscale trajectory of the JST-IC included technology usage, information practices, life management, and social engagement. Scores for the high (30.4%), medium (15.5%), and low (15.2%) JST-IC trajectories decreased by 1-2 points according to age. High stability (49.9%), late-onset decrease (41.2%), and early onset decrease (8.9%) TMIG-IC trajectories were identified, and the late-onset and early onset decrease groups decreased by 1-3 points with age. Scores for technology usage, life management, and social engagement declined with age, similar to the total score of the JST-IC; however, scores for information practice tended to remain at the same level as at 65 years of age. The participants in this study participated in a longitudinal survey, and higher-level functional capacity was almost maintained; however, we found that the JST-IC score gradually declined with age in all patterns. It has been suggested that this decline is associated with a decline in technology usage, life management, and social engagement.
DEPRESSION ANXIETY STRESS SCALE IN OLDER ADULTS: ITEM RESPONSE THEORY AND CONFIRMATORY FACTOR MODELS
Authors: Liu Wen , Zimmerman M Bridget , Hadlandsmyth Katherine , Smith Tracey , Buckwalter Joseph A , Green David M , Dindo Lilian , Rakel Barbara
Published: January 2025

The Depression Anxiety & Stress Scale (DASS) is a commonly used tool to assess patient-reported symptoms of depression, anxiety, and stress, and has been translated into multiple languages. This study examined the psychometric properties of DASS in older U.S. Veterans who experience knee pain prior to Total Knee Arthroplasty. A total of 660 Veterans (age 66.7 □ 9.1 years; 88% male; 72.2% white, 61% married) were consented and screened for enrollment in an on-going, double-blind, two-arm, randomized controlled trial, evaluating the efficacy of an Acceptance and Commitment Therapy intervention. All Veterans completed DASS during post-consent screening. Confirmatory Factor Analysis was conducted to examine the fit of the data to a 3-factor structure (Depression, Anxiety, Stress). After unidimensionality was confirmed, Item Response Theory (IRT) analysis was conducted to examine item difficulty and discrimination within each factor. The 3-factor structure showed desirable model fit such that there were strong correlations among three factors (r ranges =.837-.883, p<.001). The three factors showed acceptable to desirable internal consistency (Cronbach alpha=0.904 for Depression, 0.767 for Anxiety, 0.883 for Stress). DASS showed acceptable model fit as a 3-factor model to IRT. Items in each factor showed acceptable discriminations and spread evenly on difficulty levels. Item and test information curves were unimodal and nearly symmetric. DASS has been adopted worldwide as a self-report assessment of distress. Findings support the use of the 3-factor structure in older Veterans. Further research is needed to investigate performance of DASS in Veterans with more diversity in gender and socioeconomic status.
DYNAPENIA-OBESITY AND PHYSICAL FUNCTION AMONG MEXICAN AMERICAN OLDER ADULTS: NATIVITY DIFFERENCES
Authors: Brandt Anita , Snih Soham Al
Published: January 2025

We used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine nativity differences in the relationship between dynapenia-obesity and physical function decline over 12-years of follow-up (2004/05-2016) among 767 Mexican Americans aged ≥75 years with a score ≥7 on the Short Physical Performance Battery (SPPB) at baseline. Measures included socio-demographics, medical conditions, body mass index (BMI), depressive symptoms, cognitive function, and disability. Dynapenia was defined as handgrip strength (< 27 Kg in males and < 17 Kg in females). Obesity was defined as BMI ≥30 Kg/m2. Participants were grouped into four groups: No dynapenia – No obesity (n=360), obesity only (n=135), dynapenia only (n=203), and dynapenia-obesity (n=60). Physical function was assessed with the SPPB test. Linear Mixed models were used to estimate the population average change in SPPB as a function of dynapenia-obesity groups by nativity, controlling for all covariates. Participants with dynapenia only experienced a greater (β=-0.75, SE=0.24, p-value=0.0016) decline in physical function compared to those with No dyanpenia – No obesity among US-Born, controlling for all covariates. Participants with dynapenia-obesity group experienced a greater (β=-1.72, SE=0.53, p-value=0.0015) decline in physical function compared to those with No dynapenia – No obesity among foreign-born, controlling for all covariates. In conclusion, the relationship between dynapenia-obesity groups and physical function decline differed by nativity. Dyanpenia-obesity only was associated with decline in physical function among foreign-born. These findings highlight the need to promote healthy weight and improve muscle strength to prevent physical function decline in this population.
EVALUATING PSYCHOMETRIC PROPERTIES OF THE SOCIAL FRAIL INDEX IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Roopsawang Inthira , Aree-Ue Suparb , Chintapanyakun Teepatad
Published: January 2025

Social frailty has become a concern issue in older adults since it has a negative impact on older adults’ health with various dimensions including physical and mental health leading to a decline in the ability to self-care, increasing depression, or engaging in social activities. The original version of the Social Frail Index—Japanese— has been translated into various languages, but no information is available in Thai language. The aim of this cross-sectional study, therefore, was to evaluate the valid and psychometric properties of the Social Frail Index Thai version to further explore social frailty and its associated health consequences in Thai older adults. After translation using back translation technique, the Social Frail Index was confirmed for its validity and reliability in 380 dwelling-community Thai older adults living in four regions in Thailand. Participants responded to the Demographic and Health Information Questionnaire and the Social Frail Index. Results revealed that the item-level content validity index (I-CVI) and scale-level content validity index based on the universal agreement method (S-CVI/UA) were 0.96 and 0.80, respectively. The construct validity— Confirmatory Factor Analysis—confirmed that the model showed a well fit for the whole model. The factor loading ranged from.331 to.969 with a variance of 11.00-93.90. For its reliability, inter-ratter reliability of Kappa coefficient was.87 and internal consistency reliability of Cronbach Alpha was.80, indicating a good level. It can be concluded that the Social Frail Index Thai version was valid and reliable for evaluating social frailty in Thai older adults.
EXAMINING THE DIMENSIONALITY OF FUNCTIONAL DISABILITY MEASURES FOR OLDER ADULTS
Authors: Upton Rachel , Robinson Kristen
Published: January 2025

The National Survey of Older Americans Act Participants (NSOAAP) is an annual survey that evaluates programs on aging funded by Title III of the Older Americans Act (OAA). This session will discuss a cross-sectional study that used item factor analysis (IFA) and 2021 NSOAAP data to examine the dimensionality of functional disability measures used to classify older adults potentially at-risk for nursing home placement. Functional disabilities comprised limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). ADLs were defined as basic physical tasks required for independently caring for oneself (e.g., eating, bathing) (Fleishman, Spector, & Altman, 2002). IADLs similarly involved independent living activities such as going outside or performing housework. Research suggests that older adults can be classified as potentially at-risk for institutionalization if they display three or more functional disabilities (Tillery, 2021). However, no studies have examined whether current ADL-/IADL-limitation measures used to identify potentially at-risk older adults were unidimensional, such that these measures were accurately scored as reflecting a single construct versus being broken down into multiple, multidimensional subscales (Reise et al., 2010). Analyses focused on caregivers who reported ADL-/IADL-limitations for their care recipients and received OAA Title III caregiver support services within the past year. IFA models indicated that the ADL-limitation measure exhibited a unidimensional factor structure. Bifactor models suggested that the IADL-limitation measure was not unidimensional, with a significant portion of item variance attributed to additional subdomains or subscale(s). Overall, findings reveal the importance of assessing dimensionality for functional disability measures.
IDENTIFICATION OF ITEMS ASSESSING GENERATIVITY AND EGO INTEGRITY IN A LONGITUDINAL STUDY OF AGING
Authors: Duchow Olivia , James Bryan , Yoneda Tomiko
Published: January 2025

Generativity, the seventh stage from Erikson’s psychosocial stages of development, is defined as the willingness to guide and inspire younger generations to promote generational wellbeing. The final stage, ego integrity, is characterized by an overall sense of life accomplishment and fulfillment. Although reminiscence therapy increases generativity and ego integrity, the extent to which these constructs are associated with health outcomes in older adulthood is unclear, as most work in this field relies on experimental designs and small samples. Thus, in the current work, we aim to develop a scale assessing generativity and ego integrity based on items administered to older adults in the Memory and Aging Project (MAP; N=~1700; Mage=65 years), which is a longitudinal study of older adults in the Chicago region with up to 24 annual measurement occasions until death. Development of this scale will permit follow-up investigation of the impact of generativity and ego integrity on long-term health outcomes, such as incident dementia diagnosis and mortality risk. Based on the existing literature, we identified numerous generativity and ego integrity scales (k=12). We then identified all potential items administered to MAP participants that may overlap with these items. Using artificial intelligence, we identified conceptually overlapping items to create a novel scale assessing generativity and ego integrity in MAP. We will report the discriminant validity, construct validity, and test-retest reliability of this scale.
MONTREAL COGNITIVE ASSESSMENT SURVEY ADAPTATION IN A COMMUNITY-BASED OLDER ADULT SAMPLE, 2019–2020 NHANES
Authors: Walker Jenny , Patel Roshni , Omura John , Ali Akilah , Olivari Benjamin , McGuire Lisa
Published: January 2025

The U.S. population is aging. Some degree of cognitive change is expected as a natural part of healthy aging. Understanding the prevalence of potential impairments in community-based samples is necessary for prioritization of public health efforts. We analyzed Montreal Cognitive Assessment Survey Adaptation (MoCA-SA) data from the 2019-2020 National Health and Nutrition Examination Survey (NHANES). The full MoCA-SA was administered to a convenience sample of 1,123 individuals aged ≥60 years. Excluding incomplete inventories yielded a final analytic sample of 895. The MoCA-SA contains 20 items and is scored 0-20, with values < 17 indicative of lower cognitive performance. Scores were also analyzed for 8 subscales: orientation, naming, visual construction, executive function, attention, language fluency, abstraction, and memory. Estimates were stratified across three age categories: 60-69, 70-79, and ≥80 years. Overall, 71.2% (unweighted; 95% CI 68.2-74.1) of participants aged ≥60 years scored < 17. People aged ≥80 years scored significantly lower on the orientation and memory and higher on abstraction than those aged 60-69 years. No age-related differences were identified in the remaining subscales. While changes in cognition are a normal part of aging, not all changes are healthy. Only a healthcare provider can diagnose cognitive impairments such as Alzheimer’s disease. People experiencing changes in cognition that interfere with daily life should speak with their healthcare provider about their concerns and ways to promote brain health. Additional work is needed to determine how the MoCA-SA corresponds to cognitive functioning in daily life and which subscales may drive differences in community samples.
SENSITIVITY OF FALL RISK CUTOFFS USING LAB AND REMOTE MEASURES ON OLDER PROSTATE CANCER SURVIVORS
Authors: Guidarelli Carolyn , Stoyles Sydnee , Dieckmann Nathan , Sokolova Alexandra , Graff Julie , Roeland Eric , Winters-Stone Kerri
Published: January 2025

Prostate cancer survivors (PCS) treated with androgen deprivation therapy (ADT) have increased fall risk due to treatment-related side effects on musculoskeletal health. Fall risk is typically measured in the lab or clinic using objective assessments validated in community-dwelling older adults. It is unknown whether the same cutoffs will identify PCS at risk of falls. Conducting these assessments remotely has become more prevalent in research; however, it remains unclear whether different cutoffs are required using this modality. Thus, we explored the sensitivity and specificity of traditional fall risk cutoff scores using lab and remote measures to correctly classify faller status among older PCS. We used baseline data on 243 older (mean age 74.5 years) PCS from the GET FIT Prostate trial (NCT03741335). We captured fall history over the past year and completed lab and/or remote assessments of the 3-meter Timed Up and Go (TUG), 4-meter usual walk (4mUW), 5x Sit-to-Stand (5xSTS), and short physical performance battery (sPPB). We classified fall risk as TUG ≥13.5s, 4mUW ≤1.0m/s, 5xSTS ≥12s, sPPB ≤9, and faller ≥1 fall. Overall, 37.9% (n=92) reported a fall within the last year. Each test had similar sensitivity and specificity with AUCs of 58.5%, 56.3%, 55.4% and 56.0% for the lab-based TUG, 4mUW, 5xSTS, and sPPB, respectively. AUCs for remote testing were similar. Regardless of measure or modality, traditional fall risk cutoff scores do not accurately classify faller status in PCS exposed to ADT, leaving clinical practice with few tools to identify men at risk of falls.
SHORT PHYSICAL PERFORMANCE BATTERY OUTPERFORMS COMMON PHYSICAL PERFORMANCE TESTS IN OLDER ADULTS
Authors: Banarjee Chitra , Choudhury Renoa , Park Joon-Hyuk , Xie Rui , Fukuda David , Stout Jeffrey , Thiamwong Ladda
Published: January 2025

Interdisciplinary evaluation of older adults’ healthcare is a priority in the prevention of chronic health conditions and the maintenance of daily functioning. While studies have evaluated different physical performance tests (PPTs) from a retrospective view in predicting mortality or cardiopulmonary health, it remains unclear which of the commonly used PPTs are most effective at evaluating the current health of older adults. Various PPTs have been shown to be important predictors of mortality; however, few studies have compared the relevance of different PPTs to older adults’ physical activity, static balance, body mass index, and fear of falling within the same population of older adults. The present study evaluates 53 older adults using three different PPTs Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT), and Incremental Shuttle Walk Test (ISWT)) and constructs multiple linear regression models with measures of physical activity, static balance, and fear of falling, as assessed by an accelerometer, BTrackS balance plate, and the short Falls Efficacy Scale-International (FES-I), respectively. The models reveal that SPPB provides the most comprehensive value as indicated by a greater R2 value (0.573), and performance on the SPPB predicts physical activity (p=0.041) and fear of falling (p< 0.001). ISWT predicted body mass index (BMI, p=0.019) and fear of falling (0.010), whereas 6MWT predicted only fear of falling. The results indicate the value of a multi-component, comprehensive test such as the SPPB in evaluating the health of older adults and further distinguish ISWT as more predictive of overall health than the 6MWT in older adults.
TEACHING THE CORNELL-PENN INTERVIEW FOR DECISIONAL ABILITIES (IDA) TO ENHANCE DECISIONAL ABILITY ASSESSMENTS
Authors: Hancock David , White Bess , Lachs David , Karlawish Jason , Lachs Mark
Published: January 2025

Conventional approaches used by non-medical professionals to determine an individual’s ability to make decisions usually focus on cognitive indicators rather than the ability to reason around the particular risk at hand. The Cornell-Penn Interview for Decisional Abilities (IDA) is a novel, semi-structured interview tool that determines an individual’s ability to make decisions around a specific risk they are facing, such as the choice to remain in an abusive situation or refuse medical care. The IDA tool addresses a significant gap in the field of gerontology and promotes an individual’s right to self-determination while ensuring their safety and well-being. This study further validates the IDA by demonstrating the acceptability and efficacy of the educational program developed to teach the IDA to Adult Protective Services (APS) workers. The effectiveness of the IDA training was evaluated through feedback from 349 practitioners who completed the IDA training program. Participants rated the value of the learning experience highly, with an average score of 4.26 out of 5. Additionally, sentiment analysis of free response text using three different dictionaries (AFINN, BING, NRC) revealed overwhelmingly positive feedback, with words like “helpful,” “confident,” and “comfortable” frequently mentioned. The IDA represents a significant advancement in the assessment of decisional ability in the field of gerontology. This study proves that the IDA educational program effectively instructs APS professionals in using the IDA successfully as a rigorous, evidence-based approach to understand an APS client’s ability to make decisions around risks they are facing.
THE NEED FOR IMPROVED TACTILE ASSESSMENTS OF THE HAND IN OLDER ADULTS
Authors: Kabil Gül , Weber Madeline , Cook Rachel Logue , Haire Cameron , Urrego Daniel Duque , Cain Stephen , Newman-Casey Paula Anne , Brown Susan
Published: January 2025

Age-related sensorimotor declines of the hand significantly impact functional independence. Beyond muscle strength, tactile feedback provides valuable information regarding object characteristics that, in turn, can enhance manipulation skills. This is of particular interest in areas such as medication adherence - e.g. successful administration of eye drops or hearing aid adjustments. We investigated tactile acuity and dexterity in healthy young adults (23-35yo, n=23) and two groups of healthy older adults (65-76yo, n=24; 76-87yo, n=24). Participants completed assessments of strength (pinch, grip), dexterity (Grooved Pegboard Test, Arthritis Hand Function Test), tactile registration (Semmes-Weinstein Monofilament Test), and tactile pattern recognition using a custom-designed device. Both older groups performed significantly worse than young adults on all measures (p< 0.001). Dexterity, tactile identification accuracy, and tactile response times were significantly worse in the 76-87yo compared to the 65-76yo group (p=0.01). In contrast, strength and median monofilament scores did not differ between the two older adult groups. Across all older adults, tactile pattern recognition and dexterity were weakly correlated (p≤0.05). In the young adult group, only tactile accuracy and performance on the Arthritis Hand Function Test were correlated (p=0.04). These results suggest that clinical assessment of tactile acuity using monofilament testing may not capture declines in hand sensibility in older adults. More complex tactile assessments may be predictive of difficulties with object manipulation tasks that worsen with advanced age and negatively impact daily self-care activities.
EXPLORING THE IMPACT OF INTERMITTENT HYPOXIA THROUGH A COMPREHENSIVE MULTI-OMICS APPROACH IN AGED MOUSE MODELS
Authors: Donega Stefano , McDevitt Ross , Hernandez Rolando , Chisolm Cindy , FIshbein Kenneth , McCart Elizabeth , Wilgenburg Brian , Ferrucci Luigi
Published: January 2025

Comprehending aging’s molecular mechanisms, like RNA splicing and AMPK signaling, is vital for tackling age-related issues and boosting resilience. Oxygen fluctuations from obstructive sleep apnea (OSA) cause Intermittent Hypoxia (IH), affecting respiratory functions and health, prompting adaptive responses to counter reduced energy production. Mice as models allow simulating disorders and studying muscle cell protection under low oxygen levels. Over the past two years, we have collected more than 1500 samples from 15 different tissues of adult (9-11 months) and old (20-23 months) mice exposed to IH at 21% to 5% oxygen concentration in 2:30 minutes cycles, for 8 hours a day over 4-8 weeks, aiming to construct a comprehensive murine IH atlas by employing cutting-edge technologies across diverse tissues. Analyses include conducting detailed transcriptomic analyses of muscle tissues using hybrid RNA-seq to identify changes in splicing isoforms during IH experiments, exploring transitions between fast-to-slow fiber types, studying mitochondrial morphology using C57/BL6 and mtKeima mouse strains (both wild-type and Alzheimer’s disease models), investigating brain spatial transcriptomics to understand the neurological effects of IH, analyzing cardiorespiratory disruptions by examining the epigenetic clock of the heart and spleen, and delving into the role of liver extracellular vesicles (EVs), particularly exosomes, in our sensitive mouse IH model. The overarching goal of this project is to integrate omics data comprehensively to elucidate the impact of alternate hypoxia on health and aging and develop innovative therapeutic strategies that minimize damage in patients affected by this highly prevalent conditions in older persons.
MAPPING LONGEVITY PATHWAYS THROUGH MITOCHONDRIAL DYSFUNCTION: ROLES OF THE MICROBIOME AND METABOLISM IN AGING
Authors: Bitto Alessandro
Published: January 2025

Biological aging is characterized by a progressive deterioration of fundamental biological functions in living organisms, often codified as hallmarks or pillars. Longevity interventions impact these hallmarks, slowing down or even reversing their deterioration. Thus, we hypothesize that longevity interventions may be applied to chronic diseases characterized by failure of one or more of these fundamental biological processes, regardless of biological age. Herein, we describe how geroscience can be leveraged to gather new insight into etiology, progression, management, and treatment of chronic mitochondrial disease. With the aid of a mitochondrial dysfunction model, we investigate the effects on intermediate metabolism and the intestinal flora of two longevity interventions, the antidiabetic drug acarbose and the mTOR inhibitor rapamycin. Furthermore, we propose that models of chronic disease can be leveraged to study the mechanisms of action of known longevity pathways and develop new interventions. We describe the critical role of fatty acid metabolism in the treatment of mitochondrial disease and hypothesize that similar mechanisms may contribute to the longevity effects of mTOR inhibition in aging models.
MICROBIOME ROLE IN COGNITIVE IMPAIRMENT: MIAGB COHORT INSIGHTS
Authors: Mishra Sidharth , Buddendorff Lauren , Hoover Julia , Shukla Rohit , Kumar Vivek , Jain Shalini , Yadav Hariom
Published: January 2025

Aging population is increasing, leading to a rise in aging-related conditions, specifically diseases like Alzheimer’s disease and its related dementia (ADRD), which have poor prognosis and lack prevention and treatment strategies. Although we do not fully understand the complex pathology of ADRD, emerging evidence indicates that abnormalities in the gut microbiome contribute to ADRD pathology, but how this occurs remains largely unknown. Utilizing samples and datasets from a multi-site and comprehensive clinical study called the Microbiome in aging Gut and Brain (MiaGB) consortium, of comprising 30 older adults with mild cognitive impairment (MCI) and 43 age- and sex-matched cognitively healthy controls, we found that older adults with MCI have higher levels of circulating gut permeability markers (lipopolysaccharide [LPS] binding protein [LBP] and sCD14) and systemic inflammation markers (IL-6, CRP, and IL-1β). Increased gut permeability (leaky gut) is an understudied source of systemic inflammation as it allows pro-inflammatory ingredients including LPS and microbes from the gut lumen to enter the bloodstream, instigating systemic inflammation. Interestingly, increased LPS and TLR4 activation were found in the circulation of MCI participants compared to controls. Furthermore, we discovered that gut microbial metabolite- ethanolamine utilization pathways were decreased in MCI compared to controls. These abnormalities are significantly associated with reduced cognitive function (MoCA scores) in older adults. These findings provide mechanistic insight into how abnormalities in the gut microbiota, with reduced ethanolamine utilization, result in ethanolamine accumulation in the gut, inducing leaky gut, which in turn activates systemic inflammation, ultimately accelerating cognitive decline in older adults.
MULTIMODEL APPROACHES IDENTIFY CONSERVED ROLE OF TRP CATABOLIC PATHWAY IN THE REGULATION OF LIFE- AND HEALTHSPAN
Authors: Oz Naci , Kaya Alaattin
Published: January 2025

The activity of the conserved Kynurenine (KYN) pathway, a major catabolic pathway of Tryptophan (trp), is controlled mainly by the indoleamine 2,3-dioxygenases IDO1, and IDO2, which catalyze the first rate-limiting step of trp catabolism by converting trp into kynurenic acid. The KYN pathway is the sole de novo NAD+ biosynthetic pathway, generating NAD+ from ingested trp. In addition, increased Ido1/2 activity, and intermediate metabolites such as quinolinic acid, as a result of normal aging, are mechanistically linked to inflammaging and neurodegenerative disorders such as Alzheimer’s diseases. Therefore, circulating kynurenines were suggested as a potential biomarker of frailty in humans. In contrast, decreased trp degradation has been beneficially implicated as a potent regulator of age-related diseases and lifespan. Although the KYN pathway is a viable therapeutic target against aging and age-related diseases, there have been no comprehensive studies in mice to understand the role of the KYN pathway in regulating life- and healthspan. To understand the conserved effect of the KYN pathway in modulating life- and healthspan, we developed individual and combined whole-body knockout transgenic mouse strains lacking genes IDO1, IDO2 or IDO1/IDO2. Using multi-omics approaches, we comprehensively characterized the tissue and sex-specific biological age and molecular and metabolic alterations mediated by KYN pathway deficiency. Along with the healthspan measurements, we showed a potentially conserved role that decreased trp catabolism might be a conserved modulator of life- and healthspan.
MUSCLE PRESERVATION AND PHYSICAL ACTIVITY: HYBRID TRANSCRIPTOMIC ANALYSIS IN A MONKEY MODEL
Authors: Donega Stefano , Banskota Nirad , De Supriyo , Ferrucci Luigi
Published: January 2025

Muscle strength declines with age, leading to decreased mobility. Old sedentary people have been reported with imbalance in energetic metabolism, a pro-inflammatory profile, and proteolysis. Engaging in exercise, beyond just strength training, has been shown to mitigate this decline, although the underlying biological mechanisms remain unclear. Rhesus monkeys, trained to run on treadmills, present a valuable model for investigating the mechanisms involved in the preservation of muscle function induced by physical activity. We trained 27 males and females monkeys aged 9-15 years for 2 month to run on a ramp up to 1h for 3-5 days/week for 3 months. Continuous monitoring of heart rate, temperature, and physical activity levels was conducted using implantable data loggers, along with daily tracking of body weight and food intake. Vastus lateralis muscle punches were collected at baseline, after 3-months treadmill and ensuing 3-week sedentary state to perform deep hybrid RNA-seq combining deep short-reads (800M, Illumina) and long-reads (PacBio). Treadmill intervention revealed an enrichment in MAPK activity, keratinocyte proliferation, extracellular transport and microtubule formation alongside reductions in ribosomal compartments, ncRNA processing and lysosome. Upon transitioning to a sedentary state, the same subjects increased in extracellular matrix, immune cells migration and chemotaxis (leukocytes, granulocytes, neutrophils and monocytes) and reduced mitochondrial component and function, spliceosome, U2 complex, and ribosome. On-going analyses are focusing on differential splicing and proteomics interaction. These preliminary data suggest at RNA level, exercise enriches muscle function and metabolism while sedentary leads to decreased mitochondrial function and immune cell dynamics in monkeys.
NICOTINAMIDE RIBOSIDE SUPPLEMENTATION PROTECTS AGAINST VIRAL-INDUCED NEURODEGENERATION IN AGED MICE
Authors: Enterria-Morales Daniel , Gonzalez Anais Claire , Jallorina Bianca , Martinez Adrian , Doan Andrew , Karve Aadit , Joya Mikaela , Shtrahman Matthew
Published: January 2025

Several lines of research support the hypothesis that boosting cellular nicotinamide adenine dinucleotide (NAD+) may induce metabolic adaptation that helps neurons maintain healthy function as they age and slow neurodegeneration, making this approach a promising therapy for neuroregeneration. To prove this strategy, we tested the ability of Nicotinamide Riboside (NR), a pyridine-nucleoside precursor to NAD+, to prevent neuronal cell loss in a model of viral induced neurodegeneration using recombinant adeno-associated virus (rAAV). C57BL/6J wild-type mice (18 months old) were obtained from the National Institute of Aging (NIA). NR was administered into the animals’ drinking water (12mM) for three consecutive weeks before the injection of a recombinant rAAV expressing the LacZ gene under the control of the CMV promoter (rAAV-CMV-LacZ) at a dose of 1x1013 gc/mL into the unilateral hippocampus. For the control groups, the mice were injected either with a saline solution or with the rAAV-CMV-LacZ, but no NR supplementation was provided. For the experimental group, NR treatment was maintained for 12 weeks until the date of sacrifice. We found that NR supplementation partially rescued the rAAV-induced neurodegeneration in the CA3 of the hippocampus. NR supplementation reduced the activation of microglia and astrocytes in the CA3, partially rescuing the inflammatory response to the rAAV infection. Our findings support the idea of boosting NAD+ levels as a neuroprotective approach to metabolically help neurons of the hippocampus to respond to chronic damage in the form of aging. Further mechanistic studies are required to better understand the cellular pathways that underlie these findings.