bluuebunny/crossref_metadata_2025 huggingface dataset:
Connection to the Gay Community and Self-Appraisals Among Older Men Who Have Sex With Men
Authors: Brennan-Ing Mark , Plankey Michael , Haberlen Sabina , Meanley Steven , Brown Andre , Ware Deanna , Egan James , Friedman Mackey
Published: December 2020

Men who have sex with men (MSM) report greater body dissatisfaction compared with heterosexual men, which increases with age. This may result from internalized gay community values regarding ideal physiques and youth. Using structural equation modeling, we examined these relationships among 1,118 MSM men age 40 and older from the Healthy Aging Study (M age=59.9 years/50.1% HIV+/69.8% non-Hispanic White). We hypothesized gay community attachment would be related to self-appraisals (body dissatisfaction/internalized ageism), and that this relationship would be mediated by developmental regulation strategies (physical activity/exercise intentions). The model fit the data well (RMSEA = .048, 90% CI 0.017-0.079). Contrary to our hypothesis, connection to the gay community was related to positive self-appraisals (-.40, p<.001), with significant indirect effects via regulation strategies (-.12, p<.002). Thus, gay community connections are related to positive self-appraisals in older GB men and enhance strategies supporting physical and psychological health. Implications for practice will be discussed.
Exploring Aging Masculinities From Different Disciplines and Perspectives
Authors: Ayalon Liat , Armengol Josep , Kimmel Michael
Published: December 2020

Traditionally, gerontology research has been relatively genderless. When the intersection of age and gender was explored, this was done primarily by focusing on the experiences of older women. Much less is known about the experiences of older men. The present symposium brings together work from the humanities and the social sciences in order to explore societal images and personal experiences of aging men. The paper by Maierhofer and Ratzenböck provides a theoretical outlook on this intersection from the humanities perspective, followed by empirical applications from the social sciences. Next, Armengol uses contemporary American literature to challenge the traditional stereotype of decline in sexuality and masculinity. The paper by Ni Leime & O’Neill examines stereotypes of aging masculinities, but this time from the perspective of older men as the audience who react to their portrayal in visual culture. Finally, Ayalon and Gweyrtz-Meydan present ethical dilemmas faced by physicians who treat older men’s sexuality in light of active marketing campaigns of the pharmaceutical industry, which advocate for a model of successful aging and ongoing sexual intercourse. The discussant, Kimmel, will conceptualize the four papers by stressing the different types of information that can be obtained via different methods of inquiry. The complementary information provided by the different papers and the integration of methods and findings from the humanities with the social sciences will be discussed.
Why Age and Aging Research Matters—for Early-Career Researchers
Authors: Bernard Marie
Published: December 2020

The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, supports biomedical and behavioral research with a life-span focus. There is attention to understanding basic processes of aging, improving prevention and treatment of diseases and conditions common in later years, improving the health of older persons, as well as a focus on Alzheimer’s disease and related dementias. The NIA also supports the training and career development of scientists focusing on aging research and the development of research resources. The symposium, meant for junior faculty and emerging scholars, will provide an update on the latest research findings from the NIA followed by a brief update on funding mechanisms. An opportunity is provided to meet and consult with NIA extramural staff.
Voices in Motion: Results From a Community Choir Intervention to Promote Living Well With Dementia
Authors: Sheets Debra , MacDonald Stuart , Allison Theresa
Published: December 2020

Dementia is recognized as a global public health priority because of the significant impact it has on individuals, families and society. The numbers of people living with dementia worldwide are currently estimated at 35.6 million; this will double by 2030 and more than triple by 2050. Given the lack of a medical cure for dementia, lifestyle interventions to complement existing treatment are urgently needed to support living well with this disease. Engagement in the arts is a novel intervention which is relatively low cost and engaging. This study examines the effect of participation in an intergenerational choir on psychosocial and cognitive function for persons with dementia (PwD). Participants (n = 32), in partnership with their family caregivers and local high school students, sang in a professionally conducted choir for as many as three seasons (~ 12 weeks long) spanning up to 18 months of follow-up. Assessments of psychosocial, physiological, and cognitive function were completed every four to six weeks as part of an intensive repeated measures design. Taken as a whole, the symposium papers indicate that this novel lifestyle intervention offers an effective non- pharmacological alternative approach for older adults with dementia. Choir participation has important and significant impacts on psycho-social well-being and quality of life. Discussion focuses on policy implications and the need for community-based programs that reflect a social model for dementia and support living well by through engaging and meaningful activities
Systematic Changes in Gait Pursuant to Choir Participation for Caregivers and Persons With Dementia
Authors: Willden Michael , MacDonald Stuart , Sheets Debra , Smith Andre
Published: December 2020

Choir interventions confer psychological benefits for persons with dementia (PwD) and their caregivers. However, less is known about whether physiological function also exhibits improvements pursuant to such social-cognitive interventions. The present study, based upon a subsample of the Voices in Motion (ViM) project, explored whether participation in an intergenerational choir results in systematic improvements in gait velocity (indexed using a GAITRite computerized walkway) for both informal caregivers (n=14; 71.4% female) and PwD (n=14; 64.3% female). Longitudinal burst data from the first of three cohorts spanning 4 assessments over 3.5 months was analysed using multilevel modeling. Whereas caregivers exhibited significant improvements (p<.05) in gait velocity, PwD showed no improvement. Ongoing analyses are exploring additional cohorts, and whether improvements in gait dynamically covary with reductions in comorbidities (e.g., neuropsychological function, caregiver burden, depressive affect). These results underscore the potential of choir for facilitating both psychosocial and physiological function for caregivers and PwD.
Bringing Art to Life: Measuring Engagement Through Art, Connection, and Dignity
Authors: Reel Candice , Allen Rebecca , Lanai Bailey , Sneed Sami , Potts Daniel
Published: December 2020

The BATL program aims to improve the quality of life for community-dwelling people living with dementia (PWD) through art therapy, intergenerational contact, and life story preservation. This study utilized a modified ENGAGE measure (Hartmann et. al, 2017) to evaluate ethnographic transcripts recording activity and social engagement over time (N=100). A five-member analysis team independently coded the observation transcripts for engagement and qualitative themes. Results reveal average communication engagements (M=28.30, SD=13.36) significantly exceed the average art engagements (M=9.86, SD=5.56) over time t (98) = 20.85, p<0.001). Emergent themes included reminiscence, intergenerational communication, and creating art. These mixed method results suggest the intergenerational contact and reminiscence portions of BATL were fundamental features in comparison with art-making. More studies are needed to determine if the BATL intervention 1) has greater comparative effectiveness than typical programs in adult service centers, and 2) is scalable nationally to enhance the quality of life in PWD.
Arts-Based Programs for Older Adults for Their Cognition, Identity, Communication, Dignity, and More
Authors: Chee Kyong Hee , Kim Seoyoun
Published: December 2020

This symposium takes an interdisciplinary perspective in order to address psychological and behavioral benefits of various arts-based programs for older adults including persons living with dementia. Presenters in this symposium specialize in diverse disciplines including psychology, social work, cognitive neuroscience, education, and sociology. Using novel approaches and various research methods, the presenters will speak to the specific outcomes of arts-based interventions. The positive outcomes include: 1) improved cognitive health rediscovered identities among cognitively normal older adults; and 2) better communication and reduced agitation for persons with dementia. The first two presentations concern cognitively intact participants. Brown will present a mixed-methods study that examined cognitive benefits and differential experiences of 11 older adults who participated in a 12-week, arts-based intervention. Chow will identify the themes in the ‘Tree of Life’ drawings of 144 Hong Kong Chinese older adults, who re-authored their sense of self transcending life challenges. Next, Mohan will discuss results from an analysis of communication exchanges among 6 older participants in a 6-week, creative group storytelling program (TimeSlips) offered in a memory care community. Halpin-Healy will explain the research-based practices used in museum programming (Arts & Minds) for persons with dementia and their care partners. She will summarize the assessments of the programs that have served approximately 500 participants over a decade. As a discussant, Kim will summarize common threads that lead to effective arts-based interventions for older adults regardless of their cognitive status. She will also highlight implications regarding the benefits of arts-based interventions in late life development.
Improving Social Communication With TimeSlips Among Persons Living With Dementia: Results From a Pilot Study
Authors: Mohan Ranjini , Chee Kyong Hee , Kim Seoyoun , Gerhart Olga
Published: December 2020

Persons living with dementia (PLWD) often display declining communication and conversational skills, leading to reduced quality of life and social isolation. Given limited evidence for interventions targeting conversation skills in PLWD, we examined the transcripts of a creative group storytelling program, TimeSlips, offered in a memory care community in Central Texas. We analyzed communicative exchanges using modified rules of the ‘Conversational Act Profile’ (Fey, 1986). Utterances were coded for each participant’s interaction 1) with the facilitator and 2) with other participants. Preliminary evidence for six participants across six sessions is reported here. While the number and type of participant-to-facilitator utterances did not show a specific pattern, five of the six participants showed increased participant-to-participant communication across sessions. These findings suggest that a creative storytelling program such as TimeSlips may promote greater communication among PLWD, thereby improving social connectedness amongst them and possibly, their quality of life.
The Associations Between Physical Activity and Gut Microbiota Among Older Community-Dwelling Men
Authors: Langsetmo Lisa , Johnson Abigail , Demmer Ryan , Ensrud Kristine , Orwoll Eric , Shikany James
Published: December 2020

We determined the relationship between objectively measured physical activity (PA) and the gut microbiome among community-dwelling older men from the Osteoporotic Fractures in Men (MrOS) cohort participants at Visit 4 (2014-16). Eligible men (n=373, mean age 84 y) included participants with 5-day activity assessment and stool samples analyzed for 16S marker genes. Armband data together with sex, height, and weight were used to estimate total steps and energy expenditure. We used linear regression analysis, principal coordinate analysis, zero-inflated Gaussian models to assess association between PA and α-diversity, β-diversity, and specific taxa, respectively, with adjustments for age, race, BMI, clinical center, library size, and number of chronic conditions. There was a slight association between PA and β-diversity but no association with α-diversity. After multivariate adjustment, those who had higher step counts vs lower step counts had higher relative abundance of Cetobacterium and lower relative abundance of Coprobacillus, Adlercreutzia, Erysipelotrichaceae CC-115.
Perceived Physical Fatigability Improves After a Weight Management Intervention
Authors: Graves Jessica , Gmelin Theresa , Boudreau Robert , Albert Steven , Newman Anne , Venditti Elizabeth , Glynn Nancy
Published: December 2020

The effects of a weight loss and physical activity (PA) intervention on improving perceived physical fatigability are unknown. We examined this question in a subset (n=79) of older adults who are obese enrolled in the 13-month Mobility and Vitality Lifestyle Program (mean□SD age 68.8±4.2 years, 83.5% female, 26.6% African American, body mass index 34.6±4.3 kg/m2). Accelerometer-assessed PA (mean/day vector magnitude) was measured with a wrist-worn triaxial GT3X+ ActiGraph for 7 full days. Perceived physical fatigability was measured using the 10-item self-administered Pittsburgh Fatigability Scale (PFS, 0-50; lower score= less fatigability). Baseline PFS was 18.7±8.5 with 69.6% having higher fatigability (PFS ≥15). At 13-months, PFS decreased by 15% (2.8 points) to 15.9±8.4 (p<0.01) and prevalence of higher fatigability declined to 60.8%. Concurrently, participants lost 6.2% of their body weight and PA increased by 2.4%. A lifestyle intervention may be effective at reducing fatigability, an important component in the age-related disablement pathway.
A New Lens on Physical Activity Promotion: Can Technology Boost Exercise Prescription and Adherence?
Authors: Heyn Patricia , Watts Amber
Published: December 2020

Adherence to exercise prescription for older adults (OAs) is a significant problem and can have a detrimental effect on key health outcomes. Exercise adherence for OAs is a multifactorial problem encompassing many factors affecting adherence such as socioeconomic status, education, physical fitness, and mental and health status. Improving exercise adherence could have a significant impact on longevity, quality of life, and health care costs. This symposium brings multiple perspectives to closely examine promising technology approaches, both in the form of models and programs. We will also discuss gaps regarding adherence to physical activity (PA) and exercise prescription for OA and the application of current publicly available technologies to boost PA adherence and compliance accordingly to the U.S. Department of Health and Human Services national standards for promoting health and preventing disease. The symposium includes five novel presentations addressing several key factors related to successful implementation of technology approaches to exercise program delivery and adherence for OAs. In addition, we will have one presentation highlighting the key factors that impact exercise prescription, compliance, and adherence. The speakers will present and address important components related to technology use with the goal to increase older adult’s PA participation. The exercise programs will target key areas affecting older adult’s health such as cognitive function, falls, obesity, gender, environments, and self-efficacy. Technology user-usability perspective will be presented. Current challenges and recommendations for future research will be comprehensively discussed to properly address the exercise adherence and compliance needs of our OA populations.
Self-Determination Through Technology: Understanding Physical Activity Engagement for Older Adults
Authors: Koon Lyndsie , Mullen Sean , Rogers Wendy
Published: December 2020

Despite the known health benefits of exercise, only 30% of older adults (65-75 years) and 18.5% (85 years+) meet the recommendations for exercise. Barriers include difficulty accessing facilities, and lack of motivation and social support. Research results indicate that exercise adoption and adherence is higher among older adults when basic psychological needs are met. Technologies (e.g., exergames, activity trackers) have the potential to satisfy the three basic needs as indicated by the Self-Determination Theory. Technology may satisfy a user’s need for autonomy by offering different activities to choose from (biking versus resistance training) or intensity and duration options. They may promote competence by allowing for individualized goal setting and tracking. Technologies have the potential to promote relatedness through virtual instruction, subsequently removing the accessibility barrier. The application of this theory provides design guidelines for exercise technologies and a greater understanding of how technology may motivate exercise behavior for older adults
Geographic Disparities of Comorbidities in Mortality of Patients With Alzheimer’s Disease
Authors: Kravchenko Julia
Published: December 2020

Comorbidities can contribute to the gap in Alzheimer’s disease (AD) mortality between the East and West coast U.S. Using Multiple-Cause-of-Death and 5%-Medicare data, we analyzed age-adjusted (65+) mortality rates from AD in two Health and Human Services (HHS) areas with opposed mortality patterns in 2010-2018: 150.9±0.6/100,000 in HHS2 (NJ,NY) and 363.1±1.5/100,000 in HHS10 (AK,ID,OR,WA). Co-existing diabetes, heart failure, cerebrovascular, digestive, and kidney diseases significantly contributed to this gap, while contribution of heart diseases reduced its magnitude. An unexpectedly strong effect (higher rate in HH10 by a factor of 3-5) was identified for symptoms/signs that are not from identified specific diseases, life-threatening injures/falls and other external causes that are common among patients with AD. We concluded that although contributions of comorbidities with well-developed treatment guidelines (e.g., heart disease) to geographic disparities in AD mortality were small, the disparities can be generated by unexpected comorbidities including diseases with poorly defined conditions.
Identifying Translational Longevity Targets With Genetically Mediated Transcriptome-Wide Association Studies
Authors: Evans Daniel , Cummings Steven , Schork Nicholas
Published: December 2020

We hypothesized that trait associations with genetically mediated gene expression could be used to screen for genes that are good candidates for translational studies of longevity. We compiled a collection of genetically-mediated transcriptome-wide association studies using 33 traits and outcomes from large-scale, publicly-available GWAS meta-analysis results. The traits/outcomes were grouped within eight categories (aging, anthropometric, cardiovascular, inflammation, lung function, metabolic, musculoskeletal, and neurological). To test the utility of this approach, we examined trait associations with the drug target of statins, and we correctly identified known therapeutic effects and adverse events of statins. Specifically addressing the hypothesis, we examined a collection of candidate longevity-associated genes and identified one gene associated with lifespan that appears to also be associated with protection from atrial fibrillation and hearing impairment without being associated with adverse events. This screening approach can be used to prioritize gene targets for longevity translational efforts.
Behavioral and Social Considerations
Authors: Barry Lisa
Published: December 2020

Cognitive, behavioral and social dimensions also demonstrate increasing heterogeneity with aging. For example, a longitudinal study of over 1,000 clergy revealed increasing heterogeneity in cognitive function and rate of decline with aging. Moreover, studies of individuals with probable Alzheimer’s disease have shown heterogeneity in terms of clinical manifestations and rates of cognitive decline. Older adults also demonstrate greater heterogeneity in mood, anxiety, and the nature and patterns of symptoms over time. Heterogeneity of overall health status increases with aging, as does reported quality of life. Health and Retirement Study (HRS) data have shown that low socioeconomic status or being an underrepresented minority are both associated with greater intra-individual variability in health status in old age, with greatest differences seen in Hispanics. Finally, early life adversity can contribute to heterogeneity of multidimensional health trajectories even in late life.
Strategies to Improve Health Technologies for Older Adults With Cognitive Impairment and Dementia
Authors: Niemiec Stacey Schepens , Lee Elissa , Blanchard Jeanine , Strizich Adam
Published: December 2020

Technology may improve health self-management of older people with cognitive deficits, yet these individuals may have unique needs influencing its utility. This study’s purpose was to gather current strategies described in the literature and by expert stakeholders for utilizing digital health technologies in older adults with cognitive impairment (CI) or dementia. We conducted a rapid literature review to identify articles that featured digital health technology use in persons with CI/dementia. Additionally, we conducted interviews (n=12) with expert stakeholders who were identified through online academic, professional, and community organization biographies and snowball referral. Qualitative-based thematic analysis was used to identify emergent themes from selected literature and transcribed interviews. Recommended strategies addressed instructional methods (e.g., reducing distractions), technology adaptations (e.g., simplified interface), care partner involvement, and dosage/exposure. Findings are applicable to development of technology-driven interventions and products, with the aim of improving the effectiveness of such technology for older people with CI/dementia.
A Pilot Study on Relationships of the Workplace Intergenerational Climate Scale with Other Ageism and Sexism Scales
Authors: Bae Sangkyung , Choi Moon
Published: December 2020

Due to the demographic changes such as longevity and low birthrates, the proportion of workers over 55 years old is expected to rise more than twice in the coming years. As the age diversity in the workplace is increasing, ageism needs more attention in every context. This study aims to explore relationships of the workplace intergenerational climate scale with other ageism and sexism scales in workplace and non-workplace contexts. Data came from a pilot online survey conducted in South Korea in December 2019 (N=74; average age=46.8 years old ranged from 20 to 76), and the data was analyzed using a series of ANOVAs and logistic regressions. The results showed that chronological age did not have a linear relationship with ageist attitudes in the workplace although relatively younger groups tend to have more ageist attitudes compared to their counterparts. In particular, those in their thirties were most reluctant to work with different generations. Conspicuously, negative attitudes towards working with different generations in the workplace were statistically significantly related to ageist attitudes towards older adults in non-workplace contexts as well as sexist attitudes in the workplace. The findings imply that prejudice and stereotypes towards different age and gender groups in workplace and non-workplace contexts might be intertwined, and interventions reducing ageism in the workplace might also have positive impacts on alleviating other types of ageism and sexism while promoting diversity.
Partnering With Title VI Directors to Put Survey Data to Use in Improving the Health and Well-Being of Native Elders
Authors: Adamsen Collette , Danielson Ramona
Published: December 2020

Through Title VI of the Older Americans Act, federally recognized American Indian tribes, Alaska Native villages, and Native Hawaiians are eligible for grant funding to promote elders’ access to nutritious food and address other community-specific needs, such as transportation. Title VI directors are often short-staffed and work flexibly and creatively to accomplish administrative tasks as well as direct care for elders. The National Resource Center on Native American Aging (NRCNAA) developed the “Identify our Needs: A Survey of Elders”, conducted with adults ages 55+ every three years since 1999, to help directors fulfill grant-required requirements to report on community needs assessment data about elders’ needed services and health status. Directors administer the survey; responses are then scanned and analyzed by NRCNAA, with a site-specific summary returned to directors, at no cost to the site. To learn more about how survey data are utilized, NRCNAA staff interviewed four Title VI directors from across the US in 2018. In addition to meeting the needs assessment requirement, directors use the data to seek resources and support, build collaborative relationships, and evaluate and build their programs. Conducting the survey has allowed for discussions with elders about dimensions of elder health, advanced medical directives, and medical power of attorney. Additionally, specific interventions have been designed to address needs identified by the survey, including diabetic foot care, yoga, and falls prevention. Through the survey, the NRCNAA is able to support many dedicated Title VI directors working to improve the health and well-being of Native elders.
Amyloid beta-42 Levels in Companion Dog Brains Correlate with Age and Cognitive Function
Authors: Urfer Silvan , Darvas Martin , Keene Dirk , Czeibert Kálman , Kubinyi Enikő , Sándor Sára , Guscetti Franco , Kaeberlein Matt
Published: December 2020

The privately owned companion dog is an increasingly important model in aging research because it shares the human environment, is exposed to similar environmental risk factors, receives comparable medical care, and develops many of the same age-related pathologies. One such pathology is Canine Cognitive Dysfunction (CCD), which shares many of the clinical features of human Alzheimer’s Disease (AD), including progressive loss of cognitive function, loss of normal sleep patterns, increased anxiety, and aimless wandering. Amyloid-beta 42 (Aβ42) plaques similar to these found in humans with AD are known to naturally occur in the brains of aged dogs, making them an intriguing potential model for AD in humans. As part of the Dog Aging Project (www.dogagingproject.org), we studied frozen samples taken from the frontal cortex, medial temporal cortex, entorhinal cortex, and hippocampus of n=24 companion dogs of various ages that were euthanized for unrelated health reasons and donated by their owners. Brains were removed and frozen within 4 hours post mortem. Using a novel quantitative Luminex assay, we found a significant correlation between age and Aβ42 levels in all of these brain regions, as well as a significant correlation between Aβ42 levels and cognitive function scores as measured by the Canine Cognitive Dysfunction Scale. We will now investigate histopathology in the same dogs and brain regions, and investigate whether we can also measure Tau and pTau in these samples using Luminex and mass spectrometry.
Endurance Exercise Training Modes to Improve Physical Function in Older Mice: HIIT vs. VWR
Authors: Graber Ted , Byrd Chris , Seguin Emily , Seguin Anna , Fennel Alyssa , Nadigama Nainika
Published: December 2020

With age, we experience a progressive loss of physical function. Exercise is a promising therapy to preserve muscle health and functional aptitude. Animal models are needed to examine the underlying molecular mechanisms at the intersection of aging, exercise, and functional decline. In this study, we compare the efficacy of two types of individualized endurance exercise training in older C57BL/6 mice (26-months old at completion): HIIT (high intensity interval training on a treadmill, n=10) and VWR (voluntary wheel running, n=8). We hypothesized that while both exercises would improve function, HIIT would promote more extensive adaptation. For four months the VWR mice ran 4 days/week and the HIIT group ran 3x/week. We determined function pre/post-training by utilizing our composite scoring system, the Comprehensive Functional Assessment Battery (CFAB). CFAB consists of the following: treadmill running (endurance), rotarod (overall motor function), wheel running (volitional exercise rate/activity), grip strength (fore-limb strength), and inverted cling (overall strength/endurance). EchoMRI determined body composition. After training, we found significant CFAB improvement (repeated measures t-test, p<0.05) in both exercise groups, specifically including: rotarod (+37%, HIIT and VWR); treadmill (+61% VWR; +58% HIIT), grip strength (+20% VWR), body mass (-17% VWR, -10% HIIT), and fat percentage (-44% VWR, -20% HIIT). Contrary to our hypothesis, HIIT did not improve function more than VWR, though we suspect increasing training intensity would improve response. Thus, future studies will need to address defining HIIT dose response and optimal training volume for older mice. We conclude that our models will be useful for future mechanistic investigations.
Impact of Radiotherapy on Daily Function Among Older Adults Living with Advanced Cancer
Authors: Nehlsen Anthony , Agarwal Parul , Mazumdar Madhu , Dharmarajan Kavita
Published: December 2020

Radiation therapy (RT) improves quality of life and symptomatic burden for patients with advanced malignancies. However, RT can also confer toxicity and little is known about the contribution of geriatric conditions to RT-related outcomes in older adults. This study aims to examine changes in daily function among RT patients at 1 and 6 months following RT. We reviewed charts of 137 patients who underwent RT with intent to improve daily functioning. ADL and IADL scores ranging from 0-6 and 0-8, respectively were collected at baseline, 1-, and 6-months post-RT. Latent class analysis of baseline ADL and IADL was conducted to categorize patients into two classes (high and low deficit). Latent transition analysis was used to examine transitions at each time point. One-hundred seventy courses of RT were identified; 99 were fully evaluable. Median age was 66 years. For ADL and IADL, at baseline 28.9% and 28.3% were classified as high deficit and 71.1%, 71.3% as low deficit respectively; 2% and 7% of low deficit patients had the potential to move to high deficit group at 1 month; and 20% and 13% had the potential to have the same movement from 1 to 6 months. All patients classified as high deficit for both measures at 1 month remained so at 6 months. ADL and IADL functioning may be useful in describing changes in daily function after and identifying groups of patients who may benefit from additional supportive geriatric and/or palliative care interventions.
Influence of aging, macronutrient composition and time-restricted feeding on the rat gut microbiome
Authors: Hernandez Abbi , Burke Sara , Buford Thomas , Carter Christy
Published: December 2020

Declining health and cognition are hallmarks of advanced age that reduce both the quality and length of the lifespan. While caloric restriction has been highlighted as a strategy for increasing healthspan, time-restricted feeding and changes in dietary macronutrient composition may be more feasible alternatives with similar health outcomes. Furthermore, age-related changes in gut microbiome composition may reciprocally interact with several physiological systems – providing a good target for future therapeutic interventions. To begin to investigate the potential utility of a ketogenic (high fat, low carbohydrate) diet and/or time-restricted feeding, fully mature young (5 mo) and older (22 mo) adult male Fischer Brown Norway Hybrid rats were placed on a time-restricted feeding regimen of a ketogenic or micronutrient and calorically matched control diet for 7 months. A third group of rats was permitted to eat standard chow ad libitum. Fecal samples collected at the conclusion of the study were submitted for 16S microbiome analysis, which revealed significant differences across age and diet groups, as well as across feeding paradigms. Beta diversity analysis demonstrated distinct microbiome composition across the three diet groups regardless of age. Furthermore, diet group significantly impacted abundance in expression of several microbiota at the phylum level, including Verrucomicrobia, Cyanobacteria, Actinobacteria and Patescibacteria, though age did not. Verrucomicrobia was significantly increased (p=0.02) and Actinobacteria and Patescibacteria (p<0.01) were significantly decreased in animals fed in a time-restricted fashion. These results indicate the value of both altered macronutrient composition and altered feeding methodology for therapeutic interventions targeting the gut microbiome.
Muscle Mitochondrial DNA Copy Number, Deletion Mutation Frequency, and Physical Performance in Older Adults
Authors: Wanagat Jonathan , Herbst Allen , Prior Steven , Aiken Judd , McKenzie Debbie , Liu Nianjun , Chen Xiwei , Allison David
Published: December 2020

Mitochondrial DNA (mtDNA) quantity and quality influence hallmarks of aging – mitochondrial dysfunction and genomic instability. The interactions between mtDNA quantity and quality and physical performance have not been extensively examined in humans. The aim of this study was to test the interactions between skeletal muscle mtDNA copy number, mtDNA deletion mutation frequency, and physical performance measures in older adults. Total DNA was isolated from muscle biopsies and used for quantitation of mtDNA copy number and mutation frequency by digital PCR. The biopsies were obtained from a cross-sectional cohort of 53 adults aged 50 to 86 years. Before the biopsy, physical performance measures were collected. MtDNA deletions increased exponentially with advancing age. On average, mtDNA deletion frequency increased 18-fold between 50 and 80, with a trend toward lower deletion frequency in females. MtDNA deletion frequency predicted declines in VO2 max, where 4.7% of the variation in VO2 max was explained by mtDNA deletion frequency. MtDNA copy number was negatively correlated with age and mtDNA deletion frequency, but positively correlated with lean mass. There was a trend to lower mtDNA deletion frequency in females, consistent with increased longevity in females. Larger studies may better delineate sex effects. These data are consistent with a role for mitochondrial function and genome integrity in the maintenance of physical performance with age. Analyses of mtDNA quality and quantity in longitudinal studies could extend our understanding of the importance of mitochondria in human aging and longevity.
Depression Complicates the Relationship Between Subjective Memory Complaints and Memory in Older Adults
Authors: Wisniewski Kristi , Choi Eun Young , Beam Christopher , Zelinski Elizabeth
Published: December 2020

Subjective memory complaints (SMCs) are self-reported changes in memory performance and may indicate prospective dementia. Cognitive function and depressive symptoms are negatively correlated; however, depression’s influence on the relationship between SMCs and cognition is unclear. Data were drawn from the Long Beach Longitudinal Study, a three-panel study of community-dwelling older adults from southern California who were assessed every three years. The present study included participants ages 54-89 who completed a 20-item immediate recall task at each wave and the Memory Functioning Questionnaire Frequency of Forgetting (FOF) subscale, a measure of SMC, on 2+ occasions from 1994-2014 (n=788; Mage=73 years at baseline, Meduc=15 years). Higher FOF scores indicated fewer memory complaints. Depression was measured as the average Geriatric Depression Scale score across occasions. Bivariate linear latent growth models over age adjusted for age, sex, and education (covariates associated with cognition). The SMC and recall slopes were positively correlated (parameter estimate=1.40; p<0.05). After controlling for depression, the slope-slope correlation was not significant (parameter estimate=0.83; p=0.127). However, after removing cognitively-relevant items from the Geriatric Depression Scale then adjusting for depression, the SMC slope-recall slope correlation trended toward significance (parameter estimate=0.99; p=0.070) suggesting that the cognitively relevant items were confounding the slope-slope correlation. These findings indicate that depression impacts the relationship between SMC and objective memory over age; therefore, depression may limit the clinical utility of SMCs as a cognitive screening measure. Future studies should assess depression using scales devoid of cognitive items to differentiate its influence on subjective and objective memory performance.
Vision and Cognitive Function in the Mid- to Later-Life Transition: the Study of Women’s Health Across the Nation
Authors: Kolli Ajay , Hood Michelle , Karvonen-Gutierrez Carrie , Moroi Sayoko , Ehrlich Joshua , Gillespie Brenda , Wood Sarah , Musch David
Published: December 2020

In this analysis of data from the Study of Women Across the Nation (SWAN), a longitudinal cohort study of mid-life women, we sought to describe the relationship between vision impairment (VI) during mid-life and future CF during the mid- to later-life transition period. Presenting visual acuity was assessed at baseline, between 1996-2000, using a Titmus occupational screener. “Mild” and “moderate to severe” VI were respectively categorized as visual acuity <20/40 and <20/60 in the better seeing eye. CF was measured at near-annual visits from 2003-2015 using the East Boston Memory Test immediate (EBMTi) and delayed (EBMTd) recall and Digit Span Backwards (DSB). Linear mixed models with a random intercept and slope for age were constructed to detect associations between vision and CF, adjusting for race, education, financial strain, alcohol use, and tobacco use. The sample included 341 women aged 42-53 years (mean: 46.6) at baseline with up to 16 years of follow-up. The prevalence of VA <20/40 and <20/60 was 12.9% and 7.6%, respectively. While mild VI was associated with lower EBMTi (β= -0.46, p=0.034), EBMTd (β= -0.49, p=0.031), and DSB (β= -0.78, p= 0.015) scores in unadjusted models, these relationships were not statistically significant after adjustment for covariates. After adjusting for covariates, baseline moderate to severe VI was associated with worse EBMTi (β= -0.87, p=0.001) and EBMTd (β= -0.52 p=0.039) scores. Altogether, moderate to severe VI during mid-life was associated with lower verbal episodic memory scores (EMBTi/d) over a 16-year period representing the transition from mid-life to later adulthood.
Cognitive Impairment and Decline in Physical Function Among Older Mexican Americans Over 20 Years
Authors: Givan Amy , Snih Soham Al
Published: December 2020

The aim of this study was to examine cognitive function as a predictor of physical function decline over a 20-year follow-up period among older Mexican Americans who were non-disabled and were able to complete the Short Physical Performance Battery (SPPB) at baseline. The sample consisted of 2,232 Hispanics 65 years and older from the Hispanic Established Population for the Epidemiological Study of the Elderly. Measures included socio-demographics, self-reported medical conditions, body mass index (BMI), disability, depressive symptoms, limitations in activities of daily living, Mini-Mental State Examination (MMSE), and SPPB. General linear mixed models were used to estimate changes in SPPB over time as a function of MMSE. At baseline, 11% of the participants had cognitive impairment (MMSE < 21) and the average SPPB score for those with and without cognitive impairment was 7.16 + 2.75 and 7.81 + 2.36, respectively. Mixed model analysis showed that those with cognitive impairment (MMSE < 21) experienced a decline in the SPPB of 0.34 points per year (Standard Error = 0.09, p-value = 0.0002) after controlling for all covariates. Other significant predictor factors of decline in the SPPB were older age, depressive symptoms, diabetes, any assistance with activities of daily living, having had a hip fracture, and high BMI. Cognitive impairment predicted decline in physical function among older Mexican Americans who were non-disabled at baseline. These findings underscore the need of developing interventions to maintain cognitive and physical function to delay or prevent disability in this underserved population with high rates of disability.
Post-Hospital Care Intensity Modifies the Relationship Between Depressive Symptoms and Hospital Readmissions
Authors: Abrams Leah , Hoffman Geoff
Published: December 2020

The objective of this study was to examine whether more structured post-acute care reduces the deleterious impact of depressive symptoms on older adults’ post-hospital outcomes (30-day hospital readmissions, 30-day falls, 1-year falls, and 1-year mortality). The sample comprised 23,485 eligible index hospitalizations from 7,151 unique fee-for-service Medicare beneficiaries from Health and Retirement Study linked to Medicare claims from 2000 to 2014. Depressive symptoms were measured using the eight-item Center for Epidemiologic Scale - Depression. We ran multinomial probit models regressing post-hospital setting on depressive symptoms while adjusting for sociodemographic factors, socioeconomic factors, family support, and health status. Then, we ran adjusted logistic regression models of each outcome while interacting depressive symptoms with post-acute care setting. We found that 62% of hospitalizations were routine discharges home, 17% were discharged to home health, and 21% were discharged to a Skilled Nursing Facilities (SNF). When adjusting for sociodemographic and socioeconomic factors, each increasing depressive symptom was associated with a half percentage point higher probability of referral to home health and 1.6 percentage points higher probability of discharge to SNFs, driven by differences in family support and health status. Rehabilitation in SNFs, compared to routine discharges home, reduced the positive association between depressive symptoms and 30-day readmissions (OR=0.95, p=0.027). However, post-acute care settings did not modify the association of depressive symptoms with falls or mortality. Considering depressive symptoms in discharge decisions, above and beyond their associations with family support or health status, may help hospitals avoid readmissions but may not improve health and functioning.
Unplanned Re-Hospitalization Among Older Persons Results in Loss of their Independence
Authors: Qualls Brandon , Seyoum Hiwot , Walker Tammy , Carey Mary
Published: December 2020

The Centers for Medicare & Medicaid Services defines a hospital readmission as an inpatient stay that begins within 30 days of the discharge date of an index admission, to the same or a different hospital. The aims of the study were to analyze the recurrent readmissions of older persons admitted to a community hospital with diagnoses of: Chronic Obstructive Pulmonary Disease (COPD), Pneumonia (PNA), and Congestive Heart Failure (CHF). Based on the results, we will develop additional strategies that can be used to reduce the rate for hospital readmission for older patients. A retrospective chart review of hospitalizations was conducted. Among 30 readmissions, the mean age was 79.5±14. The index disposition was distributed among three destinations: self-care (27%), home health organization (40%), and to skilled nursing home (33%). Most of the readmissions were for CHF (27%), COPD (10%), and PNA (13%), the only other large category include respiratory failure (10%). The readmission disposition was different from the index disposition: self-care (7%), home health organization (47%), and to skilled nursing home (20%). After hospital readmission within 30 days, older persons were more likely to be discharged to home health care organization than self-care, p<0.05. Actions that can be taken by hospitals to reduce 30-day readmissions to maintain older person independence include: clinical readiness of patients for discharge, proper infection prevention techniques, reconciling medications, good communication, and adequate patient education. This study reports that that older persons are at higher risk for unplanned hospital re-admissions and often lose their independence.
Older adults’ vaccine hesitancy: psychosocial predictors of influenza, pneumococcal, & shingles vaccine uptake
Authors: Nicholls Louise Brown , Gallant Allyson , Cogan Nicola , Rasmussen Susan , Young David , Williams Lynn
Published: December 2020

Influenza, pneumococcal disease, and shingles are more prevalent in older people, with this group having an increased risk of developing severe illnesses and complications. These illnesses are preventable via vaccination, but uptake of these vaccines is low and decreasing year-on-year. However, little research has focused on understanding the reasons behind vaccine hesitancy in older adults. We implemented a cross-sectional survey to determine the self-reported vaccination behaviours of 372 UK-based adults aged 65-92 years. We assessed previous uptake and future intention to receive the influenza, pneumococcal, and shingles vaccines. Participants also self-reported their health and socio-demographic data, and completed two scales measuring the psychological factors associated with vaccination behaviour (5C and VAX scales). Self-reported daily functioning, cognitive ability, and social support were also assessed. Considerably more participants had received the influenza vaccine in the last 12 months (83.6%), relative to having ever received the pneumococcal (60.2%) and shingles vaccines (58.9%). Multivariate logistic regression analyses showed that a lower sense of collective responsibility independently predicted lack of uptake of all three vaccines in this population. Greater calculation of the disease/vaccination risk and preference for natural immunity also predicted not getting the influenza vaccine. For both the pneumococcal and shingles vaccines, concerns about profiteering predicted lack of uptake. Therefore, more understanding of vaccine benefits and disease risks may be required for these vaccines. Additional qualitative data generally supported these findings, which can contribute to future intervention development and research targeted at more diverse groups (e.g. older adults with cognitive impairments).