bluuebunny/crossref_metadata_2025 huggingface dataset:
ATTITUDES AND PREFERENCES FOR ROBOT-LED PIANO COGNITIVE TRAINING: FEASIBILITY IN MILD COGNITIVE IMPAIRMENT
Authors: Mois George , Collette Bailley , Renzi-Hammond Lisa M , Boccanfuso Laura , Ramachandran Aditi , Gibson Paul , Emerson Kerstin G , Beer Jenay M
Published: November 2019

Cognitive training has been shown to improve neural plasticity, increase cognitive reserve and reduce the risk of dementia in older adults. Specifically, learning to play the piano has been shown to be an engaging, multimodal form of cognitive training. However, accessing this form of cognitive training can pose a challenge for older adults. Socially assistive robots present a unique opportunity to increase access to user-tailored piano learning cognitive training. The present study utilized a robot-led four-week piano lesson feasibility intervention for older adults with mild cognitive impairment (N = 11; M= 74.64 ± 6.02 years of age; 72.72% female; 90.1% White/Caucasian). Cognitive Status was assessed during screening via the Telephone Interview for Cognitive Status, and after screening via the Mini-Mental State Exam and the CNS Vital Signs computerized test suite to measure cognitive domain-specific functioning. Perceptions and acceptance of the robot were measured using the Robotic Social Attributes Scale (RoSAS) and Technology Acceptance Scale. Cognitive function improved after four weeks of training in the verbal memory, executive function, reaction time and cognitive flexibility domains, and in the computed neurocognitive index score (p<0.05). Survey data and qualitative interviews show that participants perceived the robot instructor as socially engaging, competent, useful, and easy to use. These results provide insight into the potential of SARs to facilitate cognitive training in the form of piano lessons, as well as recommendations for creating a suitable robot instructor for this application.
KYNURENINE, AN ENDOGENOUS AHR AGONIST, UPREGULATES CXCL12- AND HDAC3-TARGETING MIRNAS INHIBITING OSTEOGENESIS
Authors: Elmansi Ahmed M , Eisa Nada , Kondrikov Dmitry , Fulzele Sadanand , mcGee-Lawrence Meghan , Hamrick Mark , Isales Carlos , Hill William D
Published: November 2019

Osteoporosis is among the most debilitating disorders for aging men and women. Mechanisms underlying loss of bone mass and impaired fracture healing in aged population are not completely understood. Our lab and others reported increased levels of the oxidized tryptophan metabolite, kynurenine (Kyn), in bone marrow mesenchymal stem cells (BMSCs) and interstitial fluid. Here, we report that Kyn significantly inhibits osteogenic differentiation of BMSCs likely via activating aryl hydrocarbon receptor (AhR). KYN significantly downregulated mRNA levels of pro-osteogenic CXCL12 axis, including CXCL12, and its two main receptors CXCR4 and ACKR3. Secreted protein levels of CXCL12 were significantly reduced with KYN, and were rescued upon the use of AhR antagonist 3’,4’-dimethoxyflavone (DMF). Moreover, KYN upregulated levels of pro-aging and CXCL12-targeting miRNAs miR-29b-1-5p and miR-141-3p. Additionally, KYN significantly inhibited mRNA and protein levels of the epigenetic enzyme Hdac3 which is responsible for activating osteogenesis and inhibiting adipogenesis in BMSCs. Using mutagenesis and luciferase assays, we show evidence that miR-141-3p and miR-29b-1-5p directly target CXCL12 3’-UTR. We also show that miR-29b-1-5p directly targets Hdac3 explaining the significantly increased acetylation levels of H4 with KYN treatment. Finally, we show that mRNA levels of both KYN receptor AhR, and KYN-producing enzyme IDO-1 are regulated by CXCL12. We believe this data explains a novel mechanism of the bone aging phenotype and provides multiple potential clinical intervention targets for controlling osteoporosis.
GENETIC PREDISPOSITION TO ACCELERATED BIOLOGICAL AGES PREDICTED BY BIOCHEMICAL MARKERS
Authors: Kuo Chia-Ling , Pilling Luke C , Liu Zuyun , Levine Morgan E
Published: November 2019

Biological ages predicted by biochemical markers (biomarkers) outperform other measures in predicting a variety of aging outcomes. Several have been developed in recent studies, and there is evidence that each may independently predict mortality. While the included biomarkers are disease-associated, it is unclear what aspects of aging are captured. We aimed to understand and quantify genetic predisposition to accelerated biological ages, determined based on two measures, PhenoAge (9 biomarkers plus chronological age, Levine et al. 2018) and BioAge (7 biomarkers plus chronological age, Levine 2013). We performed genome-wide scans using the UK Biobank data (n=107,460 for PhenoAge, n=98,446 for BioAge). The SNP-based (single nucleotide polymorphism) heritability estimates were 14.45% and 12.39% for PhenoAge and BioAge, respectively. Both shared the strongest signal in the APOE region, with opposite associations with e2 and e4 alleles. e2 was associated with younger BioAge but older PhenoAge. e4 was associated with older BioAge but younger PhenoAge. BioAge was highly genetically correlated with its element of systolic blood pressure (rg=0.84) and the genetic correlation between PhenoAge and red blood cell distribution width was 0.65. Previous genome-wide association study findings of the top hits suggest that BioAge mostly captures cardiac aging but PhenoAge has more to do with inflammatory aging. The results are consistent with SNP clusters by associations with a broad range of aging traits, including an independent cluster with SNPs near the APOE. Genetic risk scores will be created to quantify the genetic predisposition and will be tested for associations with numerous aging traits.
IS THERE AN ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA AND FRAILTY IN OLDER VETERANS WITH DIABETES?
Authors: Mahjabin Jahan E , Baskaran Dhanya , Lewis Christopher , Baldivieso Valeria C , Wohlgemuth William , Ruiz Jorge G
Published: November 2019

Obstructive Sleep Apnea is a highly prevalent disease, where incidence increases with age. Individuals with chronic diseases such as diabetes and obesity are at risk of OSA increasing the risk of frailty. A retrospective chart review was conducted to study the association between OSA and frailty in older diabetic Veterans. Baseline polysomnography data for 91 patients ≥ 65 years was obtained from the electronic health records at the Miami VA Medical Center. Patients were screened for frailty from January 2016 to August 2017, and followed until October 2018. Patients were then dichotomized into frail (Frailty Index (FI) ≥.21) and non-frail (robust FI =<.10 and pre-frail FI ≥.10, <.21) groups. The mean participant age is 70.9 years, with (SD) of 4.8. The mean age for the frail group is 71.1 years, with a SD of 5.2. Mean age for the non-frail group is 70.5 years, with a SD of 4.2. Linear regression demonstrated a significant positive linear relationship between BMI (t=2.096 p-value= .039) and the frailty index. In binomial logistic regression, adjusting for covariates, BMI was associated with increased apnea severity (OR=1.139, 95% CI= 1.044-1.241), p=.003. However, no significant association was found between FI and apnea severity. The severity of OSA based on the Apnea-Hypopnea Index had no significant association with frailty status. However, the study demonstrated a significant association between obesity and frailty, where higher BMI coincided with higher frailty. Increasing BMI coincided with increased severity of OSA, suggesting that BMI acts as a possible confounder between frailty and OSA.
METABOLOMICS PROFILING OF MUSCLE FAT DEPOSITION IN AGING: RESULTS FROM THE HEALTH ABC STUDY
Authors: Farsijani Samaneh , Marron Megan M , Miljkovic Iva , Baugh Mary E , Kritchevsky Stephen , Newman Anne B
Published: November 2019

Background: Age-related inter-muscular fat (IMF) deposition is associated with poor physical function in those with preserved/high muscle mass. However, the heterogeneity of IMF in aging is poorly understood. We used a semi-targeted metabolomics approach to: 1) determine the metabolites associated with IMF infiltration in aging; and 2) establish a model to predict IMF using the metabolome. Methods: We performed a cross-sectional analysis of 314 African-American men (age: 69-79 years) from the Health ABC study at baseline. Mid-thigh IMF area (cm2, by CT) and 350 plasma metabolites (by liquid-chromatography/mass spectrometry) were measured. Correlation analysis was performed to determine metabolites associated with IMF. An IMF prediction model was calculated, using regression analysis with 10-fold cross-validations on random halves of the population with metabolites, age and weight as predictors. Results: Of 161 metabolites correlated with IMF (P<0.05), 34 remained significant after adjusting for age, weight, physical activity, medications, smoking and multiple comparisons (false discovery rate ≤0.25). IMF-associated metabolites were primarily lipids (76%) and amino acids (15%). Most metabolites were positively correlated with IMF (94%), with the exception of mevalonic acid (from fatty acids sub-class) and glutamine (from organic-acids) which were negatively associated with IMF. IMF-associated metabolites predicted 49% of the variability in the actual IMF in the test set of the random half of the population (50%, n= 144). Conclusion: Identification of the unique metabolomics features associated with IMF may improve our understanding of key biological alterations of muscle during aging.
CULTURE-RELATED TASK DIFFICULTIES AND NEGATIVE CONSEQUENCES FOR CAREGIVERS FROM DIVERSE COMMUNITIES
Authors: Schaffer Rachel , Bass David , Powers Sara , McDavid Jenna , Le Ocean
Published: November 2019

The Diverse Elders Coalition, in partnership with its six member organizations and the Benjamin Rose Institute on Aging, completed a national survey of 840 family and friend caregivers from diverse racial, ethnic, and sexual orientation communities to understand their unique caregiving issues and challenges. Data from a subsample of 404 caregivers identifying as Hispanic/Latino, Asian, Southeast Asian or from multiple ethnicities were examined to determine the relationship between difficulties performing culture-related care tasks (i.e., assisting with immigration issues and language barriers) and a variety of caregiver outcomes. Regression analysis controlling for background and context characteristics showed caregivers experiencing more culture-related task difficulties had significantly higher levels of several negative caregiving consequences, including health strain (B=.19, p=.001), relationship strain (B=.17, p=.005), work strain, (B=.24, p=.000) isolation (B=.17, p=.002), and symptoms of depression (B=.29, p=.000). Moreover, higher levels of strain and depression among caregivers who reported high levels of culture-related task difficulties ranged from 26%-54%. More difficulties with culture-related tasks also were significantly related to dissatisfaction with support resources, including lower ratings of the quality of care receivers’ healthcare (B=-.20, p=.001), and lower satisfaction with support they and their care receivers received from family and friends (B=-.17, p=.006 and B=-.16, p=.011, respectively). Results suggest caregivers from diverse communities struggling with culture-related tasks experience more negative consequences of caregiving and less helpful social support. Service providers working with caregivers from diverse communities should assess for culture-related task difficulties, recognizing these problems may be a window into a variety of adverse caregiving effects.
HEARING LOSS AND SOCIAL ISOLATION: THE ROLE OF NEIGHBORHOOD SOCIAL COHESION AND DISORDER
Authors: Baik Sol , Lehning Amanda
Published: November 2019

Social isolation is a critical public health issue that socially isolated individuals are at increased risk for mortality and deteriorated health. Those who acquire hearing loss in later life experience difficulties with communication, potentially leading to social isolation. However, less is known about the social consequences of age-related hearing loss, and few studies have assessed the influence of environmental factors on hearing loss and social isolation. The aims of this study are to examine: (1) the association between hearing loss and social isolation of older adults over time, and (2) the moderating effects of perceived neighborhood social cohesion and disorder on this relationship. We analyzed 2,080 community-dwelling Medicare beneficiaries aged 65 or above from Round 1 to 3 of National Health and Aging Trends Study. We conducted random coefficient models, entering hearing loss as a random coefficient. Older adults with hearing loss were less socially isolated than those without hearing loss. However, the effect of hearing loss on social isolation varied depending on perceived neighborhood social cohesion. Older adults with hearing loss who reported high neighborhood cohesion had significantly lower social isolation compared to those without hearing loss, while those with hearing loss who perceived low social cohesion had significantly higher social isolation. Our findings suggest neighborhood social cohesion can serve as a potential protective factor for older adults with hearing loss. This poster will propose neighborhood-level interventions that could supplement other services for those with hearing loss, such as assistive devices that are rarely covered by health insurance.
COMPARISON OF CAREGIVERS FROM DIVERSE COMMUNITIES WHO IMMIGRATED TO OR WERE BORN IN THE US
Authors: Stratton Lauren , Bass David , Schaffer Rachel , Powers Sara , Le Ocean , McDavid Jenna
Published: November 2019

The Diverse Elders Coalition, in partnership with its six member organizations and the Benjamin Rose Institute on Aging, completed a national survey of 840 family and friend caregivers from diverse racial, ethnic, and sexual orientation communities to understand their unique caregiving issues and challenges. Data from a subsample of 369 caregivers identifying as Hispanic/Latino, Asian, Southeast Asian or multiple ethnicities were analyzed to understand similarities and differences between caregivers born in the US and who immigrated to the US. The Stress Process Conceptual Model guided selection of characteristics used for comparative analysis. Results of logistic regression revealed that caregivers born in the US were younger (B=-.08, p<.001), had higher educational degrees (B=.42, p<.001), and higher incomes (B=.34, p=.002). They assisted care receivers with more health-related tasks (B=.27, p=.013), but fewer culture-related tasks (B=-.51, p=.002); reported higher levels of strain in their relationship with care receivers (B=.66, p=.038); and were less satisfied with the quality of care receivers’ healthcare (B=-.62, p=.042). In terms of reasons for being a caregiver, there were no significant differences in cultural commitment to caring for older family members, however those born in the US were more likely to report providing care because it was more convenient for them than for other family and friends (B=.99, p=.002). Understanding the needs of diverse caregivers has implications for healthcare and service providers, such as providing training on diverse needs. Additionally, the differences between US born and immigrant caregivers highlights implications on the dynamic between caregivers and their care receiver.
IMPACT OF AGING POPULATIONS ON MUNICIPAL EMERGENCY MEDICAL SERVICES
Authors: Roldan Nidya Velasco , Coyle Caitlin E , Ward Michael , Mutchler Jan
Published: November 2019

The services that residents require from their local governments vary depending on the demographics of their populations. While municipalities have long sought to consider how changes in the young population may impact their school system needs, few systematic considerations have been developed relating to how aging populations may impact municipal service provision. This study aims to address this issue by focusing on demands on emergency services at the municipal level. Using data from the Massachusetts Ambulance Trip Record Information System (MATRIS) we explore the association between emergency medical services (EMS) demand and population age-structure. The data shows an overrepresentation of older people among EMS users. People age 65 and older represent 16% of Massachusetts’ population but account for 31% of the transported emergent calls —e.g., 911 calls— and 60% of the scheduled transports. Results from the OLS regression analysis suggest that communities with larger shares of older residents have significantly higher numbers of EMS calls. The type of community and other age-related community features such as the percentage of older residents living alone and the percentage of older population dually eligible for Medicare and Medicaid are also significantly associated with the number of EMS calls. Contrary to our expectations, other resources available in the community such nursing homes or assisted living facilities were not significantly associated with number of EMS calls. Our research indicates that if growth in the older population occurs as projected, the demand placed on the EMS system by older populations will grow considerably in coming decades.
IMPROVING BRAIN AGE PREDICTION MODELS: INCORPORATION OF AMYLOID STATUS IN ALZHEIMER’S DISEASE
Authors: Ly Maria , Muppidi Nishita , Karim Helmet , Yu Gary , Mizuno Akiko , Klunk William , Aizenstein Howard
Published: November 2019

Brain age prediction may serve as a promising, individualized biomarker of brain health and may help us understand the heterogeneous biological changes that occur in aging. Brain age prediction is a machine learning method that estimates an individual’s chronological age from their neuroimaging scans. If predicted brain age is greater than chronological age, that individual may have an “older” brain than expected, suggesting that they may have experienced a higher cumulative exposure to brain insults or were more impacted by those pathological insults. However, contemporary brain age models include older participants with amyloid pathology in their training sets and thus may be confounded when studying Alzheimer’s disease (AD). We showed that amyloid status is a critical feature for brain age prediction models by training a model on 808 individuals without significant amyloid pathology from the ADNI, OASIS-3, and IXI cohorts. Our model accurately predicted brain age in the training and independent test sets, comparable to previous published models: [r(807) = 0.94, R2 = 0.88, p=0.001, MAE = 4.9 years, p=0.001], [r(39) = 0.67, R2 = 0.45, and MAE = 4.6 years]. We demonstrated significant differences between AD diagnostic groups [F(3,431)=30.7, p<0.001], and our model was the first to delineate significant differences in brain age relative to chronological age between cognitively normal individuals with and without amyloid [mean difference, 95% CI; CN-Aβ(-) (-3.4, -4.9:-1.8), CN-Aβ(+) (-0.7, -1.9:0.5)]. Ultimately, incorporation of amyloid status in brain age prediction models improves the utility of brain age as a biomarker for aging and AD.
COPING BEHAVIORS THAT INCREASE STRESS AMONG OLDER ADULTS
Authors: Rainville G , Williams Alicia R , Choi-Allum Lona
Published: November 2019

This study examined the efficacy of a series of 28 behaviors (e.g., comfort eating, attending worship services, getting a massage, etc.) in moderating the perception of stress among older adults. First, 28 individual behaviors were assessed to determine whether they buffered or exacerbated the impact of an objective stress measure (i.e., the count of stressful life events) on perceptions of stress (measured using Cohen’s Perceived Stress Scale [PSS]). A full sample analysis used data from 1,000 randomly selected U.S. adults age 40 and older, but subsequent analyses explored coping behaviors for two age groups—those age 40 to 59 and those 60 and older. In the full sample analysis, multiple moderating conditions were noted including stress-buffering for worship service attendance, recreational shopping, and getting a massage. Also among the full 40+ sample, stress-exacerbation was noted for social media use and coping by “overreacting to things.” Factor analysis (employing a polychoric correlation matrix) reduced the 28 individual behaviors into 9 clusters comprised of related behaviors and representing a general coping approach. Looking within the age groups, significant stress-buffering was limited to those age 60 and older for two coping approaches—a “Self-Care and Travel” approach and an Inspirational approach (e.g., praying, attending church, etc.). For both age subgroups there was no coping approach, not even the hedonistic “blowing off steam” approach, that was found to exacerbate the impact of stressful life events on the perception of stress.
SMOOTHING THE MOVE FROM POST-ACUTE TO HOME CARE FOR OLDER CARDIAC PATIENTS: A SOCIAL WORK TRANSITIONS INITIATIVE
Authors: Burack Orah R , Auerbach-Burgoon Jessica , Mundy Sandra , Cimarolli Verena R
Published: November 2019

Transitioning across medical settings (e.g. from hospital to post-acute (PA) or PA to homecare (HC)) is a difficult time with numerous challenges, as critical information passes across sites, new systems are quickly established, and caretakers change. Older cardiac heart failure (CHF) patients, often with comorbidities and having fewer social supports, are especially vulnerable to rehospitalizations at that time. This study examines the impact of a Social Work Transitions (SWT) intervention, designed to ease older cardiac patients’ transition from a PA to HC setting, on rehospitalization rates. The SWT model for CHF patients was developed in a large healthcare system with a continuum of services for older adults including PA and HC. Once a patient enters PA from the hospital a transitions social worker (SW) remains the patient’s primary support and contact through PA discharge and the transition to HC. In HC, that same SW ensures needed services occur, conducts home visits, and provides additional follow-up via phone calls. Study 1: compared HC rehospitalization rates of CHF patients receiving SWT (N=28) with those not receiving SWT (N=26). This natural control group arose during the initial program months, as SW turnover occurred and some CHF patients were not accompanied by a transitions SW. SWT patients had half the rehospitalizations (25%) as controls (54%). Study 2 tracked 30 day rehospitalizations rates for the first 17 study months (N=257). Program rehospitalization rates (16.7%) were below the CMS benchmark (21%). These findings support using the SWT program to prevent unnecessary rehospitalizations in CHF patient.
BEYOND BINGO: THE IMPACT OF ACTIVITY ENGAGEMENT IN AN ALL-AFRICAN AMERICAN ASSISTED LIVING COMMUNITY
Authors: Vargas Inneke L , Bender Alexis A , Kemp Candace L , Perkins Molly M
Published: November 2019

More than one million older adults reside in assisted living (AL) communities in America. This figure is projected to double by the year 2030. It is typical for residents in these communities to have cognitive and physical impairments requiring differing levels of care. Due in part to these impairments, it is vital to the health and well-being of residents to participate in meaningful recreational activities. This secondary analysis of ethnographic observations totaling 818 hours and semi-structured interviews with 25 residents enrolled in an NIA-funded study (5R01AG047408) explores in depth barriers and facilitators to activity engagement in a large (90+ bed) moderate-income, all-African-American AL community located in a large urban city in the southern US. Residents range in age from 59 to 103 (mean = 85) and are predominantly female. We linked our findings from thematic analysis to six domains of quality palliative care identified by the 2018 National Consensus Project (NCP) Guidelines for Quality Palliative Care: cultural, physical, psychological, social, structures and processes, and spiritual aspects of care. Key barriers include limitations related to staffing (a low staff-to-resident ratio and high staff turnover) and activities that do not adequately address needs of residents with varying interests and abilities. A robust daily devotion and other activities that incorporate culturally relevant music are activities highly valued by most residents. Implications of these findings contribute to a larger effort to create positive change in the structures and processes of care in AL and can inform best practices for palliative care within these communities.
THE SEARCH STUDY: A QUALITATIVE INQUIRY INTO DIVERSE STAKEHOLDER PERSPECTIVES ON HEALTHY AGING ACROSS CHICAGOLAND
Authors: Khan Mushira , Graham Karen , Washington Tarisha , Kim Abigail , Shah Raj C , Glover Crystal M
Published: November 2019

Older adults face increased risk of chronic diseases of aging such as Alzheimer’s dementia and other adverse age-related outcomes. However, the conceptualization of healthy aging and how age-related issues are addressed in community-based structures, particularly among racial and ethnic minorities, remain poorly understood, especially from the Stakeholder perspective. Stakeholders, such as faith leaders and members of community-based organizations, engage in regular negotiations to advance health equity in their communities by partnering and collaborating with older adults and their families as well as other local and federal organizations. The Stakeholder Engagement in Aging Research and Community Health (SEARCH) Study employs multiple research methods to illuminate Stakeholders’ perspectives on barriers and facilitators to healthy aging in diverse communities. This presentation highlights findings from in-depth, qualitative interviews with Stakeholders (N=37) serving African American, Latinx, and South Asian older adults. Emergent themes suggest that systemic racism, stigmatization, limited health literacy, and cultural beliefs serve as barriers to healthy aging across groups. Within groups, Stakeholders report precarious immigration status and fragile and fragmented life situations as barriers among Latinx older adults, while acculturative stress presents a challenge to healthy aging in South Asian older adults. Food insecurity and neighborhood factors such as exposure to violence and socio-economic disadvantages act as barriers among African American older adults. Conversely, religious faith and spirituality, familial support, and culturally-congruent care serve as facilitators across groups. The findings from this study underscore the continued need for intersectional, inclusive, and culturally-informed approaches to supporting healthy aging within diverse communities.
LOW GLUCOSE ENHANCES THE CYTOPROTECTIVE EFFECT OF METFORMIN AGAINST DOXORUBICIN-INDUCED CYTOTOXICITY
Authors: Ameer Fathima , Zhang Xiaomin , Azhar Gohar , Che Yingni , Wei Jeanne
Published: November 2019

Metformin, an oral anti-diabetic drug, is currently being investigated for its anti-aging properties and has also been used as adjunct therapy in cancer. Cancer is a disease of aging. Type 2 diabetes is also prevalent in older adults. We wanted to test the hypothesis that metformin could protect normal cells during chemotherapy treatment under different glucose conditions. We used C2C12 myoblast cells to study cellular bioenergetics, variations in gene expressions, and biochemical alterations induced by metformin and pegylated liposomal doxorubicin (L-Doxo) under low glucose (2.7 mM or 50 mg/dL) and normal physiologic glucose (5.5 mM, or 100 mg/dL) conditions. Using confocal microscopy, we noted that treatment of C2C12 cells with 30 µg/mL L-Doxo under low glucose and normal physiologic glucose conditions induced cellular defects. Furthermore, L-Doxo treatment dysregulated the expression of mitochondrial fission and fusion genes, which may influence transformation of the network’s connectivity. L-Doxo treatment significantly reduced mitochondrial oxygen consumption rate (OCR) and extracellular acidification rate (ECAR). However, pre-treatment with 100 nM metformin provided protection against L-Doxo-induced damage and increased cell viability and ATP levels in cells even under low glucose conditions. Our data provide further evidence by which low dose metformin exerts protective effects against L-Doxo, a chemotherapeutic drug, under low glucose conditions. Metformin appears to act via AMPKα, Raptor, and SRF, and has significant cellular protective effects that may be useful in cancer and/or aging.
CHOREOGRAPHING INTERACTION WITHIN THE U-M HOMELAB: CONSIDERATIONS FOR AN OLDER ADULT POPULATION
Authors: Leonard Natalie M , Wank Marianthie , Nielsen Karen , Carmichael Alicia G , Wisniewski Maren , Raichur Vineet , Gonzalez Richard
Published: November 2019

Drawing from the lens of architecture, designing a research study for a controlled, simulated environment requires the consideration of three primary types of interaction involving people and infrastructure. These three types include the interface between and among the respondent(s) and the researcher(s), the interface between and among the people playing these roles and the infrastructure surrounding them (inclusive of self-report measures, sensing technology, furniture, etc.), and the interface between and among the various types of study infrastructure. The flow of a study across these interfaces becomes a form of choreography, with implications for protocol adherence, reproducibility, and data quality. Recently, a pilot study assessing an older adult population’s upper-body performance was our first iteration of research utilizing a simulated environment: the U-M HomeLab, an ADA-accommodating, one-bedroom apartment built within the basement of a large research facility. Nine participants, aged 61 to 72, with self-reported upper-body weakness completed a series of tasks resembling activities of daily living, such as lifting laundry baskets and vacuuming. By backtracking through our development of this pilot study, we illustrate how considerations of interface play a significant role across every stage of study design, incorporating aspects of wayfinding, dialogue, safety, acclimation, and visibility that are relevant to an older adult population. From these reflections, considerations of interface inform a “check-list” for simulation choreography, providing guiding questions for assessing these types of interactions while iterating through study design.
THE UNIQUE IMPORTANCE OF RELATIONSHIP QUALITY FOR COMMUNITY-DWELLING OLDER ADULTS
Authors: Tate Ashley M , Martire Lynn
Published: November 2019

Social networks can directly influence the health and well-being of older adults. Some work has suggested that network growth is associated with increased well-being. However, little is known about how the quality of relationships with confidants may be associated with better psychological well-being over and above the number of confidants. We aimed to test the hypothesis that feeling closer to confidants would be associated with lower anxiety and fewer depressive symptoms above and beyond the influence of the number of confidants as well as the number of children and grandchildren. To test this hypothesis, we collected data during face-to-face interviews with 131 community-dwelling adults who were between the ages of 58 and 94. Participants’ gender, age, marital status, self-rated health, and cognitive function were included as covariates in the models. In line with predictions, regression analyses showed that average closeness with confidants predicted significantly lower reports of anxiety (p < .05) and depressive symptoms (p < .001). Additionally, the number of confidants was not significantly associated with anxiety or depressive symptoms. Interestingly, having a greater number of children and grandchildren was associated with increased anxiety symptoms. These results extend previous work by suggesting that the quality of the relationship with confidants is more important for psychological well-being than the number of confidants. Future work should test these associations longitudinally so that directionality can be inferred.
CRYPTIC TRANSCRIPTION IS ASSOCIATED WITH AGE IN MAMMALIAN STEM CELLS
Authors: McCauley Brenna , Sun Luyang , Dang Weiwei
Published: November 2019

Aging is a multifaceted process that challenges organisms with stresses resulting from the dysregulation of cellular processes. Unsurprisingly, given how tightly regulated it is under normal conditions, transcription is one of the key pathways disrupted during aging. Indeed, dysregulation of transcription contributes to the activation of transposable elements, the loss of cellular identity, and decreased stem cell potency with age. Our previous work identified intragenic cryptic transcription (CT) as a novel type of age-associated transcriptional dysregulation that limits the lifespan of yeast and worms. Continuing this work, we show for the first time that CT increases with age in mammalian stem cells. Increased CT is associated with disrupted chromatin structure, particularly with the reduction of H3K36me3, a histone modification known to inhibit CT throughout eukaryotes. We propose that an age-associated reduction in H3K36me3 in actively transcribed gene bodies drives disruption of chromatin structure in these regions, resulting in an open chromatin state. This open chromatin state is permissive for the entry of RNA Pol II, which can then initiate transcription from within the gene body. These aberrant cryptic transcripts may contribute to the pathological load of mammalian aging.
VALUE AND INFORMATION NEEDS FOR DEMENTIA FAMILY CAREGIVERS: CONSIDERATIONS DURING END-OF-LIFE DECISION MAKING
Authors: Schlag Karen E , Kmetz Lorie , Burrows David , Kwak Jung
Published: November 2019

Family caregivers often make key end-of-life care decisions for their relatives. For those caring for persons with dementia (PWDs), a third of older decedents, making end-of-life decisions as a surrogate is especially challenging. Notably, few evidence-based interventions exist to support caregivers in this capacity. Guided by the Ottawa Decision Support Framework which recognizes three determinants of informed decisions - information, value clarity, and support, the current study identifies key value considerations and information needs among family caregivers as they weigh decisions regarding hospice enrollment and artificial nutrition and hydration (AHN) for PWDs. One focus group (n=7) and four individual interviews (n=4) were conducted with dementia family caregivers. All face-to-face and telephone interviews were audio-recorded, transcribed verbatim, and verified for accuracy. Thematic analysis (Braun & Clarke, 2006) was conducted to identify and organize themes. Two main themes and subthemes emerged: 1. Caregivers expressed hospice-related values including having enough knowledge about hospice treatments for both Alzheimer’s and new symptoms, having caregiver support services, considering family needs, and weighing the extent the PWD can engage with others meaningfully and remain at home. 2. Caregivers shared AHN-related values including clearly understanding AHN treatments, services and risks for the PWD considering the patient’s functional status. Participants’ information needs reflected their priority of practical needs being met. These findings offer implications for how to design decision support tools and interventions that provide practical and specific information on the benefits and risks of hospice and AHN for PWDs and caregivers.
UNIQUE TRANSCRIPTOME OF AGE-ASSOCIATED VISCERAL FAT-RESIDENT GAMMA DELTA T CELLS
Authors: Starr Marlene E
Published: November 2019

Gamma delta T cells (Tγδ) are a unique group of immune cells that perform both adaptive and innate functions. We recently identified a population of Tγδ cells which show an age-dependent expansion in the visceral fat of both mice and humans. However, little is known regarding the role of these cells in the fat. The purpose of this study was to begin delineating their role by: (1) comparing the gene expression profile of visceral fat-resident Tγδ to conventional T cells (Tconv) and to circulating Tγδ, and (2) identifying age-dependent changes in gene expression within the visceral fat-resident Tγδ population. Tγδ and Tconv were magnetically purified from blood and visceral fat of young and aged mice. Using NanoString technology, we found that overall transcriptomes of Tγδ in fat and blood were strikingly different. Transcriptomes of Tγδ and Tconv within the fat were more similar, but distinct with the former having high representation of pathways related to inflammation, cytokine and chemokine signaling, and macrophage function and the latter having high representation of pathways related to T- and B-cell function and TNF superfamily. Within the Tγδ population we identified significant (>1.8-fold change, p<0.01) age-associated differences in expression for 8 upregulated genes (C6, Cxcl13, Prg2, Il5ra, Ctla4, Marco, Ccl8, Il10) and 10 downregulated genes (Col4a1, Xcl1, Col1a1, Cfd, Col3a1, Lbp, Thbs1, Klrd1, Il6st, Ccl17). These genes will guide further research aimed at understanding the role of these cells and how their age-associated changes contribute to chronic inflammation, an underlying component of multiple age-related diseases.
ADULT DAY HEALTH SERVICES ATTENDANCE IS LINKED TO A REDUCTION IN LONELINESS
Authors: Mak Wingyun , Burack Orah R , Reinhardt Joann P
Published: November 2019

Loneliness is the subjective experience of inadequate social contact, and it is linked to numerous detrimental psychological and medical outcomes like depression, cognitive decline, sleep fragmentation, metabolic syndrome, diminished immune functioning, and morbidity. Older adults with cognitive impairment and/or other comorbidities are at greater risk for loneliness due to diminishing social roles, functional status, and death of peers. They are often encouraged to attend adult day services to engage in an environment of socialization and supported activities, and in the case of adult day health services, additional medical services such as physical therapy, skilled nursing care, medical management, and nutritional counseling. In this study we examined whether attending adult day health services (ADHS) at least once a week would be associated with decreased levels of loneliness across time. Our data came from a sample of older adults attending ADHS in New York City from 2018-2019 who scored five or greater on the Nursing Facility Level of Care Index, which is a score derived from assessments of cognition, communication and vision, mood and behavior, functional status, continence, and nutritional status from the Uniform Assessment System in New York (UAS-NY). We found that attendance was linked with fewer reports of loneliness across time, ∑2(1, N=563) = 21.33, p<.001. These results highlight the importance of attending adult day health services for people with a complex health status and the potential role ADHS may play in reducing loneliness in a vulnerable population.
HOUSING CONTEXT AND FUNCTIONAL HEALTH AMONG LOWER INCOME OLDER ADULTS
Authors: Webster Noah J
Published: November 2019

The characteristics of where older adults live have strong links with disability. Although lower income older adults experience disability at higher rates, less is known about the link between housing characteristics and functional health in this group. A within group comparison among this population is needed to understand how aspects of this vulnerable subgroup’s housing context are associated with health outcomes. The present study examines the association between housing and functional health among a U.S. nationally representative sample of independent living (i.e., not living in nursing homes or assisted living facilities) lower income adults age 65+. Using data from round one of the National Health and Aging Trends Study, a sub-sample of N=2,865 lower income (<$15,000 in the past year) older adults was selected for analysis. Regression analyses indicate that lower income older adults living in multiunit buildings reported better functional health compared to those in other housing contexts (e.g., free-standing homes). This link also significantly varied by age and gender. Living in multiunit housing was associated with better functional health among those age 90+, not associated among those age 80-90, and was negatively associated among those age 65-79. In terms of gender, the link between multiunit housing and better functional health was only significant among women. Findings highlight variation in health across lower income older adults’ housing contexts. Potential explanatory mechanisms (e.g., social isolation) will be discussed. Such information can inform senior housing policy regarding best approaches to providing housing for older adults that optimizes and promotes independent living.
ELDER SEXUAL ABUSE: A REVIEW OF LEGALLY MANDATED APPROACHES TOWARD PREVENTION AND FUTURE IMPLICATIONS
Authors: Hand Michelle
Published: November 2019

Rape stereotypes involve the assault of young women due to sexual desire, resulting in the exclusion of older adults from sexual violence research, policies, and interventions, suggesting a need to further knowledge in this area (Bows & Westmarland, 2015). Debates also persist on the prevalence and nature of elder sexual abuse (ESA), where it occurs, and its most common perpetrators (Bows, 2018). Thus a systematic scoping review was conducted to explore the nature and prevalence of ESA as well as mandated prevention and intervention strategies to guide practice, policy, research and education on prevention. Eligible sources were research-based and focused on the nature of ESA along with legal prevention and/or intervention mandates. In total, 38 peer-reviewed articles and reports were screened in for review, obtained from AgeLine, EBSCO, Clinical Key Flex, PubMed, Google, and Google Scholar databases. Findings suggest while consensus has not been reached (Bows, 2018), ESA estimates range from 0.2% to 7% of U.S. elder abuse cases, yet actual rates are likely much higher due to underreporting (Cannell et al., 2014). Additionally, results suggest ESA most often occurs in nursing homes, predominantly perpetrated by staff or residents (Ramsey-Klawsnik et al., 2008). Still, ESA remains underreported despite several mandated approaches to prevention and intervention (Payne, 2010). Thus findings demonstrate a need for reliable estimates of prevalence, location as well as common victim-perpetrator relations and awareness of required steps toward prevention and intervention (Payne, 2010). Beyond this, transdisciplinary efforts are needed to yield effective training, education, and culturally appropriate resources.
RATINGS OF PERCEIVED EXERTION: PREDICTING MOBILITY DISABILITY AND RESPONSE TO PHYSICAL ACTIVITY IN OLDER ADULTS
Authors: Cenko Erta , Gill Thomas M , Glynn Nancy W , Pahor Marco , Qiu Peihua , Valiani Vincenzo , You Lu , Manini Todd M
Published: November 2019

Ratings of perceived exertion (RPE) during exercise are linked to several physiological indices and are often elevated in older adults. This study evaluated the association between RPE of walking and incident major mobility disability (MMD) as well as response to a physical activity (PA) program. Older adults (n=1633) at-risk for mobility impairment were randomized to a structured PA or health education (HE) program. During a 400m walk, participants rated exertion as “none”, “light”, “somewhat hard” or “hard”. An MMD event was defined as the inability to complete the 400m walk. Transitions between RPE states and an MMD event—when RPE was not collected— were assessed over the follow-up (every 6 months for an average of 2.6 years). Participants rating their exertion as “hard” at baseline 400m walk had nearly 3-fold higher risk of MMD compared with those rating as “light” (HR: 2.61, 95%CI: 2.19-3.11). During follow-up, the PA group was 25% more likely to transition from “light” to “hard” RPE (1.25, 1.05-1.49), but was 27% (0.73, 0.55 – 0.97) less likely to transition from a “hard” RPE to MMD than the HE group. Additionally, the PA group was more likely to transition from an MMD event to a “hard” RPE (2.09, 1.38-3.17) than the HE group (i.e. recovery). Older adults rating “hard” effort during a standardized walk test were at increased risk of MMD. A structured PA program increased transition from light to hard effort, which may reflect greater capacity to perform the test and increased recovery from an MMD event.
STARTING THE CONVERSATION: RESULTS FROM AN INTERPROFESSIONAL WORKSHOP ABOUT ADVANCE CARE PLANNING
Authors: Barnes Stacy L , Breakwell Susan , Cannon Jordan
Published: November 2019

Advance care planning is more than documenting end of life medical decisions; it should be the beginning of an important and ongoing conversation about personal values, goals, and preferences. Health profession students must be prepared to have these conversations and overcome any existing barriers to effective patient-provider communication. To this end, a multidisciplinary planning team from Marquette University and the Medical College of Wisconsin developed a 2-hour workshop directed at students in the health professions. It was designed to be highly interactive, including guided self-reflection, drawing, writing, videos, small group work, case presentations, and large group discussion. The workshop was scheduled to coincide with National Healthcare Decisions Day (April 16th). A total of 149 students participated, representing the disciplines of medicine, nursing, physician assistants, counseling psychology, speech pathology, and biomedical sciences. Feedback from both students and faculty was overwhelmingly positive, indicating interest and need for this type of program. A post-event questionnaire, which included a retrospective pre/post-test, assessed learners’ gains in knowledge and self-efficacy. Significant (< 0.001) gains were found on all measured items. Data from an electronic follow-up survey suggested the majority of participants took additional actions steps related to advance care planning in the month following the workshop. In conclusion, this is a low-cost, replicable workshop that aligns with current recommendations for advanced care planning (IOM, 2015), is well received by students and faculty in the health professions, and may serve as a springboard for increasing the number of advance care planning conversations.
“THEY SHOULD PUT ALZHEIMER’S GROUPS IN THE CHURCHES”: A SYNTHESIS OF AFRICAN AMERICAN CAREGIVERS’ LIVED EXPERIENCES
Authors: Murphy Erin R , Brooks Destony , Bryant Julie , Fields Noelle L , Xu Ling
Published: November 2019

Alzheimer’s disease and related dementias (ADRD) are challenging chronic health conditions that disproportionately impact African Americans. Caring for a family member with ADRD can be a taxing experience that impacts the mental, social, and physical realms of the caregiver’s life. Chronic fatigue and high levels of anxiety, depression, and agitation have all been associated with caregiving. The extant literature on caregivers is limited by being conducted primarily in settings with White participants, excluding the cultural attitudes and values that may impact caregiver experience. As part of a larger, mixed-methods team studying the impact of an innovative psychoeducational intervention, the researchers conducted a qualitative interpretive meta-synthesis (QIMS) to better understand the experiences and perceptions of African Americans who care for family members with ADRD. A QIMS was chosen as the methodology for this study because of its ability to create a more holistic understanding of the phenomenon, while maintaining the integrity of the original studies. An exhaustive literature search yielded 1,285 potentially relevant studies. Studies were compared across a priori inclusion criteria. Findings of this study indicate that overall knowledge of ADRD is relatively low among caregivers and participants are unsure of how to access educational materials. Synthesis of these studies also indicate a need for incorporating spiritual well-being into caregiving services. Results of this study may help social workers and other health care professionals to better understand cultural perceptions of the disease and how to better provide psychoeducational interventions related to the specific needs of African American caregivers.