bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors of Sleep Disturbance in Older Adults With Dementia: An Actigraphy-Based Validation Study
Authors: Shin Jinhee , Cho Eunhee , Kang Bada , Kim Sujin , Hwang Sinwoo , Kwon Eunji , Heo Seok-Jae
Published: December 2021

Sleep disturbance is a common and significant symptom experienced by older adults with dementia. Early detection and timely treatment of sleep disturbance are critical to prevent adverse consequences including decreased quality of life for persons with dementia and increased caregiver burden. While direct observations and sleep diaries are often unreliable, actigraphy is a cost-effective method in measuring sleep problems in older adults with dementia and provides reliable and rich sleep data. Therefore, this study aimed to examine sleep disturbance objectively measured by actigraphy and its risk factors in community-dwelling older adults with dementia in Korea. This is a prospective study consisting of a two-wave dataset. The model was fitted using Wave 1 data (n=151) and then validated using Wave 2 data (n=59). Independent variables were demographics, cognitive and physical function, depressive symptoms, physical activity level, and neuropsychiatric symptoms measured by Neuropsychiatric Inventory(NPI), and clinical factors including dementia type, sedative use, and comorbidities. Sleep disturbance was defined as less than six nighttime sleep hours and sleep efficacy less than 75%. Using the Youden’s Index, the sample was dichotomized into sleep disturbance group (n=83) and sound sleep group (n=68). The results of the generalized linear mixed model showed that the risk factors for sleep disturbance included vascular dementia, age, step count, and having three neuropsychiatric symptoms (i.e., delusions, depression, and disinhibition). Individuals with dementia at risk for sleep disturbance should be identified to prioritize early prevention strategies and individualized interventions. Particularly, management of delusion, depression, disinhibition is critical in preventing disturbed sleep.
Impact of COVID-19 on Older Employees of a Large State University: Findings From a Mixed-Methods Study
Authors: Chen Zhao , Sokan Amanda
Published: December 2021

Burgeoning research on the effects of COVID-19 and university experiences in the U.S. tends to focus on transmission of COVID-19 virus or student-related consequences of COVID-19. However, none to our knowledge examine the effects on older university employees. Universities employ a higher percentage of older adults with diverse job responsibilities and socioeconomic status, presenting a unique closed community for understanding the pandemic’s consequences for older adults. Our aims are to: 1) understand older university employees’ concerns related to COVID-19, 2) develop intervention strategies to mitigate the adverse impact of the COVID-19 pandemic on the health and wellbeing of older employees, and 3) test the interventions within the target population to help reduce stress and promote wellbeing. Using a community participatory approach, we sought input from employees aged 50 and older at the University of Arizona. Mixed methods were used to collect qualitative (six focus groups; N= 24) and quantitative (online survey; N=1030) data. We conducted and evaluated a set of interventions (i.e., virtual Tai Chi and Qigong, walking exercises, and meditation) using focus group feedback, process evaluation, and outcome assessment with validated questionnaires on sleep quality, mindfulness and psychological wellbeing. Findings show that a significant percentage of older employees worried about getting COVID-19 and had experienced undesirable changes in sleep quality, weight, and physical activity, and concerns about caregiving; however, we also observed psychological resilience in this population. The study highlights the importance of developing immediate and effective programs for promoting health and wellbeing for older employees during the pandemic.
Measurement of Centre of Pressure Using the Wii Balance Board in Older Adults with Simulated Visual Impairment
Authors: Petersen Berkley , Murphy Caitlin , Johnson Aaron , Li Karen
Published: December 2021

Postural stability is a complex skill dependent upon the coordination of motor, sensory and cognitive systems. The purpose of this project was therefore to explore how older adults’ balance performance is impacted by increased cognitive load, hearing loss, and simulated vision loss. Twenty-eight older adults between the ages of 50 and 93 years (M = 73.86, SD = 10.43) were tested. Participants underwent standard sensory acuity and cognitive functioning tests. The balance trials varied as a function of cognitive load and visual challenge resulting in five conditions: (1) eyes closed, (2) normal vision clear goggles (NV) (3) simulated low vision (20/80) goggles (LV) (4) LV and math task, (5) NV and math task. Postural stability was assessed with three key center of pressure parameters: total path length (TPL), anterior-posterior amplitude (APA) and medial-lateral amplitude (MLA). A mixed-model ANOVA using hearing acuity as a covariate revealed significant effects of complexity in sway amplitude: (APA: p < .017; MLA: p < .020), while TPL approached significance (p < .074). T-tests revealed significant (p < .05) decreases in balance performance across all 3 centre of pressure parameters when comparing single task NV to dual-task NV, NV vs. eyes closed and single task NV vs. LV dual-task. There were significant positive correlations between hearing acuity and balance (MLA) under single task NV (r = .491) and LV conditions (r = .497). Results suggest the attentional demands from increased cognitive load and sensory loss lead to decreases in older adults’ single- and dual-task balance performance.
Co-Design Of Technology Driven Self-Management With Older Adults: An International Approach
Authors: Saney Danielle , Pollini Alessandro , Suijkerbuijk Sandra , Krijger Regina , Astell Arlene
Published: December 2021

There has been an emergence in technology applications (apps) aimed at addressing needs amongst older adults and persons with cognitive impairment (PwCI). Despite the ubiquity of these apps, utilization is low, primarily due to a lack of involvement of PwCI and the perception that these apps have little motivational value. Engaging PwCI in creative processes such as co-design could lead to the creation of apps that better meets the needs of this population. The current study applies a user-centered, participatory approach to involve PwCI in the design of a new self-management and coaching app, RESILIEN-T. Co-design workshops were held with 12 PwCI across Italy, Netherlands and Canada; structured as four modules: (1) introduction and expectation setting, (2) user analysis, (3) storytelling, and (4) collaborative design. Based on interviews with PwCI, stories of individuals which reflect the target population were created (personas) and the solutions to the needs of these personas were discussed. Information about participant’s interests, computer proficiency and self-rated cognitive decline were collected. Participants were asked to try 10 existing apps and provided feedback on the design, usability and functionality. Lastly, participants were shown a prototype for RESILIEN-T and provided feedback based on the personas that they helped create. Co-design activities revealed that personalization is crucial for adherence. Aspects of physical and social activity, nutrition and cognition were most important to participants. Participants found many apps that are recommended for older adults do not appear age appropriate and seem condescending. These findings were common across PwCI from various nations.
Social participation and attitude towards gerontechnology: The moderating role of frailty status
Authors: Lee Ka Yeon , Lee Sun Ah , Joo Susanna , Kim YoonMyung , Lim Yun Mook , Jun Hey Jung
Published: December 2021

The purpose of this study was to examine whether frailty status moderates the association between social participation and attitude towards using gerontechnology. The sample was Korean older adults without cognitive impairment (N = 310, aged 66-90, 51% women) who completed an online survey. The attitude towards using gerontechnology was measured with two questions from the Senior Technology Acceptance Model (Chen & Chan, 2014), asking whether using technology is a good idea and whether they like the idea of using technology. Social participation was assessed by asking whether the participants engage in social or community activities on a scale of 1–10. Frailty status was determined based on the Korean Groningen Frailty Indicator (K-GFI). Covariates were age, gender, marital status, employment status, education level, and household income. Results from regression analyses showed significant interaction between frailty status and social participation on attitude towards using gerontechnology. Specifically, social participation was associated with positive attitude towards using gerontechnology among non-frail older adults. This association was not significant among frail older adults. Our findings suggest that the relationship between social participation and attitude towards using gerontechnology might differ by physical health status. Among older adults who are physically healthy and actively participate in social activities, the attitude towards using gerontechnology might be more positive due to greater exposure to new technology-related information. Future studies need to address alternative ways to enhance technology-friendliness among older adults with poor physical health.
Biological Aging, Mortality, and Alzheimer’s Disease Related Biomarkers from Midlife to Old Age
Authors: Franz Carol , Buchholz Erik , Qin Amy Yongmei , Tu Xin , Kremen William
Published: December 2021

People age at different rates and in different biological systems that may differentially contribute to accelerated decline. Better understanding of biological aging may contribute to identification of better targets for intervention. In 1005 VETSA participants we created 3 indicators of biological age: physiological age (PA), frailty, and brain age. PA included hemoglobin, glucose, lipids, height, weight, waist, systolic and diastolic blood pressure, and age. PA was calculated using the Klemera and Doubal (2006) method. The frailty index summed 37 health deficits (Jiang et al. 2017). A machine learning algorithm was used to estimate brain age across cortical and subcortical regions (Liem et al, 2017); predicted brain age subtracted from chronological age comprised the predicted brain age difference score (PBAD). Frailty and PBAD were calculated at waves 1, 2 and 3 when participants were average age 56, 62, and 68, respectively. PA markers were only available at waves 2 and 3. Outcome measures included mortality by wave 3 and scores on AD-related plasma biomarkers—Neurofilament light (NFL), Tau, and AB40 and AB42 at wave 3. Frailty at wave 1 and 2 predicted mortality. Frailty at wave 1 was significantly associated with wave 3 NFL, AB42 and AB40. Wave 2 & 3 frailty was associated with all biomarkers. Neither PA nor PBAD predicted biomarkers or mortality. The results are striking given the relatively young age of the sample. Even as early as one’s 50s, frailty in a community-dwelling sample predicted accelerated decline and mortality when the outcome age was only 66-73.
Can We Simplify Aging?
Authors: Ukraintseva Svetlana , Yashin Anatoliy
Published: December 2021

Aging is indeed a complex process, but can it be simplified, so we could efficiently prioritize candidate anti-aging interventions and select those with largest impacts on key negative consequence of the aging, i.e., on increases in mortality risk and comorbidities with age? Here we argue that human aging and its negative consequences for health and lifespan are essentially driven by the interplay among three processes: (i) depletion of limited body reserves (e.g., of stem, immune, neural, muscle cells); (ii) inherent deficiency of cell/tissue repair mechanisms, which leads to accumulation of damage, allostatic load, and systems dysregulation; and (iii) general slowdown of physiological processes in the body (such as metabolism, proliferation and information processing) with age that results in slower responses to stressors and delayed recovery after damage (i.e., decline in resilience), which in turn contributes to increase in vulnerability to death with age. We show that the interplay among these processes can have ambivalent effects on health and longevity that should be taken into account to develop optimal anti-aging and pro-longevity strategies. In order to be efficient on the long-term, the anti-aging interventions may need to target the different causes of aging (reserve depletion, damage accumulation, and slowdown) simultaneously, to avoid undesirable trade-offs.
Effect of Combined Stressors on C. elegans Lifespan
Authors: Hull Bradford , Sutphin George
Published: December 2021

Cellular stress is a fundamental component of age-associated disease. Cells experience many forms of stress (oxidative, heavy metal, etc.), and as we age the burden of stress and resulting damage increases while our cells’ ability to deal with the consequences becomes diminished due to dysregulation of cellular stress response pathways. By understanding how cells respond to stress we aim to slow age-associated deterioration and develop treatment targets for age-associated disease. The majority of past work has focused on understanding responses to individual stressors. In contrast, how pathology and stress responses differ in the presence of multiple stressors is relatively unknown; we investigate that here. We cultured worms on agar plates with different combinations of arsenic, copper, and DTT (which create oxidative/proteotoxic, heavy metal, and endoplasmic reticulum (ER) stress, respectively) at doses that result in 20% lifespan reduction individually and measured the effect on lifespan. We found that arsenic/copper and arsenic/DTT combinations created additive lifespan reductions while the copper/DTT combination created an antagonistic lifespan reduction when compared to controls (p<0.05). This antagonistic toxicity suggests an interaction either between the mechanisms of toxicity or the cellular response to copper and DTT. We are now evaluating the impact of copper and DTT individually and in combination on unfolded protein and heavy metal response pathways to understand the underlying mechanism of the interaction. Additionally, we are continuing to screen stressors to identify combinations that cause non-additive (synergistic or antagonistic) toxicity to build a comprehensive model of the genetic stress response network in C. elegans.
MTOR Inhibition Alters miRNA Profile in Cultured Bone Marrow Mesenchymal Stem Cells
Authors: Stukenborg Lisa , Potnis Manali , Sell Christian
Published: December 2021

Progressive decline in adult stem cell function is a feature of aged tissues and contributes to multiple age-related diseases. Of particular interest are bone marrow mesenchymal stem cells, also known as bone marrow stromal cells (BMSCs), which are multipotent, and have significant therapeutic potential for age-related disease. BMSCs isolated from older individuals show decreased differentiation and characteristics of cell senescence. We and others find that inhibition of the mTOR pathway prevents senescence and extends BMSC proliferation. We have examined miRNA profiles in rapamycin-treated BMSCs to identify miRNAs that may be needed to maintain “stemness” and facilitate differentiation in this population in undifferentiated cell populations. The analysis reveals a distinct miRNA profile induced by rapamycin associated with enhanced differentiation capacity.
A Phase 2b Clinical Trial Assessing Lomecel-B Infusion in Individuals with Aging Frailty: Study Design and Rationale
Authors: Ramdas Kevin , Hitchinson Ben , McClain-Moss Lisa , Yousefi Keyvan , Diaz Liliana , Ruiz Jorge , Hare Joshua , Oliva Anthony
Published: December 2021

Frailty is a common and important geriatric syndrome characterized by age-associated declines in physiology and function across multiple organ systems, which lead to increased vulnerability to adverse health outcomes. A biological mechanism that underlies the decline in physical function associated with aging frailty is chronic inflammation. The MSCs in Lomecel-B have immuno-modulatory capacity and control inflammation and the cytokine production of lymphocytes. An individual’s endogenous stem cell production decreases with age, this decrease likely contributes to reduced ability to regenerate and repair organs and tissues. Aging Frailty represents an exciting potential indication for cellular based therapies like Lomecel-B. This study is intended to evaluate the effects of Lomecel-B infusion compared to placebo on mobility and exercise tolerance, patient-reported physical function assessments and biomarkers for inflammation in individuals with Aging Frailty. This is a randomized, double-blind placebo-controlled, parallel multi-arm multicenter study enrolling adults aged 70-85 years identified as mildly or moderately frail per the CSHA Clinical Frailty Scale (CFS), with reduced six minute walk test (6MWT) and elevated Tumor Necrosis Factor-α (TNF-α), at screening. 150 subjects (30 per group) were randomized to receive a single peripheral intravenous infusion of 25, 50, 100, or 200 million doses, or placebo. Safety and efficacy assessments were conducted at 30, 90, 180, and 270 days after infusion. A follow up telephone call to subjects was placed at 365 days. We describe the design and rationale in detail of this 2b study assessing the effects of Lomecel-B on older adults with Aging Frailty.
Exercise-Induced Transcriptional Changes in Aged Skeletal Muscle
Authors: Endo Yori , Zhang Yuteng , Olumi Shayan , Karvar Mehran , Sinha Indranil
Published: December 2021

Exercise is beneficial for physical functions across all ages. However, the response to exercise shifts from anabolism, resulting in limited gain of muscle strength and endurance. These changes likely reflect age-related alterations in transcriptional response underlying the muscular adaptation to exercise. The exact changes in gene expression accompanying exercise, however, are largely unknown, and elucidating them is of a great clinical interest for optimizing the exercise-based therapies for sarcopenia. In order to characterize the exercise-induced transcriptomic changes in aged muscle, a paired-end RNA sequencing was performed on the rRNA-depleted total RNA extracted from the gastrocnemius muscles of 24 months-old mice after 8 weeks of regimented exercise (exercise group) or sedentary activities (sedentary group). Differential gene expression analysis revealed upregulations in the group of genes involved in neurotransmission. In particular, genes encoding the transporters and receptor components of glutaminergic transmission were significantly upregulated in exercised muscles, as exemplified by Gria 1, Gria 2 and Grin2c encoding glutamate receptor 1, 2 and 2C respectively, Grin1 and Grin2b encoding N-methyl-D-aspartate receptors (NMDARs), Nptx1 responsible for glutaminergic receptor clustering, and Slc1a2 and Slc17a7 regulating synaptic uptake of glutamate. These changes were accompanied by an increase in post-synaptic NMDARs and acetylcholine receptors (AChRs), as well as their innervation at neuromuscular junctions (NMJs). These results suggest that neural responses predominate aged skeletal muscle following exercise, and indicate a possibility that glutaminergic transmission at NMJs may be responsible for synaptic protection and neural remodeling accompanying the exercise-induced functional enhancement in aged skeletal muscle.
Immature Pear Extract Constituents Exert Multifaceted Anti-aging Effects
Authors: Ogita Akira , Murata Wakae , Yamauchi Ken , Sakai Akiko , Yamaguchi Yoshihiro , Tanaka Toshio , Fujita Ken-ichi
Published: December 2021

Cellular senescence causes a gradual loss of physiological functions and induces chronic diseases, which negatively affect the quality of human life. Intervention in the cellular senescence process may reduce the incidence of these diseases while delaying the progression of age-related diseases, thereby prolonging human lifespan. In our previous study, we found that extending the chronological lifespan of budding yeast cells, a suitable cellular model for research on mammalian cells, could be achieved by adding immature pear extract (iPE). Moreover, at the 2020 GSA meeting, using a colony-counting method, we reported that both hydrophilic (WiPE) and hydrophobic (OiPE) iPE components exhibited a chronological lifespan prolongation on yeast cells. In this study, the expression of sirtuin-related genes, which regulate cellular senescence, was verified by quantitative real-time reverse-transcription polymerase chain reaction. Interestingly, sirtuin-related gene expression was significantly increased in the WiPE-treated cells only, and OiPE could extend the chronological lifespan of yeast cells through the mechanisms not involved in sirtuin-related gene expression. In general, hydrophobic and hydrophilic components exhibit different degradation and metabolism in cells. Since each component has a different strategy of absorption and excretion in the body, we hypothesize that iPE with multiple active components will have multifaceted effects on anti-aging. Our research on elucidating the mechanism of lifespan extension by OiPE and its application to mammalian cells is ongoing.
Kynurenine Metabolism Lifespan Extension Mediated by Oxidative Stress Response and Hypoxic Response in C. elegans
Authors: Castro-Portuguez Raul , Meyers Jeremy , Freitas Sam , Dang Hope , Turner Emily , DeNicola Destiny , Espejo Luis , Sutphin George
Published: December 2021

Aging is characterized by a progressive decline in the normal physiological functions of an organism, ultimately leading to mortality. Metabolic changes throughout the aging process disrupt the balance and homeostasis of the cell. The kynurenine metabolic pathway is the sole de novo biosynthetic pathway for producing NAD+ from ingested tryptophan. Altered kynurenine pathway activity is associated with both aging and a variety of age-associated diseases, and kynurenine-based interventions can extend lifespan in Caenorhabditis elegans. Our laboratory recently demonstrated knockdown of the kynurenine pathway enzymes kynureninase (KYNU) or 3-hydroxyanthranilic acid dioxygenase (HAAO) increases lifespan by 20-30% in C elegans. However, the mechanism of how these interventions may modulate response against different stressors during the aging process has yet to be explored. Fluorescent reporter strains show the stress-responsive transcription factors skn-1 (ortholog of NRF2/NFE2L2; oxidative stress response) and hif-1 (ortholog of HIF1A; hypoxic stress response) to be highly upregulated when the kynurenine pathway is inhibited. We also demonstrated the increase expression of gst-4 and gcs-1 (transcriptional targets skn-1), which are involved in production of the antioxidant glutathione (GSH), as well as upregulation of cysl-2 (transcriptional target of hif-1), a regulator of cysteine biosynthesis from serine. We hypothesize that lifespan extension resulting from kynurenine pathway inhibition is mediated, at least in part, by upregulation of these transcription factors, providing elevated defense against oxidative stress and hypoxic stress.
Targeting kynurenine metabolism to reduce inflammation and enhance stress response during aging
Authors: Sutphin George , Dang Hope , Espejo Luis , Castro-Portuguez Raul , Hull Bradford , Meyers Jeremy , Turner Emily , DeNicola Destiny
Published: December 2021

Aberrant kynurenine pathway metabolism is increasingly linked to aging and age-associated disease. Kynurenine metabolic activity increases with age and becomes dysregulated during various forms of age-associated pathology in humans. By manipulating one or more kynurenine pathway enzymes and metabolites, we have extended lifespan up to 40% in Caenorhabditis elegans. In particular, elevating physiological levels of the kynurenine pathway metabolite 3-hydroxyanthranilic acid (3HAA) by directly supplementing 3HAA or inhibiting the enzyme 3HAA dioxygenase (HAAO) extends C. elegans lifespan by ~30%. 3HAA delivered chronically in chow similarly extends lifespan in aged C57BL/6 mice. In ongoing work, we are investigating the mechanisms underlying the benefits of multiple kynurenine pathway interventions using tools in C. elegans, mice, and human cell culture. We have preliminary evidence for activation of broad-spectrum cellular stress response, enhanced immune function, and reduced inflammation. Among other roles, the kynurenine pathway is the sole metabolic route for de novo synthesis of nicotinamide adenine dinucleotide (NAD+) from tryptophan in Eukaryotic cells. We are examining the regulatory interaction between kynurenine metabolism and the two NAD+ recycling pathways, Salvage and Preiss-Handler, both as potential mechanistic mediators and as possible parallel targets for combined interventions with synergistic benefits in aging. We are further evaluating the impact of these interventions in several models of specific age-associated diseases, including sepsis, chronic inflammation, stroke, Alzheimer’s disease, and cancer. Finally, we are developing pharmaceutical strategies to replicate key genetic and metabolic interventions within the kynurenine pathway that can be readily translated into clinical applications.
Infusing Representativeness and Cultivating Harmonization in Alzheimer’s Trials: World Wide FINGERS
Authors: Raman Rema , Aggarwal Neelum
Published: December 2021

World Wide Fingers is a network involving over 30 countries organized to conduct randomized controlled clinical trials to slow the progression of cognitive decline and reduce dementia risks. Trials are designed to parallel the successful Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial of a multidomain lifestyle intervention featuring increased physical activity, improved diet, cognitive training, and metabolic risk factor monitoring. While FINGER found that its intervention significantly benefited cognitive function, it is not clear whether this approach might be successfully tailored to other cultures and environments to yield similar results. This is the goal of World Wide FINGERS. It infuses representativeness by enrolling cohorts that reflect the communities in which it is conducted. For findings across the many trials to be integrated, it is necessary for protocols to be harmonized as much as possible. The COVID-19 pandemic presents special challenges towards harmonization as its disruptions of trial protocols and conduct vary among countries and over time. This symposium is organized to provide the scientific background and framework for the World Wide FINGERS. Novel grassroots efforts towards enrolling representative cohorts in the US will be described. Plans for harmonization and federated data analyses spanning international boundaries and regulations will be outlined. Integrated approaches to challenges of COVID-19 pandemic across trials will be presented. The conclusion of this session will be a discussion of how World Wide FINGERS may serve as a model for collaborative approaches to identify effective, translatable approaches to reduce risks for Alzheimer’s disease.
Treadmill Training Improves Aerobic Capacity in Aged Male Mice Compared to Voluntary Wheel Running
Authors: Schmitt Emily , Graves Hunter , Bruns Danielle
Published: December 2021

Preclinical exercise studies typically use two forms of exercise training protocols: 1) voluntary wheel running and 2) forced treadmill running. Previous work from our group clearly demonstrates that older (18-month-old) male mice do not voluntarily engage in wheel running, especially compared to younger males or female mice. Therefore, we implemented a forced exercise treadmill training protocol to determine if treadmill training was superior to wheel running in improving aerobic capacity in older male mice. PURPOSE: To determine if a 3-week treadmill training protocol improved time to exhaustion (TTE) in older male mice. METHODS: 18-month-old male mice (n=5) were provided a running wheel in their individual cage for 2 weeks or underwent daily treadmill training (n=6) for 3 weeks with increasing speed/incline. At the end of the training period we assessed TTE. RESULTS: Older male mice that trained on the treadmill demonstrated higher TTE compared to wheel (1382 □ 32 seconds versus 500 □ 99 seconds, respectively). In addition, older male mice that trained on the treadmill improved on average ~8% in their TTE test. CONCLUSION: A 3-week treadmill training protocol improves aerobic capacity in older male mice to a greater extent than voluntary wheel running. Ongoing experiments will utilize this training protocol to understand age-related declines in cardiorespiratory fitness, circadian rhythm, and to test exercise as an intervention in the aging population.
Depletion of the miR-34a “sponge” MALAT1 in aging skeletal muscle: Implications for age-related muscle loss
Authors: Ruan Ling , Mendhe Bharati , Isales Carlos , Hill William , McGee-Lawrence Meghan , Fulzele Sadanand , Hamrick Mark
Published: December 2021

We have recently shown that increased levels of reactive oxygen species (ROS) in aging skeletal muscle are associated with increased expression of the senescence-associated microRNA miR-34a-5p (miR-34a). The histone deacetylase Sirt1 is a validated target of miR-34a, and miR-34a expression is induced by the tumor suppressor p53 which is itself stimulated by ROS. Long noncoding RNAs (lncRNAs) are known to function as “sponges” for microRNAs, but the role of such competing endogenous RNAs (ceRNA) in muscle aging is not well understood. We therefore examined in skeletal muscles of young (4-6 mos) and aged (22-24) male and female mice the expression of several lncRNAs that are predicted to bind miR-34a-5p in silico and whose predicted binding has been validated experimentally. Results indicate a significant decrease in lncRNA MALAT1 expression with aging. MALAT1 is known to be highly expressed during the later stages of myoblast differentiation and myotube maturation. We therefore treated C2C12 cells at 48 hrs with hydrogen peroxide (10 uM) and examined changes in MALAT1 expression. MALAT1 was significantly decreased with H2O2 treatment, whereas miR-34a is increased in C2C12 cells after hydrogen peroxide exposure. Age-related muscle atrophy mediated by ROS may therefore result in part from related mechanisms involving miR-34a activity: an increase in miR-34a targeting Sirt1 resulting from p53 activation and an increase in miR-34a bioavailability resulting from a decline in miR-34a “sponging” due to ceRNA MALAT1 depletion. These findings suggest that therapeutic interventions increasing MALAT1 expression in muscle may potentially enhance the preservation of muscle mass with aging.
Effects of glycine and n-acetylcysteine on glutathione levels and mitochondrial energy metabolism in healthy aging
Authors: Gut Philipp , Lizzo Giulia , Migliavacca Eugenia , Karagounis Leonidas , Heise Tim , Eynatten Maximilian
Published: December 2021

Glutathione is an intracellular antioxidant that neutralizes reactive oxygen species and prevents tissue damage. Dietary supplementation with the glutathione precursors glycine and n-acetylcysteine supports the maintenance of normal glutathione levels in several age-related diseases, but the optimal doses and their efficacy in healthy elderly are not established. We report results from a randomized controlled clinical trial in 114 healthy volunteers (mean age = 65 years) receiving glycine and n-acetylcysteine (GlyNAC) at three different doses for two weeks (1.2g/1.2, 2.4g/2.4g, 3.6g/.3.6g of each amino acid). Older subjects showed increased oxidative damage and a lower reduced-to-oxidized glutathione ratio (GSH:GSSG) compared to young subjects, but unchanged total glutathione levels. GlyNAC did not increase levels of circulating glutathione compared to placebo treatment, the primary study endpoint. However, stratification analyses suggest that subjects with high oxidative stress and low glutathione status responded with glutathione generation. We find that unrelated to glutathione status, healthy aging was associated with lower levels of fasting glycine that can be increased towards those observed in young subjects with supplementation. Using preclinical models, we find that tissue glycine depletion is a common feature of healthy aging. Supplementation of old mice with glycine efficiently improved age-related decline of mitochondrial respiratory function in skeletal muscle and prevented a gene program associated with protein catabolism observed in control-treated animals. In conclusion, GlyNAC is safe and well-tolerated and may selectively increase glutathione levels in older subjects with oxidative stress and glutathione demand. Our data further suggest that glycine may support mitochondrial function independently of NAC.
Technology Use Among Cancer Patients Pre- and Post- COVID-19 Pandemic: The Role of Dementia
Authors: Li Weixin , Ornstein Katherine , Li Yan , Liu Bian
Published: December 2021

COVID-19 has highlighted increasing reliance on information and communication technology (ICT) and challenges in access and use. ICT access also provides resources that benefit users’ mental health. Our study describes changes in the use of ICT before and during the COVID-19 pandemic among cancer patients with and without dementia. We identified 196 (1.6 million weighted population) older adults with a self-reported cancer history who participated in both 2019 and 2020 National Health and Aging Trends Study (NHATS). In 2019, cancer patients with dementia (9.9%) were less likely (adjusted OR 0.29; 95%CI, 0.11-0.78) to use information technology (IT) for health matters (contacting medical providers, handling health insurance matters, obtaining information about health conditions, and ordering prescription refills) compared to those without dementia. In contrast, dementia status was not associated with communication technology (CT) use (email or texts) or IT use for personal tasks (grocery shopping or online banking). IT use for personal tasks was inversely associated with anxiety symptoms (adjusted OR 0.22; 95%CI:0.06-0.83) and CT use was inversely associated with depressive symptoms (adjusted OR 0.25 (95%CI:0.07-0.97). In 2020, regardless of dementia status, all cancer patients increased their virtual (email/phone/video) contact with family, friends (3.4%-7.0%), and medical providers (17.2%-36.2%) while decreasing in-person contact (10.0%-15.7% and 21.8%-24.2%, respectively) during the pandemic. This study suggests that there are potential unmet daily needs for patients with comorbid cancer and dementia that may be met with improved ICT access. Such challenges are of increasing concern as COVID-19 has resulted in increased ICT reliance for older adults.
The relationship Between Occupation Types, Education, and Volunteer Behaviors Among Older Americans
Authors: Lai Patrick Ho Lam , Halvorsen Cal , Matz Christina
Published: December 2021

Research shows that productive engagement in later life, such as paid work and volunteering, is associated with health and wellbeing. From a life-course approach, personal history and experiences developed from occupations earlier in life may affect individual’s willingness and ability to volunteer in later life; reciprocally, volunteering tends to extend networks and roles from their previous work after retirement. Further, education, which influences career development, indirectly affects late-life volunteering. Using data from 329,938 individuals aged 50 to 85 in more than 700 occupations from the Volunteer Supplement of Current Population Survey since 2010, this study found that older adults had higher volunteer rates (40%) when their current or latest jobs require more human interactions, compared to those jobs were mainly characterized as office work (31%) and jobs not requiring much human interaction (21%). More specifically, occupations with higher volunteering rates were more likely to be related to social, educational, or spiritual sectors. Some careers seem to provide skills and networks needed in volunteer roles, such as accounting clerks (ranked 12th in volunteering) and museum technicians (ranked 13th). Diverse educational levels make the relationship between occupation and volunteering more complex. For instance, those older adults without a high school diploma and who have office work as their current or latest job (16%) have higher volunteering rates than those occupations requiring (14%) or not requiring much human interaction (10%). Policymakers can take the human interactions and skills needed in careers and educational levels into account when thinking of strategies to promote volunteering.
Best Practices to Overcome Barriers to Capacity Evaluations
Authors: Factora Ronan , Saxena Saket
Published: December 2021

Because of the increasing incidence of elder abuse and financial exploitation, Adult Protective Services (APS) cases open for these individuals often relay on capacity evaluations conducted by a clinician to facilitate legal assignment of a surrogate decision maker. Despite this growing need, the number of physicians willing and capable of performing them is limited. Barriers reported by physicians reportedly impair their ability to conduct these evaluations include absence of relevant case information and lack of knowledge about the process itself. Geriatricians and related clinicians often perform these assessments. Sharing best practices with internists and family physicians may help overcome these barriers. A survey of geriatric medicine providers was conducted to identify essential components and questions necessary in the assessment of general decision making capacity. Twenty-nine providers at 6 academic institutions in Ohio responded to the survey and its follow-up inquiries. Though variability existed in evaluation styles and content between providers, a uniform set of recommendations was able to be generated. A total of 13 different summary recommendations were generated from this survey. Necessary components to these evaluations include (1) performance of cognitive testing (2) obtaining collateral information regarding functional status from another trusted individual (3) assessing the individual’s insight into any reported functional impairments or safety concerns by explaining discrepancies between that individual’s own observations and reported concerns from the trusted individual, and (4) using hypothetical situations to assess a person’s judgment and reasoning in addressing any gaps in care or safety concerns raised during the interview.
Development of a locator device usability scale for persons with dementia at risk of getting lost
Authors: Neubauer Noelannah , Spenrath Christa , Philip Serrina , Daum Christine , Liu Lili , Miguel-Cruz Antonio
Published: December 2021

There is an increasing number of persons living with dementia who live alone. Recent COVID-19 pandemic restrictions have resulted in more persons receiving care remote through information and communication technologies. Locating technologies can be a tool to help care partners monitor their loved ones living with dementia. These devices can also mitigate risks associated with going missing, by reducing time for search and returning the lost person home safely. However, there is no clear, standardized approach to assess the usability of these devices. The purpose of this study was to develop a locator device usability scale for persons living with dementia at risk of getting lost. A two-phase study that utilized a multi-method design and included participatory and iterative strategies was conducted. In the first phase, an item pool was generated through online focus groups with service providers, technology developers, care partners and persons living with dementia. The second phase refined the item pool using an online survey and online focus groups with the same stakeholder groups. Five overarching categories were identified as important for the usability of locating device: features, inclusivity, simplicity, aesthetic appeal, and ethics. Participants identified the need for multiple versions of the usability scale including one specifically for persons living with dementia. The newly developed locator device usability scale can enhance the acceptance of these devices, thereby supporting remote caregiving and promote the safety and autonomy of persons living with dementia.
Employers’ Response to Workers With Progressive Cognitive Impairment: A Systematic Literature Review
Authors: McMurray Josephine , Levy AnneMarie , Reis Logan , Kokorelias Kristina , Boger Jennifer , Astell Arlene
Published: December 2021

An aging workforce increases the risk of workers experiencing cognitive decline that may lead to a diagnosis of mild cognitive impairment or early onset dementia (MCI|EOD) while still employed. This systematic review explores the use of technologies (defined as any methods, processes, software, hardware or equipment) deployed by employers to accommodate, or build sustainable workspaces for, workers diagnosed with MCI|EOD. After screening 3,860 titles/abstracts and 67 full text reviews, we identified and analyzed eight articles that met our inclusion criteria. We found that: 1) The existing literature almost exclusively focuses on employees’ perspectives on the quality of work life when diagnosed with MCI|EOD, 2) Negative workspace culture toward employees’ cognitive decline, and the variability of disease onset and progression, may account for low employer awareness, 3) Employer responses focus on mitigation of risk associated with workers’ impairment. While this review demonstrates there is scant research exploring employers’ perspectives on employees diagnosed with MCI|EOD, there is even less that explores technologies designed to specifically address employers’ needs and challenges. Technology will increasingly facilitate early identification of progressive neuro-cognitive disorders, and tools to help employers respond to an employee’s MCI|EOD disclosure as a disability accommodation rather than a terminal performance management challenge. Empathic research, that engages organizations in the process of understanding the value of affordable, employer-side technologies that help build diverse, sustainable, productive workspaces is critical to a foundational understanding of our aging workforce and accommodating workers who develop MCI|EOD while still employed.
Older Adults and the Impact of COVID-19: Lessons Learned from a Two-State Study
Authors: Sokan Amanda , Davis Tracy
Published: December 2021

The COVID-19 pandemic has led to increased strains on the rapidly increasing aging population’s mental, emotional, and physiological health. COVID-19, which belongs to a family of respiratory viruses, was first detected in China before spreading to other parts of the globe. Due to underlying health conditions and weakened immune systems, the aging population is at greater risk for contracting COVID-19. To better prepare for a future pandemic, it is necessary to explore the psychosocial impacts of limited human interactions to make the aging population feel safer while mitigating harm to their mental and emotional health. The purpose of this study is to highlight the experiences of the aging population with COVID-19, including psychosocial, behavioral responses to the pandemic, and older adults’ overall well-being. We surveyed a total of 203 adults 55 and older regarding their experiences with the pandemic. Survey components included the COVID-19 Household Environment Scale (Behar-Zusman, Chavez, & Gattamorta, ND), selected items from the COVID-19 Impact Study and open-ended questions, the Generalized Anxiety Disorder Assessment (Williams et al., 2006), and the UCLA Loneliness Scale (Russell, Peplau, & Ferguson, 1978). Preliminary analyses indicate that most participants had not experienced any COVID-19 symptoms, nor did they know anyone who had passed away from the virus. However, participants did report loneliness and less family cohesion because of the pandemic. Findings from this study will be used to help older adults cope with the impact of the current pandemic and future pandemics.
Older Age and Other Protective Factors of Mental Health During the COVID-19 Pandemic in the US
Authors: Smith Kelly , Chappell Amanda , Spalding Rachael , Wilson Jenna , Haliwa Ilana , Strough JoNell
Published: December 2021

Research conducted early in the COVID-19 pandemic (i.e., March 2020) suggested that older adults were less likely to experience negative pandemic-related mental health than younger people. We investigated whether this age-related advantage persisted during the July 2020 spike in COVID-19 cases and investigated links between coping strategies and mental health. We used data from the Understanding America Study (UAS) to conduct a secondary data analysis of participants (N = 5,753) aged 18-110 years (M=46.20, SD=12.88) who completed online self-report surveys twice—once immediately prior to the July spike in cases, and again during the spike. Surveys assessed engagement in protective behaviors (e.g., wearing a mask, washing hands), coping strategies (e.g., calling family/friends, getting extra exercise, meditating), and anxiety and depressive symptoms (using the Patient Health Questionnaire PHQ-4). Multiple regression analyses were used to identify predictors of anxiety and depression during the spike, controlling for previous anxiety and depression, race, ethnicity, income, education, and marital status. Older age and engaging in protective behaviors were associated with less anxiety, whereas coping by calling family/friends was associated with more symptoms, R2 = .71, F(16, 5736) = 885.90, p < .001. Coping by calling and getting extra exercise were associated with fewer depressive symptoms, whereas coping by using social media was associated with more symptoms, R2 = .72, F(16, 5736) = 906.65, p < .001. These findings highlight age as a protective factor for anxiety but not for depression and underscore the importance of social support as a protective factor for mental health.
Lower Wages of Nurses in Long-Term Care: Does Racial and Ethnic Diversity Explain the Difference?
Authors: Spetz Joanne , Wagner Laura , Bates Timothy
Published: December 2021

Registered nurses (RNs) are a key component of the long-term care (LTC) workforce and prior research demonstrates their importance to ensuring patient safety in LTC settings. RNs who work in LTC settings earn less than those who work in hospitals and also are more likely to be from racial and ethnic minority groups. This study seeks to measure wage differences between Registered Nurses (RNs) working in LTC and other settings (e.g., hospitals) and whether differences are associated with the characteristics of the RN workforce between and within settings. We used the 2018 National Sample Survey of Registered Nurses (NSSRN) public-use file to examine RN employment and earnings. Our study population included a sample of 15,373 employed RNs who provided patient care. Characteristics such as race/ethnicity, type of RN degree completed, census region, and union status were included in bivariate analyses and multiple regression analyses to examine the effect of these characteristics on wages. Logistic regression was used to predict RN employment in LTC settings. We found that RNs in LTC experienced lower wages compared to those in non-LTC settings, yet this difference was not associated with racial/ethnic or international educational differences. LTC nurses were also significantly less likely to be represented by a labor union, and there was not a statistically significant wage difference for LTC RNs who were unionized. Because RNs in LTC earn lower wages than RNs in other settings, policies to minimize pay inequities are needed to support the RN workforce caring for frail older adults.