bluuebunny/crossref_metadata_2025 huggingface dataset:
ART, AGING, AND ARTIFICIAL INTELLIGENCE: EXPLORING AGE SCRIPTS IN THE UNIVERSE OF AI-GENERATED ART
Authors: Allen Laura , Xu Wenqian , Nishikitani Mariko , Patil Vaishnavi Atul , Hule Sunil , Bradley Dana
Published: January 2025

This study investigates age-related biases in AI-generated art through a mixed method investigation of images of older and younger individuals. Employing 19 text prompts associated with social exclusion for older adults, we collected 465 images from an AI-art generator, MidJourney, and conducted quantitative and qualitative analyses to understand differences between age group depictions. We used Amazon Rekognition software to detect the numerical image properties. Results that were compared statistically (STATA and Python) revealed significant differences in attributes: images with older people exhibited lower overall brightness (M = 46.54) and sharpness (M = 58.58) compared to younger individuals (brightness: M = 60.50; sharpness: M = 72.55). Moreover, older people were more likely to be smiling (16%) and with eyeglasses (56%) compared to younger individuals (6% and 12%), all with p < 0.001. Next, we conducted a qualitative semiotics analysis with a randomly selected sample of 76 images. Older people were often depicted with a strong emphasis on nostalgia, vulnerability, and aloneness, reflected in vintage-style clothing, worn objects, and worried expressions. In contrast, younger individuals were often portrayed with a focus on modernity, energy, and independence, characterized by vibrant clothing, digital technology, and confident expressions. Together, these findings demonstrate the perpetuation of negative and reductionist age scripts in AI-generated art, such as older adults’ incompetence, loneliness, fear, and outdatedness. Implications of this research extend to societal representations of aging, emphasizing the importance of challenging age-related biases in AI-generated content. Future research should explore refinement of generative models which foster more equitable outcomes.
CAN CHATGPT IDENTIFY AND MANAGE FALL RISKS IN OLDER ADULTS?
Authors: Cheng Huai
Published: January 2025

Fall is one of the most common geriatric syndromes in older adults. Identifying and managing fall risks in older adults is very important but can be time-consuming. ChatGPT can answer complex questions such as passing USMLE and clinical questions. In this study, the author prompted ChatGPT to identify and manage fall risks in one old adult via a clinical vignette from a published curriculum and test whether ChatGPT can be used as a screening and management tool in daily practice. ChatGPT was prompted to respond to this clinical vignette with three approaches. First, ChatGPT was prompted to answer one general question on fall risks in old adults; Second, ChatGPT was prompted to answer 5 pre-test questions on fall prevention in older adults; Last, ChatGPT was prompted to answer 5 questions based on this clinical vignette. The author was the only person to determine the correctness of output from ChatGPT. ChatGPT can provide a comprehensive summary of 10 common fall risks in older adults and correctly answer 5 out of 5 pre-test questions with only a few answers missing. For a clinical vignette, ChatGPT provided correct answers on all five questions with only a few answers missing. ChatGPT can be used as a screening and management tool in daily practice.
DEVELOPMENT OF THE SWALLOWING ACTIVITY CLASSIFICATION MODEL FOR OLD ADULTS BASED ON ACOUSTIC ANALYSIS
Authors: Li Dan , Zhang Yaqing , Wu Junhui , Luo Wei , Liu Tao , Lyu Benshuai , Shang Shaomei
Published: January 2025

Dysphagia poses a significant health threat for old people worldwide, often resulting in severe complications like aspiration, choking, and aspiration pneumonia, thereby increasing hospital readmission rates and mortality. Swallowing function assessment serves as an effective means to reduce the occurrence of complications and improve patients’ survival rate. However, current assessment tools have pronounced limitations. Acoustic diagnosis, as a non-invasive method, has shown promising effectiveness in dysphagia screening and aspiration detecting, rendering it a key technology for addressing this issue. This study aims to develop a swallowing activity classifier based on acoustic recording and analysis using machine learning algorithms, which constitutes an efficient tool for non-invasive, remote, and continuous assessment of swallowing activities in old adults. The study recorded and annotated swallowing audio data from 61 old individuals, resulting in 120 acoustic samples. Signal features in time, frequency, time-frequency, and statistical domains were analyzed and extracted as inputs. Multiple models, including the Multi-Layer Perceptron (MLP), Convolutional Neural Network (CNN), and Convolutional Recurrent Neural Network (CRNN), were used for classification. The MLP, CNN, and CRNN models achieved accuracy values of 74%, 68%, and 54%, respectively, on the validation set. Results indicate that swallowing, coughing, throat clearing, choking, wet breathing, and speech are characterized by distinct acoustic patterns, which can be effectively classified and identified using machine learning methods. These findings hold promise for the research and practical application of acoustic and machine learning-based swallowing activity classification models, facilitating continuous monitoring in old people, thereby providing guidance for clinical treatment and care.
COMPARISON OF QUALITY INDICATORS IN RURAL AND URBAN ASSISTED LIVING FACILITIES
Authors: Stuifbergen Alexa , Morgan Stephanie , Trainum Katie , Becker Heather
Published: January 2025

As the population of older adults grows, the demand for assisted living facilities (ALFs) is expected to increase. This growth will disproportionately affect rural ALFs, as the proportion of older adults living in rural areas is growing at a faster rate than urban areas, and older adults living in rural areas are in poorer health compared to their urban counterparts. This exploratory descriptive study examined differences between facility characteristics and resident perspectives of care between rural and urban ALFs using data collected as part of a major statewide assessment of quality of care in ALFs. The research team conducted site visits to collect facility level data from staff and resident interviews regarding perspectives of quality of care. The sample included 517 facilities from 8 geographic regions of a large Southwestern state with 143 of the facilities located in rural settings. Overall, licensed bed size ranged from 3 to 177 with the number of occupied beds significantly greater in urban ALFs (Mean=33.71, SD 28.51) than in rural ALFS (Mean=22.54, SD 15.93) (t=5.37, p<.001). Overall, residents rated their health as good, very good, or excellent (78%) although a greater percentage of rural residents (23%) rated their health as fair or poor compared to urban residents (16%). Resident satisfaction with quality of health care and quality of experience in the facility was higher among residents of rural vs. urban ALFs. Additional research is needed to more fully explore factors influencing quality of life and quality of care in rural and urban ALFs.
FAMILY PERCEPTIONS OF THE EFFECTS OF COVID-19 ON OHIO LONG-TERM CARE FACILITIES
Authors: Dikhtyar Oksana , Heston-Mullins Jennifer
Published: January 2025

Family and friends are often the main source of emotional support and social contact for residents in long-term care facilities. The visitation restrictions imposed during the COVID-19 pandemic negatively impacted staff, family members, and residents, particularly those with cognitive impairment. However, there is limited literature on the impact that COVID-19 had on communication between residents and their family and friends, and communication between long-term care facilities and residents’ family and friends. To understand more about the effects of COVID-19, an online, state-wide survey was conducted which included questions regarding communication. A total of 1,686 involved family members or friends responded to the survey between September 2021 to May 2022. Phone calls were the most common method of communication between residents and their family and friends during visitation restrictions, followed by window visits and dropping off food and snacks. The frequency of communication also increased as a way for families to compensate for the lack of regular visits. Staff in most facilities used emails or postal mail, phone calls or text messages, and social media to communicate with family members. The amount of information respondents received from the facility affected their perceptions about the facility. These study findings can help improve facility-family communication and help facilities explore new ways of working with and engaging residents and families beyond the pandemic.
OLDER ADULTS’ EXPERIENCES OF LONELINESS AND ITS UNDERLYING MECHANISMS IN RESIDENTIAL CARE FACILITIES
Authors: Gill Amarjot , Sullivan Suzanne
Published: January 2025

Older Adults’ (OAs’) transition into residential care facilities (RCFs) detaches them from their meaningful social relationships, often precipitating feelings of loneliness. This prevalent issue in RCFs can lead to poor health outcomes, significantly disrupting OAs’ well-being and quality of life. Consequently, loneliness in RCFs emerges as a serious public health issue, necessitating a comprehensive understanding of its mechanism. This systematic review aims to explore OAs’ experiences and perceptions of loneliness and characterize mechanisms underlying OAs’ loneliness experiences through a comprehensive loneliness model. This review adhered to PRISMA guidelines. Articles from CINAHL, PubMed, PsycINFO, and Web of Science, published in English between 2018 and 2023, were examined. Of the 7,285 articles identified, 10 met the inclusion criteria. Quality appraisal for the selected studies was conducted using the Critical Appraisal Skills Programme (CASP) checklist. Three core themes of loneliness were identified: relational and individualized loneliness experiences, perception and emotional distress, and the influence of context and cognitive processes in modulating loneliness. A conceptual model delineating the mechanisms of OAs’ loneliness in RCFs was developed. This review highlights the influence of OAs’ residential context and cognitive processes, particularly their perceptions, in triggering loneliness and associated behavioral responses. OAs’ perceptions of reduced social control and insufficient social connections in RCFs exacerbate their loneliness, precipitating distressing emotional responses and diminished quality of life. Future research must explore strategic transformations of OAs’ perceptions through mechanistic targets and tailored care plans to reshape their social expectations within the context of RCF, potentially mitigating loneliness.
ASSOCIATIONS OF PROTEIN INTAKE WITH THE RISK OF ALL-CAUSE, CARDIOVASCULAR, AND CANCER MORTALITY: A META-ANALYSIS
Authors: Yang Huili , Cao Meng , Huang Chongmei , Jin Yaping , Liu Minhui
Published: January 2025

The association of the amount and sources of protein consumption with mortality for cardiovascular diseases (CVD) and cancer has been extensively studied. However, the outcomes remains controversial. The present meta-analysis was conducted to synthesize findings on the associations between total, animal, and plant protein intake and the risk of mortality from all causes, and cancer. Pubmed and Web of Science were searched to identify prospective cohort studies published up to November 2022. Random effects models were used to calculate pooled effect sizes and 95% confidence intervals for the highest versus lowest categories of protein intake. Heterogeneity were evaluated with I2 statistic, and publication bias was evaluated with funnel plots and Egger’s test. A total of 28 cohort studies were identified. The results showed that total protein (HR=0.99, 95%CI: 0.93, 1.04; HR=0.95, 95%CI: 0.87, 1.02; HR=0.97, 95%CI: 0.84, 1.11), animal protein (HR=1.02, 95% CI: 0.98, 1.07; HR=1.05, 95% CI: 0.99, 1.12; HR=1.00, 95% CI: 0.98, 1.02) were not associated with the all-cause, CVD and cancer mortality. However, the intake of plant protein was inversely associated with the risk of all-cause (HR=0.92, 95% CI: 0.87, 0.96) and CVD mortality (HR=0.87, 95% CI:0.81, 0.93), but not cancer mortality (HR=0.98, 95% CI: 0.94, 1.01). This study demonstrates that higher plant protein intake is associated with a reduced risk of all-cause and CVD mortality. Increasing plant protein intake is a potential way to decrease the risk of death.
DIETARY BEHAVIORS OF AFRICAN IMMIGRANTS LIVING WITH DIABETES AND/OR HYPERTENSION: A QUALITATIVE STUDY
Authors: Osokpo Onome , Lewis Lisa , Bracy Danny , Adeniji Dolapo , Bankole Ayomide , Riegel Barbara
Published: January 2025

Healthy dietary behaviors (e.g., low-salt diet) are a critical element of self-care and the cornerstone in managing diabetes and/or hypertension. Social determinants (e.g., cultural preferences and social support) influence dietary behaviors. However, little is known about the influence of social determinants on dietary behaviors of African immigrants living with diabetes and/or hypertension accounting for their level of acculturation. We conducted a descriptive qualitative study of a purposive sample of 24 self-identified sub-Saharan African immigrant adults in the Northeastern U.S. with symptomatic hypertension and/or diabetes who spoke and understood English. Based on scores from the Short Acculturation Scale, African immigrants were classified as more or less acculturated. The sample was mainly Nigerian (75%) and males (67%), with a mean age of 59 years [40-72]. The sample was highly educated, acculturated, employed, and reported having enough income to meet their needs. Compared to more-acculturated immigrants, less-acculturated immigrants regularly ate more African or “traditional food,” vegetables and rice, and avoided salt and fatty/fast/processed American foods. Less-acculturated immigrants cooked their meals and learned their diets from previous education or their workplace. Compared to the less acculturated, more acculturated participants ate fruits regularly and avoided meat or red meat. Interestingly, the more acculturated participants reported learning about their diet from family and friends and noted that family members cook the meals in their household. Interventions to promote healthy diets among immigrants should take into consideration cultural dietary preferences, influence of family, friends, and non-familial social connections, and level of acculturation.
EXPLORING AND CHARACTERIZING MULTIMORBIDITY PROFILES AMONG ADULTS WITH HEART FAILURE
Authors: Hiatt Shirin , Meek Paula , Lee Christopher , Denfeld Quin
Published: January 2025

Multimorbidity (MM) or coexistence of ≥2 chronic conditions is prevalent among older adults and results in poor outcomes. Among adults with heart failure (HF), MM poses exponentially more challenges, but our understanding of MM in HF is limited. The purpose of this study was to explore and characterize MM profiles in a cohort of adults with HF. We performed a secondary analysis of combined data from 6 HF studies. We used latent class analysis to identify MM profiles based on comorbidities identified with the Charlson Comorbidity Index. After identifying MM profiles, we examined sociodemographic, clinical and symptom characteristics across each profile. The sample (n=523) was 37% women, mean age 58.3±14.0 years, and mean of 2.1±1.1 comorbidities. Most patients (n=480; 92%) had MM, including HF. Among patients with MM, we identified four distinct MM profiles: Class 1-high complexity (4.6%), Class 2-moderate complexity (31.7%), Class 3-low complexity (31.9%), and Class 4-no complexity (31.9%). Class 1 was older, living alone, significantly comorbid, reported poor/fair health and depressive symptoms, and frail. Classes 2 & 3 were the next oldest but majority lived with someone. Class 4 was the youngest with the shortest duration of HF diagnosis. In conclusion, we found four distinct profiles of MM among patients with HF with marked differences in characteristics. As the prevalence of MM increases among older adults and those with chronic conditions such as HF, it is imperative to understand profiles of MM and how they contribute to function and wellbeing in order to develop effective interventions.
FILLING THE CARE GAP FOR OLDER ADULTS LIVING IN A RURAL COMMUNITY: A NURSING CARE MODEL
Authors: Dawson Walter , Womack Dana , Velk Lace , Fifield Alexis , Izumi Seiko
Published: January 2025

Ensuring older adults living with multiple chronic conditions are able to remain in their own homes and communities for as long as possible is a health policy priority. Registered nurses (RNs) play a key role in assisting older adults manage their health while living in the community. Yet, the substantial contributions of nursing care such as care management and care coordination in achieving better health outcomes and reductions in healthcare costs remains largely invisible to healthcare systems and policymakers alike. To demonstrate value of nursing care and build a model of nursing services that is effective and sustainable, we conducted a study describing nursing services needed by the patients living in community settings with complex care needs and evaluated the impact of these services on outcomes. Nurses delivering community-based nursing service (CBNS) to patients living with multiple chronic conditions in rural coastal Oregon were interviewed between July and December, 2022. Outcome data about health service utilizations and expenditure of patients who received CBNS are collected between November 2023-March 2024. Interview data describe care nurses deliver to keep older adults in the community while managing their health by filling care gaps in the rural community. Preliminary outcome data analysis suggests that CBNS is a potentially effective model helping older adults remain in their own homes and communities. These findings may inform policy development regarding reimbursement to make CBNS delivery sustainable as well as increase the options for providing optimal care for older adults living with chronic conditions across multiple geographic settings.
KNEE OSTEOARTHRITIS: PERCEPTIONS OF PSYCHOSOCIAL CONSEQUENCES, PAIN, AND MANAGEMENT COMPLEXITIES
Authors: Luborsky Mark , Hochberg Marc , Ryan Alice , Dong Yu , Beamer Brock , Shardell Michelle , Rathbun Alan
Published: January 2025

Knee Osteoarthritis (KOA) afflicts 27 million U.S. adults and has adverse health and psychosocial outcomes. Depression is twice as common among persons with KOA compared to the general population and is a barrier to pain management and physical activity. While guidelines advise depression treatment, directions on co-managing depression and pain are seldom offered; a viable adjunctive treatment, duloxetine, treats both depression and pain, yet is not routinely prescribed and could facilitate physical activity. Progress in reducing KOA distress is hampered by inadequate knowledge of perceptions and experiences of persons’ daily living with KOA especially when pain and depression co-occur. Qualitative interviews were conducted at baseline in a program evaluating aerobic exercise plus duloxetine to learn participants’ perceptions, challenges, and how depression and pain interact in managing KOA. The sample included: n=12 (5 African American, 1 Asian, 6 White) participants, aged 41-71 years (10 female, 2 male) with self-report pain severity, median 3 (scale 0-4) and moderate to severe difficulty with Activities of Daily Living. Analytic strategies featured topic, theme, and critical case comparative methods. Results identified four key constructs: (a) unpredictability and temporal variability of impacts of KOA; (b) management requiring flexible strategies encompassing a wide range of self-image and life domains beyond pain and depression; (c) barriers including concerns with medications; depression eroding energy; a sense of isolation socially and from meaningful activities; and (d) challenges to program participation. Pathways to address the constellation of intersecting domains perceived in living with KOA and treatment program participation are needed.
SYMPTOM BURDEN AND HEALTH CARE UTILIZATION AMONG OLDER ADULTS LIVING WITH MULTIMORBIDITY: THE COORDINATE PROGRAM
Authors: Benjasirisan Chitchanok , Lim Arum , Tebay Jordan , Himmelfarb Cheryl Dennison , Davidson Patricia , Koirala Binu
Published: January 2025

The increasing challenges of multimorbidity in older adults underscore the need for sustainable approaches to address care coordination and symptom management. The Care cOORDInatioN And sympTom managEment (COORDINATE) program was developed using experience-based co-design and human-centered principles by considering the needs of patients, family caregivers, and healthcare providers. The program included a need assessment, question prompt list, goals discussion, and symptom assessment in 5 visits over 6-week periods employed among adults aged 55 years and older who were living with at least 2 chronic conditions and were discharged from the intermediate care unit. Twenty-five adults agreed to participate and completed the baseline survey. The change in symptom burden and healthcare utilization at 3 months follow-up compared to baseline was examined using the Wilcoxon Signed-Rank test. The participants’ mean (± SD) age was 67 ± 7 years; 52% were women, 44% had some college/associated degree; 92% were retired/unemployed, and 72% were Black. For the goals discussion component of the program, 83% of the measurable goals were fulfilled. A preliminary analysis of the symptom burden found that the level of energy significantly improved at the 3-month follow-up (p =.032). Significant decreases in hospitalization (p =.01) and critical care admission (p <.01) were found at 3 months post-discharge compared to 3 months before program initiation. In summary, the COORDINATE study could be a pivotal initiative in addressing the holistic care needs of older adults living with multimorbidity. This intervention demonstrates promising outcomes, signaling the need for a larger effectiveness trial.
THE CORRELATION BETWEEN SHBG AND BLOOD LIPID AND GLUCOSE AMONG CHINESE MIDDLE-AGED AND OLDER ADULTS
Authors: Cao Meng , Jin Yaping , Yang Huili , Li Yuanbin , Liu Minhui , Huang Chongmei
Published: January 2025

To investigate the correlation between sex hormone binding globulin (SHBG) of serum lipid and blood glucose in middle-aged and older adults (≥ 45 years old) We recruit participants in five urban communities in Ningxia province, using a cluster stratified sampling method. Data from 1681 participants were analysed, with an average age of 63.53 ± 9.5 years old. The results showed the average level of TC, HDL, LDL, and blood glucose were lower in men than in women (P=0.000,P=0.000,P=0.000,P=0.004),LDL-c and FBG levels increased with age in men, but SHBG level decreased with age in women (P< 0.05). The results of spearman correlation analysis showed a negative correlation between SHBG and FBG (r=-0.73 P< 0.01). There was a positive correlation between age (r= 0.054 P< 0.05) and HDL-C (r=0.049 P< 0.05) and a positive correlation between SHBG level and TC (r=0.218 P< 0.05) and TG (r=0.254 P< 0.05) in Chinese women aged 75 years and more. Multiple linear regression analysis with SHBG as the dependent variable and gender, age, TC, TG, HDL-C, LDL-C and BMI as independent variables did not find statistically significant associations. Logistic regression analysis showed that sex, age, weight, SHBG,FBG and SH were risk factors for dyslipidemia. However, there was no significant correlation between SHBG level and dyslipidemia.
THE IMPACT OF EHEALTH ON SELF-MANAGEMENT AND HEALTH OUTCOMES OF PATIENTS WITH TYPE 2 DIABETES: A SYSTEMATIC REVIEW
Authors: Cheng Yu-Shan , Cuevas Heather
Published: January 2025

Self-management is crucial to maintain glycemic control in type 2 diabetes (T2DM). Prior studies have shown that various electronic health (eHealth) technologies promote diabetes self-management (DMSM) and continuity of care. However, previous reviews focused mainly on telehealth, a single aspect, and were published more than ten years ago. Therefore, the purpose of this study was to summarize the effect of eHealth interventions on improving aspects of DMSM and health outcomes, such as depression and A1C, for adults over 60 years of age with T2DM. A systematic review was conducted on papers published from October 2018 to October 2023. Three electronic databases were used. 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) served as guides. Twenty randomized control trials in diverse ethnic communities (n=3978) across 20 countries were included in the narrative synthesis. Seven health technologies were employed to provide DMSM across studies, including mobile health applications, text messaging, phone calls, online conferences, video, wearable devices, and virtual worlds. Overall, improvement in DMSM and health outcomes was mixed. In terms of depression, only three studies showed significant improvement, while four studies did not exhibit significant improvement in A1C. Additionally, positive outcomes were not maintained after seven months (the furthest post-intervention measurement). These findings differed according to eHealth literacy, economic burden, willingness, and social support. Further work is needed to consider other variables to address both short- and long-term effects for the patients while implementing healthcare technology.
RACIAL DIFFERENCES IN THE RELATIONSHIPS AMONG VOLUNTEERING, DISCRIMINATION, AND LIFE SATISFACTION
Authors: Shen Huei-Wern , Wang Yi
Published: January 2025

Discrimination, whether overt or subtle, has been consistently linked to lower life satisfaction across racial groups. While volunteering has been proven to bring physical and mental health benefits, its potential role in mediating the relationship between discrimination and life satisfaction across different racial groups is unknown. The present study included a subsample of 3115 older adults (65-98) who were non-Hispanic Whites (n=2374), non-Hispanic Blacks (n=449), and Hispanics (n=292) from the 2016 Health and Retirement Study. Discrimination was measured by the six-item Everyday Discrimination Scale (e.g. In your day-to-day life, how often are you treated with less courtesy or respect than other people) and was dummy-coded due to skewness (never experienced vs. ever experienced). Controlling for health-related variables (e.g., self-rated health), SES (e.g., income), contextual features (e.g., urban/rural), and sociodemographics (e.g., gender), findings from stratified multivariate linear regression models showed that non-Hispanic Whites who experienced discrimination reported lower life satisfaction; although older volunteers had higher life satisfaction, volunteering did not mediate the relationship between discrimination and life satisfaction. Among non-Hispanic Black older adults, neither experiencing discrimination nor volunteering was related to life satisfaction. In the Hispanic group, however, experiencing discrimination was related to lower life satisfaction, and volunteering partially mediates the negative impacts of discrimination on life satisfaction. These findings shed light on the possible extended benefits of volunteering in old age. Further research is warranted to better understand the underlying mechanisms through which volunteering may mitigate the negative impact of discrimination on life satisfaction, particularly among Hispanic older adults.
ASSOCIATION OF COGNITIVE LEVEL AND QUALITY OF LIFE INDICATORS POSTSTROKE IN OLDER ADULTS: A CROSS-SECTIONAL STUDY
Authors: Alharrasi Azza , Berish Diane
Published: January 2025

Stroke is one of the leading causes of death and disability worldwide. Post-stroke cognitive impairment (PSCI) is a common complication of stroke; however, mild cognitive impairment is highly prevalent within three months post-stroke and is associated with increased cost of care, hospitalizations, and care dependency. This study examined the association between cognition level (TICS total score) and quality of life indicators (Depression yes=1 no=0, physical limitations yes=1 no=0, socialization yes=1 no=0) among adults aged 65+. Therefore, a cross-sectional study using the 2020 wave of Health and Retirement Study (HRS) was used to conduct logistic regression Analysis using R.4.2.2. Total sample was 1259 adults 65+ who had reported experiencing a stroke, 58% were female and average TICS score of 6.5 (SD=3.5). Covariates of having high blood pressure, diabetes, or heart disease, sex, working outside the home, education level and age were included in all models. For every one-point increase in TICS score the odds of experiencing functional impairment were 21% lower (OR =0.89, p <.0001). The association for TICS scores and odds of feeling depressed (OR=0.97, p=0.27) and odds of socialization (OR 1.02, p=0.68) were not statistically significant. These results indicate that older adults who had lower cognition scores post stroke were more likely to experience physical limitations. More rigorous research studies need to be conducted to evaluate the quality of life of older adults during post-stroke based on their cognition status. This will inform medical management to individualize the rehabilitation and treatment according to the older adults’ needs.
ASSOCIATIONS BETWEEN SELF-RATED HEALTH, COGNITIVE FUNCTION, RISK OF COGNITIVE IMPAIRMENT, AND DEMENTIA
Authors: Garner Kayla , Graham Eileen , Jackson Kathryn , Chopik William , Beck Emorie
Published: January 2025

Psychosocial researchers have long sought to identify individual differences in early and middle adulthood that robustly predict health in later life. Our current pre-registered study builds on these efforts by assessing whether an individual’s subjective perception of their health is related to their cognitive health, both concurrently and later in life. Using the coordinated data analysis (CDA) methodological framework, we have identified 17 longitudinal studies (including 7 from the Gateway to Global Aging network) that had the requisite data to test our models. We conceptually harmonized all study variables and tested identical linear and logistic regression models across all study datasets. Our preliminary results suggest that individuals who have better subjective beliefs about their health have better cognitive function both concurrently and at longitudinal follow-up (ranging from 4 to 27 years after baseline). These associations were moderated by participant gender and age at baseline, and the results were somewhat robust to the inclusion of objective health indicators. We will discuss our results within the context of Lifespan Developmental Theory and the Health Behavior Model. Overall, our study serves to elucidate how subjective perceptions of health may manifest into later cognitive health outcomes, and if subjective perceptions of health could be used as an early risk factor for identifying individuals who may be vulnerable to cognitive senescence in later life.
CARDIOMETABOLIC DISEASE RISK PARTIALLY MEDIATES RELATIONSHIP BETWEEN FINE PARTICULATE MATTER AND COGNITION
Authors: Cheung Ethan Siu Leung , Grineski Sara , Curtis David
Published: January 2025

PM2.5 pollution is expected to worsen in many places due to climate change. This is because of hotter temperatures, less precipitation, and increases in windspeed. PM2.5 exposure is associated with many adverse health effects. Less is known about how physical and mental health challenges associated with aging, like the onset of cardiometabolic disease (CMB) and changes in psychological wellbeing, might mediate linkages between PM2.5 exposure and aging-related cognitive and physical limitations. Longitudinal data from the Midlife in the United States study (MIDUS 1: 2004-05; MIDUS 2: 2013-14) were adopted. A sample of 4,272 individuals aged 32 to 84 was included. Based on individuals’ residential addresses at each wave, we linked census tract identifiers to PM2.5 exposure, which was defined by five-year annual averages. Using structural equation models, we examined cross-sectional and longitudinal associations between PM2.5 exposure and executive functioning and instrumental activities of daily living (IADL) limitations, and tested CMB risk and psychological well-being as mediators using the product of coefficients method. Results suggested that higher PM2.5 exposure was associated with lower executive functioning cross-sectionally and with larger decreases over time. No significant associations were found between PM2.5 and IADL limitations. The cross-sectional association between PM2.5and executive functioning was partially mediated by CMB risk, accounting for 14% of the estimate, and the longitudinal association showed a similar, albeit nonsignificant mediation pattern. Psychological wellbeing was not a significant mediator. Findings suggest the importance of considering the complex and indirect ways in which climate change may impact health of older adults.
CAREGIVING AFFECTS WORKING MEMORY, HOPELESSNESS, AND PERCEIVED CONTROL: A MEDIATION MODEL
Authors: Luskey Valerie , Zimbinski William , Buxton Michael , Apostolou Hannah , Jacobs M Lindsey
Published: January 2025

Caregiver burden can have negative impacts, both on the caregiver and the person receiving care. One of these effects could include more depressive symptoms in the care recipient, which could impact everyday functioning and quality of life. To explore these relationships, data was used from the Health and Retirement Study in the 2014 Core. Participants included people who answered the questions regarding caregiving, perceived control, hopelessness, and completed a working memory task (n=772; female=59.5%, male=40.5%; age=71.14 (SD=11.88); years of education=11.55 (SD=3.53); race/ethnicity were masked due to confidentiality). Participants with Alzheimer’s or Dementia were excluded, and age was used as a covariate. In a mediation analysis, there was an indirect effect of increased hours of caregiving on hopelessness in the care recipient, b=0.10, SE=0.36, p=0.004, which, in turn, lowered working memory in the person being cared for, b=-0.09, SE=0.04, p=0.03. Additionally, increased caregiving led to decreased perceived control, b=-0.08, SE=0.04, p=0.02; however, this did not translate to decreased working memory, b=-0.051, SE=0.04, p=0.21. Apart from these outcomes, increased caregiving had a direct effect on cognition, b=-0.098, t(767)=-2.73, p=0.007, suggesting it influences other mechanisms that decrease working memory not included in the model. A diagnosis of depression could be an explanatory factor that we were not able to include in the model; however, the model indicates a possible area for intervention. If caregivers receive more support and learn skills to promote hope, that could offer positive contributions to increased working memory—thus, translating to overall increased functioning.
COUPLING OF WITHIN-PERSON CHANGES IN SLEEP QUALITY AND SUBJECTIVE COGNITION IN COMMUNITY-DWELLING ADULTS
Authors: Diaz Jose , Lee Soomi , Martire Lynn , Sliwinski Martin
Published: January 2025

Subjective cognitive decline is not a mere complaint by older adults; it is predictive of later development of objective cognitive decline and dementia. Sleep plays a pivotal role in maintaining cognitive, physical, and mental health, especially in older adults. While studies document age-related declines in sleep quality, limited research explores whether within-person changes in sleep quality are associated with within-person changes in subjective cognition (“coupling effect”). In this study, we examined the dynamic coupling relationship between sleep quality and subjective cognition in older adults over multiple years, adjusting for potential influence of self-report bias (gauged by self-rated health). We used nine waves’ longitudinal data from the Transitions in Health and Relationships study (n=131, Mage=77.09). Multilevel models indicated that changes in sleep quality were significantly associated with changes in subjective cognitive function (β=0.044, 95% CI [0.004, 0.084], p=.031), signifying a coupling effect independent of baseline sleep quality, sociodemographic covariates, and self-rated health. Furthermore, changes in self-rated health moderated the association between changes in sleep quality and subjective cognition (β=-0.047, 95% CI [-0.088, -0.005], p=.028), such that increases in self-rated health weakened the effect of increases in sleep quality on subjective cognition. These findings underscore the significance of within-person changes in sleep quality in predicting subjective cognitive decline in older adults. Notably, while the association was independent of self-report bias, it was weaker for those who reported their overall health was improved. Future work should focus on maintaining or improving sleep quality in order to prevent or delay subjective cognitive decline.
DIET AND COGNITION IN AGING: EFFECTS OF HIGH-FAT-SUGAR DIETS ON MEMORY AND EXECUTIVE FUNCTIONING
Authors: Atak Selen , Boye Alyssa , Botoseneanu Anda , Pecina Susana , Liu Zhong-Xu
Published: January 2025

High-fat and high-sugar (HFS) diets may affect the hippocampus, and consequently the hippocampus-dependent memory. Previously, we found that higher HFS diet consumption in young adults was associated with lower performance on hippocampus-dependent memory tasks, but not with their subjective memory report. However, whether similar associations exist in older adults has not been yet investigated. In this online study, 472 participants (age: 50 ~ 85 years; average = 62.6) reported their HFS consumption, measured by the Dietary Fat and Sugar Short Questionnaire, and their subjective memory issues. They also completed pattern-separation recognition and face-name associative memory tasks, which have been found to robustly engage the hippocampus. Participants also completed executive functioning tasks, i.e., Trail Making (TMT) and Stroop tasks. Results showed that different from young adults, higher HFS consumption was strongly associated with more subjective memory complaints in older adults after controlling for potential covariates. Moreover, age modulated associations between HFS consumption and memory/executive functioning. Specifically, higher HFS consumption was associated with worse hippocampus-dependent recognition memory and executive function, only in participants with age below 65, not in those with age above 65. Notably, HFS diet effects on recognition memory were also associated with participants’ health measured by multi-morbidity status, in that higher HFS predicted lower memory performance only in participants with no multi-morbidity. These results suggest that HFS diet effects on cognition are more complex in older than younger adults and call for further research to explore age-/health-related factors that uniquely modulate the effects of HFS diet in older adults.
DIMENSIONALITY, PROXIES, AND PREDICTORS OF COGNITIVE RESERVE IN THE MANCHESTER LONGITUDINAL STUDY
Authors: Aichele Stephen
Published: January 2025

In a sample of N=113 older adults (ages 62-86 years at MRI scan; 58.4% women) from the United Kingdom, we compared the dimensionality of general cognition before (COG) vs. after (COGr; cognitive reserve) residualization on global brain status (as indicated by brain volume loss, cerebral blood flow, and white matter lesion prevalence). Cognitive performance was assessed by 15 tasks spanning five domains: processing speed, fluid intelligence (e.g., spatial reasoning), crystallized intelligence (vocabulary), visuospatial memory, and verbal memory. Statistical tests were conducted in a series of structural factor analyses with progressive constraints on measurement invariance. Results showed that although COG and COGr were highly correlated (r =.84), item-factor loadings differed such that COGr more strongly emphasized fluid intelligence. We further examined differential associations of COG and COGr with 23 socio-demographic, health, and lifestyle variables in a series of regression models. Results from these latter tests showed consistent associations of education level, occupational class, and hobbies/interests as proxies both for COG and COGr. Difficulty with personal mobility was a salient risk factor for both COG and COGr, but only in models unadjusted for chronological age. In sum, results supported the role of intelligence as a potential compensatory factor for brain-related reductions in processing speed and memory. Efforts to preserve personal mobility and a diversity of hobbies and interests may serve as protective factors against brain-related reductions in cognitive performance.
INFLAMMATION AND DOMAIN-SPECIFIC COGNITIVE PERFORMANCE: RESULTS FROM THE EINSTEIN AGING STUDY
Authors: Wright Molly , Harrington Erin , Graham-Engeland Jennifer , Sliwinski Martin , Lipton Richard , Katz Mindy , Engeland Christopher
Published: January 2025

Inflammation may serve as a biological precursor to the development of mild cognitive impairment (MCI) and dementia. Although interleukin (IL)-6 may be more strongly associated with executive functioning (EF) or processing speed (PS) measures versus other cognitive domains, this has not been assessed simultaneously in a structural equation modeling (SEM) framework among older adults. The present study sought to address this gap. As part of the ongoing Einstein Aging Study, older adults (n=159, 65.4% female, 49.7% non-Hispanic White) without MCI at baseline completed neurocognitive testing and had two blood draws spaced two weeks apart at their baseline wave of data collection. Inflammation was assessed by averaging IL-6 levels obtained from these blood draws. Based on prior factor-analytic studies, a confirmatory factor analysis (CFA) was conducted that included an attention factor (Number Span Forward and Back, Verbal Fluency Test), memory factor (Free Selective Reminding Test, Logical Memory Test, Verbal Fluency Test), and EF/PS factor (Trail Making Test Parts A and B, Digit Symbol Test). A SEM model with pathways from IL-6 predicting cognitive factors was then specified, adjusting for relevant covariates based on fit statistics (age, years of education, sex, race/ethnicity). Both the CFA and SEM models fit the data well (RMSEA< 0.05, CFI>0.95). As expected, IL-6 was negatively associated with the EF/PS factor (β=-0.251, S.E.=0.073, p< 0.01). IL-6 was not associated with either the attention or memory factors (p>0.5). Based on these results, we predict that higher levels of IL-6 may predict nonamnestic MCI but not amnestic MCI.
ROLE OF GAIT SPEED, OLFACTION, AND PSYCHOLOGICAL FACTORS IN COGNITIVE FUNCTION AMONG OLDER ADULTS
Authors: Hanson Leah , Palmberg Kyle , Howe Clarissa , Gustafson Sally , Svitak Aleta , Barclay Terry
Published: January 2025

Slowing of gait speed, loss of smell and increased depression, anxiety and stress have been associated with lower cognitive performance among older adults. The Minnesota Memory Project is a longitudinal study of community-dwelling adults 55 and older that investigates lifestyle factors associated with cognitive aging. Annual assessments include the Montreal Cognitive Assessment (MoCA), Alberta Smell Test (AST), gait speed test (GST) and self-report inventories, including the Cognitive Change Checklist (3CL) and measures of social support, resilience, stress, anxiety, and depression. Significant associations were identified between AST and gait scores versus MoCA. Both scores differed significantly between cognitively impaired (MoCA < 26) versus cognitively intact (MoCA ≥26) participants. On average, impaired participant AST scores were significantly lower than intact participants (6.5 ± 3.9 SD, 8.7 ± 3.6 SD) and gait scores were significantly slower (4.0 ± 1.0 SD, 3.65 ± 0.8). A greater number of self-reported cognitive complaints was associated with lower MoCA scores at baseline (p< 0.0001). Participants reporting higher resilience and social support reported significantly fewer cognitive complaints (p< 0.0001), while higher stress, anxiety and depression were associated with more cognitive complaints (all p< 0.0001). Significant effects of olfaction, gait and cognitive complaints on future cognitive decline were also identified. A one-unit increase in AST score was associated with an 11% decrease in the hazard of cognitive impairment within 5 years. A one-unit increase in the GST score was associated with a 60% increase. Screening that includes gait speed, olfaction and subjective cognitive complaints could identify those at risk for future cognitive decline.
USE OF A BRAIN CARE SCORE TO IDENTIFY RISK AND PROTECTIVE FACTORS FOR MAINTAINING COGNITION AND HEALTH IN LATER LIFE
Authors: Schiloski Kylie , Taylor Morgan , Lachman Margie
Published: January 2025

The Massachusetts General Hospital McCance Center for Brain Health recently developed a Brain Care Score (BCS) to assess the risk of dementia and stroke and to promote healthier lifestyles. The BCS includes a combination of modifiable physical (e.g., blood pressure, blood glucose, cholesterol, Body Mass Index), environmental (e.g., nutrition, exercise, smoking status, sleep, alcohol consumption), and psychosocial factors (e.g., perceived stress, social support, purpose in life) that have been shown to predict dementia and stroke. The goal of the present study was to develop and test a comparable measure using data from the Midlife in the United States study (MIDUS). We examined whether the MIDUS version of the BCS predicted changes in cognition and health from the second (M2; 2004-2005) to the third wave (M3; 2013-2014) of the Biomarker sub-study sample (M2: N=1,167; Mage=54.46; SD=11.60; Age Range=34-83). Multiple regressions showed that higher BCSs predicted less decline in episodic memory (immediate and delayed recall), fluid intelligence (number series), processing speed, (backwards counting), and verbal fluency (category fluency) over time as well as less decline in functional health and fewer chronic conditions after 8 to 10 years. These findings indicate that the MIDUS version of the BCS is a promising tool to help identify those at risk of declines in cognition and health. Moreover, these findings highlight the importance of adopting a healthy lifestyle in order to reduce one’s risk of experiencing declines in cognitive and physical health in middle and later adulthood.
EXAMINING THE INTERPERSONAL-PSYCHOLOGICAL THEORY OF SUICIDE AMONG OLDER KOREANS: DOES AGE MATTER?
Authors: Lyu Jiyoung , Kim Hye-Mi , Hong Keung-Ja , Park Byoung-Jun
Published: January 2025

The interpersonal–psychological theory of suicide proposes that perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide leads to suicide attempts. However, whether this applies to all age groups is not clear. Therefore, this study was aimed to apply the interpersonal-psychological theory of suicide to older Koreans of different age groups. Participants of this study were 1,200 older adults aged 65 years and above (347 Young-old, 853 Old-old) who completed 2020 surveys on Elderly Life Conditions in Chuncheon, Korea. The Interpersonal Needs Questionnaire, the Suicidal Ideation Scale, and the Acquired Capability for Suicide Scale were used to assess participants’ perceived burdensomeness, thwarted belongingness, suicide attempts, and the capability for suicide. A multivariate regression results showed that thwarted belongingness was significantly associated with suicide attempts among young-old group, while perceived burdensomeness was significantly associated with suicide attempts among old-old group. These results suggest that the mechanisms around suicide attempts among older Koreans may be different by different age groups.