bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE IMPACT OF DIABETES AND POOR ORAL HEALTH ON COGNITION: IMPLICATIONS TO IMPROVE DENTAL CARE ACCESS
Authors: Wu Bei , Luo Huabin 
Published: November 2019

Abstract
This study examined the joint effects of diabetes and poor oral health on cognitive function among older adults aged 60 years or older in the U.S. We analyzed data of 2,937 participants from the National Health and Nutrition Examination Survey (2011-2014). We investigated the interaction effects between diabetes and significant tooth loss, i.e. differences among the following four groups: 1=neither of the two conditions, 2=non-diabetic but with tooth loss, 3=diabetic but no tooth loss, and 4=both conditions. Significant interaction effects were found in our study. Having either diabetes or significant tooth loss was associated with lower cognitive function. When the two conditions were both present, the negative effects were much stronger than the total effects from either one of the two conditions. The additional loss of cognitive function resulting from multiple health conditions illustrates the importance of improving access to dental care for older adults in the U.S.
THE UNINTENDED CONSEQUENCES OF SEAMLESS IMPLEMENTATION OF A RURAL TELEMEDICINE CLINIC
Authors: Solimeo Samantha , Steffen Melissa J , Seaman Aaron , Miller Karla L 
Published: November 2019

Abstract
Osteoporosis is largely undetected and untreated in older men who are at-risk, with even lower rates of detection and treatment in rural communities. In this presentation we report the consequences for primary care providers (PCPs) of the implementation of an osteoporosis telemedicine clinic that targeted rural patients and is purposefully designed to minimize PCP workload. Analysis of qualitative interviews with PCPs who co-managed patients with the telemedicine clinic confirmed that implementation strategies used by the telemedicine clinic were successful at minimizing workload and had a positive impact on PCPs’ work. However, the clinic’s seamless approach may have contributed to unintended consequences of low PCP awareness of program care processes and selection criteria and a missed opportunity for PCPs to reinforce osteoporosis care goals in the primary care setting.
IMPROVING ACCESS AND OUTCOMES FOR RURAL CAREGIVERS USING THE TELEPHONE
Authors: Nichols Linda , Martindale-Adams Jennifer 
Published: November 2019

Abstract
Many caregivers of older rural veterans have limited access to services. In 2017, VA’s Office of Rural Health and Caregiver Support Program funded the Memphis Caregiver Center to deliver Resources for Enhancing All Caregivers Health (REACH VA) as a national behavioral intervention to improve access to care. To date, 438 caregivers of older Veterans have enrolled. REACH is a proven 4-session caregiver intervention, structured and easily replicated. Rural internet service is often problematic. Offering REACH by telephone provides many benefits, including access to service not available in the rural area, almost universal technology penetration, ease and familiarity of use, and removal of barriers of travel and care for the loved one. Through this enhanced service, caregivers of older veterans with dementia, PTSD, ALS, MS, and other conditions have shown statistically and clinically significant improvements in managing concerns and safety relating to their loved one and their own stress and coping.
ARE THERE BIDIRECTIONAL ASSOCIATIONS BETWEEN COGNITION AND BALANCE ABILITY: EVIDENCE FROM A BRITISH BIRTH COHORT
Authors: Blodgett Joanna M , Cooper Rachel , Davis Daniel , Kuh Diana , Hardy Rebecca 
Published: November 2019

Abstract
Age-related changes in cognitive and balance abilities are well-established, as is their correlation with one another. There is, however, limited evidence regarding the directionality of associations and whether or not common biological processes may underlie their age-related declines. The main aim was to explore bidirectional associations between balance and cognitive abilities in mid-later life using data from the MRC National Survey of Health and Development, the 1946 British birth cohort (n=2735). Cognition was assessed at ages 43, 53, 60-64 and 69 with verbal memory and search speed tasks. One-legged standing balance time (eyes closed) was assessed at ages 53, 60-64 and 69. Two autoregressive cross-lagged models simultaneously assessed bidirectional associations of balance with verbal memory and search speed over time. Results suggest a unidirectional association between verbal memory and subsequent balance in both sexes, decreasing with age from 0.14 SD balance (95%CI: 0.10,0.17) per 1SD verbal memory to 0.06 (0.01,0.10) to 0.05 (0.01,0.09). Search speed at age 43 was associated with balance at age 53 [men: 0.11(0.06,0.16); women: 0.09 (0.03,0.13)]; additionally, in men, there was evidence of a bidirectional association between ages 60-64 and 69 [balance to search speed: 0.05 (0.00,0.10); search speed to balance: 0.09 (0.02,0.16)]. These findings support the notion that successful balance relies mainly upon cognitive processing to successfully integrate vestibular, visual and proprioceptive input with motor output. Including a cognitive component in balance and fall risk intervention programs could have an additive benefit in improving neural pathways involved in balance and thus reducing fall risk.
OUTCOMES OF FIT & STRONG! PLUS: A GROUP EXERCISE AND WEIGHT LOSS PROGRAM TO TREAT OSTEOARTHRITIS
Authors: DeMott Andrew , Hughes Susan 
Published: November 2019

Abstract
Overweight older adults with osteoarthritis (OA) face increased risk for disability; however, no evidence-based programs target weight and OA simultaneously. Fit & Strong! (F&S!) is an 8-week evidence-based exercise program for persons with OA that improves lower extremity (LE) strength and mobility out to 18 months. F&S! Plus, a weight loss version of F&S! was tested against standard F&S! in a comparative effectiveness trial. Two and six-month trial outcomes were previously presented, this session will present maintenance outcomes at 12 and 18 months. This trial randomized 413 participants, 210 to F&S! and 203 to F&S! Plus. The mean sample age was 67.9, 86% female, and 92% African American. At 12 months, significant and marginally significant between-group differences favoring F&S! Plus were seen in several outcomes, including weight (p=.049), BMI (p=.04), waist circumference (p=.004), LE physical function (p=.09), 6-minute distance walk (mobility) (p=.08), 30-second chair stands (LE strength) (p=.46), and anxiety & depression (p=.08). At 18 months, only LE strength remained significantly improved for the F&S! Plus group (p=.045), however several within-group improvements remained statistically significant for both groups out to 18 months, including weight, BMI, waist circumference, LE pain & physical function, 30-second chair stands (LE strength), anxiety & depression, and self-efficacy for weight-management. F&S! Plus showed significant improvements over standard F&S! for several outcomes at the conclusion of the intervention (2 months) and many were maintained out to 12 months, with LE strength continuing to 18 months. Both groups showed significant within-group improvements out to 18 months.
THE ASSOCIATION OF LONELINESS AND CHRONIC CLINICALLY SIGNIFICANT PAIN AMONG AFRICAN AMERICAN AND WHITE OLDER ADULTS
Authors: Camacho David , Burnette Denise , Aranda Maria P , Lukens Ellen 
Published: November 2019

Abstract
Loneliness and pain are significant public health problems in later life, yet limited research has examined how these factors interact among racially diverse older adults. Guided by the Biopsychosocial Model of Pain, we used data from Waves 2 and 3 of the National Social Life, Health, and Aging Project to investigate the relationship between loneliness and chronic pain among 1,102 African-American and White adults aged 50 and over. Using logistic regression analyses, our final models considered demographics, physical and mental health, functioning, medication, health behaviors and social factors. Approximately 32% of African Americans and 28% of Whites reported chronic loneliness. Compared to Whites African-Americans were 2.5 times more likely to experience chronic pain. Among White participants, loneliness was not associated with chronic pain; however, the interaction of being African-American and lonely was associated with decreased odds of chronic pain in main and gendered analyses. African American women were 4 times more likely than White women to report chronic pain. Our results address the objectives of the National Pain Strategy (2016) to elucidate the experiences of chronic pain among diverse elders in the US. Future work should seek a deeper understanding of loneliness and chronic pain among African Americans elders and how cultural dynamics may help explain our counter intuitive findings (e.g., “Superwoman Schema”).
LIFE COURSE ORIGINS OF FRAILTY IN LATER LIFE
Authors: Williams-Farrelly Monica , Ferraro Kenneth F 
Published: November 2019

Abstract
Frailty, generally characterized as a clinical state of increased vulnerability resulting from age-related decline in reserve and function across multiple physiologic systems, has been gaining attention in recent years due to its high correlates with a number of poor health outcomes including falls, hospitalization, and mortality. Similar to other adult health outcomes, research on the etiology of frailty has begun to move from proximal risk factors only to those more distal in time. This research uses data from the Health and Retirement study (2004-2016) to examine whether childhood exposures predict developing frailty in later life. A series of ordinal logistic regression models were estimated to test whether six domains of childhood exposures (socioeconomic status, infectious disease, chronic disease, impairments, risky adolescent behavior, and risky parental behavior) were associated with frailty, composed of five components: unintentional weight loss, weakness, slowness, exhaustion, and low energy expenditure (Fried et al., 2001). After adjusting for demographic factors, experiencing multiple SES misfortunes or risky adolescent behaviors in childhood are associated with higher odds of frailty in later life (OR= 1.24 and 2.37, respectively), while experiencing any infectious diseases is associated with lower odds of frailty (OR= 0.67 and 0.72). After further adjusting for adult characteristics, experiencing 2 or more chronic diseases in childhood is associated with a 1.35 higher odds of incident frailty over an 8-year period. These results reveal some of the early exposures that may raise frailty risk in later life but also the mid-life factors that mediate those risks.
ASSOCIATIONS BETWEEN CHRONIC PHYSICAL CONDITIONS, MEDICATIONS AND MENTAL HEALTH IN AN AGING COHORT
Authors: Stirland Lucy , Stirland Lucy E , Russ Tom C , Ritchie Craig W , Terrera Graciela Muniz 
Published: November 2019

Abstract
Older people increasingly live with multiple chronic conditions and medications. We explored their interactions with mental health in the PREVENT Dementia study participants. Using logistic and linear regression, we investigated the association between increasing self-reported chronic physical conditions and current medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest. Among 210 participants, each additional condition was associated with increased odds of depression (adjusted OR, 95% CI: 1.41, 1.11-1.80; P=0.005) and anxiety (1.71, 1.35-2.21; P&lt;0.001). Each additional medication was associated with depression (1.36, 1.07-1.73; P=0.010) but not anxiety. For each additional condition, CES-D scores increased by 0.62 (0.04-1.20, P=0.035) and for each medication, by 0.66 (0.12-1.21, P=0.017). There was no significant association between conditions or medications and STAI scores. These findings provide crucial information on the future brain health of these individuals.
PERCEPTIONS OF EXERGAMES FOR FALLS PREVENTION AMONG SENIORS AND THERAPISTS IN ASSISTED LIVING FACILITIES
Authors: Stanmore Emma K , de jong Lex D , Skelton Dawn A , Meekes Wytske , Mavroeidi Alexandra , Todd Chris 
Published: November 2019

Abstract
Strength and balance exercise programmes are effective in reducing the rate and risk of falls but uptake and adherence to community based programmes are low. Exergaming technology may be a promising tool to increase exercise uptake and adherence among seniors due to their motivational features. As yet, there is little published on the views of older people and therapists of their experiences of using Exergames to reduce falls in assisted living facilities that may inform implementation. This study is the qualitative component of a cluster randomized controlled trial that investigated the use of purpose-built strength and balance Exergames in community-dwelling older people in 18 assisted-living facilities in the UK. Data collection included 36 hours’ observation, semi-structured interviews with 5 physiotherapists, assistants and researchers, and 13 focus groups with residents of assisted living facilities who had participated in a 12 week Exergame programme. Transcribed data were analysed using thematic content analysis to identify themes arising from older users’ and therapists’ experiences of using the Exergames. Findings suggest that the senior users enjoyed using the strength and balance Exergames and reported physical, psychological and social benefits. Although some games were generally favoured, there was no overall consensus on game preferences although social components, feedback, music and colourful animation appeared to increase the appeal of the Exergames. This is the first study exploring older users and therapists’ perceptions of exergames in assisted living facilities and provides valuable insight into the barriers, facilitators, contextual factors and perceived benefits or drawbacks following 12 weeks use.
GENOMIC ANALYSIS OF HUMAN ISOGENIC APOE IPSC-DERIVED INHIBITORY GABAERGIC NEURONS
Authors: Ellerby Lisa , Song Sicheng , Mooney Sean , Scheeler Stephen , Naphade Swati 
Published: November 2019

Abstract
Isoforms of ApoE modify the risk for Alzheimer’s disease (AD), cardiovascular disease and are also associated with exceptional longevity. Specifically, the ApoE E2 allele is associated with lower risk of AD-related neurodegeneration and with exceptional longevity, while the E4 allele is a major risk factor for AD and is associated with higher levels of Abeta deposition in the brain. The mechanisms modulating extended lifespan/healthspan mediated by E2 compared to E3 and E4 genotypes are not clear. One hypothesis is that the E2 allele is neuroprotective and compensates for neuronal dysfunction induced by misfolded protein expression in aging and disease. To understand the molecular basis of the protective effect of the E2 allele we performed transcriptomic analysis of isogenic iPSCs with E2E2 and E4E4 genotypes differentiated into inhibitory GABAergic neurons. Our analysis revealed that ApoE2 inhibitory GABAergic neurons regulate genes involved in nuclear division, DNA integrity and DNA damage checkpoint.
AN EMOTION REGULATION THERAPY FOR LATER-LIFE PAIN: EVIDENCE OF EARLY TREATMENT EFFECTS
Authors: Petti Emily , Kiosses Dimitris , Ravdin Lisa , Henderson Charles , Meador Lauren , Maisano Julianna , Reid Cary 
Published: November 2019

Abstract
Chronic pain (CP) is a common, morbid, and costly disorder in older adults. Guidelines encourage clinicians to employ non-pharmacologic therapies for its management, but current psychological interventions (e.g., CBT for pain) have modest treatment benefits and their effects are largely unknown in older cognitively impaired adults. We developed PATH-Pain, an emotion regulation therapy focused on reducing negative emotions and augmenting positive emotions. PATH-Pain is appropriate for use by older adults with CP, negative emotions, and a wide range of cognitive functioning. Treatment consists of 8 weekly individual sessions followed by 4 monthly booster sessions. One hundred older adults (ages 60+) with CP (≥ 3 months) and at least mild-to-moderate levels of negative emotions (per the Positive and Negative Affect Schedule) were randomized to receive PATH-Pain versus Usual Care (UC). Cognitive screening revealed that 44 participants were cognitively intact (Montreal Cognitive Assessment (MoCA) score ≥26), while 56 evidenced mild-to-moderate cognitive impairment (MoCA=16-25). Participants completed follow-ups at 5 (n=89) and 10 weeks (n=84), while 24-week assessments are ongoing. Examination of the treatment × time interaction in a repeated-measures mixed model indicate the presence of treatment effects. PATH-Pain (vs. UC) participants experienced significant reductions in pain intensity (p&lt;0.044) and pain-related disability (p&lt;0.003). Reductions in pain-related disability score were more pronounced among cognitively impaired individuals. The PATH-Pain group also demonstrated significant reductions in emotional suppression (p&lt;0.019) and depression (p&lt;0.009) scores. These results suggest that PATH-Pain is an effective treatment for the management of pain in cognitively intact and cognitively impaired older adults.
PSYCHOLOGICAL PREDICTORS OF FALLS EFFICACY AMONG FILIPINO OLDER ADULTS IN AN ELDERLY DEVELOPMENT PROGRAM
Authors: Torres Godfrey Josef R , Jolejole Katrina Marie , Botor Nephtaly Joel , Laude Teri-Marie 
Published: November 2019

Abstract
Falls, common among aging persons, typically lead to catastrophic health consequences. Studies show several factors influencing an older person’s risk to falling. Depression, a psychological condition, was identified as one of these factors. With the goal of determining potential psychosocial interventions for older persons, the present study explores what other psychological variables may explain falls efficacy, i.e., perceived concern about falling. 81 older adults who were participants in an elderly development program answered a socio-demographic survey and several scales (i.e., Satisfaction with Life Scale, Flourishing Scale, Geriatric Depression Scale – Short Form, Falls Efficacy Scale – International) to measure falls efficacy and other psychological variables. Bivariate correlation revealed that falls efficacy significantly increases as family problems (r=.228, p=.045), health concerns (r=.231, p=0.040), financial difficulties (r=.345, p=.002), and depression (r=.403, p&lt;.001) increase. Conversely, it significantly decreases as psychological well-being (r=-.255, p=.022) and perceived resilience (r=-.459, p&lt;.001) decrease. Multiple regression analysis confirmed that while depression is a significant positive predictor, F (1,79)=15.31, p&lt;.001, R=.403, explaining 16.2% of falls efficacy variance, anxiety-provoking situations (i.e., family problems, health worries, financial worries) also explain additional falls efficacy (6.6% variance), F (4, 71)= 5.234, p&lt;.001, R=.477, wherein financial worry is a significant positive predictor. Furthermore, entering psychological well-being and resilience in the model adds an additional variance of 6.6%, F (6, 69)=4.533, p&lt;.001, R=.532, but only resilience is a significant negative predictor. This paper culminates with recommendations on potential research on the psychosocial dimension of falls and possible interventions to mitigate falls among older persons.
PAIN AMONG OLDER MEXICANS: FINDINGS FROM THE MEXICAN HEALTH AND AGING STUDY
Authors: Milani Sadaf A , Samper-Ternent Rafael , Rodriguez Martin , Wong Rebeca 
Published: November 2019

Abstract
In Mexico, palliative care and pain relief was recently added to the essential health services offered through Seguro Popular. Pain is more frequent in older adults, a growing segment of this population, and is a major contributor to decreased quality of life and increased morbidity. However, Mexico only has enough opioid analgesics to treat 36% of those in need. We used logistic regression models to examine correlates of pain using data from the 2012 wave of the Mexican Health and Aging Study, which includes Mexicans aged 50 and older (n=13,727). Overall, 38.2% of individuals reported that they often suffered from pain. Those who reported pain were more likely to be female (OR: 1.56; 95% CI: 1.41, 1.72), insured (OR: 1.17; 95% CI: 1.03, 1.33), live in a semi-rural locality (OR: 1.18; 95% CI: 1.04, 1.34), report their health as fair or poor (OR: 2.99; 95% CI: 2.73, 3.29), be a past smoker (OR: 1.17; 95% CI: 1.06, 1.29), have at least one ADL limitation (OR: 2.58; 95% CI: 2.27, 2.93), report depression (OR: 2.19; 95% CI: 2.02, 2.37), or report arthritis (OR: 2.74; 95% CI: 2.45, 3.07). Those who did not report pain were more likely to be widowed or have higher education. Diabetes, stroke, and cancer were not significantly associated with pain. Given that Mexico does not have the resources to treat over half of individuals living with pain, understanding the high burden of pain in this population is important to inform interventions and improve quality of life.
EXPERIENCE OF LGBT PATIENTS AND FAMILY WITH HOSPICE AND PALLIATIVE CARE
Authors: Stein Gary L , Berkman Cathy 
Published: November 2019

Abstract
This study examines the degree to which hospice and palliative care staff observe or perceive inadequate, disrespectful, or abusive care to LGBT patients and family members. A cross-sectional study using an online survey completed by 865 providers, including social workers, physicians, nurses, and chaplains. Among respondents, 55% reported that LGB patients were more likely to experience discrimination at their institution than non-LGB patients; 24% observed discriminatory care; 65% reported that transgender patients were more likely than non-transgender patients to experience discrimination; 20% observed discrimination to transgender patients; 14% observed the spouse/partner of LGBT patients having their treatment decisions disregarded or minimized; and 13% observed the spouse/partner being treated disrespectfully. Findings reported also include: institutional non-discrimination policy, staff training, intake procedures, and comfort in assessing LGBT status. Implications for future research, policy, and practice will be presented.
CARE DEPENDENCY: EXPERIENCES AND EXPECTATIONS OF COMMUNITY-DWELLING OLDER ADULTS
Authors: Jukema Jan S , Veldhuis Sharon Oude , Alphen Jacqueline Van , Jorritsma Jopie , Lange Frits De 
Published: November 2019

Abstract
“Not to be a burden” is a common phrase used by community-dwelling older adults in discussing their dependency on others in care for their daily life. This attitude may lead to conflicts with relatives, neighbors, or professionals when in their opinion, care is necessary and, ultimately, may result in unmet care needs. The goal of this study is to gain a better understanding of how older adults experience their increased dependency on others and to contribute to the development of an ethic of care. Thirty-two participants of a larger research sample (n=64) from a descriptive qualitative research were purposefully selected, resulting in an equal distribution of the following variables: gender, living situation, living with or without partner, and having children or not. From a multiphase qualitative analysis with five researchers, including two senior citizens four themes emerged: (1) relationships in the context of care; (2) experiences with giving, receiving and asking for care; (3) future perspectives towards receiving and asking for care; and (4) actual practices of caregiving and receiving. Our study clarifies how community-dwelling older adults deal with the changes in their dependency on others. The study results highlight particular dynamics which appear, at least, partly in contrast with current policy regarding care at home. Moreover, it contributes to an empirical refinement of the concepts of dependency and interdependency in an ethic of care. Further studies are needed to clarify the influential factors on asking for care in diverse groups of older adults and the response from their network.