bluuebunny/crossref_metadata_2025_split huggingface dataset:
All-cause Dementia Prediction by Machine Learning: The Health, Aging, and Body Composition Study
Authors: Wu Chenkai , Jin Xurui 
Published: December 2020

Abstract
There are several shortcomings of the currently available risk prediction models for dementia. We developed a risk prediction model for dementia using machine-learning approach and compared its performance with traditional approaches. Data were from the Health, Aging, and Body Composition Study, comprising 3,075 older adults (at least 70 years). Dementia was defined as (1) use of a prescribed dementia medication, (2) adjudicated dementia diagnosis, or (3) a race-stratified cognitive decline&gt;1.5 SDs from the baseline mean. We selected 275 predictors collected from questionnaires, imaging data, performance testing, and biospecimen. We used random survival forest (RSF) to build the full model and rank the importance of predictors. Subsequently, we built parsimonious models with top-20 predictors using RSF and Cox regression. A dementia risk score was developed using top-ranked variables. We used the C-statistic for performance evaluation. Over a median of 11.4 years of follow-up, 659 dementias (21.4%) occurred. The RSF model (both including all and top-20 variables) showed a higher C-statistic than the regression model. Digit symbol score, physical performance battery, finger tapping score, weight change since age 50, serum adiponectin, and APOE genotype were the top-6 variables. We created a dementia risk score (0-10) using the top-6 variables. A 1-unit increase in the risk score was associated with an 8% higher risk of dementia. The risk score demonstrated good discrimination (C-statistic=0.75). Machine learning methods offered improvement over traditional approaches in predicting dementia. The risk prediction score derived from a parsimonious model had good prediction performance.
Building, testing, and learning from network models of human aging
Authors: Rutenberg Andrew , Farrell Spencer , Mitnitski Arnold , Rockwood Kenneth , Stubbings Garrett 
Published: December 2020

Abstract
We have developed computational models of human aging that are based on complex networks of interactions between health attributes of individuals. Our “generic network model” (GNM) captures the population level exponential increase of mortality with age in Gompertz’s law together with the exponential decrease of health as measured by the frailty index (FI). Our GNM includes only random accumulation of damage, with no programmed aging. Our GNM allows large populations of model individuals to be quickly generated with detailed individual health trajectories. This allows us to explore individual damage propagation in detail. To facilitate comparison with observational data, we have also developed and tested new approaches to binarizing continuous-valued health data. To extract the most information out of available cross-sectional or longitudinal data, we have also reconstructed interactions from generalized network models that can predict individual health trajectories and mortality.
Role of Genetic Interactions in Alzheimer’s Disease: Lessons from Long Life Family Study (LLFS)
Authors: Yashin Anatoliy , Wu Dequing , Arbeev Konstantin , Stallard Eric , Tan Qihua , Kulminski Alexander , Feitosa Mary , Ukraintseva Svetlana 
Published: December 2020

Abstract
Experimental and clinical studies of Alzheimer’s disease (AD) provide plentiful evidence of AD heterogeneity and involvement of many interacting genes and pathways in regulation of AD-related traits. However, detailed mechanisms of genetic interactions (GxG) involved in AD remain largely unknown. Uncovering hidden patterns of such interactions from human data will help better understand the nature of AD heterogeneity and find new targets for AD prevention. In this paper, we applied a newly developed method of evaluating joint GxG effects on AD to analysis of the Long Life Family Study data. The analysis included several steps: (i) selecting candidate genes from stress response pathways that are thought to be involved in AD; (ii) estimating interaction effects of SNP-pairs on AD risk, and selecting the top interacting SNPs; (iii) running GWAS-like interaction analysis for SNP-pairs, with one SNP fixed; (iv) using characteristics of the detected SNP-pairs interactions to construct the SNP-specific Interaction Polygenic Risk Scores (IPRS); and (v) evaluating the effects of IPRSs on AD. We found that SNP-specific IPRS have highly significant effects on AD risk. For most SNPs involved in the significant interaction effects on AD, their individual effects were statistically not significant. Male and female analyses yielded different subsets of the top interacting SNPs. These results support major role of genetic interactions in heterogeneity of AD, and indicate that AD mechanisms can involve different combinations of the interacting genetic variants in males and females, which may point to different pathways of resistance/response to stressors in two genders.
Feasibility of Automating Fidelity Monitoring in a Dementia Care Intervention
Authors: Hodgson Nancy , Nencova Ani , Gitlin Laura , Summerhayes Emily 
Published: December 2020

Abstract
Careful fidelity monitoring is critical to implementing evidence-based interventions in dementia care settings to ensure that the intervention is delivered consistently and as intended. Most approaches to fidelity monitoring rely on human coding of content that has been covered during a session or of stylistic aspects of the intervention, including rapport, empathy, enthusiasm and are unrealistic to implement on a large scale in real world settings. Technological advances in automatic speech recognition and language and speech processing offers potential solutions to overcome these barriers. We compare three commercial automatic speech recognition tools on spoken content drawn from dementia care interactions to determine the accuracy of recognition and the guarantees for privacy offered by each provider. Data were obtained from recorded sessions of the Dementia Behavior Study intervention trial (NCT01892579). We find that despite their impressive performance in general applications, automatic speech recognition systems work less well for older adults and people of color. We outline a plan for automating fidelity in interaction style and content which would be integrated in an online program for training dementia care providers.
Development of an Interprofessional Training Education Program in Geriatrics
Authors: Cotton Sam , Faul Anna , Yankeelov Pamela , D’Ambrosio Joe 
Published: December 2020

Abstract
This study examines the development of an interprofessional training certificate program that prepares social work learners to infuse geriatrics and behavioral health into primary care settings. Since 2018, our program has trained 31 social work learners and 16 learners from counseling psychology and nursing. At the core of the certificate program is an emphasis on developing skills focused on the integration of geriatrics, behavioral health and primary care to address the lack of workforce trained at the intersection of these areas. Each series of workshop is aligned with core competencies that address the 4-M Model of Age-Friendly Health Care and SAMSHA’s Core Competencies in Behavioral Health. Our professional certificate includes training in Motivational interviewing, as well as Cognitive behavioral therapy, Mindfulness based cognitive therapy and Problem-solving therapy, Narrative Therapy, Strategic Therapy, Systemic Therapy, Life Review and Reminiscence Therapy. Additionally, students receive professionalization trainings to help prepare them for the job market. To measure the efficacy of this curriculum program, we examined the outcomes related to student knowledge of geriatrics and behavioral health including knowledge attainment, fidelity to modalities, learner self-efficacy, and learner satisfaction. The results of this study showed that integrating interprofessional education into social work settings can lead to positive outcomes for student knowledge, self-efficacy and learning satisfaction. Additionally, we found that having a curriculum that focused on interprofessional teams contributed to higher self-efficacy in completing tasks compared to previous cohorts. This has implications for the way that we conceptualization the use of interprofessional education.
Longitudinal Relationships Between Favorite Activities and Homebound Status in Older Adults
Authors: Sun Xiaocao , Liu Minhui , Miyawaki Christina , Li Yuxiao , Hou Tianxue , Tang Siyuan , Szanton Sarah 
Published: December 2020

Abstract
Favorite activities are usually meaningful to older adults and may influence their homebound status and vice versa. Using Round 1 (R1, in 2011) and Round 5 (R5, in 2015) data from the National Health and Aging Trends Study, we examined the patterns of favorite activity by homebound status and investigated their relationship among community-dwelling older adults (N=3,332). Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency, difficulty, and needing help of outdoor mobility. Favorite activities were named by participants verbatim and then were classified into two categories (active and non-active) based on the estimated energy needed to perform the activity. Logistic regression models were used to determine whether homebound status at R1 predicted the types of favorite activity in R5, and ordinal logistic regression models for predictions from the types of favorite activity at R1 to homebound status at R5, adjusting for demographics and health conditions. The sample was, on average, 76±7.23 years old, non-Hispanic White (72.9%), and female (59.7%). Regardless of the homebound status, reading and walking are the top two favorite activities. Homebound older adults enjoyed “non-active” activities (e.g., watching TV), while non-homebound counterparts preferred “active” outdoor maintenance. Being homebound at R1 predicted non-active favorite activity in R5 (OR=.257, p&lt;0.001), and R1 non-active favorite activity also predicted homebound status in R5 (OR=1.219, p =0.039). These findings provide new information on the activity preferences of older adults with different homebound status and how their preferences may influence their future homebound status.
The Relationship Between Physical Activity Levels and Manual Dexterity in Adults Over 60 Years Old
Authors: Kim Naomi , McGraw Rachael , Thralls Katie 
Published: December 2020

Abstract
During aging there is a natural physiological decline that contributes to a loss of function needed for activities of daily living to maintain independence and high quality of life. Physical function needed for independence includes gross motor function (e.g., lower body strength for standing) and fine motor function (e.g., manual dexterity for dressing). Physical activity (PA) has shown to maintain fitness, such as muscular strength, to delay loss in gross motor function. However, there is limited research on the association between PA and fine motor function. The purpose of this study was to examine the relationship between meeting national Physical Activity Guidelines (PAG; &gt;150 min./wk.) and manual dexterity in older adults (&gt;60 years). Participants (N=45, Mean age = 80.2±8.2 years) completed an interview-assisted self-report of their PA level and an objectively measured manual dexterity assessment (i.e., Purdue Pegboard Test (PPT)). The PPT included four fine motor skill assessments. For all four PPT’s, Analysis of Variance (ANOVA) tests showed a significant main effect for PA level, a main effect for age, and an interaction effect (PA*age) on manual dexterity for all PPTs (ps&lt;0.05). Follow-up comparisons showed a significant main effect for PA level on manual dexterity for the older group (&gt;80yrs; ps&lt;0.05), and not for the younger group (ps&gt;0.05). Pearson’s r correlations showed significant moderate-positive correlations between activity level (min./wk.) and PPTs scores (r=0.45– 0.50; ps&lt;0.005). These findings suggest that meeting PAG may be a preventative strategy to attenuate aging declines in manual dexterity to maintain hand function and independence.
Negative Marital Quality, Purpose in Life, and Depressive Symptoms Among Middle-Aged and Older Couples
Authors: Irani Elliane , Park Sumin , Hickman Ronald 
Published: December 2020

Abstract
Negative marital quality is associated with poor health outcomes. Purpose in life can serve as a psychological resource to buffer the stressors experienced from a negative marital relationship. Yet, the associations among negative martial quality, a person’s level of purpose in life, and depressive symptoms have not been fully explored in a dyadic context. We examined the actor (intra-individual) and partner (cross-spousal) effects of negative marital quality on depressive symptoms in couples and the potential mediating role of purpose in life. Structural equation modeling was used to analyze cross-sectional data on middle-aged and older married, heterosexual couples (N=1,235) who participated in the 2016 wave of the Health and Retirement Study. The final model had an acceptable fit to the data (TLI=.963, RMSEA=.040, SRMR=.038). At the actor level, negative relationship quality was positively associated with depressive symptom severity, and purpose in life mediated the relationship in wives and husbands. At the partner level, wives had more depressive symptoms when husbands reported higher negative marital quality. Comparatively, husbands had less depressive symptoms when their wives indicated a greater sense of purpose. Husbands also had a lower purpose in life when their wives had higher states of negative marital quality. This study highlights the psychological benefits of allaying negative perceptions of marital quality and enhancing the sense of purpose in middle-aged and older couples. The results support a focus on dyadic approaches to improve the psychological health, and potentially, the physical health status of middle-aged and older couples.
Barriers to Successful Aging Among Older Women Living With HIV: A Qualitative Study
Authors: Rubtsova Anna , Taylor Tonya , Wingood Gina , Ofotokun Igho , Gustafson Deborah , Holstad Marcia 
Published: December 2020

Abstract
Successful aging (SA) is the capacity of older people to thrive despite age-related changes and/or declines. Although our previous research found that older (age ≥50) women living with HIV (OWLH) can achieve SA, considerable barriers remain. The purpose of this qualitative study was to identify specific barriers to SA among OWLH. Our sample consisted of 29 OWLH recruited between October 2018 and March 2019 at two sites of Women’s Interagency HIV Study (WIHS): Atlanta, GA and Brooklyn, NY. These participants were assigned to either semi-structured interviews (N=17: 8 interviews in Brooklyn and 9 in Atlanta) or focus group discussions (FGD: 1 FGD in Atlanta with 5 participants, and 1 FGD in Brooklyn with 7 participants). Our FGD and Interview Guides included questions focused on barriers to SA. Participants were, on average, 58 years old (range 50-73), 86% Black, 83% single, and 62% with annual income ≤ $12,000. All interviews and FGD were transcribed and coded using MAXQDA software. We used thematic coding within constructivist approach. Several themes emerged identifying the following SA barriers: multiple chronic conditions and pain (e.g., arthritis, neuropathy); polypharmacy and side effects of HIV medications (“it’s wearing on me”); HIV-related stigma and loneliness (“I think my children would judge me if I would tell them I have it HIV”); substance use, giving up on yourself (“just sitting around, not doing anything”); and lack of access to resources and services (e.g., mental health providers, support groups). Our findings will help designing public health interventions promoting SA among OWLH.
The Development of a Scale to Measure HIV-Prevention Factors in Adults Age 50 and Older
Authors: Wion Rachel , Loeb Susan , Mogle Jacqueline , Fick Donna 
Published: December 2020

Abstract
Adults aged 50 and older are at risk for human immunodeficiency virus (HIV) infection. Currently, there are no measures specifically aimed at middle-aged and older adults to assess their HIV risk. Existing measures have been created for and mostly tested in adolescent and young adult populations. The purpose of this study was to modify and test existing instruments related to HIV prevention factors with an older adult population. Two rounds of an expert panel (N = 10) review were conducted to assess items from the Condom Use Self-Efficacy Scale and the Sexual Risks Scale for their applicability to older adults. Any items with content validity at the item level &lt;0.78 were either discarded or modified. New items were also added. The final adapted HIV prevention scale had 31 items and was administered via an online survey. Single adults (N = 252) aged 50 to 85 who had been on at least one date over the past year participated in the study. The HIV prevention scale underwent confirmatory factor analysis. Model fit was estimated using maximum likelihood and standardized estimates were used for factor loadings. The items loaded on eight factors in three models: Model 1 (Mechanics, Advocacy, Intoxicants); Model 2 (Attitudes, Normative Beliefs, Perceived Susceptibility); and Model 3 (Intention, Expectations). There was adequate to excellent model fit. However, there were multiple correlations of error variances suggesting that while the items are appropriate for an older adult population, the scale will need adaptations prior to using for further data collection.
The Senior Sex Education Experience Study: Qualitative Data From Developing an Adult Sex Education Program
Authors: Pierpaoli-Parker Christina 
Published: December 2020

Abstract
Older adults (OAs) account for an unprecedented proportion of STDs but receive limited sex education. We present preliminary data from the SEXEE study developing a sex education intervention for OAs 50+. The sample consisted of 17 OAs, ages 53 to 77, (M = 65, SD = 7.6; 64.7% female; 94.1% Caucasian) and seven primary care physicians, geriatricians, and other specialists (e.g. gynecologists), sampled purposively. Physicians completed a semi-structured interview to describe their experiences discussing sexual health with OAs, identify barriers to those discussions, and elicit recommendations for an educational curriculum. OAs participated in three separate focus groups to determine their interest in and suggestions for the intervention. Qualitative data underwent thematic coding separately by two researchers, with a third researcher resolving any discrepancy. One physician (14%) reported routinely assessing adults’ sexual health; others only in the context of a specific presenting concern (e.g. ED). Though the physicians considered sexuality important component of QoL, many reported barriers to assessment and treatment, including insufficient time, training, and knowledge; concerns about personal and patient discomfort; and patient complexity. Of the OAs interviewed, 15 (88%) endorsed high interest in attending a sex education program. The most commonly recommended educational topics among physicians and OAs included: sexual changes with aging and management strategies; STDs and risk factors; tools for enlarging the sexual repertoire, myths about late life-sexuality; masturbation, and dating. Findings extend previous observations about clinical barriers to sexual health discussions and provide new insights for developing a sex ed intervention for this population.
Pathway Analysis of Leisure Activity and Cognitive Function in the Long Life Family Study
Authors: Roth Nicole , Sebastiani Paola , Cosentino Stephanie , Schupf Nicole , Perls Thomas , Andersen Stacy 
Published: December 2020

Abstract
Familial longevity and greater involvement in activities purported to build cognitive reserve (e.g. education, cognitively stimulating leisure activity) have both been associated with better cognitive function in later life, yet little is known about how these protective factors relate with one another. In this work, we modeled the associations among familial longevity, proxies of cognitive reserve, and cognitive function in the Long Life Family Study (LLFS). We assessed cognitive function using a comprehensive battery of neuropsychological tests (i.e. Digit-Spans, California Verbal Learning Test, Rey-Osterrieth Complex Figure, phonemic fluency, category fluency, Word Generation, DKEFS Sorting Test, and logical memory) in a subset of LLFS family members and a referent cohort (N=314, mean age 75.7±14.6 years). To model these associations, we used a series of Bayesian hierarchical regression pathways that incorporate a random effect for family relatedness, adjusted by age and sex. All continuous variables were rescaled and bounded to be approximately between (0,1) in order to standardize regression coefficients and to allow for an asymmetrical beta-distribution. Controlling for education level, age, and sex, referents had greater engagement in late-life cognitive activities compared to LLFS family members, β=0.38 (95% CI: 0.18 to 0.57). In turn, those with higher markers of cognitive reserve exhibited better neuropsychological performance. Despite LLFS family members having lower participation in cognitively stimulating leisure activities, there were no differences between LLFS family members and referents on cognitive test performance. These results suggest long-lived family members may have more unique pathways (i.e. genetic/environmental) that preserve cognition later in life.
Identification of Research Trends in Aging in Place Using Text Mining Analysis
Authors: Kim Ha Neul , Nam Seok In 
Published: December 2020

Abstract
Since 1980s professionals and social service providers have focused on aging at the place where people lived. This is the initial concept of the Aging in Place (AIP). Over 40 years, the topics have developed and extended to other disciplines welcoming different perspectives in the study of AIP. Therefore, this study aims to understand the overall research trends in Aging in Place (AIP) studies using text mining analysis to track the evolvement of AIP subtopics not only in Gerontology but also in various fields. To identify the topic trends, we collected the titles, abstracts, and keywords from 1,372 international articles that were published from 1981 to 2019. Then, keywords were extracted and cleaned based on precedent literature and discussions. We analyzed the keywords based on the degree of centrality and visualized the keyword-networks using VOSviewer and Pajek. Top-most popular keywords are “independent living”, “housing”, “older adults”, “home care”, “daily life activity” and “quality of life.” The change in topic trends shows that in the 1980s to early-2000s, research focused on organization and management level of intervention, home(housing) for the older adults, long term care. In the mid-2010s, health-related topics such as daily life activity, health service, health care delivery and quality of life have emerged. Recently, the topics have extended further to technology, caregiver, well-being, and environment design, environmental planning that support independent living of oneself. The research result shows that the interdisciplinary approach regarding AIP is not only inevitable but also encouraged for an in-depth discussion of the field.