bluuebunny/crossref_metadata_2025_split huggingface dataset:
BRAIN FUNCTIONAL CONNECTIVITY IN OLDER ADULTS WITH MCI: DO FALLS MATTER?
Authors: Egbert Anna R , Hsu Chun Liang , Crockett Rachel , Liu-Ambrose Teresa 
Published: November 2019

Abstract
Older adults with mild cognitive impairment (MCI) are at an elevated risk of falls. We conducted a pilot longitudinal observational study to examine the natural course of brain intrinsic functional connectivity (FC) and cognitive function changes in association to falling history in older adults with MCI. 15 MCI participants (mean age 75.9, range 67-86) included 10 non-fallers and 5 fallers (minimum two falls in the previous 12 months with one in the last 6 months) from Metro Vancouver, BC, Canada. At study entry and 1-year follow-up, participants completed brain scanning session of structural MRI and resting state (RS) functional MRI, the Montreal Cognitive Assessment (MoCA), and the Mini Mental State Examination (MMSE). Results indicated an interaction between time (baseline vs. follow-up) and falls history on RS-FC in individuals with MCI (p&lt;0.001). At 1-year follow-up, MCI non-fallers showed increased FC between frontal, parietal and occipital cortex (from baseline R=0.141 to follow-up R=0.321) and lack of decline on cognitive measures. Meanwhile, MCI fallers showed weakening of FC between those brain regions (from baseline R=0.314 to follow-up R=0.201) with simultaneous cognitive deterioration. Significant relationships between FC strength and cognitive status existed only at follow-up (R=0.525, p&lt;0.05), suggesting that the triggered functional compensatory brain mechanisms in MCI non-fallers are not successfully executed in MCI fallers. Together, our pilot data suggest that older adults with MCI who fall show more advanced brain functional degradation with adjacent cognitive decline as compared to MCI individuals who do not fall.
SATISFACTION WITH OUTDOOR ACTIVITIES AMONG LONG-TERM SERVICES AND SUPPORTS RECIPIENTS
Authors: Sefcik Justine S , Hirschman Karen , Petrovsky Darina V , Hodgson Nancy , Naylor Mary 
Published: November 2019

Abstract
Being outdoors in nature has been associated with improved mental and physical health. There are no known studies exploring older adults’ satisfaction with outdoor activities at the start of long-term services and supports (LTSS; in nursing homes, assisted living, or at home). We examined characteristics of older adults receiving LTSS and factors associated with outdoor activities satisfaction. A secondary analysis was conducted of baseline data involving structured interviews with older adults new to LTSS (Health-Related Quality of Life: Elders in Long-Term Care; R01AG025524-05). Primary outcome was a single item on the satisfaction with outdoor activities (not at all satisfied to extremely satisfied). We conducted multivariable linear regression models controlling for the influence of the characteristics important to health-related quality of life (LTSS setting, gender, age, number of comorbidities, and sensory impairment [vision/hearing].) Among 356 people, the majority (59%) were satisfied with their outdoor activities. Of 339 participants with complete data, more depressive symptoms (higher Geriatric Depression Score; p&lt;.001) and higher cognitive functioning (higher MMSE score; p=.038) were associated with lower ratings of satisfaction with outdoor activities. Higher self-rated physical health (p=.038) and more independence with activities of daily living (p=.017) were associated with greater satisfaction with outdoor activities. Due to the cross-sectional nature of this study it is difficult to determine causality; however, outdoor activity is important to people receiving LTSS. Interdisciplinary teams can work with older adults receiving LTSS to assess interest level with outdoor activities and create a person-centered plan to increase outdoor activity and satisfaction levels.
TREATMENT WITH ANTIPSYCHOTICS AND RISK OF DEATH IN 58,000 PATIENTS FROM SWEDISH DEMENTIA REGISTRY
Authors: Religa Dorota , Schwertner Emilia , Garcia-ptacek sara , Johansson Bjorn , Nägga Katarina , Winblad Bengt , Eriksdotter Maria , Secnik Juraj 
Published: November 2019

Abstract
Background: Behavioral and Psychological symptoms of Dementia (BPSD) are a heterogeneous group of clinical phenomena that is subjectively experienced by the patient and/or observable by an examiner (e.g., caregiver, physician) consisting in disturbed emotions, perception, thought, motor activity, and altered personality. There are recommendations to limit antipsychotic use in patients with dementia, and the big educational effort is made to follow them. In Sweden antipsychotics use changed from 10.1% in 2007-2008 to 5.2% in 2014-2015. Aims: The aim of the study is to analyze the actors associated with treatment and mortality of dementia patients, particularly those suffering from BPSD. Particularly we focus on assessing all-cause mortality patients with dementia treated with antipsychotic drugs (APDs). Methods: We have analyzed 58,412 patients newly diagnosed with dementia. We have found that 2526 of the patients were prescribed APDs (602 typical APDs and 1833 atypical APDs)- Results In the adjusted models, use of APDs at the time of dementia diagnosis was associated with increased mortality risk in the total cohort (hazard ratio = 1.4; 95% confidence interval 1.3-1.5). We have also stratified the results. Conclusions: The risk of death in patients with dementia was increased in group that used atypical and typical APDs. Our study gives more evidence to advice caution in APD prescription for patients with dementia.
INVESTIGATING MODERATORS OF THE RELATIONSHIP BETWEEN SUBJECTIVE AND OBJECTIVE MEMORY
Authors: Falzarano Francesca , Minahan Jillian , Siedlecki Karen L , Salthouse Timothy 
Published: November 2019

Abstract
Subjective memory complaints (SMC) among older adults have been explored as an indicator of decline in objective memory functioning. While some research has found that SMC may be predictive of future cognitive impairment and dementia (Glodzik-Sobanska et al., 2007; Wang et al., 2004), others have suggested that SMC are common among healthy older adults (Cooper et al., 2011) and are not strongly related to objective memory performance. Researchers suggest that SMC may be more strongly related to affective factors (e.g., depression and anxiety; Rowell, Green, Teachman, & Salthouse, 2015). The current study examined the relationship between SMC, objective episodic memory performance (OEMP), along with depression and anxiety in a sample of 18-99 year olds (N = 5,430) from the Virginia Cognitive Aging Project (VCAP). Structural equation modeling with full information maximum likelihood estimation was used to investigate whether clinically-relevant depression and anxiety levels moderated the relationship between SMC and OEMP, controlling for age, education, gender, and health. OEMP was represented as a latent construct while the remaining variables were observed. Although depression and anxiety are significantly related to SMC (r’s = .29, .17, respectively), they are not correlated with OEMP. Furthermore, depression, but not anxiety, moderated the relationship between SMC and OEMP, such that those at risk for depression had a stronger relationship between SMC and OEMP (-.07, p&lt;.05) compared to those not at risk (-.02, p=.31). This suggests that SMC may not be a valid indicator of OEMP as it may reflect variance from other sources, such as depression.
EPIGENETIC PROFILES OF BIOLOGICAL AGING HALLMARKS
Authors: Leung Diana L , Liu Zuyun , Levine Morgan E 
Published: November 2019

Abstract
Investigation into the hallmarks of aging point to the existence of shared mechanisms that underlie the biological aging process. While there is a general consensus that hallmarks of aging rarely occur in isolation, little is known in regards to their overlapping networks or how interactions contribute to manifestations at the clinical level. Here, we examine whether shared epigenetic alterations—one of the proposed hallmark of aging—underlies diverse conditions characterized by other hallmarks, including cellular senescence, loss of proteostasis, genomic instability, mitochondrial dysfunction, and inflammation. Using weighted network analysis, we identified consistent overlaps in the methylation profiles across the different traits. For instance, epigenetic modules that were distinct in senescence were also affected in progeroid syndromes (Hutchinson-Gilford Progeria Syndrome and Werner’s Syndrome) and smokers. These CpGs tended to be located in CpG islands, which are notable for their strong association with transcriptional regulation. Overall, our results suggest that epigenetic alterations intersect with various hallmarks of aging. In moving forward, incorporation of this understanding may lead to the development of biomarkers that better capture the biological (rather than chronological) aging process.
THE EFFECTS OF AGE AND SIZE ON THE COMPANION DOG METABOLOME: ROLES OF TRYPTOPHAN AND FATTY ACID METABOLISM
Authors: Hoffman Jessica M , Austad Steven 
Published: November 2019

Abstract
Recently, the companion dog has been promoted as an ideal animal model for human aging. Dogs show an interesting phenomenon where smaller individuals are longer lived than their larger counterparts. However, many of the underlying molecular mechanisms that influence aging and longevity in the dog are unknown. To begin to uncover these physiological changes, we completed the largest metabolomics study to date in the companion dog. Here, we collected blood plasma samples from companion dogs in three in the United States for metabolomics analysis. We then looked at the effects of age and size on the metabolome to develop new hypotheses about healthy canine aging. Our most striking differences were found with regards to geographic location in the canine metabolome, in which metabolic profiles were more similar between dogs in the same city than across cities. After controlling for this location effect, we found a strong signal of amino acid metabolism, specifically tryptophan metabolism, associated with weight in the dog where metabolites in the tryptophan metabolism pathway were always higher in small, long-lived dogs. Future studies will directly investigate the role of tryptophan metabolism in model organisms.
FUTURE CARE PLANNING AND END-OF-LIFE CARE DECISION MAKING: INDIVIDUAL AND SOCIAL INFLUENCES
Authors: Lee Jeong Eun , Sörensen Silvia 
Published: November 2019

Abstract
As a growing number of older adults reach very old age, future care planning and end-of-life care decision making becomes increasingly important. Previous studies have shown that concrete future care planning steps are related to improved ability to manage illness and to better mental and physical health outcomes among older adults. Yet, relatively few older adults sufficiently plan for their future care. The purpose of this symposium is to highlight a collection of studies that each brings a unique perspective to the issue, reporting on individual and social factors that influence future care planning, end-of-life care decision making, and strategies to enhance future care planning among older adults. First, Chen and Siconolfi address common barriers and facilitators across diverse domains of age-related planning using content analysis. Second, Boerner and colleagues focus on the completion of formal planning without discussing the contents and factors associated with formal planning completion. Third, Strum investigates the complexities of navigating “fair” later life decisions involving family resources. Fourth, Moorman examines the racial differences in decisions of euthanasia and physician assisted suicide. Finally, Lee and colleagues report the findings from a future care planning intervention with older adults in rural area. The discussion by Sörensen will integrate the five papers with the goal of connecting the current evidence for meaningful steps in research and practice related to future care planning in older populations.
COMMON BARRIERS AND FACILITATORS ACROSS DIVERSE DOMAINS OF AGE-RELATED PLANNING
Authors: Chen Emily K , Chen Emily K , Siconolfi Daniel 
Published: November 2019

Abstract
Advance care planning (ACP) – plans that express wishes for healthcare for when a person is unable to communicate – is often studied independently of other age-related planning activities. This study explored a broad set of age-related planning activities, such as retirement, finances, aging in place, and healthcare, including ACP. We used directed content analysis to identify barriers and facilitators to age-related planning from semi-structured interviews with 38 respondents (ages 55-74). Surprisingly, a common set of structural, interpersonal, and individual barriers and facilitators emerged across domains. Barriers included competing demands, resistance from family members, and aversion to planning in general. Facilitators included exposure to planning behaviors through professional and social networks, having witnessed negative outcomes from others’ failure to plan, and a belief that planning would spare others future distress. These results reinforce the idea that ACP exists within of a set of age-related planning behaviors that share common characteristics.
LEVERAGING ANALYTIC METHODS TO EXPAND OPPORTUNITIES IN AGING-RELATED HEALTH DISPARITIES RESEARCH
Authors: Akushevich Igor , Hill Carl V , Whitson Heather E 
Published: November 2019

Abstract
The objective of the Symposium is to improve the understanding of how existing analytic methods and data can be leveraged to make progress in understanding the causes and mechanisms of health-related disparities in Alzheimer’s disease, related dementias and other prominent age-related diseases. Topics will cover a range of academic and administrative topics including: i) advanced analytic methods and modeling of health disparities with application to racial and geographic disparities in AD/ADRD; ii) the role of repeated anesthetic and surgical exposure in generation of disparities in AD/ADRD risk; iii) the nature of health disparities in cognitive aging as parallel to or distinct from health disparities in patterns of aging in other systems in the body; iv) recent advances in machine learning applied to large claims databases involving medical disparities; and v) geographic-related disparities in life expectancy across the U.S. A focus will be made on demonstrating how studies using established administrative data resources such as Medicare claims databases combined with innovative analytic approaches such as partitioning analyses, time-series based methods of projection and forecasting, and stochastic process models can be used to uncover previously overlooked or understudied aspects in this area of research. Analyses of such increasingly available large health datasets provides an opportunity to obtain nationally representative multiethnic results based on individual-level measures that reflect the real care-related and epidemiological processes ongoing in the U.S. healthcare system and allows the targetting of relatively rare diseases in relatively small population subgroups.
DISPARITIES IN ALZHEIMER’S DISEASE: THE ROLE OF REPEATED ANESTHETIC AND SURGICAL EXPOSURE
Authors: Kertai Miklos D 
Published: November 2019

Abstract
Annually, there are 7 million patients &gt; 65 years who undergo noncardiac surgery in the US. This number is expected to increase by 30% over the next 3 decades, and given the prevalence of surgically correctable comorbidities, the elderly will continue to undergo multiple surgical procedures. Currently, it is unclear what factors initiate or promote the development of Alzheimer’s disease (AD). Preclinical studies suggest that exposure to anesthesia and/or surgery could be one of the environmental exposures that increase AD risk through neuroinflammation and neuroapoptosis. However, previous studies indicated substantial disparities in AD risk by gender, ethnicity, and race, but failed to explore the role of anesthesia and/or surgery exposure in the risk for AD. This presentation will review the role of disparities and anesthesia and/or surgery exposure in the risk for AD in elderly surgical patients.
M. POWELL LAWTON AWARD LECTURE
Authors: Inouye Sharon 
Published: November 2019

Abstract
The M. Powell Lawton Award is presented annually to an individual who has made outstanding contributions from applied research that has benefited older people and their care. The lecture will be given by the 2018 recipient, Carol Whitlatch, PhD, Benjamin Rose Institute on Aging. The session will also include the presentation of the 2019 Lawton Award. The 2019 Lawton Award recipient is Barbara Resnick, PhD, CRNP, FGSA, of the University of Maryland. Supported by the Polisher Research Institute of the Madlyn and Leonard Abramson Center for Jewish Life.
FOLLOWING IN THE FOOTSTEPS OF A GREAT APPLIED GERONTOLOGIST (WHILE SIMULTANEOUSLY FORGING YOUR OWN PATH)
Authors: Whitlatch Carol 
Published: November 2019

Abstract
Dr. M. Powell Lawton was an inspirational and productive scholar whose work had application for improving personal care and well-being for older adults and their families. He held strong to the principles of Person- and Family-Centered Care long before this terminology and model of care was commonly practiced. He was a living example of PFCC always wearing comfortable clothes and shoes to ensure his unique creativity was not obstructed by physical discomfort. Dr. Lawton’s work has inspired countless gerontologists who have taken the next steps towards ensuring quality of care by understanding personal preferences, activities, and care values. Dr. Whitlatch will discuss Dr. Lawton’s ongoing influence on care and best practices focusing on her own research that gives voice to the care values, preferences, and activities of families facing early-stage dementia. Dr. Whitlatch encourages attendees to wear their most comfortable shoes to the lecture in honor of Dr. Lawton.
DOES DEMENTIA POLICY ACCOUNT FOR DIVERSITY? AN ANALYSIS OF CANADIAN DEMENTIA POLICIES
Authors: Wilson Kimberley 
Published: November 2019

Abstract
Background: The World Report on Ageing and Health outlines key policy challenges that need to be addressed to have successful public health response to population aging, including ‘dealing with diversity’ and ‘reducing inequity.’ Dementia has been framed as a global health challenge affecting approximately 46 million people worldwide. To reduce inequality, dementia policies must account for and respond to diversity. The purpose of this research was to conduct an analysis of current Canadian federal, provincial, and territorial dementia strategies to examine their inclusion of dimensions of diversity. Method: We conducted an internet-based search and identified 13 unique Canadian federal, provincial, and territorial dementia documents. We completed a deductive content analysis to review each policy for content on: age and sex; racial and ethnic identity; sociocultural identity; religion; socioeconomic status; gender identity and sexual orientation; geographical location; and language fluency and communicative ability. Results: Within Canadian dementia policies there is minimal focus on diversity. When diverse identities were acknowledged in policies, very little guidance was provided to local policy-makers, healthcare administrators, or service providers in how to acknowledge and accommodate different group’ needs with services. Further, none of the policies adopted an intersectional approach; that is, they failed to recognize that older adults have several overlapping and interrelating identities. Conclusion: As Canada and other countries move towards developing and revising dementia policies it is imperative that they account for diversity within aging populations.
RATES OF DISENROLLMENT FROM MEDICARE MANAGED CARE PLANS ARE HIGHER AMONG RACIAL, ETHNIC, AND LINGUISTIC MINORITIES
Authors: Martino Steven , Mathews Megan , Damberg Cheryl , Ng Judy , Agniel Denis , Tamayo Loida , Wilson-Frederick Shondelle , Elliott Marc N 
Published: November 2019

Abstract
Voluntary disenrollment from Medicare managed care (Medicare Advantage; MA) plans is related to beneficiaries’ negative experiences with their plan, disrupts continuity of care, and conflicts with goals to reduce Medicare costs. Information on associated factors may help illuminate the dynamics that drive decisions to disenroll. We used data from 17,517,852 beneficiaries enrolled in 736 MA plans in 2015 to investigate differences in rates of disenrollment by race, ethnicity, and preferred language. Disenrollment data came from Medicare’s enrollment system. Social Security Administration data on race and ethnicity were augmented with surname, address, and other Medicare administrative data to calculate probabilities of membership in seven race/ethnicity/language-preference groups: White, Black, English-preferring Hispanic, Spanish-preferring Hispanic, Asian or Pacific Islander (API), American Indian or Alaska Native, and multiracial. We summarized disparities across groups using regression models with and without plan intercepts, controlling for gender, disability, and Medicaid eligibility. Adjusted rates of disenrollment were significantly higher for Spanish-preferring Hispanics (19.1%), Blacks (10.2%), and APIs (9.4%) than for Whites (7.7%), and significantly lower for English-preferring Hispanics (7.4%, p’s&lt;0.001). Within-plan disparities accounted for only a small fraction of overall disparities, indicating that Spanish-preferring Hispanics, Blacks, and APIs tended to be enrolled in plans with higher disenrollment than plans in which Whites were enrolled, whereas English-preferring Hispanics tended to be enrolled in plans with lower disenrollment. These between-plan differences may indicate that high-minority-enrollment plans less effectively inform beneficiaries about the cost and coverage of care or that racial/ethnic/linguistic minorities more often select plans that raise rates or restrict coverage.
HEALTH-RELATED QOL IS ASSOCIATED WITH COMPLETION OF PULMONARY REHABILITATION IN OLDER VETERANS WITH COPD
Authors: Bamonti Patricia M , Moy Marilyn L , Goodwin Christina , Elsen Kdee , Silberbogen Amy 
Published: November 2019

Abstract
Pulmonary rehabilitation [PR] is the standard of care for Veterans with COPD. Psychosocial factors may play a role in PR participation. This study examined psychosocial factors among 253 Veterans with COPD (M age = 70.08, SD = 8.14) who completed (n = 110), did not complete (n = 75; “drop outs”), or never started (n = 68) PR. Measures completed at baseline were health-related quality of life (HRQL; Chronic Respiratory Questionnaire), depression (Beck Depression Inventory II), and exercise self-efficacy (Exercise Self-Regulatory Efficacy). One-way ANOVAs produced no significant differences in self-efficacy or depression. Significant differences were observed for HRQL, F(2,170)=10.58, p&lt;0.001. Post hoc analysis revealed significant differences between never starters (M=69.72, SD=16.65) and completers (M=80.22, SD=19.29), p = 0.007 and differences between drop outs (M=66.69, SD=15.24) compared to completers, p &lt; 0.001, such that better HQRL predicted completion. These findings have important clinical implications for engaging Veterans with COPD in PR.