bluuebunny/crossref_metadata_2025_split huggingface dataset:
SCHIZOPHRENIA EPIGENETIC AGING PATTERNS REFLECT ALTERED MORTALITY AND CANCER RISKS
Authors: Higgins-Chen Albert T , Vinkers Christiaan , Boks Marco P , Levine Morgan E 
Published: November 2019

Abstract
Schizophrenia (SZ) is associated with large increases in all-cause mortality, high smoking rates, and elevated levels of age-associated proteins—suggesting individuals with SZ may experience accelerated rates of biological aging. Yet surprisingly, multiple previous studies found no association between SZ and biological age using Horvath’s epigenetic clock, a well-recognized and validated biomarker of aging based on DNA methylation (DNAm) levels. However, numerous epigenetic clocks have been developed to date, many of which are better indicators of differential lifespan and healthspan than the original Horvath clock. Thus, we hypothesize that these epigenetic clocks may be better proxies for the presumed accelerated aging rate in SZ. Here we investigate 14 epigenetic clocks using three publicly available DNAm datasets from whole blood, comparing SZ to non-psychiatric controls (NPC). In all data sets, we find SZ age acceleration in three clocks previously shown to be most predictive of age-related morbidity and mortality risk. In contrast, two clocks developed to capture mitotic rate are decelerated in SZ, consistent with low cancer rates despite smoking observed in epidemiological studies of SZ. We use these clocks to investigate the determinants of altered aging in SZ, such as smoking, alcohol, BMI, age-associated proteins, blood cell composition, and psychotropic medications. Principal component analysis suggests mortality clock acceleration, mitotic clock deceleration, and medication effects are independent phenomena in SZ. Our study demonstrates the importance of studying the various epigenetic clocks in tandem and highlights their potential utility for understanding how mental illness influences long-term outcomes including cancer and early mortality.
DO PERSONALITY TRAITS INFLUENCE PERCEPTIONS OF COGNITIVE CHANGE IN COMMUNITY DWELLING OLDER ADULTS?
Authors: Meuser Thomas M , Robnett Regula H 
Published: November 2019

Abstract
Recent research has linked personality traits and risk for cognitive impairment in advancing age. Associations with neuroticism are particularly robust. Both longstanding and recent elevations may predict dementia. Other traits – conscientiousness and openness to experience – also show unique associations. These findings derive mainly from large sample population studies and smaller clinical investigations. Relevance to the general population is unclear. We investigated the “big five” personality traits and cognition in 232 community-dwelling adults (73% female, 97% Caucasian, mean age 72 years). Scores on a self-report screen for dementia – the AD8 – framed the sample: 77% scored 0 points, no dementia; 23% scored 2+, possible dementia. Age and personality were independent variables in a binary logistic regression with AD8 status as dependent. All predictors but one, extraversion, were significant (p &lt; .05), suggesting that personality traits may influence perceptions of cognitive change. Higher agreeableness and neuroticism predicted possible dementia status on the AD8, whereas higher openness and conscientiousness predicted normal cognition. Interestingly, most in the AD8 positive group (70%) denied having “more problems with memory than most” on the Geriatric Depression Scale. These perceptions would seem incompatible, especially for true positive cases. Our findings suggest that the role of personality in dementia screening (and, perhaps, diagnosis) may be more nuanced than indicated in other studies. Longstanding traits and present perceptions are both elements of the evaluative process, as much as test scores and reported history. Our findings speak to the value of a person-centered, context-aware approach in cognitive screening.
IMPORTANCE OF DIAGNOSTIC IMAGING FOR INTERPRETATION OF SELF-REPORTED SURVEYS OF SHOULDER FUNCTION
Authors: Davis Derik L , Almardawi Ranyah , Beamer Brock , Gullapalli Rao , Ryan Alice , Terrin Michael 
Published: November 2019

Abstract
Rotator cuff (RC) tear is highly prevalent in older adults. The American Shoulder and Elbow Surgeon (ASES) survey, which quantifies subjective self-reported shoulder function, was originally validated in adults &lt;60 years, and more recently is suggested to be valid in adults ≥60 years. We tested the hypothesis that ASES score (1) discriminates between adults 60—85 years with and without RC tear and (2) correlates with self-reported health quality and objective shoulder measures. Cross-sectional study: forty-two community-dwelling-older-adult volunteers (mean age, 69.4 ± 5.7 years; range, 61-84 years; male, 45%) with no history of RC surgery completed shoulder magnetic resonance imaging (MRI), shoulder forward flexion (FF) and abduction (ABD) range-of-motion (ROM) testing; and ASES, shoulder-pain and SF-36 (pain/physical function) surveys. Four groups (group-1:-pain,-tear,n=14; group-2:+pain,-tear,n=4; group-3:-pain,+tear,n=12; group-4:+pain,+tear,n=12) were compared using one-way ANOVA with ad hoc pairwise comparisons and Spearman Rank Order Correlation (rho). Age, Charlson co-morbidity index, and SF-36 pain/physical function were not appreciably different among all groups. ASES score (p&lt;0.001), FF-ROM (p=0.032) and ABD-ROM (p=0.018) comparing all groups. ASES score: group-1 versus group-4 (p&lt;0.001); but no difference between group-1 versus group-3 (p=0.999), and group-2 had lowest ASES score. ASES score correlated with SF-36 physical function (rho=0.47,p=0.002), SF-36 pain (rho=0.34,p=0.028), FF-ROM (rho=0.63,p&lt;0.001), and ABD-ROM (rho=0.66,p&lt;0.001). Our results suggest that additional research on ASES score in older adults is needed. Although valid, interpretation of ASES score in older adults should be approached cautiously in studies without shoulder diagnostic imaging tests, since painless RC tears and painful shoulders without RC tear are not rare.
EFFECT OF VISION AND HEARING IMPAIRMENT ON LIFE SPACE MOBILITY AMONG OLDER MEXICAN-AMERICANS
Authors: Monsivais Viridiana Saenz , Downer Brian , Raji Mukaila , Kuo Yong-Fang 
Published: November 2019

Abstract
Background: Poor vision and hearing can restrict an older adult’s life space mobility (LSM). Our objective was to examine if poor vision and hearing differentially impact the decline in LSM over a 2-year period among older Mexican-Americans. Methods: Data came from waves 7 (2010/11) and 8 (2012/13) of the Hispanic EPESE. Our final sample included 452 participants aged &gt;79 years. Participants who said they could not recognize a person across the street, room, or arms-length were classified as having poor vision. Participants who said they could not understand a normal voice in a quiet room were classified as having poor hearing. Participants who decreased &gt;10 points on the Life-Space Assessment were classified as having a decline in LSM. Logistic regression was used to estimate the odds for a decline in LSM according to poor hearing and vision, controlling for baseline demographic and health characteristics. Results: Poor vision was associated with 2.70 (95% CI=1.37-5.62) greater odds for a decline in LSM. This association varied according to depressive symptoms. Poor vision was significantly associated with a decline in LSM for participants without high depressive symptoms (OR=5.04, 95% CI=2.00-15.5), but not for participants with depression (OR=0.63, 95% CI=0.12-3.13). The association between poor hearing and decline in LSM was not significant (OR=0.68, 95% CI=0.36-1.27). Conclusions: Poor vision is a risk factor for decline in LSM, especially for older Mexican-Americans who do not have high depressive symptoms. Poor hearing does not appear to be a risk factor for a decline in LSM for older Mexican-Americans.
FACTORS RELATED TO QUALITY OF LIFE OF OLDER PEOPLE IN TEHRAN IN 2019
Authors: Kakhki Ali Darvishpoor , Abedsaeedi Zhila , Davidson Patricia 
Published: November 2019

Abstract
Aging is accompanied by a variety of challenges and tensions that have consequences for quality of life in older people. Optimizing quality of life is a key goal for active aging. This study was conducted to describe factors and quality of life of older people in the city of Tehran. This descriptive, correlational study was conducted on a sample of 290 older people above age 60 recruited in 10 public parks in five regions of Tehran in 2019. A socio-demographic questionnaire and instrument on Quality Of Life of Older People (QOL-OP) were used for data collection. Content validity and Cronbach’s alpha were used for evaluation of the validity and reliability of questionnaires. Data were analyzed with SPSS software. Fifty-one percent of older people were male and 49% male with a mean age of 69.52(± 7.11) years. The mean scores for quality of life domains ranged from 57.61(±7.11) for family integrity, to 64.73(±7.50) for spiritual well-being on a 100-point scale. The scores on health-related quality of life domains were influenced significantly by characteristics of age, gender, marital status, housing status, income source, treatment insurance, supplementary treatment insurance, education level, living persons, number of offspring, and annual physician referral rates. The findings of this study showed that quality of life of older people was lower than expected and related to a number of factors. Monitoring modifiable factors such as treatment insurance and non-modifiable factors will help us to preserve or improve quality of life of older people.
SOCIAL FRAILTY IN RECENTLY RELOCATED SEMI-INDEPENDENT OLDER ADULTS
Authors: Dupuis-Blanchard Suzanne , Bigonnesse Catherine , Maillet Danica , Gould Odette , Andrews Melissa , Légaré France 
Published: November 2019

Abstract
Although most older adults live outside of care institutions, not all seniors choose to live in traditional family homes. Among those who relocate, some relocate too early while others are pre-frail or frail when they relocate. Social frailty – the interaction between social vulnerability and frailty – could contribute to these untimely relocations. The goal of this study was to inform the concept of social frailty by examining a population of semi-independent older adults who recently relocated to a continuum of care community. The objectives of this study were to: 1) understand the influence of the social determinants of health on the relocation process; 2) explore whether relocation increases or reduces social frailty; and 3) measure the level of post-relocation frailty in study participants. This mixed method study combined semi-structured interviews on the relocation process, the frailty identification tool PRISMA-7, and socio-demographic surveys. Twenty-nine recently relocated seniors were recruited with the assistance of a Citizens' Advisory Committee along with advertisements, presentations, information booths, and word of mouth. Qualitative descriptive thematic analysis and descriptive statistical analyses were used to examine the relationship between frailty, socio-demographic variables and relocation. Findings indicated that several social determinants contributed to frailty and that relocation into a continuum of care community could mitigate some aspects of social frailty. A conceptual framework on the influence of social frailty on relocation is discussed. More research is needed to inform the concept of social frailty and to better understand the impact of social factors on frailty.
THE EFFECT OF ACTIVITIES OF DAILY LIVING ON FAMILY CAREGIVER SOCIAL ISOLATION
Authors: Gallanis Tony 
Published: November 2019

Abstract
Social isolation has been shown to associate with negative health outcomes including depression and stress. For family caregivers of older adults, the demands on the caregiver often are associated with increasing feelings of loneliness and decreased social contact. The degree to which the caregiver’s social isolation is related to the complexity of the caregiving situation remains unknown. Through a cross-sectional analysis of 526 family caregivers from the Family Caregiver Alliance client record database, an association has been established between care recipient functional decline and caregiver social isolation. Social isolation was measured through the Lubben Social Network Scale and functional decline was measured through ADL/IADL reporting. Covariates controlled for in the analysis included caregiver ethnicity, duration of caregiving, adult child status, caregiver education, care recipient income, and hours per week caregiving. Family caregivers of care recipients with higher functional decline experienced elevated odds of social isolation as compared to family caregivers of care recipients with little to no functional decline. The results from this study highlight the need for medical personnel and non-profit actors to anticipate social isolation as a risk factor for family caregivers of older adults given the care recipient is experiencing functional decline.
WHAT CONSUMERS SAY ABOUT HOSPICES IN ONLINE REVIEWS
Authors: Cardenas Valeria , Rahman Anna N , Singleton Mekiayla , Zhu YuJun , Enguidanos Susan 
Published: November 2019

Abstract
Until recently, consumers have had limited resources to assess quality of hospices agencies, contributing to growing numbers of consumers turning to online review sites, such as Yelp. Yet little is known about the content of hospice Yelp reviews and how these relate to recently available Center for Medicare and Medicaid Services’ Hospice Compare site data. No study has examined Yelp hospice reviews and compared the themes identified in Yelp reviews to the topics addressed by CMS’s HC measures. To better understand how consumers perceive hospice care, we drew a purposeful sample of 67 hospices in California. Researchers used grounded theory to identify themes and categories within the hospice reviews. Each of two teams of two researchers independently coded the reviews and then met to compare coding and reconcile discrepancies until 100% consensus was reached. We coded a total of 692 consumer Yelp reviews, identifying 15 themes and grouping them under five overarching thematic categories: patient/caregiver-provider relationship; clinical care; agency competency; staff professionalism; and medical equipment and supplies. We found that overall Yelp comments were positive. The most frequently mentioned Yelp themes in hospice reviews were compassionate, caring staff; patient/family gratitude; and staff responsiveness. There was considerable overlap between the themes captured in HC caregivers survey items and Yelp. However, Yelp reviews cover a greater number and more diverse themes than those measures reported on the CMS Hospice Compare site. We recommend that consumers consider both HC and online review sites such as Yelp when evaluating a hospice.
PHYSICAL ACTIVITY IN EARLY AND MIDDLE ADULTHOOD PREDICTS LATER-LIFE MEMORY TRAJECTORIES VIA HEALTH PATHWAYS
Authors: Kraal Zarina , Zahodne Laura B 
Published: November 2019

Abstract
Physical inactivity measured during late-life is a modifiable risk factor for dementia, but many studies use concurrent assessments with limited longitudinal follow-up. Less is known regarding life course exposure to physical inactivity. Physical activity patterns at different ages may make independent contributions to dementia risk, which would point to multiple critical periods for intervention. Using Health and Retirement Study Life History Mail Survey data (N=4,396), latent growth curves tested whether retrospectively-reported activity in early (18-29 years) and middle (40-49 years) adulthood predicted later-life memory trajectories over 18 years (mean age at study entry = 60.56 ± 5.44; mean follow-up = 13.27 ± 4.03 years). Total metabolic equivalents were computed from reports of moderate and vigorous physical activity. Biennial memory performance was modeled from study entry (between 1996 and 2014) to 2014. Self-reported physical and mental health at study entry were modeled as independent mediators. Models were adjusted for age at study entry, sex, education, race, ethnicity, childhood socio-economic status, year of study entry, and year of mail survey enrollment. More physical activity at ages 18-29 and 40-49 were independently associated with better initial memory, but not subsequent memory change. The association between physical activity at ages 40-49 and initial memory was partially mediated by better mental and physical health. These observational results support the possibility that physical activity interventions during multiple stages of the adult life course might be effective at lowering dementia risk. In particular, mid-life physical activity may have broad effects on later mental, physical, and cognitive health.
RETIREMENT TIMING AND POST-RETIREMENT HEALTH: QUASI-EXPERIMENTAL EVIDENCE FROM DENMARK
Authors: Qvist Jeevitha Y 
Published: November 2019

Abstract
A growing concern among policy makers in the European welfare states is that the proportion of the population in the working age has decreased over the last decades. In response to these demographic trends, many European countries have introduced reforms that roll back welfare policies that enables early retirement in order to sustain the current standards of living. However, scholars have voiced the concern that reforms which prevent early retirement could cause a rise in health inequality in old age because some people are not able to extend their working life. There are two contradictory views on post-retirement health. Retirement can either be seen as a kind of identity crisis, leading to less motivation to maintain health or retirement can be seen as a health preserving transition, enabling individuals to relieve stress and be more aware of their health. So far, empirical evidence on the effect of retirement timing on post-retirement health is inconclusive about the causal nature of this relationship. To estimate the causal effect of retirement timing on post-retirement health, this paper uses month of birth variation in incentives to postpone early retirement in the cohort born in 1939 that was created by a reform of the Danish retirement legislation, which the government introduced in 1999. The results suggest that people who retire at the age of 60 have more adverse health outcomes in old age than people who retire later, but this difference does not appear to be caused by differences in retirement timing.
VALIDATING SILICONE WRISTBANDS TO MEASURE PESTICIDE EXPOSURES AMONG OLDER ADULTS -- PROOF-OF-CONCEPT STUDY
Authors: Chanti-Ketterl Marianne , Plassman Brenda L , Parks Christine , Herkert Nicholas , Fleenor Julie , Zhang Sharon , Stapleton Heather 
Published: November 2019

Abstract
Silicone wristbands have been used to measure exposure to pesticides and other chemicals among children and younger farm workers, but not in older adults. Thus, we aimed to examine exposure to pesticides using silicone wristbands in a small cohort of older adults living on agricultural land, with variable contact with fields and pesticides. We also investigated correlations between pesticide levels on wristbands and urinary pesticide metabolites. Organophosphate (OPH) pesticides and several organochlorines were measured in wristbands worn by 15 males age 70+ (10 farmers using pesticides and 5 non-farmers with no recent pesticide use). Wristbands were worn continuously for 5-days. End-of-day urine samples were collected on days 1-3-5. Spearman correlations and Wilcoxon Scores were calculated. Five pesticides were quantified in the wristbands and detection frequencies ranged from 40-90%. In urine,12 OPH metabolites were quantified, but only 5 were detected in &gt;50% of the samples. None of 5 urinary herbicides were detected. Imputation was performed by dividing minimum-detect by square-root-2. Malathion was only detected in farmers compared to non-farmers. Correlations between OPH urinary metabolites and wristband were examined but only two were significant and were negative in direction. Notably, organochlorine DDE on the wristbands was significantly correlated with 3 OPH metabolites. These unexpected relationships, based on small numbers, suggest a need to replicate this work in a larger study sample to explore potential for confounding or mixtures in future studies of pesticides and health in older farmers.
UNDERSTANDING DEMENTIA PREVALENCE AND HEALTH CARE USE PATTERNS IN RURAL NORTH CAROLINA
Authors: Grant Amanda N , Liu Tsai-Ling , Rozario Nigel L , Mangieri Deanna A , Woodward Jennifer M , Taylor Yhenneko J 
Published: November 2019

Abstract
Rural and remote communities have limited access to high quality dementia care, prompting a need for innovative solutions to meet the health care needs of affected older adults. As part of a study aimed at implementing a telehealth intervention for primary care patients with dementia in two rural North Carolina counties, we examined baseline dementia prevalence and compared health care use between patients with and without dementia. Electronic health records from January 2018 to December 2018 were examined for 2,288 patients aged 65 or older. A zero-inflated Poisson regression model was used to compare healthcare use between patients with and without dementia adjusting for patients’ demographic and clinical characteristics. Dementia prevalence was 8.7% based on diagnosis codes. Most patients with dementia were women (70%), not married (55%), Medicare-insured (78%), and had more comorbidities (mean: 2±2) than non-dementia patients. Dementia patients had a significantly higher number of primary care visits, emergency department visits, inpatient visits, and preventable hospitalizations than patients without dementia (risk ratio = 1.1, 1.8, 2.18, and 1.3, respectively; all P&lt; 0.05). Dementia burden was higher among women and use of acute care services by patients with dementia in this rural setting was higher than patients without the disease, similar to urban settings. These findings suggest opportunities to improve care coordination and access to resources to help reduce the need for acute care services among patients with dementia and can help tailor interventions to address the health care needs of this group.
CHALLENGES FOR BLIND AND VISION IMPAIRED USERS OF A VISUAL QUESTION ANSWERING TOOL: IMPLICATIONS FOR AGING ADULTS
Authors: Davis Nathan , Xie Bo , Gurari Danna 
Published: November 2019

Abstract
Recent technological developments provide individuals with vision impairment the transformative ability to upload pictures they take and promptly receive descriptions from remote workers. This study aimed to: identify challenges for visually impaired individuals to use such technology to obtain health-related information and provide recommendations for crowd-workers and the future development of assistive artificial intelligence (AI) design. In spring and summer of 2019, we analyzed 265 images of medication packages submitted by users of a visual question answering (VQA) application called VizWiz -- a smartphone application that provides near realtime assistance to visually impaired users by employing crowd-workers. We developed a 4-category coding scheme to analyze image quality, with two independent coders achieving excellent intercoder reliability (85%-95%). Of the 265 images, we found less than half were legible (46%), contained clear indicators for information sought (40%), or had minimum background noise (40%); while only a small percentage contained complete information (6%). Through thematic analysis of the data, we also highlight seven challenges with queries submitted by vision impaired users . Based on our findings, we make recommendations for the future design of VQA technologies, such as VizWiz, for visually impaired users. We also suggest that there is both great need and potential for user-centered design research to significantly enhance such assistive technologies. While this study did not focus exclusively on data submitted by aging adults, many VizWiz users are, in fact, aging adults, and such assistive technologies have strong implications for the design of assistive technology for this age group.