bluuebunny/crossref_metadata_2025_split huggingface dataset:
LIFE-SPACE MOBILITY AS A PREDICTOR OF MEDICARE UTILIZATION AMONG COMMUNITY-DWELLING OLDER MEXICAN AMERICANS
Authors: Johnson Jason P , Chou Lin-Na , Kuo Yong-Fang , Ottenbacher Kenneth , Snih Soham Al 
Published: November 2019

Abstract
Hispanics are a large and growing group of older adults, with higher rates of morbidity and disability than other racial/ethnic groups. Mexican Americans make up more than half of this population and are well represented in the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE) survey, a longitudinal study of community-dwelling older Mexican Americans. The University of Alabama Birmingham Life-Space Assessment (LSA) is a measure assessing patterns of functional mobility in and around the home, neighborhood, and community. This study addresses the gap in research of life-space mobility and healthcare utilization with linked insurance claims data. Four hundred eight participants with 1-year continuous Medicare enrollment from wave 7 (2010) of the HEPESE were linked with Medicare claims. Logistic regression analysis was used to estimate the odds ratio of hospitalization and ER admissions. Negative binomial regression was used to estimate the rate ratio of physician visits. LSA score ranges 0 to 120, with higher scores indicating greater life-space mobility; LSA was analyzed as a 10-point decrease or dichotomously as restricted ≤59 or not restricted ≥60. A restricted LSA score among older Mexican American Medicare beneficiaries was associated with OR of 2.73 for hospitalizations (95% CI= 1.18-6.31). In addition, a 5-point decline in LSA score was associated with OR of 1.12 for hospitalizations (95% CI= 1.04-1.22). LSA score was not significantly associated with ER admission or physician visit. Interventions aimed to increase mobility in the home and the community may reduce the risk of hospitalizations in this population.
PREFRONTAL CORTICAL ACTIVITY DIFFERENCES WHILE DUAL-TASK WALKING IN OLDER ADULTS WITH IMPAIRED MOBILITY
Authors: Hernandez Manuel E 
Published: November 2019

Abstract
Mobility impairments are prevalent in older adults. Whereas walking had traditionally been viewed as an autonomous process, evidence over the last decade has shown that cognitive processes such as attention and executive function have a significant impact on gait function in older adults. However, the exact neural mechanisms underlying difficulties in the control of mobility in older adults remains an open question. We examine the changes in the executive control of mobility in older adults with mobility impairments using functional near-infrared spectroscopy, as operationalized by performance in the community balance and mobility scale (CB&M). We hypothesized that prefrontal cortical (PFC) activity increases would be higher in older adults with mobility impairments, compared with older adults without mobility impairment, as dual-task walking difficulty increased. Older adults with (n=10, mean±SD age: 77±8 years, 8 females, CB&M= 58±12) and without mobility impairment (n=14, mean±SD age: 63±9 years, 11 females, CB&M= 87±6) were recruited from the local community. Dual-task walking was performed at a comfortable pace, while the difficulty of the concurrent cognitive task was increased using the modified Stroop test. PFC activity was measured using measures of oxygenated hemoglobin across the PFC. Older adults with mobility impairments demonstrated disproportionate increases in PFC activity, in comparison to those without mobility impairments, as the difficulty of the concurrent cognitive task increased (P&lt;.001), even after controlling for age. In conclusion, these data suggest that older adults with mobility impairments may require greater attentional resources than those without mobility impairments when concurrently performing thinking and walking tasks.
TARGETED TRANSCRANIAL DIRECT CURRENT STIMULATION IMPROVES DUAL-TASK WALKING PERFORMANCE IN OLDER ADULTS
Authors: Manor Brad , Zhou Junhong , Lo On-Yee , Katz Racheli , Brozgol Marina , Thumm Pablo Cornejo , Ruffini Giulio , Hausdorff Jeffrey M 
Published: November 2019

Abstract
In older adults, the ability to walk while engaged in an unrelated cognitive task (i.e., dual tasking) depends upon activation of both motor and cognitive brain networks. Noninvasive transcranial direct current stimulation (tDCS) can facilitate the excitability of specific brain regions and their connected neural networks. In this multi-site, randomized controlled within-subject cross-over study, we tested the effects of single, 20-minute sessions of tDCS targeting 1) the primary motor cortex (M1), 2) the left dorsolateral prefrontal cortex (dlPFC, a primary region subserving cognitive function), 3) both M1 and left dlPFC, or 4) neither region (sham). Forty-eight older adults free of overt illness or disease (mean±SD age=75±6 years, 35 women) completed four study visits at least 72 hours apart, during which dual task gait was assessed before and after tDCS administration. Stimulation was delivered using the Starstim™ system (Neuroelectrics Corp) and the same array of six gel electrodes to ensure double-blinding. Participants were successfully blinded to tDCS condition and reported no unexpected tDCS side effects. Repeated-measures ANOVAs adjusted for age and sex revealed that the dual task cost to gait speed was smaller (i.e., better and closer to zero) following tDCS that targeted both M1 and the left dlPFC, as well as the left dlPFC alone, compared to all other time points (condition-time interaction: F=3.0, p=0.04). The dual task costs following these two types of stimulation were similar. These results suggest that noninvasive facilitation of cognitive-motor brain network excitability leads to acute improvement in dual task performance in older adults.
THE PORCHLIGHT PROJECT: PARTNERING WITH VOLUNTEERS TO ENHANCE COMMUNITY-BASED DEMENTIA CARE AND OUTREACH
Authors: Gaugler Joseph E , Rosebush Christina , Bustamante Gabriela , Schoonover Jeri , Jenkins Roxanne , Bauer Nicole , Beardsley Lisa , Rowe Laura 
Published: November 2019

Abstract
Families often remain unaware of long-term services and supports (LTSS) that could help to mitigate the negative effects of Alzheimer’s disease and related dementias (ADRDs). Approaches that: a) identify community-residing older persons with potential memory impairment; b) assist their families in navigating the healthcare system; and c) facilitate the identification of appropriate community-based LTSS could result in more effective management of ADRD. The Porchlight Project is a multicomponent training approach for lay volunteers in Minnesota (i.e., Senior Companions) that enhances their capability to deliver dementia care and support to underserved older persons in need. Mixed methods analysis of qualitative and quantitative data among 20 Senior Companions and up to 25 persons with ADRD and their family caregivers suggest the potential success of the Porchlight Project, as well as areas to refine and enhance prior to large-scale evaluation throughout Minnesota.
THE STUDY OF KNOWLEDGE AND ATTITUDE ABOUT LONG-TERM CARE AMONG HISPANICS
Authors: Baniya Ganesh , Moore Ami 
Published: November 2019

Abstract
Attitudes towards long-term care can help policymakers tailor policies considering different racial and ethnic experiences of the elderly population. The theory of Proactive Coping can help elderly people to better prepare for aging and minimize stressors related to aging by identifying potential sources of stress before they occur and help gather resources and skills for successful aging. The data from the “Long-term care in America: views on who should bear the responsibilities and costs of care” (2017) study showed that Hispanics generally perceived their health to be in a better status and Hispanic women perceived that they had better health compared to males. Similarly, Hispanic males generally thought that they would not need assistance at old age whereas women anticipated that they would require assistance at old age. Similarly, there was a gender difference on who should bear the caregiving responsibility. More Hispanic women thought it would be their responsibility to provide care than males. Women were more prepared than males to provide the care needed to family members of friends. In regards to financial preparation, males reported being more financially capable than females to bear expenses during the old age. Similarly, women were more likely to solely depend on using governmental assistance such as Medicare and Medicaid during old age for needed care. Most of the respondents thought that the US was not well prepared to meet the needs of the aging population and suggested that the government needs to do more before it would be too late.
THE MULTIPLE DIMENSIONS OF THE RACE EXPERIENCE AND ASSOCIATIONS WITH HEALTH IN OLDER ADULTS
Authors: Kaufman Jerry 
Published: November 2019

Abstract
Race is experienced along a number of dimensions. In the United States, education, family background (e.g., parents’ education), skin shade, experiences of racial discrimination, neighborhood racial composition, state/region of birth, and interracial marriage help to define the “race experience.” Many of these factors have been individually associated with adverse outcomes for African Americans relative to Whites, but little research has examined how these factors cohere within individuals. Using a national survey of African American and White older adults, we employed latent class analysis and, in preliminary analyses, identified three clusters of individuals who were characterized by unique race experiences. We then assessed and determined that these clusters were also unique in their differential associations with health outcomes. This data-driven approach will provide insight into the profiles of individuals whose race experience contributes to health inequities among older Americans.
THE RESOURCE EXCHANGE NETWORK: A MODEL FOR TRANSFORMATIVE CHANGE IN GERIATRIC CARE
Authors: Clark Phillip G , Clark Phillip , Ferrone Christine , Helm Faith , Morelli Alexandra 
Published: November 2019

Abstract
Transformational efforts to redesign the care system for older adults call for the development of novel partnership models incorporating academic institutions, primary care networks, and community-based organizations. The Rhode Island Geriatric Workforce Enhancement Program (RI-GWEP) has utilized the “resource exchange model” to develop innovative, interdisciplinary, and integrated projects combining educational resources, clinical expertise, programmatic experience, and impact evaluation. With particular emphasis on the challenges of developing interprofessional education spanning the traditional gaps between disciplines and departments, this presentation emphasizes the critical conditions, components, and capacities of such a collaborative network. These include: (1) mission dominance, (2) barter exchange, (3) partnership investment, and (4) interpersonal relationships. RI-GWEP’s experience provides insights into the conceptual foundation of geriatrics networks and specific, concrete examples of projects incorporating these principles. Implications for the development of networks in other settings include consideration of particular: (1) projects, (2) people, (3) places, (4) personalities, and (5) possibilities.
TORC1 INHIBITION AS AN IMMUNOTHERAPY TO DECREASE INFECTIONS IN THE ELDERLY
Authors: Mannick Joan 
Published: November 2019

Abstract
Inhibition of TORC1 has extended lifespan in multiple preclinical species. Thus drugs inhibiting TORC1 may have therapeutic benefit for aging-related conditions in humans. An aging-related condition that improves with TORC1 inhibition in old mice is immunosenescence (the aging-related decline in immune function). Immunosenescence leads to increased rates of infections including respiratory tract infections (RTIs) in the elderly. In two Phase 2 clinical trials in over 900 elderly subjects, the TORC1 inhibitor RTB101 was observed to improve immune function and decrease the incidence of RTIs. Decreasing the incidence of RTIs is important because RTIs are the fourth leading cause of hospitalization in people age 65 and above. Based on these findings, two Phase 3 studies are underway to determine whether RTB101 given for 16 weeks during winter cold and flu season decreases relative to placebo the percentage of elderly subjects with illnesses associated with RTIs.
AGING TREATMENT BY COUNTERACTING INTRINSIC DNA DAMAGE AND IMMUNOSENESCENCE
Authors: Gudkov Andrei 
Published: November 2019

Abstract
Progressive systemic poisoning by gradually accumulated damaged cells has been proposed as a major contributor to mammalian aging. Our preclinical studies support the hypothesis that this process results from a failure of innate immunity-mediated eradication of cells with DNA damaged by intrinsic mechanisms caused by the epigenetic desilencing of endogenous retroelements. This model suggests two translational approaches to improve the counteract accumulation of damaged cells: (i) by pharmacological suppression of LINE1 reverse transcriptase activities – the main driver of expansion of “retrobiome” and the trigger of damaged cell-associated inflammation and (ii) by counteracting immunosenescence by innate immunity stimulation. Preclinical proofs of concept have been obtained for both using nucleoside reverse transcriptase inhibitors and immunostimulators acting via TLR5 activation. Preparations for clinical testing of these agents in the context of age-related pathologies is in underway.
COMMUNITY-LEVEL SOCIAL CAPITAL AND COGNITIVE FUNCTION AMONG OLDER ADULTS IN FIVE LOW- AND MIDDLE-INCOME COUNTRIES
Authors: Jiang Nan , Lu Nan , Wu Bei 
Published: November 2019

Abstract
This study aims to investigate which community social capital components are associated with a higher likelihood of cognitive functions across economically and culturally distinctive low- and middle-income countries (LMICs). We used cross-sectional survey data from the World Health Organization’s Study on global AGEing and adult health (SAGE) 2007-2010. Associations between community-level social capital indicators and global cognitive scores were examined using ordinary least squares regressions and random-effects meta-analyses. The pooled analysis and meta-analyses of within-country effects indicated that trust in neighbors and coworkers were positively associated with cognitive functions for all these countries, whereas the significant effect of perceived neighborhood safety was only found in South Africa and China. Community participation approached a null effect only in South Africa. This finding explains how community social capital may contribute to better cognitive function through community environments, heath systems, and availability of public resources.
EXTENDED WORKING LIFE POLICIES: INTERNATIONAL GENDER AND HEALTH PERSPECTIVES, EMPIRICAL AND POLICY LANDSCAPE
Authors: Rasticova Martina , Ogg Jim 
Published: November 2019

Abstract
As populations age, extending the working life appears to be widely accepted and promoted by governments (OECD 2006; 2017). Without exception, all countries with modern economies have responded in one way or another to the financial challenges arising from increased life expectancy and ageing populations. Policies to extend working life are ubiquitous, each based on the premise that unsustainable pension systems must be reformed, and public spending reduced. Although there are diverse perspectives on extended working life, gender and health consistently prevail as key dimensions. To date, policies extending working life have not taken sufficiently into account these two dimensions. A clear example in the case of gender concerns the shift towards equality in retirement ages between men and women. In this presentation, we set the stage by presenting the empirical and policy landscapes across 34 countries that characterise the trend of extended working life from gender and health perspectives.
RESILIENCY PHENOTYPES FOLLOWING HIP FRACTURE IN OLDER ADULTS
Authors: Colon-Emeric Cathleen , Whitson Heather E , Pieper Carl , Sloane Richard , Orwig Denise , Huffman Kim , Parker Daniel C , Magaziner Jay S 
Published: November 2019

Abstract
Defining common patterns of recovery after an acute health stressor (resiliency phenotypes) has clinical and research implications. We examined groups of patients with similar recovery patterns across 10 outcomes following hip fracture to determine the most important predictors of resiliency group membership. This study is a secondary analysis of three prospective cohort studies. Participants, community-dwelling adults aged &gt;65 with recent surgical repair of a hip fracture (n=541), were recruited from eight hospitals near Baltimore and followed for up to one year. Self-reported function and activity measures were collected using validated scales at baseline, 2, 6, and 12 months. Physical performance tests were administered at all follow-up visits. Stressor characteristics, co-morbidities, psychosocial and environmental factors were collected at baseline, and latent class profile analysis was used to identify resiliency phenotypes and logistic regression models to identify associated factors. Three resiliency phenotypes had similar patterns across the 10 outcome measures and were defined as “high resilience” (n=163, 30.1%), “medium resilience” (n=242, 44.7%), and “low resilience” (n=136, 25.2%). Recovery trajectories for outcome measures were plotted for each resiliency group. Self-reported pre-fracture function was by far the strongest predictor of resilience group membership (AUC 0.84). Demographic factors, co-morbidities, stressor characteristics, environmental factors, and psychosocial characteristics were less predictive, but several factors remained significant in a fully adjusted model (AUC 0.88). These three resiliency phenotypes have immediate utility for clinical decision-making. They can be measured in future studies with a more parsimonious set of variables, and may prove useful for understanding mediators of physical resilience.
FUNCTIONAL STATUS ASSOCIATED WITH RISK OF READMISSION DURING HOME HEALTH CARE FOR PATIENTS WITH DEMENTIA
Authors: Knox Sara , Downer Brian , Haas Allen , Middleton Addie , Ottenbacher Kenneth 
Published: November 2019

Abstract
Approximately 14.0% of Medicare beneficiaries are readmitted to a hospital within 30-days of home health admission. Individuals with dementia account for 30% of all home health care admissions and are at high-risk for rehospitalizations. Our primary objective was to determine the association between functional status and social support at admission to home health and 30-day potentially preventable readmissions (PPR) during home health care. We conducted a retrospective cohort study of 124,119 Medicare beneficiaries receiving home health (7/2013 – 6/2015) and diagnosed with dementia (ICD-9 codes). Approximately 65% of participants were over the age of 81, 61% were female, and 80% were Caucasian. The primary outcome was 30-day PPR during home health. OASIS items were used to create mobility, self-care, social support, and cognition categories. The overall rate of 30-day PPR was 7.6% (95% CI: 7.4-7.7) but varied by patient and health care utilization characteristics. After adjusting for sociodemographic and clinical characteristics, the odds ratios (OR) for the most dependent score quartile versus the most independent was 1.68(1.56,1.80 95% CI) for mobility, 1.78 (95% CI: 1.66- 1.91) for self-care, and 1.10(95%CI: 1.03-1.17) for social support. The OR for impaired versus intact cognition was 1.12 (95% CI: 1.05-1.20). Impaired functional and cognitive status as well as limited social support at admission to home health care are associated with increased risk of PPR for individuals with dementia. Future research is needed to determine if strategies targeted at mobility and self-care can decrease PPR during home health for individuals with severe dementia.
UTILIZING NUTRITION SERVICES PROVIDERS TO PREVENT LATE-LIFE SUICIDE: IMPLEMENTING A RANDOMIZED, CONTROLLED TRIAL
Authors: Fullen Matthew C , Mize Mary Chase , Shannonhouse Laura R 
Published: November 2019

Abstract
A challenge in preventing late-life suicide is identifying and responding to persons-at-risk prior to a suicide attempt. Distressed older adults are less likely to turn to a mental health professional, meaning that community-based prevention strategies are vitally important to comprehensive prevention frameworks. Due to their “natural helper” role, nutrition services (NS) volunteers may be well-positioned to identify suicide warning signs and respond accordingly. Unfortunately, there is a lack of systematic, empirically-tested evaluations of the effectiveness of community-based strategies to prevent older adult suicide, including the use of NS volunteers. To remedy this, the authors partnered with several home- and community-based service organizations to measure the impact of training nutrition services volunteers in suicide prevention skills. The authors will present preliminary findings from this federally-funded randomized, controlled trial of suicide prevention training (i.e., ASIST; safeTALK) on late-life suicidality and its correlates.
CUMULATIVE DIS/ADVANTAGE AND HEALTH TRAJECTORY IN LATE LIFE: A COMPARISON BETWEEN FOUR COUNTRIES
Authors: Lu Peiyi , Shelley Mack 
Published: November 2019

Abstract
Cumulative Dis/Advantage (CDA) theory concerns how societal structure influences individual developmental and health trajectory across the life span, but few studies have applied CDA in the international setting with gender comparisons. This study provides a cross-national perspective to test CDA in explaining health inequality between developing and developed countries. Cross-sectional harmonized data from the international Health Retirement Study-series (United States, China, Mexico, and England) in 2013-2014 were used (n=97,978). Four health indicators were included: self-reported health, depressive symptoms, functional ability, and memory. Sociodemographic information and health behaviors were used as covariates. Regression models were fitted to examine the moderation roles of country and gender in health trajectory in later life. Results indicate self-reported health and mental health remained steady while functional ability and memory declined across late life span. Older Chinese and Mexican respondents had poorer health status than their British and American counterparts consistently except for memory in the Mexican data. Cumulative health gaps between developing and developed countries existed only for functional ability. Females in the four countries had poorer health than their male counterparts except their memory status. We conclude that CDA explains only the temporal decline of functional ability and its increasing gaps in later life between countries. Health inequality between countries could be attributed to the limited availability of healthcare and social resources in developing countries. However, other health status, including general health and mental health, depend more on individuals’ intrinsic capacity and human agency.