bluuebunny/crossref_metadata_2025_split huggingface dataset:
AGING ALTERS STEROID HORMONE METABOLISM AND EXACERBATES LOWER URINARY TRACT DYSFUNCTION IN MICE
Authors: Liu Teresa T , Ricke William A 
Published: November 2019

Abstract
Benign prostatic hyperplasia (BPH) is a disease of aging that impacts 50% of men in their 50s and 90% of men in their 80s. While rodent models have been invaluable in the study of lower urinary tract dysfunction (LUTD) associated with human disease, many studies recapitulate aspects of aging, steroid hormone fluctuations, and/or inflammation without using aged mice that would better correspond to the age range of patients. In this study, we examine the impact of age in the hormone-induced mouse model of LUTD, so we can better understand the contribution of age to disease initiation and progression. We’ve discovered that aged mice exhibit a level of LUTD that is further exacerbated by hormone implantation when compared to both treated and untreated younger mice. Examination of circulating levels of androgens and estrogens indicate an alteration in steroid hormone metabolism with age, suggesting an altered nuclear receptor activation within disease. Epigenetic modifications have been associated with normal aging, including an increase in DNA methylation to alter gene expression. Examination of the proximal promoter of a steroid enzyme gene, CYP7B1, responsible for the degradation of 3β-diol (an ERβ ligand) within the prostate shows an age-mediated increase in methylation. With this, there is a corresponding decrease in CYP7B1 gene expression in the aged mice. Taken together, this suggests the altered steroid hormone environment seen in LUTD is further exacerbated due to normal aging-related epigenetic modifications that need to be considered for better treatment efficacy.
THE PROBLEM OF INTEGRATING OF BIOLOGICAL AND CLINICAL MARKERS OF AGEING
Authors: Mitnitski Arnold , Rockwood Kenneth 
Published: November 2019

Abstract
The number of potential biological markers of ageing increases dramatically especially with the development omics technologies. These biomarkers are not generally independent from each other and also related to clinical markers of aging that also could be markers of some illnesses. We discuss three ways of integrating biological and clinical markers of ageing: a frailty index (FI), indices of biological age, and a statistical distance as a measure of physiological dysregulation. We shows that FI has a strong theoretical support in the complex dynamical network model of the ageing process. The theory allows to explain why the interdependence of variables (representing the attributes of health) is essential for understanding of the basic properties both of the FI and of ageing such as a Gompertz law of mortality. Further progress in the field will go hand-in-hand with the development of new technologies that allow more data to be collected and interpreted.
ART TO LIFE: THE IMPACT OF AN EXPERIENTIAL ARTS PROGRAM ON ENGAGEMENT IN PERSONS LIVING WITH DEMENTIAS
Authors: Reel Candice 
Published: November 2019

Abstract
The Art to Life (ATL) program aims to improve the quality of life for persons living with dementia (PWD) through art therapy, intergenerational contact with college students, and life story preservation within an adult day service. This poster will present the results of an ongoing program evaluation to determine the effects of the intervention on PWDs’ engagement in (1) communication with others and (2) art/creative activity. A two-member analysis team independently coded ethnographic field notes utilizing operational definitions of PWDs’ observed behavior during momentary time sampling, and recording events of communication and art engagement using the modified ENGAGE measure (Hartmann et. al, 2017). Results across sessions (N=97) reveal communication engagement (M=28.30, SD=13.36) significantly exceeded art engagement (M=9.86, SD=5.56), t (96)=20.85, p=0.001). These results suggest that engagement in reminiscence via intergenerational contact is a fundamental feature in comparison to art and creative activity within the ATL program. Exploratory qualitative content analysis of ethnographic field notes by a three-member coding team identified two key themes within the communication engagements. These emergent themes included validation of personhood and reminiscence of family ties. More studies are needed to determine if the scope and reach of intergenerational interventions may be increased through the nationwide translation of the ATL program.
SOCIAL MEDIA RESOURCES FOR BILINGUAL CAREGIVERS OF STROKE SURVIVORS
Authors: Sanchez-Reilly Sandra , Reilly-Sanchez Laura M , Restrepo Valeria , Restrepo Marcos I , Ross Jeanette , Mader Michael J 
Published: November 2019

Abstract
Background: Stroke survivors experience long-term disability also affecting informal caregivers (ICG). With current technology, social media might be the only way for ICG to gain training/access support. What resources are available for ICG of older adults who survived stroke (OASS)? Objective: To identify/analyze types of bilingual social media resources available to ICG of OASS Methods: Facebook data was bilingually collected (Spanish), including most popular groups and pages based on search engines containing terms such as stroke, CVA, caregiver. Similar numbers of groups (35 English vs. 52 Spanish) and pages (32 English vs. 34 Spanish) were analyzed. Data included pages and groups’ information, numbers-of-likes, type-of-organization and resources provided. Results: English-Facebook resources were more popular for pages and groups (3820/2010 vs. 190/7; p&lt;0.001), Spanish resources were present, but with little activity among ICG. Majority of Spanish posts came from experts and English posts related to offering services or raising community awareness. Among both languages, pages provided resources related to social support (81%), improving caregiver skills (35%), advocacy (100%-English vs.56%-Spanish, p&lt;0.001) and research news (84%-English vs.41%-Spanish, p&lt;0.001). For English-ICG, more opportunities for live chats, messaging and inspirational messages were found (22-44% vs.3-9%, p&lt;0.001). Conclusions: ICG of OASS could access Facebook resources to support multiple areas of caregiving including retrieving social support, gaining skills, learning new stroke-science findings and encountering live chats while getting inspired. Some resources are more available to English-ICG. Stroke-supporting organizations must consider using social media as crucial platforms to access bilingual resources and improve quality-of-life for ICG and OASS.
THE ASSOCIATION OF FRAILTY WITH MCI AND DEMENTIA IN A MEMORY DISORDERS CLINIC FOR OLDER VETERANS
Authors: Shah Aakashi , Morani Amar , Rodriguez-Suarez Mercedes , Apracio-Ugarriza Raquel , Ruiz Jorge G 
Published: November 2019

Abstract
Frailty, a state of increased vulnerability to stressors due to multiple physiological dysfunction is associated with mild cognitive impairment (MCI) as well as dementia and may moderate its progression. Frailty and cognitive decline are highly prevalent in the Veteran population. The aim of our study was to determine whether frailty is associated with MCI and dementia in older Veterans at a Memory Disorders Clinic. We performed a cross-sectional study of 308 Veterans enrolled in VA Memory Disorders Clinic during 2016-2019. MCI and dementia were diagnosed based on complete clinical assessment including cognitive testing, brain imaging and neuropsychological testing. A 44–item frailty index (FI) was constructed using potential variables (demographics, comorbidities, number of medications, laboratory tests, and activities of daily living). Binomial logistic regression was run using MCI and dementia as outcome variable and frailty status (frail and non-frail) as independent variable. Age, race, marital status, ethnicity, median household income, education, comorbidities, BMI, history of substance abuse, smoking, alcohol, hospitalizations, anticholinergic use, and utilization were considered as covariates. The mean age was 74.43± 8.31 years. 43.2% population was frail (FI&gt;0.21) and 56.8% was non-frail (FI≤0.21). The number of Veterans with MCI and dementia was 114 and 113 respectively. Frailty was significantly and positively associated with dementia (OR: 2.29 95%CI:1.25-4.21, p=0.007) but there was no association with MCI (OR: 1.06 95%CI: 0.605-1.886, p=0.820). Our study results suggest that frailty might not be associated with MCI but has significant association with dementia in a group of Veterans at a Memory Disorder Clinic.
DYNAMIC, BIDIRECTIONAL LONGITUDINAL RELATIONSHIP BETWEEN LEISURE ACTIVITY ENGAGEMENT AND COGNITIVE PERFORMANCE
Authors: Armstrong Nicole , Tom Sarah , Renteria Miguel Arce , Casaletto Kaitlin , Weuve Jennifer , Simonsick Eleanor M , Manly Jennifer , Zahodne Laura B 
Published: November 2019

Abstract
Engagement in leisure activities, i.e., intellectual, social, and physical activities, may reduce the risk of incident dementia, yet little is known about the longitudinal, dynamic relationship between overall leisure activity engagement and cognition in older adulthood. Using data from a survey measure of 13 leisure activities, e.g., doing unpaid volunteer work and playing cards, games, or bingo, and a neuropsychological battery collected concurrently over 14 years from 2,259 multi-ethnic participants (mean age of 76.0 years) in the Washington Heights-Inwood Columbia Aging Project, we used a parallel process latent growth curve model of trajectories of both leisure activity engagement and cognitive z-scores (global cognitive performance, language, memory, and visuospatial ability). Estimates were adjusted for baseline age, years of education, sex, race/ethnicity, recruitment year, occupation (unskilled, skilled, and housewife), and baseline income. More baseline activity engagement (range, 0-13, higher indicating more engagement) was associated with higher baseline cognitive performance, i.e., global cognitive performance (estimate=0.129, standard error, SE=0.017, p&lt;0.001), language (estimate=0.146, SE=0.020, p&lt;0.001), memory (estimate=0.141, SE=0.025, p&lt;0.001), and visuospatial ability (estimate=0.111, SE=0.020, p&lt;0.001). Decline in leisure activity engagement were associated with decline in global cognitive performance (estimate=0.002, SE=0.000, p&lt;0.001), language (estimate=0.002, SE=0.000, p&lt;0.001), memory (estimate=0.002, SE=0.001, p&lt;0.001), and visuospatial ability (estimate=0.001, SE=0.000, p=0.001). While both level and change in overall leisure activity engagement and cognitive performance were correlated, level of one did not predict change in the other. Similar relationships were found when examining leisure activity categories. This suggests a dynamic, bidirectional relationship between leisure activity engagement and cognitive performance among older adults.
FACTORS INFLUENCING EPISODIC MEMORY IN SUBJECTIVE COGNITIVE DECLINE: AN IMPLICATION FOR DEMENTIA PREVENTION
Authors: Ahn Sangwoo 
Published: November 2019

Abstract
Episodic memory is typically affected early in the process of Alzheimer’s disease. Little is known about factors affecting episodic memory in subjective cognitive decline (SCD). The purpose of this study was to identify vascular and neuropsychiatric risk factors associated with episodic memory changes in older adults with SCD. Using the National Alzheimer’s Coordinating Center-Uniform Data Set, the relationship between baseline modifiable risk factors and episodic memory changes was analyzed using linear mixed-effects regression models. The study included a total of 1,401 subjects with SCD (mean ages: 74.0±8.2 years, 67.5% females, 84.2% White, mean follow-up period: 4.1±2.4 years). In univariate adjusted model, statistically significant coefficients on main effect or interaction with time were selected and entered into multivariate model, which was adjusted mutually for chosen independent variables and for all covariates. Reference in the final model was subjects without 1) hypercholesterolemia, 2) cigarette smoking history, and 3) depression. Those with hypercholesterolemia and former smokers had 0.024 and 0.035 points higher episodic memory scores than reference at baseline with similar rate of score changes between each group and reference over time, respectively. Current smokers scored 0.081 points lower than reference at baseline with similar rate of change over time between groups. Despite no difference at baseline, the score of depressed subjects decreased by 0.014 points a year compared to reference. It is important to manage current smoking and depression for older adults with SCD. Further research needs to identify which levels of cholesterol and smoking have a protective effect on episodic memory.
DISCOVERING STAFFING ISSUES AND EXPERIMENTING WITH STAFFING LEVELS IN DUTCH NURSING HOMES
Authors: Prins Marleen , Erp Janne van , Heijkants Ceciel , vries Erica de , Backhaus Ramona , Aarts Sil , Verbeek Hilde , schot Astrid van der 
Published: November 2019

Abstract
Background: In 2017, the Dutch National Health Care Institute developed a quality framework describing what high quality nursing home care entails, aimed to improve nursing home care. The current study focuses on evaluating whether Dutch nursing homes comply to the framework, specifically regarding norms about staffing and formation of care teams (skill mix and educational level). Care teams that were experimenting with new staffing levels were monitored to evaluate what changes in staffing occurred and which obstructing or promoting factors they experienced. Methods: Quantitative data about staffing and team characteristics were gathered. Further, qualitative data about motives for wanting to change, the change approach, obstructing and promoting factors and evaluation of changes was collected. Telephone interviews were held at baseline, after 3 months and after 6 months. Thirty-two teams participated in the study. Results: Challenges for making changes in staffing consisted of attracting new care staff, dealing with sickness leave, communication within and between teams, communication with informal carers and combining care for and having attention for well-being of residents in the daily work routine. Additionally, teams wanted to better adjust the skill mix of staff to the needs of residents. Conclusion: For the formation of care teams, there seems to be no ‘one-size fits all’ approach. A quantitative norm that applies to all nursing homes in the Netherlands as described in the quality framework (e.g. a minimum of two care professionals for eight residents during intensive moments of care) is therefore not always the route to high quality care.
THE ASSOCIATION BETWEEN MODERATE-TO-VIGOROUS PHYSICAL ACTIVITY AND MUSCLE OXIDATIVE CAPACITY IN OLDER ADULTS
Authors: Adelnia Fatemeh , Urbanek Jacek , Osawa Yusuke , Shardell Michelle , Simonsick Eleanor M , Schrack Jennifer A , Ferrucci Luigi 
Published: November 2019

Abstract
Age-related decline in muscle oxidative capacity negatively affects muscle function and mobility, which may lead to disability and frailty. Whether exercise and other life-style practices reduce age-related decline in muscle oxidative capacity is unclear. We assessed whether, after accounting for age, higher daily physical activity levels are associated with greater muscle oxidative capacity. Participants included 384 adults (54.7% women) aged 22 to 92 years from the Baltimore Longitudinal Study of Aging. Muscle oxidative capacity was measured in vivo using phosphorous magnetic resonance spectroscopy. We determined the time constant for phosphocreatine recovery (τPCr, in seconds) after exercise, with lower values of τPCr reflecting greater oxidative capacity. Time spent in moderate-to-vigorous physical activity (MVPA) was assessed using accelerometers that participants wore for 5.9 ± 0.9 consecutive days in the free-living environment. In linear regression models, older age was associated with higher τPCr (β = 0.39, p-value &lt;.001) after adjusting for sex, race, height and weight. After including MVPA as an independent variable, the standardized regression coefficient for age was attenuated by 40% to 0.22. p-value &lt;.001). MVPA was strongly associated with lower τPCr (β = -0.33, p-value &lt;.001) after adjusting for health status, education and smoking history and was only attenuated by 3% after additional adjustment for age. These results suggest that MVPA is strongly associated with muscle oxidative capacity independent of age, providing mechanistic insights into the health benefits of daily physical activity in older persons.
E-LEARNING FOR IMPROVING PERSON-CENTERED ATTITUDE IN PROFESSIONALS WORKING WITH PEOPLE WITH DEMENTIA: PILOT STUDY
Authors: Velden Claudia van der 
Published: November 2019

Abstract
Healthcare professionals working with people with dementia (PwD) have increasingly been moving towards a person-centered care (PCC) attitude. Several studies have showed positive results of PCC on quality of life of PwD. Also, it shows positive effects on self-esteem and work-satisfaction of professionals. An effective way to educate professionals in PCC is by using online-learning-tools. We developed an e-learning - in co-creation with end-users - focusing on well-being and challenging behavior of PwD. The interactive e-learning supports healthcare professionals in developing a PCC-attitude, using practical videos and exercises. In the current pilot-study, the e-learning is evaluated. To date, 32 professionals working in Dutch care homes from different care organizations participated in the study and completed the e-learning. In addition, they filled in online questionnaires before and after completing the e-learning. The questionnaires include the Approach to Dementia Questionnaire, Dementia Knowledge, Person Centered Care, Sense of Competence in Dementia Care Questionnaire. Post-measurement also included questions about satisfaction with the e-learning and user-friendliness. The final participants are currently completing their post-measurement questionnaires and final results are expected in October 2019. Preliminary data-analysis shows promising results. Although no significant effects were found, two-thirds of the participants indicated they had more knowledge about dementia, could better deal with challenging behavior and understood better how their own behavior and actions influence the behavior of PwD. The user-friendliness was also positively evaluated. Preliminary results suggest that the e-learning helps professionals in their approach to PwD and indicate that participants have positive experiences with the e-learning.
THE FRAILTY INDEX CONSTRUCTED USING FEATURE SELECTION METHODS IS THE BEST MEASURE OF BIOLOGICAL AGE
Authors: Kim Sangkyu , Fuselier Jessica , Welsh David , Cherry Katie E , Myers Leann , Jazwinski S Michal 
Published: November 2019

Abstract
No single biomarker can reliably represent the complexity of aging. One way to overcome this shortcoming is to aggregate multiple biomarkers into a composite index. The frailty index (FI), which is simply the proportion of accumulated deficits among a set of various health markers, reflects functional abilities and risks of adverse outcomes. Furthermore, the FI accounts for the variation in mortality among individuals of the same chronological age (CA). Thus, the FI is a reliable measure of biological age (BA). Unlike the FI, other popular BA-estimating algorithms use CA directly as a biomarker or indirectly to derive model parameters. However, genetic, pharmaceutical, and intervention studies have shown that aging is delayable or reversible, indicating that CA is not the direct cause of aging. The popular Klemera-Doubal (K-D) method proposes two equations for BA estimation: BE uses CA to derive equation parameters, and BEC directly incorporates CA as an additional biomarker. BA estimates by the K-D method, especially by BEC, have been shown to outperform CA. Using Louisiana Healthy Aging Study (LHAS) data, we constructed an FI from a battery of health items selected using machine learning methods for their ability to predict mortality. We compared the FI with CA and the two K-D BA estimates and found that the FI was the better predictor of mortality, especially among nonagenarians. The results were replicable with the FI calculated from different sets of selected health items using NHANES and HRS datasets. These results demonstrate the FI as the best-performing measure of BA.
USABILITY ASSESSMENT OF A SENSOR-CONTROLLED DIGITAL GAME FOR OLDER ADULTS WITH HEART FAILURE
Authors: Radhakrishnan Kavita , Julien Christine , O’Hair Matthew , Fournier Catherine , Lee Grace , Baranowski Thomas , Kim Miyong T 
Published: November 2019

Abstract
The inability of older persons with heart failure (HF) to self-manage has contributed to poor health outcomes. Our team from nursing, digital game design, and mobile computing developed an innovative sensor-controlled digital game (SCDG) called ‘Heart Mountain’ to offer a portable, and enjoyable tool to facilitate engagement in HF self-management. We installed the SCDG application, which featured older adult game avatars on the participants’ smartphones. The SCDG utilized data from an activity tracker and weight scale to trigger game rewards, knowledge content and messages based on participants’ real-time behaviors. In this study we assessed the usability of a SCDG prototype with 10 HF older adults in Central Texas. Observations on the usability of the SCDG app by older adults were noted on a usability heuristics checklist. Acceptance and satisfaction were collected by an open-ended survey guided by Intrinsic Motivation Inventory after a week of playing the game. Participants (60% males, 60% white, ages 63-84) were able to play the game and use the devices after a training session that lasted for 15 minutes. We will present results on participants’ ease of use of the SCDG app, satisfaction with the knowledge content, quizzes and rewards features of the SCDG, and perceptions on acceptance and satisfaction with the SCDG for heart failure self-management. Our project will generate insights on designing digital gaming solutions that are acceptable to older adults and can be applied to improve self-management of chronic diseases like heart failure.
CROSS-GENERATIONAL UNDERSTANDING OF AGEISM AND ITS IMPACT ON PERSONAL-PUBLIC HEALTH
Authors: Mayo Diana , Meuser Thomas M , Robnett Regula H 
Published: November 2019

Abstract
In 2016, the World Health Organization (WHO) declared a call to combat ageism, labeling it “pervasive” and having “profound consequences on older adults’ health and well being.” This study explored generational differences in understanding the WHO’s definition of ageism, between baby boomers (ages 65-72) and silent generation members (ages 78-85), as well as the perceived impact on personal and public health outcomes. A focus group protocol built around the WHO framing of ageism was administered to boomer (n=18) and silent generation members (n=11). Discussion was transcribed, reviewed in depth by each research team member, and themes were extracted by consensus. Members of both cohorts initially denied effects of ageism, stating that they reject discriminatory behavior; later sharing explicit examples of ageism’s negative impact on their lives. Boomers conflated the words “ageism” and “aging”, perhaps implying a lack of awareness of the terms and the issues as presented by WHO. A central finding was that older adults in both groups experienced economic and health care disparities due to their age. In both groups, perceived perpetrators of discriminatory behavior were found in various environments including places of employment, healthcare sites, restaurants, public transportation, retirement communities, and at home among family and care services. Our results are critical to understanding what environments to target for public health intervention efforts, which will include establishing future education and training for people of all ages to help society learn about ageism, and to advocate for inclusive and equitable treatment of older adults in the community.