bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anticholinergic Medication Use, Dopaminergic Genotype, and Recurrent Falls
Authors: Rosso Andrea , Zhu Xiaonan , Marcum Zachary , Bohnen Nico , Sprague Briana , Rosano Caterina 
Published: December 2020

Abstract
Anticholinergic medications (A-chol) increase risk for falls; higher dopaminergic signaling may provide resilience to these effects. In 2489 older adults (mean age=74; 52% women) with 10 years of data on medication use, falls, and dopaminergic genotype (catechol-O-methyltransferase (COMT)), we assessed the association of A-chol use with recurrent falls (≥2) over the subsequent 12 months using generalized estimating equations. Effect modification by COMT (met/met, higher dopamine signaling, n=473 vs val carriers, lower dopamine signaling, n=2016) was tested; analyses were then stratified by COMT and adjusted for demographics and A-chol use indicators. During follow-up, 843 people reported recurrent falls. A-chol use doubled the odds of recurrent falls (OR [95%CI]=2.13[1.74, 2.60]), with a suggested effect modification by COMT (p=0.1). The association was present in val carriers (adjusted OR [95%CI]=1.93[1.36, 2.73]) but not in met/met (adjusted OR [95%CI]=1.30[0.53, 3.22]). Higher dopaminergic signaling may provide protection against the effects of A-chol use on fall risk.
Effects of Daily Vitamin D Supplementation on Objectively Measured Physical Activity: Results From the STURDY Trial
Authors: Schrack Jennifer , Urbanek Jacek , Wanigatunga Amal , Juraschek Stephen , Mitchell Christine , Michos Erin , Roth David , Appel Lawrence 
Published: December 2020

Abstract
Cross-sectional evidence suggests older adults with higher serum vitamin D are more physically active, but whether long-term vitamin D supplementation attenuates age-related declines in physical activity (PA) is undefined. We examined the association between vitamin D supplementation and daily PA in 639 STURDY participants (aged 77 (5.4) years; 44% women) over up to 24-months. Participants were randomized to receive 200 (n=275), 1000 (n=168), 2000 (n=59), or 4000 (n=63) IU/day of vitamin D3. PA was measured using the Actigraph Link wrist-worn accelerometer 24 hours/day for 7-days at baseline, 3, 12, and 24 months. In linear mixed models adjusted for baseline PA level, total daily PA appeared to decline (β=-43.3 counts, p=0.06) annually for all groups and there was no difference by vitamin D3 dose (p for group*time =0.14). These results suggest daily vitamin D supplementation has no effect on quantities of daily PA.
A Pharmacist-Led Medication Coaching Program Serving Senior Residents of Low-Income Housing
Authors: Bacci Jennifer , Akers Joshua , Mahan Katie , Meer Geoffrey , Kinter Jeffrey , Shields Anna 
Published: December 2020

Abstract
In 2015, one independent community pharmacy partnered with the local Area Agency on Aging to provide medication coaching to low-income, culturally diverse, older adults living in 6 affordable housing buildings in the Seattle area. A pilot was conducted during the 2015-2016 fiscal year to determine the need for and feasibility of the service. Process outcomes, including patient and service demographics, medication-related problems, and pharmacist interventions, were captured via the pharmacists’ patient care documentation. Pharmacists had 34 total visits with 17 unique residents who were taking an average of 8.1 medications. Pharmacists identified 97 medication-related problems, averaging 5.7 problems per resident, and performed 88 interventions, averaging 5.2 interventions per resident. The findings of this pilot demonstrated the needs and feasibility of implementing pharmacists’ services within a housing organization structure and has resulted in the continuation and growth of the program.
Nutritional Mediators of Cellular Decline and Mitochondrial Dysfunction in Older Adults
Authors: Fielding Roger 
Published: December 2020

Abstract
Aging is the primary risk factor for progressive loss of function, onset of disease, and increased vulnerability to negative health-related outcomes. These clinical manifestations arise from a decline in mitochondrial and metabolic processes considered the hallmarks of aging. Collectively, these changes can be defined as age associated cellular decline (AACD) and are often associated with signs and symptoms such as fatigue, reduced strength and low physical activity. This symposium will explore mechanisms, clinical signs, and emerging nutritional interventions for AACD. Dr. Feige’s presentation will serve as an introduction by highlighting mechanisms underlying functional declines in skeletal muscle with aging. He will discuss the Multi-Ethnic Molecular determinants of Sarcopenia (MEMOSA) study, which found impaired mitochondrial bioenergetic capacity in skeletal muscle of older adults with sarcopenia compared to age-matched controls, and identified mitochondrial function as a key target for intervention. Dr. Guralnik will discuss the connection between cellular changes and clinical manifestations of AACD. He will report on an expert consensus study group which developed an initial framework to identify self-reported symptoms and observable signs of AACD in adults over50 years. Lastly, Dr. Singh will discuss the evidence for nutritional interventions to address sources of AACD, focusing on those targeting mitochondrial dysfunction. Recent research on dietary interventions with urolithin A (an activator of mitophagy) and nicotinamide riboside (an NAD+ booster) will be reviewed. Overall, this symposium will highlight key mechanisms and clinical signs of AACD, and the potential for novel nutrition interventions to support cellular function and healthy aging.
Occupational Therapy for People Living With Dementia in the Community: Workforce Development Opportunities
Authors: Lepore Michael , Long Erin , Weiss Joan 
Published: December 2020

Abstract
Establishing a workforce capable of delivering evidence- and team-based HCBS for the growing population impacted by dementia is of growing public health importance. Occupational therapy (OT), in collaboration with other disciplines, offers promise for supporting people with dementia to live well at home. However, neither uptake of team-based programs for people with dementia nor availability of providers who work in teams to support people with dementia are well understood. We reviewed information from three federal programs to improve understanding of team-based workforce development needs and opportunities. Findings indicate that interprofessional evidence-based interventions for people with dementia are increasingly implemented but geographically limited and development of the OT workforce’s dementia capability is nascent in interprofessional/interdisciplinary training. OT is a key profession delivering evidence-based HCBS for people with dementia, but substantial opportunity exists for workforce development, including education, training, financing, recruitment, retention, care coordination, and translation and implementation of effective care.
Cerebral Microstructure in Aging Using Advanced Quantitative MRI
Authors: Bouhrara Mustapha , Khattar Nikkita , Kim Richard , Qian Wenshu , Alisch Joseph , Ferrucci Luigi , Resnick Susan , Spencer Richard 
Published: December 2020

Abstract
White matter (WM) maintenance through oligodendrocyte metabolism is an energy-intensive process. Myelin homeostasis is sensitive to hypoxia, ischemia, or hypoperfusion. Besides substrate delivery, adequate cerebral blood flow (CBF) is crucial for removal of metabolic byproducts such as iron. While some data show decreased myelin content and CBF with aging, the association between CBF and myelination is unknown. Further, breakdown of oligodendrocyte and iron may potentiate myelin loss through oxidative mechanisms. Whether iron deposition is related to myelination is unclear. Using advanced MRI methodology, we investigated associations between CBF deficits, myelin loss, and iron deposition in cognitively normal individuals. We found significant association between i) CBF deficits and myelin loss (N=67,age24-88), ii) myelin loss and iron accumulation (N=92,age21-94), and iii) CBF deficits and iron accumulation (N=35,age22-88) in critical brain structures. This work may lay the foundation for further investigations of age-related WM degeneration and markers to differentiate normal from abnormal alterations.
Partnering With African American Churches to Support Families Affected by Dementia Through Research
Authors: Epps Fayron 
Published: December 2020

Abstract
African Americans (AA) are disproportionately impacted by dementia when compared to the non-Hispanic white population, yet are significantly underrepresented in research. Often times, families in the AA community turn to their church for help when in distress. Recognizing that churches are frequently the cornerstone of AA communities, they are an ideal setting for health promotion, research, and education. However, many AA churches do not have the resources to support their congregants affected by dementia. To build capacity within churches to address brain health promotion and facilitate research access/participation, we partnered with 6 predominantly AA churches in the metropolitan Atlanta area to facilitate research and develop dementia-related programs. While stakeholders were initially reluctant, continual engagement with senior faith leaders helped to facilitate the successful development of a research registry of congregants interested in participating in faith-based and clinical research and establishment of new programs to congregants around brain health and dementia.
Gait and Balance as Predictors or Mediators of Falls in Glaucoma
Authors: Mihailovic Aleksandra , De Luna Regina , West Sheila , Friedman David , Gitlin Laura , Ramulu Pradeep 
Published: December 2020

Abstract
Balance and gait are modifiable targets for falls prevention and may play an important role in preventing falls in older visually impaired individuals. Balance and gait were objectively evaluated in the 239 Falls in Glaucoma Study participants (average age=70.5, 22% with moderate-severe visual field (VF) damage). Greater sway, more time in double support and greater swing time variability were associated with higher fall rates, while higher gait velocity and faster cadence were associated with lower rates (p&lt;0.05 for all). Neither gait nor balance mediated the relationship between VF damage and fall rates, with VF damage remaining an independent predictor of fall in models including gait and/or balance features (RR =1.36 to 1.48, p-value= &lt;0.001 to 0.005). While balance and gait measures are associated with fall rates, they do not explain why persons with greater VF damage fall more frequently, suggesting the importance of other factors such as hazard perception.
Fitness Matters as We Age: A Celebration of the VA Gerofit Program
Authors: Morey Miriam , Lee Cathy 
Published: December 2020

Abstract
In recognition of the GSA’s 75th Anniversary “Why Age Matters” we celebrate the 7th anniversary of the Gerofit dissemination initiative. Gerofit is an exercise and health promotion program for older Veterans that has been declared a Veterans Health Administration (VA) “Best Practice” and been disseminated to 17 VA’s across the country. Over 7000 Veterans have participated in Gerofit initiated programs and have reported robust outcomes including improved quality of life, physical and mental health, and high levels of satisfaction with the programs. For this symposium, we focus on newly acquired program outcomes that emphasize the importance of fitness as we age. The first paper compares hospitalization and emergency room visits between individuals participating in Gerofit for 12 months compared to a matched control group. The second paper describes four-year trajectories of physical performance to highlight the impact of becoming fit over expected normative trajectories. The third paper examines outcomes of a home-based geriatric walking clinic. The fourth paper describes the impact of exercise adherence on chronic pain. The fifth paper describes changes in medication utilization compared to a matched control group following 12-months of supervised exercise. These papers highlight the importance of fitness as a contributor to overall health during the aging process and celebrates that fitness matters, no matter when you start!
Food Insecurity in the United States: Identification, Treatment, and Implications
Authors: DiMaria-Ghalili Rose Ann , Bales Connie , Locher Julie 
Published: December 2020

Abstract
Food insecurity is an under-recognized geriatric syndrome that has extensive implications in the overall health and well-being of older adults. Understanding the impact of food insecurity in older adults is a first step in identifying at-risk populations and provides a framework for potential interventions in both hospital and community-based settings. This symposium will provide an overview of current prevalence rates of food insecurity using large population-based datasets. We will present a summary indicator that expands measurement to include the functional and social support limitations (e.g., community disability, social isolation, frailty, and being homebound), which disproportionately impact older adults, and in turn their rate and experience of food insecurity and inadequate food access. We will illustrate using an example of at-risk seniors the association between sarcopenia, the age-related loss of muscle mass and function, with rates of food security in the United States. The translational aspect of the symposium will then focus on identification of psychosocial and environmental risk factors including food insecurity in older veterans preparing for surgery within the Veterans Affairs Perioperative Optimization of Senior Health clinic. Gaining insights into the importance of food insecurity will lay the foundation for an intervention for food insecurity in the deep south. Our discussant will provide an overview of the implications of these results from a public health standpoint. By highlighting the importance of food insecurity, such data can potentially become a framework to allow policy makers to expand nutritional programs as a line of defense against hunger in this high-risk population.
Broadening the Conception of Food Insecurity Among Older Adults: Development of a Summary Indicator in the NHATS
Authors: Tucher Emma , Keeney Tamra , Cohen Alicia , Thomas Kali 
Published: December 2020

Abstract
Comprehensive measurement of food insecurity among older adults has focused on financial barriers to food access. Using data from the community-dwelling older adults in Round 5 of the U.S. National Health and Aging Trends Study (n=7,070), we constructed a summary indicator of food insecurity and inadequate food access incorporating items related to food scarcity within three domains: functional, social support, and financial limitations. We analyzed the construct validity of the summary indicator for known biopsychosocial factors associated with food insecurity among older adults. In 2015, 4.3% of community-dwelling older adults, approximately 1,673,775 million people, were characterized as food insecure or lacking adequate food access. Multivariable regression models identified that being homebound, frail, and experiencing community disability were associated with food insecurity and inadequate food access. These findings indicate food insecurity and inadequate food access among older adults is associated with functional and mobility characteristics and not isolated to financial barriers.
Lessons Learned From the Function and Behavior Focused Care Trial: From Efficacy to Implementation
Authors: Galik Elizabeth , Boltz Marie 
Published: December 2020

Abstract
Long term care residents with dementia are sedentary, experience rapid functional decline, and frequently exhibit behavioral and psychological symptoms of dementia. Our prior cluster, randomized controlled trial among 336 residents with moderate to severe dementia in 12 nursing homes demonstrated that it is possible to increase time spent in physical activity and decrease resistiveness to care through a theory based intervention, Function and Behavior Focused Care (FBFC). FBFC is based on the Social Ecological Model and Social Cognitive Theory and focuses on having long term care staff cue, model, and assist residents with dementia to engage in physical activity and perform functional tasks. Learning from prior work, it was noted that future implementation of FBFC would benefit from de-implementing inaccurate care practices, such as restricting resident mobility and providing custodial care and also by engaging a full stakeholder team in intervention activities. Additionally, there were measurement issues, such as the use of actigraphy with a sedentary, cognitively impaired population, and the need to assess the quality of care interactions between residents and staff. This symposium will review lessons learned from the FBFC trial and will discuss 1) facilitators and barriers to the implementation of the FBFC intervention within long term care settings; 2) measurement opportunities and challenges with a cognitively impaired long term care population; and 3) adaptation of the FBFC intervention to be appropriate for a dissemination and implementation trial that incorporates the Synthesis Model of De-Adoption and the Evidence Integration Triangle implementation strategy.
Mechanisms of Racial and Ethnic Differences in Cognitive Aging
Authors: Rosso Andrea , Manly Jennifer 
Published: December 2020

Abstract
Racial and ethnic disparities in age-related cognitive function and dementia risk in the US are well recognized. However, the psychosocial drivers of these disparities and underlying mechanisms are less well studied. This symposium will highlight novel research regarding our current understanding of racial/ethnic differences in brain and cognitive aging and the underlying mechanisms of the disparities. Frist, two papers will describe results regarding racial/ethnic differences in cognitive function and brain aging markers. Few studies have assessed racial/ethnic differences in cognitive function across age groups. Indira Turney will utilize data from a multigenerational study to explore how age impacts racial/ethnic differences in cognitive function. Underlying brain mechanisms of racial/ethnic differences in cognitive outcomes are also not well defined. Sara Godina will present a systematic review of racial/ethnic differences in structural markers of brain aging and neuropathology. Second, three papers will explore how various risk factors may explain the racial/ethnic disparities in cognitive outcomes. Melissa Lamar will demonstrate the differential associations of various blood pressure indicators with cognitive change among black older adults. B. Gwen Windham will present data from two studies that illustrate differential effects of common risk factors by race and region, highlighting inherent difficulties in race-place disparity research. Finally, Laura Zahodne will present results on how psychosocial factors, beyond socioeconomic status, contribute to racial/ethnic disparities in cognitive function. Jen Manly will lead a discussion on the implications of these results for the future of dementia prevention efforts for an increasingly diverse older US population.
The Longitudinal Association of Walking Efficiency With Brain Volumes in Community-Dwelling Older Adults
Authors: Schrack Jennifer , Liu Fangyu , Wanigatunga Amal , An Yang , Davatzikos Christos , Simonsick Eleanor , Ferrucci Luigi , Resnick Susan 
Published: December 2020

Abstract
Walking efficiency (WE) predicts mobility decline and is linked with higher fatigability. Fatigability is associated with cognitive decline and reduced brain volumes (BV), but the link between WE and BV is undefined. We examined associations between WE and BV in 860 participants of the BLSA (mean age 66.4(14.4) years, 54.5% women). WE was assessed during 2.5-minutes of usual-paced walking using indirect calorimetry and standardized per meter (ml/kg/m). BV measures were derived using MRI scans and an automated multi-atlas region-of-interest approach. In linear mixed models adjusted for demographics, education, BMI, intracranial volume, and cognitive status, lower baseline WE was associated with lower total, white, and gray matter, primarily in the frontal and temporal lobes (all p&lt;0.05). Longitudinally, declining WE was associated with increasing ventricular and decreasing hippocampal volumes over follow-up (all p&lt;0.01). Findings suggest rising age-related inefficiencies may reflect underlying brain atrophy and serve as a novel indicator for future interventions.
The Effect of Music Therapy on Cognitive Functioning Among Older Adults
Authors: Chen Kuei-Min 
Published: December 2020

Abstract
Music creates and fosters connection and interrelationships between individuals and encourages social interaction. Indeed, community-based interventions are a powerful way to engage older people. This presentation will provide an overview of music therapy and the impact it can have on the cognitive functioning of older people. Examples of music therapy interventions in the community can be found in nursing homes, hospitals, or communities. Differences in receptive (passive) music therapy and active music therapy will be discussed along with the impact these therapies may have on individuals experiencing cognitive decline. Moreover, studies of music therapy combined with other activities, such as exercise or art will be discussed. This research will be presented within the context of the recommendations put forth by the Global Council on Brain Health aimed at adults aged 50+.
Benefits of The Unforgettables: A Chorus for People With Dementia Together With Their Family Caregivers
Authors: Mittelman Mary 
Published: December 2020

Abstract
The Unforgettables was founded in 2011 for people with dementia and their family caregivers. We hypothesized that singing and rehearsing together would providing an opportunity for people in the early and moderate stages of dementia and their family caregivers to share a normative, stimulating and social activity. Pilot study results showed that quality of life and communication with the other member of the dyad improved for people with dementia; quality of life and, social support, communication and self- esteem improved for caregivers. Moreover, people with dementia learn new songs for every performance, suggesting that this activity may slow cognitive decline. The chorus continues to rehearse and perform, and now has approximately 100 members in two locations in NYC. These findings support the recommendations of the Global Council on Brain Health by underscoring the many benefits of music performance in enhancing social engagement and providing joy to participants and the community.
Perspectives of Persons With Dementia, Family, and Healthcare Providers on an Advance Care Planning Decision Aid
Authors: Geshell Lisa , Kwak Jung 
Published: December 2020

Abstract
Few evidence-based interventions to engage persons living with dementia in advance care planning (ACP) exist. We developed and explored the acceptability and appropriateness of an ACP decision aid for PLWD/family caregiver dyads living in the U.S. We conducted a mixed-methods study with 10 persons with dementia-caregiver dyads, and 4 healthcare providers. Content analysis and descriptive analysis were conducted. Major and subthemes included: (1) the role of caregivers during ACP discussion: clarifier, guide, and proxy; (2) decisional needs of persons with dementia for ACP: lack of knowledge and decisional conflict; and (3) perceptions of the decision aid: lack of clarity between advance directive types, a need to remove any questions that may be conceptually different, but appear similar to users, and need to include summary of decision-support needs. Findings provide implications for how healthcare providers can use a decision aid to facilitate ACP conversations with persons with dementia and caregivers.