bluuebunny/crossref_metadata_2025_split huggingface dataset:
QUANTIFICATIONS OF BIOLOGICAL AGING PREDICT DISABILITY AND MORTALITY IN OLDER ADULTS IN THE DUKE EPESE
Authors: Parker Daniel C , Kraus Virginia B , Belsky Daniel 
Published: November 2019

Abstract
Methods to quantify biological aging have been proposed to measure age-related decline in system integrity for population surveillance and evaluation of geroprotective therapies. However, quantifications of biological aging have been little-studied in geriatric populations. We conducted analysis of three clinical-biomarker-algorithm methods to quantify biological aging, the Klemera-Doubal Method (KDM) Biological Age, homeostatic dysregulation (HD), and Levine Method (LM) Biological Age in a cohort of N=1,374 older adults aged 71-102 years (35% male, 52% African American), the Duke-EPESE. We parameterized algorithms from analysis of US NHANES data (N=36,207). We conducted criterion validity analyses using measures of disability and mortality as end-points. We analyzed counts of ADLs and iADLs using negative binomial regression. We analyzed time-to-death using Cox regression. Models were adjusted for age, sex, and race/ethnicity. We evaluated algorithms derived from analysis of different biomarker groupings. We also compared algorithms derived from analysis of mixed age and race/ethnicity samples to algorithms derived from older-age (65+) and individual race/ethnicity samples. Duke-EPESE participants with older KDM Biological Age reported dependence in more ADLs and iADLs, and were at increased risk of death (ADL IRR=1.19 [1.12, 1.27]; IADL IRR=1.18 [1.10, 1.26]; mortality HR=1.09 [1.06, 1.13]). Quantifications of biological aging derived from analysis of a mixed-age and race/ethnicity sample predicted disability and mortality in African-American and white older adults.
LATENT DYADIC CHANGE MODEL OF SPOUSAL SIMILARITY IN PHYSIOLOGICAL MARKERS OF AGING
Authors: Mejia Shannon T , Gonzalez Richard 
Published: November 2019

Abstract
Older adult populations are known for their diversity in health. Within couples, however, population studies have documented exceptional levels of spousal similarity in health and health behaviors. The presence of spousal similarity in health among older adults suggests a process of convergence, yet few studies have examined this phenomenon longitudinally. We present a latent dyadic change model to estimate the extent to which couples’ similarity in grip strength, Cystatin C, and lung function--indicators of frailty/physiologic reserve. The model is a longitudinal extension of the latent dyadic model, where husbands’ and wives’ markers of health are parsed into variance that is attributed to the couple and individual levels. Change in the biomarkers of aging is then estimated at the couple and individual levels, resulting in estimates of husbands’ change, wives’ change, and shared change. We illustrate our model using physiological data from the Health and Retirement Study, a nationally representative panel study of individuals aged 51+ in the United States (3,500+ eligible couples). At the individual level, grip strength and lung function decreased, whereas Cystatin C increased for both husbands and wives. The shared change parameter estimated 16% to 25% of the change in markers of aging existed at the couple level. This suggests, consistent with convergence, that similarities in markers of aging at T2 were due to shared processes of change. Shared processes held after adjusting for indicators of partner selection. The latent dyadic change model offers a methodology to examine change in couples’ shared processes over time.
APOLIPOPROTEIN E, LEUKOCYTE TELOMERE LENGTH AND MEMORY IN EXCEPTIONALLY LONG-LIVED FAMILIES
Authors: Ashrafi Adiba , Barker Megan , Honig Larry , Lee Joseph , Andersen Stacy L , Zmuda Joseph M , Wojczynski Mary K , Cosentino Stephanie 
Published: November 2019

Abstract
Exceptional aging has heritable components. One genetic risk factor for cognitive aging may be Apolipoprotein E (APOE), but it is unclear to what extent APOE relates to cognitive aging versus risk of Alzheimer’s disease. Cognitive aging may also be influenced by leukocyte telomere length (LTL), posited to be a marker of “biological age”. We examine the relationship between APOE, LTL, and memory in aging. For APOE, effects of ε4 (ε3ε4/ε4ε4) and ε2 (ε2ε3/ε2ε2) versus the more common ε3ε3 referent genotype on episodic (EM) and working memory (WM) were examined, comparing longevous families to the general population. Participants belonged to a multi-generational, international cohort (Long Life Family Study) including relatives from long-lived families and spouse-controls. 3,654 participants with valid memory, APOE, and telomere data at baseline were included. Regression analyses were stratified by age group and relative status, adjusting for sex, education, and country. Among controls, ε2 was associated with better WM (p&lt;0.05) in those aged 70-79. In relatives, ε2 was linked to better EM (p&lt;0.05) in those 60-69. Within ε2 carriers, longer LTL related to higher EM/WM for those &lt;60, but lower EM/WM among those 60-69 (p&lt;0.05). In relatives, ε4 was linked to worse EM, but better WM in those &lt;50. Within ε4 carriers ≥80, longer LTL related to poor EM/WM. Thus, APOE related differently to distinct memory functions, and such associations varied by familial longevity and age. LTL demonstrated both positive and negative associations with memory functions depending on APOE status and age group.
RELATIONSHIPS BETWEEN PERSONAL NEEDS AND THE ENVIRONMENT: A STUDY OF ABUSE AND SELF-NEGLECT
Authors: Ye Minzhi , Ejaz Farida , Rose Miriam 
Published: November 2019

Abstract
Estimates of self-neglect among older and/or disabled adults are much higher than the estimated 10% of older adults in the U.S. who experience physical or emotional abuse, neglect, and exploitation by others. It is not clear how the social environment affects these vulnerable adults who become self-neglecting. This study uses network analysis and a GIS approach to explore patterns of needs and environmental risks for adult healthcare patients who had risk factors for self-neglect. Sources of data included face-to-face interviews, self-neglect risk factors (e.g., depression, dependency in activities of daily living, etc.) from electronic medical records, and neighborhood information from census block data. More than two-thirds of the 480 study participants reported an average income of less than $1,360 monthly, and 89% self-identified as Hispanic or Latino. Using ArcGIS Pro, respondents’ geocoded addresses were matched to mapped neighborhood census information. The maps showed that most respondents live in Hispanic-dominated communities, in neighborhoods with crime rates above average and median household income of less than $49,066/year. These neighborhoods were probably resource-poor and had spatial inequalities. Using network analysis, the study found that the at-risk patients’ most frequently reported needs (e.g., food assistance/nutrition, functional limitations, social isolation) appear clustered together, demonstrating that people had multiple needs. The study findings suggest that practitioners and policymakers must not only provide a range of services to help disadvantaged groups, but also focus specifically on offering services in neighborhoods where low-income minority groups reside and there is a lack of community resources.
END-OF-LIFE CARE DURING THE NATIONAL OPIOID CRISIS: A NATIONAL SURVEY OF HOSPICE PROVIDERS
Authors: Cagle John , McPherson Mary Lynn , Frey Jodi , Sacco Paul , Ware Orrin , Guralnik Jack 
Published: November 2019

Abstract
No national data exist on drug shortages, missing medications, opioid diversion, and opioid diversion prevention in hospice. We conducted a national survey of hospices (administered June-September, 2018). We randomly selected 600 hospices to survey representatives about: (1) care for patients/families with substance use disorder (SUD) (2) drug shortages; (3) instances of drug diversion; and, (4) drug disposal practices. Surveys were conducted by phone and online. Sample weights were used to adjust for non-response. A total of 371 hospices completed surveys (response rate=62%), 63% of which were administered by phone. Half (50%) of agencies were mid-sized (26-100 patients) and non-profit. Two thirds (66%) of hospices reporting that medications either “never” or “rarely” go missing. On average, there were 0.80 reported cases of confirmed diversion per agency within the past 90 days. Although a majority of hospices (78%) screen patients for SUD, only 43% screen informal caregivers. Just under half (42%) of hospices reported drug shortages over the past year. A minority (8%) of hospices stopped prescribing certain medications altogether due to concerns about diversion. 52% of hospices reported that employees are not allowed to dispose of medications after a home death. Agency representatives estimated that, after a home death, unused opioids were left in the home 32% of the time. On average, hospices have nearly one case of opioid diversion per quarter. Hospices are experiencing medication shortages and restrictions on medication disposal. Changes are needed in policy and practice to address these challenges.
AGE-ASSOCIATED INCREASE IN KYNURENINE INHIBITS AUTOPHAGY AND PROMOTES SENESCENCE IN BONE MARROW STEM CELLS
Authors: Kondrikov Dmitry , Elmansi Ahmed , Shi Xing-ming , Fulzele Sadanand , mcGee-Lawrence Meghan , Hamrick Mark , Isales Carlos , Hill William D 
Published: November 2019

Abstract
Aging is characterized by progressive decline of tissue functionality and age-related accumulation of cellular and molecular damage leading to multiple pathological conditions including osteoporosis and increased fracture rates. Bone marrow mesenchymal stem cells (BMSCs) play an essential role in bone development and regeneration with their ability to undergo differentiation into osteogenic, chondrogenic, myogenic, and adipogenic cell lines cell lines. Proliferation rate of MSC is declined with ages leading to misbalance between bone resorption and osteogenesis. A recently identified age-related change in bone and bone marrow is an accumulation of tryptophan metabolite, kynurenine (KYN), catalyzed by indoleamine-2,3-dioxygenase (IDO) or free-radical oxidation. We previously reported that KYN suppresses autophagy in BMSC. We now investigated the effect of KYN on BMSC cellular function. In vitro treatment of murine BMSC isolated from 18 month old mice with kynurenine disrupted autophagy suppressing autophagic flux. KYN treatment also induces senescence in BMSC marked by increase in SA-beta-galactosidase activity as well as, increased expression of senescence marker p21. Inhibition of Aryl Hydrocarbon Receptor (AhR) by AhR inhibitors significantly reduced β-galactosidase activity increase and blocked p21 expression elevation suggesting that KYN induces senescence in BMSC through the AhR pathway. Interestingly, KYN treatment failed to up-regulate beta-gal activity in BMSC isolated from 6 month-old mice suggesting that KYN induction of senescence maybe potentiated with aging. Together those data support the idea that KYN shifts the homeostatic balance of BMSC during prolonged stress or in aging through downregulating survival autophagic pathway in favor of driving BMSCs to senescence.
DATABASE FOR INDICES OF AGING IN NONHUMAN PRIMATES
Authors: Kemnitz Joseph W 
Published: November 2019

Abstract
The Primate Aging Database (PAD) is a multi-centered, relational database of biological variables in aging, captive monkeys and apes containing approximately one million data points for body weight, blood chemistry and hematology, for male and female subjects over time (https://primatedatabase.org). More than forty species are currently represented, primarily chimpanzees, macaques and common marmosets. Metadata include housing environment, social context and diet. Life history information for each species is also provided. Data in PAD is gathered from various research facilities, sanctuaries and zoos. PAD has recently been extensively revamped to enhance ease of use. Tools for data visualization and analysis in multiple formats are included. PAD has been useful for exploring biomarkers of aging in primates and for examining physiological dysregulation in aging across primate species. It also provides age-specific normative values that are valuable in clinical veterinary medicine. New data are being added to PAD, including additional subjects and variables, and additional contributors are solicited. (Supported by contract HHSN2711201800025C from the National Institute on Aging to CleMetric Data Analytics and Management, LLC.)
ASSOCIATION BETWEEN GERIATRIC HOME VISIT AND EMERGENCY ROOM OR HOSPITAL UTILIZATION: A RETROSPECTIVE STUDY
Authors: Zhang Xin , Takahashi Paul 
Published: November 2019

Abstract
Homebound older adults tend to have more medical comorbidities, higher risk of mortality, and higher healthcare utilization compared to non-homebound, community dwelling older adults in the U.S. Preventative primary care home visit have been shown to reduce hospitalizations and total healthcare costs in this population. Through a retrospective study, we aim to explore characteristics associated with ED and hospital utilization in patients who have received a home visit. A total 608 subjects, 70% female and median age of 86 years, were involved. A 184 (30%) of homebound subjects were hospitalized or visited the ED in 90 days. Comparing those with hospitalization or ED and those without, there was no significant difference in sex, age, race, marital status, or advance care planning. A 74% of those with 90 day ED/hospitalization had prior ED visit within 1 year of home visit compared to 59% of those without (p=0.0004). In addition, 58% of those with 90 day ED/hospitalization had prior hospitalization within 1 year of home visit compared to 44% of those without (p=0.0015). They also had significantly higher number of total medical comorbidities (median 4.5 vs 4, p=0.02). Our study suggests that prior healthcare utilization and medical comorbidity burden may be better predictors of 90 day hospitalization or ED use in geriatric patients who have received a home visit. Advance care planning and age did not significantly differ between the two groups in our study. Further studies should be performed to validate our findings in a prospective manner.
DEVELOPING RURAL INSIGHTS FOR BUILDING SUSTAINABLE AGE-FRIENDLY COMMUNITIES INITIATIVES
Authors: McCrillis Elizabeth , Skinner Mark , Colibaba Amber 
Published: November 2019

Abstract
Researchers have questioned the focus on describing features of preliminary age-friendly implementation and the absence of program evaluations or analyses of long-term implementation. This lack of knowledge inadvertently simplifies unique pathways to age-friendly sustainability, preventing researchers from conducting in-depth, retrospective examinations of age-friendly and post-age-friendly perspectives. Seeking to address this critique, this research examines the challenges to rural age-friendly program sustainability, and the factors that may help committees overcome these barriers. Data were collected through a succession of qualitative studies, including a provincial age-friendly program evaluation and a series of studies examining sustainability in rural initiatives. Eighty in-depth interviews with age-friendly leaders and older participants from 27 rural Canadian programs were conducted, seeking knowledge about programs’ development and implementation. Key findings include the conceptualization of an implementation gap between early development and long-term viability, the important role played by individual communities, the challenges of capacity and jurisdictional fragmentation, and the inability of rural age-friendly programs to tackle bigger picture issues such as housing and transportation given their necessarily limited scope and reach. Implications relevant for research and practice suggest that drawing on individual, community, and jurisdictional factors will maximize the success and sustainability of rural age-friendly programs, thereby extending the reach and scale of programs to more directly affect older people. From this, we conclude that the sustainability and success of rural age-friendly programs would benefit from consistent, renewable government funding that considers factors relevant to overcoming the implementation gap and challenges created by jurisdictional fragmentation and de-emphasizing community individuality.
RESEARCH FOR ACTION: IDENTIFYING SERVICE NEEDS OF MONGOLIAN OLDER ADULTS
Authors: Batzogs Uyanga , Braun Kathryn , Perskinson Margaret , Terada Tyran M 
Published: November 2019

Abstract
Although adults aged 60 years and older currently represent 6% of the total population of Mongolia, they are projected to increase to 19% by 2050. More than 21% of Mongolians live below the poverty line. Social security payments represent the main source of income for many retirees. With little government funding, eldercare services are limited, creating a large gap between service needs and availability. Before an effective system of eldercare can be developed, in-depth understanding of older adults’ needs and resources is required. A mixed methods design was used. Four-hundred twenty-seven Mongolians aged 55 years and older were surveyed. Two focus groups with 10 older adults and eight in-depth interviews with senior center stakeholders were conducted between June 2019 and August 2019. Descriptive statistics were run to determine frequencies of participants’ service needs. Linear regression examined the relationship between age groups, service needs, and ability to pay for services. Focus group and interview transcripts were analyzed for underlying themes. Findings indicated high service needs among older adults. Retirement homes, assisted living, home care, and places to socialize were identified as the most needed services. Lack of services, employment opportunities, and income sources concerned them the most. Ability to pay for services was negatively correlated with age groups. Qualitative analysis yielded two themes: importance of services and lack of resources. Further research on starting and sustaining networks of supportive services for older adults living in Mongolia is needed.
ECOLOGICAL MOMENTARY ASSESSMENT OF ASSOCIATIONS AMONG HIGH AND LOW AROUSAL AFFECT AND COGNITIVE HEALTH
Authors: Cerino Eric S , Sliwinski Martin 
Published: November 2019

Abstract
Negative affect (NA) and positive affect (PA) vary from moment-to-moment and these variations are associated with cognitive health. Past work has primarily focused on valence (negative/positive), however, largely ignoring the potential import of arousal (high/low). We address this gap by assessing the impact of high and low arousal NA and PA on daily cognition. A sample of 238 older adults (Mage=77.30 years, SD=5.14, Range=70–90) completed mobile surveys up to four times daily for 14 days. Participants reported current levels of high and low arousal NA and PA and performed processing speed and working memory tasks. For processing speed, there were significant within-person affect by age interactions. Moments when low arousal NA was higher than usual were associated with slower processing speed (Est.=0.87, SE=0.44, p&lt;.05), and this effect was amplified in older participants (Est.=1.69, SE=0.60, p&lt;.01). Moments when high arousal PA was higher than usual were associated with faster processing speed (Est.=-0.81, SE=0.40, p&lt;.05), and this effect was amplified in younger participants (Est.=-1.81, SE=0.56, p&lt;.01). For working memory, a significant within-person high arousal PA by age interaction emerged (Est.=0.001, SE=0.00, p=.046) such that moments when high arousal PA was higher than usual were marginally associated with worse working memory performance only among older participants (Est.=0.004, SE=0.002, p=.06). Results suggest momentary increases in low arousal NA and high arousal PA may confer greatest risk to daily cognitive health among older adults with more limited capacity and/or cognitive resources, whereas affective influences may be more facilitative among comparatively younger adults.
ADULT FOSTER HOME OWNERS' PERSPECTIVES ON REWARDS AND CHALLENGES OF OPERATING AN ADULT FOSTER HOME
Authors: Elliott Sheryl , Dys Sarah , Winfree Jaclyn , Carder Paula 
Published: November 2019

Abstract
Adult foster homes (AFHs) are small, residential settings providing older adults and persons with disabilities an alternative to nursing facilities and larger residential care settings. Some groups, including individuals with Alzheimer’s disease and related dementias, are well served by smaller settings. Although AFHs are common throughout the US, research on this setting is scant and dated. This study summarizes four years of qualitative data from Oregon AFH owners’ (N=726) responses to open-ended questions about the challenges and rewards of owning and operating an AFH. Content analysis of 924 comments indicate that providing resident care (42%), finding the work meaningful and “a life calling” (21%), developing a family-like connection with residents (15%), and working at home (8%) were the most commonly reported rewards. The most frequently described challenges included caring for residents with multiple chronic health conditions—including those with difficult behaviors (17%), difficulty hiring and retaining qualified caregivers (15%), low Medicaid reimbursement rates (14%), and adhering to administrative rules (14%). Results highlight AFH providers’ personal satisfaction with caring for and establishing connections with residents, and challenges associated with residents’ increasingly complex care needs, Medicaid reimbursement rates, and attitudes about state regulations. Although AFHs are licensed by states, they are subject to federal regulations, including the 2014 Centers for Medicare & Medicaid Services home and community-based services ruling. The new regulations, Oregon administrative rules, Medicaid reimbursement rates, and caregiver supply are presented to contextualize AFH owner comments and regulatory considerations.
DISPARITIES IN HEALTH STATUS, HEALTH BEHAVIORS AND PREVENTIVE HEALTH SERVICES OF OLDER ADULTS WITH DIABETES
Authors: Chun Sang Ah 
Published: November 2019

Abstract
The prevalence of diabetes among older adults has increased substantially and health complications resulting from diabetes have significant adverse effects on health status of older adults. While diabetes cannot be cured, it can be managed successfully with healthy lifestyle choices. The purpose of this study is to examine the disparities in health status, health behaviors, and preventive health services for older adults with diabetes. This study used data from the 2018 Behavioral Risk Factor Surveillance System. The sample included older adults 50 and over. Health behaviors included exercise, smoking, and heavy alcohol drinking. Preventive health services included dental visit, flu shot, and colorectal cancer screening. Chi-Square analysis and weighted multivariate logistic regression was performed. Not surprisingly, older adults with diabetes were significantly more likely to be in poor health than those without diabetes. Compared to non-diabetic group, older adults with diabetes were more likely to have had no exercise in the previous month. Interestingly, more older adults with diabetes reported having visited dentist, had flu shot and colonoscopy than those without diabetes. In both groups, older adults who presented health behaviors and received preventive health services were more likely to report good health compared to those who did not. The results suggest that further efforts are needed to address the health disparities for older adults with diabetes. Given the risk of comorbidities and its complications for older adults with diabetes, further research should be directed toward designing better health promotion programs and policies for older adults with diabetes.