bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mediterranean versus Western diet effects on cerebral cortical thickness and volume in cynomolgus monkeys
Authors: Frye Brett , Craft Suzanne , Register Thomas , Kim Jeongchul , Whitlow Christopher , Lockhart Samuel , Shively Carol 
Published: December 2020

Abstract
Diet may influence the risk for cognitive decline and neurodegenerative disorders, including Alzheimer’s disease (AD), but these relationships are difficult to study in humans. Cynomolgus macaques (Macaca fascicularis) are appropriate models for investigations of diet effects on the brain because, like humans, they are omnivorous, have complex central nervous systems, are susceptible to diet-induced diseases, and accumulate amyloid and tauopathies with age. Using structural magnetic resonance imaging, we examined diet effects on brain anatomy by measuring thickness and volume of several areas relevant to AD in 38 middle-aged females, at baseline and after Mediterranean or Western diet consumption for 36 months (equivalent to a 9-year follow-up in humans). Using repeated measures analysis, cortical thicknesses generally increased in the Western diet group. Western diets also resulted in increases in total brain volume and cortical gray matter and decreases in cerebrospinal fluid, white matter, and deep gray matter (striatum and thalamus) (all p’s≤0.05). In contrast, thicknesses and volumes generally remained unchanged in animals consuming Mediterranean diets. Taken together, these findings demonstrate that Western diets induce widespread structural shifts which may increase risk of cognitive decline and neuropathology, whereas Mediterranean diets may exert a stabilizing influence on the brain. This study provides important insights about the significance of diet on brain structure and lays the groundwork for future investigations to uncover the molecular underpinnings of diet-induced changes in the brain. Mediterranean diet may protect against structural changes in brain that occur with age in those consuming a Western diet.
Painting by Lesions: Functional Networks Affected by White Matter Lesions Are Associated with Poorer Cognition
Authors: Crockett Rachel , Hsu Chun Liang , Tam Roger , Handy Todd , Liu-Ambrose Teresa 
Published: December 2020

Abstract
Cerebrovascular disease (CvD) is the second most common cause of dementia. Its associated pathology, such as white matter lesions (WML), is associated with reduced cognition. Due to the high variability, the relevance of WML location remains unknown. We hypothesised that although the location of WMLs may appear sporadic, they may actually lie within common functional networks. We used novel imaging methods to map the location of WMLs in a clinical sample with the functional connectivity associated with the same location in the human connectome. This identified the functional networks containing the largest WML load (&gt;50%) in older adults with CvD. We then analyzed the association between level of disruption to these networks and measures of global cognition and executive functions. Included in this study were 164 older adults (&gt;55 years old) with CvD. Cognition was assessed using the: 1) Montreal Cognitive Assessment (MoCA); 2) Stroop Colour Word Test; 3) Trail Making Tests; and 4) Digit Symbol Substitution Test. Our results found that the visual network and ventral attention network (VAN) surpassed the 50% overlap threshold with 85% and 66% overlap respectively. Additionally, after controlling for multiple comparisons and age, the level of disruption to the VAN was significantly associated with poorer global cognition, as measured by the MoCA (p=.001). These novel findings identify the functional networks most affected by the presence of WMLs in older adults with CvD and suggest that the disruption to the VAN caused by WML load may underlie the deficits seen in cognition in this population.
Hospitalizations in Adults With Alzheimer’s Disease and Related Dementia—United States, 2016–2017
Authors: Taylor Christopher , Olivari Benjamin , McGuire Lisa 
Published: December 2020

Abstract
Alzheimer’s disease and related dementias (ADRD) are a significant public health burden. Collectively, ADRD have been called the most expensive chronic conditions in the United States due to outsized health care utilization. Data from the 2016 and 2017 Healthcare Cost Utilization Project National Inpatient Sample, an all-payer representative sample of US hospitalizations, were used to describe hospitalizations in adults ≥65 years with ADRD. Chronic conditions were defined using International Classification of Disease, Tenth Edition, Clinical Modification (ICD-10-CM) code definitions from the Centers for Medicare and Medicaid Services Chronic Conditions Warehouse. Code definitions from the Agency for Healthcare Research and Quality defined potentially preventable hospitalizations where admission might have been avoided by appropriate outpatient primary care management. One in six hospitalizations in adults ≥65 years were for persons with ADRD, including 1 in 3 adults ≥85 years. Among those with ADRD-related admissions, the most common reasons for admission, as defined by the principal diagnosis, were heart disease (18.1%), certain infections (14.5%), injuries (12.7%), respiratory illness (11.2%), and genitourinary conditions (10.4%). In hospitalized adults with ADRD, the prevalence of diagnosed urinary tract infection (37.0%)—a potentially preventable hospitalization—is more than double the prevalence in adults without ADRD (15.5%, prevalence ratio = 2.39, 95% confidence interval: 2.37-2.42). Common comorbidities, injuries, and potentially preventable hospitalizations all contribute to hospitalizations in adults with ADRD. Focusing on injury prevention and appropriate outpatient management of comorbidities in adults with ADRD might reduce the number of hospitalizations, including potentially preventable hospitalizations, among adults with ADRD.
The Effect of Social Activities on the Life Satisfaction of Korean Older Adults
Authors: Kim Meeryoung 
Published: December 2020

Abstract
As life expectancy increases, older adults need to find ways to occupy their time for 20-30 years. For Korean older adults, social activities such as having relationships with others as well as, involvement in organizations and volunteer work, are important for their social identity. Social activities are one of the categories of Rowe and Kahn’s successful aging, this study examined the effect of having relationships, involvement in organizations and volunteering on the life satisfaction of older adults. This study used the 6th additional wave of the Korean Retirement and Income Study (2016). The target population was older adults (50~59, 60~74, 75+). The sample size was 1,921, 2,344 and 962 respectively. For data analysis, ANOVA and multiple regressions were used. The demographic variables were controlled. As for independent variables, having relationships, involvement in organizations, and volunteering were used. For the dependent variable, life satisfaction was used. Having relationships, involvement in organizations and volunteering were significantly different by age group. For each age group, the factors affecting life satisfaction differ. For the middle aged group, involvement in organizations and volunteering were significant factors affecting life satisfaction. For young-old adults, volunteering had the most significant effect on life satisfaction. Finally, for old-old adults, both having human relations and involvement in organizations were significant. These findings imply that social activities differ by age group. Also, the kind of activities affecting life satisfaction differ by age group. These findings imply that it is important for older adults to be involved in society, in various ways.
Age Associated With Preference for More and Emotionally Meaningful Information in Time-Use Decisions
Authors: Shavit Yochai , Carstensen Laura 
Published: December 2020

Abstract
Socioemotional selectivity theory posits that goals change as a function of perceived time-horizons. As people age and time-horizons grow increasingly limited, people prioritize goals realized in the present over goals that will be realized in the distant future. Because goals that are emotionally meaningful are realized in their pursuit SST predicts that such goals will be prioritized by older people. Previous investigators have observed that age is negatively associated with search for information in decision making and attributed the finding to an effort to reduce cognitive load. In the present study, we hypothesized that because time becomes increasingly valued as it grows scarce, decisions about time use will show different patterns. We further hypothesized that age is associated with preference for information about present-oriented, namely emotional, benefits of activities over future-oriented benefits. 262 participants, aged 18-93 years, were presented with a hypothetical scenario inviting them to participate in one of four activities. On a grid containing 12 cells, participants were given the option to review information about activities’ emotionally meaningful and future-oriented benefits. Participants could review as many cells as they wished before indicating their interest in the activity. Across all activities, age was associated with preference for reviewing emotionally meaningful information. Moreover, in this scenario age was associated with reviewing more not less information. Age-related preferences for more information was apparent despite a negative age association with recall-memory, suggesting that cognitive load does not deter information search when decisions align with socioemotional goals.
Changing Educational Gradients in Life Expectancy With and Without Disease Among U.S. Older Adults From 2000 to 2010
Authors: Farina Matthew , Cantu Phillip , Hayward Mark 
Published: December 2020

Abstract
Recent research has documented increasing education inequality in life expectancy among U.S. adults; however, much is unknown about other health status changes. The objective of study is to assess how healthy and unhealthy life expectancies, as classified by common chronic diseases, has changed for older adults across education groups. Data come from the Health and Retirement Study and National Vital Statistics. We created prevalence-based life tables using the Sullivan method to assess sex-specific life expectancies for stroke, heart disease, cancer, and arthritis by education group. In general, unhealthy life expectancy increased with each condition across education groups. However, the increases in unhealthy life expectancy varied greatly. While stroke increased by half a year across education groups, life expectancy with diabetes increased by 3 to 4 years. In contrast, the evidence for healthy life expectancy provides mixed results. Across chronic diseases, healthy life expectancy decreased by 1 to 3 years for respondents without a 4-year degree. Conversely, healthy life expectancy increased for the college educated by .5 to 3 years. While previous research shows increases in life expectancy for the most educated, trends in life expectancy with chronic conditions is less positive: not all additional years are in lived in good health. In addition to documenting life expectancy changes across education groups, research assessing health of older adults should consider the changing inequality across a variety of health conditions, which will have broad implications for population aging and policy intervention.
Attitude Toward Family Involvement in End-of-Life Care Among Older Chinese Americans
Authors: Wang Kaipeng , Liu Yanqin , Sun Fei , Kong Dexia , Wu Bei 
Published: December 2020

Abstract
Family involvement is critical to end-of-life (EOL) care of older adults. Attitude toward family involvement in EOL care can be influenced by family relationship. Yet, mechanisms explaining such influence have not been examined among older Chinese Americans. This study aims to examine the association between family relationship and older Chinese Americans’ attitude toward family involvement in EOL care and explore pathways of this association. Potential mediators include self-efficacy, perceived benefits, and perceived barriers of discussing EOL care with family members. Data were collected from 276 Chinese Americans aged 55+ in two metropolitan areas in 2018. Participants’ average age was 74 years (SD=9.6). Approximately 64% of the sample were female. Most participants (57%) held positive attitudes toward family involvement in EOL care. Using the Structural Equation Modeling method, we found that family relationship had a significant positive total effect on positive attitude toward family involvement in EOL care (z=5.57, p&lt;0.001). Indirect direct of family relationship on attitude toward family involvement in EOL care through both self-efficacy (z=3.13, p&lt;0.01) and perceived barriers (z=2.30, p&lt;0.05) of discussing EOL care with family members was significant. Results suggest that improving family relationship may increase elder’s self-efficacy and reduce barriers of discussing EOL with family members, which is associated with more positive attitude toward family involvement in EOL care. Findings provide empirical evidence of how family relationship affects older Chinese Americans’ attitude toward family involvement in EOL care and underline the need for family-centered interventions for older Chinese Americans.
Process-Outcome-Relationships and Solution-Based Interventions With Grandparent Caregivers
Authors: Rodriguez Julian Montoro , Hayslip Bert , Ramsey Jennifer , Jooste Jane 
Published: December 2020

Abstract
Grandparents raising grandchildren face many challenges such as isolation, stigma, negative thoughts, and biases from age peers and service providers. In contrast, recent work suggests a need to re-frame grandparent caregiving in positive terms. In this light, the present study explored the processes key to the success of a solution-focused intervention with such persons. Fifty-two grandparents caregivers participated in a six-session solution focused intervention, using the theoretical framework of Selection, Optimization and Compensation (SOC) by Baltes & Baltes (1990). Throughout the program the emphases were on goal setting, solution focused thinking and communication skills. Participants were randomly assigned to intervention or waiting list control conditions. Within each session measures of hopefulness, positive thoughts about one’s grandchild, solution focused thinking, self-rated stress and perceived goal attainment were taken. Results indicated significant decreases in stress and increases over six sessions in hopefulness, positive thoughts about the grandchild, being solution-oriented and success in overcoming barriers interfering with goal setting and implementation (p&lt;.05). Measures of goal accomplishment, strategy usage, success and satisfaction with effort were uniformly high. Such findings speak to key processes underlying the efficacy of a solution-focused intervention with grandparent caregivers. Measures of such processes also predicted outcome measures, e.g., resilience, positive affect, caregiver strain, well-being, loneliness, depression, parental efficacy and adequacy of service needs met. These findings reinforce the importance of understanding change processes as predictors of solution-focused intervention outcomes with grandparent caregivers and are consistent with the need to emphasize such persons’ strengths.
Skipping Meals Is Associated With Symptoms of Anxiety and Depression in U.S. Older Adults
Authors: Anderson Loretta 
Published: December 2020

Abstract
Previous studies have shown that higher levels of economic hardship in older adults is associated with increased odds of adverse health outcomes such as insomnia, anxiety, and depressive symptoms. The objective of this study was to determine if there was a differential association between individual measures of economic hardship and aforementioned adverse health outcomes. Cross-sectional analysis was conducted using data from the 2013 National Health and Aging Trends Study (NHATS). Logistic models were developed to assess the association between four measures of economic hardship which included not having enough money for food, utility bills, mortgage/rent, or medical bills/prescription drugs. Measures of adverse health outcomes were symptoms of depression, anxiety, and insomnia. There were 4467 community-dwelling older adults (65+) in the analyses. Results indicated those who skipped meals were more likely to have depression, anxiety, and insomnia symptoms than those who did not skip meals. After adjusting for race, age, gender, education, and total number of comorbid health conditions, skipping meals was associated with depression (OR=2.71, p&lt;.05) and anxiety (OR=2.84, p&lt;.01). Skipping meals did not have a statistically significant association with insomnia. The analysis for skipping meals showed a higher odds and more statistically significant results than the other measures of economic hardship listed above. These findings are relevant to population-based efforts to improve quality of life in aging populations and may be of interest to those researchers investigating the gut-brain axis. These findings may also inform future policy efforts to address health disparities and food insecurity in older adults.
Childlessness, Individual Socioeconomic Resources, and Health: Exploring Variation in 20 Countries
Authors: Quashie Nekehia , Mair Christine , Antczak Radoslaw , Arpino Bruno 
Published: December 2020

Abstract
Childless older adults may be at risk for poorer health cross-nationally, yet most studies on this topic analyze only a small number of countries and only 1 or 2 health outcomes. To our knowledge, two papers exist that explore associations between childlessness and multiple indicators of health using data from a large number of regionally diverse countries (e.g., 20 countries from North America, Asia, and Europe), but neither study includes an examination of socioeconomic resources. The level of health risk faced by childless older adults is likely to be distinctly shaped by older adults’ socioeconomic resources (e.g., education, income, wealth). Associations between childlessness, socioeconomic resources, and health may also differ by country context. Using harmonized, cross-national data for adults aged 50 and older across 20 high- and middle-income countries (United States (HRS), European Union (SHARE), Mexico (MHAS), and China (CHARLS) from the Gateway to Global Aging data repository), we explore if and how individual-level socioeconomic resources (income, education, wealth) moderate associations between childlessness and five health indicators (self-rated health, ADL limitations, IADL limitations, chronic conditions, and depression). Results suggest that associations between childlessness and health outcomes vary by individual socioeconomic resources in some country contexts, but not in others. We discuss these findings in light of the impact of individual-level socioeconomic resources on older adults’ support options and health outcomes cross-nationally.
Does Sexual Orientation Influence Trajectories of Change in Health? A 20-Year Follow-Up Study
Authors: Nelson Christi , Andel Ross 
Published: December 2020

Abstract
We examined the differences in physical health outcomes over a 20-year period between lesbian, gay, and bisexual (LGB) and heterosexual middle-aged and older adults. We also examined whether the associations were moderated by social support and affect. The analytical sample included 168 LGB adults and 336 propensity-matched heterosexual adults from the Midlife in the United States (MIDUS) study, ranging in age from 25 to 74 years (mean age=42.83) at baseline. Using negative binomial generalized estimating equations and mixed-effects analyses, data from three waves of MIDUS, spanning approximately 20 years from 1995 to 2014, were used to examine the associations between sexual orientation and the health outcomes (number of chronic conditions and functional limitations). Social support and affect were added to the models to test for moderation. The results found that LGB participants reported one more chronic condition at baseline and scored significantly higher for functional limitations. However, LGB participants increased less over time for number of chronic conditions than heterosexual participants, and there were no significant differences in terms of changes in functional limitation over time. Positive affect reduced the strength of the relationship between sexual orientation and functional limitations for LGB participants. No other moderating effects were significant. The results of this study suggest that LGB individuals may become resilient to the negative health effects of minority stressors over time. Interventions should focus on improving the health of LGB individuals when they are younger and more at risk of negative health outcomes.
Aging and Advanced Dementia Matters: End-of-Life Care in Nursing Homes
Authors: Lopez Ruth , McCarthy Ellen , Hendricksen Meghan , McLennon Susan , Rogers Anita , Harris LaKeva , Roach Ashley , Mitchell Susan 
Published: December 2020

Abstract
Over 5 million Americans have dementia, and the majority will die in nursing home (NHs). While comfort is the main goal of care for most NH residents with advanced dementia, they commonly receive burdensome and costly interventions such as hospital transfers and feeding tubes that are of little clinical benefit. Despite 20 years of research and numerous experts and associations advocating a palliative approach to care, quantitative studies continue to demonstrate striking and persistent regional, facility, and racial differences, including: greater intensity care among African American versus White residents; greater intensity of care in the Southeastern US; and wide variation in care among NHs in the same region of the country. The reasons for these differences are poorly understood. Assessment of Disparities and Variation for Alzheimer’s disease in Nursing home Care at End of life (ADVANCE) is a 3-year, NIA funded qualitative study of 16 NHs in 4 regions of the country which aims to explain regional and racial factors influencing feeding tube and hospital transfer rates. The purpose of this presentation is to present the methodology established in this study and to highlight factors challenging and enabling implementation of the study protocol. To date, data have been collected in 11 NHs, and include 135 staff interviews, 40 proxy interviews, and nearly 800 hours of observation. These findings demonstrate that although challenging, large qualitative research is possible and holds promise as an effective method to illuminate complex processes influencing end-of-life care for NH residents with advanced dementia.