bluuebunny/crossref_metadata_2025_split huggingface dataset:
MACHINE LEARNING ANALYSIS OF MOUSE FRAILTY FOR PREDICTION OF BIOLOGICAL AGE AND LIFE EXPECTANCY
Authors: Kane Alice , Schultz Michael B , Mitchell Sarah , MacArthur Michael , Mitchell James , Howlett Susan E , Bonkowski Michael S , Sinclair David 
Published: November 2019

Abstract
In mammals, the lack of accurate biomarkers for biological age is a current limitation to identifying novel aging interventions. Molecular biomarkers including DNA methylation hold promise but are invasive and currently expensive. The Frailty Index (FI) quantifies the accumulation of health-related deficits and is fast, cheap, and non-invasive. Studies have demonstrated that FI correlates with age and mortality risk in mice and humans. However, the FI has not been modelled to directly predict biological age or life expectancy. We tracked aging male C57BL/6 mice until their natural deaths, scoring them longitudinally with the FI. We find that FI score correlates with and is predictive of age and that some but not all parameters of the FI are individually well-correlated with age. To better predict chronological age, we performed an elastic net regression on the FI termed FRIGHT (Frailty Inferred Geriatric Health Timeline) Age. FRIGHT Age is a strong predictor of age (r2=0.73, median error=47.5 days), but is not superior to chronological age at predicting life expectancy. To better predict mortality, we built a random forest model termed the AFRAID (Analysis of Frailty and Death) score, which predicted survival at multiple ages (r2=0.375, median error = 46.4 days). The FRIGHT and AFRAID models were responsive to chronic treatment with enalapril (30mg/kg/day), an angiotensin converting enzyme inhibitor that extends healthspan, and methionine restriction, a dietary intervention that extends healthspan and lifespan. Our findings underscore the value of assessing non-invasive biomarkers for aging research and may help speed the identification of aging interventions.
ANTIBIOTIC EXPOSURE IN LONG-TERM CARE FACILITIES IS ASSOCIATED WITH URINARY MICROBIOME PERTURBATIONS
Authors: Schell Brent R , Ward Doyle V , Bradley Evan S , Dutta Protiva , Haran John P 
Published: November 2019

Abstract
The discovery of the human urinary microbiome, defined as the microbial communities which colonize the human urinary tract, has shed new light on the meaning and clinical significance of bacteriuria. The prevalence of asymptomatic bacteriuria has been reported to be as high as 50% in healthy older adults living in long term care facilities, yet the urinary microbiome of this population has not been reported. The aim of this pilot study was to describe the urinary microbiome of this population and explore the cross-sectional relationship with recent antibiotic exposure. Voided urine samples were obtained from healthy, institutionalized older adults (ages 79 to 95), including non-catheterized men and women without any urinary symptoms. The bacterial genomic content of each urine sample was assessed by 16S rRNA sequencing. Among the 77 genera found across 16 urine samples, there was no significant difference in the microbial diversity across age groups. When grouped by antibiotic exposure, those recently exposed had a significantly lower diversity (Shannon’s index of 2.16 vs. 2.61, p = 0.029), and lower evenness (Pielou’s evenness of 0.58 vs. 0.69, p= 0.017) relative to those who were not recently exposed. Enrichment analysis showed that recent antibiotic exposure was associated with an increased abundance of the genus Bacteroides and decreased abundance of the genus Streptococcus. To our knowledge, this is the first report describing the urinary microbiome of institutionalized older adults and suggests that recent antibiotic exposure should be accounted for in future studies of the urinary microbiome in this population.
PALLIATIVE CARE... WHAT’S THAT? : MEDICAID PATIENT-IDENTIFIED BARRIERS TO PALLIATIVE CARE
Authors: Hoe Deborah , Wang Yu-Hsuan , Meyers Kate , Enguidanos Susan 
Published: November 2019

Abstract
Multiple studies demonstrate most consumers do not know about palliative care. And, since January 2018, California’s Medi-Cal Managed Care patients have been eligible for palliative care services under Senate Bill 1004 (SB 1004). Yet, the uptake of palliative care services has been underwhelming. The purpose of this study is to explore patient-centered barriers to palliative care. We recruited 27 adult Medicaid patients suffering from advanced cancer, chronic obstructive pulmonary disease, congestive heart failure, or liver disease, from community-based sites in Los Angeles, and conducted semi-structured qualitative interviews. Each participant was asked questions to elicit their knowledge about, and perspectives on, palliative care as well as their preferred communication approaches for receiving a referral to palliative care. The interviews were audio-recorded and transcribed verbatim. We used a grounded theory approach to guide our analysis of primary themes. Our findings indicated that the barriers to palliative care referrals among this population included lack of knowledge about palliative care and available services; the reliance on, and trust in, primary care physicians for information; language and cultural barriers; and patient believing they are neither old enough nor sick enough to need palliative care. This population also preferred direct contact, with in-person consultations more favorable than telephone calls. These findings emphasize the critical role primary care physicians play in advocating for safety net patients and the necessity for culturally sensitive education about palliative care. Promoting knowledge and understanding of palliative care among both primary care physicians and consumers is vital to ensuring access to care.
CO-DESIGNING CANCER SCREENING INTERVENTIONS WITH PEOPLE OVER 55 YEARS OLD AT RISK FOR LUNG CANCER
Authors: Tuzzio Leah , Palazzo Lorella , Brush Sarah , Ehrlich Kelly , Anderson Melissa , Gao Hongyuan , Wernli Karen 
Published: November 2019

Abstract
In 2014, the US Preventive Task Force recommended annual lung cancer screening with low dose CT (LDCT) for adults aged 55 to 80 years old with significant smoking history. Although screening reduces lung cancer mortality, the leading cause of cancer mortality in the US, adherence to screening follow-up remains low. In a human-centered design qualitative study, health services researchers and eight adults over 55 years old from Kaiser Permanente Washington who had recently had an LDCT participated in two co-design sessions. We elicited barriers, facilitators and design principles to develop multilevel interventions that aim to improve adherence to ongoing LDCT. In the initial discussion, participants identified four key areas for improvements to adherence: a) reminders for scheduling and appointments, b) knowledge about tests and follow-up, c) convenience in location and scheduling, and d) financial and non-financial incentives. In a second session, participants referenced patient personas and sketched storyboards, a comic strip-like format showing steps in a journey, to describe different ways to help patients return for LDCTs. Through qualitative analysis, we identified ten elements to consider incorporating in multilevel interventions: versatility (e.g., multiple reminder options), social support (e.g., families, peers), individualization (e.g., tailoring to patient needs), feelings (e.g., fear, relief), knowledge (e.g., harms/benefits, expectations), responsibility (e.g., who is accountable for reminders), continuity (e.g., clear pathway to adherence), consistency (e.g., same messages), cadence (e.g., rhythm of messages), and acknowledgment (e.g., recognition of screening completion). Next steps are to incorporate feedback from clinical stakeholders and develop multilevel interventions for further testing.
PERSONAL SELF-MONITORING DEVICES TO IMPROVE SLEEP AMONG OLDER PEOPLE: A FEASIBILITY STUDY
Authors: LeBlanc Raeann G , Torossian Maral , Czarnecki Paige , Spencer Rebecca , Jacelon Cynthia , Marquard Jenna 
Published: November 2019

Abstract
Chronic sleep disturbances reduce physical and mental health and affect over 8 million people age 65 years and older in the United States. There is evidence that use of a wearable Personal Self-Monitoring Device (PSMD) may improve sleep self-management in young adult populations. Feasibility of PSMD use for older individuals has not been explored and was the goal of this study. Persons age 65 years and over with self-reported sleep disturbances were recruited in a local community and were asked to wear a commercial PSMD for a 4-week period. To assess whether such an intervention may be feasible, outcomes included consent rate, study completion rate, data download interpretation, identification of a sleep self-management goal, improved knowledge about sleep, and improved sleep. Twenty-six persons (12 males and 14 females) were recruited over 3 months, out of a total of 33 expressing interest. Mean age=72, SD=4.99. Ninety-two percent of participants completed the study and reported improved awareness of sleep patterns and identified a sleep goal. Total sleep time was M=7 hours 14 minutes, SD=40 minutes; total restful sleep time was M=4 hours 33 minutes, SD=1 hour 22 minutes. In conclusion, sleep self-management with the use of a PSMD is feasible and of interest among persons in the young-old age category (65-74 years). There is potential for the use of PSMD among older people with the goal of improved sleep self-management. Future studies for sleep health self-management and interventions using personal sleep monitoring are recommended.
LONG-TERM EFFECT OF A MULTICOMPONENT INTERVENTION ON PHYSICAL PERFORMANCE AND FRAILTY IN OLDER ADULTS
Authors: Oh Gahee , Jang Il-Young , Lee Heayon , Jung Hee-Won , Lee Eunju , Kim Dae Hyun 
Published: November 2019

Abstract
Multicomponent interventions improve physical function and frailty in older adults, but their long-term benefit remains uncertain. We report the 30-month outcomes of a 24-week multicomponent intervention versus usual care in community-dwelling older adults. This prospective non-randomized study was conducted in 383 older Koreans (mean age, 76.8 years; female 72.3%) living alone or receiving medical aid in rural communities. Of these, 187 received a 24-week multicomponent intervention that consisted of group exercise, nutritional supplements, depression management, deprescribing, and home hazard reduction. The remaining 196 individuals received usual care. After 1:1 propensity score matching, we compared the short physical performance battery (SPPB) score (0-12 points), frailty phenotype scale (0-5 points), and deficit-accumulation frailty index (0-1) at 6, 18, and 30 months. Restricted mean survival time was estimated for death and institutionalization-free survival time at 30 months. The intervention group had higher SPPB scores than the comparison group at 6 months (difference 3.2; 95% CI, 2.5-3.8), 18 months (1.2; 95% CI, 0.5-1.9), and 30 months (1.1; 95% CI, 0.5-1.8). They had lower frailty phenotype scale (-0.6; 95% CI -0.9 to -0.3) and frailty index (-0.04; -0.07 to -0.02) only at 6 months, but similar scores at 18 and 30 months. Death and institutionalization-free survival time over 30 months was 28.5 months (95% CI, 27.7-29.3) in the intervention group versus 24.2 months (95% CI, 22.3-26.1) in the comparison group (difference, 5.2 months; 95% CI, 3.0-7.3). The 24-week multicomponent intervention showed sustained improvement in physical function for 30 months, but only temporary reduction in frailty.
EXTERNAL HOME DISREPAIR ASSOCIATED WITH OBJECTIVE SLEEP DISTURBANCES IN LOW-INCOME OLDER ADULTS WITH DISABILITIES
Authors: Okoye Safiyyah M , Perrin Nancy , Szanton Sarah , Spira Adam P 
Published: November 2019

Abstract
Sleep disturbances are linked to poor health, loss of independence and mortality in older adults. Rates of poor sleep are higher among socioeconomically disadvantaged older adults. Understanding how environmental factors may affect sleep in this population could lead to interventions to improve sleep-related health outcomes. We determined cross-sectional associations of home and neighborhood conditions with sleep parameters, measured by wrist actigraphy, in 136 low-income, predominantly African-American older adults with disabilities. Primary predictors were third-party-rated objective indicators of disrepair or disorder based on: 1) inside-home conditions (e.g., evidence of pests, tripping hazards, clutter); 2) outside-home conditions (e.g., broken windows, crumbling foundation); and 3) neighborhood conditions (e.g., litter, graffiti, vacant buildings). Outcomes were actigraphic total sleep time (TST; total number of minutes in bed spent asleep), wake time after sleep onset (WASO; total number of minutes spent awake after initially falling asleep), and sleep efficiency (SE; % of time in bed spent asleep). Presence of one or more outside-home conditions indicating disrepair or disorder was associated with 36.3-minutes shorter TST, 18.1-minutes more WASO, and 4.7% lower SE (all p &lt;0.05). Conditions inside the home and of the neighborhood were not associated with sleep. These preliminary findings suggest that among low-income older adults with disabilities, external-home disrepair is associated with objectively measured WASO, TST, and SE. External-home disrepair may affect sleep through physical, psychosocial and behavioral pathways. Further research should examine longitudinal associations between external-home conditions and objectively measured sleep in socioeconomically disadvantaged older adults.
PERIPHERAL ARTERIAL DISEASE AND SEDENTARY TIME IN OLDER ADULTS
Authors: Fullwood Dottington , McDermott Mary , Manini Todd M 
Published: November 2019

Abstract
Peripheral artery disease (PAD) is associated with increased rates of physical disability in older adults, yet few interventions exist to reduce this risk. Intermittent claudication, exertional calf symptoms that resolve within 10 minutes of rest, is the classic symptom for PAD, but many people with PAD are absent of these symptoms. Ankle brachial index (ABI) is a non-invasive measure that identifies the presence and severity of lower extremity arterial obstruction due to atherosclerosis. We studied whether abnormal ABI is associated with increased time spent in sedentary behavior in a large sample of community-dwelling older men and women (70-89 years) enrolled in the Lifestyle Interventions and Independence for Elders (LIFE) study. Older adults underwent an ABI test and then wore a tri-axial accelerometer on the hip for up to seven days. Total accumulated sedentary time and sedentary time spent in bout lengths of 10minutes or more, 30 minutes or more, and 60 minutes or more were calculated. ABI values, divided into PAD (&lt;.90, n=156) and non-PAD (0.90 - 1.40, n=960), were evaluated in covariate-adjusted regression models adjusting for age, body mass index, comorbidity presence, gender and smoking. Older adults with PAD had significantly higher total accumulated time spent in sedentary behavior than those without PAD (13.1 minutes per day, p&lt;0.02). No associations were found with longer bout lengths of sedentary time. These results suggest that older adults with PAD accumulate more time in shorter bouts of sedentary behavior. Future interventions may consider targeting short sedentary bout-lengths for reducing PAD symptoms.
HEAT KILLED LB. PARACASEI OR CELL WALL LIPOTEICHOIC ACID AMELIORATES AGE-RELATED LEAKY GUT AND INFLAMMATION
Authors: Wang Shaohua , Ahmadi Shokouh , Nagpal Ravinder , Jain Shalini , Mishra Sidharth , Kritchevsky Stephen , Kitzman Dalane , Yadav Hariom 
Published: November 2019

Abstract
Increased inflammation associated with leaky gut is a major risk factor for morbidity and mortality in older adults; however, successful preventive and therapeutic strategies are not available to ameliorate these conditions. In this study, we demonstrate that a human-origin Lactobacillus paracasei D3-5 strain (D3-5), even when dead, extended life span of C. elegans. In addition, feeding D3-5 to older mice (&gt;79 weeks) prevented high fat diet (HFD)-induced metabolic dysfunction and decreased leaky gut and inflammation, which were associated with improved physical and cognitive function. D3-5 feeding significantly increased mucin production and proportionately, the abundance of mucin-degrading bacteria Akkermansia muciniphila was also increased. Mechanistically, we show that the cell wall of D3-5 contains lipoteichoic acid (LTA), which enhanced mucin (Muc2) expression via TLR-2/p38-MAPK pathway, which in turn reduced age-related leaky gut and inflammation. This study indicates that the D3-5 and its LTA can prevent/treat age-related leaky gut and inflammation.
MAPPING COLLABORATION RELATIONSHIPS IN AGE-FRIENDLY COMMUNITIES INITIATIVES
Authors: Pestine-Stevens Althea 
Published: November 2019

Abstract
Age-friendly initiatives (AFIs) convene stakeholders throughout a community to improve social and built environments for long lives. Despite rapid growth in AFIs worldwide, research on how AFIs operate, sustain, and impact their communities has been slow to develop. This poster presents a new social network analysis (SNA) survey instrument, which can be used to advance research on AFIs by identifying key relationships and activities that drive collaborative community change processes. The survey asks a representative from each organizational member of an AFI coalition to select “partner” organizations with whom they have worked on AFI goals. Respondents then select from a list of activities in which they engage with each partnering organization. The questions regarding collaboration activities were developed based on theories of inter-sectoral and community-wide collaboration, SNA studies of collaboration in health prevention networks, and qualitative interviews with leaders of an established AFI coalition in Upstate New York. This tool was administered with respondents from 18 organizations comprising the New York coalition. Administration of the pilot indicated that the questions were acceptable and feasible for participants to complete. Analysis of the data through SNA software (UCINET) yielded visual maps to understand dimensions of the AFI’s inter-organizational network. Local government offices and nonprofits emerged as central network nodes for connecting stakeholders. Findings also indicated denser networks around lower-intensity collaboration activities, such as sharing information, relative to higher-intensity activities, such as sharing financial resources. Implications of the tool for future research on the development of AFIs across diverse community contexts are discussed.
ABO GENE AND AGING-RELATED OUTCOMES IN OVER 379,000 EUROPEAN-DESCENT PARTICIPANTS OF UK BIOBANK
Authors: Kuo Chia-Ling , Pan Ziwei , Pilling Luke C , Kuchel George A , Melzer David 
Published: November 2019

Abstract
Genetic variants associated with multiple traits are potential targets to delay aging. Drugs supported by genetic evidence are twice as likely to succeed in human trials. Single nucleotide polymorphisms (SNPs) in the ABO gene were reported by genome-wide associations studies, associated with breast cancer, coronary artery disease, stroke, and type II diabetes. To evaluate the potential of ABO gene as a target for aging intervention, we conducted a phenome-wide association study (PheWAS) to associate the genotype-derived blood types (based on two SNPs in the ABO gene) with a wide range of aging-related outcomes. The genotype-derived blood type distribution (41% A, 9% B, 3% AB, and 47% O) is similar to that reported by the UK National Health Service (39% A, 10% B, 3% AB, and 48% O). The blood type was not associated with parental lifespan or extreme parental longevity. Non-O types had modestly lower risk of hypertension than O type but higher risk of type II diabetes and pancreatic cancer (e.g., OR= 1.37, 95% CI: 1.17 to 1.59 comparing A to O). Additionally, “A" type had modestly higher risk of breast cancer than other types. “A” allele (in A or AB type) was associated with lower heel bone mineral density, alkaline phosphatase (e.g., 0.41 standard deviation lower in A than that in O, 95% CI: -0.42 to -0.40), and hemoglobin concentration, but higher HbA1c, direct LDL, and cholesterol. Blood types with A allele(s) are less favored than other blood types, which however are adversely associated with some aging traits.
VERIFICATION OF PAIN MEDICATION ADHERENCE IN OLDER ADULTS USING INTERACTIVE VOICE REMINDERS
Authors: Shade Marcia , Rector Kyle , Kupzyk Kevin 
Published: November 2019

Abstract
Adherence to analgesics needs to be monitored to ensure optimal pain management and avert adverse events among older adults. mHealth reminders may encourage adherence behavior, but it is unclear if medication use ensues following the reminder. The purpose of this study was to trial the use of medication event monitoring to verify the initiation of scheduled pain medication after an mHealth reminder. Methods: N=15 adults 55 and older created Google Assistant reminders to take their scheduled pain medication and write in a pain diary. A sub sample of n= 5 participants used a Medication Event Monitoring System Cap with their scheduled pain medications over 4 weeks. Data were collected on demographics, pain severity, and medication adherence. Descriptive statistics were performed. Results: Five women with ages ranging from 56-80 years, reported pain in multiple body locations. Pain severity on average was rated at 4 and at its worst 7; with pain relief ranging from 50-90%. Adherence percentages ranged from 82% to 100%. The overall latency was M = 55 min, SD = 100 min. The average latencies varied among the 5 participants; the shortest average time was 17 minutes and the longest average time was 4.5 hours. Only 15% of pain medications were taken within 5 minutes and 64% within 30 minutes of the interactive voice assistant reminder. Conclusions: It is important to ensure a behavioral intervention promotes the desired outcome. Medication event monitoring systems may help to identify non adherent behaviors when using mHealth interventions to promote pain medication adherence.
ADJUDICATION PILOT STUDY OF CAUSE OF DEATH IN THE LONG LIFE FAMILY STUDY
Authors: Diallo Habibatou , Murabito Joanne , Newman Anne B , Perls Thomas T , Ives Diane , Honig Larry 
Published: November 2019

Abstract
Background: Death certificate inaccuracy increases at older ages. The Long Life Family Study (LLFS) utilizes a physician adjudication committee to review the death certificate, medical records and a family narrative about cause of death. We report here the adjudication process and the prevalent underlying causes of death for a subsample of those who have died so far. Methods: We first describe the adjudication process. There were ~1,250 deaths in LLFS. We report underlying causes of death for a subset of proband generation subjects enrolled and evaluated by two LLFS study centers. Results: As of May 2019, we have adjudicated 190 deaths (98 male, 92 female) . Mean age 95 years (range 81-105 years). Top 5 causes of death for men: cancer (13%), coronary heart disease (CHD, 13%), dementia (13%), "other" (11%) and "unknown" (9%) and for women: dementia (21%), valvular heart disease (14%), coronary heart disease (12%), unknown (12%) and other (9%). Rate of death due to dementia was greater in women compared to men (CHI2 =7.33, p=0.006). Conclusions: In this pilot study, a significantly greater proportion of women died due to dementia compared to men. At least some portion of this difference may be due to the observation that women are known to survive chronic aging-related diseases more than men and thus have a greater opportunity to die from dementia at advanced ages. An additional cause to consider includes clinicians’ gender bias in ascribing diagnoses in the medical records that were relied upon as part of the adjudication process.