bluuebunny/crossref_metadata_2025_split huggingface dataset:
GENOME-WIDE META-ANALYSIS SUPPORTS HETEROGENEITY IN POLYGENIC ARCHITECTURE OF DISABILITY
Authors: Kulminski Alexander , Kang Chansuk , Loika Yury , Stallard Eric , Culminskaya Irina 
Published: November 2019

Abstract
Disability and frailty increase steeply with age after midlife. They comprise broad, non-specific aging-related health/well-being declines. Understanding the molecular mechanisms of these declines could help in combating processes related to intrinsic aging. We performed genome-wide meta-analysis of disability using data on N=12,550 disabled individuals of Caucasian ancestry from five independent studies with N=24,068 genotyped participants. Disability was measured using the Activities of Daily Living (ADL) scale. A subject was considered disabled if he/she had at least one ADL impairment. All subjects in our study were aged 50+ years. The analysis followed a discovery-replication strategy using two studies as discovery samples and three others as replication samples. At the discovery stage, we selected SNPs at nominal significance (p&lt;0.05) and evaluated their associations with disability in the replication samples. Meta-analysis across all studies identified 30 SNPs (24 loci) at p&lt;10e-4. SNPs from four loci (chromosomes 2, 8, and 12) attained suggestive significances at p&lt;10-5. We constructed two polygenic risk scores (PGRS) using these 30 SNPs whose minor alleles were positively (19 SNPs) and negatively (11 SNPs) associated with disability, PGRS_p and PGRS_n, respectively. Meta-analysis across all studies identified strong effects for PGRS_p (beta=0.436, p=1.18×10e-32) and PGRS_n (beta=-0.426, p=8.74×10e-19). The associations for the PGRSs observed in two discovery studies were replicated in three independent studies. The lack of genome-wide significant effects of individual SNPs combined with the highly significant effects of the PGRSs shows that, in line with the heterogeneous origin of disability, its genetic architecture is of highly heterogeneous polygenic origin.
DELIRIUM SEVERITY AND COGNITIVE OUTCOMES
Authors: Welch Sarah A , Ely E Wesley , Han Jin H 
Published: November 2019

Abstract
Delirium is heterogeneous and can vary by severity. The impact of its severity is unclear. This prospective cohort study enrolled emergency department (ED) patients who were &gt; 65 years old and admitted to the hospital. Delirium severity was determined by the Confusion Assessment Method for the Intensive Care Unit Severity (CAM-ICU-S) Scale measured at enrollment. This scale ranges from 0 (no symptoms) to 7 (most severe). Premorbid and 6-month cognition were determined using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) which ranges from 1 to 5 (severe cognitive impairment). Multiple linear regression was performed to determine if delirium severity was associated with 6-month function and cognition adjusted for pre-illness IQCODE, baseline functional status, comorbidity burden, severity of illness, and central nervous system diagnosis. Two-factor interactions were incorporated to determine if pre-illness cognition modified the relationship between delirium severity as measured by the CAM-ICU-S and 6-month cognition. A total of 228 older patients were enrolled in the ED and of these, 105 were delirious. Median (interquartile range) CAM-ICU-S scores was 2 (0, 5). In patients with intact pre-illness cognition, a point increase in the CAM-ICU-S significantly increased the 6-month IQCODE by 0.06 (95%CI: 0.01 to 0.12) points. In patients with impaired pre-illness cognition, there was no significant association between the CAM-ICU-S and 6-month IQCODE. Thus delirium severity is associated with poorer 6-month cognition, but this association is more prominent in those with intact pre-illness cognition.
USING SOMATOSENSORY GAMES TO IMPROVE HEALTH AND SOCIAL ENGAGEMENT OF TAIWANESE OLDER ADULTS IN A COMMUNITY
Authors: Chen Duan-Rung , Chen Ya-Mei , Tseng Winston Tseng 
Published: November 2019

Abstract
Objective. Playing games has become a new way to enhance the physical activity, quality of life, social engagement of older adults. This study aims to conduct a 6-month somatosensory game program, inviting older adults to play Microsoft Xbox Kinect games and study whether games can bring benefits to them. Methods. A total of 70 community-dwelling older adults (35 as experimental group, 35 as controls) were recruited. The experiment group played somatosensory games twice per week in a local health center. These games contained three types of categories: 1) Tournament games (for upper limb and lower limb); 2) Single games (for aerobic exercise and muscle training);3) Puzzle games (for collaboration and group dynamics): Results. After 6 months, in the experiment group, the body mass index decreased from 23.45 to 23.29 (p&lt;0.03). In muscular endurance category, 30 second chair rise jumped from 18 to 23.07 (p&lt;0.0001). And 2 min leg lifting increased from 119.48 to 137.75 (p&lt;0.001). In the flexibility category, back scratch test from right hand on top and left hand on top both improved (p&lt;0.026; p&lt;0.46, respectively). Trend analysis indicates that the improvements in 30 second chair rise (p&lt;0.0001) and 2 min leg lifting (p&lt;0.001) is linear. The intensity of social interactions increased noticeably in the experiment group. The SF8 health survey also revealed that experimental group perceived lower level of bodily pain. No significant improvement in the control group in all categories. Conclusion. Playing somatosensory games regularly may help older adults physically and socially.
MULTIMORBIDITY RESILIENCE IN COMMUNITY-RESIDING OLDER ADULTS: MEASUREMENT AND HEALTH OUTCOMES
Authors: Xu Yingzhi , McConnell Eleanor , Xue Tingzhong (Michelle) , Corazzini Kirsten 
Published: November 2019

Abstract
Multimorbidity is widespread, costly, and associated with a range of deleterious outcomes; it affects an estimated 67-80% of older adults. This study tests the validity of a multimorbidity resilience index developed in a Canadian sample of older adults by Wister et al., (2018), with a U.S.-based sample, using National Social Life, Health, and Aging Project (NSHAP) data, and draws upon the index to investigate the effects of resilience on outcomes over time. We mapped Wister et al.’s (2018) index to NSHAP measures, and assessed cross-sectional associations with health outcomes, using logistic regression. To assess the effects of resilience on health outcomes over time, we estimated mixed models of the relationships between resilience on outcomes over a 5-year interval. Total resilience was consistently associated with improved outcomes, including pain level (OR=.51, CI .41-.64); reduced utilization (OR=.45, CI .33-.60); improved mental health (OR=9.13, CI 6.20-13.44); self-rated physical health (OR=6.97, CI 4.76 10.19); and sleep quality (OR=3.66, CI 2.76-4.86). Longitudinal model results indicate change in multimorbidity resilience and number of chronic diseases predict (α=.001) pain level and self-rated physical health. Effects were moderated by socio-demographic factors. Our findings validate Wister et al.’s (2018) resilience index in a U.S. sample, supporting the importance of this measure to capture core components of older adults’ capacity to sustain well-being in the context of living with multiple, chronic conditions. Results from the longitudinal models provide beginning insights into the effects of resilience on symptom experience and perceived health over time, highlighting potential levers for change.
QUANTIFYING THE BURDEN OF HOSPITALIZED DAYS IN MEDICARE BENEFICIARIES WITH MULTIMORBIDITY
Authors: Wei Melissa Y , Tilton Nicholas , Mukamal Kenneth J 
Published: November 2019

Abstract
Multimorbidity predicts several health outcomes including physical and cognitive functioning and mortality. Multimorbidity also predicts healthcare burden, but this has not been studied using a patient-centered measure that weights conditions by their impact on physical functioning. Health and Retirement Study participants were continuously enrolled in Medicare Parts A/B 1-year before and after the 2012-2013 HRS interview. Medicare claims were used to compute ICD-coded multimorbidity-weighted index (MWI-ICD) by summing physical functioning-weighted conditions. Given excess observations of zero hospital days (78.1%), we used zero-inflated Poisson regression to examine the association between multimorbidity and hospitalized days. First, logit models predicted membership into the zero-coded “no hospitalizations” group. Second, Poisson models predicted hospital days for participants not in the zero-coded group. We converted adjusted regression coefficients to odds ratios to report odds of zero hospitalized days. To compare model fit between MWI-ICD and simple disease count we used AICs. The final sample N=5201 participants had mean age 77.6+/-11.6 years, MWI-ICD 16.5+/-11.6, and 1.9+/-6.0 (range 0-90) hospitalized days. Each 1-point increase in MWI-ICD was associated with 4.3% decreased odds of zero hospitalized days (OR=0.96, 95%CI: 0.95-0.96) and 2% increased number of expected hospitalized days (IRR=1.02, 95%CI: 1.01-1.03) over one year in adjusted models. MWI-ICD had a lower AIC than simple disease count. Multimorbidity measured with MWI-ICD was associated with a decreased odds of zero hospitalized days and an increased number of expected hospitalized days. Multimorbidity contributes greatly to patient burden through increased hospitalization and is better captured through an index weighting conditions to physical functioning.
FEASIBILITY OF ONLINE SYNCHRONOUS CAREGIVER DEMENTIA COACHING FOR REJECTION-OF-CARE BEHAVIORS
Authors: Jablonski Rita A , Vicki Winstead , Pilonieta Giovanna , Geldmacher David 
Published: November 2019

Abstract
Problem: Two-thirds of family caregivers of persons living with dementia have encountered rejection-of-care behavior, usually during assistance with activities of daily living. Purpose: To describe the feasibility of an online videoconferencing platform to help caregivers prevent and reduce ROC behavior. Design: Quasi-experimental. Sample: Twenty-six family caregivers: 54% female, 77% white, 62% spouses (31% wives, 31% husbands), mean age 65 years, and college-educated (92%). Their care recipients were 61% female, 77% white, mean age of 76 years, and college-educated (88%). Procedure: Family caregivers who endorsed problematic ROC behaviors in their care recipients participated in six online, individual, synchronous, sequential, and weekly 1-hour coaching sessions. We measured general burden (Zarit Burden Inventory) and the frequency, severity, and associated distress of responsive behaviors (Neuropsychiatric Inventory Questionnaire). Data collection intervals were before coaching (baseline), immediately after the final session (Time 1), and six weeks (Time 2) and 12 weeks (Time 3) after the final session, respectively. Results: Caregivers reported less overall distress scores at Time 2 compared to baseline: 13.58 (SD 6.44) versus 17.42 (SD 6.90), t=2.56, p=0.017). Distress scores returned to baseline by Time 3. Caregivers reported less severe ROC behavior at Time 2 which was not statistically significant. Burden remained unchanged throughout the 24 weeks. Conclusion: Online caregiver coaching that targets ROC behavior is feasible. Qualitative review of the encounters suggests that a longer period of intervention and an outcome measure more sensitive to ROC effects on activities of daily living may be needed in future studies.
β-GPA: AN AMPK ACTIVATOR WITH POTENTIAL EFFECTS ON HEALTHSPAN AND FUNCTION
Authors: Dorigatti Jonathan , Thyne Kevin , Liu Yuhong , Salmon Adam B 
Published: November 2019

Abstract
β-Guanidinopropionic acid (β-GPA) is a naturally occurring compound reported to activate AMP Activated Protein Kinase (AMPK) signaling in vivo. Acute administration of β-GPA in young animals has been reported to improve multiple functional measures including a switch to oxidative fatigue-resistant muscle fibers, improved glucose uptake, and increased mitochondrial biogenesis. However, it is unknown if β-GPA may promote healthy aging or prevent late-life functional decline. To address this knowledge gap, we tested the effects of β-GPA on mitochondrial energetics and cellular function in young and old genetically heterogenous mice (HET3). Both age groups were fed either 1% β-GPA or control chow for ~5 months and basic functional parameters including metabolism were assessed. β-GPA treatment decreased lean and fat mass in young males, but prevented late-life losses in these parameters in old animals. Notably, glycated hemoglobin (HbA1c) levels were lower in treated young and old males suggesting improved glucose homeostasis. Citrate synthase activity was also higher in old males fed β-GPA suggesting increased mitochondrial biogenesis. At the molecular level, mitochondrial Complex I expression decreased with β-GPA treatment in old males versus controls. High resolution respirometry revealed generally decreased respiration in old animals compared to young and decreased Complex 1 coupled respiration in soleus of β-GPA treated young but not old males. These findings indicate that the mitochondrial effects attributed to β-GPA may be mediated by its action on Complex I. While treatment outcomes varied in young and old males these results suggest β-GPA may prove beneficial in combating age-related declines in function.
SEX HORMONES AND ARTHRITIS IN A LONG-LIVED ANIMAL MODEL, THE ELEPHANT
Authors: Chusyd Daniella E , Brown Janine , Nagy Tim R , Griffin Timothy , Kraus Virginia , Huebner Janet , Allison David , Austad Steven N 
Published: November 2019

Abstract
Arthritis affects women more so than men, particularly after menopause. Sex hormones may play a role in arthritis development, yet this is still unclear. Elephants have a similar lifespan to humans and develop arthritis and joint issues (musculoskeletal impairments (MI)), but do not undergo menopause. Interestingly, many female zoo elephants do not exhibit normal ovarian cycles, closely resembling that in post-menopausal women. Objectives: 1) examine ovarian cyclicity status with MI (Asians: N=84; Africans: N=83); 2) determine whether gonadotropin and sex hormones are reduced in cycling elephants with MI (Asians: N=16; Africans: N=26); and 3) evaluate whether serum CTXI, a marker of type 1 collage degradation, is associated with MI in elephants (Asians: N=40; Africans: N=32). We used longitudinal serum and health data on ovarian cycling and non-cycling zoo African and Asian elephants with and without MI. Serum progestagen, leutinizing hormone, follicle stimulating hormone, and CTXI concentrations were measured. Cyclicity status was based on progestagen patterns. Zoo veterinarians classified the elephant with MI based on clinical exams and observations. In both Asian and African elephants, MI was significantly associated with cyclicity status (P=0.015, 0.032, respectively), but not independent of age (P=0.251, 0.091, respectively). There were no significant differences in any hormone concentration, during either the luteal or follicular phase, between elephants with or without MI (P&gt;0.135). There were no significant differences in CTXI concentrations between age- and cycling-matched elephants with and without MI (P&gt;0.957). Preliminary results do not provide compelling evidence that gonadotropin and sex hormones influence MI development in elephants.
NEUROPATHOLOGY AND GAIT SPEED DECLINE IN OLDER ADULTS: THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY
Authors: Sullivan Kevin J , Griswold Michael , Hughes Timothy , Hugenschmidt Christina E , Lockhart Samuel , Mosley Thomas , Gottesman Rebecca , Windham Gwen 
Published: November 2019

Abstract
Neuropathological markers including amyloid-beta (Aβ) have been implicated in mobility decline in older adults, but no studies have examined the relationship between these markers and longitudinal change in gait speed in a racially diverse community-based sample. In the multi-site prospective ARIC study, a subsample of participants (n=1,978, mean age=76.3, 28.5% black) underwent brain MRI at Visit 5 (2011-13). Of these, 343 participants (mean age=75.9, 42.6% black) completed PET scans using the tracer florbetapir to estimate global brain Aβ. We investigated the relationship between four neuropathological markers [white matter hyperintensities (WMH; log2cm3), infarcts (present/absent), brain atrophy (log2cm3), and global Aβ (log2SUVR)] with cross-sectional usual pace gait speed (cm/s) over 4 meters, and change in gait speed through Visits 6 (2016-17) and 7 (2018-19). Linear regression models were adjusted for age, site, sex, education, BMI, intracranial volume, and all race interactions. Cross-sectionally, slower gait was associated with higher WMH volume (β=-2.16, 95%CI: -2.92, -1.39), infarcts (β=-5.81, 95%CI: -7.86, -3.76), and brain atrophy (β=-16.39, 95%CI: -21.07, -11.71). Longitudinally, only higher WMH volume was statistically associated with gait speed decline (β=-0.14, 95%CI: -0.28, -0.01). Global Aβ was not statistically associated with gait speed cross-sectionally (β=-.269, 95%CI: -8.11, 7.57) or longitudinally (β=-1.16, 95%CI: -2.94, 0.62). There were no significant interactions with race. Detrimental relations of cerebral small vessel disease to mobility and mobility decline were observed across race in this diverse sample. The magnitude of the Aβ association with gait speed decline was high, although not statistically significant in the smaller PET subsample.
LIVING WITH MULTIPLE MYELOMA: SELF-MANAGEMENT STRATEGIES
Authors: LeBlanc Matthew R , LeBlanc Thomas W , Ashley Bryant L , Pollak Kathryn I , Bailey Donald E , Smith Sophia K 
Published: November 2019

Abstract
Multiple myeloma (myeloma), is an incurable cancer of the plasma cells that affects many older adults. Over 30,000 new diagnoses and over 12,000 deaths are attributed to myeloma annually in the United States, where the median age of diagnosis is 69 years old. Dramatic improvements in survival over the past fifteen years have transformed myeloma into a chronic disease for many. The disease and its toxic, ongoing treatment lead to significant challenges for patients. In this study we explore the self-management strategies patients use to address the challenges of living with myeloma through semi-structured one-on-one interviews with myeloma patients and clinicians. Fifteen myeloma patients and ten myeloma clinicians were interviewed between September 2017 and September 2018. Self-management strategies emerged in five major categories; managing uncertainty, finding emotional strength, seeking support, medication management, and activity management. The care of MM patients has made great strides as new and more effective treatments have extended survival for many patients. Effective self-management strategies are critical in addressing the challenges of this increasingly chronic disease. Our study explores the ways myeloma patients address the many challenges they face due to their disease and its’ treatment. Findings from this study could inform the development of interventions to optimize and support patients living with myeloma self-management.
LAY YOUR BURDENS DOWN: DEFERRED RELIGIOUS COPING AS A MARITAL STRESS BUFFER FOR OLDER AFRICAN AMERICAN COUPLES
Authors: Skipper Antonius D 
Published: November 2019

Abstract
Although growing bodies of research explore the dynamics of minority families, few consider the African American family from a strengths-focused perspective. Stressors that threaten familial stability, such as financial strain, health disparities, and sporadic employment, disproportionately affect African American families and contribute to high rates of dissolution. In response, African American families often rely on religion as a source of coping and resilience. While existing literature adequately captures the frequency of religious-based responses to stress, opportunities to examine the nuances and underlying processes of religious coping for African American families exist. This study addresses the need to move beyond the broad measures of religiosity and religious coping, in exchange for a more in-depth exploration of how various forms of religious coping, specifically deferred coping, impact well-being. Deferred religious coping is characterized as a complete reliance on a higher power during a time of stress. Thirty-five older African American couples (N=70 individuals), representing 11 states in the U.S., were interviewed regarding the dynamics of deferred religious coping in the marital dyad. Following the digital recording and transcription of the narrative data, the interviews were analyzed with an open coding procedure consistent with grounded theory and Numeric Content Analysis (Marks, 2015). Analyses reveal that nearly 75% of the couples interviewed utilized deferred religious coping in response to stressors that could threaten marital stability. Further, salient themes include: (1) The Three-Party, Divine Triangle of Marriage, (2) Deferring Health Problems Reduces Worry, and (3) A Healthy Work-Family-Prayer Balance. Implications for practice are also discussed.
FAMILY DEMENTIA CAREGIVER RECRUITMENT STRATEGIES IN LONG-TERM CARE FACILITIES
Authors: Paun Olimpia , Inventor Ben R , Fogg Louis , Vondracek Hugh , Salinas Ilse 
Published: November 2019

Abstract
Recruitment of dementia caregivers whose family members reside in long-term care facilities (LTCFs) poses unique challenges as it traditionally relies on the assistance of facility administrators. The purpose of this presentation is to examine and evaluate new recruitment strategies to determine their effectiveness in an ongoing Stage I randomized clinical trial testing the effects of a Chronic Grief Management Intervention, Video-streamed (CGMI-V) on caregivers’ mental health (grief, depression, anxiety) and facility-related outcomes (conflict with staff, satisfaction with care). A total of 144 caregivers will be randomly assigned to the CGMI-V or to the minimal treatment conditions. The initial recruitment plan was to build on already-established relationships with more than 35 LTCFs that helped recruit in a previous study. The usual approach was to offer written materials and onsite presentations about the study to facility staff and to dementia family caregivers of facility residents. Within the first six months, recruitment efforts yielded less than a dozen participants, thus we had to refine our approach. Revised recruitment strategies included the adoption of resources from the National Institute on Aging’s ADORE (Alzheimer’s and Dementia Outreach, Recruitment, and Engagement) and ROAR (Recruiting Older Adults into Research) platforms. This new approach included online study advertising on NIH and Alzheimer’s Association research study repositories and advertising on parent institution’s on-hold messaging system. Adoption of these new strategies is yielding an increase in participant screening and enrollment. Results are pending.