bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age and Socioeconomic Gradients in Frailty Among Older Adults in India
Authors: Chowdhary Ravindra 
Published: December 2020

Abstract
Although individuals with frailty and lower socioeconomic status (SES) are vulnerable to morbidity and early mortality, few studies have investigated this association. We intend to fill this gap with a study using older adults aged ≥ 50 years from the SAGE WAVE II in India. The Aim of study is to examine the association of frailty with SES and how this association varies across different age groups. A modified Fried phenotype approach with five frailty indicators was used to categorize 6560 older adults as frail, pre-frail or robust who had more than two, one or zero indicators, respectively: grip strength, exhaustion, weight loss, walking speed and physical activity. Multinomial logistic regression estimated the likelihood of being pre-frail and frail for various levels of SES, controlling and not controlling for confounders. This study also shows the overall socioeconomic gradients and age patterns of socioeconomic gradients of frailty indicators using predicted probabilities. Approximately 26%, 55% and 20% participants were robust, pre-frail and frail, respectively. The number of frailty indicators was positively associated with lower income and education levels in the case of controlling and not controlling for confounders. Also, among the higher age groups, individuals with low SES had higher chances of being frail.Overall, the results in this research indicated a negative low SES and frailty association as found in previous studies worldwide. This highlights the need for comprehensive and centered public health interventions for older adults with low SES.
Supporting Older Adults and Caregivers Through Integrative Service Learning During COVID
Authors: Chan Keith , LaFave Sarah , Ratnayake Maggie , Marsack-Topolewski Christina , Graves Jillian , Fenske Diane , Lukas Shay 
Published: December 2020

Abstract
There is a growing population of older adults who are living longer and acquiring chronic illness and disabilities, making it difficult for them to complete everyday activities and age in place. More than 2 million of these older adults are homebound and 5 million need help leaving their homes. They experience social isolation, food insecurity, and lack of connection to community resources which has intensified since the pandemic. Integrative service learning models can provide home-based support to older adults while offering valuable, hands-on learning experiences for students. This study examined findings for a community-based program which trained university students to provide practical home-based support for older adults and their caregivers. Data was collected for 109 older adults who were connected with student trainees. Students provided services with groceries, companionship, and help accessing needed services. Findings from t-test results using the UCLA Loneliness Scale indicated that older adults reported less loneliness after engagement with students (mean difference = 6.15, t = 3.14, df = 82, p &lt; 0.01). Qualitative process data suggested that older adults benefited from services and a connection to their assigned students prior to and during the pandemic. Student trainees reported that the experience enriched their learning and reaffirmed their commitment to working with older adults. Community-based service learning can address home-based needs of older adults and their caregivers and enhance learning opportunities for students. Policies and practice can support a pipeline of geriatric health professionals through innovative service learning models to benefit older adults, caregivers and students.
Voices From the Frontlines in Longterm Care During COVID-19: Narratives of Direct Care Workers
Authors: Wolf Christin , Freidus Andrea , Shenk Dena 
Published: December 2020

Abstract
Our study draws from the narratives of 30 staff caring for residents in congregate care communities in central North Carolina from June-September 2020. It is part of phase 2 of an on-going 3-phase rapid qualitative appraisal of workers providing longterm care to older adults with the purpose of disseminating findings to key stakeholders to inform policy, programming, and funding decisions. The 3-phase project involves semi-structured interviews with 60+ participants that were videorecorded using a web-based platform. We report on the emotional and visceral experiences of these direct care workers providing care during the pandemic. We organize the data into four affect categories: fear/anxiety, sadness/grief, anger/frustration, and trauma/stress. The 30 participants include nurses, activities staff, med techs, CNAs, housekeepers, dining staff, chaplains and administrators at nursing homes, assisted living communities, memory care units and continuing care retirement communities. We amplify the voices of these formal caregivers in order to demonstrate how their sensorial and emotive experiences can speak to the human suffering they bore witness to, the underlying ageism that permeates our culture, and the social hierarchy that devalues their labor and their worth as they serve on the frontlines during this unprecedented global pandemic.
Early Learning from the Healthy End of Life Project (HELP) Ottawa in the Context of COVID-19
Authors: Grassau Pamela , Miloff Hayley , Davison Emily , Stinchcombe Arne , Wright David Kenneth , Thomas Roanne 
Published: December 2020

Abstract
Healthy End of Life Project (HELP) Ottawa is a community-based participatory research initiative which is based in four community sites in Ottawa, Ontario (Canada) (2 community health centers, and 2 faith communities). Focused on the needs of people who are frail, living with advanced illness, and their caregivers, including the needs of people who are bereaved, HELP Ottawa strives to, 1)strengthen informal and community social networks, organizational cultures and linkages across local health and social care services; 2)create a community culture that supports people to build social care networks to be able to ask for and accept help, and, 3)mobilize and prepare community members to be confident and capable of offering and providing help to people in their communities. Unfolding within the context of COVID-19, each HELP Ottawa site has found ways to mobilize, adapt and respond to lockdowns, quarantines, increased isolation and altered needs and services. Drawing on 89 initial consultations, followed by 111 interviews and 16 focus group participants (n=164), qualitative findings speak to the heightened grief and fear experienced within each site during the COVID-19 pandemic, and the multiple costs of severed ‘essential’ links. Critically highlighted is the need to build and sustain social supports and connection through everyday and local means while also integrating technology and online communication. Further apparent are the critical questions that need to be asked about how compassionate communities, and communities at large, can prepare for and respond to current and future waves of COVID-19.
Fatal Crashes Among Drivers Age 60+ in Connecticut, Massachusetts, New Hampshire, and Rhode Island
Authors: Lee Chae Man , Dugan Beth 
Published: December 2020

Abstract
Fatal crashes are related with the spatial components of physical environments (e.g. roadways, land use, and political boundaries). This study compares rates of fatal crashes among drivers age 60+ by counties in 4 states of CT, MA, NH, and RI. The GIS application is used to visualize the location of fatal crashes and to identify whether it is clustered as hotspots. This study pooled data related to fatal crashes in CT, MA, NH, and RI from the Fatal Accident Recording System (2008-2018). Sample (n=2,373) inclusion criteria were subjects (driver age 60+) had to have complete data on variables of interest and be involved in a crash with at least one fatality. More than half (n=1,387, 58.5%) of drivers had a fatal injury. Results showed that the county with the highest incidents of fatal crashes was New Haven, CT (n=183 involved, 53% fatality), Worcester, MA (n=179, 61.5% respectively), Hillsborough, NH (n=75, 65.3% respectively), and Providence, RI (n=94, 59.6% respectively). The GIS spatial analysis showed that crashes were clustered along roads with the highest speed limits (interstate highways or multilane state routes) and found that the hotspots of clustered fatal crashes were located in counties with big cities with high population densities (New Haven CT, Hartford CT, Springfield MA, Worcester MA, Boston MA, Concord NH, and Providence RI). Identification of these crash hotspots will be beneficial for drivers and policy makers. The findings may alert drivers to high risk areas and policy makers can implement countermeasures.
Visitation Access to U.S. Nursing Homes: An Analysis of Facility Locations, Ratings, and Disparities
Authors: Helander Mary 
Published: December 2020

Abstract
Research findings suggest that family visits to nursing home residents are important for countering depression, increasing residents’ well-being and quality of life (Miller, 2019; Durkin et al., 2014), maintaining physical function (Shankar et al., 2017), and improving general health (Parmenter et al., 2012). Presence by family can directly impact a resident’s care quality, since family members may take a role in monitoring their older relative’s status (Miller, 2019). Unfortunately, regular family visits to nursing homes may be difficult, or impossible, due to challenges that include distance, travel time, lack of transportation, and cost (Fields et al., 2019) (Miller, 2019). These same challenges may translate to socio-economic barriers for families, eliminating long-term-care as an option for older relatives (Ferraro et al., 2017), (Angel and Berlinger, 2018). This paper considers the issue of nursing home visitation access and examines related disparities through spatial and demographic analysis of 15,000+ US facilities monitored by the Centers for Medicare the Medicaid Services. Mathematical models are used to analyze facility and population data, using access measures adapted from the geography discipline (Lou and Wang, 2003; Paez et al., 2019). Analysis explores whether higher rated nursing homes are more likely to be closer to affluent populations, and whether socioeconomic status is a significant factor in overall access. Analysis reveals patterns of access disparity with respect to nursing home ratings and geographies. For example, proximity to higher rated facilities increases monotonically with median household income. Specific policy recommendations are discussed.
Fusogenic Liposomes Deliver Resveratrol to Brain Microcirculation and Improve Neurovascular Coupling in Aged Mice
Authors: Toth Adam Nyul , Wiedenhoeft Tabea , Tarantini Stefano , Csipo Tamas , Balasubramanian Priya , Csiszar Anna , Csiszar Agnes , Ungvari Zoltan 
Published: December 2020

Abstract
Adjustment of cerebral blood flow (CBF) to the increased oxygen and nutrient demands of active brain regions via neurovascular coupling (NVC) has an essential role in maintenance of healthy cognitive function. In advanced age, cerebromicrovascular oxidative stress and endothelial dysfunction impair neurovascular coupling, contributing to age-related cognitive decline. Recently we developed a resveratrol (3,4′,5- trihydroxystilbene)-containing fusogenic liposome (FL-RSV)-based molecular delivery system that can effectively target cultured cerebromicrovascular endothelial cells, attenuating age-related oxidative stress. To assess the cerebromicrovascular protective effects of FL-RSV in vivo, aged (24-monthold) C57BL/6 mice were treated with FL-RSV for four days. To demonstrate effective cellular uptake of FL-RSV, accumulation of the lipophilic tracer dyes in cells of the neurovascular unit was confirmed using two-photon imaging (through a chronic cranial window). NVC was assessed by measuring CBF responses (laser speckle contrast imaging) evoked by contralateral whisker stimulation. We found that NVC responses were significantly impaired in aged mice. Treatment with FL-RSV significantly improved NVC responses by increasing NO-mediated vasodilation. These findings are paralleled by the protective effects of FL-RSV on endothelium-dependent relaxation in the aorta. Thus, treatment with FL-RSV rescues endothelial function and NVC responses in aged mice. We propose that resveratrol containing fusogenic liposomes could also be used for combined delivery of various anti-geronic factors, including proteins, small molecules, DNA vectors and mRNAs targeting key pathways involved in microvascular aging and neurovascular dysfunction for the prevention/treatment of age-related cerebromicrovascular pathologies and development of vascular cognitive impairment (VCI) in aging.
Neurofilament Light Chain and Cognitive Performance in Selected Siblings From the CATSLife Study
Authors: Reynolds Chandra , Smolen Andrew , Link Christopher , Wadsworth Sally 
Published: December 2020

Abstract
Markers of neurodegeneration such as neurofilament light chain (NfL) may be elevated with neurological diseases such as multiple sclerosis (MS) as well as Alzheimer’s disease. NfL is a marker of axonal integrity where higher values positively relate to the degree of damage. NfL shows variations in early adulthood among healthy individuals and may relate to executive function performance in otherwise healthy individuals aged 19-32 years. In the ongoing CATSLife (Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging) Quanterix Simoa assays of NfL were measured in 34 individuals selected based on self-reported neuroinflammatory conditions (N = 5) or by APOE genotype (N_nonE4 = 18, N_E4 = 16). The distribution of NfL was consistent with other studies of early-mid adulthood (range = 1.3 - 22.3 pg/ml). Based on partial regression weights predicting log-transformed NfL, NfL was higher in cases (exp(b)=1.08 pg/ml), in males (exp(b)=1.25 pg/ml), by age (exp(b)=1.03 pg/ml per year) and in APOE E4 carriers (exp(b)=1.11 p/mg). Moreover, correlations partialed for age, sex, APOE e4 and case status suggest higher NfL may be associated with lower Full Scale IQ and general cognitive ability (r’s = -.18 and -. 28) overall and may be more evident among APOE E4 carriers (r’s = -.42 - .44, partialed for age, sex, case status). In this pilot study, the observed NfL associations with general cognitive ability, particularly among APOE E4 carriers, suggests NfL may be a salient biomarker of cognitive functioning by early- to mid-adulthood.
Sex-Dependent Effects of Quadriceps Fat Content on Single Muscle Fiber Size in Older Adults
Authors: Straight Chad , Gordon Joseph , Foster Aurora , Remillard Nicholas , Damon Bruce , Chipkin Stuart , Kent Jane , Miller Mark 
Published: December 2020

Abstract
Evidence suggests that ectopic fat deposition interferes with skeletal muscle structure and function, but few studies have examined underlying morphological and contractile properties at the single fiber level. Healthy older (65-75 y) men (n=9) and women (n=9) underwent dynamometry for assessment of knee extensor maximal torque, water-fat magnetic resonance imaging to quantify quadriceps muscle cross-sectional area (CSA) and fat fraction (FF), and vastus lateralis biopsies to determine morphology and function of type I and II muscle fibers. Despite similar body mass indices (24.4±1.3 vs. 24.6±0.5 kg∙m2, p=0.93) and daily moderate-to-vigorous physical activity (46±7 vs. 41±9 min∙d-1, p=0.67), women had greater FF (9.0±0.3 [range: 7.6-10.6] vs. 7.9±0.4 [6.0-9.7] %, p=0.04) than men, indicating increased adipose tissue deposition in skeletal muscle. Women also had smaller quadriceps CSA (39.8±1.8 vs. 57.9±1.3 cm2, p=0.01), specific torque (1.5±0.1 vs. 1.9±0.1 Nm∙cm-2, p=0.01) and type II fiber CSA (3,943±312 [2,350-5,140] vs. 5,352±384 [3,560-6,590] µm2, p=0.01) than men. Type I CSA did not differ by sex (4,918±228 [3,740-5,600] vs. 5,630±440 [3,640-7,670] µm2, p=0.19). In older women, FF was inversely associated with single fiber CSA in type I (r= -0.81, p=0.02) and II (r= -0.76, p=0.03) fibers, and tended to be associated with slower myosin-actin cross-bridge kinetics (longer myosin attachment time) in type I fibers (r=0.65, p=0.08). These relationships were not observed in men. Overall, healthy older women have greater intramuscular fat than men, which may contribute to sex-specific effects on knee extensor specific torque through differences in muscle fiber size and cross-bridge kinetics.
Uncovering the Specific Functions of miR-33 in Regulation of Feeding and Cardiometabolic Diseases Linked to Aging
Authors: Price Nathan , Zhang Xinbo , Fernandez-Tussy Pablo , de Cabo Rafael , Fernandez-Hernando Carlos 
Published: December 2020

Abstract
Heart disease and metabolic dysfunction are two of the most important age related health issues, and feeding behavior is a critical factor contributing to these conditions. miR-33 promotes the development of atherosclerosis, by impairing macrophage cholesterol efflux and reverse cholesterol transport. Specific disruption of the interaction between miR-33 and the cholesterol transporter ABCA1 protected mice from atherosclerosis in a manner similar to that observed with loss or inhibition of miR-33. However, miR-33 has also been shown to impact other cellular functions, including targeting numerous mRNAs related to bioenergetics and inflammatory response, that may also contribute to its effects on atherosclerosis. Moreover, characterization of miR-33 deficient animals has revealed a strong predisposition to the development of obesity and metabolic dysfunction. While this phenotype appears to be due to alterations in feeding behavior, it is not clear what organ or organs are primarily driving this effect or what functions of miR-33 may be responsible. To address these questions, we have generated conditional miR-33 knockout mice to selectively remove miR-33 from a number of key metabolic tissues. Using these unique mouse models, we have performed an extensive characterization of how miR-33 impacts the function of different metabolic tissues in both chow and high fat diet fed mice, and assessed what impact this has on regulation of metabolic homeostasis and atherosclerosis. This work will improve our understanding of the mechanisms regulating feeding behavior and provide critical information for the development and evaluation of novel approaches to combat cardiometabolic diseases associated with aging.
A Panel of DNA Methylation and Proteomic Biomarkers for Specific Aging Pathways
Authors: Higgins-Chen Albert , Ferrucci Luigi , Levine Morgan 
Published: December 2020

Abstract
Most aging biomarkers such as DNA methylation and proteomic clocks have focused on measuring overall “biological age,” a single number that predicts age-related morbidity and mortality better than absolute chronological age. While intuitive and interpretable, this single biological age number does not account for the possibility that different individuals may preferentially experience aging in different molecular and cellular pathways, and therefore does not suggest personalized aging interventions. We reasoned that a panel of biomarkers each capturing specific aging pathways, such as mitochondrial dysfunction or cellular senescence, may capture the heterogeneity of aging better than existing composite measures. To address this, we employed weighted gene co-expression network analysis to cluster tissue-specific transcriptomes and the serum proteome into specific modules with distinct biological functions and characterized how these modules change with age. We trained DNA methylation proxies of these functional modules that we then applied to independent validation data to identify associations with age-related morbidity and mortality. Clustering analysis using the DNA methylation biomarkers showed that different individuals show distinct patterns of aging. These pathway-specific biomarkers will elucidate how different aging mechanisms interact with each other to produce the larger phenomenon of aging, and for evaluating novel therapeutics targeting specific hallmarks of aging.
Dementia Nursing Competency Scale at Acute Hospitals Version 2: Development and Psychometric Evaluation
Authors: Greiner Chieko , Urashima Shoko , Ryuno Hirochika , Yamaguchi Yuko , Fukuda Atsuko 
Published: December 2020

Abstract
Under an increasing number of people with dementia worldwide, the number of patients with dementia in acute settings is also growing. For patients with dementia to receive treatment with peace of mind, nurses should have competency in caring for patients with dementia. Thus, the aims of this study were to develop the Dementia Nursing Competency Scale in Acute Hospitals version 2 (DNCS-AH-v2) and to evaluate its psychometric properties. The draft was distributed to a convenience sample of 3000 nurses at 300 acute hospitals. After confirming the ceiling effect and the floor effect, reliability and validity were verified using Cronbach’s alpha, I-T correlation, test-retest reliability, G-P analysis, and exploratory and confirmatory factor analyses. This study was approved by the Institutional Review Board of Kobe University. Of a total of 3000 nurses, 878 (29.3%) responded to the questionnaire and 773 (25.8%) valid responses were analyzed. Mean age and mean working experience of the participants were 37.4 ± 9.3 and 14.0 ± 8.7 years, respectively. The 27-item DNCS-AH-v2 was developed with five factors scored on a six-point Likert scale. Cronbach’s alpha was .925, I-T correlation was between .46 and .68 (p&lt;.01), ICC coefficient (1, 1) was .76 (p&lt;.001), and significant differences were confirmed for G-P analysis (p&lt;.001). For the confirmatory factor analysis, fit indices of CFI =.868, GFI =.868, and RMSEA =.065 were obtained. High reliability and moderate validity were confirmed for the DNCS-AH-v2. The developed DNCS-AH-v2 could be used to evaluate dementia nursing competency in acute hospitals.
Enhancing Our Understanding of Transitional Care Programs
Authors: McGilton Katherine , Vellani Shirin , Krassikova Alexandra , Cumal Alexia , Robertson Sheryl , Irwin Constance , Bethell Jennifer , Sidani Souraya 
Published: December 2020

Abstract
Many hospitalized older adults experience delayed discharge. Transitional care programs (TCPs) provide short-term care to these patients to prepare them for transfer to nursing homes or back to the community. There are knowledge gaps related to the processes and outcomes of TCPs. We conducted a scoping review following Arksey & O’Malley’s framework to identify the: 1) characteristics of older patients served by TCPs, 2) services provided within TCPs, and 3) outcomes used to evaluate TCPs. We searched bibliographic databases and grey literature. We included papers and reports involving community-dwelling older adults aged ≥ 65 years and examined the processes and/or outcomes of TCPs. The search retrieved 4828 references; 38 studies and 2 reports met the inclusion criteria. Most studies were conducted in Europe (n=19) and America (n=13). Patients admitted to TCPs were 59-86 years old, had 2-10 chronic conditions, 26-74% lived alone, the majority were functionally dependent and had mild cognitive impairment. Most TCPs were staffed by nurses, physiotherapists, occupational therapists, social workers and physicians, and support staff. The TCPs provided 5 major types of services: assessment, care planning, treatment, evaluation/care monitoring and discharge planning. The outcomes most frequently assessed were discharge destination, mortality, hospital readmission, length of stay, cost and functional status. TCPs that reported significant improvement in older adults’ functions (which was the main goal of the TCPs) included multiple services delivered by multidisciplinary teams. There is a wide variation in the operationalization of TCPs within and between countries.