bluuebunny/crossref_metadata_2025_split huggingface dataset:
IT’S ACTUALLY WORSE THAN IT LOOKS: IDENTIFYING ABUSE-RELATED INJURIES AMONG APS CLIENTS
Authors: Yonashiro-Cho Jeanine , Gassoumis Zach , Wilber Kathleen , Homeier Diana 
Published: November 2019

Abstract
While recent work has described elder abuse injuries seen in medical contexts, most abuse determinations are made by community-based health and social services practitioners in the field. Little is known about the types of injuries present among victims who do not seek medical care. The purpose of this study was to identify and describe injuries more likely to occur through abuse, rather than accidental injury, among older adults seen in non-medical settings. An observational, matched-comparison group design was used to compare findings among physically abused APS clients (n=61) with those from non-abused older adults (n=104) seeking usual-care in a Geriatrics clinic. Forensic nurse examiners conducted full-body examinations of subjects and collected data on injury diagnoses, locations, and characteristics. Descriptive statistics and bivariate tests of association were used to analyze differences in injury presentation between groups. Though 21.8% of APS clients had no observable injuries upon examination, as a group, they were more likely than non-abused elders to be injured (p&lt;0.05) and had more injuries present (p&lt;0.01). Abuse victims were also more likely to have at least one upper extremity abrasion (p&lt;0.05) or a diagnosis of ecchymosis (p&lt;0.01), swelling (p&lt;0.05) or tenderness (p&lt;0.05) in the head, neck, or maxillofacial region. Because physical abuse may not result in injury to victims, screening protocols are needed to improve abuse detection. The presence of injuries among older adults at-risk for abuse warrant further evaluation or queries from medical and social service providers, regardless of injury severity.
STAFF PERSPECTIVES ON COUNTERING STAFF-TO-RESIDENT MISTREATMENT IN LONG-TERM CARE FACILITIES
Authors: Couture Melanie , Alarie Milaine , Israel Sarita 
Published: November 2019

Abstract
In Canada, as well as in other countries, resident mistreatment is common in long-term care (LTC) facilities. In many situations, residents are mistreated by LTC staff. To address this problem, LTC facility managers and their employees must play an active role in the prevention as well as in the management of staff-to-resident mistreatment situations. However, it is still unclear what type of support they need to counter this type of mistreatment. Using an exploratory descriptive qualitative design, twenty-one managers and employees working in four different LTC facilities participated in semi-structured individual interviews. To allow participants to express themselves without risking self-incrimination or feeling pressured to report colleagues, vignettes depicting fictitious and common situations of staff-to-resident mistreatment were used as a conversation starter. Data analysis was performed using Miles, Huberman & Saldaña (2013) analytical method. Results show that participants think that staff-to-resident mistreatment is mainly caused by three staff characteristics: 1) not having the psychological profile to work in LTC facilities; 2) lack of training; and/or 3) being overworked. Consequently, participants believe that mistreatment prevention starts by improving employee selection practices to ensure candidates have adequate attitudes and training to work in LTC facilities. They also argue that staff should receive more training regarding mistreatment. Lastly, support interventions are suggested to prevent and address situations involving staff experiencing high levels of stress for personal or work-related reasons. This study shows that both individual and organisational measures are needed to fight against staff-to-resident mistreatment in LTC facilities.
THE USE OF ELDERCARING COORDINATION FOR RESOLVING CASES INVOLVING OLDER ADULTS AND HIGH-CONFLICT FAMILY DYNAMICS
Authors: Teaster Pamela B , Dolbin-MacNab Megan L 
Published: November 2019

Abstract
The Association for Conflict Resolution and The Florida Chapter of the Association of Family and Conciliation Courts developed a model of Eldercaring Coordination for use in guardianship/probate cases involving high-conflict family dynamics that interfere with the well-being and safety of an older adult, limit adherence to court orders, impede court processes, or detract from the efficacy of guardianship and other appointments by the court. Developed by 40 organizations and entities in the United States and Canada, Eldercaring Coordination focuses on improving family dynamics so that the older adult, family members, and other involved parties can better work together and with professionals to make thoughtful and informed decisions and to support each other during times of transition. The purpose of this research was to gather information about participant experiences with Eldercaring Coordination. A pre-post test design was employed in which data were collected from older adults or their surrogates, family members and other court-ordered participants, judges and court administrators, and the Eldercaring Coordinators themselves. Findings from post-tests of 23 judges and court administrators revealed that the most common advantages of Eldercaring Coordination were that the intervention prioritized the older adults’ needs and improved family relationships. Post-test surveys from 17 Eldercaring Coordinators indicated some positive outcomes for older adults and their families, but also a need for enhanced authority, greater support from attorneys, and more cooperation from participants. Preliminary findings support the assertion that Eldercaring Coordination holds promise for intervening in high-conflict court cases involving older adults.
DAILY EMOTIONS AND STRESS: AGE CHANGES AND DIFFERENCES
Authors: Blaxton Jessica , Bergeman Cindy , Wang Lijuan (Peggy) 
Published: November 2019

Abstract
Developmental processes differ between individuals (interindividual differences), fluctuate within them on a short-term basis (intraindividual variability), and change over time on a longer-term basis (intraindividual change; Nesselroade, 1991). We situate the relationship between stress and emotions in this process-oriented perspective by examining how the daily relationship between stress and negative affect (NA) as well as stress and positive affect (PA) change over time, while considering cross-sectional age and stress differences. Participants (N = 966) completed daily questionnaires assessing stress, NA, and PA. Three-level multi-level models depicted how cross-sectional age, within-person age changes, and global stress differences impact the daily stress-affect relationship. Findings illustrate that cross-sectional age and the aging process uniquely buffer the stress-NA relationship whereas global stress exacerbates it. Furthermore, older adults as well as adults with low global stress experience a weaker relationship between daily stress and PA as they age, but midlife adults and adults with high global stress experience a stronger relationship. These results depict differences in aging trajectories for both midlife and older adults and thus inform intervention and preventative care strategies aimed toward promoting emotional well-being, suggesting that targeting these strategies at the daily level can promote better stress regulation. Furthermore, we see that midlife adults and adults with greater global stress perceptions are most in need of these interventions, and encouraging these adults to maintain PA in the face of daily stress can be particularly beneficial.
LINKING FAMILY TRANSITIONS AND LATER-LIFE DEPRESSION: DOES LIFE-COURSE SOCIOECONOMIC STANDING MATTER?
Authors: Recksiedler Claudia , Cheval Boris , Sieber Stefan , Stawski Robert S , Cullati Stephane 
Published: November 2019

Abstract
Research documented the impact of marital transitions—particularly marital loss—on depression in old age, yet its severity depends multiple factors. Individuals’ capability to cope with transitions depends on available resources and previous exposure to stressors, such as early-life adversity, which buffers or aggravates the impact of marital transitions on later-life depression. Although studies documented the pivotal link between early-life adversity and negative health trajectories, our study is the first attempt to examine whether early-life adversity influences the relationship between prospectively-tracked, later-life marital transitions and depression. We drew data from SHARE, which samples individuals aged 50+ across Europe (N = 13,258; 2004-2016). Using multilevel linear models, we found that women who became widowed had higher levels of depression compared to coupled and single women, but experienced lower increases in depression over time. After adjusting for early-life and adulthood SES, losing a partner remained significantly associated with depression. Life-course SES was associated with levels of depression, yet interactions between marital transitions and SES were not, with some exceptions: single women who reported difficulties in their ability to make ends meet experience higher increases of depression over time. Overall, results were similar for men. Interactions between family transitions and SES were again not significant, with a few exceptions for single men: those born in more childhood conditions, and those with high education, had lower levels of depression. We interpret and discuss our findings through the lens of life-course and stress-resiliency perspectives and in light of changing family dynamics for this age group.
COMPONENTS OF A HEALTHFUL DIET ARE ASSOCIATED WITH WAIST CIRCUMFERENCE AMONG PRE- AND POSTMENOPAUSAL WOMEN
Authors: Troy Lisa M , Witkowski Sarah 
Published: November 2019

Abstract
After menopause, women are at increased risk of diabetes and cardiovascular disease. A contributing factor to increased risk may be weight gain, especially visceral adiposity. Diet plays a role in maintaining weight at all ages but less is known about the specific contributions of a healthful dietary pattern after menopause. Therefore, we evaluated associations between diet and WC as a measure of visceral adiposity. We compared 869 pre- (aged 35-45 years) and 353 post-menopausal (aged 40-65 years) women from NHANES III (1988-94). Women were pre-menopausal if they self-reported menses in the past 2 months and postmenopausal if they reported no menses in past 12 months and were aged &gt; 40 years. Compared to premenopausal women, postmenopausal women consumed fewer Calories (-200 kcal/d) and had a higher mean waist circumference (+4.43 cm, p=0.007), after adjusting for age, race-ethnicity, height, physical activity, and smoking. Higher intakes of dark green vegetables (p=0.03) and lower intakes of potatoes (p=0.03), refined grains (p=0.001), and meats (p=0.04) were associated with lower WC for all women. Higher intakes of nuts and seeds and fish high in Omega-3 fatty acids were associated with smaller WC while higher intakes of poultry and dairy products were associated with higher WC in post- but not pre-menopausal women. Our findings generally support a diet high in nuts and seeds, dark green vegetables, and fish, and low in potatoes, refined grains, and meats. After menopause it may be important to incorporate fatty fish, nuts and seeds into the diet for lower visceral adiposity.
FRAILTY AND THE COMPARATIVE EFFECTIVENESS AND SAFETY OF SGLT2I AND SULFONYLUREA IN OLDER ADULTS WITH TYPE 2 DIABETES
Authors: Pawar Ajinkya , Patorno elisabetta , Kim Dae 
Published: November 2019

Abstract
We conducted a 1:1 propensity score-matched retrospective cohort study of 70,826 patients with type 2 diabetes (mean age, 71.4 years [standard deviation, 5.0]) initiating a SGLT2i or a second-generation sulfonylurea in Medicare data. We estimated HRs (95% CIs) for a composite cardiovascular endpoint and severe hypoglycemia comparing the two treatments in the entire population and by the CFI-based frailty subgroups. Compared with sulfonylureas, SGLT2is were associated with lower rates of the composite cardiovascular endpoint (HR, 0.68 [95% CI, 0.62-0.75]) and severe hypoglycemia (0.43 [0.35-0.53]) over a mean follow-up of 9.5 months. The lower rate of composite cardiovascular endpoint for SGLT2i vs sulfonylureas was observed in pre-frail (0.68 [0.61-0.77]) and frail (0.64 [0.53-0.77]) subgroups, but not in non-frail subgroup (0.95 [0.59-1.54]). The rate of severe hypoglycemia was consistently lower for SGLT2i vs sulfonylureas across frailty subgroups (non-frail, 0.37 [0.12-1.16]; pre-frail, 0.45 [0.35-0.59]; frail, 0.40 [0.28-0.58]).
FRAILTY AND THE COMPARATIVE EFFECTIVENESS AND SAFETY OF SGLT2I AND GLP1-RA IN OLDER ADULTS WITH TYPE 2 DIABETES
Authors: Patorno Elisabetta , Pawar Ajinkya , Kim Seoyoung , Kim Dae 
Published: November 2019

Abstract
We conducted a 1:1 propensity score-matched retrospective cohort study of 87,218 patients with type 2 diabetes (mean age, 71.5 years [standard deviation, 5.1]) initiating a SGLT2i or a GLP1-RA in Medicare data. We estimated HRs (95% CIs) for a composite cardiovascular endpoint and severe hypoglycemia comparing the two treatments in the entire population and by the CFI-based frailty subgroups. Compared with GLP1-RA, SGLT2i were associated with similar rates of the composite cardiovascular endpoint (HR, 0.94 [95% CI, 0.86-1.03]) and severe hypoglycemia (0.87 [0.71-1.07]) over a mean follow-up of 8.6 months. The rate of composite cardiovascular endpoint was not meaningfully different between SGLT2i and GLP1-RA across non-frail (1.33 [0.80-2.23]), pre-frail (0.96 [0.85-1.08]), and frail patients (0.87 [0.73-1.04]). Similarly, the rate of severe hypoglycemia was not meaningfully different between the two treatments among non-frail (0.97 [0.20-4.80]), pre-frail (0.83 [0.64-1.08]), and frail patients (0.95 [0.67-1.34]).
NOVEL METABOLOMICS MARKERS PREDICT 18-MONTH DECLINE IN HAND GRIP STRENGTH IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Siang Ng Ted Kheng , Kovalik Jean-Paul , Ching Jianhong , Chan Angelique , Matchar David 
Published: November 2019

Abstract
Sarcopenia that accompanies aging necessitates early detection tools, ideally before the presentation of clinically evident symptoms. The acylcarnitines (ACs) are a class of metabolites generated by cellular fuel metabolism and their predictive utility in declining muscle strength in community-dwelling older adults is unknown. We aim to examine whether baseline acylcarnitines levels can predict changes in hand grip strength over 18 months in 121 community-dwelling older adults. We measured ACs by targeted plasma metabolomics profiling. We then performed a biologically-relevant classification of these markers. Hand grip strength was measured using a Smedley spring-type dynamometer. Multivariate linear regressions were performed to examine if: 1) there was an association between ACs and hand grip strength at baseline and 2) baseline ACs could significantly predict changes in hand grip strength over an 18-month period. At baseline, AC levels were not significantly associated with hand grip strength. We found an inverse association between baseline short-chain carboxyl and dihydroxl acylcarnitines (AC-DC/-OH) levels and 18-month changes in hand grip strength (p=0.047, β=-0.548, 95% CI=-1.088 to -0.008). Notably, a specific AC-DC/-OH species, C4-DC/C6-OH, accounts for the majority of the variance. The mean difference between Malay and Chinese ethnicity is 2.28kg (p=0.042, β=2.275, 95% CI=0.084 to 4.466). These findings suggest an association between metabolic markers and deterioration in hand grip strength. These results suggest that perturbations in fuel metabolism are detectable way before the emergence of clinically evident sarcopenia and frailty. The use of AC-DC/-OH panel as antecedent biomarkers may enable clinicians to risk stratify patients in the future.
SOCIAL CONNECTIONS AND HEALTH AMONG OLDER ADULTS IN SENIOR HOUSING COMMUNITIES
Authors: Taylor Harry O , Morrow-Howell Nancy 
Published: November 2019

Abstract
Our study describes social connections among residents in two low-income senior housing communities and then examines if these connections influence their well-being. Operationalization of social connections included social network size, informal social support, social engagement, and loneliness. The Convoy Model of Social Relations guides our study in identifying objective and subjective social connections and examining how they affect well-being. Most residents maintained active connections: 53% saw five or more family members in the previous month, 52% felt they could rely on their family members and over 60% participated in group and/or Church activities; however, 70% of residents were moderately or severely lonely. Greater loneliness and less informal social support were associated with worse self-rated physical health, worse mental health, and lower life satisfaction. This residential setting offers promise for developing interventions to decrease loneliness and strengthen social connections to improve residents’ health and well-being.
THE ROLE OF CULTURE AND LANGUAGE IN DEPRESSION CARE EXPERIENCES AMONG OLDER LATINAS/OS AND HEALTH CARE PROVIDERS
Authors: Aranda Maria P , Christensen Janelle , Aguilar Iris 
Published: November 2019

Abstract
Older Latinas/os face significant difficulties in accessing quality depression treatment due to cultural and language barriers. In our study, Programa Esperanza (a randomized behavioral trial), we conducted after-treatment, in-depth interviews with two groups: 21 low-income Latinas/os (55+) receiving psychosocial depression care (Problem Solving Treatment, and Psychoeducation) in a health care setting, and 22 staff (interventionists, supervisors) participating in study implementation. Speaking the same language was highlighted by both groups as an overarching factor in effective depression care, although matching providers and patients by country of origin was considered less a priority than a shared language. The mechanisms by which language serves as a facilitator of effective care were highlighted: fomenting rapport; facilitating the expression of feelings; shortening initial relationship-building; understanding nuanced words and linguistic expressions; etc. Similarly, we found that shared culture included themes around intervention uptake, decreased stigma, increased advocacy, enhanced identification of coping strategies, etc. Unlike patients, providers were more likely to speak in diverse narratives of “them,” and “us.” Given that depression is still a stigmatizing disorder in our society, asking for help and receiving quality care remain significant challenges for older persons in general, and older underrepresented minorities, in particular. Our work signals the importance of differentiating language from culture in intervention development for older, primarily Spanish-speaking Latinas/os with high medical comorbidity.
DUAL DECLINE IN MEMORY AND GAIT UNIQUELY IDENTIFIES OLDER PERSONS AT HIGH RISK OF DEMENTIA
Authors: Tian Qu , Resnick Susan , Mielke Michelle , Yaffe Kristine , Rosano Caterina , Simonsick Eleanor M , Studenski Stephanie , Ferrucci Luigi 
Published: November 2019

Abstract
Recent study has shown that incident dementia risk is higher among older persons who decline in both cognition and gait. This study assesses whether this relationship exists in multiple other aging populations. Data are from the Baltimore Longitudinal Study of Aging (n=662, 51%women,22%blacks), Health, Aging and Body Composition Study (n=746, 51%women,44%blacks), and Mayo Clinic Study of Aging (n=2771, 48%women,0.3%blacks). Participants were at least 60, initially free of cognitive impairment, dementia, and dismobility (gait speed≤0.6m/s), with repeated measures of verbal memory and gait speed before dementia diagnosis (average follow-up 5.8-12.1 years). Within each cohort, participants were divided into four groups: memory decliners alone, gait decliners alone, dual decliners, or neither (healthy agers). Gait speed decline was defined as a loss of ≥0.05m/sec/year; memory decline was defined as cohort specific bottom slope tertile. Incident dementia risk was examined by Cox regression with healthy agers as reference, adjusted for sex, race, baseline age, gait speed and memory. Across studies, incident dementia ranged from 3% to 17%. Compared to healthy agers, memory decliners alone had 3.4 to 4.3 times higher risk for developing dementia (p&lt;0.01). Gait decliners alone had 2.1-5.6 times higher risk for dementia (p&lt;0.05). Dual decliners had 7.6-10.8 times the risk (p&lt;0.001). Dual decline signifies a more rapid progression to dementia. These consistent findings suggest that dual decliners might be a potentially valuable target group for both preventive interventions and mechanistic studies. Whether dual decline identifies a particular subtype or multiple subtypes of dementia remains to be investigated.
JUMP AROUND, JUMP AROUND: TRANSPOSABLE ELEMENT ACTIVATION IN NEURODEGENERATIVE TAUOPATHY
Authors: Frost Bess E , Sun Wenyan , Samimi Hanie , Zare Habil 
Published: November 2019

Abstract
Transposable elements, or “jumping genes,” constitute ~45% of the human genome. We have identified transposable element activation as a key mediator of neurodegeneration in tauopathies, a group of disorders that are pathologically defined by deposits of tau protein in the brain. Cellular defenses that limit transposable element mobilization include 1) formation of silencing heterochromatin and 2) generation of piwi-interacting RNAs (piRNAs) that clear transposable element transcripts. Using genetic approaches in Drosophila models of tauopathy, we find evidence for a causal relationship between tau-induced heterochromatin decondensation and piRNA depletion, transposable element mobilization, and neurodegeneration. 3TC, an FDA-approved inhibitor of reverse transcriptase, suppresses transposable element mobilization and neuronal death in tau transgenic Drosophila. We detect a significant increase in transcripts of the human endogenous retrovirus class of transposable elements in postmortem human Alzheimer’s disease brains. Our data identify transposable element activation as a conserved, pharmacologically targetable driver of neurodegeneration in tauopathy.
MULTI-OMICS ANALYSIS IDENTIFIES GENE NETWORKS ASSOCIATED WITH COGNITIVE AGING AND ALZHEIMER’S DISEASE
Authors: Kaczorowski Catherine , Heuer Sarah , Gaiteri Chris , Kaczorowski Catherine 
Published: November 2019

Abstract
Alzheimer’s disease (AD) is the leading cause of age-related dementia, yet no treatment exists. AD is heterogeneous, and is resultant of the dysregulation of many genetic and biological processes. To decipher this complexity, we leveraged the first translational mouse population of AD to identify 15 gene networks related to individual differences in cognitive outcomes. Using QTL mapping, we also identified a novel putative driver of a module, Gstk1, highly conserved in humans that also significantly correlated with memory outcomes. Together, these transcriptional networks provide new mechanistic insight into the biological processes that regulate individual differences in cognitive function across a genetically diverse population. We could identify how demographics (age, sex, causal AD mutations) influence these modules and how they relate to cognitive outcomes. Finally, the high degree of conservation between our mouse modules to human modules reflects the translatability of our model to human AD, adding to its face validity.