bluuebunny/crossref_metadata_2025_split huggingface dataset:
Agreement Between Proxy-Rated and Self-Reported Quality of Life for Persons With Dementia
Authors: Sakka Mariko , Igarashi Ayumi , Fukui Chie , Noguchi-Watanabe Maiko , Inagaki Asa , Takaoka Manami , Kobayashi Hiromi , Yamamoto-Mitani Noriko 
Published: December 2020

Abstract
While quality of life (QOL) is an important endpoint of homecare for persons with dementia (PWD), PWDs often have difficulty in articulating their QOL by themselves. Instead proxy-rating is often used. However, evidence is still scarce regarding to what extent proxy-ratings reflect actual QOL of PWDs. We examined the association between self-report QOL by PWDs and proxy-rated QOL. We conducted a questionnaire survey to PWDs who were 75 years and older, their family, and homecare nurse in charge of the PWD. Two measures were used: 1) a newly developed, 4-item self-report for QOL of PWDs, and 2) a standardized, 6-item proxy-rating dementia QOL scale. In the self-report, the PWD were asked about their daily mood or satisfaction in life in brief, easy-to-understand sentences. The self-reports and proxy-ratings were compared using intraclass correlation coefficients (ICC). Data from 382 PWDs, 248 family caregivers and 124 nurses were used. The mean age of PWD was 85.9 years and 60.5% were female. The proxy-rating by nurses were more strongly associated with self-reports, compared to the association between family proxy rating and self-reports (r = 0.351, p &lt; .001; r = 0.236, p &lt; .001, respectively). Proxy ratings by spouses and biological children were significantly associated with self-report (r = 0.257, p =.004; r =. 204, p = .006, respectively), while rating by children-in-law were not (r = 0.217, p = .160). Proxy-ratings may not be an appropriate substitute for self-report. Homecare nurses may evaluate the QOL of PWD better than their family caregiver.
Home Safety Evaluation Model for Older Adults With Recurrent Falls
Authors: Valencia Willy Marcos , Cabrera Kimberly , Hsu Vincent 
Published: December 2020

Abstract
Recurrent falls are a major threat in older adults. Home environment can be a hazard, but it is potentially modifiable/reversible. In Miami VA, occupational therapists conduct home safety evaluations (HSE) to ascertain the need for modifications to reduce falls risk. We reviewed the cohort of high-risk, recurrent falls patients evaluated at our Falls Prevention Clinic (FPC) between August 2017 to November 2019, to evaluate the impact of HSE. We identified 48 Veterans, age 76.5±6.9 years, of whom 15 (31.3%) reported 1-2 falls/year, 18 (37.5%) reported 3-4 falls/year, and 15 (31.3%) reported ≥5 falls/year. Twenty-eight (58.3%) were offered a HSE. Within these subjects, 74.2% reported falling at least once within their home, 43.8% had fear of falling, 5 (17.9%) had a history of substance or alcohol abuse. We observed that 29 (60.4%) would benefit from the addition of grab bars and 26 (54.2%) could benefit from toilet adjustments. Twelve (25.0%) were recommended to install bed rails. Only 15 (31.3%) Veterans agreed to all recommendations, 25 (52.1%) declined due to preference, and 8 (16.7%) declined for other reasons. Only 8 (16.7%) of these Veterans lived alone. Another factor is that 11 (22.9%) Veterans were renting and 32 (66.7%) owned their homes. Addressing and improving environmental hazards may ameliorate the risk for recurrent falls. Our next steps are to evaluate the extent of home modifications, and the long-term changes in falls/year. Further research needs to determine the long-term efficacy and cost-effectiveness of HSE, and how it can be more accessible to the community.
Bedside Ultrasound Measures of Muscle Mass and Frailty Measures in Community-Dwelling Older Adults
Authors: Madden Kenneth , Feldman Boris , Arishenkoff Shane , Meneilly Graydon 
Published: December 2020

Abstract
The age-associated loss of muscle mass and strength in older adults is called sarcopenia, and it is associated with increased rates of falls, fractures, hospitalizations and death. Sarcopenia is one of the most common physical etiologies for increased frailty in older adults, and some recent work has suggested the use of Point-of care ultrasound (PoCUS) measures as a potential measure of muscle mass. The objective of this study was to examine the association of PoCUS measures of muscle thickness (MT) with measures of frailty in community-dwelling older adults. We recruited 150 older adults (age &gt;= 65; mean age 80.0±0.5 years, 66 women, 84 men) sequentially from 5 geriatric medicine clinics (Vancouver General Hospital). We measured lean muscle mass (LMM, by bioimpedance assay) and an ultrasonic measure of muscle quantity (MT, vastus medialis muscle thickness) in all subjects, as well as two outcome measures of frailty (FFI, Fried Frailty Index; RCFS, Rockwood Clinical Frailty Scale). In our models, MT showed an inverse correlation with the FFI (Standardized β=-0.2320±0.107, p=0.032) but no significant correlation with the RCFS (Standardized β = -0.025±0.086, p=0.776). LMM showed no significant association with either FFI (Standardized β=-0.232±0.120, p=0.055) or RCFS (Standardized β = -0.043±0.119, p=0.719). Our findings indicate that PoCUS measures show potential as a way to screen for physical manifestations of frailty and might be superior to other bedside methods such as bioimpedance assay. However, PoCUS measures of muscle thickness will likely miss patients showing frailty in the much broader context captured by the RCFS.
Air Pollution and Gerontological Constructs Among Patients With End-Stage Kidney Disease
Authors: McAdams-DeMarco Mara , Jones Miranda , Feng Yijing , Walston Jeremy , Chu Nadia , Segev Dorry 
Published: December 2020

Abstract
Frailty is triggered by inflammatory pathways among patients with end-stage kidney disease (ESKD). Exposure to air pollution is associated with increased inflammation and as such may be a determinant of frailty in patients with ESKD. Therefore, we sought to estimate the impact of household-level exposure to fine particulate matter (particles &lt;2.5μm in diameter [PM2.5]) on frailty and other gerontological constructs among patients with ESKD. We leveraged a prospective, two-center cohort study of 1,482 adults with ESKD (2014-2019) from 40 US states. The physical frailty phenotype (PFP), SPPB, ADL/IADL dependence and 3MS global cognitive impairment were assessed at transplant evaluation. Household-level air pollution was estimated as annual average PM2.5 concentrations at each participant’s address using SEDAC national air pollution data. We estimated the odds of these gerontologic constructs using adjusted logistic regression by quartiles of PM2.5 concentrations accounting for confounders including socioeconomic status. Compared to patients with PM2.5 concentrations in the lowest quartile (&lt;9.3µg/m3), those with exposure to the 3rd quartile (10.0-11.1µg/m3) had 1.50-fold (95%CI:1.04-2.17) increased odds of frailty. However, exposure to PM2.5 concentrations in the second (9.3-10.0µg/m3) and fourth quartiles (&gt;11.1µg/m3) were not significant. Those with PM2.5 in the 3rd (OR=1.60, 95%CI:1.19-2.16) or 4th (OR=1.61, 95%CI:1.20-2.16) quartile had an increased risk of having dependence in ADLs or IADLs. PM2.5 was not associated with SPPB or cognitive impairment. Among ESKD patients, fine particulate matter was associated with greater frailty and dependence burden, although these association may not be linear. Further study of the role of inflammation on these associations are needed.
Life Review in Dementia: The Value of Identity
Authors: Walsh Diane , Ulatowska Hanna , Santos Tricia , Aguilar Sara , Patterson Rebecca 
Published: December 2020

Abstract
The stories told by veterans with dementia provide new insights into person-centered care for healthcare professionals. In this qualitative exploratory study, life review in seven WW II veterans with mild-moderate dementia was examined. Participants with mild-moderate dementia were selected from a larger study of seventy oldest-old veterans. Semi-structured interviews were conducted to elicit testimonial language about memorable war experiences, including their perception and evaluations of the war. The interviewer provided questions and prompts to facilitate responses when necessary. Despite decreased declarative memory manifested via reduction in details and specificity of information within narratives, participants demonstrated a desire to share their war time experiences. Veterans selected appropriate memories to share, indicating their preserved sense of self. They provided a general evaluation of their wartime experiences when prompted. Veterans expressed various types of identity related to both their social origin and their experience of participating in the war. Identities of social origin revealed cultural identities which were expressed via their sense of humor. Wartime identities include being a survivor, a patriot, and a tolerant person. Veterans also described how the GI Bill helped them become college educated. This study suggests that identity is relatively preserved more so in individuals with mild versus moderate dementia when producing autobiographical stories. The process of life review brings identity to the surface. Acknowledging the identity of individuals with dementia is essential to care as it recognizes the value of the person. Additionally, eliciting significant autobiographical memories serves as a valuable means of social engagement and connection.
Addressing Gun Safety and Dementia: Training Professionals in the Community
Authors: Orsulic-Jeras Silvia , Powers Sara , Empeno Jessica , Lagasca Regina , Abrams Amy , Barker Sarina , McDaniel Rebecca , Hanna Marcie 
Published: December 2020

Abstract
As the number of Alzheimer’s disease and related dementia (ADRD) cases grow, first responders will have more frequent interactions with individuals living with ADRD within the community. Recognizing the lack of dementia training among first responders and through the support of an Administration for Community Living grant, Alzheimer’s San Diego partnered with local law enforcement to support and educate first responders on local ADRD resources, referral systems for families and caregivers, and disease-related information, in hopes of building stronger dementia capable services within San Diego County. To date, 249 first responders have participated in dementia education trainings and completed the related evaluations that aimed to understand their experiences with and knowledge of dementia. On average, participants were 44.74 years old (SD=18.45) and served 8.72 years (SD=7.99) on their job. Majority were male (n=189), had some college education (n=94), and identified as White/Caucasian (n=105) or Hispanic/Latino (n=92). Although objective knowledge (as measured by a shortened version of the Alzheimer’s Disease Knowledge Scale [ADKS]) did not significantly differ from pre- to post-test, participants’ perceived subjective knowledge about dementia significantly increased from pre-test (M=1.17, SD=0.77) to post-test (M=1.89, SD=0.66); t(141)=10.56, p&lt;.001. Encouragingly, participants who reported receiving prior training on dementia had significantly higher ADKS scores at both pre- and post-test compared to those who did not have prior training. Results highlight the need for ongoing dementia-related training for law enforcement and the importance of evaluation requirements. Discussion will focus on policy implications and how communities can support dementia capability among first responders.
Associations Between Social Engagement and Physical Activity Among Community-Dwelling Older Adults With Dementia
Authors: Yoshikawa Aya , Smith Matthew , Ory Marcia 
Published: December 2020

Abstract
People with dementia (PWD) tend to experience loneliness and physical inactivity, which increases their risk of negative health outcomes such as depression and declined physical functioning. Research indicates the link between supportive social environments and physical activity (PA), yet this association is not fully studied among PWD. This cross-sectional study investigated associations between social engagement and moderate (i.e. walking for exercise) and vigorous PA among PWD. A subset sample of community-dwelling Medicare beneficiaries in the 2015 National Health and Aging Trends Study, representing PWD including possible (n = 779) and probable (n = 902) dementia, were analyzed using survey-weighted logistic regression analysis. All analyses were controlled for sociodemographic characteristics, living arrangement, physical functioning, and the number of chronic conditions. The majority of participants was 80 years or older (52.5%), female (53.1%), White (67.4%), had a high school or higher education (64.0%), and two or more chronic conditions (74.1%). Living alone (OR = 1.60, 95%CI 1.22, 2.10), knowing their community well (OR = 1.56, 95%CI 1.12, 2.16), and going out for enjoyment (OR = 1.93, 95%CI 1.37, 2.73) were associated with moderate PA. In addition to going out for enjoyment (OR = 2.40, 95%CI 1.65, 3.53), attending organized activities (OR = 1.97, 95%CI 1.15, 3.39) and working as a volunteer (OR = 1.63, 95%CI 1.04, 2.57) were associated with vigorous PA. Findings suggest that enjoyable activities and community familiarity may facilitate walking behavior among PWD. Integrating events and volunteer activities within communities is encouraged for supporting active living among PWD.
Development and Psychometric Examination of a Short-Form Dementia Attitudes Scale
Authors: Ebert Alexandria , Steele Jenessa , Patrick Julie Hicks 
Published: December 2020

Abstract
With the increase in research related to people directly and indirectly affected by Alzheimer’s Dementia and related disorders (ADRD), there is a need for short, psychometrically-sound instruments to assess the variety of influences on the quality of life for the person with dementia (pwd) and their care partners. We sought to develop and assess a short version of the Dementia Attitudes Scale (DAS; O’Connor & McFadden, 2010) for use in such endeavors. Using a sample of 321 adults (Mage = 39.7, range 20 to 70 yrs; 47% female), we surveyed a host of individual characteristics (e.g., age, personality, experience with pwd) and several current measures of attitudes about pwd. Ten days later, 162 of these adults completed a retest of the DAS. Results of a confirmatory factor analysis supported the 2-factor solution reported by O’Connor and McFadden. Internal consistency was acceptable for the Comfort factor (Time 1alpha = .83; T2 alpha = .82) and for the Knowledge factor (Time 1 alpha = .86; Time 2 alpha = .87). These estimates are similar to those in the original report. Due to limitations of coefficient alpha we also used structural equations to examine the regression weights for each item as a function of chronological age and experience. These analyses showed that the factor structure was robust when considering these individual characteristics. Finally, we compared different scale lengths using a series of ROC curves. We discuss our results in the context of providing brief and psychometrically-sound measures for use in large survey studies.
Predictors of Physical Resilience in Older Adults
Authors: O’Brien Catherine , Holtzer Roee 
Published: December 2020

Abstract
Physical resilience (PR), which denotes one’s ability to resist functional physical decline, can be operationalized through longitudinal assessments on the Short Physical Performance Battery (SPPB). Dual-task walking (DTW) is predictive of adverse outcomes but its role in predicting incident PR has not been assessed. Herein, we determined whether velocity during Single-Task-Walk (STW) and Dual-Task-Walk (DTW) conditions predicted incident loss of PR and identified moderators of this relationship. Participants were 163 (mean age=75.5; %female=52) non-demented, community-dwelling older adults with baseline SPPB scores of 10-12. At baseline, individuals completed neuropsychological testing, the SPPB and DTW paradigm. Cognitive reserve was evaluated using the Wide Range Achievement Test (WRAT-3) and speed of processing was assessed using the Symbol Digit Modalities Test (SDMT). Individuals with SPPB scores &lt; 10 were categorized as not physically resilient. Those with scores of 10 or higher were categorized as physically resilient. At three-year follow up 75.4% (n=123) of participants remained physically resilient while 24.5% (n=40) lost PR. Binary logistic regression revealed that slower DTW (OR= 0.96, p= 0.033, 95%CI [.926, .997]), but not STW velocity (OR= 1.00, p= 0.861, 95%CI [0.962, 1.048]), was a significant predictor of PR loss. Moreover, moderation analyses revealed that DTW velocity predicted PR loss only among individuals who had lower baseline scores on the WRAT-3 (OR=0.937, p=0.004, 95%CI [.896, .979]) and SDMT (OR=0.949, p=0.018, 95%CI [.909, .991]). We propose that cognitive reserve and speed of processing influenced the utility of DTW velocity in predicting PR loss among community-residing older adults.
Cognitive Activity as a Moderator of Educational Attainment and Work Status in Cognitive Aging
Authors: Stieger Mirjam , Lachman Margie 
Published: December 2020

Abstract
Cross-sectional findings showed that education differences in memory performance were moderated by frequent cognitive activity (Lachman et al., 2010). The present study examined whether frequent cognitive activity could compensate for lower education when focusing on change in cognitive performance across nine years. The study also explored whether cognitive activity can slow down declines in retired adults as previous research suggested that retiring is associated with an increased risk of cognitive decline (e.g., Wickrama et al., 2013). Longitudinal data from the MIDUS study included N = 3,325 middle-aged and older adults. Outcome variables were two factors of cognitive performance: Episodic Memory (EM) and Executive Functioning (EF). Independent variables were years of education, work status (working vs. retired), and frequency of cognitive activity. The results suggest that cognitive activity moderated the effect of educational attainment on change in EM. Individuals with both higher education and cognitive activity showed the smallest declines in EM. Individuals with lower educational attainment but high cognitive activity had less decline in EM compared to their low education counterparts. Those who increased their cognitive activity over time showed less decline in EF. In terms of work status, working adults had less decline in EM and EF compared to retired adults and retired adults who did not maintain their cognitive activity declined more in EF. The results emphasize the importance of frequent engagement in cognitive activity across the lifespan, which can attenuate cognitive declines especially among those who have lower education or have retired.
Does Cognitive Self-Report Measure Type Differentially Predict Cognitive Decline? A Systematic Review
Authors: Wion Rachel , Hill Nikki , Bell Tyler , Mogle Jacqueline , Yates Jennifer , Bhang Iris 
Published: December 2020

Abstract
Up to 47% of older adults without measurable cognitive impairment report difficulties with memory and thinking which potentially increases their risk for developing cognitive decline. Many measures are used for assessing self-reported cognition; however, certain types of these measures may be more predictive of cognitive decline. The purpose of this systematic review was to compare the role of cognitive self-report measure types in predicting risk for cognitive decline. PubMed, CINAHL, and PsycINFO databases were searched using the following inclusion criteria: longitudinal studies, outcome of cognitive decline, and two or more cognitive self-report measures. A total of 4,319 articles were identified during the initial search and narrowed to 19 final articles. The Quality in Prognosis Studies tool was used to determine study quality. Six comparison themes emerged during synthesis: self-reported cognition or memory with or without worry; self-reported global cognition or self-reported memory; self-reported memory decline and self-reported executive function decline; self-reported cognition and self-reported memory by others; self-reported memory and self-reported memory problems in comparison with peers; and self-reported memory and self-reported memory affecting daily function. Self-reported memory decline with worry and self-reported memory problems by others were most predictive of future impairment. It was difficult to definitively determine whether certain cognitive self-report measure types where more predictive of risk for cognitive decline because there were very few articles in some of the comparison groups. Future investigations of self-reported cognition should focus on using measures that have been shown to be the most efficacious at predicting risk for cognitive decline.
Favorite Activity Patterns Among Older Adults With and Without Dementia: Findings From the NHATS
Authors: Hou Tianxue , Liu Minhui , Miyawaki Christina E , Li Yuxiao , Sun Xiaocao , Tang Siyuan , Szanton Sarah 
Published: December 2020

Abstract
Favorite activities are usually meaningful and valuable to older adults. However, information on favorite activity patterns and their relationship with cognitive function from large samples is still limited. Using Round 1 data from the National Health and Aging Trends Study, we examined favorite activity patterns among community-dwelling older adults with and without dementia (N=6,565). Based on the 8-item Ascertain Dementia (AD8) dementia screening interview, participants were classified into no dementia, possible dementia, and probable dementia. Favorite activity was assessed by asking participants, “What their favorite activity they are currently able to do?” Multinomial logistic regression models were used to examine the association between each of the top three favorite activities and the cognitive impairment categories, controlling for demographics and general health. The sample was on average, 77±7.45 years old, non-Hispanic White (69.8%), female (57.3%), and 35.0% had high school education. The three most popular favorite activities among probable dementia participants were watching TV, walking, and outdoor maintenance. Participants who liked watching TV most were more likely associated with possible dementia (Relative Risk Ratio [RRR] = 1.49, p=0.044) compared to participants without favorite activities. Participants who liked walking most were less associated with possible dementia (RRR=0.58, p=0.003) and probable dementia (RRR=0.39, p&lt;0.001) compared to those without favorite activities. Similarly, participants who liked outdoor maintenance most were less likely to develop possible dementia (RRR=0.48, p&lt;0.001) and probable dementia (RRR=0.27, p&lt;0.001) than participants without favorite activities. Researchers may use older adults’ “active” favorite activities to create tailored interventions to slow dementia progression.