bluuebunny/crossref_metadata_2025_split huggingface dataset:
Marital Status and Risk of Dementia: Does Race Matter?
Authors: Zhang Zhenmei , Liu Hui , Choi Seung-won 
Published: December 2020

Abstract
Previous research has shown that unmarried individuals (i.e., divorced, widowed, and never married) had a higher risk of dementia than their married counterparts. However, few studies examined whether the link between marital status and dementia varies by race. To fill the gap, we used data from the Health and Retirement Longitudinal Study (2000-2014) and analyzed 15,379 respondents (13,278 non-Hispanic whites and 2,101 non-Hispanic blacks) ages 50 and older in 2000 who had no dementia. Discrete-time event history models were estimated. Our preliminary analysis showed that marital status was significantly associated with the odds of dementia for both whites and blacks. Furthermore, the associations between unmarried status (i.e., cohabiting, widowed, and never married) and dementia were stronger among blacks than whites. The effect of divorce on odds of dementia did not differ by race. The results were robust after controlling for socioeconomic status, health and lifestyle factors, and social engagements. Part of a symposium sponsored by the Alzheimer’s Disease Research Interest Group.
Rising CNS Polypharmacy Among Older Adults in the United States
Authors: Maust Donovan 
Published: December 2020

Abstract
CNS-polypharmacy is defined by the AGS Beers Criteria as using 3 or more individual medications from the following classes: antidepressants, antipsychotics, benzodiazepines, other sedative/hypnotics, opioids, antiepileptics. Dr. Maust will review data suggesting that such prescribing has increased among older adults, along with the data suggesting there are associated harms. In addition, he will review recent evidence from the Department of Veterans Affairs, which suggests that older Veterans who use both Medicare and the VA system for medical care are at higher risk of potentially inappropriate CNS-active prescribing. Part of a symposium sponsored by the Aging, Alcohol and Addictions Interest Group.
Do Gendered Psychosocial Factors Explain Sex Differences in White Matter Hyperintensities?
Authors: Shaaban C Elizabeth , Rosano Caterina , Shattuck-Heidorn Heather , Godina Sara , Wu Minjie , Rosso Andrea 
Published: December 2020

Abstract
Women have a greater burden than men of white matter hyperintensities (WMH), a marker of cerebral small vessel disease (cSVD). Psychosocial factors including education, household income, neighborhood socioeconomic status (nSES), happiness, and depression may differ by gender and could explain women’s higher burden of WMH. In a cohort of older adults (N=250, median age=82, 58% women, 39% Black), we found that women had lower education, household income, nSES and were less happy and more depressed. Race stratified Spearman correlations showed women had greater whole brain WMH volume in white participants only (white: rho=0.23, p=0.004; Black: rho=-0.05, p=0.64). In partial Spearman correlations, education, happiness, and depression attenuated but did not fully explain the relationship when added individually or all together to the model for whites (fully adjusted rho=0.19, p=0.03). Gendered psychosocial factors may partially explain sex differences in WMH; interventions targeting these factors may reduce cSVD burden, particularly in white women.
Senescence and Its Role in Fibrosis
Authors: Saux Claude Le 
Published: December 2020

Abstract
The presence of senescent cells (epithelial and mesenchymal) in fibrotic organs has been well established. Removal of senescent cells in animal models of fibrosis indicate an overall beneficial effect. The general consensus is that the senescent cells contribute to the fibrotic phenotype by the secretion of factors, mainly cytokines and chemokines. We recently demonstrated that senescent cells can also secreted eicosanoids. These lipids are implicated in the pathogenesis of fibrosis in multiple organs. Prostaglandins, especially PGE2, are generally regarded as anti-fibrotic, whereas leukotrienes are thought to be pro-fibrotic. Recent studies indicate that the senescence-associated secretory profile is a dynamic process and its composition is cell, tissue, and time-dependent. In this session I will discuss how senescent cells from specific origin have the potential to regulate fibro-genesis and its resolution by switching their eicosanoid profile expression over time. These findings have important implications for emerging senolytic drugs, which have the potential to provide novel therapeutic benefits for the treatment of fibrosis.
Honoring Preferences—The Consistency Between End-of-Life Care and a Veteran’s Goal for Comfort Care
Authors: Carpenter Joan , Scott Winifred , Ersek Mary , Levy Cari , Cohen Jennifer , Foglia Mary Beth , Phibbs Ciarian , Miller Susan 
Published: December 2020

Abstract
This study examined the alignment between Veterans’ end-of-life care and a Life-Sustaining Treatment (LST) goal “to be comfortable.” It includes Veterans with VA inpatient or community living center stays overlapping July 2018--January 2019, with a LST template documented by January 31, 2019, and who died by April 30, 2019 (N = 18,163). Using VA and Medicare data, we found 80% of decedents with a comfort care goal received hospice and 57% a palliative care consult (compared to 57% and 46%, respectively, of decedents without a comfort care goal). Using multivariate logistic regression, a comfort care goal was associated with significantly lower odds of EOL hospital or ICU use. In the last 30 days of life, Veterans with a comfort care goal had 43% lower odds (AOR 0.57; 95% CI: 0.51, 0.64) of hospitalization and 46% lower odds of ICU use (AOR 0.54; 95% CI: 0.48, 0.61).
Characterizing Physical Resilience in Older Adults: Insights From Secondary Analyses in Three Clinical Groups
Authors: Buta Brian , Newman Anne 
Published: December 2020

Abstract
Resilience is defined as the ability of a physiologic system to recover from a stressor that has pushed the system into a state far from its original state of equilibrium. The level of resilience can be understood by whether or not the system’s essential identity and function are retained following the stressor. The study of resilience in older adults has potential to provide clinically relevant insights into our understanding of who will or will not recover when encountering a stressful medical procedure, especially those common to older patients. The main Study of Physical Resilience and Aging (SPRING) at Johns Hopkins includes prospective data collection of determinants, phenotypes, surrogates, dynamic stimulation measures, and outcomes of resiliency among older persons undergoing knee replacement surgery, or the initiation of hemodialysis, or bone marrow transplantation. SPRING also includes analyses of existing data sources to inform these prospective studies. This symposium briefly presents the conceptual framework and design of SPRING, and focuses on the results of secondary analyses from three existing data sets that mirror the ongoing stressor studies: FORCE-TKR (knee/joint replacement, N=9006), CHOICE (dialysis initiation, N=487), and a database of patients undergoing treatment for hematologic malignancies (bone marrow transplantation, N=1011). For each clinical population, we present results on phenotypic and/or biomarker trajectories, as well as the factors associated with resilience phenotypes and how these are predictive of clinical outcomes. These analyses display the utility of resilience phenotypes for predicting risk of adverse outcomes and complement the new data being collected in our main study.
Predicting Survival After Bone Marrow Transplant Using Time Series of Routine Laboratory Biomarkers
Authors: Varadhan Ravi , Tang Bohao , Tsai Hua-Ling , Imus Phil 
Published: December 2020

Abstract
Bone marrow transplant (BMT) is a curative therapy for patients with hematologic malignancies. However, there is still a high rate of relapse and mortality after BMT. It would be tremendously valuable if we can identify older adults at high-risk for mortality using readily available information. A number of biomarkers are routinely collected during follow-up for clinical care, but this information is seldom used in prediction models. We examined the data from 1011 patients who had BMT at Johns Hopkins between 2013 and 2019. There were 364 death over a median follow-up of 431 days. We considered 4 biomarkers: albumin, hemoglobin, lymphocytes count, and platelets. Biomarker data from one week pre-BMT to 8 weeks post-BMT was used for prediction using a random survival forest model. The model performed quite well and had a 5-fold cross-validated c-index of 0.733 (95%CI: 0.724-0.739). Routine laboratory biomarkers can help identify poorly resilient older BMT patients.
Dopaminergic Vulnerability and Motor Impairments in Older Adults: Need for Targeted Pharmacotherapy
Authors: Bohnen Nicolaas 
Published: December 2020

Abstract
Motor impairments, including slow walking, are common in older age in the absence of prototypical Parkinson’s disease (PD). The etiology of such disturbances is heterogeneous and multi-system in nature. Dopamine is a key neurotransmitter involving motor, cognitive and behavioral circuitry. Normal aging is associated with substantial dopaminergic losses in the brain. Dopaminergic vulnerability of aging can be augmented by genotypic changes that may further compromise dopaminergic signaling, such as polymorphisms in the COMT gene. These observations may augur dopaminergic pharmacotherapy studies to treat gait disturbances in older adults. Prior dopaminergic therapy studies have shown overall limited effects in non-PD older adults. A major limitation of these studies is the non-targeted selection calling for personalized medicine approaches. Recent dopaminergic treatment studies targeting specific sub-groups of non-PD older adults conducted by us and others will be discussed.
The Meeting Centre Support Programme: International Evaluation of a Dyadic Intervention in Dementia
Authors: Szcześniak Dorota , Lion Katarzyna , Meiland Franka , Brooker Dawn , Farina Elisabetta , Chattat Rabih , Dröes Rose-Marie , Rymaszewska Joanna 
Published: December 2020

Abstract
In Europe, 10 million people are living with dementia. Most of them reside in their own home, cared for by their loved ones. As a consequence, there is a great need to provide both, people with dementia and their carers, tailored support. The Dutch Meeting Centres Support Programme (MCSP), adaptively implemented in three European countries within the JPND-MEETINGDEM project, is an excellent example of an effective dyadic psychosocial intervention, which seems to have no cultural barriers. The mixed-methods analysis showed that participant-dyads reported great satisfaction with MCSP. People with dementia experienced improvement of their quality of life, motivation and ability to participate in everyday activities, as well as improvement in their relationship with family members. Carers felt less burdened and highly appreciated the emotional and social support they received. Repeated user evaluation shows that this dyadic support effectively helps people with dementia and their families better deal with dementia.
Engaging Pharmacists in Interprofessional Programs to Support Older Residents of HUD-Assisted Housing
Authors: Slattum Patricia , Price Elvin 
Published: December 2020

Abstract
Medications are one of the pillar 4Ms of an age-friendly healthcare system. Ensuring that benefits of a medication regimen outweigh the risks and that medications are not contributing to meaningful outcomes such as functional or cognitive decline is a challenge for our healthcare system, particularly for older persons experiencing adverse social determinants of health, health disparities or uncoordinated care. More fully engaging pharmacists in the older person’s health care team is one strategy to improve clinical, humanistic and economic outcomes. This workshop reports findings on medication management capacity among older residents of five low-income apartment buildings in urban Richmond, VA, indicating that this population experiences challenges in managing medications as measured by MedMaIDE. The second presentation describes a pilot partnership between an independent community pharmacy and a local area agency on aging to provide medication coaching to residents of six affordable housing buildings in Seattle, WA, demonstrating feasibility of engaging pharmacists in the healthcare team and resulting in an average of five interventions per resident. The third presentation describes an interprofessional educational intervention based in two low-income apartment buildings for older persons in underserved West Baltimore, MD involving pharmacy students, to better prepare pharmacists to engage in interprofessional team care and meet the needs of a low income culturally diverse older adult population. Discussion will focus on barriers and opportunities to more fully engage pharmacists to support urban residents of low-income housing buildings to optimize medication outcomes and reduce medication-related harm.
Focus on Function in Hospitalized Persons With Dementia: The Impact of Hospital-Acquired Complications
Authors: Boltz Marie , Mion Lorraine 
Published: December 2020

Abstract
Persons with dementia (PWD) are two-three times more likely to be hospitalized as persons without dementia and comprise one fourth of hospitalized older adults. Hospitalization often has a dramatic impact upon the health and disposition of the older PWD. They are at increased risk for hospital acquired complications (HAC) such as functional decline, behavioral symptoms of distress, and delirium, all of which contribute to increased disability, mortality, and long-term nursing home stays. Despite the unprecedented number of PWD admitted to acute care, little attention has focused on their specialized needs and HAC, and how they impact functional recovery. The purpose of this symposium is to describe the incidence of common HACs, and factors that influence their occurrence and presentation in PWD. Utilizing baseline findings from the Family-centered Function-focused Care (Fam-FFC) trial, the presentations will address this objective and discuss the ramifications for functional and cognitive post-acute recovery in PWD. The first presentation will describe the incidence and pharmacologic management of pain in PWD, and its association with common HACs. The second presentation will describe physical activity in PWD on medical units and the validity of the Motionwatch8 actigraphy. The third session will describe differences in common HACs between white and black PWD. The final presentation will examine function-focused goals developed in collaboration with family caregivers and patients, and the functional outcomes associated with goal attainment. Our discussant, Dr. Lorraine Mion, will synthesize the research findings and lead a discussion of future directions for policy and practice in dementia-capable acute care.
Physical Activity in Hospitalized Persons With Dementia: Feasibility and Validity of the Motionwatch 8
Authors: Kuzmik Ashley , Resnick Barbara , Boltz Marie 
Published: December 2020

Abstract
Interventions to prevent functional decline in hospitalized persons with dementia (PWD) require objective measures of physical activity (PA). This secondary analysis described PA using MotionWatch 8 actigraphy and considered the feasibility and validity of the MotionWatch 8 in hospitalized PWD. In the first 320 PWD enrolled in the Fam-FFC study, 261 agreed to wear a MotionWatch for 24 hours within 48 hours of admission. Minutes were recorded in sedentary ( x̄ =1767.35, SD= 1327.43), low (x̄ = 202.52, SD=127.78), moderate (x̄ =7.93, SD=25.80 ), and vigorous activity ( x̄ = .85, SD=4.50). Controlling for age, gender, race and comorbidity, counts of activity were significantly associated with ADL function (t =4.3, p &lt;.001). Sedentary (t =-3.9, p&lt;.001), low (t =2.8, p =.006), and moderate (t =3.0, p =.003) activity, but not vigorous activity were significantly associated with ADL function. MotionWatch 8 appears feasible and valid when evaluating PA among hospitalized PWD.
Post-Diagnostic Support and Occupational Therapy Program for Community-Based Dementia Services
Authors: Shivers Stephani , Robison Julie , DeFrancesco Erica , Keefe Caroline Kate , Sommerer Deidre , Bailey Christine , Ohlheiser Alis 
Published: December 2020

Abstract
Service gaps and the absence of a clear-cut care/symptom management pathway for people recently diagnosed with dementia and their family carepartners motivated LiveWell Dementia Specialists to implement a multi-service post diagnostic support program including three occupational therapy (OT) interventions. Program services include an education series on ‘Resilient Living with Dementia’, family coaching and topical education sessions, and OT services including Care of Persons with Dementia in their Environments (COPE), Skills2Care®, and Home Based Memory Rehabilitation. Program services promote adoption of adaptive strategies and action steps to increase carepartner capacity and enhance quality of life among people with dementia. Participants complete assessments at baseline, program completion, and 4- and/or 10-month follow-up. Carepartners show improvements in dementia knowledge (mean baseline score = 24.6, 4-month = 26.0) and preparedness for caregiving (mean baseline score = 18.1, 4-month = 21.9). Program elements and adaptations of COPE for real world practice are discussed.
Medial Temporal Tau Pathology Is Associated With Verbal Memory
Authors: Bilgel Murat , Ziontz Jacob , Shafer Andrea , Ferrucci Luigi , Wong Dean , Resnick Susan 
Published: December 2020

Abstract
Medial temporal tau pathology is frequently observed in individuals over 70 regardless of cognitive status. To understand the link between tau and cognitive performance, we evaluated tau pathology using 18F-flortaucipir positron emission tomography among 95 cognitively normal participants from the Baltimore Longitudinal Study of Aging. We examined tau levels in early Braak regions (entorhinal cortex and hippocampus) in relation to verbal episodic memory performance concurrent with and prior to the tau scan using linear mixed effects models adjusted for age, sex, amyloid status, and time from PET scan. Higher hippocampal tau burden had a trend-level association with lower concurrent memory performance (p=0.05). Greater tau pathology in the hippocampus and entorhinal cortex was associated with steeper decline in memory performance prior to tau scan (p=0.013 and 0.026, respectively). These findings suggest that therapeutic interventions targeting tau pathology may need to be administered early among cognitively normal individuals to prevent memory decline.
Leveraging Digital Methods to Engage Sexual and Gender Minority Caregivers of People With Dementia
Authors: Anderson Joel , Flatt Jason , Tree Jennifer Jabson , Gross Alden , Rose Karen 
Published: December 2020

Abstract
Digital methods are a way to engage marginalized populations, such as sexual and gender minority (SGM) adults. No study to date has leveraged these methods to engage SGM caregivers of people with dementia. We used digital methods to access SGM caregivers of people with dementia in our study of psychosocial measures of caregiving for recruitment and data collection. Posts on social media and online registries targeted SGM caregivers. The study landing page received 2201 views; 285 caregivers completed the survey. Participants learned of the study most frequently from Facebook (45%). The sample was 84% white, with gay (52%), lesbian (32%), bisexual (11%), and other sexual orientations (5%) and transgender (17%) caregivers represented. While we exceeded goals for inclusion of Latinx (26%) and Native American (4%) caregivers, the number of African American SGM caregivers was lower than projected (7%). Digital methods are effective for engaging SGM caregivers of people with dementia.
Comparing Longitudinal Changes in Physical Activity and Fear of Falling in Non-Fallers, Fallers, and Injurious Fallers
Authors: E Jian-Yu , Schrack Jennifer , Mihailovic Aleksandra , Li Tianjing , Friedman David , West Sheila , Gitlin Laura , Ramulu Pradeep 
Published: December 2020

Abstract
Older adults with visual impairments experience a higher risk of falling, and are more vulnerable to associated adverse health consequences than those with normal vision. We investigated the onset and magnitude of declines in physical activity (PA), and corresponding changes in self-reported fear of falling (FoF) in 234 visually impaired persons (mean age=69.8, 48.7% women) over three years. PA was measured using the Actical hip-worn accelerometer and falls were reported using a calendar. In fully adjusted linear models, PA declined 426 steps/year (p&lt;0.01) and 15.1 active minutes/year (p&lt;0.01) among injurious fallers compared to non-fallers; PA did not change among non-injurious fallers. No longitudinal declines in FoF scores were observed. Among visually impaired older adults, an injurious fall contributed to subsequent declines in activity, although FoF remained unchanged. Further longitudinal research is warranted to better understand how different groups respond to falls, either by behavioral changes and/or changes in FoF.
Older Veterans With Chronic Pain Who Persist in Group Exercise Show Improved Mobility
Authors: Addison Odessa , Giffuni Jamie , Kelly Megan , Hogans Beth , Katzel Leslie , Morey Miriam 
Published: December 2020

Abstract
Approximately 50% of older adults receiving care at VA are Veterans with chronic pain (V-CP). While physical activity can reduce chronic pain and increase mobility, little is known about group exercise (GE) effects for V-CP. We hypothesized that attrition may limit GE effectiveness. In this study, we retrospectively compared program attrition and participant mobility at three-months of Gerofit GE. At baseline, Older V-CP (N=21) had lower mobility assessment scores (gait speed, 6MW, chair stands, TUG: 1.04 m/s, 443 yd, 11, 9.35s vs. 1.09 m/s, 463 yd, 12, 8.19s respectively) compared to unaffected Veterans. Three-month attrition was higher for older V-CP (54% vs 39%). For those completing three months GE, gains in mobility were similar. We conclude that Veterans with chronic pain are less likely to persist in group exercise but those who persist benefit much like those without pain. Further study is needed to understand successful exercise adherence.