bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metrics of Phenotypic Aging From the Energetics Perspective
Authors: Kuo Pei-Lun , Shardell Michelle , Schrack Jennifer , Levine Morgan , Simonsick Eleanor , Ferrucci Luigi 
Published: December 2020

Abstract
Identifying the most critical metrics of aging is an ongoing challenge due to a lack of comprehensive measurements and heterogeneity of the aging process. Using the Baltimore Longitudinal Study of Aging, we developed a conceptual framework to identify metrics of aging that capture the hierarchical and temporal relationships between functional aging, phenotypic aging, and biological aging based on four hypothesized domains: energy regulation, body composition, homeostatic mechanisms, and neurodegeneration. Focusing on the energetics domain, we examined trajectories of eight phenotypes using more than 10 years of longitudinal data. The standardized Cronbach’s alpha for these variables was 0.80, providing construct validity of our concept. We further implemented item response theory to integrate these phenotypes into a summarized energy score. Linear mixed models were used to assess the cross-sectional and longitudinal associations between the summarized energy score and physical functioning as measured by gait speed and time to walk 400m as quickly as possible (number of participants ~ 811, number of observations ~ 1700). After adjusting for age, sex, weight, and height, a higher summarized energy score was independently associated with faster baseline gait speed (0.13 m/s, p&lt;0.001 ) and faster 400m time (-35.3 seconds, p&lt;0.001), and longitudinally associated with slower gait speed decline (0.08 m/s/decade, p&lt;0.001) and slower 400m time increase (-37.8 secs/decade, p&lt;0.001). This work demonstrates the utility of our energetics domain-based summarized score. Moving forward, it will be important to clarify relationships between this summarized score and other functional metrics and assess its generalizability to the other cohorts.
SARC-F Capacity to Tracking Sarcopenia in Women From Manaus-Am
Authors: Faber Myrian , Baptista Fatima 
Published: December 2020

Abstract
This study aimed to analyze the performance of SARC-F for the identification of sarcopenia in women from Manaus. For the analysis of the performance of the SARC-F, the criteria defined by the EWGSOP (2018) and the SDOC (2019) were considered. The sample consisted of 236 women aged 66.27±5.76 years. In addition to the SARC-F, a dynamometer was used to assess the muscle strength and gait speed was determined on a 2.44 m course. To identify sarcopenia, the following cut-off valueswere used: SARC-F ≥ 4 points; grip strength: EWGSOP &lt;27kg for men and 16kg for women, SDOC &lt;35.5kg for men and &lt;20.0 kg for women; grip over body mass index (BMI, kg/m2) &lt;1.05 for men and 0.79 for women; grip over body weight (BW, kg) &lt;0.45 for men and &lt;0.34 for women; gait speed ≤ 0.8 m/s for both men and women. The results revealed a prevalence of sarcopenia in 54% of the sample. The Kappa statistic intended to analyze the agreement between the SARC-F and the grip strength, the grip strength corrected for BMI or for BM, and the gait speed. The cross-classification analysis showed linear weighted Kappa coefficients near 0 with exception of gait speed (0.264±0.054, agreement in 61.2% of the participants) and grip strength when the cut off is 20 kg (0.248±0.062 - agreement in 63% of the participants). Cross-classification analysis between SARC-F and objective measures of physical capacity (grip strength and gait speed) showed linear weighted Kappa coefficients with slight or fair agreement in women from Manaus.
The Impact of ApoE e4 Allele in the Effects of Physical Activity Interventions on Major Mobility Disability Incidence
Authors: Cenko Erta , Manini Todd 
Published: December 2020

Abstract
The apolipoprotein E (ApoE) e4 polymorphism is traditionally linked to increased rates of cognitive impairments and Alzheimer’s Disease. Recently, however, studies have connected ApoE e4 to self-reported mobility disability in those without cognitive impairment. We aimed to estimate the extent to which ApoE status is associated with incident major mobility disability (MMD) and whether it modifies the known beneficial effects of physical activity on incident MMD. Data were from 1,372 participants 70+ years old at risk for mobility impairments, enrolled in The LIFE Study. Participants were randomized to a structured physical activity (PA) or a health education program. The primary outcome was MMD, defined as the inability to walk 400 meters and measured every 6 months for an average follow-up period of 2.6 years. We used proportional hazards regression to examine the main effect of ApoE allele status and interaction with intervention group on MMD incidence. Cumulative MMD incident rates were similar in ApoE-e2 (31.46%), ApoE e3 (33.41%), and ApoE-e4 (33.33%) carriers. Compared to the common ApoE-e3, MMD risk was similar in ApoE-e2 (hazard ratio [HR], 0.945 [95%CI, 0.70-1.27], P=0.71) and ApoE-e4 carriers ([HR], 1.187 [95%CI, 0.95-1.48], P=0.41). Additionally, ApoE carrier status did not modify the positive effect that a PA intervention had on MMD risk (interaction p-value &gt; 0.20). These results suggest that ApoE carrier status is not associated with incident mobility disability. ApoE carrier status does not impact the effect a structured PA program has on reducing the risk of MMD in older adults.
Traveling the Path to Stroke Caregiver Readiness
Authors: Lutz Barbara , Camicia Michelle 
Published: December 2020

Abstract
Family members are often poorly prepared to assume the caregiving role post-stroke leaving them feeling overwhelmed, frustrated, and abandoned by the healthcare system leading to physical, mental, and emotional strain. To address this, we developed and tested the Preparedness Assessment for the Transition Home after stroke (PATH-s) instrument based on a theoretical framework for improving stroke caregiver readiness. Consecutive studies were conducted over the past 10 years to 1) develop the caregiver readiness theoretical model identifying gaps in caregiver preparation in 80 interviews with caregivers and stroke survivors as they transitioned home from inpatient rehabilitation care; 2) develop and validate the PATH-s instrument with 183 caregiver-stroke survivor dyads, and 3) develop and implement a corresponding catalogue of interventions developed in consultation with 5 expert rehabilitation nurse case managers to improve stroke caregiver readiness. The Improving Caregiver Readiness Model has 2 preparedness domains; commitment and capacity and six sub-domains. In a factor analysis each domain/sub-domain subscale in the PATH-s demonstrated satisfactory internal consistency (a=0.69-0.86). The overall mean score was 3.11 (range 1.68 to 4.00) with high internal consistency reliability (a=0.90). The PATH-s is highly correlated with the Preparedness for Caregiving Scale. The stroke survivor’s total FIM score at discharge had a small but significant correlation with the PATH-s. Case managers find the PATH-s results and corresponding interventions helpful in tailoring transitional care plans. Caregivers worldwide describe the negative impacts of providing stroke care post-discharge. The Path to Stroke Caregiver Readiness Program shows promise for improving stroke caregiver preparation for discharge home.
Unmet Caregiving Needs Are Associated With Cognitive Functioning Among Older Sepsis Survivors
Authors: Chase Jo-Ana , Jordan Lizyeka , Whitehouse Christina , Bowles Kathryn 
Published: December 2020

Abstract
Sepsis survivorship is associated with cognitive decline and complex post-acute care needs. Family caregivers may be unprepared to manage these needs, resulting in decline or no improvement in patient outcomes. Using a national dataset of Medicare beneficiaries who were discharged from the hospital for sepsis and received post-acute HHC between 2013 and 2014 (n=165,228), we examined the relationship between unmet caregiving needs and improvement or decline in cognitive functioning. Multivariate logistic regression was used to determine associations between unmet caregiving needs at the start of HHC and changes in cognitive functioning. Unmet caregiving needs included seven items from the start of care Outcome and Assessment Information Set (OASIS). Changes in cognitive functioning were measured using the start of care and discharge OASIS assessments. Twenty-four percent of patients either declined or did not improve in cognitive functioning from HHC admission to discharge, with variation seen by unmet need type. Sepsis survivors with unmet caregiving needs for activities of daily living assistance (OR 1.05, 95% CI 1.01, 1.09), medication assistance (OR 1.06, 95% CI 1.02,1.10), and supervision and safety assistance (OR 1.110, 95% CI 1.06,1.16) were more likely to decline or not improve in cognitive functioning, even after accounting for clinical and demographic characteristics. Older sepsis survivors with both cognitive impairment and unmet caregiving needs in the post-acute HHC setting are at high-risk for worsening cognition. Alerting the care team of cognitively impaired sepsis survivors with unmet caregiving needs may trigger evidence-based strategies to enhance caregiver training and reduce unmet caregiving needs.
Disability Prevention Program Improves Life-Space and Falls Efficacy: A Randomized Controlled Trial
Authors: Liu Minhui , Xue Qian-Li , Gitlin Laura , Wolff Jennifer , Guralnik Jack , Leff Bruce , Szanton Sarah 
Published: December 2020

Abstract
Life-space and falls efficacy are essential to physical independence and consistently predict disabilities. However, it remains unknown whether the CAPABLE, a disability prevention program, improves life-space and falls efficacy in older adults. We evaluated the effects of a home-based disability prevention program on life-space (N=194) and falls efficacy (N=233) among low-income older adults with restricted daily activities. The CAPABLE intervention consists of up to 6 one-hour home visits with an Occupational Therapist (OT), up to 4 one-hour home visits with a Register Nurse (RN), and up to $1300 worth of home repairs, modifications, and assistive devices with a handyman, during four months. Life-space and falls efficacy were measured by the Telephone Assessment of Mobility for homebound older adults and the Tinetti Falls Efficacy Scale at baseline and five months, respectively. Multinomial logistic regression and generalized linear models were used for data analyses. Participants in both samples were, on average, 75 years, predominantly black (86%) and female (85%-86%). Compared to participants in the control group, participants receiving the intervention were more likely to have improved (Odds Ratio [OR]: 2.10, 95% CI: 1.06-4.20) or unchanged overall life-space (OR: 2.62, 95% CI: 1.10-6.27) vs. decreased overall life-space. Participants who received the intervention also had significantly higher falls efficacy in performing daily activities (exponentiated coefficient: 1.11, 95% CI: 1.04-1.19). Life-space and falls efficacy can be significantly improved by CAPABLE program. These findings provide more evidence for the reasons for the increased physical independence.
Urban-Rural Differences in Sarcopenia Prevalence and Nutritional Risk Factors: The NHANES (2001–2002 and 2011–2014)
Authors: Aziz Jason , Reid Kieran , Batsis John , Fielding Roger 
Published: December 2020

Abstract
Background: Older adults living in rural areas experience health inequities compared to their urban counterparts. These include comorbidities, poor diet and physical inactivity; known risk factors for sarcopenia. No studies examining urban-rural differences in the prevalence of sarcopenia and slow gait speed among older adults in the United States exist. Objective: To compare the prevalence of sarcopenia and slow gait speed between urban and rural older adults living in the United States. As a secondary aim, we examined relationships between rural residency, total energy and total protein on gait speed and grip strength. Methods: We performed a secondary data analysis of two cohorts in the continuous NHANES (2001-2002 and 2011-2014), using gait speed or grip strength data, along with urban-rural status, dietary, examination, questionnaire and demographic data in older (≥ 60 yrs.) adults. Results: The prevalence of GripBMI weakness was higher in urban vs. rural participants (27.4% vs. 19.2%), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). Total energy, total protein and relative protein intakes were similar between urban and rural participants. Total energy intake was associated with gait speed and grip strength. Conclusions: Older adults living in urban areas of the United States, were weaker compared to their rural counterparts. Rural residency was not associated with gait speed or grip strength. Total energy intake was associated with slower gait speed but higher grip strength. This report is the first to examine urban-rural differences in sarcopenia and slow gait speed in older adults living in the United States.
Interventions for Improving Psychosocial Adjustment in Nursing Home Residents: A Network Meta-Analysis
Authors: Zhang Yanyan , Xiao Huimin , Yong Binbin 
Published: December 2020

Abstract
This study aimed to identify the evidence of interventions for improving psychosocial adjustment in older adults relocating to nursing homes. We followed PRISMA-NMA guidelines to conduct a network meta-analysis. 12 electric databases were used to search for eligible randomized controlled trials (RCTs) and clinical trials (CCTs) from inception to August 27th, 2019. Two reviewers independently conducted article screening, data extraction, and risk of bias appraisal with the Revised Cochrane risk-of-bias tool for RCT and Risk Of Bias for CCT. The network plots were plotted to provide a visual representation of the evidence base. Bayesian fixed-effects pairwise and network meta-analysis were exhibited in the forest plot. A Bayesian network meta-analysis was performed on 30 eligible RCTs with 2119 participants, and 12 eligible CCTs with 491 participants. The quality of the most included studies was rated as moderate in RCTs and low in CCTs. Treatment effects showed that compared to conventional treatment, group reminiscence and group counseling resulted in significant improvements in loneliness (MD: 11, 95%, CI: 2.7–17, SUCRA: 99.5%; MD: 7.7, 95%, CI: 0.53–15, SUCRA: 53.9%, respectively). Similar results were obtained for art therapy (MD: 5.5, 95%CI: 0.8–10, SUCRA: 97.3%) in self-esteem. The model fit was good, and the inconsistency was low. Group reminiscence, group counseling, and art therapy are recommended for reducing loneliness and enhance self-esteem in nursing practice.
Combining tDCS With a Motor-Cognitive Task to Reduce the Negative Impact of Dual-Tasking on the Gait of Older Adults
Authors: Hausdorff Jeffrey , Schneider Nofar , Brozgol Marina , Thumm Pablo Cornejo , Giladi Nir , Katz Rachel , Mirelman Anat , Manor Brad 
Published: December 2020

Abstract
The simultaneous performance of a secondary task while walking (i.e., dual tasking) increases motor-cognitive interference and fall risk in older adults. Combining transcranial direct current stimulation (tDCS) with the concurrent performance of a task that putatively involves the same brain networks targeted by the tDCS may reduce the negative impact of dual-tasking on walking. We examined whether tDCS applied while walking reduces the dual-task costs to gait and whether this combination is better than tDCS alone or walking alone (with sham stimulation). In 25 healthy older adults (aged 75.7±10.5yrs), a double-blind, within-subject, cross-over pilot study evaluated the acute after-effects of 20 minutes of tDCS targeting the primary motor cortex and the dorsal lateral pre frontal cortex during three separate sessions:1) tDCS while walking on a treadmill in a virtual-reality environment (tDCS+walking), 2) tDCS while seated (tDCS+seated), and 3) walking in the virtual-reality environment with sham tDCS (sham+walking). The complex walking condition taxed motor and cognitive abilities. During each session, single- and dual-task walking and cognitive function were assessed before and immediately after stimulation. Compared to pre-tDCS performance, tDCS+walking reduced the dual-task cost to gait speed (p=0.004) and other gait features (e.g., variability p=0.02), and improved (p&lt;0.001) executive function (Stroop interference score). tDCS+seated and sham+walking did not affect the dual-task cost to gait speed (p&gt;0.17). These initial findings demonstrate that tDCS delivered during challenging walking ameliorates dual-task gait and executive function in older adults, suggesting that the concurrent performance of related tasks enhances the efficacy of the neural stimulation and mobility.
Neural Inefficiency During Dual-Task Walking in Older Adults: The Moderating Effect of Brain Morphology
Authors: Ross Daliah , Wagshul Mark , Izzetoglu Meltem , Holtzer Roee 
Published: December 2020

Abstract
Aging is accompanied by changes in cognitive, physical, and brain function. Research has found increased activation in the prefrontal cortex (PFC) in dual-task-walk (DTW) as compared to single-task walk (STW) due to increased cognitive demands in the former condition. Older adults have more difficulty with DTW than younger adults, and difficulty with DTW has been found to predict functional decline in aging. As the population gets older, it is important to identify biomarkers predictive of functional decline. The neural inefficiency hypothesis posits that some people, including older adults, utilize more neural resources than others without showing benefits to behavioral performance. We examined the moderating effect of cortical thickness on PFC activation from STW to DTW. We predicted that less cortical thickness would be associated with increased PFC activation but without benefit to behavioral performance, to compensate for limited neural resources. Participants were 55 right-handed community-residing healthy older adults (mean age = 74.84 + 4.97; %female = 49.1). Cortical thickness was measured via MRI. Activation in the PFC was measured via functional near-infrared spectroscopy-derived (fNIRS) oxygenated hemoglobin (HbO2) levels. Analyses controlled for behavioral performance. Linear-mixed-effects models revealed that cortical thickness in several brain regions significantly moderated the increase in HbO2 from STW to DTW, p &lt; 0.01. Thinner cortex, in regions implicated in walking and cognition, was associated with a greater increase in HbO2 levels. Supporting the neural inefficiency hypothesis, results suggest that older adults with greater cortical thinning over-activate the PFC during attention-demanding walking.
Memory Matters: Education About Cognition in Two Naturally Occurring Retirement Communities
Authors: Hinrichsen Gregory , Fogel Joyce , Foerg Anne , Leipzig Rosanne 
Published: December 2020

Abstract
“Memory Matters” is a program for older residents and staff of two New York City naturally occurring retirement communities (NORC). The program is in its third year of implementation with the broader goals of enhancing resident knowledge of normal cognitive changes and cognitive impairment including risk factors for dementia. The emphasis is on engaging residents to improve brain health. With staff, goals are to enhance their capacity to understand, identify, refer, and support residents with cognitive impairment. This is done with case conferences, consultation, lectures, and workshops. For residents, the program provides lectures, interactive workshops, films, as well as periodic “Ask the Doc” individual meetings where residents can discuss cognitive and related concerns. A geriatrician and geropsychologist conduct these activities with invited guest speakers including geriatric fellows. Yearly, approximately 180 unique individuals are served in this program. Resident program satisfaction surveys were favorable. For example, 80% of residents replied “a lot” to the question, “Did you find this presentation interesting?”, in the past six months of programming. Building on these efforts, we conducted a formal survey with 249 resident participants of one NORC that found: 15% have dementia/experience memory loss; 12% live with someone with dementia/ memory issues; 16% identify as a dementia caregiver; and 75% are concerned about developing dementia. We then hosted a community-wide forum to discuss survey results. Our experience has underscored the need for expansion of our efforts. Future plans include creating a “dementia friendly” NORC. Funded by the UJA-Federation of New York.
Patterns of Cognitive Function Trajectory and Their Associated Factors in Korean Older Women in Single Households
Authors: Yoon DoKyung , Jun Hey Jung , Lee Sun Ah 
Published: December 2020

Abstract
The aim of this study was to identify distinct patterns of cognitive function trajectory among Korean older women in single households and to investigate their associated factors. We used data from the five waves of the Korean Longitudinal Study of Ageing (KLoSA), a nationally representative longitudinal survey collected biennially from 2006 to 2014. The sample was 244 women aged 65 or above who had maintained the single household status for the five waves. Using Growth Mixture Modeling, distinct patterns of cognitive function trajectory were identified. Then, multinomial regression analysis was employed to examine the associations between identified trajectories and various factors (socio-demographic, health-related, psychological, and interpersonal factors at wave 1). Results showed that there were three distinct patterns of cognitive function trajectory: ‘maintaining-low’ (20.9%), ‘moderate-decreasing’ (33.6%), and ‘maintaining-high’ (45.5%). Specifically, compared to the ‘maintaining-low’ group, younger women were more likely to belong to the ‘moderate-decreasing’ group and the ‘maintaining-high’ group. Furthermore, those with higher household income, and who participated in more various types of social activities (e.g., participation in leisure/culture/sports clubs, volunteering work) were more likely to belong to the ‘maintaining-high’ group. Compared to the ‘moderate-decreasing’ group, those who were younger and participated in more various types of social activities were more likely to belong to the ‘maintaining-high’ group. Findings suggest that socioeconomic status and social engagements may be critical for cognitive function among older women in single households, and encouraging them to remain socially active may help prevent poorer cognitive outcomes.