bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inter-Species Interactions in the Fly Gut Microbiome Shape Aging
Authors: Ludington William 
Published: December 2020

Abstract
Gut bacteria affect key aspects of host fitness, including fecundity and lifespan. However, it is unclear to what extent individual species versus complex interactions drive host fitness. We dissected the natural microbiome of Drosophila melanogaster and revealed that interactions between bacteria shape host fitness through life history tradeoffs. Empirically, we made germ-free flies and colonized them with each possible combination of the five core species of bacteria. We measured the microbiome and fly fitness traits including reproduction and lifespan. Notably, flies that reproduced more died sooner. Removing bacteria after reproduction extended lifespan in most cases, suggesting an indirect tradeoff. However, in certain cases, antibiotics did not extend lifespan, indicating a metabolic memory of the microbiome. Overall, complex interactions within the microbiome had significant effects on host fitness. We suggest that model systems with reduced complexity will be instrumental in elucidating mechanisms of microbiome-host interactions.
Circadian Regulation of Mitochondrial Uncoupling and Lifespan
Authors: Ulgherait Matthew 
Published: December 2020

Abstract
Because old age is associated with defects in circadian rhythm, loss of circadian regulation is thought to be pathogenic and contribute to mortality. We show instead that loss of specific circadian clock components Period (Per) and Timeless (Tim) in male Drosophila significantly extends lifespan. This lifespan extension is not mediated by canonical diet-restriction longevity pathways, but is due to altered cellular respiration via increased mitochondrial uncoupling. Lifespan extension of per mutants depends on mitochondrial uncoupling in the intestine. Moreover, up-regulated uncoupling protein UCP4C in intestinal stem cells and enteroblasts is sufficient to extend lifespan and preserve proliferative homeostasis in the gut with age. Consistent with inducing a metabolic state that prevents over-proliferation, mitochondrial uncoupling drugs also extend lifespan and inhibit intestinal stem cell overproliferation due to aging or even tumorigenesis. These results demonstrate that circadian-regulated intestinal mitochondrial uncoupling controls longevity in Drosophila and suggest a new potential anti-aging therapeutic target.
Uncovering the Molecular Underpinnings of Oxidative Stress-Induced Senescence
Authors: Carpenter Melissa , Pomatto Laura Corrales-Diaz , Kato Jonathan , Wong Sarah , Bosompra Oye , Bernier Michel , de Cabo Rafael 
Published: December 2020

Abstract
The aging process is sexually dimorphic, with males having higher occurrence rates of cancer and facing a greater risk of mortality. Sexual dimorphism in the response to cellular damage may account for distinct phenotypic changes with age as they relate to the accumulation of cellular damage leading to cancer. Cellular senescence triggers permanent cell cycle arrest in order to protect against malignant growth. However, organismal senescence increases with age and is associated with the release of pro-inflammatory signals (cytokines, chemokines, and proteases) known as the ‘senescence-associated-secretory-phenotype’ (SASP) that, if unchecked, accelerates tissue damage and creates a microenvironment ripe for cancer development. In this study, we hypothesized that sexual disparities in mortality and cancer prevalence stems from differences in the rate of accumulation of senescent cells in mice. Male and female C57BL/6J mice were fed ad libitum or subjected to 30% calorie restriction, a nutritional intervention known to delay the onset of various cancers and prevent senescent cell accumulation. Primary skin fibroblasts were collected longitudinally to allow measurement of cell proliferation, wound healing and the release of SASP factors. The results indicate that when compared to males, fibroblasts of CR-fed females showed significant improvements in cell growth rate, wound healing and SASP markers vs. AL controls. Work is underway to determine how sex influences cellular protective pathways. Thus, like other cell processes, cellular senescence is unequal between males and females and CR delays the emergence of the senescence phenotype.
A Comparison of Home Health Care Between Finland and South Korea in Long-Term Care Services
Authors: Park Jihyun , Kim Suhyun 
Published: December 2020

Abstract
Population aging is one of the significant global issues. Long-term care is emphasized as “aging in place,” and it is known that home and community-based service is a cost-effective way to achieve this. Over ten years have passed since the introduction of long-term care insurance in Korea, and it is necessary to improve home health care in long-term care. The aim of this study was to identify the measures that must be undertaken for enhancing home health care in Korea by comparing it to the home health care in Finland. The data were collected via a literature review, expert interview, and field survey in Kuopio, Eastern Finland, from March 16 to 23, 2018. Based on the comparison between Korean and Finnish home health care, some issues related to home health care in Korea that need to be resolved were identified: the complex process involved in availing home health care, low utilization rate, higher cost than home health aide services in long-term care, and undifferentiated roles in home health care between registered nurses and nurse assistants. Several strategies could be utilized to enhance home health care in Korea, such as a simplified procedure to use home health care, clarification of roles between registered nurses and nurse assistants in home care, supervision of the integration of home care services by registered nurses, and an expansion of home health care into comprehensive assessment and nursing activities for chronic illness care and health promotion.
Substance Use Disorder–Related Hospitalizations and ED Use in Those Returning to Community From Prison in Later Life
Authors: Barry Lisa , Steffens David , Covinsky Kenneth , Conwell Yeates , Byers Amy 
Published: December 2020

Abstract
High rates of substance use disorders (SUDs) in persons age 50 and older are concerning. Those reentering the community in later life after incarceration are especially at risk. We determined if later-life prison release increases risk of SUD-related hospitalizations and ED visits in a national sample of veterans (N=7,671) released from prison between 2012 to 2014 and matched never-incarcerated controls (N=7,671). Later-life prison release was associated with increased risk of any SUD-related hospitalization/ED visit (2907.1 vs. 465.0 per 100,000/year; adjusted HR=2.67; 95% CI, 2.11-3.36) and 3-fold risk of hospitalizations/ED visits due to alcohol use disorder (1955.4.1 vs. 282.6 per 100,000/year; adjusted HR=3.04; 95% CI, 2.24-4.13) and drug use disorder (1586.1 vs. 252.0 per 100,000/year; adjusted HR=3.09; 95% CI, 2.23-4.30). Those reentering the community in later life after prison are at higher risk of experiencing SUD-related hospitalizations or ED visits. Prevention and intervention efforts targeting later-life prison-to-community care transitions are needed. Part of a symposium sponsored by the Aging, Alcohol and Addictions Interest Group.
Caregiving Arrangements and Health Outcomes of Chinese Older Adults With Disability in Cross-National Settings
Authors: Wang Jing , Wu Bei 
Published: December 2020

Abstract
This symposium focuses on the wellbeing of older adults with disability/cognitive impairment and their family caregivers. More specifically, it aims to understand how familly support, community resources utilization, internal migration, and immigrant status impact older adults’ caregiving arrangement, health outcomes and end-of-life preferences and family caregivers’ caregiving burden in China and the U.S. The first study explored how perceived spousal relationships and support impact dyadic experiences of living with cognitive impairment through a person-centered care lens during a three-year period. The second presentation examined the association between adult children’s support and the trajectories of depressive symptom level among Chinese older adults with disabilities. The third investigated how family relationship and immigrant status matter in advanced care planning (ACP) engagement and end-of-life preferences over burial plan among US-born and foreign-born older Chinese Americans living in Honolulu, Hawaii. The fourth study study explored family caregivers’ caregiving burden for community-dwelling patients with dementia and its associated factors. The last study conducted an inventory of longitudinal aging survey datasets to stimulate research on intersection of migration and caregiving arrangement. It paved the way to use existing high-quality datasets to examine the significant impact of massive rural-to-urban migration on caregiving arrangement among Chinese older adults. This symposium presents empirical evidence of the impact of family, migration and culture-related factors on caregiving arrangement and health outcomes of Chinese older adults. The presenters emphasize the importance of providing family-centered care and design culturally sensitive interventions to improve the health outcomes of older adults.
Caregiver Burden of Family Caregivers of Patients With Dementia in a Shanghai Community
Authors: Li Juan , Liu Zhijian , Yin You 
Published: December 2020

Abstract
This study explored the level of and factors related to Chinese dementia family caregiver burden. We recruited 109 dyads of patients with dementia and their family caregivers from communities in Shanghai, China. Caregiver burden was assessed by Caregiver Burden Inventory. We used multivariate linear regression model to investigate factors associated with caregiver burden, including patients’ socio-demographic information, cognitive function, ADL, neuropsychiatric symptoms, caregivers’ depression, coping strategy, social support and community service utilization. The level of caregiver burden was moderate (65.92±16.74). The patients’ cognitive function and social support were negatively associated with caregiver burden (β=﹣0.850, p＜0.01, β=﹣1.787, p=0.044, respectively). Caregivers’ depression and community service utilization were positively associated with caregiver burden (β=2.109, p＜0.01,β=1.215, p＜0.01, respectively). These findings suggest enhancing social support and reducing depression of caregivers may have the potential of decreasing caregiver burden.
Analyzing Nursing Home Complaints: From Substantiated Allegation to Deficiency Citations
Authors: Bhattacharyya Kallol Kumar , Peterson Lindsay , Bowblis John , Hyer Kathryn 
Published: December 2020

Abstract
Complaints provide important information to consumers about nursing homes (NHs). Complaints that are substantiated often lead to an investigation and potentially a deficiency citation. The purpose of this study is to understand the relationship between substantiated complaints and deficiency citations. Because a complaint may contain multiple allegations, and the data do not identify which allegation(s) lead to a complaint’s substantiation, we identified all substantiated single allegation complaints for NHs in 2017. Our data were drawn from federally collected NH complaint and inspection records. Among the 369 substantiated single-allegation complaints, we found most were categorized as quality of care (31.7%), resident abuse (17.3%), or resident neglect (14.1%). Of the deficiency citations resulting from complaints in our sample, 27.9% were categorized as quality of care and 19.5% were in the category of resident behavior and facility practices, which includes abuse and neglect. While two-thirds (N=239) of the substantiated complaints generated from 1 to 19 deficiency citations, nearly one third had no citations. Surprisingly, 28% of substantiated abuse and neglect allegations resulted in no deficiency citations. More surprisingly, a fifth of complaints that were categorized as “immediate jeopardy” at intake did not result in any deficiency citations. We also found a number of asymmetries in the allegation categories suggesting different processes by Centers for Medicare and Medicaid Services (CMS) region. These results suggest that the compliant investigation process warrants further investigation. Other policy and practice implications, including the need for better and more uniform investigation processes and staff training, will be discussed.
Resilience in Incident Hemodialysis: Characterization and Outcome Prediction
Authors: Bandeen-Roche Karen , Zhu Jiafeng , Crews Deidra , McAdams-DeMarco Mara , Buta Brian , Varadhan Ravi , Walston Jeremy 
Published: December 2020

Abstract
The Resiliency in Dialysis Initiation (ReDI) Study aims to develop physical resilience signatures in older adults initiating hemodialysis. Study design—comprising a pilot, confirmatory study, and secondary data analyses—will be presented. So also will a method for characterizing resilience phenotypes—using mixed-model analysis of SF-36 subscale trajectories—among participants of age 55 and older who had undergone hemodialysis in the Choices for Healthy Outcomes in Caring for ESRD study (n=485). Analyses revealed stable, improving, and declining phenotypes. In Cox models, both baseline phenotypic status and trajectory type predicted mortality after adjusting for age, CVD status, and CHF (global Wald test for trajectory type P-value=0.020 for vitality; 0.030 for general health). These analyses evidence usefulness of resilience phenotypes as markers of adverse outcome risk and foreshadow application to novel ReDI data.
Risk Factors for Poor Recovery After Total Knee Replacement Among Older Adults in the FORCE-TJR Cohort
Authors: Laskow Thomas , Zhu Jiafeng , Buta Brian , Sieber Frederick , Bandeen-Roche Karen , Walston Jeremy , Franklin Patricia , Varadhan Ravi 
Published: December 2020

Abstract
Total knee replacement (TKR) is a common procedure in older adults with broad variability in outcomes. We sought to identify factors that contribute to resilient outcomes in 7,239 older adults (age 60 or older) who underwent TKR in the TJR-FORCE, a prospective registry of total joint replacement. Outcomes utilized were bodily pain and physical component score (PCS) from the Short Form 36 Health Survey (SF-36), at pre-op, 1-year, and 2-year post-procedure. Participants were grouped according to their outcome trajectories as “improving”, “worsening”, “variable,” or “stable.” Multinomial regression (with 4 outcome categories) was used to evaluate demographic risk factors (age, gender, BMI, marital status, education, smoking history, comorbidity count, household income). Older age, larger comorbidity count, low-income, smoking, and being unmarried were significant risk factors for poor recovery (not “improving”) in terms of bodily pain and physical component score. Next steps include evaluating risk factors for resilience outcomes in prospective studies.
Digital Interventions to Promote Health and Well-Being of Older Adults
Authors: Gutman Gloria , Shade Marcia 
Published: December 2020

Abstract
The population of older adults is on the rise and so is their adoption of technology. According to the Pew Research Center, growing numbers of older adults are using smartphones, tablets, and the internet. Technology can also be an innovative and accessible way to deliver interventions that promote positive health outcomes. But implementing and evaluating digital interventions, especially those targeted to cognitively frail or otherwise vulnerable older adults, is not easy. The first presentation in this international interdisciplinary symposium sets the stage for discussing some of the barriers encountered. Specifically, it addresses the issue of compliance of adults with Mild Cognitive Impairment (MCI) while using internet-based cognitive behavioral therapy for sleep disturbance. The second presentation described a digital tool to screen and interview older adults in a hospital emergency department who may be experiencing mistreatment. This is followed by a study of use of voice assistant reminders to help aging adults adhere to daily completion of a diary to self-monitor pain symptoms. The fourth presentation describes a feasibility study of a digital screen-based device to calm long-term care home residents exhibiting disruptive Behavioral and Psychological Symptoms of Dementia. Symposium speakers and participants will be encouraged to dialogue on how some of the implementation and evaluation barriers described might be overcome or avoided as well as to share success stories from their own research on digital interventions for older adults living at home, in congregate housing or in hospital settings.
Dopaminergic Signaling: Driver of Mobility Resilience and Moderator of Response to Pharmacotherapy
Authors: Rosano Caterina , Rosso Andrea , Bohnen Nicolaas 
Published: December 2020

Abstract
Although effective mobility is the end result of the functional capacity of multiple systems, some adults appear resilient and maintain higher mobility later in life. Epidemiological studies suggest up to 20% of adults aged 65 and older maintain fast walking speed in the presence of multi-system impairments. What could be the reason for such mobility resilience? In this symposium, we focus on the brain dopaminergic signaling as a potential driver of mobility resilience. We examine the genetic val158met polymorphism of catechol-O-methyltransferase (COMT), an enzyme regulating dopaminergic signaling in the brain. The Met allele results in higher tonic dopamine levels; the Val allele results in lower tonic dopamine levels. The influence of COMT polymorphism on mobility is known for Parkinson’s disease (PD) and neurodegenerative conditions, but it not clear for asymptomatic adults aged 65 living in the community. We present data from the Cardiovascular Health Study, the Health Aging Body Composition Study, and several neuropharmachological studies with extensive information on PD ascertainment, medications, and health characteristics. We test the hypothesis that the Met allele of the COMT gene is associated with a) lower fall risk (Rosso), b) slower decline in gait reserve (Sprague), c) less gait slowing due to frailty (Mannon), d) more favorable response to pharmacotherapy in older adults without PD (Bohnen). Our results suggest a unique modulatory capacity of dopaminergic-related genes that may favor mobility resilience and predict better response to therapy. Our data provide clues for novel targeted interventions to delay physical disability in older adults.
Correlates of Skilled Nursing Facility (SNF) Performance in the SNF Value-Based Purchasing Program
Authors: Andersen Dan , Binu Sherly , Sacca Mike 
Published: December 2020

Abstract
We examined the results of the 2020 skilled nursing facility (SNF) value-based purchasing (SNF VBP) program to identify correlates and potential drivers of SNF performance in this program. The SNF VBP program provides incentive payments to SNFs based on their performance on a risk-adjusted hospital readmission measure (i.e., the rate at which SNF residents are admitted back to the hospital within 30-days of being admitted to the SNF). SNFs are assessed on this measure for both improvement compared to their historical baseline and overall achievement compared to their peers. All SNFs that are covered under Medicare’s prospective payment system are included in the SNF VBP program. We performed analyses to assess the correlation between individual SNFs’ performance in the 2020 SNF VBP (n=15,201), which is based on actual performance in fiscal year 2018, with contemporaneous matched data related to SNF health inspection results, staffing, and performance on quality measures (these data form the basis of the five-star quality rating system on the Nursing Home Compare website). We also examined longitudinal trends in these non-SNF VBP program variables and their association with changes in SNF performance in the SNF VBP program. We controlled for important SNF-specific factors (e.g., for-profit status, connected to a hospital). We found strong contemporaneous and longitudinal associations between SNF VBP program performance and some, but not all, of these factors. Our findings are supported by decades of empirical research in SNF quality and highlight potential policy alternatives that could further incentivize high quality care in SNFs.
Dyads in Dementia Care: An International Perspective on Research Challenges and Opportunities
Authors: Boltz Marie , Wolf-Ostermann Karin , Maslow Katie 
Published: December 2020

Abstract
Dementia poses a societal challenge that is life-changing not only for persons with dementia (PWD) but also for family members and friends (informal carers) directly involved in the care arrangement. Informal carers (IC) have typically poorer outcomes in terms of well-being, quality of life (QoL), health status, and use of health care resources. Dyads of PWD and IC living with dementia are characterized by strong reciprocal relationships and complex living contexts. Therefore, research should investigate home based dementia caregiving from a dyadic perspective to yield interventions that support the PWD, the IC, and the unit as a whole. However, it is an ongoing challenge to investigate dyadic needs and preferences in daily practice and develop effective interventions. Challenges are related to incomplete understanding of dyadic characteristics, attitudes and beliefs within the dyad, as well as how to adapt research approach to engage and retain the dyad in research. This international symposium will therefore address these issues. The first presentation will describe a typology of dementia care dyad characteristics and needs in Germany. The second presentation will examine the challenges and opportunities associated with recruiting and retaining dementia dyads. The third presentation will explore ethical challenges posed in communication with dyads and possible solutions for the researcher. The final presentation reports on the Meeting Centre Support Program as an example of an effective psychosocial intervention employing research strategies that transcend cultural barriers. Our discussant, Katie Maslow, will synthesize the presentations and lead a discussion of future directions for policy and practice.
Design and Main Results of STURDY: A Randomized Clinical Trial of Four Vitamin D3 Doses to Prevent Falls in Older Adults
Authors: Appel Lawrence , Schrack Jennifer , Michos Erin , Mitchell Christine , Juraschek Stephen , Miller Edgar , Roth David 
Published: December 2020

Abstract
STURDY was a Bayesian, response-adaptive trial with dose-finding and confirmatory stages. Participants (n=688; ≥70years with serum 25(OH)D of 10-29ng/mL) were randomized to 200 (control), 1000, 2000, or 4000 IU/day of vitamin D3. The primary outcome was time to first fall or death over 2 years. During dose-finding, the best non-control dose was determined to be 1000IU/day based on higher primary outcome event rates in the 2000 and 4000IU/day doses than the 1000IU/day dose (posterior probability of being best dose=0.90; hazard ratios[HR] were 1.86 [95%CI: 1.16-2.97] and 1.68 [95%CI: 1.05-2.69], respectively). Participants were then switched from other non-control doses to 1000IU/day, and event rates did not differ between the pooled higher doses and control groups (HR=1.02, P=0.84). There was no heterogeneity by baseline 25(OHD). In conclusion, high-dose vitamin D supplementation ≥1000IU/day did not prevent falls. Whether vitamin D doses &gt;2000IU/day increase the risk of falls is uncertain.