bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolism and Aging: New Approaches to Nutrition and Diet in Aging
Authors: Rogina Blanka 
Published: December 2020

Abstract
Aging is associated with a functional decline in metabolic, physiological, proliferative, and tissue homeostasis leading to deterioration at an organismal level and increases risk for disease and death. Genetic, pharmacological and nutritional interventions have been successfully used to preserve metabolic health, which leads to preserved healthspan and extended longevity. This symposium will discuss new approaches to nutrition and diet and mechanisms underlying interventions such as calorie restriction and genetic CR. We will also discuss species-specific metabolic mechanisms based on longitudinal studies in mice, monkeys and humans.
Neurons Putting Out the Trash: A Novel Facet of Proteostasis and Mitochondrial Quality Control
Authors: Driscoll Monica 
Published: December 2020

Abstract
Toxicity of misfolded proteins and mitochondrial dysfunction are pivotal factors that promote age-associated functional neuronal decline and neurodegenerative disease across species. Although these neurotoxic challenges have long been considered to be cell-intrinsic, considerable evidence now supports that misfolded human disease proteins originating in one neuron can appear in neighboring cells, a phenomenon proposed to promote pathology spread in human neurodegenerative disease. We have found that C. elegans adult neurons that express aggregating proteins can extrude large (~5µM) membrane-surrounded vesicles that can include the aggregated proteins and damaged mitochondria. We speculate that throwing out the trash may correspond to a conserved mechanism that constitutes a fundamental, but formerly unrecognized, branch of neuronal proteostasis and mitochondrial quality control. I will discuss our current understanding of the mechanisms of neuronal trash elimination.
Senescence and Senolytics: State of the Art on Cellular Senescence, Senolytics, and Healthspan
Authors: Campisi Judith 
Published: December 2020

Abstract
Cellular senescence is a cell fate decision that is made by many mammalian cell types in response to damage, stress or certain physiological signals. Senescent cells arrest proliferation, essentially permanently, and develop a complex multi-component senescence-associated secretory phenotype (SASP). Recent studies using human and rodent cells, tissue samples and transgenic mouse models have defined a causal role for senescent cells, acting largely through the SASP, in a surprisingly large and diverse number of age-related diseases. Subsequently, several synthetic and natural compounds have been identified that have the ability to selectively kill senescent, but not non-senescent, cells. These compounds, termed senolytics, are now of intense interest to both basic research groups and biotechnology companies because they hold promise for postponing, ameliorating or, in some cases, reversing certain age-related pathologies. A related group of compounds, termed senomorphics, hold similar promise and act by selectively suppressing certain modules of the SASP. This symposium will feature presentations on some of the latest developments in the fields of cellular senescence and the SASP and how these cellular responses affect organismal health span. The symposium will particularly emphasize recent findings on the identification and activities of senolytic and senomorphic agents that have the potential to significantly extend the health span of mammalian organisms.
Cellular Senescence and Mammalian Healthspan
Authors: Campisi Judith 
Published: December 2020

Abstract
Cellular senescence is a complex cell fate, often induced by stress or damage, that can be beneficial or deleterious, depending on the physiological context and age of the organism. A prominent feature of senescent cells is a multi-faceted senescence-associated secretory phenotype (SASP), which includes growth factors, cytokine and chemokines, growth factors, proteases, bioactive lipids and metabolites. Senescent cells increase with age in most, if not all, mammalian tissues. Through the use of transgenic mouse models, senescent cells are now known to causally drive numerous age-related pathologies, largely through the SASP. Eliminating senescent cells, genetically or through the use of senolytic/senomorphic agents, can improve the health span, at least in mice, and hold promise for extension to humans in the near future.
The Epidemiology of Dementia in LGBTQ Older Adults
Authors: Flatt Jason 
Published: December 2020

Abstract
Over 3 million or more adults aged 60 + live in the US who identify as lesbian, gay, bisexual, transgender, and/or queer (LGBTQ). Less is known about dementia risk in LGBTQ older adults. We will discuss dementia risk and related risk factors among LGBTQ adults from multiple population-based and cohort studies. We found higher rates of subjective memory problems among lesbian, bisexual and transgender adults compared to both gay men and heterosexual men and women. Using medical record data, 8% (343) of LGB adults aged 60+ were diagnosed with dementia. They were more likely to identify as male (63% vs. 44%), had a higher education level (college degree+ 63% vs. 40%) and were younger than their non-LGB counterparts. These findings highlight dementia risk and related problems among LGBTQ older adults. Future studies are needed to better understand dementia risk and recruiting, screening and improving dementia-related outcomes in LGBTQ older adults.
Changing Culture Around Serious Illness: The VA Life-Sustaining Treatment Decisions Initiative
Authors: Carpenter Joan , Burke Robert 
Published: December 2020

Abstract
Discussing and documenting goals of care and life-sustaining treatment decisions with seriously ill patients is a widely endorsed practice by healthcare and professional organizations. In 2018, The Veterans Health Administration (VA) initiated a new national policy to standardize such practices, the Life Sustaining Treatment Decisions Initiative (LSTDI), which included a coordinated set of evidence-based strategies and practice standards for conducting, documenting, and supporting high-quality goals of care conversations (GoCCs); staff training to enhance skills in conducting, documenting, and supporting GoCCs; standardized, durable electronic health record tools for documenting patients’ goals and preferences; and monitoring and information technology tools to support implementation and improvement. In this symposium, we will describe the first 20 months of implementing the LSTDI across the VA, the largest integrated healthcare system in the US. The first paper will focus on the factors associated with documentation of a GoCC and treatment preferences. The second paper will present findings describing facilitators and barriers to implementing the LSTDI and identifying factors that promote high rates of LSTDI documentation. The third paper examines patient level outcomes associated with a documented goal of comfort care, specifically the odds of receipt of hospice/palliative care, hospitalization, or ICU admission. This symposium will provide attendees with important information regarding a wide range of individual and system strategies to enhance the care of seriously ill older adults by engaging patients with serious illness in GoCCs and documenting their preferences for treatment in durable, easily accessible notes and orders.
Cultural and Institutional Issues in ACP for Care Home Residents: Perspectives of Loved Ones
Authors: de Vries Brian , Gutman Gloria , Kwan Helen , Jang Katrina , Soheilipour Shimae , Vashisht Avantika , Kaur Taranjot 
Published: December 2020

Abstract
Focus groups were held with family/decision makers of residents in an exclusively Chinese (EC; N=7) and a multi-ethnic (ME; N=8) care home, as well as South Asian (SA; n = 5) and lesbian, gay, bisexual and transgender caregivers (LGBT; n = 5) who had/have a loved one in a care home. Shared themes across groups included the role of the care home in Advance Care Planning (ACP) discussions, the timing of such discussions (i.e., at admission), and the extent to which another person was available and appropriate for such discussions. Issues unique to groups included superstition and the equation of ACP with funeral planning (EC), family history and regrets about not having planned (ME), gender differences and the need for education about ACP (SA) and the absence of traditional family among LGBT older adults. These themes highlight the challenges in ACP among diverse populations and the need for targeted interventions.
To Lie or Not to Lie: The Views of People With Dementia and Their Carers
Authors: Casey Dympna , Lynch Una , Cooney Adeline , Houghton Catherine , Smyth Siobhan , Jordan Fionnuala , Felzman Heike 
Published: December 2020

Abstract
In Ireland over 36,000 people with dementia live at home cared for by informal carers. Yet often these carers do not know how to deal with cognitive symptoms, including repeated questions wherein ‘truthful’responses cause distress. Carers face a dilemma, do they avoid, distract or ‘correct’ the person and tell the ‘truth’, or lie? This paper explores the concept of lying from the perspective of the carer and person with dementia. A descriptive qualitative methodology was used. Focus groups with a purposive sample of people with memory problems (n = 14) and carers (n = 18) were conducted. The results found that deliberate lying with the intention to deceive was deemed unacceptable by all. However, in certain circumstances telling a ‘good lie’ or ‘white lie’ was considered acceptable when the carer knew the person and the intention behind the ‘lie’ was to mitigate the distress of the person with dementia.
Effects of a Novel Approach to Reducing Costly Hospitalizations of Nursing Home Residents
Authors: Tappen Ruth , Wolf David , Southard Karen 
Published: December 2020

Abstract
The reduction of preventable hospitalizations from long term care facilities has been identified by CMS as an important measure of quality, both in terms of resident outcomes and nursing home performance. As many as one-quarter of individuals admitted to nursing homes from acute care are rehospitalized within the month placing them at high risk for increased falls, delirium, skin breakdown, nosocomial infection and the like and costing an estimate $4.3 billion annually. To address this well documented threat to care quality, CMS has imposed significant penalties for excessive readmissions on facilities with high rehospitalization rates. An important contributor to these preventable readmissions is resident and family insistence on the transfer. Early efforts to reduce potentially preventable hospitalization of nursing home residents focused on developing systems to identify and respond to acute changes in condition before hospitalization becomes necessary. Reports from facility staff, however, brought to our attention the additional problem of resident and family insistence on transfer despite provider recommendations to the contrary. A series of funded studies to understand this problem, develop a solution and test the effectiveness of this solution will be reported by an interdisciplinary team. We begin with description of the development and clinical trial of Go to the Hospital or Stay Here?, an evidence-based, patient-centered decision aid, with individual residents and families, followed by a pilot test of facility-wide implementation; then an eight state regional dissemination supported by CMS and participating states and finally a discussion of best practices for effective implementation of the Guide.
Go to the Hospital or Stay Here?: A Randomized Clinical Trial
Authors: Worch Sarah , Tappen Ruth 
Published: December 2020

Abstract
With the exception of guides for making end of life choices, there are very few if any patient decision aids created for residents of long-term care facilities. Further, only half of patient decision aids produced for any purpose have actually been field tested with patients and even fewer have been evaluated by providers other than the developers of the decision aid. Development of Go to the Hospital or Stay Here? was based on expert experience combined with extensive input from over 270 long-term care residents, their families and their caregivers. The initial clinical trial of this decision aid is reported in this presentation. Increased knowledge, reduced decisional conflict, increased preference for care in the nursing home when possible and a high rating of the helpfulness of the Guide were found in those who received the Guide (n=97) compared to those who did not (n=95).
CuidaTXT: A Text Message Dementia-Caregiver Intervention for Latinos
Authors: Puchalt Jaime Perales 
Published: December 2020

Abstract
Latino family caregivers of people with dementia have low access to caregiver support. Text messaging holds potential to dramatically enhance the reach of caregiver support interventions among Latinos. This presentation will describe the CuidaTXT Project, with a special emphasis on approach to recruitment and community engagement to achieve the objectives of designing and testing the first dementia caregiver-support text message intervention for Latinos. Based on the Stress Process Framework, CuidaTXT incorporates social support and coping components including AD education, problem-solving skills training, social network support, care management and referral to community resources via tailored two-way messaging. Engagement in CuidaTXT benefited from multi-source recruitment efforts in the Latino community-network built over a three-year period. The network is comprised of senior, religious and community centers, the local media, clinics, a Latino registry and a dementia health navigation service. This presentation will describe processes for assembling and engaging the network for CuidaTXT.
Choice Food Pantries in the Deep South: A Novel Approach to Addressing Food Insecurity in Older Adults
Authors: Buys David , Smith Masey , King Erin 
Published: December 2020

Abstract
Older adults in the deep south are living with high food insecurity rates; this is exacerbated by challenges with rural-living, like transportation limitations and no grocery stores. To address this, we must increase emergency food assistance offerings and adopt best practices for food pantries including choice food pantry approaches, which empowers clients with some autonomy in choosing the foods they receive as part of their pantry distribution. Coalitions in eight income-limited, aging, rural Mississippi Delta counties received support from a Centers for Disease Control and Prevention Grant to enhance the food-related infrastructure in their communities through technical assistance and economic investments. A detailed process evaluation was conducted on this effort. Each coalition adopted food pantry-related policies like adding new food pantries and adapting their existing food pantries with the choice model. Both aging volunteers and clients indicated positive outcomes from the process of adding pantries and adapting existing ones.
Are all homebound older adults frail?
Authors: Sheehan Orla , Bandeen-Roche Karen , Ritchie Christine , Chung Shang-En , Walston Jeremy , Roth David , Leff Bruce 
Published: December 2020

Abstract
Seven million adults in the United States are homebound and suffer the negative, powerful synergies of multiple chronic conditions, functional impairment, social stressors, and limited social capital. The prevalence of frailty in this vulnerable homebound population is unknown. Using representative data from the National Health and Aging Trends study (NHATS) study linked to Medicare claims (n=4756) we sought to assess the prevalence of frailty in the homebound population (n=361). Among the homebound, 68.5% met the frailty criteria compared to 12.3% of the non-homebound population. The frail homebound had lower educational attainment, were more likely to live alone, self-reported poorer health and more chronic physical and mental health conditions than the non-frail homebound (p&lt;0.05 for all). Frail homebound older adults utilized more health services utilization than non-frail homebound and were twice as likely to be hospitalized (49.8% versus 28.0%, p=0.004).
Cognitive Reserve and Well-Being Among Centenarians
Authors: Martin Peter , Lee Gina , Gondo Yasuyuki , Poon Leonard 
Published: December 2020

Abstract
The purpose of this study was to assess cognitive reserve among centenarians and to evaluate whether reserve variables explain significantly more variance in cognitive functioning than education alone. Centenarians from the Georgia Centenarians Study were included. Results indicate that education, activity, social engagement, and engaged lifestyle significantly related to cognitive functioning. After adding cognitive reserve variables, the effect of education on cognitive functioning diminished. The overall model fit well, Χ2 (df=6) = 12.35, p = .06; CFI = .97, RMSEA = .067. Education indirectly related to cognitive functioning through occupational responsibility and engaged lifestyle. Social engagement directly related to cognitive functioning but also indirectly through activity levels. The four direct predictors (i.e., education, social engagement, activity, and engaged lifestyle) explained 33 percent of the variance in cognitive functioning. The results provide important information for cognitive reserve theories with implications for physical health and interventions that build cognitive reserves.
Correlates of Pain, Opioid Use, and Psychotropic Medications Among Older African Americans
Authors: Cobb Sharon , Bazargan Mohsen , Assari Shervin 
Published: December 2020

Abstract
Unrecognized and undertreated pain among older African Americans (AAs) is well-documented. This study explored the link between social, behavioral, and health correlates of pain and psychotropic as well as opioid-based medications in a sample of underserved 740 AA older adults. Almost 16% and 17% of participants used at least one psychotropic and opioid-based medications, respectively. Of those who use opioid-based medications, 73% used opioids only, 28% used opioids and at least one psychotropic medication. Use of opioid or psychotropic medications were associated with increased polypharmacy. Multivariate analysis showed different types of pain are predictors of opioid use, however, depressive symptoms and level of pain were associated with use of psychotropic medication. Moreover, the relationship of pain and psychotropic medications warrants more study due to emerging mental health crisis. These findings underscore the need for optimal concurrent management of pain and mental health for older AAs with potential inappropriate medication use.
Adapting the KAER Framework to Support Early Diagnosis and Treatment of Dementia in Asian Americans
Authors: Sadarangani Tina , Zanowiak Jennifer , Pan Janet , Salcedo Vanessa , Yi Stella , Kwon Simona , Chodosh Joshua , Trinh-Shevrin Chau 
Published: December 2020

Abstract
Asian Americans (AAs) are frequently diagnosed with dementia in advanced disease stages and have difficulty accessing services. The NYU Center for the Study of Asian American Health, set out to culturally adapt The Kickstart-Assess-Evaluate-Refer (KAER) framework to support earlier detection of dementia in AA communities. Working with Bangladeshi, Chinese, and Korean senior centers, we used a participatory action approach to assess cultural relevancy, usability and acceptability of KAER to improve timely diagnosis and access to care. We found that community-based organizations (CBOs), not physicians, were often “first responders” in identifying and managing dementia. However, CBO staff felt unprepared to “Kickstart” discussions, found certain KAER questions were not culturally appropriate, and encountered barriers in communicating their concerns to physicians. Adaptations to KAER can maximize its impact and reach in AA communities. Suggestions include group education, as opposed to individualized screening, and stronger linkages between physicians and CBOs to ensure care continuity.
Impacting Health Behaviors of Older Adults Through a Volunteer-Led Health Literacy Program
Authors: Cortes Tara , Seidel Liz , John Cinnamon St 
Published: December 2020

Abstract
A community based, peer volunteer-driven educational program was developed to empower older adults to improve health behaviors through health literacy. A community needs assessment determined the curricula which included classes on chronic disease management and issues impacting older adult health. Volunteers were recruited and trained on the curricula by health educators using a train-the-trainer module. 173 volunteers convened 302 workshops, and trained 2,065 unique older adults who account for 5000 attendees. Using a pretest posttest design, an outcome evaluation found statistically significant increases in knowledge among older adult workshop attendees on 6 of the 7 health topics (p&lt;.01). Eighty-three percent of attendees reported positive health behavior changes at 3-month follow-up. The most commonly cited changes were increased physical activity and improved nutrition. Program challenges included volunteer scheduling and retention. Building a sustainable community-based, peer volunteer-driven health education program for older adults will be discussed.
A Patient Work Lens to Understanding and Supporting Health Care at Home
Authors: Werner Nicole 
Published: December 2020

Abstract
A majority of healthcare today occurs in private homes and is performed by older adults and their informal caregivers. However, only recently have we begun to understand more about the healthcare work of older adults and their caregivers and the home as a healthcare delivery system. Work science allows us to conceptualize the healthcare activities of older adults and their caregivers as a type of health-related work that has been conceptualized under the broad term, patient work. Applying a patient work lens can offer a unique perspective to addressing the persistent and pervasive challenges faced by older adults and their caregivers as they manage their healthcare at home and across healthcare settings. I will describe the historical development of the patient work approach and highlight recent efforts to use a patient work approach to understand and support the work of older adults and their caregivers providing care in the home.
Evidence for a Novel Care Management Program for Low-Income Older Adults
Authors: Lessem Rachel , Danilovich Margaret 
Published: December 2020

Abstract
The purpose of this study was to evaluate the implementation and effectiveness of a novel care management program for low income older adults in Chicago. Older adults (n=200) who had annual income below $31,225 but about the state level for home and community based services were received care management. Program participants completed a battery of assessments (UCLA Loneliness Scale, single item Quality of Life and Physical Health scales, and Nutritional assessment) at initial assessment and 1-year follow-up. We also conducted interviews with clients and care managers. We used a t-test to evaluate participant outcomes and coded qualitative data to identify themes. Results showed no significant differences between baseline and 1 year follow-up indicating that this care management program kept participants stable. Only 5 of 200 (2.5%) of clients transitioned to a nursing home. This study contributes important results on a novel program to sustain vulnerable older adults in the community.