bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative Experiences of Multi-Sensory Engagement for Acutely Ill Persons With Dementia
Authors: Molony Sheila , Waszynski Christine 
Published: December 2020

Abstract
Delirium occurs in up to 25% to 50% hospitalized patients and the risk is increased for older adults with dementia. Multi-sensory stimulation has been effective in community and nursing home settings to reduce delirium in persons with dementia. This paper presents qualitative findings from field notes, observations and participant/family interviews. A sample of 25 individuals with dementia and were recruited from 2 medical units and randomized to intervention with two sessions in the multi-sensory “Hub” on 2 hospital days or receive usual care. One investigator recorded field notes prior to and during the intervention (or control). An RN in the Hub documented participant engagement. Audio-taped interviews with participants and family were recorded immediately after Hub visits. All data was transcribed and analyzed by two other team members using NVivo 12.0. Both coders reached consensus after independently coding the first 12 transcripts using open coding and descriptive content analysis. Pre-intervention data revealed common symptoms of delirium in both groups and post-intervention fatigue as a prominent theme. Participants in both groups were able to engage with the researcher and respond to interviews. Hub participants demonstrated high levels of engagement with some surprising positive responses and improvement from pre-intervention behavior. Qualitative findings from this pilot study highlight the abundance of delirium risk factors encountered by hospitalized older adults with dementia and demonstrate positive, engaging MMSE experiences, despite these risks. Further study is needed to identify longer-term impact.
Adiposity Is Positively Associated With AD-Signature Cortical Thickness in Older Adults
Authors: Brinkley Tina , Lockhart Samuel , Sachs Bonnie , Cleveland Maryjo , Williams Benjamin , Bateman James , Rogers Samantha , Craft Suzanne 
Published: December 2020

Abstract
Mid-life obesity is associated with a higher risk for Alzheimer’s disease (AD). However, this association is attenuated or even reversed in late-life, when weight loss may be a preclinical sign of AD. While neuropathological changes likely occur alongside aging-related changes in body composition, this has not been largely investigated. We aimed to determine the association between adiposity and a specific pattern of reduced cortical thickness associated with AD risk and progression. Global and regional adiposity (via dual-energy x-ray absorptiometry) and AD-signature cortical thickness (via surface-based cortical analysis of 3T brain MRI scans) were measured in 35 middle-aged and older adults from the Wake Forest Alzheimer’s Disease Clinical Core (mean age: 69.4±7.8 years, 80% female, 91% White, 29% cognitively impaired). Partial correlations adjusted for age, sex, and cognitive status were examined overall and stratified by age (0.59, p≤0.05). No significant associations were observed in middle-aged adults. These findings suggest that AD-related cortical thinning may be accompanied by a global reduction in body fat among older adults.
Compare Breast Cancer Screening, Diagnosis, and Treatment Between Medicare Patients With and Without ADRD
Authors: Weng Xingran , Shen Chan , Vasekar Monali , Gupta Sachin , Wang Li 
Published: December 2020

Abstract
Background: Incidence of both breast cancer and Alzheimer’s disease and related dementias (ADRD) increases with advancing age. Little research has delineated breast cancer screening, diagnosis, and treatment among women with ADRD. Method: Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data were used. Female breast cancer patients diagnosed between 2005-2015 were identified. Chi-square tests were conducted to compare the characteristics of two groups with and without ADRD. Multiple logistic regression models were estimated to explain the diagnosis and treatment differences. Results: A total of 44,112 female Medicare beneficiaries age 65 or older were identified. Patients with ADRD (17.5%) were less likely to receive breast cancer screening (42.8% vs. 46.6% for all data years combined, p&lt;0.0001), more likely to be diagnosed with breast cancer after death by autopsy or death certificate (8.1% vs 2.0%, p&lt;0.0001). Among those who are diagnosed before death, patients with ADRD were more likely to be diagnosed with breast cancer at age 75 and older (84.8% vs. 15.2%, p&lt;0.0001). After adjusting for age, race, poverty level, marital status, cancer stage at diagnosis, cancer screening history, wellness visit history, comorbidity, and rural/urban residence, logistic regressions suggest that patients with ADRD were less likely to receive surgery (AOR=0.48, 95%CI: 0.45-0.52), radiation (AOR=0.41, 95%CI: 0.39-0.44), or chemotherapy (AOR=0.38, 95%CI: 0.35-0.41). Conclusion: Breast cancer screening was less utilized and breast cancer was diagnosed at an older age in patients with ADRD than those without. Treatments (surgery, radiation, and chemotherapy) were given less frequently to patients with ADRD.
Depression Moderates the Effect of Physical Functioning Over Time in Cancer Survivors
Authors: Bamonti Patricia , Naik Aanand , Bean Jonathan , Moye Jennifer 
Published: December 2020

Abstract
Cancer survivors are at-risk for physical functioning (PF) decrements particularly among older adults. However, few studies have examined moderators of PF over time which may guide rehabilitation interventions. This study examined the moderating effect of depressive symptoms on the association between PF at 6 months following cancer diagnosis and PF 18 months after diagnosis controlling for age, education, and treatment status (whether still in treatment). We hypothesized that the association between PF (T1) and PF (T3) would be attenuated by higher depression scores 12 months after diagnosis (T2). Participants (N = 170; Mage 65.3 +/- 9.17, 98.2% male; 81.2% White) with head and neck, esophageal, gastric, or colorectal cancers were recruited from tumor registries at two VAMCs. Self-report measures included demographics, treatment status, depression symptoms (PHQ-9), and physical functioning (PROMIS) were collected. Performance-based measure of PF (SPPB) was administered. Depression symptoms at Time 2 moderated the relation between performance-based PF (SBBP: ΔR2 = .07, F(6, 103) = 10.1, p &lt; .001) but not self-reported PF, PROMIS: ΔR2 = .001, F(6, 110) = 15.3, p =.733. The turning point of non-significance to significance of SBPP T1-T3 was a PHQ-9 score of 7.2. In the absence of depression, the best predictor of future functioning is prior functioning. For those with PHQ-9 scores &gt; 7.2 (28% of the sample), prior functioning does not predict future functioning. Depression should be measured closely with performance-based measures of PF, including gait speed, to improve prediction of future functioning and guide personalized interventions.
Association of Balance Scores With Cognitive Function in Older Adults
Authors: Meunier Claire , Smit Ellen , Fitzpatrick Annette , Odden Michelle 
Published: December 2020

Abstract
Previous research has reported an association between balance and cognitive function; however, there is a paucity of data on this relationship over time. This study examined the cross-sectional and longitudinal association between balance and cognitive function in 4,811 participants aged 65 years and older in the Cardiovascular Health Study (CHS). Cognitive function measures included the Modified Mini-Mental State Examination (3MSE) and Digit Symbol Substitution Test (DSST); measures were collected annually for six years, starting in 1992-1993. A tandem stance balance test was administered at baseline; this test was held for 5 seconds. Cross-sectional and longitudinal models were adjusted for demographics, behavioral and disease covariates. We found that participants with worse balance scores had lower cognitive function scores, and this effect was limited to participant who were above the median age (76 years) (p-value for interaction = 0.03 in a demographic-adjusted model). Participants 76 years and older who failed the balance test had an average adjusted decline of -0.97 (95% CI: 1.20, 2.29) 3MSE scores per year more than participants who completed the balance test. DSST showed similar results; participants with poor balance decreased -0.21 (95% CI: -0.37, -0.05) points per year more than participants who completed the balance test. The adjusted Cox proportional hazard model found participants with poorer balance had a higher risk of cognitive impairment over the six years (HR= 1.72 95% CI: 1.30, 2.29). A better understanding of the pathophysiological link between balance and cognition may inform strategies to prevent cognitive decline.
Contemplative Practices and Later Life Memory Among Women
Authors: Lekhak Nirmala , Bhatta Tirth 
Published: December 2020

Abstract
Contemplative practices such as meditation, yoga, and prayer had been used as coping resources to reduce the adverse impacts of stressful life experiences. Despite emerging scholarship on the benefits of contemplative practices for cognitive health, scant research has examined the influence of such practices on both episodic and working memory among women in later life. While the use of private prayer outside of church or temple has been shown to have statistically significant positive effect on episodic memory among older adults, previous studies have relied on measures that fail to capture various aspects of meditative practices (e.g., mental imagery, relaxation). Drawing from the Study of Women’s Health Across the Nation (n=2245) conducted during 2006-2008, this study investigates the effect of contemplative practices (e.g. meditation / imagery / relaxation technique, yoga, and prayer) on episodic and working memory. Multivariate regression model estimates suggests women who either used meditation, imagery or relaxation techniques had significantly better episodic (b=0.61, p=0.001) and working memory (b=0.32, p&lt;0.05) as compared to those who did not use those methods. Surprisingly, the influence of prayer on episodic memory was negative (b=-0.36, p&lt;0.05), while the influence of yoga on memory was not statistically significant. Our findings underscore the need to incorporate meditative practices in non-pharmacological interventions that are designed to improve later life memory.
Global Cognition Modified the Longitudinal Relationship Between Anemia and Depression in Old Age: The IMIAS Study
Authors: Ahmed Tamer , Vasiliadis Helen-Maria 
Published: December 2020

Abstract
Background: We examined the longitudinal relationships between hemoglobin concentrations or the severity of anemia and depression and whether baseline cognitive function modifies these longitudinal relationships over 4 years of follow-up. Methods: A total of 1608 community-dwelling older adults from the International Mobility in Aging Study (IMIAS) aged 65 to 74 years were recruited in Natal (Brazil), Manizales (Colombia), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). The study outcome was depression, defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D). Longitudinal associations over four years follow-up were examined using generalized estimating equations. Models reported were either unadjusted and adjusted for research sites, alcohol drinking status, body mass index, chronic conditions, activities of daily life disabilities, and polypharmacy. Results: Longuitinal relationships suggested an evidence of multiplicative interaction by baseline global cognition in which 1g/dL increase in hemoglobin concentrations there was a significant reduction in the risk of depression with a stronger effect among participants with good cognitive function (Odds Ratio (OR)=0.85, 95% CI: 0.78-0.92) compared to those with poor cognition (OR=0.89, 95% CI: 0.80-0.97). Anemia and poor cognition at baseline were associated with an increased risk of depression over 4 years of follow-up (OR=5.80, 95% CI: 1.84-18.23). Global cognition was an effect modifier of the longitudinal association between the severity of anemia and depression. Conclusion: In international samples of older adults, hemoglobin concentrations, as well as the severity of anemia, were independent risk factors for depression and these associations differed by global cognitive function.
Job Strain and Mental Health Among Older Adults: Results From the National Health Interview Survey
Authors: Hatten Christina , DuPont-Reyes Melissa , Gonzalez Tailisha , Murillo Rosenda , Echeverria Sandra , Vasquez Elizabeth 
Published: December 2020

Abstract
Increased life expectancy and retirement age have contributed to a gradual aging of the US workforce. Extant literature has identified job strain (e.g. job demands, work-related stressors etc.) as a risk factor for both physical and mental health outcomes in working populations. However, there is comparatively less evidence examining job strain and mental health among older working adults. We utilized National Health Interview Survey data (2015), which contained detailed information on work conditions, to investigate the relationship between fear of job loss and self-rated mental health among working adults at 25-54 and 55+ years of age. We fit multiple logistic regression models that accounted for the complex survey design. Mental health was assessed using the K6 screening instrument that measures nonspecific psychological distress. In the sample of 16,291 working adults, 11.6% worried about job loss and 13.3% reported moderate/severe mental distress. Overall, we found that the odds of poor self-rated mental health among those who reported fear of job loss were 2.35 times that of respondents with perceived job security after adjusting for age, sex, educational attainment, race and/or ethnicity, body mass index, and smoking behaviors (95% Confidence Interval (CI): 2.01-2.75). Age-stratified results showed that perceived job insecurity corresponds with a 2.33 odds of mental distress among workers aged 25-54, and a 2.44 odds of mental distress among older workers. Our findings highlight the importance of age dynamics in mental health for working adults and suggest that job strain presents a persistent challenge for the wellbeing of workers.
Determinants of Satisfaction With Health Services by Dimensions of Care: An Age-Stratified Analysis
Authors: Vasiliadis Helen-Maria , Pitrou Isabelle , Berbiche Djamal 
Published: December 2020

Abstract
Studies that examined satisfaction with care in older adults are scarce. The aim of this research was to analyse satisfaction among older adults considering mental health, socio-clinical and health system factors and by age category. Data come from the Étude sur la Santé des Aînés Services study including 1,624 adults aged ≥65 years recruited between 2011-2013 in primary care in Quebec. Patient satisfaction was assessed during interviews with questions adapted from the Primary Care Assessment Survey. Mental health (anxiety, depression, suicidal ideation, psychological distress, cognition), social support, quality of life, the presence of pain and chronic conditions were self-reported. Health service use was extracted from administrative registries. Logistic regressions stratified by age were used to examine the associations of low satisfaction in three dimensions of care. For continuity of care, the determinants of low satisfaction were pain and attraction index for psychiatric services in adults 65 to 75 years versus anxiety, cognition and hospitalizations in adults 75 years and older. For patient-provider interactions, the determinants were psychological distress, attraction index for psychiatric services in adults 65 to 75 years versus quality of life and cognition in adults 75 years and older. For adequacy of care, anxiety, psychological distress, social support, pain, quality of life and attraction index for psychiatric services were significant in adults 65 to 75 years versus quality of life and cognition in adults 75 years and older. Results highlight different patterns of satisfaction by age category that should be used to improve care delivered in primary care.
Exclusion of Medicare Advantage Enrollees From Medicare Health Outcomes Analyses: Potential for Bias
Authors: Yashkin Arseniy , Akushevich Igor , Yashin Anatoliy 
Published: December 2020

Abstract
The aim of this paper is to assess the extent of the potential bias introduced by the exclusion of the Medicare Advantage (MA) population– an increasingly sizeable (31% of all beneficiaries in 2017) subset of the Medicare population which does not provide claims data to the Centers for Medicare and Medicaid Services– from Medicare-based health outcomes and epidemiologic analyses. Using self-reported data from the Health and Retirement Study together with monthly information on Medicare enrollment, we compared MA enrollees with individuals enrolled in traditional Medicare (TM) on 42 variables representing demographic, socioeconomic, adverse health behavior and health status-related characteristics over the 1991-2015 period. We used both univariate analysis (t-tests and standardized differences) and multivariate logistic regression to compare the two groups. We found that apart from differences in economic (higher in TM group) and education status (lower in MA group) – which have been increasing in magnitude over the 1991-2015 period– the MA subset was highly comparable with the traditional Medicare (TM) population. Even though the TM population was characterized by slightly higher levels of morbidity, the resulting crude prevalence rates for common age-related diseases in the TM/MA groups were within each other’s 95% confidence intervals and did not represent a major source of bias. MA membership was not associated with increased mortality at any point over the 1991-2015 period. We conclude that exclusion of the MA population will not lead to notable bias in health outcome analyses apart from those for which income and education are important explanatory factors.
Identifying a Population Living With Alzheimer’s: Concordance Between Medicare Claims and Survey Reports
Authors: Akincigil Ayse , McKenzie Camille 
Published: December 2020

Abstract
Community-level estimates of Alzheimer’s disease and related dementias (ADRD) are necessary to assess health care needs and supports (to patients and family members), determine the burden of disease, conduct public health planning, improve access and care quality improvement, and to build a workforce with the necessary skills. Data from Medicare claims can provide efficient and timely estimates. However, earlier studies suggest that identifying ADRD populations solely from Medicare claims fails to capture many individuals that live with ADRD, with false-negative cases as high as 60%. We examined nationally representative data from the 2015-2017 Medicare Current Beneficiary Survey (MCBS) to assess the claims-based case ascertainment method, covering the transition to the International Classification of Diseases, Tenth Revision (ICD-10). The study population included community dwellers aged 65 or older, enrolled in traditional fee-for-service (n=12,409). Claims based method identified 1,325 cases (10.7% prevalence). However, there were 196 (1.6%) additional cases that self/proxy reported ADRD, but there was no ADRD diagnosis in any of their Medicare claims (hereafter referred to as self-report only). On average, the self-report only group reported higher numbers of limitations in activities, or instrumental activities of daily living, worse overall health, and more difficulty in concentrating or remembering, suggesting they are likely to be false negatives under claims-based case ascertainment method. In conclusion, claims based case ascertainment methods failed to capture some individuals with ADRD, but the magnitude of false-negative cases declined substantially in the era of ICD-10.
High Intensity Walking Reduces Frailty and Improves Physical Function Among Older Adults Living With HIV
Authors: Danilovich Margaret , Achenbach Chad , Yeh Chen , Balmert Lauren , Berzins Baiba 
Published: December 2020

Abstract
Walking is a preferred mode of exercise for older adults, yet limited evidence exists on the optimal intensity to promote health gains, particularly among those with the frailty syndrome. Older adults aging with HIV have physical function impairments and higher prevalence of frailty, yet there is a paucity of evidence on therapeutic options to help these individuals maintain or improve their physical functioning. The purpose of this study was to investigate the feasibility and efficacy of a high intensity walking training (HIWT) intervention for pre-frail and frail older adults living with HIV. We enrolled n=11 older adults (&gt;50 years of age and pre-frail or frail on the SHARE-FI). Participants underwent 16 walking sessions 2x/week consisting of 5 minute intervals of stair climbing, fast walking, weighted walking, balance tasks, and steps ups for a total of 30 minutes of high intensity (&gt;70% of HRmax or &gt;15 Rating of Perceived Exertion) activity. All participants were able to achieve the targeted high intensity levels throughout the sessions. We used a t-test to compare pre-post test means on a variety of physical performance measures. We found statistically significant improvements in the frailty score on the SHARE-FI, PROMIS fatigue, self-selected gait speed, Short Physical Performance Battery (SPPB), and Six Minute Walk Test. Importantly, all improvements were far above minimally clinically important differences suggesting this novel exercise approach may contribute to substantial improvements in physical function to reduce frailty in this population of older adults. Participants had no adverse events and were highly satisfied with training.
Perceptions and Understandings of Frailty Language: A Scoping Review
Authors: Sakamoto Mariko , Durepos Pamela , Alsbury Kyla , Hewston Patricia , Takaoka Alyson , Borges Julia 
Published: December 2020

Abstract
Diagnosing and responding to frailty in older adult populations is of growing interest for health care professionals, researchers and policymakers. Preventing frailty has the potential to improve health outcomes for older adults, which in turn has significant implications for health care systems. However, little is known about how older people understand and perceive the term “frailty”, and what it means for them to be designated as frail. To address this concern, a scoping review was undertaken to map the breadth of primary research studies that focus on community-dwelling older adults’ perceptions and understanding of frailty language, as well as explore the potential implications of being classified as frail. Searches were conducted in MEDLINE, Ageline, PsychInfo, CINAHL and EMBASE databases for articles published between January 1994 and February 2019. 4639 articles were screened and ten articles met the inclusion criteria, detailing eight primary research studies. Using content analysis, three core themes were identified across the included studies. These themes included: 1) understanding frailty as a multi-dimensional concept and inevitable consequence of aging, 2) perceiving frailty as a generalizing and harmful label; and 3) resisting and responding to frailty. Recommendations stemming from this review include the need for health care professionals to use person-centered language with older adults, discuss the term frailty with caution, and be aware of the potential consequences of labeling a person as frail. Importantly, this review demonstrates that for frailty interventions to be successful and meaningful for older adults, ongoing and critical examination of frailty language is necessary.