bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causes of Time Trends in Prevalence and Mortality of Major Cancers Among U.S. Older Adults
Authors: Akushevich Igor , Yashkin Arseniy , Kravchenko Julia , Yashin Anatoliy 
Published: December 2020

Abstract
The time trend of prevalence and mortality of major cancers is the result of three competing processes: changes in the incidence rate, stage-specific survival, and ascertainment at early stages. Partitioning approach allows for evaluating the relative contribution of each of these competing processes to the overall trend. In this report we applied the partitioning methodology developed for the SEER registry data for prostate, colorectal, lung, female breast, bladder, ovarian, stomach, pancreas, kidney, liver cancers and melanoma. The analysis involves the design and estimation of four models for each cancer site: i) incidence rate using the Armitage-Doll model with individual predisposition modeled by the gamma distribution, ii) probability of relative survival after cancer diagnosis using the Weibull model for time after disease onset, iii) frequencies of stage at onset, and iv) mortality in the general population using the Gompertz model. B-splines are used to fit the time patterns of model parameters obtained for each year Relative contributions of the partitioning components were evaluated for individual cancers (e.g., increase of prevalence in prostate cancer in 2000 was due to increased incidence (59%), improved survival (29%), and improve stage ascertainment (12%)) and compared among all considered cancers. The results were discussed in the light of the effect of the accumulation of survivors occurring in early years (due to improving survival) and their higher mortality (because of higher prevalence of survivors) in later years (i.e., mortality is transferred to latter time periods due to overall improvements in survival).
Screening Neurocognitive Disorders in Primary Care Services: The Quick Mild Cognitive Impairment Approach
Authors: Paul Constanca , Sousa Susana , Santos Pedro , O’Caoimh Rónán , Molloy William 
Published: December 2020

Abstract
Neurocognitive Disorders (NCD) is an increasingly common condition in the community. The General Practitioner (GP) in Primary Care Services (PCS), have a crucial role in early detection of NCD and is usually the first professional to detect the signs of MCI. The objective of this study was to test the feasibility and utility of the cognitive screening instrument QMCI in Primary Care. A community sample of 436 people 65+ living in the community was randomly selected from a larger group of old people with mental health concerns (N=2734), referred by their GPs. The mean age of the sample was 75.2 years (sd 7.2), with 41.3% men and 58.7% women; 60.4% married followed by 28.7% widows. The education level was low with 21% illiterate and 69,8% people with 4 years education. The QMCI mean was 37.1/100 (sd 16.2). The amount of people screening positive for cognitive impairment QMCI (&lt;62/100) was 94.2%. In the distribution of people with cognitive impairment by Global Deterioration Scale (GDS) three recoded categories, of the 286 people 76,1% where classified as having very mild or mild impairment, 19,4% moderate or moderately serious and 4,5% severe or very severe impairment. These results confirm the perception of GPs about their clients having mental health concerns and the ability of QMCI accurately discriminate MCI. The QMCI is very brief (3-5mins) fitting the short time of GPs to assess cognitive status and timely refer clients to nonpharmacological interventions that could postpone NCD symptoms.
Dementia Adjudication Triggers Associated With Increased Mortality for Older Australians: Evidence From ASPREE
Authors: Banaszak-Holl Jane , Lin Xiaoping , Xie Jing , Ward Stephanie , Brodaty Henry , Shah Raj , Murray Anne , McNeil John 
Published: December 2020

Abstract
Research Aims: This study seeks to understand whether those with dementia experience higher risk of death, using data from the ASPREE (ASPirin in Reducing Events in the Elderly) clinical trial study. Methods: ASPREE was a primary intervention trial of low-dose aspirin among healthy older people. The Australian cohort included 16,703 dementia-free participants aged 70 years and over at enrolment. Participants were triggered for dementia adjudication if cognitive test results were poorer than expected, self-reporting dementia diagnosis or memory problems, or dementia medications were detected. Incidental dementia was adjudicated by an international adjudication committee using the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) criteria and results of a neuropsychological battery and functional measures with medical record substantiation. Statistical analyses used a cox proportional hazards model. Results: As previously reported, 1052 participants (5.5%) died during a median of 4.7 years of follow-up and 964 participants had a dementia trigger, of whom, 575 (60%) were adjucated as having dementia. Preliminary analyses has shown that the mortality rate was higher among participants with a dementia trigger, regardless of dementia adjudication outcome, than those without (15% vs 5%, Χ2 = 205, p &lt;.001). Conclusion: This study will provide important analyses of differences in the hazard ratio for mortality and causes of death among people with and without cognitive impairment and has important implications on service planning.
Self-Perceptions of Driving Ability in Older Adults With and Without Alzheimer’s Disease
Authors: Davis Rebecca , Owens Megan 
Published: December 2020

Abstract
A concern for families and persons with dementia is determining when driving cessation is necessary. Older adults often modify driving behaviors as they age due to self-perception of a decline in their abilities. However, it is not known how persons with Alzheimer’s disease modify driving behaviors. The purpose of this study was to determine difference in how similarly aged persons with and without Alzheimer’s disease perceive their driving behaviors and modify them. Data were collected for 48 persons with early stage AD or mild cognitive impairment (MCI) due to AD; and 53 similarly aged older adults without cognitive diagnoses, using a survey on driving frequency, habits, and wayfinding ability. Chi-square analysis was used to determine any statistically significant differences in reported driving habits and difficulties between the study groups. Results from the analysis showed that the majority of the sample was still driving (n=81, 83%). Persons with AD/MCI (n=33, 73%) were less likely to be driving than the control group (n=48, 91%). Of those who were still driving, those with AD/MCI were more likely to limit driving frequency, avoid driving alone and in unfamiliar routes. Worries about getting lost were more frequently noted in those with AD/MCI. The AD group was more likely to make modifications to their driving such as limiting driving to daylight hours and not driving alone. These important results indicate persons with early stage AD/MCI may have self-awareness about driving impairments and make modifications to their driving habits that may increase their driving safety.
Older Adults in Poor Health Received Social Support Mainly From Family: The Singapore Chinese Health Study
Authors: Barrenetxea Jon , Yi Yang , Markides Kyriakos S , Koh Woon Puay , Qiushi Feng 
Published: December 2020

Abstract
While having social support can contribute to the health of older adults, those in poor health may be limited in their capacity to receive social support. We studied health factors associated with social support among 16,948 participants from follow-up 3 of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese. Participants were interviewed at mean age of 73 years (range from 61 to 96 years) using the Duke Social Support Scale. Latent Class Analysis (LCA) was applied to derive groups based on the source and intensity of social support. We ran multivariate logistic regression models to study health factors associated with group membership. LCA revealed four groups in increasing social support scores: The “family restricted”, who had the lowest social support scores and only received support from family (50%); the “loners”, who had some support from extended family and non-family (5%); the “family oriented”, who had broad family support and some non-family support (28%); and the “overall supported”, who had the highest social support scores and received broad support from family, extended family and non-family (17%). Compared to the “overall supported” group, health factors associated with being “family restricted” were: having instrumental limitations [odds ratio (OR) 1.34, 95% confidence interval (CI) 1.19-1.50], having poor self-rated health (OR 1.40, 95% CI 1.28-1.54), being depressed (OR 2.49, 95% CI 2.21-2.81) and being cognitively impaired (OR 1.19, 95% CI 1.04-1.37). Our results showed that older adults in poor health received social support mainly from family.
Association of Vaginal Microbiota With the Genitourinary Syndrome of Menopause Across Reproductive Stages
Authors: Shardell Michelle , Gravitt Patti , Ravel Jacques , Burke Anne , Brotman Rebecca 
Published: December 2020

Abstract
The genitourinary syndrome of menopause (GSM) is a collection of signs and symptoms related to estrogen decline that involves physical changes to the vulva, vagina, and lower urinary tract. GSM signs and symptoms may occur during any reproductive stage but are most common during menopause. Vaginal microbiota, particularly Lactobacillus spp., protect the female genital tract from multiple conditions; however, Lactobacillus spp. abundance declines during menopause. We aimed to determine the longitudinal association of vaginal microbiota with GSM signs and symptoms across reproductive stages. In a two-year cohort study comprising 750 women aged 35-60 years who contributed 2111 semiannual person-visits, low-Lactobacillus spp. vaginal microbiota communities were observed at 21.2% (169/798), 22.9% (137/597), and 49.7% (356/716) of person-visits among pre-, peri-, and post-menopausal women, respectively (p&lt;.001). After covariate adjustment, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were associated with vulvovaginal atrophy relative to high-Lactobacillus spp. communities dominated by L. crispatus (OR[Odds Ratio]=3.04, 95% Confidence Interval[CI]=1.02-9.06) among post-menopausal, but not among peri- or pre-menopausal women. Also, post-menopausal women with low-Lactobacillus spp. communities reported decreased libido (OR=1.79, 95%CI=1.04-3.12) and vaginal dryness (OR=1.61, 95%CI=0.89-2.90) more frequently than their counterparts with high-Lactobacillus spp. communities, but not among peri- or pre-menopausal women (p for interaction&lt;.05). Specifically, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were related to both decreased libido (OR=2.82, 95%CI=1.11-7.14) and vaginal dryness (OR=3.50, 95%CI=1.18-10.44) compared with high-Lactobacillus spp. communities dominated by L. gasseri/L. jensenii. Vaginal microbiota, particularly Lactobacillus spp., and menopause may synergistically influence GSM.
Evidence for Publicly Reported Quality Indicators in Residential Long-Term Care: A Systematic Review
Authors: Zúñiga Franziska , Osinska Magdalena , Zuniga Franziska 
Published: December 2020

Abstract
Quality indicators (QIs) are used internationally to measure, compare and improve quality in residential long-term care. Public reporting of such indicators allows transparency and motivates local quality improvement initiatives. However, little is known about the quality of QIs. In a systematic literature review, we assessed which countries publicly report health-related QIs, whether stakeholders were involved in their development and the evidence concerning their validity and reliability. Most information was found in grey literature, with nine countries (USA, Canada, Australia, New Zealand and five countries in Europe) publicly reporting a total of 66 QIs in areas like mobility, falls, pressure ulcers, continence, pain, weight loss, and physical restraint. While USA, Canada and New Zealand work with QIs from the Resident Assessment Instrument – Minimal Data Set (RAI-MDS), the other countries developed their own QIs. All countries involved stakeholders in some phase of the QI development. However, we only found reports from Canada and Australia on both, the criteria judged (e.g. relevance, influenceability), and the results of structured stakeholder surveys. Interrater reliability was measured for some RAI QIs and for those used in Germany, showing overall good Kappa values (&gt;0.6) except for QIs concerning mobility, falls and urinary tract infection. Validity measures were only found for RAI QIs and were mostly moderate. Although a number of QIs are publicly reported and used for comparison and policy decisions, available evidence is still limited. We need broader and accessible evidence for a responsible use of QIs in public reporting.
Making Quality Improvement Data Meaningful for Long-Term Care Administrators
Authors: Cranley Lisa , Weeks Lori , Lo T K T (Thomas) , Norton Peter , Estabrooks Carole 
Published: December 2020

Abstract
Tailoring feedback data to engage end-user stakeholders when sharing organizational context data is a central component of quality improvement and integrated knowledge translation. For over a decade, our research team has collected survey data (using the validated Alberta Context Tool) on modifiable aspects of organizational context from long-term care (LTC) staff (e.g., nurses, unregulated providers) across a representative cohort of 94 LTC facilities in Western Canada. We have fed back data at the facility and care unit level with the goal of making research findings more useful for decision-making and aiding improvement efforts. We have used a binary method (more favourable / less favourable organizational context) to report multidimensional data. While useful to our stakeholders (e.g., administrators) we are continually seeking ways to increase the detail in our reporting, while maintaining usability for stakeholders. We have now developed a more detailed method – the context rank summary, which displays rankings of care units within and across LTC facilities. In this study, we used a qualitative descriptive design to explore perspectives of administrators and managers (leaders) from LTC facilities on the two different methods for reporting survey data. We conducted a total of three focus groups with 16 leaders in the Maritimes and Ontario, Canada. Transcripts were analysed using content analysis. Leaders preferred a feedback report that combines a binary method with the greater detail of the context rank summary. Providing organizational context data that is more meaningful, relevant and actionable could offer an additional path to identifying areas for improvement.
Stress and Nursing Home Adjustment: Mediation by Resourcefulness and Self-Efficacy
Authors: Xiao Huimin , Yong Binbin 
Published: December 2020

Abstract
Relocation to a nursing home is often assumed to be associated with stress for older adults. This study aimed to explore how stress affect psychological adjustment of nursing home residents. A cross-sectional survey was conducted. A sample of 386 nursing home residents was recruited from 11 nursing homes in Fujian Province, Southeast China. The Nursing Home Adjustment Scale, Perceived Stress Scale, Resourceful Scale, and General Self-Efficacy Scale were adopted to collect data. The path analysis was used to analyze the relationship of stress, nursing home adjustment, resourcefulness, and self-efficacy. The results indicated that stress directly caused poor nursing home adjustment. It also indirectly affected nursing home adjustment through the mediators of resourcefulness and self-efficacy, respectively. Furthermore, chained mediation was found from stress to nursing home adjustment through resourcefulness, and then through self-efficacy to cope with the negative affect. The current study contributes to the understanding of the mechanism of stress on nursing home adjustment in older adults. To improve their psychological adjustment, additional focus should be placed on enhancing resourcefulness and self-efficacy in nursing home residents.
Inter-Individual Differences in Exercise Responses in Alzheimer’s Disease
Authors: Yu Fang , Salisbury Dereck , Mathiason Michelle 
Published: December 2020

Abstract
Aerobic exercise is widely supported as a disease-modifying treatment for Alzheimer’s disease (AD) in animal models; however, its effects on cognition have been mixed in human studies, which may be attributable to inter-individual differences in aerobic fitness and cognitive responses to aerobic exercise. This study evaluated inter-individual differences in aerobic fitness and cognitive responses to 6-month aerobic exercise in participants with AD dementia by secondarily analyzing the FIT-AD Trial data. Aerobic fitness with the shuttle walk test (SWT), 6-minute walk test (6MWT), and maximal oxygen consumption (VO2max) from cycle-ergometer exercise test, and cognition with the AD Assessment Scale–Cognition (ADAS-Cog). Inter-individual differences were calculated as the differences in the standard deviation of 6-month change (SDR) in outcomes between the intervention and control groups. The sample size was 78 (77.4±6.3 years old, 15.7±2.8 years of education, 41% women). VO2max was available in 26 participants (77.7±7.1 years old, 14.8±2.6 years of education, 35% women). The results show that the SDR was 37.0, 121.1, 1.7, and 2.3 for SWT, 6MWT, VO2max, and ADAS-Cog, respectively, but there were no statistically significant differences between the intervention and control groups in these measures over six months. Our results indicate that inter-individual differences exist in aerobic fitness and cognitive responses to aerobic exercise in AD, which contributed to the favorable, but not statistically significant between-group differences in aerobic fitness and cognition. To conclude, our study is the first to demonstrate inter-individual differences in the responses to aerobic exercise in AD dementia using SDR.
Relationship Between Physical Activity and Function With Quality of Life in Community-Living Older Adults
Authors: Chang Milan , Geirsdottir Olof , Thorsdottir Inga , Jonsson Palmi , Ramel Alfons , Gudjonsson Milan Chang 
Published: December 2020

Abstract
Background: Quality of life (QOL) is a multidimensional concept which is often used as an evaluation of a person‘s health and psychological status. Increasing longevity can be associated with better QOL as long as older adults are independent in daily life. The aim of the study was to examine the associations of QOL with muscle strength and physical function among community-dwelling older adults. Methods: The current cross-sectional study had 225 participants (73.7±5.7yrs, 58.2% female) living in Reykjavik, Iceland. QOL measured using the 36-item short-form survey (SF-36). Covariates were anthropometrics, muscle strength, physical function including timed up and go test (TUG), and 6-minute walking distance (6MWD), physical activity per week (PA). Linear regression analysis was used to examine the association of QOL with physical function. Results: The mean QOL score for the study population was 54.9±6.13. The analysis was adjusted for age and gender, body mass index, height, and PA. We found that QOL was associated with better grip strength (B=1.4, P&lt;0.0001), 6MWD (B=0.03, P&lt;0.0001), slower TUG (B=-0.9, P&lt;0.0001), and higher PA (B=0.03 m, P=0.039). However, QOL was not associated with quadriceps leg strength. Conclusion: The study suggests that QOL was associated with better physical function including grip strength, walking ability and the level of PA among community-dwelling older adults in Iceland.
Usability and Feature Evaluation of the Amazfit Bips Smart Watch in the Precision START Lab
Authors: Chase Jo-Ana , Howland Chelsea , Gallimore Malaika , Reeder Blaine 
Published: December 2020

Abstract
Interventions utilizing consumer-grade wearable and mobile devices may support older adult health and wellness. However, rapid technology change and short industry product release cycles limit timely incorporation of these devices. We developed a novel, multi-stage process to rapidly move from within-team evaluations to lab- and field-based participants studies based on small-sample technology testing methods from Human-Computer Interaction. We present findings from a first-stage evaluation of the Amazfit Bips smart watch for potential use in studies with older adults as part of the methodology validation. A four-person research team conducted evaluations using: 1) a wearables framework for user experience and feature availability; and 2) the System Usability Scale (SUS). Evaluators wore the watch seven days straight from the box. User experience checklists indicated high usability. However, corresponding comments identified challenges with downloading the mobile app, pairing the watch and phone, navigating watch and mobile interfaces, and privacy controls. Average SUS score was 65.6 indicating marginal usability (C grade). While meeting study goals, divergence in usability perceptions suggest the process could be improved by completing each set of instruments separately for the watch and mobile app rather than all at once. Given failures in pairing, app navigation challenges, and small screen size, the Amazfit Bips may be best suited for studies among older adults with a high degree of technical proficiency. For those with little technical experience or high disease burden, training materials and dedicated training with support may be required. Future steps are lab- and field-based tests with older adult participants.
Complementary and Integrative Health Approaches Are Underused Among Older Veterans With Musculoskeletal Pain
Authors: Han Ling , Kerns Robert , Skanderson Melissa , Luther Stephen , Fodeh Samah , Goulet Joseph , Brandt Cynthia 
Published: December 2020

Abstract
Complementary and integrative health (CIH) approaches are recommended in national policy guidelines as viable options for managing chronic pain, yet their use among Veterans has been suboptimal, especially for older Veterans. We identified 64,444 Veterans with a diagnosis of musculoskeletal disorders (MSD) who reported a moderate to severe pain intensity during primary care visits in 2013 from the Veterans Health Administration (VHA) electronic records. Using natural language processing (NLP), CIH use (acupuncture, chiropractic care and massage) was documented for 8169 (6.5%) of 125408 primary care visits in providers’ progress notes. Compared to their younger counterparts, older Veterans aged ≥ 65 years had 21% lower likelihood of using CIH during the year [Odds Ratio (OR): 0.79; 95% Confidence Intervals (CI): 0.73, 0.86] after accounting for demographic, clinical, temporal and spatial confounding using a generalized estimating equation logistic model. Non-white race/ethnicity, tobacco use, medical comorbidities and diagnosis of alcohol or substance use disorders were independently associated with less CIH use (ORs ranging 0.97-0.80, p&lt;0.03-0.0001); whereas female gender, being married and number of MSD diagnoses were associated with greater CIH use (ORs ranging 1.13-1.30, p&lt;0.0001). Redefining CIH use as chiropractic care alone [4.8% person-visits; OR: 0.78 (95% CI: 0.70, 0.86)] or incorporating structured data [9.0% person-visits; OR: 0.76 (95% CI: 0.70-0.82)] in the adjusted GEE model derived consistent results. Research to identify and address barriers to CIH use among older Veterans is encouraged.