bluuebunny/crossref_metadata_2025_split huggingface dataset:
RELATIONSHIP OF CARDIOPULMONARY EXERCISE TESTING AND FIELD WALKING TESTS IN MILD-MODERATE ALZHEIMER’S DEMENTIA
Authors: Salisbury Dereck L , Yu Fang 
Published: November 2019

Abstract
The purpose of this study was to investigate relationships among peak exercise parameters on 6-minute walk (6MWT) and shuttle walk tests (SWT), and laboratory-based cardiopulmonary exercise testing (CPET). These relationships have been established in cardiopulmonary patient populations, but not in community-dwelling older adults with mild-moderate Alzheimer’s dementia (AD). This study is a cross-sectional analysis of the baseline data of 6MWT, SWT, and CPET from the FIT-AD Trial (n=88: 49 males [76.6 {7.0} years and MMSE 21.5{3.5}] and 39 females [77.3 {6.5} years and MMSE 22.1 {3.4}]). Peak values for each test included heart rate (HR), systolic blood pressure (SBP), and rating of perceived exertion (RPE). Peak oxygen assumption (VO2) was measured in the CPET. Peak walking distance (PWD) was measured for the 6MWT and SWT. CPET produced significantly higher peak HR (118.7 [17.5] vs. 106 [22.8] vs. 106 [18.8] bpm), RPE (16 [2.1] vs. 12 [2.3] vs. 11 [2.1]) and SBP (182 [23.7] vs. 156 [18.9] vs. 150 [16.9] mmHg) compared to the SWT and 6MWT respectively. PWD on SWT (240.4 [128.1] m) and 6MWT (364.3 [108.5] m) significantly correlated with peak VO2 (17.0 [4.3]ml/kg/min) on CPET (r=.44 and r=.43) respectively. Correlations of peak VO2 and PWD on SWT in persons with AD are considerably lower than what is seen for persons with cardiopulmonary diseases. This lower correlation seen in our sample may be due to shorter PWD on walking tests. Future research should focus how mobility affects correlation of peak values on these tests.
SUPPORTING FAMILY CAREGIVERS THROUGH PATIENT TRANSITIONS FROM HOSPITAL TO HOME: THE CARE ACT AND BEYOND
Authors: Griffin Joan M , Holland Diane , Bangerter Lauren R , Ingram Cory , Wild Ellen , Taylor Erin , Gentes Rachel , Vanderboom Catherine 
Published: November 2019

Abstract
To date, nearly 40 U.S. states have passed the Caregiver Advise Record and Enable (CARE) Act to support family caregivers during transitions from hospital to home. These laws require hospitals to: 1) record designated family caregivers’ name in a patient medical records during a hospital stay; 2) inform the caregiver when the patient will be discharged; 3) provide education and instructions on care tasks needed for post-hospital discharge. Transitions from hospital to home are often fraught with adverse event risk and poor continuity of care, especially for rural patients with progressive life-limiting conditions. The CARE ACT has potential to address healthcare system factors that are sometimes attributable to poor transitions in care. Our presentation focuses on preliminary findings from an intervention that provides teaching, guidance, and counseling to caregivers caring for an individual receiving palliative care in the hospital and transitioning home to a rural setting. Findings suggest that the CARE ACT may be vital, but not fully sufficient, for successful transitions. Additional targets for caregiver interventions to improve transitions for this subset of very ill patients include: 1) attend to caregivers’ medical and non-medical needs which may impact their capacity to provide care; 2) advise clinical teams to communicate truthfully about prognosis and likely outcomes when creating post-hospital plans of care; 3) encourage caregivers to identify and engage services early in the transition; 4) urge caregivers to draw on multiple sources for social support. Findings can help optimize the CARE Act implementation, particularly in states with large rural populations.
ADDRESSING OLDER ADULT SOCIAL ISOLATION AND ABUSE THROUGH RURAL OUTREACH AND INTER-ORGANIZATIONAL COLLABORATION
Authors: Meinertz Naomi R , Gilligan Megan , Lee Jeongeun , Peitz Louise 
Published: November 2019

Abstract
Elder abuse is commonly linked with social isolation and in a rural state, such as Iowa, older adults may be at increased risk of social isolation and elder abuse. A community-based needs assessment aimed to record the first-hand perspectives of service providers regarding the needs of older adults in rural areas across the state of Iowa, covering 54 of the 99 counties. Through a survey (N=202) and focus groups (N=24), service providers, including direct care, Area Agencies on Aging, law enforcement, and attorneys, offered ways in which to address the gaps in service provision and prevention of elder abuse. Based on survey and focus groups, suggestions included ways to decrease social isolation among older adults by improving service outreach, provider training, and inter-organization communication. Discussion will outline gaps in service outreach and address future inter-organizational collaboration and strategies to prevent social isolation and elder abuse in rural communities.
THE TRANSFORMATION OF LATE-LIFE SINGLEHOOD: EMERGENCE OF THE SOCIETY OF DIVORCEES
Authors: Bildtgard Torbjorn , Öberg Peter 
Published: November 2019

Abstract
More than four decades ago Lopata coined the concept “society of widows” to describe the gendered reality of late life singlehood, where widowed women were excluded from coupled social life and had to depend on other widows for social integration. We have coined the concept “society of divorcees” to describe the changing reality of late life singlehood. Swedish, American and EU census data and a national survey to Swedes 60-90 years old (n=1225; response rate 42%). Results show that more people enter later life as divorcees or become divorced at a high age. Among Swedes 60+ divorcees outnumber widowed people, and the incidence of late life divorce has more than doubled since the millennium in what has been called the grey divorce revolution. Many other Western countries follow the same demographic trend, posing important questions about late life singlehood. Based on two Swedish studies we will show that the structure of the late life single community is becoming less gender skewed as a consequence of the emerging society of divorcees, and that in this society relationship careers are increasingly complex, attitudes to repartnering increasingly liberal and partner sanctification seldom an issue. We conclude by discussing the consequences of the emerging society of divorcees for late life support structures.
MULTIPLE FACTORS INFLUENCING SUCCESSFUL AGING
Authors: Fuller Heather 
Published: November 2019

Abstract
Empirically-based theories on successful aging have emphasized the multidimensional nature of aging well, including physical health and functioning, cognitive and emotional well-being, and social connectedness and engagement (e.g., Rowe & Kahn, 1987, Depp & Jeste, 2006). Yet, the field is still continuing to discover, deeply characterize, and better understand the biopsychosocial mechanisms through which varying social, physical, or cognitive activities may influence unique domains of successful aging. The current symposium builds on this growing body of research by addressing factors supporting successful aging across multiple dimensions of well-being and among a diversity of samples ranging from urban to rural, West Coast to Midwest, and community populations to professional athletes. Webster and Antonucci examine the links between social engagement and successful aging among affordable senior housing residents. They found that more frequent participation in social activities was associated with increases in life satisfaction over time. Toyama and Fuller examine how social engagement and health affect aging well, finding that older adults’ subjective health plays a more important role than objective health in maintaining social integration over time. Similarly, Turner describes the role of social networks and religiosity for health outcomes among aging NFL athletes. Finally, Casaletto and colleagues examined mechanisms underlying cognitive wellness as an aspect of successful aging. They found that engagement in both physical and cognitive activities independently support brain health and cognitive reserve in late-life. Taken together, these presentations provide a diverse and broad perspective on how varying factors influence the multiple dimensions of successful aging.
RELIGIOUS ATTENDANCE, SOCIAL SUPPORT, AND SELF-RATED HEALTH IN FORMER NATIONAL FOOTBALL LEAGUE ATHLETES
Authors: II Robert W Turner , Turner Robert , Sonnega Amanda , Cupery Tim , Bush Evelyn , Rosales Teri , Jackson James S 
Published: November 2019

Abstract
Concern exists about the health and well-being of football players, yet little research exists on the psychosocial risk and protective factors of NFL athletes’ well-being. This study assesses the role of religious attendance, social support, and self-rated health in former NFL athletes. Data comes from a stratified, random sample of 1,063 former NFL players. A set of nested linear regression models evaluated the relationship between self-rated health status and two indices of social support (family and friends) and attendance at religious services. Frequent attendance at religious services (β=0.19, p&lt;.01), support from family (β=0.06, p&lt;.05), and support from friends (β=0.06, p&lt;.01) are positively and significantly related to better self-rated health. The ability to get out of the house did not affect these associations. However, the pain symptoms index fully accounted for any positive effect of family support and religious attendance in self-rated health.
PHYSICAL VERSUS COGNITIVE ACTIVITY FOR SUCCESSFUL AGING: BRAIN MAINTENANCE OR COGNITIVE RESERVE?
Authors: Casaletto Kaitlin , Casaletto Kaitlin B , Pa Judy , Tom Sarah , Arce-Renteria Miguel , Harrati Amal , Armstrong Nicole , Zahodne Laura 
Published: November 2019

Abstract
Mechanisms by which physical (PA) and cognitive (CA) activities promote healthy cognitive aging are unknown. We examined independent contributions of PA and CA to “brain maintenance” (MRI markers of brain integrity) versus “cognitive reserve” (better cognition than predicted by brain integrity) in two independent samples of non-demented older adults (UCSF n=344; UCD n=482). In UCSF, only PA was positively associated with white matter (WM) integrity, while CA attenuated the relationship between WM and cognition. This pattern suggests PA supports brain maintenance, while CA contributes to cognitive reserve. In UCD, CA was positively associated with total gray matter volume; PA was positively associated with age-related WM integrity, and attenuated the association between WM and cognition. This indicates that both PA and CA support brain maintenance, with PA more strongly related to cognitive reserve. There may be preferential, but overlapping pathways by which PA and CA maintain age-related brain and cognitive health.
MULTIMORBIDITY, MENTAL HEALTH, AND TERMINAL DECLINE IN LATER LIFE
Authors: Cadar Dorina , Stirland Lucy , Terrera Graciela Muniz 
Published: November 2019

Abstract
The close interlink between physical and mental health outcomes has long been recognised in gerontological research. Mental-physical comorbidities – the presence of at least one physical health long term condition, and at least one mental health-related long term condition are common in older age individuals. Numerous studies have shown a positive association between the prevalence of multimorbidity and age so, as the population of older individuals in developed nations continues to grow, multimorbidity is likely to become increasingly higher in ageing populations. A major goal in current gerontological neuropsychology and neuroepidemiological research is to better understand how interindividual differences in cognitive and mental health in old age emerge. Cognitive reserve (a marker of brain resilience) may come into play when facing stressors that affect cognitive decline and mental health, such as suffering from chronic diseases. We present data from three different longitudinal studies of ageing i) the Lothian Birth Cohort of 1921, ii) PREVENT and iii) the English Longitudinal Study of Ageing from the United Kingdom. These studies are ideally placed to address key research questions related to mental ageing, psychological health, terminal decline and their determinants. We explored the following objectives: 1) to investigate the association between an increasing number of chronic physical conditions, medication and mental disorders 2) to assess the role of childhood intelligence and education on the terminal decline in later life 3) to investigate the associations between different markers of cognitive reserve and dementia
THE LONG ARMS OF CHILDHOOD INTELLIGENCE AND EDUCATION ON TERMINAL DECLINE: EVIDENCE FROM LOTHIAN BIRTH COHORT 1921
Authors: Cadar Dorina , Cadar Dorina , Robitaille Annie , Pattie Alison , Deary Ian J , Terrera Graciela Muniz 
Published: November 2019

Abstract
We investigated the heterogeneity of cognitive trajectories at the end of life by assigning individuals into groups according to their cognitive trajectories prior to death. Data were from the Lothian Birth Cohort of 1921. Growth mixture modelling was employed to identify groups of individuals with similar trajectories on the Mini-Mental State Examination in relation to time to death, accounting for childhood intelligence, education, hypertension, diabetes and cardiovascular disease. Two distinct groups of individuals (classes) were identified: a smaller class (18%) of individuals whose MMSE scores dropped linearly with about 0.5 points per year, and a larger group (82%) with stable scores across the study period. Childhood intelligence was associated with an increased probability of belonging to the stable class of cognitive functioning prior to death. These findings support a protective role of childhood intelligence, a marker of cognitive reserve, against the loss of cognitive function prior to death.
SURVIVAL ADVANTAGE OF APOE2
Authors: Seshadri Sudha 
Published: November 2019

Abstract
Apolipoprotein E is a glycoprotein mediator and regulator of lipid transport and uptake. The APOE-ε4 allele has been associated with higher risk of Alzheimer’s disease and of mortality, but the effect of the less prevalent APOE-ε2 on survival remains elusive. We aggregated data of 38,537 individuals of European ancestry (mean age 65.5 years; 55.6% women) from six large population-based cohorts to determine the association of APOE-ε2, with survival in the general population. During a mean follow-up of 11.7 years, 17,021 individuals died. Compared with homozygous APOE-ε3 carriers, APOE-ε2 carriers were at lower risk of death (hazard ratio,95% confidence interval: 0.94,0.90-0.99; P=1.1*10-2), whereas APOE-ε4 carriers were at increased risk (HR 1.17,1.12-1.21; P=2.8*10-16). Risk was lowest for homozygous APOE-ε2 (HR 0.89,0.74-1.08), and highest for homozygous APOE-ε4 (HR 1.52,1.37-1.70). Results did not differ by sex. The association was unaltered after adjustment for baseline LDL or cardiovascular disease. Larger, multiethnic collaborations are ongoing.
REDUCED COGNITIVE DECLINE WITH THE APOE ε2/ε2 GENOTYPE IN THE LONG LIFE FAMILY STUDY AND NEW ENGLAND CENTENARIAN STUDY
Authors: Sweigart Benjamin , Sweigart Benjamin , Andersen Stacy L , Cosentino Stephanie , Schupf Nicole , Perls Thomas T , Sebastiani Paola 
Published: November 2019

Abstract
A growing body of evidence has suggested a protective effect on cognition of the ε2 allele of APOE. To determine if APOE ε2 is associated with protection against cognitive decline, we analyzed repeated measures of the Telephone Interview for Cognitive Status (TICS) from 2,933 Long Life Family Study subjects and 679 New England Centenarian Study subjects using a multivariable linear mixed effects model. The median age at first TICS administration was 73 (interquartile range [IQR] 64, 83). Subjects had a median of 3 TICS assessments (IQR 2, 4) and a median follow-up time of 5.0 years (IQR 2.9, 7.0). Carriers of the ε2/ε2 genotype had a significantly slower rate of decline in TICS score compared to the ε3/ε3 reference group (-0.05 points per annum for ε2/ε2 carriers compared with -0.15 points for ε3/ε3 carriers, p-value for difference 0.017). These results support a protective effect of the ε2 allele.
A SERUM PROTEIN SIGNATURE OF APOE GENOTYPES IN CENTENARIANS
Authors: Monti Stefano , Monti Stefano , Sebastiani Paola , Gurinovich Anastasia , Tanaka Toshiko , Jennings Lori L , Glass David J , Perls Thomas T 
Published: November 2019

Abstract
The discovery of treatments to prevent or delay Alzheimer’s disease is a priority. The gene APOE is associated with cognitive change and late onset Alzheimer’s disease, and epidemiological studies have shown that the e_2 allele of APOE has a neuroprotective effect, and it is associated with increased longevity. We correlated APOE genotype data of 222 New England Centenarian Study participants, including 79 centenarians, 84 centenarian offspring and 55 carriers of APOE e_2, with aptamer-based serum proteomics (SomaLogic technology) of 4783 human proteins corresponding to 4137 genes. We discovered a signature of 16 proteins that associated with different APOE genotypes, and replicated the signature in 3 independent studies. We show that the protein signature tracks with gene expression profiles in brains of late onset Alzheimer’s disease vs. healthy controls. Finally, we show that seven of these proteins correlate with cognitive function changes. Therefore, targeting APOE e_2 molecularly may preserve cognitive function.
DO WARMED BLANKETS CHANGE PAIN, AGITATION, MOOD, OR ANALGESIC USE AMONG NURSING HOME RESIDENTS?
Authors: Kovach Christine 
Published: November 2019

Abstract
Warmed blankets have not been empirically tested for use in long-term care. The purpose of this study was to describe the use of warmed blankets in a nursing home setting and to determine if use was associated with changes in pain, agitation, mood, or analgesic use. Short-term measures were compared from baseline to post warmed blanket use and longer term differences were compared between those receiving warmed blankets and a randomly selected comparison group. Excluded from eligibility were those using a transdermal drug, with an acute injury, acute inflammatory process, multiple sclerosis, open skin wound, or other condition that could be worsened by superficial heat. Measures included the Revised Faces Pain Scale, PAIN-AD scale, the Brief Agitation Rating Scale, and from the electronic medical record one month measures pain complaints, pain severity, and analgesic use. Long-term measures were taken from the electronic medical record. Of the 141 eligible residents, 24.1% (n = 34) received a warmed blanket over the one month study period. There were statistically significant decreases in both pain level and agitation between baseline, 20 minutes after application, and the subsequent shift assessments (p &lt; .001). There were also long-term changes in the number of pain complaints (p = .040), severity of pain complaints (p = .009), and prn analgesic use (p = .011). There were no statistically significant differences between the treated group and comparison group on any long-term measures. Warmed blankets are a low-cost intervention with a high potential for bringing comfort to nursing home residents.
ACCESS TO HEALTH CARE FOR LGBT PEOPLE
Authors: Bristowe Katherine 
Published: November 2019

Abstract
LGBT people have higher risk of life-limiting illnesses and unmet needs when facing advanced illness.The ACCESSCare research programme aims to improve health and social care for LGBT people. ACCESSCare-A explored experiences of 40 UK LGBT people facing serious illness. Discrimination, heteronormative assumptions, and insensitivity influenced whether individuals disclosed relationships to professionals and place-of-care decisions. Professionals must go beyond anti-discrimination to proactive inclusion: 10 evidence-based recommendations were developed to improve care for LGBT people. Our sister study in Zimbabwe explored the healthcare experiences of key populations (LGBTI people, sex workers). Access to healthcare was dependent on conforming to ‘sexual norms’ and care was negatively affected by professionals’ attitudes to key populations. There are two ongoing research projects in the ACCESSCare programme: ACCESSCare-B, a mixed-methods population-based comparative study of LGB and heterosexual bereavement outcomes; and ACCESSCare-C a qualitative study to develop communication guidance for professionals supporting LGBT people facing serious illness.
END-OF-LIFE EXPERIENCES AND CARE NEEDS IN THE LIVES OF OLDER LGBT PEOPLE
Authors: Almack Kathryn 
Published: November 2019

Abstract
The socio-cultural and legal position of LGBT citizens varies across nations. However, even in the most liberal countries, an historical legacy of stigma impacts on older LGBT people’s access to care. This paper draws upon the qualitative strand of a two-year UK project exploring the end of life experiences and care needs of older LGBT people. (N = 60 in-depth interviews with LGBT participants aged 60+). Findings highlight that the majority of respondents reported ways in which they manage their personal networks to minimize any vulnerability to discrimination. In planning or needing end-of-life-care, respondents identify new ‘layers’ of decisions about disclosing or hiding their sexual or gender orientation; informed by past experiences and fears about discrimination or exclusion from service providers. In conclusion, older LGBT people’s histories and a legacy of stigma have ongoing profound influences on the means of support available to them at the end of life.
SOCIAL AND BIOLOGICAL PREDICTORS OF HOSPITAL ADMISSIONS FOR A FALL IN THE ENGLISH LONGITUDINAL STUDY OF AGEING (ELSA)
Authors: Abell Jessica G , Lassale Camille , Steptoe Andrew , Batty G David , Zaninotto Paola 
Published: November 2019

Abstract
Falls are the most frequent type of accidents among older people, with one in three people aged over 65 falling each year. Falls serious enough to result in hospital admission are especially problematic, since they can lead to an increased likelihood of future disability, loss of independence, and premature mortality. Understanding the factors that may determine the risk of experiencing a fall, which requires admission to hospital, is therefore an important priority. This paper seeks to examine this issue using Hospital Episode Statistics (HES) data – administrative data from English hospitals in the National Health Service (NHS). These data have recently been linked with the English Longitudinal Study of Ageing (ELSA). We examine the association between a range of predictors (demographic, social environment, physical and mental functioning) drawn from wave 4 of ELSA with the first occurrence of hospitalisation due to an accidental fall, identified using ICD-10 codes. Analysis using Cox regression suggest a range of factors are negatively associated with admission to hospital with diagnosis of a fall, such as living alone (HR=1.42; 95% CI: 1.19, 1.68), urinary incontinence (HR=1.33; 95% CI: 1.09, 1.61) and depressive symptoms (HR=1.50; 95% CI: 1.23, 1.82). High walking speed (HR=0.30; 95% CI: 0.23, 0.39) and good hand-grip strength (HR=0.97; 95% CI: 0.96, 0.98) were found to be protective. The prevention of serious falls amongst older people will require determinants to be identified and managed effectively by health and social care services.