bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lifestyle Interventions for Persons with Dementia: Singing your Way Toward Wellness
Authors: McDowell Cynthia , Santana Sebastian , Smith André , Sheets Debra , MacDonald Stuart 
Published: December 2020

Abstract
Arts-based interventions represent an inexpensive, non-pharmacological, and non-invasive approach to help mitigate negative symptoms and improve quality of life for persons with dementia (PwD). The present study examined whether a social singing intervention can modulate patterns of cognitive change and whether select biopsychosocial indicators exhibit concomitant within-person time-varying covariation. Participants with dementia (n=32, mean age=79.6 years; 53% female) engaged weekly in the Voices in Motion project, an intergenerational, social-cognitive choral intervention spanning up to 18 months and 9 individual assessments. The Mini Mental State Examination (MMSE), gait velocity, and positive and negative affect were assessed using an intensive repeated-measures design, with multilevel models of change employed to disaggregate both between- and within-person effects. Across months of the social intervention, several significant within-person time-varying associations were observed; on occasions when a given individual performed one unit faster on gait velocity (p&lt;.05) or one unit lower on negative affect (p&lt;.01), relative to their personal average, there were corresponding improvements in cognitive function. Notably, in contrast, MMSE change remained relatively stable over the course of the 18-month intervention (-0.105, p=0.12), with little between-subject variability in rates of change. These findings imply that, within-persons, reducing comorbidities associated with dementia (e.g., elevated negative affect and its corresponding impact on cognitive resource competition) through participation in a lifestyle intervention may facilitate increases in cognitive, physiological, and psychological function. Implications are discussed with regard to the merits of invoking virtual lifestyle interventions for socially isolated individuals (e.g., PwD and those in residential care).
Age Differences in Executive Control Assessed with a Robotic Object Hit and Avoid Test of Rapid Motor Decision Making
Authors: Watral Alexandra , Trewartha Kevin 
Published: December 2020

Abstract
Motor decision-making processes are required for many standard neuropsychological tasks, including the Trail Making Test (TMT), that aim to assess cognitive functioning in older adults. However, in their standard formats, it is difficult to isolate the relative contributions of sensorimotor and cognitive processes to performance on these neuropsychological tasks. Recently developed clinical tasks use a robotic manipulandum to assess both motor and cognitive aspects of rapid motor decision making in an object hit (OH) and object hit and avoid (OHA) task. We administered the OH and OHA tasks to 77 healthy younger adults and 59 healthy older adults to assess age differences in the motor and cognitive measures of performance. We administered the TMT parts A and B to assess the extent to which OHA performance is associated with executive functioning in particular. The results indicate that after controlling for hand speed, older adults performed worse on the OH and OHA tasks than younger adults, performance declines were far greater in the OHA task, and the global performance measures, which have been associated with cognitive status, were more sensitive to age differences than motor measures of performance. Those global measures of performance were also associated with measures of executive functioning on the TMT task. These findings provide evidence that rapid motor decision making tasks are sensitive to declines in executive control in aging. They also provide a way to isolate cognitive declines from declines in sensorimotor processes that are likely a contributing factor to age differences in neuropsychological test performance.
Age, Sex and Cerebral Microbleed Effects On White Matter Degradation After Traumatic Brain Injury
Authors: Irimia Andrei , Dharani Ammar , Ngo Van , Robles David , Rostowsky Kenneth 
Published: December 2020

Abstract
Mild traumatic brain injury (mTBI) affects white matter (WM) integrity and accelerates neurodegeneration. This study assesses the effects of age, sex, and cerebral microbleed (CMB) load as predictors of WM integrity in 70 subjects aged 18-77 imaged acutely and ~6 months after mTBI using diffusion tensor imaging (DTI). Two-tensor unscented Kalman tractography was used to segment and cluster 73 WM structures and to map changes in their mean fractional anisotropy (FA), a surrogate measure of WM integrity. Dimensionality reduction of mean FA feature vectors was implemented using principal component (PC) analysis, and two prominent PCs were used as responses in a multivariate analysis of covariance. Acutely and chronically, older age was significantly associated with lower FA (F2,65 = 8.7, p &lt; .001, η2 = 0.2; F2,65 = 12.3, p &lt; .001, η2 = 0.3, respectively), notably in the corpus callosum and in dorsolateral temporal structures, confirming older adults’ WM vulnerability to mTBI. Chronically, sex was associated with mean FA (F2,65 = 5.0, p = 0.01, η2 = 0.1), indicating males’ greater susceptibility to WM degradation. Acutely, a significant association was observed between CMB load and mean FA (F2,65 = 5.1, p = 0.009, η2 = 0.1), suggesting that CMBs reflect the acute severity of diffuse axonal injury. Together, these findings indicate that older age, male sex, and CMB load are risk factors for WM degeneration. Future research should examine how sex- and age-mediated WM degradation lead to cognitive decline and connectome degeneration after mTBI.
Neuropsychiatric Symptoms by Cognitive Status for Mexican-Americans Aged 85 and Older
Authors: Vu Lan 
Published: December 2020

Abstract
Older adults with dementia and cognitive impairment often experience neuropsychiatric symptoms (NPS). Few studies have investigated the presence of NPS among older Mexican-American adults. Our objective was to describe the NPS of Mexican-Americans 85 years and older according to cognitive status. Data came from wave 9 (conducted in 2016) of the Hispanic Established Populations for the Epidemiological Study of the Elderly. The final sample consisted of 381 care recipients aged 85 years and older, along with their caregivers. The 12-item Neuropsychiatric Inventory (NPI-12) was administered to measure behavioral and psychiatric symptoms among the care recipients. Cognitive impairment was defined as a score of 18 or less on the Mini Mental Status Exam (MMSE). Care recipients with a diagnosis of dementia as reported by the caregiver were also classified as cognitively impaired. Overall, 259 (68.0%) participants had one or more NPS. Logistic regression models were used to estimate the average marginal effect (range = -1 to 1) of cognitive impairment on NPS, controlling for care-recipient characteristics. Approximately 87% of care recipients with cognitive impairment had at least one NPS compared to 55.8% of those without cognitive impairment (p&lt;0.01). The predicted probability of having one or more NPI symptoms was 0.25 percentage points (95% CI=0.14-0.35) higher for participants with cognitive impairment than those without. NPS are present in the majority of older Mexican American adults, particularly in those with cognitive impairment. Future research could also investigate sociodemographic correlates of NPS.
Older and Younger Adults Reappraise Negative Life Events in Different Ways
Authors: Hamilton Lucas , Allard Eric 
Published: December 2020

Abstract
Past reappraisal studies have been equivocal regarding age and reappraisal efficacy potentially due to the use of laboratory-generated stimuli. We examined reappraisal in a more self-relevant context: negative autobiographical events. 49 younger adults (YA) and 47 older adults (OA) generated 50 negative memories and provided negativity, positivity, and vividness ratings. One to two weeks later, participants underwent the reappraisal task during which physiological data were collected. Participants implemented one of three instructions for 30 seconds: remember naturally, increase negative reactions, or decrease negative reactions via a “positivizing” tactic. Each instruction was provided for 10 unique memories with negativity, positivity, and vividness ratings collected after each trial. 2 (Age; YA, OA) × 3 (Instruction; Remember, Increase, Decrease) mixed ANOVAs uncovered no differences in negativity or vividness ratings before reappraisal. However, OAs rated all memories more positively than YAs. This age difference persisted after reappraisal; however, OAs rated all memories more negatively and vividly than YAs, although both decreased compared to pre-reappraisal levels. Cardiorespiratory data were tested via 2 × 3 mixed ANOVAs, uncovering only a main effect of age on average heart rate. A multilevel model revealed significant variability in the time-course of pupillary responses. 2 × 3 mixed ANOVAs illustrated that reappraisal brought about faster and more frequent spikes in pupil diameter, particularly for OAs. We conclude that OAs and YAs may achieve reappraisal in different ways. Contrary to strict hedonic orientations, OAs simultaneously maintain higher negativity and positivity than YAs challenging existing propositions regarding age-related prioritization of hedonic goals.
Clinical Interventions for HIV-Associated Neurocognitive Disorder (HAND): A Systematic Review
Authors: Mitchell Hannah , Robinson Erin , Donehower Allison 
Published: December 2020

Abstract
Despite the widespread use of antiretroviral therapy, HIV-associated neurocognitive disorder (HAND) continues to be one of the most common central nervous system complications of human immunodeficiency virus type 1 (HIV-1). The severity and prevalence of HAND underscores the need for safe, effective therapies to mitigate or eliminate the impacts of the disorder to improve the quality of life of individuals living with HAND. The current study conducted a systematic review of the literature regarding experimental studies of clinical therapeutic interventions for HAND. An electronic search of four databases (PsycINFO, SCOPUS, Ovid MEDLINE, and CINAHL) initially returned 4,280 articles, 31 of which met the inclusion criteria for this study. Articles were selected for inclusion based on several criteria, including the use of a clinical experimental study design and measurement of neuropsychological performance. A large number of studies were excluded due to utilizing observational or cross-sectional designs, relevance, or for otherwise not meeting inclusion criteria. The results of this review revealed 31 articles that investigated both pharmaceutical and cognitive therapies for HAND. Pharmaceutical interventions range from common antiretroviral therapies to novel drug classes with various mechanisms of action. Importantly, this review revealed a number of limitations present in the greater body of HAND research including inconsistencies among methods of diagnosis of HAND and study design, which ultimately make comparisons across studies difficult. This review presents the current evidence that exists regarding therapies for HAND and broadly discusses trends, limitations, and gaps in the literature.
The BAND Test: Improving Reliability and Balance Testing for People with Neurocognitive Impairments: A Pilot Study
Authors: Hahn Evelyn , Moore Melissa , Neirman Lindsay , Arcadia Stephanie , Krasa Stacy-Jo , Majid Tabassum 
Published: December 2020

Abstract
People with neurocognitive impairments have a higher risk of falls compared to other older adults and require specific cues for evaluation. Additional options for balance testing is necessary to improve reliability and assessment of fall risk. This study established the efficacy of the novel Balance Assessment for Neurocognitive Deficits (BAND) in order to improve measurement of fall risk for people with neurocognitive impairments. The BAND was analyzed for construct validity and reliability through comparison with the Berg Balance Scale (BBS). Older adults with neurocognitive impairments (n=15) in subacute and long-term settings performed BAND and BBS assessments during therapy. Clinicians determined ambulation assistance, fall risk, and time. Calculation of intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable change (MDC95) values was completed. Corresponding ICC values were 0.985 (95% confidence interval (95% CI), 0.956-0.995) for test-retest reliability and 0.995 (95% CI, 0.985-0.998) for inter-rater reliability. Other values included SEM=0.79 and MDC95=2.18. A linear-regression graph including Pearson’s coefficient (r) demonstrated validity through comparing BAND and BBS and showed a strong correlation (r=0.94, 95% CI, 0.825-0.98). A Bland-Altman plot was created to assess agreement between clinicians, and the mean difference was 0.2667 with 95% limits of agreement (-0.897 to 1.430). The BAND demonstrated excellent reliability and agreement for clinicians providing the test. Further research is necessary to compare the BAND with additional assessments and to demonstrate the utility in expanded populations including the community.
An Assessment of Attendee Experiences With a Workshop to Reframe Aging-Related Communications
Authors: Chesser Stephanie , Porter Michelle 
Published: December 2020

Abstract
In 2018, the Centre on Aging at the University of Manitoba adapted the FrameWorks Institute’s Gaining Momentum toolkit into an interactive workshop that was delivered to aging-related stakeholders (e.g., health professionals, educators, researchers, advocates, older persons) across the province of Manitoba, Canada. The purpose of this study was to complete a qualitative assessment of attendee experiences with the workshop and its impact, if any, on their aging-related communication behaviours. Study participants completed two telephone interviews—one approximately two weeks and one approximately three months post-workshop—about their workshop experiences, motivations for attending, and short and long-term communication goal setting. Through the interviews, most participants expressed positive experiences with the workshop content, as well as an enjoyment of its interactive elements (e.g., self-introduction activity, reframing short and long form aging-related communications, group feedback). Several also shared specific examples of how workshop content was influencing their short/long-term aging communication strategies. Some participants, however, also identified ways that local culture could impact the interpretation of and, thus, potential success of workshop language and/or framing recommendations in specific communities. Overall, the findings from this study suggest that the Gaining Momentum workshop was a valuable experience for attendees that inspired critical assessment of, and changes to, the ways they communicated about aging in their professional and personal lives. Future research is warranted to explore the ways its content could be adapted to better meet the unique communication considerations within the province of Manitoba (e.g., cultural, geographic, and language-related implications).
Virtual Reality Therapy Takes Greenspace to Older Nursing Home Residents: A Pilot Study
Authors: Blankenship Jody 
Published: December 2020

Abstract
Nature-based virtual reality (VR) interventions can offer a safe adjunct approach for managing depression and anxiety, but applications of this innovative technology have not been studied in the nursing home (NH) setting. Pleasant events like those generated with VR may provide a psychological time-out from the ongoing stress associated with living in an NH, and thereby, may facilitate adaptive coping. This study, conducted between January and February of 2020, aimed to pilot test the effects of ViRT-Ta-GO: Virtual Reality Therapy Takes Greenspace to Older NH residents on the severity of depressive and anxiety symptoms among NH residents aged 60 years and older and obtain estimates of effect sizes on outcome measures. Using a quasi-experimental, one-group, pretest-posttest design, nine cognitively intact NH residents (Mage = 81, SD = 10.23) were recruited from two Pennsylvania NHs. The outcome measures included the Patient Health Questionnaire-9, Geriatric Anxiety Inventory, and 10 open-ended questions. Residents participated individually in three 10-minute VR sessions per week for four weeks. There were no adverse effects. Participant attrition and self-report indicated that ViRT-Ta-GO was feasible and acceptable. At posttest, a Wilcoxon signed rank test showed a significant decrease in anxiety symptoms (z = -2.02, p = .04) with a large effect size (r = -.48). Nonsignificant trend improvements in depression were observed (p = .08), pretest to posttest. The 4-week VR intervention was effective in reducing symptoms of anxiety. Preliminary findings demonstrate utility within an NH population, suggesting it will be advantageous to evaluate ViRT-Ta-GO through controlled clinical trials.
Exploration of Barriers and Facilitators for Deprescribing Opioids and Benzodiazepines to Reduce Older Adult Falls
Authors: Roberts Ellen , Henage Cristine , Armistead Lori , Hughes Tamera , Niznik Joshua , Schlusser Courtney , Busby-Whitehead Jan , Ferreri Stefanie 
Published: December 2020

Abstract
As part of a randomized control trial for deprescribing opioids and benzodiazepines (BZD) to reduce falls (funded by Centers for Disease Control), we conducted a virtual focus group and surveys to evaluate opioid and BZD prescribing practices among healthcare providers in four primary care clinics in North Carolina. Survey and focus group questions measured providers’ confidence in their abilities to weigh benefits and harms of opioids and/or BZDs in older adults; determine alternative interventions; create a safe dosing plan; and incorporate patient preferences. A validated pre-intervention survey, adapted from a survey by the Canadian Deprescribing Network, was administered to providers in control and intervention clinics (n=29). Providers expressed high confidence in their abilities to weigh risks and benefits of deprescribing opioids and BZDs, but low confidence in deprescribing under impeding circumstances (e.g. when not the original prescriber or when there is no evidence to inform them). Results were similar across opioids and BZDs. A focus group was conducted among seven providers from the two intervention clinics. Barriers to deprescribing identified included patient resistance, lack of knowledge of deprescribing best practices, and lack of time to discuss deprescribing during regular clinic visits. Providers also expressed concerns about deprescribing medications initiated by or managed by other prescribers. Key facilitators of deprescribing included patient trust in physician, patients being agreeable to reduce medications, and use of gradual tapering rather than abrupt discontinuation. Barriers and facilitators were subsequently used to optimize training and provider resources for the deprescribing intervention, which is currently being implemented.
Investigating Falls and Rehabilitation Use in Older Wheelchair Users from the National Health and Aging Trends Study
Authors: Nie Qiong , Rice Laura , Sosnoff Jacob , Rogers Wendy 
Published: December 2020

Abstract
Falling is a serious health concern among older wheelchair users as falling may result in functional impairment, morbidity, and mortality. Researchers have examined prevention strategies of falls. However, little is known about the prevalence of falls and rehabilitation service use among wheelchair users over age 65. We analyzed a population-based data set – the National Health and Aging Trends Study– to describe trends over time of wheelchair use among older adults who completed a sample interview in this study; we further identified 417 community-dwelling older wheelchair users in wave 5, described prevalence of falls and rehabilitation service use among them and investigated indicators of fall-related rehabilitation service utilization using multinomial logistic regression. The results indicated that there was an increasing trend of wheelchair use from 2011 (7.2%) to 2019 (10.6%). Falling was a common problem (56.1%); however, only 12.1% received rehabilitation service addressing the problem of falls. Around half of rehabilitation service users reported that their functioning improved, but the effect was not lasting. Age (74-79 years old: odds ratio [OR] =2.72, 95% confidence interval [CI], 1.01-7.33; 80-84 years old: OR= 2.93, 95% CI, 1.19-7.25) and balance or coordination problem (OR= 4.70, 95% CI, 1.84-12.06) were associated with receiving fall-related rehabilitation. These data suggest that we need to understand more about the underuse of the rehabilitation services, ensure that older wheelchair users are equally utilizing the services to prevent falling and improve the long-lasting effect of the services.
Dementia Caregivers Perspectives of Caregiving, Burden, Emergencies, and Emergency Preparedness
Authors: Crawford Nicole , Levin Bruce , Amber Gum , Martinez-Tyson Dinorah , Huntington-Symons Makeba , Masys Anthony 
Published: December 2020

Abstract
Limited research has been conducted regarding the perspectives of caregivers of persons with dementia (PWD) regarding preparing for emergencies. The purpose of this study was to understand dementia caregivers’ perceptions of burden, emergencies, and emergency preparedness through the caregiving lens. Fourteen semi-structured interviews were conducted with a purposive sample of dementia caregivers who reside in Hillsborough County, Florida, to gain participants’ perspectives. Data were analyzed using the thematic analysis method. Caregivers discussed emergencies in terms of medical issues, mostly related to the PWD’s health, as well as natural disasters such as hurricanes. Caregivers discussed their perspectives of caregiving and burden as centered around their roles and experiences with the PWD, including ways in which they would deal with emergencies such as natural disasters. Caregivers reported that they were physically prepared for emergencies (i.e., hurricanes) but not mentally prepared for coping with or helping their loved ones cope with the stress of an emergency related event. The interviews presented opportunities to raise awareness of emergency preparedness resources and provide information specific to each caregivers’ situation. The results suggest the caregiver role may be essential to mitigating the adverse effects of emergencies on PWDs. Recommendations for practice include providing person-centered care, individualized emergency planning, and interprofessional collaboration.