bluuebunny/crossref_metadata_2025_split huggingface dataset:
OSTEOSARCOPENIC OBESITY AND VITAMIN D IN U.S. ADULTS AGES 50 AND OLDER: A CROSS-SECTIONAL STUDY
Authors: Saltzman Barbara S , Kenney Kevin C 
Published: November 2019

Abstract
Osteosarcopenic Obesity (OSO) is the concurrent presence of obesity (excess body fat), sarcopenia (low muscle mass) and osteoporosis (low bone mineral density). Low levels of serum vitamin D (vitD) have been associated with each disease and their simultaneous presence. We examined this association in adults aged ≥50 years from the 2001-2006 survey cycles of the National Health and Nutrition Examination Survey (NHANES) (N=3791). SAS v9.4 complex survey procedures were used. Demographics and vitD status were compared across OSO components (0,1,2,3) by chi-squared tests and ANOVAs. Odds ratios and 95% confidence intervals for the association between vitD status and increasing number of OSO components were calculated using multinomial logistic regression (alpha=0.05). The mean age was 65.0 years (30% were older adults ≥ 65), 45.6% were female, and prevalences for obesity, osteoporosis, sarcopenia and OSO were 84.7%, 8.0%, 16.3%, and 1.8%, respectively. Additionally, 30.9% of the sample was vitD deficient. After adjusting for supplement use, and race, women with 1 or 2, and men with 1,2 or 3 OSO components were more likely to be vitD deficient than sufficient, compared to those with none [women: 2.8(1.4-5.7), 2.1(1.4-6.8), and men: 2.3 (1.5-3.6), 3.5(2.1-5.9) and 6.3(1.0-38.5), respectively]. Vitamin D status was associated with having one or two OSO components in women, and OSO and components in men, after adjusting for supplement use, sex, and race. These results suggest it is important to consider obesity, osteoporosis, and sarcopenia jointly with respect to vitamin D status in the chronic disease management of aging and older adults.
PARADOXICAL ASSOCIATION OF ADIPONECTIN WITH MORTALITY AMONG LONG-LIVED INDIVIDUALS AND THEIR OFFSPRING
Authors: Miljkovic Iva , Boudreau Robert M , An Ping , Thyagarajan Bharat , Christensen Kaare , Schupf Nicole , Kulminski Alexander , Zmuda Joseph M 
Published: November 2019

Abstract
Adiponectin is an adipokine with well-recognized roles as an insulin-sensitizing, anti-inflammatory, and cardioprotective factor. Despite these biological properties, higher circulating adiponectin levels have recently emerged as a potential risk factor for mortality among older adults. We evaluated the relationship between adiponectin and all-cause mortality further using data collected on 3525 men and women who were participants in the Long Life Family Study (LLFS), a multicenter cohort study of two-generation families with a clustering of healthy aging and exceptional survival. Fasting serum adiponectin levels were measured at study entry. Date of death was abstracted from death certificates and proxy. Cox proportional hazards models were used to estimate the risk of mortality per one SD increase in adiponectin. We adjusted for age, sex, field center, education, lifestyle factors, BMI, comorbid conditions (diabetes, hypertension, lung diseases, heart disease, stroke, and cancer) and intra-familial correlation structure. The mean age of participants at study entry was 71.7 ± 16.3 years (range, 32-110 years; 44.4% male). A total of 1147 deaths occurred during an average 11 years of follow-up (25295 person-years). Higher serum adiponectin was associated with increased mortality even after adjusting for several potential confounding factors (Hazard ratio [95% CI]: 1.19 [1.12, 1.27]; P&lt;0.0001). Consistent with prior studies and contrary to its beneficial metabolic properties, higher adiponectin level was associated with greater all-cause mortality among long-lived individuals and their offspring. Further studies are needed to assess the potential mechanisms underlying this paradoxical association.
DETERMINANTS OF QUALITY OF LIFE IN COMMUNITY-DWELLING OLD ADULTS
Authors: Ramel Alfons 
Published: November 2019

Abstract
Background: Quality of life (QoL) has been regarded as a critical predictor of successful aging in gerontological research. Aim: The aim of this study was to examine the associations between physical activity, muscle strength, body composition, physical-/cognitive function and disease with quality of life community-dwelling older adults. Methods: Participants (N=225, 73.7±5.7yrs, 58.2% female) from the Reykjavik capital area in Iceland took part in this cross-sectional study. Socioeconomics, QoL, body composition, muscular strength, timed up and go test (TUG), six minute walk for distance (6MWD) and disease related information were measured. Fasting blood samples were analyzed for routine clinical measures. Results: In our subjects, only 19.1% had QoL below the age and gender corrected norm score of 50. A simple comparison between subjects with QoL below 50 vs subjects with a score above 50 indicated that participants with higher QoL had higher physical and cognitive function, higher muscular strength, lower blood glucose, exercised more and used a lower number of medicines. Differences in education, smoking, alcohol consumption, dietary intake and gender distribution were not significant. According to age and gender corrected linear models, TUG (B=-0.54,P=0.022), number of drugs (B=-0.67,P=0.018) and fasting glucose (B=-0.96,P=0.025) were the strongest independent correlates of QoL. In the models insulin/glucose and TUG/6MWD were interchangeable. Conclusion: Physical function, number of drugs and glucose metabolism are independently related to QoL and represent therefore potentially modifyable targets for future interventions in order to improve QoL in community dwelling old adults.
LIVING ALONE IS ASSOCIATED WITH POORER PHYSICAL FUNCTION AND BONE MINERAL DENSITY IN ICELANDIC OLD ADULTS
Authors: Ramel Alfons 
Published: November 2019

Abstract
Background: Loneliness and living alone have been significant public health concerns among older adults given their association with a wide range of adverse health outcomes. Aim: The aim of this study was to examine whether living alone is associated with physical function and bone health in community-dwelling older adults. Methods: This was a secondary analysis of existing cross-sectional data of old adults (N=182, 73.7±5.7yrs, 58.2% female) from the Reykjavik capital area in Iceland. Information on socioeconomics, health, dietary intake and physical function was collected. 25-hydroxy-vitamin D (25OHD) and bone mineral density (BM were grouped retrospectively into “living alone” and into “in cohabitation”. Results: Of our subjects, 76.4% were in cohabitation and and 23.6% lived alone. Participants who lived alone were older (74.5±5.6 vs. 72.1±5.0,P=0.008) and more often female (74.4 vs. 53.2%,P=0.014), but there were no differences in education, smoking, number of medications, physical activity (PA) or body mass index (BMI). According to age and gender corrected analyses, participants in cohabitation had higher grip strength (6.2±2.4lb,P=0.011), higher 25OHD (13.1±6.3nmol/L,P=0.037) and higher BMD (z-score lumbal: 1.195±0.417,P=0.005; z-score femur: 0.421±0.219,P=0.054; z-score total: 0.846±0.290,P=0.004). Statistical correction for PA, BMI, education and fish oil intake did not change the results. Conclusion: In comparison to old adults who live in cohabitation, Icelandic old adults who live alone have poorer physical function, lower 25OHD and lower BMD, which increases their risk for wrist or hip fracture. These differences between groups were not explained by physical, dietary or social confounding variables.
LONGITUDINAL RELATIONSHIP BETWEEN ENERGY UTILIZATION AND PHYSICAL AND COGNITIVE PERFORMANCE AS A FUNCTION OF AGE
Authors: Kuo Pei-Lun , An Yang , Gross Alden , Simonsick Eleanor M , Resnick Susan M , Schrack Jennifer A 
Published: November 2019

Abstract
Energy utilization, which becomes more inefficient with age and is measured by a ratio of energy-cost-to-energy-capacity (“cost-ratio”), has been associated with functional decline. However, the interplay between longitudinal changes in energy efficiency and physical/cognitive functioning remains unclear. We investigated this relationship in 1020 participants of the Baltimore Longitudinal Study of Aging (baseline age: 68.9 (IQR: 59.8, 80.5), male: 44.7%). In linear mixed effects models adjusted for baseline age, sex, and height, an increasing cost-ratio was associated with faster decline in usual gait speed among those aged 50-64 years (beta = -0.20 m/s, p = 0.003), and &gt;=65 years (beta = -0.16 m/s, p less than 0.001), but not those less than 50 years (beta = -0.22 m/s, p = 0.178). In models adjusted for baseline age, sex, race, and years of education, higher cost-ratio was associated with faster declines in executive function, as measured by time to finish Trail B, among those aged &gt;=65 years (beta = 22.96 seconds, p = 0.020), but not &lt;50 years (beta = -13.65 seconds, p = 0.557) or 50-64 years (beta = -15.61 seconds, p = 0.353). Together, these results suggest that energy utilization becomes more inefficient in the two to three decades prior to change in physical and cognitive functioning, implying it may act as an early marker of physiological aging. Further research is needed to understand the drivers of energy inefficiency, which may shed light on the biological mechanisms contributing to these declines.
SENSITIVITY OF SELF-REPORTED COMORBIDITIES COMPARED TO MEDICARE CLAIMS IN OLDER ADULTS WITH TRAUMATIC BRAIN INJURY
Authors: Vadlamani Aparna , Albrecht Jennifer 
Published: November 2019

Abstract
Patient reported history of comorbid illness may be the only information available to the treatment team during an acute injury admission. Nevertheless, acute injury, particularly traumatic brain injury (TBI) which affects cognition, may decrease the patient’s ability to accurately report medical history. Thus, the objective of this study was to evaluate the accuracy of patient-reported comorbid illness burden compared to the patient’s Medicare administrative claims. Records of older adults treated for TBI at an urban level 1 trauma center 2006-2010 were linked to their Medicare administrative. Comorbidities were recorded in Medicare claims based on ICD9 codes and were reported in the trauma registry (TR) based on patient medical history recorded by a physician or nurse. Prevalence of each of the following comorbidities was calculated using information from the TR and claims: Alzheimer’s disease and related dementias, chronic kidney disease, COPD, heart failure, diabetes, depression, stroke, and hypertension. Sensitivity of each patient-reported comorbidity was calculated using Medicare claims as the gold standard. We identified patient factors associated with accurate self-report using logistic regression. Among 408 older adults with TBI that linked to their Medicare claims, prevalence of each comorbidity was higher in Medicare claims compared to the TR, except for hypertension. Sensitivity for detecting these comorbidities using the TR ranged from 2% to 68%, with the highest sensitivity observed for hypertension. Older age and race were predictors of less accurate reported medical history. Reconciling self-reported patient history of these comorbidities with those reported in claims can better inform decisions regarding treatment.
TOWARD AN OPERATIONAL DEFINITION OF COGNITIVE LIFESTYLE: MODELING RESERVE ACROSS THE LIFESPAN
Authors: Swann Lisa , Matthews Fiona E 
Published: November 2019

Abstract
A recent systematic review of current definitions of cognitive reserve across the lifespan was undertaken by our group and five reserve constructs were identified: Educational attainment, sociological position, occupational complexity, cognitive ability, and engagement in leisure activities. The aim of this study was to test whether the different constructs are predictive of cognitive performance in older adults. A theoretical model of cognitive lifestyle was designed to assess reserve across the lifespan and the different measures were mapped in individuals aged &gt;=65 years (N=7,762; 54.47% women) from the Cognitive Function and Ageing Study (CFAS II). Multivariable logistic regression analyses, controlling for age and sex, were used to determine the relationship between later life cognitive function and the five identified measures of reserve. In support of previous findings, the results show that risk of cognitive decline decreases with additional education (OR=0.89; 95% CI= 0.86, 0.94), increasing fluid intelligence (OR=1.00; 95% CI= 0.99, 1.00), and participation in leisure activities (OR= 0.27; 95% CI=0.17, 0.42), and that the lower the hierarchical position of a person’s social strata, the greater their odds of cognitive impairment in later life (OR=1.02; 95% CI=1.00, 1.05). However, though greater occupational complexity with data (OR=1.11; 95% CI=1.03, 1.19) and with people (OR=1.10; 95% CI= 1.03, 1.19) was found to be protective of cognitive decline as expected, greater occupational complexity with things was associated with greater decline (OR=0.98; 95% CI=0.93, 1.04). Given the cross-sectional nature of the present study, further longitudinal work is needed to ascertain what is driving these results.
HOW NETWORKS OF MEDICARE BENEFICIARY PATIENT TRANSFERS AFFECT HOSPITAL C. DIFFICILE OUTBREAK RISK
Authors: Cohen Catherine C , Muggy Timothy Luke 
Published: November 2019

Abstract
Clostridium difficile (CDI) is the most common healthcare associated infection (HAI), and it causes particularly high morbidity and mortality among older adults. While risk factors for this deadly HAI have been explored at the patient and facility levels, less is known about transmission between facilities. Recent literature suggests that more patient transfers to a hospital are correlated with elevated CDI levels. However, this work excludes skilled nursing facilities (SNFs), although SNFs are a major contributor of older adult patients to hospitals. We use multiple large data sets to make progress in filling several existing knowledge gaps. First, we construct and analyze healthcare facility networks using transfers of Medicare beneficiaries in the Minimum Data Set 3.0 and Medicare claims data from New Mexico, New York, Connecticut, and Colorado. We evaluate the role of SNFs in networks through the volume and frequency of patient flows in and out of individual hospitals. We also assess the level of interaction (i.e., transfers) between facilities of different sizes, locations, and types. Second, using the Healthcare Cost and Utilization Project State Inpatient Databases, we examine whether a hospital CDI outbreak is predictive of CDI incidence across a network of hospitals, using multiple existing metrics of CDI incidence, noting strengths and weaknesses for each. These two aims lay the foundation for future work to examine the relationship between patient transfers and the distribution of outbreaks. Such work may be able to identify facilities that present the greatest CDI risk to older adults across a facility network.
TEMPORAL TRENDS IN INCIDENCE RATES OF VISION IMPAIRMENT AMONG MIDDLE-AGED AND OLDER CHINESE
Authors: Cao Gui-Ying , Yao Shan-Shan , Chen zi-shuo , Huang Zi-Ting , Xu Beibei 
Published: November 2019

Abstract
This study aimed to investigate temporal trends in the incidence rates (IRs) of vision impairment (VI) and explore its associated factors among middle-aged and older Chinese. Data were obtained from China Health and Retirement Longitudinal Study (CHARLS, 2011-2015) and Chinese Longitudinal Healthy Longevity Survey (CLHLS, 1998-2014). There were 20,467 participants with a mean age of 57.4 years from CHARLS and 21,210 participants with a mean age of 90.0 years from CLHLS. Distance and near vision were self-reported in CHARLS and performance-based vision was assessed in CLHLS. Crude and age-adjusted IRs per 1,000 person years (PY) of distance vision impairment (DVI), near vision impairment (NVI) and both distance and near vision impairment (DNVI) in CHARLS and VI in CLHLS were calculated for each wave of surveys. Risk factor adjusted temporal trends in the incidence were examined using regression models. Age-standardised IRs for DVI, NVI and DNVI significantly decreased from 79.4 to 41.2, 95.1 to 48.0 and 40.0 to 21.3 (P &lt; 0.001) from 2013 to 2015, respectively. Male gender, higher education, no ADL disability, no depression, no multimorbidity were associated with lower IRs of DVI, NVI or DNVI. Younger age was associated with lower IRs of DVI and DNVI but higher IRs of NVI. Age-standardised IR of VI significantly decreased from 131.6 to 71.9 (P = 0.010) from 2000 to 2014, and higher education and living in the South were associated with lower IR of VI. Future studies may further investigate the causality of such phenomenon.
CHARACTERISTICS OF CAREGIVERS WITH FAMILY CONFLICT
Authors: Dieker JoAnna , Bacharz Kelsey , Weber Kendall , Qualls Sara H 
Published: November 2019

Abstract
The family environment is often overlooked in caregiver research and assessment, despite having implications for caregiver health and well-being (Zarit et al., 2019). The purpose of the present study was to examine differences on two types of family conflict (beliefs and support) among a diverse sample of caregivers. The present sample consisted of help-seeking (n = 375) and non-help-seeking (n = 415) caregivers (total n = 790). Caregivers filled out the Caregiver Reaction Scale (O’Malley & Qualls, 2017), a multidimensional assessment of the caregiver experience. Results of a 2 (adult children, spouse) x 2 (help-seeking, non-help-seeking) ANOVA indicated that help-seeking caregivers reported significantly more conflict over family beliefs than did non-help-seeking caregivers (M = 1.93 and 1.58, respectively), F(3,606) = 21.10 p &lt; .001. Adult children caregivers reported significantly greater conflict over family beliefs (M = 1.91) than did spouse caregivers (M = 1.60), F(3,606) = 10.66, p &lt; .001. Adult children caregivers also reported significantly greater conflict over family support (M = 1.87) than did spouse caregivers (M = 1.57), F(3,600) = 16.23, p &lt; .001. Results highlight that certain caregiving contexts (e.g., adult children caring for a parent) potentially increase family conflict, which has implications for caregiver burden. Family conflict over beliefs is also related to help-seeking in caregivers. Findings inform appropriate assessment and intervention regarding the family environment in caregiving.
THE EVALUATION OF INTERPROFESSIONAL EDUCATION IN PRIMARY CARE: A SOCIAL NETWORK ANALYSIS
Authors: Smit Linda C , Dikken Jeroen , Moolenaar Nienke M , Schuurmans Marieke J , De Wit Niek J , Bleijenberg Nienke 
Published: November 2019

Abstract
Effective, safe, person-centred care relies on skilled interprofessional collaboration (IPC) and practice. Little is known about interprofessional education (IPE) to increase IPC in the context of care for frail older people in the community. This study evaluates the effectiveness of IPE on IPC of primary health and social care providers providing care to frail older people in three districts in the Netherlands. A before-after study among 55 health care professionals using social network analysis was performed. The number of contacts increased on average with two contacts. The reciprocity in the districts increased with 15%, 2% and 13%. The diversity of contacts increased between 6% and 10% (p &lt;.001; p .055; p .371). The IPE effectuated a larger, more collaborative, and diverse interprofessional network of health and social care professionals providing care to frail older people suggesting a ripple-effect of networked interventions.
SOCIOECONOMIC DETERMINANTS OF INFORMAL CAREGIVING IN INDIA
Authors: Cheng Kent Jason G , Wilmoth Janet M 
Published: November 2019

Abstract
This study investigates the socio-economic determinants of informal caregiving for elderly parents in urban India, with a focus on caste differences. Bivariate and multivariate logistic regression models of caregiving are estimated with data from 2011 data of Osaka University’s Preference Parameters Study. Three types of caregiving are examined: helping with housework, financial assistance, and providing care. The control variables include: age, sex, marital status, wealth, religiosity, self-rated health, parents requiring care, number of siblings, and number of co-resident children. The bivariate analysis indicates that the highest caste is significantly less likely than the lowest caste to help with housework (OR=.734, SE=.127). In the fully specified models, there is not a significant difference between caste groups in the likelihood of helping with housework or providing financial assistance, but the highest caste is more likely than the lowest caste to provide care (OR=1.443, SE=.309). Being female and married significantly lowers the odds of each type of caregiving. Wealth increases the likelihood of providing help with housework and financial assistance. When both parents require care, children are more likely to provide financial assistance and help with housework, but when one parent requires care, children are more likely to provide care. Overall, sex, marital status, and wealth are the strongest predictors of helping with housework and financial assistance, whereas sex, marital status, and caste are the most important predictors of providing care. The implications of these findings for aging parents and adult children in urban India are discussed.
LONGITUDINAL CHANGES IN WELL-BEING OF PARENTS OF INDIVIDUALS WITH DEVELOPMENTAL OR MENTAL HEALTH PROBLEMS
Authors: Sloan Carlie J , Mailick Marsha R , Hong Jinkuk , Ha Jung-Hwa , Greenberg Jan S , Almeida David M 
Published: November 2019

Abstract
The negative impact of having a child with special needs on parental well-being is well documented. Previous research has suggested age attenuation of these impacts. However, this has not yet been examined longitudinally in late life. Therefore, it is unclear how the effect of having a child with a developmental disability or mental health problem changes as parents age and children become less likely to live at home. Using responses from the Study of Midlife in the United States (MIDUS), this study investigates: (1) longitudinal changes in the effect of having a child with a developmental or mental health problem on parental well-being, (2) age and gender moderations on these effects, and (3) the unique impact of factors directly related to the child’s condition. Multiple linear regressions revealed that having a child with a developmental disability was predictive of higher negative affect, more somatic symptoms, and lower psychological well-being longitudinally. Additionally, there was a main effect of having a child with a mental health problem in predicting higher negative affect. However, age moderations were revealed such that the effect of having a child with a developmental disability or mental health problem was diminished for older parents. Additionally, within-group analyses revealed that longer duration of developmental disabilities and later parental age of onset of mental health problems were predictive of better outcomes. Overall, results suggest that although having a child with special needs is related to poorer well-being, these effects can attenuate as parents age and adapt.