bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamics of Multimorbidity Resilience and Health Outcomes Over Time in Community-Residing Older Adults
Authors: Xu Yingzhi , Rahmaty Zahra , McConnell Eleanor , Xue Tingzhong (Michelle) , Kang Bada , Corazzini Kirsten 
Published: December 2020

Abstract
Multimorbidity resilience may mitigate the adverse effects of multiple chronic diseases on older adults’ health. Wister et al.’s (2018) multimorbidity resilience index was developed and tested in a cross-sectional sample of older adults in Canada. Building on these findings, we examined the reciprocal relationships of resilience on outcomes to test these potentially mitigating effects in a community-based, U.S. sample of older adults over time. The study sample includes 1,054 older adults from waves 2 and 3 of the National Social Life, Health, and Aging Project (NSHAP) study (Waite et al 2020). Wister et al.’s (2018) index was mapped to NSHAP measures, and reciprocal relationships of multimorbidity resilience and health outcomes over a 5-year period was tested using structural equation modeling (SEM). Results indicated significant effects of multimorbidity resilience on self-rated physical health and pain. Interestingly, a better functional resilience at baseline conferred better self-rated physical health at follow-up, while better psychological resilience predicted lower pain level. By contrast, the influence of health outcomes on any domain of multimorbidity resilience was not detectable at all, supporting the direction of these associations from resilience to outcomes. The study systematically investigated the dynamic hypotheses between multimorbidity resilience and health outcomes. That is, whether they are determinants or consequences, or both. Our findings suggest multimorbidity resilience predicts subsequent 5-year change in health outcomes, especially self-rated physical health and pain level, but not vice versa, strengthening the evidence of the importance of resilience in the health of older adults.
Can Light Physical Activity Improve Cognition Among Older Adults? A Scoping Review
Authors: Erlenbach Emily , McAuley Edward , Gothe Neha 
Published: December 2020

Abstract
Although the physical and cognitive benefits of moderate-vigorous intensity physical activity (MVPA) for older adults is well documented, this population often faces age-related functional and physical limitations impeding recommended MVPA participation. Recently, there has been a surge of interest in the independent health benefits of light-intensity physical activity (LPA) and its association with morbidity and mortality risk. LPA is the most common form of activity among older adults and its potential to combat cognitive aging needs to be investigated. The purpose of this scoping review was to catalog existing evidence on the association between device-based or technologically measured LPA and cognition among healthy older adults, identify trends in the literature, and pinpoint future areas of research. Six electronic databases were searched between January and August 2020. Eighteen published studies met the inclusion criteria: one acute exercise study, two randomized control trials (RCTs), twelve cross-sectional studies, and three longitudinal studies. Overall, n=9 studies (n=1 RCT, n=7 cross-sectional, and n=1 longitudinal) reported a significant, positive relationship between LPA and one or more cognitive outcomes including memory, attention, executive function and global cognition (MMSE/MOCA). These heterogeneous findings can largely be attributed to the diverse study designs, inconsistent definitions of LPA and numerous assessments used to test the cognitive domains. Collectively, these findings suggest LPA may be a potential lifestyle intervention to improve cognition among healthy older adults. However, the inconsistent approaches used among these studies suggests a more concerted, unified scientific approach and rigorous methodology are needed to further understand the LPA-cognition relationship.
A Longitudinal Analysis of the Association Between Subclinical Hearing Loss and Cognition
Authors: Irace Alexandria , Armstrong Nicole , Deal Jennifer , Chern Alexander , Ferrucci Luigi , Lin Frank , Resnick Susan , Golub Justin 
Published: December 2020

Abstract
Several studies have demonstrated that age-related hearing loss (defined as &gt;25 dB pure tone average [PTA]) is longitudinally associated with worse cognition. We aimed to investigate whether subclinical hearing loss (SCHL), or imperfect hearing traditionally categorized as normal (PTA ≤25 dB), may be similarly linked to cognitive decline. Subjects included cognitively normal adults ≥50 years old in the Baltimore Longitudinal Study of Aging with PTA ≤25 dB measured between January 1991 - September 1994 who had repeated cognitive assessments from January 1991 - November 2019 (n=263). The exposure was hearing based on the better ear PTA. The outcomes were standardized test scores in the following domains: learning/memory, mental status, executive function, visuospatial ability, and language. Multivariable linear-mixed effects models with random intercepts and slopes and unstructured variance-covariance structure were used to model the association between hearing and change in cognition over time, adjusting for baseline age, sex, years of education, and race. Mean age was 68.3 years (standard deviation [SD]=8.9) and follow-up ranged from 0-27.7 years (mean=12.5, SD=7.9). A 10-dB worsening in hearing was longitudinally associated with an annual decline of 0.016 SDs (95% confidence interval [CI]: 0.0002, 0.033) in California Verbal Learning Test (CVLT) short-delayed recall, 0.019 SDs (95% CI: 0.002, 0.036) in CVLT long-delayed recall, and 0.017 SDs (95% CI: 0.006, 0.028) in letter fluency after covariate adjustment. Poorer hearing among those with SCHL was associated with steeper declines in memory and verbal fluency scores. This relationship may begin at earlier levels of hearing loss than previously recognized.
Early Indicators of Cognitive Decline in Online Financially Active Older Adults
Authors: Mattek Kimberly Grzesek Nora , Sharma Nicole , Wild Katherine 
Published: December 2020

Abstract
As access to computers and use of technology becomes more common in older adults, the incidence of online financial fraud increases. Law enforcement officials and fraud experts predict this trend to continue as aging baby boomers increasingly become targets. One reason this population might be at risk for financial fraud is due to subtle, undetected decline in cognitive abilities that have been associated with decline in financial capacity. Many cases of incipient cognitive decline go undetected. Further, those with early cognitive decline often have poor insight to its potential impact on daily functioning. Assessment of Activities of Daily Living Skills (ADLs) is paramount to determine early decline in daily activities. The ORCATECH Life Lab was designed to evaluate subtle neurological and other health changes and their relation to changes in daily functioning. Older adults participating in the Life Lab complete annual ADL and neurocognitive assessments. Additionally, 97 participants completed an online technology questionnaire where 64 participants reported participating in online financial activity. Results revealed that within the online financially active group, some assistance in ADL’s was required. However, inconsistencies in ADL change over time highlight the challenges of screening for early signs of mild cognitive impairment (MCI) in patients that fall between normal cognition and MCI. In-home information technology may help overcome these challenges. Defining subtle changes in ADLs is a crucial step to enable early diagnosis of neurocognitive disorders and assist health care providers in improving disease management and to prevent incidents of financial fraud in this vulnerable population.
An Analysis of the Impact of Sexual Orientation on Longitudinal Depression
Authors: Thompson Anna , Wardecker Britney 
Published: December 2020

Abstract
Research suggests that mental health and well-being improve as we age, and this trend is dubbed “the paradox of aging” (Charles & Carstensen, 2010). However, little is known about whether this trend happens for individuals who may experience lifelong disadvantage, such as those who identify as lesbian, gay, or bisexual. We used data from the Midlife in the United States Study (MIDUS) to examine lesbian/gay, bisexual, and heterosexual adults’ changes in depression from 1995 to 2014. Participants identified as lesbian/gay (n = 46), bisexual (n = 37), and heterosexual (n = 3030) and 45.1% identified as female. Participants’ ages ranged from 20-74 years (M = 45.61, SD = 11.41) in 1995 and 39-93 years (M = 63.64, SD = 11.35) in 2014. We analyzed our data using a repeated measures ANOVA and our results indicate that depression decreased on average from 1995 to 2014 for heterosexual [Wilk’s Lamda = .996, F (1, 3029) = 12.23, p &lt; .001] and lesbian/gay adults [Wilk’s Lamda = .848, F (1, 45) = 8.08, p = .007]. However, bisexual adults did not experience this decrease in depression [Wilk’s Lamda = .990, F (1, 36) = 0.36, p = .550] and their depression remained relatively stable. Our results are consistent with previous studies that indicate bisexuals experience poorer mental health when compared to lesbian/gay and heterosexual adults (Bostwick, Hughes, & Everett, 2015). The current research highlights depression as a condition that may not decrease universally over time. We discuss implications for bisexuals’ health and well-being.
Delivery of Community Support Services for Older Adults in Social Housing
Authors: Yau Matthew , Sheppard Christine , Charles Jocelyn , Austen Andrea , Hitzig Sander 
Published: December 2020

Abstract
Community support services are an integral component of aging in place. In social housing, older adult tenants struggle to access these services due to the siloed nature of housing and health services. This study aims to describe the relationship between community support services and social housing for older adults and examine ways to optimize delivery. Data on government-funded community support services delivered to 74 seniors’ social housing buildings in Toronto, Ontario was analyzed. Neighbourhood profile data for each building was also collected, and correlational analyses were used to examine the link between neighbourhood characteristics and service delivery. Fifty-six community agencies provided 5,976 units of services across 17 service categories, most commonly mental health supports, case management and congregate dining. On average, each building was supported by nine agencies that provided 80 units of service across 10 service categories. Buildings in neighbourhoods with a higher proportion of low-income older adults had more agencies providing on-site services (r = .275, p &lt; .05), while those in neighbourhoods with more immigrants (r = -.417, p &lt; .01), non-English speakers (r = -.325, p &lt; .01), and visible minorities (r = -.381, p &lt; .01) received fewer services. Findings point to a lack of coordination between service providers, with multiple agencies offering duplicative services within the same building. Vulnerable seniors from equity-seeking groups, including those who do not speak English and recent immigrants, may be excluded from many services, and future service delivery for seniors should strive to address disparities in availability and access.
Sensory Loss and Cognitive Decline among Older Adults: An Analysis of Mediation and Moderation Effects of Loneliness
Authors: Ge Shaoqing , Pan Wei , Wu Bei , Plassman Brenda , Dong XinQi , McConnell Eleanor 
Published: December 2020

Abstract
Multiple studies have reported that hearing and vision loss are linked to cognitive decline. Yet little is known about factors that may influence the association between sensory loss and cognitive decline. This study examined if loneliness mediates or moderates the impact of sensory loss on cognitive decline as individuals age. This was a longitudinal study using data (N = 243) from the Health and Retirement Study (HRS) (2006 – 2014) and its supplement: The Aging, Demographics, and Memory Study (ADAMS) (Wave C). Hearing loss was defined by an inability to hear pure-tone stimuli of 25 dB at frequencies between 0.5 – 4.0 kHz in either ear. Vision loss was defined as having corrected binocular vision worse than 20/40. Loneliness was measured by the 3-item UCLA Loneliness Scale. Longitudinal parallel-process (LPP) analysis was conducted at a significance level of α = .05 (one-tailed). Loneliness moderated but did not mediate the associations between vision loss and the rate of cognitive decline (standardized β = -.108, p &lt; .05). No moderation or mediation effect of loneliness was found for the association between hearing loss and cognitive decline. Both hearing and vision loss were significantly associated with increased severity of loneliness. Vision loss combined with an elevated level of loneliness may produce a more synergistic, deleterious impact on older adults’ cognitive function than vision loss alone. This study highlights the importance of promoting a healthy social and psychological status for older adults with vision loss.
Alcohol use and mental health among older American adults during the early months of the COVID-19 pandemic
Authors: Eastman Marisa , Kobayashi Lindsay , Finlay Jessica 
Published: December 2020

Abstract
We investigated the association of self-reported changes in alcohol consumption with the prevalence of anxiety, depression, and loneliness in the early months of the COVID-19 pandemic among middle-aged and older US adults. Between April and May 2020, 6,938 US adults aged 55+ completed online questionnaires in the COVID-19 Coping Study, a national cohort study of older adults’ mental health and well-being. Multinomial logistic regression estimated self-reported changes in the frequency of alcohol consumption relative to before the pandemic, according to anxiety (5-item Beck Anxiety Inventory), depression (8-item Center for Epidemiologic Studies Depression Scale), and loneliness (3-item UCLA Loneliness Scale). All models were population-weighted and adjusted for confounders. Nearly half (46%) of adults reported drinking 1-7 drinks/week prior to the pandemic, 12% reported drinking 8+ drinks/week, and 42% reported not drinking. One in five adults (21%) reported a change in their alcohol consumption since the start of the pandemic, while 38% indicated they were drinking the same amount, and 42% reported not drinking alcohol. Older adults who screened positive for each of anxiety, depression, and loneliness reported drinking more than usual (OR=1.92; 95% CI: 1.92–1.93 for anxiety; OR=2.67; 95% CI: 2.67–2.68 for depression; OR=2.46; 95% CI: 2.45–2.46 for loneliness), compared to drinking the same as before the pandemic. These results demonstrate potentially negative changes in alcohol intake among middle-aged and older adults experiencing mental health symptomology during the early months of the COVID-19 pandemic.
Bereavement and Physiological Dysregulations in African American Adults
Authors: Song Jieun , Mailick Marsha 
Published: December 2020

Abstract
This study uses data from National Survey of Midlife in the U.S. (MIDUS) to examine the effect of bereavement on physiological dysregulations in African American adults, with moderating effects of gender. Models were estimated using data from 210 Non-Hispanic African American respondents who participated in MIDUS 2 (M2: 2004-2005) and the biomarker data collection (2004-2009). We analyzed data from two groups, respondents who experienced the death of an individual(s) close to them, either family or friends (97 women, 40 men) and respondents who did not experience any deaths of close individuals during the same period (46 women, 27 men), controlling for age, education, marital status, prior family bereavement, number of negative life events since M2, and physical health prior to bereavement. Physiological dysregulations were assessed for 7 systems: HPA axis, glucose metabolism, lipids metabolism, sympathetic system, parasympathetic system, inflammation, and cardiovascular functioning. The results show that African American men and women who experienced bereavement were at higher risk of dysregulation of glucose metabolism (assessed by HbA1c, HOMA-IR, and fasting glucose) than the non-bereaved, even after adjusting prior diabetes diagnosis. In addition, African American women (but not men) who experienced recent bereavement were at higher risk of dysregulation of HPA axis functioning (assessed by urinary cortisol and blood DHEA-S) than their counterparts. The other physiological systems were not significantly associated with bereavement experience in African American adults. The findings suggest that bereavement has adverse impacts on health in African American adults via dysregulations in glucose metabolism and HPA axis functioning.
Disruptions to Care and the Use of Telehealth Among Older Adults During the COVID-19 Pandemic
Authors: Prusaczyk Beth , Carpenter Brian , Morrow-Howell Nancy , Lenze Eric 
Published: December 2020

Abstract
Reports emerged early in the 2020 COVID-19 pandemic that older adults were foregoing non-COVID19-related care, due to fears of contracting the virus during appointments and because of healthcare providers’ reduced operations. Beginning in July, 2020, we explored the impact of the pandemic on disruptions to care and older adults’ use of telehealth. Preliminary results from 53 older adults aged 66 to 93 (mean: 72.6) found that many older adults experienced disruptions in their care, ranging from 30-50% depending on the type of care. The most commonly disrupted care types were mental health and rehabilitation care (occupational, physical, or speech therapy), with 50% of older adults reporting disruptions to mental health and 50% to rehabilitation care. The most common reason for the disruptions was closed care providers’ offices. Similar results were found for primary care (46% reporting disruptions), dental care (44%), and vision care (30%), with between 62-71% citing closed offices as a reason for the disruption. The use of telehealth among the sample was high (44%), and the majority (83%) of these older adults reported never having used it previously. All who used it reported being very or somewhat comfortable with the technology, and 83% said they would use it again even if in-person care was available. These findings suggest the pandemic has had a significant impact on older adults’ care and that the expansion of telehealth could be increase access to care during and after the pandemic.
National Early Warning Scores And COVID-19 Deaths In Care Homes: An Ecological Time Series Study
Authors: Stow Daniel , Barker Robert , Matthews Fiona , Hanratty Barbara 
Published: December 2020

Abstract
Tracking COVID-19 infections in the care home population has been challenging, because of the limited availability of testing and varied disease presentation. We consider whether National Early Warning Scores (NEWS/NEWS2) could contribute to COVID-19 surveillance in care homes. We analysed NEWS measurements from care homes in England (December 2019 to May 2020). We estimated pre-COVID (baseline) levels for NEWS and NEWS components using 80th and 20th centile scores for measurements before March 2020. We used time-series to compare the proportion of above-baseline NEWS to area-matched reports of registered deaths in care home residents from the Office for National Statistics We analysed 29,656 anonymised NEWS from 6,464 people in 480 care home units across 46 local authority areas. From March 23rd to May 20th, there were 5,753 deaths (1,532 involving COVID-19, 4,221 other causes) in corresponding geographical areas. A rise in the proportion of above-baseline NEWS was observed from March 16th 2020. The proportion of above-baseline oxygen saturation, respiratory rate and temperature measurements also increased approximately two weeks before peaks in deaths. We conclude that NEWS could contribute to disease surveillance in care homes during the COVID-19 pandemic. Oxygen saturation, respiratory rate and temperature could be prioritised as they appear to signal rise in mortality almost as well as total NEWS. This study reinforces the need to collate data from care homes, to monitor and protect residents’ health. Further work using individual level outcome data is needed to evaluate the role of NEWS in the early detection of resident illness.
Do Perceptions of Own and Spouse Survival Affect Advance Care Planning?
Authors: Carr Deborah , Lou Yifan 
Published: December 2020

Abstract
COVID-19 has intensified the need for advance care planning (ACP), or formal preparations for end-of-life care, prior to the time such decisions are required. We propose that older adults’ perceived chances of survival, and one’s perceptions of whether they will outlive their spouse may be powerful motivators of ACP. Using data from the Wisconsin Longitudinal Study (WLS, n=4908, M age = 65), we examine the extent to which: (a) one’s perceived 10- and 20-year survival and (b) projections of dying before, after, or at the same time as one’s spouse affect three aspects of ACP (living will, durable power of attorney for health care designations (DPAHC), and discussions). Multivariate analyses are adjusted for health, demographics, socioeconomic characteristics, and death anxiety. In the full sample, women who perceived a high likelihood of 20-year survival were less likely (OR=.604, p &lt; .05) whereas their male counterparts were more likely (OR = 1.4, p &lt;.01) to name a DPAHC (relative to those who perceived a medium likelihood of survival). Among married persons only (n=3860), people who perceive that they will pre-decease their spouse are 1.5 times as likely to name their spouse as DPAHC (vs. no DPAHC), but are no more likely to name a different person to the role (relative to those who perceive that they and spouse will die at the same time). Practitioner and family conversations about older patients’ projected survival and how it shapes decision making are especially important as COVID-19 may require rapid decisions about end-of-life treatments.
A Genome-Wide Integrative Study of DNA Methylation, Gene Expression, and Later Life Hand Grip Strength
Authors: Soerensen Mette , Mengel-From Jonas , Christensen Kaare , Christiansen Lene , Tan Qihua 
Published: December 2020

Abstract
Hand grip strength (HS) measures muscular strength and associates with multiple health outcomes and mortality. Studies of epigenetic and transcriptomic markers could help elucidate the biology behind HS; markers for which monozygotic (MZ) twins are excellent study populations. We performed integrated enrichment analyses (IEA) of an epigenome-wide association analysis (EWAS) and a transcriptome-wide association analysis (TWAS) of HS in blood samples of 452 MZ twins (56-80 years of age). Unsupervised IEA were conducted by the KeyPathwayMiner algorithm, while supervised IEA were performed by the KEGG and Reactome databases. No individual CpG site or probe passed correction for multiple testing. Investigating the overlap in genes with p-values&lt;0.01, 0.005 or 0.001 in the EWAS and TWAS, revealed 67, 21 and 2 unique genes, respectively. The latter 2 were TESK2 and VWA1. By the supervised approach, the 67-gene overlap identified three pathways related to “antigen processing and presentation”, driven by HLA-A, HLA-B, TAP2 and PSME2. With the unsupervised approach the 21-gene and 67-gene overlaps revealed networks containing 7 and 19 genes, respectively. Exception nodes (added by the algorithm for structure) were CREBBP and CSNK2A2 for the former, and APP and HSP90AB1 for the latter. The remaining IEA revealed no gene sets or networks. Several of these genes have previously been linked to HS relevant traits, e.g. arthritis (HLA-A, HLA-B and TAP2), smooth muscle and cardiovascular function (TESK2, HLA-B and APP) and sarcopenia (HSP90AB1). Hence, this study reports genes and pathways previously reported for physical functioning, yet also novel candidates for further verification.