bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association of Freezer Storage Time With Vitamin K and Vitamin D Concentrations in Human Brain Tissue
Authors: Shea Kyla , Fu Xueyan , Dolinkowski Gregory , Dawson-Hughes Bess , Holland Thomas , Dhana Klodian , Booth Sarah 
Published: December 2020

Abstract
Vitamins K and D are present in the human brain and have been implicated in Alzheimer’s disease and related dementias (ADRD). Because the use of banked brain tissue in ADRD research is increasing, we evaluated the stability of vitamin K and vitamin D in human brain tissue over long-term freezer storage using samples obtained from the Rush Memory and Aging Project (n=500, mean age=91, 29% male). Specimens were stored at -80□C until analyzed. Vitamin K (menaquinone-4, MK4) and vitamin D (25(OH)D) were measured in four regions (mid-temporal and mid-frontal cortexes, cerebellum, anterior watershed white matter) and averaged across regions. Storage time was categorized into two-year increments. Differences in MK4 and 25(OH)D concentrations according to storage time were evaluated using general linear models. MK4 concentrations did not differ in brains stored ≤8 years (geometric mean±SEM MK4 pmol/g: storage ≤2.0 years=1.2±0.1, 2.1-4.0 years=1.2±0.1, 4.1-6.0 years=1.4±0.1, 6.1-8.0 years=1.4±0.2; p≥0.21). MK4 in brains stored &gt;8.0 years (0.8±0.1 pmol/g) was 33% lower than the concentration in brains stored ≤2.0 years (p=0.005). The 25(OH)D concentrations did not differ in brains stored ≤6 years (geometric mean±SEM 25(OH)D pmol/g: storage ≤2.0 years=1.2±0.1, 2.1-4.0 years=1.1±0.1, 4.1-6.0 years=1.2±0.1; p≥0.37). The 25(OH)D concentration in brains stored &gt;6.0 years was 31-37% lower than that in brains stored ≤2.0 years (6.1-8.0 years=0.8±0.06, &gt;8.0 years=0.7±0.04; p&lt;0.001). MK4 and 25(OH)D appeared to be stable in human brain tissue stored at -80oC for up to 8 and 6 years, respectively. Storage time merits consideration when designing and interpreting studies that relate brain nutrient concentrations to ADRD.
The FoxO3 Longevity Genotype Is Associated With Better Survival After Acute Myocardial Infarction in Older Patients
Authors: Chen Randi , Nakagawa Kazuma , Masaki Kamal , Donlon Tim , Elliott Ayako , Allsopp Richard , Willcox D Craig , Willcox Bradley 
Published: December 2020

Abstract
Background: Although numerous studies have been published on prognostic factors after a first acute myocardial infarction (AMI) among middle-aged men, little is known about the prognostic factors and genetic determinants for post-AMI elderly patients. Methods: The Kuakini Honolulu Heart Program (KHHP) is a prospective population-based study of cardiovascular disease (CVD) (defined as coronary heart disease (CHD) and stroke) among men of Japanese ancestry living in Hawaii. We identified 141 first AMI patients from participants of the KHHP exam 4 (1991-93) by ECG and/or cardiac enzymes (onset age: 73-96 years). Men who survived more than one year after AMI were followed for mortality from onset of AMI to December 2018 (all were deceased by 28 years of follow-up). All had FOXO3 genotype information available. Quantile regression was used to compare the median survival times of FOXO3-G allele carriers (longevity genotype) with FOXO3-TT homozygotes (common genotype). Results: Adjusting for age at AMI onset, baseline body mass index (BMI) and glucose levels (at exam 4), median survival times differed between FOXO3-G allele carriers and FOXO3-TT homozygotes by 2.1 years (95% CI=0.24-3.95, p=0.027). Adding other known CHD risk factors (i.e. hypertension, etc.) to the model reduced the difference to 2.03 years (95% CI=0.17-3.89, p=0.033). Furthermore, chi-square testing showed the mortality rate from CVD among FOXO3-G allele carriers was significantly lower than that among the common FOXO3-TT genotype. Conclusions: The data suggest that the FOXO3 longevity genotype reduces the risk of dying from CVD and extends survival time of elderly patients with acute myocardial infarction.
Exploring Formal Caregiver Burden Within Nursing Homes: An Integrative Review
Authors: Kunkle Rachel , Chaperon Claudia , Berger Ann 
Published: December 2020

Abstract
The purpose of this integrative review was to explore formal caregiver burden in nursing homes among direct care nursing staff. The aim was to gain an understanding of the state of the science of formal caregiver burden, it’s measurement, and its effect on resident care. Based on PRISMA guidelines, a systematic search of CINAHL, PubMed, PsycINFO and Embase databases was conducted using terms from the definition of formal caregiver burden, three conceptual models, and the thesaurus feature of each database for years ranging from 1979-2019. Inclusion criteria consisted of peer-reviewed articles in English that focused on the key terms of formal caregiver burden among direct care nursing staff only in nursing home facilities. Out of 925 citations, 20 articles met criteria; 15 quantitative and 5 qualitative studies. Sample sizes ranged from 11-1283, number of facilities from 1-55, and bed size from 31-203. Psychometric measures used in the studies reported lower validity and reliability, a variety of conceptual definitions interchangeably, and primarily studied nursing assistants (n=19). Five studies included nurses as formal caregivers, and one studied only nurses. Variables used to identify burden were racial disparities (n=2), trauma experience (n=1), depression (n=4), distress (n=3), mental health (n=1), stress (n=2), health complaints (n=1), and alienation (n=1). Two studies evaluated the effect on resident care, one finding significant results of in-service training contributing to positive attitudes of formal caregivers toward confused residents. Current limitations in the understanding of formal caregiver burden limit the advancement of research.
How Healthcare Interactions Contribute to Burden for Care Partners of Older Adults
Authors: Mueller Anne , Fields Beth 
Published: December 2020

Abstract
As the aging population in the U.S. continues to grow, care partners (i.e. family and friends) are assuming increasingly intense and complex caregiving responsibilities. Care partner burden is associated with poorer health outcomes for older adults and more frequent rehospitalizations. This secondary data analysis aims to examine the relationship between different types of health care interactions and care partner burden. A total of 2,588 care partners of Medicare beneficiaries age 65 and older were included. Secondary analyses were conducted using cross-sectional data from the 2017 National Study of Caregiving. Logistic regression analyses were used to determine the relationship between health care interactions and care partner burden while controlling for demographic characteristics. The average care partner was 62 years old (range 18-98), female (68.1%), and white (62.8%). More than half of the care partners (51.3%) reported financial, emotional, and/or physical difficulty as a result of helping the older adult. Logistic regression analyses show that care partners who made medical appointments (AOR=2.04), accessed online medical information (AOR=1.55), and coordinated care between medical providers (AOR=2.15) were significantly more likely to report burden. Care partners are important allies in supporting the health of older adults but may experience excess burden due to health care interactions. Practitioners and researchers may need to evaluate ways to improve the ease, efficiency, and accessibility of different types of health care interactions for care partners of older adults. A better understanding of factors that contribute to care partner burden may inform tailored interventions and future health and aging policies.
Symptom Experience Among Family Caregivers: Symptom Cluster Analysis
Authors: Chang Yu-Ping , Seo Young , Von Visger Tania 
Published: December 2020

Abstract
Family caregivers of older adults experience physical and psychological symptoms such as fatigue, insomnia, depression, or anxiety which may negatively impact their quality of life. Although those symptoms often co-occur, there is no prior research on symptom clusters identification among family caregivers. Symptom cluster analysis in chronic disease populations demonstrates usefulness in clinical management. An in-depth understanding of the pattern of symptom experience can guide intervention development to improve caregiving experience, coping skills, and well-being. This study aimed to identify symptom clusters as experienced by family caregivers in the US. We analyzed responses of 2,652 unpaid caregivers from the National Study of Caregiving (NSOC) III (2017) survey to identify underlying symptom clusters. The NSOC is a nationally representative survey of family caregivers to older adults with limited functions in daily activities. We used 17 binary items measuring the physiological and psychological symptoms of caregivers. We conducted a hierarchical cluster analysis with Ward linkage method to identify the symptom clusters. Three symptom clusters were identified based on the optimum silhouette width as follows: (1) Cluster 1 (lack of cheerfulness, peacefulness, and full of life, breathing problems, and sleep interrupted); Cluster 2 (feeling lonely, down, bored, nervous, worrisome, upset, and having little interest); and (3) Cluster 3 (limited strengths in arms and legs, having low energy, pain, and troubles falling back asleep). Our findings indicate that physical and psychological symptoms are highly preventable in family caregivers. Future research on symptoms management strategies can focus on targeting multiple symptoms based on their co-occurence.
Understanding the Link between Family Caregiver Quality of Life and the Care Provided to Older People With Dementia
Authors: Hazzan Afeez 
Published: December 2020

Abstract
Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.
Nurses’ Fall Prevention Interventions in Nursing Home Patients With Acute Versus Chronic Underlying Conditions
Authors: Gray-Miceli Deanna , Kris Alison 
Published: December 2020

Abstract
Nursing Home (NH) nurses care for over 1.6 million older residents each year. Among this vulnerable population, an estimated 50 percent of older residents fall each year. Although licensed nurses caring for NH residents who fall intervene to prevent fall recurrence, we know little about nurse’s perceptions of the most effective interventions for various types of falls they manage. The purpose of this qualitative study is to describe and compare licensed nurse’s perceptions of fall prevention interventions believed to be due to acute underlying causes of a fall versus those believed to be due to chronic underlying conditions. This study is a secondary analysis of existing qualitative data from a multi-site parent study conducted in three NH sites in the northeastern U.S. designed to test nurse’s knowledge of falls prevention and interventions. Forty seven registered or licensed practical nurses, English speaking who were full or part time employees were recruited to participate. Most were female (n=46; 98.7%) with a median age of 49.5 years and ten years’ experience. Using Colazzi’s (1978) method, 47 responses of nurse’s were read from typed transcripts and analyzed independently by 2 judges. Significant statement were extracted to derive meanings and form themes. For falls related to acute causes, nurses most often stated they would collaborate with the physician, propose a blood pressure intervention and promote safety. For falls due to chronic causes, nurses promoted ambulation safety, pain interventions and collaborated with specialists. Since nurses intervened differently, identifying fall type is critical in selecting appropriate interventions.
Aging in Place in Subsidized Housing: Roles and Perspectives of Staff Members
Authors: Pandit Sonia , Jahan Momana , Reyes-Farias David , Resnick Barbara , Reid Carolina , Brown Rebecca 
Published: December 2020

Abstract
Nearly 3 million older Americans with low incomes live in subsidized housing. This population has disproportionate rates of functional impairment, cognitive impairment, and nursing home admission. Staff members who work in subsidized housing may have unique insight into how to improve aging in place for this vulnerable population, but little is known about their perspectives. We conducted 12 focus groups with 69 staff members from 7 subsidized housing sites. Staff included property managers, service coordinators, maintenance workers, administrative assistants, and security guards. Transcripts were analyzed using qualitative thematic analysis. The majority of participants noted that they “wear multiple hats” and their roles are not limited to professional responsibilities. Instead, their role is to maximize residents’ quality of life. As a result, staff members often adopt personal roles akin to serving as residents’ “surrogate family” members. This relationship gives staff a unique window into residents’ lives which enables them to detect early warning signs among residents. For example, staff often observed changes in residents’ physical appearance and hygiene, mood, behavior, and function which could indicate physical illness, mental illness, or cognitive impairment. Staff reported having some resources to address these warning signs, such as involving families and connecting residents to community resources. However, they also highlighted unmet needs to address these issues, such as on-site clinical staff and affordable mental health services. Our findings suggest that building staff are a valuable and underutilized resource for identifying at-risk residents in subsidized housing and helping to deliver interventions to improve aging in place.
Applications of Stochastic Process Models to Constructing Predictive Models of Alzheimer’s Disease
Authors: Arbeev Konstantin , Bagley Olivia , Yashkin Arseniy , Duan Hongzhe , Akushevich Igor , Ukraintseva Svetlana , Yashin Anatoliy 
Published: December 2020

Abstract
Large-scale population-based data collecting repeated measures of biomarkers, follow-up data on events (incidence of diseases and mortality), and extensive genetic data provide excellent opportunities for applying statistical models for joint analyses of longitudinal dynamics of biomarkers and time-to-event outcomes that allow investigating dynamics of biomarkers and other relevant factors (including genetic) in relation to risks of diseases and death and how this may propagate to the future. Here we applied one such model, the stochastic process model (SPM), to data on longitudinal trajectories of different variables (comorbidity index, body mass index, cognitive scores), other relevant covariates (including genetic factors such as APOE polymorphisms and polygenic scores, PGS), and data on onset of Alzheimer’s disease (AD) in the Health and Retirement Study. We observed that different aging-related characteristics estimated from trajectories of respective variables in SPM are strongly associated with risks of onset of AD and found that these associations differ by sex, APOE status (carriers vs. non-carriers of APOE e4) and by PGS groups. The approach allows modeling and estimating time trends (e.g., by birth cohorts) in relevant dynamic characteristics in relation to the disease onset. These results provide building blocks for constructing the models for forecasting future trends and burden of AD that take into account dynamic relationships between individual trajectories of relevant repeatedly measured characteristics and the risk of the disease. Such models also provide the analytic framework for understanding AD in the context of aging and for finding genetic underpinnings of such links between AD and aging.
Telephone-Based Health Coaching: Reduction in Alzheimer’s Risk Behaviors
Authors: Rhodes Annie , Wilkerson Taylor , Inker Jennifer , Richardson Joann , Zanjani Faika 
Published: December 2020

Abstract
Objective: Explore the feasibility of integrating intensive, telephone-based health coaching programs in low-income senior housing communities to reduce Alzheimer’s risk behaviors. Design: Participants meeting study criteria: 60 years or older, a working telephone, no cognitive diagnoses, income below 1,000 USD monthly, and active cardiovascular or diabetic health symptoms were recruited from low-income housing units. Engagement in Alzheimer’s risk behaviors: Cigarette use, alcohol overuse, polypharmacy, inactivity, depression, and cognition status, were measured at enrollment, and 12 weeks post. Weekly coaching sessions focused on reducing behavioral risk for Alzheimer’s disease. Setting: Low-income senior apartments in Richmond, Virginia Participants: Twenty older adults, living in low income senior high rises. Participants were majority (95%) African-American (Mean= 69 years, SD=4.17, Range=61-77). Intervention: Participants engaged in a call with a coach for 12 weeks, focused on Alzheimer’s risk reduction. Participants identified with coach specific behaviors to target. Primary Outcome Measure: Feasibility of telephone-based health coaching to reduce Alzheimer’s Risk Behaviors. Feasibility is defined as participant engagement in health coaching and self-rated health outcomes. Results: Of the original 20 enrollees, 19 (95%) participated in coaching sessions. On average, 8.75 sessions were completed. All participants rated their experience as positive, and self-reported an improvement in health and healthy behaviors, in exit interviews. The coaching experience was rated 94.11 on a scale from (0-100). Participants rated their health coach, on average, 90.44 on a scale from (0-100). Participants rated their health improved as 92.37 on a scale from (0-100). Conclusion: Telephone-based health coaching was feasible based on participant engagement.
Determinants of Mortality Among Older Adults by Area-Level Material and Social Deprivation
Authors: Vasiliadis Helen-Maria , Guerra Samantha Gontijo , Pitrou Isabelle 
Published: December 2020

Abstract
Although social inequalities are increasing worldwide, few studies have examined their consequences on mortality among older adults. The aim of this research was to examine determinants of mortality among older adults at the individual, health system and area level. Data come from the ESA-Services study conducted in 2011-2013 in Quebec including 1,765 adults aged ≥65 years. Mortality 3 years after the survey interview was obtained from vital statistics data. Material and social deprivation of area of residence was determined using the Pampalon index categorized into quintiles as follows: least deprived (1st quintile), middle quintiles (2nd, 3rd, 4th quintiles), most deprived (5th quintile). Other variables included clinical, psycho-behavioural, socio-economic and demographic factors. Cox regressions were used to examine the determinants of mortality while stratifying by level of area deprivation. Compared to most deprived areas, mortality was higher for those living in middle quintiles of deprivation. In the overall analyses, age, chronic conditions, social support and continuity of care were associated with mortality. When examining mortality by area of deprivation, results showed higher mortality ratios with cognitive impairment in middle and least deprived areas. In least deprived areas, female sex, the presence of bipolar disorder and dementia were associated with mortality. The strong associations between mortality, cognition, dementia, bipolar disorder and female sex in least deprived areas might be partially explained by a closer follow-up and earlier detection of this population. Continuity of care was also associated with significantly lower mortality ratios for those living in middle and most deprived areas.
Smoking, but Not Other Environmental Exposures, Increases Risk for Advanced Brain Aging
Authors: Whitsel Nathan , Franz Carol , Kremen William 
Published: December 2020

Abstract
Exposure to harmful substances and chemicals such as tobacco smoke, chemicals (e.g., herbicides, pesticides, Agent Orange) and metal dust has been associated with increased risk of developing cancer, cardiovascular disease, and other diseases that contribute to shorter life expectancy. Associations with brain health in relation to these exposures are less well studied. We examined the relationship between brain health and prolonged exposure to different harmful substances in 498 male participants average age 68 (range 61 to 73) from the Vietnam Era Twin Study of Aging (VETSA). For self-reported tobacco smoke, herbicides/pesticides, and metal dust we created three groups reflecting recency of exposure (current/former/never). For Agent Orange we examined two exposure groups (ever/never). Brain health, defined as predicted brain age (PBAD), was evaluated by applying Brain-Age Regression Analysis and Computation Utility software (BARACUS) to magnetic resonance images collected at age 68. Tobacco smoking (r=-0.15, p=0.0004 ) was significantly correlated with PBAD and remained significant (F=5.56, p=0.005) in multivariate analyses adjusted for age, socioeconomic status (SES), age 20 general cognitive ability, and non-independence of twins within pairs. Never smokers had significantly younger brains than current or former smokers. PBAD did not differ for current versus former smokers. In other analyses, more advanced PBAD was associated with non-amnestic MCI. In this sample, tobacco smoking had the strongest relationship with overall brain health in late midlife compared with other types of environmental exposures, reinforcing its role in pathological aging and its importance as a public health priority.