bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Care Provider Attitudes and Perceptions of Routine Cognitive Screening in Older Adults
Authors: Potenza Giovanna , Mattos Meghan 
Published: December 2020

Abstract
The 2011 Annual Wellness Visit (AWV) Medicare benefit includes a cognitive screening component intended to improve screening of older adults. However, available literature only presents physician perspectives on cognitive screening prior to 2011. The purpose of this study was to explore primary care provider (PCP) attitudes and perceptions of cognitive screening in older adults. An Internet-based survey link was sent to Virginia professional organizations and clinics to distribute to PCPs serving older adults. Likert scale, multiple choice, and free response questions were used to understand current attitudes, perceptions, and practices. The sample (N=39) was comprised of 26 nurse practitioners (NPs), 9 physicians, and four who did not disclose role. Most participants were aware of the AWV (n=31, 88.6%) and agreed that early detection “promotes earlier diagnosis and access to resources” (mean ± standard deviation,1.58±0.69). However, less than half of NPs screened annually (n=10/26, 38.5%) and even less conducted screening during an AWV (n=7/26, 26.9%). About half of MDs conducted cognitive screening during an AWV (n=5/9, 55.6%). Although NPs screened less, they more strongly agreed that screening should occur annually (1.92±1.15 vs. 2.67±1.23) and “additional training would improve [screening] ability” (2.04±1.0 vs. 3.22±1.20). Also, few NPs independently managed impairment (n=5/26, 19.2%) compared to MDs (n=5/9, 55.6%). Our findings demonstrate that NPs screen less and feel less prepared to conduct cognitive screenings. It is important to provide additional resources and training for all PCPs, but especially NPs who are rapidly entering primary care to help improve identification and management of cognitive impairment.
Physical Activity Adherence Rates in Older Kidney Transplant Recipients: A Pilot Randomized Controlled Trial
Authors: O’Brien Tara , Rose Karen , Tan Alai 
Published: December 2020

Abstract
Daily walking activities are associated with improving cardiovascular and well-being in older kidney transplant recipients. Multicomponent interventions using technology and goal setting holds promise for sustaining daily walking activity among this population. The purpose of this randomized controlled trial pilot study was to evaluate the feasibility of a multicomponent intervention called SystemCHANGE™ + activity tracker for daily walking activity in older (age 60 and over) kidney recipients from baseline to 12 months. The intervention group implement a personal-system solution and wore a mobile activity tracker daily for 12 months. The attention-control group received educational information on healthy living as a transplant recipient and was asked to wear a mobile activity tracker daily for 12 months. Participants were randomized 1:1 to the intervention or control group. The sample consisted of 53 participants (n = 27 intervention, and n = 26 control). At the 12-month follow-up visit, the total study attrition rate was 23%. The adherence rates at 12 months were 96.5% in the intervention group and 80.8% in the attention- control group. The intervention group increased their steps from baseline to 12 months by 334 steps per day. The attention-control group demonstrated a decrease in steps by 563 steps per day. We found a mean difference of 1041± 2440 (Cohen’s d = 0.43) in daily steps between the groups from baseline to 12 months. The data suggests SystemCHANGE™ in combination with activity trackers may be feasible for older kidney transplant recipients to enhance and sustain physical activity with daily walking.
Effects of Angiotensin (1-7) Expressing Lactobacillus and Exercise on Gut-Brain Axis in Aged Rats
Authors: Sun Yi , Yang Youfeng , Banerjee Anisha , Verma Amrisha , Li Qiuhong , Carter Christy , Buford Thomas 
Published: December 2020

Abstract
Aging is associated with gut dysbiosis – a condition linked with altered central nervous system function (“gut-brain axis”). Age-related health benefits have been ascribed to the renin-angiotensin system, mediated partially via the angiotensin(1-7) axis. Research has shown exercise altering gut microbiota composition and function. This study explored the effects of a genetically modified probiotic expressing angiotensin (1-7) and exercise on the gut-brain axis. Sixty-two male F344/BN rats were randomized at 24-months-old to receive oral gavage of angiotensin (1-7) Lactobacillus paracasei (LP) or LP-A, wide-type LP, or control 3-times/week for 12 weeks; with or without exercise. Rats in exercise groups were walking on a treadmill 10-minutes/day for 5-days/week. Microbiome taxonomic analysis of fecal samples post intervention was performed via 16S-based PCR. A battery of behavior tests were performed before and after the intervention. PCoA revealed that groups differed in the overall fecal microbiota community structure by weighted UniFrac (p=0.034). Indices of alpha-diversity, including Shannon (p=0.02) and Simpson (p=0.019) indexes, displayed LP-A groups with more diverse microbiome than controls. Grip strength (p=0.042) and exercise tolerance (p&lt;0.001) tests showed exercise groups had more muscle strength and aerobic capacity than the sedentary groups. Exercise groups had more lean mass (p=0.019); both LP-A and LP groups had lower fat mass compared to the controls in body composition measurement. LP-A travelled longer distance in the central area than the control in the open field test showing reduced anxiety (p=0.029). Therefore, we conclude LP-A and exercise have distinct and possibly overlapping beneficial effects on the gut-brain axis.
Social Well-Being and Chronic Disease Condition among Older Adults
Authors: Min Jungkyung , Harvey Idethia , Yeh Yuchen 
Published: December 2020

Abstract
Aging is characterized by the decline in physical health, functional status, and loss of social roles and relationships that can challenge the quality of life. A protective factor that moderates the impact of these phenomena is psychological (e.g., social) well-being. Despite the high prevalence of chronic conditions among older adults, research exploring the relationship between social well-being and chronic disease is sparse. The study aims were to investigate the relationship between social well-being among older adults (N = 1,251, R = 65 – 92 years) who participated in the National Survey of Mid-life in the United States (MIDUS 3). This study used variables for the MIDUS 3 study to test a structural equation model to examine the hypothesized relationships between social well-being, chronic conditions, life satisfaction, self-esteem, active coping, optimism, and religious coping. The findings indicate that perceived control, self-esteem, active coping, optimism, and religious coping were statistically significant for the participants’ social well-being (β =.29, p &lt;.001, β =.16, p&lt;.001, β =.08, p&lt;.05, β =.35, p&lt;.001, and β =.07, p&lt;.05, respectively). However, life satisfaction was not significantly associate with social well-being (β =.04, p &gt;.05). For individuals’ diagnosed with more than one chronic condition, perceived control, self-esteem, and optimism statistically significant impact their social well-being (β = .33, p &lt; .001, β =.17, p &lt; .001, and β =.33, p &lt; .001, respectively). Findings suggested that multiple chronic conditions influence social well-being. Chronic disease management programs may be useful in increasing social well-being among individuals with multiple chronic conditions.
Examining Cognitive Function and Self-Esteem of Middle Aged and Older Adults
Authors: Catarino Daniela , Adams Colin 
Published: December 2020

Abstract
Research shows that self-esteem and well-being have strong correlations to cognitive abilities. People with high self-esteem, compared to those with a low self-esteem, tend to evaluate themselves as more favorable after both high and low performance. However, less research has been conducted on self confidence among the older population and how this can potentially negatively or positively influence the aging process. The purpose of the study was to see if there is an effect of age on cognitive function. The second aim was to see if there is an effect of cognitive function on self-esteem. The first hypothesis was that middle-aged adults would exhibit higher cognitive functioning than older adults. The second hypothesis was that those with lower cognition would exhibit lower self-esteem. A secondary analysis of data from the National Social Life, Health, and Aging Project (NSHAP) was performed on 60 randomly selected individuals from a total of 3,005 participants. A 2 x 2 chi square test revealed that the younger group (63%) compared to the older group (37%) were significantly more likely to exhibit perfect cognitive functions (versus not), χ² (1) = 4.27, p &lt; .05. A One-Way ANOVA revealed no significant main effect of cognitive function on self-esteem, F(1, 58) = 2.97, p = .09. This suggests that cognitive functions are more likely to decline as one ages but cognitive function alone might not strongly influence self-esteem. Future research should aim to understand under what conditions confidence influences cognitive function to promote healthy interventions for successful aging.
Examining the intersection of cognitive & physical function in the Brain Networks and Mobility Function (BNET) Study
Authors: Handing Elizabeth , Miller Michael , Chen Haiying , Baker Laura , Kritchevsky Stephen 
Published: December 2020

Abstract
Cognitive function and physical function are associated however less is known about task complexity and how individual tasks relate to one another. This project seeks to describe the relationship between cognition and physical function measures across 22 tasks ranging in task complexity and difficulty. Data are from the baseline visits of a new longitudinal study, Brain Networks and Mobility Function (B-NET) Study, mean age: 76.0±4.2 years; 55% women, and 90% Caucasian. We hypothesize there would be a set of “complex” tasks that would intersect both cognitive and physical function abilities such as the Four Square Step Test or Dual Task. We conducted principal components analysis on data from the first 110 participants to describe what factors could be identified across cognition and physical function measures. Seven factors, explaining 73% of the variability, were identified: 1) a complex physical function (postural sway on foam, expanded Short Physical Performance Battery, 400 meter walk, Four Square Step Test, Dual Task), 2) physical strength (grip strength and leg press), 3) visual recall (Brief Visuospatial Memory Test- immediate and delayed), 4) Craft story recall (immediate and delayed), 5) global cognition & fluency (MoCA, category and word fluency) 6) auditory recall (Auditory Verbal Learning Test- immediate and delayed), and 7) executive function (Trail Making Test A & B). We did not identify factors that intersected both physical and cognitive tasks. These results may help to inform measurement selection in future studies that seek to evaluate components of function among older adults.
Longitudinal Daily Living Limitations and Cognitive Status: Results from the 1998-2016 Health and Retirement Study
Authors: Wu Benson , Toseef Mohammad Usama , Tarraf Wassim , Stickel Ariana , Kaur Sonya , Ramos Alberto , Gonzalez Hector 
Published: December 2020

Abstract
Data increasingly points to midlife health and modifiable risk factors as critical targets for improving older-age health outcomes and mitigating potential cognitive impairment and disease. We used biennial Health and Retirement Study data (1998-2016) collected on adults ages 50-64 years who did not meet criteria for dementia at baseline and who remained living by 2016 (unweighted-n=4,803). Cognitive status was defined using Langa-Weir criteria: Normal, Cognitively Impaired Not Dementia (CIND), and Dementia. We examined how 18-year patterns in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) predicted cognitive status in 2016. We used latent class analysis to extract longitudinal phenotypes of activities limitations, followed by survey multinomial logistic regressions to examine their associations with cognitive status and test for race/ethnic modifications. We identified three groups of functional impairment: (1) gradually increasing (15.7%), (2) stable elevated (5.6%), and (3) minimal dysfunction (78.7%). After covariates adjustment, both the gradual and stable elevated impairment groups (vs. minimal) had substantially higher relative risk ratios (RRR) for dementia (RRR=5.71[3.89;8.39] and RRR=7.87[4.23,14.64]) and CIND (RRR=2.21 [1.69,2.88] and RRR=1.92[1.16;3.17]). We detected modifications by race/ethnicity such that Hispanics with stable elevated impairment had a higher probability of dementia compared to their White counterparts. The results varied for Blacks and did not significantly differ from Whites. Data-driven methods may improve our understanding of heterogeneous functional impairment patterns among late middle-aged adults and allow for tailored ADRD prevention strategies. Focused risk-based interventions can yield important public health savings and reductions in structural, social, and individual health burdens.
Anxiety and Depression as Predictive Factors of Quality of Life in Old Age: A Longitudinal Analysis
Authors: Ribeiro Oscar , Araújo Lia , Teixeira Laetitia , Rodríguez-Blázquez Carmen , Forjaz Maria Joao 
Published: December 2020

Abstract
Research on the effect of age in quality of life (QoL) is controversial, and doubts remain if this effect is continuous and if it disappears when controlling for other factors. Most studies have verified the association of health-related factors, such as poor physical health, functional impairment, and depression with lower scores of QoL in old age. But studies that analyse such an association in non-clinical samples through longitudinal analysis and including anxiety as a mental health factor remain very rare. This study relies on data from two waves from the Survey of Health, Ageing and Retirement in Europe (SHARE) and focuses on a representative sample of individuals aged 50+ from Portugal. It comprises 1782 participants (baseline), of which 1201 were reassessed. The mean age was 64.8 years (sd=9.3 years) and 55.4% were female. Linear Mixed Effects models were performed to identify potential factors associated with changes of QoL across age. According with the final model (pseudo-R2 equal to 0.421), a significant effect of age as time-dependent factor was verified, observing a decline of QoL with increasing age. Years of education, depression and anxiety at baseline were significantly associated with QoL. Thus, the effect of age on quality of life remains significant even when other factors are considered. The influence of mental health on QoL reinforces the importance of intervening in both depressive and anxiety symptoms in old age.
Trajectories of Health Changes in Older Adults with Chronic Hepatitis B Infection
Authors: Wu I-Chien , Chen Chang-Hua , Yang Yu-Wen , Liu Yen-Tze , Chiu Yen-Feng , Hsu Chih-Cheng , Chuang Shu-Chun , Hsiung Chao A 
Published: December 2020

Abstract
Despite the increasing burden of chronic hepatitis B (CHB) in aging populations, little is known about the course of health-related quality of life (HRQoL) changes during older adulthood in CHB patients. We aimed to assess individual-level longitudinal HRQoL changes in older patients with CHB and to examine their correlates. A 5-year prospective cohort study was conducted in 503 hepatitis B surface antigen-positive community-dwelling adults aged 55 years or older. Participants underwent comprehensive assessments at baseline and serial measurement of HRQoL using the short-form (12) health survey version 2. Of these participants, 82.7% remained in good physical health throughout the study period, whereas 9.1% had declining physical health and 8.2% were in poor physical health. We likewise identified three trajectories of mental health changes (“good mental health” [86.9%], “declining mental health” [6.8%], and “poor mental health” [6.4%]). Three baseline characteristics were independently associated with a lower likelihood of remaining physically or mentally healthy during older adulthood: sarcopenic obesity (odds ratio [OR] with 95% confidence interval [95% CI] of 7.5[2.8-20.5] for poor physical health, 3.1 [1.1-8.4] for declining physical health, 4.3 [1.4-13.0] for poor mental health), higher number of metabolic abnormalities (OR [95% CI] of 3.6 [1.6-8.0] for poor physical health) and depressed mood (OR [95% CI] of 21.7 [5.8-81.0] for poor physical health, 5.3 [1.4-19.9] for declining physical health, 83.1 [19.7-350.2] for poor mental health, 13.6 [2.9-64.8] for declining mental health). In conclusion, we demonstrated the heterogeneity and nonlinearity of HRQoL changes and their associations with variations in specific extrahepatic organs/systems.
Dimensions of Social Isolation and Weight Loss among Older Men and Women in S. Korea
Authors: Bae Youngjoon , Pachucki Mark 
Published: December 2020

Abstract
Older men who live alone are typically believed to be highly susceptible to malnutrition. However, recent studies report their living alone status is associated with frailty negatively and with Type 2 diabetes positively. Meanwhile, older women who live alone are believed to be less susceptible to malnutrition, but qualitative research point out their high likelihood of malnutrition. There is little literature to explain these paradoxes. To evaluate this gap in understanding of how a metabolic process may be shaped by social context, this study examines whether different aspects of social isolation among older men and women (living alone, social contact, loneliness) are associated with adverse weight loss, as well as with indicators of meal frequency and body weight. For this, a data set comprised of 6,680 older adults from the Korean Longitudinal Study of Aging surveyed every two years from 2006 to 2018 was analyzed using panel regression models. Among older men, living alone was negatively associated with logged body weight even when considering loneliness but not associated with meal frequency and 5kg or more weight loss. Among older women, living alone was not associated with logged body weight but associated with fewer meals and 5kg or more weight loss. The association disappeared when considering loneliness. Unexpectedly, social contact was not significant to prevent adverse weight loss.
The reciprocal causal relationship between frailty and physical activity among Korean older adults by age groups
Authors: Sagong Hae , Yoon Ju Young 
Published: December 2020

Abstract
Among associated factors to frailty, physical activity is a highly recommended intervention that prevents the risk factors of the frailty. However, most of the older adults are lack of sufficient physical activity to obtain health-related benefits. The purpose of this study is to investigate the reciprocal relationship between frailty and physical activity among Korean older adults by age groups of middle-old (70-79) and oldest-old (more than 80) between two years using cross-lagged panel analysis. This study is a secondary data analysis of the Korean Frailty and Aging Cohort Study (KFACS) and a total of 1,092 participants were included. Frailty was measured by the FRAIL scale and physical activity was measured by the International Physical Activity Questionnaire (IPAQ). As for the result, in the middle-old group, frailty and high PA had significant reciprocal causal relationships while moderate PA with frailty had no significant relationship reference to low PA. In short, frailty was associated with less high PA, and high PA predicts less frailty after two years. In the oldest-old group, surprisingly, there was no reciprocal causal relationship between frailty and any level of PA reference to low PA which means PA has no effects on frailty and vice versa. This can be explained by the ceiling effect or overestimation of the physical activity. Therefore, further studies on the relationship between frailty and physical activity of the oldest-old population are needed. Also, specific physical activity guidelines and effective measurement of physical activity for older adults by age segment should be developed.
Recruitment and Retention Strategies of Cancer Patients and Their Caregivers in Family-based Intervention Studies
Authors: Guan Ting , Qan’ir Yousef , Jung Ahrang , Xu Shenmeng , Idiagbonya Eno , Song Lixin 
Published: December 2020

Abstract
Family-based psychosocial behavioral interventions (PBIs) that target both the cancer patients and their caregivers may more effectively help them with self-care and improve quality of life; however, family-based PBIs often face unique challenges during study implementation. This systematic review aimed to a) examine the recruitment and retention rates of cancer patients and their caregivers in clinical trials testing family-based PBIs; and b) explore the recruitment and retention strategies. We systematically searched five electronic databases to identify randomized controlled trials that tested family-based psychosocial or behavioral interventions among adult patients with cancer and their adult family caregivers. Our searches yielded 48 studies. The average recruitment rates of patients and caregivers were 56.8% (SD=31.8%; range=8-100%) and 54.5% (SD=32.4%; range=8-100%), respectively. The majority of the studies have focused on white and female patients and caregivers. The average retention rate at end of follow-up times was 69.1%. Only 13 studies reported retention strategies, including providing money/gift cards upon returning of each follow-up survey or study completion, and excluding advanced cancer patients. Reasons for attrition, i.e., dropping out of studies, were classified as: health-related (e.g., death, illness, psychological distress), intervention-related (e.g., intervention does not meet expectation, frustration with group allocation, intervention burden) and other reasons (e.g. lack of time, unable to establish contact). Recruitment and retention of patients and caregivers in family-based PBI are integral to the success of interventions. Researchers need to incorporate effective strategies for optimizing recruitment and retention at the planning stage of their studies.