bluuebunny/crossref_metadata_2025_split huggingface dataset:
USING ECHO TO SUPPORT DEMENTIA DIAGNOSIS IN THE PRIMARY CARE NETWORK
Authors: Lindauer Allison , Wild Katherine , Natonson Andrew , Wolf Miriam , Mattek Nora , Messecar Deborah 
Published: November 2019

Abstract
Approximately 60% of those with dementia do not carry a diagnosis, undermining patient participation in clinical trials and family access to support. Under-diagnosis is driven by lack of knowledge about dementia, stigma, clinician inexperience and therapeutic nihilism. To address clinician-based contributors to under-diagnosis, we developed and implemented “Dementia 360,” a telementoring program modeled on the ECHO (Extension for Community Health Outreach) framework. Remote participants (n=67) learned about the diagnostic process, pharmacological management, family support and dementia-related resources. The video-conference-based one-hour sessions occurred weekly over 2 months. Instruction was provided by a multi-disciplinary faculty team with extensive clinical experience. Didactic presentations were followed by case studies offered by participants. Physicians, nurses, psychologists and social workers from 40 organizations participated, of which 62% were from medically underserved rural clinics. Participants were administered pre- and post-program questionnaires about their level of confidence in assessing and treating individuals with memory loss and dementia-related behavioral symptoms. Of the 54 clinicians who completed pre-intervention confidence assessments, 30 completed post-assessment. The clinicians had significantly increased confidence in diagnosing and treating dementia and managing behavioral symptoms of dementia (p ranging from .0002 to .003). Qualitative feedback from focus groups was generally positive, for example, “Knowing the diagnosis criteria and steps to take to rule out other diagnoses will help me more accurately diagnose and rule out dementia for my patients.” Our findings suggest that delivering case-based education via ECHO has potential to increase clinician workforce confidence in diagnosing and managing dementia.
MOVE UP STUDY RESULTS: WEIGHT LOSS POSITIVELY AFFECTS HEALTH-RELATED QUALITY OF LIFE BUT NOT DEPRESSIVE SYMPTOMS
Authors: Venditti Elizabeth M , Boudreau Robert M , Newman Anne B , Danielson Michelle E , Kieffer Lori A , Rager Judith R , Albert Steven 
Published: November 2019

Abstract
Obesity is prevalent among older adults as are increases in depressive symptoms and declines in health-related quality of life (HRQOL). Healthy weight loss and mitigating mild depressive symptoms (MDS) and HRQOL could have critical public health significance. The Mobility and Vitality Lifestyle Program (MOVE UP) led by Community Health Workers delivered 32 healthy aging/weight management group sessions over 13 months. Data from 240 participants were evaluated to assess program impact on CES-D (20-item) depressive symptom and SF-36 HRQOL scores. Participants were 88% female, 28% black/other race, 42% ≥ college-educated. Mean (SD) age was 67.6 (4.1) and BMI was 34.7 (4.7). At baseline, average CES-D score was 7.9 (7.2) and 27.9 % (N = 67) had MDS, scoring 17.1 (6.2). Results show significant mean (SD) weight change of -12.7 (13.3) lb from baseline (p&lt;0.0001). Overall, CES-D mean (SD) score change was -0.4 (6.7) (p=0.33); participants with MDS had an average CES-D decrease of -4.4 (7.8) points (p&lt;0.0001). Further, HRQOL improved significantly in all realms, particularly the physical component score (p&lt;0.0001). SF-36 (SD) total score improved +1.1 (7.6), mental + 2.1 (11.7), and physical + 5.0 (16.7). Regression analyses (age/sex adjusted) demonstrate that for each 5 lb of weight loss there was an average (SEM) 3.35 (1.49) point increase in SF-36 total score (p=0.03). The mitigation of depressive symptoms in the MDS subgroup was not significantly associated with weight loss but may reflect other positive effects of the intervention experience. Conversely, positive HRQOL changes appear to be driven strongly by weight loss.
CUSTODIAL GRANDPARENTS: AN ANALYSIS OF PARENTING AND ITS IMPACT ON HEALTH
Authors: Clark Karen C , Lane Kari R , Bullock Linda 
Published: November 2019

Abstract
In the United States, there are 2.7 million grandparents raising grandchildren without a biological parent present (U.S. Census, 2014). Caring for grandchildren can present challenges and stressors to custodial grandparents as they find themselves adjusting to this unanticipated role. Despite the growing knowledge base related to custodial grandparents, there has been limited research into the relationship between parenting self-efficacy and psychological well-being. This study was guided by the Parenting Self-Efficacy Theory derived from Bandura’s Social Cognitive Theory. The purpose of this study was to examine the relationship between parenting self-efficacy and psychological well-being (anxiety and depression) among custodial grandmothers. Additionally, self-reported general health was examined to determine if it moderated the relationship between parenting self-efficacy and psychological well-being. Sixty-eight custodial grandmothers recruited across the United States participated in the study. Their mean age was 58 years old; 57% were Caucasian, 35% African American, and 3% Hispanic. With a mean income of $26,000.00, most were retired (32%) or working full-time (29%). Participants responded to psychometrically sound instruments measuring anxiety, depression, general health and parenting self-efficacy. Findings indicated parenting self-efficacy scores were not significantly associated with anxiety scores (r = .029; p = .816) or depression scores (r= -.207; p = .090) among participants. Furthermore, general health did not moderate a relationship between parenting self-efficacy, anxiety (R2= .030; p= .5753) or depression (R2= .051; p= .3376). Further research is needed to determine whether the role of parenting self-efficacy in custodial grandparents. Implications for policy will also be discussed
EXPLORING PROMISING PRACTICE MODELS FOR HOUSING OLDER PERSONS EXPERIENCINGHOMELESSNESS
Authors: Walsh Christine , Canham Sarah L , Humphries Joe , Burns Victoria F , Dharshi Natasha , Sussman Tamara , Hangar Jackson 
Published: November 2019

Abstract
The numbers of older persons experiencing homelessness (OPEH) is on the rise globally Yet housing and shelter options that support the varied and complex needs of this population are scarce. In order to understand effective solutions for housing OPEH, it is critical to explore promising practices that support aging in the right place for OPEH. In an effort to inform this critical gap, 100 OPEH and service providers were purposefully selected and invited to attend one of three World Café workshops held in three major urban cities in Canada: Vancouver, Calgary, and Montréal. Participants engaged in facilitated discussions aimed at supporting knowledge exchange and generating dialogue about gaps, opportunities and promising local housing options. Thematic analyses of audiotaped deliberations revealed three themes: 1) The limited nature of current housing options and programs in each locality; 2) The importance of supporting integrative housing models that increase access to formal health and social support staff, transportation, and income supports; and 3) The significance of supporting sustainability, by conducting regular program evaluations, increasing public awareness of homelessness issues, and involving multi-sector stakeholders. Findings highlight how meeting the unique health and psychosocial needs of OPEH requires a nuanced understanding of the development, design, and sustainability of effective housing options. World Café dialogues revealed that identifying and sustaining existing promising practice models provides an avenue to supporting aging in the right place for OPEH.
LOW-INTENSITY EXERCISE ENHANCES MUSCULAR ANDROGEN/ANDROGEN RECEPTOR TO INHIBIT MYOSTATIN PATHWAY
Authors: Son Bo-Kyung , Eto Masato , Oura Miya , Akishita Masahiro 
Published: November 2019

Abstract
Background: Physical exercise is well documented to induce muscle size, strength, and energy metabolism. Although the contribution of systemic or local androgen in exercise-adapted muscle hypertrophy has been suggested, less is known about the molecular pathway of androgen in response to exercise. In the present study, we examined roles of androgen/androgen receptor (AR) after exercise, especially for the suppression of myostatin, a potent negative regulator of muscle mass. Methods and Results: To examine the effects of exercise, we employed low-intensity exercise in mice and electric pulse stimulation (EPS) in C2C12 myotubes. Both mRNA and protein levels of AR significantly increased in skeletal muscle of low-intensity exercised mice and C2C12 myotubes exposed to EPS. Production of testosterone and DHT from EPS-treated C2C12 myotubes was markedly increased. Of interest, we found that myostatin was clearly inhibited by EPS, and its inhibition was significantly abrogated by flutamide, a specific antagonist of AR. Furthermore, IL-6 and phospho-STAT3 (pSTAT3) expression, the downstream pathway of myostatin, were decreased by EPS and this was also reversed by flutamide. Similar downregulation of myostatin and IL-6 was seen in skeletal muscle of low-intensity exercised mice. Conclusion: Muscle AR expression and androgen production were increased by exercise and EPS treatment. As a mechanistical insight, it is suggested that AR inhibited myostatin expression transcriptionally, which downregulates IL-6/pSTAT3 pathway and thus contributes to the prevention of muscle degradation.
ANALYSIS OF THE EFFECTS OF SOCIAL CAPITAL ON SMOKING BEHAVIOR AMONG OLDER ADULTS IN CHINA
Authors: Sun Xiaojie , Yuan Linlin 
Published: November 2019

Abstract
By 2030, China will become the most aging country in the world. At the same time, China is the world's largest producer and consumer of tobacco, also the largest victim of tobacco. Tobacco exposure is one of the most important risk factors for many chronic non-communicable diseases among older adults. Based on the data from China Health Retirement Longitudinal Study(2011&2015), we aim to analyze the effects of base-period social capital on current smoking behaviors among Chinese older adults of 60 and above (N=7686) with univariate analysis and ordered logit model. Resluts show that, older adults with high social trust (OR=0.783) preferred to choose not to smoke ; those who had emotional support (OR=0.933) and financial support (OR=0.967) would be more possible to choose not to smoke; and older adults were more likely to choose heavy smoking if they had two or more types of social participation (OR=1.223). This study demonstrates that social trust and social support are the protective factors of smoking behavior among Chinese older adults, while social participation was a risk factor. The Chinese government has launched "the 2030 Plan for healthy China" to promote people’s healthy behaviors, and this study will provide good evidence for actions aiming at reducing smoking behaviors among Chinese older adults.
CEREBRAL ATROPHY CORRESPONDING TO TOOTH LOSS IN ELDERLY INDIVIDUALS
Authors: Umezaki Yojiro , Egashira Rui , Makino Michiko , Naito Toru 
Published: November 2019

Abstract
Recent advances in the aging of Japanese society, have meant that the chance of encountering dementia patients in dental clinics is dramatically increasing. Many studies have shown that the brain volume decreases along with the progression of dementia. Although previous studies have reported a relationship between tooth loss or periodontitis and the onset of dementia, the pathological mechanisms underlying this association have not been elucidated. In this study, we focused on the relationship between the oral condition and brain atrophy to discuss how to adequately deal with dementia patients. This study included fifteen participants who underwent brain MRI (magnetic resonance imaging). We obtained information on the oral condition, lifestyle, cognitive function and brain atrophy. The cognitive function was assessed using the Mini-Mental State Examination (MMSE). MR images of each patient were analyzed with the Voxel-based Specific Regional Analysis System for Alzheimer's Disease to quantitate the degree of brain atrophy. The study population included 4 male and 11 female patients. The mean age was 75.9 years. The mean number of present teeth was 15.0. The median MMSE score was 26. The degree of atrophy of the whole brain was significantly correlated with the number of present teeth (r=-0.72, p&lt;0.05) and the presence of a daily exercise habit (r=-0.66, p&lt;0.05). This study showed that the number of present teeth could be an indicator reflecting the progress of dementia. Preserving the teeth as well as the acquisition of a regular exercise habit might be important for preventing dementia.
HEALTHCARE ACCESS AND SOCIAL ENGAGEMENT OF OLDER MINORITY ADULTS: EXPERIENCES NAVIGATING TRANSPORTATION BARRIERS
Authors: Maxwell December , Mauldin Rebecca L , Kao Dennis 
Published: November 2019

Abstract
Transportation is vital in the daily lives of older adults and provides access to health care services and health enhancing activities, such as social engagement. Disparities in mobility exist for older African American and Hispanic adults compared to non-Hispanic Whites, including higher likelihood of driving cessation at an earlier age and having a higher risk for reduced life space. This poster presents findings from a qualitative analysis of data from the Using Geo-Ethnography to Explore the Spatial Accessibility of Health Services for Aging Minorities Study (GeoSAS), a mixed methods study of older minority adults in Houston, TX. Using interpretive phenomenological analysis, the transcripts of semistructured interviews with 23 older adults (13 African American and 10 Hispanic; 17 female; mean age = 71.3 yrs, SD = 6.3 years) were analyzed to address the research question: What are the mobility experiences and perceptions of minority older adults regarding healthcare access and social engagement? Based on an ecological systems theoretical framework, we found reciprocal influences of (1) healthcare systems and transportation utilization and (2) participants’ health and well-being, mobility, and social engagement. Support from family members and financial capacity were critical for participants’ mobility. Implications of this research include educating health care providers about patients’ transportation experiences and barriers, optimizing social support to increase mobility, and addressing systematic disparities in transportation access to enhance health and well-being for older minority adults.
THE EFFECTS OF FRAILTY, POLYPHARMACY, AND COGNITION ON HEALTH OUTCOMES: A STUDY ON INTERRAI RESIDENTIAL CARE DATA
Authors: Zou Macy , Kelly Ronald , Chinda Betty , Braley Mckenzie , Zhang Tony , Arvan Tara , Mcdermid Robert , Song Xiaowei 
Published: November 2019

Abstract
Frailty Index (FI), polypharmacy and cognition status are significant health concerns in older adults. We conducted this study to investigate the interplay of frailty, polypharmacy, and cognition, in determining health outcomes. InterRAI Residential Care (RAI-RC MDS2.0) data were retrieved from residential care homes in Surrey, BC, Canada. Older residents (65+ years) who had RAI-RC records between 2016 and 2018 were used in the analysis (n=976). A deficit accumulation-based FI was generated using 36 variables. Information on polypharmacy and cognition were obtained by accounting the total number of medications and the cognitive performance scale. Information on falls, emergency visits, and mortality were followed. Multivariate Cox proportional hazard models were used to examine the effects of these variables on different outcomes. The FI showed a near Gaussian distribution (median= 0.370 mean= 0.372 SD= 0.143), and increased linearly with age on a logarithm scale (R=0.75, p&lt;0.001). Residents with cognitive impairment showed a higher level of the FI (KW= 863.3, p&lt;0.001). A higher FI was associated with an increased risk of death (HR=15.2 p=0.006) and emergency visits (HR=2.72 p=0.048), adjusting for age, sex, medications, and education levels. Frailty, polypharmacy, and cognition levels are associated and have interactive effects on health outcomes. Ongoing research is to validate the findings with large samples in different health settings, and to understand the underlying processes of the effect. The close relationships between frailty, polypharmacy, and cognition with health outcomes call for effective integrated strategies for healthcare of older adults with multiple complex health problems.
WHITE MATTER INTEGRITY UNDERLYING SUBSYNDROMAL DEPRESSION SYMPTOMS IN DEMENTIA CAREGIVERS
Authors: Smagula Stephen , Santini Tales , Stahl Sarah , Ibrahim Tamer , Reynolds Charles , Schulz Richard , Banihashemi Layla , Zhan Liang 
Published: November 2019

Abstract
Past research shows that major depression is associated with lower white matter integrity in fronto-limbic and other areas. But it is not known whether the integrity of these white matter connections is associated with subsyndromal depression symptoms, a marker of risk for major depression, in family dementia caregivers (dCGs) who reported stress. If specific aspects of white matter integrity are related to depression symptoms in this high-risk group, this could provide a biomarker of vulnerability or target for treatment. Participants included 41 dCGs (average age=69, standard deviation=6.4), who underwent a 7 Tesla 64-direction (12-minute) diffusion-weighted imaging sequence. Analyses compared dCGs with (n=20) and without (n=21) subsyndromal depression symptoms (nine-item Patient Health Questionnaire scores ≥5). Using fractional anisotropy (FA), we assessed differences in the integrity of 11 white matter aspects implicated in prior studies of major depression. We found that caregivers with subsyndromal depression had lower FA in tracts connecting to the posterior cingulate cortex (Cohen’s D=-0.9, p-value=0.006, FDR=0.03) and in white matter connecting the dorsolateral prefrontal cortex with the rostral cingulate (Cohen’s D=-1.2, p-value=0.0005, FDR=0.006). Thus, differences in the integrity of white matter (and related functions) reaching the posterior cingulate (autobiographical memory/planning) and connecting dorsolateral prefrontal and rostral cingulate regions (emotion re-appraisal) may contribute to depression vulnerability in dCGs. These observations require contextualizing further (e.g., assessing roles of depression history and other risk factors) for their meaning to be fully elucidated. Potentially, relationships between known risk factors (e.g., subjective stress) and depression emerge from or drive changes in white matter.
CARDIAC MYBP-C IN C57BL/6 MICE: THE EFFECTS OF AGE
Authors: Pinheiro Amanda , Graber Ted G , Thompson LaDora V 
Published: November 2019

Abstract
Aging is a known contributor to cardiovascular dysfunction. It is well-established that with age there are functional changes in the heart; yet, the proteins responsible for maintaining sarcomere integrity are not well understood during the aging process. A key protein, cardiac myosin binding protein C (cMyBP-C), contributes to the structural integrity and the regulation of actomyosin interactions. To date, little is known about the effects of aging on cMyBP-C. Therefore, the first step in evaluating this sarcomere protein was to determine the expression of cMyBP-C in cardiac tissue across the lifespan. Using ten C57BL/6 male mice per age group (adult (6-7 months), old (22-25 months), and very old (≥29 months)), body and heart mass were determined. Next a portion of the cardiac tissue was homogenized, and protein concentration was determined (BCA assay). The protein samples were probed for cMyBP-C with MYBPC3 (Abcam, #ab133499) by Western Blot. One-way ANOVA was performed to evaluate differences between groups. Results indicated there was an increase in heart mass with age, but relative to body weight there was no significant difference between the three age groups. Western blot analysis revealed no significant age-related difference in the expression of cMyBP-C. Although there was no change in expression levels, it is not possible to rule out cMyBP-C as a contributor to age-related cardiac dysfunction because phosphorylation is known to play a critical role in the function of cMyBP-C. Thus, further investigation of the phosphorylation status of cMyBP-C is needed and is ongoing.
EXAMINING COMMUNITY-BASED SERVICES DISCONNECTS IN LATE OLD AGE: PATHS FOR REACH THROUGH THE COMMUNICATION ECOLOGY
Authors: Leach Carrie , Novak Julie 
Published: November 2019

Abstract
As potentially eligible recipients continue to increase in number, understanding service system utilization and barriers can help ensure very old adults can access support from their communities when needed. A communication disjuncture between seniors and community-based service providers was revealed through a multi-year, county-wide older adult needs assessment utilizing data from 1,870 individuals. In response, officials convened a post assessment team that formed the three-person Community Advisory Group (CAG, all ≥69 years) who participated in this community-based participatory research (CBPR) study. This applied, qualitative study, guided by an ecological health communication research framework, conducted multilevel examinations of interactions among older adults and their social environment. Twenty in-depth, face-to-face, semi-structured interviews (mean = 82.5 years) were conducted based on a critical threshold of understanding achieved via researcher immersion in the community preceding this study, data collected, and CAG insight revealed through collaborative analysis. Communication Infrastructure Theory helped to reveal how participants’ diminishing social network interrelated with the communication environment acted to impede connections to services. In addition to utilization impediments, enabling elements of the communication infrastructure were identified so those resources might be leveraged to bridge the senior-provider divide. Findings from this study suggest new outreach approaches for connecting to older adults through their communication ecology. The findings add to the growing convergence of evidence that calls for improved communication with older adults to minimize poor interactions that hinder accessing resources that may enhance their social, emotional, and physical well-being.