bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D Supplementation on Detailed Fall Characteristics
Authors: Wanigatunga Amal , Sternberg Alice , Blackford Amanda , Cai Yurun , Schrack Jennifer , Miller Edgar , Roth David , Appel Lawrence 
Published: December 2020

Abstract
Evidence suggests Vitamin D supplementation may reduce fall risk in older adults, but effects on fall location and severity are less well described. We used STURDY trial data to examine whether Vitamin D supplementation reduces indoor, outdoor, “consequential” (falls resulting in injury or medical care), and repeat fall risk. Participants (77[SD=5.4] years; 44% women) were randomized to receive 200 (n=339) or 1000IU/day (n=349) of vitamin D3. Indoor, outdoor and consequential fall rates were similar between the ≥1000IU/day and 200IU/day groups (rate ratio [RR]:1.22, 95%CI:0.96-1.55; RR:0.85, 95%CI:0.65-1.10; and RR:1.16, 95%CI:0.93-1.45, respectively) during follow-up. The proportion of repeat fallers was similar between ≥1000IU/day versus 200IU/day groups over 3 months (7.8%[27/346] versus 6.5%[22/336], p=0.22), 6 months (18.8%(60/319) versus 16.2%(51/315), p=0.40), 12 months (29.9%(81/271) versus 31.2%(84/269), p=0.78) and 24 months (48.2%(66/137) versus 49.6%(66/133), p=0.90). In conclusion, Vitamin D supplementation ≥1000IU/day did not reduce indoor, outdoor, consequential or repeat fall risk.
Vitamin D Supplementation and Change in Objectively Measured Physical Performance
Authors: Guralnik Jack , Schrack Jennifer , Wanigatunga Amal , Sternberg Alice , Mitchell Christine , Appel Lawrence 
Published: December 2020

Abstract
Change in usual gait speed (GS) was a prespecified secondary outcome in STURDY and additional physical performance measures were also assessed. Over 12 months, gait speed declined slightly in both the 200IU/d (control) and the intervention groups receiving 1000 or more IU/d, with identical declines in both groups. However, at month 24 GS declined 0.09 m/s from baseline in controls and 0.03 m/s in the intervention group (p=0.03). Subgroup analyses of persons receiving just 1000IU/d throughout the trial compared to controls did not reach significance (p=0.07). Neither SPPB, balance, chair stand tests, or 6-minute walk test showed differences between controls and intervention at any follow-up point. The timed up and go (TUG) test showed a significantly greater improvement in the intervention group at 2 months (p=0.004) but not 12 or 24 months (p=0.17 and 0.79, respectively). Effects of long-term vitamin D supplementation on physical functioning remain unclear.
Pilot Study to Implement a Resident and Family Decision Guide
Authors: Wolf David , Sopcheck Janet 
Published: December 2020

Abstract
In this first stage of an 8 state initiative designed to assist nursing homes in reducing unnecessary hospital readmissions, 16 nursing homes were identified and invited by CMS and state agency advisors to participate in the pilot study of the effects of intervention (use of the Guide). Selected facilities received an online orientation to the project and onsite visit from project team leadership prior to launch. Pre and post implementation data were uploaded to a secure section of the project website by the facilities. Three facilities withdrew due to change in top management and a fourth facility provided incomplete data resulting in data for analysis from 12 pilot facilities. Results show the average reduction in readmissions was 31.2% for the project period as compared with the 3-month pre-project period. This presentation will include facility reports of the effect of Guide use on resident and family decision making.
Preparing Pharmacy Students for Practice to Support Underserved Older Persons
Authors: Mansour Daniel 
Published: December 2020

Abstract
Interprofessional collaboration is needed to ensure high quality care. Effective programs teaching necessary team-based care skills are under investigation. This study evaluated the Aging in Place program, an interprofessional practice experience (IPE), in preparing pharmacy students for practice with underserved older persons. The Assessment of Interprofessional Team Collaboration Scale (AITCS) and Team Decision Making Questionnaire (TCMQ) were administered to students before and after their experience. The number of disciplines represented, campuses involved, resident sessions, resident interactions, and health screenings performed were documented. Overall, AITCS and TDMQ scores improved after participation in the program. Since the program’s inception, there have been 7 disciplines represented, 2 campuses involved, 125 student participants, 2 housing buildings, 90 resident sessions, and 370 health screenings performed. The Aging in Place program has grown and shown that an IPE program is feasible to better prepare pharmacy students for collaborative care with older residents of affordable housing buildings.
Cognitive and Neuroimaging Profiles of Individuals With Dual Decline in Memory and Gait
Authors: Tian Qu , Resnick Susan , Davatzikos Christos , Studenski Stephanie , Ferrucci Luigi 
Published: December 2020

Abstract
Across 6 aging cohorts we showed that dual decline in memory and gait speed was associated with increased risk of dementia compared to memory or gait decline only. We now characterize dual decliners. Using longitudinal BLSA data, we examined associations of phenotypic groups with changes in cognition, depressive symptoms, and brain volumes in areas important for cognitive (dorsolateral prefrontal, medial temporal) and motor functions (precentral gyrus,striatum,thalamus,anterior cingulate cortex) using linear mixed effects models (usual agers=reference), adjusting for covariates. Compared to usual agers, dual decliners had faster decline in card rotation score, greater increase in CES-D, and greater atrophy in thalamus and anterior cingulate cortex. Rates of change in these parameters did not differ among the other three groups. Dual decliners experience faster decline in visuospatial ability, greater atrophy in selected motor areas, and greater increase in depressive symptoms, suggesting potential mechanisms underlying increased dementia risk in dual decliners.
Engaging Underrepresented Caregiving Communities in Dementia Research
Authors: Gilmore-Bykovskyi Andrea , Williams Ishan 
Published: December 2020

Abstract
Family and friend caregivers of persons with dementia from underrepresented and traditionally underserved backgrounds are significantly underrepresented in dementia and caregiving research despite heightened disease risk, poorer outcomes, and disproportionate use of services within these populations. Efforts to develop and disseminate methods that foster greater inclusion of underrepresented caregiving populations in research are essential to ensuring that culturally specific understandings, priorities, and needs of these groups are systematically understood and addressed. In this symposium, we present a variety of studies that illustrate successful efforts to include dementia caregivers from underrepresented backgrounds in research. Two presentations focus on African American caregivers, one on caregivers residing in highly under-resourced areas, one on Latino caregivers, and one on sexual and gender minority (SGM) caregivers. The first presentation describes a capacity building approach through African American faith communities to develop a research registry and address informational needs regarding dementia. The second presentation focuses on eliciting African American caregivers experiences of crisis events. Presentation three describes a coalitional, community-informed approach to engaging caregivers in highly under-resourced areas to investigate experiences with post-acute care. The fourth presentation describes a community-network approach to implementing a text-message based support intervention among Latino caregivers; and the fifth presentation illustrates the utility of digital methods for engaging SGM dementia caregivers. Collectively, these presentations demonstrate a variety of approaches to engaging dementia caregivers from underrepresented and traditionally underserved backgrounds in research that are specific to individual communities and local contexts – as well as the findings that result from these efforts.
Engaging Dementia Caregivers in Under-Resourced Areas to Examine Disparities in Post-Acute Care Quality and Access
Authors: Gilmore-Bykovskyi Andrea , Block Laura 
Published: December 2020

Abstract
Dementia disproportionately impacts racial/ethnic minorities and individuals from under-resourced environments, yet these groups are under-represented in research. For caregivers, managing dementia often involves navigating frequent post-acute care (PAC) transitions. Despite evidence of segregation-associated disparities in PAC access and quality, the perspectives of caregivers from under-resourced areas regarding these disparities and how they are experienced, are poorly understood. We engaged a coalitional, community-informed approach to engaging caregivers in highly under-resourced areas to elicit experiences surrounding PAC through semi-structured interviews (N=25; 65% African American; 25% White; 88% female). Data were analyzed using thematic analysis. Caregivers spontaneously connected issues in PAC quality to racial/ethnic disparities and discrimination citing differences in geographic availability, financial barriers, eligibility, access to information, and transportation. To mitigate these challenges caregivers remained highly involved in the care recipient’s PAC, describing the need to continue to “advocate” and “supervise.” Collectively, these perspectives can help inform future, targeted policy interventions.
Translating Exercise Benefits Over Telehealth
Authors: Padala Kalpana , Lensing Shelly , Evans Tammy , Pearson Megan , Morey Miriam , Padala Prasad 
Published: December 2020

Abstract
Background: Gerofit-Geriatric walking clinic is a home-based program that helps older veterans engage in regular walking via different platforms to improve access. The objective was to compare the outcomes of face-to-face visits to telehealth visits. Methods: Older Veterans (N=646) and walking-buddies (N=154) were seen either face-to-face or via telehealth at baseline, 2-, and 6-months. The primary intervention, pedometer feedback and motivational phone calls were delivered remotely. Results: Demographic data were similar in both Veteran groups and 47% were seen via telehealth. Compared to face-to-face, a higher proportion in the telehealth group had walking buddies (10% vs. 27%; p&lt;0.001), received exercise counseling (75% vs. 95%; p=0.001), and reported perceived barriers (40% vs. 67%; p=0.004). There were statistically significant improvements in step-counts at 2- and 6-months compared to baseline (57% and 99% improvement; p&lt;0.01) with no significant between-group differences. Conclusion: Tailored activity promotion programs via telehealth are effective in reaching older veterans.
Gerofit Decreases Medication Use Among Older Veterans
Authors: Intrator Orna , Li Jiejin , Veazie Peter , Wesgate Sara 
Published: December 2020

Abstract
We examined whether Veterans enrolled in Gerofit for at least 12 months between 10/2012-3/2017 saw reductions in their medication utilization (5 sites, 226 Veterans). VA outpatient pharmacy data was used to identify medications used 12-months prior, and 12-months following Gerofit enrollment. Seven drug classes were identified (cardiovascular, diabetic, lipid, mental health, opioids, vitamins, other medications). Nearest-neighbor propensity-matched analyses was conducted with exact match on number of baseline medications and site. At baseline, Gerofit participants were taking, on average, 11.6 medications (1.7 cardiovascular, 0.6 diabetes, 0.7 lipid lowering, 0.7 mental health, 0.5 opioids, 0.6 vitamins, 7.0 other). At 12-month follow-up, Gerofit patients were taking fewer medications: any (-2.7 [-4.4, -1.0]); cardiovascular (-0.5 [-0.7, -0.3]); diabetes (-0.7 [-1.2, -0.2]); mental health (-0.9 [-1.5, -0.2]); and other (-2.4 [-3.5, -1.4]) compared to matched comparisons. No significant differences at 12-months were found for lipid lowering, opioids, or vitamins. Conclusion: Gerofit participation reduced medication use.
An Effectiveness Trial of STEADI in an Outpatient, Primary Care Practice
Authors: Rein David , Hackney Madeleine , Dougherty Michele , Vaughan Camille , Imhof Laurie , Johnson Theodore ,   The Emory Clinic at St. Josephs STEADI Implementation Group
Published: December 2020

Abstract
The STEADI Options trial uses a randomized, controlled-trial design to assess the effectiveness and cost-effectiveness of the STEADI Initiative . Beginning March, 2020, we will randomize 3,000 adults ≥ 65 years of age at risk for falls seen in an Emory Clinic primary care practice to: (1) full STEADI; (2) a STEADI-derived gait, balance, and strength assessment with physical therapy referrals; (3) a STEADI-derived medication review and management; or (4) usual care. This presentation will discuss decisions made by the study team to facilitate implementation of STEADI including electronically conducting screening prior to the date of encounter, the use of dedicated nursing staff to conduct assessments, implementation of strength, balance, orthostatic hypotension, and vision testing, methods to facilitate medication review, and communication of assessment information to providers. The results from this study will be used to estimate the impact of STEADI on falls, service utilization, and costs over one year.
Exploring Inner Strength in People Aging With Serious Illness and Cognitive Impairment
Authors: Morgan Brianna 
Published: December 2020

Abstract
Inner strength is a psychological resource that supports people as they move through challenging life events. Understanding how people living with serious illness conceptualize inner strength is key in informing person-centered healthcare. This concept analysis used dimensional analysis methods to explore the nature of inner strength in people aging with serious illness to define a situation specific theory. 1212 abstracts and articles from the published literature were reviewed. 30 articles were included and analyzed as data sources. The resulting explanatory matrix conceptualized inner strength in people as an inward and outward process of “meeting me” – an authentic version of oneself – in the context of shifting health. Of note, while other serious illnesses were represented, no literature focused on dementia. Understanding inner strength in people with dementia is the next step for further inquiry. A pilot study exploring feasibility and informing further research is planned.
Race and Regional Differences in Risk Factors for Cognitive Impairment From a Combined Cohort Analysis
Authors: Windham B Gwen , Griswold Michael , Henegan James , Knopman David , Lirette Seth , Mielke Michelle , Petersen Ron , Mosley Thomas 
Published: December 2020

Abstract
Few studies examined race-regional influences on mild cognitive impairment (MCI) and dementia risk factors. We examined 14 risk factors in 5 race-regions, e.g. cross-sectional age- and sex-adjusted relative prevalence ratios (RPR) from multinomial regression comparing associations of low education (&lt;12yrs) with MCI and dementia (versus normal cognition) across 3 race-region groups, average age 76yrs: whites in the Mayo Clinic Study of Aging[MCSA, Olmsted County, MN—MCSA-MN-Whites); Atherosclerosis Risk in Communities(ARIC) whites in suburban Minneapolis, MN—ARIC-MN-Whites); ARIC-African Americans in Jackson, MS—ARIC-MS-AA. Among 3,787 MCSA-Whites, low education exerted a 2-fold risk for MCI, RPR=2.09(95%CI: 1.57,2.78). Conversely, low education was not a supported MCI risk factor for ARIC-MN-Whites (n=1,901—RPR=0.63(0.31,1.28) or ARIC-MS-AA, (n=1,416—RPR=.0.81 (0.60,1.10)), with substantially differential race-region effects. Low education RPRs for dementia also differed by race-region: RPR=4.43(2.68,7.31-MCSA-MN-W), RPR=0.70 (0.16,2.99-ARIC-MN-Whites), and RPR=2.54 (1.74,3.72-ARIC-MS-AA). Understanding why risk factors differ by race and region likely requires diverse samples and harmonized methods using culturally-appropriate assessments.
Global Council on Brain Health: Consensus and Recommendations for Promoting Brain Health Through Music Engagement
Authors: Mintzer Jacobo 
Published: December 2020

Abstract
This presentation will summarize the points of consensus reached by the experts and describes the major points of discussion that led to their recommendations for men and women age 50 and older. The GCBH considered questions surrounding what happens in the brain when listening to music as well as creating music. Topics such as music therapy and the clinical dimensions of introducing music into caring for patients will be addressed. Alongside the consensus points, recommendations and practical tips will be presented. Moreover, we will also identify gaps in our knowledge that currently exist in the evidence base surrounding music and brain health.
A Preliminary Measurement and Understanding of Movement-Evoked Pain in African American Elder Adults
Authors: Booker Staja 
Published: December 2020

Abstract
Osteoarthritis (OA) is a principal cause of disabling knee pain, and movement is a known exacerbator of pain in African Americans (AAs). Still, research has neglected to understand the relationship between pain with movement and its impact on function and mobility. Our previous study found significantly higher movement-evoked pain between AAs and White American (WAs). Therefore, this case-control observational study investigated inter-racial and intra-racial differences in movement-evoked pain in AAs and WAs (N= 28) who were 55-78 years-of-age (M= 65.75, SD= 6.23). We measured pain intensity (0-10) pre/ante/post multiple performance-based functional activities; we report preliminary results for 7-meter GAITRite® walk and Stair climbs. Pain intensity was higher before and after the 7-meter walk and stair climbs in AAs, although not significantly different than WAs. We will conduct additional statistical tests for the remaining functional activities to identify potential differences and ethnic-specific factors that distinguish movement-evoked pain and function by race.
Applying Engagement Frameworks to Case Scenarios: A Retrospective Analysis
Authors: McGaffigan Erin 
Published: December 2020

Abstract
The LeadingAge LTSS Center @UMass Boston has worked with the Patient-Centered Outcomes Research Institute (PCORI), service recipients, researchers, and providers since 2017 to understand the obstacles and creative solutions for meaningful and effective engagement in research. The LTSS Center’s work has been informed by multiple engagement frameworks, including Dr. McGaffigan’s 2011 PAE Attention Framework, the result of a multi-state, multi-site research study examining the factors to user engagement in Cash & Counseling programs. In this presentation, we will apply the PAE Attention Framework (2011), the PCORI Engagement Rubric (2014), and the NHS INVOLVE Framework (2015) to three research study case scenarios to understand the strategies used, outcomes realized, and factors influencing engagement success. Lessons learned from each and their application to future research will be discussed, including ethical considerations. Part of a symposium sponsored by the Patient/Person Engagement in Research Interest Group.
Physical Activity and Health: Does the Pattern Matter?
Authors: Koster Annemarie , Stenholm Sari , Gardiner Paul 
Published: December 2020

Abstract
It is well-known that physical activity is key in the prevention of many diseases and disability in old age. Much less is, however, known about the pattern of activity in relation to health. While there are differences in how people spread their activity and sedentary behavior over the day or over the week, we don’t know which activity pattern of most beneficial for health. This symposium focuses on patterns of physical activity and sedentary behavior and health in five different studies with accelerometry data in Europe and the USA. Dr. Rosenberg will show how sedentary behavior patterns are associated with various health outcomes in the Adult Changes in Thought (ACT) study. Using data from The Maastricht Study, Dr. Vandercappellen will present how weekly activity patterns, in particular comparing regularly actives to weekend warriors, are associated with arterial stiffness. Dr. Shiroma will show how patterns of physical activity and sedentary behavior, taking the volume, intensity, and frequency of sessions into account, are associated with mortality in the Women’s Health Study. Dr. Caserotti will present the association between physical activity fragmentation and physical function in the SITLESS Study. Dr. Stenholm will present data from the Finish Retirement and Aging Study, using latent class trajectory analyses to identify daily activity patterns and how these patterns are associated with health-related physical fitness. Taken together, this symposium will provide insight into different ways patterns of activity can be operationalized using accelerometer data and if the patterns of activity and sedentary behavior are associated with health.
Patterns of Sedentary Behavior in a Community-Based Cohort of Older Adults
Authors: Rosenberg Dori , Walker Rod , Greenwood-Hickman Mikael Anne , Richmire KatieRose , Bellettiere John , Wing David , LaCroix Andrea 
Published: December 2020

Abstract
Few epidemiologic studies have examined device-measured sitting patterns by demographics and health status. The Adult Changes in Thought (ACT) study is an on-going epidemiologic study of adults age ≥65 years. We conducted a sub-study that added a thigh-worn activPAL device and sleep logs for 7 days to the measurement protocol. A total of 997 had valid wear time (≥4 days with 10-20 hours of data per day) and covariate data. activPAL sedentary pattern measures included number of sitting bouts lasting 30 minutes or more and mean sitting bout duration. On average, participants (56% female, 57% &gt; age 75, 89% non-Hispanic white) sat in bouts lasting 17 minutes (SD = 12) and had 5.9 (SD = 1.7) bouts of sitting lasting 30 minutes or more. Participants who were older, were male, had obesity, had worse self-rated health, had depression, and had difficulty walking had longer sitting bouts and more prolonged bouts.
Daily Physical Activity Patterns and Their Association With Health-Related Physical Fitness Among Aging Workers
Authors: Stenholm Sari , Pulakka Anna , Leskinen Tuija , Pentti Jaana , Heinonen Olli , Koster Annemarie , Vahtera Jussi 
Published: December 2020

Abstract
This study aimed to identify accelerometer measured daily physical activity patterns and to examine how they associate with health-related physical fitness among 258 participants (mean age 62.4 years, SD 1.0) from the Finnish Retirement and Aging Study. Wrist-worn ActiGraph accelerometer was used and health-related physical fitness measures included body composition, cardiorespiratory fitness and muscular fitness. Based on latent class trajectory analysis, six different patterns of daily physical activity was identified on workdays and two on days off. Having low activity throughout the workday was associated with poorest health-related physical fitness, whereas a combination of low or moderate activity during working hours and increase of activity level in the evening was associated with most favorable body composition and better physical fitness compared to the other trajectories. In conclusion, a large variation in the workday physical activity patterns and health-related physical fitness was observed among aging workers.