bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECT OF SELF-PACED WALKING ON REDUCING COGNITIVE DEMANDS OF WALKING WHILE TALKING
Authors: Kim Hyeon Jung , Fallahtafti Farahnaz , Yentes Jennifer M , Venema Dawn , Boron Julie Blaskewicz 
Published: November 2019

Abstract
Although walking is considered an automated process, internal and external factors can alter gait performance. Fear of falling leads to walking with a wider base of support and decreased walking speed, due to a combination of shorter stride lengths and/or stride time. Exacerbation of gait deficits have been reported under high cognitive load situations (HCLS, also known as dual-tasks). Talking on a phone is considered an increased HCLS over talking in-person due to visualization of the individual on the phone. The purpose of the study was to explore the added effects of walking while talking on a phone compared to talking in-person. Fifteen healthy older adult subjects (70.86±4.7yrs) performed three conditions while walking on a self-paced treadmill for ten minutes: (1)walking alone, (2)walking while talking in-person, (3)walking while talking on a phone. Mean stride length(SL), stride time(ST), and step width(SW) were compared using one-way, repeated-measures ANOVAs (p=0.10). Dual-task cost of walking while talking in-person and on a phone was calculated for each gait variable and compared with t-tests. Mean gait variables did not differ between conditions (SL p=0.95, ST p=0.77, SW p=0.57). Dual-task costs were not significantly different between talking conditions (SL p=0.99, ST p=0.54, SW p=0.14). Use of a self-paced treadmill allowed the subjects to perform in their “comfort zone”, however, walking on a set-speed treadmill may force walking speed outside of the comfort zone, pushing one’s “reserve”, and revealing differences. Use of a self-paced treadmill better approximates daily life by providing the opportunity to make adaptations under HCLS.
THE AGING BRAIN AND MOTOR LEARNING
Authors: Tian Qu , Mullins Roger , Corkum Abby , Reiter David , Pupo Daniel , Simonsick Eleanor M , Kapogiannis Dimitrios , Studenski Stephanie 
Published: November 2019

Abstract
The effect of aging on motor learning is poorly understood. This study investigated response time and patterns of brain activation induced over the course of a bimanual motor learning task in three age groups. Twenty-two cognitively unimpaired participants (32%women) were grouped into Young (&lt;35,n=6), Middle-Age (36-59,n=10), and Old (60+,n=6). A self-paced bimanual motor learning task was performed during fMRI. The task consisted of using 2 capital and 2 lower case letters in strings of 16 cues with 6 novel alternating with 6 repeated sequence blocks. To assess learning, a repeated measures ANOVA tested whether average time per slide differed over time between novel and sequence conditions. Voxel-wise changes in brain activation between novel and sequence conditions over time were examined using a within-subject repeated measures model. Faster initial time per slide was associated with younger age (p0.05). Old had increased brain activation in repeated sequence than novel conditions in right postcentral and superior parietal regions during the early half of the task compared to the second half (p0.05). We found behavioral evidence of motor learning in Middle-Age and Old, but not Young, perhaps because younger individuals performed quickly and learned sequence almost immediately. Among older individuals, sequence-specific learning in parietal regions challenges the view that it is mediated by only motor areas.
QUADRICEPS STRENGTH IS ASSOCIATED WITH COGNITION IN OLDER ADULTS WITH CHRONIC STROKE
Authors: Bennett Kimberly , Crockett Rachel A , Brinke Lisanne F ten , Davis Jennifer C , Liu-Ambrose Teresa 
Published: November 2019

Abstract
Individuals who have suffered a stroke are at risk for developing cognitive impairment and dementia. Thus, it is important to identify modifiable risk factor for cognitive decline in this population. Among older adults without a history of stroke, greater muscle strength is associated with better cognitive function. Whether this relationship also exist in older adults with a history of stroke is not known. Thus, we aimed to examine whether cognition, as measured by both the Montreal Cognitive Assessment (MoCA) and the 13-item Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog 13), is associated with lower extremity muscle strength in adults with chronic stroke (&gt; 1 year post stroke). Ninety-one community-dwelling adults, aged 55 years and older, with chronic stroke were included in this analysis. Isometric strength of the quadriceps was measured bilaterally in kilograms. Two linear regression models were constructed to determine the independent association of quadriceps strength (mean kilograms of both legs) with: 1) MoCA; and 2) ADAS-Cog 13, after controlling for age, sex, and mood. Mean quadriceps strength was independently associated with both MoCA and ADAS-Cog scores, after accounting for age, sex, and mood. Specifically, quadriceps strength explained an additional 5.6% of the variable in MoCA scores; total variance explained by the model was 12.0%. For ADAS-Cog 13, quadriceps strength explained an additional 5.4% of the variance; total variance explained by the model was 16.5%. Our current cross-sectional results suggest that the maintenance of muscle strength may be important for cognitive health in older adults who have suffered a stroke.
ASSOCIATIONS BETWEEN COGNITIVE FUNCTION AND BIOACTIVE FOOD COMPOUNDS IN 100% WATERMELON JUICE
Authors: Ellis Amy , Hansen Ann Bradford , Baidwan Navneet , Nagabooshanam Vinoth Aryan , Crowe-White Kristi 
Published: November 2019

Abstract
Objectives: Decline in cognitive function and increases in inflammation and oxidative stress are part of normal aging. Watermelon contains numerous bioactive compounds including lycopene, arginine, and citrulline that exhibit both anti-inflammatory and antioxidant functionality. Thus, the objective of this study was to examine the effect of 100% watermelon juice supplementation on cognitive performance. Methods: A placebo-controlled, randomized, double-blind, crossover trial was conducted with postmenopausal women (n = 16, 60 + 4.1y). Participants initiated a low-lycopene diet during a one-week run-in period and adhered to this diet throughout the study. For four weeks, participants were randomized to consume either two 360 mL servings of pasteurized 100% watermelon juice or a placebo beverage. Following a two-week washout period, participants received the opposite beverage for an additional four weeks. Pre/post each intervention arm, fasting blood samples were collected, and cognitive tests were administered to assess various neurocognitive domains. Statistical analyses included mixed models and Spearman correlations. Results: Serum lycopene exhibited a significant treatment effect (p=0.002); however, lycopene was not correlated with any cognitive test. In contrast, no significant treatment effect was observed for serum arginine or citrulline, yet arginine was significantly inversely correlated with Digit Span Forward (p = 0.005, r = -0.547) and Letter Fluency (p = 0.024, r = -0.507). Conclusion: Despite research supporting the relationship between lycopene and enhanced cognition, lycopene was not related to improvements in cognitive performance in this study. Nevertheless, consumption of 100% watermelon juice may be beneficial for increasing circulating levels of this antioxidant.
A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS OF COGNITIVE TRAINING INTERVENTIONS IN OLDER ADULTS
Authors: Malatyali Ayse , Reive Carol , Williams Christine 
Published: November 2019

Abstract
There has been a growing interest in cognitive training interventions for their potential effect of maintaining and promoting cognitive functioning in older adults. Rapid and significant changes in technology has had a significant impact on the design and assessment methods of cognitive training interventions. Investigating changes in brain networks and blood markers are relatively new approaches and sparsely examined in the literature. The purpose of this systematic literature review is to analyze the effect of cognitive training interventions on brain networks, blood markers and associated cognitive performance of healthy older adults. We conducted a comprehensive literature search on four databases, following PRISMA guidelines. Initially, 2426 citations were retrieved, and 251 full-text publications were evaluated in detail for eligibility. Fourteen randomized control trials were included in this review. Functional imaging analysis of brain networks showed significant activity changes primarily in the Default Mode Network. These changes were associated with improvement in memory, learning, attention, and affective performances. Also, there were activity changes in the Central Executive Network that were associated with improvement in reasoning, attentional control, innovative thinking, and processing speed. Training-induced changes have been observed in the brain-derived neurotrophic factor levels and the markers of antioxidative and anti-inflammatory regulatory mechanisms. Improvement in attention and memory performances were significantly related to these changes. Limitations of the studies included methodological inconsistencies, sampling issues, and the lack of long-term follow up assessment. Cognitive training appears to promote improvement and maintenance of cognitive functioning in healthy older adults.
REDUCING OPIOID OVERDOSE RISK IN A COMMUNITY CARE COORDINATION CLINIC: RICHMOND HEALTH AND WELLNESS PROGRAM
Authors: Zanjani Faika A , Brooks Marshall , Waters Leland , Parsons Pamela , Slattum Patricia 
Published: November 2019

Abstract
Objective Opioid safety is increasingly important in the care of older adults due to higher risk for negative opioid-related outcomes related to higher prevalence of chronic pain, multimorbidity, polypharmacy, and age-associated changes in drug metabolism and elimination. Evidence-based practices for screening and safe opioid use for older adults are needed. Our project aims to develop, implement, and evaluate a care-coordination workflow and interprofessional clinical opioid misuse screening, support, and referral training to support older adult care. Methods Our research occurs in context of the Richmond Health and Wellness Program (RHWP), a community-based interprofessional care coordination initiative, with interprofessional faculty and students providing on-site integrated care to residents in low-income senior housing communities. Curriculum development, and interprofessional clinical faculty, peer support, and health professions student training have been conducted. Results will discuss the findings from the health professions student training. Findings The Opioid Overdose Risk Reduction Curriculum was delivered via Blackboard and in-person during student orientation. Pre (n=66)/Post (n=59) assessment indicated that after the training, there was an increase in knowledge, specifically change from 50% at baseline, 60% recognized Tramadol as an opioid, change from 80% to 97% understanding that MME represents Morphine Milligram Equivalent, and change from 62% to 93% understanding that 50 MME level greatly increases overdose risk. Only 20%, change from 60%, reported not being able to calculate MME. Conclusions Our findings indicate that opioid safety training within community care coordination is feasible. Future works needs to explore the impact on resident health as the workflow is implemented.
THE ROLE OF IMPROVED SOCIAL SUPPORT FOR HEALTHY EATING IN A LIFESTYLE INTERVENTION: TEXERCISE SELECT
Authors: Yoshikawa Aya , Smith Matthew L , Lee Shinduk , Towne Jr. Samuel D , Ory Marcia G 
Published: November 2019

Abstract
Healthy diet is essential to the management of chronic conditions such as cardiovascular disease and diabetes. Research suggests an association between social support and dietary behavior, yet the relationship is not fully explored. The role of social support in nutrition consumption was examined among older participants in a group-based lifestyle enhancement program (Texercise Select) designed to improve dietary behaviors and physical activity and related supports. Factor analysis and structural equation modeling were performed using secondary data from a quasi-experimental study of participants who completed a baseline survey and three-month follow-up (Intervention group N = 211, comparison group N = 175). The majority of participants were age 70 years or older (Mean = 74.30, SD = 8.54), female (82.1%), and had at least two chronic conditions (63.5%). The two groups did not differ in baseline levels of nutrition intake or social support. Program participants improved in terms of intake of water and fruits/vegetables as well as social support. Structural equation models adjusting for the effect of baseline scores indicated that the intervention effect on fruits/vegetable intake (β = 0.19, p &lt; 0.001) was partially mediated (β = 0.03, p = 0.021) by social support for planning and keeping dietary goals and reducing barriers to healthy eating (X2/df = 1.89; RMSEA = 0.04; CFI = 0.99; TLI = 0.99; SRMR=0.02). Findings suggest that programs designed to enhance social support may be effective in improving dietary behaviors among older adults. Future research should investigate various types of social support for promoting healthy diets.
CNA WORK IS BETTER LEARNED HANDS-ON: TRAINING CERTIFIED NURSING ASSISTANTS TO FEED RESIDENTS WITH DEMENTIA
Authors: Douglas Joy W , Jung Seung Eun , Noh Hyunjin , Ellis Amy , Ferguson Christine 
Published: November 2019

Abstract
In nursing homes across the United States, Certified Nursing Assistants (CNAs) provide essential mealtime assistance to residents with dementia who have difficulty feeding themselves. However, dementia-related training content in CNA programs can vary. In this qualitative study, we sought to understand the training provided to CNAs in Alabama, and to identify the ideal training modality for content related to feeding residents with dementia. Nine focus groups were conducted with 53 CNAs. Each participant had at least one year of working experience as a CNA caring for older adults. Focus groups were audio recorded and transcribed verbatim. Data were analyzed using the directed content analysis approach. Analyses revealed several key themes related to training CNAs to feed residents with dementia. Across focus groups, CNAs agreed that they needed additional training about feeding residents with dementia. They unanimously agreed that the best person to provide such training should be an experienced CNA, not a nurse or other healthcare provider. In terms of delivery, they preferred hands-on training and role playing. CNAs also emphasized that while some learning takes place in a didactic setting, the most valuable learning moments involve on-the-job experience in feeding residents, where they are mentored by seasoned CNAs. Findings from this study revealed the need for providing CNAs training on feeding residents with dementia. CNA training programs that includes hands-on activities mentored by seasoned CNAs could increase CNAs’ ability to provide optimal meal assistance to nursing home residents with dementia.
EDUCATIONAL CHALLENGES OF CHILDREN IN SKIPPED GENERATION HOUSEHOLDS IN NIGERIA
Authors: Popoola Bayode I , Togonu-Bickersteth Funmi , Aransiola Joshua O , Akintomide Akinjide , Ekundayo Opeyemi 
Published: November 2019

Abstract
The paper examined the challenges of accessing education by Nigerian children raised in an unusual family context, the skipped generation households. Specifically, it determined the proportion of Nigerian school-age children in skipped generation households enrolled in the formal school system and investigated the children’s perception of the effect of living in skipped generation household on their education. The paper also ascertained regional differences in education challenges experienced by children in skipped generation households. The study adopted the descriptive survey design. The research procedure involved the collection of primary data through the administration of a survey questionnaire on 2144 indexed children from three purposively selected states representing the three major ethnic groups in Nigeria. The results showed that 88.2% of Nigerian children in skipped generation households were enrolled in the formal school system, and that significant regional variations existed in school attendance by children in skipped generation households. Also, a substantial majority (74.1%) of grandchildren reported that living in SGHs had no negative effect on their academic performance. The specific education challenges of school-going children in skipped generation households included having to do assignment alone, not getting enough time to study, and difficulty in paying school fee. The results further indicated that the education challenges experienced by children in skipped generation households were significantly different across the selected states which constitute the study area. The paper highlighted the need for government to improve the welfare of older adults in Nigeria, especially those who serve as custodial grandparents for their grandchildren.
WHAT IT TAKES TO COMBAT DECLINE: LEARNING THROUGH AN INTERPROFESSIONAL STUDENT SENIOR PARTNERSHIP
Authors: Katz Anne D , Axonovitz Judy 
Published: November 2019

Abstract
Healthcare is in need of a workforce with the knowledge and skills to meet the needs of our aging population. Seniors face social, mental, and physical issues as they move into the later stages of life. The Student Senior Partnership Program (SSPP) connects teams of students with healthy senior volunteers in the community. Through this partnership, students learn the strategies seniors implement to stay engaged and maintain their activities of daily living to combat decline and frailty. The SSPP focuses on increasing student’s capability to assess older adults, and learn from their senior within an interprofessional team. Faculty provided training to the senior volunteers so they were prepared to function in a role as “teachers” to students from six professional disciplines (Medicine, Social Work, OT, PT, Dentistry, Pharmacy) through meaningful dialogue focused on physical well-being, relationships with family, friends, community, memory and cognition . Evaluation was performed using the Geriatrics Attitudes Scale (GAS). The pre and post survey (n=72) measured the reported capability to assess older adults and evaluate their attitudes toward the elderly. There were statistically significant improvements in six of nine assessment topics. The largest improvements were in the capability to assess resource gaps (mean=2.79 to 3.44 on a 5-point scale, p&lt;0.001), mental status (3.03 to 3.57, p&lt;0.001) and fall risk (2.99 to 3.50, p&lt;0.001). Attitudes toward the elderly were measured using the Geriatrics Attitudes Scale (GAS). Overall, students improved during the program (mean=3.88 to 4.05 on a 5-point Likert scale, p&lt;0.001).
EDUCATION AND TRAINING ELECTRONIC NAVIGATION SYSTEMS’ IMPACT ON OLDER DRIVER PERFORMANCE AND TRAINING TO OVERCOME UNFAMILIARITY
Authors: Dickerson Anne E , Thomas F Dennis , Graham Lindsay , Coleman M Chandler , Blomberg Richard , Wright Tim 
Published: November 2019

Abstract
Technology may assist older adults in improving their driving performance and therefore driving safety. However, it is sometimes a distraction and some older adults avoid its use due to the complexity of learning the systems. This study examined how older drivers interacted with an electronic navigation system (e.g., GPS) and the extent to which it impacted driving performance on unfamiliar routes. It also examined three approaches to training older adults how to program the devices. In Phase 1, 80 older drivers navigated unfamiliar routes using a GPS or paper directions and completed destination entry tasks. In Phase 2, 60 older drivers completed one of three training conditions (video, video with hands-on, placebo) to examine the impacts of training on destination entry performance. Driving performance was improved with GPS over paper directions (p = .025), as evaluated by a driver rehabilitation specialized on counterbalanced standardized routes. Analyses also showed significant effects for familiarity for use of GPS (p=.035) and age group (60’s versus 70’s) (p&lt;.001), but many drivers had difficulty entering destinations. In Phase 2, a main effect of training was found (p=.02) with using video and one-on-one training showing the best performance. This study demonstrates older drivers could benefit from the use of such devices when driving to unfamiliar destinations, but training is needed with hands-on training with a live instructor being the best.
TWO STEPS FORWARD AND THREE STEPS BACK: STUDENTS’ PERSPECTIVES ON LIVING AND WORKING WITHIN AN AGING SOCIETY
Authors: Tompkins Catherine J , Ihara Emily S , Bittinger Katelyn 
Published: November 2019

Abstract
Each day, 10,000 Americans celebrate a 65th birthday, but there are still many young adults not choosing to enter a field that focuses on working with the older population. As part of a continued effort to understand low enrollments in a minor in aging studies and a graduate certificate program in gerontology, focus groups were held with students to explore why they are not choosing to learn more about one of the fastest growing sectors of the U.S. population. A total of 21 students participated in two focus groups. Students’ majors varied but included social work, public health, nursing and communications. All of the students were between the ages of 18 and 22 except for one student who was 68 years old. Only 6 students had taken an aging class, but every student indicated that they were close to a family member, 60 years old or older. Two researchers coded and analyzed the focus group data for themes. Examples of the themes about older adults included being unwilling to change, having negative views toward millennials, and being hampered by technology. Themes relative to student perspectives included needing empathy and patience to work with older adults, assuming decline and lacking opportunities within their majors to take gerontology courses. Comparing views and perspectives of older adults decades ago by traditional college-aged students to current day perspectives resulting from this data will be discussed as well as successful strategies for increasing enrollments in gerontology programs.