bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geographic distribution of availability of adult day services in Missouri
Authors: Amano Takashi , Chun Yung , Park Sojung , Wang Yi 
Published: December 2021

Abstract
Adult day service (ADS) is an important component of long-term supportive services. Geographic availability of ADS is an essential factor for aging in place especially for people with assistance needs. This study aims to examine the geographic distribution of availability of ADS and its relationship with the disadvantaged characteristics of neighborhoods. Data from the Missouri Department of Health and Senior Services and the American Community Survey were utilized. Geographic availability of ADS was measured as capacity (number of clients served) of ADS centers per week divided by the number of people who were 65 or older and under poverty at the census tract level. To examine neighborhood disadvantaged characteristics, principal component analysis was applied to construct a socioeconomic deprivation index (SDI). Using geographic information systems, we mapped ADS centers, geographic availability of ADS, and SDI scores. Pearson correlation coefficient was calculated between geographic availability of ADS and SDI scores. In 92.3% of the census tracts in Missouri, ADS centers are not available. Further, ADS centers are less likely to locate in rural areas or census tracts with higher numbers of residents 65 or older and poor. Also, lower availability of ADS was associated with higher levels of neighborhood disadvantage at a marginal level (r = - 0.163). Our findings suggested that strategies should be identified to provide ADS in rural areas, especially in the areas with higher levels of neighborhood disadvantage. Further investigation on the geographic distribution of ADS accessibility and its association with neighborhood characteristics is warranted.
Healthcare Disparity and Comorbidity Burden in Heart Failure Patients Over the Age of 80
Authors: Blach Anna , Pangle Amanda , Wei Jeanne , Azhar Gohar 
Published: December 2021

Abstract
The healthcare industry is currently struggling with providing access and coverage for a rapidly ageing and increasingly diverse population with multiple co-morbid conditions. This retrospective study analyzed the electronic health records of elderly heart failure patients (age range 80-103; mean 87 ±4.9) for common co-morbid conditions of hypertension, hyperlipidemia, dementia and diabetes mellitus. Chart review analysis of 316 patients showed a racial distribution of 251 White vs. 65 Black patients (79% vs. 21%). Male patients were under-represented (B= 13.8% and W= 26.3%). Females patients predominated (B= 86.2% and W= 73.7%). Overall, the prevalence of all four comorbidities was approximately three times higher in Blacks (18.5%) vs. White (7.2%). The proportion of Blacks and Whites with HTN and was comparable at 98.5 and 92.4% respectively. Hyperlipidemia was present in 84.6% Black and 63.3% White. The diagnosis of diabetes was higher in Blacks, 41.5% compared to Whites, 21.9%. The greatest disparity was in the diagnosis of dementia which was higher in Blacks, 61.5% vs Whites, 44.6%. Our study is unique for studying healthcare disparity in octogenarian and nonagenarian residing in a rural setting. Our results also highlight the importance of making a special effort to engage older Black patients in seeking healthcare in addition to designing strategies to reduce barriers that impede access and availability of resources and clinical care, especially in economically underserved regions of the country.
Development & Testing of a Comprehensive Digital Self-Care Support System for Older Adults With Chronic Conditions
Authors: Nambisan Priya , Stange Kurt , Lyytinen Kalle , Kahana Eva , Duthie Edmund , Potnek Michael 
Published: December 2021

Abstract
This 3-phase study involves the conceptualization and design, development and usability testing of a Comprehensive Digital Self-care Support System (CDSSS) named myHESTIA for older adults with multiple chronic conditions (MCC). The objective of this study was to test whether a CDSSS can be developed for those who are dealing with MCC and whether such a system that is specifically developed for older adult patients will enable daily capture of self-care data. Participants for this 3-phase study included: 10 older adults (age&gt;60) and 10 caregivers in Phase 1; 15 Geriatrics clinicians and 25 community-dwelling low-income older adults in Phase 2; and, 10 older adults (age&gt;60) with MCC in Phase 3. Agile method of system development was used for the design and development of the system. The first two phases involved collecting data for designing and developing myHESTIA. The third phase involved small group usability and feasibility testing, in which the participants used myHESTIA trackers for 4 weeks. Results from phase 3 shows daily inputs were possible and the self-reported data shows that it was not at all difficult for older adults to track their symptoms daily. User experience data (n=10) shows overall positive experience along pragmatic (5.8 out of 7), hedonic (4.6 out of 7), sociability (5.5 out of 7) and usability (6.3 out of 7) experience dimensions. Finally, all the participants (n=10) who completed the phase 3 study reported intention to continue using myHESTIA. Results indicate that it is feasible to design a CDSSS for older adults with MCC.
The Digital Divide Amongst High-Need High-Risk Veterans
Authors: Li Shirley , Muralidhar Kiranmayee , Tang Fei , Valencia Willy Marcos , Dang Stuti 
Published: December 2021

Abstract
High-need high-risk (HNHR) veterans are medically complex and at the highest risk of hospitalization and long-term institutionalization. Technology can mitigate challenges these veterans have in accessing healthcare. Willingness to use technology as well as access and ability to use technology were assessed in this study. At the time of the survey, 2543 Miami VAHS veterans were listed as HNHR. 634 veterans ultimately completed the questionnaire, and 602 answered the “willingness to use video-visits” question. Of the 602 respondents, 327 (54.3%) reported they were willing for video-visits with the VA, while 275 (45.6%) were not. Those who were willing were significantly younger (P&lt;0.001), with higher educational qualifications (P=0.002), and more health literate than those not willing (P&lt;0.001). They were more also capable of using the Internet, more likely to use email and be enrolled in the VA’s patient portal, My HealtheVet (P&lt;0.001). However, of the veterans who were willing, 248 (75.8%) had a device with video-capable technology. Those with video-capable technology were younger (P=0.004), more health literate (P=0.01), and less likely to be Black or African American (P=0.007). They were more capable of using the Internet, more likely to use email, and be enrolled in My HealtheVet than those without (P&lt;0.001). Half of the respondents were willing for video-visits but a quarter of those willing lacked requisite technology, thereby making only about 41.2% of the respondents willing and video-capable. To minimize the digital divide, especially during the ongoing COVID-19 pandemic, targeted measures need to address these disparities in this vulnerable population.
Using Artificial Intelligence to Improve Pain Assessment and Pain Management: A Scoping Review
Authors: Zhang Meina , Zhu Linzee , Lin Shih-Yin , Herr Keela , Chi Nai-Ching 
Published: December 2021

Abstract
Approximate 50 million U.S. adults experience chronic pain. It is a widely held view that pain has been linked to sleep disturbance, mental problems, and reduced quality of life. Uncontrolled pain has led to increased healthcare utilization, hospitalization, emergency visits, and financial burden. Recognizing, assessing, understanding, and treating pain can improve outcomes of patients and healthcare use. A comprehensive synthesis of the current use of AI-based interventions in pain management and pain assessment and their outcomes will guide the development of future clinical trials. This review aims to investigate the state of the science of AI-based interventions designed to improve pain management and pain assessment for adult patients. The electronic databases Web of Science, CINAHL, PsycINFO, Cochrane CENTRAL, Scopus, IEEE Xplore, and ACM Digital Library were searched. The search identified 2131 studies, and 18 studies met the inclusion criteria. The Critical Appraisals Skills Programme was used to assess the quality. This review provides evidence that machine learning, deep learning, data mining, and natural language processing were used to improve efficient pain recognition and pain assessment (44%), analyze self-reporting pain data (6%), predict pain (6%), and help physicians and patients to more effectively manage with chronic pain (44%). Findings from this review suggest that using AI-based interventions to improve pain recognition, pain prediction, and pain self-management is effective; however, most studies are pilot study which raises concerns about the generalizability of findings. Future research should focus on examining AI-based approaches on a larger cohort and over a longer period of time.
Effect of Dance Movement Therapy on Depression and Anxiety for Persons with Dementia: A Systematic Review
Authors: Wang Ying , Liu Mandong , Dong Zhixiao , wu Jing , Cui Huan , Shen Dianjun , Tan Youyou 
Published: December 2021

Abstract
Dance movement therapy（DMT）is a physical and psychological intervention, but there was no meta-analysis of RCTs in the systematic review of DMT for dementia, and the results of RCTs were inconsistent. The study aimed to assess the effectiveness of dance movement therapy on depression and anxiety of persons with dementia in comparison to no treatment, standard care. Six electronic databases (Cochrane, PsycINFO, Web of Science, PubMed, EBSCO, CNKI) were searched through January 2021. Randomized controlled trials (RCTs) in Chinese and English language were considered, including: (1) population is women and men of all age with dementia and MCI; (2) intervention is dance movement intervention; (3) comparison is no treatment or standard care; (4) outcome is depression or anxiety. The four review authors independently reviewed studies on an abstract/title level and again after reading the full paper, and we independently evaluated methodological quality. Six randomized controlled trials were identified on depression and anxiety symptoms in persons with dementia. The target sample size was 29-842 older adults. Meta-analysis showed there were significant differences in favor of dance in depression (SMD = 1.17, 95% CI: 0.39 to 1.95, P = 0.003), but not in outcomes of anxiety. Trials of high methodological quality, large sample sizes, and clarity in the way the intervention is put together and delivered are needed to assess whether dance movement therapy is an effective intervention on depression and anxiety for persons with dementia.
Alzheimer’s Disease Risk Reduction: An Evidence-Based, Multi-Component Lifestyle Program, Pre- & Intra-Covid-19
Authors: Touch Gina , Bendheim Paul 
Published: December 2021

Abstract
Alzheimer’s disease (AD) is the 5th leading cause of death in the USA. With nearly 300 failed therapeutic trials to date, lifestyle modifications have been shown to reduce AD risk by as much as 50%. Preceding the FINGER Study by nearly a decade, the BrainSavers Brain+Body Total Fitness program was developed by an interdisciplinary team to reduce the risk of AD / all-cause dementia and promote healthy aging via education, exercise, and engagement. This evidence-based program utilizes the principles of neuroplasticity and cognitive reserve. Pre-Covid, BrainSavers was delivered live, led by certified instructors. Two years of curriculum were developed, comprised of six lifestyle components: cognitive exercise, physical exercise, healthful nutrition, socialization, stress reduction, and sleep hygiene. Results of a six month beta trial documented self-rated improvements in memory and general cognitive performance, quality of life, socialization, nutritional status, and physical fitness. Quantitative results showed statistically significant differences in physical fitness measures including cardio-respiratory endurance, lower body strength, balance, speed, and agility. Trends were seen in six of nine cognitive skills. During Covid the program was transformed into an online format as BrainSavers Synapse: Staying Connected, which has been enthusiastically received. Future research will compare longer-term outcomes of both formats. Based on results to date and extensive peer-reviewed literature on lifestyle as a modifier of dementia risk, we predict this program will contribute to better individual and societal outcomes, including substantial improvements in cognitive and overall health, and a significant reduction in healthcare costs.
Trajectories of cognitive function and associated factors in community-dwelling older adults: a prospective study
Authors: Wu Zimu , Woods Robyn , Storey Elsdon , Chong Trevor , Shah Raj , Orchard Suzanne , Murray Anne , Ryan Joanne 
Published: December 2021

Abstract
There is variability in cognitive aging between individuals. This study aimed to investigate cognitive aging trajectories, the associated modifiable factors, and the association of these trajectories with dementia. Community-dwelling older adults (n=19,114) without dementia or major cognitive impairment at inclusion were followed for up to 7 years, with regular standardized cognitive assessments. Group-based (multi-) trajectory modeling identified distinct cognitive trajectories. Structural equation modeling (n=16,018) was used to analyze the associated predictors. Four to seven trajectories were identified per cognitive domain, with generally stable trajectories. Improvement in verbal fluency and minor psychomotor slowing were common. Substantial decline in global cognition and episodic memory were observed in a small proportion of individuals. The highest proportions of dementia cases were in trajectories with major decline in global cognition (56.9%) and memory (33.2%). A number of sociodemographic characteristics, health behaviors and chronic conditions were either directly or indirectly associated with cognitive change in older adults. This study found that some individuals appear resilient to cognitive decline even with advancing age, and that factors that promote healthy cognitive aging are not simply the absence of factors which confer risk for decline.
Eating Difficulties among Older Adults with Dementia in South Korean Long-Term Care Facilities: A Scoping Review
Authors: Choi Eunju , Jung Dukyoo , Lee Kyuri 
Published: December 2021

Abstract
This study aims to synthesize existing literature concerning eating difficulties among older adults with dementia in long-term care facilities. A scoping review, using the framework proposed by Arksey & O'Malley (2005) and improved and supplemented by Levac et al. (2010), was conducted. Literature was searched from five bibliographic databases—Research Information Sharing Service (RISS), Korean studies Information Service System (KISS), National Digital Science Library (NDSJ), Korean Medical Database (KMBASE), DataBase Periodical Information Academic(DBPia), Google Scholar, and gray literature. Literature selection and characteristics were approved by two independent reviewers, using pre-tested forms to determine final inclusion. Eventually, 111 articles from 2012–2020 were identified, and the 11 articles were used for the final analysis. We found that primarily utilized Eating behavior scale (EBS) and Edinburgh feeding evaluation in dementia scale (EdFED) had utilized as measurement tools for evaluating eating behavior. The most common factors related to eating behavior of older adults with dementia included cognitive and physical functions in the individual domain, the caregiver's attitude toward eating in the inter-individual domain, and types of meal in the environmental domain. Therefore, it is essential to develop measurement tools that reflect the eating behavior of older adults with dementia, a comprehensive understanding of the eating behavior of old adults with dementia, and create effective interventions that can be implemented in the specificity of long-term care facilities in Korea. The results of this analysis are intended to be used as basis to develop a meal support programs for older adults with dementia.
Which Cognitive Behavioral Therapy Formats Work for Depression in Dementia Family Caregivers ?
Authors: Sun Yue , Wang Zhi-wen 
Published: December 2021

Abstract
Cognitive behavioral therapy (CBT) has been shown to be effective to delay cognitive decline for family dementia caregivers (DCs). However, whether cognitive intervention could effectively reduce depression through internet, group, telephone, individual, unguided self-help and combined formats remains unclear. Pubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, Web of science, China National Knowledge Infrastructure database, Chinese Biomedical Literature database and Wan Fang database were systematically searched. A total of 34 studies were included in our analysis based on a series of rigorous screenings, which comprised 3577 DCs. We conducted a network meta-analysis (NMA) to evaluate the relative effects and rank probability of different CBT delivery formats. A series of analyses and assessments, such as the pairwise meta-analysis and the risk of bias, were performed concurrently. Compared with controls, internet, telephone, and individual showed the largest improvement on depressive symptoms, whereas the unguided self-help delivery format was less effective. Internet delivery formats had the highest probability among the five CBT delivery formats. Our study indicated that the internet might be the best delivery formats for reducing the depression of family DCs. The findings from our study may be useful for policy makers and service commissioners when they make choices among different CBT delivery formats.
Apolipoprotein E impairs aged bone fracture healing
Authors: Balu Abhinav , Huang Rong , Molitoris Kristin , Baht Gurpreet 
Published: December 2021

Abstract
Bone fracture healing and osteoblast differentiation are impaired with advanced age. Using a combination of parabiosis and proteomic models, we identified apolipoprotein E (ApoE) to be an aging factor in bone regeneration. Circulating levels of ApoE increased with age in patients and in mice. ApoE impaired bone fracture healing by decreasing bone deposition in the fracture callus which subsequently decreased the mechanical strength of healed tissue. Osteoblasts serve as the sole bone forming cells within the body. In tissue culture models, ApoE treatment decreased osteoblast differentiation and activity which led to decreased matrix formation and mineralization. This inhibition of osteoblast differentiation relied on down-regulation of the Wnt/β-catenin pathway. In mouse models, aged bone repair was rejuvenated when we lowered circulating ApoE levels using a hepatotropic AAV-siRNA model – serving as a proof of concept that ApoE can be targeted to improve bone repair in an older population. While promising, knockdown of circulating ApoE in such a fashion is likely not translatable to patient care. Thus, current work in our laboratory is focused on developing treatment strategies that temporally decrease circulating ApoE levels and consequently improve bone healing after acute injury and/or surgical orthopedic procedure in the geriatric population.
Effects of FOXO3 on Markers of Aging in Blood : An Okinawan Longevity Cohort Study
Authors: Allsopp Richard , Willcox D Craig , Torigoe Trevor , Gerschenson Mariana , Shimabukuro Michi , Chen Randi , Donlon Tim , Willcox Bradley 
Published: December 2021

Abstract
FOXO3 is among only a few genes that demonstrate a consistently reproducible genetic association with human longevity. We previously demonstrated, in a cross-sectional study of Okinawan Japanese, that the principal longevity variant of FOXO3 (rs 2802292 “G allele”) protects against age-associated attrition of telomere length. We now expand upon this initial observation in a more detailed cross-sectional analysis of the effect of FOXO3 on telomerase activity, FOXO3 expression and inflammatory cytokine levels in both men and women. In agreement with our initial study, we found the FOXO3 longevity variant conferred significant protection against telomere shortening to roughly the same degree in elderly (ages 55 and older) men and women. Carriers of the G - allele also had slightly higher levels of blood telomerase activity in young (ages 20 – 54) and elderly participants (P≤0.1). The expression (mRNA) of FOXO3 increased steadily with age in young and old G – allele carriers (borderline P≤0.08), in contrast to a lack of association with age in non-carriers. The FOXO3 G - allele was also observed to significantly impact levels of both interleukin 6 (IL 6) and IL10, but in a sex dependent manner (P&lt;0.05). These sex-specific effects may point to different mechanisms by which FOXO3 exerts its effect on longevity in men and women.
Loneliness and marijuana use among Older Adults: An examination of the 2018 Health and Retirement Study
Authors: Yang Jie , Yockey Andrew 
Published: December 2021

Abstract
Introduction: There is substantial literature to suggest that loneliness is a risk factor for marijuana initiation, use, and continued use into adulthood. However, these relationships have yet to be investigated among older adults. Given that recent research suggests marijuana use is increasing among older adults, the purpose of the present study was to examine loneliness and other risk factors among a national sample of older adults ages 50 years or older. Methods: A secondary data analysis was conducted on the 2018 Health and Retirement Study (HRS) was conducted (n = 1,431). The HRS is a national, biannual survey conducted in the United States to assess health, psychosocial, and demographic questions among adults ages 50 years or older. We created a loneliness scale from the available questions and assessed differences based on demographics, lifetime use, and past-year use of marijuana. Weighted analyses with cyclical tree-based hot-deck imputation were conducted. Results: A sizeable percentage (23.5%) of older adults have ever used marijuana and a considerable amount (14.8%) of adults have used marijuana in the past year. Differences were found based on sex (p &lt;.0001), age (p &lt;.0001), race (p &lt;.0001), and income (p &lt;.0001). Loneliness significantly predicted marijuana usage, with adults who reported loneliness nearly 5 times more likely to use marijuana (aOR: 4.87, 95% CI 3.89, 6.10). Discussion: The present study investigated loneliness and marijuana usage among a national sample of adults. Findings from the present study may inform behavioral health interventions, harm reduction, and gerontological health.