bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining Attitudes and Experiences of Ageism During COVID-19: Are They on the Rise?
Authors: Vale Michael , Sublett Jennifer , Bisconti Toni 
Published: December 2021

Abstract
Gerontologists have warned of rising ageism amidst the COVID-19 pandemic. Older adults have been portrayed as a homogenous group given their health vulnerabilities and have been viewed with mixed perceptions. For instance, the pandemic has been viewed as an “old person’s” disease and older adults have been inherently linked to imposing health and safety lifestyle changes. Others have responded with acts of overaccommodative care that have minimized older adults’ autonomy. Taken together, there have been inferences of increased hostile and benevolent ageism. Currently, these claims lack empirical data, and the goal of this study was to examine if attitudes and experiences of ageism are on the rise. Across two studies, we examined young adults’ (N=268) attitudes of older adults and older adults’ (N=65) experiences of ageism before and after the start of the pandemic. In study 1, we examined ageist attitudes at 3 time points (2017, 2019, 2020) from separate, but equitable, college samples and found that hostile ageism was higher during the pandemic (F(2,265)=5.48, p&lt;.001) and benevolent ageism demonstrated no differences. In study 2, we explored older adults’ experiences of ageism pre-and post-pandemic onset (2019, 2020) and, found that they reported experiencing less hostile ageism (t(64)=2.45, p&lt;.05), with no differences in experienced benevolent ageism. Our findings suggest an increase in hostile ageist views, but a decrease in experiences, partially supporting the alleged claims of rising ageism. Nevertheless, the last year of the pandemic is dynamically contextualized and research should elaborate on the extent and consequences of this rise.
Racial Differences in the Effect of Alzheimer’s Disease on Adherence to Medication Therapy for Chronic Diseases
Authors: Yashkin Arseniy , Yashin Anatoliy , Gorbunova Galina , Akushevich Igor 
Published: December 2021

Abstract
Multiple dementia (the presence of one or more types of dementia in a single individual) and multi-morbidity (the presence of multiple chronic diseases in an individual) present a major challenge to the U.S. healthcare system. The reduction in cognitive function associated with neurocognitive disorders such as Alzheimer’s Disease (AD) and Related Dementias (ADRD) reduce the ability of the affected individual to take care of him/herself. This can manifest as reduced adherence to medication regimens designed to manage other chronic conditions, in reduced ability to engage in healthy behavior such as exercise, or in other ways. The result is an increase in the probability of otherwise avoidable adverse health outcomes and related healthcare costs. In this study, we showcase two high impact chronic conditions common in the elderly: hypertension and type 2 diabetes mellitus (T2D). Using a 5% sample of the total Medicare population we identify groups of individuals with AD/ADRD and i) hypertension, ii) T2D or iii) both. Each group is then propensity-score-matched to similar individuals with hypertension, T2D or both but without a diagnosis of AD/ADRD. The primary explanatory variable of interest is the medication possession ratio (MPR) calculated at 1-year intervals for prescribed diabetes and/or hypertension medications. MPRs were compared between the two groups using t-tests and standardized differences each year after baseline and until death/censoring. A Cox proportional hazard model was then used to estimate differences in survival between these two groups and across race/ethnicity-related strata. Reduced adherence with time and notable race/ethnicity-related differences were identified.
Subjective Aging in Context: Neighborhood Social Environment and Self-perceptions of Aging among Older Adults
Authors: Choi Eunyoung , Zelinski Elizabeth , Ailshire Jennifer 
Published: December 2021

Abstract
Self-perception of aging (SPA), one’s attitude toward one’s own aging, has been associated with health and well-being in later life. Whereas existing literature identifies individual-level predictors of SPA (e.g., education and health), little is known about the role of neighborhood context. The present study examines whether 1) neighborhood social environment is related to SPA and 2) age moderates this relationship. Our analytic sample includes 11,394 adults aged 50+ from the 2014 and 2016 waves of the Health and Retirement Study (Mean Age=68, SD=10.14, range 50-98). Indicators of neighborhood social environment include (a) perceived neighborhood social cohesion (the trust and social ties among community residents), (b) neighborhood friends, and (c) relatives living in the neighborhood. Regression analyses were performed to investigate the associations of each neighborhood-level indicator with the positive and negative dimensions of SPA. The models controlled for demographic, socio-economic, and health covariates. Greater neighborhood social cohesion (B=0.13, SE=0.01, p&lt;.001) and having neighborhood friends (B=0.14, SE=0.02, p&lt;0.001) were associated with higher levels of the positive SPA. As for the negative dimension of SPA, neighborhood social cohesion was the only significant predictor (B=-0.13, SE=0.01, p&lt;0.001). Furthermore, we found significant interaction effects between neighborhood social cohesion and age: higher neighborhood cohesion was associated with more positive (B=-.003, SE=.00, p&lt;.001) and less negative SPA ratings (B=-.003, SE=.00, p&lt;.001) at younger ages than older ages. Our findings provide insights into how neighborhood social context shapes subjective aging, suggesting that a socially cohesive neighborhood may promote more favorable perceptions of aging, particularly for younger residents.
Is Cancer History Related to Neurologic Specialty Care in Patients with Dementia?
Authors: Fowler Mackenzie , Triebel Kristen , Rocque Gabrielle , Irvin Ryan , Kennedy Richard , Wright Nicole 
Published: December 2021

Abstract
Background: The incidence and prevalence of aging-related diseases such as dementia and cancer are increasing, as are cancer survival rates. Cancer and its treatments have been associated with cognitive effects for those who later develop dementia. Guidelines have suggested that cancer patients return to follow-up in primary care following remission and be referred to specialists for cognitive complications, but it is unclear how well these guidelines are followed. Methods: Electronic health record data at the University of Alabama at Birmingham were extracted from July 2003 May 2020. Rates of specialty care utilization on or after dementia diagnosis were compared by cancer history status in adults 50 years old or older at dementia diagnosis. Predictors of specialty care utilization were examined using logistic regression. Results: Rate of specialty care utilization was lower for those with cancer history compared to those without on the date of dementia diagnosis (11.3% vs. 17.1%) and after diagnosis (13.5% vs. 19.2%). Older age at dementia diagnosis, non-Hispanic Black race, anticholinergic burden, socioeconomic status, and vascular risk factors were associated with lower odds of specialty care utilization. Dementia medication use was associated with higher odds of specialty care utilization on and after dementia diagnosis. Conclusions: Cancer survivors with a dementia diagnosis are less likely to utilize specialty care than those with no history of cancer. Several factors predicted specialty care utilization. Additional studies should assess potential barriers in referring cancer survivors to specialty care for cognitive impairment.
Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults.
Authors: Orchard Suzanne , Broder Jonathan , Lockery Jessica , Gibbs Peter , Espinoza Sara , Ernst Michael , Woods Robyn , McNeil and John 
Published: December 2021

Abstract
Diabetes increases risk of malignancies, and this association increases with age. Metformin may protect against cancer development and progression, but results are mixed and limited to younger cohorts. We examined whether metformin, in the presence or absence of aspirin, reduces incident cancer and cancer-related mortality in older adults. ASPirin in Reducing Events in the Elderly (ASPREE) was a primary prevention trial of daily aspirin vs placebo which enrolled community-dwelling adults from Australia (70+ years) and the US (65+ years for minorities) followed for a median of 4.7 years. Invasive cancer was adjudicated by an expert panel. Cox proportional-hazards models, controlling for age at randomization and known cancer risk factors, were used to analyse the relationship between baseline metformin use, randomized treatment arm, cancer incidence (first in-trial cancer) and mortality. For participants with controlled diabetes, there was a significant reduction in cancer mortality in metformin users compared to nonusers (Adjusted [Adj] HR=0.24, 95%CI=0.07, 0.80), but not for cancer incidence (Adj HR=0.61, 95%CI=0.29, 1.27). For participants with uncontrolled diabetes, there was no significant difference in cancer incidence (Adj HR=0.95, 95%CI=0.66, 1.38) or mortality (Adj HR=1.18, 95%CI=0.62, 2.26) between metformin and non-metformin users. Uncontrolled diabetes, irrespective of metformin use, increased risk of cancer incidence and mortality compared to non-diabetics. Aspirin did not modify the effect of metformin on cancer incidence or mortality. Our findings show that metformin may have protective effects against cancer-related mortality for those older persons whose diabetes is well-controlled, and underscores the importance of diabetes control to minimise cancer risk.
Sarcopenic Obesity in Older Adults: Findings From the National Health and Aging Trends Study
Authors: Dondero Kathleen , Falvey Jason , Beamer Brock , Addison Odessa 
Published: December 2021

Abstract
Sarcopenic obesity increases risk for dysmobility and loss of independence, (Gandham et al., 2021). However, the national burden of sarcopenic obesity and the resultant impacts for older adults has yet to be described. Within a nationally representative sample from the National Health and Aging Trends Study (NHATS), 2066 community-dwelling older adults were obese, representing 12,136,374 individuals in the United States, or 31.8% of all community dwelling older adults. Based on the European Working Group definition, 18% of the obese older adults were sarcopenic. Sarcopenic obese older adults were more likely to have fallen in the last month and been hospitalized over the prior year. After adjusting for age and sex, sarcopenic obese older adults were 3.7 times more likely (95% CI 2.2-5.0) to have 2 or more comorbid conditions and frailty was 6.4 times more likely (95% CI 4.4-9.5) compared to nonsarcopenic obese older adults. Sarcopenic obese older adults were also more likely to have 1+ ADL disabilities (OR 3.7; 95% CI 2.5-5.4). Further, they were more likely to be socially isolated (OR 2.1; 95% CI 1.3-3.2) and report food insecurity (OR 1.5; 95% CI 0.8-2.9). These findings suggest older adults with obesity and sarcopenia have higher rates of geriatric vulnerabilities, which might indicate a need for caution when recommending weight loss alone as an intervention. A more comprehensive intervention may be necessary to address social and physiological risks. Future studies should examine whether early intervention in sarcopenic obese older adults can reduce chronic health risk and preserve independence.
Impact of Green Space, Air Pollution, and Weather on Cognitive Function in Middle and Old Age in China
Authors: Zhang Lingling , Luo Ye , Pan Xi , Wang Qing 
Published: December 2021

Abstract
Population aging will inevitably bring an increasing burden of poor cognitive function. The risk factors for cognitive decline have been widely studied. Even though environmental hazards have the greatest adverse impacts on older adults and the existing evidence has shown that green space, air pollution, and weather have an impact on cognitive function, most of the studies were conducted in developed countries and limited to cross-sectional analyses. China has the largest aging population in the world so the research evidence from it can offer an insight to the study in other developing countries facing similar issues and inform future public health policy and disease control. Using the data from a nationally representative sample of adults aged 45 years and older from the three waves of China Health and Retirement Longitudinal Study (CHARLS 2011-2015) and China City Statistical Yearbook, this study estimated multilevel growth curve models for the effects of green space coverage, air pollution, and weather conditions on cognitive function and cognitive decline. It showed that after controlling for sociodemographic characteristics, built area green coverage rate was positively associated with cognition score at baseline, and higher annual minimum temperature was associated with faster decline in cognitive function. These effects did not substantially change after weekly total hours of physical activities and levels of social engagement were added and the interaction effects were examined between environmental conditions with them, respectively. More research on the mechanisms of the effects of environmental factors on cognition is needed such as the subgroup analyses.
Race/Ethnicity Moderation on the Relationship Between Neighborhood Minority Composition and Depressive Symptoms
Authors: Cho Seungjong 
Published: December 2021

Abstract
Research showed neighborhood of residence is an important determinant of depressive symptoms. However, the complex effects of neighborhood racial/ethnic composition and individuals’ race/ethnicity on depressive symptoms were not fully explored in previous studies. This study tested whether individuals’ own race/ethnicity moderates the relationship between neighborhood racial/ethnic composition and depressive symptoms. Applying social disorganization theory, this study investigates the relationships between neighborhood racial/ethnic composition (proportion of racial and ethnic minorities), individual race/ethnicity, and depressive symptoms. This study used a merged data from Health and Retirement Study 2016 and the American Community Survey 2014-2018 (N=5,241; all age 50 or older). This study applied a mixed-effects negative binomial regression model. It has four statistical models by race/ethnicity: (a) non-Hispanic Blacks only, (b) Hispanics only, (c) non-Hispanic Whites only, and (d) combined model. Covariates were included two individual-level variables (age and gender) and three census tract-level variables (the proportions of (a) population of income below the poverty level; (b) population of unemployed; (c) population of aged 65 and over). The results showed none of the neighborhood racial/ethnic minority composition was associated with depressive symptoms for the final combined model. The moderation effects of individuals’ race/ethnicity were not significant. Not as a moderator but as the main effect, both non-Hispanic Blacks and Hispanics had higher depressive symptoms, compared to non-Hispanic Whites. Living in neighborhoods with higher poverty rates and females were also related to higher depressive symptoms. This study contributes to explore the subtle nature of depressive symptomatology and race both at individual-level and neighborhood-level.
African-American Race Predicts 1-Year Cognitive Decline Among Adults Without Moderate Dementia
Authors: Babiker Niser , Gonzalez Alan , Soto Jovany , Shi Chengjian , Rzhetsky Andrey , Huisingh-Scheetz Megan 
Published: December 2021

Abstract
Previous literature shows conflicting conclusions about the association between race and cognitive decline, particularly in early impairment. In this study, we aimed to test whether race predicted 1-year change in Montreal Cognitive Assessment (MoCA) score among older adults without moderate-severe dementia. We secondarily explored whether multimorbidity, polypharmacy, depressed mood, antidepressant use, body composition, or frailty changed the association. We analyzed data (n=122) from predominantly African American (AfA, 78.7%) community-dwelling older adults from the south side of Chicago. Participants underwent baseline and 1-year MoCA testing. Age, gender, race, education, monthly income, co-morbidities (Charlson Comorbidity Index), medication use (&lt;5 vs ≥5), depression (PHQ-2), proportion lean mass (DEXA), and the frailty phenotype (range 0-5) were collected at baseline. In a multivariate linear model, we regressed 1-year MoCA score on baseline MoCA score, race, and demographics and then evaluated the impact of each covariate added separately to the model on the race-cognition relationship. The mean MoCA score at baseline was 25.2+/-0.2 (range 18-30) and 41.0% of participants experienced ≥1 point MoCA decline at 1 year. After adjusting for demographics, AfAs experienced a greater 1-year MoCA decline (β= -1.3, p=0.04) compared to other races. The effect size was unchanged after adjusting for multimorbidity and polypharmacy (β= -1.3, p=0.04), attenuated slightly after adjusting for frailty (β= -1.2, p=0.06), depressed mood (β= -1.2, p=0.05), lean mass (β= -1.2, p=0.04), and attenuated notably after adjusting for antidepressant use (β= -1.0, p=0.11). Findings support the need to further explore racial differences in cognitive decline and potentially related anti-depressant underuse.
Association of Social Determinants, Multimorbidity, and Functional Status with Mortality after Pneumonia
Authors: Park Chan Mi , Rhim Hye Chang , Lee Eun Sik , Kim Wonsock , Kim Jong Hun , Kim Dae 
Published: December 2021

Abstract
Social support, multimorbidity, and functional status are important determinants of health in older adults, but their prognostic implications remain unclear after an acute illness. We conducted a prospective cohort study of 201 patients 65 years or older who were hospitalized for pneumonia at a university hospital in Korea in 2019-2020. K-means cluster analysis was performed using social deprivation score (range: 0-5), activities of daily living (range: 0-7), instrumental activities of daily living (range: 0-7), physical limitation score (range: 0-7), and Gagne comorbidity index (range: 0-24) (higher scores indicate higher risk). Four groups were identified: 1) Group A: physically limited and non-disabled group with limited social support; 2) Group B: multimorbid but functional group with social support; 3) Group C: multimorbid and disabled group with social support; 4) Group D: multimorbid and disabled group with limited social support. For Groups A through D, the Kaplan-Meir estimates for 6-month mortality were 10.0%, 18.0%, 34.2%, and 43.6%, respectively, and the 6-month mean survival times were 166.4 days (95% CI: 156.1-176.6), 156.9 days (95% CI: 140.8-173.1), 145.2 days (95% CI: 126.6-163.8), and 125.9 days (95% CI: 107.7-144.1), respectively. After adjusting for sex, age, and pneumonia severity score, the hazard ratios for Groups B through D versus Group A were 2.07 (95% CI: 0.70-6.13), 3.14 (95% CI: 1.17-8.42), and 4.38 (95% CI: 1.73-11.04), respectively. Our results suggest that multimorbidity and disabilities were implicated in higher risk of 6-month mortality after pneumonia, and social support may mitigate this risk among those with multimorbidity and disability.
Does Race/Ethnicity Influence the Health of LGBT Older Adults? An Analysis of Adults Aged 50 and Older
Authors: Magdael Adrielle , Parashar Aditi , Ozair Aisha , Nelson Christi 
Published: December 2021

Abstract
Lesbian, gay, bisexual, and transgender (LGBT) health disparities have been well documented in previous research; however, limited research has been conducted on racial/ethnic differences in health among LGBT older adults. Past research suggests that LGBT adults from racial/ethnic minority groups may encounter more discrimination and stigma than white LGBT adults, resulting in poorer health. This study investigated differences in general health between racial/ethnic groups in LGBT adults aged 50 and older from the 2018 and 2019 Behavioral Risk Factor Surveillance System annual surveys. The average ages were 64.2 years for the lesbian, gay, and bisexual (LGB) participants (n=3636) and 65.4 years for the transgender participants (n=972). For self-rated general health, the chi-square analysis indicated that there were significant differences between the racial/ethnic groups for both LGB and transgender participants, χ2(4, n=3630)=46.47, p&lt;.001 and χ2(4, n=969)=19.03, p=.001, respectively. Logistic regression analyses found that, compared to White LGB adults, Hispanic LGB adults had higher odds (aOR=1.8, 95% CI=1.2-2.5) and Asian LGB adults had lower odds of reporting fair or poor health, (aOR=0.43, 95% CI=0.2-0.9). For transgender participants, Hispanic and Other Race adults had approximately twice the odds of reporting fair or poor health compared to White adults (aOR=2.1, 95% CI=1.2-3.7, and aOR=1.9, 95% CI=1.2-3.0, respectively).In conclusion, the results of this study suggest that cultural differences in racial/ethnic groups may influence the health of the LGBT community, making it an important factor to consider in research on LGBT older adults.
Age-Associated Epigenetic Alterations, Somatic Mutations, and Their Crosstalk in Alzheimer’s Disease
Authors: Markov Yaroslav , Thrush Kyra , Levine Morgan 
Published: December 2021

Abstract
Aging is the major risk factor for Alzheimer’s Disease (AD), and as life expectancy increases, neurodegeneration will continue to afflict an ever-increasing proportion of the population. While numerous theories are attempting to explain the drivers behind AD pathology, what unites them is the observation that AD is reliably associated with a progressive buildup of age-related molecular changes. Because of the varying clinical presentations of AD in patients with similar genetic backgrounds, it has been postulated that epigenetics may be implicated in its etiology. Building on our prior work showing that AD pathology is linked to alterations in age-related DNA CpG methylation (DNAme) across various brain regions, we use state-of-the-art machine learning approaches to identify patterns of molecular damage in postmortem brain samples. We show that alterations in DNAme are associated with accelerated biological aging, AD, and the APOE e4 genotype, which is a major risk factor for AD. We also demonstrate that these associations are present in the PFC but not cerebellum -- in line with the current understanding of AD progression in the brain. Finally, we perform whole-exome sequencing and protein mass spectrometry on the same brain samples to test our hypothesis as to whether AD-associated alterations of DNAme are linked with the accumulation of somatic mutations that affect the structural and binding properties of protein epigenetic regulators.