bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEPRESSIVE SYMPTOMS AND HANDGRIP STRENGTH IN MEXICAN AMERICAN OLDER ADULTS: SEX DIFFERENCES
Authors: Okada Jamil , Patino Joshua , Martinez Ariza , Snih Soham Al 
Published: January 2025

Abstract
The aim of this study was to examine the role of sex in the relationship between depressive symptoms and handgrip strength decline among Mexican American older adults aged ≥65 who scored normal or high in handgrip strength (≥17 Kg in females and ≥27 Kg in males) at baseline over 23 years of follow up. Participants (N=1226) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1993/1994-2016). Measures included high depressive symptoms as the independent variable assessed with the Center for Epidemiological Study Depression Scale (CES-D ≥16), handgrip strength in kilograms as outcome variable, and socio-demographics, comorbidities, body mass index, cognitive function, physical function, and disability as covariates. General linear mixed models were used to estimate the population average change in handgrip strength as a function of high depressive symptoms over time. Female participants with high depressive symptoms experienced a greater [β= -1.34, Standard Error (SE)= 0.26, p-value= &lt; 0.0001] decline in handgrip strength over time than females without high depressive symptoms after controlling for all covariates. No significant decline (β= - 0.52, SE= 0.39, p-value= 0.1812) in handgrip strength as a function of high depressive symptoms was found among male participants over time after controlling for all covariates. In conclusion, we found that the effect of high depressive symptoms was greater among female than male participants. Screening and treatment of depressive symptoms may delay decline in muscle strength to further delay disability, maintain independence, prevent institutionalization, and reduce the risk of mortality in this underserved population.
DEVICE MEASURED SLEEP QUALITY AND PHYSICAL ACTIVITY IS ASSOCIATED WITH COGNITION IN CHRONIC STROKE
Authors: Stein Ryan , Falck Ryan , Tai Daria , Davis Jennifer , Hsiung Ging-Yuek , Eng Janice , Middleton Laura , Liu-Ambrose Teresa 
Published: January 2025

Abstract
Having a stroke increases risk for dementia two-fold. Both moderate to vigorous physical activity (MVPA) and sleep are positively associated with cognitive function. These associations may vary by biological sex. Notably, evidence shows physical activity mitigates the negative impact of poor sleep on cognitive function. Poor sleep quality is a common consequence of stroke and may contribute to cognitive impairment and dementia poststroke. We examined if MVPA attenuates the relationship of device-measured sleep quality and cognitive function in older males and females living with chronic stroke (i.e., &gt; 12 months since stroke). We used baseline data acquired from 97-community-dwelling older adults with chronic stroke (71±9 years; n=38 female) enrolled in a 6-month randomized controlled trial. We measured MVPA and sleep duration using wrist-worn actigraphy. Global cognitive function was measured with the 13-item Alzheimer’s Disease Assessment Scale (ADAS-Cog). We assessed whether MVPA moderated the association between sleep duration and the 13-item ADAS-Cog score in: 1) the full sample; and 2) among males and females separately. Fugl-Meyer score, Montreal Cognitive Assessment score, age, and biological sex were included as covariates. In the full sample, MVPA significantly moderated the association between sleep duration and the 13-item ADAS-Cog score (ß=0.0006±0.0003; p=0.041). Specifically, among individuals with shorter sleep duration, those with greater MVPA had better global cognitive function. This interaction was significant in males (ß=0.0013±0.0005; p=0.016) but not females (ß=0.0004±0.0004; p=0.259). We suggest that MVPA is beneficial for preserving global cognitive function among stroke survivors with shorter sleep duration, particularly among males.
EFRAILTY.ORG: ANALYSIS OF INITIAL USERS
Authors: Cheslock Megan , Sison Stephanie , Zhong Lily , Newmeyer Natalie , Wang Kuan-Yuan (Ken) , Schwartz Andrea , Orkaby Ariela , Kim Dae Hyun 
Published: January 2025

Abstract
In March 2024, eFrailty.org was launched to the public with the goal of making frailty assessment tools accessible to clinicians and researchers. We report the uptake and initial user experiences of eFrailty between January 1, 2024 and July 31, 2024, as measured by Google Analytics. eFrailty was viewed over 23,000 times by more than 5,400 users. More than 1000 users (18%) returned after their initial visit. There were 4 distinct spikes in usage coinciding with the airing of a GeriPal Podcast episode, two international geriatrics conferences, and publication of a NEJM review article—all of which mentioned eFrailty. Analytics data indicated the site was accessed from over 60 different countries. The highest number of users were from the United States (2,400 users), followed by China (802), and Canada (522). The most frequently visited site feature was the ‘Help Me Choose a Frailty Tool’ page, which guides the user through a series of questions to identify an assessment tool that is best aligned to their purpose and available information. Of the 15 validated frailty assessment tools featured, the three most frequently viewed were the CGA-FI (2,105 views), Clinical Frailty Scale (709), and FRAIL Scale (680). User feedback was gathered informally from local and international colleagues using the site, and via e-mails sent through the site’s ‘Contact Us’ link. In response to feedback about the CGA-FI, the authors created a dedicated instruction manual. These initial data suggest the utility of eFrailty website for clinical care, research, and education.
ELEMENTS OF DIGNITY FROM THE VIEWPOINT OF STAFF IN LONG TERM CARE FACILITIES AND THE INTERACTION DIGNITY MODEL
Authors: Hasegawa Nanako , Niimi Yukari , Sone Chikako , Otake Eriko , Jacelon Cynthia 
Published: January 2025

Abstract
Japan has the highest proportion of older people of any country in the world. Culturally, it is important that older adults who enter long term care (LTC) facilities maintain their dignity as they did in their previous lives. However, providing dignified is challenging. Lack of dignity in care threatens not only the dignity and health of residents, but also that of staff. To contextualize and visualize elements of dignity from the perspective of staff, and using a hermeneutic phenomenological prospective approach, we conducted individual and follow-up interviews (18 interviews total) with 9 staff members (4 nurses and 5 certified care workers; age 25–43) working in LTC. Interviews were recorded and transcribed verbatim. Codes were extracted and organized into subthemes and themes. Member checking, blind checking, and a panel of seven judges were used to reduce bias and improve the validity of the findings. Two themes emerged as the core of individual dignity: “Individual dignity not affected by others” and “The individual dignity of the staff.” Three themes were identified as representing the interactions between staff and society: “Dignified care in the narrow sense,” “Dignified care by LTC facilities and the LTC system,” and “Dignity in relation to family members, friends, society, and other residents”. Identifying the “individual dignity of the staff” was identified as a significant finding. Dignity in LTC facilities includes not only dignity of residents but also of the staff, and “Dignified care in the narrow sense” was identified in the interaction between these two.
EXPLORING FALL RISK MANAGEMENT OF OLDER ADULTS IN A SAMPLE OF RURAL HEALTH CLINICS
Authors: Venema Dawn , Yao Yao , Kennel Victoria 
Published: January 2025

Abstract
Fall risk management (FRM) is an important component of primary care for older adults. Rural populations are aging more rapidly than urban ones, increasing the importance of FRM in rural communities. The Centers for Disease Control’s (CDC) Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit supports FRM implementation, including fall risk screening, assessing, and intervening. However, factors such as gaps in knowledge, time and financial constraints, and lack of patient engagement can limit FRM implementation. Using questions based on the STEADI toolkit, we surveyed Nebraska Rural Health Clinics (RHCs) to explore current FRM practices, facilitators, and barriers; 27% responded. Eighty-two percent screened older adult patients for fall risk. The percent of responding RHCs that conducted the following assessments for over half of their patients identified at-risk were: home environment (70%), comorbidities (45%), gait/strength/balance (40%), vitamin D (34%), orthostatic hypotension (21%), medication (17%), and footwear (17%). External reporting of quality measures focused on screening, assessment, and care plan documentation. Long-term FRM impacts (fall-related emergency department visits, hospitalizations) were rarely tracked, nor required for external reporting. Facilitators of FRM were availability of rehabilitation therapists in the community, time to conduct screening and assessments, and the Medicare Wellness Visit. Barriers were time to provide interventions, reimbursement, and patient receptivity to FRM activities. We are developing a quality improvement program called Coordinated Action Toward Community Health: RedUce Risk And Limit (CATCH RURAL) Falls to facilitate implementation of the CDC’s STEADI toolkit in RHCs for older adults including possible adaptations for FRM in rural communities.
FACTORS ASSOCIATED WITH LONGITUDINAL DIGITAL SURVEY ENGAGEMENT IN THE ELECTRONIC FRAMINGHAM HEART STUDY
Authors: Zhang Yuankai , Pathiravasan Chathurangi , Rong Jian , Borrelli Belinda , Faro Jamie , Wang Xuzhi , Liu Chunyu , Murabito Joanne 
Published: January 2025

Abstract
Smartphone surveys are increasingly used in health research, but factors affecting long-term survey response among older adults, are not well understood. We conducted a study of 611 participants (mean age 74 years, 57% women, 86% White) from the electronic Framingham Heart Study to identify sociodemographic, health-related, and technological factors associated with survey response over 32 weeks assessed longitudinally across four 8-week periods. The same number of surveys were sent to the participants with one group receiving half of surveys every 2 weeks and the other group receiving all surveys every 4 weeks. The outcome was the proportion of surveys each participant returned during each period (up to 22 surveys of 20 unique types were sent during each period). Multivariable mixed-effects regressions with random intercepts examined associations between multiple factors and response rates, adjusting for age group (≤75 versus &gt;75 years), sex, and time periods. Lower depressive symptom score (20-item CES-D; β=-0.04, p-value=0.028), younger age group (≤75 years; β=0.08, p-value=0.009), and use of iPhone (vs. Android; β=0.24, p-value&lt; 0.001) were significantly associated with higher response rates. Significant effect modification by time periods (p-value&lt; 0.05) indicated that over time, non-drinkers, iPhone users, and the 2-week survey group had less decline in response rates compared to their counterparts. Findings suggest that sociodemographic, health-related, and technological factors significantly influence digital survey engagement among older adults, with interactions between these factors and time. This highlights the need for targeted strategies to improve long-term engagement, particularly among older participants and those with higher depressive symptom scores.
FEASIBILITY OF WHEY PROTEIN SUPPLEMENTATION TO IMPROVE OLDER ADULT FUNCTION POST-HOSPITALIZATION
Authors: Yang Michelle , Gongloor Pratik , Deer Rachel , Volpi Elena , Li Shuang , Hommel Erin 
Published: January 2025

Abstract
Sarcopenia, the age-related involuntary loss of muscle mass and function, is frequently accelerated following hospitalization. Whey protein supplementation may reduce sarcopenia and improve functional recovery. We performed a pilot randomized-controlled trial to assess feasibility of providing whey protein to older adults during and following an acute hospitalization with the goal to improve function. Subjects ages 65+ were recruited from a single academic hospital’s medical-surgical units. Subjects were randomized into three arms: maltodextrin, whey protein, or collagen supplementation, provided twice daily during hospitalization and for 30-days post-hospitalization. Primary outcomes were recruitment, retention, adherence, and data collection feasibility rates. Secondary outcomes were preliminary efficacy on physical function and body composition. From June 2019 to February 2024, 116 subjects were enrolled, a rate of ~2 per month. Retention was 76.8%. Adherence rates were 58.5% for maltodextrin, 58.6% for whey protein, and 60.6% for collagen. Adherence was significantly higher for subjects completing the study compared to those that withdrew or were re-hospitalized. Data collection feasibility rates were moderate to high with SPPB completed on 100% of participants and DEXA collection on 61% of participants. Preliminarily, there were no statistically significant differences in physical function or body composition between groups. Overall, we demonstrated slow recruitment, low adherence, and moderate retention rates in this study of adults 65+ following an acute hospitalization. A prior trial suggested potential efficacy of whey protein on improving function of frail hospitalized older adults. However, strategies to optimize recruitment, retention, and supplement adherence are necessary before performing further assessment of efficacy.
FINANCIAL HEALTH AND WELL-BEING OF RURAL CAREGIVERS OF OLDER ADULTS WITH CHRONIC ILLNESSES
Authors: Osei Evans , Lalani Nasreen , Yang Siqi , Wagle Sampada , Katare Bhagyashree 
Published: January 2025

Abstract
Rural caregivers experience various financial stressors and challenges in providing care to their ill family members. Rural health disparities such as limited access to care, economic opportunities, resources, and support pose increased financial threats and insecurity resulting in poor patient and caregiver outcomes. Our study aimed to explore perceived financial stressors/challenges and their impacts on the self-care and well-being of rural caregivers of older family members with serious chronic illness. Using a purposive sampling approach, we did qualitative interviews among N=20 rural female caregivers caring for their older family member with any serious chronic illness. Interviews were done in-person and online, interview duration was about 30-45 minutes. Data was transcribed and analyzed deductively and inductively using thematic content analysis. Major financial impacts of caregiving included: leaving job or reducing work hours, time constraints on caregivers’ self-care, inability to balance family relations and caregiving roles, and difficulty navigating financial processes in the existing healthcare system. These challenges led to cutting down on groceries, reliance on retirement savings, and lack of personal time. Participants faced sleep and diet disruptions, shouldered financial decisions alone with limited or no support, and felt guilty over unfulfilled care recipient wishes due to financial constraints. Adequate self-care, coping, and well-being are associated with improved financial well-being and reduced financial threat. Caregiver support programs should focus on strategies and interventions to improve the financial well-being and overall quality of life of caregivers in the rural communities.
FRAILTY, FALL RISK, AND FEAR OF FALLING POSITIVELY ASSOCIATED IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Tice Abigail , Conner Norma , Zhang Wei , Huo Qun , Li Yingru , Emrich Christopher , Xie Rui , Thiamwong Ladda 
Published: January 2025

Abstract
More than one in four older adults fall annually, resulting in 3 million emergency department visits. Frailty, a biological syndrome resulting from declining physiological systems, increases vulnerability to adverse outcomes in older adults. Frailty has been identified as a risk factor for fall occurrence in older adults. Many community-dwelling older adults report heightened fear of falling (FOF), and FOF is recognized as a risk factor for fall occurrence. While frailty is significantly, positively correlated with fall risk and FOF, the relationship between all three measures is less understood. The current objective was to examine relationships between frailty, fall risk, and FOF using the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL), Stopping Elderly Accidents, Death, and Injuries (STEADI), and short Fall-Efficacy International (short FES-I) questionnaires, respectively, in 178 older adults 65 years or older in Orlando, Florida. Spearman correlation analysis revealed significant associations between FRAIL and STEADI scores (p&lt; 0.0001, r=0.6291), FRAIL and short FES-I scores (p&lt; 0.0001, r=0.5294), and STEADI and short FES-I scores (p&lt; 0.0001, r=0.7230). Linear regression analysis supports the significant associations between FRAIL and STEADI scores (p&lt; 0.0001, r2=0.4407), FRAIL and short FES-I scores (p&lt; 0.0001, r2=0.3293), and STEADI and short FES-I scores (p&lt; 0.0001, r2=0.4636). The significant positive relationships suggest that as frailty increases, fall risk and FOF increase and that as FOF increases, fall risk increases. This work implicates the importance of screening in older adults to prevent the progression of frailty to reduce fall risk and FOF. Addressing FOF is important to reduce fall risk in older adults.
HEALTH SEEKING BEHAVIOR FOR YOUNG ONSET DEMENTIA IN WESTERN COUNTRIES AND EAST ASIA: A SCOPING REVIEW
Authors: Chen Ko-Xin , Chang Han-Yun , Cotter Valerie 
Published: January 2025

Abstract

Aim
We aimed to investigate the impact of culture in Western countries and East Asia on the health-seeking behavior in young onset dementia.

Background
While previous research has largely focused on the impact of culture on health-seeking behaviors in late onset dementia, a gap exists in understanding these influences in young onset dementia since they present unique challenges and needs.

Design and Methods
A scoping review was conducted using Arksey and O’Malley’s framework. Databases searched included Embase, Ovid MEDLINE, Cochrane Trials, CINAHL, PsycINFO, Scopus, Airiti Library, and Taiwan’s National Digital Library of Theses and Dissertations, with coverage up to July 22, 2024. The PRISMA-ScR checklist was employed to ensure the rigor of this scoping review.

Results
From 1,611 retrieved articles 27 studies were included. The synthesized results were analyzed using the Health Belief Model. Two main themes emerged from the analysis: (i) perceived susceptibility, severity, and barriers, with subthemes including stigma, financial impact of working, psychological and emotional effects, diagnostic challenges, and access to healthcare; and (ii) perceived benefits, self-efficacy, and cues to action, with subthemes including welfare, individualistic or collective values, meaningful activities, and environmental support.

Conclusion
Health-seeking behavior for young onset dementia is influenced by cultural differences between Western countries and East Asia. Specifically, Western cultures emphasize individualistic values, while East Asian cultures prioritize collective decision-making. Clinical implication: It is crucial to develop informed and culturally appropriate care for persons with young onset dementia that is tailored to the distinct needs of Western and East Asian populations.
INADEQUATE SLEEP ASSOCIATED WITH FRAILTY DEVELOPMENT AND FALL RISK IN LOW-INCOME OLDER ADULTS
Authors: Tice Abigail , Chen Chen , Gurupur Varadraj , Ng Boon Peng , Fukuda David , Lopez Janet , Choi Hwan , Thiamwong Ladda 
Published: January 2025

Abstract
Sleep, which is important for improving brain performance and overall health, declines with aging, and older adults from disadvantaged socioeconomic groups are more likely to have poorer sleep. Frailty, the decline of physiological systems, is associated with poor sleep parameters (e.g., less deep sleep and sleep duration) in older adults. As frailty progresses, fall risk and fear of falling (FOF) increase, increasing the likelihood of a fall that can result in serious injury, hospitalization, and even death. The relationship between sleep duration and frailty, fall risk, and FOF is not well understood, therefore, the objective of this study was to investigate the relationships between them. The Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL), Stopping Elderly Accidents, Death, and Injuries (STEADI), short Fall-Efficacy International (FES-I), and Pittsburgh Sleep Quality Index (PSQI) questionnaires were administered to 124 community-dwelling, low-income older adults aged 60 years or more in Orlando, Florida. Spearman correlation analysis revealed associations between sleep duration and FRAIL (p=0.0258, r=-0.1741), STEADI (p=0.0010, r=-0.2537), and short FES-I (p=0.0083, r=-0.2056). While unpaired t-test analysis revealed no difference in short FES-I between low sleep (&lt; 7 hours; n=83) and healthy sleep (7-8 hours; n=72), FRAIL (p=0.0248) and STEADI scores (p=0.0338) significantly increased with low sleep duration. In conclusion, inadequate sleep duration appears to increase the development of frailty and fall risk in community-dwelling older adults. Screening older adults for sleep problems and interventions to improve sleep duration have the potential to reduce frailty and fall risk in low-income older adults.
KNOWLEDGE GAPS REGARDING NALOXONE USE AMONG OLDER ADULTS IN HIGH OPIOID PRESCRIBING REGIONS IN SOUTHERN USA
Authors: Azhar Gohar , Armstrong Naomi , Camp Lauren , Coker Karen , Savary Patricia E , Sharma Shakshi , Gibson Regina , Wei Jeanne Y 
Published: January 2025

Abstract
Arkansas has one of the highest opioid prescribing rates in the country. Nevertheless, there is a dearth of knowledge regarding opioid use and naloxone among older adults. We surveyed community dwelling older adults about opioid risks and naloxone use in rural Arkansas. Total number of respondents was n=461, and the age ranged from 50-59 (22%), 60-69 (34%), 70-79 (30%), or 80+ (14%) with 77% females and 52% black or African Americans. The percentage correct answers received from survey respondents decreased as age increased. Older adults underestimated their risk for opioid overdose (older vs younger; 35% vs 16%, P=0.020). In addition, more older adults believed that only heroin or fentanyl users were likely to overdose on opioids (older vs younger; 85%,vs 68% P=0.029). The use of naloxone as an overdose antidote was much less recognized by older adults (older vs younger; 66% vs 87%, P=0.016), as well as the requirement to administer as second dose of naloxone if the initial dose was unsuccessful (older vs younger; 40% vs 63%, P=0.033). Most older adults were unaware that naloxone could be obtained from the pharmacy without a prescription (older vs younger; 47% vs 71%, P=0.018). In summary, knowledge gaps regarding opioids and naloxone use were significantly higher in older adults. Since older adults are frequently prescribed opioids for pain, it is imperative that greater educational efforts are directed towards ameliorating the knowledge deficits about opioids and correct use of naloxone to prevent adverse effects and deaths due to opioid overdose.