bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Evaluation of Treatment Adherence Interventions for Older Adults With MCI Using IoT Devices
Authors: Shin Jinhee , Cho Eunhee , Kim Gwang Suk , Kim Heejung , Ye Byoung Seok , Pack Chang-Gi 
Published: December 2021

Abstract
For older adults with mild cognitive impairment (MCI), treatment adherence is essential to prevent and delay dementia. Older adults with MCI should maintain treatment for chronic diseases, exercise regularly, and adhere to treatment to maintain health status. There is a lack of comprehensive interventions to promote treatment adherence (medication adherence and physical activity) for older adults with MCI. The purpose of this study was to develop an internet of things (IoT)-based real-time treatment adherence for old adults with MCI and examine the effectiveness of the program. This study was a randomized controlled trial. The patients were enrolled from the neurology outpatient department clinic at a hospital in Korea. The subjects were 18 in the experimental group and 20 in the control group. This study intervention was IoT-based medication adherence device and real-time monitoring sever plus wrist wearable device. The study consists of a 10-week intervention period. The intervention program was provided for only the experimental group and the control group with a wearable device and usual care. Assessments were conducted at baseline, 6 weeks, and 10-weeks. A mixed-effects model was used in the analysis to evaluate the program. The IoT-based treatment adherence intervention was effective in improving medication adherence over time (β =11.465, p&lt;.001), physical activity (K-PASE) (β =27.376, p&lt;.001) and average the number of steps per week (β=3202.53, p&lt;.001). Health care providers can use this program to improve treatment adherence for chronic disease management and dementia prevention of older adults with cognitive impairment.
Interactions Between Plasma Amyloid and Aging Markers to Determine Clinically Meaningful Cognitive Decline
Authors: Lu Wan-Hsuan , Giudici Kelly , Vellas Bruno , de Barreto Philipe Souto 
Published: December 2021

Abstract
Background: Brain amyloidosis is a well-known pathological hallmark of Alzheimer’s disease (AD) and can be early identified by measuring plasma amyloid-β (Aβ) status. Growing evidence implicates the biological mechanisms of aging, including chronic inflammation, mitochondrial dysfunction and neurodegeneration, in AD pathogenesis. This study aims to investigate the interactions between plasma Aβ status and aging markers on clinically meaningful cognitive decline. Methods: This secondary analysis from Multidomain Alzheimer Preventive Trial (MAPT) enrolled 401 community-dwelling older adults (mean age ± SD: 76.7 ± 4.6 years) who had clinical dementia rating (CDR) scale as 0 or 0.5, and who had their plasma biomarkers measured: amyloidosis: Aβ42/40 ratio; inflammatory: tumor necrosis factor receptor type 1 (TNFR-1), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), C-reactive protein (CRP); mitochondrial dysfunction: growth differentiation factor 15 (GDF-15); neurodegeneration: neurofilament light chain (NfL). Cognitive decline was determined by diagnosed dementia and worsening CDR status. Cox regression and moderation modeling were applied to examine the interrelationships between biomarkers and risk of cognitive decline. Results: Among 401 participants, 43.9% were cognitive normal (CDR=0) and 56.1% were mild cognitive impairment (CDR=0.5) initially. After 3.3 ± 1.1 years of follow-up, 7.0% of population evolved dementia and 34.2% had worsening CDR status. GDF-15 and NfL presented prospective associations with incident dementia. However, risk of dementia associated with plasma Aβ did not change after considering the serum level of GDF-15 and NfL. Conclusion: The markers of mitochondrial dysfunction and neurodegeneration did not partially explain the associations between plasma Aβ status and cognitive decline in older adults.
Long-Term Visit-To-Visit Blood Pressure Variability and Cognition: A Systematic Review of Observational Studies
Authors: Yoneda Tomiko , Knight Jamie , Zhang Amelia , Muniz-Terrera Graciela , Piccinin Andrea 
Published: December 2021

Abstract
Existing literature suggests that in comparison to a single blood pressure (BP) measurement, or the mean of multiple recordings, BP variability (BPV) may reflect dysfunction in cardiovascular regulatory mechanisms, leading to compromised cognitive health. No systematic review has yet synthesized observational reports examining the association between cognition and long-term visit-to-visit BPV. In response, a comprehensive literature search was executed in December, 2019, and updated in December, 2020. Methodological approach was pre-registered (https://osf.io/vmnuq/). Of 1385 reports, 27 met eligibility criteria. Most executed secondary analyses using existing longitudinal datasets of older adults (N=21). Intervals between measurement occasions ranged from 30 days to four years, and follow-up ranged from 0.5-25 years. Most studies computed more than one index of BPV (range=1-6), and all included at least three BP recordings (range=3-12). Given extensive between-study variability in analytic approach (e.g., BPV and cognition treated as continuous and/or categorical variables; number of covariates ranged 0-18), our team determined that meta-analyzing the results would be inappropriate. Despite heterogeneity in study characteristics, the majority (85.2%) reported that systolic BPV (sBPV) was negatively associated with cognition; specifically, higher sBPV was associated with cognitive impairment (N=9), cognitive decline (N=6), and/or risk of dementia (N=5). Four studies also revealed higher sBPV in individuals with dementia compared to controls. Three studies reported no association, while one reported a positive significant association between BPV and cognition. Results were similar for diastolic BPV. Despite considerable heterogeneity in study characteristics, greater variability in visit-to-visit BP appears to be consistently associated with adverse cognitive outcomes.
The Association Between Leisure Games and Cognitive Functioning Among Older Adults
Authors: Terada Tyran , Lee Yeonjung 
Published: December 2021

Abstract
Stimulating leisure games have been shown to offer cognitive stimulation among older adults. This cross-sectional study examined the association between word games (crossword puzzles and scrabble) / cards and games (games such as chess) and cognitive functioning among adults aged 65 years and older (n=3271). All data were collected from the Health and Retirement Study (2016). Results from the hierarchical regression models suggest that higher levels of participation in word games (p&lt;.01) and cards and games (p&lt;.01) predicted higher levels of cognitive functioning. In the final model, after controlling for age, gender, ethnicity, marital status, education, and income, a total variance of 31 percent was explained. All covariates were statistically significant except marital status. Word games (β=.117, p&lt;01) and cards and games (β=.054, p&lt;.01) had a significantly positive association with cognitive functioning. These findings suggest that participation in word games and cards and games are associated with cognitive functioning among older adults.
The Effects of Mild Cognitive Impairment on Fall Severity in Older Adults
Authors: Jones Megan , Paulson Sally , Gills Joshua , Campitelli Anthony , Glenn Jordan , Madero Erica , Myers Jennifer , Gray Michelle 
Published: December 2021

Abstract
Falls affect more than 30% of older adults and are one of the leading causes of injury, hospitalization, and mortality in this populations. Mild cognitive impairment (MCI) is one of the risk factors for falls in older adults. The purpose of this study is to determine if older adults with MCI have increased fall severity than older adults without MCI. Participants (n: 81: age: 79 ± 6) completed a Montreal Cognitive Assessment (MoCA) and a Hopkins Falls Grading Scale, a tool used to grade the severity of falls on a scale of 1-4 (1 = loss of balance without fall; 4 = fall requiring hospital admission). Participants were categorized as having MCI (score &lt;26: N: 44: age: 81 ± 6.4) or non-MCI (score ≥26: n: 37: age: 77 ± 6). Groups were analyzed using a one-way ANOVA in SPSS to compare the severity of falls within the previous 12 months. There were no differences between groups for fall grade 1 (p =.22) or fall grade 2 (p =.45). There was a significant difference between groups for fall grade 3 (p =.04) and fall grade 4 (p =.05) with the MCI group having more of these falls compared to the non-MCI group. Older adults with MCI had a higher number of falls requiring medical attention than older adults without MCI. Although falls are a risk in all older adults, those with MCI may be at higher risk of more injurious falls than older adults without MCI.
Maintaining Integrity of Worldwide FINGER Clinical Trials During the COVID-19 Pandemic
Authors: Roehr Susanne 
Published: December 2021

Abstract
The COVID-19 pandemic presents challenges to the conduct of randomized clinical trials of lifestyle interventions. World-Wide FINGERS international network convened a forum for researchers to discuss statistical design and analysis issues they faced during the pandemic. We report experiences of three trials that, at various stages of conduct, altered designs and analysis plans to navigate these issues. We provide recommendations for future trials to consider as they develop and launch behavioral intervention trials. The pandemic led researchers to change recruitment plans, interrupt timelines for assessments and intervention delivery, and move to remote intervention and assessments protocols. The necessity of these changes add emphasis to the importance, in study design and analysis, of intention to treat approaches, flexibility, within site stratification, interim power projections, and sensitivity analyses. Robust approaches to study design and analysis are critical to negotiate issues related to the intervention.
Involvement in Decision-Making for Daily Care and Cognitive Decline among Older Adults Who Need Care in Japan
Authors: Komatsu Ayane , Nakagawa Takeshi , Noguchi Taiji , Saito Tami 
Published: December 2021

Abstract
Effective decision-making regarding daily care for older adults with needs could reduce the risk of dementia by preventing loss of motivation and improving care quality. However, empirical studies are scarce, particularly in non-Western countries with different socio-cultural backgrounds. By using 2-year longitudinal data of older Japanese adults aged 65 years and above who were receiving care at home, as well as of their family caregivers, we examined the association of involvement in decision-making with the onset of cognitive decline among older Japanese adults requiring care. The analysis included 219 cases of individuals with normal cognition and no missing variables at baseline and responded to the follow-up survey. An MMSE score of 23 or lower at follow-up was defined as the onset of cognitive decline. The level of involvement in decision-making was assessed by one item and dichotomized (not involved/involved). The covariates were age, gender, education, MMSE score, eligibility level for long-term care, and others at baseline. At baseline, 67.1% were 75 years or older, 58.9% were female, and 91.8% responded being “involved” in the decision-making. The incidence of cognitive decline at follow-up was 30.6%. The multivariable logistic regression analysis showed that involvement in decision-making (OR=0.298 [95% CI: 0.10-0.88], p=0.029) was negatively and significantly associated with the onset of cognitive decline. Our findings show the importance of involvement in the decision-making for daily care to reduce the risk of subsequent cognitive decline in older adults requiring care, even in a culture of familism.
Depressive Symptoms Moderate the Association Between Lifetime Discrimination and Inhibition Among Older Adults
Authors: Wright Regina , Bygrave Desiree 
Published: December 2021

Abstract
Discrimination has been identified as a potentially modifiable environmental stressor that reduces cognitive function. As the burden of discrimination can extend from early to late life, understanding its role in cognition in late life is critical. Further, understanding the potential moderating influence of depressive symptoms, which are common among older adults, on the linkage between discrimination and cognition, may provide further insight into the potential patterns of psychosocial stress and negative affect that may promote cognitive decline and dementia. Thus, we sought to examine whether depressive symptoms moderate linear relations of lifetime discrimination to cognitive function in the domains of visuospatial, verbal, and working memory, executive function, and psychomotor ability, adjusting for age, sex, race, and education. Participants were 165 older adults (34% male) with a mean age of 68.43y. Participants completed a health screening, a battery of cognitive tests, a psychosocial assessment, and cardiovascular testing relevant to the larger study. Linear regression results showed a significant interaction between lifetime discrimination and depressive symptoms (p&lt;.05) related to the Stroop interference score, a measure of inhibition. A probe of the interaction showed that greater lifetime discrimination was associated with better inhibition among participants with fewer depressive symptoms. This paradoxical finding is consistent with scant research that shows exposure to discrimination may heighten performance, and is more common among individuals that have achieved more, both educationally and vocationally. Greater depressive symptomatology may reduce this paradoxical association. Future research should explore this question both longitudinally and in a larger sample.
Perceptual Versus Conceptual Value-Directed Strategic Processing in Younger and Older Adults
Authors: Nguyen Lydia , Lydon Elizabeth , Mudar Raksha 
Published: December 2021

Abstract
Value-directed strategic processing involves selectively attending to and processing information deemed more important while ignoring or inhibiting less important information. What we selectively attend to can be driven by the value we ascribe to the information, often based on stimulus factors such as perceptual features that make the information stand out, or conceptual features that make it easy to group information. The current study investigated whether behavioral measures of value-directed strategic processing are differentially affected when value is defined by perceptual versus conceptual features, and how normal cognitive aging impacts processing. Cognitively normal younger (N = 16; mean age: 22.1 ± 2.9 years) and older adults (N = 16; mean age: 66.9 ± 7.3 years) completed two value-directed strategic processing tasks, where value was defined by either perceptual (i.e., uppercase and lowercase letters; Letter Case task) or conceptual (i.e., animals and household items; Categories task) features. Both groups had higher recall on the Categories task compared to the Letter Case task, and higher recall for high- than low-value words. However, older adults recalled fewer total words than younger adults, but the groups did not differ across task types. These findings indicate that manipulating perceptual and/or conceptual features to define value can be used to study value-directed strategic processing in younger and older adults. Furthermore, grouping information based on conceptual features may be more effective for promoting subsequent recall in both younger and older adults.
Gender Differences in Mental and Physical Health: Implications for Aging With a Traumatic Brain Injury
Authors: Swinford Emma 
Published: December 2021

Abstract
Traumatic Brain Injury (TBI) is a major cause of disability and death in the U.S., and survivors often experience temporary or life-long health effects as a result of their injury. While risks and outcomes of fall-related TBI in older adults have been well-documented, the intersection of TBI-related health challenges and the experience of aging with a TBI is less well understood. This project explores gender differences in health outcomes among TBI survivors. A Needs Assessment survey was conducted in early 2020 with adult TBI survivors in Missouri (n=150). The mean age of respondents was 46 and 58% identified as male. Bivariate analyses reveal gender differences in health conditions among TBI survivors before and after injury. Significantly more males than females reported substance use disorder for alcohol (20.7% and 7.9%, p &lt; .05) prior to injury, whereas twice as many females reported developing chronic pain after injury than males (68.3% and 31.0%, p &lt; .001). Further, while about 21% of both male and female respondents reported experiencing other mental health conditions, such as anxiety, prior to injury, over 35% of males and almost 58% of females experienced mental health concerns after injury. Additionally, balance/mobility issues, sleep disorders, sensory issues, and cognitive challenges were frequently identified post-injury conditions. Co-morbidities impact our experiences, capabilities, and quality of life as we age. Policies and programs to support TBI survivors and their families may better address the co-occurring health conditions among TBI survivors by considering gender differences in the experience of aging with a TBI.
Lessons for Humanities and Arts in Gerontology and Geriatrics Curricula From the Medical and Health Humanities
Authors: O'Neill Desmond 
Published: December 2021

Abstract
The role of Humanities, Arts and Cultural Gerontology in gerontology and geriatrics curricula finds a metaphor in the rapidly evolving field of medical and health humanities, with which this author has been involved for three decades. Behind the call for increasing humanities and arts scholarship in the pedagogy of both fields lies the challenge of establishing an interdisciplinary nexus of scholarship that avoids the challenges of dilettantism and gestures such as providing lists of novels and movies. This presentation draws on the presenter's bibliometric research in the medical and health humanities which indicates authorship in the majority to be either solely from the humanities or from healthcare, with little indication of joint working in either authorship or acknowledgements (the scholar's courtesy), and explores the background issues of academic culture with a view to proposing solutions to elevate the inclusion of humanities and arts as a significant element of gerontology education.
Challenges in caring for people with dementia during COVID-19: Findings from long-term care facilities across Japan
Authors: Ikeuchi Tomoko , Suzuki Mizue , Kikuchi Kazunori , Kan Akiko , Shimada Chiho 
Published: December 2021

Abstract
Long-term care facilities for older adults have been profoundly affected by the coronavirus disease 2019 (COVID-19) pandemic in Japan. This study investigated the challenges that care staff members faced by the height of the first wave (i.e., April 2020) and the height of the second wave (i.e., October 2020) of the pandemic at long-term care facilities in Japan. We mailed questionnaires in October 2020 to 5,895 care facilities throughout Japan. A total of 22.7% of the questionnaires were returned. Of those, 87.4% had at least one resident with dementia. Based on the results, 65.2% reported having restricted all visitors during the first wave. Although 42.8% reported continuing to restrict all visitors during the second wave, more than 54% allowed visitors while limiting the number of visitors or the time of each visit. Nearly 76% reported that restrictions on visitations may have exacerbated the behavioral and psychological symptoms of dementia (BPSD) among residents. In place of visitations, over 50% used video calls or phone calls to communicate with the family members, and 45.7% reported that the virtual visits were efficacious in alleviating the BPSD. However, more than 70% reported not having adequate Internet services and computer equipment at their facilities, and nearly 90% reported insufficient staffing. Our findings suggest that the pandemic may have pressed for a change of direction for dementia care with the introduction of virtual visitations and other initiatives. Nevertheless, facilities may face difficulties with implementing such changes due to inadequacies in the availability of resources.
The Effect of Vaccines on Older African Americans Emotional Experiences During the COVID-19 Pandemic
Authors: Hanna Sophie , Bass Dwana , Shair Sarah , DiCerbo Loraine , Giordani Bruno , Kavcic Voyko 
Published: December 2021

Abstract
The COVID-19 pandemic is an unprecedented health emergency that has forced a change in the daily life of all individuals across the nation for over a year. As vaccinations have begun in Detroit, we examined their effect on older African Americans’ emotional experiences and intent to get vaccinated during the pandemic to help understand how persons make decisions to accept vaccinations. For this study, 194 community-dwelling older African Americans (mean age = 75, age range = 64-94) were recruited from the Wayne State Institute of Gerontology Healthier Black Elders Center and general Detroit area. A telephone survey was administered to assess pandemic experience including demographics, emotional responses (e.g., gratitude, happiness, anger, fear), everyday stressors (e.g., economic problems, reduced privacy), and vaccination attitude (e.g., concern over safety, intent to vaccinate). Of the 194 participants, 149 completed the survey before the first vaccination occurred in the United States on December 15, 2020, and 45 completed the survey after. Participants had not yet been vaccinated, but 67% said they would as soon as available. Participants in the post-vaccination group, as compared to pre-vaccination group, showed increases in stress-related locus of control (p=.03) and reported being more likely to get vaccinated (p=.02). They showed decreased worry about availability of health and safety supplies (p=.01), reduced perceived stress (p=.02), and a decrease in fears of COVID-19 (p=.05) and vaccination safety (p&lt;.001). The current study highlights the effect of vaccinations on the attitudes and emotions experienced by an older minority population living in an urban area.
The Relationship Between Covid-19 Anxiety and Well-Being Outcomes in Older Veterans
Authors: Kintzle Sara , Castro Carl 
Published: December 2021

Abstract
Understanding the impacts of the COVID-19 pandemic on the well-being of vulnerable populations is essential in planning for care post pandemic and preparing for future pandemics. One such population often overlooked during the COVID-19 pandemic is older veterans, whose military service often results in physical and psychological effects that creates vulnerability to the impacts of COVID-19 beyond their age risks. The purpose of this research was to examine the relationship between COVID-19 anxiety and well-being in older veterans. Survey data was collected from the end of June 2020 through August 2020 and examined the well-being of veterans during the COVID-19 pandemic. This research looked at the 122 veterans in the sample who were aged 65 and older. Age ranged from 65 to 94 years (M=73, SD = 5.0). The sample was predominately Male (90%), White (83%), educated (65%) and married (69%). Moderate to high COVID-19 anxiety was reported in 38 percent of the sample. Older veterans who reported moderate to high COVID-19 anxiety were 5 times more likely to report loneliness, 11 times more likely to meet the diagnostic cut off for anxiety, 3 times for depression, 2 times for PTSD, and 3 times for moderate to severe insomnia. Results revealed a clear association between COVID-19 anxiety and the well-being of older veterans. Findings have implications for ensuring well-being outcomes are restored in older veterans as cause for pandemic anxiety is reduced. Results also demonstrate older veterans should be recognized as a vulnerable population in preparation for care future pandemics.