bluuebunny/crossref_metadata_2025_split huggingface dataset:
Six-Month Lower-Leg Sensory Stimulation Augments Neural Network Connectivity Associated With Improved Gait
Authors: Hsu Chun Liang , Iloputaife Ikechukwu , Oddsson Lars , Manor Brad , Lipsitz Lewis 
Published: December 2021

Abstract
Foot sole somatosensory impairment associated with peripheral neuropathy (PN) is prevalent and a strong independent risk factor for gait disturbance and falls in older adults. A lower-limb sensory prosthesis providing afferent input related to foot sole pressure distributions via lower-leg vibrotactile stimulation has been demonstrated to improve gait in people with PN. The effects of this device on brain function related to motor control, however, remains equivocal. This study aimed to explore changes in brain network connectivity after six months of daily use of the prosthesis among individuals with diagnosed PN and balance problems. Functional Gait Assessment (FGA) and resting-state functional magnetic resonance imaging were completed before and after the intervention. Preliminary analysis on participants who have completed the study to date (N=5; mean age 76 years) indicated altered connectivity of the sensorimotor network (SMN), frontoparietal network (FPN), and the default mode network (DMN) post-intervention (Z&gt;3.11, unadjusted p&lt;0.05). Participants displayed an average improvement of 5.5 point in the FGA (Minimal Clinically Important Differences&gt;4 for community-dwelling older adults) that was correlated with connectivity changes (unadjusted p&lt;0.05). Specifically, improved FGA was associated with: 1) increased connectivity between the SMN, cerebellum, and occipital cortex; 2) increased connectivity between the FPN, cerebellum, calcarine and intracalcarine; and 3) decreased connectivity between DMN and intracalcarine. These early findings suggest that long-term use of a lower-limb sensory prosthesis may induce neuroplastic changes in brain network connectivity reflecting enhanced bottom-up sensory-attentional processing and suppression of the DMN that are relevant to gait improvements among older adults with PN.
What works and what doesn’t: Gerontology focused PhD/ DSW graduates speak out
Authors: Myrick Matthew , Snedeker Lauren 
Published: December 2021

Abstract
Lin et al. (2015) projected there would be a shortage of approximately 195,000 social workers in the United States by 2030. In the next twenty years, it is estimated that Americans over the age of 65 will actually outnumber children under the age of 18 (US Census, 2018). With a longstanding reputation for being less “glamorous”, social work with older adults will continue to experience deficits in the amount of those who commit to this field of practice unless more lasting change occurs (Cummings et al., p. 645, 2005). We must take a closer look at what takes place in the classroom at schools of social work to understand why social workers are not interested in working with older adults (Scharlach et al., 2000). Berkman et al. (2016) described in their work that a critical shortage of gerontology-focused social work faculty exists in schools of social work. Thus, we cannot expect more social workers to work with older adults unless they are exposed to this work in their educational programs. The purpose of this study is to report on the academic experience, research agenda, professional experiences (practice and teaching), and future goals of social work PhD/ DSW graduates. Ten social work doctoral graduates were interviewed in order to understand the impact their academic programs had on their commitment to older adults in their field and to learn their recommendations for schools of social work in an effort to sustain and grow the gerontological workforce.
A Platform to Study the Effects of Home Environment on Health and Wellbeing of Older Adults
Authors: Baniassadi Amir , Manor Brad , Yu Wanting , Lipsitz Lewis , Pascual-Leone Alvaro 
Published: December 2021

Abstract
While older adults’ living environment is rarely well-tuned to their specific needs, technological advances provide new opportunities to understand, and ultimately optimize, the relationship between the home environment and health outcomes. We aimed to establish proof-of-concept and feasibility of a platform enabling real-time, high-frequency, and simultaneous monitoring of environment, biological variables, and outcomes related to health and wellbeing in older adults. We recruited 7 participants (6 females, 1 male, aged 78-90, MoCA scores 14–28), installed environmental sensors measuring temperature, humidity, and CO2 inside their homes, provided them with wearables that measure sleep, activity, body temperature, and heart rhythms, and asked them to use a tablet to complete four sets of questionnaires and cognitive tests per day for three consecutive weeks. Environmental sensors collected data with no disruption or complaint from participants. Average compliance with the wearables was 81% (ring) and 60% (watch). All participants preferred the ring due to ease-of-use. Compliance was better in those with higher MoCA scores. Three participants were able to use the tablet successfully and completed 90% of prescribed questionnaires and cognitive tests. Cognitive and/or motor issues prevented the other participants from using the tablet. Exit interviews revealed that participants would prefer to complete a maximum of two sets of daily questionnaires and cognitive tests (five minutes each) in longer-term studies. These results suggest that it is feasible to study the impact of the environment on biological rhythms, cognition, and other outcomes in older adults and provide recommendations for ensuring long-term compliance with the protocol.
Age-related Changes in Ongoing Thought Relate to External Context and Individual Cognition
Authors: Turnbull Adam , Poerio Giulia , Lin Feng , Smallwood Jonathan 
Published: December 2021

Abstract
Understanding how age-related changes in cognition manifest in the real world is an important goal for aging research. One means of capturing these changes involves “experience sampling” participant’s self-reported thoughts as they go about their daily lives. Previous research using this method has shown age-related changes in ongoing thought: e.g., older adults have fewer thoughts unrelated to the here-and-now. However, it is currently unclear how these changes reflect cognitive aging or lifestyle changes. 78 younger adults and 35 older adults rated their thought contents along 20 dimensions and the difficulty of their current activity in their daily lives. They also performed cognitive tasks in the laboratory. In a set of exploratory analyses using Principal Component Analysis (PCA), we found that older adults spent more time thinking positive, wanted thoughts, particularly in demanding contexts, suggesting they may use different strategies to regulate their emotions. In line with previous research, older adults spent less time mind wandering about their future selves. Past-related thought related to episodic memory differently in older and younger adults. Additionally, PCA analyses performed separately in older and younger adults showed high similarity to an analysis performed on the combined sample, suggesting a similar structure to ongoing daily life thought in older and younger adults. These findings inform the use of experience sampling to understand cognitive aging, highlighting the need to consider content along multiple dimensions as well as the context in which thoughts are reported when analyzing aging ongoing thought.
An Online Community Intervention for Older Persons with Pre-Frailty and Frailty: Pilot Studies
Authors: Zaslavsky Oleg , Chu Frances , Ge Shaoqing , Teng Andrew , Lin Shih-Yin , Demiris George , Chen Annie 
Published: December 2021

Abstract
Online community interventions can support self-management in older populations but have rarely targeted symptomology of pre-frailty and frailty. To support older adults’ pre-frailty/frailty symptom management, we iteratively refined an approach entitled Virtual Online Community for Aging Life Experience (VOCALE) in three consecutive pilot studies (2018-2020). These studies employed asynchronous online discussions in which participants were asked to respond to weekly prompts. A study facilitator moderated the discussion, encouraging participants to respond to both the prompts and comments of other participants. In the first pilot (n=8), participants engaged in a collective exploration of different symptoms of pre-frailty and frailty. The second (n=10) and third (n=10) pilots employed a hybrid approach including collaborative exploration and learning of different problem-solving therapy skills over eight weeks. The mean age of participants of the three pilots combined was 80.6 (SD = 7.0). Most participants were female (71%). Participant attrition ranged from 20-25%. Many participants who completed the study noted that they enjoyed the discussions. The participants also found the moderators' follow-up questions and support timely and engaging. Additionally, we observed small but positive changes in self-efficacy measures. These pilot studies have confirmed that older adults with pre-frailty and frailty are interested, and can successfully engage in online community interventions, with the technical support and moderation provided, even during the initial stages of the COVID-19 pandemic, when lockdown policies were rolled out. Participation in the intervention was also associated with increased awareness of the need to be proactive in self-management concerning frailty-related symptoms.
Association of Dual Sensory Impairment with Incident Mobility and ADL Difficulty
Authors: Armstrong Nicole , Teixeira Camila Vieira Ligo , Brenowitz Willa , Swenor Bonnielin , Simonsick Eleanor , Jones Richard , Gendron Colby 
Published: December 2021

Abstract
Hearing and vision impairment are each independently associated with incident mobility disability and disability in activities of daily living (ADL). Whether dual sensory impairment (DSI) in both hearing (pure-tone average &gt;25 dB) and vision (impaired visual acuity and/or impaired contrast sensitivity) is associated with greater risk of incident mobility and ADL difficulty, as compared to single or no sensory impairments, has not been well-studied. To examine these associations, we used data from 2,020 Health Aging and Body Composition Study participants aged 70-79 years without mobility limitations. Incident mobility difficulty was defined as the first instance of a lot of problems or inability to walk ¼ mile and/or climb 10 steps, and incident ADL difficulty was defined as the first instance of problems with any ADL. Cox proportional hazards models adjusted by demographic covariates, diabetes, hypertension, and depressive symptoms were used to model these associations. Approximately 22.7% of the study had DSI. DSI was associated with increased risk of both incident mobility (Hazard Ratio [HR]=2.43, 95% Confidence Interval [CI]: 1.60, 3.69) and ADL difficulty (HR=2.39, 95% CI: 1.60, 3.56). Vision impairment only was associated with risk of incident mobility difficulty (HR=1.74, 95% CI: 1.09, 2.78), but not incident ADL difficulty (HR=1.45, 95% CI: 0.91, 2.32). Hearing impairment only was not associated with risk of either outcome. Synergistic effects of DSI on the additive scale were present. Sex and race did not modify associations. Monitoring of DSI may be beneficial in delaying incident difficulty.
Dementia Risk in Older Veterans With Frailty: A Cross-Sectional Study
Authors: Hernandez Christian Gomez , Diaz Alma , Sow Ahmadou , Athouriste Gauty , Ijaopo Ezekiel , Ruiz Jorge 
Published: December 2021

Abstract
Frailty, a clinical syndrome characterized by vulnerability to stressors resulting from multisystemic loss of physiological reserve, predicts future cognitive decline. However, frailty has also been proposed as a dementia risk factor, predicting future cognitive impairment. The study aim was to determine frailty in older veterans and its association with risk of dementia. Community-dwelling Veterans ≥50 years completed a mailed socio-demographic questionnaire and Self-Administered Gerocognitive Examination (SAGE), July 2019-May 2020. The information was complemented with EHR data. We calculated the CAIDE score, a validated tool predicting dementia (≥6 points= high risk 20 years later) and the 31-item VA frailty index data (frail ≥.20, non-frail ≤.20). After adjusting for socio-demographic characteristics, smoking, alcohol/substance abuse, OSA and anticholinergic use, odds ratio (OR) and 95% CI were calculated using BLR to assess the cross-sectional association between frailty and dementia risk (CAIDE ≥6 points and MCI). The survey response rate was 19.75% (1,073 of 5,432). Participants mean age was 68.38 (SD=8.49) years, 57.50% (n=617) Caucasian, 69.34% (n=744) non-Hispanic, 95.81% (n=1,028) male, and 36.72% (n=394) frail. 11.84%(n=127) screened positive for MCI and 15.38% (n=165) for dementia. 689 (75.88%) veterans were at high risk for dementia of whom 426 (61.83%) were non-frail and 263 (38.17%) were frail. Frailty was cross-sectionally associated with higher risk for dementia in older Veterans, adjusted OR:1.45 (95%CI:1.016-2.070), p=.041. The mailed screening was a feasible and practical approach to screen for dementia risk. Early identification of patients with frailty can help in the implementation of interventions aimed at preventing or delaying dementia.
Depression Mediates the Causal Effect of Food Insecurity Transition on Cognitive Function
Authors: Lu Peiyi , Kezios Katrina , Hazzouri Adina Zeki Al 
Published: December 2021

Abstract
Despite substantial evidence on the relationship between food insecurity and worse cognition, few studies have examined the underlying mechanisms. This study examined whether and to what extent depression mediated the casual effect of food insecurity on cognition in midlife. Longitudinal data from the Coronary Artery Risk Development in Young Adults Study were used. The 2000 survey was used as our study’s baseline, when respondents aged 33-45. We lagged the explanatory and mediator variables to set up temporality. Food insecurity transition from 2000-2005 surveys was recoded (persistent food secure, persistent food insecure, became food insecure, and became food secure). Depression was measured in 2010, while cognitive functions were measured in 2015. Causal mediation analysis examined and decomposed the direct and indirect effect. Compared to persistent food security, both persistent and became food insecure were linked to worse cognition, after adjusting demographic and cardiovascular risk factors. Further, for both exposure groups, depression had significant and strong mediation effects (natural indirect effect ranged from -0.037 to -0.018). Specifically, as respondents experienced persistent food insecurity or became food insecure, their depression increased, which, in turn, reduced their cognition. The proportion of the total effect of food insecurity transition on cognition mediated by depression ranged from 7-24% for processing speed, verbal memory, cognitive, and language functions. Persistent and became food insecure reduced cognitive function directly or indirectly through increasing depression among middle-aged adults. Interventions targeting either food insecurity or treatment of depression among food insecure individuals may have the potential to slow premature cognitive aging.
Do Inflammation Markers Moderate Associations Between Caregiving and Quality of Life, Health, and Depression?
Authors: Orsega-Smith Elizabeth , Kuczmarski Marie , Davey Adam , Wolfle Brianna , Zonderman Alan , Evans Michele 
Published: December 2021

Abstract
Caregiving responsibilities can put stress and strain on older adults including emotional distress, depression, decline in physical functioning, and decreased self- reported quality of life. Chronic stress such as from caregiving may be related to chronic inflammation, but this has been less widely examined. Therefore, the purpose of this study is to examine whether the association between caregiving and outcomes including quality of life indicators, self-rated health, and depressive symptoms are moderated by physical activity, stress coping, diet quality inflammatory index, and selected biomarkers of inflammation. We used data from waves 3 and 4 of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. In wave 3, 733 reported caregiving for grandchildren. They were mostly African American (59%) and female (55%) with a mean age was 47.7 years at the start of the study. In linear regression models, caregiving for grandchildren (CGC) predicted higher depressive symptoms and lower quality of life and self-rated health. Results demonstrated that the association between erythrocytes sedimentation rate (ESR) was a significant moderator between CGC and quality of life, self-rated health, and depressive symptoms (p&lt;0.05). In a separate analysis of wave 4 data (152 reported caregiving for elders), serum magnesium was a significant moderator between caregiving for elders and both quality of life and self-rated health (p&lt;0.05). These results suggest that inflammatory factors may influence the health of diverse older adult caregivers. Further (or Future) research may evaluate the effect of these moderators over time.
Does Frailty influence Inhospital Management and Outcomes of COVID-19 in Older Adults in the US?
Authors: Setoguchi Soko , Madhira Vithal , Bergquist Timothy , Kuhrt Nathaniel , Islam Jessica , Spratt Heidi , Siu Joseph , Kennedy Richard 
Published: December 2021

Abstract
Older age has been consistently associated with adverse COVID-19 outcomes. Frailty, a syndrome characterized by declining function across multiple body systems is common in older adults and may increase vulnerability to adverse outcomes among COVID-19 patients. However, the impacts of frailty on COVID-19 management, severity, or outcomes have not been well characterized in a large, representative US population. Using the National COVID Cohort Collaborative, a multi-institutional US repository for COVID-19 research, we calculated the Hospital Frailty Risk Score (HFRS), a validated EHR-based frailty score, among COVID-19 inpatients age ≥ 65. We examined patient demographics and comorbidities, length of stay (LOS), systemic corticosteroid and remdesivir use, ICU admission, and inpatient mortality across subgroups by HFRS score. Among 58,964 inpatients from 53 institutions (51% male, 65% White, 18% Black, 9% Hispanic, mean age 75, mean Charlson comorbidity count 3.0, and median LOS 7 days), 38,692 (66%), 4,180 (7%), 3,531 (6%), 3,525 (6%) and 7,862 (13%) had HFRS scores of 0-1, 2, 3, 4, and &gt;=5 , respectively. Frailty was only moderately correlated with age and comorbidity (ρ=0.178 and 0.348, respectively, p&lt;0.001). Overall, 34% received systemic corticosteroid and 19% received remdesivir. We observed 4% ICU admissions and 16% inpatient death. Among non-ICU admissions, after adjusting for demographics and comorbidities, frailty (HFRS ≥ 2) was associated with 79% greater systemic corticosteroid use and 22% greater remdesivir use, whereas a higher HRFS score was marginally associated with higher rates of severe COVID disease, inpatient death, or ICU admission.
Duration of Reproductive Period and Risk of Transitioning to Mild Cognitive Impairment and Dementia
Authors: Yoneda Tomiko , Knight Jamie , Lewis Nathan , Muniz-Terrera Graciela , Bennett David , Piccinin Andrea 
Published: December 2021

Abstract
Decreasing estrogen levels have been hypothesized to be associated with increased risk of dementia, yet the current literature reveals conflicting results. This study aimed to determine whether a longer reproductive period, as an indicator of longer exposure to endogenous estrogens, is associated with risk of transitioning to MCI and dementia. Women 65 and over (N=1507) from the Rush Memory and Aging Project met eligibility for the current analysis. The average length of reproductive period (menopause age minus menarche age) was 35 years (range=16-68 years), and 64% had natural menopause. Multistate survival modeling (MSM) was used to estimate the influence of reproductive period on risk of transitioning through cognitive states including mild cognitive impairment (MCI) and clinically diagnosed dementia, as well as death. Multinomial regression models estimated total and cognitively unimpaired life expectancies based on the transition probabilities estimated by the MSM. Results suggest that women with more reproductive years were less likely to transition from no cognitive impairment (NCI) to MCI, and were more likely to return to NCI from MCI. Analyses also suggest two additional years free of cognitive impairment for women with 45 vs 25 years of reproduction, though reproduction period did not significantly impact overall life expectancy. This study suggests that the number of years of reproductive duration is not associated with the transition to dementia, but is possibly associated with delayed cognitive decline, reduced risk of MCI, increased likelihood of returning to NCI from MCI, and increased lifespan free of cognitive impairment.
Effects of Tinnitus on Cognition and Depressive Symptoms Over Time
Authors: De Anda Jennifer , Warren Teresa , Bell Tyler , Kremen William , Franz Carol 
Published: December 2021

Abstract
Evidence suggests links among tinnitus, depression, and cognition. We examined these associations over time. We hypothesized baseline tinnitus would predict poorer cognitive performance and more depressive symptoms an average of 11.4 years later. We examined 839 men at two timepoints (baseline age M=55.94; follow-up age M=67.56). At each time point participants responded yes/no if they had tinnitus. We created three tinnitus status groups – no tinnitus at either time, tinnitus at both, and no tinnitus at baseline but tinnitus at follow-up. At both time points we measured cognitive performance with tests of episodic memory, processing speed, executive function, and verbal fluency. Depressive symptoms were based on the Center for Epidemiological Studies Depression scale. There was no association between tinnitus and any measure of cognitive performance. Depressive symptoms declined from baseline to follow-up. In separate mixed models predicting depressive symptoms, there was a significant main effect for tinnitus status at baseline (p = .003) and follow-up (p &lt; .001). Those with tinnitus at both times had significantly higher depressive symptoms than the “No tinnitus” group (p &lt; .001). This association remained significant after accounting for baseline depressive symptoms (p = .011) at follow-up. Results did not support the hypothesis that tinnitus would be associated with poorer cognitive function. However, depressive symptoms declined among those with no tinnitus than the other groups. The relationship between tinnitus and depressive symptoms may have implications for future cognitive performance among older adults, given previous evidence that depressive symptoms are risk factors for cognitive decline.