bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEVELOPMENT AND VALIDATION OF THE CLINICAL PHYSICAL RESILIENCE ASSESSMENT SCALE (CHEES) IN OLDER ADULTS
Authors: Ma Lina 
Published: January 2025

Abstract

Objective
Physical resilience is an emerging concept that describes an individual’s capacity to recover from stressors. However, few instruments are currently available for assessing physical resilience. We aimed to develop and validate an easy-to-use physical resilience scale, Clinical pHysical rEsilience assEssment Scale (CHEES), in Chinese older adults.

Methods
Delphi method was used to establish an initial scale. Psychometric evaluation of the scale was then tested on 172 older adults. The reliability and validity of CHEES was tested in 1982 community-dwelling and 362 hospitalized older adults. Cronbach’s α coefficient, Spearman-Brown coefficient and Guttman coefficient were used for reliability test. Validity was assessed by content validity and construct validity based on exploratory factor analysis.

Results
After two rounds of expert consultations, three primary and 16 secondary items were determined. Two items were removed after the psychometric evaluation. The final CHEES containing three primary (“intrinsic capacity”, “adapt to change”, and “external support”) and 14 secondary items showed promising properties both in community-dwelling and hospitalized older adults. The acceptance rate of the CHEES was 90.88%, and the qualified rate of the scale was 100%. The Cronbach’s α coefficient of the total scale was 0.826, Spearman-Brown coefficient was 0.737, and Guttman coefficient was 0.731. Exploratory factor analysis extracted three common factors. The factor load of each item was 0.446-0.656, and the cumulative variance contribution rate was 57.49%. Conclusions: CHEES has good reliability and validity, and is suitable for the evaluation of physical resilience of the older adults in both hospital and community.
EXPLORING DIGITAL LITERACY, HEALTH LITERACY, AND SELF-MANAGEMENT IN YOUNGER AND OLDER LIVER TRANSPLANT RECIPIENTS
Authors: Lee Hanna , Choi JiYeon , Choi Seongmi , Chu Sang Hui 
Published: January 2025

Abstract
Liver transplant recipients (LTRs) face challenges in self-management, including adhering to immunosuppressant therapy and navigating healthcare systems. Adequate health literacy enables LTRs to manage daily tasks, while digital proficiency enhances self-management. Understanding health and digital literacy among older LTRs is crucial for targeted self-management strategies amidst increasing digitalization and liver transplantation in older adults. This descriptive study compared health literacy, digital literacy, and self-management between younger LTRs (&lt; 60 years; n=97, 50.88±7.19 years, 27 male, 20.57±17.42 months since LT) and older LTRs (≥ 60 years; n=58, 64.52±3.48 years, 21 male, 27.33±16.21 months since LT) and explored associations among these variables. LTRs responded to a cross-sectional survey on digital literacy (Everyday Digital Literacy Questionnaire, 22 items), health literacy (European Health Literacy Survey, 16 items), and self-management (modified Transplant Self-Management Scale, 16 items). Younger and older LTRs differed in self-management (56.95±9.43 vs 61.83±7.73, p&lt; 0.001) and digital literacy (85.58±16.99 vs 71.17±22.98, p&lt; 0.001), but not health literacy (13.62±3.43 vs 13.50±3.30, p=0.833). When exploring the role of health literacy and digital literacy in predicting self-management in the entire sample after controlling for age, sex, education level, household income, and time since LT, health literacy had a significant association with self-management (B=0.479, p=0.04) whereas digital literacy did not (B=0.007, p=0.87). In our sample, older LTRs reported better self-management and similar health literacy levels but poorer digital literacy compared to younger LTRs. Supporting digital literacy in older LTRs may enhance their self-management. Further studies are needed to understand digital literacy and self-management in older LTRs.
QUADRICEPS MUSCLE THICKNESS MEASURED BY POINT-OF-CARE ULTRASOUND AND HOSPITAL LENGTH OF STAY
Authors: Ganbat Uyanga , Byambaa Altan-Ochir , Meneilly Graydon 
Published: January 2025

Abstract

Background
Accurate prediction of hospital length of stay (LOS) and readmission rates could help improve effective healthcare resource allocation. Recent evidence suggests point-of-care ultrasound for muscle assessment, specifically muscle thickness, as a promising tool in this regard. This study explores the hypothesis that ultrasound measurements of quadriceps muscle thickness (MT) and echointensity (EI) can serve as predictors for these crucial patient outcomes.

Methods
The study measured quadriceps MT and EI using point-of-care ultrasound for patients in a supine position in the emergency department of Vancouver General Hospital. Predictor variables included age, sex, muscle thickness, and echo intensity. Outcome variables were hospital LOS, readmission rate, and discharge destination. Follow-up was conducted after one month to assess hospital readmissions and mortality.

Results
A total of 120 participants were included (average age 76.9 ± 7.5, with 64 women and 56 men). Mean LOS was 27.4 ± 31.4 days, and mean MT was 20 ± 6 mm. Sex-based differences in MT were statistically significant (P = 0.032). MT correlated significantly with LOS (Standardized β = -0.152 ± 0.016, R² = 0.290, P = 0.001). In the multivariate regression model, MT remained a significant predictor (Standardized β = -0.152 ± 0.563, P = 0.008).

Conclusion
Muscle thickness is a significant predictor of hospital stay duration. The findings of this study indicate the potential of point-of-care ultrasound in measuring skeletal muscle as an effective predictor of discharge outcomes.
INDUCIBLE SKELETAL MUSCLE SOD2 KNOCKDOWN MIMICS AGE-RELATED MITOCHONDRIAL DYSFUNCTION IN MOUSE SKELETAL MUSCLE
Authors: Ostrom Ethan , Sandhu Sahir , Marcinek David 
Published: January 2025

Abstract
Aging causes declines in mitochondrial energetic efficiency and increased reactive oxygen species (ROS) production in skeletal muscle, leading to declines in muscle function and impaired stress resilience. While perturbations in redox homeostasis have been associated with declines in muscle and mitochondrial function, the mechanisms and time course of this decay have not been established. Here we use a new model of inducible skeletal muscle specific knockdown of SOD2 (KD) to produce an oxidative stress and compare the functional declines to those seen in aging muscle mitochondria. We demonstrate the model induces skeletal muscle specific SOD2 protein KD by 50% at 3 weeks and 90% decrease by 8 weeks. KD showed a significant decline in in vivo muscle force in female KD mice (p=0.0249), but not male KD mice compared to controls at eight weeks. KD resulted in significant reductions in aconitase 2 (ACON2) activity an enzyme sensitive to oxidative stress. Similar to aged skeletal muscle, KD showed significant deficits of complex I-driven respiration (p&lt; 0.0001), max oxphos capacity (p=0.0001), and maximal ROS production rate (p&lt; 0.05) in permeabilized muscle fibers. Interestingly, the CI impairment in SOD2 KD was dependent the order of substrate addition indicating that SOD2 KD affects metabolic flexibility of the mitochondria. These results show that short term redox stress reproduces some aspects of aged skeletal muscle mitochondria. Ongoing experiments are testing the metabolic and molecular mechanisms underlying impaired metabolic flexibility related to elevated redox stress in the SOD2 KD and their relevance to aging muscle.
INTEGRATED PERSON-CENTERED INTERVENTIONS FOR OLDER PEOPLE’S CARE IN SWEDEN: SCOPING REVIEW AND EXPERT OPINION
Authors: Kirvalidze Mariam , Boström Anne-Marie , Liljas Anne , Doheny Megan , Hendry Anne , McCormack Brendan , Agerholm Janne , Calderón-Larrañaga Amaia 
Published: January 2025

Abstract
The recent shift towards a holistic, person-centered approach to older people’s care that considers a person’s overall well-being requires collaboration within and between medical and social healthcare organizations. To map and contextualize the scientific literature on the effectiveness of integrated person-centered care interventions, including implementation experiences in Sweden. Publications were identified by searching MEDLINE and contacting experts. Workshop discussions in Stockholm (Sweden), on 21/03/2023, were recorded and transcribed. Original peer-reviewed articles published in Swedish or English from 01/01/2000 to 10/03/2023, were screened. Evidence from included studies was narratively synthesized and interventions were categorized using two frameworks: (1) Integrated Care for Older People (ICOPE) and (2) Integrated People Centered Health Services (IPCHS). Workshop discussions were thematically summarized. We included 73 publications analyzing 31 unique and heterogeneous interventions pertaining, mainly, to the micro and meso levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability in 48%, and service utilization in 58%. Experts emphasized the need for participatory designs and shared ownership for adoption and scalability of interventions, and transitions from person- to people-centered integrated care. In conclusion, integrated person-centered care interventions demonstrated the strongest evidence for the optimization of service utilization. Unexpectedly, evidence for health outcomes was less consistent. This could be due to several issues mentioned by the experts, such as poor evaluation practices, lack of participatory research approaches, and scarcity of macro-level initiatives. Our findings offer internationally transferable perspectives on the real-world challenges in delivering integrated care.
PATIENT PORTAL USE, PATIENT TRUST, SOCIAL DETERMINANTS OF HEALTH, AND SHARED DECISION-MAKING AMONG US OLDER ADULTS
Authors: Chen Yuling 
Published: January 2025

Abstract

Background
Shared decision-making (SDM) and patient portals are increasingly embraced in health care and recommended in cardiovascular disease (CVD) guidelines. This study investigated the associations between patient portal use, patient trust in the healthcare system, social determinants of health (SDOH), and patient involvement in SDM among adults 65 years or older with or at risk of CVD.

Methods
We conducted a cross-sectional study of US adults from the 2022 Health Information National Trends Survey. CVD risk was defined as reporting a heart condition, diabetes, hypertension, and/or current smoking. SDM was measured by asking how often patients’ providers involved them in health decisions over the past year. A weighted multivariable logistic regression model was employed, adjusting for sociodemographic and clinical characteristics.

Results
The study included 1,139 older adults with or at risk of CVD, with a mean age of 73.5 (SD 6.7) years. The sample included 54.0% females; 66.4% identified as white. Older adults who accessed the patient portal 6 to 9 times in the past year were 1.98 times more likely to engage in SDM (95% CI 1.13-3.48) compared to those without access. Older adults with high trust in the health system were 3.15 times more likely to engage in SDM (95% CI 1.89-5.23) than those with low trust. However, SDOH (inability to afford meals, being forced to move, and lack of transportation) was not significantly associated with SDM.

Conclusion
These findings underscore the vital role of utilizing patient portals and fostering trust in enhancing older adults’ engagement in SDM.
A CRISIS LEADERSHIP FOR NURSE MANAGERS IN CRISIS SITUATIONS: DEVELOPMENT AND PSYCHOMETRIC EVALUATION
Authors: Kim Sun Ju 
Published: January 2025

Abstract
Crisis situations such as COVID-19 have a negative impact on society and the economy, with increased mental health issues, medical crises, and mortality among nurses. The inadequate leadership of nurse managers during crisis situations can negatively impact the quality of patient care and infection transmission. Consequently, the aims of this study were to develop a crisis leadership scale for nurse managers and to evaluate its psychometric properties. For the development of the initial items, the literature was reviewed along with the existing measuring tools. This study was conducted from August to October 2023. A total of 443 nurse managers in 34 hospitals in Korea participated in the study to verify the validity and reliability of the instrument. The exploratory and confirmatory factor analyses yielded a five-factor solution, while the confirmatory factor analysis showed a good fit (RMSEA =.07, SRMR =.02, CFI =.92, TLI =.91). Therefore, the final instrument was derived, containing 28 items on “crisis management competency” (12), “decision-making” (6), “collaboration” (4), “communication” (3), and “building trust” (3), as well as 5 factors, scored on a 5-point Likert scale. The Cronbach’s α for this instrument was.96. In conclusion, the crisis leadership scale showed good psychometric properties for four validity metrics (content, construct, convergent, discriminant and criterion validity) and internal reliability. These findings indicate that the instrument can be applied in both research and clinical practice, being capable of quantitatively measuring the degree of crisis leadership skills of nurse managers.
ANTI-AMYLOID THERAPIES FOR ALZHEIMER’S DISEASE: PATIENTS’ AND FAMILIES’ PERCEPTIONS
Authors: Lucca Kaitlyn , Lapins Allison , Morhardt Darby 
Published: January 2025

Abstract
With new drug therapies available aimed to slow the progression of Alzheimer’s Disease (AD), this study hopes to gain insight into the perceptions, concerns and perceived barriers from patients and families who are impacted by AD. Drug consultations for these therapies are currently taking place at the Northwestern Neurobehavior and Memory Clinic with potentially eligible patients and their families. Study aims are to: 1) measure patient and family perception, barriers and concerns of the drug therapy following a formal consultation or informal discussion with a neurologist, and 2) gather data on the patient and family experience with the drug consultation as a method for making an informed decision. After consultation with their behavioral neurologist, participants are asked to complete the survey with a study team member. To date, 10 participants have completed the survey following consultation with a neurologist. Preliminary results found the highest reported concerns with starting anti-amyloid therapies to be medical complications [larger brain bleeds, brain swelling, micro-hemorrhages] and financial burden. The majority of participants’ interest levels remained the same or were increased following the consultation. Those who reported a decrease in interest level were concerned that the therapy would not be impactful on their daily life. Families will continue to be surveyed following consultation with a neurologist with additional results reported in the coming months.
INTEGRATED PRIMARY CARE MODEL FOR PEOPLE LIVING WITH DEMENTIA REDUCES HIGH-RISK MEDICATIONS AND HOSPITALIZATIONS
Authors: Clevenger Carolyn , Khakharia Anjali , Medders Laura , Moore Miranda 
Published: January 2025

Abstract
Harmful care including the prescribing of high-risk and potentially inappropriate medications for older people is widespread among older adults, including people living with dementia (PLWD). Integrated Memory Care (IMC) is a comprehensive dementia care model where patients and their family caregivers access dementia-sensitive geriatric primary care. The IMC conducted a retrospective observational study of patients of IMC, Cognitive Neurology (CN), and Primary Care (PC) clinics aged 65 and older with a diagnosis of dementia in 2019-2021. We matched patients by age, gender and race and measured the hospitalization, rate of deprescribing and inappropriate screening test referrals using logistic regressions controlling for clinic. Additionally, we conducted a regression adjusted for state of illness (proxied by activities of daily living (ADL)) for the IMC and CN clinics. IMC patients had higher odds of deprescribing high dose antipsychotics, benzodiazepines, and opiates when compared to CN patients. IMC also had higher odds of deprescribing high dose antipsychotics, benzodiazepines, and opiates when compared to PC patients. For hospitalizations, CN had 10% [2 times] higher odds, when compared to IMC patients in unadjusted models. After adjusting for ADL scores, CN patients had 66% higher odds of having a hospital admission during the study period. Dementia-sensitive primary care reduces the rate of total and ambulatory-sensitive hospitalizations reducing healthcare costs and causing less disruption to care as well as reduces inappropriately prescribed medications among PLWD.
TRANSFORMATIVE CARE: LIFESTYLE INTERVENTIONS IN UNDERSERVED AGING
Authors: Neises Kristen 
Published: January 2025

Abstract
In response to the escalating challenges posed by an increasingly aging population in the United States, particularly in rural areas, an urgent demand arises for innovative healthcare solutions. This presentation illuminates the formidable hurdles faced by older adults with multiple chronic conditions, most of which result from lifestyle. The Optimal Aging Lifestyle Medicine (OALM) program emerges as a catalyst for transformative change in older adult care. Focused on medically underserved regions, this program empowers healthcare professionals through education in age and dementia-friendly lifestyle medicine, emphasizing evidence-based lifestyle interventions for preventing, managing, and reversing chronic diseases. The OALM program forges a collaborative care approach, uniting professionals across disciplines using the Flourish Model and extending outreach via Project ECHO to remote rural areas. Its mission encompasses filling training gaps by educating healthcare workers across Kentucky and evolving a traditional geriatric clinic into an innovative lifestyle medicine center for older adults. This presentation delves into the integration of lifestyle medicine into geriatric clinics, explores older adults’ perspectives on care through focus group discussions, and the development of an interdisciplinary lifestyle medicine curriculum. Case studies will spotlight a resilient patient care approach, highlighting successes and addressing challenges in groundbreaking initiatives navigating the intricacies of geriatric care, ultimately optimizing aging outcomes and reshaping narratives in rural communities.
ADHERENCE TO INTERVENTIONS AND COGNITIVE CHANGES IN FALLEN OLDER PEOPLE: RANDOMIZED CLINICAL TRIAL
Authors: Ansai Juliana , Pereira Graziele Norberto , de Melo Mariana Luiz , Sossai Mariana Ignácio , Maciel Leticia Teodoro , Silva de sá Mel , Dias Ana Laura Oliveira , Gramani-Say Karina 
Published: January 2025

Abstract
Falls are an important health challenge for older people and society. Understanding how to reduce cognitive risk factors for falls is essential to develop effective prevention strategies. The purpose of this work was to assess the impact of adherence to interventions on cognitive changes after 16 weeks in older people with a history of falls. A controlled, randomized, single-center clinical trial was conducted with brazilian community-dwelling older adults with a history of recurrent falls in the past 12 months. Participants were allocated to Intervention Group (IG) and Control Group (CG). The IG underwent case management, including multidimensional assessment, explanation of fall risk factors, proposal of intervention based on risks, development of an individual fall intervention plan, plan monitoring and review. The CG received monthly health-related guidance. The assessment included cognitive measures (Addenbrooke’s Cognitive Examination ACE-R, Mini-Mental State Examination, Verbal Fluency tests, Clock Drawing test CDT) at baseline and after 16 weeks, and adherence (frequency) to the intervention after 16 weeks. As results, the sample was composed by 55 participants (26 CG, 29 IG). The mean adherence to intervention was 80.27%. The IG improved the TDR performance, compared to the CG (p=0.034). Both groups presented a non-significant improvement in the ACE-R score over time. Adherence to the case management intervention did not influence changes in cognitive risk factors for falls (p&gt;0.050). This findings point the need to understand better the factors related to improvement on risk factors for falls, to achieve personalized approaches in older people.
HARMONIZATION OF LATER-LIFE COGNITIVE FUNCTION ACROSS POPULATION-BASED COHORT STUDIES: RESULTS FROM HRS AND NHATS
Authors: Chen Diefei , Sekhon Vishaldeep , Roth David , Kaufmann Christopher , Gross Alden 
Published: January 2025

Abstract
Population-based cohort studies offer unique opportunities to study characteristics of people at greatest risk for cognitive decline. Harmonizing large, well-characterized cohorts powers investigations into subgroups or rare exposures/outcomes in their associations with cognitive decline. We derived a harmonized cognition score based on cognitive tests from the Health and Retirement Study (HRS) and the National Health and Aging Trends Study (NHATS), two of the largest nationally representative cohorts of older adults in the US. Using an item banking approach based on item response theory, we leveraged tests conducted in 2012-2018 Core interviews of two studies to leverage both common (i.e. anchors) and unique items to statistically harmonize a general cognition factor score. We evaluated concurrent and predictive criterion validity of the harmonized scores by 1) cross-sectionally comparing scores at baseline (year 2012) with algorithmically defined cognitive impairment status and demographics, and 2) longitudinally assessing associations between demographics and established risk factors for cognitive decline with cognitive trajectories using mixed effects models. Cross-sectionally, the harmonized score was lowest among dementia/probable dementia group (mean = -1.84, sd = 0.75). Longitudinally, cognitive decline was steeper for participants reporting hypertension (b = -0.04, se = 0.002), stroke (b = -0.06, se = 0.004), or diabetes (b = -0.04, se = 0.003) compared to those without. Inferences were similar in each study separately. This harmonized score using data from HRS and NHATS had strong criterion validity, and can be a resource for aging researchers to examine the rare factors associated with cognitive performance in diverse populations.