bluuebunny/crossref_metadata_2025_split huggingface dataset:
LIGHT EXPOSURE IN NURSING HOME RESIDENTS WITH DEMENTIA: IMPACT ON AFFECT AND NEUROBEHAVIORAL SYMPTOMS
Authors: Jao Ying-Ling , Liao Yo-Jen , Berish Diane , Wang Julian , Calkins Margaret , Chiu Ching-Ju , Kuan Yun-Han , Boltz Marie 
Published: January 2025

Abstract
Persons with dementia are at a higher risk for circadian disturbances and need more bright light to regulate circadian rhythm due to age-related vision deficiencies and reduced activity in suprachiasmatic nuclei. However, the impact of light exposure on nursing home (NH) residents with dementia has not been well evaluated. This secondary analysis examined the associations of daytime light exposure with affect and neurobehavioral symptoms in this population. Circadian stimulus (CS) was included as a lighting measure. Data of 13-week repeated measures were from a clinical trial with 27 residents with dementia. Participants wore light sensors to measure individual light exposure (lux, CCT, and CS) and Philadelphia Affect Rating Scale and Neuropsychiatric Inventory were used to assess affect and neurobehavioral symptoms every other week. Correlation and multilevel modeling (MLM) analyses were performed. Participants’ average age was 87 and 74% were female. Results showed that higher lux levels were significantly correlated with more contentment (r=0.162, p=0.0399) and less sadness (r=-0.185, p=0.0183), less depression (r=-0.157, p=0.0459), and less anxiety (r=-0.207, p=0.0081). Higher CCT levels were significantly correlated with less delusion (r=-0.182, p=0.0205) and appetite changes (r=-0.159, p=0.0434). Higher CS levels were significantly correlated with aberrant motor behavior (r=-0.171, p=0.0293) and anxiety (r=-0.210, p=0.0072). MLM showed that CS significantly predicted decreased aberrant motor behavior (β=-5.04, p&lt; 0.05), nighttime behavior (β=-4.85, p&lt; 0.05), and anxiety (β=-6.08, p&lt; 0.05). The results revealed the importance of light exposure in this population. The findings can guide environmental design to improve affect and neurobehavioral symptoms for NH residents with dementia.
LONGITUDINAL AUTOREGRESSIVE AND CROSS-LAGGED EFFECTS BETWEEN FRAILTY AND COGNITIVE FUNCTION OVER 14 YEARS
Authors: Kim Min Jung , Park Chang Gi 
Published: January 2025

Abstract
Frailty and cognitive impairment are common geriatric conditions with a strong association, though it remains unclear whether frailty leads to cognitive impairment or vice versa. Both conditions are typically irreversible and follow worsening trajectories that vary among individuals. This study examined the longitudinal autoregressive and reciprocal causal relationships between frailty and cognitive impairment, accounting for within-person processes, using a nationally representative sample, Korean Longitudinal Study of Aging 2006 to 2020. Frailty Index (FI) scores were derived from 33 items, while cognitive impairment was assessed using the Korean Mini-Mental Status Examination (K-MMSE). The sample included 3,853 adults aged 45 years or older at baseline with complete FI and K-MMSE data. A random-intercept cross-lagged panel model with robust maximum likelihood estimation was employed to address non-normality in the outcomes. The analysis revealed significant reciprocal causal relationships between FI and K-MMSE scores, with the strength of these relationships gradually increasing over time. The magnitudes of these relationships were comparable at each time point. Both FI and K-MMSE exhibited significant autoregressive effects, with FI showing consistently higher autoregressive coefficients than K-MMSE over the 14-year period. These findings suggest that frailty and cognitive function may serve as therapeutic targets for each other, with frailty being more persistent over time and cognitive impairment potentially influenced by other factors, including changes in frailty. Early interventions targeting either condition may yield synergistic preventive effects on both frailty and cognitive impairment, offering a valuable approach to managing these debilitating conditions.
LONGITUDINAL STUDIES OF COGNITIVE AGING: STUDY DESIGNS TO OPTIMIZE STATISTICAL POWER TO DETECT COGNITIVE DECLINE
Authors: Duehring Jasmin , Ong Lawrence , Edland Steven 
Published: January 2025

Abstract
Practice effects in longitudinal studies of cognitive function in aging and Alzheimer’s disease refer to the observation that performance on cognitive measures may improve on repeated assessments, because of increased familiarity with testing procedures and content of the tests. We have previously shown that a clinical trial run-in period intended to wash out practice effects can dramatically improve the efficiency of clinical trials. We now show that a run-in period can dramatically improve the efficiency and statistical power of longitudinal cohort studies of cognitive aging as well. Data are 1,094 participants with a baseline diagnosis of amnestic mild cognitive impairment (aMCI) enrolled in the National Alzheimer Coordinating Center (NACC) cohort (mean age 74.8, range 60 – 97, 44.1% female). In these data, the signal-to-noise in annual change after a run-period was approximately twice (2.4-fold) that observed without a run-in period. This increased signal translates to an 80% reduction in sample size required to detect a given effect of exposure, or, conversely, to an increase in statistical power given available sample size. For example, in the NACC cohort, p-values for detection of a one year change were p=0.086 without run-in, and p=8e-5 with a run-in period. Incorporating an early run-in period to longitudinal cohort studies of aging and Alzheimer’s disease can dramatically improve the statistical power of these studies to detect predictors of cognitive decline.
MULTILEVEL ANALYSIS OF AARC GAINS AND LOSSES IN OLDER ADULTS
Authors: Shiraishi Natsue , Yamamoto Yasuhiro , Nakagawa Takeshi , Horiuchi Takashi 
Published: January 2025

Abstract
This study investigates the factors associated with Awareness of Age-Related Change (AARC) gains and losses in older adults. Numerous educational institutions offer programs tailored to older adults, fostering continuous learning. Therefore, in the case of older people, lifelong learning, and not just educational history, should be investigated. Thus, this study examined whether lifelong learning as social participation is associated with AARC. We conducted a comprehensive analysis using an 12-month 3-wave survey collected between 2023 and 2024 (N=878, ages 70 and above at baseline). The independent variables were those measured at Time 1. AARC was analyzed in association with initial values. As a result, initial AARC-gain values were higher for those with more lifetime learning at Time 1. Our multilevel model results indicate that age (b = 0.02, p &lt; 0.001) and lifelong learning (b = 0.11, p &lt; 0.001) significantly are associated with levels of AARC-gains, while physical activity (b = -0.0002, p &lt; 0.001) and IADL (b = -1.49, p &lt; 0.001) are associated with levels of AARC-losses. No individual differences in slope were observed. These findings underscore the importance of continuous education and physical activity in mitigating age-related losses and enhancing gains, providing valuable insights for interventions aimed at improving the well-being of older adults.
NURSE STAFFING LEVELS AND OTHER FACTORS ASSOCIATED WITH NURSING HOME QUALITY
Authors: shin Juh Hyun , Harrington Charlene , Lee Soo-Kyoung , Ahn Jinhyun , Lee Yeonwoo , Ali Sanna 
Published: January 2025

Abstract
This study evaluated the quality of nursing homes (NHs) by analyzing deficiency citations reported by the Centers for Medicare and Medicaid Services (CMS). Key factors examined included CMS nurse staffing standards, ownership types, demographic characteristics, facility size, occupancy rates, geographic location, and Medicaid funding. Data from all U.S. NHs for Fiscal Year 2019 were sourced from CMS and LTCFocus, encompassing 13,086 facilities. Using ordinary least squares (OLS) regression, the study found that NHs with a total hours per resident day (HPRD) of 4.1 and registered nurse (RN) HPRD of 0.75 experienced fewer deficiency citations (1.18 and 0.8, respectively). In contrast, the CMS 2024 standards predict 3.48 total HPRD and RN HPRD of 0.5, with deficiencies of 0.82 and 0.6. The analysis showed that higher RN, licensed nurse, and certified nursing assistant HPRD correlated with reduced deficiency scores, indicating better quality. Conversely, higher bed occupancy rates were associated with fewer deficiencies, while increased proportions of non-White residents and urban locations correlated with more deficiencies. Additionally, larger facilities and those with higher Medicaid coverage had more deficiencies. Not-for-profit NHs generally had lower deficiency scores. These results emphasize the crucial role of adequate nurse staffing in maintaining NH quality and illustrate how various provider characteristics influence deficiency levels.
ORAL FRAILTY ASSESSMENT TOOL: INSTRUMENT DEVELOPMENT AND CROSS-SECTIONAL VALIDATION STUDY
Authors: Wan Qiaoqin , Yang Yue , Yang Chengfengyi 
Published: January 2025

Abstract
Oral frailty is widespread in older adults, which will gradually contribute to multiple adverse health outcomes. The current assessment tools may not comprehensively assess oral frailty, thus a practical and feasible oral frailty scale is needed. The study aimed to develop an oral frailty assessment tool and evaluate its psychometric properties. The scale was developed in two stages. First, based on the Gilbert Multidimensional Conceptual Model of Oral Health, the items were generated through a literature review and Delphi expert correspondence. For psychometric analysis, content validity, structure validity, concurrent validity, convergent and discriminant validity, and internal consistency reliability of the scale were assessed. Data were collected from a convenient sample of 372 Chinese older adults, and exploratory and confirmatory factor analyses were used. The diagnostic accuracy was further conducted through receiver operating characteristic curve analysis. The newly developed scale consisted of five dimensions and 16 items. The content validity of the scale was 0.974, with 0.649 for concurrent validity, and the aggregation and differentiation validity were ideal as well. Besides, the samples were cross-validated by exploratory factor and confirmatory factor analyses. The internal consistency reached 0.865, and the retest reliability was 0.940. Meanwhile, by comparing the diagnostic accuracy with Oral Frailty Instrument-6 (OFI-6), it was found that the cutoff value was 9.5. Findings demonstrate that the Oral Frailty Assessment Tool has acceptable content validity, structure validity and reliability in measuring oral frailty. A wider range of cultures and samples are needed to refine the scale.
PHYSIO-FEEDBACK EXERCISE PROGRAM (PEER) ON ACCELEROMETER-BASED DATA: A SMOOTHING SPLINE ANOVA MODEL
Authors: Liu Chang , Liu Yi , Thiamwong Ladda , Nguyen Tho , Zhang Wei , Xie Rui 
Published: January 2025

Abstract
Exercise is crucial for reducing falls in older adults. Physio-fEedback Exercise pRogram (PEER) consists of physio-feedback, cognitive reframing, and peer-led exercises that can reduce fall risk. However, there is a lack of data on the outcome of PEER on physical activity (PA) that may provide valuable insights for immediate and long-term improvements. We examined the effectiveness of PEER intervention on the daily PA level from 64 low-income older adults (mean age = 73.1 ± 6.26 years, female 87.5%), randomized into either PEER or control groups. The PEER group participated in weekly exercise sessions led by a trained peer for 8 weeks, followed by 13 weeks of follow-up, while the control group data was collected over a similar 21-week period without intervention. Physical activity was measured using a commercial accelerometer (Fitbit device). Data were categorized into sedentary, lightly active, moderately active, and very active minutes. We evaluated the peer-led group exercise days on four daily activity levels using a Smoothing Spline ANOVA (SSANOVA) model with partial splines and incorporated parameter covariates into the classic SSANVOA model. The results indicated a significant increase in moderately active and very active minutes in the PEER group during the 8-week intervention period, highlighting the short-term effectiveness of the program. We also observed the attenuation of the intervention’s effects over the 13-week follow-up across all four activity levels. PEER intervention significantly boosts daily activity levels among older adults in the short term, and sustained efforts may be necessary to maintain these benefits over the long term.
PRESENTING VISION IMPAIRMENT AND RESIDENTIAL CARE USE AMONG OLDER ADULTS
Authors: Brault Matthew 
Published: January 2025

Abstract
Nursing home and assisted-living facility use is common among older adults but is financially burdensome. Identifying risk factors for residential care use may focus attention on interventions that reduce or delay need for these services. Using data from the National Health and Aging Trends Study (NHATS) from 2021 (Round 11) and 2022 (Round 12), we measured the association of presenting visual acuity and contrast sensitivity on residential care use. Survey participants were assessed for presenting distance and near visual acuity and contrast sensitivity using a tablet-base examination tool. Residential care status, determined by the location of the Round 12 interview, was modeled as a function of vision impairment and relevant confounders using logistic regression. Of 2,727 participants, 2.1% were in residential care in 2022. Presenting near (19%) and distance acuity impairment (9%) were not associated with residential care, with adjusted odds ratios (aOR) of 1.48 (95% CI: 0.68 – 3.22) and 0.55 (0.17 – 1.81) respectively. Presenting contrast sensitivity impairment (24%) was associated with higher odds of residential care (aOR: 2.16 [95% CI 1.20 – 3.88]). This association was mediated by covariates for gait speed and recurrent falls. Results suggest that contrast sensitivity impairment may represent a separate risk factor for residential care use, apart from physical frailty or cognitive decline. Interventions to address or prevent eye diseases associated with impaired contrast sensitivity could reduce or delay residential care placement, a possibility that requires further investigation.
PREVALENCE OF POSSIBLE SARCOPENIA AND ASSOCIATED FACTORS AMONG OLDER HOMELESS ADULTS IN HOME FOR DESTITUTE
Authors: Whaikid Phatcharaphon , Piaseu Noppawan , Srisuk Wasana 
Published: January 2025

Abstract
Sarcopenia is a significant problem leading to increased morbidity and mortality risk, particularly in older homeless adults in home for destitute as they are vulnerable and are experiencing premature degeneration. The Asian Working Group for Sarcopenia (AWGS) 2019 introduces possible sarcopenia for early prevention of sarcopenia. Therefore, this study aimed to describe the prevalence and risk factors of possible sarcopenia among older homeless adults. This cross-sectional study included 163 older homeless adults aged 50 and above in homes for destitute in Thailand. The participants completed a questionnaire on personal and health-related factors, and assessments according to AWGS 2019 criteria. Data were analyzed using descriptive statistics and multinomial logistic regression. Results revealed that the prevalence of case finding, and possible sarcopenia was 74.9% and 71.2%, respectively. Among participants aged 50-59, the prevalence rates were 60.8% and 55.1%, while those aged 60 years and over showed a significantly higher prevalence of 90.8% and 89.5%, respectively. Multinomial logistic regression analysis revealed four risk factors significantly associated with possible sarcopenia, including age, gender, BMI, and number of comorbidities (odds ratio (OR) = 1.253, 95% confidence interval (CI) = 1.117-1.405, OR =.222, 95% CI =.056-.874, OR =.584, 95% CI =.458-.745, and OR =.308, 95% CI =.109-.868, respectively). This study confirmed that possible sarcopenia can begin as early as age 50, aligning with indications of premature degeneration in this population. Therefore, it is recommended to start screening earlier than usual to ensure proper management and delay the progression of sarcopenia.
PRIMARY LANGUAGE’S ROLE IN SOCIAL INTEGRATION AND FUNCTIONAL INDEPENDENCE AFTER TRAUMATIC BRAIN INJURY
Authors: Jung Wonkyung , Taylor Janiece 
Published: January 2025

Abstract
Social integration is an ultimate goal of neurorehabilitation and linked to better functional outcomes. However, older immigrants whose primary language is not English may have difficulties reintegrating into society after their injuries. This study investigated the moderating role of primary language in the relationship between social integration and functional independence following traumatic brain injury (TBI) among older adults at the first-year post-injury. Data were obtained from the Traumatic Brain Injury Model System National Database (TBIMS-NDB). Using Hayes’s PROCESS macro-Model 1, data were analyzed to assess the impact of social integration and primary language on functional independence. We finally had 1442 older adults aged between 65 and 88 years at the time of TBI. The results revealed that social integration significantly influenced functional independence (β = 11.399, p &lt; 0.001), while primary language had an insignificant impact (β = -3.735, p = 0.051). Additionally, a significant interaction effect was found between social integration and language (β = 6.912, p = 0.006), indicating that the relationship between social integration and functional independence was moderated by primary language. The model explained a substantial proportion of the variance in functional independence (R-Square = 0.328). Further analysis showed that the effect of social integration on functional independence varied based on language proficiency, with a stronger association observed among non-native English speakers (β = 25.224) compared to native English speakers (β = 18.311). These findings highlight the need to consider primary language in interventions to improve social integration and functional outcomes for older adults with TBI.
QUANTIFYING NURSING HOME CARE QUALITY FOR OLDER HIV AND SEXUAL AND GENDER MINORITY POPULATIONS: A SCOPING REVIEW
Authors: Moriarty Haley , Wong Chelsea , Olivieri-Mui Brianne 
Published: January 2025

Abstract
Standardized quantitative measures of nursing home (NH) care quality for older people with human immunodeficiency virus (HIV) or sexual and gender minority (SGM) populations are sparce. This scoping review identified the current literature empirically measuring quality of care in NHs for people with HIV (PWH) and SGM populations including, but not limited to, validated measures endorsed by national organizations. The initial librarian-assisted search strategy across four databases resulted in 764 articles. Literature that quantified care quality for HIV (8 studies) or SGM (1 study, 1 report) populations in the NH setting were included. No studies examined the overlap of HIV and SGM populations nor were there studies of general clinical care for either population. The lowest quality was seen with measures of ART prescriptions (n=4/8 studies) and CD4/viral load monitoring (n=2/8 studies). NHs tended to have lower overall care quality (e.g. antipsychotic prescribing, star rating, rehospitalizations) for PWH v people without HIV unless PWH were the majority patient population (n=4/8). One study and one report measured staff/clinicians’ levels of discrimination toward SGM populations finding low willingness to provide care and high rates of refusal to admit SGM patients, respectively. There is insufficient empirical data measuring clinical care quality for SGM using NHs. In conclusion, HIV care quality in NHs has been measured but general clinical care quality for PWH using NHs has not. The growth of the aging HIV and SGM populations demands more research empirically evaluating NH care quality beyond HIV care and including intersecting HIV and SGM identities.
RESULTS OF A STEPPED EXERCISE PROGRAM AMONG VETERANS WITH KNEE OSTEOARTHRITIS AND CO-OCCURRING BACK PAIN
Authors: Burrows Brett , Woolson Sandra , Coffman Cynthia , Allen Kelli 
Published: January 2025

Abstract
Co-occurring back pain can exacerbate an already high risk of disability among patients with knee osteoarthritis (OA). We described the effect of a stepped exercise program for patients with knee OA (STEP-KOA) versus arthritis education (AE) on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for participants with and without co-occurring back pain. Veterans with knee OA (n= 345) were randomized 2:1 to STEP-KOA or AE control group that received mailed materials. STEP-KOA began with 3 months of internet-supported home exercise (Step 1), followed by 3 months of bi-weekly physical activity coaching (Step 2), then 3 months of physical therapy (Step 3) if participants did not make clinically relevant improvement in pain or function with the prior step. WOMAC, which assesses lower-extremity pain, stiffness and function was the primary outcome at 9 months. Self-reported back pain was reported at baseline. Differences in mean WOMAC scores at 9-months were compared between arms in those with and without back pain using t-tests. Overall, 72.4% (n=250) reported having co-occurring back pain. Among participants with co-occurring back pain (n= 176), 9-month mean WOMAC score was 10.1 points lower (95% CI -15.5, -4.7; p&lt; 0.001) in STEP-KOA vs. AE. Among participants without co-occurring back pain (n= 79), 9-month mean WOMAC score did not differ between arms (Mean Difference= 4.3; 95% CI -5.3, 13.9; p=0.37). In conclusion, among participants with co-occurring back pain, the STEP-KOA intervention resulted in a significant reduction in mean WOMAC score at 9-months compared to AE alone.
SINGLE AND DUAL-TASK SPATIOTEMPORAL GAIT ANALYSIS OF OLDER ATHLETES PARTICIPATING IN THE NATIONAL SENIOR GAMES
Authors: Leach Susan , Doerfler Deborah , Schilz Jodi , Vallejo Rose , Jordre Becca , Jones Beth Moody 
Published: January 2025

Abstract
One purpose of this study was to gather normative spatiotemporal gait parameters in older athletes and determine differences under three walking conditions: Forward Usual Single Task, Forward Usual Dual Task, and Forward Fast Single Task. Post hoc analyses were explored to determine a) the impact of a cognitive dual task during usual speed on gait parameters b) to determine the impact of a change in gait speed from usual to fast on gait parameters. A secondary purpose was to determine if Open, Closed or Continuous sport category influenced gait parameters. It was hypothesized that gait parameters would change with the addition of a dual task, with increased speed, and sport category. Regarding methodology, participants included 335 athletes 50 years or older in this single center cross-sectional, quasi-experimental study. Spatiotemporal gait parameters were quantified using ProtoKinetics’ Zeno Walkway system. A multivariate analysis of variance compared gait parameters under three walking conditions. Post-hoc analyses determined the impact of a cognitive dual task during usual walking speed, and a change in gait speed from usual to fast. Results indicated a significant effect of walking condition on all spatiotemporal gait parameters. From single to dual task, all gait parameters were significant with the exception of stride width coefficient of variation. From usual to fast speed, select gait parameters were significant. Sport category also demonstrated changes in select gait parameters. To conclude, normative spatiotemporal gait parameters were established for older athletes in three walking conditions and differences identified.