bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors of Going Missing in People Living With Dementia: A Scoping Review
Authors: Neubauer Noelannah , Perez Hector , Miguel-Cruz Antonio , Daum Christine , Marshall Samantha Dawn , Letts Elyse , Liu Lili 
Published: December 2021

Abstract
Critical wandering is common in persons living with dementia, it is defined as wandering that results in an individual going missing. This exposes the missing vulnerable older adult to risks and dangers. Persons with dementia who become lost and go missing and get lost can face adverse outcomes, such as injury and death, yet the amount of information available on the risk factors associated with these incidents is scarce. The aim of this study was to identify the risk factors associated with critical wandering in persons living with dementia. We used Tricco et al.’s (2018) approach for scoping reviews and searched the following databases: Medline, EMBASE, CINAHL, and Scopus. We included studies that referred to critical wandering in persons with dementia, cognitive impairment, or Alzheimer, and published since 1980. We identified 3,376 publications, which was reduced to 1641 publications after we removed duplications. A total of 78 studies met the inclusion and exclusion criteria for analysis and extraction. A rigorous process to synthesize and categorize the research evidence was followed. We identified four different types of risk factors associated with going missing: (1) personal, (2) physical environment and geographical location, (3) cultural environment, and (4) social environment and support resources. Recognition of these risk factors can help persons living with dementia and their care partners identify interventions and proactive strategies to mitigate or prevent critical wandering. This will support persons with dementia, their care partners, and community organizations to balance safety, autonomy, and independence to maximize quality of life.
Underdiagnosis of Dementia among Indigenous Older Adults with Cognitive Impairment
Authors: Amano Takashi , Gallegos Carlos Andres , Waters William , Freire Wilma 
Published: December 2021

Abstract
Early and timely diagnosis of dementia has been recognized as key to improving health outcomes. However, underdiagnosis among the indigenous population has not been adequately investigated. This study examines the association between indigenous ethnic identity and receiving a diagnosis of dementia and identifies factors associated with receiving a diagnosis of dementia. Data were drawn from Ecuador’s Survey of Health, Welfare and Aging (SABE) – 2009, based on a probability sample of households in Ecuador with at least one person 60 years or older. This is a robust data set that allows for understanding ethnic dimensions and disparities, especially because of the successful recruitment of indigenous households. The final sample consisted of 1,437 people who had cognitive impairment. Whether participants had ever been told that he/she had dementia was compared between the groups of people who identified themselves either as indigenous or others. Binary logistic regression analysis was utilized. Indigenous participants had a lower probability than others of receiving a diagnosis of dementia after controlling for health and function related covariates. This association became statistically insignificant after including socioeconomic factors in the model. The final model revealed that people who had higher educational attainment were more likely to receive a diagnosis of dementia. Findings suggest that underdiagnosis among indigenous older adults can be explained by their lower socioeconomic status rather than by health and functional status. This finding implies the possibility of developing strategies to promote timely diagnosis by targeting populations who are especially susceptible to underdiagnosis of dementia.
Detecting early signs of Alzheimer’s disease and related dementia onset from the EHR
Authors: Schliep Karen , Shepelak Zachary , Bitter Nicolas , Gouripeddi Ramkiran , Ostbye Truls , Smith Ken , Abdelrahman Samir , Tschanz Joanne 
Published: December 2021

Abstract
As dementia is widely under-detected, a predictive model using electronic health records (EHR) could provide a method for early screening to implement preventive strategies. There is limited research on using EHR to identify persons with Alzheimer’s disease (AD) and related dementias (RD). In a data-driven approach, we used all ICD-9 diagnosis and CPT procedure codes from statewide inpatient, ambulatory surgery, and Medicare records, in addition to age at baseline and gender, to detect AD/RD from the Cache County Study on Memory in Aging (1995–2009). After removing participants diagnosed with dementia at baseline (n=335), 3882 (82%) Cache County Study participants could be linked to inpatient, ambulatory surgery, and/or Medicare EHR records; 484 (12.5%) of these 3882 had incident all-cause dementia, with 308 (7.9%) having AD/AD comorbid with RD; and 176 (4.5%) having RD without AD. We removed participant’s ICD-9 codes occurring after first AD/RD diagnoses. EHR features (~2000) along with gold-standard diagnoses as class labels were then used to train and detect AD and/or RD using a Gradient Boosting Trees machine learning algorithm. Models evaluated with nested cross-validation yielded AUCs of 0.70 for all-cause dementia, 0.69 for AD/AD comorbid with RD, and 0.67 for RD without AD. Key factors detecting AD/RD included age at enrollment, cardiovascular, metabolic, and kidney disease, and sleep disturbances, with feature importance varying by record type and time frame prior to dementia onset. Our findings suggest that a patient’s health status up to 12 years prior may be useful in identifying individuals at-risk for dementia development.
Horticulture-based Interventions to Enhance Health and Wellbeing of People Living With Dementia in the Community
Authors: Scott Theresa , Jao Ying-Ling , Tulloch Kristen , Eloise Yates , Pachana Nancy 
Published: December 2021

Abstract
The majority of people living with dementia in the early and middle stages are cared for at home by family caregivers. Participation in meaningful activities is important for good quality of life. Recreation based on horticulture is beneficial for people living with dementia in residential settings, yet evidence within community settings is less clear. The aim of this research was to examine the existing evidence for the impact of using contact with nature, gardens and plants to enhance well-being of people living with dementia in the community. Our secondary aim was to explore the outcome domains and instruments that were employed in the existing research studies, to inform future research efforts and guide clinical practice. A systematic search was conducted covering several databases and gray literature. Original studies that examined group or individual horticulture-based activities or interventions were included. Of 2127 articles identified through searching, 10 were selected for full review. The findings reveal that horticulture-based intervention showed positive impacts on food intake, social interaction, and well-being in older adults with dementia. Some evidence shows that horticulture-based activities may alleviate stressful symptoms associated with living with dementia. Future research may further evaluate the effect of the interventions on cognitive function, physical function, and behavioral symptoms in a more rigorous intervention design.
Implications of Racial Differences in the Shifts in the Setting of Care for Alzheimer’s Disease and Related Dementias
Authors: Yashkin Arseniy , Gorbunova Galina , Yashin Anatoliy , Akushevich Igor 
Published: December 2021

Abstract
The prevailing setting of care has strong associations with the progression of a disease at time of first diagnosis, subsequent treatment, resulting health outcomes as well as both long-term and short-term costs. The care of Alzheimer’s Disease (AD) and Related Dementias (ADRD) has been experiencing a shift from skilled nursing facility to home health care. However, changes in practice do not disseminate equally across the race/ethnicity spectrum of the U.S. and disadvantaged race/ethnicity-related groups often encounter differing conditions from those experienced by the majority. In this study, we calculated the race/ethnicity-related direct healthcare costs of individuals with AD and ADRD, stratified by care-provider structure (physician, inpatient, outpatient, skilled nursing facility, home health, hospice), and modeled the trends and the relative contributions of each setting over the 1991-2017 period using administrative claims from a 5% sample of Medicare beneficiaries. Inflation and the gradual switch of Medicare compensation to the HCC model between 2004 and 2007 were accounted for. We then applied an inverse probability weighting algorithm to propensity-score-match the AD/ADRD race/ethnicity-specific groups to Medicare beneficiaries to make them comparable in demographics and co-morbidity status but without AD/ADRD. Finally, we performed a comparison of the Medicare costs and associated survival within (AD/ADRD vs. No AD/ADRD) and between (Black vs. White vs. Hispanic) race/ethnicity-related groups. Comparisons were done for: i)1-year before; ii) 1-year after iii) years 2-11; iv)years 12-21 and v) years 22+ after an AD/ADRD diagnosis. We found significant race/ethnicity-related differences in costs and survival both before and after propensity score matching.
Finding Factors in Footfalls: Exploring the Factor Structure of Gait in Older Adults.
Authors: Willden Michael , Palmer Josh , Kowalski Kristina , Hundza Sandra , MacDonald Stuart 
Published: December 2021

Abstract
Gait is a reputed marker of global health spanning various bodily systems (MacDonald et al., 2017) and is a robust predictor of deleterious age-related outcomes (Van Kan et al., 2009). However, the sheer number of individual gait variables employed as predictors in the existing literature can obscure interpretations. To address this issue, researchers have explored the factor structure of gait indicators to explain variance in age-related gait performance, identifying disparate models characterized by three to five underlying latent gait constructs comprised of 8 to 23 indicators (Hollman et al., 2011; Lord et al., 2013). Beyond this heterogeneity, additional limitations characterizing this literature include solutions that assume statistical independence among gait constructs, as well as inclusion of severely multicollinear indicators. Using data from the Healthy Minds Healthy Bodies (HMHB) study, the present research focused upon replicating and contrasting previous factor analytic efforts. HMHB participants (n=128) were healthy community-dwelling adults (Mage=72.81±5.24 years; female=100). Gait indicators from a GAITRite computerized walkway were selected according to a priori theoretical rationale, compatibility with previous studies, and consideration of multicollinearity. Gait factor structure was initially analyzed using principal component analysis. Results indicate the presence of three latent gait domains reflecting pace, rhythm, and variability, accounting for over 82.4% of the variance in gait performance. Current proceedings involve implementing confirmatory factor analysis to compare competing gait models. Findings will address disparities across factor models in the gait literature, as well as discuss the optimal number of factors for describing the underlying dimensionality of gait.
Measurement Invariance in the Assessment of Mood Between American and Mexican Community Studies
Authors: Herrera Manuel , Paulson Daniel 
Published: December 2021

Abstract
The Health and Retirement Study (HRS), a principal source for American public health research, has numerous global sister studies. Harmonization efforts seeking to establish measurement equivalence amongst these various datasets, is a critical prerequisite to cross-cultural research. Given well-known cultural variability in depressive symptom endorsement, the purpose of this study was to assess measurement invariance in a brief mood measure used in the HRS and the Mexican Health and Aging Study (MHAS). Total sample size using both groups was 15,319 participants (10,931 HRS; 4,388 MHAS) who were 65 and older from Waves 6 to 13 in the HRS and Waves 1 to 4 in the MHAS. MPlus Version 8.4 was used to conduct CFA analyses of measurement invariance. A contemporary approach with categorical data calls for examining threshold invariance first while establishing configural invariance, before examining invariance tests of thresholds, loadings, and intercepts in a second step. Results were that measurement invariance was not supported in this series of two steps with four out of six indices showing model fit in the first model and none of the indices showing model fit in the second model. These findings implied that there were differences in ways of responding to the brief mood measure between HRS and MHAS participants at the conceptual level. Thus, comparisons based on these measures may result in misleading findings and should be interpreted very conservatively. This study adds to the growing body of literature guiding harmonization efforts from the Program on Global Aging, Health and Policy.
Measurement Invariance of Negative Affect in Ambulatory Assessments of Young-Old and Old-Old Adults
Authors: Schilling Oliver , Lücke Anna , Katzorreck Martin , Kunzmann Ute , Gerstorf Denis 
Published: December 2021

Abstract
Gero-psychological research increasingly considered intense longitudinal assessments of momentary affect to address affective aging. In particular, many studies employed negative emotion item lists for ambulatory assessments of negative affect. However, frequent self-reports on emotion items within short time intervals might change alertness towards and perception of one’s emotional experiences. From an item-response-theoretic point of view, this might impair the stability of item functioning in terms of item discrimination between levels of affectivity and item severity (difficulty). Thus, we examined measurement invariance of negative emotion items commonly used for ambulatory assessments of negative affect. Ambulatory assessments from the EMIL study, obtained over seven consecutive days at six occasions per day from 123 young-old (aged 66-69) and 47 old-old (86-89) adults, were analyzed. Respondents self-reported on 13 negative emotion items, using a 0-100 slider to express the degree to which they felt the respective emotion. We ran multilevel structural equation models with Bayes estimation to analyze variability of negative affect factor loadings, item intercepts, and measurement error variances across repeated measures, thus checking for metric, scalar, and strict factorial invariance. For all sets of parameters, the findings do not strongly support measurement invariance, but point at partial invariance for item subsets. Taking on literature suggesting that criteria for invariance testing should not be too restrictive to meet pragmatic measurement equivalence requirements, further analyses and our conclusions focus on strategies that might allow for acceptable degrees of differential item functioning, enabling reliable analyses of intra-individual short-term variability in negative affect.
Factors Affecting the Intention to Use Exoskeleton for exercise and the Moderating Effect of Frailty
Authors: Bomi Choi , Joo Susanna , Lee Changmin , Kim Chang Oh , Lim Yun Mook , Jun Hey Jung 
Published: December 2021

Abstract
This study aims to find relevant factors influencing the intention to use exoskeletons for exercise (IEE) among older adults and to analyze the moderating effect of frailty. The sample of this study is 310 people (65 or older) without cognitive impairment who completed an online survey. The intention to use exoskeletons was measured with three questions from the Senior Technology Acceptance Model (STAM). Potential relevant factors comprise sociodemographic characteristics, physical and psychological health, exercise, attitude towards aging, and social relationship. Linear regression analyses showed that depressive symptoms, regular exercise, attitude towards aging, and social participation were significantly related to IEE. People with more depressive symptoms and a negative attitude towards aging are more likely to have a higher level of IEE. People who exercise regularly and actively participate in social activities showed a higher level of IEE. Subgroup analyses were performed based on the frailty status measured with Korean Groningen Frailty Indicator (K-GFI). Among people without frailty (N=177), regular exercise, and social participation were positively related to IEE. The number of chronic diseases and social participation was positively related to IEE among people with frailty (N=133). The results of this study implied that poor health conditions lead to an increased need for exoskeletons. The results of this study also suggested that exercise and social participation work as facilitating factors in the context of gerontechnology acceptance. Results of subgroup analyses suggested that influencing factors on IEE can vary depending on the physical functional status.
Technology Anxiety on Attitude Towards Technology: The Moderating Effect of Age-friendly Environment
Authors: Yoon Do Kyung , Lee Seolah , Kim DaeEun , Kim Chang Oh , Jun Hey Jung 
Published: December 2021

Abstract
The purpose of this study was to examine the moderating effect of an age-friendly environment on the relationship between technology anxiety and attitude towards technology among Korean older adults. We collected data by online surveys in February 2021, and the sample was 324 Korean older adults aged 65 and above. The dependent variable was the attitude towards technology, which meant the appraisal about using a wearable robot for exercise. The independent variable was technology anxiety, meaning an individual’s apprehension of using a wearable robot. The moderating variable was age-friendly environment, which comprises domains of the physical environment, social environment, and municipal services. The higher the score is, the more age-friendly the environment was perceived. Control variables were age, sex, education, household income. The moderation effect was estimated by bootstrapping and PROCESS macro. Results showed that when older adults showed a higher level of technology anxiety, their attitude towards technology was less positive. Moreover, the moderation effect of an age-friendly environment was significant. Concretely, in the case of living in a less age-friendly environment, older adults with a higher level of technology anxiety were more likely to report a less positive attitude towards technology. However, the effect of technology anxiety on attitude towards technology was not significant among older adults living in a more age-friendly environment. It suggested that a practical intervention to reduce the level of technology anxiety is in need in order to promote a positive attitude towards technology, especially for older adults living in a less age-friendly environment.
Using Smart Speakers in Low-Income Senior Housing to Enhance the Aging in Place Experience: Stakeholder Views
Authors: Chung Jane , Winship Jodi , Falls Katherine , Parsons Pamela , Bleich Michael 
Published: December 2021

Abstract
Smart speakers provide a platform that can integrate smart home technology and/or safety devices within the home to enhance quality of life and independent living for older adults. However, few attempts to utilize this technology specifically within low-income senior housing (LISH) residents have been documented. Our purpose was to explore different stakeholder perceptions about the use of smart speakers to support aging in place in older adults living alone in LISH. Smart speakers were deployed in individual LISH apartments, equipped with a voice technology-based aging in place solution for the facility. A qualitative analysis of semi-structured interviews using a constant comparative approach for emerging themes was conducted (n=10: older adult users, n=2: housing staff, n=2: voice technology developers). The three participant groups showed diverging perceptions in terms of benefits, uses, and stakeholder interests. Older adults found smart speakers useful in four main areas: assistance with daily tasks, feeling connected, safety measures, and emotional wellbeing. The two other groups showed a broader interest in the use of the smart speaker device, such as residential management tools and communication channels in addition to its potential use as safety and wellness tools. Older adults experienced significant difficulty setting up desired functions or finding instructions, which restricted utilization of the technology to a limited set of tasks. All stakeholder groups addressed a need for formal training or personalized tech support for older adult users. Findings indicate the importance of developing deployment strategies tailored to the needs and characteristics of the target user group.
Age-Related Phenotypes Linked to Aberrant Expression and Localization of a Telomeric Protein
Authors: Stock Amanda , Wang Kun , Liu Chengyu , McDevitt Ross , Sun Chongkui , Gong Yi , Liu Yie 
Published: December 2021

Abstract
Telomere attrition is associated with telomere biology disorders and age-related diseases. In telomere biology disorders, telomere uncapping induces a DNA damage response that evokes cell death or senescence. However, a causal mechanism for telomere attrition in age-related diseases remains elusive. Telomere capping and integrity are maintained by shelterin, a six-protein complex. Rap1 is the only shelterin member that is not required for telomere capping and is expressed at non-telomeric genomic and cytosolic regions. The objective of this study was to determine aberrant phenotypes attributed to non-telomeric Rap1. To test this, we generated a Rap1 mutant knock-in (KI) mouse model using CRISPR/Cas9 editing, in which Rap1 at telomeres is prevented, leaving only non-telomeric Rap1. Cell fractionation/western blotting of primary fibroblasts from Rap1 KI mice demonstrated decreased Rap1 expression and Rap1 re-localization off telomeres, with an altered cellular distribution. This same difference in Rap1 is also observed in human cells with telomere erosion, indicating that aberrant Rap1 in our model may recapitulate Rap1 in aging and human telomere biology disorders. Compared to wild-type control mice, Rap1 KI mice exhibited increased body weight, altered cytokine levels, behavioral deficits, and decreased lifespan. In conclusion, our results reveal a novel mechanism by which telomere shortening may contribute to age-related pathologies by disrupting Rap1 expression and cell localization.