bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of Mild Cognitive Impairment, Conversion to Probable Dementia, and Mortality
Authors: Zhang Yun , Natale Ginny , Clouston Sean 
Published: December 2021

Abstract
Background: Few studies have jointly estimated incidence of MCI, conversion to probable dementia, and mortality. Methods: We used data from six waves of the National Health and Aging Trends Study (2011-2016). Multivariable-adjusted multi-state survival models (MSMs) were used to model incidence upon accounting for misclassification. Results: A total of 6,078 eligible NHATS participants 65 years of age and older were included (average age: 77.49 ±7.79 years; 58.42% females; 68.99% non-Hispanic White). Incidence of MCI was estimated to be 41.0 [35.5, 47.3]/1,000 person-years (PY). Participants converted to probable dementia at a high rate of 241.3 [189.6, 307.0]/1,000 PY, though a small number also reverted from MCI to cognitively normal. Education was associated with lower incidence of MCI and probable dementia, but increased mortality in those with MCI. There were also substantial racial and ethnic disparities in the incidence of MCI and dementia. Conclusions: Our results underscore the relatively common incidence of and conversions between MCI and dementia in community-dwelling older Americans and uncover the beneficial impact of education to withstand cognitive impairment before death.
Modifiable Risk Factors of Behavioral and Psychological Symptoms in People with Dementia
Authors: Seo Shinae , Mattos Meghan 
Published: December 2021

Abstract
Over ninety percent of people with dementia (PWD) experience behavioral and psychological symptoms, known to increase burden on care providers and healthcare systems. The purpose of this integrative review was to examine the modifiable risk factors of behavioral and psychological symptoms of dementia (BPSD) at the individual, caregiver, and environmental levels. An electronic database search was performed using PubMed, CINAHL[EBSCO], Web of Science, and PsycINFO from 2010-2020. Search terms included “dementia” AND (“Behavioral” OR “Behavioural” OR “Psychological” OR “Neuropsychiatric”) AND “symptoms” AND (“Independent Living” OR “Community Dwelling” OR “Community Living” OR “Living at Home” OR “Ageing in Place.” The search yielded 1,121 articles, and 14 articles were included in this review. Among the 14 articles, there were 11 modifiable risk factors presented across the individual, caregiver, and environmental levels. Individual-level factors included the presence of affective disorder, low quality of life, and leisure dysfunction. The modifiable caregiver-level factors included relationship with PWD, frequency of contact, caregiver burden, distress, frustration level, caregiver as a resource for PWD, and quality of dyadic relationship. One environmental factor, the presence of pandemic disease (e.g., COVID 19), was identified. This review presents the modifiable factors that contribute to the varied symptoms and multi domains of BPSD. Further research is necessary to determine whether, and to what degree, interventions targeting individual, caregiver, or environmental risk factors may reduce BPSD for PWD, caregivers, and providers within the community setting.
Cardiometabolic risk factors predict executive function scores in high-risk individuals
Authors: Gills Joshua , Jones Megan , Campitelli Anthony , Paulson Sally , Madero Erica , Myers Jennifer , Glenn Jordan , Gray Michelle 
Published: December 2021

Abstract
Alzheimer’s disease (AD) is expected to triple by 2050, affecting 16 million Americans. As a result, it is essential to combat this alarming increase in cognitive impairment through early detection. Cardiometabolic risk factors have shown to be associated with higher risk of AD. The purpose of this study was to determine if cardiometabolic risk factors could predict executive function scores in a high-risk population. Fifty (60.9±8.8 years) high-risk adults (classified by the Australian National University Alzheimer’s Disease Risk Index) were enrolled in this study. Participants completed a 6-minute walking test, venous blood draw, blood pressure measurement, and the digit coding symbol test (DCS). Results were examined through a multiple linear regression with DCS as the dependent variable and age, sex, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), glucose, 6-minute walking test, systolic blood pressure (SBP), and diastolic blood pressure (DBP) as predictor variables. The model explained 42% of the variance of DCS (p = .04) with SBP (45%; p = .003) as a significant predictor. LDL (p = .087) and DBP (p = .123) accounted for 24% and 22% of the variance for this model, respectively. These results suggest cardiometabolic risk factors predict executive function values in high-risk individuals. Higher SBP was significantly associated with lower DCS scores indicating SBP as a valuable tool for practitioners when evaluating cognitive decline. Further research should expand sample size and track values longitudinally to substantiate these claims.
Sources of Positivity in the Daily Life of Family Caregivers of Persons with Dementia
Authors: Lee Kyungmi , Archer Breannlyn , Cox Kaitlyn , Pickering Carolyn 
Published: December 2021

Abstract
Family caregivers often experience fatigue, burnout, and health complications yet also enjoy many aspects of caregiving that may benefit their well-being. This study identifies positive aspects of caregiving in the daily life experiences of dementia family caregivers in order to inform interventions to support caregivers’ well-being. This case study entails a secondary analysis of open-ended question data obtained from 165 family caregivers who answered daily diaries over 21 days (n = 2841 responses). We used content analysis to organize and elicit thematic categories from the data collected in response to the question “what was the best part of your day.” A final 762 responses were selected as meeting the “care” criteria for the study, with an inter-rater reliability of 91.6%. Data analysis revealed three major sources of daily positive aspects including: caregiver-focused, patient-oriented, and support-system based. The analysis also revealed seven different kinds of daily positive aspects, such as getting to enjoy time with the care recipient or getting to accomplish other non-caregiving tasks. Many of the positive aspects of caregiving reported were enabled by social support, but they were ultimately from how they utilized that support (e.g., getting alone time) that provided the positivity. The findings of this study demonstrate the important role social support plays in caregiving, as well as highlights other possible intervention targets to create easier, more positive days for family caregivers.
Cognitive Status & Dementia Severity in CVLT-II-SF Forced Choice Recognition: Implications for Effort Assessment
Authors: Grewal Karl , Trites Michaella , O'Connell Megan , Kirk Andrew , MacDonald Stuart , Morgan Debra 
Published: December 2021

Abstract
Effort testing is critical to neuropsychological practice, including dementia assessment. Questions exist around whether cognitive status or impairment severity impacts effort test performance in this population. Presently, we examined whether scores on an embedded effort test - the California Verbal Learning Test II Short Form (CVLT-II-SF) Forced Choice Recognition (FCR) - differed across diagnostic cognitive status groups and how severity of impairment modulated test performance. In a sample of memory clinic patients, three cognitive status groups were identified: subjective cognitive impairment (SCI; n = 92), amnestic mild cognitive impairment (a-MCI; n = 18), and dementia due to Alzheimer’s Disease (AD; n = 70). Significant group differences in FCR performance were observed using one-way ANOVA (p &lt; .001), with post-hoc analysis indicating the AD group performed significantly worse scores than the other groups. Using multiple regression, FCR performance was modelled as a function of cognitive status, impairment severity indexed MMSE, and their interaction, with a parallel analysis for the Clinical Dementia Rating Sum of Boxes (CDR-SOB) scores as an alternate severity measure. Results yielded significant main effects for MMSE (p = 0.019) and cognitive status (p = 0.026), as well as a significant interaction (p = 0.021). Thus, increases in impairment severity disproportionately impaired FCR performance for persons with AD, calling into question research-based cut scores for effort determination in dementia contexts. Corresponding CDR-SOB analyses were non-significant. Future research should examine whether CVLT-II-SF-FCR is an appropriately specific inclusion in a best-practice testing battery for evaluating effort in dementia populations.
Examining Stereotype Threat in Neuropsychological Testing: A Usability and User Experience Pilot Study
Authors: Armendariz Jazlyn , Hwang Sarah , Blanco Giovanna Garrido , Pena Maria , Chan Thomas 
Published: December 2021

Abstract
Stereotype threat is defined as the situational predicament when people feel at risk of conforming to social stereotypes. Correspondingly, stereotype threat may negatively impair a persons’ working memory and cognitive abilities during neuropsychological tests due to hyper awareness of negative stereotypes. Moreover, it is critical to test the usability and the user experience of application-based neuropsychological assessments within diverse aging adult populations. In this pilot study, verbal expressions of feeling pressure to succeed, within a diverse population of young adults, were examined while taking an application-based neuropsychological assessment. Data was collected from 15 self-identified respondents (i.e., 7 Latinx, 5 Asian, 3 Bi-racial). Before beginning the assessment, 8 out of 15 participants exhibited self-handicapping behaviors such as offering explanations of mental exhaustion due to work and lack of sleep. Literature suggests these expressions are related to the onset of anxiety prior to taking cognitive tests, and contribute to potentially offering an excuse in anticipation of poor performance. Additionally, 3 out of 15 participants noted that even though the tasks were simple, they felt unintelligent because they did not complete the tasks to their best abilities (e.g., “I felt stupid. It was simple”). Findings from this pilot support the negative impact stereotype threats have on feelings of inadequacy and increase of anxiety levels among ethnic minorities in testing settings. Further emphases on examining the usability and user experience of application-based tests are needed, particularly within a diverse population of aging adults to facilitate more culturally competent neuropsychological testing experiences.
Gender Differences in Online Health-Related Search Behaviors Among Older Adults
Authors: Picchiello Matthew , Rule Payton , Lu Tina , Carpenter Brian 
Published: December 2021

Abstract
Nearly 60% of older adults use the internet for health-related reasons. Some studies have demonstrated differences in the frequency at which men and women perform various online activities. However, few studies have investigated gender differences in health-related search behaviors (HRSB). The purpose of this study was to examine differences in self-reported HRSB between older men and women. A total of 47 older adults (M age = 66.6, 55% female, 87% White) completed a survey assessing perceived usefulness and trust in the internet for health-care information, types of websites used, and reasons for looking up health information. Independent samples t-tests revealed that, compared to women, men regard the internet as more useful in helping them make health care decisions (t (45) = 2.715) and as a more trustworthy source (t (45) = 2.24, p's &lt; 0.05). Men were more likely to get health information through sources affiliated with educational institutions (χ2(1) = 3.9) and government agencies (χ2(1) = 8.8), whereas women were more likely to use social media, (χ2(1) = 4.3, p's &lt; 0.05). Lastly, men were more likely to use the internet to learn about information on medical procedures (χ2(1) = 5.1), while women were more likely to learn about alternative treatments (χ2(1) = 4.9, p 's &lt; 0.05) online. As 72.3% of participants indicated the internet as their first source for health information, interventions geared towards enhancing HRSB for older adults are needed, especially for older women whose HRSB may make them particularly vulnerable to misinformation.
Interaction Effect of Subjective Health and Attitude about Aging on Gerontechnology Acceptance
Authors: Park Hayoung , Joo Susanna , Kim Kwang Joon , Kim Chang Oh , Lim Yun Mook , Jun Hey Jung 
Published: December 2021

Abstract
This study examined the interaction effect of subjective health and attitude about aging on gerontechnology acceptance among Korean older adults. The sample was 310 Korean older adults aged 65 and above without cognitive impairment who completed an online survey. The dependent variable was the attitude about gerontechnology, especially an exoskeleton robot for exercise. The independent variable was subjective health measured by the questions about self-reported health conditions. The moderating variable was the attitude about aging, which was measured by asking how much they feel less useful as they age. Covariates were age, gender, education level, employment status, income, and marital status. The results from the regression analyses using PROCESS macro and bootstrapping showed that the interaction effect of subjective health and attitude about aging is significant for gerontechnology acceptance; when older adults consider themselves less useful as they age, they tend to have positive attitudes about gerontechnology despite their subjective health. However, of those who consider that they are not less useful as they age, they tend to have positive attitudes about gerontechnology only when they consider themselves unhealthy. Thus, they tend to have negative attitudes about gerontechnology when they consider themselves healthy and useful. The findings imply that gerontechnology-based exercise programs or interventions could be welcomed by those who consider themselves unhealthy and think they are useless as they age. Also, the findings suggest that when applying an intervention program using gerontechnology, health status and self-assessment of aging should be considered in advance.
Older Koreans' Information Support and Internet Use: Internet Skills and Technology Attitudes
Authors: Lee Hye Soo 
Published: December 2021

Abstract
While older Koreans have growing access to Internet, they still lag in actual utilization. This study examined effects of different information support sources on Internet utilization and whether these were mediated by Internet skills and technology attitudes among older men and women. This study used secondary data from 2019 Digital Divide Survey conducted by National Information Society Agency of Korea. The sample consisted of 1,031 Korean Internet users aged 60+, including 495 men and 536 women. Support sources included personal and professional. Skills were measured by ability to use specific features of mobile devices such as smartphones (seven items), while utilization was measured by the use of mobile devices for specific reasons (25 items). Serial mediation analyses using both skills and attitudes were conducted separately according to gender and support sources, covarying for demographics and health. In general, information support was positively associated with utilization. For men, personal informational support was mediated by technology attitudes only. For women, professional informational support was mediated by both Internet skills and technology attitudes, but the serial indirect effect was not significant for this model. The other two models showed significant serial mediation effects through Internet skills and technology attitudes, in this order. Only women had significant direct associations between information support and Internet utilization. Regardless of the source, informational support is positively associated with older Koreans’ Internet utilization. Professional support for men and personal support for women may be most beneficial for greater Internet utilization.
Privacy and Usability in COVID Enrollment Apps
Authors: Calloway Laura , Huber Lesa , Camp L Jean 
Published: December 2021

Abstract
Enrollment apps for COVID-19 vaccinations are meant to be privacy-enhancing, but poor design puts privacy at risk. We report on a qualitative exploration of the experiences of older adults attempting to register for vaccination. We engaged in a think-aloud protocol with six participants over age 65 over Zoom as they used the New York state vaccination portal. Authentication requirements were: Medicare ID, DOB, address, and phone (optional). For this cohort, Social Security numbers were the default Medicare ID. We found that a privacy-enhanced authentication option exists, but efforts to use privacy-preserving enrollment were confounded by security-enhancing timeouts. Choosing to use the time-consuming privacy-preserving authentication increased the risk that available vaccines were taken. As a result, older adults reliant on volunteers to enroll revealed sensitive information and risked identity theft. A design that was meant to be privacy-enhancing by offering multiple avenues for authentication and ensuring logout via timeouts created a system where the more secure option was not effectively available due to a competing security mechanism. This was exacerbated by a counter counting down the number of vaccine sites available, similar to a well-known stress condition used to create cognitive load in laboratory experiments. All six participants used privacy-sensitive information to enroll; provided adequate information for identity theft; and all six encountered stop points. The countdown of available vaccination sites, the time required for insurance validation as an alternative to Medicare ID, and logging off after inactivity to prevent session theft each are good practices; but fail together.
BDNF SNP C270T Modifies the Association Between History of Head Injury and Cognitive Status in Older Adults
Authors: Drewel Mikaela , Gonzalez Hector , Rattinger Gail , Matyi Joshua , Hammond Alexandra , Kauzor Kaitlyn , Buhusi Mona , Tschanz JoAnn 
Published: December 2021

Abstract
Brain derived neurotrophic factor (BDNF), is a neurotrophin involved in neurogenesis and neuroplasticity. Several BDNF genes have been associated with cognitive function. Studies suggest head injury (HI) alters BDNF levels, and activities enhancing BDNF signaling promote better cognitive outcomes. We investigated the relationship between HI and BDNF single-nucleotide polymorphisms (SNPs) in predicting cognitive performance in a population-based sample of older adults. 4165 participants (56.7% female), dementia-free at baseline, were assessed triennially [follow-up years: mean (SD) = 5.85 (4.20), median = 7.33, maximum = 11.39]. Mean (SD) age was 75.36 (6.84). Cognition was assessed using the Modified Mini-Mental State Exam (3MS) and HI history from self-report. We examined interactions between BDNF SNPs [rs56164415 (BDNF C270T), rs6265 (Val66Met), rs2289656 (BDNF receptor trkB), and rs2072446 (NGF/BDNF receptor p75)] and history of HI (none, one, or multiple) in predicting cognitive decline. Covariates included age, education, sex, and apolipoprotein (APOE) E4 allele presence. Linear mixed-effect models indicated BDNF C270T significantly modified the association between HI and cognitive status (p &lt; .006). Specifically, minor T allele carriers with single or multiple HI scored on average 2.08 and 3.21 points lower on the 3MS, respectively, than non-T carriers with no HI. Unexpectedly, there was a trend for APOE4*HI (p = .078) in that APOE E4 carriers with multiple HI scored higher than those lacking APOE E4 and HI. In this population-based sample, rs56164415 predicted cognitive outcomes that varied by history of HI. Factors influencing BDNF signaling may provide a potential avenue for intervention in recovery from HI.
Sirtuin-1 isoforms differentially regulate mitochondrial function
Authors: Zhang Xiaomin , Ameer Fathima , Crane Jasmine , Azhar Gohar , Wei Jeanne 
Published: December 2021

Abstract
Alternative splicing generates multiple distinct isoforms that increase transcriptome and proteome diversity. Alternatively spliced isoforms may lose part of the protein domain and have different intracellular localization as well as distinct functions. The main form of the SIRT1 (SIRT1v1) protein contains 11 exons. We have identified two new isoforms, SIRT1v2 (lost 2 exons), and SIRT1v3 (lost 3 exons), but their effect on mitochondrial gene expression has not been reported. To study the effect of the three SIRT1 isoforms on mitochondrial gene expression and function, neuronal cells were transfected with SIRT1 isoforms v1, v2 or v3 plasmids, respectively. Gene expression was measured by quantitative reverse transcription PCR (RT-qPCR). Our data showed SIRT1 isoforms v1, v2 and v3 differentially regulated PCG-1alpha and PCG-1beta, which are the upstream regulators of mitochondrial structure and function. SIRT1v1 upregulated mitofusin-1 (MFN1), the mitochondrial dynamin-like GTPase (OPA1) gene, and the transcription factor A mitochondrial (TFAM) gene. In contrast, the SIRT1-v2 isoform repressed the MFN1, MFN2, and TFAM genes, while the SIRT1-v3 isoform repressed the MFN1 gene. In addition, the three SIRT1 isoforms differentially affected the mitochondrial respiratory complex I genes, including NDUFAB1, NDUFS1, NDUFV1, NDUFV2. The data indicates that SIRT1 regulates mitochondrial biogenesis and function through a signaling pathway involving PGC-1alpha, PCG-1beta, mitofusin 1 and 2, OPA1, and TFAM genes. Taken together, alternative splicing generated three SIRT1 isoform proteins with diverse functions. Age-related changes in the alternative splicing events are likely to impact sirtuin-regulated cellular functions and signaling pathways in aging and senescence.
Caregiver Support for Asian American Alzheimer’s Disease and Related Dementias Caregivers: A Conceptual Synthesis
Authors: Hu Mengyao , Squires Allison , Wu Bei 
Published: December 2021

Abstract
Informal caregiver support has been defined as different types of interventions. However, it has not been well explained in the social context and not well discussed as an integrative concept for dementia caregivers who are Asian Americans. Therefore, the aim of this study was to conduct a dimensional analysis--a type of evidence synthesis--to explore caregiver support in the context of Asian American dementia caregivers. A synthesis of 40 articles produced four interrelated dimensions of caregiver support: Individual (language, information, psychological issue, and culture); Family (family member support, availability of extended family, and decision making); Community (bilingual and bicultural help, and religion and spiritual source); and Professional healthcare system (expectations from healthcare professionals and caregivers for caregiver interventions, communication concordance, initiative in seeking help, and trust). The findings provide guidance for future studies on this population in promoting caregiver’s health and developing caregiver interventions.