bluuebunny/crossref_metadata_2025_split huggingface dataset:
To Fall or Not to Fall – Falls and Perceptions of Control and Meaning of the Home
Authors: Slaug Björn , Iwarsson Susanne , Schmidt Steven 
Published: December 2021

Abstract
Falls are a major public health problem among older people. Even if the outcome of a fall is not fatal, it may be a traumatic experience with both physical and psychological consequences. However, there is a lack of studies examining how falls in the home may impact the perception of the home. To compare perceptions of the home between those who had fallen and those who had not, we utilized data from the Swedish SNAC-GÅS study (N=371; mean age=68; 43% men). Perceptions of control and meaning of the home were captured by established psychological instruments. Excluding falls in other environments than the home (n=99), those who fell in the home the previous year (n=34) scored notably higher on housing control by “powerful others” (p=0.053) and notably lower on perceived “behavioral home bonding” (p=0.056) compared to non-fallers (n=238). These results warrant further research into the impact of falls on perceived housing.
Reasoning About Life Transitions in Relation to Perceived Housing: In-Depth Data From Germany
Authors: Wanka Anna , Wazinski Karla , Oswald Frank 
Published: December 2021

Abstract
Partially different to the Swedish contribution, this paper analyses the relationships between perceived housing, life course transitions and wellbeing among community-dwelling older adults in Germany. Based on 15 qualitative interviews with persons aged 60-75 years, the contribution focuses on the experience of interrelationships between different life course transitions and perceived housing, and how they contribute to wellbeing in later life. First findings indicate a concourse of different transitions around the retirement age (e.g. illnesses, changes in partnerships) and a temporal as well as causal relationship between the two transitions relocation and retirement (for example, relocation becomes possible only after retiring or people relocate with the retirement phase in mind). The entanglement of life course transitions, in turn, shapes the person-place-relationships and perceived housing in different ways, which will be exemplified and interpreted in the presentation. However, further research is needed to consider the effects of social inequalities in these processes.
A Transitional Care Model for Veterans With Complex Needs During COVID: The Behavioral Recovery Outreach (BRO) Team
Authors: Matthews Kathleen , Vinson Latrice 
Published: December 2021

Abstract
The Veterans Health Administration’s Care for Patients with Complex Problems (CP)2 Program developed a national infrastructure to disseminate promising practice models to improve care for Veterans with complex medical, mental health, and/or neurocognitive conditions, who may also have behaviors disruptive to care. A strategic priority is improving safe and effective transitions to community care for Veterans with complex care needs, many of whom have historically been limited to VA settings as a result of behavioral concerns. The Behavioral Recovery Outreach (BRO) Team was the first model identified for national dissemination and evaluation at partner sites. Developed at VA Central Iowa, BRO is an interdisciplinary team model that identifies Veterans in long-term VA care settings with complex care needs to engage in individualized behavioral programing to manage/stabilize behaviors and safely transition them to more appropriate and less costly community settings. This symposium will describe the BRO team model, highlight the facilitators and barriers to nationally disseminating the BRO model with VA partner facilities, discuss adaptations in continuing community transitions following the COVID-19 pandemic, and describe program outcomes. The first speaker will discuss development of the BRO model and outcomes of a regional dissemination. The second speaker will present results from the program evaluation of the national dissemination. The final speaker will describe BRO Team expansion and lessons learned from the perspective of a VA partner facility. The (CP)2 Program Director will integrate findings and highlight implications for scaling and evaluating promising models for national dissemination for policy, practice, and future research.
Daily Physical Activity Patterns: A Window on Cognitive Decline in the Baltimore Longitudinal Study of Aging (BLSA)
Authors: Wanigatunga Amal , Liu Fangyu , Wang Hang , Urbanek Jacek , An Yang , Simonsick Eleanor , Resnick Susan , Schrack Jennifer 
Published: December 2021

Abstract
Gradual disengagement from essential daily physical activity (PA) necessary for independent living could signal present or emerging mild cognitive impairment (MCI) or Alzheimer’s disease (AD). We used BLSA data to examine whether PA patterns including: 1) total activity counts/day, 2) minutes/day spent active, and 3) activity fragmentation (reciprocal of the mean active bout length) differs between participants with adjudicated normal cognition (n=498) and MCI/AD diagnoses (n=32). Linear models were used and adjusted for demographics, APOE-e4 status, morbidity, and gait speed. Compared to those with normal cognition, those with MCI/AD had 3.0% higher activity fragmentation (SE=1.1%, p=0.006) but similar mean total activity counts/day (p=0.08) and minutes/day spent active (p=0.19). Results suggest that activity fragmentation may arise as a compensatory strategy in the absence of reduced activity in MCI and early AD and that activity monitoring may be potentially useful for detecting MCI and AD at an earlier stage.
Stability and Variability of Indoor Room Transitions and Mild Cognitive Impairment in Older Adults
Authors: Wu Chao-Yi , Reynolds Christina , Barnes Lisa , Silbert Lisa , Dodge Hiroko , Kaye Jeffrey , Beattie Zachary 
Published: December 2021

Abstract
Indoor room transition is an underexplored real-world activity outcome. We estimated the stability and variability of indoor room transitions and their associations with mild cognitive impairment (MCI) in older adults. Older adults living-alone (n=159, age=78.3±8.8 years, 14% MCI) from the Oregon Center for Aging & Technology (ORCATECH) and the Minority Aging Research Study (MARS) were included. Room transitions were detected using passive infrared motion sensors in bathroom, bedroom, kitchen, and living room. The hourly number of room transitions was used to calculate the interdaily stability and intradaily variability of room transitions. MCI was operationalized by the Clinical Dementia Rating equaled 0.5. Generalized estimating equations models adjusted for demographics, health, and environmental factors revealed that older adults with MCI had a lower interdaily stability of room transitions than cognitive healthy peers (z=-2.06,p=0.03). A pervasive-sensing system deployed in homes can obtrusively measure room transition activities to inform cognitive health in older adults.
Metformin Inhibits Mitochondrial Complex I To Promote Health
Authors: Chandel Navdeep 
Published: December 2021

Abstract
The major function of mitochondria in cellular homeostasis has been the generation of ATP through oxidative phosphorylation. However, we have previously demonstrated that mitochondria can serve as signaling organelles by releasing low levels of reactive oxygen species (ROS) and TCA cycle metabolites that are essential for hypoxic activation of HIF, antigen activation of T cells, cellular differentiation and proliferation of cancer cells. The anti-diabetic drug metformin has been proposed to inhibit mitochondrial complex I. We will present data indicating that metformin inhibits mitochondrial complex I to exert it’s biological effects through controlling ROS, ATP, and NAD+.
Delaying Health Care Due to the COVID-19 Pandemic: Associations With Physical and Mental Health and Preventive Care
Authors: Wheaton Felicia , Scatliffe Terika , Johnson Matilda 
Published: December 2021

Abstract
Health care is important for maintaining optimal physical and mental health. However, due to the COVID-19 pandemic, many older adults have delayed or postponed care. Data from the special midterm release of the 2020 Health and Retirement Study (HRS) were used to examine the relationship between chronic conditions and delayed care, as well as between delayed care and mental health outcomes and preventative care among Americans aged 50+ (N=3,266). Approximately 30% of respondents said yes when asked “Since March 2020, was there any time when you needed medical or dental care, but delayed getting or did not get it at all?” Of those, 55% said their provider cancelled, closed or suggested rescheduling, 28.5% decided it could wait, and 20.8% were afraid to go. Results from OLS and logistic regression, controlling for sociodemographic characteristics, indicate that those with lung disease and those with a heart condition had significantly higher odds of delaying care. Delaying care was associated with significantly higher odds of poor self-rated health and feeling depressed, as well as significantly higher average hopelessness, loneliness and negative affect and significantly lower average positive affect. Surprisingly, delaying care was not associated with receiving a flu shot, cholesterol test, colonoscopy, mammogram or prostate exam in the previous two years. It is likely that the full effects of delaying health care during the pandemic have yet to be felt and there is a need to study the implications of such delays.
Lung Function in Old Age and Physical Activity From Midlife to Old Age: Longitudinal Study With 24-30 Years' Follow-Up
Authors: Kåreholt Ingemar , Mehmedi Liberta , Nilsen Charlotta 
Published: December 2021

Abstract
The study investigated the role of physical activity, from midlife to older age, in relation to lung function in older age. In order to increase the understanding of the relationship between physical activity and lung function, the relationship between physical activity in midlife and physical activity in older age was also studied. Two Swedish studies based on nationally representative samples were used in this study, the Level of Living Survey, LNU, and the Swedish Panel Study of Living Conditions of the Oldest Old, SWEOLD. The participants were interviewed on three occasions; at the mean ages of 53 years, 61 years, and 81 years. The average follow-up time from the last to the first interview was 24-30 years. The results show that more physical activity in late midlife (mean age of 61 years) was associated with better lung function in older age. The association persists but attenuates when physical activity in older age was included in the analyses. There was also a strong association between physical activity in older age and better lung function in older age. Physical activity in late midlife had a positive association with physical activity in older age. This study shows the importance of physical activity in late midlife and in older ages to maintain good lung function in older ages. To invest in preventive actions in the form of physical activity are vital to be able to promote healthy aging, and should include the oldest old (76+).
Changes in Physical Fitness of Older People During the COVID-19 Pandemic in Germany: Objective Training Data
Authors: Koschate Jessica , Hackbarth Michel , Lau Sandra , Zieschang Tania 
Published: December 2021

Abstract
The purpose of this study was to analyze objective training data on changes in leg muscle training before and after the COVID-19 lockdown during spring 2020 in Germany. Overall, the training data of 4435 individuals in the age group (AG) 45-64 years (55±5 years, 66% ♀) and of 2853 in the AG 65-95 years (72±6 years, 54% ♀) were exported from chip-controlled exercise circuits. Training weight and number of repetitions performed on the leg extensor were used to calculate a leg score (LS), considering the last three training sessions before the lockdown (baseline) and the first ten individual sessions as well as the averaged sessions for August, September and October after individual training resumption. Based on the baseline LS, three training intensity groups (TG_low, medium, high) were defined, and analyzed for differences (ANOVA). The LS in TG_low remained stable after the lockdown, but increased compared to baseline in both AGs after the first ten sessions (p&lt;0.05). In TG_medium, LS was reduced at the first post training session (p&lt;0.05) and returned to baseline levels at training session eight in the younger and session two in the older adults. In both AGs, LS was reduced in the TG_high (p&lt;0.001), and did not reach baseline levels by October. Hence, the LS of TG_high was identified as being particularly affected by the training interruption, irrespective of age. More individually tailored training recommendations should be made for these individuals to be able to regain their initial training levels and avoid long-term adverse health effects.
Impact of the COVID-19 Stay-at-Home Order on Diet and Health in Community-Dwelling Older Adults With Obesity
Authors: Starr Kathryn Porter , Borack Michael , Miller Marshall , Hutchins-Wiese Heather , King Alyssa , Young Kenlyn , Bales Connie 
Published: December 2021

Abstract
Profound restrictions were placed on previously free-living older adults due to mandatory stay-at-home orders for Covid-19. Recognizing the potential for worsening health and heightened risk of Covid-19 complications with older age and obesity, we conducted a survey to assess the impact of stay-at-home requirements on diet, health/social behaviors, and food security in 58 older adults (age=70.8±6.2, 55% Black, 93% female) who had participated in past obesity-reduction trials. A 71-item questionnaire was administered by phone and included demographics, health, lifestyle and dietary habits, food attitudes, and food security questions. Results showed indicators of heightened health risk, including health care appointments either delayed/cancelled (69%) and self-reported weight gain (62%). Of those with weight gain, 22% reported a gain of &gt;10 pounds (33% gained 5-10 pounds and 7% &lt; 5 pounds). Increased food intake was reported by 67% and 45% felt their eating patterns were less healthy due to increased snacking (71%) and consumption of sweets (41%). Food access and isolation were also an issue, as 51% were concerned about leaving the house for food and 81% reported eating alone. While some positive behaviors were reported (new ways to access food and health information, more reported cooking at home), the majority of findings indicated increased risk of obesity and its complications. The findings emphasize the need for effective lifestyle interventions that can be delivered remotely to high-risk older adults; this would benefit those presently self-restricted for Covid-19 concerns as well as other isolated older adults who need better access to individualized interventions.
Prior Physical Performance Impacts Social Contact and Social Participation of U.S. Older People During COVID-19
Authors: Zhang Yun , Hou Wei , Clouston Sean 
Published: December 2021

Abstract
Objective: To assess what roles the prior physical and cognitive performances of US older people played in changes of social contact and social participation due to the COVID-19 pandemic. Methods: We used the 2020 National Health and Aging Trends Study (NHATS) COVID-19 questionnaire (n=3,188, response rate=80.5%), linked to demographic information from the 2019 NHATS wave. We excluded participants who reported COVID-19 diagnosis and/or symptoms (n=288), and those represented by a proxy (n=414). We compared older people’s social contact with family and friends, social contact with health care providers, and social participation, prior to and during the COVID-19. We used paired t-test for the summed scores, Wilcoxon signed-rank for paired categorical variables, and McNamara test for paired binary variables. We further used weighted linear and logistic regressions adjusted for multiple covariates to investigate the effects of prior physical and cognitive performances on social contact and social participation, prior to, during, and changes in the COVID-19. Results: The sample included 2,486 participants that were predominantly females (56.20%) and non-Hispanic whites (88.43%), with participants averaging 78.24 years old. The COVID-19 pandemic resulted in significantly increased social contact with family and friends but decreased social participation of the US older people. Better prior physical performance was associated with significantly increased video calls and volunteering work during the COVID-19, while prior cognitive ability was not a significant risk factor. Conclusion: Prior physical performance, rather than prior cognitive ability, significantly affected the social way old people responded to a pandemic crisis.
Loneliness at Older Ages in Japan: Variation in Lonely Life Expectancy and the Role of Social Isolation
Authors: Furuya Shiro , Raymo James 
Published: December 2021

Abstract
Despite growing media, policy, and research attention to loneliness, it remains an understudied dimension of inequality in demography. Additionally, research on loneliness often fails, both methodologically and conceptually, to distinguish loneliness from social isolation. This is an important limitation given the positive correlation between measures of these two distinct concepts, a relationship that may be particularly relevant in collectivistic societies. This study focuses on Japan, describing the synthetic cohort duration of exposure to loneliness at older ages, with and without adjusting for the correlation between loneliness and social isolation. Combining life tables from the Human Mortality Database with individual data from the National Survey of Japanese Elderly, we calculated isolation-adjusted lonely life expectancies. We also evaluated regional and educational differences in isolation-adjusted lonely life expectancies. Results showed significant differences in lonely life expectancy before and after adjusting for social isolation; however, the attention to social isolation did little to alter our general understandings of trends and differentials in lonely life expectancy. In contrast to public perceptions of growing loneliness, we find that lonely life expectancy is short among older Japanese and has not increased over time. Additionally, we found no clear regional nor educational differences in isolation-adjusted lonely life expectancy.
Going Into a Community, We Need to Start From Where They’re At: Caregiver and Advocate Perspectives
Authors: Baker Zachary 
Published: December 2021

Abstract
We recorded and inductively coded an open-ended discussion of jargon surrounding “dementia” with the “Supporting Dementia Caregivers After Death” community advisory board (CAB). CAB-members included current and former caregivers of PLWD due to early- and normal-onset Alzheimer’s, Lewy body, and Parkinson’s, a co-president of the Alzheimer’s Association (ALZ) Young Champions, a dementia trainer/consultant and member of a Catholic church that preserves American Indian spiritual traditions, a senior program manager at ALZ who was entrusted by American Indian reservation elders to provide dementia education, a care partner support group leader, and an Alzheimer’s Ambassador chosen by multiple US senators. Themes identified included differential inclusiveness of terms like “memory loss” versus “dementia”, misuse and misunderstanding of “dementia” versus “Alzheimer’s,” and the difficulty of translating “dementia” into the American Indian Ojibwe (i.e., Anishinaabemowin) language where suggested translations directly translated to “slow memory loss”, “brain deterioration”, “absent mindedness”, or even “craziness”.
From DemenTia to DemenCia: Way More Than a Single Letter
Authors: Britton Maggie 
Published: December 2021

Abstract
Hispanic or Latino/a/x/e (H/L) individuals are at 1.5x risk for Alzheimer’s Disease and Related Dementias (ADRD) compared to non-H/L White individuals. Although H/L individuals make up roughly 18% of the U.S. population, they are vastly underrepresented in ADRD research. For example, less than 9% of individuals in the National Alzheimer's Coordinating Center (NACC) data set are H/L. Collaborative efforts like the ECHAR Network are working to increase the representation of H/L individuals in ADRD research across the U.S. A non-exhaustive list of barriers to H/L participation include limited health literacy, perspectives on aging, and preferences for family-centered care that aligns with H/L cultural values (e.g., familismo). For example, H/L individuals are less likely to have a medical conceptualization of the Spanish translation for dementia. The cognate “demencia” is more likely to be conflated with alternative meanings like insanity, which may create barriers when developing community-facing recruitment and study materials.
Either Sent by God or Used by God: Impact of COVID-19 on the Religious Lives of Black Families With Dementia
Authors: Epps Fayron , Ge Yiran , Sainz Mayra , Gore Janelle 
Published: December 2021

Abstract
The COVID-19 pandemic has underscored systemic disparities and laid its effects on the Black community. Often overlooked is how health disparities heighten stress and affect the emotional well-being of Black American caregivers. The purpose of this study is to explore the impact of COVID-19 on church engagement for Black families affected by dementia. A qualitative design was employed to collect data from current caregivers, faith/church leaders, and persons with cognitive impairment. Participants (n = 17) were predominantly female, all identified as Black. During semi-structured interviews, participants were asked how COVID-19 has impacted their participation in faith practices. The following themes emerged: (a) ability to continue faith practices, (b) increased church engagement, (c) new normal, (d) importance of fellowship, and (e) role of technology. Participants believed COVID-19 did not impact their faith practice partly due to the ability to continue with faith traditions in a virtual format. Online worship services enabled more families affected by dementia to participate. Many church leaders expressed the intent of continuing to provide online worship services post-pandemic. Families highlighted their need to have fellowship with other parishioners. Technology was perceived as a double-edged sword that serves as both a motivator and a barrier to religious engagement. These findings will support faith leaders and churches in understanding the needs of their congregation during the COVID-19 pandemic, specifically, it will allow families living with dementia to continue engaging in religious activity and living in meaningful ways.
Development of a Staff Informant Measure of Lucidity
Authors: Teresi Jeanne , Luchsinger José , Ramirez Mildred , Silver Stephanie , Devanand Davangere , Ellis Julie , Boratgis Gabriel , Gonzalez-Lopez Paloma 
Published: December 2021

Abstract
Lucidity Measure Development: An existing questionnaire measuring lucidity length, degree, content, coinciding circumstances, and time from lucid episode to death was expanded to include time of day, expressive and receptive communication and speech the month prior to and during the lucid event. Pilot Study: 33 interviews with staff were conducted; 73% reported ever witnessing paradoxical lucidity. Among 29 events reported, 31% lasted several days, 20.7%, 1 day, and 24.1% less. In 78.6% the patient engaged in unexpected activity. 20% died within 3 days and 17% within 3 months after the event. Qualitative Analyses: To refine the measure, 10 family caregivers and 20 LTSS staff caregivers completed a web-based focus-group type exercise using QualtricsXM. A content-thematic analysis with an inductive approach was applied to make qualitative inferences by analyzing the meaning and semantic relationship of words, phrases, and concepts. Using the reduction method of selection, conceptual content categories will be developed.