bluuebunny/crossref_metadata_2025_split huggingface dataset:
Touchscreen Technology to Improve Dementia Care Management for Older Adults Living in the Community
Authors: Brown Ellen , Ruggiano Nicole , Munoz mariateresa H , Roberts lisa , Framil C Victoria , Arroyo Bernardo , Bourgeois Michelle 
Published: December 2021

Abstract
Chronic disease management challenges for persons living with dementia (PLWD) often includes difficulties communicating how their feeling or describing symptoms to caregivers. To address this issue, an interdisciplinary team is developing a touchscreen mobile technology that will allow the assessment of clinical information about the PLWD, such as sleep quality, appetite, pain level, and mood. The mobile technology also allows caregivers to share this information with providers in real-time from their homes. In the team’s effort to incorporate a graphic measure to assess mood into the technology, a literature review revealed no such measurement tool has been established and validated for assessment with PLWD. This study focused on developing a graphic clinical assessment tool that can be used to assess mood for PLWD and establishing the face and content validity for this assessment tool. A team that included multidisciplinary clinical experts and a graphic artist designed a series of pictures of facial expressions and body language depicting a continuum of mood states (i.e., happy through depressed). The research team consulted with existing artistic depictions of sadness expression, including medical illustrations depicting depression. Multiple iterations have resulted in a series of images that represent moods from happy to very sad. The team considered a number of factors in developing the images including gender, ethnicity, and race. Consensus on the construct validity was achieved by the expert clinical panel. Details of a follow-up study to evaluate construct validity will be presented.
Use of Long-Term Care Decreased Over Time Among the Oldest-Old With and Without Dementia - A Register-Based Study
Authors: Aaltonen Mari , Forma Leena , Pulkki Jutta , Raitanen Jani , Jylhä Marja 
Published: December 2021

Abstract
Care policies for older adults emphasize aging-in-place and home care over residential long-term care (LTC). We explore how the use of residential LTC in the last five years of life among people with and without dementia changed between those who died in 2001, 2007, 2013, and 2017 in Finland. Retrospective data drawn from the national health and social care registers include all those who died aged 70+ in 2007, 2013, and 2017, plus a 40% random sample from 2001 (N=128 050). Negative binomial regression analysis was used to estimate the association of dementia with LTC use during the last five years of life (1825 days). The independent variables included dementia, age, marital status, annual income, education, and chronic conditions. In the total study population, the proportion of LTC users and the mean number of days in LTC increased until 2013, after which it decreased. Changes in LTC use differed between different age groups and by dementia status. Over time, the decrease in round-the-clock LTC use was steep in those aged 90≤ with dementia and in people aged 80≤ without dementia. The individual factors related to morbidity and sociodemographic factors did not explain these results. The changes in LTC care policy may have contributed to the decrease in LTC use among the oldest. However, according to national statistics, the availability of formal home care has not increased. This development may suggest that the oldest-old and those with dementia – a highly vulnerable group – are left without proper care.
Co-Designing a Virtual Reality Application to Enhance Reminiscence Therapy for Persons with Dementia
Authors: Sun Winnie , Quevedo Alvaro 
Published: December 2021

Abstract
Reminiscence therapy for persons with dementia is often being conducted by employing analog media including pictures and videos organized and presented by a caregiver. However, such media lacks the immersive experience to support patient engagement and successful recollection of reminiscence events. Recently, Virtual Reality (VR) is gaining momentum as a potential technological tool to support dementia care due to its increased immersion, presence, and embodiment. Haptic artifacts can be used to enrich reminiscence therapy as part of the multi-sensory stimuli to increase immersion and patient engagement, as well as improving social connectedness and cognitive health. The purpose of this project is to explore the use of VR application to advance reminiscence therapy for persons with dementia. We have prototyped an immersive and non-immersive VR framework that allows caregivers to deliver reminiscence therapy for persons with dementia with varying stages in their disease progression. These reminiscence therapy sessions are built by employing a narrative storyboard and content management through a series of co-designing sessions with content experts at the Geriatric Dementia Unit in Ontario, Canada. A caregiver-led VR framework will be adopted to enable the caregiver to guide the persons with dementia to safely navigate through the interactive VR environment, while allowing the patients to engage with the interactive VR elements using a point-and-pinch gesture approach. We anticipate that the VR experiences hold the potential for improving the interactions between persons with dementia and caregivers, as well as enhancing the reminiscence experiences to promote the maximal therapeutic benefit of patient’s recovery.
Communication Difficulties and their Association with Caregiving Burdens in Aphasic Dementia
Authors: Roberts Angela , Santos Haylie , Gill Nathan , Zhang Hui , Salley Elizabeth , Rogalski Emily 
Published: December 2021

Abstract
Primary progressive aphasia (PPA) is a clinical dementia syndrome for which there is no effective disease-modifying treatment. Impairments in language are the primary and persistent symptoms, and severely limit participation in everyday activities and family conversations. Despite this, there are no published studies examining the objective relationship between conversation difficulties and caregiving burden in PPA. We tested the hypothesis that the severity of care partner perceived conversation difficulties predicts caregiving burden using the Perception of Conversation Difficulty-Dementia Alzheimer’s Type and the Montgomery Borgatta Caregiving Burden Scale. The analysis included baseline data from 78 care partners (62% female) enrolled in the Communication BridgeTM-2 randomized control clinical trial of a speech-language intervention for PPA. Care partners had a mean age of 64.5 years (SD=10.76) and a mean relationship duration with the PPA participant of 38.6 years (SD=15.29). Eighty-six percent were spouses, 5% were adult children, and the remaining 9% were friends or siblings. Higher ratings of conversation difficulties were associated with increased caregiving burden for both objective burden (p &lt; 0.001) and subjective stress burden (p &lt; 0.001). The relationship between conversation difficulties and objective burden was mediated by dependence in activities of daily living and care partner depression, whereas the relationship with subjective stress burden was mediated by depression only. This is the first large scale study of care partner reported conversation difficulties and caregiving burden in PPA. The finding that conversation difficulties have a direct relationship with caregiving burden is an important consideration for interventions and outcome measurement in PPA.
Concurrent and Predictive Associations between the Life's Simple 7 & Brain Structure in Middle-Age and Early-Old Age
Authors: Warren Teresa , Williams McKenna , Fennema-Notestine Christine , Elman Jeremy , De Anda Jennifer , Kremen William , Franz Carol 
Published: December 2021

Abstract
American Heart Association’s (AHA) Life’s Simple 7 (LS7), an index of cardiovascular health risks, has been associated with worse brain outcomes but few examined this relationship in midlife. We examined whether LS7 scores at midlife were associated with brain morphometry in early old age. Participants were 471 men who participated in the Vietnam Era Twin Study of Aging. The LS7 index was assessed at mean age 62 (range 55-66) and 68 (range 61-71) and included smoking, physical activity, diet, body mass index, cholesterol, glucose, and blood pressure. Each factor was coded, per AHA criteria, on a 3-point scale (0/poor-2/ideal) and summed to create a composite score (0-14). At mean age 68, participants underwent structural magnetic resonance imaging, which was used to create the previously validated brain measures. Scores included: the ratio of abnormal white matter to white matter, and two Alzheimer’s disease brain signatures (cortical thickness/volume signature and a mean diffusivity (MD) signature). Analyses controlled for age, education, income, ethnicity, and APOE genotype. Concurrently at mean age 68, the LS7 was associated with cortical thickness/volume (F=4.85, p = .028), MD (F=10.89, p = .001) signatures and abnormal white matter ratio (F=14.04, p &lt; .001). Prospectively, the LS7 at mean 62 was significantly associated with age 68 cortical thickness/volume (F=5.08, p = .025) and MD (F=5.54, p = .019) signatures but not with abnormal white matter ratio. These results suggest that prevention strategies that promote heart healthy behaviors could have implications for healthy brain aging.
Consequential Impacts of Tobacco Use on Cognitive Performance
Authors: Pahlen Shandell , Stallings Michael , Corley Robin , Wadsworth Sally , Reynolds Chandra 
Published: December 2021

Abstract
Tobacco use represents a pernicious lifestyle factor that may influence processes of aging, including cognitive functioning. As individuals tend to start smoking before adulthood, it may serve as an important factor in cognitive development and maintenance. We explored smoking history-cognition associations in a sample approaching midlife. Study data was derived from the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (CATSLife 1; N = 1195 [53% F]; x̄age = 33.2 years, SD = 5.0). All cognitive measures were t-scored covering working memory, spatial reasoning, processing speed (WAIS-III Digit Span, Block Design, and Digit Symbol, and Colorado Perceptual Speed) and episodic memory domains (Picture Memory, immediate and delayed). Tobacco use measures included ever-smokers, current-smokers, and log-transformed packyears. Mixed-effects regression models were applied, accounting for sex, age, race, ethnicity, and clustering among siblings. Tobacco use was associated with worse episodic memory, spatial and speed performance, but not working memory. When educational attainment was included, patterns remained consistent though attenuated. Results suggested current-smokers scored 0.27 to 0.36 SD lower than non-smokers on speed and spatial reasoning tasks. Episodic memory performance was reduced by approximately 0.07 to 0.1 SD per log packyear. In a sample approaching midlife, the harmful impacts of tobacco use on cognitive performance may be already apparent with cumulative impacts of packyears on episodic memory and current smoking associated with spatial and speed performance. This work helps to elucidate the temporal associations of an important lifestyle factor that may influence cognitive functioning prior to midlife.
Creation of a Latin-American Dementia Advance Care Planning Guide
Authors: Cajavilca Moroni Fernandez , Solkowski Lauren , Utz Rebecca , Sanchez-Birkhead Ana , Aruscavage Nancy , Supiano Katherine , Iacob Eli , Dassel Kara 
Published: December 2021

Abstract
The LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia) is an advance care planning conversation guide for use within the context of dementia (Dassel et al., 2019). Considering that Latino adults have the highest risk of ADRD, a culturally sensitive and translated Spanish version of the LEAD Guide was needed. Therefore, the objective of this study was to: 1) translate the LEAD Guide into a Latin-American Spanish version (i.e., LA LEAD) and 2) assess the applicability and acceptability of the LA LEAD through focus groups with Latino older adults. First, the LEAD Guide was translated into a “neutral” Spanish version. Second, forward and backward translation was conducted to create the LA LEAD. Third, two 1.5-hour focus groups with Spanish-speaking Latino adults age 50+ who were: a) healthy adults (N=7) or b) current or previous dementia caregivers (N=7) were held. The focus groups were recorded, translated, and transcribed for descriptive analysis, which revealed three domains regarding the LA LEAD: 1) Family Dynamics: the guide could help prevent family conflict, designate a health care proxy, and reduce burden; 2) Cultural Expectations: acknowledgement of cultural nuances between LA countries, the familial responsibility of caring for family in the home, and the influence of religion on end-of-life care decisions, and 3) Health Literacy: lack of knowledge about advance care planning conversations, documentation, and dissemination. This process resulted in the creation of a validated LA LEAD Guide, which is a culturally and linguistically appropriate and acceptable advance care planning tool for Latino older adults.
Examining the Impact of COVID-19 on Loneliness and Social Isolation Among Affordable Housing Residents
Authors: Mock Marilyn , Goebelbecker Roisin , Pomerantz Sherry , DeGennaro Jennifer , Perweiler Elyse 
Published: December 2021

Abstract
Loneliness and social isolation are serious public health concerns associated with higher risks of clinical depression, suicidal ideation, coronary artery disease, stroke, functional decline, an increased risk of developing dementia and cancer mortality. Recent reports indicate the prevalence and dangers of loneliness and social isolation have increased as a result of the COVID-19 pandemic, especially among older populations. In order to address these concerns among residents living at Northgate II (NGII), a 302-unit affordable housing development in Camden, NJ, Fair Share Support Services, Inc. (FSSS), the non-profit arm of Fair Share Housing Development, collaborated with the New Jersey Institute for Successful Aging (NJISA) and the DHHS-funded Geriatric Workforce Enhancement Program (GWEP) to develop a loneliness/social isolation survey using two evidenced-based tools, the UCLA Loneliness Scale and the Steptoe Social Isolation Index. FSSS piloted the loneliness and social isolation survey with 192 low-income minority older adults residing at NGII. Results indicate that 49% of the NGII residents surveyed fall into 5 "at-risk" categories: 1) lonely and isolated (9%), 2) lonely/somewhat isolated (8%), 3 ) lonely/not isolated (9%), 4) isolated/somewhat lonely (9%), and 5) isolated/not lonely (14%). FSSS, will utilize survey results and follow-up interviews to tailor social service/other interventions to meet the needs and preferences of residents with the goal of preventing serious health problems associated with loneliness and social isolation, allowing residents to age in place.
Focus Group Findings of Trial Participants in a Caregiver Psychosocial Intervention: Savvy Caregiver Program
Authors: Aranda Maria , Aguilar Iris , Maldonado Rene 
Published: December 2021

Abstract
Previous work highlights the importance of sociobehavioral interventions to address dementia caregiving health and wellbeing outcomes. By empowering caregivers to become objective managers of their loved one’s illness, and own self-care, they are less likely to exhibit negative outcomes. We are conducting a mixed-method, randomized trial to test manualized, multi-family psychoeducational group interventions: Savvy Caregiver Express, and Savvy Caregiver Program. This poster describes the qualitative findings of four focus group interviews recently conducted to elucidate the study participation experiences of family caregivers enrolled in the parent study. Twenty-five racially and ethnically diverse participants (21 women, 4 men) caring for a family member with cognitive decline participated in focus group interviews conducted via videoconferencing methods. We captured more nuanced experiences from the perspective of study participants with regards to the caregiver interventions and their research participation. Interviews were conducted by trained research personnel, lasted 60-75 minutes, and followed an open-ended questioning route. Based on thematic analyses, we identified the following themes: 1) Changing one’s mindset: Seeing life through their shoes; 2) Getting information in one place; 3) Expanding the personal experience; 4) Fears and vulnerability; 5) Time constraints vs. wanting more; 6) Not everyone is at the same place; 7) Technology: It’s going to be part of our lives; and 8) Research: Not always in sync. Our findings indicate high satisfaction with most components of the program while specific recommendations were offered to improve the intervention and study experience such as tailoring materials to stage-specific needs.
Genomic Sequencing of sod1D Yeast That Escape Spore Death
Authors: Adanlawo Temiloluwa , Wende Helen Vander 
Published: December 2021

Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that impacts nerve cells and the spinal cord, which in some cases are linked to mutations in the Superoxide Dismutase 1 (SOD1) gene. Sod1 is an antioxidant within cells that converts reactive oxygen from superoxide into water using a copper and zinc ion to deactivate the oxygen. When the SOD1 gene is deleted, yeast cells are still able to undergo meiotic divisions and generate four spores, but the spores that are produced are inviable. However, we see that randomly, sod1∆ spores can grow on rich media. This leads us to hypothesize that somewhere in the genome, there is a suppressor mutation that allows these cells to grow. We tested this hypothesis by preparing samples for whole genome sequencing. By comparing the genomic sequences from our suppressor mutants to wild-type controls, we’re able to identify a single point mutation within a gene called NCA2, which codes for a protein that regulates expression of Fo-F1 ATP synthase subunits 6 and 8. Given this result, we are now working to try and understand the relationship between the sod1∆ spore death phenotype and the modulation of ATP synthase activity. In summary, the results from our work have the potential to further help us understand what role Sod1 plays in yeast meiosis and may be able to give us a deeper understanding for ALS cases that are linked to Sod1.
Goals of Care Conversations in Nursing Home and Assisted Living Care Plan Meetings
Authors: Towsley Gail , Tay Djin , Edelman Linda 
Published: December 2021

Abstract
Me & My Wishes is a novel systematic approach for long-term care residents living with dementia to record videos about their care preferences that can be shared with staff and families in care plan meetings. To understand how the videos were utilized in Goals of Care (GOC) conversations, we coded and analyzed transcripts of recorded care plan meetings at the time of sharing the video using a priori codes derived from GOC conversation elements. Coding discrepancies were resolved in team meetings; finalized codes were summarized to derive themes. Thirty-four care plan meeting conversations between residents (n=34), family members (n=29) and staff (n=35) were analyzed. Residents appreciated sharing personal histories and preferences via video, while staff members appreciated deeper understanding of residents’ care preferences. Two themes described care plan meeting conversations: Everyday Care - a checklist-style assessment of the resident’s daily care (e.g., help with activities of daily living), activities engaged in and satisfaction with care; and Clarifying Care Goals - checking the resident’s treatment preference (e.g., pain management, CPR), explaining hospice, or confirming the resident’s contact person. Several elements of GOC were not discussed (e.g., disease progression) and conversations lacked depth and comfort evidenced by apologetic language and abrupt transitions of topics rather than exploring alignment of goals with care preferences. Me & My Wishes videos are a mechanism for residents to voice preferences. Standardized guidance, which is lacking in long-term care, is needed to help care teams engage in meaningful conversations to ensure alignment of goals and treatment preferences.
How Can We Encourage Older Adults to Adopt Digital Services?
Authors: Xie Yutong , Wu Jiayi , Yow W Quin 
Published: December 2021

Abstract
Majority of older adults (OA) do not use technology frequently. For example, 84% of Singapore OA own a smartphone, however, only 22% have tried apps like online shopping. Similarly, 42% of US OA own a smartphone, yet one-third of them have never used the internet. Past research indicated poorly designed user interfaces as a barrier to technology use. Based on the Technology Acceptance Model (TAM), we hypothesize that OA-friendly user interfaces can increase perceived usefulness (PU) and perceived ease of use (PEOU) of technology, which would translate into increased digital services adoption rate. Forty healthy participants aged 65 to 86 (6 males, 34 females, mean age = 72.3) were recruited through OA activity centers in Singapore and assigned to either control or experimental groups. Both groups used an online website to perform specific shopping tasks and answered a TAM questionnaire. The control group used a website modeled after current websites while the experimental group used an OA-friendly website designed based on literature review and pre-survey, with features like OA-friendly mode, tutorial and online helpdesk. Data analysis was conducted using an independent sample t-test and bootstrapping. The experimental group showed a significantly higher proficiency in performing tasks (p=0.037), PEOU (p=0.049), and PU (p=0.044) than the control group. This suggests that user interfaces friendlier to OA increases their acceptance of technology, which could translate into a higher digital service adoption rate. Therefore, this research sets the basis for further research on digital services guidelines for older adults, including for telehealth and others.
Intake of Flavonoids and Odds of Frailty Onset in Adults in the Framingham Offspring Cohort
Authors: Nguyen Thuy Nga , Millar Courtney , Kiel Douglas , Hannan Marian , Sahni Shivani 
Published: December 2021

Abstract
Polyphenols (antioxidants derived from plant-foods) could play a role in inhibition of oxidative stress and frailty reduction, yet data on the polyphenol subclass of dietary flavonoids is limited. This study sought to determine the association between dietary flavonoids and frailty onset in middle-aged and older adults. This prospective cohort study included non-frail individuals from the Framingham Offspring Cohort (FOC) with total flavonoid intake (mg/day; defined as sum flavonols, flavan-3-ols, flavonones, flavones, and anthocyanins via Harvard Food Frequency Questionnaire), frailty (via Fried phenotype), and covariate information measured at baseline (1998-2001). Follow-up frailty was evaluated in 2011-2014. Logistic regression estimated odds ratio (OR) and 95% confidence intervals (95% CI) adjusting for relevant confounders. Participants (n=1,701; 55.5% female) had a mean age of 58.4 years (SD ± 8.3). Mean flavonoid intake was 309 mg/d (SD ± 266). After 12.4 years (SD ± 0.8), 224 (13.2%) individuals exhibited frailty. In age and sex adjusted models, every 50 mg/day of higher total flavonoid intake was associated with 3% reduced odds of frailty [OR (95%CI): 0.97 (0.94-1.00), p-value: 0.05). Further adjustment for smoking, energy and protein intake, and disease indicators did not appreciably change the association, and associations became non-significant (p-value=0.12). Thus, there was no association between flavonoid intake and odds of frailty onset in adults in the FOC. This could be due to participants' higher intake of flavonoids compared to average intake of ~200 mg/d in Americans.