bluuebunny/crossref_metadata_2025_split huggingface dataset:
Race Differences in COVID-19 Stress and Social Isolation: Implications for Depressive Symptoms
Authors: Birditt Kira , Oya Akari , Turkelson Angela , Polenick Courtney , Fingerman Karen 
Published: December 2021

Abstract
The experience of the COVID-19 pandemic may vary widely by race. This study examined race differences in pandemic-related stress, social isolation and the implications for well-being. Participants included 1260 adults (45% women) ages 18 to 97 from the May and June 2020 nationally representative Survey of Consumers and 562 who completed a 6 month follow up in November/December. A total of 76% were White, 10% were Black, 3% were Asian, and 11% were Hispanic. Participants reported experiences of pandemic-related stress, social isolation and depressive symptoms in the last month. Analyses showed that minority groups reported greater pandemic related stress that had negative implications for depressive symptoms over time. The implication of social isolation for the stress-depressive symptoms link also varied by race. Overall this study showed racial inequities in the implications of COVID-19 pandemic and that reducing social isolation may only be beneficial for certain racial/ethnic groups.
Developing, Testing, and Implementing a Falls Prevention and Healthy Aging App (Keep-On-Keep-Up) for Older Adults
Authors: Stanmore Emma 
Published: December 2021

Abstract
Falls are a common and costly concern for older adults. Digital technologies can offer new, inexpensive approaches to increase access and engagement with falls prevention programmes. Keep-On-Keep-Up is a personalised, falls prevention App with strength and balance exercises plus health literacy games. This study reports on the user-centred design, usability testing and implementation of the KOKU App. Older adults aged 55 years and older in the UK were invited to take part in the study. Data collection included focus groups; baseline and 6 week questionnaires and assessments; semi-structured interviews and one focus group with falls prevention therapists to explore App usability. Thirty older adults were invited to use KOKU unsupervised, 3 times a week for 6 weeks. Data were analysed using thematic content analysis. Focus groups (n=11) with 66 older users and 11 therapists informed development. Thirty older adults (mean age = 75) were recruited for the in-depth testing. Mean SUS score was 71 indicating high usability. Qualitative themes included: ease of use (app usability; iPad properties; exercise presentation), usefulness (physical/psychological benefits; falls education), attitude towards the App and intention to use (technological barriers; flexibility of use; exercise class versus App). Therapists (n=6) viewed the KOKU platform positively and suggested extensions for further progression. No adverse events were reported during the study. This research demonstrates that KOKU is an acceptable and easy to use falls prevention intervention that facilitates older adults’ ability to access falls prevention training at a time, and in a location, that suits them.
My Faith Gives Me Strength: Black Churches Supporting Dementia Care Partners
Authors: Sloan Danetta , Cotter Valerie , Samus Quincy , Spliedt Morgan , Means Samuel , Bowie Janice , Gaskin Darrell 
Published: December 2021

Abstract
Inequities in dementia care require an in depth understanding of dementia care partner life experiences, care needs, sources of support and ways to improve those experiences at the community level. In partnership with Black Churches in Baltimore, MD and rural Pennsylvania, we facilitated three focus groups (n=30) with Black dementia care partners to understand: 1) unique dementia care-related needs and challenges, and 2) how the church can be a supportive care partner. Participants noted three overarching themes related to challenges and needs: 1) unique challenges in caregiving - assuming various roles to provide comprehensive care, working within policies of support services, environmental challenges (neighborhood safety), and family conflicts; 2) lack of dementia education and educational materials; and 3) unmet needs of the care recipient – lack of dementia friendly neighborhoods, lack of meaningful activities, and undiagnosed dementia. Regarding the supportive role of the church, the theme of perceived role of the church included providing emotional and social support for care partners and recipients, reducing burden through providing respite, support groups, networking/ connections to resources, and promoting health events.
Transcending Inequities in Dementia Care in Black Communities: Lessons From the MIND Care Coordination Program
Authors: Sloan Danetta , Johnston Deirdre , Fabius Chanee , Antonsdottir Inga , Spliedt Morgan , Pyatt Tabitha , Reuland Melissa , Samus Quincy 
Published: December 2021

Abstract
Resolution of ongoing inequities in dementia care requires careful examination of how care is delivered to ensure we are aware of, and meeting needs for all people affected, especially those most vulnerable and in under-resourced communities. Maximizing Independence at Home (MIND) is a multicomponent, home-based dementia care program designed to provide high quality, wholistic care coordination for to persons and families living with dementia. Program goals are to delay transition from home, improve life quality, and reduce unmet care needs. We completed three focus groups (n = 25) with Black (e.g., African American) dementia caregivers who received the intervention to understand (1) the unique dementia related needs of Black dementia caregivers and barriers and challenges to caregiving experienced within the Black community , (2) perceived benefits of MIND, and (3) ways to improve the MIND intervention. Participants noted three overarching themes related to needs and challenges in dementia care in the Black community: difficulty finding and accessing dementia information, help, and related services; familial conflict/lack of sibling and familial support; and lack of effective communication about dementia within Black Communities. Regarding benefits of the program, four themes emerged including that the program helped find resources (formal and informal); provided caregivers an opportunity for socialization and interaction; included comprehensive assessments and helpful linked information; and resulted in a “much needed break.” Increased diversity of MIND personnel and greater clarity and consistency in MIND program promotion and communications were themes for how the program could be improved.
Cumulative Stress Burden and Cognitive Function in African American Adults Living in Low-Income Neighborhoods
Authors: Fan Erica , Dubowitz Tamara , Troxel Wendy , Weinstein Andrea , Gary-Webb Tiffany , Butters Meryl , Ghosh-Dastidar Bonnie , Rosso Andrea 
Published: December 2021

Abstract
African Americans (AA) are more likely to experience stressors due to racial discrimination and segregated neighborhoods, potentially contributing to higher risk for dementia. We investigated the association between stressors and cognitive function in older AA adults through cumulative stress burden (CSB) indices. Stressors and cognitive domains were measured in 253 participants &gt;50 years, recruited from primarily AA neighborhoods in Pittsburgh, PA. CSB included perceived and psychological distress, unfair treatment, post-traumatic stress disorder, and neighborhood-level stressors such as walkability, safety, satisfaction, and social cohesion. Indices were formed by dichotomizing stressor scores and summing. Cognitive domains were z-scores adjusted for age, sex, and education. Adjusted generalized linear models assessed the relation between CSB indices and cognition, and between specific stressors and cognition. Interactions with age were tested. Greater individual-level CSB index was associated with lower language (□= -0.11, p= 0.03) and executive function (□= -0.087, p=0.04). The neighborhood-level CSB index was not associated with any cognitive domain. The combined index was marginally associated with language in adjusted models (□= -0.07, p= 0.05). There were no significant associations between specific stressors and cognition, except for neighborhood safety with 3MS (□= -0.28, p= 0.001) and language (□= -0.16, p= 0.02). Age interactions indicate that findings were stronger for younger participants. Greater cumulative stress is associated with poorer cognitive function in some domains in older AA. A comprehensive assessment of cumulative stress is vital in understanding the dimensionality of racialized stress for older adults potentially experiencing cognitive decline.
COVID-19 Mortality In Adult Congregate Living Settings Across Five U.S. States
Authors: Rein David , Shapiro Lindsey , Mancino Mairin , Pearson Caroline 
Published: December 2021

Abstract
The magnitude of COVID-19 mortality in adult congregate living settings other than nursing homes (NH) is unknown. To address this, we created an individual property level dataset for five U.S. states (Colorado, Connecticut, Florida, Georgia, and Pennsylvania) using multiple public and private sources. The data included information on each observation’s state and county, level of care (LOC), the estimated number of residents, COVID-19 deaths through December 31, 2020, and county-level cases of COVID-19 per 100,000. We restricted our sample to market grade properties with 25+ residents, for which we able to estimate resident and LOC information. We defined LOC as County, non-congregate (CN), Independent Living (IL), Assisted Living (AL), Memory Care (MC), and Nursing Home (NH). We used multilevel, multivariable logistic regression models to estimate the expected death rate for each LOC controlling for differences in reported COVID-19 infections and county and state reporting differences. We identified 3,059 properties that met our inclusion criteria (69 CN, 477 IL, 1,118 AL, 179 MC, and 1,216 NH). We estimated deaths per 1,000 persons of 4.4 (95% CI: 4.0-4.8) for CN, 4.4 (3.9-4.9) for IL, 16.2 (14.7-17.9) for AL, 50.3 (44.4-56.8) for MC, and 32.0 (29.3-34.9) for NH. The order of death rate severity was the same in each state, except MC in Georgia. Additional research is needed to evaluate whether death rate differences resulted from congregate living risks, from COVID mortality risk factors at each LOC, or a combination of factors.
Relation Between Volunteering and Suicidal Ideation Among Older Adults
Authors: Fenstermacher Erika , Owsiany Montgomery , Fiske Amy , Van Orden Kim 
Published: December 2021

Abstract
Suicide disproportionally affects older adults, necessitating further investigation into potential protective factors for suicide in late life. Volunteering is associated with psychological well-being in older adults. However, there is scant literature examining the association between volunteering and suicidal ideation or behavior in this age group. The present study involved a cross-sectional examination of volunteering and suicidal ideation using baseline data from the Helping Older People Engage study. This sample (N = 245, 88% White, 68% female, 60-92 years old) was recruited from primary care practices. Inclusion criteria included clinically significant loneliness (UCLA loneliness scale M = 49.5; SD = 5.7). Forty-three percent of the sample reported engaging in recent volunteer activity. Passive and active suicidal ideation in the past month were endorsed, respectively, by 20% and 9% of the sample. Results of hierarchical linear regression analyses examining the association between volunteering and suicidal ideation, controlling for covariates, will be discussed.
Metabolomics-Based Biomarkers for Frailty in Chinese Older Adults
Authors: Pan Yiming , Liu Pan , Li Yun , Ma Lina 
Published: December 2021

Abstract
Background: Frailty is a clinical state characterized by decline in physiological function, and increased vulnerability to adverse outcomes. The biological mechanisms underlying frailty have been extensively studied in recent years. Advances in the multi-omics platforms have provided new information on the molecular mechanisms of frailty. Thus, identifying omics-based biomarkers is helpful for both exploring the physiological mechanisms of frailty and evaluating the risk of frailty development and progression. Objective: To identify metabolomics biomarkers and possible pathogenic mechanisms for frailty with untargeted-metabolomics profiling. Methods: LC-MS-based untargeted metabolomics analysis was performed on serum samples of 25 frail older inpatients and 49 non-frail older controls. The metabolomics profiling was compared between the two groups. Results: We identified 349 metabolites belonging to 46 classes, in which 2 were increased and 3 were decreased in frail older adults. Citrate cycle (with up-regulated cis-Aconitic acid, Fumaric acid, L-Malic acid, and Isocitric acid), fatty acid metabolism (with up-regulated Palmitic acid and L-Palmitoylcarnitine) and tryptophan metabolism (with up-regulated 5-Hydroxy-L-tryptophan, L-Kynurenine, Kynurenic acid, and 5-Hydroxyindoleacetic acid) were significantly associated with frailty phenotype. Conclusions: Our results revealed characteristics of metabolites of frailty in Chinese older adults. The citrate cycle related metabolites (Isocitrate, (s)-Malate, Fumarate and cis-Aconitate), saturated fat (Palmitic acid), unsaturated fatty acid (Arachidonate and Linoleic acid), and some essential amino acid (Tryptophan) might be candidate biomarkers for early diagnosis of frailty. Disorders of energy metabolism, lipotoxicity of saturated fatty acids, disturbances of unsaturated fatty acid metabolism, and increased degradation of tryptophan were potential mechanisms and therapeutic targets of frailty.
The Association Between Metabolic Syndrome and Frailty in Healthy Community-Dwelling Older Adults
Authors: Ekram A R M Saifuddin , Espinoza Sara , Ernst Michael , Beilin Lawrence , Stocks Nigel P , Ryan Joanne , Woods Robyn 
Published: December 2021

Abstract
This study examined the association between metabolic syndrome (MetS) and frailty status in relatively healthy community-dwelling older adults. Participants included 19,114 individuals from the “ASPirin in Reducing Events in the Elderly” (ASPREE) trial. The diagnostic criteria for MetS were according to the International Diabetes Federation Task Force on Epidemiology and Prevention and the American Heart Association/National Heart, Lung, and Blood Institute (2009); and comprised any three of five parameters: waist circumference, triglycerides, fasting blood glucose, high-density lipoprotein cholesterol or hypertension. Frailty and prefrailty were defined using a modified Fried phenotype (FP) comprising exhaustion, body mass index, grip strength, gait speed and physical activity and a deficit accumulation frailty index (FI) of 66 items. The association between MetS and frailty was examined using multinomial logistic regression. At baseline, 51.1% of participants met the criteria of MetS; of those, 41.8% and 2.5 % were prefrail and frail, respectively, according to Fried phenotype, while 49.6% and 11.8 % were prefrail and frail, respectively, according to FI. MetS at baseline was associated with an increased likelihood of prefrailty (RRR: 1.25; 95% CI: 1.17, 1.33) and frailty (RRR: 1.60; 95% CI: 1.28, 2.01) compared to no frailty after adjustment for potential confounders according to Fried phenotype, while the association was stronger for prefrailty (RRR: 2.74; 95% CI: 2.55, 2.94) and frailty (RRR: 5.30; 95% CI: 4.60, 6.11) according to FI. Overall, at baseline, more than half of the participants had MetS, and the presence of MetS was significantly associated with pre-frailty and frailty.
Cognitive-Behavioral Styles of Dementia Care Management: Targeting and Tailoring to Style
Authors: Leggett Amanda , Koo Hyungjung , Connell Cathleen , Gitlin Laura , Kale Helen 
Published: December 2021

Abstract
Despite an extensive literature on the stress process of caregiving, little attention has focused on how caregivers provide care (caregiving styles). To explore caregiving styles among 100 primary caregivers for persons living with dementia, we utilize k-modes machine learning analysis. This technique clusters caregiver’s use of behavioral (Dementia Management Strategies Scale; criticism, active management, encouragement) and cognitive (Caregiver Readiness Scale; understanding, adaptability) approaches into style profiles. Three styles were identified: Managers (n=25; high use of criticism, moderate use of active management and encouragement, poor understanding and adaptability), Adapters (n=48; low use of criticism, high use of adaptive management and encouragement, good understanding and adaptability), and Avoiders (n=27; low use of all behavioral strategies, moderate adaptability and understanding). Styles differ by demographic and care characteristics. Findings suggest that caregivers have variable approaches to care that are measurable, thus, targeting/tailoring interventions to caregiver style could be an effective approach.
Social Isolation Among Older Military Veterans
Authors: Suntai Zainab , Laha-Walsh Kirsten 
Published: December 2021

Abstract
Social isolation is an increasingly critical issue among older adults and has been found to affect several domains of well-being, including physical, psychological, and cognitive health. Research has found that military veterans often experience hardships in the transition back to civilian life including emotional trauma, depression, substance misuse and pain from combat-related injuries, which have been shown to persist well into older adulthood. As such, this study aimed to examine the prevalence of social isolation among older military veterans and determine which veterans are most at-risk of experiencing social isolation, using the Berkman-Syme Social Network Index as a framework. Data were derived from Round 1 of the National Health and Aging Trends Study (NHATS), an annual longitudinal panel survey of adults aged 65 and older living in the United States. Results showed that about 4.5% of veterans in the NHATS are severely socially isolated while another 20.9% are socially isolated. After controlling for other explanatory variables, being White, being 85 and older, having lower educational attainment, being unmarried/unpartnered and having lower income were associated with an increased risk of experiencing social isolation. Interventions aiming to improve the well-being of older veterans should consider employing both preventative and amendatory measures. These may include the creation and administration of a standardized social isolation scale during visits to veterans’ affairs (VA) medical centers and a general effort to address stressors from military service by destigmatizing and improving access to mental health services.
Lithium Receipt and Risk of Dementia in Older Veterans With Bipolar Disorder in the VA Health System
Authors: Szymanski Benjamin , Ahearn Eileen , Smith Eric , Jedele Jenefer , McCarthy John , Katz Ira 
Published: December 2021

Abstract
Older adults with bipolar disorder are at increased risk of developing dementia. The literature suggests lithium treatment may reduce the incidence of dementia. This study sought to inform clinical practice in the Veterans Affairs (VA) health system by estimating the effect of past year lithium receipt on dementia incidence among Veterans with bipolar disorder. Divalproex receipt was used as a comparison. Using VA medical records, 121,094 Veterans aged 50 and older with a diagnosis of bipolar disorder but no dementia diagnosis were identified in fiscal years 2005-2019. Follow-up continued until dementia diagnosis, 36 months from the index date, death, or the end of fiscal year 2020, whichever came first. 4347 (3.6%) were diagnosed with dementia during follow-up. Time-varying indicators of receipt of lithium and divalproex in the prior 365 days were calculated for each day, categorized as 301-365, 61-300, 1-60, or 0 days of receipt. Unadjusted Cox proportional hazards regression analyses indicated reduced dementia incidence with 301-365 (HR=0.86, 95% Confidence Interval [95%CI] 0.75-0.99) and 61-300 (HR=0.75, 95%CI 0.65-0.87) days of lithium receipt, compared to 0 days. For divalproex, 301-365 (HR=1.34, 95%CI 1.23-1.47) and 61-300 (HR=1.13, 95%CI 1.03-1.23) days of receipt were each associated with increased dementia incidence. Lithium effects were not statistically significant after adjusting for age, sex, race, ethnicity, medical comorbidities, and antidepressant, antipsychotic, and anxiolytic medication receipt. Divalproex effects remained statistically significant. Past year divalproex, but not lithium, receipt was significantly associated with dementia incidence among VA patients with bipolar disorder when adjusting for demographics and medical comorbidities.
Gait Speed Maintenance Is Associated With Sensorimotor and Frontoparietal Network Connectivity Among Older Adults
Authors: Hsu Chun Liang , Manor Brad , Lipsitz Lewis 
Published: December 2021

Abstract
Mobility impairment is a geriatric giant. Particularly, slow gait is associated with elevated risk for cognitive decline, disabilities and dementia. Gait is the product of complex neural network interactions and changes in their connectivity pattern may negatively impact gait speed. However, mechanistic neural correlates for gait speed maintenance and decline remained unclear. As such, the aim of this study is to investigate differences in neural network connectivity in older adults with and without gait speed decline over 24 months. This sub-analysis included 35 community-dwelling older adults age &gt;70 years from the MOBILIZE Boston Study. Baseline assessments included four-meter gait speed test and resting-state fMRI. Gait speed was reassessed at a 24-month follow-up. Participants were stratified to “Maintainer” and “Decliner” groups based upon a cut-off of &gt;0.05 m/s decline in gait speed from baseline to follow-up. A priori selected functional network included sensori-motor network (SMN) and frontoparietal network (FPN). Multivariate analysis of variance was performed to determine between group differences in network connectivity. Discriminant analysis was conducted to identify relative contribution of network connectivity to group classification. Between the 14 Maintainers and 21 Decliners (mean age 83.9 years), Maintainers were younger (p=0.088). After adjusting for age, Maintainers exhibited lower SMN premotor-precentral gyrus connectivity (p=0.023), greater FPN ventral visual-supramarginal gyrus connectivity (p=0.025), and trend level greater SMN-FPN cerebellum-occipital connectivity (p=0.053). Premotor-precentral gyrus connectivity showed greatest contribution to discriminant function. These preliminary findings suggest aberrant connectivity patterns of the SMN and FPN may be predictive of older adults’ ability to maintain gait speed.
Workplace Prosocial Activities and Daily Well-Being During COVID-19
Authors: Chi Kevin , Carstensen Laura 
Published: December 2021

Abstract
Workplace prosocial activities, such as providing unpaid assistance to colleagues, has been linked to better well-being. However, little is known about how these associations unfold in daily life. This study examines how prosocial activities at work are associated with daily well-being during the COVID-19 pandemic. A sample of 22 employees (aged 22-69 years) from a wealth management firm reported their daily activities and well-being on 10 consecutive workdays. On days when individuals provided help to someone they work with, they experienced higher positive affect, and greater enjoyment and interest at work, compared to days when they did not provide help. Individuals who provided more help reported greater meaning at work. Initial findings suggest that workplace prosocial activities have positive implications for daily well-being during the pandemic. Subsequent analyses will examine whether these findings replicate in a separate sample of working adults. Age differences in helping and meaning will be discussed.