bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Relationship-Oriented Model of Research Participation: The Brain Health Community Registry
Authors: Bykovskyi Andrea Gilmore , Fuhr Haley , Mullen Shannon , Block Laura , Benson Clark , Harris Danielle , Cotton Quinton , Kendall Jessica 
Published: December 2021

Abstract
Historically excluded and minoritized populations are significantly under-included in health studies of Alzheimer’s disease and related dementias (ADRD) despite bearing a disproportionate burden of disease—evidenced by higher incidence, prevalence, and poorer health outcomes. Meaningful progress toward identifying and alleviating causes of health disparities in ADRD necessitate effective and scalable approaches for broadening inclusion in research. Rigorous studies evaluating research participation among minoritized populations are limited and have predominantly focused on individual-level factors and behavioral change (i.e. religiosity, willingness). These approaches frequently overlook the influence of unequally distributed structural and social determinants on participation despite the compounded financial, social, emotional, and logistical consequences that result from ADRD. Using an intersectional and social justice lens, we developed the Participant and Relationship-Oriented Research Engagement Model, which characterizes research as a form of relationship and extends social determinants frameworks to the context of research participation. We report core components of the model and its application in the design and preliminary evaluation of the Brain Health Community (BHC) Registry, which features proactive and systematic evaluation of potential unmet needs among prospective participants, and connections to relevant services (i.e. respite care, adaptive devices). Preliminary testing of the model and participant feedback on the BHC suggest it is a feasible approach to research engagement, and that associated assessment tools and resource protocols are acceptable and sufficiently adaptable to heterogeneous sets of unmet needs. Primary challenges include ongoing assessment of engagement and routine changes in service ability, which can be addressed through community-based resource networks.
Chronic Diseases and Self-Reported Health Status Among American Indian/Alaska Native Older Adults
Authors: Danielson Ramona , Adamsen Collette , Mason Agnieszka 
Published: December 2021

Abstract
Background: In the 1800s and 1900s, U.S. federal “Indian” policy (e.g., boarding schools, relocation) created historical trauma with impacts that reverberate today, such as the significant health challenges experienced among American Indian/Alaska Native (AI/AN) populations. Our study seeks to better understand the burden of chronic disease, and also resilience, among AI/AN older adults. Methods: Data came from Cycle VII (2018-2020) of the National Resource Center on Native American Aging’s “Identifying Our Needs: A Survey of Elders” survey of AI/AN adults ages 55+ from primarily rural tribal survey sites (N=20,642). Analysis explored self-assessed health status (very good/excellent, good, fair/poor) and looked for significant differences in prevalence of chronic conditions a doctor ever told them they had (e.g., high blood pressure, diabetes, depression, arthritis, asthma). Results: Self-reported health among AI/AN adults age 55+ was: 26% very good/excellent, 39% good, and 35% fair/poor. 87% of respondents had 1+ chronic illness; 37% had 3+. Among those reporting very good/excellent health, 75% had 1+ chronic illness and 19% had 3+. High blood pressure was the most common chronic disease, at 56% (44% for very good/excellent compared to 67% for fair/poor), followed by diabetes, at 36% (24% for very good/excellent compared to 46% for fair/poor). Conclusions: All of the chronic conditions examined showed significantly higher prevalence among AI/AN adults 55+ with fair/poor health. Notably, 1 in 5 respondents with 3 or more chronic conditions indicated very good/excellent health, reinforcing that successful aging can still be experienced by those with chronic health conditions.
Circadian rhythm for female entering old age: exploration on the effect of eating behavior
Authors: Tang Hsiao-Han , Chiu Ching-Ju 
Published: December 2021

Abstract
Unhealthy lifestyle and eating behavior are associated with circadian rhythm disruption which contributes to numerous harmful outcomes. The relationship between circadian rhythm and eating behavior remains unclear. The study aims to investigate different types of eating behavior in middle-aged women and their variation in circadian rhythm. A descriptive, cross-sectional design was used. We recruited a convenience sample of 150 female aged 45 years or over from the community in southern Taiwan. Sociodemographic status, sleep diary and eating behavior were collected by questionnaires; behavioral circadian rhythm were monitored with the wrist-worn application. Four middle-aged participants were interviewed. Preliminary data show three main findings: (1) Sleep efficiency was decrease with age, (2) First meal within 2 hours after waking up was associated with higher amplitude (2.24 vs 1.43 log count), relative amplitude (0.92 vs 0.71), middle to vigorous physical activity time (101.22 vs 58.41 minute), lower lowest active 5 hr midpoint (2.63 vs 4.34 hour) and acrophase (13.67 vs 15.75), (3) Participants with morning chronotype have less sedentary behavior and higher most active 10 hr during wake time. Age and timing of first meal after waking up seem dominating circadian rhythm. Chronotype might be a significant factor for physical activity level. More data is needed to further confirm the association.
Novel Technology Support Program for Older Adult Program With Interprofessional Geriatrics Students
Authors: Olsen Bonnie , Segal-Gidan Freddi , Thayer Erin , Guardia Yeini , Penate M Christina , Kogan Alexis Coulourides 
Published: December 2021

Abstract
During the COVID-19 pandemic, many older adults were not receiving primary care services because they could not negotiate the technology for telehealth visits. Coupled with persisting pandemic physical distancing, increased social isolation in older adults was- and continues to be a significant problem. To combat these issues, we aimed to 1) prepare older adults for longitudinal isolation by encouraging social connectedness, and 2) enable older adults to safely access remote primary care services during the pandemic. We paired older adults from 9 housing sites in Los Angeles, CA with health professions graduate students from 9 programs at USC (N = 88 dyads) and provided iPhones to participants without a smartphone. Students educated and supported older adults about the use of technology to access primary care services and to socially connect with family/friends. When requested, 3 additional students provided enhanced 1:1 technology support. Among the 45 participating older adults who received iPhones (51.1%), 22 requests were made for enhanced technology assistance during the 6-month program. Most requests related to initial setup/navigation of iPhone (81.8%) or video calls (27.3%), where others requested help with Wi-Fi (13.6%), composing emails (4.5%), and adding language/translation features (4.5%). Nineteen (83%) technology support requests were successfully resolved; the remaining were unresolved due to loss to follow-up. Our findings demonstrate that older adults can successfully cross the digital divide when technology support is provided. Additionally, pairing older adults with health professions students is an effective strategy to enable access to remote primary care and social connectedness.
Pilot study of a new telehealth program for depressed older adults: The Positive Experience Project (P.E.P.)
Authors: Gallagher-Thompson Dolores , Morioka-Douglas Nancy , Fogg B J , Le Keck Mei- 
Published: December 2021

Abstract
Social isolation, logistical challenges, and limited access to mental health providers who accept Medicare contribute to older adults having a higher risk for untreated depression. Primary care providers (PCPs) are strained due to time demands and lack of training in behavioral activation and similar therapies. This study was designed to reduce depression in older adult primary care patients without burdening their PCPs. We evaluated whether outpatients age 65+ with mild to moderate self-reported depressive symptoms (measured by PHQ-8) benefited from a brief evidence-informed program, the Positive Experience Project(PEP). This is derived from the tenets and practices of both behavioral activation and the “tiny habits” program. The former emphasizes the value of increasing engagement in everyday positive activities to lift mood; the latter provides a method to enhance success by encouraging patients to link these activities with existing habitual behaviors, and to celebrate completion. A script was written for each of four 30-minute sessions conducted in small groups using a telehealth platform. An analysis of patients of the first author yielded 50 eligible patients. 8 were invited to participate and 7 did. The group’s mean PHQ-8 score pre-intervention was 10.1; post-intervention (4 weeks later), the average was 6.1 (P=.039). The use of “scripts” that guide the PCP through the visit enhances adoption. And PCPs can bill for these 30-minute sessions, making it feasible to help patients receive treatment for their depression. These promising results are currently being replicated by additional PCPs and their data will be included in the poster presentation.
The 4Ms of Age-Friendly Care: Successful Infusion into Electronic Medical Records Leads to Improved Care
Authors: Tobey Leah , McAtee Robin 
Published: December 2021

Abstract
Electronic Medical Records (EMR) and Health Information Technology (HIT) have changed the daily operations of the healthcare industry. For primary care systems/clinics, it has meant the purchase and tailoring of systems to fit specific needs of users and patients. As one of the HRSA funded Geriatric Workforce Enhancement recipients, the AR Geriatric Education Collaborative (AGEC) worked with a rural federally qualified healthcare clinic system for over a year to help them become IHI certified in Age-Friendly Care and the EMR has been a critical link. The system was crucial in identifying compliancy to the clinical Merit-based Incentive Payment System (MIPS) measures which helped identify the areas where most improvement was needed. Included in the process was a new geriatric screening tab in the EMR system. This tab contains 8 screenings including: depression, anxiety, alcohol use, prescription opioid use and recreational drug use, mentation, medication and mobility. This is in addition to asking “what matters” so that all four of the 4M’s age friendly framework components were included. Clinicians are successfully using the systems and improvements in outcomes are beginning to be noted. The outcome MIPS measures are obtained quarterly from an EMR report and data is shared with the staff and new quality improvement projects are developed using PDSA (plan, do, study, act) cycles based on the outcomes of the data. Next steps with the EMR will be the development of flags that will notify the clinicians when a screening is needed.
Decoupling of Global Brain Activity and Cerebrospinal Fluid Flow Is Linked to Alzheimer's Pathology
Authors: Han Feng , Chen Jing , Belkin-Rosen Aaron , Gu Yameng , Luo Liying , Buxton Orfeu , Liu Xiao 
Published: December 2021

Abstract
Alzheimer’s disease (AD) is the most common cause of dementia in the old adult population. AD pathogenesis has been linked to the aggregation of toxic proteins, e.g., amyloid-β and tau. The glymphatic system may play an important role in clearing out these proteins via cerebrospinal fluid (CSF) flows through perivascular and interstitial spaces. Recent studies have suggested low-frequency (&lt;0.1 Hz), sleep-dependent global blood-oxygenation-dependent-level (gBOLD; global resting-state functional MRI signal) during resting state is coupled with CSF movements, suggesting their potential link to glymphatic function. Here, we directly investigated whether the coupling between the gBOLD and CSF signals is related to AD-related pathology. By analyzing neuroimaging, neurobiological, and neuropsychological data from 118 human subjects (58-90 years of age; AD, early-stage AD, and control subjects included) collected in the Alzheimer's Disease Neuroimaging Initiative project, we found a strong coupling between the gBOLD and CSF signals. More importantly, the strength of this gBOLD-CSF coupling was significantly correlated with cortical amyloid-β level (p = 0.019), cognitive decline in the subsequent two years (p = 0.013), disease severity (p = 0.035), and several AD-related risk factors, including aging (p = 0.011), and gender (p = 0.026). These findings provide initial evidence for the critical role of resting-state low-frequency (&lt;0.1 Hz) neural/physiological dynamics in AD pathology. They also suggest that the gBOLD-CSF coupling may serve as a non-invasive imaging marker for gauging the glymphatic function.
Significant Associations of the Interplay Between Stress Related Genes With Alzheimer’s Disease
Authors: Yashin Anatoliy , Wu Deqing , Arbeev Konstantin , Bagley Olivia , Akushevich Igor , Duan Matt , Yashkin Arseniy , Ukraintseva Svetlana 
Published: December 2021

Abstract
The lack of efficient medication against Alzheimer’s disease (AD) is the most important problem for this health disorder today. One possible reason for this -- the implementing medical interventions “too late in the disease stage” – has been recently addressed in the initiative that defined the preclinical AD stage by measuring changes in preclinical AD biomarkers. According to this definition, beta amyloid (Aβ) is one of the key preclinical AD biomarkers. Experimental studies showed that Aβ results from proteolytic cleavage of APP by β- and γ-secretases. Production of β-secretase involves BACE1 gene, activated by cellular stress response. This suggest that AD might be initiated by cellular stressors and that multifactorial regulation of AD is likely to be driven by genes involved in cellular stress response. In this paper we investigate whether interplay between SNPs from the EIF2AK4 gene involved in sensing cellular stress signals and the APP gene dealing with Aβ production may be associated with AD in human data. For this, we evaluated association of the interactions of the pairs of SNPs from these genes with AD in the analysis of HRS data. We found that interactions between several SNPs have statistically significant associations with AD. The results of this analysis confirm that the interplay between gene served as a sensor of cellular stress and gene involved in production of preclinical AD biomarker in response to stress may influence human AD. This analysis illustrates an important step towards translation of the results of experimental AD studies to human applications.
Systemic Bioenergetic Capacity Changes with Cognitive Status and Insulin Sensitivity in Older Adults
Authors: Mahapatra Gargi , Gao Zhengrong , Bateman James , Gonzalez-Armenta Jenny L , Amick Allison , Casanova Ramon , Craft Suzanne , Molina Anthony J A 
Published: December 2021

Abstract
Systemic mitochondrial dysfunction is reported with AD progression, suggesting that peripheral blood cells may be used to investigate systemic mitochondrial alterations related to cognitive decline. We aimed to identify bioenergetic signatures associated with AD-related dementia and differences in insulin sensitivity associated with AD risk. We analyzed mitochondrial bioenergetics in peripheral blood cells collected from 365 older adults with varying cognitive status (normal, mild cognitive impairment, and AD) and insulin sensitivity. Normoglycemic individuals exhibited lower maximal bioenergetic capacity with AD (PBMCs: 239.6 pmol·min−1, p = 0.02; Platelets: 151.7 pmol·min−1, p = 0.06) compared to normal cognition (PBMCs: 271.5 pmol·min−1; Platelets: 171.7 pmol·min−1). Individuals with impaired insulin sensitivity exhibited lower maximal bioenergetic capacity in platelets with AD (171.6 pmol·min−1, p = 0.008) compared to normal cognition (210.6 pmol.min−1). Participants with impaired insulin sensitivity also exhibited unique bioenergetic profiles exemplified by overall higher levels of mitochondrial respiration, indicating that comorbidities such as diabetes can significantly influence bioenergetic capacity. We observed strong positive associations between maximal respiration in normoglycemic individuals with cognitive function, as measured by Modified Preclinical Alzheimer’s Cognitive Composite (mPACC5) (p = 0.06), and fatty acid oxidation in individuals with impaired insulin sensitivity with cortical thickness (p = 0.05). This study demonstrates that circulating cells may provide a cost-effective and minimally invasive way to monitor systemic bioenergetic changes associated with AD risk, progression, and insulin sensitivity. These findings also suggest that blood-based bioenergetics are related to key features of AD development and progression and should be further developed as a potential biomarker.
Using Drosophila to Identify Naturally-Occurring Modifiers of Alzheimer's Disease
Authors: Wang Adrienne , Yang Ming , Fitzgerald-Cook Cecilia , Harrison Ben , Green Akimi , Hartman Kensington , Zinkgraf Matthew , Promislow Daniel 
Published: December 2021

Abstract
Despite significant progress in identifying risk factors for late-onset Alzheimer’s Disease (LOAD), much of the variance in disease pathogenesis remains unexplained, likely due to the contribution of many genes of small effect size. Model organisms such as Drosophila Melanogaster exhibit conservation in both disease-causing genes and cellular processes implicated in Alzheimer’s Disease (AD), offering a genetically tractable model that can be statistically leveraged to identify causal variants. Here, we combine a Drosophila model of AD with the Drosophila Genetic Reference Panel (DGRP), a model of natural variation consisting of over 200 fully sequenced, isogenic lines derived from a wild-caught population. Expression of two proteins closely associated with AD pathogenesis, A□42 and Tau, in the Drosophila eye results in a “rough eye” phenotype, an easily quantifiable phenotype caused by degeneration of the ommatidial array. By quantifying the degree of A□42- and Tau-mediated degeneration across 164 lines of the DGRP and using a gene-based approach to map associations, we have identified and validated a subset of naturally occurring modifiers of degeneration in Drosophila. Enrichment analysis reveals that the set of genes identified in our screen show significant enrichment for genes identified as significant or suggestive (4x10-6&gt;p&gt;2x10-11) in human GWAS studies. The results presented here provide proof-of-principal for an approach that combines the strengths of forward genetic screens in model organisms with the power of human GWAS studies to identify and validate potential risk factors that have been difficult to detect in human studies alone.
Analysis of Survival Data with Competing Risks in ADRD (Alzheimer's Disease and Related Dementias) Research
Authors: Ren Dianxu , Lopez Oscar , Lingler Jennifer 
Published: December 2021

Abstract
Competing risk is an event that precludes the occurrence of the primary event of interest. For example, when studying risk factors associated with dementia, death before the onset of dementia serve as a competing event. A subject who dies is no longer at risk of dementia. This issue play more important role in ADRD research given the elderly population. Conventional methods for survival analysis assume independent censoring and ignore the competing events. However, there are some challenge issues using those conventional methods in the presence of competing risks. First, no one-to-one link between hazard function and cumulative incidence function (CIF), and Kaplan-Meier approach overestimates the cumulative incidence of the event of interest. Second, the effect of covariates on hazard rate cannot be directly linked to the effect of cumulative incidence (the risk). We will discuss two types of analyses in the presence of competing risk: Cause-specific hazard model and Fine-Gray subdistribution hazard model. Cause-specific hazard model directly quantify the cause-specific hazard among subjects who are at risk of developing the event of interest, while Fine-Gray subdistribution hazard model directly model the effects of covariates on the cumulative incidence function. The type of research questions (Association vs. Prediction) may guide the choice of different statistical approaches. We will illustrate those two competing risk analyses using the large national dataset from National Alzheimer’s Coordinating Center (NACC). We will analyze the association between baseline diabetes status and the incidence of dementia, in which death before the onset of dementia is a competing event.
Association Between Body Weight Change In Late Life And Risk Of Dementia: A Population-based Cohort Study
Authors: Guo Jie , Marseglia Anna , Shang Ying , Dove Abigail , Grande Giulia , Fratiglioni Laura , Xu Weili 
Published: December 2021

Abstract
Background. Adiposity in midlife is a modifiable risk factor for dementia. However, the effect of adiposity in late-life on dementia remains unclear. We investigated the association of body mass index (BMI) and weight changes after age 60 with the incident dementia. Methods. Within the Swedish National Study on Aging and Care-Kungsholmen, 1,673 dementia-free participants with data on BMI/weight both at baseline and the 6-year follow-up were followed to detect subsequent incident dementia cases. BMI change was assessed as the percentage of the difference between BMI at baseline and the initial 6-year follow-up and categorized into large (&gt;10%) or moderate (5–10%) loss, stable (≤5%), and moderate (5–10%) or large (&gt;10%) gain. Weight change (difference between weight at baseline and the 6-year follow-up) was categorized into large (&gt;7.5 kg) or moderate (2.5–7.5 kg) loss, stable (≤2.5 kg), and moderate (2.5–7.5 kg) or large (&gt; 7.5 kg) gain. Dementia was diagnosed following the DSM-IV criteria. Data were analyzed using Cox regression models. Results. During the follow-up (median 5.78 years), 102 incident dementia cases developed. BMI/weight change showed U-shaped associations with dementia. Compared with stable BMI, the hazard ratios (95% confidence intervals) of dementia were 2.93 (1.72−4.91) for large BMI loss and 2.61 (1.09−5.54) for large BMI gain. Similar results were observed for a large weight loss (2.92 [1.67−5.07]) or gain (2.95 [1.16−6.53]). These associations became stronger among participants carrying an ApoE ɛ4 allele. Conclusion. Both large bodyweight loss and gain are associated with a higher risk of dementia, especially among ApoE ɛ4 carriers.
Activities Under the RAISE Family Caregiving Act: Developing a National Strategy to Support Family Caregivers
Authors: Fox-Grage Wendy 
Published: December 2021

Abstract
This presentation describes the unique collaboration between The John A. Hartford Foundation, the Administration or Community Living (ACL), and the National Academy for State Health Policy (NASHP) in supporting the RAISE Act Family Caregiver Resource and Dissemination Center, and the goals and activities of the RAISE Act Family Caregiving Advisory Council. Most importantly, she will present the the development of recommendations for a national strategy to support family caregivers involving all levels of government as well as private-sector actors. These recommendations fall into five primary areas, which Fox-Grage will discuss in detail. She will also discuss the Center’s development of family caregiving resources for state and federal policymakers and other stakeholders as well as next steps in turning the Council’s recommendations into concrete action.