bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contribution of Sensory Function to Preclinical Indicators of Physical and Cognitive Functioning With Aging
Authors: Agrawal Yuri , Schrack Jennifer , Swenor Bonnielin 
Published: December 2021

Abstract
There are well established associations between sensory loss and physical and cognitive deficits with aging, but gaps remain in our understanding of the associations between sensory function and early preclinical indicators of physical and cognitive decline. This symposium will present data from the Baltimore Longitudinal Study of Aging (BLSA) on a series of studies investigating the links among sensory function, motor function, and physical and cognitive outcomes in older adults. In the first study, Dr. Gross will present an operational definition of early cognitive impairment (ECI) based on a combination of two cognitive measures – the Card Rotations test and the California Verbal Learning Test Immediate Recall – to predict progression to MCI/AD. In the second study, Dr. Cai will evaluate the relationship between multisensory impairment (in vision, hearing, olfaction, proprioception and vestibular function) and the algorithmic definition of ECI. In the third study, Dr. Armstrong will evaluate the association between multisensory impairment and another biomarker of ECI or preclinical AD, specifically PET-PiB deposition. In the fourth study, Dr. Schrack, will present the joint contribution of multisensory (hearing and vision) impairment and motor function (gait speed) on risk of incident MCI/AD in longitudinal analyses. Finally, Dr. Martinez Amezcua will present the longitudinal association between hearing and vestibular function and decline in higher level physical function and endurance performance. Taken together, these studies present compelling data about the contribution of sensory function to preclinical indicators of physical and cognitive functioning with aging.
Derivation and Validation of an Algorithmic Classification of Early Cognitive Impairment
Authors: Gross Alden , An Yang , Lin Frank , Ferrucci Luigi , Schrack Jennifer , Agrawal Yuri , Resnick Susan 
Published: December 2021

Abstract
The long prodromal period for dementia pathology demands valid and reliable approaches to detect cases before clinically recognizable symptoms emerge, by which time it may be too late to effectively intervene. We derived and compared several algorithms for early cognitive impairment (ECI) using longitudinal data on 1704 BLSA participants. Algorithms were based on cognitive impairment in various combinations of memory and non-memory tests, and the CDR. The best-performing algorithm was defined based on 1SD below age-and race-specific means in Card Rotations or California Verbal Learning Test immediate recall, two tests that in prior work show the earliest declines prior to dementia onset. While this ECI algorithm showed low concordance with concurrent adjudicated MCI/dementia (AUC: 0.63, sensitivity: 0.54, specificity: 0.73), it was among the best predictors of progression to MCI/dementia (HR: 3.65, 95% CI: 1.69,7.87). This algorithm may be useful in epidemiologic work to evaluate risk factors for early cognitive impairment.
Aging Through the Time of COVID-19: Healthcare Access for Older Adults Living With Chronic Conditions
Authors: Peckham Allie , Maxfield Molly , Pituch Keenan , Guest M Aaron , Sivanandam Shalini , Doebbeling Brad 
Published: December 2021

Abstract
Chronic conditions require on-going continuous management and preventive treatment. Over 80% of adults aged 65 and older have multiple chronic conditions. Concerns have arisen about how the COVID-19 pandemic is affecting the management of chronic conditions. Delay, avoidance, and poor management of healthcare during the COVID- 19 pandemic may increase the risk of unnecessary hospitalizations and mortality. This study aims to understand the impact of COVID-19 on healthcare access in a U.S. sample of Americans 50 years of age or older. Participants completed an online survey about healthcare access and other risk factors during the COVID-19 pandemic. Multinomial regression analysis examined the results of two key access points: healthcare provider /doctor (n=468) and medication (n=754). One-half (56%) of those who needed access to a provider were able to be seen. Participants who were older, had multiple chronic conditions, and those with a provider were more likely to have access. However, when individuals with more chronic conditions did not have access, they indicated that this lack of access was due to COVID-19. When not receiving access to medications, unemployed participants attributed the lack of access more often to COVID-19 than other reasons. These findings demonstrate an important lack of access to providers and medication among older adults during the pandemic. In multivariate models, this lack of access was most often due to COVID-19, in addition to traditional factors such as insurance, employment, and medical and behavioral comorbidity. Interventions are needed to lower access barriers to care even further during COVID-19.
Accelerometer-Measured Daily Steps, Physical Function, and Subsequent Fall Risk in Older Women: The OPACH Study
Authors: Schumacher Benjamin , Bellettiere John , LaMonte Michael , LaCroix Andrea 
Published: December 2021

Abstract
We sought to investigate the association between steps per day (steps/d) and incident fall risk while also assessing the role of physical functioning on this association. Steps/d were measured by accelerometer for 7 days in 5,545 women aged 63 to 97 years between 2012 - 2014. Falls were ascertained from daily fall calendars for 13 months. Median steps/d were 3,216. There were 5,473 falls recorded over 61,564 fall calendar months. The adjusted incidence rate ratio comparing women in the highest vs. lowest step quartiles was 0.71 (95% confidence interval, 0.54 - 0.95; P-trend across quartiles of steps/d = 0.01). After further adjustment for physical function using the Short Physical Performance Battery, the rate ratio was 0.86 (0.64-1.16; P-trend = 0.27). Mediation analysis estimated that 66.7% to 70.2% of the association of steps/d and fall risk may be mediated by physical function. In conclusion, higher steps/d were related to lower incident falls primarily through their beneficial association with physical functioning. Interventions that improve physical function, including those that involve stepping, could reduce falls in older adults.
Finding Static Stability Limits: Comparison of Reactive Balance in Older People With and Without a History of Falls
Authors: Hackbarth Michel , Koschate Jessica , Lau Sandra , Zieschang Tania 
Published: December 2021

Abstract
Reactive balance is a highly relevant fall risk factor, but is rarely considered in clinical practice. Especially medio-lateral perturbations lead to a pronounced instability of the gait pattern. However, there is no consensus on a method for the assessment of individually challenging perturbation intensities to apply during walking. The aim of this study is to determine and compare the static stability-limits in older adults with and without a history of falls. Twelve older adults with (OAF; 75.6 ±3.66,9♀) and 19 older adults without a history of falls (OA; 77.5 ±4.99,12♀) were subjected to progressive-intensifying perturbations while standing on a perturbation treadmill. In addition, functional performance (Mini-BESTest), fear of falling (FES-I), and physical activity (kcal) were assessed Deflection of the treadmill-platform was randomized by timing and direction and was increased until the subject had to compensate with a step (stability-limit). The maximum deflection distance for each direction, as well as the FES-I score, mini-BESTest score, and activity level were evaluated for group differences using the t-test and Mann-Whitney-U test (α≤5%). There were no significant group differences in the mini-BESTest and between the maximum tolerated deflection distances. The OAF-subjects showed an increased FES-I score (median for OA=18.0 and OAF=22.0, p=0.032) and higher activity levels (median for OA=1974 kcal and OAF=3365 kcal, p=0.011). Despite an increased fear of falling, the older adults with a fall history showed a similar stability-limit, but higher activity levels. In future experiments these static stability limits should be tested during walking and evaluated via motion analysis.
Family Caregiving Disrupted by COVID-19: Overcoming Challenges Through Resilience and Flexibility
Authors: Wyman Mary , Wray Laura 
Published: December 2021

Abstract
The impacts of the COVID-19 pandemic have been global and pervasive – yet only partially understood. Older adults and their family caregivers have experienced profound and unprecedented challenges as a result of COVID-19. This symposium features research on these disruptions and the creative adaptations undertaken in response. Four presentations present a variety of geographic regions, caregiving settings, and research focal points. Avidor and Ayalon present findings from interviews with family caregivers of residents in long-term care, highlighting the issues faced as a result of dramatic shifts in policy and procedures in support of pandemic infection control. Gum and colleagues focused on how service access has changed for community-dwelling older adults and their families during the pandemic, and how agencies may best leverage the flexibility of caregivers to adapt service provision. Boucher et al. compare the challenges faced by family caregivers during COVID-19 with those faced during a natural disaster, and highlight unique differences in service access for caregivers of military veterans. Finally, Ko and co-authors share their experience with the implementation of a technology intervention to reduce caregiver stress as part of a research trial, and how the protocol adjustments necessitated by COVID-19 revealed the unique potential of such technologies to support caregivers under isolated conditions. The presenters will focus on themes of resilience and lessons learned for health care systems, service agencies, and society to best support family caregivers in challenging circumstances moving forward.
Disaster Caregiving: Caregivers Negotiating Storms and COVID-19 for Veterans and Non-Veterans on the Gulf Coast
Authors: Boucher Nathan , McKenna Kevin , Dombeck Carrie , Clark Amy , Wang Ke , Olson Jennifer , Shepherd-Banigan Megan 
Published: December 2021

Abstract
Natural disasters and COVID-19 likely add complexity to caregiving efforts, yet little is known about these effects. We will discuss our findings exploring additional needs and challenges experienced by caregivers during hurricanes, floods, and COVID focused on US Gulf Coast states. We interviewed caregivers of both Veterans (n=13) and non-Veterans (n=11). The presentation will include an overview of 1) types of resources needed or used related to storms and to COVID, including social support and access to information for both emergency planning and recovery; 2) caregiver experience before, during, and after the disaster including psychological effects on caregivers and addressing special health needs; 3) comparisons of challenges during storms versus COVID including emotional impact and access to health and specialty care; and 4) additional resources used by caregivers of Veterans. We will also address how these data are informing national caregiver support programs.
Isolation in Older Adults in the United States and Japan: An Early Examination of IOT Possibilities
Authors: Bradley Dana , Sceppa Carmen , Sceppa Carmen 
Published: December 2021

Abstract
Isolation in older adults is a growing problem in both the US and Japan. This symposium showcases work funded by NSF and JST (Japan Science Technology Committee) to develop smart technology to create caring, connected communities by integrating gerontology and technology research. The U.S. and Japan are experiencing dramatic population aging and share several similarities: Populous (U.S. 327 million at #3 and Japan 127 million at #11) and economically developed (GDP: the U.S. #1 and Japan #3) and isolation was increasing even before the pandemic. This multi-year project addresses the challenges of isolation by using smart technologies in culturally appropriate ways to support older adults and suggests ways that isolation and loneliness may be managed by older persons, local governments, and NGOs. The first paper examines the experiences of loneliness as characterized by early retirees in both countries. The interdisciplinary research team has used this qualitative set of case studies to identify promising technology support points. Our second paper explores these issues surrounding isolation using data from Study on the Lifestyle and Values of Senior Citizens (Japan). This analysis focuses on longitudinal data from both countries and helps situate our work outside the Covid-19 Pandemic. The third presentation focuses on the intersection between culture and technology and proposes a continued research collaboration model. Our discussion will highlight how community stakeholders in U.S. and Japan have a role in creating evidence-based adaptive environments to detect and mitigate isolation by developing and using gero-centric approaches.
A Quantitative Comparison of Social Interactions of Older Adults Pre-COVID-19 Between the United States and Japan
Authors: Nishikitani Mariko 
Published: December 2021

Abstract
Using the Study on the Lifestyle and Values of Senior Citizens (The Eighth International Study by the Japan Cabinet Office), the social interactions were assessed in the context of health and life satisfaction of the older adults of the U.S and Japan to confirm the relationship between ICT usage and social interactions. The less social interaction was defined as those who answered that they had no "role in the family," "working," or "social activities such as volunteering." The proportion of less-social interaction people and non-use of ICT increased with age, but the proportions of Japanese were higher than that in Americans. The adjusted odds ratio for non-use of ICT to the risk of isolation of the older adults in Japan was 2.43 (95% CI: 1.59-3.73), but no significant relationship was observed in American older adults. Future research will examine the use of ICT by older adults in each country.
Managed Long-Term Care Services: A Playbook Innovation or a Hail Mary?
Authors: Polivka Larry , Applebaum Robert 
Published: December 2021

Abstract
The approach to providing long-term services and supports (LTSS) has changed dramatically over the last three decades in both the financing and delivery arenas. In the U.S., long-term strategies have varied by state in organizational structure, scope of delivery and administrative practices. In the past two decades an additional change has emerged with over half the states adopting some form of managed LTSS. This shift has deepened the divide in state approaches to LTSS system design and delivery. The shift to managed LTSS has been largely fueled by ideological expectations and concerns about growing Medicaid costs: Empirical research findings have played a minimal role. For example, the large CMS evaluation conducted in this area did not include Medicaid data or encounter data from the managed care plans as part of the study efforts. However, the managed LTSS experiment does create an opportunity to compare costs and outcomes of these different models of financing and delivery. This symposium will present preliminary evaluation findings from two states, Ohio and Pennsylvania, which are generating data to assess both the implementation and outcomes of these alternative LTSS models. To set the context an initial paper will discuss the expansion of managed LTSS programs across the nation and examine how these efforts compare to the development occurring in the European LTSS systems. The third presentation will discuss the results of the Community Catalyst dual eligibles’ managed care demonstration program monitoring project.
Rolling Out Behavioral Recovery Outreach (BRO) Teams: Perspectives From an Inaugural Partner Site
Authors: Gaudig Trisha 
Published: December 2021

Abstract
The Sioux Falls VA Community Living Center (CLC) is a partner site for the Behavioral Recovery Outreach (BRO) Team dissemination. This CLC is home to over 55 Veterans requiring a variety of specialty needs such as dementia care, short-term rehabilitation, respite, hospice, and/or psychosocial needs. Many of the Veterans followed by the BRO Team on the CLC experienced frequent rehospitalizations and difficult placement in the community due to behavioral concerns. Local leadership encouraged participation in the BRO Team dissemination due to the growing need in this VA system to open access to dementia and mental health care, successfully discharge Veterans to appropriate community settings, and reduce unnecessary rehospitalizations. This presentation will discuss BRO Team development, including several factors facilitating successful BRO Team implementation (e.g., leadership support, community outreach approaches, staff partner buy-in), and identify barriers impacting successful implementation with a case example to illustrate strategies to overcome such barriers.
Pennsylvania's Transition to Medicaid Managed Long-Term Services and Supports
Authors: Degenholtz Howard 
Published: December 2021

Abstract
Implemented through five health plans, Ohio’s MyCare demonstration began in 2014 and was designed to coordinate primary, acute care, behavioral health and long-term services in the major urban areas of the state. Individuals who are dually eligible for both Medicaid and Medicare and who reside in specified geographic regions must enroll into a managed MyCare plan. MyCare beneficiaries are assigned to two primary categories: community well and those needing long-term services and supports (LTSS). Individuals receiving the integrated MyCare intervention were expected to have lower acute care hospitalizations, lower long-term nursing home use, better longevity and lower overall health and long-term care costs. Using a propensity score matching design, the evaluation compared MyCare enrollees to comparison group members in non-MyCare counties of the state, using Medicaid and Medicare claims data. The 120,000 MyCare program participants represented about half of the dual eligible individuals in the state.
Can Rural Migrant Workers Afford to Retire in China? A Study of Chinese Migrant Worker’s Retirement Savings
Authors: Liu Jing , Zhan Heying , Qiu Fengxian 
Published: December 2021

Abstract
This paper makes connections between social policies of retirement, migrant worker’s migration experience, and migrant workers’ retirement savings. Using insight from the political economy of aging and stress theory, this paper links the macro levels of understanding with the micro levels of work and aging experiences for migrant workers. Using binary logistic regression with a sample of 699 Chinese migrant workers from three emigration provinces (Anhui, Henan, Sichuan), this paper explores four specific aspects of migrant worker’s migration experience in relation to their retirement savings: financial status; length of employment; social support, and levels of hopefulness. Findings reveal that migrant workers with better financial status, social support, and higher level of hopefulness towards future are more likely to have retirement savings as compared to their counterparts. Discussions linking the macro and micro levels of social policies were provided. Policy implications were discussed.
New Aspects in Metabolism of Aging
Authors: Anderson Rozalyn 
Published: December 2021

Abstract
In recent years there has been a renewed emphasis on metabolism as a key contributor to a host of chronic non-communicable conditions: cancer, neurodegeneration, frailty, and functional declines in immune and inflammatory processes. All share a common connection in metabolic dysfunction. Furthermore, aging itself is associated with changes in metabolism, although the underlying drivers for these changes are unknown. Here we introduce speakers working at the cutting edge in metabolism research, and whose studies are of direct relevance to aging. Dr. Chandel will focus on mitochondrial biology, describing recent advances in understanding the mechanisms of the beneficial effects of metformin. Dr. Haigis takes the mitochondrial theme to cancer biology, the area of research that revived metabolic perspectives in biomedical research. Dr. Najt’s talk describes a less well studied organelle, the lipid droplet, and its role in a rapidly expanding area of research on lipid metabolic regulation specifically in the context of aging. Dr. Brown-Borg will present data on nutritional and genetic modulation of metabolism and how pathways converge to influence chromatin and epigenetic regulation of gene expression. Together our speakers explore new concepts in metabolism research that are of particular relevance to aging. This session aligns with the concept of GeroScience, the more we know of aging biology the better we understand diseases and disorders of aging. This session will demonstrate that metabolism, its regulation, and its influence on key processes linked to health and longevity, place it in a central position as we seek to discover targets and interventions to improve human aging.
Methionine Metabolism in Aging Regulation
Authors: Brown-Borg Holly 
Published: December 2021

Abstract
Aging is the major risk factor for many diseases but the mechanisms are poorly understood. The risk of developing hepatic steatosis increases with age and the health impact of this disease is negative and high. When challenged with high fat diets, long living Ames mice withstand the detrimental metabolic effects that occur in normal mice. We examined transcriptomic and epigenomic profiles of Ames and wild type hepatocytes in the presence or absence of fat to demonstrate that the epigenomic profile drives transcription factor and downstream gene expression resulting in susceptibility or resistance to fatty liver disease. We found that markers of steatosis are related to gene expression in wild type and Ames mice, and dwarf mice retain fewer lipid droplets compared to wild type mice. These studies will provide data to guide our understanding of mechanisms leading to hepatic disease and define factors that provide protection from age-related metabolic disorders.
Advancing the Science on Unexpected Episodes of Clarity and Lucidity in People With Dementia
Authors: Griffin Joan , Eldadah Basil 
Published: December 2021

Abstract
People with late-stage Alzheimer’s disease and related dementias (ADRD) have been reported, largely by way of anecdote, to exhibit unexpected episodes of spontaneous, meaningful, and relevant communication or behavior. These episodes of lucidity (EL) are characterized by spontaneous mental clarity in people living with dementia (PLWD) who are assumed to have lost coherent cognitive capacity. Given the transient nature and limited understanding of underlying mechanisms responsible for this phenomenon, these episodes are frequently overlooked and have received little scientific attention. Few studies have documented EL among PLWD with precision; scientific understanding is limited to anecdotes and case studies, which have not operationalized EL. Thus, there is a critical need for an evidence-based understanding and systematic operationalization of EL. Precise and robust operationalizations of EL will allow future research to assess if EL has different effects on ADRD prognosis or alters how family members manage and adapt to ADRD progression in their care recipient. The National Institute on Aging (NIA) has funded six studies to advance the scientific understanding of EL in dementia. These studies use a variety of methodological approaches to capture EL experiences, and together, they will provide evidence-based operational definitions of EL, novel approaches for measurement of this phenomenon, and estimates of its prevalence. This symposium will provide an overview of the funded studies and three different methodological approaches that are being used to better operationalize and understand EL.