bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prescription Patterns of Anti-dementia and Psychotropic Drugs in People Living With Dementia in China
Authors: Yingyang Zhang , Luo Hao , Wong Gloria H Y , Lum Terry Y S , Chui Celine , Wong Ian C K , Wang Huali 
Published: December 2021

Abstract
Pharmacotherapy of dementia is a critical intervention for managing symptoms of and slowing progression of dementia. However, evidence on prescribing patterns of dementia medications and their associated factors in China is lacking. This study aimed to examine prescribing rates of anti-dementia and psychotropic drugs, and investigate factors associated with prescription of anti-dementia drugs and its co-prescription with psychotropic drugs in China. We used data from the Clinical Pathway for Alzheimer’s Disease in China study, an eight-week multi-center registry study that was conducted in tertiary hospitals between Nov 12, 2012, and Jan 31, 2013. Anti-dementia and psychotropic drugs were coded according to the Anatomical Therapeutic Chemical codes. Logistic regressions were performed to examine factors associated with prescription patterns after controlling for demographic and clinical characteristics of people living with dementia and caregivers’ characteristics. A total of 746 participants were included in this study, of which almost 80% of participants were prescribed anti-dementia drugs, and one-third were prescribed at least one psychotropic drug. The concomitant prescription rate of anti-dementia and psychotropic drugs was 24·3%. Logistic regression results showed that first consultation, dementia subtypes, dementia severity, functioning level, and having symptoms of psychosis and apathy were significantly associated with anti-dementia drug prescription. Frontotemporal dementia, worse functioning level, psychosis, agitation, and depression were significantly associated with co-prescription of anti-dementia and psychotropic agents. Practices of dementia prescriptions generally concurred with clinical guidelines in tertiary hospitals in China, while prescription of anti-dementia and psychotropic medications mainly depended on clinical symptoms of patients with dementia.
Gait Speed and Grip Strength Are Predictors of Cognitive Decline and Dementia in Older Individuals.
Authors: Orchard Suzanne , Ryan Joanne , Polekhina Galina , Storey Elsdon , Shah Raj , Chong Trevor , Murray Anne , Woods Robyn 
Published: December 2021

Abstract
Lower gait speed and grip strength are common in older adults. However, the results of lower motor function on cognitive outcomes have been mixed. We examined the longitudinal association between baseline slow gait speed and weak grip strength, alone and in combination, with risk of incident dementia or cognitive decline in a cohort of older adults. Participants (n=19,114) aged 70 and over (65 if U.S. minority) without documented evidence of dementia, significant cognitive impairment, physical disability or previous cardiovascular disease at baseline, were recruited from community settings. Incident dementia was adjudicated by an expert panel using DSM-IV criteria. Incident cognitive decline was defined as a persistent intra-individual decline in score of &gt;1.5 SD from baseline on any of the cognitive tests. Using cox proportional hazard models, slow gait speed at baseline was associated with an increased risk of dementia (63%) and cognitive decline (43%), over a median 4.7 years. Weak grip strength was not as strong a predictor, but was also associated with risk (43% and 11%, respectively). Both outcomes showed higher risk for dementia than cognitive decline. There was no gender-specific interaction. When considered together (adjusted for one another), gait speed and grip strength were both independently associated with cognitive decline and dementia. The synergistic association of these physical measures, each of which is readily administered in the clinic or home, serve as effective early markers of increasing risk of cognitive decline and incident dementia and thus, should be considered for routine health assessments for older adults.
Exercise and Attitude for Exoskeletons: The Mediation of Technology Anxiety and Perceived Usefulness
Authors: Lee Seolah , Yoon Do Kyung , Kang Miseon , Kim Kwang Joon , Kim YoonMyung , Lim Yun Mook , Jun Hey Jung 
Published: December 2021

Abstract
The present study aimed to examine the effects of regular exercise on attitude towards using exoskeletons and the mediating effects of technology anxiety and perceived usefulness among Korean older adults. Data was collected through online recruitment in February 2021. The sample comprised 310 people (Age: 65-89, M=70.18, SD=4.58) who did not report dementia. The dependent variable was the attitude towards using technology, especially lower limb exoskeleton robots for exercise. The independent variable, regular exercise, was coded as a binary variable. The mediating variables were technology anxiety and perceived usefulness measured by the sum of three questions about exoskeleton robots, respectively. Gender, age, education level, and household income were included as control variables. The mediating effect was estimated by serial path analysis and bootstrapping (model fit indices: χ2=18.400, df=8, p&lt;0.05, RMSEA=0.065, CFI=0.973, TLI=0.940, SRMR=0.044). Results showed the total effect of regular exercise was significant (B=1.253, p&lt;0.01) and the total indirect effect of it was significant(B=1.540, p&lt;0.001). There was no significant direct effect of regular exercise on the attitude towards using technology. The association between regular exercise and the attitude of using technology was completely mediated by perceived usefulness (B=1.439, CI=0.569-2.358, p&lt;.01). Although technology anxiety had no mediating effect alone, the serial mediating effect via the path from technology anxiety to perceived usefulness was significant (B=0.119, CI=0.004-0.332, p&lt;.05). This study will be the first empirical study to examine the effects of health habits by expanding the senior technology acceptance model for older adults in Korea.
Trust with Autonomous Intelligence Systems to Promote Adoption in Assistive Technologies: A Literature Review
Authors: Carrillo Jared , Pena Maria , Milyavskaya Nonna , Chan Thomas 
Published: December 2021

Abstract
While advancements in machine learning are increasing rapidly, very little progress has been made in its mass adoption despite its benefits in assistive technologies for older adults. By examining how users interact with smart technologies, characteristics of trust can be identified and enhanced to increase adoption of the next generation of assistive systems. The current study conducted a literature review to understand better how trust with autonomous systems is formed and maintained. Twenty-two pertinent articles were identified in which three themes emerged. First, people tend to forgive human errors more than errors made by machines -- meaning mistrust is exaggerated when systems make mistakes. Second, the development of trust depends on how the system solves the tasks it is assigned, for instance if a user does not believe the system acted in an “ethical way,” distrust may form and the continuation of adoption is decreased. Lastly, trust depends on the situation and the risk/reward associated with using the system, for example the trust needed to board an autonomous plane differs from that for a simple grammar correction. Taken together, the black box ideology of autonomous systems may be an issue that prevents trust in them to be formed and maintained. Promising future directions are to create machine language translators that improve transparency of autonomous system behaviors (i.e., explainability). Even if assistive technologies are created to aid older adults -- the lack of focus on understanding the factors that foster trust may dampen their actual use.
Demonstration Of Age-Related Increase In Blood-Brain Barrier Permeability By Longitudinal Intravital Microscopy
Authors: Toth Adam Nyul , Tarantini Stefano , DelFavero Jordan , Yan Feng , Balasubramanian Priya , Tang Qinggong , Csiszar Anna , Ungvari Zoltan 
Published: December 2021

Abstract
Age-related blood-brain barrier disruption and cerebromicrovascular rarefaction contribute importantly to the pathogenesis of both vascular cognitive impairment and dementia (VCID) and Alzheimer's disease (AD). Recent advances in geroscience research enable development of novel interventions to reverse age-related alterations of the cerebral microcirculation for prevention of VCID and AD. To facilitate this research there is an urgent need for sensitive and easy-to-adapt imaging methods, which enable longitudinal assessment of changes in BBB permeability and brain capillarization in aged mice, that could be used in vivo to evaluate treatment efficiency. To enable longitudinal assessment of changes in BBB permeability in aged mice equipped with a chronic cranial window, we adapted and optimized two different intravital two-photon imaging approaches. By assessing relative fluorescence changes over the baseline within a volume of brain tissue, after qualitative image subtraction of the brain microvasculature, we confirmed that in 24 month old C57BL/6J mice cumulative permeability of the microvessels to fluorescent tracers of different molecular weights (0.3 kDa to 40 kDa) is significantly increased as compared to that of 5 month old mice. Real-time recording of vessel cross-sections showed that apparent solute permeability of single microvessels is significantly increased in aged mice vs. young mice. Cortical capillary density, assessed both by intravital two-photon microscopy and optical coherence tomography (OCT) was also decreased in aged mice vs. young mice. The presented methods have been optimized for longitudinal (over the period of 36 weeks) in vivo assessment of cerebromicrovascular health in preclinical geroscience research.
The Interplay Between Stress Related Genes and Its Role in Human Longevity: Insights for Translational Studies
Authors: Yashin Anatoliy , Wu Deqing , Arbeev Konstantin , Bagley Olivia , Akushevich Igor , Yashkin Arseniy , Duan Matt , Ukraintseva Svetlana 
Published: December 2021

Abstract
Human lifespan is a multifactorial trait resulted from complicated interplay among many genetic and environmental factors. Despite substantial progress in clarifying many aspects of lifespan’ variability the mechanism of its multifactorial regulation remains unclear. In this paper we investigate the role of genes from integrated stress response (ISR) pathway in such regulation. Experimental studies showed that persistent cellular stress may result in cellular senescence (for proliferating cells), or in apoptosis (for post-mitotic cells) which may affect health and lifespan in laboratory animals. These studies also showed which ISR genes are likely to interplay to produce joint effects on these traits. Note that in humans, the interplay between these genes does not necessarily influence these traits. This is because biological mechanisms regulating these traits in laboratory animals and humans may differ. This means that, when possible, the experimentally detected connections promising for human applications, should be verified using available human data before their testing in expensive clinical trials. In this paper we used HRS data to test connection between SNPs from the EIF2AK4 gene that senses cellular stress signals and the DDIT3 gene from the apoptosis regulation part of the ISR. We found genome wide significant associations between interacting SNPs from these genes and longevity. This result shows that available human data may be successfully used for making important steps in translation of experimental research findings towards their application in humans. Following this strategy may increase efficiency of clinical trials aiming to find appropriate medications to promote human health and longevity.
Geriatric Oncology: Cognition and Communication
Authors: Parker Patricia , Alici Yesne , Nelson Christian , Banerjee Smita , Malling Charlotte , Coyle Nessa , Korc-Grodzicki Beatriz 
Published: December 2021

Abstract
With the dramatic increase in the older adult population, assessment and care of chronic diseases of aging, notably cancer, cognitive impairment and functional decline, have increasing clinical importance. Most healthcare practitioners (HCPs) receive minimal education in geriatrics and/or communication skills and are not optimally prepared to treat older cancer patients. Geriatric Oncology: Cognition and Communication (Geri-Onc CC) trains HCPs to identify cognitive impairment and/or functional decline and improve communication with patients and caregivers. Geri-Onc CC is a 2-day virtual training. Day 1 covers depression, dementia, delirium, pharmacology, cognitive rehabilitation, language barriers, and decision-making capacity. Day 2 focuses on communication skills experiential practice in geriatric syndromes, cognitive syndromes and shared decision making. In addition, HCPs engage in 6 bimonthly web-based collaborative learning activities post-training. Thus far, three cohorts have participated (n=56). Participants were primarily female (88%), 68% non-Hispanic White, and represented multiple disciplines [psychologists (29%) social workers (25%), physicians (21%), others(25%)] and they work in various settings: comprehensive cancer centers (43%),community hospitals (18%), and others (33%). Most (48%) have been caring for older cancer patients for 1-5 years. All reported the training had value to them as a clinician, increased their knowledge of geriatrics, and helped them meet their training goals and 84% were extremely satisfied with the program. Recruitment has been successful. Participants have been diverse in terms of race/ethnicity, profession, practice characteristics and the populations they serve. Overall, participants have found the training valuable, future work will describe outcomes of the training.
Shaken Identities, Reserve Masculine Capital, and the Lived Experiences of Aging Men with Breast Cancer
Authors: Thompson Edward , Beard Renee 
Published: December 2021

Abstract
A question that begs to be examined is: How does aging men’s discovery they have breasts as a result of their breast cancer diagnosis and having a breast removed through a mastectomy, affect their masculine subjectivities and practices, as they also go about also living with a life-threatening illness? The present study aimed to better understand how men come to live with the knowledge that they have both breasts and cancer. Interviews with seventeen men in the U.S. (mean age 62.8) with a breast cancer diagnosis, mastectomy, and, most often, post-surgical hormonal treatment uncovered stories of body-self disruption and identity dilemmas. All the men’s identities had been shaken. After their mastectomy, they were reminded every morning that the body reflected in the mirror differed significantly from who they once were. Their stories revealed strategic themes: how they lived with cancer by slightly modifying conventional masculinities; and how others interacted with them, with the exception of mammography technologists, in terms of their gender, not their atypical illness. Only a few men initially felt their breast cancer was a gendered stigma. Noticeable was how the historical era when diagnosed and the age of the man at diagnosis contextualized their illness stories. In this presentation, three cases are used to exemplify the men’s varied experiences with their non-normative bodies and their commonality in finding reserves of masculine capital to rebuke the existential loneliness of a man with breast cancer.
A qualitative inquiry on self-management decision making among rural African Americans with type 2 diabetes
Authors: Harvey Idethia Shevon 
Published: December 2021

Abstract
Living in a rural area has been recognized as a unique health disparity associated with higher rates of chronic disease. It is further compounded for those who are the most structurally vulnerable complicating access to care and negatively affecting health outcomes. Barriers to type 2 diabetes (T2DM) self-management remain a growing concern, particularly among minority communities living in underserved geographical areas. Much of the self-management research focused on compliance with medication regimens and modification of lifestyle choices. A less well-understood but arguably more critical aspect is the social factors in disease management decision-making. Purposive sampling was used to identify rural African Americans (n = 34). The mean age of participants was 65.9 years (SD = 12.3), and T2DM diagnosis was 15 years (SD = 12.4). The study utilized the consensual qualitative research methodology and the "Sort and Sift, Think and Shift" approach to identify themes. The participants reported an alternative way of integrating glucose monitoring through a "feedback loop" of body sensing. The longer they live with the condition (i.e., knowing my body), the more they can interpret whether they are hypoglycemic or hyperglycemic (i.e., deciphering the cues) to create and navigate their disease management strategy (i.e., body sensing). Self-management decision-making is a complex developmental process that includes disease trajectory and cultural and environmental factors. Findings from this study may provide a conceptual framework for ongoing inquiry and may provide insights to help T2DM educators and clinicians fully understand the complexity of long-term disease management among rural African Americans.
Fall Prevention in Adults With Cognitive Impairment: Systematic Review and Meta-Analysis
Authors: Racey Megan , Markle-Reid Maureen , Ali Muhammad Usman , Gagné Hélène , Hunter Susan , Ploeg Jenny , Sztramko Richard , Sherifali Diana 
Published: December 2021

Abstract
Cognitive impairment increases an individual’s risk of falls due to the role cognition plays in gait control. Older adults with dementia fall 2-3 times more than cognitively healthy older adults and there is a lack of evidence for effective fall prevention interventions for community-dwelling cognitively impaired adults. We conducted a systematic review and meta-analysis to investigate the effectiveness of fall prevention interventions in improving falls, perceived risk of falls, gait, balance, and functional mobility. We searched 7 databases for interventions involving community-dwelling adults ≥50 years with mild to moderate cognitive impairment. Reviewers screened citations, extracted data, assessed risk of bias and certainty of evidence (GRADE). We performed a meta-analysis of 509 community-dwelling adults (mean age 67.5 to 84.0 years) with mild to moderate cognitive impairment from 12 randomized controlled trails (8 exercise interventions, 3 multifactorial, and 1 providing medication). Interventions had medium significant effects on perceived risk of falls (SMD -0.73 [-1.10, -0.36]), balance (SMD 0.66 [0.19, 1.12]), and timed up and go test (SMD -0.56 [-0.94, -0.17]) and small significant effects on gait speed and control (SMD 0.26 [0.08, 0.43]) with moderate certainty of evidence. There were no significant effects for falls. Sub-analysis showed that exercise and studies at low risk of bias remained significant for balance and perceived risk of falls. The effect of fall prevention interventions on falls remains unclear; exercise interventions are effective at addressing fall risk factors. However, high quality and longer studies with adequate sample sizes are needed to determine their effectiveness on falls.
Harmonizing Data Collection and Analysis In Worldwide FINGERS Trials
Authors: Peltonen Markku 
Published: December 2021

Abstract
One of the goals of the World-Wide FINGERS (WW-FINGERS): A Global Approach to Dementia Prevention network is to prospectively facilitate data sharing and joint analyses across clinical trials on prevention of cognitive impairment and dementia. The aim with prospectively harmonizing studies in different countries and settings regarding interventions, outcomes, measurements, data collection, and establishing best practices for responsible data sharing and access to data for remote joint analyses, is to increase the use of clinical trial data. By utilizing federated database system which connects multiple autonomous, decentralized databases and enables data-analyses to be conducted without individual level data being transferred, could be a feasible and acceptable technical solution for countries around the world, given wide variations in data protection and sharing regulations. Ultimately, prospectively harmonizing clinical studies and establishing a culture of harmonization and sharing, will promote international joint initiatives to identify globally implementable and effective preventive strategies.
Person, Place, and Time Effects on Cognitive Function Among Older People in Taiwan
Authors: Hsu Hui-chuan , Bai Chyi-Huey 
Published: December 2021

Abstract
Purpose: Individual’s factors across time or combined with area characteristics related to cognitive function for older people have been widely explored, but little research examined person, place, and time effects altogether. The purpose of this study was to examine the effects of individuals, cities, and time on older people’s cognitive function in Taiwan. Methods: A nation-representative longitudinal individual data were from Taiwan Longitudinal Survey on Aging (TLSA) 1999-2015 panel data (analysis sample n=6349 persons, observations=12042). Cognitive function was scored 0-19. Individual’s factors included demographics, health conditions and health behaviors, mental health and stress, social support and social participation, etc. Eleven city-level indicators were based on 22 cities and data were from the government open data sources. Mixed linear modeling analysis was applied. Results: Better cognitive function was significantly related to individuals’ working, ethnicity, younger age, better education level, better self-rated health, less psychological stress, receiving more emotional support, having higher economic satisfaction at the intercept. Sex, ethnicity, age, education, self-rated health, physical function, and social connectedness were significant at the time slope. When controlling for individuals’ factors, population density and green land were significant at the intercept and at the time slope. Interactions of individual- and city-level factors were not significant. Discussion: Individual’s social participation and social support are protective factors of cognitive function for older adults. And an age-friendly environment providing appropriate cognitive stimulation and chances of social participation may be beneficial for cognitive function.