bluuebunny/crossref_metadata_2025_split huggingface dataset:
Connecting the Dots: Pain Mental Models of Spousal Caregivers of Veterans with Dementia and Pain
Authors: Block Phoebe , Shrestha Srijana , Evans Tracy , Hilgeman Michelle , Loup Julia , Kunik Mark , Snow A Lynn 
Published: December 2021

Abstract
Pain is prevalent among persons with dementia (PWDs), yet often goes underrecognized and undertreated. Exploring caregivers’ pain mental models may provide valuable insight into how they conceptualize pain, and how such conceptualizations affect their identification of and response to PWDs’ pain. We identified and described the pain mental model(s) of spousal caregivers of community-dwelling veterans with dementia and pain through a secondary qualitative thematic analysis of recordings of a psychosocial intervention aimed at preventing aggression in PWDs with pain. Thirty female spousal caregivers (11 Black, 10 non-Hispanic White, and 9 Hispanic) comprised the present sample. Two themes were identified: Pain Assessment Beliefs and Knowledge (PA) and Pain Management Beliefs and Knowledge (PM). In our proposed mental model framework, PA and PM affect the ways caregivers answer two PA-related questions (Is there a problem?, Is this problem pain?) and three PM-related questions (Is the pain treatable?, Is it worth treating?, How do I prefer to treat it?). Caregivers are moved to action when they “connect the dots” by identifying a problem in PWDs’ behavior, labeling the problem as pain, and identifying a response (i.e., a treatment approach) they consider worth trying. Disconnects in caregiver understanding of PWDs’ behavior are common in this sample, and predictably lead to inaction. The proposed mental model provides further explanation about how caregivers do or do not synthesize and apply pain knowledge and experience, allowing for the identification of potential areas of intervention (e.g., pain psychoeducation) to improve pain treatment for the PWDs under their care.
Pain Interference and Conscientiousness in Older Adults
Authors: Judge Stephanie , Meyr Kaitlyn , Segerstrom Suzanne 
Published: December 2021

Abstract
Pain interference increases with age and occurs when pain interrupts daily activities. Individuals vary in their amount of interference at a given level of pain. Conscientiousness is a personality trait characterized by diligence, perseverance, and goal-directedness, and is associated with fewer unhealthy behaviors and better health, including less pain and fewer functional limitations. This study tested three hypotheses on the relationships between pain, Conscientiousness, and pain interference among community-dwelling older adults (N=210) in a longitudinal study. At semi-annual interviews, participants reported their pain and interference. Conscientiousness was measured at baseline and follow-up. Multilevel models tested the between- and within-person relationships among study variables. Greater pain predicted more interference (person: γ01=.541, SE=.042, p&lt;.0001; visit: γ10 =.495, SE=.014, p&lt;.0001) but higher Conscientiousness decreased interference (γ02=-.156, SE=.064, p&lt;.025). There was an interaction between Conscientiousness and pain: At higher levels of pain, older adults higher in Conscientiousness experienced much less interference than their less conscientious peers (γ11=-.199, SE=.089, p&lt;.025). Older age at baseline predicted a greater decrease in Conscientiousness over the study period (b=-0.013, t(91)=-2.07, p&lt;.05). Conscientiousness reduces the negative impact of pain on daily function. This protective effect may reflect perseverance and commitment to valued activities, consistency with proactive health behaviors, or other attitudes and behaviors that reduce the likelihood of psychosocial sequelae of pain. Overall, the sample decreased in Conscientiousness over time; however, the direction and amount of change varied considerably. These results refine existing knowledge of personality in old age and implicate personality factors as a potential target for pain management.
Pathological Traits and Interpersonal Difficulties in Depressed Older Adults: Clinical versus Community Sampling
Authors: Lederer George , Freedman David , Atlas Lauren , Kafker Shira , Yenko Ira , Mak Angel , Francois Dimitry , Zweig Richard 
Published: December 2021

Abstract
Personality pathology, represented by high neuroticism and low agreeableness in the Five Factor Model of Personality, has been identified as a predictor of depression in mixed-age samples and preliminary studies of older adults. Research on older people, however, has not examined the differential impact of pathological personality traits and processes on depression or examined them across treatment settings. This secondary analysis examined personality traits and processes as predictors of depression, evaluated the moderating effect of interpersonal problems, and assessed stratification of these personality variables across community and clinical settings. Older adults (N=395) ranging in age from 55 to 99 (M = 72.06; SD = 10.10) from inpatient psychiatric, outpatient medical, and community settings completed self-report measures of personality traits (NEO-FFI Agreeableness and Neuroticism), processes (Inventory of Interpersonal Problems), and depression (GDS-30). Higher neuroticism predicted worsened depressive symptoms (β = .765, p &lt; .001), as did lower agreeableness (β = -.163, p = .002) and more interpersonal problems (β = .459, p &lt; .001). Findings partially supported the stratification of personality traits and processes by setting. Interpersonal problems moderated neither the neuroticism-depression or agreeableness-depression relationships. Personality traits and processes predict depression in older adults across care settings but do not significantly interact. Levels of pathological traits and processes vary across community and clinical settings.
The Interpersonal Circumplex and the Alternative Model of Personality Disorders: Relationships among Older Adults
Authors: Stone Lisa , Segal Daniel 
Published: December 2021

Abstract
Introduction: The interpersonal circumplex model measures interpersonal dysfunction along two axes (communion and agency), resulting in eight unhealthy patterns: Domineering, Vindictive, Cold, Socially Avoidant, Nonassertive, Exploitable, Overly Nurturant, and Intrusive. It is unclear how the circumplex model applies to older adults and their unique biopsychosocial contexts. This study examined relationships between the circumplex and personality disorder features, using the Alternative Model of Personality Disorder’s (AMPD) personality functioning and pathological personality trait constructs. Method: Older adults (N = 202) completed the Inventory of Interpersonal Problems-Short Circumplex (IIP-SC), the Levels of Personality Functioning Scale-Self-Report (LPFS-SR), and the Personality Inventory for DSM-5 (PID-5) to measure pathological personality traits. Results: Correlations were computed between the IIP-SC’s eight circumplex scales with the LPFS-SR’s four personality functioning domains and with the PID-5’s five domains. All circumplex scales significantly (p &lt; .001) and positively correlated with all LPFS-SR and PID-5 domains, with large effect sizes (&gt; .45). Next, regressions were conducted, with the LPFS-SR and PID-5 domains predicting each IIP-SC scale. Across the eight regressions, the AMPD constructs accounted for significant variance in the IIP-SC scales, ranging from 38% (Nonassertive) to 64% (Domineering and Cold). Discussion: Significant overlap between the interpersonal circumplex and the AMPD was demonstrated, but patterns are distinct from previous research among younger adults. The circumplex was limited in its relation to the AMPD’s personality functioning, but the pathological personality trait model was well represented through the circumplex. Results indicate that the circumplex may have some validity among older adults and warrants further investigation.
Actigraphy Measured Physical Activity on Cognitive Functioning in Older Adults
Authors: Thangwaritorn Pilar , Watts Amber 
Published: December 2021

Abstract
Physical activity may preserve cognitive functioning in older adults. This study examined associations between objectively measured physical activity and cognitive functioning. We recruited participants (Mage = 75.38 years, SD = 5.99) with (N=26) and without (N=181) cognitive impairment from the University of Kansas Alzheimer’s Disease Center (KU-ADC). We collected cognitive data representing verbal memory, attention, and executive function. Accelerometers (Actigraph GT9X) were used to measure physical activity 24 hours a day for 7 days in a free-living environment. Physical activity was categorized as moderate to vigorous physical activity (MVPA) based on the Freedson (2011) Adult Vector Magnitude cut points. The association between cognitive functioning and total MVPA was evaluated by using multiple regression. We used factor analysis to create three composite scores (verbal memory, attention, executive function) from 11 individual cognitive tests. Compared to verbal memory and attention, results indicate that total MVPA was more strongly associated with executive function (β = 0.001, p = .024). These findings are consistent with the literature suggesting that executive function in older adults may benefit from physical activity. Future research should investigate the physiological mechanisms by which MVPA benefits executive function in contrast to types of activity that might benefit verbal memory and attention.
Dual-Task Costs in Gait Speed Differs Across Age Groups
Authors: Paulson Sally , Gray Michelle , Gills Joshua , Campitelli Anthony , Jones Megan , Sanders Joohee , Madero Erica , Glenn Jordan 
Published: December 2021

Abstract
With age, there are simultaneous reductions in gait speed (GS). This decrease in GS has been associated with an increased fall risk and negatively impacts independence. Further, GS naturally declines with the addition of a secondary stimulus (i.e., cognitive requirements). Combined, these decrements can be additive in nature potentially leading to robust declines with advancing age. Therefore, the aim of this study was to examine age-related effects of dual-task cost (DTC) while walking. Adults (N = 145), over the age of 45 years, completed two walking trials for each GS condition: habitual (HAB) and fast (FST), with and without a DT (i.e., counting backwards by serials of three). Subjects were classified into four age groups: youngest-old (YG ≤ 64 years, n = 24), young-old (YO, 65-74 years, n = 46), middle-old (MO = 75-84 years, n = 54), and oldest-old (OO ≥ 85 years, n = 21). DTC was calculated and ANOVAs were used to assess differences between the groups. There was no difference in HAB DTC between the age groups (p=.61). However, there was a significant difference in FST DTC (p=.04) between the YO (M±SD: -14 ± -11%) and OO (M±SD: -24 ± -12%). These data indicate there was an age-related affect for fast dual-task cost, but not for habitual dual-task cost while walking. An increase in dual-task cost among the oldest-old may be associated with an inability to properly maintain a faster cadence while performing an arithmetic task which may be related to task prioritization.
Effect of High-Intensity Interval Training on Rheumatoid Arthritis CD4+ T Cell Oxidative Metabolism
Authors: Andonian Brian , Bartlett David , MacIver Nancie , Kraus William , Huffman Kim 
Published: December 2021

Abstract
Persons with rheumatoid arthritis (RA) have poor cardiorespiratory fitness and accelerated biological aging driven by systemic impairments in metabolism and inflammation. In this study of older RA participants, our goal was to identify the effects of a high-intensity interval training (HIIT) program on cardiorespiratory fitness and peripheral CD4+ T cell metabolism. We isolated CD4+ T cells from peripheral blood mononuclear cells in sedentary female RA participants (n=6; age=64.0+/-6.3 years) who underwent cardiopulmonary exercise testing and phlebotomy before and after 10 weeks of HIIT. HIIT improved RA cardiorespiratory fitness by 6.5+/-6.0% (pre-HIIT VO2 peak=25.1+/-5.1 ml/kg/min, post-HIIT VO2 peak=26.7+/-5.0; p=0.05). As measured by Seahorse XF Mito Stress Test, there were no significant mean changes in CD4+ T cell oxidative (oxygen consumption rate (OCR); pmol/min) or glycolytic (extracellular acidification rate (ECAR); mpH/min) metabolism, however there was large interindividual variability. RA peripheral CD4+ T cells preferred glycolytic metabolism (pre-HIIT mean basal OCR/ECAR ratio=0.78+/-0.13 pmol/mpH), while HIIT non-significantly shifted cellular preference toward oxidative metabolism (post-HIIT mean basal OCR/ECAR ratio=0.86+/-0.16; p=0.30). Increases in RA cardiorespiratory fitness following HIIT were significantly associated with increases in RA peripheral CD4+ T cell OCR/ECAR ratio (Spearman’s rho=1.0, p&lt;0.001) and basal and maximal respiration (rho=0.89, p=0.02 for both). Additionally, increases in CD4+ T cell mitochondrial ATP-linked respiration were significantly associated with increased quantities of circulating naïve CD4+CCR7+CD45RA+ T cells (rho=0.89, p=0.02). Our findings suggest that targeting cardiorespiratory fitness may be key in modulating T cell specific oxidative metabolism and function to prevent immunosenescence in older patients with chronic inflammatory diseases.
Effect of Video assisted Home-Based exercise intervention on fall risk and gait parameters in older adults in India
Authors: Kulkarni Snehal , Nagarkar Aarti 
Published: December 2021

Abstract
Countries across the globe recommended isolation to protect older adults from COVID-19 infection. However, this led to decreased mobility and physical inactivity potentially increasing their risk of fall. The study was conducted in a group of 88 older adults between 60-74 years with known gait impairments and high fall risk. The participants were part of our cohort study on fall prevention program. Fall risk and gait impairments were measured using wearable sensors during the Timed-up and go test (TUG) at baseline. Using technology, a 16-week video assisted home based exercises intervention was delivered to reduce fall risk and improve gait parameters. The intervention consisted of flexibility, strengthening, balance and gait training exercises given progressively through one video session per week. The participants performed these exercises at home for the rest of the week. A home visit immediately after 16th week was arranged to collect post intervention parameters. Results showed an average 20% decrease in fall risk post intervention. An overall large effect size with Cohen’s d of 0.90 was reported for fall risk. Significant difference in TUG time (Z = -4.610, p&lt; 0.000), stride velocity (Z= -5.035, p&lt;0.000), stride length (Z = -5.867, p&lt;0.000), time taken to stand (Z = -7.363, p&lt;0.000) and time taken to turn (Z = -6.079, p&lt;0.000) was observed in the post-test measurements as compared to pre-test measurements. Therefore, we conclude that video assisted exercise programs can be highly beneficial as alternatives to in person exercise intervention to prevent falls during COVID-19 isolation.
Physical Activity Impacts Walking Distances and Energy Consumption of Patients with Peripheral Artery Disease
Authors: Evans Nathaniel , Hassan Mahdi , Dinkel Danae , Johanning Jason , Pipinos Iraklis , Myers Sara 
Published: December 2021

Abstract
Lower extremity peripheral artery disease (PAD) is attributed to buildup of atherosclerotic plaques preventing adequate blood flow, leading to pain during walking, and ultimately physical inactivity. Normal day-to-day levels of physical activity may impact the distance a subject can walk before claudication pain onset, as well as their energy consumption capabilities. This study compared walking performance (initial claudication distance (ICD) and absolute claudication distance (ACD)), and energy consumption (EC) between active and inactive subjects with PAD. The distinction between groups was made using previous research that declared the average PAD patient walks 3586 steps/day. Ten subjects were classified as active (□3586 average steps/day) and sixteen participants as inactive (&lt;3586 steps/day) based on a 7-day accelerometer measurement. The Gardner progressive treadmill test was used to asses ICD, ACD, and EC. EC was measured using a metabolic cart and calculated from the second minute of walking and the last minute prior to stopping due to claudication pain. The average ICD and ACD for the active group were 130.6±106.7 meters and 306.0±184.7 meters, respectively and 143.8±119.0 meters and 248.0±156.0 meters, respectively for the inactive group. The average EC for the second minute and last minute were 9.6±1.9 mlkg-1min-1 and 11.5±2.4 mlkg-1min-1 respectively for active group and 7.0±3.1 mlkg-1min-1 and 8.1±3.8 mlkg-1min-1 respectively for inactive group. The data suggests that the active group had better walking performance and greater energy consumption indicating increased efficiency of oxygen transport and extraction capability in the leg muscles.
Prescribing Personalized Exercise Programs Using Smartphone Sensors For Remote Fitness Assessment
Authors: Jacobs Jeremy , Yekutiel Ziv , Arnon Mical , Argov Esther , Karlinsky Keren Tchelet , Benmoha Eti , Netz yael 
Published: December 2021

Abstract
Guidelines for physical activity emphasize multiple fitness components among people aged &gt;65. The age-related increase in variability of fitness components necessitates accurate individualized assessment prior to optimal prescription for personalized exercise program. Accordingly, we tested feasibility and effectiveness of a novel tool designed to remotely assess balance, flexibility, and strength using smartphone sensors (accelerometer/gyroscope), and subsequently remotely deliver personalized exercise programs via smartphone. This pilot study enrolled 52 healthy volunteers (34 females) aged 65+, with normal cognition and low fall-risk. Baseline preliminary data from smartphone fitness assessment were analyzed to generate 42 fitness digital-markers, used to generate personalized exercise programs (5 times/week for 6 weeks). Programs included graded exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, vestibular). Fitness was remotely assessed at baseline and after six weeks. Average age was 74.7±6.4 years; adherence was 3.6±1.7 exercise sessions/week. Significant improvement for pre/post testing was observed for 10/12 digital-markers of strength/flexibility for upper/lower body (sit-to-stand repetitions/duration; arm-lift duration; torso-rotation; arm-extension/flexion). Balance improved significantly for 6/10 measures of tandem-stance, with consistent (non-significant) trends observed across 20 balance digital-markers of tandem-walk and one leg-stance. Balance showed greatest improvement among the 37 participants exercising ≥3/week. These preliminary results serve as proof of concept among people aged &gt;65: high adherence and improved fitness confirm the potential benefits and niche for remote fitness assessment used to generate personalized exercise programs. Future research is required to confirm the benefits among specific patient groups, such as those with frailty, deconditioning, cognitive and functional impairment.
Reliability of Grip Strength as a Predictor of Hand Limitation Among U.S. Older Adults: How Good is Grip Strength?
Authors: Logue Rachel , Brown Susan , Hasson Rebecca , Davis Matthew 
Published: December 2021

Abstract
Grip strength is commonly used to assess hand function in older adults and is associated with health outcomes including muscle strength, cognition, and mortality. However, the degree to which grip strength predicts an actual hand limitation is unknown. This study evaluated grip strength as a predictor of hand limitations associated with activities of daily living. Using the 2011-14 National Health and Nutrition Examination Survey (NHANES), we selected five self-reported hand-related functional limitations to classify older adults reporting one or more limitations versus those with no limitations. We identified 2,064 older adults (age≥65), 31% of whom reported a hand-related limitation. Odds ratios were used to assess the association between grip strength quartile and the likelihood of a hand limitation while controlling for sex, race/ethnicity, education level, income, and pain. Receiver operator curves were used to evaluate the degree to which grip strength discriminates between those with limitations versus those without. Older adults with very low grip strength (lowest quartile) were more likely to have at least one limitation (OR:6.1, 95% CI:3.2,11.8) than those with high grip strength (highest quartile). However, receiver operator curves suggested grip strength only modestly discriminated hand limitations (area under curve:0.71). While self-reported hand limitations were associated with lower grip strength, it was a relatively poor predictor of hand impairments among older adults. This study suggests grip strength may not predict hand function as well as previously thought. Better assessments are needed to adequately evaluate upper extremity impairments to help older adults maintain functional independence.
Sex differences in power decrement identified across the lifespan
Authors: Campitelli Anthony , Paulson Sally , Vincenzo Jennifer , Glenn Jordan , Jones Megan , Powers Melissa , Gills Joshua , Gray Michelle 
Published: December 2021

Abstract
Muscular power has been shown to be a significant predictor of physical function in older adults, but assessments of power have traditionally been performed in movements not specific to activities of daily living (ADLs). Recent research examined power in the context of ADL-specific movements, but it is unclear how ADL-specific lower-body power differs over lifespan in males and females. This investigation sought to describe ADL-specific power decline across the lifespan and analyze differences between the sexes. Adults (n = 557) aged 18-89 volunteered and were divided into age cohorts (18-30, 50-59, 60-69, 70-79, and 80-89 years). Participants performed a sit-to-stand (STS) task with as much velocity as possible while connected to a linear position transducer (LPT). The LPT calculated average and peak power. The average result of 5 individual STS trials was analyzed for each of the power variables. The first significant decrement in average STS power (p &lt; .01) was observed at an earlier age cohort in males than females (60-69 in males vs. 70-79 in females). The per decade magnitude of power decrement after age 60 was larger in males than females in both absolute magnitude and percent decrease (11.74 vs. 10.09% decrease per decade). As power and physical function are correlated, this may have implications for the rate and age of functional decline in males. Additionally, understanding the differences in ADL-specific power decline between males and females gives clinicians and health professionals valuable information for developing preventative fitness paradigms specific to members of a given sex.