bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Genetic and Cognitive Findings From the Long Life Family Study
Authors: Wojczynski Mary , Glynn Nancy W , Hadley Evan 
Published: December 2021

Abstract
The Long Life Family Study (LLFS), funded by the National Institute on Aging, is an international collaborative study of the genetics and familial components of exceptional longevity and healthy aging. We phenotyped 4,953 individuals from 539 two-generational families (1,727 proband; 3,226 offspring) at baseline (2006-2009). A second visit (2014-2017) was conducted for 2,904 (478 proband; 2,426 offspring) participants. The longitudinal, comprehensive in-person visits measured domains of healthy aging, including physical performance, cognition, and blood markers. Extensive genetic analyses were performed using the baseline blood draw, including genotyping with the Illumina 2.5M Human Omni array, linkage analyses with the families, whole genome sequencing using the TopMED protocol, and metabolomic assays. Collectively, this symposium will present novel findings that elucidate new potential genes and genetic interactions, investigate metabolomics profiles among APOE4 carriers, and refine phenotypic cognition definitions. Specifically, Dr. Santanasto will share results flanking the mesothelin gene associated with longitudinal gait speed. Then, Dr. An will share his findings of a new intronic variant in PKD1L2 gene associated with adiponectin, a marker of insulin resistance. Next, Dr. Arbeev will discuss genetic interactions between candidate genes for physiologic dysregulation and candidate genes for Alzheimer’s disease (AD, UNC5C gene). Ms. Yao will examine metabolomic profile differences between APOE4 carriers who develop AD and those who do not. Lastly, Mr. Xiang will introduce a method for combining multiple cognitive tests into a more sensitive overall cognitive score. As Discussant, Dr. Evan Hadley will share insights and propose future directions for LLFS.
Linkage Guided Sequence Analysis Revealed a Novel Gene PKD1L2 for Adiponectin: The Long Life Family Study (LLFS)
Authors: An Ping , Lee Joseph , Anema Jason , Wang Lihua , Daw Warwick , Christensen Kaare , Zmuda Joseph , Province Michael 
Published: December 2021

Abstract
Adiponectin is involved in regulating insulin resistance (IR) and is a potential regulator of healthy aging and lifespan. To identify novel variants associated with adiponectin, we further assessed our previously identified linkage peak on 16q23.2 (LODs=3.8). We used sequence data of 632 participants (age, 24-110 years) from 47 families of European ancestry in the Long Life Family Study, a study with familial clustering of exceptional longevity in the US and Denmark. Adiponectin levels were log-transformed, and adjusted for age, sex, sites, and PCs for ancestry. We found a variant in the PKD1L2 (rs527459046, p=2e-8, MAF=3%, r2=1.5%, accounting for linkage=28%). The PKD1L2, 1.4 Mb upstream of the CDH13 (adiponectin receptor gene) is expressed in heart, liver, and adipocytes, known to function as an ion-channel regulator or a GPCR regulator for aging-related lipolysis, IR, and adiponectin/leptin secretion. Haplotyping, epistatic and bioinformatic analyses will be engaged to capture additional/functional variants and regulatory networks.
Hospital-Associated Disability Associated With Delirium Among Older Adults
Authors: Kennedy Richard , Freeman Hyun , Martin Roy , Whittington Caroline , Osborne John , Markland Alayne , Buford Thomas , Brown Cynthia 
Published: December 2021

Abstract
Hospital-associated disability (HAD), defined as a loss of activities of daily living (ADLs) occurring during hospitalization, is a common complication among older adults. Delirium is also a common complication during hospitalization and is associated with multiple long-term sequelae. We sought to determine the effect of delirium and known covariates on the risk of incident HAD in hospitalized older adults. We examined electronic health record (EHR) data for 35,201 older adults ≥ 65 years of age admitted to the general inpatient (non-ICU) units of UAB Hospital from January 1, 2015 to December 31, 2019. Delirium was defined as a score ≥ 2 on the Nursing Delirium Screening Scale (NuDESC) during hospital admission, and HAD defined as a decline on the Katz ADL scale from hospital admission to discharge. Generalized linear mixed models were used to examine the association between delirium and HAD, adjusting for covariates and repeated observations for individuals with multiple admissions. We found that 21.2% of older adults developed HAD during their hospitalization and experienced higher delirium rates as compared to those not developing HAD (25.2% vs. 16.3%). Presence of delirium, medical comorbidity score, baseline cognitive status, and baseline ADL function were associated (all p &lt;0.001) with incident HAD. Mediation analyses also showed that 8% of the effect of comorbidity on incident HAD was due to delirium (p &lt; 0.001). Reducing rates of delirium can be one component of a comprehensive approach to reduce rates of HAD in older adults.
Predicting Unscheduled Emergency Department Revisits Leading to Acute Hospital Admissions Among Older Adults
Authors: Rosen Tony , Huang Yufang , McCarty Matthew , Stern Michael , Zhang Yiye , Barchi Daniel , Sharma Rahul , Steel Peter 
Published: December 2021

Abstract
Background: Unscheduled emergency department (ED) revisits leading to acute hospital admission (RVA) are tantamount to a failed discharge, associated with physician error, mis-prognosis, and inadequate care planning. Previous research has shown RVA to be associated with adverse outcomes such as ICU admissions, long hospitalizations and mortality. Given the limited impact of pre-existing screening tools for older adults, we developed and validated a machine learning model to predict individual patient risk of RVA within 72 hours and 9 days of index ED visits. Method: A machine learning model was applied to retrospective electronic health record (EHR) data of patients presenting to 2 geographically and demographically divergent urban EDs in 2019. 478 clinically meaningful EHR data variables were included: socio-demographics, ED and comorbidity diagnoses, therapeutics, laboratory test orders and test results, diagnostic imaging test orders, vital signs, and utilization and operational data. Multiple machine learning algorithms were constructed; models were compared against a pre-existing adult ED-RVA risk score as a baseline. Results: A total of 62,154 patients were included in the analysis, with 508 (0.82%) and 889 (1.4%) having 72-hour and 9-day RVA. The best-performing model, combining deep significance clustering (DICE) and regularized logistic regression, achieved AUC of 0.86 and 0.79 for 72-hour and 9-day ED-RVA for older adult patients, respectively, outperforming the pre-existing RVA risk score (0.704 and 0.694). Discussion: Machine learning models to screen for and predict older adults at high-risk for ED-RVA may be useful in directing interventions to reduce adverse events in older adults discharged from the ED.
Preparing for the New Normal: Chronicling the Impact of COVID-19 on Older Adults and Providers
Authors: DiMaria-Ghalili Rose Ann , Sefcik Justine 
Published: December 2021

Abstract
COVID-19 and social distancing heralded an unprecedented change in the way older adults and health care providers live, work, socialize and manage their health. Early “calls-to-action” included the call for researchers to chronicle the impact of the COVID-19 pandemic on care of older adults to inform models of care and best practices in the new normal. This symposium explores the impact of COVID-19 on the health of older adults across the care continuum and healthcare delivery augmented by technology. The perspectives of older adults living in the community and providers who care for this population are highlighted. Additionally, there is a focus on the most vulnerable, those living in skilled care facilities and continuing care retirement communities. Fisher analyzes the key themes in 37 COVID-19 video communiques over 11 months at a continuing care retirement community. Sefcik explores coping strategies including outdoor activities among community-dwelling older adults. DiMaria-Ghalili examined patterns of physical and mental health, technology usage and loneliness in older adults, including those living in the community and a continuing care retirement community. Using longitudinal data and COVID-19 supplemental survey data from the National Health and Aging Trends Study, Huh-Yoo discusses disparities in online patient-provider communication and implications for the Post-COVID era. Coates discusses the facilitators and barriers perceived by interdisciplinary providers deploying telehealth during the COVID-19 pandemic and implications for healthcare delivery in older adults. The symposium will conclude with a discussion by Dr. Sefcik on the implications for research, practice and policy in the post COVID-19 era.
Recruiting and Conducting Online Dyadic Semi-Structured Interviews With LGBTQ+ Couples Facing Advanced Cancer
Authors: Bybee Sara , Cloyes Kristin , Ellington Lee , Baucom Brian , Supiano Katherine , Mooney Kathi 
Published: December 2021

Abstract
In this study, LGBTQ+ adult couples facing advanced cancer were recruited online. Eligible couples were sent a direct link to electronic consent and surveys in REDCap®. Participants were then invited to complete a 45-minute dyadic semi-structured interview regarding their experience of coping with cancer as a couple. This study faced difficulties in recruiting LGBTQ+ couples, and also faced the challenge of identifying and managing online responses from individuals misrepresenting themselves, and from automated accounts or “bots”. LGBTQ+ aging scholars must acknowledge how conducting research remotely with LGBTQ+ adults may necessitate changes in study design, such as changes to recruitment and more comprehensive eligibility screening designed to prevent and detect the collection of untrustworthy data. Ultimately, protecting the integrity of participant data in online research supports research accessibility and inclusion for LGBTQ+ older adults, and is the first step in conducting research that promotes health equity.
Qualitative Research With HIV+ Older Adults Living in Rural Areas: Methodological Considerations During COVID-19
Authors: Robinson Erin 
Published: December 2021

Abstract
Older adults living with HIV/AIDS (OALWHA) in rural areas of the U.S. are a highly marginalized community. Intersectional stigma related to age, HIV status, geography, sexual orientation, gender identity, and race oftentimes create a complex lived experience for this population group. While there is a significant need for qualitative research that highlights the intersecting stigmas experienced by OALWHA in rural areas, recruitment challenges exist. Fear of being outed in their rural communities, due to their HIV status and LGBTQ+ identities, makes many OALWHA reluctant to participate in research. However, there is much resiliency in the population as well, especially during the COVID-19 pandemic. In fact, as research approaches have pivoted to phone/virtual data collection during the pandemic, this can help promote anonymity among this population group. This presentation will detail methodological considerations for recruitment, data collection, and analysis for qualitative research with OALWHA in rural areas of the U.S.
User-Centered Design of a Dementia-Friendly Privacy Policy for the FindMyApps Intervention
Authors: Neal David , Kerkhof Yvonne , Ettema Teake , Dijkstra Karin , Dröes Rose-Marie 
Published: December 2021

Abstract
The ability of people with dementia and their caregivers to successfully navigate online environments is increasingly important to their social health. However, uncertainty about privacy online is an important barrier. Theoretically, access to published privacy policies should allow users of websites or software applications to make informed decisions. In practice, such documents are often complicated texts, and consequently even less accessible to people with cognitive impairment than to the general population. We present results from a multi-stakeholder, user-centred design process, towards an accessible alternative: a ‘dementia-friendly privacy policy’. Three design sprints took place in 2021, led by participants of the ‘Smart Solutions Semester’ at Saxion University of Applied Sciences in the Netherlands, in collaboration with cognitively unimpaired laypeople, people with dementia, informal caregivers, and expert stakeholders. Outputs were specifications for the solution, low-fidelity prototypes and high-fidelity prototypes, respectively. The dementia-friendly privacy policy is now ready for implementation and further evaluation.
Addressing the Adverse Effects of Climate Change on the Human Rights of Older Persons
Authors: Burk-Leaver Erin 
Published: December 2021

Abstract
The common consequences of climate change events include: displacement, loss of sustainable shelter and housing, and limited access to medical care and other resources such as food, clean water, and sanitation services. These adverse effects coincide to an alarming degree with the human rights most essential to those in vulnerable or marginalized groups, including older populations. Whether through displacement or disruption of supply, the stressors of climate change events greatly exacerbate older populations’ vulnerability, especially when compounded by negative social determinants of health, such as existing social, political, and economic barriers to successful aging. Using the SDGs as a framework to develop policies around (13) climate action and the use of improved (9) industry, innovation, and infrastructure to create (11) sustainable cities and communities, it is possible to establish (10) reduced inequalities to promote overall (3) good health and well-being in our older populations.
Empowering Caregivers in the Midst of Climate Change
Authors: Cox Carole 
Published: December 2021

Abstract
More than 2.7 million children in the United States are raised in kinship families, with the majority of these caregivers, grandparents. Nationally, 1 in 11 children is raised in a kinship family, among Black children, the ratio is 1 in 5. Many of these families struggle economically, welcoming their young relatives into small, often substandard public housing where nonexistent or inadequate heating and cooling exacerbate attempts to moderate extreme temperatures in crowded apartments. For others, responsibility for the children follows the loss of life or permanent disruption of family composition due to weather events such as hurricanes or tornadoes. Grandparent resilience is reflected in their commitment to the well-being of these children, especially observed throughout COVID-19. This presentation will demonstrate that a Grandparent Empowerment Program is an effective strategy to tap into their strength as advocates for adequate health care, educational opportunity, resources, and a world free from climate disruption.
The 9th Decade and Beyond: The Perils of the Narrative of Decline
Authors: Eliopoulos Elaine 
Published: December 2021

Abstract
Twenty-three participants ranging in age from 80-102 years living on remote islands in the Pacific Northwest, USA reported the privileges of their current years. The aim of the study was to explore lived bodily experience and its impact on social exclusion. Participants utilized a unique visual methodology by photographing their experiences which highlighted daily life. While acknowledging that their years ‘before’ were different, and that life going forward may present unwelcome challenges, life in the now brought new joys and self-determination, despite various bodily compromises. Their perceptions of their bodies defied the dominant narrative of decline. These important findings warrant further investigation of the ways in which this emerging cohort views the challenges of aging bodies and their ability to remain socially connected. The role the dominant narrative of decline plays in their lives may prove to misdirect supports.
A Delirium Risk Stratification Tool and Interdisciplinary Rounds to Prevent Delirium in Hospitalized Older Adults
Authors: Woodward Jennifer , Byrnes Tru 
Published: December 2021

Abstract
Delirium is a disturbance of attention accompanied by a change in baseline cognition that is commonly seen in acute care settings, and effects up to 80% of ICU patients. The development of delirium has adverse effects on patient outcomes and high health care costs. Of patients aged 65+ admitted to our hospital in 2019, non-delirious patients had a five-day length of stay (LOS) compared to a 10-14 days LOS in delirious patients. A five days LOS increase adds an additional $ 8,325 per patient for an extra annual cost of 15 million dollars. Additionally, delirium is often not recognized. A prior retrospective study showed that 31% of older adults seen by a Geriatrics provider were diagnosed with delirium, while only 11% were detected by nurse’s CAM screen. Given the need to improve delirium detection and management, a QI project was undertaken with a goal to recruit an interdisciplinary team, create a risk stratification tool to identify patients at substantial risk for developing delirium, and develop a delirium prevention protocol. Patients with a score of ≥ 4 were initiated on a nurse driven delirium protocol that included a delirium precaution sign and caregiver education. 6 months data has shown increased delirium detection of 33%, a reduction in 7.7 days LOS, reduced SNF discharge by 27%, and a significant LOS saving of 231 days. The results were statistically significant, p &lt; 0.04 for LOS reduction. The cost avoidance in LOS alone were $384,615 for delirium patients.
Predicting Factors of Clinical Outcomes in Traumatized Adults and Older Adults
Authors: Suyasith Pornthip , Chayaput Prangtip , Thosingha Orapan , Leveille Suzanne G , Sirikun Jatuporn 
Published: December 2021

Abstract
To investigate factors predicting hospital mortality and hospital length of stay (LOS) in traumatized adults and older adults, we conducted a three-year retrospective study at an academic hospital, Bangkok, Thailand. We reviewed medical records of 627 trauma patients admitted to the ED. Subjects were classified into 2 groups: adults (□55y), and older adults (□55y). Data were collected for demographic and clinical characteristics, physiologic deterioration using the Modified Early Warning Score (MEWS), severity of injury using the Circulation Respiration Abdomen Motor and Speech Score (CRAMS), and outcomes of hospital mortality and LOS. Multivariable logistic and linear regression models were performed. For hospital mortality, an elevated MEWS (Older adults [n= 267]: MEWS≥3, OR=4.80, 95%CI, 1.02-22.56 vs Adults [n = 360]: MEWS≥4, OR=11.63, 95%CI, 1.94-69.82) and CRAMS (Older adults: CRAMS≤9, OR=19.21, 95%CI, 2.78-132.98 vs Adults: CRAMS≤6, OR=18.58, 95%CI, 3.40-101.65) were strongly predictive, adjusted for demographic and clinical data. For LOS, road traffic accident (RTA) (Older adults: β=0.80, 95%CI, 0.31-1.29, p &lt; .01 vs Adults: β=0.44, 95%CI, 0.21-0.67, p &lt; .001) and falls (Older adults: β=0.88, 95%CI, 0.44-1.32, p &lt; .001 vs Adults: β=0.33, 95%CI, 0.02-0.65, p &lt; .05) were associated with LOS, adjusted for demographic and clinical data. MEWS and CRAMS predicted hospital mortality, and RTA and falls predicted LOS in both age groups. Results support the need for interventions for close monitoring and medical management for older traumatized patients based on CRAMS and MEWS assessment to decrease the risk of death, and targeting those sustaining falls and RTA to reduce prolonged LOS.
Toward interventions to reduce internalized ageism
Authors: Steward Andrew 
Published: December 2021

Abstract
Ageism is an insidious form of injustice that is internalized from an early age with accumulating negative health impacts across the lifespan. Internalized ageism is associated with numerous public health outcomes, including physical and mental health, functional impairment, cognition, cardiovascular stress, hospitalizations, and longevity. Research has begun to document how ageism negatively impacts health through psychological, behavioral, and physiological pathways. Yet, limited research has addressed interventions to reduce internalized ageism. This study integrates stereotype embodiment theory, theories of successful and productive aging, and recent scholarly literature to present a conceptual model with potential downstream, midstream, and upstream interventions at micro, meso, and macro levels. Micro interventions include: social, physical, and cognitive engagement, as well as stress management. Meso interventions include: education, intergenerational contact, and narrative reframing. Macro interventions include anti-ageism policy, such as amendments to the Age Discrimination in Employment Act (ADEA). The conceptual model is described in detail, and implications for practitioners are discussed. The need to examine how policy influences health through the three pathways in stereotype embodiment theory is discussed. This study provides a working model for scholars and practitioners to use when considering paths toward reducing internalized ageism and optimizing well-being for aging adults.
Awareness of age-related change and its relationship with inductive reasoning and ageism
Authors: Voelkner Abigail , Caskie Grace 
Published: December 2021

Abstract
Subjective aging is important due to its relationship with well-being. Diehl and Wahl (2010) proposed Awareness of Age-Related Change (AARC) as a measure of subjective aging; their theoretical model proposed that cognition’s relationship to AARC is mediated by ageist experiences. The current study tests this model and proposes an alternative model where cognition is hypothesized to mediate the relationship of ageist experiences to AARC. Inductive reasoning was used to measure cognition due to its susceptibility to ageism. Participants were 283 older adults aged 66-90 years (M=69.08, SD=3.36) without a dementia diagnosis or cognitive impairment. Inductive reasoning was measured by Word Series, Number Series, Letter Sets, and a composite score. AARC total losses, cognitive losses, total gains, and cognitive gains were used. Age, gender, and education covariates were included. Analysis of Diehl and Wahl’s (2010) model showed that the composite and individual reasoning measures had negative direct effects on all AARC measures. Ageism mediated the effect of the composite and individual reasoning measures on AARC total and cognitive losses. In the alternative model, ageist experiences had positive direct effects on AARC total and cognitive losses. The composite, Number Series, and Letter Sets mediated the effect of ageism on all AARC measures. Word Series mediated the effect of ageism on total and cognitive losses. Overall, inductive reasoning seems to play an important role in understanding the relationship of ageism with AARC. Thus, inductive reasoning abilities may be a potential intervention point to cultivate well-being. Future research should assess additional domains of cognition.