bluuebunny/crossref_metadata_2025_split huggingface dataset:
CONTEXTUALIZING HOW DAILY DISCRIMINATION EXPERIENCES IMPACT EVERYDAY METAMEMORY
Authors: Ly Timothy , Allen Rebecca , Cundiff Jeanne , DeCaro Jason 
Published: December 2023

Abstract
Examining day-to-day responses to everyday stressors, such as discrimination, contextualizes how cognitive aging trajectories may vary across the lifespan. Furthermore, recent research investigating stress-induced impairment of metamemory may address the relationship between discrimination experiences and cognitive impairment. This study sought to articulate the association between daily experiences of discrimination and impaired metamemory across the lifespan, as defined by the number of subjective cognitive complaints, using data collected from the Midlife in the United States Refresher Study Daily Diary Project (N = 782; ages 20-75; M = 47.91 years, SD = 12.67 years). A two-level linear mixed model was conducted to examine the within and between-persons relationships concerning lifetime and daily experiences of discrimination, daily affect balance, baseline objective cognitive performance, and sociodemographic variables (age, race, ethnicity, and sex) on impaired everyday metamemory. Results from linear mixed model analyses showed significant within-person fixed effects of daily discrimination and daily affect balance on metamemory accuracy, as well as significant between-persons fixed effects of race and ethnicity on metamemory accuracy. Furthermore, significant interactions were found between race and daily discrimination experiences, ethnicity and daily discrimination experiences, daily affect balance and daily discrimination experiences, daily affect balance and age, and endorsement of lifetime experiences of discrimination and daily discrimination experiences on day-to-day metamemory accuracy. These findings extend our understanding of how discrimination experiences may impair metacognitive processes and demonstrate the need for more research into understanding metamemory accuracy as an underlying mechanism by which the psychosocial stressor of discrimination impacts cognition across the lifespan.
DO DEPRESSIVE SYMPTOMS MEDIATE SEGREGATION’S IMPACT ON COGNITIVE AGING IN OLDER MEXICAN AMERICANS?
Authors: Morris Emily , Grant Jeremy , Clark Alexandra , Esiaka Darlingtina , Ajrouch Kristine , Tarraf Wassim 
Published: December 2023

Abstract
Segregation in the United States has important implications for cognitive aging among Mexican Americans as a social determinant of health. Because segregation is systemically engrained, identifying more immediately modifiable mechanisms, such as depressive symptoms, that may underly segregation-cognition associations could point to intervention targets to reduce cognitive aging disparities. We used path mediation modeling to test whether depressive symptoms mediated (indirect effect) the segregation-cognition associations. We used H-EPESE data on older Mexican Americans from the first (n=3,050) wave and returning at wave 5 (n=1,167) combined with Census data from the National Neighborhood Data Archive, which provided indicators for county level segregation (isolation, interaction, dissimilarity). Cognition was operationalized as baseline MMSE, MMSE at wave 5, and change between baseline and wave 5. Depressive symptoms were measured by the CESD at baseline. Covariates included age, sex, and years of education. The sample was 58% female with an average age of 73.6 (SD=6.2) and an average 5-years education (SD=3.9). Higher dissimilarity (i.e., less exposure to non-Hispanic Whites) was associated with better baseline (B=.078, SE=.031, p=.012) and wave 5 cognition (B=.130, SE=.037, p&lt;.001), independent of depressive symptoms. More depressive symptoms were associated with worse baseline and wave 5 cognition, independent of segregation indices (CESD B values range from -.063 to -.142, ps &lt;.05). Depressive symptoms did not mediate segregation-cognition associations. Results suggest that there may be an enclave effect that is protective for both depressive symptoms and cognition in older Mexican Americans. Future research should examine additional biopsychosocial mechanisms underlying segregation-cognition associations.
TECHNOLOGY-SPECIFIC AGEISM AS A PREDICTOR OF NOT OFFERING TECHNOLOGY-BASED PHYSIOTHERAPY FOR OLDER ADULTS
Authors: Mannheim Ittay , Neiertz Cynthia , Wouters Eveline 
Published: December 2023

Abstract
Incorporating digital technologies in healthcare can potentially improve the quality and accessibility of older persons’ care. However, ageist attitudes among healthcare professionals can lead to discrimination in treatment decisions and deprive older patients of technology-based treatment. This study explores whether technology-specific ageism influenced physiotherapists’ decisions to use technology-based healthcare with older patients. Seventy-eight physiotherapists in Luxembourg filled out an online survey. Technology-specific ageism was measured by the Attitudes Towards Older Adults Using Technology (ATOAUT-11) scale. Additional measures included the Expectations Regarding Aging scale, attitudes towards technology use in the work environment, and whether physiotherapists had not offered technology-based treatment in the past because of a patient’s age. Thirty-one percent of the participants reported that they had not offered technology-based treatment to a patient in the past because of the patient’s older age. Importantly, using logistic regression, it was found that higher levels of technology-specific ageism predicted not offering technology-based treatment, such that participants with more negative attitudes (1 standard deviation) were two times more likely not to offer treatment. Positive attitudes toward using technology in the work environment were also found to be a significant predictor. All other characteristics (gender, age, work experience, and percentage of patients over 50) did not predict not offering treatment. This study provides initial evidence that technology-specific ageism may lead to discrimination and deprive older persons of receiving optimal treatment. More research is needed to identify the magnitude of ageism in using technology-based treatment in healthcare and develop interventions to mitigate it.
METABOLOMIC PROFILES OF DEMENTIA RISK AND MOBILITY DECLINE IN A BIRACIAL COHORT OF OLDER ADULTS
Authors: Tian Qu , Yao Shanshan , Ferrucci Luigi , Murthy Venkatesh , Shah Ravi , Newman Anne 
Published: December 2023

Abstract
Age-related mobility decline precedes future cognitive impairment and dementia. Blood biomarkers underlying this connection are less clear. This study aims to examine metabolomic profiles of dementia risk and mobility decline in the Health, Aging and Body Composition Study. Dementia diagnosis was determined by race-specific decline in Modified Mini-Mental State Examination scores, medication use, and hospital records. 2450 participants were free of dementia at year 2 and had 613 targeted plasma metabolites. 534(22%) developed dementia during a mean follow-up of 9.3(SD=4.1) years. 2028 participants had repeated 20-meter usual gait speed up to 10 years follow-up. We performed Cox regression and linear regression with LASSO models to determine which metabolites would predict dementia risk and gait speed decline, respectively. After adjustment for age, sex, race, and education, 30 metabolites were significant predictors of incident dementia. Top-ranked metabolites included glyceric acid, niacinamide, androsterone 3- glucuronide, phosphatidylcholine (P-34:4)/PC(O-34:5), aminobutyric acid, xanthine, sphingomyelin (d18:1/14:0) (hazard ratios&lt; 1), suberic acid, lysophosphatidylethanolamine (18:1), threitol, and andrenic acid (hazard ratios&gt;1). These metabolites were enriched in arginine biosynthesis, alanine, aspartate and glutamate metabolism, glyoxylate and dicarboxylate metabolism and arginine and proline metabolism(p&lt; 0.05). Of these metabolites, threitol, sphingomyelin (d18:1/14:0), adrenic acid, and phosphatidylethanolamine (P-36:0)/PE(O-36:1) were also significant predictors of mobility decline in a consistent direction. This longitudinal study reveals unique and shared metabolomic risk profiles for dementia and mobility decline. Several metabolites in amino-acid pathways and urea may be important in the development of dementia and certain sugar and lipids with long-chain and very long-chain fatty acids also predict mobility decline.
EXPERIENCES OF VETERANS, CAREGIVERS, AND VA HOME-BASED CARE PROVIDERS POST-HURRICANE IAN
Authors: Haverhals Leah , Manheim Chelsea , Hernandez-Lujan Deisy 
Published: December 2023

Abstract
On September 28, 2022, Hurricane Ian pummeled parts of south Florida. Disaster and climate change research has shown that disasters exacerbate inequalities, especially amongst older and physically vulnerable people. Florida has a large population of Veterans managing multiple chronic health conditions and receiving long-term services and supports in-home. Many such Veterans receive care from the Veterans Health Administration (VA) Home Based Primary Care (HBPC) or Medical Foster Home (MFH) programs. To describe how VA staff provided high quality care during and post-hurricane, and how Veterans and caregivers accessed needed healthcare and supports post-hurricane, we conducted a site visit to the Fort Myers, Florida area in May 2023. We conducted N=25 in-person interviews with VA HBPC and MFH staff, Veterans, and family and VA MFH caregivers. Findings from qualitative thematic analysis showed that Veterans and caregivers felt highly supported by VA care teams who made proactive changes in the days prior to and the months post-hurricane. Staff efforts post-hurricane focused on improving care coordination in anticipation of future disasters, especially around communicating with Veterans and their caregivers, and a VA workgroup formed to implement changes. Some Veterans and caregivers experienced significant challenges during and post-hurricane, with a few displaced and having to relocate, and others having difficulty accessing needed oxygen and suffering injuries related to the hurricane. As climate change causes more severe natural hazard events, lessons learned from this project can inform how to better support healthcare staff, older adults, and their caregivers pre-and post-major disasters.
ENHANCED SUPPORT FOR CHINESE AND KOREAN AMERICAN DEMENTIA CAREGIVERS: INSIGHT FROM SERVICE PROVIDERS
Authors: Wang Jing , Johnson Min Kyoung , Leong I tek , Pei Yaolin , Mittelman Mary , Epstein Cynthia , Lee Kyung Hee , Wu Bei 
Published: December 2023

Abstract
As members of two large Asian immigrant populations in the U.S., Korean and Chinese American family caregivers of persons with dementia (PWD) have unique challenges impacted by their cultural background. Many of them prefer to and are relying on social services providers who speak the same language as they do for support and assistance. As part of the project to inform the cultural adaptation of NYU Caregiver Intervention-Enhanced Support (NYUCI-ES) program for Chinese and Korean American caregivers with multiple chronic conditions, we explored the perspectives of 13 Chinese and 12 Korean services providers (physicians and social service staff). During focus group discussions, services providers shared their perspectives on care challenges facing these populations, including challenges in initiating advanced care planning, family conflict in decision making and caregiving, insufficient community resources, staffing shortage associated with the pandemic and some care aides’ stigmatic beliefs about providing dementia care. We identified nuances in the following aspects: utilization of home health aides’ help, attitudes towards diagnosis and education, approaches to selfcare, preferences for engagement settings, trust-building, and family involvement. For instance, Korean services providers highlighted Korean caregivers’ strong preference for home health aides of the same gender as PWD and having individual rather than group session to learn about dementia. What we found from services providers largely echoed our findings from family caregivers but also provided unique insights from their work experiences. These findings will inform cultural adaptation of the content of the NYUCI to improve its applicability to Chinese and Korean American caregivers.
POSITIVE EMOTION LANGUAGE PREDICTS IMPROVING DEPRESSION TRAJECTORIES AFTER DEMENTIA CAREGIVING ENDS
Authors: Wells Jenna , Scheffer Julian , Shdo Suzanne , Yee Claire , Possin Katherine , Levenson Robert 
Published: December 2023

Abstract
There are striking differences among caregivers of people with dementia (PWDs) in how their health and well-being changes during active caregiving; however, less is known about these differences after caregiving has ended. One important factor influencing caregiver health is the emotional quality of the caregiver-PWD relationship. The present study evaluated caregivers’ emotional connection to the PWD (during caregiving) and associations with caregivers’ depression both concurrently (N = 326 active caregivers) and longitudinally (n = 91 former caregivers). Active caregivers described a recent time they felt connected to the PWD, and their responses were transcribed verbatim. Caregivers’ emotional connection to the PWD was operationalized by summing the number of positive and negative emotion words from the transcripts using text analysis software and dividing each figure by the total number of words in the response. Results indicated that neither positive nor negative emotional language was significantly correlated with caregivers’ concurrent depression. However, two-wave latent change score modeling revealed that caregivers’ greater positive emotional language (adjusting for caregivers’ baseline depression and negative emotional language) predicted steeper declines in depression (i.e., improvements in depression trajectories) after the death of the PWD (ß = -.11, SE(ß) = 0.04, p = .033). Negative emotional language was not significantly associated with changes in caregivers’ depression. This finding highlights positive emotion expressed by caregivers when describing their connection with the PWD as a potential resilience factor and underscores the important role that positive emotional qualities of the caregiving relationship play in improving caregivers’ mental health after caregiving ends.
SOCIAL PARTICIPATION AND DEPRESSIVE SYMPTOMS ON THE RELATIONSHIP BETWEEN COGNITIVE FRAILTY AND DISABILITY
Authors: Ning Hongting , Feng Hui , LI Junxin , Li Mengchi 
Published: December 2023

Abstract
To explore the multiple mediating effects of social participation and depressive symptoms on the relationship between cognitive frailty and functional disability. A total of 6122 participants from four waves of the China Health and Retirement Longitudinal Study (CHARLS) were included. Functional status was assessed by activities of daily living (ADL) and instrumental ADL (IADL). Analyses were restricted to middle-aged and older adults free of functional disability at baseline. Competing-risks regression and multiple mediation effects analysis adjusted for covariates were conducted. Cognitive frailty (hazard ratio [HR] 1.27, 95% confidence interval [CI] 1.09, 1.48), social participation (HR 0.87, 95%CI 0.79, 0.97), and depressive symptoms (HR 1.75, 95%CI 1.56, 1.95) were associated with the incidence of ADL disability. These factors were also found to predict the occurrence of IADL disability. Cognitive frailty was found to be associated with ADL disability, not only through the pathways of social participation (β = 0.009, 95% CI 0.001, 0.018) and depressive symptoms (β = 0.094, 95% CI 0.062, 0.131) separately, but also through social participation and depressive symptoms sequentially (β = 0.002, 95% CI 0.001, 0.003). Similar findings were also observed for the outcome of IADL disability. Cognitive frailty has been associated with functional disability, wherein social participation and depressive symptoms partially mediate the association. To prevent functional disability, it’s suggested to implement integrated and comprehensive intervention measures, including preventing and managing cognitive frailty, promoting social participation, and improving depressive symptoms.
THE IMPACT OF INFORMAL CARE ON FORMAL CARE UTILIZATION AMONG ELDERLY AMERICANS
Authors: Ke Yemiao , Zhang Yun 
Published: December 2023

Abstract

Objectives
This research aims (1) to examines the impact of informal care on the utilization of formal care among elderly Americans, and (2) to investigate how probable dementia affect this relationship.

Method
Using cross-sectional data from the National Health and Aging Trends Study (NHATS 2011 & 2015), we build a correlated Tobit model to analyze the quantity of informal and formal care received by elderly individuals, which not only handles the censored nature of the dependent variables, but also allows a more flexible error structure. To address endogeneity concerns, instrumental variables derived from the characteristics of the elderly’s children are incorporated.

Result
Participants who did not live in long-term care facilities (N = 7,090) were included. Our estimation results indicate that when monthly hours of informal care received are below 83 hours, the monthly hours of formal care decrease with an increase in informal care. Conversely, when monthly hours of informal care received exceed 83 hours, the monthly hours of formal care increase with additional informal care. Probable dementia increases the monthly hours of informal care by 31.2 hours and the monthly hours of formal care by 6.4 hours.

Conclusion
Informal care substitutes for formal care when elderly individuals require only a low to moderate level of informal care. However, informal and formal care become complementary when the elderly requires more intensive care. Probable dementia has a significant impact on both informal care and formal care.
CARDIOVASCULAR AND MORTALITY RISK WITH COEXISTING HYPERTENSION, DYSLIPIDEMIA AND SYSTEMIC INFLAMMATION
Authors: Karadimas Thomas , Meier Helen 
Published: December 2023

Abstract
Hypertension and dyslipidemia are established risk factors for cardiovascular disease (CVD), but are often insufficient alone in predicting CVD. Inflammation also contributes to CVD, but research on the co-occurrence of inflammation, hypertension, and dyslipidemia and CVD risk is limited. Prospective data from the Health and Retirement Study, a representative cohort of US adults over 50 years of age (n = 1,527) were used. Hypertension, dyslipidemia, and elevated C-reactive protein (CRP) were used to create a CVD risk: low (0-1 factors), medium (2 factors), or high (all 3 factors). Weighted logistic regression models estimated the odds ratio (OR) of 1) prevalent and incident CVD for medium and high-risk groups versus the low-risk group and 2) 4-year mortality adjusting for covariates. Cross-sectionally, high-risk participants had significantly higher odds of CVD prevalence compared to participants with low-risk (adjusted OR = 1.68, 95% CI: [1.12 - 2.53]). Prospectively, medium and high-risk participants had higher odds of 4-year CVD incidence (medium: OR = 1.41, 95% CI: [0.71 - 2.79]; high OR = 2.05, 95% CI: [0.93 - 4.53]) compared to those with low-risk, but not statistically significant. Risk of 4-year mortality was higher in both medium (OR = 2.00 95% CI: [1.21 - 3.30]) and high-risk (OR = 2.11 95% CI: [1.15 - 3.86]) participants vs. low-risk. Co-occurrence of hypertension, dyslipidemia, and elevated CRP was associated with CVD prevalence and 4-year mortality in older US adults, emphasizing the importance of multifactor screening for CVD risk.
PLASMA METABOLOMICS OF VIGOR TO FRAILTY AMONG OLDER BLACK AND WHITE MEN AND WOMEN
Authors: Marron Megan , Yao Shanshan , Shah Ravi , Murthy Venkatesh , Newman Anne 
Published: December 2023

Abstract
Older women and Black individuals are more likely to experience frailty. Metabolomics can provide a metabolic characterization of frailty that can help inform more effective interventions aimed at improving health, reducing disparities, and preventing frailty with aging. We sought to identify metabolites and pathways associated with vigor to frailty and determine whether these associations differed by gender and/or race among N=2189 older Black and White men and women from the Health, Aging, and Body Composition (Health ABC) study. Fasting plasma metabolites were measured using liquid chromatography-mass spectrometry. Vigor to frailty was based on weight change, physical activity, gait speed, grip strength, and energy level. We used linear regression of a single metabolite on vigor to frailty, adjusting for age, gender, race, study site, and multiple comparisons using a Bonferroni correction. Among 500 metabolites, 113 were associated with vigor to frailty (p&lt; 0.0001). Associations between metabolites and vigor to frailty did not differ significantly by race and/or gender. Lower amino acids, glycerophospholipids, & sphingolipids and higher acylcarnitines, fatty acids, amino acid derivatives, carboximidic acids, benzenoids, nucleosides, organoheterocyclic compounds, carbohydrates, and trimethylamine oxide were associated with frailer scores. Pathway analyses identified the citrate cycle (p=0.00005), where higher levels of measured metabolites involved in the citrate cycle were associated with frailer scores. Daily calories and protein intake did not differ by vigor to frailty. Frailer Health ABC participants may have lower utilization of energy pathways, potentially a result of less efficient utilization of similar amounts of nutrients and energy demand than more vigorous participants.
IMPROVING COGNITIVE DECLINE FOR PERSONS LIVING WITH DEMENTIA: A RCT ART THERAPY BASED ON THE ETC FRAMEWORK
Authors: Jeon Heesu J 
Published: December 2023

Abstract
Abstract This randomized controlled trial explored the impact of Expressive Therapies Continuum (ETC)-based art therapy interventions for older adults with dementia living in a complex care home. The trial examined the efficacy of 10 art therapy intervention sessions over 4 months, comparing results with an active control group that participated in 10 art sessions. Pre- and post-assessments, including the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), and the Older People’s Quality of Life (OPQOL-Brief) questionnaires, were conducted. Results demonstrated that participants displayed similar visual expression elements, shared preferences for specific media types, and equivalent ETC-based intervention entry levels. In addition, participants in the experimental group showed significant increases in OPQOL-Brief scores. Finally, MMSE-Language scores demonstrated statistically significant increases in the experimental group and a decrease in the control group. The current study aligns with previous research demonstrating that art therapy can improve cognitive functioning and enhance the quality of life in older adults living with dementia. It expands on previous research by providing new insights into expressive and stylistic elements, ETC entry-level, and media preferences for engaging in artmaking. Keywords: Art therapy, dementia, older adults, Expressive Therapies Continuum, cognitive functioning, quality of life