bluuebunny/crossref_metadata_2025_split huggingface dataset:
SARCOPENIA AND POST-HOSPITAL OUTCOMES FOR OLDER PATIENTS IN AN EMERGENCY DEPARTMENT
Authors: Ho Tai-Hung , Huang Hsien-Hao 
Published: December 2023

Abstract

Introduction
Sarcopenia, an important condition in older adults, is associated with increased adverse outcomes, including falls, functional decline, frailty, and mortality. Sarcopenia is often not diagnosed in emergency department (ED) settings. Therefore, this study aimed to determine the prevalence, risk factors, and clinical outcomes of sarcopenia patients admitted to the ED.

Methods
This observational study included patients aged ≥ 65 years admitted to the ED of Taipei Veterans General Hospital from September 2019 to November 2021. The patients were divided into two groups according to the definition of the Asian Working Group for Sarcopenia: sarcopenia and non-sarcopenia.

Results
Among 867 enrolled, 447 (51.6%) were categorized into non-sarcopenia and 420 (48.4%) into sarcopenia groups. Sarcopenia patients were significantly older, shorter, weighed less, and had significantly lower values of body mass index, skeletal muscle mass, skeletal muscle index, and handgrip strength. The sarcopenia group had significantly fewer daily living and instrumental activities. The independent risk factors for sarcopenia were age (odds ratio [OR] 1.07, P &lt; 0.001), malnutrition (OR 3.83, P &lt; 0.001), and frailty (OR 1.91, P = 0.001). Sarcopenia patients had significantly higher admission (66.7% vs. 59.1%, P = 0.021) and 1-month mortality rates (P = 0.002).

Conclusion
Sarcopenia patients are at risk of functional decline, hospital admission, and 1-month mortality. The independent risk factors for sarcopenia include age, malnutrition, and frailty. The recognition of sarcopenia as a medical condition in an ED may prompt targeted nutritional interventions, tailored discharge plans, and referrals to reduce disability, admission, and mortality.
SUBSIDIZED SENIOR HOUSING IN THE U.S.: A SCOPING REVIEW
Authors: Park Sojung , Park Soobin , Ryu Byeongju , Baek Jihye , Amano Takashi , Kim BoRin 
Published: December 2023

Abstract
Although Subsidized Senior Housing (SSH) has been considered an important model to promote healthy aging among vulnerable subgroups of older adults, progress in developing, expanding, and improving SSH has been limited compared to other housing models. A comprehensive review of the recent knowledge base is a critical step toward developing and expanding policies and programs for senior housing for low-income older adults. This scoping review used a five-stage scoping review methodology to answer two research questions: 1) What are the trends in SSH empirical studies? 2) What are the main topics in the existing literature on SSH in the US? This review explores the social, physical, and service environments related to SSH in older adults in the US. Personal and environmental factors were key in examining study outcomes or main focus. We reviewed a total of 61 articles and found several notable trends, including a focus on racial and ethnic minorities, cognitive impairment among SSH residents, and Collaborative partnerships between housing operators and healthcare providers. More than half of the studies (54%) were quantitative, while the rest were qualitative (38%) or mixed-methods (8%). The lack of longitudinal or causal design research reflects the limited empirical knowledge of SSH. Four themes emerged: health and well-being (52.5%), healthcare use and health behaviors (31.1%), social relations (8.2%), and housing relocation (8.2%). We discussed implications for future research and program development efforts in SSH. Future research should explore the fit between individual characteristics and the multiple-factor environmental context.
TEAM BASED LEARNING, AN OPPORTUNITY TO PROMOTE INTERPROFESSIONALISM IN GERIATRICS EDUCATION: A SYSTEMATIC REVIEW
Authors: Pajuelo-Vasquez Renzo , Gutierrez-Baca Wendy , Flores-Cohaila Javier , Runzer-Colmenares Fernando M 
Published: December 2023

Abstract
Geriatric care is complex and requires high coordination between healthcare providers. Thus, interprofessional education remains a priority, and innovative teaching methods are needed. Team-Based Learning (TBL) - “an active learning and small group instructional strategy that focuses on higher-cognitive abilities through a sequence of activities including individual work, teamwork and immediate feedback through significant problems.” – appears as one of the most valuable solutions. Following BEME recommendations, this systematic review examined the current evidence on TBL in health professions education (HPE). PubMed, EMBASE, WoS, and Scopus were searched from inception till August 2023 using key terms/subject headings related to TBL and Geriatrics. Four studies published between 2013 and 2022 met our inclusion criteria. Two studies included solely nurses and the remaining two – students from different disciplines. One study was quasi-experimental, while others were cross-sectional. Studies involved undergraduate (n=4) and graduate (n=2) students. Geriatric care was the curriculum’s focus in two studies, while it was a component in the remaining two (covered in one or two modules). All studies followed the sequence of a TBL session. Although TBL was not preferred over traditional lectures for students (n=1), there was a gain in knowledge and skills in most of the studies (n=3). To analyze the quality of studies, the MERSQI was employed (Mean = 9.87, SD =1.31), but there was a lack of validity in assessment instruments and zero patient-reported outcomes. TBL is an opportunity to promote interprofessional education. However, further studies using better assessment methods and higher-level outcomes are needed.
THE HEALTHY AGING INITIATIVE: LONGITUDINAL RESEARCH EMPOWERING OLDER ADULTS TO LIVE THEIR BEST LIVES
Authors: Andrews Heather , Gilfix Talia , Stein Benjamin , Cappon Davide , Syme Maggie , Pascual-Leone Alvaro 
Published: December 2023

Abstract
The World Health Organization (WHO) has designated this the decade of Healthy Ageing--focused on developing and maintaining functional ability that enables well-being in older age. We developed the Healthy Aging Initiative (HAI), a prospective cohort study of adults 55+ measuring functional ability, going beyond a disease-focused model of population ageing to holistic intrinsic capacity (physical, cognitive, emotional, behavioral, cultural health) and environmental context. A multidisciplinary team of geroscientists developed a protocol of subjective and objective assessments evaluating several known modifiable risk factors for disability and dementia, mobility, strength, functional status, and mental wellness. By tracking these domains annually, we influence participant health trajectories with timely, actionable feedback and gain insight into causal factors that impact functional ability, creating a blueprint for translational clinical research in healthy ageing. A feasibility pilot (N=37; 80.8 avg. age, 67-93 age range; 92% White) was conducted within two affiliated older adult living communities. The revision process included evaluating specificity, sensitivity, and utility of all assessments (results to be presented), and accounting for participant suggestions (results to be presented). The majority of pilot participants perceived benefit from the assessment (81%) and would participate again (86%), despite 43% reporting the length as challenging. Results were used to revise the protocol content and process, including reducing assessment time from 2+ hours to 40 minutes, and completing surveys over the phone. We have begun the full roll out (HAI 2.0) into all affiliated older adult living communities (2023), and will have second annual assessments in the upcoming months.
THE IMPACT OF WORKPLACE DEMANDS AND RESOURCES ON THE JOB SATISFACTION OF MINORITY AND IMMIGRANT CNAS
Authors: Hawes Frances , Wang Shuangshuang 
Published: December 2023

Abstract
This study examines the association between occupational stress (job resources and demands) and job satisfaction among nursing assistants (NAs) in the long-term care (LTC) sector, considering differences based on race/ethnicity and immigration status. Data from 2,763 NAs were retrieved from the National Nursing Assistant Survey (NNAS). Guided by the JD-R model, our findings indicate that higher job resources, including organizational support, personal development opportunities, benefits, and peer support, are associated with greater job satisfaction among NAs. Conversely, higher job demands, such as structural, physical, and emotional demands, are linked to lower job satisfaction. Importantly, significant differences in occupational stress were observed based on race/ethnicity and immigration status. Hispanic NAs reported the lowest benefits, Black NAs reported the lowest levels of residents’ respect, and White NAs reported the lowest peer support. Naturalized NAs experienced higher job satisfaction with greater job resources, while resident NAs had lower satisfaction associated with higher job demands. These findings highlight the need for tailored support mechanisms to address disparities in job rewards and recognition among different racial/ethnic and immigration groups.
THE MEDIATION EFFECT OF SOCIAL SUPPORT BETWEEN DEPRESSIVE SYMPTOMS AND LONELINESS IN OLDER ADULTS WITH DIABETES
Authors: Cho Emma 
Published: December 2023

Abstract
The purpose of this study was to examine the relationship between depressive symptoms and loneliness in older adults with diabetes, and to explore the mediating role of social support in this association. This study was developed as a secondary data analysis using data from the National Social Life, Health, and Aging Project in the USA. The sample consisted of 407 older adults aged 50 to 93 years (mean = 64.76, SD=9.03; 50.9% male; 60% married and white). A multi-item survey questionnaire was used to assess loneliness, social support, and depressive symptoms. Spearman correlation analysis was used to examine the relationship between depressive symptoms, social support, and loneliness; the macro PROCESS on SPSS was used to examine the mediating effects of social support on the association between depressive symptoms and loneliness. Despite the significant correlation between depressive symptoms and social support, social support and loneliness, and depressive symptoms and loneliness, social support did not mediate the influence of depressive symptoms on loneliness. The results of this study support the need for increased awareness of depressive symptoms in older adults with diabetes. Depressive symptoms should be treated to alleviate loneliness, and more research is needed to explore how other social factors influence the relationship between depressive symptoms and loneliness, thereby preventing a synergistic effect of depressive symptoms and loneliness.
THE ROLE OF SELF-EFFICACY IN ADVANCE CARE PLANNING: DOES RACE AND ETHNICITY AFFECT THIS RELATIONSHIP?
Authors: Yauk Jessica , Dobbs Debra 
Published: December 2023

Abstract
Advance care planning (ACP) has been identified as essential in improving end-of-life patient satisfaction and goal-concordant care. Despite the benefits of ACP, rates remain particularly low among marginalized populations. Marginalized populations are also at an increased risk of receiving care incongruent with their wishes and reporting low-quality end-of-life care. ACP is a complex process where individuals must decide to plan and implement those plans. Because the ACP process is complex, an individual’s self-efficacy- or belief that they can perform a particular task, may be an important component when predicting ACP completion. Using data from the 2018 wave of the Health and Retirement Study (HRS), the current study aimed to understand how two facets of self-efficacy- mastery and constraint-, related to varying levels of ACP completion (living will, durable power of attorney for healthcare, and advance care planning discussions (DPAHC)). Furthermore, we looked at the possible moderating effects of race/ethnicity between self-efficacy and ACP. Results indicated that Black and Hispanic older adults are significantly less likely to complete all types of ACP. Furthermore, higher self-reported constraint- was significantly related to lower completion of ACP discussions (OR = 0.9, p= .05). Neither mastery or constraint were related to completion of a living will or DPAHC. Race/ethnicity was not found to moderate the relationship between self-efficacy and any level of ACP. Individual variables may be less important than community level variables or life-long discrimination when assessing completion of ACP among marginalized populations.
UNDERSTANDING AGE-RELATED DISPARITIES AND ENVIRONMENTAL BARRIERS IN OLDER ADULTS WITH MULTIPLE SCLEROSIS
Authors: Lee Kyungmi , Plow Matthew 
Published: December 2023

Abstract
Given the increasing life expectancy of individuals with multiple sclerosis (MS), the challenges faced by older adults with MS in terms of health changes and decreased physical function contribute to a potentially diminished quality of life. Despite this, our understanding of how this condition manifests in the context of aging remains limited. This study aims to examine age-related variations in fatigue, anxiety, depression, community engagement, and environmental barriers in older adults with MS, as well as to explore health disparities among older adults with MS. This secondary analysis involved 288 individuals with MS, divided into two age groups: below 60 years and 60 years and above. Aim 1 used T-tests and Aim 2 employed ANCOVA with disability adjustment. The results show that older adults with MS had higher levels of community engagement, disability, and behavioral-cognitive fatigue, reporting lower levels of anxiety, cognitive-motor fatigue, fatigue severity, and participation barriers than younger adults with MS. Noteworthy health disparities emerge, characterized by reduced community integration/participation (F=10.622, p=.001) and heightened environmental barriers (F=4.323, p=.039), even when adjusting for disability levels. The study highlights environmental barriers impeding social participation among older adults with MS, emphasizing the need to address these obstacles to enhance their quality of life. This underscores the imperative for customized interventions targeting reduced community disengagement and heightened environmental barriers faced by older adults with MS.
WITHIN TWIN PAIR DIFFERENCES INDICATE GENETIC EFFECTS OF SES INDICATORS ON LONGITUDINAL CHANGES IN PHYSICAL AGING
Authors: Finkel Deborah , Ericsson Malin , Gatz Margaret 
Published: December 2023

Abstract
Socioeconomic status (SES) predicts change in health status over age, even after accounting for measured confounders such as environmental and biological risk factors. Nonetheless, the source of SES-health associations continues to be heavily debated. Twin studies offer a method for testing causal hypotheses by incorporating within and between twin pair differences in longitudinal latent growth curve models (LGCM) of physical aging on both level of functioning and rate of change with age. Three longitudinal twin studies of aging from the Swedish Twin Registry (N = 2059) included up to 27 years of follow-up on a Functional Aging Index (FAI) consisting of lung function, grip strength, walking speed, and self-report sensory functioning. SES indicators included education, financial strain, and occupation. Pair means (between family effect) and within pair differences (within family effect) were included as covariates of both intercept and slopes in a two-slope LGCM (intercept at age 75); models were corrected for sex and parental SES. LGCM results were compared across full sample, monozygotic twins, and dizygotic twins. For the FAI intercept, MZ within pair effects in all SES variables were strongly attenuated, indicating genetic confounding. For slope 1, only MZ within pair effect for education was attenuated, and no SES indicators were related to rate of change in FAI after age 75. Thus, results suggest shared genetic factors explain the association between education and change in physical aging in early aging processes. In other words, genes that impact educational achievement may also influence health behaviors and physical aging.
EFFECT OF EARLY-LIFE DISCRIMINATION IN PARENTING ON THE PHYSICAL AND MENTAL HEALTH OF MIDDLE-AGED AND OLDER ADULTS
Authors: Guo Chao , Liu Lan , Liu Jie 
Published: December 2023

Abstract
This study aimed to explore the early-life discrimination in parenting on the physical and mental well-being of middle-aged and older adults, while also exploring the potential mediating role of early-life health. By combined data from the China Health and Retirement Longitudinal Study (CHARLS) in 2018 and related life history survey in 2014, 8204 females and 7305 males aged 45-84 were analyzed in this study. Logistic regression was employed to analyze the association between early-life discrimination in parenting and the incidence of chronic diseases as well as depression in middle-aged and older individuals. The KHB method was used to assess the mediating effect of early-life health in these connections. Regarding gender-based discrimination in parenting, parental preference for sons during early life was found escalated the probability of chronic diseases by 18% (OR=1.18, 95%CI: 1.01-1.38) and increased depression risk by 16% (OR=1.16, 95%CI: 1.03-1.31) among middle-aged and older females. In terms of sibling-related discrimination, parental inclination towards specific siblings heightened the likelihood of depression during middle and older years among females (OR=1.17, 95%CI: 1.03-1.34). However, these effects were not significant in males. The study further identified that early-life health partially mediated the influence of gender-based parental preferences on the mental well-being of middle-aged and older females, accounting for 8.603% of the overall effect. These findings underscored the potential for early-life discrimination within parenting to impact both the physical and mental health of middle-aged and older females by shaping their early-life health status, consequently resonating throughout their mental well-being in later life.
COGNITIVE FRAILTY: PREVALENCE, RISK FACTORS, AND THE RISK OF MORTALITY IN CHINESE MIDDLE-AGED AND OLDER ADULTS
Authors: Ning Hongting , Feng Hui , LI Junxin 
Published: December 2023

Abstract
To examine the age-specific prevalence, risk factors, and magnitude of the association between cognitive frailty and all-cause mortality in Chinese middle-aged and older adults. We used baseline (2011) and follow-up waves (2013, 2015, and 2018) data from the China Health and Retirement Longitudinal Study (CHARLS). The age group was categorized as middle-aged, old, and very old. Factors associated with cognitive frailty and the associations between cognitive frailty statuses and mortality were examined using multinomial logistic regression and Cox proportional hazards models, respectively. Totally 7947 participants were included in this study, and the overall prevalence of cognitive frailty was 12% (middle-aged, 11%; old, 10%; very old, 26%; P&lt; 0.0001). Cognitive frailty was independently associated with rural residential status, long sleep duration, lack of social participation, depressive symptoms, and multimorbidity among all the age groups. Over the 7-year follow-up, participants with cognitive frailty were at a higher risk for all-cause mortality than the robust group (HR 1.70, 95%CI 1.12-2.57 for the middle-aged group, HR 1.70, 95%CI 1.02-2.84 for the old group, and HR 2.06, 95%CI 1.17-3.65 for the very old group). Pre-cognitive frailty was associated with a higher mortality risk in the middle-aged group only (HR 1.34, 95%CI 1.01-1.79). The prevalence of cognitive frailty in middle-aged adults was comparable with that in the old group. Cognitive frailty, a significant risk factor for mortality, was associated with multiple factors in middle-aged and older adults, calling for integrated cognitive frailty prevention strategies. Noticeably, pre-cognitive frailty in middle-aged people increases mortality risk and requires special attention.
DAILY ENGAGEMENT IN MEANINGFUL ACTIVITY FOR HOME CARE PATIENTS WITH SUBJECTIVE COGNITIVE DECLINE AND CAREGIVERS
Authors: Lu Yvonne , Ellis Jennifer , Perkins Susan , Hickman Susan , Chang Pei-Shiun , Haase Joan , Otis Laurie , Winton Rebecca 
Published: December 2023

Abstract
Patients with subject cognitive decline (SCD) often lose sense of control, disengage from meaningful activities, and have less confidence in their ability to manage daily challenges. The objectives of pragmatic pilot phase study were to evaluate the feasibility and benefits of a Daily Engagement in Meaningful Activity Professional (DEMA-Pro) for patients with SCD; and explore nurses’ experience of DEMA-Pro implementation. Forty-nine patients at four home healthcare sites received six weekly DEMA-Pro telephone sessions. The Outcome and Assessment Information Set-D were collected at starting date (pre-intervention) and discharge date (post-intervention). Quantitative surveys and qualitative focus group methods were used to explore the DEMA-Pro nurses (n = 3) experiences. The consent rate was 67.1%, the completed intervention rate 36.7%, and the partial completed intervention rate 25.5%. For 36 subjects with discharge data available, both IADLs and self-care scores improved (d = 3.11 and d = 2.66, respectively). Specifically, those that completed all DEMA-Pro sessions (n=14), partial completers (n=12), and non-completers (n=10), had improved scores on IADLs (d = 4.0, 4.2, and 2.5, respectively) and Self-Care (d = 3.7, 3.1 and 2.0, respectively). Completers had greater improvement than non-Completers for both outcomes and greater improvement on IADLs than partial completers (all p-values &lt; 0.03). Nurses reported high satisfaction with their training, and high confidence that the implementation of the intervention met patient and caregiver needs. The DEMA-Pro has shown benefits and feasibility that will need further testing in a large pragmatic trial in homecare settings.