bluuebunny/crossref_metadata_2025_split huggingface dataset:
QUANTITATIVE RELAXOMETRY APPROACHES TO CHARACTERIZING BRAIN AGING: APPLICATIONS ACROSS THE LIFESPAN
Authors: Dean Doug 
Published: December 2023

Abstract
Quantitative magnetic resonance imaging (qMRI) aims to measure meaningful physical or chemical parameters that are sensitive to and that can be used to characterize the underlying tissue microstructure. The quantitative nature of these data suggest that derived measures are ideally reproducible within and across different sites, allowing qMRI data to be more readily compared across different anatomical regions, among different subjects, and across time. The longitudinal (T1) and transverse (T2) relaxation times are fundamental to the measured MRI signal and, in the brain, highly sensitive to several anatomical changes, including changes of free water, iron content, and brain myelination. Thus, measurement of these relaxation times can be used to characterize the underlying tissue microstructure and can provide insight into the underlying processes of brain development and aging. As such, there is growing interest in using relaxometry-based techniques for a broad range of clinical and research applications. In this presentation, I will discuss recent advancements in quantitative relaxometry approaches and describe how these techniques are being used to gain a better understanding of the highly dynamic and nonlinear mechanisms that support brain development and aging.
SLEEP AND DEPRESSIVE SYMPTOMS IN COMMUNITY-DWELLING OLDER ADULTS: FINDINGS FROM AMBULATORY SLEEP EEG
Authors: Huang Jing , Spira Adam , McPhillips Miranda , Calderon Russell , Li Mengchi , Tufa Yeabsira , LI Junxin 
Published: December 2023

Abstract
There is limited and inconsistent evidence on the association between electroencephalography (EEG) measured sleep and depressive symptoms among community-dwelling older adults. This study investigated the cross-sectional association between EEG-measured sleep and depressive symptoms in 72 community-dwelling older adults without dementia [Age&gt; 65 years; Montreal Cognitive Assessment (MoCA)&gt;17], using baseline data from a randomized clinical trial (NCT03959202). Sleep and depressive symptoms were measured using two-night in-home sleep EEG (Sleep Profiler™) and the Geriatric Depression Scale (GDS-15). Multiple linear regression analyses were conducted with each sleep parameter as the primary predictor and GDS score as the outcome; models were adjusted for age, sex, race, education, marital status, chronic conditions, and MoCA score. Several sleep variables were associated with depressive symptoms (GDS score), including a higher percentage of sleep stage N1 (b = 0.11, 95% confidence interval [CI]: 0.02 – 0.20) and N2 (b = 0.04, 95% CI: 0.00 – 0.08), a lower percentage of N3 sleep (b = -0.04, 95%CI: -0.08 – -0.01), greater wake after sleep onset [b = 0.01, 95%CI: 0.00 – 0.02], and more awakenings ≥ 90s/hour (b = 0.87, 95%CI: 0.21–1.53). Neither total sleep time nor sleep efficiency were associated with GDS score. In conclusion, we found that more lighter (stage N1, N2) sleep, less deep (N3) sleep, and more fragmented sleep, measured by EEG, were associated with more depressive symptoms among community-dwelling older adults without dementia. Sleep architecture and fragmentation may play more important roles than sleep duration in relation to depression.
GENDER DIFFERENCES IN ASSOCIATIONS OF SLEEP INTRAINDIVIDUAL VARIABILITY AND MILD COGNITIVE IMPAIRMENT
Authors: Shen Yuqi , Ji Linying , Graham-Engeland Jennifer , Derby Carol , Buxton Orfeu 
Published: December 2023

Abstract
Previous studies suggest that cognitive function in older adults is related to sleep, with females more vulnerable to poor sleep. Little is known about the relationship between cognition and intraindividual variability of sleep (IIV). We examined the cross-sectional relationship between sleep IIV and mild cognitive impairment (MCI) by gender using data from the Einstein Aging Study. We hypothesize that individuals with MCI have a greater IIV in daily sleep characteristics, and these associations will be stronger for females. Eighty-nine men (age = 76.81±4.73, 61% White, 28% Black, 27% MCI) and 197 women (age = 76.60 ± 4.93, 40% White, 46% Black, 29% MCI) were included in the analysis. Individuals completed 2 weeks of actigraphy (mean ± SD = 15.7 ± 1.1 days), and the Montreal Cognitive Assessment, and MCI was based on the Jack/Bondi criteria. Sleep IIV was estimated as within person standard deviation of nighttime sleep duration, 24-hour sleep duration, wake after sleep onset, and nighttime sleep midpoint. Linear regression models evaluated associations between sleep IIV and MCI status separately by gender, controlling for BMI, age, ethnicity/race, nocturnal hypoxemia, Oxygen Desaturation Index ≥15. Among women, having MCI was associated with greater IIV in nighttime sleep midpoint (b=0.19, p=.002), and in 24-hour total sleep duration (b=13.10, p = .047) with a similar trend in nighttime sleep duration (p = .050). No significant associations were found among men. Findings suggest the importance to keep considering gender in work to understand how sleep variability relates to MCI status in older adults.
PREDICTING DEMENTIA DIAGNOSIS FROM COGNITIVE FOOTPRINTS IN ELECTRONIC MEDICAL RECORDS USING MACHINE LEARNING
Authors: Zhou Jiayi , Luo Hao , Liu Wenlong , Zhou Huiquan 
Published: December 2023

Abstract
The cognitive footprint theory suggests that a person’s risk of dementia is affected by activities and events (footprints) across the lifespan. This study aimed to develop a clinical algorithm for predicting dementia diagnosis from cognitive footprints in electronic medical records (EMRs) using machine learning. Population-based EMRs from the Clinical Data Analysis and Reporting System in Hong Kong were employed. We included all patients with dementia diagnosed at 65+ between 2000 and 2018. Controls without dementia were matched (1:1) by age, sex, and index date. The prediction accuracy of a standard logistic regression model was compared with five machine learning models (LASSO, Random Forest, Multilayer perceptron, XGBoost, and LightGBM), using a wide range of established and exploratory risk factors identified at mid- ( &lt; 65 years) and late-life (65+ years). A total of 261,116 individuals (59.3% female; mean age at index date [SD]: 82.70 [8.54]) with and without dementia were included. Compared with the logistic model (area under the curve [AUC]: 0.60), the predictive and diagnostic accuracy of dementia improved substantially in machine learning models. The Multilayer perceptron and LightGBM models showed comparable performance with the same test AUC of 0.720. LASSO (AUC: 0.765) and Random Forest (AUC: 0.768) showed a slightly worse performance. Antipsychotic drugs, education, antidepressants and head injury in late life were the top 4 important predictors in all models. The machine learning-based algorithm for predicting dementia can be used to identify patients with an increased likelihood of dementia to allow precise and timely primary interventions.
THE ASSOCIATION OF A NOVEL PHYSICAL ACTIVITY METRIC WITH COGNITION AND RISK OF DEMENTIA
Authors: Cai Yurun , Zhou Junhong , Tian Qu , Wanigatunga Amal , Simonsick Eleanor , Resnick Susan , Ferrucci Luigi , Schrack Jennifer 
Published: December 2023

Abstract
Physical activity (PA) is associated with cognitive function and Alzheimer’s disease and related dementias (ADRD). Although associations between continuously measured PA and ADRD have been assessed, multiscale entropy (MSE), which quantifies dynamics of physiological systems over multiple time scales, has not been used to quantify daily activity rhythms in older adults by cognitive status. We examined the association of this novel metric of PA complexity with cognitive function, mild cognitive impairment (MCI), and dementia in participants of the Baltimore Longitudinal Study of Aging. A total of 615 older adults (mean age=73.9±11.3 years, 54.5% women) completed a 7-day wrist-worn accelerometer assessment between 2015-2019. Global cognitive function was measured using the Mini-Mental State Examination (MMSE). Mild cognitive impairment (MCI) or dementia was diagnosed based on Petersen criteria and Diagnostic and Statistical Manual of Mental Disorders, respectively. Unadjusted logistic regression models showed that participants in the lowest tertile of complexity had 2.31 times the odds of low MMSE score (≤26) compared to those in the highest tertile (odds ratio [OR]=2.31, 95% confidence interval [CI]=1.09-4.89). This association lost significance after adjusting for age, sex, race, and education years. The lowest tertile of complexity was also associated with 2.58 times the odds of MCI/dementia diagnosis, adjusting for demographics (OR=2.58, 95% CI=1.06-6.31). These results suggest that lower complexity of accelerometry-detected movement is associated with poorer cognitive function and greater risk of MCI/dementia. Future longitudinal studies are warranted to examine whether altered complexity of daily activity rhythms may act as a preclinical indicator of ADRD.
BUILDING RESILIENCE IN SKILLED NURSING (BRISK): A CASE OF COMMUNITY-ENGAGED RESEARCH IN SKILLED NURSING FACILITIES
Authors: Plys Evan , Lyons Christopher , Vranceanu Ana-Maria 
Published: December 2023

Abstract
Older adults receiving post-acute rehabilitation care in a skilled nursing facility (SNF) commonly present with high physical, psychological, and social needs. Psychosocial stressors and associated consequences (e.g., poor transitions, re-hospitalizations) may be magnified among families with limited financial resources. The current study aimed to co-develop a dyadic psychological intervention tailored to meet the unique psychosocial needs of socioeconomically disadvantaged patients and their care-partners during the transition from SNF to home. In this presentation, we describe the process of partnering with SNFs and forming a community advisory board (CAB) to meet the objectives of the current study. First, we discuss practical and regulatory considerations related to identifying facility partners (e.g., facility chains, physician groups) and recruiting patient-care-partner dyads in partner facilities. Second, we highlight strategies to incentivize potential SNF partners as well as historically and systematically under-represented patient participants, including budgetary considerations, recruitment strategies, sustained contact after discharge, and clinical service provision. Third, we discuss the recruitment, formation, and role of a CAB with diverse perspectives, including patients, family care-partners, SNF staff, policy makers and advocates. Overall, this presentation will generate discussion on practical strategies for building and maintaining mutually beneficial research partnerships with SNFs and similar hard-to-reach healthcare settings (e.g., long-term care facilities, home health agencies).
BEST PRACTICES FOR STUDYING OLDER MIGRANTS IN CONTEXT
Authors: Ritter Ashley , Glicksman Allen , Schrauf Robert 
Published: December 2023

Abstract
Understanding health outcomes of the older migrant (ages 60+) requires insight into the perceptions of the older person and considering the impact of the environment in which the older person lives. The four papers on this panel address these issues, each using a different methodology. Bilecen’s study, using qualitative methods, examines the impact of the wording of questions on the ways in which older Turkish migrants in the Netherlands discuss loneliness. The paper helps us understand both perceptions of older migrants and the influence of methodology used on the types of responses collected. Diederich’s paper on Cuban migrants to the United States uses census data to investigate the impact of changes in the environment of arrival at different points in time on care arrangements later in life. She demonstrates the value and limitations of using this type of data. Torres uses a survey of the scientific literature to ask questions about the impact of bigotry on the well-being of older immigrants and whether lack of attention to this topic means there is an important missing piece in our understanding of the experience of the older migrant. Glicksman et. al. use clinical data to describe interactions with the formal health and social service systems by persons of limited English proficiency, an opportunity to understand both actual service use and the benefits and limitations of using clinical data for this purpose. Schrauf’s response will discuss both the findings and the relation of methods to goals in the study of older migrants. This is an International Aging and Migration Interest Group Sponsored Symposium.
ORAL HEALTH INTERVENTIONS AND TREATMENTS FOR OLDER ADULTS WITH COGNITIVE IMPAIRMENT AND DIABETES
Authors: Shuman Stephen , Wu Bei , Saunders Michele 
Published: December 2023

Abstract
Older adults with cognitive impairment or diabetes have a higher risk of poor oral health. It is therefore critically important to develop effective intervention strategies to improve oral health for these vulnerable populations. In this session, we have included three studies that aim to achieve this goal using different strategies. The first study used stakeholder engaged processes to develop an app that provides information and guidance to caregivers (i.e., paid and family caregivers) to support their oral care provision for older adults with dementia. Findings from this study show that the app was well-accepted and provided an easily accessible tool for caregivers during care provision. The second study aimed to improve oral hygiene outcomes (plaque index and gingival index) for individuals with mild cognitive impairment (MCI) or mild dementia (MD). In this study, the authors identified and compared active behavior change techniques (BCT) used in a care partner-assisted oral health intervention for individuals with MCI and MD using a qualitative, secondary analysis of coaching sessions with care partners. Findings from this study provide insight into the mechanisms of change in individuals’ behaviors using these interventions. The third study was a systematic review aiming to explore the age differences in the effect of multi-component periodontal treatments on oral and metabolic indicators among individuals with periodontitis and diabetes. This study identified 115 eligible trials. This study found that the effect of multi-component periodontal treatments on periodontal outcomes and HbA1c may be more effective among younger populations. This is an Oral Health Interest Group Sponsored Symposium.
DAILY FACTORS ASSOCIATED WITH EMOTIONAL DYSREGULATION AMONG DEMENTIA CAREGIVERS
Authors: Puga Frank , Wang Danny , Bibriescas Natashia , Poe Abigail , Alvarez Loreli , Jablonski Rita , Vance David 
Published: December 2023

Abstract
Family dementia caregivers experience increased burden and stress that can negatively impact emotion regulation and overall well-being. Further, a lack of social connection may contribute to emotion dysregulation among dementia caregivers. The purpose of this study was to examine relationships between daily caregiving stress, social isolation, emotion regulation, and depression in a sample of community-dwelling dementia caregivers. Participants (N=30) completed a baseline survey and a series of daily diaries over a 14-day period (n=323 data points) that asked about day-to-day caregiving experiences. Data were analyzed using mixed-level modeling. Higher than average stress related to behavioral symptoms of dementia was associated with an increase in the odds of experiencing feelings of losing control over one’s emotions (OR=1.08, 95% CI [1.01, 1.15], p&lt;0.05). Similarly, higher perceived social isolation on a given day was associated with an increase in the daily odds of feeling a loss of control over one’s emotions (OR=1.28, 95% CI [1.00, 1.27], p&lt;0.05). Further, feeling a loss of control over one’s emotions was associated with an increase in the daily odds of depression-related symptoms (OR=3.39, 95% CI [1.43, 8.08], p&lt;0.01). These findings highlight the importance of addressing the emotional well-being of family dementia caregivers, particularly in the context of stress related to behavioral symptoms of dementia and social isolation. Caregiver support programs and interventions that focus on improving emotion regulation and reducing social isolation may help promote the mental health and well-being of dementia caregivers.
LISTENING TO THE PATIENTS’ VOICE: A CONCEPTUAL FRAMEWORK OF HIP FRACTURE PATIENTS’ WALKING EXPERIENCE
Authors: Delgado-Ortiz Laura , Polhemus Ashley , Keogh Alison , Rochester Lynn , Frei Anja , Puhan Milo , Garcia-Aymerich Judith 
Published: December 2023

Abstract
Walking is crucial for an active and healthy ageing, but it changes with age and in the presence of diverse health conditions, including hip fracture and frailty. So far, conceptual frameworks of walking have not included the impact of these conditions and individuals’ lived experiences on their walking. Thus, we aimed to identify and synthesize evidence describing the walking experience from the perspective of individuals recovering from a hip fracture, as well as from the perspective of individuals living with highly prevalent walking-impairing conditions of diverse etiology. We conducted a systematic review and meta-ethnography, following appropriate guidance. Out of 2,552 unique records, 117 (8.5% hip fracture) were deemed eligible for the meta-ethnography. We identified seven themes that explain the experience of walking: (1) becoming aware of the walking experience, (2) the walking experience as a link between individuals’ activities and sense of self, (3) the physical walking experience, (4) the mental and emotional walking experience, (5) the social walking experience, (6) the context of the walking experience, and (7) behavioral and attitudinal adaptations resulting from the walking experience. We proposed a framework that describes the interplay between these themes, providing a conceptualization of walking that is grounded in the experiences of individuals recovering from a hip fracture or living with other walking-impairing health conditions, and that may be used to set priorities and improve patient centricity in clinical practice, research and public health initiatives.
IMPROVING COGNITIVE FUNCTION IN THE NEW COHORT—BUT ONLY FOR MEN. FINDINGS FROM THE KYOTANGO CENTENARIAN STUDY
Authors: Gondo Yasuyuki , Zhang Xinyu 
Published: December 2023

Abstract
The Kyotango Centenarian Cohort Study was established with the aim of tracing long-term changes in the overall functioning of centenarians. This study started in 2014 in Kyotango City. Since then, new centenarians and those who were expected to be 100 years old the following April were invited to the study every year in September. Eligible centenarians were invited by the city, and centenarians and their families agreed to participate to answer questions either by mail or face-to-face interviews, according to their preference. For the non-participants, anonymized living conditions and care need levels were provided by the city. The number of centenarian candidates varied by year (24-55). However, the number of woman centenarians had increased through the 8-year surveyed period (31 and 42 for women, 10 and 9 for men in 2014 and 2021). On average, every year 40 new centenarians were invited and 80% of them participated in the survey. Among the functional variables, cognitive function was estimated by proxies, which had a high correlation with MMSE. No clear improving trend for nursing care level in Japanese long-term care insurance, as measured by activities of daily living and cognitive function rating, was observed. Meanwhile, an improving trend for cognitive function was observed among men but not among women. This might be caused by the gender difference in the survival ratio that frail women were more likely to survive. Future research should investigate possible reasons for a cohort improvement in Japanese centenarian men, and cognitive intervention programs should particularly target women.
SERIAL TRICHOTOMIZATION TO IDENTIFY UNSAFE DRIVERS: UPDATE FROM A PROSPECTIVE STUDY
Authors: Bedard Michel , Dubois Sacha , Maxwell Hillary , Schurr Stephanie , Weaver Bruce , Stinchcombe Arne 
Published: December 2023

Abstract
Identifying older adults who may be unsafe to drive remains a difficult task. Gibbons et al. (2017, American Journal of Occupational Therapy) used serial trichotomization based on five cognitive tests to determine if drivers should: 1) continue driving, 2) undergo further evaluation, or 3) stop driving. The tests included the Trail-making-tests A and B (TMT-A/B), the clock-drawing test (CDT), the Motor-Free Visual Perception Test (MVPT), and the Montreal Cognitive Assessment (MoCA). Gibbons et al. relied on dual cut-off values to achieve 100% sensitivity and specificity (within their sample) to reduce false positives and false negatives that arise from using these tests in stand-alone fashion. We used the Gibbons et al. cut-off values prospectively on a cohort of 293 drivers (mean age = 66, SD = 14) referred for driving evaluations at a chronic care and rehabilitation hospital. Each driver completed the five tests. Trained occupational therapists (OTs) provided a recommendation to continue driving, undergo further evaluation, or stop driving. We examined congruence between the tests and the OTs recommendations. Weighted Kappas ranged from a low of .03 (95% CI = -.01 to .08) for the CDT, to a high of .53 (95% CI = .45 to .61) for the TMT-B. Using the same cut-offs, and serial trichotomization, the congruence with the final recommendations was moderate (k = .57, 95% CI = .49 to .66). These results remind us of the variability inherent in stand-alone cognitive tests and even within a serial trichotomization framework.
RECEIPT OF GENDER-AFFIRMING SURGERY AMONG MEDICARE BENEFICIARIES
Authors: Balkan Em , Babbs Gray , Shireman Theresa , Hughto Jaclyn , Meyers David 
Published: December 2023

Abstract
While transgender and gender diverse (TGD) people may never seek treatment related to their gender identity, many require access to gender-affirming treatments, including surgery. Starting in 2014, Medicare began covering gender-affirming surgery (GAS) on a case-by-case basis. In this study, we use national Medicare data to compare receipt of GAS by beneficiary characteristics. We classified TGD beneficiaries using an algorithm that combines diagnosis and procedure codes. Our study compared characteristics for all TGD identified beneficiaries and those who received GAS using a population-averaged logistic model using a generalized estimating equation (GEE) adjusting for dual status, age group, race/ethnicity, original reason for entitlement, and CMS region. Our sample accounted for 49,945 observations for 11,162 individuals, with a total of 290 identified records of GAS. In our adjusted analysis, we found that TGD beneficiaries in certain parts of the country had lower odds of GAS compared to their counterparts. Compared to CMS Region 1 (which includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont), those living in Region 3 (Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia), Region 4 (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee), and Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, and Texas) had a significantly lower odds of receiving GAS. Access to gender-affirming care may be influenced by CMS regional contractors, as well as state-by-state variation in Medicaid coverage for gender-affirming care. Further research is needed to explain why beneficiaries may have lower access to GAS to inform policy recommendations.