bluuebunny/crossref_metadata_2025_split huggingface dataset:
RACE DIFFERENCES IN THE RELATIONSHIP BETWEEN HIGH AND VARIABLE BLOOD PRESSURE AND DOMAIN-SPECIFIC COGNITIVE CHANGE
Authors: Oliver Michael , Morrison Cassandra , El-Hulu Sondos 
Published: December 2023

Abstract
Elevated blood pressure (BP), or hypertension, is a risk factor for several health conditions including Alzheimer’s disease. High BP in early- and mid-life is associated with cognitive decline, whereas research is mixed regarding BP and cognition in late-life. Moreover, hypertension disproportionately affects minority populations. Consequently, the effects of hypertension on cognition may differ by race. The present study investigates the relationship between BP and cognition. 4419 older adults (Black, n=1189; White, n= 3230), with 32116 follow-ups for a maximum of 10-years were included from the Rush Alzheimer’s Disease Center. Results reveal individuals with high BP exhibit significantly greater declines in global cognition compared to normal BP, regardless of race. When stratifying high BP by race, Blacks exhibit greater declines in working memory and perceptual speed, whereas Whites exhibit greater declines in episodic memory, semantic memory, and visuospatial ability compared to normal BP. Blacks with high BP exhibit greater decline in perceptual speed compared to variable BP, whereas no cognitive domain was worse in Whites with high BP compared to variable. When stratifying variable BP by race, Blacks exhibited greater decline in working memory compared to normal BP. Alternatively, Whites exhibited greater decline in episodic memory, semantic memory, working memory, and global cognition compared to normal and high BP counterparts. Our findings reveal racial differences in the relationship between BP and cognitive decline. Specifically, Blacks and Whites with high and variable BP experience cognitive decline in different cognitive domains, which may give insight into differences in disease trajectory and cognitive outcomes.
UNIQUE MICROBIOME SIGNATURES RELATED TO CANCER SURVIVORSHIP AND COGNITIVE DECLINE IN OLDER ADULTS
Authors: Haggler Jayden , Miller Brandi , Chaudhari Diptaraj , Yadav Hariom , Jain Shalini 
Published: December 2023

Abstract
Significant scientific advancements have resulted in new and effective therapies for patients with cancer. Although this leads to an increased cancer survivor population, there are several long-term side effects of cancer treatments, including a high risk of developing dementia. Emerging evidence shows that the gut microbiota significantly contributes to brain health and dementia pathology; however, its role in cancer treatment-related side effects, specifically in older adults, is not well known. Here, we used 110 participants from our MiaGB (Microbiome in aging Gut and Brain) consortium aged 60 years and older and analyzed their gut microbiome (using whole genome sequencing) with cognitive function (using Montreal Cognitive Assessment (MoCA) and MiniCog). We observed an 8% increase in cognitive impairment (CI) in cancer survivors compared to non-cancer participants (46% vs 38%, respectively). When only comparing cognitively healthy versus CI, the abundance of Escherichia coli was significantly higher in the CI group, while Streptococcus thermophilus was higher in the cognitively healthy group. Additionally, the abundances of Dorea sp. CAG 317, Ruminococcus gnavus, Roseburia faecis, and Eggerthella lenta were significantly increased in the gut of cancer survivors compared to non-cancer participants. Specifically, the abundance of Dorea sp. CAG 317 was increased in cancer survivors with CI. These findings suggest that unique microbiome signatures induced by cancer treatments may impair cognitive function. Furthermore, understanding the associations between the microbiota and cognitive function in cancer survivors will aid the development of therapeutics to combat cancer treatment-related side effects, which are a growing public health concern.
CIRCULATING MICRORNA PROFILE IN OKINAWAN CENTENARIANS
Authors: Noureddine Sarah , Ashiqueali Sarah , Schneider Augusto , Strader Sydney , Allsopp Richard , Willcox D Craig , Willcox Bradley , Masternak Michal 
Published: December 2023

Abstract
Centenarians are a successful example of aging and extended longevity, exhibiting advanced regulation of biological mechanisms and homeostasis. Since human longevity is a complex field of study that navigates molecular and biological mechanisms that influence aging, we hypothesized that microRNAs, a class of small non-coding RNAs implicated in regulating gene expression at the post-transcriptional level, demonstrate altered expression profiles in circulation across young, middle-aged, and centenarian cohorts. We sequenced circulating microRNAs in Okinawan males and females &lt; 40, 40-80, and &gt;90 years of age accounting for FOXO3A genetic variations (TT and TG alleles) and validated the findings through RT-qPCR. We report 5 microRNAs exclusively upregulated in both male and female centenarians demonstrating predictive functional roles in TGF-β, FoxO, AMPK, Pi3K-Akt, and MAPK signaling pathways. Our findings suggest that these microRNAs upregulated in centenarians may provide novel insight into their enhanced longevity and warrant further exploration into their roles in human aging and longevity.
MID-LIFE PLASMA PROTEINS ASSOCIATE WITH PREFRAILTY AND FRAILTY: A PROTEOMIC ANALYSIS
Authors: Liu Fangyu , Schrack Jennifer , Walston Jeremy , Mathias Rasika , Coresh Josef , Walker Keenan 
Published: December 2023

Abstract
Physical frailty is a syndrome that typically manifests in later life, although the pathogenic process causing physical frailty likely begins decades earlier. To date, few studies have examined the biological signatures in mid-life associated with frailty in late life. We evaluated 4955 plasma proteins (log 2-transformed and standardized) measured using the SomaScan platform among 3810 participants (57.8+/-5.0 years, 58.2% women) at Visit 3 of the Atherosclerosis Risk in Community (ARIC) study, and their frailty status across up to 3 study visits in late-life (median follow-up 19 years). We used multinomial logistic regression models to examine the associations between the protein levels and the frailty status, adjusting for demographics, health indicators, comorbidities, and follow-up time. Two sets of 2 proteins were identified to be associated with prefrailty and frailty, respectively, after Bonferroni correction (p&lt; 1.01×10-5). Higher concentration of hydroxymethylglutaryl-CoA synthase (HMGCS1; OR=1.22), a regulator of cholesterol synthesis, and lower concentration of dual specificity protein phosphatase 13 isoform A (DUSP13A; OR=0.82), a protein involved in cell apoptosis, were associated with higher odds of prefrailty. Higher concentration of growth differentiation factor 15 (GDF15; OR=1.39), a protein related to inflammation and cell senescence, and lower concentration of contactin-1 (CNTN1; OR=0.72), a protein involved in nervous system development and signalling, were associated with higher odds of frailty. The pathway and upstream regulator analyses of the physical frailty- or prefrailty-associated proteins (p&lt; 0.01) revealed the dysregulation of apoptosis, inflammation, and neuromuscular communication in mid-life. Our findings provides new insights into frailty etiology earlier in the life course.
MULTIPLE ENRICHMENT TOOLS POINT TO A CENTRAL ROLE OF CARDIAC MUSCLE IN EXTREME LONGEVITY
Authors: Ukraintseva Svetlana , Wu Deqing , Duan Hongzhe , Arbeev Konstantin , Yashin Anatoliy 
Published: December 2023

Abstract
Few genes showed consistent positive associations with extreme longevity in humans. We conducted genome-wide association study of various parental lifespans, LS (85+, 90+, 95+, 100+ vs. 75-), using UK Biobank data. At ages 100+, the negative effect of APOE4 on LS diminished, while SNPs with positive associations with LS emerged among the top results, including rare variants. One of the top SNPs (rs756319938) was in CDKN1A (P21) gene involved in cell senescence, and its rare variant (protein truncating) was significantly (P-value&lt; 10-7) overrepresented in extreme longevity cases. Such nonsense mutations generally result in non-functional protein. In case of P21, this might contribute to longevity via better regenerative response. The latter was previously demonstrated in mice that lacked the p21 expression. For SNPs that were associated with LS&gt;=100 with P-value &lt; 10-4, we identified ~400 corresponding genes and run multiple pathway/process enrichment analyses using different tools utilizing various resources (GO, KEGG, OMIM, MSigDB, and others), to identify pathways/processes that show up across most analyses. We found that cardiac muscle function was among the top pathways/processes yielded by majority of the enrichment tools. In conclusion, we found new rare and common SNPs that were positively associated with extreme longevity of mothers and fathers of UKB participants, and investigated relevant biological pathways. Results of multiple enrichment tools converged on a central role of cardiac muscle function in extreme longevity, while separate enrichment tools did not allow to see this picture. Our results imply that cardiac regeneration is a plausible target for interventions into longevity limits.
PROTOCOL OF A RANDOMIZED, PARALLEL, DOUBLE-BLIND, PLACEBO-CONTROLLED PILOT TRIAL OF A KETONE ESTER IN AGING
Authors: Stubbs Brianna , Peralta Sawyer , Diaz Stephanie Roa , Azanedo Gabriela Alvarez , Alexander Laura , Silverman-Martin Wendie , Johnson James , Newman John 
Published: December 2023

Abstract

Background
Ketone bodies function as an energy and signaling metabolite and are hypothesized to interact with several geroscience pathways. Ketone esters (KE) are a nutritional tool that induce ketosis without other dietary changes; no studies have addressed KE in an aging population.

Objectives
The primary objective of this randomized, placebo-controlled, double-blinded, parallel-group, pilot study is to determine the tolerability of 12-weeks of KE ingestion in older adults (&gt;65y). Secondary outcomes include safety and acute ketone kinetics. Exploratory outcomes include physical function, cognitive function, quality of life, general and inflammatory aging biomarkers and gut microbiome.

Methods
Community dwelling older adults who are independent in activities of daily living, and with no unstable acute medical conditions (n=30) will be recruited. The study intervention is a KE (n=15) or a placebo (PLA). Firstly, ketone kinetics after 12.5 or 25g of KE consumption will be assessed over four hours. Secondly, after collection of baseline safety, functional and biological measurements, participants will be randomly allocated to consume KE or PLA daily for 12-weeks. A questionnaire will assess tolerance daily for 2-weeks, and then via recall at 2-week intervals. Safety assessments will be repeated at week 4. All measures will be repeated at week 12.

Conclusion
This study will provide data demonstrating the feasibility, tolerance, and safety of 12-weeks of KE consumption in older adults as well as exploratory data across a range of geroscience-related endpoints. This will facilitate our long-term goal: use of KE to study geroscience mechanisms and clinical outcomes relevant to frailty.
FRAILTY ASSESSMENT FROM PAPER TO ONLINE: THE E-FI-CGA WEB APP
Authors: Song Xiaowei , Kianpoor Kiarash , Sepehri Katayoun , Kwok Stanley , Glashutter Margit , McDermid Robert , Park Grace 
Published: December 2023

Abstract

Background
Early frailty assessment is crucial for improving care for older adults through enhancing frailty-informed care planning and execution. To increase the access and use of the established electronic Frailty Index based on the Comprehensive Geriatric Assessment tool, we developed an online software application: the web-based eFI-CGA.

Methods
End-user requirements primarily adapted the standalone version of the eFI-CGA and covered assessment competency, interface familiarity, accessibility and convenient use by front-line health professionals. Web app-bounded features included user-account authentication and authorization, user-space management, record-search and retrieval, and functions for data management, analysis and display. The web app development used the Microsoft Azure web server with the ASP.NET framework, combined Webforms and Model-View-Controller architecture, and C# programming language with standard client-side libraries incorporating scripting and mark-up languages.

Results
The web-based eFI-CGA was technically released and accessible online (efi-cga). Tests on the web pages for all the web pages (e.g., Home, Signup Login, Assessment, Search, and Analysis) using large sizes of systematically designed test data and mocked patient cohorts showed that the web software functions meet the requirements with 100% accuracy.

Conclusion
The web-based eFI-CGA provides a valuable remote frailty assessment and information retrieval method for healthcare professionals, promoting effective multidisciplinary integrated care of older adults. Further work is needed to allow the safe use of the web app. We are also planning a patient-oriented frailty assessment tool for community-dwelling older adults.
DOES HAND GRIP STRENGTH CORRELATE WITH SHOULDER DYSFUNCTION AMONG OLDER WOMEN?
Authors: Almardawi Ranyah , Davis Derik , Orwig Denise 
Published: December 2023

Abstract

Background
Shoulder dysfunction and pain are common problems among older adults. Nearly 20% of those aged 65 and older reported shoulder pain in the 2011 National Health and Aging Trends Study. Shoulder pain and dysfunction may lead to the inability to carry out essential household and daily activities, burdening both patients and society. HGS is commonly tested and considered a reliable measure to assess overall muscle strength and function. Objective: The aim of this cross-sectional study is to determine the association between hand grip strength (HGS) and shoulder dysfunction. We hypothesize that HGS is correlated with shoulder dysfunction among older women.

Methods
A total of 36 older women volunteers with an age range of 62 to 84 years were included. We assessed the HGS for dominant hands using Jamar Plus Digital Hand Dynamometer. We measured both hands twice and used the strongest measure for the dominant hand. Degree of shoulder dysfunction was self-reported using the American Shoulder and Elbow Surgeon survey (ASES) [0, worst; 100, best].

Results
Participants had a mean age of 70.9 years (SD:5.7), mean grip strength of 18.2kg (SD:5.9), and mean ASES score of 86.8(SD: 17.2). A significant and positive correlation was found between HGS and ASES score (r=0.612, P=0.001).

Conclusion
The moderate correlation of HSG with ASES score supports the hypothesis. The results suggest that future research is warranted to test the feasibility of HSG as a clinical screening tooling for shoulder dysfunction in larger diverse samples of older adults, including men and women.
MEDICATION DE-ESCALATION AND GLYCATED HEMOGLOBIN AMONG OLDER ADULTS WITH DIABETES AND DEMENTIA
Authors: Adeyemi Oluwaseun , Arcila-Mesa Mauricio , Rapozo Crystalinda , Chodosh Joshua 
Published: December 2023

Abstract
Patients with co-occurring diabetes and dementia and low (&lt; 7.0) glycated hemoglobin (HbA1c) are at risk for adverse events and may require antihyperglycemic medication de-escalation. Whether de-escalation leads to a desired HbA1c is unknown. We assessed the relationship between antihyperglycemic de-escalation and attainment of a desired HbA1c. We selected older adults with diabetes and dementia with low HbA1c enrolled in the Enhanced Quality in Primary Care for Elders with Diabetes and Dementia, a multicenter cluster-randomized pragmatic trial. We determined whether antihyperglycemic medications were de-escalated during the twenty-four-month intervention. We classified a positive outcome as a subsequent desired HbA1c range for those who entered the study with HbA1cs &lt; 7.0. We controlled for age, sex, race/ethnicity, Charlson comorbidity index, antihyperglycemic medications, and the COVID-19 pandemic. We performed a multivariable generalized linear binomial regression analysis and report the likelihood (adjusted risk ratio; aRR) (plus 95% confidence interval (CI)) of achieving the desired range HbA1c. The predominant population was older adults 85 years and older (42%), females (60%), and non-Hispanic Whites (64%). A tenth of the population had de-escalation and 19% of the population achieved the desired HbA1c range at the end of the study period. Metformin was the most frequently retained medication after de-escalation (66.7%). After adjusting for potential confounders, de-escalation was associated with 2.2 times the likelihood of attaining the desired HbA1c range (aRR: 2.20; 95% CI: 1.34 – 3.55). In conclusion, antihyperglycemic medication de-escalation improves the glycemic control of older adults with DM/ADRD.
EFFECT OF COVID-19 PANDEMIC ON A BODY MASS INDEX OF OLDER AMERICANS: A REPEATED CROSS-SECTIONAL STUDY
Authors: Sapkota Krishna , Brown J Scott , Kinney Jennifer 
Published: December 2023

Abstract

Introduction
The COVID-19 pandemic resulted in greater social and physical isolation, potentially leading to changes in eating, physical activity, and health behaviors, which may increase BMI. This study explored whether body mass index (BMI) among middle-aged and older Americans has been affected by the pandemic.

Methods
This study uses data from the Behavioral Risk Factor Surveillance System to assess the effects of COVID-19 on BMI changes among middle-aged (50-64 years) and older (65 years and above) Americans. Changes in BMI over time are measured for 2019 and 2021. Data from 2013, 2015, and 2017 are used to note the trend of BMI, and sex and racial differences in BMI trajectories are explored.

Results
Initial results show that the BMI of older adults increases over time but does so at a decreasing rate (2013 to 2105 BMI difference = 0.19, 0.16 from 2015 to 2017, 0.13 from 2017 to 2019, and 0.09 from 2019 to 2021). On the other hand, among middle-aged adults, BMI significantly increased over time and accelerated during COVID-19. The difference in BMI was 0.20 from 2013 to 2015, 0.16 from 2015 to 2017, 0.22 from 2017 to 2019, and 0.28 from 2019 to 2021. BMI increases consistently over the period for middle-aged men and older adult women, whereas BMI growth accelerates for middle-aged women and decelerates for older adult men. Similarly, racial differences are noted in the BMI changes of middle-aged and older adults.

Conclusion
The COVID-19 pandemic accelerated the accumulation of body mass among middle-aged Americans.
MORE ADULT AMERICANS ARE AT NUTRITIONAL RISK SINCE THE COVID-19 PANDEMIC
Authors: Monroe-Lord Lillie , Ardekani Azam , Whitman Cassidy 
Published: December 2023

Abstract
The nutritional status of individuals has changed since COVID-19 pandemic due to disruptions in social, economic, and psychological factors. This study determines how nutritional status has changed since COVID-19 among American adults. The second aim is to examine which age range group was at a higher risk of nutritional status due to the pandemic. The study design was cross-sectional, with 10,035 participants aged 40-100 who answered a survey distributed by Qualtrics. Nutritional status was measured twice before and since the COVID-19 pandemic by the Dietary Screening Tool (DST). The total DST score was calculated for each participant, which categorized them into three different groups, including “at risk,” “possible risk,” and “not at risk.” The results revealed that the mean DST score before the pandemic was 56.04 (IQR: 48.00–65.00); this score significantly decreased since COVID-19 to 55.54 (IQR: 47.00–64.00) (p &lt;.001). Of those participants who were not at risk before COVID-19, 28.5% became either at risk or at possible risk since COVID-19. Of those participants who were at possible risk before COVID-19, 21% are now at risk since COVID-19. Almost 60% of the younger group (40-60) were at risk before COVID-19 compared to 54.8% of participants aged 61-80 and 45.8% of older participants (81-100). These percentages increased by about 2% since COVID-19 among all three age groups. As a good nutritional status reduce the risk of severe illness, these findings can help policymakers to develop heath-protecting behavior sessions against future pandemics to manage crises.
A SCOPING REVIEW FOR PERSON-FOCUSED FALL PREVENTIVE INTERVENTIONS IN LONG-TERM CARE FACILITIES
Authors: Jung Wonkyung , Lim Sungwon , Thompson Hilaire 
Published: December 2023

Abstract
Falls are a significant concern in long-term care facilities (LTCFs) as fall-related injuries (FRI) can result in functional impairment, disability, and death. Older adults living in LTCFs are at greater risk for falls than those in the community. Using scoping review methodology, we aimed to synthesize evidence examining intervention effects of person-focused interventions for risk assessment and prevention in LTCFs to identify evidence-based practices. Databases searched included Medline, CINAHL, and EMBASE to identify original research from 2017 to April 2022 in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline. Following the removal of duplicates, 888 articles were identified for possible review, following title and abstract screening 84 studies underwent full-text review against inclusion/exclusion criteria, with 30 studies remaining for analysis. We conducted a narrative synthesis to summarize the included studies. Evidence-based interventions for fall prevention identified include (1) exercise programs (e.g., high-intensity functional exercise, aerobic exercise, short stick exercises, etc.); (2) balance training programs (e.g., Wii Fit); (3) multifaceted, nurse-led education; and (4) others (e.g., whole body vibration, and lavender olfactory stimulation). Outcomes of included studies included the number of falls, fall rate, risk of falls, and fear of falls before and after interventions. Overall, most studies reported significant effects of person-focused interventions in LTCFs. Available evidence supports that well-designed person-focused interventions can reduce falls and fear of falls for individuals in LTCFs.
FALL ENCOUNTERS AMONG OLDER ADULTS: IMPACT OF COVID-19
Authors: Lach Helen , salas Joanne 
Published: December 2023

Abstract
It was suspected that the restrictions in activity and clinical care during the COVID-19 pandemic would result in increased fall risks and falls in older populations. To explore the impact of the pandemic on falls, we examined the trajectory of fall rates among older adults cared for through a large, multi-state, Midwest healthcare system. De-identified medical record data was used to measure falls presenting to emergency, urgent, and hospital care in adults age 50+ from April 2019 through September 2022. We compared the fall rate during the pre-and post-COVID-19 time periods. Differences in fall rates were compared based on age groups, gender, race, and neighborhood socioeconomic status (nSES). The overall fall rate after COVID onset was significantly greater compared to prior to before COVID (11.59; 95%CI:11.50-11.67 vs. 11.20; 95%, CI:11.06-11.33). While White patients had a significantly higher rate of falls post-pandemic, changes in fall rates did not differ based on age, gender, or race. The changes did vary based on nSES, with the lower groups experiencing the largest increases. Findings may be related to differences in access to care and other services both early in the pandemic and as restrictions were lifted. Given the high cost of fall injuries, further work is needed to reduce falls and injuries in older adults.