bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXPLORING THE COMPLEXITY OF LUCID EPISODES IN DEMENTIA: PERSPECTIVES FROM MULTIDISCIPLINARY CLINICAL EXPERTS
Authors: Bangerter Lauren , Griffin Joan , Kim Kyungmin , Maria Lapid , Gaugler Joseph , Finnie Dawne , Frangiosa Theresa 
Published: December 2023

Abstract
Lucid episodes (LE) occur in people living with dementia who have seemingly lost cognitive capacity. Understanding LEs is a relatively new area of scientific inquiry. Most LE studies have utilized different conceptual and operational definitions. Reaching a definition of LE is critical foundation to facilitate more systematic investigation and new knowledge of LEs. The goal of this study was to convene a group of 13 clinical experts to brainstorm on the key components needed to understand LE among people living with dementia (PLWD). We aimed to reach consensus from the group on (1) potential medical or clinical explanations for LEs; (2) necessary medical and clinical questions to understand LE; (3) interpretation of the presence of LE. Thirteen experts from different disciplines (neurology, psychiatry, psychology, pharmacy, palliative care, hospice, nursing, social work, primary care, geriatrics, and professional home caregivers) participated in a virtual Delphi Method study. Experts provided a range of opinions on potential medical and clinical explanations for LE, necessary questions to understand LE, and did not reach consensus on the presence of LE when presented with clinical vignettes. Panelists highlighted key medical and contextual factors as well as a need to know more information about the general demeanor and typical behavior of the PLWD to make a definitive judgement about whether LE occurred. Clinical consensus on LEs is complex. There is great variability in how behaviors and cognitive fluctuations in PLWD are appraised by clinical experts.
EXPLORING THE EXPERIENCES OF PERCEIVED NEIGHBORHOOD SAFETY OF BLACK ADULTS: RESULTS FROM THE THINK PHRESH STUDY
Authors: Staben Omar , Palimaru Alina , Troxel Wendy , Dubowitz Tamara , Rosso Andrea 
Published: December 2023

Abstract
Racial residential segregation is a complex socio-economic phenomenon that affects many communities across the U.S. Such residential segregation is a result of historic policies in the United States including redlining and inequitable urban redevelopment. Black adults who live in segregated areas face challenges and experience psychosocial stressors, including poverty, crime, and feeling unsafe in one’s neighborhood which are risk factors for many negative health and cognitive outcomes. To date, few studies have explored perspectives on experiences of racial residential segregation, and specifically, neighborhood safety trajectories that may relate to healthy aging. This qualitative study used data from a sample of participants in adulthood and older adulthood (aged 35-89, Mage= 64 years) from two predominantly black, low-income neighborhoods that have had different histories with regard to disinvestment and systemic racist policies. We used 60 in-depth interviews to explore perceptions around neighborhood safety trajectories and their perceived impact on aging outcomes. The results highlight several dimensions of perceived changes in neighborhood safety over time and how these are perceived to relate to aging outcomes, e.g., psychological stress. The findings also show a few differences between the two neighborhoods concerning policing strategies, individual behaviors, and resource availability, all of which may contribute to perceptions of safety. Implications of this work highlight the importance of developing culturally relevant interventions that target upstream social determinants of healthy aging and health disparities.
EXPLORING THE STRESS-RELATED GROWTH AMONG ELDERLY KOREAN IMMIGRANTS IN THE CONTEXT OF COVID-19 PANDEMIC
Authors: Lee Jooah , Kim Yongseop , Park Hyejin , Kim Junhyoung 
Published: December 2023

Abstract
While some studies investigated stress-related growth (SRG) during the COVID-19 pandemic, little research has been pursued to explore positive psychological changes associated with COVID-19 among older Asian immigrants. Thus, we aimed to find positive changes resulting from the COVID-19 pandemic based on the SRG framework. Using a purposeful criterion sampling strategy, semi-structured in-depth interviews were conducted with 11 participants. Content mapping and content mining questions were used. Data were qualitatively analyzed using the constant comparative method. Challenges and stressors associated with the pandemic such as fears of physical or verbal attack, COVID-19 infection, strict COVID-19 regulations and mandates, and limited opportunities to interact with others were identified based on the statements of participants. We identified three salient themes that were characterized as components of SRG: (a) increasing leisure-time physical activity participation, (b) developing a closer relationship with others, and (c) improving resilience. The findings of the present study present qualitative evidence that older Korean immigrants experienced positive changes associated with the pandemic such as being physically active, developing closer relationships, and improving resilience. These changes are associated with the main elements of SRG, and it appears that the pandemic did lead to older Korean immigrants experiencing SRG.
EXTRACELLULAR VESICLES BIOMARKERS FOR PARKINSON’S DISEASE: A SYSTEMATIC REVIEW AND DIAGNOSTIC META-ANALYSIS
Authors: Taha Hash Brown , Bogoniewski Aleks 
Published: December 2023

Abstract
Parkinson’s disease (PD) and related disorders are frequently misdiagnosed due to shared symptoms and a lack of specific biomarkers, especially in early-stages. Moreover, the prediction of progression and conversion of prodromal conditions, such as RBD, is not possible. Extracellular vesicles (EVs) are tiny, lipid-bilayer bound vesicles released by all cells into the extracellular space and bodily fluids that contain cell-state-specific messages. As such, they have become potential diagnostic tools, but inconsistencies and poor reproducibility hinder their clinical translation. This meta-analysis aimed to clarify the diagnostic ability of EVs extracted from different bodily fluids, such as cerebrospinal fluid (CSF), plasma and serum, for distinguishing patients with parkinsonian disorders from one another or from healthy controls (HCs). Following PRISMA guidelines, we analyzed 21 studies using bivariate and HSROC models, focusing mainly on 1,265 patients with PD vs. 783 HCs due to limited research on other comparisons. The results showed a moderate diagnostic ability of the test (DOR = 21.6 and AUC = 0.852), but substantial heterogeneity and publication bias. The trim-and-fill method estimated two missing studies with null or low DOR. Sub-analysis of media showed that CSF-EVs performed the best (DOR = 42.4 and AUC = 0.924), while plasma-EVs showed the lowest effectiveness. Comparison of biomarkers from general EVs vs. central nervous system (CNS)-originating EVs (n = 13) showed that the former approach is more effective with less publication bias. Though promising, the emphasis should be on standardizing the field by rigorous validation to avoid making practical clinical application a reality.
FACIAL-TRUSTWORTHINESS AND BEHAVIORAL-EVALUATION FACILITATE DECISION MAKING AMONG YOUNG AND OLDER ADULTS
Authors: Liao Shuyao 
Published: December 2023

Abstract
Objectives. Older adults prefer non-diagnostic cues (e.g., facial-appearance) than diagnostic behaviors when making decision in trust games. However, previous research on decision-making heavily focused on memory, requiring older adults to remember multiple faces and corresponding behaviors. Due to cognitive deficits and the rarity of repetitive interactions with partners in real-life, older adults may experience limitations in their memory-based decision making. This study employs multi-trial one-shot trust game to investigate the reliance of younger and older adults on non-diagnostic (facial-trustworthiness) and diagnostic (behavioral-evaluation) cues, and whether older adults would learn the rule of basing decisions on diagnostic cue, when both cues are available. Method. 104 younger adults (Mage = 21.38, SD = 2.41) and 105 older adults (Mage = 65.5, SD = 4.15) completed 96-trial one-shot trust game, in which partner’s facial-trustworthiness and behavioral-evaluation were presented simultaneously. Regardless of facial-trustworthiness, decision outcomes were based on behavioral-evaluation. Results. A reinforcement learning model was established, including learning rate and different weights for facial-trustworthiness and behavioral-evaluation. Results reveled that older adults could indeed show rule-based learning, by exhibiting a non-zero learning rate, and an increase in their weights for behavioral-evaluation after learning, although they initially had higher weights for facial-trustworthiness and lower weights for behavioral-evaluation. Discussion. The present study indicated that older adults tended to rely more on facial-appearance initially. However, they could learn the right rule to adjust decision-making resembling those of younger adults. Keywords: decision-making, facial-trustworthiness, behavioral-evaluation, rule-based learning
FALL RISK AND FEAR OF FALLING IN LOW-INCOME COMMUNITY-DWELLING OLDER ADULTS USING A SIMPLE CHECKLIST
Authors: Uddeen Aleeyah , Komalasari Renata , Thiamwong Ladda 
Published: December 2023

Abstract
Fall risk is common among older adults and can seriously threaten their well-being and increase fear of falling (FOF). FOF can affect the ability of older adults to maintain daily activities and may cause depression. Using a simple checklist to assess the levels of fall risk and FOF can help tailor interventions to prevent falls and promote physical activity. The purpose of the study was to assess fall risk and FOF using simple checklists and examine the association between fall risk and FOF in community-dwelling older adults in low-income settings. A descriptive cross-sectional design was used to assess 103 older adults (men=16, women=87, mean age=75.70, SD±7.19). We used the CDC’s Stay Independent checklist with twelve items to measure fall risk and the Short Fall Efficacy Scale International (Short FES-I) with seven items to assess FOF. Scores equal to or greater than four on the Stay Independent and greater than ten on the Short FES-I indicate high fall risk and high FOF, respectively. The data was analyzed using SPSS version 28. Spearman correlation tests showed that fall risk was positively correlated with FOF (r=.606, p&lt;.001). Our finding suggests that using simple checklists to assess both fall risk and FOF may be helpful for older adults in understanding their risk of falls, thus attenuating their FOF. It may be useful to increase accessibility to these two checklists in efforts to prevent falls and FOF among community-dwelling older adults in low-income settings.
FEASIBILITY OF AN ONLINE DEMENTIA CAREGIVER EDUCATION CURRICULUM FOR FAITH-COMMUNITY LEADERS
Authors: Graupner Jeffrey , Thompson Katherine , Long Monica , Smith Tiffany , Bennett Jenil , Williams Shellie 
Published: December 2023

Abstract
Dementia caregivers have well-documented needs including dementia education, resources, and emotional support. Our prior work demonstrated the efficacy of a novel dementia education program designed to transform urban faith-community leaders into “Dementia Resource Champions” equipped to start their own support groups. We adapted this program to be delivered virtually. A 6-week curriculum of presentations, resources, and video interviews with caregivers was created by an interprofessional team of geriatrics specialists. Recruitment for “DRC: Online” utilized email blasts and online sign-up forms. While registration for the course was open to all, recruitment emphasized that this program was originally developed for local faith-based communities. Each week, participants received an email with a pre-recorded video didactic presentation, a caregiver interview video, and a link for the weekly videoconference discussion. Fourteen participants completed the pre-training survey, and seven went on to complete the 6-week course and post-training survey. Participants’ reported self-confidence in dementia knowledge increased significantly from pre- to post-training (5-Likert Scale, Paired t-test: Pre (M = 2.1 , SD = 1.1); Post (M = 4, SD = 0.6), t(6) = 7.1, p &lt; .001). Self-reported ability to use the internet to find dementia resources also increased significantly (Pre: (M = 3.9, SD = 1.1); Post: (M = 4.7, SD = 0.5), t(6) = 2.5, p = .045.) Participants’ average rating of the program was 4.7 (5-Point Likert, 5=Excellent). Results indicate that this relatively low-tech approach to virtual dementia education is a feasible way to train community leaders to become resources for dementia caregivers.
FEELING CLOSER WITH FUTURE-SELF PROMOTES RETIREMENT PREPARATION OF YOUNGER AND OLDER WORKERS
Authors: Yeung Dannii , Tang Esther Y K , Lin Gloria , Ho Alvin 
Published: December 2023

Abstract
Working adults’ preparation for retirement and later life remains low despite past research has revealed its benefits on the well-being of retirees. This study utilized an experimental method to test whether the positive effect of exposure to future-self on retirement planning would be retained two weeks after the manipulation. Younger and middle-aged Hong Kong Chinese workers were recruited and were randomly assigned to one of the four conditions: exposure to a future-self photo plus a 5-day writing task (FSW), exposure to a future-self photo only (FS), exposure to a current-self photo plus a 5-day writing task (CSW), and exposure to a current-self photo only (CS). Participants in the FSW and CSW conditions were further asked to do a 5-day writing task. Intention to make retirement plans was assessed after viewing the future- or current-self photo (Time 1), while actual preparatory activities for retirement were also assessed two weeks after the photo viewing (Time 2). Preliminary analyses on 91 participants [41 younger (M=31.01,SD=5.55) and 51 middle-aged (M=50.04,SD=6.59) workers] showed significant interaction effects between condition and age on T2 overall retirement planning (F=4.06, p=.01, ηp2=.13) and financial planning (F=4.42, p=.006, ηp2=.14). Specifically, younger participants in the two future-self conditions had more preparatory activities than those in the CSW condition. Middle-aged workers in the FSW condition also reported more retirement preparation than those in the FS condition. These findings suggest that exposure to future-self increases retirement preparation in the short run, and such effect was stronger on younger workers than on older workers.
FRAILTY AS A PREDICTOR OF MORTALITY: A COMPARATIVE COHORT STUDY IN COSTA RICA AND THE UNITED STATES
Authors: Santamaría-Ulloa Carolina , Lehning Amanda , Cortés-Ortiz Mónica , Méndez-Chacón Ericka 
Published: December 2023

Abstract
Geriatric frailty results from aging-related declines in multiple systems and leads to increased vulnerability for loss of mobility, falls, hospitalization, and mortality. The aim of this study is to compare the association between frailty and mortality in older adults from Costa Rica and the United States. This prospective cohort study uses secondary nationally representative data of community-dwelling older adults from the Costa Rican Longevity and Healthy Aging Study (CRELES, n = 2124) and the National Health & Aging Trends Study (NHATS, n = 6,680). Frailty status was assessed using Physical Frailty Phenotype, which includes shrinking, exhaustion, weakness, slowness, and low physical activity level. We estimated Cox proportional hazard models to examine the association between frailty and all-cause mortality at 8 years from the date at baseline. Survey weights were used. Sociodemographic characteristics and health behaviors were included as covariates. The death hazard for frail compared to non-frail older adults was three-fold in Costa Rica (HR = 3.14, p&lt; 0.001) and four-fold in the white US (HR = 4.02, p&lt; 0.001). Older age, being male, and smoking were death risk factors in both countries. High education was a protective factor in the US, whereas being married or in union was a protective factor in Costa Rica. Results indicate that frailty can have a differential impact on mortality depending on the context of different countries. The identification of behavioral, social, and policy determinants of frailty may serve as an essential component of population interventions that prevent the progression of frailty and its consequences.
FRAILTY-FOCUSED ENHANCEMENTS TO SENIORS’ HOSPITAL CARE (FRESH): DOES SPECIALIZED EDUCATION WORK?
Authors: Peterson Jennifer , Fowler Samantha , Faig Karla , Flanagan Kelly , Clancy Olivia , Robertson Caitlin , Yetman Linda , Feltmate Patrick 
Published: December 2023

Abstract
Research suggests that specialized education for nurses decreases frailty and improves functionality in hospitalized older adults. This study explored the impact of a specialized geriatric education program on care delivery for older adults in acute care in 5 hospitals across the province of New Brunswick. A mixed-methods approach with pre- and post- questionnaires was used to explore facilitators and challenges of caring for hospitalized older adults, the knowledge base and experiences of staff, and the impact of providing specialized education. Acute care staff (N=64) participated in a geriatric education intervention and completed pre and post questionnaires. A sub-set (n=26) participated in semi-structured interviews guided by Kirkpatrick’s theoretical framework. Data was collected on mobility, medications, and delirium from patients’ charts (N=99) to identify changes in outcomes pre- and post intervention. Findings revealed that staff had positive attitudes toward caring for older adults; however, their understanding and application of geriatric principles were limited and remained unchanged post-education. There was no significant change in the patient-level measures after the intervention. Interview participants shared that their work environment affects their mindset and workflow, limiting their capacity to deliver the type of care presented in the education sessions. Staff identified the need for specialized education; however, there was no impact on care after participation. Environmental constraints hindered staff from implementing best practices, leading to both practical and psychological challenges to care delivery. These results will inform changes to specialized education programming with the aim of improving care for older adults in hospital.
FROM FRONT TO BACK SEAT DRIVER: INVESTIGATING DRIVING RETIREMENT DECISION-MAKING WITH THE 85+
Authors: Ashebir Sophia , Patskanick Taylor , D’Ambrosio Lisa , Coughlin Joseph 
Published: December 2023

Abstract
It is impossible to consider personal transportation in the United States without engaging with the topic of driving. Over 90% of U.S. households own cars, while 83% of people report they drive several times a week. A critical but often overlooked component of the driving narrative particularly among older adults is the decision of when or if to forfeit the car keys, a topic which is both complex and, for many individuals and families, a source of stress and conflict. With a rapidly growing population of the oldest of older adults, the 85+ age demographic, it is crucial to understand the attitudes and behaviors of this diverse age group regarding the experience of driving retirement. Utilizing four semi-structured focus groups (n=17) and a 48-item survey of original and adapted measures (n=34) with a panel of the 85+, this study sought to understand people’s perspectives on driving, how current drivers think about and plan for driving retirement – or not, and participants’ general perceptions and attitudes toward the future of technology and driving. The data suggest four different vignettes or transportation paths with respect to driving among this age group that intersect with themes of autonomy, the experience of physical aging, the role of family, and key inflection points. Implications of this research highlight the need for targeted solutions and materials for people at varying levels of acceptance with their driving stage and underscore the need for more research and greater involvement of different stakeholders in conversations around transportation and aging.
GEROSCIENCE BLOOD-BASED BIOMARKER INDICES AND PHYSICAL PERFORMANCE IN OLDER ADULTS
Authors: Houston Denise , Pathak Deeya , Neiberg Rebecca , Justice Jamie , Nicklas Barb , Miller Michael 
Published: December 2023

Abstract
Dysregulation in cellular and molecular aging biomarkers are hypothesized to contribute to worse physical performance. We examined associations between blood-based geroscience biomarker indices and physical performance in 414 older adults (77.4±4.4 years; 69% female). Physical performance measures included the expanded SPPB, 4m and 400m walk, and grip strength. Serum IL-6, CRP, TNFr1, GDF15, and insulin were measured and three biomarker indices created: 1) a quintile index calculated by summing quintile scores for each of the biomarkers; 2) a composite z-score calculated using the standardized mean of individual biomarker z-scores; and 3) a principal component analysis (PCA) to identify biomarker factor(s). The quintile index and composite z-score were highly correlated (r=0.94, p&lt; 0.0001). PCA identified two factors: TNFr1 and GDF-15 weighted heavily on Factor 1 and IL6 and CRP weighted heavily on Factor 2. The quintile index and composite z-score were correlated with PCA Factors 1 and 2 (r&gt;0.61, p&lt; 0.0001). Similar standardized beta coefficients were observed for the quintile index, composite z-score, and PCA Factor 1 with 4m and 400m gait speed (all p&lt; 0.0001); every 1 SD higher biomarker index score was associated with ~0.25 SD slower gait speed. For expanded SPPB, higher standardized beta coefficients were observed for the quintile index and composite z-score (~-0.32) than PCA Factors 1 and 2 (~-0.24; all p&lt; 0.0001). Weak associations between all indices and grip strength were observed (p≥0.05). Geroscience biomarker indices that capture inflammation and poor stress response appear to have similar associations with worse physical performance in older adults.