bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE RELATIONSHIP BETWEEN CROSS-TISSUE AND INTRA-TISSUE MEASURES OF AGING BIOLOGY IN OLDER ADULTS
Authors: Waziry Reem 
Published: December 2023

Abstract
The present study included individuals (N=2406) aged 50 and older who had complete data for saliva-based telomere length and blood-based biological aging measures in the Health and Retirement Venous blood and Telomere length studies. Average telomere length was assayed using quantitative PCR (qPCR). DNA methylation clocks included: Horvath (353 CpG sites), Hannum (71 CpG sites), Levine (referred to as phenoAge, (513 CpG sites)), GrimAge, (epigenetic surrogate markers for select plasma proteins), Horvath Skin and Blood (391 CpG sites), Lin (99 CpG sites), Weidner (3 CpG sites), and VidalBralo (8 CpG sites). Physiology measures included albumin, creatinine, glucose, [log] C-reactive protein, lymphocyte percent, mean cell volume, red blood cell distribution width, alkaline phosphatase, and white blood cell count. Relationships between aging biology measures in blood and saliva and variations according to gender were assessed. Blood-based measures showed an inverse relationship with saliva-based telomere length. Increase in saliva-based telomere length was associated with 1 to 4 years slower biological aging based on blood-based measures with the highest magnitude being Weidner (Coefficient= -3.97, P = 0.005), GrimAge (-3.33, P &lt; 0.001), and Lin (-3.45, P = 0.008). Variations in DNA methylation and physiology measures of aging biology with changes in telomere length provide new avenues for integration of these measures in clinical care of vulnerable and clinically difficult to reach individuals.
TRANSITIONS BETWEEN SARCOPENIA STATES AND ITS DETERMINANTS IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Kim Miji , Shin Hyung Eun , Won Chang Won 
Published: December 2023

Abstract
Sarcopenia is characterized by an age-related progressive reduction in muscle mass and function. Few observational studies have characterized the dynamic nature of sarcopenia, which is potentially reversible. However, little is known about the determinants of sarcopenia reversal among community-dwelling older adults. We aimed to explore transitions in sarcopenia status and identify factors associated with the reversibility of sarcopenia over a 2-year follow-up period. We conducted prospective analyses (n=1,992) among participants (mean age, 76.3±3.9 years; 47.6% men) who underwent measurement of sarcopenia status at baseline and 2-year follow-up from the Korean Frailty and Aging Cohort Study. Sarcopenia status was diagnosed using the criteria of the 2019 Asian Working Group for Sarcopenia. After 2 years of follow-up, 224 (11.2%) individuals developed sarcopenia, 176 (8.8%) had reversed their sarcopenia, 276 (13.9%) remained in a sarcopenic state, and 1,317 (66.1%) had maintained a non-sarcopenic state. For men, moderate to high levels of physical activity (odds ratio [OR]=2.50 [95% confidence interval (CI)]: 1.31–4.56), resistance training more than 2–3 times per week (OR=2.03, 95% CI: 1.04–3.97), and lower body mass index (OR=0.67, 95% CI: 0.55–0.82) were associated with greater odds reversing sarcopenia. For women, cognitive function (OR=1.12, 95% CI: 1.05–1.26 per 1-point increase in the Mini-Mental State Examination) was associated with higher rates of reversing sarcopenia. To conclude, our results support the dynamic nature of sarcopenia and potentially reversible factors such as higher levels of physical activity and cognitive function, which could be beneficial in the treatment of community-dwelling older adults with sarcopenia.
IMPROVING HAND FUNCTION AMONG OLDER ADULTS THROUGH AN INTERGENERATIONAL SERVICE-LEARNING PROGRAM
Authors: Cook Rachel Logue , Schwartz Anna , Vanderlaan Courtney , Brown Susan 
Published: December 2023

Abstract
Adequate hand function is essential for performing daily activities such as eating and dressing, but declines with age. Homebound older adults in particular are at greater risk for losing hand function necessary to remain independent. However, hand function in this population remains largely understudied. The purpose of this study is to determine whether Hands and Health at Home, an intergenerational upper limb-based intervention, improves hand function among homebound Meals on Wheels (MOW) clients. In this program, pre-health college students are trained to deliver a variety of hand strength, dexterity, and sensory exercises to a MOW client twice a week for 8 weeks. In addition, clients are instructed to complete exercises twice a week on their own. Measures of strength, dexterity, and sensation, as well as self-reported hand function are measured before and after the intervention. Preliminary results indicate MOW clients improved their grip strength an average of 42% in the dominant hand and 26% in the nondominant. Approximately 50% of clients improved dexterity (measured via the Purdue Pegboard) in their nondominant hand, and over 65% self-reported increased upper limb mobility. All clients and students valued this hands-on experience with several requesting continued involvement in the program. Results from Hands and Health at Home suggest this intergenerational approach to delivering hand therapy is an effective and mutually beneficial way to serve the needs of homebound older adults in the community and promote student interest in aging careers.
SOCIAL ISOLATION AS A RISK FACTOR FOR GRIP STRENGTH DECLINE: FINDINGS FROM THE NHATS STUDY
Authors: Taani Murad , Ellis Julie , Lee Yura , Cho Chi , Hammouri Ammar , Schlueter Amy 
Published: December 2023

Abstract
Low grip strength is associated with negative health outcomes among older adults, including poor physical performance, sarcopenia, and all-cause mortality. Social isolation has been also linked with decreased physical function and mortality. Limited studies examined whether social isolation is a risk factor for grip strength decline among older adults and whether race differences exist in this association using population-based longitudinal data. The aim of this study was to evaluate the relationship between social isolation and grip strength among older adults and whether the relationship varies by race and over time. We analyzed National Health and Aging Trends Study (NHATS) data (2015 - 2018) and the sample included 4877 adults &gt; 65 years old. Grip strength was measured using a digital hand dynamometer. Social isolation was measured using six NHATS items from the literature and the composite score ranged from 0 to 6, with a higher score indicating more isolation. The sample mean age was 75 (SD = 22; 68 - 110 years). Repeated-measures analysis of variance showed significant differences in grip strength across social isolation scores (p = .001) indicating that socially isolated older adults have significantly lower grip strength. We also found that grip strength significantly decreased by 2.046 kg over the four-year period (p = &lt; .001). The findings showed no significant difference in grip strength across race and change in grip strength across time did not differ by race and social isolation. Interventions to improve muscle strength and reduce social isolation among older adults are needed.
COGNITIVE TRAJECTORIES IN MIDDLE-AGED AMERICANS, 1995–2018
Authors: Brown Rebecca , Zuo Xi , McMillan Corey , Stites Shana , Elo Irma , Langa Kenneth , Karlawish Jason , Xie Dawei 
Published: December 2023

Abstract
Given evidence that Alzheimer’s disease and related dementias (ADRD) develop over decades, middle age is increasingly recognized as a key life course period to target modifiable risk factors for cognitive decline and ADRD. Epidemiological trends show that the prevalence of chronic conditions that are risk factors for ADRD has increased in middle-aged adults over the past several decades, but it is unknown if cognitive trajectories have worsened in middle-aged people over this time period. We conducted a retrospective cohort study using data from 19,660 adults ages 50-64 enrolled from 1995-2018 in the longitudinal nationally representative Health and Retirement Study, followed through 2018. We fit group trajectory models to describe changes in cognition over time based on Telephone Interview for Cognitive Status scores and used mixed effects models to investigate change in slope adjusted for key risk factors (age, gender, race/ethnicity, education, net worth, chronic medical conditions, body mass index, age cohort). We identified four distinct groups of participants with differing start points in their cognitive trajectories. In adjusted analyses, trajectories of cognitive decline were steeper among racial/ethnic minorities, persons with lower education, lower net worth, history of stroke, and earlier age cohort. The effect of age cohort on the rate of decline was similar across racial/ethnic groups but differed across education and net worth groups. These findings suggest that cognitive trajectories among middle-aged adults have improved since the mid-1990s. However, disparities in cognitive trajectories persist among racial/ethnic minorities and those with lower education and net worth.
DETERMINING THE ASSOCIATION BETWEEN THE 24 HOUR COMPOSITION OF WAKING BEHAVIORS AND SLEEP WITH RECURRENT FALLS
Authors: Roe Lauren , Strotmeyer Elsa , Cawthon Peggy , Glynn Nancy , Ensrud Kristine , Stone Katie , Gabriel Kelley Pettee , Cauley Jane 
Published: December 2023

Abstract
Physical activity (PA), sleep, and sedentary behavior are individually associated with falls, but analyses examining one activity omit information about all other activities. We examined the combination of PA, sedentary behavior, and sleep on recurrent fall risk (2+ falls/year in any year) in older men using compositional data analysis. Data were from 2,705 men aged 79.0±5.1 years in the Osteoporotic Fractures in Men Study (MrOS). Twenty-four-hour accelerometer-measured time sedentary (&lt; 1.5 METs), physically active (PA; &gt;1.5 METs), and sleeping were used to calculate isometric logratios (ILR). ILRs were predictors in logistic regression models estimating the proportion of time in one activity relative to time in all other activities simultaneously, associated with recurrent falls. A total of 1,025 (37.9%) men experienced recurrent falls after four years of follow-up. In minimally adjusted models (age, race, clinic site, season of accelerometer wear), more PA relative to sedentary behaviors and sleep equated to lower odds of recurrent falls (OR: 0.70, 95%CI: 0.60, 0.79). More sedentary behavior relative to PA and sleep resulted in higher odds of recurrent falls (OR: 1.54, 95%CI: 1.14, 2.09). Associations were substantially attenuated after adjustment for height, weight, diabetes, health and smoking status, comorbidities, and instrumental activities of daily living impairments (MVPA vs. sedentary and sleep – OR: 0.88, 95%CI: 0.75, 1.02; sedentary vs. PA and sleep – OR: 1.33, 95%CI: 0.97, 1.82) and not significant. More PA and less sedentary behavior relative to other behaviors were associated with recurrent falls, with associations explained by poor health and comorbidities.
ASSESSMENT OF THE LINK BETWEEN FRAILTY AND DEMENTIA IN THE OLDEST-OLDS USING JOINT MODELS
Authors: Massa Franklin , Marroig Alejandra , Muniz-Terrera Graciela , Johansson Boo 
Published: December 2023

Abstract
Frailty and dementia affect many older adults worldwide. As the world’s population ages, the number of people experiencing frailty and dementia is increasing, posing significant challenges for individuals, health care systems and caregivers. Here, we aim to assess the link between the evolution of frailty and the time to dementia diagnosis in the oldest-old. We derived the frailty index (FI) using data from 5 waves of the OCTO-Twin Study: Origins of Variance in the old-old, and fitted joint longitudinal-survival models to repeat measures of the index and time to dementia diagnosis to understand the association between the trajectory of the FI and time to diagnosis. We accounted for possible effects of sex, education and the presence of the APOE e4 gene. A nonlinear trajectory of the frailty index (p &lt; 0.001) and an effect of education attenuating the levels of the frailty index (p = 0.032) were observed. Additionally, the results agree with the literature regarding the effect of the APOE e4 as a greater risk for dementia (HR = 2.034, p &lt; 0.001). Moreover, an increasing frailty trajectory is associated with an earlier time to diagnosis of dementia (HR = 1.096, p &lt; 0.001). Our findings advance our understanding of the relation between frailty and dementia in the oldest old. Our approach accounts for the non-linearity of the trajectory of frailty and deliver a dynamic tool that updates dementia prognosis when a new measurement of frailty is available.
EVALUATING A TRANSITIONAL CARE PROGRAM FOR OLDER ADULTS WITH FRAILTY BETWEEN HOSPITAL AND HOME
Authors: Lee Ji Yeon , Cho Eunhee , Kim Sue , Kim Gwang Suk , Lee Kyung Hee , Kim Chang Oh 
Published: December 2023

Abstract
Older adults with frailty experience numerous health problems even after hospital discharge, highlighting the necessity of continued intervention until their recovery and return to daily routines. This mixed methods research (i.e., quantitative and qualitative studies) aimed to evaluate the effectiveness of a transitional care program developed for older adults with frailty during the transition from hospital to home and how it was helpful. From June to December 2021, 32 older adults with frailty were enrolled in a randomized controlled trial at a university-affiliated hospital in Korea. They were allocated to either an intervention group (n=16) or a control group (n=16) according to a random number sequence. The intervention group received a 12-week transitional care program that included inpatient care, structured discharge, and follow-up interventions (e.g., home visits and phone follow-ups); the control group received usual care only. At 12 weeks, program participants (eight frail older adults and eight family caregivers) had interviews for the qualitative research. The results showed that the intervention group had a higher score in knowledge readiness (p=.046) at discharge, empowerment (p=.032), and connectedness at four weeks (p=.037); community resource utilization (p &lt;.001) and emergency room visit rate (p=.049) at 12 weeks; and improvement in depression (p &lt;.001), family interaction (p=.045), and subjective health status (p=.002) over time. Participants described the program as a supportive, connected, timely, and personalized intervention. Overall, the study demonstrated that the transitional care program effectively improved the health outcomes of older adults with frailty and facilitated a safe transition between hospital and home.
EXAMINING FRAILTY SUBDOMAINS (PHYSICAL, PSYCHOLOGICAL, COGNITIVE, SOCIAL) IN COMMUNITY-LIVING ADULTS 45–85
Authors: Griffith Lauren , Muniz-Terrera Graciela , van den Heuvel Edwin , Khattar Jayati , Hogan David , O’Connell Megan , Levasseur Melanie , Raina Parminder 
Published: December 2023

Abstract
Frailty prevalence estimates vary considerably (4.0% to 59.1% in one review). Understanding these differences and what drives frailty among individuals could lead to more focused interventions. Breaking frailty into subdomains and exploring their relationships is one approach to this. A 127-item overall Frailty Index (FI) based on data collected on Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort participants (n = 30,097 community-living adults aged 45-85 at baseline) was used to create physical, psychological, cognitive, and social subdomain-specific FIs. Each FI was divided into quintiles with the highest 20% (Q5) considered the frailest. We assessed subdomain FI quintile concordance (Goodman and Kruskal’s gamma), described the joint distribution of those most frail (Q5), and estimated the association between sex and age with Q5 subdomain FIs membership (logistic regression). The concordance among FI subdomain quartiles was low. The highest gammas (0.25-0.36) were between the physical/psychological and psychological/cognition subdomains. Concordance was generally higher in females who had higher odds of Q5 membership for overall (1.5), physical (1.7), psychological (1.6) and social frailty (1.1), and lower odds for cognitive frailty (0.7). The odds of Q5 membership increased with age for overall frailty and all subdomains except psychological frailty, which decreased with age. Our results suggest low concordance among frailty subdomains and the relationship between Q5 membership with sex and age differed by subdomain. These data may help to better target frailty interventions, but longitudinal data are needed to explore both the time course and interrelationships across subdomains.
FACTORS RELATED TO THE FRAILTY OF OLDER PEOPLE WITH STROKE IN TEHRAN
Authors: Kakhki Ali Darvishpoor , Aghaali Elham 
Published: December 2023

Abstract
Older people are the fastest growing segment of the population particularly in developing countries such as Iran. Older people encounter not only decreasing physical function but also diseases such as stroke which can lead to their frailty. This study was conducted to describe factors related to frailty of older people with stroke in Tehran. This descriptive, correlational study was conducted on a sample of 170 older people with stroke above age 60 in ten educational hospitals in 2020. A socio-demographic questionnaire, the Zarit Scale of Caregiver Burden, and the Frailty Index for Elders were used for data collection. Content validity and Cronbach’s alpha were used for evaluating the validity and reliability of questionnaires. Data were analyzed with SPSS 25. 55.9% of participants were female and 54.1% lived with their spouse; mean age was 77.18 (± 8.57). 92.4% were at risk for severe frailty, and 7.6% were at risk of frailty. The scores of frailty were associated significantly with increasing family caregiver burden and hospital admission rates, not having treatment insurance, and not having a reliable income source. The best predictors of frailty were family caregiver burden, hospital admission rates, and treatment insurance. The study showed that frailty is very common in older people with stroke and is related to a number of factors. Reducing family caregiver burden and admission rates to hospital, and having treatment insurance, will help prevent or reduce frailty in older people with stroke.
GERIATRIC MEASURES OF PHYSICAL FUNCTION HAVE THEIR ROOTS IN EARLY CHILDHOOD BRAIN HEALTH
Authors: Xie J Kathy , Winslow Lauren , Caspi Avshalom , Moffitt Terrie 
Published: December 2023

Abstract
Midlife is a pivotal period in the life course in terms of investing resources to mitigate challenges that can come in older age. It is important to understand the relationship between childhood and midlife health, as it could have predictive properties for aging. We investigated the association between early childhood brain health and midlife physical function in the Dunedin Study, a longitudinal birth cohort (n=1,037). Brain health was measured when Study members were age 3 using a neurological examination, tests of cognitive functioning, and temperament rating. Physical function was measured at age 45 using gait speed, step-in-place, chair stands, balance, and grip strength tests. Children with worse brain health had significantly worse physical function as adults (β, 0.23; 95% CI, 0.16 to 0.30; P &lt; .001), after controlling for sex and childhood socioeconomic status. This relationship supports a link between cognitive and physical function in the aging and development process, the reconceptualization of aging and development on the same ontological path, and the utility of physical function tests – which can be used in many clinical settings – as reflections of lifelong, integrated health in addition to indicators of musculoskeletal integrity in older adults.
THE RELATIONSHIP OF SELF-MONITORING OF LIFESTYLES WITH PHYSICAL FUNCTION AND METABOLITES IN DIABETIC OLDER ADULTS
Authors: Du Yan , Song Lixin , Gonzales Mitzi , Espinoza Sara , Jaen Carlos , Wang Jing , Sharma Kumar 
Published: December 2023

Abstract
Type 2 diabetes (T2D) is a major risk factor for functional decline in older adults. Mobile/wearable devices are evidenced to improve lifestyles for diabetes management and improve functionality. This study assessed the associations of technology tracked lifestyle and self-monitoring behaviors with glycemic control, physical function and mitochondrial function related metabolites in older adults with T2D. Fitbit fitness trackers were used to track physical activity and food intake over 12-week in 15 older adults with T2D (age=70.5±4.8). Physical function was assessed by Short Physical Performance Battery (SPPB) and grip strength. First void urine was used to assess metabolites. The associations of percentage of days with tracked steps (PDWTS), percentage of days with food log (PDWFL), and 7-day mean steps with HbA1c, SPPB, grip strength and metabolites were examined using Pearson Correlation analysis. At week 12, PDWTS was negatively associated with 3-Hydroxyisovaleric acid and Hydroxyhippuric acid (P&lt; 0.05). PDWFL was negatively associated with HbA1c, Hydroxyisovaleric acid, Hydroxyhippuric acid, and Hydroxybutyric acid (p&lt; 0.05); SPPB was not related to any self-monitoring and lifestyle behaviors, but was negatively related to Hydroxyisovaleric acid, Glycolic acid and Hydroxyisobutyric acid (p&lt; 0.05). In older adults with T2D, self-monitoring might improve glycemic control. Self-monitoring and SPPB were related to several urine metabolites, but the underlying mechanisms is unclear in this study with small sample size. Future research with sufficient power is needed to investigate the underlying mechanisms of self-monitoring and lifestyle behaviors on these metabolites, and how these metabolites might be applied to improve physical function in older adults with T2D.
CO-PRESCRIPTION OF OPIOIDS AND BENZODIAZEPINES AND 30 DAY HOSPITAL RETURNS IN OLDER ADULTS
Authors: Park JuYoung , Engstrom Gabriella , Ouslander Joseph 
Published: December 2023

Abstract
With the current opioid epidemic, greater attention has been focused on polypharmacy, in particular use of benzodiazepine (BZD). This study compared prescription of opioids or BZD, co-prescription of both, and prescription of neither at discharge with returns to the hospital within 30 days of discharge of older patients (75+ years). This is a secondary analysis of a quality improvement database developed during implementation of a care transition intervention for hospitalized patients age 75+. The database includes all non-ICU admissions over a 2-year period (24,784 admission cases). Returns to the hospital included Emergency Department visits, inpatient hospital stays, and observation admissions. Among the 24,262 discharges that had medication data, 1,594 (6.6%) were prescribed opioids only, 3,594 (15.0%) BZD only, 544 (2 %) opioids and BZD together, and 18,530 (76.4%) neither opioid or BZD. Each of the four prescription groups had a &gt; 20% return rate within 30 days of discharge: 22.1% opioids only, 23.8% BZDs only, 23.7% opioids and BZDs, and 20.2% neither. Opioids were not associated with a significantly higher incidence of hospital returns. The data highlight the importance of educating healthcare providers about appropriate use of BZD and opioids in hospitalized and post-discharge older patients. Individualized care by interdisciplinary team members and support for family caregivers, as well as careful use of opioids for pain that cannot be managed by other modalities, may reduce hospital return rates and their associated morbidity and costs in the older population.