bluuebunny/crossref_metadata_2025_split huggingface dataset:
MARKERS OF GLUCOSE METABOLISM ARE ASSOCIATED WITHCCOGNITIVE DECLINE AMONG FAMILIES WITH EXCEPTIONAL SURVIVAL
Authors: Miljkovic Iva , Cvejkus Ryan , Andersen Stacy , Cosentino Stephanie , Zmuda Joseph 
Published: December 2023

Abstract
Although the connection between type 2 diabetes (T2D) and dementia is known, it is less clear whether this relationship extends to cognitive decline. Our aim was to examine whether baseline fasting plasma glucose, insulin, HOMA-IR, and HbA1c, and T2D status predict cognitive decline in a multicenter cohort study of families with a clustering of exceptional survival. We analyzed change across five cognitive tests collected over 7.9 years: Mini-Mental State Examination, Digit Span, Logical Memory, Animal Fluency and Digit Symbol Substitution. Among 2,175 family members (mean age 63±11 years (range 32-100); 54% women), 39.8% had prediabetes and 6.8% had T2D. Multiple linear mixed models were adjusted for age, sex, field center, education, APOEε4 status, BMI and family relatedness. A trend was observed for immediate (p=0.047) and delayed (p=0.037) memory, with normal glucose tolerance (NGT) predicting increased scores, prediabetes showing no change, and T2D predicting decreased scores. Among those without T2D (N=2,026), each standard deviation (SD) higher glucose (11.5 mg/dl) was related to a greater decline in delayed memory (-0.34±0.16mg/dl; p=0.032), each SD higher HbA1c (0.32%) was related to a greater decline in immediate (-0.36±0.15 mg/dl; p=0.016) and delayed (-0.31±0.16 %; p=0.05) memory, while each SD higher HOMA-IR (1.5) was related to a greater decline in Digit Span Backwards (-0.13±0.06; p=0.047). Findings suggest that among individuals with a clustering of exceptional survival, T2D, glucose, and HbA1c may predict greater decline in episodic memory, an ability typically affected early in Alzheimer dementia. The possible mechanisms, including genetic and metabolic mediators, warrant further investigation.
MODELING HETEROGENEITY IN COGNITIVE TRAJECTORIES IN THE FRAMINGHAM HEART STUDY
Authors: Fang Yuan , Chen Jiachen , Murabito Joanne , Lunetta Kathryn 
Published: December 2023

Abstract
The prevalence of cognitive impairment in the population is growing. Maintaining good cognitive health is central to successful aging, independence, and well-being. Although older age is generally associated with worse cognitive function, there are substantial heterogeneities in the rate of cognitive decline across different cognitive domains and in terms of the clinical onset age of dementia. Recently, harmonized factor scores measuring global cognitive function for the memory, executive function, and language domains have been created in the Framingham Heart Study (FHS). In this work, we identified FHS participants with two or more repeated factor scores after the age of 60 (n=2339; 57% female; 17% APOE-ϵ4 carriers; 64% attended colleges) and were dementia-free at the baseline visits. We fitted latent class mixed models (LCMM) to cluster cognitive trajectories from all three domains using the harmonized factor scores. Non-linear trends with age in the trajectories were modeled via piecewise linear LCMM models followed by stepwise selections to select cluster-specific change points. We identified different latent classes of participants, some characterized by an early cognitive decline before age 70 as compared to late decliners, across different domains. Using 10-fold cross-validation, we also showed that the subgroupings of participants are stable. Our findings indicate class-related differential patterns in cognitive aging in the FHS. Future associations between the identified subclasses, cognitive outcomes, and physical or biological markers may advance the knowledge of multiple pathways of cognitive aging.
HYPERTENSIVE URGENCY IN OLDER ADULT WITHOUT HYPERTENSION HISTORY: THE DANGERS OF OVERTREATMENT WITH LEVOTHYROXINE
Authors: Evardone Vanessa Joyce , Gendernalik Jesssica , Blondet Ricardo , DiScala Sandra , Silverman Michael 
Published: December 2023

Abstract
A 72-yr old woman with well-controlled depression and active lifestyle was seen at urgent care for “nervousness.” She was found to have borderline tachycardia and blood pressure of 187/114 mmHg. There were no other associated symptoms. Physical examination and labs were unremarkable, with normal renal function. EKG showed sinus tachycardia at 110 bpm. Recheck of BP after 30 minutes was 135/80mmHg, and she was discharged home on Lisinopril. Two days later, she again had “nervousness” and was taken to the Emergency Department. Blood pressure was 200/105 mmHg. Again, she denied any other symptomatology, and had unremarkable physical exam and labs. Repeat BP was improved, and she was discharged home with instruction to follow up with PCP. Medication list included Bupropion for depression which she has been taking and tolerating well for years, and Levothyroxine 25 mcg daily, which was started by her PCP 8 weeks prior, for TSH of 5.43 mIU/L and FT4 of 1.1 ng/dL. Thyroid hormone therapy was stopped during recent ED visit, and she has had no recurrence of her anxiety symptoms. Her BP has been checked daily at home and has been at baseline level.
A PILOT STUDY OF YIN YOGA AND THE EFFECTS ON BURDEN AND SELF-COMPASSION IN CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Parkman Suzanne E , Olausson Jill 
Published: December 2023

Abstract
Informal caregivers for persons with dementia face tremendous challenges in balancing their own needs and those of the care recipient. The purpose of this pilot study was to test the feasibility and acceptability of a Yin yoga intervention on caregiver burden and self-compassion. Authors explored recruitment, retention, adherence, and satisfaction with the yoga intervention. Using the three elements of the Neff’s Model of Self-compassion, this pilot study was a quasi-experimental pre/post comparisons of caregiver burden (Zarit Burden Interview Scale-ZBI) and self-compassion (Neff Self-compassion Scale-SCS) in which the participants served as their own control group. A total of five participants (N=5) were recruited and completed an 8-week Yin yoga intervention via Zoom. Statistical analysis revealed non-significant results for ZBI (t (4) = .95, p= .39) and SCS (t(4) = -.23, p= .83). Wilcoxon signed rank test identified two questions on ZBI pre-and post-intervention had differences approaching significance (p= .059). Despite the non-significant results, burden was decreased in three participants and self-compassion scores were increased in four participants. The main perceived benefits were ease of survey process, feeling relaxed after intervention, and treatment fidelity. The main barriers identified were recruitment and retention of participants throughout the 8-week intervention. Overall, we found the study protocol to be feasible and acceptable. Possible modifications to the study would include extending the scope of the study nationally in efforts to recruit maximum participants. Future research is needed with larger sample sizes, randomization, control of confounding variables, and efforts to promote recruitment and retention of participants.
CHARACTERIZING END-OF-LIFE COMMUNICATION IN FAMILIES
Authors: Horning Melanie 
Published: December 2023

Abstract
The chronic disease course can be uncertain, contributing to delayed end-of-life discussion within families resulting in missed opportunity to articulate wishes, increased decisional uncertainty, and delayed hospice care. Consistent with the Family Communication Patterns Theory (FCPT), family communication patterns may increase understanding of end-of-life discussion, hospice utilization, and may affect the experience of “a good death.” This cross-sectional study used a modified Revised Family Communication Pattern instrument (RFCP) to examine the family communication characteristics of 56 family members of loved ones who died from chronic illnesses while in hospice. Most families (42.9%) were pluralistic, reporting communication styles with high conversation and low conformity orientation; (39.29%) were protective, reporting low conversation and high conformity orientation. Pluralistic families had more end-of-life conversations than did protective families. This study’s findings support the idea that using the RFCP to assess familial communication patterns may be useful for end-of-life conversation and decision-making
FEAR OF FAILING: PERSPECTIVES ON HOME- AND COMMUNITY-BASED SUPPORT SERVICES FOR RURAL CAREGIVERS
Authors: Marfeo Elizabeth , Chamberlin Elizabeth , Venegas Maria , Moo Lauren 
Published: December 2023

Abstract
Many older adults rely on family caregivers not only for day-to-day assistance, but also to help navigate the healthcare system and attend medical visits. Finding, scheduling, arranging transportation for, and attending medical visits involves considerable planning, adaptability to a broad array of contextual factors, and can often cause disruption in day-to-day routine of both the family caregiver and the older adult. For Veterans living in rural areas, limited VA and community resources may magnify these challenges leading to higher caregiving burden and negative health and quality of life outcomes for both the Veteran and caregiver. The aim of this study was to conduct in-depth interviews to better understand key contextual factors related to the logistics of managing and attending medical visits among family caregivers of Veterans living in rural communities (N = 19, mean age 65). A clear disconnect emerged between caregiver needs and (1) access to community support services and (2) effective utilization of existing services. Seventy-nine percent of the caregivers reported living with the Veteran and receiving no home services. Interviews revealed both the caregiver and Veteran having significant, complex healthcare needs. Caregivers described fears of their own health negatively affecting their ability to continue providing sufficient supports for their loved one, lack of resources for home management needs, and limited access to transportation assistance. Findings from this study are important for informing continued development and evaluation of caregiver support programs nationwide, especially among those living in rural communities.
UNMET NEEDS OF CAREGIVERS OF HOSPITALIZED VETERANS LIVING WITH DEMENTIA: A QUALITATIVE STUDY
Authors: Horstman Molly , Guo Crystal , Sonnenfeld Mandi , Evans Tracy , Stevens Alan , Kunik Mark 
Published: December 2023

Abstract
Family caregivers are essential to safe care transitions for hospitalized adults living with dementia. We aimed to identify resource and training needs of dementia caregivers during care transitions. We conducted semi-structured interviews with caregivers (6 Spouses, 5 Children, 1 Friend) of hospitalized Veterans with dementia at the Michael E. DeBakey Veterans Affairs (VA) Medical Center. Interviews were recorded and transcribed verbatim. Rapid qualitative analysis using structured summaries and matrices were conducted. Although caregivers received information about the Veteran’s admitting medical condition, health professionals did not ask about dementia or provide dementia-related health information to the caregiver. Caregivers were willing to assist Veterans with activities of daily living in the hospital; however, caregivers were either prevented from assisting or did not receive training to assist Veterans safely. Caregivers desired information on how to get the Veteran “back on track” and address cognitive and functional declines experienced in the hospital. Although pre-hospital services and supports were easy to restart, caregivers needed earlier and more consistent communication regarding new services and supports starting after discharge, such as rehabilitation at skilled nursing facilities and respite care. Caregivers expressed a need for health professionals to help set “realistic expectations” for post-discharge care as some services and supports did not meet their expectations. Caregivers valued access to support groups for themselves but received inconsistent referrals to the VA Caregiver Support Program. These results will inform the adaptation of a dementia caregiver support intervention for caregivers of hospitalized Veterans living with dementia.
COMPARISON OF DIAGNOSTIC COMPLEXITY AND IMAGING DECISIONS IN YOUNGER, MIDDLE AGE, AND OLDER ADULTS
Authors: Saraswathula Varun , Mwinyogle Aubrey , Schadt Lili , Kowdley Gopal , Kelz Rachel , Friedman Ari 
Published: December 2023

Abstract
A primary reason for visit of abdominal pain in the emergency department (ED) defines a syndromic presentation that can carry morbidity and mortality comparable to a myocardial infarction. Whether imaging decisions in the ED adequately account for this risk, and whether this risk is mediated in part by greater diagnostic complexity remains unknown. In a prospective cohort of 1,169 patient visits to a US community ED, a surgeon codified each visit according to history, examination, laboratory testing, imaging (the acuity of CT findings), diagnosis, and disposition. Chi square tests (two-tailed, alpha=.05) tested for differences between age groups (younger: 18-40, middle: 40-60, older adult: 60+). We found that 42.5% of younger adults received a CT, compared to 66.7% and 70.0% of middle age and older adults (P&lt; 0.001). 20.5% of CT findings were acute in younger, 34.0% in middle, and 39.6% in older adults (P&lt; 0.001). The top 3 acute diagnoses accounted for 75.5% of younger, 62.9% of middle, and 62.7% of older adults, with Herfindahl Indices of 0.25 for younger, 0.16 for middle, and 0.15 for older adults. ED clinicians tested modestly more in older adults, but still potentially over-test younger adults and under-test older adults as judged by test positivity. Older adults had greater diagnostic complexity than younger adults. Dissemination of these findings may improve appropriateness of testing.
LEVERAGING NURSING ASSESSMENT DATA TO IDENTIFY FRAILTY INDICATORS OF HOSPITAL DISCHARGE DISPOSITION
Authors: Ser Sarah , Solberg Laurence , Bjarnadottir Ragnhildur , Lucero Robert , Prosperi Mattia , Snigurska Urszula , Celso Brian 
Published: December 2023

Abstract
Frailty among older adults is associated with higher morbidity and mortality rates and poorer hospital outcomes. Although frailty is not routinely assessed in the hospital setting, elements of frailty are captured in nursing assessments. The purpose of this study was to examine components of the Risk Analysis Index (RAI) captured in electronic health record (EHR) assessment data and their associations with discharge disposition. This was a retrospective observational study of EHR assessment data which included encounters of older adult patients (≥ 65 years) who were admitted from home to a medical/surgical unit of an academic hospital in North Central Florida between January 2012 and May 2021. The components of the RAI included in the study were sex, age, cancer, renal failure, heart failure, cognitive decline, unintentional weight loss, poor appetite, and shortness of breath at rest. Descriptive statistics were generated and compared between patients discharged to home versus those who were discharged to Post-Acute Care (PAC) facilities. Unadjusted associations were assessed using univariate logistic regression. Consistent with existing literature on frailty, all but one of the included RAI components (i.e., male sex) exhibited higher odds of discharge to a PAC facility with strong statistical support. Recognizing functional decline due to frailty is integral to the mission of improving patient safety. This study provides a preliminary proof of concept for leveraging existing assessment data in the EHR to capture frailty in older adults. Future studies of the overall predictive value of RAI with disposition are warranted.
LARGE-SCALE ANALYSIS OF HUMAN GUT MICROBIOTA PATTERNS ACROSS GEOGRAPHY AND PEDIATRIC TO GERIATRIC AGES
Authors: Huang Sherri , Chaudhari Diptaraj , Kanani Pushti , Burrow Wesley , Lin Yi , Mankowski Robert , Jain Shalini , Yadav Hariom 
Published: December 2023

Abstract
Limited studies to-date have evaluated differences in gut microbiota across a global and temporal scale. Herein, we aim to examine the gut microbiota patterns across geography as defined by continent and countries and how gut microbiota vary across age groups within each geographic region. To approach these questions, we designed a large-scale analysis of gut microbiota across North America, Europe, Africa, Asia and Oceania. Literature across countries within each region was screened to include publications employing human stool samples and 16s rRNA sequencing of gut microbiota;116 publications resulted from this first screen. In the second screen, publications without metadata files or whose metadata files did not clarify sample type, collection timepoint or location were excluded. Raw 16s rRNA sequencing data for included publications were collected, and metadata for corresponding fastq files were screened to include only those of healthy, non-intervention groups. This final screen resulted a total of 25,665 metadata. Corresponding 16s rRNA gut microbiota sequences will be analyzed via the QIIME2 workflow in which we aim to compare and contrast gut microbiota and diversity across continents and countries and evaluate changes in gut microbiota from pediatric to geriatric age. This study will provide insight on biodiversity on a worldwide scale and inform on the changes in gut microbiota across time, allowing further examination of the role of the gut microbiome in the development of chronic disease in human aging. Altogether, our study represents one of the largest scale evaluation of gut microbiota patterns across geography and time.
UNIQUE MICROBIOME-PROTEOME SIGNATURES OF SALIVA IN PREDICTION OF COGNITIVE DECLINE IN OLDER ADULTS OF MIAGB COHORT
Authors: Chaudhari Diptaraj , Jain Shalini , Labyak Corinne , Golden Adam , GB Mia , Holland Peter , Masternak Michal , Yadav Hariom 
Published: December 2023

Abstract
The prevalence of age-related cognitive decline and dementia is increasing in older adults, with limited prevention and therapeutic options, increasing tremendous burden on healthcare system. Alzheimer’s disease (AD) is the most common age-related cognitive disorder, for which no treatment is available when its pathology is fully developed. Although current FDA-approved therapies are proven to be effective in delaying AD progression, however, inexpensive and non-invasive markers for routine laboratory examination are poorly developed. Studies indicate that poor oral health is associated with a higher risk of dementia via microbiome alteration. In this pilot study, we explored the importance of the multiomics analysis in discriminating cognitively healthy from mild cognitive impaired and dementia by comparing the microbiome and proteomic profiles of saliva from controls (n=37), MCI (n=16) and dementia (n=6) participants of the MiaGB (Microbiome in aging Gut and Brain) consortium. We detected significantly reduced abundance of oral commensals like B. animalis, E. brachy, and F. fastidiosum in MCI and dementia samples than controls with specific increase of P. histicola in MCI and neuronal Aβ1–42 promoting V. parvula in the dementia. In addition, proteome analyses revealed that highly neuronal relevant nitrite-nitrate conversion cycle genes were significantly differed in dementia and MCI than controls. Discriminatory predictive analyses revealed that combination of microbiome and proteome signature are stronger discriminator for dementia/MCI from cognitively healthy controls. Our results indicate the potential links among oral microbiome, proteome and dementia, as well as diagnostic potential for dementia risk.
DIETARY RESTRICTION OF ISOLEUCINE INCREASES THE HEALTHSPAN AND LIFESPAN OF GENETICALLY HETEROGENEOUS MICE
Authors: Green Cara 
Published: December 2023

Abstract
Low protein (LP) diets promote health and longevity in diverse species, andreducing dietary levels of the branched-chain amino acids (BCAAs) leucine, isoleucine and valine recapitulates these effects in C57BL/6J mice, promoting metabolic health in both sexes, and increases lifespan while reducing frailty in males. Each BCAA has unique metabolic effects, and we recently showed that restriction of isoleucine is both sufficient to promote metabolic health and required for the metabolic benefits of an LP diet in C57BL/6J males. Here, we tested the hypothesis that specifically restricting dietary isoleucine could promote healthy aging in adult genetically heterogenous UM-HET3 mice. We find that isoleucine restriction (IleR) improves the metabolic health of both young and old HET3 mice, promoting leanness and glycemic control in both sexes, and reprograms hepatic metabolism, blunting age-related molecular changes in males and, to a lesser extent, in females. Finally, we find that IleR reduces frailty and extends both the median and maximum lifespan of both male and female HET3 mice, but to a much greater degree in males. Our results demonstrate that restricting dietary isoleucine can increase health span and longevity in a genetically diverse population of mice and suggest that reducing dietary levels of isoleucine, or drug regimens that mimic this effect, may be a novel intervention to promote healthy aging.
L-VALINE TREATMENT IMPROVES CELLULAR MITOCHONDRIAL FUNCTION
Authors: Sharma Shakshi , Azhar Gohar , Zhang Xiaomin , Wei Jeanne 
Published: December 2023

Abstract
Branched-chain amino acids (BCAAs) are pivotal for the health of the human body. Leucine, isoleucine, and valine, which make up the BCAAs, are α-amino acids that promote skeletal muscle growth and development. Valine is one of the essential BCAAs required for the synthesis of muscle proteins and the support growth of skeletal muscles. Valine also plays a favorable role in enhancing insulin sensitivity, preserving intestinal health, and optimizing lipid metabolism. Considering the relevance of valine in promoting muscle growth and metabolism, we utilized C2C12 skeletal muscle cell line to investigate the role of valine in regulating mitochondrial functions. C2C12 cells grown on physiological normal glucose media (100mg/dL) were used for the experiments. Cells were treated with a 1.0 mM concentration of valine for 24 h. The effect of valine treatment on gene expression of important mitochondrial-related genes such as PGC-1α, and PGC-1β and mitofusin (MFN1, MFN), and mitochondrial fission 1 (Fis 1) was determined. Further, Oroboros oxygraph-O2K high-resolution respirometer was used to analyze the mitochondrial respiration in the intact C2C12 cells after valine treatment. The results showed increased gene expression of PGC-1α, PGC-1β, and mitochondrial fission and fusin genes after treatment with valine. The basal respiration, leak respiration, as well as maximal capacity of mitochondrial ETC (Electron Transport Chain), were also significantly improved after valine treatment. The findings from this study enhance our understanding of valine as an important nutrient to improve mitochondrial function to drive cellular function and biological processes.