bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMAGING MICROSCOPIC NEUROPATHOLOGY OF ALZHEIMER’S DISEASE USING MRI: FROM MODEL SYSTEMS TO HUMAN IN VIVO
Authors: Benjamini Dan 
Published: December 2023

Abstract
Microstructural magnetic resonance imaging (MRI) techniques are unique among neuroimaging modalities because they probe tissue features at the micron scale that are invisible using other methods. This class of MRI methods promises to address the unmet needs for neuroimaging in Alzheimer’s disease (AD) and related dementias: (1) early detection of subtle cellular and protein alterations and (2) delineation of comorbid pathologies. In particular, diffusion MRI is sensitive to alterations in cellularity and other microstructural changes, and relaxometery MRI is sensitive to chemical composition and macromolecular content. Benefiting from both modalities, multidimensional MRI is a new and emerging modality that maximizes chemical and microstructural information by probing relaxation and diffusion mechanisms simultaneously. This approach is ideal for detecting AD pathology, namely beta-amyloid plaques and Tau tangles, as well as comorbid pathologies, because of the microstructural and compositional alterations they induce in the affected regions. In order to actualize the promise of this method, a bridge must be built between the pathologic changes that define AD and detectable multidimensional MRI signatures. Our strategy starts with a ``bottom-up’’ approach that first uses radiologic-pathologic correlation in postmortem human tissue to elucidate the associations between specific cellular and macromolecular alterations in AD and their unique multidimensional MRI signatures. Building on that knowledge, we can then adapt this technology towards clinical in vivo application and complete the journey from bench-to-bedside.
THE IMPORTANCE OF PERSONALITY TRAITS FOR COGNITIVE HEALTHSPAN
Authors: Yoneda Tomiko , Lozinski Tristen , Graham Eileen , Piccinin Andrea , Muniz-Terrera Graciela 
Published: December 2023

Abstract
The existing literature consistently finds that personality traits are associated with dementia and with risk of mortality. However, few studies have simultaneously examined the impact of traits on dementia while accounting for death as a competing risk, which is critical as dementia and mortality are dependent outcomes and the likelihood of each increases alongside older age. In response, data were drawn from the Rush Memory and Aging Project (N=1954; baseline mean age=80 years; 74% female; up to 23 annual assessments). We used multi-state survival models to investigate whether traits (conscientiousness, extraversion, and neuroticism) were associated with transitions between cognitive status categories (No Cognitive Impairment, NCI; Mild Cognitive Impairment, MCI; dementia) and death. Further, multinomial regression models estimated cognitive healthspan (i.e., years without cognitive impairment) and total longevity. Adjusting for demographics, depressive symptoms, and APOEε4, personality traits were most important in the transition from NCI to MCI; higher conscientiousness was associated with a ~22% decreased risk of transitioning from NCI to MCI (HR=0.78, 95%CI=0.72, 0.85), whereas higher neuroticism was associated with a ~12% increased risk of transitioning from NCI to MCI (HR=1.12, 95%CI=1.04, 1.21). Life expectancy analyses suggested that participants who were higher in conscientiousness were estimated to live longer without cognitive impairment compared to individuals lower in conscientiousness. Findings were similar, though less pronounced, for individuals higher in extraversion or lower in neuroticism. Importantly, none of the traits appeared to be important for total longevity. Together, these results highlight the importance of personality traits, particularly conscientiousness, for maximizing cognitive healthspan.
CHALLENGES AND OPPORTUNITIES FOR RECRUITMENT AND RETENTION OF OLDER HISPANICS FOR CLINICAL RESEARCH
Authors: Samper-Ternent Rafael 
Published: December 2023

Abstract
Older Hispanics represented 9% of the population over 65 years of age in the USA in 2019. That number is expected to increase to 21% by 2060. Representation of older Hispanics in clinical research is not proportional to the projected increase of older Hispanics. I will discuss the lessons learned on recruitment and retention of older Hispanics and their family caregivers from a large multi-site pragmatic clinical trial I am a part of and a small pilot project I am co-leading. The pragmatic trial compares a health-system-based approach and a community-based approach to dementia care. For this pragmatic trial, 2,176 dyads of persons living with dementia and their family caregivers were recruited. More than 20% of participating dyads belong to underrepresented racial and ethnic groups and 8.8% identified as Hispanic. The pilot project tests the cultural adaptation of the Patient Priorities Care (PPC) approach for older Hispanics. For the pilot project, we recruited 5 older Hispanics with multiple chronic conditions (MCC) and 20 Hispanics with MCC and dementia. I will describe the recruitment strategies used in each study, the barriers we faced, and the approaches we think worked best for the recruitment of Hispanics. I will also reflect on the challenges we currently face to conduct pragmatic trials that include older Hispanics and the opportunities for improvement.
ADAPTING A PHYSICAL ACTIVITY INTERVENTION FOR RURAL AREAS: PEOPLE WITH MCI AND CARE PARTNER DYADS
Authors: Hoffman Rashelle , Watanabe-Galloway Shinobu , Riffin Catherine , Monin Joan 
Published: December 2023

Abstract
Rural populations face an increased risk of Alzheimer’s Disease (AD) compared to urban populations. Physical inactivity is a modifiable risk factor of AD and a prevalent issue for people with mild cognitive impairment (MCI) that can be addressed remotely with telerehabilitation. However, rural older adults differ from urban-dwelling as they often view physical activity as physical labor and have unique barriers (e.g., low social support). Involving a care partner for social support and improving physical activity is essential for people with MCI. The telerehabilitation physical activity behavioral (TPAB) intervention involves weekly discussions about self-monitoring physical activity with a FitBit, setting goals, and discussing personal barriers/facilitators and has been shown to be feasible and efficacious to increase daily step count in other older adult populations. Evidence is lacking for the TPAB’s use in people with MCI living in rural settings and their care partners (patient + care partner dyads). Results from the first phase of our study include three focus groups (four people per group) from a Nebraska rural community including medical providers, care partners, and older community-dwelling adults to identify ways to adapt the study design and TPAB intervention for rural patient + care partner dyad implementation. Discussion will focus on feasibility (Person-Based Approach) and adaptation (FRAME framework) of the TPAB intervention for implementation in rural communities. The results of this project will lead towards using telehealth technology to overcome detrimental geographical impacts on health (i.e., living in rural communities) to advance the care for patient + care partner dyads.
THE READYR PROGRAM FOR WELL-BEING IN DEMENTIA: PILOT STUDY AND SIX-MONTH FOLLOW-UP RESULTS AMONG SPOUSE–PARTNER DYADS
Authors: Miller Lyndsey , Steele Joel , Hiatt Shirin , Kaye Jeffrey , Whitlatch Carol 
Published: December 2023

Abstract
The READyR Program assesses and targets everyday routines of care dyads (older adults with cognitive impairment and their co-habiting partners) using in-home sensors and video-conference sessions in order to understand future care needs, and promote greater well-being. This study aimed to evaluate the feasibility, acceptability, and pilot test of efficacy for READyR. Fifteen dyads (96% married) were enrolled in the 6-month study, and randomized to immediately join READyR (n=8 dyads) or to complete READyR after an educational control condition (n=7 dyads). Feasibility was high: 100% of enrolled dyads completed ≥1 session; 80% completed all sessions. Acceptability was also high: responding participants (n=26) reported that READyR helped them express their care values and understand their care needs (92%), that they were comfortable sharing their views (92%) and doing so with their partner present (96%). Hearing and visual impairments were reported to interfere with online sessions for 4 and 6 participants, respectively, but 93% of participants reported that the digital components were easy to use and understand. After receiving the READyR sessions, awareness of future care needs among care partners increased (d = 0.85) and relationship strain for both dyad members decreased (d = 0.58–0.82), when compared to changes among participants in the active control group. No effect was observed on participants’ quality of life, mood, or care-related strain at post-test or at 6 month follow-up. As a remote dyadic intervention, READyR is feasible, acceptable, and may help dyads decrease strain in the care relationship and prepare for future care needs.
USING INTENSIVE REPEATED MEASUREMENT TO EXAMINE THE AFFECTIVE CONSEQUENCES OF NEGATIVE RELATIONSHIP EXPERIENCES
Authors: Witzel Dakota , Cichy Kelly 
Published: December 2023

Abstract
Across midlife and older adulthood, daily relational contexts provide a lens through which daily experiences shape health and well-being. How daily relational contexts inform health and well-being is complex, with buffering and exacerbating effects of the relationship context on well-being reported in past work. One mechanism through which daily relational experiences influence health and well-being is through changes in emotions. The current series of talks examine how daily relational experiences (interpersonal stress, marriage and loneliness, perceived social isolation, caregiving stress) influence emotional well-being using innovative intensive repeated measurement designs. First, using eight days of daily diary data from the National Study of Daily Experiences, Dakota Witzel will consider the protective effects of perceived control on affective reactions to interpersonal daily stressors on the same day and the following day. Second, using a pre-registered, 14-day ecological momentary assessment design, Jin Wen will discuss the potential implications of affective reactions to interpersonal daily stressors on subsequent sleep quality. Third, using 14 days of ecological momentary assessments from the Einstein Aging Study, Karina Van Bogart will explore the moderative influences of marriage and cognitive impairment on the effects of daily emotional loneliness on intrusive thoughts. Finally, using a 14-day daily diary design, Frank Puga will present on the implications of daily caregiver stress and perceived social isolation on perceived emotional control. Kelly Cichy will serve as discussant and summarize the theoretical and methodological contributions of these studies for enhanced understanding of the dynamic interplay between relational experiences and emotional well-being in daily life.
COMPARING EARLIER- VERSUS LATER-BORN CENTENARIAN COHORTS FROM THE HEALTH AND RETIREMENT STUDY
Authors: Lee Gina , Martin Peter 
Published: December 2023

Abstract
The current study aimed to compare the health status of earlier and later born centenarian cohorts. Using the data from the Health and Retirement Study, we selected those who survived to at least 98 years and divided them into earlier (n=189) and later (n=304) cohorts. The birth year of the earlier cohort ranged from 1890 to 1906, and the birth year of the later cohort ranged from 1907 to 1920. We first recoded variables to examine health status when all participants were at least 98 years old. To explore differences in health status between earlier vs. later cohorts, we computed t-tests/χ2 difference tests with activities of daily living, depressive symptoms, self-report of health and health change (SRHC), BMI, current smoking, drinking, cognition, and a number of diseases. There were significant differences in depressive symptoms, SRHC, high blood pressure, and current drinking between the earlier and later centenarian cohorts. The later cohort had significantly higher blood pressure, more depressive symptoms, worse SRHC, and later cohorts had a higher proportion of participants who currently consumed alcohol. Finally, the results of two separate regression analyses predicting depressive symptoms indicated that no demographic or health variables of the earlier cohort significantly predicted depressive symptoms, but years of education and current diagnosis of cancer significantly predicted depressive symptoms for the later cohort. Overall, the later born cohort had a worse health status compared to the earlier born cohort. This findings highlights the need for healthcare providers to pay attention to psychological health among cancer-diagnosed centenarians.
AGE-VARYING COGNITIVE IMPAIRMENT AND SOCIAL SUPPORT AMONG PEOPLE AGING WITH AND WITHOUT HIV
Authors: Bender Alexis , Haardörfer Regine , Perkins Molly , Moore David , Cooper Hannah 
Published: December 2023

Abstract
There is compelling but limited evidence that the combination of HIV, methamphetamine (meth) use, and aging form a deleterious trio that undermines cognitive functioning. Currently, a gap exists in our understanding of the intertwining relationships among drug use, HIV, and cognitive function across biological ages and over time. Interventions to reduce meth use and support brain health among aging PWH are vital and improving social relationships is a promising area of intervention. Cross-sectional and limited longitudinal studies indicate that positive social relationships and social support are associated with better cognitive function among healthy older populations. This association has received limited attention among PWH who use drugs beyond adolescence and young adulthood. This study leverages NIH’s prior and ongoing investments in research to develop a new analytic cohort by combining participants from 23 studies at the HIV Neurobehavioral Research program. Enrollment in this cohort spans from 2009-2021. At baseline, our sample consists of 862 people with a mean age of 52 (range 18-81). Most participants are male (73%), White (74%), and over half (61%) are living with HIV. Using a life course perspective and time-varying estimation modeling, we examine age-varying cognitive impairment and variation in cognitive function across age by HIV status, meth use, and social relationships. First, we examine how cognitive impairment changes over time for the full sample then examine the differing transitions/turning points among those aging with and without HIV and meth use. Lastly, we show how positive and negative social relationships alter these trajectories among each group.
PRESIDENTIAL SYMPOSIUM: IMPACT OF DISCRIMINATORY POLICIES ON LGBTQ+ OLDER ADULTS’ HEALTH AND WELL-BEING AND HOW TO COMBAT THEM
Authors: Kwak Jung , Fredriksen-Goldsen Karen 
Published: December 2023

Abstract
Despite some advances in LGBTQ+ rights over the past few decades, many states lack legal protections against discrimination based on sexual orientation or gender identity, and the current political climate raises concerns about future challenges to LGBTQ+ rights. This symposium explores the implications of discriminatory policies on the health, housing, and economic well-being of LGBTQ+ older adults, and solutions for promoting empowerment, equity, and inclusion throughout the care continuum, from long-term services and supports to end-of-life care. The first presentation describes a complex paradox in which sexual and gender minority (SGM) older adults avoid formal services due to fear of discrimination and poor treatment despite significant health disparities and a lack of informal support, discusses opportunities to improve access and health through education and awareness, and elucidates implications for policy and research. The second presentation describes geographic variations in access to, and receipt of gender-affirming surgery among transgender and gender-diverse Medicare beneficiaries using national Medicare data and discusses policy implications. The third paper focuses the role of spirituality and faith in the lives of LGBTQ+ older adults and reports findings from a mixed-methods study on how involvement in faith communities shape their end-of-life care perceptions and preparation. The fourth presentation describes barriers and facilitators to communicating with SGM hospice patients and caregivers about their sexual orientation and gender identity and recommendations for developing communication training to promote authentic end-of-life care for this population. Karen Frederickson-Goldsen as discussant will provide policy and practice implications of these important works.
FAITH, SOCIAL SUPPORT, AND END-OF-LIFE CARE PREPARATION AMONG LGBTQ+ OLDER ADULTS
Authors: Lampe Nik , Barbee Harry , Tran Nathaniel , McKay Tara 
Published: December 2023

Abstract
Faith communities can provide older adults support as they plan for end-of-life care, but how this support unfolds for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people is uncertain. Although many LGBTQ+ people experience marginalization within faith communities, they also report experiences of acceptance and affirmation. This mixed-methods study investigates how LGBTQ+ older adults’ involvement in faith communities shape their end-of-life care perceptions and preparation. First, we analyze panel data from the Vanderbilt University Social Networks, Aging, and Policy Study (N=1,256) to assess the relationship between faith community involvement and levels of social support. We find that 63% of older LGBTQ+ respondents identify with a religious affiliation, and 31% attend religious services several times a year or more. Attending religious services several times a year are more is associated with having a spouse in the household (11.4 vs 7.1%, p&lt;.05) and reporting larger personal networks (11.7 vs 9.9 individuals; p&lt;.001). Service attendance is also associated with having support when seeking advice about important decisions and having social support from friends. In the second portion of our study, we analyze data from in-depth interviews with 47 LGBTQ+ older adults to understand how faith communities influence preparation for end-of-life care. Many interviewees described their faith communities as guides that help them select reliable healthcare providers and formulate their end-of-life care plans. Overall, these findings reveal important ways that faith communities can foster social support and promote optimal end-of-life care among older LGBTQ+ adults.
BUILDING BRIDGES ACROSS AGE-FRIENDLY ELEMENTS GUIDED BY THE 4MS FRAMEWORK
Authors: Petrovsky Darina , Mitchell Anne 
Published: December 2023

Abstract
The 4 Ms framework is a set of evidence-based elements of high-quality care delivered to older adults. These include What Matters, Mobility, Medication, and Mentation. By following these principles and practicing age-friendly older adults are more likely to experience good quality care that addresses their needs. This symposium aims to build bridges across age-friendly elements that focus on the 4 Ms framework by highlighting the research of four nurse scientists. Representing the “What Matters” element, advance care planning and palliative care interventions aim at understanding and aligning care with older adults’ care preferences. In the first presentation, Dr. Rahemi will present findings of health disparities across sociodemographic groups in advance care planning using data from the Health and Retirement Study. In the second presentation, Dr. Carpenter will report on findings from a pilot pragmatic clinical trial that examined the feasibility, acceptability, and preliminary effectiveness of a primary palliative care intervention among nursing home residents with serious illness. Under the element of “Mobility”, Dr. Sefcik will present findings from a qualitative descriptive study aimed at discovering how the COVID-19 pandemic affected the outdoor activities of senior living community-residing older adults. In the fourth presentation, Ms. Coates presentation examines the last two elements of the framework - Medication and Mentation. She will report on findings from a longitudinal case-control observational study using data from the National Health and Aging Trends Study examining differences in the frequency of unpleasant symptoms experienced by older adults with polypharmacy and/or dementia.
OUTDOOR ACTIVITY ENGAGEMENT PRIOR TO AND DURING THE COVID-19 PANDEMIC IN SENIOR LIVING COMMUNITIES
Authors: Sefcik Justine , Euiler Elizabeth , Na Annalisa , Greenberg Sherry , Katsev Danielle , DiMaria-Ghalili Rose Ann 
Published: December 2023

Abstract
There is growing evidence regarding the benefits of spending time outdoors. However, it is less understood if the COVID-19 pandemic has deterred or increased older adults’ outdoor leisure activities when they reside in senior living communities. This study aimed to discover how the pandemic affects senior living community-residing older adults’ outdoor activities. Older adults 65 and older were recruited through ResearchMatch and university partnerships. A qualitative descriptive approach was taken with semi-structured individual interviews conducted over Microsoft Teams, telephone, or in-person. A conventional content analysis was employed. Interviews were conducted in 2021-2022 with 4 females and 3 males from suburban Pennsylvania. While there were indoor restrictions and regulations (e.g., mask wearing when around others), the outdoor environments were less regulated and routine outdoor activities continued during the pandemic. Facilitators to outdoor activities were: 1) senior living campus features (e.g., paved walking paths, outdoor recreational sport areas), 2) structured outdoor activities (e.g., bocce ball and golfing tournaments facilitated by staff), and 3) access to transportation (e.g., to drive or visit other locations). A barrier to outdoor activities was: needing assistance from staff to exit buildings due to decreased mobility. This study illuminates that amenities and structured activities at senior living facilities promoted mobility in outdoor activities for those who preferred going outside. Findings inform design features that encourage mobility and outdoor activities among older adults. Policy implications include supporting senior living communities with less resources for maintaining campuses and neighborhoods, which could contribute to promoting outdoor activities and health equity.