bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION AND RISK PREDICTION OF PAIN AND FALL-RELATED INJURIES AMONG COMMUNITY-DWELLING OLDER ADULTS IN CHINA
Authors: Chen Xiaodong , Shi Kewei , He Lingxiao , Fang Ya 
Published: December 2023

Abstract

Background
Pain is common in older adults and has also been identified as a fall risk factor, whereas the impact and mechanism of fall-related injuries are still unknown. This study aims to examine the association and risk prediction of pain and fall-related injuries among Chinese older adults.

Method
This study enrolled 5,721 older adults from the China Health and Retirement Longitudinal Study (wave 2011-2015). Logistic regression was used to analyze the associations between pain characteristics and fall-related injuries. Furthermore, 2022 older adults with pain at baseline were further used to build a fall-related injury prediction model, using five machine learning algorithms (logistic regression, naive bayesian, random forest, adaptive boosting and artificial neural network) with 118 input variables as candidate features, and SHapley Additive exPlanations was used for the prediction model explanation.

Results
Logistic regression models showed that whether pain (OR=1.35) or pain severity (ORmoderate=1.37, ORsevere =1.48) and multisite pain (OR=1.41) independently predicted fall-related injuries. The Random forest model achieved the best performance among the prediction model with an area under the receiver operating characteristic curve of 0.764. Interpretable results showed that the top 10 significant predictors were: experience of falling, frailty, sex, short physical performance battery, received inpatient care, estimated glomerular filtration rate, lung function, pain quantity, White Blood Cell and Age.

Conclusions
Pain is associated with fall-related injuries among Chinese older adults. Fall-related injury prevention strategies for older adults with pain should specifically focus on fall history, frailty, and women.
ASSOCIATION BETWEEN TIME SPENT OUTSIDE THE HOME AND EXECUTIVE FUNCTION IN PATIENTS WITH PAST TRAUMATIC BRAIN INJURY
Authors: Richards Emily , Donahue Patrick , Moored Kyle , Eldreth Dana , Crane Breanna , Carlson Michelle 
Published: December 2023

Abstract
Time spent out of the home and in the surrounding neighborhood has numerous physical health benefits, but the cognitive benefits are less clear. Evidence suggests that executive functions are important to navigating activity outside the home. This study examined whether time spent outside in participants’ immediate neighborhoods was more strongly associated with executive function than memory. Participants were adults with mild cognitive impairment and history of traumatic brain injury (TBI) enrolled in an immersive computer game intervention (N=11; 63.6% male; mean=59.0 years, range: 42-75). At baseline, participants completed the Life Space Questionnaire (LSQ) and cognitive tests of Stroop (executive function), Rey Auditory Verbal Learning Test (RAVLT) (memory), and Pattern Comparison Test (PCT) (processing speed). Cognitive tests were performed on an iPad to precisely measure reaction time. Pearson correlations were used to examine the association between the LSQ and cognitive measures. Although time spent in the neighborhood was not statistically associated with performance on cognitive measures, the magnitude of the correlations was noteworthy. After adjusting for age and education, days spent in the neighborhood were more strongly associated with better executive function (Stroop) (r=-0.58, p=0.10) and processing speed (PCT) (r=-0.27, p=0.49). Additionally, neighborhood exposure explained a larger proportion of the variance in Stroop and PCT rather than in RAVLT. In patients with past TBI, time spent outside of the home in the neighborhood may be associated with better executive functions through engagement with one’s environment. We will further describe objective measures of time spent outside the home using GPS.
ASSOCIATION OF MASSETER MUSCLE VOLUME WITH RISK OF OSTEOPOROSIS IN OLDER ADULTS: THE BUNKYO HEALTH STUDY
Authors: Abudurezake Abulaiti , Kakehi Saori , Sakamoto Shota , Morikawa Minami , Kaga Hideyoshi , Tamura Yoshifumi , Tabata Hiroki , Kawamori Ryuzo 
Published: December 2023

Abstract
Abstract The relationship between bone mineral density (BMD) and oral function has been previously studied. However, the relationship between the masseter muscle, which plays an important role in oral function, and BMD and osteoporosis in older adults has not been investigated. This study investigated the association between masseter muscle volume (MMV) and old age in relation to osteoporosis prevalence and hip joint BMD. Body composition and BMD of 1534 people aged 65–84 years living in Bunkyo-ku, Tokyo, were measured using dual-energy X-ray absorptiometry. MMV was measured using a three-dimensional medical image analysis system. Participants were divided into five groups based on MMV by 20% for each gender (Quintile 1–5: Q1–5, Q1&lt; Q5). Logistic regression models were employed to estimate multivariable-adjusted odds ratios (ORs) for osteoporosis determined by T-score (&lt;−2.5 standard deviation) using the Q5 reference. Subsequently, analysis of covariance was used to investigate the relationship between MMV and BMD. Adjustment for age, body mass index, smoking history, alcohol intake, calcium intake, 25(OH)D, diabetes, and osteoporosis drugs or estrogen. In men, Q1 had higher hip osteoporosis prevalence than Q5 (OR 11.65; 95% confidence interval, 1.48–1.62, p=0.020). Further, hip BMD was significantly higher in Q5 than in Q1 (p=0.001). In women, MMV and old age was not associated with osteoporosis prevalence. However, hip BMD was significantly higher in Q3,4 than in Q1 (p=0.003). Older adults with lower MMV had lower BMD in the hip joint. Additionally, men had higher odds of osteoporosis of the hip joint.
ASSOCIATIONS BETWEEN COGNITIVE CHANGE AND OBJECTIVE CHANGE IN PHYSICAL ACTIVITY AMONG OLDER ADULTS: THE LIFE STUDY
Authors: Cenko Erta , Seidler Rachael , Cheng David , Pearson Thomas , Manini Todd 
Published: December 2023

Abstract

Objective
To investigate the associations between domain-specific cognitive change and objectively measured change in physical activity in a sample of community-dwelling older adults. We hypothesized that domain-specific changes in cognition are associated with longitudinal changes in physical activity levels.

Methods
We used data from 955 participants from The LIFE Study, a multi-center randomized clinical trial. Longitudinal relationships between cognitive domains (i.e., memory, attention, processing speed, executive function) and accelerometer-measured change in daily minutes of physical activity were examined using multivariable linear regression. Cognitive tests included Modified Mini-Mental State Examination (3MSE), Hopkins Verbal Learning Test (HVLT), Digital Symbol Substitution Test (DSST), Task Switching Test, Eriksen Flanker Test and N-Back Test. Physical activity was measured longitudinally using an accelerometer and was categorized to total, light, and moderate to vigorous according to standardized activity count cut points.

Results
Our results showed an association between cognitive change in the processing speed domain and change in minutes of total (β = 0.47; 95% CI: 0.04, 0.89; p = 0.034) and light (β = 0.42; 95%CI: 0.03, 0.80; p= 0.033) physical activity. Relationships between all other cognitive assessments and physical activity categories were not statistically significant.

Conclusions
This study demonstrates an association between a decline in processing speed and a decline in the duration of total and light daily physical activity in older adults with low to moderate physical function.
ASSOCIATIONS BETWEEN SENSE OF PURPOSE, NEGATIVE AFFECT, AND CORTISOL: EVIDENCE FROM REPEATED DAILY ASSESSMENTS
Authors: Lewis Nathan , Pauly Theresa , Ashe Maureen , Madden Kenneth , Gerstorf Denis , Hoppmann Christiane 
Published: December 2023

Abstract
A growing literature suggests that having a sense of purpose in life is key to supporting optimal aging outcomes. One proposed mechanism for such benefits posits that having strong sense of purpose facilitates better management of and less reactivity to daily negative experiences, which over time may impact health. However, there remains a paucity of research investigating sense of purpose, affective experiences, and biological stress markers as individuals engage in their daily life routines. The present study sought to examine everyday associations between sense of purpose in life, negative affect, and salivary cortisol using repeated daily life assessments. A sample of 170 older adults aged 60 to 87 (M =71.18 years, SD=6.06) completed affect ratings and provided concurrent salivary cortisol samples 4 times per day over 7 consecutive days. Multilevel growth modeling was used to examine whether trait sense of purpose in life moderated within-day associations between negative affect and log-transformed cortisol levels (nmol/L), adjusting for relevant demographic information and factors that may impact cortisol (e.g., time since waking, caffeine intake). Analyses revealed that sense of purpose was indeed associated with lower daily negative affect, but it did not predict everyday cortisol and was also not moderating the within-person couplings between everyday negative affect and cortisol. Our results suggest that purpose in life shapes daily affect dynamics of older adults, yet not through modulating the physiological implications of negative affect. Follow-up analyses will explore whether these findings generalize to vulnerable groups of very old adults and those in poor health.
ASSOCIATIONS BETWEEN THE GERIATRIC DEPRESSION SCALE AND APNEA-HYPOPNEA INDEX IN OLDER ADULTS
Authors: Persad Alyssa , Hammel Edward , Roberts Mitchell , Sappington Erica , Dagum Paul , Iliff Jeffrey , Levendovszky Swati Rane , VandeWeerd Carla 
Published: December 2023

Abstract
The prevalence of sleep apnea increases with age and depression. Sleep plays an important role in memory consolidation, therefore, changes in sleep quality may play a contributing factor to neurodegenerative diseases such as Alzheimer’s. Findings from a retrospective analysis of a randomized control sleep study are presented for healthy participants (N=33) with no self-reported mental health conditions between 11/7/2022-6/7/2023. As part of a larger study, this sub-study occurred in The Villages in a partnership between the UFHealth PHRC and Applied Cognition. Participants completed the Geriatric Depression Scale (GDS-15), and Polysomnography (PSG), with the Apnea-Hypopnea Index (AHI) extracted from the PSG data. The relationship between sleep apnea and depression was examined using descriptive statistics and linear regression. The mean age of participants was 61.9, with 55% being male. GDS-15 scores showed a strong negative correlation with AHI (p&lt;.001), indicating that as GDS scores increased, AHI decreased. The R2 value (0.06) indicates little variation in the data and is a good fit for the model. Limited data due to the small sample size may contribute to the observed relationship. Although the effect size was small, symptoms related to depression could contribute to decreased AHI. A sample from The Villages may be biased towards a higher social cohesion lifestyle than other communities, showing how elements of depression may differently impact sleep apnea. Further studies are needed to identify further associations and implement appropriate interventions.
CANCER HISTORY AND FRAILTY LEVEL IN OLDER ADULTS AND THEIR HEALTHCARE UTILIZATION: EVIDENCE FROM THE NHIS IN THE US
Authors: Su Mingzhu , Liu Siqi , Lao Jiahui , Liu Li 
Published: December 2023

Abstract
Previous studies didn’t compare effect measures of frailty between cancer survivors and counterparts without a cancer history, and this makes us unable to judge whether the impact of frailty is more substantial in cancer survivors. This study aimed to examine the association between cancer history and frailty level with healthcare utilization among older adults. A descriptive survey design consistent with the STROBE guidelines was used. 14,562 old adults were identified in the 2019 and 2020 National Health Interview Survey (stratified by old cancer survivors [N=3,944] and older adults without a cancer history [N=10,618]). Frailty was assessed by Fatigue, Resistance, Ambulation, Illness, and Low BMI. Healthcare utilization was measured by urgent care, emergency care, hospitalization, delayed care, and needed but did not get care. Multivariable logistic regressions were used to examine the association between frailty-cancer characteristics and healthcare utilization. Participants with cancer (vs without) were older (75+: 49.7% vs 36.8%) and more likely to be frail (23.8% vs 14.5%) and pre-frail (36.0% vs 33.7%). The strength of associations between cancer and health utilization (emergency care and hospitalization) among older adults was significantly modified by their frailty status. Compared with robust older adults, frail cancer survivors were more likely to report emergency care (OR=4.7, 95% CI: 3.9–5.8) and hospitalization (OR=5.6, 95% CI: 4.5–7.0). Our findings are essential for risk stratification and informed decision-making in future healthcare service provision planning.
CARE COMPARE STAR RATINGS AND FAMILY SATISFACTION IN MARYLAND NURSING FACILITIES
Authors: Millar Roberto , Diehl Christin , Kusmaul Nancy , Stockwell Ian 
Published: December 2023

Abstract
Nursing facilities provide critical services and supports to individuals with long-term care needs. The quality of care in nursing facilities varies depending on facility structural characteristics. Moreover, the measurement and perceptions of what constitutes quality of care varies across stakeholders. We used publicly available data to examine the association between family satisfaction with care and the Centers for Medicare & Medicaid Services’(CMS’s) Care Compare five-star quality ratings in the context of facility characteristics. Facility-level data of family satisfaction with care were merged with CMS’s five-star star ratings of 220 Maryland nursing facilities in 2021. Using univariate and bivariate statistics, we explored differences in family ratings and five-star ratings across facility ownership (for-profit vs. non-profit), geographic location (urban vs. rural), and average resident occupancy (1-60, 61-120, and 121+). Relationships were examined across overall ratings, as well as across subdomain of the two quality rating frameworks (e.g., staffing, autonomy, health inspections). Family members of residents in non-profit, rural, and low-occupancy facilities rated facilities higher. Non-profit and low-occupancy facilities were statistically more likely to be rated four or five stars, while no significant association was observed across geographic location. The association between subdomain-specific family satisfaction and star ratings varied across facilities of different structures. Findings emphasize the need for comprehensive quality of care frameworks that consider views of quality across stakeholders and types of facilities. A clear understanding of nursing facility structure and quality of care is critical to advance data-driven decision making.
CARE COORDINATION INTERVENTIONS FOR DEMENTIA CAREGIVERS: AN INTEGRATIVE REVIEW
Authors: Layne Diana , Logan Ayaba , Lindell Kathleen 
Published: December 2023

Abstract
Alzheimer’s disease is a serious illness with an extended caregiving experience however care coordination interventions often lack integration of palliative care. The aim of this integrative review is to identify existing care coordination interventions which integrate palliative care for community dwelling individuals with dementia and their caregivers. An integrative review guided by the Whittemore and Knafl framework was conducted, and the Mixed Methods Appraisal Tool was utilized to assess study quality. The systematic search was initially conducted in June 2021 and repeated in May 2023 to ensure no additional studies were available in collaboration with a medical informationist. Nine interventions across eighteen publications were identified that incorporated informal family caregivers and were aimed at improving care coordination for community dwelling PLWD and their caregivers. Only a single intervention used the term palliative care while the remaining interventions included traditional components of palliative care such as advance care planning, symptom management, and emotional support. Many existing care coordination interventions are not grounded in theory or conceptual models and have been studied in a homogenous sample which is not representative of the population. Further study of the existing interventions in a more heterogenous sample is needed. Additional research is necessary to better understand the lived experience of those persons with dementia and their caregivers to reduce burden associated with care coordination activities.
CASE STUDY - TREATMENT OF AMIODARONE-INDUCED THYROID DYSFUNCTION IN LONG TERM CARE PATIENT WITH DEMENTIA
Authors: Chen John , Cheng Ling Ling 
Published: December 2023

Abstract
Pharmacodynamic and pharmacokinetic changes in geriatric population warrant a stepwise, patient-focused and interdisciplinary approach for treatment with potent, class III anti-arrhythmic Amiodarone by reviewing 1) benefits of cardiac tachyarrhythmia treatment, 2) risks of adverse drug events (ADE) i.e. pulmonary, hepatic and thyroid dysfunctions, 3) alternative treatment option(s) with consultation1. 81 years old African American female with history of stroke with vascular dementia, non-ST-elevation myocardial infarction (NSTEMI) and Atrial Fibrillation residing in long term care (LTC) was transferred via 911 for intractable supraventricular tachycardia (SVT) stabilized with Amiodarone treatment. The peak level of Thyroid Stimulation Hormone (TSH) 36.67 (reference range 0.35-4.0) reflexed the initiation of Levothyroxine for ADE Amiodarone-induced hypothyroidism, albeit thyrotoxicosis can also result2. Countering the prescribing cascade and polypharmacy, gradual uptitration of Levothyroxine and weaning of Amiodarone resulted in the nadir level of TSH 8.19 (reference range 0.35-4.0)2. Virtual consultation with Cardiology and Endocrinology Teams provided alternative treatment options with recommendations 1) taper off Amiodarone, 2) substitute with beta-blocker Bisoprolol for heart rate control and 3) continue Levothyroxine trending thyroid function tests. Further interdisciplinary research in vulnerable, older patients in LTC settings is imperative to align the risks, benefits, and alternative treatment option(s) of acute and chronic disease with fundamental geriatric principles, including continuous medication reconciliation, shared decision-making, and life care planning. 1 Basaria S, Cooper DS. Amiodarone and the thyroid. Am J Med. 2005;118(7):706-714. doi:10.1016/j.amjmed.2004.11.028 2 Danzi S, Klein I. Amiodarone-induced thyroid dysfunction. J Intensive Care Med. 2015;30(4):179-185. doi:10.1177/0885066613503278
CHARACTERIZING SYMPTOM BURDEN AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: McKay Michelle , Bernhardt Paul , O’Connor Melissa , Leveille Suzanne 
Published: December 2023

Abstract
One-third of symptoms reported by older adults are unexplained and not directly related to a chronic disease diagnosis. This ambiguity contributes to undertreatment and chronic functional burdens in vulnerable older patients. Previous studies have found that older adults often experience multiple co-occurring symptoms that contribute to disablement. Symptom burden in older adults increases healthcare utilization, decrease physical performance, and leads to poorer quality of life. This study aimed to characterize symptom burden in a population-based cohort of community-dwelling older adults enrolled in the MOBILIZE Boston study (n=765). We used descriptive statistics for symptom prevalence including pain, balance, weakness, endurance, sleep difficulty, depression/anxiety and sensory impairments. We used latent class analysis to identify 4 distinct classes based on overall symptom burden: 1) mild (26.6%), 2) moderate (53.8%), 3) moderate-severe (12%) and 4) severe (7.5%). Moderate to high levels of pain, the most prevalent symptom, were reported in all symptom burden classes except the mild class. Older adults with severe symptom burden, group 4, experienced worse levels of all symptoms compared to other classes. They also experienced moderate endurance and weakness symptoms, and mild and/or severe balance symptoms. Older adults in the moderate-severe class tended to also report mild endurance, balance, and weakness symptoms. Understanding overall symptom burden, both in terms of numbers and severity of symptoms, is the first step in determining the impact of symptom burden as a possible new clinical indicator for fall risk and other detrimental health outcomes.
CIRCULATING IMMUNE CELLS ARE ASSOCIATED WITH BRAIN MRI MEASUREMENTS IN THE FRAMINGHAM OFFSPRING
Authors: Cao Yumeng , Doyle Margaret , Chen Jiachen , Ragab Ahmed A Y , Murabito Joanne , Lunetta Kathryn 
Published: December 2023

Abstract
Mounting evidence supports the role of the immune system in brain health, yet little is known about the role of circulating immune cells in brain health. We investigated the association of immune cell phenotypes with brain MRI phenotypes in the Framingham Heart Study Offspring participants who attended Exam 7 (mean age 61, 52% women). Immune cells (43 analyzed here) were determined by flow cytometry and previously published. Analysis of the immune cell phenotypes with MRI measurements of 13 brain regions revealed several significant associations, adjusting for age, sex and CMV status (Model 1) in the full sample (n=703) and the CMV+ stratum (n=327). In the full sample, higher senescent/exhausted CD8+ cells (CD8+CD45RO-CCR7-CD27-(Teff), CD8+CD45RA+CD28-CD57+(TEMRA), CD8+CD27-CD28-) associated with higher cerebrum and frontal gray volumes. These associations were strengthened when cardiovascular risk factors were included in the model (Model 2). In the CMV+ stratum, two CD8+ cell types (TEMRA, and Teff) were significantly associated with higher cerebrum gray and frontal gray matter volumes in both models. Also in the CMV+ stratum, higher levels of CD8+CD45RO+CCR7+CD27+ (Central Memory) were associated with lower frontal gray matter, and higher CD3+ (T cells) cells were associated with higher temporal gray matter and higher CD8 Teff associated with lower cerebrum white volumes. There were no associations of CD4 subtypes with brain MRI measures in the full sample or the CMV+ stratum. These associations with brain volumes in adults aged 40-88 may improve understanding of the role of the immune system early in the brain aging process.