bluuebunny/crossref_metadata_2025_split huggingface dataset:
PROSPECTIVE ASSOCIATION OF INTRINSIC CAPACITY WITH FALLS AND MULTIPLE FALLS IN OLDER ADULTS (NHATS)
Authors: Shi Kewei , He Lingxiao , Chen Xiaodong , Fang Ya 
Published: December 2023

Abstract

Background
Intrinsic capacity (IC) is a recently proposed novel metric of evaluating the overall health condition of older people. The IC has been associated with multiple adverse health outcomes while its associations with falls and multiple falls in community-dwelling older adults are not well studied.

Methods
2113 community-dwelling older adults (aged 68-97 years) were selected from two waves of the National Health and Aging Trends Study (NHATS). Data of five IC domains (cognitive, sensory, locomotion, vitality, psychological), falls and multiple falls were collected via questionnaires at baseline and a 4-year follow-up. The IC was evaluated as an IC score calculated by averaging the Z-score in each IC domain. Logistic regression was used to analyze the associations between falls and IC scores with controls for age, gender, marital status, comorbidity index and social activity index.

Results
A higher baseline IC score was associated with a lower risk of falls (OR= 0.459, 95%CI [0.309,0.681]) and multiple falls (OR= 0.278, 95%CI [0.154, 0.502]). Participants with smaller IC score change demonstrated greater risk of fall (OR= 0.512, 95%CI [0.336, 0.777]) and multiple falls (OR= 0.238, 95%CI [0.128, 0.435]). In terms of interactive effects, there were also no significant interactions between baseline IC score and IC score change in their associations with fall outcomes.

Conclusions
The IC is longitudinally associated with falls and multiple falls in older adults. Our findings emphasize the potential role of IC as a valuable marker for predicting fall risk in the older population.
PSYCHOSOCIAL PHENOTYPES OF OLDER ADULTS WITH PAIN AND THEIR ASSOCIATED CLINICAL OUTCOMES
Authors: Holmes Ashleigh , Wang Weijun , Chang Yu-Ping 
Published: December 2023

Abstract
Older adults experience higher rates of pain than any other age group, with a domino effect on quality of life and well-being. Existing literature reveals associations between pain and adverse psychosocial, physical, and cognitive outcomes, with psychosocial variables linking all other aspects of well-being in older adults. Therefore, a comprehensive understanding of the associations of psychosocial variables with clinical outcomes in older adults with pain is needed. Grounded in the Biopsychosocial Model of Chronic Pain for Older Adults, we analyzed cross-sectional 2021 data from the nationally representative survey conducted by the National Health and Aging Trends Study. We performed latent class analysis to identify psychosocial clusters (including anxiety, depression, affect, self-realization, resilience, and social participation) of older adults with pain and then used multiple regression analyses to compare pain characteristics, physical health, and cognition among different clusters. We identified four clusters: “Intermediate Psychosocial Phenotype,” “Favorable Psychosocial Phenotype,” “Adverse Psychosocial Phenotype,” and “Compensated Psychosocial Adversity.” Clusters with more psychosocial adversity had worse pain, physical, and cognitive outcomes while controlling for race/ethnicity, gender, and age. Increased self-realization and resilience were seen in clusters with better clinical outcomes. Our findings provide important information for precision pain management interventions for older adults based on their psychosocial phenotypes. Further research should analyze longitudinal trajectories of psychosocial phenotypes as older adults’ pain experience progresses. Clinically, pain treatment decisions should include a comprehensive evaluation of psychosocial factors, with associated health policy initiatives aimed at assessing differences in care utilization and cost among older adults based on phenotype.
PTSD IS ASSOCIATED WITH LONGITUDINAL CHANGES IN DOMAIN-SPECIFIC COGNITIVE FUNCTION IN OLDER ADULTS
Authors: Lawrence Karen , Speaks Hannah , Abner Erin , Schmitt Frederick , Vasterling Jennifer , Smith Brian , Segerstrom Suzanne 
Published: December 2023

Abstract
Posttraumatic stress disorder (PTSD) is associated with an increased risk for all-type dementia yet whether PTSD is associated with domain-specific cognitive decline, that may lead to dementia, is unknown. Using existing data from the National Alzheimer’s Coordinating Center, we tested the hypothesis that PTSD is associated with cognitive decline in episodic memory, working memory and attention, and executive function. After exclusion for history of dementia, stroke, Down syndrome, Parkinson’s and Alzheimer’s diseases, schizophrenia, and neurodevelopmental disorders, 130 (1.25%) participants with PTSD and 10,261 (98.75%) without PTSD remained. Prior to analysis, inverse probability of treatment weighting was used to adjust for confounding. Inverse probability estimates were based on PTSD status and conditional on covariates for age, sex, race, ethnicity, APOE ɛ4 status, anxiety, depression, TBI status, diabetes, and hypertension. Generalized estimating equations (GEE)-type linear regression models with robust standard errors were fit to the weighted data for z-scores for each cognitive domain. During the study, unexpectedly, PTSD was associated with an additional .043 standard deviations of improvement in episodic memory (b = .043, 95%CI: .020, .066) compared to the same population without PTSD. Expectedly, PTSD was associated with an additional .143 standard deviations of decline in working memory and attention (b = -.143, 95% CI: -.225, -.062) and an additional .415 standard deviations of decline in executive function (b = -.415, 95%CI: -.563, -.267). Investigations are ongoing to probe the unexpected finding for episodic memory. These findings suggest that PTSD should potentially be a target for early prevention of cognitive decline.
QUALITY OF LIFE AND NUTRITION SCREENING: OVERLAPS, OPPORTUNITIES, AND IMPLICATIONS FOR HEALTHY AGING
Authors: Arensberg Mary Beth , Gahche Jaime , Pemau Raquel Clapés , Kerr Kirk , Dwyer Johanna 
Published: December 2023

Abstract
Quality of life (QoL) is important for healthy aging, both for older adults themselves and healthcare providers/systems caring for them. Eating/nutritious food are essential for maintaining good nutrition status, provide pleasure, help older adults remain healthy/independent, and contribute to important QoL domains. Yet research on nutrition and QoL is limited. This study describes connections between QoL and nutrition by examining QoL instruments and nutrition screening tools used with community-living older adults. 20 validated QoL instruments were evaluated to determine if they included nutrition-related items involving 8 previously identified QoL domains. 75% of QoL screening tools included at least 1 nutrition-related item, most commonly in autonomy (n=11), physical health (n=7), social connection (n=3), environment (n=3), emotional state (n=2), mental health (n=2), and personhood (n=1) domains; none in spiritual feeling domain. 16 validated nutrition screening tools were evaluated to determine how their nutrition items related to the same specific QoL domains; all tools included at least 1 nutrition item related to physical health (n=16). Other domains represented by nutrition items were autonomy (n= 9), emotional state (n=5), social connection (n=5), environment (n=4), and mental health (n=3). Although commonalities existed between QoL instruments and nutrition screening tools in types of nutrition-related items included, there were many inconsistencies/gaps. Only 1 QoL instrument and no nutrition screening tools included items in the personhood domain that were related to enjoyment in eating. Nutrition is a potentially modifiable factor benefiting healthy aging and QoL outcomes; these gaps represent opportunities for further research and policy and program development.
RACISM AND DISCRIMINATION EXPERIENCES AMONG STAFF IN LONG TERM CARE HOMES
Authors: Nerayo Liwam , Travers Jasmine , Wagner Laura 
Published: December 2023

Abstract
In long term care facilities (LTCFs), there is a growing population of people with dementia and an increasingly racially and ethnically minoritized care workforce. Previous research has shown that relationships between residents with dementia and minoritized care workers have been contentious, involving several racial and discriminatory acts (e.g., racial slurs, physical abuse). This has led to an unsupported and burnt out care workforce. The aim of this study is to develop a survey tool, aimed at examining experiences and understanding the prevalence of racism and discrimination in the LTC care workforce. We pilot tested the study in two LTCFs and performed content validity with experts. We then deployed the survey across 560 facilities in racially and ethnically diverse states. When analyzing responses from the first 113 nursing assistants and vocational nurses, we found that many of the respondents reported having positive perceptions of residents with dementia and no experiences with racism. However, among the one-third of care workers who did experience racism, we discovered that respondents primarily experienced racism through verbal insults (48%) and care refusal (23%). Over 87% of victims of this experience felt supported by their manager, yet only 50% reported getting reassigned. Finally, almost 80% responded that it is more challenging to care for residents who exhibit racist behavior. This feedback on the perspectives and experiences of the care workers who did experience racism can inform improvements for dementia care training and offer discussions among stakeholders and families. Additional data from more diverse LTCFs is forthcoming.
REAL EXPERIENCE OF FRONT-LINE NURSING HOME STAFF DURING COVID-19: A SYSTEMATIC REVIEW AND META-SYNTHESIS
Authors: Yang Xiufen , Qu Chaoran , Peng Weisi , Xiong Lile , Guan Hua , Luo Weixiang , Cheng Yiping 
Published: December 2023

Abstract

Objective
The COVID-19 has become less of a threat around the world. However, the threat to nursing homes and older adult still exists. The study aimed to explore the challenges and coping strategies of front-line nursing home staff during COVID-19 and provide recommendations for coping strategies and measures for public health of emergency in nursing homes in future. Design: Qualitative Meta-synthesis. Date sources: From the beginning until 30 May 2023, searches were conducted in five international databases (CINAHL, PubMed, Web of Science, PsycINFO and Cochrane library). The studies were screened and reviewed separately by two reviewers using the checklist from Joanna Briggs Instifor assessing qualitative research. A pragmatic meta-aggregator approach was applied to synthesise the findings.

Results
The meta-synthesis included 16 qualitative studies and four mixed studies, which included 642 participants were analyzed to identify 199 findings that were organized into 15 categories and combined into three syntheses. Three synthesised findings were concluded: ①The challenge of the front-line nursing home staff during the COVID-19, ②The coping strategies of the front-line nursing home staff during the COVID-19, and ③Suggestions for future nursing homes to deal with public health of emergency. Conclusion(s): Social/Health organizations and government, especially health organization, should make joint efforts to provide guidance knowledge and practice, and long-term material and mental support for nursing homes. To improve the quality of life of residents and staffs in nursing homes, further research should implement high-quality interventions based on the victory fighting epidemic experience and clinical treatment.
RECOGNIZING THE ROLE OF PETS IN HOME ASSESSMENTS FOR OLDER ADULTS
Authors: Keeler Carlyn Ellison , Struckmeyer Linda , Applebaum Jennifer 
Published: December 2023

Abstract
To support aging in place, health professionals may identify safety and accessibility concerns via home assessments. Although 50% of older adults share their homes with pets, standardized home assessments often overlook pet care, an instrumental activity of daily living (IADL). To bridge this gap in existing knowledge, we conducted four focus group sessions with older adult pet owners to identify potential elements for a novel assessment tool. We utilized directed content and thematic analysis, informed by the International Classification of Functioning, Disability and Health model. Researchers recruited a purposive sample of older adults (65 years or older) who were the primary caretakers of a dog or cat. Participants (N=30) discussed age-related changes to their body’s function that hindered their participation in pet care activities (e.g., the strength needed to pick up a pet). Participants explained how the interaction of their pets and housing features (e.g., stairs) contributed to falls and injuries. Further, personal factors (e.g., restricted income) may contribute to home safety issues (e.g., unable to afford needed modifications). The results indicate that pets’ behavior, care needs, and caregiving activities may impact home safety, thereby influencing the potential for aging in place. Findings support the development of holistic approaches when evaluating older adults’ functioning in their homes and emphasize the importance of pet care within home assessments.
RECONSTRUCTING PERSON-CENTEREDNESS FROM A SYSTEMS PERSPECTIVE: IMPLICATIONS FOR THE CARE OF OLDER ADULTS
Authors: Syed Ayesha , Sloane Philip , Zimmerman Sheryl , Fazio Sam 
Published: December 2023

Abstract
Person-centeredness has become a common, almost hackneyed phrase in the context of care for older adults, despite a lack of consensus regarding its definition, measurement, and application. As part of a series of studies aimed at better understanding person-centeredness, we sought to identify key themes about person-centeredness as it applies to the system (macro) level, as opposed to the setting (meso) and interpersonal (micro) levels. Four think-tank meetings (two in-person; two virtual) were held and results analyzed; the 32 participants included researchers, providers, policy makers, ethicists, and consumers. Think-tank meeting prompts addressed a range of systems, including education, government, workplace, and healthcare. Analyses identified themes associated with variation in person-centeredness. Five key themes emerged: (1) The goals and manifestation of person-centeredness vary depending on the type of system, level within a system, and the role of the individual within the system. (2) Principles of person-centeredness from the hospitality industry can be applied to other settings, including healthcare and long-term care. (3) Some limits on person-centeredness are necessary for system success. (4) The amount of person-centeredness provided in a setting depends on available resources such as time and money. (5) Societal inequities, such as discrimination, bias, and language barriers, hinder person-centeredness. Presentation of results will draw parallels between a variety of systems, demonstrating universal applicability, including to healthcare and long-term care for older adults. The themes identified may help guide future policy and practice regarding realistic and effective application and evaluation of person-centeredness in relation to the care of older adults.
REENGAGING AFRICAN AMERICAN AND BLACK OLDER ADULTS DURING THE COVID-19 ERA: A FOCUS GROUP STUDY
Authors: Parekh Rupal , Tocchi Christine 
Published: December 2023

Abstract
Churches and senior centers are social engagement hubs for older Black and African Americans (BAA) that can positively impact well-being. Although these facilities re-opened after the COVID-19 pandemic, engagement with these facilities has not returned to pre-pandemic levels. Our long-term goal is to develop a behavioral intervention to address the re-engagement needs/concerns of BAA older adults as a means of preventing/reducing depressive symptoms and disability. In the first phase of this work, we used a community-based participatory research approach to determine barriers to, and facilitators of, activity reengagement through the perspectives of leaders of BAA churches and senior centers around Hartford, Connecticut. We conducted three focus groups with key stakeholders (n=4 senior center staff; n=4 senior center staff; n=5 church staff) between May 2023 and July 2023. Using a Framework Method approach and semi-structured interviews, participants were asked to define engagement as it relates to senior center and church involvement since re-opening and to quantify, in their own words, the problem of disengagement. Participants were also asked about the effectiveness of online engagement vs. in-person engagement and members experience(s) with social isolation and loneliness. Line-by-line thematic analysis of the transcriptions was used to identify and group meaningful phrases and responses into major themes. Three organizing themes emerged: “transportation” concerns impacting members during COVID-19 pandemic, increased health issues among members; and issues and concerns related to family support. Leaders from churches and senior centers provided valuable insights into the overarching issues affecting re-engagement among older BAA senior center and church members.
RELATIONSHIP BETWEEN LEISURE CONSTRAINTS AND WELL-BEING IN MIDDLE TO OLDER ADULTS
Authors: Tian Junyan , Sardina Angie , Allan Alexa , Gamaldo Alyssa , Mogle Jacqueline 
Published: December 2023

Abstract
Leisure activity engagement is correlated with several health outcomes, such as depression, a lower risk of dementia and better physical health. However, older adults report experiencing leisure constraints in daily lives due to intrapersonal (e.g., stress), interpersonal (e.g., interaction with friends) and structural factors (e.g., availability of opportunity). Since relatively few research investigated the impact of leisure constraints on middle and older adults’ eudaimonic well-being, the major aim of this study was to explore whether perceived leisure constraints are uniquely associated with eudaimonic well-being after adjusting for sociodemographic, loneliness, health and neighborhood covariates. This study accessed leisure constraints using Leisure Barriers and Interest Questionnaire, and accessed eudaimonic well-being by 4 items from the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire among 378 adults (age range: 40-92, M = 58.4). Correlation results indicated that better well-being was correlated with less perceived leisure constraints (r = -.40, p &lt; .01), greater household income (r = .14, p = .01), less reported loneliness (r = -.53, p &lt; .01), greater reported neighborhood safety (r = -.18, p &lt; .01), and better reported neighborhood quality (r = .23, p &lt; .01). Linear regressions revealed that individuals who perceived a lower level of leisure constraints associated with better well-being (β = -0.20, p &lt; .01) after adjusting for age, sex, income, health conditions, loneliness, and neighborhood quality and safety. Our results highlight the importance of reducing leisure constraints in intrapersonal, interpersonal and structural levels to help older adults live a meaningful and happy life.
RELATIONSHIP BETWEEN QUADRICEPS ECHOGENICITY AND KNEE EXTENSOR STRENGTH IN OLDER ADULTS: A SYSTEMATIC REVIEW
Authors: Harris-Love Michael , Oranchuk Dustin , Boncella Katie , Rush Ben , Bodkin Stephan 
Published: December 2023

Abstract
The clinical availability of assessing muscle quality through diagnostic ultrasound provides a viable screening tool for geriatric syndromes that impair mobility. However, relationships between muscle echogenicity and clinical assessments require further inquiry. The authors aimed to systematically identify and synthesize the literature regarding the relationship between quadriceps echogenicity and maximal knee extensor strength in older adults. A total of 12 extracted articles (N=701, 73.6±5.4 years) independently assessed the relationship between quadriceps echogenicity and peak knee extensor torque. Correlations were weak to moderately negative between knee extensor strength and rectus femoris echogenicity in older adults (mean ±standard deviation; r=-0.398±0.159 [range=-0.681 to -0.080]). While the limited number studies did not warrant advanced analyses, but it appears that the echogenicity of the vastus medialis (study n=3, r=-0.426±1.97 [range=-0.640 to -0.253]) and vastus lateralis (n=3, r=-0.411±0.095 [range=-0.511 to -0.322]) may be superior to the vastus intermedius (n=4, r=-0.341±0.166 [range=-0.484 to -0.120]) and rectus femoris (n=7, r=0.290±0.140 [range=-0.460 to -0.080]) for predicting knee extension strength in older adults. Furthermore, averaging across multiple quadriceps muscles generally improved correlations (n=4, r=-0.544±0.154 [range=-0.681 to -0.334]). Overall, correlations with knee extensor strength were stronger when echogenicity was corrected for subcutaneous fat thickness (n=3, r=-0.491±0.04 [range=-0.521 to -0.453]). However, results regarding fat correction were inconsistent within studies (n=2, uncorrected r=-0.120 and -0.527 versus corrected r=-0.500 and -0.453, respectively). Future studies should aim to report correlations for all quadriceps muscles and for both corrected and uncorrected echogenicity values to allow for more thorough analytical approaches.
ROAD DIETS IMPACT ON DRIVING BEHAVIOR AMONG OLDER ADULTS WITH AND WITHOUT PRECLINICAL ALZHEIMER’S PATHOLOGY
Authors: Carr David , Wisch Julie , Ances Beau , Babulal Ganesh 
Published: December 2023

Abstract
Road diets (that is, the reallocation of one or more lanes of car traffic to other uses) have been proposed as a modification to increase pedestrian safety, particularly for older adults. We considered the impacts of road diets on aging drivers, and on those with early pathological accumulation of AD. We observed naturalistic driving data for 60 cognitively normal older drivers (Age Range = 62 – 87 years, Median = 75 years) driving across three road segments located in St. Louis, Missouri. We used neuroimaging and lumbar puncture derived biomarker data to determine which of the drivers had preclinical AD. Since previous AD studies identified a variety of changes in driving behavior among older drivers with preclinical AD, we examined driving speed before and after lane repurposing. We found that drivers with preclinical AD drove at lower speeds compared to those without preclinical AD prior to road diet implementation. After lanes were repurposed, there was no statistical difference in the speed between older drivers with and without preclinical AD. We evaluated cognitive performance and found that attentional control had a mediating effect on driver speed, suggesting that an individual’s ability to focus on a specific task and filter out distractions was associated with faster driving. Driving speed after lane repurposing is not mediated by attentional control, suggesting that road diets are impervious to individual driver capacity. We conclude that lane repurposing has potential as an important mobility infrastructure solution that could enhance older driver safety and facilitate aging in place.