bluuebunny/crossref_metadata_2025_split huggingface dataset:
SEX DIFFERENCES IN THE LINK BETWEEN DNA METHYLATION–BASED BIOLOGICAL AGING AND HEALTH IN OLDER INDIVIDUALS
Authors: Phyo Aung Zaw Zaw , Fransquet Peter , Wrigglesworth Jo , Woods Robyn , Espinoza Sara , Ryan Joanne 
Published: December 2023

Abstract
It is well-established that women live longer than men, however, sex differences in biological aging have not been consistently reported, and may differ depending on the measure used. This study aimed to determine the correlation between DNA methylation (DNAm) age acceleration (AA) measures, with system-wide frailty-index (FI) aging and brain-predicted age difference (brain-PAD), in an initially healthy population of men and women aged ≥70 years. We additionally explored the extent to which these AA measures were associated with clinical measures, and chronic conditions, separately in men and women. DNAm age (Horvath, Hannum, PhenoAge, GrimAge, and DunedinPACE) were estimated in blood from 560 Australians (women, 50.7%) enrolled in the ASPREE study. FI was a deficit accumulation of 67 items including cognition and morbidities. Brain age was estimated from T1-weighted MRI. Clinical measurements, laboratory tests, and self-reports were used to identify chronic illnesses. FI had the strongest correlation with GrimAA and DunedinPACE (range r: 0.20 to 0.24 in both sexes) but was not associated with HorvathAA. Brain-PAD was not correlated with any biological aging measure. Correlations between AA and clinical measures were more commonly found in women than men and were the strongest for DunedinPACE and clinical measures including grip strength, gait speed, and self-rated health (r: -0.23 to 0.24). AA measures, especially GrimAA and DunedinPACE, were significantly associated with hypertension, diabetes, chronic kidney disease in men, and obesity and depression in women. Our findings highlight the importance of considering sex differences when investigating the link between biological age and clinical measures.
PATTERNS OF ALCOHOL USE OVER TIME AMONG OLDER COUPLES: IMPLICATIONS FOR SELF-RATED HEALTH
Authors: Turkelson Angela , Birditt Kira , Polenick Courtney , Cranford James , Blow Fred 
Published: December 2023

Abstract
Alcohol use in older adults is increasing which can have implications for health outcomes. Research has examined longitudinal patterns of drinking for individuals over time, but not couples. Couples often engage in concordant drinking behaviors but it is unknown if couples become more or less concordant or discordant in their drinking over time or how increased concordance or discordance influences health. The purpose of this study was to examine patterns of alcohol use over time among older couples and their links with self-reported health. A total of 8,570 husbands and wives completed the main interview of the Health and Retirement Study (HRS) for at least three consecutive biennial waves between 1996 and 2016. Latent class growth analysis revealed five trajectories of couple drinking: 1. Concordant - husband and wife light (n = 6398, 75%); 2. Concordant - husband and wife light/moderate (n = 781, 9%); 3. Concordant - husband and wife moderate (n = 296, 3.5%); 4. Discordant - husband heavy and wife light (n = 293, 3.5%); 5. Discordant - husband moderate and wife light (n = 802, 9%). Discordant couples and concordant light couples reported worse self-rated health over time compared with concordant light/moderate and concordant moderate couples. The most common pattern of drinking was concordant drinking with husbands showing light decreasing drinking and wives showing light stable drinking over time. Findings are consistent with literature and suggest that discordant drinking couples have poorer health.
VIEWS ON HELPFUL SUBSTANCE USE RECOVERY PATHWAYS: DO OLDER AMERICANS DIFFER FROM THEIR YOUNGER COUNTERPARTS?
Authors: Meier Naomi , Sharma Rachita , Garland Paula , Moore Ami 
Published: December 2023

Abstract
Recovery from substance use is generally a lifelong process with different pathways. This study used data from the Justice Community Opioid Innovation Network (JCOIN), 2021, a nationally representative survey of over 6,000 American adults, to examine factors that influence the views on most helpful pathways for recovery among older Americans (60 years and older) compared to their younger counterparts (less than 60 years old). Multiple linear regression was used to determine differences across age, political affiliation, cultural identity, and regional location. A factor analysis of 9 questions that asked respondents to rate the most helpful pathways for recovery generated three domains: 1. Medical services enabling environment (PCP, intensive inpatient program, and rehab program); 2. Direct conventional treatment (Prescription medication and therapist); and 3. Sociocultural factors/non-conventional treatment (Family/friends, spiritual/natural healer, self-help group, and faith-based organization). Older and younger Democrats, Independents, and residents of the Northeast and Midwest regions agreed that the medical services were helpful for recovery. While younger and older Democrats believed that direct conventional treatment was helpful, younger and older Republics as well as younger married people believed it to be less helpful. While older Democrats agreed that non-conventional treatments are most helpful, younger Democrats and Independents believed them to be less helpful. However, younger Republicans, Blacks and Hispanics believed that they are most helpful. Given the significant differences in the views of older and younger Americans on helpful pathways to recovery, policymakers and stakeholders are encouraged to be mindful of the several policy recommendations presented in the paper.
USE OF VIDEO-BASED DATA TO INFORM PSYCHOSOCIAL INTERVENTIONS FOR PEOPLE LIVING WITH DEMENTIA
Authors: Wong Gloria Hoi-Yan , Choy Jacky C P 
Published: December 2023

Abstract
The pandemic has accelerated technological developments in care services. Emerging evidence suggests feasibility of delivering evidence-based psychosocial interventions such as group cognitive stimulation therapy using information and communication technology (ICT) platforms. A unique opportunity offered by ICT is the more readily available data at session level to investigate nuanced, theoretically based outcome predictors, to improve efficacy of these complex interventions. Theoretically, the cognitive and wellbeing benefits of group cognitive stimulation therapy is related to the level of person-centred engagement. As part of an ongoing randomised controlled trial involving ICT-delivered group cognitive stimulation therapy, this study examines the use of big data analytics of session behavioural data to develop predictive algorithms of cognitive and wellbeing outcomes. In 78 people living with mild to moderate dementia from 26 groups, we create automatically estimated markers of facial expression and eye movement pattern, and hand-coded markers (using time-sampling method) of engagement level and speech/verbal production information, to autobiographical information presented in the session. These markers are used to predict changes in cognitive and wellbeing outcomes. Pilot analysis using hand-coded speech sample suggested strong correlation between time-sampled engagement level with cognitive benefits, and changes in information content and fluency with cognitive benefits after the group intervention (ranging from r=0.76 to 0.97, p&lt; 0.001). The markers we develop in this study using video-based data from ICT-delivered therapy sessions, including deep learning-based emotion recognition and eye movement analysis with hidden Markov model, allow further application in understanding the mechanisms of action in different psychosocial interventions.
INVESTIGATING PSYCHOLOGICAL FACTORS AS A PREDICTOR OF FEAR OF FALLING AND FALL RISK IN OLDER ADULTS
Authors: Blount Amber , Thiamwong Ladda , Lighthall Nichole , Xie Rui , Park Joon-Hyuk , Loerzel Victoria , Stout Jeffrey 
Published: December 2023

Abstract
Psychological factors related to appetitive and avoidant motivation, perceptions of aging, and regulatory focus (promotion focus on gains versus a prevention focus on non-losses) are likely to play an important role in predicting one’s fear of falling (FOF) and resulting impact on physical activity engagement. This pilot study aimed to investigate the gap in current research related to these psychological factors as predictors of older adults’ Fear of Falling and Fall Risk Appraisal (FRA). The study assessed positive and negative perceptions about aging in regards to control and consequences of aging (Brief Aging Perceptions Questionnaire [B-APQ]), motivation (Behavioral Inhibition System/Behavioral Activation system [BIS/BAS]), regulatory focus in goal achievement (Regulatory Focus Questionnaire [RFQ]), FOF (Fall-Efficacy Scale-International [FES-I]), and static balance levels (BTracks Balance system [BBS]). Participants (n=48) were categorized into four FRA groups: rational (low FOF/normal balance), irrational (high FOF/normal balance), incongruent (low FOF/poor balance), and congruent (high FOF/poor balance). A Spearman Rho correlation found that FOF was positively correlated with two of the BAPQ sub-domains of Control-Positive (ρ = 0.46, p&lt;.001) and Consequences and Control Negative (ρ = 0.43, p =.002),. A Kruskal-Wallis test found the relationship between BAPQ Control Positive and the Irrational and Rational FRA group baselines to be significant. The results suggest that among other psychological factors, perceptions about aging may be predictive of FOF and FRA in aging. These results highlight the importance of clinicians addressing not only the physiological factors of fall risk, but also the psychological factors underlying fall risk in older adults.
POTENTIAL PROTECTIVE EFFECTS OF INSTRUMENTAL ACTIVITIES OF DAILY LIVING ON ALZHEIMER’S DISEASE CHARACTERISTICS
Authors: McCray Rachel , Oruru Daisha , Locklear Clarence , Bubu Omonigho , Turner Arlener 
Published: December 2023

Abstract
Previous research has shown the significance of self-efficacy in improving cognitive trajectory. Additionally, it has been demonstrated that impaired cognitive functioning is a predictor for low functionality in both basic and instrumental activities of daily living (iADLs). However, little research has been done on potential protective effects of iADL functionality on markers of Alzheimer’s disease. To examine if iADL functionality (possibly through self-efficacy) has a protective effect on Alzheimer’s disease characteristics in older adults, we assessed the relationship between functionality and hippocampal atrophy. This study utilized data from the National Alzheimer’s Coordinating Center Uniform Dataset (NACC UDS) covering September 2005 to February 2021. Participants included in the analyses (N=2517, 65.7% women, 11.9% Black/African American, mean age 68.7, SD=9.15) were all cognitively normal. The analyses use baseline Functional Activities Questionnaire (FAQ) assessment, measures of independent living, and required assistance, in addition to presence or absence of Hippocampal Atrophy (measured ~5 years later) in two 2x2 contingency tables. While no relationship between baseline FAQ and later hippocampal atrophy emerged, a relationship between independent living status at baseline and hippocampal atrophy was demonstrated (X2{2,446}=11.38, p=0.003) with higher independence in iADL tasks associated with less atrophy. Though further research is needed, these preliminary results suggest living independently and having agency over iADL tasks may confer some neurocognitive protection and indicate the possibility of less hippocampal atrophy over time in individuals with higher levels of independence. Future studies should also explore the potential positive influence of iADLs on other characteristics of Alzheimer’s disease like cognition.
IDENTIFYING CONFLICTS EXPERIENCED BY OLDER ADULTS WHILE AGING IN PLACE
Authors: Murawski Alaine , Tschoe Marianne , Miller-Winder Amber , Schierer Allie , Relerford Raven , Ramirez-Zohfeld Vanessa , Lindquist Lee A 
Published: December 2023

Abstract
Older adults are faced with making decisions about aging-in-place as their health changes. These decisions create conflicts with others causing stress and frustration. We sought to characterize the conflicts older adults experience. As part of a larger study on decision making about aging-in-place (R01AG058777), we are longitudinally following a cohort of older adults with surveys every 6 months. Subjects are asked to describe conflicts that have occurred regarding their living situation. Responses were coded using constant comparative analysis examining type, content, and whether statements were interests, rights, or power-based. We enrolled 293 subjects (mean age 73.5 yrs, SD 5 yrs, 40.4% non-White; 94.5% retention rate) and 124 conflicts were reported over 18 months. Thematic analysis revealed three types of conflicts: Interpersonal (subcategories: spouse, intergeneration, other), task, and value-based. Content was coded into 6 themes: Location change, home maintenance issues (e.g., My son insisted I put in a new lower tub, and I didn’t want to), different ways of completing tasks (e.g., it is about my children and the way we do things), safety (e.g., Neighbor’s boyfriend kicked in the door and destroyed our property), financial, and health-related. Most statements were either interests or rights-based. Older adults experience a range of conflicts involving aging-in-place decision making. Most often older adults experience interpersonal conflicts with supporters about moving from their home or maintaining/adapting their home. Training in negotiation may help alleviate these conflicts between older adults and their care supporters.
INSOMNIA AND UNHEALTHY ALCOHOL USE DURING THE COVID-19 PANDEMIC AMONG WOMEN VETERANS AGE 50 YEARS AND OLDER
Authors: Tighe Caitlan , Quinn Deirdre , Atchison Karley , Bachrach Rachel 
Published: December 2023

Abstract
Older women Veterans have a high burden of comorbid medical and mental health conditions and may be particularly at risk for co-occurring insomnia and unhealthy alcohol use. Some research suggests rates of both increased during the COVID-19 pandemic; however, few studies extended beyond pandemic year one or examined administrative data. Using Department of Veterans Affairs (VA) electronic health record data, we examined rates of insomnia (diagnoses, prescription insomnia medications) and unhealthy alcohol use (diagnoses, positive alcohol screens) in a national sample of women Veterans aged 50 years and older (N=239,638) prior to and during the pandemic (March 2018-2022). During this timeframe, insomnia rates increased across age groups. Annual insomnia rates were highest among women ages 50-59 (12.8-14.9%) and lower for women age 60 and older (6.2-12.1%). The annual rate of unhealthy alcohol use was also highest among women ages 50-59 (13.9-15.3%) and lower for women age 60 and older (5.4-12.9%). For the youngest and oldest age groups, rates of unhealthy alcohol use decreased annually until 2021 and then increased; for women aged 60-79, rates increased except in 2020, when rates declined. The proportion of women with both conditions in a given year ranged from .5-2.9% and was highest at younger ages and lowest at older ages. Together, results indicate annual rates of insomnia and unhealthy alcohol use during COVID were highest in midlife women but increased over time across ages, signaling a potential need for intervention and prevention efforts aimed at addressing sleep health and alcohol use across mid-late adulthood.
METABOLOMIC SIGNATURES OF HEALTHY AGING AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Yao Shanshan , Marron Megan , Newman Anne , Shah Ravi , Murthy Venkatesh 
Published: December 2023

Abstract
Metabolomic signatures of healthy aging were created by relating comprehensive mass-spectrometry-based metabolomic profiles with the Healthy Aging Index (HAI), a composite of cardiovascular, lung, cognitive, metabolic, and renal function, scored 0-10. Black and white older adults (N=2017, mean age 75 years; 35% Black) in the Health, Aging, and Body Composition Study were randomly divided into a training (70%) and test (30%) sample. In the training sample, metabolites associated with baseline HAI were identified. Penalized regression was used to generate a parsimonious metabolomic risk score for baseline HAI, which was entered into linear regression models for Year 10 HAI and Cox models for mortality adjusting for baseline age, race, gender, and study site. We identified 12 baseline HAI-related metabolites associated with Year 10 HAI after adjusting for baseline HAI. One standard deviation (SD) higher metabolomic risk score was associated with 0.25 [95%confidence interval: 0.10-0.40] higher Year 10 HAI (training adjusted beta: 0.25 [0.10-0.40]; test: 0.42 [0.15-0.68]). Baseline HAI was associated with mortality (training adjusted hazard ratio: 1.54 [1.43-1.66] per SD; test: 1.33 [1.18-1.50]). Adjusting additionally for metabolomic risk score attenuated the association between baseline HAI and mortality by 41% (training) and 67% (test). In this model, the metabolomic risk score was associated with higher mortality (training: 1.28 [1.18-1.40]; test: 1.42 [1.22-1.65]). Pathway analysis suggested that metabolic pathways of Aminoacyl-tRNA biosynthesis, Arginine biosynthesis, and Citrate cycle may contribute to healthy aging. Metabolomic signatures of baseline healthy aging are associated with long-term healthy aging and mortality independent of lifestyle and traditional risk factors.
HOUSING CONCERNS AND TRAJECTORIES OF KINLESS OLDER ADULTS WITH DEMENTIA
Authors: Perry Tam , Taylor Janelle , Mehmood Yasir 
Published: December 2023

Abstract
Housing preferences of older adults (e.g., to remain in residence, or relocate), housing options available, and housing needs related to changing physical and cognitive abilities are common concerns of aging. The challenges are possibly more complex for those living with dementia, who may have difficulty articulating housing preferences, and whose housing needs may include supportive care. For those with dementia who lack close kin, these challenges are likely significantly compounded. This paper focuses on the intersection of housing concerns for 64 participants in the Adult Changes in Thought (ACT) study who were kinless (no living spouse or children) when they developed dementia. All the ACT participants were 65+ when recruited. Everyone in this sample had received a research diagnosis, and their mean age at dementia onset (estimated at the midpoint between the research study that triggered the diagnostic evaluation, and the last research study before that -- usually one year before diagnosis) was 87 (Standard Deviation [SD] 7 years), with a median age of 86 and a range of 71-103.We present an analysis of their housing trajectories, as captured in chart notes from their medical records. We highlight multiple themes illustrating how housing intersects with health and social well-being and conclude by commenting on the potential of medical records for understanding and documenting issues related to housing.
PROJECTION OF MEDICAID SPENDING ON PEOPLE WITH ALZHEIMER’S DISEASE AND OTHER RELATED DEMENTIAS
Authors: Degenholtz Howard 
Published: December 2023

Abstract
As the US population is aging, the number of people with Alzheimer’s Disease and Other Related Dementias (ADRD) is increasing. People with ADRD have high expenditures on medical care and long-term services and supports (LTSS). Medicaid is the largest single payor for LTSS, however, the literature on the demographic trends and epidemiology of people with ADRD does not offer projections of Medicaid spending. The goal of this study was to develop an estimate for future Medicaid spending for people with ADRD for the state of Pennsylvania. The approach taken was to develop a demographic projection of the size of the older population, then estimate the fraction of people with ADRD who are eligible for Medicaid. Next, we used estimates of current spending trends to project future spending through 2025. Nearly all Medicaid participants with ADRD are dually eligible for both Medicaid and Medicare, however, Medicare managed care encounter data were not available for analysis. Thus, the prevalence of ADRD was constructed using Medicaid and Medicare fee-for-service (FFS) claims data. Two alternate estimates of the prevalence of ADRD among Medicare managed care enrollees were used (same as Medicare FFS, or slightly lower). Estimates were generated under several growth rates in per person spending on home and community-based services (HCBS). The results shows that growth in HCBS spending is the largest factor in predicting spending, leading to estimates ranging from $2.8 billion to $3.5 billion. Future research will extend the model to additional years.
FIT AND STRONG! IN ILLINOIS: LESSONS LEARNED
Authors: Hughes Susan , DeMott Andrew , Bobitt Julie 
Published: December 2023

Abstract
This session will describe lessons learned from a major effort to disseminate Fit & Strong! (F&S) statewide in Illinois, a state with both strong urban and rural counties. F&S is an evidence-based program for older adults who experience lower extremity mobility challenges. It is recommended for dissemination by the Administration on Community Living and the Centers for Disease Control and Prevention and is currently offered in 32 states. We received a substantial ARPA contract from the Illinois Department of Public Health (IDPH) to disseminate F&S sustainably throughout Illinois, between July 2022 and June 2023. We have convened Referral Network and Sustainability Workgroups to guide the work. Our goal is to identify 111 community-based organizations (CBOs) who can enroll 1,667 older adults into the program. We have developed an extensive number of collaborators including the aging network and a large number of healthcare systems and plans. We are also collaborating with the Illinois Extension Program to reach underserved rural areas of the state. This extensive collaborative effort has enabled us to enroll 70 CBOs that plan to offer the program. This collaboration between aging and healthcare networks that is co-sponsored by the Illinois Department on Aging and IDPH appears to be enabling us to reach a considerable number of providers who previously were not aware of or offering F&S. We are collecting pre/ post participant outcomes to evaluate program impact and examining state fall rates and uptake of lower extremity joint replacements. Lessons learned and preliminary findings will be discussed.