bluuebunny/crossref_metadata_2025_split huggingface dataset:
FAMILIES AND DEMENTIA: ESTIMATES AND EXPOSURES
Authors: Friedman Esther , Freedman Vicki , Patterson Sarah 
Published: December 2023

Abstract
Roughly 10 to 20% of older adults in the U.S. have dementia, which could have implications for their families and household members, who are likely to be called upon to provide care. Yet, it is not clear how many families and households include someone with dementia. This study provides national level estimates of families and households with an older adult with possible dementia using the 2017 Panel Study of Income Dynamics (PSID). Consistent with prior work, we find that 21.5% of older adults 65+ have possible dementia. Moreover, more than a quarter (26.3%) of households with an adult aged 65+ include an older adult with dementia, and 37.0% of extended family networks (with at least one adult aged 65+) have at least one older adult with dementia. Individual-level stratification of dementia by racial-ethnic group and socioeconomic status translates directly to household- and family-level patterns. For instance, households and families with an older adult who is either Black or Hispanic or does not hold a college degree are more likely to include at least one person with possible dementia. These findings have implications for the extent to which American families and households include someone with dementia, which comes with a risk of serving as a caregiver as well as possible implications for health and well-being. Our findings also establish important baseline estimates that can be measured against future estimates, for instance those post COVID-19.
A COMPARISON OF THE IMPACT OF ADVERSE CHILDHOOD EXPERIENCES ON BRAIN HEALTH IN LATINA AND NON-LATINA WOMEN
Authors: Tsotsoros Cindy 
Published: December 2023

Abstract
Early-life experiences and social determinants of health influence late-life cognitive performance, cognitive aging trajectories, and risk of Alzheimer’s disease and related dementias (ADRD). Research shows adversity during childhood plays a central role in health outcomes later in life, such that more adverse childhood experiences (ACEs) predict higher likelihood of negative physical and mental health outcomes. As ACEs may also predict neurocognitive performance and historically marginalized groups are disproportionately exposed to ACEs, this study aims to enhance diversity in research on ACEs and cognitive aging by clarifying the role of ethnicity. Latinos are 51% more likely to experience ACEs and 1.5x more likely to experience ADRD than their non-Latino counterparts. Data were collected in two studies assessing cognitive functioning in women aged 65-85 who reported no ACEs or 3+ ACEs (54 non-Latinas, Oklahoma; 50 Latinas, Rhode Island). ACEs were measured with the Adverse Childhood Experiences Questionnaire. Cognition was measured using NIH Toolbox Cognition-Battery and Automated Neuropsychological Assessment Metrics. In the non-Latina white sample (Mage=73.2), those with 3+ ACEs exhibited inferior scores on Stroop Interference, p=.050, d=-.44. The ACEs group demonstrated higher scores on List Sorting, p=.003, d=-.78. Small effects were found in Stroop Color, Stroop Color-Word, Cognition Fluid Composite, Flanker, and Cart Sort (d=-.25, -.39, -.29, .24, -.25, respectively). These findings are compared to those within the Latina sample, demonstrating the need to extend research on life course risk factors for ADRD to this underrepresented group, which is at elevated risk of both ACEs and ADRD.
THE USE OF CAREGIVER SUPPORT SERVICES AND CAREGIVING IMPACT AMONG DIVERSE CAREGIVERS OF OLDER ADULTS WITH DEMENTIA
Authors: Bouldin Erin , Eppich Kaleb , Webster Noah , Leggett Amanda , Zahodne Laura 
Published: December 2023

Abstract
Caregiver support services may improve experiences among caregivers of people with dementia, but racial/ethnic disparities exist in service use. Using data from the 2021 National Study of Caregiving, we measured caregiver service use and caregiving impacts among 470 Black (n=187), Hispanic (n=37), and White (n=246) caregivers of older adults with possible/probable dementia from the National Health and Aging Trends Study. We classified caregivers as using at least one or none of the following services in the past year: caregiver support group, training, or respite care. We calculated the weighted proportion of caregivers reporting caregiver burden (at least one: physical, emotional or financial difficulty), exhaustion, and feeling overwhelmed within each racial/ethnic group. Caregiver service use varied by race/ethnicity (47% of Hispanic, 29% of Black, and 32% of White caregivers). Black and White caregiver service-users were significantly more likely to report a burden than their peers using no service (59% versus 36% of Black, p=0.04, and 90% versus 41% of White, p&lt;0.001, caregivers). There was no significant difference in burden among Hispanic caregivers (59% versus 69%, p=0.65). In each racial/ethnic category, caregivers reported similar prevalence of exhaustion and feeling overwhelmed from caregiving whether they used a service or not. Based on these cross-sectional data, we hypothesize that Black and White caregivers who feel burdened use services more often, and that service use mitigates caregivers’ feelings of being exhausted or overwhelmed by caregiving, despite burden. Racial/ethnic differences highlight the need to understand contextual factors that influence caregiver burden and service use.
DOES INCREASING LIGHT PHYSICAL ACTIVITY IN MIDLIFE AND OLD AGE BUFFER AGAINST COGNITIVE DECLINES?
Authors: Hamm Jeremy , Parker Kelly , Lachman Margie , Mogle Jacqueline , Duggan Katherine , McGrath Ryan 
Published: December 2023

Abstract
Although it is well established that moderate-to-vigorous physical activity (MVPA) buffers against cognitive declines, less is known about the benefits of lower intensity physical activities that are more feasible, inclusive, and amenable to change in old age. Our study examined the extent to which increases in light physical activity protected against longitudinal declines in cognitive functioning and whether such a relationship become pronounced in old age when opportunities for MVPA are often reduced. We analyzed 9-year data from the national Midlife in the United States Study (n=2,229; age=56±11.13 years) using regression models that assessed whether change in light physical activity predicted corresponding changes in episodic memory and executive functioning for adults across the lifespan. All models controlled for age, sex, socioeconomic status, functional status, and moderate and vigorous physical activity. Beyond more vigorous forms of physical activity, increasing light physical activity predicted less decline in episodic memory (β=.06, p=.010) and executive functioning (β=.15, p&lt;.001) over the 9-year follow-up period. Effect sizes for moderate and vigorous physical activity on episodic memory (βs=.01-.02) and executive functioning (βs=.03) were less than half that observed for light physical activity. Moderation models showed that, for episodic memory, the benefits of increasing light physical activity were pronounced at older ages. Findings provide initial evidence that increasing light physical activity may help slow age-related declines in episodic memory and executive functioning and that its protective influence may become paramount in later life when individuals commonly encounter constraints that can limit their capacity to engage in MVPA.
PHYSICAL FUNCTIONING 12 YEARS BEFORE AND AFTER KNEE OR HIP SURGERY IN OLDER WOMEN
Authors: Peeters Geeske , de Munck Isabel , Tooth Leigh , Melis Rene 
Published: December 2023

Abstract
Understanding long-term recovery patterns in the context of ageing-related decline may improve knee or hip surgery outcomes. We examined the impact of hip and knee surgery on long-term trajectories of physical functioning (PF) in older women, and profiled women with higher and lower resilience to surgery. Resilience, defined as bouncing back (PF) after a stressor (hip or knee surgery), was quantified using the expected recovery differential method. Data were from 10,434 women (73-79 yrs) in the Australian Longitudinal Study on Women’s Health who completed surveys 2-6 (1999-2011). Adjusted linear mixed models were run to examine the surgery-by-time (-12 to +12 yrs) interaction in association with PF (SF-36 subscale). The difference between observed and expected PF were calculated, with positive/negative values reflecting higher/lower resilience, respectively. PF trajectories differed between women with (n=982) and without (n=8117) hip surgery (p&lt;0.001). Among hip surgery patients, the decline was more rapid pre-surgery than post-surgery (b=-0.7, p&lt;0.001). Women with knee surgery (n=1144) had lower PF than those without surgery (n=7971), but with a slower rate of decline (p=0.01). Among knee surgery patients, the rate of decline was similar pre- and post-surgery (b=-0.3, p=0.25). Both in hip and knee patients, women with higher resilience had fewer comorbidities and symptoms, and were more often physically active and independent in daily activities than those with lower resilience (p&lt;0.05). In conclusion, women with and without hip or knee surgery have different trajectories of PF. Women who function better than expected after surgery, tend to have fewer health problems.
INTEGRATING A PATIENT-CENTERED, WHOLE-HEALTH APPROACH WHEN CARING FOR PEOPLE AGING WITH HIV
Authors: Fix Gemmae , Clark Janet , Gifford Allen 
Published: December 2023

Abstract
The US Department of Veteran Affairs (VA) is implementing a patient-centered, “Whole Health System of Care” to align care with What Matters Most to patients within their unique circumstances. Implementation is focused on primary care, where most patients receive care. Yet HIV Clinics have historically provided both HIV and primary care because of the complexity of HIV. People living with HIV are now aging and experiencing a constellation of health and life circumstances that would benefit from a Whole Health approach. While there is desire to spread Whole Health beyond primary care, little is known about how to integrate Whole Health into HIV Clinics. We sought to identify Whole Health implementation considerations for HIV Clinics. Our qualitative study design included interviews with vignettes based on our prior work, illustrating themes like aging alone. Findings were mapped to the i-PARIHS implementation framework which includes recipients (HIV providers), context (HIV clinics), and innovation (Whole Health). We interviewed physicians, psychologists, nurses and leadership (N=11) from three HIV Clinics (Northeast, Northwest, South). Participants were largely aware of Whole Health, although few had taken trainings and no clinics currently offered Whole Health services. Many expressed interest incorporating Whole Health into HIV care. They also saw great value, given patients’ complexities. Participants described logistical barriers hindering implementation, like awareness of specific resources or how to refer. Only some providers were able to conceptualize a Whole Health clinical encounter- where patients’ life circumstances are connected to health. HIV Clinics offer an ideal setting to spread Whole Health.
UNRAVELING NONGENOMIC MECHANISMS BY WHICH 17Α-ESTRADIOL EXTENDS HEALTHSPAN AND LONGEVITY
Authors: Zomer Helena , Sirohi Vijay , Medrano Theresa , Cooke Paul 
Published: December 2023

Abstract
Recent work indicates that exogenous 17α-estradiol (17α-E2), a stereoisomer of 17β-E2, produces unprecedented longevity increases (~20%) in male mice, challenging prevailing assumptions that 17α-E2 is a weak estrogen. However, is unclear how 17α-E2 acts. Therefore, this study aimed to obtain mechanistic insights into 17α-E2 actions in the uterus, the most widely used vivo model system for estrogen action. We hypothesized that 17α-E2 signals through membrane (m)ESR1 to affect target tissues and promote longevity. To test this, we treated pre-pubertal (postnatal day 20) female CD-1 mice with 3 daily IP injections of vehicle or 10 mg/kg of 17α-E2 or 17β-E2 (n=4/group). 17α-E2 treatment did not significantly increase uterine weight – a marker of nuclear (n)ESR1 signaling (20.3 ± 2.1 mg vs. vehicle 15.7 ± 2.0 mg, p&gt;0.05), while 17β-E2 strongly increased it to 41.4 ± 1.1 mg (p&lt;0.05). Accordingly, histological analysis revealed reduced cell proliferation in 17α-E2- vs. 17β-E2-treated uteri. Both 17α-E2 and 17β-E2 robustly stimulated epithelial p-ERK and p-AKT expression, the active phosphorylated forms of these protein kinases, and western blotting showed a strong and comparable stimulation of EZH2, a critical mediator of estrogen’s epigenetic effects, which are linked to mESR1 signaling. In conclusion, our results indicate that despite limited actions through nESR1, 17α-E2 robustly signals through mESR1 to activate uterine protein kinase cascades and produce epigenetic effects. These findings may cause a significant reappraisal of 17α-E2 biological effects and role in normal estrogen physiology and provide critical insights into its unique ability to stimulate longevity.
ACCELERATED BIOLOGICAL AGE IS ASSOCIATED WITH DELIRIUM AND PLASMA NEUROFILAMENT LIGHT IN GERIATRIC HIP FRACTURE
Authors: LaHue Sara , Youn Joy , Fuentealba Matias , Douglas Vanja , Furman David , Rojas Julio , VandeVrede Lawren , Newman John 
Published: December 2023

Abstract

Background
Biological age may be distinct from chronological age. Epigenetic clocks (e.g., PhenoAge) estimate biological age by quantifying changes in DNA methylation (DNAm). Biological age is “accelerated” (AgeAccel) when epigenetic&gt;chronological age. AgeAccel predicts age-related diseases but its association with delirium or neuronal injury markers (e.g., neurofilament light “NfL”) is unknown.

Methods
Adults age 65+ hospitalized for acute hip fracture underwent daily delirium screening with the Confusion Assessment Method Long Form. DNAm status of 850,000 CpG sites was measured in triplicate from pre-op peripheral blood mononuclear cells using Illumina MethylationEPIC arrays. AgeAccel represented the residual of the linear regression model of PhenoAge regressed on chronological age. Plasma NfL was measured in duplicate using Simoa immunoassays. Group differences calculated by T-test.

Results
Of 12 subjects (enrollment ongoing): mean age 79±8, 75% women, 42% with dementia, 33% were delirious on pre-op blood collection day. Mean AgeAccel was 4.4 years (p=0.02) in delirious vs non-delirious subjects (Fig1A). Those with positive (vs negative) AgeAccel had higher mean NfL (Fig1B, p=0.002). Delirious (vs non-delirious) subjects had higher mean NfL (p=0.004). We found no difference in either AgeAccel or NfL by dementia status.

Conclusions
In this geriatric hip fracture pilot, accelerated biological age was associated with higher delirium prevalence and NfL. Delirium was also associated with higher NfL. This pilot demonstrates feasibility and utility of measuring biological aging in delirium that warrants study in a larger cohort.
HEALTH SYSTEM PARTNERSHIPS IN INTERVENTION AND OBSERVATIONAL STUDIES: REFLECTIONS FROM AN EARLY-CAREER SCHOLAR
Authors: Gassoumis Zach 
Published: December 2023

Abstract
The early knowledge base and interventions in the field of elder mistreatment were built by clinician researchers, leading to a natural research-to-practice pipeline. But with more non-clinical researchers steadily entering the field, care must be taken to forge strong research-practitioner partnerships, to three ends: 1) developing clinically informed research and intervention approaches, 2) recruiting clinically relevant samples, and 3) implementing findings into clinical practice. This process can be particularly challenging for early-career non-clinical researchers, who may lack strong partnerships on which to build their research. This presentation extracts lessons for early career scholars by providing overviews of the development of and findings from two studies. The Comprehensive Older Adult Caregiving Supports (COACH) EM prevention program was delivered in partnership with a managed care health system, with referrals received from health system providers. The Better Together study of dementia care groups (i.e., persons living with dementia and their care partners) received referrals from clinicians in mixed managed care/fee-for-service settings, county health facilities, and community partners. Drawing from the principles of community-engaged research, the presentation highlights the relevance of various engagement approaches to elder mistreatment research, including: 1) partnering with senior researchers with existing networks; 2) taking the time to learn the health system’s and clinicians’ operational systems, pressures, and constraints; 3) honoring practitioner expertise in building research projects and developing research questions; 4) prioritizing meaningful reciprocal engagement, through offering topical or research presentations, funding, co-authorship, etc.; and 5) educating health system administrators about the nuances of conducting elder mistreatment research.
RISKY WORK ENVIRONMENTS AND METABOLIC DISEASE: CUMULATIVE CONSEQUENCES OF BAD JOBS IN EARLY AND MID LIFE
Authors: Carpenter Rebekah 
Published: December 2023

Abstract
Approximately one in three adults in the United States have a metabolic disease or illness. Metabolic diseases and illnesses are particularly costly for older adults, often resulting from decreased human capital and increased health care-based costs in later life. Social contexts have been hypothesized to be a key contributor to later-life health; however, work environments are often understudied as a critical social factor shaping health over the life course. Utilizing new data from the Health and Retirement Study’s Life History Mail Survey linked to occupational work context data from the Occupational Information Network (O*NET), we examine how exposure to dangerous work environments over one’s working career relates to the likelihood of developing a metabolic disease or illness between the ages of 50 and 62. Results from logistic regressions suggest that dangerous work environment exposures, such as exposures to contaminants or hazardous conditions, are associated with increased risk of developing metabolic disease and illnesses between ages 50 and 62; however, these associations are dependent upon when in the life course people are exposed to dangerous work contexts and for how long people are exposed to dangerous work contexts. This study speaks to the growing need for understanding the role of occupations as an important social and contextual factor shaping population health. Specifically, findings from this study may better inform the development of social and organizational policies targeted at improving work environments in the US, thereby helping to reduce the risk of developing health-related challenges, including metabolic diseases and illnesses.
OLDER WOMEN AND HIV: THE IMPACT OF PROVIDER COMMUNICATION OF HIV/AIDS ON CONVERSATIONS WITH NEW SEXUAL PARTNERS
Authors: Robinson Erin , Park Geunhye , Nyang’au Getrude 
Published: December 2023

Abstract
Older adults account for 50% of people living with HIV and nearly 20% of new HIV infections in the U.S. Inadequate communication with a healthcare provider has been identified as a contributing factor, as stigma surrounding older adults, sex, and HIV/AIDS is persistent. Many older adults report having conversations with their healthcare providers about HIV prevention more routinely in their younger years. To date, however, little is known about provider communication of HIV with older patients. This cross-sectional study aims to help fill that gap. Survey participants (N=427) were asked about the frequency in which their primary healthcare providers talked with them about HIV/AIDS before they turned 50, as well as their future likelihood to discuss HIV/AIDS with a new sexual partner. Participants ranged in age from 50 to 84 years (M=58; SD=6.3), and were predominately white (94%) and female (73%). Regression analysis demonstrated that among women in the sample, provider communication about HIV/AIDS prior to them turning 50 year of age was associated with their future likelihood of talking with new sexual partners about HIV/AIDS (β=0.151, p&lt;.05). Eighty-seven percent of the sample reported intentions to discuss condoms with a new sexual partner with a mean of 4.89 (SD=1.47, Range=1-6) indicating “Somewhat Agree” and “Agree”. These findings suggest that provider communication of HIV/AIDS is important for risk prevention. Those conversations help guide future decision making among women in particular, even into their later years.
IMMUNOMETABOLIC CHECKPOINTS OF INFLAMMAGING
Authors: Dixit Vishwa 
Published: December 2023

Abstract
Inflammation is a key hallmark and driver of age-related functional decline. Evidence that innate immune sensor NLRP3 inflammasome links aging to functional decline supports Metchnikoff’s original prediction that phagocytes or macrophages drive aging-associated degenerative diseases in an organism. Tissue resident macrophages are key to maintenance of homeostasis, a response that is compromised with age. It remains unclear whether negative energy balance in a host elicited by caloric restriction (CR) impacts mechanisms that control inflammation. The precise identity of factor(s) that link alterations in organismal metabolism to macrophage response are unclear. CR in rodents clearly elicits anti-inflammatory effects, but despite several years of research efforts, the endogenous drivers that couple energy balance to inflammatory cellular quiescence or activation is unknownThe RNA-sequencing analyses of adipose tissues from CALERIE-II study participants identified that CR in humans activates transcriptional programs implicated in mitochondrial metabolism, anti-inflammatory responses, and longevity. Our results show that macrophage derived protein PLA2G7, that is inhibited by CR in humans, reduces inflammaging, protects against thymic involution and protects against metabolic dysfunction. Furthermore, the CR in humans identifies unique regulators of inflammation including a CR-inhibited adipokine called SPARC that controls healthspan. Collectively, our studies establish that CR is relevant to human physiology and immunobiology and offers an important platform to harness immunometabolic checkpoints of inflammation and longevity.