bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSESSING THE UPTAKE OF CORE OUTCOME SETS IN RANDOMIZED CONTROLLED TRIALS FOR PARKINSON’S DISEASE
Authors: George Joanna , Paul Eli , Ward Shaelyn , Fitzgerald Kyle , Jones Garrett , Magana Kimberly , Ford Alicia , Vassar Matt 
Published: December 2023

Abstract

Background
Parkinson’s Disease (PD) affects 1% of adults aged 60 and older, including 10 million individuals worldwide. As PD’s incidence rises, research funding is increasing substantially. PD’s core outcome set (COS) provides standardization for PD clinical trial outcomes. Adherence to the PD COS may improve research quality and study comparability. Objective: Analysis of the COS uptake rate before and after the PD COS publication.

Methods
On June 26th, 2023, we conducted a search of ClinicalTrials.gov to retrieve phase III/IV adult PD trials between 2013 and 2023. Screening for inclusion and data extraction occurred in a masked, duplicate fashion. Trial characteristics and COS uptake rate were extracted from this sample.

Results
In our 111 included trials, the COS uptake rate was highest for the ‘Walking and Balance’ outcome and lowest for the ‘Hospital Admissions’ outcome. Overall, there was a non-significant monthly increase of 0.26% (P = 0.266, CI = [-0.20, 0.72]) in “COS-defined outcome” measurement when comparing pre- and post-COS publication.

Conclusion
Overall, our study found no significant increase in COS uptake in PD clinical trials. We found multiple outcomes to be vastly unmeasured and heterogeneity among the measurement instruments used. These findings introduce complexity to the standardization and comparability of RCT outcomes. Barriers to COS uptake may be complex; however, overcoming these factors is vital to improving the usefulness of PD research.
ASSESSMENT OF DECISIONAL COMPETENCE IN DEMENTIA– A QUALITATIVE STUDY OF 60 EUTHANASIA CASES
Authors: van den Bosch Arne , Marijnissen Radboud , Hanssen Denise , Voshaar Richard Oude 
Published: December 2023

Abstract
The Netherlands allows euthanasia or assisted suicide (EAS) for people with dementia. The number of dementia EAS cases gradually increases every year, up to 288 cases in 2022. This practice remains controversial, as dementia is not directly lethal and may impair decisional competence. The Dutch euthanasia review committees (RTE) refer to Appelbaum and Grisso’s criteria for the assessment of decisional competence, but how these criteria are applied in clinical practice remains unknown. This study examined qualitatively which factors, and how, influence the judgment of decisional competence for EAS requests of people with dementia. Thematic analysis of 60 dementia EAS case summaries published online by the RTE between 2012 and 2021. Twenty patients had an advance directive and were decisionally compromised at time of EAS. Forty patients were decisionally competent at time of EAS, of which twenty also had an advance directive (purposive sampling). Two researchers independently coded all text related to decisional competence. A theoretical framework was developed. The four cognitive criteria of Appelbaum and Grisso were dimensional and cut-off points were influenced by six supporting factors that also directly impacted on competence assessment, i.e., level of communication, psychiatric comorbidity, personality, presence of an advance directive, consistency of the request, and the patient-physician relationship. The number of involved physicians and executed investigations were two contextual factors. The multidimensionality and subjectivity of decisional competence assessment may pose ethical and legal challenges. Continuous quality improvement processes may be needed in daily care, including possibilities for reflection.
BRIDGE EMPLOYMENT OR ENCORE CAREER? PREDICTORS THAT DISTINGUISH LATER LIFE CAREER TRANSITIONS
Authors: Oh Yun taek 
Published: December 2023

Abstract
Moving away from the traditional lock-step retirement to multiple retirement pathways, later-life career transition has been prevalent for about a half-century (Ruhm, 1990). So-called “encore career,” many older workers start their second career after leaving their original career jobs. However, leaving one’s career job is not a distinct prequel to an encore career; instead, it is an essential step to bridge employment as well. While these two transitions have different purposes, reasons, and outcomes, the predictors distinguishing between them are relatively not well-documented. Using the sample of respondents with career jobs in the Health and Retirement Study, this study distinguished various later-life transitions by the voluntariness of career transition and the duration of labor force participation after the transition and then investigated the predictors that distinguish between bridge employment and encore career. Based on the theoretical predictions from multiple disciplines, such as the resource-based dynamic process model and continuity theory, I stated and tested a set of hypotheses using multinomial logit estimation. The result showed that financial, physical, and mental health resources, and retirement identity when transitioning to new jobs predict whether older workers take bridge employment or encore careers. This result provides a helpful hint to policymakers and employers who want to retain older workers in the labor force. Because the indicators for the voluntariness of career transition are available for those who left their career employers only, further research is needed once the voluntariness measures for other work adjustments are available.
CHALLENGES AND CONSIDERATIONS IN RESEARCH WITH OLDER ADULTS EXPERIENCING HOMELESSNESS
Authors: Pope Natalie , Latimer Abigail , Moser Debra , Sasdi Olivia , Okeyo Hilda 
Published: December 2023

Abstract
Individuals in their late 50s and 60s constitute the fastest growing cohort of homeless adults; homelessness among the older adult population is expected to triple by 2030 (Culhane et al., 2019). Older adults find themselves homeless due to systemic (e.g., unaffordable housing, structural racism, increasing healthcare costs) and individual factors (e.g., substance misuse, mental health diagnoses). Unhoused older adults have high rates of multiple chronic conditions (Henwood et al., 2018) worsened by unmet healthcare needs (Baggett et al., 2010). Older adults, especially those with serious illness, struggle to find and maintain housing compared to younger adults without illness. Patient and clinician-informed services/programs are needed, but the nature of serious illness and homelessness research comes with unique considerations. Research challenges in this population include inclusive and adequate recruitment, participant screening, and boundary issues (Hanson et al., 2014; Lashley, 2023). We will present lessons learned from completing two successful qualitative studies with unhoused older adults and clinical subject groups. Issues encountered during our research include dealing with recruitment obstacles, evaluating and responding to participants’ cognitive impairment and mental health issues, managing emotional labor experienced by the research team, developing stakeholder relationships, and making decisions about adequate and appropriate study compensation. We describe challenges, opportunities, and suggestions for collecting primary data from unhoused older adults. We encourage gerontological researchers not to avoid this hard-to-reach, high-risk population. The lessons learned in designing and implementing studies tailored to the unique challenges of unhoused older adults can promote inclusion of the perspectives and needs this population.
CHILDHOOD SOCIOECONOMIC STATUS GRADIENTS IN FUNCTIONAL LIMITATIONS: THE ROLE OF MACRO-ECONOMIC CONTEXT
Authors: Fuller-Rowell Thomas , Sultana Samia , Hudson Amy , Kim Eric , Ryff Carol 
Published: December 2023

Abstract
A large number of studies have documented an association between childhood socioeconomic status (SES) and adult health or illness. However, relatively little is known about how this SES-health gradient varies across macro-economic contexts. The current study examined state-level mean income as a moderator of the association between the education level of a person’s parents and functional limitations in the United States (N = 10,685, Mean age = 47.7, SD = 13.6, 51% female, 86% White; 6% Black; 8% other or missing). Data were from an economic time series database (1917-2018) and the Midlife in the United States Study (MIDUS). Time series data were merged with MIDUS data (1995 core sample and 2012 refresher) by state of residence and year to determine exposure to state economic characteristics during three periods of the life span: prime working years (ages 30-55), early adulthood (20-25) and childhood (0-15). Results indicated that the SES-functional limitations gradient was attenuated for those who lived in a state with a higher mean income from ages 30-55, 20-25, and 0-15 (p’s &lt; .05). The moderating role of state-level economic exposures between ages 30 and 55 (but not at earlier life stages) differed by gender such that the attenuation of the SES-functional limitations gradient in more affluent states was more strongly evident among females than males. Findings suggest that the role of childhood SES in later life health varies across state-level economic contexts with notable differences by gender and age group. Future directions and policy implications are discussed.
CIRCADIAN CLOCK DISRUPTION: SEX-SPECIFIC EFFECTS ON METABOLISM & COGNITION IN AN ALZHEIMER’S MODEL
Authors: Scroggins Laila , Zhang Qing , Koronowski Kevin , Palavicini Juan 
Published: December 2023

Abstract
Preclinical studies have been largely performed on transgenic murine models of early-onset AD, which only accounts for a small fraction of AD cases. A number of confounds have impacted and limited the translatability of these mouse models, including potential off-target genetic effects, artifacts resulting from ultra-physiological overexpression of specific gene products, and overblown pathologies in non-fully developed brains. The objective of this study is to leverage a new microtubule-associated protein tau knockin (MAPT H1-GR) mouse model to assess the effects of an understudied environmental factor associated with AD, a disturbed circadian rhythm, on whole body and brain metabolism, tauopathy, neuroinflammation, neurodegeneration, and cognition. For the experimental design, a cohort of 32 mice was divided into two groups, normal light conditions (NLC) and chronic jet lag (CJL). The CJL mice have a regulated light schedule which shifts 4 hours ahead every 3 days while the NLC mice have a continuous 12 hours of light and 12 hours of dark schedule. Non-fasted and overnight-fasted glucose, ketones, and lactose levels were measured. CJL led to a sex-dependent disruption of fuel utilization during fasting conditions with males displaying more dramatic phenotypes than females. CJL also led to sex-specific changes in body composition, assessed via qMRI testing every other month, specifically at the level of fat mass in males. Cognitive assessment through the Barnes Maze test revealed a disruption of spatial memory in males, while females seemed to be protected from the deleterious effects of CJL on cognition.
COMPARING THE FEASIBILITY OF A LONELINESS AND SOCIAL ISOLATION GROUP IN A PRIMARY CARE VS COMMUNITY SETTING
Authors: Zubatsky Max , Berg-Weger Marla , Tziarli Dimitra , Livingston Rachel , Drake Judy , Taylor Ashley 
Published: December 2023

Abstract
Social isolation and loneliness is now considered a public health epidemic in the United States for the older adult population. While providers try to address certain health and lifstyle issues in this population through medications and other medical referrals, there are few non-pharmacological group interventions to curb feelings of isolation and loneliness. This study will determine if a psychosocial group intervention in primary care results in decreases of loneliness and health risks compared to a community-based group. The intervention is called “Circle of Friends,” which is an evidence-based group to alleviate loneliness and increase socialization through a rehabiliation model of care. Participants must be 60 years and older, report subjective feelings of loneliness, have reported being homebound and/or isolated over the last six months, and have very few social connections. The current study has collected initial pre-group data from eight older adults from the community group, and the research team is recruiting participants in the primary care group setting. It is anticipated that the Primary Care Circle of Friends Group will report higher improvements in loneliness and health indicators compared to the community-based group. The primary group will take place in an underserved Federally Qualified Health Center, and the community-based group will take place in the conference room of a university setting. Early qualitative themes that facilitators have reported around recruitment include: 1.) Challenges with planning transportation, 2.) Building trust in joining a new group, and 3.) requests of extra resources in addition to this group.
CORRELATES OF SLEEP HEALTH AMONG OLDER PEOPLE WITH AND WITHOUT HIV IN UGANDA
Authors: Yoo-Jeong Moka , Ratnayake Aneeka , Olivieri-Mui Brianne , Tong Yao , Tsai Alexander C , Okello Samson , Asiimwe Stephen , Siedner Mark 
Published: December 2023

Abstract
The proportion of older people in Uganda is expected to grow rapidly. Sleep issues disproportionately affect older people and people with HIV (PWH). Identifying determinants of sleep health is essential in the development of interventions. Thus, we assessed sleep-related factors in older Ugandans (aged ≥50 years) using cross-sectional data from the Quality of Life and Aging with HIV in Rural Uganda study. Sleep outcomes were measured by the Pittsburgh Sleep Quality Index (quality, duration, efficiency). The associations between sleep outcomes and potential determinants (loneliness, urban/rural setting, depression, anxiety, alcohol use, physical activity) were evaluated using multivariable linear regressions. Of 556 participants, 271 were PWH and 285 were people without HIV (PWoH). The two groups were similar in age, sex, and education. Depression screening via the 13-item Hopkins Symptoms Checklist was positive in 131 participants (PWH: 28.2%; PWoH: 21.6%; p=.05). There were no differences in sleep outcomes by HIV serostatus. Mean sleep quality was 0.89 (SD=0.78; range=0-3, 0=very good to 3=very bad), mean sleep duration was 6.5 hours (SD=1.7), and mean sleep efficiency was 74% (SD=19.5%; &gt;85% is optimal). Depressive symptoms were associated with worse sleep quality (b=0.58; p&lt;.001), reduced sleep duration (b=-0.94; p&lt;.001), and worse sleep efficiency (b=-0.12; p&lt;.001) regardless of HIV serostatus. Interestingly, older age was related to increased sleep duration (B=0.04, p=.001). Interventions targeting depression among older Ugandans may help with sleep. Longitudinal studies are needed to determine the bi-directionality of this relationship and further elicit potential pathways to support sleep health among older Ugandans.
CORRELATION OF SHOULDER RANGE OF MOTION WITH LOWER EXTREMITY PERFORMANCE AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Almardawi Ranyah , Gray Vicki , Frakes Nathan , Liang Yuanyuan , Davis Derik 
Published: December 2023

Abstract
More than one-third of older adults have mobility limitations. Yet the impact of shoulder dysfunction on lower extremity performance is only nascent in description. We tested the hypothesis that shoulder range of motion (ROM) correlates with lower extremity performance. Data were collected from 26 community-dwelling older women (80.8%) and men aged ≥ 65 years (mean±standard deviation=71.9±5.3 years) enrolled in a pilot study at one time point. Bilateral shoulder ROM testing for forward flexion (FF), abduction (ABD), and adducted external rotation (Add-ER); and Short Physical Performance Battery (SPPB), gait speed (GS), 6-meter narrow walk test (6M-NWT), and stair climb power test (SCPT) were performed. The sum of bilateral FF, ABD, and Add-ER was determined (Total-ROM) for each participant. Spearman’s rank-order correlation (rho) with 95% confidence intervals (CIs) was used to measure the strength and direction of correlation for Total-ROM with the mobility outcome measures. The study sample demonstrated Total-ROM, 709.5° ± 80.1°; SPPB score, 10.9 ± 1.3; GS, 1.2 ± 0.2 m/s, 6M-NWT time, 7.3 ± 3.9 s; and SCPT, 240.7 ± 90.7 watts. Total-ROM correlated with: SPPB 0.56 (0.22,0.78), p=0.003; GS, 0.59 (0.27,0.80), p=0.001; SCPT, 0.54 (0.20,0.77), p=0.004; and 6M-NWT, -0.63 (-0.82,-0.33), p&lt; 0.001. The results provided preliminary evidence that shoulder ROM correlates moderately with measures of lower extremity performance in community-dwelling older adults. Future studies are warranted in older populations to test for the longitudinal association of shoulder ROM with lower extremity performance and to determine if treatment of shoulder dysfunction provides effective prehabilitation to mitigate age-related declines in mobility.
CROSS-CULTURAL VALIDATION OF THE OARS INSTRUMENT FOR THE ASSESSMENT OF ELDERLY ANGOLANS
Authors: Barbara Rita 
Published: December 2023

Abstract

Background
The Older Americans Resources and Services (OARS) instrument is widely used internationally, but requires validation in specific contexts, such as Angola. This study aims to cross-culturally validate the OARS for assessing elderly Angolans.

Methods
The cognitive and functional domains of the OARS were cross-culturally adapted, followed by psychometric analysis on a representative sample. Domains of activities of daily living and mental health were evaluated. Internal reliability was assessed using Cronbach’s alpha coefficient, resulting in 0.80 for activities of daily living and 0.80 for mental health, with a 95% confidence interval.

Results
The psychometric analysis demonstrated consistent reliability in the domains of activities of daily living and mental health, with Cronbach’s alpha coefficients of 0.80 for both, supported by 95% confidence intervals. These results indicate substantial reliability.

Conclusion
The cross-cultural validation of the OARS is ongoing, and preliminary results from the psychometric analysis reinforce the reliability of the domains of activities of daily living and mental health. Adapting the OARS could be a valuable tool for assessing elderly Angolans, providing reliable and internationally comparable data. Keywords: OARS, elderly, cross-cultural validation, psychometric analysis.
CULTURALLY SENSITIVE STRATEGIES TO RECRUIT FOREIGN EDUCATED NURSES FOR US LONG-TERM CARE RESEARCH
Authors: Thompson Roy , Wipke-Tevis Deidre , Olanrewaju Sherif , Odemuyiwa Olumayowa A , Squires Allison 
Published: December 2023

Abstract
Long-term care (LTC) facilities experience chronic nursing staff instability which negatively impacts resident health outcomes. Recruiting Foreign Educated Nurses (FENs) is one strategy to stabilize the nursing workforce but most studies on FENs, use secondary data from: American Community Survey and the National Sample Survey of Registered Nurses. Few empirical studies have examined FEN experiences, employment outcomes, and impact on US LTC facilities. Since LTC facilities are dependent on FENs to meet minimum staffing requirements, additional research is needed to better understand FEN workforce issues in LTC, how to improve its sustainability, and the links to resident outcomes. Mistrust of researchers, however, may make FENs hard to reach. Therefore, conducting primary research on FENs in LTC requires culturally sensitive and community-engaged recruitment strategies. Drawing from existing literature and lessons learned from primary research conducted with FENs working in LTC facilities in the southeastern US, we will review best practices for recruitment so researchers can understand the cultural and structural issues that may affect research conduct in facilities where FENs are employed and their recruitment as participants. Developing relationships with FEN leaders as well as the Nigerian, Jamaican, Filipino, and/or Asian nurses associations can facilitate access to the population. Key stakeholder relationships also include the American Nurses Association, State Boards of Nursing, and Commission on Graduates of Foreign Nursing Schools as they can facilitate entrée into data sources and networks for recruitment. Understanding recruitment strategies will strengthen research that deepens our understanding of workforce issues among FENs in LTC.
ADAPTING TELEHEALTH EVIDENCED BASED PROTOCOLS FOR VETERANS WITH MOOD AND NEUROCOGNITIVE DISORDERS: A CASE STUDY
Authors: Hosseini Charissa 
Published: December 2023

Abstract
Aging Veterans with mood and neurocognitive disorders typically have a complex medical and psychiatric presentations leading many providers to exclude them from treatment, expressing that psychotherapy is not appropriate. This form of exclusionary care may decrease help seeking behavior and amplify existing psychological symptoms to an already stigmatized and isolated population. The following case study, outlines a 24-session approach to integrating evidenced based protocols such as Cognitive Behavioral Therapy (CBT) and Narrative Life Review Therapy via telehealth. The presentation will discuss cultural considerations to take when working with Aging Veterans that have co-occurring mood and cognitive difficulties as well as reflect upon the successes and challenges of providing telehealth with this population.
DIETARY NITRATE SUPPLEMENTS AND AEROBIC EXERCISE MODIFY FRAILTY IN AN AGE-DEPENDENT MANNER IN FEMALE C57BL/6 MICE
Authors: Bisset Elise , Howlett Susan 
Published: December 2023

Abstract
We previously demonstrated that aerobic exercise attenuates the development of frailty in older female mice. Here we combine the common dietary supplement, sodium nitrate, with aerobic exercise to determine if this combination will work to attenuate frailty across lifespan. Adult (7-9 months) and aged (24-25 months) female mice were given free access to a running wheel and/or sodium nitrate (1mM, drinking water), or neither for 3 months. We measured blood pressure (tail cuff), running volume, frailty (frailty index), and body composition (DEXA). Blood pressure was unaffected by nitrates or exercise at both ages. While young mice ran more than older mice (3.5±0.4 vs 1.2±0.2 km/day), running was unaffected by nitrates. Older mice were frailer at baseline than younger mice (0.13±0.04 vs 0.03±0.004; p&lt; 0.001). In older sedentary controls, frailty increased over time (0.15±0.02 to 0.19±0.03: p=0.03), but this was prevented by nitrates (0.13± 0.02 to 0.12 ± 0.01), exercise (0.12±0.03 to 0.18±0.03), and both (0.12±0.02 to 0.12±0.01). Older sedentary controls saw age-related weight loss (32.5±3.0g to 29.7±2.3g: p=0.02) which was prevented by exercise or nitrates. In older mice, mortality was highest in sedentary controls (46%) and lowest in exercised mice fed nitrates (0%). In contrast, while exercise attenuated frailty in young mice, nitrates did not. Young mice also had few changes in body composition; none died. While nitrates with or without exercise are beneficial for older mice, they had little effect in younger mice. These results suggest that nitrates alone or with exercise, may help prevent frailty in older females.