bluuebunny/crossref_metadata_2025_split huggingface dataset:
OLDER WOMEN WITHOUT AND WITH DIABETES MELLITUS: RISK OF FALLS
Authors: de Silva Alessandro Oliveira , Funghetto Silvana , de Lima Luciano Ramos , Stival Marina Morato 
Published: December 2023

Abstract
Evidence points to an association between hyperglycemic state and worsening mobility, with increased risk of falls. The aim of this study was to compare the risk of falls in the women older with and without diabetes mellitus in a sample of women older 60 to 65 years of age (N = 205) care in primary health care in the Federal District - Brazil. The results of the statistical model showed that the highest prevalence of falls was in the group of older women with type 2 diabetes mellitus (52.8%). It was possible to verify in the Time Up and Go performance test that most older women with type 2 diabetes mellitus were at risk of falling (79.2%) (p=0.003). Furthermore, women with type 2 diabetes mellitus showed a higher risk of falls in the Berg Balance test (51.76±5.87). The results suggest that type 2 diabetes mellitus significantly increased the risk of falls in this population. The potential benefits of this approach contribute to the planning of strategies and interventions to prevent falls in this population of older women.
IMPLEMENTING SMART AMBIENT BRIGHT LIGHT (SABL) IN NURSING HOME RESIDENTS WITH DEMENTIA: CHALLENGES AND STRATEGIES
Authors: Jao Ying-Ling , Wang Julian , Liao Yo-Jen , Berish Diane , Boltz Marie , Calkins Margaret 
Published: December 2023

Abstract
Effective non-pharmacological interventions are critically needed to reduce agitation for nursing home residents with dementia. Lighting interventions (LIs) improve agitation among persons with dementia. However, LIs have not been widely implemented in “real-world” care settings, and a feasible implementation approach to ambient LIs has not been established. This study describes challenges and strategies in implementing the smart ambient bright light (SABL) to provide auto-controlled, consistent indoor lighting that incorporates natural daylight. This SABL includes tunable LED lights, photosensors, and controllers and has a pre-programmed 24-hour control schedule for illuminance. The SABL will be installed in participants’ bedrooms, dining areas, and activity rooms for four weeks. Key challenges include nursing home leadership team’s concerns about compliance with regulations and increased staff workload. Our implementation strategies include 1) engaging the nursing home stakeholders early on to address their concerns, 2) setting up an advisory board at each facility to involve the administrator, director of maintenance, and frontline healthcare workers to ensure the implementation protocol is congruent with their regulations, policy, and staffing, 3) tailoring lighting schedule based on the care routine and resident schedules, and 4) monitoring the SABL operation on-site and remotely. Moreover, the study incorporates a mixed methods design to interview staff/administrators and evaluate the intervention’s acceptability, feasibility, and appropriateness from their perspectives. This is the first study that addresses the implementation strategies of LIs. Findings will establish evidence-based implementation strategies and the best design for SABL to reduce agitation for nursing home residents with dementia.
PATTERNS OF SOCIAL CARE USE WITHIN THE OLDER POPULATION: WHAT CAN WE LEARN FROM ROUTINELY COLLECTED DATA?
Authors: Brotherhood Kelly , Hanratty Barbara , Spiers Gemma , Caiado Camila , Newton Julia 
Published: December 2023

Abstract
Research with routinely collected social care data has untapped potential to inform new care delivery approaches and techniques. To identify opportunities for service improvement and enhance our understanding of care pathways experienced by the older population, we collaborated with a local authority in the North East of England. We set out to characterise the use of social care services and associated outcomes within the local older population (aged 65+). 171,386 records were extracted from the local authority’s social care case management system, relating to 38,191 unique individuals across the last 40 years. We identified the care packages provided to the local population, including care provided in care homes (with and without nursing), private households and assisted living facilities. The study population varied in terms of the number of care packages provided to each individual (median 7 packages, IQR 4-11) and the average duration of individual care packages (median 41 days, IQR 14 - 274 days). The care pathways that are most common amongst the older population will be described, including sequencing and outcomes, and grouped by the reason for providing care (e.g., respite, long-term care) and the reason why each care package ended (e.g., death, returning home). The wide range of care pathways experienced demonstrate the heterogeneity in needs and preferences within the older population. This dataset and analyses are an invaluable way of identifying areas of potential unmet need and evaluating the effectiveness of short-term care services.
PRESERVING THE DISCRETENESS OF DEFICITS LEADS TO LOWER FRAILTY INDEX IN INDIVIDUALS LIVING IN LONG-TERM CARE
Authors: Greeley Brian , Low Hilary , Kelly Ronald , McDermid Robert , Song Xiaowei 
Published: December 2023

Abstract
The frailty index (FI), based on the deficit accumulation model, has potential to advance healthcare, but conventional coding of raw scores introduces noise. This study assesses the impact of the two different coding approaches on the FI. Two FI were calculated using 43 variables from 29,758 older (&gt; 65 years old) Canadians adults (84.6 ± 8 years old; 64% female) living in long-term care. Scores were coded as 0, 0.5, or 1 regardless of the number of levels (grouped), or preserved (e.g., a 4 level variable was coded as 0, 0.33, 0.67, or 1; discrete). FI was correlated to age. Each ordinal variable was removed from the FI to further test the impact of the two coding approaches. The median FI for the grouped approach (0.302 (0.221 – 0.372)) was higher relative to the discrete approach (0.237 (0.170 - 0.307)). The discrete (r = .91) and grouped (r = .93) FI showed similar relationships to age. Removal of any ordinal variable reduced the grouped FI it by 0.004 or 0.016, whereas removal lead to both increases (range: 0.003 - 0.001) and reductions (range: 0.002 - 0.008) for the discrete FI. Using a grouped coding approach when quantifying frailty status artificially inflates FI among a large sample of older Canadians adults living in long-term care. The study underscores the importance of future FI research to adopt a discrete coding approach that accurately reflects the true level of impairment, for reducing noise in statistical models and better clinical utility.
A SYSTEMATIC REVIEW OF FUNCTIONAL TRAINING EXERCISE IN COMMUNITY-DWELLING OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Shin Yun Chan , Liu Chiung-ju , Breton Kellen , Mason Justin , Hu Yi-Ling , Morgan-Daniel Jane 
Published: December 2023

Abstract
Older adults with cognitive impairment are at risk of becoming care dependent. Functional training involves movements necessary for daily tasks, which may help maintain or improve independence. As part of a larger systematic review examining the effects of a functional training exercise in community-dwelling older adults, this study aimed to synthesize the functional and cognitive outcomes in those with cognitive impairment. A systematic search was conducted in 10 electronic databases to identify relevant studies published between January 2010 and September 2021. Studies were selected if recruited adults aged &gt; 60 years, participants had a cognitive impairment that was not due to acquired brain injury, and activities of daily living and/or cognitive function were measured. Nine studies (847 participants) were identified. Five studies were conducted on older adults with mild cognitive impairment, all showed an improvement in activities of daily living, and 4 showed an improvement in global cognition. Three were conducted on older adults with dementia, and one showed an improvement in activities of daily living but not global cognition. One was conducted on older adults with mild cognitive impairment or dementia and reported an improvement in both outcomes. Functional training exercise seems effective in improving cognitive function and activities of daily living in older adults with mild cognitive impairment. For those with dementia, although research on functional training is limited, some preliminary evidence suggests that incorporating functional training with other components may be beneficial. Despite inconclusive findings, functional training exercises may hold potential for older adults with cognitive impairment.
COMPARISON OF CUT POINTS FOR PREDICTING PHYSICAL ACTIVITY INTENSITY IN OLDER ADULTS
Authors: Chakravarthy Ameera , Resnick Barbara , Galik Elizabeth , Doran Kelly , Renn Cynthia , Lehr Eric , Knopp Kasey 
Published: December 2023

Abstract
The differences between cut-points, and scarcity of comparative impact studies have prevented researchers from reaching consensus regarding the application of intensity-related accelerometer cut-points for older adults. This study will focus on the measure of physical activity using the MotionWatch 8 in older adults and compare the differences using traditional Freedson cut points versus those developed by Landry for older adults and evaluate the impact of these differences on age, gender, race, cognition, comorbidities as well as function based on the Barthel Index. A total of 177 participants between the ages of 59 to 101 (M 83) from an acute care study were used for the analysis. Physical activity intensity was estimated using 24-hour count data and compared using two independently developed cut-points. Impact on outcomes were evaluated with hierarchical regression and Multivariate analysis of variance. After controlling for age, gender, race, comorbidities, and cognition, Landry sedentary cut-points were all significantly associated with function. Overall, 14% of the variance in function was explained by all the variables in the model. The findings provide support for use of the Landry cut points to quantify physical activity intensity in hospitalized older adults living with dementia to identify low levels of activity.
SELF-REGULATION AND SELF-EFFICACY OF EXERCISERS DURING COVID-19
Authors: Brown Candace , Chiles Kira 
Published: December 2023

Abstract
Employment, which was greatly impacted by the COVID-19 pandemic, caused alterations to the ‘work-from-home’ culture, and resulted in increased time sitting and decreased time in leisure activities, like exercise. This study explored the relationship of full time employment, intrinsic motivation, and self-efficacy to exercise with the understanding that social distancing and quarantining led to increased social isolation among all ages around the world. Methods Guided by the Self-determination theory, online data was collected from U.S. exercisers ages 18 and older who completed the Exercise Self-Regulation Questionnaire and Self-Efficacy for Exercise Scale during the height of the pandemic, in April 2020, and after, in February 2022. Results There were n = 320 participants that completed the surveys at T1 and n = 107 returned for T2 for a total of N = 427 participants. MANOVA results revealed a significance in intrinsic motivation (p &lt; .001) in 2020 to exercise when gyms and outdoor spaces were closed. The greatest determinants of not achieving self-efficacy to exercise in 2022, when gyms and outdoor spaces were reopened, included “being bored” (36.1%) and “not enjoying” (29.6%) the activity. Conclusion Results suggest that full time employees, regardless of age, endorse high levels of personal accepted values and goals to exercise that are enjoyable, to them, for continued self-efficacy to exercise.
THE VARIATION IN DAILY HABITUAL PHYSICAL ACTIVITY LINKS TO GLOBAL COGNITIVE FUNCTION IN OLDER ADULTS
Authors: Ask Levi , Manor Brad , Lo On-Yee 
Published: December 2023

Abstract
Being physically active is critical to the maintenance of physical and cognitive function into old age. Wearable sensors with the ability to monitor step counts have become popular, making it easier for individuals to track their physical activity levels from day to day. While average daily step count has traditionally been used to quantify physical activity, emerging evidence suggests that the magnitude of day-to-day variation in physical activity or other clinical outcomes may provide additional insight into health. This study aimed to investigate the relationship between the characteristics of habitual physical activity and global cognitive function in older adults. A secondary analysis from a pilot randomized controlled trial was conducted. Thirty-two older adults (79±7 y/o, 29 women) completed the Montreal Cognitive Assessment (MoCA) of global cognitive function at baseline (Total MoCA score: 25.0±2.9). Physical activity was tracked using a Fitbit wrist-worn activity tracker for two consecutive weeks with all participants having 10 complete days. Daily step count mean and standard deviation were calculated to quantify the daily average (4435.12±2768.88 steps) and daily variation (1671.05±1134.03 steps) in physical activity, respectively. After adjusting for age and sex, participants with greater daily variation in step counts exhibited better global cognitive function (r=0.52, p=0.02). In contrast, average daily steps did not significantly correlate with MoCA performance. Neither of these physical activity outcomes were significantly linked to any MoCA subscore. These results suggest that monitoring day-to-day step count variation may serve as a particularly sensitive indicator of global cognitive health in older adults.
ACCEPTABILITY OF HIGH-INTENSITY FUNCTIONAL STRENGTH TRAINING AT HOME FOR POSTINJURY OLDER ADULTS
Authors: Morgan Ashley , Heisz Jennifer , Tang Ada , Thabane Lehana , Richardson Julie 
Published: December 2023

Abstract
Regular exercise plays a vital role in optimizing aging and preventing functional decline. Despite the recognized benefit of exercise, adherence is challenging, and acceptability of exercise interventions is crucial. Acceptability is influenced by various factors, including content, context, and delivery. The purpose of this qualitative descriptive study is to determine the acceptability to older adult participants of a home-based high-intensity functional strength training (HIFST) intervention delivered by a physiotherapist via videoconferencing. HIFST involves the use of periods of ‘hard’ effort using everyday strength-building movements alternating with ‘easy’ recovery periods. This study accompanies an ongoing pilot randomized controlled trial investigating the feasibility of HIFST (completion: spring 2023). We are conducting semi-structured interviews and a short anonymous survey with participants who have completed HIFST. Data collected is being analyzed using qualitative content analysis. To date, results from 8 participants (2 men, 6 women, 55-81 years) demonstrate a positive overall impression of HIFST with all participants noting enjoyment, a good experience, and/or meeting their expectations. Participants reported certain aspects less/more enjoyable than others (e.g., specific exercises). No technical difficulties have been noted and many participants appreciated the convenience of an online format. Prior knowledge of interval-based exercise was minimal for most participants and the majority commented on a preference for shorter intervals with shorter rest periods. Further data collection and analysis will provide a contextualized understanding of the HIFST intervention and important considerations for exercise prescription in an aging population.
OLDER ADULTS’ ACCEPTANCE OF TELEGRACE: A HYBRID TELEHEALTH CARE MODEL
Authors: Preddie Alaina , Penney Lauren , Schwartzkopf Ashley , Schubert Cathy , Bravata Dawn , Damush Teresa 
Published: December 2023

Abstract
The VA Geriatric Resources for Assessment and Care of Elders (GRACE) at Veterans Health Indiana is an interdisciplinary, home-based program providing comprehensive geriatric assessment and ongoing care management for community-dwelling older Veterans’ experiencing geriatric syndromes. TeleGRACE is an extension of the GRACE program and delivers care via a hybrid, telehealth home visit. The TeleGRACE technician operates the audio-visual equipment in the patient’s home while the clinical dyad (GRACE nurse practitioner and social worker) conducts the assessment. The specific aim of this study was to evaluate patient acceptability of TeleGRACE. We conducted a mixed methods study which included Likert-scale ratings and open-ended interviews. Participants used a 5-point scale to indicate agreement (5) to disagreement (1) regarding the acceptability of program elements ratings including ease with technician and virtual dyads; access; and clinical telepresence. The sample included 12 Veterans (mean [M] age, 78.7 years; standard deviation [SD] 7.5) who completed both an initial and follow-up TeleGRACE visit. Veterans reported high agreement of TeleGRACE acceptability (M=4.9, SD=0.3). They agreed: TeleGRACE hybrid visits helped them get care that they could not access otherwise (M=4.7, SD=0.65), they were as well taken care of by TeleGRACE virtual clinicians as those met at in-person visits (M=4.8, SD=0.4), they could hear (M=4.8, SD=0.6) and see (M=5.0, SD=0) the clinical dyads through the video visits, and they were able to ask direct questions of the TeleGRACE clinical staff (M=5.0, SD=0). These results indicated that TeleGRACE’s key elements of a hybrid telehealth home visit were acceptable to older, community-dwelling Veterans.
“IT’S NOT THE DESTINATION BUT THE JOURNEY”: PERSPECTIVES AND ADVICE ON WISDOM
Authors: Lehpamer Nicole 
Published: December 2023

Abstract
While wisdom has been a common topic of contemplation for hundreds of years, a common theme in the wisdom literature relates to how wisdom is acquired through experiences. However, others have found that it can also be developed through individual factors, such as cognition, emotional intelligence, and personality, and cultivated through social interactions and self-reflection. Older adults have more experience than those of any other generation, giving them the time to develop the individual factors associated with wisdom and the skills to cultivate it. Given their unique social position, older adults are thus most qualified to share wisdom. In attempts to capitalize on the wisdom of older adults, the study uses survey data from adults aged 55 and better to examine how older adults characterize wisdom, it’s association with age, and how it can be achieved. Data was collected using surveys administered through the Survey Monkey Platform and the Mather Institute Research Panel. Findings indicate that most older adults believe that wisdom increases with age. They further believe that wise individuals accept their limitations, are realists, have developed strong relationships with others, and seem in control of their lives. Older adults believe that wisdom can primarily be achieved by making mistakes, interacting with people who are different, experiencing adversity, and trying new things. Understanding the ways in which older adults perceive wisdom can be used to enhance intergenerational interactions that are mutually beneficial.
AGEISM IN SUB-SAHARAN AFRICA: PROFESSIONALS’ PERSPECTIVES
Authors: Adeniji Dolapo , Teshome Abraham , Ashirifi Gifty , Adamek Margaret 
Published: December 2023

Abstract
While ageism is increasing across the globe, older adults in Sub-Saharan Africa are more vulnerable to ageism and are often denied a stable means of livelihood leading to poor health and a decreased quality of life. Scholars report that ageism can be experienced in multiple forms including economic, employment, and healthcare, with the intersectionality of gender and other factors complicating ageism. As little is known about ageism in Sub-Saharan Africa, this study explored the perspectives of scholars and professionals about the levels of ageism and age discrimination against older Africans. A cross-sectional study was conducted with scholars and professionals from sub-Saharan Africa. The 78 respondents ranged in age from 24-75 and over half (55.2%) were female. Using descriptive analysis, our findings show that the perceived level of discrimination against older adults is moderate with over half of the respondents (55.7%) indicating that ageism is getting worse. Respondents indicated that older adults are most discriminated against and face barriers in the areas of economic advantages (72.1%), employment opportunities (60.3%), healthcare access (49.4%), and housing (35.3%). Social workers, practitioners, and policymakers should directly address the problem of ageism to promote the healthy living of older adults in sub-Saharan Africa. To turn the tide of ageism and age discrimination in Sub-Saharan Africa, governments need to provide basic social protection to older adults so that they can have a stable means of support in their later years and will be less likely to be perceived as a burden to families and societies.
STRATEGIES TO MITIGATE MACHINE LEARNING BIAS AFFECTING OLDER ADULTS: RESULTS FROM A SCOPING REVIEW
Authors: Chu Charlene , Donato-Woodger Simon , Khan Shehroz , Leslie Kathleen , Shi Tianyu , Nyrup Rune , Grenier Amanda 
Published: December 2023

Abstract
Digital ageism, defined as age-related bias in artificial intelligence (AI) and technological systems, has emerged as a significant concern for its potential impact on society, health, equity, and older people’s well-being. This scoping review aims to identify mitigation strategies used in research studies to address age-related bias in machine learning literature. We conducted a scoping review following Arksey & O’Malley’s methodology, and completed a comprehensive search strategy of five databases (Web of Science, CINAHL, EMBASE, IEEE Xplore, and ACM digital library). Articles were included if there was an AI application, age-related bias, and the use of a mitigation strategy. Efforts to mitigate digital ageism were sparse: our search generated 7595 articles, but only a limited number of them met the inclusion criteria. Upon screening, we identified only nine papers which attempted to mitigate digital ageism. Of these, eight involved computer vision models (facial, age prediction, brain age) while one predicted activity based on accelerometer and vital sign measurements. Three broad categories of approaches to mitigating bias in AI were identified: i) sample modification: creating a smaller, more balanced sample from the existing dataset; ii) data augmentation: modifying images to create more training data from the existing datasets without adding additional images; and iii) application of statistical or algorithmic techniques to reduce bias. Digital ageism is a newly-established topic of research, and can affect machine learning models through multiple pathways. Our results advance research on digital ageism by presenting the challenges and possibilities for mitigating digital ageism in machine learning models.