bluuebunny/crossref_metadata_2025_split huggingface dataset:
HOME-BASED END-OF-LIFE CARE COOPERATION BETWEEN VISITING NURSES AND CARE MANAGERS IN JAPAN
Authors: Ono Keiko 
Published: December 2023

Abstract
End-of-life care patients use home-visit nursing services under Japanese long-term care insurance; however, they require a care manager to implement the care plan. However, the cooperation procedure of home-based medical care between visiting nurses and care managers has not been adequately researched. Thus, this study aimed to clarify the presence of support between visiting nurses and care managers to be adapted to this situation. This study was conducted in March and April 2023 at home-visit nursing stations located in a prefecture in Japan. Self-administered questionnaires were mailed to 192 visiting nurses in Japan, and 136 response forms (70.8%) were received through postal mails. A total of 130 questionnaires (67.7%) were determined to be valid responses, which also included the participants’ written consent for research. The presence or absence of work experience and the importance of collaboration in the preparatory, introductory, stable, and near-death stages of end-of-life care were answered. The presence of work experience at each stage was over 53.1%. The importance of collaboration at each stage was over 76.9%. Query regarding collaborating well with care managers was answered on a scale from 0 to 100 %. Good collaboration with care managers had an average score of 75.4%. The presence or absence of experience and the importance of collaboration items were clarified at each stage. The research findings could contribute to the development of education and training. This work was supported by JSPS KAKENHI Grant Number JP21K02802.
IDENTIFYING CARE TRANSITIONS NEEDS EXPERIENCED BY OLDER ADULTS AND CAREGIVERS HOSPITAL TO HOME
Authors: Regan Claire , Hirschman Karen , McHugh Molly , Osokpo Onome , Mccauley Kathleen , Shaid Elizabeth , Naylor Mary 
Published: December 2023

Abstract
Transitions from hospital to home are a fragile period for older adults, associated with increased risks for hospital readmission and mortality. The Transitional Care Model (TCM), a multi-component, advanced practice registered nurse (APRN) led, team-based care intervention designed to support older adults and their family caregivers during this transition, has consistently demonstrated improvements in both patients’ health outcomes while lowering care costs. This secondary analysis of data generated during a large-scale replication trial of the TCM conducted in three U.S. healthcare systems (ClinicalTrials.gov: NCT04494295) was designed to identify the key challenges experienced by APRNs in implementing TCM’s intervention protocol as designed. Data from multiple sources (i.e., case studies, case presentations, APRN documentation related to 184 intervention group patients) collected from September 2020 through August 2022 were analyzed using qualitative content analysis. Across sites, the top challenges in implementing the TCM and percentage reporting these issues were: social determinants of health (SDoH, 23%); complexity of care (15%); patient engagement (14%); and communication with patients/families (12%) and with providers (10%). Non-Veteran Affairs (VA) hospitals faced a higher number of SDoH challenges such as delays in accessing care and supporting non-English speaking patients, while VA hospitals had a higher number of patients with housing safety concerns. The VA sites also had a slightly higher percent of complexity of care (15%) challenges compared to non-VA sites (12%). Findings offer insight into enhancing the design of transitional care interventions by targeted challenges associated with SDoH, complexity of care, engagement, and communication.
IDENTIFYING NEW ADRD DIAGNOSES IN HOME HEALTH CARE PATIENTS USING NATURAL LANGUAGE PROCESSING OF NURSES’ NOTES
Authors: Barrón Yolanda , Ryvicker Miriam , Song Jiyoun , Zolnoori Maryam , Topaz Maxim 
Published: December 2023

Abstract
Patients at risk of developing Alzheimer’s Disease and Related Dementias (ADRD) admitted to home health care (HHC) may show signs of the disease before receiving a formal diagnosis. HHC nurses are uniquely positioned to observe signs of patients’ cognitive symptoms and may record them in free-text notes in the electronic health record (EHR). We applied natural language processing (NLP) to approximately 1.8 million nurses’ notes to identify signs and symptoms of ADRD in a retrospective cohort of 56,652 patients receiving care from a large HHC agency. In a subset of 38,032 patients starting HHC without an ADRD diagnosis, we used survival analysis competing risks models to examine associations between NLP-derived indicators of ADRD constructs during the HHC episode and new ADRD diagnoses during a four-year follow-up period, adjusting for patient demographics, clinical characteristics, and functional status derived from structured standard assessment tools. By the end of follow-up, 23% of the patients were newly diagnosed with ADRD, while 35% died without a diagnosis. We observed higher 4-year cumulative incidence rates of ADRD when more ADRD-related symptoms were present in the nurses’ notes (e.g., confusion only, 0.35, 95% CI: 0.32; 0.38, memory loss only, 0.38, 95% CI: 0.36, 0.39; both, 0.52, 95% CI: 0.48, 0.56; none, 0.10, 95% CI 0.097, 0.103). These findings indicate that data from free-text notes taken during HHC serve as significant predictors for potential ADRD diagnoses. Such information can facilitate prompt specialist referrals, allowing for early diagnosis and potentially more effective treatments during the disease’s initial stages.
IDENTIFYING PATTERNS OF CHANGE IN SPIRITUAL WELL-BEING OVER TIME AMONG NEURO-ONCOLOGY CAREGIVERS
Authors: Zhu Jiayi , Sherwood Paula , Sereika Susan , Donovan Heidi 
Published: December 2023

Abstract
Spiritual well-being/spirituality has been recognized as a protective factor against caregiver burden, depression, anxiety, and poor quality of life in family caregivers (CG) of patients diagnosed with serious illnesses, such as cancer. However, inconsistent previous findings may be attributed to the limited understanding of spirituality as a dynamic, multidimensional concept. To address this gap, we conducted a secondary analysis using longitudinal data from two independent studies of CGs of patients with primary malignant brain tumors (pooled N=261) to identify trajectories in overall spirituality (FACIT-SP) and its 3 sub-dimensions (faith, meaning, peace) from diagnosis to 10-12 months post-diagnosis, as well as predictors and outcomes associated with trajectory group membership. For overall spirituality, 3 unique trajectories were identified: low-increasing, medium-stable, and high-stable. The faith and meaning sub-dimensions had 3 and 2 stable trajectories, respectively, while the peace sub-dimension showed low-increasing, medium-stable, and high-increasing trajectories. Older age and higher levels of perceived social support at baseline were associated with increased odds (up to 1.06 and 1.20, respectively) of being in the high-stable/high-increasing trajectories for overall spirituality and the sub-dimensions. The trajectories of overall spirituality and sub-dimensions were positively associated with CG’s mental well-being (η2=.030-.069) and self-esteem (η2=.072-.162), and negatively associated with CG’s depression (η2=.053-.319), anxiety (η2=.055-.271), and feeling of abandonment (η2=.032-.160) at 10-12 months. This study supports recognizing spirituality in CGs as a dynamic, multidimensional concept. Future interventions focusing on early screening in younger adults and supportive measures for low spiritual well-being through improving social support might improve important CG outcomes.
IMPACT OF A 4-MINUTE STRENGTH TRAINING PROGRAM ON LOWER BODY FUNCTION IN OLDER ADULTS WITH MOBILITY DISABILITY
Authors: Kurth Jordan , Sciamanna Christopher , Stine Jonathan , Ladwig Matthew , Conroy David , Schmitz Kathryn , Herrell Cheyenne 
Published: December 2023

Abstract
One in four older adults experience mobility disability, often resulting in financial strain and declines in quality of life. Though resistance training (RT) can improve physical function, too few older adults do RT. This study specifically reports on the impact of a short, daily RT program called Functional Activity Strength Training (FAST) on lower extremity function. FAST entailed one 30-second bout each of four exercises (push-ups, chair stands, two-arm resistance band rows, stair-stepping) followed by 30 seconds of rest daily for 12 weeks. Ninety-seven participants were randomly assigned to either intervention (n = 44) or delayed treatment control (n = 53) group. Research staff remotely provided one-on-one coaching relating to modifications and progress every 2 weeks until week 8. Participants received a daily email reminder to complete the exercises and report repetitions completed for each exercise. Outcome measures (5-time sit-to-stand, maximum 30 second chair stand performance, and single-leg stance duration) were evaluated at baseline and week 12. Participants completed exercises on 80% of possible days. Over the 12 weeks, the intervention group improved over and above the control group by +4.2 chair stands (d = 1.21), -2.3 seconds (d = -0.43) on the 5-times sit-to-stand, and +3.58 seconds (d = 0.46) on the single-leg stance. In sum, a four-minute daily, 12-week functional RT program led to improvements in chair stand, 5-times sit-to-stand, and single-leg stance performance. Efficacy trials, using gold-standard assessments should examine whether similar improvements are observed and adherence is maintained over a longer period of time.
IMPACT OF GRANDPARENTS’ CHRONIC STRESS ON GRANDPARENT-PARENT RELATIONSHIP AND LIFE SATISFACTION BY GENDER AND RACE
Authors: Mozid Nusrat E , Guastaferro Kate 
Published: December 2023

Abstract
Grandparents raising grandchildren are a rapidly growing population in the United States—an estimated 7.1 million children under 18 live with a grandparent in 2023. Family system theory suggests raising a grandchild impacts grandparents’ immediate and extended family relationships and amplifies stressors in the relationship with the parent of the grandchild. The quality of relationships with the parents negatively impacts grandparents’ psychosocial well-being but may also have lasting adverse effects on the grandchild. Using the most recent wave (2020) of the nationally representative Health and Retirement Study, we conducted linear regression analyses to understand the association between grandparents raising grandchildren’s (N=4,238) chronic stress (e.g., health, finances, housing) and anxiety symptoms by gender and race. Then, we examined the grandparents’ relationship with the parent and satisfaction with life as potential mediators in these associations. Results suggest grandparents’ stressors were significantly associated with anxiety symptoms (β=0.349; p&lt; 0.01); however, there were no significant differences in total chronic stress by either gender or race. Path analysis showed both the grandparent-parent relationship and grandparents’ satisfaction with life partially mediated the association between grandparents’ chronic stress and anxiety symptoms (p&lt; 0.001). Cultivating a consistent and quality relationship between grandparent and parent as well as focusing on grandparents’ perspectives of life suggests innovative intervention targets to improve the health and well-being of both grandparents and grandchildren.
IMPROVING HEALTHCARE REGULATIONS FOR RESIDENTS WITH DEMENTIA: PERSPECTIVES OF REGISTERED DIETITIANS
Authors: Thaitrong Phatt , Douglas Joy , Knol Linda L , Ellis Amy , Noh Hyunjin , Sanchez Shena 
Published: December 2023

Abstract
In order to admit residents on Medicare or Medicaid, long-term care (LTC) facilities in the United States are required to comply with federal regulations provided by the Centers for Medicare and Medicaid Services (CMS). However, limited research exists regarding the first-hand experiences of Registered Dietitians (RDs) working in LTCs and their perceptions on the extent to which the current healthcare regulations adequately address the nutritional needs of residents with dementia. Exploring the perspectives of RDs is crucial since residents with dementia may face difficulties expressing their nutritional needs. Our study explored RDs’ perspectives and identified how menu planning (F803) and mealtime environment (F558) regulations could be improved to better meet the needs of LTC residents with dementia. RDs who work with residents with dementia in the U.S. (n = 18) participated in one of five focus groups. Focus groups were led by a trained moderator using a semi-structured interview guide, transcribed verbatim, and audited by the research team for accuracy. Transcripts underwent descriptive content analyses using NVivo© software. Analyses revealed the RDs’ suggestions that F803 and F558 regulations need to 1) be more clear, 2) specify objective criteria to measure adherence, 3) work toward patient-centered care, and 4) give priority to residents with dementia. To meet the needs of LTC residents with dementia, mealtime-related healthcare regulations need to incorporate clear verbiage with measurable criteria. This will allow for easier understanding of the regulations and assessment of compliance with the regulations in LTCs.
INCREASING DEPRESSION PREVALENCE AMONG OLD ADULTS DURING THE COVID-19 PANDEMIC
Authors: Zhu Jiangyuan , Li Guohua , Lang Barbara , Chihuri Stanford 
Published: December 2023

Abstract
Previous research has reported worsening mental health outcomes in children and young adults amid the COVID-19 pandemic. The purpose of this study was to assess the impact of the COVID-19 pandemic on the prevalence of depression in older adults. The Longitudinal Research on Aging Drivers (LongRoad) study involved prospectively following (between July 2015 and September 2022) 2990 drivers aged 65-79 years recruited from five sites across the contiguous United States. Study participants were assessed at baseline and annually during the follow-up period using the Patient-Reported Outcomes Measurement Information System (PROMIS). The overall response rate was 69.1%. The prevalence of depression increased from 7.12% during 2015-2019 to 9.89% during 2020-2022 (p &lt; 0.001). After adjusting for age, gender, race and ethnicity, marital status, and annual household income, the risk of depression increased by 42% [adjusted odd ratio (aOR) 1.422, 95% confidence interval 1.237-1.635] during the COVID-19 pandemic. The results of this study indicate that the prevalence of depression among older adults increased significantly during the COVID-19 pandemic.
INVESTIGATING DREAMING IN COGNITIVELY DIVERSE OLDER ADULTS
Authors: Britton Warren , Strong Jessica 
Published: December 2023

Abstract
Dreaming changes across the lifespan. While our understanding of how dreaming relates to aging and well-being has developed with respect to early and middle phases of the lifespan, the dreams of older adults remain under-studied. Reviews of the literature suggest decreases in dream recall and the emotionality of dream content that often precede age-related changes in sleep architecture, with few changes in dreaming occurring between ages 45-75, after which dream recall declines steeply. However, these findings are based on relatively few studies. This point is underscored when considering the effects of secondary aging on dreaming, where virtually no literature exists on the dreams of older adults experiencing mild cognitive impairment. Studying the dreams of older adults experiencing cognitive impairment may seem trivial when compared to other processes implicated in secondary aging, but recent studies examining the relationship between frequency of negative dream content and the increased risk of onset and acceleration of cognitive decline beg a closer examination of how dreaming contributes to a broader understanding of health and functioning across the lifespan. The scoping review of sleep, dreams, well-being and cognition across the lifespan, and the subsequent proposed study design seeks to employ the Hall and Van de Castle Coding System of content analysis to contribute to the literature on the dream frequency and content of cognitively typical older adults while also exploring the feasibility and methodological considerations of studying the dream content of older adults with mild cognitive impairment.
LONGITUDINAL CHANGE IN PERFORMANCE ON THE MONTREAL COGNITIVE ASSESSMENT IN THE PEOPLE WITH DEMENTIA
Authors: Wu Kuan-Ching , Jin Jessica , Chien Shao-Yun , Zaslavsky Oleg 
Published: December 2023

Abstract
The Montreal Cognitive Assessment (MoCA), a widely employed cognitive screening tool, is designed to identify mild cognitive impairment and diverse forms of dementia. Through its multidimensional evaluation of cognitive domains, MoCA supports clinicians in precise assessment and intervention planning for individuals manifesting cognitive deficits. Despite MoCA’s prevalence, limited research has explored its temporal dynamics in individuals experiencing memory loss, particularly across different stages of dementia. This study examined the MoCA changes of a longitudinal study analyzing the conversational speech in 8 older adults (5 males 3 females) with mild- to moderate-stage of dementia. Repeated biweekly measures at 12 intervals over six months were employed to gauge changes in total MoCA scores and its sub-tasks. Our findings reveal: 1) a significant negative correlation (r=-0.22, p=0.03) between the total MoCA score and the total time spent in tests; 2) most participants present a positive correlation (r=0.03 to 0.6) in their first memory trial session and a negative correlation (r=-0.1 to -0.8)in the second trial between words recalled and the time spent; 3) over 60% of participants demonstrating a declining trend in naming sessions, while orientation sessions exhibit no clear trend. These outcomes imply MoCA’s susceptibility to a “learning effect” with repeated measurements in people with dementia. Future longitudinal studies should consider alternate MoCA versions or extended assessment intervals to mitigate this effect.
LONG-TERM NMN TREATMENT INCREASES LIFESPAN AND HEALTHSPAN IN MICE IN A SEX DEPENDENT MANNER
Authors: Kane Alice , Chellappa Karthikeya , Schultz Michael , Diener Christian , Gibbons Sean , Baur Joseph , Rajman Luis , Sinclair David 
Published: December 2023

Abstract
Levels of nicotinamide adenine dinucleotide (NAD+) decline by up to 50% in aging. NAD+ is an essential co-factor for many metabolic processes, including the deacetylase activity of sirtuins, and previous studies have demonstrated that supplementing NAD+ levels has a range of health benefits in both mice and humans. Here we investigate the effect of long-term (from 13 months of age) administration of the NAD+ precursor nicotinamide mononucleotide (NMN) on frailty and lifespan in male and female mice. NMN treatment delayed the onset of frailty in both sexes, improved metabolic health in male mice, and increased median lifespan by 8.5% in female mice. Exploration of the potential mechanisms of this protection showed that NMN treatment prevented age-related gene expression changes in skeletal muscle and led to a large increase in levels of Anaerotruncus colihominis, a microbe associated with reduced inflammation, in the gut. A thorough characterization of NMN metabolism across age, sex and tissues shows context-specific sex differences in metabolic pathways, including greater Preiss-Handler pathway metabolism in females than males, which may contribute to observed sex differences in health and lifespan. Overall, this data provides preclinical evidence that chronic NMN treatment increases lifespan and improves frailty and metabolic health in aging, and highlights the importance of using both sexes for interventional lifespan studies.
MIDLIFE MEDIATORS OF EDUCATIONAL DIFFERENCES IN DEMENTIA RISK IN LATER LIFE:PRELIMINARY RESULTS FROM THE HUNT STUDY
Authors: Mekonnen Teferi , Skirbekk Vegard , Kohler Hans-Peter , Stern Yaakov , Håberg Asta , Engdahl Bo , Zotcheva Ekaterina , Strand Bjorn Heine 
Published: December 2023

Abstract
There is a well-known association between education and dementia risk. However, there is limited knowledge of the mediating mechanisms. Using data from the HUNT study linked with registries (n=9745), we examined the mediating role of occupation complexity, smoking, physical inactivity, systolic blood pressure, body mass index(BMI), cardiovascular diseases, hearing impairment, diabetes, and depression score (only in HUNT2) assessed during HUNT1(age 45years) and HUNT2(age 56years) for the association between education and dementia among 70+ years using causal mediation analysis. Among eligible participants, 15.7% had dementia at age 70+ years, completed compulsory education (25.7%), lower-secondary (41.7%), upper-secondary(12%), undergraduate(16.5%), and postgraduate education(4%). For every one-unit increase in educational level from compulsory education to the following levels, a decrease in the odds of having dementia among 70+ years was found (OR=0.74). Midlife mediators assessed at 45 and 56 years jointly explained 17.3% and 26.8% of the effect of education on dementia among 70+ years, respectively. Smoking and systolic blood pressure (each explained 3.7%) followed by BMI(explained 2.3%) showed a significant independent mediating role for the educational differences in dementia among 70+ years. Whereas, among the mediators assessed at the age of 56 years, systolic blood pressure(explained 6.1%), hearing impairment (explained 4.4%), smoking(explained 3.1%) and depression score(explained 2.7%) showed significant independent mediating effects. Midlife risk factors of dementia considered in this study explained nearly one-fourth of the effect of education on dementia in particular, systolic blood pressure, hearing impairment, smoking, depression score and BMI. If truly causal, these factors could indicate potential targets for interventions.
MINDFULNESS AND DEPRESSION ASSOCIATED WITH FALL RISK IN LOW-INCOME COMMUNITY-DWELLING OLDER ADULTS
Authors: Uddeen Aleeyah , Komalasari Renata , Thiamwong Ladda 
Published: December 2023

Abstract
Mindfulness is the state of being aware and present using mind-body exercises. Practicing mindfulness and reducing depression can improve balance and reduce fall risk among older adults. The purpose of the study was to examine the correlation between mindfulness and depression with fall risk among community-dwelling older adults in low-income settings. A descriptive cross-sectional survey design was used to assess 103 older adults (males=16, females=87, mean age=75.70, 95% CI±7.19) using questionnaires to measure mindfulness, depression, and fall risk. Mindfulness was measured using the Day-to-Day Experiences, which is a fifteen-item scale with lower scores indicating less awareness. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Fall risk was assessed using the CDC’s Stay Independent checklist. Data analysis was run using SPSS version 28. Spearman rank analysis showed that mindfulness was negatively correlated with fall risk (r=-.437, p&lt;.001), whilst depression was positively correlated with fall risk (r=.486, p&lt;.001). Using regression analysis, we examined if mindfulness and depression predicted fall risk. The results of the multiple regression indicated that the model explained 23% of the variance (R²=.230, F (2,100)=14.97, p&lt;.001). Mindfulness (β=-.060, p=.010) and depression (β=.341, p=.002), respectively, were significantly associated with fall risk. It can be concluded that mindfulness and depression are predictors of fall risk in this study. Older adults, particularly in low-income settings, could potentially benefit from improving mindfulness through mind-body exercises that enhance awareness and mindful movement, as well as from improving mental health, thereby reducing fall risk.