bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATIONS OF ACTIGRAPHIC SLEEP WITH ADIPOKINES IN OLDER ADULTS
Authors: Yue Yiwei , Wei Zhikui , Rabinowitz Jill , Chia Chee , Tanaka Toshiko , Simonsick Eleanor , Ferrucci Luigi , Spira Adam 
Published: December 2023

Abstract
Adipokines are adipose-derived cytokines that play important roles in metabolism and obesity. Accumulating evidence suggests that sleep disturbance could alter adipokine levels and contribute to systemic metabolic dysfunction in younger and middle-aged populations. Less is known about links between sleep disturbance and adipokines in older adults. We examined cross-sectional associations of actigraphic sleep parameters with adipokine levels in 353 community-dwelling older adults aged 74.8±8.3 years (51.3% male, 26.6% non-white) enrolled in the Baltimore Longitudinal Study of Aging. Participants completed 6.56±1.06 nights of wrist actigraphy and had morning fasting adipokine levels measured in plasma. Predictors included actigraphic total sleep time, sleep onset latency, wake after sleep onset, sleep efficiency, and average wake bout length (WBL), and outcomes were levels of the adipokines, specifically adiponectin and leptin. Adjusting for sex, age, race, years of education, BMI, hypertension, and diabetes, longer WBL was associated with lower adiponectin (B=-1.73, 95%CI: -3.07,-0.38) and leptin (B=-2.93, 95%CI: -4.61,-1.24). WBL interacted with sex (p-value for interaction = 0.018); higher WBL was associated with lower adiponectin in men (B=-4.12, 95%CI: -6.46, -1.79), but not in women (B=-0.34, 95%CI: -2.48,1.80). Findings link sleep fragmentation to lower leptin and adiponectin in older adults, particularly lower adiponectin in older men. Findings provide a potential mechanism by which disturbed sleep may promote metabolic derangements in later life. Prospective studies and sleep intervention trials are needed to evaluate whether these associations are causal, and to elucidate factors contributing to sex differences in these associations.
GENDER DIFFERENCES IN THE ASSOCIATION BETWEEN SLEEP AND INFLAMMATORY MARKERS: RESULTS FROM THE EINSTEIN AGING STUDY
Authors: Ji Linying , Shen Yuqi , Graham-Engeland Jennifer , Derby Carol , Engeland Christopher , Buxton Orfeu 
Published: December 2023

Abstract
Prior research links poor sleep and higher systemic inflammation. Gender differences in both sleep and in inflammatory responses have been observed. We investigated gender differences in the association between levels as well as variability of objective sleep health and inflammatory markers (including stimulated inflammatory markers) among a diverse sample of older adults. Participants free of dementia (N=215, Mage=77.5 years, 64% women; 46% White, 39% Black, 15% Hispanic/other) were from The Einstein Aging Study. Actigraphy (2 weeks) yielded wake after sleep onset (WASO), total night sleep time (TST), and midpoint night sleep. Inflammatory markers included circulating C-reactive protein (CRP) and circulating and lipopolysaccharide (LPS)-stimulated levels of interleukin (IL)-1β, IL-4, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-𝛼. Bayesian variability models evaluated associations of inflammatory markers with mean and variability of sleep measures, adjusted for BMI, gender, age, education, race/ethnicity. Circulating inflammatory markers were not associated with sleep measures, except higher TST variability with higher circulating IL-6 among women. For stimulated cytokines, among men, higher mean WASO, TST, and later midpoint were associated with higher stimulated IL-8 and TNF-𝛼. All stimulated cytokines except IL-1β were associated with greater variability in WASO, TST, and sleep timing among men. Among women, the only significant association with stimulated cytokines was between higher mean TST and higher stimulated IL-8. We found gender differences in the associations between sleep and inflammation in older adults, primarily in men and for stimulated (not circulating) cytokines. Interestingly, associations were also more frequently observed for sleep variability than mean levels.
PHYSIOLOGICAL LINKAGE WITH CAREGIVERS IS ASSOCIATED WITH EMOTION RECOGNITION IN CARE RECIPIENTS
Authors: Chen Kuan-Hua , Casey James , Brown Casey , Merrilees Jennifer , Levenson Robert 
Published: December 2023

Abstract
Persons with neurodegenerative diseases (PWDs) often develop profound declines in the ability to recognize emotions in others that lead to diminished social connectedness with their loved ones. Physiological linkage, which refers to the degree that people’s physiological responses change in coordinated ways, can serve as a proxy measure for social connectedness. Physiological linkage has been found to be diminished during interactions between PWDs (i.e., care recipients) and their family caregivers. However, the association between diminished physiological linkage and PWDs’ lower emotion recognition has not been determined. In a sample of 28 PWD-family caregiver dyads, we quantified physiological linkage as the positive (“in-phase”) correlations between PWD’s and caregiver’s somatic activity. Somatic activity was measured remotely via actigraphy using wristwatches worn by both partners in their homes during waking hours for 7 days. PWDs’ emotion recognition was quantified as the ability to recognize positive and negative emotions of their caregivers accurately during a 10-minute conflict conversation in our laboratory prior to the 7-day home assessment. Lower emotion recognition by PWDs of their caregivers’ negative emotions (β = .49, p = .01), but not positive emotions (β = .12, p = .52) in the laboratory assessment was associated with lower physiological linkage between PWDs and caregivers in their home. Establishing a relationship between PWDs’ deficits in emotion recognition and diminished physiological linkage during conversations with their caregivers provides a basis for understanding problems in establishing social connections that are often observed in PWDs.
GENDER-BASED VIOLENCE IN HOMICIDE–SUICIDE EVENTS: A CALL FOR ADHERENCE TO THE CDC DEFINITION FOR “MERCY KILLING”
Authors: Salari Sonia , Sillito Carrie , Videla Emma 
Published: December 2023

Abstract
Intimate partner homicide suicide (IPHS) events are overwhelmingly male perpetrated (90%). Gender-based violence (GBV) prevention requires ‘best practices’ for media reporting. Consider the following: In a patient room of a busy hospital, an overwhelmed man (71) suicided after firing shots at his wife (70) who had survived a stroke. The gunfire caused trauma among witnesses. Media reports used the term ‘mercy killing,’ but critical ingredients were missing. The CDC’s NVDRS (2022) defines ‘mercy killing’ as “…Killed, at the victim’s request…to end…pain or distress…Do not assume…murder/suicide by a sick, elderly couple is mercy killing.” Evidence of a clear wish to die, is needed “due to a hopeless or terminal condition.” Our IPHS, news surveillance study was updated 1999-2022 and used content analysis to identify GBV rationalizations, based upon 2219 events and over 5000 fatalities across young (n=987), middle aged (n=699), and older 60+ (n=533) categories. Only the 60+ group had claims of ‘mercy killing,’ mostly without adherence to the CDC definition. Older men who are suicidal may also harm an unsuspecting partner. For women, end of life decision-making is lost in ‘safe spaces,’ like homes or care facilities, which is made worse by rationalized excuses. Women are rarely suicidal and use passive methods (i.e., drugs). When women care for an ailing partner, they don’t commit IPHS. Older men are more suicidal and utilize more lethal firearm methods (similar to the IPHS patterns). Media best practices involve valuing persons with disabilities, publicizing services and recognizing violence is a public health problem.
MIGRATION AS A PATHWAY TO KINLESSNESS AMONG OLDER ADULTS LEFT BEHIND
Authors: Matos-Moreno Amilcar , Santos-Lozada Alexis , Sheftel Mara , Verdery Ashton 
Published: December 2023

Abstract
Recent research examines the topic of kinless adults, people over the age of 50 who have neither a living spouse nor living children. Crossnational examinations find that the prevalence of kinlessness in these age groups ranges between 2% and 10% in most countries around the world and that kinless individuals tend to be disadvantaged on health and well-being dimensions. Prior work has not, however, examined migration in the context of kinlessness. Given high rates of migration in numerous sending contexts around the world, this study examines the prevalence of kinlessness in Puerto Rico, Mexico, Costa Rica, and the United States incorporating migration as a pathway to kinlessness and examining its association with well-being. Using surveys from the Health and Retirement family of studies from Puerto Rico, Mexico, Costa Rica, and the United States, we estimate the prevalence of kinlessness focusing on how these estimates change when treating adult family migrants as not available for the provision of social support. We also estimate the association between kinless typologies and health status. Puerto Rico exhibits the highest older adult kinlessness prevalence (Puerto Rico: 8.4%, Costa Rica:6.0%, Mexico:6.5%, United States:7.2%). The incorporation of migration as a pathway to kinlessness increases the prevalence in Puerto Rico (+3.8%) and Mexico (+5.2%) more so than for Costa Rica or United States. Kinlessness is associated with higher levels of depression among Puerto Rican older adults. This study reveals the importance of considering migration as a pathway to kinlessness in high outmigration countries and its impact on health.
THE CO-EVOLUTION OF PERSONAL NETWORKS AND LONELINESS FOLLOWING WIDOWHOOD FOR MEN AND WOMEN
Authors: Lee Jina , Schafer Markus 
Published: December 2023

Abstract
Late-life transitions such as widowhood often re-calibrate people’s close personal networks. Some network change—particularly growth in network size and closer geographic access to network members—is assumed to protect against loneliness, but scholars have yet to systematically examine these processes post widowhood. This study uses data from four waves of the German Aging Survey (DEAS), conducting gender-specific hybrid panel modeling to estimate both within- and between-individual effects of (1) network conditions up to seven years past widowhood, and (2) the effects of network change on loneliness. Results reveal that network size takes on a reversed U-shape: Germans becoming widowed tend to see an influx of new core ties from beyond their family, but this trend slows and reverses with time. There was also some evidence of non-linear change related to distance: geographic distance to core network members tended to shrink following widowhood before expanding back outward. Furthermore, moderation analyses an important role for these network characteristics on loneliness. Larger non-kin networks in the aftermath of widowhood partially alleviated the loneliness associated with that transition. The role of geographic proximity was gender-specific, as widowed men with nearby non-kin ties were most protected against loneliness, whereas widowed women fared best if their kin ties were farther away. Altogether, this study presents novel insight into how personal networks evolve after widowhood, revealing the nuanced, gendered ways that networks adapt. Efforts to reduce loneliness after widowhood may consider how gender roles and expectations shape the transmission and meaning of companionship and support.
PILOT RCT TO EXAMINE A MOBILE HEALTHY EATING INTERVENTION FOR PERSONS WITH FRAILTY
Authors: Zaslavsky Oleg , Wu Kuan-Ching , Naik Aishwarya , Su Yan 
Published: December 2023

Abstract
New scalable approaches are needed to promote healthy eating and improve health in persons with frailty. We evaluated a new mobile intervention consisting of a patient-facing app and clinician interface to support Mediterranean-style eating in a pilot RCT. Fourteen females and one male, averaging 71 years of age, were randomized to intervention (n=8) or control (n=7) for three months. In the intervention, participants were encouraged to interact with the app at least once a week, whereas, in control, participants received handouts with information and online resources concerning the Mediterranean Diet. Mann-Whitney and Cohen’s d estimates were used to compare groups and evaluate effects. All participants completed and consistently adhered to the study protocol throughout the study. At the end of the study, there was a significant improvement in the intervention compared to the control in the following outcomes: SPPB (W=45, p=0.049; d=1.14); Mediterranean Diet Knowledge (W=49.5,p=0.013; d=1.26); consumption of vegetables (W=47, p=0.03; d =1.42); consumption of legumes (W=54, P=0.001; d=1.32), and negative outcome expectations (W=9,p=0.03; d=0.56). Albeit insignificant, intervention group participants improved their inflammatory, lipids, and glycemic blood measures. At the exit interviews, most participants expressed satisfaction with the app and acknowledged that the app was useful and easy to operate. They also provided points for improvement concerning control over the frequency of interactions with the app, more personalized choices for meals, and better visualization of their progress. The study demonstrated the preliminary efficacy of the digital intervention and suggested several mechanistic measures involved in behavioral change.
A SYSTEMATIC REVIEW OF MEASURES OF SOCIAL CONNECTION FOR PEOPLE LIVING IN LONG-TERM CARE HOMES: THE SONNET STUDY
Authors: Bethell Jennifer , Sommerlad Andrew , Chapman Hannah , Dewan Neha , Liougas Madalena , Livingston Gill , McGilton Katherine 
Published: December 2023

Abstract
Social connection is important for quality of life and care in long-term care (LTC) homes. However, measuring social connection in LTC residents is challenging and research is limited by a lack of consensus on best approaches to measurement. Our study objective is to systematically review measures of social connection developed for LTC residents. We are following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) systematic review methods. We searched multiple bibliographic databases to April 2022 for studies conducted in LTC residents that quantified any aspect(s) of social connection and reported at least one psychometric property for the measure(s) of social connection. We are using COSMIN guidelines to evaluate the properties reported for each measure. We identified 60 studies reporting on 38 measures that assess social connection in LTC homes. Twenty-eight were measures of quality of life, wellbeing or life satisfaction and included a social connection subdomain. Only 10 measures specifically targeted social connection. From our evaluation of 32 measures to date, we found that 16% (n=5) have sufficient structural validity, 9% (n=3) have sufficient internal consistency, 22% (n=7) have sufficient reliability, and 19% (n=6) have sufficient construct validity. Many measures have assessed social connection in LTC homes, but few are designed for this purpose and many have insufficient psychometric properties. This review will provide detailed evidence of the quality of these measures to enable researchers to prioritise valid and reliable tools. Our results will inform our development of a new person-centred measure of social connection for LTC residents.
PATTERNS OF ANTIHYPERTENSIVES CHANGE AND MORTALITY IN VA NURSING HOME RESIDENTS
Authors: Liu Xiaojuan , Odden Michelle 
Published: December 2023

Abstract
Antihypertensive treatment is common in nursing home residents, yet data on the frequency and pattens of treatment changes in this group are lacking. We described the patterns of antihypertensive treatment changes and examined the mortality rate in 24870 Veterans Affairs (VA) nursing home residents ≥65 years with long-term stays (≥180 days) from 2006-2019. The number and dose of antihypertensive use was averaged weekly, and two change events were defined: deprescribing (reduced number of antihypertensives or dose of ≥30% compared to previous week) and intensification (opposite to deprescribing). More than 91% of residents were prescribed antihypertensive and 75% experienced at least one event during their stay. Death occurred in 7881 (32%) residents. We categorized residents into 10 distinct pattern groups: no change (27%), 1 deprescribing event (11%), 1 intensification event (10%), multiple deprescribing events (5%), multiple intensification events (7%), 1 deprescribing followed by 1 intensification (3%), 1 intensification followed by 1 deprescribing (4%), 3 changes with mixed deprescribing/intensification (7%), &gt;3 changes with mixed deprescribing/intensification (10%), and no antihypertensive use (15%). We found treatment changes were more frequent in residents with better mobility and cognitive function. Residents who experienced deprescribing events had higher mortality than those experienced intensification events. The highest mortality was for those without medication (incidence = 344/1000 person-year) and this group also had the worst cognitive function. These findings indicate that complex patterns of medication changes exist in VA nursing home residents. A better understanding of the consequence of antihypertensive treatment changes could inform clinical practice in this population.
DIGITAL LITERACY, INTERGENERATIONAL RELATIONSHIPS, AND CARE PREPARATION AMONG CHINESE AGING ADULTS IN HONG KONG
Authors: Bai Xue , Yu Wing-Lam , Liu Chang 
Published: December 2023

Abstract
The rapid ageing trend spotlights the need for more eldercare. Care preparation as a form of proactive coping can mitigate the negative effects of potential eldercare needs. Acquisition and preservation of resources are essential for effective proactive coping. The roles of digital literacy and intergenerational relationships as two significant resources in older people’s care preparation are still understudied. Integrating social convoy theory, intergenerational solidarity theory, and proactive coping theory, this study compared the levels of digital literacy, intergenerational relationships, and care preparation in son-dominant, daughter-dominant, and daughter & son-balance families; and examined the mediating effects of intergenerational relationships on the relationship between digital literacy and care preparation. Data from 3,626 participants with at least one adult child were drawn from the Panel Study of Active Ageing and Society, a biennial study conducted with a representative sample of people older than 50 years in Hong Kong. ANOVA was used to compare scores of key variables in three types of families. PROCESS was used to examine the mediation effects. Results showed that participants in a son-dominant family had the highest level of digital literacy; those in a daughter-dominant family reported the highest levels of intergenerational relationship quality and care preparation. Intergenerational relationship quality mediated the relationship between digital literacy and care preparation in three types of families while the effect sizes differed. These findings implicate the need to enhance older people’s digital literacy and foster their intergenerational relationships, thereby assisting them to be well-prepared for care needs in later life.
ADVANCED-COMFORT: TESTING A CARE PLANNING INTERVENTION FOR NURSING HOME RESIDENTS WITH ADVANCED DEMENTIA
Authors: Lopez Ruth Palan , Wei Andrea , Locke Jenna , Plys Evan 
Published: December 2023

Abstract
Many nursing home (NH) residents with advanced dementia receive burdensome interventions rather than interventions that promote comfort or quality of life. The purpose of this study was to test the usability of a novel intervention called ADVANCED-Comfort that aims to enhance the provision of personalized, comfort focused care for residents with advanced dementia. The intervention consisted of structured care plan meetings between the NH team and proxies of residents with dementia (e.g., family members). Using the ADVANCED-Comfort workbook, proxies and staff created individualized care plans addressing 6 domains adapted from the Age Friendly Health System Framework (what Matters; Meaningful activities; Mealtime; Mobility; Medications and treatments; and Make comfortable). We evaluated the intervention using surveys, observation, and exit interviews. We found the intervention to be highly usable (acceptable, appropriate, and feasible) and exit interviews identified several promising outcomes. Both families and staff reported that the intervention improved communication and trust. Families reported that they had a newfound trust in staff to provide consistent quality care. Staff reported that the intervention helped them build better relationships with families and allowed families to articulate what they prefer rather than waiting until “something goes wrong.” Staff also reported that the intervention improved their excitement to go to work and enhanced their sense of teamwork. Finally, both staff and proxies reported exciting implications for residents such as a reduction in antipsychotic medication, decrease in distressed behaviors, weight stabilization, and initiation of hospice. Based on these preliminary findings, additional testing of the ADVANCED-Comfort intervention is warranted.
ANTI-ASIAN RACISM AMONG OLDER KOREAN AMERICANS DURING THE COVID-19 PANDEMIC
Authors: Kwon Soonhyung 
Published: December 2023

Abstract

Background
Hate crimes in the U.S. targeting adults of Asian descent have sharply increased during the COVID-19 pandemic. Korean Americans experience the highest level of everyday racism (37.5%), followed by Chinese (15.2%) and Vietnamese during the pandemic (Jung et al., 2021). Moreover, perceived discrimination in older Korean Americans is significantly related to a greater risk for poor mental health (Chau et al., 2018). However, older Korean Americans were likely to experience barriers to mental healthcare services. With this concern in mind, this study explored how older Korean Americans perceived discrimination related to ethnicity/race and coped with adverse mental health during the pandemic.

Methods
Our study used the thematic analysis of textual data to reconstruct and categorize, engaging in six steps: 1) familiarizing the qualitative data, 2) generating initial codes, 3) searching for themes, 4) reviewing themes, 5) defining and naming themes, and 6) producing a final report.

Results
This study identified that older Korean Americans (N=18) experienced direct and vicarious racism during the pandemic but felt barriers (limited English proficiency and a lack of accessible resources) to mental healthcare services. Active religious activities ameliorated discrimination-related stress. Some participants tried to solve the stress through wrong behaviors that criticized Chinese Americans. As a result, barriers to mental healthcare were likely to cause secondary discrimination and prejudice against Chinese Americans.

Discussion
To ameliorate adverse mental health and prevent secondary discrimination, it is essential to identify well-accepted, well-timed, sustainable, and cost-effective therapeutic strategies to alleviate the adverse mental health associated with discrimination-related stress.