bluuebunny/crossref_metadata_2025_split huggingface dataset:
SENIOR TECHNOLOGY ACCEPTANCE, FEAR OF FALLING AND FALL RISK ASSESSMENT IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Ojo Eunice Oladepe , Ng Boon Peng , Thiamwong Ladda 
Published: December 2023

Abstract
The use of technology, such as the BTrack balance system (BBT) for fall risk assessment and the Senior Technology Acceptance (STA) survey is important for understanding technology-based fall prevention efforts for at-risk older adults. The purpose of this study was to examine the relationship between technology-based fall risk assessment and STA among community-dwelling older adults aged 60 years and older (n=124). Descriptive statistics, bivariate analysis, and multiple linear regression adjusted for socio-demographics were performed. The STA tool was used to obtain information about older adults’ acceptance of technology. The STA consists of four domains and 14 items. The Short Fall Efficacy Scale International (FES-I) and the BBT were used to measure fear of falling and balance performance, respectively. Of the study population, 77.4% were female, 22.6% were non-white, 8% reported financially inadequate, 46% had low BBT scores and low FES-I scores, whereas 33.9% had high BBT and high FES-I scores, and 20.2% had low BBT and high FES-I scores. For the bivariate analysis, we found a statistically significant difference in the STA scores based on age (p=0.006) and education (p=0.032). In the adjusted analysis, only age was negatively associated with the STA (p=0.004); fall risk assessment using the BBT and FES-I were not significantly associated with STA. With a small study population, readers should be aware of this limitation to our findings. Further studies are needed to address this issue and to identify effective strategies to encourage older adults to use technology to improve their well-being.
SEQUENTIAL ANALYSIS OF DEMENTIA FAMILY DYADIC COMMUNICATION: EFFECT OF CAREGIVER DISABLING COMMUNICATION
Authors: Kim Sohyun , Chen Will , Sun-Mitchell Shan 
Published: December 2023

Abstract
This study examined temporal relationships between antecedent family caregiver disabling communication and subsequent care recipient (persons living with dementia) communication during 75 in-home care video observations. Secondary analysis of 5-, 10-, 15-, 20-, 25-, and 30-second timed-window analysis was conducted. 95% confidence intervals, p-values, and Yule’s Q statistics were used. The results showed that care recipient engaging, challenging, and neutral communication occurred at differing frequencies within each time window following disabling communication by family caregivers. Care recipient challenging verbal communication was more likely to occur within all time widows after caregiver challenging verbal communication preceded (OR = 1.51 – 1.77, p &lt;.001, Yule’s Q = 0.204 – 0.277). Care recipient engaging verbal communication was more likely to occur with weaker chance within all time widows except 30-second window after caregiver disabling verbal communication preceded (OR = 1.11 – 1.17, p = .001 - .028, Yule’s Q = 0.151 – 0.080). Care recipient neutral communication was more likely to occur within all time widows after caregiver disabling verbal communication preceded (OR = 1.34 – 1.39, p &lt;.001, Yule’s Q = 0.144 – 0.162). Care recipient neutral communication more likely occurred within all time widows except 5-second and 10-second windows after caregiver disabling nonverbal communication preceded (OR = 1.28 – 1.34, p =.009 - .029, Yule’s Q = 0.123 – 0.144). Caregiver disabling communication was associated with more likely subsequent care recipient communication. Future research can further explore how participant characteristics and types and frequencies of caregiver communication influence care recipient communication.
SEVERE ALZHEIMER’S DEMENTIA ALTERS THE RELATIONSHIP BETWEEN EXECUTIVE FUNCTION AND FALLS
Authors: Delgado Ferdinand , Yu Fang , MacKinnon David , Peterson Daniel , Ofori Edward , Beach Thomas , Adler Charles , Der Ananian Cheryl 
Published: December 2023

Abstract
Falls are a public health concern for older adults, particularly those with cognitive impairments, like mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia. Executive function (EF) is linked to falls in older adults, but little is known about the relationship between individual EF assessments and falls in individuals with varying cognitive statuses. Using cross-sectional secondary data analyses with binary logistic regression, we examined the associations between EF assessments (Trail Making Test (ΔTMT), Digit Span (DS), Stroop test, Clock Drawing Test, and phonemic/semantic fluency tests) and falls (fall history and subsequent falls) in 466 participants (aged 66-103) with either intact cognition, MCI, or AD dementia. Surprisingly, a significant interaction effect emerged with AD dementia and EF assessments (ΔTMT, DS, and semantic fluency), revealing that individuals with AD dementia with worse EF had a lower probability of prior fall history. These findings were influenced by a low percentage of reported falls in people with severe AD dementia. Further stratified analysis of the interaction effects showed that DS and semantic fluency were significantly associated with fall history in people without AD dementia. While some EF assessments were individually associated with falls, interpretations should be made cautiously, especially considering the appropriateness of the assessments for specific populations. The counterintuitive result may stem from factors specific to severe AD dementia. In conclusion, this study uncovers complex interactions between cognitive status, EF assessments, and fall history, and the potential for further investigation to enhance our understanding of falls in individuals with severe AD dementia.
SEX DIFFERENCES IN EMPLOYMENT HISTORY AND LATE-LIFE COGNITION AMONG OLDER CHINESE
Authors: Lu Peiyi , Yin Hongyu , Li Chihua 
Published: December 2023

Abstract
This study characterizes the employment history of older Chinese men and women and examines the associations between employment trajectories and late-life cognition. Individuals aged 60+ in the 2011 China Health and Retirement Longitudinal Study were included (2,733 men and 2,363 women). Multiple waves of surveys were conducted to assess their cognition in 2011, 2013, and 2015. Sequence analysis identified employment trajectories among men and women separately based on self-reported employment history of whole working age (15-60 years). Mixed-effect models examined the relationship between employment trajectories and cognition. Three distinctive employment trajectories were identified for men and women, separately. Among men, 45% men was consistently agriculture employed, 26% were consistently non-agriculture employed and retired at age 60, and 29% had fluctuating employment featuring in agriculture and early-retirement. Among women, 70% women was consistently agriculture employed, 15% were consistently non-agriculture employed and retired at age 55, and 14% had fluctuating employment featuring unemployment, home, and early-retirement. Compared to the consistently agriculture employed, the consistently non-agriculture employed group reported better cognition for both men and women (men: β=1.26, 95%CI=0.81, 1.66; women: β=1.63, 95%CI=1.09, 2.30). Men with fluctuating employment trajectory also had 0.62 points higher cognition (95%CI=0.27, 0.96) than men who were consistently agriculture employed. Older Chinese experienced distinct life-course employment trajectories reflecting the economic and historic development in China. The sex difference was evident as women were more involved in agricultural work and working at home. Non-agricultural employment was associated with better cognition, highlighting the disadvantaged health status of Chinese farmers.
SLEEP DISORDERS AND MUSCLE STRENGTH IN OLDER MEXICAN AMERICANS: SEX DIFFERENCES
Authors: Okada Jamil , Snih Soham Al 
Published: December 2023

Abstract
We used data from the Hispanic Established Population for the Epidemiological Study for the Elderly to examine sex differences in the relationship between sleep duration and handgrip strength (HGS) among Mexican Americans aged ≥ 77 years with normal or high HGS (≥ 17 in women and ≥ 27 in men) at baseline over a 9-year period (2007/08 to 2012/13; N=1542). Measures included socio-demographics, sleep duration, HGS (Kg), body mass index, medical conditions, depressive symptoms, physical function, cognitive function, disability, and pain. We categorized sleep duration as ≤ 7, 8, 9, and ≥ 10 hours/night and used linear mixed models to estimate the changes in HGS as a function of sleep duration by sex, adjusting for covariates. Both men and women in the highest sleep duration group (≥10 hours/night) had on average the greatest decline in HGS (1.54 kg and 0.95 kg, respectively) compared to those who slept 8 hours/night, after controlling for all covariates over the follow-up period. Older age, time (years), depressive symptoms, one or more falls in the last year, and low physical function were associated with greater decline in HGS among women. Older age and time (years) were associated with greater decline in HGS among men. In conclusion, longer sleep duration was associated with greater loss of HGS over time in older Mexican Americans. Sleep health promotion and sleep behavioral interventions may reduce the risk of decline in HGS, which has been associated with disability, institutionalization, and mortality in this population.
SOCIAL DETERMINANTS OF DEPRESSION AMONG OLDER ADULTS IN THE UAB STUDY OF AGING: THE ROLE OF RACE-BASED DISCRIMINATION
Authors: Buys Katie , Buys David , Bowen Pamela , Kennedy Richard 
Published: December 2023

Abstract
Mental health is known to be influenced by social determinants of health (SDoH). However, little is known about how racial discrimination, in the context of other social factors, impacts the mental health of older adults. The focus of this research is specifically on the different effects of racial discrimination in that broader context on depression diagnosis vs. symptomology. Using the UAB Study of Aging’s cohort of 1000 Alabamians 65+ balanced on rural/ urban status, sex (men/women), and race (Black/white), we evaluate the impact of SDoH, including race-based discrimination, on clinically verified depression diagnosis and on depressive symptomology using the Geriatric Depression Scale. Other independent variables include environmental factors (eg: neighborhood disadvantage), status and assets, interpersonal factors, and fixed demographic characteristics. Using generalized estimating equations, we found that experience of racial discrimination is associated with a depression diagnosis (OR: 2.33) independent of race and other factors. Other variables that were significant predictors of having a verified depression diagnosis include life-space mobility and race. Factors associated with depressive symptomology include fear of crime, financial difficulty, social support, life-space mobility, race (Black), and sex (female). While demonstrating that experience of race-based discrimination was associated with depression diagnosis is not surprising, finding in an otherwise identical model, that it was not associated with symptomology was unexpected. Authors will discuss some potential reasons for this counterintuitive outcome and future directions for better understanding this inconsistency.
STAKEHOLDER INSIGHTS: STANDARDIZING END-OF-LIFE CARE TRANSITIONS FOR NURSING HOME RESIDENTS WITH DEMENTIA
Authors: Beltran Susanny , Chisholm Latarsha , Jaijairam Emily 
Published: December 2023

Abstract
Sixty-seven percent of dementia patients die in nursing homes (NHs), where end-of-life care is often suboptimal, and hospice not accessed in a timely manner. The eligibility criteria for the Medicare Hospice Benefit (&lt; 6 months prognosis) poses challenges for patients with Alzheimer’s disease and related dementias given the variable disease progressions that characterize most dementias. This study describes current NH processes used to identify dementia residents to refer to hospice, and stakeholders’ input into the design of a standardized process for clinical decision-making, using the Mitchell Index, a dementia mortality prediction tool. Individual interviews and focus groups were conducted with NH administrators, medical directors, directors of nursing, MDS coordinators, and social workers (N=11). Participants completed an online survey including facility (e.g., size, profit status) and individual demographics (e.g., years of experience), then participated in an interview that involved a brief presentation of the proposed standardized process using the Mitchell Index. Qualitative data analysis followed a deductive approach, guided by constructs from the Consolidated Framework for Implementation Research (CFIR). Preliminary analyses indicate providers believe the Mitchell Index can be successfully adapted for NH use. Participants stated the tool added something to current processes (CFIR relative advantage), would be easy to use (CFIR complexity), and pointed to external influences (i.e., regulations; CFIR domain 2: outer setting) which would be important to consult in later stages of intervention development. Overall, nursing home stakeholders endorse the potential for a standardized process using the Mitchell Index to be acceptable and feasible in high-Medicaid nursing homes.
SUCCESSFUL CARE CONFERENCES: NURSING HOME STAFF, PERSONS WITH DEMENTIA AND CAREGIVER PERSPECTIVES
Authors: Towsley Gail , Edelman Linda , Montez Shelby 
Published: December 2023

Abstract
Work demands of the care team, time constraints, and a lack of guidance from the regulatory environment often result in short, perfunctory mandated quarterly care conferences (e.g., care plan meetings) that lack focus on resident preferences. Me & My Wishes is a video recording approach for documenting, viewing, listening, and discussing nursing home (NH) residents’ living with dementia preferences for daily and end-of-life in care conferences. As part of a study adapting Me & My Wishes for remote delivery, we used a qualitative descriptive design to conduct focus groups (February – June 2023) with experts representing persons living with dementia (PLWD) (n=6), informal care partners (CPs) (n=8), and NH staff (n=9) to inform us of what comprises a successful care conference. We coded and analyzed audio-recorded transcripts, resolved coding discrepancies in team meetings, and derived domains from finalized codes. All groups discussed three primary domains characterizing a successful care conference: 1) resident- engagement; 2) key staff and CPs identified and engaged to support the resident perspective; and 3) structured meetings led by trained facilitators for resident-centered discussion and problem-solving. NH Experts noted that a facilitator who anticipates and mitigates potential barriers (e.g., conflicting discourse) is key for a successful care plan meeting. PLWD identified providing technology assistance for the resident and CPs as important. Care conferences that allow virtual attendance of staff and CPs who know the resident well, are resident-driven, and are well organized can facilitate communication and problem solving resulting in improved resident-centered care.
SYMPTOM BURDEN, POSITIVE AFFECT AND RESILIENCY IN OLDER ADULTS EXPERIENCING NORMAL AGING
Authors: Anctil Reid , Chang Angela , Mitchell Calli , Traeger Lara , Park Elyse , Ahmad Zeba 
Published: December 2023

Abstract
Older adults (age≥65) with multimorbid disease burden may be at chronic risk for bothersome symptoms, which can consequently reduce positive affect (e.g., feelings of excitement and enthusiasm). However, we hypothesized that individuals with more resiliency (the ability to “bounce back” from distress) may experience positive affect despite symptom burden. We conducted secondary analysis of baseline self-report survey data (collected between 8/2023-10/2023) from a prospective study of resiliency in older adults residing in nine continuing care retirement communities (CCRCs) across the U.S. Eligible participants lived independently in CCRCs and scored &gt;11/15 on the five-minute Montreal Cognitive Assessment. Surveys assessed symptom burden (Condensed Memorial Symptom Assessment Scale), resiliency (Current Experience Scale), and positive affect (Positive and Negative Affect Schedule-Positive Affect). Bivariate correlations and multiple linear regression evaluated associations of symptom burden and resiliency with positive affect. Participants (M age =81, SD=5.6) were predominantly White (96%) and female (75%). Greater symptom burden correlated with lower positive affect (r=-.295, p&lt;.001) and lower resiliency (r=-2.56, p&lt;.001). In a multiple regression model, lower symptom burden (β = -.136, p=.003) and more resiliency (β=.626, p&lt;.001) were independently associated with greater positive affect. The overall model accounted for 45.4% of variance in positive affect (F(2, 284) =117.198, p&lt;.001). Lower symptom burden and more resiliency contributed to more positive affect among older adults in senior living communities. Because resiliency and positive affect are both potentially modifiable targets for intervention, longitudinal study and psychosocial interventions should explore the effects of increased resiliency on positive affect and general well-being over time.
SYSTEMS BIOLOGY OF HUMAN AGING - NETWORK MODEL 2023
Authors: Furber John 
Published: December 2023

Abstract
This network is presented to aid in conceptualizing the many processes of aging, the causal chains of events, the interactions among them, feedback, and vicious cycles. It suggests promising intervention points for therapy development. The signs of human senescence are hypothesized to result from several primary causes. This network includes both intracellular and extracellular processes, ranging from molecular to whole-body. Lifestyle, environment, and proposed interventions are highlighted. Important pathways include: Nuclear mutations, transposon insertions, telomere shortening, chromosome breaks, chromatin alterations, epigenetic DNA adducts. Extracellular protein damage results in stiffness, weakness, inflammation. Altered niches for cells cause transdifferentiation, arrested cell division, cell death, cancer, stem cell depletion, tissue wasting, neurodegeneration, organ malfunction. Stiffer blood vessels promote stroke, heart disease. Lysosomes accumulate reactive, crosslinked Lipofuscin, which impairs autophagic turnover of macromolecules and organelles. Lipofuscin leaking into cytosol triggers apoptosis. Mitochondrial DNA Mutates; Lamin-A progerin, accumulates in nuclear scaffold, impairing mitosis and telomere maintenance. Nuclear Envelope Pore Proteins become oxidized, allowing inappropriate traffic of other proteins into and out of nucleus. Oxidized Aggregates in cytoplasm crosslink, resist turnover, inhibit proteasome activity, increase redox poise, and physically interfere with intracellular transport in axons. Proteasomes inhibited, reduce turnover of damaged molecules and expired molecular signals. Increased Redox Poise alters signaling and enzyme activities, and erodes telomeres. Inflammatory Cascades, promoted by damaged molecules and sick cells, further damage tissues. Neuroendocrine and immune systems degrade. Misfolded Proteins accumulate in Endoplasmic Reticulum. This diagram is maintained on the Web as a reference for researchers and students. www.LegendaryPharma.com/chartbg.html
TARGETING HEALTH-PROMOTING ACTIVITY IN OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS AND FUNCTIONAL LIMITATIONS
Authors: Klinedinst Tara , Hollman Nicholas , Ciro Carrie , Kendzor Darla 
Published: December 2023

Abstract
Nearly half of older adults in the U.S. have multiple chronic health conditions in addition to functional limitations (MCC + FL) that restrict health self-management activities. We tested an innovative combination of occupational therapy (OT) and behavioral activation (BA) to improve health self-management using the goal setting, scheduling/monitoring activities, and problem-solving components of the BA approach, as well as skill building, environmental modification, activity adaptation, and focus on daily routines from OT (BA+OT). BA+OT was delivered by occupational therapists over 10 sessions in the homes of participants. We present descriptive statistics from this single-blind randomized control pilot study of 11 older adults with MCC + FL who received BA+OT (n = 6) or enhanced usual care (UC; n = 5). Participants in both groups were given a Fitbit, and the UC group received a handout on managing chronic conditions. The BA+OT group was required to set at least one goal for improving physical activity. On average, participants were 73.1 years old (SD = 8.4), majority female (n = 8), and white (n = 1 Hispanic/Latino). They had an average of 3.9 chronic conditions (SD = 1.5), and 2.0 functional limitations (SD = 1.8). The most common chronic conditions were depression, high blood pressure, and arthritis. Aside from physical activity, the most common participant-identified goal areas were sleep hygiene and positioning, medication routines, and community access. This study is in progress (aiming for n = 40) but shows promise for improving health self-management by targeting meaningful, goal-directed, and health-promoting daily activity.
TARGETING OF P21CIP1-HIGHLY-EXPRESSING CELLS ALLEVIATES NEUROPSYCHIATRIC DISORDERS WITH OBESITY
Authors: Wang Lichao , Wang Binsheng , Gasek Nathan , Xu Ming 
Published: December 2023

Abstract
Obesity remains a major factor for diabetes associated with insulin resistance and increases the risk of neuropsychiatric disorders, such as anxiety, depression, and cognitive deficits, resulting in a shortened in lifespan and healthspan. Cellular senescence, a state of permanent cell-cycle arrest, has been recognized as an important biological process underlying obesity and obesity-associated neurological disorders. My project aims to alleviate metabolic and neuropsychiatric dysfunction in obesity by targeting of p21Cip1-highly-expressing (p21high) cells, a rarely examined senescent cell population. By leveraging a novel transgene containing a p21 promoter driving Cre, we demonstrate the accumulation of p21high cells in brain with obesity, whereas, intermittently clearing p21high cells alleviates anxiety- and depression-related behavior and improve the cognitive function for obese mice. Of note, clearance of p21high cells decreased key factors of the senescence transcriptional program in hippocampus and amygdala. A survival study shows the intermittent clearance of p21high cells extends the lifespan of obese mice fed with high-fat diet. Our findings indicate p21high cells serve as a potential therapeutic target for neuropsychiatric disorders.