bluuebunny/crossref_metadata_2025_split huggingface dataset:
GENDER DIFFERENCE IN USING DIGITAL HEALTH TECHNOLOGIES AMONG OLDER ADULTS WITH CANCER: A PILOT QUALITATIVE STUDY
Authors: Hwang Misun , Cho Youmin , Gahn Katie , Manojlovich Milisa , Jiang Yun 
Published: December 2023

Abstract
Digital technologies hold promises to improve health and care delivery for various populations, including older adults with cancer. However, older adults’ adoption of digital health technology is less optimal. While age and gender can interfere with people’s technology behavioral intention, it is unknown how gender differences may influence older adults with cancer’s technology use experiences. This pilot qualitative study investigated gender differences in older adults’ experiences using digital technologies to manage their cancer and care. Semi-structured interviews were conducted with 16 older adults with breast, colorectal, lung, or prostate cancer (men=7 and women=9) aged 65 to 78 years. Thematic data analysis revealed that older men favored the adjustability and efficiency of using technology to save time and cost compared to in-person visits. Also, they perceived that technology facilitated their adherence to treatment plans. Older women, however, preferred technology-supported individualized care and perceived being able to review their medical notes as beneficial. Women were comfortable using technology to timely communicate with their trusted care providers. However, they preferred to see their providers in person if they experienced severe condition changes or unanticipated symptoms. Despite all these different preferences, both genders were comfortable using video calls with their providers, using the portal to keep track of their medical records and share decision-making with clinicians. These pilot results demonstrated gender differences in experiences and perceptions of using digital technology among older adults with cancer and suggested integrating gender preferences into technology design and development to facilitate personalized user experience and improve patient engagement.
DOES SELF-REPORTED DISCRIMINATION INCREASE AS COGNITION DECLINES?
Authors: Hanes Douglas , Clouston Sean 
Published: December 2023

Abstract
Progressing cognitive decline causes limitations on daily life and emotional changes, including increased aggression, agitation, and restlessness that might occasion greater scrutiny, limitations, discrimination, and disrespect due to a combination of care-provision and ageism. While there are a number of studies of discrimination as a cause of cognitive decline, there are no studies of how real and perceived discrimination during cognitive decline might affect the aging person and their caregivers. This study analyzes whether people currently experiencing cognitive decline report greater frequency of discrimination. Using the Health and Retirement Study (HRS; 2006–18; N = 37,059), we used multilevel ordered logistic regression to test the role of changes in cognitive performance in predicting self-reported frequency of six forms of discrimination, adjusting for age, socioeconomic, and demographic covariates. We found that lower cognitive scores were associated with increased discrimination frequency in three forms of treatment: less respect (β=-0.010; p=0.022), being treated as “not smart” (β=-0.026; p&lt; 0.001), and worse medical treatment (β=-0.014; p=0.027) though no differences were evident in service quality (β=-0.002, p=0.736), evidence of being threatened (β=-0.11, p=0.069), or having people report being afraid of you (β=-0.004, p=0.455). Results suggest that perceptions of discrimination could emerge as a result of declining cognitive performance and highlight the need for greater sensitivity to discrimination among older adults in both everyday and medical settings. Further investigation will enable us to distinguish between experienced discrimination due to changes in treatment versus ageism.
CULTURALLY TAILORED INTERVENTION EFFICACY TO PROMOTE BREAST CANCER SCREENING AMONG AMERICAN INDIAN WOMEN
Authors: Roh Soonhee , Lee Yeon-Shim , Kenyon DenYelle , Elliott Amy , Petereit Daniel , Gaba Anu 
Published: December 2023

Abstract

Purpose
The purpose of this project was to develop and evaluate the feasibility and effectiveness of the Mobile Web App Breast Cancer Screening (wMammogram) intervention among American Indian (AI) women. Method: Using a randomized controlled trial design, 122 AI women (40-70 years old) were recruited and randomly assigned to the wMammogram group (n=62) to receive culturally and personally tailored multimedia messages through a mobile web app along with health navigator services or the control group (n=60) to receive a printed educational brochure. Outcome measures included mammogram receipt, intention to receive breast cancer screening after the intervention, and satisfaction with and perceived effectiveness of the intervention. Result: A significantly higher proportion of women who received the intervention (42%, 26/62; p&lt;.01) completed mammograms by the 6-month follow-up compared with the control group (20%, 12/60). The wMammogram group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22, p&lt;.001), increase in knowledge (t120=-4.75, p&lt;.001), and satisfaction with the intervention (t120=-3.61, p&lt;.001). The wMammogram group also expressed greater intention to receive a mammogram in the future when it is due (100%, 62/62 vs. 85%, 51/60) and were more willing to recommend the intervention they received to their friends (98.4%, 61/62 vs. 90%, 54/60) compared with the brochure group. These differences were statistically significant.

Conclusion
Based on our results, a mobile web app-based intervention combined with health navigator service was a feasible, acceptable, and effective intervention mechanism aimed at promoting breast cancer screening in AI women.
EXPLORING THE PHENOMENON OF BOREDOM IN THE CONTEXT OF LEISURE AMONG OLDER ADULTS
Authors: An Jaesung , Payne Laura , Janke Megan 
Published: December 2023

Abstract
Boredom is a concept that seems at odds with leisure, yet research on this topic indicates these constructs are often connected. Leisure boredom has been studied primarily among adolescents (Donati et al., 2019; Weybright et al., 2015). However, boredom is prevalent among older adults. Social isolation and loneliness often intertwine with boredom, and research suggests that prolonged boredom can negatively affect health and well-being (An et al, 2022; Goldberg et al., 2011). Yet, there is a dearth of research on this topic and existing literature typically examines adults’ functional status and disengagement or selective investment in leisure activities (Kleiber et al., 2008) rather than examining boredom more broadly. Thus, the purpose of this study was to examine the concept of boredom holistically in the context of leisure among community-dwelling older adults. The study used a multi-method approach utilizing focus groups and projective techniques of sentence completions and drawings. Forty-two older adults were recruited from senior centers and senior communities located in four western US cities. Thematic analysis with a six-step process outlined by Braun and Clarke (2006) was employed to analyze the data. Boredom was described as a personal state (e.g., negative self-perception, low energy and sensation/arousal, lacking motivation) and as activity-related emotions derived from unsatisfied/disengaged leisure participation. Participants also highlighted how life events and circumstances shaped their identity and contributed to boredom. Findings offered meaningful insights into how participants defined boredom, articulated causes of boredom, and strategies they use to alleviate boredom.
QUALITY OF LIFE OF OLDER ADULTS DURING THE COVID-19 PANDEMIC: RACIAL DISPARITIES AND SOCIAL CONNECTEDNESS
Authors: Ogunjesa Babatope , Ashrafi Sadia Anjum , Guimaraes Rafael , Schwingel Andiara 
Published: December 2023

Abstract
Social connectedness is crucial for well-being, especially among older adults. The Covid-19 pandemic has worsened mental distress in society due to prolonged social isolation practices aimed at curbing the virus’s spread. This study examined disparities in older adults’ self-reported quality of life during the pandemic and the influence of family and friends interaction. This study utilizes secondary data from the coronavirus worries and social isolation among older adults study by AP-NORC Center for Public Affairs Research on individuals aged 50 years and above (N=1,051). We aim to observe the effect of social interactions on the self-reported quality of life (QoL) of adults. Logistic regression analysis and marginal effect post-estimation analysis were utilized in this study, with adjustments made for race, education, gender, and income. The result showed that individuals who meet with family and friends more often (AOR=17.19, 95% CI=3.75-78.88, p&lt; 0.05), or about as often (AOR=2.24, 95% CI=1.15-4.36, p&lt; 0.05), are more likely to report a high quality of life than those who meet with them less frequently. A marginal effect analysis revealed that White adults had an 89.5% probability of reporting a high quality of life, non-Hispanic Black adults had an 83.4% probability of high quality of life, Hispanic adults had an 88.3% probability of high quality of life, and individuals from other ethnic groups had an 83.3% probability of high quality of life. These findings underscore the need for targeted interventions that address social isolation, especially among older adults, particularly those from racial and ethnic minority groups.
ASPECTS OF AMYLOID SCAN DISCLOSURE WHICH INFLUENCE PATIENT AND CARE PARTNER SATISFACTION DURING DEMENTIA DIAGNOSIS
Authors: Couch Elyse , Zhang Wenhan , Belanger Emmanuelle , DePasquale Nicole , Gabois Emily , Shepherd-Banigan Megan , Van Houtven Courtney , Wetle Terrie 
Published: December 2023

Abstract
Amyloid PET scans can be used to make a differential diagnosis of dementia or indicate a person’s risk of developing dementia in the future. The use of biomarkers for diagnosing dementia is not yet standard in clinical practice. Research is needed to better understand how to disclose the results from amyloid PET scans to patients and care partners. We interviewed 38 patients with MCI or dementia and 68 care partners from the CARE-IDEAS study to explore their experiences of receiving the results from amyloid PET scans as part of the diagnostic process for dementia. We were specifically interested in identifying aspects of amyloid disclosure which affected patient and care partner satisfaction. Patients had an average age of 73.5, were mostly male (65.8%), and Non-Hispanic White (67.6%). Care partners were mostly female (75.8%), caring for their spouse (87.1), with a mean age of 69.5. We identified 5 factors affecting patient and care partner satisfaction: 1) clarity of the explanation of the scan result and its implications, 2) discussion of potential options for treatment, research opportunities or follow-up support, 3) disclosure of scan results in person, 4) involvement of a care partner during disclosure, and 5) provision of a written summary of the scan result after disclosure. As diagnostic procedures for dementia evolve, it is important to consider their effect on patients and care partners. These findings can be used to inform the development of disclosure procedures for amyloid PET scans.
EVALUATING THE IMPLEMENTATION OF A SELF-CARE INTERVENTION FOR CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Fisher Lauren , Massimo Lauren , Hirschman Karen 
Published: December 2023

Abstract
In this study, we evaluated the implementation of the Virtual Caregiver Coach for You (ViCCY) intervention delivered as part of the “iCare4Me for FTD” (Frontotemporal Degeneration) Study (NCT04686266). This randomized controlled trial was designed to evaluate the efficacy of the evidence-based ViCCY intervention designed to increase self-care in caregivers of persons living with FTD. All caregivers received health information (HI) which included targeted caregiver and FTD websites on an iPad. The intervention group received ViCCY, 10 health coaching sessions focused on self-care and delivered via an iPad over 6 months. Guided by the Consolidated Framework for Intervention Fidelity (CFIF), the goal of this sub-study was to evaluate intervention implementation by measuring key CFIF components: coverage, exposure, and content delivered. Thirty-one caregivers were randomly assigned to ViCCY+HI (n=15) or HI only (n=16). One caregiver withdrew from the HI group. For exposure, at Month 1, a higher number of HI participants (87%) reported reviewing the websites 30 minutes a week compared to ViCCY group (67%). By Months 3 and 6 the groups were identical (3M: 100%, 6M: 93%). Thirteen out of 15 ViCCY caregivers completed all 10 health coaching sessions. On average, these sessions lasted 52 minutes (range: 24.8-113.5). For content adherence, 28% (40/142) of the completed sessions were examined for adherence to the protocol across the 10 sessions. Overall, content adherence across all sessions was 96% (range: 92-100%). This evaluation demonstrated that a virtual intervention targeting self-care is feasible and acceptable in this population. Implications for future research will be discussed.
LINKING PLASMA PROTEOMICS TO BRAIN ACCELERATED/RESILIENT AGING IN THE ATHEROSCLEROSIS RISK IN COMMUNITY STUDY
Authors: Casanova Ramon , Justice Jamie , Walker Keenan , Anderson Andrea , Barnard Ryan , Hughes Tim , Kritchevsky Stephen , Wagenknecht Lynne 
Published: December 2023

Abstract
Machine learning models are increasingly being used to estimate ‘brain age’ from neuroimaging data. The gap between chronological age and the estimated brain age (BAG) is potentially a measure of accelerated/resilient brain aging, and we estimated BAG based on an elastic net regression approach. Here, we report associations between this brain age measure and plasma protein levels (measured using an aptamer-based proteomic platform) in the Atherosclerosis Risk in Communities (ARIC) Study to determine whether BAG was associated with proteins linked to biologic aging. We used brain MRI scans from 1507 ARIC visit 5 participants: 938 were Cognitively Normal (CN), 495 had mild cognitive impairment (MCI) and 74 had dementia. The proteomic dataset contains 4877 plasma proteins in these same individuals. We fitted univariate linear regression models adjusting for age, race, smoking, education, sex, diabetes, hypertension and intra-cranial volume. A Bonferroni correction was applied to account for multiple testing to maintain an analysis-wise α=0.05. In total 31 proteins were significantly associated with BAG. Among these SEVP1, GDF-15, pleiotrophin, MMP7, Natriuretic-peptides and Hsp70 were found to be associated with accelerated BAG, whereas EGF-receptor, mast/stem-cell-growth-factor-receptor (KIT), Coagulation-factor-VII and cGMP-dependent-protein-kinase-1 were associated to resilient BAG. The analysis based only on CN participants produced 3 significant proteins: retinoblastoma-2 and SEVP1, which were associated with accelerated BAG and Coagulation-factor-VII, which was associated to resilient BAG. These results suggest circulating proteins implicated in biological aging, cellular senescence, angiogenesis and coagulation are associated with a neuroimaging measure of accelerated brain aging.
PARTNER ENGAGEMENT STRATEGIES FOR AN EMBEDDED PRAGMATIC CLINICAL TRIAL: A CASE STUDY
Authors: Reddy Ann , McCreedy Ellen , Mitchell Susan , Baier Rosa 
Published: December 2023

Abstract
Embedded pragmatic clinical trials (ePCTs) rely on providers, rather than research staff, to implement study protocols. Partnerships need to be carefully managed to ensure a sustainable relationship. This case study describes strategies used by our research team while partnering with a large physician practice on an ePCT to improve advance care planning for people with dementia living in 160 assisted living centers. We focus on engagement between the research and provider teams co-designing and leading the implementation. Communication and project management tools held the teams accountable to decisions and set expectations for time and resources. At project initiation, we discussed the commitment of resources through different phases of the research (planning, executing, and monitoring) and determined the frequency and expected attendance for meetings during each phase. We focused on ensuring the intervention and protocols were feasible and integrated into existing clinical workflows. Regular meetings and continuous communication enabled us to make iterative modifications driven by provider needs and feedback. We used a project management register to track deliverables and document key decisions and next steps. A single point of contact on the research team fielded all inquiries and ensured timely responses to provider partners. ePCTs require a unique and active partnership between researchers and providers. In this case study, communication and project management tools enabled researchers and provider partners to identify and make changes to the ePCT’s intervention design and implementation protocol in real time. This case study provides best practices for management of stakeholder relationships in the ePCT context.
SELF-ASSESSED ORAL HEALTH IN DETROIT SENIOR CENTERS
Authors: Byrappagari Divesh , Jones Judith 
Published: December 2023

Abstract
The objective of the Detroit Mercy Senior Oral Health Equity Project (SOHEP) survey was to gather information from seniors about their opinion regarding their oral health status and satisfaction with their past dental care experience. The questionnaire was developed based on previously tested questions from other national senior oral health surveys. Data were collected using Qualtrics© and analyzed using SPSS©. The majority of the seniors screened were African American (88.9%), female (79.1%) and between the ages of 65 and 85 yrs. Over half (58.2%) reported their oral as Fair or Poor. Over one third (37.3%) reported avoiding eating certain foods due to poor oral health, and 43.3% have not been to a dentist in over 2 years. Although most participants indicated that they have insurance and have good experiences with their past dental care, a significant number of seniors have not used dental care. A community-based program that is accessible to seniors, especially in places where they congregate frequently might be helpful and improve access to preventive dental care for this population.
POPULATION REFERENCE VALUES FOR PEAK EXPIRATORY FLOW IN OLDER US ADULTS
Authors: Donahue Patrick , Balasubramanian Aparna , Davoudi Anis , Schrack Jennifer , Wanigatunga Amal , Carlson Michelle 
Published: December 2023

Abstract
Respiratory function predicts physical and cognitive health outcomes in older adults. Peak expiratory flow (PEF) is simple, inexpensive, and has been validated against traditional respiratory function measures (FEV1, FVC). PEF has additional utility because it measures maximal respiratory effort without relying on spirometry equipment. However, there is a lack of epidemiological data to support PEF reference values for aging populations, especially those ≥80 years. The National Health and Aging Trends Study (NHATS) is a large, nationally representative sample of US adults ages ≥65 that offers a unique opportunity to develop PEF population reference values. Using a healthy subsample from NHATS Round 1 (N=2,082), excluding those with history of smoking, respiratory, or cardiovascular diseases, we applied NHATS sampling weights to estimate age- and sex-specific PEF percentiles. The sample was stratified by sex (68.9% female) and categorized into six, 5-year age groups: 65-69, 70-74, … ≥90 (36.6% age ≥80 years). In a secondary analysis, we estimated age- and sex-specific PEF/height3 percentiles, per current recommendations. We calculated 5th, 95th, and 10th, 20th, … 90th percentiles, by age and sex, for both absolute and height-adjusted PEF. PEF population estimates were higher in healthy males vs. females (456.8±130.1 vs. 293.9±89.9 liters/minute [mean±SD]). After adjusting for height, estimates remained higher for males (83.1±22.4 vs. 70.9±21.5 liters/m3/minute) and higher for younger (65-79 years) vs. older (≥80 years) participants (78.9±19.7 vs. 62.9±26.6 liters/m3/minute). These results may serve as PEF population reference values for healthy older adults in the US.
THE ASSOCIATION OF FRAILTY AND MORTALITY IN OLDER ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF COHORT STUDY
Authors: Gao Xianqi , Song Rhayun , Park Moonkyoung , Li Yuelin , Lyu Linyu , Oh Eunna , Fan Xing 
Published: December 2023

Abstract
Frailty is associated with poor health outcomes in later life, improving lifespan and death through different mechanisms. This study aimed to systematically review the epidemiological evidence from cohort studies investigating the association between frailty and all-cause mortality, and to determine if frailty affects mortality in older adults. We searched for studies published and indexed in 4 electronic databases (EMBASE, PubMed, Cochrane Library, and Web of Science) and manual search and identified 28 cohort studies before Dec 31, 2022. We include studies if their design was longitudinal; the exposure of interest was measured frailty; the endpoint of interest was mortality; they provided a risk estimate (i.e., hazard ratio [HR]) and the corresponding 95% CI for the association between frailty and mortality. They used different indexes as their frailty as exposed definitions. Two investigators independently screened the full-text articles for inclusion. We used a random-effects model to obtain pooled HRs. Thirty-one studies were included for qualitative review, of which twenty-eight were eligible for meta-analysis, and included 67,114 individuals from 16 countries. Compared with healthy adults, frail adults had a significantly higher mortality risk. The pooled HR for mortality per increment of 0.1 frailty of community-dwelling adults was 2.33 (95% CI 2.05-2.65; I2 76.9%). The present study demonstrated that frailty was not only significantly related to an increased mortality risk but was also a strong predictor of mortality in community-dwelling adults.
EVALUATION OF A TECHNOLOGY-BASED EXERCISE PROGRAM FOR OLDER ADULTS IN THOSE WITH CHRONIC MEDICAL CONDITIONS
Authors: Lieber Sarah , Moxley Jerad , Sharit Joseph , Pirolli Peter , Reid M Cary , Czaja Sara 
Published: December 2023

Abstract
Although physical exercise is known to be beneficial, most older adults do not engage in recommended levels of physical activity, particularly those with chronic medical conditions. In an exploratory analysis, we evaluated the efficacy of a technology-based exercise program (Fittle) for sedentary community-dwelling adults ≥60 years of age with social support features in a subset of participants with ≥2 self-report chronic medical conditions. Participants in the Fittle condition received group training and were placed into teams to complete exercises at home via a computer tablet. They also were able to “chat” with other team members. Participants in the control condition were directed to exercise websites designed for older adults. A total of 181 participants with a mean age 70.1 years were randomized to the intervention or control condition. Participants were predominantly women (80.1%) and came from diverse backgrounds, with 13.4% self-identifying as Black or African American and 12.7% as Hispanic or Latino. Among 93 participants with ≥2 self-report chronic conditions, individuals in the intervention (versus control) arm described greater social support (t(162)=1.97, p=0.03) and less loneliness (t(163)=-1.97, p=0.03) at 6 months; there was a non-significant trend for higher self-report physical activity in the Fittle arm (t(166)=1.17, p=0.12). Fittle improved perceptions of social support and loneliness in older adults with chronic medical conditions. Further study is needed in a larger dedicated cohort of older adults with chronic medical conditions to determine Fittle’s efficacy in this population.