bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIFFERENCES IN WHITE MATTER MICROSTRUCTURE IN MIDDLE-TO-OLDER AGE ADULTS WITH CHRONIC KNEE PAIN
Authors: Bell Kristina , Strath Larissa , Nodarse Chavier Laffitte , Valdes-Hernandez Pedro , Fillingim Roger , Cruz-Almeida Yenisel 
Published: December 2023

Abstract
Abundant research suggests aberrant white matter microstructure in patients with chronic pain as well as in older adults independently, where pain can significantly impact daily function. However, most studies fail to consider pain and aging interactions, particularly in middle and older-age. We aimed to explore differences in white matter microstructure (i.e.,Fractional Anisotropy (FA)) by pain’s impact on daily function (i.e., high (n=60) versus low pain impact (n=111) in middle-(45-59 years old, n=129) versus older adults (60-XX years old, n=77) using diffusion tensor imaging. Participants (n=171) underwent laboratory visits to collect multi-modal pain and neuroimaging measures. We employed a linear mixed model approach to test main effects of pain impact and age groups as well as their interaction with Bonferroni-corrected multiple comparisons. Findings demonstrated a significant pain impact and age interaction on FA (p’s≤0.05) in the left caudal anterior cingulate, left caudal middle frontal, left and right rostral middle frontal and left and right insular regions. Specifically, middle-aged adults with high impact pain had significantly worse brain microstructure across these regions compared to the older adults reporting high impact pain (p’s≤0.05). These findings highlight the need to study pain across the lifespan. Given the higher prevalence of chronic pain in middle-age compared to older age, future studies are urgently needed to test whether interventions in middle-age could halt pain’s impact on brain and function.
EARLY DETECTION OF ALZHEIMER’S DISEASE AND RELATED DEMENTIAS FROM VOICE RECORDINGS: THE FRAMINGHAM HEART STUDY
Authors: Ding Huitong , Lister Adrian , Karjadi Cody , Au Rhoda , Lin Honghuang , Bischoff Brian , Hwang Phillip 
Published: December 2023

Abstract
With the aging global population and the increasing prevalence of dementia, there is a growing focus on identifying mild cognitive impairment (MCI), a pre-dementia state, to enable timely interventions that could potentially slow down neurodegeneration. Producing speech is a cognitively complex task that engages various cognitive domains, while the ease of audio data collection underscores the potential cost-effectiveness and noninvasiveness that voice may offer. This study aims to construct a machine learning pipeline that incorporates speaker diarization, feature extraction, feature selection, and classification, to identify a set of acoustic features that exhibit strong MCI detection capability. The study included 100 MCI cases and 100 healthy controls (HC) matched for age, sex, and education from the Framingham Heart Study. Participants’ speech responses during cognitive tests were recorded, and the recorded audio was processed to identify segments of each participant’s voice from recordings that included voices of both testers and participants. A comprehensive set of 6385 acoustic features was then extracted from these voice segments using the OpenSMILE and Praat softwares. Subsequently, we constructed a random forest model using the features that exhibited significant differences between the MCI and HC groups. We identified an optimal subset of 29 features that resulted in an AUC of 0.87, with a 90% confidence interval ranging from 0.82 to 0.93. This study showcases the potential of human voice as a valuable resource for improving early detection of ADRD and motivates future opportunities to use passive voice collection tools, such as hearing aids, to measure brain health.
EFFECTS OF HIGH-INTENSITY AQUATIC EXERCISE ON INFLAMMATION AND COGNITION IN OLDER ADULTS WITH MCI
Authors: Louras Peter , Savettiere Adriana , McNerney Windy , Fairchild Kaci 
Published: December 2023

Abstract
Exercise shows immune benefits in older adults and can reduce the risk of late-life cognitive impairment and dementia. This study sought to explore the effects of high-intensity aquatic-based exercise on older adults with mild cognitive impairment (MCI), specifically by examining changes in inflammatory plasma protein concentrations and cognitive performance. A secondary data analysis was conducted on 20 healthy volunteers (mean age 68.2 ±7.75 years) who participated in 6 months of supervised aquatic exercise training. Participants completed a battery of neuropsychological assessments and whole blood draws at pre- and post-intervention. Plasma protein concentration levels were attained using the Olink Target96 Inflammation panel [Uppsala, Sweden]. Mixed effects models assessed the effects of protein concentration change scores on selected cognitive outcomes, while controlling for age. Results indicated that following the exercise intervention, significant changes in two inflammatory-related proteins (Extracellular newly identified receptor for advanced glycation end-products binding protein [EN-RAGE]; Interleukin-20 receptor subunit alpha [IL-20RA]) were associated with improved verbal memory and processing speed endpoints. Specifically, decreased EN-RAGE concentrations resulted in significantly improved delayed verbal memory scores (parameter estimate= -0.893, p= .023), while increased IL-20RA concentrations led to better task completion (parameter estimate= 2.145, p= .030). These findings demonstrate the cognitive benefits of aquatic-based exercise for older adults and those with MCI, and suggest these effects are mediated by alterations in pro- and anti-inflammatory protein markers such as EN-RAGE and IL-20RA. Larger studies are warranted to replicate these findings, and to further explore the role of activity-induced inflammatory changes on late-life brain health.
EFFICACY OF MALNUTRITION SCREENING AMONG OLDER VETERANS AT AN URBAN VA HOSPITAL
Authors: Cassatt Sarah , Parker Elizabeth 
Published: December 2023

Abstract
Nearly half of the Veteran population is &gt;65 years. Older Veterans are at increased risk of malnutrition associated with increased mortality, morbidity, length of stay, and readmissions. Malnutrition-focused quality measures are needed to combat this public health issue. The purpose of this study was to identify gaps in malnutrition screening at an urban VA facility. Chart auditing was conducted for all medical admissions during 72 hour periods across 14 months. Auditing determined if nutrition screening was completed, with an admission weight, and if nutrition was consulted for nutritionally compromised Veterans. Screening was conducted using the Malnutrition Screening Tool (MST). Additionally, estimated prevalence of nutritionally compromised Veterans was assessed using auditing data from 30 days. Audit data showed that on average only 57.4% (n=458) of Veterans admitted for inpatient care were screened correctly. Of those screened incorrectly, the three most common errors were 1) not collecting a weight on admission (N=82 (42.1%)); 2) inaccurate weight change interpretations (N=41 (21%)); 3) failure to refer nutritionally at-risk Veterans to nutrition services (N=38 19.5%)). Prevalence auditing demonstrated over 1/3 of Veterans were nutritionally compromised at the start of their hospitalization (36.43%, (N=295)). With an increasingly aging population in the United States there is a focus on shifting to value based payment systems. The new CMS Global Composite Malnutrition Score will include evaluation of hospitals malnutrition screening processes. There is a significant opportunity to close these gap areas and to adopt clinically relevant best practices to provide nutrition care earlier to at risk Veterans.
ELDER ABUSE RISK ASSESSMENT MODEL FOR ALZHEIMER’S DISEASE WITH SOCIAL DETERMINANTS OF HEALTH AND MEDICAL FACTORS
Authors: Pappadis Monique , Wood Leila , Westra Jordan , Schlag Karen , Czyz Rebecca , Kuo Yong-Fang , Raji Mukaila , Mouton Charles 
Published: December 2023

Abstract
Older adults with Alzheimer’s Disease and Related Dementias (ADRD) are at an increased risk for elder abuse (EA). Using a 20% national Medicare database, we developed an EA risk-assessment model, including older adults with and without ADRD. Beneficiaries aged 66 and older in 2016, without an EA diagnosis in 2015 or 2016, and Medicare Part A/B/D eligible with no HMO through 2018 were included (N=2,261,166; ADRD, n=187,805, 8.3%). Outcome of interest was an EA diagnosis. The cohort was split into three subsets, training (50%), testing (25%), and validation (25%). Predictive models included demographics, comorbidities, symptoms, injury history, claims-based frailty scores (0-1), medical screening and procedures, and social determinants of health (SDoH). Only 0.2% had an EA diagnosis. EA models were conducted using logistic regression and machine learning methods (random forest, gradient-boosted tree classification, and multilayer perceptron classification). The logistic regression model was the best predictive model (AUC=0.73; Sensitivity=0.80; Specificity=0.47; GINI Impurity=0.50; Agreement=46.77%). Many SDoHs (e.g., primary support and marital problems, housing/income problems and dual eligibility, Black Race), STI testing, behavioral health and medical conditions, and greater frailty were associated with increased risk of EA at 2 years for the total sample (with and without ADRD). For those with ADRD, SDoHs (e.g., marital and housing/income problems), male sex, aged 71-75 (vs 66-70), lung cancer, PTSD , and greater frailty were associated with increased EA risk. Coupled with qualitative interviews, our findings will guide the selection of the most pertinent risk and protective factors to incorporate into an EA screening intervention tool.
END-OF LIFE CARE PLANNING: THE ROLE OF FAMILY FOR VIETNAMESE AMERICANS AND FILIPINO AMERICANS
Authors: De Fries Carson , To My Ngoc , Sun Fei , Wu Bei , Levkoff Sue , Wang Kaipeng 
Published: December 2023

Abstract
Research has demonstrated a lack of understanding around the significant disparities in end-of-life (EOL) care decisions and culturally sensitive EOL care practices among older Southeast Asian Americans (SAA). Little is known regarding the factors related to the experiences and attitudes toward family involvement in EOL care, especially among these populations. This study explored how family relationships shape attitudes towards and experiences of family involvement in EOL care among older Vietnamese American and Filipino Americans. Three focus groups consisting of one Filipino group (in English), and two Vietnamese groups (one in English, one in Vietnamese) were held with 12 participants aged 55 or above. Interview questions centered around EOL care preferences and experiences and the role of family relationships in EOL care. Participants reported they could trust their children the most with their EOL care wishes, and expressed the preferred place for EOL care to be “home” rather than institutional settings. While some reflected that previous experiences with older family members (e.g., parents, aunts and uncles) facilitated EOL care discussions, others acknowledged resistance from some in participating in these conversations. Cultural and language differences led to participants’ resistance to formalized care and hindrances to EOL care planning. Finally, financial cost, concern about burdening younger generations who “have their own lives”, and difficulty navigating information were cited as barriers to EOL care. Findings from this study can provide improved understanding of the role that family plays in individuals’ EOL care experiences and improve culturally responsive EOL care practices for SAA populations.
END-OF-LIFE DOULAS: EXPLORATION OF VALUES, GOALS, AND MOTIVATIONS
Authors: Thompson Amber 
Published: December 2023

Abstract
End-of-life doulas provide non-medical support to individuals and families during end-of-life. Current research focuses on identifying the doula role and services offered at end-of-life, primarily in relation to existing medical care. The findings highlight the ambiguity of the role and resulting confusion for healthcare providers, individuals, and families. Using data collected from on-line surveys, the aim of this study was to explore the values, goals, and motivation of those identifying as end-of-life doulas (n=232). In addition to questions about the role and services provided, 14 items assessed the doulas’ underlying values through goals and motivations. Questions addressed their motivation for becoming a doula and their goals for this role, such as: 1) promoting well-being during end-of-life 2) providing a less medicalized model, including advocating for death reform, and 3) wanting to professionalize and/or commodify the non-medical care they provide. Exploratory factor analysis supports two underlying factors describing the doulas’ goals and motivations including social values (i.e., perceived positive impact on society) and functional values (perceived problem solution) (Cronbach’s alpha .85 and .75 respectively). Content analysis of open-ended survey responses describing motivations for becoming an end-of-life doula strengthen this perspective and expand it to include emotional motivations (i.e., “called” to the work, or personal experiences with death). These unique findings demonstrate the need for more research documenting the underlying values organizing end-of-life doulas. The potential benefits of investigating values include progress towards clarification about the role of end-of-life doulas, and how they may contribute to providing person-and-family centered care during end-of-life.
ENGAGING DIVERSE OLDER ADULTS IN AGING RESEARCH: IDENTIFYING COMMUNICATION AND COMMUNITY ENGAGEMENT STRATEGIES
Authors: Gaillard Trudy , Carr Dawn , Sheffler Julia , Weiss Ursula , Neff Donna , Charness Neil , Webb Fern 
Published: December 2023

Abstract
A growing challenge is ensuring that diverse older adults participate in research studies. If studies are not inclusive of diverse populations, it is not possible to determine if interventions are likely to be universally beneficial or reduce health disparities. Smaller and more regional studies are particularly likely to struggle to recruit and retain diverse older adults for their research. This project uses quantitative and qualitative data based on a new collaboration consisting of independent scholars at four research institutions associated with three participant research registries on aging in Florida. The aims of this project are to: 1) describe characteristics of aging-focused research registrants, and 2) share communication strategies for recruitment specifically designed to increase participation of a variety of underrepresented populations, including minority, rural, and under-served. Preliminary results show that it is important to specifically adopt culturally informed recruitment strategies given its direct result in adequate representation from diverse and under-represented groups. All three participating registries are currently enrolling persons and seek a specific diverse demographic which captures the racial, cultural and geographic variation observed in residents throughout Florida. For example, these registries seek individuals who self-identify as African American/Black, Caribbean, Hispanic/Latino adults aged &gt; 55 years; persons living in rural communities, and persons who have survived cancer or are interested in cancer-related research. We describe current infrastructure employed at each institution as well as recommendations in building long-term trust across each collaborating institution. Finally, we share an innovative model leveraging strengths and opportunities for statewide engagement across each registry.
EPIDEMIOLOGIC PATTERNS OF POTENTIALLY INAPPROPRIATE MEDICATION USE IN OLDER ADULT DRIVERS
Authors: Cotton Jesse , Huang Beicheng , Chihuri Stanford , Lang Barbara , Li Guohua 
Published: December 2023

Abstract
Use of potentially inappropriate medications (PIMs) by older adult drivers has been linked to increased crash risk. The objective of this study was to examine the epidemiologic patterns of PIM use in a cohort of 2990 drivers aged 65-79 years at the time enrollment (July 2015 to March 2017). We applied the 2023 Beers Criteria to identify PIMs from medication data collected through the “brown-bag review” method at baseline, year 2 and year 4 of follow-up for older adults participating in the Longitudinal Research on Aging Drivers project. We assessed time trends in the prevalence of PIM use and the composition of PIMs using the chi-square tests. The prevalence of PIM use was 16.2% at baseline, which decreased slightly in year 2 (14.0%) and year 4 (13.2%). The three most frequently used PIMs were nonbenzodiazepine hypnotics, antidepressants, and estrogens, accounting for 19.4%, 17.8% and 14.1% of all PIMs, respectively. Of PIM users, 12.7% were using ≥2 PIMs at baseline, 12.5% in year 2, and 10.0% in year 4. PIM use among older adult drivers is fairly common. Epidemiologic patterns of PIM use among older adult drivers have remained stable during the four years of follow-up.
EVALUATING THE SENIOR EMPLOYMENT AND SOCIAL ACTIVITY SUPPORT PROGRAM IN KOREA: A SYSTEMATIC REVIEW OF SATISFACTION
Authors: Koh Young Bin , Lee Yeonjung 
Published: December 2023

Abstract
For older people, jobs provide not only income security, but also a social role. Jobs also give them a sense of subjective security in terms of maintaining self-esteem and self-identity, and improve their overall life satisfaction. The Senior Employment and Social Activity Support Program (SESAP) provides for older Koreans for supplemental income security and social participation in old age by creating and providing social jobs that match the aptitudes and abilities of the senior citizens. It has been 20 years since the SESAP was introduced, and many studies have accumulated to evaluate the program in many different aspects. This study aims to summarize the existing studies focusing on satisfaction with program among participants. A systematic literature review was conducted to identify empirical research studies written in Korean and published in a peer-reviewed journal between 2004 and 2023. To this end, we searched through RISS, KISS, and DBpia databases using the selected keywords and obtained 126 articles. After removing duplicates and excluding gray literature, 26 articles were selected and analyzed through a peer-review process. Analysis of the selected literature shows that a majority of the program participants are women, and satisfaction with salary was lower compared to other types of program satisfaction (i.e., job content, work environment, and relationship with co-workers). Lastly, satisfaction with program are associated with other indicators such as better life satisfaction, and quality of life. This systematic review provides suggestions for further research to improve the satisfaction with SESAP among participants.
EXAMINING DEMENTIA AND NONDEMENTIA CAREGIVERS’ NUTRITION AND OVERALL HEALTH
Authors: Nehrkorn-Bailey Abigail , Edmonds Tanner , Quatsoe Alissondra 
Published: December 2023

Abstract
The literature on dementia caregivers is sparse. A study from Sheehan et al. (2021) concluded that the well-being of dementia caregivers and nondementia caregivers largely did not differ. To note, the sample size in that study was limited and no health behaviors were assessed. This study extends and adds to the Sheehan et al. (2021) study by utilizing the July 2023 Behavioral Risk Factor Surveillance System data (CDC, 2023) to examine nutrition (i.e., fruit and vegetable intake) and overall physical and mental health among (1) dementia caregivers and (2) nondementia caregivers. Two multiple mediation analyses were conducted comparing caregiving group (n = 4,853 dementia caregivers; n = 28,698 nondementia caregivers): physical health was the outcome in Model 1, and mental health was the outcome in Model 2. The direct pathway from caregiving group to (1) physical health in Model 1 was significant (b = -.05, p &lt; .001) and (2) mental health in Model 2 was significant (b = -0.11, p &lt; .001). The pathway from caregiving group to vegetable intake was significant in both models, but the caregiving group-fruit intake pathway was not significant. The pathways from vegetable and fruit intake to physical and mental health were all significant. Lastly, vegetable intake significantly mediated the pathway from caregiving group to (1) physical health (b = 0.001, CI = [.0003 to .0020]) and (2) mental health (b = 0.001, CI = [.0002 to .0015]). These findings indicate important diet and overall health differences between dementia and nondementia caregivers.
EXAMINING THE ASSOCIATION BETWEEN LAND COVER AND PHYSICAL MOBILITY: FINDINGS FROM THE NHATS STUDY (2021)
Authors: Perera Rohini , Gronlund Carina , Noppert Grace , Duchowny Kate 
Published: December 2023

Abstract
The vast majority (88%) of adults wish to age in place. An aesthetically pleasing environment has been found to be associated with better physical functioning and reduced disability, however specific land cover features (i.e. blue, green, urban spaces) and their relation to mobility have not been fully investigated. Data come from the National Health and Aging Trends Study (NHATS, 2021), a nationally representative sample of Medicare beneficiaries, and the National Neighborhood Data Archive (NaNDA), a data repository with census-tract measures of land cover. Mobility was assessed using the objective Short Physical Performance Battery (SPPB) and subjective physical capacity (PC) (range = 0-3 for both measures). Higher categories for both measures indicate better mobility. The analytic sample included 2,939 individuals (58.3% women) with mean age 81.8 years (SD = 6.4) from 2,071 census tracts. In fully-adjusted ordinal logistic regression models, compared to those in the lowest SPPB category, each percentage increase of blue space was associated with a 3.6 greater odds of being in the next highest category of SPPB (aOR= 3.61, 95% CI = 1.20-10.84 ). In contrast, each percentage increase of urban space was associated with a 18% decreased odds of being in the next highest category of SPPB (aOR= 0.82, 95% CI = 0.67-0.99). Similar associations were observed with PC, although were not statistically significant. Since decreased mobility is associated with numerous negative health outcomes, results from this study highlight the need to consider land cover as a potential policy lever to promote mobility among older adults.