bluuebunny/crossref_metadata_2025_split huggingface dataset:
MAP GERIATRICS CLERKSHIP LEARNING OBJECTIVES WITH GERIATRICS 5MS
Authors: Cheng Huai 
Published: December 2023

Abstract

Background
Minimum Geriatrics Competencies (MGC) are used to guide teaching geriatrics for medical students in a required geriatrics clerkship since 2011. These learning objectives can be mapped to Entrustable Professional Activities (EPA). Since 2017, Geriatrics 5Ms (mind, mobility, medication, multi-complexities, and what matters most) was developed to guide teaching geriatrics for medical students and to promote a Geriatrics 4Ms Age-friendly health care system as well. The aim of this study is to examine whether an MGC-based geriatrics clerkship is consistent with geriatrics 5Ms by mapping its learning objectives with geriatrics 5Ms.

Methods
This geriatrics clerkship is a two-weeks required rotation for all fourth-year medical students. It includes didactic classroom teaching and clinical rotation in different geriatrics practice, palliative care, and physical medicine rehabilitation. This clerkship has a total of 50 learning objectives with corresponding MGC teaching methods/strategies, assessment, and evaluation. The author will map each learning objective with Geriatrics 5Ms. Results 13 learning objectives are mapped to “Mind”. 9 learning objectives are mapped to “Mobility”. 10 learning objectives are mapped to “Medications”. 14 learning objectives are mapped to “multi-complexity”. 6 learning objectives are mapped to “Matters most”. 12 learning objectives are not mapped to any of geriatric 5Ms. Conclusion and discussion The majority of 50 learning objectives in a required geriatrics clerkship can be mapped to geriatrics 5Ms. This MGC-based learning objective can be adopted to teach medical students geriatric 5Ms and geriatric 4M Age-friendly health care system. Take-home message MGC-based learning objectives are aligned with geriatrics 5Ms.
MEDIATING EFFECTS OF QUALITY OF LIFE IN THE ASSOCIATION OF DEBTS AND LATER MEMORY FUNCTION IN CHINA, ENGLAND, AND THE US
Authors: Cho Tsai-Chin , Choi HwaJung , Langa Kenneth , Adar Sara , Kobayashi Lindsay 
Published: December 2023

Abstract
Non-mortgage debts were linked to negative cognitive health outcomes in later-life older adults. It is unclear how they may be associated with later-life memory function through psychosocial pathways, and whether the associations vary by health care system and policy environment. We examined the mediating effects of depressive symptoms and dissatisfaction with life in the association between non-mortgage debts and subsequent memory function among adults aged 65-101 years in the US, China, and England. Data were from harmonized, nationally representative longitudinal studies of aging in the US (Health and Retirement Study; n=8,388), China (China Health and Retirement Longitudinal Study; n=1,180), and England (English Longitudinal Study of Aging; n=3,390). Non-mortgage debt burden was defined as any pre-existing or new non-mortgage debts in two years (2010-2012 for the US and England; 2011-2013 for China). Memory function was measured by 20-point immediate and delayed word recall summary scores over a subsequent 5- or 6-year follow-up period. Within each country, we used sampling-weighted, multivariable-adjusted causal mediation analysis (product method) to estimate the total and direct effects of non-mortgage debts on memory function, and the indirect effects mediated by depressive symptoms and dissatisfaction with life. We observed significant mediating effects of depressive symptoms on the association between non-mortgage debts and memory function in China only. Dissatisfaction with life had a significant mediating effect on this association in US and China, not in England. Although more investigation is needed, the relationships between non-mortgage debts and later-life memory function through psychosocial pathways may differ across macro-level socioeconomic structures.
TOBACCO USE AND COGNITIVE FUNCTION AMONG OLDER ADULTS IN MEXICO AND BRAZIL
Authors: Avila Jaqueline , Goncalves Natalia Gomes , Saenz Joseph , Suemoto Claudia , Wong Rebeca 
Published: December 2023

Abstract
Older adults in Brazil and Mexico have high lifetime tobacco exposure, which is an important modifiable dementia risk factor. They also have lower levels of education, which is associated with lower cognitive reserve. This study examines how tobacco use is associated with cognition and how this association differs by education among older adults in Brazil and Mexico. Data included adults 50 and older in the 2015 waves of the Mexican Health and Aging Study (MHAS, n=14,018) and the Brazilian Longitudinal Study of Aging (ELSI, n=9,409). The outcome was a global cognitive score, calculated with standardized cognitive tasks. Tobacco use was defined as current, former, and never smoker. Linear regression models were used to test differences in cognitive function by tobacco use, adjusted by sex, educational level, rural/urban area, chronic disease and included the interaction between smoking and education. Current and former smokers represented 17% and 37% of the sample in Brazil and 13.4% and 27.4% in Mexico, respectively. Current smokers in both countries were more likely to be men and be younger. However, current smokers in Brazil were more likely to have lower educational levels whereas those in Mexico were more likely to have 8+ years of education. In Brazil, current smokers had lower cognitive scores than never smokers (B= -0.06; 95%CI: -0.11; -0.01). In Mexico, current and former smokers had higher cognitive scores than never smokers (B=0.09 ; 95%CI: [0.05; 0.13] and B=0.10 [0.07;0.13], respectively). Cognitive scores for current smokers were significantly lower as education increased in Mexico.
DYADS’ POSITIVE AND NEGATIVE AFFECT ASSOCIATION WITH MENTAL HEALTH AND PERCEIVED GENERAL HEALTH
Authors: de Rosa Cristina , Wang Weijun , Chang Yu-Ping 
Published: December 2023

Abstract
Positive and negative affect may impact health in older adults and their family caregivers. However, how members of a caregiving dyad may influence each other’s health outcomes is not well understood. The purpose of this analysis was to simultaneously examine whether both dyad members’ positive and negative affect were associated with their own and each other’s mental health (depression and anxiety) and perceived general health. Dyadic data were obtained from the National Health and Aging Trends Study (NHATS) (2021) linked to the National Study of Caregiving (NSOC) IV (2021). The sample consisted of 1,209 pairs of adults aged 71 and older and their respective primary caregivers, defined as the family member or friend who provided the greatest number of hours of care in the preceding month. Actor-partner interdependence models were used to examine associations between positive and negative affect, mental health, and perceived general health, controlled for dyad members’ own gender, age, and race/ethnicity. Results indicated that positive and negative affect significantly predicted caregivers’ and older adults’ own mental health and perceived general health. Furthermore, older adults’ negative affect significantly predicted caregivers’ expressing little interest or pleasure in doing things (b = 0.033 (0.016), p = .046). Our results suggest that an individual’s mood influences their mental health and perceived general health even when considering partner effects. Caregivers’ interest or pleasure is particularly impacted by older adults’ negative affect. Dyadic supportive strategies to improve mood could be beneficial for both older adults and their family caregivers.
ELECTROCONVULSIVE THERAPY FOR TREATMENT OF TACTILE HALLUCINATIONS
Authors: Kummerlowe Megan , Utter Kierstin , Maria Lapid 
Published: December 2023

Abstract
Tactile hallucinations can be highly distressing and lead to psychiatric morbidities and functional impairments. There are no established treatments for tactile hallucinations that occur outside of primary psychotic disorders, and available pharmacologic and nonpharmacologic therapies may have limited effectiveness. We present a case of a 75-year-old female with treatment-refractory tactile hallucinations successfully treated with electroconvulsive therapy (ECT). She endorsed 13 months of distressing tactile hallucinations described as slimly substances on her skin. Symptoms started insidiously, became more severe with time and refractory to multiple antipsychotic medications. She became so severely distressed from the tactile hallucinations that she developed a major depressive episode and became suicidal. Relevant medical history included one prior depressive episode, occipital lobe stroke, restless legs syndrome, and obstructive sleep apnea. She was hospitalized in an inpatient psychogeriatric unit and treated with ECT for 12 sessions over 3.5 weeks. Hallucinations responded well to ECT. Patient experienced some mild memory impairment from treatment. Treatment was optimized with duloxetine titration, addition of mirtazapine and repletion of B6 vitamin. Following the acute course of ECT, she reported an 80 % improvement in tactile hallucinations. Depressive symptoms improved, and suicidal thoughts resolved. She was able to discharge from the hospital and continued with maintenance ECT. Our case illustrates the potential therapeutic role of brain stimulation in the treatment of refractory cases of tactile hallucinations. Further studies are needed to determine effective treatment strategies for treatment-refractory tactile hallucinations to prevent progression to severe psychiatric disturbances and improve quality of life.
GENDERED TRAJECTORIES OF DEPRESSIVE SYMPTOMS IN OLDER KOREAN PARENTS BEREAVED OF AN ADULT CHILD
Authors: Park Sujeong , Kim Jinho 
Published: December 2023

Abstract
Despite the existing body of research on the impact of child bereavement, little is known about whether time to the death of an adult child is associated with changes in depressive symptoms among older Korean parents. This study examines (a) trajectories of depressive symptoms before and after the loss of an adult child and (b) whether these trajectories differ across parent-child pairs (father-son, father-daughter, mother-son, and mother-daughter). Using eight waves of the Korean Longitudinal Study of Ageing (KLoSA), the study employs fixed effects models to mitigate potential bias due to unobserved individual-level heterogeneity. The result of this study revealed that depressive symptoms increased within the first year following the loss of an adult child among bereaved parents. Considering the gender of both the parent and the deceased child, differences in psychological adjustment to bereavement were observed in different dyads. Depressive symptoms surged within the first year and persisted even beyond the fourth year of loss among daughter-bereaved fathers, while only an immediate rise in depressive symptoms within the first year of loss occurred for other pairs. Given prevailing gender role socialization in the Korean context, men’s conformity to masculinity norms and the traditional expectation for daughters to provide emotional support may contribute to the long-term increase in depressive symptoms for fathers who have lost a daughter. Thus, in societies where Confucian gender culture is ingrained as a social norm, policies for the psychological support of older parents who have lost adult children must consider the different trajectories of parent-child relationships.
INTEGRATING GEROPSYCHOLOGY SERVICES INTO MEDICAL SETTINGS
Authors: Pearman Ann 
Published: December 2023

Abstract
Integrating behavioral health into medical settings, such as primary care clinics, has been shown to have a positive impact on the well-being and health of patients. Increased access to mental health services as well as increased identification of psychological issues is an important goal for all patients but may be of particular importance for geriatric patients who often have multiple chronic conditions along with an increased risk of neurocognitive disorders. This paper is intended to describe the process of starting an integrated geriatric behavioral health service line into geriatric and internal medicine clinics at a large urban hospital that serves a primarily underserved population of patients. MetroHealth Medical Centers serves over 300,000 patients, 75% of whom are uninsured or covered exclusively by Medicare and/or Medicaid. The system has one centralized geriatric medicine clinic as well as geriatric providers throughout the system. In 2021, a geropsychologist was brought on board to create a geriatric mental health service for the system. Three different models of integrated care are being used – within-clinic collaborative care, co-location of services, and referrals – and will be described further. There have been over 1200 referrals to the service since its inception, many of whom are receiving mental health care for the first time. This presentation will highlight the types of patients being referred and the efforts put forth to reach as many patients as possible. Finally, the development of Geropsychology-specific training opportunities for psychology and medical residents and fellows will be described.
TAILORED INTERVENTION PROGRAM USING HUMANOID AI MINI-ROBOT FOR OLDER ADULTS WITH DEPRESSION IN RURAL AREAS
Authors: Lim Young Mi , Kim Jungsug , Lim Junghee , Sun Minjung 
Published: December 2023

Abstract
Loneliness, and social isolation have worsened because most mental health centers were forced to suspend elderly-centric programs due to COVID-19. Recently, with the demand for a frail elderly-care model that enables non face-to-face interactions, strategies to utilize various technologies using robots for depression prevention are emerging. This pilot study aimed to develop and analyze a tailored intervention program using humanoid AI mini-robot for older adults with depression in rural areas. An experimental group of eight depressed elders participated daily in a tailored intervention program using humanoid AI mini-robot involving physical (stretching exercise) and emotional activities (listening to music) for ten weeks. A control group of ten depressed older adults received routine case management with non face-to-face at a mental health center. We compared the grip strengths and levels of depression and mental well-being between the experimental and control groups before and after the intervention, using Mann-Whitney U test and Wilcoxon signed rank test Statistically significant difference (U =12.0, p &lt; 0.05) was observed between the mental well-being levels of the two groups; by contrast, grip strengths and depression levels did not differ significantly. The experimental group exhibited a significant difference (Z = –2.038, p &lt; 0.05) between pre- and post-intervention grip strengths. The number of subjects was too small and the intervention period was not long enough to draw a meaningful conclusion. However, the findings have implications for the need of potential tailored interventions using humanoid AI mini-robot for mental well-being of community dwelling frail older adults.
DEALING WITH INJURED OR REPAIRED ANKLES IN OLDER ADULTS: ASSESSING ANKLE IMMOBILIZATION METHODS DURING LOCOMOTION
Authors: Dickin Clark 
Published: December 2023

Abstract
Orthopedic walking boots (OWB) are an alternative to casting and immobilizing an injured ankle. Unfortunately, OWB causes a change in leg-length and pelvis angle which alters gait and postural stability and can lead to chronic back pain. Immobilizing the ankle without changing leg-length would be beneficial, especially for individuals with impaired gait and postural stability. The purpose of this study was to assess level-ground walking and stair negotiation in healthy older adults across three ankle support conditions (1) OWB, (2) TayCo ankle brace (TAB) and (3) athletic footwear (SHOD). Sixteen older adults (69+/-7.0 years) performed 2-3 trials of walking, stair ascent, and stair descent using each of the three ankle support conditions. Ankle motion in all three planes was monitored using 3D motion capture cameras to assess differences during walking and stair negotiation. For all tasks, significant differences were revealed between the SHOD and both ankle support methods for all three planes (p &lt; .001). Significant differences were also revealed between OWB and TAB during walking in the transverse plane (abd/adduction) (p = .036 OWB&gt;TAB) and for stair descent in the sagittal plane (dorsi/plantarflexion) (p = .001 TAB&gt;OWB). No other differences were observed between the OWB and TAB for walking or stair negotiation. Ankle motion was similarly controlled with both the OWB and TAB indicating that either method would be appropriate to immobilize an injured ankle, however the TAB does not alter leg length or pelvic tilt since it fits over the individual’s footwear.
POOR ACTIVITIES OF DAILY LIVING PREDICT FUTURE WEIGHT LOSS IN OLDER ADULTS AFTER HOSPITAL DISCHARGE
Authors: Ramel Alfons 
Published: December 2023

Abstract
The aim was to investigate whether older adults with poor activities of daily living (ADL) at hospital discharge had increased weight loss after six months of follow-up and whether nutrition therapy can prevent this weight loss. This was a secondary analysis of the HOMEFOOD dietary intervention trial (N=104) investigating community dwelling older adults (66-95 years) discharged from hospital and at risk for malnutrition, receiving either 6 months nutrition therapy or standard care without any further nutrition intervention. ADL were assessed using seven questions on self-care including mobility.Of the participants, 45 (43%) had good ADL at discharge, 36 (35%) had medium ADL and 23 (22%) had poor ADL with no differences between control and intervention group. During the study period, 79% of the control group lost more than 1 kg body weight with a mean weight loss of -3.5 ± 3.9 kg, whereas only 2% of the intervention group lost more than 1 kg with a mean weight gain of 1.7 kg ± 2.5 kg. According to general linear models, participants in the control roup with poor ADL had significantly higher weight loss than participants with good ADL (estimated and adjusted: 3.6 kg (95%CI: 1.0-6.1 kg, P=0.007). No such difference was observed in the intervention group. In our study, participants with poor ADL at hospital discharge develop lower body weight by around 3.5 kg six months later when compared to participants with good ADL. Receiving nutrition therapy post discharge can nullify these differences in body weight between ADL categories.
PREVALENCE AND SOCIOECONOMIC DETERMINATES OF FOOD INSECURITY IN VETERANS: FINDINGS FROM NHANES
Authors: Robbins Ronna , Addison Odessa , Parker Elizabeth , Wherry Sarah , Serra Monica 
Published: December 2023

Abstract

Objective
Determine predictors of the association between being a Veteran and adult food security, as well as to examine the relation of potential covariates to this relationship.

Methods
Data collected during 2011-2012, 2013-2014, and 2015-2016 National Health and Nutrition Examination Survey (NHANES) were pooled for analyses. 1,227 self-reported Veterans (mean age: 57 years) were matched to 2,432 non-Veterans (mean age: 53 years) on age, race/ethnicity, sex, and education. Adjusted logistic regression was used to determine the odds of Veterans having high food security vs. the combination of marginal, low, and very low food security compared to non-Veterans.

Results
Veteran-status had no effect on the proportion of food insecurities between Veterans and non-Veterans reporting high (Veterans vs. non-Veteran: 79% vs. 80%), marginal (9% vs. 8%), low (5% vs 6%), and very low (8% vs. 6%) food security (p=0.11). However, after controlling for covariates (age, race, education, diabetes, cardiovascular disease, hypertension, and depression), Veterans tended to be less likely to have high food security (OR: 0.82 (95% CI: 0.66, 1.02), p=0.07). Further, non-Hispanic Veterans (OR: 0.72 (95% CI: 0.55, 0.95), p=0.02) and Veterans completing some college (OR: 0.71 (95% CI: 0.50, 0.99), p&lt; 0.05), were significantly less likely to experience high food security compared to non-Veterans.

Conclusion
This study supports previous research findings that after controlling for covariates, Veterans tend to be less likely to have high food security. It also highlights ethnicity and level of education as important socioeconomic determinates of food security status in Veterans.
BRAIN HEALTH COMMUNITY REGISTRY: DEVELOPMENT OF A MODEL FOR CONNECTING PARTICIPANTS TO COMMUNITY-BASED SUPPORTS
Authors: Block Laura , Haas Meghan , Kay Lilli , Benson Clark , Gilmore-Bykovskyi Andrea 
Published: December 2023

Abstract
Growing evidence demonstrates social and economic factors (e.g. socioeconomic status, level of education) contribute to risk for Alzheimer’s disease and related dementia (ADRD). These factors also serve as barriers to research participation, contributing to systematic under-inclusion in ADRD research. The Participant and Relationship-Oriented Research Engagement (PRORE) Model outlines mechanisms through which socioeconomic determinants and reciprocal relationships may shape research participation; however, scalable protocols that address these mechanisms are lacking. Our objective was to develop and pilot the feasibility and acceptability of a research-based resource-matching protocol. The Brain Health Community Registry (BHCR) recruits adults ages 40 and above with and without changes in memory, and caregivers of individuals experiencing memory changes. BHCR connects participants with research opportunities and conducts a needs assessment to match individuals with community-based services and supports. Of 168 participants enrolled in BHCR, 33 (20%) report changes in memory, 93 (55%) do not, and 42 (25%) are caregivers. More than half (n=91, 58%) requested resource matching. Resource matching took 1.8 hours per participant (range 0.5-4.5 hours). Challenges included navigating rural counties with limited resources and effective follow-up; strategies included an interdisciplinary approach, offering multiple modes of contact, and a strengths and relation-based approach. Participants who responded to follow-up at two and six weeks (45% of total), and at annual review (100%, N=6) described resource-matching as instrumental for successful connection to supports, general knowledge/preparation, or on behalf of a friend or family member. Future work must ascertain whether needs assessment and resource matching change study participant perceptions of research.