bluuebunny/crossref_metadata_2025_split huggingface dataset:
RELATIONSHIP OF SOCIAL SUPPORT AND SOCIAL ENGAGEMENT WITH COGNITION IN AN ETHNICALLY DIVERSE OLDER POPULATION
Authors: Tappen Ruth , Koszalinski Rebecca , Newman David 
Published: December 2023

Abstract
One quarter of older adults in the U.S. are socially isolated; far more experience subjective loneliness. The potentially negative effects of limited social support and social engagement pose a concern for maintaining the well-being of older individuals, including the effect on cognitive function. To test the hypothesis that cognitive function is associated with social support and social engagement, we employed structural equation modeling (SEM) to analyze data from an ethnically diverse sample (118 African American, 147 Afro-Caribbean, 133 Hispanic, and 235 European American) of 623 community-dwelling older adults age ≥ 65 (173 male, 450 female). Using the model proposed by Cenè et al. (2022), we conceptualized level of social support and engagement as the exposure, emotional state (anxiety, depression, general emotional well-being), and physical function (functional activity, life space, general physical function, and self-rating of health) as mediators and cognitive function as the outcome of interest. Statistically significant direct and indirect effects were found between the three latent variables (emotional state, physical function, and social support and social engagement), indicating that the level of social support and engagement the older individual is related directly and indirectly to cognition (β=-.75, SE=.49, p&lt;.028; β=-0.08, SE=0.795, p=0.017). The SEM models showed goodness of fit with χ2/df=3.001, CFI=0.931, AGFI=0.966, SRMR=0.045, and RMSA=0.058, and explained 35.3% of the variability. These values support the hypothetical model. Results suggest the importance of maintaining existing social support and engagement activities as well as development and testing of approaches to increase social support and engagement in later life.
STRUCTURAL DIFFERENCES IN HEALTHY YOUNG AND OLD HUMAN MUSCLE CELLS: APPLYING DEEP LEARNING TO VOLUMETRIC SEM IMAGES
Authors: Hartnell Lisa 
Published: December 2023

Abstract
Several studies have shown that muscle strength and mitochondrial function degrade in individuals over time as a function of aging and/or disease. To better understand this process, we examined the relationship between structure and function of muscle in healthy young, healthy old and frail old participants in the Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing (GESTALT) study. Muscle was examined at the level of the mitochondrial reticulum and sarcomere, the basic contractile units of muscle, using volumetric Scanning Electron Microscopy (SEM) imaging. Volumetric SEM imaging using Focused Ion Beam (FIB)-SEM yields isotropic volumes enabling analysis at near membrane resolution and is ideal for mapping the mitochondrial reticulum and structural components of the sarcomere in 3D. The mitochondrial reticulum is a highly organized continuum of individual mitochondria that distribute and provide energy for contraction throughout muscle. We will show our approach to apply deep learning segmentation to volumes of gastrocnemius muscle ranging from 10-20 micrometers cubed collected from young (20-29y) and old (75-89y) participants in GESTALT to quantify differences in the reticulum including fragmentation and degeneration, as well as distribution and number of mitochondria. Preliminary findings suggest a difference with increasing age and more marked structural differences in both sarcomeres and mitochondria associated with frailty. Future work aims to increase the number of individuals sampled and extend the analysis to muscle from middle-aged individuals using biological markers and tests that indicate a functional aging phenotype.
CASUAL EFFECTS OF EARLY-LIFE ADVERSITY AND MID/LATE-LIFE BEHAVIORAL INTERVENTION ON THE PACE OF BIOLOGICAL AGING
Authors: Belsky Daniel , Ferrucci Luigi 
Published: December 2023

Abstract
Epigenetic clocks have taken gerontology by storm. With the advent of 2nd and 3rd generation epigenetic clocks, including GrimAge and DunedinPACE, the field now has genomic biomarkers of aging that exhibit strong and consistent associations with aging-related morbidity and mortality. But the causes of variation in these powerful indices of aging-related biological changes remain poorly understood. In this symposium, we present four studies at the vanguard of research to elucidate causal drivers of 2nd and 3rd generation epigenetic clocks drawn from four disciplines. From life-course epidemiology, we present a natural-experiment study of the long-term impact of in-utero famine exposure. From economics, we present a quasi-natural experiment study of long-term impacts of early-life exposure to the Great Depression. From psychology, we present results from a randomized controlled trial (RCT) of cognitive behavioral therapy (CBT) for insomnia in older adults. And from geroscience, we present results from an RCT of long-term calorie restriction in healthy, non-obese adults (CALERIE). These studies report novel and important findings that suggest early-life adversity acts to accelerate the pace of biological aging –and— that it may be possible to slow the pace of biological aging in mid- and later-life through behavioral intervention. They also illustrate study designs and methods that can help move the field forward as costs for measurement of epigenetic clocks fall, enabling their introduction into many more cohort and intervention studies.
IN UTERO EXPOSURE TO THE DUTCH HUNGER WINTER AND THE PACE OF BIOLOGICAL AGING
Authors: Cheng Mengling , Heijmans Bas , Li Chihua , Lumey Lambert , Ryan Calen , Wang Shuang , Zhou Jiayi , Belsky Daniel 
Published: December 2023

Abstract
Adults with histories of early-life adversity experience younger age-of-onset for aging-related disease and shorter lifespan, suggesting an accelerated pace of biological aging. To test this hypothesis, we analyzed data from an established natural experiment: in-utero exposure to famine conditions induced by a Nazi blockade of the Southern Netherlands in Winter 1944-5. We analyzed data from the Dutch Hunger Winter Families Study (DHWFS, N=951). DHWFS enrolled survivors of in-utero famine exposure, matched controls born in the same hospitals as the survivors immediately prior to and following the famine period, and siblings of these individuals. Blood samples were collected when the famine survivors were aged 58. We analyzed blood DNA methylation data to measure the GrimAge and PhenoAge 2nd-generation epigenetic clocks and the DunedinPACE 3rd-generation clock. We tested if famine survivors were biologically older and aging faster as compared to controls. We found that famine survivors had faster DunedinPACE pace of aging, as compared with controls, but similar PhenoAge and GrimAge biological ages. In sex-stratified analyses, we found stronger effects of famine exposure in women as compared with men, including for the GrimAge and PhenoAge clocks; among women, famine exposure was associated with faster DunedinPACE and older GrimAge and PhenoAge, whereas in men effect-sizes were near zero. Famine effects were not accounted for by blood-cell composition and were similar for individuals exposed early and later in gestation. Sibling-difference analyses reproduced size and direction of effect estimates. Findings provide natural-experiment evidence for long-term effects of in-utero famine exposure on the pace biological aging.
FINDINGS FROM A PILOT PRAGMATIC CLINICAL TRIAL EMBEDDING CAREGIVER PROGRAMS IN OUTPATIENT SETTINGS
Authors: Fortinsky Richard , Hepburn Kenneth , Clevenger Carolyn , Berg Karina , Higgins Melinda , Pascoe Tori , Medders Laura , Aldrich Vicky 
Published: December 2023

Abstract
Many interventions targeting family/informal caregivers of community-dwelling persons living with dementia have been tested in clinical trials, but few efficacious interventions have been offered in “real world” settings using embedded pragmatic clinical trial (ePCT) methods. This pilot ePCT engaged outpatient geriatrics and memory care clinics in two health systems to implement two caregiver support programs. We used patient portals in electronic health records (EHR) and caregiver registries to invite caregivers to receive one of two remotely-delivered caregiver support programs: the efficacious partly-synchronous Tele-Savvy (TS) program; or the completely-asynchronous Caregiving During Crisis (CDC) program. Random assignment (3TS:2CDC) was employed. Outcome measures were: self-reported caregiving mastery; perceived stress; and caregivers’ reaction to behavioral issues. Measures were collected using self-administered questionnaires sent via patient portals or secure email messaging before randomization and 3 months later (3m). In total, 74 caregivers participated: 59.5% received TS; 73.0% females, 17.6% Black caregivers, with average age 65.5+/-11.8 years. Thirty-four (45.9%) caregivers completed 3m. Compared to the caregivers in CDC, the TS caregivers experienced moderate-to-large effect size improvements in caregiver mastery and frequency of depressive behaviors (mastery: TS Cohen’s d=0.65, CDC d=0.00; depressive frequency: TS d=-0.64, CDC d=-0.04); caregivers in both groups reported moderate decrease in stress (TS d=-0.68; CDC d=-0.54). Implementation evaluation findings included: successful EHR buildout to capture and store caregiver-reported outcomes at one site; recruitment challenges due to caregiver difficulties gaining patient portal access and disinterest in randomization; and sub-optimal provider engagement in inviting caregivers to join the study through the EHR.
A MEDITERRANEAN LIFESTYLE AND FRAILTY INCIDENCE IN OLDER ADULTS: THE SENIORS-ENRICA-1 COHORT
Authors: Prieto Mercedes Sotos , Maroto-Rodriguez Javier , Delgado-Velandía Mario , Ortola Rosario , Rodriguez-Artalejo Fernando 
Published: December 2023

Abstract

Background
Frailty is a geriatric syndrome that entails high risk of hospitalization, disability, and death. While adherence to Mediterranean diet has been associated with lower risk of frailty, the joint effect of diet and lifestyle is uncertain. This study examined the association between a Mediterranean lifestyle (diet, customs, and traditions) and frailty incidence in older adults.

Methods
We analyzed data from 1 880 individuals aged ≥ 60 from the prospective Seniors-ENRICA-1 cohort. Adherence to the Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (higher scores representing better adherence), divided into 3 blocks: (1) “Mediterranean food consumption,” (2) “Mediterranean dietary habits” (practices around meals),” and (3) “Physical activity, rest, social habits and conviviality.” Frailty was ascertained as the presence of ≥ 3 of the 5 Fried criteria: (a) Exhaustion; (b) Muscle weakness; (c) Low physical activity; (d) Slow walking speed; and (e) Unintentional weight loss. Main statistical analyses were performed using logistic regression models, adjusting for the main confounders.

Results
After a 3.3-year follow-up, 136 incident frailty cases were ascertained. Compared with participants in the lowest tertile of the MEDLIFE score, the OR (95% CI) for frailty was 0.88 (0.58-1.34) for the second tertile, and 0.38 (0.21-0.69) for the third tertile (p-trend = .003). Blocks 1 and 3 of the MEDLIFE score were independently associated with lower frailty risk. Most items within these blocks showed a tendency to reduced frailty.

Conclusions
Higher adherence to a Mediterranean lifestyle was associated with lower risk of frailty.
PATHWAYS LINKING PARENTAL DEATH BEFORE 18 TO ACCELERATED EPIGENETIC AGING
Authors: Farina Mateo , Klopack Eric , Crimmins Eileen 
Published: December 2023

Abstract
Parental death before 18 is one of the most challenging adverse events that can lead to poor health in later life. Accelerated biological aging may be a key physiological mechanism that underlies this association. Data come from the Health and Retirement Study: the core surveys and the 2016 Venous Blood Study (VBS). We used second- and third- generation epigenetic clocks (GrimAge, PhenoAge, DunedinPace) to evaluate accelerated aging. Parental death before 18 and other covariates were obtained from the core surveys. To assess direct and indirect pathways, we used Structural Equation Modeling with educational attainment, depressive symptoms, and adult health behaviors (smoking, drinking, and BMI) as potential adulthood pathways that link parental death before 18 to accelerated aging. Parental death before 18 was associated with .79 years of accelerated aging. We found evidence of an indirect pathway through adulthood depressive symptoms. We did not find evidence of indirect pathways through educational attainment or adulthood wealth despite their strong negative associations with parental death before 18. Parental death before 18 was associated with accelerated epigenetic aging, which indicates that epigenetic aging may be a a key biological mechanism that links parental death in early life to health in older adulthood. Some of the association may be reduced by addressing mental health challenges that are associated with this traumatic event.
COMBINATIONS AND SEQUENCES OF LIFE TRANSITIONS DURING A 10 YEAR PERIOD AROUND RETIREMENT AGE
Authors: Slaug Björn , Eriksson Erik , Iwarsson Susanne , Kylén Maya , Oswald Frank , Wanka Anna , Wazinki Karla , Schmidt Steven 
Published: December 2023

Abstract
Our lives can be characterized as periods of stability, alternating with events that bring about change of both practical and psychological nature which require some life adjustment. The scope and depth of such life transitions are related to the kind of event, but also to whether it is perceived as positive or negative, occurs together with other events, addresses an entirely new topic or something that is biographically familiar, comes after a long period of stability or if it is an event in a chain of events occurring shortly after one another. Applying a quantitative approach to qualitative interview data from the Swedish German HoT-age project (N=50; mean age=69; 50% men), life transitions were analysed by means of sequential and configural frequency analysis. During an approximate 10-year period around retirement age, the participants experienced in average 3.7 life transitions and 24% of them more than five. Fifteen different kinds of transitions (retirement, relocation, divorce/separation, new partner, chronic illness etc) were recorded. Besides retirement experienced by almost all (96%), relocation (66%), becoming a grandparent (40%) and chronic illness (40%) were most frequent. The transitions significantly more often (p=0.041) occurring in combination were retirement and relocation. Those who had experienced chronic illness often had a sequence of several events preceding the illness recorded as a transition. Those who found a new partner often had a sequence of events after that. Large variation in sequences and distances between events were found. This study contributes with new knowledge on life transitions around retirement age.
LONELINESS AND SOCIAL ISOLATION: TO SCREEN OR NOT? PROVIDERS’ COMMUNICATIONS AND COMFORTABILITY
Authors: Hou Su-I 
Published: December 2023

Abstract

Purpose
Research has shown that loneliness and social isolation (SI) can seriously impact older adults’ health and well-being. However, it is unknown whether healthcare providers communicate with their older patients about these issues. This pilot study examines providers’ communication and comfortability on loneliness screening.

Methods
A convenience sample of providers who see older patients were recruited from healthcare and long-term care settings (n=59). Communication about social isolation was adapted from the revised UCLA 3-item Scale. De Jong Gierveld’s loneliness 6-item scale was used to assess social and emotional loneliness. Comfortable levels with loneliness screening (4 items) were adapted from UCF researchers’ food insecurity screening study.

Results
Providers’ mean age was 46 years; the majority were females (70%), and 67% were whites, with an average of 17 years of practice experience. About 60% of providers believe loneliness screening should be conducted among older patients during every visit. All the scales showed high internal consistencies with Cronbach’s alphas, ranging from .825 to .897. Data showed that communications about loneliness and social isolation were both low, with item means of 2.34 and 2.15, respectively. Overall, providers showed moderate comfort in conducting such screenings (mean=3.72 on a 5-point Likert scale).

Discussion
This pilot provides evidence of high reliabilities of these validated measures to assess providers’ communication and comfortability to screen for loneliness and SI. Data showed concerning findings on low communication and only moderate comfort among providers. It calls attention to providing provider training for early intervention, particularly among older patients.
THE VOICE OF OLDER ADULTS ON DIGITAL INCLUSION FOR HEALTHY COMMUNITY IN SINGAPORE
Authors: Ma Carol 
Published: December 2023

Abstract
With the rapid ageing population and the experience of Covid-19 pandemic, there is an urgent need to create a digitally inclusive healthy society. Singapore, as a smart nation, has been at the forefront of promoting digital inclusion to all age groups, including older adults. According to the Statista (2022), 88.5% of the population in Singapore are using internet and 56% of those over 60 are smartphone users. The use of digital technology for health promotion holds enormous potential to empower individuals and communities, particularly in the context of healthy and active ageing. The older adults in this study are adept at using the basic function of the smart phone rather than a computer. Some have even attended the national program, “Seniors Go Digital,” to learn about basic communication tools, file messaging, video calling, accessing government digital services, using e-payment tools, etc. They have also shared the barriers they face in using the internet, such as declines in vision, cognitive ability, and hearing, as well as the opportunities they have found, such as arrange telemedicine and access to the e-health systems. Besides, they found that the peer support and social networks are very important to support their digital learning journey. Though fear of encountering cheats and scams is common, they can be overcome by building confidence through peer support and self-efficacy. During the presentation, the authors will identify the contextual influences of digital inclusion and its impacts on healthy ageing in Singapore.
NURSE STAFFING CHARACTERISTICS AT US NURSING HOMES: NURSING MIX AND INTENSITY
Authors: Orewa Gregory , Davlyatov Ganisher , Ghiasi Akbar , Weech-Maldonado Robert 
Published: December 2023

Abstract
NHs have long struggled with lack of appropriate and consistent supply of nursing staff. Recruitment of qualified nursing staff is difficult due to the relatively low pay, supply-demand mismatch, and onerous regulatory and administrative demands. Research suggests that approximately 80% of NHs are understaffed. Despite NHs offering financial incentives to attract staff nurses, the use of contract nurses has been on the rise with 78% facilities reporting using agency nurse staff. However, much of this evidence remains anecdotal or precedes the COVID 19 pandemic, which had a disproportionate impact on the NH industry. The purpose of this research was to explore the overall nursing staffing trends at US NHs from 2017-2022. The study used the CMS Payroll Based Journal (PBJ) data for years 2017-2022. We examined the nursing staffing intensity, the proportion of contract nurses to total nurses, and the proportion of registered nurses (RN) to total nurse staffing. Our results suggest that the RN and licensed practical nurses (LPN) hours per resident day (PRD) stayed relatively consistent through 2017-2022, with a slight increase noted during the COVID-19 pandemic. There was a significant decrease in CNA hours PRD in 2022 compared to 2017. Contract nurse utilization across RNs, LPNs, and CNAs increased in 2022 compared to 2017. Looking at the trends, contract nurse utilization has been consistently increasing, but it may have peaked during the pandemic. RN to total nurse ratio increased in 2022 compared to 2017, though noticeably, the sharpest increase was during the pandemic.
FALLS, FEAR OF FALLING, DAILY ACTIVITIES, AND QUALITY OF LIFE IN THAI COMMUNITY-DWELLING OLDER ADULTS
Authors: Rodniam Jaroonrat , Thiamwong Ladda 
Published: December 2023

Abstract
This study aimed to examine the prevalence of falls, fear of falling (FoF), activities of daily living (ADL) and quality of life (QoL) in community-dwelling older adults in Thailand. A cross-sectional survey of 433 community-dwelling older adults was conducted. We used a simple random sampling method to recruit urban and rural adults aged 60 years and older from 23 districts in Thailand. The measurements included demographics, fear of falling, history of falls, QoL, the modified Barthel ADL, chronic diseases, and medications. Data were analyzed by using both descriptive and inferential statistics. Among the participants, 45.3% reported having at least one fall in the past year, and 80% reported high level of fear of falling. Compared to non-fallers and persons without fear of falling, fallers and persons with fear of falling were more likely to have at least one chronic disease, hypertension and stroke. Fallers and persons with fear of falling were more likely to take more medications or anti-hypertensive drugs. Daily activities including eating, bathing, dressing, toileting, and walking differed significantly between non-fallers and fallers (p&lt; 0.01 for all), and between persons with and without fear of falling (p&lt; 0.01). Quality of life measures also differed significantly between fallers and non-fallers (p &lt; 0.01). In conclusion, fallers and persons with fear of falling were more likely to have poorer health, more medications, lower quality of life, and different daily activity patterns. Future interventions should consider the differences between fallers and non-fallers and persons with and without fear of falling.
IF YOU KNOW ONE CAREGIVER, YOU KNOW ONE CAREGIVER: UNDERSTANDING THE DIVERSITY OF US CAREGIVING EXPERIENCES
Authors: Choula Rita , Reinhard Susan , Caldera Selena , Houser Ari 
Published: December 2023

Abstract
For many years, the image of a family caregiver has been of a white woman in her late 40s providing care to her much older mother. The shifting demographics of the U.S. population have lead to a new understanding of the heterogeneity of family caregiving experiences and arrangements. Delays in having children and increasing longevity have led to an increase in caregivers sandwiched between care for someone under 18 at home and an older family member or friend and the share Gen Z and Millennial caregivers. The increasing racial and ethnic diversity and acceptance and visibility of persons identifying as LGBTQ has been reflected in the population of caregivers. Each of these communities of family caregivers have distinct care experiences and face unique challenges providing that essential care to family and friends with chronic, disabling, or serious health conditions. This presentation explores the diversity of the U.S. population of family caregivers and their unique care experiences detailed in the Valuing the Invaluable: 2023 Update. An overview of existing survey data on caregivers and quantitative and qualitative research into distinct caregiver experiences will provide attendees with a nuanced understanding of who family caregivers are and what they and their care recipients experience. In summary, the range of challenges these different caregivers face and positive experiences will be discussed.