bluuebunny/crossref_metadata_2025_split huggingface dataset:
DO OLDER ADULTS BELIEVE THEY ARE AGING SUCCESSFULLY IN THE CIRCUMPOLAR NORTH?
Authors: Howell Britteny , Worthington Amber , Golden Dale , Redmond Leslie 
Published: December 2023

Abstract
People’s perspectives on successful aging may impact their own aging outcomes. To gain more insight, we surveyed a convenience sample of 58 adults aged 55+ years in urban Alaska about their perceptions of their own aging using Fowler’s successful aging scale. Overall, older adults rated their aging in the middle of the 1-7 scale across all three questions: how well they are aging, how “successfully” they have aged up to now, and how they rate their lives these days (M=4.17, SD=1.16, range=1-7 where 1 = not at all successful and 7 = extremely successful). Correlational analyses indicated that as perceptions of successful aging increase, self-reported good general health (M=2.90, SD=1.00, range=1=5) increases, r(56)=.499, p&lt;.001, and self-reported disability (M=0.71, SD=0.92, range=0-3) decreases, r(56)=-.27, p&lt;.05. Despite a small sample size, these findings that perceptions of successful aging increased as general heath increased and self-reported disability decreased, suggest that participants may perceive successful aging and good general health to be positively correlated. Perceptions of successful aging were not related to age in this sample (M=71.98, SD=8.74), r(56)=.125, p=.349. This is promising, as it may indicate that older adults recognize good health and absence of disability as integral components for successful aging regardless of chronological age providing opportunities for targeted messaging in future interventions. Future work will explore opportunities to promote successful aging and overcome some of the challenges related to healthy aging in this urban location, including the Circumpolar environment, historical trauma of Indigenous peoples, and a lack of accessible healthcare across Alaska.
ENHANCING CAPACITY OF SERVICE PROFESSIONALS TO PREVENT FINANCIAL EXPLOITATION IN RURAL OLDER ADULTS WITH DEMENTIA
Authors: Sun Fei , Zhang Zhenmei , Kim Ha Neul , Zhang Xuehan , Xiong Yuan , Yang Huiyu , Wang Xia 
Published: December 2023

Abstract
Cognitive impairment renders older adults more vulnerable to financial exploitation (i.e., financial abuse committed by family members, or someone known to victims, and financial fraud committed by strangers). This study developed and tested the efficacy of a community-based financial exploitation prevention model for older adults living with dementia in rural Michigan. Guided by the routine activity theory, we chose to address external risk factors for financial abuse and fraud by focusing on service professionals (i.e., social and health care providers) who are at stake for identifying and reporting abuse. Using a randomized control design, we assigned 52 service professionals in intervention groups that received training on dementia and financial exploitation and available community resources, and 39 in control groups that received community resources only. Participants were assessed at baseline and 3 months following the intervention, while 26 dropped out at 3-month follow-up. Linear mixed modeling (LMM) was used to examine time and group effects in dementia literacy, understanding of financial exploitation, and competence in handling financial exploitation. Both groups reported an increase in their knowledge of dementia and their competence of handing financial exploitation cases. Moreover, those in the intervention groups reported more understanding of risk factors for financial abuse committed by family members. Community service agencies comprise a strong safety network for vulnerable older adults at risk for financial exploitation. Policies and practice need to be in place to sustain the coordinated efforts among community service agencies and adult protective services to prevent financial exploitation.
FUNCTIONAL IMPACT ON ADULTS AND OLDER PEOPLE AFTER HOSPITALIZATION BY COVID-19
Authors: Ochiai Gabriela , De Godoy Caroline , Silva Erika Gouveia E , De Carvalho Celso Ricardo Fernandes , Fu Carolina , Tanaka Clarice , De Carvalho Carlos Roberto Ribeiro , Pompeu Jose 
Published: December 2023

Abstract
Cross-sectional study of 159 individuals, one month after hospitalization at the Hospital das Clínicas of the University of São Paulo for Covid-19, divided into groups: 54.7% (n=87) were adults (&lt; 60 years), and 45.3% (n=72) were older people (≥60 years), with 43.4% (n=69) being female. Those who did not accept to participate, without availability, or without ability to understand the questionnaires were excluded. Functional capacity was assessed by the Barthel Index (BI). Statistical analysis was performed using JASP Statistics-0.15.0, considering significance level of alpha=0.05. Wilcoxon and Mann-Whitney tests were applied to compare pre- and post-Covid periods and to compare adults and older people, respectively. Data collection went from June 30, 2020, to August 24, 2021. The median length of hospitalization was 23 (15-34) days. The median total BI scores were lower one month after discharge in older people, 95 [90-100], when compared to adults, 100 [92.5-100] (p=0.001). Bladder control (p=0.009), toilet use (p=0.021), chair/bed transfers (p=0.043), ambulation (p=0.006), dressing (p=0.015), stair climbing (p&lt; 0.001), and bathing self (p=0.006) were the activities of daily living most affected in older people. Hospitalization due to Covid-19 had functional impacts in the post-discharge period, particularly in older people, manifested by limitations in performance of daily activities with higher physical demand. These findings emphasize the need for functional capacity screening after hospitalization for Covid-19, especially in older people.
GENETIC VARIANTS ASSOCIATED WITH BLOOD PRESSURE PHENOTYPES IN OLDER ADULTS
Authors: Sargent Lana , Dixon Dave , Mackiewicz Marissa , Price Elvin 
Published: December 2023

Abstract
African Americans (AAs) suffer from higher rates of uncontrolled HTN even when receiving commonly prescribed classes of antihypertensive medications. Variation in blood pressure (BP) in older adults is known to be associated with a variety of cardiovascular endpoints, yet our understanding of underlying mechanisms is limited. This study aimed to determine if HTN genetic variants influence blood pressure variation within a population of AA older adults taking antihypertensives. Community-dwelling older adults from the Translational Approaches to Personalized Health (TAPH) cohort were recruited to enroll in a 24-hour ambulatory BP monitoring (ABPM) phenotyping study. The Quant Studio 12-K Flex system was used for genotyping participants for three previously established CACNA1C and CACNB2 genetic risk alleles (rs758173, rs2228645, and rs2357790). 69 participants had ABPM data that passed the minimum 80% successful readings threshold: age=68□6, Female=50.3%, Black=73%, White=21%, and Other=6%. ABPM revealed 50.7% controlled HTN, 27.5% Sustained uncontrolled HTN, 14.5 % White coat uncontrolled HTN and 7.2% Masked uncontrolled HTN. ANOVA and Linear regression models found that the CACNB2 genetic risk allele rs2228645 broadly impacts ABPM Phenotypes (C/C SBP= 120.8+/-12.9 mmHg, C/T SBP= 125.73+/-13.5, and T/T SBP= 140+/-34.8 mmHg, p=0.011), mean awake 24-hour SBP (C/C SBP= 124+/-12.7 mmHg, C/T SBP= 133.5+/-14.8, and T/T SBP= 143.7+/-25.6 mmHg, p=0.012), and mean sleep SBP (C/C SBP= 114+/-16 mmHg, C/T SBP= 125.4+/-15, and T/T SBP= 136+/-50 mmHg, p=0.024). CACNA1C and CACNB2 genetic variants influence blood pressure phenotypes in older AAs. Determining genetic variants that affect antihypertensive effectiveness could lead to improved antihypertensive therapy for individuals with HTN/CVD.
GERIATRICS IN HEALTH PROFESSIONS EDUCATION: A BIBLIOMETRIC ANALYSIS OF 70 YEARS OF RESEARCH
Authors: Pajuelo-Vasquez Renzo , Gutierrez-Baca Wendy , Flores-Cohaila Javier , Runzer-Colmenares Fernando M 
Published: December 2023

Abstract
To move forward in the field of Geriatrics in Health professions education (HPE), we must understand its conception and recognize current trends and future directions. Therefore, we conducted a bibliometric and network analysis of all studies indexed in the Scopus Database related to Geriatrics and HPE from 1953 to 2022. We retrieved 2940 studies comprising 7344 authors and 618 journals; these were imported to bibliometrics (RStudio) and Vos Viewer. To understand the intellectual structure, we employed a co-citation analysis; we identified 5 clusters that described fundamentals in geriatrics, nursing education, needs assessment, and interprofessional education (IPE). Furthermore, six topics were placed in the keyword co-occurrence, ranging from medical, nursing, dental, social workers, and interprofessional education. Consequently, we identified geriatrics education for medical students and interprofessional education between 2004 and 2016; furthermore, clinical competence was the most recent trending topic, accompanied by end-of-life care and geriatric psychiatry. In the evolution map, three topics emerged in the last ten years: IPE, online learning, and geriatric dentistry. These findings were confirmed in the bibliographic coupling analysis. Four major themes emerged among 13 clusters: IPE, Attitudes and career orientation to geriatrics, innovative educational methods such as gamification, and geriatric undergraduate education. Although we identified several studies, this barely represents the 1% of production in HPE. Furthermore, we identified a trend toward IPE, undergraduate medical education, career orientation, and innovative education. However, there is a lack of themes such as simulation and entrustable professional activities, with an underrepresentation of the developing world.
HEALTH RELATED SOCIAL NEEDS AND TREATMENT PREFERENCES OF OLDER ADULTS WITH SERIOUS ILLNESS
Authors: Jackson Amy , Carpenter Joan 
Published: December 2023

Abstract
The Centers for Medicare & Medicaid Services’ (CMS) health related social needs (HRSNs) include housing instability, food insecurity, transportation, utility difficulties, and interpersonal violence. HRSNs shape the experiences and outcomes of seriously ill older adults, influencing their access and ability to choose preferred treatments —from the time of diagnosis until the end of life. Little research has explored disparities in healthcare experiences related to unmet HRSNs and treatment choices, including palliative and end of life care. The purpose of this integrative review is to explore the literature regarding unmet HRSNs and provide research, practice, and policy considerations for investigators, clinicians, and payers regarding HRSNs and their impact on palliative and end of life treatment decisions. We searched PubMed, Embase, CINAHL, PsychINFO, Scopus, and Google Scholar using keywords related to HRSNs and palliative and end of life care. We identified 38 articles between 1998 and 2023 within the United States. Of the 38 articles, housing instability was the most often addressed (n=36), followed by transportation (n=1) and interpersonal violence (n=1). None of the articles explored food insecurity and utility difficulties related to serious illness and treatment preferences. Many of the articles describe the perspectives of people experiencing homelessness at the end of life (n =16). The current literature does not comprehensively address unmet HRSNs in relation to palliative and end of life care treatment choices. Future work must address HRSNs of seriously ill older adults to ensure equitable access to compassionate and person-centered palliative and end of life care.
HISTORICAL CHANGES IN COLLEGE EDUCATION AND EMPLOYMENT: GENDER EFFECTS ON LATE-LIFE COGNITIVE STATUS
Authors: Larkina Marina , Smith Jacqui 
Published: December 2023

Abstract
Early-life education and gender are well-known predictors of cognitive status in old age but multiple mechanisms underlie these associations. Recent US research on late-life cognition and dementia prevalence has highlighted the roles of age-cohort and racial/ethnic differences K-12 education. Less attention has been given to historical increases since the 1970s in the completion of college degrees by women and their subsequent employment histories. We examined new data for two cohorts (N = 9926; 50% born before 1948 vs. Baby Boomers, born 1948-1959) in the Health and Retirement Study (HRS) about the quantity (years, degree types) and content (field of study) of their college degrees. College information and employment histories were collected in a Life History Mail Survey (2015-2017). Cognitive status based on the Langa-Weir algorithm was defined as normal, cognitive impairment not dementia or dementia (CIND/D). Compared to men, women were less likely to have post-high school education (p &lt; .002) or to have worked after their education. Cognitive status was predicted by degree type and work history. Gender by degree and gender by work interactions (for Baby Boomers only) revealed that having a BA/BS degree provided more protection against cognitive impairment for women than for men with the same degree, and women who worked had lower odds ratio of having CIND/D (0.36 [CI 0.17-0.77], p &lt; .01). College majors were gendered and significantly accounted for variance in late-life cognitive status among the college educated. These findings provide new insight into the gendered life histories related to late-life cognition.
IMPACT OF DUAL-TASKING AND DEMENTIA DISEASE SEVERITY ON POSTURE, GAIT, AND FUNCTIONAL MOBILITY IN RESIDENTIAL CARE
Authors: Jehu Deborah , Langston Ryan , Sams Richard , Young Lufei , Hamrick Mark , Zhu Haidong , Dong Yanbin 
Published: December 2023

Abstract
Dual-tasking may be a useful tool for fall-risk screening among people living with dementia (PWD), but more evidence is needed. Our aims were to compare single- and dual-task posture, gait and functional mobility; and examine the relationship between dementia severity and dual-task interference among PWD. Thirty PWD (Age:81.8±7.3years; 35% Female; Montreal Cognitive Assessment:10.5±6.1points) from two residential care facilities wore six APDM inertial sensors and completed two trials of single- (feet apart) and dual-task posture (feet apart while counting backwards by 1’s), single- (walk 4m) and dual-task gait (walk 4m while naming words), and single- (timed-up-and-go (TUG)); and dual-task functional mobility (TUG while completing a category task). Results revealed that greater frequency, jerk, and area were observed during dual- than single-task posture (ps&lt; 0.05), with no differences in velocity. Slower gait speed, greater double limb support, shorter stride length, and reduced elevation at mid-swing were detected during dual- relative to single-task gait (ps&lt; 0.05), with no differences in medial-lateral trunk sway. Dual-tasking resulted in a longer duration, reduced turn angle, and slower turn velocity than single-tasking for the TUG (ps&lt; 0.05), with no differences in sit-to-stand lean angle. Dual-task interference (greater jerk, faster gait speed) was related to moderate-to-severe compared to mild dementia (ps&lt; 0.05). Dual-tasking was more sensitive to detect impairments in posture, gait, and functional mobility than single-tasking. Moderate to severe PWD had poorer dynamic stability and a reduced ability to appropriately select cautious gait during dual-tasking than those with mild dementia, which should be considered in fall-risk screening.
INCREASED HIPPOCAMPAL ATROPHY IN HIGH INTENSITY INTERVAL TRAINING GROUP 4 YEARS AFTER 5-YEAR EXERCISE INTERVENTION
Authors: Håberg Asta , Reitlo Line , Pani Jasmine , Stenvold Dorthe 
Published: December 2023

Abstract
The Generation 100 Study is a randomized controlled trial (NCT01666340) investigating the effects of a 5-year exercise intervention on several health outcomes, including brain volumes from MRI. Participants (born 1936-42) were living independently at inclusion. They were randomized (1-1-2) to supervised exercising with either high intensity interval (HIIT) or moderate continuous training (MICT) twice a week, or to a control group adhering to the national guidelines of ≥30 min of moderate to vigorous physical activity at least 5 days a week. The intervention lasted for 5 years, during which participants underwent physical and clinical examinations at baseline, 1-, 3-, 5-years. 105 participants (n: HIIT=33, MICT=24, Cont=48) also underwent brain MRI at 3T. Linear mixed models were used and the interaction between group and time on brain volumes was the main outcome. We have previously reported that the HIIT group had significantly greater hippocampal atrophy rate compared to the control group during the intervention. Participants were invited back 4 years after end of intervention and underwent the same examinations including brain MRI . A total 73 participants (n: HIIT24=, MICT=19, Cont=30) took part. The HIIT group trained at a higher intensity than the other groups. There were no associations between objective VO2 or any self-reported exercise measurements and hippocampal volume/atrophy rate at any timepoint. Still, the hippocampal atrophy rate remained greater in the HIIT group than in the controls 4 years after end of the exercise intervention.
PACE AND FFS MEDICARE OUTCOMES BEFORE AND DURING COVID-19: A PROPENSITY SCORE MATCHED ANALYSIS
Authors: Perry Morgan , Obbin Samuel , McCall Stephen , Dorris Joseph , Nardone Michael , Turner Ani , Stanik Christine 
Published: December 2023

Abstract
We compared outcomes of Program of All-Inclusive Care for the Elderly (PACE) participants and fee-for-service (FFS) Medicare, dually eligible individuals using a retrospective cohort study with propensity score matching on demographic, socioeconomic, and participant-specific acuity level variables. PACE participants in 132 PACE centers nationwide who were dually eligible, enrolled during the study period, and did not have end-stage renal disease were included. Over 80% of eligible PACE participants were matched with FFS beneficiaries during each period, bringing many covariates closer between groups. We assessed differences during each period using Wilcoxon signed rank test and over time using differences-in-differences analyses. PACE participants spent significantly more time in the community and less time in nursing homes and hospitals (all p&lt; 0.01). PACE participants had fewer COVID-19 diagnoses and hospitalizations per member per month (all p&lt; 0.01). Due to the blinding of data, we could not determine definitively which performed better in limiting severe pressure ulcers. However, the results indicate PACE performed better when the mean assumption for blinded data is used. For all-cause mortality, PACE participants continued to perform better than FFS both before and during the pandemic (all p&lt; 0.01), but the rates were closer during the pandemic periods. The flexibility in the PACE model and its person-centered care delivery approach may have contributed to the positive outcomes compared to FFS before and during the pandemic. We should consider how best to leverage the PACE model of care to support older adults to remain in their homes and avoid institutional settings.
RACIAL/ETHNIC DIFFERENCES IN SUBJECTIVE COGNITIVE DECLINE (SCD) AND SCD-INDUCED OUTCOMES
Authors: Jacobs Moyosoreoluwa , Lichtenberg Peter , Tarraf Wassim 
Published: December 2023

Abstract
Alzheimer’s disease and related dementias (ADRD) prevalence will double by 2060, with significant racial/ethnic (R/E) differences in rates. Understanding R/E differences in risk factors of subjective cognitive decline (SCD)—a precursor to ADRD—is critical for timely premorbid interventions to modify ADRD onset. We used 2015 CDC Behavioral Risk Factor Surveillance System data from non-Hispanic White (NHW), Black (NHB), and Hispanic individuals aged ≥45 years (n=142,657) to examine R/E differences in SCD Status and five SCD-induced functional limitations and healthcare outcomes (e.g., health provider communication). We used generalized linear modeling to assess the contributions of predisposing (e.g., age), enabling (e.g., insurance), and health need (e.g., chronic disease) factors to explaining R/E differences. NHWs were generally older and healthier, with higher educational attainment than NHBs and Hispanics. NHBs (13.5%) were slightly more likely to endorse SCD (11.5% overall). NHBs and Hispanics endorsing SCD were significantly more likely than NHWs to report SCD-induced functional limitations. R/E differences were minimally attenuated after adjusting for the above-mentioned factors. We found no R/E differences in getting access to help, or in communicating with healthcare providers. NHBs and Hispanics (vs. NHWs) endorsing SCD are more likely to also endorse functional limitations despite reporting equivalent access to help and communication with healthcare providers. Clinical cognitive impairment depends on functional status and as such NHBs and Hispanics are potentially more vulnerable to cognitive disease (e.g., ADRD) onset. More research is required to understand gaps in care and how interventions can help mitigate this differential risk.
OLDER ADULT MISUSE OF OVER-THE-COUNTER MEDICATIONS: BENEFITS OF A NOVEL PHARMACY-BASED INTERVENTION
Authors: Chladek Jason , Gilson Aaron , Stone Jamie , Lehnbom Elin , Hoffins Emily , Berbakov Maria , Moon Jukrin , Chui Michelle 
Published: December 2023

Abstract
Older adults’ inappropriate use of over-the-counter medications (OTCs) is prevalent and comprises: (1) Drug-Age misuse – medication risks due to advanced age, (2) Drug-Drug misuse – medication interactions, (3) Drug-Disease misuse – contraindications with health conditions, and (4) Drug-Label misuse – deviations from label instructions. Since pharmacies are ubiquitous sources of OTC accessibility and medication safety expertise, a structural redesign of pharmacy aisles (Senior SafeTM) was conceived to mitigate older adult OTC misuse. A central feature of Senior Safe is the use of Stop Signs for high-risk OTCs and Behind-the-Counter Signs (BTC) for particularly high-risk OTCs. Given the signage’s practical importance, this study’ principal aim was to determine whether Senior Safe reduced misuse of Stop Sign/BTC OTCs. Twenty pharmacies from a mid-Western healthcare system were matched and randomly allocated to either control or intervention groups, from which 288 older adults were recruited (ages 65-91). Participants’ reported OTC use for a symptom scenario (pain, sleep, cough/cold/allergy) was evaluated to determine whether it fulfilled the four misuse types. Misuse occurrences between intervention/control sites were compared using multivariate modeling. Drug-Age and Drug-Drug misuse frequencies were significantly lower in intervention sites (Coef.=-1.012, p=.004; Coef.=-1.702, p=.004, respectively), while Drug-Disease and Drug-Label misuse had too few occurrences in intervention sites for statistical comparisons. Also, adults aged 85+ had the greatest likelihood of all misuse types. Senior Safe shows substantial benefit reducing high-risk OTC misuse, which is important particularly for vulnerable adults ages 85-91. Future research should document intervention mechanisms contributing to lower older adult OTC misuse.