bluuebunny/crossref_metadata_2025_split huggingface dataset:
AGING IN PLACE IN JAPAN: CHALLENGES AND FACILITATORS OF OLDER-TO-OLDER CAREGIVING
Authors: Wada Mineko , Hanaoka Hideaki 
Published: December 2023

Abstract
The proportion of older adults (age 65+) in Japan has been steadily growing, and reached almost 30% in 2022, its highest-ever level. As the benefits of aging in place have been promoted at individual, community, and policy levels, the number of households where an older adult cares for another older adult has been increasing. However, currently little is known about the challenges and facilitators of older-to-older caregiving. This study aims to review extant literature to identify challenges experienced by older-to-older caregivers and facilitators that could help them. Drawing on a review protocol informed by Arksey and O’Malley’s framework and Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR), we searched six databases (MEDLINE, CINAHL, PsycINFO, Cochrane, Scopus, Google Scholar) using combinations of search terms including “older,” “aged,” “senior,” “caregiver,” “carer,” “care provider,” and “care recipient.” To be included in the study, the literature must be written in English and based on empirical studies focusing on older caregivers (age 65+) who care for older adults (age 65+) in community settings. The reviewed literature suggests that older caregivers experience substantial distress, caregiver burden, and sleep deprivation, which increases the risk of depression and diminished well-being, particularly if they care for older adults living with dementia. Facilitators of caregiving include strategies for self-care and problem-solving to address challenges. Future research needs to investigate (1) support options that could reduce older caregivers’ burden and promote their well-being and (2) older care recipients’ experiences of being cared for by older cares.
HEALTH-SEEKING BEHAVIOR OF COMMUNITY-LIVING OLDER ADULTS RELATES TO AWARENESS OF COMMUNITY SERVICES
Authors: Connelly Denise , Gill Navjot , Beauchamp Marla , Brunton Laura 
Published: December 2023

Abstract
Research has shown that older adults desire to age in their homes. To age at home safely and comfortably, there are a variety and number of community support services available, however, previous studies show older adults do not utilize these services fully. There is a need for clarity about this gap between availability and use. Understanding the construct of health-seeking behaviour by community-living older adults may provide insights into this identified gap. Therefore, the objective was to determine whether health-seeking behaviour in community-living older adults is related to: dimensions of wellness; awareness of community support services; living as an older man or woman; or being younger or older than 75 years. A cross-sectional study design involving 99 community-living older adults (≥ 65 years, without impaired executive function) employed validated outcome measures of physical function, fear of falling, personal resilience, social well-being, spiritual well-being, awareness of community support services, and health-seeking behaviour. Relationships were calculated using multiple linear regression. Health-seeking behaviour was positively correlated (R= 0.40, p&lt;.01) with awareness of community support services. Health-seeking behaviour was not correlated with dimensions of wellness (i.e., physical function, fall risk, personal resilience, spiritual wellbeing, or social wellbeing). No difference between age groups (U=986.5, n1=68, n2=31, p=0.61) nor sex (U=931.5, n1=66, n2=33, p=0.24) was found for health-seeking behaviour. The findings indicate that awareness of community support services positively influenced health-seeking behaviour. The healthcare system should ensure equitable, accessible, age-friendly, and relevant information and distribution strategies to increase awareness of older adults for local supportive services.
RELATIONSHIP BETWEEN SOCIAL ISOLATION AND EXPECTATION FOR PERMANENT LIVING IN A MARGINALIZED COMMUNITY IN JAPAN
Authors: Watanabe Yuichi 
Published: December 2023

Abstract
Social isolation is a predominant issue for the well-being of older adults in Japan. In marginalized communities, there is a high aging ratio of over 50%, and many older adults live alone. If they did not have connections in the community, there would be huge problems, not just loneliness but also the lack of necessities of daily life. This fact could threaten their permanent living. Therefore, This research examines the relationship between social isolation and permanent living expectation. Data were gathered by surveying a marginalized community every two years from 2015 to 2019 (N=435). Logistic regression analysis was conducted. For measuring social isolation, the questionnaire includes two items as independent valuables; “How many contacts do you have with community residents in a week?”, “How many contacts do you have with someone living out of this community in a week?.” An item measured permanent living expectation as a dependant valuable; “Would you like to be living here permanently when you live alone?” Gender, age, economic status, health status, and living alone were also included in the analysis. The results show that the number of contacts with community residents significantly predicted the permanent living expectation(P&lt;.00, odds ratio=1.099). Health status is also significantly associated with a permanent living expectation. Findings suggest that social isolation in a community is a risk for giving up a permanent living. It could be social exclusion. Our effort to make mutual connections and contacts among the community residents could ease the risk of social exclusion.
USING INTERPERSONAL RELATIONSHIPS AND SOCIAL NETWORK TO UNDERSTAND ELDER MISTREATMENT RECURRENCE
Authors: Xue Wei- Lin , Hass Zachary , Liu Pi-Ju 
Published: December 2023

Abstract
The incidence of elder mistreatment are often recurrent rather than one-time. The recurrence of mistreatment contributes to severe physical and psychological problems for victims and negative social consequences. Poor interpersonal relationships and social isolation are the main factors of mistreatment occurrence in the literature. However, very few studies have considered how the quality of interpersonal relationships and the level of social networks affect the likelihood of mistreatment recurrence. We used the National Social Life, Health, and Aging Project waves 1 (2005–06) and 3 (2015–16) data for longitudinal analyses (N=1,592). The quality of interpersonal relationships (i.e., supportive relationship, strained relationship) and the level of social networks (i.e., social engagement, social isolation, and feeling safe in society) were conceptualized using factor analysis to estimate factor scores. Logistic regression models were built to predict the risk of recurrent mistreatment using interpersonal relationship quality and the level of the social networks. Controlling for demographic variables, victims in wave 1 with support from interpersonal relationships are more likely to experience reoccurring mistreatment (p&lt; 0.05, OR=1.58). Model interaction effects indicated that older adults with strained interpersonal relationships and low social engagement are most at risk of experiencing mistreatment recurrence. The surprising finding that supportive interpersonal relationships are positively associated with mistreatment recurrence might indicate that those who support older adults are potential perpetrators. Identifying potential perpetrators and assessing the quality of interpersonal relationships and social networks are essential to preventing mistreatment recurrence.
PERCEPTIONS OF HEALTH PROFESSIONALS, PATIENTS, AND FAMILIES ON DECISION TO DISCONTINUE LIFE-SUSTAINING TREATMENT
Authors: Lee Jooseon , Song Eunjeong , Shin Dongsoon , Yun Seon Young , Eom Minjeong , Oh Suhee , Lee Heejung , Song Rhayun 
Published: December 2023

Abstract
Withholding and withdrawing treatment is debated among health professionals who care for individuals at the end of life. This study aimed to compare the perception of life-sustaining treatment decisions by health professionals, patients, and families by providing data to guide medical professionals to support patients in making self-directed decisions about when to limit or continue their life-sustaining treatment. A descriptive survey was conducted with health professionals (220 from general tertiary hospitals) and 110 patients and their families. The majority of participants (85-95%) agreed with the suspension of meaningless life-sustaining treatment. In a clinical situation, the decision was made mainly by the family (84%), followed by the patient (10%) or the primary doctor (6%). However, the patients and their families reported that patients should make decisions (74%). The appropriate timing to discuss the suspension of the life-sustaining treatment was when the patients were still conscious but expecting severe deterioration” consistently reported by participants (45-58%). The most important factor during their decision-making would be “possibility of the patient’s recovery” by health professionals (43-55%), but “pain of the patients (58%)” was reported by the patients and their families. In conclusion, there is still a significant discrepancy in the perception of life-sustaining treatment decisions among health professionals, patients, and their families. The ambiguity of the timing for the decision to terminate life-sustaining treatment and the discrepancy between patients and their families’ opinions remain obstacles to implementing the Act to respect the patient’s right to self-determination and achieve the goal of a dignified end-of-life.
IMPACT OF BODY POSITION AND ARM USE ON EYE DROP INSTILLATION IN OLDER ADULTS
Authors: Trenary Tanner , Droste Andrew , Cook Rachel Logue , Cain Stephen , Sample Alanson , Burke David , Newman-Casey Paula Anne , Brown Susan 
Published: December 2023

Abstract
Visual impairments in older adults are associated with declines in physical, cognitive and social functioning, often leading to a loss of independence and quality of life. Increased age is a major risk factor, with conditions such as glaucoma having a 7-fold increase in prevalence from the 50s to the 80s (Klein & Klein, 2013). Treatment in the form of eye drops is commonly prescribed yet suboptimal adherence can significantly impact outcomes (Newman-Casey et al., 2015). The purpose of this preliminary study was to determine the effects of body posture and hand use on eye drop instillation success in a sample of 20 healthy, non-eye drop users (mean age: 70.0 +/- 3.7 y). Participants administered eyes drops without instruction while seated, standing and in a supine position. Video analysis was used to determine the number of attempts before successful instillation occurred (failed attempts) as well as whether participants used one or two hands. Despite published recommendations to use both hands (Davis et al, 2018), only 65% adopted a bimanual approach. The percentage of failed attempts was lowest in the supine (11.6%) compared to the seated (25.7%) or standing (21.2%) positions. Pinch strength was not correlated with successful instillation as has been previously reported (Naito et al., 2021), possibly due to participants’ overall level of physical functioning. Based on these results, a supine position is recommended for eye drop instillation where the head and neck are stabilized.
ADVERSE EVENTS IN OLDER ADULTS AT RISK FOR DEMENTIA DURING VIRTUAL EXERCISE AND COGNITIVE TRAINING
Authors: Faig Karla , Gallibois Molly , Bohnsack Alanna , McGibbon Chris , Sexton Andrew , Haché Josée , Knill Samantha , Jarrett Pamela 
Published: December 2023

Abstract
Synchronizing Exercises, Remedies in Gait and Cognition at Home (SYNERGIC@Home/SYNERGIE~Chez soi) is a home-based, double-blind, randomized controlled trial (NCT04997681) targeting community-dwelling older adults at risk for dementia. Anglophone and Francophone participants living in an Atlantic Canadian province (New Brunswick) underwent 16 weeks (three sessions/week) of interventions which consisted of virtual cognitive and physical exercise designed to delay or prevent the onset of dementia. This research aims to determine the frequency, severity, and relationship of the adverse events (AEs) that occurred during the intervention phase. All reported AEs were reviewed and managed by members of the research team, including a geriatrician. Participant’s (n=60) mean age was 68.9 years (SD 6.58), and the majority (76.7%) were female. Forty percent were living in rural communities, and 60% were urban. Of these participants, there was a total of 88 AEs reported by 42 individuals; 70% having at least one AE. The most common AE (39.8%) was musculoskeletal in nature. The majority (71.6%) of all AEs were unrelated to the intervention, and 69.3% of all AEs were classified as mild. There was only one serious AE, and it was unrelated to the intervention. The intervention had to be discontinued in two individuals, and modifications were required in 59 cases for participants to continue in the study. When delivered virtually with videoconference supervision, physical and cognitive interventions resulted in no serious related AEs and few related, mostly mild AEs, that were safely managed through modifications to the physical interventions.
COGNITIVE IMPAIRMENT IS ASSOCIATED WITH INFERIOR POSTURAL BALANCE AND REDUCED GAIT SPEED
Authors: Schmidt Laura Katharina , Stuckenschneider Tim , Koschate Jessica , Zieschang Tania 
Published: December 2023

Abstract
Fall-related sequelae including balance as well as gait impairments are more pronounced in older adults with cognitive impairment (CIOA) compared to cognitively healthy older adults (CHOA). Evidence is scarce about differences in postural balance and gait in CHOA and CIOA after a fall, even though these are major risks for recurrent falls. Especially, there is a dearth of data based on validated sensor technologies. Thus, it is our aim to use sensor-based data to investigate differences between these two groups. Postural balance and gait were measured using three wirelessly synchronized IMU’s (APDM, Inc., Portland, USA) in n=50 CHOA, mean age 73.82±8.25 years and n= 56 CIOA, mean age 78.27±8.0 years. Data were collected at participants’ homes as part of a comprehensive geriatric assessment in the “SeFallED” study within four weeks after presentation to the emergency department (ED) after a sentinel fall (German Clinical Trials Register ID: 00025949). Differences in postural balance and gait between two groups were analyzed by using a Mann-Whitney-U-Test. Statistical analysis revealed a significantly poorer postural balance in CIOA compared to CHOA for the parameters Jerk (m2/s5; p=0.039) and mean velocity (m/s; p=0.036). Further, CIOA had a significantly lower gait speed (m/s; p=0.035) and stride length (m/s; p=0.028) compared to CHOA. Even though both groups had shortly experienced a fall with presentation to the ED, impairments in gait and balance parameters were more prominent in CIOA. Based on these results, physical exercise interventions should focus on the improvement of impaired gait speed and balance particularly in CIOA.
IMPLEMENTATION OF BRAINCHECK FOR COGNITIVE ASSESSMENT AND CARE PLANNING IN THE CLINICAL SETTING
Authors: Huang Bin , Zavala Patrick , Mann Christine , Harlock Sarah , Dekle Kori , Knighton Amy , Ajtai Bela , Hemphill John 
Published: December 2023

Abstract
With the growth of the older adult population (age ≥ 65 years), age-associated neurocognitive disorders, such as Alzheimer’s disease and related dementias (ADRD), are becoming more common in America and worldwide. The increasing number of patients has surpassed the capacity of healthcare systems. Thus, there is a need for time-efficient, cost-effective solutions for better allocation of limited clinical resources that can benefit clinicians and patients. Here, we conducted a quality improvement study in collaboration with Savannah Neurology Specialists and Dent Neurologic Institute. We evaluated users’ perspectives on the usability and feasibility of implementing BrainCheck, a computerized tool for cognitive assessment and care planning. One neurologist and their team from each institute received 45 minutes of training on BrainCheck and used it on an iPad from mid-November to the end of December 2022. In total, 49 patients have completed BrainCheck Cognitive Assessment, and 7 of them also completed BrainCheck Cognitive Care Planning during the study period. On average, it took 13-18 minutes to administer BrainCheck Cognitive Assessment, interpret the result, and document it in EHR. The majority of patients (96%) reported satisfaction with the testing experience and found the instructions easy to understand. Both providers reported high usability of BrainCheck (6.2/7.0) as measured by the Post-Study System Usability Questionnaire. These results demonstrate the great potential of BrainCheck for clinical use, as it can support providers in assessing the cognitive function of their patients in a timely and efficient manner.
RISK FACTORS OF OSTEOARTHRITIS AMONG OLDER ADULTS WITH COGNITIVE DECLINE IN SOUTH KOREA
Authors: Kim Jennifer (Jeehyun) , Kang Bada 
Published: December 2023

Abstract
Individuals with cognitive decline are vulnerable to developing osteoarthritis owing to reduced physical activity and impaired communicational ability. While the cross-sectional relationship between cognitive decline and chronic diseases has been previously studied, longitudinal studies are needed to identify determinants associated with the onset of osteoarthritis among older adults with cognitive decline. This study was aimed at elucidating the risk factors of osteoarthritis based on cognitive status. 1,142 older adults, including 334 cognitive decline and 808 normal cognition individuals, were selected from the Korean Longitudinal Study of Aging. Kaplan-Meier curves were plotted to estimate the probability of osteoarthritis based on the participants’ sex and cognitive status. Cox proportional hazard regression analysis was performed to determine factors associated with the risk of osteoarthritis after the participants were stratified by cognitive status. Female sex and advanced age were associated with a greater risk of osteoarthritis in both the participants with and without cognitive decline. Furthermore, the risk of osteoarthritis was significant among older adults with cognitive decline if they lived alone, were depressed, had social engagement fewer than once per week, or had a high dependency on others for completing activities of daily living. However, there was an increased risk of osteoarthritis among older adults with normal cognition who had a high body mass index and a chronic medical condition. Therefore, comprehensive coping strategies focusing on the socio-environmental characteristics and clinical symptoms of older adults with cognitive decline should be considered to prevent a further increase in the healthcare burden associated with osteoarthritis.
CARDIOVASCULAR DISEASE AND FRAILTY IN OLDER ADULTS FROM COLOMBIA
Authors: Sosa-Sarmiento Paola , Ocampo-Chaparro Jose , Reyes-Ortiz Carlos 
Published: December 2023

Abstract
Cardiovascular disease (CV) is a leading cause of death worldwide. Frailty is a growing geriatric syndrome. Limited research has explored the relationship between cardiovascular disease and frailty. This study assesses the association between a cardiovascular disease history and older adults’ frailty. We used data from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study, a cross-sectional nationwide population-based survey (2015) including community-dwelling adults ≥60 years. A secondary dataset of 5,242 participant responses was analyzed. Frailty was assessed according to the Fried Frailty Phenotype (weakness, low speed, low physical activity, exhaustion, and weight loss) and categorized as frail (3 or more components) vs. not frail or pre-frail. We performed logistic regression analysis to assess the association between a history of cardiovascular disease (hypertension, stroke, heart disease) and frailty, adjusting for socio-demographics, other comorbidities, and functional status. The prevalence of cardiovascular disease was 59.4%, and frailty was 20.0%. Compared to those who do not have CV disease, those having 1 CV disease (OR=1.23, 95% CI 1.04-1.46) or ≥2 CV diseases (OR=1.55, 95% CI 1.24-1.94) were associated with higher odds for frailty. A higher number of CV diseases were independently associated with frailty among older Colombian adults. In future studies, preventing CV disease might help to decrease frailty in older adults.
CHANGE IN USE OF REMOTE HEALTH TECHNOLOGIES AMONG OLDER AFRICAN AMERICAN MEN DURING THE COVID-19 PANDEMIC
Authors: Sherman Ledric , Alexander-Bady Janae 
Published: December 2023

Abstract
It is well known that minority communities are disproportionately affected by disparities present within the US health care system. With the onset of COVID-19, these gaps in health quality continue to be exacerbated. Understanding health technology use differences pre-COVID and post-COVID among African American men is a necessary first step towards improving health outcomes that may be targeted via health technology interventions. The purpose of this study was to explicate and contextualize post-COVID health technology use among African American men in the United States for self-management of health. Of the 54 participants, all between the ages of 65-85, who completed a 30-item technology use questionnaire, a majority reported having type 1 diabetes and high blood pressure and that their current health was good or very good. For technology devices used pre-COVID, the highest reported devices owned were smartphones, desktop computer, laptop, and fitness tracker. Post-COVID, participants purchased fitness tracker CGM, glucose meter, and scale to check weight. As researchers and providers work towards addressing the prevalent health disparities disproportionately affecting members of our communities, these results provide an informative description of pre- and post-COVID.
HEALTH PRIORITIES ALIGNED DECISION MAKING FOR DISCRETE DECISIONS
Authors: Banks Jack , Soni Suha , Madrid Vanessa , Samper-Ternent Rafael , Arain Salman , Tinetti Mary , Naik Aanand 
Published: December 2023

Abstract
The outcomes that establish the evidence-base and frame expectations for discrete interventions, primarily survival and disease-specific markers, may not be the outcomes older adults with multiple chronic conditions (MCCs) prioritize. An advisor group consisting of 6 health professionals with expertise in geriatrics, cardiology, vascular surgery and decision-making plus a panel of patient stakeholders created a decision-making framework titled ‘health priorities identification – discrete intervention decision’ (HPI-DID) process. This study aimed to refine the HPI-DID process using revascularization for peripheral arterial disease (PAD) as an exemplar procedure through eliciting feedback on the HPI-DID process from patients and caregivers. Seven older adults who recently underwent a revascularization procedure for PAD or their caregivers took part in one-to-one interviews with JB and SS. During interviews, participants were asked to verbalize or ‘think-aloud’ their thoughts while reviewing and performing each component of the health priorities process and probed what could be added or cut to improve the procedure-related communication and decision-making process. Participant feedback resulted in structural changes to the process. Font size was increased and specific words were bolded. Three additional tables detailing expected benefits, tradeoffs and complications from the procedure and their expected durations were added. The mean percentage of patients who experience these outcomes is now also listed. We will conduct a pilot trial to evaluate the feasibility and acceptability of our refined HPI-DID process with clinical interventionalists and older patients with MCCs considering revascularization for PAD.