bluuebunny/crossref_metadata_2025_split huggingface dataset:
SLEEP MEDICATION USE AND FALLS IN OLDER ADULTS WITH OSTEOPOROSIS
Authors: Anderson Loretta , Ek Stina , Orwig Denise , Wennberg Alexandra 
Published: December 2023

Abstract
One third of older adults take sleep medications, but they are associated with fall risk. One in four older adults experiences a fall each year, costing the U.S. $50 billion dollars annually. Osteoporosis is linked to falls, but little research has examined sleep medication use and falls risk among older adults with osteoporosis. We examined the 2011 National Health and Aging Trends Study (NHATS). Outcomes were falls in the last month, falls in the last year, multiple falls in the last year, and fear of falling. Self-reported sleep medication use dichotomized for analysis (0= once/week or less; 1= 2 or more times/week) was the exposure of interest. Osteoporosis was self-reported (yes/no). Of 8,245 participants, 58% female, 68% white, and 20.5% had osteoporosis. Multivariable logistic regression showed, sleep medication users, compared to rare- or non-users, had higher odds of a fall in the last month (O.R. = 1.64, 95% CI: 1.10, 2.47), in the last 12 months (O.R. = 1.60, 95% CI: 1.20, 2.12), multiple falls in the last 12 months (O.R. = 1.64, 95% CI: 1.08, 2.50), and fear of falling (O.R. = 1.58, 95% CI: 1.18, 2.11). Osteoporotic sleep medication users show increased risk of falls, multiple falls per year, and fear of falling. As older adults with osteoporosis are at increased risk, reducing sleep medication use may decrease this risk, thus decreasing the need for costly medical care. This study contributes to clinicians’ efforts to reduce falls in vulnerable older adults and may reduce overall burden to Medicare.
THE STUDY OF MUSCLE, MOBILITY AND AGING (SOMMA): MITOCHONDRIAL ENERGETICS OF SKELETAL MUSCLE
Authors: Coen Paul , Hepple Russell , Goodpaster Bret 
Published: December 2023

Abstract
Aging leads to a decline in mitochondrial energetics of skeletal muscle. We hypothesize that worse mitochondrial energetics is associated with greater comorbidity burden and worse fatiguability. Furthermore, sex differences in mitochondrial decline with aging are poorly understood. Prior human muscle biopsy studies have tended to be small and did not account for confounding factors including physical activity and adiposity levels. The Study of Muscle, Mobility, and Aging (SOMMA) is an observational longitudinal cohort study of 879 older adults designed to discover the biological basis of mobility disability and to collect tissues and measurements for future studies of the biology of human aging. The multidisciplinary SOMMA team includes two clinical centers (University of Pittsburgh and Wake Forest University), a biorepository (Translational Research Institute at AdventHealth), and the San Francisco Coordinating Center (California Pacific Medical Center Research Institute). At baseline, SOMMA collected biospecimens (muscle and adipose tissue, blood, urine, fecal samples); a variety of questionnaires; physical and cognitive assessments; whole-body imaging (magnetic resonance and computed tomography); accelerometry; and cardiopulmonary exercise testing. Primary outcomes include change in walking speed and change in fitness (VO2 peak). In this symposium, we will present new findings from SOMMA baseline data that link skeletal muscle mitochondrial energetics to age-associated comorbidities, including diabetes, and performance fatiguability. We also highlight the critical role that sex differences in mitochondrial energetics plays in mobility limitation. SOMMA is supported by the National Institutes of Aging (R01AG059416).
CARDIORESPIRATORY FITNESS AND MITOCHONDRIAL ENERGETICS IN THE OLDEST OLD: THE STUDY OF MUSCLE, MOBILITY AND AGING
Authors: Distefano Giovanna , Noone John , Ramos Sofhia , Kramer Philip , Cawthon Peggy , Newman Anne , Marcinek David , Goodpaster Bret 
Published: December 2023

Abstract
Cardiorespiratory fitness (CRF) and mitochondrial energetics are known to decrease with aging, albeit with a great degree of heterogeneity. Studies reporting these declines typically include individuals younger than 85 years of age. We investigated CRF and mitochondrial energetics in a cohort of old (O: 70-84yrs.; n=698) and oldest old (OO: 85+yrs.; n=70) adults enrolled in SOMMA. Cardiorespiratory fitness (VO2peak) was measured by modified Balke treadmill protocol, and mitochondrial energetics was assessed by 31P Magnetic Resonance Spectroscopy (ATPmax) and high-resolution respirometry of myofibers (oxidative phosphorylation, OXPHOS). Bivariate associations and group differences were assessed using unadjusted and adjusted regression models with clinical site/technician, gender, race, body mass index and physical activity (steps per day) as covariates. Old and oldest old groups showed an association between VO2peak and OXPHOS (R2=0.282, p&lt;0.001; R2=0279, p=0.0083; respectively, adjusted for site/technician), but only the old group showed associations between VO2peak and ATPmax (R2=0.201, p&lt;0.001; R2=0.017, p=0.609; respectively, adjusted for site/technician). Group comparison adjusted for clinical site, gender, and race, showed lower VO2peak (p &lt; 0.001), OXPHOS (p=0.026), and ATPmax (p=0.0014) in the OO compared to O group. However, no group differences in OXPHOS (p=0.08) and ATPmax (p=0.09) are observed when adjusting for body composition and physical activity, factors known to affect mitochondria. In conclusion, CRF associates with different measures of mitochondrial energetics in older adults, but only with mitochondrial respiration in oldest old. Additionally, we suggest that decreases in mitochondrial energetics observed in the oldest old are related to age, changes in body composition and physical activity.
ASSOCIATION OF DIABETES WITH BODY COMPOSITION, CARDIORESPIRATORY FITNESS, AND MITOCHONDRIAL ENERGETICS
Authors: Ramos Sofhia , Distefano Giovanna , Kramer Philip , Cawthon Peggy , Toledo Frederico , Cummings Steven , Goodpaster Bret , Coen Paul 
Published: December 2023

Abstract
We investigated the association of diabetes with cardiorespiratory fitness and skeletal muscle mitochondrial energetics in older adults (N=876, mean age ± SD: 76.3 ± 5.0 yrs.; 59% females) from the Study of Muscle, Mobility and Aging (SOMMA). Participants were grouped by self-reported diabetes status (N=131, with diabetes). Cardiorespiratory fitness (modified Balke protocol), mitochondrial energetics (31P magnetic resonance spectroscopy [31P-MRS] and high resolution respirometry from skeletal muscle biopsy), physical activity (wearable accelerometer) and body composition (magnetic resonance imaging) were measured. Generalized linear regression models were used to calculate means adjusted by age, race, gender, BMI, and co-morbidities. Thigh fat-free muscle volume (p=0.12) and abdominal subcutaneous adipose tissue depot (p=0.15) were similar between those with and without diabetes. However, visceral (18.84%, p&gt;0.01) and intramuscular adipose tissue (6.57%, p=0.02) were higher in older adults with diabetes. VO2peak (-4.79%, p&gt;0.01), and mitochondria energetics measured by ATPmax (-5.10%, p=0.04), maximum complex I+II carbohydrate (maxOXPHOSCHO) (-6.67%, p=0.02) and fatty acid (maxOXPHOSFAO) (-8.70%, p=0.01) stimulated respiration were lower in those with diabetes compared to those without. Following further adjustments for both physical activity and visceral adiposity, revealed that only VO2peak (-4.65%, p&gt;0.01) and maxOXPHOSFAO (-7.38%, p=0.02) remained significantly lower in older adults with diabetes. Overall, our data suggests that cardiorespiratory fitness and skeletal muscle mitochondria energetics are reduced in older adults with diabetes, independent of visceral adiposity and physical activity.
AGE MATTERS IN FINANCIAL STRAIN AND SUBJECTIVE HEALTH AND WELL-BEING FOR PEOPLE WITH LTSS NEEDS IN CALIFORNIA
Authors: Chen Lei 
Published: December 2023

Abstract
Long-Term Services and Supports (LTSS) are a big concern for older adults and people with disabilities. It is important to reset aging and disability silos and create coordinated LTSS networks for people with disabilities of all ages, including those with cognitive impairments, difficulties performing activities of daily living (ADLs) and/or instrumental activities of daily living (IADLs). This study examined how age differentiates the associations among disability status, financial strain, and subjective health and well-being for people with LTSS needs in California. This study used the first cycle of data (2019-2020) from the California Long-Term Services and Supports (CA-LTSS) survey, merged with select data from the California Health Interview Survey (CHIS) (N = 2,030). Multivariate Regressions and Conditional Process Analysis (CPA) were applied to test the hypothesized relationships. Findings show that young and middle-aged participants with LTSS needs struggled to make financial ends meet. Middle-aged and older participants with LTSS needs reported worse self-rated health, and young participants with LTSS needs had severer psychological distress. Participants with difficulty in IADLs or more types of disability difficulties tended to have more financial strain, and these associations were significantly stronger for young participants than older participants. Similarly, participants with difficulty in IADLs or more types of disability difficulties tended to report severer psychological distress, and these associations were significantly stronger for young participants than older participants. The findings suggest the value of approaching younger people with disabilities and target policies and service programs to meet their financial and mental health needs.
DESIGNING FOR PROGRAM SUSTAINABILITY: AN EVALUATION OF BC’S PROVINCIAL BETTER AT HOME PROGRAM
Authors: Hannah Camille , Symes Bobbi , Lalji Kahir 
Published: December 2023

Abstract
Better at Home programs help older adults in communities across British Columbia with non-medical tasks such as light housekeeping, yard work, transportation to appointments, grocery and meal delivery, and friendly visiting, helping them to remain at home and stay connected to their communities. Better at Home is funded by the Province of British Columbia and managed by the United Way. An evaluation of 81 Better at Home programs took place over 2022/23 focusing on the delivery, design, and sustainability of programs. A multipronged evaluation approach was utilized, including site visits; document and administrative data review; interviews with program staff, older adults, and caregivers (n=87); and a survey of program stakeholders (n=399). Over 2021/22, a total of 244,875 services were provided through Better at Home. The most common services provided were light housekeeping, friendly visiting, prepared meal delivery, and grocery services. The evaluation identified design and delivery best practices (e.g., building trust and relationships), program opportunities (e.g., leveraging communities of practice), and lessons learned (e.g., increasing awareness of burnout, capacity, and duplication). Some challenges to program efficiency were also identified (e.g., increased demand for services and complexity of client needs, staff and volunteer turnover). Six program improvements were recommended to ensure the long-term sustainability of Better at Home programs: 1) Securing multi-year funding that accounts for inflation, 2) Ensuring sufficient human resources for service delivery, 3) Offering strategic training opportunities, 4) Continuing to invest in existing programs, 5) Growing partnerships and community networks, and 6) Providing comprehensive supports to program staff.
AN INTEGRATED TRANSITIONAL CARE INTERVENTION IMPROVES PATIENT-REPORTED OUTCOMES IN OLDER ADULTS WITH STROKE
Authors: Markle-Reid Maureen , Fisher Kathryn , Ganann Rebecca , Pollard Chris , Whitmore Carly 
Published: December 2023

Abstract
The transition between hospital and home is associated with significant challenges resulting in hospital readmissions and poor health outcomes. This study aimed to test, in real-world clinical practice, the effectiveness of a Transitional Care Stroke Intervention (TCSI) compared to usual care on patient-reported outcomes and health and social service use costs in older adults (&gt; 55 years) with stroke and multimorbidity (&gt; 2 chronic conditions). The TCSI was delivered virtually by an interprofessional (IP) team, and included care coordination/system navigation support, phone/video visits, monthly IP team conferences, and an online resource co-designed with patient partners to support self-management and system navigation. The primary outcome was risk of hospital readmission after six-months. Secondary outcomes included physical and mental functioning, stroke self-management, patient experience, and health and social service costs. Ninety participants were enrolled (44 intervention, 46 control); 11 (12%) participants were lost to follow-up, leaving 79 (39 intervention, 40 control). Differences favoring the intervention group were seen in physical functioning (SF-12 PCS mean difference: 5.10; 95% CI: 1.58-8.62, p=0.005), self-management (Southampton Stroke Self-Management Questionnaire mean difference: 6.00; 95% CI: 0.51—11.50, p=0.03), and patient experience (Person-Centred Coordinated Care Experiences Questionnaire mean difference: 2.64, 95% CI: 0.81, 4.47, p=0.005). No significant between-group differences were seen for baseline to six-month risk of hospital readmission or total health and social service costs. The TCSI produced greater gains in patient-reported physical health, self-management and experience compared with usual stroke care. These improvements were achieved without increasing total healthcare costs.
ELEVATED PREVALENCE AND RISK OF KIDNEY DISEASE AMONG SEXUAL MINORITY OLDER ADULTS IN THE US
Authors: Cahill Sean , Chandra Meghana , Hertel Mollie , Khanna Saumya , Mitra Shimontini , Mirabella Jack , Cropper Avareena 
Published: December 2023

Abstract
Pooled data from the Behavioral Risk Factor Surveillance System (2014–2019) were used for 22,114 lesbian, gay, bisexual adults and adults who said that their sexual orientation was “other” or “something else” aged 50 and over, and 748,963 heterosexual older adults. Logistic regressions were used to compare prevalence of self-reported kidney disease among older adults by sexual orientation. After adjusting for age, race and ethnicity, and BMI, GB+ men had increased odds of self-reported kidney disease (AOR 1.42; 95% CI, 1.21–1.68). LGB+ women also had higher odds of self-reported kidney disease (AOR 1.29; 95% CI, 1.09–1.52). After controlling for sociodemographic factors, health behaviors, access to healthcare, and self-reported coronary heart disease, HIV, and diabetes, older gay, bisexual and other men (GB+) men (AOR 1.3; 95% CI, 1.09-1.54) were more likely than their heterosexual counterparts to report kidney disease. LGB+ men and women also reported high incidences of known risk factors for CKD. For example, both GB+ men (OR 1.39; [95% CI], 1.26-1.54) and LGB+ women (OR 1.39; [95% CI], 1.25-1.55) were more likely to be smokers and have a higher incidence of activity limitations, adverse health outcomes, and limited access to health care, housing and employment. We did not find any statistically significant differences in kidney disease between transgender and cisgender respondents. There is an increased need for screening for CKD risk factors, for preventative education and culturally responsive and affirming care, and for interventions to address social drivers of marginalization and vulnerability in older LGBT+ adults.
PREVALENCE OF SINGLE AND MULTIPLE CHRONIC CONDITIONS AMONG RESETTLED BHUTANESE OLDER ADULTS IN OHIO
Authors: Karmacharya Isha , Shrestha Aman , Subedi Janardan , Ghimire Saruna 
Published: December 2023

Abstract

Background
Migrants and refugees are more prone to chronic health conditions, which can worsen with age and accumulated stressors. Bhutanese older adults with refugee backgrounds in the US have not been well-studied. This study aimed to assess the prevalence of chronic diseases (single and multiple conditions) and to identify factors associated with multimorbidity among resettled Bhutanese older adults in Ohio. Additionally, the study compared the prevalence of chronic diseases with state-level data for other racial/ethnic groups.

Methods
Structured interview was conducted among 276 resettled Bhutanese, aged 55 years and above, in four major Ohio cities (Columbus, Akron, Cleveland, and Cincinnati), selected through snowball sampling with local Bhutanese organizations. State-level data of people, aged 55 years and above in Ohio, from the 2021 Behavioral Risk Factor Surveillance System for Non-Hispanic White, Non-Hispanic Black, Hispanic, and Asian populations were used for comparison. Binary logistic regression was used to identify factors associated with multimorbidity.

Results
Only 14.1% of participants were free of chronic diseases, while 62.3% had multimorbidity. Depression (31.8%), diabetes (42.8%), and respiratory diseases (26.4%) in older Bhutanese were considerably higher than in other racial/ethnic groups. Hypertension prevalence (63.0%) was higher than all other race/ethnic groups, except Non-Hispanic Black individuals (72.3%). Poor self-reported health and the presence of depressive symptoms had higher odds of having multimorbidity. Study Implications: This study underscores valuable insight into the disease burden among resettled Bhutanese older adults and can inform stakeholders to develop targeted public health programs and practices to meet the needs of minority populations.
SUBJECTIVE COGNITIVE DECLINE PHENOTYPES, SOCIAL ENGAGEMENT, AND CARDIOVASCULAR HEALTH
Authors: Dowling Maritza , Theeke Laurie 
Published: December 2023

Abstract
Epidemiological studies report subjective cognitive decline (SCD) as a risk factor for incident dementia. The co-occurrence of SCD, chronic conditions, and loneliness may contribute to functional limitations and decline. SCD etiologies are multifaceted, suggesting possible underlying phenotypes defined by clustering factors that characterize decline. Using pooled data (2015-2021) from the Behavioral Risk Factor Surveillance System (BRFSS) we investigated SCD phenotypes based on the six-item self-reported Cognitive Decline Module that measured challenges in daily life due to memory loss and confusion over the prior twelve months. We hypothesized that SCD phenotypes would be associated with socio-demographic, cardiovascular health and social engagement variables. Mixture modeling was used to determine unobserved SCD phenotypes (latent classes) based on item response patterns. Latent class membership was predicted from socio-demographic variables using multinomial logistic regression. The resulting classes predicted a six-item cardiovascular risk index (CVRI) and a measure of aloneness. SCD symptoms were reported by 65,217 (45-80+ years old). Mixture models produced four-latent SCD classes labeled as mild (43%), mild-moderate (23%), moderate (24%), and severe (10%). Mean CVRI scores were significant across classes (p &lt; 0.001) and highest in the severe subgroup (n=6,491) which was more likely to be non-Hispanic Blacks, female, younger (45-64), low-income, non-homeowners, and report depression, and poor/fair health status. Class membership also significantly predicted aloneness. Studies are needed to examine how SCD phenotypes may be used in the design and development of interventions that are more precise to the cluster of modifiable risk factors which could, subsequently, prevent or delay dementia pathogenesis.
FACTORS ASSOCIATED WITH HELP-SEEKING AMONG US CHINESE OLDER ADULTS WHO REPORTED ELDER MISTREATMENT
Authors: Chao Ying-Yu , Seo Jin Young , Chang Yu-Ping 
Published: December 2023

Abstract

Purpose
Elder mistreatment (EM) is an important public health issue. Guided by the Andersen’s Behavioral Model of Health Services Use, this study aimed to examine factors that impede or facilitate help-seeking intentions and behaviors among U.S. Chinese older adults who reported EM.

Methods
Data were from the Population Study of Chinese Elderly in Chicago (PINE). Different types of mistreatments, informal and formal help-seeking intentions and behaviors were assessed. Descriptive statistics, linear regression, and multinominal logistic regression were used.

Results
Among 450 participants who reported EM, 46.55% experienced psychological mistreatment, 29.91% had financial exploitation, 14.92% had caregiver neglect, 4.68% had physical mistreatment, 1.11% had sexual mistreatment, and 17.78% had multiple victimizations. Intentions of informal help-seeking was higher among victims who were female and married, and those who experienced financial exploitation and caregiver neglect. Formal help-seeking intentions were lower among victims who had a larger social network size. EM victims who were female, married, perceived more social support, experienced financial exploitation, and experienced caregiver neglect were more likely to seek help from informal resources. EM victims who had higher income, perceived more social support, and had multiple victimizations were more likely to seek formal resources. Conclusion/implication: Our findings suggest that the predisposing factors, enabling resources, and need factors that impacted seeking help from informal and formal resources among older Chinese Americans who reported mistreatment. Findings provided important insights for developing early screening programs and interventions, such as increasing help-seeking channels and improving access to care services.
SELF-PERCEPTION OF AGING AND THE SELF-REPORTED HEALTH/FRAILTY PARADOX
Authors: Buta Brian , Hladek Melissa , Alzahrani Mallak , Xue Qianli 
Published: December 2023

Abstract
We aimed to study the cross-sectional association between self-perception of aging (SPA) and frailty paradox, defined as self-reporting excellent/very good health despite being frail or fair/poor health despite being robust. The study sample included 2,950 participants from the Health and Retirement Study (2008 wave) who were 65 years and older, completed the Psychosocial and Lifestyle Questionnaire, and had no missing data on the variables included in the models. Frailty was measured by the physical frailty phenotype. Self-reported health (SRH) was rated as either excellent, very good, good, fair, or poor. SPA was measured using an 8-item questionnaire spanning subjective well-being, positive affect, and life satisfaction; respondents rated their agreement with statements such as “Things keep getting worse as I get older” and “So far, I am satisfied with the way I am aging.” Negative statements were reverse-coded and the average of all items was calculated; higher scores indicated more positive SPA. 181 (6%) participants met the criteria for the frailty paradox: 54 reported being in excellent/very good health despite being classified as frail, while 127 reported fair/poor health despite being classified as robust. After adjusting for potential confounding variables, including age, sex, race, education, and comorbidity burden, we found that individuals with higher SPA scores had greater odds of excellent/very good SRH despite frailty. Specifically, the odds nearly doubled for every one unit increase in SPA score (p-value&lt; 0.01). Positive self-perception of aging may be a potential interventional buffer against negative impact of physical frailty on self-assessment of overall health status.