bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFICACY OF COMBINED THERAPEUTIC EXERCISE AND PSYCHOLOGICAL INTERVENTIONS ON DISABILITY OUTCOMES: A SCOPING REVIEW
Authors: Rose Grace , Bruni Pietra , Wingood Mariana , Kallmi Selmi , Finer Elizabeth , Bamonti Patricia 
Published: December 2023

Abstract
The goal of therapeutic exercise (i.e., physical activity/exercise programs, physical therapy, rehabilitation), restoring and maintaining function in older adults (≥60 years), is hindered by personal factors (e.g., low self-efficacy) impacting exercise engagement. Combining therapeutic exercise with psychological interventions is a promising solution for maximizing treatment benefits. The purpose of this scoping review is to systematically synthesize the knowledge of randomized controlled trials (RCTs) testing combined therapeutic exercise and psychological interventions targeting disability outcomes in older adults. A comprehensive review of the literature, searching four databases, was performed following PRISMA-ScR guidelines. Articles (n=4,995) underwent iterative screening, resulting in 31 RCTs. The World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) model was utilized as a conceptual framework. Studies assessed at least one major domain of the ICF model: Body Function and Structure was an outcome in 67.74% of RCTs and both Activity and Participation were an outcome in 77.42% of RCTs. Personal factors were assessed in 64.52% of RCTs. Psychological interventions utilized were cognitive-behavioral (32.26%), motivational interviewing (29.03%), meditation (12.90%), or other (32.26%). Combined interventions compared to either therapeutic exercise alone (25.81%) or control (74.19%) demonstrated greater efficacy on at least one major ICF outcome in 77.42% of RCTs. This review indicates that incorporating psychological interventions within therapeutic exercise can maximize treatment benefits in older adults across diagnoses and setting. Future research is needed to better understand which psychological interventions demonstrate greatest efficacy when paired with therapeutic exercise within certain patient subgroups, in order to guide best practice guidelines.
GAIT ANALYSIS OF ELDERLY PEOPLE IN ANGOLA: COMPARISON BETWEEN ESTABLISHED ROUTE AND VIRTUAL REALITY AND TIME UP AND GO
Authors: Barbara Rita , Luanda Natália 
Published: December 2023

Abstract

Background
Aging limits physical and mental abilities, particularly gait, compromising quality of life and increasing the risk of falls, which is a public health challenge in Angola. Technologies, such as virtual reality, may offer a promising alternative for treatment and prevention of these limitations. Objective: This study aimed to analyze the gait of elderly individuals in Angola by comparing gait on an established course and in a virtual environment, using motion analysis software and SPSS for statistical analysis with a p&gt;0.05.

Methods
Seven elderly individuals, aged 60-80, participated in the study. Gait was evaluated using the Timed Up and Go (TUG) test, an established course, and gait in a virtual environment.

Results
Statistically significant differences were found between gait on the established course and in virtual reality, with elderly individuals showing slower and more variable gait in the virtual environment. There were also significant correlations between gait and TUG, highlighting the importance of motor coordination and balance in elderly gait.

Conclusion
Gait analysis in elderly individuals can be performed precisely and stably through virtual reality technology. The results of this study suggest that virtual reality may be an interesting alternative for the treatment and prevention of falls in the elderly. The findings also emphasize the importance of motor coordination and balance in gait and the need for further research on the use of virtual reality technology in this population.
MEASURING ANKLE FLEXIBILITY IN OLDER HOME CARE RECIPIENTS WITH DISABILITIES IN THEIR HOME SETTING
Authors: Skowronski Jordan 
Published: December 2023

Abstract
Ankle flexibility is critical for daily activities, such as climbing stairs. Ankle range of motion (AROM), or the range through which the ankle joint can bend up and down, decreases with age. Thus, interventions to improve or maintain AROM is an important goal in geriatric rehabilitation. Evaluating the outcome of such interventions requires AROM measures. However, existing measures either require large equipment or for the participant to stand and lunge, and so are not appropriate nor practical for home-bound older adults. This paper aims to (1) describe how we developed an AROM measure for frail, older adults as part of the Promoting Seniors’ Health with Home Care Aides (Pro-Home) Study, and (2) examine the convergent and discriminant validity of the AROM measure. Data came from the baseline assessment of older home care participants’ physical function (N=115). AROM was moderately correlated with lower extremity function as measured by the Short Physical Performance Battery, r(113) = 0.30, p&lt; 0.01 and the gait speed component scores, r(113) = 0.33, p&lt; 0.01, and AROM was not correlated with self-reported upper extremity function. Results from the robust regression analyses are that 1 standard error unit greater averaged AROM is associated with 0.06 points higher SPPB score (p&lt; 0.00) and 0.06 greater Gait Speed Score (p&lt; 0.00), after adjusting for age, gender, and ambulatory device use. The significant associations between AROM and SPPB and AROM and gait speed indicate that the AROM measure has convergent validity, while the nonsignificant associations among AROM and upper extremity function show its discriminant validity.
FROM MISFIT TO FIT: THE IMPACT OF NURSING PRACTICE ON COMPLEX NURSING INTERVENTION DEVELOPMENT
Authors: ten Cate Debbie , Schuurmans Marieke , Schoonhoven Lisette , Ettema Roelof 
Published: December 2023

Abstract
Nurses have a key role in providing nutritional care to older adults to prevent and treat malnutrition, and stimulate health and well-being. However, evidence for nursing activities regarding nutritional care is often lacking. Therefore, intervention development is necessary. From earlier studies, an evidence-based nutritional intervention carried out by nurses appeared the best solution. The aim of this study was to outline the steps taken to develop a complex nursing intervention to prevent and treat malnutrition in older adults and the challenges faced during this stage. Following the phase of intervention development of the Medical Research Council (MRC) Framework, a systematic review, a questionnaire survey, semi-structured interviews, focus groups and participant observation were carried out. The purpose was to gather information about current nursing practice and context, the needs of future users and providers, and gain insight into the problem. The studies showed that nurses had moderate knowledge of (mal)nutrition. They gave nutritional care low prioritization during daily nursing activities. These results provided insight that the intended nursing nutritional intervention would most likely lead to a misfit with the context. To fit the intervention properly into nursing practice, it was decided to develop an educational intervention targeting nurses instead of a nutritional intervention carried out by nurses. Building proofs in context leads to challenges but is essential to prevent a misfit between complex nursing interventions and nursing practice. As an element of rigorous intervention development following systematic steps, it increases the chance of successful implementation.
EDUCATION AS A MEDIATOR OF GENDER DIFFERENCES IN COGNITION IN OLDER ADULTS
Authors: Rijnhart Judith , Valente Matthew , Kok Almar , Huisman Martijn 
Published: December 2023

Abstract
Although dementia is more prevalent in women than in men, studies on the socio-cultural mechanisms that cause and sustain gender differences in dementia remain scarce. Historic gender differences in education may explain why older women are at higher risk of dementia nowadays. This study aimed to investigate education as a mediator of gender differences in cognitive function, as measured with the Mini-Mental State Examination (MMSE). We used data from the Longitudinal Aging Study Amsterdam. The analytical sample consisted of 2,909 older adults aged 55-85, of whom 1,601 were women and 1,506 were men. We used causal mediation analysis to estimate total, indirect, and direct effects of gender on MMSE. Effect estimates were adjusted for confounding by age, parental education, and childhood adversity. The total effect was -0.60 (95% CI: -0.90; -0.32), indicating that women on average had a 0.60 lower MMSE score than men. The indirect effect was -0.84 (95% CI: -1.11; -0.59), indicating that women on average had a 0.84 lower MMSE score compared to men, because women completed fewer years of education. The direct effect was 0.24 (95% CI: 0.04; 0.44), indicating that if women had the same number of education years as men, their MMSE score would on average be 0.24 points higher than the average MMSE score in men. These findings indicate that education is an important mediator of gender differences in cognitive function. Future studies are needed to explore whether gender differences in cognitive function decrease as gender equality in education increases.
HOW THE PATIENT-CENTERED MEDICAL HOME MODEL IMPACTS OLDER ADULTS’ ACCESS TO HEALTH CARE IN RURAL GEORGIA
Authors: Childs Elisa 
Published: December 2023

Abstract
Rural Americans face several healthcare access barriers, including limited providers and driving further distances to receive care. Georgia healthcare access is especially problematic given its high rurality, hospital closure rate, number of medically underserved areas, and older adult population. The government promotes the Patient-Centered Medical Home (PCMH) model to improve healthcare access. This study supports a better understanding of older Georgian’s access to care by exploring PCMH’s ability to improve healthcare access. Older adults were surveyed using a modified version of the Healthcare Quality Survey (N=746). Analyses included univariate, bivariate (t-test, ANOVA, chi-square, and a crosstabulation), and multivariate (multiple linear regression). Healthcare access was statistically significantly different depending on care source type, with significant associations between PCMH users and income, age, urban/rural status, and health status. Access was also statistically significantly different based on annual household income, educational attainment, age, and health status. Further, a significant relationship was found between access and age, income, and health status. PCMH users were primarily Caucasian and most often had an advanced degree and income of $60,000 or more. PCMH users most often reported living in Three Rivers, Atlanta Region, Northeast Georgia, and the Georgia Mountains. Finally, urban and rural residents with a regular care source reported “always” receiving needed care more often than PCMH users and those with no care source. The National Committee for Quality Assurance and other accreditation agencies should target low-income rural areas with high older adult populations when implementing the PCMH model to increase older adults’ healthcare access.
MALE BREAST CANCER IN OLDER ADULTS BELONGING TO THE LOWER-INCOME GROUP
Authors: Chakravarty Esha 
Published: December 2023

Abstract
Male breast cancer is a rare type of cancer constituting around 1% of male malignancies. Cases of 21 elderly (aged&gt;60) patients diagnosed with breast cancer were studied with respect to age of onset, treatment choices, access to care, ability to perform activities of daily living (ADL) from CMIG, resource centre on ageing in east India. All 21 patients belonged to lower income group in society and the study was conducted over a 5 year period of 2018-2022. Primary symptom leading to diagnosis was self-detection of lump and the median time of diagnosis from onset of symptoms was 6 months. Twenty of the 21 patients were diagnosed with Stage III or Stage IV breast cancer and 1 patient was diagnosed with Stage I cancer. The average age of diagnosis of the patients was found to be 69 years. The main method of treatment was surgery for patient diagnosed in Stage I and surgery followed by chemotherapy and radiation therapy for the rest. None of the patients underwent hormone therapy and information regarding presence of hormone receptors was not available in all cases. Five of the 21 cases reported metastasis- 4 in bone and 1 in lung. Spouse or adult children were found to be caregivers with no access to trained caregivers or counsellors. All patients showed moderate decline in motor function and ADL after surgery alongwith susceptibility to fall or injury. Free hand exercises showed slight improvement. Further studies can attract state funding and influence heath policies for lower income groups.
RELATIONSHIP BETWEEN INFORMAL AND FORMAL HELP-SEEKING BEHAVIORS FOR ELDER MISTREATMENT AMONG CHINESE IMMIGRANTS
Authors: Chao Ying-Yu , Seo Jin Young , Chang Yu-Ping 
Published: December 2023

Abstract

Purpose
Help-seeking minimizes the consequences from elder mistreatment (EM). However, formal help-seeking could be challenging for older immigrants due to cultural and linguistic barriers. Informal supporters have been shown to promote formal help-seeking among EM victims. This study aimed to examine whether informal help facilitates U.S. Chinese EM victims with seeking help from formal sources.

Methods
Data were derived from the Population Study of Chinese Elderly in Chicago. EM measurements included psychological, physical, sexual mistreatment, financial exploitation, and caregiver neglect. Seeking help from informal and formal sources were evaluated. Descriptive statistics and multinominal logistic regression were conducted.

Results
Among 450 EM victims, 53.48% of them sought informal help, 31.75% did not seek any help, 11.42% sought both informal and formal help, and 3.34% sought formal help. The most common informal sources were adult children, partners, and friends/neighbors. The most common formal sources were community social services organizations, followed by legal criminal justice systems. Compared to those who did not seek any help, victims who reported more emotional closeness within their social network and experienced financial exploitation were more likely to seek help from formal sources. However, informal help-seeking was not significantly associated with formal help-seeking. Conclusion/implication: The findings suggest that most U.S. Chinese older adults who experienced EM did not seek formal help. Higher levels of contact with social networks could increase seeking help from formal sources. However, future research is needed to explore why informal supporters did not facilitate seeking help from formal sources in Chinese EM victims.
DNA METHYLATION-BASED BIOLOGICAL AGING, PLASMA PROTEINS, AND INCIDENT FRAILTY AND PHYSICAL DISABILITY
Authors: Phyo Aung Zaw Zaw , Espinoza Sara , Murray Anne , Fransquet Peter , Wrigglesworth Jo , Woods Robyn , Ryan Joanne 
Published: December 2023

Abstract
Decline in physical function occurs with advanced age, and biological aging may be a useful marker of decline in physical function, beyond chronological age. This study investigated the associations between DNA methylation-based biological aging (DNAm-based age acceleration (AA)) and plasma proteins and the risk of frailty (based on Fried phenotype and a frailty deficit accumulation index (FI)), and persistent physical disability (defined as loss of ability to perform one or more Katz ADL), among community-dwelling people aged ≥70 years enrolled in the ASPREE study. Five AA indices (Horvath, Hannum, Pheno, Grim, and DunedinPACE) and seven plasma proteins (including plasminogen activation inhibitor-1 (PAI-1), growth differentiation factor-15 (GDF-15), and leptin) were measured in blood from 560 participants (50.7% women). Incident health events were captured over a mean of 5.2 years. Cox proportional-hazard regression adjusted for gender, education, and cell counts. One-standard deviation (SD) increase in AA was associated with an increased risk of frailty (FI) (GrimAA: HR=1.48 (95% CI, 1.19 – 1.84), and DunedinPACE: HR=1.39 (95% CI, 1.11 – 1.73)) and physical disability (GrimAA: HR=1.78 (95% CI, 1.15 – 2.77)). One-SD increase in plasma proteins except for leptin was associated with a higher risk of frailty (both Fried phenotype and FI) (range HR: 1.26 to 2.14). In conclusion, accelerated Grim age and DunedinPACE appear as markers of physical impairments, even in initially healthy individuals. Variations in plasma protein levels might be helpful for the identification of pathophysiological pathways associated with the increased risk of physical impairment in later life.
GENES FROM PEROXISOME AND INTEGRATED STRESS RESPONSE IN REGULATION OF HUMAN LONGEVITY
Authors: Yashin Anatoliy , Wu Deqing , Arbeev Konstantin , Duan Hongzhe , Akushevich Igor , Yashkin Arseniy , Holmes Rachel , Ukraintseva Svetlana 
Published: December 2023

Abstract
Dietary/caloric restriction shares pathways with peroxisome, a cellular organelle that regulates the synthesis and turnover of complex lipids. PEX3, a peroxisomal biogenesis factor involved in selective type of autophagy. EIF2AK4, a sensor of amino acid deprivation in the integrated stress response (ISR) involved in lifespan regulation. We hypothesize that interplay between EIF2AK4 and PEX3 is associated with human survival. We applied logistic regression model with the interaction term to the analysis of Health and Retirement Study (HRS) and UK Biobank (UKB) parents data to test whether interactions of SNPs from the EIF2AK4 and SNPs from the PEX3 are associated with the dichotomous survival trait (ST) with case group defined as: lifespan ≥ 85; and control as: 75 ≤ (lifespan or age at last follow-up) &lt; 85. Analyses of HRS data showed that interactions between SNPs rs4924405, rs2250402, rs8031319, rs16970049, rs3816899, rs16970112, rs2412459 from the EIF2AK4 gene and SNP rs161070 from the PEX3 gene are significantly associated with ST. In the UKB data, interactions of rs161070 from the PEX3 gene and rs7176881 and rs117778159 SNPs from the EIF2AK4 gene showed nominally significant associations with ST. Analyses of linkage disequilibrium (LD) between the EIF2AK4 SNPs detected in HRS and UKB data showed that their LD are close to the highest values for SNPs with allele frequencies specific for detected variants. Our results confirm association of interplay between EIF2AK4 and PEX3 with human longevity. They also show how information from experimental studies could be transformed to the form useful for human applications.
TRANSCRIPTOMIC SIGNATURES FOR AGING AND EXTREME OLD AGE IDENTIFIED IN LONG LIFE FAMILY STUDY
Authors: Li Mengze , Song Zeyuan , Karagiannis Tanya , Monti Stefano , Sebastiani Paola , Perls Thomas , Brent Michael 
Published: December 2023

Abstract
Transcriptional studies of blood have previously identified changes in gene expression profiles associated with age. Centenarians, a rare population of individuals that reach 100 years of age, experience delays in aging-related diseases and mortality. Thus, the analysis of their blood transcriptome may help shed light on mechanisms contributing to healthy aging and extreme longevity, as well as enable the discovery of candidate molecular therapeutic targets. In this project, we analyzed RNAseq-based blood transcriptomic data and genetic data from 1,286 participants in the Long Life Family Study age ranged from 25 to 108. To identify transcripts with different abundances at different ages, we used linear mixed-effect models and included relevant covariates to control for genetic, socioeconomic, and technical confounders. We also estimated a genetic relationship matrix (GRM) from the genotype data to account for familial relatedness. We used the same models and covariates to compare transcripts’ abundance between the extreme old and younger participants to discover markers of extreme old age. Among the 11k RNA transcripts tested, we identified 5,249 aging markers (FDR ≤ 0.01) and 761 extreme old age markers (FDR ≤ 0.01). We successfully replicated our aging signature with previously published aging signature in another cohort with comparable Z-scores. Currently, further investigation is ongoing to distinguish markers that contribute to extreme longevity from markers that represent extreme old age. This study found large signatures of age and extreme old age and will serve as a valuable reference for future research to identify molecular mechanisms of healthy aging.
CROSS-COUNTRY COMPARISONS OF FUNCTIONING AND CARDIOVASCULAR RISKS IN OLDER ADULTS
Authors: Zhang Mutian , Zhang Yuan , Ailshire Jennifer , Crimmins Eileen 
Published: December 2023

Abstract
Life expectancy at birth in China has increased more than 20 years over the past 50 years and is one year higher than in the US in 2021. Whether the rapid improvement in Chinese life expectancy has been accompanied by similar changes in other aspects of the aging process compared to the US remains unclear. In this study, we focus on measured physical functioning and cardiovascular risk factors which signify disability and disease processes, and address how age and gender differences and change with age in these indicators are similar for the two countries. We use data from the 2015 China Health and Retirement Longitudinal Study (n=8,303) and the 2016/18 Health and Retirement Study (n=10,804) on performance-based functioning (e.g., walking speed) and cardiovascular biomarkers (e.g., systolic blood pressure) for those over age 60. We first examine the distribution of each measure by gender and age and conduct t-tests on mean differences. Then we conducted regression analyses to examine cross-country differences. In both countries functioning worsens with age (e.g., mean scores of walking speed for CHARLS females decreased from 0.76 to 0.47 m/s). In contrast, only among older Chinese does cardiovascular risk increase with age while in the US risk is flat (e.g., mean scores of systolic blood pressure for CHARLS females increased from 129.59 to 142.39 mm hg). Although life expectancy is nearly equivalent in these two countries, there are large gaps in health and functioning between China and the US, especially in cardiovascular disease risk.
DESCRIPTIVE EPIDEMIOLOGY ON THE TRENDS OF SUICIDAL ATTEMPTS AMONG OLDER ADULTS IN KOREA FROM 2007–2020
Authors: Lee Seoyoon , Shin Hyung Eun , Lee SeungCheor , Oh In-Hwan 
Published: December 2023

Abstract
When a suicide attempt results in the act of suicide, personal and social losses increase to a degree that is difficult to quantify. It is urgent to evaluate the status of suicide attempts in Korea accurately. This study is to examine a 14-year time series of older adults who have engaged in suicidal behavior or attempted suicide. We used claim data from Health Insurance Review and Assessment Service. A total of 3,440 individuals with a diagnosis code, 768 individuals with a primary diagnosis, and 2,672 individuals with a secondary diagnosis, were included in the analysis. Suicide attempts were defined by intentional self-harm(X60-X84), harmful biological control agent(X87), and personal history of self-harm(Z91.5). To analyze the frequency of suicide attempts by age, a chi-squared test was conducted. Among those over 60 years with a primary diagnosis of suicide attempt, personal history of self-harm was the most common, accounting for 92.4%, followed by intentional self-harm with a rate of 7.5%. No subjects had a primary diagnosis as code of X87. A similar trend was observed for those under the age of 60. In the case of those with a secondary diagnosis of suicide attempt, personal history of self-harm was the highest at 93.5%. Subsequently, intentional self-harm accounted for about 6.4%, and each code was evenly distributed except for alcohol addiction and exposure(X65) in 2007 and X87 in 2020. Conclusively, this study reported the trend of suicide attempts in Korea, which can provide the basis for preparing effective short- and long-term health policies.