bluuebunny/crossref_metadata_2025_split huggingface dataset:
NOT ALL CREATED EQUAL: THE IMPACTS OF POSITIVE, NEGATIVE, AND PARTNER RELATIONSHIPS ON COGNITION IN LATELIFE
Authors: Ee Nicole , Matthews Fiona , Peters Ruth , Anstey Kaarin 
Published: December 2023

Abstract

Background
Social engagement has been linked to higher cognitive function in later life and it is a well evidenced protective factor against dementia and cognitive decline. However, far less is understood about how the type, quality and quantity of social engagement differentially affects cognitive health outcomes in older adults.

Methods
The sample consisted of 1972 participants aged 68-74 (M = 70.60, SD = 1.49) from a large population-based study in Australia, Personality and Total Health Through Life (PATH). The constructs underlying nine observed measures of social engagement were first identified through exploratory and confirmatory factor analysis (CFA). A Latent Variable Path Model (LVPA) was then employed to examine the relationships between positive, negative and partner social engagement on memory and executive function, as measured by six validated cognitive tests.

Results
The CFA identified partner relationship as a distinct social engagement construct, separate to positive and negative relationships. The main analysis demonstrated that negative relationships and partner relationship were positively associated with better memory and executive function, with the former twice the strength of the latter.

Discussion
These findings provide support that more frequent social interactions and larger support structures contribute to better cognitive function in later life, with partner relationship making a significant and distinct contribution. Positive or high-quality social engagement, however, appears to be a less critical factor in bolstering cognitive health. Close and cognitively demanding relationships may promote cognitive health via frequent cognitive stimulation, but more research is required to confirm the mechanisms underpinning observed effects.
VISION IMPAIRMENT AND COGNITION IN INDIA: ASSOCIATIONS AFTER ADJUSTMENT FOR POTENTIAL BIAS
Authors: Nichols Emma , Chen Yizhou , Hazzouri Adina Zeki Al , Gross Alden , Nagarajan Niranjani , Lee Jinkook , Ehrlich Joshua 
Published: December 2023

Abstract
Increasing evidence suggests that vision impairment may be an important modifiable risk factor for dementia, particularly in low- and middle-income settings where the prevalence of uncorrected vision impairment is high. Although prior studies in various settings, including India, have found strong associations between vision impairment and cognition, this work has not considered potential bias in cognitive testing due to vision impairment. We evaluated and adjusted for measurement differences by vision impairment status using data from the Longitudinal Aging Study in India–Diagnostic Assessment of Dementia (LASI-DAD) study (N=3780). We used Multiple Indicators Multiple Causes models to assess differential item functioning (DIF) (e.g. bias) in cognitive testing by objective near and distance vision impairment. We estimated associations between vision impairment and cognition adjusting for hypothesized confounders before and after DIF adjustment. Although there was statistical evidence of DIF (near vision: 3/10 items, distance vision: 4/10 items), differences between DIF-unadjusted and -adjusted scores were small compared to the standard error of measurement, indicating no evidence of clinically meaningful measurement differences. Both near and distance vision impairment were associated with cognition before and after DIF-adjustment; after DIF-adjustment, severe near and distance vision impairment were associated with -0.43 [95% CI -0.53--0.33] and -0.60 [-0.76--0.43] standard deviation units lower cognitive scores compared to those with normal vision, respectively. In well-conducted large-scale surveys, bias in cognitive testing due to vision impairment is likely minimal, even in low- and middle-income settings. Findings strengthen the evidence base on vision impairment as a risk factor for dementia.
OLDER ADULTS’ PERSPECTIVES ON USING TECHNOLOGY TO ASSESS SOCIAL ISOLATION AT THE ONSET OF COVID-19
Authors: Nanthakumar Jarshini , Patel Karishma , Aratia Shahrose , Thakkar Priyanka , Wang Rosalie , Khan Shehroz 
Published: December 2023

Abstract
Social isolation (SI) among older adults (OA) is a global health issue that was exacerbated by the pandemic. This study examines OA’s perspectives on technology use (i.e., home-based ambient sensor or wearable technology) to assess SI, with consideration of understanding these perspectives in relation to the pandemic. Two questions were examined: (i) How familiar are OA with technology that can be used to assess SI? and (ii) Are OA agreeable to using technology to assess SI? Online surveys (n=4379) and semi-structured interviews were completed by community-dwelling OA at the onset of COVID-19. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using content analysis. From survey responses, 16.79% indicated they would be agreeable to using technology to assess SI, whereas 40.37% and 42.83% indicated no and maybe/not sure, respectively. Although most participants were familiar with some technologies that could be used as part of an SI assessment tool, interviews suggested they were unfamiliar with this application of technologies. Preliminary analysis of the interviews (n=31) revealed three broad categories addressing the research questions: (1) perceived barriers to sensor-based technology adoption, (2) user experience and acceptance, and (3) changing social norms. Our study is one of the first to examine the views of OA regarding familiarity and openness to technology use for SI assessment that emerged with COVID-19. Technology developers and healthcare providers need to address ethical concerns around sensor-based technology use and increase opportunities to improve OA’s digital literacy and accessibility to support technology acceptance for SI assessment.
INVESTIGATING THE RELATIONSHIP BETWEEN HABITUAL ACTIVITY AND COGNITIVE DOMAINS AMONG PEOPLE LIVING WITH DEMENTIA
Authors: Pottayil Faheem , Dong Yanbin , Zhu Haidong , Sams Richard , Young Lufei , Jehu Deborah 
Published: December 2023

Abstract
Habitual activity preserves cognitive function in people without dementia, but the relationship between habitual activity and cognitive domains among people living with dementia is unclear. The purpose of this study was to explore the association between habitual activity and cognition domains among people living with dementia. Participants living with dementia in residential care facilities (complete case analysis: n=24/42) completed a battery of cognitive tests (global cognition: Montreal Cognitive Assessment; executive function: Trail-Making Test, Digit Span Forward Test; perception and orientation: Benton Judgement of Line Orientation Test; language: Boston Naming Test; learning and memory: Rey Auditory Verbal Learning Test; complex attention: Digit Symbol Substitution Test). Participants wore an actigraphy monitor on their non-dominant wrist over seven days. We conducted a linear regression for total habitual activity (independent variable) with race (white/black), fall risk (Morse Fall Scale), and the number of comorbidities (Functional Comorbidities Index) as covariates, and cognitive tests as variables of interest. Participants were primarily male (75%), white (87.5%), and 50% had unspecified dementia (Alzheimer’s disease: 33%). Greater habitual activity was associated with poorer global cognition, better executive function, and better learning and memory (ps&lt; 0.05). Habitual activity was not related to visuospatial perception, language, or complex attention. Habitual activity may preserve executive function and learning and memory among people living with dementia. Wandering is more common in later stages of dementia, which may explain greater habitual activity observed with lower global cognition. Regularly assessing habitual activity may be useful in screening and monitoring cognitive changes.
PSYCHOSOCIAL WELL-BEING AND COGNITION AMONG OLDER ADULTS IN A LATE LIFE LEARNING PROGRAM IN LEBANON
Authors: Lu Peiyi , Elbejjani Martine , Chehabeddine Lara , Arabi Hana , Chahine Maya Abi , Kezios Katrina , Hazzouri Adina Zeki Al , Sibai Abla 
Published: December 2023

Abstract
Growing evidence suggests that engaging in cognitively stimulating activities across the lifecourse is associated with improved health. However, very few studies have evaluated the benefits of late life learning (LLL), especially in the low- and middle-income country setting. We designed a prospective cohort study to evaluate whether LLL is associated with better cognition among older Lebanese and related underlying mechanism. The University for Seniors (UfS) is an established and ongoing LLL program at the American University of Beirut, since 2012, providing cognitively and socially enriching activities (e.g., lectures, study groups, social and cultural events) to older adults, aged 50 and above. Our study will select 700 members (both previous longer-term members and new enrollees) and recruit a comparison group composed of 700 age-, sex-, and education-matched non-UfS-participating community residents. Participants will be interviewed on various topics at baseline and at a two-year follow-up visit. Older Lebanese are exposed to a host of lifecourse psychosocial adversities. We developed a questionnaire to capture their life history such as war-related exposures and economic changes due to recent financial crises. We will also measure participants’ psychological well-being including social network and support, ageism, resilience, hopelessness, loneliness. The challenges of adapting psychosocial scales and capturing lifecourse collective and individual adversities in a particularly burdened low-resourced settings and contextual complexity will be presented. With comprehensive data on LLL and lifecourse adversities, we will be able to examine the potential for scalable low-cost LLL programs to mitigate the impacts of earlier and accumulated psychosocial adversities on cognition.
USE OF CHRONIC CARE MANAGEMENT SERVICE AMONG MEDICARE BENEFICIARIES IN 2015-2019
Authors: Jang Jieun , Kim Dae Hyun 
Published: December 2023

Abstract
The Centers for Medicare and Medicaid Services (CMS) introduced Chronic Care Management (CCM) services in 2015 for patients with multiple chronic diseases. Few studies examined the use of CCM services by demographic, geographic, and clinical characteristics. We used 2014-2019 Medicare claims data from a 5% random sample of fee-for-service beneficiaries aged 65 years or over and enrolled Medicare Part B. Of the approximately 1.4 million beneficiaries annually, approximately 75% were potentially eligible beneficiaries of CCM services who had been diagnosed with two or more chronic conditions before the year (2015: 1,073,729; 2016: 1,094,277; 2017: 1,106,929; 2018: 1,118,386; 2019: 1,130,523). The primary outcome was the rate of patients receiving CCM services among potentially eligible beneficiaries using CPT codes 99490, 99491, and 99487 in each year. Among the potentially eligible beneficiaries, the rate of patients receiving CCM services increased from 1.1% in 2015 to 3.4% in 2019 (2015: 11,480; 2016: 22,154; 2017: 31,890; 2018: 37,341; 2019: 38,863). CCM use was concentrated in the South (2015: Georgia: 1.4%; Vermont: 0.1%; 2019: Georgia: 6.1%; Vermont: 0.1%). The increase was higher in beneficiaries with ten or more chronic diseases than in those with two to five chronic diseases (2015: 2-5 chronic diseases: 0.7%; 10 + chronic diseases 2.0%; 2019: 2-5 chronic diseases: 2.1%; 10 chronic diseases: 7.0%), and higher in severely frail beneficiaries than in robust beneficiaries (2015: robust: 0.6%; severely frail: 3.3%; 2019: robust: 1.9%; severely frail: 9.4%). Variations were observed in the utilization of CCM services across demographic, geographic, and clinical characteristics.
SOCIAL DETERMINANTS OF BRIDGE EMPLOYMENT: DO BIRTH COHORTS MATTER?
Authors: Choi Gayoung , Lee Haena 
Published: December 2023

Abstract
A growing number of retirees now engage in bridge employment, a term referring to their continued participation in the workforce post-retirement. The generation in South Korea born between 1945 and 1955, a period marked by leading industrialization and experiencing economic crises during their working age, exhibits unique socioeconomic characteristics distinct from later generations. Consequently, their retirement trajectories diverge significantly from those of later cohorts, including the Baby Boomer generation (born between 1956 and 1965). In this paper, we investigate whether social, demographic, psychological, and health factors are associated with bridge employment and whether this association differs across birth cohorts. Data were drawn from seven waves of the Korean Longitudinal Study of Aging, conducted between 2008 and 2020. We employ an integrative framework that considers socioeconomic status, health status, and psychological factors as the main variables to explain the odds of continuing to work after retirement. Retirement status includes three categories: employed, bridge, and total retirement. Results from a multinomial logit model reveal birth cohort differences in the relationship between social/psychological predictors and bridge employment. Additionally, higher educational attainment, a private pension, and poor mental health are associated with decisions regarding bridge employment for the industrialization generation, but not for Baby Boomers. Furthermore, females are more likely to participate in bridge employment than males for the industrialization generation, but not for Baby Boomers. Our findings contribute to the current literature on bridge employment by identifying the social determinants of bridge employment and highlighting the importance of cohort differences in bridge employment.
FACTORS ASSOCIATED WITH A FOUR-YEAR SARCOPENIA TRANSITION IN CHINESE OLDER ADULTS
Authors: Lin Shujing , He Lingxiao , Yang Jinzhu , Fang Ya 
Published: December 2023

Abstract

Background
Previous studies have reported a dynamic change of sarcopenia status while factors associated with such status changes remained unexplored. This study aimed to identify factors associated with sarcopenia status transitions based on Chinese older adults.

Methods
6065 older adults (aged 66.8±6.2) with complete data at baseline and at least one follow-up (2 years) were included from the China Health and Retirement Longitudinal Study (CHARLS). Sarcopenia was determined based on AWGS2019 criteria. Multistage Markov model was used to explore potential sociodemographic, behavioral, psychological and disease-related factors associated with sarcopenia transitions.

Results
At baseline, 59.1% of participants were non-sarcopenic, 24.7% had probable sarcopenia and 16.2% were diagnosed with sarcopenia. Participants with non-probable sarcopenia had 1-year transition probability of developing probable sarcopenia (0.101) or sarcopenia (0.056). Overweight (HR=1.89, 95%CI: 1.55-2.30), obesity (HR=1.85, 95%CI:1.37-2.48) and presence of chronic diseases (HR=1.26, 95%CI: 1.03-1.56) increased the risk of progression from non-sarcopenia to probable sarcopenia. Older age (HR=1.10, 95%CI:1.08-1.13), female sex (HR=1.38, 95%CI: 1.08-1.75), shorter sleep duration (HR=1.42, 95%CI:1.12-1.80), depression (HR=1.27, 95%CI:1.01-1.59) and presence of chronic diseases (HR=1.35, 95%CI: 1.05-1.74) were associated with transition towards sarcopenia from non-sarcopenia. Higher cognitive function (HR=1.03, 95CI:1.01-1.05), rural dwelling(HR=1.25, 95%CI: 1.00-1.55) and alcohol consumption (HR=1.41, 95%CI:1.15-1.73) were associated with reversed status from probable sarcopenia to non-sarcopenia. Higher cognitive function increased the conversion from sarcopenia to probable sarcopenia (HR=1.21, 95%CI:1.06-1.37) and non-sarcopenia (HR=1.03, 95%CI:1.00-1.06) .

Conclusions
Sarcopenia is a dynamic condition in older adults. Possible interventions should focus on improving cognitive functions, sleep quality and better controlling on chronic conditions.
RCT OF A BEHAVIORAL, TELEHEALTH WELLNESS PROMOTION PROGRAM FOR MIDDLE-AGED ADULTS WITH DISABILITIES
Authors: Molton Ivan , Rivera Donovan , Singsank Katie , Flaster Aaron , Munroe Leah , Humbert Andrew 
Published: December 2023

Abstract
For people aging with physical disabilities, there is a striking need for evidence-based approaches to promote positive health behaviors and to support active community participation. This is especially true in midlife, which is a period of significant health and social vulnerability for this population. This study describes a 3-arm, randomized controlled trial of a telehealth, motivational-interviewing based health promotion program (EnhanceWellness, EW) adapted for people with physical disability. 505 individuals with long-term physical disability were randomized to 8 sessions of individual EW coaching over 6 months, or to one of two control conditions (health education or treatment as usual). Primary outcomes included self-report of ability to participate in social activities, satisfaction with community participation, and mood, using validated NIH PROMIS scales. Participants completed assessments before randomization, at 7 and 12 months post-randomization. Statistical analysis included linear mixed-effects modeling with random intercepts. Participants were on average 56 years old (SD=5.6), were mostly women (77%) and had lived with a medical condition causing ADL impairment (disability) for an average of 23 years. Results demonstrated significant group by time interaction terms (p’s &lt; .01), underlying statistically significant improvements in the EW group in both ability to participate and satisfaction with community participation, relative to either control condition. These changes tended to increase or maintain over time. There were no significant intervention effects on mental health outcomes. Results emphasize the applicability of individualized health behavior change coaching in supporting community participation among adults aging with disability.
UNDERSTANDING OLDER ADULTS’ MOTIVATIONS TO ADOPT DIGITAL HEALTH PORTALS
Authors: Trinh Mimi , Hattakitjamroen Varitnan , Rogers Wendy 
Published: December 2023

Abstract
Older adults are likely to develop chronic illnesses (e.g., hypertension or high cholesterol), resulting in the need to manage their symptoms. Self-management often involves tracking symptoms, medication taking, nutrition, or exercise. Digital health portals (DHPs) have the potential to fulfill these tracking needs by viewing records of symptoms, doctor’s notes relating to diet or exercise, and reviewing medication regimens. However, DHPs are often not used to their full potential. The goal of this study was to understand what motivates older adults to utilize their DHPs, and what features are needed for health self-management. We conducted a qualitative study consisting of surveys and semi-structured interviews to elicit the thoughts of 26 older participants. Following Self Determination Theory and Unified Theory of Acceptance and Use of Technology Integrated Model, we organized their responses into motivation factors of autonomy, competence, and relatedness as well as facilitators such as perceived usefulness, perceived ease of use, social influence, and facilitating conditions. Using this integrated analysis approach, we identified themes related to health portal experience, motivation, barriers and facilitators, health provider support, and ideal design. These themes provide insights into how the DHPs were used and perceived; why older adults use DHPs; and their overall positive experiences using them. The participants generally found the DHPs to be convenient due to features related to self-management. They also shared their core needs and what could be improved for a better and easier experience. The Integrated Model helps in understanding the foundation needed to motivate the acceptance of DHPs.
A pharmacy-led sore throat test and treat (STTT) service: antigen testing and antibiotic supply rates during the period of heightened public awareness of Group A Streptococcus infections
Authors: Mantzourani Efi , Ahmed Haroon , Evans Andrew , Gunnarsson Ronny , Cannings-John Rebecca 
Published: December 2023

Abstract

Background
Community pharmacies in Wales delivered an NHS-funded sore throat test and treat (STTT) service during the period of increased invasive Group A Streptococcus (iGAS) incidents in winter 2022–23. Service users were screened using FeverPAIN/CENTOR scores, offered GAS rapid antigen detection tests (RADT) if appropriate, and antibiotics if indicated.

Objectives
To evaluate the service’s response to a substantial rise in sore throat presentations during a period of heightened public anxiety.

Methods
Cross-sectional study with anonymized individual-level data from electronic pharmacy records of all eligible STTT service users, between January 2022 and March 2023.

Results
Antibiotics were supplied to 24% (95% CI: 23–24) of people who used the STTT service and 31% (95% CI: 31–32) of those who met the threshold for an RADT. Of 27 441 STTT consultations, 9308 (33.9%) occurred during December 2022. In the week commencing 2 December 2022, following the announcements of increased iGAS incidents, we observed a statistically significant increase of 1700 consultations (95% CI: 924–2476) and a statistically significant decrease in supply rate of 13.9 antibiotics per 100 RADT (95% CI: −18.40 to −9.40). Antibiotic supply rates increased thereafter to those observed before the announcements of iGAS incidents. Referral rates to other primary care or emergency settings remained below 10% throughout the study period.

Conclusions
Our findings suggest that, despite a dramatic increase in sore throat consultation rates in response to media reports, the pre-specified pathway followed by pharmacists ensured appropriate use of antibiotics, and absorbed a substantial workload that would otherwise end up in other healthcare settings.