bluuebunny/crossref_metadata_2025_split huggingface dataset:
SEX AND RACE/ETHNIC DIFFERENCES IN TERMINAL COGNITIVE DECLINE
Authors: Mejía-Guevara Iván 
Published: December 2023

Abstract

Background
Cognitive decline has been documented in older adults, but sex and racial/ethnic differences among decedents have not been studied. Here we investigate the relation of mortality to change in the cognitive function of older individuals by sex and race/ethnicity.

Methods
The study analyzed data from the Health and Retirement Study (HRS) between 1993 and 2018, which included information on total word recall, mental status, and total cognition of individuals aged 65 and older. The study estimated the loss of cognitive function using a multilevel random coefficient model, considering sex and racial/ethnic differences in the risk of death, age, and death status. The study also approximated terminal cognitive decline using cognitive scores reported within two years before death for decedents.

Results
On average, older women performed better than older men in word recall and overall cognition, while older White Americans performed better than African Americans and Hispanics/Latinos in overall cognition at all ages. Decedents had a similar cognitive function to survivors at age 65, but their cognition declined quickly with age, especially among older women and White Americans. Evidence of terminal cognitive decline within two years before death was significant regardless of age but less conclusive for African Americans and Hispanics/Latinos due to smaller sample sizes.

Conclusions
This paper indicated evidence of sex and race/ethnic differences in cognitive decline and terminal cognitive decline among older adults, which may have critical clinical implications directly linked to the onset and duration of dementia risk.
THE RELATIONSHIPS OF VOICE PROSODY MEASURES TO COGNITIVE CHANGES OVER 10 YEARS
Authors: Mahon Elizabeth , Lachman Margie 
Published: December 2023

Abstract
Voice prosody measures, especially jitter and shimmer, can differentiate cognitive impairment from healthy cognition, and may be promising early biomarkers for identifying high risk before later-life disease onset. In our past work, higher jitter and lower pulse assessed during the second cognitive assessment were associated with 10-year cognitive declines in middle-age and older adults from the Midlife in the U.S. (MIDUS) study. The current study assessed voice biomarkers taken at baseline, 10 years before the second cognitive assessment, and measured voice on speech that was independent of the cognitive assessments to address the possible influence of cognitive performance on concurrent voice prosody measures. Participants (ages 34 to 82 at the first occasion) were included if they were in the Boston Longitudinal Study (BOLOS, a subset of MIDUS) and had voice measures collected from the audio recordings of the cognitive interviews. Multilevel analyses controlled for age, sex, education, race, neurological conditions, and depressive symptoms at baseline. Higher jitter, lower shimmer, and lower pulse predicted greater 10-year declines in episodic memory. Higher pitch and lower pulse were associated with greater increases in reaction time on an executive functioning task. Thus, voice biomarkers previously associated with cognitive impairment could be useful as early indicators of later-life cognitive declines. Identifying voice biomarkers that could predict 10-year cognitive change may facilitate earlier intervention for decline through modification of disease risk factors.
EXPLORING THE EFFECT OF EXOSOMES AND RADIATION ON GLIOBLASTOMA CANCER CELLS
Authors: Hausman Hannah , Azizi Linda , Pajonk Frank 
Published: December 2023

Abstract
Glioblastoma is the most common and aggressive type of brain cancer, with higher incidences in aging adults over 75 and little to no long-term survival or cure. The median survival time under the current standard of care, surgical resection and chemoradiation, is 15-18 months. Glioblastoma tumors consist of multiple cell types, including mature brain cells in cell cycle arrest and cancer stem cells (CSCs) that replenish cancer cell populations. However, the cancerous non-stem cells are induced into a cell fate called glioma-initiating cells in response to radiation, where they begin to express stem-like phenotypes. Glioma-initiating cells proliferate at an aggressive rate and are the reason for cancer recurrence, making them a necessary target for new and more effective therapeutics. This research is studying the effect of exposure to exosomes, extracellular vesicles that carry proteins and RNA, on the stem-like phenotype expression of irradiated non-stem cells. Irradiated glioblastoma cells were exposed to varying concentrations of exosomes isolated from glioblastoma CSCs in vitro. The results showed a decrease in ZsGreen expression, a marker for stem-like phenotypes, as exosome concentration increased. Exposure of glioblastoma cancer cells to exosomes post-irradiation decreased the rate of transition to glioma-initiating cells. This suggests that CSC exosomes may signal that stem cells are present, decreasing the need for the formation of glioma-initiating cells. Further research is necessary to better understand the role of exosomes in glioblastoma tumors, however, this result may suggest exosomes as a potential way to delay or reduce the aggressive nature of glioblastoma cancer recurrence.
THE IMPACT OF FAR-INFRARED TECHNOLOGY ON QUALITY OF LIFE IN OLDER ADULTS
Authors: Rath Shavonnye , Guggenheimer Joshua , Homan Melanie , Myers Marcella , Hutson Jennifer , Green Ginny 
Published: December 2023

Abstract
Identifying methods of pain amelioration to meet the unique demands of older adults (OA) may be crucial to increasing quality of life (QOL) for this population. This study aimed to examine the effects of far-infrared heat (FIR) on pain management and QOL in OA. FIR utilizes a long light wavelength that simulates dry sauna-like conditions. Examining the relationship between FIR and pain is important due to the increased prevalence of chronic pain associated with aging and the corresponding impact it has on QOL and physical performance. Seventeen OA completed the study. Participants were randomly assigned to either a convective heat group (CON) or a convective and far-infrared heat (FIR) group, with convective heat set to 60℃ (140℉.) Participants received six, 30-minute sessions. Physical assessments were measured (range of motion, gait speed, timed up-and-go, and hand grip strength) as well as pain severity and its interference with daily life, and the impact pain had on overall QOL. T-tests were used to compare pre- and post-assessment measures. Results indicated that pain severity was significantly reduced (from 3.31 to 2.5, P &lt; 0.05) in the FIR group and that pain interference was significantly reduced (from 1.26 to 0.43, P &lt; 0.05) in the CON group. Findings suggest that heat therapy successfully reduced pain over time, but that FIR heat specifically was not superior to that of convective heat alone. Further research is required to correctly identify the relationship between QOL and the use of FIR.
A META ANALYSIS ON THE ASSOCIATION OF NOVEL PLASMA BIOMARKERS TESTING FOR EARLY DETECTION OF ALZHEIMER’S DISEASE
Authors: Dunnam Charles 
Published: December 2023

Abstract
The latest research confirms the heterogeneity of Alzheimer’s Disease Related Dementia (ADRD). This justifies a meta-analysis study on the association of novel plasma biomarkers with screening assessments for early detection of ADRD. The conceptual framework model will be analyzed from the 2020 edition of the GSA KAER Toolkit with updates. The purpose of the current study is two-fold. First, to determine the need of a universal protocol method for early assessment of ADRD by primary care teams. Second, implementation of Food and Drug Administration (FDA) approved novel plasma biomarkers testing as a follow-up protocol to a screening assessment. The two suggested protocols have recently established Medicare coverage. The study will conclude with an extensive review of the known novel plasma biomarkers that are available for testing, at present and a brief overview of available screening assessments for early detection of ADRD.
AGE BIAS IN ARTIFICIAL INTELLIGENCE (AI): A VISUAL PROPERTIES ANALYSIS OF AI IMAGES OF OLDER VERSUS YOUNGER PEOPLE
Authors: Allen Laura , Xu Wenqian , Nishikitani Mariko , Patil Vaishnavi Atul , Bradley Dana 
Published: December 2023

Abstract
Concerns about age-related biases in Artificial Intelligence (AI)’s design, development, and data generation raise alarms for potential social inequalities. AI art-generators like MidJourney, known for creating distinctive and artistic images, have gained attention recently. However, the critical examination of their potential biases remains limited. Our study aims to investigate age-related bias in MidJourney by comparing how older and younger individuals are visually depicted. Using 19 keywords (as text prompts) tied to domains of potential social exclusion for older adults, we automated the collection of “old person” and “young person” images in MidJourney. The text-to-image prompts yielded 456 AI-generated images that were analyzed with Amazon Rekognition image detection software to transform them to quantitative data. Data were compared statistically using STATA (version 16). The results show that the images of older people are significantly less bright (p&lt; 0.001) and less sharp (p&lt; 0.001) than the images of younger people. Additionally, images of older people have significantly more smile expressions (16%; p&lt; 0.001) and are more likely to be wearing glasses (56%; p&lt; 0.001) compared to images of younger people (6% and 12%, respectively). The findings reveal that MidJourney’s algorithm associates older people with a negative sense of antiquity, irrelevance, and dread. The findings also align with the Stereotype Content Model in which older people are seen as having warm personalities but not as competent or capable as younger people. We interpret these results as age bias that the AI art generator MidJourney has learned and in turn, creates, through image generation.
ARE OLDER ADULTS’ PERCEPTIONS OF ELDERSPEAK INFLUENCED BY SELF-REPORTED PSYCHOSOCIAL CHARACTERISTICS?
Authors: Weimar Lisa , Shaw Clarissa 
Published: December 2023

Abstract
PROMIS (Patient-Reported Outcomes Measurement Information System) is a system of highly reliable measures of patient-reported health status. Elderspeak is speech that sounds childish to older adults. Use of elderspeak by nursing staff can result in rejection of care. The Iowa Coding Scheme for Elderspeak (ICodE) contains 11 elderspeak attributes: diminutives, childish terms, collectives, short words, directives, reflectives, minimizers, exaggerated praise, laughter, tag questions and exaggerated prosody. Thirty-one older adults (aged 74.5±7.8 years) responded to short form PROMIS instruments measuring self-efficacy, physical function, isolation, cognitive function, depression, anxiety, and pain interference. Participants listened to 41 audio recordings of nursing staff providing care to hospitalized patients with dementia and were asked to rate each audio recording using a 5-point Emotional Tone Rating Scale for patronizing and respectful (5=very, 1=not at all). Using the ICodE, each audio recording was classified as neutral (no elderspeak), containing a single attribute, or containing an attribute combined with exaggerated prosody. Ratings for elderspeak attributes ranged from 2.1 to 2.9 for patronizing and 2.8 to 3.8 for respectful. Using the SPSS statistical package, a Spearman’s rho correlation was calculated for each elderspeak rating and health status domain identified above. Among this small, homogenous sample, no statistically significant correlation was found between participants’ self-efficacy, isolation, physical or cognitive function, depression, anxiety, or pain interference, as measured by PROMIS tools, and their rating of elderspeak attributes as respectful or patronizing. Future research should continue to explore what factors influence older adults’ perceptions of elderspeak as being respectful or patronizing.
ASSOCIATION BETWEEN LONG-TERM CARE FACILITY STAFF TRUST IN LEADERSHIP AND RECEIVING THE COVID-19 VACCINE
Authors: Li Xinjun , Gifford David , Williams Valerie 
Published: December 2023

Abstract
Trust in the sources recommending COVID-19 vaccine is thought to be associated with COVID-19 vaccine uptake. We compared long-term care (LTC) staff’s trust with leadership and public health organizations and their vaccination status. We administered a questionnaire to all staff in 48 long term facilities (39 Skilled Nursing Facilities (SNFs) and 9 Assisted Living (AL) facilities) to assess their overall trust level on a 5-point Likert scale with leadership and public health agencies along with their reported used COVID-19 vaccination status. We received 759 responses, with 34 were excluded due to incomplete data. Overall, 12% were not vaccinated, 25.2% completed initial series, 25.0% received one booster, and 37.8% received bivalent booster. Average trust was lowest with CDC (3.62) & CMS (3.60) and highest with leadership (Supervisor (4.07), Administrator (3.98) and DON (3.89)), which were higher than trust with the LTC organization (3.74). Trust levels increased as the staff’s vaccination status increased (p&lt; 0.01) for each category in ANOVA tests. Building overall trust may help increase staff compliance with vaccination recommendations.
CONDITIONS ASSOCIATED WITH SUCCESSFUL IMPLEMENTATION OF AN ADVANCE CARE PLANNING INTERVENTION IN NURSING HOMES
Authors: Hickman Susan , Miech Edward , Stump Timothy , Mack Laramie , Tu Wanzhu , Unroe Kathleen 
Published: December 2023

Abstract
Implementing evidence-based interventions in nursing homes is challenging in part because clinical trials requiring a controlled experimental environment are difficult to sustain. In contrast, pragmatic clinical trials develop and evaluate evidence-based interventions in the “real world” with the goal of streamlining implementation after study completion. However, there is minimal information available identifying conditions associated with successful implementation of pragmatic interventions in the nursing home setting. The “Aligning Patient Preferences - a Role Offering Alzheimer’s patients, Caregivers, and Healthcare Providers Education and Support” (APPROACHES) project is a pragmatic trial designed to test and evaluate a staff-led advance care planning (ACP) intervention for residents with ADRD in 131 nursing homes (64 intervention, 67 control) between September 1, 2021 and August 31, 2022. ACP Specialists received training on ACP facilitation and implementation of the ACP program in the facility. Twenty of 65 (31%) sites successfully implemented the APPROACHES intervention and had &gt; 75% of residents with documented ACP conversations. Using configurational analysis, we found two solutions directly linked with successful pragmatic implementation: (1) no executive director turnover during the observation period combined with site participation in monthly intervention support calls with ACP staff at other facilities; and (2) higher rates of hospitalization (3.96 – 7.2 per 1000 resident days) combined with a low number of certified beds. Findings suggest that leadership stability and engagement with peers were essential drivers of successful implementation. Having greater improvement opportunities as well as a more manageable caseload for the ACP Specialist may also help explain successful implementation.
CONDUCTING A NEEDS ASSESSMENT TO INFORM AGE-FRIENDLY HEALTH SYSTEMS INITIATIVE FOR UNIVERSITY OF UTAH HEALTH
Authors: Cadiz Ashley , Perkins Rebekah , Farrell Timothy , Edelman Linda 
Published: December 2023

Abstract
Today, people live longer and more productive lives than ever. The number of adults aged 65 and older is projected to nearly double 98 million by 2060 to 24% of the U.S. population (Administration on Aging & Administration for Community Living, 2018). Increased life expectancy, coupled with the exponential growth of the older adult population will create more demand for healthcare professionals to meet the care needs of older adults living with chronic conditions. Chronic conditions can lead to complex care and increase the usage of healthcare systems (Axon & Kamel, 2021). The Age-Friendly Health Systems initiative provides specific evidenced-based best-practice interventions to all older adults in a health system setting (Fulmer et al., 2022). An Age-Friendly Health System is one in which every older adult’s care is guided by an essential set of evidence-based practices known as the 4Ms framework: What Matters, Medications, Mentation, and Mobility (Institute for Healthcare Improvement, 2022). This project developed and delivered a Needs Assessment to providers practicing in the U Health Ambulatory Care Clinics to identify baseline knowledge, gaps in knowledge, and current practices related to the AFHS 4Ms Framework. The Needs Assessment consists of using online surveys and semi-structured interviews. Significant findings were that: 1) U Health ambulatory care clinic providers have very little to no baseline knowledge of the AFHS 4Ms Framework, 2) U Health ambulatory care providers are already providing care that aligns with the 4Ms framework, 3) There are barriers and challenges to providing Age-Friendly care.
CORRELATES OF MILD BEHAVIORAL IMPAIRMENT IN OLDER ADULTS WITH COGNITIVE DECLINE
Authors: Yoon Seolah , Jeong Innhee , Kim Jennifer (Jeehyun) , Kang Bada 
Published: December 2023

Abstract
Implementing early interventions in individuals with subjective cognitive decline and mild cognitive impairment during preclinical and prodromal stage of Alzheimer’s dementia spectrum, addresses modifiable risk factors thereby reducing potential dementia. Mild behavioral impairment (MBI) is considered as a potential predictor and prognostic marker for dementia. However, comprehensive reviews on how MBI is associated with other factors in these at-risk groups are limited. This scoping review identified and mapped associated factors of MBI on health outcomes among older adults with subjective cognitive decline and mild cognitive impairment. Following Joanna Briggs Institute methodology, we sourced studies from databases including PubMed (MEDLINE), CINAHL, Web of Science, EMBASE, PsycINFO, Cochrane, and SCOPUS, focusing on English-language publications published between January 2003 and July 2023. A total of 36 studies met the inclusion criteria. We classified MBI correlates identified from these studies into three categories: neurocognitive, physical, and psychosocial. Neurocognitive functions such as objective cognitive decline and progression to Alzheimer’s disease showed distinct health outcomes related to the MBI. Biomarkers including brain atrophy, beta-amyloid, and p-tau were found to be associated with MBI. Frailty, low gait speed, and hearing loss were physical functional outcomes associated with MBI. Studies on psychosocial aspects with MBI were limited, except one study demonstrating the relationship between caregiver burdens and MBI severity. This review underscores the importance of taking into account MBI and its correlates for developing tailored care approaches to prevent functional decline and improving health outcomes among older adults with subjective cognitive decline and mild cognitive impairment.
DEVELOPMENT OF AN AI-POWERED EMOTIONALLY INTELLIGENT, INTERACTIVE AGENT PROTOTYPE TO SUPPORT INFORMAL CAREGIVERS
Authors: Chang Yu-Ping , Dwibedi Aditya Kumar , Joshi Suryakanth , Bhattacharjee Sreyasee Das 
Published: December 2023

Abstract
Long-term informal caregiving for older adults with dementia is exhausting and poses risks to caregivers’ health outcomes. Most informal caregivers are not well prepared for their new role, facing various challenges and receiving limited support. With the advent of artificial intelligence (AI) and information and communication technologies (ICTs), assistive technology is increasingly useful for supporting caregivers. However, limited research assesses the potential for AI to facilitate a privacy-preserving computation environment to provide proactive assistance to caregivers. This project aims to fill this gap by leveraging the tremendous potential of Multimodal Machine Learning and Large Language Models (LLMs) to develop a prototype of an AI-powered emotionally intelligent, interactive agent for informal caregivers. We introduce an effective context-driven instruction tuning technique that enables LLMs to finetune various caregiving-related tasks (tips generation, answering questions, elaborating a specific training module) with instructions. The project will also deliver a first-of-its-kind custom dataset augmented with manualized instructions for relevant caregiving tasks, which is used for finetuning several state-of-the-art LLM models. Our intelligent interactive agent prototype currently has the ability to evaluate caregivers’ unique affective states at query times to provide personalized assistance, addressing various types of caregivers’ situation-specific queries (e.g., managing agitation, wandering, or medications). The prototype is capable of understanding and responding to the user’s natural language queries and designing short, machine-driven persuasive conversations on a pre-defined set of topics. Our prototype has the potential to provide individualized and contextualized support for caregiving tasks which in turn may greatly reduce caregiver burden.
DIETARY IMPACT ON GUT MICROBIOTA, COGNITIVE PERFORMANCE, AND HIPPOCAMPAL MARKERS IN AGING RATS
Authors: Solch-Ottaiano Rebecca , Harper Colin , Engler-Chiurazzi Elizabeth , Ismael Saifudeen , Prats Madison , Volic Milla , Bix Gregory , Maraganore Demetrius 
Published: December 2023

Abstract
Many patients with mild cognitive impairment have alterations in gut microbiota composition and dietary consumption directly modulates gut microbiota; therefore, the quality of a diet may impact cognitive function. Twelve-month-old male Fischer 344 rats (n=10/group) were assigned to a Mediterranean diet (MeDi), Western diet (WD), or Chow for three months to determine the effect of diet in aged animals. Animals underwent neurobehavioral assessments including the Morris water maze (MWM), and radial arm water maze (RAWM). Fecal samples were analyzed via 16S rRNA sequencing. Markers of barrier and immune function in the hippocampus were measured via qPCR. The MeDi (p=0.06) and Chow (p=0.003) groups had a trend to or swam a shorter distance compared to the WD in the MWM. There was no difference in RAWM total errors between Diets (p=0.43). Microbiota analyses exhibited differences in alpha- and beta-diversity. Chow diet had a higher Simpson and Shannon index compared to MeDi (p&lt; 0.02) and WD (p&lt; 0.001). The MeDi (p=0.03) and Chow (p&lt; 0.001) groups had a higher Chao1 index compared to the WD group. Beta-diversity differed by Diet for weighted UniFrac (p&lt; 0.03), and unweighted UniFrac (p&lt; 0.001). For barrier integrity, there was a trend for Occludin expression to differ by Diet (p=0.07) but Claudin-5 did not differ (p=0.81). For immune function, the WD group had a trend to have a higher expression of GFAP compared to the MeDi (p=0.05) but a lower Iba-1 expression (p=0.009). A short-term diet had a subtle effect on cognitive performance but modulated microbiota compositions and hippocampal immune marker expression.