bluuebunny/crossref_metadata_2025_split huggingface dataset:
TRAJECTORIES OF DEPRESSIVE SYMPTOMS BEFORE THE ONSET OF DEMENTIA: EXAMINING RACIAL/ETHNIC DISPARITIES
Authors: Lee Ji Hyun , Maher Amanda Cook , Palms Jordan , Mudrazija Stipica , Chopik William , Zahodne Laura 
Published: December 2023

Abstract
Biological and cognitive changes can often be detected up to 16 years prior to a formal diagnosis of Alzheimer’s disease (AD). Psychological symptoms of AD (e.g., depression) may also start to develop during this prodromal phase. Depressive symptoms may be an early marker of neurodegeneration and/or a reaction to early cognitive decline. Higher levels of depressive symptoms could create additional burdens for individuals with preclinical AD and their families. Unfortunately, little is known about the trajectory of depression during the preclinical phase of AD. Using the Langa-Weir method for algorithmic classification, a sample of incident dementia cases (n=2168) was identified from longitudinal data from the Health and Retirement Study (2000-2018). Depressive symptoms were measured with eight dichotomous items from the Center for Epidemiologic Studies Depression (CES-D). Latent growth curve models estimated the trajectory of depressive symptoms over up to 10 waves prior to dementia classification, and disparities across racial/ethnic groups were examined. Results show that depressive symptoms increased slightly over time throughout the preclinical phase of AD, following a quadratic trajectory. Older Hispanic adults reported consistently higher levels of depressive symptoms across timepoints, followed by older non-Hispanic Black and older non-Hispanic White adults. These findings highlight the importance of examining the psychological changes occurring during the preclinical phase of dementia for understanding the disease progression of AD and racial/ethnic disparities in psychological burden. The implications of using algorithmic dementia classifications in studying cognitive race/ethnic disparities will also be discussed.
THE IMPACT OF CHANGES IN COGNITIVE FUNCTIONING ON SOCIAL ISOLATION
Authors: Kayser Jay , Li Lydia 
Published: December 2023

Abstract
This study examines if transitioning from normal to impaired cognitive functioning is associated with changes in social isolation among community-dwelling older adults without cognitive impairment at baseline. This study uses nine waves (2011-2019) of data from the National Health and Aging Trends Study (NHATS). The sample (N=8,245) was representative of Medicare beneficiary at baseline. Social isolation was measured using a seven-item index that captures a range of social activities and network characteristics. Cognitive status was assessed through self-report of having Alzheimer’s disease, the Dementia Screening Interview (AD8), and cognitive testing. Based on pre-determined criteria, participants were grouped as either cognitively intact or impaired. Fixed effect linear modeling with robust standard errors was used to examine the impact of transitioning from intact to impaired cognitive functioning on social isolation. At baseline 5,575 Participants were cognitively intact. At each successive wave, between 12% and 16% of the sample was cognitively impaired. After controlling for time-varying covariates, transitioning from intact to cognitive impairment was associated with a statistically significant increase in social isolation (β=.18, SE=.03, p &lt;.001). Gender and educational attainment did not impact this association. These findings underscore the need for policies and interventions to increase social connection among older adults, particularly during early stages of cognitive impairment.
DYNAMICS OF PSYCHOLOGICAL WELL-BEING ACROSS THE TRANSITION TO WIDOWHOOD
Authors: Li Lydia , Hu Rita , Kayser Jay , Cho Joonyoung 
Published: December 2023

Abstract
The present study examines within-person changes in psychological well-being (PWB) associated with the transition to widowhood. We analyzed 9-wave data collected annually from a probability sample of Medicare beneficiaries. The analyzed sample included married respondents at baseline (N=3,711). Five hundred ten respondents, 208 men and 202 women, became widowed in the survey period. We created variables to indicate widowhood status, the time before and the time since widowhood. Depressive symptoms measured by the PHQ9 and positive well-being assessed by a 6-items scale (e.g., My life has meaning and purpose) were dependent variables. Fixed-effect linear regression, which uses only within-person change over time in the panel data, was used. Results show that immediately after the spouse’s death, depressive symptoms increased and positive well-being decreased. There is a curvilinear relationship between time since widowhood and both depressive symptoms and positive well-being. Specifically, after the widowhood transition year, depressive symptoms began to decline, positive well-being began to increase, up to about four years after widowhood when depressive symptoms slightly rose and positive well-being slightly declined. Men and women have similar patterns. The findings suggest that right after spousal loss is challenging for older adults; some may need counseling and extra support. About two years after the spouse’s death, they return to the pre-loss level of PWB and continue improving until about four years after widowhood. Improvement in depressive symptoms and positive well-being shows older adults’ resilience and potential for personal growth after adversity.
AGING AND CIRCADIAN CLOCK
Authors: Hurley Jennifer 
Published: December 2023

Abstract
Circadian rhythms are highly conserved, 24-hour, oscillations that tune physiology to the day/night cycle, enhancing fitness by ensuring that appropriate activities occur at biologically advantageous times. Disruption of proper circadian timing negatively impacts organismal fitness, making understanding the mechanism underlying circadian regulation over cellular physiology critical to appreciating a fundamental rule of life on earth. As we age, our bodies circadian rhythms change due to stress, chronic disruption of our clocks, neurodegeneration, and a host of other reasons, which can have a profound effect on our systems. Therefore, understanding the aging circadian clock is important to promote longevity and healthy aging. In this session, we will investigate some of the research going on that links the clock to aging. Topics will include the investigation of the role of the clock in timing immunometabolic regulation in the context of inflammation and Alzheimer’s disease, the optimization of the timing of exercise in the effort to maintain homeostasis and decrease risk, the connection between aging and the reduction of the number of rhythmically expressed genes and the weakening of circadian control, and the effect of dietary restriction on the circadian clock. The take home message of this session will be the importance of factoring daily time into research, preventative measures, and treatment regimens, to maximize overall health as we age.
CIRCADIAN TIMING OF THE IMMUNOMETABOLIC RESPONSE AFFECTS ALZHEIMER’S DISEASE PATHOLOGY
Authors: Hurley Jennifer 
Published: December 2023

Abstract
Though the predominant model of the biological mechanisms underlying ADRDs is based on the beta-amyloid (Aβ) hypothesis, evidence suggests that inflammation from resident immune cells is also a key component of the development of ADRD pathophysiology. A major biological regulator of inflammation is the circadian clock, the 24-hour molecular timekeeper that broadly regulates gene expression throughout mammalian tissues to synchronize biology to the Earth’s day/night cycle. Concordantly, chronic disruption of the circadian clock (CD) increases the risk for and severity of ADRDs. Our research has revealed that the circadian clock times metabolism, with the clock timing mitochondrial division which in turn times the response of mammalian macrophages to ADRD pathological factors. We show that subunits of the enzyme NOX2, a driver in the creation of reactive oxygen species (ROS) that uses metabolites to impart inflammation, are driven to oscillate in a 24 hr rhythm by the circadian clock in macrophages and microglia. Notably, oscillations in these NOX2 subunits are dysregulated when an organism undergoes CD, leading to an increase in the levels of ROS released by macrophages and microglia and elevating overall levels of inflammation. Given the apparent interconnection between inflammation, circadian rhythms, and ADRDs, an understanding of the circadian timing of the immune system could be exploited to develop treatments that alleviate ADRD symptoms, contribute to a potential cure, and prevent a population-wide increase in neurodegeneration due to a societal surge in CD.
AGE-ASSOCIATED DECLINE IN TISSUE CIRCADIAN CLOCK FUNCTION
Authors: Esser Karyn 
Published: December 2023

Abstract
Cellular circadian clocks direct a daily transcriptional program that supports homeostasis and resilience. Emerging evidence has demonstrated age-associated changes in circadian functions. To define age-dependent changes at the systems level, we profile the circadian transcriptome in the hypothalamus, lung, heart, kidney, skeletal muscle, and adrenal gland in three age groups. We find age-dependent and tissue-specific clock output changes but these changes exhibit tissue specific patterns. In general, aging reduces the number of rhythmically expressed genes (REGs), indicative of weakened circadian control. These REGs are enriched for the hallmarks of aging, adding another dimension to our understanding of aging. We determined there were tissue specific changes in the phase distribution of REGs with the hypothalamus and skeletal muscle tissues of the old mice showing a large reduction with REG peak expression at only one phase of the day. Analyzing all expressed genes within a tissue for differences at four distinct times of day identified unique clusters of differentially expressed genes (DEGs). These outcomes identify non-circadian but temporally distinct age associated changes in gene expression. This analysis extends the landscape for understanding aging and highlights the impact of aging on circadian clock function and temporal changes in gene expression.
DIETARY RESTRICTION AND THE TRANSCRIPTION FACTOR CLOCK DELAY EYE AGING TO EXTEND LIFESPAN IN DROSOPHILA MELANOGASTER
Authors: Kapahi Pankaj 
Published: December 2023

Abstract
Many vital processes in the eye are under circadian regulation, and circadian dysfunction has emerged as a potential driver of eye aging. Dietary restriction (DR) is one of the most robust lifespan-extending therapies and amplifies circadian rhythms with age. We have previously shown that lifespan extension upon DR requires the presence of circadian clocks for maximal benefits. Herein, we demonstrate that dietary restriction extends lifespan in Drosophila melanogaster by promoting circadian homeostatic processes that protect the visual system from age- and light-associated damage. Altering the positive limb core molecular clock transcription factor, CLOCK, or CLOCK-output genes, accelerates visual senescence, induces a systemic immune response, and shortens lifespan. Flies subjected to dietary restriction are protected from the lifespan-shortening effects of photoreceptor activation. Inversely, photoreceptor inactivation, achieved via mutating rhodopsin or housing flies in constant darkness, primarily extends the lifespan of flies reared on a high-nutrient diet. Our findings establish the eye as a diet-sensitive modulator of lifespan and indicates that vision is an antagonistically pleiotropic process that contributes to organismal aging.
CONNECTING THE DOTS: SUPPORTING OLDER ADULTS LIVING WITH HIV-ASSOCIATED NEUROCOGNITIVE DISORDERS
Authors: Weinstein Elliott , Jimenez Daniel , Gouse Hetta 
Published: December 2023

Abstract
Although people living with HIV are living longer than ever before, significant HIV-related physical and mental health disparities remain among older adults living with HIV (OALWH) due to issues related to advanced aging. HIV-associated neurocognitive disorders (HAND) are becoming increasingly common and have the potential to negatively impact the cognitive, motor, and psychological well-being of OALWH. However, more research on both predictors of HAND and interventions to support cognitively impaired OALWH is needed. This symposium offers insights along the spectrum of intervention development. Two presentations will focus on best identifying predictors of HAND among groups most at-risk up while the other three discuss tailoring and evaluating interventions to alleviate HAND-related symptoms within diverse samples of OALWH from across the country. The first presentation centers on how cerebrospinal fluid markers of Alzheimer’s-related pathology can disentangle diagnosing HAND and amnestic mild cognitive impairment among OALWH in Southern California while the second highlights the role of grip strength in predicting frailty and cognitive impairment among OALWH living in South Florida. The third presentation assesses the feasibility, acceptability, and preliminary intervention effects of a physical activity intervention on cognition adapted for Latino OALWH in South Florida while the fourth examines qualitative feedback from several focus groups on adapting cognitive remediation group therapy as a hybrid group intervention for OALWH with cognitive concerns living in two Canadian provinces. Finally, the last presentation reviews findings of a 2-year randomized clinical trial examining speed of processing training on everyday functioning among OALWH in the U.S. Deep South.
A TWO-YEAR RCT EXAMINING SPEED OF PROCESSING TRAINING ON EVERYDAY FUNCTIONING IN ADULTS WITH HAND IN THE US DEEP SOUTH
Authors: Vance David , Fazeli Pariya , Azuero Andres , Khalidi Sarah , Frank Jennifer , Wadely Virgina , Raper James , Pope Caitlin 
Published: December 2023

Abstract
Approximately 44% of people living with HIV (PLWH) experience HIV-associated neurocognitive disorders (HAND). Cognitive training approaches, such as speed of processing (SOP) training, may reduce the detrimental impact of HAND on everyday functioning. In this experimental design study, 216 participants 40 and older with HAND or borderline HAND (82% Black) were randomized to one of three groups: 1) 10 hours of SOP training (n=70); 2) 20 hours of SOP training (n=73), or 3) 10 hours of Internet Navigation Control Training (a contact control group; n=73). Participants completed several everyday functioning measures at baseline, posttest, and year 1 and year 2 follow ups. Everyday functioning measures included: 1) Modified Lawton and Brody Activities of Daily Living (ADL) Questionnaire; 2) Timed Instrumental Activities of Daily Living (TIADL) Test; 3) Patient’s Assessment of Own Functioning (PAOFI); 4) Medication Adherence Questionnaire (MAQ); and 5) Medication Adherence Visual Analog Scale (VAS). Linear mixed-effect models and generalized estimating equation models were fitted to estimate between group differences at all follow-up time points. At follow-up timepoints, those in the 10-hour and 20-hour training groups performed better on medication adherence measures (MAQ and VAS) than those in the control group, with effects (Cohen’s d) ranging from 0.13 to 0.41 for MAQ and 0.02 to 0.43 for VAS. In conclusion, SOP training improved some indicators of everyday functioning, specifically medication adherence; however, the therapeutic effects diminished over time. This is an interesting finding given the importance of medication adherence in viral suppression and overall survival in PLWH.
HEALTH CARE EMPLOYERS’ PERSPECTIVES ON SKILLS REQUIRED FOR STUDENT SUCCESS IN THE WORKPLACE
Authors: Cummins Phyllis , Chidebe Runcie , Karam Rita , Kramer Jenna 
Published: December 2023

Abstract
Community colleges (CCs) play a critical role in educating healthcare workers that are important to an aging population. This study investigated the role literacy, numeracy, and problem-solving skills play in CC student success in the classroom and the workplace. Semi-structured virtual and in-person interviews were completed with CC administrators (n=9) and faculty (n=6), along with employers (n=10) who hire students from CCs. We focus on healthcare employers (i.e., home healthcare, nursing homes and hospitals) and the skills they value along with skills that are lacking in CC hires. Examples of health care occupations filled by CC students include certified nursing assistants, qualified medication aides, licensed practical nurses (LPNs), and registered nurses (RNs). Employers reported working closely with CCs, including providing opportunities for clinical rotations, serving on program advisory councils, and providing input into program development. Numeracy skills, such as measuring medication dosages, critical thinking skills, and problem-solving skills, including conflict resolution, are important and expected by employers. Communication skills are also highly valued, especially the ability to communicate on the level of the nursing home resident or hospital patient, along with their family members. Employers noted that LPNs and RNs sometimes have limited leadership and supervisory skills and remarked they are working with CC faculty and administrators to identify mechanisms (e.g., role playing, case studies) to improve those skills. Findings from this project will inform both CC administrators and employers regarding skills that are necessary to succeed as students and healthcare workers to meet the needs of an aging population.
MEDICAL LABORATORY SCIENTISTS’ ROLE IN THE CARE OF AN AGING POPULATION
Authors: Kaur Tripat 
Published: December 2023

Abstract
Medical Laboratory Scientists (MLS) are a group of highly skilled professionals in the healthcare industry who are responsible for working on specimens and providing results that are accurate in diagnosing medical disorders and monitoring treatments. These heroes work behind the scenes and face a critical shortage of personnel required to meet the needs of an ageing population. The number of clinical tests has increased 388% since 1993, from 12,683 to nearly 62,000. In addition, the Centers for Disease Control reports that for the &gt;500 million primary care patient visits each year, one out of three patient encounters result in the ordering of at least one laboratory test. To meet these high testing volumes medical and clinical laboratories are highly automated with instrumentation utilized in all aspects of testing to improve the turnaround time for reporting results. Programs that offer medical laboratory science programs often must prepare the students for this highly technical field. To assist in the shortages that the laboratories faced, 6 years ago, BayCare Health System approached Hillsborough Community College Health Science division about setting up a post-baccalaureate medical laboratory science program. The program has now had approximately 100 graduates who have jobs around the Tampa Bay hospitals. Educational institutions face challenges in meeting current needs because of the lack of visibility of the medical laboratory science profession, a drop in the total enrollment in colleges over the last 5 years, and a rise in the national median age of the current population.
IMPLEMENTATION OF A COMMUNITY WALKING PROGRAM FOR OLDER ADULTS WITH MOBILITY CHALLENGES—WALK-ON!
Authors: Nicklas Barb , Hughes Jaime , Starr Kathryn Porter 
Published: December 2023

Abstract
Clinical trials in controlled settings show walking interventions improve function and reduce mobility loss in older adults. In the NIA-funded LIFE study, participants with more compromised function derived the most benefit, yet improvements were not sustained. Based on this research, clinicians often prescribe walking for older patients. However, few communities provide accessible opportunities for those with limited function to engage in safe, ability-appropriate, walking. Additionally, no evidence-based National Council on Aging exercise programs emphasize ambulation over longer distances in supervised and social settings. In collaboration with community partners, we developed and initiated Walk On!, a group-based, facilitator-led program designed to improve walking endurance, balance, confidence, and social connectedness in older adults with mobility challenges. In addition to walking, the program incorporates balance, gait, and flexibility components, and follows a safe progression based on individual ability. Sessions take place for one-hour, twice/week, over 12 weeks. The program is currently offered at four sites in Winston-Salem and Charlotte, NC (two churches-one primarily black membership and one primarily white, a YWCA, and a community fitness center). This symposium provides an overview of Walk On! and initial implementation. Both quantitative and qualitative program data on feasibility, satisfaction, and effectiveness for improving physical and psychosocial outcomes will be presented. Based on these early data, we believe there are countless underserved older adults who may be socially isolated due to limited mobility, yet are willing and would benefit from incorporating more ambulation in a safe and accessible environment.
LOOK AHEAD SLEEP: STUDY DESIGN AND BASELINE CHARACTERISTICS
Authors: Spira Adam , Bertisch Suzanne , Chen Haiying , Ding Jingzhong , Redline Susan , St-Onge Marie-Pierre , Hayden Kathleen 
Published: December 2023

Abstract
Older adults with obesity and type 2 diabetes (T2D) are at elevated risk for mild cognitive impairment (MCI) and dementia. Compared with younger persons, older adults are more likely to have sleep-disordered breathing (SDB), which is also common among adults with T2D and obesity and is associated with higher risk of dementia. The Look AHEAD Sleep (LA-Sleep) study investigates links of SDB and circadian rest/activity rhythms with cognitive performance, MCI, and dementia in older adults with T2D and obesity/overweight enrolled in Look AHEAD Aging (LA-A). LA-Sleep participants completed cognitive measures at baseline and were randomized to sleep measurement in the first (2022-2023) or second year (2023-2024). Sleep measures include assessments of SDB (WatchPAT), circadian rest/activity rhythms (ActiGraph) and daily sleep diary. Of those who enrolled in LA-A, 62.8% consented to LA-Sleep. To date in 203 participants have provided data from WatchPAT and 107 provided actigraphy data. Participants were a mean (±SD) age of 76.1±5.4 y, had a mean BMI of 34.2±6.7 kg/m2, 56.7% identified as female, and 75.4% were Non-Hispanic White, 12.3% Non-Hispanic Black, and 6.9% Hispanic. Approximately 90.2% had &gt;high school education. Of participants with obesity in 2018-2020, 27.9% (41/147) had an apnea hypopnea index (AHI) of ≥15 to &lt;30/h (moderate SDB) and 20.4% (30/147) had ≥30 events/h (severe SDB). Mean actigraphy-estimated total sleep time was 7.1±1.4 h, and mean wake after sleep onset was 62.5±31.0 min/night. Among adults with T2D and overweight/obesity, a high proportion have SDB and sleep fragmentation, potentially increasing risk for dementia.