bluuebunny/crossref_metadata_2025_split huggingface dataset:
UNVEILING TENSIONS: CAREGIVING FOR OLDER ADULTS WITH CANCER IN THE COVID-19 ERA
Authors: Weiss Charlotte , Johnson-Koenke Rachel , Sousa Karen , Ulrich Connie , Hirschman Karen 
Published: December 2023

Abstract
The COVID-19 pandemic was traumatic for many individuals, including older adults with serious illness and their families. This qualitative study aimed to explore family caregiver narratives for the historical, societal, and institutional context of caring for older adults with advanced cancer during the COVID-19 pandemic. Using narrative inquiry alongside photo elicitation, 5 caregiver narratives were co-created during in-person semi-structured interviews or virtually through Zoom video conferencing. Each of the participant caregivers started caring for an older adult family member with cancer during the COVID-19 pandemic. Narratively derived thematic threads of COVID-19 emerged as short stories of tension woven throughout the cancer caregiver narratives. The themes within and across the narratives included: advocacy of quality healthcare for care recipients, protection of care recipients from COVID-19; protection of care recipients from medical institutional disregard; financial strain and uncertainty; lack of medical, emotional, social, and spiritual support; intention towards self-care; and saying goodbye in isolation. The backdrop of COVID-19 contributed to caregiver fear, anxiety, feelings of being alone, guilt, and emotional and physical exhaustion. Findings from this study highlight that cancer family caregivers experienced multiple layers of tension when caring for older adults with advanced cancer during COVID-19. By acknowledging tensions emergent through storytelling, researchers and clinicians contribute to valuing the diversity of individually and collectively lived human caregiving experiences and the uncertainty and turmoil in their lives.
USABILITY OF A SMARTPHONE APP DESIGNED TO COLLECT HEALTH INFORMATION IN OLDER ADULTS
Authors: Murabito Joanne , Faro Jamie , Zhang Yuankai , Demalia Angelo , Hamel Alexander , Agyapong Nakesha , McManus David , Borrelli Belinda 
Published: December 2023

Abstract
Few studies evaluate the usability of mobile-phone assessments in older adults. The aim of this study was to identify design-based barriers and facilitators to mobile app survey completion among two samples of older adults; those in the Framingham Heart Study (n=15, mean age 72 years, 40% women, 100% non-Hispanic, White) and, to aid with generalization, a more diverse sample (n=15, mean age 71 years, 47% women, 53% non-White, 20% Hispanic). We used mixed methods to ascertain information about challenging or beneficial features and functions of the mobile app. A variety of measures with different response formats were tested including self-reported surveys, pictorial format assessments (image of a body with checkboxes to indicate pain sites), and cognitive testing tasks, including Trail Making Test (TMT) and Stroop. Participants completed each of the measures using a think-aloud task, while being audio- and video-recorded. Recordings were coded for usability errors by two pairs of coders. Participants completed the Mobile App Rating Scale (MARS) to assess functionality and aesthetics of the app (range 1-5). In general, participants were satisfied with the app. In Framingham Heart Study participants, the average MARS functionality score was 3.6 (SD=0.7) and aesthetics score was 3.9 (SD=0.7) with no significant differences in the diverse sample. The majority of older adults did not have difficulty completing the self-report measures, unless there were lengthy instructions or the pictorial measure, but participants had usability issues with the Stroop and TMT. Our methods and results can guide app development and survey construction for older adults.
USING HEALTH INFORMATION EXCHANGE DATA FOR SOCIAL RESEARCH: CHALLENGES AND OPPORTUNITIES
Authors: Glicksman Allen , Ritter Ashley , Albert Steven , Davey Adam , Friedman Ari , Ring Lauren , Rodriguez Misha , Liebman Michael 
Published: December 2023

Abstract
Data collected in encounters between health providers and older adults can provide an important source of information regarding the experience of older persons with limited English Proficiency (LEP) in the health care system further enhancing our knowledge about health access in disadvantaged populations. Using data acquired from the local health information exchange (HIE) our team examined usage patterns of health services by Spanish and Chinese speaking older adults in Philadelphia. The data, which became available in July, represents one of the first opportunities to use HIE data to study these issues. HIE data link EMR records from providers across a defined geographic area to deliver information on patients served through participating organizations. The initial sample included reports on almost 200,000 persons with 7.7 million encounters. Each record contains information on type of encounter, diagnoses, insurance status, and related items. While availability of these data opens the opportunity to explore a variety of questions regarding health service use, methodological challenges to using HIE data are significant. These include (but are not limited to): 1) different coding schemes for key variables (e.g., encounter type, diagnosis); 2) LEP status, geography, and coding schemes may be confounded; 3) coding schemes used by providers may change over time so longitudinal data can include multiple coding types for the same patient; and 4) significant variation in coding race/ethnicity may be introduced for the same patient. We present examples of such challenges and approaches for resolution to enable and facilitate our analyses.
WHAT INTERFERES WITH OLDER ADULTS’ PARTICIPATION IN A MODIFIED PRESCRIBED EXERCISE PROGRAM?
Authors: Sefcik Justine , Harrison Sean , Skubic Marjorie , Richmond Therese , Hodgson Nancy , Demiris George 
Published: December 2023

Abstract
Exercise programs have great potential to help keep older adults active and independent in their homes. However, barriers to participation in a virtual coaching exercise program aimed at fall prevention is not well understood. This qualitative descriptive study with a conventional content analysis examined older adults’ perceptions of what interfered with their participation in a modified 3-month Otago exercise program. Ten older adults participated in five bi-weekly telephone coaching calls and interviews where they were asked about their last two weeks of exercise participation. Participants were mean age 71.3 (range 66 - 81), and mostly female (90%), Black (70%), and non-Hispanic (90%). While most of the participants routinely participated in their prescribed exercises, a few had difficulty completing the plan for some weeks. We identified two themes of what participants expressed had gotten in their way of routinely exercising: 1) distracted and busy (e.g., prepping for the holidays, death in the family, needing to clean home) and 2) physical problems (e.g., pain, being sick, injury). Only one participant said they lacked motivation, which resulted in them exercising less than their initial intention. These findings suggest that older adults want to participate in a routine exercise program, however, they sometimes have other priorities or physically cannot exercise. Program implementers should consider expanding timelines of physical training to account for weeks when older adults are unable to exercise and provide modifications for participants when ill, experiencing chronic pain, or have a new injury.
WORK-RELATED VIOLENCE OR HARASSMENT AND SICKNESS ABSENCE DUE TO COMMON MENTAL DISORDERS: A PROSPECTIVE TWIN STUDY
Authors: Hanson Linda Magnusson , Wijkander Maria , Narusyte Jurgita , Alaie Iman , Lindfors Petra , Xu Tianwei , Svedberg Pia 
Published: December 2023

Abstract
The aim of the present study was to investigate the association between exposure to unacceptable behaviors and practices or threats thereof in working life that result in or aim to result in physical, psychological, sexual or economic harm, such as violence and harassment including unwelcome conduct based on e.g. sex or gender (gender-based harassment/discrimination), and future sickness absence due to common mental disorders among Swedish twins. The study included 8795 twins, from the Swedish Study of Twin Adults: Genes and Environment, asked to report exposure to work-related violence or threats of violence and harassment or bullying and whom were followed-up for certified sickness absence (min 12 years of follow-up). Standard logistic regression indicated that exposure increased the odds of sickness absence due to common mental disorders (adjusted OR 2.11; 95% CI 1.52-2.95 for violence/threats, adjusted OR 1.52; 95% CI 1.10-2.11 for harassment/bullying). A co-twin control analyses based on conditional logistic regression restricted to twin pairs discordant for exposure, in which a co-twin control was used as reference, however, resulted in attenuated ORs (2.0; 0.79-5.07 and 1.56; 0.66-3.66, respectively). This indicates that the relationships could be at least partially confounded by familial factors, such as genetics and shared environment. These results suggests that more work is needed to clarify whether there is a causal association between these types of unacceptable behaviors/practices and mental health outcomes considering familial/genetic factors, and whether prevention of such behaviors/practices can keep individuals increasingly healthy, active on the labor market and promote healthy aging.
EFFECTS OF THE COVID-19 ON MEDICAL USE OF ELDERLY PATIENTS WITH HYPERTENSION: A NATIONWIDE COHORT STUDY IN KOREA.
Authors: Cho Eunbyul 
Published: December 2023

Abstract
COVID-19 pandemic disrupted healthcare services, including chronic disease management for vulnerable groups like older individuals with hypertension. This study aims to evaluate hypertension management in South Korea’s elderly population during the pandemic using treatment consistency indices like Continuity of Care (COC), Modified, Modified Continuity Index (MMCI), Most Frequent Provider Continuity (MFPC). This study used the the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service cohort (K-COV-N cohort) from the National Health Insurance Service (NHIS) between 2017 and 2021 The research included a total of 4,097,299 hypertensive patients aged 65 or older. We defined 2018 and 2019 as baseline period before COVID 19 pandemic, and 2020 and 2021 as COVID 19 period, and calculated the indices of medical continuity (Number of visits, COC, MMCI and MFPC) on a yearly basis were measured. The number of visits were decreased during COVID 19 period compared to baseline period ( 59.64 ±52.75 to 50.49 ± 50.33, p&lt; 0.001) respectively. However COC, MMCI and MFPC were not decreased in baseline period compared to COVID-19 period ( 0.71 ± 0.21 vs. 0.71 ± 0.22, p&lt; 0.001), (0.97 ± 0.05 vs. 0.96 ± 0.05, p&lt; 0.001), and (0.8 ± 0.17 vs. 0.8 ± 0.17, p&lt; 0.001) respectively. In conclusion, COVID-19 had no significant impact on continuity of care, but it did affect the frequency of outpatient visits of older hypertensive patients. However, this study highlights the importance of addressing healthcare inequalities, especially for older hypertensive patients, during pandemics and advocates for policy changes to ensure continued care for vulnerable populations.
MAKING OLDER ADULT FALL PREVENTION A ROUTINE PART OF HEALTHCARE IN TRIBAL CLINICAL SETTINGS
Authors: Bergen Gwen , Egashira Leo , Parker Myra , Causey Shakiera , Haddad Yara 
Published: December 2023

Abstract
Over one-third of American Indian and Alaska Native (AI/AN) elders (age 65+) report falling annually. This percentage is higher compared to other race/ethnic groups except for White non-Hispanic older adults. CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative provides guidance for making elder fall prevention a routine part of clinical care. The presentation will describe a survey of healthcare providers serving AI/AN populations to gauge their readiness to adopt STEADI. Additionally, it will focus on a culturally informed approach to implementing STEADI within tribal settings. The National Network of Public Health Institutes and Seven Directions, A Center for Indigenous Public Health, surveyed a convenient sample of healthcare providers in clinics serving AI/AN patients to assess providers’ knowledge and acceptability of fall prevention best practices, efforts to prevent falls, and receptiveness to receiving fall prevention training and support. The final sample included 94 healthcare providers from 27 clinics. Less than half of those surveyed reported screening elders for fall risk. Only 22% were familiar with STEADI. Most (84%) providers were willing to take part in fall prevention with additional training. Based on these findings CDC is funding two tribes to use an indigenous evaluation approach to improve their tribal health center’s elder fall prevention capacity through evidence-based clinical and clinical-community linked strategies. Results from these activities will be used to outline a best practices guide focused on coordinated care for fall prevention and tailored to the varied environments, governments, cultures, and capacity for public health action in tribal health centers.
THE VALUE OF TECHNOLOGY IN LGBT OLDER ADULTS’ SOCIAL NETWORKS: LESSONS LEARNED FROM COVID-19
Authors: Breder Kelseanne , Bockting Walter , Ziyalan Elvan , George Maureen 
Published: December 2023

Abstract
LGBT older adults maintain unique social networks. They are more likely to live alone, more likely to rely on peers for caregiving, and less likely to have intergenerational support to adopt technologies that help maintain relationships. This research explores how LGBT older adults used technology for social support during COVID-19 social distancing and identifies recommendations for improving social isolation and wellbeing in this population through telehealth guidelines and community programs. Semi-structured individual interviews were conducted with a racially and ethnically diverse sample of 15 LGBT older adults during the summer of 2020. Interview guides were designed according to The Convoy Model of Social Relations. Verbatim transcripts were coded using conventional content analysis. Three major themes were identified, highlighting ways LGBT older adults used technology to meet social support needs, and the perceived gaps in technological fluency that hinder social connectedness and telehealth acquisition: (I) Yearning for “The Hug Factor,” (II) Navigating Online Social Boundaries and (III) “Not for My Generation.” Findings emphasize resiliency strategies employed by LGBT adults during social distancing and quarantine mandates that may optimize social and psychological wellbeing among the general aging population, as well as other minority geriatric groups. Our finding may hold relevance during future periods of isolation due to aging, mobility limitations, and climate change. Recommendations for improving social support beyond the pandemic include talk therapies, telehealth policy initiatives, and targeted community programs.
DEVELOPMENT OF THE LONGITUDINAL STUDY OF HEALTH AND AGEING IN KENYA (LOSHAK)
Authors: Nagarajan Niranjani , Ehrlich Joshua , Ngugi Anthony , Mwangi Eunice , Riang’a Roselyter , Sayed Shaheen , Gichu Muthoni , Langa Kenneth 
Published: December 2023

Abstract
In Kenya, the number of adults aged ≥60 is expected to nearly quadruple by 2050, making it one of the most rapidly aging countries in Sub-Saharan Africa (SSA). Accordingly, we designed the Longitudinal Study of Health and Ageing in Kenya (LOSHAK) to generate novel data to address the health and economic consequences of this demographic transition. Modeled on the U.S. Health and Retirement Study (HRS), LOSHAK joins a network of harmonized studies on aging in &gt;45 countries worldwide; however, LOSHAK will be only the second such study in SSA. LOSHAK will advance population aging research in low- and middle-income countries through the study of: (1) biomarkers and physiological measures; (2) the impacts of air pollution and climate vulnerability; (3) Alzheimer’s disease and related dementias, mental health, disability, caregiving, and psychosocial wellbeing; and (4) economic security, including the impact of social welfare. The current feasibility and initial pilot testing phase of LOSHAK is nested within the Kaloleni/Rabai Community Health and Demographic Surveillance System on the coast of Kenya and aims to validate measures and data collection procedures in a purposive sample of Kenyan adults aged ≥ 45 years. Among 205 participants surveyed, the mean age was 64 years, 58% were female, and 37% were currently employed. In the future, a full-scale Wave 1 LOSHAK will collect data from a nationally representative panel of Kenyans aged ≥45 years and will inform future public health and economic policy to address challenges related to rapid aging in Kenya and throughout SSA.
MACHINE-LEARNING-BASED INTERPRETABLE PREDICTION FOR MILD COGNITIVE IMPAIRMENT: FROM ADNI DATABASE
Authors: Wu Yafei , Jia Maoni , Fang Ya 
Published: December 2023

Abstract

Objective
An accurate prediction model was still lacking for mild cognitive impairment (MCI). Therefore, this study aimed to predict the 3- and 5-year MCI risk utilizing interpretable machine learning, and to identify possible biomarkers for intervention.

Methods
A total of 444 participants were obtained from the ADNI database. Sociodemographic, neuropsychological, ApoE gene, and structural MRI imaging information was used as predictors. Data was randomly divided into training (70%) and test sets (30%). Six machine learning methods were constructed to predict the risk of MCI. Model performance was assessed by area under the ROC curve (AUC). SHapley Additive exPlanations (SHAP) was used to select important predictors. We also constructed a simplified MCI prediction model for clinical practice.

Results
The mean age (standard deviation) of study population was 73.7 (6.1) years old. A total of 40, and 60 participants progressed into MCI within 3, and 5 years, respectively. Logistic regression (AUC: 0.97) and support vector machine (AUC: 0.93) are the optimal model for 3- and 5-year prediction. The simplified models based on top three neuropsychological test scores also showed high prediction accuracy (AUC &gt; 0.90). APOE gene, intracranial volume, and Clinical Dementia Rating Scale Sum of Boxes (CDRSB) score were top three predictors for 3-year prediction, while CDRSB score, modified Preclinical Alzheimer’s Cognitive Composite Test with Follow-up Test scale (mPACCtrailsB) score, and Functional Activity Questionnaire (FAQ) score were top three predictors for 5-year prediction.

Conclusion
Interpretable machine learning showed promise in early identification of MCI, and would be valuable for targeted prevention.
AGE-RELATED KYNURENINE PATHWAY METABOLITES DRIVE SENESCENT-LIKE CHANGES IN NEURONS: POTENTIAL NOVEL AD MECHANISM
Authors: Kondrikov Dmitry , Kondrikova Galina , Dixon Steven , Krieg Carsten , Wang Gavin , Hill William 
Published: December 2023

Abstract
Kynurenine pathway (KP) metabolites are emerging as important factors of aging-related pathologies. Kynurenine (KYN) and its metabolites increase with age and are known to affect multiple organ systems including CNS, musculoskeletal, and vascular systems. Our group has previously shown that KYN and sub-KYN metabolites below the enzyme Kynurenine monooxygenase (KMO) can act to inhibit osteogenesis of bone marrow MSCs via senescence induction. However, inhibition of KMO, blocks KYN induced senescence and restores osteogenic potentials of MSCs. We are now expanding this work to see if KYN metabolites act on cells of the aging CNS in a similar fashion potentially helping to drive cognitive decline and Alzheimer’s disease (AD) progression. We report for the first time that treatment of neuroblastoma-like SH-SY5Y cells with KYN, and sub-KMO metabolites 3-hydroxykynurenine (3HK), or quinolinic acid (QA) significantly increased senescence-associate beta-galactosidase activity, and expression of senescence associated secretory phenotype (SASP) markers, p21, PAI-1, TIMP2 as well as Histone 3 K9methylation. Treatment of SH-SY5Y cells with KMO inhibitors prevented elevated expression of SASP proteins and histone methylation. This makes KMO an attractive target to inhibit kynurenine pathway effects. Taken together, these data suggest that KYN and its metabolites may contribute to pathogenesis of AD via inducing senescence-like changes and SASP-mediated neuroinflammation in neuronal cells. Inhibition of KMO may allow rescue of brain microenvironment, limit cognitive decline and AD progression in older persons. Blocking KYN downstream metabolite formation, by inhibiting KMO, presents a novel therapeutic target for a potential novel AD mechanism.
FEASIBILITY OF AEROBIC FITNESS TESTING IN AMNESTIC MILD COGNITIVE IMPAIRMENT FROM THE ACT TRIAL
Authors: Yu Fang , Salisbury Dereck , Lin Feng 
Published: December 2023

Abstract
Aerobic fitness has been postulated as a physiological mechanism of action for aerobic exercise to modify Alzheimer’s disease, but it has not been adequately studied in older adults with (MCI). The purpose of this study is to evaluate the feasibility of a gold-standard, laboratory-based, symptom-limited cycle-ergometer exercise testing (GXT) in older adults with amnestic mild cognitive impairment (aMCI) to assess peak oxygen consumption (VO2max [ml/kg/min]) using baseline data from the ACT Trial. The test was categorized as a submax, near-max, and max test based on if 0, 1, and ≥2 of the American College of Sports Medicine criteria was met: &gt;90% of age-predicted maximum heart rate, plateau in VO2Peak, respiratory exchange ratio &gt;1.10, and rating of perceived exertion &gt;17. VO2max was predicted as 3.5*maximal metabolic equivalents (METs). Among 146 enrolled participants (73.8±5.7 years old with 16.9±2.9 years of education, 51.4% men, and 91.8% Caucasian), 145 completed GXTs. Sixteen GXTs (11.0%) were submax (VO2Peak 13.5±4.4), 53 (36.6%) were near-max (VO2Peak 16.5±4.1), and 76 (52.4%) were max (VO2Peak 18.4±5.1). Predicted VO2max were 21.6±6.8, 28.7±26.3, and 30.0±20.5 from submax, near-max, and max tests, respectively. Among max GXTs, VO2max was 19.5±4.9 in men (n=37) and 17.4±5.1 in women (n=39). In conclusion, GXTs was feasible for ~52% of the participants. METs-based prediction overly inflates VO2max estimates, in comparison to VO2max obtained from max GXTs. VO2max levels are substantially lower in older adults with aMCI than peers (23.1±6.3 in men and 21.1±3.4 in women), suggesting aerobic exercise as an important intervention for this population.