bluuebunny/crossref_metadata_2025_split huggingface dataset:
DO RELIGION, CULTURE, RACE, OR ETHNICITY PLAY A ROLE IN CHOOSING PEG TUBE AT THE END OF LIFE?
Authors: Park Isabella , Hernandez Guisela , Lambert Frederick , Loccisano Elisabeth , Nouryan Christian , Cho Catherine , Gajraj Asha , Burns Edith 
Published: December 2023

Abstract
Although there is substantial evidence that Percutaneous Endoscopic Gastrostomy (PEG) causes significant morbidity and does not change mortality for patients with advanced dementia it continues to be used. We describe a quality initiative of Palliative Care Consultation (PCC) in conjunction with any new PEG evaluation. EMR review and interview with patient (and/or proxy) being evaluated for first-time PEG in two community hospitals within large health system in demographically diverse major metropolitan area. PCC teams provided consistent, culturally/religiously, language-sensitive education regarding PEG, conducted interviews about subsequent decision. Post-initiative PEG placement dropped from &gt;75% to 17.6%, 76 patients received PCC with PEG evaluation. Average age 83.5 (range: 56-108), 55% female. Religion: 54% Christian, 7% Muslim, 10% Jewish, 11% non-religious, 18% other; 46% White, 37% Black, 8% Asian, 8% Hispanic. Common evaluation reasons: difficulty swallowing (30%), low PO intake (30%). Majority of patients had dementia (71%), stroke (18%), Parkinson’s (8%). Most decision-makers (66%) hadn’t received prior counseling regarding alternate nutrition options. After PCC, 17.6% chose PEG, 79.7% careful hand feeding, 2.7% remained unsure. Those choosing PEG mostly desired “guaranteed” nutrition despite risks (10/13), and/or a trial seeking patient recovery (5/13). There were no apparent differences in race/ethnicity, age, sex, or religion that distinguished those electing PEG. PCC initiative to support patients and families “choosing wisely” around PEG placement for those with advanced illness has resulted in significant reduction. Decision-makers mostly cited wish to guarantee nutrition while some hoped for patient recovery. Religious affiliation and sex were not cited as reasons in this group.
DOES CRIMINAL VICTIMIZATION RAISE THE RISK OF IADL LIMITATIONS AMONG OLDER ADULTS?
Authors: Ren Jinnan , Sauerteig-Rolston Madison , Bell Mallory , Ferraro Kenneth 
Published: December 2023

Abstract
Many studies have analyzed the effect of victimization on children and young adults, but relatively few have explored its impact on older adults’ well-being. Drawing from cumulative inequality theory, this study analyzed a sample of 11,860 respondents aged 50 and older from the Health and Retirement Study (HRS) to examine whether victimization experiences, measured by physical attack/assault, robbery/home burglary, and fraud, raise the risk of limitations in performing instrumental activities of daily living (IADLs). The analysis, which used zero-inflated negative binomial models to examine the onset and severity of IADL limitations, revealed that criminal victimization was associated with a higher likelihood of IADL limitations (IRR=0.735, p&lt; 0.01), even after adjusting for demographic and health-related factors. Additional analyses examining the influence of each type of victimization showed that the experiences of a physical attack and robbery were related to IADL limitations. These findings demonstrate that criminal victimization experiences are associated with compromised IADL function, especially when the encounter involves an intentional act of immediate harm. There is a need for (a) additional research on the consequences of criminal victimization on the health and well-being of older adults and (b) interventions to help older adults who experience a personal or property crime.
EGG CONSUMPTION AND INCIDENT CARDIOVASCULAR DISEASE: VARIATION BY DIETARY PATTERN
Authors: Kritz-Silverstein Donna , Anuskiewicz Blake Blake 
Published: December 2023

Abstract
Some studies link egg consumption with cardiovascular disease, but none considers modification by dietary pattern. This study examines effects of egg consumption on incident cardiovascular disease (CVD), and variations of associations within the context of dietary pattern. Participants were 4,930 men and women from the Rancho Bernardo Study without prevalent CVD in 1972-74, who were followed through 2021 via mailed surveys, follow-up visits, and death certificates. Dietary data from 1988-91 enabled calculation of the alternate Mediterranean diet (aMed) score for 1632 individuals. Comparisons showed those with incident CVD (N=2066, 49.1%)were older (p&lt; 0.001), had higher BMI (p=0.004), cholesterol, triglycerides, systolic and diastolic blood pressures (p’s&lt; 0.001) than those without incident CVD, but did not differ in egg consumption. Those consuming more eggs/week were older (p&lt; 0.001) and had higher BMI (p=0.002). Men consumed more eggs/week than women (means=4.2 vs. 3.2, p&lt; 0.001). Adjusted Cox proportional hazards models showed there were no significant associations of egg consumption with incident CVD in men or women (HR=1.00, 95%CI=0.98-1.02; HR=1.01, 95%CI=0.99-1.03, respectively). However,analyses by dietary patterns showed that in men, but not women, increased egg consumption was associated with a 7% reduced risk of incident CVD (HR=0.93; 95%CI=0.88-0.98) among those with high aMed scores, but a 6% increased risk (HR=1.06; 95%CI=1.01-1.11) among those with low aMed scores. In conclusion, for men, dietary pattern modified associations such that among those with a healthier dietary pattern, egg intake was associated with lower incident CVD. For women, egg intake was unassociated with incident CVD regardless of dietary pattern.
ELDERLY CARE POLICY IN CHINA: ITS EVOLUTIONARY PATH AND IMPLICATIONS ON GOVERNANCE
Authors: Wang Qingwei , Ma Yu , Chen Jiayu 
Published: December 2023

Abstract
Over the years, the Chinese elderly care policy has undergone significant changes, leading to the systematic development of a comprehensive elderly care service system. This study explores the pivotal policies formulated by central policy-making bodies and examines the historical and current state of the elderly care system in China. The findings demonstrate a consistent alignment between the system’s evolutionary trajectory, the practical expectations of the population, and the Communist Party of China’s (CPC) objective of fostering a unified and balanced society. The study also highlights inherent issues concerning governance mechanisms and role-position within the system. Notably, we highlight the successful protection of older adults during the COVID-19 pandemic as an exemplary care of care service provision and draw lessons from international experience.
ENGAGING WITH AGING: OLDER ADULTS’ ADAPTATIONS TO URINARY CONCERNS
Authors: Wu Kuan-Ching , Ge Shaoqing , Chien Shao-Yun , Jin Jessica , Park Suah , Belza Basia 
Published: December 2023

Abstract
Urinary concerns (UC) increase with age impacting health and quality of life. The aims of this study were to describe: 1) UC as an age-related change (ARC); 2) the challenges of UC; 3) adaptation strategies used to manage UC; and 4) the value of engaging with aging (EWA) as a framework to promote self-management of UC. Data was used from semi-structured interviews with 29 older adults (mean age 77 years). An iterative coding process was used. A codebook was developed based on a-priori themes derived from the EWA framework, our previous publication, and a line-by-line coding of one of the transcripts. As the analysis progressed, additional codes emerged, enriching the codebook. Six themes emerged: 1) the participants’ experiences of UC; 2) responses to UC, 3) adaptation and management strategies; 4) knowledge and understanding of UC; 5) available capacities and resources; and 6) the impact of the COVID-19 pandemic on UC. Participants tended to address their UC by adjusting routines, medication schedules, or diet patterns. They tried to secure restroom locations or use tools or reminders to resolve their UC. COVID-19 led to increased inconvenience for older adults to engage in outdoor activities due to the closure of public restrooms. Through a comprehensive qualitative study and in-depth analysis of older adults’ UC and adaptations, these participants developed personalized adjustments to address their needs and abilities to their UC. These findings offer insights into the individual aging experience, which will further enhance our understanding and advancement of person-centered care.
EPISTASIS ASSOCIATION STUDY TO IDENTIFY NETWORK HUB GENES IN ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Evans Luke , Reynolds Chandra , Hoeffer Charles 
Published: December 2023

Abstract
Despite recent advances in understanding ADRD genetic risk, the vast majority of the genetic variance of AD/ADRD risk remains unexplained by identified loci such as APOE or the polygenic signal. One unexplored reservoir of genetic effects is interactions among genes (epistasis), which could identify key and novel molecular pathways, networks, and specific cell types in which the ADRD genetic risk is manifest. We tested all pairwise gene-gene interactions using our recently-developed transcriptome-wide interaction study method on ADRD in the UKBiobank. While no individual epistatic association was genome-wide significant (p&lt; 2.56e-10), several approached significance (p&lt; 3e-8). More importantly, we identified three core genes with &gt;10 suggestive epistatic interactions. These include genes with some limited, prior evidence of a role in ADRD etiology, but none that have been identified in single-locus GWAS. In follow-up enrichment analyses of neuronal annotations underlying the interaction associations, we found genes intolerant to protein truncating mutations (PI), and those expressed specifically in endothelial cells, excitatory neurons in the prefrontal cortex , neuronal stem cells, and PI excitatory dentate gyrus cells to be nominally enriched (p&lt; 0.05) in interaction associations with ADRD using prefrontal cortex imputed expression. Together, these suggest that we can uncover novel aspects of AD biology through these interaction associations and identify genes that may play a key role in integrating signals of AD risk. We anticipate identifying additional core genes and pathways as we integrate other larger and more diverse datasets.
ETHICAL CONSIDERATION IN HOME MONITORING ASSISTIVE ROBOT FOR COGNITIVE IMPAIRMENT: A SCOPING REVIEW
Authors: Wang Jing , LaRoche Dain , Begum Momotaz , Choquette Cassidy , Tang Xueting , Arthanat Sajay 
Published: December 2023

Abstract
As the aging population continues to grow, the demand for innovative technologies to support individuals with cognitive impairment in their daily lives has risen significantly. Home monitoring assistive robots (HMAR) have emerged as a promising solution, offering assistance with tasks, scheduling and safety monitoring. This scoping review aims to explore and synthesize the ethical considerations surrounding the use of HMARs for persons with cognitive impairment. We adopted the Arksey and O’Malley framework, encompassing five stages: identifying the research question, identifying relevant studies, selecting studies, charting the data, and summarizing and reporting results. A comprehensive search strategy was employed across electronic databases, including PubMed, PsycINFO, Scopus, and CINAHL, using search terms derived from titles, abstracts, and keywords identified in key publications and previous reviews relevant to the scope of this review. The synthesis of the 25 included literature highlights several key ethical dimensions related to HMARs for individuals with cognitive impairment, including autonomy and decision-making, privacy and surveillance, family dynamics and dyadic relationships, human-robot trust, cultural considerations, and equitable access to technology. The review underscores the complexity of ethical dilemmas posed by HMARs, including issues of informed consent, data security, power differentiation between persons with cognitive impairment and their caregivers, and disparities in technology access. The findings of this scoping review contribute to the ongoing discourse on the ethical implications of utilizing HMARs for cognitive impairment and provide insights for the development of responsible and inclusive technological solutions.
EVALUATING STOCHASTIC EPIGENETIC MUTATIONS: RELIABILITY, SUBTYPES, AND AN ALTERNATIVE DETECTION APPROACH
Authors: Markov Yaroslav , Higgins-Chen Albert 
Published: December 2023

Abstract
Stochastic Epigenetic Mutations (SEMs) have emerged as promising biomarkers for aging and age-related disorders. Conceptually, a SEM is defined as an outlier in DNA methylation (DNAme) value at a specific genomic site, compared to a given population or cohort. These mutations are seldom shared among subjects, emphasizing their potential to capture the heterogeneity of age-associated DNAme changes, and their cumulative count in individuals rises with age. We hypothesized that the original statistical method for SEM detection is not well suited for DNAme data and demonstrated its reliability constraints at both the individual and aggregate levels, using technical replicates from whole blood samples. In response to these challenges, we explored the factors influencing individual SEM reliability and identified best practices for SEM detection. We also developed an alternative machine learning-based detection method. Importantly, our classifier demonstrated improvements in the proportion of shared SEM and ICC scores when tested in an independent dataset with technical replicates, maintaining the associations of higher SEM loads with age, mortality, and cardiovascular disorders in the FHS study cohort. To support the wider application of our findings and address the need for SEM analysis tools, we have introduced a novel R package, SEMdetectR. Leveraging parallel programming, this package offers rapid SEM identification using both the original and new methods, accompanied by robust downstream analysis features.
EVALUATION OF THE ILLINOIS PUBLIC HEALTH ASSOCIATION ALZHEIMER’S DISEASE EARLY DETECTION AND AWARENESS CAMPAIGN
Authors: Bobitt Julie , Zahir Zohaib , Roseberry Krissy 
Published: December 2023

Abstract
Of the 55.8 million adults aged 65 and over in the US, nearly 12% are at risk for or have subjective cognitive decline (SCD), yet more than half have not seen a healthcare provider about their SCD. Furthermore, studies show that fewer than 50% of individuals with Alzheimer’s or a related dementia (ADRD) have been diagnosed by a physician. Missed diagnoses of dementia are more common among Blacks/African Americans than Whites and both Black/African American and Latinx individuals with cognitive impairment are less likely than Whites to report that a physician has diagnosed them. To adequately address community needs for ADRD early detection and awareness, the Illinois Public Health Association (IPHA) established the Alzheimer’s Disease Early Detection and Awareness Campaign and partnered with community-based organizations (CBOs) and their community health workers to educate underserved populations about the risk for ADRD and the importance of early screening, and to assist clients in achieving referral to ADRD care services. To evaluate the campaign, IPHA partnered with the University of Illinois Chicago. We used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) implementation outcomes framework to guide the evaluation and share quantitative and qualitative results including the number of participants that reached our target audiences, effectiveness of the program on participant knowledge and behaviors, adoption of the campaign elements by the CBOs, implementation barriers and facilitators, and intentions for program maintenance. Results and lessons learned can be used to inform awareness and education efforts in other communities with special emphasis on reaching underserved populations.
EXAMINING THE ASSOCIATION BETWEEN HYDRATION STATUS AND OBESITY IN OLDER ADULTS
Authors: Lafontant Kworweinski , Thiamwong Ladda , Stout Jeffery , Park Joon-Hyuk , Xie Rui , Fukuda David 
Published: December 2023

Abstract
Adequate hydration is an important modifiable determinant of overall physical health within community-dwelling older adults. Research and clinical practice often use urine osmolarity and bioelectrical impedance analysis (BIA) to assess hydration status. Prior evidence links inadequate hydration to increased obesity, typically measured by body mass index (BMI). However, this association has not yet been evidenced in community-dwelling older adults, especially in low-income settings. This cross-sectional study assessed 103 older adults (16 men, 87 women; mean age 75.7 ± 7.19 years; BMI 26.8 ± 5.22 kg/m2). Total body water (TBW), intracellular water (ICW), fat mass (FM) and fat-free mass (FFM) were measured using multi-frequency BIA (InBody S10). Linear regression analysis examined continuous BMI. TBW/FFM and ICW/FFM as hydration indicators showed weak correlation with FM (TBW/FFM: r = 0.357, p &lt; 0.001; ICW/FFM: r = -0.243, p = 0.013). However, only TBW/FFM significantly correlated with BMI (TBW/FFM: r = 0.236, p = 0.016; ICW/FFM: r = -0.143, p = 0.151). These results suggest TBW/FFM and ICW/FFM may not adequately indicate hydration status while maintaining sensitivity to body composition in adults aged 60-96 years. Further research should examine these findings using urine osmolarity as the hydration assessment.
EXAMINING THE ASSOCIATION OF HISTORICAL REDLINING WITH NURSING HOME QUALITY
Authors: Plummer Narcissa , Ratnayake Aneeka , Wong Chelsea , Olivieri-Mui Brianne 
Published: December 2023

Abstract

Aim
Redlining systemically relegated people of color to lower-resourced areas which are known to have had long-term effects on access to healthcare; however, it is not currently known if access to nursing home (NH) quality was impacted.

Methods
In this cross-sectional descriptive study, we created a Geographical Information Systems map of the distribution of Massachusetts NH in the year 2021, layered over a 1934 redlining map with neighborhood categories: Best, Still Desirable, Declining, and Hazardous. Our dataset included redlining categories, 2021 NH characteristics (e.g., bed size, 5-star quality rating), and change in median household income from 1930 – 2021 (proxy for resources, in 2021 dollars). Descriptive statistics estimated the association of each variable with NHs’ 5-star quality rating.

Results
The majority of NHs were in historically Declining (n=45,71%) or Hazardous (n=10,16%) neighborhoods. While 3% (n=2) were in Best neighborhoods. Both NHs in Best neighborhoods were 5-star, while 1 NH was 5-star in Hazardous neighborhoods. There were 63 NH included with a mean change in median household income of $47,684.06 (SD $37,844.01). The greatest increases in mean income were observed in hazardous neighborhoods containing 1-4-star NHs. The highest increase in mean income was $140,000 (n=1), occurring in a neighborhood with a 4-star NH.

Conclusion
Despite the growth of resources in hazardous neighborhoods, most NHs in these areas were less than 4-stars. Increasing resources may not benefit NH quality in historically redlined/hazardous areas. Future research should examine this phenomenon at a national level.
EXAMINING THE NON-LINEAR ASSOCIATION BETWEEN YEARS OF EDUCATION AND LATE-LIFE COGNITION
Authors: Robinson Sara , Salemi Jason , Meng Hongdao , Rijnhart Judith 
Published: December 2023

Abstract
Dementia, a rising health concern, is expected to impact 13 million adults in the United States by 2050. Low education is a well-established risk-factor for dementia. However, few studies have investigated possible non-linearity of the association between years of education and late-life cognition, nor have investigated gender differences in this association. This study aimed to investigate whether years of education is non-linearly associated with late-life cognition, and whether the size of this association differed across men and women. To address this aim, we used data from the U.S. representative Health and Retirement Study, encompassing a sample of 32,712 respondents with episodic memory data available between 1998 and 2018 and with complete data on self-reported education (median=12, interquartile range=12-15), gender (18,509 women, 14,203 men), and confounders (ethnicity, race, parental education, childhood immigration status, and birth year). Episodic memory was measured as immediate and delayed recall using a 10-word recall test. We used confounder-adjusted linear mixed-effects models to estimate the associations between years of education and immediate recall (model 1) and delayed recall (model 2). In both models, the estimated education-recall association was non-linear based on the statistically significant squared and cubic terms (p&lt; 0.001). Generally, an increase in education was associated with an increase in immediate and delayed recall, and these associations were more pronounced for larger education values. There were no statistically significant gender differences in the education-recall associations in both models. These findings indicate the importance of assessing non-linearity of the association between years of education and late-life cognition.
EXPLORATION OF STRESS FLUCTUATIONS IN FAMILY CAREGIVERS OF OLDER PEOPLE WITH MILD COGNITIVE IMPAIRMENT
Authors: Kabaya Sonoko , Greiner Chieko , Nakamura Masahide , Yamaguchi Yuko , Ryuno Hirochika 
Published: December 2023

Abstract
Mild cognitive impairment (MCI) is common, affecting 10%-35% of people over 65, and around two-thirds overall develop dementia over their lifetime. Previous studies have reported that family caregivers (FCs) caring for older people with MCI experience considerable burden, which tends to cause various neuropsychiatric symptoms, such as depression, apathy, and irritability. However, it is not clear how FCs’ stress, which leads to increased burden, fluctuates within a day through their daily activities. The aim of this study was to explore the characteristics of stress variability in FCs. We recruited one dyad of an older adult with MCI over the age of 65 and a FC. Data collection was performed continuously for 7 consecutive days. We adopted smart watches (GARMIN vívosmart 4) to measure Heart Rate Variability (HRV)-based stress. Moreover, we asked a FC to talk with a Virtual Agent (VA) on a laptop freely to understand when and what kind of daily activities were done and the FC’s feelings. Detecting change points in time series data was performed using Python 3.9. Results showed that change points in the FC’s daily stress appeared when the FC starts specific activities such as preparing meals and confirming some medicine that an older adult with MCI should take and daily schedules. The FC also expressed anticipatory grief at the prospect of future dementia through the VA. This finding is beneficial for considering how to reduce FCs’ stress during daily activities.