bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEIGHBORHOOD HEALTH CARE FACILITIES AND INCIDENT DEMENTIA: RESULTS FROM THE EINSTEIN AGING STUDY
Authors: Hyun Jinshil , Hall Charles , Katz Mindy , Derby Carol , Lipton Richard 
Published: December 2023

Abstract
Though access to health care is associated with improved chronic health outcomes, data on dementia risk are limited. From the Ecological Model of Aging, limited access to health care facilities may be associated with increased likelihood of developing dementia through poor management of comorbidities. The current study aims to investigate the association between the density of neighborhood health care facilities and incident dementia. Participants were community-dwelling older adults, systematically recruited from Bronx, NY (N=1,461, mean age=78.4; mean follow-ups=4.6 years; 68% non-Hispanic White, 26% non-Hispanic Black). Density of health care facilities in each participant’s Census Tract was derived from the National Establishment Time-Series data. We used Cox proportional hazards models using age as the time scale and adjusted for sex, race, education, income, and neighborhood deprivation. Incident dementia developed in 10% of the sample. Older adults living in the areas with lower density of health care facilities, compared to those living areas with a higher density of health care facilities, were at increased risk for incident dementia (HR=1.79, 95% CI=[1.12, 2.87] for lowest vs. highest tertile; HR=1.65, 95% CI=[1.02, 2.66] for intermediate vs. highest tertile). Further controlling for cardiovascular and other comorbidities did not change the pattern of results. The current results suggest that unequal distribution of health care facilities across geographic locations may help account for cognitive health disparities among older adults. Future studies will need to identify behavioral and individual-level mechanisms (e.g., healthcare use, better treatment before disease occurs) in the association between neighborhood health care facilities and dementia.
NURSING ASSISTANT TURNOVER IN HOME HEALTH CARE AGENCIES: A SCOPING LITERATURE REVIEW
Authors: Wagner Jennifer , Miller Vivian , Maziarz Lauren , Burek Melissa , Bell Julia , Perry Kaley 
Published: December 2023

Abstract
Certified nursing assistants (CNAs) who work in Home Health Care (HHC) are part of the continuum of care and aid in reducing the burden to the acute care system. CNAs assist patients with their activities of daily living and provide social engagement. Since CNAs see patients more frequently, they are crucial for referral to the nursing staff in times of crisis. The Affordable Care Act was enacted in 2010 which expanded HHC services and provides consumers with more health care options. There is a projected 25 percent increase in CNAs needed in HHC between 2021 and 2031. Despite the growth in HHC, the sector has high turnover rates of CNAs. It is estimated that 35 to 65 percent of CNAs leave HHC employment annually. This scoping review utilized the Job Demands-Resource (JD-R) and the Social-Ecological (SE) models to identify trends in turnover. The JD-R can be used to understand how the demands of one’s job as well as the engagement in one’s work can affect overall work-related stress, health, and motivation, and is contrasted with available job resources. The SE framework was used to explore levels of influence, and examines how individuals, relationships, communities, and society interact to influence behavior and perceptions. By using both the JD-R and SE models, it is easier to conceptualize the interaction of factors impacting turnover and that many of these factors are unique to CNAs in HHC. The difficult nature of the work, low pay, and low autonomy mean identifying job resources is critical.
OBLIGATIONS IN JAPAN: A THREE-YEAR LONGITUDINAL STUDY OF MID-LIFE ADULTS
Authors: Oh Jeewon , Lee Han Na 
Published: December 2023

Abstract
Obligations embody a sense of responsibility, whether they are directed toward close relationships or the broader public community. Middle-aged adults may find themselves in increased caregiving roles, but research examining the role of their obligation on their well-being and relationships is scarce. Across studies, obligation is linked with both positive (e.g., higher well-being and relationship quality) and negative outcomes (e.g., greater burden). A previous study in the U.S. suggested that these mixed findings may be partially because there are various types of obligations that differ on the level of investment. Given the Japanese collectivistic culture that values intricate social connection, their obligation may take on a different form and play a different role. We used two waves of data from the Midlife in Japan Project (2009-2012). Participants were 371 middle-aged adults (M = 55.47, SD = 14.04, 56.02% women, 43.98% men, 71.73% married) living in Japan. We factor-analyzed the structure of obligation and found a 3-factor solution fit best (e.g., RMSEA = .06, SRMR = .01, CFI = 1.00). Obligation could be characterized by holding light and substantive obligations to close others and obligations to the public community. Results suggest differential links between the types of obligation and well-being outcomes. For instance, light obligation predicted less negative affect (β = -.24, p = .035) after three years, but otherwise, other types of obligation did not predict positive or negative affect. Links with relational outcomes (e.g., support/strain) and implications of midlife obligations will be discussed.
OLDER ADULTS’ PERCEPTIONS OF HOPE REGARDING THEIR ABILITY TO MAKE DIET AND EXERCISE CHANGES
Authors: Worthington Amber , Golden Dale , Howell Britteny 
Published: December 2023

Abstract
Successful aging is facilitated by healthy diet and exercise levels; however, older adults may face barriers to obtaining these. One key motivator for improving older adults’ diet and exercise may be perceptions of hope. Persuasive Hope Theory (PHT) posits that hope motivates behavior by focusing peoples’ thoughts on opportunities for actions that lead to future rewards. Research suggests hope is particularly motivational for older adults, yet little work has examined factors that lead older adults to feel hope. In line with PHT, this project examined whether older adults’ perceptions that increasing fruit and vegetable intake (FVI) and exercise are important, possible, congruent with their goals (i.e. goal congruence), and will lead to a better future (i.e., future expectation), influence feelings of hope. A convenience sample of participants (N=58) aged 57-87 (M=71.98, SD =8.74) living in urban Alaska completed a questionnaire as part of a larger study. A multiple regression analysis revealed that importance (M=4.40, SD=0.67) and future expectation (M=4.47, SD=0.66) for increasing FVI significantly predicted feeling hopeful about increasing FVI (M=4.40, SD=0.75), but perceptions that increasing FVI is possible (M=4.26, SD=0.74) and goal congruent (M=4.34, SD=0.64) did not (F(4, 53)=11.29, p&lt;.05, R2=.46). The PHT variables for increasing exercise did not significantly predict feeling hopeful about increasing exercise. These results suggest PHT, specifically importance and future expectation, may be used to strategically design messages to increase older adults’ hopeful feelings for increasing FVI; however, more research is needed due to the limitations of the small convenience sample.
OPTIMIZING MEALTIME (OPTIMAL) IN NURSING HOME RESIDENTS WITH ADRD: A PILOT TRIAL OF A PERSON-CENTERED CARE PROGRAM
Authors: Liu Wen , Suh Heather , Williams Kristine , Galik Elizabeth , Resnick Barbara , Buckwalter Kathleen , VanHaitsma Kimberly , Rakel Barbara 
Published: December 2023

Abstract
Nursing home (NH) residents living with dementia (residents) commonly experience behavioral symptoms during mealtime that negatively impact nutrition and function. Residents may not receive optimal, person-centered mealtime care (PCMC) due to multilevel factors. PCMC training that teaches staff to actively engage residents in eating is a prioritized modifiable factor. We developed Optimizing Mealtime (OPTIMAL), a multifaceted, evidence-based, theoretically grounded PCMC program with five components: community stakeholder engagement, environment/policy assessment/modifications, staff education, individualized care planning, and ongoing motivation. OPTIMAL is designed to create and maintain a supportive PCMC culture/environment through appropriate assessments and modifications of factors to optimize mealtime care and outcomes. Our pilot trial (single-group repeated measures design, stakeholders’ interviews) demonstrated OPTIMAL was feasible, acceptable, and perceived useful as evidenced by high recruitment (74%, 77%) and retention (94%, 99%) rates for residents and staff, successful completion of data collection/coding and intervention delivery, and positive stakeholders’ feedback. We recruited 95 staff (age=45±12.1 years, 8.5% male, 12.3% non-white, 89% experienced mealtime care challenges) and17 residents (age=74±7.9 years, 88.2% male, 11.8% non-white) from 8 memory care units of one NH. Stakeholders perceived OPTIMAL was useful for staff who provide care to residents with and without dementia who need assistance and/or experience behavioral symptoms during mealtime. Videotaped observations of dyadic mealtime interactions (N=265) at baseline and 6- and 12-weeks following OPTIMAL showed that resident functional impairments and resistive behaviors during mealtime decreased during the study period. Findings provide preliminary evidence for feasibility, acceptability, and usefulness of OPTIMAL in NH staff and residents with dementia.
ORAL HEALTH AMONG FILIPINO OLDER ADULT IMMIGRANTS
Authors: Ea Emerson , Wu Bei , Hu Jinyu 
Published: December 2023

Abstract
Poor oral health has been associated with decreased quality of life, various non-communicable diseases, and a higher risk of mortality. There is also evidence that older immigrants and those who have been in the US for less than 5 years are more likely to have periodontitis, a serious gum disease and a common oral health condition. Despite this evidence, there is a paucity of studies investigating the influence of acculturation, immigration-related experiences, and resilience on oral health among older Filipino immigrants. To address this significant knowledge gap, a mixed methods study using a survey and focus group interviews was conducted among community-dwelling Filipino immigrants aged 60 years and older. This poster will present the results of the survey (N=103), which used a socio-demographic questionnaire, as well as valid and reliable instruments such as the Geriatric Oral Health Assessment Index, A Short Acculturation Scale for Filipino Americans, Everyday Discrimination Scale, and Connor-Davidson Resilience Scale. The results of the regression analysis revealed that the perception of discrimination and resilience were significantly associated with the perception of oral health among the participants surveyed [F(10,92) = 1.985, p &lt; 0.05]; this regression model accounted for 18.6% of variance in the perception of oral health. The findings support the need for culturally sensitive interventions that could optimize oral health, including the utilization of dental care services for this underserved population.
PERCEIVED HOUSING PROBLEMS AND DEPRESSIVE SYMPTOMS AMONG MIDDLE-AGED AND OLDER AMERICANS
Authors: Lu Peiyi , Kong Dexia , Cao Feifan , Shelley Mack 
Published: December 2023

Abstract

Background
Housing insecurity has been shown to be associated with worse mental health. However, previous studies mostly examined one dimension of housing insecurity (e.g., affordability) and few focused on older adults. This study examined the relationship of perceived housing problems with depressive symptoms among middle-aged and older Americans.

Method
Longitudinal data from the Health and Retirement Study 2006-2018 were used. A total of 7,285 respondents (aged 50+ at baseline) were followed-up every 4 years. Respondents self-reported the status, severity, and duration of their housing problems. Depressive symptoms were assessed by the Center for Epidemiological Studies-Depression Scale (CESD). Mixed-effect models were used to examine the association between perceived housing problems and depressive symptoms, adjusting for individual-level, household-level, and housing-related confounders.

Results
About 5%-7% of respondents had housing problems during every study visit and 5.67% of them experienced persistent housing problems over the study period of 12 years. Having housing problems was associated with higher risk of depressive symptoms (IRR=1.30, 95% CI=1.23, 1.36). A dose-response relationship was observed in the severity and duration of housing problems, with greater increase of depressive symptoms risk among those experiencing more severe or longer duration of housing problems. Results were similar when modelling the risk of elevated depressive symptoms using a binary measure (CESD score ≥ 4).

Conclusion
Perceived housing problems were associated with worse mental health among middle-aged and older Americans. The dose-response pattern highlighted the importance of early intervention and consistent assistance to those experiencing housing problems.
PERCEPTIONS OF THE ROLE PLAYED BY LIVING ALONE IN PROVIDING SERVICES TO PATIENTS WITH COGNITIVE IMPAIRMENT IN THE US
Authors: Portacolone Elena , Johnson Julene , Kotwal Ashwin , Stone Robyn 
Published: December 2023

Abstract
Given the estimated 4.3 million older adults from diverse racial/ethnic backgrounds who are living alone with cognitive impairment in the US, the objective of this study was to identify the potential moderating role of living alone in the use of healthcare and social services for patients with cognitive impairment by eliciting providers’ perceptions of caring for diverse patients with cognitive impairment living alone, in comparison to counterparts living with others. This study used semi-structured interviews conducted between March 2021 and June 2022 with purposively sampled providers of services to patients with cognitive impairment in MI, CA, and TX. An inductive content analysis was used to analyze the data. The majority of the 76 interviewed providers cared for racially/ethnically diverse patientt. Providers represented 20 professions. Providers elucidated specific factors that made serving people living alone with cognitive impairment (PLACI) more challenging, as well as specific factors that increased their concerns when serving PLACI. Providers also elucidated reasons for systematic unmet needs of PLACI for essential healthcare and social services. The vast majority of providers underscored the critical, yet understudied, role of living alone in moderating access to essential healthcare and social services among patients with cognitive impairment. Findings suggest that living arrangement are a social determinant to health among patients with cognitive impairment because PLACI are more likely to experience gaps in services because they are more challenging to serve than counterparts living with others and the healthcare system is not equipped to address these challenges.
PHARMACOLOGIC AMPK ACTIVATION IMPROVES HEALTHSPAN AND LIFESPAN IN NORMAL AND PREMATURE AGING MODELS
Authors: Akin Ozlem Altintas , Mitchell Sarah , Sturla Shana , MacArthur Michael 
Published: December 2023

Abstract
Cockayne Syndrome (CS) is a rare autosomal recessive childhood disease, caused by mutations in CSA (ERCC8) or CSB (ERCC6) genes leading to defective DNA damage repair. CS characteristics include UV sensitivity and premature aging. Deficiencies in CSA or CSB may lead to impaired AMP-activated protein kinase (AMPK) activation. Notably, AMPK-activating interventions have shown promise in preclinical CS mouse models. We tested whether MK8722, an AMPK activator, could mitigate CS phenotypes in a C. elegans model. Our preliminary data show that MK-8722 increases lifespan in wild-type and CS worm model. We also tested the effect of MK-8722 on brood size as a fitness parameter and showed that it does not change the total brood size. We also showed that treating aged mice with MK-8722 improves multiple measures of healthspan including body composition, grip strength and age-associated inflammation. These data suggest that AMPK activation may be a promising therapeutic avenue for both normal and CS-associated aging phenotypes
PRESENCE OF DYSPHAGIA IN A COHORT OF PERSONS LIVING WITH DEMENTIA: OUTCOMES FROM A MULTIDISCIPLINARY CLINIC
Authors: Yee Joanne , Brates Danielle , Mackowicz-Torres Meredith , Robison Raele , Lewis Brian , Clark Lindsay , Wanninger Ellen , Rogus-Pulia Nicole 
Published: December 2023

Abstract
The Cognitive Care Clinic (CCC) provides evaluation for Veterans living with dementia. Speech-language pathology (SLP) is incorporated to facilitate early identification and proactive management of dysphagia. This project sought to describe dysphagia frequency in persons living with dementia (PWD) in CCC. Multidisciplinary assessments led to consensus diagnosis of dementia subtype. Stage was determined using the Functional Assessment Staging Tool (FAST). Validated dysphagia screening tools included Eating Assessment Tool (EAT-10), water swallow test (WST), and Test of Mastication and Swallowing Solids (TOMASS). Penetration-Aspiration Scale (PAS) scores were determined following videofluoroscopic swallow studies (VFSS); scores were classified as “safe” (PAS&lt; 3) or “unsafe” (PAS&gt;=3). Descriptive statistics were calculated for dementia subtype, stage, and dysphagia measures. 78 Veterans were diagnosed with dementia between 2017 and 2023 (mean age=77 years; 5% female) and completed dysphagia screening. The majority had Alzheimer’s disease (43%) and were in the mild disease stage (61%). 37% failed the WST, suggesting impaired safety. 49% failed the TOMASS, indicating masticatory inefficiency. 26% scored 3 or higher on EAT-10, indicating increased dysphagia risk. 22 patients completed VFSS; 55% exhibited unsafe swallows. No significant differences in EAT-10 total scores were observed between those with safe and unsafe PAS scores. Nearly half of this cohort demonstrated signs of swallowing impairment based on clinical testing and/or VFSS. Additionally, EAT-10 scores were low overall with no differences based on dysphagia status on VFSS, which suggests underreporting of dysphagia. These findings highlight the necessity of SLPs in dementia care teams to support early identification and management of dysphagia.
PREVALENCE OF METABOLIC COMORBIDITIES AMONG COGNITIVELY NORMAL AND IMPAIRED WHITE AND AFRICAN AMERICANS
Authors: Turaani Mohammad , Pal Subhamoy , Reader Jonathan , Giordani Bruno , Kavcic Voyko 
Published: December 2023

Abstract
Assessing comorbidities associated with a MCI diagnosis is crucial for diagnostic accuracy and for understanding the role of comorbidities in cognitive decline. In this study of amnestic (aMCI) and non-amnestic (naMCI) MCI participants and persons with normal cognition (CN), we compared the prevalence of three primary comorbidities: Hypertension (HTN), Hyperlipidemia (HLD), and Diabetes Mellitus (DM) across African American and White populations using Chi-squares. Participant data (N = 9,342, 17% African American) were available through the National Alzheimer’s Coordinating Center and included: CN (n = 5,963; MOCA mean=27), aMCI (2,694; MOCA=22), and naMCI (685; MOCA=24) with diagnosis and data per their first Uniform Data Set (Version 3) visit. Significant differences in the distribution of HTN, HLD, and DM were found among the diagnostic groups for the total cohort and racial groups, separately; however, diagnostic differences across races were not always consistent. The relative rates of DM and HLD across the diagnostic groups for both races were generally similar, though higher percentages were seen in African Americans (25% of African Americans, 10% of Whites). As for HTN (52% of African Americans, 39% of Whites), however, the distributions differ across the diagnostic groups and race (%yes for diagnosis; White Americans: CN 35%, aMCI 47%, naMCI 44%; African Americans: CN 66%, aMCI 70%, naMCI 79%, p&lt; 0.001). These findings highlight the importance of considering the contributions of both race and diagnosis when evaluating the role of comorbid factors and metabolic disorders in NC and MCI groups, in particular when considering blood pressure-related measures.
RED BLOOD CELL DISTRIBUTION WIDTH: WHAT CAN IT TELL US?
Authors: Oberdier Matt , Zampino Marta , Shardell Michelle , AlGhatrif Majd , Lakatta Edward , Simonsick Eleanor , Ferrucci Luigi 
Published: December 2023

Abstract
Red blood cell distribution width (RDW), a measure of red blood cell size variability used in evaluating anemia, has been found to predict cardiovascular disease (CVD) morbidity and mortality. RDW increases with age, but the determinants of age-associated elevation in RDW independent of CVD and associated risk factors is limited. Therefore, we examined the association of RDW within the normal range (11.5-15.0%) with age, sex, race, other red blood cell properties, major cardiovascular disease risk factors, and other physiologic data. Data were from 606 men and 627 women (aged 50-95) participating in the Baltimore Longitudinal Study of Aging. Candidate correlates of RDW were included in multiple linear regression models; a reduced model was then obtained by backward selection. RDW was higher with age and female sex. Differences in RDW by sex were explained by hemoglobin, mean corpuscular hemoglobin, and mean corpuscular volume. Further, mean platelet volume (STβ=0.0779, P=0.007), interleukin-6 (STβ=0.0774, P=0.011), erythrocyte sedimentation rate (STβ=0.0746, P=0.028), institutional normalized ratio (STβ=0.0836, P=0.004), thyroid stimulating hormone (STβ=0.0653, P=0.023), and body mass index (STβ=0.1725, P=8.98E-8) were all independently associated with RDW. In the final model, age remained a strong correlate of RDW (STβ=0.2412, P=2.91E-12). In summary, inflammation, metabolic rate, and body habitus independently predict RDW, but do not completely explain its association with age. Future investigation of longitudinal change in RDW with age and its association with these and other factors is needed to advance knowledge on the timing and potential mechanisms of age-associated increases in RDW, and its implication for health outcomes.