bluuebunny/crossref_metadata_2025_split huggingface dataset:
SOCIAL DETERMINANTS OF HEALTH AND AGING: DISPARITIES AND BARRIERS TO ORAL HEALTH CARE AMONG OLDER ADULTS IN ALABAMA
Authors: Smith Nathan , Cofield Stacey , Mazer Raquel 
Published: December 2023

Abstract
Limited data exists on the oral health status of the older adult population of Alabama; improved surveillance programs are needed for estimations and planning. Aim: This study compares gender, racial, and economic differences in barriers to oral healthcare among older adults in Alabama. Methods: Self-reported, voluntary surveys including sociodemographics, oral care behaviors, and care utilization were completed along with intraoral screenings at senior centers and senior living communities. Univariate analyses were conducted using Chi-Square or Fisher’s Exact test, p&lt; 0.05 considered meaningful. Results: 357 respondents were assessed: mean age 73.4 (SD 8.4), 70.3% female, 57.1% Black/African American (AA), 42.9% Caucasian (Ca), 88.8% sole source of income Social Security/Disability. Ca were more likely than AA to have dental insurance (65.0 vs 51.5%, p=0.013), and more likely to have had a cleaning/check-up (20.9 vs 12.3%, p=0.029). Those with income &lt;$1500/month who received dental care were more likely to receive care for dentures compared to those with higher income (17.1 vs 8.0%, p=0.030). Those still driving who received dental care were more likely to have had a cleaning/check-up compared to those not still driving (20.9 vs 9.2%, p=0.025). Untreated tooth decay was detected in 25% of those with remaining dentition and was more common among AA than Ca (57.4 vs 44.4%, p=0.035). Conclusions: The preliminary analysis points to the need to further explore access to oral health services for older Alabamians living independently. Further data is needed for planning and policy making. Barriers to care were not explored for those who are homebound.
EPIGENETIC AGE ACCELERATION AND IMMUNE CELL COUNT: A TWIN STUDY
Authors: Penichet Eric , Beam Christopher , Bakulski Kelly , Turkheimer Eric , Higdon Kristin , Ryan Lesa , Sikes Kendra , Davis Deborah 
Published: December 2023

Abstract
Accelerated aging, as measured by epigenetic clocks, is associated with declines in immune system functioning. Investigating the causal basis of this association may provide mechanistic insight into the link between DNA methylation, on which epigenetic clocks are based, and age-related changes in immune cell composition. Using preliminary data from the Louisville Twin Study, this study examined the genetic and environmental sources of covariation between immune cell count (neutrophils, lymphocytes) and GrimAge Acceleration. GrimAge is a composite biomarker derived from 7 DNA methylation-based surrogates associated with mortality and smoking pack years. GrimAge Acceleration is the residual of GrimAge regressed onto chronological age. Participants consisted of 43 monozygotic twin pairs and 30 (18 same-sex) dizygotic twin pairs with a mean age of 54.5 years (sd = 5.27). Phenotypic analyses revealed that GrimAge Acceleration was significantly associated with neutrophil and lymphocyte count (r = 0.45 and -0.49, respectively). To examine the sources of covariation between these variables, biometric regression models were used to decompose the covariance between GrimAge Acceleration and neutrophils (and lymphocytes) into genetic and environmental components. Bivariate analyses revealed moderate, marginally significant genetic correlations between GrimAge Acceleration and immune cell count (rg = 0.32 and -0.38 for neutrophils and lymphocytes, respectively) and large, significant nonshared environmental correlations (re = .58 and -.54 for neutrophils and lymphocytes, respectively). Common genetic factors accounted for 39% of the phenotypic correlation in neutrophils and 43% in lymphocytes, whereas common nonshared environmental factors accounted for 61% and 57% of the correlation in these cell types, respectively.
UNRAVELING NONGENOMIC MECHANISMS BY WHICH 17A-ESTRADIOL EXTENDS HEALTHSPAN AND LONGEVITY
Authors: Zomer Helena , Sirohi Vijay , Medrano Theresa , Cooke Paul 
Published: December 2023

Abstract
Recent work indicates that exogenous 17α-estradiol (17α-E2), a stereoisomer of 17β-E2, produces unprecedented longevity increases (~20%) in male mice, challenging prevailing assumptions that 17α-E2 is a weak estrogen. However, is unclear how 17α-E2 acts. Therefore, this study aimed to obtain mechanistic insights into 17α-E2 actions in the uterus, the most widely used vivo model system for estrogen action. We hypothesized that 17α-E2 signals through membrane (m)ESR1 to affect target tissues and promote longevity. To test this, we treated pre-pubertal (postnatal day 20) female CD-1 mice with 3 daily IP injections of vehicle or 10 mg/kg of 17α-E2 or 17β-E2 (n=4/group). 17α-E2 treatment did not significantly increase uterine weight – a marker of nuclear (n)ESR1 signaling (20.3 ± 2.1 mg vs. vehicle 15.7 ± 2.0 mg, p&gt;0.05), while 17β-E2 strongly increased it to 41.4 ± 1.1 mg (p&lt; 0.05). Accordingly, histological analysis revealed reduced cell proliferation in 17α-E2- vs. 17β-E2-treated uteri. Both 17α-E2 and 17β-E2 robustly stimulated epithelial p-ERK and p-AKT expression, the active phosphorylated forms of these protein kinases, and western blotting showed a strong and comparable stimulation of EZH2, a critical mediator of estrogen’s epigenetic effects, which are linked to mESR1 signaling. In conclusion, our results indicate that despite limited actions through nESR1, 17α-E2 robustly signals through mESR1 to activate uterine protein kinase cascades and produce epigenetic effects. These findings may cause a significant reappraisal of 17α-E2 biological effects and role in normal estrogen physiology and provide critical insights into its unique ability to stimulate longevity.
WORKING TOGETHER TO PROVIDE GERIATRIC CARE: INTERDISCIPLINARY TEAM CREATION AND EVALUATION IN CANADA
Authors: Strong Jessica , Kerzner Rachel 
Published: December 2023

Abstract
Prince Edward Island is Canada’s smallest province (pop. 160,000) and has one of the oldest populations in Canada. While there is a robust and growing geriatrics program through provincial healthcare, it consists exclusively of medical providers (i.e., geriatricians and nurse practitioners). An opportunity for formal interprofessional collaboration presented itself when the University of Prince Edward Island began a Doctor of Psychology (PsyD) program in 2019. Soon thereafter, we established an interdisciplinary team between the PsyD and the provincial geriatrics programs. The goals of the team included: 1) enhancing care for older adults on the island, 2) providing training for PsyD students, and 3) increasing interprofessional collaboration and learning. In an evaluation of the first year of the collaboration, we collected data on the types of referrals and characteristics of the patients referred (e.g., number of medications), and asked all providers on the team (N=4 geriatricians, N=9 nurse practitioners, and N=4 psychology student clinicians) to answer open ended questions on the highlights and challenges of establishing the team, the organization of formal team meetings, and provision of patient care. Of the 74 patients seen by psychology, reasons included cognitive or psychodiagnostic assessment (N=22, 30%), psychotherapy (N=20, 27%), caregiver support (N= 25, 34%), or multiple services (i.e., both assessment and intervention; n=7, 10%). Additional patient characteristics will be shared, as well as themes from provider survey responses. Our program has implications for other areas in rural North America, particularly training opportunities built into our team functioning.
UNDERSTANDING THE MEANING OF CARE: FROM THE PERSPECTIVE OF SPOUSE CAREGIVERS OF PEOPLE WITH PARKINSON’S DISEASE
Authors: Lee JuHee , Yoo Subin , Kim Eunyoung , Park Hyeran , Kim Yun Joong , Chung Seok Jong , Yoo Jee-Hye 
Published: December 2023

Abstract
Parkinson’s disease is a highly prevalent geriatric disease in people aged 60 years and over. Parkinson’s disease can largely affect an individual’s life because it causes diverse motor and non-motor symptoms. As symptoms worsen, people with Parkinson’s disease are likely to become dependent, which can lead to caregiver burden. Therefore, the aim of this study is to understand the meaning of care in spouse caregivers who care for people with Parkinson’s disease. This study is a qualitative study using face-to-face in-depth interviews. A total of 15 spouse caregivers (10 husbands and 5 wives) were recruited from a neurological outpatient clinic at a tertiary hospital in South Korea. Two trained nurses interviewed spousal caregivers, and thematic analysis was used for data analysis. In this study, four themes were identified: (a) symptom management, (b) struggling to care, (c) intimacy with one’s spouse, and (d) uncertainty of the future illness progress. People with Parkinson’s disease experienced at least more than one motor or non-motor symptoms. Physical function and lifestyle modification of people with Parkinson’s disease, caregivers’ positive attitude towards the care role, and intimate relationships were key factors of self-care. For caregivers, the progression of disease was the major concern of care. Given that the number of older households is increasing in Asia, it is important to understand older spouse caregivers’ perspective for care of people with Parkinson’s disease. By understanding their needs and difficulties, healthcare providers can build further plans for them.
YOGA, TAI CHI, AND PILATES AND FAMILY CAREGIVERS’ SUBJECTIVE WELL-BEING: FINDINGS FROM MIDUS
Authors: Bhattacharyya Kallol Kumar , Liu Yin , Fauth Elizabeth 
Published: December 2023

Abstract
Being an informal caregiver has been associated with stress and lower levels of subjective well-being. Exercise/movement therapy techniques of yoga, tai chi, and Pilates are physical activities that also incorporate stress reducing practices. The current study aimed to examine the association of exercise/movement therapy techniques on family caregivers’ subjective well-being assessed by life satisfaction and mindfulness. Participants were part of the Midlife in the United States (MIDUS) study (wave 2, N = 507 aged 35-86 years; Mage = 56±11, 68% women) who provided informal care in the past 12 months. We recoded the aforementioned exercise/movement therapy activities into three categories, based on the distributions in MIDUS, including regular practice (defined as participating in one or more of them “a lot” or “often”), irregular practice (participating “sometimes” and “rarely”), and no practice (“never”). Subjective well-being was measured using the 5-item global life satisfaction scale and the 9-item mindfulness scale. We considered sociodemographic factors and health as covariates. We used multivariate linear regression models to examine associations between practice and caregivers’ subjective well-being. After controlling for covariates, the findings indicated that regular practice was associated with both better mindfulness-related well-being (b = 2.26, p &lt; .05) and better life satisfaction (b = 0.43, p &lt; .05). Future research should examine whether there is a selection effect of caregivers with higher well-being being more likely to choose these activities, and/or if exercise/movement therapies are effective non-pharmacological interventions to improve family caregivers’ overall quality of life.
ANXIETY IN PATIENTS UNDERGOING OPEN-HEART SURGERY: THE ROLE OF CHARACTER, STRENGTH, AND HOPE IN A STRUCTURE EQUATION MODEL
Authors: Nash Veronika , Ai Amy 
Published: December 2023

Abstract
In an era of patient-centered care, more research is needed to examine the protective function of patients’ internal strengths against the damage of poor mental health. Mental health plays a significant role in cardiac health. Anxiety is a mortality risk for cardiac patients, the evidence has indicated high prevalence (13-59.5%) post cardiac events. However, anxiety hasn’t been extensively investigated as depression in cardiac patients, especially after open-heart surgery (OHS). Even less is known about protective function of Character Strength Hope in cardiac anxiety during stressful OHS, also a life-altering intervention for advanced heart conditions. This interdisciplinary study evaluated a structural equation model (SEM) on the relationship of Hope with pre- and post-OHS anxiety. Two weeks prior to the scheduled operation, research assistants conducted a face-to-face psychosocial interview with 481 patients (male, 58%; mean age=62 years, range=35-89) at the hospital, followed by a second telephone interview to assess an indicator of Hope two-days prior to surgery. Postoperative measures were assessed 36 days after OHS. Female and older patients reported higher levels of anxiety preoperatively. The SEM demonstrated adequate fit of the final solution in which pre- and post-OHS anxiety levels were related. Higher levels of pre-OHS anxiety were related to lower levels of optimism and hope right before OHS. Higher levels of optimism, indicating Hope predicted lower levels of post-OHS anxiety. Because patients with high anxiety would be disadvantaged in postoperative recovery, our finding suggests enhancing preoperative strength, Hope, might have some psychological benefits for optimal outcomes in patients undergoing OHS.
DEVELOPING A GERIATRIC ONCOLOGY FELLOWSHIP SUBSPECIALTY TRACK FOR ADVANCED PRACTICE PROVIDERS
Authors: McMillan Sincere , Korc-Grodzicki Beatriz , Cataldo Amelia , Zakak Nicole , Haviland Kelly 
Published: December 2023

Abstract
Although a relatively young subspeciality, geriatric oncology is a fast-growing discipline. As the population ages, clinicians skilled in geriatric oncology principles and management are needed to care for an increasingly complex older adult population. Educating Advanced Practice Providers (APP) in geriatric oncology may offer innovative ways of increasing access to care, supporting patient health, and improving quality of life. The need for trained clinicians represented a unique opportunity for the development of a geriatric oncology focused APP fellowship subspecialty track at our institution. In 2019, with support from the Samuels Foundation, an electronic geriatric oncology needs assessment was completed among the APPs at our institution. Data from this needs assessment and from a thorough literature review were used to develop the geriatric oncology fellowship track curriculum. With support from APP leadership at our institution, the fellowship track launched in September, 2021. It is a 12-month postgraduate academic program that focuses on geriatric assessment, risk stratification prior to cancer directed therapies, management of geriatric syndromes, and geriatric co-management. Additionally in 2023, the fellowship track will include an elective in a long-term care facility. We believe this unique elective rotation will be a strong addition to the clinical experience of the fellow. Our current program has one position per fellowship year with the goal of increasing the number of positions in the future. This is a major step forward in the education of APPs in the care of older adults with cancer that we hope will be replicated across the country.
INITIAL EFFICACY OF THE SAVVY CAREGIVER PROGRAM IN KOREAN AMERICAN DEMENTIA CAREGIVERS
Authors: Jang Yuri , Hepburn Kenneth , Park Juyoung , Haley William , Kim Miyong 
Published: December 2023

Abstract
Dementia caregivers in ethnic minority communities have often been excluded from access to caregiver interventions and their benefits because of linguistic and cultural barriers. In pursuit of equal treatments for all, it is imperative to make evidence-based interventions available and accessible to ethnic minority dementia caregivers, and linguistic and cultural adaptation is indispensable for reaching out to them. In the present study, we adapted the Savvy Caregiver Program for Korean American dementia caregivers and tested its initial efficacy for reducing depressive symptoms. This pilot intervention was delivered to 13 Korean American dementia caregivers by two Savvy-certified Korean-speaking trainers. Over the 6-week period of program implementation, there was no attrition (session completion rate = 98%). All participants’ depressive symptoms were reduced at completion of the program, and the level of reduction was statistically significant, with a large effect size (t = 8.64, p &lt; .001, Cohen’s d = .89). Although patterns of change did vary among participants, the score difference between post-intervention and 6-month follow-up was not statistically significant (t = .74, p = .47). The program played a significant role in reducing depressive symptoms in this pilot sample of Korean American dementia caregivers, and this benefit was sustained at the 6-month follow-up. Along with the program’s notably high retention rate, its efficacy suggests strong unmet needs for psychoeducational programs among Korean American dementia caregivers. The study offers promise for sharing the therapeutic benefit of the Savvy program with linguistic minorities when delivered in a linguistically, culturally appropriate manner.
INVESTIGATING THE NEURAL CORRELATES OF SOCIAL AND INDIVIDUAL SINGING IN PERSONS WITH DEMENTIA
Authors: Tamburri Nicholas , Sheets Debra , Smith Andre , MacDonald Stuart 
Published: December 2023

Abstract
Music interventions for persons with Alzheimer’s Disease and related dementias (PwADRD) have documented psychological benefits; however, the neurological correlates underlying these advantages remain less certain. Using functional near infrared spectroscopy (fNIRS), the present study i) investigated within-person patterns of cortical oxygenation during choral vs. individual singing; ii) explored how singing context (choral vs. individual) modulated patterns of functional connectivity (FC) within and across frontal and parietal cortices; and iii) leveraged these functional activations as predictors of cognitive status (degree of impairment) in a series of discriminant function analyses (DFA). Participants were 13 PwADRD who volunteered from a larger, ongoing social-cognitive choir intervention. fNIRS data were collected using a TechEn Cw6 system during both choral and individual singing conditions. Paired sample t-tests evaluated differences in activation patterns between singing conditions, with DFA used to determine whether these activations and neuropsychological function were predictive of between-person differences in cognitive impairment. Significant differences in cerebral oxygenation were identified in the right anterior PFC, with individual singing associated with significantly greater cortical oxygenation relative to group singing. Although not significant, individual singing was also associated with bilateral increases in cortical oxygenation across the majority of fNIRS channels, as well as increased FC, relative to group singing. The DFA analyses were not significant. This novel study is the first to examine differences in music-cognition correlates across environmental contexts for PwADRD. Patterns of functional activation suggest that choral singing in particular may represent an optimal lifestyle activity, placing comparatively fewer demands on cognitive function.
PREDICTORS OF RESILIENCE AMONGST INFORMAL DEMENTIA CAREGIVERS
Authors: Grelle Kaitlin , Vacek Sarah , Rayha Kara , Hale Willie , Deason Rebecca 
Published: December 2023

Abstract
Informal caregivers of People with Alzheimer’s Disease (PwAD) report greater levels of burden compared to non-caregivers, which is associated with an increase of impaired physical and mental health (Pinquart & Sorensen, 2003; Cheng, 2017; Zhou et al., 2021). Recent studies focusing on resilience (a person’s adaption to the physical and psychological demands of providing care) showed higher levels of resilience in caregivers was inversely related to depression, burden, and anxiety (Lopes Da Rosa et al., 2018; Zhou et al., 2021). With resilience being a protective factor against burden in caregivers, it is imperative to understand what psychological characteristics act as predictors of resilience. Participants (N = 59) completed questionnaires about resilience, mental health, and knowledge of Alzheimer’s disease. A classification and regression tree (CART) analysis was conducted to evaluate caregiver psychological characteristics as possible predictors of resilience. The analysis produced a tree with four terminal nodes, with one characterized by having scores greater than 152 for self-efficacy, followed by scores greater than 15 for knowledge of Alzheimer’s Disease. The overall model is 79.7% correct in predicted resilience, with a specificity of 95.7% and a sensitivity of 69.4%. These findings provide evidence that caregivers with greater confidence in their abilities are more likely to be resilient, especially for those with increased knowledge about Alzheimer’s disease (Choi et al., 2018; Kim & Bolkan, 2022). Interventions that focus on bolstering knowledge of Alzheimer’s disease and increasing self-efficacy may be critical in enhancing resilience in caregivers, in turn reducing depression and burden.
SOURCES OF BURDEN IN CAREGIVERS OF PERSONS WITH EARLY- AND LATE-ONSET ALZHEIMER’S DISEASE
Authors: Crouch Adele , Massimo Lauren 
Published: December 2023

Abstract
Functional impairment and neuropsychiatric symptoms (NPS) are common in Alzheimer’s disease (AD) and contribute to caregiver burden. Persons with early-onset AD (EOAD) on average experience greater functional impairment and NPS compared to late-onset AD (LOAD), yet their contribution to caregiver burden have not been explored. Objectives were to: 1) compare functional impairment, NPS, and caregiving burden in EOAD and LOAD; 2) identify sources of caregiver burden including functional impairment and NPS in EOAD and LOAD. Caregivers of 85 persons with EOAD (n=63) and LOAD (n=22) completed questionnaires [Functional Activities Questionnaire, Neuropsychiatric Inventory, Zarit Burden Inventory]. T-tests compared group differences in function, NPS, and caregiver burden. Persons with EOAD had greater NPS frequency than LOAD (t= 2.275, p=0.026). There were no significant differences between groups in function or caregiver burden. Multivariate regression analyses were performed in AD groups, with function and NPS frequency as predictors of caregiver burden covarying for age, caregiver sex, and global cognitive function (MMSE). In the total AD sample, the model explained 12.6% of the variance in caregiver burden [F(5,52)=2.64, adjusted R2=0.126; p=0.033] and poor function was a significant predictor (standardized B=0.42, p=0.003) of caregiver burden. In EOAD, the model explained 17% of the variance in caregiver burden [F(5,35)=2.64, adjusted R2=0.17; p=0.04], and poor function was a significant (standardized B=0.42, p=0.015) predictor of caregiver burden; however this was not the case in LOAD. Results suggest poor function predicts caregiver burden in EOAD. Although NPS in EOAD are more frequent, this was not a predictor of caregiver burden.