bluuebunny/crossref_metadata_2025_split huggingface dataset:
DOES TAI CHI PROMOTE COGNITIVE FUNCTION WITHOUT THE EFFECTS OF PHYSICAL FUNCTION?: META-REGRESSION APPROACH
Authors: Song Rhayun , Park Moonkyoung , Shin Jacqueline , Gao Xianqi , Li Yuelin 
Published: December 2022

Abstract
This systematic review aimed to examine the effects of TCQ on cognitive and physical functions in older adults using a meta-regression approach. The systematic search in 13 electronic databases identified 19 randomized studies (n=2365, mean age=70.3 years) published in English (k=17), Korean (k=1) and Chinese (k=1). A review of bias was assessed by two raters according to Cochrane RoB 2.0, resulting in low risk (k=6), some concern (k=12), and one high-risk study. Tai Chi (k=16) and Qigong (k=3) were applied for an average duration of 20.2 weeks. The control groups received either alternative exercise (k=14) or no treatment (k=5). The results of the meta-analysis on 19 RCTs using a random-effects model showed the significant effect of TCQ on cognitive function (Hedges’s g =0.32, 95% CI= 0.18, 0.46) and physical function (Hedges’s g= 0.35, 95% CI= 0.21, 0.49). In addition, meta-regression was used to explore the effect size of TCQ in association with the level of physical function. The effects of TCQ on cognitive function remained significant (Q=38.86, p=.003) when controlling for the effect of physical function in this model (unexplained variance = 0.0199). The coefficient of the physical function was significant (b=0.47, p=.008), showing that 58% of heterogeneity was explained by physical function as a moderator variable. It confirmed that changes in physical function were associated with changes in cognitive function. The findings imply the potential health benefits of TCQ in promoting cognitive function among older adults directly and indirectly through improving physical function.
CONSTRUCT VALIDITY OF EXERCISE ADHERENCE RATING SCALE IN COMMUNITY DWELLING OLDER WOMEN: PROOF OF CONCEPT
Authors: Graham Helen , Scott Judith , Benton Melissa 
Published: December 2022

Abstract
Exercise is an effective health promotion strategy that has a positive effects on frailty and sarcopenia, particularly in older women, yet they do not adhere to exercise guidelines. Accurate assessment is critical for clinical management and research with this population. Interviews and exercise logs are most commonly used to assess adherence to exercise. However, they are burdensome and not highly reliable. A brief validated measure of exercise adherence for assessment is greatly needed. The six-item Exercise Adherence Rating Scale (EARS) was originally validated among a clinical orthopedic population but not been used in community-dwelling adults. Our aim was to determine the feasibility of using the EARS to assess exercise adherence among community-dwelling older women. Twelve women (age=72±7 years) completed one-time assessment for this proof-of-concept study. For the EARS, overall Cronbach’s alpha was 0.78 with inter-item correlations of 0.72–0.89 for all but item three that pertains to healthcare professionals (correlation of 0.27). When item three was removed, overall Cronbach’s alpha increased to 0.80. Correlation analysis with the reduced five-item scale demonstrated good construct validity. There were significant relationships with global quality of life (r=0.76, p &lt; .01) and physical function (r=0.61, p &lt; .05). There were also moderate to strong relationships with variables expected to be linked to exercise adherence including mobility (r=0.57), BMI (r=0.51), vigorous (r=0.40) and moderate (r=0.36) exercise, upper body strength (r=0.41) and lower body strength (r=0.30). Based on these findings use of a five-item version of the EARS is feasible and appears to be a valid measure of exercise adherence.
THE IMPACT OF THE OLD AGE PENSION EXPANSION ON BLOOD PRESSURE AMONG OLDER MEN IN RURAL SOUTH AFRICA
Authors: Chang Haeyoon , Jock Janet , Rosenberg Molly , Kobayashi Lindsay 
Published: December 2022

Abstract
The impact of improved socioeconomic welfare after retirement on cardiovascular health among older men in low-income settings is unknown. Using natural experiment, we investigated the impact of eligibility for additional Old Age Pension (OAP) income on systolic blood pressure (SBP) among older men in rural South Africa using data from 1,208 men aged ≥60 in the population-representative “Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in Rural South Africa” (HAALSI) cohort. The South African Old Age Pension (OAP) incrementally expanded age eligibility for men from age 65 prior to 2008 to age 60 in 2010. This expansion provided exogenous variation in pension income among men, based on their year of birth. We estimated predicted SBP among the birth cohorts of men who were eligible for one through five extra years of OAP income, using a multivariable linear regression model estimated in those without access to extra pension income (over age 65 when the expansion rolled out) based on covariates. We then estimated mean SBP difference scores among men in each of these five birth cohorts, based on their observed SBP minus predicted SBP. Men in OAP expansion birth cohorts had lower SBP than those who were not exposed to extra pension, although the differences were not statistically significant (5-years estimate = -2.735 (p=0.353) vs. 1-year estimate = 1.633 (p=0.531)). This trend suggests a possible long-term benefit of blood pressure control with greater cumulative pension income among men living in rural, low-income settings.
ENTERING MEDICARE ADVANTAGE FROM EMPLOYER-SPONSORED PLANS: CHANGE IN OUT-OF-POCKET COSTS AND UTILIZATION AT AGE 65
Authors: Hames Alexandra Glynn , Roberts Eric 
Published: December 2022

Abstract
An increasing proportion (nearly 40%) of older adults entering Medicare at age 65 are electing to enroll in private Medicare Advantage (MA) plans, which reflects more generous coverage relative to traditional Medicare and similarity to many features of employer sponsored plans. However, few studies have examined the impact of transitioning to MA from an employer-sponsored plan on out-of-pocket costs and health services utilization. We used longitudinal administrative data from Optum Insights between 2010 and 2021 to follow individuals from ages 62 through 67, spanning continuous enrollment in employer-sponsored insurance and MA. We employed an event-study design to estimate within-person changes in our outcomes after individuals entered to MA at age 65 (n=5,548), controlling for linear age trends. Relative to ages 62–64, MA enrollees at ages 66 and 67 had lower out-of-pocket spending on outpatient services (-$503/year, 95% CI: -$602, $404), emergency department visits (-$27/year, 95% CI: -$35, -$19), and prescription drugs (-$77/year, 95% CI: -$101, -$53). In contrast, utilization of outpatient services increased (1.4 visits/year, 95% CI: 0.8, 2.0), including physician evaluation and management visits (0.46 visits/year, 95% CI: 0.25, 0.68). After entering MA, individuals were more likely to have physician office visits with no out-of-pocket costs than at ages 62–64 (0.99 additional zero-cost visits/year, 95% CI: 0.81, 1.2). These results suggest MA may offer older adults more affordable care for routine and chronic conditions, compared to employer-sponsored insurance. These findings are timely as policymakers continue to deliberate proposals, such as expanding Medicare eligibility, to improve access to affordable insurance.
ASSESSING THE NEW INFLATION REDUCTION ACT’S IMPACT ON EXPANDING MEDICARE PART D LOW-INCOME SUBSIDIES
Authors: Loh Feng-Hua , Stuart Bruce 
Published: December 2022

Abstract
The recently enacted Inflation Reduction Act (IRA) of 2022 extends full low-income subsidies (LIS) to Medicare Part D recipients with limited assets and incomes up to 150% of the Federal Poverty level (FPL) beginning in 2024. Under current law, full Part D subsidies (no annual premiums and nominal cost sharing) are available only to those with incomes up to 135% of the FPL. Partial subsidies are available to those with incomes between 135% and 150% of FPL. Increasing the level of benefits to those currently only eligible for partial subsidies has the potential of significantly lowering out-of-pocket medication costs that pose a barrier to adherence for many low-income Medicare beneficiaries, but the outcome of the new policy will depend on how many enroll. Historically, enrollment among those eligible for partial subsidies has hovered around 30%, but the latest data on LIS participation rates are for 2014. We undertook this study to update LIS eligibility and enrollment numbers to 2019, with a particular emphasis on identifying characteristics of beneficiaries who may benefit from the new policy. Using data from the Medicare Current Beneficiary Survey, we determined that 73% of beneficiaries eligible for full subsidies under current law were enrolled, but only 25% eligible for partial subsidies were enrolled. We conclude that while the IRA will raise the overall level of Part D subsidies, it will be important to engage stakeholders and promote outreach to maximize participation in the leadup to implementation.
AGE DIFFERENCES IN DISTINCT TYPES OF SOCIAL INTERACTIONS AND EMOTIONAL WELL-BEING
Authors: Chen Yuxuan , Chi Kevin , Carstensen Laura 
Published: December 2022

Abstract
Social interaction is central to emotional well-being. However, less is known about how the surroundings of social interactions are associated with emotional well-being and whether they differ by age. The present study examined age differences in the predication of emotional well-being as a function of two aspects of social interactions: (1) the extent to which individuals would rather be interacting with someone else and (2) the degree of closeness to the interactant(s). A sample of 190 people, aged 18 to 94 years, participated in an experience sampling study where they reported emotional experience and aspects of the social interaction at five randomly selected times each day across a one-week period for a total of 35 randomly selected occasions. Across age groups, the greater the extent to which people would rather be interacting with someone else was associated with higher levels of negative emotion and lower levels of positive emotion. However, these associations were more pronounced for younger adults, who compared to older adults, experienced greater increases in negative emotions and greater decreases in positive emotion in these contexts. Furthermore, younger but not older adults experienced lower levels of negative emotion when interacting with someone they knew well. Results highlight the important role that age plays in the link between daily social interactions and emotional well-being. Age differences in social interactions, emotional resilience, and situation selection will be discussed.
PHOTO-ELICITATION- A VIEW OF DEEP OLD AGE AND SOCIAL INCLUSION
Authors: Eliopoulos Elaine 
Published: December 2022

Abstract
Photo-elicitation- A View of Deep Old Age and Social Inclusion While visual methodologies have gained prominence in aging research, focus on deep old age has been uncommon. The variety of visual representations portraying a range of ‘ageless aging’ to frail older people may not fully capture daily lived experience. The inclusion of those in deep old age to depict their aging bodies is a crucial missing element enhancing our understanding of the nuances of deep old age. This study fills that gap. Photo-elicitation, followed by semi-structured interviews, was used to examine the role of the body for participants 80 years+ in three US island contexts to understand what impact, if any, their bodies had on their ability to be socially included in ways they chose. Digital cameras were provided to participants to photograph their lived bodily experience. Those who had visual challenges were assisted in taking photographs. Recent analysis of the photographs revealed important findings that will contribute to theoretical development of deep old age: participants who took photos without assistance did not take a single photograph of their bodies. They took photos primarily of their environment and places of community connections while minimising physical challenges. Their photos contextualised their experience of the physical challenges that played a role in their sense of inclusion within their communities. This finding questions current dominant models of the third and fourth age as dichotomous formulations related to embodied agency. In doing so it opens new possibilities for theoretical reflection on deep old age.
WOMEN AT RISK: SOCIOECONOMIC STATUS, LIFESTYLE FACTORS, AND BRAIN VULNERABILITY AMONG JAPANESE AND SWEDISH FEMALE
Authors: Liu Yingxu , Tatewaki Yasuko , Thyreau Benjamin , Liu Yinghao , Zhang Ye , Karalija Nina , Boraxbekk Carl-johan , Taki Yasuyuki 
Published: December 2022

Abstract

Background
While multiple modifiable lifestyle factors and disease management have been highlighted for preventing dementia and ameliorating neurodegeneration, women and the disadvantaged socioeconomic status (SES) population still bear disproportionate burdens. Objective: Investigate and compare the potential pathways of SES, lifestyle factors, imaging biomarkers, and cognition in two community dwelling cohorts in Japan and Sweden. Subjects: The Kumamoto Cohort included 576 cognitively healthy females (73.66 ± 5.96 years); the Betula Cohort included 195 cognitively healthy females (63.91 ± 13.41 years).

Methods
We constructed structural equational modeling by lifestyle factors including exercise, social activity, sleep, drinking, and smoking status; disease conditions included obesity, diabetes, hypertension, and depressive disorder; brain imaging biomarkers included regional gay matter volume (GMV) and cortical thickness obtained from T1 weighted magnetic resonance imaging scans and global cognition score. We also examined SES-related gray matter volume and cortical thickness map locations at the whole brain level.

Results
SES was positively associated with GMV of limbic lobe (not cortical thickness), Kumamoto Cohort: standardized direct β =0.21 (0.13;0.28); Betula Cohort: standardized direct β =0.27 (0.13; 0.41). This SES-GMV association was mediated by disease conditions and lifestyle in Kumamoto Cohort: indirect β =-0.013 (0.001; 0.054). We also found several regions, including the medial frontal gyrus, superior frontal gyrus, hippocampus, and thalamus, were commonly sensitive to SES status in two cohorts. Conclusions: Although the observational nature of the study precludes proof of causality, our findings suggest that promoting disease management is crucial to tackling the neurodegeneration burden in the female facing SES disparities.
THE EFFECTS OF VISUAL SEARCH ON POSTURAL SWAY COMPLEXITY IN OLDER ADULTS WITH AND WITHOUT TYPE 2 DIABETES
Authors: Jason Kellyn , Zhou Junhong , Yu Wanting , Manor Brad , Jor’dan Azizah 
Published: December 2022

Abstract
Type II diabetes mellitus (T2DM) is linked to impairments in the interconnecting and interacting components (e.g., cognitive-motor demand) essential for standing postural control. The temporal dynamics of postural sway are complex, thus higher complexity reflects the system’s capacity to adapt to cognitive-motor demands. We aimed to characterize the effects of T2DM on postural sway complexity during visual search tasks (VST). Twenty-four older adults without T2DM (OA) (age=67–93 years) and 20 older adults with T2DM (age=70–90 years) performed multiple trials of quiet standing with and without a VST. The VST consisted of low difficulty (LD) (i.e., counting the frequency of one designated letter in a random grid of letters) and high difficulty (HD) (i.e., counting two different letters). The complexity of the postural sway acceleration signals in the anterior-posterior (AP) and medial-lateral (ML) directions were quantified using multiscale entropy. Across participants, matched-pairs analyses revealed that both AP and ML sway complexity increased during the LD condition, compared to control (p &lt; 0.007). During HD, only the AP sway complexity increased, compared to control (p=0.0001). Within the OA, both AP and ML sway complexity increased during the LD condition (p &lt; 0.009), while performance of the HD task showed an increase in AP sway complexity compared to control (p=0.0002). Within the T2DM, AP sway complexity increased only during LD, compared to control (p=0.03). The multi-scale dynamics of postural control when standing while performing VSTs differ among older adults with and without T2DM, reflected by diminished capacity to increase complexity during the visual search conditions.
EFFECTS OF REMOVING VISUAL INPUTS ON POSTURAL SWAY COMPLEXITY IN YOUNG ADULTS AND OLDER ADULTS WITH AND WITHOUT T2D
Authors: Jason Kellyn , Zhou Junhong , Yu Wanting , Manor Brad , Jor’dan Azizah 
Published: December 2022

Abstract
Standing postural control is complex and involves sensory inputs from the visual, vestibular, and somatosensory systems. Postural sway complexity, as often assessed by multiscale entropy, has been linked to the ability of the postural control system to adapt to “stressors,” including the removal of visual inputs. We aimed to determine the effects of removing visual inputs (i.e., eyes closed, EC) on postural sway complexity in young adults (YA), and older adults (OA) with and without type 2 diabetes mellitus (T2DM). Twenty-five YA (age=21–30 years), 25 OA (age=70–90 years), and 19 T2DM (age=67–93 years) stood for 30 seconds under two conditions – eyes open (EO), and EC for three trials. Postural sway acceleration was measured in the medial-lateral (ML) and anterior-posterior (AP) direction during EO and EC conditions. Sway complexity was quantified using multi-scale entropy. The YA group had a significant reduction in ML and AP sway complexity during EC when compared to EO (p=0.04 and p &lt; 0.001, respectively). Though not significant, the OA group exhibited a trend towards increased ML sway complexity during EC compared to EO standing (p=0.07). No significant changes in AP sway complexity were observed in OA or T2DM, or in ML sway complexity in T2DM. The dynamics of postural control differ between YA, OA, and T2DM groups. There was a significant difference in postural sway complexity between the EO and EC among YA, with no differences in OA and T2DM between conditions. The lack of change suggests maladaptation to stressors, such as vision loss.
SLEEP AND CAREGIVER BURDEN FOR CAREGIVERS OF PERSONS WITH DEMENTIA: A SCOPING REVIEW
Authors: Mattos Meghan , Bernacchi Veronica , Shaffer Kelly , Gallagher Virginia , Seo Shinae , Manning Carol 
Published: December 2022

Abstract
Caregivers of persons with dementia report worse sleep when compared to the general population. This scoping review synthesizes evidence regarding the link between caregiver burden and dementia caregivers’ sleep. A systematic search was completed in PubMed, CINAHL, PsycINFO, and Web of Science for pertinent literature published through March 2022. Included original research articles studied informal adult caregivers of persons living with mild cognitive impairment or dementia, documented the relationship between subjective caregiver burden and caregiver sleep, and were written in English. Extracted data were organized in tables, compared, and synthesized. The search yielded 540 non-duplicate articles screened by title and abstract; 118 full-text articles were reviewed; of these, 26 were included. Most studies were cross-sectional, with variable sample sizes (range n=40–669). Sleep was operationalized across the 25 quantitative studies in terms of subjective quality (n=19) and objective sleep parameters using actigraphy (n=4), and polysomnography (n=2). Of studies reporting subjective sleep quality, 16 reported a significant positive association between caregiver burden (84%) with the remaining found null results. Half of the studies that used objective measures of sleep (actigraphy and polysomnography) found a positive association between sleep and caregiver burden, while the other half did not (n=3). Results suggest that, while subjective sleep quality is commonly impacted by dementia caregiving burden, there is a lack of corresponding evidence on the relationship between burden and objective sleep metrics. Caregiver burden was also not measured consistently across studies, and future studies should focus on consistent measurement of caregiver burden and determination of directionality.
PATHWAYS OF IMPROVING SOCIAL CAPABILITY OF OLDER ADULTS WITH FUNCTIONAL LIMITATIONS: FINDINGS FROM MIXED METHODS
Authors: Zhang Yalu , Xiong Yiyi , Chen Gong 
Published: December 2022

Abstract

Objectives
Social capabilities are the opportunities to realize people’s potential. Despite an established positive link between health status and social capabilities among older adults, the relationship mechanisms are understudied.

Methods
Using the China Longitudinal Aging Social Survey data 2014–2018, this paper examined the possible mediating role of community participation through which older adults (aged 60 and above) in China with functional limitations improved or maintained their social capabilities. By conducting the 12 in-depth interviews, this study explores how community participation altered the negative associations between functional limitations and social capabilities among Chinese older adults.

Results
Findings from the quantitative study show that both physical (-.136, p &lt; 0.001) and cognitive (-.149, p &lt; 0.001) functional limitations showed consistent and negative effects on the social capabilities of older adults, and the effects varied between males and females. The mediation analysis results show that community participation accounted for a substantial proportion of the impact of functional limitations (36.33%) on social capabilities. However, functional limitations still had strong, negative direct effects of their own. Findings from the qualitative narrative synthesis show that peer companionship, regular physical activities, and reduced digital obstacles to accessing online social media during social participation are the self-perceived driving force in enhancing their sense of security, freedom of expression, and sense of social cohesion. Discussion: Findings from this study highlight the need for more social policies and services to encourage community participation among older adults.