bluuebunny/crossref_metadata_2025_split huggingface dataset:
TIME IS OF THE ESSENCE: RELIABLE MEASUREMENT OF HEART RATE VARIABILITY IN OLDER ADULTS
Authors: Pinheiro Cristina , Segerstrom Suzanne , Karr Justin 
Published: December 2022

Abstract
Heart rate variability (HRV) decreases with age and is an important correlate of psychosocial and physical health. Recommendations for the minimum duration of EKG to accurately derive HRV vary from 1 minute to several minutes. However, the definition of “accuracy” or reliability depends on study design, including whether the focus of the study is on stable or momentary between-person differences or within-person changes in HRV. In a sample of 216 older adults (Mage = 72.7, 62.5% women), ECG was measured at 1000 Hz for 10 minutes every 6 months for up to 6.5 years. HRV was high-frequency power (0.15–0.40). A generalizability study determined the variance due to minute, occasion, person, and their interactions. The most variance was due to idiosyncratic occasion differences (46%), followed by stable person variance (18%). A decision study determined how accuracy in HRV measurement could be achieved. Between-person differences in HRV at a specific occasion could be reliably measured with 6 minutes of ECG (.80); within-person changes in HRV between occasions could be reliably measured with 3 minutes of ECG (.83). For stable individual differences, 10 or more occasions of 1-minute duration produced a more reliable estimate (.73) than increasing the length of a single ECG recording to 10 minutes (.25). The necessary duration of ECG for measuring HRV reliably depends on the study design and research question. Ultra-short durations (1-2 minutes) are generally not recommended for older adults.
THE EFFECTS OF SLEEP DEFICIENCY ON MULTIMORBIDITY AMONG OLDER ADULTS IN THE PHILIPPINES AND VIETNAM
Authors: Chen Tuo-Yu , Cruz Grace , Vu Nguyen , Saito Yasuhiko 
Published: December 2022

Abstract
Multimorbidity increases the risks of disability and death and are prevalent among older adults. Evidence shows that sleep might play an important role in multimorbidity. However, previous research studies sleep quality and quantity in isolated manners, where in reality sleep quality and quantity are likely to affect each other. Besides, no study has been done to understand such relationship among older adults in low- and middle- income counties where the prevalence of multimorbidity increases rapidly. This study investigated the relationship between sleep deficiency (i.e., poor and insufficient sleep) and multimorbidity among community-dwelling older adults in the Philippines and Vietnam. Cross-sectional data were obtained from the Longitudinal Study of Ageing and Health in the Philippines (N = 3,562) and the Longitudinal Study of Ageing and Health in Vietnam (N = 3,936). Multimorbidity was defined by having two or more of chronic conditions (i.e., heart disease, heart attack, cardiovascular disease, hypertension, diabetes, lung diseases, renal diseases, liver diseases, and arthritis). Sleep deficiency was conceptualized as self-reported short sleep duration (&lt; 6 hours), having trouble with falling asleep or maintaining sleep, and/or experiencing non-restorative sleep. Logistic regression was used to analyze the data adjusting for demographics, body mass index, sleep medications, naps, mental health, and lifestyle. The results showed that having deficient sleep was significantly related to increased odds of experiencing multimorbidity by about 81% in the Philippines and Vietnam. Our findings revealed that treating sleep deficiency among older adults in the Philippines and Vietnam can potentially reduce the risks of multimorbidity.
THE MEDIATING ROLE OF FATIGUE/SLEEPINESS BETWEEN STATE MINDFULNESS AND SUBJECTIVE COGNITION
Authors: Rehman Aziz , Mu Christina , Lee Soomi 
Published: December 2022

Abstract
Previous studies have established a connection between higher mindfulness and cognitive abilities; however, few studies have considered the mechanism underlying this relationship. The cognitive benefit of mindfulness may be through reduced fatigue and daytime sleepiness. This study examined if higher, naturally occurring mindfulness is associated with higher subjective cognition and whether lower fatigue or sleepiness mediate this relationship. Two independent samples of nurses (N1=60 inpatient (IP); N2=84 outpatient (OP)) completed 14 days of ecological momentary assessment (EMA). Fatigue/sleepiness, mindfulness, and subjective cognition (mental speed, processing sharpness, memory) were assessed using EMA. The 5-item Mindful Attention Awareness Scale assessed state mindfulness. Multilevel mediations were conducted in Mplus to account for the nested data. At the within-person level, daily subjective cognition was higher than average on days when mindfulness was higher in both OP and IP samples. This association was mediated by lower levels of fatigue (IP indirect effect: B=2.08, p&lt;.001; OP indirect effect: B=2.57, p&lt;.001) and lower sleepiness (IP indirect effect: B=1.72, p=.001; OP indirect effect: B=0.92, p=.027). The daily indirect pathways were found after controlling for between-person differences; those with higher mindfulness reported higher subjective cognition through lower fatigue, and this effect was only significant in OP nurses (indirect effect: B=11.61, p=.001). Results highlight the importance of monitoring momentary mindfulness and intervening on daily fatigue and sleepiness as these may influence one’s subjective cognition and ultimately their objective performance. These findings may help identify modifiable factors to promote quality of care in nurses and their own well-being.
NEIGHBORHOOD IMPACTS ON KOREAN OLDER ADULTS’ DEPRESSION
Authors: Kim Seon 
Published: December 2022

Abstract
Older adults are more influenced by their neighborhood than young adults, however neighborhood impacts on older adults are little known. In response to the increasing depression of older adults in Korea, this study aims to identify the effect of perceived and objective neighborhood characteristics in depression and find differences between rural and urban areas. This study uses the Korean Elderly Survey conducted in 2020 on 10,097 older adults aged 65 and over residing in 17 states, and Korean administration data by connecting them. Multilevel modeling results show that after controlling individual characteristics, depression decreases when older adults perceive their housing condition (b=-.64, p&lt;.001), interaction with neighbors (b=-.29, p&lt;.001), overall neighborhood environment (b=-.26, p&lt;.001) positively. Although objective neighborhood characteristics do not significantly reduce depression in older adults living in urban area, for older adults living in rural areas, the number of social worker (b=- .42, p &lt;.001), the number of senior center (b=-6.70, p&lt;.001), and home care services (b=-49.5, p &lt;.001) are negatively associated with depression in older adults. This study discusses that neighborhood characteristics may play an important role in older adults’ depression, and that their effects may differ between rural and urban areas. This study encourages policy makers to consider neighborhood characteristics to improve the mental health of Korean older adults.
THE ROLE OF SPIRITUALITY IN LATER LIFE: A STUDY OF OLDER ADULT UNIVERSITY STUDENTS IN PORTUGAL
Authors: Casanova Giuliana 
Published: December 2022

Abstract
In Portugal, little has been done to investigate spirituality and its impact on later life. This study aims to discover whether spirituality contributes to successful aging in the lives of Portuguese older adults. This mixed-methods research study is based in Porto, Portugal. The sample size is 58 students from universities of the third age, ages 65 to 89 with no cognitive deficit. Data was collected by a demographic questionnaire, Spirituality Scale, Scale of Psychological Well-Being, and a mix method questionnaire. The data analysis was conducted by descriptive statistics and thematic analysis.
Results: Participants rated high in both the Spirituality Scale and the Psychological Well-Being Scale. The data also showed a significant and positive correlation between the dimension of hope/optimism from the Spirituality Scale and the dimension of autonomy from the PWB Scale; as well as between global spirituality and the dimension of autonomy. The mix-methods questionnaire showed 90% of the participants believe in God or a higher power, 81% considered themselves spiritual while 89.4% felt spirituality had always been a part of their lives. The three most significant themes that emerged were the connection to a higher power/divine, personal well-being, and the importance of spirituality throughout their lifetime. Discussion: Spirituality demonstrated to be correlated with the participant's ability and perception of autonomy and independence; having their spirituality as a coping mechanism to deal with life′s adversities while being able to look at the future with optimism. Spirituality can provide purpose, guidance, and meaning in the later years of life.
A ROUTINE BLOOD PARAMETER BIOLOGICAL AGE COMPOSITE IS ASSOCIATED WITH FRAILTY IN THE BERLIN AGING STUDY II (BASE-II)
Authors: Demuth Ilja , Vetter Valentin , Drewelies Johanna , Duezel Sandra , Spira Dominik , Steinhagen-Thiessen Elisabeth , Bertram Lars , Gerstorf Denis 
Published: December 2022

Abstract
High-quality biomarkers are needed to predict age-related phenotypes and evaluate health-related interventions. Telomere length has been known as a biomarker of aging for some time, however, its potential for clinical use is limited. Epigenetic age estimators and biological age (bioage) composites have been developed and refined over the past decade and their evaluation is ongoing. Aim of the current study was to further evaluate a recently developed bioage composite based on 12 routine laboratory blood parameters which have been shown to individually predict mortality risk. To this end, we assessed the relationship between the bioage composite, frailty and a number of functional assessments. The bioage composite was calculated for participants of the Berlin Aging Study II (BASE-II) aged ≥ 60 years (N=1,278, mean age 68.6 ±3.7 years, 53.3% women). Frailty was operationalized by Fried’s five-point frailty score. Functional capacity was assessed with a battery of tests including the Tinetti mobility test, finger-floor distance (FFD), Mini-Mental State Examination (MMSE), Center for Epidemiologic Studies Depression Scale (CES-D), activities of daily living (ADL) and instrumented ADL (IADL). In covariate adjusted regression analyses the deviation of the bioage composite from chronological age was significantly associated with frailty (beta = -0.014, p= 0.014), the CES-D and ADL in men, and with the FFD in women. These results will be discussed with respect to their clinical relevance and compared to previously reported BASE-II data on the relationship between frailty, functional assessments and the biomarkers of aging derived from epigenetic clock algorithms and telomere length.
OLDER PEOPLE LIVING WITH DEGENERATIVE SPINE DISEASE WHO UNDERGO SPINE SURGERY—TRYING TO BE NORMAL
Authors: Strayer Andrea , King Barbara 
Published: December 2022

Abstract
Lumbar degenerative spine disease (DSD), a consequence of aging, occurs globally in 266 million persons annually. As the population ages, the number of spinal surgeries will increase. The purpose was to investigate older peoples’ understandings of living with and having surgery for DSD and the process they engage in to return to normal. Grounded theory (GT) was used to guide this study. Fourteen older people (≥ 65yrs) were recruited for 2 in-depth interviews (audio-recorded/transcribed verbatim) at 2-time-points: T1 during hospitalization and T2, 1-3-months post-discharge. All 14 interviewed at T1; 10-T2 (1mo); 2-T2 (2mo); 2-T2 (3mo) post-discharge (N=28 interviews). Consistent with GT, purposive and theoretical sampling was used. Data analysis (interdisciplinary team) included open, axial, and selective coding. A conceptual model was developed illustrating the phases older persons with DSD go through in their trajectory of trying to return to normal. Three key categories were identified (1) Losing Me (2) Fixing Me and (3) Recovering Me. All described a prolonged process of losing functional independence and being able to socialize. Fixing Me was proving they needed surgery and preparing for surgery. Recovering Me involved monitoring and ongoing progress. Conditions, including setbacks and delays, slowed recovery. Throughout, participants had to continually adjust their expectations. The conceptual model details how older people engage in living with and undergoing DSD surgery. Our model can serve as the foundation for developing interventions to guide older patient education programs, improve care transitions and develop patient-centered approaches for treating older people with DSD and spine surgery.
STRUCTURAL EQUATION MODELING OF HEALTH-RELATED QUALITY OF LIFE AMONG PEOPLE WITH VISUAL IMPAIRMENT
Authors: Yang Eunjin , Chang Sun Ju 
Published: December 2022

Abstract
Visual impairment can lead to limited accessibility and activities and a decreased quality of life. This study aimed to test a hypothetical model based on the International Classification of Functioning, Disability, and Health to predict the health-related quality of life (HRQOL) of people with visual impairment. Data from 202 people with visual impairment were collected from August 2020 to November 2020 via telephone or e-mail. The overall fitness indices of the model for physical HRQOL (Normed χ2=2.076, GFI=.878, TLI=.900, CFI=.928, RMSEA=.073) and the model for mental HRQOL (Normed χ2=2.232, GFI=.884, TLI=.904, CFI=.932, RMSEA=.078) complied with the recommended criteria of structural equation model fitness, indicating that the models were appropriate for predicting the HRQOL of people with visual impairment. The socioeconomic status, multimorbidity, perceived environmental barriers, and activity limitation/participation restriction directly affected the participants’ physical HRQOL. Moreover, depression, disability identity, and activity limitation/participation restriction directly affected participants’ mental HRQOL. Age, socioeconomic status, depression, social support, and perceived environmental barriers affected the participants’ physical and mental HRQOL by means of activity limitation/participation restriction. The findings of the study suggest that the strategies aimed at increasing the activity/participation of people with visual impairment will be helpful in improving their HRQOL. Based on the results of this study, nursing intervention programs and services for people with visual impairment should be developed and implemented to provide more comprehensive care for this group and expand nursing science.
INDIVIDUAL FACTORS AFFECTING GLYCATED HEMOGLOBIN LEVELS AMONG OLDER ADULTS WITH DIABETES: A CROSS-SECTIONAL STUDY
Authors: Min Jungkyung , Harvey Idethia 
Published: December 2022

Abstract

Introduction
Many older adults fail to maintain glycemic control even though reasonable glucose control can prevent the onset of macro- and microvascular complications. This present study aimed to determine the independent association of demographic characteristics, clinical factors, treatment modalities, and lifestyle behaviors with glycated hemoglobin levels (HbA1c) among Korean older adults, a group at a very high risk of diabetes.

Methods
We analyzed data from a representative sample of participants (N = 707) aged &gt; 65 years in the Korea National Health and Nutrition Examination Survey (KNHANES), 2016-2018. Participants were classified into two groups according to their age [group 1 (ages 65 to 74) and group 2 (age ≥75)]. Data were analyzed using t-test, analysis of variance, Pearson’s correlation, and hierarchical multiple regression.

Results
Age (p=0.003), place of residence (p=0.01), treatment modality (p&lt; 0.001), sedentary behavior (p=0.04), and moderate activity (p=0.002) significantly affected HbA1c levels. In comparison to the factors in two age groups, duration of diabetes was the variable more strongly associated with HbA1c levels (p&lt; 0.001, β=0.283) in group 1, whereas treatment modality was the one strongly associated with HbA1c levels (p&lt; 0.001, β=0.249) in group 2.

Conclusion
It is essential to consider the age duration of diabetes, and biochemical factors to manage HbA1c levels in older adults. Furthermore, our findings suggest including physical activity in the educational program to provide information for diabetes management. In the clinical setting, more close attention should be taken among healthcare providers to control the glucose level for older adults with diabetes.
CHRONIC CONDITION SELF-MANAGEMENT FOR OLDER AFRICAN AMERICANS: THE CHALLENGE OF COMPLEXITY
Authors: Fritz Heather , Cutchin Malcolm 
Published: December 2022

Abstract
Older African Americans have higher rates of comorbidity and face substantive challenges with chronic condition self-management (CCSM), including less effective and supportive CCSM care than their white counterparts. Such disparities in care stem, in part, from physicians’ lack of understanding about challenges older African Americans face as they engage in CCSM. Yet little is known about the CCSM experiences of older African Americans with comorbidity. In this study, we aimed to determine the central dynamics of those experiences. As part of a larger study on African American CCSM and physician empathy, we conducted in-depth qualitative interviews with 30 older African Americans living in Detroit aged 65 years and older with comorbidity. We used grounded theory analysis to distill findings into a core conceptual category as well as component domains and dimensions. “Complexity” emerged as the core category to describe CCSM in our sample. Complexity resides often at the intersection of race, age, and social position making the older African American CCSM experience inherently difficult for those of different races, ages, and social positions to understand. Data illustrate that domains of complexity include "care time", "care roles", "social context", "logistics", "learning", and "pain management". Each domain is composed of 2 to 4 dimensions, further fleshing out the nature of CCSM complexity for older African Americans with comorbidity. Findings provide a basis to enhance understanding and empathy for older African Americans with comorbidity. We discuss how the model will be used to test understanding of older African American CCSM by medical students.
PHYSICAL FUNCTIONING AND BODY SIZE IN MID-LIFE WOMEN: THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION
Authors: Oh Minsuk , Ylitalo Kelly , Leis Aleda , Lange-Maia Brittney , Strotmeyer Elsa , Cauley Jane , Karvonen-Gutierriez Carrie 
Published: December 2022

Abstract
To evaluate patterns of age-related changes in physical functioning (PF) and associations with body size, we utilized data from the longitudinal Study of Women’s Health Across the Nation (SWAN). Participants (n=1,793) with self-reported SF-36 PF data at visit 4 (2000-01; mean age:50.0 years ±2.7), visit 15 (2016-17), plus one additional visit were included. Body weight and waist circumference were measured at each visit; change from visits 4 to 15 was calculated. Five PF trajectories were identified using latent class growth modeling (% of women): (1) persistently low (4.1%); (2) start moderate and improve slightly (5.4%); (3) start high and decline slightly (24.0%); (4) persistently high (59.5%); and (5) start high and decline substantially (7.0%). Participants with persistently low PF (Group 1) lost weight during follow-up (mean change: -3.2% body weight) whereas there was little change in all other groups (ANOVA p&lt; 0.0001). Women with persistently low PF (Group 1) had &lt; 2% increase in waist circumference over follow-up; all other groups had more than double that increase (range: 4.1%-6.1%; ANOVA p=0.002). No statistically significant differences in anthropometry changes across the PF groups were observed after adjustment for sociodemographic and time-variant health characteristics. PF trajectories may be associated with changes in body weight or waist circumference during midlife and transition to older adulthood; however, these associations may be explained by other major health-related variables. Future research is needed to understand the complex interplay between PF and body size, particularly for women at-risk for late-life disability that may benefit from preventive efforts in mid-life.
THE FIT OF THE HAPA MODEL TO THE EXPERIENCE OF EXERCISING AFTER STROKE: A DEDUCTIVE CONTENT ANALYSIS
Authors: Silva-Smith Amy 
Published: December 2022

Abstract
Sustained physical activity is recommended for secondary stroke prevention. Persons with stroke leave rehabilitation having learned exercises to reduce disability. However, once discharged, people may be on their own to navigate psychological, emotional, social, and physical challenges of maintaining those activities and starting new ones. The Health Action Process Approach (HAPA) provides a framework for understanding how self-efficacy differs depending on where a person is in the process of engaging in physical activity. The purpose of this study was to assess the qualitative fit of the HAPA model to the experience of exercise after discharge from formal stroke rehabilitation using a deductive (directed) content analysis approach. Interviews with 12 stroke survivors were analyzed deductively using the HAPA model concepts task self-efficacy, coping self-efficacy, and recovery self-efficacy to create the analysis matrix. In this sample, a period of psychological adjustment interfered with maintaining exercise and included anxiety, depression, embarrassment, and fear of falling that affected motivation and intention to exercise. Experiences with physical activity and exercise as a child and routines prior to the stroke were factors influencing task, coping, and recovery self-efficacy and ease of dealing with interruptions in exercise, including the discharge from formal rehabilitation. The findings support the qualitative fit of the HAPA model with the experience of exercise after having a stroke. A HAPA model framed intervention is being developed to support the transition from formal rehabilitation support to living in the community.