bluuebunny/crossref_metadata_2025_split huggingface dataset:
ABNORMALITIES IN THE CITRATE CYCLE METABOLISM ARE ASSOCIATED WITH DECLINED INTRINSIC CAPACITY IN OLDER ADULTS
Authors: Pan Yiming , Liu Pan , Li Yun , Ma Lina 
Published: December 2022

Abstract

Background
Aging is accompanied by a decline in physical and mental functions, manifested as the declines in intrinsic capacity. However, there is still a lack of understanding about the metabolic mechanisms underlying the declining intrinsic capacity. Objective: To explore the metabolic characteristics and pathways of the declines in intrinsic capacity with the assistance of metabolomics methods.

Methods
Our study recruited 38 participants in total. The Short Physical Performance Battery, Mini-Mental State Exam, 30-item Geriatric Depression Scale, self-reported hearing/visual impairment and Mini Nutritional Assessment were used to assess the five domains of intrinsic capacity respectively. The untargeted liquid chromatography-mass spectrometry-based metabolomics was performed on the serum of participants. Multivariate statistical analysis and pathway analysis were then implemented.

Results
Among the 38 participants aged 66.50±15.20 years, 22 were with the declines in at least one domain of intrinsic capacity. In the 349 identified metabolites, 35 were candidate biomarkers for declining intrinsic capacity with variable importance in the projection &gt; 1.5 and p &lt; 0.05. Citrate cycle, tryptophan metabolism, phenylalanine and tyrosine metabolism, and Arginine biosynthesis were significant pathways associated with the declines in intrinsic capacity.

Conclusions
Decreased intrinsic capacity is an age-related change with characteristic metabolomics features. Many pathways, especially the dysregulation of the citrate cycle metabolism, may be involved in the pathogenesis of intrinsic capacity decline.
PATTERNS OF AGING CHANGES IN BODY WEIGHT AND BMI MAY PREDICT CHANCES OF ALZHEIMER'S DISEASE AND LONGEVITY
Authors: Ukraintseva Svetlana , Arbeev Konstantin , Duan Hongzhe , Holmes Rachel , Akushevich Igor , Yashkin Arseniy , Whitson Heather , Yashin Anatoliy 
Published: December 2022

Abstract

Background
Lower bodyweight/BMI was previously linked to AD and frailty; however, the role of long-term changes in the bodyweight/BMI in both AD and longevity is not well understood, as is the role of APOE polymorphism in such changes.

Methods
Using longitudinal data from the Framingham Heart Study (FHS) and the Health and Retirement Study (HRS), we estimated trajectories of the weight and BMI at ages 40 to 75, and compared them between individuals who did and who did not develop AD at ages 75+. We also evaluated associations between APOE4 carrier status and key characteristics of the age-trajectories of weight/BMI, including the age at peak value of the bodyweight/BMI (AgeMax), and slope of the decline in bodyweight/BMI after reaching the maximum.

Results
Women with late-onset-AD had lower bodyweight/BMI values up to three decades before AD diagnosis. They reached the peak of bodyweight in their 50s, about 10 years earlier than AD-free women. Younger AgeMax was associated with lower survival chances after age 80 in women. APOE4 carriers showed earlier/faster declines in weight and BMI than non-carriers; however, relevance of this to AD was unclear.

Conclusion
Younger age at peak value of the bodyweight/BMI indicates higher chances of late-onset-AD, while older age can predict better survival later in life and may favor longevity in women. The earlier start of the decline in bodyweight/BMI values could be sign of accelerated aging, which may contribute to AD. Relevance of APOE4 effects on age-trajectories of weight/BMI to AD warrants further investigation.
THE ROLE OF SYSTEMIC INFLAMMATION IN HEALTH NOW, LATER, AND CHANGE OVER TIME: EVIDENCE FROM MIDUS
Authors: Allen Julie Ober 
Published: December 2022

Abstract
Systemic inflammation is theorized to be a biological pathway through which chronic stressors (e.g., discrimination, social marginalization) contribute to adverse health outcomes and disparities among older adults. Cross sectional research documents associations between inflammation and a broad array of health outcomes. Less is known about whether and how inflammation may influence health longitudinally. This study investigated whether a composite measure of inflammatory burden predicted physical health: a) concurrently, b) approximately 7 years later, and c) changes during that time. Data derive the National Survey of Midlife in the United States (MIDUS) participants who provided inflammatory biomarker data (2004-2009 Biomarker study) and health data in MIDUS 2 (2004-2006) and MIDUS 3 (2013-2014) (N=931, Mage 57, 45% male, 91% White). Inflammatory burden reflected the number of inflammatory biomarkers in the highest risk quartile, out of five: C-reactive protein, interleukin-6, fibrinogen, E-selectin, and intracellular adhesion molecule. Three general indicators of physical health were examined: number of commonplace chronic physical health conditions, out of 7; functional limitations; and self-rated physical health. Multivariate regression analyses indicated that inflammatory burden predicted all three concurrent physical health outcomes and the same health outcomes seven years later (p-values &lt;.02). Inflammatory burden was unrelated to changes in these outcomes over time. This study adds to the literature on stress-related biological mechanisms of health and identifies a potential clinical indicator of enduring health problems. It also suggests that while inflammatory burden may demonstrate consistent relationships with physical health over time, other mechanisms may account for health changes and deterioration.
RISK REDUCTION OF HOSPITAL ADMISSIONS FOR PEOPLE WITH DEMENTIA IN SHARED-HOUSING ARRANGEMENTS: THE DEMWG STUDY
Authors: Wolf-Ostermann Karin , Stiefler Susanne , Schmidt Annika , Friedrich Anna-Carina , Gräßel Elmar , Donath Carolin , Scheel Jennifer , Kratzer André 
Published: December 2022

Abstract
People living with dementia (PlwD) have an increased risk of hospital admission which may result in severe consequences. The DemWG-study therefore aims to investigate whether a complex intervention in shared housing arrangements (SHA) for PlwD reduces the number of hospital admissions. Furthermore, quality of life, risk of falls, and stabilization of cognitive abilities are assessed. The intervention includes motor and cognitive training for PlwD and education of caregivers and general practitioners. The study is conducted in 88 SHA in Germany with a total of 330 PlwD and a 6 months intervention. Data are collected up to 18 months after baseline, including quantitative and qualitative data. Results from caregivers’ perspectives on the intervention designate a perceived improved social interaction, which in turn has a positive effect on living together in the SHA. Based also on the results of the ongoing quantitative assessments recommendations for better care and support will be derived.
HOW DO GREEN CARE FARMS FOR PEOPLE LIVING WITH DEMENTIA SUCCESSFULLY INTEGRATE OUTDOOR SPACES?
Authors: Rosteius Katharina , de Boer Bram , Verbeek Hilde 
Published: December 2022

Abstract
Green Care Farms (GCFs) are an innovative care environment for vulnerable groups. This study explores the design, and the successful integration of the natural environments of GCFs. By actively integrating outdoor spaces into daily care, they may encourage residents to participate in meaningful activities. A case study was conducted on a Dutch GCF using mixed ethnographic methods. 129 hours of observations of daily life were combined with 24 semi-structured interviews with residents, family, volunteers, staff and management, and a focus group with staff. The physical environment was assessed quantitatively. Data was analyzed thematically and triangulated. Results indicate that some factors supported the integration of the outdoor spaces into daily care. First, the physical environment was specifically designed to stimulate residents. Second, the outdoors was easily and openly accessible for residents. Third, residents’ security was supported in several ways. Lastly, staff members creatively motivated residents to use the outside spaces.
CREATION AND VALIDATION OF A POLYSOCIAL SCORE FOR PHYSICAL FRAILTY AMONG COMMUNITY-DWELLING OLDER ADULTS IN THE US
Authors: Wu Chenkai , Tang Junhan 
Published: December 2022

Abstract
The interrelatedness between social determinants of health impedes researchers from identifying important social factors for health investment. A new approach is needed to quantify the aggregate effect of social factors and develop person-centered social interventions. Data are from the Health and Retirement Study; 6,075 older adults initially not frail (non-frail or prefrail) were included. Frailty was assessed by slowness, weakness, exhaustion, inactivity, and shrinking. Persons were classified as “nonfrail” (0 criteria), “prefrail” (1–2 criteria), or “frail” (3–5 criteria). We included 24 social factors from five categories (economic stability, neighborhood environment, education, community/social context, and healthcare system) and used forward stepwise regression to screen for important ones. Polysocial score was created using 15 social factors and was classified as low (0-29), intermediate (30-42), and high (43+). We used the Poisson regression to estimate the risk of incident frailty by three polysocial score categories. We found that 444 (34.5%), 651 (17.9%), and 108 (9.4%) cases of incident frailty at the 4-year follow-up among participants with a low, intermediate, and high polysocial score, respectively. In the multivariable-adjusted Poisson model, the risk of frailty among participants in the intermediate and high polysocial score categories was 35% and 59% lower than those in the low polysocial score category, respectively. We found a universal association between polysocial scores and frailty across race/ethnicity and sex subgroups. The polysocial approach may offer possible solutions to monitor social environments and suggestions for older people to improve their social status for specific health outcomes.
DISTINCT PROFILES OF SEDENTARY BEHAVIORS IN OLDEST OLD ADULTS
Authors: Webster Katelyn , Zhou Weijiao 
Published: December 2022

Abstract
Sedentary behavior (SB) is a significant health risk. Emerging research suggests that mentally active SB (such as computer use and reading) were associated with better health than mentally passive SB (such as watching TV). However, this has not been examined among the oldest old (age ≥80). The aims of this study were to (1) identify distinct profiles of oldest old adults based on six domains of SB (watching TV, using a computer/tablet, talking to friends or family members, doing hobby or other activities, transportation, and resting/napping); and (2) compare health-related outcomes across identified profiles, using the National Health and Aging Trends Study (NHATS) dataset. Latent profile analysis was used to identify distinct profiles of SB. Design-based linear and logistic regressions were used to examine associations between different profiles and health outcomes, accounting for sociodemographic characteristics. We identified four profiles and named them based on total sedentary time (ST) and passive/active pattern (n=852, “Low ST”, “High ST-passive”, “Medium ST-TV”, “High total ST-mentally active”). Compared to the “High ST-passive” group, “Low ST” group was associated with fewer difficulties with activities of daily living, fewer problems limiting activities and higher cognitive function; “High ST-mentally active” group was associated with the above outcomes, as well as lower anxiety and depression. This study, with a national representative sample of the oldest old population, suggests that both total ST and SB pattern matter when evaluating health outcomes of being sedentary. Interventions should encourage oldest old adults to reduce ST and especially target mentally passive ST.
OBJECTIVELY MEASURED PHYSICAL ACTIVITY PATTERNS OVER 24-HOURS BY APOE-Ε4 CARRIER STATUS
Authors: Wanigatunga Amal , Marino Francesca , Liu Fangyu , Simonsick Eleanor , Tian Qu , Deal Jennifer , Resnick Susan , Schrack Jennifer 
Published: December 2022

Abstract
The Apolipoprotein-ε4 (APOE-ε4) genotype is associated with earlier onset and greater risk of β-amyloid deposition, but whether APOE-ε4 status is associated with physical activity amount or fragmentation remains unclear. In 563 BLSA participants aged 55-97 years with APOE-ε4 and ≥3 days of wrist accelerometry data, multivariable linear regression models were fitted to estimate differences in activity amount (daily or by 6-hour time blocks) or fragmentation by APOE-ε4 status and to test whether age modifies these effects. Overall, daily activity amount and fragmentation did not differ by APOE-ε4 status (p=0.28 and p=0.93, respectively). Yet, age significantly modified the APOE-ε4 effect. Per each additional year of age, APOE-ε4 carriers had less activity during early morning (12:00-6:00AM) than non-carriers (p=0.035). This association was non-significant among the oldest-old (p=0.697 at age 80 years, p=0.347 at age 90 years), suggesting possible decreases in the predictive power of APOE-ε4 with increasing age.
WHAT CAN DUAL-TASK WALKING AND TAPPING TELL US ABOUT SUBJECTIVE COGNITIVE DECLINE? AN FNIRS STUDY
Authors: Salzman Talia , Perreault Hannah , Farhat Farah , Vallejo Diana Tobon , Fraser Sarah 
Published: December 2022

Abstract
Older adults who pass standard cognitive tests but report subjective cognitive decline (SCD) may be identifying early changes in cognition at a stage when intervening can prevent further declines. Changes may be subtle highlighting the need for novel approaches, such as divided attention tasks, to distinguish between those with and without SCD. This pilot study examined 15 older women (9 SCD, 6 non-SCD) completing dual-task walking and tapping. Brain (cerebral oxygenation) and behavioural (gait and tap speed, accuracy, and vocal response) measures were assessed during single and dual-tasks. Older adults with SCD were marginally less accurate during dual-task tapping (p &lt; .06) and had greater cerebral oxygenation than the non-SCD group (p = .01). SCD did not moderate gait speed from single to dual-task while non-SCD did (p = .02). Findings suggest that challenging dual-task paradigms may help identify different behavioural and brain activity markers of SCD and intervention targets.
EARLY CHARACTERISTICS AND BIOMARKERS OF COGNITIVE IMPAIRMENT AND DEMENTIA WITH PRIOR MOTOR IMPAIRMENT
Authors: Tian Qu , Resnick Susan , Ferrucci Luigi 
Published: December 2022

Abstract
Motor impairment is one early feature of preclinical Alzheimer’s disease and strongly predicts future dementia. Whether older persons with dementia who had prior motor impairment present specific characteristics is less clear. In the Baltimore Longitudinal Study of Aging, we compared characteristics of participants with cognitive impairment or dementia who had slow gait on average 6 years before symptom onset (&lt;1.0m/sec)(n=65,81±7 years,35%women,25%black) to those who did not (n=93,77±7 years,61%women,16%black). Early cognition and key biomarkers on average 7 years before onset were compared between groups using multivariable linear regression, adjusted for demographics. Those with prior slow gait had early unfavorable metabolic panel (higher fasting glucose,higher 2hr-OGTT insulin,lower HDL,higher triglyceride,higher BMI and waist,higher blood pressure), lower manual dexterity and processing speed, and lower lysophosphatidylcholine 18:1 and 18:2, critical in the synthesis of cardiolipin-an essential component of mitochondrial membranes. Strategies to prevent metabolic dysfunction at an early stage may slow down dementia progression.
NURSING FACILITY QUALITY, CLOSURES, AND STAFFING
Authors: Tyler Denise 
Published: December 2022

Abstract
The quality of care provided in nursing facilities has long been a societal concern and an important focus of policy at the federal and state level. The COVID-19 pandemic has drawn increased attention to nursing facilities due to high infection and mortality rates as well as increased media attention on staffing shortages that have occurred in the wake of the pandemic. The Office of the Assistant Secretary for Planning and Evaluation (ASPE) and RTI International have recently completed a series of studies focused on nursing facility quality and staffing. This symposium will present the results of four of those studies. First, we will report the results of a study exploring states’ use of value-based payment (VBP) programs as part of their nursing facility Medicaid payment systems. Second, we will present the results of a study examining inappropriate discharges from nursing facilities. Third, we will report findings from a study that examined the factors associated with nursing facility closures. Finally, we will present findings from a study that explored the effect of the pandemic on nursing facility staffing. Together these studies provide important information about the state of nursing facilities in the wake of the COVID-19 pandemic and suggest key areas of focus for policymakers.
ASSESSING THE FACTORS ASSOCIATED WITH NURSING HOME CLOSURES
Authors: Hughes Kelly , Li Qinghua , Feng Zhanlian , Oliveira Iara , Dey Judith 
Published: December 2022

Abstract
The media has reported recent increases in nursing home closures. This study examined closures from 2011-2019, identified facility and market characteristics associated with closures, and assessed the impact of closures on quality and access. We identified closures using termination dates and gaps in certification surveys and conducted descriptive and multivariate analysis. We identified 1,220 closures, with large increases in closure rates in 2018 and 2019 and geographic clusters. Chain facilities, urban facilities and smaller facilities were more likely to close, as were facilities with higher percentages of non-white and Medicaid residents. Staffing and quality five-star ratings had a nonlinear relationship with closure, which suggests Medicaid funding may impact closures rates. We found both the number of beds per 1,000 elderly and occupancy rates decreased, including in high-quality facilities. Closures should be examined further in the context of the COVID-19 pandemic.
COMING OUT AND GOING BACK IN: AGING AND STRATEGIC IDENTITY DISCLOSURE AMONG LGBTQ ADULTS
Authors: Sweeny Brian 
Published: December 2022

Abstract
In addition to facing social, economic, and health disparities, LGBTQ older adults face prejudice and discrimination across various social domains, leading some to re-enter the closet. When might older adults openly identify as LGBTQ, and when might they conceal this identity? Based on participant observation and interview data collected in two naturally occurring retirement communities in New York City, this paper examines LGBTQ identity and coming out in relation to aging processes, especially changing care networks and family structures, decreasing autonomy, and increasing engagement with health and social services. The older LGBTQ adults in the study feel the benefits of broad social changes and increasing cultural competencies regarding LGBTQ issues, yet they also speak of unsafe spaces, experiences of exclusion, and uncertainties. I analyze three specific identity disclosure strategies older LGBTQ adults use as they navigate prejudice and discrimination and work to affirm identities as aging gender and sexual minorities.
SEEING THROUGH A HOUSING LENS: STUDYING HOUSING-FOCUSED RESPONSES TO THE NEEDS OF OLDER ADULTS DURING THE PANDEMIC
Authors: Berlinger Nancy 
Published: December 2022

Abstract
This paper draws on a study of unindexed literature produced by local and state policymakers, Area Agencies on Aging, nonprofit organizations, for-profit companies, age-friendly initiatives, affordable housing providers, and other groups responding to the needs of older adults at home during the COVID-19 pandemic. By collecting and analyzing descriptions of how service providers pivoted or improvised to meet urgent challenges, we sought to identify promising practices and policy ideas preserved in reports, newsletters, websites, and other communications. This paper reviews study methods and recommendations, and explores a concept that emerged from this research: recognizing services and support for older adults at home as “housing-focused” care that relies on the affordability, accessibility, and safety of a person’s home. The applications of the “housing lens” to future research on housing, aging, and health and to making progress on better integrating housing policy and health policy in aging societies will be discussed.
LEVERAGING THE STRENGTH OF UNIQUE PARTNERS TO IMPROVE GERIATRIC EMERGENCY CARE IN RURAL CRITICAL ACCESS HOSPITALS
Authors: Rodi Scott 
Published: December 2022

Abstract
Developing a level 1 accredited geriatric emergency department during the pandemic was challenging. The greater challenge has been to support rural critical access hospitals on their journey of becoming level 2 accredited geriatric emergency departments. This has been accomplished through a novel collaborative approach between the level 1 accredited emergency department, a newly established Geriatric Center of Excellence at Dartmouth-Hitchcock Health and a HRSA funded Geriatric Workforce Enhancement Program. This talk will focus on bringing together system partners and funders who have a history of success through: (a) development, testing and dissemination of tool kits and implementation guides; (b) boot camp training that includes interprofessional team training, QI and specific geriatric content training; (c) implementation support and coaching using data and QI methodology through learning collaboratives; (d) scaling successful models of evidence based geriatric care; (e) expertise in implementation science; (f) expertise in evaluation and (g) disseminating findings to achieve our goals.
IMPACT OF CAREGIVING DURING THE COVID-19 PANDEMIC: COMPARISON BETWEEN DEMENTIA AND NONDEMENTIA CAREGIVERS BY RACE
Authors: Moon Heehyul , Rote Sunshine , Sears Jeanelle , Niemiec Stacey Schepens 
Published: December 2022

Abstract
Despite evidence of increased caregiving intensity, stress, and burden during the COVID-19 crisis and clear racial disparities in COVID-19, there is a lack of research on the impact of dementia (vs. non-dementia) care provision on caregivers’ (CGs) quality of life by race. The current study used the National Health and Aging Trends Study COVID-19 Family Members and Friends data (N=1,462, 15% Black and 85% Non-Hispanic White CGs) to explore differences in primary stressors (changes in the provision of help with ADL and IADL tasks and emotional support) by dementia care and race during COVID-19. Most respondents were adult children. Dementia CGs in particular reported increases in stressors (ADL and IADL provision) during the pandemic. Black dementia CGs reported significantly more provision of help with ADL tasks before and after the COVID-19 onset and a significantly higher level of emotional support to their care recipients compared with the other three groups (Black non-dementia, White dementia, and White non-dementia CGs). Black dementia CGs also reported the highest care burden and worst psychological well-being and self-rated health during COVID-19. Findings revealed significant differences in the magnitude and nature of the changes in CG help provision before and amidst the pandemic, by race and dementia care status. Future studies should examine the longitudinal impact of the pandemic on the well-being of CGs from other racial and ethnic minority groups.