bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREVALENCE, BURDEN, AND LOCATION OF CEREBRAL MICROINFARCTS AND THEIR ASSOCIATION WITH LATE-LIFE BLOOD PRESSURE
Authors: Sin Mo-Kyung , Cheng Yan , Ahmed Ali , Roseman Jeffrey , Zamrini Edward 
Published: December 2022

Abstract
Little is known about the relationship of late-life blood pressure (BP) profiles (level, trend and variability) with the presence, number and regional distribution (cortical vs subcortical) of cerebral microinfarcts. We examined these associations in older adults (age ≥65) using the Adult Changes in Thought (ACT) data. 551 participants (94.6% ≥80 years, 58.6% women, 94.2% white) had complete data on microinfarcts and 4 BP measures. Late-life BP, defined by the four BP values before death (2 year-time gap between measures), was treated using 3 different approaches: (1) categories (based on mean of 4 values); (2) trend (based on the difference between values 1 and 4); and (3) variability (based on standard deviation of the mean of the changes in 4 BP values from 1 to 4). Multivariable-adjusted logistic regression models were used to examine the associations of the late-life BP with microinfarcts, adjusting for relevant covariates. Each of the 5 systolic BP categories between 120 and 169 mmHg (reference: 110–119 mmHg) had significant twice higher odds (4 times for SBP ≥170) of presence and number of microinfarcts, which was only significant for subcortical region. Similar higher odds were observed for systolic BP trend (increase/decrease/no change), which was significant for both cortical and subcortical microinfarcts. Systolic BP variability had no significant association with microinfarcts. Similar associations were observed with diastolic BP. In conclusion, the presence (especially for subcortical regions) and number of microinfarcts were more likely to be in those with higher mean BP and those whose BP changed over the study.
CARDIOVASCULAR DISEASES PREDICT ALZHEIMER’S DISEASE ONSET IN NON-DEPRESSED ADULTS
Authors: Natale Ginny , Clouston Sean 
Published: December 2022

Abstract
We examined the mediating or moderating effect of stroke on the effect of cardiovascular disease (CVD) and the onset of Alzheimer’s disease (AD) in a nationally-representative sample of older Americans with and without clinical depression. Diagnosis of CVD was adjudicated with the established Health and Retirement Study (1992–2016) methodology and included self-reported coronary heart disease, angina, heart failure, myocardial infarction, or other heart conditions. Probable-AD and probable-Stroke were identified inferentially using a validated pattern recognition algorithm. Analyses were stratified by a validated cutoff of the Center for Epidemiologic Studies Depression Scale (CES-D.) Participants (Nf17,154) were observed an average of 8 times over the span of 20 years (Obs=138,510). 12% of all AD cases are preventable by eliminating CVD in older adults in the US, compared to the 31% of all AD cases are preventable by eliminating stroke in the population. In non-depressed adults, risks for accelerated AD onset included: CVD, stroke, age, diabetes, and current smoking. Non-depressed females had delayed AD onset than males. The interaction of CVD x Stroke accelerated AD onset by 1.79 times (95%C.I. =1.63–1.97) in non-depressed adults. CVD was not a significant risk of AD onset in depressed adults. We conclude that 1)reducing the incidence of CVD and strokes in the US would drastically reduce the number of new cases of AD; and 2) stroke compounds the CVD hazards of accelerated AD onset; and 3) clinical depression is a key modulator of the effect of the risk factors of accelerated AD onset.
A QUALITY INITIATIVE TO INCREASE HOSPICE REFERRALS FOR STARS PATIENTS DURING THE SECOND COVID SURGE
Authors: El Shanawany Perihan , Nouryan Chris , Choi Chris , Flynn Ann , Burns Edith 
Published: December 2022

Abstract

Background
CMS uses the Overall Hospital Quality Star Rating program to stratify hospitals based on specific quality criteria (e.g., 30-day readmissions of older adults with pneumonia). “STARS patients” experience more readmissions, longer LOS and often have more complex discharge plans. During the second surge of COVID we implemented a program to increase hospice referrals through early identification and implementation of goals of care (GOC) conversations.

Methods
Electronic Medical Records reviewed for STARS patients from pre- (1/2019-7/2020) and post (3/2021–2/2022) program implementation. Location: 2 community-based hospitals. Data collected: demographics, hospital outcomes, discharge disposition. Data compared with Student’s t tests and Chi square.

Results
459 patients, 177 pre-program and 282 post-program were included. Groups were similar in age (83.0 vs 83.6), LACE score (13.0 vs 12.8), principal diagnoses (PNA: 41.5% vs 46.0%, HF/COPD/AMI: 58.5% vs 54.0%), and mortality (3.5 vs. 4.0%). LOS increased 4.9 days vs. 6.1 days (p &lt; 0.01), readmission rates unchanged: 12.6% vs 13.0% (p=0.90). GOC conversations increased, 48.6% to 75.0% (p &lt; 0.01), DNR from 24% to 44% (p &lt; 0.01), and comfort measures from 0.5% to 5% (p &lt; 0.01). Hospice referrals increased from 0.5% to 11.2% (p &lt; 0.01). Discussion: Early identification of STARS patients increased GOC conversations, DNR, comfort measures and hospice referral. Patients across time periods were similar in age, LACE and admitting diagnoses. LOS increased by a day, likely reflecting time needed to arrange discharge disposition. Increased hospice at end-of-life is associated with better quality care and patient/family satisfaction. This program may be adapted to larger, academic medical centers within the health system.
GLOBAL ELDER ABUSE: A MEGA-MAP OF SYSTEMATIC REVIEWS
Authors: Estenson Lilly , Marnfeldt Kelly , Yon Yongjie , Mikton Christopher , Wilber Kathleen 
Published: December 2022

Abstract
Elder abuse is an increasingly prevalent public health problem that requires a global political and evidence-based response. To make global evidence on elder abuse easier to locate and analyze, we constructed a mega-map – an interactive map that systematically identifies and overviews existing systematic reviews – on elder abuse prevalence, consequences, risk and protective factors, and interventions. Following Campbell Collaboration methodological guidelines, we conducted a comprehensive database and grey literature search of the global elder abuse literature (n=2,776) to identify systematic reviews that examine one or more of these four abuse domains among adults age 60+ (n=111). We then coded the reviews to identify key characteristics, including the types of abuse, settings, World Health Organization (WHO) geographic regions, and demographic subgroups represented in each review, that can be filtered in the mega-map. We also adapted the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Review and Research Syntheses to appraise the quality of each review. We found that the focus of existing evidence syntheses is most commonly interventions (n=59), followed by prevalence (n=52), risk factors (n=51), consequences (n=31), and protective factors (n=16). The majority of published elder abuse studies have been conducted in the European, Western Pacific, and Region of the Americas WHO geographic regions. Few reviews examine systemic abuse and system-level interventions. Future studies on elder abuse should address these gaps in research on protective factors and systemic aspects of elder abuse, and build evidence about elder abuse in the African, South-East Asian, and Eastern Mediterranean WHO geographic regions.
PERSONALITY PROFILE OF RURAL-DWELLING OLDER ADULTS IN AN ONGOING HOARDING TREATMENT STUDY
Authors: Nix Caitlyn , Dozier Mary 
Published: December 2022

Abstract
Symptoms of hoarding disorder, such as significant household clutter, difficulty discarding, and excessive acquisition tend to increase in later life. With many challenges involved in aging in place, older adults may be particularly vulnerable to adverse events occurring while living with excessive clutter (e.g., fall risk, sanitation issues). Therefore, understanding what factors predict hoarding symptom severity is an essential step towards increasing older adults’ ability to age in place while experiencing hoarding symptoms. Personality traits have been demonstrated to predict hoarding symptoms in a wide range of ages. However, a sample of older adults in this clinical population has not been evaluated. The IPIP-NEO-60 is a shortened version of a widely used open-source personality measure that utilizes the five-factor model of personality (Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness). We used this measure to evaluate the personality profiles of rural-dwelling older adults (age 50 and up, M = 63) enrolled in an ongoing treatment study for hoarding disorder (n = 14). Compared to normative data from 910 adults aged 50 and up and matched for gender, most participants scored in the average range for Neuroticism, Extraversion, and Openness, with a nearly even split between high, low, and average scores for Agreeableness. Half of participants scored in the low range for Conscientiousness. Given the considerable proportion of participants demonstrating low Conscientiousness in this sample, screening a larger sample for beyond-average facet scores within this factor (e.g., self-efficacy, cautiousness) may assist clinicians in selecting impactful treatment targets for hoarding disorder in older adults.
RISK FACTORS FOR HAZARDOUS DRINKING AMONG DEMENTIA FAMILY CAREGIVERS
Authors: Chilatra Jessica Hernandez , Browning Wesley , Wang Danny , Pickering Carolyn 
Published: December 2022

Abstract
Little is known about alcohol use disorder (AUD) among family caregivers of people living with dementia, even though it is suspected as a contributing cause for caregiving outcomes such as elder mistreatment. This study examines the frequency of and potential risk factors for hazardous drinking (one dimension of AUD, measured by the Alcohol Use Disorders Identification Test AUDIT-C) among a sample of dementia family caregivers (Nf165). We used data from the first wave of an ongoing longitudinal study on daily dementia caregiving experiences. We computed binary logistic regression models using SPSS version 28 to identify potential risk factors. Among our sample, 20% of caregivers identified as positive for hazardous drinking. Caregivers with greater difficulty regulating their emotions (OR= 1.046, P=0.005, [95%CI] = 1.014–1.079) had significantly greater odds for hazardous drinking, as well as those with a history of physical neglect in childhood (OR=1.176, P=0.01, [95%CI] =1.037–1.334) and those who seek social support as a coping mechanism (OR=1.119, P=0.01, [95%CI] = 1.027–1.220). Additionally, the higher number of ADLs their relative needs assistance with the lower the odds (OR=0.775, p=0.01, [95%CI] =0.64–0.94) of hazardous drinking. Demographic factors such as gender and age were not associated with hazardous drinking, though the sample was predominantly female (90%). Findings show that dementia family caregivers experience hazardous drinking at a rate higher than the general population (6–16%) suggesting family caregivers are at a uniquely higher risk for AUD. Furthermore, the potential risk factors could inform future screening efforts to identify family caregivers experiencing hazardous drinking.
A DEMENTIA IMMERSION SIMULATION EXPERIENCE AS A TRAINING TOOL FOR HEALTH CARE PROFESSIONALS
Authors: Sanchez-Reilly Sandra , Reilly Paula , Reilly Elizabeth , Silva Isabella , Arevalo Lyda , Zaragoza Gabriela 
Published: December 2022

Abstract

Background
Dementia, a progressive, devastating and incurable disease affects millions of older Americans and their caregivers. Effective dementia-training programs for caregivers and healthcare professionals (HP) can lead to improved patient outcomes. Simulation-educational experiences are innovative with long-lasting impact. Currently, there are no simulation hands-on experiences focused on dementia care to train HP or hired caregivers (HC). Objective: To evaluate the educational effectiveness of a Dementia Immersion Simulation Experience (DISE) intervention among HP and HC.

Methods
DISE is a face-to-face 2-hour intervention that includes virtual reality, hands-on simulation with multiple sensory experiences, group debriefing led by dementia-caregiving expert. Program evaluation and pre/post knowledge assessments were administered.

Results
Nf110. HP, Nf72; HC, Nf25. Pre/post mean score of knowledge assessment (scale 0–12) for all was 8.3/9.7 (p &lt; 0.0001). Participants were also grouped by whether they were “well-informed” (achieving 10 or better on knowledge assessment) or had “knowledge gap” (9 or fewer). 25% were well-informed on dementia before DISE; 63% after DISE (p &lt; 0.0001). DISE program evaluation showed 98% participants highly rated experience across all categories. Evaluation scores further support an effective program. Furthermore, number of clinical referrals seeking expertise from a dementia specialist/team increased by 50% two months post-intervention.

Conclusion
DISE is a successful tool to teach, support and empower HP and HC, effectively changing care provided to individuals with dementia by using hands-on simulation training. Further studies are needed to evaluate the effectiveness of DISE in improving behavioral symptoms, training family caregivers, and decreasing other dementia-related undesirable outcomes such as nursing home placement.
UNIQUE TRANSKINGDOM MICROBIOME SIGNATURES LINKED WITH COGNITIVE DECLINE IN OLDER ADULTS OF MIAGB CONSORTIUM COHORT
Authors: Chaudhari Diptaraj , Jain Shalini , Yadav Hariom , Masternak Michal , Holland Peter , Agronin Marc ,   MiaGB Consortium Team
Published: December 2022

Abstract
The prevalence of age-related cognitive disorders is increasing. Effective prevention and treatment interventions are unavailable due to a poor understanding of aging biology. Multiple emerging evidence indicates that the gut microbiome is linked with age-related disorders; however, their clinical importance in differentiating and predicting the risk of cognitive decline or dementia is largely elusive. Utilizing samples and data of a large, multi-site clinical study across the state of Florida called Microbiome in aging Gut and Brain (MiaGB) Consortium, our whole genome microbiome sequencing revealed that the viral and archaeal population was significantly reduced in the gut of older adults with dementia (n=8) compared to those with mild cognitive impairment (MCI) (n=25) and normal cognition (n=59). Whereas the fungi were exclusively detected in the controls only. Alpha diversity of the participants with MCI and dementia was lower than the cognitively healthy controls. The abundance of Actinobacteria and Verrucomicrobia phyla was higher, and Firmicutes phylum was lower in the participants with dementia. Bacteriophages Lactobacillus prophage Lj771 and Microbacterium phage Min1 were exclusively detected in the gut of the participants with dementia. The study also identifies key metabolic pathways altered in the controls versus the cognitive impairment state. Our biomarker discovery analyses also revealed that these unique microbiome signatures and pathways might have predictive power for cognitive decline and dementia risk and offer new targets for future therapeutic interventions.
THE WHATMATTERS APP: CO-DESIGNING PERSON-CENTERED CARE FOR PEOPLE WITH DEMENTIA IN CARE SETTINGS
Authors: Hung Lillian , Guo Ellen , Sakamoto Mariko , Lok Karen , Wong Yi , Tran Candy , Mann Jim , Berndt Annette , Egeberg Eva 
Published: December 2022

Abstract
The purpose of our study is to provide comfort through digital resources (e.g., music and visual materials) for patients/residents with dementia in hospitals and long-term care. By working with users (patients/residents, families, and staff) and using a co-design approach, we have developed a mobile app prototype called “WhatMatters” to equip staff with a useful digital tool for delivering person-centered care in hospitals and long-term care homes. Using user experience co-design methods, we conducted a series of virtual co-design workshops with acute and long-term care staff (n=10), clinical experts (n=3), residents (n=3), and patient and family partners (n=7) to understand: (a) what “comfort” means, (b) how care needs are communicated and provided for, and (c) how a mobile app may be used to support psychosocial needs of people living with dementia in hospital and long-term care settings. Thematic analysis has identified three themes to inform the development of the mobile app WhatMatters: (a) familiarity brings comfort, (b) sharing of information between staff and families allows for continuity of care and person-centered care, and (c) accessible and curated content can evoke memories and create a comforting space. Our study conclusions are: It is feasible and necessary to work with users (including clinical staff, patient, and family partners) and relevant stakeholders to co-design a mobile app, a useful tool to support the delivery of person-centered care in care settings.
UNDERSTANDING THE ROLE OF A SOCIALLY ASSISTIVE ROBOT TO SUPPORT AGING IN PLACE
Authors: Mois George , Vergara Lizandra , Ali Afnaan Afsar , Trinh Mimi , Rogers Wendy 
Published: December 2022

Abstract
Communities may lack the infrastructure and required resources to support healthy aging and aging in place. Advancements in technology development such as socially assistive robots and artificial intelligence present new opportunities to support and meet the needs of older adults. For example, Misty is a socially assistive robot designed to allow customizability and adaptability to support and meet diverse user needs pertaining to tasks and activities. Our research aim is to understand if Misty can facilitate social interactions with older adults, control the home environment, and provide reminders. We are exploring older adults’ attitudes towards Misty through demonstrations of these activities. Through this research we provide insights pertaining to the facilitators and barriers in the acceptance and use of a socially assistive robot like Misty, to support healthy aging. Furthermore, our findings will provide guidance for design and implementation of artificial intelligence through socially assistive robots in a home environment.
LIGHT THERAPY FOR SLEEP DISTURBANCE OF NURSING FACILITY RESIDENTS WITH DEMENTIA: A SYSTEMATIC REVIEW
Authors: Bian Wenxin , Toles Mark , Xavier Rose Mary 
Published: December 2022

Abstract

Background
Bright light therapy has shown promise in addressing sleep problems in nursing facility residents with dementia. However, recent studies yielded conflicting outcomes and few studies focused on nursing facilities. The purpose of this systematic review was to describe effectiveness of light interventions in nursing facility residents with dementia. Method: We searched PubMed, CINAHL, EMBASE, PsychINFO, and Scopus using key terms “sleep”, “dementia” and “residential facilities”, and synthesized data with thematic analysis and vote-counting.

Results
Of eight studies that met inclusion criteria, six were randomized controlled trials and 2 were quasi-experimental. Sample size ranged from 11 to 77 residents. Studies tested 3 light therapies: timed bright light (n=6), timed regular light (n=1), and variable 24hour light (n=1). Light delivery method, light exposure, and adherence to therapy protocols were not consistently reported. All studies indicated light therapy improved some resident outcomes, such as sleep efficacy and total sleep time; however, 88% of studies did not report sampling strategies or a statistical power analysis and 22% had small sample size (n &lt; 15).

Conclusion
Insufficient evidence is available to recommend light therapies for nursing facility residents with dementia. Adequately statistically powered studies that are rigorously designed with representative samples are needed for robust estimation of the effects of light therapy on sleep. Future studies must account for the unique characteristics of nursing facility residents with dementia that impact their adherence to light therapy.
DEVELOPMENT AND IMPLEMENTATION OF THE COGDRISK DEMENTIA RISK ASSESSMENT TOOL AND INTERACTIVE WEBSITE
Authors: Kootar Scherazad , Peters Ruth , Huque Md Hamidul , Eramudugolla Ranmalee , Anstey Kaarin 
Published: December 2022

Abstract
We developed a comprehensive risk assessment tool for dementia – Cognitive Health and Dementia Risk Assessment (CogDrisk) and a version specifically for Alzheimer’s disease called CogDrisk-AD that could be applicable in low and high-resource settings. This tool incorporates risk and protective factors identified through systematic synthesis of observational studies that report risk ratios. Risk and protective factors included in the tool were selected on the strength of evidence as well as the availability of measures that are practicable in a range of clinical and research contexts. Seventeen risk/protective factors were identified for inclusion in the dementia algorithm to estimate the risk of dementia while sixteen factors were identified for the AD model, with an overlap in the majority of the factors. CogDrisk and the CogDrisk-AD were predictive of dementia and AD when validated across four high-quality international cohort studies. To enable the CogDrisk tool to be implemented in practice our team has developed an interactive website where individuals 18 years and above can complete the CogDrisk questionnaire, obtain a personalised risk profile, and receive feedback on their risk profile. The website was developed with the capacity to collect and store data. We anticipate that the tool can be used by members of the public, in clinical settings and as a screening or outcome measure for clinical trials.
ANTICIPATED SUICIDAL AND DEATH IDEATION IN RESPONSE TO AN IMAGINED DEMENTIA DIAGNOSIS
Authors: Maxfield Molly , Peckham Allie , James Dara , Lathrop Laura , Fiske Amy 
Published: December 2022

Abstract
Alzheimer’s disease and related dementias are prevalent, incurable, and highly impactful diagnoses. Dementias are therefore feared diagnoses. Dementia-related anxiety (DRA) is anxiety about a current or future diagnosis of dementia and the associated complex symptoms. In a mixed methods study, semi-structured interviews were conducted to identify causes of DRA and revealed that numerous adults anticipated suicidal or death ideation if diagnosed with dementia. Fifty cognitively healthy, community-dwelling adults aged 58 to 89 (M = 70.92, SD = 6.08; 64% female) were recruited from a university participant registry and Memory Clinic. Among participants endorsing anticipated suicidal or death ideation, responses ranged from active plans, including interest in physician-assisted suicide, to more passive wishes to hasten death rather than continue to live with dementia. Within reports of both anticipated suicidal and death ideation, subthemes emerged, including the concern about becoming a burden to others in more advanced stages of dementia, the devaluation of life or the self with dementia, and the desire for (and anticipated thwarting of) control and independence. Statements of anticipated suicidal and death ideation were contingent on a future dementia diagnosis and may reflect errors in affective forecasting. Nevertheless, given the prevalence of dementias and older adults’ elevated rates of suicide, the intersection of these two public health issues warrants greater attention and further investigation.