bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEUROPSYCHIATRIC SYMPTOMS AND MORTALITY FOR COGNITIVELY NORMAL OLDER MEXICAN AMERICANS
Authors: Cantu Phillip , Snih Soham Al , Markides Kyriakos 
Published: December 2022

Abstract

Objectives
Neuropsychiatric symptoms (NPS) present in older adults with Alzheimer’s disease (AD) and other dementias are related to mortality. Research on the relationship between NPS and mortality in a non-dementia population has not been conducted. This study examines NPS as a predictor of six-year mortality among community dwelling Mexican Americans aged 80 years and older.

Methods
Data included 466 cognitively normal participants from wave 7 of the Hispanic Established Population for the Epidemiologic Study of Elderly. NPS were measured using the Neuropsychiatric inventory (NPI). Cox proportional hazard modes were used to estimate the hazard ratio (HR) of mortality.

Results
The hazard ratio death at six years was 1.02 (95 % CI, 1.00-1.04) as a function of having any NPI score and 1.09 (95% CI 1.02-1.17) for number of NPI conditions, controlling for demographic and health characteristics. Apathy, irritability, and aberrant motor behavior were all independently predictors of mortality.

Conclusions
NPS may be modifiable risk factors to increase survival time or may by indicative of underlying healthy problems. NPS may be related to underlying health conditions among older adults with normal cognitive functioning.
WEALTH INEQUALITIES IN PHYSICAL AND COGNITIVE IMPAIRMENTS AMONG OLDER ADULTS ACROSS EUROPE AND JAPAN
Authors: Quashie Nekehia , Le Dung D , Ibuka Yoko , Brandt Martina 
Published: December 2022

Abstract
Although prior research has provided insights on the association between country-level factors and health inequalities, key research gaps remain. First, most previous studies examine subjective rather than objective health measures. Second, the wealth dimension in health inequalities is understudied. Third, a handful of studies explicitly focus on older adults. To bridge these research gaps, this study aims to: i) measure wealth-related health inequalities in physical and cognitive impairments; and ii) examines the extent to which welfare states moderate wealth inequalities in physical and cognitive impairments among older people across Japan and Europe. We utilized harmonized data of non-institutionalized individuals aged 50-75 for physical and cognitive impairments from the Japanese Study of Aging and Retirement (JSTAR) and the Survey of Health, Ageing and Retirement in Europe (SHARE), for (n= 31,969 and 31,348, respectively). We applied a concentration index to quantify the degree of wealth inequalities in impairments. Our multilevel linear regression analyses examined whether national public health spending and healthcare access resources explained cross-country differences in wealth inequalities in physical and cognitive impairments. Findings indicated that inequalities in both impairment outcomes favored wealthier individuals in all countries, but the magnitude of inequality varied across countries under examination. Furthermore, a higher share of public health spending, lower out-of-pocket expenditures, and higher investment in healthcare resources were associated with lower wealth inequalities especially for physical impairments. Our findings suggests that different health interventions and policies may be needed to mitigate specific impairment inequalities.
INFORMAL CAREGIVING NETWORKS FOR PERSONS WITH DEMENTIA SUPERIMPOSED ON COMPLEX MULTIMORBIDITY
Authors: Song Mi-Kyung , Paul Sudeshna , Happ Mary Beth 
Published: December 2022

Abstract
Informal caregiving research has focused on the primary caregiver and caregiver-patient dyad. Thus, we know little about caregiving beyond the dyadic relationship. This study was to gain a comprehensive understanding of informal caregiving networks for individuals with dementia superimposed on complex multimorbidity. We used egocentric social network analysis to obtain caregiving information of 46 patients with moderate to severe cognitive impairment, 5 chronic conditions on average, and undergoing hemodialysis (4.3 mean years). Most patients (n=35, 77.8%) were Black, 22 (47.8%) male, and mean age of 73.9 years. Starting with the primary family caregiver (FCG), up to 2 additional FCGs were recruited for each patient, totaling 76 FCGs (46 primary, 30 non-primary). Most were a child of the patient (n=39, 51.3%), female (n=57, 75%), and 54.2 years of age. Of the 46 networks, 16 (35%) included only one FCG (singletons). Multimember networks (n=30, 65%) provided longer caregiving than singletons (7.7 vs 3.8 years, p=0.008). Average network size was 2.8, and 26 (54.5%) networks had at least one male caregiver. Among the 30 multimember networks, average size was 3.8, density (proportion of possible ties) was 0.9, and mean degree and maximum degree (number of ties per member to other network members) were 2.5 and 2.8, respectively. Higher mean and maximum degrees were associated with fewer 12-month patient hospitalizations (r=-0.47, p=0.01; r=-0.43, p=0.02, respectively). Including additional caregiver informants significantly increased network size, ties and maximum degree centrality compared to those based on primary caregiver only, allowing for fuller network description.
UNDERSTANDING THE IMPACT OF CARE LITERACY ON PREVENTATIVE CARE: EVIDENCE FROM FAMILY CARERS IN JAPAN
Authors: Costantini Hiroko 
Published: December 2022

Abstract
To address the importance of family carers’ understanding of care, encompassing their own care as well as the broader care and health social systems, this paper leverages the notion of ‘care literacy’. The aim of this study is to understand the variation in care literacy and the impact of care literacy on preventative care. The empirical focus is on working family carers for older relatives in Japan, through a cross-sectional online survey that includes a novel operationalization of care literacy, established measure of health literacy, assessment of information used to understand care, and measures of preventative care. The participants’ (n = 292) mean age was 53, with 44% women, and an average of 8.3 hours per week caring for their parent(s). The measure of care literacy is shown to be correlated, as expected, but distinct to health literacy (correlation 0.60). Based on regression analysis of care literacy, significant explanatory variables are health literacy (p&lt; 0.001), gender (p=0.044), number of sources of information on care (p=0.029), and care hours (p&lt; 0.001). In contrast, proximity in living arrangements of carer and care receiver, and severity of care needs were not significant predictors. Turning to the impact of care literacy, care literacy is a significant explanatory variable for use of preventative measures (p=0.002), in particular related to nutrition (p&lt; 0.001), frailty (p=0.028), dementia (p=0.090) and general home renovations (p=0.018). The pattern of results from this cross-sectional analysis indicates the importance of understanding the potential for improved care literacy as an enabler of better care.
MENTAL HEALTH AND WELL-BEING OF OLDER CARERS DURING THE COVID-19 PANDEMIC: EVIDENCE FROM ENGLAND
Authors: Gessa Giorgio Di , Price Debora 
Published: December 2022

Abstract
Older people caring at home or in the community play a vital role in supporting population health and wellbeing and in protecting health and care systems, often at cost to their own health. Yet there has been very little research or policy attention given to this group of carers during the pandemic. Exploiting longitudinal data from Wave 9 (2018/19) and the first two COVID-19 sub-studies (June/July 2020; November/December 2020) of the English Longitudinal Study of Ageing, we use logistic and linear regression models to investigate associations between changes in provision of informal care and mental health during the pandemic, controlling for socio-demographic characteristics, pre-pandemic physical and mental health, and social isolation measures. During the first months of the pandemic, about a quarter of older people provided informal care (with ~10% caring for members living in the same household). Those caring in the household experience worse mental health during the pandemic. Even controlling for prior characteristics and lack of social interactions, those caring for family members in the household had higher odds of reporting elevated depressive symptoms (OR=1.67, 95%CI=1.07;2.62), poor self-rated health (OR=1.73, 95%CI=1.09;2.73), anxiety (OR=2.21, 95%CI=1.20;4.06) as well as lower quality of life (B=-0.85, 95%CI=-1.66;-0.05) and life satisfaction (B=-0.43; 95%CI=-0.78;-0.09) than those who were caring for friends and family outside the household. As we aim to build back society and restore the wellbeing of our populations, policies and services should be better directed to support those people who during the pandemic struggled to cope while caring for their family members.
EMPOWERING BEHAVIOR CHANGE TO SUPPORT BRAIN HEALTH AMONG OLDER ADULTS
Authors: Lock Sarah , Han Duke 
Published: December 2022

Abstract
This symposium will provide highlights from the Global Council on Brain Health’s (GCBH) body of work on behavior change. This work is focused on developing a better understanding of (a) how to persuade and motivate people to engage in sustained healthy behaviors, (b) how to change policies within local communities to support individuals’ ability to make healthy choices, and (c) how to optimize conditions for brain health so all can thrive. The GCBH is an independent collaborative of scientists, clinicians, scholars, and policy experts convened by AARP to provide evidence-based advice on what people and professionals can do to maintain and improve brain health. The Council translates scientific research into actionable recommendations aimed at helping to drive behavior change in individuals across communities and cultures. Experts were brought together to build consensus around a range of factors at the individual and societal level that influence individual behavior and decision-making. This presentation will also draw upon lessons learned from the field of health promotion and examples from communication campaigns around heart health will be discussed as they relate to brain health. Nationally representative surveys, fielded by AARP Research including diverse respondents of adults 40+ and health care professionals diagnosing and treating dementia, found that misperceptions and stigma about dementia are commonplace and hinder efforts to address brain-healthy behaviors. Physicians who used to treat dementia patients, now themselves living with dementia, discuss how championing change, providing hope and refuting stigma can even help those living with a dementia diagnosis.
CLINICAL TRIAL OF METFORMIN FOR FRAILTY PREVENTION IN COMMUNITY-DWELLING OLDER ADULTS WITH PRE-DIABETES
Authors: Espinoza Sara , Wang Chen-pin , Michalek Joel , MacCarthy Daniel , Cortes Tiffany , Powers Becky , Musi Nicolas 
Published: December 2022

Abstract

Background
Metformin may reduce frailty through improving insulin resistance and inflammation, aging mechanisms known to increase frailty risk. We describe a randomized clinical trial of metformin for frailty prevention in community-dwelling older adults with pre-diabetes and provide baseline characteristics of randomized participants.

Methods
Older adults (65+ years) are studied in this randomized, double-blind, placebo-controlled trial of metformin (max 2,000 mg/day). Pre-diabetes, required for inclusion, is assessed by 2-hour oral glucose tolerance test (OGTT). Individuals with glomerular filtration rate &lt; 45 mL/min and frail individuals (Fried criteria) are excluded. The primary outcome, frailty, is assessed by both Fried criteria and frailty index. Secondary outcomes are physical function (short physical performance battery), lower extremity strength (Biodex), 6-minute walk, inflammation (systemic and skeletal muscle tissue), muscle insulin signaling, insulin sensitivity (insulin clamp), glucose tolerance (OGTT), and body composition (dual-energy x-ray absorptiometry). Subjects are followed for 2 years with safety assessments every 3 months and frailty assessment and OGTT every 6 months.

Results
145 participants (49% female, 35% Hispanic) are randomized. Mean age is 71.8 ± 5.4 years (range: 65-88), body mass index is 30.8 ±6 kg/m2, and Hemoglobin A1c is 5.6 ±0.4%. Using Fried criteria, 63.4% have frailty score of 0, 30.3% a score of 1, and 6.2% a score of 2.

Conclusion
Metformin is being examined as a potential therapeutic agent to prevent frailty in older adults with pre-diabetes. Findings from this trial may have future implications for screening and treatment of pre-diabetes in older adults for the prevention of frailty.
HEART-HEALTHY LIFESTYLES REDUCE THE RISK OF COGNITIVE DECLINE
Authors: Lock Sarah , Yaffe Kristine 
Published: December 2022

Abstract
The Global Council on Brain Health (GCBH) convened experts from around the world to examine the impact of cardiovascular risk factors on brain health. GCBH issue experts carefully considered how high blood pressure, diabetes and stroke, as well as lifestyle choices such as diet and exercise, influence brain health in adults age 50 and over. The GCBH concluded that the best evidence to date shows us “what’s good for the heart is good for the brain.” Their consensus puts powerful tools in the hands of adults wanting to protect their brain as they age. The GCBH adopted 10 recommendations for individuals to incorporate into their lives to keep heart and blood vessels healthy and reduce the risk for cognitive decline and dementia. These recommendations and 16 practical tips are provided in the final report. Liaisons from numerous civic and nonprofit organizations with expertise in heart and brain health helped develop these recommendations for adults 50+ and their health care providers.
RISK OF FRAILTY ASSOCIATED WITH COGNITIVE DECLINE, SENSORY IMPAIRMENTS, AND FUNCTIONAL LIMITATION IN OLDER ADULTS
Authors: Shin Jinhee , Kim Gwang Suk , Afaya Agani 
Published: December 2022

Abstract
The purpose of this study was to examine the effects and risk factors of cognitive decline, sensory impairment, and functional limitation associated with frailty among older adults. We conducted secondary data analysis using data from the Korean Longitudinal Study of Aging (2006–2018). The participants of this study consisted of 1,789 older adults over the age of 65 in South Korea who had never experienced frailty at the beginning of the survey (2006). Participants were classified into two groups, frailty and non-frailty, based on frailty events over time. We used Kaplan–Meier analysis to determine the effects of frailty-related group differences on cognitive decline (K-MMSE), sensory impairment (visual and hearing), and functional limitation (K-ADL) from 2006 to 2018. To determine the risk factors associated with frailty, the Cox regression analysis was performed. This study established that over time, approximately 71.2% of the older adults (n = 1,274) developed frailty. The study also revealed that over time, both physical (sensory impairment and functional limitation) and psychological factors (cognitive decline) could lead to frailty. We also identified that demographic (age, female), physical (BMI, chronic disease, hearing, vision, and K-ADL), and psychological (K-MMSE) factors were associated with frailty. This study provides an opportunity for healthcare professionals and policymakers to implement intervention programs tailored to ensure regular monitoring prevention and among of these risk factors.
BOTH HEALTH CARE PROFESSIONALS AND PATIENTS HARBOR MISPERCEPTIONS ABOUT DEMENTIA
Authors: Mehegan Laura , Parkes David 
Published: December 2022

Abstract
Healthcare providers underestimate the willingness of adults to engage in a healthier lifestyle to potentially slow the progress of the disease and the willingness of patients to participate in research. Few adults recognize the impact lifestyle modifications have on the risk for cognitive decline and dementia, but some significant differences exists among perceptions amongst diverse communities. While most adults are willing to modify selected brain-healthy behaviors, relatively few currently engage in brain-healthy behaviors all or most of the time. Numerous discrepancies exist between the realities of dementia and overall feelings about a diagnosis. Among the more startling findings is 48% of adults believe they will likely have dementia — far more than will actually develop it. Health care providers substantially overestimate the worry that adults age 40 and older would feel if they had dementia. While one in five adults (19%) said they would feel ashamed or embarrassed if they had dementia, a staggering seven in 10 providers (69%) said their patients would feel ashamed or embarrassed. These negative perceptions by healthcare providers carry over into the interactions they have with patients when dealing with cognitive function. Nine in 10 adults age 40 and older (91%) want to be told of a dementia diagnosis, but only 78% of providers said they always tell patients the truth. There is a recognition by everyone that early diagnosis is beneficial, but most adults over 40 are not aware there are treatments available for dementia. More than half of adults do not know that dementia cannot be cured.
THE RELATION BETWEEN DEATH PREPARATION AND LIFE SATISFACTION AMONG KOREAN OLDER ADULTS
Authors: You Suha , Kim Giyeon 
Published: December 2022

Abstract

Objectives
There is a growing interest in death preparation as an important process to achieve ego integrity at the last stage of life. However, in South Korea, conversations about death remain taboo especially with older adults. Thus, this study aims to examine the association between preparation for one’s death and life satisfaction among Korean older adults.

Methods
Data for this study were drawn from the 2020 National Survey of Older Koreans conducted by the Korean Ministry of Health and Welfare. The sample was limited to adults aged 65 and older (N=10,097). The survey measured preparation for death, life satisfaction, and various covariates (e.g., sociodemographic characteristics, physical conditions, psychological conditions). Hierarchical multiple regression analysis was used to examine whether death preparation influences life satisfaction among Korean older adults.

Results
Results from hierarchical multiple regression showed that after adjusting for covariates, those who reported more preparations for death mentally (B=.054, p&lt;.001) and materially (B=.035, p&lt;.001) were more likely to have greater satisfaction in life than their counterparts.

Conclusion
Findings suggest that it is necessary to generate proper information and recognition about death at the government level and activate discourses on death preparation in later life.
PHYSICIANS LIVING WITH DEMENTIA CHAMPION CHANGE, PROVIDE HOPE AND REFUTE STIGMA
Authors: Beresh Arnold , Roberts Brenda , Cooper Lisa Dedden 
Published: December 2022

Abstract
This section of the symposium will show how to empower behavior change amongst the medical profession and the people they serve. Health care professionals who were diagnosing and treating dementia patients who are now themselves living with dementia will share insights into what needs to change by sharing “What I Wish I Knew Then.” We have asked three people from the National Council of Dementia Minds to join us for the symposium. Dr. Arnold Beresh, Brenda Roberts, and Lisa Cooper to speak on What I Wish I Knew Then. This part of the presentation is designed to provoke discussion on how best to engage doctors to support better brain health for older adults in the future.
SUBTYPES OF FRAILTY AND NONFRAIL HEALTH IMPROVEMENT OF DISABILITY PREVENTION PROGRAM: LATENT CLASS ANALYSIS
Authors: Chen Ya-Mei , Chiu Wan-Yu , Mao Hui-Fen , Chang Ling-Hui , Wu Shwu-Chong 
Published: December 2022

Abstract
Frailty has become a public health priority in many advanced countries. However, the effects of national implemented intervention remained unclear. Taiwan implemented a disability prevention program nationwide targeting on people aged 65 and over in 2019. We aimed to identify the subtypes of function outcomes of the national disability prevention programs and compare the different outcome subtypes between frail and non-frail older adults. The current study analyzed participants’ outcomes before and after the program. Two years of data (2019-2020) from the national disability program were used for analysis. Among the participants, 622 were frail (3.8%), and 13084 are non-frail (81.3%). Outcomes were nine domains of Kihon checklist assessed, including nutrition, depressive mood, oral function, fall risk, cognitive function, socialization, independent function, mobility and health knowledge. Latent Class Analysis is used to identify the subtypes of classes in frailty and non-frail older adults. Four classes of outcomes subtypes for frail and non-frail older adults were identified, and both of them have groups of multi-aspect improvement and no improvement groups. The other two classes for frail people were cognitive and independent function improvement group and social and fall risk improvement group, whereas non-frail group had independent function improvement group, and independent and mobility function improvement group. The similar groups identified indicated both frail and non-frail can benefited and not benefited from the program. The two different subtypes identified benefited from the program. Further study investigating the characteristic of people in different outcome subtypes may shed some light for future tailored-made disability prevention.
A META-ANALYSIS OF MUSIC THERAPY AND SLEEP QUALITY: TRENDS AND IMPLICATIONS FOR OLDER ADULTS
Authors: Rowan Noell , Sardina Angie , Newsham Tina , Pond Richard , Chen-Edinboro Lenis , Leist Christine , Johnson Daniel , Erich Michele 
Published: December 2022

Abstract
Music therapy (MT) has been an established healthcare profession in the United States for over seven decades. MT interventions are non-pharmacological approaches, administered by board-certified music therapists, designed to promote physical, emotional, cognitive, and spiritual well-being. One aspect of health where MT may be of use to older adults is in improving poor sleep quality, which is associated with increased risk for morbidity and mortality. Many pharmacological treatments for insomnia and other conditions carry adverse effects. Investigating the impact of evidence-based non-pharmacological interventions (e.g., MT) on sleep could be beneficial, particularly among older adults who are at greater risk for polypharmacy-related challenges. The purpose of this study was to investigate the average effect of MT on sleep quality via a meta-analysis across 46 studies (N=2912). This study included a review of the effects of MT on sleep, the characteristics of strongest and weakest MT interventions, the role age plays on the efficacy of MT, and differences in effects between adults with and without dementia. Results revealed robust improvements in sleep quality, as a function of MT. These improvements were observed among teams that included a professional music therapist. Clinical and practical implications will be discussed, particularly as they apply to older adults and interprofessional practice.