bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXPLORING AND CHARACTERIZING MULTIMORBIDITY PROFILES AMONG ADULTS WITH HEART FAILURE
Authors: Hiatt Shirin , Meek Paula , Lee Christopher , Denfeld Quin 
Published: January 2025

Abstract
Multimorbidity (MM) or coexistence of ≥2 chronic conditions is prevalent among older adults and results in poor outcomes. Among adults with heart failure (HF), MM poses exponentially more challenges, but our understanding of MM in HF is limited. The purpose of this study was to explore and characterize MM profiles in a cohort of adults with HF. We performed a secondary analysis of combined data from 6 HF studies. We used latent class analysis to identify MM profiles based on comorbidities identified with the Charlson Comorbidity Index. After identifying MM profiles, we examined sociodemographic, clinical and symptom characteristics across each profile. The sample (n=523) was 37% women, mean age 58.3±14.0 years, and mean of 2.1±1.1 comorbidities. Most patients (n=480; 92%) had MM, including HF. Among patients with MM, we identified four distinct MM profiles: Class 1-high complexity (4.6%), Class 2-moderate complexity (31.7%), Class 3-low complexity (31.9%), and Class 4-no complexity (31.9%). Class 1 was older, living alone, significantly comorbid, reported poor/fair health and depressive symptoms, and frail. Classes 2 & 3 were the next oldest but majority lived with someone. Class 4 was the youngest with the shortest duration of HF diagnosis. In conclusion, we found four distinct profiles of MM among patients with HF with marked differences in characteristics. As the prevalence of MM increases among older adults and those with chronic conditions such as HF, it is imperative to understand profiles of MM and how they contribute to function and wellbeing in order to develop effective interventions.
FILLING THE CARE GAP FOR OLDER ADULTS LIVING IN A RURAL COMMUNITY: A NURSING CARE MODEL
Authors: Dawson Walter , Womack Dana , Velk Lace , Fifield Alexis , Izumi Seiko 
Published: January 2025

Abstract
Ensuring older adults living with multiple chronic conditions are able to remain in their own homes and communities for as long as possible is a health policy priority. Registered nurses (RNs) play a key role in assisting older adults manage their health while living in the community. Yet, the substantial contributions of nursing care such as care management and care coordination in achieving better health outcomes and reductions in healthcare costs remains largely invisible to healthcare systems and policymakers alike. To demonstrate value of nursing care and build a model of nursing services that is effective and sustainable, we conducted a study describing nursing services needed by the patients living in community settings with complex care needs and evaluated the impact of these services on outcomes. Nurses delivering community-based nursing service (CBNS) to patients living with multiple chronic conditions in rural coastal Oregon were interviewed between July and December, 2022. Outcome data about health service utilizations and expenditure of patients who received CBNS are collected between November 2023-March 2024. Interview data describe care nurses deliver to keep older adults in the community while managing their health by filling care gaps in the rural community. Preliminary outcome data analysis suggests that CBNS is a potentially effective model helping older adults remain in their own homes and communities. These findings may inform policy development regarding reimbursement to make CBNS delivery sustainable as well as increase the options for providing optimal care for older adults living with chronic conditions across multiple geographic settings.
KNEE OSTEOARTHRITIS: PERCEPTIONS OF PSYCHOSOCIAL CONSEQUENCES, PAIN, AND MANAGEMENT COMPLEXITIES
Authors: Luborsky Mark , Hochberg Marc , Ryan Alice , Dong Yu , Beamer Brock , Shardell Michelle , Rathbun Alan 
Published: January 2025

Abstract
Knee Osteoarthritis (KOA) afflicts 27 million U.S. adults and has adverse health and psychosocial outcomes. Depression is twice as common among persons with KOA compared to the general population and is a barrier to pain management and physical activity. While guidelines advise depression treatment, directions on co-managing depression and pain are seldom offered; a viable adjunctive treatment, duloxetine, treats both depression and pain, yet is not routinely prescribed and could facilitate physical activity. Progress in reducing KOA distress is hampered by inadequate knowledge of perceptions and experiences of persons’ daily living with KOA especially when pain and depression co-occur. Qualitative interviews were conducted at baseline in a program evaluating aerobic exercise plus duloxetine to learn participants’ perceptions, challenges, and how depression and pain interact in managing KOA. The sample included: n=12 (5 African American, 1 Asian, 6 White) participants, aged 41-71 years (10 female, 2 male) with self-report pain severity, median 3 (scale 0-4) and moderate to severe difficulty with Activities of Daily Living. Analytic strategies featured topic, theme, and critical case comparative methods. Results identified four key constructs: (a) unpredictability and temporal variability of impacts of KOA; (b) management requiring flexible strategies encompassing a wide range of self-image and life domains beyond pain and depression; (c) barriers including concerns with medications; depression eroding energy; a sense of isolation socially and from meaningful activities; and (d) challenges to program participation. Pathways to address the constellation of intersecting domains perceived in living with KOA and treatment program participation are needed.
SYMPTOM BURDEN AND HEALTH CARE UTILIZATION AMONG OLDER ADULTS LIVING WITH MULTIMORBIDITY: THE COORDINATE PROGRAM
Authors: Benjasirisan Chitchanok , Lim Arum , Tebay Jordan , Himmelfarb Cheryl Dennison , Davidson Patricia , Koirala Binu 
Published: January 2025

Abstract
The increasing challenges of multimorbidity in older adults underscore the need for sustainable approaches to address care coordination and symptom management. The Care cOORDInatioN And sympTom managEment (COORDINATE) program was developed using experience-based co-design and human-centered principles by considering the needs of patients, family caregivers, and healthcare providers. The program included a need assessment, question prompt list, goals discussion, and symptom assessment in 5 visits over 6-week periods employed among adults aged 55 years and older who were living with at least 2 chronic conditions and were discharged from the intermediate care unit. Twenty-five adults agreed to participate and completed the baseline survey. The change in symptom burden and healthcare utilization at 3 months follow-up compared to baseline was examined using the Wilcoxon Signed-Rank test. The participants’ mean (± SD) age was 67 ± 7 years; 52% were women, 44% had some college/associated degree; 92% were retired/unemployed, and 72% were Black. For the goals discussion component of the program, 83% of the measurable goals were fulfilled. A preliminary analysis of the symptom burden found that the level of energy significantly improved at the 3-month follow-up (p =.032). Significant decreases in hospitalization (p =.01) and critical care admission (p &lt;.01) were found at 3 months post-discharge compared to 3 months before program initiation. In summary, the COORDINATE study could be a pivotal initiative in addressing the holistic care needs of older adults living with multimorbidity. This intervention demonstrates promising outcomes, signaling the need for a larger effectiveness trial.
THE CORRELATION BETWEEN SHBG AND BLOOD LIPID AND GLUCOSE AMONG CHINESE MIDDLE-AGED AND OLDER ADULTS
Authors: Cao Meng , Jin Yaping , Yang Huili , Li Yuanbin , Liu Minhui , Huang Chongmei 
Published: January 2025

Abstract
To investigate the correlation between sex hormone binding globulin (SHBG) of serum lipid and blood glucose in middle-aged and older adults (≥ 45 years old) We recruit participants in five urban communities in Ningxia province, using a cluster stratified sampling method. Data from 1681 participants were analysed, with an average age of 63.53 ± 9.5 years old. The results showed the average level of TC, HDL, LDL, and blood glucose were lower in men than in women (P=0.000,P=0.000,P=0.000,P=0.004),LDL-c and FBG levels increased with age in men, but SHBG level decreased with age in women (P&lt; 0.05). The results of spearman correlation analysis showed a negative correlation between SHBG and FBG (r=-0.73 P&lt; 0.01). There was a positive correlation between age (r= 0.054 P&lt; 0.05) and HDL-C (r=0.049 P&lt; 0.05) and a positive correlation between SHBG level and TC (r=0.218 P&lt; 0.05) and TG (r=0.254 P&lt; 0.05) in Chinese women aged 75 years and more. Multiple linear regression analysis with SHBG as the dependent variable and gender, age, TC, TG, HDL-C, LDL-C and BMI as independent variables did not find statistically significant associations. Logistic regression analysis showed that sex, age, weight, SHBG,FBG and SH were risk factors for dyslipidemia. However, there was no significant correlation between SHBG level and dyslipidemia.
THE IMPACT OF EHEALTH ON SELF-MANAGEMENT AND HEALTH OUTCOMES OF PATIENTS WITH TYPE 2 DIABETES: A SYSTEMATIC REVIEW
Authors: Cheng Yu-Shan , Cuevas Heather 
Published: January 2025

Abstract
Self-management is crucial to maintain glycemic control in type 2 diabetes (T2DM). Prior studies have shown that various electronic health (eHealth) technologies promote diabetes self-management (DMSM) and continuity of care. However, previous reviews focused mainly on telehealth, a single aspect, and were published more than ten years ago. Therefore, the purpose of this study was to summarize the effect of eHealth interventions on improving aspects of DMSM and health outcomes, such as depression and A1C, for adults over 60 years of age with T2DM. A systematic review was conducted on papers published from October 2018 to October 2023. Three electronic databases were used. 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) served as guides. Twenty randomized control trials in diverse ethnic communities (n=3978) across 20 countries were included in the narrative synthesis. Seven health technologies were employed to provide DMSM across studies, including mobile health applications, text messaging, phone calls, online conferences, video, wearable devices, and virtual worlds. Overall, improvement in DMSM and health outcomes was mixed. In terms of depression, only three studies showed significant improvement, while four studies did not exhibit significant improvement in A1C. Additionally, positive outcomes were not maintained after seven months (the furthest post-intervention measurement). These findings differed according to eHealth literacy, economic burden, willingness, and social support. Further work is needed to consider other variables to address both short- and long-term effects for the patients while implementing healthcare technology.
RACIAL DIFFERENCES IN THE RELATIONSHIPS AMONG VOLUNTEERING, DISCRIMINATION, AND LIFE SATISFACTION
Authors: Shen Huei-Wern , Wang Yi 
Published: January 2025

Abstract
Discrimination, whether overt or subtle, has been consistently linked to lower life satisfaction across racial groups. While volunteering has been proven to bring physical and mental health benefits, its potential role in mediating the relationship between discrimination and life satisfaction across different racial groups is unknown. The present study included a subsample of 3115 older adults (65-98) who were non-Hispanic Whites (n=2374), non-Hispanic Blacks (n=449), and Hispanics (n=292) from the 2016 Health and Retirement Study. Discrimination was measured by the six-item Everyday Discrimination Scale (e.g. In your day-to-day life, how often are you treated with less courtesy or respect than other people) and was dummy-coded due to skewness (never experienced vs. ever experienced). Controlling for health-related variables (e.g., self-rated health), SES (e.g., income), contextual features (e.g., urban/rural), and sociodemographics (e.g., gender), findings from stratified multivariate linear regression models showed that non-Hispanic Whites who experienced discrimination reported lower life satisfaction; although older volunteers had higher life satisfaction, volunteering did not mediate the relationship between discrimination and life satisfaction. Among non-Hispanic Black older adults, neither experiencing discrimination nor volunteering was related to life satisfaction. In the Hispanic group, however, experiencing discrimination was related to lower life satisfaction, and volunteering partially mediates the negative impacts of discrimination on life satisfaction. These findings shed light on the possible extended benefits of volunteering in old age. Further research is warranted to better understand the underlying mechanisms through which volunteering may mitigate the negative impact of discrimination on life satisfaction, particularly among Hispanic older adults.
ASSOCIATION OF COGNITIVE LEVEL AND QUALITY OF LIFE INDICATORS POSTSTROKE IN OLDER ADULTS: A CROSS-SECTIONAL STUDY
Authors: Alharrasi Azza , Berish Diane 
Published: January 2025

Abstract
Stroke is one of the leading causes of death and disability worldwide. Post-stroke cognitive impairment (PSCI) is a common complication of stroke; however, mild cognitive impairment is highly prevalent within three months post-stroke and is associated with increased cost of care, hospitalizations, and care dependency. This study examined the association between cognition level (TICS total score) and quality of life indicators (Depression yes=1 no=0, physical limitations yes=1 no=0, socialization yes=1 no=0) among adults aged 65+. Therefore, a cross-sectional study using the 2020 wave of Health and Retirement Study (HRS) was used to conduct logistic regression Analysis using R.4.2.2. Total sample was 1259 adults 65+ who had reported experiencing a stroke, 58% were female and average TICS score of 6.5 (SD=3.5). Covariates of having high blood pressure, diabetes, or heart disease, sex, working outside the home, education level and age were included in all models. For every one-point increase in TICS score the odds of experiencing functional impairment were 21% lower (OR =0.89, p &lt;.0001). The association for TICS scores and odds of feeling depressed (OR=0.97, p=0.27) and odds of socialization (OR 1.02, p=0.68) were not statistically significant. These results indicate that older adults who had lower cognition scores post stroke were more likely to experience physical limitations. More rigorous research studies need to be conducted to evaluate the quality of life of older adults during post-stroke based on their cognition status. This will inform medical management to individualize the rehabilitation and treatment according to the older adults’ needs.
ASSOCIATIONS BETWEEN SELF-RATED HEALTH, COGNITIVE FUNCTION, RISK OF COGNITIVE IMPAIRMENT, AND DEMENTIA
Authors: Garner Kayla , Graham Eileen , Jackson Kathryn , Chopik William , Beck Emorie 
Published: January 2025

Abstract
Psychosocial researchers have long sought to identify individual differences in early and middle adulthood that robustly predict health in later life. Our current pre-registered study builds on these efforts by assessing whether an individual’s subjective perception of their health is related to their cognitive health, both concurrently and later in life. Using the coordinated data analysis (CDA) methodological framework, we have identified 17 longitudinal studies (including 7 from the Gateway to Global Aging network) that had the requisite data to test our models. We conceptually harmonized all study variables and tested identical linear and logistic regression models across all study datasets. Our preliminary results suggest that individuals who have better subjective beliefs about their health have better cognitive function both concurrently and at longitudinal follow-up (ranging from 4 to 27 years after baseline). These associations were moderated by participant gender and age at baseline, and the results were somewhat robust to the inclusion of objective health indicators. We will discuss our results within the context of Lifespan Developmental Theory and the Health Behavior Model. Overall, our study serves to elucidate how subjective perceptions of health may manifest into later cognitive health outcomes, and if subjective perceptions of health could be used as an early risk factor for identifying individuals who may be vulnerable to cognitive senescence in later life.
CARDIOMETABOLIC DISEASE RISK PARTIALLY MEDIATES RELATIONSHIP BETWEEN FINE PARTICULATE MATTER AND COGNITION
Authors: Cheung Ethan Siu Leung , Grineski Sara , Curtis David 
Published: January 2025

Abstract
PM2.5 pollution is expected to worsen in many places due to climate change. This is because of hotter temperatures, less precipitation, and increases in windspeed. PM2.5 exposure is associated with many adverse health effects. Less is known about how physical and mental health challenges associated with aging, like the onset of cardiometabolic disease (CMB) and changes in psychological wellbeing, might mediate linkages between PM2.5 exposure and aging-related cognitive and physical limitations. Longitudinal data from the Midlife in the United States study (MIDUS 1: 2004-05; MIDUS 2: 2013-14) were adopted. A sample of 4,272 individuals aged 32 to 84 was included. Based on individuals’ residential addresses at each wave, we linked census tract identifiers to PM2.5 exposure, which was defined by five-year annual averages. Using structural equation models, we examined cross-sectional and longitudinal associations between PM2.5 exposure and executive functioning and instrumental activities of daily living (IADL) limitations, and tested CMB risk and psychological well-being as mediators using the product of coefficients method. Results suggested that higher PM2.5 exposure was associated with lower executive functioning cross-sectionally and with larger decreases over time. No significant associations were found between PM2.5 and IADL limitations. The cross-sectional association between PM2.5and executive functioning was partially mediated by CMB risk, accounting for 14% of the estimate, and the longitudinal association showed a similar, albeit nonsignificant mediation pattern. Psychological wellbeing was not a significant mediator. Findings suggest the importance of considering the complex and indirect ways in which climate change may impact health of older adults.
CAREGIVING AFFECTS WORKING MEMORY, HOPELESSNESS, AND PERCEIVED CONTROL: A MEDIATION MODEL
Authors: Luskey Valerie , Zimbinski William , Buxton Michael , Apostolou Hannah , Jacobs M Lindsey 
Published: January 2025

Abstract
Caregiver burden can have negative impacts, both on the caregiver and the person receiving care. One of these effects could include more depressive symptoms in the care recipient, which could impact everyday functioning and quality of life. To explore these relationships, data was used from the Health and Retirement Study in the 2014 Core. Participants included people who answered the questions regarding caregiving, perceived control, hopelessness, and completed a working memory task (n=772; female=59.5%, male=40.5%; age=71.14 (SD=11.88); years of education=11.55 (SD=3.53); race/ethnicity were masked due to confidentiality). Participants with Alzheimer’s or Dementia were excluded, and age was used as a covariate. In a mediation analysis, there was an indirect effect of increased hours of caregiving on hopelessness in the care recipient, b=0.10, SE=0.36, p=0.004, which, in turn, lowered working memory in the person being cared for, b=-0.09, SE=0.04, p=0.03. Additionally, increased caregiving led to decreased perceived control, b=-0.08, SE=0.04, p=0.02; however, this did not translate to decreased working memory, b=-0.051, SE=0.04, p=0.21. Apart from these outcomes, increased caregiving had a direct effect on cognition, b=-0.098, t(767)=-2.73, p=0.007, suggesting it influences other mechanisms that decrease working memory not included in the model. A diagnosis of depression could be an explanatory factor that we were not able to include in the model; however, the model indicates a possible area for intervention. If caregivers receive more support and learn skills to promote hope, that could offer positive contributions to increased working memory—thus, translating to overall increased functioning.
COUPLING OF WITHIN-PERSON CHANGES IN SLEEP QUALITY AND SUBJECTIVE COGNITION IN COMMUNITY-DWELLING ADULTS
Authors: Diaz Jose , Lee Soomi , Martire Lynn , Sliwinski Martin 
Published: January 2025

Abstract
Subjective cognitive decline is not a mere complaint by older adults; it is predictive of later development of objective cognitive decline and dementia. Sleep plays a pivotal role in maintaining cognitive, physical, and mental health, especially in older adults. While studies document age-related declines in sleep quality, limited research explores whether within-person changes in sleep quality are associated with within-person changes in subjective cognition (“coupling effect”). In this study, we examined the dynamic coupling relationship between sleep quality and subjective cognition in older adults over multiple years, adjusting for potential influence of self-report bias (gauged by self-rated health). We used nine waves’ longitudinal data from the Transitions in Health and Relationships study (n=131, Mage=77.09). Multilevel models indicated that changes in sleep quality were significantly associated with changes in subjective cognitive function (β=0.044, 95% CI [0.004, 0.084], p=.031), signifying a coupling effect independent of baseline sleep quality, sociodemographic covariates, and self-rated health. Furthermore, changes in self-rated health moderated the association between changes in sleep quality and subjective cognition (β=-0.047, 95% CI [-0.088, -0.005], p=.028), such that increases in self-rated health weakened the effect of increases in sleep quality on subjective cognition. These findings underscore the significance of within-person changes in sleep quality in predicting subjective cognitive decline in older adults. Notably, while the association was independent of self-report bias, it was weaker for those who reported their overall health was improved. Future work should focus on maintaining or improving sleep quality in order to prevent or delay subjective cognitive decline.