bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE LIFESTYLE AND UNMET NEEDS AMONG UNMARRIED MIDDLE-AGED AND OLDER ADULTS IN TAIWAN
Authors: Chiu Ching-Ju 
Published: January 2025

Abstract
This study used in-depth interviews and questionnaires to explore the lifestyle and psychological state of Generation X singles in urban areas of Taiwan, using a mixed methodology that combines qualitative and quantitative research methods. The interview focuses on the individual’s understanding and planning of single life, as well as the acceptance of emerging technologies, while the questionnaire includes personality traits and loneliness tests to supplement the qualitative information in a quantitative way. This mixed research strategy maximizes the understanding of the target group, focusing on the target group’s preparation for future changes in the life stage of legal old age (65 years old) and their attitudes towards emerging technologies, and also provides a scientific basis for formulating more effective policies. After conducting in-depth conversations with multiple participants and understanding their life choices, expectations and challenges, the results of this study revealed the participants’ diverse attitudes towards single life and their flexible preparations for the future, as well as their acceptance of new technologies in daily life. It also provides many valuable insights to financial planners and government policy makers.
ADHD SYMPTOMOLOGY AND COGNITIVE PERFORMANCE IN LATER LIFE
Authors: Mansoor Marrium , Katz Ben 
Published: January 2025

Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder affecting up to 6.7% of adults worldwide. Validated questionnaires to diagnose ADHD often include scales for both the inattention and hyperactivity symptoms which characterize this disorder. Although inattention symptoms have been previously linked to cognitive performance in younger samples, very few studies have examined links between these ADHD symptoms and cognitive performance in adult samples, and very few have done so with middle aged and older adults. In this study, we drew from a nationally representative sample from the Health and Retirement Study (HRS) of ~ 1400 middle to older adults (M = 69 years, SD = 10.3; Range = 55-107 years) who completed a set of cognitive measures and an ADHD symptomology questionnaire. We found statistically significant associations between self-reported symptoms of inattention and cognitive measures including Number Series (B=-0.056, p=0.036), Serial 7s (B=-0.088, p&lt; 0.001), Delayed Recall (B=-0.112, p&lt; 0.001), Immediate Recall (B=-0.116, p&lt; 0.001), and global cognition (B=-0.148, p&lt; 0.001) while controlling for age, gender, years of education, and self-rated health. Hyperactivity symptoms were only significantly predictive of global cognition (B=-0.077, p=0.01) and no other measures. These results are consistent with previous work on the links between ADHD symptomology and cognitive performance in younger populations and add to the literature on ADHD in later life. This may have implications for clinicians and practitioners as well as future research on older adults with ADHD.
DEPRESSIVE SYMPTOMS, SLEEP, AND QUALITY OF LIFE IN ADULTS WITH CHRONIC CONDITIONS
Authors: Diallo Idiatou , Bass Judy , Musci Rashelle , Adams Leslie , Gallo Joseph , Spira Adam 
Published: January 2025

Abstract
Physical, mental, and sleep problems threaten well-being; however, there is limited research on the temporal connections of these issues. We investigated the longitudinal associations among depressive symptoms, sleep disturbances, and quality of life (QoL) among middle-aged and older adults (aged 50+) with diabetes, hypertension, and/or cardiovascular disease in the United States. Participants (N=17,283) drawn from the Health and Retirement Study (HRS) reported at least one of these medical conditions, and data from the 12th (T1), 13th (T2), and 14th (T3) waves (2014-2018) was used. Depressive symptoms were assessed via a modified version of the 8-item Center for Epidemiological Studies-Depression (CES-D) scale (scores: 0-7). Sleep disturbance was measured using the 4-item Jenkins Sleep Scale (JSS) (scores: 2-6). QoL was evaluated through the 5-item Satisfaction with Life Scale (SWLS) (scores: 5-35). Within-person associations showed short-term reciprocal links: higher depressive symptoms predicted higher sleep disturbance (T2–T3: β=0.036, p&lt; 0.05), and higher sleep disturbance predicted higher depressive symptoms (T2–T3: β=0.035, p&lt; 0.01). Higher QoL predicted lower sleep disturbance (T2–T3: β=-0.076, p&lt; 0.001), and higher sleep disturbance predicted lower QoL (T2–T3: β=-0.064, p&lt; 0.001). Within-person associations also indicated a one-way association over time: higher depressive symptoms predicted lower QoL (T1–T2: β=-0.104, p&lt; 0.001; T2–T3: β=-0.141, p&lt; 0.001). Future studies should evaluate the dynamic nature of the associations over longer study periods while assessing the influence of mediators/moderators at different time points. Policies should prioritize integrating sleep, depression, and QoL programs/services into primary care due to their temporal associations among individuals with physical illnesses.
HISPANIC DEMENTIA CAREGIVERS INVOLVEMENT IN EVERYDAY DECISION-MAKING
Authors: Poe Abigail , Alvarez Loreli , Wang Danny , Bibriescas Natashia , Puga Frank 
Published: January 2025

Abstract
This analysis aimed to examine the degree of decision-making involvement (DMI) of Hispanic and Latinx (H&L) dementia caregivers of people living with dementia (PLWD). Data was used from an ongoing study on the daily mental health experiences of H&L caregivers of PLWD, entitled “Nuestros Días” (Our Days). Analysis of variance was used to examine differences in caregiver involvement in everyday decisions, such as determining meals (Decision-Making Involvement Scale), based on H&L dementia caregiver age (e.g., 40-49, 50-59, etc.). A subset of 47 H&L dementia caregivers from the main study who completed the DMI scale were included in the analysis. The majority of the H&L caregivers identified as female (91.3%), with a mean age of 47 (SD = 17.4). Around half (48.6%) of the H&L caregivers were working full-time (30+ hours a week). H&L dementia caregivers reported moderate involvement (M = 22.9, SD = 7.1, Range 0-36) in DMI for the PLWD. Caregiver age was significantly associated with DMI (F(3, 40) = 3.08, p =.03). Post hoc comparisons using the Tukey HSD test indicated that the mean DMI for caregivers in the 60-69 age group was significantly higher than the mean DMI for caregivers in the 70+ age group (MD = 11.05, SD = 2.93, p =.027). Age may influence H&L caregiver DMI for the PLWD. Further studies are needed to identify additional factors (e.g., contextual, cultural, contextual) associated with H&L dementia caregiver’s DMI for the PLWD and potential associations with caregiver stress and burden.
DESIGN AND MODELING FOR SPARSELY SAMPLED PHYSIOLOGICAL SYSTEMS DATA
Authors: Clapham Charlotte , Varadhan Ravi , Bandeen-Roche Karen 
Published: January 2025

Abstract
Physical resilience is a pressing research area in aging. The Study of Physical Resilience and Aging (SPRING) posits that resilience is rooted in the fitness of specific physiological systems: It is studying resilience by introducing stressors on selected systems and monitoring their return to homeostasis as time series. We aim to use data from these dynamical stimulation tests to model the fitness of underlying dynamical systems; However, the extreme sparsity and measurement error in SPRING presents a methodological challenge. This presentation reports studies to evaluate alternative methods for recovering system dynamics. We first explored the limits of Local Linear Approximation (LLA) for this purpose using data simulated from curves sampled with varying levels of sparsity and measurement error. We found that LLA could not accurately or precisely recover the curves’ dynamics when data was extremely sparsely sampled or had moderate measurement error, making it unviable for SPRING. Our presentation also reports work to develop more nuanced methodologies that implement integro-differential equation modeling, smoothing techniques, and leveraging of ancillary data from other studies that performed dynamic stimulation tests on older adults. These strategies aim to enhance signal, reduce measurement error and borrow strength incorporating existing knowledge. This work has implications on our ability to better understand and predict resilience.
PAN-CANADIAN ESTIMATES OF THE PREVALENCE ASSOCIATED WITH CRITICAL WANDERING AMONG HOME CARE CLIENTS
Authors: Miguel-Cruz Antonio , Perez Hector , Jantzi Micaela , Liu Lili , Hirdes John P 
Published: January 2025

Abstract
Wandering is a behaviour common in people living with dementia. Persons living with dementia are at increased risk of getting lost and going missing due to critical wandering. However, the evidence is inconclusive. We used 17 years of cross-sectional clinical assessment records from home care services based on interRAI Home Care assessments to provide Pan-Canadian estimates of the prevalence and clinical risks associated with recent critical wandering. (n=1,598,191). The main clinical variable of interest was recent occurrence of critical wandering. We tested associations between wandering and dementia and cognitive impairment. In all the study regions combined, the overall rate of recent wandering is 3.0%, representing 48,641 unique individuals. The sample was comprised of mainly older adults, with 84.3% over the age of 65. The sample was also predominately female (60.9%). A dementia diagnosis including Alzheimer’s disease or other dementias was present in 23.6% of the sample. Dementia was strongly associated with the prevalence of recent wandering Chi-squared(1, N=1,598,191) = 101,298.866, p &lt; 0.0001). Cognitive impairment was also strongly associated with the prevalence of recent wandering Chi-squared(1, N=1,598,191) = 155,414.738, p &lt; 0.0001). Our analyses also show that persons with wandering behaviour experience many different additional clinical problems that can pose important risks to their health and would require attention of first responders and health professionals. interRAI HC offers insights into wandering risk and health profiles of home care client. This information should be used to manage risk in the community and should be shared with first responders where appropriate.
ASSOCIATION OF SYSTEMIC IMMUNE-INFLAMMATION INDEX ON THE RISK OF STROKE IN AMERICAN ADULTS
Authors: Qiu Xichenhui , Huang Yiqing , Wei Changning , Wang Qun 
Published: January 2025

Abstract

Background
Chronic inflammation is associated with various health consequences, including cardiovascular diseases and cancer. The systemic immune-inflammation index (SII) and system inflammation response index (SIRI) have emerged as novel inflammatory and prognostic markers. However, the relationship between SII, SIRI, and stroke risk in representative populations remains understudied. This study aimed to investigate the association between SII, SIRI, and stroke risk in US adults.

Methods
A cross-sectional investigation utilized datasets from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2018. Multivariate regression models were employed to assess the relationship between SII, SIRI, and stroke risk. Nonlinear relationships were described using smoothing curves and a two-tailed linear regression model. Subgroup analysis and interaction tests were performed to assess relationship stability.

Results
The study included 36,129 adults aged 20 to 85 years. The analysis revealed a significant positive association between stroke risk and both SII (OR = 1.27, 95% CI = 0.98 to 1.65, p for trend = 0.0438) and SIRI (OR = 1.49, 95% CI = 1.13 to 1.97, p for trend= 0.0016) after adjusting for confounding factors.

Conclusion
Elevated levels of SII and SIRI are associated with an increased risk of stroke in US adults. These findings underscore the importance of managing inflammatory indices as potential interventions to mitigate stroke risk.
COMPARE FRAILTY IN OLDER ADULTS AND NONOLDER ADULTS WITH HEART FAILURE
Authors: Hsieh Jenny , Chou Pi-Ling 
Published: January 2025

Abstract
Frailty is commonly presented among patients with chronic diseases, including heart failure(HF), leading to poor prognosis. However, the association between age and frailty in patients with HF remains unclear. Therefore, our study aims to compare the difference in frailty status in older and non-older adults with chronic HF symptoms. A cross-sectional study was conducted, where data was collected between January 1, 2023, and January 31, 2024. Participants were recruited from cardiology departments of two hospitals in southern Taiwan (N=110). Instruments measuring frailty included the Frailty Phenotype Criteria (FPC) and Clinical Frailty Scale(CFS). Data analysis was conducted using R version 4.3.2. In our study, we observed pre-frailty and frailty in older adults with proportions of 49.1% (n=26) and 22.6% (n=12) according to FPC, respectively. For non-older adults, the proportions were 36.4% (n=16) and 18.1% (n=5), respectively. The CFS revealed that 50.8% (n=31) of older adults exhibited frailty, while 38.8% (n=19) of non-older adults did. No significant difference was observed in frailty status between older and non-older adults, as indicated by both the FPC (p = 0.21) and the CFS (p = 0.29). The findings suggested a high prevalence of frailty in patients with heart failure, irrespective of age group. Our results indicated that frailty was a functional decline not limited to older adults. This study highlighted the importance of frailty assessments in patients with heart failure symptoms across all age groups, providing an evidence base to innovate potential strategies to promote improvement in prognosis.
EXAMINING THE RELATIONSHIPS BETWEEN RESILIENCE, CARDIOVASCULAR HEALTH, AND RACE AMONG US ADULTS
Authors: Sprague Briana , Mosesso Kelly 
Published: January 2025

Abstract
Modifiable risk and resilience factors explain up to 90% of cardiovascular disease risk. These may contribute to racial cardiovascular health (CVH) disparities, but there has been limited examination of the role of resilience on CVH and disparities. Our goal was to examine (1) which risk and resilience measures were associated with CVH and (2) whether there were differences in these measures by race among a sample of US adults. Aim 1’s sample included adults aged 34-84 from the MIDUS biomarker substudy (N = 1255). Aim 2’s sample comprised of adults aged 28-84 from the MIDUS parent study (N = 4702). The primary outcome of interest was CVH, operationalized as the AHA’s Life’s Essential 8 total score, behavior, and health subscores. The hypothesized resilience measures were psychological well-being (“PWB”; assessed with Ryff and Multidimensional Personality Scale), purpose in life, mindfulness, gratitude, and optimism (MPS subscales). Of those, greater PWB (Ryff), purpose in life, and optimism correlated with better Essential 8 total score and behavioral subscore (ps &lt;.01). Higher PWB (MPS), as well as higher gratitude, were associated with better Essential 8 behavioral scores (p &lt;.05). Of these, PWB (MPS), gratitude, and optimism were significantly differences by race, where Black adults had significantly greater values on all measures (p &lt;.001). Implications for future research and practice will be discussed.
PLANT-BASED DIETS AND CARDIOVASCULAR DISEASE RISK FACTORS IN OLDER ADULTS: AN INTEGRATIVE LITERATURE REVIEW
Authors: VanCleef Tricia 
Published: January 2025

Abstract
Cardiovascular disease (CVD) is the leading cause of mortality globally, disproportionately impacting older adults. Plant-based diets (PBDs) have emerged as a dietary strategy to mitigate CVD risk, characterized by foods derived from plants and minimal to no animal-derived foods. This integrative review assesses the effectiveness of PBDs for improving CVD risk factors in older adults. A search was conducted in CINAHL, PubMed, and Medline databases for studies of PBDs and CVD risk factors in individuals aged 65 years and older. Quality assessment was performed using the Mixed Methods Appraisal Tool (MMAT). 17 publications were analyzed, 7 experimental and 10 non-experimental. All studies showed at least one positive association between PBDs and cardiovascular health in older adults. Findings highlighted significant associations between PBD adherence and reductions in key CVD risk factors such as low-density lipoprotein cholesterol (LDL-C), blood pressure, and body mass index (BMI), alongside potential benefits in reducing coronary artery calcium and enhancing endothelial function and serum isoflavone concentrations. There is evidence for the potential of PBDs as an effective dietary strategy to prevent the onset and progression of CVD in older adults and reduce the risk of CVD mortality. This review indicates the need for further research, specifically larger randomized control trials focused on older adults to strengthen the evidence base and to guide healthcare recommendations. PBDs should be considered as a part of holistic CVD prevention and management strategies for older adults, encouraging dietary patterns that are rich in fruits, vegetables, legumes, beans, nuts, seeds, and whole grains.
PREDICTORS OF CHANGE IN CAROTID ARTERY ULTRASOUND MEASURES IN THE LONG LIFE FAMILY STUDY
Authors: Kuipers Allison , Kline Caitlyn , Cvejkus Ryan , Barinas-Mitchell Emma , Zmuda Joseph 
Published: January 2025

Abstract
Early vascular changes of cardiovascular disease can be assessed using carotid ultrasound. The Long Life Family Study (LLFS) may help elucidate factors associated with decelerated vascular aging. Therefore, we identified predictors of change in carotid intima-media thickness (IMT) and interadventitial diameter (IAD) over ~6.0 years of follow-up (range 3.2-8.4) in 674 participants from the LLFS. Common carotid artery B-mode ultrasound was conducted using a GE LOGIQ 3 ultrasound system. We calculated change and annualized percent change (APCT) in mean carotid IMT and IAD. Age, sex, and study site were included in all models, and baseline measures of lifestyle, cardiometabolic conditions, and medication were tested in linear regression models (α=0.05). Final models were adjusted for relatedness using GEE. Participants were 67.5 years old (range 46-90), 43% male, 35% hypertensive, 6% diabetic, and 30% were on lipid-lowering medication, 96% didn’t smoke and 80% regularly walked &gt;3hours/week. IMT increased 0.046mm or 1.08% annually, while IAD increased 0.166mm or 0.37% annually (all P&lt; 0.0001). IMT APCT change was greater in those aged &lt; 65 (1.37%) than over 65 (0.95%, P=0.004) but did not differ by sex (P=0.20). Whereas IAD APCT change did not differ by age group (P=0.10) but was greater in females (0.44%) than males (0.29%, P=0.006). Outside of age, sex, and site, independent predictors of IMT and IAD APCT included fasting glucose and smoking, plus triglycerides for IMT and systolic blood pressure for IAD. These findings highlight the need for continued research into the role of glucose homeostasis in vasculature aging.
RACIAL/ETHNIC DISPARITIES IN TRAJECTORIES OF CARDIOVASCULAR RISK FACTORS IN US ADULTS
Authors: Dhingra Radha , Xu Hanzhang , Lynch Scott , Yang Qing , Green Michael , West Jessica , Dupre Matthew 
Published: January 2025

Abstract
Racial/ethnic disparities in major cardiovascular disease (CVD) risk factors are well documented. However, studies have not considered racial/ethnic differences in the interrelationships among these CVD risk factors and how they vary across age. We used six waves of longitudinal data from the Health and Retirement Study ([HRS] 2006-2016; n=10,292) to examine co-occurring changes in systolic blood pressure ([BP] mmHg), non-HDL cholesterol (mg/dl), diabetes (y/n), and smoking (y/n) at ages 50-80. Group-based multi-trajectory models were used to identify age-related trajectories of CVD risk factors and multinomial logistic regression models were used to identify participant characteristics associated with the trajectories of CVD risk factors. In our cohort (mean (SD) age: 62 (7.2) years; 41% male; 66% non-Hispanic White, 17% non-Hispanic Black, 13% Hispanic, and 3% other race/ethnicity), we found eight distinct trajectories of age-related changes in CVD risk factors (37% of adults had optimal CVD levels). We also found that non-Hispanic Black and Hispanic adults were significantly more likely to exhibit elevated age-related risks related to BP, cholesterol, diabetes, and/or smoking compared with non-Hispanic White adults. The associations were differentially attenuated with the inclusion of multiple covariates and showed that education, household income, and nativity status (among Hispanics) contributed most to the excess CVD risks observed in non-Hispanic Black and Hispanic adults. Overall, our findings demonstrate the impact of social determinants on racial/ethnic disparities in age-related changes in CVD risk factors in middle-aged and older adults in the United States.
SOCIOECONOMIC DISADVANTAGE AND EARLY AND RECURRENT ADMISSIONS IN PATIENTS WITH HEART FAILURE
Authors: Dhingra Radha , Xu Hanzhang , Hammill Bradley , Lynch Scott , West Jessica , Green Michael , Dupre Matthew 
Published: January 2025

Abstract
The association between socioeconomic status and 30-day readmissions is well-documented in patients with heart failure (HF). However, it is less clear whether socioeconomic disadvantage has an immediate and/or lasting impact on risk of hospital admissions following the diagnosis of HF. We examined whether area-level disadvantage was associated with early and recurrent risks of hospitalizations in patients diagnosed with HF. We included 5,889 patients (ages 65-85 years) with newly diagnosed HF between January 2015 and July 2018 in the Duke University Health System and followed them for up to eight years. We assessed the association of area-level socioeconomic disadvantage (low, moderate, or high) with hospital admissions within 30-days after HF diagnosis using multivariable logistic regression models. We also assessed the risks of recurrent admissions over the entire duration of follow-up using Prentice, Williams, and Peterson models with total time. In our cohort (mean (SD) age: 75 (6) years; 51% female; 67% non-Hispanic White), 71% patients had at least one admission and 40% patients died over a median follow-up of 5.6 years. Area-level disadvantage was not associated with risks of admission within 30-days after HF diagnosis (hazard ratio [95% CI]: HR=1.09 [0.90-1.31]; P=.371). However, patients living in high-disadvantaged areas had significantly greater risks of recurrent admissions over follow-up (HR=1.11 [1.05-1.16]; P&lt;.001). We observed similar patterns for 30-day mortality and mortality over the entire follow-up period. Overall, results from this study suggest that area-level socioeconomic disadvantage should be considered in clinical decision-making and guidelines to improve long-term outcomes in patients managing HF.