bluuebunny/crossref_metadata_2025_split huggingface dataset:
GENDER DIFFERENCES IN THE ASSOCIATION BETWEEN FRAILTY AND HOSPITALIZATION AMONG OLDER ADULTS IN SOUTH KOREA
Authors: Choi Bokyoung , Shin Yumi , Kim Chang-O , Choi Ahreum , Choi Eunhee , Lee Hyeyeon , Jang Soog-nang 
Published: January 2025

Abstract
This study aimed to investigate the association between frailty and hospitalization experience among older adults in South Korea, while also exploring potential gender differences in this association. We used data from the Korean Longitudinal Study of Aging (2018-2020). Frailty was assessed using the frailty instrument (weakness of grip strength, exhaustion, and social isolation) and divided into three groups: non-frail, pre-frail, and frail. Experience of hospitalization over the past two years was measured by self-reported. Multivariate logistic regression model was applied to examine the association between frailty and hospitalization experience after adjusting for potential confounders including age, education level, and physical activity. Among aged 65 and over older adults in South Korea, the prevalence of frailty was 14.4% (N=656), and the prevalence of hospitalization over the past two years was 9.6% (N=437). Compared to the non-frail group, the frail group had a statistically significantly higher risk of hospitalization (pre-frail OR:1.63 95% CI:1.28-2.08, frail OR:2.50 95% CI:1.85-3.39) after adjusting potential confounders. However, after stratification by gender, the relationship between frailty and hospitality was still statistically significant among older women (pre-frail OR:2.00 95% CI:1.45-2.75, frail OR:3.27 95% CI:2.22-4.80), but not in men. These findings suggest that understanding gender differences in the association between frailty and hospitalization would be beneficial for reducing the care burden among older adults in South Korea. Tailoring interventions and healthcare services to address the specific needs of frail older individuals, particularly focusing on gender-specific differences, may help in preventing hospitalizations and improving overall well-being.
IMPACT OF FRAILTY AND DEMENTIA ON REHABILITATION OUTCOMES IN OLDER ADULTS SURGICALLY TREATED FOR HIP FRACTURE
Authors: Caggiu Giulia , Compagnoni Matteo Monzio , Floris Patrizia , Manna Martina , De Filippi Francesco , Passamonte Michela , Mazzola Paolo 
Published: January 2025

Abstract
We investigated the impact of frailty and dementia on rehabilitation outcomes after hip fracture (HF) surgery in an Italian Orthogeriatric Unit (OGU). We prospectively enrolled all patients aged ≥70 years admitted to the OGU at Sondrio Hospital (Italy) in 2011-2019, with HF requiring surgery. We administered a comprehensive geriatric assessment, including factors related to fracture and surgery. A frailty index (FI) based on 16 variables expressed frailty (FI=number of deficits/16), with which we obtained three categories: fit (FI&lt; 0.15; reference), mild (0.15&lt; FI&lt; 0.34), moderate-to-severe (FI≥0.35). Among 818 participants (mean age 85.6 years, 83.3% females), 21.6% had pre-existing dementia. The average time-to-surgery was 1.9 days (77.6% in spinal anesthesia). Rehabilitation success, i.e. Rehabilitation Efficiency Index (REI)&gt;0.5, was achieved by 70.2% of subjects. From multivariable logistic regression, factors impacting rehabilitation success were frailty (both categories), dementia (OR: 0.14, 95% CI: 0.10-0.21), and age ≥90 years (OR: 0.37, 0.21-0.64). The chances of rehabilitation success were lower for patients with dementia than for those without. Although there is no clear link between age and rehabilitation success, frailty has a decreasing influence as age increases. In nonagenarians, severe frailty does not limit rehabilitation success as much as in younger patients. Previous research showed that dementia potentially acts as a surrogate for frailty in predicting post-operative 1-year mortality after HF surgery. We show that dementia and frailty significantly influence rehabilitation success, thus early mobilization and initiation of physical therapy regardless of age should target non only frail subjects, but also those with dementia, possibly with specifically dedicated interventions.
INTERACTIONS BETWEEN FRAILTY AND SOCIAL VULNERABILITY ON THE SURVIVAL AND HEALTH TRANSITIONS OF OLDER ADULTS
Authors: Wu Heng , Song Xiaowei , Rockwood Kenneth 
Published: January 2025

Abstract
Frailty, an age-related state, is dominated by declining health over time, although stabilization and improvement can occur. We investigated how the accumulation of physical and social deficits interacts in health transitions and survival. Data from participants aged 65+ years in the Chinese Longitudinal Health Longevity Survey (CLHLS) 2005 cohort were analyzed (n=15613; women=57%; mean age=86.2±11.7). Participants were followed in 2008, 2011, 2014, and 2018, with their health and survival status reassessed each time. We constructed both a 47-item frailty index (FI) and a 26-item social vulnerability index (SVI). The FI included domains of morbidities, cognition, lifestyle, and disabilities; the SVI included World Health Organization-defined social determinants of health as – i.e., education, social security and inclusion, work/life/dwelling/services conditions, and early childhood development. At each follow-up, the FI strongly affected survival in a Logistic Regression model with baseline age, FI, SVI, and sex as covariates (e.g., a 1% FI increase for 14-year mortality: Odds Ratio OR=1.07, 95% CI=1.06-1.08). The SVI showed a marginally significant effect on 3-year survival (e.g., a 1% SVI increase, OR=1.01, 95% CI=1.00-1.01), and diminished at longer follow-ups. The FI also affected health transitions (Figure 1A), as did the SVI, albeit to a lesser extent (Figure 1B). In health transitions and survival of older adults, frailty increases risk and often interacts with social vulnerability. Our study underscores why we should characterize both physical and social factors to understand health and its dynamics in aging.
TRAJECTORIES OF QUALITY OF LIFE AMONG FRAIL OLDER ADULTS IN KOREA: THE ROLE OF SOCIAL NETWORK
Authors: Shin Yeonsoo , Kim Giyeon 
Published: January 2025

Abstract
The purpose of this study was to examine the trajectories of quality of life among frail older adults in Korea, with a specific focus on the role of social networks on quality of life. Using data from waves 1 (2006) to 6 (2016) of the Korean Longitudinal Study of Ageing (KLoSA), a total of 3,177 older adults aged 65 and older at baseline was included in analyses. This study analyzed the trajectories of quality of life in all subjects, as well as frail and non-frail groups. Furthermore, the study investigated the effect of social networks on both the intercept and slope of quality of life. Results from multiple-group latent growth curve modeling showed that the intercept of quality of life for the frail group was lower than that of the non-frail group. While quality of life showed a declining trajectory for both the overall sample and the non-frail subgroup, the frail subgroup exhibited an increasing trajectory. Moreover, participation in social activities positively affected the quality of life intercept for both frail and non-frail older adults. Interestingly, quality of life among frail older adults living alone was found to be increasing. These findings provide valuable insights into the nuanced dynamics of quality of life among frail older adults in Korea. The study underscores the importance of promoting participation in social activities among this population and suggests further research focusing on frail older adults living alone.
AN ANCHOR FOR BETTER PHYSICAL HEALTH AMONG OLDER ADULTS: POSITIVE FAMILY WELL-BEING
Authors: Liu Yuchen , Kim Dae Hyun , Wittenberg Eve 
Published: January 2025

Abstract
The decline in physical health among older adults corresponds to an increased need for social support and caregiving. In the Chinese context, where formal long-term care options are limited, families predominantly shoulder caregiving responsibilities. We hypothesize that the quality of these familial interactions could significantly influence older adults’ objective health. We used data from the China Health and Retirement Longitudinal Study, assessing family well-being through satisfaction with spouse and children, and measuring objective health via frailty index based on the accumulation of deficits. Our findings indicate that satisfaction with children or spouses is negatively associated with the accumulation of additional deficits, demonstrating a mean ratio (MR) of 0.80 (95% CI: 0.76-0.83) for children and an MR of 0.77 (95% CI: 0.74-0.80) for spouses. After stratifying the analysis by marital status, the association between satisfaction with children and frailty status revealed a more substantial effect size in single or unpartnered individuals (relative risk (RR): 0.74 CI: 0.68-0.81) compared to those who were married or partnered (RR: 0.81, 95% CI: 0.77-0.86). We speculate that those without a spouse or partner may rely more heavily on their children for physical support, thus developing a stronger bond and accounting for the observed larger effect size. In conclusion, positive family well-being correlates with better physical health. Implementing policies that offer financial assistance or incentives for family involvement in elderly care could mitigate financial strains and enhance health outcomes for older adults.
FREE TESTOSTERONE, SEX HORMONE BINDING GLOBULIN, AND INCIDENT FRAILTY IN MEN WITH HIV
Authors: Dias Jenny Pena , Fitzgerald Kathryn C , Shardell Michelle , Wolinsky Steven , Lake Jordan , Koletar Susan L , Basaria Shezhad , Brown Todd 
Published: January 2025

Abstract

Background
Older men with HIV (MWH) have a higher prevalence of frailty than matched men without HIV, but the underlying mechanisms are unclear. Testosterone (T) contributes to higher muscle (mass, strength), and it binds to sex hormone-binding globulin (SHBG), which regulates testosterone bioavailability to the tissues. Aging MWH experience increase in circulating SHBG and decline in circulating free T concentrations. We hypothesized that these hormonal changes may contribute to the development of frailty in MWH.

Methods
Free T and SHBG were measured in 306 non-frail MWH (129 robust and 177 prefrail) who had at least one frailty assessment at a semi-annual follow-up visit in the Multicenter AIDS Cohort Study. Marginal structural models were used and adjusted for covariates: age, race, education, comorbidity burden, BMI, smoking status, alcohol use, HIV parameters and loss to follow-up.

Results
Mean age at baseline was 55±5 years, (median 58 years, Q1=55, Q3=63); follow up frailty assessments visits was 8.5(SD:2.5) years. MWH with low free T (&lt; 50 pg/ml) were more likely to become frail compared to those with free T ≥50 pg/ml (HR,1.58 (95%CI:1.12, 2.24); p-value=0.03). Low free T was also significantly associated with transition from prefrailty to frailty, [&lt; 50 pg/ml: 47%; ≥50 pg/ml:34%], a difference of 12.4% (95% CI:2.9,24.3%). In contrast, SHBG concentrations were not associated incident frailty or transition to frailty.

Conclusion
Low free T, but not SHBG, predicted incident frailty in men with HIV at high risk of developing frailty, in particular those in the prefrail state.
PLASMA PROTEIN BIOMARKERS AND THEIR CORRELATION TO COGNITIVE PERFORMANCE IN WOMEN LIVING WITH HIV
Authors: Li Wei , Wang Ge , Vance David , Li Daniel 
Published: January 2025

Abstract

Background
Individual plasma protein biomarkers have been shown to correlate to cognitive performance in people with HIV (PWH). This study aimed to investigate the association between plasma proteomic signatures and cognition in virologically well-controlled women with HIV (WWH).

Methods
Seventy-seven WWH from three Women’s Interagency HIV Study (WIHS) sites completed neuropsychological (NP) testing and a blood draw. Targeted protein biomarkers were analyzed using a multiplexing method. Random forest analysis was used to identify the top 10 positively or negatively biomarkers associated with cognitive function. Next, ingenuity pathway analysis (IPA) was used to facilitate data interpretation.

Results
Tumor necrosis factor receptor 1 (TNF RI), TNF RII, interleukin 1 receptor 1 (IL-1RI), and IL-6R are negatively associated with attention/working memory; IL-7 and CD40 are positively associated with executive function; IL-1RI, hepatocyte growth factor (HGF), transforming growth factor beta-1 (TGFβ1), TGFβ2, and sonic hedgehog (SHH) are negatively associated but IL-7 is positively associated with fluency; IL-9, IL-15, and IL-21R are positively associated with motor function; brain-derived neurotrophic factor (BDNF), HGF, SHH, and vascular endothelial growth factor (VEGF) are negatively associated with processing speed. HGF, VEGF, and insulin are negatively associated with the global NP function. Based on the IPA, one to three signaling networks were proposed for associating plasma biomarkers with each domain-specific or global NP function.

Discussion
It is likely that a panel of plasma protein biomarkers can be used to predict domain-specific or global NP function. Multiple signaling networks might explain cognitive functioning in WWH.
CHILDHOOD HOUSING AND OLD AGE HEALTH AMONG CHINESE: THE MEDIATION ROLE OF ADULTHOOD LIFE HISTORY
Authors: Kong Dexia , Lu Peiyi , Lou Vivian Weiqun 
Published: January 2025

Abstract
Housing insecurity is linked to worse health. However, very few studies examined this relationship from a lifecourse perspective and its underlying mechanisms. This study examined the association of childhood housing with old age health among Chinese and whether adulthood socioeconomic and medical history mediated that relationship. Respondents were middle-aged and older adults (aged 45+) from the China Health and Retirement Longitudinal Study (N=12,842). They were asked about their childhood housing conditions (e.g., if their houses had clean water, water closet, and electricity). Adulthood socioeconomic and medical history and middle- and old-age health were measured. Causal mediation analysis examined the pathways via which childhood housing affects health in later life. Results show about 28%-37% of respondents had access to electricity or energy for cooking/heating during their childhood. However, very few had access to clean water (6%) or water toilet (2%). Childhood better housing was directly associated with fewer depressive symptoms and better cognition in middle- and older age, and indirectly through increasing the likelihood of obtaining more education during adulthood. However, the proportion-mediated estimate had very wide confidence intervals to be certain. Other adulthood life history pathways (i.e., marital status, work and medical history) were not statistically significant. Our findings suggested targeting services among those who grew up in poor housing conditions may be crucial to promoting healthy aging.
MEDICAID HOME- AND COMMUNITY-BASED SERVICES IN THE WAKE OF THE COVID-19 PANDEMIC
Authors: Miller Edward , Beauregard Lisa 
Published: January 2025

Abstract
Medicaid, the joint federal-state health insurance program for people with low income, provides coverage for home and community-based services (HCBS). States have significant discretion to offer HCBS programs within federal regulations. The federal government matches state Medicaid program spending according to state per capita income, with the matching rate varying from 50% to 77.27%. The need to bolster Medicaid HCBS became evident during the COVID-19 pandemic. This recognition stemmed from the challenges of keeping people safe in nursing homes and the acute workforce shortages in the HCBS sector. This presentation examines two major federal developments and state responses in HCBS options as a result of the pandemic. The first initiative entails a one-year increase of the federal Medicaid matching rate for HCBS included in the American Rescue Plan Act championed by the Biden administration. The second initiative encompasses administrative flexibilities that permitted states to temporarily expand and modify their existing Medicaid HCBS programs. It concludes that the effects of the pandemic flexibilities and enhanced federal funding on most state HCBS programs will be limited without continued investment and leadership on the part of the federal government, a Biden administration priority. States that make the American Rescue Act and COVID-19 flexibilities initiatives permanent are states that have the fiscal resources and political commitment to expanding HCBS benefits that other states lack. States’ different approaches to bolstering Medicaid HCBS during the pandemic may contribute to widening disparities in access and quality of HCBS across states and populations who depend on Medicaid HCBS.
EXPLORING THE IMPACT OF ATTENDANCE IN AN OUTDOOR WALKING PROGRAM ON HEALTH IN OLDER ADULTS WITH MOBILITY LIMITATIONS
Authors: Su Tai-Te , Barclay Ruth , Moineddin Rahim , Salbach Nancy 
Published: January 2025

Abstract
Walking in an outdoor environment offers numerous health benefits for older adults with mobility limitations. Effects may vary, however, depending on the level of attendance. This study aimed to investigate whether a dose-response relationship existed between attendance in an outdoor walk group (OWG) program and improvement in health outcomes among older adults with mobility limitations. We analyzed data from a randomized controlled trial conducted across four cities in Canada and focused specifically on community-dwelling older adults assigned to a 10-week OWG program (n=79, age=74.7±6.6 years, 72% female). Participants were categorized into three groups based on attendance tertiles, with the first, second, and third tertiles corresponding to attending 0–9, 10–15, and 16–20 outdoor walking sessions in total. Outcomes were operationalized as change in scores on measures of walking endurance, comfortable and fast gait speed, balance, lower extremity strength, walking self-confidence, and emotional well-being pre- to post-intervention. Results from multiple linear regression models showed that, compared to those who attended 0–9 OWG sessions, participants who attended 16–20 sessions exhibited a 52.7-meter greater improvement in walking endurance (95% CI:12.3, 93.1); 0.15-meter/second greater improvement in comfortable gait speed (95% CI:0.00, 0.29); and 0.17-meter/second greater improvement in fast gait speed (95% CI:0.02, 0.33), after adjusting for sex and study site. No significant dose-response relationships for balance, lower extremity strength, walking self-confidence, and emotional well-being were observed. The role of attendance highlighted in this study provides critical information relevant to the design and implementation of outdoor walking interventions aimed at improving health among older adults.
RESTRICTED YET EXPANDED: EVOLVING MOBILITY OF OLDER ADULTS WITH COGNITIVE IMPAIRMENT IN URBAN CHINA
Authors: Yin Qingqing , Chen Lin 
Published: January 2025

Abstract
Cognitive impairment restricts older adults’ mobility within and beyond the neighborhood. Existing literature primarily focuses on the declining mobility of older adults with mild cognitive impairment (MCI) and the implications of such decline for this vulnerable group. However, how older adults with MCI experience their changing mobility has received limited attention. Informed by community gerontology and the preventive and corrective proactivity (PCP) model, this study aims to explore how older adults with MCI perceive and adapt to their changing mobility. Through purposive sampling, we took a phenomenological approach to conduct face-to-face, in-depth interviews with community-dwelling older adults with MCI in Zhengzhou, China (N = 34). By applying the geographic information systems (GIS), we spatially situated participants’ routine activities to visualize their changing mobility. Recognizing their cognitive decline, most participants voluntarily constrained their out-of-home activities within the neighborhood. Still, they tried to keep a strong grip on the existing mobility and prolong independent living as much as possible. One of the most useful strategies was to take advantage of their social networks in the neighborhood. Social interactions and mutual support created new opportunities for participants, which facilitated their out-of-home mobility even beyond the neighborhood. Their restricted mobility in the physical environment was thus continually defended and expanded by the social environment. The findings of this study inform the importance of promoting neighborhood built and social features to support older adults with different levels of cognitive and mobility functioning.
ALTERNATIVE SPLICING DYNAMICS IN MYOGENESIS: A TRANSCRIPTOMIC ATLAS FOR HUMAN SKELETAL MUSCLE CELLS
Authors: Donega Stefano , Banskota Nirad , Yang Jen-Hao , Rossi Martina , Tsitsipatis Dimitrios , De Supriyo , Gorospe Myriam , Ferrucci Luigi 
Published: January 2025

Abstract
Myogenesis entails the fusion of myoblasts to form multinucleated myotubes. Although alternative splicing (AS) in myogenesis has been explored in non-human species, its characterization in humans remains incomplete, both in vitro and in vivo. We studied two human skeletal muscle cell lines (AB1167 and AB678) over a 5-day differentiation period, with RNA samples collected every 24 hours. Utilizing a Hybrid RNA-sequencing approach (combining short and long-read sequencing), we applied linear regression in Differential Gene Expression (DGE) and Likelihood Ratio Test – Hierarchical Clustering models (LRT-HCl), and discovered 3,079 upregulated genes and 2,357 downregulated genes in the overlapping models. Gene Set Enrichment Analysis (GSEA) highlighted pathways related to muscle formation and contraction showing upregulation, while those associated with nuclear separation and DNA synthesis were downregulated until day 3, followed by an increase in inflammation and interferon-like pathways by day 5. Differential Transcript Usage analysis (DTU) identified 2,584 myogenesis-dependent isoform-switches, which were primarily linked to actin-filament processes and muscle regulation. Validation of the models was conducted for the top 5 genes using qPCR. Additionally, three novel protein-coding genes associated with muscle differentiation were identified through an Alphafold-based computational pipeline and validated via qPCR. Comparison of clusters within a 0–3-day model with a Peripheral Artery Disease (PAD) dataset confirmed significant enrichment of up-regulated clusters observed in the myogenesis model. This project aims to establish a comprehensive transcriptomic atlas for myogenesis models and set a benchmark for future research in the multi-omic fields of muscle biology.