bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEW MEASURES OF MULTIMORBIDITY BASED ON A THEORY OF DEPENDENT COMPETING RISKS
Authors: Akushevich Igor , Yashkin Arseniy , Kravchenko Julia , Yashin Anatoliy 
Published: January 2025

Abstract
The phenomenon of multimorbidity is increasingly common among older U.S. adults, however the driving forces behind multimorbidity development remain unclear. In this study we develop a novel approach for the identification and explanation of causal pathways generating multimorbidity patterns in the population of older U.S. adults. Our approach is based on the evaluation of the dependent competing risks among diseases potentially determining the process of generating a given multimorbidity cluster using parametric and non-parametric methods. This approach allows for modeling the joint distribution of time-to-disease-onsets with mutual correlations; characterizing cluster properties such as speed of cluster formation and their prevalence in the population. This joint distribution is estimated using individual morbidity trajectories extracted from Medicare administrative claims data and dynamically constructed for all ages resulting in an age-specific-function of multimorbidity generation. The identified clusters and estimated properties were compared to those obtained using traditional methods (e.g., cluster analysis or latent structure analyses). Our method strongly outperforms the current methods of identification of multimorbidity clusters which were characterized by approximate cluster composition with no room for improvement without additional methodologic assumptions. The substantive results of this study encompass the identification of multimorbidity clusters and their properties and allows extensions for the quantification of the effects of risk factors on these clusters (including evaluating causality), the provision of causal explanations for disparities in multimorbidity, and the development and testing of novel approaches for multimorbidity analysis through simulation studies.
CAMKII HYPERACTIVATION IN SKELETAL MUSCLES IS A DRIVER AND POTENTIAL THERAPEUTIC TARGET OF SARCOPENIA
Authors: Wang Qinchuan , Bene Michael , Fountain William , Rosales-Soto Giovanni , Hernandez-Ochoa Erick , Chung Tae Hwan , Walston Jeremy 
Published: January 2025

Abstract
Sarcopenia, the loss of muscle mass and strength, is a major risk factor for physical frailty in older adults. Ca2+/calmodulin-dependent protein kinase II (CaMKII) is activated by Ca2+ and reactive oxygen species in contracting muscles to enhance muscle performance and adaptation to exercise training. We assessed CaMKII activity in the skeletal muscles of young (4-month-old) and old (20-month-old) C57BL/6J mice and found significantly increased CaMKII activity in old mice at rest, suggesting that CaMKII activity is chronically elevated and disconnected from muscle contractile activity in aged muscles. To determine the role of increased CaMKII, we used an adeno-associated viral vector (AAV9) to express a CaMKII inhibitor, CN19o, in the tibialis anterior (TA) muscles of 20-month-old mice and found a significant improvement of muscle contractile force at 24 to 26 months of age. Conversely, when we expressed a constitutively active CaMKII (CaMKIICA) in the TA muscles of young mice (3-month-old), we observed a striking reduction of muscle contractility. Electromyography studies showed that the muscles expressing CaMKIICA had a subtle but significant reduction of compound muscle action potential (CMAP) that could not explain the reduction of contractile force. Single muscle fiber analyses showed that CaMKIICA did not affect action potential-evoked Ca2+ release. Ongoing research is assessing the clinical relevance of CaMKII activation in humans and examining the histological and transcriptomic profiles of muscles with either inhibited or hyperactivated CaMKII to uncover the mechanisms underlying CaMKII-induced muscle dysfunction. Our findings suggest that CaMKII hyperactivation is a driver and potential therapeutic target of sarcopenia.
EFFECTS OF MULTICOMPONENT EXERCISE INTERVENTION ON SARCOPENIA PREVENTION IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Shi Kewei , He Lingxiao , Fang Ya 
Published: January 2025

Abstract

Objective
To assess the effects of multicomponent exercise intervention on sarcopenia and its components among community-dwelling older adults. Design, Setting, and Participants: In a randomized controlled trial conducted in 11 communities across Xiamen, China, with 200 older adults (aged &gt; 65 years) being randomly assigned to an exercise group (n=100) or a control group (n=100).

Interventions
The exercise group followed a multicomponent exercise program, consisting of resistance, balance and flexibility training, twice a week for six months. The control group received monthly sarcopenia-related health education. Outcome measures: The primary outcome was the incidence of sarcopenia. The secondary outcomes included muscle mass, muscle strength (knee extension and grip strength), the Short Physical Performance Battery (SPPB) score, 4-meter gait speed, and 5-time chair stand test (CST) performance. Generalized mixed-effects model was performed for primary outcome comparison between two groups. Repeated measures ANCOVA was performed to evaluate the effects on secondary outcomes.

Results
The exercise group showed a decrease of 4.3% on the incidence of sarcopenia after 6-month intervention, with no significant difference from the control group (P=0.171). The exercise group demonstrated significant improvements in knee extension (β=1.95, 95% CI [0.082, 3.84]), grip strength (β=2.07, 95% CI [0.857, 3.290]), SPPB score (β=1.99, 95% CI [1.600, 2.380]), gait speed (β=0.182, 95% CI [0.128, 0.235]) and CST (β=-1.590, 95% CI [-2.400, -0.786]). No between-group difference was observed in muscle mass (P=0.767).

Conclusion
A 6-month multicomponent training can significantly improve physical function and muscle strength but not muscle mass among community-dwelling older adults.
ASSOCIATION OF HEARING LOSS AND INCIDENT PARKINSON’S DISEASE: A COHORT STUDY IN US VETERANS
Authors: Neilson Lee , Reavis Kelly , Wiedrick Jack , Scott Gregory 
Published: January 2025

Abstract
Parkinson’s disease (PD) is a heterogeneous disease with non-motor manifestations that often precede motor symptom onset. Sensory disturbances such as loss of sense of smell and visual problems are well-characterized, but the impact of hearing loss on PD incidence remains unclear. We undertook an electronic health record-based cohort study of US military Veterans with objective audiogram data (n=3,596,365), using inverse probability of treatment weighting to calculate cumulative incidence of PD, adjusted for competing risk of death and key confounders. Risk difference and 95% confidence intervals (CI) were estimated by hearing loss severity. We also analyzed how this varied when combined with known comorbid conditions and receiving a hearing aid. Results suggest that hearing loss increases the risk of developing PD in a dose-dependent manner; worse hearing confers a higher risk. The number of additional cases of PD per 10,000 person-years at 5-years due to mild, moderate, moderately-severe, and severe-to-profound hearing loss was 2.0 (95% CI: 0.9, 3.1), 5.4 (95% CI: 3.7, 7.1), 5.8 (95% CI: 3.3, 8.3), and 10.6 (95% CI: 4, 17.2), respectively. Hearing loss also synergized with known prodromal disorders, increasing PD risk more than additively. Dispensation of a hearing aid within two years of the audiogram attenuated the risk of incident PD; the reduction in cases of PD per 10,000 person-years at 5-years was -9.2 (95% CI: -10.7, -7.7). Hearing loss appears to be an independent risk factor for development of PD. Widespread screening for hearing loss and appropriate use of hearing aids may attenuate this risk.
ASSOCIATION OF MELANOMA AND INCIDENCE OF PARKINSON’S DISEASE: A COHORT STUDY IN US VETERANS
Authors: Scott Gregory , Neilson Lee , Unni Vivek , Arnold Moriah 
Published: January 2025

Abstract
Melanoma is associated with subsequent Parkinson’s disease (PD) and identifying the clinicopathologic properties of melanoma driving this association could give insight into PD pathophysiology. We undertook a retrospective cohort study of US military Veterans (n=13,737,081) to determine if malignant and premalignant phenotypes were associated with PD by using propensity score matching 4-to-1 and adjustment for competing risk of death and key confounders. Broad cancer categories were obtained from the Oncology VA registry. Data about melanoma were obtained from clinical and pathology reports using manually validated natural language processing. Risk difference and 95% confidence intervals (CI) were estimated by presence or absence of cancer. For broad cancer categories, we found decreased PD incidence associated with multiple malignancies with some novel associations (e.g. HR = 0.4 [0.2,0.5] for myeloma). In terms of melanoma, BRAF and NRAS mutational status was not associated with incident PD. Atypical/dysplastic nevi was associated with increased PD incidence (HR = 1.4 [1.2,1.7]). Melanoma subtypes in the Oncology registry were associated with PD and included superficial spreading type (HR = 1.8 [1.0, 3.3]) and lentigo maligna (HR = 1.6 [1.2, 2.1]). In people with VA pathology reports, this effect was replicated with greater effect size for superficial spreading type (HR = 10.4 [6.5,16.9]) and lentigo maligna (HR = 6.4 [3.4,11.8]) although adjustment for ascertainment bias is needed. These data show PD is associated with melanoma subtypes and precursor lesions and suggest screening for PD could be appropriate in those with melanocytic lesions once early diagnostic tests are developed.
DIFFERENCES IN SELF-CARE AND QUALITY OF LIFE BETWEEN SPOUSES AND ADULT CHILDREN IN PATIENTS WITH PARKINSON’S DISEASE
Authors: Lee Juhee , Kim Eunyoung , Park Hyeran , Kim Kiyeon 
Published: January 2025

Abstract
Self-care of patients with chronic illness involves various caregiver types like spouses, adult children, and other relatives or friends. Several studies have reported differences in self-care and quality of life (QOL) according to caregiver type in patients with chronic illness. Nevertheless, there are few studies comparing the difference by caregiver type in patients with Parkinson’s disease (PD). This is a cross-sectional study to explore differences in self-care and QOL between spouse and adult child caregivers of patients with PD. Participants were recruited from two neurology outpatient departments of the tertiary hospitals in Korea. They reported self-care and QOL using a structured questionnaire. A total of 111 paired of PD patients and caregivers including 83 of spouse and 28 of adult child were analyzed using SPSS 26.0. Spouse caregivers reported higher in domains for self-care of efficacy and monitoring in both patients (p=0.014 to 0.054) and caregivers (p=0.026 to 0.002) compared with adult child caregivers. Patients with spouse caregivers showed better QOL of parkinson symptoms(p=0.008), and emotional function(p=0.003) with the exception of social functioning (p=0.31). Social functioning contained the questionnaire like hobby, vacation, or sexuality. This study finding showed that patients whose caregivers are spouses had better in both self-care and QOL domain than patients whose caregivers are adult children. These differences between spouse caregivers and adult child caregivers can suggest the needs of tailored care strategy for patients with PD according to caregiver type.
BINGE EATING DISORDER AND THE RISK OF SUICIDE IN OLDER WOMEN
Authors: Mendez Therese , O’Hanlon Ann 
Published: January 2025

Abstract
Binge Eating Disorder (BED) is a psychiatric condition marked by repeated instances of excessive food consumption without control. Research on eating disorders tends to focus on younger populations, but recent studies have shown an increasing prevalence of BED in older women. Binge Eating Disorder may pose unique challenges and heightened risks for older women, including an increased potential for suicidality. This review aims to spotlight the critical intersection of binge eating disorder, its prevalence among older women, and the associated risk of suicide. A scoping literature review was done in accordance with the PRISMA-ScR criteria, targeting studies published between 1996 and 2024 on PubMed, PsychINFO, CINHAL, Web of Science, and Google Scholar. The search focused on research pertaining to women aged 40 and above, exploring the association between BED and suicide risk within this demographic. Of the literature surveyed, there were no studies that focused explicitly on the population of interest. Only eight studies met the inclusion criteria for BED and the risk of suicidality in women. These studies show that BED significantly correlates with an elevated suicidality risk, highlighting a complicated relationship that adversely impacts mental health and possible mortality. Despite acknowledging the general risk BED poses for suicidality, the review underscores a concerning scarcity of research dedicated to understanding BED’s prevalence and specific suicidality risk among older women. The findings reveal a need for further research to delve into the nuanced psychological effects of BED on older women and its contribution to heightened suicide risk.
COVID-19 MORTALITY RATES AND CHANGES IN ANTI-DEMENTIA AND PSYCHOTROPIC MEDICATION USE AMONG NURSING HOME RESIDENTS
Authors: Rataj Alison , Alcusky Matthew , Ott Brian , Baek Jonggyu , Liang Shiwei , Lapane Kate 
Published: January 2025

Abstract
Objective. We examined the relationship between nursing home (NH) COVID-19 mortality rates and changes in antidementia and psychotropic medication initiation before and during the pandemic and explored the influence of staffing and resident factors. Methods. Changes in medication initiation were collected through a novel, nationally representative cross-sectional Dementia Treatment Survey (2022) of NH Directors of Nursing. Outcome measures were created by collapsing a 5-point Likert scale contrasting less/about the same vs. more initiation and less versus more/about the same initiation. NH’s peak monthly COVID-19 death rate per 1,000 residents (05/2020-12/2022) was calculated from the CMS COVID-19 Nursing Home data file. Covariates were drawn from NH Compare, Provider of Service, Master Beneficiary Summary, Minimum Data Set 3.0, and Medicare administrative claims files. Adjusted odds ratios (aORs) were estimated from multivariable logistic models. Results. NHs with higher COVID-19 death rates at the peak of the pandemic were less likely to report changes in antidementia medications (aORdecrease: 0.38, 95% CI: 0.15-0.94; aORIncrease: 0.27, 95% CI: 0.08-0.85), but no association with psychotropic medication initiation was observed. NH’s that reported increased resident behavior problems during the pandemic had higher odds of psychotropic initiation (aOR=11.25, CI=3.86-32.83). Discussion. Increased COVID-19 mortality rates were not associated with changes in antidementia medication use during compared to before the pandemic. Increased behavior changes may be due to consequences of COVID-19 (i.e., social isolation); our findings indicate that increased behavior changes were associated with more psychotropic drug use.
MICROBIOME-KIDNEY METABOLISM PROVIDES INSIGHT INTO THE MECHANISM OF ICARIIN ALLEVIATES AGING IN OLDER FEMALE MICE
Authors: Li Xiaoang , Zhang Yiming , Duan Liping 
Published: January 2025

Abstract
The average life expectancy of women in most countries and regions is significantly higher than men’s. Whether in rich developed countries or relatively poor third-world countries, women are more likely to live. Our previous study revealed that Icariin enhances youth-like features by attenuating the declined gut microbiota in older male mice. To further study the mechanism of icariin on delaying aging in older female mice on gut microbiota and metabolism, two age groups of C57BL/6J female mice (8 week- and 24 month- mice) were given a single dose of icariin at 100mg/kg by gavage for 15 days. The 16S rRNA gene pyrosequencing analyzed the fecal microbiome. We observed clear differences in gut microbial profiles between the young and older female mice. Interestingly, while older male mice did not show this effect, treatment with icariin increased the abundance of the short-chain fatty acid (SCFA)-producing bacteria Akkermansia muciniphila and Eubacterium ramulus in older female mice, bringing their levels close to those of untreated young female mice at the species level. Further, we used non-targeted metabolomics technology to detect all metabolites in the kidney. We found that the level of D-serine in the kidneys of older female mice was significantly lower than that of young female mice, and the metabolite levels were significantly increased after icariin treatment. SCFA and D-serine are gut microbial-derived products with kidney-protective properties. This study provides valuable insights into the molecular mechanisms of icariin, highlighting target characteristics and key pathways for slowing the aging process.
OLDER ADULTS’ PERCEPTION TOWARD DEPRESCRIBING INAPPROPRIATE MEDICATIONS
Authors: Rababa Mohammad , Ghazo Ali Al 
Published: January 2025

Abstract

Introduction
Inappropriate prescription of medications is a problem of growing interest in geriatrics. Initiatives have been ongoing to evaluate interventions targeting the hazards of inappropriate prescription of medications; Deprescribing is one of these initiatives. However, no current study has examined medicine-related perceptions toward deprescribing inappropriate medications among older adults.

Methods
A convenience sample of older adults who regularly visited the outpatient clinics during July 2023 for regular checkups were recruited. Data were collected by a graduate nursing student from one pharmacy located in a public hospital, five days per week, via in-person interviews using the Patient’s Perceptions of Deprescribing survey.

Results
The study found that older adults’ perceived interest in stopping medications, belief about medicine overuse, the unimportance of medicines, and medication concerns are significantly associated with a variety of sociodemographic (e.g., age), clinical (e.g., comorbidities), and PCP-related factors (e.g., knowledge of medications).

Conclusion
Inappropriate prescription of medication is one of the most common polypharmacy-related issues among older adults. The current study reported its findings on medicine-related perception toward deprescribing inappropriate medications among older adults. Care providers should discuss the benefits of deprescribing inappropriate medications with their patients to prevent the side effects associated with long-term unnecessary use. The long-term use of inappropriate medications by older adults should be carefully evaluated. Future studies on the effectiveness of an evidence-based deprescribing protocol on minimizing the clinical side effects associated with inappropriate prescription of medications among older adults are recommended.
TOWARD OPTIMIZED CLINICAL TRIALS OF BOTANICAL DIETARY SUPPLEMENTS IN OLDER ADULTS
Authors: Speers Alex , Soumyanath Amala 
Published: January 2025

Abstract
The use of dietary supplements, which includes botanical dietary supplements, is increasingly common among older adults. This is concerning due to a) the lack of high-quality efficacy studies for botanical products, b) issues with product quality and variability, and c) the potential for herb-drug interactions, which is increased in older adults due to higher rates of polypharmacy. Given the growing popularity of these products among consumers, more rigorous data are needed, but a rational, stepwise approach is required. At Oregon Health & Science University (OHSU) and collaborating institutes, a pipeline is being developed to study botanical dietary supplements in an older population. The BENFRA Botanical Dietary Supplements Center at OHSU studies Botanicals Enhancing Neurological and Functional Resilience in Aging, with a focus on two botanicals: Centella asiatica (gotu kola) and Withania somifera (ashwagandha). This work includes product characterization studies, exploration of mechanisms in vitro and in vivo, and the development of methods for measuring plant compounds in plasma. Separate from the BENFRA Center, studies are now underway at OHSU to investigate the safety, pharmacokinetics, and biological signatures of these botanicals in humans. Collectively, this pipeline of research will generate the necessary data to support future optimized efficacy trials in older adults. The presentation will outline the rigorous studies being undertaken and provide preliminary data from these preclinical and clinical investigations.
ACADEMIC DETAILING INTERVENTION: INCREASING TRENDS OF NALOXONE PRESCRIBING IN RURAL ARKANSAS
Authors: Tobey-Moore Leah , Breckling Meghan , Ali Mohab , McAtee Robin 
Published: January 2025

Abstract
This longitudinal study analyzes naloxone prescribing trends of rural primary care providers (PCPs) in Arkansas (AR). As one of the HRSA-funded Geriatric Workforce Enhancement grant recipients, the AR Geriatric Education Collaborative (AGEC) worked with a rural federally qualified healthcare system (ARcare) to reduce the likelihood of patient’s accidental overdose by co-prescribing naloxone, when indicated. A multi-disciplinary Academic Detailing (AD) team of a PT, PharmD and MBBChB conducted AD trainings. AD is clinician-to-clinician customized education connecting recipients to updated evidence and practice guidelines. These interactive telehealth trainings stimulated PCPs to share knowledge deficits and perspectives, encouraged a commitment to increase patient safety and adhere to naloxone prescribing guidelines from Centers for Disease Control and state laws especially during cases when naloxone should be co-prescribed alongside high-risk medications like opioids. ARcare PCPs received “Preventing Opioid Overdose with Naloxone” AD training. Before training, previous naloxone prescribers (group 1) prescribed naloxone 39 times, 106 times in period 1 (P1=11 months post-training), and 91 times in period 2 (P2=22 months post-training), a 14.2% decrease. Group 2 previously did not prescribe naloxone during the baseline period, then prescribed 46 times in P1 and 63 times in P2, a 40% increase. Group 3 did not prescribe naloxone in P1, but prescribed naloxone 13 times during P2. Overall, P1 data from all groups totaled 152 naloxone prescriptions after AD, a 290% increase; in P2, naloxone was prescribed 167 times, a 328% increase. In summary, AD was effective in encouraging naloxone prescribing among prescribers in rural AR.