bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION OF ALCOHOL CONSUMPTION WITH IMMUNE CELL PHENOTYPES IN THE FRAMINGHAM HEART STUDY
Authors: Ragab Ahmed , Chen Jiachen , Cao Yumeng , Doyle Margaret , Lunetta Kathryn , Murabito Joanne 
Published: January 2025

Abstract
Alcohol consumption, prevalent among 2.3 billion people worldwide, accounts for 4.7% of global mortality. While excessive drinking is harmful, moderate intake may have nuanced effects on immune function, though this relationship is not well-studied. We analyzed the relationship between average daily alcohol consumption and immune cell phenotypes among Framingham Heart Study Offspring participants. Consumption was examined in multiple ways: categorized and ordinalized (nondrinkers, moderate, at-risk, heavy), using average grams per day, and dichotomized as light vs heavy drinkers, with and without non-drinkers omitted. We profiled immune cell phenotypes using flow cytometry, including T, B, and NK cells, and T subtypes: CD4+, CD8+, CD4+CD28-CD27-, CD8+CD28-CD27-, CD4+ TEMRA, CD8+ TEMRA, CD4+/CD8+ ratio, CD4+(TN/TM), CD8+ (TN/TM), CD8+ Tc17/Treg ratio, CD4+ Th17/Treg ratio and GranzymeB CD8+/CD4+ratio. We used linear mixed effects models adjusting for age, sex, and cytomegalovirus status to test for associations, and FDR≤0.05 within an analysis set (defined by consumption definition) to declare significance. Among 928 participants (mean age 62 years, range 40-88, 52% female), 64% consumed alcohol. Compared to abstainers, CD4+(TN/TM) ratio was significantly increased in the moderate and at-risk daily consumption categories (β=0.26 for both, FDR=0.03). There were no significant linear associations between consumption and any of the immune cell phenotypes. However, among drinkers, we observed a significant negative association between average daily alcohol consumption and CD8+(TN/ TM) ratio (β= -0.14 for each higher category of consumption, FDR=0.03). The effects of consumption appeared stronger in males than females. Our findings suggest alcohol consumption may impact immune cell phenotypes.
ASSOCIATION OF CARDIOMETABOLIC RISK FACTORS AND TRANSITION OF DISABILITY STATUS AMONG CHINESE ADULTS
Authors: Pei Heming , Chen Gong , Li Jiajia , Liang Bo 
Published: January 2025

Abstract

Background
Chronic diseases significantly increase the risk of functional disability. Understanding the relationship between cardiometabolic risk factor (CMRF) comorbidities and transitions in disability status is crucial for devising early intervention strategies at the population level.

Method
This study utilized a prospective cohort design, drawing data from the China Health and Retirement Longitudinal Study (CHARLS) spanning from 2011 to 2018. A total of 6,397 Chinese middle-aged and older adults were followed for a total of 44,779 person-years. A Multi-state Markov model was employed to simulate longitudinal disability status transitions and to estimate the effect sizes of CMRFs, along with demographic, socioeconomic, and behavioral factors.

Results
Over the 7-year follow-up, CHARLS participants experienced an increased likelihood of transitioning from normal physical function to IADL (Instrumental Activities of Daily Living) impairment, rising from 7.6% to 11.0%. Moreover, the transition intensity from intact ADL (Activities of Daily Living) to IADL impairment was 2.5 times higher than that from intact ADL to ADL impairment. Unlike other chronic conditions, CMRFs particularly influenced ADL by significantly reducing the probability of recovery from ADL impairment to a better physical function state. Specifically, the probability of shifting from IADL impairment to intact ADL decreased by 30% (HR=0.70, 95% CI [0.53-0.92]) among individuals with two CMRF components.

Conclusion
The findings suggest that CMRFs act as risk factors by impeding the recovery process of ADL impairment. Early intervention targeting obesity, hypertension, hyperlipidemia, and diabetes could help reduce or delay the incidence of functional disability.
ASSOCIATION OF CREATININE- AND CYSTATIN-C–BASED INDICES WITH INCIDENT SARCOPENIA: A LONGITUDINAL STUDY
Authors: Jang Jae Young , Shin Hyung Eun , Lee Daehyun , Jung Heeeun , Cho Hyunjin , Lim Nahyun , Won Chang Won , Kim Miji 
Published: January 2025

Abstract
Creatinine and cystatin-C–based indices have been reported to be associated with sarcopenia; however, the long-term relationship between these indices and sarcopenia remains unclear. This study examined the longitudinal relationship between baseline serum creatinine and cystatin-C–based indices and incidence of sarcopenia during a 6-year follow-up to compare which indicator well predicts sarcopenia in community-dwelling older adults. This study included 698 participants (mean age=75.1±3.7years; women=54.4%) from the Korean Frailty and Aging Cohort Study (KFACS). Baseline Creatinine-to-cystatin-C ratio estimated glomerular filtration rate (eGFR) ratio (eGFRcystatin-C[mL/min/1.73m2]/eGFRcreatinine[mL/min/1.73m2]), sarcopenia-index (serum creatinine[mg/dL]×eGFRcystatin-C[mL/min/1.73m2]), predicted skeletal muscle mass index (pSMI), and total-body muscle mass index (TBMM) were measured. Sarcopenia was defined by following the guidance of the Asian Working Group for Sarcopenia 2019. The incidence of sarcopenia during 6-year follow-up was 22.5% in men and 16.7% in women. The pSMI and TBMM showed higher area under the receiver operating characteristic curves for predicting the incidence of sarcopenia in men (pSMI==0.634; TBMM=0.635) and women (pSMI=0.727; TBMM=0.724) than other indices. Higher pSMI and TBMM were associated with the incidence of sarcopenia in both men (pSMI, odds ratio [OR]=0.370, 95% confidence interval [CI]=0.223–0.614; TBMM, OR=0.928, CI=0.896–0.962) and women (pSMI, OR=0.149, CI=0.072–0.307; TBMM, OR=0.896, CI=0.857–0.936), after adjusting confounders. pSMI and TBMM showed higher predictive capabilities for the incidence of sarcopenia compared to other indices. Also, higher pSMI was strongly associated with a lower risk of incident sarcopenia. These findings suggest that monitoring pSMI could help predict the onset of sarcopenia in community-dwelling older adults.
ASSOCIATIONS BETWEEN 10-YEAR PHYSICAL FUNCTION TRAJECTORIES AND 24-HOUR ACTIVITY CYCLE BEHAVIORS IN OLDER ADULTS
Authors: Greenwood-Hickman Mikael Anne , Zhu Weiwei , Idu Abisola , Harrington Laura , McCurry Susan , LaCroix Andrea , Shaw Pamela , Rosenberg Dori 
Published: January 2025

Abstract
Physical activity (PA), sedentary behavior (SB), and sleep comprise an individual’s 24-hour activity cycle, which is likely bidirectionally associated with physical function over the life course. To explore how function predicts activity, we examined whether self-reported (activities of daily living [ADLs]) and objective (short Performance-based Physical Function [sPPF]) measures of physical function predicted PA, SB, and sleep in the Adult Changes in Thought (ACT) cohort. We fit linear mixed effects models to define trajectory slopes for each functional measure over the prior 10 years. We used multivariable linear regression to investigate the relationship between trajectories and device-measured PA and SB and self-reported sleep. Participants (N=905) were 77.6 (SD=6.9) years old, 55% female, 91% White, and reported impairment on a median of 1 ADL (IQR=[0,2]) with a median score of 9 (IQR=[8,11], higher=better functioning) on the sPPF at activity measurement. A steeper increasing slope of ADL impairment was associated with more sitting time (35.0 mins/day [4.3,65.0] per 0.4-unit increase in slope), longer mean sitting bout duration (3.5 min/bout [0.8,6.2]), fewer steps (-1372 [-2223,-638]), less MVPA (-13 min/day [-22.6,-5.0]), and more time in bed (25.5 min/day [6.5,43.5]). More steeply decreasing sPPF slope was associated only with steps and MVPA (-1180 steps [-2853,-185] and -15.7 min/day [-35.6,-2.3] per 0.3-unit decrease in slope). Standing time, Light-intensity PA, and self-reported sleep quality were not associated with either measure. Combined with prior literature suggesting associations with future function, these findings support the bidirectional nature of the relationship between the late-life 24-hour activity cycle and physical function.
ASSOCIATIONS BETWEEN PULMONARY FUNCTION AND PHYSICAL REHABILITATION OUTCOMES AMONG OLDER ADULTS
Authors: Mathis Lindsey , Sun Na , Ho Simon , White Lane , Addison Odessa , Savin Douglas , Falvey Jason 
Published: January 2025

Abstract
Physical rehabilitation is crucial for older adults with functional impairments, as persistent impairments are linked to increased risks of hospitalization, mobility disability, and mortality. Impaired pulmonary function and associated symptoms of dyspnea may limit participation in rehabilitation programs, but it is unclear whether these impairments negatively impact outcomes. To answer this question, our analysis included 819 community-dwelling rehabilitation users (63% female; weighted n=3,882,191) from Round 5 (2015) of the National Health and Aging Trends Study (NHATS). Peak expiratory flow (PEF) categorized participants into “normal,” “moderately impaired,” or “severely impaired” lung function. Participants reported whether they met rehabilitation goals during their latest episode of care (yes/no). Multivariable survey-weighted logistic regression, adjusting for demographics and medical complexity, was used to estimate these relationships. In our sample, 71% had normal PEF, 22% had moderate PEF impairment, and 7% had severe PEF impairment. Severe impairment had 57% lower odds (aOR=0.4, 95% CI 0.2-0.9) and moderate impairment had 35% lower odds (aOR=0.6, 95% CI 0.4-1.0) of meeting rehabilitation goals compared to normal PEF. Similar trends were observed when limiting rehab users to only musculoskeletal condition (e.g., joint replacement). This study found that nearly 4 million older adults in the U.S. use rehabilitation annually, with 29% having impaired lung function. Our data suggest impairments in PEF may limit progress with rehabilitation, even for those with musculoskeletal indications, and thus suggests care pathways to more optimally manage older adults with limited lung function in rehabilitation settings may be needed to help them achieve their goals.
ASSOCIATIONS OF MEAN COGNITIVE PERFORMANCE AND INTRAINDIVIDUAL VARIABILITY WITH WHITE MATTER LESIONS
Authors: Urias Uriel , Thomas Kelsey , Garcia Mary Ellen , Gonzalez Amanda , Luu Britney , Gutierrez Victoria , Bangen Katherine 
Published: January 2025

Abstract
White matter lesions (WMLs) are magnetic resonance imaging markers of small vessel cerebrovascular disease and have been associated with Alzheimer’s disease and related dementias. Intraindividual variability (IIV), often measured as variability in performance across neuropsychological tests at a single time point, has emerged as a sensitive marker of early cognitive difficulties that may have utility beyond measures of mean neuropsychological performance (MP). However, the associations of IIV with neuroimaging variables remains understudied. This study included 70 older adults without dementia (mean age=68.57) who completed a comprehensive neuropsychological battery and underwent MRI brain scans. WMLs were adjusted for estimated total intracranial volume and transformed to reduce skew. Linear regression models examined the associations of IIV, MP, and WMLs both across and within the cognitive domains of memory, attention/processing speed, and executive function. Covariates included age, sex, and education. IIV showed no significant association with WMLs, neither within nor across the domains examined (all p’s&gt;.05). In the domains of memory (B=-.035, p=.025), executive function (B=-.039, p=.018), and in global cognition (B=-.065, p=.003) lower MP was associated with more WMLs. In the attention/processing speed domain, MP was not significantly associated with WMLs (all p’s &gt;.05). The present study only examined cross-sectional data, so future studies should re-evaluate the associations with IIV, MP, and WMLs longitudinally. While the small sample size may limit the generalizability of this study, these findings suggest that measures of MP may better reflect WMLs relative to measures of IIV.
BEREAVED DEMENTIA CAREGIVERS MAKE MEANING THROUGH RELIGION IN A PHOTO-ELICITATION INTERVENTION
Authors: Yang Annabelle , Bogdewiecz Taryn , Benson Jacquelyn , Washington Karla , Rolbiecki Abigail 
Published: January 2025

Abstract
Many persons living with dementia (PLWD) rely on informal caregivers, who undergo extensive personal upheaval approaching and after end-of-life for their PLWD. To promote successful adaptation in bereavement, caregivers can engage in a process of meaning making as they make sense of their loss, find “silver linings” in their experiences, or undergo shifts in identity. Religious and spiritual coping can facilitate this meaning making. Prior evidence has found that successful meaning making improves bereavement outcomes, reducing risk for grief complications. Caregiver Speaks is an intervention designed to facilitate such meaning making in caregivers of PLWD through photo-elicitation, whereby hospice family caregivers share stories and images narrating their experiences within a private Facebook group during active caregiving and bereavement. The purpose of the current study was to explore how caregivers from the bereavement arm of the Caregiver Speaks project made meaning of their experiences. Participants were recruited from hospices across the Midwest and Northeast US. A deductive and inductive qualitative analysis of Facebook posts was performed by two independent coders. They engaged in consensus coding to refine and categorize codes into themes. Religious and spiritual coping was a primary theme, as caregivers expressed feelings of peace knowing their loved ones were in Heaven, hope for the future because God has a plan, and comfort in scripture. Others described inner peace found in nature or meditative practices that provided comfort. These findings hold promise for meaning making interventions designed to facilitate religious and spiritual coping to improve bereavement outcomes.
BLOOD BIOMARKERS ASSOCIATED WITH POSTOPERATIVE DELIRIUM INCIDENCE, SEVERITY, DURATION AND SUBTYPE
Authors: Lee Hyangkyu , Cho Hyeonmi , Choi Jeongeun , Park Hyunki 
Published: January 2025

Abstract
To evaluate the associations of neurological biomarkers —specifically tau, phosphorylated tau, amyloid β40, amyloid β42, amyloid β42/40 ratio, glial fibrillary acid protein (GFAP), neurofilament light (NfL), and brain-derived neurotrophic factor (BDNF) —with the incidence, severity, duration, and subtype of postoperative delirium. In a group of patients over 70 years old who had spine surgery, delirium patients (n=95) and non-delirium patients (n=95) were matched 1:1 with propensity score matching using demographic, lifestyle, and clinical characteristics. Neurological biomarkers were measured after collecting peripheral blood samples immediately after the surgical procedure in the recovery unit. Delirium was observed twice a day from the first to the third postoperative day, and once a day thereafter. Although there were no significant associations between biomarkers and the incidence of postoperative delirium, patients who developed postoperative delirium, each 1 standard deviation increase in NfL was associated with a 1.51 increase in the peak DRS-R-98 severity score (95% confidence interval: 0.07 to 2.95). Each 1 standard deviation rise in GFAP and NfL was associated with an odds ratio of 2.08 (95% confidence interval: 1.15 to 3.74) and 2.35 (95% confidence interval: 1.13 to 4.92), respectively, for delirium duration of 4 days or more. The odds ratio for the hypoactive subtype of delirium increased by 1 standard deviation in A□42 (95% CI: 1.28 to 6.66). Our study demonstrated that blood biomarkers could be useful in predicting the severity, duration, and subtype of postoperative delirium among older adults.
BRIDGING GAPS IN GERIATRIC EXPERTISE: OREGON ECHO NETWORK’S IMPACT ON INTERPROFESSIONAL EDUCATION AND CARE
Authors: Brandis Leah , Herreid-O’Neill Anders , Abbott Maryan Carbuccia , Byerly Laura , Slingerland Kerri Smith 
Published: January 2025

Abstract
The United States faces a critical shortage of healthcare professionals trained in geriatric care, exacerbated by a rapidly aging population. In response to this pressing need, the Oregon ECHO Network (OEN) has forged partnerships with local and statewide organizations to pioneer a series of ECHO programs aimed at disseminating geriatric care principles across diverse care settings. Over six years, the network’s reach has expanded from primary care to encompass post-acute and long-term care communities, culminating in a portfolio of geriatric care ECHO courses. This presentation will share results from an Older Adult ECHO Impact Report covering 28 cohorts of 11 different older adult-related ECHO programs since 2018. OEN has engaged more than 50 faculty and guest speakers and 881 registrants for older adult health care education alone. Faculty panels are interdisciplinary and have included prescribing clinicians, such as physicians and nurse practitioners, along with occupational therapists, pharmacists, registered nurses, behavioral health professionals, physical therapists, peer support specialists and others. Emergent themes, ongoing gaps, lessons learned and program impacts will be shared from participant surveys and interviews. Highlighted are new collaborations with the Oregon Center of Excellence for Behavioral Health & Aging and the Geriatric Workforce Enhancement Program, underscoring efforts to address gaps in geriatric expertise through innovative educational models.
CANDIDACY 2.0-UNRAVELING HEALTH INEQUITIES IN CHRONIC CONDITION CARE ACCESS
Authors: Koehn Sharon , Jones C Allyson , Barber Claire , Jasper Lisa , Pham Anh , Lindeman Cliff , Drummond Neil 
Published: January 2025

Abstract
The Inverse Care Law, positing that those most in need of healthcare are least likely to receive it, continues to describe persistent health inequities among older adults with chronic conditions. This study introduces Candidacy 2.0 (Chronic Condition (CC)), an innovative framework designed to unravel the complex mechanisms of these inequities in healthcare access for diverse older adult populations. Using Critical Interpretive Synthesis, we analyzed qualitative and mixed methods literature on rheumatoid arthritis experiences across various populations, including racial and ethnic minorities, LGBTQI+ individuals, and those with disabilities. Our key finding was the identification of a crucial eighth dimension: the “embodied relational self,” which transforms the framework into a powerful tool for understanding intersectional experiences of health inequity. Candidacy 2.0 (CC) offers a comprehensive understanding of how patients’ and care providers’ experiences are shaped by systemic injustices and social determinants of health. By integrating approaches like intersectionality, concordance, and recursivity, this model provides a new lens to conceptualize and address health disparities in chronic condition management for older adults. The framework’s significance lies in its potential to guide the development of culturally relevant health promotion and intervention efforts, offering concrete explanations for access challenges rooted in socially patterned influences. Our findings have substantial implications for enhancing health equity in geriatric healthcare delivery, informing policy, and driving further research. By implementing Candidacy 2.0 (CC), stakeholders can develop targeted interventions that address the unique healthcare needs of diverse older adults, working towards eliminating disparities across the life course.
CARDIOVASCULAR DISEASE RISK AND FALLS IN MEN AND WOMEN LIVING WITH AND WITHOUT HIV: MACS/WIHS COMBINED COHORT STUDY
Authors: Vasquez Elizabeth , Kuniholm Mark , Appleton Allison , Sharma Anjali , Yin Michael , Brown Todd , Tien Phyllis , Gustafson Deborah 
Published: January 2025

Abstract
Falls risk assessment tools underestimate the risk among People Living with HIV (PLWH). The aim of this cross-sectional analysis was to measure associations between American College of Cardiology/American Heart Association (ACC/AHA) 10-year cardiovascular disease (CVD) risk scores and history of falls in a multi-center United States cohort of PLWH and similar people living without HIV (PLWOH). CVD risk was categorized as low, borderline, intermediate and high (&lt; 5%, 5-7.4%, 7.5-19.9% and ≥20%, respectively) and history of falls was ascertained using a standardized protocol across study sites. Among n=2728 participants (Men, n=939, 578 MLWH/361 MLWOH; (Women, n= 1789, 1274 WLWH/515 WLWOH), median ages were 58 (IQR:51-65) and 55 (IQR:49-60) years for men and women, respectively. Median CVD risk within 10 years was 11% (IQR:6%-18%) and 5% (2%-11%) for men and women, respectively. All analyses were adjusted for age and stratified by sex and HIV status. Higher CVD risk was associated with increased history of falls (high vs low CVD risk: OR=2.31; 95%CI:1.16,4.62; intermediate vs low CVD risk OR=2.13; 95%CI:1.11,4.07) among MLWOH. Findings were similar in MLWH after adjustment for CD4+ T cell count and HIV-1 RNA detectability (&lt;=200). In WLWH, only high CVD risk was associated with falls (OR:1.76; 95%CI:1.13,2.7), while among WLWOH, no association of CVD risk with falls was observed when compared with a low-risk score (&lt; 5%). Results suggest CVD risk scores may be beneficial to guide providers’ lifestyle or clinical management recommendations to decrease risk of falls and preserve and/or improve quality of life among MLWOH, MLWH, and WLWH.
CARE TRANSITION EXPERIENCES OF HISPANIC PATIENTS WITH DEMENTIA FOLLOWING EMERGENCY DEPARTMENT DISCHARGE
Authors: Sandoval Jacqueline , Brook Juliette , Lien Zoe , Monin Joan , Gettel Cameron , Hagaman Ashley , Hwang Ula 
Published: January 2025

Abstract
Older patients report fragmented emergency department (ED) care, including insufficient communication with clinicians and inadequate referrals to outpatient care and social services. These challenges are likely even greater for those with cognitive impairment (CI) and their care partners (CPs) and especially for non-English speaking populations, where language differences bring additional challenges. This study seeks to fill a gap in the literature by exploring ED discharge care transition experiences for Hispanic patients with dementia. Ten dyads - consisting of a patient with CI or dementia diagnosis and their CP - were enrolled in the ED and completed semi-structured interviews (via video or telephone) 1 week later addressing their ED and post-discharge experiences. Interviews investigated participants’ experiences in the ED and subsequent care transitions back to the community. Interviews were recorded, transcribed and coded by three research team members for thematic content, adopting a combined deductive-inductive approach until thematic saturation was reach across all dyads. Prespecified codes were adapted using the National Quality Forum’s Quality Measurement Framework on ED Transitions of Care and included eight outcomes for ED transitions of care: accessibility of services, shared decision-making, connection and alignment, care coordination, information sharing/communication, safety, healthcare utilization/costs, and experience of care. Key study findings emphasize patient and care partner priorities of shared decision-making with the ED treating team, how patients and care partners manage language barriers and cognitive impairment challenges and identifying factors that either support or hinder the quality and safety of ED discharge care and transitions back home.