bluuebunny/crossref_metadata_2025_split huggingface dataset:
DAILY STRESSORS, POSITIVE EXPERIENCES, AND DAILY FATIGUE AMONG DEMENTIA FAMILY CAREGIVERS
Authors: Lee Eunju , Kim Kyungmin , Liu Yin , Zarit Steven 
Published: January 2025

Abstract
Family caregivers of individuals with dementia (IWD) suffer from physical and mental fatigue, but little is known about daily fluctuation of caregiver fatigue in response to daily care-related and non-care experiences. Caregivers are also likely to encounter conflict with other family members on caregiving issues—one of the secondary stressors that may amplify their fatigue. This study examined the within-person associations of daily fatigue with care-related stressors (i.e., relative’s behavioral and psychological symptoms of dementia), non-care stressors, and positive experiences, and whether family conflict on caregiving issues exacerbates the relationship between daily experiences and fatigue. We analyzed a sample of 173 family caregivers of IWD who participated in daily interviews across 8 consecutive days (N = 1,359). Participants reported daily fatigue and daily experiences each day, while family conflict was reported at baseline. Multilevel models showed that experiencing more care-related and non-care stressors than usual was associated with higher levels of daily fatigue, whereas having more positive experiences than usual was associated with lower levels of fatigue. At the between-person level, caregivers with more care-related stressors on average were more likely to show higher levels of fatigue. Further, family conflict on caregiving issues exacerbated the relationship between daily care-related stressors and fatigue. The findings suggested that not only care-related stressors, but also non-care daily experiences were related to fluctuations of daily fatigue among family caregivers. Exposure to positive experiences and resolving family disagreement concerning caregiving issues may help caregivers relieve fatigue and tiredness.
DEMENTIA RISK REDUCTION SUMMIT: ADDRESSING DEMENTIA RISK ACROSS THE PREVENTION SPECTRUM
Authors: Kline Chelsea , Baumgart Matthew , Roberts Shelby 
Published: January 2025

Abstract
As the science around dementia risk reduction has evolved in the last 20 years, public health action to address the risk factors has become an increasing imperative. In May 2023, the Alzheimer’s Association Public Health Center of Excellence on Dementia Risk Reduction, funded by the CDC, held the first Dementia Risk Reduction Summit (Summit) at the CDC in Atlanta. The event convened 230 public health professionals, academics, and researchers with 43% of attendees representing state, local, and tribal health departments. The Summit included six sessions focusing on each level of the spectrum of prevention– (1) strengthening individual knowledge and skills, (2) promoting community education, (3) educating providers, (4) fostering coalitions and networks, (5) changing organizational practices, and (6) influencing policy and legislation – and showcased how public health could address risk factors for cognitive decline and dementia at each level. An additional session focused on social determinants of health. Initial evaluations of the Summit found most attendees would recommend the event to a colleague. Additionally, nearly all had taken action to address dementia risk within two months following the Summit (46%) or said they planned to (44%). 90% of attendees reported the Summit provided helpful information that could be applied to their organization’s approach to dementia risk reduction. Recordings of the Summit have been viewed 1,725 times. Additional follow-up surveys were sent to key health department officials in March 2024 to understand the long-term impact of the Summit. This structured national convening increased knowledge and confidence around dementia risk reduction.
DYADIC AMBIVALENCE IN ALZHEIMER’S DISEASE: LINKING BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS TO LIFE SATISFACTION
Authors: Huo Meng , Gilligan Megan , Kim Kyungmin , Richards Nicole , Fingerman Karen , Zarit Steven 
Published: January 2025

Abstract
Caring for a spouse with Alzheimer’s disease (AD) can elicit considerable distress but there are also positive moments. A growing body of work has examined caregivers’ ambivalence in the care relationship and linked it to negative caregiver outcomes such as depression, but dyadic assessments of both parties’ perspectives are missing. We examined ambivalence in both people with AD and their spousal caregivers, seeking to identify the predictors and well-being outcomes of such ambivalence in this unique context. Participants included 73 couples managing early-stage AD. People with AD and spousal caregivers independently self-reported positive and negative relationship qualities (used to indirectly calculate their ambivalence) and life satisfaction. Caregivers reported both partners’ demographic characteristics and their spouses’ behavioral and psychological symptoms of dementia (BPSD), focusing on memory-related behaviors and psychological symptoms. Path analyses revealed that the number and frequency of psychological symptoms in people with AD were positively associated with their own and caregivers’ ambivalence. Caregivers’ distress ratings of memory-related behaviors and psychological symptoms were positively associated with their ambivalence. Greater ambivalence was associated with lower life satisfaction in both spouses. BPSD directly affected both spouses’ life satisfaction but there was also a marginally significant indirect effect via ambivalence. This study utilizes a dyadic approach to assess ambivalence in dementia care. Findings reveal the conflicting emotions that couples experience as they cope with early-stage AD, identify sources of such ambivalence, and shed light on the development of dyadic interventions that can promote positive outcomes in both partners.
MEALTIME BEHAVIORS IN NURSING HOME RESIDENTS WITH DEMENTIA ARE ASSOCIATED WITH RESIDENT-INITIATED FOOD INTAKE
Authors: Suh Heather , Lee Kyuri , Liu Wen 
Published: January 2025

Abstract
Nursing home (NH) residents with dementia experience challenging behaviors that interfere with their engagement, eating performance, and food intake during mealtime. Supporting resident-initiated food intake, defined as how well resident initiate and complete attempts of food intake with or without staff assistance, is a critical indicator of resident engagement and independence. Understanding the association between resident mealtime behaviors and resident-initiated food intake attempts informs future mealtime interventions. In a pilot trial for the OPTIMAL (Optimizing Mealtime) study, NH resident mealtime behaviors and interactions with direct care staff were observed and characterized. A total of 197 videotaped observations of full-meal resident-staff interactions were coded from 12 residents (age 71.9±7.5 years; 91.7% male; 91.7% white; 41.7% married). The average mealtime durations at breakfast, lunch, and dinner were 36.4 ± 20.6, 39.4 ± 16.7, and 39.7 ± 17.0 minutes, respectively. Out of 10,092 behaviors coded using the refined Cue Utilization and Engagement in Dementia (CUED) coding scheme, resident behaviors were categorized as positive/neutral behaviors (18.2%), chewing/swallowing difficulties (47.5%), functional impairment (13.3%), and resistive behaviors (21.0%). The majority of resident behaviors occurred at lunch (36.9%) and dinner (36.3%), with slightly fewer behaviors at breakfast (26.8%). Proportion of resident-initiated food intake attempts (0.51 ± 1.4, number of resident-initiated food intake attempts divided by total number of food intake attempts) was significantly associated with chewing/swallowing difficulties (b= -1.91, p=0.014), controlling for resident age and cognitive score. Addressing resident chewing/swallowing difficulties has the potential to improve resident-initiated food intake attempts to enhance resident mealtime engagement and independence.
MENTAL ILLNESS AND EMERGENCY DEPARTMENT USE IN VETERANS WITH DEMENTIA: DOES RESIDENCE MATTER?
Authors: Miller Katherine , Shepherd-Banigan Megan 
Published: January 2025

Abstract
Likelihood of dementia increases among individuals with mental illness. For patients with Alzheimer’s-related and related dementia (ADRD), mental illness can complicate clinical care and may reduce care quality, leading to more intensive health service use and higher costs. For individuals living in nursing homes, this may be exacerbated as nursing home staff may not be trained to provide care appropriately to people with mental illness. We describe presence of mental illness (MI), defined as major depressive disorder, post-traumatic stress disorder, generalized anxiety disorder, bipolar disorder, or schizophrenia, in a cohort of Veterans with a new ADRD diagnosis stratified by nursing home residence versus community-dwelling. Of Veterans with new ADRD diagnoses, 96% are community-dwelling and 4% reside in nursing homes. Yet 19% of nursing home residents have pre-existing MI while 12% of community-dwellers have pre-existing MI. Among both community-dwellers and residents, those with pre-existing MI are younger at the time of ADRD diagnosis. In the year post-ADRD diagnosis, 17.5% and 9.5% of community-dwelling Veterans with and without pre-existing MI, respectively, had any emergency department (ED) visits. In contrast, 7.2% and 3.2% of nursing home residents with and without pre-existing MI, respectively, had any ED visits. Notably, a greater share of nursing home residents with pre-existing MI had any ED visits in the 2 years pre-ADRD diagnosis relative to community-dwellers with pre-existing MI (74% versus 43%, respectively). Our findings suggest that community-dwelling Veterans with pre-existing MI and newly diagnosed ADRD may benefit from targeted interventions to reduce ED use.
THE FAITH CARE FAMILY PROJECT: A QUALITATIVE ANALYSIS OF AN INTERVENTION FOR AFRICAN AMERICAN AD/ADRD CAREGIVERS
Authors: Fields Noelle , Xu Ling , Williams Ishan , Epps Fayron , Handique Swasati 
Published: January 2025

Abstract
Alzheimer’s disease and related dementias (AD/ADRD) disproportionately impact older African American populations. Although there are interventions for AD/ADRD caregiving, there remain research gaps related to culturally congruent psychoeducational interventions for African American AD/ADRD family caregivers. The Faith Care Family (FCF) Project was developed to train volunteers from a predominantly African American church to work with African American AD/ADRD family caregivers through a 6-week, telephone-based intervention. Qualitative interviews were conducted with the family caregivers (N = 9) following the intervention. Using a semi-structured interview guide, questions focused on knowledge of AD/ADRD, caregiver stress and coping, feelings about the behavioral symptoms of AD/ADRD, differences in caregiving before and after the FCF Project, and recommendations for future program iterations. Braun and Clarke’s six-step thematic analysis was followed to examine the interview data. The majority of caregivers identified as women, and the median age was 62. Over half had some college or below, and most reported little to no financial strain. The median length of caregiving was 5 years, and caregivers typically spent 10 hours per day providing care. Slightly over half of caregivers lived with the care recipient. Thematic analysis revealed four themes: establishing a connection, normalizing the caregiving experience, reinforcing knowledge, and resource sharing. Recommendations included adding additional AD/ADRD content to the manual. Overall findings suggest that the FCF Project is a promising intervention for African American AD/ADRD family caregivers. Lessons learned and recommendations for future research on ‘faith-placed’ ADRD interventions are offered.
WHAT DO DIRECT CARE WORKERS NEED TRAINING IN TO HELP OLDER ADULTS WITH DEMENTIA DURING MEALTIMES?
Authors: Jung Dukyoo , Park Jisung , Choi Eunju , Yoo Leeho , Kim Kahyun , Cho Seyoung , Shin Soogyung 
Published: January 2025

Abstract
Older adults with dementia in long-term care facilities often encounter challenges in self-feeding owing to cognitive and physical impairments. Although direct care workers play a crucial role in facilitating meal-time activities, they lack adequate training and specific educational programs. To develop an effective program, it is essential to understand the educational needs of direct care workers providing meal assistance. This study aimed to identify the educational needs of direct care workers in long-term care facilities regarding providing meal assistance for older adults with dementia. Adopting a mixed-methods approach, this study combined quantitative analysis, using Borich’s needs assessment, and the locus for focus models, with qualitative insights from focus group interviews. Participants comprised 175 direct care workers and 5 nursing managers from various long-term care facilities in South Korea. This study identified four main educational priorities: enhancing knowledge of swallowing functions, understanding institutional support mechanisms, applying multisensory stimulation techniques, and addressing food forgetfulness in older adults with dementia. These findings were supported by qualitative data that emphasized the necessity of training to improve the quality of meal assistance provided to this vulnerable population. The findings underscore the critical need for focused educational programs that equip direct care workers with the skills and knowledge necessary to effectively assist older adults with dementia during mealtime. This study advocates the implementation of continuous education and training initiatives led by nursing management to foster an environment conducive to autonomous and independent eating among patients with dementia, thereby enhancing their overall care and quality of life.
A NEW ROLE FOR KYNURENINE METABOLISM IN THE AGE-ASSOCIATED DECLINE OF THE BACTERIAL IMMUNE RESPONSE
Authors: Sutphin George , Espejo Luis , Haskins Anne , Chang Leah , Balsa Jonah , Antenor Angelo , Dang Hope , Freitas Samuel 
Published: January 2025

Abstract
Tryptophan metabolism through the kynurenine pathway becomes dysregulated during normal aging and is implicated in age-associated disease, including chronic inflammation, atherosclerosis, neurodegeneration, and cancer. Kynurenine pathway enzymes and metabolites influence a range of molecular processes critical to healthy aging, including regulation of inflammatory and immune responses. Kynurenine metabolism is active in immune cells and activated in response to proinflammatory cytokine signaling. We previously determined that elevating physiological levels of the kynurenine pathway metabolite 3-hydroxyanthranilic acid (3HAA) via either direct supplementation or inhibition of the enzyme that degrades 3HAA, 3HAA dioxygenase (HAAO), extends lifespan and delays age-associated health decline in both Caenorhabditis elegans and mice. Published work suggests that 3HAA is anti-inflammatory in mammals, for example by reducing the ratio of activated to regulatory T cells and inhibiting pathological activation of macrophages. In recent work, we find that elevating physiological 3HAA can beneficially enhance the immune response of C. elegans to bacterial pathogens during aging. 3HAA is sufficient to kill bacterial and inhibit bacterial growth in culture. When HAAO is inhibited in C. elegans, 3HAA accumulates in lysosome related organelles (LROs) in the intestinal cells, the same subcellular compartment that contains engulfed bacteria. LROs are a cellular repository for both iron and zinc, and we further find that iron chelation or zinc supplementation dramatically enhances the bactericidal properties of 3HAA. Here we present a mechanistic model in which age-dependent accumulation of 3HAA in intestinal LROs combines with zinc to enhance bacterial resistance with age in C. elegans.
BLOOD BIOMARKERS OF ALZHEIMER’S DISEASE AND MUSCLE STRENGTH TRAJECTORIES IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Ornago Alice , Pinardi Elena , Grande Giulia , Valletta Martina , Calderón-Larrañaga Amaia , Fredolini Claudia , Bellelli Giuseppe , Vetrano Davide Liborio 
Published: January 2025

Abstract
The age-related muscle strength decline is a major impediment to the achievement of healthy aging. This study aimed to investigate the association between a panel of Alzheimer’s disease (AD) blood biomarkers and longitudinal trajectories of muscle strength. This 12-year population-based cohort study included 2011 dementia-free participants from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). Muscle strength was measured through the grip strength and chair stand tests, while baseline levels of AD biomarkers (total tau [t-tau], phosphorylated tau181 [p-tau181], neurofilament light chain [NfL], glial fibrillary acid protein [GFAP], and amyloid-β [Aβ] 42/40 ratio) were assessed by Quanterix Single Molecule Arrays. Linear mixed models, adjusted for socio-demographics and clinical factors, were used to estimate the association between AD biomarkers and muscle strength decline. Higher baseline levels of p-Tau181 (β 0.94, 95%CI 0.72;1.16), NfL (β 0.79, 95%CI 0.59;0.99), and GFAP (β 0.38, 95% CI 0.22;0.54) were associated with an accelerated worsening of the chair stand test over the follow-up. The adjustment for Mini-Mental State Examination (MMSE) led to an attenuation of these associations. Higher baseline levels of p-Tau181 (β -0.11, 95%CI -0.16;-0.06), and NfL (β -0.05, 95%CI -0.09;-0.003) were associated with a faster decline in the grip strength test over the follow-up; no attenuation was observed after adjusting for MMSE. Several blood biomarkers implicated in AD pathophysiology are associated with distinct trajectories of muscle strength. Cognitive function appears to influence this association, mostly concerning muscle strength as measured by the chair stand test.
CAUSALITY-INFORMED REPRODUCTIVE CLOCKS REFLECT IMPACT OF CHILDHOOD MALTREATMENT ON EPIGENETIC AGING
Authors: Ye Qiaofeng , Shalev Idan 
Published: January 2025

Abstract
Machine-learning-based epigenetic clocks have been widely used to predict an organism’s age, pace of aging, and mortality. Here, we report the development of two novel reproductive clocks to reflect biological aging relative to menarche (MenarcheClock) or menopause (MenopauseClock) in females. First, Mendelian randomization was employed to identify CpG sites with significant causal effects on age at menarche or menopause. Next, models of MenarcheClock and MenopauseClock were trained using elastic net regression with array-measured DNA methylation of buccal cells from 540 females aged 0.2-18.94 years. In total, 186 and 141 CpG sites were selected into the MenarcheClock and the MenopauseClock, respectively, which had little overlap with published epigenetic clocks. Based on the Developmental Origin of Health and Disease model and evolutionary theories of aging, we further examined the impact of childhood maltreatment, race, ethnicity, and family income on deviations of the two clocks in 187 girls aged 8-14 years. Clock deviations were calculated by residualizing the clock estimates from chronological age, with positively greater deviations indicating expedited menarche or menopause. Preliminary analyses indicated that exposure to childhood maltreatment, including physical and sexual abuse and neglect, was associated with greater MenarcheClock deviation, controlling for BMI, race/ethnicity, income, and immune cell proportion. African American girls had greater MenopauseClock deviation than White peers. Our study demonstrated the feasibility of utilizing causality information based on Mendelian randomization to develop epigenetic clocks indicating reproductive aging. Findings also support the theory that adverse exposure during early development leads to earlier sexual maturation to increase reproductive success.
CROSS-TISSUE EPIGENETIC AGE COMPARISONS
Authors: Apsley Abner , Shalev Idan 
Published: January 2025

Abstract
Accurately measuring the process of biological aging – the progressive deterioration of cells, tissues and organs – is crucial in studying the effects of aging interventions. A common group of tools used to measure the process of biological aging are epigenetic clocks (i.e., algorithms that take advantage of the age-related changes observed in the DNA methylome to estimate an individual’s biological age). Although epigenetic clocks have been trained almost exclusively using blood-based tissues, there is a growing desire to estimate epigenetic age using less-invasive mouth-based tissues (i.e., buccal or saliva). However, by definition, differentiated cell types exhibit unique DNA methylation landscapes and age-related alterations to the DNA methylome. Therefore, using epigenetic age estimates via mouth-based tissues that rely on blood-based tissues can introduce errors when estimating biological age. We tested the within-person comparability of common epigenetic clocks across five tissue types: buccal epithelial, saliva, dry blood spots, buffy coat (i.e., leukocytes), and peripheral blood mononuclear cells. Our sample included individuals from 9-70 years old (N=83) across 284 distinct tissue samples. Overall, significant differences in mouth-based versus blood-based tissue estimates were observed, with differences of more than 30 years being observed in some clocks. In addition, most blood-based clocks exhibited a low correlation with buccal and saliva tissues, even after controlling for cellular proportions, indicating that buccal and saliva are both uniquely different from blood-based estimates. Our findings indicate the deviance of mouth-based versus blood-based epigenetic clock estimates, and highlight important differences of using diverse tissue types to estimate biological age.
EXAMINING THE RELATIONSHIP BETWEEN ALPHA-KLOTHO, INSULIN RESISTANCE, AND DIABETES IN OLDER ADULTS
Authors: Ahmad Anam , Shardell Michelle , Kalyani Rita , Semba Richard , Ferrucci Luigi 
Published: January 2025

Abstract
Higher circulating concentrations of alpha-klotho protein have been associated with greater longevity and inversely linked with aging-related phenotypes in human and animal studies. Impaired insulin signaling contributes to deregulated nutrient sensing, a hallmark of aging that plays a role in age-related adiposity, diabetes risk, and reduced lifespan. Whether alpha-klotho is part of this longevity pathway is unknown. We aimed to assess the relationships of alpha-klotho with insulin resistance and diabetes, and whether these relationships depended on adiposity in 860 adults aged ≥55 years from the Invecchiare in Chianti Study. Insulin resistance was operationalized using the homeostasis model for insulin resistance (HOMA-IR); diabetes was defined as having fasting blood glucose ≥126 mg/dL, glycosuria, taking diabetic medications, or a combination of patient self-report and diet assessment, and adiposity was defined using body mass index (BMI). Stratified linear and logistic regression were used to quantify associations of alpha-klotho with HOMA-IR and diabetes, respectively. Inverse probability weighting was used to address missing data. Among 394 overweight participants (BMI 25.0-29.9 kg/m2), each logarithm higher alpha-klotho (pg/mL) was associated with 0.42 units higher HOMA-IR (95% confidence interval [CI] 0.09-0.75) and 1.34 times higher, though not statistically significant, odds of diabetes (95% CI 0.35-5.10), after adjustment for covariates. There was little evidence of association among those with BMI&lt; 25.0kg/m2 or BMI≥30 kg/m2. The positive association with HOMA-IR in overweight only and no significant association with diabetes may reflect an alternative hypothesis of alpha-klotho overexpression promoting insulin resistance. Further studies are needed to understand the mechanism of these findings.