bluuebunny/crossref_metadata_2025_split huggingface dataset:
INDOOR TEMPERATURES AND MENTAL HEALTH IN COMMUNITY-DWELLING OLDER ADULTS: A SYSTEMATIC REVIEW
Authors: Park Min Kyung , Hong Dahye , Yoon Seolah , Kim Yubeen , Kim Minsub , Kang Bada 
Published: January 2025

Abstract
The relationship between indoor temperature and mental health is becoming increasingly important as climate change leads to extreme temperature fluctuations. Older adults are particularly vulnerable to indoor temperature changes because of their diminished ability to regulate body temperature and because they spend a significant amount of time indoors. This systematic review examined the relationship between indoor temperature and mental health outcomes among community-dwelling older adults. A comprehensive search of seven electronic databases (MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, Google Scholar, and PROQUEST) was conducted on April 4, 2024. Of the 2,328 identified studies, 15 met the inclusion criteria. Mental health outcomes associated with indoor temperature were categorized into four groups: sleep problems such as insomnia and sleep disturbance; emotional problems such as emotional distress and negative mood; social interaction problems such as social exclusion and low social participation; and other mental health issues such as anxiety, agitation, and annoyance. Sleep problems were the most frequently reported mental health outcome related to indoor temperature (n=9). Older adults living in substandard housing conditions, those with economic difficulties, and those residing in urban areas were vulnerable to exposure to hot or cold indoor temperatures because of housing-related risks such as low energy efficiency, inadequate heating or cooling, and limited access to green spaces. These findings highlight the need for evidence-based guidelines to improve mental health by ensuring appropriate indoor temperatures in the community. Improving housing conditions through policy support could be an effective strategy for enhancing the mental health of community-dwelling older adults.
INSIGHTS FOR IMPROVING OLDER ADULT NUTRITION WITH MULTIVITAMIN/MINERAL SUPPLEMENTS
Authors: Fielding Roger , Blancato Robert , Starr Kathryn Porter , McDonald Shelley , Zimmer Rachel , Pettis Jennifer , Tracy Karen 
Published: January 2025

Abstract
In June 2024, GSA convened an expert roundtable to address the role of multivitamin/mineral supplements (MVMs) as part of complete nutrition for older adults. Older adults often do not obtain adequate amounts of micronutrients from their regular dietary patterns and are at risk for nutritional deficiencies. Reasons cited by experts included physiologic changes; comorbid conditions; conditions associated with aging (e.g., sarcopenia, frailty); socioeconomic factors; declines in physical function; and interrelated changes in cognition, functional capacity, mental health, and mobility. Nutrition has wide-ranging effects on health and well-being, and nutrition screening would aid in identifying deficiencies. However, nutritional status is not consistently assessed and documented in clinical practice. Experts proposed expanding interdisciplinary care and expanded payment opportunities as strategies to improve nutritional assessments and identified emerging care models that successfully address the nutritional needs of older adults. Expanded education and training opportunities related to nutrition for clinicians and implementing strategies for effectively educating older adults about nutrition were also cited as important needs. Experts noted that MVMs may be recommended to help meet nutritional needs in older adults. Providers should consider polypharmacy, potential medication/MVM interactions, and chronic conditions when making recommendations, and educational supports are needed to enhance acceptance of and adherence to recommendations. Experts also identified strategies for enhancing nutritional research and incorporating nutritional information into clinical practice guidelines to increase the clinician confidence around MVM recommendations.
INTRINSIC CAPACITY TRANSITION AND ITS ASSOCIATION WITH INCIDENT DISABILITY: FINDINGS FROM THE KFACS
Authors: Cho Hyunjin , Shin Hyung Eun , Jung Heeeun , Lee Daehyun , Jang Jae Young , Lim Nahyun , Won Chang Won , Kim Miji 
Published: January 2025

Abstract
Intrinsic capacity (IC) progressively decreases with age, accelerating the risk of disability. However, it is less known whether IC transition is associated with disability. We aimed to investigate the association between IC transition and incident disability among community-dwelling older adults. A retrospective analysis was conducted over a 6-year follow-up with biennial measurements, including 2,104 participants (52.7% women; mean age 76.1 ± 3.7 years) from the Korean Frailty and Aging Cohort Study. Participants were categorized based on the IC transition from the baseline to Wave 2: “Remained well and improved”, “Worsened”, and “Remained poor”. Disability was defined as a need for assistance in any items in activity of daily living. Incident disability was measured at Wave 3 and 4. Multivariate logistic regression was used to assess the relationship between IC transition and incident disability. The IC transition probability for “Remained well and improved” was the highest at 72.0%, followed by 15.8% for “Remained poor” and 12.2% for “Worsened”. Furthermore, over a 4-year follow-up, the incidence of disability among participants was 6.2% (n = 131). Compared with the “Remained well and improved”, the “Worsened” (odds ratio [OR]: 1.73, 95% confidence interval [CI]:1.01–2.98) and the “Remained poor” (OR: 2.34, 95% CI:1.45–3.79) had an increased risk of incident disability after adjusting covariates. Worsened IC and Remained poor groups were significantly associated with an increased risk of incident disability, compared to Remained well and improved group. Our findings suggest that early monitoring of IC is meaningful to prevent disability.
LONGITUDINAL ASSOCIATIONS OF HEARING IMPAIRMENT WITH SOCIAL ISOLATION AMONG BLACK AND WHITE OLDER ADULTS
Authors: Thoma Mary , Ferguson Erin , Torres Jacqueline , Armstrong Nicole , Yaffe Kristine , Brenowitz Willa 
Published: January 2025

Abstract
Social isolation has been declared an epidemic by the U.S. Surgeon General. Hearing impairment (HI) may be an important risk factor for isolation among older adults. Studies of HI and isolation have been inconclusive and use primarily cross-sectional and self-reported data. We used data from the HealthABC study (N=2227 Black and White adults aged 70-79 at recruitment) to examine associations of baseline objective HI (average pure-tone audiometry &gt;40 dB, with and without use of hearing aids) with frequency of contact with family and friends (&lt; weekly vs. at least weekly), depressive symptoms (CESD-10), and loneliness (frequency in past week; 1-4) across 6 visits (6-7 years). We used mixed effects models adjusted for demographic and clinical variables. Untreated objective HI was associated with increased odds of &lt; weekly contact with friends (OR=1.47; 95% CI: 1.08,2.00) and more depressive symptoms (B=0.64; 95% CI: 0.26,1.01) across follow-up, but was not with frequency of family contact or loneliness. Objective HI treated with hearing aids was not associated with any outcome. We additionally found that self-reported HI (“hearing limits personal/social life”) was associated with more depressive symptoms (B=1.49; 95% CI: 1.03,1.95) and loneliness (B=0.09; 95% CI: 0.01,0.16) across follow-up. Our results provide novel evidence that untreated objective hearing loss is associated with social isolation and subjective HI is associated with psychosocial wellbeing. Treatment for HI may reduce the likelihood of social isolation.
LONGITUDINAL TRANSITIONS IN FRAILTY STATES OVER SIX-YEAR FOLLOW-UP: RESULTS FROM THE KFACS
Authors: Jung Heeeun , Shin Hyung Eun , Lee Daehyun , Jang Jae Young , Cho Hyunjin , Lim Nahyun , Won Chang Won , Kim Miji 
Published: January 2025

Abstract
The longitudinal nature of frailty reveals its dynamic process through transitions of frailty states over time. However, the transitions between frailty states, including their progression and reversibility, remain unclear in Korea. We investigated these longitudinal transitions in frailty states among Korean community-dwelling older adults. We conducted a 6-year follow-up analysis of 2,633 older adults (52.0% women; mean age 76.5 ± 3.9 years) from the Korean Frailty and Aging Cohort Study (KFACS). Participants who had frailty status measured at baseline and experienced at least one frailty state transition during follow-up were included. Frailty states are categorized as follows: robust, pre-frail, and frail according to the Fried frailty phenotype and death. Multi-state Markov models estimated 1-year transition probabilities and explored associations between sociodemographic factors (age, sex, education level) and frailty transitions. Over a mean follow-up period of 4.6 years, a total of 5,942 frailty state transitions were observed. Of these, 3,568 (61.5%) were maintained, 1,358 (22.9%) worsened, and 926 (15.6%) improved. The 1-year progression probability to pre-frail was higher than the probability of moving to frail (20.2% vs. 0.9%) in the robust state. Pre-frail individuals were more likely to revert to robust than frail individuals (17.7% vs. 2.6%). Furthermore, the 1-year transition to death was highest for those in the frail state compared to other states. Frailty progression was associated with older age, being female, and lower education level. In conclusion, understanding the dynamic changes between frailty states and the sociodemographic factors influencing these changes may offer opportunities to reverse frailty progression.
MACHINE LEARNING-BASED PREDICTION MODEL FOR IN-HOSPITAL MACCE IN OLDER PATIENTS WITH CHD
Authors: Tang Wen , Wang Xuedong , Yang Xuebing , Sun Ying 
Published: January 2025

Abstract

Objectives
Older patients with coronary heart disease (CHD) are at a higher risk of major adverse cardiac and cerebrovascular events (MACCE) during hospitalization. This study aims to develop a risk prediction model for in-hospital MACCE events in older patients with CHD using emerging machine learning methods.

Methods
The study included 885 older inpatients with CHD (74.68±6.89 years, 58.3% male). We created prediction models via XGBoost, Support Vector Machine(SVM), random forests, Histogram-Based Gradient Boosting Classifier(HGBC) and Gradient Boosting Decision Trees(GBDT) using 38 features, and evaluated its performance using five-fold cross-validation..

Results
MACCE was identified in 106 patients. The XGBoost model demonstrated the best performance, achieving an accuracy (ACC) of 93.56% and an area under the curve (AUC) of 0.8736 (95% confidence interval: 0.756–0.967). The SVM model achieved an ACC of 90.17% and an AUC of 0.8028 (95% CI: 0.684–0.906); the Random Forest model achieved an ACC of 91.53% and an AUC of 0.8675 (95% CI: 0.764–0.953); the HGBC model achieved an ACC of 93.45% and an AUC of 0.8550 (95% CI: 0.741–0.953); and the GBDT model achieved an ACC of 93.11% and an AUC of 0.8674 (95% CI: 0.756–0.957). Finally, SHAP analysis revealed that the top three most important features were troponin T, the FRAIL score, and the NYHA functional classification.

Conclusion
Machine learning models can effectively predict in-hospital MACCE events in older patients with CHD. Troponin levels, frailty status, and cardiac function are strong predictive indicators.
MALNUTRITION RISK AMONG OLDER AMERICANS ACT (OAA) NUTRITION PROGRAM PARTICIPANTS IN 2022 AND 2023
Authors: Gahche Jaime , McGrath Lydia , Borth Laura , Chao Shirley , Simon Judy , Arensberg MaryBeth , Dwyer Johanna 
Published: January 2025

Abstract
Identifying older adults at risk for malnutrition is essential to combat poor outcomes associated with malnutrition. In 2022, the National Survey of Older Americans Act Participants (NSOAAP) included the Malnutrition Screening Tool (MST), a validated, self-report of unintentional weight loss and poor appetite. This provided the first opportunity to evaluate malnutrition risk (MR, defined as a score ≥2) consistently in a representative sample of Older Americans Act (OAA) program participants. In this cross-sectional analysis of 2022 (n=3531) and 2023 (n=4159) NSOAAP data, MR prevalence was estimated for total sample and within OAA programs included in NSOAAP (home-delivered meals (HDM), congregate meals (CM), homemaker (HM), case management (CS), transportation services (TR)). 2022 overall MR prevalence was 19.4%, with no significant differences between programs. 2023 overall MR prevalence remained fairly stable (17.2%) with no significant difference vs. 2022 (p&lt; 0.0984). 2023 MR prevalence was 20.8% (HDM), 9.9% (CM), 26.6% (HM), 21.1% (CS), 17.7% (TR). 2023 MR prevalence among CM participants was significantly lower compared to MR risk in other OAA programs and also significantly lower compared to 2022 (9.9% vs. 16.7% p&lt; 0.0195). Further research is needed to understand these trends, which may be partially affected by pandemic-related program changes. These data indicate a substantial proportion of OAA program participants were at MR in 2022—with very little change in 2023, except decreased prevalence in CM program participants. The findings highlight the continued need for including MR measures in the NSOAPP to evaluate program effectiveness and help reduce malnutrition in older adults.
MONITORING CHRONIC PAIN AND QUALITY OF LIFE USING TABLET SURVEYS IN OLDER ADULTS LIVING IN RURAL ARKANSAS
Authors: Gibson Regina , Azhar Gohar , Sharma Shakshi , Swafford Riley , Coker Karen , Wei Jeanne Y 
Published: January 2025

Abstract
Arkansas has the second highest legal opioid prescribing rate in the U.S. We did a pilot study to assess the feasibility of using tablets to measure chronic pain and its impact of cognition, sleep, depression, and quality of life in older adults. Seventy-one older adults were trained in the use of tablets to use at home for 90 days that were pre-loaded with surveys on opioids, daily pain diary, sleep Pittsburgh Sleep Quality Index (PSQI), and Geriatric Depression scale (GDS-15). 1,944 responses were recorded over three months by 71 participants with mean age ± SD 70 ± 8 years (range 55-91). Males 23%, females 50%. Of females, 51% were African American and 49% white. All but one male was white. 80% of participants reported some pain with most ratings between 5 or 6 out of 10 (10 being worst). None of the participants were on opioids during the period of the study. Memory symptoms were reported most frequently in 28% of respondents, followed by daytime sleepiness in 33%. PSQI scores indicated poor sleep quality in 28%. Only one participant’s GDS score suggested depression. The feasibility of using tablet-based assays in older adults living in rural regions was successfully demonstrated, showing that older adults are receptive to learning new information and recording their health parameters on a tablet. The data obtained can provide clinicians a broader picture of the older adults pain-associated symptomatology and thereby assist them in designing better personalized pain management programs.
NURSING HOME CONTEXTUAL FACTORS IMPACTING PALLIATIVE CARE CONSULTATION IMPLEMENTATION
Authors: Carpenter Joan , Oduro Elisha , Lopez Ruth , Unroe Kathleen 
Published: January 2025

Abstract
Palliative care (PC) consultation has been shown to improve the quality of life of nursing home (NH) residents. However, its implementation in NHs is uneven and poorly characterized. Grounded in the Integrated Promoting Action on Research Implementation in Health Services framework, we used a qualitative descriptive approach to explore how the inner context (organization leadership, staff, culture) and the outer context (policy, finances) impact the implementation of PC consultation in NHs. We conducted semi-structured interviews with key partners in fourteen NHs in the Eastern US. We used directed content analysis to analyze transcripts and identify key themes. Participants (N=33) were NH leaders, nurses, social workers, and palliative care agency leaders and nurse practitioners, predominantly female (93.9%), White (93.9%), and one-third had at least 20 years of experience working in NHs. Our findings reveal factors within the inner and outer contexts that either pull consultations toward or push consultations away from residents. In the inner context, factors that pull consultations toward residents were supportive organizational leadership, staff referrals with detailed residents’ information and assistance during consultations, and a welcoming NH environment. However, the absence of a reliable screening tool for staff to identify residents for consultation was seen as pushing away from residents. In the outer context, policies that levy monetary penalties for hospital readmission were seen to pull consultations toward residents while financial “burdens” and “drains” were seen as pushing consultations away from residents. These fndings will be used to develop a sustainable and scalable PC consultation model in NHs.
OUTCOMES OF A PALLIATIVE CARE INTERVENTION FOR ADULTS WITH DEMENTIA IN SKILLED NURSING FACILITIES
Authors: Oduro Elisha , Carpenter Joan , Hodgson Nancy , Hanson Laura , Zhu Shijun , Gurlu Merve , Ersek Mary 
Published: January 2025

Abstract
Older adults living with Alzheimer’s disease and related dementias (ADRD) often receive disease-focused rehabilitative care in post-acute skilled nursing facilities (SNF) without access to palliative care (PC). To address this gap, our team developed a primary PC intervention and tested it among SNF patients with ADRD. We conducted a pilot pragmatic clinical trial comparing the primary PC intervention to usual care in 9 SNFs in the MidAtlantic US. Using a nonequivalent group design, SNF resident participants (n=18) were clustered by site and assigned to intervention or control group in a 2:1 (respectively) ratio. We measured patient quality of life with the Palliative Outcome Scale Version 2 (POSv2, range 0-40; higher scores reflect poorer quality of life) and analyzed data using linear mixed effects model. Patients (n=13 intervention, n=5 control) had a mean age 84 years, were mostly White (94%) and female (72%). Our results showed that quality of life had a trend of improvement for the intervention group (POSv2 baseline=12, follow up=10.5) but not for the control group (POSv2 baseline=6.6, follow up=9.3); the intervention demonstrated a clinically meaningful effect yet was not statistically significant (effect size=-.51, p=.20). Our findings suggest that a primary PC intervention is promising in its effect to improve quality of life among patients with ADRD during SNF care. Future work will focus on testing the intervention in a larger more diverse sample and exploring the most valuable intervention components as assessed by patients with ADRD and their care partners.
PAIN AND MOBILITY OF OLDER ADULTS IN MEDICAL AND SURGICAL UNITS: AN EHR-BASED DATA ANALYSIS
Authors: Snigurska Urszula , Ser Sarah , Prosperi Mattia , Bjarnadottir Ragnhildur , Lucero Robert , Manini Todd 
Published: January 2025

Abstract
Pain accelerates age-related decline in mobility. One in five hospitalized older adults have pain. Pain experience varies by the type of hospitalization. The purpose of this study was to describe pain and mobility in hospitalized older adults. We hypothesized that pain would be higher in patients with lower mobility. We analyzed electronic health record data from an academic health center in Florida between 2012 and 2021. We used the mean pain score and mean score on the mobility subscale of the Braden Scale for each encounter. We used the Wilcoxon Rank-Sum Test and Pearson’s correlation coefficient to measure the differences and relationship between pain and mobility. The cohort included 19,854 older adults (13,878 medical and 5,976 surgical patients). The mean mobility score was 3.05 ± 0.57 in medical and 2.88 ± 0.51 in surgical patients (W = 48697407, p &lt; 0.001). The mean pain score was 1.93 ± 2.72 in medical and 2.25 ± 2.61 in surgical patients (W = 36893487, p &lt; 0.001). There was no correlation between pain and mobility in either medical (r = 0.01, p = 0.427) or surgical patients (r = 0.02, p = 0.085). Mean pain intensity may not be associated with mobility in hospitalized older adults. Instead, the highest level of pain or uncontrolled pain may be associated with mobility decline. Our findings provide motivation for a future study to account for confounders of the relationship between pain and mobility, such as analgesics, and temporality of pain and mobility assessments in the hospital.
PAIN ASSESSMENT AND MANAGEMENT IN NURSING HOME RESIDENTS WITH ADRD: INSIGHTS FROM INTERDISCIPLINARY TEXT MESSAGES
Authors: Woods Ashley , Farmer Matthew , Popescu Mihail , Powell Kimberly 
Published: January 2025

Abstract
The study aims to evaluate the relationship between the representation of pain assessment and management in interdisciplinary text messages about older adults residing in Nursing Homes (NH) with and without Alzheimer’s Disease and Related Dementias (ADRD) before NH to hospital transfer. A retrospective cohort study and secondary data analysis of (n=21,000) text messages exchanged among healthcare team members caring for NH residents who transferred to the hospital from 2016 to 2020 was performed. Natural language processing was used to identify mentions of pain assessment, management, and pain medications in text messages. A two-sample independent T-test was used to test our hypothesis. A negative binomial generalized linear model was used to assess the association between pain mentions and various resident characteristics, including ADRD status. The analysis included 694 transfer events involving 414 residents, 39% of whom had ADRD. Significant differences were found in the t-test with pain assessment and management mentions, with ADRD residents having fewer mentions (t= 2.38, p=0.02) of pain assessment and management than those without ADRD. The generalized linear model identified statistically significant predictors (age, race, and specific comorbidities) of the number of text messages exchanged among NH residents, but interestingly, dementia stage and avoidable transfers were not significant. Our findings indicate that pain is underrepresented in communications regarding ADRD residents, as well as Black patients, potentially contributing to disparities in pain assessment and management in these populations.