bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEVELOPING A FRAILTY INDEX USING THE ELECTRONIC HEALTH RECORDS TO EXPLORE THE POLYPHARMACY AND FRAILTY RELATIONSHIP
Authors: Yasin Reham , Lekan Deborah , Kennedy-Malone Laurie , McCoy Thomas , Boone Anna , Bacon Cindy 
Published: January 2025

Abstract
The association between polypharmacy and frailty among hospitalized adults was explored using a secondary data analysis of the EHR in adults aged 50 years or older (N=46,645) hospitalized in medical-surgical units between 2013 and 2017. A Frailty Index (FI) was created based on the accumulation of a deficit theoretical framework (Mitnitski et al., 2001). The FI was constructed following the guidance provided by Searle et al. (2008) and Theou et al. (2023). This study’s FI was unique because it included indicators from nursing flowsheets, ICD-10 codes, laboratory blood biomarkers, as well as other frailty indicators (35 deficits in this study). The indicators were coded as “1” for present and “0” for absent. FI-35 was calculated by dividing the number of indices in an individual by the total number of indices measured, with frailty defined by a cut-off point of ≥ 0.25. In the study (25,961), 42.0% were identified as frail. A significant association was found between polypharmacy and frailty. The study showed 54.5% of individuals with polypharmacy classified as frail, compared to 31.4% in the non-polypharmacy group (χ²=1283.886; p&lt; 0.001). The odds of frailty were 53.1 % higher for those in the polypharmacy groups relative to non-polypharmacy groups, adjusting for age and Elixhauser comorbidity index score (AOR=1.531, 95% CI=[1.437, 1.631], p&lt; 0.001). When recognizing frailty in hospitalized patients with known polypharmacy, consideration should be made for medication reconciliation and medication deprescribing before discharge.
DEVELOPMENT OF A NOVEL PHENO FRAILTY INDEX FOR MICE
Authors: Samuelson Brady , Zhu Dantong , Kane Alice 
Published: January 2025

Abstract
Frailty is assessed in both model organisms and people with frailty index tools that quantify health related deficits. Here we aim to develop a new mouse frailty assessment tool (Pheno-FI) based on clinically-relevant physiological and functional measures that are easily obtainable, and can be measured longitudinally. The Pheno-FI score was developed using male and female C57BL/6 mice (N=40) at 12 months of age. We selected 17 items to include that changed with age, were health-associated, and were not correlated with each other. These included variables like HR, PLT, RBC, WBC, basophils, QRS, QT, open field, glucose, nesting and burrowing to provide a holistic view of frailty. The standard deviation (±1.5) of the baseline mice were used to determine the sex-specific cut points for our deficits, and if values were outside these cut points they were given a score = 1, and within the cut points a 0. Pheno-FI is the average of these items. Once developed in the baseline data, the Pheno-FI was calculated for male and female mice aged 12 to 36 months. Pheno-FI scores increase with age in both males and females, and are positively correlated with the previously validated mouse clinical frailty index (Females R2=0.6, p= 7.7e8 Males R2=0.62, p= 3.1e11). Additionally, Pheno-FI scores show a negative correlation with lifespan (Female R2= -0.56 p=6.7e-7 Male R2= -0.5 p=2.3e7). The Pheno-FI provides a new tool for the field to classify frailty in longitudinal aging mouse studies, to explore frailty mechanisms, biomarkers and interventions.
ECOLOGICAL MOMENTARY ASSESSMENT OF SOCIAL INTERACTION, LONELINESS, AND FRAILTY IN PREDEMENTIA
Authors: Hong Dahye , Kim Jennifer , Yoon Seolah , Kang Chaeeun , Kang Bada 
Published: January 2025

Abstract
The pre-dementia stage, encompassing subjective cognitive decline (SCD) and mild cognitive impairment (MCI), is recognized as being vulnerable to frailty and is associated with adverse health outcomes, such as falls or disability. Although social interaction and loneliness are considered to be associated with frailty, little is known about the relationship between social interaction, loneliness, and frailty in the pre-dementia stage. Therefore, this study examined the relationship between social interaction, loneliness, and frailty among 101 community-dwelling older adults in the pre-dementia stage (individuals with SCD = 67; individuals with MCI = 34) in Korea. To capture real-time measurements of social interaction and loneliness, we utilized an ecological momentary assessment that involved repeated sampling of individuals’ states. Participants reported their frequency of social interactions and loneliness via a mobile application four times a day for two weeks. Multivariate logistic regression analysis was used to investigate the associations between social interaction, loneliness, and frailty. We adjusted for mild behavioral impairment (MBI), which indicates dementia risk and increases vulnerability to frailty, alongside sociodemographic, health-related characteristics, and functional limitations. Our study demonstrated that social interaction has a negative association with frailty among individuals in the pre-dementia stage, regardless of the presence or severity of MBI symptoms. However, loneliness was not significantly associated with frailty. This study highlights that the assessment of social interactions using ecological assessment will help identify at-risk individuals and implement targeted interventions for the prevention and management of frailty in older adults in the pre-dementia stage.
ENHANCING MUSCLE FUNCTION IN FRAILTY: FINDINGS FROM A PILOT STUDY ON MAGNETIC MITOHORMESIS THERAPY
Authors: Sagong Hae , Tsai Pao-Feng , Wang Chih-Hsuan , Brown Lynn , Edison Jos 
Published: January 2025

Abstract
Magnetic Mitohormesis Therapy (MMT) employs low-amplitude pulsing electromagnetic fields (PEMF) and has demonstrated the ability to enhance muscle function and metabolism. Given that muscle weakness is a key contributor to frailty, this study employed a double-blind pilot randomized controlled crossover trial design involving prefrail/frail participants without neurodegenerative diseases, from two distinct types of long-term care facilities. Eight Participants underwent 12 weeks of twice-weekly treatment followed by 12 weeks of sham control, or vice versa, with two groups randomly assigned: Sham-Treatment (S-T group) and Treatment-Sham (T-S group). Treatment was delivered using The QuantumTx BIXEPS Fitness and Wellness device delivered PEMF at 1.5 mT flux densities. FRAIL Scale, SPPB, SF-12v2 Health Survey, SWAY Cognitive Tests, and Body Composition Measurements were assessed at every 6 weeks. Results showed that the S-T group demonstrated improved performance in the Gait Speed test. Their scores from the Gait Speed test were higher at 24 weeks compared to baseline (p=.01), and their overall SPPB scores were higher at 24 weeks compared to baseline (p=.01). Participants noted the study site’s accessibility and described the treatment as quick and straightforward. This study provided preliminary evidence of the benefits of MMT in frail older adults; however, further research with a larger sample size and shorter study duration is needed to lower the dropout rate and mitigate the development of new health issues.
FEASIBILITY OF A LIFESTYLE-INTEGRATED EXERCISE DELIVERED VIA AN MHEALTH PLATFORM IN PREFRAIL OLDER ADULTS
Authors: Li Na , Wang Nan , Lin Siyang , Yuan Yin , Huang Feng , Zhu Pengli 
Published: January 2025

Abstract

Background
Lifestyle-integrated Functional Exercise, which integrates exercise into daily life, may be a promising alternative to overcome traditional exercise barriers. Recent advances in mHealth technology hold the promise of preserving the benefits of supervised exercise training in group settings by remotely guiding and tracking exercise progress. Objective: To assess the feasibility and acceptability of an mHealth platform to deliver a personalized lifestyle-integrated multicomponent exercise program for pre-frail individuals.

Methods
This was a community-based, mixed-methods, prospective, single-cohort feasibility study. All participants were prescribed a lifestyle-integrated multicomponent exercise program by healthcare professionals using the PF-Life platform (web-based portal), and participants engaged in customized exercise following in-app video instructions and feedback on the PF-Life platform (smartphone application). Physical activity was registered daily through wearable devices. Result：16 participants successfully completed the study with a retention rate of 100%. Mean adherence to the number of days exercised per week was 88.8% (95% CI 75%-100%). Changes were observed from baseline to follow-up for total Handgrip strength (21.41±6.38 vs. 24.12± 6.62 kg, d =0.714), TUG (8.23±1.33 vs. 7.48± 2.01 seconds, d=1.647) and 30-second chair rise test (17.13±4.3 vs. 20.04±4.54 repetitions, d =0.94). The sedentary time decreased by a mean of 33 minutes/day and low physical activity increased by 31 minutes/day during the intervention.

Conclusion
This study provides preliminary evidence that an lifestyle-integrated exercise based on mHealth platform has good adherence, safety, reliability and usability, with initial results in reducing sedentary time and improving physical function.
FRAILTY TRAJECTORIES AND ITS ASSOCIATED FACTORS IN JAPANESE OLDER ADULTS
Authors: Taniguchi Yu , Kitamura Akihiko , Hata Toshiki , Fujita Koji , Abe Takumi , Nofuji Yu , Seino Satoshi , Yokoyama Yuri 
Published: January 2025

Abstract
The present study had two objectives: to identify aging trajectories in frailty status from age 65–90 years among community-dwelling older Japanese; and to identify factors associated with this trajectory among these people. The present prospective study used repeated measures data on frailty status from a 13-year longitudinal study. 1706 older adults completed an annual frailty assessment at least once during the follow-up. Frailty status was determined using an index based on the Fried frailty phenotype criteria. Potential associated factors for frailty trajectory included physical, biological, lifestyle-related, and psychological factors, as well as comorbidities. We identified five trajectory patterns in the frailty score from age of 65 to 90 years —individuals who were robust (10.5%) as well as individuals with late-onset frailty (16.1%), middle-onset frailty (25.6% and 35.2%), and early-onset frailty (12.7%). The early-onset frailty group were already pre-frail at the age of 65 years, and their frailty score gradually progressed to frail status. Compared with the robust group, the early-onset group showed a higher prevalence of cerebrovascular diseases, bone and joint diseases, poor nutrition, sarcopenia, hospitalization, low cognitive function, and smoking at the end of follow-up. Associated factors in the middle-onset group largely overlapped with those of the early-onset group. The late-onset frailty group tended to have a higher association with heart disease and bone and joint diseases compared with the robust group. Proposed effective population-based frailty prevention strategies in each age group may contribute to effective strategies to extend healthy life expectancy.
LONGITUDINAL SEX DIFFERENCES IN FRAILTY AND AGING IN UM-HET3 MICE
Authors: Wu Judy , Samuelson Brady , Betz Elizabeth , Kane Alice 
Published: January 2025

Abstract
Frailty is a common geriatric syndrome characterized by age-associated decline and vulnerability to adverse health outcomes. Frailty can be quantified using frailty indices (FIs) which count the number of health deficits in an individual. Sex differences are observed in aging with women living longer than men, despite women being frailer. Our goal is to assess sex differences in behavioral and molecular assessments of aging, and how frailty may influence these changes. Across the lifespan of UM-HET3 male and female mice(n=37) we are longitudinally measuring FI score, behavioral assessments and blood outcomes including white blood cell counts (WBC) and glucose levels. Preliminary data from the first 3 timepoints unexpectedly suggest frailty scores decrease over time(p=9.98e-13), with no clear sex differences. For nesting, females have higher scores at all timepoints (p=7.71e-04). Males have higher WBC than females (p = 1.29e-06), with no change over time. Glucose levels increase overtime for both sexes, (p=2e16), but males have lower glucose counts than females (p=5.25e-3). Frailty is associated with lower glucose levels in both sexes (p= 4.45e-05). Heart rate is higher in females (p= 3.52e-04) and increases over time for both sexes (p=3.59e-03). Additionally, higher frailty scores are associated with lower heart rates(p=0.0236) in both sexes. Data collection is ongoing and we expect to see more significant effects of sex, age, and frailty as the mice grow older. This work will help understand the impact of frailty and sex differences on aging.
METABOLOMICS BIOMARKERS FOR FRAILTY: A LONGITUDINAL STUDY OF AGING MICE
Authors: Zhu Dantong , Wu Judy , Samuelson Brady , Kane Alice 
Published: January 2025

Abstract
Aging is associated with changes in dynamic biological processes which may contribute to the development of aging-related diseases. Metabolomic profiling allows us to measure a wide spectrum of metabolites as read outs of these biological processes. The temporal dynamics of metabolites can be utilized to identify age-related biomarkers and to elucidate possible aging mechanisms. We performed a longitudinal study of aging female (n = 20) and male (n = 25) C57 mice and measured frailty index and derived metabolomics from plasma samples at five time points from 13 to 30 months of age. We identify differentially abundant metabolites by differential analysis over the time course and select metabolite features by a machine learning approach both in the whole cohort and in sex-stratified subgroups. We reveal novel metabolites associated with △frailty index (difference between individual frailty index and median frailty index at a given sex and age group), and merge these metabolites with frailty index and age related metabolites to generate a union set of metabolite features associated with frailty in aging. We found frailty related metabolites are generally enriched in lipid metabolism, amino acid metabolism and metabolism of cofactors and vitamins, although there is strong sex dimorphism of the specific metabolites. Notably, we identify FAD and 4−hydroxyhippurate in females and ergothioneine and creatine in males as candidate metabolites associated with frailty. In summary, our results identify sex-specific metabolite biomarkers of frailty in aging, and shed light on potential mechanisms involved in aging and the development of frailty.
THE EFFECT OF FRAILTY ON COGNITION IN OLDER ADULTS: THE MEDIATING ROLE OF DEPRESSIVE SYMPTOMS
Authors: Yuan Yiyang , Lapane Kate 
Published: January 2025

Abstract
This study aims to examine the effect of physical frailty on cognitive function with depressive symptoms as a mediator in older adults in the United States. The Health and Retirement Study (HRS 2016; baseline) was linked to its sub-study Harmonized Cognitive Assessment Protocol (HCAP; follow-up), which was conducted in a randomly selected half of the 2016 HRS participants, to identify 1,503 adults aged 65 and above. The exposure physical frailty and mediator depressive symptoms were measured in HRS at baseline respectively by the Fried frailty phenotype on low weight, physical inactivity, exhaustion, weakness, slowness (total score: 0-5; dichotomized as not frail (score: 0) vs. frail (score: 1-5)) and the Center for Epidemiological Studies Depression (CES-D) Scale (total score: 0-8). The outcome overall cognitive function was measured in HCAP at follow-up by the Mini-Mental State Examination (total score: 0-30). Causal mediation analysis was used to assess the direct effect of physical frailty and its indirect effect through depressive symptoms on cognitive function, considering the interaction between the exposure and the mediator. Having physical frailty would decrease cognitive function by a total effect of -0.26 (95% CI: -0.59 to 0.07), with total natural direct effect of -0.14 (95% CI: -0.48 to 0.20) and pure natural indirect effect through depressive symptoms of -0.12 (95% CI: -0.22 to -0.01). The lack of clinically meaningful effects is likely due to the short length of follow-up. This study employs the natural temporal order in HRS and HCAP, but analysis with longer follow-up is warranted.
EPIDEMIOLOGICAL FEATURES OF URINATION AND DEFECATION DYSFUNCTION: INSIGHTS FROM THE CHARLS STUDY (2011–2020)
Authors: Zhu Haoran , Zhang Jing , Liu Guangtian , Jing Liwei , Wang Rui , Ye Yan 
Published: January 2025

Abstract
With the population aging, China has over 42 million older adults with disabilities, experiencing Urination and Defecation Dysfunction (UDD). The study aims to understand the epidemiological characteristics of UDD from 2011 to 2020, utilizing the China Health and Retirement Longitudinal Study (CHARLS) database. CHARLS is a longitudinal study, involved adults aged 45 and older, with having a cross-sectional survey at each two years. All participants in the CHARLS database who had UDD were included in the study. Chi-square tests and a logistic regression analysis were conducted. A total of 17,156, 17,897, 17,715, 19,097 and 19,129 eligible participants were recruited in each wave of survey, respectively, while associated prevalence were 4.4%, 4.0%, 4.7%, 4.7%, and 5.0%. The prevalence remained stable without significant changes across the ten years. In the univariable analysis, a higher prevalence was observed among older adults over 76 years (P&lt; 0.05), compared to younger adults. Urban residents had a higher prevalence in Northern, Central and Southern China (P&lt; 0.05) than other regions. Furthermore, through the multivariable analysis with the logistic model, higher UDD prevalence was identified among urban older female in Northern, Central, Southern, and Southwest China. Therefore, health educational campaigns and medical intervention programs should be provided for these high-risk population in China. The findings emphasize the potential burden of UDD in older populations, and underscore the importance of integrating urinary and fecal incontinence into geriatric health education.
INTEGRATED DEMENTIA CARE CENTER IN TAIWAN: A SIX-YEAR JOURNEY TO DEVELOP A HOLISTIC CARE MODEL
Authors: Kuo Tsuann , Huang Yi-Jia , Chen Yu-Chun , Lu Yu-Lan , Lin Yi-Hsiu 
Published: January 2025

Abstract
Taiwan launched its 8-year Dementia Action Plan 2.0 in 2017 and has developed over 114 Dementia Integrated Care Centers (DICC). Using the Chronic Disease Management Model, a multi-disciplinary and holistic care center was established by Chung Shan Medical University Hospital to care for more than 400 people with dementia and their family members each year. The DICC was consisted of medical, care, and support divisions so patients can be cared for by medical specialties, nurses, nutritionists, pharmacists, physical therapies, occupational therapies, social workers, psychologists and legal representatives. This study also analyzed over 2000 patients’ records retrospectively and found out that with the help of care managers at DICC, people with dementia were less likely to be hospitalized, entering emergency room, reduced caregiver burdens, and maintained cognitive level longer. The center also outreached to the community and established a network where people with dementia can attend physical, arts, leisure, and learning programs. The caregivers who were interviewed and attended these programs indicated that they were able to accept their family’s conditions faster and more at ease with their family dynamics. The DICC also served as an important site for University students to be trained to become future dementia specialists. In conclusion, a center with multi-disciplinary professionals took years to integrate and build collaborations so people with dementia and their families could get the best coordinated care. This paper will reveal how the Dementia Integrated Care Center will be implemented in Taiwan.
LIFE SATISFACTION OF OLDER ADULTS: IMPACT OF LEISURE PARTICIPATION AND REGIONAL CHARACTERISTICS
Authors: Lee Rokbit , Heo Jinmoo , Lee Inheok , Kim May , Im Sua 
Published: January 2025

Abstract
As Korea is transitioning into an aged-society, improving well-being of older adults has become important, and literature has demonstrated various individual and societal factors that impact their well-being. The purpose of this study is to explore the role of individual and regional factors that are associated with older adults’life satisfaction. Specifically, we used leisure participation as individual factor and regional characteristics include perceived stress and volunteer participation rate. Data were drawn from the 2020 National Survey of Korean Elderly and Statistics Korea. As the individual data were nested in regions (cities and provinces), we used hierarchical linear modeling to analyze the data. Findings show that volunteering, traveling, and participating in club activities were positively related to life satisfaction of older adults. The relationship observed between older adults’ participation in travel, club activities, volunteering, and life satisfaction suggests that engaging in productive leisure activities is a crucial aspect of daily life of older adults. At regional level, perceived stress level was negatively associated with life satisfaction whereas volunteer participation rate was positively related to life satisfaction. The negative correlation between older adults’ perceived local stress and life satisfaction, and the positive correlation between local social volunteer participation rate and life satisfaction suggest that stress perceived by individuals due to their residential area or surrounding environment has a negative impact on their lives. A statistically significant cross-level interaction was observed indicating that the impact of volunteer participation rate on life satisfaction was stronger in regions with higher levels of perceived stress rate.
INTRAINDIVIDUAL VARIABILITY MODIFIES COGNITIVE TRAINING IN COGNITIVELY VULNERABLE OLDER ADULTS WITH HIV
Authors: Vance David , Azuero Andres , Schexnayder Julie , Puga Frank , Byun Jun , Xiao Chunhong , James Dara , Wheeler Pariya 
Published: January 2025

Abstract
Cognitive Intra-Individual Variability (IIV), the fluctuation in cognitive performance within an individual, often stems from compromised cognitive control due to brain pathology. In cognitive aging studies, cognitive IIV has been shown to predict cognitive decline 3 years later, dementia, and mortality. Those with HIV-Associated Neurocognitive Disorder (HAND) frequently exhibit heightened cognitive IIV; this is concerning as the HIV population has become an aging epidemic (i.e., by 2030 70% of people with HIV will be 50 and over). This study investigated whether computerized Speed of Processing (SOP) training could mitigate cognitive IIV and whether baseline cognitive IIV influenced the impact of SOP training on individuals with HAND or borderline HAND. In a 3-group experimental design, 216 middle-aged and older individuals living with HIV (PLWH) and HAND were randomly assigned to: 1) 10 hours of SOP training (n=70); 2) 20 hours of SOP training (n=73); or 3) 10 hours of Internet Navigation Control Training (n=73). Participants underwent a seven-domain cognitive battery at baseline, posttest after training, and at 1 and 2-year follow-ups, with the coefficient of variation (CoV) representing cognitive IIV dispersion. Linear mixed-effect models did not reveal an obvious pattern of SOP training effects on cognitive IIV. Albeit, a three-way interaction tests between group, time, and baseline IIV CoV [F(6, 453.96)=1.74, P= 0.11], and group, time, and baseline IIV CoV median split indicator [F(6, 467.84)=2.024, P= 0.061] posited potential moderation effects. While SOP training did not directly enhance cognitive IIV, its effects may be influenced by individual baseline cognitive IIV.