bluuebunny/crossref_metadata_2025_split huggingface dataset:
GERIATRIC PSYCHIATRY OUTPATIENT REACTIONS TO A POST-COVID TRANSITION FROM VIRTUAL TO IN-PERSON CARE
Authors: Mertz Kathryn , Baldinger Samantha , RIvas Jennifer , Nikzad Amir , Scarpelli Michael , Greenwald Blaine 
Published: January 2025

Abstract
Because of social distancing/quarantining, the COVID-19 pandemic catalyzed necessary shifts to telepsychiatry in outpatient mental health settings. To enable access and reimbursement for elders, the Centers for Medicaid and Medicare Services (CMS) liberalized restrictive telemedicine regulations. In our Geriatric Psychiatry Clinic, in-person visits quickly shifted to virtual. Tele-video and audio-only services became universally operative between Spring 2020 through May 2023, when – with the public health emergency (PHE) ending - CMS determined hospital-based clinics were ineligible for the ‘facility fee’ if patients were seen virtually, so return to in-person care was strongly encouraged. Shortly thereafter, to determine impact, consecutive geriatric psychiatry clinic patients over a several days period were surveyed re: satisfaction with virtual versus in-person care, and about challenges experienced returning in-person. Of 134 patients surveyed, 43% had engaged in tele-video, 43% in audio-only, and 17% utilized both. Utilizing a 5 -point Likert scale (very unsatisfied = 1 to very satisfied = 5), virtual (video, audio or both) (mean = 4.1) and in-person (mean = 4.2) care did not differ (p-value = 0.82 [Wilcoxon signed-rank test]). Amongst challenges associated with returning to in-person, 75% identified medical issues as very difficult/difficult, 46% financial issues, 25% distance to clinic, 23% transportation concerns, and 16% caregiving responsibilities. Taken together, findings suggest that geriatric psychiatry outpatients are comparably satisfied with virtual and in-person visits, however notable proportions experienced challenges reverting to in-person, especially because of medical and financial issues. As such, continuing advocacy supporting virtual options in psychiatric care of elders is warranted.
LONELINESS, SOCIAL ENGAGEMENT, AND COGNITIVE STATUS AMONG OLDER BLACK AND WHITE ADULTS
Authors: Beech Bettina , Bruce Marino , Udo Charles , Velazquez Ana , Thorpe Roland 
Published: January 2025

Abstract
Social connection has been consistently shown to influence health status and recent research findings suggest that an absence of relationships with significant others can increase risks for cognitive impairment. Few studies have examined how the presence or absence of social connections have implications for cognitive impairment and even fewer have considered how these associations can vary by race and gender. The purpose of this study was to examine race and gender differences in the associations between loneliness, social engagement, and cognitive impairment among Black and White adults in the Health and Retirement Study (HRS). Data were drawn from participants who completed the Core and Leave Behind Questionnaire items in the 2016 HRS. Any cognitive impairment, a dichotomous variable derived from the Telephone Interview for Cognitive Status, was the outcome of interest. Loneliness and social engagement were the primary independent variables. Black men (35.5%) and Black women (27.0%) were disproportionately represented among respondents with any cognitive impairment relative to White men (14.6%) and White women (16.2%). Results from race- and gender-stratified Modified Poisson Regression models indicated that loneliness was associated with a higher prevalence of any cognitive impairment (PR=1.29, CI:1.07-1.57) among White women. Social engagement was inversely related with any cognitive impairment among White men (PR=0.97, CI:0.95-0.99). Neither of the main independent variables were significant for Black men or women in the study. Studies with robust and inclusive social connection measures are needed to further examine the association between loneliness, social engagement, and cognitive functioning among diverse populations.
MULTIMORBIDITY, MUSCLE STRENGTH, AND FALLS AMONG OLDER MEXICAN AMERICANS
Authors: Uribe Alondra , Snih Soham Al 
Published: January 2025

Abstract

Abstract objectives
To determine the relationship of multimorbidity and muscle strength with falls among older Mexican Americans without a history of falls at baseline. Design: Longitudinal study. Setting and Participants: This 12-year prospective cohort study included 899 non-institutionalized Mexican Americans aged ≥75 residing in Arizona, California, Colorado, New Mexico, and Texas from the Hispanic Established Population for the Epidemiologic Study of the Elderly.

Methods
Measures include socio-demographics, medical conditions, Body Mass Index, disability, handgrip strength (HGS), depressive symptoms, pain, cognitive function, and multimorbidity (≥2 self-reported medical conditions). Participants at baseline were divided into four groups: high HGS and multimorbidity (N=349), low HGS and multimorbidity (N=263), high HGS and without multimorbidity (N=181), and low HGS and without multimorbidity (N=104). Generalized estimating equation models estimated the odds ratio (OR) and 95% Confidence Interval (CI) of falls as a function of multimorbidity and HGS groups controlling for all covariates.

Results
The OR of falls was 0.72 (CI=0.54-0.95) for those with multimorbidity and high HGS, 0.52 (95% CI=0.33-0.82) for those without multimorbidity and high HGS, and 0.46 (95% CI=0.29-0.74) for those without multimorbidity and low HGS, versus those with multimorbidity and low HGS, after controlling for all covariates. Conclusions and Implications: Mexican American older adults with multimorbidity and high HGS had a 28% decreased risk of falls over time. Increasing muscle strength through exercise may help prevent falls among those with multimorbidity.
METABOLOMIC CHARACTERIZATION OF UNINTENTIONAL WEIGHT LOSS AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Yao Shanshan , Marron Megan , Farsijani Samaneh , Shah Ravi , Murthy Venkatesh , Newman Anne 
Published: January 2025

Abstract
Unintentional weight loss is associated with higher mortality and impaired mobility in older adults. Metabolomics can provide insight into yet unknown pathways of unintentional weight loss and inform its early prediction and targets for intervention. Here we investigated plasma metabolite associations of subsequent unintentional weight loss over 2 years (mean annual change [SD]=-1.5 [2.0] kg) in 2330 participants (mean age 74.6 years, 51% women, 37% Black) from the Health, Aging and Body Composition study. Metabolites were measured by liquid chromatography-mass spectrometry. Multinomial logistic regression models were used to identify the associations of each of the 478 metabolites with weight loss with/without an intention and weight gain (&gt;3% annual weight gain/loss), relative to weight stability. The metabolite associations of unintentional weight loss differed from those of intentional weight loss and weight gain. Forty-seven metabolites were only significantly associated with unintentional weight loss after age, sex, race, current obesity, and multiple comparison adjustments compared with weight stable (FDR &lt; 0.05). Lower levels of branched-chain amino acids, aromatic amino acids, phospholipids, long-chain poly-unsaturated triglycerides, and higher levels of amino acid derivatives, poly-unsaturated fatty acids, and carbohydrates were associated with higher odds of unintentional weight loss relative to weight stable. The identified metabolite associations were independent of smoking, energy expenditure, diet, inflammation, chronic conditions, and medication (&lt; 20% attenuation). Altered amino acid metabolism, impaired mitochondrial fatty acid oxidation, and inflammaging implicated by the identified metabolites, which have been linked to insulin resistance and sarcopenia in literature, may precede unintentional weight loss in older adults.
A REINFORCEMENT LEARNING APPROACH TO ENHANCE PHYSICAL ACTIVITY AND REDUCE FALL RISK IN OLDER ADULTS
Authors: Liu Chang , Thiamwong Ladda , Nguyen Tho , Suarez Jethro Raphael , Park Joon-Hyuk , Lou Qian , Xie Rui 
Published: January 2025

Abstract
The proliferation of sensing technology enables us to accurately track physical activity (PA) using wearable devices. Consequently, based on the PA patterns provided, it offers us an opportunity to design personalized interventions delivered via notifications, aiming to promote healthy behaviors and eventually reduce fall risk among older adults. We assessed minute-level accelerometer-based PA data, in total 1.24 million observations, from 134 participants (average age 74.26, SD 6.85, female 88.8% and 70.15% have no history of falls) in our Physio-Feedback Exercise Program (PEER) and control groups. The study targets the reduction of fall risk and the improvement of PA levels in economically disadvantaged older adults recruited in 2023. We employed a reinforcement learning (RL) approach with a policy network that continuously learns steps and vector magnitude from participants, aiming to find an optimal policy to encourage participants to take the action of ‘standing’. We assigned a positive reward when participants achieved Moderate to Vigorous Physical Activity status, a neutral reward for Light Physical Activity, and a negative reward for sedentary behavior. A three-layer fully connected neural network with sigmoid activation functions identified a significant difference in action probabilities, with the control group averaging 0.6456 and the PEER group at 0.7192. Significantly, from 9 AM to 6 PM, probabilities surged for both groups, peaking at 0.7438 (control) and 0.8188 (PEER). After 6 PM, probabilities declined across all groups. The probability of an event is directly proportional to its likelihood; therefore, a higher probability corresponds to the greater likelihood of the event occurs.
ARE LIFE ACCOMPLISHMENTS RELATED TO WELL-BEING: FINDINGS FROM THE HEALTH AND RETIREMENT STUDY (HRS)?
Authors: Larkina Marina , Smith Jacqui 
Published: January 2025

Abstract
Butler (1963) proposed that engaging in a whole life review is especially beneficial for older adults because it promotes a sense of self-worth. Previous research highlights links between reminiscing and psychological well-being, however, life review narratives are rarely collected in the context of large, population-based aging studies. This study uses data from the HRS Life History Mail Survey (2017, 2019) to 1) examine factors that predict older adults (N=12,815; Mage= 68 years; range 50-101) willingness to share their life’s most important accomplishments (up to three); and 2) establish relations between content and complexity (content variety) of reported accomplishments and participants’ well-being. Participants who reported their accomplishments (59%), compared to those who didn’t, were more likely to be better educated, currently married, wealthier, have better memory and fewer depressive symptoms. Importantly, they also were more likely to perceive their life-as-a-whole as either completely or very satisfied (OR=1.315, CI=1.214-1.425, p&lt;.001). Multinomial analysis of content and complexity of reported accomplishments revealed that people with higher life satisfaction were more likely to report relationship-related accomplishments (47%; family, friendship, or caring for others) compared to those who were most proud of their societal achievement (35%; education, work, military services), adjusted RRR=1.207, CI=1.061-1.372, p&lt;.005. People, who wrote about personal qualities (e.g., their faith, health) did not differ from other two groups. The complexity of reported accomplishments was not associated with life satisfaction but was related to respondents’ education and memory. Our findings support the proposal that reviewing one’s life accomplishments enhances well-being in later life.
INTERGENERATIONAL QUALITY OF LIFE: SIMILARITIES AND DIFFERENCES AMONG MUSICIANS
Authors: Nesser Whitney , Snyder Scott 
Published: January 2025

Abstract
Music has been shown to improve Quality of Life (QoL) for various populations. However, few studies have studied older musicians’ QoL or QoL in an intergenerational sample of musicians. To address this gap this study assessed four QoL domains (physical, psychological, social, and environmental) in a nationally representative intergenerational sample of musicians using the WHOQOL-BREF scale. Data were obtained via a survey of professional and amateur musicians (N=407) across the United States (US). Results demonstrated that while the oldest subgroup of musicians had the highest mean scores for environmental, psychological and social QoL, there were no significant differences between age groups for any of the QoL domains. Rating scale responses for all QoL items were independent of age group except for “How often do you have negative feelings” (p=.01). Examination of standardized residual showed that significant effect was due to the older musicians responding “never” more frequently than expected. The Spearman correlations of environmental QoL with psychological, and social QoL were significantly lower (p &lt;.05) in the older musicians (r=.442, r=.494) than in the aggregate of other age groups (r=.715, r=.733). Furthermore, there was a significantly lower Spearman correlation between “enjoyment of being a musician” and “impact of being a musician on QoL” for older respondents (r=.384) compared to younger respondents (r=.678). Future research is needed to establish normative QoL data for the US on all age groups as measured by the WHOQOL-BREF and to examine the role of music as a mediator of QoL across the lifespan.
TWO-LEVEL CONFIRMATORY FACTOR ANALYSIS OF THE POSITIVE AND NEGATIVE AFFECT SCHEDULE (PANAS) IN MID- AND LATE LIFE
Authors: Nichols Madeline , Geldhof John 
Published: January 2025

Abstract
The Positive and Negative Affect Schedule (PANAS; Watson et al., 1988) is widely used in the study of well-being; however, its factor structure continues to be a source of debate (Wedderhoff et al., 2021). The present study examined the factor structure of the PANAS using data from the third wave of the National Study of Daily Experiences (NSDE; N=1176, Mage=62.48, SD=10.20, Range=43-91, %Female=57.38) in which participants indicated how much of the time they felt positive and negative emotions each day for eight days. We conducted two-level confirmatory factor analyses in MPlus informed by the 45-degree rotation hypothesis (Yik et al., 1999) that classifies emotion words by both valence (negative or positive) and activation (high or low). Results revealed that a five-factor structure at both the within and between levels exhibited good fit (χ2(188) = 989.76; p &lt;.001; RMSEA = 0.02; CFI = 0.960; TLI = 0.949). These factors were: high activation negative (upset, angry, frustrated); negative (worthless, sad, hopeless, lonely); high activation positive (enthusiastic, attentive, proud, active, confident); positive (happy, cheerful); and low activation positive (calm, satisfied). Latent correlations indicated factor separation at both the within- and between-person levels (median absolute correlations of.44 and.60, respectively). These results emphasize the importance of considering both valence and activation in the study of daily affective well-being. The authors recommend that researchers using the PANAS consider the implications of valence and activation when examining associations between affect and health-related outcomes.
CONCEPT ANALYSIS: SLEEP QUALITY IN OLDER ADULTS
Authors: Park Suah , Byun Eeeseung 
Published: January 2025

Abstract
Sleep quality is crucial in determining one’s overall quality of life, particularly among older adults disproportionately affected by poor sleep. Despite its significance, there exists a gap in the analysis of the concept of sleep quality in older adults. This concept analysis was guided by Walker and Avant’s method to conceptualize sleep quality in older adults comprehensively. A systematic search of studies published between 2018 and 2023 was conducted across databases, including CINAHL, EMBASE, PubMed, and Web of Science. Inclusion criteria encompassed quantitative and qualitative studies exploring sleep quality in older adults. The analysis identified key elements, such as defining attributes, antecedents, and consequences of sleep quality in older adults, based on the content of the articles. Fifty articles provided data for sleep quality in older adult conceptualization. Six defining attributes were identified: (a) number of awakenings, (b) sleep duration, (c) sleep disturbance, (d) sleep efficiency, (e) sleep latency, and (f) sleep satisfaction. Antecedents encompassed factors such as Diet, Physical activity, Circadian rhythm, Perceived health, Chronic disease, Psychosocial factors, Sociodemographic factors, and Environmental factors. Consequences included Fall, Daytime dysfunction, Physical health, Mental health, Mortality, and Quality of life. The bidirectional relationships between consequences and sleep quality indicated that some antecedents could be part of consequences and vice versa. This concept analysis presents a conceptual model of sleep quality in older adults based on defining attributes, antecedents, and consequences. The model provides a foundation for further testing and developing measures and interventions for addressing poor sleep quality in older adults.
EDUCATION AS A MODERATOR IN THE ASSOCIATION OF SLEEP DURATION AND DEPRESSIVE SYMPTOMS
Authors: Dong Wuyi , Su Yan-Jhu , Liang ChangPu , Hong Dongfang 
Published: January 2025

Abstract
Optimal sleep duration is critical for older adults’ health and either too long or too short sleep duration potentially leads to mental disorders such as depression, anxiety, and distress. This study explores the association between sleep duration and depression among older adults, with a focus on whether education achievement buffers the association. To create a pooled cross-sectional dataset, we combined data from the National Health and Nutrition Examination Survey (NHANES) of two consecutive waves (2015-16 and 2017-18). Our analysis includes a weighted sample of individuals aged 60 and older without missing responses (n=9,254). We measured sleep duration for three categories based on weekday reports: short sleep (&lt; 7 hours), optimal sleep (7 to 9 hours), and long sleep (&gt;=9 hours). Depression was evaluated using total scores from a 9-item Patient Health Questionnaire (PHQ; range: 0-27). Through multiple linear regression models—adjusting for demographics characteristics, self-reported health, health behaviors, and living arrangements, we found either people with short sleep duration or long sleep duration is associated with higher depression symptoms (β=1.28, p&lt;.001 and β=1.24, p&lt;.001, respectively), compared to optimal sleep duration individuals. The interaction effect showed that higher education levels (college or above) significantly decrease depression associated with longer sleep (β=-1.66, p&lt;.05). These findings suggest that both insufficient sleep and excessive sleep increase the depression risks among older adults, while higher education may have protective effects against mental health challenges related to non-optimal sleep durations.
LAYPERSON’S UNDERSTANDING OF GEROTRANSCENDENCE
Authors: Ribeiro Oscar , Abreu Taiane , Teixeira Laetitia , Araujo Lia 
Published: January 2025

Abstract
Gerotranscendence is an adaptive theory of aging that posits a mindset shift across three dimensions: cosmic, coherence, and solitude. Despite its consolidation in recent years, the theory’s depth continues to evolve, stimulating a need for broader perspectives to enhance its practical comprehension. This study aimed to explore laypersons’ perceptions regarding gerotranscendence’s aspects. Three focus groups were conducted with a total of 18 participants, ranging in age from 58 to 98 years old (mean=79.5). Open-ended questions were used to collect information regarding what gerotranscendence and its dimensions meant to them; thoughts on the components of the theory after a brief explanation were also obtained. Transcripts from recorded sessions underwent content analysis and organized under two overarching themes: general assumptions and personal perceptions. The latter theme encompassed two sub-themes highlighting participants’ identification of personal experiences, as well as their diverse and complementary interpretations of the theory. Initially, participants encountered challenges grasping the theory’s terminology. Subsequent clarification facilitated their recognition and resonance with gerotranscendence’s components. Further discussions exposed associations between concepts of gerotranscendence and other theoretical frameworks of successful aging, notably the life cycle theory and socio-emotional selectivity theory. This interconnection highlights the theory’s relevance within broader aging frameworks. Engaging lay individuals in gerotranscendence discussions yields profound insights into both its fundamental principles and culturally embedded nuances. By associating theoretical concepts with lived experiences, such dialogues enrich the understanding of aging paradigms, paving the way for more holistic approaches to aging research and practice.
THE MULTIDIMENSIONAL SUCCESSFUL AGING SCALE: A LONGITUDINAL VALIDATION STUDY
Authors: Chung Edwin Ka Hung , Yeung Dannii Y 
Published: January 2025

Abstract
The diversified measurement tools of successful aging have restricted comparison of findings between studies and hindering development of this field advancement (Cosco et al., 2014). This study thereby aimed to validate the 25-item Multidimensional Successful Aging Scale (MSAS) through examining its overall structure, measurement invariance, and predictive validity. Four hundred and fourteen community-dwelling older Chinese adults (Mage=68.92 years, SD=6.64, range=60–91; 59.9% females) were assessed on the MSAS in conjunction with demographic, physical and psychological measures at baseline (Time 1) and at 6 months (Time 2). The results of confirmatory factor analysis first revealed a good model fit of the 9-factor model of the MSAS in the two assessments, and indicated that the 9-factor model fitted the data better than other higher-order factor models. In addition to the metric invariance across age and gender groups as well as strict invariance across groups of individuals with and without chronic illness, a strict form of longitudinal invariance was shown at the 6-month interval. Furthermore, the overall results of hierarchical linear regression analyses indicated that, among all dimensions of MSAS in Time 1, positive attitudes and perceived constraints were more predictive of depressive symptoms, functional ability, and pain in Time 2. Overall, the present study advances the previously established psychometric properties of MSAS (Chung & Yeung, 2021; 2022) by demonstrating its temporal stability and predictive value. Findings also support the multidimensional nature of successful aging, and provide health care practitioners and policymakers a more holistic understanding of what is important to older adults.