Gerontology Commons^™

Clinical Geography: A Commentary Response, Jessica M. Finlay, Graham D. Rowles

Graduate Center for Gerontology Faculty Publications

No abstract provided.

Driving Habits, Cognition, And Health-Related Quality Of Life In Middle-Aged And Older Adults With Hiv, Josiah J. Robinson, Tess Walker, Cierra Hopkins, Brittany Bradley, Peggy Mckie, Jennifer S. Frank, Caitlin N. Pope, Pariya L. Fazeli, David E. Vance

Graduate Center for Gerontology Faculty Publications

Cognitive impairment is known to increase with aging in people living with HIV (PLWH). Impairment in cognitive domains required for safe driving may put PLWH at risk for poor driving outcomes, decreased mobility, and health-related quality of life (HRQoL). This study described the driving behaviors of middle-aged and older PLWH and examined correlations between driving behaviors and cognitive functioning (Aim 1), and driving behaviors and HRQoL domains (Aim 2). A sample of 260 PLWH ages 40 and older completed a comprehensive assessment including a battery of cognitive tests, an HRQoL measure, and a measure of self-reported driving habits. Associations between …

Clinical Geography: A Proposal To Embrace Space, Place And Wellbeing Through Person-Centered Practice, Jessica M. Finlay, Graham D. Rowles

Graduate Center for Gerontology Faculty Publications

This essay envisions how geography can operationalize nuanced understandings of space and place to enrich the lives of individuals across the lifespan. We propose a focused integration of geography into person-centered practice: a clinical geography dedicated to working directly with people to promote optimal physical and mental health outcomes and wellbeing. Our proposal integrates spatial modifications to facilitate access and utility, behavioral interventions to maximize effectiveness in using space, and therapeutic engagement to nurture a deeper sense of ‘being in place’ that enhances wellbeing and quality of life. This focus is timely given societal instability and precariousness resulting from incongruous …

Mobile Technology Use During The Covid-19 Pandemic, Yi Lin

Theses and Dissertations--Gerontology

The COVID-19 pandemic led to quarantines and mandatory spatial distancing; people of all ages were encouraged to use technologies instead of actual human contact for COVID-19 prevention and daily activities. The special circumstances of living plus innovation and promotion of mobile applications (apps) during the pandemic influenced mobile technology use behavior. In this study we explored age differences in mobile technology use, the factors that influenced use behavior during the COVID-19 pandemic, and proposed a research model that aimed to predict behavioral intention and mobile technology use behavior. A pilot-tested survey was distributed through online survey software. Participants were 35 …

Why Won’T Grandma Cross The Road? Neighborhood Perceptions And Walking Behavior Among Older Adults In Lexington, Kentucky, Sadie Middleton

Theses and Dissertations--Urban and Environmental Design

Many urban places contain subtle details that can unintentionally deter pedestrian activity. These details can be assessed through six themes: safety, comfort, pedestrian infrastructure, aesthetics, proximity, and ease of navigation. Adults over age 65 may have more concerns about walking in urban settings than people in other age groups. This study identifies urban design elements that encourage and discourage walking among older adults and makes recommendations for design improvements. Study participants (n= 67) completed an online survey about walking behaviors, perceptions of health and community, and perceptions of seven unidentified scenes of pedestrian environments in Lexington, Kentucky. Findings suggest that …

Cellphone Laws And Teens' Calling While Driving: Analysis Of Repeated Cross-Sectional Surveys In 2013, 2015, 2017, And 2019, Li Li, Caitlin N. Pope, Rebecca R. Andridge, Julie K. Bower, Guoqing Hu, Motao Zhu

Graduate Center for Gerontology Faculty Publications

BACKGROUND: Distracted driving among teens is a public health and safety concern. Most states in the U.S. have sought to restrict cellphone use while driving by enacting laws. This study examines the difference in prevalence of self-reported calling while driving (CWD) between states with different cellphone bans.

METHODS: Demographics and CWD data were extracted from state Youth Risk Behavior Surveys (YRBS) from 14 states in 2013, 2015, 2017, and 2019. The state YRBS is conducted every 2 years with a representative sample of 9th through 12th grade students attending public school. States were grouped by type of cellphone law(s): no …

Rural Caregivers: Identification Of Informational Needs Through Telemedicine Questions, Shoshana H. Bardach, Allison Gibson, Kelly Parsons, April Stauffer, Gregory A. Jicha

Sanders-Brown Center on Aging Faculty Publications

OBJECTIVES: The prevalence of Alzheimer's disease and associated disorders is increasing. Rural residents in the United States have less access to memory care specialists and educational and community resources than in other areas of the country. Over a decade ago, we initiated an interdisciplinary rural caregiving telemedicine program to reach Kentucky residents in areas of the state where resources for supporting individuals with dementia are limited. Telemedicine programs involve a short informational presentation followed by a question and answer session; programs are offered 4 times a year. The purpose of this study was to explore questions asked over 1 year …

Adolescents' Attitudes And Intentions To Use A Smartphone App To Promote Safe Driving, Caitlin N. Pope, Emre Sezgin, Simon Lin, Nichole L. Morris, Motao Zhu

Graduate Center for Gerontology Faculty Publications

Purpose

Designing effective driving safety interventions is imperative as traffic crashes are the leading cause of injury and death for adolescents. Using concepts from the Integrated Behavioral Model, we investigated adolescents' attitudes and intentions towards engaging in safe driving practices and using smartphone-based driving safety technology.

Methods

Two-hundred and seven adolescents aged 14–18 (M = 16.1, SD = 0.8) completed a safe driving survey. A path model testing the associations between individual scores of attitudes, perceived norms, and perceived behavioral control with intentions controlling for demographic covariates was conducted.

Results

Greater intentions to drive safely was associated with greater …

Will "Social Distancing" Lead To Future "Research Distancing": A Reflection On Covid-19 Impacts On Alzheimer's Disease Research, Shoshana H. Bardach, Allison K. Gibson, Elizabeth K. Rhodus, Gregory A. Jicha

Sanders-Brown Center on Aging Faculty Publications

Coronavirus disease 19 (COVID-19) has dramatically altered everyday life, including the field of Alzheimer's disease (AD) research. This perspective article explores some of the ways in which COVID-19 has already impacted the field, anticipates some of the long-lasting effects, and explores strategies for addressing current and future needs. Areas of impact include study integrity, regulatory and industry issues, and participant engagement. Proposed strategies for addressing these challenges include analytic methods to deal with large degrees of missing data and development of patient-centered, user-friendly, remote data collection tools and assessments. We also highlight the importance of maintaining participant well-being as a …

Post-Acquisition Processing Confounds In Brain Volumetric Quantification Of White Matter Hyperintensities, Ahmed A. Bahrani, Omar M. Al-Janabi, Erin L. Abner, Shoshana H. Bardach, Richard J. Kryscio, Donna M. Wilcock, Charles D. Smith, Gregory A. Jicha

Neurology Faculty Publications

BACKGROUND: Disparate research sites using identical or near-identical magnetic resonance imaging (MRI) acquisition techniques often produce results that demonstrate significant variability regarding volumetric quantification of white matter hyperintensities (WMH) in the aging population. The sources of such variability have not previously been fully explored.

NEW METHOD: 3D FLAIR sequences from a group of randomly selected aged subjects were analyzed to identify sources-of-variability in post-acquisition processing that can be problematic when comparing WMH volumetric data across disparate sites. The methods developed focused on standardizing post-acquisition protocol processing methods to develop a protocol with less than 0.5% inter-rater variance.

RESULTS: A series …

Hospitalization-Associated Change In Gait Speed And Risk Of Functional Limitations For Older Adults, Wei Duan-Porter, Tien N. Vo, Kristen Ullman, Lisa Langsetmo, Elsa S. Strotmeyer, Brent C. Taylor, Adam J. Santanasto, Peggy M. Cawthon, Anne B. Newman, Eleanor M. Simonsick, Teresa M. Waters, Kristine E. Ensrud

Health Management and Policy Faculty Publications

BACKGROUND: Hospitalization-associated functional decline is a common problem for older adults, but it is unclear how hospitalizations affect physical performance measures such as gait speed. We sought to determine hospitalization-associated change in gait speed and likelihood of new limitations in mobility and activities of daily living (ADLs).

METHODS: We used longitudinal data over 5 years from the Health, Aging and Body Composition Study, a prospective cohort of black and white community-dwelling men and women, aged 70-79 years, who had no limitations in mobility (difficulty walking 1/4 mile or climbing 10 steps) or ADLs (transferring, bathing, dressing, and eating) at baseline. …

Mortgage Loans And Financial Security Among Middle-Aged And Older Americans, Qun Zhang

Theses and Dissertations--Family Sciences

Mortgage loan debt is prevalent among middle-aged and older Americans. With higher average outstanding balances, many people are unlikely to pay off their mortgage debt by retirement. Meanwhile, as people age, health shocks are more likely to occur. Medical expenses may compete with mortgage payments and relate to financial insecurity in later years. In order to alleviate financial strain during times of financial hardship, senior homeowners may find reverse mortgage the solution they are looking for. Targeting American adults age 50 and older, this dissertation investigates mortgage loan debt and financial security using panel data from the Health and Retirement …

Social Networks, Identity, Health, And Quality Of Life Among Older Gay And Lesbian Individuals In Rural Environments, Marc Aaron Guest

Theses and Dissertations--Gerontology

The goal of this dissertation was to explore aging lesbian and gay individuals living in rural communities, in terms of their social networks and the relationships between these networks, identity, health, and quality of life. Guiding the study were three overarching questions. Using a multi-method design, the research was grounded within a socio-ecological context and focused on how structural systems create pathways for health and are affected by social position (intersectionality). Participants (n=25) were recruited from Kentucky (n=20), West Virginia (n=3), and Tennessee (n=2). Thirteen participants self-identified as gay and twelve as lesbian. Findings highlight the complexity of the aging …

Toward An Understanding Of Behavioral And Sensory Experiences When Living With Dementia And Related Disorders: An Environmental Gerontology Perspective, Elizabeth K. Rhodus

Theses and Dissertations--Gerontology

Behavioral and psychological symptoms of dementia create challenges for those living with neurodegenerative cognitive impairment and their care partners. Pharmacological approaches for treatment of challenging behaviors seen in dementia have limited success and serious side effects. Because of this, nonpharmacological approaches are being investigated with increasing frequency. Of particular interest are nonpharmacological approaches involving environmental stimulation to change behaviors. Success of such approaches relies on sensory processing systems, personal preferences, and environmental congruence. There is limited evidence describing behaviors of persons with cognitive impairment in relation to these components. Currently, there is no guiding model for implementation of environmental and …

Gerontological Social Work Roles In Disaster Preparedness And Response, Nancy Kusmaul, Allison Gibson, Skye N. Leedahl

Social Work Faculty Publications

No abstract provided.

Age Drives Distortion Of Brain Metabolic, Vascular And Cognitive Functions, And The Gut Microbiome, Jared D. Hoffman, Ishita Parikh, Stefan J. Green, George Chlipala, Robert P. Mohney, Mignon Keaton, Bjoern Bauer, Anika M. S. Hartz, Ai-Ling Lin

Sanders-Brown Center on Aging Faculty Publications

Advancing age is the top risk factor for the development of neurodegenerative disorders, including Alzheimer’s disease (AD). However, the contribution of aging processes to AD etiology remains unclear. Emerging evidence shows that reduced brain metabolic and vascular functions occur decades before the onset of cognitive impairments, and these reductions are highly associated with low-grade, chronic inflammation developed in the brain over time. Interestingly, recent findings suggest that the gut microbiota may also play a critical role in modulating immune responses in the brain via the brain-gut axis. In this study, our goal was to identify associations between deleterious changes in …

Pro-Angiogenesis Therapy And Aging: A Mini-Review, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Apart from major illnesses and chronic afflictions, the elderly experience lesser ailments, such as muscle weakness, cold intolerance, and transient memory lapses. Physical signs in the aged include wrinkled skin and the slow healing of skin abrasions. These ailments and signs are grouped together because they may be due in part to an age-linked, waning microcirculation. A reduced capillary density (CD) throughout the body of aged people and animals has been reported in over 40 papers. The reduced CD is due in turn to declining levels of angiogenic growth factors (AGFs) throughout the body during old age, as documented in …

Using Neonatal Skin To Study The Developmental Programming Of Aging, Leryn J. Reynolds, Brett J. Dickens, Benjamin B. Green, Carmen J. Marsit, Kevin J. Pearson

Pharmacology and Nutritional Sciences Faculty Publications

Numerous studies have examined how both negative and positive maternal exposures (environmental contaminants, nutrition, exercise, etc.) impact offspring risk for age-associated diseases such as obesity, type 2 diabetes, hypertension, and others. The purpose of this study was to introduce the foreskin as a novel model to examine developmental programming in human neonates, particularly in regard to adipogenesis and insulin receptor signaling, major contributors to age-associated diseases such as obesity and diabetes. Neonatal foreskin was collected following circumcision and primary dermal fibroblasts were isolated to perform adipocyte differentiation and insulin stimulation experiments. Human neonatal foreskin primary fibroblasts take up lipid when …

Csf Protein Changes Associated With Hippocampal Sclerosis Risk Gene Variants Highlight Impact Of Grn/Pgrn, David W. Fardo, Yuriko Katsumata, John S. K. Kauwe, Yuetiva Deming, Oscar Harari, Carlos Cruchaga, Alzheimer’S Disease Neuroimaging Initiative, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

Objective—Hippocampal sclerosis of aging (HS-Aging) is a common cause of dementia in older adults. We tested the variability in cerebrospinal fluid (CSF) proteins associated with previously identified HS-Aging risk single nucleotide polymorphisms (SNPs).

Methods—Alzheimer’s Disease Neuroimaging Initiative cohort (ADNI; n=237) data, combining both multiplexed proteomics CSF and genotype data, were used to assess the association between CSF analytes and risk SNPs in four genes (SNPs): GRN (rs5848), TMEM106B (rs1990622), ABCC9 (rs704180), and KCNMB2 (rs9637454). For controls, non-HS-Aging SNPs in APOE (rs429358/rs7412) and MAPT (rs8070723) were also analyzed against Aβ1-42 and total tau CSF analytes.

Results—The GRN risk …

Adverse Events And Treatment Discontinuations Of Antimuscarinics For The Treatment Of Overactive Bladder In Older Adults: A Systematic Review And Meta-Analysis, Scott Martin Vouri, Clark D. Kebodeaux, Paul M. Stranges, Besu F. Teshome

Pharmacy Practice and Science Faculty Publications

Introduction

Antimuscarinics should be used with caution in older adults with overactive bladder (OAB) due to anticholinergic adverse events (AEs). Systematic reviews and meta-analyses (SRMAs) have analyzed safety-related outcomes but have not specified risk in the elderly, the population at highest risk for AEs. The aim of this review is to explore and evaluate AEs and treatment discontinuations in adults 65 or older taking antimuscarinics for OAB.

Methods

Keywords were searched in MEDLINE, EMBASE, SCOPUS, and Cochrane Central Register for Controlled Trials. Randomized controlled trials (RCTs) along with sub-analyses and pooled analyses that compared antimuscarinics to placebo or another antimuscarinic …

Healthy Aging In The North: Sociocultural Influences On Diet And Physical Activity Among Older Adults In Anchorage, Alaska, Britteny M. Howell

Theses and Dissertations--Anthropology

Increasing rates of overweight, obesity, and related cardiovascular diseases among older adults in the United States present unique public health challenges. Cross-cultural research has shown marked variation in health across the world’s elder populations because aging is a biological process rooted in sociocultural context. The sociocultural environment contributes to complex negotiations of food and physical activity patterns for older adults. It is well established in the literature that urban residents report low levels of physical activity and have easy access to fast food outlets, which tend to be concentrated in lower-income neighborhoods. I utilize a biocultural framework, integrating nutritional anthropology …

A Systems Approach To The Problem Of Falls In Old Age, Patrick A. Dillon

Theses and Dissertations--Gerontology

The problem of falls in old age is enormously costly and disruptive for the older individual, others, and society, and its severity is likely to intensify as our population ages. This dissertation takes a systems-oriented approach toward the falls problem and is presented in two parts. The first part critically develops a new approach to the problem of falls. The second part describes an empirical study that applies this new approach in a pragmatic manner.

Conventional fall prevention strategies employ a reductionist approach to the problem of falls. This approach is questioned because it corresponds poorly to the holistic nature …

Dna Methylation Signatures Of Chronic Low-Grade Inflammation Are Associated With Complex Diseases, Symen Ligthart, Carola Marzi, Stella Aslibekyan, Michael M. Mendelson, Karen N. Conneely, Toshiko Tanaka, Elena Colicino, Lindsay L. Waite, Roby Joehanes, Weihua Guan, Jennifer A. Brody, Cathy Elks, Riccardo Marioni, Min A. Jhun, Golareh Agha, Jan Bressler, Cavin K. Ward-Caviness, Brian H. Chen, Tianxiao Huan, Kelly Bakulski, Elias L. Salfati, Whi-Empc Investigators, Giovanni Fiorito, Charge Epigenetics Of Coronary Heart Disease, Simone Wahl, Katharina Schramm, Jin Sha, Dena G. Hernandez, Allan C. Just, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for inflammation.

Results: We performed a meta-analysis of epigenome-wide association studies (EWAS) of serum C-reactive protein (CRP), which is a sensitive marker of low-grade inflammation, in a large European population (n = 8863) and trans-ethnic replication in African Americans (n = 4111). We found differential methylation at 218 CpG sites to be associated with CRP (P < 1.15 × 10^–7) in the discovery panel …

Development, Validation And Application Of A New Fornix Template For Studies Of Aging And Preclinical Alzheimer's Disease, Christopher A. Brown, Nathan F. Johnson, Amelia J. Anderson-Mooney, Gregory A. Jicha, Leslie M. Shaw, John Q. Trojanowski, Linda J. Van Eldik, Frederick A. Schmitt, Charles D. Smith, Brian T. Gold

Physical Therapy Faculty Publications

We developed a merged younger-older adult template of the fornix and demonstrated its utility for studies of aging and preclinical Alzheimer's disease (AD). In Experiment 1, probabilistic tractography was used to reconstruct the fornix in younger and older adults and successful streamlines were then averaged to create a merged template in standard space. The new template includes the majority of the fornix from the hippocampal formation to the subcallosal region and the thalamus/hypothalamus. In Experiment 2, the merged template was validated as an appropriate measure for studies of aging, with comparisons against manual tracing measures indicating identical spatial coverage in …

Alzheimer's Biomarkers Are Correlated With Brain Connectivity In Older Adults Differentially During Resting And Task States, Yang Jiang, Haiqing Huang, Erin Abner, Lucas S. Broster, Gregory A. Jicha, Frederick A. Schmitt, Richard Kryscio, Anders H. Andersen, David Powell, Linda J. Van Eldik, Brian T. Gold, Peter T. Nelson, Charles D. Smith, Mingzhou Ding

Behavioral Science Faculty Publications

β-amyloid (Aβ) plaques and tau-related neurodegeneration are pathologic hallmarks of Alzheimer’s disease (AD). The utility of AD biomarkers, including those measured in cerebrospinal fluid (CSF), in predicting future AD risk and cognitive decline is still being refined. Here, we explored potential relationships between functional connectivity (FC) patterns within the default-mode network (DMN), age, CSF biomarkers (Aβ₄₂ and pTau₁₈₁), and cognitive status in older adults. Multiple measures of FC were explored, including a novel time series-based measure [total interdependence (TI)]. In our sample of 27 cognitively normal older adults, no significant associations were found between levels of Aβ …

Factors Associated With Unmet Needs Among African-American Dementia Care Providers, P. J. Desin, Allison M. Caban-Holt, Erin L. Abner, Linda J. Van Eldik, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Racial and ethnic minorities currently comprise 20% of the U.S. population; in 2050, this figure is expected to rise to 42%. As a result, Alzheimer’s disease (AD), the 5th leading cause of death for people aged 65 and older, is likely to increase in these groups. Most dementia caregiving for these populations comes from family and friends, especially among families with lower socioeconomic status. A convenience sample of 30 African-American dementia caregivers was interviewed to determine unmet needs. Participants expressed a limited desire for formal services, such as support groups, legal advice, case management, and homemaker services. Instead, commonly expressed …

Posttraumatic Growth Among Older Adults With Late-Life Cancer Diagnoses, Aasha I. Hoogland

Theses and Dissertations--Gerontology

Gerontological scholarship has often focused on the ways older adults deteriorate or decline with time, but it is plausible that positive change continues into and throughout old age. Late-life psychosocial growth may even be facilitated by a life-altering event such as a cancer diagnosis, a phenomenon broadly termed posttraumatic growth (PTG). PTG has been examined in a variety of general population samples, but there is a noticeable lack of research on PTG that focuses on older adults—a population for whom cancer diagnoses are particularly prevalent. Using a mixed methods design, this dissertation was designed to advance our understanding of PTG …

Chronic Pancreatitis, Pain, And Anxiety In An Alcohol And High Fat Mouse Model, Tiffanie Clinkinbeard

Theses and Dissertations--Gerontology

Homeodynamic space (HDS) shrinks as vulnerability increases with aging and repeated damage to the cells. HDS is lost in alcoholic pancreatitis patients due to overconsumption of alcohol, smoking, and high fat diets. Etiologically relevant animal models for study of chronic pancreatitis (CP) are needed. In order to begin filling this gap a central purpose of this dissertation research was to examine relationships between the alcohol and high fat diet (AHF) and pancreatitis with attention to hypersensitivity and anxiety-like behaviors. The AHF diet induced pancreatitis described here etiologically mimics human risk factors of AHF consumption for advancement to alcoholic CP.

In …

The Influence Of Time On Food Intake Patterns: Age, Period, Cohort Differences, Karina L. Christopher

Theses and Dissertations--Gerontology

The impact of diet and exercise on overall health and chronic disease risk has been well examined. Multiple studies show that Americans eat more now than they did fifty years ago. What isn’t known is how much of an impact time has on food intake patterns of individuals in terms of different age groups, historic periods of structural influences, and birth cohorts.

In order to identify the impact of time on food intake this study examined time from multiple perspectives. The first aim of this study was to determine food intake patterns among age groups across five time periods using …

It Is All About (U)Biquitin: Role Of Altered Ubiquitin-Proteasome System And Uchl1 In Alzheimer Disease, Antonella Tramutola, Fabio Di Domenico, Eugenio Barone, Marzia Perluigi, D. Allan Butterfield

Chemistry Faculty Publications

Free radical-mediated damage to macromolecules and the resulting oxidative modification of different cellular components are a common feature of aging, and this process becomes much more pronounced in age-associated pathologies, including Alzheimer disease (AD). In particular, proteins are particularly sensitive to oxidative stress-induced damage and these irreversible modifications lead to the alteration of protein structure and function. In order to maintain cell homeostasis, these oxidized/damaged proteins have to be removed in order to prevent their toxic accumulation. It is generally accepted that the age-related accumulation of “aberrant” proteins results from both the increased occurrence of damage and the decreased efficiency …