bluuebunny/crossref_metadata_2025 huggingface dataset:
TRANSCENDING ‘INTERDISCIPLINARY PARADOX’: TOWARDS AN AUTONOMOUS BODY OF KNOWLEDGE THROUGH TRANSDISCIPLINARITY
Authors: Chen Shiyu , Zhou Shandong
Published: January 2025

Autonomous body of knowledge (BoK) in gerontology is not only an extrinsic requirement to address the challenges of an aging society, but also an intrinsic need for the discipline to achieve its independency. The establishment of such a BoK requires an introspective reflection. This poster presents a review of the progress on the establishment of gerontology’s autonomous BoK, and explores the evolvement of the discipline following the “multidisciplinary-interdisciplinary-transdisciplinary” continuum. The study finds a ‘interdisciplinary paradox’ in current gerontological BoK, which manifests as: programmatic discourse on interdisciplinarity in gerontology continues to proliferate and disseminate, yet disciplinary and sub-disciplinary differentiation and specialization are ever-increasing. Moreover, there remains structural barriers in academia supporting interdisciplinary research in gerontology. To resolve this paradox and reinforce the establishment of gerontological autonomous BoK, a transdisciplinary research model (ISOE model) consisting of 3 phases could be adopted. The 3 phases in the model are as following: a. Breaking down barriers between organizations, interacting with diverse stakeholders and framing the real-world problem collectedly b. Integrating research methodologies and perspectives, and collaborating on producing solution-orientated knowledge and transferable results; c. Translating and applying research results to real world practice. In conclusion, transdisciplinary method offers a promising pathway to establish an autonomous BoK in gerontology.
TRENDS IN CHRONIC DISEASE SPENDING AND HEALTH OUTCOMES AMONG MEDICARE FFS BENEFICIARIES IN PUERTO RICO
Authors: Campos Matthew , Rivera-Hernandez Maricruz
Published: January 2025

There is growing recognition of disparities in chronic disease outcomes between Puerto Ricans on the island and those on the US mainland, yet comparative data are limited. We assessed the prevalence of key chronic conditions—Alzheimer’s disease and related dementias (ADRD), diabetes, and chronic kidney disease (CKD)—and total care costs for Medicare fee-for-service (FFS) beneficiaries in Puerto Rico (PR) compared to states with high older adult (65+) Puerto Rican populations [Florida (FL), New York (NY), Georgia (GA), New Jersey (NJ), California (CA)] from 2015 – 2020. We used data from the Mapping Medicare Disparities Tool from the Center for Medicare and Medicaid Services. Outcomes of interest included age-adjusted prevalence and risk-adjusted total costs per beneficiary. From 2015 – 2020, age-adjusted prevalence trends in PR showed decreases in ADRD by three percentage points (13% to 10%) and diabetes by six percentage points (46% to 40%). Conversely, CKD prevalence increased by 12 percentage points from 21% to 33%. Despite ADRD trends aligning with national averages, diabetes (PR: 40%, Nation: 26%, FL: 28%, NY: 27%, GA: 29%, NJ: 29%, CA: 24%) and CKD (PR: 33%, Nation: 25%, FL: 29%, NY: 24%, GA: 30%, NJ: 25%, CA: 23%) rates in Puerto Rico remain notably higher. Additionally, PR risk-adjusted average total spending per beneficiary in 2020 was below national averages for all assessed chronic conditions (ADRD: $13,037 vs. $20,678; diabetes: $11,363 vs. $15,525; CKD: $13,181 vs. $18,376). These disparities suggest potential impacts on access and quality of care and highlight the need for policy interventions.
UNDERSTANDING OLDER ADULTS’ INTEREST IN USING VIRTUAL REALITY TO SUPPORT SOCIAL ENGAGEMENT ACTIVITIES
Authors: Mois George , Eraslan Emre , Cheng Qiyuan , Sun Tongxin , Louis-Charles Willencia , Gupta Avinash , Rogers Wendy
Published: January 2025

The experience of loneliness affects one in four adults over age 65. These experiences can have significant impacts on wellbeing and quality of life. Changes associated with aging such as retirement, relocation, loss of friends and family can impact access to social engagement opportunities. Moreover, communities often lack resources required to meet individuals’ social needs. Leveraging immersive information communication technologies such as virtual reality (VR) presents a unique opportunity in bridging the resource gap, enabling individuals to connect with others, meet new people, and engage in diverse virtual activities. However, due to a limited body of research, there is little understanding of the types of VR activities older adults are interested in partaking in with in-network (e.g., family, friends) and out-of-network (e.g., strangers, new acquaintance) individuals. We explored older adults’ interests in using VR to engage with others and the types of activities they might be interested in engaging in. Participants were 21 older adults, aged 61-80 (M=69, SD=5.45). Our mixed methods approached included questionnaires, passive virtual reality demonstrations, and a semi structured interview. The older adults had positive attitudes about the VR and were interested in using it with family and friends. They could also see the potential of using VR to interact with other people with shared interests (e.g., hobbies, traveling). Participants reported interest in a diverse set of VR based activities to engage with others. These findings illustrate the potential of VR for social engagement activities for older adults, accessible from their homes, to reduce loneliness.
UNIVERSITY-CITY PARTNERSHIP TO RECRUIT DIVERSE, LOW-INCOME SENIORS TO ALLEVIATE HEALTH DISPARITIES
Authors: Leinbach Carla , Tice Abigail , Lopez Janet
Published: January 2025

Recruitment challenges are the top cited reason that research studies miss their goals. Recruiting under-represented groups including people of color, those with cognitive or physical challenges, socio-economically marginalized persons, and older persons exacerbates recruitment challenges. We aimed to explore strategies to recruit diverse, low-income, older participants for our NIH-funded clinical trial study and compared recruitment numbers between pre-post recruitment implementations. We collected data from May to August 2024 from Orlando, Florida. Pre-implementation, locations had fewer than 10 participants per site and required 8 to 12 weeks to organize. Our findings indicated four recruitment strategies 1) creating university-city partnerships resulted in 17 new senior programs to recruit from; 2) recruiting untapped places resulted in an uptick in new participants; 3) Multi-lingual marketing increased enrollment inquiries, and 4) Efficiently captured inquiries increased enrollment. Pre-implementation, the study struggled to identify locations with sufficient senior population density, identified limited physical spaces to conduct assessments, struggled to obtain permission to recruit on-site, and faced market rental rates for use of space. Enrollment rates were low due to the facilities’ leadership and potential participants viewed researchers as “vendors”, not trusted partners. Post-implementation, cohorts ranged from 25 – 40+ seniors and required approximately 2 weeks to organize. This partnership expanded the reach of recruitment into historically difficult to access populations and contributed to a net regain of committed completion timelines. Strategic utilization of local city and county government for participant recruitment and facility access can aid research projects in reaching their goals and diversifying the participant pool.
UNMET NEEDS AND HEALTHCARE SERVICE UTILIZATION AMONG OLDER ADULTS: A SYSTEMATIC REVIEW
Authors: Khan Maham , Sands Laura , Comer Cozette , Hoch Jackson
Published: January 2025

Unmet needs refer to the absence of necessary assistance for completing Activities of Daily Living (ADLs), and they are associated with severe health consequences, such as hospitalizations, emergency room visits, nursing home placement, and mortality among older adults. The high cost of unmet needs pose challenges at both individual and systemic levels. While the prior literature has focused on immediate consequences of unmet needs (such as going without bathing or toileting), this systematic review consolidates evidence to assess the impact of unmet needs on healthcare utilization and emphasizes the importance of improving community-based care to mitigate (costly) consequences. A comprehensive search of multiple databases, including Scopus, Web of Science, PubMed, and CINAHL, using appropriate keywords (unmet needs, acute healthcare utilization) identified 6,475 studies. After a rigorous screening process, eight studies met the inclusion criteria for analysis, focusing on non-institutionalized older adults in the U.S. with at least one ADL difficulty. Results show that individuals with unmet needs experience double the hospitalization rates compared to those with met needs. Emergency room visits are also 31% higher, especially among those with unmet self-care needs. From the hospital deaths, 74 % report to have experienced unmet needs at end-of-life. Sociodemographic factors, such as older age, being minority race, living alone, and cognitive impairment further exacerbate the risks acute healthcare utilization. Addressing unmet needs is crucial not only for improving quality of life among older adults but also for alleviating the strain on healthcare resources through targeted policy interventions.
UNTOLD STORIES OF AGING – FOSTERING INTERGENERATIONAL DIALOGUE THROUGH AN ART-BASED COMMUNITY ACTION PROJECT
Authors: Jen Sarah
Published: January 2025

Individuals who can imagine their aging futures are better prepared for the aging process. However, stories of later life often go untold, limiting public understanding of this complex phase of life. The Untold Stories of Aging Project was created to combat societal ageism through encouraging the creation of aging-focused art and intergenerational dialogue. Between 2021 - 2024, we have amassed a digital art exhibition including over 50 pieces of artwork from over 40 artists. Seven individual artists or groups have received awards for their submissions, honoring the evocative impact of their pieces, their connections to aging-related insights, and their creativity and originality. We present findings from interviews with awardees who discussed their artistic process, lessons learned about their own aging futures, and the intergenerational dialogue surrounding their pieces. Artists often cited intergenerational dialogue or the importance of family relationships as the motivation for their pieces. For example, one 26-year-old chose to challenge ageist stereotypes through her art following a conversation with her mother who described being perceived as “incapable” as she aged. Older artists shared how meaningful it was to be recognized as artists, with one 90-year-old stating, “It’s thrilling to know that something we are doing in such a common and ordinary way is impressive to anybody.” Through this project, artists have cultivated space for older adults to share their stories and legacies, illustrating how art and surrounding dialogue can combat societal ageism, foster intergenerational healing, and inspire audiences to consider and plan for their own aging futures.
WHAT ARE FAMILY CAREGIVERS NOT PREPARED FOR?
Authors: Singh Roshni , Lamba Saanvi , Munoz Richard , Tyagi Pranjal , Garcia-Davis Sandra , Dang Stuti , Ruiz Diana ,   VA Elizabeth Dole Center of Excellence
Published: January 2025

Informal family caregivers of patients have a myriad of non-medical needs that are burdensome to caregivers and critical for disease management. Yet, caregivers are often not adequately prepared to address the needs of their Veterans. This study aimed to identify what caregivers feel unprepared for. We used round one data from the HERO CARE Survey. Here, we describe the preparedness of caregivers of Veterans, who responded to the following open-ended question: Out of all the tasks that you help the Veteran with, Is there anything specific you would like to be better prepared for? Qualitative responses to the open-ended question were coded and analyzed thematically. We received responses from 690 caregivers, 68.2 (SD: 12.2) years-old on average, 601 (87.1%) female, 70.7% non-Hispanic White, 62.0% spousal caregivers, 83.8% primary caregivers and 46.8% had provided care for >5 years. Twenty-one (3.0%) felt not prepared, 345 (50.0%) somewhat prepared, and 342 (49.6%) very prepared. Caregivers most important concerns reported were dealing with changes related to declining health (20.4%), equipment/home modifications (10.6%), dealing with memory loss (9.6%), advocating for services (8.8%), preparing for the future (7.8%), managing finances/legal matters (7.1%), mobility/falls/transfers (7.0%), respite/HHA (6.8%), handle emergencies (5.2%), and financial assistance (4.3%). Caregivers will be able to better meet the needs of patients if they are more prepared with the knowledge and skills to do their caregiving tasks. Developing ways to provide support, education, training, and resources will be pivotal in improving outcomes for veterans and their caregivers.
WHAT KIND OF HEALTH SCREENING IS USEFUL FOR PERSONS AGING WITH HIV?
Authors: Ramos Manuel , Brage Shelby , Nouryan Christian , Hirsch Bruce , McGowan Joseph , Mattam Ashwin , Burns Edith
Published: January 2025

Background

In the United States, 54% of people aging with HIV (PAWH) are age >/= 50 and 89.7% are virally suppressed. HIV is linked to increased risk of developing comorbidities and may accelerate aging. This population may not receive adequate screening for changes related to advancing age. We describe initial findings of a “Maturity Screen” for PAWH.

Methods

Setting and population. Convenience sample of PAWH aged 50 years or older receiving care at an HIV specialty clinic in a major metropolitan area. Patients completed a series of measures administered by trained care team members. Measures. sociodemographic (e.g., age, sex), comorbid conditions. Maturity Screen: MoCA, PHQ2, ADL, IADL, GAD2, gait speed and Edmonton Frail Scale.

Results

82 participants were screened to-date; 41 males, 36 females, 4 unknown. Mean age 63 (SD: 7.6 yrs.); mean # comorbid conditions 1.8 (SD: 1.3, range 0-5); top four comorbidities were hyperlipidemia (56%), hypertension (43%), diabetes (11%), and CKD (11%). Mean MoCA 24.9 (SD: 3.7, range 15-30); mean PHQ2 0.6 (SD: 1.2); ADL 5.9 (SD: 0.5); IADL 7.8 (SD: 0.8, max score 9).

Conclusion

In this sample of PAWH maturity screening suggests healthier group than anticipated and low levels of depression. Borderline mean cognitive screen suggests need to monitor for emerging issues likely to impact quality of life. Examining social support in the context of PAWH and potential cognitive decline may identify those with increased future healthcare needs and poor outcomes. Gait speed and frailty measures are currently being analyzed and may identify additional functional needs.
CLINICAL EFFICACY OF A DIGITAL COGNITIVE ASSESSMENTS IN DETECTING COGNITIVE IMPAIRMENTS: A POOLED ANALYSIS
Authors: Huynh Duong , Patterson Mary , Huang Bin
Published: January 2025

Dementia has become a public health concern worldwide with significant social and economic impacts. Early detection of dementia, which involves diagnosis of mild cognitive impairment (MCI), a possible prestage of dementia, is crucial for timely interventions, care planning, and reducing healthcare costs. To promote proactive screening, it is important to equip primary care providers with assessment tools that are not only validated and reliable but also easy-to-administer and seamlessly integrated into their routine workflows. BrainCheck’s cognitive assessment tool (BC-Assess), with its demonstrated high diagnostic efficacy, usability, and feasibility of implementation, offers a promising solution. This study aimed to re-evaluate the efficacy of BC-Assess in identifying MCI and dementia based on a pooled dataset. The dataset included BC-Assess data of 193 individuals (age mean=73.7; SD=11.2), comprising those with normal cognition (NC; N=48) and those diagnosed with MCI (N=53) or dementia (N=92), acquired from two previous studies and from BrainCheck’s clinical partners. Each individual’s cognitive status was determined based on results from provider clinical diagnoses (N=158; 82%) or from the Montreal Cognitive Assessment (N=35; 18%). Significant differences in BC-Assess overall scores were found between the three groups (p<.001). ROC analysis shows that BC-Assess can achieve high sensitivity (>=85%) and specificity (>=81%) in distinguishing MCI and dementia patients from those with normal cognition, comparable with performance level obtained previously from a single data source. These results demonstrate the ability of BC-Assess to hold its diagnostic efficacy over combined data collected from different settings.
CLINICAL TRIALS USING MUSIC IN DIVERSE COMMUNITIES OF OLDER ADULTS
Authors: Rose Tara
Published: January 2025

Music is being integrated into health care services and nonpharmacological treatment options as part of physical health and well-being programs for older adults. When health care professionals and older adult providers try to locate successful programs to initiate, they look to clinicaltrials.gov as a resource to find the most rigorous and robust programs implemented. In large US cities, such as Los Angeles, where there are multiple ethnic populations with specific cultural music interests, it is important to have knowledge of culturally specific interventions in order to create evidence-based programs for multiple community members. The purpose of this review is to analyze music programs and interventions for African American, Asian American, and Latino/Hispanic older adults to better understand emerging best practices. A search of all trials registered in the clinicaltrials.gov was conducted using key words describing these ethnic populations and also the word “music.” Of the 146 studies generated, 15 met the eligibility criteria, with all studies enrolling older adults along with other age groups. Studies were conducted across four regions of the US, 53% in Northeast, 20% South, 13% Midwest, and 13% West. Music interventions for specific medical conditions (20% dementia and 27% other diseases) and mental health/well-being (53%) were the primary foci in studies. Data on intervention types, demographics, and methodology will be presented. Results to date suggest that more research is needed on best practices in music interventions for specific cultural groups and that new approaches would benefit cities and communities, especially in areas with diverse multicultural populations.
COMPARING STROKE MORTALITY TRENDS IN RURAL AND URBAN AREAS DURING AND BEFORE THE COVID-19 PANDEMIC
Authors: Lin Vivian , DiVall Sasha , Cheng Mengyuan , Ferdows Nasim
Published: January 2025

COVID-19 has undeniably disrupted healthcare services, with many individuals advised to avoid hospital visits unless necessary. However, timely treatment following a stroke is critical to minimize damage or fatality, raising concerns about how these disruptions may have affected stroke outcomes. This study explores the association between COVID-19 and stroke mortality rates across different ruralities across a three-year period (2018-2020). Using data from the CDC WONDER database and County Health Rankings, we examined stroke mortality trends, adjusting for county-level characteristics. The study classified rurality using Rural-Urban Commuting Area codes from the Economic Research Service into three categories: urban, rural-adjacent to an urban area, and rural non-adjacent to an urban area, given the generally lower access to medical care in rural settings. Our analysis, which utilized data up to 2020—covering less than a full year of the COVID-19 pandemic—found no significant differences in stroke mortality rates across the different rurality levels. However, it is important to note that the limited data from the early stages of the pandemic may not fully capture the potential impact of COVID-19 on stroke mortality. As more recent data from 2021-2022 become available, we anticipate that a more comprehensive analysis could reveal different trends, particularly as the effects of prolonged lockdowns and healthcare disruptions become more evident. This research aims to provide a clearer understanding of stroke mortality trends during the pandemic, offering insights that may guide healthcare practices and policy decisions to ensure that all populations, especially those in rural areas, have access to necessary care.
CULTURAL AND PSYCHOMETRIC VALIDATION FOR COGNITIVE ASSESSMENT OF OLDER ADULTS
Authors: Bárbara Rita , Gonçalves Rui , Lopes Mario
Published: January 2025

Introduction

Cognitive assessment is vital for the early detection and management of cognitive disorders in older adults. Instruments developed in one cultural context may not be applicable to other populations without proper adaptation. This study aims to culturally adapt the cognitive domain of the Older Americans Resources and Services (OARS) instrument for use with Angolan elderly, ensuring it accurately captures the cultural and specific needs of this group. Objective: The primary goal is to validate the cognitive domain of the OARS for its cultural relevance and clinical reliability in Angola. This involves modifying the instrument to better suit the Angolan cultural context.

Methods

The study included 127 Angolan older adults. An initial factor analysis identified items misaligned with the local cultural context. These items were revised and adapted. A follow-up factor analysis evaluated the coherence of the revised instrument. Reliability was measured using Cronbach’s alpha.

Results

The initial analysis revealed several problematic items, which were modified for improved cultural fit. The revised factor analysis demonstrated a more coherent structure, with Cronbach’s alpha rising to 0.82, indicating good internal consistency among the updated items.

Discussion

Culturally adapting the OARS was crucial for improving its sensitivity to Angolan older adults’ needs, leading to a more accurate and equitable cognitive assessment.

Conclusion

The adaptation and psychometric validation of the OARS have produced a more suitable tool for cognitive assessment in Angola, highlighting the importance of considering cultural factors in instrument development. Keywords: Cognitive assessment, cultural adaptation, elderly.
DELIRIUM AND CARDIOVASCULAR DISEASE IN OLDER ADULTS WITH COVID-19
Authors: Park Esther , Petrovic Milenko , Azhar Gohar
Published: January 2025

SARS-COV-2 is often associated with cardiovascular diseases such as arrhythmias and congestive cardiac failure (CHF), and cardiovascular disease is itself linked with the development of delirium. In this retrospective study we explored the relationship between heart disease and acute delirium in 319 COVID-19 patients 65 and older, seen at the University of Arkansas for Medical Sciences from January 7, 2018 to January 5, 2021. We reveiwed the frequency of cardiac conditions (atrial fibrillation, atrial flutter, tachycardia, bradycardia, CHF, CAD, other) in this cohort with emphasis on timing before and concurrent with COVID-19 delirium. We found a strong association of acute delirium during COVID-19 infection in patients with cardiac disease as compared to patients without cardiac disease (p< 0.00001). 128/319 (40.1%) COVID-19 patients suffered from delirium during or after COVID-19, and 88 of these patients had cardiac disease. 121/319 (37.9%) COVID-19 patients had no other cardiac conditions excluding essential hypertension. The majority (83/121, 68.6%) of those with no cardiac conditions listed in EMR also had no delirium documented during or after infection. Patients with cardiac conditions had a risk ratio of 1.38 of developing delirium during or after COVID-19 infection compared to patients without COVID-19. In conclusion, having a preexisting cardiac condition increases the likelihood of delirium in older adults with COVID-19 infection. Improved treatment strategies that optimize cardiovascular care during COVID-19 will also benefit cognition and enhance outcomes in older adults. A better understanding of these complex interactions should improve treatment of delirium in older adults with SARS-COV-2.
DEVELOPMENT AND ASSESSMENT OF THE PERFORMANCE OF A LARGE LANGUAGE MODEL FOR ADMINISTERING THE SHORT BLESSED TEST
Authors: Jaman Rafeeul , Nessen Sarah , Adjei-Poku Michael , Byerley Joella , Sailors Olivia , Karlawish Jason , O’Brien Kyra , Friedman Ari
Published: January 2025

Universal health system-based screening for mild cognitive impairment (MCI) or impairment consistent with dementia can modify care and increase access to disease-modifying therapies and memory centers, potentially reducing disparities. Constraints on nurse and clinician time have hindered existing efforts. Large language models (LLMs) present a potential solution. However, they are subject to confabulation and poor arithmetic accuracy, and were not trained on data containing definitive assessments of cognitive impairment. We hypothesized that using an LLM to administer the Short Blessed Test (SBT) and calculating test scores from item scores would mitigate these errors. We conducted prompt engineering on OpenAI GPT4o to construct an interactive tool. A team member then simulated being patients with different levels of cognitive impairment across an orthogonal matrix spanning the 6 SBT item scores, answering each question to achieve the intended item score. We summed the LLM-reported item scores to the total score that should have been obtained based on the input answers. We evaluated 57 sets of item scores with total scores of 2-26. Of these, 54.7% had an LLM score equal to the true score. All errors except 2 were within 3 points of the true score. Using a cutoff of >=5 points for mild cognitive impairment, specificity was 100.0%, and negative predictive value was 50%. LLMs may play a role in reducing nurse and clinician screening burden in hospital settings, where the benefit of being able to conduct screening at all outweighs the possibility of missed diagnoses, but requires human confirmation.
DOCUMENTING REPORTS OF SUSPECTED ABUSE AND NEGLECT: THE EVALUATION OF A STANDARDIZED PATIENT NOTE
Authors: Webster Amy , Webb Sara , Sperber Nina , Decosimo Kasey , Halaszynski Jaime , Koget Jennifer , Silva Jennifer , Makaroun Lena
Published: January 2025

Elder abuse (EA) impacts 10% of older adults in the U.S. annually with devastating health consequences, yet few healthcare systems systematically document reports of EA in the electronic health record (EHR). We present acceptability and usability findings from the first of a two-phase Veterans Health Administration (VHA) quality improvement pilot of a standardized note template developed by the National Social Work Program for documenting reports of suspected abuse/neglect in the EHR. In spring 2024, we conducted a usability evaluation through semi-structured interviews with 22 staff from 3 sites including the following roles: 19 social workers, 1 nurse, 1 physical therapist, and 1 mental health case manager. Overall, participants found the note easy to access and use describing it as “really straightforward”, “simple”, and “self-explanatory.” Participants reported the standardized note made it easier to identify that a report was made and facilitated follow-up care for patients who needed it. Half of participants completed the note in ≤5 minutes. Staff in one location said that the template streamlined the reporting process, making it “quicker and easier.” Several staff suggested improving procedures to ensure patient privacy and safety when documenting. Modifications based on findings were incorporated to improve usability. Following the second phase of the pilot with 5 additional sites (ongoing), the refined note template will be disseminated for national use in VHA, creating opportunities for real-time monitoring of EA at a population level. Lessons learned from this initiative could inform other healthcare systems interested in systematizing clinical documentation for abuse/neglect reports.
DUAL SENSORY IMPAIRMENT AND PHYSICAL FUNCTION AMONG MEXICAN AMERICAN OLDER ADULTS
Authors: Bendapudi Arati , Snih Soham Al
Published: January 2025

The study objective was to examine the relationship between hearing impairment (HI) and vision impairment (VI) on physical function over 12-years of follow-up among Mexican Americans aged 75 years and older. Participants (N=662) were from the Hispanic Established Population for the Epidemiological Study of the Elderly who scored 7 or more on the Short Physical Performance Battery (SPPB) at baseline. Measures included socio-demographics, medical conditions, pain, depressive symptoms, falls, cognitive function, disability, and handgrip strength. Dual Sensory Impairment (DSI) was defined as the presence of sensory and visual impairment. Physical function impairment (PFI) was defined as having a score of less than 7 on the SPPB. Participants were grouped into four groups: No HI - No VI (n=503), HI only (n=70), VI only (n=32), and VI-HI (n=17). Generalized Estimating Equation models estimated the odds ratio (OR) and 95% Confidence Interval (CI) of PFI as a function of DSI over time after controlling for all covariates. Participants with HI only, and those with DSI had greater odds (OR=1.64, 95% CI=1.17-2.31, p-value=0.0043 and OR=2.35, 95% CI=1.38-4.83, p-value=0.0209, respectively) of developing PFI over time compared to those without DSI after controlling for all covariates. No significant association was found between those with VI only and PFI. In conclusion, Mexican American older adults with DSI were at higher risk of developing PFI over time. These findings highlight the importance of culturally informed clinical practices that address DSI in an underserved population with language barriers and limited access to health care.
DYNAMIC STANDING BALANCE AND MOBILITY IMPROVES WITHIN SIX MONTHS OF EXERCISE PARTICIPATION IN OLDER VETERANS
Authors: Dondero Kathleen , Giffuni Jamie , Kelly Megan , Addison Odessa
Published: January 2025

Older veterans are particularly vulnerable to declines in balance and mobility. Gerofit is a nationwide clinical exercise program aimed at improving physical function. However, it is unclear if Gerofit has an impact on balance, particularly in those that are already at high risk for falls. The Four-Square Step Test (FSST) is a valid and reliable measure of dynamic balance where completion times >12 seconds indicates a high risk for falls. The FSST was assessed at baseline, 6-months, and 1-year in 140 older Veterans who participated in the Gerofit exercise program. This sample included 88 “low fall risk” veterans (FSST < 12 seconds; age 71 ± 5.8 yrs; SPPB Score 11.08 ± 1.4; gait speed 1.2 ± 0.22 m/s) and 52 “high fall risk” veterans (FSST > 12 seconds; age 74 ± 8.1 yrs; SPPB Score 8.65 ± 2.2; gait speed 0.95 ±0.24 m/s). On average, FSST times improved ~13% from baseline (13.31 ± 7.6 seconds) to 6-months (11.55 ± 7.1seconds; P< 0.001) and was retained through 1 year of exercise participation (11.54 ± 7.1 seconds; P=1.0). Importantly, high fall risk veterans showed clinically meaningful improvements in FSST times from baseline (19.1 ± 1.4) to 6 months (15.2 ± 1.4; P=.001) in the program and maintained these improvements through 1-year (15.8 ± 1.4; P=1.0). Veterans, regardless of fall risk, can experience improvements in balance and mobility within 6 months of regular exercise participation and retain these improvements with continued exercise participation.
EARLY DETECTION: A COMPREHENSIVE COGNITIVE SCREENING TOOL FOR ADRD THROUGH INNOVATIVE MOBILE APP TECHNOLOGY
Authors: Smith Lenora , O’Brien Charles
Published: January 2025

Currently, there are no curative treatments for Alzheimer’s Disease; it is imperative to detect cognitive decline early to provide lifestyle factors that may play a protective role in older individuals, delaying the progression of mild cognitive impairment (MCI). Neurospective is a mobile application platform being designed to facilitate the early detection of cognitive decline, including MCI and pre-clinical Alzheimer’s disease and related dementias (ADRD). It will utilize a unique combination of engaging cognitive assessment games, diverse user data collection, and machine learning to establish a robust and accessible screening tool. The app is being built around cognitive assessments from a suite of mini-games. The activities are inspired by established screening tests, like 3MS, MoCA, and SLUMS, to assess language, problem-solving, reasoning, memory, and motor function. This innovative app will be easily accessible for screening MCI and assess outcomes based on an evolving machine learning algorithm. The continuously evolving models, based on user data, will lead to increasingly accurate predictions of cognitive health and potential ADRD risk. This app will initially establish a relative measure of cognitive health within the population, eventually progressing into a reliable screening tool for early detection of MCI. Neurospective presents a unique and promising approach to early detection of MCI through its accessible mobile app format, comprehensive data collection, and evolving machine learning models. This project has the potential to significantly improve our understanding of cognitive health and contribute to earlier intervention for individuals at risk of ADRD.
EFFECTIVENESS OF A WEB-BASED INTERVENTION FOR LEWY BODY DEMENTIA CAREGIVERS: IMPACT BY DEPRESSION STATUS
Authors: Su Yan , Chen Annie T , Zaslavsky Oleg
Published: January 2025

Lewy Body Dementia (LBD) affects 1.4 million Americans, with 80% of care provided by family members who often face significant mental health challenges. Few digital interventions are tailored specifically for LBD or offer a fully remote, asynchronous format. This pilot study evaluated the effectiveness of an 8-week web-based intervention among 39 LBD caregivers, comparing its impact on those with and without depression. The intervention included online discussions on caregiving and problem-solving skills, moderated by a trained facilitator, with participants required to post at least twice weekly. Measurements were taken at baseline, post-intervention, and one month later. Of the 39 caregivers, 21 were classified as having depression, and 18 as without depression. Among those with depression, the intervention significantly reduced depressive scores from baseline to post-intervention (𝑑 = −1.35, 95% CI: −3.36, −0.61) and to follow-up (𝑑 = −2.01, 95% CI: −3.36, −1.25). Reductions in burden (𝑑 = −0.47, 95% CI: −1.04, −0.02) and perceived stress (𝑑 = −1.12, 95% CI: −2.05, −0.54) were also observed, with sustained stress reduction at follow-up (𝑑 = −1.33, 95% CI: −3.17, −0.36). Improvements in self-efficacy (𝑑 = 0.48, 95% CI: 0.00, 1.32) and social support (𝑑 = 0.71, 95% CI: 0.08, 1.38) were noted from baseline to follow-up. In contrast, caregivers without depression showed no significant improvements in these areas, except for a modest increase in social support at follow-up (𝑑 = 0.33, 95% CI: 0.10, 0.57). This study highlights the potential of the intervention to effectively support LBD caregivers, particularly those with depression.
EFFECTIVENESS OF INTERVENTIONS FOR CHRONIC DISEASE MANAGEMENT AMONG OLDER ADULTS IN THAILAND: A META-ANALYSIS
Authors: Piaseu Noppawan , Whaikid Phatcharaphon
Published: January 2025

This study aims to assess effectiveness of interventions in managing chronic diseases in older Thais. We searched PubMed, Embase, Scopus, and Thai-Journal Citation Index Centre databases. This systematic review included articles published between 2018 and 2023, focusing on randomized controlled trials or quasi-experimental designs. Research quality was assessed using JBI critical appraisal tools. Meta-analysis employed JBI-SUMARI software. The protocol was registered on PROSPERO under identification code CRD42023475031. Thirty-seven articles met inclusion criteria, showing a significant effect favoring interventions. Systolic blood pressure (SBP) decreased by -12.27 mmHg (MD), 95% CI: -16.06, -8.47), and diastolic blood pressure (DBP) by -7.53 mmHg (95% CI: -9.72, -5.34). Subgroup analyses indicated a significant decrease in SBP due to self-management (MD -16.79 mmHg, 95% CI: -25.21, -8.38), lifestyle modification (MD -16.40 mmHg, 95% CI: -22.24, -10.56), physical and exercise (MD -8.77 mmHg, 95% CI: -13.02, -4.51), and application use (MD -3.49 mmHg, 95% CI: -5.73, -1.25). DBP decreased with self-management (MD -9.34 mmHg, 95% CI: -10.95, -7.72), lifestyle modification (MD -9.88 mmHg, 95% CI: -15.29, -4.47), physical and exercise (MD -4.65 mmHg, 95% CI: -6.51, -2.78), and application use (MD -4.09 mmHg, 95% CI: -5.92, -2.25). T2DM management decreased fasting blood sugar (SMD -0.78, 95% CI: -1.27, -0.311) and HbA1c (SMD -0.56, 95% CI: -0.81, -0.311). Lifestyle modification (SMD -0.70, 95% CI: -1.17, -0.24) and physical and exercise (SMD -0.46, 95% CI: -0.80, -0.13) decreased HbA1c. Self-management is effective in reducing BP in older Thais with hypertension, while lifestyle modification proves optimal for those with T2DM.
EFFECTS OF AN IMMERSIVE VIRTUAL REALITY TAI CHI INTERVENTION ON THE MENTAL HEALTH OF OLDER ADULTS
Authors: Kim Jaehyun , Lobos Marcos Ardon , Park Serim , Kim Richard , Seo Jinsil , Kim Junhyoung
Published: January 2025

A significant proportion of the older population (approximately 1 in 5) suffers from diagnosed and sub-clinical mental health conditions. However, evidence indicates that older adults are less likely to seek mental health services than younger adults, primarily due to stigma and limited mental health literacy. As researchers have highlighted the urgent need for innovative solutions in geriatric mental health care, we explored the effectiveness of the use of an immersive virtual reality Tai Chi intervention (IVTC) as a potential solution. Eighteen older adults from senior centers in North Carolina, United States participated in eight 15-minute IVTC sessions over a month and completed surveys at the start (T1) and end (T2) of the program. Analysis using two-tailed paired t-tests revealed significant reductions in depressive symptoms following participation in the IVTC (t(17) = 4.594; p <.001; SE =.12), with a large effect size (d = 1.10). Additionally, perceived stress levels were significantly decreased after participation (t(17) = 2.541; p <.001; SE =.09), showing a moderate effect size (d =.60). Participants also reported high usability scores, indicating a favorable response to use of the IVTC program. These findings suggest that the IVTC program effectively reduces the stress and depressive symptoms of older adults, highlighting its potential as an innovative, technology-based intervention for those at higher risk of developing mental disorders. Study findings also provide important implications for future research and emphasize the need for further exploration of IVTC as a promising approach to geriatric mental health care.
EFFECTS OF IZUMIOTSU CITY’S COGNITIVE DECLINE PREVENTION DANCE AS A STRUCTURED ACTIVITY IN ADULT DAY SERVICES
Authors: Miyazaki Atsuko , Ueki Kaori , Hiyama Atsushi
Published: January 2025

This study examined the effects of an innovative cognitive decline prevention dance program in adult day services. Developed through a community co-creation living lab in Izumiotsu City, Japan, this Hip-Hop-inspired dance is specifically designed for individuals with mild cognitive impairment (MCI), who often struggle with imitation tasks. The program replaced 40 minutes of a 2-hour high-intensity circuit training session in day services. Twenty-six day service users (3 males, 23 females; mean age 82.62 years, SD=4.09) participated in a 4-month intervention study, divided into a dance group (n=14) and a fitness group (n=12, continuing full circuit training). Results showed significant improvements in the dance group compared to the fitness group in cognitive function tasks, including arithmetic operations (F(1,21) = 5.65, p = 0.018, η2 = 0.205) and spatial memory accuracy (F(1,21) = 4.23, p = 0.036, η2 = 0.168). Postural assessments revealed significant improvements in the dance group, including increased shoulder height symmetry (F(1,21) = 3.53, p = 0.046, η2 = 0.143) and reduced left knee hyperflexion in standing position (F(1,21) = 19.19, p = 0.001, η2 = 0.477), indicating better postural alignment. This dance program is a product of industry-academia-government-civil collaboration, combining university research, municipal policy-making, corporate development, and citizen participation. As a result of this collaborative approach, an effective program tailored to the needs of older adults was created. The significant improvements observed suggest that innovating structured activities in adult day services, through such collaborative efforts, offers a promising approach to addressing health challenges in super-aged societies.
ENHANCING VISUOMOTOR INTEGRATION IN OLDER ADULTS: INSIGHTS FROM A MULTI-FACETED TRAINING PROTOCOL
Authors: Ofori Edward , Foster Justin
Published: January 2025

This investigation rigorously assessed the impact of an 8-week training regimen on visual-motor integration and balance in older adults, particularly focusing on individuals diagnosed with Parkinson’s Disease (PD). Seven participants over the age of 50 years (mean age: 62.4 ± 8.6 years for Control, 73.0 ± 5.7 years for PD) underwent pre- and post-intervention evaluations using the Senaptec Sensory Station and Sway Medical systems. The assessments targeted Eye-Hand Coordination (EHC), Multiple Object Tracking (MOT), and balance metrics. Participants engaged in weekly in-person training sessions and bi-weekly at-home exercises designed to enhance dynamic balance, visual-motor integration, and cognitive function. Each at-home session included activation (saccades, brisk walk, dynamic balance), dynamic vision (customized Senaptec app exercises), and a final phase tailored to individual needs, focusing on either eye-hand coordination or parasympathetic nervous system (PNS) activation. Results indicated no statistically significant improvements in balance assessments (p>0.10); however, significant improvements were observed in Central EHC within the PD group (t = 14.35, p = 0.04), with combined analysis across groups also showing significance (t = 2.73, p = 0.03). For peripheral EHC, the Control group exhibited significant task time improvements (t = 3.61, p = 0.02), with combined group analysis confirming significance (t = 3.14, p = 0.02). MOT scores showed the Control group outperforming the PD group (p < 0.02, 1712±605°/s vs 893±220°/s). The findings suggest that targeted visual-motor training can mitigate cognitive and motor declines in aging and neurodegenerative conditions, warranting further large-scale studies.
EVALUATING FRAILTY INDEX INTEGRITY: INSIGHTS FROM AN INTERNATIONAL NETWORK STUDY
Authors: Cavanaugh Robert , Yanover Chen , Wong Chelsea , El-Hay Tal , Orkaby Ariela , Bivas-Benita Maytal , Akiva Pinchas , Olivieri-Mui Brianne
Published: January 2025

Deficit-accumulation Frailty indices (FIs) are a key tool in population-level translational geroscience approaches to understanding function, health, and aging. International applications of Fis have been enabled by the uptake of common data models (CDMs) but the validity of such applications is not guaranteed. We compared frailty prevalence using two validated electronic health record based FIs - the United States (US)-based Veterans Affairs FI (VAFI) and United Kingdom (UK)-based electronic FI (eFI) across 5 Observational Medical Outcomes Partnership CDM databases. Frailty was calculated by age for patient-records 40+ years old with 1+ years of data in the 1) US All of Us database (n=211,568), 2) US IQVIA Pharmetrics+ (n=5,292,854), 3) UK IMRD-THIN (n=3,080,557), 4) UK IMRD-EMIS (n=843,928), 5) UK BioBank (n=209,566). Code and results are available in an open-source R package and interactive website. The VAFI identified higher prevalence of frailty in US databases (All of US: VAFI 10.3% v eFI 2.5%, Pharmetrics+: 9.6% v 2%) while the eFI identified higher prevalence in UK databases (IMRD-THIN: < 0.003% v 0.08%, IMRD-EMIS: 0.09% v 0.4%, UK BioBank: 0.03% v 0.1%). eFI prevalence was lower than previously reported (2.2% v 15-20%, >65 years old; Clegg et al., 2016). FIs appear to be dependent on their development context, limiting external validity for international network studies. FIs must be vetted for consistency and validity when used across CDM sources if they are to contribute to the study of health and aging at scale. Future work will extend this comparison to additional international data sources.
EXPLORING DIET’S IMPACT ON CARDIOMETABOLIC AND COGNITIVE HEALTH IN AMERICAN INDIANS
Authors: Chanti-Ketterl Marianne , Jones-Locklear Jennifer , Brooks Jada , Williams Cierra , Locklear Jessica , Strickland-Yanick Leslie , Whitson Heather
Published: January 2025

Objective

This study explores the link between cardiometabolic biomarkers and neurocognition in older American Indians, focusing on diet quality as measured by the Healthy Eating Index (HEI).

Methods

Participants provided biological specimens and completed health, diet, and exposome questionnaires in a mobile clinic. Cardiometabolic biomarkers (lipids, glucose) were measured with a Cholestech LDX Analyzer and log-transformed. Neurocognition was assessed using the Montreal Cognitive Assessment (MoCA). OLS regressions, adjusted for age and education, examined the association between biomarkers and neurocognition across HEI tertiles to assess effect modification.

Results

Across three months, we enrolled 41 participants, predominantly women (76%), with a mean age of 72 years (SD 7.8) and an average of 12.6 years of education (SD 3.2). HDL-Cholesterol levels were higher in women than in men (n=39, p=0.008). The mean HEI score was 64.3(SD 11.4), with varied diet quality among participants; lowest HEI tertile (44.2-58.1), highest HEI tertile (71.4-84). In the lowest HEI-tertile, higher MoCA scores were associated with higher LDL-C, lower triglycerides, and higher glucose. In contrast, the mid-HEI-tertile showed higher MoCA scores associated with lower TC and lower glucose, but higher LDL-C and triglycerides. For the highest HEI-tertile, higher MoCA scores were associated only with lower triglycerides.

Discussion

These preliminary findings suggest the relationship between cardiometabolic markers and cognitive function may depend on diet quality. Understanding the role of nutrition on brain and cardiometabolic health among older American Indians may lead to culturally tailored nutritional interventions to promote brain health in aging. Further analysis of specific nutrients, the microbiome, and the metabolome are forthcoming.