bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECTS OF A GAIT TRAINING PROGRAM USING A WALKING-ASSIST WEARABLE ROBOT ON COMMUNITY-DWELLING OLDER ADULTS
Authors: Hwang Sinwoo , Cho Eunhee
Published: January 2025

Two-thirds of people aged 65 and older require help with daily activities such as eating, bathing, and getting in and out of bed or a chair. Walking-assist wearable robots have shown significant improvements in physical function in controlled settings for patients. In this study, we aimed to determine the feasibility and evaluate the effectiveness of a gait assistance and gait resistance training program using a walking-assist wearable robot for community-dwelling older adults. A total of 23 community-dwelling older adults aged 65 and older (30 participants recruited, 7 dropped out) enrolled in a 12-session, 6-week gait assistance and gait resistance training program using a walking-assist wearable robot. A single-group, pre- and post-test design was employed to evaluate effectiveness. Paired t-tests and linear mixed model analysis reveal that the functional performance (assessed using the 10-Meter Walk Test, Timed Up-and-Go, and Four Square Step Test) and leg muscle strength of the participants improved significantly at the end of the program compared to the baseline values (P < 0.01). This study stands out for applying gait assistance and resistance training across various terrains, unlike previous studies that only tested gait assistance in controlled environments. The results demonstrated significant improvements in functional performance and muscle strength in older adults, suggesting the effectiveness of preventive healthcare services utilizing a walking-assist wearable robot as an intervention that can contribute to improving independent functioning and frailty among community-dwelling older adults.
EXPLORING BED SENSOR SLEEP TECH: INSIGHTS FROM INTERDISCIPLINARY TEAM IN A GERIATRIC ASSESSMENT INPATIENT SETTING
Authors: Acosta Cromwell , Zhao Yong , Lawrence Joanna , Towell Michelle , MacKay-Dunn Marion , D’Oyley Heather , Chow Bryan , Hung Lillian
Published: January 2025

Poor sleep can affect cognitive function and decrease overall quality of life. Evaluating sleep is critical in the care of hospitalized older adults. This study compared the use of traditional paper-based logs charted by nurses to record sleep patterns with smart sensors offering continuous monitoring and analysis of sleep patterns. The goal was to investigate the perspectives of staff members in an interdisciplinary team on sleep monitoring methods. We also asked participants about barriers and facilitators in implementing bed sensor technology in an Inpatient setting. Employing Interpretive Descriptive methodology, we conducted interviews and focus groups involving 29 staff members with diverse roles in one inpatient setting. The Consolidated Framework for Implementation Research (CFIR) guided our data analysis. Our findings indicate that while the traditional paper-based method, somnolog, is prone to inaccuracies from subjective estimates and sleep disturbances, bed sensor sleep technology is perceived as efficient, data-driven, and evidence-supported. Barriers to technology adoption include resistance to change, consent issues, patient comfort and safety concerns, and familiarity with the technology. On the other hand, facilitating factors comprise orientation and training, trial integration, effective communication, and evidence-based incentives. Utilizing the CFIR framework provides valuable insights into the challenges and aids in incorporating technology into care settings. Future research should focus on practical strategies involving interdisciplinary teams to facilitate innovative practices.
FACTORS ASSOCIATED WITH PERCEPTION OF PATIENT-GENERATED HEALTH DATA AMONG OLDER PATIENTS POST LUNG CANCER SURGERY
Authors: Choi Mona , Cho Hyeonmi , Kim Yesol , Kim Yeonju
Published: January 2025

This study examines factors related to the perceived usefulness of patient-generated health data (PGHD) among older patients who underwent lung cancer surgery. This descriptive cross-sectional study involved individuals aged ≥65 years who had lung cancer surgery at least 4 weeks prior. Participants were recruited from an outpatient clinic, and survey data from 102 patients were analyzed. Thirty-seven PGHD items were categorized into 7 groups: Environmental Factors (EF), Lifestyle Factors (LF), Body Composition and Activity Level (BCAL), Medication-related Factors (MF), Physiological Parameters (PP), Physical and Mental Well-being Factors (PMWF), and Digital Engagement (DE). Stepwise linear regression models were used to identify factors associated with patients’ perceptions of PGHD. Higher digital literacy was associated with greater perceived usefulness in EF and DE categories. Older individuals perceived PGHD in LF and BDAL categories as less useful. Unemployed individuals found PGHD less useful in LF compared to employed individuals. Higher household income was associated with greater perceived usefulness in PMWF category. Non-smartphone users perceived PGHD as less useful in BCAL and PP categories. Patients who underwent surgery more than 5 years ago found PGHD less useful in MF and PP categories than those with more recent surgeries. Individuals with lower education levels and those living alone showed lower perceived usefulness in PP compared to their counterparts. Understanding patients’ personal characteristics, digital literacy, and technology access is crucial for utilizing PGHD effectively for health promotion among older patients with lung cancer surgery. This understanding can assist healthcare providers in identifying and addressing potential challenges.
FAMILY EXPERIENCE IN USING TELEPRESENCE ROBOTS WITH RESIDENTS IN LONG-TERM CARE
Authors: Hung Lillian , Hu Grace , Wong Joey , Ren Haopu (Lily) , Mann Jim , Wong Lily
Published: January 2025

Informal care, most often provided by family or friends, remains a hidden and underrecognized undertaking within long-term care (LTC) settings. As care recipients transition into LTC, informal care partners experience a parallel shift in their caregiving roles: transitioning from primary care partner to visitor. Many care partners report this transition to be difficult, as they must surrender an unpredictable level of control and involvement over their loved one’s care. The COVID-19 pandemic intensified this experience by introducing new challenges: individual health concerns, fluctuating care home protocols, and isolating government policies. Telepresence robots are emerging as a tool that can ease the care partner transition. The main aim of this study is to examine the experiences of care partners who used telepresence robots with loved ones living in LTC settings, during the COVID-19 pandemic. This study took place between May 2021 and August 2023 in five urban LTC homes located in British Columbia, Canada. A total of 20 care partners were recruited through purposive sampling. The care partners participated in semi-structured interviews, in-person or virtually, and thematic analysis was employed to identify four key themes characterizing their experiences using the robot: 1) Decreases care partner burden, 2) Facilitates care partner-staff relationship, 3) Creates relational autonomy, and 4) Expands the scope of what is possible. Findings capture the ability of the robot to enhance the caregiving experience for informal care partners. Further research on the sustainability of robot implementation amongst diverse geographic regions and care home compositions is needed.
LEVELING UP ADHERENCE PREDICTION: MOTIVATION’S INFLUENCE ON ENGAGEMENT WITH TECH-BASED COGNITIVE INTERVENTIONS
Authors: Shaleha Rinanda , Roque Nelson , Harrell Erin
Published: January 2025

In this study, comprising a sample size of N=118 older adults with an age range of 65 years and above, we investigated the impact of individual motivation on adherence behavior within a technology-based cognitive training intervention. Despite previous research indicating limited effects of framing conditions (negative, positive, and disabled) on adherence (Harrell et al., 2021), we hypothesized that individual motivation levels would significantly influence adherence behavior. Motivation is operationally defined based on participants’ performance in cognitive training games, where high motivation is indicated by a pattern of low failure rates and successful game performance. Utilizing advanced multilevel modeling techniques, we compared adherence models with and without motivation as a predictor. Our findings supported our hypothesis. The linear mixed model analysis revealed a significant effect of motivation on adherence (Estimate = 1.35939, SE = 0.24490, t (1422.78) = 5.551, p <.001), indicating that for each unit increase in motivation, there is a significant increase in adherence. Likelihood ratio tests (LRTs) comparing the model fit showed significantly divergent log-likelihoods between the two models (Δχ² (1) = 27.559, p <.001). These findings suggest that high levels of motivation play a crucial role in driving adherence behavior within the context of technology-based cognitive training interventions. By leveraging motivational factors and harnessing the power of gamification, researchers and practitioners can design more effective interventions that promote adherence, facilitate behavior change, and ultimately improve outcomes for participants.
NAMING AND STORYTELLING IN SOCIAL ROBOT INTERACTIONS: A NARRATIVE ANALYSIS OF ENGAGEMENT AND PERSONAL CONNECTIONS
Authors: Cheng Clio Yuen Man , Lou Vivian Weiqun
Published: January 2025

Social robots have emerged as promising tools with gerontology, offering the potential to enhance human-computer interaction and improve the well-being of older adults. This study employs narrative analysis approach to examine the impact of naming and storytelling in social robot interactions among older singletons. A total of 17 participants, aged between 60 to 73, engaged in 15-minute interaction sessions with a social robot (LOVOT), during which they provided a name for the robot and crafted a story around it. Through a comprehensive narrative analysis, this study uncovers the intricate dynamics of naming and storytelling in shaping older adults’ engagement and personal connections within social robot interactions. The analysis reveals that naming and storytelling serve as powerful vehicles for expressing expectations, personal experiences, and emotional connections. Participants drew upon their individual backgrounds, memories, and cultural references to create narratives that reflected their unique perspectives and desires. The narratives showcased the participants’ desires for intelligent and emotionally responsive robots while evoking nostalgia through connections to past experiences. Additionally, the narratives revealed a longing for companionship and emotional support, exemplified by associations of robot naming with deceased pets. Understanding the role of naming and storytelling in social robot interactions is crucial for designing robots that effectively cater to the needs and desires of older adults, ultimately enhancing their engagement and overall well-being. This study contributes to the field of human-robot interaction in gerontology by shedding light on the significance of personal narratives in fostering meaningful connections between older adults and social robots.
PREDICTING ACCIDENTS OF OLDER ADULTS LIVING WITH DEMENTIA USING ASSISTIVE TECHNOLOGIES AND MACHINE LEARNING
Authors: Lee Kyung Hee , Yang Eunjin , Lee Ji Yeon , Cho Aeyoung
Published: January 2025

Although older adults living with dementia prefer to age in their own homes, they face many challenges such as falls, injuries, and night-time disturbances. Predicting and preventing those challenges could help both older adults and their caregivers to maintain aging in place. This study aimed to develop and validate machine learning models in predicting accident subgroups among individuals with dementia using assistive technologies (i.e., in-home motion sensors and actigraphy). Data were collected from 75 older adults living with dementia and their family caregivers in South Korea. Utilizing 966 days of data on sensors, sleep, and survey from dyads, various machine learning models were developed to predict three accident subgroups—physical impact, night-time behaviors/wandering, and risky behaviors. The performances of five machine learning classification models were compared and important features were extracted. Python 3.9 was used for all analyses. The Gradient Boosting Model excelled in predicting physical impact and night-time behaviors, while CatBoost performed best for risky behaviors, achieving F1-scores of 0.50, 0.71, and 0.87, respectively. Important features were different by type of accidents. For physical impact, caregiver’s age, comorbidity severity, and total sleep time were the three top features; for night-time behaviors/wandering, cognitive function and number of medications were the most important features; neuropsychiatric and depressive symptoms were the most important features for risk behaviors. In addition, activity patterns recorded by in-home motion sensors emerged as important features. The findings highlight the potential of these assistive technologies to identify high-risk individuals, provide a safer environment, and support family caregivers.
PREFERENCE FOR DIGITAL DEVICES AND PATIENT-GENERATED HEALTH DATA UTILITY IN OLDER PATIENTS AFTER LUNG CANCER SURGERY
Authors: Choi Mona , Kim Yeonju , Cho Hyeonmi , Kim Yesol
Published: January 2025

This study aimed to investigate the preference for digital devices and the utility of patient-generated health data (PGHD) among older patients who have undergone lung cancer surgery. A cross-sectional descriptive study included patients at least four weeks after lung cancer surgery and excluded those with cognitive impairments. Participants in this study were recruited from a tertiary hospital outpatient clinic and conducted using a structured questionnaire: 1) patient’s general characteristics; 2) experience and duration of use of digital devices; 3) preference for wearable or attachable digital devices for PGHD collection; and 4) PGHD usability. Descriptive and bivariate analyses were performed. 135 patients were analyzed (age = 70.19 ± 11.80 years; 47.0% female). Smartphones (94.1%) were the most experienced digital devices, and the period of use varied from 4 months to 15 years. The wristwatch type was the most preferred wearable digital device (61.5%), and men preferred the belt type. Depending on the level of education, there was a difference in preference between the watch type and the skin patch type, and there was a difference in preference for the glasses type depending on the quality of sleep. The most informative PGHDs were lung function (91.1%), blood pressure (83.7%), and step count (83.7%). The usefulness of PGHD, such as drug side effects and social relationships, differed depending on the number of drugs taken. This study may help healthcare providers select appropriate digital health devices and utilize useful PGHD to improve health outcomes among older patients after lung cancer surgery.
ADAPTED CONVERSATION ANALYSIS TO EVALUATE DYADIC DEMENTIA-RELATED ADVANCED CARE PLANNING DISCUSSIONS
Authors: Bybee Sara , Utz Rebecca , Clayton Jordana , Aruscavage Nancy , Supiano Katherine , Iacob Eli , Dassel Kara
Published: January 2025

Persons living with dementia (PLWD) and their care partners should engage in advance care planning (ACP) prior to serious cognitive decline. This pilot study assessed the effectiveness of the Life-Planning in Early Alzheimer’s and Other Dementias (LEAD) Guide in promoting ACP concordance among PLWD and their care partners. Discussions of dyads’ (N=7) responses to the LEAD Guide were audio/video-recorded and analyzed by two coders for the following elements of Conversation Analysis (CA) (related to ACP concordance and relationship quality, respectively): turn-taking (listening leading to understanding, respect/mutual regard); Repair (giving and taking to gain shared understanding, apology); Action formation (assumed topic of discussion and norms, agreement on discussion subject and scope); Action ascription (trusting, understanding of previous turn); Action sequencing (acceptance of discussion norms towards goal, unconditional love). Coders demonstrated moderate agreement across all recordings (M=73.1%, SD=4.4), with unanimous agreement on: the presence of listening leading to understanding, assumed topic of discussion and norms, agreement on the subject and scope of discussion, and understanding of previous turn in all recordings, and the absence of apology and blind trust in 3 (42.8%) recordings. CA may be unable to capture ACP concordance as some elements may be inherent to the LEAD Guide discussion itself while others are unobservable in ACP conversations. To objectively examine how interactions foster ACP concordance, CA methodology should account for 1) multiple ACP discussions, 2) factors related to either the LEAD Guide or dementia diagnosis that impact turn-taking, and 3) the dynamics between the PLWD and their care partner.
ADVANCING CULTURALLY INCLUSIVE RESEARCH AND TOOLS IN ALZHEIMER’S DISEASE AND RELATED DEMENTIAS (ADRD)
Authors: Magid Maryam Abdel , Taylor Jean , Turner Anne
Published: January 2025

Background and Significance

Existing research underscores cultural norms’ influence on healthcare decisions but lacks depth in exploring their impact on dementia care transitions, critical for improving ADRD care outcomes. Research Aims include (1) Analyze interviews with dementia care providers and staff to better understand how cultural norms influence the decision-making processes for care transitions. (2) Explore methods used to facilitate inclusive and engaging discussions regarding care transitions.

Methods

Nested in the NIA-funded Decision Making in Alzheimer’s Research (DMAR) study, we examined interviews with 18 providers and staff on dementia care transitions. Prioritizing inclusivity, we leveraged the Alzheimer’s Disease Research Center (ADRC) registry and community partnerships coupled with tailored methods including diversifying the team and targeted outreach efforts. We’re employing a novel framework to analyze dementia care transitions, integrating societal and cultural aspects for nuanced understanding. This approach accounts for intergenerational culture, cognition perception, and care expectations, evolving to capture cultural nuances. Qualitative findings will be enriched with quantitative sentiment analysis, validated manually for accuracy.

Key findings

Novel framework will allow us to identify and analyze cultural norms affecting care transitions, as perceived by ADRD providers.

Implications

The study’s findings advocate for inclusive decision-making tools in ADRD care to accommodate diverse patient preferences. Future steps involve applying this framework to patients and caregivers and integrating findings into diverse settings involved in care decision-making. Funding statement: Funded in part by NIA grant #R01 AG066957 and the NLM T15 training grant #5T155LM007442-22. Content responsibility lies with authors, not representing NIH views.
COST EFFECTIVENESS ANALYSIS OF IMPLEMENTING A SCREENING PROGRAM FOR EARLY-STAGE ALZHEIMER’S DISEASE DETECTION
Authors: Jung Yeongin , Wu Kaili , Alnufeay Mashael , Jin Xiaotong , Ballreich Jeromie , Drabo Emmanuel
Published: January 2025

Recent advancements in Alzheimer’s Disease(AD) diagnosis have been propelled by the advent of disease-modifying therapies and the emergence of plasma-based biomarkers, notably P-tau217, which offers diagnostic accuracy comparable to cerebrospinal fluid assays and enables early disease detection. This study evaluates the cost-effectiveness of two AD early detection strategies for individuals aged 65 and above showing early-stage neuropathological abnormalities: solely using blood biomarker testing(P-tau217) and a sequential approach starting with plasma biomarker followed by confirmation via Aβ-PET scan. The cost-effectiveness of two early screening methods in a representative cohort of older adults in the US aged 65 and above with early-stage brain abnormalities(n=1000) is evaluated: 1) P-tau217 blood biomarker testing alone(Strategy 1); and 2) P-tau217 blood biomarker testing followed by confirmatory Aβ-PET scan(Strategy 2). Employing a hybrid model combining a decision tree and a Markov model, we simulated screening decisions, outcomes, costs, and quality-adjusted-life-years(QALYs) across AD progression stages(preclinical, mild, moderate, severe) and death over 35 years. Results suggest that Strategy 1(blood biomarker testing alone) dominates Strategy 2, producing 891 incremental QALYs at the additional cost of $49.2million translating to an incremental cost-effectiveness ratio(ICER) of $55,194/QALY gained and an incremental net monetary benefit of $39.9million at the decision threshold of $100,000/QALY gained. These results were attributable to the direct medical costs from delayed AD identification by false-negative misclassifications, and the avoided disutility from Aβ-PET. The findings were robust to uncertainties in model input parameters and highlight the utility of blood biomarkers as a cost-effective preclinical AD screening option in US older adults.
IMPLEMENTATION OF DEMENTIA FRIENDS IN WASHINGTON STATE
Authors: Zeitler Katie
Published: January 2025

Dementia Friends (DF) is a global movement whose mission is to raise awareness about dementia and the challenges associated with its stigma. The purpose of this presentation is to trace the journey including the evidence supporting the implementation of DF in Washington State and describe next steps. The movement has 13.5 million participants worldwide and utilizes a train-the-trainer model to deliver information sessions to members of the community that discuss what dementia is, five key messages, and communication tips. From 2018-2019, DF was piloted in Washington with the support of the Dementia Action Collaborative. Data showed that Dementia Attitudes Scale scores improved after a DF session and that this improvement was maintained through the one-month follow up. The results from the pilot program led to the approval of funding from Washington state for the implementation of the program in 2022. The state lead for DF Washington, the UW Memory and Brain Wellness Center, implemented the program by partnering with Regional Lead Organizations to assist in deploying the train-the-trainer model to expand DF in their regions. Each Regional Lead Organization nominated a Regional Coordinator to oversee the DF program in their region and train new volunteer “DF Champions” to lead information sessions. Funding from the state and partnerships with Regional Lead Organizations have facilitated the expansion of DF program from 214 participants in 3 counties in 2019 to 2,170 participants in 24 counties in 2024. A key challenge for DF will be cultivating community partnerships in rural areas and underserved populations.
A REFLECTION OF A STUDENT-LED VIRTUAL REALITY ADOPTION PROGRAM FOR PEOPLE LIVING WITH DEMENTIA IN LONG-TERM CARE
Authors: Wong Joey , Wong Karen Lok Yi , Van Mary , Hayat Yumna , Wallsworth Christine , Mann Jim , Wong Lily , Hung Lillian
Published: January 2025

Previous research suggests that virtual reality (VR) holds promise in improving residents’ well-being in long-term care (LTC). With ongoing staff shortages, there is a critical need to explore, evaluate and share learnings on innovative approaches for adopting technologies, including VR, in LTC. In our research study conducted at two LTC homes in Vancouver, Canada, undergraduate students supported staff members in VR adoption. This study reflects on the opportunities and challenges of VR adoption from the students’ perspectives. Utilizing a critical reflection framework, our interdisciplinary team engaged in extensive discussions and reflections via Zoom meetings, resulting in the following five themes: (1) Challenging the stigma towards dementia in LTC, (2) Addressing ageism in older adults’ technology usage, (3) Building relationships through consistent and repeated visits to facilitate technology adoption, (4) Recognizing students’ value in technology implementation and their potential impact on LTC’s future workforce, and (5) Recognizing the importance of emotional and organizational support. Based on these reflections, our team devised the “ENRICH” framework, offering six practical tips to support student involvement in enhancing technology adoption in LTC. The team’s insights highlight the potential of engaging university students in promoting technology adoption in LTC settings. The “ENRICH” framework provides a practical approach to fostering technology uptake while offering valuable learning experiences for students. This study encourages further exploration of student participation in LTC research to advance future initiatives in this field.
A SYSTEMATIC REVIEW OF QUANTITATIVE STUDIES OF LONELINESS AND SOCIAL ISOLATION IN LONG-TERM CARE
Authors: Smith LaTonya , Theeke Laurie
Published: January 2025

Loneliness and social isolation, though conceptually different, are both prevalent conditions for adults in long-term care facilities. These individuals, often separated from their previous lives, communities, and families, can experience a significant disconnect, leading to a pervasive sense of isolation and abandonment. Both conditions elicit a stress response, exacerbate physical health issues, lead to anxiety and depression, and significantly decrease quality of life and longevity; making it critical to understand these conditions in this population. The purpose of this paper is to present a systematic review of quantitative studies that operationalized loneliness or social isolation in samples of older adults in long-term care. The literature search used EbscoHost and included MEDLINE Complete, CINAHL complete, APA PsycArticles, and APA PsycINFO and resulted in 20 articles for inclusion. The synthesis of study findings makes it clear that loneliness and social isolation are associated with harmful health outcomes with up to 56% of residents reporting loneliness. Older adults with more functional ability and higher resilience scores were less lonely. Those with pain and those with rumination, deterministic thinking and confabulation reported increased loneliness. Intervention programs that included gardening, music, videoconferencing with families, laughter yoga, and peer mentor programs were effective for diminishing loneliness. Future studies are needed for comparative effectiveness of current interventions and for the testing of new interventions designed for this setting that are more precise to each condition. Clinical protocols for assessment and treatment of loneliness and social isolation in long-term care could enhance resident experience and potentially, longevity.
INNOVATIVE COLLABORATION: DEVELOPING DEMENTIA TRAINING WITH STUDENTS, SCHOLARS, AND PRACTITIONERS
Authors: Shean John , Jackson Eva , Redd Tara , Shakir Madiha , Roberts Shelby
Published: January 2025

The growing prevalence of Alzheimer’s and other dementias and the urgent need for public health awareness necessitates innovative, interactive, and accessible dementia training for students entering the workforce. The curriculum, A Public Health Approach to Dementia, is a new tool to meet this need. Through partnership between the Alzheimer’s Association, CDC, and Emory Centers, four new modules were launched in 2023 and 2024. These free, asynchronous, online learning modules support the training needs of the current and future public health workforce. Throughout the development, the team relied on students, researchers, professors and practitioners to ensure the modules provide accessible, comprehensive knowledge on the public health approach to dementia. The curriculum includes courses on the public health impact of dementia, health equity and dementia, and public health and dementia caregiving. Data from the first two modules released in 2023, show that they are impactful. Health Equity in Dementia — Using a Public Health Lens to Advance Health Equity in Alzheimer’s and Other Dementia was released in August and has over 520 people enrolled. Public Health and Dementia Caregiving was released in December and has over 200 people enrolled. Both modules had over 900 registrants for each launch webinar. Across both modules, most learners reported an increase in knowledge after taking the course (89% and 92%) and reported that it will be useful in their work or studies (87% and 90%). This curriculum demonstrates the strengths of partnering across backgrounds and expertise to support innovative learning opportunities for students entering the workforce.
THE CONTINUOUS LEARNING NEEDS OF PERSONAL SUPPORT WORKERS WHO CARE FOR PEOPLE LIVING WITH DEMENTIA IN LONG-TERM CARE
Authors: Norris Grace , Savundranayagam Marie , Vafaei Afshin , Teachman Gail
Published: January 2025

Personal support workers (PSWs) in long-term care (LTC) homes comprise over half of the workforce responsible for providing care to people living with dementia. Compared to other healthcare professionals, PSWs receive the least education, which fails to equip them with the necessary competencies for quality dementia care. To provide optimal care to people living with dementia, PSWs need to be offered opportunities for continuous education that addresses their specific learning needs. Therefore, this study identified and examined the dementia-specific learning needs of PSWs in LTC. Interpretive description guided the secondary qualitative analysis of 22 focus groups with ‘mid-career’ PSWs (n = 39) in LTC. The analysis identified specific learning needs along with ways in which those needs are best met. The learning needs include: 1) addressing responsive behaviours, 2) person-centered communication and attitudes, 3) delirium, and 4) dementia as a chronic condition. Learning needs were most commonly attributed to limited preparation during formal PSW education and a lack of continuous training opportunities throughout their career. Learning needs are best met through experiential methods involving peer learning, feedback, and evaluation within a supportive environment. For the learning needs to mediate practical outcomes, there needs to be an openness to dementia education and a good teamwork culture within LTC. The data generated from this research study will be essential to developing future continuing education for PSWs, contributing to knowledge about dementia care within LTC settings, and improving the quality of care provided to people living with dementia.
THE USE OF MINDFULNESS-BASED INTERVENTION FOR LONG-TERM CARE RESIDENTS: A REVIEW OF THE LITERATURE
Authors: Raciti Audrieanna , Chang Yu-Ping
Published: January 2025

Physiological and psychological health is a significant concern among people residing in long term care. Researchers have begun to design and test mindfulness-based interventions (MBIs) as a strategy to lessen the burden of these impacts on long-term care residents as well as our already strained healthcare system. The purpose of this review is to synthesize the use of MBIs and their impact on health-related outcomes and quality of life among long term care residents. Six databases: CINAHL, PUBMED, Cochrane, Web of Science, Psychinfo, and Embase were searched to identify original studies leveraging the use of mindfulness to improve health-related outcomes for long term care residents. Multiple keywords were used including mindfulness-based stress reduction, meditation, mindfulness intervention, long-term care, nursing home, residential care, older adult, elderly, and aged. Nine studies meeting the selection criteria were included in this systematic review. Most of the studies have a small to medium sample size. The types of MBIs include mindfulness-based cognitive therapy, silent meditations, mountain meditations, loving-kindness meditations, awareness exercises, breathing exercises, visualization, and guided imagery. The majority of those MBIs demonstrate a significant improvement in alleviating symptoms of stress, depression, anxiety, relocation anxiety, worsening dementia, and other mental health concerns, while one study also showed significant improvement in A1C levels among residents with type 2 diabetes. However, some studies have a high attrition rate. Future research is needed to utilize a more rigorous design with a large sample size and longitudinal studies. Participant engagement should be considered as part of the intervention activities.
A COMPARATIVE STUDY OF INTEGRATED LONG-TERM CARE SERVICES IN TAIPEI CITY AND NINGBO CITY
Authors: Liu Huan , Mi Hong
Published: January 2025

This study aims to compare the integrated long-term care service models in Taipei and Ningbo, exploring their similarities, differences, and experiences for mutual learning. Through literature review and field research, it was found that Taiwan’s long-term care system has advantages such as comprehensive coverage, diversified services, professional teams, smart technology applications, community participation, policy support, and a supportive social and cultural environment. On the other hand, Ningbo’s integrated long-term care services also have unique features in terms of service content and format, emphasizing family care, promoting the integration of medical care and older people care, and developing community rehabilitation services. The comparative study reveals that Taiwan’s long-term care system is more mature and comprehensive, with higher service quality and coverage, while Ningbo has certain advantages in the integration of medical care and older people care, as well as in community rehabilitation services. Based on this, the study proposes recommendations for the complementary development of long-term care service models in Taipei and Ningbo, including strengthening policy coordination, promoting inter-departmental cooperation, and enhancing service quality and efficiency, aiming to provide reference for the improvement and development of long-term care services in both regions.
CLINICAL PRESENTATION OF INTERSTITIAL LUNG DISEASE AS AN INITIAL MANIFESTATION OF ANTISYNTHETASE SYNDROME
Authors: De Pablo Pamela Salcido , Encarnación Carolina Escorcia , Olvera Alfredo
Published: January 2025

Antisynthetase syndrome (ASS) is an autoimmune disease, categorized as a type of idiopathic inflammatory myopathy, where interstitial lung disease is the most common manifestation, presenting in up to 80% of cases. It is related to antibodies and aminoacyl-transfer RNA (tRNA) and the most common one, anti-Jo. It has an incidence of 0.56 per 100,000 inhabitants, commonly in adults with an average age of 45 to 70 years old. A 72-year-old female, with a medical history of dyslipidemia, depression, and gonarthrosis, presents with dyspnea, hypoxemia, wheezings, asthenia, arthralgias, and myalgias. A chest radiograph showed abnormal parenchyma, with bilateral opacities in peripheral and subpleural zones, diagnosis was compatible with pneumonitis, treated with quinolones, steroids, and short-acting bronchodilators. With partial recovery, TC scan showed patchy ground-glass-like pattern, bronchi ecstasies, and honeycomb zones, spirometry showed restrictive pattern and rheumatology tests reports were negative for antibody anti-Jo-1 and positive in antinuclear antibodies (ANAs). After several differential diagnoses and studies; a diagnosis of antisynthetase syndrome was reached. Although its low prevalence in the general population, the importance of knowing about antisynthetase syndrome lies in understanding the pathology and encouraging research on it, thus achieving a good diagnosis and adequate interdisciplinary management that these patients should require in a syndrome that still exists. For this reason, this case report intends to mention some of the most used tools currently in use, which helped to diagnose this interesting and uncommon case.
IMPROVING RECOVERY FROM HOSPITALIZATION IN GERIATRIC PATIENTS THROUGH WHEY SUPPLEMENTATION AND TESTOSTERONE
Authors: Yang Michelle , Gongloor Pratik , Deer Rachel , Volpi Elena , Li Shuang , Hommel Erin
Published: January 2025

Background

Sarcopenia, the age-related loss of muscle mass and strength, remains a significant concern among hospitalized geriatric populations due to functional decline and increased mortality. A previous pilot study demonstrated potential benefits for testosterone or whey supplementation (WS) during and post-hospitalization towards improved physical function and reduced re-admissions. Our follow-up study assesses the feasibility and preliminary efficacy of these interventions.

Methods

This Phase I, single center, randomized clinical trial enrolled 80 participants, 65 years+, hospitalized for acute conditions. Participants were randomly assigned to one of four interventions: placebo oral and injectable (PO/PI) supplement, PI-WS, PO-testosterone injection (TI), or WS-TI. WS was provided twice daily during and post-hospitalization. TI was provided once pre-discharge. Testing was conducted at baseline and 4-weeks post-hospitalization. Primary outcome included Short Physical Performance Battery (SPPB) score change. Secondary outcomes included readmission rate and additional measures of physical function and body composition.

Results

Mean age was 71.5 years with 70% female. Age-adjusted Charlson Comorbidity Index was 4. Fifty-two participants (65%) completed the study; 15 were re-hospitalized and 13 withdrew or were lost to follow-up. Among those completing the 4-week intervention, we found no statistically significant differences in SPPB score or readmission rate.

Conclusion

We failed to demonstrate significant improvements in recovery among geriatric patients receiving testosterone, WS, or combination therapy. Compared to the previous study, participants were younger, healthier, and less likely to complete follow-up. We need further studies with larger samples of frail older adults to elucidate the relationship between these interventions and post-hospital functional recovery.
PERCEPTION OF NEIGHBORHOOD WALKABILITY INFLUENCES PHYSICAL THERAPISTS’ WALKING RECOMMENDATIONS FOR OLDER ADULTS
Authors: Blackwood Jennifer , Karczewski Hannah
Published: January 2025

Background/objectives

Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults’ participation in outdoor walking. Physical therapists (PTs) may identify factors that influence decisions about outdoor participation in walking. Current understanding of PTs’ knowledge and perceptions of walkability, and utilization of walkability assessments is not described and serves as the purpose of this study.

Methods

A cross-sectional survey was sent via email to 5000 PTs nationwide with IRB approval. The 40-item survey covered the following: walking and walkability perceptions and assessments, perception of responsibilities, and demographics. Categorical variables were compared using Chi-square analyses.

Results

After inclusion and exclusion criteria, a total of 122 outpatient PTs who worked in geriatrics were used for analysis. A significant difference was found between perceptions of whether PTs should assess walkability and whether they assess walkability (x2=78.7, p< 0.001). Components that influenced decisions to prescribe outdoor walking were prioritized in this order: availability (n=79, 64.8%) and maintenance (n=11, 9.0%) of sidewalks, crime (n=9, 7.4%), hills (n=7, 5.7%), aesthetics (n=6, 4.9%), and other (n=10, 8.2%). Objective measures were not used to assess walkability.

Conclusion

Respondents had a significant difference between perceptions of their responsibility to assess walkability and whether they do assess walkability in older adults before prescribing walking. Built environment constructs were prioritized over the social environment. Significance/Implications: Assessment of walkability may allow PTs to identify barriers and make more informed recommendations concerning outdoor walking for older adults. Objective measures are available for PTs when prescribing outdoor walking.
RISK FACTORS FOR NINE-YEAR MORTALITY OF OLDER PATIENTS WITH COGNITIVE IMPAIRMENT AT ADMISSION
Authors: Yamamoto Hiroshi , Ogawa Kenichi , Hisamatstu Yasushi , Ishitake Tatsuya
Published: January 2025

Background

Dementia can be a major cause of mortality and morbidity in geriatric patients. So, it would be essential to assess their mental state in the early. Aims: We aim to appraise the impact on mortality and hospital outcomes by revised simplified short-term memory recall test (STMT-R) and collecting clinical data simultaneous.

Methods

The subjects were 612 acute inpatients ≥65 from December 2014 to September 2015. Following the collection of clinical data, survival was subsequently measured for 8-9years until December 2023. An STMT-R score of ≤4 were considered to indicate cognitive dysfunction. To explore the association between the risk factors and mortality in cognitive impairment subjects, Kaplan-Meier method and Cox’s proportional hazards regression models were used to examine mortality and survival rates.

Results

The mean age of the subjects was 82.1 (±7.94), and 55.9% were female. Cognitive function was classified into three categories according to severity respectively; Incomplete Testing Group (Incomplete), Cognitive dysfunction (Abnormal) and Non-Cognitive dysfunction Group (Normal). 349 patients (57.0%) died during follow-up. Kaplan-Meier and the log-rank tests showed the negative prognostic effect of cognitive impairment, malnutrition, pneumonia and cancer-bearing state (p < 0.01). After adjustment for potential covariates the Cox regression showed that mortality hazard is increased with “Incomplete” (HR 3.526 CI 95% 2.388-5.206 p< 0.0001) and “Abnormal” (HR 1.676 1.210-2.321 p=0.0019).

Conclusion

Malnutrition, pneumonia and cancer-bearing state can significantly decrease the survival rate in patients with cognitive impairment at admission. Cognitive impairment also has independently an impact on survival rate in acutely ill geriatric patients.
ANALYZING THE INFLUENCE OF MIDLIFE EMPLOYMENT TRAJECTORIES ON COGNITIVE AGING IN CHILE
Authors: Delaporte Magdalena , Behrman Jere
Published: January 2025

As the global population ages, understanding the factors contributing to healthy aging becomes increasingly crucial. This paper delves into the relationship between mid-life employment trajectories and later-life cognition, utilizing a Chilean longitudinal dataset. Employing the Group-Based Trajectory Model (GBTM), distinct employment trajectories for males and females between 1980 and 2016 are estimated. Subsequently, we link these trajectories to cognitive function scores to investigate the associations between individual trajectories and cognitive function in later life. Preliminary findings reveal significant associations between certain cognitive domains and labor force participation trajectories. We find four distinct labor force participation trajectories for men and women. Results show that men that have a high probability of continued employment demonstrate better cognitive outcomes, including orientation, memory, attention, and executive function. For women, a higher likelihood of working during between ages 30 to 60 correlates with improved performance in delayed memory, attention, and executive function. These results provide valuable insights for policymakers and practitioners seeking to enhance cognitive well-being among older adults.
FINANCIAL TRANSFERS BETWEEN OLDER FILIPINOS AND THEIR ADULT CHILDREN: THE ROLE OF EDUCATION AND PUBLIC PENSIONS
Authors: Cheng Kent Jason
Published: January 2025

Objectives

The Philippines is expected to transition to an aging society in less than two decades. Provision of resources and safety nets largely befalls family members since government support is limited. This study examines how education and public pensions shape older Filipinos’ financial transfers to and from their adult children.

Methods

Data on Filipinos aged 60+ with at least one living child came from the 2018 Longitudinal Study of Ageing and Health in the Philippines (n=5,645). Logistic regressions interacting educational attainment and public pension receipt (no pensions, have contribution-based pensions, have social pensions, have both) were ran, controlling for relevant sociodemographic factors, average characteristics of children, and living arrangements. Predicted probabilities were generated and pairwise comparisons were conducted.

Results

Higher educational attainment and having contribution-based public pensions were associated with higher (decreased) odds of giving (receiving) transfers. Interactive models suggest a modest moderating effect of education and public pension types on giving and receiving financial transfers. Within education level, public pension receivers, especially those with contribution-based pensions, tend to have the highest probability of transferring to children and lowest probability of being exclusively on the receiving end of money transfers.

Discussion

Public pension receivers being more likely to give downward financial transfer across all educational levels suggests that public transfers for older adults benefit both the intended beneficiaries and their descendants. Additionally, older parents having contribution-based pensions as an income source spares their adult children from providing upward transfers. Results support crowding in – that public transfers facilitate private transfers.
HEALTH CARE UTILIZATION AND COSTS FOR HOSPITALIZED DEMENTIA PATIENTS IN CHINA
Authors: Lin Zhuoer , Ba Fang , Allore Heather , Chen Xi
Published: January 2025

Background

Dementia poses challenges to patients and healthcare systems; yet little is known about the healthcare utilization and costs for dementia patients in China and their major contributors.

Methods

We identified 51,530 inpatient records of Chinese older adults who were admitted to 1,917 hospitals during 2017-2019 with a primary diagnosis of dementia. Multivariable logistic regressions estimated associations for emergency room (ER) admission and tertiary hospital admission; and linear regressions were performed to examine the determinants of length of stay (LOS), daily and total costs in Chinese Yuan (CNY). The potential contributors included age, sex, insurance type, working status, comorbidity, admission type and hospital level.

Results

The sample had a median age 78 (IQR: 72-84), of whom 46.2% were females, 20.2% were admitted through an ER, and 69.0% were admitted to tertiary hospitals. LOS, daily and total costs per admission were 21 days, 948 CNY and 12,602 CNY, respectively. Increased adjusted odds of ER admission were associated with having lung diseases or lower insurance coverage. LOS was longer for older patients, females, retirees, or those with more insurance coverage or admitted to lower-level hospitals. The total costs were higher among older patients, males, patients with lung diseases, more insurance coverage, and patients admitted to ER or tertiary hospitals.

Conclusion

There are large variations in inpatient care utilization and costs across dementia patients of different demographics, insurance types, and comorbidities. Our findings highlighted the importance of promoting chronic disease management and insurance coverage, as well as providing affordable and equitable dementia care.