bluuebunny/crossref_metadata_2025 huggingface dataset:
CHALLENGES AND STRATEGIES FOR HOME PAID CAREGIVERS: ADVANCING CARE FOR OLDER ADULTS IN URBAN CHINA
Authors: Wu Zixuan , Wang Qingwei
Published: January 2025

Older adults living in community settings often depend on family caregivers, especially those suffering from chronic illnesses. To mitigate caregiving burdens and secure professional nursing support, many families in China’s urban centers opt for high-end paid caregivers who offer integrated medical-care services. This study aims to explore the challenges faced by paid caregivers in providing care to older adults in Shanghai and to develop a framework for advancing caregiving for China’s aging population. Using a qualitative research design, this study draws on in-depth interviews with 10 paid caregivers from Yi Jia, a local aging care company that offers tailored nursing services. The interview data are supplemented with ethnographic observations and video recordings during home visits. Preliminary thematic analysis revealed three major themes: 1) Home-based care poses logistical challenges, including high technological demands that exceed the capabilities of caregivers from less developed regions and inadequate living conditions that compromise privacy and safety; 2) Paid caregivers face emotional burdens from the high demands of their work and must also cope with homesickness and limited social support due to their migration and separation from their families; 3) Cultural compatibility between caregivers, older adults, and families influenced by regional differences would lead to failure in accommodating local living habits and result in mismatches in health communication. Policymakers should regulate the paid caregiving market to ensure that caregivers are proficient in professional skills, emotional resilience, and cultural adaptability. Continuous collaboration between organizational supervisors, families, and caregivers is crucial to delivering comprehensive care.
ASSOCIATION OF CHILDHOOD RESIDENTIAL CHANGE WITH LATER LIFE MEMORY TRAJECTORIES IN THE HEALTH AND RETIREMENT STUDY
Authors: Hamlin Abbey , Alhasan Dana , Meier Helen , Manning Mark , Yu Xuexin , Gutierrez Sirena , Webster Noah
Published: January 2025

Childhood residential change may affect later life memory, although few studies have examined this relationship, and research in diverse racial/ethnic samples is sparse. Data were from the US Health and Retirement Study. Childhood residential change was measured by the number of residences before the age of 16 (0-1, 2, 3, 4 or more) (N=4020). Moving due to financial difficulties before 16 years old was categorized as yes versus no (N=4005). Memory function was measured using composite memory z-scores incorporating direct and proxy assessments from 1996-2016. We utilized mixed-effects linear regression models with subject-specific random slopes and intercepts adjusting for sociodemographic characteristics to estimate associations between residential change and memory, by race/ethnicity and parental education. The mean age was 57.5±5.9 years, 82.1% self-identified as non-Hispanic White, 12.7% as non-Hispanic Black, and 5.2% as Other/Unknown. Fewer moves during childhood were associated with a higher initial average memory level, but a faster rate of memory decline. Moving due to financial difficulties during childhood was not associated with initial memory levels, but was associated with faster memory decline. We did not observe effect modification by race/ethnicity or parental education. Results suggest that childhood residential change and the reasons for residential change may contribute to later life memory function and decline.
CLINICAL PHENOTYPING OF THE COGNITIVELY UNIMPAIRED IN THE AD SPECTRUM USING PET IMAGING
Authors: Felix Cynthia , Kollasserry Felix Joy , Rebok George , Snitz Beth , Ferreira Pamela , Klunk William , Baker Suzanne , Pascoal Tharick
Published: January 2025

Clinical phenotyping of cognitively unimpaired (CU) older adults who may progress to dementia is a pressing issue in Alzheimer’s disease (AD) since early interventions are the most effective. Out-patient cognitive screening commonly uses rapid and simple tests such as the Montreal Cognitive Assessment (MoCA) but its role in preclinical AD remains unclear. We hypothesize that sub-categorizing CU based on the presence of amyloid (A) and/or tau (T) pathologies, as measured by PET, can cognitively phenotype CU using MoCA. We studied 147 CU [CDR global score 0] older adults with MK6240 and Flortaucipir tau-PET and PiB or NAV4694 amyloid PET from the ongoing HEAD study. Based on tracer uptake, individuals were divided into A-T-, A-T+, A+T- and A-T- groups. They were evaluated using the UDS-3 battery. One-way ANOVA with Tukey’s correction for multiple comparisons, was used to test for significant differences between groups. With both MK6240 and Flortaucipir, MoCA total scores revealed significant differences between A+T+ and A-T- groups [mean: -1.74 (SE: 0.56), p: 0.013 and mean: -1.56 (SE: 0.6), p: 0.049] respectively. A+T- vs A+T+ was also significant with MoCA total and MoCA Delayed Recall using MK6240 [mean: -2.05 (SE: 0.77), p: 0.041 and mean: -1.15 (SE: 0.42), p: 0.033]. MK6240 shows more sensitivity than Flortaucipir. Therefore, MoCA, a simple and commonly used in-office neuropsychological test can detect cognitive dysfunction in Aβ and tau positive (A+/T+) CU older adults. This highlights the value of precisely characterizing preclinical AD subtypes that are more likely to develop AD dementia.
HOW DO SOCIAL NETWORKS CHANGE IN THE LEAD-UP TO DEMENTIA DEATH
Authors: Baker Zachary , Alberth Andrew , Guest M Aaron , Peckham Allie , Segundo Joahana , Saenz Joseph
Published: January 2025

Larger social networks are associated with a lower risk of dementia, but little is known about how social networks shift when someone has dementia as they approach death. We investigate how social networks among individuals with dementia change as they approach death. We hope this research will inform support systems and care practices that benefit individuals with dementia and their care partners. Participants: 2,295 deceased people with dementia from the Health and Retirement Study (2004-2018). Multilevel models estimated associations between dementia, race/ethnicity, time, and close family and friend network size while controlling for several sociodemographic variables. Social networks shrank linearly as death approached. A decrease in close friends primarily drove shrinkage. Some more unusual patterns emerged when race/ethnicity were crossed with time. Specifically, Hispanic/Latino persons with dementia showed the opposite pattern: as they approached death, the number of close extended family increased dramatically, an increase of one person every two and a half years. Dementia risk, social networks, and patterns of social network shrinking are unequal across people of different races and ethnicities. Contrasting patterns of increasing numbers of extended may be driven by familismo. Perhaps as the needs of the people with dementia increased, family members “rallied around” to provide care. Given the importance of social networks, especially during challenging times, and their tendency to shrink closer to death, if non-Hispanic/Latino individuals could adopt the effective strategies used by Hispanic/Latino older adults to maintain and grow their social networks, they might experience similar benefits of robust social networks.
THE BURDEN OF SPOUSAL CAREGIVERS IN YOUNG-ONSET DEMENTIA: INSIGHTS FROM A MIXED-METHODS STUDY
Authors: Cui Xiaoyan , Wang Junqiao , Wu Bei , Ding Ding , Zhao Qianhua , Tang Xueting , Wang Jing
Published: January 2025

Becoming a spousal caregiver for a person with young-onset dementia (YOD) is an unexpected event that deviates from the normal life course trajectory, creating unique and profound challenges. Understanding their burden, the primary sources of this burden, and their coping resources is essential for developing tailored support services. We employed a mixed-methods approach to gain a comprehensive understanding of the burden experienced by eleven spousal caregivers of persons with YOD living in the community. We used the Zarit Burden Interview to quantify caregiving burden and conducted semi-structured qualitative interviews to explore the caregiving experience in depth. We utilized a joint display method to integrate and present the converging findings from quantitative and qualitative data, offering a holistic perspective on the caregiving burden. All spousal caregivers in this study experienced varying degrees of burden, driven primarily by the dynamic care needs and dependency of their loved ones. The integrated data showed that they face significant challenges in maintaining their personal identity and social life, with many sacrificing career aspirations and enduring social isolation. Societal expectations compounded the burden, leading to self-imposed guilt and dissatisfaction. While caregiving reconfigures family dynamics, it often strengthens bonds with children. The lack of support resources and overwhelming responsibilities places immense psychological stress on them. Despite these challenges, caregivers remain committed to their roles. There is an urgent need to develop family-centered community support services and respite care to provide younger spousal caregivers with the time and space to manage their personal lives and alleviate their burden.
PREDICTORS OF INTENT TO USE DIGITAL MEMORY BOOK AMONG DEMENTIA CAREGIVERS
Authors: Lee Yura , Oh Chorong , Park Min Sook , Bong Ji Yae
Published: January 2025

A memory book is a popular reminiscence approach for people with dementia (PWD) and caregivers (CGs). Recently, it has evolved into a digital form by incorporating music, videos, or other multimedia, referred to as a digital memory book (DMB). Like conventional memory books, DMBs have been found to improve quality of life, cognition, communication, and mood for PWD and CGs, while also reducing CG burden. Despite these benefits, the usage of DMBs remains low, and there is limited research identifying factors influencing intent to use DMBs in this population. Considering that family CGs are most often the facilitators of DMBs for PWD, this study aims to examine the predictors of intent to use DMB among dementia CGs. Based on the Technology Acceptance Model, we collected data from 170 dementia CGs. Findings from linear regression analyses show that dementia type, primary caregiver status, age, race, education, caregiver health, and relationship to PWD were significantly related to intent to use DMBs. We also found a significant interaction effect between dementia type (Alzheimer’s disease [AD] vs. other dementias) and stage (mild vs. moderate to severe) (b=0.493, SE=0.217, p <.05). Specifically, differences in intent to use DMBs between mild and moderate to severe stages were significantly greater among CGs for AD compared to other dementias (ΔM= 0.45 vs. 0.05). This study contributes to identifying predictors of the intent to use DMB among dementia CGs. Considering these factors will be crucial in developing and implementing DMB programs to enhance their use, thereby benefiting this population.
USING TRANSFER LEARNING TO IMPROVE ALGORITHMIC DEMENTIA CLASSIFICATION ACROSS DIFFERENT RACIAL AND ETHNIC GROUPS
Authors: Leist Anja , Glymour M Maria , Langa Kenneth , Kim Jung Hyun
Published: January 2025

Background

In the absence of clinical assessments, algorithmic ‘probable dementia’ estimation aids public health and epidemiological research on determinants and consequences of dementia. Algorithmic performances have differed by social and racial/ethnic groups due to heterogeneous sample sizes. In this study, we present improvements in the accuracy of group-specific ‘probable dementia’ estimation using a transfer learning approach. Transfer learning – a novel approach not previously applied in algorithmic dementia classifications – uses a large “source” dataset with imprecise (non-clinical) outcome assessments to develop an initial algorithm with a large and diverse sample, complemented by a smaller “target” dataset with high-quality (clinical) outcome assessments to develop models with refined estimation of model coefficients.

Methods

Data came from the Health and Retirement Study (source data: N=6,630) and the Harmonized Cognitive Assessment Protocol (target data: N=2,388). Different algorithms to estimate probable dementia were evaluated through overall accuracy (Brier score), calibration (intercept, slope), and discriminative ability (area under the receiver operating characteristic curve, AUC; area under the precision-recall curve, AUPRC).

Results

Among non-Hispanic Black participants, the transfer-learned algorithm had higher accuracy than the best previously reported algorithm (Brier 0.049 vs. 0.061; AUC 0.84 vs. 0.81; AUPRC 0.52 vs. 0.39). Among Hispanic participants, the transfer-learned algorithm improved model calibration (Intercept −0.07 vs. −1.19; Slope 0.88 vs. 0.08).

Discussion

The use of transfer learning can improve algorithms to estimate probable dementia from non-clinical assessments for groups historically underrepresented in research. More accurate classification will lead to more equitable epidemiological and public health research on dementia.
FEASIBILITY AND ACCEPTABILITY OF MBCT AND BA TO REDUCE PRE-DEATH GRIEF IN FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Neugebauer Benjamin , Cummings Caroline , Sparks Sarah , Elliott Lauren , Neugebauer Volker , Chrzanowski Lauren , McLean Elisabeth , Singer Jonathan
Published: January 2025

Family caregivers of individuals with Alzheimer’s Disease and Alzheimer’s Disease Related Dementia (AD/ADRD) may experience pre-death grief (PDG). Behavioral activation (BA) and mindfulness-based cognitive therapy (MBCT) improve grief outcomes for bereaved individuals but neither have been investigated in the context of PDG. Notably, there are high rates of treatment attrition for family caregivers of persons with AD/ADRD underscoring the need to improve treatment options for this population. The present study is Stage I of NIH Stage Model for Behavioral Intervention Development that examines the acceptability and feasibility of two interventions. Participants in West Texas have limited to no resources due to a lack of respite, neurologists, and caregiving interventions, as they live 5 hours from a large urban setting. Family caregivers in West Texas were randomized to receive MBCT or BA following administration of neuropsychological and psychological assessments. Participants completed a shorter battery of assessments each session, and the full battery during the final session and at all follow ups. Thirty-three participants were recruited and consented, 84.8% (n=28) completed the study, 96.0% (n=27) of participants completed the final survey, and 86% (n=24) completed the 1-month follow up. When comparing the number of sessions attended by participants receiving MBCT vs. BA, there was no significant differences (p=0.73). Qualitatively, participants endorsed enjoying the interventions, and reported they were not burdensome. Results support the feasibility and acceptability of these evidence-based interventions for family members of persons with AD/ADRD in a unique West Texas sample.
IMPLEMENTING SMART AMBIENT BRIGHT LIGHT FOR NURSING HOME RESIDENTS WITH DEMENTIA: ASSESSING FIDELITY
Authors: Berish Diane , Wang Julian , Beiglary Shevvaa , Jao Ying-Ling , Liao Yo-Jen
Published: January 2025

Up to 90% of persons with dementia experience neurobehavioral symptoms and poor sleep which may be associated with limited daylight exposure and circadian disruptions. Lighting interventions regulate the circadian rhythm and have been shown to reduce agitation. Smart Ambient Bright Light (SABL) incorporates natural light and is an automatic lighting system that delivers bright light during the day (photopic illuminance ≥400 lux, circadian stimulus [CS]≥0.3) and dim light during the night (lux≤40, CS ≤0.1). Two methods were used to assess SABL fidelity. First, manual measurements were conducted during the daytime twice a week. Second, each participant wore a light sensor to measure individual lighting exposure for 24 hours, 7 days a week, every other week. Manual measurement results indicated that the SABL lighting conditions across different spaces generally met the targets during daytime (lux: mean=394.2, SD=49.75; CS: mean=0.302, SD=0.07). Individual sensors also showed that participants’ average daytime light exposure during the intervention met the target for lux (mean=406.9, CI=369.9-443.8) and CS (mean=0.363, CI= 0.332-0.393). Individual nighttime lighting exposure during the intervention was above target for lux (mean=94.5. CI= 82.3-106.7) and CS (mean=0.111, CI=0.098-0.124). Additionally, participants received higher daytime CS (t=-8.7, p< 0.001) and daytime lux (t=-8.48, p< 0.0001) while also receiving lower nighttime CS (t=4.43, p=0.0001) and nighttime lux (t=7.4, p< 0.0001) during the intervention period than the control period. The results indicate the SABL achieved fidelity for daytime, but its fidelity for nighttime, especially lux, could be improved. Future studies should incorporate lessons learned to improve SABL implementation fidelity.
ACTIVITY INTENSITY AND FALL-RELATED DEATHS AMONG OLDER ADULTS: RESULTS FROM A 12-YEAR NATIONAL SURVEY
Authors: Adeyemi Oluwaseun , Chodosh Joshua
Published: January 2025

Fall-related deaths among older adults are a growing public health concern, with activity intensity potentially playing a critical role in mitigating these outcomes. This study assessed the relationship between activity intensity and fall-related death among community-dwelling U.S. older adults. We pooled twelve years of survey data (2006 to 2017) from the Integrated Public Use Microdata Series of the National Health Interview Survey for this retrospective cohort study. We identified older adults (65 years and older) who sustained fall injuries (N=2,454). The outcome variable was fall-related death. We defined low activity intensity as a binary variable using the American Heart Association’s weekly 500 Metabolic Equivalent of Task (MET) as a cut-off. We controlled for sociodemographic, healthcare access, and health characteristics, performed survey-weighted logistic regression analysis, and reported the adjusted mortality odds (plus 95% confidence interval (CI)). The survey comprised 2,454 older adults with fall injuries, representing 863,845 US older adults. The population was predominantly female (68%), non-Hispanic Whites (85%), and divorced/separated (54%). During the follow-up period, 45% of the study population died. Approximately 81% of the study population had low activity levels. However, between 2006 and 2017, the proportion of the study population with low physical activity decreased from 90% to 67%. After adjusting for sociodemographic, healthcare access, and health characteristics, low activity level was associated with two-fold increased odds of death (AOR: 2.11; 95% I: 1.59 – 2.81). Promoting higher physical activity levels may significantly reduce the risk of fall-related deaths among older adults.
TRENDS IN DRUG-DRUG INTERACTIONS AMONG US OLDER ADULTS, 2015-2016 VS. 2021-2023
Authors: Qato Dima , Veetil Shyam Krishnan Ondanat , Wilder Jocelyn
Published: January 2025

Background

Adverse drug events due to drug-drug interactions are a leading cause of preventable mortality in older adults yet current information on the use of interacting regimens is limited. In this study, we quantify changes in the frequency and types of potential major (contraindicated and generally avoid) drug-drug interactions among older US adults.

Methods

Descriptive analyses of a longitudinal, nationally representative sample of community-dwelling older adults in the U.S. In-home interviews with medication logs were conducted in 2015-2016 and 2021-2023. We used Micromedex to identify potential major drug-drug interactions. Primary outcomes were the prevalence of the concurrent use of medications with a major drug-drug interactions overall and for specific medications.

Results

The study comprised of 4175 participants in 2015-2016 and 2819 in 2021-2023. In 2015-2016, 12.3% of older adults were at risk for a major drug-drug interaction compared with 10.8% in 2021-2023(P =.051). While declines in the use of interacting regimens involving aspirin (3.1% to 1.7%), warfarin (1.3% to 0.4%), and hydrocodone (0.9% to 0.4%) were observed during this time period, increases in the use of citalopram (0.9% to 1.4%), tizanidine (0.2% to 0.6%) and albuterol (0.3% to 0.6%) in interacting combinations was also found (all P< 0.05). Conclusions: Although the use of interacting medications among older adults has modestly declined since 2015, 1 in 9 is still potentially at risk for a major drug-drug interaction. Improving patient awareness of commonly used drug-drug interactions has the potential to reduce preventable adverse drug events associated with their use among older adults.
UNDERSTANDING GOAL SETTING AND BEHAVIOR CHANGE MECHANICS IN OLDER ADULT SITTING REDUCTION
Authors: Greenwood-Hickman Mikael Anne , Arterburn David , Cooper Julie , Green Bev , Holden Erika , McClure Jennifer , Rosenberg Dori
Published: January 2025

While sedentary behavior (SB) is highly prevalent in older adults, scant evidence documents how participants actionably change this behavior. We explored intervention fidelity, participant satisfaction, and the types of goals participants set based on their preferences within a 6-month randomized controlled trial of a SB intervention for adults aged ≥60 years that successfully reduced participant sitting. Coaches tracked goals for all participants, and 8% of visits were randomly reviewed and coded for fidelity using a structured template. At study completion, participants completed a brief satisfaction questionnaire. Goals data were qualitatively coded and grouped by reminder strategy and topic. Fidelity and satisfaction data were summarized using frequencies and mean (standard deviation). Intervention participants (N=140, mean age 69 [6.0], 62% women, 66% Non-Hispanic White) had high satisfaction (95% Satisfied or Very Satisfied), and 83% reported perceived improvements to health and/or daily functioning. Fidelity to intervention content and techniques was also high across coded intervention sessions (SMART goals set in 98% of sessions, 93% active problem solving with coach, 95% discussed specific sitting break reminder strategies). Participants primarily set sitting reduction goals leveraging outward (e.g., fitness band prompts, using a standing desk for certain tasks) and habit (e.g., adding standing to a meal, standing during daily chores) reminder strategies tailored to individual preferences and lifestyle. Using inner cues such as awareness of pain or stiffness were less common. Specific goals to reduce SB varied widely, suggesting tailored SB reduction intervention approaches are likely important, particularly for older adults with chronic conditions.
ADVANCING AGE-FRIENDLY CARE IN THE VA: MIXED-METHODS IMPLEMENTATION RESULTS OF 39 IMPLEMENTATION INSTANCES
Authors: Peeples Amanda , Ashcraft LauraEllen , Goodman Octavia , Whiteside Phoebe , Brown Rebecca , Burke Robert , Warren Connor , Pelcher Lindsay
Published: January 2025

Age-friendly care integrates the 4Ms (what Matters, Medication, Mentation, Mobility) to promote evidence-based care for older adults. The Safer Aging through Geriatrics-Informed Evidence-Based Practices Quality Enhancement Research Initiative (SAGE QUERI) is a hybrid type-III implementation-effectiveness trial comparing an implementation strategy bundle to dissemination as usual. We implemented four evidence-based practices (EBPs) aligned with the 4Ms across 9 VA Medical Centers. We used descriptive statistics and qualitative interviews with 30 implementing clinicians to report mixed-methods outcomes for reach, adoption, implementation, and maintenance across 39 implementation instances. Reach to Veterans varied widely across EBPs: Mobility n=30; Mentation n=37; Medication n=184; what Matters n=8000+. Eligibility criteria impacted reach; clinicians reported the ease of enrolling Veterans in an EBP with wide eligibility (e.g., every Veteran who is a candidate for surgery) versus an EBP with strict eligibility (e.g., “all the moons have to be aligned” to identify/enroll Veterans). Across 39 implementation instances, 77% (n=31) initially adopted the EBP, with a total of 169 clinicians trained (what Matters n=21; Mobility n=29; Medication n=30; Mentation n=89). Clinicians described training requirements, alignment of EBPs with current practices, and organizational support as key factors influencing adoption. Implementation fidelity varied by EBP: 34% what Matters; 80% Mobility; 100% Mentation and Medication. Clinicians noted the wider impact of EBP-related practice changes, including using new skills with Veterans ineligible for the full EBPs. Across 39 implementation instances, 51% (n=20) reached full maintenance; an additional 23% (n=9) achieved implementation. Sites that had successfully integrated EBPs into practice expressed intentions to sustain EBPs.
DESCRIBING ADVANCED PRACTICE REGISTERED NURSES’ INFLUENCE ON IMPROVED NURSING HOME OUTCOMES
Authors: Johnson Alisha , Vogelsmeier Amy , Thompson Veronica
Published: January 2025

Advanced practice registered nurses (APRN) embedded full-time within nursing homes (NH) improve key resident outcomes such as reducing hospitalizations, increasing advance directive use, and improving resident/family satisfaction. Despite positive evidence, this care model is not widely adopted, and there has been minimal research on how APRN practice impacts outcomes. Informed by Donabedian’s Structure-Process-Outcome framework, we conducted a cross-case analysis to understand how APRNs influenced patient (direct) and facility-level (indirect) outcomes through nursing home structures and processes. We used eight years of data generated from The Missouri Quality Initiative, a CMS-funded demonstration project aimed to reduce avoidable hospitalizations through embedded APRN care in 16 midwestern nursing homes. Cases consisted of two higher-performing homes and two lower-performing NHs. Each case was analyzed using deductive coding of four databases to create a cross-database table. First and second level thematic coding was applied to the cross-database tables to create the high and low performing cases for cross-case comparison. Stark differences arose between the higher and the lower performing cases around themes including proactive/reactive processes, individual vs. group-oriented processes, and administrative supports (present/absent/lip-service). APRNs applied proactive processes at the patient (direct) and facility (indirect) level when NH structure (i.e. adequate administrative support) was present. More successful homes, even with higher turnover, demonstrated proactive mentoring processes, initiated and supported by the APRN, instead of passive, reactive processes and deference to administration. APRNs are effective caregivers if structural supports allow for proactive processes maximizing APRN expertise, supporting the inclusion of APRNs within NH care delivery models.
PROSPECTIVE ASSOCIATIONS BETWEEN THE STATE MINIMUM WAGE AND COGNITIVE FUNCTION IN OLDER AMERICANS
Authors: Lee Boram , Petito Lucia , Kim Daniel
Published: January 2025

Limited research has explored how social policies influence cognitive health in older age. This study aimed to examine the associations between the state-level minimum wage and cognitive function in older US adults. We used data from the Health and Retirement Study (1998-2020) on non-self-employed workers who were age 50-75 and free of dementia at baseline, with cognitive function measured during the study period (N=7490). For cognitive function, we used data based on the Telephone Interview for Cognitive Score (TICS; 0-27, with higher values indicating better cognitive function). We explored the state-level minimum wage, adjusted to 2021 US dollars, lagged by 2, 6, and 10 years. We employed individual fixed-effects linear models and examined for differences in associations by wage, working hours, race/ethnicity, and sex. Among all workers, the state minimum wage was not associated with cognitive function. However, for low-wage workers and part-time workers, a $1 increase in the 6-year lagged state minimum wage was associated with a 0.40 (95% CI=0.17 to 0.64, p=.001) and 0.17 (95% CI=0.03 to 0.32, p=.01) point increase in the TICS, respectively, controlling for time-invariant individual factors and time-varying individual-level and state-level covariates. Among low-wage workers, stronger associations between the state minimum wage and increases in cognitive function were observed in non-Hispanic Whites (β= 0.43, p<.001) but not Black Americans (β=0.04, p=0.91) and Hispanic Americans (β=0.30, p=0.21). There were no differences by sex. Overall, our findings support that increasing the state minimum wage could benefit the cognitive health of older adults, particularly among low-wage workers.
LOCAL USE OF POLLUTING COOKING FUELS AND ADULT COGNITIVE HEALTH
Authors: Mani Sneha , Gupta Aashish , Elo Irma
Published: January 2025

Scientific understanding of the relationship between environmental hazards and cognitive health at older ages in low- and middle-income countries (LMICs) is poor. Using data from the Longitudinal Aging Study of India and the World Health Organization’s Survey on Global AGEing and adult health for four LMICs, we examine the association of direct and local exposure to polluting cooking fuels with cognitive health at older ages. We document the negative influence of both: cognitive health is poorer among household members who use polluting fuels and among residents of neighborhoods where the use of polluting fuels is more common. We find that women living in households that use polluting fuels and where the local use of polluting fuels is the highest have the lowest predicted cognitive scores. Conversely, men living in households that do not use polluting fuels and in areas with no local use of polluting fuels have the highest predicted cognitive scores. These associations cannot be explained by accounting for individual or local differences in socioeconomic status. Our findings reveal the substantial direct and indirect influence of polluting fuel use in LMICs and help understand why overall cognitive health may be poor in these settings, especially for women. Additionally, the presence of negative externalities of solid fuel use for cognitive health implies a greater justification for efforts to reduce the use of such fuels.
ANALYSIS OF THE DEMAND AND INFLUENCING FACTORS FOR SMART HOME CARE AMONG COMMUNITY-DWELLING ELDERLY PEOPLE
Authors: Jia HongFei , Ding YaPing
Published: January 2025

Objective

To investigate the smart home care requirements for community-residing adults in their later years, analyze the factors influencing these needs, and establish a scientific basis for the development of targeted smart care solutions.

Methods

Between December 2023 and February 2024, a convenience sampling method was employed to select 322 community-residing adults in their later years from Jiangsu Province as participants in this study. Assessment tools included a general information questionnaire, the Mini-Mental State Examination (MMSE), the Barthel Index for activities of daily living, and a custom scale to measure the demand for smart home care within this population. Data analysis involved independent samples t-tests, one-way ANOVA, and multiple linear regression to assess the smart home care needs and influencing factors among community-residing adults with disabilities in their later years.

Results

The multiple linear regression analysis indicated that pre-retirement occupation, self-care ability, cognitive function, and the willingness to use smart care technologies in the future are significant factors influencing the demand for smart home care (all P-values < 0.05).

Conclusion

The current demand for smart home care among community-residing adults in their later years exhibits diversity. To adequately meet their multifaceted smart care needs, it is essential to consider the main influencing factors such as their occupational background, level of self-care, and cognitive abilities.
THE ASSOCIATION BETWEEN CLOSE RELATIONSHIPS AND HAPPINESS AMONG OLDER ADULTS
Authors: Abaei Elnaz , Martin Peter
Published: January 2025

Close relationships have long been recognized as crucial in shaping older adults’ happiness and well-being. This study investigated the association between close relationships (including those with a spouse, children, and friends) and happiness among older adults using random intercept cross-lagged panel models (RI-CLPMs). We pooled waves 11-12, 13-14, and 15-16 from the RAND file of the Health and Retirement Study (HRS). Our analytic sample included 15,758 individuals aged 50 years and older (Mean age=67.14). We ran three RI-CLPMs to examine how close relationships with spouse, children, and friends affect the happiness of older adults. All models demonstrated a good fit with the data (spouse’s model, χ2 (df=7)=6.979, p=.43, CFI=TLI=1.00; children’s model, χ2 (df=8)=13.91, p=.08, CFI=TLI=1.00; friend’s model, χ2 (df=8)=17.35, p=.03, CFI=.999, TLI=.996). We also conducted a sensitivity analysis by computing models without missing data imputation. The results were mostly consistent with the initial analysis. In the initial waves, we did not find carry-over and spill-over effects between close relationships and happiness. However, carry-over effects were observed for models in the later waves. We also found that married individuals tend to be happier as they age. Additionally, women were more likely to have close relationships with children and friends compared to men. Practical implications should focus on fostering positive interactions among older adults with close social contacts, like encouraging companionship and supportive communication from spouses and children. Group interventions, such as peer support groups, can enhance happiness by monitoring social interactions to promote well-being in older adults.
TRENDS IN HEALTH CONDITIONS, HEALTH NEEDS, HEALTH SERVICES & MEDICATION USE AMONG OREGON AFH RESIDENTS (2017-2023)
Authors: Albalawi Wafi , Tunalilar Ozcan , Carder Paula
Published: January 2025

The aging U.S. population is increasing the demand for Long-Term Care Services. Adult Foster Homes (AFHs) offer a home-like environment for residents with complex health needs, particularly beneficial for older adults, including those with dementia. However, these settings remain understudied. This study evaluated trends in resident characteristics, chronic conditions, service utilization, medication use, activities of daily living (ADLs), and family involvement among AFH residents in Oregon from 2017 to 2023, using data from the Oregon Community-Based Care study. Data were analyzed using descriptive statistics and OLS regression. Results indicate that the proportion of female residents remained stable at 60-64%. Residents aged 75-84 increased from 18.7% to 25.7%, while those aged 85+ decreased from 41.6% to 31.5%. Hypertension (48.7-51.6%) and dementia (43.6-47.7%) are the most prevalent conditions. Arthritis declined from 37.8% to 30.0%, and multiple medication use peaked at 61.5% in 2023. Bathing (78.4-82.9%) and dressing (60.5-69.5%) are the ADLs requiring the most assistance. Family involvement saw significant changes during the pandemic, with social visits decreasing from 64.9% to 37.8% and outings from 39.8% to 17.4%. The study found both similarities and differences between AFH residents and assisted living (AL) residents in the U.S. Hypertension and dementia were the most prevalent conditions in both groups. However, AFH residents had higher rates of dementia and arthritis, as well as greater reliance on Medicaid (54%-63.2%) compared to AL residents (17%). These findings highlight the higher acuity among AFH residents and emphasize the need for further research on smaller residential settings for older adults.
ADVANCE CARE PLANNING IN A SUBSIDIZED HOUSING COMMUNITY: PRELIMINARY RESEARCH RESULTS FROM A PILOT INTERVENTION
Authors: Kimpel Christine , Chavez Lorely , Ketel Christian , Clouse Kate
Published: January 2025

Advance care planning (ACP) can improve end-of-life outcomes, but ACP remains low among adults with low SES, who likely have had multiple adverse life experiences. To reduce the stress of ACP, we are piloting a trauma-informed advance care planning (TI-ACP) intervention in a subsidized housing community. Following IRB approval, we purposively and snowball sampled 15 adults (aged 18+) in a 150+ unit subsidized housing community in Nashville, Tennessee (May 2024-present). Using a pre-post single-arm intervention design, we conducted visits to collect mixed methods data in the onsite Resiliency Hub, a resource center. The intervention included a researcher-led conversation using a discussion prompt checklist. The median age was 60 (IQR: 57-65), seven (46.7%) identified as Black or African American, and eleven (73.3%) identified as men (n=15). At 30-day follow-up (n=9), implementation acceptability, appropriateness, and feasibility score medians and ranges were 16 (16-18), 16 (15-17), and 16 (15-18), respectively. Implementation barriers included competing priorities, limited social support, skepticism about outsiders, ACP skepticism, and medical mistrust. Potential adaptations included explaining privacy procedures and including supplementary education for challenging medical concepts. Participants rated the innovation as acceptable, appropriate, and feasible and provided insight into potential barriers and adaptations. The conversation checklist and educational materials may be utilized across clinical and community-based contexts. A team-based approach may maximize the benefit of TI-ACP by holistically addressing complex social and health barriers for older adults with low SES. Future iterations will explore using community health workers as interventionists and a community advisory council to design training.
USING THE SAMHSA TRAUMA-INFORMED PRINCIPLES TO ADAPT ADVANCE CARE PLANNING FOR OLDER ADULTS WITH LOW SES
Authors: Kimpel Christine , Chavez Lorely , Ketel Christian , Clouse Kate
Published: January 2025

Advance care planning (ACP) is the process of preparing for future medical care received during times of cognitive incapacity, but the process may be very stressful for low SES communities. To address lifetime traumas and the everyday stress of unmet needs, we used the Substance Abuse and Mental Health Services Administration’s (SAMHSA) trauma-informed principles to adapt an ACP intervention. Using a single-arm pre-post intervention design and mixed methods approach, we continually adapted the intervention with participant feedback (n=19). The initial intervention consisted of an audio-recorded, one-time, in-person, flexible conversational approach using a discussion prompt checklist, conducted in a quiet private setting in a subsidized housing community. We thematically analyzed field notes and intervention transcripts using the SAMHSA framework. Nineteen participants completed the intervention (median age: 60, IQR: 58-63): 10 identified as Black or African American and 12 as men. Themes included trauma awareness (safety), facilitating privacy (trustworthiness), peer referral (peer support), person-centered communication (collaboration), healthcare risk-benefit analysis education (empowerment), and acknowledgment of historical trauma, stigma, and access challenges (equity). We have found the SAMHSA framework useful for enhancing trauma awareness during the ACP process. There is significant conceptual overlap between the person-centeredness of ACP and the SAMHSA principles. The universal safety precautions help to avoid re-traumatization while discussing previous death-related experiences. The equity focus provides opportunities to tailor the approach. These trauma-informed principles should be implemented in clinical provider training, organizational policy and procedures, and future research interventions with similar communities.
Effects of failure parametrization on pre- and coseismic earthquake rupture
Authors: Bolotskaya Ekaterina , Hager Bradford H , Ampuero Jean-Paul
Published: January 2025

This study investigates the impact of different slip-dependent fault failure parametrizations on the pre-seismic and coseismic phases of the earthquake cycle using 2-D finite element simulations. Various failure laws are considered: linear slip-weakening, double slip-weakening, parabolic cohesive zone and exponential cohesive zone laws. The pre-seismic phase is modelled using a quasi-static approach, while the coseismic phase is modelled dynamically. Results demonstrate the importance of accounting for the different shapes of failure laws during the pre-seismic phase, as they lead to variations in pre-seismic phase duration, associated pre-seismic slip and lateral extent of slip front. Failure laws with gentler initial slopes require more time to initiate dynamic rupture compared to those with steeper initial weakening slopes. The presence of an initial strengthening segment in the failure law affects the amount and lateral extent of pre-seismic slip. During dynamic rupture propagation, the specific details of the failure law become less significant due to the Lorentz contraction of the process zone. However, variations in the duration of the pre-seismic phases result in different dynamic stress drops and, consequently, variations in rupture acceleration times and earthquake magnitudes for different failure laws.
NCFDet: Enhanced point cloud features using the neural collapse phenomenon in multimodal fusion for 3D object detection
Authors: Xu Yaming , Xu Minglei , Wang Yan , Li Boliang
Published: January 2025

The accurate and effective detection of 3D objects represents a crucial component in the development of multi-sensor autonomous driving and robotics systems, particularly in the context of navigating complex urban environments. The complementary nature of image and point cloud data allows for the detection of objects with greater accuracy and robustness when both image and point cloud features are employed. At present, there is no optimal solution for the timing of multi-sensor fusion, particularly in the case of cross-modal data formats. In order to address these issues, we propose a multi-sensor object detection scheme based on Neural Collapse (NC) theory augmented point cloud, which we have designated NCFDet. In particular, we have incorporated an image pre-training model at the network layer where the NC occurs and designed a fusion module based on Transformer Attention. Furthermore, we investigate the interconnection between NC and transmodal transfer, and provide an explanation for the efficacy of the former based on the latter. The NCFDet system performs well for the detection of small targets in scenes due to the advantage of a compact image data format. The performance of the proposed NCFDet system was validated on the KITTI (Karlsruhe Institute of Technology and Toyota Technological Institute) dataset in comparison to existing methods. Furthermore, the object detection performance of the proposed framework was demonstrated on our visual rotation platform. The results show that the detection system achieves advanced fusion results. The code will be published after the paper is published.
Validation of a fingertip home sleep apnea testing system using deep learning AI and a temporal event localization analysis
Authors: Chen Ke-Wei , Tseng Chun-Hsien , Lee Hsin-Chien , Liu Wen-Te , Chou Kun-Ta , Wu Hau-Tieng
Published: January 2025

Study Objectives

This paper validates TipTraQ, a compact home sleep apnea testing (HSAT) system. TipTraQ comprises a fingertip-worn device, a mobile application, and a cloud-based deep learning artificial intelligence (AI) system. The device utilizes photoplethysmography (red, infrared, and green channels) and accelerometer sensors to assess sleep apnea by the AI system.

Methods

We prospectively enrolled 240 participants suspected of obstructive sleep apnea (OSA) at a tertiary medical center for internal validation and 112 participants independently at another center for external validation. All participants underwent simultaneous polysomnography and TipTraQ HSAT. We compared TipTraQ-derived total sleep time (TQ-TST) and TipTraQ-derived Respiratory Events Index (TQ-REI) with expert-determined TST and apnea–hypopnea index (AHI), based on AASM standards with the 1B hypopnea rule. Temporal event localization analysis for respiratory event prediction was conducted at both event and hourly levels.

Results

In the external validation, the Spearman correlation coefficients for TQ-TST vs. TST and TQ-REI vs. AHI were 0.81 and 0.95, respectively. The root mean square error were 0.53 hours for TQ-TST vs. TST and 7.53 events/h for TQ-REI vs. AHI. For apnea/hypopnea prediction with a 10-second grace period, the true positive, false positive, and false negative rates in temporal event localization analysis were 0.76, 0.24, and 0.23, respectively. The four-way OSA severity classification achieved a Cohen’s kappa of 0.7.

Conclusions

TQ-TST and TQ-REI predict TST and AHI with comparable performance to existing devices of the same type, and respiratory event prediction is validated through temporal event localization analysis.

Clinical Trials

Development of TipTraQ Home Sleep Test, https://clinicaltrials.gov/study/NCT06474351?term=NCT06474351&rank=1, NCT06474351

TipTraQ Home Sleep Test Study, SHH, https://clinicaltrials.gov/study/NCT06633887?term=NCT06633887&rank=1, NCT06633887
Cotton Plants Presenting Symptoms Associated with Cotton Leafroll Dwarf Virus Revealed a Novel Caulimovirid, Cotton Virus A, with Endogenous Caulimovirids in Its Hosts
Authors: West-Ortiz Michael , Olmedo-Velarde Alejandro , Stuehler Jr. Douglas , Pollock Emma , Alvarez-Quinto Robert , Wilson Jennifer R. , Preising Stephanie , Larrea-Sarmiento Adriana , Alabi Olufemi J. , Fuchs Marc , Heck Michelle
Published: January 2025

The dynamics of cotton leafroll dwarf virus (CLRDV) symptomology in Gossypium plants was investigated in Mississippi in 2019 and 2022. High-throughput sequencing of libraries constructed from ribo-depleted total RNA or total nucleic acids and bioinformatic analyses revealed a novel virus, cotton virus A (CotVA), that clusters within the family Caulimoviridae alongside two unclassified viruses related to ruflodiviruses and caulimoviruses. Endogenous CotVA elements, referred to as endogenous caulimovirids (ECVs), were identified in multiple chromosomes of seven out of 26 Gossypium species analyzed, including two commercial species: G. hirsutum (Upland cotton) and G. barbadense (Pima cotton). The circular nature of the episomal genome of one CotVA isolate was confirmed using five overlapping primer sets. A DNase protection assay on purified virus preparations revealed evidence of CotVA virions. The presence of CotVA ECVs and/or an episomal form of CotVA in cotton fields complicates the interpretation of CLRDV symptoms, but proper studies are needed to determine if CotVA is associated with any symptomology. Possible synergistic interactions among CLRDV, CotVA, and proteins, or other molecules produced by ECVs and the impact of these interactions on any possible disease progression require further investigation.