bluuebunny/crossref_metadata_2025 huggingface dataset:
INTERNET USE, PERCEIVED CONTROL, AND INFORMATION ANXIETY AMONG CHINESE OLDER ADULTS
Authors: Zhang Jiaan
Published: January 2025

Despite increasing evidence that Internet use may contribute to Internet-related anxiety in the digital age, studies specifically focusing on older adults remain limited. This study investigates the association between Internet use and information anxiety among older adults, and examines whether this relationship is mediated by perceived control. We analyzed newly collected data from a random sample of adults aged 55 and older living in Shanghai, China in 2024. The total sample comprised 428 older Internet users. Internet use was assessed by measuring the duration of Internet use, frequency of Internet use, and types of Internet use. Information anxiety was measured using a 23-item scale based on Wurman’s theory of Information Anxiety, with each item rated on a 5-point scale ranging from strongly disagree to strongly agree. Perceived control was evaluated by asking respondents to indicate their agreement with statements including four items of personal mastery and eight items of perceived constraints, using a 7-point scale. The results indicate that the duration of Internet use is significantly associated with lower levels of information anxiety, and that Internet use for communication and social use reduces information anxiety. Additionally, perceived control is negatively associated with information anxiety. Further analysis reveals that perceived control partially mediates the relationship between Internet use duration and information anxiety. These findings have important implications for developing effective interventions to alleviate Internet-related anxiety among older adults.
LIFELONG LEARNING: HOW HEALTH LITERACY SHIELDS OLDER ADULTS FROM THE MORTALITY RISKS OF LOWER EDUCATION
Authors: Lee Hee , Song Jieun , Do Jonghwa
Published: January 2025

Research has demonstrated the significant impacts of education and health literacy (HL) on mortality risks. However, the combined effects of education and HL on mortality in older age, particularly using population samples, remain underexplored. This study investigates whether the association between education and mortality is moderated by varying levels of HL among older adults, using data from the Wisconsin Longitudinal Study (1957-2020). The analytic sample includes participants aged 60 and older at the 2010-2012 data collection (n=3,381, mean age=70.8). Mortality data were obtained from the National Death Index 2021 files, and HL was measured using the Newest Vital Sign (NVS) Health Literacy Score. Within this cohort, 531 respondents had limited HL, 893 had possibly limited HL, and 1,957 had adequate HL. Survival analysis using Cox Proportional Hazard models revealed that older adults with limited HL who completed only high school or some college education faced 22% and 49% higher mortality risks, respectively, compared to their peers with a college degree. Notably, high school graduates with adequate HL exhibited a 20% lower risk of mortality compared to those with a college degree but limited HL. These findings suggest that the adverse effects of lower education on mortality can be significantly mitigated by adequate health literacy, even in older age. This underscores the importance of interventions focused on enhancing health literacy, particularly among older adults with relatively lower educational attainment.
LIVED EXPERIENCE OF DEMENTIA FAMILY CAREGIVERS IN RURAL CHINA: FINDINGS FROM A QUALITATIVE STUDY
Authors: Kong Dexia
Published: January 2025

Background

Currently, China has the highest prevalence of dementia worldwide. The prevalence of dementia is greater in rural areas than in urban ones, mostly because over two-thirds of Chinese older adults reside in rural regions. Moreover, the cultural preference for family-based eldercare, in conjunction with the absence of dementia-related services in rural areas of China, has resulted in the responsibility of caring for older adults with dementia falling solely on family caregivers. Nevertheless, there has been no prior research that has examined the lived experiences of caregivers of individuals with dementia in rural China. This study investigates the lived experiences of dementia family caregivers in rural China, thereby addressing the knowledge gap.

Methods

In-depth qualitative data were collected from 25 family caregivers residing in a rural county in southwestern China. All interviews were recorded and transcribed verbatim. The interview narratives were analyzed using the conventional content analysis approach. All transcripts were coded by two experienced researchers with qualitative training. Discrepancies in coding were resolved by consensus.

Results

Main themes that emerged from the data include caregivers’ perceptions of dementia, motivation for caregiving, challenges in caregiving, dynamics within family relationships, coping strategies, and unmet needs.

Conclusion

In rural China, families are crucial to the care of older adults living with dementia. The findings underscore the pressing need to develop psychoeducational intervention strategies for supporting family caregivers of individuals with dementia in rural or low-resource regions in China. Policy and service implications will also be discussed.
MAKING BUILT ENVIRONMENT MORE AGE-FRIENDLY -- FIRST TASK OF UNIVERSITY OF COLORADO AGE-FRIENDLY TASKFORCE
Authors: Nearing Kathryn , Waterhouse Jodi
Published: January 2025

When the Age-Friendly University (AFU) Taskforce at the University of Colorado Anschutz Medical Campus initiated strategic planning in 2023, the built environment – an antecedent condition for achieving AFU priorities – emerged as priority #1. The taskforce tailored an existing tool available from University of Massachusetts-Boston to align the built-environment assessment with the broader mission-focused areas of CU Anschutz – one of the first four academic medical campuses in the world to receive the AFU designation. During April 2023, each taskforce representative paired with an older adult community member; each dyad was assigned a campus zone to assess using the adapted Age-Friendly Inventory and Campus Climate Survey. The community member provided first-hand accounts of how they experienced aspects of the built environment, while the taskforce representative recorded observations. Once compiled, the taskforce reviewed data and identified the following areas of concern: wayfinding supports (e.g., signs and campus maps -- printed, online); parking kiosk accessibility; distances (e.g., from parking to campus buildings); campus building and restroom accessibility. Taskforce members presented results and recommendations to the Chancellor, campus architect, Vice Chancellor for Facilities, and Communications team. Through campuswide collaborations that expanded to include parking managers and the campus shuttle service, issues with campus maps, parking kiosks, crosswalks, walking distances, and building/restroom accessibility are being addressed, with a progress report provided to the Chancellor in July 2024. This work is essential. The built environment fundamentally influences campus accessibility across the lifespan and the age-inclusivity of events, classes, research studies and healthcare services.
NON-PHARMACOLOGICAL DEMENTIA CARE APPROACHES: IMPLEMENTING STAR-VA IN A SHORT-STAY, SUBACUTE MEDICAL SETTING
Authors: Christopher Jennifer , Christopher Theresa , Yuelling Thomas
Published: January 2025

Staff Training in Assisted Living Residences for Veterans Affairs Medical Centers (STAR-VA) is an evidenced-based, interdisciplinary, non-pharmacological approach to managing dementia-related behavioral and psychological symptoms in long-term care settings (Karlin et al., 2017). The program involves a psychologist and nurse who provide dementia education, facilitate behavioral analysis, and implement person-centered behavior plans. This study highlights the piloting of STAR-VA in a short-stay, subacute, medical rehabilitation setting. The case study involves a 74-year-old African American, male, Veteran diagnosed with Dementia due to Multiple Etiologies (Frontotemporal Degeneration and Vascular Disease). The Veteran exhibited elopement attempts, refusal to follow directions, falls, verbal aggression, and emotional distress. Behavioral analysis suggested these were related to lack of independence, boredom, psychosocial stressors, and medication side effects. Behavior plan interventions included individual psychotherapy, scheduled recreation therapy sessions focused on preferred pleasant activities, and chaplain services. The clinical pharmacist reviewed the medication list and psychiatry and general medicine providers adjusted medications. Care providers were encouraged to use effective nonverbal and verbal communication strategies, including the “listen with respect, comfort, and redirect” approach. After two months, assessments (i.e., Neuropsychiatric Inventory Questionnaire, Cohen-Mansfield Agitation Inventory–Short Form, Geriatric Depression Scale–Short Form) revealed discontinued elopement attempts, compliance with care, improved mood, reduced falls, and decreased nursing staff distress. These interventions facilitated the Veteran’s transition to long-term community placement. Six-month follow-up assessments revealed the Veteran remained behaviorally stable. This case demonstrated that STAR-VA can be effectively adapted for short-stay, subacute medical rehabilitation settings. It further supports interdisciplinary, non-pharmacological approaches for dementia.
PSYCHOTHERAPY AND CARE QUALITY OF LONG-STAY NURSING HOME RESIDENTS WITH MENTAL ILLNESS OR DEMENTIA
Authors: Huan Tianwen , Intrator Orna , Simning Adam , Boockvar Kenneth , Grabowski David C , Cai Shubing
Published: January 2025

This study aims to fill the knowledge gap on the effect of psychotherapy on the quality of care of long-stay nursing home (NH) residents with mental illness or Alzheimer’s Disease and Related Dementias (ADRD). The 2017-2018 MDS and Medicare claims (e.g., Carrier file) and Residential History File were used to identify mental illness and ADRD diagnoses, patient characteristics, psychotherapy and quality of care. Fee-for-service Medicare beneficiaries aged 65 and older enrolled in Medicare Parts B who had six quarterly MDS assessments with/ without psychotherapy in the last four quarters were compared on two subgroups of residents: those with mental illness but no ADRD and those with ADRD. Five quarterly outcomes were examined: any 1) physical behavior; 2) verbal behavior; 3) other behavior; 4) hospitalization; 5) emergency-room visits. Covariates included predisposing, enabling characteristics and need factors. Propensity score matching was used to balance covariates between treatment and control groups. Difference-in-difference models of quarterly data, clustered within patients, were estimated for each outcome among each cohort. Analyses included 525,114/180,000 resident-quarter observations from 87,519/30,000 unique NH long-stay residents with ADRD/mental-illness-only. Among the ADRD/mental-illness-only group, 579/469 unique residents received psychotherapy. Psychotherapy was associated with lower likelihood of hospitalization (Odds ratio: 0.73, 95%CI: 0.53, 0.99) in residents with mental-illness-only. No significant results were found for the other outcomes nor the ADRD group. Findings suggest that psychotherapy may have limited effects on the quality of care for residents with ADRD but may contribute to lower hospitalization risk among residents with mental-illness-only.
ENHANCING DEMENTIA CLASSIFICATION FOR DIVERSE GROUPS: TRANSFORMER-BASED CONTINUOUS SCORING OF CLOCK DRAWING TEST
Authors: Hu Mengyao , Murphey Yi , Qin Tian , Zahodne Laura , Gonzalez Richard , Freedman Vicki
Published: January 2025

Alzheimer’s disease and related dementias (ADRD) significantly impact older adults’ quality of life and pose challenges to public health systems. The clock-drawing test (CDT) is a widely used dementia screening tool due to its ease of administration and effectiveness. However, manual CDT-coding in large-scale studies can be time-intensive and prone to coding errors. In this study, we developed a deep learning neural network (DLNN) system based on Vision Transformer (ViT) to automate CDT-coding using continuous scoring and investigate its value for dementia classification, compared to ordinal CDT scores. Using a nationally representative sample of older adults from the National Health and Aging Trends Study (NHATS), we trained ViT models on CDT images to generate both ordinal and continuous scores. We compared the predictive power of these scores for dementia classification and identified demographic-specific thresholds. Continuous CDT scores provided more precise thresholds for dementia classification than ordinal scores, varying by demographic characteristics. Lower thresholds were identified for Black individuals, those with lower education, and those aged 90 or older. Compared to ordinal scores, continuous scores also allowed for a more balanced sensitivity and specificity. This study demonstrates the potential of continuous CDT scores generated by DLNN models in enhancing dementia classification. By identifying demographic-specific thresholds, it offers a more inclusive and adaptive approach for dementia classification. Results of this study could lead to improved guidelines for using CDT in dementia screening, allowing more accurate dementia classification across diverse demographic groups.
ASSESSING THE EFFECTS OF VR URBAN GREENNESS WITH PEER SUPPORT MODEL FOR MENTAL HEALTH IN AGING POPULATION
Authors: Lu Shiyu , Chui Hiu-kwan , Li Linyan
Published: January 2025

Engaging with green spaces has shown to benefit mental health in later years. However, global urbanization has limited city-dwellers’ access to nature, especially older adults who may struggle to reach such spaces. Virtual Reality (VR) urban greenness offers a cost-effective solution for promoting mental well-being in this demographic. This study aimed to assess the effectiveness of the VR urban greenness with peer support model in enhancing mental health among the aging population. From October 2023 to July 2024, we collaboratively developed a 5-minute 360-degree VR video of urban green spaces with older individuals in Hong Kong, using the photovice method. Subsequently, we conducted a 3-arm randomized controlled trial involving 25 participants with mild depressive symptoms in each arm: VR urban green space with peer supporters (A), VR urban green space without peer supporters (B), and non-biophilic VR intervention without peer supporters as a control group. Both intervention groups (A and B) reported significant reductions in stress levels, anxiety, and negative emotions, coupled with an increase in positive emotions. Conversely, no significant changes were observed in the control group. Following the qualitative study, it emerged that participants in both intervention groups displayed favorable attitudes towards VR and showed strong acceptance of the 360-degree VR urban green spaces. The research further delved into the policy and practical implications of integrating VR technology into mental health promotion strategies for the elderly.
AGEISM SOURCES AFFECT TECHNOLOGY ACCEPTANCE ON WEARABLE ROBOTS: A RANDOMIZED BETWEEN-SUBJECT EXPERIMENT
Authors: Cheng Clio Yuen Man , Lou Vivian Weiqun
Published: January 2025

Existing literature shows that ageism contributes to the widening of digital divide. However, it remains largely mysterious how ageism specifically impacts technology acceptance, particularly in the context of soft wearable robots. This study aims to fill this gap by conducting a randomized between-subject experiment with six animation vignettes: self-directed ageism, ageism from family and friends, ageism from technology developers, ageism from strangers, unframed, and control. A total of 237 older adults aged 50 to 74 in Hong Kong joined the experiment. The Kruskal-Wallis tests show group significant difference in the intention to use wearable robots, χ2(5) = 12.470, p =.029. Specifically, the study found that ageism from technology developers had a significant negative impact on the intention to use wearable robots, in contrast to ageism from family and friends or strangers. Additionally, ageism from family and friends was associated with a significantly higher perceived external control of wearable robots, χ2(5) = 12.184, p =.032, as well as a significantly higher perceived performance of wearable robots, χ2(5) = 14.767, p =.011, when compared to ageism from technology developers and the control condition. Ageism from family and friends yielded a notably higher perception of health benefits associated with wearable robots, χ2(5) = 23.766, p <.001, surpassing self-directed ageism, ageism from technology developers, and the control condition. These findings highlight the distinct effects of ageism from different sources on wearable robot acceptance, underscoring the importance of considering the specific origins of ageism when examining its impact on technology acceptance.
INNOVATING THE DETECTION OF CARE PRIORITIES IN HEART FAILURE USING LARGE LANGUAGE MODELS
Authors: Albashayreh Alaa , Zeinali Nahid , White Stephanie
Published: January 2025

Engaging older adults with advanced chronic conditions, such as heart failure, in discussions about their care priorities is crucial for ensuring treatments align with their preferences, especially at the end of life. Despite the abundance of data in electronic health records (EHRs), documentation of care priorities is often inconsistent and underutilized. This study utilizes natural language processing (NLP) to detect and characterize care priorities in the EHRs of older adults with heart failure, aiming to enhance patient-centered care. We retrained Bio-Clinical-BERT, a Bidirectional Encoder Representations from Transformers (BERT) large language model, using EHR data from a Midwestern U.S. hospital to create Care-BERT, a novel model for predicting care priorities in clinical narratives. We developed a gold-standard corpus of 1,068 notes, focusing on comfort measures only and life-sustaining treatments, with the dataset divided into training (80%) and testing (20%) sets. Care-BERT outperformed BERT-base, Bio-Clinical-BERT, and PubMed-BERT, achieving the highest performance in predicting care priorities (internal validation: F1-score = 0.941, AUC = 0.978; external validation with 200 GPT-based synthetic notes: F1-score = 0.876, AUC = 0.966). Applied to 2,218,251 EHR notes for 7,984 older adults with heart failure (mean age = 76.9 years), Care-BERT revealed that 2.8% had comfort measures only and 17.3% had life-sustaining treatments documented. This study highlights the potential of Transformer-based NLP models like Care-BERT to improve the documentation of care priorities in EHRs and enhance patient-centered care. Future research will explore documentation variations across patient groups using NLP-based labels, providing further insights into care preferences.
TRANSRURAL LIVES: LESSONS FROM AN INTERDISCIPLINARY COMMUNITY-BASED DIGITAL STORYTELLING PROJECT
Authors: Tester Griff , Eliatamby-O’Brien M
Published: January 2025

TransRural Lives is an interdisciplinary, community-based digital storytelling project focused on transgender older adults (50+) living in non-metropolitan areas of the Pacific Northwest. Through unstructured interviews, we create audio vignettes that capture their unique experiences, which are featured on our website. While social science research often groups lesbian, gay, and transgender older adults together, older transgender individuals face distinct health and community-building challenges. Additionally, much of the scholarship overlooks the urban-rural divide, often portraying transgender people as primarily urban subjects. However, rural areas offer alternative sites for transgender identity formation that are equally significant. TransRural Lives provides a platform for non-linear and metaphorical storytelling, allowing participants to express joy, repression, and gender knowledge on their terms, without the constraints of linear, medicalized narratives. Our project highlights the socio-cultural, geographic, and historical factors that have shaped transgender experiences in rural areas, revealing the complexity of their lives. This paper reflects on the first two years of our work, including the relationships we’ve developed with community partners and the challenges of navigating university policies that often do not accommodate community engagement – such as debates over the use of incentives and disputes about “ownership” of stories. This issue is particularly relevant for partners like the Northwest Portland Area Indian Health Board’s Paths (Re)Membered Project, which empowers the Two Spirit and Indigenous LGBTQ+ community by emphasizing their strengths, resilience, and histories in the pursuit of health equity, and actively challenges research procedures rooted in colonial practices.
CLINICIAN TYPE AND SETTING OF CARE DELIVERED TO MEDICARE BENEFICIARIES WITH DEMENTIA IN THE U.S
Authors: Maust Donovan , Davis Rachel , Muench Ulrike , Marcus Steven , Spetz Joanne
Published: January 2025

Improving care coordination for persons living with dementia (PLWD) requires understanding of the types of clinicians delivering care and the settings in which they practice. We identified all beneficiaries with dementia in traditional Medicare in 2019. We used the Medicare Carrier file—i.e., where bills for care provided by individual clinicians are recorded—to identify clinicians providing care to PLWD, which we then linked to the National Plan & Provider Enumeration System (NPPES). Using the Carrier and NPPES files, we characterized the workforce providing care to PLWD, including specialty and licensure (e.g., primary care physician, neurologist, nurse practitioner), setting of care delivery, and whether the clinician included a dementia diagnosis in the billing information. Overall, 1,934,318 PLWD received care from 783,225 unique clinicians. The most common settings of care were office (74.8% of PLWD), emergency room (63.9%), inpatient hospital (52.1%), and skilled nursing facility (37.1%). 87.0% of PLWD received care from a primary care physician, 62.9% from a nurse practitioner, and 33.1% from a physician assistant. Among all the clinicians that care for PLWD, 20.3% are primary care physicians, 15.3% nurse practitioners, and 9.0% physician assistants. 2.4% are psychiatrists, 1.7% neurologist, and just 0.5% are geriatric subspecialist physicians. For clinicians providing care to PLWD, the majority provide care in the outpatient setting, followed by hospital-based care. Programs to improve care coordination for PLWD, such as GUIDE Model programs, must account for delivery across multiple health care settings, recognizing that geriatric subspecialists comprise an extremely small proportion of the PLWD-serving workforce.
TEN-YEAR ANALYSIS OF ADVERSE DRUG REACTIONS IN PEOPLE WITH DEMENTIA USING FDA ADVERSE EVENT REPORTING SYSTEM DATA
Authors: Mao Jieyu , Yamakawa Miyae , Takeya Yasushi
Published: January 2025

Dementia often leads to polypharmacy and increased ADR risk, making ADR recognition vital since People with Dementia (PwD) struggle to communicate discomfort. This study used the FDA Adverse Event Reporting System (FAERS) database from 2013 to 2024 to extract dementia-related ADR reports. A total of 23,519 ADR reports were analyzed after data cleansing. Missing data was addressed using the MissForest algorithm and refined with KNN imputation. Signal detection calculated PRR (Proportional Reporting Ratio) for frequently reported drugs and ADRs. Over the ten years, the number of dementia-related ADR reports fluctuated significantly, while showing a sharp peak around 2023. Consumers are the most common reporters of ADRs, accounting for 33.4% of the reports, followed by medical doctors at 30.1%. The median time from treatment initiation to the occurrence of ADR was 20 days. Regarding patient outcomes, 38.2% reported hospitalization, and 12.4% reported death. The most reported ADRs were death (706 cases), drug ineffective (527 cases), off label use (502 cases) and aggression (458 cases). Approximately 48.8% of the top 100 ADR reports can be observed and reported by nurses. Exelon Patch was the drug most frequently reported to cause ADRs, strongly associated with death, while Epidiolex showed significant signals for seizure. Cholinesterase inhibitors and antipsychotics/anticonvulsants had high ADR report counts across multiple system organ classes, especially nervous system. Due to cognitive impairments, PwD often face challenges in reporting symptoms, highlighting the importance of objective observation and monitoring by healthcare professionals to ensure accurate ADR identification and improve PwD outcomes.
FASTER EPIGENETIC AGING AND INCREASED RISK OF PROSPECTIVE MORBIDITY AND MORTALITY FOR U.S. VETERANS
Authors: Bourassa Kyle
Published: January 2025

Epigenetic measures of aging have promise as biomarkers of future morbidity and mortality, but require validation in real-world medical settings. To provide evidence of this validation, we investigated whether an epigenetic measure of aging—DunedinPACE—was associated with prospective health for 2,216 post-9/11 U.S. military veterans enrolled in the Post-Deployment Mental Health Study (472 women, 1,744 men; 1,077 non-Hispanic Black veterans, 1,139 non-Hispanic White veterans). Prospective health outcomes included chronic disease burden (Charlson comorbidity index), predicted annual VA healthcare costs (Nosos scores), chronic disease incidence, and mortality—all assessed using VA electronic health records (EHR). Veterans averaged 37.4 years old at enrollment and with an average of 13.1 years of EHR follow-up. Veterans with faster DunedinPACE aging scores developed greater chronic disease burden and greater predicted healthcare costs over the subsequent 5, 10 year, and 15 years. Faster aging scores were associated with increased risk for incident myocardial infarction, stroke, diabetes, cancer, liver disease, and renal disease, as well as greater risk of mortality due to all-causes and death due to chronic disease. Results remained when controlling for demographic and technical covariates, as well as self-reported smoking and smoking methylations scores, replicated when stratifying by sex and race/ethnicity, and replicated when using an alternative measure of epigenetic aging (PC-GrimAge). These findings suggest DunedinPACE is a biomarker of accelerated aging that associated with prospective morbidity and mortality across multiple chronic diseases and organ systems. With further refinement, epigenetic aging scores have the potential to be useful clinical biomarkers of future health.
AN ASSESSMENT OF STATE EMPLOYEE BACKGROUND CHECK POLICIES FOR IMPROVING QUALITY IN NURSING FACILITIES
Authors: Mehboob Gul Rukh , Kaskie Brian , Sharma Hari
Published: January 2025

Employee background checks are important measures for ensuring the safety of older adults in nursing homes. Programs like the National Background Check Program (NBCP) provide federal grants to help states enhance their background check systems for long-term care receivers. While these checks require resources, their effectiveness in reducing abuse, neglect, and exploitation remains uncertain. We aim to compare NBCP grant-receiving states (N=27) with non-receiving states (N=23) to identify regulatory changes and adaptation of specific policy measures over time to improve employee background check systems. We used a policy scan approach to compare and rank states by thoroughly analyzing regulations, bills, documents and reports from 2005 to 2024. We evaluated states based on three policy domains: types of LTC providers required to conduct employee background checks, the disqualifying offenses considered by the states, and the processes used to implement and administer these checks. We also analyzed temporal changes in states’ background check systems over time. We found notable differences in regulations concerning the types of LTC providers involved and disqualifying offenses between NBCP and non-NBCP states. However, we found little difference in the processes between these two groups. Overall, the NBCP states show better adaptation and temporal changes due to advanced technical systems and improved regulations. To our knowledge, this is the first study to comprehensively assess the regulatory framework of state employee background check systems. Our study has direct policy implications for state and national policymakers debating the effectiveness of NBCP in improving nursing home quality.
THE PERCEIVED LIFE EXPERIENCES OF AFRICAN METHODIST EPISCOPAL (AME) MEMBERS
Authors: Lane-Nelson Nia
Published: January 2025

The African American (AA) church has played an essential role in the AA community. Using the Life Course Theory (LCT) as a sensitizing framework, this qualitative descriptive study described how AA members of one AME church perceived their life experiences as influencing their current health status. LCT key concepts (pathways or trajectories, early life experiences, critical or sensitive periods, cumulative impacts, and risk and protective factors) concentrate on the socioeconomic and environmental contexts within the life of an individual. Individual interview questions were developed based on the LCT key concepts. Seventeen in-depth interviews were conducted. Qualitative content analysis was used to identify categories and subcategories. Within the key concept of early life experiences 3 categories (Economic hardships, Personal hardships, and Protective influences in early childhood) were identified. Within the category of Economic hardships 3 subcategories were identified; not having food, living was tight, and neglect in early childhood due to economic hardships. Within Personal hardships the subcategories were parental responsibilities in early childhood, separation in family, family trauma, and experiences with racism at an early age. Within Protective influences in early childhood the subcategories were receiving love and support, feeling safe and protected, learning from parents and others, dealing with racism, and active in childhood activities. Through using the LCT, participants were able to highlight the social, economic, and environmental issues experienced throughout their lives and the impact on their health. Participants shared narratives spanning from early childhood to the present, with a common stressor being experiences with racial discrimination.
UNDERSTANDING RACIAL BIAS AWARENESS ACROSS ADULTHOOD: THEMES OF BIAS, JUSTIFICATIONS, AND EMOTIONS
Authors: Beatty Jennifer , Hill Patrick , Doriscar Jonathan E , Leath Seanna
Published: January 2025

This project employed a mixed-methods approach to analyze how age-diverse White Americans (N = 345; age range: 19 to 85) make meaning of specific instances of personal racial bias. Across three data collections, that targeted younger, middle-aged, and older adults, we asked participants to write about a time when they were racially biased. In the samples, 98% of younger adults, 91% of middle-aged adults, and 86% of older adults indicated specific instances of racial bias, and many indicated antiblack bias. Age-diverse adults frequently assumed that racial out-group members were criminal or deviant or assumed that those individuals had an undesirable culture. The participants also often indicated numerous justifications and emotions about their bias. For example, common justifications across all ages included perceived threat or the ambiguity of the situation. Specific emotions and justifications only differed moderately by age. Our findings indicate that while age-diverse White adults may make meaning of their bias in different ways, they tend to do so with self-conscious emotions and bias justifications that do not mitigate bias. Critically, middle-aged and older adults were less likely to indicate emotions at all in their reports. These findings may reflect a positivity bias among older adults who are less willing to highlight or remember their negative emotions or it may speak to the possibility that they may feel less fear in intergroup settings. The current work offers insights into more personalized approaches to bias regulation by integrating specific bias contexts with bias justifications and emotional awareness.
ADVERSE CHILDHOOD EXPERIENCES AND SOCIAL PARTICIPATION ON FRAILTY STATE TRANSITIONS: A 10-YEAR PROSPECTIVE COHORT
Authors: Li Jiajia , Pei Heming , Kang Ning , Chen Gong , Pei Lijun
Published: January 2025

Background

Adverse childhood experiences (ACEs) is associated with frailty, while the association with frailty state transitions and the role of social participation remain unclear. This study aimed to investigate the association between ACEs and frailty state transition, alongside the moderation effect of social participation

methods

Data from 9,621 adults aged 45+ from the CHARLS (2011-2020) were analyzed. Frailty was measured with the frailty index, while ACEs and social participation were measured with a validated questionnaire. The association between ACEs and frailty state transitions was estimated with multi-state models. Interaction analysis was used to examine the moderation effects of social participation.

Results

Participants exposed to higher ACEs levels (≥ 4) were associated with an increased risk of forward transition (robust to pre-frail, HR=1.36, 95%CI: 1.21-1.53; prefrail to frail, HR=1.38, 95%CI: 1.17 - 1.62) and decreased risk of backward transition (pre-frail to robust, HR = 0.64, 95%CI: 0.54 – 0.76). Additionally, participants with social participation were associated with increased risk of backward transition (frail to pre-frail, HR = 1.14, 95%CI: 1.02 – 1.27). Social participation moderated the association between ACEs exposure and frailty (P for interaction < 0.05), while participants with lower ACEs exposure levels and social participation were associated with an increased risk of transition from frail to pre-frail (ACEs levels =1, HR = 1.57, 95%CI: 1.06 – 2.32; ACEs levels =2, HR = 1.49, 95%CI: 1.02 – 2.17).

Conclusion

High levels of ACEs exposure were associated with a greater likelihood of adverse frailty development. Older adults with ACEs exposure might benefit from intervention strategies to improve social participation.
CREATING A SUCCESSFUL DATA PLAN: NIA BEHAVIORAL AND SOCIAL AGING RESEARCH DMS REVIEW EXPERIENCE
Authors: McNally James , Jain Paavani
Published: January 2025

The revised NIH Data Management and Sharing (DMS) Policy took effect in January 2023, requiring all researchers applying for NIH funding to develop a detailed DMS plan as part of the application. In turn, NIH became responsible for reviewing and approving the submitted plan before issuing an award and monitoring compliance. Having recently completed our first year of DMS reviews, this presentation will report lessons learned by the NIA Division of Behavioral and Social Research (DBSR). One of the critical changes was the requirement for a six-element document addressing Data Type; Related Tools, Software, and Code; Standards; Data Preservation, Access, and Associated Timelines; Access, Distribution, or Reuse Considerations; and Oversight of Data Management and Sharing study. Despite efforts to educate and prepare all parties for this transition, researchers had questions about the best way to prepare a DMS plan and from NIA staff on reviewing the submitted requests. Within DBSR, the Office of Data Resources and Analytics (ODRA) established a review team to examine DMS plans, develop necessary resources, and coach grantees. The presentation will present lessons learned for best practices in DMS development. We will discuss handling primary versus secondary data, metadata, and source code, selecting an appropriate repository for socio-behavioral and interdisciplinary aging data, data restrictions, and navigating various grant mechanisms and their data prospects. A non-compliant DMS plan can delay or reverse funding decisions; NIA seeks to ensure all researchers understand this plan’s importance and how to successfully create one that supports ongoing scientific discovery.
FUNCTIONAL LIMITATIONS AND MORTALITY AMONG PERSONS AGING WITH HIV INFECTION AND SUBSTANCE USE
Authors: Ramamurthi Hema , Gruber-Baldini Ann , Orwig Denise
Published: January 2025

Aging individuals living with HIV experience earlier onset of adverse health outcomes, increased hospitalization rates, and mortality. However, there is limited research demonstrating the impact of HIV, substance use and functional limitations on survival. We analyzed self-reported longitudinal data collected during biannual visits from 2005 to 2020 among 2,633 participants contributing 120527 study visits in the community-engaged, AIDS Linked to the Intravenous Experience (ALIVE) cohort. Functional limitation was defined as having reported “limited a lot” in one of the 4 items of the physical activity section of Medical Outcomes Study-HIV scale. Scores from each visit were summed and categorized into: No Limitation = 0, Moderate Level of Limitation = 1-2 and Severe Limitation > 3. The sample included 751 (28.52%) People Living with HIV (PLWH), who were slightly older than HIV-negative counterparts (47.97 years vs. 44.89 years, p< 0.001). PLWH had a higher prevalence of functional limitations compared to HIV-negative individuals (44.1% vs. 38.3%, p< 0.05). In Cox Proportional Hazards models adjusted for socio-demographic, lifestyle factors and comorbidities, detectable viral load (HR=2.49, CI=2.08-2.97), and having 1-2 or >3 functional limitations (HR=1.27, CI =1.07-1.50 & HR=1.78, CI=1.51-2.10) respectively were predictive of mortality. This analysis highlights the importance of self-reported functional limitations and other potentially modifiable risk factors as important correlates of mortality among PLWH. These factors should be of key focus in the development of future interventions to effectively reduce adverse outcomes among PLWH.
BEING A SUPERWOMAN, THE EXPLORATION OF AFRICAN AMERICAN WOMEN DEMENTIA CAREGIVERS AND THEIR MENTAL HEALTH
Authors: Rhodes Shanae
Published: January 2025

Existing literature presents evidence that African American caregivers experience a health paradox where they have commonly reported having worse physical health but better mental health related to caregiver burden when compared to other racial groups. However, there are inconsistencies across the research literature regarding mental health outcomes for this population. Guided by Pearlin’s Stress Process Model and the Superwoman Schema, the purpose of this study was to explore the influence of the Superwoman Schema characteristics and caregiver burden on the psychological health (anxiety and depressive symptoms) of African American female caregivers. A mixed methods design was used for this study. This presentation will focus on the quantitative segment. Cross-sectional correlations and regression analyses were conducted using data collected from 127 participants to investigate the relationship between caregiver burden, the five Superwoman characteristics, and psychological health for African American female caregivers. Results showed that caregivers who reported a higher endorsement of any of the Superwoman characteristics were more likely to report higher caregiver burden, anxiety, and depressive symptoms. Endorsement of some of the Superwoman characteristics (i.e., obligation to present an image of strength and obligation to help) partially mediated the relationship between caregiver burden and anxiety and caregiver burden and depressive symptoms. Future research should continue to examine the mediation of Superwoman characteristics on the relationship between caregiver burden and psychological health outcomes. These partial mediators can inform intervention development to mitigate the negative impact of caregiver burden on mental health.
ENHANCING COGNITIVE AND EMOTIONAL WELL-BEING THROUGH PIANO TRAINING IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT
Authors: Lin Rose , Robinson Laura , Freer Elinor , Heffner Kathi
Published: January 2025

Neuropsychiatric symptoms such as depressed mood are increasingly recognized alongside cognitive decline in older adults with mild cognitive impairment (MCI). In response to international guidelines advocating a holistic approach to address both emotional and cognitive symptoms, we conducted a descriptive qualitative study to assess the feasibility and acceptability of a 12-week structured piano training program for seven older adults with MCI. This program included weekly one-hour sessions alternating between individual and group formats, focusing on music theory and scales, with 15-minute daily practices. Content analysis of semi-structured interviews revealed that participants found piano training rewarding, they appreciated integrating piano practice into daily routines, which fostered a sense of purpose and enhanced their ability to manage schedules and handling everyday tasks. Notably, 71.4% of participants enrolled in community school piano class following program completion. They valued interacting with peers facing similar cognitive challenges provided comfort and shared understanding of cognitive decline. Positive reinforcement from instructors and tailored support were crucial in sustaining motivation, particularly when frustrations associated with acquiring new skills, as noted in prior and current studies, could worsen neuropsychiatric symptoms. Recognizing their abilities to learn, despite cognitive decline, boosted self-confidence that often compromised by cognitive impairment. Some adopted piano playing as a new strategy to cope with negative emotions, enhancing overall emotional resilience. Our preliminary findings suggest that piano training has potential to improve well-being in older adults with MCI, setting stage for assessing its long-term impact on cognitive and emotional well-being in larger trials.
UNDERSTANDING THE SUBJECTIVITIES OF OLDER ADULTS WITH DEMENTIA IN A RESIDENTIAL CARE FACILITY
Authors: Shen Lingyi
Published: January 2025

China has the largest population of people with dementia. However, inadequate care support is available, leading to families to being overwhelmed and compelled to send their loved ones to residential care facilities. While much attention has been paid to understanding institutional dementia care from the caregivers’ perspectives, seldom does research focus on the experiences of older adults with dementia, especially in China. This study aims to explore the subjectivities of older adults with dementia in a residential care facility in the Chinese context. Over a two-month period, participant observation was conducted with informal conversations in a dementia unit in eastern China. Based on the collective perception, reconstructed memory and oral histories, different individuals’ realities were articulated. Through verbal and physical behaviors such as resistance to care, othering and grouping, older adults with dementia constructed the understanding towards themselves and their surroundings, as well as their own meaning of life. Constant manifestation of intersubjectivity was also observed within the group. Despite their disrupted lived experiences, older adults with dementia maintained their established relationships, with family and beyond, and connections with the broader society through their performance of embodied experiences, disclosing the complexity of family dynamics in contemporary China and the social history of the country. The study also identifies elements that constrain their subjectivities, such as the overuse of antipsychotics and therapeutic lies. A new and dialectical perspective towards the relationship between older adults with dementia and the care institution is provided, informing the development of person-centered dementia care in China.
UNDERSTANDING CHALLENGES & ADAPTIVE STRATEGIES FOR BATHING & SHOWERING AMONG ADULTS WITH MOBILITY DISABILITIES
Authors: Bhowmick Pallabi , Remillard Elena , Daliparthi Meghana , Shahid Kainat , Rogers Wendy , Rice Ian
Published: January 2025

Self-care and bathing activities are among the most challenging and dangerous activities for individuals aging with mobility disabilities, yet their technology needs remain largely unexplored. There is a need for more specificity about the nature of the challenges. Two user needs studies were conducted exploring challenges and strategies for everyday activities among individuals with long-term mobility impairments (lasting at least 10 years). We analyzed data on bathing/showering challenges from a subsample of participants from these two studies (n=28), aged 52–86 (M=64; SD=9.2), who were wheelchair users and were unable to stand due to lower body mobility impairments. Findings reveal several critical issues and adaptive strategies around bathing/showering. 82% of the participants either stopped bathing (i.e., submerging in a tub) or could not bathe without assistance, relying instead on overhead shower systems and adaptations like roll-in, no-threshold showers, grab bars, and shower chairs/benches. Secondly, the majority transitioned to handheld showerheads over fixed showerheads, and to using bathing wands/reacher sticks for greater flexibility in cleaning themselves. Lastly, several participants expressed concerns about the loss of upper body strength with age, making it difficult to use heavy showerheads or adjust water temperature with controls that are difficult to reach and press. These findings underscore the need for customizable, assistive showering devices for individuals who must shower in a seated position, a research area that has received limited attention. Designing a lightweight robotic showerhead with accessible controls could be a promising solution, which would significantly enhance independence and quality of life for these individuals.
INITIAL DEVELOPMENT OF THE WRITING TO HEAL APP: A STRUCTURED WRITING SERIES FOR CAREGIVERS OF SPOUSES LIVING WITH ADRD
Authors: LeRoy Angie , Weiss Samantha , Harris Katherine , Maza Valentina , Wickline Sierra , Henderson Alexandria , Liskovec Leona
Published: January 2025

Caregiving for a spouse living with Alzheimer’s or a Related Dementia (ADRD) is incredibly stressful, and puts caregivers at risk for developing health problems, themselves. Caregivers’ health issues may affect not only their own quality of life but also their ability to care for their spouse. Thus, developing interventions that support caregivers and help mitigate the stress associated with caregiving, is critical. In Part I of the study, we conducted focus groups with people caring for a spouse living with ADRD) to identify opportunities for targeted treatment and potential barriers to a cognitive-based online expressive writing intervention specifically tailored to spousal caregivers. Results from Part I indicated that caregivers had dynamic needs and requested an intervention that was efficient, mobile, and readily accessible. Collaborating with a product designer to review the qualitative results from Part I, the research team determined that an app would be the best-fitting modality for intervention delivery. In Part IIa, we conducted a second wave of focus groups, throughout which we iteratively adapted the design for an app-based writing intervention for stress and grief among spousal caregivers. To prepare for app development, we conducted preliminary usability testing (Part IIb), during which caregivers interacted with a prototype of the future app to complete a number of proposed task flows. In this article, we present methods and results from Parts I & II as well as reviewing our future plans for app development and subsequent beta testing of the intervention in a pilot RCT.