bluuebunny/crossref_metadata_2025 huggingface dataset:
BLOOD BIOMARKERS OF NEURODEGENERATION ARE ASSOCIATED WITH SMARTPHONE-ASSESSED SUBJECTIVE COGNITIVE CONCERNS
Authors: De La Garza Ángel García , Wang Cuiling , Mogle Jacqueline , Derby Carol , Lipton Richard , Rabin Laura , Katz Mindy
Published: January 2025

The association between blood-based biomarkers of Alzheimer’s Disease (BBBs) and daily diary smartphone assessment of subjective cognitive concerns (SCC) is unexplored. In the Einstein Aging Study, we collected digital diary information on 18 types of cognitive lapses per day over a 14-day period on 271 participants (mean age 77.50, SD 4.90, 66.8% Female, 47.6% Non-Hispanic-White, 40.2% Non-Hispanic-Black, 12.1% Hispanic). BBBs investigated included β-amyloid (Aβ40, Aβ42), the Aβ42:Aβ40 ratio, pTau181, neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). Daily diary SCC was analyzed by calculating the average daily number of lapses related to memory (12 items, mean = 0.99, SD = 0.97), the average daily number of lapses related to executive functioning (6 items, mean = 0.53, SD = 0.74), and the daily average number of all cognitive lapses (18 items, mean = 1.53, SD = 1.59), where higher scores indicated greater self-reported cognitive difficulties. Utilizing separate linear regression, we assessed the association between BBB levels and cognitive lapses, adjusting for age, sex, ethnicity, depression, and years of education. Findings indicate that, on average, for every 1 standard deviation increase in blood levels of pTau181, participants reported an additional 0.21 additional cognitive lapses in the memory domain (p< 0.001) and 0.11 in the executive functioning domain (p=0.012) for a total of 0.32 daily cognitive lapses (p< 0.001). No significant associations were identified between Aβ40, Aβ42, Aβ42:Aβ40 ratio, NfL, GFAP, and daily diary SCC. Captured in this manner, SCC may serve as a scalable indicator of AD pathology, progression, and monitoring the disease.
MITOPHAGY ACTIVATION EXTENDS LONGEVITY AND PREVENTS AGE-RELATED CARDIAC FUNCTIONAL DECLINE
Authors: Sun Nuo
Published: January 2025

Mitophagy is a specialized autophagic pathway that removes damaged mitochondria, providing a critical mechanism to maintain mitochondrial quality. Accumulating evidence suggests that a decline in mitophagy might contribute to the development of age-related cardiac pathologies. Therefore, pharmacological manipulation of mitophagy offers a novel therapeutic strategy to alleviate the risks of disease and mortality associated with aging. We conducted high-content image-based assays for mitophagy modulators using the pH-dependent fluorescent mitophagy reporter, mt-Keima. Additionally, we designed an algorithm to analyze a collection of over 10,000 compounds at 15 concentrations. This algorithm identified several selective mitophagy inducers, with Mito-I emerging as the most effective mitophagy activator. We demonstrated that Mito-I potently induces mitophagy in human cardiac myocytes derived from induced pluripotent stem cells (hiPSC-CM) and mouse hearts. Interestingly, our mechanistic studies revealed that Mito-I effectively upregulates BCL2-interacting protein 3 (BNIP3), which acts as a mitophagy receptor and is indispensable for Mito-I-induced mitophagy. Excitingly, we also found that Mito-I treatment extended lifespan in C. elegans. Moreover, we showed that Mito-I administration in aged (18-month-old) mice alleviates the detrimental effects of aging on cardiovascular health. These results demonstrate that the age-induced decrease in mitophagy contributes significantly to diminished cardiovascular function and identifies a novel therapeutic strategy to improve cardiovascular function with aging.
DIGITAL MOBILITY MONITORING FOR HEALTHY AGING: RESULTS FROM LARGE AGING COHORTS IN EUROPE AND CANADA
Authors: Jansen Carl-Philipp , Beauchamp Marla
Published: January 2025

Mobility has been deemed the ‘sixth vital sign’ because of its ability to predict critical health outcomes in later adulthood. Up to now, there is no consensus on the ideal measurement of mobility, but previous findings and experiences with movement sensors have led to regular application of digital technology. Important but unanswered questions remain around the potential of digital mobility outcomes (DMOs) to monitor individuals’ health status, to serve as markers for physical or functional decline, and to predict clinically meaningful events such as falls and hospitalisations. This could provide a better understanding of older adults’ and patients’ general health based on recurrent monitoring of their mobility. Against this background, data from major cohort studies in Europe and Canada are presented. Marla Beauchamp will present a recently proposed unified framework for mobility measurement, outlining three distinct aspects of mobility and investigating their relationship in a cohort of 1,200 older adults. Carl-Philipp Jansen will complement this data by looking at the same three aspects in a clinical cohort of 566 hip fracture patients, however, comparing their trajectories over one year. Laura Delgado-Ortiz will explore sensor-derived real-world walking in 550 older adults with COPD with healthy older counterparts, thereby capturing different characteristics of walking activity and gait from a single device worn at subjects’ lower back for one week. Karen Van Ooteghem will provide a look beyond single-sensor approaches, highlighting the large potential and presenting principles of multi-sensor approaches to provide comprehensive and meaningful information on mobility in older adults.
UNIFIED FRAMEWORK FOR MEASURING MOBILITY IN OLDER PEOPLE: EMERGING DATA FROM A CANADIAN AGING COHORT
Authors: Beauchamp Marla
Published: January 2025

In the 2015 World Health Organization (WHO) World Report on Aging and Health, mobility is described as movement in all its forms either powered by the body or by a vehicle. Mobility thus encompasses basic movements such as standing up from a chair to more complex activities such as walking or using transportation. Many outcome measures have been developed to assess mobility, however, the variability in constructs being assessed and lack of standardisation in terminology present challenges to advance research and practice in this area. We propose a unified framework for mobility measurement in older populations consistent with the latest language and terminology endorsed by the WHO. The framework outlines three distinct constructs: perceived mobility (“what can you do?”), locomotor capacity for mobility (“what could you do?”), and actual mobility (“what do you do in daily life?”). The latter construct, actual mobility, has been less well studied until recently. Wearable devices offer the unique advantage of comprehensively monitoring the real-world actual mobility of older people in their homes and communities. In this talk, we will present emerging data from the McMaster Monitoring My Mobility (MacM3) study, a digital mobility cohort of over 1200 community-dwelling older adults with detailed mobility measurements spanning all three aspects of mobility and examine their relationships with clinically important health outcomes. In this way, we will be able to test the suitability of our framework and highlight the potential of digitally derived measures of actual mobility for informing aging research and practice.
HOW DOES THE USE OF HIGH-COST TREATMENTS IMPACT UTILIZATION OF THE MEDICARE HOSPICE BENEFIT?
Authors: Plotzke Michael , Christian Thomas
Published: January 2025

Medicare patients who may benefit from palliative chemotherapy, radiation, or blood transfusions for symptom management (hereafter called “high-cost treatments”) may face difficulties accessing those treatments while electing hospice. The Medicare hospice benefit allows these high-cost treatments, but the treatments’ cost may exceed hospice agencies’ Medicare payments, limiting hospices’ ability to cover high-cost treatments. Lack of access to high-cost treatments may discourage transitions to hospice, resulting in costly and less patient-centered care. Using 100% Fee-for-Service (FFS) Medicare Part A/B claims, we examine how frequently these high-cost treatments are used at the end of life and how hospice use varies by the receipt of high-cost treatments. 7,631,620 FFS Medicare beneficiaries died from FY 2017-2021 and roughly 19.8% of those received at least one high-cost treatment in the 180 days before death (8.3% used chemotherapy, 3.73% used radiation, 12.8% used transfusions) and 47.1% used hospice in the 180 days before death. Of the 786,402 beneficiaries that used both hospice and at least one high-cost treatment in the 180 days before death, only 16,478 (2.1%) used hospice and a high-cost treatment simultaneously. We also found that the average hospice length of stay for those using high-cost treatments in the last 180 days of life is substantially shorter than for beneficiaries electing hospice without using those services (chemotherapy recipients - 22.9 days, radiation recipients – 23.2 days, transfusion recipients -25.5 days, non-recipients – 105.6 days). These findings may indicate barriers to receiving hospice for beneficiaries who may benefit from high-cost palliative treatments.
INPATIENT AND OUTPATIENT PALLIATIVE CARE AMONG VETERANS: THE NATIONAL LANDSCAPE
Authors: Kaufman Brystana , Woolson Sandra , Burns Madison , Ma Jessica , Thorpe Joshua M , Hastings Susan , Bekelman David , Van Houtven Courtney
Published: January 2025

Palliative care (PC) improves quality of life for people with life-limiting conditions (LLC), which is common among older adults. In the United States, use of PC in the outpatient setting has expanded over the past decade; yet, most research has focused on inpatient PC. This study compared characteristics and use for veterans with inpatient or outpatient PC care nationally. The sample included veterans with specialty VA PC encounters, identified using VA and Medicare administrative data (2014-2017). Specialty PC encounters were identified using clinic stop codes (353, 351) and current procedural terminology codes (99242-99245). Of 120,249 unique veterans with specialty PC, 67.8% had PC only in the inpatient setting (n=81,523) and 32.2% had at least one PC encounter in the outpatient setting (n=38,726). One third experienced the first PC encounter within 2 years of meeting LLC criteria. Outpatient versus inpatient PC users were more likely to have cancer and less likely to have high frailty, but sociodemographic factors including rurality and housing instability were similar. Duration of hospice use was similar between inpatient (median = 37 days; interquartile range, IQR =11, 112) and outpatient (median=44 days; IQR=14, 118) PC users, and shorter among those with only one PC encounter (median =18 days; IQR=5, 64). Among veterans with PC use, one third received at least some PC in the outpatient care setting. Differences between veterans with inpatient and outpatient use motivates the need for further research to understand how care setting and timing of PC impacts outcomes for veterans and older adults.
THE ROLE OF HEALTH CARE STEREOTYPE THREAT IN END-OF-LIFE PLANNING AMONG OLDER SEXUAL MINORITY ADULTS
Authors: Singleton Meki
Published: January 2025

Healthcare stereotype threat (HCST), defined as “the threat of being reduced to group stereotypes within healthcare encounters”, may occur when social identities negatively impact healthcare experiences. Prior research has shown that individuals report experiencing HCST related to age, gender, weight, race/ethnicity, HIV status, and sexual orientation. However, little is known about how HCST may be associated with end-of-life care planning. The aim of this study was to examine the association between comfort with medical decision making and advance care planning (ACP) activities and HCST related to sexual orientation and race. We conducted an online survey from 2022—2023 to collect information about older sexual minority (SM) adults’ ACP activities and perceptions of HCST. Respondents (N=281) included Black (n=133) and White (n=148) SM adults. Logistic regression revealed that those with higher levels of HCST–sexual orientation had 13% lower odds of being very comfortable with medical decision-making (p< 0.001) and 6% higher odds of having ACP discussions (p< 0.05). Higher rates of HCST–race was associated with 8% lower odds of being very comfortable with medical decision-making (p< 0.05) and 10% higher odds of having ACP discussions (p< 0.001), 7% higher odds of having completed a living will (p< 0.05), and 10% higher odds of having designated a healthcare proxy (p< 0.001). Findings demonstrate that HCST may negatively impact comfort in healthcare decision-making while also potentially motivating older SM adults to formally engage in ACP. Research is needed to investigate the barriers and challenges to engaging in ACP among older SM adults and interventions to reduce HCST.
DISASTER AND EMERGENCY SUPPORT NETWORKS OF FAMILIES PROVIDING CARE TO PERSONS LIVING WITH DEMENTIA
Authors: Ashida Sato , Lynn Freda , Donohoe Maria , Killian Emily
Published: January 2025

Persons living with dementia (PLWD) and their caregivers are especially vulnerable in disaster situations. Research describes the composition and function of caregiving support networks, but not how these networks support families in terms of disaster preparedness. Currently, a study is underway to investigate disaster and emergency support networks and caregiver resilience. The baseline data collected thus far show that caregivers (N=59) identified 633 support members in total (M=10.4 members per respondent) via four prompts: family members important to PLWD (25%), others important to PLWD (37%), others important to themselves (25%), and additional members who would support them in disaster situations (12%). Of all named members, respondents identified 44% (M=4.5 members per respondent) as those who would provide assistance in emergency situations. However, respondents shared emergency preparedness information with only 9% (M=1 member) and discussed disaster plans with only 16% (M=1.7 members). Respondents’ perceived preparedness to provide care in general was higher compared to their perceived preparedness to provide care in emergency situations (p<.001 for difference in means). Respondents with a greater number of assistance providers in their network reported higher caregiving preparedness in disaster situations (b=0.09, p=0.02) but not higher caregiving preparedness in general. Results suggest that caregivers may mobilize their support networks differently in the context of general caregiving versus caregiving in emergency situations. Efforts to increase discussions about disaster preparedness and management plans with support network members will be beneficial. Future research should focus on identifying strategies to strengthen caregiving support networks to be resilient in disaster situations.
AGE DISPARITIES IN EXPOSURE TO HEAT WAVES, EXTREME WEATHER, AND WILDFIRES IN A NATIONAL UNITED STATES SAMPLE
Authors: Wong Roger
Published: January 2025

Severe climate events have become increasingly frequent. Extensive research has shown that older adults are more adversely impacted by these climate events, often due to more prevalent health conditions contributing to functional impairment. There is, however, no existing research that has examined whether age disparities may exist across exposures to different types of climate events, especially with a national sample. To address this gap, the 2022 American Trends Panel data were analyzed to examine age group differences in exposure to heat waves, extreme weather (flood or intense storm), and wildfires in a nationally representative U.S. sample of 10,282 adults aged 18 and older. In a multiple logistic regression model, adults aged 65+ had 42% significantly lower odds of exposure to heat waves compared to adults aged 18-29 (adjusted odds ratio [aOR]=0.58, 95% CI=0.45-0.76, p<.001), after applying survey sampling weights and adjusting for a variety of sociodemographic covariates. For extreme weather exposure, adults aged 65+ had 44% significantly lower odds compared to adults aged 18-29 (aOR=0.56, 95% CI=0.43-0.72, p<.001). The odds of wildfire exposure was 45% significantly lower among adults aged 65+ compared to adults aged 18-29 (aOR=0.55, 95% CI=0.38-0.79, p<.01). Across all age groups, our results indicate older adults are the least likely to be exposed to climate events related to heat, extreme weather, and wildfire despite the higher strain placed on this populations. Future research is warranted to understand factors contributing to lower climate event exposures, and degree of burden when these different climate events occur among older populations.
A QUALITATIVE STUDY IN COGNITIVE CARE PLANNING: THE ROLE OF FAMILY CAREGIVERS
Authors: Britt Katherine , Xaio Xaviera , Sun Kevin , Ge Shaoqing , Huang Bin
Published: January 2025

Patients with cognitive impairment and dementia may benefit from cognitive care planning, a process of routinely and systematically evaluating patient needs and making lifestyle recommendations (i.e., physical exercise, healthier eating, medication recommendations, and advance care planning). Though dementia is progressive, tailored lifestyle recommendations and planning can improve emotional health, quality of life, and resource utilization to alleviate the disease burden. However, cognitive care planning is underutilized, and barriers to optimizing the process remain. We conducted a qualitative descriptive study with family care providers (N=9) who provide care for older adults, including patients with cognitive impairment and dementia, to explore the role of family caregivers in cognitive care planning with patients. Conventional content analysis was used. Several facilitators and barriers around family caregivers in cognitive care planning implementation were identified across four categories: uncertainty, burden, absence, and priority. Family caregivers were often older, experiencing their own health challenges, and uncertain how to get help and navigate the healthcare system. Family and caregivers’ presence during cognitive care planning was reported as a critical facilitator as it’s essential for gathering patient context, documenting changes in daily abilities, and facilitating provider communication. Our study has important implications for stakeholders. Family caregivers indicated education needs for steps to take in cognitive planning when noticing cognitive changes in a loved one. Healthcare systems (i.e., providers, schedulers, clinical staff) need to make provisions for encouraging family companionship in cognitively impaired older adults’ checkups, offering support and resources for navigation.
RECEIVED SOCIAL SUPPORT SATISFACTION MAY INFLUENCE THE PERCEIVED STRESS-COGNITION ASSOCIATION IN BLACK AMERICANS
Authors: Byrd DeAnnah , Coon David , Thorpe, Jr. Roland , Whitfield Keith E
Published: January 2025

Previous research suggests that perceptions of stress shape cognitive health. Social support has been shown to be protective. Yet, it is not clear whether satisfaction with support is also beneficial. The aim of this study was to determine whether perceived stress is associated with cognitive changes over time and if satisfaction with receipt of emotional or instrumental support acts as a moderator in a sample of older Blacks 48 to 95 years of age, who were enrolled in the Baltimore Study of Black Aging—Patterns of Cognitive Aging and interviewed at two time points, approximately 3 years apart (N = 450). Cognition included 5 domains: working memory, processing speed, verbal memory, vocabulary, and inductive reasoning. Social support satisfaction was measured by asking participants “How satisfied are you with the emotional or instrumental support that you get from your family and friends in terms of how they make you feel and how much it helps you?” Results from the linear regression model showed no direct effect of stress on cognitive decline. Satisfaction with instrumental support marginally (p <.10) modified the relationship between stress and working memory at follow-up but was not related to any other cognitive domains, adjusting for age, sex, education, depressive symptoms, comorbidities, and baseline cognition. Findings demonstrate the joint effects of stress and social support satisfaction on cognition, highlighting the need for more research documenting protective factors for domain-specific cognitive decline. This approach provides a basis for developing cognitive interventions and support networks for this population of Black Americans.
EMERGENCY PREPAREDNESS COMMUNICATION PREFERENCES OF OLDER IMMIGRANTS AND REFUGEES
Authors: Dabelko-Schoeny Holly , Rao Smitha , Sheldon Marisa , Traver Anthony , Doherty Fiona , Acharya Jhuma
Published: January 2025

Older immigrants and refugees in the U.S. face unique challenges with transportation, service access, and social integration, all critical risk factors for negative outcomes from extreme weather. This study aimed to: (1) Identify where older immigrants and refugees get information about weather-related emergencies; (2) Explore the role trusted information sources play in weather-related emergency-preparedness; and (3) Understand what supports older immigrants and refugees need to prepare for weather-related emergencies. Eleven focus groups were conducted (in English, Nepali, Tigrinya, Kinyarwanda, Somali, Amharic, Mandarin Chinese, Russian, and Khmer) with adults aged 62 and older (N = 56) in a large metropolitan Midwestern U.S. city. Most participants were immigrants and refugees, had annual incomes below $15,000, and lived alone. Preliminary analyses reveal television, radio, phone alerts, and school notifications were predominant information sources. Participants emphasized the importance of receiving communication in their native language, translation services, and simple visuals conveying preparedness information. Participants stressed the importance of reliable information sources and personal judgment in determining information trustworthiness. When asked about motivation to prepare for extreme weather, participants underscored the desire to avoid getting hurt or sick. Specifically, participants identified the need for better access to air quality information during pollution events. Participants suggested the government provide safe spaces for those without secure homes. Participants also emphasized the importance of home visits to address isolation and assistance with medication pick-up during emergencies. Findings lend insights into unique communication needs and priorities among older refugees and immigrants related to increasing extreme weather events.
SOCIOECONOMIC STATUS AND COGNITIVE DIFFICULTY: DIMINISHED RETURNS AMONG OLDER BHUTANESE REFUGEES IN THE US
Authors: Kitchens Katherine , Kirsch Jaclyn
Published: January 2025

Refugee populations report cognitive difficulties at a rate significantly higher than observed among older immigrants and native-born U.S. adults. There is evidence that socioeconomic status acts as a buffer against mild cognitive impairment. This study aimed to examine how socioeconomic status is differentially associated with cognitive difficulties between older Bhutanese refugees and other refugee groups in the United States (N = 5,666), using the 2021 American Community Survey five-year estimates and the official refugee counts from the Department of Homeland Security. Binary logistic regression analyses examined the moderating effect of Bhutanese refugee status on the association of income level and high school completion with self-reported cognitive difficulty, controlling for demographic and integration variables. High school completion was associated with a 43% decrease in the odds of cognitive difficulty among older refugees (AOR = 0.57, p<.001, 95% CI [0.43,0.75]), yet educational attainment was not a significant protective factor for older Bhutanese refugees, who had almost three times the odds of experiencing a cognitive difficulty compared to other refugee groups (AOR = 2.86, p<.001, 95% CI [1.86,4.40]). Interactions with income level indicated that living above 138% of the federal poverty level significantly increased the odds of reporting a cognitive difficulty (AOR = 2.86, p<.001 95% CI [1.86,4.40], suggesting that higher income does not serve as a protective factor against cognitive difficulty for older refugees from Bhutan, giving evidence of diminished returns. Findings suggest a need for policies that enable Bhutanese refugees to convert their resources more effectively into concrete cognitive health outcomes.
FACES OF FORTITUDE: DIVERSE CAREGIVERS PROVIDING COMPLEX CARE
Authors: Young Heather , Bell Janice , Kelly Kathleen
Published: January 2025

Last year, more than 56 million family caregivers provided unpaid care to a family member, a number that will grow along population aging and increased prevalence of chronic and serious illness. The demands, resources and outcomes of family caregiving are shaped by the social and environmental context and the particular demands associated with the condition of the care recipient. In 2021, California adopted a Master Plan on Aging, including two investments to strengthen community-based supports for caregivers: Improving caregiver resource centers and adult day programs. This mixed method symposium highlights the fortitude of family caregivers and community-based organizations. We focus on specific health conditions in understudied family caregiver populations as well as the interface with formal services. The first paper examines experiences of caregiving and home care among caregivers of persons with Amyotrophic Lateral Sclerosis. The second paper compares caregiving activities and outcomes among caregivers of individuals with Parkinson’s Disease/Lewy Body Dementia to those with Alzheimer’s Disease and related dementia and other chronic conditions. The third paper examines building family capacity through family and nurse collaboration during acute illness. The fourth presentation describes the impact of adult day care services from the perspectives of family caregivers of persons with dementia. The final presentation, using a large statewide database, describes caregiving demands, unmet needs and resource gaps of diverse family caregivers to inform a caregiving equity plan for the State of California. Together, these papers reflect complexity, diversity and fortitude in family caregiving.
NURSE–FAMILY INTERACTION DURING ACUTE HOSPITALIZATION OF OLDER ADULTS
Authors: Tonkikh Orly , Siegel Elena , Johnson Yuuko , Ogugu Everlyne , Young Heather
Published: January 2025

Family caregivers play a vital role for older adults during acute illness, yet there is limited research on the dynamics between nurses and families of older adults in acute care settings. This descriptive qualitative study explored perspectives on interactions during acute hospitalization in medical-surgical units among 24 nurses and caregivers. We conducted semi-structured interviews and used thematic analysis to identify key conditions and patterns of interaction. Nurses acknowledge the importance of family input to tailor and execute care plans to improve patient outcomes. Hospital structures (e.g., discharge planning guidelines) and nursing values and priorities (e.g., patient safety) influence the ways nurses interact with families. For example, nurses take a proactive approach in response to perceived safety and behavioral concerns and discharge planning. Without the structure of a formal assessment of caregiver needs and priorities, nurses rely on families to initiate interaction and glean insights about family context and preferences from anecdotal information. For the most part, nurses and families operate in parallel worlds with three main patterns of interaction: (1) caregiver proactivity leading to bi-directional interaction; (2) unidirectional interaction from nurses to caregivers; and (3) limited interaction. The study highlights lost opportunities for meaningful engagement to advance the older adult’s health. While nurses acknowledge the benefits of family engagement, few structures (e.g., training and standardized assessment) exist to facilitate family involvement in the current patient-centered healthcare system. This provides direction for further exploration of structures to support optimal nurse-family interaction, to enhance continuity and quality of acute care.
COPING WITH AMYOTROPHIC LATERAL SCLEROSIS (ALS): EXPERIENCES OF PERSONS LIVING WITH ALS AND THEIR FAMILY CAREGIVERS
Authors: Ogugu Everlyne , Tonkikh Orly , Famula Jessica , Young Heather , Bell Janice , Fields Bronwyn , Oskarsson Bjorn
Published: January 2025

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that profoundly impacts the lives of people with the condition and their family caregivers. Little is known about the experiences of care at home among individuals with ALS and their family caregivers. This qualitative study explored these experiences in 14 in-depth interviews that included seven persons with ALS and 13 family caregivers. The findings were organized based on the Salutogenic Model of Health. The main sources of stress reported included the overwhelming nature of getting an ALS diagnosis, inadequacy of health care teams in providing emotional support and promoting shared decision-making in regard to the management of ALS, high level of illness acuity, the intense nature of caregiving involved in ALS, high cost of treatments and equipment, difficulties navigating the healthcare system, unavailability of suitable medical equipment, scarcity of paid caregivers competent in managing ALS, and lack of adequate training for family caregivers. Perspectives on positive coping included mental toughness, maintaining a positive outlook about life and the future, being proactive in seeking support to maintain function and quality of life, proactively communicating with care teams, advanced care planning, having a sense of control over ALS management plan of care, and taking a break from caregiving. Instrumental and emotional support from family, friends, community organizations, and healthcare teams, as well as sufficient insurance and financial coverage for ALS treatments, facilitated better coping. Future research and policies should focus on identifying effective multisectoral strategies for supporting people with ALS and their caregivers.
PROTECTING THE HEALTH OF VIETNAMESE REFUGEES BY LOCAL HEALTH PROFESSIONALS AND UNIVERSITY STUDENTS
Authors: Miyawaki Christina , Nguyen Kim , Ho Tuong-Vi , McClellan Angela
Published: January 2025

Nearly 50 years after the fall of Saigon (1975), studies continue to show the high prevalence of physical (ADL, IADL), mental (depressive symptoms), and cognitive (dementia) disabilities in older Vietnamese refugees. Adverse lifelong experiences in Vietnam and host countries may have impacted these results. Some refugees who arrived during their youth became health professionals while their children attend universities, predominantly enrolled in pre-health courses. Leveraging their bilingual/bicultural and health background, they have hosted free health fairs for their monolingual older Vietnamese for the past 16 years in Houston, Texas, the 2nd largest Vietnamese-populated city in the nation. Despite the high prevalence of dementia, no free cognitive healthcare has been provided. The purpose of the study is to report the collaborative efforts to fill the gap using the Cultural Exchange Model (CEM) and improve dementia literacy. The CEM teaches that to create knowledge, two constituencies need to merge within the Community. One arm of Vietnamese stakeholders (older adults, medical doctors) already exists. We formed another arm, Cognitive Health Initiative (CHAIN): 28 bilingual/bicultural Vietnamese university students, who were trained in Montreal Cognitive Assessment (MoCA). During 2023, we jointly attended 11 health fairs with Vietnamese medical professionals and offered 337 MoCA in Vietnamese and English. The results showed that older Vietnamese (≥65) scored the lowest (22.4/30) among participants (White=24.8; Black=23.9; Hispanic=23.3). Utilizing existing, underlying resilience and the unique affinity among local Vietnamese health professionals, our next steps include continuing to offer a “Memory Booth” by local Vietnamese pre-health students, thereby strengthening intergenerational relationships.
PERCEIVED NEIGHBORHOOD CHARACTERISTICS AND ACTIVITY ENGAGEMENT AMONG RACIALLY DIVERSE OLDER ADULTS
Authors: Jang Jeein , Avila Jaqueline , Burr Jeffrey
Published: January 2025

Engagement in social, cognitive, and physical activities is vital for healthy aging. Perceived neighborhood environment is associated with activity engagement, but there may be differences in this association between racial and ethnic groups. This study investigates the associations between neighborhood characteristics and activity engagement, emphasizing different activity domains and how race/ethnicity modifies this relationship. Using Health and Retirement Study data, the sample includes 9,180 adults aged 50 and above. The outcome is engagement in a list of 21 activities in the 2018-2020, measured as a total composite score and by domain (social, cognitive, and physical activities). The predictors are neighborhood social cohesion and physical disorder. Poisson regression analyses show a positive association between social cohesion and total activity engagement among older adults. Physical disorder is also positively associated with total activity engagement, suggesting that older adults in neighborhoods with high physical disorder may have tight-knit communities and strong bonds, working together to prevent further deterioration. Black older adults exhibit 1.03 times greater activity engagement than non-Hispanic Whites, while there were no differences compared to Hispanic individuals. Importantly, the association between social cohesion and overall activity engagement is weaker among Hispanics, even with the highest cohesion level. This suggests that Hispanics may prioritize individual autonomy in their activity choices over the influence of neighborhood social cohesion. Results by activity domains showed that the impact of social cohesion extended to each domain. Racial and ethnic differences warrant closer investigation in studies of neighborhoods and activity engagement in later life.
CO-DESIGNING A MOBILE-BASED COGNITIVE TRAINING WITH OLDER CHINESE AMERICANS AND THEIR ADULT CHILDREN
Authors: Xue Tingzhong (Michelle) , McConnell Eleanor , Wei Amy , Wu Bei , Xu Hanzhang
Published: January 2025

Older Chinese Americans are at high risk for dementia, yet often fail to access to prevention services/programs due to language barriers, transportation issues etc. BrainHQ is a mobile-based, effective cognitive training program that can potentially address these barriers and delay cognitive decline in older Chinese Americans. In this study, we will apply an experience-based co-design approach that leverages the existing BrainHQ features and older Chinese Americans’ prior knowledge, lived experience, and social norms around dementia to co-develop a cognitive training intervention. We first have worked with BrainHQ to translate and adapt more than 30 evidence-based cognitive training exercises into Chinese. We then hosted focus groups among older Chinese Americans (n=21) to understand their perceived benefits and barriers regarding participating in cognitive training. We also interviewed their adult children separately as they are often influenced by the ideology of filial piety and assume a major responsibility for caregiving. Utilizing the findings of the focus groups, we will then conduct an experience-based co-design workshop with older Chinese Americans (n=6), their adult children (n=6), and community stakeholders (n=2) to improve the cultural and linguistic relevance of the intervention. We will start with a journey map where participants are guided to brainstorm challenges (e.g. fears and anxieties related to performance, time constrains, distrust) they may experience when participating in the intervention. Then they will be asked to create prototypes of intervention components to address these challenges. These findings will facilitate better delivery of the cognitive training among older Chinese Americans and inform broader implementation.
OVERVIEW OF NIA MISSION AND RESEARCH
Authors: Hodes Richard
Published: January 2025

Dr. Hodes will provide an overview of NIA’s structure and mission, in addition to discussing research foci from across the Institute’s scientific divisions.
ADVERSE CHILDHOOD EXPERIENCES AND DEMENTIA AMONG OLDER US ADULTS: ASSESSMENT OF GENDER AND RACIAL DISPARITIES
Authors: Brown Monique
Published: January 2025

Six in ten US adults report exposure to adverse childhood experiences (ACEs). However, their effects on health outcomes are seen across the life course. ACEs have been linked to cognitive impairment. However, less is known about the association between ACEs and a dementia diagnosis. In addition, gender and racial disparities may exist in this relationship. Therefore, this study aimed to determine the association between ACEs and dementia, and to assess the related gender and racial disparities. Data were obtained from the 2012-2020 Health and Retirement Study (N=4,235 respondents aged 51 and older). ACEs assessed included emotional neglect, parental substance abuse, physical abuse, economic adversity, academic challenges, and problems with the law. Dementia was operationalized as ever having dementia. Crude and adjusted logistic regression models were used to determine the associations between ACEs and dementia. Additive and multiplicative interaction effects by gender and race were tested. Approximately 70% of participants reported ACEs and 3% reported ever having dementia. After adjusting for sociodemographic factors, depression, and gender and race interactions, individuals who reported ACEs had 15 times higher odds (aOR: 14.5; 95%CI: 1.56 – 133.9) of ever having dementia compared to individuals without ACEs. Interaction by gender was statistically significant where the relationship between ACEs and dementia was statistically significant for men (aOR: 3.29; 95%CI: 1.28 – 8.42) but not for women. Interaction by race was not statistically significant. Trauma-informed interventions addressing ACEs may reduce the odds of dementia onset, especially for men. Future research should examine pathways between ACEs and dementia.
LASTING IMPACTS OF ACES ON DEPRESSION/SUICIDAL THINKING IN BLACK DEMENTIA CAREGIVERS: A WITHIN-GROUP ANALYSIS
Authors: Browning Wesley , Yildiz Mustafa , Pickering Carolyn
Published: January 2025

Family caregivers take on the caregiving role despite the quality of the pre-morbid relationship, and pre-morbid relationship quality is linked to many caregiving outcomes. As compared to White dementia family caregivers, Black caregivers often have lower rates of mental distress giving the misleading idea that they are not at risk for poor mental health outcomes. However, within-group analyses have been argued as a better design to understand variability of caregiver outcomes within racially minoritized groups. Therefore, we examined the long-term effects of childhood trauma on depression, depressive symptoms and suicidal thinking among Black dementia family caregivers. This study presents findings from a multi-time series study, in which participants (N=101) completed three waves including 21-day bursts of daily diary surveys (n=5,124). We utilized Generalized Linear Mixed Models (GLMM) to assess the influence of childhood physical neglect, emotional abuse, and physical abuse on risk of clinically significant depression, daily depressive symptom severity and daily suicidal thinking. GLMMs were conducted separately for each form of childhood trauma to avoid multicollinearity. GLMMs revealed all three forms of childhood trauma as risk factors for clinically significant depression over at each wave. Additionally, each form of childhood trauma was independently associated with increased daily depressive symptoms and suicidal thinking. Findings provide compelling evidence of the detrimental effects of childhood trauma on mental health among Black caregivers and help explain within-group variability. These findings underscore the need for targeted interventions aimed at mitigating the long-term mental health consequences of early-life adversity in caregiving contexts.
SKELETAL MUSCLE MITOCHONDRIAL RESPIRATION ASSOCIATES WITH COGNITIVE FUNCTION IN OLDER ADULTS
Authors: Rosano Caterina , Kritchevsky Stephen , Miljkovic Iva , Newman Anne , Cawthon Peggy , Cummings Stephen , Coen Paul
Published: January 2025

Lower skeletal muscle oxidative capacity has been linked with poor cognition in older adults. Prior studies have relied on spectroscopy assessment of post-exercise PCr recovery rate to indirectly determine muscle oxidative capacity. Here, we evaluated if mitochondrial energetics assessed in muscle biopsies and by spectroscopy is associated with processing speed and general cognition. The sample included 858 adults (mean age 76.34 +/- 4.97 years, 59% female, 84% Non Hispanic White) from the Study of Muscle, Mobility and Aging (SOMMA). Mitochondrial respiration was measured in permeabilized fibers from biopsies of the vastus lateralis as maximal oxidative phosphorylation (MAXOXPHOS). Muscle oxidative capacity (ATPmax) was assessed by 31P MRS. Cognitive function was assessed by Digit Symbol Substitution Test (DSST), and Montreal Cognitive Assessment (MoCA) with scores adjusted for age and education, and sex. Multivariable linear regression models tested the hypothesis that higher mitochondrial energetics (MAXOXPHOS and ATPmax, in separate models) would be associated with higher scores on DSST and MoCA; all models were adjusted for race, muscle area, hypertension, diabetes and BMI. Each SD decrement in MAXOXPHOS was associated with a -1.7 point lower DSST score (95% CI: 0.68, 2.72) and a non-significantly -0.23 point lower MoCA score (95% CI: -0.00, 0.45). ATPmax was not significantly associated with either DSST or MoCA. Higher mitochondrial respiration is associated with faster processing speed in this population, independent of other known predictors of cognition. Future studies should assess the mechanisms underlying this association.
RECRUITING SEXUAL AND GENDER MINORITY OLDER ADULTS WITH AND WITHOUT DEMENTIA IN LONG-TERM CARE: OVERCOMING BARRIERS
Authors: Wright Morgan , Shippee Tetyana , Skarphol Tricia , Flatt Jason , Alberth Andrew , Moone Rajean , Rosser B R Simon
Published: January 2025

Sexual and gender minority (SGM) older adults, including those using long-term care and living with cognitive impairment, are a growing population, but little is known about their unique experiences as they are often missing from research. This study investigates barriers and facilitators for recruitment of SGM older adults utilizing long term care (LTC) into research studies. As part of a larger study on SGM policies in LTC, we used purposive sampling to select twenty assisted living and nursing home directors for qualitative interviews. Participants were assisted living and nursing home administrators in Minnesota, identified as part of a larger survey on SGM policies in LTC. Qualitative coding and partially inductive/deductive thematic analysis resulted in the generation of three themes. The themes include the challenge of identifying SGM residents in long-term care, a need to be mindful of discrimination against SGM residents by other residents which can also hinder self-identification, and special considerations in working with SGM residents with AD/ADRD. Several strategies to overcome these barriers exist. The themes all contained information for future researchers that work with older SGM adults in long-term care facilities who may have AD/ADRD. Understanding barriers to identifying participants, addressing discrimination, and crafting appropriate consent processes for those with AD/ADRD are all important points for researchers.
MEASURING NATIONAL TRENDS IN SOCIAL ISOLATION AND LONELINESS AMONG OLDER ADULTS AND THEIR CAREGIVERS
Authors: Pomeroy Mary Louise , Qian Yiqing , Ornstein Katherine
Published: January 2025

Social isolation and loneliness have negative implications for the health and care of older adults. Few studies have examined longitudinal patterns of social isolation and loneliness among older adults, or how these experiences are shared by caregivers and personal care networks. This research symposium uses various survey data methods to highlight trends in social isolation, loneliness, and care isolation among older adults and their caregivers. First, we report on trends in social isolation and loneliness over time. Leveraging six waves of data from the Longitudinal Ageing Study Amsterdam (LASA), Dr. Mehrabi describes the temporal sequence of social isolation, loneliness, and frailty across 21 years among a national sample of older adults from the Netherlands. Dr. Umoh uses the National Health and Aging Trends Study (NHATS) to describe trends in intermittent and persistent social isolation among older Americans between 2011–2021. Next, we examine social isolation and loneliness in the context of caregiving. Dr. Clair reports on personal care networks and care isolation among family and friends caring for older adults with Type II diabetes. Dr. Qian uses the National Study on Caregiving (NSOC) to examine prevalence and correlates of social isolation and loneliness among family and unpaid caregivers of older adults. Dr. Pomeroy concludes the session with a discussion of the strengths and challenges of using national survey data to measure social isolation, offering methodological strategies for handling missing data and proxy reports for persons with dementia. Dr. Ornstein, as discussant, synthesizes the implications for policy, practice, and future research.
SOFT-TISSUE COMPOSITION ASYMMETRY PREDICTS LEG MUSCLE STRENGTH CHANGES OVER FIVE YEARS AMONG ICELANDIC OLDER ADULTS
Authors: Chang (Gudjonsson) Milan , Recenti Marco , Ricciardi Carlo , Ponsiglione Alfonso Maria , Amato Francesco , Gislason Magnus Kjartan , Gargiulo Paolo
Published: January 2025

Background

Age-related functional decline emphasizes the need to investigate how tissue composition impacts mobility and independence in older adults. One of the most critical functions associated with mobility disability among older adults is leg muscle strength. The current study investigated the significance of lower leg tissue composition asymmetry on leg muscle strength changes over 5 years among older adults.

Methods

A community-based population from Reykjavik, Iceland (n=3156, mean age=74.9) participated in a 5-year longitudinal study. Tissue composition asymmetry was defined by differences between the right and left sides of non-linear Trimodal Regression Analysis (NTRA) parameters assessed by CT scans at baseline. Among the total of 3156 study participants, 2737 were available for the longitudinal analysis. The maximum strength of the knee extension on the dominant side was measured by using a computerized dynamometer attached to a stable chair at baseline and follow-up assessment. Linear regression analysis was performed with covariates adjustment including age, gender, body mass index, and other lifestyle-related factors.

Results

The results of the study indicate that, after adjusting for covariates, two baseline asymmetry indicators (the amplitude of fat tissue (p< 0.04) and the location of muscle tissue (p< 0.03)) were significantly associated with changes in leg strength over 5 years.

Conclusion

The findings show that higher baseline leg asymmetry indicators, involving both fat and muscle tissue, can predict a greater decline in leg muscle strength during the 5-year follow-up. The composition asymmetry of tissues could serve as an important indicator for predicting mobility disability among older adults.