bluuebunny/crossref_metadata_2025 huggingface dataset:
COMMUNITY RATES OF CAREGIVING IN RI AND CT: FINDINGS FROM THE HEALTHY AGING DATA REPORTS
Authors: Qu Shan , Jansen Taylor , Lee Chae Man , Silverstein Nina , Dugan Elizabeth
Published: January 2025

Informal caregivers are a significant but often overlooked part of the US healthcare system. Grandparents may provide and receive care and may be important members of the informal support network for many families. The demands and stresses of caregiving may negatively impact caregivers’ health. Understanding the prevalence of caregiving at the community level can guide resource allocation, policy decisions, and advocacy efforts to support caregivers and improve all residents’ well-being. The present study examines disparities in community rates in Rhode Island (RI) and Connecticut (CT) for three caregiving indicators: older adults aged 60+ who provided caregiving in the last month, grandparents raising grandchildren, and grandparents who live with grandchildren. For this study, rates were calculated from the following data sources: the Behavioral Risk Factor Surveillance System (2015-2017) and the American Community Survey (2016-2018). Small area estimation techniques were used to calculate age-sex adjusted community rates (https://healthyagingdatareports.org/). Results showed that while RI had a slightly higher statewide rate of caregiving (22.5% vs 21.7% in CT) the range in community rates (14.84%-27.43%) was much larger in CT compared to RI (19.17%-27.30%). RI (0.8%) also had a slightly higher rate of grandparents raising grandchildren than CT (0.7%), but Hartford CT had the highest community rate in the two states (2.93%). RI (2.8%) also had a higher rate of grandparents who live with grandchildren than CT (2.5%). This study found that older adults providing caregiving is prevalent, and older adults play a significant role in raising grandchildren in CT and RI.
ENHANCING POSITIVE AFFECT AND CAREGIVER EFFICACY (ENHANCE): INTERVENTION DEVELOPMENT FEEDBACK
Authors: Mason Hannah , Torres Ana Sophia Garces , Chang E-Shien , Czaja Sara
Published: January 2025

Currently about 11.5 million informal caregivers are providing care for older adults with Alzheimer’s Disease and Related Dementias (ADRD). The overburdening of these caregivers fosters an urgency for assistive programs and services. Two important determinants of caregivers’ use of available services are accessibility and relevance, both having potential to be a facilitator or barrier to service use. To address the need for accessible and efficacious caregiver interventions, the Enhancing Positive Affect and Caregiver Efficacy (ENHANCE) intervention program is being developed. ENHANCE is a multicomponent, technology-based and personalized intervention that offers self-guided opportunities and one-on-one sessions to deliver caregiving skills, access to resources, and intrapersonal support. As part of the development process, two focus groups (n=11) were conducted with ADRD caregivers to identify caregiving challenges and obtain feedback on the ENHANCE intervention prototype. This presentation will discuss findings from the focus groups. Thematic analysis revealed three common challenges among the caregivers: (1) identity loss and emotional repression, (2) communication difficulties particularly with family and healthcare providers, and (3) unreliable formal support services. Caregivers were enthusiastic about the topics included in the ENHANCE program, particularly legal/financial planning and communication. Several participants wanted to meet again, highlighting the value of open discussion among caregivers and the importance of having their voices at the table when developing caregiving services. Incorporating caregivers’ perspectives to aid the development of caregiving interventions like the ENHANCE program can improve their design, utility, and accessibility.
FAMILY CAREGIVING COMPETENCIES FOR NURSING EDUCATION: COURSE AND CURRICULAR INTEGRATION
Authors: Hart Sara , Davis Andra , Sexson Kathryn , Zhao Hui , Seward Tanya , Perkins Connie , Cowen Nannette , Mongoven Jennifer
Published: January 2025

The U.S. health care system is increasingly dependent on family caregivers who play an essential role in addressing the needs of loved ones who are aging, managing chronic or disabling conditions, or facing life-limiting illnesses. The National Consortium for Family Caregiving in Nursing Education has developed twenty entry-level nursing education competencies for identifying, integrating, and supporting family caregivers in person-centered and family-centered healthcare teams. These competencies fall within four domains: the Nature of Family Caregiving, Family Caregiving Identification and Assessment, Providing Family-centered Care, and the Context of Family Caregiving. Given the time and content limitations of nursing education and the dynamic nature of healthcare, new educational competencies often encounter resistance. Here we present the competencies, along side course and curricular resources and exemplars created by the Consortium. These resources are designed to support nursing educators in identifying and integrating content and teaching methods that advance the inclusion of family caregivers in patient and family-centered care teams and that promote nursing student development of family caregiving competencies.
HEALTH INSURANCE AND FAMILY CAREGIVERS: CAREGIVERS’ PERCEPTIONS OF COMMUNICATION BY SERVICE PROVIDERS
Authors: Balmuth Alexa , Felts Adam , Ashebir Sophia , Brady Samantha , Lee Chaiwoo , D’Ambrosio Lisa , Coughlin Joseph
Published: January 2025

Health insurers not only play a key role in older adults’ access to medical care and services, but also interact with and, in some cases, provide benefits for caregivers of older family members. Additionally, family caregivers interact with their care recipient’s insurer to manage healthcare-related payments and when seeking information and support for their caregiving role. The relationship between health insurers and family caregivers can be just as important as their relationship with the plan member. Understanding how caregivers perceive and interact with their care recipient’s insurer is important to ensuring continuity of communication and care for older adults, as well as support for caregivers themselves. Paired with qualitative interviews, results from a survey of 244 current family caregivers in fall 2023, found that despite high levels of reported health insurance coverage among care recipients, many caregivers reported that their loved one’s health plans did not provide caregiving benefits, and many reported that they did not know if their care recipient’s health insurance offered any caregiving benefits. Results highlight caregivers’ perceptions and trust in health insurers – and how these vary across insurance types and providers. This session will provide implications for health service providers to improve communications with caregivers, including communications around their full range of offerings to caregivers and identifying caregivers’ preferred frequencies and modes of communication with insurers. Ultimately, this research aims to contribute to better health outcomes and quality of life for older adults and improved support for family caregivers.
HOURS CAREGIVING, ADLS, ROLE OVERLOAD, AND DEPRESSION SYMPTOMS: AN EXAMINATION AMONG FAMILY DEMENTIA CAREGIVERS
Authors: McDonald Claire , Bravo Adrian
Published: January 2025

The present study examined the associations between hours spent caregiving, Activity of Daily Living (ADL) dependency, role overload as a stressor, and depression symptoms among caregivers of adults aged 65 and older living with probable dementia. Specifically, we hypothesized that more time spent caregiving and greater ADL dependency would both be associated with more depression symptoms via greater role overload. To test study aims, we analyzed data from round 11 of the National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC). To replicate findings from NHATS and NSOC, a second sample of data was collected using Academic Prolific. In the NHATS sample, there were 283 caregivers and the majority of caregivers were female (70%), white (63%) and reported an average age of 65. For the Prolific sample, there were 150 caregivers and the majority were female (51%), white (68%), and reported an average age of 40. Mediation models were tested using the PROCESS Macro (Hayes, 2013) in SPSS. In both NHATs and Prolific samples, role overload significantly mediated the associations between hours caregiving and depression symptoms (NHATs indirect β =.119, CI [.07,.18]) (Prolific indirect β =.118, CI [.02,.21]). In both NHATs and Prolific samples, role overload significantly mediated the associations between ADL dependency and depression symptoms (NHATs indirect β =.07, CI [.01,.13]) (Prolific indirect β =.111, CI [.02,.20]). These findings highlight the impact of burden among family dementia caregivers and should be investigated in more diverse populations.
IDENTIFYING CAREGIVERS IN US COMMUNITIES WHO REPORT A LACK OF SUPPORT SERVICES
Authors: Kilmer Greta , Ali Akilah , Walker Jenny , Spears Katie
Published: January 2025

Support services for caregivers are important community health tools that can help address health equity. Many caregivers report support services as unavailable, and understanding the characteristics of these caregivers could help identify who could benefit from greater availability or accessibility. Caregivers were identified in 2023 Summer ConsumerStyles for U.S. adults (n=437) and 2022 Estilos for US Hispanic adults (n=122). Availability and use of seven support services were assessed (out-of-home services, in-home services, food and nutrition services, transportation services, financial planning, caregiver support groups or classes, and caregiver skills-based training). Respondents were asked if each of the services were available for them or their care recipient (yes/no), and if they currently used or would use the service (yes/no). Values were weighted in accordance with the U.S. Current Population Survey proportions. A lack of at least one support service was identified if they reported it not available and they would use the service if available. In 2023, 34.2% of U.S. caregivers overall reported a lack of at least one service, which was significantly associated with caregivers having difficulty paying household expenses (p< 0.001) and having a care recipient with Alzheimer’s disease, dementia, or other cognitive impairment (p< 0.05). In 2022, over half of Hispanic caregivers reported a lack of at least one service (56.7%), which was associated with fewer years living in the U.S. (p< 0.01). Findings suggest that community support services are not always available or accessible, and caregivers with financial difficulties or recent immigration report a particular lack of community-based caregiving support resources.
PROFILING DEMENTIA FAMILY CAREGIVING NETWORK MEMBERSHIP AND PSYCHOSOCIAL FUNCTIONING
Authors: Leggett Amanda , Haldar Srabani , Lai Wenhua , Tsuker Sophia , Nemmers Natasha
Published: January 2025

Family caregiving research predominantly takes a “primary” caregiver lens, while ignoring the multifaceted caregiving networks surrounding a person living with dementia (PLWD). We explore profiles of dementia family caregiving networks based on their compositional and psychosocial characteristics. Our sample includes 184 dementia family caregiving networks drawing data from the 2017 National Health and Aging Trends Study and the associated National Study of Caregiving. Latent profile analysis was run to define distinct network profiles considering compositional (e.g., proportion of immediate family, extent of task sharing) and psychosocial (e.g., network mean and variability in caregiver stress, family disagreement surrounding care) components. Chi-squares and ANOVAs test network differences in PLWD demographic characteristics. A four-profile network was found to have best fit based on the AIC and BIC: 1) Adjusted specialists (38% of sample)- immediate family network, limited task sharing, high psychosocial well-being; 2) Disagreeing (30%)- diverse network, sharing self-care tasks, mixed reports of overload and family disagreement; 3) Strained (16%)- diverse network, limited sharing, poor psychosocial adjustment; and 4) Generalists (16%)- immediate family generalists, extensive task sharing, caregiving burden. PLWDs’ race varied significantly by network profile (χ2=29.8, p<.001). In particular, 78% of the Strained networks were assisting White PLWD while 49% of the Generalist networks were assisting Latinx/other race PLWD. Networks varied psychosocially even when composition and task sharing were similar, suggesting the need to consider both factors in defining networks. How networks function may have critical implications for care quality and well-being of both caregivers and PLWD.
RACE, CAREGIVING, AND PERCEIVED DISCRIMINATION AMONG WORKING ADULTS IN THE UNITED STATES
Authors: Templeman Maureen , Haley William
Published: January 2025

General and workplace discrimination have been studied extensively in the general population, with Black/AA individuals consistently reporting more discrimination than White individuals. However, the intersection of race, employment, and caregiving has rarely been studied. We applied stress process and minority stress theories to address these issues. Using data from the Midlife in the United States study, we examined perceived general discrimination (lifetime and everyday) and workplace discrimination (chronic job discrimination and work inequality) among working Black/AA caregivers (n = 50), working Black/AA non-caregivers (n = 396), working White caregivers (n = 266), and working White non-caregivers (n = 2895). We conducted a series of two-way (caregiver status, race) analyses of variance and covariance to investigate the role of perceived general and workplace discrimination in the stress process for working Black/AA and White caregivers and non-caregivers. We also conducted item analyses to explore whether some experiences of discrimination were identified as particularly common for Black/AA and White caregivers. Results indicated that working Black/AA adults reported more lifetime and everyday discrimination and work inequality than working White adults. Working caregivers also reported more lifetime discrimination than working non-caregivers. Item analyses revealed several specific experiences of discrimination that were especially common among Black/AA caregivers, including being hassled by the police. Results are consistent with prior research demonstrating high levels of discrimination experienced by Black/AA individuals, but findings that working caregivers, particularly Black/AA working caregivers face additional discrimination are troubling and deserve future research attention.
USING SOCIAL CONVOY THEORY TO IDENTIFY AND RECRUIT CAREGIVERS FOR HEALTH-RELATED AGING RESEARCH
Authors: Portz Jennifer , Silvasstar Josh , Coats Heather
Published: January 2025

This study focuses on addressing the challenge of identifying and recruiting caregivers for health-related aging research. Social Convoy Theory, a framework for capturing social support over the lifespan, may be a helpful recruitment model. As part of a larger qualitative project, the objective is to compare two recruitment

methods

the “Helpers” Strategy, which directly asks older adults about who “helps” them with their health, and the “Social Convoy” Strategy, which utilizes a Social Convoy approach to complete a social support diagram. Both strategies involved contacting identified caregivers by phone, email, and text for recruitment. Analysis of the two strategies leveraged a data visualization tool, Tableau, to examine the data. Both strategies successfully identified at least one caregiver among 77-78% of the 31 older adults enrolled in the qualitative study, resulting in a total of 49 caregivers. However, the Social Convoy Strategy yielded more caregivers per participant (1.72) compared to the Helpers Strategy (1.5). While the Helpers Strategy predominantly identified one caregiver, the Social Convoy Strategy identified a broader range, including convoys of multiple caregivers. Caregiver participation rate was 61.2%, with the Helper Strategy showing a higher rate of participation (66.7%) than the Social Convoy Strategy (58.1%). However, the Social Convoy Strategy facilitated interviews with more caregivers across the network. The findings suggest that although the Social Convoy Strategy may have a lower overall recruitment rate, it enables the identification and interview participation of more than one caregiver per older adult across the caregiving network compared to the Helper Strategy.
A COMPREHENSIVE DIGITAL SELF-CARE SUPPORT SYSTEM FOR OLDER ADULTS IN PAIN: IMPACT OF SOCIAL SUPPORT ON CHRONIC PAIN
Authors: Nambisan Priya , Ellis Julie , Taani Murad , Lee Yura , Anupindi Meenakshi , Nortey Rose
Published: January 2025

Social support has been associated with positive health outcomes among older adults, contrasting with the adverse effects associated with social isolation and loneliness, which are linked to poor physical and mental health. Previous studies examined social isolation, loneliness, and physical health either at different time points or through correlations within secondary data. While interventions incorporating social support have demonstrated improvements in health and alleviation of symptoms such as pain for older adults, comprehensive assessments require controlling for various factors such as the impact of medication, diet, exercise, and other activities. Remarkably, observational studies simultaneously measuring social support, physical health changes, and factors like physical activity and diet are lacking. This pilot study uses a Comprehensive Digital Self-Care Support System (CDSSS), equipped with tools to monitor over 50 physical and mental health conditions, diet, activity, sleep, medication intake, alcohol use, smoking, and other self-care activities. The CDSSS also includes a robust online forum with video chatting facilities. This mixed methods pilot study aims to test whether we can evaluate in real time the changes in health indicators such as stress, mood, and chronic pain when participants engage in the online social space within the CDSSS. Participants are Black older adults (age >50), suffering from chronic conditions where pain is the main symptom such as Migraines, Fibromyalgia, Arthritis, Gout, and Backpain. This study integrates qualitative data from the social support forum and interviews, along with quantitative data from over 13 pain-specific trackers and surveys measuring social support, loneliness and social isolation.
EAGERNESS OF NURSING HOME RESIDENTS TO INTERACT WITH ROBOT TEMI
Authors: Abul Zeynep , Raza Sakeena , McNicoll Lynn
Published: January 2025

Loneliness and social isolation existed among older adults before the COVID-19 pandemic, worsened due to lockdown, and visiting policies in nursing homes (NH) during pandemic. The aim of this study is to improve the interaction between robot Temi USA, Inc and NH residents. This is the preliminary finding of a quality improvement (QI) project. We conducted in-depth interviews with 54 long-term care NH residents to better understand their expectations from the self-navigating, autonomously driving humanoid robot temi. We asked the following focused question “If you wave a magic wand, what are some activities you would like to do with the robot?” and noted the answers. 5.6 % of the residents (n=3) responded neutrally by stating “I do not know “or “can’t think of anything”. Sixty-seven percent of the NH residents(n=36) responded with requests for interaction with temi. The most common request for interaction was “playing” chess, cards, piano, pool, baseball, Yahtzee, Bingo, and Wordhunt (n=20 out of 36; 56%).The remaining residents wanted to engage with temi by going outside (n=5), having temi sing with them (n=4); drawing with them (n=3); exercising with them (n=2); or just having a conversation with them (n=2). Fifteen residents (28%) wanted to have no interaction with temi. The high number of responses requesting interaction may imply that NH residents have an eagerness to interact with the robot. We will use those results to program an intervention to relieve loneliness of the NH residents for ongoing QI projects.
SOCIAL ENGAGEMENT AND DEPRESSIVE SYMPTOMS: DIFFERENTIAL EFFECTS IN OLDER ADULTS WITH AND WITHOUT CANCER
Authors: Babenko Natalia , Elayoubi Joanne , Haley William , Small Brent
Published: January 2025

Recent studies have shown that social connection and engagement can serve as protective factors against depression. Buffering effects are sometimes found, suggesting greater protective effects for people experiencing high levels of stress. We examined whether social connection and engagement had a greater protective effect for depressive symptoms in cancer survivors compared to people without cancer. We analyzed longitudinal data from 856 participants with incident cancer and 856 propensity-matched non-cancer controls from the Health Retirement Study. Multilevel modeling was used to examine the associations between social connection and engagement and changes in depressive symptoms over time. Social connection and engagement were generally associated with fewer depressive symptoms before and after the onset of cancer (or a matched timepoint for controls). These protective effects were stronger for cancer survivors who were partnered and lived in a larger household compared to controls. Participants with cancer who were partnered pre-cancer experienced a significant decrease in depressive symptoms after cancer compared to partnered controls who did not exhibit decline. Becoming partnered in post-cancer period led to decreased depressive symptoms compared to the pre-cancer partnership status in both groups. Consistent with the buffering hypothesis, results suggest that social connection is generally advantageous, especially for people with cancer in a post-cancer period. Prospective public health interventions increasing social engagement to build resilience in the overall population may enhance psychological resilience and facilitate recovery from cancer. Future research should examine whether people with cancer benefit from support-enhancing interventions and whether this effect also occurs in other illness populations.
THE EXPERIENCES OF COLORECTAL CANCER SURGERY AMONG OLDER PATIENTS WHO LIVED ALONE IN TAIWAN
Authors: Chen Li-Ying , Kuo Tsuann
Published: January 2025

In Taiwan, it is a common practice that family takes care of their older adults when hospitalized. However, people who were never married or living alone would face challenges in coming up with a caregiver in the hospital. The shortage of caregiver among Taiwanese older population was due to its low fertility and high aging rate as Taiwan will enter a super-aged society in 2025. The purpose of this paper was to understand how inpatient surgical experiences on older adults who lived alone. The research methodology used qualitative interviews with structural questions followed by content analysis. Eight older adults participated to share their experiences who live alone and hospitalized for colorectal cancer surgery. The result showed that prognosis, postoperative care and Activities of daily living(ADL) were concerned. Older adults living alone were not only worried about the results of the surgery but also concerned about their reduced self-care ability and postoperative care without help. In addition to determining the recovery of digestive system function, doctors consulted rehabilitation to strengthen their mobility, taking into account the factor of living alone. Based on the results, the author suggested that it is essential to discuss postoperative care arrangements and whether the patient will be able to regain their self-care abilities after surgery. With the increasing number of people living alone, greater emphasis should be placed on the patient’s own decisions not relatives. For older patients living alone and undergoing inpatient surgery, developing in-hospital rehabilitation plans is crucial to strengthen their self-care abilities.
A KETOGENIC DIET REDUCES AGE-INDUCED CHRONIC NEUROINFLAMMATION IN MICE
Authors: Nomura Mitsunori , Newman John
Published: January 2025

Beta-hydroxybutyrate (BHB) is a ketone body synthesized during fasting or strenuous exercise. Our previous study demonstrated that a cyclic ketogenic diet (KD), which induces BHB levels similar to fasting every other week, reduces midlife mortality and improves memory in aging mice. BHB actively regulates gene expression and inflammatory activation through non-energetic signaling pathways. Neither of these activities has been well-characterized in the brain and they may represent mechanisms by which BHB affects brain function during aging. We investigated whether BHB affects brain cells transcriptionally in vitro. Gene expression analysis in primary human brain cells (microglia, astrocytes, neurons) using RNA-seq shows that BHB causes a mild level of inflammation in all three cell types. However, BHB inhibits the more pronounced LPS-induced inflammatory gene activation in microglia. Furthermore, we confirmed that BHB similarly reduces LPS-induced inflammation in primary mouse microglia and bone marrow-derived macrophages (BMDMs). BHB is recognized as an inhibitor of histone deacetylase (HDAC), an inhibitor of NLRP3 inflammasome, and an agonist of the GPCR Hcar2. Nevertheless, in microglia, BHB’s anti-inflammatory effects are independent of these known mechanisms. Next, we examined the brain gene expression of 12-month-old male mice fed with one-week and one-year cyclic KD. While a one-week KD increases inflammatory signaling, a one-year cyclic KD reduces neuroinflammation induced by aging. In summary, our findings demonstrate that BHB mitigates the microglial response to inflammatory stimuli, like LPS, possibly leading to decreased chronic inflammation in the brain after long-term KD treatment in aging mice.
“INCORPORATE INTO MY DAILY LIFE”: RESPONSES TO MITOFIT INTERVENTION VIDEOS ON MITOCHONDRIAL FITNESS
Authors: Boon Jeffrey , Grubbs Brandon , Patel Maulik , Dunavan John , Knickerbocker Kelly , Maxwell Cathy
Published: January 2025

Mitochondrial fitness is a term that reflects the ability of mitochondria to adapt/maintain optimal performance. As a key predictor of age-related decline, mitochondrial fitness is a target for interventions in healthy aging. MitoFit is a novel instructional communication intervention designed for improving physical activity in persons aged 50 and over. We aimed to determine participants’ responses to the MitoFit educational videos and clarify factors that contributed to reactions.

Methods

Focus groups with community-dwelling adults (aged 50+) viewed six literacy-friendly MitoFit videos two at a time followed by a semi-structured group interviews to elicit verbal feedback. Interviews were audio-recorded and transcribed verbatim. Transcribed data were independently coded by three researchers, followed by a consensus process to identify themes, codes and subcodes.

Results

101 adults (mean age: 67.8 years (8.9); 75.0% female) participated in 15 focus groups at six sites. A conceptual model emerged, centered around the concept of cognitive restructuring (mental adjustments to prior or unhelpful beliefs) related to understanding about exercise. Contributing themes included: a) initial reactions (codes: impactful, motivating, fascinating), b) biological content (codes: this is biology, battery analogy, energetics), and c) personal integration (codes: prompts reflection, unaware, leads to more questions). The theme of key take-aways included codes: a) have to do it (subcodes: consistency, find what works, find what I like, making a plan), b) hope (subcode: not too late), c) reversible, and d) sense of agency (subcode: doing it for me).

Conclusion

MitoFit video content provoked positively strong reactions that may contribute to self-efficacious lifestyle change.
MITOCHONDRIAL SUBSTRATE UTILIZATION FOLLOWING CONTRACTION IN 3D ENGINEERED MUSCLE TISSUE MODELS OF AGING
Authors: Campbell Matthew , Erker Jayma , Mack David , Marcinek David
Published: January 2025

Altered mitochondrial function in aging skeletal muscle leads to elevated oxidative stress, reduced substrate oxidation and energy maintenance that contribute to decreased skeletal muscle mass, specific force and increased fatty infiltration and frailty with age. Metabolic flexibility in response to increased energy demand is a critical component of the mitochondrial adaptive response to muscle contraction. We have found that aged muscle mitochondria do not utilize substrates the same way young muscle mitochondria do following high-intensity and low-intensity contraction. We also found that high-intensity contraction specifically inhibits oxidation of glutamate in both stimulated and non-stimulated aged muscle, suggesting that intense muscle contraction in aged muscle may inhibit substrate flexibility beyond the contracting myofibers. To test the mechanisms that contribute to this impaired metabolic signaling to muscle contraction in a human cell model of aging we have partnered with the Study of Muscle, Mobility and Aging to obtain primary human myoblasts from well phenotyped older adults to develop a three-dimensional engineered muscle tissue (3D-EMT) model of skeletal muscle aging. 3D-EMT force and contraction/relaxation kinetics were tested with high reproducibility using a Magnetometric Analyzer for eNgineered Tissue ARRAY (Mantarray, Curi Bio) platform. Aged 3D-EMT shows characteristic force-frequency and increased force up to 28 days after tissue casting and increased mitochondrial oxidative phosphorylation following contraction. Developments in tissue engineering using primary cells purified directly from patients offer some of the best opportunities yet to link specific mechanistic tests of metabolic and muscle function to patient data.
THE INSECT ACHETA DOMESTICUS IS A PROMISING MODEL FOR AGING AND AGING INTERVENTION STUDIES
Authors: Liao Gerald , Wezeman Jackson , Ladiges Warren
Published: January 2025

A number of animal species are being used as models to study aging and age-related diseases. They have varying advantages such as shorter lifespan, relatively low costs, and full access to internal organs. While no single model can replicate all aspects of human aging, there are unexplored non-mammalian species that may have additional advantages. The domestic house cricket (Acheta domesticus) has a short lifespan, a simple but well-defined organ system, an omnivorous diet from young to old, very low maintenance costs, and neurogenesis in a hippocampus-like brain structure. A preliminary study investigated effects of flax oil, rich in omega-3 fatty acids, on lifespan in adult crickets. Cold pressed flax oil was added to moistened guinea pig chow mash as a 10% mixture and fed to crickets starting at 8 weeks of age and continuing for 11 weeks when the last cricket died. Results demonstrated a significant extension in survival for crickets fed the flax oil diet, emphasizing the low cost, simplicity, and short time required for dietary studies in this species. This observation provides the rationale for additional studies to characterize the house cricket as a promising model for aging and aging intervention investigations.
ASSESSING THE COMPLEXITIES OF LONG-TERM SERVICES AND SUPPORTS FOR OLDER ADULTS OF TEXAS
Authors: Murphy Sara , Anaab Esme , Severance Jennifer , Yockey Robert
Published: January 2025

Background

Long-term services and supports (LTSS) encompass a broad range of medical and personal care assistance needed by individuals who are unable to perform self-care tasks due to aging, chronic illness, or disability. The No Wrong Door (NWD) System is a statewide network that coordinates the system of access to long-term services and supports. As an offshoot of the person-centered planning movement, the NWD System is premised on ensuring that no matter where individuals first interact with the system, they are guaranteed comprehensive information, assessment, and services. This work will help the Texas Health and Human Services Commission create a consumer-driven, cost-effective, and efficient system.

Methods

A mixed methods approach was constructed to understand the challenges and barriers to accessing LTSS, assess NWD System performance based on stakeholder perspectives, and identify community needs.

Results

Of 4,153 respondents, 56% identified as an adult 50 years or older and 53% older adults reported a LTSS need in the past year. The top three problems faced when trying to get services include a confusing system, long service wait times, and not knowing where to get help. Unpaid informal caregiver respite services, caregiver education, and caregiver support groups were among the services and supports that inadequately met people’s needs. Conclusions: Our results form the blueprint for facilitating access to care throughout Texas to ensure vulnerable populations obtain a high quality of life. Recommendations for the NWD system include effective community outreach and streamlined application processes for services and supports.
EHEALTH INTERVENTIONS TO PROMOTE PHYSICAL ACTIVITY AMONG OLDER ADULTS WITH MCI: A SYSTEMATIC REVIEW
Authors: Shin Jinhee , Konlan Kennedy Diema , Park Chang Gi
Published: January 2025

Physical activity positively influences and improves motor ability, increases desirable behavior, promotes brain activity, and increases marginal memory and thinking among older adults with mild cognitive impairments. This systematic review explored current trends and the effectiveness of digital health (eHealth) interventions to promote physical activity among older adults with mild cognitive impairment. We used the PRISMA guidelines and the PICO framework to search for literature in five electronic databases (PubMed, Embase, CINAHL, and Web of Sciences). The search outcome was transferred to Endnotes software and independently screened based on title, abstract, and full text using predetermined eligibility criteria. The screening resulted in 10 articles for extraction using a self-developed matrix. The JBI quality appraisal tool was used for quality appraisals and the conventional thematic data synthesis method of analysis was used. The strategy used was diverse and multiple technological platforms for the implementation of digital interventions, and included hardware technology like tablets, smartphones, smartwatches, Bluetooth devices, earpieces, computers, or durable covers, while, software techniques like promoting, customization, multimedia, multisensory, hands-on practice, demonstration, cueing, tech support, user manual or in the training of care practitioners were used. The use of digital-based health interventions for people with mild cognitive impairment to improve physical activity is still rudimentary even though the potential influence of such interventions is enormous. Interventions that use digital methods focusing on promoting physical activity among older adults with mild cognitive impairments should provide detailed information on the types of interventions, implementation, development process, and the resultant improvements.
HEALTH CARE COST BURDEN AND SELF-REPORTED FREQUENCY OF DEPRESSIVE/ANXIOUS FEELINGS IN OLDER ADULTS
Authors: Choi Namkee
Published: January 2025

Many older adults are burdened by out-of-pocket healthcare costs. Using the 2018-2021 National Health Interview Survey data, we examined: (1) healthcare cost burden and its associations with depressive/anxious feelings; and (2) whether during the pandemic (2020-2021), COVID infection and COVID-related healthcare access problems would also be associated with a higher likelihood of reporting healthcare cost burden and depression/anxiety. Nearly 12% of older adults (age 65+) reported healthcare cost burden, and a little over 18% reported daily/weekly depressive/anxious feelings. In generalized linear modeling analyses, the risk of healthcare cost burden was higher among women, racial/ethnic minorities (Blacks: incident risk ratio or IRR=1.49, 95% CI=1.35-1.65; Hispanics: IRR=1.27, 95% CI=1.12-1.44), those with chronic illnesses, mobility impairment, and those with Medicare Part D (IRR=1.14, 95% CI=1.04-1.20), but lower among individuals with Medicare-Medicaid dual eligibility, Medicare Advantage, VA/military insurance, and private insurance. The risk of daily/weekly depressive/anxious feelings was higher among healthcare cost burden reporters (IRR=1.76, 95% CI=1.64-1.88), controlling for sociodemographic and health status characteristics. The COVID-19 pandemic-related delay of or lack of access to medical care was also associated with a higher risk of reporting healthcare cost burden (IRR=1.67, 95% CI=1.52-1.84) and depression/anxiety (IRR=1.40, 95% CI=1.29-1.52). In sum, healthcare cost burden reporters were 1.8 times more likely to report high-frequency depressive/anxious feelings. Healthcare and social service providers should recognize the interconnection between financial strain associated with physical health problems and mental health in older adults. Policies and programs are needed to alleviate healthcare cost burden and ensure adequate access to healthcare services.
HYPERTENSION CONTROL AND ISCHEMIC STROKE RISK: REAL-WORLD DATA IN HISPANIC MEDICARE BENEFICIARIES IN SOUTH FLORIDA
Authors: Chaves Paulo , Desoria Maureen , Roque Leslye , Mas Rafael
Published: January 2025

The extent to which the magnitude of stroke risk reduction associated with blood pressure (BP) control in highly controlled trial research settings is translated to real world clinical settings remains to be better characterized, particularly in understudied populations. We examined the odds of hospitalization for acute stroke as a function of BP control in the previous year in Medicare Beneficiaries of Hispanic origin in south Florida. We analyzed de-identified electronic health records (2015-2019) from outpatients ≥65 years old receiving care at Leon Medical Centers (LMC), a major integrated healthcare services provider to Medicare and Medicare/Medicaid dually eligible (DE) Beneficiaries in Miami-Dade County, FL. In each year, within-person average systolic (SBP)< 140 mmHg and diastolic (DBP)< 90 mmHg were used to define controlled BP. Acute ischemic strokes were identified from hospital claims (ICD-CM-10 codes). Pooled longitudinal logistic regression with 1-year lagged time (n=36,519) with adjustment for age, sex, and DE status. Mean age (76.1±7.2 to 77.5±7.2), proportion of Hispanics (>90%), and annual BP control rates (>90%) remained constant throughout 2015-2019. Patients with controlled BP in a specific year had 39% lower (OR.61; 95%CI: 0.51, 0.73) odds of hospitalization for acute stroke in the subsequent year than those with uncontrolled BP. Neither sex, nor DE status modified the BP control–stroke risk relationship. In a large healthcare system in south Florida, we observed very high BP control levels, and, in line with published trial data, documented a substantially lower risk of ischemic stroke 1 year later in both Medicare and DE patients of Hispanic origin.
INTERNET AND HEALTH INFORMATION TECHNOLOGY USE AMONG MIDDLE-AGED AND OLDER ADULTS WITH ARTHRITIS
Authors: Lieber Sarah , Moxley Jerad , Reid M Carrington , Czaja Sara
Published: January 2025

Arthritis is a leading cause of healthcare utilization in older adults. Healthcare delivery increasingly occurs virtually. We assessed health information technology (HIT) use in middle-aged/older adults with and without self-reported arthritis by analyzing 2022 National Health Interview Survey data. Prevalence of internet access and internet use for health information, communication with doctor’s office, and review of test results was compared between adults ≥50 years of age with (versus without) arthritis (i.e., arthritis, rheumatoid arthritis, gout, lupus, fibromyalgia). Logistic regression was used to examine the relationship between arthritis and internet access and HIT behaviors. Among adults with arthritis (N=6371) for whom relevant survey data were available, 2640 (83%) reported internet access, and 1617 (61%), 1180 (45%), and 1359 (52%) used the internet for health information, communication with doctor’s office, and review of test results. Among adults without arthritis (N=9268) for whom relevant survey data were available, 4150 (88%) reported internet access, and 2367 (57%), 1687 (41%), and 2023 (49%) used the internet for health information, communication with doctor’s office, and review of test results. Arthritis was significantly associated with internet access and internet use for health information, communication with doctor’s office, and review of test results (all p< 0.01); the relationship between arthritis and internet use for health information, communication with doctor’s office, and review of test results remained significant after adjustment for age and sociodemographic characteristics (all p< 0.01). Further study of factors impacting HIT use in middle-aged/older adults with arthritis is needed to improve healthcare delivery in this population.
MICROBIOTA COULD REDUCE THE BRACHIAL-ANKLE PULSE WAVE VELOCITY TO PROTECT FROM CARDIOVASCULAR DISEASE
Authors: Zeng Shengyin , Li Yaxin , Chen Bangwei , Ruan Lei , Zhang Jianguo , Zhu Shida , Zhang Cuntai , Li Tao
Published: January 2025

Brachial-ankle pulse wave velocity (baPWV) is a risk factor for cardiovascular disease (CVD), and is associated with blood pressure and lipoprotein. However, research on the microbiota associated with baPWV has been limited. Here, we used two-sample bidirectional mendelian randomization (MR) analysis to assess the causality between gut microbiotas and baPWV. The exposure instrumental variables (IVs) were selected as significant independent variants (Linkage Disequilibrium (LD) R2 < 0.01; P-value < 5×10-8) from 1,521 gut microbiota genome-wide association studies (GWAS) summary data including class to species in the IEU OpenGWAS project. We performed baPWV GWAS analysis in Tongji-BGI research cardiovascular health (TORCH) cohort to obtain baPWV-related variants (rs141045630, rs11138617, rs77947040 and etc.) and selected suggestive variants (LD R2< 0.01; P-value < 1×10-5) as outcome IVs. The inverse variance weighted (IVW) was used as the primary MR analysis. In addition, we adjusted sex, age and other Framingham risk score factors. The sensitivity analysis involved changing the covariates, altering MR method and heterogeneity test. The analysis results showed higher abundance of Bifidobacterium adolescentis (P-value:1.81×10-4) and Lachnospiraceae (P-value:2.88×10-5) associated with lower baPWV. Moreover, MR evidence suggested a causal relationship between higher abundance of 3 microbiotas (Lactobacillales, P-value:1.72×10-3;Citrobacter, P-value:1.46×10-2; Ruminococcus, P-value:1.36×10-4) and higher baPWV. On the other hand, baPWV didn`t have potential causal effects on the abundance of B. adolescentis and Lachnospiraceae. In conclusion, a higher abundance of butyric acid-producing bacteria decreases baPWV and reduces arterial stiffness. We are currently performing more analyses with the metabolic pathway to explore more details in these results.
PATIENT PERCEPTIONS OF A PERSONALIZED MUSIC PLAYLIST PROGRAM FOR HOSPITALIZED OLDER ADULTS
Authors: Wong Kayla , Nandigam Maanasa , Nguyen Victor , Morka Angela , Kiwak Eliza , Li Judy , Sharninghausen Jody , Marottoli Richard
Published: January 2025

Personalized music playlists may be therapeutic for hospitalized older adults. As part of the “Creativity in Aging” project at Yale Geriatrics, this study aims to bring personalized music to hospitalized older adults and explore their perceptions of its effect on emotional and physical health. Patients (N = 57) hospitalized in an inpatient geriatrics unit participated in the program from October 2023 to February 2024. Qualitative data were collected from 19 patients. Trained undergraduate volunteers took detailed “music histories” from patients and, when appropriate, their family caregivers (e.g. patients with dementia), and created personalized playlists using iPads. Patients could listen to their playlists during volunteer shifts throughout their hospital stay. Pre and post-listening surveys were conducted to elicit patient perceptions through brief semi-structured interviews and ratings on a Likert mood scale. A qualitative thematic analysis using the principles of grounded theory was performed to create thematic categories of patients’ perceptions. Two coders open-coded separately then came together to agree on codes and themes. Saturation was reached, as no new themes were generated at the end of the thematic analysis. Five core themes emerged from the analysis: patients expressed feeling 1) calmer and more relaxed, 2) generally more positive, 3) reminiscent, 4) a want to sing and dance, and 5) physically and emotionally healed after listening to music. Constructive feedback included technical issues with iPads and wanting to listen to playlists more often. We aim to increase accessibility and expand the program to older adults in other areas of the hospital. The first two listed authors (MN and KW) contributed equally.
VACCINATION MOTIVATORS AND DETERRENTS AMONG UNDERVACCINATED OLDER ADULTS IN NORTH DAKOTA
Authors: Huseth-Zosel Andrea , Fuller Heather , Carson Paul
Published: January 2025

Despite increased risk of morbidity and mortality among older adults due to preventable infectious diseases such as influenza, shingles, pneumonia, and COVID-19, many older individuals forego receiving some, if not all, of these vaccinations. This study examines vaccination motivators and deterrents for undervaccinated older adults in North Dakota (ND). Adults aged 65+ in ND were mailed a survey (n=901) with questions gauging vaccination behaviors and perceptions. Of these participants, 132 indicating not receiving influenza, shingles, pneumonia, or COVID-19 vaccinations. Further questions assessed reasons they had not been vaccinated against each specific disease (e.g., “Concerned about side effects”, “Vaccines are dangerous”, “I’m healthy and I do not need it”) and what would make it more likely to get a vaccine (e.g., “More information”, “Doctor recommendation”, “Easy access to vaccines”). Reasons for remaining unvaccinated varied by vaccine type. For influenza and pneumococcal vaccines, respondents were more likely to indicate they are healthy and do not need the vaccine. For shingles and COVID-19, respondents were more likely to indicate concerns about side effects. Factors reported to motivate increasing the likelihood of getting any vaccine were receiving a doctor recommendation, receiving more information, and having a vaccine provided at no cost. These results contribute to our understanding of vaccination behaviors among older adults and underscore specific issues around which to frame interventions tailored to increase vaccine uptake for this population.