bluuebunny/crossref_metadata_2025 huggingface dataset:
TOWARDS GAIT-BASED SCREENING FOR COGNITIVE IMPAIRMENT
Authors: Hentnik Haley , Phillips Christine , Stephan Abigail , Ross Lesley , Gurchiek Reed
Published: January 2025

While cognitive impairment is a hallmark feature of Alzheimer’s disease, it can be difficult to detect in preclinical stages. Gait metrics, like speed and variability, have been suggested to augment early detection efforts and could be used in combination with existing cognitive-based screening tools such as the modified Telephone Interview for Cognitive Status (TICS-m). However, the specificity of these gait metrics and their relationship with cognition remains unclear. This study aimed to quantify the relationship between gait and a cognitive screening assessment (TICS-m) and cognitive attention (Useful Field of View Test, UFOV) in a sample of 106 older adults (71.9 +/- 5.9 years old). Three gait metrics were significantly (p < 0.05) correlated with TICS-m including usual gait speed (r = 0.27), gait symmetry (r = 0.30), and gait smoothness (r = -0.23). These metrics were also correlated with a composite UFOV score; the strongest relationship indicated that individuals with worse attention and slower processing speed presented with a less smooth gait (r = -0.42). Interestingly, gait smoothness was more strongly related to UFOV than was TICS-m (r = -0.30). These results corroborate previous research reporting similar relationships between visual-spatial processing and gait variability in individuals with cognitive impairment. However, gait smoothness was correlated with gait speed, and thus it remains unclear if our findings are independent of this relationship. Future research should explore the specificity of gait-based digital biomarkers of cognitive impairment and their utility for early detection and screening.
VOICES FROM THE FIELD: EXPLORING THE VALUE OF GERONTOLOGISTS IN INTERPROFESSIONAL GERIATRIC CARE TEAMS
Authors: Boakye Alfred , Martin Diane
Published: January 2025

Interprofessional healthcare teams effectively deliver safe and high-quality care to patients with complex healthcare needs. Through collaborative team-based efforts, doctors, nurses, social workers, pharmacists, and other professionals address multiple aspects of health, including physical, mental, and social well-being. Team-based care is now recognized as a national priority to optimize the health and social well-being of older adults and their families; however, geriatric care teams often do not include professionals with expertise in aging, such as gerontologists. The aim of this study was to explore what gerontologists can contribute to a geriatric interprofessional care team. Sixteen (16) gerontology students, faculty, and healthcare professionals completed semi-structured surveys, and the results were analyzed using a modified grounded theory. Respondents highlighted that the unique interdisciplinary perspective on the aging process held by gerontologists can promote person-centered care and bridge the gap between older adults and community resources. These findings illustrate the valuable role that gerontologists can have as members of interprofessional geriatric healthcare teams. Additional research is needed to evaluate whether integrating gerontologists can lead to enhanced care, improved care coordination, and advance evidence-based practices, research, and policy.
A LATENT CLASS ANALYSIS OF INSTRUMENTAL ACTIVITIES OF DAILY LIVING (IADL) CAREGIVING NEEDS
Authors: Kim Suyoung , Rote Sunshine , Cantu Phillip , Andrade Flávia , Angel Jacqueline
Published: January 2025

Objectives

Mexican American caregivers experience time-intensive caregiving situations yet studies on heterogeneity in caregiving needs are limited. This study (1) utilizes latent class analysis (LCA) to classify caregivers into groups based on care recipient IADL intensity and type of support need and (2) examines caregiver psychological outcomes by care recipient support need.

Methods

Data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (Wave 7, N = 885) was analyzed using LCA. Characteristics of both caregivers and care recipients were included as predictors for a dyadic analysis, and caregiver perceived stress, depression, overall life satisfaction were investigated as tertiary outcomes.

Results

Four distinct groups of Mexican American caregivers were identified by care recipient IADL assistance need: comprehensive (39%), social task only (29%), minimal (23%), and physical mobility only (9%). Care recipient cognitive functioning and nativity status as well as caregiver homeownership status were associated with IADL assistance need. Caregiver perceived stress was highest for comprehensive IADL assistance need and lowest for social task only need. Caregiver life satisfaction peaked for those providing care for care recipients with minimal need, and caregiver depressive symptoms were more prevalent for comprehensive and physical mobility only IADL assistance need.

Discussion

Caregiving demands, especially for mobility and comprehensive social, household, mobility, and financial care needs, are associated with greater caregiver psychological burden. Targeted, culturally competent interventions aimed at improving the mental health of Mexican American caregivers should address the unique challenges with mobility and comprehensive care needs.
A MOBILE CLINIC STUDY ON BRAIN HEALTH IN OLDER ADULTS IN A RURAL, SOCIOECONOMICALLY DISADVANTAGED COUNTY
Authors: Chanti-Ketterl Marianne , Jones-Locklear Jennifer , Brooks Jada , Williams Cierra , Bullard Misty , Locklear Keenya , Davis Scott , Whitson Heather
Published: January 2025

Objective

This collaborative pilot project assessed the feasibility of enrolling 50 older adults from underrepresented populations in Robeson County, North Carolina (NC), considered a racially diverse and socioeconomically disadvantaged area.

Methods

The study protocol, adapted from the Alzheimer’s Gut Microbiome Project, was modified to fit local cultural contexts with input from community and local academic partners. The Lumbee Tribe of NC, headquartered in Robeson County, and its Tribal IRB endorsed the project and community-informed recruitment materials. Participants were recruited through the NC Registry for Brain Health, community-based referrals, and local meetings. A mobile clinic facilitated study visits. After consenting, participants underwent immediate fasting glucose and cholesterol testing via finger prick and biomarker collection through venipuncture. They completed a Montreal cognitive assessment and answered demographics, lifestyle, medical conditions, environmental exposures, and diet questionnaires. Instructions for home stool sample collection and shipment were provided. A nurse then reviewed participants’ physical measures, offering health counseling and resources. Participants received a printed summary of most study results except those from venipuncture, which were sent to the lab. Compensation with merchant cards was provided after shipment of stool samples.

Results

Fifty-seven individuals expressed interest; nine declined participation, two were ineligible, and five are pending the visit. To date, we have 41 people enrolled, nearly all recruited through community outreach.

Discussion

This study demonstrated the feasibility of enrolling older adults in research from a rural, underserved area. The strong community-academic engagement, including endorsement from the Lumbee Tribe and using a local mobile clinic, was key to the recruitment process.
A NETWORK ANALYSIS OF HOW COMPONENTS OF WELL-BEING DIFFER ACCORDING TO EDUCATION ATTAINMENT
Authors: Khoo Shuna S , Ma Zhihao , Jia Lile
Published: January 2025

Singapore is on the cusp of ushering in a new wave of older adults. As one of the Four Asian Tigers, the country underwent rapid industrialization in the 1950s - 90s and buttressed its development upon a foundation of high education attainment for its citizens. This has created a disparity in the educational profile of our current (low educational attainment) and future (high educational attainment) older adults. To future-proof our aging interventions and programs, there is an urgent need to understand how different factors define and affect individuals’ well-being based on their educational attainment. We surveyed a representative community sample (N = 5,224, Mage = 52.8 years) and, employing a network analysis, mapped out the relationships among the key elements of well-being. Machine learning techniques revealed distinct network patterns between low- and high-education adults (p <.001). Low-education residents’ well-being revolves around factors relating to their present life conditions (e.g., chronic illnesses, eating habits, quality of life). By contrast, high-education residents’ well-being is centered around factors that relate to an overall sense of balance (e.g., feelings of harmony) and a future orientation (e.g., anticipated quality of life in ten years). Our findings can be used to assess well-being interventions based on how they impact the central factors for low- and high-education residents, respectively. The present methods and findings would be relevant to any fast-developing country; understanding the residents’ well-being profiles is critical to finetuning support for current older adults while anticipating future older adults’ needs regarding longevity.
A QUALITATIVE EXPLORATION OF A PSYCHOSOCIAL INTERVENTION FOR LONELINESS AND SOCIAL ISOLATION IN OLDER ADULTS
Authors: Zubatsky Max , Berg-Weger Marla , Tziarli Dimitra , Livingston Rachel , Lauck Jen
Published: January 2025

Loneliness and social isolation is a public health epidemic in older adults. Although providers are exploring more psychosocial interventions to help curb this trend in the community and healthcare settings, very few evidence-based approaches have been able to deliver effective interventions and strategies for this population. Circle of Friends (CoF) is an emerging global intervention that has been implemented in a variety of settings for older adult socialization and improving overall mood. The CoF group consists of weekly one hour sessions over 12 weeks, targeting different themes around health and lifestyle, arts and hobbies, and theraeutic writting and activities. The purpose of this study is to explore the experiences of participants in their involvement of Circle of Friends from three different group settings (university, virtual, and primare care). A focus group format helped collect qualitative themes from 11 participants across three completed groups between 2022-2024. Overall, a consensus of main themes were found across all three groups regarding access to a social group, motivation to improve other health and lifestyle activities, and better coordination with other providers and resources in their area. Over 50% of the reports from these focus groups mentioned the lack of any social group options or resources given by their healthcare team (Geriatrics or Primary Care). This study highlights not only the impact that a psychosocial group has for older adult patients, but the need for more older adult group options in integrated care and community settings in the older adult population.
ACCEPTABILITY OF A CHATBOT FOR INFORMATION AND ADVICE ON DEMENTIA CAREGIVING
Authors: Cheng Sheung-Tak , Ng Peter , Wakui Tomoko
Published: January 2025

Providing ongoing support to caregivers as their needs change in the long-term course of dementia is a serious challenge to any healthcare system. Conversational artificial intelligence (AI) operating 24/7 may help to tackle this problem. This presentation describes the development of a generative AI chatbot (called Chatbot-A) using the GPT-4o large language model, with a personality agent to constrain its behavior to providing advice on dementia caregiving based on a revised version of the Benefit-Finding Intervention manual (an intervention reported in JG:PS and other journals). The chatbot’s responses to 21 common questions were compared with those of another chatbot (called Chatbot-B) using a collection of authoritative sources (World Health Organization iSupport, By Us For Us Guides, and 185 webpages by Alzheimer’s Association, National Institute on Aging, and UK Alzheimer’s Society) as its knowledge base. Results showed highly context-sensitive and rather sophisticated answers by both chatbots, with Chatbot-A performing slightly better on mental health-related questions. Subsequently, 10 caregivers used Chatbot-A for two weeks and provided ratings and comments on its acceptability. They found Chatbot-A highly user-friendly, and its responses quite helpful and easy to understand. They were rather satisfied with it and would strongly recommend it to other caregivers. During the 2-week trial period, the majority used Chatbot-A more than once per day. Results supported conversational AI as a viable approach to improve support to caregivers. Due to space limitation, this poster will present the two chatbot’s answers to selected questions and the caregivers’ feedback on Chatbot-A in detail.
ADDRESSING CAREGIVER TRANSPORTATION BARRIERS TO ENHANCE HEALTH CARE ACCESS FOR OLDER ADULTS
Authors: Louis Renée St , Zanier Nicole , Zakrajsek Jennifer , Peterson Colleen
Published: January 2025

Providing transportation assistance to an aging family member who no longer drives remains a pivotal caregiving task. Caregiver challenges related to coordinating and providing this transportation can have an impact on the frequency and level of health care an older adult can access. Applying the social ecological model, this qualitative study aimed to gain a contemporary, in-depth understanding of caregiver experiences facilitating health care access for those who no longer drive to inform health care solutions across various levels of the system. Transcribed audio recordings of four focus groups divided between urban and rural areas (N=21 individuals providing transportation assistance to aging adults) were iteratively reviewed to draw out themes to meet this aim. Participants described their health care transportation burden and barriers to health care access for their care recipients as well as their visions for more viable options and services. Participants expressed the need for streamlined care services including, for example, organization-based policy changes to improve safe transference from a personal or service vehicle and into the hospital/clinic. Perceived inadequacy of community transportation options led to participants filling the gaps by providing rides, asking friends for help, or posting on social networking sites to ensure health care access for their care recipients. On an interpersonal level, participants highlighted the benefits of intangible yet critical support, such as compassionate employees. Findings underscore multifaceted challenges caregivers face in providing transportation assistance, emphasizing the need for systemic improvements and policy changes to enhance health care access and support services.
AGE DIFFERENCES IN OPEN-ENDED DECISION EVALUATIONS AND THEIR IMPLICATIONS FOR DECISION AVOIDANCE
Authors: Nolte Julia , Löckenhoff Corinna
Published: January 2025

Decision avoidance is more frequent with age, but associated mechanisms remain underexplored. To address this gap, a mixed-methods study captured decision makers’ subjective evaluation of choice options prior to making or avoiding choices. An adult lifespan sample (N = 227, 18-88 years, M = 50.71, SD = 19.22, 55% women) evaluated four health and consumer decision scenarios. Specifically, participants were asked to write down what they liked and disliked about the available choice options before making or avoiding a choice. Decision avoidance was positively associated with age. Open-ended responses were on average 33.08 words long (SD = 22.38) and contained a sum of 21.18 statements (SD = 16.42). The number of words or statements was unrelated to age. Responses were coded for remarks about positive (κ =.79-.88), negative (κ =.60-.74), and fixable/acceptable (κ =.32-.85) choice attributes, as well as choice preferences (κ =.34-.67). No significant findings emerged with respect to the latter two categories; among the former, the number of negative remarks dominated the positive ones. Decision makers who focused relatively more on negative attributes were older and reported poorer mental well-being. Among middle-aged and older adults, but not younger adults, a stronger focus on negative compared to positive attributes was associated with more pronounced decision avoidance tendencies. All findings remained significant after accounting for the number of words or statements. In combination, this may suggest that older age groups hold stricter decision standards or are less willing to trade-off between favorable and unfavorable choice attributes.
BARRIERS AND SOLUTIONS TO VOLUNTEERING FOR OLDER ADULTS WITH DISABILITIES
Authors: Nickrent Megan , Rehman Haseeb , Sharp Bethanie , Koon Lyndsie , Rogers Wendy
Published: January 2025

Volunteering is associated with improved health, decreased symptoms of depression, and increased companionship for older adults. Volunteering can empower people with disabilities, and both the volunteer and the recipient of services experience benefits. Unfortunately, older adults with disabilities often experience barriers to participating in volunteering. Understanding those barriers can highlight areas wherein we can facilitate volunteerism for older adults with disabilities and enable their participation in community activities. We performed an archival analysis of data from Aging Concerns, Challenges, and Everyday Solution Strategies study. Older adults aged 60-79 with vision, hearing, or mobility disabilities were asked about challenges they faced and their responses to those challenges. They provided detailed information in an interview across a range of daily activities, discussing in-depth those that were most difficult. Across the three disability groups, 17 participants discussed difficulty volunteering. Common challenges included organizers of the event not providing accommodations, supervisors not knowing what tasks to assign to persons with disabilities, and other people doubting the abilities of persons with disabilities. Participants expressed frustration with these barriers to volunteering. We explored their responses to these barriers as well. Many participants reportedly used tools or sought assistance from others, but some responded by simply not participating in the activity. Understanding the range of challenges experienced by older adults with disabilities when engaging in the community and exploring their current solutions can help determine ways to increase volunteer engagement for this population. In turn, this can help improve quality of life for older adults with disabilities.
BEDROOM ENVIRONMENTAL QUALITY PARAMETERS ASSOCIATED WITH OLDER ADULTS’ BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS
Authors: Au-Yeung Wan-Tai , Beattie Zachary , Kaye Jeffrey
Published: January 2025

Behavioral and psychological symptoms are common among older adults with apathy, depression and anxiety being the most prevalent. Identifying factors associated with such symptoms may help mitigate them. The study, Monitoring Apathy, Depression and Anxiety Using Technology Evaluations, aimed to identify indoor environmental quality factors that may trigger these symptoms. The study was a 9-month observational study in 12 participants’ personal residences. Participant mean age was 79.0 (6.4) years, 7 were males (58.3%), 7 had normal cognition, 4 had MCI and 1 had early-stage AD. The participants self-reported the severity of their apathy, depression and anxiety weekly online by answering standard surveys sent via email, which consisted of the 6-item Withdrawal-Apathy-Vigor subscale from the Geriatric Depression Scale for assessing apathy, and depression, and anxiety subscales from Patient-Reported Outcomes Measurement Information System for assessing depression and anxiety respectively. Bedroom environments were assessed with environmental sensors (Awair Omni, San Francisco) which measured light level, noise level, temperature, humidity and air quality every 5 minutes. Individual mixed-effect models were built with each symptom severity being the outcome, and each weekly mean bedroom environmental quality factor being the predictor, while controlling for age, sex and the week the data was collected. Lower light level in the bedroom was significantly associated with more severe depression scores (p< 0.01) and higher temperature was associated with more severe apathy scores (p< 0.05). Optimizing specific aspects of indoor environmental quality in older adults’ personal homes can potentially assist in improving management of behavioral and psychological symptoms.
BODY MASS INDEX AND OLDER WOMEN AND FEMMES EXPERIENCES WITH DISCRIMINATION IN THE HEALTHCARE SETTING
Authors: Roache Tavia , Brown Lauren , Mathershed Amor , Stewart Heaven , Benton Leilani , Singleton Mekiayla
Published: January 2025

BMI is used widely both within and outside of healthcare settings to understand health despite the contradictory evidence around the impact of obesity on mortality in middle age and older adulthood. We examine how BMI impacts reports of older white, Black and Latine women and femmes’ self-reports of ever experiencing discrimination in the health care setting over their lifetime using the Health and Retirement Study (HRS) leave behind questionnaire (n=7,614). We also examine if experiencing this type of discrimination in the healthcare setting impacts these women’s mental health. Having ever been unfairly denied health care or treatment was more commonly reported by older Black (n=1,059) and Latine (n=588) women/femmes relative to older white women. Regardless of race/ethnicity, women and femmes with a higher BMI have an increased likelihood of reporting being unfairly denied health care (OR=1.03, p=0.01). Women who report being unfairly denied treatment in the doctor’s office also report more depressive symptoms (ℬ=0.93; p< 0.001). Findings demonstrate that women with higher BMI are at increased risk of experiencing discrimination in a health care setting over their lifetime. This is especially true for Black and Latine women/femmes who are more likely to report discrimination. Anti-racist efforts in healthcare must also address unfair treatment of women and femmes based on their BMI.
BUILDING THE OLDER ADULT BEHAVIORAL HEALTH WORKFORCE: OREGON’S CENTER OF EXCELLENCE FOR BEHAVIORAL HEALTH & AGING
Authors: Brandis Leah , Dawson Walter , Stodola Allyson , Himes Dani , Dhar Nirmala , Smith Lindsey , Carder Paula
Published: January 2025

The need for behavioral health workforce support is prevalent nationwide. Older adult Oregonians have a 26% prevalence of anxiety disorders, 12% prevalence of serious mental illness and Oregon has the 4th highest rate in the nation for older adult deaths due to intentional self-harm. The newly established Oregon Center of Excellence for Behavioral & Aging (OCEBHA) is designed to support the behavioral health needs of older adults. A primary objective is to boost the capacity of the workforce to support older adults living with behavioral health needs. The workforce is defined broadly and includes behavioral health and aging subject matter experts, clinical and administrative health care workers, direct care workers in long-term care settings, first responders, care managers, and older adults themselves. There are already workforce training efforts happening across Oregon, therefore, in order to collaborate and align efforts, OCEBHA has launched a coalition of organizations (n= 15) who already train this workforce. This coalition will meet quarterly to share upcoming training opportunities in order to support the sectors’ efforts, identify gaps, as well as brainstorm future collaborations. In addition, Oregon has recently received the state’s first Geriatric Workforce Enhancement Program (GWEP) award and OCEBHA is already working closely with the Oregon GWEP to collaborate on future training endeavors. Based on identified gaps, a comprehensive workforce training plan for the next four years is in development. The intention is to collaborate with partners across the state to ensure training is available to meet basic older adult behavioral health competencies.
CLOSED-INCISION NEGATIVE PRESSURE WOUND THERAPY (NPWT) IN OLDER PATIENTS FOLLOWING PRESSURE SORE RECONSTRUCTION
Authors: Jee Young Min , Lee Seungkeun , Park Jun Ho
Published: January 2025

Pressure sores significantly affect older patients, with the sacrum being especially vulnerable due to its proximity to the anus and potential for fecal contamination. Despite preventive measures, some sores still require surgical intervention. Postoperative care focuses on monitoring, hygiene, and pressure alleviation. This study assessed the efficacy of Closed-Incision Negative Pressure Wound Therapy (CI-NPWT) for postoperative wound management in patients with sacral pressure sores treated with local flaps. A retrospective analysis was performed on sacral sore patients who underwent reconstructive surgery from March 2019 through April 2023. Surgical procedures involved debridement and wound coverage using gluteal artery perforator-based fasciocutaneous flaps, followed by postoperative monitoring. Patients were grouped into either conventional monitoring or NPWT management using the INFOV.A.C. Data on patient demographics, flap metrics, fluid drainage amounts, and six-month postoperative outcomes were collected, and then analyzed with SPSS Statistics. In this study of 52 patients, 25 received NPWT and 27 received conventional dressing after surgery. While flap survival rates were 100% in both groups, the NPWT group demonstrated a significantly lower incidence of flap complication and reduced drainage amounts on the seventh postoperative day (17.2 vs. 27.8 cc, P< 0.05). The conventional dressing group exhibited one case of wound infection and three cases of dehiscence, while the NPWT group had no complications. Closed-incision NPWT may outperform conventional monitoring in treating immobilized sacral pressure sore patients following local flaps. This technique holds promise as a potential gold standard in sacral sore flap care in older patients.
COMMUNICATING DEMENTIA ACROSS THREE GENERATIONS WITHIN CHINESE FAMILIES
Authors: Xu Shicheng , Lou Vivian Weiqun , Gonzales Ernest
Published: January 2025

Despite the benefit of early detection and diagnosis of dementia, globally, nearly 75% of people living with dementia are not diagnosed, indicating the barriers to help-seeking behaviors in the early stages. While in individualistic culture, help-seeking is subject to self-determination, in collectivist culture like China, help-seeking is subject to family determination that requires communication among multigenerational family members, including adult grandchildren. Research focusing on pre-diagnostic family communication is scarce. We aimed to understand how the family communicated to get the initial screening, disclose the diagnostic result, address the uncertainties, and manage emotions across three generations. Guided by constructivist grounded theory, we conducted semi-structured interviews with 28 Chinese participants (6 adult grandchildren, 5 adult children, 9 people with early-stage dementia, and 7 spouses). The results revealed “disconnected” and “connected” family communication patterns between the message sender and receiver. Barriers to connected communication include hierarchical family relationships, limited emotional expression, preference for implicit and crisis-induced communication. Family members tend to put an invisibility clock on dementia symptoms, the diagnostic result, and even the self-consciousness of people living with dementia. Nonetheless, older adults who received an early-stage dementia diagnosis expressed a strong desire to engage in family communication. Adult grandchildren also exerted a key role in family communication and decision-making processes. Social workers should empower intergenerational family members with communication and persuasion strategies to enhance diagnosis, prognosis, and emotional communication. This study underscores the fundamental role of family communication in early-stage dementia to increase screening and facilitate the subsequent care arrangement.
DECODING EHR DATA: THE ROLE OF SOCIAL SUPPORT IN PRESSURE INJURIES AMONG HOMEBOUND OLDER ADULTS
Authors: Chow Christine , Kim Yijung , Bangerter Lauren , De Jonge Karl
Published: January 2025

Homebound older adults are increasingly susceptible to acquiring pressure injuries (PIs) due to a variety of pathological and physiological changes associated with aging. However, the impact of social risk factors of PIs among homebound older adults remains largely understudied. This research was conducted to explore how unstructured data via House Call clinical notes can provide insights of psychosocial factors that influence pressure ulcer conditions compared to formal diagnoses via ICD-10 codes. Using electronic health records and clinical notes (N= 1,770) from patients enrolled in a home-based primary care program (04/01/2021-03/31/2024), we evaluate the impact of a novel natural language process (NLP) algorithm to identify PIs among older adults (N= 664 patients, Mean age= 86.55, 78% female, 84% Black or African American). These clinical notes were analyzed using bigram analysis to identify patterns of psychosocial and other factors that influence documentation of pressure ulcers. Themes included known common risk factors for PIs (functional impairment, malnutrition, co-morbidities, frailty, and poor tissue perfusion). However, social support was a unique category identified with multiple associated bigram phrases, suggesting a strong relationship with PIs and underscores a need for further investigation. This study highlights the emerging potential of NLP methodology in clinical research for the systematic analysis of large volumes of clinical narratives, offering valuable insights from these interpersonal relationships. Furthermore, understanding social risk factors can contribute to the early identification of PIs, inform clinical practices, and help reduce the incidence of PIs in homebound older adults.
DEMENTIA CARE SHARED BY MULTIPLE CHINESE FAMILY CAREGIVERS: EXPLORING FAMILY-LEVEL PREPAREDNESS FOR CAREGIVING
Authors: Choy Jacky C P , Wong Dipsy H S
Published: January 2025

Involvement of multiple family members as caregivers is commonly observed and often essential in families living with dementia. While preparedness for caregiving was found to be associated with better caregiver outcomes, previous studies centred on one primary caregiver and rarely enquired their preparedness at a family level. This qualitative study aims to explore the preparedness of family as a unit for dementia care. Participants were 30 caregivers (12 spousal caregivers; 31 to 86 years old) who took care of a person living with dementia (PLwD) in the community and reported having more than one family members involved (3.8 caregivers involved in average). We conducted semi-structured in-depth interviews to understand the care needs of PLwD, their care arrangements, family dynamics, and perceived family preparedness. Thematic analysis with an inductive approach was adopted. Seven themes suggesting 7 components of family preparedness emerged: 1) Common understanding of PLwD care needs, 2) Aligned caregiving roles and expectations, 3) Identification of primary caregiver, 4) Flexibility for care task sharing and substitution, 5) Conflict resolution in care arrangement decision making, 6) Exchange of caregiving resources and information, and 7) Sharing of feelings and emotional support. Proximity, composition, family values, and prior communication patterns among members substantially shape their preparedness for caregiving. These components largely resonate with the dimensions of communication, roles, problem solving and affective exchange in McMaster model of family functioning and resemble concepts in models of team effectiveness. Family-centered interventions targeting family preparedness for caregiving can potentially improve caregiver as well as family outcomes.
DETECTION OF AI-GENERATED IMAGES: A MIXED METHODS STUDY ON AGE-RELATED DIFFERENCES
Authors: Velazquez Enilda , Flores-Cruz Gabriela , Roque Nelson
Published: January 2025

Generative artificial intelligence (AI) content has become widely accessible but continues to face misuse for spreading misinformation that often targets older adults. This is concerning considering that AI generated content is projected to occupy 10% of the internet by 2025 (Gartner, 2024). Previous research has implicated age and analytical thinking as potential predictors in how well individuals identify misinformation (Pehlivanoglu et al., 2022; see CISDA model, Frazier et al., 2019). This study uses a mixed methods approach to examine the vulnerability of individuals across age groups (young adulthood: 18-39, middle adulthood: 40-59, old adulthood: 60-89; within-subjects) to discern AI manipulated images (AI-generated, non-AI generated; between-subjects) by using (1) signal detection analyses (i.e., hit, miss, false alarm, correct rejection) and (2) response time measures while controlling for analytical thinking (Cognitive Reflection Test score, Frederick, 2005) as an external variable (N = 190). A mixed methods ANOVA suggests that older adults (M = 0.426, SD = 0.150) exhibited significantly higher false alarms than younger adults (M = 0.306, SD = 0.180, p = 0.007, n2p = 0.053). However, there were no differences of age cohort on the rate of hits, misses, or correct rejections, nor on image discernment reaction time while controlling for analytical thinking. The increased false alarm rate among older adults may reflect AI sensitivity toward images, potentially indicating that AI sensitivity acts as a protective factor in the AI interactions of older adult’s AI interactions. Future research should explore this sensitivity as a safeguard against misinformation exploitation.
DETERMINANTS OF SLEEP HEALTH IN THE CONTEXT OF THE COVID-19 PANDEMIC AMONG OLDER CHINESE IMMIGRANTS IN THE U.S
Authors: Marquez Stephanie Lyn , Da Wendi , Tang Fengyan , Jiang Yanping
Published: January 2025

Good sleep is crucial for healthy aging. While recent studies have examined psychosocial factors related to sleep health, their impact on older Asian immigrants is not well understood. Notably, few studies have examined how psychosocial factors and immigration factors may intensify the COVID-19 pandemic’s effect on sleep among this population. This study investigated how these factors, assessed prior to the pandemic, affected sleep health during COVID-19 among older Chinese immigrants. Data were drawn from the Population Study of Chinese Elderly (PINE), focusing on participants who completed the Pittsburgh Sleep Quality Index and Women’s Health Initiative Insomnia Rating Scale in wave 6 (2021-2023) and at least one prior wave between wave 4 (2017-2019) and wave 5 (2019-2021). A mixed-effects linear spline model analyzed predictors across five domains: individual characteristics (age, sex, marital status, education, income, health literacy, chronic conditions), psychological distress (depressive symptoms, anxiety, perceived loneliness), immigration factors (years living in the U.S., acculturation), interpersonal factors (social support, social strain, filial piety receipt and expectations), and perceived neighborhood environment (disorder and cohesion), all adjusted in the context of COVID-19. Results were stratified by residential environment (living in Chinatown versus living outside of Chinatown). The findings revealed that the pandemic worsened sleep health, with depressive symptoms being significantly related to a faster decline in sleep quality and faster increase in insomnia, regardless of residential environment. These findings suggest that the pandemic intensified the influence of psychosocial and immigration factors on sleep health among older Chinese immigrants, highlighting the need for targeted interventions.
DIGITAL AGEISM PERSISTS IN ARTIFICIAL INTELLIGENCE-GENERATED IMAGES
Authors: Derenne Nicole , Martens Lindsey , Virgin Nicole , Hoffarth Phillip , Van Eck Richard , Klug Marilyn , Manocha Gunjan , Jurivich Donald
Published: January 2025

Artificial intelligence systems (AI), including text-to-image models, often reflect and amplify societal age-related biases, a phenomenon known as digital ageism. This study examines if instances of digital ageism in AI-generated representations of older adults lessen over time. Examining how digital ageism evolves in AI-image generation can provide insight into the interplay between technology advancements, societal attitudes toward aging, and the well-being of older adults interacting with the dynamic digital landscape. This mixed methods project compared 164 images generated by Open AI’s DALL-E 2 image generator at two points, one year apart. Text prompts, identical at both points of inquiry, included terms from the geriatric lexicon (e.g., frail older adult, dementia, successful aging). Images were qualitatively evaluated to identify perceived gender, race, socioeconomic status, and emotional expression. Quantitative analysis of the frequency with which each category was represented found significant differences in gender and socioeconomic representation at both points of inquiry but no difference between the two points. The number of white racialized representations of older adults was 5-fold higher than other racialized representations at both points, with an increase of Asian racialized representations at the second point of inquiry. There was no significant difference between emotional expressions between the inquiry points. Despite the increased social emphasis on positive views on aging, AI text-to-image generators persistently generated predominantly white racialized middle-class male figures. A limitation of this study is that it focuses only on AI text-to-image generation and no other AI-generated content.
DOMAINS OF PERSON-CENTERED CARE IN LONG-TERM CARE COMMUNITIES
Authors: Seidel Elizabeth , Lin Shih-Yin , Cortes Tara
Published: January 2025

Person-centered care (PCC) in long-term care (LTC) has been integrated in a patchwork fashion. No standard nomenclature or quality indicators exist for PCC culture, policy, training, or practice. As part of the 2nd phase of a large study to establish the standards of care for PCC, we conducted 8 resident (n=56, age 65-102) and 9 staff (n=66) in-person focus groups, at 5 LTC communities in NY, PA, IL, AZ, and CA to validate essential PCC domains and concepts. Deductive content analysis was applied to validate person-centered domains previously established by the University of Maine during phase 1 of the study: personhood; resident care, choice, and empowerment; food and dining; enrichment and socialization; staff empowerment; physical environment, and family engagement. Phase 2 focused on populations that are more inclusive of residents from historically marginalized groups. We successfully validated all domains previously proposed with minor revisions to the domain definitions and a clearer understanding of the elements within them. For instance, consistent quality across all levels of care was added to the resident, care, choice, and empowerment domain, and the personhood domain was expanded to include staff advocating for the residents when their care preferences differ from their family. The top three domains discussed across the focus groups were resident care, choice and empowerment; personhood; and enrichment and socialization. By identifying elements that drive PCC, measures can be developed to ensure standards are in place to guide excellence in PCC in LTC communities.
EXAMINING THE CHARACTERISTICS OF UNIVERSITY EMPLOYEES AND STUDENTS PROVIDING CARE TO ADULTS WITH ADRD
Authors: Southerland Jodi L , Mauck Erin , Zheng Shimin , Smith Matthew
Published: January 2025

University employee and student caregivers face challenges balancing caregiving with employment and educational responsibilities. With over 4,000 degree-granting institutions in the United States, this represents a growing need for intervention. Data were collected via a Qualtrics survey from university employees and students (n=350) who provided unpaid care to a relative or friend 18 years or older. Participants completed assessments including the Zarit Burden Index, Center for Epidemiologic Studies 4-item Depression Scale, Generalized Anxiety Disorder 2-item scale, and Connor-Davidson Resilience Scale. Chi-square and independent t-tests were employed to compare personal, socio-emotional, and caregiving characteristics between caregivers to people with Alzheimer’s Disease and related dementias (ADRD) and non-ADRD caregivers. Compared to non-ADRD caregivers, the care recipients of ADRD caregivers were older and had more health conditions. ADRD caregivers also had been caregivers for fewer years than non-ADRD caregivers. Although ADRD caregivers were more likely to provide personal care, they also had more caregiving support (e.g., unpaid and paid) than non-ADRD caregivers. Compared to non-ADRD caregivers, ADRD caregivers reported significantly higher caregiver burden (t=-2.39, P=0.02). ADRD caregivers reported a greater need for caregiving resources and were more likely to disclose their caregiving status to university personnel compared to non-ADRD caregivers. Findings highlight the need for university-based resources to support the unique challenges of employee and student ADRD and non-ADRD caregivers. Opportunities exist to introduce programs and services (e.g., respite care, flexible scheduling, problem-solving interventions) to help employees and students succeed in their work/studies, manage caregiver burden, and provide high-quality care to care recipients.
EXAMINING THE IMPACT OF TRAUMA-INFORMED CARE ON NEUROPSYCHIATRIC SYMPTOMS IN THE LONG-TERM CARE SETTING
Authors: Saiyed Sahebi , Bender Alexis
Published: January 2025

Major life changes, such as transitioning into skilled nursing care, can trigger a traumatic stress response in older adults. In 2019, CMS released the requirement for trauma-informed care (TIC) in Skilled Nursing Facilities (SNF). This exploratory project aimed to assess the effectiveness of TIC on reducing neuropsychiatric symptoms, assessed using the NPI-NH, among patients with a history of trauma in one SNF. We conducted a retrospective chart review and trauma screening of 59 patients; primarily female (n=51, 86%), white (n=35, 59%) and ranged in age from 67-102 (Mean=82.97). 43 (73%) patients reported trauma and 27 (46%) patients were defined as “high risk” (i.e., history of trauma and either an NPI-NH score (≥ 20) or ≥2 psychotropic medications). 12 (44%) “high-risk” patients received a targeted care plan intervention (i.e., consistent staffing, music therapy, spiritual support, and specialized nursing care) based on the trauma reported and input from patients or their care partners. NPI-NH scores we reassessed one month after the intervention initiation. The NPI-NH score for the intervention group was 36.00 (SD=19.34) at baseline and 24.56 (SD=19.68) at follow-up. We conducted a paired samples t-test (pre- to post-intervention) with a more lenient p-value of 0.10 due to the exploratory nature of this intervention. We found there was a significant difference with a moderate effect between the mean NPI-NH scores from pre- to post-intervention, t(11) = 1.95, p=.08, Cohen’s d = 0.59, indicating promise for TIC interventions to improve the quality of life for patients admitted into SNF with a trauma history.
EXERCISE IN RURAL COMMUNITIES: A QUALITATIVE STUDY OF HOW PAST EXPERIENCES IMPACT CURRENT EXERCISE PRACTICES
Authors: O’Leary Bryant , Shaffer Tasha , Routh Brianna , Whitten Justin , Tarabochia Dawn
Published: January 2025

As the aging population continually grows, understanding how to keep older adults engaged in exercise is of increasing importance. This is critical as exercise trends show that engagement dramatically decreases with age. Moreover, older adults are more likely to live in rural communities as compared to urban communities (Cohen & Greaney, 2023). Previous studies explored barriers related to the overall decrease in exercise engagement, yet few have focused on older adults’ motivation to maintain exercise practices. The purpose of this project was to explore how past experiences with exercise influence current exercise participation among rural, older adults. Residents engaging in exercise and aged 55+ (n=42) from a western state were recruited using convenience sampling (partnership with local Extension agents and social media outlets). As part of a larger online survey, participants completed an open-ended questionnaire specific to past experiences with exercise. Participant results were analyzed using Van Manen’s (1990) hermeneutical approach with three members of the research team developing themes from participant responses. Trustworthiness was established by a peer reviewer to assess the themes for accuracy. Researchers identified five themes associated with how past experiences influenced current exercise practices. These included health and wellness (18), accessible instruction/resources (17), friends and family (13), community programming (10), and youth activity (4). By understanding past experiences, outreach professionals may find more impactful early or later life supports to promote exercise across the lifespan.
EXPLORING DELIBERATE PRACTICE TO REDUCE AGE-RELATED PERFORMANCE DIFFERENCES IN A COMPLEX TASK
Authors: Prevratil Michael , Charness Neil , Boot Walter
Published: January 2025

Can age-related differences in complex task performance be overcome with simple behavioral interventions? We monitored differences between older and younger adults’ performance in a complex psychomotor task with the intent of developing a behavioral intervention grounded in principles of deliberate practice. An older (N = 24, M age = 71) and younger (N = 28, M age = 19.1) sample were taught to play a complex videogame called Space Fortress Participants also completed several cognitive tests and a semi-structured interview. The older adults performed significantly worse on Total score (Cohen’s d = 1.45) and three of four subscore metrics (Control, Points, and Speed). Like the differences between men and women (Harwell, Boot, and Ericsson, 2018), score differences between younger and older adults appeared to be driven by strategic and potentially modifiable behaviors. For example, older adults held control inputs for twice as long compared to the younger sample (Cohen’s d = 0.98), a common strategic error. Older adults primarily implemented variants of the “drifter” strategy, letting their ship float uncontrolled through the game environment, while most younger adults implemented the optimal “orbiter” strategy, piloting their ship in a clockwise path around the central fortress. These differences demonstrate likely modifiable aspects of performance that can be improved with targeted behavioral interventions. Findings will be used to develop practice environments and instructions anticipated to greatly reduce or eliminate age-related performance differences.