bluuebunny/crossref_metadata_2025 huggingface dataset:
UTILIZING COMMUNITY CONNECTIONS: A SOCIAL DETERMINANTS OF HEALTH SCREENING FOR COMMUNITY-DWELLING OLDER ADULTS
Authors: O’Sullivan Kelly , Weaver Raven , Bolkan Cory , Gotch Chad , Geissal Erik , Swanson Breanne
Published: January 2025

Community-based aging resources, like Area Agencies on Aging (AAA), are often underutilized. Establishing partnerships with healthcare providers can promote better awareness and use of available services/supports. We evaluated a community partnership between a primary care clinic and an AAA; both community partners were committed to reducing adverse health outcomes. This exploratory intervention study assessed social determinants of health (SDH) needs of Medicare-eligible primary care patients (n = 385) during an annual visit (Mage=72.5; 89.6% White) and connected patients to appropriate supportive aging services. There were 284 participants with identified unmet SDH needs, but only 36 participants accepted referral to AAA resources. We analyzed Medicare’s Risk Adjustment Factor (RAF) score at baseline and participants’ use of advanced care (i.e., ER visits/hospital readmissions/institutionalizations), urgent care, and primary care, over a 6-month period. Descriptive, bivariate, and multivariate analyses revealed positive associations between RAF score with age (p< 0.001) and number of SDH needs (p< 0.001), advanced care with SDH needs (p=0.004) and RAF score (p< 0.001), and primary care visits with SDH needs (p=0.003) and RAF score (p< 0.001). The screening revealed that older adults’ SDH needs are often unmet and underrecognized. Cross-sector partnerships between medical and social models of health can reduce risk and meet needs of community-dwelling older adults. Policy provisions that encourage such partnerships are needed to improve community-dwelling older adults’ wellbeing, independence, and ability to age-in-place.
DO LIFE SATISFACTION AND LEVEL OF OPTIMISM IMPACT SUCCESSFUL AGING IN MID AND LATE LIFE?
Authors: Bhattacharyya Kallol Kumar , Molinari Victor , Gupta Debasree Das , Hueluer Gizem
Published: January 2025

Earlier theoretical frameworks of successful aging (SA) included either objective or subjective evaluations or both. Guided by the Rowe and Kahn model, the current study expands prior work by examining the association of objective and subjective components of SA with individuals’ life satisfaction and level of optimism across adulthood. Data were from waves 2 (2004-05) and 3 (2013-14) of the Midlife in the United States (MIDUS) study. To obtain a multidimensional SA score, we considered successful agers as those with a higher score in cognition, with minimal difficulties in performing physical activities, maintaining active engagement with life, and free of multiple chronic conditions. We used structural equation modeling to examine whether subjective life satisfaction (wave 2) has any effect on a composite measure of SA (wave 3) while controlling for baseline sociodemographic and health factors; we also examined the reverse directional association. Further, we also examined the mediation effects of level of optimism in the above associations. A total of 2,040 individuals (Mage=64±11; women 56%) were included. After controlling for covariates, findings revealed that prior life satisfaction has a positive direct effect (b=0.094; SE=0.019; p< 0.001) on SA; also, this effect is bidirectional. Further, high level of optimism mediates the association between life satisfaction and SA. While SA is often examined in relation to various risk/protective factors in late life, this study identified life satisfaction and level of optimism as having potentially positive impacts on achieving SA in middle-aged and older MIDUS participants.
INVESTIGATING CAUSAL LINK BETWEEN VOLUNTEERING AND BLOOD PRESSURE BY GENDER, RACE, AND COHORT
Authors: Kim Seoyoun , Halvorsen Cal , Shiba Koichiro
Published: January 2025

Given that nearly half of adults 50 and older have hypertension in the United States, public health interventions focus on reducing risk factors. However, population-based approaches that aim to enhance protective factors, such as social engagement, can be applied to larger groups, resulting in a downward shift in the population blood pressure distribution. Further, understanding the potential heterogeneous effects of volunteering frequency by demographic factors help identify the population subgroups in which volunteering is more (or less) protective against hypertension. The current project examines the link between volunteering and changes in systolic and diastolic blood pressure by gender, race/ethnicity, and cohort as potential effect modifiers. Using the Health and Retirement Study (2006-2016, N=18,847), this study assessed the longitudinal relationships between volunteering (2010/2012) and blood pressures (2014/2016) within each stratum of gender, race/ethnicity, and age cohort. The analyses adjusted for pre-volunteering covariates (2006/2008) as well as selection into volunteering using Inverse Probability Treatment Weighting (IPTW). The joint exposure of volunteering and effect modifiers was estimated by the relative excess risk due to interaction (RERI). Results show that individuals volunteering 201+ hours annually had a lower likelihood of clinically high diastolic (PR=0.84, p=0.04) and systolic (PR=0.98, p=0.04) blood pressure. Moderate level of volunteering was predictive of low systolic blood pressure. The combination of volunteering 201+ hours and being female was protective against high diastolic blood pressure (RERI=-0.09, p=0.02). Given the modest effect modification, frequent volunteering has an anti-hypertensive effect for the general population of adults 50 and older.
LONELINESS AND COGNITIVE FUNCTION IN OLDER ADULTS: A LONGITUDINAL ANALYSIS
Authors: Abaei Elnaz , Martin Peter
Published: January 2025

Only a few studies have confirmed cognition as a predictor of loneliness. This study investigated the dynamic relationship between loneliness and cognitive performance in older adults through a random intercept cross-lagged panel model. Data from 8,443 individuals aged 65 years and older, drawn from Waves 9–14 of the Health and Retirement Study (HRS), were analyzed. Loneliness was assessed using the UCLA Loneliness Scale, and cognitive function was measured using delayed memory recall. Age, gender, and education were included as covariates. We combined waves 9-10, waves 11-12, and waves 13-14 to include all participants. Bivariate correlations revealed that older age was negatively correlated with cognitive function, loneliness was positively correlated with older age, and male gender and higher education were positively correlated with cognitive function, and negatively correlated with loneliness. Cognition and loneliness were negatively associated. Using Mplus, we computed an unconditional random intercept cross-lagged panel model (RI-CLPM) with no exogenous predictors (X2=.186, df=1, p=0.67, RMSEA=0.000 [.000,.018], CFI=1.0, TLI=1.0) and a conditional model (X2=13.431, df=7, p<.06, RMSEA=0.009 [.000,.015], CFI=.999, TLI=.997) including age, gender, and education as predictors. Results indicated individuals reporting higher loneliness exhibited lower cognitive functioning scores and older age. Male gender and higher education were negatively associated with loneliness and positively with cognitive function. This study underscores the link between loneliness and cognitive decline in older adults, emphasizing the need to address loneliness to potentially reduce cognitive decline. Insights into demographic predictors of loneliness and cognitive function could inform targeted interventions for promoting successful aging.
PREDICTORS OF CONTINUED ENGAGEMENT IN ONE’S FAVORITE ACTIVITY DURING THE COVID-19 PANDEMIC
Authors: Kim Jeehoon , Lee Ji Hyun
Published: January 2025

Active engagement is one of the important pillars in successful aging (Rowe & Kahn, 1997), however less is known about one’s favorite activity, a key source of enjoyment and meaning, in later life. In the context of higher constraints imposed during the pandemic, continuing one’s favorite activity can play a pivotal role in maintaining well-being for older adults. The current study aimed to examine which factors are associated with sustaining engagement in one’s favorite activity in 2020. Data comes from Round 10 of National Health and Aging Trends Study. Participants (n= 4,389, Age M(SD)=78(6), 55% female, 83 % White) answered, during last year, whether they were able to participate in their favorite activity previously reported at Round 5 (84% yes). Survey weighted logistic regression models were performed stratified by gender. We found that women who reported health better (OR= 1.28, p=.018) and engaged in vigorous physical activity (OR=1.96, p =.007) were more likely to continue their favorite activity. For men, younger age (OR=.97, p=.017), social engagement (OR=1.22, p =.011) and physical activity participation (walking OR=1.91, p=.014; vigorous OR=2.07, p=.001) were positively, but depressive symptoms (mild OR=.57, p =.006; major OR=.50, p=.028) were negatively linked to continuing in favorite activities. The findings show that engagement in physical activity supports continued enjoyment of one’s favorite activity; social engagement and mental health are also protective factors for men. Implications for how to support older women and men’s continued activity engagement will be discussed.
SUPPORT FROM FRIENDS, BUT NOT CHILDREN, BUFFERS AGAINST DEPRESSION AMONG LEFT-BEHIND OLDER ADULTS
Authors: Wang Suyi , Lu Minjie , Fung Helene H
Published: January 2025

As adult children migrate, old parents are facing the choice of migrating with their children or remaining in their hometowns (being left-behind). Being left-behind is associated with deteriorating psychological well-being among older adults (Adhikari et al., 2011; Song, 2016; Song, 2017; Zhang, 2016). This study aims to examine whether support from children and friends may benefit the well-being of left-behind older adults. The study recruited 52 left-behind older adults (30 females, Mage = 64.96, SD = 5.291), 69 older adults migrated with their children (54 females, Mage = 64.78, SD = 4.465), and 64 older adults who were currently living with their children in the city they grew up (34 females, Mage = 66.28, SD = 5.072, local group). Consistent with previous findings, the results showed that left-behind older adults reported a higher depression level compared to the local group, and the migration group was in-between. In addition, perceived support from children was negatively associated with depression level among the migration group and the local group, but not among the left-behind group. However, only among the left-behind older adults was perceived support from friends living in the same city negatively associated with depression level. The difference in depression level between the left-behind group and the local group was mitigated among participants who perceived strong support from friends. These results highlight the salutary effect of support, especially from friends, on buffering against depression among left-behind older adults.
BRIDGING THE DIGITAL DIVIDE: EXPLORING DETERMINANTS OF TELEHEALTH UTILIZATION AMONG US OLDER ADULTS
Authors: Hwang Misun , Veliz Philip , Jiang Yun
Published: January 2025

The growing older population emphasizes the need for effective integration into the digital health ecosystem. Multiple factors can affect technology adoption among older adults; however, few studies have comprehensively examined their use of telehealth. This study aimed to explore determinants of telehealth utilization among older adults based on the Senior Technology Acceptance Model. Logistic regression was conducted to analyze a nationally representative survey of 6,327 community-dwelling older adults (≥65 years) from the 2022 National Health and Aging Trend Study (NHATS). Telehealth utilization was defined as communicating with health professionals online to manage health. Findings indicated that 46.1% of respondents reported telehealth utilization last year. Respondents who were older, non-white, living in non-metropolitan areas, had lower levels of education and income, or lacked access to technologies were less likely to utilize telehealth. Additionally, poor cognitive function and a lack of social networks or social participation were associated with the non-use of telehealth. However, poorer health status and multiple comorbidities, including cancer (OR=1.47, 95% CI=1.12-1.92) and anxiety (OR=1.56, 95% CI=1.10-2.26), were associated with greater odds of telehealth utilization. Gender, marital status, sensory impairment, limitation of strength or movement, instrumental activities of daily living, and depression were not associated with telehealth utilization. This study confirms the digital divide among vulnerable older adults in the US. Although they have an increased need for telehealth services with their health conditions, they might not fully benefit from telehealth. There is an urgent need to improve digital inclusion and advance health equity in this population.
EFFECTIVENESS OF USING TECHNOLOGIES FOR COMMUNITY DWELLING OLDER ADULTS: A PILOT STUDY
Authors: Chang Pei-Fen , Thomas Lisa , Feng Jeff , Tsai Kai-Li
Published: January 2025

Many challenges arise with an aging population, particularly the increase of isolation and lack of social relationships. A strong sense of social connections is considered as a protective factor that is associated with general well-being. One novel approach that has been shown to increase social connection in older adults is the utilization of technology. During this post-pandemic period, we lack an understanding of whether or not older adults use technologies for daily living, especially for social connections. The aim of the study was to examine the effectiveness of an information and communication technology (ICT) program for community dwelling older adults for social connection by decreasing loneliness and increasing quality of life. A one-group pre and post-tests design was used including the inclusion criteria: older adults aged 70 and older, living alone in the community, and able to speak and understand English. Outcome measures included the SF-12 for physical and mental health, UCLA 3-item loneliness Scale for loneliness, and Technology Acceptance Model questionnaire for the self-perceived acceptance and ease of use of the technology. After receiving a 6-week intervention by using iPads, all participants demonstrated significant increase in quality of life and decreased loneliness scores. However, results of the self-perceived acceptance and ease of use of the technology were mixed. Results from this pilot study demonstrated that community dwelling older adults who live alone could benefit from using technology for communication to decrease loneliness and increase quality of life. Future study with larger sample size is needed.
GENDERED PATHWAY TO LIFE SATISFACTION VIA HELPING SPOUSES WITH DIGITAL TECHNOLOGY USE
Authors: Park Hayoung , Joo Susanna , Lee Sun Ah
Published: January 2025

Digital capabilities are closely related to the quality of life, and due to rapid digitalization, the exchange of help regarding digital technology use frequently occurs within close relationships in later life. As digital technology penetrates deeply into daily life, exploring the role of exchange of help regarding digital technology use within couple relationships could help specify daily interaction strategies improving the quality of life of individuals. This study explored how the husband and wife’s digital capabilities affect life satisfaction via helping their spouses with digital technology use within dyadic associations. For this, we used the Digital Aging in Dyads (DAID) data collected through an online survey in May 2023, targeting 257 older Korean straight couples aged 45 to 74. According to the modified Actor-Partner Interdependence Mediation Model analysis with bootstrapping, two mediating paths were found to be significant; the higher the digital capabilities of husbands, the more help with digital technology use provided by husbands to wives, which increases the life satisfaction of both husbands and wives. However, for wives, only the direct association between helping their husbands with digital technology use and wives’ life satisfaction was significant. These findings indicate gender asymmetric associations as the husband’s digital capabilities serve as greater power within later-life couple relationships whereas the wife’s digital capabilities nor helping their husbands with digital technology use do not play significant roles. This study is meaningful in presenting a new model for improving life satisfaction in the context of couple relationships in the digital era.
DEVELOPING OF AN SDM NURSING PRACTICE MODEL FOR OLDER PATIENTS WITH DEMENTIA IN ACUTE CARE HOSPITALS
Authors: Saito Taeko , Masaki Harue
Published: January 2025

This study aims to implement a Shared Decision-Making (SDM)nursing practice model for older patients with dementia in acute care hospitals among acute care nurses and evaluate its feasibility. As a preliminary step, a hybrid concept analysis was conducted, and a SDM nursing practice model was developed and refined based on the results of semi-structured interviews with nursing practitioners and researchers. In this study, five acute care nurses were recruited as research participants to confirm the feasibility of this model. Data analysis involved conducting content analysis from verbatim transcripts of individual interviews with the five participants after practice to assess feasibility. Additionally, both before and after the practice, surveys based on SDM-Q9 and Group’s SDM, validated tools for assessing the SDM process, were administered to the five research participant nurses and five health care professionals involved in support (MD, MSW), generating data from the perspectives of users and stakeholders. The results indicated the feasibility of implementing the SDM process within the constraints of the acute care setting. Moreover, the study demonstrated that the SDM nursing practice model effectively adheres to the SDM process during acute phases, thereby clarifying the role of clinical nurses in facilitating the Sharad decision-making for older patients with dementia.
EXPLORING GENDER DISCORDANCE AND RISK OF CAREGIVING NEGLECT IN DEMENTIA CAREGIVING: A DYADIC PERSPECTIVE
Authors: Hancock David , Chang E-Shien , Czaja Sara
Published: January 2025

Neglect in caregiving relationships, defined as unmet Activities of Daily Living (ADL) or Instrumental Activities of Daily Living (IADL) needs, remains a critical impediment undermining the safety of persons living with dementia (PLWD). This study explores the occurrence of neglect in gender-concordant and discordant caregiving dyads, where the caregiver and care recipient are of same or different genders. Data were drawn from 244 dyads of racially/ethnically diverse caregivers (CR) and PLWD. We operationalized neglect as CG’s failure to meet any of the 6 ADL or 8 IADL for PLWD. Chi-squared tests were employed to compare neglect occurrences across three groups: female-male, male- female, and same-gender dyads. Overall, female-male caregiving dyads were most common in our study sample (n=103), followed by same gender dyads (n=102), and male-female dyads (n=39). The chi-square test indicated significant differences in neglect occurrences across the three groups (p<.05). Specifically, male caregivers caring for female care recipients exhibited more instances of one-week prevalence of neglect. ADL/IADL item-level analyses did not reach statistical significance due to small sample sizes; they generally supported the overall pattern. The findings suggest that gender concordance and discordance between CG and PLWD may be an important area for dementia caregiving intervention research. Future studies should focus on vulnerabilities and strengths of male CG caring for female PLWD to better support and mitigate risks of neglect in this population. These results have implications for policy and caregiving research, emphasizing the need to consider gender dynamics in caregiver support and training programs.
HETEROSEXUAL AND SEXUALLY DIVERSE OLDER ADULTS’ LIFETIME EXPERIENCE OF IPV: FINDINGS FROM THE CLSA
Authors: Gutman Gloria , Karbakhsh Mojgan , Stewart Heather
Published: January 2025

This study addresses knowledge gaps concerning prevalence and risk factors for intimate partner violence (IPV) among lesbian, gay and bisexual (LGB) compared to heterosexual Canadians aged 50+. Data derive from the Canadian Longitudinal Study on Aging (CLSA), a national cohort study with follow-up every 3 years for 20 years or until death. Participants who reported having ever been in an intimate partner relationship (n=11,727) who answered ‘yes’ to at least one item on the Composite Abuse Scale (Revised) – Short Form (CASR-SF) which was used to assess the prevalence of lifetime and past-year exposure to IPV and IPV types were included in this analysis. Main explanatory variables are sexual orientation and gender identity. Overall prevalence (exposure to any type) of IPV was 23.1% (16.6% among males; 29.1% among females) (p< 0.001). The lifetime prevalence rate was highest among LB women (35.8%), followed by GB men (29.3%), heterosexual women (29.0%) and heterosexual men (16.2%) (P< 0.001). The most common type of IPV was psychological (18%), with highest prevalence among LB women (27.5%) followed by heterosexual women (23.2%), GB men (20.4%) and heterosexual men (12.8%) (P < 0.001). The pattern of higher rates among sexually diverse woman and men then among their heterosexual age mates was also seen in lifetime experience of physical and sexual IPV. Recognition and prevention of IPV among sexually diverse older adults has been largely overlooked despite the fact that the IPV rates among same sex couples are reported to be similar or higher in comparison to opposite sex couples.
TRACING THE FOOTSTEPS OF THE SCHOLARS FROM DE TORNYAY CENTER FOR HEALTHY AGING AT UNIVERSITY OF WASHINGTON
Authors: Liang Yanjing , Carmiol-Rodriguez Priscilla , McKiddy Sarah , Bartlett Paige , Sanchez Heather Wicklein , Belza Basia
Published: January 2025

The de Tornyay Center for Healthy Aging has been pivotal in advancing research, education, and practice since 1998. The center faculty has mentored over 165 students, connected them to community partners, awarded them over $757,000 in research funding, and supported the dissemination of their work through travel scholarships. This paper presents the evolution of the scholar community by showcasing scholars’ contributions over time. An online survey was distributed to 87 former de Tornyay Center scholars, resulting in 32 responses. Results indicate that after graduating scholars pursued careers in practice (n=21, 65.6%), teaching (n=18, 56.2%), and research (n=13, 40.6%). Contributions include publishing in high-impact journals, securing research funding from institutions like the National Institutes of Health, and pioneering innovative practice models. Scholars demonstrated leadership in the COVID-19 response and made impactful changes in clinical settings. Scholars have engaged in shaping the next generation of nursing professionals through teaching, developing educational models, and contributing to professional service globally. Scholars credited the de Tornyay Center with boosting their research skills (n=24, 75%) and providing crucial career guidance and mentorship (n=24, 75%). Early involvement in scientific research at the center influenced students’ academic paths, fostering a commitment to gerontological nursing. These findings contribute to understanding scholars’ journeys and form a foundation for shaping the center’s strategic plan. The results underscore the center’s role in nurturing scholars who significantly contribute to healthcare, cultivating a talented workforce, and influencing scholars’ career paths. The de Tornyay scholar program is instrumental in fostering professionalism in scholars’ careers.
UNDERSTANDING AND ENDING AGEISM: AN INNOVATIVE COLLEGE COURSE
Authors: Sasser Jennifer
Published: January 2025

Understanding and Ending Ageism is an online community college course developed as part of a grant-funded project that aimed to raise awareness about aging and ageism, as well as to make the case for integrating these dimensions of human experience into college-wide diversity, equity, and inclusion initiatives. Designed and first offered in 2016, the course continues to be offered two terms per year and has been periodically refreshed to incorporate new perspectives and resources (including the Reframing Aging Initiative and updated AGHE Competencies). Course content includes a comprehensive overview of the characteristics, mechanisms and effects of ageism (and how ageism is experienced across the life course and at different ages and stages); examination of how ageism intersects with other “isms” in forming a system of oppression and yet is not often enough considered in discussions about diversity, equity, and inclusion; identification and planning of interventions and projects connected to increasing age-appreciation and challenging ageism; themes of aging-awareness, social justice and intergenerational solidarity; and an emphasis on reflection, critical thinking, and praxis. Unique features of the course include its collaborative learning design and its focus on “practices” that we can engage in at every level at which ageism operates and at which we can intervene: the individual; interpersonal; social/organizational; societal/political; and cultural. In addition to weekly assigned readings and roundtable discussions, students create an Ending Ageism Synthesis & Action Project as their capstone assignment.
COMMUNICATION OF LONG-TERM-CARE PLANS AMONG OLDER ADULTS
Authors: Olvera Charlie , Miller-Winder Amber , Murawski Alaine , Ramirez-Zohfeld Vanessa , Lindquist Lee
Published: January 2025

Older Adults (OAs) making long-term care (LTC) plans for post-hospitalization or Alzheimer’s Disease (AD) care must communicate their plans to ensure their wishes are honored. What factors increase the likelihood of this communication? The PlanYourLifespan (PYL) study examines OA LTC decision-making, employing a tool proven effective in helping OAs make LTC decisions. Subjects were administered PYL after baseline assessment, with follow-up assessments every 6 months thereafter. Subjects indicating they made LTC plans were asked if they communicated these plans. We employed GLMM to identify significant (p< 0.05) factors increasing the likelihood of plan communication. 293 subjects enrolled, mean age 73.5, 72.7% female, 40.4% URM. Subjects were more likely to communicate AD LTC plans if they were married (OR2.131), had advanced directives (OR2.004) or living wills (OR1.562), or had higher health literacy (OR2.174). Subjects were more likely to communicate AD in-home care plans if they were married (OR1.871), displayed higher health activation (OR2.425) or health literacy (OR1.883), had advanced directives (OR1.651) or living wills (OR1.596). Subjects who perceived adequate social support (OR2.163), or had advanced directives (OR1.828), living wills (OR1.565), or power of attorney (OR1.529) were more likely to communicate post-hospitalization LTC plans. Married subjects (OR2.034) and those with high health activation (OR1.96) or health literacy (OR1.929) were more likely to communicate post-hospitalization in-home care plans. OAs with higher health literacy and activation, stronger social support, and pre-existing legal directives in place are more likely to communicate LTC plans. These results can help future interventions optimize communication of LTC plans among OAs.
HOME AND COMMUNITY-BASED SERVICE USE AMONG VETERANS WITH DEMENTIA VARIES BY COMORBIDITY LEVEL AND HEALTH CARE TEAM
Authors: Quach Emma , Moo Lauren , Franzosa Emily , Ni Pengsheng , Zhao Shibei , Hartmann Christine
Published: January 2025

Home and community-based services (HCBS) such as home care and adult day centers (adult day) are vital to supporting adults with dementia in community settings. Using 2019 data of 143,281 patients with dementia from the Veterans Health Administration, we investigated HCBS use (use of both home care and adult day, use of only one service, and use of neither service) in older adults with dementia. These adults may receive care from one of three types of case-managed health care teams (Home Based Primary Care, geriatrics-based outpatient primary care, and dementia-focused outpatient specialty care). They had various comorbidity levels, measured as the number of (adapted) Elixhauser comorbidities index and dichotomized as < 4 or ≥ 4 comorbidities. We compared HCBS use (use of neither service as referent) by patients’ type of case-managed team (patients in no team as referent), stratified by patients’ non-dementia comorbidity levels (< 4 or ≥ 4). Use of both home care and adult day was associated with each type of health care team at each comorbidity level. Home Based Primary Care and dementia-focused specialty care were more consistently associated with HCBS use--only adult day and of only home care--than geriatrics-based primary care for patients with ≥ 4 non-dementia comorbidities. Our findings suggest that, in patients who have both dementia and other comorbidities, case-managed health care teams in primary and specialty care settings contribute to use of critical community supports. Among these, implementation of case management faced more challenges within outpatient primary care teams.
MODERATING ROLE OF NEIGHBORHOOD ENVIRONMENT IN ASSOCIATIONS BETWEEN HEARING LOSS AND COGNITION AMONG OLDER ADULTS
Authors: Cheung Ethan Siu Leung , Zhang Zhe
Published: January 2025

The relationships between hearing loss and late-life cognitive challenges have been documented. However, little is known about how the relationships may be moderated by the built and social neighborhood environments. This study examined the associations between hearing loss and cognitive challenges among community-dwelling older adults and whether neighborhood characteristics (physical disorder and low social cohesion) moderated the associations. Cross-sectional national data from Round 11 of the National Health and Aging Trends Study were adopted (N = 2,515). Multinomial logistic regressions were used to examine associations among variables and interactive analyses were conducted to examine moderating effects. Results indicated significant relationships between the experience of hearing loss and possible dementia and between severe or profound hearing loss and probable dementia. Interactive models suggested that residing in neighborhoods with physical disorder and low social cohesion were negatively associated with possible dementia among older adults with moderate and severe or profound hearing loss, respectively, compared to those without hearing loss. Findings underscore the necessity of environmental and social interventions to enhance cognitive health among older adults with varying degrees of hearing challenges.
PROBLEMS AND ISSUES FOR HOSTS OF SOCIAL PARTICIPATION ACTIVITIES: A CASE STUDY FROM JAPAN
Authors: Takase Mai , Goto Jun
Published: January 2025

Social participation is important for maintaining the health of older adults. In Japan, many recreational activities and hobbies are available for community-dwelling older adults for social participation. Meanwhile, little is known about the problems and issues that hosts face when conducting these activities. In this study, we aimed to clarify the problems related to hosting activities and possible measures that could be taken to alleviate these problems. Activity hosts providing activities for older adults in a community space in Chiba Prefecture (Japan) were approached. The activity content included musical events, movie, crafts, exercise, and cafés. This community space is operated by city’s Social Welfare Council and all of the activities are hosted voluntarily by citizens. Semi-structured interviews were conducted with ten hosts. All hosts were ≥ 65 years old and the average years of operation was 9 ± 2.7 (mean ± SD) years. As a result, nine out of ten hosts reported that the decline of members who supported the activity owing to aging and death was the major problem. Directly asking friends for help in the operation, receiving help from attendees, and decreasing the frequency of activities were measures that was taken to continue with the activities. The hosts also found it difficult to recruit younger generations who could become the next leaders of the activity group because of their lack of personal connections with the younger generation. Social Welfare Council mediating the connection between activity hosts and the younger generation who are interested in voluntary activities were anticipated.
PROSPECTIVE ASSOCIATIONS BETWEEN MULTIDIMENSIONAL NEIGHBORHOOD CONTEXTS AND PSYCHOSOCIAL OUTCOMES IN LATER LIFE
Authors: Cheung Ethan Siu Leung , Wen Ming , Curtis David , Grineski Sara , Wei Yehua Dennis
Published: January 2025

Despite extensive literature having reported on contextual place effects on older adults’ individual health and well-being outcomes, the longitudinal relationships between multidimensional neighborhood environments and diverse psychosocial outcomes remain less known. This study addresses two questions: 1) What are the prospective associations between multidimensional neighborhood environments and psychosocial outcomes (i.e., purpose in life, depression, generalized anxiety disorder, life satisfaction) among older adults? 2) Do these relationships differ based on age groups (Youngest-old 65-74, Middle-old 75-84, Oldest-old 85 or over) and biological sex? This investigation adopts individual data from waves 2 (2004-2006) and 3 (2013-2014) of the core sample in Midlife Development in the United States, supplemented with an oversample of African Americans in Milwaukee. Tract-level neighborhood data come from multiple public sources and are measured in 2010. The analytic sample includes 1,249 individuals aged 65 and above at wave 3. Time-random-effect linear and logistic regressions are used to examine the main place effects, and interaction analyses by age and sex are conducted for each psychosocial outcome. Results suggested that area-level economic disadvantage is associated with a lower level of purpose in life. Social disorganization is a significant risk factor for generalized anxiety disorder. Some of these effects significantly vary by female. The findings highlight the importance of neighborhood social, built, and natural environments for various psychosocial outcomes and underscore the need for age-sensitive environmental interventions and programs to enhance psychosocial well-being in later life.
SUPPORTING AGING IN PLACE THROUGH IWISH: LESSONS FROM THE SUPPORTIVE SERVICES DEMONSTRATION
Authors: Vandawalker Melissa , Giardino Elizabeth , Hendricksen Meghan , Breunig Ian
Published: January 2025

Most Americans prefer to live independently in their homes as long as possible. The U.S. Congress sponsored the Supportive Services Demonstration to learn whether the Integrated Wellness in Supportive Housing (IWISH) model can help adults aged 62 and older remain in HUD-assisted housing developments longer and delay transitions to long-term care. After three years of the demonstration, we found little evidence that IWISH affected residents’ tenure or healthcare utilization as intended, but there are reasons for optimism about IWISH’s long-term impact and lessons learned from 40 properties that implemented IWISH between 2017–2020. Based on enrollment and services data for 2,927 IWISH participants, 21 focus groups with 180 residents, and interviews with property management and onsite wellness staff, we conducted an implementation analysis of IWISH properties’ fidelity to the model and identified IWISH’s strengths and weaknesses. We observed substantial variation in resident participation and how properties implemented the model. We identified challenges with hiring and retaining onsite wellness staff for a diverse multilingual resident population, developing partnerships with local healthcare organizations, and addressing residents’ privacy concerns over their health information. Residents and staff reported numerous benefits from IWISH suggesting a promising strategy for helping residents age in place, including examples of preventative actions by IWISH staff that helped residents avoid unnecessary emergency care, transitional care after returning from the hospital, and feeling safe and secure with a dedicated, onsite medical professional.
A COMPREHENSIVE DIGITAL SELF-CARE SUPPORT SYSTEM FOR CAREGIVERS AND PERSONS WITH DEMENTIA/MCI AND MCC
Authors: Nambisan Priya , Lee Yura , Ellis Julie , Taani Murad
Published: January 2025

Research indicates that 95% of people with Alzheimer’s and other dementias also suffer from one or more other chronic conditions, increasing the risk of hospitalizations and complications such as contraindicated health care and drug interactions. Effective self-management practices are vital for maintaining cognitive function and preventing the onset of new chronic conditions among those with Multiple Chronic Conditions (MCC). However, managing MCC alongside cognitive impairment (CI) can make it very challenging for both patients and caregivers. Studies suggest that computer usage can enhance cognitive functioning and potentially delay further deterioration and digital apps are beneficial for self-care support. Despite this, there is a severe lack of technological applications that support those with CI and MCC and are often digitally excluded due to lack of understanding of their needs. We present the findings of a pilot test of a Comprehensive Digital Self-care Support System (CDSSS) known as myHESTIA. This system offers caregivers and persons with Alzheimer’s/Dementia a range of personalized tools including: 1) Health management tools: daily trackers for monitoring health conditions, reminders, to- do lists and educational resources; 2) Healing technologies: e.g. breathing exercises for relaxation, music therapy, learning activities like dancing or Yoga, and memory games and 3) Online social support forum: for connecting with others. This qualitative study aims to shed light on the perceived benefits of the system for both caregivers and persons with dementia/MCI, its utility in addressing unmet needs among those with CI, and its potential to improve the quality of life of caregivers.
ADVANCING CULTURALLY INCLUSIVE RESEARCH AND TOOLS IN ALZHEIMER’S DISEASE AND RELATED DEMENTIAS (ADRD)
Authors: Magid Maryam Abdel , Taylor Jean , Turner Anne
Published: January 2025

Background and Significance

Existing research underscores cultural norms’ influence on healthcare decisions but lacks depth in exploring their impact on dementia care transitions, critical for improving ADRD care outcomes. Research Aims include (1) Analyze interviews with dementia care providers and staff to better understand how cultural norms influence the decision-making processes for care transitions. (2) Explore methods used to facilitate inclusive and engaging discussions regarding care transitions.

Methods

Nested in the NIA-funded Decision Making in Alzheimer’s Research (DMAR) study, we examined interviews with 18 providers and staff on dementia care transitions. Prioritizing inclusivity, we leveraged the Alzheimer’s Disease Research Center (ADRC) registry and community partnerships coupled with tailored methods including diversifying the team and targeted outreach efforts. We’re employing a novel framework to analyze dementia care transitions, integrating societal and cultural aspects for nuanced understanding. This approach accounts for intergenerational culture, cognition perception, and care expectations, evolving to capture cultural nuances. Qualitative findings will be enriched with quantitative sentiment analysis, validated manually for accuracy.

Key findings

Novel framework will allow us to identify and analyze cultural norms affecting care transitions, as perceived by ADRD providers. Implications: The study’s findings advocate for inclusive decision-making tools in ADRD care to accommodate diverse patient preferences. Future steps involve applying this framework to patients and caregivers and integrating findings into diverse settings involved in care decision-making. Funding statement: Funded in part by NIA grant #R01 AG066957 and the NLM T15 training grant #5T155LM007442-22. Content responsibility lies with authors, not representing NIH views.
ASSOCIATION BETWEEN GUT MICROBIOTA, DIET, AND COGNITION IN ELDERLY PATIENTS WITH MILD COGNITIVE IMPAIRMENT
Authors: Chen Lili , Hou Zhaoyi , Liu Jinxiu , Li Xiuli , Zhang Yuping , Yang Shuhui , Zhang Peiling
Published: January 2025

Objectives

To compare the gut microbiota in individuals with mild cognitive impairment (MCI) and normal controls (NCs) and explore the association between dietary intake and various cognitive domains across identified enterotypes, providing a basis for dietary interventions based on the Microbiota-Gut-Brain Axis.

Methods

We analyzed fecal samples and 16S ribosomal RNA sequences for microbiota among 100 participants (NCs: 50, MCI: 50). Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), and Auditory Verbal Learning Test (AVLT). A semi-quantitative food frequency questionnaire was used to assess participants’ dietary intake, and differences in dietary habits and cognitive function among distinct enterotypes were analyzed.

Results

Participants with MCI exhibited lower bacterial richness. Linear Discriminant Analysis of Effect Sizes (LEfSe-LDA) revealed different major microbial genera between the groups, and a random forest model based on dominant bacterial genera could distinguish between MCI and NCs (AUC=0.743, 95%CI:0.646-0.840). Cluster analysis identified two enterotypes: Escherichia-Shigella (enterotype E) and Bacteroides (enterotype B). When grouped by enterotypes, similar dietary intake was associated with different cognitive domains: notably, egg intake positively correlated with MOCA and AVLT scores for enterotype E, but not for enterotype B. Conclusions: Significant differences exist in the gut microbiota of individuals with MCI compared to those with normal cognition, with dominant genera showing good predictive performance. The impact of different enterotypes on the relationship between dietary intake and cognitive function should be considered when making dietary recommendations in clinical practice.
DIFFERENCES OF RANKINGS IN DEATH CERTIFICATES AMONG PERSONS WITH ALZHEIMER’S DISEASE
Authors: Brown Candace , Pan Yinghao , Miller Maggi , Lohman Matthew
Published: January 2025

A 2021 report indicates that 19.1% of people ages 76-84 and 34.6% of people aged 85 and older have Alzheimer’s disease (AD). Data provided on death certificates using the International Statistical Classification of Diseases is guided by the WHO for coding cause and contributing comorbidities of death. Death rankings assist in monitoring which diseases need attention for better informed decision making in healthcare. However, classifying immediate cause of death presents challenges when the likelihood of polymorbidity occurs with advancing age in patients with presenting AD but inconclusive diagnoses of the disease. We used the Alzheimer’s Disease and Related Dementia South Carolina (SCADR) registry and linked it with state death certificates to examine sociodemographic variables and survival probabilities of decedents between the years 2014-2019. Cox proportional hazards models were fitted and hazard ratios (HRs) computed, adjusting age at diagnosis and race. Turnbull’s method estimated the survival probabilities or curves for subgroups as the time from AD diagnosis to death. Of the 78,534 patients in the study 94% were diagnosed with AD at age 61 or older. AD was listed as the immediate cause of death among all racial groups, except for Native American/American Indian, contrasting from previous research of underreporting of the disease by factor of 2.7 with underestimations more likely for people identifying as Black and Latino. However, only 1.4% had a conclusive diagnosis of the disease by autopsy. Survival probabilities drop precipitously in the first few years after diagnosis with only 25% of the cohort surviving beyond 5 years.
ENABLING PRIORITIZATION FOR AMYLOID POSITIVITY TESTING WITH DIGITAL COGNITIVE ASSESSMENT
Authors: Jannati Ali , Thompson Karl , Toro-Serey Claudio , Banks Russell , Showalter John , Bates David , Tobyne Sean , Pascual-Leone Alvaro
Published: January 2025

Primary care providers currently wait for a complaint to initiate a ‘for-cause’ cognitive evaluation and often refer the patient to a specialist. Specialist evaluation then leads to the diagnosis, but treatment occurs late and is unlikely to meaningfully prevent or reduce disability. We hypothesized a brief digital cognitive assessment (DCA), the Digital Clock and Recall (DCR), could concurrently identify CI and predict PET Aβ status, thereby providing an efficient means for timely identification and prioritization of patients for disease-modifying treatments. 930 participants (age 72.0±6.7; 56.8% female; 23% minorities) were classified as cognitively unimpaired, mild cognitive impairment, or probable Alzheimer’s dementia, and 35.1% were Aβ+ on 18F-florbetapir PET scan. DCR-based models were compared with blood-based biomarkers (BBMs) Aβ42/40, pTau-181, and pTau-217, which poorly classified CI (AUCs=0.63, 0.66, 0.72) but accurately classified Aβ status (AUCs=0.81, 0.78, 0.89). DCR accurately classified CI and predicted Aβ status (AUCs=0.85, 0.83). Moreover, combining the DCR with Aβ42/40, pTau-181, and pTau-217 improved their Aβ-status prediction performance to AUCs of 0.882, 0.835, and 0.905, respectively. DCR was superior to BBMs in detecting cognitive impairment and boosted their Aβ-PET prediction ability to levels comparable to CSF biomarkers. We propose a workflow in which implementation of DCAs such as the DCR facilitates early identification of individuals with MCI or early dementia likely due to AD, thanks to the concurrent classification of CI and accurate prediction of Aβ PET status.
EXAMINING KNOWLEDGE ABOUT FIVE ALZHEIMER’S DISEASE–RELATED SERVICE AREAS AND ITS CORRELATES IN KOREAN AMERICANS
Authors: Hong Michin , Lee Sang
Published: January 2025

This study examined knowledge about Alzheimer’s disease (AD) related services and its predictors among Korean Americans (KAs). A total of 268 KAs in the Greater Washington metropolitan area participated and completed a cross-sectional survey. Knowledge about AD related services was assessed by asking how well they knew about each of the following areas: Diagnostic services, Alzheimer’s specialists, community-based services, home-based services, and institutional care, with four categories of responses from don’t know at all to know well. Multiple regression analyses were conducted for each service area with predictors including education, English proficiency, exposure to AD, sources and frequency of health-related information, and AD knowledge about treatment and management. KAs were more knowledgeable about community- and home-based services and institutional care than diagnostic services and Alzheimer’s specialist. All regression models except for diagnostic services were significant: Having more exposure to AD is related to being more knowledgeable in Alzheimer’s specialist, community- and home-based services, and institutional care; having more sources and frequency of health information is related to being more knowledgeable about Alzheimer’s specialist; and being more knowledgeable about AD management and treatment is related to having more knowledge about community- and home-based services, respectively. Our findings revealed specific areas of services more and less known to KAs, which needs to be addressed in educational outreach. Multivariate analyses identified variations in the predictors of different service areas while confirming the robust role of exposure to AD across the service areas, suggesting ways to increase knowledge about certain types of AD services.