bluuebunny/crossref_metadata_2025 huggingface dataset:
SOCIAL SUPPORT NETWORKS AND LONELINESS: DIFFERENCES ACROSS RACIAL/ETHNIC GROUPS
Authors: Burack Orah , Mak Wingyun
Published: January 2025

Higher levels of social support (SS) has been associated with a number of positive health and well-being outcomes including lower levels of loneliness. Additionally, SS networks have been found to vary across race/ethnicity. Researchers have therefore begun to examine how specific aspects of SS differentially impact outcomes among racial/ethnic groups. In this study we examined whether visits with different types of SS providers (children, siblings, friends), impact loneliness differentially across race/ethnicity. Data were drawn from the AARP Loneliness and Social Connections Survey with a national sample of community dwelling adults age 45+ years (M=61.84, SD=10.12; N=4040). Participants self-identified as White non-Hispanic (N=3149), Black non-Hispanic (N=420), or Hispanic (N=472). A series of hierarchical linear regressions (one for each racial/ethnic group) examined the relationship between loneliness and frequency of in-person visits from: children, siblings, or friends, after controlling for age, gender, marital status, and perceived health. While older, married, healthier adults reported less loneliness across all groups, differences were found by SS provider type. Less loneliness was significantly related to more visits from: siblings (β=.05, p<.001) and friends (β=.11, p<.001) for Whites (ΔR2=.03, p<.001); friends (β=.09, p=.008) for Hispanics (ΔR2=.02., p=.01); while for Black subjects there were similar size trends for children (β=.08, p=.08), siblings (β=.07, p=.03., p=.001), and friends (β=.07, p=.09). These results highlight that SS providers are not interchangeable, with differing impacts on loneliness across ethnicity/race. Implications and reasons for these findings will be discussed.
STATE-LEVEL OPPORTUNITIES TO ADDRESS BEHAVIORAL HEALTH NEEDS OF OLDER ADULTS: A NEW CENTER OF EXCELLENCE FOR OREGON
Authors: Dawson Walter , Stodola Allyson , Cellarius Karen , Himes Dani , Smith Lindsey , Brandis Leah , Dhar Nirmala , Carder Paula
Published: January 2025

Serious mental illness and substance use disorders among older adults frequently intersect with neurocognitive changes and complex physical health issues. At the same time, access to behavioral health services is often poor for many older adults. Multiple underserved populations such as older adults from communities of color and individuals living in rural/remote communities experience substantial barriers to access and use of behavioral health services. There is a need for enhanced program and policy actions to ensure access to behavioral health for these populations of older adults. This session describes the state of behavioral health and aging services for older adults in Oregon and efforts to address local and statewide needs. This includes the impetus for establishing the Oregon Center of Excellence for Behavioral Health and Aging (OCEBHA), the goals of OCEBHA, and the long-term vision of the Center to address behavioral health disparities.
THAT’S ANTHROPOLOGY: CONFRONTING AGEISM AND STUDENT DISCOMFORT IN SERVICE LEARNING
Authors: Cho S M , Williams Cara , Freidus Andrea , Shenk Dena
Published: January 2025

Undergraduate anthropology majors participated in a 15-hour, semester-long service-learning project at an adult day and health care center during Spring 2024. While a research-based model of intergenerational service-learning has been incorporated in the undergraduate gerontology program curriculum at UNC Charlotte for 25 years, this was the first time anthropology undergraduates engaged in intergenerational research as part of their senior seminar. With no prior coursework in gerontology, and limited intergenerational experiences, anthropology senior seminar students began the semester with uncertainty and ageist biases. The founding director of the gerontology program, a professor emerita of anthropology, guided students’ practical development by providing lectures, leading exercises, and facilitating discussions throughout the semester. During the course, the students learned about and confronted complex presentations of ageism. Their time at the day center involved socializing with participants, assisting staff, creating and tending a therapeutic garden, working with participants to create memory boxes, and building rapport. These steps were essential for building a reciprocal, collaborative intergenerational research relationship that integrates anthropological pedagogy. We suggest their initial resistance to this work is the result of age segregation and internalized sociocultural narratives of ageism, as well as misguided expectations of the frustrating, messy, challenging reality of undertaking anthropological research using participant observation. Consistent narrative themes of unprecedented gratitude, personal growth, and learning about ageism emerged from student field notes, class discussions, and written reflections. This program evaluation presents novel insights for future integration of intergenerational programming and gerontological knowledge into anthropological pedagogy.
THE ASSOCIATION BETWEEN DIGITAL TECHNOLOGY ACTIVITIES AND COGNITIVE DOMAINS OF COMMUNITY DWELLING OLDER ADULTS
Authors: Hsu Erh-Chi , Jutkowitz Eric , Thomas Kali
Published: January 2025

While prior research has established a relationship between digital technology use and improved cognitive function among older adults, the impacts of different technology activities on specific cognitive domains remain underexplored. This study examines associations between various technology activities and cognitive trajectories in community-dwelling older adults without dementia. We utilized repeated cross-sectional data from 5,596 participants in the National Health and Aging Trends Study (2015-2022). Technology activities included online shopping, banking, medication refills, social network site visits, and checking health conditions online. Cognitive domains assessed were episodic memory, executive function, and orientation. Covariates included sex, age, race, education, living arrangement, income, daily and instrumental activity difficulties, self-rated health, rurality, and device ownership. Survey-weighted mixed-effect models with random intercepts evaluated the associations between technology activities and cognitive trajectories, with descriptive stratification by sex. In 2015, online banking (28%) and visiting social network sites (25%) were the most popular activities, with females generally showing lower usage except for social network visits (F: 27%; M: 23%). Social engagement online had the strongest positive association with episodic memory (β=0.50, 95% CI: 0.33-0.67, p< 0.001) and orientation (β=0.15, 95% CI: 0.10-0.21, p< 0.001) independent of time. Online banking showed the strongest positive association with executive function (β=0.12, 95% CI: 0.06-0.18, p< 0.001) independent of time. Notably, all five activities were more beneficial for females regarding episodic memory (p< 0.001). These findings suggest that interventions promoting online instrumental activities (shopping, banking, medication refills) and social engagement online could enhance cognitive function in older adults, particularly females.
THE FORTITUDE FACTOR FOR CAREGIVERS: UNDERSTANDING THE EFFECT OF EMPLOYMENT AND CAREGIVING ON CAREGIVER WELLBEING
Authors: Clem Sarah , Davitt Joan , McCorvey Stephanie , Becker Todd , Eastman Jennifer , Sesek Greg
Published: January 2025

Shifting support services from community-based facilities to home-based settings has highlighted the dual roles of family/friend caregivers. This study investigated challenges experienced by caregivers of vulnerable adults in one east coast state. A convenience sample (N= 2,129) of caregivers, recruited through state and local agencies, completed an anonymous online survey to enhance understanding of caregiving experiences, challenges, and service utilization patterns. This paper focused on employed caregivers who reported greater service utilization than caregivers who were not employed. Within employed caregivers, we found they made workplace compromises to balance caregiving responsibilities including: going in late, taking a less demanding job, taking a leave of absence, and going from full to part-time work. There were positive associations between the number of compromises made in the workplace with caregiver-reported stress levels, financial strain, and service utilization. To address these challenges, employed caregivers reported using various coping strategies including exercise, mental health support, spiritual practice, hobbies, and support groups. Employer support to caregivers included: flexible hours, remote work options, paid sick days, paid family leave, referral/counseling supports, and unpaid family leave. Mixed results were found for relationships between employer supports and caregiver compromises, stress levels and financial strain. Research shows that multiple demands on employees can reduce worker productivity and efficiency. Responding to trends indicating an increase of informal caregivers in the workforce, this study highlights the needed support to promote caregiver resilience and their ability to remain employed. Implications for employers, community agencies, and government systems will be discussed.
THE ROLE OF HEALTH IN RETIREMENT PLANNING TOWARDS EXTENDED WORKING LIVES
Authors: Crossdale Rachel , Penning Nehle
Published: January 2025

Decades of research have shown that health is a key determinant of labour force participation in later life. As the ageing global population necessitates extended working lives (EWLs) for broader economic sustainability, the importance of the older population for the labour market is emphasised. Understanding the role of health and health inequality across the life course is crucial for impactful policy development to protect the health of the older workforce and encourage participation in EWLs. Using 100 interviews on risks and turning points in working life with older workers in Germany, Poland, Sweden, and the UK, this research explores the role of health as a barrier and facilitator of EWLs across the working life course. Drawing on policy and literature to contextualise our findings, this research reveals the role of health in retirement planning, including assumptions about health decline, impact on work, and the importance of partner’s health. Health as a ‘push and pull’ factor is also explored, with good health both fostering labour market engagement and encouraging early retirement, while physical and mental health can be both positively and negatively impacted by work. Inequalities by sector of employment, gender, and education level are also explored, with all four countries facing a ‘double bind’ whereby the most vulnerable must work longer for financial security but are limited by poor health. For future older populations to be healthier and more productive the current treatment-based model of health care needs to be challenged with preventative policy interventions throughout the life course.
TRAJECTORIES OF CHRONIC PAIN AMONG OLDER VETERANS: IDENTIFYING PAIN-WORSENING PREDICTORS VIA MACHINE LEARNING
Authors: Lee Chiyoung , Kim Yeri , Kim Seoyoung , Cohen Beth , Kwoh kent , Ahn Hyochol , Park Juyoung , Kim Heewon
Published: January 2025

Chronic pain is a major public health problem affecting approximately 100 million Americans and United States military Veterans, who constitute a particularly vulnerable group. While pain research in Veterans is actively underway, information on the longitudinal course of pain in this population is limited. This study aimed to 1) identify the various longitudinal pain status trajectories among older Veterans over a 10-year period and 2) detect factors predicting membership in the worsening trajectory of chronic pain. We analyzed data from 619 Veterans (mean age: 58.5 years) participating in the Mind Your Heart Study, an ongoing prospective cohort study examining diverse health outcomes among Veterans. Initially, we employed a generalized mixture model to identify pain trajectory classes using Brief Pain Inventory (BPI) pain intensity subscale score collected at 2-, 5-, and 10-year intervals. Two distinct trajectories were identified—low and high—both of which remained relatively stable. Subsequently, several feature selection methods extracted the predominant features from participants’ baseline characteristics that predicted membership in the high vs. low pain trajectory. These included: prior arthritis diagnosis; prior post-traumatic stress disorder (PTSD) diagnosis; depression symptoms; PTSD symptoms of avoidance, hyperarousal, and negative mood alterations; physical functioning; sleep quality; and overall health. The scikit-learn RandomForestClassifier, utilizing the refined feature set, achieved a classification accuracy of 0.79, yielding results nearly identical to those obtained using all 261 features. These findings are clinically informative and pertinent, highlighting potential intervention targets warranting intensive pain care plans based on probable long-term prognosis and discussing early treatment strategies among older Veterans.
TREATMENT BURDEN AMONG DIVERSE MIDDLE-AGED AND OLDER ADULTS WITH MULTIMORBIDITY
Authors: Quiñones Ana , Markwardt Sheila , Botoseneanu Anda , Tran Viet-Thi , Montori Victor
Published: January 2025

The demands associated with ongoing disease management may overwhelm middle aged and older adults living with two or more chronic conditions. Treatment burden refers to both (a) the numerous demands—such as the time and costs of travel to clinical appointment, administrative burden, and coordinating fragmented care—healthcare makes on patients and (b) the negative impact on the patient’s wellbeing. We evaluated data from respondents of the treatment burden experimental module included in the 2022 Health and Retirement Study data collection wave (N=1,888). We analyzed responses to the 15-item Treatment Burden Questionnaire (TBQ; 15 questions scored 0-10; total sum 0-150; >59 considered unsustainable burden). We compared mean total TBQ score by sociodemographic and multimorbidity combination groups using either a t-test (among 2 groups) or ANOVA (among >2 groups). We compared sustainability across groups using a chi-square test. Respondents (mean 69 years; 62% female, 71% living with 2+ chronic conditions) had a mean TBQ score of 20.3/150 (SD 22.7) with 125 (6.6%) reporting unsustainable burden. Administrative and financial tasks and lifestyle changes were the most burdensome activities. Unsustainable burden was significantly more likely among younger (51-64 vs. older), lower educated (< high school vs. ≥high school), and Black and Latino (vs. non-Latino White) respondents, and in those living with 2+ chronic conditions. In this nationally-representative sample of US adults, participants reported less treatment burden than previously reported in international studies. Certain sociodemographic groups reported high and unsustainable burden of treatment, informing future interventions to reduce treatment burden in mid and late life.
TRENDS AND CHARACTERISTICS OF WORKING CAREGIVERS USING PAID FAMILY LEAVE PROGRAMS IN RHODE ISLAND AND WASHINGTON
Authors: Im Jennifer , Wong Edwin , Fishman Paul , Hill Heather , Weiner Bryan
Published: January 2025

Many family caregivers are part of the workforce and integral to older adults’ care. State Paid Family Leave (PFL) programs offer partial wage replacement to working caregivers. However, data on caregiving leave use is limited. This study examines trends and characteristics of workers who sought caregiving leave in Rhode Island (RI) and Washington (WA) using PFL program administrative data. Outcomes were application and approval for caregiving leave. Covariates included age, sex, ethnicity (WA only), income, primary language, and industry. Logit models with average marginal effects were used. In RI, 14,323 claims were recorded between 2015-22; 82.3% were approved. In WA, 75,739 claims were recorded between 2020-23; 76.7% were approved. Overall, caregiving applications increased annually. Applicants’ mean ages were mid-to-late 40s (RI=48.3; WA=46.9). Most applicants were female (RI=68.3%; WA=61.5%) and English-speaking (RI=95.1%; WA=89.2%). WA applicants were predominantly White (57.5%), Hispanic (13.8%), and mixed race (8.3%). Applications for spousal caregiving was most common in RI (36.3%); caregiving for children was most common in WA (39.1%). The lowest-earning workers had the highest percentage of denied claims (RI=35.5%; WA=29.8%). In both states, older age and higher income were significantly associated with claim approval. In RI, worker caring for spouse, parent, or grandparent had significantly lower probabilities of claim approval, compared to children; In WA, the opposite was observed. The results suggest caregiving PFL is rising among workers, with claim approval more likely for older workers. Higher income was associated with claim approval suggesting programs may not benefit workers that need it the most.
UNDERSTANDING COMMUNITY RESOURCES FOR OLDER ADULTS WITH DISABILITIES
Authors: Han Sunghei , Park Sojung , Park Soobin , Shin Esther , Kang Sarah , Kwon Eunsun , Ahn Seoyeon , Kim BoRin
Published: January 2025

For older adults with various disabilities—physical, mental, cognitive, and others—diverse community resources are essential for daily functioning and their Aging in Place (AIP). This scoping review analyzed 21 peer-reviewed studies from databases like PsycINFO, CINAHL, MEDLINE, Scopus, and PubMed to identify gaps in research on community resources for this population. Thematic analysis revealed four main themes: 1) the development of partnerships among local governments, service providers, and stakeholders to coordinate resources; 2) evaluation of community-level interventions such as telerehabilitation and mental health programs; 3) factors affecting access to and use of community resources; and 4) the impact of these resources on health and well-being. The studies primarily focused on home and community-based services (HCBS), but while some addressed specific care aspects like fall prevention and dementia care, broader research often overlooked the comprehensive needs of older adults with disabilities. Only two studies focused on resources for mental health and substance use disorders, highlighting significant gaps, particularly in primary care. Additionally, many studies lacked clear definitions of disabilities, leading to a fragmented understanding of community resources. This lack of clarity hinders efforts to address the unmet needs of older adults with disabilities, including diverse subgroups like LGBTQ individuals and ethnic minorities. The study highlights the need for more systematic research into the availability and accessibility of community resources to support older adults with varying disabilities better, ensuring no critical needs are left unmet in this vulnerable population.
USE OF REHABILITATION SERVICES AMONG OLDER CANCER SURVIVORS IN THE NATIONAL HEALTH AND AGING TRENDS STUDY
Authors: Huang Min-Hui , Chung Thomas
Published: January 2025

Older cancer survivors (OC) have higher risks of physical impairments than non-cancer older adults (NC). Cancer rehabilitation utilization remains a challenge. This study examined rehabilitation usage in OC using the National Health and Aging Trends Study (NHATS) round 12 (2022) dataset. Objectives were: 1) estimate rehabilitation prevalence in OC and NC; 2) identify factors associated with rehabilitation in each group; 3) compare rehabilitation duration, areas, and outcome between OC and NC. Community-dwelling adults ≥65 years with rehabilitation and cancer diagnosis responses were included (OC: N=653, age=78.7±7.33 years; NC: N=5168, age=79.9±7.63 years). General linear models (Objectives 1 and 2), Chi-square tests and t-tests (Objective 3) were conducted in IBM-SPSS version 28. Rehabilitation prevalence in the past year was similar between groups (OC: 26%; NC: 23%). Pain (OC: p=0.037; NC: p=0.004), higher education (OC: p< 0.001; NC: p< 0.001), and lower physical function (OC: p< 0.001; NC: p< 0.01) were linked to rehabilitation use in both groups. Unique factors linked to rehabilitation included low energy (p=0.030) for OC, and impaired lower-body strength (p=0.037) and balance (p=0.050) for NC. OC had longer rehabilitation durations (2.2±0.94 vs. 2.1±0.80 months, p< 0.001) and were more likely to rehabilitate for low energy (p=0.004), falls (p=0.040), walking inside (p=0.035) and outside the home (p=0.027). More OC (81.1%) reported meeting rehabilitation goals than NC (70.1%)(p=0.010). Despite similar rehabilitation prevalence between groups, distinct factors linked to rehabilitation usage in OC highlight the need for tailored programs. Positive rehabilitation outcomes in OC support more rehabilitation referrals to improve physical function.
USING AN OLDER ADULT MENTORING PROGRAM TO INCREASE INTEREST IN GERIATRICS AMONG MEDICAL STUDENTS
Authors: Arnette Shannon , McIntyre Madeline
Published: January 2025

Older adults are the largest consumers of healthcare, yet there is a projected shortage of geriatricians in the future. The Older Adult Mentoring Program at a large, urban-serving, mid-Atlantic university aims to educate first-year medical students by increasing their awareness of internal and external ageism within healthcare through three semi-structured interviews conducted by the students with their mentors over two semesters, allowing them to interact with community-dwelling older adults and gain a person-centered perspective of aging. We conducted a quantitative study to determine the program’s impact on the students’ openness to working in geriatrics as a specialty. In April 2024, at the end of the program, we asked the students several questions, such as how they think about their healthcare goals as they age, their comfort level working with older adults, and their openness to pursuing geriatrics. Our findings suggest that the program positively impacted students’ attitudes to working with older adults. Over 75% of students agreed that the program changed how they think about their healthcare needs and/or goals as they age. Approximately 77% of students agreed that they feel more confident working with older adults. Over 60% of students either somewhat agreed or agreed that they are more open to pursuing geriatrics as a specialty, and over 90% were more open to working with older adults regardless of their future specialty. This shows how meaningful a program like this can be in changing students’ attitudes towards older adults and geriatrics.
USING GEOGRAPHIC INFORMATION SYSTEMS ANALYSIS TO UNDERSTAND THE BURDEN OF PROVIDING RIDES FOR OLDER ADULTS
Authors: Mauldin Rebecca , Handique Swasati , Jang Soeun , Parekh Rupal
Published: January 2025

Transportation is a significant factor for older adults’ mobility and quality of life. However, some older adults need rides from others for transportation and ride providers may experience burdens when providing rides regularly. This study explores the use of geographic information systems to develop geospatial models (or “activity spaces”) of routine travel patterns, both for regular activities and for providing transportation to older adults. This exploratory study was a cross-sectional survey among people who provided rides to older Vietnamese immigrants in the Dallas-Fort Worth metroplex area (N=20). Geospatial analyses using ArcGIS were employed to examine activity spaces (AS) and the geospatial burden of providing rides. Results indicated that nearly half of the ride providers experienced transportation costs, missed work, and increased personal stress from giving rides. Significant portions of ride-provision activity spaces were found outside the provider’s regular activity spaces. We present and compare three potential indicators for assessing ride providing burden based on the ride providers’ regular and ride-provision activity spaces. The percentage of the ride-provision AS outside the AS was associated with giving fewer rides per month. Findings suggest potential ways to measure ride provider burden for research and practice and have the potential to inform transportation subsidy policies. This study has implications a policy subsidizing private ride providers which could reduce costs and improve accessibility without additional infrastructure. Geospatial tools can assess ride-provision burdens, guide subsidy eligibility, and provide valuable data for city planning and service location optimization.
WORKPLACE RETENTION FRAMEWORKS FOR NURSING IN LONG-TERM CARE: AN INTEGRATIVE REVIEW
Authors: Sun Winnie , Martignetti Lucas , Calver Jen
Published: January 2025

Background

Nurses and Personal Support Workers are essential for care and services provided for Long term Care (LTC) homes. Concerns regarding unsafe living and working condition resulting in high turnover rates. Despite high turnover rate, very little guidance to help improve staffing stability and workforce retention planning. The purpose of this integrative review is to synthesise the existing literature regarding LTC staff retention to guide the development of a comprehensive framework addressing LTC staffing issues.

Methods

This review was conducted using Whittemore and Knafl’s integrative review methodology to assess both empirical, theoretical and grey literature. Databases were searched such as CIHNL, PubMed, PyschINFO. Included articles are published in English; use empirical and theoretical methodologies; and focuses on workplace retention frameworks, models, and strategies for the LTC workforce. Articles involving non-facility based LTC and those focused on recruitment rather than retention was excluded. Thematic analysis using Braun & Clark was used to identify themes related to retention frameworks and models influencing turnover.

Results

A total of 1196 articles were retrieved, with 1086 articles screened, while 17 articles were included in the final sample. Examples of identified models including Huber’s Structural Model and the Dual-Driver Model. Retention framework focuses on five group factors: Organizational and personal characteristics, leadership/management, social systems and labour market conditions.

Conclusion

The results of this study will be useful to guide subsequent stages of this research to gain consensus of LTC staff using Delphi methodology to support the co-creation of a workforce retention framework in LTC sector.
CLINICAL CORRELATION OF MMSE AND TAU RESULTS FROM BLOOD OR IMAGING REPORTS
Authors: Sunil Surya , Nair Malini , Huang Rui , Obando Viviana , Ferreira Kyra , Glynn Jennifer , Nair Anil
Published: January 2025

Background

A novel blood test for Alzheimer pathology is now available. Abnormal tau measurements from blood or brain PET may indicate brain tau. We analyzed the correlation of Mini Mental Status Examination (MMSE) to tau results disclosed to patients in a memory clinic.

Objectives

To assess the correlation of blood or PET tau positivity to MMSE test scores. To evaluate an MMSE score cut-off that translates optimally to tau positivity.

Method

Retrospective observational chart review of patients attending a memory clinic in Boston, MA, with a MMSE test score and blood tau or tau-results were included for analysis. Baseline MMSE and a binary blood or PET scan result were analyzed with covariates age, sex and race. Spearman correlation of MMSE to blood/PET tau. Kruskal Wallis/Chi square tests for relationship of age, sex, gender and education with MMSE score and tau-PET status. ROC analyses and sensitivity/specificity were obtained.

Results

We disclosed 45 positive and 10 negative tau results. 58.2% were female and 82.7% were white. Mean age was 70.12 ± 14.17, mean MMSE was 21.35±7.36. Tau abnormality trended negatively with MMSE score (r= -0.26, p=0.07). A cut point of 28 for MMSE estimated tau deposition in the brain by PET scan or blood tau, with an AUC of 0.694 (95%CI 0.48 to 0.90).

Conclusion

In a small pilot study, tau blood or PET results trended negatively with MMSE scores, possibly indicating a ceiling effect as we only analyzed very mildly impaired subjects.
COMPREHENSIVENESS AND READABILITY OF CHATGPT’S ANSWERS TO DEMENTIA FAMILY CAREGIVERS’ QUESTIONS
Authors: Han Soojeong , Aryoyudanta Bayu , Choi Yong Kyung
Published: January 2025

Family caregivers experience challenges in deciding on care transitions. As ChatGPT is a powerful tool for obtaining information, this study aims to evaluate the comprehensiveness and readability of ChatGPT’s answers to dementia family caregivers’ questions regarding transitioning to hospice and palliative care. We extracted data from a public online forum, ALZConnected.org, dedicated to caregivers and individuals affected by dementia. Our dataset comprised 35,482 original posts collected from 2011 to 2023. By filtering with the search terms “palliative”, “hospice”, or “end of life”, 123 questions regarding transitioning were discovered. Of 123 questions, 24 were selected with convenience sampling and entered into ChatGPT. The comprehensiveness of ChatGPT’s answers was evaluated using single-turn and then multi-turn conversations. The readability of all final answers was assessed using the Flesch Reading Ease (FRE) (Rouhi et al., 2024). Results revealed that 41.67 % (n = 10) was scored as comprehensive, 33.33 % (n = 8) as adequate, and 25.00 % (n = 6) as incomplete. The median comprehensiveness score was 2.00 (mean 2.08, SD 0.88). The mean (SD) FRE score was 25.37 (10.39), indicating ‘very difficult to read’. We further investigated whether ChatGPT can provide answers that are easier to read on a different literacy level. The mean (SD) FRE score of revised answers was 46.42 (12.99), indicating ‘difficult to read’. The t-test revealed significant differences between the two answers on the FRE scale (t = -6.20; p < 0.0001). Further studies can explore how to maximize the benefits of using ChatGPT for family caregivers.
DETERMINATION OF PHYSICAL ACTIVITY AND SLEEP LEVELS FROM ACTIGRAPH LEAP USING OPEN-SOURCE R PACKAGE
Authors: Suarez Jethro Raphael , Banarjee Chitra , Park Joon-Hyuk , Thiamwong Ladda
Published: January 2025

Accelerometers are the most common devices used for objectively assessing physical activity (PA) and sleep levels, but cleaning and analysis of the data takes time and requires expertise. Raw Accelerometer Data Analysis (also called GGIR) is an open-source R package that helps researchers process and analyze raw multi-day data from accelerometers and calculates PA and sleep levels. GGIR can process various formats of raw data (e.g.,.csv,.gt3x) from several types of accelerometers but not the raw.csv data from the ActiGraph LEAP device. We aimed to determine PA and sleep levels from LEAP devices by investigating how the raw.csv data file could be manipulated to be compatible with GGIR. We used the pilot data from our NIH-funded study with 24 community-dwelling older adults aged 62 to 91 (mean age = 74.63 ± 7.73 years) who wore the LEAP device for 7 consecutive days. The raw.csv data files were analyzed using a code created in R language that read each raw.csv data file in chunks using the “read.csv” function. We found that manipulation of the column and row structure of the raw.csv file in R resulted in compatibility with GGIR only after removal of the Time Stamps column and matching the header formatting of raw accelerometer.csv files exported from the ActiLife program. Our findings indicated that GGIR can be used to analyze data from LEAP devices and allows for creating a detailed report of PA and sleep levels that benefits both researchers and older adults.
DIGITAL INTERVENTIONS FOR URINARY TRACT INFECTIONS PREVENTION IN PERSONS LIVING WITH DEMENTIA: A SCOPING REVIEW
Authors: Wu Kuan-Ching , Belza Basia , Berry Donna , Lewis Frances , Zaslavsky Oleg
Published: January 2025

People with dementia are significantly more prone to hospitalizations for urinary tract infections (UTIs) and experience more severe health outcomes compared to those without dementia. Digital interventions, such as smartphone applications, wearable devices, and telehealth platforms, show potential for transforming UTI detection, monitoring, and adherence to preventive measures. However, there is a lack of studies examining how existing digital interventions support UTI prevention in persons living with dementia. This paper reviewed various digital interventions tested in current literature for managing or preventing UTIs in this population and identified key outcomes. Utilizing the PRISMA-ScR framework, this scoping review searched five databases for studies from January 1998 to January 2024 that included digital interventions using technological devices. After screening 1800 citations, we included seven studies and evaluated three digital interventions: Technology Integrated Health Management (TIHM), a real-time locating system (RTLS), and a smart diaper system. These studies reported various outcome variables and AI algorithms for health monitoring and UTI prediction, with sensitivities up to 91%. TIHM and RTLS were highly effective in UTI detection, while the smart diaper system had lower sensitivity for urine voiding detection. Despite the prevalence of sensor-based technology and AI algorithms for early UTI detection, most interventions lack theoretical foundations and preventive strategies, highlighting the need for comprehensive approaches involving dementia caregivers. Future research should diversify its scope and integrate preventive measures guided by clinical guidelines and behavioral theories to enhance UTI management, improve quality of life, and reduce healthcare costs for persons with dementia and their caregivers.
EFFECT OF TIME-RESTRICTED EATING ON NEUROVASCULAR COUPLING AND METABOLIC PROFILE IN OLDER ADULTS
Authors: da Langley Ana Clara Costa Pinaffi , Pinto Camila Bonin , Kleszynski Keith , Tarantini Stefano , Yabluchanskiy Andriy
Published: January 2025

Vascular cognitive impairment and dementia (VCID) account for up to 30% of dementia cases worldwide, representing an important public health challenge. Normal cognitive function requires adequate cerebral blood flow (CBF) regulation. Therapeutical strategies aimed at rescuing age-related CBF dysregulation can delay or mitigate the incidence of VCID. Time-restricted eating (TRE) is an accessible alternative to caloric restriction that has demonstrated benefits on cardiometabolic outcomes. However, the effect of TRE on cerebrovascular function in older adults remains unexplored. Therefore, this pilot study aimed to investigate whether TRE improved cerebrovascular function and metabolic profile in heathy older adults. Participants were instructed to maintain a 10:14 intermittent fasting regimen daily for 6 months. Outcomes of interest were changes from baseline to endpoint in neurovascular coupling (NVC) response assessed with near-infrared spectroscopy and metabolic profile assessed using metabolomics analysis. Six participants (100% female, mean age: 59±5 years) completed the pilot study. Six months of TRE were associated with a significant increase in NVC responses (n=5) in the dorso-lateral prefrontal cortex, the region relevant to the cognitive stimulation paradigm. TRE was also associated with an increase in the levels of tetrahydrofolate, L-arginine and nicotinamide, metabolites involved in vascular health (n=5). TRE resulted in an increase in several metabolites directly implicated in antioxidant, anti-inflammatory, or anti-senescence pathways in the vasculature. Further, principal component analysis revealed a distinct clustering of the before and after TRE data. Our limited dataset indicates that TRE may improve NVC and the availability of metabolites relevant to vascular health in older adults.
EFFECTIVENESS OF A NOVEL MEDITERRANEAN DIET APP IN ENHANCING ADHERENCE: RCTS BASED ON SCT
Authors: Su Yan , Zaslavsky Oleg
Published: January 2025

Adherence to the Mediterranean diet is a proven nutritional intervention that supports healthy aging and reduces chronic disease risk among community-dwelling older adults. Two pilot RCTs were conducted to evaluate the feasibility and efficacy of a novel mobile health intervention aimed at enhancing adherence to this diet among older users. A total of 34 participants, aged 56-88, were randomized into intervention and control groups. The intervention group used a mobile app for 3 months, receiving feedback on food choices, personalized recipe recommendations, and in-app messaging. Outcomes measured included adherence to the Mediterranean diet, five Social Cognitive Theory (SCT) constructs, and Mediterranean diet knowledge. Linear mixed models (LMMs) showed the intervention group had a significantly greater improvement of 1.52 points in Mediterranean diet adherence compared to the control group after the intervention (P<.05). The intervention group also increased their whole grain intake by 1.53-ounce equivalents more than the control group (P<.01) and their legume intake by 0.14-ounce equivalents more than the control group (P<.01). Additionally, the intervention group reduced their red meat consumption by 0.67 ounces more than the control group (P<.05). However, when each SCT construct or Mediterranean diet knowledge was included in the models individually, none were significant predictors, nor did they affect the group-time interaction, suggesting these factors did not mediate the intervention’s effectiveness. The novel mobile intervention effectively improved dietary adherence among community-dwelling older adults, likely due to the combined influence of multiple behavior change techniques or other factors not captured by SCT.
EFFECTS OF ACUTE EXERCISE AND A DUAL COGNITIVE TASK ON A NOVEL CIRCULATING BIOMARKER
Authors: Croucher Madison , McCall Jennifer R , Sausman Kathryn , de Albuquerque Lidio L , Arms Tamatha , Peterson Matthew
Published: January 2025

This study reports on the effect of aerobic exercise, with or without a concurrent cognitive task on circulating levels of beta hydroxybutyric acid (b-HBA) and glucose in older adults with normal cognition.

Methods

Two bouts of exercise one week apart were performed to examine pre-post b-HBA and glucose in, 1) 10-minutes of stationary bicycling, and 2), 10-minutes of stationary bicycling with a cognitive challenge. Variables included cognitive screening (MoCA), fasting blood samples, health status, physical performance (SPPB), hand function, and depressive symptoms.

Results

N=10 female participants were 90% Caucasian, 71.6 +/-4.3 years old with 3.2 +/-2.1 comorbidities, normal cognitive functioning (MoCA=27 +/-1.5) and good physical performance (SPPB 11.1 +/-1.1). There was a clinically meaningful positive association between change in circulating concentrations of b-HBA and MoCA scores with the dual task condition (r=0.32). Glucose was utilized more in the exercise only task compared to the dual condition task (Visit 2 – Visit 1 difference: mean increase of 9.5% +/- 16.4% in pre-post % change), whereas b-HBA was depleted in the dual task condition (Visit 2-Visit 1 difference: mean decrease of 17.0% +/- 33.4% in pre-post % change). Both b-HBA and glucose concentrations changes had moderate effect sizes (Cohen’s D=0.51 and 0.57, respectively). Conclusions: This study provides proof of concept for differing energy substrate utilization, when the brain is tasked with a cognitive challenge added to an already moderately intense whole-body cycling exercise. Future studies will objectively quantify energy substrate utilization in the brain using this experimental design and imaging studies.
EVALUATION OF PRECLINICAL ALZHEIMER’S DEMENTIA USING PLANTAR PRESSURE REGULATION ABILITY
Authors: Yoon Jieun , Ota Kazuki , Arai Tetsuaki , Nemoto Miyuki , Nemoto Kiyotaka , Ota Miho , Miyashita Mariko , Okura Tomohiro
Published: January 2025

Strong connectivity between peripheral sensors and the central nervous system assists in cognitive load distribution. Aging and neurological disorders, including various peripheral neuropathies cause decreased plantar skin sensitivity. The early detection and prevention of Alzheimer’s disease, particularly during the preclinical period, is highly important. The preclinical Alzheimer’s cognitive composite 5 (PACC5) test formula is an effective test for assessing the preclinical AD period. However, completing the PACC5 is time consuming and psychologically and physically challenging for 60- to 87-year-old patients. We developed a plantar pressure performance test to evaluate the correlation between PACC5 scores and graded plantar distributions in the preclinical period. Participants (n = 210) aged 60–87 years (mean: 71.0 ± 7.0) provided informed consent. PACC5, gap_total, gap_downslope, gap_upslope, and error (deviation from the target value) values for each relaxing- and exerting-force movement of the legs were evaluated. We used the BM-220 (prototype, Tanita Co. Ltd) for analyzing plantar pressure. The participants were divided into three groups (upper, middle, and lower) based on plantar pressure. Group differences were assessed using Spearman’s correlation and the Kruskal-Wallis tests, with P < 0.05 considered statistically significant. All items showed a weak negative correlation value trend (R = –0.370 to –0.234). PACC5 scores among the upper, middle, and lower groups (differences ordered from lowest to high) showed significant differences, and the PACC5 scores of the lower group were less than those of the upper group. Thus, plantar pressure movement may serve as a preliminary performance index for preclinical period selection.
EVERYDAY CHALLENGES IN OLDER ADULTS WITH TRAUMATIC BRAIN INJURY: A CASE STUDY OF TWO DYADS
Authors: Umar Tooba , Payonk Cassie , Kuhl Olivia , Mudar Raksha , Rogers Wendy
Published: January 2025

Traumatic Brain Injury (TBI) results in various cognitive, somatic, and psychological challenges that affect daily life. We explored self-perceptions of these challenges in older persons with TBI (PwTBI) and their care partners (CareP), using data from two dyads (N=4). We interviewed participants about daily activities and related cognitive challenges in five domains: health, social engagement, transportation, domestic life, and leisure activities. Participants rated the difficulty of activities for the PwTBI on a scale from 1 (very easy) to 5 (very difficult). Thematic and content analyses revealed discordances in perceptions between PwTBI and CareP on several domains in both dyads, with concordance only in diet and nutrition activities in Dyad 1, which are crucial aspects of the health domain. Other activities showed discordances across both participants. In Dyad 1, PwTBI reported cognitive challenges more frequently than their CareP. However, in Dyad 2, the PwTBI reported cognitive difficulties much less frequently during activity ratings. Conversely, their care partner reported cognitive difficulties related to episodic memory and social cognition affecting the domains of health, social engagement, and transportation. These findings underscore the complexity of cognitive challenges faced by PwTBI and the differing perspectives between participants and care partners. The study highlights the need for tailored interventions that address both the challenges expressed by PwTBI and those noticed by their CareP to better support daily functioning and quality of life in older adults with TBI. This dyadic approach provides valuable insights for developing personalized care strategies.
EXPERIENCES OF FAMILY CAREGIVERS OF INDIVIDUALS WITH HYPERTENSION AND DIABETES: A META-ETHNOGRAPHY
Authors: Alhabodal Ashwag , Edoziuno Confidence Francis- , Williamson Marsha , Henderson Wendy , Lucas Ruth
Published: January 2025

The number of older adults diagnosed with chronic diseases such as hypertension or diabetes mellitus is growing, and their home care is often managed by family caregivers. The purpose of this meta-ethnography is to synthesize qualitative evidence, published between 2014 and 2024, and identify common challenges, motivations, and coping strategies of caregivers. Ten articles were included, conducted in diverse settings across high-, middle-, and low-income countries with 261 caregivers, mostly females. Through Noblit and Hare’s approach, five overarching themes were identified: caregiving expertise and knowledge, psychosocial impact, support and coping mechanisms, financial and physical burdens, and intrinsic motivations and values. Many caregivers receive inadequate formal training and resources, which often lead to intense emotional, financial, and physical burdens. These personal burdens were balanced by their strong personal values and motivation to provide care. The voices of caregivers reveal not only the depth of their commitment but also the significant cost caregiving takes on their mental and emotional health. Caregivers speak of isolation and anxiety, as well as the resilience they draw from family bonds and religious beliefs. Their narratives highlight the universal challenges experienced by caregivers globally. However, the availability and quality of support systems may differ widely. Caregivers have a critical role in the management of chronic diseases for their older adult family members, and they require interventions and policy changes to ensure their well-being and the quality of care they provide.
EXPLORATION OF VARIABILITY IN STRESS AND SLEEP QUALITY IN OLDER PEOPLE WITH MILD COGNITIVE IMPAIRMENT
Authors: Kabaya Sonoko , Greiner Chieko , Yamaguchi Yuko , Nakamura Masahide
Published: January 2025

Mild cognitive impairment (MCI) is common, affecting 10%-35% of people over 65, since medical technology has advanced. Previous studies have reported that stress in older people with MCI exacerbates cognitive decline and can lead to daily depressive affect contagion between family caregivers (FCs) caring for older people with MCI. They have also indicated that stress adversely affects sleep quality and duration among older people with MCI. However, it is not clear how stress and sleep quality in older people with MCI fluctuate within a day especially throughout night. The aim of this study was to explore the characteristics of variability in stress and sleep quality in older people with MCI. We recruited dyads of older adults with MCI over the age of 65 and FCs. Data collection was performed continuously for 7 consecutive days. We adopted smart watches (GARMIN vívosmart 4) to measure Heart Rate Variability (HRV)-based stress and sleep quality. The Mann-Whitney U test was performed using Python 3.12. Results showed that stress levels were significantly higher during wakefulness compared to nighttime sleep (p=0.05e-89); however, no significant differences were observed based on the depth of sleep (p >.05). This finding is beneficial for considering how to reduce their stress especially during deep sleep and how to improve sleep quality.