bluuebunny/crossref_metadata_2025 huggingface dataset:
PROFILE OF OKLAHOMA CLIENTS REFERRED TO ADULT PROTECTIVE SERVICES FOR ALLEGED SELF-NEGLECT
Authors: Tuft Samantha , Ejaz Farida , Rose Miriam , Reynolds Courtney
Published: December 2022

Self-neglect is the most commonly reported allegation of abuse to Adult Protective Service (APS) agencies nationwide. Researchers collaborated with Oklahoma APS to understand characteristics of allegedly self-neglecting clients who were reported to APS (focus of this paper), and to subsequently refer a random sub-sample to home-and community-based services and track outcomes. Clients (n = 188) were interviewed by phone; data were collected on demographic and background characteristics, physical and mental health, social support, social isolation, and the impact of COVID-19 on them. Most clients were white, 18% were American Indian, and 14% were African American. Their ages ranged from 18–92 years, 63% were women, most were low-income ($12,000-$15,000 annually), and 60% lived alone. Many used public benefits such as Medicare (75%), Social Security, and Medicaid. Based on PHQ scores, about a third had moderate to severe symptoms of depression; and 27% scored similarly on anxiety. More than a third saw family and friends less often during the pandemic. APS administrative data was also obtained on these clients and preliminary analyses indicated that the 188 study participants had a total of 205 allegations of self-neglect prior to the study, with 76% of the allegations needing a referral for community services. During the intervention phase, however, only 31 clients had any type of abuse allegations with 24 being for self-neglect. About half needed community services. It is possible that services they were referred to prior and during the study was related to the decline in self-neglect allegations during the study period.
POTENTIALLY INAPPROPRIATE MEDICATION USE INCREASES RISK OF INCIDENT DISABILITY IN HEALTHY OLDER ADULTS
Authors: Lockery Jessica , Collyer Taya , Woods Robyn , Orchard Suzanne , Murray Anne , Ernst Michael
Published: December 2022

Background

Efforts to minimize medication risks among older adults include avoidance of potentially inappropriate medications (PIMs). However, most PIMs research has focussed on aged or inpatient care, creating an evidence gap for community-dwelling older adults. To address this, we investigated the impact of PIMs use in the ASPREE clinical trial.

Methods

ASPREE enrolled 19,114 community-dwelling participants aged 70+ years (65+ if US minorities) without a history of major cardiovascular disease, cognitive impairment, and significant physical disability. PIMs was defined according to a modified 2019 AGS Beers Criteria. Cox proportional-hazards regression models were used to estimate the association between baseline PIMs exposure, and disability-free survival, death, disability, and hospitalization, with adjustment for comorbidities including frailty.

Results

At baseline, 7396 (39% of total) participants were prescribed at least one PIM. Compared with those unexposed, participants on a PIM at baseline were at an increased risk of persistent physical disability (Adjusted HR 1.47, 95%CI 1.21, 1.80) and hospitalization (Adjusted HR 1.26, 95%CI 1.20, 1.32), but had similar rates of disability free survival and death. These effects did not vary by polypharmacy status. PIMs exposure was associated with higher risk of disability followed by hospitalization (Adjusted HR 1.92, 95%CI 1.25, 2.96) as well as vice versa (Adjusted HR 1.54, 95%CI 1.15, 2.05). Conclusions: PIMs exposure is associated with increased risk of incident disability and hospitalization. Increased risk of disability prior to hospitalization suggests that PIMs use may start the disability cascade, emphasizing the importance of caution when prescribing PIMs for community-dwelling older adults.
THE POSSIBILITY OF PREVENTION: THE PUBLIC HEALTH CENTER OF EXCELLENCE ON DEMENTIA RISK REDUCTION
Authors: Baumgart Matthew
Published: December 2022

While we may not be able to predict with certainty whether any particular individual can prevent dementia, we are now able to talk about dementia risk reduction at the population level. The Public Health Center of Excellence on Dementia Risk Reduction reviews and synthesizes the state of the science on modifiable risk factors for cognitive decline and dementia. The Center translates that science into public health action – identifying interventions and best practices to address those risk factors – and develops tools and resources for public health agencies. The Center disseminates this information and works with public health to undertake community-level actions to address risk factors. The Center also works with public health agencies to: (a) address the social determinants of health with respect to dementia risk; (b) build capacity to enable smaller agencies to engage in risk reduction activities; and (c) partner with health systems to advance risk reduction.
APPLYING REFRAMING AGING GUIDELINES WHEN REVIEWING FOR NON-AGING JOURNALS
Authors: Suntai Zainab
Published: December 2022

The Reframing Aging initiative began in 2012 with the aim of changing the way in which the public views aging, and one of the key tenets of the initiative centers around language that perpetuates negative views of aging. Despite widespread knowledge about the initiative, recent publications in high-tier journals point to a gap in adopting the Reframing Aging initiatives outside of aging journals. Terms that project a negative view of older adults are still used in manuscript titles and within abstracts and bodies of research publications in non-aging journals. As researchers who publish aging-related work, members of organizations such as the Gerontological Society of America are often solicited as reviewers for their expertise in the field of aging. While many researchers in aging may review for aging-related journals, such expertise is often needed in non-aging journals. As such, it is critical for aging researchers to continue to advance the Reframing Aging initiative when conducting reviews of manuscripts that do not adhere to the guidelines. This presentation will provide explicit examples of such publications and review specific steps that reviewers can take in addressing the Reframing Aging initiative in future reviews.
AN AGE-FRIENDLY NURSING HOME PROJECT ECHO IN RURAL COMMUNITIES
Authors: Jennings Lee , Round Teri , Sturdevant Diana , Kleszynski Keith
Published: December 2022

We launched an Age-Friendly Nursing Home Project ECHO in October 2021 focused on the 4Ms (mobility, medications, mentation, what matters most) with emphasis on dementia and QI in long-term care. One-hour virtual sessions included a short expert presentation and case discussion, were offered twice weekly, and recordings were posted online. Topics included person-centered care, advance care planning, LGBTQIA+ care, fall prevention, medication reduction, dementia resident activities, oral health, skin integrity, staff retention, COVID-19, PDSA cycles, root cause analysis, team huddles, among others. 235 individuals from 80 nursing homes, 19 ALFs, 6 continuing care communities, and 10 VA-affiliated sites in 5 states (OK, AR, KS, MO, CO) participated in the first four 6-week ECHO series; 27% attended ≥2 series. Most attendees were nursing home administrators (46%), directors of nursing (20%), nursing assistants (12%), or activity directors (11%). Most were female (91%) and worked in rural settings (77%). 237 attended an additional COVID-19 update session. 152 participants (65%) completed an evaluation. 91% rated the program as valuable (score≥8/10); 99% would recommend to others; 57% discussed topics with colleagues; 59% reviewed materials after sessions; 25% implemented new QI processes; and 25% made a change to resident care. Suggestions for future sessions included: active shooter training, antibiotic stewardship, team building, staff-resident communication, dementia training for non-clinical staff, weight loss, capacity determination, and family caregiver support. An age-friendly nursing home Project ECHO was well-received by health professionals in long-term care. ECHO can successfully expand the reach of training in long-term care, especially in rural areas.
INITIAL EXPERIENCE OF THE FIRST HELPLINE DEVOTED TO SUPPORTING CONCERNED PERSONS IN THE LIVES OF ELDER ABUSE VICTIMS
Authors: Chang E-Shien , Rachmuth Lisa , Seki Yuichi , Regenbogen-Weiss Sandy , Ross Serena , Irias Lina , Lachs Mark , Rosen Tony
Published: December 2022

Elder abuse is common and can deeply impact older adults who experience it. Little is known, however, about another group that may be profoundly affected: non-abusing family members, friends, and neighbors, referred to as “concerned persons”. We describe the initial experience of the first telephone helpline in the U.S. devoted to supporting these concerned persons. The New York City Elder Abuse Center developed a Concerned Persons Helpline to assist concerned persons and alleged victims in New York State. Using this frontline call data, we examined characteristics of concerned persons, circumstances surrounding alleged abuse, and interventions offered. Overall, the helpline received 864 total calls (16.6 calls per week) over a one-year period between 10/1/20 to 9/31/21. An initial subset of 149 logged calls were used for this exploratory analysis. Concerned persons most commonly reported that an older adult in their life was suffering from financial exploitation (28.9% of all callers), followed by caregiver neglect (26.2%), with 42.2% reporting poly-victimization. Relationship of callers to alleged victims was most commonly non-abusing adult child (37.6%), followed by other relatives (13.4%), friends (12.8%), and neighbors (10.0%). An adult child was also the most commonly reported perpetrator (36.9%). A large proportion of alleged victims suffered from cognitive impairment and/or physical disabilities (55.7%). Intervention provided included referrals to social services, civil and legal services, victim assistance programs, and caregiver counseling programs. Developing resources to support concerned persons should continue to be a research and practice priority in elder abuse.
EARLY OUTCOMES OF A NATIONAL CONSORTIUM TO ADVANCE FAMILY CAREGIVERS IN NURSING EDUCATION
Authors: Zhao Hui , Mullins Lindsay , Davis Andra , Sexson Kathryn , Hart Sara
Published: December 2022

Family caregivers (FCGs) hold primary responsibility in caring for people with chronic illness often with little training and insufficient resources Standardized guidance for supporting FCGs currently does not exist. Given this fact, it is an urgent call to healthcare professionals, particularly nurses as the key members of the healthcare team, to promote education for FCGs. In April 2022, experts in the field of family caregiving from UC Davis and University of Utah schools of nursing, convened educators and champions of FCGs from across the country and formed the Family Caregiving Nursing Education Consortium to advance the inclusion of FCGs in nursing education in order to address the lack of standardized nursing competencies for family caregiving. The consortium consists of members from nine diverse universities representing member expertise in pediatrics, geriatrics, palliative care, disabilities, mental health, and underserved communities in order to address a broader range of health issues through the lifespan. Preliminary data were reviewed and identified as a framework, including Family Caregiver Competencies for Interprofessional Education (4 domains) developed by the school of nursing at UC Davis and the AACN Essentials (10 competency categories). Members mapped the family caregiving competencies to the AACN Essentials (2021) during monthly meetings. Though current work presented an early-stage outcome, it marched through crucial steps, including institutional environmental scans, needs assessments, and toolkit development, as building blocks that not only advanced the inclusion of family caregiving education in nursing curricula but also provided foundation to guide the next stage of work.
AGEISM: AGING KNOWLEDGE AND PERSPECTIVES OF THE AGING NUTRITION NETWORK
Authors: Schultz Savannah , Francis Sarah , Bauman Alexandra
Published: December 2022

Addressing ageism is essential to support older adult well-being. The Nutrition and Aging Resource Center (NRCNA) (1) examined the general characteristics, aging perceptions, and preferred training modalities of national aging nutrition network providers and (2) measured the impact an ageism webinar had on topic familiarity, knowledge, and behavioral intent. Frequencies were run to analyze the characteristics, aging perceptions, and behavioral intent while Wilcoxon signed rank tests measured outcome changes. Ageism was assessed via the W.H.O. Ageism Quiz (AQ) while aging perceptions were measured with the Facts on Aging Quiz (FAQ) and Expectations Regarding Aging (ERA). Respondents (n=1910) were primarily female (63%), non-Hispanic (90%), and white (87%) with an average age of 50 years. At least one-half had moderate ageism and aging perspective scores [Mean scores: AQ = 4.9±1.9 (max 8); FAQ =5.9±1.8 (max 10); ERA = 54.4±18.7 (max 100)]. The most preferred continuing education format was live webinars (44.3%). In response, a one-hour webinar about unconscious aging bias was offered in June 2022. A retrospective evaluation was used to assess the webinar impact (n=130 responses). A significant increase in subject matter familiarity (Z= -8.8, p < 0.0001) and knowledge (Z= -8.5, p < 0.0001) was noted. Further, analyses revealed positive attitudes (beneficial, good idea), perceived behavior control, indirect social norms (client support), and intent to reflect on past interactions with an older adult(s) to see how age-related biases might have influenced those interactions. These results illustrate the need for and the impact of ageism awareness training among those who work with the aging population.
AGE-INCLUSIVE PRINCIPLES ON CAMPUS: EMBRACING DIVERSITY ACROSS THE LIFESPAN
Authors: Munly Kelly , Jacobson Lauren
Published: December 2022

In this poster, researchers based at a Mid-Atlantic university campus provide an understanding of their evaluative steps informing an adaptation of the Diversity Circles program to include a multigenerational component, supporting diversity across the lifespan. Project methods and analysis have been informed by critical theoretical frameworks, including feminist gerontology, that illuminate the invisibility of age, even in the context of intersectional work. Pilot feedback from five participants from a condensed program in an Adult Development and Aging course informed the interview approach. Post-program semi-structured interviews, with program participants, including students and older adults (n=7), and community stakeholders (n=18), provided feedback on diversity needs at the campus and in the surrounding community, as well as on program content and experience and opportunity for further curriculum integration of concepts of age-friendliness, ageism, and age-awareness. Stakeholders interviewed included community practicum liaisons, university advising and student affairs staff, faculty and staff previously engaging in diversity-related activities, university administrators, university personnel attending to enrollment matters, and staff and faculty interested in student-centered curriculum design. Semi-structured interviews were chosen for data collection because of their capacity to provide saturated data from a small, purposeful sample. Focused codes emergent from the interviews included both a) suggestions for curriculum adaptation and modification as well as the value of existing content and b) issues of age-friendliness and ageism more generally. The research team looks toward incorporating suggestions within their findings in an expansion of the program on their campus, and disseminating findings for the benefit of other campuses’ programs.
PROMOTING EFFECTIVE DIAGNOSIS: THE PUBLIC HEALTH CENTER OF EXCELLENCE ON EARLY DETECTION OF DEMENTIA
Authors: Chodosh Joshua
Published: December 2022

The Public Health Center of Excellence on Early Detection of Dementia brings together a broad coalition of stakeholders to assure widespread awareness of why early detection of dementia matters. The Center assesses and disseminates the best evidence supporting early detection and how to accomplish it – the first step on the pathway to high quality, effective diagnosis and health care for people living with dementia. The Center’s advisory group represents key state and county Departments of Health, healthcare systems and primary care providers, community organizations, and professional societies. The Center identifies effective materials and marketing strategies for increasing awareness about cognitive impairment, the value of earlier detection, and how best to conduct detection strategies. The Center works closely with state, county, and tribal public health agencies in dissemination, and seeks to establish collaborative linkages with healthcare systems and their primary care providers to build strategies for post-detection diagnosis and care.
A PILOT STUDY OF AN INTERGENERATIONAL BOOK CLUB: LESSONS LEARNED FOR IMPROVING FEASIBILITY
Authors: Frey Katelyn , Sublett Jennifer , Stanley Jennifer , Stearns Harvey
Published: December 2022

Intergenerational book clubs have been successful in reducing ageist attitudes of younger adults (YA) while increasing feelings of social connectedness among older adults (OA; Lohman et al., 2003). We implemented both in-person (Nf11: YA=4, OA=7) and virtual (Nf8: YA=5, OA=3) modalities for an intergenerational book club to increase intergenerational interactions on campus, considering aging researchers’ claim of heightened ageism and exacerbated loneliness following the beginning of the COVID-19 pandemic (Ayalon et al., 2020; Brooke & Jackson, 2020). Both groups met thrice over twelve weeks and completed measures on ageist attitudes (α=.83), engagement with the group (α=.91), and social connectedness (α=.91) each time. There was attrition in both groups (final meeting: Nf9 (in-person) and Nf3 (virtual)). To better understand overall motivations to participate and what factors may have contributed to attrition, we utilized content analysis with participants’ feedback to examine their motivation for joining, what they enjoyed most after participating, and what they would improve. Participants were motivated to join because they enjoyed reading; comparatively, they enjoyed group discussions and hearing different perspectives. Future recommendations include meeting more often, increasing the number and size of groups, and scheduling meetings closer together. The majority wished to continue participating. The data suggest future expansion of intergenerational book clubs on campus are desired to support age-friendly interactions and needed to further examine if these interactions can curb ageism and increase social connectedness among diverse age groups. Discussion will include recommendations regarding measures, lessons learned for an optimal protocol, and next steps.
COMMUNITY-DWELLING OLDER ADULTS’ PERCEPTIONS OF SMART HOME SURVEILLANCE: AN INTEGRATIVE REVIEW
Authors: Khan Shehroz , Campbell Jessica , Buchan Jacob , Bianchi Andria , Hoey Jesse , Chu Charlene
Published: December 2022

Background

Many older adults wish to use smart homes for aging in place, health monitoring, and enhanced safety. However, concerns over privacy and security remain pressing. User perception studies can help to inform policy and design solutions. Aim: To explore community-dwelling older adults’ (50+) perceptions of smart home surveillance.

Methods

As part of a larger scoping review of smart home user perception based on four non-mutually exclusive categories: privacy, safety, purpose of data collection, and risk, we found 68 results. 15 studies focused on older adults exclusively and were included in this review.

Results

The included studies mainly focused on smart speakers, motion sensors, or home monitoring systems. 13 studies (87%) discussed user privacy concerns in terms of data collection and access. Nine studies (60%) reported that users were enthusiastic about the potential for home safety, improved health outcomes and independent living with smart homes. Seven risk awareness studies (47%) featured a range of perspectives on sharing sensitive information due to the possibility of data breaches and third-party misuse, with some reporting a willingness to trade privacy for enhanced safety. Finally, four studies (27%) explored user knowledge of data collection purposes. While many were uncertain of the details, users were generally more comfortable sharing smart home data with healthcare professionals than others.

Conclusion

This review has helped us in creating a user perception survey that is currently in the fielding stage. Given Canada’s increasing aging population and technological advances, privacy regulators and designers should focus on older adults’ concerns.
ADULT INFECTIONS ARE ASSOCIATED WITH HIGHER RISK OF ALZHEIMER’S DISEASE BUT LOWER RISK OF CANCER
Authors: Ukraintseva Svetlana , Popov Vladimir , Duan Hongzhe , Yashkin Arseniy , Akushevich Igor , Arbeev Konstantin , Yashin Anatoliy
Published: December 2022

Growing evidence suggests that infections may promote Alzheimer’s disease (AD). Chronic infections have also been linked to several cancers. However, there is evidence that acute febrile infections may treat some cancers, suggesting that anti-pathogen immune response could help fight off transformed cells. To explore potentially ambivalent role of infections in cancer and AD, we estimated associations between history of infection and subsequent risks of AD, cancer (all sites combined), and all-cause mortality, in sample of 270K participants of the UK Biobank. We found that prior infection is associated with 29% higher risk of AD (RR=1.29, 95% CI[1.02,1.63], both sexes). In contrast, the overall cancer risk was 49% lower in people with history of infection, compared to individuals without such history (RR=0.49, 95% CI[0.46,0.52], both sexes). History of infections was also associated with 7% reduced total survival at ages 70+ (RR=0.93, 95% CI[0.92,0.94]); however, the negative effect was less evident at younger ages. Results of our study suggest that infections may antagonistically influence chances of AD and cancer. They also show that impact of infections on survival depends on age and is more detrimental at older ages, which may reflect general decline in immune resilience due to aging, as well as the fact that cancer becomes a major contributor to mortality risk at younger ages than AD. Understanding the trade-offs between major diseases is essential for optimizing disease prevention and pro-longevity interventions, since measures aiming to prevent one disease may sometimes increase risks of other major conditions and/or all-cause mortality.
A THEORETICAL FRAMEWORK FOR UTI PREVENTION AND MANAGEMENT IN COMMUNITY-DWELLING OLDER PERSONS WITH DEMENTIA
Authors: Wu Kuan-Ching , Zaslavsky Oleg
Published: December 2022

UTI admission rates are 3.4 times higher among persons with dementia (PWD) than among those without dementia. The hospitalizations often result in adverse health complications such as the increased risk of delirium, cognitive decline, and higher mortality. To date, several UTI guidelines exist for specific populations, including women, children, people with catheters, and long-term care patients; however, there has been little focus on non-pharmacological prevention and management in PWD. The goal of this work is to propose a theoretical framework for UTI prevention and management in community-dwelling older PWD with the following three aims: 1) identify factors and outcomes of UTIs in community-dwelling older PWD; 2) generate a conceptual framework informed by Bronfenbrenner’s 1977 ecological model; 3) integrate preventive measures to the adapted framework. We conducted a scoping literature review utilizing the following keywords and concepts: risk factors, UTI management and prevention, community-dwelling older adults, and dementia. The UTIP framework was generated with four levels of risk factors (individual, interpersonal, community, and national) and four domains of affected outcomes (PWD, caregivers, PWD and their caregivers, and community/national). Additionally, seven themes of preventive measures emerged: physical activity and mobility, behavioral therapy, personal hygiene, phytotherapy, dietary, compound, and hormone. Finally, a table of care management opportunities was proposed according to dementia severity and caregivers’ involvement. In conclusion, the UTIP framework synthesizes exciting and is flexible to accommodate new evidence. As such, the framework is informative for programs, practices, and policies to lower the risks of preventable admission in PWD.
A COMPREHENSIVE ALZHEIMER’S AND DEMENTIA CARE PROGRAM (ADCP) FOR PATIENTS AND CAREGIVERS
Authors: Ramirez Madieska , Kakarla Prabhash , Gieniusz Marzena , Alvarez Jessica , Nouryan Chris , Burns Edith
Published: December 2022

Background

Alzheimer’s and related dementias (ADRD) are progressive and associated with behavioral and psychological symptoms (BPSD) contributing to caregiver stress. We report initial impact of implementing UCLA-designed ADCP to support ADRD patients and caregivers. The program centralizes care, utilizing a nurse dementia-care specialist.

Methods

Prospective repeated measures of ADRD patient/caregiver dyads from 3/2021–7/2022. Measures: BPSD, ADL/IADL, cognition, and caregiver burden, distress and depression.

Results

Total of 154 patient/caregiver dyads enrolled to-date. 42 have been enrolled for one-year: 23 with complete data, 5 pending follow-up, 14 disenrolled (2 expired, 3 to hospice, 2 moved, 7 lost contact). For 23 patients with baseline and follow up, Neuropsychiatric Inventory Questionnaire decreased from 16.3 to 13.1 (p=0.170), Patient Health Questionnaire-9 (PHQ-9) for caregivers decreased (3.5 to 2.2, p=0.044), Montreal Cognitive Assessment decreased from 11.3 to 8.4 (p=0.045), and Dementia Burden Scale (DBS) showed nonsignificant decrease, 20.6 to 18.4 (p=0.312). Cornell Scale for Depression in Dementia was unchanged, 5.67 to 5.14 (p=0.380), and ADL and IADL decreased one year after enrollment, from 4.05 to 2.36 (p < 0.01) and 1.38 to 0.238 (p < 0.01) respectively.

Conclusion

Although attrition rate was high for the small sample (1/3 of dyads enrolled in the program for a year), there were improvements in some metrics for both patients and caregivers, despite the expected decline in cognitive function and ADL/IADL. As data is accrued, we anticipate it will identify patients and support resources that will be most beneficial.
ARTIFICIAL INTELLIGENCE AND ROBOTIC APPROACHES TO SUPPORTING OLDER ADULTS
Authors: Boot Walter
Published: December 2022

Emerging technologies in the domains of artificial intelligence (AI) and robotics hold tremendous potential for supporting the health, wellbeing, independence, and quality of life of older adults. This session presents a sampling of research examining the promise of these technologies and barriers necessary to overcome in order for these technology-based solutions to be implemented, accepted, and adopted. This session will start with K. Trainum presenting a broad overview of the potential of robots to benefit individuals living in senior-living facilities, and a summary of the literature to date. L. Vergara will describe findings related to older adults' attitudes toward a socially assistive robot and implications for the design and implementation of artificial intelligence through socially assistive robots in the home environment. M. Han will present a study examining older adults' preferences for digital conversational agents that can be used to help monitor health, and factors that influence older adults' intention to adopt digital conversational agents. Finally, S. Zhang will discuss the potential of artificial intelligence approaches to maximizing adherence to technology-based cognitive assessment and training through a just-in-time adherence support system tailored to the motivations of the individual. An overarching theme of the session is the need for a careful, thoughtful, user-centered design approach to ensure the success of emerging technology-based solutions to support the health and wellbeing of older adults.
UNDERSTANDING DEMENTIA DISCOURSE DURING ALZHEIMER’S AWARENESS MONTH IN CANADA: FIRST INSIGHTS FROM A TWITTER STUDY
Authors: Bacsu Juanita-Dawne , O’Connell Megan E , Cammer Allison , Azizi Mehrnoosh , Ahmadi Soheila , Grewal Karl , Green Shoshana , Berger Corinne
Published: December 2022

Twitter has become a key platform for public health campaigns, ranging from mental health awareness week to diabetes awareness month. However, there is a paucity of knowledge about how Twitter is being used to support health campaigns, particularly for Alzheimer’s Awareness Month. This presentation aims to: 1) identify how Twitter was used to share dementia discourse during Canada’s Alzheimer’s Awareness Month in January; and 2) explore actions to enhance dementia awareness using Twitter for future Alzheimer’s Awareness Month campaigns. Tweets were collected from Twitter using the Twint application in Python from January 1 to January 31, 2022. Filters were used to exclude irrelevant tweets (5,820), and the remaining 1,289 tweets were exported to Excel. Tweets were divided among eleven coders and analyzed using inductive thematic analysis. Analysis revealed four main themes: dementia education and advocacy; fundraising and promotion; sharing experiences of dementia; and opportunities for future actions such as collaborative partnerships and educational tweets to correct stigmatizing language and dementia stereotypes. Increased educational content, collaborative partnerships, and evidence-informed research are essential to enhancing dementia awareness strategies on Twitter during Alzheimer’s Awareness Month in Canada. Further research is needed to develop, implement, and evaluate methods to improve dementia awareness on Twitter during Alzheimer’s Awareness Month and beyond.
THE COMPARISON OF DUAL TASK TIME AMONG APOE CARRIERS AGAINST NON-APOE CARRIERS IN AGING ADULTS
Authors: Diehl Cody , Campitelli Anthony , Jones Megan , Gills Joshua , Paulson Sally , Glenn Jordan , Bryk Kelsey , Gray Michelle
Published: December 2022

No single variable has been identified as the sole factor for predicting an individuals’ declining health status. In order to predict mental or physical decline in older adults, researchers have designed tasks that include both a physical and mental or cognitive demand known as dual task (DT). The purpose of implementing dual task is to assess the possible changes in accuracy when a second task gets compounded with a given single task. Our study consists of males and females aged from 45 to 75 years who have risk factors for dementia. Each subject was randomly assigned to either a health coaching (HC), or health education (HE) control group. The HC group received coaching to address the lifestyle areas known to be linked to AD risk, such as diet, exercise, sleep, stress, cognitive training, and social interaction. Blood markers of each individual have been assessed to determine carrier status of Apolipoprotein E 4 (APOE4) due to the correlation between the allele and increased risk of Alzheimer’s. To be included in the study, the participants must have at least 2 positive risk factors for AD as determined by the Australian National University-Alzheimer Disease Risk Index (ANU-ADRI). Among non-APOE carriers, a 2x3 (group x time) mixed ANOVA revealed a significant interaction effect wherein the HC group improved DTC score more than the HE group from time 1 to time 3, F (2, 362) =1.253, P=0.017. No significant interaction was noted for APOE carriers.
THE ASSOCIATION OF LIFESTYLE AND SOCIAL ENGAGEMENT WITH DEMENTIA: A NATIONWIDE POPULATION-BASED COHORT STUDY
Authors: Jang Jiyoon , Lee Sang Hwa , Cho Eunhee
Published: December 2022

As the aging population increases, the number of people with dementia is expected to rise rapidly, resulting in a growing burden on families and society. Delaying and preventing the clinical onset of dementia are significant public health goals. Unhealthy lifestyles and social disengagement have been identified to be modifiable risk factors for all-cause dementia. However, this has not been fully examined in the Korean population. Therefore, this study aimed to determine the association of lifestyle and social engagement with dementia incidence, based on the Korean Longitudinal Study on Aging (KLoSA) database with recently added dementia-related variables (diagnosis, medication administration, and treatment). The study included 5,071 participants; cases are patients diagnosed with dementia from 2010 to 2020 and controls are older adults without dementia. Logistic regression analysis was used to examine the relationship of dementia with lifestyle factors (alcohol consumption, smoking, exercising) and social engagement. Among the lifestyle factors, the current smoking status was associated with an increased risk of dementia (OR = 2.359, p < .05) after controlling the health-related covariates and general characteristics. Furthermore, increased participation in social activities was significantly related with a decreased risk of dementia (OR = 0.575, p < .01). This study highlighted the importance of non-smoking and social engagement in reducing the risk of dementia in later life. Therefore, implementation of interventions that focus on these leading risk factors can significantly reduce the burden of dementia in Korea.
PERCEIVED SOCIAL ISOLATION IS CORRELATED WITH BRAIN STRUCTURE AND COGNITIVE TRAJECTORY IN ALZHEIMER’S DISEASE
Authors: Zhang Ye , Tatewaki Yasuko , Liu Yingxu , Tomita Naoki , Takano Yumi , Nakase Taizen , Mutoh Tatsushi , Taki Yasuyuki
Published: December 2022

Perceived social isolation was associated with future cognitive decline and increase risk of Alzheimer’s disease (AD). However, the impacts of perceived social isolation depending on different clinical stages of AD have not been elucidated. This study was to investigate the influence of perceived social isolation, or loneliness on brain structure and future cognitive trajectories in patients who are living with or are at risk for AD. 176 patients (mean age of 78 years, 39 subjective cognitive decline [SCD], 53 mild cognitive impairment [MCI], 84 AD) underwent structural MRI and neuropsychological testing. Loneliness was measured by one binary item question “Do you often feel lonely?”. Voxel-based morphometry was conducted to evaluate regional gray matter volume (rGMV) difference associated with loneliness in each group. Subgroup analysis was performed in 51 patients with AD (n=23) and pre-dementia status (SCD-MCI, n=28) using the longitudinal scores of Alzheimer’s Disease Assessment Scale-cognitive component-Japanese version (ADAS-Jcog). Whole brain VBM analysis comparing lonely to non-lonely patients revealed loneliness was associated with decreased rGMV in bilateral thalamus in SCD patients, and in the left middle occipital gyrus and the cerebellar vermal lobules Ⅰ-Ⅴ in MCI patients. Annual change of ADAS-Jcog in patients who reported loneliness was significantly greater comparing to these non-lonely in SCD-MCI group, but not in AD group. Our results indicate that perceived social isolation, or loneliness, might be a comorbid symptom of patients with SCD or MCI, which make them more vulnerable to the neuropathology of future AD progression.
INTERNATIONAL LONG-TERM CARE HOME QUALITY ASSURANCE: HOW DO EUROPEAN MEASURES ADDRESS DEMENTIA?
Authors: Lepore Michael , Zúñiga Franziska , Schols Jos , Wingenfeld Klaus , van Achterberg Theo , Murray Briana
Published: December 2022

Alzheimer’s Disease and related dementias (ADRD) are prevalent conditions in long-term care homes (LTCHs) with about 50% of LTCH residents living with ADRD in many countries. Despite the prevalence of ADRD in LTCHs, a recent examination of LTCH quality assurance programs in four countries revealed a small percentage of LTCH quality measures across those countries addressed ADRD, most commonly as a risk adjuster, and once each as an inclusion or exclusion criterion. To better understand how quality assurance programs address ADRD internationally, we examined LTCH quality measures in four European countries—The Netherlands, Switzerland, Germany, and Belgium—following procedures previously used to examine international LTCH quality assurance measures. 73 measures were examined across 4 quality assurance programs. 26% of the measures addressed ADRD. The programs addressed ADRD in starkly different ways: in The Netherlands and Belgium no measures addressed ADRD; in Germany the majority (13/15) of measures addressed ADRD as an exclusion or inclusion criterion; and in Switzerland all the measures addressed ADRD through risk adjustment. Although limited to examining measures from LTCH quality assurance programs in four European countries, this study adds evidence that ADRD tends not to be addressed by LTCH quality measures, but when ADRD is addressed, it tends to be through risk adjustment. LTCH regulators, policymakers, and providers can use this information to assess options for addressing ADRD in quality assurance programs. Future research is needed to assess how standard indicators of quality differ across quality assurance regimes and how to address dementia beyond risk adjustment.
GAIT AND/OR BALANCE DISTURBANCES AND THE ONSET OF ALZHEIMER’S DISEASE IN MILD COGNITIVE IMPAIRMENT
Authors: Ahn Sangwoo
Published: December 2022

Physical frailty is one of the fundamental hallmarks of aging. Older adults with mild cognitive impairment (MCI) are more likely to exhibit some characteristics of physical frailty such as worse gait and/or balance. Gait and/or balance disturbances may precede cognitive decline among cognitively healthy older adults. The purpose of this longitudinal observational study was to identify the temporal relationship between gait and/or balance disturbances and the onset of Alzheimer’s disease (AD) because it has not been well characterized among older adults with MCI. Data of 2,692 older adults with MCI (ages 74.5 ± 7.1 years, women making up 47% of the sample) were from the National Alzheimer’s Coordinating Center’s Uniform Data Set. Risk of incident AD by baseline gait and/or balance disturbances was examined by Cox regression models over 4.0 ± 3.0 years, adjusting for demographic characteristics, medical conditions, and study site where the data were collected. The presence of gait and/or balance disturbances predicted 38% to 55% (hazard ratios [HR] 1.38 to 1.55) increased risk of AD. Findings remained robust in sub-group analyses by sex and there were no noticeable changes compared with the original analyses. Thus, regardless of sex, gait and/or balance disturbances predicted the onset of AD among older adults with MCI. Health care providers may need to (1) catch a warning of possible cognitive decline by a frequent assessment of gait and/or balance disturbances and (2) provide effective strategies to improve gait and/or balance disturbances to potentially delay the onset of AD.
EXPLORATION OF CARE CONTENTS AFFECTING STRESS VARIABILITY IN FAMILY CAREGIVERS OF OLDER PEOPLE WITH DEMENTIA
Authors: Kabaya Sonoko , Greiner Chieko , Nakamura Masahide , Yamaguchi Yuko , Xuanrong Zhang
Published: December 2022

Support for family caregivers (FCs) caring for older people with dementia in the home settings is a common issue in developed countries. Previous studies have reported that the increase in the burden of FCs not only causes health problems, but also makes it difficult to continue care at home and causes serious problems such as abuse. However, it is not clear how FCs’ stress, which leads to increased burden, fluctuates within a day through daily care activities. The aim of this study was to explore care activities that influence the increase in FCs’ stress. We recruited one dyad of an older adult with dementia over the age of 65 and a FC. Data collection was performed for consecutive 7 days throughout 24 hours. We adopted hamon® developed by Mitsufuji Corp. Japan to measure Heart Rate Variability (HRV)-based stress. Moreover, we asked a FC to talk with Virtual Agent on a laptop freely to understand when and what kind of care activities were done and how FC’s feelings were. Kruskal-Wallis’s test and Bonferroni’s multiple comparison test were used to compare differences in stress in the care contents. Results showed that sleeping care, which is composed of such as assistance in using the toilet and changing clothes, gives more stress to FC, compared with morning care which includes such as assistance in changing clothes, eating breakfast, and taking medicine (p=0.042). this finding is beneficial for considering how to reduce FC’s stress on daily care activities.
REFRAMING AGING: INTRA- AND INTERGENERATIONAL DIGITAL CONVERSATIONAL AGENTS TO SUPPORT OLDER ADULTS
Authors: Han Molly , Piercy Cameron
Published: December 2022

Digital conversational agents (DCAs) have become extraordinarily ubiquitous. Researchers envision the prospects of using DCAs to monitor health among older adults. However, older adults show hesitation to engage with DCAs. It is possible older adults prefer receiving human assistance rather than getting help from a machine. Another potential explanation is that communicative cues of DCAs such as voice need to be further optimized to invoke behavioral engagement. To understand how DCAs can better support older adults, we develop an experiment with three scenarios in which an agent (a human, an embodied DCA, a mixed presence of human and DCA) shares active aging information. We manipulate the agent’s voice in terms of age (older voice, younger voice). We investigate how the interplay of agent categories and intragenerational/intergenerational voice cues affect older adult participants’ evaluation of information and intention to adopt DCAs. Our study will contribute to DCAs design for older clients.
ENGAGING A DIVERSE PATIENT AND CARE PARTNER COUNCIL TO REFINE DEMENTIA CARE DIGITAL HEALTH TOOLS
Authors: Cassidy Jessica , Fisher Mary , Romeo Evelyn , Holden Samantha , Caffrey Melanie , Nease Donald , Lum Hillary
Published: December 2022

Digital health tools have potential to reduce health disparities for persons with dementia and their family care partners (i.e., dementia dyads). We aimed to promote digital health equity through engaging stakeholders to identify priorities and suggestions for refinements to digital health tools. We convened a council, “Memory Research Partners in Caring and Technology” comprised of three dementia dyads, two care partners, and 10 community members with experience as research partners. The council met six times over seven months. Methods of engagement included: a) delivering preparatory educational materials and hosting guest speakers; b) World Café participatory methods and small group discussions using Google jamboards; and c) individual consultations with partners for additional input. Data was analyzed using rapid qualitative analysis and member checking with research partners. We evaluated engagement methods with a research partner survey and analyzed responses using descriptive statistics. Research partners identified key priorities for equitable refinement of digital health tools, including: 1) Communicating with dementia dyads based on their preferences; 2) Creating user-friendly patient portals; 3) Ensuring digital health tools offer dementia dyads convenience; 4) Providing technology supports; and 5) Facilitating connection to community resources. Stakeholder feedback regarding project engagement indicated majority strongly agreed their input was accurately heard (69%); communication and scheduling was accommodating (77%); they contributed to the research project (69%); and they gained new knowledge on digital tools (54%) and dementia (85%). Research partner insights and ongoing member checking will inform future next steps towards improving dementia care coordination and communication using digital tools.
EMOTIONAL FUNCTIONING IN PEOPLE WITH DEMENTIA AND CAREGIVER AFFECT DURING DYADIC INTERACTIONS
Authors: Cozad Hannah , Chen Yuxuan , Brown Casey , Scheffer Julian A , Chen Kuan-Hua , Levenson Robert W
Published: December 2022

Dementia caregivers can experience negative affect when interacting with their care recipients. However, few studies have examined the specific factors that predict caregiver negative affect in this dyadic context. We hypothesized that deficits in care recipients’ emotional functioning would be associated with increased intensity of caregivers’ negative affect during interactions with their care recipient. Caregivers (Nf100) reported on two aspects of their care recipients’ emotional functioning: (1) emotion recognition (the ability to recognize other people’s emotions), and (2) negative emotional reactivity (the ability to generate negative emotional responses). Dyads then visited the laboratory and engaged in a 10-minute conversation about an area of conflict in their relationship. Caregivers then watched recordings of their conversation while rating the valence and intensity of their experienced affect using a rating dial. We used these ratings to quantify changes in caregivers’ emotional valence across the course of the conversation. Caregivers of care recipients with greater deficits in emotion recognition demonstrated greater increases in negative affect across the conversation. In contrast, care recipients’ negative emotional reactivity was not related to changes in the valence of caregivers’ affect across the conversation. Findings remained significant even after accounting for caregiver baseline valence ratings, biological sex, and age, as well as the care recipients’ diagnosis and level of cognitive impairment. Results reveal the important role that care recipients’ deficits in emotion recognition play in caregivers’ emotional lives. Caregivers’ negative affect may be more likely to increase when their care recipient has deficits in emotion recognition.
COGNITIVE STATUS AND HEALTH CARE UTILIZATION IN AN EMERGENCY DEPARTMENT: EARLY RESULTS OF A LONGITUDINAL PILOT STUDY
Authors: Dawson Walter , Spoden Natasha , Gothard Sarah , Wright Kirsten , Kaye Jeffrey
Published: December 2022

Many people living with Alzheimer’s disease and related dementias (ADRD) never receive a formal disease diagnosis. This compromises wellbeing and increases health services utilization and care costs. Wider screening and assessment for ADRD may increase access to supportive care, improve allocation of medical care, and foster interventions that prevent or delay disease progression. A sample of Medicare-enrolled individuals 65+ (n=60) consecutively presenting to the Oregon Health & Science University (OHSU) emergency department (ED) in Portland, Oregon consented to the study and were administered the TICS, a validated tool for telephone-based assessments of cognition, post-discharge from the ED. Study participants were asked about their physical health via the modified Cumulative Illness Rating Scale (M-CIRS), and their cognitive health via the PROMIS Cognitive Measure Questions on Mental Clarity. Care utilization patterns were measured via review of participants’ electronic health records (EHR) for three years prior to study enrollment focusing on total hospitalizations, ED visits, and primary care (PC) visits.Medicare-enrolled adults 65+ recently discharged from the ED were a feasible population to perform a cognitive assessment. The study enrollment rate was 24.2% (n=60). Enrollment was limited to patients with their PC affiliated with the OHSU health system, which excluded the majority (792, 73.8%) of ED patients Medicare-enrolled, 65+ from our study (1,072). This study provides preliminary evidence to support focusing on older ED patients to administer cognitive assessments, linking outcomes to the EHR, and ultimately providing a platform for future research on impacts of under-diagnosed ADRD on population-level health outcomes and care utilization.