bluuebunny/crossref_metadata_2025 huggingface dataset:
PLASMA PROTEIN BIOMARKERS AND THEIR CORRELATION TO COGNITIVE PERFORMANCE IN WOMEN LIVING WITH HIV
Authors: Li Wei , Wang Ge , Vance David , Li Daniel
Published: January 2025

Background

Individual plasma protein biomarkers have been shown to correlate to cognitive performance in people with HIV (PWH). This study aimed to investigate the association between plasma proteomic signatures and cognition in virologically well-controlled women with HIV (WWH).

Methods

Seventy-seven WWH from three Women’s Interagency HIV Study (WIHS) sites completed neuropsychological (NP) testing and a blood draw. Targeted protein biomarkers were analyzed using a multiplexing method. Random forest analysis was used to identify the top 10 positively or negatively biomarkers associated with cognitive function. Next, ingenuity pathway analysis (IPA) was used to facilitate data interpretation.

Results

Tumor necrosis factor receptor 1 (TNF RI), TNF RII, interleukin 1 receptor 1 (IL-1RI), and IL-6R are negatively associated with attention/working memory; IL-7 and CD40 are positively associated with executive function; IL-1RI, hepatocyte growth factor (HGF), transforming growth factor beta-1 (TGFβ1), TGFβ2, and sonic hedgehog (SHH) are negatively associated but IL-7 is positively associated with fluency; IL-9, IL-15, and IL-21R are positively associated with motor function; brain-derived neurotrophic factor (BDNF), HGF, SHH, and vascular endothelial growth factor (VEGF) are negatively associated with processing speed. HGF, VEGF, and insulin are negatively associated with the global NP function. Based on the IPA, one to three signaling networks were proposed for associating plasma biomarkers with each domain-specific or global NP function.

Discussion

It is likely that a panel of plasma protein biomarkers can be used to predict domain-specific or global NP function. Multiple signaling networks might explain cognitive functioning in WWH.
CHILDHOOD HOUSING AND OLD AGE HEALTH AMONG CHINESE: THE MEDIATION ROLE OF ADULTHOOD LIFE HISTORY
Authors: Kong Dexia , Lu Peiyi , Lou Vivian Weiqun
Published: January 2025

Housing insecurity is linked to worse health. However, very few studies examined this relationship from a lifecourse perspective and its underlying mechanisms. This study examined the association of childhood housing with old age health among Chinese and whether adulthood socioeconomic and medical history mediated that relationship. Respondents were middle-aged and older adults (aged 45+) from the China Health and Retirement Longitudinal Study (N=12,842). They were asked about their childhood housing conditions (e.g., if their houses had clean water, water closet, and electricity). Adulthood socioeconomic and medical history and middle- and old-age health were measured. Causal mediation analysis examined the pathways via which childhood housing affects health in later life. Results show about 28%-37% of respondents had access to electricity or energy for cooking/heating during their childhood. However, very few had access to clean water (6%) or water toilet (2%). Childhood better housing was directly associated with fewer depressive symptoms and better cognition in middle- and older age, and indirectly through increasing the likelihood of obtaining more education during adulthood. However, the proportion-mediated estimate had very wide confidence intervals to be certain. Other adulthood life history pathways (i.e., marital status, work and medical history) were not statistically significant. Our findings suggested targeting services among those who grew up in poor housing conditions may be crucial to promoting healthy aging.
MEDICAID HOME- AND COMMUNITY-BASED SERVICES IN THE WAKE OF THE COVID-19 PANDEMIC
Authors: Miller Edward , Beauregard Lisa
Published: January 2025

Medicaid, the joint federal-state health insurance program for people with low income, provides coverage for home and community-based services (HCBS). States have significant discretion to offer HCBS programs within federal regulations. The federal government matches state Medicaid program spending according to state per capita income, with the matching rate varying from 50% to 77.27%. The need to bolster Medicaid HCBS became evident during the COVID-19 pandemic. This recognition stemmed from the challenges of keeping people safe in nursing homes and the acute workforce shortages in the HCBS sector. This presentation examines two major federal developments and state responses in HCBS options as a result of the pandemic. The first initiative entails a one-year increase of the federal Medicaid matching rate for HCBS included in the American Rescue Plan Act championed by the Biden administration. The second initiative encompasses administrative flexibilities that permitted states to temporarily expand and modify their existing Medicaid HCBS programs. It concludes that the effects of the pandemic flexibilities and enhanced federal funding on most state HCBS programs will be limited without continued investment and leadership on the part of the federal government, a Biden administration priority. States that make the American Rescue Act and COVID-19 flexibilities initiatives permanent are states that have the fiscal resources and political commitment to expanding HCBS benefits that other states lack. States’ different approaches to bolstering Medicaid HCBS during the pandemic may contribute to widening disparities in access and quality of HCBS across states and populations who depend on Medicaid HCBS.
EXPLORING THE IMPACT OF ATTENDANCE IN AN OUTDOOR WALKING PROGRAM ON HEALTH IN OLDER ADULTS WITH MOBILITY LIMITATIONS
Authors: Su Tai-Te , Barclay Ruth , Moineddin Rahim , Salbach Nancy
Published: January 2025

Walking in an outdoor environment offers numerous health benefits for older adults with mobility limitations. Effects may vary, however, depending on the level of attendance. This study aimed to investigate whether a dose-response relationship existed between attendance in an outdoor walk group (OWG) program and improvement in health outcomes among older adults with mobility limitations. We analyzed data from a randomized controlled trial conducted across four cities in Canada and focused specifically on community-dwelling older adults assigned to a 10-week OWG program (n=79, age=74.7±6.6 years, 72% female). Participants were categorized into three groups based on attendance tertiles, with the first, second, and third tertiles corresponding to attending 0–9, 10–15, and 16–20 outdoor walking sessions in total. Outcomes were operationalized as change in scores on measures of walking endurance, comfortable and fast gait speed, balance, lower extremity strength, walking self-confidence, and emotional well-being pre- to post-intervention. Results from multiple linear regression models showed that, compared to those who attended 0–9 OWG sessions, participants who attended 16–20 sessions exhibited a 52.7-meter greater improvement in walking endurance (95% CI:12.3, 93.1); 0.15-meter/second greater improvement in comfortable gait speed (95% CI:0.00, 0.29); and 0.17-meter/second greater improvement in fast gait speed (95% CI:0.02, 0.33), after adjusting for sex and study site. No significant dose-response relationships for balance, lower extremity strength, walking self-confidence, and emotional well-being were observed. The role of attendance highlighted in this study provides critical information relevant to the design and implementation of outdoor walking interventions aimed at improving health among older adults.
RESTRICTED YET EXPANDED: EVOLVING MOBILITY OF OLDER ADULTS WITH COGNITIVE IMPAIRMENT IN URBAN CHINA
Authors: Yin Qingqing , Chen Lin
Published: January 2025

Cognitive impairment restricts older adults’ mobility within and beyond the neighborhood. Existing literature primarily focuses on the declining mobility of older adults with mild cognitive impairment (MCI) and the implications of such decline for this vulnerable group. However, how older adults with MCI experience their changing mobility has received limited attention. Informed by community gerontology and the preventive and corrective proactivity (PCP) model, this study aims to explore how older adults with MCI perceive and adapt to their changing mobility. Through purposive sampling, we took a phenomenological approach to conduct face-to-face, in-depth interviews with community-dwelling older adults with MCI in Zhengzhou, China (N = 34). By applying the geographic information systems (GIS), we spatially situated participants’ routine activities to visualize their changing mobility. Recognizing their cognitive decline, most participants voluntarily constrained their out-of-home activities within the neighborhood. Still, they tried to keep a strong grip on the existing mobility and prolong independent living as much as possible. One of the most useful strategies was to take advantage of their social networks in the neighborhood. Social interactions and mutual support created new opportunities for participants, which facilitated their out-of-home mobility even beyond the neighborhood. Their restricted mobility in the physical environment was thus continually defended and expanded by the social environment. The findings of this study inform the importance of promoting neighborhood built and social features to support older adults with different levels of cognitive and mobility functioning.
ALTERNATIVE SPLICING DYNAMICS IN MYOGENESIS: A TRANSCRIPTOMIC ATLAS FOR HUMAN SKELETAL MUSCLE CELLS
Authors: Donega Stefano , Banskota Nirad , Yang Jen-Hao , Rossi Martina , Tsitsipatis Dimitrios , De Supriyo , Gorospe Myriam , Ferrucci Luigi
Published: January 2025

Myogenesis entails the fusion of myoblasts to form multinucleated myotubes. Although alternative splicing (AS) in myogenesis has been explored in non-human species, its characterization in humans remains incomplete, both in vitro and in vivo. We studied two human skeletal muscle cell lines (AB1167 and AB678) over a 5-day differentiation period, with RNA samples collected every 24 hours. Utilizing a Hybrid RNA-sequencing approach (combining short and long-read sequencing), we applied linear regression in Differential Gene Expression (DGE) and Likelihood Ratio Test – Hierarchical Clustering models (LRT-HCl), and discovered 3,079 upregulated genes and 2,357 downregulated genes in the overlapping models. Gene Set Enrichment Analysis (GSEA) highlighted pathways related to muscle formation and contraction showing upregulation, while those associated with nuclear separation and DNA synthesis were downregulated until day 3, followed by an increase in inflammation and interferon-like pathways by day 5. Differential Transcript Usage analysis (DTU) identified 2,584 myogenesis-dependent isoform-switches, which were primarily linked to actin-filament processes and muscle regulation. Validation of the models was conducted for the top 5 genes using qPCR. Additionally, three novel protein-coding genes associated with muscle differentiation were identified through an Alphafold-based computational pipeline and validated via qPCR. Comparison of clusters within a 0–3-day model with a Peripheral Artery Disease (PAD) dataset confirmed significant enrichment of up-regulated clusters observed in the myogenesis model. This project aims to establish a comprehensive transcriptomic atlas for myogenesis models and set a benchmark for future research in the multi-omic fields of muscle biology.
EXERCISE AND NUTRITION ON SARCOPENIA AND FUNCTIONAL SARCOPENIA: FINDINGS FROM RANDOMIZED CONTROLLED TRIALS
Authors: Ji Sunghwan , Jang Il-Young
Published: January 2025

The Korean Working Group on Sarcopenia (KWGS) established guidelines for diagnosing sarcopenia, introducing the concept of functional sarcopenia. However, the effectiveness of exercise and nutrition interventions among sarcopenia and functional sarcopenia based on these guidelines remains unexplored. To address this gap, we recruited 86 older adults with sarcopenia and 42 with functional sarcopenia from a rural Korean community, randomly assigning them to intervention and control groups in a 1:1 ratio. Sarcopenia was defined by low grip strength and/or low physical performance with low muscle mass, while functional sarcopenia was identified by low grip strength and low physical performance with preserved muscle mass. Participants in the intervention group underwent group exercises and a nutrition program for 24 weeks. Comprehensive geriatric assessments were conducted for both groups before and after the interventions. The primary outcome measure was the change in gait speed, with additional sarcopenia-related parameters also compared. The intervention group showed significantly greater improvement in gait speed in both sarcopenia (mean change (m/s) 0.14 vs. -0.04; p< 0.001) and in functional sarcopenia (0.24 vs. 0.00, p< 0.001). Furthermore, the intervention group exhibited greater improvement in short physical performance battery score, grip strength, quality of life in both sarcopenia and functional sarcopenia. There were no significant differences in muscle mass or clinical frailty scale between the intervention and control groups. In conclusion, exercise and nutrition interventions were beneficial for physical performance and muscle strength in sarcopenia and functional sarcopenia according to KWGS guidelines, among community-dwelling Korean older adults. (Registration number: KCT0008952, KCT0008953)
DIETARY INFLAMMATION AND FALL RISK IN THE ELDERLY: DII AND E-DII SCORE ANALYSIS FROM THE HEALTH AND RETIREMENT STUDY
Authors: Fallahi Afsaneh , Lohman Matthew , Hebert James , Price Sherry
Published: January 2025

Background and Objective

The Dietary Inflammatory Index (DII) and Energy-adjusted DII (E-DII) are quantitative tools assessing the inflammatory potential of a diet, but these metrics have seldom been applied or compared in a large representative population of older adults. This study aims to calculate and evaluate the association of these indices with fall risk in the elderly.

Methods

DII and E-DII scores were computed for a subsample of 8,035 respondents from the 2013 Health Care and Nutrition Study (HCNS), integrated within the Health and Retirement Study (HRS). Using self-reported data from the Harvard FFQ for 33 out of 45 nutrient parameters, individual DII, and E-DII (adjusted per 1000 kcal intake) scores were computed. Using 2022 HRS data on the history of falls, which was measured binary, and after adjusting for other covariates, logistic regression analyses in SAS software were conducted to assess the associations of interest.

Results

The mean DII score was 0.56 (SD = 2.74) and the E-DII was -0.08 (SD = 2.01). The DII model showed no significant association with fall risk (F-value: 0.85, p = 0.36). Conversely, the E-DII model demonstrated a significant inverse association (F-value: 10.49, p= 0.0012) with an E-DII coefficient of -0.059, p = 0.00012.

Conclusion

Results suggest that higher anti-inflammatory diets, according to E-DII scores, are associated with a lower fall risk among the elderly. E-DII may better reflect the diet’s impact on health outcomes. Keywords: DII, E-DII, HRS, Falls, Older Adults
EFFECT OF D-ALLULOSE ON INSULIN RESISTANCE AND ENDURANCE ABILITY: IS D-ALLULOSE AN EXERCISE MIMETIC?
Authors: Koike Teruhiko , Gou Yang , Liu Bingyang , Natsume Yukie , Tsuzuki Takamasa , Shahriar Kamal , Banno Ryoichi
Published: January 2025

D-Allulose, a rare sugar and C3-epimer of D-fructose has been proposed as a candidate for dietary restriction mimetics via inhibition of glycolysis. Anti-hyperglycemic and anti-obesity effects have been reported in rodents and human subjects. Here, we report that D-allulose increases the glucose infusion rate in the two-step hyperinsulinemic-euglycemic clamp test in high-fat or high-sucrose diet-fed rat models. Consistently, the insulin-induced phosphorylation of AKT in the skeletal muscle was higher with D-allulose administration with decreased levels of inflammatory cytokine, TNF-α. We also report the effect of D-allulose on insulin sensitivity and aerobic performance in a healthy mice model and compare them with exercise training effects. D-allulose enhanced insulin sensitivity, increased running distance, and maximal aerobic speed (MAS). The improved exercise performance was associated with lower blood lactate levels and increased liver glycogen contents. D-allulose also enhanced the phosphorylation of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC), and the expression of peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α). Our results indicate that D-allulose administration improves insulin sensitivity and enhances endurance ability like exercise training.
PILOT NUTRITION EDUCATION PROGRAM FOR VETERANS LIVING WITH DEMENTIA AND THEIR CAREGIVERS
Authors: Giffuni Jamie , Barton-Ort Kelly , Dennis Elizabeth , Addison Odessa
Published: January 2025

The prevalence of dementia is expected to increase as the Veteran population ages. Caring for a Veteran with dementia impacts the physical and mental health of the caregiver. Programs are needed to support the health and wellbeing of both Veteran and caregiver. Vets & Veggies is a whole health(y) aging program that provides free produce to Veterans visiting the Geriatric Wellness Center. This project describes the development of a novel, pilot nutrition program combining nutrition education with kitchen skill development and fresh produce access for Veterans living with dementia and their caregivers, Vets & Veggies for Caregivers (V&VC). One-hour in-person classes led by a registered dietitian with experience in geriatrics occurred weekly for 4 weeks. Topics included: Feeding tips for Caregivers/Caring for YOUR nutrition; MyPlate/Healthy Eating for Older Adults; the importance of protein intake; cooking with spices/low sodium cooking. Participants received free produce with recipes/tips for use, and adaptive kitchen equipment for safe preparation by the Veteran. Behavioral Risk Factor Surveillance System – Fruit and Vegetable Module, Caregiver Self Efficacy 8-Item Scale, Zarit Caregiving Burden 6-Item Survey, and the Mini Nutritional Assessment were completed by the caregiver pre and post-program. Two Veteran/caregiver dyads and one caregiver attended all classes with small positive trends in fruit and vegetable intake, decreased caregiving burden score, and improved nutrition assessment score. Participants enjoyed and looked forward to the classes. This pilot program demonstrated feasibility for developing and implementing a program designed to improve the whole health of Veterans living with dementia and their caregivers.
VETS AND VEGGIES: FEASIBILITY OF OFFERING A FREE ONSITE FARMER’S MARKET TO OLDER VETERANS
Authors: Dennis Elizabeth , Drumheller Jake , Barton-Ort Kelly , Giffuni Jamie , Beans Jeffrey , Addison Odessa
Published: January 2025

This project evaluated a 6-month, free, onsite farmer’s market offered through Gerofit, a health promotion program for older Veterans. Each week, 4-8 fresh produce items were delivered to the Gerofit gym facility as a strategy to overcome barriers related to fresh produce access. Participants self-selected items, taking as many or few items as preferred. Gerofit staff sent weekly emails with suggested recipes for produce preparation and recorded weekly leftover produce. An end of season administered questionnaire assessed Veterans’ perceived impact on diet, reasons for choosing weekly produce items and open-ended feedback. The most common weekly leftover items were leafy greens (e.g., lettuce, chard) and squash. Of 25 participants who completed questionnaires, 60% reported eating new types of produce because of the farmer’s market. Eleven participants reported trying a new item specifically because of Gerofit staff recommendations. When asked why they didn’t choose specific items, 15 reported being unsure of preparation methods and 10 reported disliking the item. When asked what participants did with the produce received, most (84%) said they cooked it using their own recipe. Nineteen participants (76%) reported that the farmer’s market saved them money, 72% reported that it made it easier for them to eat healthier, and 60% said it helped them eat a wider variety of produce. Veterans rated the weekly produce 9.7/10 (1-10 scale; 10 being most helpful). Future studies are needed to implement and evaluate strategies designed to increase overall participation, encourage trying new produce, and reduce weekly food waste.
EVALUATION OF PHARMACY-BASED RECOMMENDATIONS WITHIN A COMPREHENSIVE GERIATRIC ASSESSMENT TEAM
Authors: Cervantes Maria , Patel Nikil , Tillmann Jacob , Cigolle Christine , Bieber Heather , Dunlap Janette , Phillips Kristin
Published: January 2025

Background

Rural older Veterans face unique challenges in managing multiple chronic conditions. A novel, virtual Comprehensive Geriatric Assessment (CGA) clinic, at a southeastern Veterans Affairs (VA) medical center, aimed to optimize medications for this population. The objective of this study is to evaluate the geriatric clinical pharmacist (GCP) recommendations and their implementation for the CGA patients’ medication regimens.

Methods

The study performed electronic health record review of North Florida/South Georgia VA CGA patients, focusing on GCP recommendations targeting potentially inappropriate medications (PIMs) and polypharmacy. Recommendations were categorized as: discontinue, switch, taper, request further provider review, address polypharmacy. Recommendations were evaluated as to whether they were implemented and when the implementation occurred.

Results

The study population consisted of 273 Veterans. 86 Veterans received no recommendations. The GCP provided 323 recommendations for 187 Veterans, with 156 (48.3%) implemented. Recommendation uptake was highest for requesting provider review of a medication issue (58%); it was lowest for switching medications (27.9%). Implemented recommendations regarding medication categories included: non-anticholinergic BEERs Criteria medications, 36.3%; anticholinergic medications, 41.8%; hypoglycemic or hypotensive risk medications, 69%; general polypharmacy issues, 42.9%; other medications, 56.7%.

Conclusion

This virtual GCP intervention, as part of a broader virtual CGA clinic, demonstrated successful implementation of deprescribing and medication optimizing recommendations, resulting in reduction in use of PIMs and polypharmacy in rural older rural Veterans. The intervention also resulted in increased collaboration with PCPs. Future evaluation needs to study the intervention’s long-term outcomes in decreasing polypharmacy and increasing medication safety for this vulnerable population.
OPTIMIZING POLYPHARMACY CARE: INSIGHTS FROM PHARMACISTS INFORMING A POPULATION HEALTH APPROACH
Authors: Tantipinichwong Nicha , Mustafa Dina , Avidon Irina , Rosen Sonja , Keller Michelle
Published: January 2025

Over 60% of older adults grapple with multimorbidity (more than one chronic condition), while polypharmacy (taking four or more medications) is prevalent in 65% of cases. Polypharmacy correlates with adverse outcomes such as mortality, falls, fractures, hospitalizations, and decline in functionality and cognition. Many health systems lack systematic monitoring of polypharmacy and its consequences. To address this, we aimed to develop a population health outcomes dashboard for a large urban health system, focusing on polypharmacy outcomes. We also aimed to increase the effectiveness of our polypharmacy consults. Our qualitative study, employing Framework Analysis, involved interviews with eight clinical pharmacists conducting polypharmacy medication review consults for older adults. We aimed to identify challenges, enhance clinic efficiency, and pinpoint data and outcomes for tracking on the dashboard. Major challenges included time constraints due to lengthy medication lists, lack of documentation of herbal supplements on medication lists, and patients’ readiness for consultations. Opportunities for efficiency improvement included pre-consultation patient preparation, streamlined note templates, and prioritizing intervention elements in each visit. Beyond clinical and disease-related outcomes, valuable dashboard measurements encompassed patients’ and physicians’ perceived benefits (e.g., improved medication adherence). These findings will guide enhancements to the polypharmacy clinic workflow and provide insight for the development of the polypharmacy outcomes and interventions dashboard.
THE ROLE OF SOCIODEMOGRAPHIC FACTORS IN COMMUNITY-BASED REHABILITATION USE AFTER HIP ARTHROPLASTY
Authors: Bove Allyn , Bise Christopher , Terhorst Lauren , Allen Kelli , Magnani Jared , Delitto Anthony , Freburger Janet
Published: January 2025

Community-based rehabilitation in the home health and outpatient settings is an important element of recovering function after total hip arthroplasty (THA). While there is ample evidence confirming sociodemographic differences in THA rates and short-term outcomes (e.g., post-operative complications), it is unclear whether there are differences in use of rehabilitation after THA. We analyzed 5 years of data (2017-2021) from a large health system on patients who received rehabilitation in the home health (n=6577) and/or outpatient setting (n=3,094) after THA. We estimated several regression models to examine the separate associations between sex, race, area deprivation, or rural residence with the number of visits and length of care in home health and outpatient settings, adjusting for age, hospital, hospital length of stay, non-home discharge, comorbidities, and marital status. Female sex was associated with greater rehabilitation use for 3 of 4 outcomes: number of home health visits (p<.001), number of outpatient visits (p=.04), and length of outpatient care (p<.001), but not length of home health care. High area deprivation was associated with higher use of home health visits (p<.001), but not length of the episode of home health care or outpatient rehabilitation use. Rural residence was associated with fewer home health visits (p=.04) and shorter outpatient episodes of care (p=.02). Race was not significantly associated with any of the outcomes. Overall, results were mixed, with rural residents generally receiving less post-arthroplasty rehabilitation, and women and those residing in more-deprived neighborhoods receiving more rehabilitation services.
TRAINING ASIAN AND WHITE FAMILY CAREGIVERS LIFE REVIEW DEPRESSION INTERVENTION: A MIXED-METHODS COMPARATIVE STUDY
Authors: Miyawaki Christina , McClellan Angela , Bouldin Erin
Published: January 2025

Approximately 10% of older Americans living with Alzheimer’s dementia experience depression, yet behavioral interventions remain scarce. We developed a 6-week depression intervention, Caregiver-Provided Life Review (C-PLR) based on life review therapy. The purposes of this study were to examine the feasibility of training Asian and White family caregivers in life review skills and examine the impact on care recipients’ depressive symptoms as 77% of Asian dyads conducted the study in their native language. Using a mixed-methods design, Asian (n=15: 7=Chinese, 4=Japanese, 2=Vietnamese, 1=Filipino and Korean) and White (n=25) caregiver-care recipient dyads were trained. We measured care recipients’ pre- and post-intervention depression (primary outcome), life satisfaction, caregivers’ burden, rewards of caregiving, and dyads’ relationship quality (secondary outcomes) scores, and compared them by paired t-tests. We evaluated the feasibility of caregivers’ training by fidelity check-in scores. All dyads completed the study. Asian (mean age=52 years) and White (60 years) caregivers were working, female, and in good/excellent health. Their care recipients (Asian=82 and White=80 years) were female and in poor/fair health. Both Asian and White care recipients’ depression and dyads’ relationship from baseline to post-intervention significantly improved (Asian=1.9, p< 0.001; 0.9, p=0.029; White=1.0, p=0.034; 0.6, p=0.033, respectively). Both caregivers’ fidelity scores were identical and similarly high (15.4; 15.3, p=0.91). Qualitative interviews of both caregivers supported the sentiments of the quantitative results. The language of Asian dyads appeared no influence on any outcomes. This study demonstrates that the C-PLR can be added to a list of successful non-pharmaceutical interventions for Asian and White older adults.
BRIDGING SOCIAL GAPS WITH THE VIRTUAL FRIENDLY VISITORS INITIATIVE
Authors: Gordon Barbara , Yankeelov Pamela , Faul Anna , Miceli Chelsea , Cotton Samantha
Published: January 2025

Social isolation affects one in four older adults aged 65 and over, significantly increasing the risk of premature death and dementia. The COVID-19 pandemic exacerbated this isolation, highlighting the urgent need for strategies to foster connections among older adults. Utilizing COVID-Cares Act funds, our Geriatrics Workforce Enhancement Program (GWEP) transformed the Friendly Visitors Program into a virtual initiative (VFVP), distributing tablets to enable social engagement through virtual visits. Ninety-six older adults actively engaged with 45 volunteer visitors across 601 virtual visits. The areas of interaction revolved around life reviews, family support, validating feelings, social determinants of health and hobbies. Evaluation data indicates improved mood, increased awareness of community resources, and high levels of satisfaction with the program. These visits led to the identification of changes in biological and behavioral health, home health needs, and neglect concerns by the visitors, resulting in appropriate referrals. VFVP not only improved mood and social engagement among participating older adults but also played a crucial role in monitoring health, connecting participants with vital resources, and assisting with environmental challenges to support independence. This success underscores the importance of community and technology in combating isolation and promoting the well-being of older adults, highlighting the potential of virtual programs. In this presentation, our team will explore the critical role friendly visitors play in monitoring health conditions. The session will also examine how friendly visitors can act as vital links between older adults and essential community resources, ensuring that needs ranging from nutrition to mobility are met.
COMMUNITY ORGANIZATIONS’ OUTREACH AND SERVICE DELIVERY TO OLDER ADULTS LIVING WITH DEMENTIA AND FAMILY CAREGIVERS
Authors: Lee Kathy , Cassidy Jessica , Jang Soeun
Published: January 2025

The current study examined various types of social services for older adults living with Alzheimer’s disease or related dementia (ADRD) and their family caregivers, as well as the methods of delivery employed by home- and community-based organizations. Using a qualitative study design, this study aimed to identify strategies for enhancing support for older adults with ADRD and their family caregivers. A convenience sample method was employed to recruit service providers from nine home- and community-based organizations working closely with older adults living with ADRD and their family caregivers. Semi-structured, individual interviews were conducted online and transcribed verbatim by professionals. Three themes emerged: (1) culturally tailored outreach and services, (2) engagement of older adults living with ADRD and their family caregivers, and (3) collaboration efforts between home- and community-based organizations. Our findings revealed that organizations have tried creative ways to reach their population and educate people on dementia and dementia care. Especially, nonconventional methods (e.g., religion-based outreach or edutainment – an approach combining educational content with entertaining/easy-to-understand elements, such as storytelling or drama) were more frequently discussed among organizations serving people from diverse cultural and ethnic backgrounds. While many organizations have adopted technology to deliver services, many mentioned technologies were not a long-term solution, specifically for older adults with ADRD, as non-verbal cues such as eye contact and physical touch were considered critical for communication and providing care for older adults with ADRD.
COMMUNITY RESOURCE AWARENESS AND REFERRAL PRACTICES OF HEALTH CARE PROVIDERS TO SUPPORT OLDER ADULTS
Authors: Rudolph Catherine , Francis Sarah , Bauman Alexandra
Published: January 2025

There is mounting evidence that social determinants of health (SDOH), such as housing, income, and food insecurity, have a significant impact on health outcomes. Support for SDOH is vital to ensuring optimal well-being among older adults and preventing unnecessary strain on healthcare resources. Successful partnerships between healthcare and community-based services can help to identify and address the SDOH affecting aging adults’ health. This study examined SDOH screening and intervention practices among healthcare providers, and their awareness and partnerships with community-based food and nutrition services. A nationwide online survey was completed by 160 U.S. healthcare providers who provide care to adults over 60. Descriptive statistics were conducted to assess screening and referral practices. Associations between these practices and provider characteristics are being assessed via Chi-square analyses. SDOH screening was highest for healthcare access, mental health, and food insecurity and lowest for social isolation and transportation. Respondents were most aware of and referred older patients to food pantries, the Supplemental Nutrition Assistance Program, and nutrition education. They were least aware of the Senior Farmers’ Market Nutrition Program, Congregate Meal Program, and nutrition counseling. A majority shared that their healthcare practice has a protocol for community-based referrals. Paper handouts and verbal information were primary referral methods. Common referral barriers were staffing shortages and lack of program access. Over one-half expressed high/very high interest in learning more about community-based food and nutrition services. These findings can inform strategies and opportunities for partnership between healthcare and community-based services to address the needs of aging adults.
EDUCATION AS A MEDIATOR THROUGH THE EFFECT OF AGE AT MIGRATION ON COGNITIVE HEALTH AMONG OLDER IMMIGRANTS IN THE US
Authors: Hong Dongfang , Dong Wuyi
Published: January 2025

Background

Age at immigration is a critical determinant that influences long-term cognitive outcomes among older adults, often through disruptions or enhancements in educational opportunities. Previous research has underscored the importance of educational attainment as a key factor in cognitive resilience and decline. The mediating role of education in the relationship between the timing of immigration and cognitive function remains underexplored. This study addressed whether age at migration is associated with cognition among older immigrants whether education mediates this association?

Methods

Data were taken from the 2020 Health and Retirement Study (N=1,587). Linear regression is employed to examine the direct association between age at migration and cognitive function and the indirect association through years of completed education.

Results

This study revealed a significant association between age at immigration and cognitive function, with immigrants who migrated during young adulthood (ages 18-40) displaying notably lower cognitive function compared to those who migrated at younger ages (before 18). The results also provided evidence for the partial mediation of educational attainment for the association between age at immigration and cognitive function. This indicated that disruptions in education due to migration contribute to cognitive outcomes.

Discussion

This study contributed to our understanding of how immigration timing and educational attainment intersect to affect cognitive function, with implications for policy and intervention strategies aimed at supporting the cognitive health and educational opportunities of immigrant populations. Future research should consider additional mediators, such as socioeconomic status and social support, to further elucidate these relationships
EDUCATION, ADULT LITERACY, AND HEALTH AMONG MIDDLE-AGED AND OLDER IMMIGRANTS IN THE UNITED STATES
Authors: Narine Donnette , Yamashita Takashi , Chidebe Runcie , Cummins Phyllis , Kramer Jenna , Karam Rita
Published: January 2025

The education-health pathway is well-documented whereby greater human capital such as educational attainment can provide health benefits over the life course. However, there is evidence of diminishing health benefits from education for immigrants compared to non-immigrants, partially due to structural factors (e.g., health insurance) limiting health-related benefits among immigrant populations. Older immigrants are more likely to be college-educated compared to their non-immigrant counterparts. However, the decades-old degrees from their home countries, along with English not being their native language, pose a particular concern for older immigrants’ health. As formal educational attainment cannot be easily promoted among older populations, adult literacy proficiency is another useful form of foundational human capital indicator, which is malleable at any life stage. This study examined the mediation effect of adult literacy proficiency on the education-health pathway among middle-aged and older immigrants in the United States. The nationally representative sample of immigrants aged 45 years and older (n = 590) in the 2012/2014/2017 U.S. Program for International Assessment of Adult Competencies (PIAAC) restricted-use file (RUF) data were analyzed. The mediation analysis showed that the association between educational attainment (college vs. less than college degree) [95% Confidence-Interval (CI): Lower-Limit (LL), Upper-Limit (UL) = 0.168, 0.780] and health (good vs. fair/poor) was mediated by adult literacy proficiency scores (0 to 500 points) [95% CI: LL, UL = 0.053, 0.352] among older immigrants in the United States. Findings from this study are informative to future interventions to support the health of older immigrants by way of adult literacy training.
INCREASING CHILDREN’S EDUCATION IMPROVES PARENTAL DEMENTIA RISK AND REDUCES GRADIENTS IN RISK
Authors: Luo Liying , Warren John , Xu Jiahui , Langa Kenneth
Published: January 2025

Recent research suggests that adult children’s education may influence their parents’ health at older ages. The empirical evidence about this upstream influence remains somewhat mixed, however. This is due in part to differing methodological approaches. To account for intergenerational selection and interdependent pathways, we use multilevel marginal structural models and well-defined casual estimands to analyze longitudinal data from the Health and Retirement study. We ask two important questions: (1) At the individual level, for whom does children’s education convey health benefits in older ages? (2) At the population level, what are the implications of increasing education levels among younger generations for (a) the health and well being of their parents’ generation and (b) educational disparities in health and well being? Our analyses suggests that at the individual level, increasing levels of children’s education decreases parents’ dementia risk. At the population level, educational disparities in dementia risk may be reduced as younger generations obtain more education.
LOVE HURTS: MARITAL STATUS AND CHRONIC PAIN
Authors: Choi S Emily , Wagner Brandon
Published: January 2025

While chronic pain is a highly prevalent and costly public health concern among older adults in the United States, longitudinal research on the social determinants of chronic pain, particularly its association with social relationships, has been limited. To address this gap, this study investigates how marital status influences later-life chronic pain with a focus on gender-specific variations. Drawing on the Health and Retirement Study (1998–2016), we estimated fixed effects logit models using an analytic sample of community-dwelling American adults aged 50 and above (N = 19,975). At baseline, women reported moderate-to-severe limiting pain (27.07%) significantly more frequently than did men (19.41%). Among men, unmarried groups, specifically the divorced/separated [OR = 0.72] and the widowed [OR = 0.55], had significantly lower odds of experiencing moderate-to-severe limiting pain compared to married individuals, controlling for demographic characteristics, socioeconomic status, health conditions and health behaviors. Among women, only the widowed had significantly lower odds of experiencing moderate-to-severe limiting pain [OR = 0.72] compared to their married counterparts. These findings suggest that though intimate social relationships may be important risk factors in shaping chronic pain in later life, they do so in perhaps surprising ways.
SOCIAL DETERMINANTS, LONELINESS, DEPRESSION, AND CHRONIC ILLNESS FOR MIDLIFE AND OLDER ADULTS IN APPALACHIA
Authors: Theeke Laurie , Hutto Lashawn , Smith LaTonya
Published: January 2025

Loneliness constitutes a significant health risk among midlife and older adults in Appalachia. This study presents a secondary data analysis exploring relationships among social determinants of health, loneliness, depression, and chronic illness. Common variable data from two prior studies that collected data from adults at a family health center was used for the analysis. The sample of 150 adults (88 women) ranged in age from 46 to 91years (mean 63.5, SD11.16) with mean loneliness score of 39.5 (SD11.13)- indicating high loneliness and averaged 3.2 (SD 1.88) chronic illnesses which increased with age. Over 40% were married with 74% living with others. An associate degree or higher was earned by 46%. Though 69.3% worked full-time, 43.3% reported income below $40,000 annually. Age inversely correlated with loneliness (p =.04) and depression scores (p <.001). Loneliness highly correlated with depression (p,.001) and inversely correlated (p <.01) with emotional, tangible, affective, positive, and total social support. Loneliness correlated with resting heart rate (p <.001) and body mass index (p=.05) but not with blood pressure. Men had higher loneliness (p=.027) and were more frequently diagnosed with hyperlipidemia, heart disease (p=.047), hypertension (p=.049), and stroke (p=.004). Women had higher scores for social support (p=.005) and functional ability. Findings highlight inequities in health for older adults, particularly men, living in Appalachia. Future studies are planned for larger cohort studies to better explicate psychophysiological pathways from loneliness to illness in this population and to examine the effectiveness of LISTEN, an intervention designed to target loneliness that demonstrated effectiveness in this population.
SOCIAL ENGAGEMENT IS ASSOCIATED WITH COGNITION IN OLDER ADULTS FROM UNDERSERVED QUILOMBOLA COMMUNITIES IN BRAZIL
Authors: Simon Sharon Sanz , Cappi Carolina , Junior João Cabral , Alves Gilberto , de Oliveira Bruno Carneiro Alves
Published: January 2025

Quilombos are settlements founded by descendants of runaway slaves in Brazil, typically located in rural areas. Quilombola communities often present poor basic sanitation, high levels of illiteracy, and limited access to social and health services. Although the Quilombola population is socially vulnerable and likely to present an increased risk for dementia, it is underrepresented in aging research. The present study aims to investigate the association between cognition and socio-cultural engagement, potentially protective for dementia. Method: This cross-sectional study was conducted in 11 Quilombola communities in Maranhão, Brazil. The study comprised 221 older adults (60-104 years), selected in partnership with local services and community health workers. Participants completed a health survey and a cognitive screening. Demographics, cardiovascular risk factors (CRF), cognitive performance, and social engagement were described. Regression analysis examined the association between social engagement and cognition, controlling for age, sex, race, education, family income, and cardiovascular risk factors. We also examined moderation effects of sex and age on the regressions.

Results

Higher social engagement was associated with better cognition (p <.001) above and beyond demographics and CRF. We observed the social activities that mostly drove the results were attending “community meetings” and “religious/faith services”. Age and sex did not moderate the associations.

Conclusion

Social engagement may be a key aspect of cognitive/brain health in Quilombola population. Social engagement may not only provide social/emotional support, but also facilitate access to basic needs. Although the results are limited by the cross-sectional design and survival bias, it may inform strategies in underserved populations.
UNIQUE STRATEGIES AT CEDARS-SINAI TO SCREEN FOR AND ADDRESS SOCIAL DETERMINANTS OF HEALTH IN OLDER ADULTS
Authors: Rosen Sonja , Cohen Emma , Hren Katie , Harris Christina , Green Krystal
Published: January 2025

To effectively address health disparities and bridge systemic gaps between health and social care, healthcare institutions must cohesively address shortcomings in identifying, supporting, and monitoring social determinants of health (SDoH) to better serve communities. In 2021, Cedars-Sinai, a Los Angeles urban Academic Medical Center, launched a robust strategy to address SDoH needs across health system settings. Cedars-Sinai’s SDoH strategy includes a customized 12-domain screener to identify patients unmet social care needs and additional workstreams to support patient and community needs, including an electronic resource referral platform, an inaugural Community Health Worker (CHW) program, and a network of community-based organizations (CBOs) with accountable referral pathways. As one of the largest Medicare providers in the region, and serving more older adults over the age of 80 than any other academic medical center, this SDoH strategy included tailored interventions for older adults such as embedding a CHW within the geriatrics outpatient practice and cultivating community partnerships with CBOs experienced in serving older adults. In the first 2.5 years of Cedars-Sinai’s SDoH strategy, 97,757 older adult patient screenings identified 30,245 unmet HRSN needs; 411 of these older adult patients received CHW support, 61.24% of whom were successfully connected to resources. These systemwide efforts highlighted that older adults experience more nuanced SDoH inequalities fueled by aging-specific structural barriers and succeed with greater dosages of social care interventions. Findings from Cedars-Sinai’s approach to SDoH has demonstrated that healthcare institutions are most effective in addressing SDoH through comprehensive strategies that create population-specific solutions in tandem with screening.