bluuebunny/crossref_metadata_2025 huggingface dataset:
PAN-CANADIAN ESTIMATES OF THE PREVALENCE ASSOCIATED WITH CRITICAL WANDERING AMONG HOME CARE CLIENTS
Authors: Miguel-Cruz Antonio , Perez Hector , Jantzi Micaela , Liu Lili , Hirdes John P
Published: January 2025

Wandering is a behaviour common in people living with dementia. Persons living with dementia are at increased risk of getting lost and going missing due to critical wandering. However, the evidence is inconclusive. We used 17 years of cross-sectional clinical assessment records from home care services based on interRAI Home Care assessments to provide Pan-Canadian estimates of the prevalence and clinical risks associated with recent critical wandering. (n=1,598,191). The main clinical variable of interest was recent occurrence of critical wandering. We tested associations between wandering and dementia and cognitive impairment. In all the study regions combined, the overall rate of recent wandering is 3.0%, representing 48,641 unique individuals. The sample was comprised of mainly older adults, with 84.3% over the age of 65. The sample was also predominately female (60.9%). A dementia diagnosis including Alzheimer’s disease or other dementias was present in 23.6% of the sample. Dementia was strongly associated with the prevalence of recent wandering Chi-squared(1, N=1,598,191) = 101,298.866, p < 0.0001). Cognitive impairment was also strongly associated with the prevalence of recent wandering Chi-squared(1, N=1,598,191) = 155,414.738, p < 0.0001). Our analyses also show that persons with wandering behaviour experience many different additional clinical problems that can pose important risks to their health and would require attention of first responders and health professionals. interRAI HC offers insights into wandering risk and health profiles of home care client. This information should be used to manage risk in the community and should be shared with first responders where appropriate.
ASSOCIATION OF SYSTEMIC IMMUNE-INFLAMMATION INDEX ON THE RISK OF STROKE IN AMERICAN ADULTS
Authors: Qiu Xichenhui , Huang Yiqing , Wei Changning , Wang Qun
Published: January 2025

Background

Chronic inflammation is associated with various health consequences, including cardiovascular diseases and cancer. The systemic immune-inflammation index (SII) and system inflammation response index (SIRI) have emerged as novel inflammatory and prognostic markers. However, the relationship between SII, SIRI, and stroke risk in representative populations remains understudied. This study aimed to investigate the association between SII, SIRI, and stroke risk in US adults.

Methods

A cross-sectional investigation utilized datasets from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2018. Multivariate regression models were employed to assess the relationship between SII, SIRI, and stroke risk. Nonlinear relationships were described using smoothing curves and a two-tailed linear regression model. Subgroup analysis and interaction tests were performed to assess relationship stability.

Results

The study included 36,129 adults aged 20 to 85 years. The analysis revealed a significant positive association between stroke risk and both SII (OR = 1.27, 95% CI = 0.98 to 1.65, p for trend = 0.0438) and SIRI (OR = 1.49, 95% CI = 1.13 to 1.97, p for trend= 0.0016) after adjusting for confounding factors.

Conclusion

Elevated levels of SII and SIRI are associated with an increased risk of stroke in US adults. These findings underscore the importance of managing inflammatory indices as potential interventions to mitigate stroke risk.
COMPARE FRAILTY IN OLDER ADULTS AND NONOLDER ADULTS WITH HEART FAILURE
Authors: Hsieh Jenny , Chou Pi-Ling
Published: January 2025

Frailty is commonly presented among patients with chronic diseases, including heart failure(HF), leading to poor prognosis. However, the association between age and frailty in patients with HF remains unclear. Therefore, our study aims to compare the difference in frailty status in older and non-older adults with chronic HF symptoms. A cross-sectional study was conducted, where data was collected between January 1, 2023, and January 31, 2024. Participants were recruited from cardiology departments of two hospitals in southern Taiwan (N=110). Instruments measuring frailty included the Frailty Phenotype Criteria (FPC) and Clinical Frailty Scale(CFS). Data analysis was conducted using R version 4.3.2. In our study, we observed pre-frailty and frailty in older adults with proportions of 49.1% (n=26) and 22.6% (n=12) according to FPC, respectively. For non-older adults, the proportions were 36.4% (n=16) and 18.1% (n=5), respectively. The CFS revealed that 50.8% (n=31) of older adults exhibited frailty, while 38.8% (n=19) of non-older adults did. No significant difference was observed in frailty status between older and non-older adults, as indicated by both the FPC (p = 0.21) and the CFS (p = 0.29). The findings suggested a high prevalence of frailty in patients with heart failure, irrespective of age group. Our results indicated that frailty was a functional decline not limited to older adults. This study highlighted the importance of frailty assessments in patients with heart failure symptoms across all age groups, providing an evidence base to innovate potential strategies to promote improvement in prognosis.
EXAMINING THE RELATIONSHIPS BETWEEN RESILIENCE, CARDIOVASCULAR HEALTH, AND RACE AMONG US ADULTS
Authors: Sprague Briana , Mosesso Kelly
Published: January 2025

Modifiable risk and resilience factors explain up to 90% of cardiovascular disease risk. These may contribute to racial cardiovascular health (CVH) disparities, but there has been limited examination of the role of resilience on CVH and disparities. Our goal was to examine (1) which risk and resilience measures were associated with CVH and (2) whether there were differences in these measures by race among a sample of US adults. Aim 1’s sample included adults aged 34-84 from the MIDUS biomarker substudy (N = 1255). Aim 2’s sample comprised of adults aged 28-84 from the MIDUS parent study (N = 4702). The primary outcome of interest was CVH, operationalized as the AHA’s Life’s Essential 8 total score, behavior, and health subscores. The hypothesized resilience measures were psychological well-being (“PWB”; assessed with Ryff and Multidimensional Personality Scale), purpose in life, mindfulness, gratitude, and optimism (MPS subscales). Of those, greater PWB (Ryff), purpose in life, and optimism correlated with better Essential 8 total score and behavioral subscore (ps <.01). Higher PWB (MPS), as well as higher gratitude, were associated with better Essential 8 behavioral scores (p <.05). Of these, PWB (MPS), gratitude, and optimism were significantly differences by race, where Black adults had significantly greater values on all measures (p <.001). Implications for future research and practice will be discussed.
PLANT-BASED DIETS AND CARDIOVASCULAR DISEASE RISK FACTORS IN OLDER ADULTS: AN INTEGRATIVE LITERATURE REVIEW
Authors: VanCleef Tricia
Published: January 2025

Cardiovascular disease (CVD) is the leading cause of mortality globally, disproportionately impacting older adults. Plant-based diets (PBDs) have emerged as a dietary strategy to mitigate CVD risk, characterized by foods derived from plants and minimal to no animal-derived foods. This integrative review assesses the effectiveness of PBDs for improving CVD risk factors in older adults. A search was conducted in CINAHL, PubMed, and Medline databases for studies of PBDs and CVD risk factors in individuals aged 65 years and older. Quality assessment was performed using the Mixed Methods Appraisal Tool (MMAT). 17 publications were analyzed, 7 experimental and 10 non-experimental. All studies showed at least one positive association between PBDs and cardiovascular health in older adults. Findings highlighted significant associations between PBD adherence and reductions in key CVD risk factors such as low-density lipoprotein cholesterol (LDL-C), blood pressure, and body mass index (BMI), alongside potential benefits in reducing coronary artery calcium and enhancing endothelial function and serum isoflavone concentrations. There is evidence for the potential of PBDs as an effective dietary strategy to prevent the onset and progression of CVD in older adults and reduce the risk of CVD mortality. This review indicates the need for further research, specifically larger randomized control trials focused on older adults to strengthen the evidence base and to guide healthcare recommendations. PBDs should be considered as a part of holistic CVD prevention and management strategies for older adults, encouraging dietary patterns that are rich in fruits, vegetables, legumes, beans, nuts, seeds, and whole grains.
PREDICTORS OF CHANGE IN CAROTID ARTERY ULTRASOUND MEASURES IN THE LONG LIFE FAMILY STUDY
Authors: Kuipers Allison , Kline Caitlyn , Cvejkus Ryan , Barinas-Mitchell Emma , Zmuda Joseph
Published: January 2025

Early vascular changes of cardiovascular disease can be assessed using carotid ultrasound. The Long Life Family Study (LLFS) may help elucidate factors associated with decelerated vascular aging. Therefore, we identified predictors of change in carotid intima-media thickness (IMT) and interadventitial diameter (IAD) over ~6.0 years of follow-up (range 3.2-8.4) in 674 participants from the LLFS. Common carotid artery B-mode ultrasound was conducted using a GE LOGIQ 3 ultrasound system. We calculated change and annualized percent change (APCT) in mean carotid IMT and IAD. Age, sex, and study site were included in all models, and baseline measures of lifestyle, cardiometabolic conditions, and medication were tested in linear regression models (α=0.05). Final models were adjusted for relatedness using GEE. Participants were 67.5 years old (range 46-90), 43% male, 35% hypertensive, 6% diabetic, and 30% were on lipid-lowering medication, 96% didn’t smoke and 80% regularly walked >3hours/week. IMT increased 0.046mm or 1.08% annually, while IAD increased 0.166mm or 0.37% annually (all P< 0.0001). IMT APCT change was greater in those aged < 65 (1.37%) than over 65 (0.95%, P=0.004) but did not differ by sex (P=0.20). Whereas IAD APCT change did not differ by age group (P=0.10) but was greater in females (0.44%) than males (0.29%, P=0.006). Outside of age, sex, and site, independent predictors of IMT and IAD APCT included fasting glucose and smoking, plus triglycerides for IMT and systolic blood pressure for IAD. These findings highlight the need for continued research into the role of glucose homeostasis in vasculature aging.
RACIAL/ETHNIC DISPARITIES IN TRAJECTORIES OF CARDIOVASCULAR RISK FACTORS IN US ADULTS
Authors: Dhingra Radha , Xu Hanzhang , Lynch Scott , Yang Qing , Green Michael , West Jessica , Dupre Matthew
Published: January 2025

Racial/ethnic disparities in major cardiovascular disease (CVD) risk factors are well documented. However, studies have not considered racial/ethnic differences in the interrelationships among these CVD risk factors and how they vary across age. We used six waves of longitudinal data from the Health and Retirement Study ([HRS] 2006-2016; n=10,292) to examine co-occurring changes in systolic blood pressure ([BP] mmHg), non-HDL cholesterol (mg/dl), diabetes (y/n), and smoking (y/n) at ages 50-80. Group-based multi-trajectory models were used to identify age-related trajectories of CVD risk factors and multinomial logistic regression models were used to identify participant characteristics associated with the trajectories of CVD risk factors. In our cohort (mean (SD) age: 62 (7.2) years; 41% male; 66% non-Hispanic White, 17% non-Hispanic Black, 13% Hispanic, and 3% other race/ethnicity), we found eight distinct trajectories of age-related changes in CVD risk factors (37% of adults had optimal CVD levels). We also found that non-Hispanic Black and Hispanic adults were significantly more likely to exhibit elevated age-related risks related to BP, cholesterol, diabetes, and/or smoking compared with non-Hispanic White adults. The associations were differentially attenuated with the inclusion of multiple covariates and showed that education, household income, and nativity status (among Hispanics) contributed most to the excess CVD risks observed in non-Hispanic Black and Hispanic adults. Overall, our findings demonstrate the impact of social determinants on racial/ethnic disparities in age-related changes in CVD risk factors in middle-aged and older adults in the United States.
SOCIOECONOMIC DISADVANTAGE AND EARLY AND RECURRENT ADMISSIONS IN PATIENTS WITH HEART FAILURE
Authors: Dhingra Radha , Xu Hanzhang , Hammill Bradley , Lynch Scott , West Jessica , Green Michael , Dupre Matthew
Published: January 2025

The association between socioeconomic status and 30-day readmissions is well-documented in patients with heart failure (HF). However, it is less clear whether socioeconomic disadvantage has an immediate and/or lasting impact on risk of hospital admissions following the diagnosis of HF. We examined whether area-level disadvantage was associated with early and recurrent risks of hospitalizations in patients diagnosed with HF. We included 5,889 patients (ages 65-85 years) with newly diagnosed HF between January 2015 and July 2018 in the Duke University Health System and followed them for up to eight years. We assessed the association of area-level socioeconomic disadvantage (low, moderate, or high) with hospital admissions within 30-days after HF diagnosis using multivariable logistic regression models. We also assessed the risks of recurrent admissions over the entire duration of follow-up using Prentice, Williams, and Peterson models with total time. In our cohort (mean (SD) age: 75 (6) years; 51% female; 67% non-Hispanic White), 71% patients had at least one admission and 40% patients died over a median follow-up of 5.6 years. Area-level disadvantage was not associated with risks of admission within 30-days after HF diagnosis (hazard ratio [95% CI]: HR=1.09 [0.90-1.31]; P=.371). However, patients living in high-disadvantaged areas had significantly greater risks of recurrent admissions over follow-up (HR=1.11 [1.05-1.16]; P<.001). We observed similar patterns for 30-day mortality and mortality over the entire follow-up period. Overall, results from this study suggest that area-level socioeconomic disadvantage should be considered in clinical decision-making and guidelines to improve long-term outcomes in patients managing HF.
A NEW MEDICATION-RELATED CUMULATIVE ANTICHOLINERGIC EXPOSURE INDEX EVALUATING RISK OF COGNITIVE IMPAIRMENT
Authors: Michaud Veronique , Autar Kaveena , Condon Gerald , Honore Chelsea , Grisales Maria , Hickman James , Turgeon Jacques
Published: January 2025

Given the associations between anticholinergic exposure and poor clinical outcomes in older adults, precise quantification of the cumulative anticholinergic burden appears advisable to evaluate the risk–benefit ratio of prescribing or deprescribing some medications. Numerous examples of anticholinergic quantification scales have been used for the past two decades. These were all developed using varying methods of measuring the anticholinergic activity of drugs and varying methods of classifying drugs into distinct potency categories. Recently, we have performed a systematic review of scales and models used to quantify anticholinergic burden in older adults. We have compiled the most comprehensive list of drugs with anticholinergic activities (N=642 drugs); the AntiCholinergic and Sedative Burden Catalog (ACSBC). Using human-on-a-chip technology, we have computed a quantitative Potency AntiCholinergic Score (PACS) by performing a dose-response LTP- suppression for each drug. Furthermore, to better inform our proprietary Aggregated PolyPharmacy Regimen Assessment Index for Safety and Equity (APPRAISE™), we have developed a new unique Medication-Related Cumulative Anticholinergic Exposure (MeReCAE) index. Using drug regimen data from 12,383 patients extracted from the Medical Expenditure Panel Survey (MEPS), we have sequentially proceeded to the virtual addition of amitriptyline, amantadine, asenapine and caffeine to the drug regimen of these patients. A more important shift toward higher MeReCAE values was observed when amitriptyline and asenapine were added to the drug regimen of patients. The quantitative analysis performed allowed us to determine exactly how many patients were in the Low, Moderate and High risk of the MeReCAE index following the addition of the tested drugs.
CONFLICT MONITORING IN AMNESTIC MILD COGNITIVE IMPAIRMENT: FINDINGS FROM A PICTURE–WORD INTERFERENCE PARADIGM
Authors: Lydon Elizabeth , Mudar Raksha
Published: January 2025

Older adults with amnestic mild cognitive impairment (MCI) experience a decline in episodic memory but do not meet diagnostic criteria for dementia. Mounting evidence suggests other aspects of cognition may be impacted, including behavioral and neural alterations in conflict monitoring. Neural underpinnings of these changes have been captured through the use of electroencephalography (EEG) by most frequently examining event-related potentials (ERPs). Fewer studies have examined event-related spectral perturbations (ERSPs) that underlie conflict processes in MCI. We examined differences between 27 individuals diagnosed with amnestic MCI (age: 75.3 ± 5.6) and 27 age- and education-matched cognitively healthy controls (HC; age: 72.6 ± 7.9) using a novel picture-word interference paradigm. Stimuli for this task included line drawings of animals and objects with matched or mismatched word labels. Participants judged if the picture-word pairs were matched or mismatched using a response box while continuous EEG was recorded. We examined differences between HC and MCI on behavioral performance (accuracy and reaction time) and ERSP measures (mean spectral power in theta, alpha, and beta frequency bands). Behavioral results reveled that the MCI group took longer to respond and was less accurate than the HC group on mismatched (conflict) trials across both tasks. Additionally, both groups were less accurate when responding to mismatched versus matched trials across tasks. Preliminary analysis of ERSP measures showed different patterns of neural oscillatory activity within and across the two groups. Findings support the presence of behavioral and neural alterations in conflict processing in amnestic MCI.
EXAMINING THE IMPACT OF POSTSTROKE COGNITIVE IMPAIRMENT ON FUNCTIONAL MOBILITY
Authors: Tiwari Anjali , Lodha Neha
Published: January 2025

Approximately, 70% of individuals experience some degree of cognitive impairment following stroke. The study aims to determine the impact of post-stroke cognitive impairment on functional mobility.

Methods

Twenty-nine stroke survivors (cognitively impaired; N = 15 and cognitively normal; N = 14) participated in this study. Participants performed (1) Overground walking while simultaneously performing a secondary cognitive task. We measured gait speed (m/s) and stride time variability (%). 2) Simulator driving task: Participants performed a car-following task and responded to the brake lights of the lead car. We measured the mean (pounds), and variability in brake force (%). To examine whether post-stroke cognitive impairment influences performance on walking and driving tasks, we conducted a one-way ANCOVA test while adjusting for the stroke motor severity assessed by the Modified Rankin Scale. Results – The cognitively impaired stroke group showed slower gait speed (F(1, 26) =9.594, p=0.005), increased stride length variability (F(1, 26) =5.505, p=0.033), and brake force variability (F(1, 26) =3.316, p= 0.035) compared with the cognitively normal stroke group. The two groups showed no significant difference in mean brake force (F (1, 26) = 3.345 p= 0.087). Conclusion- Post-stroke cognitive impairment significantly impacts functional mobility and contributes to impaired walking and braking function, even after controlling for the severity of motor impairment post-stroke. Significance- The findings underscore the critical role of cognitive function in post-stroke recovery of functional mobility, above and beyond motor function. Intervention targeting cognitive function alongside motor function would be important for optimal functional recovery following stroke.
IMPACT OF RTMS ON CAREGIVER BURDEN
Authors: Padala Prasad , Parkes Christopher , Gauss C Heath , Padala Kalpana
Published: January 2025

Background

Caregivers of persons with cognitive impairment experience a high level of burden. While the deleterious psychosocial and mental health effects of dementia caregiving are firmly established, very little is known about the burdens or psychiatric outcomes of providing care to a spouse with mild cognitive impairment (MCI). These individuals may be ideal targets for selective preventive interventions to maximize their psychological well-being as caregiving burdens related to their spouses’ cognitive impairment increase. The objective is to assess the changes in caregiver burden after the single session repetitive transcranial magnetic stimulation (rTMS) in participants with MCI.

Methods

Participants with MCI (N=32) along with their caregivers were recruited as part of an interventional study for apathy using rTMS. The ongoing study is a double-blind randomized sham-controlled study of 20 treatments with rTMS/sham coil. In order to test the use of single session as a prognosticator of the full treatment, all participants received a single active treatment 2-weeks prior to the full treatment. Baseline assessments included measures of memory, behavioral problems, functioning and caregiver burden.

Results

Mean age was 76.7(±7.3) years, 90% were Caucasian and 10% were female. Mean Mini Mental State Examination (MMSE) score was 25.7(±2.9), Apathy Evaluation Scale-Clinician version (AES-C) was 47.1(±7.7), and the Zarit Burden Score was 43(±6.1) at baseline. There was a significant improvement in the caregiver burden and apathy after the single session rTMS although there was no statistically significant change in MMSE. Conclusions: Noninterventional neuromodulation such as rTMS may play a role in alleviating caregiver burden.
MODERATING EFFECT OF DEPRESSION ON THE ASSOCIATION OF COGNITIVE IMPAIRMENT WITH EVERYDAY FUNCTION IN OLDER ADULTS
Authors: McIntyre Thomas , Becker Jacqueline , Hackett Katherine , Chan Lili , Carnavali Fernando , Wisnivesky Juan , Curtis Laura , Federman Alex
Published: January 2025

Cognitive impairment (CI) and depression often co-occur, and each is known to impair older adults’ ability to perform activities of daily living. We sought to determine whether co-morbid depression moderates the association of CI with impairments in instrumental activities of daily living (IADL). We recruited English speaking adults ages ≥55 years without preexisting dementia or CI from primary care practices in New York City and Chicago (n=1,045). IADLs were assessed using Lawton’s 8-item scale and impairment was defined as ≥1 activity requiring assistance. Cognitive function was measured using Montreal Cognitive Assessments (MoCA); moderate-severe CI was defined as MoCA score ≥1.5 standard deviations below the age and education adjusted z-score. Depression was defined as a score ≥10 using Patient Health Questionnaires (PHQ)-8. We fit linear regression models estimating the association of mild CI, moderate-severe CI, and depression with counts of IADL impairments, adjusting for age and sex. We then added an interaction term for CI and depression. The mean age was 67 (8.0) years, 54% were female, 35% Black and 25% Hispanic. Median IADL impairments were 0 (IQR 0-7); 16% had mild CI, 5% moderate-severe CI, and 15% had depression. Moderate-severe CI (β=0.84, p< 0.01) and severe depression (β=1.31, p< 0.01) were each independently associated with IADL impairments in the adjusted model. The interaction term of moderate-severe CI with depression was also significant (β -0.85, p < 0.01). Depression significantly worsens the association of CI with IADL impairment, highlighting the importance of identifying and treating this common condition in older adults.
NEUROCOGNITIVE CORRELATES OF COMORBIDITIES IN OLDER ADULTS WITH CHRONIC PAIN AND NEGATIVE EMOTIONS
Authors: Mindlis Irina , Ravdin Lisa , Reid M Carrington , Kiosses Dimitris
Published: January 2025

Chronic pain and depression are associated with poor cognition in older adults, yet little is known regarding the additional contribution of comorbidities to performance on specific neurocognitive domains in this population. We examined specific neurocognitive domain performance using baseline data from the Problem Adaptation Therapy for Pain Collaborative Care Program (PATH-Pain) trial, which tested a psychosocial intervention designed to improve emotion regulation in 100 adults ≥ 60 years with comorbid chronic pain and negative emotions (vs. usual care). Participants completed questionnaires on comorbidities (Charlson Comorbidity Index), depressive symptoms (Montgomery-Asberg Depression Rating Scale), pain intensity, and were remotely administered the Montreal Cognitive Assessment with no visual elements (MoCA-blind) and the Repeatable Battery for Neuropsychological Status. Regression assessed the relationship between specific neurocognitive domains and comorbidities, adjusting for depressive symptoms and pain intensity. In adjusted models, greater comorbidities remained associated with poorer immediate memory (b = -.352, p <.001) adjusting for pain intensity (b =.217, p =.040) and depressive symptoms (ns). After excluding participants with neurologic conditions, immediate memory remained associated with comorbidities (b = -.304, p =.019), but not pain intensity. Similar patterns emerged for attention, with greater comorbidities associated with poorer performance among all participants (b = -.266, p =.015), and for participants without neurological diagnoses (b = -.301, p =.020). No associations were found with language, delayed memory, abstraction, or orientation. Findings suggest difficulties with initial encoding and verbal learning; further research is needed to understand the potential impact on health behaviors and outcomes.
OLFACTION AND COGNITIVE FUNCTION IN NONDEMENTED OLDER ADULTS: FINDINGS FROM HEALTH ABC
Authors: Yuan Yaqun , Chamberlin Keran , Li Chenxi , Luo Zhehui , Kucharska-Newton Anna , Shrestha Srishti , Simonsick Eleanor , Chen Honglei
Published: January 2025

We examined olfaction in relation to longitudinal change in cognitive function among 1987 community-dwelling participants of the Health, Aging and Body Composition study (aged 71-82 years, 52.8% women, and 33.1% Black race), free of dementia and Parkinson’s disease. Participants completed the Brief Smell Identification Test at the year 3 clinic visit in 1999-2000. Olfaction was defined as good (test score 11-12), moderate (9-10), hyposmia (7-8), or anosmia (0-6). Cognitive function was assessed using the Modified Mini-Mental State examination (3MS) up to 5 times at clinic visits in year 3, 5, 8, 10 and 11. We conducted multivariable joint model analyses to account for potential bias due to death and loss to follow-up, in addition to potential confounders. Olfaction status was inversely associated with 3MS test score in both cross-sectional and longitudinal analyses over 8 years of follow-up. At baseline, compared with participants with good olfaction, the 3MS test score was 0.80 (95%CI, 0.21-1.38) points lower for those with moderate olfaction, 1.82 (95%CI, 1.08-2.57) points lower for those with hyposmia, and 1.87 (95%CI, 1.00-2.75) points lower for those with anosmia. Longitudinally, the annual decline was 0.09 (95%CI, 0.01-0.17) faster for those with moderate olfaction, 0.22 (95%CI, 0.11-0.32) faster for those with hyposmia, and 0.30 (95%CI, 0.17-0.43) for those with anosmia. Similar associations were observed across subgroups defined by sex, race, self-reported general health status, and APOE-ε4 genotype. Our study provides important evidence that poor olfaction is associated with a faster decline in cognitive function in non-demented older adults.
POTENTIAL MENTAL BENEFITS OF REMOTE EXPRESSIVE ARTS PROGRAM IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT
Authors: Luo Yuting , Li Hong
Published: January 2025

The use of expressive arts program (EAP) in mild cognitive impairment may positively impact the psychological well-being. A future direction for EAP may be to explore a new channel for MCI patients to participate via the mobile internet, as this could improve accessibility. The study explores the impact of a remote expressive arts program (rEAP) on the mental health of older adults with mild cognitive impairment (MCI). Conducted through a two-arm, single-blinded, pilot, randomized controlled trial, participants were assigned to either a 12-week rEAP or health education (HE) group. Pre- and post-treatment psychological evaluations were conducted. Results from 73 MCI patients showed significant improvements in anxiety mood (Self-Rating Anxiety Scale, P=0.032) and potential benefits in subjective well-being, depression, self-esteem, and self-efficacy in the rEAP group compared to the HE group. Qualitative interviews with rEAP participants highlighted enthusiasm, feasibility, usability, and content satisfaction. Positive cognitive and mental benefits were reported, with themes including enhanced cognitive function perception, relaxation, creativity, self-confidence, and social engagement. The findings suggest that a 12-week rEAP can enhance the psychological well-being of older adults with MCI, indicating its feasibility and applicability for this population. The study underscores the significance of rEAP as a feasible intervention leveraging mobile internet to improve mental health in older adults with MCI.
SUBJECTIVE COGNITIVE DECLINE AND DAILY AFFECTIVE WELL-BEING
Authors: Jeong Mijin , Mogle Jacqueline , Jang Heejung , Hill Nikki , Katz Mindy
Published: January 2025

Subjective cognitive decline (SCD) is self-reported cognitive decline in the absence of objective cognitive deficits. Although SCD (especially SCD accompanied by worry about the decline) is considered as the earliest progress of dementia, less is known about daily experiences of affect among older adults with SCD. Considering depression is deeply associated with progress of dementia, it is important to understand how individuals with SCD have experienced daily affect. We examined differences in levels of daily affective well-being for older adults with and without SCD. In the Einstein Aging Study (EAS), a total of 210 participants reported whether they perceived SCD and if so, indicated whether were worried by this decline. Daily positive affect (PA) and daily negative affect (NA) were measured using 8 items (happy; relaxed; energetic, enjoy; anxiety; loneliness; depression; and frustration) each day for 14 continuous days (between May 2017 and March 2020). We tested hypotheses by using multilevel models (MLM). For daily PA, SCD (either with or without worry) was associated with lower average daily reports of total PA specifically driven by differences on the items “happy” and “relaxed” compared to individuals without SCD. For daily NA, endorsement of SCD with worry was associated with higher total NA, specifically for the items “anxiety,” “depression,” and “frustration” compared to individuals without SCD and those with SCD but without worry. This study helps to better understand the impact of perceiving early cognitive changes on different aspects of daily affect to identify targets for promoting psychological well-being among older adults.
SUBJECTIVE COGNITIVE DECLINE AND ITS IMPACTS AMONG MIDDLE-AGED AND OLDER WOMEN VETERANS AND NONVETERANS
Authors: Henion Amy , Cheney Amanda , Sundstrom Kim , Alshanbari Mohammed , Bouldin Erin
Published: January 2025

Veterans more frequently experience traumatic brain injuries than their non-veteran peers and therefore may be at higher risk of cognitive decline. Little is known about subjective cognitive decline (SCD) among women veterans. We aimed to describe the prevalence and impacts of SCD among women veterans and compare them with non-veteran women using 2021-2022 Behavioral Risk Factor Surveillance System data from 29 jurisdictions that included the optional Cognitive Decline module. Respondents aged ≥45 years were classified as having SCD if they experienced increased memory problems or confusion over the past year. We calculated weighted estimates among 1,905 women veterans (n=268 with SCD) and 66,880 women non-veterans (n=7,609 with SCD). Women veterans were slightly younger than non-veterans (mean 61.8 versus 64.0 years, p=0.045) and more often had depression history (65.8% versus 47.9%, p=0.003). Other demographic and health characteristics – including risk factors for dementia – were similar. SCD prevalence was 13.3% among veterans and 11.7% among non-veterans (p=0.24). Among women with SCD, there were no significant differences in SCD-related social or household limitations by veteran status. Similarly, the prevalence of needing help because of SCD was similar for women veterans and non-veterans (34.6% and 35.4%, p=0.89). Veterans had more frequently discussed their SCD with a healthcare provider than non-veterans (65.7% versus 47.4%, p< 0.001). SCD prevalence and SCD-related impacts were similar among veteran and non-veteran women. The question of why veterans are more likely to discuss their SCD with providers warrants exploration and may inform strategies to facilitate such discussions in other groups.
CAREGIVER CONVERSATIONS WITH PERSONS WITH MILD COGNITIVE IMPAIRMENT, ALZHEIMER’S DISEASE, AND PARKINSON’S DISEASE
Authors: Savundranayagam Marie , Schumann Annette , Orange Joseph , Pritchard Sharon , Pichora-Fuller M Kathleen , Wittich Walter , Mick Paul , Campos Jennifer
Published: January 2025

This study describes conversations between persons living with mild cognitive impairment (MCI), Alzheimer’s Disease (AD), Parkinson’s Disease (PD) and their family caregivers, and the possible contributions of sensory loss. Conversations (N=130) between a participant (60% male) and a family caregiver (75% female; spouses) in the COMPASS-ND study were analyzed. Conversations were transcribed verbatim, segmented into communication units (c-units), and analyzed using the trouble-source repair (TSR) paradigm that includes analyses of communication breakdowns, repair initiators, and repair strategies. A one-way analysis of variance was conducted to evaluate between-group differences among sensory and communication variables. The AD group had poorer hearing than the MCI and PD groups. Both AD and MCI groups had poorer vision than the PD group. The MCI group used significantly more c-units than the AD and PD groups. The mean proportion of the TSR sequences was 13% across all groups, but with significantly more sequences in the AD and PD groups than the MCI group. Notably, the proportion of trouble sources created by caregivers was significantly greater for conversations in the AD group than the MCI or PD groups. The proportion of repair initiators used was significantly greater for the AD group than the MCI or PD groups. The intersection of cognition and sensory variables will be illustrated using three case studies. The findings highlight the active participation of persons living with AD and sensory loss in signalling misunderstandings created by caregivers. However, the interface between cognitive and sensory abilities influences the communication among both conversational partners.
COMMUNITY PREVALENCE OF HEARING LOSS AMONG OLDER ADULTA IN MA, RI, CT, AND NH: COMPARING MEASURES
Authors: Frimpong Eric , Fleet Alexa , Gallero Constanza Tamara Matta , Jansen Taylor , Dugan Elizabeth
Published: January 2025

Background

Hearing impairment and hearing loss may negatively impact social engagement and social relationships. Understanding community rates of hearing loss would identify disparities and may inform service delivery and potentially improve quality of life for adults with hearing loss. The aim of this study is to describe community prevalence of hearing loss and to compare two measurement approaches: self-report and clinically derived from Medicare claims.

Methods

Data were from the Healthy Aging Data Report (healthyagingdatareports.org) for the New England states (MA, NH, CT, and RI) with indicators calculated from the American Community Surveys (MA: 2012-2016; RI:2016-2018; CT: 2014-2018 and NH: 2012-2016), and the Medicare Master Beneficiary Summary Files (MA: 2014-2015; RI: 2016-2017; CT: 2016-2017 and NH: 2014-2015).

Results

rates derived from CMS clinical diagnosis were higher (MA: 16.1%; RI: 16.4%; CT: 15.7%, and NH: 14.4%) compared to the self-reported ACS rates (MA: 14.2%; RI: 13.9%: CT: 12.4% and NH: 15.0%). The highest community prevalence rate of self-reported hearing loss (36.36%) was in Monroe MA. For clinically diagnosed hearing loss, Hanover NH (home to Dartmouth College and health system) reported the highest rate (26.12%). Having excellent access to health care is associated with higher community rates of clinically diagnosed hearing loss. Results showed that the community prevalence of hearing impairment was variable by community. The potential impact of hearing loss on social, emotional, and physical well-being indicates a need for interventions to diagnose and treat it.
FEASIBILITY AND ACCURACY OF A POINT-OF-CARE COMMUNICATION FEEDBACK APP FOR NURSING HOME STAFF
Authors: Williams Kristine , Coleman Carissa , Hu Jinxiang , Chen Xi
Published: January 2025

Educating the long-term-care workforce in dementia care skills is critical. Research has established that reinforcing learned skills in practice is important for successful adoption. However, on-site, expert feedback is costly and not always feasible. The 3-hour Changing Talk (CHAT) educational intervention decreases staff elderspeak (communication that sounds like babytalk) which in turn, reduces negative behavioral responses of care recipients with dementia. We developed an automated feedback IOS application that records staff and uses natural language processing to analyze their speech, providing just-in-time feedback on their use of elderspeak diminutives (terms of endearment). This study evaluated feasibility and accuracy of the SPEEKO for Elderspeak app for point-of-care feedback on staff elderspeak communication. Long-term-care staff (n=17) self-recorded their communication during resident care. Amazon Translate language processing and a customized elderspeak algorithm were used to identify staff use of diminutives, a common part of elderspeak, in the recordings. Trained coders also completed manual transcription and psycholinguistic coding of diminutives in the recordings that were compared to the app results with chi-squared tests. The relationship of total diminutives comparing human and app identification was significant χ2=12.21, p<.001. Associations were significant for elderspeak diminutive word roots (“dear” χ2 =0.01, p=.004); “sweet” (χ2=20.20, p<.001); and “girl” (χ2=5.08, p=.02). Other terms were not significantly correlated (“honey” χ2=2.70, p=.10) and “baby” (χ2=0.85, p=.36). With improvements to overcome issues in accuracy of recording, transcription, and analyses, the SPEEKO for Elderspeak app has potential to provide self-monitoring feedback promoting implementation of communication skills in dementia care.
A QUALITATIVE ANALYSIS OF PERCEIVED BEREAVEMENT NEEDS OF COMMUNITY-DWELLING OLDER ADULTS
Authors: Praska Nicole , Chur Marcus , Collins-Pisano Caroline , Weiskittle Rachel
Published: January 2025

This paper presentation will discuss the qualitative findings of a city-wide community needs assessment on available grief support with particular emphasis on service needs for older adults. The purposive sampling of this survey targeted local professionals who frequently interact with bereaved individuals in their work, such as mental health providers, funeral directors, faith leaders, and healthcare providers. Survey items asked participants to identify local grief support demand, engagement, barriers, and interests. Of the 141 participants who completed the survey, 80 (57%) provided free response answers eligible for qualitative analysis. Themes were extracted using manifest coding across three raters. Major themes on older adult bereavement include: perceived gaps in available services, service format suggestions (e.g., virtual vs. in-person, faith-based vs. secular), and suggestions for the creation of older adult grief support based on type of loss (e.g., pet loss, kinshiplessness), and perceived educational interest, such as substance use and emotions in grief. In this presentation, qualitative methodology of the study, as well as its resulting themes and subthemes, will be further described to offer insight into participant perspectives on service needs for older adult bereavement.
ENHANCING DEMENTIA-FRIENDLY COMMUNITIES IN TOKYO, JAPAN THROUGH COMMUNITY-BASED PARTICIPATORY RESEARCH
Authors: Sugiyama Mika , Inagaki Hiroki , Ito Kae , Awata Shuichi
Published: January 2025

In Japan, grappling with the challenges of an increasingly aging population, the Basic Law on Dementia was enacted in June 2023 to foster the development of dementia-friendly communities (DFCs) nationwide. Over the past decade, starting from 2013, a community-based participatory research (CBPR) initiative has been underway in Chiyoda Ward, Tokyo, aimed at establishing a comprehensive dementia support system. Monthly team meetings have served as forums for discussing institutional progress and addressing challenges, with efforts toward DFCs guided by the PDCA cycle. In partnership with Chiyoda Ward, a longitudinal mail survey was conducted to assess the needs of approximately 10,000 older adults. For non-respondents, visiting nurses conducted home visits to provide early-stage dementia support. Additionally, a novel system was implemented to extend “early support” and “watchful waiting support by visiting nurses” to individuals at high risk of dementia who did not engage with public consultation services. Chiyoda Ward has actively organized “dementia cafes” and support meetings for affected individuals, along with training “dementia supporters” for community volunteering. Additionally, the introduction of the “Chiyoda Dementia Support Company/University Certification System” in 2022 has acknowledged outstanding efforts, resulting in the certification of six entities. Notably, there has been a positive trend in the proportion of elders feeling confident about living safely within their community despite dementia, as indicated by the mail survey increasing from 28% in 2016 to 35% in 2021. As a result of CBPR efforts, significant progress has been made in the social implementation of DFC in Chiyoda Ward.
FORTY YEARS OF CARING: THE STATE OF THE VOLUNTEER CAREGIVING MOVEMENT
Authors: Berkowsky Ronald
Published: January 2025

With the expansion of the older adult population and its impacts on demands and costs of healthcare in the US, there has been a shift from relying on paid care work towards supporting informal unpaid caregiving. While there is an abundance of research that examines the impacts and value of informal caregiving provided by close family and friends, there is little that examines the impacts and value of volunteer caregiving (i.e., unpaid caregiving services provided by community members who do not have a close relationship with the care recipient). Services provided by community volunteers can provide needed assistance to community-dwelling older adults who encounter significant barriers to other care sources (e.g., cannot afford paid caregiving, lack access to family/friends, etc.). This community-based model of caregiving was first piloted in 1984 through support from the Robert Wood Johnson Foundation’s Faith in Action program and, in addition to promoting services that support older adults aging in place, is seen as an avenue to promote intergenerational collaboration, civic engagement, and well-being among community members. In this presentation, I present data collected in collaboration with the National Volunteer Caregiving Network (NVCN) from member sites to assess the current state of volunteer caregiving in the US. More specifically, I present data which elucidates the reach of volunteer caregiving, the characteristics of care recipients and volunteers, the services utilized, and the economic value of these services. I conclude with a discussion on the impacts of the volunteer caregiving movement as it enters its 40th year.
HEALTH CARE UTILIZATION BEFORE AND AFTER ENROLLMENT IN HOME-BASED PRIMARY CARE
Authors: Rizzo Samantha , Wahl Anne , Chameli Thomas , Ayers Lindsay , Mahmoudi Parsa , Kim Yijung , Bangerter Lauren , De Jonge Karl
Published: January 2025

Homebound older adults typically exhibit higher rates of emergency department (ED) visits and hospital admissions compared to non-homebound individuals. This study evaluated health care utilization rates before and after patients enrolled in the MedStar Washington Hospital Center House Call Program, a home-based primary care (HBPC) model. Data were drawn from the electronic medical record for 12-months before and 12-months after enrollment in the HBPC program. A total of 530 patients enrolled in HBPC between June 30, 2018, and July 1, 2023. Most patients were female (76.4%) and African American (80.8%), with an average age of 84.3 at enrollment. Over 40% of the patients were living with dementia, 23% had experienced a stroke, and 81% had hypertension. Using paired t-tests, we found a decrease in the average annual rate of ED visits (1.58 vs. 0.92, p < 0.001) and hospital admissions (0.91 vs. 0.53, p < 0.001) from the pre-12-month enrollment period to the post-12-month period. Linear regression revealed important predictors of post-enrollment ED visits, including greater pre-enrollment ED use, history of chronic obstructive pulmonary lung disease (COPD), and coronary artery disease (CAD). Post-enrollment hospital admissions were predicted by the frequency of pre-enrollment admissions, presence of chronic kidney disease (CKD), and CAD. Patients with CAD, CKD, or COPD are more likely to present to the ED or hospital during enrollment in HBPC than those without these comorbidities The overall utilization results suggest that enrollment in a HBPC model lessens the rate of ED visits and hospital admissions in a homebound population.
URINARY INCONTINENCE AS A RISK TO PHYSICAL, MENTAL, AND SOCIAL HEALTH AMONG OLDER KOREAN AMERICANS IN SENIOR HOUSING
Authors: Park Juyoung , Jang Yuri
Published: January 2025

Urinary incontinence (UI) or involuntary leakage of urine, is a common geriatric condition. Despite its harmful effect on health and well-being, UI has often been neglected in geriatric care. In the present study, we examined the risks posed by UI to the physical, mental, and social health of older Korean Americans living in subsidized senior housing. Survey data were collected from 313 older Korean-American residents in subsidized senior housing in the Los Angeles area. UI was assessed with a question on the frequency of experiencing involuntary leakage of urine. Physical, mental, and social health risks were indicated by a single item self-rated health (fair/poor rating), the Patient Health Questionnaire−9 (probable depression), and the Lubben Social Network Scale−6, (isolation from family and isolation from friends). More than half of the sample reported UI, with the experience being infrequent (i.e., seldom) for 46.3% and frequent (i.e., sometimes or often) for 10.3%. Regardless of the frequency, UI posed a significant risk to physical and mental health. The odds of reporting fair/poor health and having probable depression were 1.82 to 6.81 times higher among those with infrequent/frequent UI than among those without. Family isolation was not associated with UI; however, the odds of being isolated from friends were 2.95 times higher among those with frequent UI compared with the reference group. Our findings underscore the importance of addressing UI in the health promotion effort in senior housing, calling for interdisciplinary approaches for resident care.