bluuebunny/crossref_metadata_2025 huggingface dataset:
SEEKING SUPPORT FOR MENTAL HEALTH IN EAST ASIAN AMERICAN DEMENTIA CAREGIVERS: A GROUNDED THEORY STUDY
Authors: Ko Eunjung , Tate Judith , Wright Kathy , Rose Karen
Published: January 2025

Asian Americans in general are reluctant to seek mental health support. This can be detrimental to those who are also dementia caregivers. Unfortunately, Asian Americans and each subgroup in this population are underrepresented in dementia caregiving research. We explored help-seeking behaviors for mental health in East Asian American dementia caregivers using a qualitative analysis based on constructivist grounded theory. We conducted 60–90 minute interviews with each participant. Interviews were recorded and transcribed verbatim. To date, 16 participants have completed the interviews using purposive sampling. Thirteen were females, including 12 daughters and one daughter-in-law. Twelve were first-generation immigrants. The average caregiving duration was 40 months. We developed seven themes—“providing care,” “individual values,” “a need for support,” “seeking support,” “barriers to using support,” “benefits from support,” “living now and the future”—comprising 18 categories. While providing care, caregivers observed care recipient’s symptoms, experienced caregiving challenges, and encountered personal life events, leading them to need and seek help. Individual values of caregivers—cultural acceptance, faith, caregiving competence, dyadic connectedness—could influence how they perceive their situations. Caregivers then sought formal, informal, and self-support separately or in combination, albeit with several barriers to accessing support. Through the support, caregivers could achieve benefits (connecting, learning, relieving, reassuring). The benefits, along with individual values while providing care, could affect caregivers’ viewpoints on the present and future. These initial findings can provide researchers with valuable insights into the imperative need for focused research on Asian American communities and the development of strategies to bolster mental health support for this population.
SELF-CARE AND WELL-BEING INTERVENTIONS FOR FAMILY CAREGIVERS OF FRAIL OLDER ADULTS IN A RURAL CONTEXT
Authors: Yang Siqi , Cuevas Nicolas , Shelar Shatakshi , Lu Yu , Katare Bhagyashree , Lalani Nasreen
Published: January 2025

The rapid aging of the population and limited access to healthcare in rural communities pose significant challenges for caregivers caring for older family members suffering from serious chronic illnesses. The heavy burden of care and multiple responsibilities cause poor coping, self-care and wellbeing outcomes and therefore need interventions to promote their resilience and overall quality of life. Our systematic review aims to explore interventions available in the existing literature to promote the self-care and well-being of family caregivers of frail older adults residing in rural underserved areas. Arksey & O’Malley’s methodological framework of scoping studies was employed for the analysis. Databases such as PubMed and Scopus were used to search the articles. PRISMA and Covidence tools were followed to review and analyze the study. The CASP tool was used to examine the quality of the study and consensus was established among three research assistants and the advisor in the team. Our findings include 24 selected articles, with the majority of studies conducted in the U.S. (63%). Interventions were categorized into four groups as digital-web-based interventions (7), telehealth interventions (6), psychoeducational interventions (9), and other interventions (2). The most common outcomes observed across these interventions were increasing caregiver knowledge, self efficacy and reducing caregiver burden. Our review emphasizes the need for more research using community-engaged and culturally based approaches to promote the wellbeing and resilience of rural caregivers.
STRUCTURAL INFLUENCES ON WHY OLDER ASIAN IMMIGRANTS PROVIDE CARE FOR SPOUSES WITH DEMENTIA
Authors: Kim Julie , Lee Jung-Ah
Published: January 2025

Elder care and dementia caregiving studies on Asian immigrant families commonly cite cultural expectations, filial piety, and Confucianism as motivations for substantial reliance on informal caregivers such as adult children and children-in-law. Yet in Asian immigrant families of older adults with dementia, spouses assume primary caregiving roles as much as daughters and daughters-in-law do. This study moves beyond cultural arguments by exploring the influence of structural forces that leave caregiving responsibilities to spouses rather than adult children, or other caregivers, in Asian immigrant families of older adults with dementia. Data come from a larger dementia caregiver home-visit-based intervention study with bilingual and bicultural community health workers (CHW) visiting caregivers. The present study employs content analysis of CHW’s home visit logs with 14 Korean immigrant (10 wives) spousal caregivers and 18 Vietnamese immigrant (10 wives) spousal caregivers, both ethnic groups associated with strong cultural norms of filial piety. Detailed home visit logs contain observations of living arrangements and environments and recount conversations and events from each home visit, contextualizing the social and physical environments of caregivers and spouses with dementia. Findings show Asian immigrant spousal caregivers do not expect high levels of care support from their adult children, as assumed in cultural arguments. Instead, structural influences, such as ethnic enclaves and resources therein, the couples’ relative socioeconomic positions, access to institutional resources, and changing structures in family relationships, shape spousal caregiving arrangements and modify older immigrants’ expectations of adult children.
BLURRING BOUNDARIES: QUALITATIVE RESEARCH ON DIRECT CARE WORKERS’ EXPERIENCES
Authors: Pond Brittney
Published: January 2025

In the United States, there are 4.8 million direct care workers who provide care and services to older adults and people living with disabilities (PHI, 2023). Research suggests that direct care workers in home and community-based services occupy a unique role between family and non-family. In this poster, I discuss how direct care workers’ close relationships with their clients often led to blurring personal and professional boundaries that created challenges through semi-structured interviews with 43 (n=43) direct care workers providing care and services to older adults in the U.S. This research addresses two primary research questions: 1) what is the nature of work and relationships with clients for paid direct care workers? 2) how do direct care workers for non-family older adults navigate personal and professional boundaries? Through these interviews, I found that direct care workers unique roles within home care settings often caused challenges such as doing or feeling pressure to do additional labor on and off their shifts and hesitancy to be away from their clients. These findings support and expand upon existing literature that direct care workers often form close, reciprocal relationships with non-family clients and often participate in additional labor beyond their work requirements.
EXPLORING THE MEDIATION EFFECT OF SOCIAL SUPPORT ON CAREGIVERS’ PHYSICAL HEALTH FOR PERSONS WITH DEMENTIA
Authors: Cho Hannah , Huang Liming , Washington Karla , Oliver Debra Parker , Demiris George
Published: January 2025

In the U.S., over 11 million families provide 18 trillion hours of unpaid care yearly to Persons with Dementia (PwD). Families, often primary caregivers, face overwhelming stress and health decline due to caregiving demands and employment. This study examines how social support affects caregivers’ stress and physical health in hospice settings for caregivers of PwD. From September 2022 to February 2024 the parent study (n= 167) was assessed using the Medical Outcomes Survey and the Short-Form 12 Questionnaire. The correlation analysis revealed that social support is positively correlated with caregiving duration and negatively correlated with physical health in hospice care. Consequently, a path analysis was conducted to examine the impact of social support on the relationship between caregiving duration and physical health of caregivers of PwD during hospice care. We controlled for age and gender in regression. Preliminary results showed the mediation effect of social support is 0.12 (p =.12). The direct and total effects of caregiving duration on physical health are 0.04 (p = 0.9) and 0.16 (p =.58), respectively. The model is just identified with an RMSEA of 0 and a TLI and CFI of 1. Non-significant results imply that the mediation effect may not be a substantial component of the total effect or that with the sample size statistical power is not high enough to detect it. Given these findings, further investigation is needed, and the data should be re-run as the intervention is ongoing with the full dataset for more definitive insights.
EXPLORING USE OF COMMUNITY SUPPORT SERVICES BY BLACK FAMILY DEMENTIA CAREGIVERS: FACILITATORS AND BARRIERS
Authors: Johnson Florence , Robinson-Lane Sheria
Published: January 2025

In this qualitative study, we delve into the factors influencing community support services (CSS) utilization, including respite care and support groups. We conducted focus group discussions to uncover the barriers and facilitators that lead individuals to engage with or abstain from these services. Analyzing these factors will provide insights to enhance the effectiveness of CSS and its impact on the community. Our focus group involved six current or former Black family caregivers of persons with dementia (PWD). The virtual meeting, lasting approximately 1.5 hours, collected information on community support use, dementia care knowledge, and self-care practices. Transcriptions were thematically analyzed using the Rigorous and Accelerated Data Reduction (RaDAR) method—a team-based strategy to extract relevant data for specific project deliverables. Four key themes emerged to aid caregivers in managing their responsibilities: Education on Dementia Stages: Understanding different stages of dementia helps caregivers effectively manage challenging behaviors. Empowerment through Dementia Subtypes: Knowledge of various dementia subtypes enables caregivers to seek support groups for guidance. Respite Care Access: Learning about and accessing respite care prevents burnout and promotes well-being. Emotional Support: Addressing guilt provides emotional well-being for caregivers. As the older adult population grows, dementia caregiving becomes a critical public health issue. Family members caring for PWD in the community face significant challenges, emphasizing the importance of effective support services.
WHAT COMES AFTER BEING NAMED EMERGENCY CONTACT: EXPERIENCES OF CURRENT AND POTENTIAL SURROGATE DECISION-MAKERS
Authors: Berry-Stoelzle Maresi , Murray Sarah , Karr Daniel , Walkner Tammy , Alexander Bruce
Published: January 2025

Veterans have high rates of chronic health conditions than non-veterans. As their comorbidity progresses, recommended therapies are often more complex and may not contribute to the Veteran’s quality of life. During hospital admissions, a combination of medication and illness can result in the Veteran being unable to make decisions for themselves. Their designated Durable Power of Attorney (DPOA) or, if none is designated, the Emergency Contact/Next of Kin (EC/NoK) then makes these decisions. This mixed-methods study identified Veterans and their EC/NoK who had been hospitalized at a VAMC during the last year. Semi-structured interviews with EC/NoKs focused on identifying support needs, challenges of the health care system, perceptions of “goals of care” conversations, and the responsibilities of being a medical decision-maker. Questions were determined from prior literature on 1) experience of caregivers and 2) medical decision making for others. Four themes were identified via Consolidated Framework for Implementation Research: 1) when EC/NoK have higher social connections with the Veteran’s healthcare team, they report higher confidence and preparedness for their role; 2) most preparation consisted of conversations with the Veteran about terminal decisions, 3) EC/NoK with the highest self-report of preparedness reported previous experience with medical decision-making; 4) those whose self-reported lower confidence also reported higher levels of isolation and a lack of support in their caregiver role. These interviews with EC/NoK demonstrate opportunities to increase knowledge of medical decision-making and the opportunities to support EC/NoK’s in their role as DPOA’s within a healthcare system.
THE RELATIONSHIP BETWEEN DYADIC COPING AND INTIMACY OF PATIENTS WITH STROKE AND SPOUSES: A DYADIC APPROACH
Authors: Liu Xiaohui , Liang Nana , Du Xuan , Gao Haihua , Yang Xiaoping , Wang Huijuan , Yuan Jialin
Published: January 2025

Most studies have focused on coping in middle-aged and elderly stroke patients and spouses in isolation. However, marital intimacy is more prominent when middle-aged and elderly stroke patients and spouses are coping with the disease together. This study conducted from December 2020 to July 2021,included 203 stroke patients and their spousal caregivers. They completed the General Data Questionnaire, Dyadic Coping Inventory, the Quality of Relationship Index. Data was analyzed using SPSS 26.0 and Amos 22.0, including descriptive statistics, paired t test, Pearson correlation analysis. And this research used actor-partner interdependence mediation model to explore the relationship of intimacy, among stroke patients and their spousal caregivers.The actor-partner interdependence model revealed actor effects of stress communication, supportive coping, delegated coping.and common coping on intimacy for both patients and their spouses(β =0.572; β = 0.500; β=1.283; β = 0.665, p < 0.05). There were no similar partner effects (p > 0.05). Although patients’ stress communication had a partner effect on spouses intimacy (β = 0.221, p < 0.05), spouses had no similar partner intimacy effect (p >0.05). There were actor and partner effects of negative dyadic coping on intimacy for both patients and their spouses(β = -0.587; β = -0.206, p < 0.05).Our results describe the middle-aged and elderly patients and their spouses as an interactional unit in which positive dyadic coping supports a satisfactory relationship. This study highlights the need for couple-based interventions, including strategies combined with individual and dyadic therapy for both partners.
LONGITUDINAL CHANGES IN ALCOHOL USE ACROSS 20 YEARS: A DAILY DIARY STUDY
Authors: Miller Sara , Almeida David
Published: January 2025

Longitudinal studies often identify declines in alcohol consumption with aging. However, drinking trajectories may vary across alcohol use indicators and person-level characteristics. The current study utilized three bursts of daily diary surveys from the National Study of Daily Experiences to examine changes in alcohol consumption across 20 years among a sample of adults aged 24 to 81. Participants (N=1,429; Mage=49.9) completed 2+ bursts of 8-day telephone diary interviews. Outcome measures included burst-level abstaining, drinking frequency, frequency of exceeding guidelines of the National Institute on Alcohol Abuse and Alcoholism (1+/2+ drinks for females/males), and average drinking quantity (i.e., number of drinks on drinking days). Moderating variables included baseline age, biological sex (1=Male), education (1=Less than high school to 5=Graduate school), and perceived physical health (1=Poor to 5=Excellent). Multilevel linear and logistic regression analyses revealed that alcohol use quantity declined over time, while frequency of drinking, frequency of exceeding guidelines, and likelihood of alcohol abstention were stable, adjusting for baseline sociodemographic, health behavior, psychosocial, and health characteristics. There were also individual differences in drinking trajectories. Older age was associated with drinking more frequently and consuming fewer drinks per occasion at baseline as well as stronger declines in most alcohol use indicators across time. Furthermore, graduate education was linked with increasing drinking frequency, while male sex and poorer physical health were associated with stronger declines in drinking quantity. Future studies should evaluate mechanisms of age-related declines in alcohol use and examine contributing factors of individual differences in alcohol use trajectories across adulthood.
ANALYSIS OF DIFFERENCE OF FOOT PLANTAR PRESSURE IN OLDER WOMEN WITH DIFFERENT BONE MINERAL DENSITY LEVELS
Authors: Liu Min , Chen Gong , Wang Dongmin , Kang Ning
Published: January 2025

Objectives

To explore the characteristics of foot plantar pressures in the older women with different bone mineral density levels.

Methods

50 older women (68.84 ± 3.73 yr) were recruited from one community in Beijing, China. T value of the bone mineral density and average force of 10 plantar partitions (toe 1, toe 2-5, metatarsal 1, metatarsal 2 and metatarsal 3, metatarsal 4, metatarsal 5, midfoot, medial heel, and lateral heel) in two feet were tested. Taking the median of T value, the participants were divided into low and high bone mineral density group (L group: N = 27, T = -3.43 ± 0.80, 68.62 ± 3.42 yr; H group: N = 23, T = -1.37 ± 0.68, 69.09 ± 4.12 yr). Independent T test was used to analyze the difference of foot plantar pressures between two groups.

Results

(1) The average force of toe 1 on the dominant side in the L group was significantly lower than that in the H group (t = -2.161, p = 0.036). (2) The average force of metatarsal 5 on the dominant side and that of metatarsal 1 on the non-dominant side were significantly higher than that in the H group (t = 2.413, p = 0.020; t = 2.182, p = 0.034). Conclusions: The difference of average force in the older women with different bone mineral density levels was greater on the dominant side than that on the non-dominant side, and greater on the forefoot than that on the arch and heel.
APPLYING A SALUTOGENIC MODEL TO EXPLORE RESOURCES UTILIZATION IN OLDER ADULTS WITH PREDIABETES: A QUALITATIVE STUDY
Authors: Liu Yaqian , Leung Angela , Montayre Jed
Published: January 2025

Background

Older adults with pre-diabetes face unique health challenges, including limited awareness and resources for disease management. The Salutogenic model of Health focuses on identifying and utilising available resistance resources surrounding people to cope with tension created by stressors. This approach is crucial for this vulnerable population addressing both prevention and effective management of pre-diabetes.

Objectives

To explore pre-diabetes population’s experience towards receiving diabetes risk information, and what available resources employed to cope with stressful pre-diabetes situation.

Methods

This descriptive phenomenological qualitative study using six-step inductive thematic analysis was conducted in Hong Kong. Individual in-depth semi-structured interview guided by Salutogenic model were conducted to explore the experience of coping with prediabetes through the lens of sense of coherence (comprehensibility, manageability, meaningfulness), available resources and their utilization. Purposive sampling was used to select adults above 65 years diagnosed with pre-diabetes.

Results

The study revealed that older adults with pre-diabetes primarily leverage personal resilience, community support, and healthcare guidance as coping resources. Comprehensibility was enhanced through tailored health education, enabling participants to grasp their condition’s implications. Manageability was facilitated by accessible healthcare services and social support networks, aiding in lifestyle adjustments. Meaningfulness emerged as participants perceived their proactive health behaviors as future investments. Despite varying levels of resource accessibility, a common thread was the pursuit of a balanced, informed approach to pre-diabetes management.

Conclusion

This study provided resource map and coping mechanisms of pre-diabetic population in Hong Kong. This informs the development of a Resources-Oriented Salutogenic intervention tailored to prediabetes population.
EHEALTH LITERACY AMONG OLDER ADULTS: THE ROLE OF DIGITAL LITERACY AND SELF-EFFICACY
Authors: Göbl Linda , Jokisch Mario R , Wahl Hans-Werner , Leopold David , Doh Michael
Published: January 2025

Particularly for older adults with an increased risk of multimorbidity, digital health technologies can provide added value for health management. Successful use of these technologies requires appropriate skills. Key constructs are eHealth literacy and internet self-efficacy, which become particularly relevant in older age. This study investigated the relationship between these two multifactorial constructs in older adults, with eHealth literacy as a dependent variable, focusing on the mediating effect of digital literacy, and task-specific eHealth self-efficacy (i.e., contacting doctors via video communication and online health information seeking). A cross-sectional dataset with 327 internet-savvy German adults (mean age=71.75±6.06; 41% female) was analyzed using a structural equation model. After controlling for age, sex and subjective health, general internet self-efficacy showed a positive direct association on eHealth self-efficacy (β=.45, p< 0.01). General internet self-efficacy showed no indirect association on eHealth literacy, mediated by digital literacy, but a positive direct association on digital literacy (β=.72, p< 0.001). Digital literacy (β=.30, p< 0.05) was the strongest predictor of eHealth literacy. The model fit the data good (CFI=0.980; RMSEA=0.044) and explained 22.9% of the variance of eHealth literacy and 69.7% of the variance of digital literacy. These results point to the need for programs improving eHealth literacy to also focus on the use of digital devices and the promotion of general and task-specific internet self-efficacy. Implications for public health strategies will be discussed in order to improve eHealth literacy among older adults in a targeted manner and enable the successful use of digital health technologies.
INTERGENERATIONAL DIFFERENCES: HPV KNOWLEDGE AND PERCEIVED HEALTH STATUS AT A MIDWESTERN UNIVERSITY, 2016–2022
Authors: Nesser Whitney , Snyder Scott
Published: January 2025

Studies of Human Papillomavirus (HPV) knowledge and health status have been conducted with university students, but typically exclude faculty and staff. The study aim was to assess HPV knowledge and perceived health status among students, staff, and faculty at a Midwestern university. Three cross-sectional surveys were conducted at a Midwestern university in 2016, 2019, and 2022 assessing HPV knowledge and perceived health status. A total of 2678 student, staff, and faculty responses were received. Perceived health status was measured using a standard health status question. Knowledge of HPV was measured as total score on a 15-item true/false test. There were 145 respondents 61 years or older. A factorial ANOVA revealed that HPV knowledge was significant for age group (p <.001) but not cohort or interaction. Respondents 61 and older performed better than those aged 18-21 but lower than groups between ages 27-45. Main effects for minority status and age group (p <.001) were found but no interaction (p =.655). No cohort effect was found for perceived health status. Chi-square analyses showed perceived health status relates to age group (p <.01) with significantly more individuals 61 and older rating their health status as excellent than expected (SD = 2.6). Perceived health status for this age group was independent of cohort (p =.22). These findings highlight the need to increase HPV education to individuals under age 27, further investigate health status perceptions in individuals 61 and older, and explore perceived health status in minority respondents.
RESIDENTS’ PERSPECTIVES ON PROGRAM IMPACT OF A GROUP-BASED MIND–BODY INTERVENTION IN CCRCS
Authors: Mitchell Calli , Psenka Riley , Anctil Reid , Scully Madeleine , Laird Barrett , Park Elyse , Traeger Lara
Published: January 2025

Older adults in continuing care retirement communities (CCRCs) may experience critical stressors related to biological and social aging. Few interventions have been established to assist residents with managing life stressors, daily functioning, and sense of community. We conducted an analysis of exit feedback from intervention participants in a randomized trial of group-based stress management skills training (SMART-Relaxation Response Resiliency Program [SMART-3RP]; 9 weekly sessions delivered by a community clinician) versus waitlist control for independent living residents at nine CCRCs across the United States (N=288; 8/2022-1/2023). SMART-3RP is an evidence-based mind-body resiliency program that integrates relaxation response training with cognitive-behavioral and positive psychology principles. Intervention participants (n=148) completed a post-intervention questionnaire including 3 categorical items and open-text fields to evaluate program helpfulness with managing life stressors, daily functioning, and sense of community. Responses were evaluated using descriptive statistics and qualitative content analysis. 131/148 (88.5%) intervention participants provided feedback (77% female, M age=81 years [range=66-93 years], 91.5% White non-Hispanic). Most endorsed that the program helped manage life stressors (82.4%) and daily functioning (77.9%); participants further identified benefits of learning or strengthening skills for practicing gratitude, relaxation, emotion regulation, mindful awareness, self-compassion, and cognitive restructuring. Over half (56.9%) felt the program enhanced sense of community; residents reflected the value of connecting with group leaders and/or other group members and increasing motivation to engage in other community social and physical activities. Findings support that community residents valued participation in a group-based intervention to enhance skills for managing life stressors, daily functioning, and social connection.
AGE DIFFERENCES IN THE TEMPORAL PATTERNS OF SELF-CONTINUITY AND TEMPORAL DISCOUNTING
Authors: Lu Yi , Loeckenhoff Corinna
Published: January 2025

Self-continuity, the perceived connectedness with past and future selves, varies across the life span. Previous research found that both past and future self-continuity are positively associated with age and that such effects are more pronounced for more distant time intervals (Rutt & Löckenhoff, 2016). Questions remain about the appropriate mathematical modeling of such patterns and potential associations between age differences in self-continuity and temporal discounting, the tendency to devalue future outcomes. In response, the present study assessed both past and future self-continuity as well as temporal discounting across four temporal distances (0.5, 1, 5, 10 years) in a U.S. adult life-span sample (N=461, aged 18–96, M = 51.38, SD =19.54, 52% female, 65% Non-Hispanic White). When compared to linear and exponential models, hyperbolic models provided the best fit for both self-continuity and temporal discounting. Subsequent analyses therefore focused on hyperbolic slope parameters (k) derived for each participant. Chronological age was negatively associated with k for both self-continuity and temporal discounting, indicating that, with age, the perceived connectedness with past/future selves and the perceived value of delayed rewards show fewer decrements with increasing temporal distance. However, although k parameters for past/future self-continuity were significantly associated with each other, they were not significantly associated with temporal discounting. Moreover, age differences in temporal discounting remained significant after controlling for age differences in past/future self-continuity. The present study extends our understanding of previously reported age differences in self-continuity and temporal discounting but suggests that they cannot be traced to the same underlying mechanism.
CHINESE–WHITE DIFFERENCES IN SOCIAL ACTIVITY, SOCIAL SUPPORT, AND MENTAL HEALTH AMONG OLDER ADULTS
Authors: Chen Lingming , Procter-Gray Elizabeth , Le Qun , LoPilato Danielle , Ferretto Marianella , Zhang Meng , Kane Kevin , Li Wenjun
Published: January 2025

Studies on healthy aging of older Asian Americans, especially Chinese Americans, are rare. This study evaluated Chinese – Non-Hispanic White differences in social activity, social support and mental health. The study enrolled 554 community-dwelling older adults (434 Non-Hispanic White and 120 Chinese) aged 65-95 years old in central and northeastern Massachusetts (2018-2023). Social activity and social support were measured by the Lifestyle Questionnaire. Mental health includes depressive symptoms assessed by the Center for Epidemiologic Studies Depression Scale, anxiety symptoms assessed by the Beck Anxiety Inventory, perceived stress assessed by the Perceived Stress Scale, and resilience assessed by the modified Brief Resilience Scale. Chinese - White differences in these factors were analyzed using linear regression models adjusting for age, gender, self-rated health, physical activity, body pain, and living alone. Results showed that in both unadjusted and adjusted models, older Chinese had less social support, lower frequency of social activities, and lower level of resilience compared to Non-Hispanic Whites. In the unadjusted models, older Chinese had higher levels of perceived stress, anxiety, and depressive symptoms compared to Non-Hispanic Whites, but there were not differences in these three factors after adjusting for covariables. In conclusion, social activity, social support, and mental health were different between Chinese and Non-Hispanic Whites among older adults in the study population. The findings from this study can inform the design and implementation of health programs tailored to specific groups, thereby reducing health disparities and improving overall well-being for older adults.
EXPLORING CENTRAL SYMPTOMS OF SUBTHRESHOLD DEPRESSION IN OLDER ADULTS: A NETWORK ANALYSIS
Authors: He Rendong , Chen Li , Qiu Yiming , Li Junxin
Published: January 2025

Subthreshold depression (StD), a precursor to major depressive disorder, has not been well studied in older adults. Identifying central symptoms among various symptoms within the mental disorders enhances understanding of mental disorder structures and informs prevention strategies. We investigated the central symptoms of StD in community-dwelling older adults in China in a cross-sectional study. Depressive symptoms were assessed by prime care physicians during older adults’ well visits using the Hamilton Depression Scale-17 (HAMD-17). Those with StD (7≤ HAMD-17< 17) were included in the study (n = 424). We also collected data on demographics, depressive symptoms, anxiety symptoms, and cognitive function. The network model was constructed using the “least absolute shrinkage and selection operator” technique with the tuning parameters minimizing the extended Bayesian information criterion. Node centrality was assessed using Expected Influence (EI). Network stability was examined with a case-dropping subset bootstrap featuring a correlation stability coefficient (CS). The sample consisted of 53.5% females who, on average, were 69.69 ± 6.80 years and with a HAMD-17 score of 10.46 ± 3.21. Among the 17 symptoms, the two most central symptoms were “Loss of interest in work or activities” (EI = 0.51) and “Depressed Mood” (EI = 0.41). The correlation between these two symptoms is the strongest (Edge weight = 0.26) among all symptoms. The estimated network has a good stability (CS = 0.44). Our findings suggest that “Loss of interest in work or activities” and “Depressed Mood” are potential intervention targets for StD in older adults.
TRANSFORMING TELEHEALTH ACCESS: INTEGRATING BEHAVIORAL HEALTH AND TECHNOLOGY COACHING
Authors: Carbajal-Madrid Pedro , Holben Rachel
Published: January 2025

Research indicates only 21% of older adults in the U.S. utilize telehealth services, with economic, linguistic or literacy challenges exacerbating barriers to accessing quality health care. The Insights Program at SCAN / Independence at Home is a behavioral health program that provides individual and group therapy for people aged 55 and over and their caregivers. Serving over 2,400 individuals in 2023, the Insights program offers no cost services to those who otherwise may not be able to access mental health treatment, with a reduction in symtoms of depression and anxiety over 50%. During the Covid-19 pandemic, transitioning from in-person to telehealth sessions highlighted clients’ struggles with technology as they were expected to engage with online platforms without prior training. This led to older adults avoiding scheduling appointments or missing scheduled visits due to a lack of understanding of technology. To meet this unmet need, Independence at Home launched the T.E.C (Technology, Education and Coaching) program in 2021. This program pairs trained Digital Coaches with Insights’ clients, providing individualized support to help them use virtual platforms for online therapy sessions and access other health and social services. Early outcomes show the T.E.C program significantly increased digital literacy (1.13 vs 2.94, p<.0001 [eHealth Literacy Scale]) and technology engagement (.44 vs.75, p=.0014 [Program’s Technology Engagement Survey]) based on pre (n=22) and post (n=22) testing. These findings demonstrate the program’s positive impact on the clients’ understanding and proficiency in utilizing technology and navigating electronic health platforms.
USING AN MBSR MOBILE APP FOR MENTAL HEALTH: EXPERIENCES OF OLDER ADULTS IN UNDERSERVED COMMUNITIES
Authors: de Rosa Cristina , Chang Yu-Ping
Published: January 2025

Older adults living in underserved and racial/ethnic minority communities during the COVID-19 pandemic and beyond faced challenges regarding access to mental health care, compounded by additional vulnerability to disease. Technological solutions such as mobile applications provide great opportunities to address mental health concerns. This qualitative, descriptive analysis explores experiences of participating in an interactive and culturally-tailored mindfulness-based stress reduction (MBSR) mobile application intervention for mental health among older adults from an underserved, primarily African American community. Individual semi-structured interviews were conducted with participants who completed an 8-week MBSR mobile app intervention. Interviews were transcribed verbatim and analyzed using Braun and Clarke’s reflexive thematic analysis. A total of 17 participants were included in the analysis. Participants were ages 60-84 (M = 65.76, SD = 6.02); 94.1% were female; 82.4% reported their race/ethnicity as Black or African American. Four themes were identified in our preliminary analysis: app technology facilitated an openness to mindfulness and deconstructed barriers to access, enabled participants to come into a greater awareness of self and surroundings, allowed on-demand practices particularly during prime opportunities and stressful situations, and encouraged personal habits for maintaining and revisiting calm and relaxing states. Findings suggest feasibility and acceptability of a mobile app-delivered MBSR intervention addressing mental health needs for older adults, as well as satisfaction with app content, delivery, and support. Innovative technologies such as mobile apps have immense potential to bridge gaps in care and should be further evaluated for effectiveness and possible implementation to ameliorate mental health symptoms in underserved communities.
A PRELIMINARY EXAMINATION OF SOCIAL MEDIA USE AMONG HISPANIC/LATINX DEMENTIA CAREGIVERS
Authors: Chana Sofia Mildrum , Alvarez Loreli , Azuero Andres , Crowe Michael , Puga Frank
Published: January 2025

Hispanic/Latinx (H&L) family caregivers of people living with dementia (PLWD) experience elevated stress levels that can negatively affect their mental health. Caregivers are also prone to loneliness and social isolation and may rely on technology and social media to enhance social ties, seek support or cope with stressors. However, no studies to date have examined social media use patterns in this population. Thus, this analysis presents a preliminary description of social media use habits among H&L caregivers of PLWD (n=45) employing data from the ongoing national-level, NIA-funded study entitled, “Nuestros Días (Our Days).” We examined bivariate associations between social media use, distress from behavioral symptoms of dementia, perceived general stress, and depressive symptoms. Participants (93.3% female, Mage=55.69, SDage=8.75) reported using social media an average of 158.18 minutes (SD=131.44) per day, with Facebook (31.55%) and Instagram (27.8%) being the most used platforms. Average time spent using social media was positively associated with behavioral symptom distress (r=.37, p=.04) and depressive symptoms (r=.41, p=.02). Passive social media use (i.e., consumption of social media content without active engagement, such as ‘doomscrolling’) was positively correlated with behavioral symptom distress (r=.49, p<.001) as well as perceived stress (r=.33, p=.03) and depressive symptoms (r=.36, p=.02). But active social media use (i.e., engagement with content and deliberate interaction with other users) was not significantly correlated with any mental health outcomes. Findings highlight the different contributions of active versus passive social media use to mental health outcomes, with passive use being more closely linked to worsened mental health.
EXAMINING CHANGES IN CAREGIVING NETWORKS BY RACE AND ETHNICITY BETWEEN 2015 AND 2022
Authors: Bragg Alexa , Fabius Chanee
Published: January 2025

The growing heterogeneity of the aging population in the United States exists alongside an increasing demand for family and unpaid caregivers, particularly for those living with disability in the community. Caregivers often “role-share,” whereby multiple caregivers assist with the same tasks. Given well-documented differences in caregiving networks by race and ethnicity, it is important to assess the evolution of these arrangements over time. Leveraging the National Health and Aging Study (NHATS), a nationally representative study of Medicare beneficiaries, we compare sociodemographic and caregiving network characteristics of community-dwelling Non-Hispanic Black, Hispanic, and Non-Hispanic White groups living with disability in 2015 (n=1851) and 2022 (n=1475). Role-sharing was examined across four domains: medical, household, mobility, and self-care. While few older adult characteristics changed, Black and Hispanic older adults consistently experienced disparities in income, Medicaid-enrollment, and probable dementia. Fewer children were identified as caregivers in 2022 than in 2015 among older Black and White adults; this proportion remained stable among Hispanic older adults. More “other family” members were identified as helpers across all groups. The greatest amount of role-sharing was observed in household tasks; roughly 30% of Black, White, and Hispanic older adults experienced role-sharing in these activities in 2015 and 2022. Race differences in role-sharing patterns were evident across both time points. For instance, Hispanic older adults experienced greater role-sharing with self-care tasks than Black and White older adults in both years. Findings demonstrate reliance on alternative support structures and better inform caregiver policies for those caring for diverse groups of older adults.
LIFE EXPECTANCY AND COVID-19 MORTALITY DISPARITIES AMONG NATIVE AMERICAN OLDER ADULTS IN WYOMING
Authors: Siebecker Megan , Boateng Josephine , Fleet Alexa , Jansen Taylor , Dugan Elizabeth
Published: January 2025

Accumulated inequities contribute to health disparities. Striking evidence of this is found in Native older adults in Wyoming. The history of violence and racism against Native peoples in the US is a national shame. Documenting the health challenges experienced by Native older adults brings awareness and potential remedy to this racist history. American Indian and Alaska Native communities are a historically under-researched population and are at greater risk than non-Hispanic white older adults for many chronic conditions. The current study reports on results from the Wyoming Healthy Aging Data Reports (healthyagingdatareports.org). We compared community rates of life expectancy and COVID-19 mortality in Wyoming and in Fremont County (home to the largest proportion of older Native adults in WY). Data sources include US Census Bureau American Community Survey 2016-2020 (population characteristics), Robert Wood Johnson Foundation (community life expectancy), and the Wyoming Department of Health (COVID-19 infection and mortality rates). Small area estimation techniques were used to calculate rates, and ArcGIS software was used for mapping and geographic analyses. Results show an estimated 2,430 Native American older adults who are 55+ are living in Wyoming, and 56% of them reside in Fremont County. Life expectancy rates in Fremont County (73) are 5 years lower than the state average (78.1). There is also a 1.5x higher COVID mortality rate in Fremont County (513.7) as opposed to the state average (340.4). Communities that have experienced systematic discrimination and inadequate health care services have poor outcomes. Policy interventions to address such inequities are warranted.
MULTIMORBIDITY AND ADL DISABILITY AMONG MEXICAN AMERICAN OLDER ADULTS: SEX DIFFERENCES
Authors: Silveyra Eduardo , Snih Soham Al
Published: January 2025

Medical advancements in the 20th century allowed the development of treatments for many diseases, increasing people’s average life expectancy. We examined sex differences in the relationship between multimorbidity and disability among Mexican American older adults ages ≥75 years who were non-disabled at baseline over 12-years of follow up. Participants (N=999) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/2005-2016). Measures included socio-demographics, body mass index, pain, falls, depressive symptoms, cognitive and physical function, handgrip strength, multimorbidity and limitations in activities of daily living (≥ 1 ADL’s). Participants were divided into four groups according to the number of chronic conditions (CC): 0-1, 2, 3, and ≥ 4). Generalized Estimating Equation model were used to estimate the odds ratio and 95% Confidence Interval of ADL disability over time as a function of multimorbidity and number of chronic conditions controlling for all covariates. We found that female participants reporting 3 CC had greater odds of ADL disability (OR=1.60, 95% CI=1.08-2.38) over time than those with 0-1 CC after controlling for all covariates. Female and male participants reporting ≥4 CC had greater odds of ADL disability (OR=2.13, 95% CI=1.44-3.16 and OR=1.46, 95% CI=0.94-2.27, respectively) over time than those with 0-1 CC after controlling for all covariates. In conclusion, female participants were at increased risk for ADL disability when reporting ≥3 CC while the association was non-significant among males. Our findings indicate the need for evidence-based prevention and interventions targeting multimorbidity to prevent or delay ADL disability in this population.
PERSON-CENTERED PRACTICE OF NURSES IN LONG-TERM CARE HOSPITALS
Authors: Kim Su Hyun , Choi Yoon Saeng
Published: January 2025

Objective

This study investigates how professional competence, professional commitment, and nursing organizational culture influence the implementation of person-centered care by nurses in long-term care facilities. Method: A sample of 131 nurses from seven long-term care hospitals in South Korea participated in this research. Standardized measures were utilized to assess professional competence, professional commitment, nursing organizational culture, and person-centered care. Data analysis was conducted using hierarchical multiple regression analysis.

Results

Nurses in long-term care hospitals displayed average scores of 4.77±0.84 for professional competence and 4.27±0.89 for professional commitment on a scale of 1 to 7, and 3.45±0.44 for person-centered care on a scale of 1 to 5. Notably, nurses scored highest in relation-oriented culture and lowest in task-oriented culture. Professional competence (β=.59, p<.001) and innovation-oriented culture (β=.36, p<.001) significantly impacted person-centered care, explaining 52.5% of the variance.

Conclusion

Improving person-centered care in long-term care settings requires interventions aimed at enhancing nurses’ professional competence and cultivating an innovation-oriented nursing organizational culture.
PROTEOMIC BRAIN AGE GAP, DEMENTIA RISK, AND BRAIN VOLUME MEASUREMENTS
Authors: Kou Minghao , Ma Hao , Wang Xuan , Qi Lu
Published: January 2025

Aging is the most profound risk factor for dementia, yet the molecular basis for brain aging and dementia remains largely unknown. We utilized levels of proteins primarily originating from the brain to measure brain-specific aging signature (age gap) and assessed its associations with all-cause dementia, Alzheimer’s disease (AD), and vascular dementia. We analyzed Olink Explore 1536 proteomics data from 45,113 UK Biobank participants, followed until December 31, 2022. Machine learning models estimated the brain age gap based on 53 brain-enriched proteins, demonstrating strong correlation with chronological age (Spearman r = 0.84). Per-unit increment in the brain age gap z-score was associated with significantly elevated risks of all-cause dementia (hazard ratio [95% confidence interval], 1.82 [1.69-1.96]), AD (2.12 [1.88-2.39]), and vascular dementia (1.91 [1.58-2.31]), respectively. Notably, 2.1% of the study population exhibited extreme brain aging defined as brain age gap z-score <-2 or >2, correlating with over 4-fold increased risks of all-cause dementia and vascular dementia (4.39 [2.94–6.55] and 4.16 [1.27–13.64], respectively), and up to 6-fold increased risk of AD (HR 6.15 [3.35–11.28]). These findings were corroborated by Magnetic resonance imaging (MRI) assessments showing that a higher brain age gap aligns with cortex atrophy and increased white matter hyperintensity. Conclusively, the proteomic brain age gap serves as a meaningful indicator of brain structural degeneration and dementia risk, independent of chronological age.
USE OF OCULOMETRICS AS AN AT HOME BRAIN HEALTH MONITORING TOOL: A CASE STUDY
Authors: Kennedy Quinn , Hernandez Beatriz , Liston Dorion
Published: January 2025

Quick, objective brain health assessments are needed to monitor long term cognitive function. Oculometrics, the measurement of eye movements, may be one solution as they can quantify the health of cortical circuitry associated with perception and motor tracking. Our previous work demonstrated that an oculometric task is sensitive to a wide range of neurocognitive function. The purpose of this case study was to examine the feasibility of using an oculometric task as an at home brain health monitoring tool. The five-minute task is based on a classic step-ramp visual tracking paradigm that was administered on a PC computer with a camera and eye tracking capability. It yields 10 z-scored eye tracking metrics that are computed into a summary score. A 51-year-old woman completed the oculometric task at home on 138 days over the course of six months and recorded notes regarding anything that may have impacted performance. Data was successfully captured on 111 days (mean score = 0.02 (s =.48)). Distractions in the environment (n = 15 instances) led to worse performance (mean score = -0.37 (s =.51)). Poor sleep the night before (n = 7 instances) also may impair performance (mean score = -.051 (s =.52). Anecdotally, worse scores after poor sleep motivated the participant to improve her sleep habits. Longitudinal plots indicated improvement in the task over the first few weeks, then scores stabilized. Results provide preliminary support for oculometrics as an at-home brain health monitoring tool but point to challenges in controlling environmental factors.