bluuebunny/crossref_metadata_2025 huggingface dataset:
THE RELATIONSHIP BETWEEN SPIRITUALITY AND COGNITION WITHIN BLACK AND WHITE ADULT IN THE HANDLSLEEP STUDY
Authors: Hampton Marsha , Allan Alexa , Ji Linying , Ross Lesley , Thorpe Roland , Zonderman Alan , Evans Michele , Gamaldo Alyssa
Published: January 2025

This study explored associations between spirituality and cognitive performance within Black and White adults in the HANDLS Sleep Study (n=85; 52% Black adults; age range: 46-82). The Spirituality Transcendence Scale-Short Form measured overall spiritual transcendence orientation and three subscale scores (Prayer Fulfillment, Universality, and Connectedness). Cognitive performance was measured by several tests (MoCA, Trails Making Test, AVLT, Digit Span, Clock Drawing, Verbal Fluency). Race-stratified regression analyses explored the association between each spirituality score and cognitive test after covariate adjustment (age, sex, poverty status, depression severity and health conditions). Within Black adults, the spiritual subscale (universality and connectedness) and total scores were significantly associated with better delayed AVLT (memory; b = -.409, p = 0.014), phonemic verbal fluency (executive function; b = 1.312, p =.044) and clock drawing (visuospatial skill; b = 0.092, p = 0.040). However, these findings became non-significant after covariate adjustment. Within White adults, results indicated that higher spiritual personal fulfillment (b = -.281, p = 0.014) was significantly associated with worse performance on digit span forward (executive function); however, higher connectedness (b =.442, p = 0.014) was significantly associated with better performance on the same test after covariate adjustment. Higher connectedness was significantly associated with faster performance on Trials B (b = -4.452, p = 0.015; executive function), but was non-significant after covariate adjustment. Findings illustrate differential associations between the spirituality and cognitive performance within Black and White adults, which suggest further exploring psychosocial factors culturally relevant to each racial group to understand current findings.
LONGITUDINAL TRENDS OF FAMILY CAREGIVERS’ FINANCIAL WELL-BEING AND SUPPORTIVE CARE SERVICE USE
Authors: Liu Yin , Kim Kyungmin , Ferguson Melissa , Li Niying , Batura Josey
Published: January 2025

The stress process model denotes financial well-being and caregiving support as two important resources for family caregivers. Financial well-being can be a critical factor in securing paid/formal care services at home and in community settings. When care-related out-of-pocket expenses are high, however, it can also become a secondary strain (i.e., financial burden) for caregivers. We conducted a longitudinal trend analysis, utilizing four waves of cross-sectional data collected over time from caregivers enrolled in the National Study of Caregiving study (i.e., family/unpaid caregivers of participants in the National Health and Aging Trends Study 1, 2, 11, and 12 rounds). The findings suggested that across waves, subjective financial difficulty was associated with income, and there were disparities in financial well-being (i.e., defined as subjective financial difficulty and income) by care recipients’ chronic health conditions as well as caregivers’ race/ethnic minority status and levels of education. Further, financial well-being (including subjective financial difficulty and income) was associated with using community-based care services such as respite programs (e.g., adult day care services) and paid help for personal care at home. Caregiving policy needs to consider caregiver financial well-being and financial disparities as factors affecting care service use.
KEEPING THE FAITH IN ADVERSITY: UNPACKING THE PARADOX OF INTENSIVE CAREGIVING
Authors: Maulod Ad , Farhan Nur ‘Atiqah Mohd , Rouse Sasha , Malhotra Rahul
Published: January 2025

Striving to live an authentic life while fulfilling caregiving duties is a common challenge among family caregivers. Previously, based on the distribution of the burden and benefits of caregiving, we identified four distinct archetypes – balanced (40%), satisfied (33%), intensive (17%) and dissatisfied (10%) – among family caregivers of older adults in Singapore. “Intensive” caregivers were most burdened in terms of poor health and financial strain yet continued to express caregiving as a highly rewarding endeavor, reporting benefits which were similar or greater than the other archetypes. In this paper, we interrogate this paradox by exploring the experiences of “intensive” caregivers through a one-year longitudinal qualitative study (Quali-T, N=39) conducted with caregivers across the different archetypes. Study findings reveal complex narratives of “intensive” caregivers seeking rewards to justify their burden. A karmic belief in intangible spiritual benefits seems to be the key explanation for this phenomenon. While the supportive effects of spirituality in overcoming caregiving challenges have been studied at length, we identify the intricate processes that occur when highly stressed caregivers negotiate meaning out of their circumstances, in relation to their personal need for spiritual well-being and authenticity. While spiritual support can be profoundly comforting for many caregivers, it is not a panacea to address all the challenges they face. By addressing the spiritual dimension of care in parallel to other aspects of caregiver support, healthcare and social service providers can offer more comprehensive person-centered care that supports caregivers’ holistically.
OLDER AMERICANS ACT: TARGETING OLDER ADULTS WITH GREATEST SOCIAL AND ECONOMIC NEEDS
Authors: Robinson Kristen
Published: January 2025

The overall purpose of the Older Americans Act (OAA) is to help older adults remain in their communities through the provision of long-term services and supports. The Administration for Community Living administers the National Survey of OAA Participants (NSOAAP) to collect data on OAA clients in six service areas (home-delivered meals, congregate meals, homemaker services, transportation services, case management services, and caregiver support services). The annual survey includes questions on consumer assessment of service quality as well as client characteristics such as health status, physical and social functioning, and demographics. The OAA targets older adults with the greatest social and economic need. Older adults who receive in-home services (home-delivered meals, case management, and homemaker services) are often the ones with the highest level of need. For example, between one-half and three-quarters of in-home service clients live alone, more than half report mobility limitations, and one-third report limitations in 3+ activities of daily living (ADLs). In 2022, a module on emergency preparedness was added to the 16th NSOAAP. Findings show that one-third of in-home service clients experienced severe weather events such as a tornado, hurricane, or wildfire. Living alone and having medical devices that require electricity can be an added complication during emergencies. Among OAA clients, 41% of home-delivered meal, 60% of case management, and 42% homemaker clients reported having 3+ ADLs and rely on medical devices that require electricity. This presentation will discuss uses of the annual survey, findings from the rotating modules, and how researchers can access the data.
DEMONSTRATION OF COMMUNITY-ENGAGED RESEARCH CONTINUUM THROUGH A UNIVERSITY AND AREA AGENCY ON AGING PARTNERSHIP
Authors: Sheldon Marisa , Calhoun Katie , Rao Smitha , Happel Christine , Dabelko-Schoeny Holly , Traver Anthony
Published: January 2025

Area Agencies on Aging (AAA), which were originally established to support the planning and delivery of community-based support, are well-positioned to build knowledge and develop innovative responses to community needs through community-engaged research partnerships. This presentation illustrates a relationship between the Age-Friendly Innovation Center (AFIC) at The Ohio State University College of Social Work and the Central Ohio Area Agency on Aging (COAAA), focused on advancing community-engaged research in response to multiple aspects of aging in the community. This presentation will explore the continuum of community-engaged research, to build meaningful collaborations between two entities that shared similar values and identified shared concerns, as demonstrated through three research projects. The projects address three different critical needs among older adults and reflect different levels of engagement, 1) Low-income housing residents, especially older adults with disabilities, face heightened risks during weather-related disasters, 2) The increasing rate of older adult renters that are considered extremely housing cost burdened, and 3) The unique needs of an increasingly diverse population of older adults, in particular the rising number of older adults that are LGBTQ+. The three projects represent different methodological approaches and levels of engagement, illustrating unique funding, staffing, and project implementation activities. Preliminary findings from interviews, focus groups, and survey activities for each research project will be presented. The primary focus will be understanding the development and design of the projects, ranging from consultation, collaboration, to partnership, emphasizing challenges and points of success experienced by AAA and by AFIC.
PATIENT PRIORITIES CARE FOR HISPANICS WITH DEMENTIA (PPC-HD)
Authors: Samper-Ternent Rafael
Published: January 2025

Persons living with dementia frequently experience difficulty managing multiple chronic conditions (MCC) and have poorer outcomes. Managing MCC typically involves adhering to single-disease clinical practice guidelines. This approach results in burdensome care with outcomes that may not reflect what matters most to patients. Studies using the Patient Priorities Care (PPC) approach have demonstrated feasibility and effectiveness of PPC in different clinical settings. Physical, emotional, and cognitive impairments related to dementia interfere with disease self-management. Care partners, therefore, play an essential role in the care and decision-making of PlwD. Care partners are essential in translating ‘what matters most’ for PlwD into healthcare decisions. Patient and care partner involvement should include identifying outcome goals and care preferences (health priorities) as well as aligning care to meet those priorities. PlwD from minority groups face more barriers and have poorer outcomes compared to Non-Hispanic Whites. Hispanics are the fastest growing underrepresented population in the USA, and have higher risk of dementia compared to Non-Hispanic Whites. Hispanics rely heavily on their families and there is a cultural expectation of families to provide care to members in need. Cultural differences and language barriers shape healthcare priorities and how priorities impact outcomes among Hispanics. We recently completed a feasibility study among older Hispanics with cognitive impairment and their care partners. Results from this study confirm Hispanics with dementia and their care partners are willing and able to identify health priorities, and clinicians can align care to achieve these priorities when placed in the electronic health record (EHR).
JGMS EDITOR’S CHOICE ARTICLES OF 2023: RISK AND RECOVERY OF FUNCTIONAL DECLINE AND FRAILTY
Authors: Lipsitz Lewis , Kim Dae
Published: January 2025

This symposium will present four 2023 “Editor’s Choice” articles from the Journal of Gerontology Medical Sciences that focus on the risk and recovery of functional decline and frailty. Courtney Millar and her colleagues, in their article “Association of Proinflammatory Diet With Frailty Onset Among Adults With and Without Depressive Symptoms: Results From the Framingham Offspring Study” examine the association between an inflammatory diet and increased odds of frailty in those with depressive symptoms. Nicholas Rowan and his coauthors, in “The Association of Peripheral and Central Olfaction With Frailty in Older Adults” examine olfactory impairment, specifically olfactory identification and sensitivity, as a potential biomarker and risk factor for frailty. “Supplementing Glycine and N-Acetylcysteine (GlyNAC) in Older Adults Improves Glutathione Deficiency, Oxidative Stress, Mitochondrial Dysfunction, Inflammation, Physical Function, and Aging Hallmarks: A Randomized Clinical Trial”, written by Sekhar Rajagopal and colleagues, studies the effects of GlyNAC (combination of glycine and N-acetylcysteine [NAC]) supplementation on hallmarks of aging in older adults. Theresa Mau and coauthors, in their article, “Mitochondrial Energetics in Skeletal Muscle Are Associated With Leg Power and Cardiorespiratory Fitness in the Study of Muscle, Mobility and Aging,” examine the associations between mitochondrial energetics and functional outcomes, including leg power and cardiorespiratory fitness. Our discussant, Roger Fielding, will highlight commonalities and lessons learned from these studies.
ASSOCIATION OF PRO-INFLAMMATORY DIET WITH FRAILTY ONSET AMONG ADULTS WITH AND WITHOUT DEPRESSIVE SYMPTOMS
Authors: Millar Courtney , Dufour Alyssa , Hebert James , Shivappa Nitin , Okereke Olivia , Kiel Douglas , Hannan Marian , Sahni Shivani
Published: January 2025

Dietary inflammation is associated with increased risk of frailty. Those with depressive symptoms may be at higher risk of frailty onset since they typically have higher levels of inflammation. The study objective was to determine the association between a pro-inflammatory diet and frailty onset in those with and without clinically relevant depressive symptoms. This prospective study included 1,701 non-frail individuals with self-reported baseline (1998-2001) data available for the evaluation of energy-adjusted dietary inflammatory index (E-DIITM) (calculated from food frequency questionnaires), depressive symptoms (from the Center for Epidemiologic Studies Depression; CES-D), and follow-up frailty measurements (2011-2014). Frailty was defined as fulfilling ≥3 Fried frailty criteria. Results are presented by baseline CES-D scores <16 or ≥16 points, which denotes the absence or presence of clinically relevant depressive symptoms, respectively. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (95% CI) between E-DII and frailty onset, adjusting for confounders. In all study participants, mean (standard deviation; SD) age was 58(8) years and E-DII was -1.95 (2.20; range: -6.71 to +5.40, higher scores denote a more pro-inflammatory diet), and 45% were male. In those without clinically relevant depressive symptoms, one-unit higher E-DII score was associated with 14% increased odds (95% CI:1.05-1.24) of frailty. In those with depressive symptoms, one-unit higher E-DII score was associated with 55% increased odds of frailty (95% CI: 1.13-2.13). The association between inflammatory diet and increased odds of frailty appeared somewhat stronger among those with depressive symptoms. This preliminary finding warrants further investigation.
THE ASSOCIATION OF PERIPHERAL AND CENTRAL OLFACTION WITH FRAILTY IN OLDER ADULTS
Authors: Rowan Nicholas , Nagururu Nimesh , Bernstein Isaac , Voegtline Kristin , Olson Sarah , Agrawal Yuri
Published: January 2025

Olfactory impairment is increasingly recognized as a biomarker of frailty, but the relationship between olfactory subdomains that describe peripheral or central dysfunction and frailty remains unexplored. In this study, we examined 1,160 older adults from the National Social Life, Health, and Aging Project Wave 3. Olfactory identification (OI): the ability to identify an odorant; and olfactory sensitivity (OS): the ability to detect the presence of an odorant, were assessed using 5 and 6-point measures respectively. Frailty was operationalized as both a 37-item Frailty Index (FI) and the 5-item Physical Frailty Phenotype (PFP). Mixed models were fit to examine the association between OI, OS, FI and PFP, while adjusting for demographic and clinical covariates. Subjects in the most-frail PFP category had lower OI and OS scores (OI: 3.88 vs 4.19, p= 0.016; OS: 3.15 vs 3.47, p= 0.031), whereas, subjects in the most-frail FI category exhibited lower OI scores but not OS scores when compared to non-frail subjects (OI: 3.72 vs 4.27, p= 0.014; OS: 3.19 vs 3.43, p= 0.476). Adjusted mixed models showed that a point increase in OI was associated with a lower PFP score (β= -0.107, p= 0.006) and FI score (β= -0.009, p= 0.010). A point increase in OS was associated with a lower PFP score (β= -0.058, p= 0.016), but not FI score (β= -0.004, p= 0.064. These finding reveal distinct associations between peripheral and central measures of olfaction and frailty, highlighting the potential use of olfaction assessment as a biomarker and risk factor for frailty.
MITOCHONDRIAL ENERGETICS IN SKELETAL MUSCLE ARE ASSOCIATED WITH LEG POWER AND CARDIORESPIRATORY FITNESS IN SOMMA
Authors: Mau Theresa , Kramer Philip , Coen Paul , Hepple Russell , Kritchevsky Stephen , Newman Anne , Cawthon Peggy , Cummings Steven
Published: January 2025

Mitochondrial energetics are an important property of aging muscle, as generation of energy is pivotal to the execution of muscle contraction. However, its association with functional outcomes, including leg power and cardiorespiratory fitness, is largely understudied. In the Study of Muscle, Mobility and Aging, we collected vastus lateralis biopsies from older adults (n = 879, 70–94 years, 59.2% women). Maximal State 3 respiration (Max OXPHOS) was assessed in permeabilized fiber bundles by high-resolution respirometry. Capacity for maximal adenosine triphosphate production (ATPmax) was measured in vivo by 31 P magnetic resonance spectroscopy. Leg extension power was measured with a Keiser press system, and VO2peak was determined using a standardized cardiopulmonary exercise test. Gender-stratified multivariate linear regression models were adjusted for age, race, technician/site, adiposity, and physical activity with beta coefficients expressed per 1-SD increment in the independent variable. Max OXPHOS was associated with leg power for both women (β = 0.12 Watts/kg, p <.001) and men (β = 0.11 Watts/kg, p <.050). ATPmax was associated with leg power for men (β = 0.09 Watts/kg, p <.05) but was not significant for women (β = 0.03 Watts/kg, p =.11).
LEVERAGING PATIENT PORTALS TO IDENTIFY AND INTERVENE IN DEMENTIA CARE: CAREGIVING, MEDICATION, AND ACUTE CARE
Authors: Portz Jennifer , Demiris George
Published: January 2025

Care partners play a pivotal role in supporting people living with dementia (PLWD), yet their systematic identification and involvement in clinical care are often lacking. This symposium presents four studies highlighting ground-breaking care partner identification methods to inform patient portal-based interventions targeting care partners to enhance dementia care. The first study, a retrospective cohort analysis focuses on automating care partner identification via structured patient contact data and unstructured portal notes in the electronic health record to better deliver evidence-based caregiving interventions through patient portals. The second study explores the associations between the documentation of a care partner and documentation of care partner education in the electronic health record and hospital length of stay. The third study presents an analysis of patient secure portal messages and clinical notes that identified modifiable contributors to potentially preventable acute care visits among PLWD including unmet care needs, particularly in care coordination, health systems navigation, and medication management that contribute. The final study describes the content of patient portal messages relating to medications among PLWD, care partners, and clinicians in a single health system, to inform the development of a portal-based intervention to reduce the use of potentially inappropriate medications among PLWD Our Discussant, Dr. George Demiris, PhD, an informatics and caregiving technology expert, will lead a conversation emphasizing the importance of systematic care partner identification and integrating care partner engagement tools with patient portals to enhance support for PLWD and their care partners, ultimately improving dementia care delivery and outcomes.
IDENTIFICATION OF PATIENT PORTAL MESSAGES SENT FROM NON–PROXY ACCOUNT CARE PARTNERS AND THEIR PORTAL USE PATTERNS
Authors: Portz Jennifer , Martin Daniel , Gleason Kelly , Washington Karla , Daddato Andrea , Powers Dave , Lyons Jason , Bayliss Elizabeth
Published: January 2025

Automating care partner identification via the electronic health record (EHR) can streamline the delivery of evidence-based caregiving interventions through patient portals and is vital for supporting care partners of people living with dementia (PLWD). This retrospective cohort study focused on identifying patient portal messages from non-proxy care partners and exploring associated portal usage. Conducted at Kaiser Permanente Colorado, it analyzed data from 789 PLWD aged ≥60, utilizing the EHR and Virtual Data Warehouse. Structured patient contact data (e.g., emergency contact, family contact) and unstructured portal notes were used to match contact names with caregiver terms, employing a rule-based algorithm to identify care partner messages. Results showed that 95% of PLWD had at least one care partner listed, with an average of 2.1. A majority (77%) engaged with the patient portal, and 57% had messages sent by care partners, predominantly non-proxy (7% were from proxy accounts). Non-proxy care partners sent an average of six messages during the study period. Additionally, 54% of PLWD had portal activity on days when care partners sent messages, showing their involvement in healthcare management. Care partners mainly accessed clinical visit information, medication details, lab scheduling/results, and primary care provider information on these days. This study underscores the importance of automated care partner identification and non-proxy engagement via patient portals, facilitating better support for PLWD and enhancing their care partners’ involvement.
ASSOCIATION BETWEEN PARTNER IDENTIFICATION AND EDUCATION WITH HOSPITAL LENGTH OF STAY FOR PATIENTS WITH DEMENTIA
Authors: Werner Nicole , Medlin Austin , Fields Beth
Published: January 2025

Despite overwhelming reliance on care partners to care for people living with dementia (PLWD) after a hospitalization, care partners rarely receive adequate education to meet post-hospitalization caregiving demands, which is associated with health consequences including adverse clinical outcomes for PLWD, and increased levels of stress, depression, and morbidity for care partners. The present study aimed to explore associations between care partner identification as documented in the electronic health record (EHR), documented care partner education, and PLWD length of stay (LOS). We extracted EHR data from a large academic medical center in the Midwest between 1/1/2019 and 8/1/2022 (N = 8038). To assess association between care partner identification and PLWD LOS, encounters were coded dichotomously, either ‘lacking a care partner’ or ‘care partner present’, depending on EHR documentation. Similarly, encounters received designations of increased education if care partners received more education on post-discharge care than the education sample median. Independent t-tests analyzed mean differences on LOS for care partner identification. The same approach was used on a subsample of encounters with care partner identification (n=1644) to analyze associations between care partner education and LOS. We found no significant difference in LOS based on care partner identification status (p=.072). Among PLWD with identified care partners, significant differences in LOS were found between education groups (p=.017), where longer hospitalizations were associated with more care partner education (less education M=5.9 days, more education M=6.9). These results suggest that targeted education could better support care partners when a shorter LOS is expected for PLWD.
LEVERAGING ELECTRONIC MEDICAL RECORD DATA TO IDENTIFY MODIFIABLE CONTRIBUTORS TO ACUTE CARE USE IN DEMENTIA
Authors: Nothelle Stephanie , Ahmidouch Mohamed , Loosen Julia , Boyd Cynthia , Wolff Jennifer
Published: January 2025

Persons living with dementia (PLWD) are at increased risk of potentially preventable acute care visits (hospitalizations and emergency department visits), but modifiable contributors are poorly understood. We aimed to identify potentially modifiable factors from patient secure portal messages and outpatient clinical notes in the 30 days leading up to a potentially preventable acute care visit. We examined data from the Johns Hopkins Health System electronic medical record from 2017-2022. We included adults >64 years with dementia diagnosis, 1+ advanced chronic illness (advanced liver disease, chronic obstructive pulmonary disease, congestive heart failure, diabetes with complications, chronic kidney disease), 2+ primary care visits who had a potentially preventable acute care visit. Two coders coded each message or note using a qualitative content analysis approach. We included 128 PLWD of whom 75 (69%) were female, and 68 (53%) were white. Approximately 47 (37%) had at least one patient/caregiver initiated portal message. Topics identified were similar across patient portal message and clinical notes. The most commonly mentioned needs related to care coordination, health systems navigation, medication management, access to and timeliness of care, and new physical symptoms. Cognitive concerns or symptoms were more commonly mentioned in clinical notes than portal messages. Portal messages and outpatient clinical notes prior to a potentially preventable acute care visit contain information about unmet care needs, predominantly related to coordinating and accessing care. Needs identified in this analysis may be addressable by a care manager to prevent unnecessary acute care use.
FAMILY CAREGIVER PERSPECTIVES ON THE PALLIATIVE CARE NEEDS OF HOSPITALIZED PERSONS LIVING WITH DEMENTIA
Authors: Kwak Jung , Kvale Elizabeth , Mills Sarah , Oppong Kwaku Duah
Published: January 2025

The progressive nature of dementia results in significant symptom burden, functional decline, and frequent hospitalizations, underscoring the need for specialized palliative care for persons living with dementia (PLWDs) and their caregivers. Existing studies, primarily retrospective analyses of health records or provider interviews, lack information on the critical psychosocial and social support contexts that significantly influence the palliative care needs of PLWDs. Addressing this gap, our study explored the perspectives of family caregivers on the palliative care needs of hospitalized PLWDs, informed by the Adapted Conceptual Model Integrating Palliative Care in Serious Illness and Multiple Chronic Conditions. We interviewed 37 caregivers of hospitalized PLWDs who were referred for palliative care. Caregivers identified primarily as female (66%) and caring for parents (58%), and as White (46%), Black (17%), Asian (5%), and Latino (31%). Most common challenges caregivers reported were about addressing health issues (58%), managing emotional difficulties (53%), and making care plan decisions (42%). Three related themes emerged from in-depth qualitative interviews: the complex care needs of PLWDs, including pain and symptom management; caregivers’ needs for support in discharge preparation; and challenges in making care transition decisions into facilities. These insights underscore the caregivers’ critical role in managing care and making decisions during critical care transitions for hospitalized PLWDs. The findings provide implications for practice and research including enhanced care coordination between primary, palliative, and discharge planning services in acute settings and future research on the impact of psychosocial and social support factors on palliative care outcomes for this vulnerable population.
THE PARADOX OF CONNECTION: MUTUAL FOLLOWING’S IMPACT ON LONELINESS AMONG OLDER ADULTS IN ONLINE NETWORKS
Authors: Kim Nahyun , Katagiri Keiko
Published: January 2025

Online communities serve as a resource for many older adults to create new connections, such as friendships and acquaintanceships that can help alleviate loneliness. Despite the many advantages, there is a lack of research on the network size in online communities tailored for older adults and its effects on loneliness reduction. This study examines mutual following on online platforms as an indicator of new connections, focusing on its relationship with the perceived formation of new connections and their subsequent effect on loneliness reduction among community members. In February 2023, we conducted an online survey within an online community for older adults in Japan, involving participants aged 60–79 (n=819). The platform provided features such as photo sharing, group participation, and user following. Data collected included group participation, mutual following, perceived establishment of new online connections, and loneliness. A path analysis revealed that a greater number of mutual followers was positively related to the perception of establishing new online connections, leading to a reduction in loneliness. However, we also found a direct positive association between mutual following and loneliness, indicating a paradoxical finding: the mere increase in mutual followers, devoid of meaningful engagement, may exacerbate loneliness. This suggests that the effectiveness of online connections in reducing loneliness is contingent upon the quality of relationships formed. These findings highlight the importance of fostering quality interactions within online communities, to enhance older adults’ well-being in digital environments.
PERSPECTIVES OF PERSON-CENTEREDNESS ACROSS LONG-TERM CARE AND COMMUNITY-BASED SETTINGS
Authors: Stratton Lauren , Zimmerman Sheryl , Efird-Green Lea , Fazio Sam
Published: January 2025

Within long-term care, person-centeredness is key to providing quality care to people living with dementia. However, there are discrepancies on how long-term and community-based organizations provide care that is person-centered and how it is integrated within their organizations and among staff. To better understand the concept of person-centeredness within long-term and community-based services, we conducted three focus groups with members of the Alzheimer’s Association Dementia Care Provider Roundtable, which consists of leadership of long-term and community-based care organizations. Prompts asked questions on person-centeredness in relation to current organizational systems, care, and workforce. Overall, themes emerged on types of care that are delivered in a person-centered way, challenges in delivering care in a person-centered care, the integration of person-centeredness into staff training, and if person-centered is the correct term to use. Additionally, discussion included integrating technology in a more person-centered way to benefit both the staff and the person living with dementia. Understanding these themes may help to provide recommendations on how to create guidelines for training staff and integrate person-centered care with the long-term care workforce more effectively.
USC ALZHEIMER’S DISEASE AND ALZHEIMER’S DISEASE-RELATED DEMENTIAS (RCMAR) CENTER: LESSONS LEARNED
Authors: Ailshire Jennifer
Published: January 2025

The National Institute on Aging has awarded another five-year, $3.6M grant to fund the University of Southern California Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias Resource Center for Minority Aging Research. The Center is led by the multidisciplinary team of Julie Zissimopoulos, Jennifer Ailshire, and Emma Aguila. The USC AD/ADRD RCMAR supports junior scientists exploring health and economic disparities associated with dementia. The RCMAR – housed within the USC Schaeffer Center for Health Policy & Economics – focuses on pathways by which social, behavioral, and economic factors – as well as policies and health systems – affect disparities in risk of dementia and disparities in the health, health care and economic outcomes of persons living with dementia. The center also helps launch the careers of underrepresented junior investigators, providing funding, mentorship, and tools to support their pilot research projects. The Center was established in 2012 and has supported 34 scholars from USC and 14 other institutions. Alumni of the program have received more than $11.2 million in research funding and have published more than 268 peer-reviewed articles. Many scientists have received academic promotions and met career goals. The Center has an extensive network of supporters and collaborators including Howard University, Spelman College, Cal State Fullerton and other NIA-funded centers at USC including: Roybal Center for Behavioral Interventions of Aging, Alzheimer Disease Research Center, Center for Economic and Sociodemographic Study of AD/ADRD, and USC/UCLA Center on Biodemography and Population Health. The Center also supports the annual Science of AD/ADRD for Social Scientists.
GEOGRAPHIC DISPARITIES IN ALZHEIMER’S DISEASE AND RELATED DEMENTIAS USING BAYESIAN MULTISTATE LIFE TABLE METHODS
Authors: Wong Jason , Zang Emma
Published: January 2025

Research has documented persistent regional disparities in the risk of Alzheimer’s disease and related dementias (ADRD) in the United States based on individuals’ current residence. However, it remains unclear how childhood region and current region jointly shape later ADRD outcomes. This obscurity conceals significant variations among older adults who reside in the same current region. Using data from the 1998-2020 waves of the Health and Retirement Study, we employ an innovative Bayesian multistate life table method to estimate how ADRD-related life expectancies vary across combinations of birth regions and current regions. Our results show that ADRD-related life expectancies are more strongly associated with regions of birth than with current regions of residence. Especially, at age 50, individuals born in the South, regardless of current residence, were expected to have shorter years (Men: 13.8-15.2 years; Women: 17.3-18.4 years) of life living without ADRD and longer years (Men: 2.7-3.0 years; Women: 3.6-3.9 years) of life with dementia, compared to those born in other regions. Our findings offer new evidence of the Southern disadvantage of ADRD by demonstrating that growing up in the South during the critical period of childhood may have long-lasting impacts on cognitive functioning later in life.
HOW DO PLACES OF RESIDENCE OVER THE LIFE COURSE SHAPE THE DYNAMICS OF HEALTH DISPARITIES IN LATER LIFE?
Authors: Lin Zhuoer , Chen Xi
Published: January 2025

Background

Significant geographical disparities persist in cognitive and health outcomes. According to life course theory, these disparities may stem from a history of place-based exposures throughout lifespan. However, due to data limitations, no study has explored how residential history impacts later-life health inequalities.

Methods

We addressed this gap by constructing an exceptionally comprehensive residential history dataset. Drawing from the Health and Retirement Study, we identified state-level places of residence for each individual from birth to age 60, and subsequently linked this information to a broad range of cognitive and health outcomes in later life (N=10,124). Employing regression-based Shapley value decomposition, we quantified the contribution of place of residence at each age to cognitive and health outcomes, thereby delineating the trajectories of place effects on cognition and health.

Results

Our analysis revealed distinct contributions of place of residence at various ages, particularly in relation to cognitive health compared to other health outcomes. Notably, place of residence exerted the most significant influence on cognition at birth, with this contribution decreasing linearly and rapidly during the initial 20 years of life (from age 0 to age 20), before stabilizing during adulthood. In contrast, we observed an overall upward trend in the contribution of place of residence to other health outcomes such as disability and depression.

Discussion

Our findings underscore the dynamic nature of the contribution of place of residence to health inequalities over the life course, emphasizing substantial disparities in the effects of location on cognitive health compared to other health outcomes.
SUPPORTING FAMILY CAREGIVING IN MULTICULTURAL CONTEXTS
Authors: Yuwen Weichao , Ramirez Maggie , Xie Serena Jinchen
Published: January 2025

There are 53 million family caregivers providing an estimated $470 billion in unpaid care services in the U.S. annually. Over 40% of them self-identify as having a racial or ethnic minority background, and at least one-third speak a language other than English at home. Caregivers from racial and ethnic minority groups experience significantly more physical and emotional stress than their white counterparts. This session focuses on supporting family caregiving in multicultural contexts. Berridge will discuss cultural values as they relate to technology intervention considerations for caregivers of older adults. Li and Liang will discuss a study exploring the needs of Chinese American families caring for older adults and their perceptions of using technologies such as chatbots. Specifically, Li will discuss results from four focus groups with community-based organizations’ staff supporting these families, and Liang will discuss results from family caregivers. Cardoso-Arias will discuss structural barriers to accessing supportive services among Latino family caregivers. Finally, Aguilar will describe a conceptual model of family caregiving and health equity. To conclude, our discussant Ms. Xie will discuss cross-cutting implications across studies and offer insights on how to incorporate cultural considerations in developing technologies to support family caregivers.
CULTURAL CONTEXTS AND BEYOND: THE NEED FOR VALUE SENSITIVE DESIGN IN TECHNOLOGIES TO SUPPORT CARE
Authors: Berridge Clara
Published: January 2025

It has long been understood in fields such as science and technology studies that technologies and data are not value-neutral, but digital technology interventions to support care partners of older adults are often treated as such. Understanding that values are cultural commitments that are not universally prioritized is critical for effective and non-harmful interventions. This presentation will describe ways in which values, assumptions, and priorities are embedded in digital interventions, drawing on findings from multiple studies of families’ experiences with care technologies. The importance of attention to norms, values, and expectations in care relationships, as well as contextual factors such as trauma history and intergenerational family cultural conflict will be discussed. Practical questions will be offered to guide the broader application of Value Sensitive Design in technology design and research to make all stakeholders’ values explicit, understand value tensions, and center and operationalize the values and needs of intended users.
STRUCTURAL BARRIERS TO UTILIZATION OF SUPPORTIVE SERVICES AMONG LATINO CAREGIVERS OF PEOPLE LIVING WITH DEMENTIA
Authors: Cardoso-Arias Rafael , Ramirez Maggie
Published: January 2025

Underutilization of supportive healthcare and social services may contribute to Latino caregivers’ higher risk of experiencing adverse health outcomes. The study objective was to understand structural barriers to utilization of supportive services among Latino caregivers of people living with dementia (PLWD). In Washington State, we interviewed 30 Latino caregivers of PLWD and 14 healthcare and social service providers. We applied deductive coding to the interview transcripts—relying on predefined codes representing the Cultural Treatment Adaptation Framework. We then examined excerpts coded under “Treatment Access/Entry.” Lastly, we inductively derived themes representing structural barriers to Latino caregivers’ utilization of supportive services. We identified structural barriers within the following three themes: 1) ethnic and language discordance between providers and Latino caregivers, 2) limited coordination between health systems and the broader network of providers in the community, and 3) digital health inequities.These interconnected themes underscore the importance of culturally competent, linguistically accessible care and technologically innovative approaches for Latino families. Healthcare systems often adhere to standards of care primarily designed for a majority population, which may fall short in meeting the unique needs and preferences of Latino communities and lead to disparities in access to and utilization of supportive services. Overall, the study findings can inform decision makers to adapt and adopt targeted interventions, policies, and practices, to increase and improve utilization of supportive services for Latino PLWD and their family caregivers.
TECHNOLOGY AND TRADITIONAL TOOLS FOR INTERGENERATIONAL CONNECTIONS IN HIGHER EDUCATION
Authors: Fassi Janelle , Rickenbach Elizabeth , Newsham Tina
Published: January 2025

While the benefits of connecting older adults with college-aged students are well-documented in literature, the practical application of connecting these individuals together in intergenerational learning spaces is more challenging. This session focuses on the challenges and strategies for successfully implementing and sustaining intergenerational connections in higher education using technology or traditional tools like board games. Each presentation outlines an innovative way for connecting college-aged students with older adults both inside and outside the classroom. The first presentation focuses on the factors that impact the implementation and sustainability of the Cyber-Seniors program through an implementation science framework. The second presentation describes the use of a waitlist control design for examining and identifying the strengths of the Cyber-Seniors Program. The third presentation identifies the feasibility and reflections from an in-person intergenerational game collaboration with Saint Anselm College undergraduate students and community partners. The fourth presentation examines the benefits and challenges of Tellegacy, an intergenerational story-telling project facilitated by university students via in-person, phone or virtual one-on-one visits with older adults in retirement communities. Aligning with the Annual Scientific Meeting 2024 theme, these presentations demonstrate fortitude in refining processes to ensure we are building optimal experiences to connect students and older adults.
GAMES ARE FOR EVERYONE: A PILOT PROJECT TO FACILITATE INTERGENERATIONAL ENGAGEMENT THROUGH GAMES
Authors: Rickenbach Elizabeth , Brady Loretta , Clifford Adeline , Gamache Seana
Published: January 2025

Undergraduate students and faculty participated in a pilot project to facilitate intergenerational engagement with older adults in the community through games. Each age group shared “their generation’s” games and learned games together by playing new games curated by a game designer that are specific to an intergenerational audience. Previous research has demonstrated that intergenerational activities are beneficial to physical and mental health, mood, age-related biases, and reduced loneliness. Intergenerational activities that involve games can add an element of play, collaboration, and cognitive enrichment across all participants that may extend the benefits across all participants and encourage co-learning. Intergenerational research has often included life-interviews (older teaching younger) and when games are considered, they are often video games (younger teaching older); this project is novel in that it includes socialization, play, and cognitive engagement with traditional games with an “equal playing field” (both younger and older adults will teach and learn games). The specific purpose of the project was to demonstrate the feasibility of a facilitated game collaboration as an intergenerational activity through participant feedback. Results showed that the experience provided collaboration, joy, learning, and an opportunity for facilitated exposure to challenging topics (e.g., political discourse across generations, sharing life stories during play, expressing grief and loss during or prompted by play, experiencing frustration and satisfaction due to play experiences). Students reported that the games provide an opportunity for engagement with older adults that felt comfortable, and at times, the experience was “more about the conversation, and less about the games.”
VIRTUAL IMPLEMENTATION OF MOBILITY PROGRAMS IN MEDICALLY COMPLEX POPULATIONS
Authors: Garbin Alexander , Stevens-Lapsley Jennifer
Published: January 2025

Utilization of virtual platforms (e.g., Zoom, Teams, VA Video Connect) has rapidly expanded in both clinical and research settings since the onset of the COVID-19 pandemic. Within research, the use of virtual platforms affords numerous advantages including access to a broader geographical range of older adults, lack of dependency on transportation, and ability to monitor fidelity remotely. However, there also exist numerous considerations to ensure success when using virtual platforms as part of a research study. This symposium will detail four research projects utilizing virtual platforms. The research projects discussed share the overarching theme of improving mobility in older adults with medical complexity while varying in their stages of research, methodologies used, and how they use virtual platforms. The first speaker (Ritchey) will detail implementation of a virtual fall prevention clinical trial, MOVing FREEly. The second speaker (Garbin) will present on the use of a virtual platform to 1) determine the prevalence of fall risk factors in older Veterans using virtual fall risk factor assessments and 2) examine Veterans’ and providers’ perceptions of virtual fall prevention strategies. The third speaker (Rauzi) will discuss the development and refinement of a multicomponent telerehabilitation intervention delivered via virtual platform to older Veterans, using mixed-methods approaches. The fourth speaker (Stevens-Lapsley) will discuss challenges and successes of using virtual platforms and technologies to remotely monitor fidelity in a large-scale pragmatic clinical trial. These talks will provide a comprehensive understanding of barriers, solutions, and considerations for employing virtual platforms across a range of studies.