bluuebunny/crossref_metadata_2025 huggingface dataset:
CORRELATIONS AMONG SLEEP BIOMETRICS, DAILY STEPS, AND SELF-REPORTED FUNCTION IN OLDER COUPLES WITH AND WITHOUT MCI
Authors: Alimohammadbeik Kourosh , Jacelon Cynthia
Published: January 2025

Altered sleep patterns are common among older individuals and those with Mild Cognitive Impairment (MCI). Sleep changes can lead to fatigue, and alterations in physical and social function. In couples, disrupted sleep of one partner can affect the other’s sleep patterns. We compared measures of sleep and steps, captured by actigraph, with self-reported fatigue, physical function, and social roles among cognitively intact couples, and those with one partner who had MCI. The WHO International Classification of Functioning, Disability, and Health was the framework. Using a correlational design, we compared biometric measures with scales on the PROMIS 29 at three points in time in 13 couples >70 years old. Eight couples had one partner who scored < 25 on the MoCA. Significance was set at P =0.05. In cognitively intact couples, total and deep sleep time were correlated with fatigue (negative) and social roles. Deep sleep time was associated with physical function. Bedtime and time awake were correlated with fatigue (negative) and social roles. In couples with MCI, total and deep sleep time were associated with fatigue (negative). Steps correlated with physical activity, fatigue (negative), and social roles. Time awake was positively associated with fatigue. Bedtime and number of awakenings were associated with social role (negative). Sleep quality and steps have significant effects on self-reported function of couples with and without MCI. Total and deep sleep time were most important for cognitively intact couples, and number of steps was most important for couples with MCI.
DIGITAL INTERVENTIONS FOR PEOPLE WITH MILD COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW OF RCTS
Authors: He Chanchan , Jiang Nan , Chen Ke , Yu Yue , Xiao Yexuan
Published: January 2025

Background

Digital interventions aim to improve outcomes in irreversible Mild Cognitive Impairment (MCI) with limited evidence on effective strategies. This review evaluates the effectiveness of such interventions through randomized controlled trials (RCTs), identifying key characteristics of success.

Methods

The search was conducted on CINAHL, Embase, MEDLINE, PubMed, PsycINFO, and grey literature from January 1, 2010, to November 20, 2023, to identify randomized controlled trials that examined the effects of digital interventions on global cognitive function outcomes in individuals with MCI. Mean differences and standard deviations of neuropsychological assessment scores were extracted to derive standardized mean differences.

Results

Out of 2,859 studies, 19 were analyzed. Digital interventions improved global cognitive function in MCI patients (SMD (95% CI) = 0.40 (0.22-0.59)), executive function (-0.48 (-0.76 to -0.21)) and attention (0.39 (0.16-0.61)). Four critical factors contribute to the success of these interventions: (1) Ease of use; (2) Opportunities for social interactions; (3) Human support; (4) Engagement in physical exercises; and (5) interventions tailored to the participants’ needs. Additionally, methodological considerations for future randomized controlled trials on digital MCI interventions include: (1) Inclusion of both a healthy control group and an intervention group with clinically diagnosed MCI; (2) Collecting support-related data throughout the intervention period; (3) Assessing intervention success qualitatively and quantitatively; (4) Conducting follow-up interviews and surveys up to 1-year post-intervention to evaluate long-term outcomes.

Conclusion

The insights from this systematic review empower future digital MCI intervention researchers, health professionals, clinicians, and patients to design, develop, and implement successful interventions for older users.
NEIGHBORHOOD DISORDER AND COGNITIVE HEATH: THE CAUSAL MEDIATING EFFECTS OF ALLOSTATIC LOAD AND PHYSICAL ACTIVITIES
Authors: Yu Jiao , Wang Yi , Chen Xi
Published: January 2025

Numerous studies have attempted to establish a link between neighborhood disorder and later life cognitive decline, with stress accumulation and reduced physical activity hypothesized as potential mediators. However, there remains a significant gap in our understanding of the causal mechanisms underlying this link. This research utilizes data from the Health and Retirement Study (2006-2008 and 2010-2012) to investigate whether stress accumulation, as measured by allostatic load, and physical activity mediate the association between perceived neighborhood disorder and cognitive health. Older Americans aged 65 years and older without dementia at baseline were selected (n=4,346). Cognitive function was measured using the Telephone Interview for Cognitive Status (TICS). Employing propensity score matching followed by causal mediation analyses, we find that higher levels of perceived neighborhood disorder at baseline are associated with poorer cognitive health at a subsequent wave. Under a counterfactual framework, if every respondent had experienced one standard deviation above the mean level of neighborhood disorder, the cognitive score would be 0.68 lower than the score if everyone had experienced one standard deviation below the mean (total effect: -0.68, 95% CI: -0.94, -0.42). Approximately three percent (natural indirect effect = -0.02, 95% CI: -0.04, -0.01) of this effect is attributable to physical activity. Notably, we find no significant mediating effect of allostatic load (natural indirect effect = -0.005, 95% CI: -0.02, 0.004) after adjusting for individual-level characteristics. Our findings underscore the significant role of the behavioral factor in mediating the relationship between disadvantaged neighborhoods and cognitive health among older adults.
PREDICTING MILD COGNITIVE IMPAIRMENT AND DEMENTIA: MACHINE LEARNING VERSUS TRADITIONAL METHODOLOGIES
Authors: Kang Bada , Hong Dahye , Kim Jennifer , Oh Sarah
Published: January 2025

Although mild cognitive impairment (MCI) faces significant challenges in terms of early diagnosis and intervention, machine learning (ML) shows promise in managing complex data for MCI and dementia prediction. This study assessed and compared the predictive accuracy of ML models with traditional logistic regression in identifying MCI and dementia onset using the Korean Longitudinal Study of Aging (KLoSA) dataset. The sample comprised 4,975 older adults aged 60 years or older. Identification of MCI and dementia relied on self-reported diagnoses with sociodemographic, lifestyle, and health-related variables as key covariates. The dataset was categorized into training and test sets to predict MCI and dementia, employing models such as logistic regression, light gradient-boosting machine, XGBoost, CatBoost, and Random Forest. Shapley additive explanation values were used to determine the contribution of each feature to the prediction rate. Logistic regression excelled in predicting dementia onset, whereas XGBoost performed better in predicting MCI (XGBoost AUC: 0.7271; Random Forest AUC: 0.6741). Increased assets reduced MCI risk, however, lower education, reduced activities of daily living functional ability, and pain in daily life increased MCI risk. Predictors of developing dementia were being female, older age, reduced activities of daily living functional ability, and lower education. The ML algorithms, particularly XGBoost, demonstrated potential for predicting MCI onset using KLoSA data. This study underscores the crucial role of sociodemographic factors in the early prediction and prevention of cognitive impairment. By leveraging readily available sociodemographic and health-related characteristics, more cost-effective and targeted interventions can be provided to at-risk community-dwelling older adults.
RACIAL/ETHNIC DIFFERENCES IN SUBJECTIVE COGNITIVE DECLINE SYNDROMES
Authors: Jacobs Moyosoreoluwa , Lichtenberg Peter , Tarraf Wassim
Published: January 2025

Subjective cognitive decline (SCD) is a precursor to Alzheimer’s Disease and Related Dementias (ADRD). SCD rates vary by race/ethnicity. SCD is also heterogenous in the population and can yield different syndromes. We used Behavioral Risk Factor Surveillance System data (2015/2016 and 2019/2020) from non-Hispanic White (NHW), Black (NHB), and Hispanic individuals aged 50+ years (unweighted-n=44,152) who endorsed SCD, to fit latent class analysis (LCA) and derive SCD syndromes based on measures of activities limitations, need for assistance, and consulting with healthcare providers. We used multinomial logistic regression to model differences in syndrome prevalence by R/E and assess the contributions of predisposing (e.g., age), enabling (e.g., insurance), and health need (E.g., cardiovascular) factors to explaining these racial/ethnic (R/E) differences. Three groupings (social limitations [13.3%], mixed functional limitations [26.2%] and uncomplicated [60.5%]) fit the data well. Compared to NHWs (21.9%), Hispanics and NHBs were significantly more likely to meet criteria for mixed functional limitations [38.2% and 41.2% respectively] and less likely to be in the uncomplicated group. Predisposing, enabling, and health need factors only partially attenuated (10-22%) the Relative Risk Ratios for classification in the mixed functional limitations for NHBs and Hispanics. Hispanics and NHBs presented with more mixed SCD-related functional limitations compared to NHWs, suggesting higher risk for developing ADRDs. Since nearly 2/3 individuals in the mixed functional limitations group reported discussing SCD with healthcare providers, there are opportunities to provide interventions for this high risk group at their place of care, and reduce R/E disparities in SCD and ADRD.
TRENDS IN THE PREVALENCE OF CARDIOMETABOLIC COMORBIDITIES AMONG INDIVIDUALS WITH COGNITIVE IMPAIRMENTS
Authors: Zheng Yaguang , Qi Xiang , Wu Bei
Published: January 2025

Individuals with cognitive impairment have common cardiometabolic comorbidities; however, their prevalence trends remain unknown. We aimed to address this knowledge gap by selecting participants with cognitive impairment from the Health and Retirement Study. Cognitive status was evaluated using the validated Telephone Interview for Cognitive Status (TICS), categorizing participants into normal cognition (TICS≥12), mild cognitive impairment (MCI) (TICS 7-12), and dementia (TICS < 7). The study analyzed data from 40,170 participants with cognitive impairment, with an average age of 73.4±11.2 years. Between 1996 and 2018, there was an observed increase in the prevalence of hypertension, diabetes, and stroke among adults with dementia and MCI. Specifically, hypertension prevalence rose from 60.5% to 77.0% in the dementia group and from 55.7% to 72.9% in the MCI group, diabetes prevalence increased from 21.8% to 37.9% among those with dementia and from 19.1% to 34.5% among those with MCI, and stroke prevalence escalated from 13.5% to 18.0% in the dementia group and from 8.7% to 12.3% in the MCI group. Conversely, heart disease prevalence decreased in individuals with dementia (from 35.3% to 32.2%) but slightly increased in those with MCI (from 28.4% to 29.6%). Our study found that adults with dementia or MCI had an increased prevalence trend in hypertension, diabetes, and stroke over the past two decades, although those with dementia had a decreased prevalence trend in heart disease. Further action is needed to reduce the cardiometabolic burden in this vulnerable population.
WHAT TYPES OF SUPPORT BURDENED DEMENTIA CAREGIVERS LOOK FOR?
Authors: Hwang Yeji , Cho Hannah
Published: January 2025

As dementia caregivers provide excessive amount of care daily to persons living with dementia, many caregivers feel physical or emotional burden. However, lack of information is available on what kind of support that caregivers seek for when they feel physical or emotional burden. Therefore, this study aimed to investigate support that burdened dementia caregivers look for. We conducted a secondary data analysis of the National Study of Caregiving (NSOC) IV, focusing on caregivers of persons living with possible or probable dementia (n=518). Descriptive data analyses, chi square tests, and logistic regression analyses were performed for data analysis. In this study, when caregivers felt emotional burden (42%), they were more likely to use service that take care of the care recipient so that they could take some time away from caregiving (OR= 3.160, p=0.001) or find paid helper to do household chores or personal care (OR= 2.259, p=0.004). Similarly, when caregivers felt physical burden (23.98%), they were more likely to use service that take care of the care recipient so that they could take some time away from caregiving (OR= 3.050, p=0.004) or find paid helper to do household chores or personal care (OR= 2.651, p=0.006). Other support such as support group or training for caregivers did not show any significance. This study found dementia caregivers seek support services when they feel emotional or physical burden. Policy makers should consider these services readily accessible to dementia caregivers.
RECOLLECTING AND REFLECTING: STORY ASIDES IN YOUNG AND OLDER ADULTS’ AUTOBIOGRAPHICAL STORIES
Authors: McCune Teagan , Alea Nicole
Published: January 2025

The ways people tell autobiographical stories changes with age. One change is the amount of tangentially-related information included in these stories. These pieces of information–story asides–add context (e.g. knowledge about the world or storyteller). Story asides are expressed more frequently in the autobiographical stories of older adults compared to young adults, but the underlying mechanism is unclear. One potential mechanism is how people remember the story. The current study tested two potential mediators of this expression in young and older adults’ autobiographical stories. As part of a larger study, 61 young (M = 19.9 years) and 35 older (M = 73.8 years) adults shared an autobiographical story about the same event, a positive vacation. Participants then completed a modified version of the Autobiographical Memory Questionnaire, including 5 items about recollection (e.g., feeling the emotions they felt then) and 3 items about reflection (e.g., how significant this event is) on their autobiographical story. Mediation regression analyses indicated that story aside expression, recollecting about events, and reflecting on events all increased with increasing age. However, recollection and reflection did not predict story asides, nor were there any mediating effects of these variables between age and story aside expression in autobiographical stories. These findings suggest the way people remember and reflect on their stories is perhaps not an underlying mechanism for age group differences in story aside expression. If not the subjective indicators of memory quality and experience (recollection, reflection), then other cognitive and goal-oriented variables might explain these changes.
ACADEMIC-NGO PARTNERSHIP IN CONSTRUCTING A LOGIC MODEL FOR EVALUATION OF A CARER-CENTRIC COMMUNITY-BASED PROJECT
Authors: Tang Vera Mun Yu , Lou Vivian Weiqun , Chandola Tarani , Cheng Clio Yuen Man , Ruan Iris Xiaoyu , Pang Vincy Wing Sze
Published: January 2025

Evaluation is the cornerstone of demonstrating a particular project’s success and paving the way for continuous improvement. However, most of the existing evaluation in social service sector focused on outcome, whereas some evaluated process and a very few included both process and outcome evaluation. Logic models have been found useful in programme evaluation but little is known about how to construct and apply logic models for guiding the process and outcome evaluation of community-based projects, and even less for projects with academic-NGO partnership. A pilot project adopting a carer-centric approach has been launched in 2023, which is anticipated to serve carers and older adults with caring needs in the district-based caregiver support units operated by five NGO partners in Hong Kong. This paper reports how the university as a project partner constructs a comprehensive logic model for evaluation through engaging different stakeholders (including NGO partners, funder, and potential beneficiaries) in two rounds of small group semi-structured interview. Deductive approach is applied for thematic analysis using MAXQDA to identify and prioritize inputs, activities, outputs, and outcomes of the project at initiate phase. Findings provide academics, NGOs and funding bodies with fresh insights into new elements of logic model, including volunteers as important inputs, co-creation workshops as important activities for project positioning and service alignment, number of referral cases as important outputs, and experience consolidation for service adjustment as important intermediate outcomes. This study highlights that process and outcome evaluation can be advanced by promoting stakeholder engagement to co-construct logic model.
COMPARISON OF ENERGY AND NUTRIENT INTAKE WITH DIETARY GUIDELINE OF RURAL ELDERS AND ITS CONTACT WITH OXIDATIVE STRESS
Authors: Shi Jing , Ning Yanhua , Kong Weijuan
Published: January 2025

The aging in rural areas has surpassed that in urban areas, becoming increasingly severe, and the health status of the older should be of concern. Diet and nutrient intake are important influencing factors for the occurrence and development of chronic diseases, and are currently relatively easy to control. Previous studies have shown that oxidative stress is a common pathogenic mechanism of chronic diseases. This cross sectional study invited 376 older residents from 3 rural communities to complete a dietary survey and collect blood samples for calculating dietary intake and laboratory testing of oxidative stress levels, respectively. Compared the energy and nutrient intake of the participants with recommendation in the Dietary Guidelines, and employed latent analysis based on whether the intake meets the recommended. The results revealed three classes, “imbalanced nutrient-high energy” (37.50%, imbalanced in intake of energy and nutrients with high energy and protein intake), “sufficient nutrient-low energy and protein” (18.35%, sufficient and balanced intake of other nutrients except for energy and protein), and “low nutrient” (44.15%, low intake of energy and various nutrients). Among the oxidative stress biomarkers, imbalanced nutrient-high energy had higher value than did the other classes for 8-iso-PGF2α; sufficient nutrient-low energy and protein valued higher than imbalanced nutrient-high energy and low nutrient classes for SOD. Oxidative stress can be measured based on the different classes of energy and nutrient intake classes and their predictors.
CULTURAL ADAPTATION: THE POWER OF COMMUNITY VOICE IN DESIRING A DEMENTIA SUPPORT INTERVENTION FOR LATINE CAREGIVERS
Authors: Cotton Quinton , Kissell Paul , Johnson Elma , Nkimbeng Manka , Gaugler Joseph
Published: January 2025

Intro

Latine family caregivers of persons living with Alzheimer’s disease and other related dementias (ADRD) need access to culturally congruent support services. Interventions incorporating community engagement have shown effectiveness in providing ADRD-specific education, supporting caregivers, and mitigating accessibility concerns (transportation and meeting occupational demands).

Methods

Data was collected via structured conversations (World Cafe style discussions) with youth, adult caregivers, and older adults (n=52) on their perspectives, needs, and preferences about aging and dementia needs in the community. Data were coded deductively and analyzed via directed content analysis.

Results

Latine community members shared their interest in developing a community-engaged program that addressed training on health conditions, emphasized the importance of patience and compassion in dementia caregiving, and language concerns. Content analysis revealed community youth emphasizing interpersonal connection and integration of older adults with the broader community; adult caregivers suggesting a need for caregiver self-care and the mitigation of daily scheduling conflicts; and older adults emphasizing need for emotional support, respectful communication, and language barriers in medical, occupational, and service environments. Implications: Community-engaged feedback is vital in developing interventions reflecting Latine community needs and cultural values. Culturally responsive interventions are necessary because they integrate community member experiences and needs while concurrently promoting community ownership over the research process.
DEVELOPING A HEALTH PROMOTION PROGRAM WITHIN THE CARE LIVING LAB FOR COMMUNITY-DWELLING OLDER ADULTS
Authors: Lee Ji Yeon , Cho Eunhee , Shin Jiyoung , Cho Hyeonmi , Kang Bada
Published: January 2025

Health promotion for community-dwelling older adults is necessary to facilitate aging in place as the world moves towards an aging society. Substantial efforts have been made to increase the participation of older adults in health promotion programs; however, they were often fragmented due to a lack of active participation of older adults and stakeholders in community settings. This project aimed to co-create a health promotion program for older adults in the community within a care living lab focusing on the five principles: co-creation, engaging end-users and stakeholders, multiple methods, and real-life settings. Older adults as end-users and stakeholders were included in the co-creation of the health promotion program. Multiple methods, such as workshops, meetings, and interviews, were conducted within the existing community program. In total, 37 older adults, 19 frontline staff members, and stakeholders engaged in the co-creation process. The health promotion program ultimately included education for dementia, insomnia, and falls, cognitive worksheets, and exercise, which improved the level of frailty in older adults. The developed program was applied to another group of older adults, effectively improving their physical and cognitive functions, as well as their quality of life. Satisfaction with the program was high, and frontline staff reported positive experiences with the co-creation process. The health promotion program, developed within the care living lab, improved older adults’ health status and brought positive experiences among both older adults and staff. The living lab can be an effective method to improve older adults’ health status by facilitating co-creation and engagement.
GRIEF LITERACY: COMMUNITY-BASED STRATEGIES TO REFRAME GRIEF IN OLDER ADULTS
Authors: Supiano Katherine , Laura Bradbury
Published: January 2025

Grief Literacy is the ability to be compassionately present with a person who is suffering. Older adults realize more grief experiences than the population in general, and have the highest likelihood of poor bereavement outcomes, including risk for Prolonged Grief Disorder. Recognizing that our society is fragmented, and the varying norms and traditions to support one another in times of suffering are unclear, increasing grief knowledge would equip both the public and professionals to identify grief and suffering more readily and to activate appropriate supports to be proactive in avoiding complications from the grief and suffering such as isolation and suicide-risk. In addition to formal care offered by palliative and hospice care professionals, grief counselors, and mental health clinicians, the Grief Literacy Movement equips all citizens to support one another in times of loss, suffering and bereavement. We developed and implemented a year-long State-funded program to promote grief literacy across the State of Utah, targeting persons most impacted by the pandemic; older adults, indigenous persons, Veterans, rural communities—and their overlapping constituencies. Rather than confining this effort to provision of support, we developed grassroots strategies for mutual empowerment of community members to reframe and address individual and collective loss. We present applications including education of mental health providers/health providers, first responders, religious communities, and the engagement of citizen groups. We will provide outcomes of our framework applied across multiple social and community settings that enhance supportive care and contribute to mitigating risk of interpersonal harms that can affect bereaved older persons.
RECIPROCALITY OF COGNITIVE IMPAIRMENT, PAIN, AND DEPRESSION: MODELING WITHIN-PERSON EFFECTS
Authors: Nakanishi Miharu , Perry Marieke , Bejjani Rachele , Yamaguchi Satoshi , Usami Satoshi , van der Steen Jenny
Published: January 2025

Cognitive impairment, pain, and depressive symptoms are common and interrelated factors in older adults. However, the directionality and specificity of their association remains unclarified. This study explored whether these factors prospectively increase reciprocal risk and examined the longitudinal association between these factors and quality of life (QoL). We used longitudinal data from The Older Persons and Informal Caregivers Survey Minimal Data Set (TOPICS-MDS; the Netherlands). The data of 11,582 home-dwelling older adults with or without cognitive impairment were analyzed. Older adults self-reported cognitive impairment, pain, depressive symptoms, and QoL at baseline and after 6 and 12 months of follow-up. A Random Intercept Cross-Lagged Panel Model was used to assess the prospective association between the three factors, while a multilevel linear regression analysis in a two-level random intercept model was used to examine the longitudinal associations between the three factors and QoL at the within-person level. At the within-person level, pain at 6 months was associated with subsequent depressive symptoms (β=.04, P=.024). The reverse association from depression to pain, and longitudinal associations between pain and cognitive impairment and between depressive symptoms and cognitive impairment were non-significant. Pain, depressive symptoms, and cognitive impairment showed a significant association with poor QoL 6 months later. A directional relationship was observed from pain to depressive symptoms. Pain reduction may be important in the prevention of depressive symptoms, ultimately optimizing the QoL of older adults.
FROM KNOWLEDGE TO PRACTICE: TRAINING FAITH LEADERS IN AGING AND MENTAL HEALTH
Authors: Wilson Annalee , Keefe Bronwyn , Emery-Tiburcio Erin
Published: January 2025

Faith leaders can play a leading role in recognizing and supporting the mental health of their older congregants. Older adults attend faith services more frequently than members of other age groups and often turn to faith leaders for mental health support. To increase faith leaders’ knowledge and skills pertaining to mental health and aging, the Center for Aging and Disability Education and Research (CADER) developed an online course, Mental Health and Aging for Faith Leaders. In this course, participants learn to identify mental health conditions, to describe barriers to treatment, to identify services and resources available for treating mental health conditions in older adults, and to explain the role that faith leaders can play in supporting older adult mental health. CADER piloted the course with 44 faith leaders from Massachusetts (n=7) and Chicago, Illinois (n=37). Of the Chicago-based faith leaders, all except one indicated that they serve a congregation that is majority Black. Faith leaders showed significant improvements (p< 0.05) in all learning competencies from the pre-course competency self-assessment to the post-course competency self-assessment. When asked what changes they anticipate making after taking the course, faith leaders reported that they intended to make changes on the individual level (e.g., by continuing to learn more about aging and mental health); the interpersonal level (e.g., by identifying the signs of mental health concerns in their older congregants); the organizational level (e.g., by implementing mental health programming at their faith organizations); and at the societal level (e.g., by promoting awareness about mental health).
A GRAPHICAL MODEL APPROACH TO UNVEILING FALL TRIGGERS IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Nguyen Tho , Liu Chang , Liu Yi , Thiamwong Ladda , Lou Qian , Xie Rui
Published: January 2025

We aim to enhance understanding of fall risk factors and examine their interrelationships in community-dwelling older adults from various domains: sociodemographics, mental well-being, body composition, self-assessed and performance-based fall risk assessments, and physical activity patterns. Our study included 120 subjects aged 60 to 96 years old from Central Florida (average age of 74.8, SD 7.38), 77.5% female, and 29.2% with a history of falling. We used a novel machine learning technique known as the Graphical Model (GM) to analyze the association among 37 fall risk factors. GM reveals the higher-order dependence structure and graphical relationships among variables, including continuous and categorical types. This approach goes beyond traditional correlation analysis, providing innovative insights into sophisticated interactions within a high-dimensional dataset. Among the identified features, 34 exhibited pairwise relationships, while COVID-19-related factors and housing composition remained conditionally independent. Prominent relationships include sedentary behavior having strong negative links to both light physical activity and moderate-to-vigorous physical activity. Participant age was positively correlated with balance score but negatively correlated with body composition factors and Senior Technology Acceptance. The CDC’s Stopping Elderly Accidents, Deaths, and Injuries score had moderate positive relationships with the Rapid Assessment of Physical Activity (strength and flexibility) and Mindful Attention Awareness Scale, while it had moderate negative relationships with the Short Falls Efficacy Scale-International score and history of falls. The findings of this study serve as an initial exploration, laying the foundation for future research, including the longitudinal dynamics of these features that contribute to fall prevention in older adults.
ASSESSING MOBILITY AND FALL RISKS IN TAIWAN’S OLDER ADULT POPULATION: A LONGITUDINAL STUDY
Authors: Kuo Fang-Lin , Liao Zih-Yong
Published: January 2025

Mobility difficulties impact older adults’ health significantly, leading to adverse outcomes and loss of independence. In Taiwan, 21% of community-dwelling older adults report falls, and over half have a fear of falling, highlighting the importance of identifying individuals at risk. This study aimed to explore mobility changes and repeated falls in Taiwan’s rural areas, where the older population exceeds 24%. A longitudinal study was conducted annually from 2022 to 2023, focusing on physical ability and gait assessments in community-dwelling older adults (65+) who were able to walk (n=250). We used linear mixed-effects regression models and logit models to examine whether personal characteristics are associated with changes in mobility and falls. The findings showed no significant differences in falls and walking performance at the 1-year follow-up after confounder adjustments. However, individuals living in buildings without elevators, using walking devices with cognitive impairment and exhibiting poorer gait performance such as slower gait speed, peak angle velocity at swing phase and toe clearance were more likely to experience repeated falls. Furthermore, about 14.78% of participants who were independently walking at baseline began using a walking device by 2023, indicating a transition to new walking dependence (NWD). The NWD group tended to have a higher number of chronic illnesses, repeated falls and slower walking speed. This study highlights the need to consider environmental and gait characteristics in addressing the mobility dependence and fall risks. Interventions to prevent falls and facilitate the adaptation to walking assistive devices could help manage mobility decline among older adults.
CLINIMETRIC PROPERTIES OF THE ABC-6, ABC-16, AND MODIFIED FALLS EFFICACY SCALE WHEN DELIVERED ELECTRONICALLY
Authors: Blackwood Jennifer , Carpenter Matthew
Published: January 2025

The Activities Specific Balance Confidence Scales (ABC, ABC-6) and the Modified Falls Efficacy Scale (M-FES) are outcome measures used to assess self-efficacy in maintaining balance in older adults. All three measures have established reliability and validity when delivered in a clinician-driven paper assessment. However, it is unknown what the clinimetric properties of these measures are when delivered electronically without verbal direction. Therefore, the purpose of this study is to establish the reliability, validity, standard error of measurement, and the minimal detectable change (95% confidence interval) of these measures when delivered electronically in community-dwelling older adults. 67 participants were recruited electronically through the University of Michigan’s Health Research platform. Older adult participants were English-speaking; aged 65+ years; had access to a computer or electronic device with reliable internet; and were diagnosed with various health conditions. A Qualtrics survey was distributed to participants that consisted of the ABC-16 and M-FES with written directions. Results from the 67 participants demonstrated excellent test-retest reliability (ICC2,1 = ≥0.94) and excellent internal consistency (α = ≥0.94) for all measures. The ABC-16 had a smaller SEM (3.85) and MDC95 (10.67) compared to the ABC-6 (SEM = 4.99, MDC95 = 13.83). For the MFES, the SEM was 0.27 and MDC95 was 0.75. All measures had significant Pearson correlations (p < 0.01) with the falls history indicating construct validity. These results indicate the ABC-16/6 and M-FES can be utilized in an electronic format when assessing older adults’ self-efficacy in balance.
ENHANCING DEMENTIA CARE PARTNER ENGAGEMENT IN FALL PREVENTION PROGRAMS: A SYSTEMATIC REVIEW
Authors: Zeng Xiaoyi , Zhou Yuanjin , Choi Namkee
Published: January 2025

Community-dwelling older people with cognitive impairment/dementia (CI/D) experience a higher risk of falls than age-matched peers without CI/D. Fall prevention programs for this population often engage their family/friend care partners. Care partner engagement (CPE) has five components: care partners’ recruitment, retention, attendance, active participation, and maintenance of changes. Little is known about the facilitators and barriers that impact CPE in those programs and strategies used to enhance CPE. We conducted a mixed-methods systematic review following PRISMA guidelines (PROSPERO: CRD42023422200). Twenty-nine unique fall prevention programs from 32 studies were included. Most studies described retention (n=19, 60%), attendance (n=12, 38%), and active participation (n=32, 100%) aspects of CPE. Fewer studies illustrated factors related to care partner recruitment (n=6, 19%) and maintenance of change (n=6, 19%). Commonly reported CPE facilitators were older people with CI/D and care partners’ perceived benefits and suitableness of the fall prevention programs and positive relationships between the dyads. The main barriers to CPE are the dyads’ poor health and the burden related to the study logistics of participating in the programs. Program characteristics (e.g., structured/group format, social engagement opportunities, delivery mechanisms, timing) and providers’ characteristics are commonly reported organizational-level factors impacting CPE. Twenty-seven studies mentioned the use of educational (e.g., training, consultation, booklet), relational (e.g., strengthening care relationships, engaging paid caregivers), and behavioral strategies (e.g., action plans, visual reminders, cognitive approach, tracking logs) to promote CPE. Findings proposed a theoretical framework and identified potential strategies to enhance CPE in fall prevention programs for older people with CI/D.
FALL RISK FACTORS IN COMMUNITY-DWELLING OLDER ADULTS: AN UMBRELLA REVIEW OF SYSTEMATIC REVIEWS
Authors: Saunders Stephanie , D’Amore Cassandra , Hao Qiukui , Kuspinar Ayse , Richardson Julie , Beauchamp Marla
Published: January 2025

Falls are an imperative public health concern, resulting in disability, mental health challenges, and increased mortality risk. An extensive body of literature has examined falls risk factors; however, it has become challenging to navigate. We summarized systematic reviews examining risk factors for falls among community dwelling older adults. We searched seven databases (Medline, Embase, CINAHL, Cochrane Library, PsychINFO, Ageline) for systematic or scoping reviews including community-dwelling older adults (≥60 years) and reporting risk factors for falls in prospective studies. Three independent reviewers screened 8,173 records and included 57 reviews. Thirty-three reviews conducted meta-analyses and 24 reported relationships from primary studies. Reviews were published between 2004-2023 and examined patients with stroke (n=2), diabetes (n=2), frailty (n=3), and cognitive impairments (n=3). Types of falls examined included recurrent falls (n=45) and injurious falls (n=18). Reviews reported risk factors across every construct of the WHO’s ICF model; health conditions (n=20 reviews), body structure and function (n=26), activity (n=23), participation (n=11), environmental factors (n=10), and personal factors (n=11). Most commonly conducted meta-analyses included: mobility impairments (demonstrating increased risk across gait, strength, and clinical performance tests, n=12/20), balance impairments (increased risk n=15/16), BMI (null risk n=12/12), frailty (increased risk n=9/10). Heterogeneity of reported effect sizes prohibited the calculation of pooled magnitudes for risk factors. Narrative synthesis results are summarized separately. Physical risk factors for falls are well established and can be addressed through interventions. Findings highlight narrow examination of psychosocial and environmental risk factors for falls in community dwelling older adults, indicating areas for future research.
FALLS IN ADULTS: STEADI AND DURABLE MEDICAL EQUIPMENT PREDICTIVE ANALYSIS
Authors: Probst Karen , Unger Kathryn
Published: January 2025

Falls are the leading cause of death with fall rates continuing to rise. The Center for Disease Control, (CDC, 2020) predicted that by the year 2030 there will be 53 million falls among older adults. This alarming rate of falls resulted in a comparative study of the Stopping Elderly Accidents, Deaths & Injuries (STEADI) assessments as well as the sensitivity and specificity of the tools. Research was conducted (n=116) to determine if a condensed 3-question questionnaire could provide a brief comprehensive evaluation of fall risk. The data was then analyzed to determine if the provision of specific durable medical equipment (DME) impacted the results of either STEADI assessment. The study involved distributing both versions of the STEADI electronically to participants at Chosen Mission Incorporated, a non-profit that distributes DME at no cost to their local community. The condensed STEADI was found to have a strong correlation to the comprehensive STEADI as well as the acquisition of DME. The assessment demonstrated a high sensitivity and low specificity indicating a connection between fall risk and actual falls within six months. The findings from this research may benefit healthcare professionals to better and more quickly identify individuals with increased fall risk and potential for falls within six months.
CAREGIVERS’ POOR SLEEP AND PLASMA BIOMARKERS FOR NEURODEGENERATION
Authors: Song Yeonsu , Choi Sarah , Moore Raeanne , Erickson Alexander , Camacho Karen , Cappelletti Monica , Alessi Cathy , Martin Jennifer
Published: January 2025

Family caregivers of people living with dementia (PLWD) have an increased risk of dementia. Poor sleep is common among caregivers, but the relationship between sleep and biomarkers of neurodegeneration in this population is unknown. In a secondary analysis of data from a behavioral sleep intervention trial among caregivers of PLWD, we tested the relationship between subjective and objective sleep and plasma biomarkers of neurodegeneration and explored the preliminary effects of the intervention on these biomarkers. Participants included 18 caregivers of PLWD who received a sleep education program (active treatment versus control). Sleep measures included the Pittsburgh Sleep Quality Index, total nights of good sleep (sleep diary), and wrist- actigraphy-measured sleep duration, sleep efficiency (SE), and total wake time (TWT). Plasma biomarkers included amyloid beta-40 (Aβ40), amyloid beta-42 (Aβ42), Glial Fibrillary Acidic Protein (GFAP), Neurofilament light (NfL), and Aβ42/40 ratio. All measures were collected at baseline (n=18), post-intervention (n=11), and three months (n=7). Pearson correlations and t-tests were performed. At baseline, greater (worse) TWT was associated with higher Aβ40 (r=0.60, p=0.009) and Aβ42 (r=0.62, p=0.006) levels. Lower (worse) SE was associated with higher Aβ40 (r= -0.52, p=0.026), Aβ42 (r= -0.61, p=0.008), and NfL (r= -0.48, p=0.043). Less nights of good sleep were associated with a lower Aβ42/40 ratio (r=0.51, p=0.032). Biomarker levels were not significantly different between treatment and control at follow-ups. In conclusion, poor sleep is associated with increased biomarkers of neurodegeneration among caregivers of PLWD. Larger studies are needed to test whether sleep interventions reduce this population’s neurodegeneration risk.
DAILY AFFECT AND SLEEP AMONG FAMILY CARE PARTNERS OF PEOPLE LIVING WITH DEMENTIA
Authors: Song Yeonsu , Kuehn Kevin , Lewis Nicole , Erickson Alexander , Mausbach Brent , Martin Jennifer , Moore Raeanne
Published: January 2025

Caregiving can be a positive and negative experience simultaneously. However, many of the family care partners of people living with dementia (PLWD) often experience poor sleep, leading to heightened levels of depression and caregiving strain. This study examined daily variations in positive and negative affect and the bidirectional role of sleep and daily affective states. A total of 35 care partners (mean age 63 years, 39% non-White, 81% women) completed ecological momentary assessment surveys of their positive and negative affect and subjective sleep three times a day for seven days. Variables included positive (currently feeling energetic, happy, motivated, rested, relaxed) and negative affect (currently feeling anxious, depressed, helpless, hopeless, nervous, tense, worried, worthless; range 1-5), and ‘good sleep’ (i.e., no trouble with falling asleep and staying asleep) on previous nights. Descriptive and mixed-effect logistic regressions were performed. Mean levels of positive affect were significantly lower in the evening compared to the morning/afternoon (F (df= 1, 491) = 54.24, p< 0.001); no time-of-day differences were found for negative affect (F (df= 1,492) = 1.33, p=0.25). Higher levels of mean positive affect were associated with a higher probability of good sleep (OR=2.23, 95%CI=1.26-3.94, p< 0.01). No significant relationships were found between negative affect and good sleep. This study demonstrates a within-day variation in positive affect among family care partners, which is related to the quality of sleep the night before. Understanding these dynamics is crucial for developing targeted interventions to improve the sleep and emotional well-being of care partners of PLWD.
DEMENTIA CAREGIVING STYLES: USING EXPERT FEEDBACK TO ADAPT THE PARENTING STYLES MODEL
Authors: Simon Darby , Ertle Emilee , Mast Benjamin
Published: January 2025

Identifying how family caregivers provide care to people living with dementia has important implications for the quality of life for both parties. This project adapted the well-researched parenting styles framework to create a new measure reflecting Dementia Caregiving Styles. Although there are important differences between people with dementia and children, there are similarities between parents and family caregivers in how they approach these caring relationships. This creates comparable experiences such as balancing autonomy versus safety, making decisions on behalf of their care-recipient, and changing family roles. The current framework measures caregivers’ levels of responsiveness, demandingness, and autonomy-granting during interactions with their care-recipients. This poster reviews the process of adapting the Parenting Styles Inventory-II into the proposed Dementia Caregiving Styles Inventory by collecting feedback from dementia caregiving experts on this topic. For each item, experts rated the relevance to dementia caregiving and provided qualitative feedback. Experts could also provide their overall thoughts about adapting the parenting styles framework for dementia caregivers. Lynn’s (1986) standards were used to establish each item’s content validity via expert agreement. Several themes emerged from the experts’ feedback. Most notably, the demandingness subscale’s items required major revisions to apply to dementia caregiving. Conversely, the subscales regarding responsiveness to the care-recipient’s needs and balancing autonomy versus safety were applicable to dementia caregivers. At the end of the revision process, the experts were overwhelmingly in support of the items suggesting that adapting parenting styles to dementia caregiving could provide a framework that helps family caregivers provide better dementia care.
PARTICIPANT EVALUATION OF A SOCIAL ENGAGEMENT PROGRAM FOR FAMILY CARE PARTNERS OF PERSONS WITH DEMENTIA
Authors: Baby Eliza , Lydon Elizabeth , Jones Sarah , Chen Xiayu , Mathias Vincent F , Rogers Wendy , Raj Minakshi , Mudar Raksha
Published: January 2025

Caregivers of persons with dementia (PwD) often experience increased social isolation, loneliness, and negative health outcomes. While support groups provide critical education and connection for care partners, there is less opportunity for engagement outside of the caregiving role. We developed and assessed the benefits of a technology-based social engagement program, CareEngage, designed to be convenient and accessible to older adult caregivers (60+ years) of a family member with dementia. Sixty-four older caregivers completed the intervention. Participants attended eight social engagement sessions over 4-6 weeks. During each session, participants met remotely via Zoom for casual, unmoderated conversations on various topics of interest. The topics were intentionally unrelated to caregiving and covered five categories: Arts and Culture; Life Experiences; Nature, Health, and Wellness; Recreation and Sports; and Science and Technology. Immediately following each session, participants completed a survey to assess self-reported enjoyment, engagement, and connection on a five-point scale in addition to providing an open-ended comment. Participants also completed a post-program survey to capture overall program satisfaction. A mixed methods approach was employed to assess post-session and post-program surveys. High scores were reported on enjoyment (mean = 4.41 ± 0.89), engagement (mean = 4.52 ± 0.78), and connection (mean = 4.44 ± 0.84). On the post-program survey, the majority reported they enjoyed the program (75%), and they would recommend it to others (72%). Findings suggest virtual social engagement opportunities may be beneficial for enhancing the social well-being of older care partners of PwD.