bluuebunny/crossref_metadata_2025 huggingface dataset:
“THIS IS NOT MY WAR”: MORAL CHALLENGES FACED BY MIGRANT HOME CARE WORKERS IN ISRAEL AT TIMES OF WAR
Authors: Ayalon Liat , Ulitsa Natalie
Published: January 2025

The October 7 massacre had a tremendous impact on all persons residing in Israel, including the migrant workers community, which was specifically targeted by the Hamas terrorists. Subsequently, migrant workers have left the country in unprecedented numbers. This paper is based on interviews with 25 migrant home care workers who stayed in Israel during the Israel-Hamas war. Thematic analysis of in-depth interviews was conducted. Analysis revealed three main themes concerning moral dilemmas in the context of the war. The first moral dilemma concerned views of the war. Whereas migrant home care workers of Muslim background, attempted to distance themselves from the war, others expressed a strong identification with Israel. A second moral issue concerned the need to seek shelter within a short period of time, which often prevented older persons from reaching a safe room on time. This resulted in some workers leaving their care recipient during a missile attack to ensure their own safety. Workers attributed this behavior to specific instructions provided by the children of the care recipient. A third dilemma concerned the decision not to leave the country. Although many workers reported a wish to leave Israel following the war, this dilemma was largely resolved through the understanding that they have a financial debt that prevents them from returning to their home country. The findings highlight the challenges faced by migrant home care workers, who transitioned for financial reasons, but find themselves in a war situation with financial, emotional, and social commitments that challenge their loyalties.
HOW MEDICAL OBJECTS, MEAL PREP ASSISTANCE, AND RELATIONAL CULTURE IMPACT THE MEANING OF “HOME” FOR HOME CARE CLIENTS
Authors: Spring Lauren , Mason Stephanie , Kuryk Kaitlyn , Keefe Janice , O’Neil Kelly
Published: January 2025

Home care policies, programming, and services in Canada are designed to support older adult clients to age well in their homes and communities. Because the medical model dominates programming and policy decisions about home care services, the delivery of home care services is rarely viewed as relational and intra-active, in which interdependent relationships and interactions occur between clients and care workers. This paper applies a relational lens that incorporates a symbolic interactionist perspective to analyze qualitative data from a series of three interviews over an 18-month period (2019-2021) with 12 older adult home care clients and 10 of their paid caregivers. The overall study explored care pathways for older adult home care clients who received publicly-funded home care services in Manitoba and Nova Scotia. Our analysis revealed that this exchange of affect notably materialized through meal preparation and medical devices in the client’s home. The inter-/intra-actions between clients and care workers inscribed food-related practices and medical objects with symbolic values/meanings of home that were often unique and surprising. Better awareness of the relational cultures of meal preparation and medical devices to meanings of home and how these meanings for clients are sometimes in tension with those held by caregivers, can benefit clients and enrich home care policies and service delivery
IMPACT OF ALTERED ROUTINES ON SOCIAL AND MENTAL HEALTH AMONG OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Finlay Jessica , Kobayashi Lindsay , Milan Rebecca , Sagehorn Mallory , Bowman Grace , Perera Rohini
Published: January 2025

The COVID-19 pandemic has altered the daily lives of older adults, necessitating adaptations in social, creative, and exercise routines while highlighting the importance of shared ‘third places’ (sites outside of home and work/school) as vital community support. This mixed methods study delves into the nuanced relationship between lifestyle shifts and mental health outcomes among older Americans. The COVID-19 Coping Study’s national three-year follow-up survey was conducted April-May 2023 among 1,915 participants aged 59 years and above. The Beck Anxiety Inventory, Center for Epidemiologic Studies Depression Scale (CES-D), and UCLA Loneliness Scale assessed anxiety, depression, and loneliness. Reflexive thematic analysis of open-ended participant responses investigated underlying motivations and experiences driving lifestyle changes. Participants, predominantly Non-Hispanic White (93%), female (71%), and college-educated (86%), reported significant modifications to their routines influenced by viral exposure concerns, personal health considerations, and broader societal challenges since the pandemic onset. Changes in social routines were most prevalent (52%) and significantly correlated with increased experiences of anxiety (β=0.30, p=0.02), depression (β=0.33, p< 0.01), and loneliness (β=0.30, p< 0.01). Once vital hubs for social interaction and civic engagement, our qualitative findings identified that fear of infection and societal tensions led many to withdraw from shared community and civic ‘third places’. As older Americans navigate the ongoing challenges of COVID-19 and other infectious diseases, understanding the complex interplay between altered lifestyle routines and community support is paramount. Results may inform interventions to develop more inclusive and accessible interventions that foster resilience and wellbeing in later life.
IS AGING IN THEIR CURRENT DWELLING THE BEST OPTION FOR OLDER ADULTS?
Authors: Cho Joonyoung , Dunkle Ruth
Published: January 2025

Although the majority of older adults in the United States stay in their current residence, there has been an increase in the number of housing transitions among older adults since 2000. While aging in their current dwelling is the preferred option for most older adults, according to the Ecological Theory of Aging, the Person-Environment fit changes over time, and relocation is one strategy older adults may use to promote better psychological well-being. The association between housing transition and psychological well-being has yet to be fully explored and the effects of housing transition on psychological well-being may vary across different settings and individuals. Using data from the National Health and Aging Trend Study (2011-2015 n=3,549), we applied multilevel growth modeling to examine the association between housing transition and psychological well-being across different settings including within the community, non-nursing residential facilities, and nursing homes over 5 waves. We found that within-community movers tended to report higher well-being over time compared to non-movers (adj. β= 0.32, p=0.021). In contrast, compared to non-movers, non-nursing facility movers and nursing home movers were no different in terms of changes in psychological well-being over time. (adj. β= 0.23, p=0.348; adj. β= 0.41, p=0.394). Our findings suggest that within-community housing transition can be viewed as one way to achieve aging in the right place.
MOBILITY-RELATED PHYSICAL FUNCTION AND AGING IN PLACE FOR OLDER ADULTS WITH CHRONIC CONDITIONS
Authors: Jensen-Battaglia Marielle , Wang Ying , Block Robert , Loh Kah Poh , Mohile Supriya , Agree Emily , Seplaki Christopher
Published: January 2025

Chronic conditions may influence difficulty mobilizing inside the home (mobility), which presents a barrier to the goal of aging in place for many older adults. Understanding this relationship is critical as the prevalence of chronic conditions increases. In prior work (currently under review) we used data from community-dwelling adults aged ≥65 participating in ≥2 consecutive rounds (2011-2019) of the NHATS to show self-reported mobility difficulty was positively associated with moves to homes with fewer environmental barriers or more household members, but not to other destinations (e.g., homes with more barriers, nursing home/residential care). In the current analysis we use this dataset of 25,490 person-years of follow up from 5,894 unique participants who moved 1,456 times to investigate modification of this association by chronic conditions [non-skin cancer (5,472/25,490 person-years), myocardial infarction/stroke (6,621/25,490 person-years), dementia (8,011/25,490 person-years)]. All chronic conditions were positively associated with relocation to nursing home/residential care in bivariate multinomial logistic regression models (cancer: OR 1.43; 95% CI 1.02, 2.02; myocardial infarction/stroke OR 1.43; 95% CI 1.04, 1.96; dementia OR 2.87; 95% CI 2.08, 3.96). After adjusting for confounders, only dementia remained associated with moves to nursing home/residential care (OR 1.40; 95% CI 1.06, 1.85) for those without any mobility difficulty. However, the association of mobility with relocation did not vary significantly by chronic condition (p for interaction >0.05 for all conditions and relocation destinations). These results highlight mobility difficulty and barriers in the home environment as potentially modifiable factors to promote aging in place, regardless of chronic conditions.
THE SOCIAL ROLES AND ITS RELATED FACTORS OF COMMUNITY-DWELLING OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Segawa Dai , Uchida Hayato , Suganuma Ippei , Itotani Keisuke , Kitayama Atsushi , Watanabe Yuki
Published: January 2025

This study focused on the social roles of community-dwelling older adults during the COVID-19 pandemic in Japan and aimed to clarify their actual conditions and related factors. We compared the two groups of the values of four social roles of the Tokyo Metropolitan Institute of Gerontology Index of Competence and various survey items in 127 elderly subjects aged 65 years or older. The group who talked to young people tended to eat alone more (p = 0.00), to be more depressed (p = 0.00), and had lower food intake diversity scores (p = 0.04) than the group who didn’t talk to young people. No significant associations were found between the three other social roles and the values of the various survey items. The results of the Logistic regression analysis showed that the no-involvement group was significantly associated with eating alone (OR=4.28, 95%CI=1.69-10.83, p=0.00) and depression-prone individuals (OR=3.73, 95%CI=1.02-6.96, p=0.01). Tanaka et al. (2016) reported that even at the level of intergenerational interaction of “talking to younger people” in daily life, the “with opportunity” group had a 1.2 to 1.5 times lower risk of future anxiety than the “without opportunity” group. In the present study, the results support the previous studies, although the interaction was at the level of “talking to younger people. It suggested that ensuring opportunities for intergenerational exchange is important to maintain the physical and mental health of the elderly during the pandemic.
UNDERSTANDING THE HOME-BASED SERVICE NEEDS FOR OLDER ADULTS: A SCOPING REVIEW FROM CHINA
Authors: Zhang Hengyuan , Zhang Sifeng
Published: January 2025

The range of home-based services for older adults in China haven’t been clearly defined, which adversely affects their effectiveness in enhancing well-being. It is crucial to develop a better understanding of the home-based service needs of older adults. This paper employs a scoping review methodology to explore the service needs of older adults aging in place. We searched empirical research articles from four Chinese databases, including CNKI, CQUVIP, CSDP and ChaoXing. A framework based on pecking order preference theory and demand spillover theory was established to categorize and analyze the literature findings. The final analysis includes 134 studies selected from a pool of 6,565 articles. By encoding the results of the articles, home-based services for older adults were categorized into four domains: medical and health services, family replacement services, disability care services, and individual auxiliary services. Among these, medical and health services emerge as the most urgently needed category for older adults. Family replacement services follow closely, as their benefits extend to family members. While the need for disability care services remains relatively low, they exhibit high rigidity. Individual auxiliary services, although least needed, consume significant public resources. We advocate for targeted public policies that allocate resources effectively, enhance older adults’ health, and provide care services for those with disabilities in daily living activities.
ASSOCIATION BETWEEN DIET AND RETINAL IMAGING MARKER IN THE PREVENT DEMENTIA STUDY
Authors: Gregory Sarah , Gibbon Samuel , MacGillivray Thomas , Terrera Graciela Muniz
Published: January 2025

Eating a healthy diet is associated with a lower risk of neurodegenerative diseases, such as Alzheimer’s disease (AD). Identifying associations between diet and AD biomarkers is key to understanding and identifying critical periods for interventions. The retina provides a unique, non-invasive, window into brain health. This study explored cross-sectional and longitudinal associations between diet and retinal imaging markers in the PREVENT Dementia cohort (UK/Ireland). We calculated a Mediterranean diet (MedDiet) adherence score (Pyramid) for each participant and tested for associations with measures of retinal vessel morphology (CRAE Hubbard Zone C (HZC) and artery tortuosity) using generalised additive models due to abnormally distributed residuals. Additionally, we tested for associations with dietary intake of manganese. All analyses were completed cross-sectionally and then longitudinally in the participants with follow-up data (data collection ongoing). In a preliminary study, we included 86 participants, mean age 50.87 (5.63) years, majority female (57%), with 31 APOEe4 carriers (36%). Participants had a moderate mean Pyramid score (8.16 (SD = 1.40)), which was comparable to scores in other UK cohorts, and a dietary intake of 4.77 mg (SD = 3.05) manganese. There was evidence of an association between higher dietary manganese intake and lower CRAE HZC density in the right eye. There was no evidence of associations between the Pyramid score in either eye or dietary manganese in the left eye, and no signs of longitudinal associations (n=47). Further research is needed to explore any these analyses in a larger sample, and expand with other variables.
COGNITIVE IMPAIRMENT AND SOCIAL DETERMINANTS OF HEALTH AMONG INDIGENOUS WOMEN
Authors: Roh Soonhee , Lee Yeon-Shim , Moon Heehyul , Warne Donald K , Thin-Elk Serene , Stone Sasheen T
Published: January 2025

The current study aimed to examine 1) differences between cognitively impaired and cognitively intact groups regarding demographics, education, health literacy, social and community involvement (i.e., social engagement and religious activity/participation), and health (i.e., chronic conditions), 2) the amount to Alzheimer’s Disease and Related Dementias (ADRD) knowledge among the cognitively impaired group, and 3) predictors of cognitive impairment. We considered three dimensions of social determinants of health (SDOH) to predict cognitive impairment: education and health literacy, social and community involvement, and health (i.e., depression and chronic conditions). Collaborating with a Northern Plains tribe, participants were recruited 123 self-identified Indigenous women aged 40 to 70 through a comprehensive recruitment strategy. Employing the SDOH framework, the research assessed cognitive impairment and Alzheimer’s disease knowledge, utilizing the Ascertain Dementia 8 and AD knowledge scales (ADK-30). The investigation examined the relationships between selected SDOH variables and cognitive impairment status. More than half of the participants showed signs of cognitive impairment, which correlated with lower income and education levels. Increased knowledge about Alzheimer’s disease, particularly in terms of treatment management and its life impact subscales, was associated with lower odds of cognitive impairment. Conversely, higher levels of depressive symptoms and participation in religious activities were linked to increased odds of cognitive impairment. Findings underscore the importance of culturally grounded tools and SDOH frameworks tailored to Indigenous contexts in addressing ADRD disparities. Future research should integrate historical and cultural factors to advance health equity within Indigenous communities, ultimately mitigating the impact of ADRD and promoting overall well-being.
DEPRESSION AND COGNITIVE FUNCTION IN OLDER MEXICAN DESCENT LATINOS: THE MEDIATING ROLE OF SOCIAL ENGAGEMENT
Authors: Talavera-Garza Liza
Published: January 2025

Mexican descent Latinos have significantly higher rates of Alzheimer’s disease and related dementias (ADRD) compared to the general population. Latinos also report higher rates of depressive symptoms in older adulthood relative to non-Latino Whites. Depression in older age is associated with poor cognitive health; however, the mechanisms that underlie this relationship are not well-understood. The current study examined social engagement, which has been linked with better cognitive health, as a mediator of the association between depressive symptoms and cognitive function among older Mexican descent Latinos. Method: A convenience sample of Mexican descent Latinos (N=159), aged 55 to 88 years (M=68.2, SD=7.05) and without diagnosed cognitive problems, were recruited from a community in South Texas. They were administered in-person interviews, in their choice of English or Spanish in Summer 2023 that included demographic questions and measures of cognitive function, depressive symptoms, and social engagement.

Results

Pearson correlations found that depressive symptoms were significantly negatively associated with social engagement (r = -.25, p <.002) and cognitive function (r = -.39, p <.001). Hierarchical Bayesian simulations indicated strong indirect effects of depressive symptoms on cognitive function through social engagement (unstandardized 95% CI = -.2408, -.0119, p<.0001).

Conclusion

The current findings suggest that cognitive decline in individuals with depressive symptoms may occur because of reduced participation in social activities. Community-based approaches, with a focus on increasing social engagement in individuals who exhibit symptoms of depression, may be viable interventions that could be leveraged to reduce the burden of ADRD in Latinos.
EXPLORING THE LANDSCAPE OF GENERATIVE AI AND LARGE LANGUAGE MODELS IN ALZHEIMER AND DEMENTIAS RESEARCH
Authors: Wei Duo , Elmasri Jeannine , Hernandez Bianca , Goyal Riya , Burdick David
Published: January 2025

With the introduction of ChatGPT in November 2022 and Google Bard (now Gemini) in March 2023, the artificial intelligence (AI) landscape has undergone a significant and rapid evolution. An in-depth scoping review was utilized to investigate the application of generative AI and Large Language Models (LLM) in research on Alzheimer’s Disease and Related Dementias (ADRD) among older adults. The objectives were twofold: first, to investigate specific applications of generative AI and LLM in ADRD research, and second, to delineate the diverse usage of these technologies within this domain. Leveraging PubMed, search terms such as “AI,” “Dementia/Alzheimer,” and “Older Adults” were employed, resulting in the retrieval of 196 articles published in January 2022-December 2023. Of 196 articles found, 145 meeting eligibility criteria were meticulously categorized into two topics: ADRD domain and AI-related tasks. Statistical analysis revealed compelling insights, with significant differences in the application of generative AI (χ2 = 21.91, p <.005) and LLM (χ2 = 21.42, p <.005) in ADRD research. Notably, generative AI predominantly focused on “Research/Drug Discovery” (34.38%) and “Improved Treatment & Care” (37.50%), while LLM emphasized “Challenges/Opportunities” and “Early Detection/Diagnosis.” Within the ADRD domain, articles were categorized into distinct areas such as “Care,” “Cognitive Decline,” “Diagnosis,” “Genetics,” “Imaging,” and “Other.” Caregiving and support emerged as predominant themes, comprising 55% of the reviewed articles, followed by diagnosis (34%). This comprehensive analysis sheds light on the multifaceted applications of AI in ADRD research, offering valuable insights into potential areas for further investigation.
FUNCTIONAL OUTCOME IN HOME HEALTH AMONG TRADITIONAL MEDICARE AND MEDICARE ADVANTAGE BENEFICIARIES WITH DEMENTIA
Authors: Basu Rashmita
Published: January 2025

This study examines the difference in functional outcomes among Traditional Medicare (TM) and Medicare Advantage (MA) beneficiaries with Alzheimer’s disease and related dementias (ADRD) during a home health admission, which is unknown. This cohort study used data from the 2019 Outcome and Assessment Information Set (OASIS) and Medicare claims (Home Health (HH) and inpatient), enrollment, and Chronic Condition Warehouse (CCW) files from the CMS. Functional outcome was measured as a change in the composite ADL score (grooming, bathing, toileting, dressing, walking, transferring, ambulation, and hygiene) from HH admission to discharge. A binary logistic model with an outcome variable (1/0: if the composite score was ≤0 (improvement or static) at discharge (1), and 0 if score >0 (decline) from HH admission to discharge) was estimated. The independent predictor was a binary indicator of MA enrollment (if enrolled ≥1 month in 2019). The ADRD cohort was identified based on CCW criteria and ICD-10 codes from inpatient and HH claims. The analysis included 81,735 Medicare beneficiaries; 30.5% had MA, and 69.5% had TM. There was no difference in the number of HH visits between TM and MA enrollees (2.14 vs. 2.13; P=0.39). Adjusting for patients’ demographics, total number of diagnoses, and availability of caregiving support, MA enrollees were 26% less likely to report improvement or maintenance of ADL composite score (95% CI: 0.71-0.77) than TM. A less favorable outcome for MA enrollees highlights the importance of addressing the inefficient use of home health services among people with ADRD in MA.
HEALTH CARE PROVIDER ADOPTION OF COGNITIVE ASSESSMENT AND CARE PLAN SERVICES FOR PATIENTS LIVING WITH DEMENTIA
Authors: Mulcahy John
Published: January 2025

In 2017 the Centers for Medicare and Medicaid Services introduced a new billable code for Cognitive Assessment and Care Plan (CACP) Services to encourage healthcare providers to take a more active role in identifying their patients who are living with Alzheimer’s Disease and Related Dementias (ADRD), and to work with these patients and their care partners to develop a comprehensive long-term care plan. This CACP service has seen very low adoption with 0.5% of Medicare beneficiaries with an ADRD diagnosis having received CACP in 2017 and only 2.9% of beneficiaries with ADRD having received it by the end of 2020. Receipt of CACP was even more dismal among beneficiaries living with ADRD who are Hispanic/Latino, dual-eligible, or living in a rural county with 1.8%, 1.9%, and 1.8% of these beneficiaries receiving CACP by 2020 respectively. It is unknown if there are specific barriers to adoption driving this low uptake. This analysis uses a 100% samples of Medicare fee-for-service claims and Medicare Advantage encounters to identify provider and practice level predictors correlated with CACP adoption. The model predicts adoption of CACP using provider specialty, peer adoption of CACP, a previously denied CACP claim, number of patients living with ADRD treated by the provider, percent of patients in Medicare Advantage, overall patient volume, and practice size. Understanding the relative contribution of these potential barriers/facilitators to provider adoption will help inform dissemination efforts and changes that can be made to billing requirements to encourage widespread CACP uptake.
INTENTIONAL SUPPORT REDUCES TECHNICAL BARRIERS TO BEHAVIORAL INTERVENTIONS FOR DEMENTIA CAREGIVERS
Authors: Tupper Emily , Irish Stephanie , Gothard Sarah , Zonker Christina , Mooney Aimee , Lindauer Allison
Published: January 2025

Utilizing technology to provide research interventions can reduce historic barriers to participation, such as travel for study visits, but also presents new challenges for participant retention. Technological issues, including malfunctioning equipment or operator error, are routinely identified as a source of attrition in telehealth studies, and are often associated with a lack of technical support. The Tele-STELLA study, a telehealth intervention aimed at supporting caregivers of persons with dementia, found employment of a tech-support staff eliminated technological issues as a source of attrition. In addition to an interventionist leading each session, a support person was assigned to monitor and address any technical issues. Technical difficulties and subsequent support were recorded for each session. Of 374 recorded sessions, interventionists reported 64(17%) technical difficulties, of which 62(16.5%) were resolved in less than 15 minutes, allowing the session to continue as scheduled; 2(0.5%) sessions required rescheduling. Participant feedback about overall technical experience was gathered at 8 and 16 weeks, and at the time of withdraw. Of 150 enrolled participants, 49 withdrew before completing the study(33%), and experience data was available for 30(61%). Of those, none reported technical issues as a reason for withdrawing, and 28 reported to “strongly agree” or “agree” that they had good technical support(93%). Although attrition is higher than those reported in comparable studies, Tele-STELLA circumvented the barrier of technological issues with targeted technical support during sessions. These findings suggest that purposeful technical support could eliminate a known cause for similar interventions.
INVESTIGATING DRUG-INDUCED DEMENTIA IN A CNS MPS ASSESSING DEFICITS IN LTP FROM ANTICHOLINERGIC COGNITIVE BURDEN
Authors: Autar Kaveena , Grisales Maria , Honore Chelsea , Guo Xiufang , Morgan David , Michaud Veronique , Turgeon Jacques , Hickman James
Published: January 2025

Microphysiological systems (MPS) provide an avenue for small-scale modelling of organ constructs. In conjunction with human induced-pluripotent stem cells (hiPSCs) cultured on microelectrode arrays (MEAs), MPS enable the exploration of functional deficits in concurrence with drug efficacy. Central nervous system (CNS) neural network MPS can evaluate compound-induced cognitive impairment via synapse-dependent, long-term potentiation (LTP). The present work employed a previously validated hiPSC-cortical neuron LTP model to investigate drug-induced dementia onset by Anticholinergic Cognitive Burden (ACB). Utilizing an established CNS model of LTP, we have successfully been able to evaluate a dose-response relationship between ACB drug concentration and cognitive deficits. After discovering that many ACB drugs cause clinical drowsiness, caffeine was employed to re-awaken neuronal activity, akin to increased vigilance. Donepezil, an acetylcholinesterase inhibitor commonly used in the treatment of Alzheimer’s disease (AD), confirmed that LTP deficits resulted from cholinergic neurotransmission, demonstrating the ability of our CNS MPS to assess mechanism-specific synaptic decline. Synergistic effects of ACB drugs and amyloid-beta42 oligomers, which agglomerate to produce neurotoxic plaques in AD, depicted an exacerbation of LTP deficits, suggesting a higher risk of cognitive decline in patients with early-onset AD using anticholinergics. This study illustrated the ability of our human, CNS-based MPS to recapitulate cognitive dysfunction preceded by neurotransmitter homeostatic imbalance, further validating our LTP model for investigating mechanism-dependent disease phenotypes. This model can be expanded to assess synergistic effects of drugs effecting neural network integrity on preexisting conditions causing cognitive impairment, which were observed to be translatable to clinical symptoms.
INVESTIGATING MEDIATORS OF SYSTEMIC MITOCHONDRIAL BIOENERGETICS IN COGNITIVE IMPAIRMENT AND ALZHEIMER’S DISEASE
Authors: Mahapatra Gargi , Bergstrom Jaclyn , Pinto Antonio Michel , Diedrich Jolene , Craft Suzanne , Molina Anthony
Published: January 2025

We previously showed peripheral blood mononuclear cell (PBMC) and platelet mitochondrial bioenergetic capacities are lower in older adults with Alzheimer’s disease (AD), with notable changes in fatty acid oxidation (FAO)-mediated respiration. The metabolic pathways underlying mitochondrial functional differences remain un-identified. This study investigated lipid metabolites that are differently expressed across different stages of cognitive impairment (CI). Targeted lipidomics analyzed 51 fatty acids (FAs) in PBMCs and platelets of older adults with normal cognition (NC), mild cognitive impairment (MCI), and AD dementia (DEM). 10 FAs were selected in each cell type based on significant concentration differences between different cognitive groups. In PBMCs, 9 FAs exhibited higher concentrations in MCIs than NC and DEM, with significantly lower concentration in DEM than MCI, while 1 FA exhibited progressively declining concentrations from NC to MCI to DEM. Significant positive correlations were observed between FA concentrations and FAO and maximal mitochondrial respiration (Max). In platelets, 7 FAs showed progressively declining concentrations from NC to MCI to DEM, and significant positive correlations with FAO and Max, while 3 FAs showed progressively increasing concentrations with cognitive impairment, and significant negative correlations with FAO and Max. Significant negative correlations were also observed with mPACC5 cognitive assessment scores and hippocampal volumes. Pathway analyses identified FA biosynthesis, alpha-linolenic acid, and alpha-linoleic acid metabolism as involved pathways differently impacted across cognitive groups. These findings emphasize the importance of FAs and related metabolic pathways in systemic bioenergetic decline in CI, and may facilitate development of preventative, diagnostic, and therapeutic approaches in AD.
THE IMPACTS OF VIRTUAL REALITY (VR) INTERVENTION ON DEMENTIA CARE EDUCATION: A SYSTEMATIC REVIEW
Authors: Li Xiaoli , Collins Sandra , Liu Xiaoyu , Mutthina Ramesh , Chiu Chung-Yi
Published: January 2025

VR technology has been explored for its potential to deepen the understanding of individuals living with dementia, allowing students and caregivers to immerse themselves in the lives of those affected by this condition. To date, research evidence regarding the implementation and effectiveness of VR interventions in this domain have not been evaluated and synthesized. We aimed to address this gap in the evidence. The study protocol was registered with PROSPERO, and literature published from 2000 onwards was searched from six databases: Academic Search Complete, APA PsycINFO, CINAHL, MEDLINE, Web of Science, and PubMed. Additionally, hand searches of keywords and citation tracking were conducted in Google Scholar. Both qualitative and quantitative literature were considered, and study reporting quality was assessed using the JBI Critical Appraisal Checklists. Among the 318 articles initially identified, 22 were selected for the review. The review encompassed 17 experimental studies and five qualitative studies, involving formal / informal caregivers and university students. Sample sizes ranged from 20 to 278 participants, originating from seven countries and regions, utilizing 11 distinct VR prevention programs. Overall, the incorporation of VR in dementia care education emerges as a novel and underexplored research avenue. VR interventions demonstrated enhancements in caregivers’ and students’ empathy, knowledge, attitude, and understanding of people with dementia, although not all experimental studies found statistically significant changes. VR-based education emerged as a valuable complement to traditional teaching and training methodologies, offering a more engaging and realistic learning experience. However, further research in larger and more diverse samples is needed.
CAN CHATGPT PERFORM GERIATRIC KNOWLEDGE TESTS AS WELL AS MEDICAL STUDENTS, RESIDENTS, AND GERIATRICS FELLOWS?
Authors: Cheng Huai
Published: January 2025

ChatGP was released to the public in November of 2022 and immediately emerged as a quick information resource and application to medical education. ChatGPT passed USMLE step 1, 2 and 3. This study was to examine whether ChatGPT can perform well on 18 published validated geriatric knowledge questions compared to medical students, residents, and geriatrics medicine fellows. These 18 geriatric knowledge questions with 8 True or False questions and 10 clinical vignettes were developed to assess geriatric knowledge for medical students, residents, and geriatrics medicine fellows. In this study, ChatGPT was treated as a human or study participant and prompted to answer these 18 questions four times from April to November of 2023. Outputs from ChatGPT were collected for analysis. The mean scores of 18 questions were compared between ChatGPT and the trainees including medical students, residents, and geriatrics medicine fellows. It was found that the mean score (14.25, n=4 prompts) from ChatGPT was higher than the scores from medical students and similar to residents, however lower than geriatrics medicine fellows. Additionally, half of output from ChatGPT gave good rational for their response to the questions. This indicated ChatGPT performed reasonably well on 18 validated geriatric knowledge questions. ChatGPT could be used as a supplemental resource in geriatrics for trainees at their early stage of training and perhaps for lay persons as well.
THE EXPERIENCE OF SOCIAL WORKERS IN BIG DATA–BASED CARE SERVICES ON PREVENTING SOCIAL ISOLATION FOR OLDER ADULTS
Authors: Kim Haklyoung , Hwang Boram , Kang Sungwan , Choi Seongsu , Mun Kyoungmi , Lee Yeong Ju
Published: January 2025

In response to the increasing occurrence of social isolation among older adults in South Korea, local governments and ICT companies are collaborating to introduce various intelligent care initiatives based on big data, including AI care calls, AI speakers, and activity detection sensors. This study investigates the experiences of social workers providing on-site intelligent care services to older individuals living alone to prevent social isolation. Five focus group interviews involving 15 welfare officials and social workers were conducted. The findings are as follows. Firstly, they recognized biases regarding intelligent technology, such as concerns about privacy infringement, as barriers to identifying high-risk groups and accepting services. Secondly, challenging living environments with limited internet access and low digital literacy were acknowledged as obstacles hindering the sustained use of intelligent care services. Thirdly, the presence of personnel capable of providing education and support for smart device usage was deemed essential for the continued utilization of services. Fourthly, it was acknowledged that additional personnel and support beyond smart devices are necessary for groups with impaired vision, hearing, or mobility. Lastly, the involvement of social workers with a deep understanding of high-risk groups, from planning to evaluation of service models, was recognized as essential for enhancing the effectiveness and efficiency of services. Based on these findings, this study suggests practical and policy implications regarding intelligent living environments, digital literacy, ethics of artificial intelligence, caregiver training, and the involvement of social workers.
A COMPARISON OF HEARING AID USERS AND NONUSERS AMONG PERSONS LIVING WITH COGNITIVE IMPAIRMENT
Authors: Kim Jayeong , Hwang Yeji
Published: January 2025

Hearing impairment is common in older adults, including those with cognitive impairment. While hearing aids can alleviate the challenges posed by hearing impairment, less is known about the usage of hearing aids among individuals living with cognitive impairment. Therefore, this study was conducted with two main

objectives

To identify the prevalence of hearing aid usage among individuals with both cognitive and hearing impairment, and to examine the characteristics of those utilizing hearing aids. Secondary data analyses were conducted using 2020 National Survey of Older Koreans, which includes a nationally representative sample of community-residing older adults. This study included older adults aged 65 years and older who had both cognitive and hearing impairment (n=755). Chi-square tests and independent t-tests were employed to compare the characteristics of hearing aid users to non-users. Among those experiencing both cognitive and hearing impairment, only 32.8% used hearing aids. Individuals using hearing aids were older (t=-4.69, p<.001) and had a higher number of chronic diseases (t=-2.10, p=.036) and medications (t=-2.57, p=.010) compared to non-users. Furthermore, hearing aid users exhibited poorer cognition (t=4.17, p<.001), reported greater depressive symptoms (t=-3.7247, p<.001), and participated less in leisure activities (Chi2=11.73, p<.001). Given that only a small portion of individuals facing hearing difficulties utilized hearing aids, there is a need for greater access to these devices to enhance overall quality of life. Additionally, this study revealed that individuals using hearing aids had poorer health conditions compared to non-users. Future research should consider objectively measuring hearing impairment to better examine this relationship.
PHYSICAL ACTIVITY AND SEDENTARY BEHAVIOR IN RESIDENTS OF ASSISTED LIVING: A PILOT LONGITUDINAL STUDY
Authors: Son Jung Yoen , Tucker She’Lon , Vos Carol , Larson Janet
Published: January 2025

Low levels of physical activity (PA) and high sedentary behavior (SB) place older assisted living (AL) residents at risk for functional decline and premature transfer to a higher level of care. This study aimed to examine the feasibility and acceptability of conducting a longitudinal study using two objective measures of PA and SB. We recruited participants from four AL facilities in Michigan. Participants wore two devices (ActiGraph at the wrist and ActivPal on the anterior thigh) for seven consecutive days twice, once at baseline and again six months later, and completed questionnaires. We evaluated recruitment, retention, and compliance with and acceptability of wearing devices, and conducted a longitudinal multilevel model to estimate preliminary changes in PA and SB over 6 months. Forty-two people volunteered, 19% were excluded with a low Mini-Cog score, 62% completed baseline (77% female; mean age=80.1), and 60% completed 6 months data collection. Most participants were willing to perform two measures of PA and SB and generally found the procedures to be acceptable. Over 6 months, moderate to vigorous PA significantly declined by 8 min/day (p=0.02), light PA declined by 18 min/day (p=0.13), and SB increased by 15 min/day (p=0.48). In conclusion, the results support the feasibility and acceptability of this research protocol. Participants had a small decline in PA over a six-month period of time, which was not clinically meaningful but could become significant if the trend continued.
RECRUITMENT STRATEGIES IN LONG-TERM CARE: NEW AND NOVEL APPROACHES
Authors: Maxwell Cathy , Tate Judith , Juckett Lisa , Colopietro Kelley , Kilpatrick Abbey , Mion Lorraine , Sarkar Nilanjan
Published: January 2025

Older adults residing in long term care (LTC) can benefit from social and behavioral research to improve health outcomes and promote evidence-based practice; however, recruitment is often difficult and time/cost-intensive. Systematic reviews of literature report recruitment barriers, as well as specific recruitment strategies. This presentation extends this work by reporting on new outreach endeavors within two state-based regions with over 300 LTCs. Our work is based on three longitudinal studies in LTC facilities to promote engineering and technology-based interventions that address apathy and loneliness in LTC residents. Relationship-building is the core of successful recruitment with establishment of trust and altruistic outreach. Our strategies include: 1) utilization of personnel with longstanding presence in the community and associated organizations (e.g., Alzheimer’s Association), 2) outreach opportunities to regional, state-based health care professional organizations, 3) repeated phone contacts to gauge interest, 4) provision of health screenings for residents (e.g., blood pressure, fall risk assessment), and 5) educational and enjoyable activities for residents (i.e., games, health-related topics [medications, nutrition, mind/body health, safety]). Research opportunities include studies using socially-assistive robots to address apathy among older adults with mild to moderate cognitive impairment, and augmented reality/avatar-based interventions to address loneliness among LTC residents. Our strategies established trust and promoted relationship-building between local and regional LTC facilities and the specific universities, resulting in successful recruitment of 17 (45%) out of 37 LTCs who responded to initial contact.

Conclusion

Successful recruitment in LTC requires multiple strategies. Trust and relationship-building promote reciprocity that can benefit both LTC facilities and universities.
SENSE OF AESTHETICS AMONG OLDER ADULTS NEW TO LONG-TERM CARE SERVICES AND SUPPORTS
Authors: Weiss Charlotte , Hirschman Karen , Naylor Mary
Published: January 2025

Engagement in aesthetic experiences and activities can contribute to older adults’ quality of life and social connection. Few studies explore older adults’ sense of aesthetics (the extent to which one obtains pleasure from sensory awareness and appreciation of beauty) and how this information may be useful in supporting older adults during transitions to long-term services and supports (LTSS; in home, assisted living, or nursing home). We conducted a secondary analysis of interviews with older adults new to LTSS (R01AG025524) to examine the factors associated with Sense of Aesthetics (SOA) [a Dementia Quality of Life subscale]. A total of 376 LTSS recipients had complete data. The average score of the SOA was 3.44 (SD: 0.98, range= 1-5, median=4; higher scores indicate a greater sense of aesthetics. Using multivariable linear regression, we controlled for the influence of important health-related quality of life covariates (e.g., LTSS setting, sex, age, education, number of comorbidities, sensory impairment [vision/hearing], cognitive status). Older adults with greater positive interaction with social support (p>0.001) and a greater spiritual/religious disposition (p=0.004) had higher SOA. Older adults receiving LTSS in the nursing home had lower SOA compared to those in the home (p=0.029) and no difference between those receiving LTSS in home vs assisted living (p=0.49). The findings highlight the opportunity for LTSS intradisciplinary teams to consider the value that older adults assign to aesthetics and increase access to aesthetic experiences, especially within the nursing home setting. Implications for innovative ways to increase older adults’ sense of aesthetics will be discussed.
“WE ARE SYMBIOTIC”: THE IMPACT OF MULTIPLE CHRONIC CONDITIONS ON RELATIONSHIP DYNAMICS AMONG OLDER COUPLES
Authors: Eagle Angelica , Polenick Courtney
Published: January 2025

Despite the growing recognition of the impact of multiple chronic conditions (MCC) on individuals’ lives and relationships, there is limited understanding about the effects on spousal relationships when both spouses live with MCC. This qualitative study evaluated how older couples living with MCC perceive the impact of their conditions on their relationship. A total of 56 wives (M = 66.84 years, SD = 9.73) and husbands (M = 68.16 years, SD = 10.69), who both reported having two or more chronic conditions, completed separate semi-structured interviews that included open-ended questions about the effect of their conditions on their relationship. We separately evaluated couples that included a partner living with early-stage dementia (n = 15) and couples not living with dementia (n = 41) to assess whether the presence of dementia affects couples with MCC differently due to distinct care needs and communication challenges. The data were coded using qualitative content analysis to develop major themes. Themes for the relationship impacts of MCC among couples not living with dementia included: 1) adapting daily routines around functional limitations; 2) changes in emotional and physical intimacy; 3) changes in shared activities; and 4) stronger relationship impact on one partner. Themes for couples living with dementia included: 1) changes in emotional and physical intimacy; 2) stronger relationship impact on spouses of people living with dementia; and 3) increased time spent together. These findings identify potential targets for dyadic interventions to improve relationship functioning and quality among older couples living with MCC.
AN INVESTIGATION OF CDSMP OUTCOMES FOR PARTICIPANTS ENROLLING WITH DIFFERENT LEVELS OF NEED
Authors: Teply Abby , McKibbin Christine , Clapp Joshua , Carling Stacy , Goodwin Laurance , Carrico Catherine , Dabrowski Barbara , Punke Elizabeth
Published: January 2025

The Self-Management Resource Center’s evidence-based Chronic Disease Self-Management Program (CDSMP) empowers people to actively engage in their own care through a variety of evidence-based solutions. CDSMP strategies and foci align with the Age-Friendly framework - an evidence-based approach to guide health care with older adults that emphasizes 4Ms: “What Matters,” “Medication,” “Mentation,” and “Mobility.” In prior analysis of CDSMP baseline data, participants were represented by two distinct latent profiles based on age-friendly measures: individuals needing support (“NS”) and those who were coping well (“CW”). The purpose of this study was to examine differences in CDSMP outcomes among the participant profiles. Those completing baseline and follow-up assessments (n = 147) were included. Participants were predominantly White (n = 139; 94.6%) females (n = 18; 80.3%) with a mean age of 75.21 (SD = 18.83). Repeated measures ANOVAs revealed significant interactions between CW (n = 42) and NS (n = 105) groups from pre- to post-intervention. Relative to those in the CW group, those in the NS group had greater improvement on measures of interference with daily activities, F(1,144) = 5.15, p =.03, and self-efficacy, F(1,136) = 7.39, p =.01. Despite greater improvement, those in the NS profile still had greater interference with daily activities (M = 1.94, SD = 1.00) than those in the CW group (M = 1.19, SD = 1.08) at post-intervention, t(144) = 1.99, p =.05. Additional strategies may be needed to further improve outcomes for those belonging to the Age-Friendly, “needs support” profile.