bluuebunny/crossref_metadata_2025 huggingface dataset:
ADDRESSING LANGUAGE BARRIERS: PERSPECTIVES INTO THE ROLE OF FAMILY CAREGIVERS FOR OLDER ASIAN AMERICANS
Authors: Raj Minakshi , Quintero Laura
Published: January 2025

Language barriers influence the healthcare experience. Limited communication due to language differences impacts rapport establishment and decision-making processes, often increasing caregivers’ care burden by making them responsible for language interpretation when such service is not offered in healthcare settings (HCS). This study aimed to describe the challenges that caregivers face regarding navigating language barriers in HCS with or on behalf of their older Asian American relatives. Ninety-six caregivers completed a cross-sectional online survey of questions on a) language-related characteristics (e.g., at-home language, other languages spoken), b) language-related experiences in HCS, c) demographic information (e.g., age, residence, immigration status), and d) caregiving characteristics (proximity to care recipient, hours of caregiving per week, and types of support provided). Most respondents (72%) reported that a language other than English was the primary language spoken at home, while 41% of care recipients understand English “not well” (25%) or “not at all” (16%). In HCS, 54% of care recipients wanted interpretation services, with 30% “always” having it. Among types of interpretation, caregivers and relatives performed this task more frequently (53%). Regarding challenges, caregivers referred care recipients’ aging and cognitive decline, medical and technical vocabulary not translatable to native languages, and lack of training are the issues they experience in navigating language barriers in HCS. Despite significant cultural diversity, the United States continues to experience gaps in providing equitable health services to linguistically diverse individuals. It is necessary to develop support strategies to improve healthcare experiences and reduce the additional burden of language barriers on caregivers.
COMMON FEATURES OF AREA AGENCIES ON AGING AND IMPLICATIONS FOR AGING SERVICE INNOVATIONS
Authors: Wilson Traci
Published: January 2025

Established by the Older Americans Act (OAA) in 1973, Area Agencies on Aging (AAAs) across the country assess local community needs and plan, coordinate, and deliver a range of long-term services and supports that help older adults and people with disabilities to age well at home. There is a commonly heard phrase, “if you’ve seen one AAA, you’ve seen one AAA”, but is this helpful or true? Based on an analysis of organizational-level data from USAging’s 2022 National Survey of AAAs (74 percent response rate), this paper delineates typologies of AAAs based on characteristics such as organizational structure, funding sources, agency size, location and how this relates to the types of services offered by AAAs, populations served, and their involvement in initiatives such as age-friendly communities or housing and homelessness prevention. The findings illustrate that all AAAs deliver a core set of OAA-funded services and supports, and funding sources outside of the OAA, including state and local funding, Medicaid Waiver, and contracts with health care entities provide opportunities to deliver additional services to more older adults. While state regulations largely determine the organizational structure and setting of AAAs, there is evidence that each typology of AAA innovates, collaborates and delivers high-quality aging services and supports. By understanding these commonalities, researchers, practitioners, advocates and policy makers can better support the local organizations that support community-living older adults across the country.
HOW CLINICIANS INVOLVE CARE PARTNERS IN THE HEALTH PRIORITIES IDENTIFICATION PROCESS IN DYADS AFFECTED BY DEMENTIA
Authors: Monin Joan
Published: January 2025

Care partners play a crucial role in supporting their kin and friends who are living with dementia and multiple chronic conditions (MCCs) in decision making; yet, we know little about how clinicians include care partners in the Health Priorities Identification Process (HPIP) when they are present at clinic visits. We conducted an online survey with 34 clinicians who currently use HPIP with patients living with dementia with MCCs. On average, clinicians reported that at 53% of sessions, a care partner was present. When care partners are present, clinicians reported the extent to which care partners are involved in the following ways: (1) the patient responds to the HPIP questions on their own or with minor support from their care partner (80% of clinicians said sometimes, often, or always); (2) the patient and the care partner work together to respond to the questions (93% said sometimes, often, or always), and (3) the patient almost fully defer to the care partner to answer the questions (70% said sometimes, often, or always). About 87% of clinicians agreed that patients could successfully complete HPIP with a care partner involved; 84% of clinicians said it is easier for them to complete HPIP when a care partner is involved; and 87% said if care partners had more guidance about how to serve as active listener when patients complete HPIP, they believe care partners would be better prepared to make decisions for the patient if the care partner had to serve as a proxy-decision maker.
“I BELIEVE I CAN WORK, BUT THEY THOUGHT I CAN’T WORK”: THE WORKING CONDITIONS OF PEOPLE WITH YOUNG ONSET DEMENTIA
Authors: Wang Zih-Ling
Published: January 2025

“Young-onset dementia” is a medical condition where a person is diagnosed with dementia before the age of 65. Experiencing behavioral changes and committing mistakes in the workplace due to dementia can lead to issues with employers, pension funds, and financial matters. However, there have been few studies on individuals with young-onset dementia or their working conditions in Taiwan. A qualitative research design was utilized to conduct semi-structured in-depth interviews from three perspectives: people with young-onset dementia, family care partners, and employment specialists. This approach aimed to gain insights into whether and how reasonable accommodation could be implemented in the workplace before COVID-19, how affected individuals adapt to work, and how family care partners and employment specialists assist them in continuing their employment. The research identified three main themes: (1) adaptive strategies and resilience in the workplace among young onset dementia, (2) advocating for supportive environments, and (3) empowering individuals with young onset dementia through tailored career support. This study highlighted areas for improvement in protecting the right to work and ensuring reasonable accommodation for young onset dementia, emphasizing the need for appropriate adjustments in their work environment. The goal is for the public to recognize the capabilities of such individuals and to safeguard their right to work.
MITIGATING SOCIAL ISOLATION AND LONELINESS AMONG RESIDENTS IN SUBURBAN HOUSING COMPLEXES IN JAPAN
Authors: Katagiri Keiko , Kim Nahyun
Published: January 2025

Social isolation and loneliness represent significant societal challenges in Japan, particularly with the increasing number of older adults living alone. Comparative international surveys have highlighted weaker familial and neighborly ties among Japanese older adults, indicating a heightened risk of social isolation. In response, we initiated an action research, “Waigaya project” in Kobe, Japan, in 2022 to foster community connections and combat isolation among older suburban residents. The project comprises “Waigaya forums” and “Waigaya college.” Forums were events which aim to engage residents and promote participation, while “Waigaya college” offered ongoing educational opportunities to enhance knowledge and cultivate resilience for individuals facing extended lifespans. Over two forums and six college sessions, 103 participants aged 3 to 92 attended, with 25.7% attending both, 35.6% exclusively attending college, and 38.6% only participating in forums. College attendance varied, with 19.4% attending 4 to 6 times, 20.9% attending 2 to 3 times, and 59.7% attending once. Post-session surveys consistently showed high participant satisfaction and meaningful peer interactions, underscoring the project’s success. Notably, the project showed promising signs of identifying and nurturing potential core participants who may contribute to future community leadership, while also supporting the initial stages of developing a community network. The “Waigaya project” emerges as an effective strategy for addressing social isolation and loneliness among suburban residents in Japan, offering a promising model for similar initiatives worldwide. By prioritizing community engagement and lifelong learning, this project demonstrates the potential for meaningful impact in combatting social isolation and promoting well-being among older adults.
UNDERSTANDING ENGAGEMENT OF OLDER ADULTS IN SOCIAL CONVERSATIONS TO MITIGATE SOCIAL ISOLATION AND LONELINESS
Authors: Yow W Quin , Sou Ka Lon , Wong Alina Clarise , Ang Chi Shuen
Published: January 2025

Six percent of older adults in Singapore experience social isolation. Given that social isolation and loneliness are associated with cognitive decline and increased mortality rates, there is a pressing need for effective interventions to address these issues among older adults. Traditional approaches, such as in-person befriending interventions, have encountered challenges, e.g., inflexible visit schedules and transportation barriers. There are recent interests exploring how technology can help tackle social isolation and loneliness among older adults. As part of such initiative, we develop an older-friendly conversation agent (CA) utilizing state-of-the-art large language model technology. This CA aims to provide a virtual companion to older adults while prioritizing safety, autonomy, and flexibility. To our knowledge, there are very few studies, and none in Asia, that examine how social conversations among older adults can alleviate isolation and loneliness. As a first step in this investigation, an observational study was undertaken to identify typical conversation topics among older adult friends to build the CA capability. Preliminary findings from three recorded conversations, each lasting approximately 30 minutes and involving a total of eleven older adults (aged 65-79, nine females), revealed recurring topics such as “activities”, “characteristics or personality of others and self”, “location of place or an event”, “episodic events”, “life stories”, and “surroundings”. These insights set the baseline to test the effectiveness of the technology in reducing social isolation in older adults. How interactions with the virtual CA could alleviate social isolation and loneliness among older adults will be shared at the symposium.
CONCEPTUALIZING PERSON-CENTEREDNESS
Authors: Efird-Green Lea , Zimmerman Sheryl , Stratton Lauren , Sloane Philip , Fazio Sam
Published: January 2025

The concept of person-centeredness (PC) has become commonplace in health and supportive care, and perhaps for this very reason, there is no agreed upon understanding as to what constitutes “person-centeredness.” To clarify the concept, a systematic review of current definitions of PC in the literature was conducted; it revealed that most papers referencing person-centered or patient-centered interventions do not define the term, and that definitions that when they do, they vary widely. Given the benefit of having a common understanding of PC, think-tank meetings were held with 65 experts in the fields of health and aging policy, research, and practice. The experts were provided numerous prompts (e.g., in the context of being person-centered, how do issues of dependency and competency enter in?); responses indicated that they conceptualize and implement the concept of PC differently at the macro, meso, and micro levels. At the macro level, there is a focus on core values, the influence of privilege and oppression, and how PC is implemented – or not – in systems and cultures. On the meso level, there is a focus on organizational responsibility, the applicability of PC to various communities, and the importance of relationships. On the micro level, PC is focused on care, including individualization and personalization, the importance of care partners/family, and the limitations of PC in individual settings. This presentation will address the three levels of PC, including each level’s focus, implementation, and challenges, with the goal of establishing a multilevel conceptualization of PC.
PERSPECTIVES ON PERSON-CENTEREDNESS ACROSS HEALTH CARE SETTINGS
Authors: Sloane Philip , Zimmerman Sheryl , Syed Ayesha , Fazio Sam
Published: January 2025

Systems perspectives generally identify three levels of action: the interpersonal (micro) level, the institutional (meso) level, and the broader societal (macro) level. Person-centeredness is generally viewed at the interpersonal level, but especially in the context of health and supportive care, broader systems can shape and impact the quality and outcomes of these one-on-one interactions. To better understand how and why person-centeredness varies across health care settings (e.g., hospitals, nursing homes), we conducted interviews and convened think tank meetings with 31 diverse stakeholders including direct care workers, administrative staff, consumer advocates, and academic researchers focusing on care of older persons. Prompts asked examples of person-centeredness (or lack thereof) in numerous settings. The following themes were identified that help explain the wide range in person-centeredness across health care settings: 1) variation in system goals related to person-centeredness; 2) variation in systems’ perceived need to limit person-centered; 3) relationships between resource availability and person-centeredness; 4) cultural values and societal inequity as root causes of much variation in person-centeredness; and 5) influence on person-centeredness of the degree to which hospitality is a core value within a given system. Understanding and responding to these themes within a given setting may more effectively help meet resident needs and preferences; it also has implications for policymaking, such as creation of training guidelines for care staff and benchmarks for program leaders.
TOWARD A GLOBAL DEFINITION OF PERSON-CENTERED DEMENTIA CARE
Authors: Fazio Sam , Moczygemba Walter , Stratton Lauren , Zimmerman Sheryl
Published: January 2025

Person-centeredness is instrumental to quality dementia care, yet there remains inconsistency surrounding its definition and attempts to unify disparate conceptualizations are often based on high-income and Eurocentric perspectives. To address this, we surveyed 39 Alzheimer’s Disease International members on their perspectives and experiences with quality of dementia care, definitions of person-centered dementia care, and the challenges and successes of person-centered dementia care in their countries. Overall, respondents describe a lack of global quality dementia care, naming several barriers to its successful implementation. Respondents also agreed the creation of a universal definition of person-centered dementia care is necessary for furthering high quality dementia care globally. Five core tenets representative of the geographically and economically diverse sample were identified to be included in such a definition: individualize care, value the individual, empower the individual, acknowledge the importance of caregivers, and address dimensions of wellness. Discussion will focus on recommendations for practitioners, researchers, and policy advocates on how to embody global tenets of person-centered dementia care. Additionally, internationally common barriers to person-centered dementia care are identified for further study and advocacy efforts.
MENTORED-BASED AGING RESEARCH IN THE BEHAVIORAL AND SOCIAL SCIENCES: RCMAR VI NCC, AN INFRASTRUCTURE FOR SUCCESS
Authors: Barnes Lisa
Published: January 2025

The RCMAR VI NCC is led by a diverse, multidisciplinary MPI team, with the purpose to develop a robust infrastructure and community that will grow and diversify the research workforce in the behavioral and social sciences to address minority aging, AD/ADRD, and/or health disparities among older adults. This goal will be achieved through the following strategies. 1) Provide support and interaction among RCMAR Centers via an interactive website, robust community-wide online networking platform, tools to enhance collaboration, and resources supporting the creation of new scholarship. 2) Leverage existing and develop new evidence-based tools to provide early career scientists and mentors from diverse backgrounds with skills and technical support necessary to advance their professional growth, foster culturally aware and responsive mentorship and career development. 3) Catalyze resource sharing between and among the RCMAR Centers and cultivate sustainable engagement with key stakeholders including Minority serving institutions; Historically Black Colleges and Universities, Tribal Colleges and Universities, Hispanic Serving Institutions and other academic institutions serving predominately racially minoritized students and groups, all NIA research Centers, the aging research community, and the public. 4) Foster reverence for the value of Diversity, Equity, Inclusion and Anti-Racism (DEIA) in the aging research enterprise by broadly elevating and disseminating the activities and findings of the Centers and their scientists in academic and public venues. 5) Establish consensus on essential common evaluation metrics and implement a streamlined process for collecting data to support the evaluation of RCMAR Center activities, including research, collaboration, mentoring, networking, stakeholder engagement, and DEIA.
EXPERIENCES FROM A RCMAR SCIENTIST (ALUMNA): A MEANINGFUL AND REWARDING JOURNEY
Authors: Baker Tamara
Published: January 2025

RCMAR was established to develop a research and mentoring infrastructure that fosters rigorous behavioral and social science research on aging in a high priority research area that can advance aging-relevant scientific discoveries, lead to the elimination of health disparities and health inequities, and improve the health and well-being of older adults. The primary objectives of RCMAR are 1) career development, which aims to support the career development of early-career scientists conducting social, behavioral, psychological, and economic research related to aging, and 2) advancement of scientific discoveries related to aging. Scientists participating in this program are afforded opportunities to establish a successful program of research; personalized guidance through professional development activities, helping scientists develop skills, knowledge, and confidence in the field; networking opportunities, expanding their professional network and potential career opportunities; personal growth; feedback and advice, helping scientists improve performance and make informed decisions; career advancement, receiving guidance on strategies for success; and knowledge transfer, fostering continuity and innovation in the field. These opportunities are recognized in developing some of the most established scholars in the discipline. Dr. Baker, a former RCMAR scientist will reflect on how her participation as a RCMAR scientist has allowed her to build a successful research career on the intersection of social determinants and chronic pain in older adults; be an advocate in diversifying the workforce; and become a leader in the gerontology discipline. Highlighting these successes is intended to broaden the outreach of program while encouraging others to consider this opportunity.
SCOPING REVIEWS: A METHODOLOGY TO UNDERSTAND HEALTHY AGING AND IDENTIFY NEW AREAS FOR RESEARCH
Authors: Belza Basia
Published: January 2025

Scoping reviews is an approach to synthesize evidence. They are used to categorize literature in a field in terms of its nature, features, and volume. The purpose of this symposium is to provide an overview of how to conduct a scoping review and highlight examples of recent scoping reviews. The first presentation builds on the social determinants of health report by World Health Organization (WHO) and defines and categorizes approaches that have been implemented to achieve health equity among older adults. The second presentation is on social frailty which results from a lack of social resources and support and poses a significant threat to healthy aging by increasing the risk of adverse health outcomes. Creatively using a person-environment-occupation model, the third presentation categorizes the effectiveness of interventions into mealtime for people living with dementia who reside in care communities. Building on the growing body of literature that links benefits of music to health outcomes, the fourth presentation focuses on a review of the terminology used for music-based interventions. The fifth presentation focuses on identifying the outcomes of community-based physical activity programs for people with dementia, a group that frequently is missing from our study populations. The symposium will conclude with recommendations for areas that need improvement related to scoping reviews: 1) engaging stakeholders earlier and more often with scoping reviews to facilitate interpretation of results and effective knowledge translation, and 2) identifying ways to use the scoping review results as a decision-making tool.
PHYSICAL ACTIVITY INTERVENTIONS FOR PEOPLE LIVING WITH DEMENTIA: A SCOPING REVIEW
Authors: McKiddy Sarah
Published: January 2025

Dementia poses significant challenges globally, necessitating effective interventions to mitigate its impact on individuals and societies. Physical activity has emerged as a promising avenue for enhancing physical and cognitive function among people living with dementia. This scoping review aimed to evaluate the characteristics and outcomes of various physical activity interventions in this population including articles from Australia, Belgium, Germany, New Zealand, Sweden, the United States, and Japan, reflecting a global effort to address the complexities of considerations for physical activity interventions for dementia. Predominantly utilizing randomized control trials (RCTs), the studies explored interventions ranging from strength and balancing exercises to multicomponent training, targeting individuals aged 50 and older diagnosed with Alzheimer’s disease, other forms of dementia, or mild cognitive impairment. Notably, interventions primarily involved in-person sessions, with a few incorporating remote platforms, emphasizing the importance of accessibility and flexibility in delivering interventions to diverse populations. Results indicated improvements in physical function, cognitive performance, and quality of life, suggesting the potential of physical activity as a multifaceted intervention for dementia management. Despite methodological variations and limitations observed across studies, the findings highlighted the promising role of physical activity in enhancing the well-being of individuals living with dementia. Future research should focus on addressing methodological inconsistencies, expanding diversity in study populations, and exploring optimal intervention strategies to maximize the benefits of physical activity in dementia care.
ADDRESSING THE EDUCATIONAL DISPARITIES IN COGNITIVE FUNCTION: THE COMPENSATION EFFECTS OF SOCIAL NETWORKS
Authors: Peng Siyun , Perry Brea
Published: January 2025

Educational disparities have been widely considered a key driver of disparities in dementias and cognitive aging. In this study, we ask: Is it too late for less educated older adults to engage in cognitively stimulating environments (e.g., bridging social capital in networks) to shorten their cognitive gaps with more educated older adults? Bridging social capital is defined as access to novel information and is thought to be a source of cognitive stimulation that may confer resilience to cognitive decline. Using rich cognitive assessments and egocentric network data from the state representative Person to Person Health Interview Study (P2P; N=685), we find that the associations between bridging social capital and cognitive outcomes are strongest for people with less than a high school education. Importantly, the cognitive gaps among people with different educational levels disappear among those with higher bridging social capital. One important implication of this study is that stimulating environments in later life (e.g., bridging social capital) is most effective for the population with lower distal stimulating environments (e.g., people without a high school diploma). Finally, the relationship between bridging social capital and cognitive health is discussed in the context of cumulative stimulating environments across the life course.
FAMILY HEALTH EQUITY CONCEPTUAL MODEL
Authors: Aguilar Genevieve
Published: January 2025

Family Health Equity applies to the family unit when engaging in health care. The family (chosen and biological) unit is often the center of support for Black, Indigenous, and People of Color (BIPOC) communities. I am passionate about fully incorporating the patient and family into the care plan. This is especially true if there are barriers to care. Growing up along the US-Mexico border, I saw many barriers to care for my family. I propose this conceptual model of Family Health Equity. In this model, the patient has an equal voice and power to the caregiver and the provider. Other Health Equity models do not put the patient and caregiver equally at the center. This model starts with nursing driving the change and builds from there. The Family Health Equity conceptual model includes communication as a key element. This means including health literacy, interpretation, translation, identity, and cultural consideration in communication practices that can improve health equity for BIPOC communities. Any statements made by the patients or caregivers should be treated with respect and as truth. The outcome of these practices is an increased level of trust, which can lead to improved care. Studies suggest that patients have improved communication and experience fewer health disparities with racially concordant healthcare providers. The Family Health Equity conceptual model can be utilized to examine issues in family theory, aging, and clinical practice. It provides a blueprint for institutions to address equity in their environments.
APPLYING THE DYNAMIC SUSTAINABILITY FRAMEWORK TO AN INTERGENERATIONAL TECHNOLOGY PROGRAM IN HIGHER EDUCATION
Authors: Juris Jill , Scrivano Rachel , Leedahl Skye , Colvin Meaghan , Santilli Josie , Jarrott Shannon
Published: January 2025

Cyber-Seniors (CS) is an intergenerational technology program developed to increase older adults’ digital competence and adoption through reverse-mentoring facilitated by trained students. Leveraging higher education as a platform offers mutual benefits, fostering positive attitudes toward aging among students while enhancing technology literacy among older adults. CS often operates within community settings with volunteers and high school students; however, systematic assessment within higher education remains unexplored. This study examined the determinants of sustainability associated with implementing CS in higher education through the Dynamic Sustainability Framework. Through semi structured interviews conducted between April and October 2023, we explored challenges and facilitators employed by ten partnered higher education institutions and two key CS representatives. Data were analyzed by two coders using directed qualitative content analysis in Atlas.ti. Three themes characterized higher education and CS representative experiences implementing CS: adapting the intervention for higher education, navigating the role of resources, and engaging university and community buy-in. The COVID-19 pandemic introduced unique challenges to CS implementation. This study presents the first comprehensive evaluation of CS in higher education, highlighting the necessity of tailored approaches and identifying barriers to sustainability. Results suggest the need for a structured implementation checklist to optimize program delivery within higher education.
INTERGENERATIONAL HEALTH PROMOTION PROJECT TO REDUCE OLDER ADULT SOCIAL ISOLATION AND LONELINESS: A FEASIBILITY STUDY
Authors: Holloway Jeremy
Published: January 2025

Emerging research demonstrates that social isolation and loneliness are linked to significant physical and mental health conditions. To address these concerns, the Tellegacy program was developed as an intergenerational health-promoting intervention to ameliorate older adult social isolation and loneliness in an effort to increase wellness. The purpose of this study was to reflect on testing of the Tellegacy program as a behavioral intervention. University students trained in goal setting, mindfulness, and listening strategies were paired with 11 older adults in the northern Midwest area via weekly in-person and phone conversations. Oral reminiscence therapies were used and books containing their stories were given to the older adults after participation. Older adults were surveyed using the University of California Los Angeles Loneliness Scale, Satisfaction of Life Scale, and patient health questionnaire-9 (PHQ-9) scale to elucidate the effectiveness of the intervention. Improved scores in loneliness, satisfaction of life, and PHQ-9 demonstrated favorable improvements in older adults. Additional benefits for the student Legacy Builder were revealed from self-reported changes. This suggests the potential benefits of structured encounters between trained students and isolated or lonely older adults. The Tellegacy intergenerational feasibility program warrants further studies to fully demonstrate its impact on health outcomes.
ACADEMIC–PRACTICE PARTNERSHIPS IN NURSING HOMES: INTERNATIONAL EXPERIENCES, PROCESSES, AND OUTCOMES
Authors: Boltz Marie , Wolf-Ostermann Karin , Spilsbury Karen
Published: January 2025

The Academic-Practice Partnership model is increasingly gaining attention as a feasible approach to grow the geriatric workforce, generate meaningful research, and integrate evidence-based, person centered care into nursing home operations. They offer practicable approaches to optimize knowledge and skill development for students, support lifelong learning of staff, optimize research capacity and productivity, and improve resident outcomes. This symposium will describe interdisciplinary collaboration between scientists, care providers, and educators in nursing homes in three countries: United States, Germany, and the Netherlands. The engagement and experiences of stakeholders, daily operations, and research activity will be discussed. The first presentation will describe the TCALL project in Germany, which creates a direct pathway for research to care delivery via training and vice versa. The Teaching Home project in the US will be presented next, including the process of co-designing the program with nursing home leadership and staff, developing the curriculum, preparing faculty, and the content for practice. A qualitative exploration of the US students’ experiences and lessons learned in the teaching home program will be shared in the third presentation. The fourth presentation will provide an overview of the Dutch Living Lab in Long-term care; the outcomes related to quality of life of older people and their families, quality of care and quality of work will be discussed. A discussion will follow addressing future directions including inter-university collaboration, measurement considerations, and policy implications.
REVISITING THE US TEACHING NURSING HOME: WHAT ARE STUDENTS’ PERCEPTIONS OF CARING FOR OLDER ADULTS?
Authors: Kitt-Lewis Erin , Heaton Felicia , Yoder Maria , Fick Donna , Boltz Marie
Published: January 2025

The U.S. Census Bureau predicts that by 2050, over 20% of the U.S. population will fall into the category of older adults and will be the “core business” of the nursing profession. This growing demand is coupled with critical staff shortages, especially in nursing homes, a deficit that was exacerbated by the experiences of the COVID-19 pandemic. The American Association of Colleges of Nursing has identified care for older adults as a priority for undergraduate nursing programs and nursing education literature suggests there are critical barriers toward greater integration of the knowledge, skills, and dispositions needed to adequately care for older adults living in nursing homes. The purpose of this study was to understand undergraduate nursing students’ perceptions about their first clinical learning experience in a nursing home and working with older adults., Students (N= 105) from a large research university who were enrolled in the Nursing Fundamentals course were recruited to participate in the study. De-identified course artifacts (e.g., Age-Friendly Health Systems 4Ms Framework course assignments) generated by consented participants were compiled and analyzed using thematic analysis. Two themes emerged from the data and included students’ assumptions and lessons learned about caring for older adults living in nursing homes. In addition, students identified opportunities that could improve care for older adults, especially around “What Matters” and functional mobility. These findings will serve as the basis to guide best practices for integrating additional learning experiences in the undergraduate nursing curriculum using the Age-Friendly Health Systems 4Ms Framework.
PATIENT-REPORTED PAIN AND SLEEP DISTURBANCE AFTER HOSPITALIZATION FOR MEDICAL ILLNESS
Authors: Hastings Susan , Stechuchak Karen , Coffman Cynthia , Kappler Caitlin , Hughes Jaime , Webster Amy , Allen Kelli
Published: January 2025

Older adults experience a well-documented period of vulnerability following hospitalization; yet contributing factors are not fully understood. The goal of this cross-sectional study was to examine associations between post-discharge pain and sleep disturbance with quality of life (QoL) and function in the month following hospitalization for medical illness. As part of a larger study evaluating the effectiveness and implementation of a hospital-based mobility program, we conducted telephone surveys with 618 adults aged ≥60 discharged from one of 8 Veterans Affairs (VA) hospitals. Primary predictors of interest were pain interference and sleep disturbance measured by PROMIS-29 short forms. Outcomes were QoL measured by EQ-5D, function measured by late-life function and disability instruments (LLFDI total and advanced lower extremity function) and community mobility measured by Life Space. For each outcome, separate multiple linear regression models were fit including the key explanatory variables of interest (pain interference and sleep disturbance) and selected covariates (sociodemographic, clinical, hospitalization characteristics) social/regional factors (e.g., social vulnerability, hospital). Participants were mean age 70.6 years, 95% male, 25% Black, 34% lived alone, 8% reported being discharged to a nursing home and 15% had been readmitted to the hospital. In adjusted models, pain interference and sleep disturbance were negatively associated with QoL, total function, lower extremity function, and community mobility (P-values < 0.01). In this sample of recently hospitalized older adults, pain and sleep disturbance were independent contributors to worse QoL and functional status. Pain and sleep may warrant further attention and/or intervention during the post-hospitalization period.
IMPACT OF FRAILTY SCREENING IN A BURN CENTER: A QUALITY IMPROVEMENT PROJECT
Authors: Patel Purvi
Published: January 2025

Burn injuries create significant risk for the development of new or worsening frailty. Identifying risk for frailty is key to recognizing patients who are at risk for negative outcomes who may benefit from a comprehensive geriatric assessment (CGA). A quality improvement project was conducted in a burn center setting with the primary aim to determine if implementation of the FRAIL scale screening tool impacted frequency of consultation to the geriatric medicine team for a CGA within a 10-week pilot period. Secondary aims were to evaluate feasibility of implementation and to stratify patients’ risk of frailty into categories based on the tool measurements: robust, pre-frail, or frail. The project included 44 patients (22 in the pre-frailty tool group and 22 in the post-frailty tool group). The data revealed a three-fold increase in the number of consultations to the geriatric medicine team between the pre (n=5) and post (n=15) groups with statistical significance (p =.002). The frailty tool was most often administered on the first (54.5%) or second (31.8%) hospital day. In the post group, stratification of frailty risk was 27.3% robust, 45.4% pre-frail, and 27.3% frail. The FRAIL scale is shown to be useful in identifying patients who would benefit from a CGA compared to routine clinical practice. The tool is feasible to implement in a burn center. The clinical significance of the majority of patients being classified as pre-frail and frail underscores the need to identify patients’ frailty risk and implement measure to mitigate adverse outcomes.
AGE AS A PREDICTOR OF BURN-RELATED OUTCOMES IN OLDER ADULTS IN LOW- AND MIDDLE-INCOME COUNTRIES
Authors: Wang Claire , Lee Jieun , Khvatova Elizabeth
Published: January 2025

While older age has been linked to worsened burn outcomes, the specific effects of age on high-risk older adult burn patients in low- and middle-income countries (LMICs) are not well understood. Utilizing the WHO Global Burn Registry data from 2017-2021, older adults (n=2,257) were stratified into three age groups at time of burn injury (>40 and ≤60; >60 and ≤80; >80). Multivariable logistic regression models were employed to evaluate the association between age groups and detailed burn outcomes (left against medical advice, discharged home without physical impairment, discharged home with physical impairment, or mortality), adjusting for potential confounders such as sex, country, percentage of total burn surface area, access to rehabilitation services, and surgical interventions during hospitalization. After adjustment, individuals ages 80+ showed a statistically significant increase in burn-related mortality/impairment compared to those in the >40 and ≤60 age group, with an adjusted odds ratio (OR) of 2.06 (95% confidence interval [CI]: 1.33-3.20). A separate analysis on mortality revealed that those 80+ had significantly higher odds of burn-related mortality compared to the youngest age group, with an OR of 3.47 (95% CI: 2.10-5.74). No significant differences were identified in impairment outcomes across the age groups. Our study reveals a marked increase in mortality risk from burns in individuals 80+ in LMICs, not observed in younger counterparts. Despite no significant age-impairment correlation, the findings indicate a need for age-tailored interventions to improve outcomes for this high-risk group, urging further research into targeted, age-specific care.
SELF-REPORTED FRAUD VERSUS OBSERVED VICTIMIZATION INCIDENTS: A RISK FACTOR COMPARISON
Authors: DeLiema Marguerite , Gao Siyu , Langton Lynn , Brannock M Daniel
Published: January 2025

According to the age-associated financial vulnerability model, older adults may be more susceptible to scams. Research is needed to identify modifiable risk factors for targeted intervention. We surveyed 934 law enforcement-identified victims of mass marketing scams (mean age=74.7) to determine what characteristics and behaviors are associated with the number of (1) self-reported victimization incidents, and (2) observed victimization incidents. The survey was administered online and by mail. Data on participants’ observed incidents of mail fraud victimization between 2022 and 2023 were provided by the US Postal Inspection Service. Linear regression results indicate that behaviors that increase fraud exposure (e.g., answering calls from unknown numbers, talking with telemarketers, opening all pieces of mail), as well as purchasing lottery tickets, loneliness, and a preference to take financial risks are associated with a greater number of self-reported fraud and exploitation incidents. Identifying as non-Hispanic White and being more active online were protective. Purchasing lottery tickets and greater preference for financial risks were also significantly associated with observed incidents of fraud. Being female and reporting less social engagement were significant for observed incidents only. Based on the difference in significant risk factors between the two models, results indicate that self-reported victimization is an imperfect measure of actual fraud victimization. Fraud prevention programs that increase social engagement and reduce behaviors associated with fraud exposure are promising targets for intervention. Results also suggest that embedding fraud awareness education in locations where lottery tickets are sold may be a prevention strategy to reach vulnerable older adults.
USE OF MOTIVATIONAL INTERVIEWING TO INTERVENE ELDER ABUSE: A RANDOMIZED CONTROL TRIAL
Authors: Yan Elsie , To Louis , Wan Debby , He Jasmin , Lai Daniel W L , Burnes David , Pillemer Karl , Lachs Mark
Published: January 2025

Elder abuse causes serious harm to individuals, families, and society. There is an urgent need to develop and test appropriate interventions to tackle it. This study tested the effectiveness of a motivational interviewing (MI)-based intervention in reducing elder abuse severity and promoting positive changes among community dwelling older Chinese in Hong Kong. The intervention involved a 90-minute individual engagement session and three 30-minute booster sessions delivered by trained MI facilitators. Personal goals for improvement of known risk factors such as poor physical and psychological health, lack of social support were set out followed by the application of MI processes. Pre- and post-test comparison of 33 intervention cases and 28 control cases are presented here. Analysis of pre-treatment differences found significant difference between the two groups in their monthly income, number of offspring and co-residing persons, physical frailty, general self-efficacy and abuse severity. Difference in differences technique was applied to mitigate the effects of extraneous factors and selection bias. Results show that intervention group performed significantly better than the control group upon completing the intervention program. Significant between group differences were found in terms of changes in psychological distress (GHQ, z=-3.043, p< 0.05), general self-efficacy (GSES, z=-4.988, p< 0.05), social support (MSPSS, z=-3.080, p< 0.05), abuse severity (CTS2, z=-2.593, p< 0.05), and perceived ability to change (z=-3.749, p< 0.05). MI has demonstrated good potential for elder abuse intervention. Further study should be conducted to identify key elements in MI leading to positive changes and refine the model for elder abuse prevention and intervention.
THE HEALTHIER BLACK ELDERS CENTER COMMUNITY-ENGAGED PROGRAM
Authors: Lichtenberg Peter , Perry Tam , Rorai Vanessa , Hall LaToya
Published: January 2025

For the past 25-years the Healthier Black Elders Center has been the community-engaged program run by the Wayne State University Institute of Gerontology as part of the Michigan RCMAR program. The HBEC has an active Community Advisory Board and engages in year round community education and health programs, provides a lay person newsletter and has a Participant Registry. During the past five years the HBEC began a community-engaged consultancy program in order to assist others across the country in engaging with older black adults for research participation. The HBEC is also a science generating program, with research publications across the past 20 years on recruitment and retention of older black adults into research. Beginning in 2012 the HBEC also expanded to include the Successful Aging through Financial Empowerment program. The SAFE program has been the nexus for financial-decision making, financial exploitation and day to day financial management in older black adults. The SAFE program is not only a research program but also a service program. The SAFE program provides 1:1 assistance for older adults who were victims of scams or identity theft and are having difficulty straightening out their finances. In order to reach older black adults and the professionals who work with them the SAFE program has its own year round community engaged efforts including the program “Financial First Fridays” and a regular series of community-based talks. SAFE has assisted over 350 older adults and caregivers and provided 1:1 services for 200 clients during the past five years.
ADVANCING HEALTH EQUITY AND REDUCING DISPARITIES: COMMUNITY-IDENTIFIED AND DRIVEN PROJECTS
Authors: Frazier Robbin , Johnson Elma
Published: January 2025

Soon after its re-launch in 2021, the Center for Healthy Aging and Innovation (CHAI) at the University of Minnesota established its Equity and Community Engagement (ECE) Core to develop the infrastructure for community engagement in CHAI and build relationships with a variety of community partners serving older adults in BIPOC and underserved communities. After careful planning and a thoughtful recruitment process, the ECE Core launched CHAI’s first Community Advisory Board (CAB) in the fall of the same year. This diverse group brings together older adults from the largest ethnic groups in the state, and provides input, wisdom and lived experience to guide CHAI’s work and priorities. Two years after its launch, the CAB has identified key community needs related to aging and started work on several community-led projects to address ageism and social isolation among diverse older adults. It also helped form the Strategic Advisory Council, a group complementary to the CAB composed of community leaders, faculty, scholars, and policymakers, and charged with developing recommendations to address systemic inequities impacting the aging experience of diverse older adults. In 2024, the group entered its next phase, focused on strengthening the academic-community collaboration and aligning research priorities with those of the communities CHAI serves. CHAI will present key findings and highlights from each stage of its community-engagement process and will share lessons learned on its way to achieving its mission - the one of a truly community-engaged academic Center on Aging.