bluuebunny/crossref_metadata_2025 huggingface dataset:
BARRIERS AND FACILITATORS TO SOCIAL PARTICIPATION WHEN AGING WITH A LONG-TERM DISABILITY: A SCOPING STUDY
Authors: Turcotte Samuel , Kheroua Sirine , Labbé Angéline , Lapointe Mia , Nguyen Manh Hung , Veilleux Megan , Simard Pascale , Levasseur Melanie
Published: January 2025

Introduction

Supporting the social participation of individuals aging with a long-term neurological disability contributes to active and healthy aging. However, knowledge about factors influencing the social participation of this population remains scarce.

Objectives

Integrate knowledge regarding the barriers and facilitators to social participation for people aging with a long-term neurological disability.

Methods

A scoping review following the Joanna Briggs Institute guidelines was conducted across four databases (MEDLINE, CINAHL, PsycInfo, and EMBASE). Analysis relied on the Human Development Model - Disability Creation Process (HDM-DCP). This study is reported according to the PRISMA extension for scoping review (PRISMA-ScR).

Results

Eighteen articles (8 quantitatives and 10 qualitatives) representing 1,319 participants and eight neurological conditions (e.g., stroke, multiple sclerosis, traumatic brain injury, spinal cord injury, aphasia, post-polio, spina bifida, and cerebral palsy) were included. Participants’ average age ranged from 53.4 to 72 years and the average time since their disability ranged from 5 to 46.26 years. A total of 26 barriers and 42 facilitators to social participation were identified. The most recurrent barriers were associated with the organic system (e.g., presence of comorbidities) and the societal environment (e.g., transportation accessibility). The most frequent facilitators included identity factors (e.g., acceptance of one’s condition) and the community environment (e.g., available social participation opportunities).

Conclusion

This study lays the groundwork for developing interventions aimed at promoting active and fulfilling aging among older adults with long-term disabilities. Supporting social participation for this population should involve harnessing individual strengths and environmental resources as well as eliminating environmental systematic barriers.
BATTLING HEAT: COMMUNITY ENGAGEMENT AND HEALTH STRATEGIES FOR LOW-INCOME OLDER ADULTS LIVING ALONE
Authors: Zhong YunYing , Li Jianwen , Jackson Ajani , Kim Dahee , Thiamwong Ladda , Crook Jennifer , Emrich Christopher , Xie Rui
Published: January 2025

Low-income older adults living alone are at higher risk for falls, social isolation, and worsening functions. The impacts of extreme heat on their health are worthy of further investigation. This study investigates the data from 45 low-income older adults living alone (M=76.6 years old, SD =7.42) in Florida to understand their responses and adaptation strategies to extreme heat or hot days. Most respondents (66.7%) reported discomfort, ranging from slightly uncomfortable (24.4%), uncomfortable (13.3%), very uncomfortable (24.4%), to extremely uncomfortable (4.4%). Less than half of participants (42.2%) reported feeling hot or very hot, and 71.1% reported feeling moderately thirsty to very very thirsty. Overall, participants rated the threat of hot weather on health and day-to-day activities as 5.44 out of 10 (SD=3.25). Despite participants recognizing the potential health risks, there is a disconnect between the perceived threat and actions taken to decrease it. Majority of them did not stay inside (64.4%), nor reduce physical activity (75.6%), nor visit a cool place (93.3%), nor stay hydrated (60.0%), nor take cold bath/shower (95.6%). They appeared lack of knowledge of managing heat in multiple ways, with most respondents reporting only one way to manage heat (57.8%). Most respondents are participating in programs in local senior centers (53.3%) and they have future interested in community programs on heat prevention (53.3%). These findings emphasize the need for specific community-based interventions that provide health strategies to adapt to the extreme heat to address the immediate comfort and health concerns of low-income older adults living alone.
BELIEFS ABOUT AGING AND TRAUMA-INFORMED CARE WITHIN SKILLED NURSING FACILITIES
Authors: Meynadasy Melissa , Bashian Hannah , Moye Jennifer , Sullivan Jennifer , Mills Whitney , Driver Jane , Ruopp Marcus , O’Malley Kelly
Published: January 2025

Pessimism about aging is ubiquitous and impacts emotional well-being and willingness to implement healthcare strategies with older adults. Individuals experiencing increased stress may be motivated to differentiate themselves from an older, more vulnerable group, which may further intensify pessimistic beliefs. This is particularly important to consider in skilled nursing facilities (SNFs) due to vulnerabilities residents experience. Healthcare environments/approaches can contribute to re-engagement with trauma symptoms, and pessimism about aging are related to trauma symptom endorsement. To explore how expectations about aging may impact staff perceptions of trauma-informed care (TIC), we assessed staff across disciplines (n = 78; nursing, rehabilitation, psychosocial, medical) in a sample of VA SNFs. Staff completed Expectations Regarding Aging (e.g., cognition, physical) and Attitudes Related to Trauma-Informed Care (e.g., beliefs about behavior) questionnaires. Higher total and subscale scores indicate positive expectations of aging and greater TIC endorsement. Expectations of aging differed significantly by discipline (F(3, 65) = 6.79, p <.001, ƞ2 =.24); nurses had lower expectations compared to other disciplines – and a significant difference compared to rehabilitation staff (p =.001; Bonferroni correction). Expectations about aging were not significantly related to overall perceptions of TIC (p =.09). However, staff expectations about cognitive functioning, were positively correlated with TIC attitudes about underlying causes of behavior (r =.25, p =.037), suggesting accurate knowledge about cognitive aging relates to more accurate understanding of resident behavior. This preliminary work suggests beliefs about aging may be related to some but not all aspects of TIC attitudes.
BETTER TOGETHER? PERCEIVED PROSPECTIVE MEMORY FAILURES RELATE TO COGNITIVE COLLABORATION IN MIDDLE AND LATE LIFE
Authors: Sharma Anisha , Reese-Melancon Celinda , Margrett Jennifer , Wyatt Riley , Harrington Erin , Byrd-Craven Jennifer , Turner Rachael , Rendell Peter
Published: January 2025

Research examining everyday memory among older couples indicates that partners rely on one another for cognitive support (e.g., Harris et al., 2022). We built upon this body of work to determine whether perceptions of a partner’s everyday prospective memory (PM) forgetfulness are related to the perceived cognitive support (e.g., planning, reminders) one offers the partner. Participants were 196 middle-aged and older married individuals (M = 64.51 years, Range = 40–88 years) who completed self and proxy versions of the Prospective and Retrospective Memory Questionnaire (Smith, 2000) as well as a measure of self-reported collaborative prospective memory (adapted from Reese-Melancon et al., 2018 and Harrington & Reese-Melancon, 2022). Regression analyses indicated that age and perceptions of one’s partner’s forgetfulness predicted significant variance in the amount of PM support one reports offering one’s partner. Participants who perceived greater PM forgetting in their partner reported providing more help to them, with older adults reporting providing more assistance to their partners. Additional analyses indicated biological sex and one’s own forgetfulness were significant predictors of respondents’ perceived support from their partners. Participants who reported more PM forgetting reported receiving more partner assistance with males reporting receiving more assistance than females. These findings contribute to our understanding of collaborative cognition in adulthood, especially prospective memory, an aspect of memory that is instrumental to the maintenance of independence in late life.
BRIDGING THE DIGITAL DIVIDE: A USER-CENTERED DESIGN APPROACH TO ENHANCING SOCIAL CONNECTIVITY AMONG OLDER ADULTS
Authors: Chanquin Edward , Navarro Sheila Salinas , Falzarano Francesca
Published: January 2025

Social isolation is highly prevalent among older adults, leading to negative health outcomes and increased healthcare costs. With the U.S. Census Bureau projecting a near doubling of adults aged 65 and older by 2060, addressing this issue is crucial. Innovative, user-centered solutions are imperative because older adults often face health, cognitive, and mobility limitations that diminish opportunities for engagement. Technologies can help overcome these barriers. This study aimed to develop a potential intervention to enhance social connectivity among older adults through user-centered design, understanding their needs in using digital technologies. This qualitative study employed an ethnographic approach, engaging 50 older adults in Los Angeles. Semi-structured interviews and participant observations were conducted. Thematic analysis informed the iterative design of a prototype named TwinFlame. The study revealed three key insights: 1. Older adults prioritized user-friendly interfaces facilitating communication with loved ones. 2. Participants expressed a need for educational support in using digital devices, particularly for advanced features. 3. Cultural competence was critical in ensuring inclusivity and acceptance of the proposed solution. TwinFlame, a device resembling a candle with integrated digital communication features, was developed to address these needs. Its design incorporates simplified interfaces, built-in tutorials, and culturally sensitive elements. While not yet tested, TwinFlame’s potential for enhancing social connectivity lies in its user-centered approach, directly addressing the identified needs of older adults. This research contributes to understanding how tailored digital tools can potentially reduce the digital divide and social isolation among older adults, highlighting the importance of user-centered design in gerontechnology.
CHILDHOOD SPEECH IMPAIRMENT AND DEMENTIA RISKS AMONG US OLDER ADULTS
Authors: Wang Haowei , Xu Shu , Pei Yalian
Published: January 2025

Speech problems in childhood have profound implications for learning, communication, as well as the development of social and cognitive skills in adulthood. However, research has yet examined how early life speech problems may impact subsequent dementia risks in later life. Using a nationally representative data from the longitudinal Health and Retirement Study, this study investigated how the experience of speech problems before age 16 was associated with the risk of dementia among older adults aged 50 and older. We pooled the full life history information about childhood speech problems for N = 19,082 participants who had 1-11 observations for cognitive and sociodemographic information from 2000 to 2020. We constructed person-interval data and estimated discrete-time event history models to examine risks for developing dementia, which was measured using a validated Langa-Weir classification of cognitive function. We found that about 3.45% of US older adults had speech problems in childhood, with a higher prevalence for younger cohorts, male, and non-Hispanic White, compared to their counterparts. Results showed that older adults with childhood speech problems had higher risks of developing dementia in later life (RRR = 1.49, p < 0.01), compared to those who never had speech problems in childhood. The effects of childhood speech problem on dementia risks were partially explained by BMI, activities of daily living (ADL) limitations, and cardiometabolic and depressive symptoms. Findings highlight the long-arm impact of early life health adversity and suggest the needs for screening and early intervention programs for childhood speech impairment.
COMPARING GAINS AND LOSSES: EXAMINING THE EFFECTS OF INCENTIVES ON WORKING MEMORY CAPACITY IN OLDER ADULTS
Authors: Pham Julie , Bowen Holly
Published: January 2025

Aging is associated with declines in cognition, particularly in areas of working memory responsible for the temporary storage, processing, and manipulation of information. Prior studies have shown that the use of incentives can be successful at modulating cognition in older age. However, much of the previous work has largely focused on reward incentives. Limited research on loss avoidance incentives has been done to understand whether its use can differentially improve cognition, especially in working memory capacity. Arguably, this is an important area of focus as older adults can experience greater losses with age, such as in health, independence, and social networks, that may shift decision-making priorities towards conserving resources and minimizing decline. The current study aimed to investigate whether older adults prioritize gains or losses differently while completing a spatial working memory task. An online sample of 75 older adults (ages 60+) were recruited using the Cloud Research Connect Platform. Each participant completed both a reward and loss avoidance block using a single-item change detection task discriminating between different colored squares. A paired samples t-test was conducted to evaluate the effect of reward and loss avoidance conditions. Findings did not indicate a significant difference in working memory performance between conditions. This suggests that use of either rewards or loss incentives may not differentially improve working memory capacity and can both have potential benefits in modulating cognitive function in an older adult sample.
COMPARISON OF HEALTH OUTCOMES AMONG TWO SEPTUAGENARIAN COHORTS A DECADE APART IN JAPAN
Authors: Wang Can , Gondo Yasuyuki , Nakagawa Takeshi , Masui Yukie , Kamide Kei , Kasuga Ayaka , Yasumoto Saori , Ogawa Madoka
Published: January 2025

Background

Previous studies have suggested that the health status of older adults living in the community has improved significantly over the past two decades. To reassess whether this trend continues, this study examined the health profiles of a current cohort of 70-year-olds and compared them with a cohort born a decade earlier.

Method

This cohort comparison study was part of the observational Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. Data were collected from two groups of 69 to 71-year-old community-dwelling older adults in 2010 (born between 1938 and 1941 (n=483)) and in 2023(born between 1951 and 1954 (n=283)), using identical methodologies. All participants underwent comprehensive physical, mental, social, and cognitive assessments.

Result

Overall, the later cohort was healthier than the earlier cohort. In physical performance, the later cohort showed 21.08% higher grip strength, 13.65% higher gait speed, 7.02% higher chair-seated stepping, and in cognitive function, the later cohort showed 7.93% higher MOCA-J score. The later cohort also reported higher levels of social support(η2=0.013) and showed higher perceived health(η2=0.011). However, mental health assessed by WHO-5 was lower in later cohort(η2=0.008).

Conclusion

Our findings regarding functional capacity were in-keeping with previous studies, which showed later cohort exhibited superior health outcomes across multiple domains compared to earlier cohort. However, there is an inconsistency with previous studies, which reported that later cohorts had better mental health than earlier cohorts at the same age. Future research should explore the reasons for this discrepancy.
CONSCIENTIOUSNESS MODERATES THE RELATIONSHIP BETWEEN INTERLEUKIN-6 AND MEMORY DECLINE
Authors: Segerstrom Suzanne
Published: January 2025

Evidence supports the role of the pro-inflammatory cytokine interleukin-6 in accelerating cognitive decline and increasing ADRD risk. Personality may influence this relationship in a pathoplastic way, by protecting against or exacerbating the cognitive consequences of inflammation. Conscientious (i.e., controlled, planful, organized) people are characterized by healthier behaviors, which may play a protective role. Among 182 older adults (Mage=74 years, 41% female), Rey Auditory Verbal Learning Test (RAVLT) performance was measured annually for up to 16.6 years (M=6.5 years). Total learning and delayed recall were regressed on expected performance (norms based on age, gender, and IQ), time, IL-6, conscientiousness, and their interactions with each other and with gender. There was a significant interaction among time, IL-6, and conscientiousness (F(1,167.51)=5.36, p=.021) such that people with high conscientiousness and low IL-6 maintained total learning and thus increased their performance relative to norms over time; people with low conscientiousness and/or high IL-6 maintained performance relative to norms. The same interaction was observed for delayed recall (F(1,165.22)=5.20, p=.024). The recall effect decreased after adjusting for learning, but in a gender-specific way (interaction with gender, F(1,164.74)=4.97, p=.027). Adjusting for total learning eliminated the interaction for men but not for women. Rather than a pathoplastic relationship, IL-6 and conscientiousness had a synergistic effect on memory decline over time. Neither low IL-6 nor high conscientiousness alone were sufficient to preserve memory. The healthy habits of conscientious older people may need an advantageous physical environment in order to affect memory and possibly other cognitive functions.
CONTROL AT EVERY AGE: HOW EMOTIONAL RESPONSES VARY ACROSS LIFESPAN
Authors: Muskin Ryan , Popivker David , Allard Eric
Published: January 2025

Control may play a crucial role in regulating emotional reactivity, with this regulation potentially differing between older and younger adults across various emotional subtypes. Research suggests that perceptions of control tend to decrease with age, which may result in older adults being more sensitive to low-control situations. To explore this, we recruited 60 younger adults (18-35) and 50 older adults (60+) who were asked to relive strong emotional memories involving either loss or failure. Emotional reactivity was assessed through self-reported affect, heart rate variability, and electrodermal activity. Our findings support the hypothesis that as perceived control increases, emotional reactivity decreases for older adults but increases for younger adults (p <.05). Further analysis of discrete emotions revealed a positive correlation between perceived control and positive affect for older adults (Pearson’s r =.34), but not for younger adults. These results suggest that lower perceived control in older adults may lead to greater emotional reactivity and reduced positive affect. Future research should investigate how the interplay between age, control, and emotions influences emotion regulation strategies, particularly those that involve accepting diminished control.
CULTURALLY ADAPTING A CREATIVITY AND WELL-BEING ARTS CURRICULUM FOR MANDARIN SPEAKING OLDER ADULTS
Authors: Qu Doria , Graupner Jeffrey , Kroplewski Renee , Mensik Ashley , Thompson Katherine
Published: January 2025

Creativity Circle program is an English-language arts curriculum previously shown to reduce social isolation in older adults. This curriculum was translated, culturally adapted, implemented, and evaluated for a group of 16 Mandarin-speaking older adults over eight weeks. Modifications included incorporating Cantonese songs, Chinese poetry, and culturally significant art activities such as clay modeling of traditional items and illustrating group values using meaningful symbols. Of the 16 initial participants, 15 completed the program, with one dropout due to illness. Participants found the adapted curriculum helpful and culturally appropriate. Key qualitative findings reveal that participants prioritized intrinsic values such as happiness, health, and family over materialistic pursuits, and approaching aging and death with acceptance. Participants reported feeling less lonely after the series (Median=1, n=12; Likert: 5=Completely Agree, 1=Completely Disagree: “I feel lonely”),) when compared to the pre-series survey (Median=2, n=10though the difference did not reach significance (Mann Whitney U Test, U=85, p =.077). This study highlights the effectiveness of cultural adaptation in enhancing program relevance and participant well-being, underscoring the need for gerontological practices that respect diverse cultural perspectives. It demonstrates the feasibility of culturally adapted creative activities to engage older adults, reinforce cultural identity, and promote overall well-being in later life. Future research will focus on larger-scale implementation and quantitative assessment of impact on social isolation.
DAILY DYADIC COPING AND SALIVARY CORTISOL RHYTHMS IN COUPLES LIVING WITH EARLY-STAGE DEMENTIA
Authors: Polenick Courtney , Turkelson Angela , Garner Charity , Liu Yin , Birditt Kira
Published: January 2025

Dyadic coping (i.e., how couples cope with stress) is associated with subjective well-being in dementia care dyads. However, we know little about dyadic coping and physiological stress reactivity in the context of daily dementia care. We evaluated how daily perceptions of individual and partner supportive (when one partner provides problem-focused and/or emotion-focused coping to help the other) and delegated (when one partner takes over responsibilities to help the other) dyadic coping are associated with salivary cortisol among couples living with early-stage dementia. Participants included 34 people living with dementia (PLWD; M = 72.2 years, SD = 7.5) and their spouse caregivers (M = 69.5 years, SD = 8.7) who completed 7 days of morning and evening phone interviews and collected saliva samples (four times per day) during four of those days. We estimated multilevel models with outcomes including the cortisol awakening response (AR; awakening to 30-min post-awakening) and wake-evening slope (WES; 30-min post-awakening to bedtime). PLWD had a higher next-day AR when they reported higher individual supportive and delegated dyadic coping. PLWD also had a higher same-day and next-day AR and a steeper decline in WES when they reported higher partner delegated dyadic coping. On average across days, PLWD had a flatter decline in WES when caregivers reported higher partner delegated dyadic coping. Finally, on average across days, caregivers had a higher AR when they reported higher individual supportive and delegated dyadic coping. These findings identify targeted strategies to improve health and well-being in couples navigating early-stage dementia.
DAYTIME ACTIVITY ATTENUATES ASSOCIATIONS BETWEEN SLEEP EFFICIENCY AND MORTALITY AMONG OLDER ADULTS
Authors: Sakal Collin , Li Xinyue
Published: January 2025

Adequate sleep is crucial for promoting longevity, and yet epidemiological understanding of the relationship between sleep and mortality is largely based on a single metric: sleep duration. This study examined associations between sleep efficiency and mortality in a cohort of 33,428 older adults in the UK Biobank over approximately 9-years of follow-up. Sleep efficiency was derived from wrist-worn accelerometer data using a Hidden Markov Model-based sleep-wake detection algorithm and was summarized based on sufficiency (average) and irregularity (standard deviation) across the wear periods. Associations were examined using Cox Proportional Hazard models adjusting for sociodemographic factors, smoking, drinking, depression, social support, medications, cancer, and sleep duration. In fully adjusted models, average accelerometer-assessed total daytime activity was further included using restricted cubic splines to examine its potential to attenuate observed associations. In adjusted Cox models without daytime activity, low average (< 0.85) sleep efficiency was associated with greater risk of mortality (Ref: ≥0.85, HR: 1.31, 95% CI: 1.18, 1.46) as was high irregularity (top quartile) in sleep efficiency (Ref: bottom quartile, HR: 1.35, 95% CI: 1.20, 1.53). However, neither measure of sleep efficiency was significant after adjusting for daytime activity. L-shaped relationships were observed between daytime activity and mortality where low activity levels were associated with an increased risk and high levels of activity were associated with a decreased risk. Our findings suggest that daytime activity attenuates associations between both sufficiency and irregularity in sleep efficiency with mortality among older adults in the United Kingdom.
DEMENTIA FRIENDS IN INCARCERATED SETTINGS: RESULTS OF A STAFF E-LEARNING SESSION
Authors: Bibbo Jessica , Nicolay Sarah , Burman Bonnie , Williman Marty , Kinzig Elizabeth , Bollin Salli
Published: January 2025

Individuals aging in incarcerated settings such as prison develop dementia at a higher rate than those outside of such settings. The percentage of inmates aged 60 or older is rapidly increasing, yet there is little training for staff about dementia. The Ohio Council for Cognitive Health worked with the Ohio Department of Rehabilitation and Correction (ODRC) to develop Dementia Friends for Incarcerated Settings, an e-learning course made available to all ODRC staff. These results are from the optional and anonymous pre- and post-surveys embedded in the session; 125 of the 364 respondents completed both (Mage=53.2, SDage=9.1, Female=53.6%; Full time=95.2%). A series of McNemar Tests indicated significant improvement in one of the four true/false items measuring knowledge about dementia (Changing the environment will make no difference to a person who has dementia [False]), p <.001. A series of Wilcoxon Signed Rank Tests indicated significant improvement in five of the sliding-scale items (range: 0 indicating no agreement to 100 indicating total agreement) measuring attitudes about dementia (e.g., I am confident interacting with people living with dementia; It is possible to improve the lives of people living with dementia) (p ≤.010). Most respondents agreed or strongly agreed that the material covered in the session would be useful in their work (90.2%), that they learned new information (88.6%), and that they would recommend the session to coworkers (89.5%). These results indicate the potential impact of and underscore the need for dementia education within incarcerated settings.
DIFFERENCES IN PATIENTS WHO FAIL A COGNITIVE SCREEN IN PRIMARY CARE VS. THOSE WHO “ALMOST FAIL”
Authors: Higbie Anna , Baucco Christina , Perkins Anthony , Fowler Nicole
Published: January 2025

In primary care, short cognitive screening tools are used to measure potential cognitive impairment. These tools have been validated in patients aged 65+ and have published cut points to determine if further assessment is needed. We conducted a secondary analysis of data from the Caregivers Outcomes in Alzheimer’s Disease (COADS) trial to compare characteristics of patients who screened positive using established cut points versus those who scored one point away. Screening tests included the Mini-Cog, MIS-T, and MIS-T & Virtual Clock Draw. We also compared mild cognitive impairment (MCI) and Alzheimer’s Disease and Related Dementias (ADRD) diagnoses between the two groups at 24 months. Among the sample, n=44 failed based on standard cut points, and n=94 scored one point from fail. There were no significant differences in the age, gender, or Charlson Comorbidity Index (CCI) between the groups. Patients one point from failing were significantly more likely to have more education and report daily in-person interactions (p=0.013 and p=0.020). At 24 months, no significant differences in the rate of MCI or ADRD diagnoses were found in electronic medical records. Although the group who had a positive screen at baseline had statistically significant differences in cognitive impairment at 24 months, as measured by the IQCODE (4.4 times more likely to score above 3.6, p=0.009, with higher cognitive decline indicated by their IQCODE scores, p=0.014). These findings suggest better performance on cognitive screeners is associated with reduced cognitive decline over time, underscoring the importance of early detection for at-risk populations.
DIFFERENTIAL DIGITAL DIVIDES: AGE GAPS ACROSS EXISTING AND EMERGING TECHNOLOGIES
Authors: Sanders Edie , Mois George , Rogers Wendy , Boot Walter
Published: January 2025

As the necessity of digital technology and the number of devices needed to participate in everyday life increases, understanding age differences in the use of familiar and emerging technologies is crucial for implementing technology-based solutions to enhance independence and wellbeing. We conducted an online survey to understand the types of technology categories used across age groups to support everyday life. Forty younger adults (aged 18-35 years), 40 middle-aged adults (35-64 years), and 40 older adults (65+ years) reported technology use across 13 categories (e.g., smart phones, robots) within the past year. Age-related differences in technology use varied across technology categories. For example, nearly every participant in each age group reported using a computer, a navigation device, a smartphone, and a TV, devices commonly used for everyday activities. Several technologies, including virtual reality and wearable devices, were reported most frequently by middle-aged adults. The use of tablets was reported least frequently by younger adults, voice-activated assistants were reported most frequently by older adults, and gaming consoles were reported less frequently with each increasing age group. Robots were less commonly used, and this pattern was similar for all age groups. These data challenge the idea that older adults are overall less likely to adopt and use technology compared to younger age groups. Understanding technology use at the level of an individual may be more important than at the level of age group for tailoring technology interventions that support everyday activities.
DIGITAL SOCIAL PRESCRIBING LITE: ADDRESSING BARRIERS OF PREVENTIVE INTEGRATED CARE THROUGH COMMUNITY ENGAGEMENT
Authors: Gan Daniel , Hoverman Adam , Mulligan Kate
Published: January 2025

Digital social prescribing solutions attempt to integrate health and social care by targeting both preventive and complex health challenges. However, a lack of community engagement impedes referral uptake. This paper uses “customer discovery” to explore and address current barriers of digital social prescribing from the perspectives of service users and staff of health and community sectors. Phase 1 prioritized community perspectives and led to a community-generated place-based wellness model to align interests across sectors. Phase 2 conducted market research with over 70 health and community stakeholders in Metro Vancouver through snowball sampling. Insights were gathered on current referral processes, barriers to social prescribing, and stakeholder perspectives. From the insights shared, it was evident that achieving integrated care faces twin challenges of resource allocation and staff burnout. Funding-related barriers include inadequate partnership, intermittent funds, lack of billable codes, variations in cost, and lack of monitoring and evaluation. Staffing-related barriers include time-intensive processes, outdated information, inappropriate referrals and lack of guidance for quality improvement. Based on insights from stakeholders, initial cross-sectoral implementation may fruitfully focus on preventing the effects of social isolation. This “lite” version of digital social prescribing requires an automated referral and monitoring platform which allows prevention for the masses while flagging complex cases for intervention. This reduces clinician burden and empowers community sector to support wellbeing. The place-based model “Connectedness, feeling At home, and joyful Play” was incorporated into a web app. Digital social prescribing lite may pave the way for data-driven, organic scaling up of preventive integrated care.
DISPARITIES IN LOW DOSE COMPUTED TOMOGRAPHY LUNG CANCER SCREENING IN THE UNITED STATES: A MULTI-LEVEL ANALYSIS
Authors: Tseng Tung-Sung , Li Chien-Ching , Lin Hui-Yi , Witmeier Kelsey N , Chiu Yu-Wen , Celestin Michael , Trapido Edward J
Published: January 2025

Low-dose computed tomography (LDCT) screening is recommended for high-risk smokers to decrease lung cancer-related mortality and increase prognosis. In the U.S., the uptake of LDCT screening among eligible smokers is suboptimal. The impacts of social-environmental and individual factors on LDCT screening uptake using nationally representative datasets are understudied. The current study investigated multi-level factors associated with LDCT screening using national data.

Methods

The 2017-2021 Behavioral Risk Factor Surveillance System (BRFSS) data, as well as other state-level variables (Medicaid expansion status and the number of screening facilities), were applied. The final study sample consisted of 15640 respondents from 29 states. All analyses were weighted to account for the complex sampling design applied in BRFSS.

Results

The overall utilization rate of LDCT screening is only 18.4%. The LDCT screening rate varied by state (6.2 -31.1%). LDCT screen rates were positively associated with the number of lung cancer screening facilities per 10,000 smokers (r=0.67, p< 0.001). Among the respondents, individuals who were employed, never married, reported good health status, did not have primary care physicians, economic concerns like low income, did not have routine checkups, and did not have certain chronic conditions (i.e., cancer, asthma, COPD) had a lower utilization rate of LDCT screening compared with their counterpart.

Conclusion

The use of LDCT screening among eligible smokers remains low. Enhancing access to care for high-risk individuals, promoting services to diverse racial and socioeconomic groups, and expanding Medicaid coverage to incorporate annual LDCT screening can be used to guide future lung cancer screening programs.
EARLY-LIFE EDUCATION CONTEXTS AND LATE-LIFE COGNITIVE STATUS: TOWARD IDENTIFYING MODIFIABLE RISKS
Authors: Johnson Kimson
Published: January 2025

The complexity of K-12 school environments arises from their diverse student compositions, historical and geographical contexts, all of which may influence late-life cognition. Despite this, the long-term impacts of these factors on cognitive status in later life are not well understood. This study utilized data from the Health and Retirement Study (HRS) 2015-2017 Life History Mail Survey (N = 6,980; Mage = 72.5) to investigate how K-12 educational contexts—specifically school racial composition (White, Black, Hispanic, Other, and Mixed) and school setting (Public, Private, Mixed)—affect cognitive status in late life. Cognitive status was assessed in the 2020 HRS biennial wave using the Langa-Weir algorithm, classifying participants into Normal, Cognitive Impairment but No Dementia (CIND), and Dementia categories. After adjusting for sociodemographic and childhood factors, multinomial logistic regression analysis revealed that participants who attended predominantly Black K-12 schools had a higher risk of CIND and Dementia (RRR=2.28, 95% CI: 1.36, 3.80 and RRR=2.09, 95% CI: 1.08, 4.07, respectively). In contrast, those who attended private and mixed schools had a lower relative risk for CIND compared to public school attendees (RRR=0.43, 95% CI: 0.27, 0.68 and RRR=0.54, 95% CI: 0.37, 0.79). Additionally, participants from mixed school settings exhibited the lowest relative risk for dementia (RRR=0.51, 95% CI: 0.30, 0.88). Rural education was associated with a higher relative risk for CIND (RRR=1.26, 95% CI: 1.02, 1.58) compared to urban education. These findings highlight the need for targeted interventions and policies to create equitable educational environments that support cognitive health in later life.
ENGAGING RURAL OLDER ADULT COMMUNITY CENTERS TO SUPPORT COGNITIVE HEALTH: CBPR LESSONS AND BARRIERS
Authors: McCoy Megan , Cerino Eric , McCarthy Michael , Martinez Margarita , Lucero Louis , Seaton Thomasina , Goldtooth Amanda , Livingston Raechel
Published: January 2025

Academic-community partnerships grounded in community-based participatory research (CBPR) methods can further health equity and improve cognitive health for older adults and caregivers in rural communities. Older adult community centers, specifically, can serve as partners to advance preventative memory screening and early interventions to address cognitive health disparities and provide support for caregivers. The aim of this study is to describe a model for researchers in the early stages of partnership development, aspiring to use CBPR, to better align activities with community needs. Informed by the Quality Improvement and Innovation Partnership (QIIP) model, we describe the process of engaging older adult community centers as research partners to advance the Northern Arizona Memory Study. Descriptive findings from surveys with 6 center leaders, combined with thematic analysis of partnership development process notes, illuminate lessons and barriers to engagement, as well as conceptual advances for CBPR methods. Lessons include the importance of honoring mutual expertise, informal engagement with center staff and participants to establish trust, and “word of mouth” as affirmation of shared vision. Contextual barriers specific to rurality also impact partnership development capacity (limited staffing/resources) and logistics (travel distances). Findings suggest community centers serving older adults in rural communities are interested in collaborating with researchers to support cognitive health. However, logistical and capacity barriers limit the extent to which centers can commit to CBPR partnerships. Consideration of unique community contextual factors is necessary, requiring researchers to tailor partnership development to each center rather than adopting a “one size fits all” approach.
EXAMINING SITUATION SELECTION ACROSS THE LIFESPAN USING A NOVEL DAY RECOLLECTION METHOD
Authors: Kwak Judy , Hill Patrick
Published: January 2025

Situation selection is the process by which people approach or avoid certain people, places, or objects to regulate their emotions. Prior research suggests that older adults engage in situation selection more frequently than younger adults because they become more adept at avoiding situations that provoke negative emotions. However, research on these behaviors is limited, in part due to the lack of a reliable scale. The current study addressed this gap by surveying 304 adults ranging 18-79 years old (M=46, SD=16) from Prolific to test a novel measure of day recollection situation selection. First, participants reflected upon the previous day’s events and wrote about how they felt, as if writing in a diary. Next, their diary entry was presented in a read-only format at the top of the following page, where they answered questions about how they chose to approach or avoid situations. Exploratory factor analyses revealed a 3-factor structure reflecting distinct forms of situation selection: (1) approaching positive, (2) approaching negative, and (3) avoiding negative. Internal consistency of these subscales was high (alphas = 0.81–0.89), and intercorrelations were small-to-moderate (rs = -0.04–0.35). No age differences were found in approaching positive or avoiding negative situations (rs = -0.02– -0.07). However, older adults reported approaching negative situations less frequently than younger adults (r = -0.14). These findings suggest that older adults strategically select environments to enhance their well-being. With age, adults may prioritize emotional goals by selecting situations conducive to minimizing stressors while increasing positive experiences.
EXAMINING SPIRITUALITY, COGNITIVE, AND FUNCTIONAL HEALTH IN OLDER U.S. ADULTS
Authors: Britt Katherine , Dong Fanghong , Massimo Lauren , Hamilton Jill , Hodgson Nancy , Stites Shana , Mechanic-Hamilton Dawn
Published: January 2025

Used as a salient resource among Black communities to cope with stress, spirituality and religion are associated with better overall cognitive function. However, their impact on individual cognitive domains and functional health is limited, and understanding these relationships could inform targeted interventions for optimizing cognitive and functional health. Using data from cognitively unimpaired older Black and White U.S. adults in 2021-2022 from the Aging Brain Cohort (ABC) at The University of Pennsylvania Alzheimer’s Disease Research Center, we examined cross-sectional associations between spirituality (measured with one item, “To what extent do you consider yourself a spiritual person?”), religiousness (measured with one item, “To what extent do you consider yourself a religious person?”), cognition (i.e., memory measured with Benson Delayed Recall and executive function measured with Trail Making B) and functional health (measured with the Functional Rating Scale (FRS) and Functional Activities Questionnaire (FAQ) (N=158) using multivariable regression analysis. Participants were 27.8% Black, 64.6% women, with mean age (74.4 years) and education (16.7 years). Controlling for age, education, sex, and social interaction, spirituality was positively associated with memory (β = 0.19, 95%CI [0.05, 0.33], p<.007) but not executive function or functional health. In comparison, religiousness was positively associated with functional health (FAQ only)(β = 0.31, 95%CI [0.01, 0.61], p<.046)) but not memory or executive function. Older Black and White adults with greater spirituality had higher memory scores, and those with greater religiousness had a higher functional health score. Longitudinal studies are needed to examine associations further.
EXAMINING THE EXPERIENCES AND UNIQUE CARE NEEDS OF SPEC POPS IN AL: FACILITATORS AND BARRIERS TO MAINTAINING THE SELF
Authors: Lentz Jeffrey , Bender Alexis , Kemp Candace , Perkins Molly
Published: January 2025

The assisted living (AL) population is growing more diverse. This diversity is reflected in the increasing use of AL by African Americans, Latinos, and other cultural groups who have traditionally “cared for their own,” as well as a rising number of members of other special populations (e.g., sexual minorities and persons aging with HIV) requiring and using residential care. As part of a 5-year study of care at the end of life in AL funded by the National Institute on Aging (R01AG047408), we use the Sort and Sift, Think and Shift method to investigate the experiences and unique care needs of AL residents who represent various special populations within our sample. Data include in-depth and informal interviews with residents. These cases (three females and two males) reflect intersecting social statuses (e.g., race, class, ethnicity, sexual orientation, illness, and disability). Our analysis identified facilitators and barriers to maintaining the self. These statuses make them particularly vulnerable to stigma and other challenges that adversely affect their quality of life, including trauma earlier in life, language barriers, cultural marginalization, discrimination, and inadequate social support. Strengths that contribute to their ability to negotiate these risks and maintain a positive sense of self include religiosity and spirituality, as well as having a sense of community or group pride (e.g., as an HIV survivor or member of a racial/ethnic group). Findings have implications for interventions to improve the quality of life at the end of life for residents who represent members of special, often hidden populations.
FAMILY HEALTH STRESS AND INSOMNIA SYMPTOMS AMONG OLDER ADULTS: THE ROLE OF RELATIONSHIPS WITH THEIR CHILDREN
Authors: Jang Jeein
Published: January 2025

Insomnia symptoms that arise from stress pose a significant physical and psychological health concern for older adults. Yet, little empirical research has explicitly examined the association between stress caused by family health concerns and insomnia symptoms, along with the role that relationships with children play in moderating this relationship. This study uses Pearlin’s stress process model and data from the 2018 and 2020 Health and Retirement Study (N=7,755) to investigate these associations in adults aged 50 and above. Ordered logistic regressions assess the link between family health stress and insomnia severity using four items (i.e., trouble falling asleep, nighttime awakening, early morning awakenings, and feelings of nonrestorative sleep). Additionally, the moderating role of two relationships with children, positive and negative, is included in the analysis. All statistical analyses are adjusted for sociodemographic, health-related factors, caregiver status, and their children’s socioeconomic status. Results show older adults experiencing ‘somewhat upsetting’ and ‘very upsetting’ family health stress had 24% and 50% higher odds, respectively, of experiencing more severe insomnia symptoms compared to those with no family health stress. Interestingly, both positive and negative relationships only moderated the association between ‘somewhat upsetting’ stress and insomnia symptoms. These findings underscore the need for targeted clinical and public health interventions to help older adults with family health stress reduce their insomnia symptoms by fostering positive relationships with their children.
FROM TWINS TO DIGITAL TWINS: LLM-DRIVEN COGNITIVE PERFORMANCE PREDICTION
Authors: Zheng Anqing , Gustavson Daniel , Corley Robin , Reynolds Chandra
Published: January 2025

Human digital twins, virtual representations of individuals that simulate one or more aspects of human behavior and characteristics, have gained increasing attention for their potential applications in training optimization and personalized interventions. This study explores the use of Large Language Models (LLMs) with in-context learning to simulate cognitive performance, leveraging the power of real human sibling pairs. Our study aims to assess the accuracy of these simulated representations by comparing their predictive power against actual performance and their siblings’ performance across various cognitive domains in those approaching midlife. We utilize the CATSLife dataset of 1,040 individuals from 505 sibships (including twins and non-twin pairs, ages 28-49). Our dataset encompasses over 60 characteristics with empirical associations with cognitive maintenance, spanning across lifestyle, psychosocial, environmental, and demographic domains, serving as the foundation for simulating cognitive performance. For evaluation, we employ intraclass correlation coefficients to quantify similarities between sibling-sibling, individual-simulation, and sibling-simulation pairs. Preliminary analyses reveal strong cognitive performance correlations among monozygotic pairs (MZ; rs =.37~.85), establishing a benchmark for our simulations. We expect our LLM-based simulation will outperform traditional statistical approaches in predicting individual cognitive performance, while remaining within the bounds of observed MZ similarities. By comparing sibling-sibling and sibling-simulation similarities, we aim to demonstrate a novel evaluation metric for human digital twins and provides insights into the capabilities of advanced computational methods in predicting individual cognitive performance. This approach could open avenues for developing more precise, personalized strategies in cognitive health management and targeted cognitive enhancement interventions.