bluuebunny/crossref_metadata_2025 huggingface dataset:
TIME SPENT FOR OTHERS: VARIED ASSOCIATIONS WITH WELL-BEING ACROSS TWO TIME SCALES AND SOCIODEMOGRAPHIC GROUPS
Authors: Cho Kyoungmin , Almeida David , Lee Soomi
Published: January 2025

Existing research on spending time for others yields inconsistent findings regarding its effects on well-being. Some studies report positive effects, while others find negative effects. To address this inconsistency, our study explored whether spending time for others differentially impacts overall eudaimonic well-being and day-to-day hedonic well-being, considering potential differences across sociodemographic groups. 665 participants (Mage=48.27) in the Midlife in the United States Study completed both monthly survey and eight-day diary survey. Monthly and daily time spent for others, overall eudaimonic well-being (psychological and social domains), and daily hedonic well-being (positive affect, negative affect, daily stressors) were measured. OLS regression and multilevel models evaluated the associations of time spent for others with eudaimonic and hedonic well-being at the two time scales, adjusting for sociodemographic and health covariates (e.g., age, gender, education, self-reported physical health, marital status, day of week, and number of missed diary). Results indicated that, at the monthly level, participants who spent more time for others reported higher overall psychological and social well-being. However, at the daily level, they experienced more negative affect and stressors, with these effects more pronounced in men and adults under 56-year old. This study clarifies inconsistencies in prior research, highlighting differential associations of spending time for others with individual well-being across different time scales and sociodemographic groups. While short-term responses tend to be negative, particularly among men and younger individuals, long-term outcomes appear to be positive.
UNDERSTANDING BARRIERS TO PARTICIPATE IN DEMENTIA RESEARCH AMONG OLDER ADULTS IN THE BRONX, NEW YORK
Authors: Jayakody Oshadi , Ceide Mirnova , Grabanski Morgan , George Claudene
Published: January 2025

The Bronx County in New York (NY) has the highest prevalence of dementia in the state and is considered the least healthy of NY counties. This study aims to identify the barriers to participation in dementia research among older adults in the Bronx and explore strategies for improving their research readiness. We are distributing a brief survey to 100 older adults (aged ≥60) visiting ambulatory practice and memory clinics at Montefiore Medical Center and community-based older adult centers in the Bronx. This survey, which will be completed in September 2024, assesses participants’ knowledge of dementia research, awareness of local dementia research studies, willingness to participate in different types of research and barriers for participation. Currently, we have collected survey data from 15 older adults (n=46% White,15% Black, 30% Hispanic). Our preliminary results show that 50% of older adults were aware of available local dementia research studies. Only 17% reported prior participation while 80% reported willingness to participate in future research. Most respondents (81%) were interested in studies investigating cognitive function and healthy aging, whereas 36% were interested in research involving brain imaging, drug trials or lifestyle interventions and genetic studies. The main barrier to participation was limited access to our study centers (55%) followed by lack of time (27%). Interestingly, 82% indicated that free transportation or parking would incentivize their participation. These findings highlight the knowledge gaps and what barriers to address (i.e. enhance accessibility) to improve readiness to participate in future dementia research among older adults in the Bronx.
USER-CENTRED DIGITAL TRANSFORMATION: JAPANESE OLDER ADULTS’ PERSPECTIVES ON DIGITIZATION
Authors: Wada Mineko , Takeda Kazuya
Published: January 2025

This community-based study aimed to explore how Japanese community-dwelling older adults perceived the use of digital technologies in daily life. Although the importance of including older adults in aging and technology research and development has been increasingly emphasized in recent years and the Japanese government has been using the slogan “No One Left Behind” to promote user-centred digital transformation, older adults’ perspectives on a digitized society have not been explored in depth to date. In this qualitative study, 18 Japanese older adults participated in either semi-structured individual interviews (10 participants) or focus groups (8), depending on their preferences. Both the interviews and focus groups elicited participants’ experiences of adapting to digitization in their daily lives and their related perceptions of this shift (i.e., challenges, benefits, and concerns). All the interviews and focus group discussions were digitally recorded, transcribed verbatim, and analyzed thematically. Our analysis generated five themes that illustrate Japanese older adults’ negative and positive perspectives on digital transformation: 1) disapproval of dehumanization, 2) concerns about being monitored and controlled through the digitizing of personal information, 3) increasing risks of scams and fraud, 4) lack of access to immediate support for issues relating to digital adaptation, and 5) potential for expanding social connection and entertainment. We discuss strategies for addressing negative perspectives among older adults that are related to low digital literacy, including, for example, increasing and improving the accessibility of immediate support to help with challenges relating to digitization.
VALIDATION OF DEMENTIA CARE-RELATED SCALES AMONG INFORMAL CAREGIVERS OF LATINOS WITH DEMENTIA OR MCI
Authors: Perales-Puchalt Jaime , Cabrera Monica Fracachan , Baker Christina , Mantilla Mariana Ramirez , Burns Jeffrey
Published: January 2025

We aimed to test the psychometric properties of several dementia care-related scales among Latinos. We leveraged secondary baseline data from a one-arm mHealth trial on dementia caregiver support. We included 100 responses for caregiver-focused scales and 88 responses for care recipient-focused scales. Scales included the Neuropsychiatric Inventory Questionnaire Severity and Distress scales, six-item Zarit Burden Inventory, Ten-item Center for Epidemiologic Studies Depression Scale, Geriatric Depression Inventory, Quality of Life in Alzheimer’s Disease, and Single-item Satisfaction With Life Scale. We calculated concurrent validity using Pearson and Spearman correlations and expected correlations amongst all variables in line with the Stress Process Framework. We calculated internal consistency reliability using Cronbach’s alpha. All concurrent validity correlations followed the expected directionality, with 19/21 inter-scale correlations in the total sample reaching statistical significance (p< 0.05), and 17/21 reaching at least a low correlation (0.3). Cronbach’s alpha ranged from 0.832 and 0.879 in all scales in the total sample. Findings suggest that these English and Spanish caregiver-administered scales have good psychometric properties.
WEALTH, DEBT, AND COGNITIVE AND SELF-CARE DIFFICULTY AMONG AMERICANS AGED 65+
Authors: Sheehan Connor , Jang Jiwon , Saenz Joseph , Connor Dylan
Published: January 2025

As the American population ages, the number of individuals with cognitive and self-care challenges is projected to increase substantially, stressing the importance of understanding their social determinants. Previous research has connected socioeconomic status, specifically educational attainment and income, to cognitive and self-care problems. However, considerably less research has examined the role of wealth in older adulthood. This is an oversight, as wealth reflects cumulative life course exposure and accumulation of socioeconomic resources, and debt may be a unique stressor. We use novel geographic machine learning-based estimates of wealth for every American household to predict cognitive and self-care difficulties among Americans aged 65+. We linked GEOWEALTH data, a machine learning estimate of household wealth, to the 2019-2021 American Community Survey (n=742,348) to create one of the largest data sources of wealth and health heretofore analyzed. Regression models predict cognitive and self-care difficulties adjusting for demographic and socioeconomic characteristics, including income and education. Cognitive and self-care difficulties decreased with increasing wealth, while being in debt nearly doubled the probability of these difficulties at every age. This pattern is amplified among White Americans and those in areas with concentrated debt. Wealth consistently shows stronger associations with cognitive and self-care difficulties than educational attainment or income. Our findings emphasize the importance of wealth and debt for well-being in older adulthood. Future research should explore the directionality of this association and the impact of different sources of wealth and debt.
WHEN I’M 64 – LONGITUDINAL OBSERVATIONS FROM AN INTERDISCIPLINARY COURSE ON AGING FOR FIRST-YEAR STUDENTS
Authors: Thomas Karuna , Picchiello Matthew , Morrow-Howell Nancy , Stark Susan , Carpenter Brian
Published: January 2025

Research has highlighted the value of education for college students on the aging process. Curricula have the potential to address misconceptions about aging and draw students toward further coursework and experiences with older adults. This study explored the impact of participation in an interdisciplinary course on aging across one year for the Fall 2023 cohort (N = 50) with a control group that did not participate in the course (N = 33), and after five years for the Fall 2017 cohort (N = 59) and control group (N = 57). The course was offered to first-year undergraduate students. Weekly classes included older adults from the community. Surveys assessing attitudes towards aging and participation in aging-related activities were administered prior to and at the end of the academic year, and an annual follow-up. Group-by-time analyses showed that participants from the class had significantly more positive attitudes towards aging [F(1, 82) = 13.67, p <.05, ηp2 =.03], and significantly fewer ageist beliefs [F(1, 82) = 9.21, p <.05, ηp2 =.02] at the end of the academic year compared to the control group. In the 5-year follow-up, students in the course also reported more engagement in aging-related fields compared to the control group [t(114) = 4.65, p <.05]. The course content was reported to be relevant to 45.8% of former students in their professional life, and 57.6% in their personal lives. These results substantiate the short and long-term positive impact of engaging undergraduate students in curriculum on aging.
48 HOUR HOSPICE HOME IMMERSION RESEARCH KEY MEDICAL STUDENT LEARNING OUTCOMES: UNE COM 2019-20 STUDENT COHORT
Authors: Okpoebo Amanda , Berkowitz Jennifer , Gugliucci Marilyn
Published: January 2025

Traditional palliative and end-of-life care education in US medical schools is often inadequate in preparing students to care for patients. To address this, the University of New England College of Osteopathic Medicine (UNE COM) introduced the Learning by Living 48-Hour Hospice Home Immersion (HHI) Project. This innovative program immerses students into an 18-bed acute care (ICU) hospice home for 48 hours, where they provide care to patients, support families, and engage in postmortem care while working with an interprofessional staff team and independently. Utilizing qualitative ethnographic/autobiographic research designs, two key research questions included: (1) What significant lessons were learned from the 48-hour home hospice immersion?; and (2) What skills will they apply in their future practice? Students documented their experiences in journals. Eleven second-year medical student journals from the 2019-20 cohort were selected for analysis; 300+ pages of data. During each of three stages: pre-fieldwork, fieldwork, and post-fieldwork, qualitative analysis included content review, creating a codebook, and conducting a final analysis with NVIVO 14 software. Three key themes emerged for question one: (a) Holistic comfort care/medicine, (b) Subjectivity of suffering, and (c) Religion/spirituality. For question two, students reported: (a) Increased confidence in caring for dying patients and their families, (b) Improved ability to discuss death, and (c) Enhanced understanding of the physician’s role in curing versus caring. Each student’s experience at Gosnell Hospice Home was unique, yet all gained critical insights that will shape their development into compassionate and skilled physicians in palliative and end-of-life care.
A CHALLENGE HONORING SELF-DETERMINATION OF NURSING HOME RESIDENTS WITH DEMENTIA; WHICH SELF -- THEN SELF OR NOW SELF?
Authors: Bern-Klug Mercedes , Levine Meredith
Published: January 2025

Medicare and/or Medicaid certified nursing homes (NHs) are required to inform residents they have a right to an advance directive. The government’s Resident Rights requires staff to honor resident self-determination. What happens when instructions in an advance directive are in opposition to the current expressed requests of a person with advanced dementia? Using qualitative descriptive methodology, in this pilot study, 12 NH staff members in various roles engaged in individual interviews and responded to questions that speculated they had a resident with dementia who, when they had decisional capacity, indicated in a written advance directive they did not want to be fed, once they lost the ability to feed themselves. Staff were unanimous in declaring the need to honor the resident’s self-determination, and yet could foresee instances in which a person with said advance directive, and unable to self-feed, would indicate through words or gestures, the desire to eat. Many staff indicated they would go ahead and feed the person; others worried that would dishonor the advance directive. Staff also expressed other challenges including how “self-feed” is operationalized, the fluctuating nature of functional capacity in dementia, and the potential conflict that could result with families and NH surveyors. Some staff indicated it would be against their religion or sense of morality to not feed a person who expressed an interest in eating. We conclude that although such advance directive templates are readily available online, the potential for logistical and moral challenges in the NH context are real and serious.
A FRAMEWORK FOR UNDERSTANDING PALLIATIVE CARE PREFERENCES AMONG AFRICAN AMERICAN PATIENTS WITH CANCER: THE 6S MODEL
Authors: Oduro Elisha , Carpenter Joan
Published: January 2025

African American (AA) patients with cancer have the highest mortality rates and poorest outcomes among all racial groups in the US, yet they are almost one-third less likely to receive palliative care (PC) than their White counterparts. AAs are less likely to receive PC due to systemic racism, discrimination, provider bias, and culturally insensitive healthcare services. Additionally, research has primarily focused on highlighting the disparities in PC access among AA patients with cancer rather than understanding the experiences and preferences of those who do receive PC services. Grounded in 6S-Model for Person-Centered Palliative Care, this presentation aims to illustrate a theoretically derived approach for clinicians and researchers to develop culturally sensitive PC for AA patients with cancer. The model comprises six concepts elucidating different aspects of patient care to ensure sensitive care and overcome disparities: self-image, symptom relief, social relations, self-determination, synthesis, and strategies. Self-image is the model’s central concept, reflecting the patient’s personal experiences and identity. To preserve self-image, it is crucial to alleviate the patient’s symptoms and physical suffering while maintaining their social connections. Self-determination ensures patient involvement in their care, and synthesis and strategies address their care preferences, spiritual and existential needs. Utilizing the 6S Model for Person-Centered Palliative Care in studies and clinical care, will allow AA patients with cancer to share their PC experiences and collaborate in creating culturally sensitive PC, thereby integrating AA patients with cancer preferences and needs into PC, improving quality of life, care outcomes, and promoting equity in PC services.
ACCURACY OF MINIMUM DATA SET FALL ASSESSMENTS IN LONG-TERM CARE RESIDENTS
Authors: Graham Laura , Li Yongmei , Dave Chintan , Odden Michelle
Published: January 2025

The Minimum Data Set (MDS) is commonly used to ascertain falls among long-term care residents for research and quality improvement. However, studies have shown that MDS may underreport falls compared to chart abstraction. Natural Language Processing (NLP) algorithms to detect falls are limited but have demonstrated effectiveness in identifying falls in medical records. Thus, we aimed to develop and validate a rule-based NLP algorithm to identify falls in Veterans Health Administration (VA) long-term care residents and compare it to MDS. To do so, we identified a national cohort of patients receiving care at 114 VA long-term care facilities (10/1/2006-9/30/2019). Using text mining in VA clinic notes, we developed a rule-based NLP algorithm to identify falls. The algorithm was validated using manual chart abstraction on 200 patients (positive predictive value [PPV] 0.99). We then compared the results of the NLP algorithm to the MDS assessment, which identifies a fall within the past 30 days at the time of the assessment, using sensitivity, specificity, and PPV. In our cohort of 45,183 patients, we identified 154,165 falls (7.8 per 1,000 days) among 22,331 residents using NLP compared to 16,356 falls (0.8 per 1,000 days) among 8,859 residents using MDS. Compared to NLP, the MDS had a sensitivity of 0.30, a specificity of 0.91, and a PPV of 0.77. Our findings suggest that MDS may dramatically undercount falls among long-term care residents, potentially leading to misclassification in research studies. Future studies should focus on alternative methods of fall detection in retrospective cohorts.
ADVANCES IN GERONTOLOGY CURRICULUM DESIGN: CENTRING LIVED EXPERIENCES OF LGBTQ+ OLDER ADULTS
Authors: Wilson Kimberley , Pevie Noah , Hofstra Emma
Published: January 2025

While research on LGBTQ+ aging in Canada has increased, post-secondary educators have identified gaps in pedagogical aids to facilitate their teaching in this area. Older LGBTQ+ individuals have unique social/historical contexts compared to their majority peers, often involving minority stress experiences (e.g., stigma, discrimination, physical violence) that contribute to inequalities during late life. To create a future workforce that understands and appreciates the unique needs and social/historical contexts of aging LGBTQ+ individuals, our team prioritized developing curriculum resources that center the voices of LGBTQ+ older adults. We interviewed 26 LGBTQ+ older adults (M = 65.9, Range = 51-89). Participants shared stories about their own life courses and how they reflected the landscape of current curricula. They offered strategies for enhancing curriculum to ensure that post-secondary education include diverse LGBTQ+ narratives. Through conventional content analysis we identified topics that LGBTQ+ older adults named as requirements for students to understand the experiences of LGBTQ+ aging within hetero- and cis-normative health/social contexts. Through our analysis we articulated the importance of co-construction of educational materials with LGBTQ+ communities. Participants also identified the development of tools to be used within classrooms to challenge instructors to unpack their own assumptions about LGBTQ+ aging. They shared the importance of highlighting unique experiences of aging within these communities including the histories of queer/trans discrimination and the experiences of survivors of the HIV/AIDs crisis. Findings from this project will inform curriculum design and resources that move beyond normativity and include narratives of the lived/living experiences of LGBTQ+ older adults.
AGING IN AMERICA: CARE AND COMMUNICATION ACROSS THE FIELD
Authors: Margulis Brianna , Garcia Alexandra , Matarazzo Richelle , Tepper Lynn , Kunzel Carol , Whalen Stacey
Published: January 2025

Northern Manhattan has the largest population of individuals over 65. Students within the graduate programs of Columbia University electively participated in the workshop “Aging in America: Care and Communication Across the Field.” The workshop aimed to provide future professionals with communication techniques and best practices when caring for the aging population. Before and after participating in the workshop, participants completed a survey asking them to self-assess their readiness to communicate with the aging population. The workshop also taught participants how to recognize at-risk-for lower health literacy individuals and diminish barriers whenever possible. The workshop randomized participants into small groups composed of different participating programs (College of Dental Medicine, Programs in Physical Therapy, Programs in Occupational Therapy, School of Nursing, MD Program, Clinical Pastoral Education Program, Program in Genetic Counseling, Institute of Human Nutrition, Mailman School of Public Health, and School of Social Work). Participants facilitated discussions about how they would utilize the tools provided to navigate scenarios concerning older adults. The pre and post-surveys indicated that our efforts impacted participants by making them feel more prepared to communicate with an older adult who has experienced sensory, cognitive, physical, and/or behavioral changes. Participants reported that they learned more about their future colleagues’ scope of practice, which promotes better communication. The limitations of our workshop were within the smaller sample size of responses we received. Graduate programs should implement this workshop among health professional students in the future.
AGING WITH DISABILITY AND AGING INTO DISABILITY: HOW INCOME AND MISTREATMENT EXPERIENCE ALTER SELF-PERCEIVED AGE?
Authors: Zhang Yalu , Chen Ziyan
Published: January 2025

Individuals who experience early-onset disability (aging with disability) might have a lifetime of adaptation and resilience that shapes their views on aging differently from those who encounter disability in later life (aging into disability). Conversely, older adults with late-onset disability might maintain higher financial stabilities which could significantly impact their aging experience. It remains understudied if these contrasting effects tend to offset each other or if one has a more significant impact. Using 2018 China Longitudinal Aging Social Survey data, this study examined whether the onset timing of disability shapes attitudes towards aging differently, and how the experience of elder abuse could alter this association. Attitudes toward aging were measured both in subjective age and an index of self-perceived capabilities and values. Consistent with previous findings, this study found that the majority of older adults with impairments in (instrumental) activities of daily living had the onset of disabilities after the age of 65 (n=660, 91%). This study uniquely identified that, compared to older adults with early-onset disabilities, those who had later-onset disabilities perceived their aging, capabilities, and social values more negatively (O.R.=2.56, p=0.003). The odds drastically increased to 9.03 times if limiting the analytical sample to those who experienced elder abuse in the last 12 months (p=0.013). This study provides valuable insights into how the timing of disability onset influences older adults’ attitudes toward aging. The marked impact of elder abuse on these perceptions highlights an urgent need for targeted prevention and interventions among those who have disabilities with aging.
ALZHEIMER’S DIAGNOSIS AND CARE BY RACIAL AND ETHNIC GROUP IN THE MEDICARE POPULATION
Authors: Hoyt Margaret , Bailey-Taylor Melissa , Chandler Julie , Johnston Joseph
Published: January 2025

Little is known about differences in healthcare resource utilization (HCRU) among racial/ethnic groups with Alzheimer’s disease (AD). Our study aims to address this gap with an incident AD cohort in Medicare claims data. We identified Medicare patients ≥65 years old with a first (index) AD code (ICD-10 G30*) or medication (galantamine, rivastigmine, donepezil, or memantine) in 2018 or 2019 who were continuously enrolled (gap < 45 days) one year pre- and post-index. Descriptive analyses of HCRU and cost data were stratified by race/ethnicity. Our analysis included 887,984 patients, the majority female (64.2%), with mean (sd) age 80.6 (7.5) years. 72.0% identified as non-Hispanic White, 9.9% non-Hispanic Black, 12.8% Hispanic, and 3.8% Asian. In the 2018-2019 Medicare population, the incidence of Alzheimer’s disease per 100,000 person-years was 1,349 for White, 1,649 Black, 2,003 Hispanic, and 1,500 for Asian patients. Fewer White patients (18.8%) were dual-Medicare/Medicaid eligible than non-White patients (46.0-64.4%), and non-White patients had higher rates of many chronic comorbid illnesses. More White patients had at least one neurologist visit in the year pre-index (39.0%) compared to Black (35.1%), Hispanic (37.5%), and Asian (33.1%) patients. More Black patients had an inpatient admission with AD as the primary diagnosis post-index (11.0%) than White (9.5%), Hispanic (7.6%), and Asian (5.8%) groups, and costs for long-term care and hospice were highest for Black and Hispanic patients, respectively, which could indicate more severe disease. These statistically significant results suggest discrepancies between racial/ethnic groups in the Medicare AD population; further research is needed to understand the differences.
ASSESSING RACIAL DISPARITIES IN UTILIZATION OF HEALTHCARE SERVICES, 2010-2020
Authors: Dong Yanjun , Wang Kun , Rizzo Victoria
Published: January 2025

Objectives

Little is known about the intersectional effects of race, gender, income, and education on healthcare service utilization among BIPOC (Black, Indigenous, and People of Color) older adults. This study fills this gap by analyzing longitudinal data of older adults in the U.S. from 2010 to 2020.

Methods

Using six waves of longitudinal data from the Rand Health and Retirement Study (n= 26,304), this study employed random-effect Poisson and logistic models to examine disparities across seven healthcare services, focusing on the interactions of BIPOC with gender, education, and income.

Results

The findings show disparities in healthcare utilization, with BIPOC older adults consistently reporting lower utilization across different types of services, including hospital stays, prescription drug use, outpatient surgery, home healthcare, physician visits, and dental care. For the interactions, the results indicate that, compared with others, low-income BIPOC older adults are less likely to access prescription drugs (β = -1.10, p < 0.01) but more likely to use home healthcare (β = 0.52, p < 0.05) and physician services (β = 0.75, p < 0.05). BIPOC women were less likely to utilize nursing home services (β = -0.84, p < 0.05).

Discussion

This study underscores the effects of socioeconomic factors and systemic inequities on healthcare utilization. Policy implications include the need for targeted interventions to reduce financial barriers, culturally competent care models, and enhanced health literacy programs. The findings highlight the urgent need for systemic changes to create an equitable healthcare system that addresses the needs of marginalized populations.
ASSOCIATION OF IMMUNE CELLS AND INFLAMMATORY BIOMARKERS WITH DEPRESSIVE SYMPTOMS IN THE FRAMINGHAM HEART STUDY
Authors: Iyer Sandhya , Cao Yumeng , Lunetta Kathryn , Liebegott Ryan , Doyle Margaret , Chen Jiachen , Ragab Ahmed , Murabito Joanne
Published: January 2025

Depression is a common mental health disorder with substantial impact on older adults. Immune dysfunction has been studied as a mechanism for depressive symptoms, providing the opportunity for new targeted treatment approaches. This study investigated the associations between immune cell phenotypes, determined by flow cytometry, and peripheral inflammatory biomarkers, measured using the OLINK Inflammation panel, with Center for Epidemiologic Studies Depression Scale (CES-D) scores, indicative of depressive symptoms, in the Framingham Heart Study Offspring Cohort. Participants (n=996) had a mean age 62, were 52% female, and had a mean CES-D score 5 (SD=7) with 8% having a CES-D score >/=16. A linear mixed-effects model was used (generalized estimating equation model for the dichotomous CES-D) with the proteins and immune cells as predictors and CES-D scores as the outcome, adjusting for age, sex, BMI, smoking status, CVD, depression medication use, NSAID use, and cytomegalovirus (CMV) status (immune cells only). We used Bonferroni adjusted p< 0.005 to declare significance. Effect estimates (beta) are reported in standard deviation units. Our results suggested a positive association between FGF-19 and CES-D score (beta=0.11, p=0.0004), as well as a suggestive negative trend between the CD8+IL17+:CD8+CD25+FoxP3+ ratio (Tc17/CD8+Tregs) and CES-D score (beta=-0.1, p=0.03). In addition, we observed a positive suggestive trend between IL-17C and depressive symptoms (CES-D >/= 16) (beta=0.35 p=0.009), that strengthened with higher levels of symptoms (p< 0.005). This study helps to expand our understanding of the role of inflammation in the pathophysiology of depression.
ASSOCIATIONS OF SOCIAL RELATIONSHIPS WITH INFLAMMATORY, CARDIOVASCULAR AND IMMUNE CELL BIOMARKERS
Authors: Ragab Ahmed , Chen Jiachen , Cao Yumeng , Doyle Margaret , Murabito Joanne , Lunetta Kathryn
Published: January 2025

Social relationships are essential for health, as social isolation and loneliness are linked to higher risks of morbidity and mortality. These associations may result from behavioral changes, physiological alterations, increased inflammation, and a weakened immune system. Community-based cohorts investigating the association between social isolation and inflammation have not included immune cell phenotypes and have been limited to a small number of inflammatory and cardiovascular biomarkers. We investigated the relationship between the Social Network Index (SNI), and 3 biomarker datasets: 1) 68 inflammatory biomarkers (N=875), 2) 71 cardiovascular biomarkers (N=3295), and 3) 28 immune cell phenotypes(N=996), among Framingham Heart Study Offspring participants (mean age 61). SNI was calculated as the sum of four components: marital status, the presence of close friends or relatives, attendance at religious services, and participation in social groups and treated as an ordinal predictor (1=lowest level of connections, 4= highest). We used Linear Mixed Effects models with SNI as the predictor and biomarkers/immune phenotypes as the outcomes, adjusting for age and sex and CMV (immune phenotypes). We used FDR≤0.05 to declare significance within each biomarker dataset. SNI was positively associated with inflammatory biomarkers HGF, IL-6, OSM, and IL-10RB. SNI was also positively associated with cardiovascular proteins CNTN1, IGFBP3, FGF23, CD56, sRAGE, and IGF1, and negatively associated with GDF15, MMP9, FBN, MCP1, CD14, A1M, IGFBP2, CRP, EFEMP1, and PPBP. SNI was not significantly associated with any of the immune cell phenotypes in the full sample. We conclude that social isolation is associated with multiple inflammatory and cardiovascular biomarkers.
BRICKS FOR BETTER BRAINS©: STRATEGIES TO ENHANCE ENGAGEMENT IN PERSONS LIVING WITH DEMENTIA
Authors: Kasperovich Natalia , Sasser Jennifer
Published: January 2025

The Bricks for Better Brains© activity is an intervention to slow down the progression of cognitive decline for persons living with dementia. The activity utilizes various carefully selected, interlocking bricks (LEGO®) in bright colors as an innovative medium for stimulating participants’ creative capacities, using visual perception and motor sensory skills, as well as strengthening social engagement. Cognitive impairments can present unique challenges for effectively engaging this population in meaningful activities. An in-person observational study was conducted as a preliminary exploration of strategies to increase engagement of persons living with dementia in activities with viable therapeutic potential using The Bricks for Better Brains© protocol. The study consisted of two groups (five males and fifteen females total) of people 75 years of age and older living with moderate-to-severe dementia and residing in an institutional care setting. Four activity modification strategies were tested – modification to objects and property; modification to space demands; modification to social demands; and modification to sequence and timing. All modifications in space demands increased engagement. Modification in objects and property, sequence and timing, and social demands were positive for the group but showed mixed efficacy for individual. These results support the person-centered care model and highlighted the importance of creating stimulating environments by understanding how people living with dementia interact with their surroundings. By identifying efficient activity modification strategies we can increase activity engagement and improve the quality of life of the people living with dementia. Future studies will need to include the reliability of observational measures.
CARDIOVASCULAR RISK FACTORS AND MENTAL HEALTH OUTCOMES AMONG LGB+ OLDER ADULTS
Authors: Smith Jennifer , Rodriguez Robert , Anderson Joel
Published: January 2025

Emerging evidence highlights that sexual and gender minority (SGM) adults exhibit a higher prevalence of cardiovascular disease (CVD) and its risk factors compared with their non-SGM peers. This increased susceptibility underscores a critical intersection with cognitive health given the link between CVD and cognitive decline and early-onset dementia. Additionally, mental health challenges such as depression and anxiety not only heighten CVD risk but also predict severe cardiovascular complications. Utilizing cross-sectional data from the National Health Interview Survey (NHIS), this study examined these interconnected health issues among older adult LGB+ populations to inform comprehensive interventions aimed at addressing both cardiovascular and cognitive health. This cross-sectional study analyzed data from the 2022 NHIS data to describe cardiovascular and cognitive health characteristics among LGB+ and non-LGB+ older adults using chi-squared tests. The sample was limited to adults who self-reported being age 50 years or older. A CVD risk variable was created based on Framingham criteria. Data from 13,426 participants, including 341 LGB+ individuals, revealed significant differences in demographic characteristics, health, and lifestyle. LGB+ older adults were younger and more frequently formally educated. They exhibited lower rates of CVD risk factors and increased physical activity and preventative health behaviors, yet higher incidence of depression and anxiety and higher rates of smoking and alcohol use. These preliminary findings highlight the unique characteristics of LGB+ older adults in terms of cardiovascular health, offering potential targets for culturally tailored interventions.
CARE MANAGER PERCEPTIONS OF A CARE COORDINATION INTERVENTION IN THE ED FOR RESIDENTS IN ASSISTED LIVING COMMUNITIES
Authors: Wittenberg Grace , Serina Peter , Stetten Nichole , Reddy Ann , McCreedy Ellen
Published: January 2025

Of the 800,000 residents in US assisted living communities, nearly half are transferred to the Emergency Department (ED) each year, often without a support person or up-to-date medical information. This lack of information can lead to more testing in the ED, increased ED length of stay, and unnecessary hospitalizations. To address this problem, Bluestone Physician Services, providing care to ALC residents in Florida, Minnesota, and Wisconsin, developed the ED Early Response Program for patients in its accountable care organization. In the program, a complex care manager (CCM) is notified when one of Bluestone’s ALC patients registers at an ED. Bluestone staff then provide standardized, clinical information to the ED via phone and fax. To analyze the feasibility and acceptability of the program, we conducted semi-structured interviews with 12 CCMs involved in the program. Using directed content analysis, we identified five overarching themes: populations most likely to benefit from the program (e.g. people living with dementia, hospice), key components of the program, program strengths, areas of opportunity, and impact on patient care. CCMs described that the program positively impacted care transitions to the ED by providing added clinical information and fostering interprofessional communication. However, they also noted areas for improvement, including enhancing ED provider receptivity by increasing awareness of the program in the ED. Overall, by using CCM insights gained during implementation, this program can be used as a model to address key communication gaps for ALC residents during transitions of care, including ED visits.
CAREGIVING STRESS IN ADRD CAREGIVERS: THE INFLUENCE OF SOCIAL DETERMINANTS OF HEALTH AND SOCIAL SUPPORT
Authors: Lee Kyungmi , Xiao Chunhong
Published: January 2025

Alzheimer’s disease and related dementias (ADRD) caregivers face significant physical, emotional, and financial challenges. These stressors are influenced by social determinants of health (SDOH), such as income and service accessibility, as well as caregiver-specific factors like health status and caregiving burden. Social support can help mitigate caregiving stress. This study aimed to examine the relationships among SDOH, caregiver-specific factors, social support, and caregiving stress in ADRD caregivers. Utilizing data from the Caregiving in the U.S. 2020 study (n = 357 ADRD caregivers), we conducted a multiple regression analysis (F = 15.236, p < 0.001). Results show that social support significantly reduces caregiving stress (β = -0.261, p = 0.004). Caregiver health status (β = -0.592, p < 0.001), difficulty accessing services (β = 0.770, p < 0.001), and caregiving burden (β = 0.511, p < 0.001) are also significant predictors of stress. Although age did not directly impact caregiving stress, it significantly influenced service access (β = -0.010, p = 0.036), which in turn affected stress levels. Financial strain (β = 0.270, p < 0.001) and physical strain (β = 0.171, p = 0.005) were also associated with service accessibility issues. These findings suggest that enhancing social support and improving service access could effectively reduce caregiving stress. Future research should further investigate these areas to develop targeted interventions for ADRD caregivers.
CARING FOR NURSING HOME RESIDENTS WITH DEMENTIA AND SERIOUS MENTAL ILLNESS: A QUALITATIVE STUDY
Authors: Block Laura , Gilmore-Bykovskyi Andrea , Maust Donovan , Roberts Tonya
Published: January 2025

Over half of nursing home (NH) residents are living with dementia, and a growing number also experience serious mental illness (SMI) and/or comorbid dementia and SMI. Despite the heightened vulnerability of this population, studies indicate NHs struggle to meet their needs, yet little research has documented specific challenges or strategies for their care. By employing a qualitative descriptive design, this study aims to describe NH staff perspectives on caring for residents with dementia and SMI. Partnerships were developed with NH and provider networks servicing rural and urban areas of a Midwest state, with purposive sampling of not-for-profit, county-run and for-profit facilities. Staff completed semi-structured interviews, which were analyzed applying thematic analysis. Ten individuals from three facilities have participated. While all participants identified dementia as common among residents, recognition of SMI as prevalent varied by staff and facility type. Participants described an interaction whereby a resident’s past (e.g., trauma) interacts with their mental health, functional, behavioral, and cognitive needs, which then influences selection of care and symptom management strategies. Staff described person-centered care as a universal best practice, while prescribing clinicians were attuned to appropriate pharmacology that reflected the resident diagnosis. Staff in some facilities described developing tailored behavioral and crisis plans. Findings suggest potential best practices to support residents with dementia and SMI, yet ongoing challenges caring for individuals with more complex behaviors and/or comorbid SMI. Future research should integrate further frontline nurse and nursing assistant perspectives, as additional strategies and challenges translating care plans to practice may exist.
CHALLENGES FACING PRIMARY CARE NURSE PRACTITIONERS CARING FOR PERSONS LIVING WITH DEMENTIA
Authors: Featherston Kyle , Dougherty Maura , Wang Siqing , Poghosyan Lusine
Published: January 2025

The nurse practitioner (NP) workforce plays a vital role in caring for the growing population of persons living with dementia (PLWD). However, organizational and structural barriers hinder their contribution to patient care. This study presents results from a national sample of 968 primary care NPs who care for PLWD. NPs were asked to report on the organizational support and resources available in their practices to care for PLWD. NPs also reported on the relationships between NPs and administration, as well as NP job satisfaction, burnout, and intentions of leaving their jobs. NPs reported their organizations lacked the resources to care for PLWD that they had for patients with other chronic diseases. Specifically, only 14.67% reported a registry of PLWD overdue for services and fewer than 60% had tools, templates, and reminders for PLWD that were largely available for chronic conditions like hypertension and dementia. Crucially, these deficits in the organizational context of care resulted in NPs rating the quality of the care provided to PLWD at their organization lower than the overall quality of care the organization delivered. Although NPs were largely satisfied with their jobs, over one-third reported being burned out, and over one-fifth reported they intended to leave their jobs within the next year. Addressing these barriers to care and creating work environments conducive to NP practice are necessary to fully utilize the capacity of the NP workforce to improve care of the older adult population living with dementia.
CHARTING NEW PATHS: LGBTQIA+ GERIATRICS FELLOWSHIPS
Authors: Noy Roy , Javier Noelle Marie Coloma
Published: January 2025

Background

As the global population aged 65 and older continues to grow, so does the number of individuals identifying as LGBTQIA+. Despite this increase LGBTQIA+ health content are often overlooked in medical education, leading to significant disparities in care. Recognizing this gap, the American Geriatrics Society emphasized addressing LGBTQIA+ health disparities as early as 2015.

Methods

Our pilot program, a collaboration between the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai in New York and the Tel Aviv Medical Center (TAMC), is designed to address disparities in LGBTQIA+ healthcare. As part of this initiative, a geriatric resident from TAMC completed a four-month observership at Mount Sinai, receiving specialized training tailored to LGBTQIA+ healthcare for older adults. The hands-on curriculum allowed the resident to shadow various services, including geriatric and palliative care, rehabilitation, and specialized clinics such as the Institute for Advanced Medicine and the Center for Transgender Medicine. In addition, the resident engaged in one-on-one educational sessions focused on LGBTQIA+ care.

Results

The outcomes of this pilot program include the creation of a tailored and replicable curriculum for geriatric residency that can be applied to other programs, scholarly peer-reviewed publications, sustainable collaborations, partnerships with advocacy organizations, and the establishment of Tel Aviv’s first LGBTQIA+ geriatric clinic.

Conclusions

Pilot programs like ours hold significant promise for advancing LGBTQIA+ health education and improve the quality of care for older LGBTQIA+ adults, as evidenced by the establishment of Tel Aviv’s first LGBTQIA+ geriatric clinic.
CHATGPT ANALYSIS OF AGEISM IN THE 2024 PRESIDENTIAL ELECTION: RESEARCH, POLITICS, AND POLICY IMPLICATIONS
Authors: Hopp Faith
Published: January 2025

Gerontologist Robert Butler introduced the concept of Ageism, described as “the great sleeper in American life” in a 1968 interview with journalist Carl Bernstein. Ageism refers to discrimination based on age and has been particularly evident during the 2024 election season. To further examine this relevant phenomenon, we used ChatGPT to analyze instances of ageism related to President Biden’s campaign. We instructed ChatGPT to collect a sample of articles from mainstream media mentioning President Biden (N=23), asking the program to score the frequency and type of ageist language during the month before and after the June 27 2024 Biden-Trump debate. Ageist themes included statements about Biden being a bad leader, not trustworthy, not mentally and/or physically fit, and not competent and/or relevant as a candidate. The number of ageist statements about Biden increased in the month following the debate compared with the pre-debate month. We found fewer ageist-related statements about Biden in the African American press both before and following the debate, but access to these articles was limited due to paywall restrictions. These findings suggest that ageism continues to be relevant and will continue to drive age-related discourse, impacting policy, practice, and older adult life experiences. Future researchers should consider the role of internet paywalls in limiting public access to news sources and the breadth of content available for ChatGPT analysis. We recommend that researchers obtain full-text articles using newspaper databases rather than relying on ChatGPT internet scans to ensure comprehensiveness and analytical depth.
CREATING DIGITAL STORIES ON AGING EXPERIENCES: A RAPID METHODOLOGICAL REVIEW OF DEVELOPMENT PROCEDURES
Authors: Gopalakrishnan Nisha , Mellett Katlyn , Mirza Noeman , Hulko Wendy , Gan Daniel , Wong Karen Lok Yi , Kupferschmidt Anthony L , Lee Heather
Published: January 2025

Digital storytelling is increasingly used to showcase the life histories of older adults and their communities. The Mobilizing Aging in Place (MAP) project team was tasked to engage older adults in the creation of five digital stories as a means of sharing the findings of two studies on aging in place with municipal and regional planners and health care policy/decisionmakers. While there were numerous examples of digital stories on aging experiences, the best way to develop digital stories with older adults was unclear. To create clarity in effective methods, we conducted a rapid methodological review of existing literature on digital storytelling involving older adults and experiences of aging. After searching in the Discovery search engine, we reviewed 61 abstracts and articles based on specific inclusion and exclusion criteria. This yielded 18 articles that we included in the review. The included literature discussed digital stories on various health and intergenerational knowledge transfer topics. Researchers used a variety of software, editing tools, and recording methods to combine images, videos, and sounds. Digital stories were developed both in collaboration with older adults and by the older adult participants themselves. The review showed that there are no set criteria or best practices for creating digital stories, and that workshops and interviews are commonly used to engage older adults in digital storytelling. We recommend a more comprehensive and broader review be undertaken with a focus on all forms of digital storytelling regardless of type of population and context.