bluuebunny/crossref_metadata_2025 huggingface dataset:
WHEN DO PAID CAREGIVERS SUPPORT THE HEALTH OF OLDER ADULTS? GERIATRICIAN PERSPECTIVES
Authors: Reckrey Jennifer , Estrada Leah , Watman Deborah , Franzosa Emily
Published: January 2025

Paid caregivers (e.g., home health aides, personal care attendants, other home care workers) may support not only the function but also the health of the older adults they care for in the home, but little is known about how medical providers view paid caregiver role in healthcare. This secondary qualitative analysis of interview data from geriatricians (n=9 geriatricians, n=27 interviews) used thematic analysis to identify geriatrician perspectives on when paid caregivers do the most to support the health of their older adult clients. Geriatricians perceived that paid caregiver contributions were greatest in the care of high-needs older adults including those with multimorbidity, dementia, and significant functional impairment. They described that paid caregivers stepped up to fill healthcare gaps when families could not provide all needed support (e.g., long distance family caregivers). They also described how the personal qualities and internal motivation of paid caregivers affected their role in care, but rarely acknowledged the systemic barriers to greater paid caregiver participation in health-related care. As the locus of long-term care continues to shift from institutions to the community, a greater number of older adults with multimorbidity and dementia will rely on paid caregiver to live at home despite growing functional impairment. Future work should consider how to best integrate paid caregivers who are already providing health-related support into the care team and explore barriers to paid caregiver participation in health-related care more generally, especially for older adults with the highest care needs.
IDENTIFICATION AND MACHINE LEARNING PREDICTION OF MEDICARE BENEFICIARIES’ COGNITIVE FUNCTION TRAJECTORIES
Authors: Lin Haiqun , Xia Weiyi , Zafar Anum , Kim Hyosin , Setoguchi Soko , Kobylarz Fred , Roy Jason , Jarrín Olga
Published: January 2025

This work aims to characterize the functional decline in cognition during the last five years of life. A 10% random sample consisting of 195,240 Medicare beneficiaries who died in 2019, aged fifty or older and continuously enrolled in Medicare during their last five years of life, was analyzed. Cognitive function status, characterized by no impairment, memory loss, mild cognitive impairment, and dementia, was obtained from the assessment and the claim file for each beneficiary whenever it was available. Changes in cognitive function over the last five years were examined using the group-based trajectory model for ordered categorical outcomes: Ten trajectory groups of cognitive function were identified and had a better value of Bayesian Information Criterion than either the 9-class or the 11-class solution. The 10 trajectory groups were categorized into four clusters: the cognitively intact cluster (38% of beneficiaries) which contains one trajectory group with beneficiaries maintaining their cognitive function throughout the last five years, the mild cognitive impairment (MCI) cluster (27%) which contains four trajectory groups with beneficiaries experiencing slow decline in cognitive function and died with MCI, the steady decline cluster to dementia (25%) which contains four trajectory groups with beneficiaries experiencing steady decline in cognitive function and died with dementia, and the early-decline dementia cluster (10%) which contains only one trajectory group with beneficiaries whose cognitive decline started more than five years before death. Sociodemographic and clinical factors were assessed for their association with the trajectories and used to predict trajectory clusters with machine learning algorithms.
RACIAL/ETHNIC AND SEX DIFFERENCES IN LATE-LIFE COGNITIVE TRAJECTORIES
Authors: Jarrín Olga , Thorpe Roland , Kobylarz Fred , Xia Weiyi , Kim Hyosin , Zafar Anum , Lopez Maria , Lin Haiqun
Published: January 2025

Prior research on racial/ethnic and sex difference in late life cognitive trajectories has been limited by small sample sizes in clinical and survey cohorts. We overcome these challenges through leveraging real-world data for the U.S. Medicare beneficiary population to examine within-group differences in cognitive function trajectories and their predictors. Specifically, we found Black, Hispanic, and Asian American men and women have a higher risk of severe cognitive impairment and spend more months and years of their lives with significant cognitive impairment. These differences are largely driven by differences in the risk of cognitive impairment associated with older age, consistent with prior research on life course stress and the ‘weathering’ hypothesis that early health deterioration is a consequence of the cumulative impacts of social or economic adversity and political marginalization. Our findings replicate, and in some cases refute, findings from prior studies from smaller longitudinal cohorts, including the Health and Retirement Study. Results will be discussed from a life course perspective with attention to variation in environmental, sociocultural, political, and historical factors that create and sustain health disparities for racial/ethnic minority older adults in the United States.
NAVIGATING HEALTH AND IDENTITY TO PROMOTE FORTITUDE AMONG SGM PEOPLE: INSIGHTS FROM AGING WITH PRIDE
Authors: Hoy-Ellis Charles , Fredriksen-Goldsen Karen
Published: January 2025

This symposium showcases groundbreaking research illustrating the multifaceted nature of fortitude among sexual and gender minority (SGM) older adults, focusing on health, digital health access, generativity, and intersectionality. The collection of studies in this symposium leverages cross-sectional and longitudinal data from Aging with Pride: National, Health, Aging and Sexuality/Gender Study (NHAS) to address critical gaps in our understanding of the unique strengths in this population despite the adversity they face. The first presentation illuminates the disproportionate experiences of violence and abuse among older transgender adults, revealing significant links between intimate partner violence (IPV), victimization, internalized stigma, and adverse mental health outcomes. It spotlights the need for interventions that target these risk factors and promote fortitude. The second presentation examines the digital divide, exploring how older SGM adults utilize health information technologies. By comparing usage patterns and identifying barriers and facilitators, this research emphasizes the importance of improving health care access. The third presentation will examine the predictors of generativity among SGM older adults, highlighting how psychological and social resources can mitigate stigma. This study offers valuable perspectives on fostering intergenerational support and community engagement within SGM communities. Lastly, the symposium will feature research examining the intersectionality of identity among SGM older adults, showcasing heterogeneity among this population by identifying patterns based on identity centrality and discrimination experiences. Highlighting the impacts of recent policy shifts targeting SGM communities, these studies collectively underscore the crucial need for resilience-enhancing strategies that incorporate intersectional approaches for promoting health equity among vulnerable, at-risk populations.
CROSS-NATIONAL STUDIES OF RISK FACTORS FOR COGNITIVE DECLINE AND DEMENTIA
Authors: Steptoe Andrew , Brocklebank Laura
Published: January 2025

Cross-national studies of cognitive decline can provide insights into the relevance of risk factors in different cultural settings. They help determine whether relationships are universal or depend on the lifestyles and social context prevailing in different countries. However, cross-national studies present challenges. One important issue is harmonization of self-report and cognitive measures, and this has been greatly facilitated by the Gateway to Global Aging initiative. But there are other factors related to consistency in data collection that require careful consideration. These will be illustrated by a study relating physical activity and sleep patterns to cognitive decline and dementia risk in England using ELSA (the English Longitudinal Study of Ageing) and in China using CHARLS (The China Health and Retirement Longitudinal Study). Absolute levels of physical activity and sleep vary greatly among older people living in urban and rural settings, and with histories of predominantly non-manual work (ELSA) and more mixed occupations (CHARLS). These factors color self-report measures, making comparison difficult. In this study, we have been carrying out 8-day wrist-worn accelerometry in ELSA and CHARLS to provide objective data on movement behaviours (physical activity, sedentary behaviour, and sleep) in more than 20,000 individuals. This presentation highlights challenges related to consistency of data collection, variations in instrumentation, differences in response and adherence rates, and the suitability of machine-learning behavior classification models developed in one cohort but applied in very different people and/or contexts. We will describe our approaches to resolving these issues in order to carry out robust cross-national comparisons.
TWENTY YEARS OF FOLLOW-UP OF THE MEXICAN HEALTH AND AGING STUDY (MHAS): ITS POTENTIAL FOR CROSS-NATIONAL COMPARISONS
Authors: Wong Rebeca
Published: January 2025

The availability of population-based, national representative, longitudinal data for aging research has been building up for the last twenty years. As a result, the ability to make cross-national research has been enhanced greatly. Almost 20 percent of the publications that use the MHAS data are making cross-national comparisons, but the cross-national work is still in infancy. Most research focuses on documenting health and functionality trajectories and the individual determinants of these trajectories. I will present an overview of what has been done, illustrate with a couple of examples, and conclude with gaps in knowledge that could be supported by cross-national data. The lack of comparable data for many low-middle income countries may be the challenge we can help meet in the next 20 years to advance research on global aging.
BIOLOGICAL AGING PATHWAYS THAT UNDERLIE LIFE COURSE SOCIOECONOMIC DISPARITIES IN PHYSICAL FUNCTION AND LONGEVITY
Authors: Gruenewald Tara , Podber Naomi
Published: January 2025

The poorer functioning and greater morbidity and mortality risk in those with greater life course socioeconomic disadvantage has led to the search for the biological processes that underlie these associations, including accelerated cellular and system aging. Our study examines whether a DNA methylation profile of the pace of biological aging (DunedinPACE) and a multi-system index of physiological dysregulation (allostatic load (AL)) mediate associations between life course socioeconomic disadvantage (SESDIS) and both physical function (gait speed, chair stand time) and survival. Data are from the Midlife in the U.S. Study (N=1,295, age 26–86, 55.4% female, 69.0% white). Measures included a multi-indicator composite of childhood and adult socioeconomic indicators (SESDIS), DunedinPACE as described in Belsky et al. (2022), AL as described in Gruenewald et al. (2012), gait speed (time to complete a 50-foot walk), and chair stand time (5 consecutive rises from a seated position). Analytic models included z-scored predictors, age, race, and gender covariates and accounted for family clustering. Greater SESDIS was associated with increased mortality hazard (HR=1.42***), higher gait speed (b=0.70***) and chair stand time (b=0.85***), and higher DunedinPACE (b=0.27***) and AL (b=0.19***). Greater DunedinPACE and AL were associated with slower gait and chair stand time and lower survival. Multi-mediation analyses indicated significant bootstrapped (1,000 replications) indirect effects for DunedinPACE and AL as mediating pathways of the slower gait and chair stand time and lower survival in those with greater SESDIS. Findings highlight biological aging pathways that may contribute to life course socioeconomic disparities in physical function and longevity.
INDIVIDUAL DIFFERENCES IN TIME OF DAY EFFECTS ON AMBULATORY COGNITIVE FUNCTIONING IN MIDDLE AND OLDER ADULTS
Authors: Beck Emorie , Hawks Zoe , Germine Laura
Published: January 2025

Previous work indicates that (1) changes in diurnal cycles are associated with the onset and progression of dementia and cognitive impairment and (2) that cognitive function itself tends to show diurnal cycles in the laboratory. But no work to date has examined whether cognitive function assessed via ecological momentary assessment can recover such daily cycles and whether individual differences in those cycles are associated with short- and long-term outcomes. In this presentation, we examine whether ambulatory cognitive assessments assessed via ecological momentary assessment (EMA) demonstrate intra-day cycles of cognitive performance. This study specifically aims to test whether such cycles emerge, whether there are individual differences in those cycles, and whether individual differences are associated with cross-sectional measures of cognitive health and psychosocial risk factors. At baseline, 200 (Mean age = 55; 50.1% female) participants responded to five surveys per day for 20 days capturing their cognitive function, contextual factors, and psychological experiences. We will examine nonlinear changes in cognitive function through the day using both multilevel time series decomposition and cosinor models, which also allow us to examine individual differences in these patterns. We will then examine whether these individual differences are concurrently associated with global cognitive functioning, cognitive impairment, personality traits, and other psychosocial factors.
LONELINESS AND MEMORY LAPSES AMONG OLDER ADULTS IN DAILY LIFE
Authors: Van Bogart Karina , Harrington Erin , Mogle Jacqueline , Kang Jee eun , Sliwinski Martin , Graham-Engeland Jennifer
Published: January 2025

Loneliness has been linked to objective cognitive decline and dementia risk; however, less is known about how loneliness relates to subjective cognition. Assessing daily subjective cognition related to prospective memory (i.e., for future events; PM) and retrospective memory (i.e., for past information; RM) may be particularly useful in identifying associations with daily emotional and cognitive health. The current research examined associations between loneliness and self-reported PM and RM lapses among 311 older adults (mean age=77.45 years, 40% Black, 13% Hispanic, 67% women) who completed 14 consecutive days of ecological momentary assessment that included self-reports of momentary loneliness (5x/day) as well as evening self-reports of memory lapses that occurred that day. Separate multilevel models were estimated to assess daily associations between loneliness and number of PM or RM lapses, and the amount of disruption and irritation associated with these lapses. All models controlled for age, gender, years of education, MCI status, and depressive symptoms. Days when loneliness was higher than typical were significantly associated with a higher number of PM lapses (b=0.011, p<.001), and more disruption to daily activities (b=0.113, p <.001) and irritation (b=0.036, p=.002) associated with experiencing PM lapses. Daily loneliness was not associated with the number of RM lapses, but was significantly linked with more disruption to daily activities (b=0.131, p<.001) and irritation associated with RM lapses (b=0.103, p<.001). Findings suggest that loneliness may uniquely impact daily PM and perceived disruption from RM issues, which has important implications for cognitive health and maintaining independence in late life.
RURAL HEALTH AND FAMILY CAREGIVING: IDENTIFYING CHARACTERISTICS AND ADDRESSING NEEDS ACROSS POPULATIONS
Authors: Stephens Caroline , Telonidis Jacqueline , Ornstein Katherine
Published: January 2025

The rural population in the U.S. is growing and aging faster, and they have more comorbidities, than the overall aging population. Despite the greater need for resources and supports, rural residents may experience the most barriers to formal services (e.g., hospital, hospice/palliative care, nursing home care) and may lack available family caregivers. Unfortunately, there is a dearth of population-based research comparing the characteristics and needs of older adults living and dying in rural vs. urban areas, particularly related to availability of family. This symposium includes 4 presentations focused on rural health and family caregiving and identifying the characteristics and addressing needs across populations. The first presentation uses a retrospective population cohort design with cancer registry and state-wide claims data to examine urban/rural differences in palliative care-related service claims among older adult cancer patients diagnosed with metastatic breast, lung, colorectal, head and neck, bladder, and melanoma cancers. The next two presentations use data from the Utah Caregiving Population Study (Utah C-PopS) to examine how family size and characteristics impact EOL care utilization for urban vs. rural NH residents and for persons with dementia. The last presentation describes a program evaluation of an interagency collaboration to support caregivers in rural communities. Together, these presentations shed light on the diverse characteristics, gaps in care, and novel strategies to address the needs of rural populations to better inform rural health practice and policy considerations.
ROLE OF FAMILY CHARACTERISTICS OF RURAL AND URBAN NURSING HOME RESIDENTS AT END-OF-LIFE (EOL)
Authors: Stephens Caroline , Utz Rebecca , Hollingshaus Mike , Tay Djin , Edelman Linda S , Iacob Eli , Smith Ken , Ornstein Katherine
Published: January 2025

Nursing home (NH) EOL disparities are an increasingly important focus for policymakers. Despite the critical role of families in resident EOL care, no studies to date have explored how family size and characteristics impact EOL care utilization for urban vs rural NH residents. This study describes the size and characteristics of first-degree families (FDF) of Utah NH residents who died in rural/frontier (n=10,440) vs. urban (n=32,366) NHs between 1998-2016. Using the Utah Caregiving Population Study (Utah C-PopS), we linked NH decedents to their FDF (urban FDF n=90,829; children=57%; siblings=32%; spouses=11%; rural FDF n=30,512; children=55%; siblings=34%; spouses=11%) and compared characteristics of those with and without FDF by urban and rural status. Rates of ER visits and hospitalizations in the last six months of life by FDF type were estimated. Rural NH decedents were slightly more likely to lack FDF in the state compared to urban NH decedents (23% vs 22%, respectively). Having a spouse was associated with increased rates of hospitalization among both urban [IRR 1.12 (1.06,1.17)] and rural NH decedents [IRR 1.11 (1.03,1.19)], but increased rates of ED visits [IRR 1.10 (1.01,1.20)] were only observed among urban decedents. Having at least one child, or a child and spouse, was associated with increased rates of hospitalization in urban decedents [IRR 1.06 (1.03,1.10), IRR 1.13 (1.08,1.19), respectively], but not among rural NH decedents. A better understanding of family role in EOL care in the NH setting will advance research on disparities in EOL NH care, particularly related to rural and urban differences.
IMPACT OF RURALITY ON PALLIATIVE CARE–RELATED SERVICE USE: FINDINGS FROM A POPULATION DATASET
Authors: Tay Djin , Guo Jia-Wen , Ornstein Katherine , Dubose Kline , Sheng Xiaoming , Ellington Lee
Published: January 2025

Palliative care, including hospice, supports quality of life of individuals living with serious illness. However, residents in rural areas may have limited access to these services. This study examined urban/rural differences in palliative care-related service claims among older adult cancer patients diagnosed with metastatic breast, lung, colorectal, head and neck, bladder, and melanoma cancers. We hypothesized that rural patients would have less palliative care-related service claims. This study used a retrospective population cohort design with cancer registry and state-wide claims data. Data from patients aged 65 and above with a diagnosis of metastatic cancers were analyzed. N=1,798 patients were identified, with n=511 (28%) living in rural or frontier regions. Patients living in rural areas differed from urban patients by cancer types (p<0.006), race (p=0.015), advance care planning (p=0.002), and hospice use (p=0.040). After diagnosis, only 2% of rural patients and 6% of urban patients had advance care planning claims and approximately half had ever received hospice care (54% rural; 49% urban). While insignificant, rural patients had palliative care (35% vs. 31%) and chemotherapy claims (53% vs. 49%) at higher proportions compared with urban patients (p=0.076 and p=0.055 respectively). There were no observed differences in use of life-sustaining and/or cancer treatments. This was one of the few population-based studies examining rural-urban disparities in palliative care-related services. Despite being a clinical guideline and marker of quality of care in advanced cancers, findings imply low uptake of palliative care services overall, suggesting room for improvement for palliative and end-of-life cancer care delivery.
THE ROLE OF SOCIAL RELATIONSHIP PARTNERS FOR WELL-BEING AFTER SOCIAL INTERACTIONS IN DIFFERENT MODALITIES
Authors: Hueluer Gizem , Borgards Kaila , Macdonald Birthe
Published: January 2025

Social relationships and social interactions are essential for psychological well-being. In the present study, we examine the role of social relationship partners (relationship closeness and social network size) for well-being after social interactions in different modalities (face-to-face, telephone, text-based digital). We use 7,861 observations from 113 participants (age: M = 72 years, SD = 5, range = 65 to 94; 40% women), who completed a short questionnaire about their social interactions over 21 days in an event-contingent experience sampling study. With regard to main effects, our findings showed that within persons, participants reported higher levels of well-being after social interactions with closer vs. less close social interaction partners. Social network size was unrelated to well-being after social interactions. Well-being was highest after face-to-face social interactions, followed by telephone and digital text-based social interactions. With regard to moderation effects, the effect of relationship closeness on well-being was not moderated by social interaction modality. The effect of social network size on well-being after social interactions was moderated by social interaction modality, indicating that the difference in well- being experienced after face-to-face and telephone vs. text-based digital social interactions was smaller for participants with smaller social networks. In summary, our findings show that social interactions with more close social partners are associated with higher well-being regardless of modality and that digital text-based communication may play a compensatory role for older adults with smaller social networks. We discuss implications of these findings for future research.
A RETROSPECTIVE COHORT STUDY OF HOSPITAL DISCHARGE INSTRUCTIONS FOLLOWING DELIRIUM EPISODES
Authors: Golden Blair , Sonnentag David , Kaiksow Farah , Gilmore-Bykovskyi Andrea , Shah Manish , Inouye Sharon , Vasilevskis Eduard
Published: January 2025

Delirium impacts an estimated 25% of hospitalized older adults and is associated with adverse outcomes, including increased mortality. Delirium can persist or recur after discharge, and prompt recognition is critical. Caregiver education may improve delirium recognition and management in the post-acute care period, but it is unclear if delirium is routinely incorporated into hospital discharge instructions. We sought to characterize how clinicians communicate about delirium in written discharge instructions. We performed a retrospective chart review of a random sample of 50 hospitalized older adults (age ≥65) with delirium. Trained team members identified delirium diagnoses from discharge summaries and assessed all mentions of delirium within discharge instructions. We also identified new anti-psychotic or benzodiazepine prescriptions and neurology or geriatrics referrals, as these are routinely communicated at discharge and may represent indirect delirium instruction. Almost all (48, 96%) patients had personalized discharge instructions regarding at least one non-delirium hospital diagnosis, but only 2 cases (4%) had delirium included in discharge instructions. A quarter of instructions (13, 26%) had terms that could be considered synonyms for delirium (e.g., “confusion” (5), “altered mental status” (5)). Three cases (6%) had proxies for delirium instruction (new prescriptions or clinic referrals). Documentation trends were similar for populations from whom delirium instructions would be particularly important, including patients discharging home and persons living with dementia. These findings demonstrate a large gap between clinician recognition of delirium and instructions to patients and caregivers during a vulnerable transition period. Future work is critical to understand discharge educational needs surrounding delirium.
HOW ARE FAMILIES INVOLVED IN THE CARE OF HOSPITALIZED OLDER ADULTS? A QUALITATIVE EVIDENCE SYNTHESIS
Authors: Vick Judith , Fogleman Connor , Neiman Joseph , Cantrell Sarah , Selmanoff Mollie , Oyesanya Tolu , Goldstein Karen , Van Houtven Courtney
Published: January 2025

In the outpatient setting, roughly 36 million family members in the US assist with caregiving tasks for older adults including managing medications, coordinating care, communicating with clinicians, and assisting with activities of daily living. The roles and impact of family involvement during hospitalizations of older adults are less well described. To better understand family involvement during hospitalizations of older adults, we designed a systematic review of qualitative research known as a qualitative evidence synthesis. We assembled a multidisciplinary research team including members with expertise in nursing, internal medicine, library science, evidence synthesis, social work, and health services research. We developed a search strategy and executed it in four databases: MEDLINE (via Ovid), Embase (via Elsevier), PsycINFO (via Ovid), and CINAHL Complete (via EBSCO). Our search identified 6,157 articles, and our title/abstract screening yielded 157 articles for full text review. Preliminary analysis suggests that family members participate in many ways in the care of hospitalized older adults including giving information about patients, preventing and managing delirium, providing hands-on care, advocating for patients, aiding in decision-making, and planning for discharge. The quality of existing qualitative research on family involvement during hospitalizations of older adults varies widely. Most existing evidence comes from countries outside of the US. Ultimately, our findings will contribute to the refinement of a conceptual model that will establish a shared language for future multidisciplinary work, inform future intervention development, and support workflow and policy changes.
ORGANIZATIONAL BARRIERS TO INCLUDING CAREGIVERS OF HOSPITALIZED PATIENTS LIVING WITH DEMENTIA
Authors: Hoel Sydney , Still Catherine , Thuemling Teresa , Strayer Andrea , Werner Nicole , Fields Beth
Published: January 2025

Caregivers play a critical role in managing the health and well-being of hospitalized family members or friends living with Alzheimer’s disease and related dementias. Yet, caregivers often report feeling excluded in hospital care. In order to effectively include caregivers in hospital care, the organizational barriers to inclusion faced by clinicians must be addressed by healthcare systems. The objective of this study was to identify organizational barriers to including caregivers of hospitalized patients living with dementia. We conducted semi-structured interviews with clinicians (n=26) who provide care to patients living with dementia in the hospital setting. Participants were nurses (42%), doctors (19%), social workers (12%), and rehab professionals (19%), and had an average of 11 years of experience in their role. Interview data were analyzed using a team-based content analysis directed by the Systems Engineering Initiative for Patient Safety (SEIPS) framework. We identified 6 categories of organizational barriers: culture, staffing, communication, policies, collaboration, and teamwork. Specifically, clinicians noted that organizations tend to emphasize “quantity over quality” culture, de-incentivizing and reducing time for interaction with caregivers. Most clinicians perceived a lack of organization support to include caregivers and could not recall receiving training on how best to include caregivers. These findings indicate multiple opportunities for healthcare systems to better support and prepare clinicians to include caregivers in hospital care. Information gleaned from this study can be utilized to guide the development of a more inclusive hospital organization, consistent with Goal 2 of the 2022 National Strategy to Support Family Caregivers.
OBJECTIVE SLEEP QUALITY ASSOCIATES WITH PLASMA BIOMARKER FOR COGNITIVE IMPAIRMENT
Authors: Kim Jinyoung , Dangler Kevin , Nam Stephanie , Fudolig Miguel , Kinney Jefferson
Published: January 2025

Aim

Emerging evidence suggests that poor sleep (i.e., lack of sleep and low sleep quality) significantly impacts the risk of severe cognitive impairment. However, research on the use of sleep quality metrics as early predictors of cognitive impairment risk remains scarce. In this study, we investigated the association between objective sleep quality measures and plasma levels of Eotaxin-1, an early biomarker for cognitive impairment, among nurses.

Methods

We used data from 35 nurses who underwent multiple home sleep studies with electroencephalograms on workdays and days off were included. Objective sleep quality measurements included percentage of stage-3 non-rapid eye movement sleep in total sleep time (%N3) and wake time after sleep onset (WASO). Blood samples were collected in all participants and plasma levels of multiple cytokines (27Plex Cytokine array), including Eotaxin-1 were measured by Luminex multiplexing.

Results

Sleep quality indicators showed that WASO increased by 8% on days off compared to workdays, while %N3 decreased by 1% (p<.001). After adjusting for age, sex, shift, and BMI, higher WASO (β=1.22, p<.05) and lower %N3 (β=-5.09, p<.05) on workdays were significantly associated with increasing levels of Eotaxin-1. Sleep parameters on days off did not significantly correlate with Eotaxin-1 levels.

Conclusion

Our findings indicate a correlation between objective sleep quality measurements on workdays and an early biomarker of cognitive impairment. Further research is necessary to elucidate the underlying mechanisms linking sleep quality to future cognitive impairment, as well as to explore the potential differential associations of these parameters between workdays and days off.
THE BENEFITS OF CREATIVE ACTIVITIES FOR DIVERSE GROUPS OF OLDER ADULTS
Authors: Adams-Price Carolyn , McGovern Justine
Published: January 2025

Participation in creative activities is said to be beneficial for older adults and is often suggested for healthy cognitively intact and cognitively impaired populations. The purpose of this symposium will be to explore the benefits of different kinds of creative programs and interventions offered to diverse groups of older adults of different ability levels. The first paper in this symposium will discuss theory and the psychosocial context of creativity in older adults. The observed and hypothetical benefits will also be discussed from different frameworks, including life-span developmental psychology and dementia studies. LaVona Traywick will present the physical and emotional benefits of her dance program with older adults with Parkinson’s disease. Jennifer Dorris will discuss her experience incorporating music into her activities with older Down’s syndrome patients. Justine McGovern will be a discussant for this session, tying together the different presentations.
THE BENEFITS OF CREATIVE ARTS INTERVENTIONS FOR OLDER ADULTS: THE SOCIOCULTURAL MODEL AND THE DEMENTIA STUDIES MODEL
Authors: Adams-Price Carolyn
Published: January 2025

Over the past 25 years, there has been a huge increase in the employment of interventions for older adults that incorporate as a primary feature participation in creative activities. Interventions have focused on art domains as distinct as photography, dance, music, traditional handicrafts (such as quilting or pottery), and many others. In addition, programs have been created for older adults with a huge range of ability levels and cognitive efficacy, from highly functioning older adults to older adults with severe cognitive deficits. The purpose of this paper will be to describe the benefits of creative interventions for different types of older adults with different types of capabilities. Two different perspectives will be highlighted; including the sociocultural model of creativity, which is linked to life-span developmental psychology, and the dementia studies model, which derives from holistic and qualitative approaches to aging. The paper will discuss the ways in which these two approaches are fundamentally different, and the ways in which they are similar, and discuss what they have to say about the nature of creativity.
DANCE AS A CREATIVE ARTS PROGRAM FOR SEINOR ADULTS WITH PARKINSON’S DISEASE AND THEIR CAREGIVERS
Authors: Traywick LaVona
Published: January 2025

The Dance with PD (Parkinson’s Disease) program is offered as a free community creative arts outreach program by Arkansas Colleges of Health Education (ACHE), Research Institute Health & Wellness Center for individuals with PD and their care partners. Dance with PD is a therapeutic approach to programming that involves dance and movements as a form of therapy for individuals living with Parkinson’s Disease. The program aims to improve mobility, balance, coordination, and overall quality of life through structured dance exercises and routines. The program is offered by a trained instructor and the sessions are tailored to the specific needs and abilities of the participants. Volunteer assistants are students from ACHE’s medical college. The class is offered once a week for one hour to mimic a traditional dance class. Due to the rolling admission, participants have attended for different lengths of time when they complete their assessments. The Dynamic Gait Index (DGI), Falls Efficacy Scale, and Geriatric Depression Scale—short form are administered each semester and compared to attendance records.
THE BLUES AND OLDER MINORITY MUSICIANS: MORE THAN JUST MUSIC XXXI
Authors: Migliaccio John , Marcus Michael
Published: January 2025

The Blues may have emerged in the Mississippi Delta but its influence and music is mightily represented today in the Puget Sound! Seattle’s Blues Bash, Blues Awards, and the Rhapsody Project make intergenerational cultural connections between the Blues and the community by tuning into cultural heritage exploration and social justice. With a lively array of bars, clubs, and iconic Blues musicians with insights into their lives, influences, resilience and productive aging this popular session draws an enthusiastic crowd of GSA members for a lecture/interview and “mini-performance” with leading older musician. But Wait! Theres more- later that evening, a full performance and party at a local Blues joint guarantees good music, dancing, libations, and Blues swag. This is a “don’t miss” combo with 31 years of GSA history.
THE BLUES AND OLDER MINORITY MUSICIANS: MORE THAN JUST MUSIC XXXI
Authors: Migliaccio John
Published: January 2025

The Blues and Older Minority Musicians: More Than Just Music has been a session at GSA for 31 years straight.
THE BLUES AND OLDER MINORITY MUSICIANS: MORE THAN JUST MUSIC XXXI
Authors: Marcus Michael
Published: January 2025

This session has been a popular academic and social event since 1993. We’re on a mission from God.
DO FUNCTIONAL ABILITY MEASURES IMPROVE THE ACCURACY OF A 12-MONTH MORTALITY PREDICTION MODEL?
Authors: Luth Elizabeth , Bowles Kathryn , Brickner Carlin , Gao Oude , Rakotoarivelo Harivony
Published: January 2025

Mortality prediction algorithms using administrative claims data can help identify seriously ill individuals eligible for palliative care. However, predefined measures of functional ability, which clinicians report as important for eligibility determinations, may be inadvertently omitted or underweighted in the algorithm general design. In response to clinician input, we developed measures of functional ability using claims data and examined their association with death: activities of daily living (ADL) support, feeding support, respiratory support, physical and occupational therapy (PT/OT), and skilled nursing. Descriptive statistics were calculated. Multivariable logistic regression tested associations between five functional ability measures, symptom management, and death for Medicare Advantage plan members on census during the July 2022-June 2023 period. Of the 6625 Medicare Advantage plan members, 32% identified as Black, 32% White, 9% as Asian, and 26% as Other races; 37% as Hispanic/Latino; 69% female; average age of 73.5 years (SD: 11.8). Of these, 186 (4.6%) died the following year. Having PT/OT was associated with 24% lower odds of death (aOR: 0.76, 95%CI: 0.62-0.85, p< 0001). Receiving respiratory support was associated with 45% higher odds of death (aOR: 1.45, 95%CI: 1.17-1.78, p< 0.001). ADL support, feeding support, and skilled nursing were not associated with death. These functional ability measures, while not directly measured in claims data, were successfully approximated. Oxygen and ventilation use and PT/OT were associated with 12-month mortality, in opposite directions. Future work should examine how other factors used by clinicians for PC eligibility determinations can be measured using administrative claims data and their associations with mortality.
A LONGITUDINAL INVESTIGATION OF ALCOHOL USAGE AND COGNITIVE OUTCOMES AMONG HISPANIC/LATINO ADULTS
Authors: Lemus Armando , Araujo-Menendez Carlos , Carpio Rubi , Stickel Ariana
Published: January 2025

High alcohol use may lead to cognitive deficits and is recognized as a modifiable risk factor for dementia. However, recent cross-sectional research is contradictory: low to moderate alcohol may be protective against cognitive performance. The present study aimed to investigate the associations between alcohol use and cognitive decline within Hispanic/Latino adults, a community often underrepresented in the research field. Participants included 336 self-identified Hispanic/Latino adults (67% female; ages 65 - 92 years, M = 73.29 years, SD=5.5) without dementia from the National Alzheimer’s Coordinating Center dataset collected from 33 sites between 2015 – 2022. Alcohol use was assessed through self-reported consumption of any alcohol in the past 3 months (yes or no). Outcomes included cognitive tests administered to participants at a minimum of two visits. Using linear mixed models, we analyzed the relationships between alcohol use and cognitive trajectories, including possible modifications by sex and depressive symptoms (as assessed by the Geriatric Depression Scale), while adjusting for age, education, and cognitive status at baseline. Our results indicate that individuals who consumed alcohol performed better at baseline, (all F’s ≥ 6.187, all p’s < 0.01) but declined at the same rate across all cognitive tests, except for language. We did not detect significant modifications. Our results suggest that alcohol use is not protective against cognitive aging among Latino adults. However, additional measures (e.g., number of binges in a month) are needed to better understand its impact on dementia risk.
ASSESSING FALLS RISK AND BALANCE SYSTEMS PROTOCOLS IN ADULT CANCER SURVIVORS
Authors: Marrone-Lloyd Kenzi , Nielsen Kelli , Christopher Emma , Hinrichs Raegan , O’Donnell Caitlin , Gilchrist Laura
Published: January 2025

Adult cancer survivors have been shown to have an elevated risk of falling compared to control. These risks are hypothesized to be residual effects of chemotherapy treatment that can impact patients’ balance long-term through changes to vestibular, visual, and somatosensation systems. Medical providers and rehabilitation professionals may be asked to screen for fall risk, yet best screening measures for these balance system changes have not been identified. The purpose of this study is to determine if balance assessment outcomes differ between adult cancer survivors and control groups and if these balance outcomes are associated with prior falls history. Twenty participants underwent a series of sensory organization testing (SOT) using computerized posturography (BERTEC) and the MiniBest Test, which measures dynamic balance, gait and functional mobility. Cancer survivors (n=10) fell more than their control (n=10) counterparts (X²=3.81, p=0.050). On the SOT, cancer survivors (88.2 ± 13.4) had a preference for vision, even when distorted, compared to control (100.3 ± 11.9) (t=2.14, p=.023) however, scores for all other tests were not different between groups (p>0.05). This preliminary data supports that cancer survivors fall more often than non-cancer survivors and that cancer survivors rely more on vision, as a means to maintain balance. Indicating that other balance systems may be unreliable or damaged. Continued development of screening tools to gauge the impact of cancer on balance and fall risk is indicated to improve the care of cancer survivors.
EFFECTS OF HDC-KNOCKOUT ON MITOCHONDRIAL FUNCTION AND SKELETAL MUSCLE IN BALB/C MICE
Authors: Hall Leighanna , sayles anijah
Published: January 2025

Histamine is a signaling molecule widely associated with inflammatory and anaphylactoid responses. It is synthesized by the decarboxylation of L-histidine by an enzyme called histamine decarboxylase (HDC) that is mainly located in mast cells. According to previous study we obtained BALB/c mice with histamine knockout (KO) as well as wild type (WT) control that we confirmed through genotyping (the knockout of the HDC enzyme would further be confirmed through western blotting and histamine assay).Techniques used were; familiarization of exercise, examining the muscle fiber diameter of tibialis anterior using microscopy, and recording the muscle weight and mitochondrial data set to assess if the HDC knockout effected these measurements. Results suggest that HDC-KO confirmation requires a larger data set, future steps involve western blots and histamine assays.
EVIDENCE SUPPORTING CERAMIDE ACCUMULATION AS A NOVEL HALLMARK OF AGING
Authors: Scroggins Laila , Echevarria Klarisse , Gutierrez Eduardo , Palavicini Juan , Quiles Penelope
Published: January 2025

Aging is the single greatest risk factor for all major chronic diseases, and thus, understanding the biological mechanisms that modulate aging is critical for the development of health-maximizing interventions. Lipids are small hydrophobic molecules that not only serve as fundamental cellular components, but also act as important cellular signaling molecules, with well-established roles in nutrition, health, and disease. The first longevity gene discovered in yeast, i.e. the longevity-assurance gene (LAG1), encodes an enzyme that synthesizes ceramides, a lipid class that has been associated with insulin resistance, apoptosis, mitochondrial dysfunction, senescence, inflammation, sarcopenia, frailty, among other age-related pathways and phenotypes. Using a number of animal models and methodologies, we have amassed a significant amount of data that place ceramides as a novel major driver of aging. Specifically, we found that: (1) ceramides consistently accumulate with age in circulation and in multiple organs in multiple mouse strains and marmosets; (2) circulating ceramides are dramatically reduced in long-lived isolated growth hormone deficient mice; (3) hepatic ceramides are substantially reduced in old marmosets treated with rapamycin, a well-established anti-aging drug, through a mechanisms that seems to involve an acid ceramidase (ASAH1); (4) low doses of myriocin, a potent inhibitor of ceramide synthesis, improves healthspan (i.e. glucose homeostasis and grip strength) in WT C57BL/6J, Balb/c, and UM-HET3 mice fed with Western diet. In addition, preliminary data suggests that myriocin significantly extends lifespan in mice as well. Taken together, our results place ceramide accumulation as a novel driver of aging.
HEPATIC STELLATE CELLS ARE A MAJOR COLLAGEN PRODUCING CELLS IN THE LIVER AND DRIVE LOCAL LIVER FIBROSIS
Authors: Iluobe Victory , Zhao Shangang
Published: January 2025

Hepatic stellate cells (HSCs) are the major collagen-producing cells in the liver and key drivers of local fibrosis. Adiponectin, is also expressed in quiescent HSCs and plays a role in the progression of liver fibrosis. To assess adiponectin’s effects on fibrosis progression mice line models were crossed using these models liver fibrosis progression either progressed or reduced. We moreover show that adiponectin expression in HSCs correlates positively with that of PPARγ, suggesting a mechanistic involvement of this transcription factor. The involvement of this transcription factor has a marked influence on the progression of local fibrosis.
IBA1 EXPRESSION IN THE HIPPOCAMPUS OF APOLIPOPROTEIN EPSILON 4 SALT-TREATED MICE
Authors: Major Chloe’ , Rivers Mia , Khundmiri Syed , O’neil Jahn
Published: January 2025

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by a decline in cognitive abilities, memory loss, and heightened neuroinflammation. The presence of the APOE4 allele is the most significant genetic risk factor for AD, known to accelerate the onset and progression of the disease by interacting with hallmark features such as beta-amyloid plaques and neurofibrillary tau tangles. Additionally, APOE4 directly impairs microglial function in AD leading to neuroinflammation, further contributing to neurodegeneration. While the relationship between AD and dietary habits or comorbid conditions, particularly hypertension, remains unclear, we hypothesize that high dietary salt intake will exacerbate neuroinflammation within the hippocampus of APOE4-expressing mice, providing a potential mechanistic link between diet, hypertension, and Alzheimer’s disease. To test this hypothesis, we utilized mice that exclusively expressed human APOE4 or the control APOE3 in the brain. Young adult male and female mice, aged 5–7 months old (n=18 in each group), were given a 4% NaCl (high salt) or a 0.1% NaCl (low salt) diet for 4 weeks. Using design-based stereology, we evaluated the total count of Iba1 positive microglia in the hippocampus of APOE4 expressing mice and the control APOE3 mice. Preliminary results show APOE4 mice exhibit significant neuroinflammation in the hippocampus when compared to APOE3 mice. However, the APOE4 low-salt diet was seen to be beneficial. Further work is needed, and results will be discussed.