bluuebunny/crossref_metadata_2025 huggingface dataset:
AN INNOVATIVE APPROACH TO EXPANDING AGING SERVICES ACCESS IN RURAL COMMUNITIES: RURAL AGING ACTION NETWORK
Authors: Wylie Molly , Washington Ashley , Cimarolli Verena , Stone Robyn
Published: January 2025

A significant share of older adults live in rural areas and wish to remain in their homes and communities. Aging in rural communities poses unique challenges that can limit access to healthcare, transportation, and other services that promote independence. To address these challenges, Lutheran Services in America (LSA) developed Rural Aging Action Network (RAAN), an innovative collaborative that leverages existing community-based services and supports for older adults who are underserved in rural communities of Minnesota, Montana, North Dakota, and South Dakota. A mixed-method evaluation of RAAN was conducted over a three-year period to assess the extent of community need, the network’s effectiveness in addressing care gaps, and lessons learned in implementing RAAN. Descriptive analyses of client-level data showed that 483 older adults have been in contact with the network, and over half (55%) were referred to services. Chi-square tests indicated that older adults with restricted incomes were significantly more likely to be referred to any service than older adults whose incomes meet their needs (69% versus 31% respectively, X2 (1, N = 258) = 9.8, p =.002)), suggesting RAAN’s effectiveness in reaching low-income populations. Focus groups and interviews with 12 older adults and 9 caregivers found that transportation, technology training, and English translation remain service gaps in the community. Respondents expressed the value of RAAN in raising awareness about available services and providing a one-stop-shop for aging resources. This evaluation can help inform the implementation of similar networks in rural communities nationwide.
BARRIERS AND FACILITATORS TO TECHNOLOGY USE AMONG RURAL CAREGIVERS OF PEOPLE LIVING WITH DEMENTIA
Authors: Boucher Sarah , Jolliff Anna , Zuraw Matthew , Elliot Christian , Werner Nicole
Published: January 2025

Caregivers of people living with Alzheimer’s disease or related dementias (ADRD) who live in rural areas experience more difficulty in accessing resources to support caregiving. Technology may be a promising tool to connect rural caregivers to support. However, little is known about rural ADRD caregivers’ technology use. The objective of this study was to assess the barriers and facilitators to technology use among ADRD caregivers living in rural communities. In this qualitative study, rural caregivers of people living with ADRD were recruited through community partners to complete virtual semi-structured interviews. Interview questions focused on formal and informal supports used by caregivers and the role of technology in accessing those supports. Two coders completed an inductive, iterative thematic analysis. Caregivers (N=19) were 73.7% female and had a mean age of 66.4(SD=10.1). Within the sample, 57.9% of caregivers were caring for a partner, while 31.6% cared for a parent or parent-in-law. Analyses resulted in fourteen codes, which were combined into three themes. Barriers and facilitators to technology use included 1) systemic influences, such as access to technology and support with using it; 2) alignment between technologies available and caregivers’ informational needs; and 3) a preference for technological versus in-person support, including features of technology that influence this preference. The results of this study demonstrate systemic barriers that must be addressed when introducing technology-based interventions to rural caregivers. Further, results point to enhancements that can be made to technology-based interventions to improve their usefulness to rural caregivers.
FOUR-YEAR LONELINESS TRAJECTORY AND ITS PREDICTORS IN OLDER ADULTS
Authors: Huang Yan , Martire Lynn , Jones Damon
Published: January 2025

Loneliness is a modifiable risk factor for health decline in older adults and its level may change over time. This study aimed to explore how loneliness changes on average across 4 years in older adults and investigate potential predictors accounting for the formation of this trajectory. Data were collected annually between 2017 to 2020 from 128 older adults (Mage = 77.91) in independent-living or retirement communities in the U.S. Growth curve modeling showed a quadratic model best fit the loneliness trajectory with significant fixed effects of the intercept (b = 2.497, p < 0.001); the linear slope of time (b = -0.036, p = 0.009); and the quadratic term of time (b = 0.002, p < 0.001) as well as three significant random effects (ps < 0.05). The quadratic trajectory showed the level of loneliness decreased first and then increased with individual differences in the intercept and rate of change. We further found being married, having more family and friends, and receiving greater social support at baseline were negatively linked to the overall levels of loneliness. By contrast, living alone, having social strain, depressive symptoms, and difficulty with social participation were positively linked. When including all significant individual variables, only depressive symptoms were still significant (b = 1.850, p < 0.001). Findings suggest the loneliness trajectory follows a nonlinear trend. Baseline relationship and health factors, especially depressive symptoms, are linked to the average level of loneliness at baseline. The COVID-19 pandemic may have influenced the uptick in loneliness in 2020.
FACTORS AFFECTING IMPLEMENTATION OF SOCIALLY ASSISTIVE ROBOTS IN LONG-TERM CARE FACILITIES
Authors: Tate Judith , Maxwell Cathy , Migovich Miroslava , Khan Nibraas , Ghosh Ritam , Colopietro Kelley , Kilpatrick Abigail , Sarkar Nilanjan
Published: January 2025

Older adult residents in long term care (LTC) often experience apathy. Technology can provide support for addressing the older adults’ psychosocial needs. However, introducing new technology into LTCs can be challenging. As part of a randomized clinical trial on socially assistive robots (SAR) in LTCs to engage older adult dyads in activities, we examined determinants to implementation. Seventeen LTCs participated in the study, ranging in size from 24 to 132 participants; 53% were not-for-profit. All robot sessions were conducted by trained research staff. Each participant attended 16 sessions averaging 30 minutes over 8 weeks; half with an animal SAR and half with a humanoid SAR. Research assistants noted observations of the SAR, participant, staff, and facility environment and conducted interviews at the conclusion of the experiment. Sixty older adults participated (62% women, ages 60 to 98). Common SAR barriers included internet connections, equipment breakage, and speaker volume. Participant barriers included paranoia, dislike of partner, hearing and vision, level of cognitive impairment, and acute illness. Staff issues consisted of workflow issues and knowledge of the research. Facility issues included competing demands that interrupted scheduling and rollout, physical area for conduct of experiments, noise and lighting, and communication among key staff. Successful implementation and sustainability of new technology, including SAR, will depend upon addressing multiple barriers at the resident, staff, and facility levels.
BLOOD PRESSURE MONITORING BY CAREGIVERS: EXAMINING THE INTERSECTION OF ALZHEIMER’S DISEASE AND HYPERTENSION
Authors: Regos-Stewart Dalia , Barragan Noel , Fraser Renee , Kuo Tony
Published: January 2025

Older adults (OA) experience a high prevalence of comorbid chronic conditions, for which they oftentimes rely on the aid of unpaid caregivers. OA with Alzheimer’s disease (Alzheimer’s) are particularly reliant on these caregivers to monitor their health. For example, hypertension can be highly prevalent in this group, predisposing them to a variety of heart-brain complications. Yet, in spite of emerging evidence of home blood pressure monitoring’s (HBPM’s) effectiveness, caregivers do not always perform nor view this duty as essential. To date, little is known about their experiences with monitoring/managing hypertension. To address this gap in practice, an online panel survey of U.S. caregivers was conducted July-August, 2023. Overall, 600 caregivers (18+ years) of adults (45+ years) participated in the survey; 29% (n=175) provided care to a person with Alzheimer’s. A majority reported monitoring chronic conditions, administering medications, managing medical appointments, and measuring BP. Among those who measure BP, 90% reported feeling confident in their ability to do so accurately; 70% measure it daily/few times a week. A higher proportion of caregivers who work with OA with Alzheimer’s (versus without) reported receiving proper training for measuring BP (50% vs. 45%). The former group reported cultural, language, and transportation barriers to receiving BP monitoring information from health professionals, compared to the latter group (28% vs. 20%). Rich insights about caregivers’ experiences with hypertension management were gleaned from this survey. They suggest opportunities where medicine and public health can further assist caregivers, especially caregivers who are helping OA with Alzheimer’s.
CARE PRIORITIES AND PREFERENCES OF PEOPLE LIVING WITH DEMENTIA DURING EMERGENCY DEPARTMENT VISITS
Authors: Benson Clark , Merss Kristin , Vergenz Laura , Dillon Kayla , Block Laura , Gilmore-Bykovskyi Andrea
Published: January 2025

Over half of the 6 million persons living with dementia (PLWD) in the United States visit an Emergency Department (ED) annually. Dementia is often under-recognized in the ED, and visits are associated with significant adverse outcomes for PLWD. Yet, little is known about the perspective and priorities of PLWD and their caregivers regarding ED care. In this descriptive qualitative study, we examined the priorities of PLWD and caregivers during ED visits. We recruited patients living with dementia from a large academic ED with options to participate in a semi-structured interview during or after their ED visit and individually or dyadically with a caregiver. All PLWD completed capacity assessments prior to the interview. Capacity assessments were completed for all PLWD participants. We iteratively analyzed interviews using thematic analysis. We conducted interviews with 33 participants (N=10 PLWD, 15 caregivers, 4 dyads). PLWD and caregivers largely evaluated the ED experience positively. Findings highlight aspects of ED care uniformly shared among participants, including being informed at every step. Our findings also describe individually specific values and preferences such as approach to decision-making; as well as conditions that shape priorities across the experience such as degree of uncertainty. Both PLWD and caregivers value feeling informed in the ED and cite the importance of awareness of the impact of cognition on care. Our findings will support the development of patient-centered assessment tools to evaluate PLWD ED care experiences, enabling proximal and sensitive evaluation of within ED care practices for this vulnerable population.
DEMOGRAPHICS’ IMPACT ON CURRENT AND NOVEL NEUROPSYCHOLOGICAL MEASURES FOR ALZHEIMER’S DISEASE SCREENING
Authors: Reed Alexandra , Duff Kevin , Schaefer Sydney
Published: January 2025

Neuropsychological assessments are often affected by demographic factors, such as age, education, and sex. These demographic variables frequently lead to differences in test scores between minorities and non-minorities, lowering diagnostic accuracy of Alzheimer’s disease (AD) among minoritized groups. A new test (quick Behavioral Exam to Advance Neuropsychological Screening, or qBEANS) has been developed to assess early signs of AD. This study compared the influence of demographic variables on qBEANS and other neuropsychological tests that are commonly used in the assessment of AD. In this study, 165 participants (68 cognitively unimpaired; 52 amnestic Mild Cognitive Impairment; 45 mild AD) completed the Symbol Digit Modalities Test (SDMT), Hopkins Verbal Learning Test-Revised (HVLTR); Brief Visuospatial Memory Test-Revised (BVMTR); and Trails Making Test (TMT) A and B. Participants also completed the qBEANS, which involves spooning two raw kidney beans at once with the nondominant hand to one of three target cups in a simple sequence, with higher scores being worse performance. Results indicated that significant age effects were observed for all tests except qBEANS and TMT-A, with older ages being associated with worse scores. Similarly, there were significant education effects for all tests except qBEANS and TMTs A and B. Only the HVLTR (total and delayed recall) showed a significant sex effect, with females performing better than males. These data suggest that qBEANS may be appropriate for screening diverse populations without controlling for demographic variables.
FUNCTIONAL OUTCOMES IN HOME HEALTH STAY FOR PEOPLE WITH DEMENTIA: INTERSECTIONALITY OF GENDER AND RACE
Authors: Basu Rashmita
Published: January 2025

This study explores the difference in functional outcomes of Medicare beneficiaries during a home health (HH) admission across the intersectionality of race and gender because these outcomes may be by virtue of their gender and racial/ethnic composition. This cohort study used data from the 2019 Outcome and Assessment Information Set (OASIS) and Medicare claims (Home Health (HH) and inpatient), enrollment, and Chronic Condition Warehouse (CCW) files from the CMS. Functional outcome was measured as a change in the composite ADL score (grooming, bathing, toileting, dressing, walking, transferring, ambulation, and hygiene) from HH admission to HH discharge. Binary logistic regressions with an outcome variable (1/0: if the composite score was ≤0 (improvement/static) at discharge (1), and 0 if > 0 (decline) during HH admission) were performed. The ADRD cohort was identified based on CCW criteria and ICD-10 codes from inpatient and HH claims. The independent predictor was a six-category intersectionality variable that included White female (reference), White male, Black female, Black female, other female, and other male. The analysis included 81,735 Medicare beneficiaries with ADRD, contributing to 174,093 home health stays. Adjusting for patients’ demographics (age, sex, race/ethnicity), number of diagnoses, caregiving support, and MA enrollment, compared to White females, all the other groups were 3% (95% CI:1.01-1.06) to 18% (95% CI: 1.08-1.26) more likely to have improvement or maintenance of ADL composite score from HH admission to discharge. The combination of gender and race/ethnicity composition is critical in examining the functional outcomes of Medicare beneficiaries using postacute care.
MAPPING ASSISTIVE TECHNOLOGIES ON THE PROGRESSION OF ALZHEIMER’S DISEASE: A SCOPING REVIEW
Authors: Mirjan Nadia , Zecevic Aleksandra
Published: January 2025

A growing population of people living with Alzheimer’s Disease urges improved support for aging in place and with dignity. Assistive technologies (ATs) can be used to delay institutionalization, reduce caregiver burden, and improve quality of life for this population and their care partners. The abilities and needs of this population change during disease progression, requiring a better understanding of which ATs could be used at each stage of the disease. The purpose of this scoping review is to generate knowledge on how ATs can be mapped on seven stages of Alzheimer’s Disease progression described by the Global Deterioration Scale. The review follows the Arksey and O’Malley framework to identify and harvest information from Medline OVID, Scopus, CINAHL, and Embase OVID databases. Inclusion criteria were Alzheimer’s Disease, technology interventions of any type and duration, English language, and the time frame between 2000-2023. Data was extracted and thematically analyzed using six predetermined domains of ATs for dementia, namely safety devices, clinical devices, memory aids, ATs for preventing social isolation, ATs for leisure activities, and ATs for supporting everyday tasks. A total of 53 articles were included. Findings show that a variety of ATs are available throughout the disease progression. High technology (e.g., tracking devices) mainly target early stages, while low technology (e.g., weighted blanket) target later stages. Some, such as music therapy, are present at every stage of disease. The map has the potential to inform people with dementia, care partners, technology companies, distributors, policy makers and service providers.
PREVENTABLE HOSPITALIZATIONS IN ADULTS WITH ALZHEIMER’S DISEASE AND RELATED DEMENTIAS, 2016–2019
Authors: Walker Jenny , Patel Roshni , Olivari Benjamin , Taylor Christopher , Baumgart Matthew , McGuire Lisa
Published: January 2025

Reducing preventable hospitalizations in adults with Alzheimer’s disease and related dementias (ADRD) is a public health and National Healthy People 2023 priority because the associated negative health and financial outcomes may be avoidable through proactive primary and outpatient care recognizing and managing co-morbidities. This study used data from the 2016–2019 Healthcare Cost Utilization Project National Inpatient Sample, an all-payer inpatient care database. Using ICD-10-CM codes, we identified 8 conditions that are potentially preventable, including acute and chronic ambulatory care sensitive conditions and injuries. Of the hospital discharges among adults aged ≥45 years with ≥1 of 11 conditions (n=4,611,423), 11.2% (95%CI=11.1-11.3) also listed an accompanying ADRD diagnosis for the patient. Among adults with an ADRD diagnosis, the proportion of potentially preventable hospitalizations increased linearly with age, with 82.4% (95%CI=82.2-82.5) of potentially preventable hospitalizations occurring among those aged ≥75 years. In contrast, potentially preventable hospitalizations among those without ADRD skewed younger, with only 34.2% (95%CI=34.0-34.4) occurring among those aged ≥75 years. Of the 8 potentially preventable conditions, most common among those with ADRD were sepsis (34.1%), injuries (21.1%), urinary tract infections (UTIs; 14.0%), and heart failure (12.9%). Adults with ADRD were more likely to be hospitalized due to UTIs than those without ADRD (adjusted prevalence ratio=2.34 (95%CI=2.32-2.37)), even after adjusting for sex, age, and long-term care facility residency. Future public health measures, policy, and programs with targeted ADRD hospitalization prevention goals may potentially mitigate the issue, with special attention to increased risk of hospitalization due to older age and UTIs.
METABOLOMIC AND IMMUNOLOGIC INSIGHTS INTO RACIAL DIFFERENCES IN REPRODUCTIVE AGING
Authors: Borgogna Joanna-Lynn , Holm Johanna , Ravel Jacques , Brotman Rebecca , Voyich Jovanka , Yeoman Carl , Shardell Michelle
Published: January 2025

Menopause is linked to declining levels of estrogen, loss of protective vaginal lactobacilli, and age-related comorbidities. Vaginal metabolites reflect metabolic activity of the microbiota and human host, along with exogenous influences, and can modify susceptibility to multiple pathologies. Racial/ethnic minorities experience earlier and more intense symptoms of menopause but are underrepresented in reproductive aging studies. To address these gaps, we applied 16S rRNA gene sequencing, untargeted metabolomics, and cytokine profiling to characterize the vaginal microenvironment across reproductive stages, with an emphasis on comparisons between post-menopausal racial/ethnic groups. 476 participants (aged 35-60 years) contributed semiannual person-visits over two years (N=1,153 samples). Bayesian mixed-effects regression of log2-transformed metabolites (n=770) assessed metabolomic differences in samples from pre- (n=287), peri (n=335), and post-menopausal (n=531) participants, 25% of whom were racial/ethnic minorities. Samples collected from post-menopausal participants had distinct metabolomic profiles compared to pre- or peri-menopausal samples (548 metabolites were lower in post-menopausal samples; p< 0.05). After adjustment for vaginal microbiota, post-menopausal samples had lower concentrations of most micronutrients (e.g., vitamins B, C, and D; p< 0.05). Metabolites reflecting epithelial damage and oxidative stress, along with host-produced lysophospholipids (e.g., lactosyl-N-palmitoyl-sphingosine), were highest in samples from post-menopausal participants (p< 0.05), with post-menopausal Black participants having the highest levels (relative to post-menopausal white participants, and non-postmenopausal Black or white participants) (p< 0.05). Lysophospholipids are immunogenic, and many were positively correlated with TNF-α, but negatively correlated with IL-19. Further investigations linking menopause and race/ethnicity with inflammatory or oxidative stress-related metabolites are needed to reduce disparities in healthy reproductive aging.
CHILDBEARING STATUS, PARITY, AND COGNITIVE HEALTH AT MIDLIFE: A LONGITUDINAL APPROACH
Authors: Thomeer Mieke , Wolfe Joseph , Reczek Rin , Ferguson Dee , Cao Rui
Published: January 2025

Childbearing histories matter for multiple health outcomes across the life course. Further, there is growing evidence that childbearing may also shape mid- and later-life cognitive health, although previous research is limited due to difficulty in accounting for the role of selection. Multiple factors that place women at risk for specific childbearing experiences also place them at risk for poor cognitive health—including socioeconomic background, health issues in early life, and cognitive ability in adolescence. We advance research by analyzing the 1979 National Longitudinal Survey of Youth (NLSY79) (N=2,257), a longitudinal nationally representative dataset from the US that began collecting data when women were in their late teens and early 20s. Final models account for a large array of social, economic, demographic, cognition, and health variables to estimate how childbearing histories matter for three cognitive health outcomes at age 48. In unadjusted models, we find that childbearing status, parity, and age at first birth are associated with self-reported memory and word recall, and age at first birth is also associated with backwards number counting. In fully adjusted and matched models, the only significant differences relate to memory. In future analysis, we will examine which specific factors drive associations, incorporate cognitive health at age 60, and replicate analyses in additional datasets. We demonstrate the role of childbearing as a determinant of cognitive health, suggesting the need to incorporate childbearing into life course models of dementia risk. We also draw attention to the importance of considering selection when identifying social determinants of cognitive health.
COGNITIVE GROWTH AND DISPERSION AT MIDLIFE: IMPLICATIONS FOR COGNITIVE MAINTENANCE AND RESERVE
Authors: Reynolds Chandra , Zheng Anqing , Muñoz Elizabeth , Corley Robin , Wadsworth Sally
Published: January 2025

Dispersion in performance across cognitive tasks provides a unique perspective of cognitive functioning beyond overall performance and may be predictive of poorer memory and dementia risk in older adults. What dispersion indexes at earlier age periods is unclear, although a lifespan perspective may provide an earlier window on cognitive specialization and reserve at the cusp of midlife. We sought to evaluate individual differences in dispersion in growth from adolescence and at midlife. Using twin and sibling data from the Colorado Adoption Twin Study of Lifespan behavioral development and cognitive aging (CATSLife1; N = 1245, MAge = 33.30, SD = 5.00, 53% Female), we evaluated dispersion using a latent model approach across tasks from a specific cognitive ability (SCA) battery, referencing age 16 and CATSLife1 assessment norms, and WAIS-III subtests at CATSLife1. At midlife, overall performance was modestly positively correlated with dispersion for the SCA tasks and the WAIS-III subtests (r=0.07 and 0.37). Referencing age 16 norms, SCA performance was correlated with dispersion at 0.88, suggesting differential growth from age 16 correlates strongly with CATSLife1 performance. Education predicted more dispersion referencing age 16 norms (B=0.41; CI=0.31 to 0.48], but not midlife dispersion for SCA or WAIS-III. Sibling similarity for the latent dispersion measures were moderate for identical (MZ) twins (r’s=0.55-0.86) and smaller for fraternal twins (DZ) (r’s=0.26-0.60), other biological siblings (r’s=0.10-0.36), and siblings in adoptive families (r’s=-0.15-0.11). Dispersion in growth may reflect differential specialization with implications to reserve, whereas variability in performance at midlife may be reflective of differences in maintenance.
EYE MOVEMENTS REVEAL AGE DIFFERENCES IN HOW AROUSAL MODULATES MECHANISMS OF ATTENTIONAL CONTROL
Authors: Kim Andy , Nguyen Kristine , Mather Mara
Published: January 2025

The arousal-biased competition theory posits that inducing arousal increases attentional priority of salient stimuli while reducing priority of non-salient stimuli. However, older adults are hypothesized to exhibit dysfunction in the locus coeruleus-noradrenaline system that mediates both global arousal and attentional control. Unlike in young adults, older adults primarily do not exhibit shifts in attentional priority under increased arousal. However, the mechanism of how arousal biases attention in older adults is conflicting. We investigated whether the threat of unpredictable shock exhibits age differences in modulating multiple mechanisms of attentional control by observing eye movements. Participants completed two oculomotor search tasks in which the salient distractor is reactively disengaged (singleton search) or proactively suppressed (feature search). During singleton search, young adults made more first saccades toward the salient distractor when under the threat of shock. However, older adults did not exhibit changes in attentional priority for any stimuli under increased arousal. Our findings reveal older adults do not exhibit elevated priority for salient stimuli because arousal does not lead to shifts in priority. Furthermore, we observed that arousal did not affect the speed of attention processing in both age groups and that proactive suppression of the distractor persisted despite elevated priority. Lastly, we demonstrated that threat of shock modulated the locus coeruleus-noradrenaline system as seen with pupillometry and that evoked pupil responses are correlated with oculomotor function. Using a systems neuroscience approach, our findings demonstrate age differences in how the locus coeruleus-noradrenaline system interacts with neural networks of attention and oculomotor function.
ECOLOGICAL MOMENTARY ASSESSMENT AND MACHINE LEARNING FOR PREDICTING DEPRESSION AMONG OLDER ADULTS
Authors: Jiang Nan , Chen Ke , Xiao Yexuan , Lou Vivian Weiqun
Published: January 2025

Depression represents a significant global health concern, particularly among older populations. While numerous studies have focused on investigating chronic stressors, the precise predictive impact of daily experiences on depression remains uncertain. The objective of this study was to assess the extent to which mood fluctuations, daily stressors, contextual stressful events, and psychophysiological responses experienced by older adults with functional decline may predict later short- and long-term depression. This study employed a combination of longitudinal investigation and ecological momentary assessment (EMA) to collect data on the mood status and stressful events of older adults with functional limitation. Data were gathered 2 times per day over a 14-day period and followed up with a revisit one year later. To predict long-term depression, the study explored several approaches using machine learning techniques.These included analyzing chronic stress baseline data (baseline approach), examining dynamic patterns of mood states and stressful events through EMA approach, and combining baseline data with dynamic patterns (EMA plus baseline approach). A total of 166 older adults participated in the study. The baseline plus EMA approaches showed better performance than the baseline and the EMA approaches at 1-year follow-up (area under the receiver operating characteristic curve [AUC], 0.798; 95%CI: 0.599，0.932) on the prediction of depression. The results underscore the significance of contextual risk factors encountered by older adults during different stages. Leveraging machine learning techniques could enhance the identification of older adults at risk and contribute to the creation of personalized, process-based early prevention programs aimed at mitigating future depression.
INTERDEPENDENCY OF COUPLES’ EVERYDAY COGNITIVE PERFORMANCE
Authors: Luchetti Martina , Rupprecht Fiona , Nikitin Jana , Karakose Selin , Stokes Jeffrey , Terracciano Antonio , Sutin Angelina R
Published: January 2025

Longitudinal studies suggest an interdependency of marital partners’ well-being and health behaviors, which can impact cognitive health. To date, however, few studies have taken a dyadic approach to examine interrelations of cognitive function within romantic partners and none in daily life. This study examines momentary cognitive performance within middle-aged and older romantic couples, and how their performance is interrelated over 8 consecutive days. Data were from 137 opposite-sex couples (274 participants), between 40 and 70 years old, who completed a smartphone-based processing speed task and a visual memory task, three times a day, over the study period. A combination of dynamic structural equation and actor-partner interdependence modeling was used for the analysis. The analysis indicated that mean-level performance on both tasks were correlated between partners. There was a significant time-lagged partner effect for processing speed: Poor performance (longer reaction times) of a participant at one momentary assessment was associated with poor performance of their partner at the next assessment. When controlling for contextual factors (e.g., location, day of the week, presence/absence of others), only the time-lagged effect from female to male partners remained significant. Further, this time-lagged effect was stronger for couples of younger ages. There was no lagged effect for visual memory. This work sheds light on the interdependency of couples’ daily functioning, which might have implications for long-term cognitive outcomes.
COMMUNICATION TRAINING FOR MEDICAL PROFESSIONALS: PROOF OF CONCEPT
Authors: Brown Nancy , De Klerk-Rubin Vicki
Published: January 2025

Despite the prevalence of patients living with dementia, physicians and medical students in particular, have received little or no dementia-specific training to help them communicate effectively with this population. Connecting and communicating with persons living cognitive change requires specific skills. These skills are taught in the Validation for Physicians and Medical Provider training, based upon the evidence-based Validation method by Naomi Feil. Developed with physicians and pedagogical expert in online learning, the training was designed for healthcare professionals, specifically doctors, with quality of care for patients and their carers in mind. The training comprised of a variety of teaching methods including: online on-demand videos, quizzes, case studies, and live webinars for each of the five blocks. The pilot program included physicians and other healthcare professionals. Pre and Post surveys consisted of a knowledge scale and SRDB (self-efficacy) ranked on a Likert scale of 1 to 5 and analyzed using SPSS. Post-training individual interviews concluded the beta-testing. Thirty professionals enrolled in the training; eight participants completed every aspect of the beta-testing. Despite the small sample size, there were trends approaching significance in knowledge and self-efficacy. Participants highly valued the contents of the training as well as the pedagogy. Technical problems were the main reason for attrition. Overall, the Validation method was found useful in practice, improved confidence, knowledge, and communication behaviors. Improvements are needed in the choices for validated measures and the online platform. “Validation has made me a better doctor. It has changed my perspective on aging” (participant).
EVALUATING VIRTUAL MONTESSORI DEMENTIA TRAINING USING NORMALIZATION PROCESS THEORY AMONG VA NURSING HOME STAFF
Authors: Kennedy Katherine , Snow A , Mills Whitney , Mochel Amy , Haigh Sylvia , Bishop Teddy , Hartmann Christine , Hilgeman Michelle
Published: January 2025

This paper uses Normalization Process Theory (NPT) to examine staff impressions of Montessori-based program training and implementation at Veterans Affairs Community Living Centers (VA CLCs; nursing homes). We conducted a mixed-methods evaluation of Montessori Approaches to Person-Centered Care (MAP-VA) at eight VA CLCs. Trainings were conducted as either a live virtual course or a pre-recorded asynchronous class. Two NPT constructs, coherence building and cognitive participation, informed qualitative interview questions, surveys, and analyses focused on staff movement from knowledge to action during initial implementation. Data collection included staff-completed standardized post-training exams (N=906), post-training evaluations (N=761), and optional validated surveys on perceptions of Montessori training (N=307). Champions (peer-leaders) from each CLC completed semi-structured qualitative interviews post-training (N=22). The majority of staff (83%-90%) passed all courses. Staff evaluated the training highly (80%+ agreement) on learning relevant new knowledge and confidence applying new skills. On average, staff felt MAP-VA would become a normal part of their work (7.68/10 scale) and reported increased familiarity with Montessori approaches after training (p =.002). Qualitative interview data from staff trained in Montessori supported three themes concordant with the NPT dimensions of coherence building and cognitive participation. Montessori virtual training resulted in high levels of coherence and cognitive participation among multidisciplinary staff, evidenced by high knowledge, self-efficacy, and readiness to act. The asynchronous and synchronous trainings were accessible, relevant, and supported diverse learners. Virtual dementia training can be an effective and efficient method of teaching nursing home staff about Montessori approaches to reduce responsive behaviors.
OMG! THEY LOOK JUST LIKE ME: EXPERIENTIAL LEARNING RELATED TO OLDER ADULTS AND HOMELESSNESS
Authors: Greenberg Phyllis , Boateng Isaac Asirifi , Moriarty Sheila , Zuniga Claudia Burgos
Published: January 2025

In 2023, nearly 1 in 4 people experiencing homelessness were over the age of 55. (National Alliance to End Homelessness 2023). As shocking as this number might be, it is estimated that the numbers of older adults who are homeless or at risk of homelessness are expected to nearly triple by 2030.To raise awareness in gerontology students a class studying research methods and a class studying policy teamed with social work students for Central Minnesota’s Project (Homeless) Connect. This a semester long project where students develop information for the larger community, city and state officials, as well as professionals about the growing numbers of older adults that are homeless or at risk of homelessness. In addition, to putting together and disseminating information students raise funds to (silent auctions, outreach to community donors, etc.) prepare basic necessity bags. The bags include everything from mini flashlight, rain poncho, shelf stable foods and a can opener among other things. Students also get socks, coats, and disposable underwear and other sanitary products that participants can choose from. The Project (Homeless) Connect event takes place annually and students work with participants to help them secure a variety of services from community vendors as well as learn more about them as individuals. Many of the participants have mentioned how they felt seen just by someone asking them their name and talking with them. This has been one of the more impactful experiences as well for students, faculty, staff and the community.
DAILY AFFECTIVE REACTIVITY ACROSS THE COVID-19 PANDEMIC: THE MODERATING ROLES OF POSITIVE AFFECT AND AGE
Authors: Nelson Niccole , Bergeman Cindy
Published: January 2025

On March 11, 2020, the World Health Organization declared COVID-19 a pandemic. Given COVID-19 had the capacity to make any individual seriously ill, several emergency directives, including cancelation of social gatherings and closures of non-essential businesses, were put in place to slow its spread. Individuals over the age of 60 were considered high-risk for serious COVID-19-related illness, which was associated with greater mitigation efforts and lifestyle changes among this group. Although prior work indicates that the emergency phase of the pandemic influenced stress-and-coping processes, less is known about age differences in these processes, especially how they have unfolded across the past four years of the pandemic. Thus, leveraging data from the Notre Dame Study of Health & Well-being—COVID Study, we examined daily stress and affect across five 28-day, daily diary bursts that were collected approximately every six months between April 2020 and February 2022. Using three-level, multilevel modeling, we examined daily negative affective reactivity, the ‘undoing’ effect of daily positive affect on daily negative affective reactivity, as well as age differences in these daily processes. We found that individuals experienced greater negative affect on days of particularly high stress, and that this process was buffered on days of particularly high positive affect. We also found that older individuals exhibited both lower affective reactivity to stress, as well as a greater ‘undoing’ effect, than younger adults. These results indicate that the mobilization of positive affect may be a promising avenue for intervention in daily stress processes, especially among older adults.
EMPATHY AND RELATIONSHIP QUALITY IN CHINESE PARENT–CHILD DYADS: THE MODERATING ROLE OF DAILY INTERACTION HOURS
Authors: Huang Zewen , Da Jiang
Published: January 2025

Empathy has been consistently found to be associated with the quality of relationships in parents and children across the lifespan. However, little is known regarding whether and how such association would be influenced by the amount of time parents and children interact. We aimed to examine the relationship between empathy and relationship quality, and the moderating role in the relationship between aging parents and adult children from 99 parent-child pairs (Mage(parents)=48.3, SD=4.53, 79.8% women; Mage(children)=22.38, SD=3.49, 85.9% women) in this 14-day diary survey. We focused on both daily empathy collected in daily assessment and trait empathy collected in the pretest. By applying the actor-partner interdependence models and multilevel analysis, we found that the actor effects of daily and trait empathy on relationship quality were significant for both parents and children. Regarding the partner effects, parents’ daily empathy was significantly associated with children’s relationship quality, but not vice versa. Daily interaction hours moderated the associations. Specifically, for daily empathy, the impact of children’s daily empathy on parents’ relationship quality was significant only when parents and children interacted for a longer (vs. shorter) period of time. For trait empathy, the relationship between parents’ trait empathy and their own relationship quality, and that between parents’ trait empathy and their children’s relationship quality were stronger among parent-child dyads reporting shorter (vs. longer) average daily interaction hours over the 14 days. These findings elucidated the complex associations between empathy and relationship quality in parent-child relationships by highlighting the moderating role of daily interaction hours.
HIGH AROUSAL AFFECT RELATED TO WORSE WORKING MEMORY BUT MORE FOR YOUNGER ADULTS
Authors: Kircher Julie , Cerino Eric , Mogle Jacqueline , Charles Susan
Published: January 2025

Studies have found that high emotional arousal states, assessed by reports of negative affect, are often related to poorer working memory. Findings for positive affect (e.g., excitement or joyful), however, are more mixed, with some studies indicating that higher arousal is linked to better cognitive task performance. The purpose of this study was to examine how reports of negative and positive affect throughout the day are associated with verbal working memory, and how this relationship may vary by age. We hypothesized that moments of high negative or positive affect will be related to poorer cognitive task performance, and that age would moderate the relationship between affect and cognition. Data from the Effects of Stress on Cognitive Aging, Physiology, and Emotion (ESCAPE) study consisted of five assessments throughout the day across 14 days among 263 community residents ranging from 25-65 years old (Mage = 46.5). At each assessment, participants completed the n-back adapted for mobile phones and reported the current affect. Across all ages, higher levels of reported negative and positive affect at each assessment were related to worse momentary working memory (γNA = -.0004, SE =.0002, p =.02; γPA = -0.0003, SE =.0002, p =.04) and younger age was related to worse working memory as levels of positive affect increased.
COGNITIVE PERFORMANCE DIFFERENTIALLY MODERATES THE ASSOCIATION BETWEEN GAIT VELOCITY AND FALL RISK
Authors: Hundza Sandra , MacDonald Stuart , Klimstra Marc , von Hacht Markus
Published: January 2025

Cognitive-walking dual-task paradigms are an effective tool for assessing fall risk. Surprisingly, the moderating influence of cognitive performance on the association between gait velocity (GV) and fall risk has not been explored. The present investigation examines whether cognitive performance moderates the relationship between GV and fall risk. Community-dwelling older adults (76 years ±3.44) were classified as fallers and non-fallers based on self-report (at least one fall in the past 12 months). GV was indexed using the GAITRite system while counting backwards by serial 7s. Performance on the serial 7s task was recorded, with Adobe Audition subsequently employed to index cognitive function in terms of the number of counts (NC) and percentage of true counts (PTC) from the recorded audio files. Logistic regression was employed to examine the predictive influence of GV on the likelihood of fall risk classification (GV model), as well as the moderating influence of NC and PTC on the GV-fall risk association (GCI model). Notably, there was a significant moderating effect of PTC on the GV-fall risk association for individuals with PTC scores ≥-2.41 units (Johnson-Neyman analysis); those with lower GV were at increased risk of falling, with this relationship magnified as PTC scores increased. The sensitivity of the GCI interaction model (88%) represented a 17% improvement over the GV model. This investigation is the first to demonstrate the importance of interactions between gait and cognition measures in fall risk modelling, and underscores the potential clinical utility of including cognitive performance measures in dual-task paradigms.
EXPERIENCE OF OLDER ADULTS WITH OBJECTIVELY MEASURED PHYSICAL ACTIVITY IN FALL PREVENTION INTERVENTION
Authors: Ojo Eunice , Loerzel Victoria , Thiamwong Ladda
Published: January 2025

Falls are a preventable event that negatively affects the health of older adults. Unfortunately, they have many risks for falls including impaired gait and balance, and muscle weakness. Objective assessment of older adults’ physical activity with portable technology including accelerometers helps plan fall prevention interventions but there is limited information about their experience. This study aimed to explore participants’ experiences with physical activity measured with an accelerometer. A qualitative descriptive study was conducted among 23 older adults, 60 years, and older living in low-income community settings in Central Florida. Participants were included if they participated in the Physio-Feedback Exercise Program (PEER) study that involved using a wrist-worn accelerometer (Fitbit) to measure physical activity. A semi-structured interview guide was used to obtain participants’ experiences with physical activity and the technology used. Participants were individually interviewed, and audio recorded. They were offered an incentive of $20 for participating in the qualitative study. The responses were transcribed verbatim, coded, and analyzed using thematic analysis. Two major themes and sub-themes emerged from the data. These included 1) Barriers to physical activity (physical limitation, challenges with technology, fear of falling), and facilitators of physical activity (feedback from the accelerometer, progress monitoring, self-motivation). The use of the accelerometer encouraged participants’ engagement in physical activity. Reducing barriers and encouraging facilitators of physical activity with accelerometers could promote fall prevention interventions. Future studies should include exploring the experience of cognitively impaired older adults’ engagement in physical activity with the accelerometer.
GLOBAL TRENDS IN FALL-RELATED INJURIES: A THREE-DECADE ANALYSIS
Authors: Harada Ko , Koyama Toshihiro , Yamada Yuji
Published: January 2025

Background

Falls pose a significant public health challenge in our aging world, resulting in 684,000 deaths annually. Understanding the current situation is essential for developing data-driven policies and providing appropriate healthcare services. However, studies analyzing global trends in the disease burden of falls are scarce.

Methods

This study utilizes the Global Burden of Disease database to explore the disease burden of falls between 1990 and 2019, focusing on mortality rates, incidence, and disability-adjusted life years (DALYs). Falls were defined as ICD-9 codes E880-E886, E888, and ICD-10 codes W00-W19.9, and the data was analyzed by regions based on the World Bank regional classifications.

Results

Over the past 30 years, global deaths from falls per 100,000 population have increased by 29%, from 7.5 to 9.7. However, the global age-standardized mortality rate and age-standardized incidence rate from falls decreased by 8.4% and 2.8%, respectively. Trends in age-standardized mortality rate varied by region, with North America showing the most significant increase of 53%. Although age-standardized DALYs decreased by 14% worldwide, there was a 6.3% increase in North America. Conclusions: Our study showed that global fall-related mortality has increased worldwide over the past three decades, and the disease burden from falls has increased, particularly in North America, even after age adjustment. These trends can be attributed to the increase in multimorbidity, the prevalence of polypharmacy among older adults, and improved reporting quality. Developing and implementing targeted prevention strategies and policies is imperative to reduce the social impact of unintentional falls.