bluuebunny/crossref_metadata_2025 huggingface dataset:
INTENTIONAL EVALUATION OF DYADIC BENEFITS OF EARLY-PHASE INTERVENTIONS: ROLES OF PRETEST RISK AND RELATIONAL IMPACT
Authors: Lyons Karen , Russell Luke , Johnson Kalisha Bonds , Brewster Glenna , Miller Lyndsey
Published: January 2025

The evaluation of early-phase (i.e., Stage I, NIH Stage Model), small sample dyadic interventions is still primarily focused on testing separate effects for each member of the older adult-care partner dyad, rather than the benefits for dyads as a whole. Moreover, there is little attention to assessing pre-test risk status within dyads (especially in quasi-experimental or single-arm designs) or the relational impact of interventions. We first examined pre-test risk status across several outcomes (e.g., depressive symptoms, self-efficacy, communication) in 39 dyads and found 37-68% of older adults with chronic illness were at-risk at baseline; 40-79% of care partners; and 15-53% of dyads. Second, we examined dyadic benefits of a health behavior intervention, using two approaches, and found above zero approaches may deflate dyadic benefits compared to pre-test risk approaches. We used a pattern analysis to examine benefits across outcomes and within dyads and found 40% of dyads who received the intervention had expected positive outcomes for depressive symptoms and self-efficacy; 20% had expected positive scores for depressive symptoms, self-efficacy and aerobic exercise; and 13% had expected positive scores for all five target outcomes. Dyads where both members had highest pre-test risk level did not experience expected dyadic benefits. Finally, although we did not find strong evidence the intervention improved communication compared to a wait-list condition, there was no evidence it resulted in worse communication. Implications of using each approach and selecting different benchmarks for defining success are discussed. Results provide rationale for more intentional evaluation of small-sample, early-phase dyadic interventions.
SINGLE-CELL ANALYSIS OF SOMATIC MUTATIONS IN HUMAN LUNG REVEALS ASSOCIATION WITH TRANSCRIPTIONAL CHANGES IN AGING
Authors: De Man Ruben , Adams Taylor , McDonough John , Cala-Garcia Juan , Moss Benjamin , Yan Xiting , Rosas Ivan , Kaminski Naftali
Published: January 2025

Age is a major risk factor for lung disease. Accumulation of somatic mutations has been implicated in both aging and cellular senescence. We analyzed somatic mutations called from single-cell RNAseq (scRNAseq) data. scRNAseq was performed on lung parenchyma samples from healthy donors (32 samples, 11-72 years, 21M/11F). Following standard pre-processing and cell type annotation, mutations were called using SComatic with the default parameters. Mutation burden was calculated for each cell type-sample combination by dividing the number of mutations by the number of callable sites. Our resulting scRNAseq dataset consisted of 199,400 cells, comprising 25 distinct cell types. Mutation burden was highest in alveolar type 1 (AT1) cells (93.6 mutations/MB), alveolar macrophages (79.1), and general capillary (gCap) cells (62.1). Mutation burden was positively correlated with age (r=0.28, p< 0.001). Globally, the top genes correlated with mutation burden included ubiquitin ligase genes (AMBRA1, ANAPC1, SEL1L, USP25, USP33) and DNA damage response genes (RAD50, PRKDC). Notably, mutation burden also correlated with expression of senescence marker CDKN2A (r=0.48, p< 0.05). In AT1 cells, mutation burden correlated with decreased expression of cell marker genes such as AGER (r=-0.64, p< 0.05) and HOPX (r=-0.83, p< 0.05). Similarly, gCap cells exhibited decreased expression of marker genes Il7R (r=-0.54) and VIPR1 (r=-0.64), while MAPK/ERK signaling genes were increased (p < 0.05). These genes were also significantly correlated with age in the same direction (p < 0.05). These results suggest that somatic mutation accumulation may contribute to age-associated transcriptional changes and loss of cell function, with cell types of the alveoli and endothelium experiencing the greatest effects.
AN INTERNATIONAL COLLABORATION TO SUPPORT AGING RESEARCH IN GHANA
Authors: Washington Tiffany , Bortey Dennis , Epps Fayron , Gore Janelle , Dey Venance
Published: January 2025

Nearly 3 million people live with dementia in sub-Saharan Africa (SSA). However, ineffective methods for increasing detection and raising awareness contribute to stigma about dementia. By leveraging the resources of universities in developed countries, global community engaged research can increase knowledge and education about dementia in SSA. Using a collaboration between Ghanian community partners and two research-intensive universities in the U.S. as a case example, this paper offers guidance on conducting community-engaged aging research in Ghana. The Alter Program is a dementia education initiative to increase dementia-friendly spaces in faith communities. We used thematic analysis of field notes to identify key components of building international partnerships centered on dementia education. Five were identified: ethics review, relationship-building with community partners, identifying community needs, cultural adaptations, and capacity building. Future research can leverage these aspects of community-universities partnerships to increase dementia knowledge and attitudes in SSA countries.
THE VALUE OF COMMUNITY–UNIVERSITY PARTNERSHIPS IN GHANA: IMPLEMENTING CULTURALLY RESPONSIVE DEMENTIA EDUCATION
Authors: Gore Janelle , Epps Fayron
Published: January 2025

Alzheimer’s disease and related dementias have not been given much attention in sub-Saharan Africa. Although the prevalence of dementia in Ghana is not yet established, those who present cognitive impairment are often stigmatized, discriminated against, or physically harmed by community members. The mistreatment may be due to a lack of dementia knowledge and awareness in Ghana. Recognizing the critical need to increase dementia knowledge and awareness in Ghana, Alzheimer’s Ghana (Ghana), AlterDementia (US), and researchers from the University of Georgia and Emory University (US) partnered to develop and implement a culturally adapted and relevant dementia education intervention. Through a series of collaborative sessions, both organizations and researchers co-created educational materials and intervention strategies addressing dementia awareness and knowledge. Education sessions consisted of a dementia overview, brain health overview, community testimonies, local resources, question and answer session, and closing remarks. Community-based participatory research principles were used to engage public officials, faith-based organizations, television personalities, healthcare professionals, secondary school educators, and researchers in Ghana to facilitate nine dementia education sessions, spanning 15-90 minutes, to over 800 participants across four regions of Ghana. Surveys and field notes were used to collect demographic and dementia knowledge and awareness data. Preliminary findings suggest promising avenues for improving dementia knowledge and reducing stigma. This work underscores the value of community-university partnerships to culturally adapt evidence-based interventions to advance ongoing community initiatives addressing dementia.
GHANAIAN NURSING STUDENTS’ EXPERIENCES IN CARING FOR OLDER ADULTS IN ACUTE CARE SETTINGS
Authors: Abudu-Birresborn Diana , Puts Martine , McCleary Lynn , Chu Charlene , Yakong Vida , Cranley Lisa
Published: January 2025

Evidence suggests that nursing students’ experiences in acute care settings may negatively impact their views on caring for older adults, resulting in poor interest and quality of care. However, Ghanaian nursing students’ experiences caring for older adults are unknown. We aimed to explore students’ experiences in caring for older adults to help develop and improve strategies, that promote students’ positive experiences and promote quality of care for older adults. We employed a descriptive qualitative approach and interviewed 17 second and third-year nursing students since they had clinical exposure. Interviews were conducted face-to-face and via telephone from November 2020- December 2020 and lasted 45-60 minutes. Interviews were audio recorded, transcribed, coded, and sorted with Nvivo. Data were analyzed and interpreted, themes were generated using critical thematic analysis and contextual meanings students ascribed to their responses. Two broad themes were generated. 1) experiences in caring for older adults and 2) inadequate staff and resources. Students had challenging experiences caring for older adults who were dependent and unable to manage their activities of daily living. They described caring for older adults as physically and emotionally demanding. They noted that limited staff and resources constrained caring for older adults which frustrated them when providing care. However, they expressed caring for older adults as a positive learning experience as they perceive them as a source of wisdom and blessings. Nurse leaders and administrators can help shape students’ experiences caring for older adults by ensuring adequate staff and resources and supporting students’ clinical learning.
MOMENTARY ASSESSMENT OF SOCIAL DISCONNECTION IN OLDER ADULTS AT HEIGHTENED RISK FOR SUICIDE
Authors: Bower Emily , Loskot Taylor , Van Orden Kimberly
Published: January 2025

Social disconnection is a proximal and modifiable risk factor for suicide among older adults. Identifying periods of acute or intensified disconnection can inform just-in-time interventions for individuals at heightened risk for suicide. Ecological momentary assessment (EMA) using mobile devices is feasible and acceptable for older adults, and is a promising method for capturing daily changes in social disconnection. To assess preliminary validity of EMA for assessing social disconnection in older adults at heightened risk for suicide, we compare mobile EMA to paper-and-pencil assessments of social disconnection within a sample of older adults with subjective cognitive decline (n=27, mean age=69 years, 81% female). Participants completed baseline paper-and-pencil measures of social disconnection (INQ) and depression symptoms, then completed daily surveys (EMA) that were delivered to their smartphone up to 4 times a day for 14 days. Three EMA LIkert-type items items assessed aspects of social disconnection (burdensomeness, belonging, and disconnection). Participants completed a mean of 37.2 surveys with an average response rate of 67%. EMA items correlated strongly with INQ scores (r’s=.6-.7) and depression (r’s=.5-.7). Intercorrelations among EMA items were low to moderate (r’s=.3-.6), suggesting items assessed unique aspects of social disconnection. Among 19 participants who reported no perceived burden on the INQ, 63% reported daily variability in the EMA burden item. Additional analyses will examine within-person variations in EMA items using multilevel mixed models. Findings provide initial evidence of validity for mobile EMA to assess momentary changes in social disconnection among older adults at heightened risk for suicide.
DYNAMICS OF DAILY LONELINESS AND DIURNAL CORTISOL
Authors: Van Bogart Karina , Almeida David , Felt John , Rush Jonathan , Cerino Eric , Charles Susan
Published: January 2025

Loneliness impedes healthy aging. Previous research shows robust findings between loneliness and poor health, including stress-related diseases and conditions (e.g., cardiovascular disease). Less is known about how loneliness experienced in daily life relates to indices of health, such as diurnal cortisol level patterns. The slope of diurnal cortisol shows a peak upon waking from sleep and a nadir close to bedtime; however, specific rhythms of cortisol slopes fluctuate in daily life. Emerging research suggests that capturing the dynamic range of diurnal cortisol in daily life could be an important marker of allostatic load (i.e., the cumulative burden of chronic stress), with a compressed range indicating dysregulation and a wider range suggesting a more adaptive cortisol profile. In the current research, we investigated whether daily self-reported loneliness related to the dynamic range of diurnal cortisol (calculated via 4 days of salivary cortisol collection, 4 times a day) and explored age differences across the lifespan. Data come from a national daily assessment study with participants ranging between 25-75 years old who completed 8 days of daily diary assessments on loneliness and other factors in daily life. Findings from the current analyses will be presented in the context of how the dynamic range of cortisol might serve as a potential mechanism for outcomes related to loneliness in later life.
THE LANGUAGE OF LONELINESS: ANALYZING UNSTRUCTURED SPEECH TO DETECT LONELINESS AND SOCIAL ISOLATION
Authors: Lee Ellen , Wang Ning , Badal varsha , Goel Sanchit , Subbalakshmi Koduvayur
Published: January 2025

The mental and physical toll of loneliness and social isolation lead to increased mortality for older adults. Early detection of social disconnection will aid in delivering timely interventions, however current assessments involve long surveys that cannot capture the individualized experiences of loneliness. Our group has been analyzing unstructured speech data using Natural Language Processing (NLP)and openSMILE as well as identifying linguistic and audio features that are associated with social disconnection among older adults. We will present our findings from using linguistic features alone, thematic categories, analyses of different interview segments, sex differences, and audio features. We will also present the association of social disconnection with longitudinal physical, mental, and cognitive outcomes in a community-dwelling healthy aging sample in San Diego. The sample includes older adults living independently in senior housing communities who have completed semi-structured interviews, sleep and physical activity assessments using wearable fitness trackers, a cognitive assessment battery, and clinical assessments for mental health concerns.
DAILY SLEEP, SOCIAL ENCOUNTERS, AND MOMENTARY LONELINESS IN LATE LIFE
Authors: Zhou Zexi , Fingerman Karen
Published: January 2025

Social experiences have implications for well-being in late life, and everyday sleep may play an important role in shaping those experiences. This study examines the associations between sleep, quality of social encounters, and momentary loneliness in older adults’ daily life. We used the ecological momentary assessment (EMA) data over 5 to 6 days from the Daily Experiences and Well-being Study (N = 287, Mage = 74.88). Every morning, older adults reported their sleep the prior night (e.g., duration, subjective quality, disturbances). At each three-hour assessment, they reported encounters with close social partners and partners not identified as close (i.e., less close partners), indicated the pleasantness and stressfulness of each encounter, and rated their feelings of loneliness. Multilevel models showed that older adults who overall reported higher sleep quality or fewer sleep disturbances also had more pleasant encounters and fewer stressful encounters with both close and less close social partners across the study period. More pleasant and less stressful social encounters with close partners were associated with feeling less lonely especially on days when older adults had better sleep the prior night, compared to days when they had worse prior night’s sleep. Higher-quality encounters with less close social partners were associated with feeling less lonely throughout the day regardless of prior night’s sleep. Findings suggest the promotive and protective role that better sleep plays in older adults’ everyday social life, and highlight the robust benefits that positive social encounters with less close ties may confer in mitigating loneliness in late life.
SHORT-TERM ASSOCIATIONS OF ACTIVITY ENGAGEMENT WITH COGNITIVE PERFORMANCE
Authors: Luo Minxia , Driver Charles , Scott Stacey , Zavala Daisy , Hall Charles , Roecke Christina
Published: January 2025

Prior research showed that activity engagement had short-term effects on numerical working memory over hours in German-speaking older adults. However, it is unclear whether these effects could be generalized to other cognitive outcomes and populations. This study examined short-term associations of activity engagement with cognitive performance using data from two studies that included adults of different demographic backgrounds in the US. That is, 16 days’ data from 282 older adults aged 70 to 90 years (M = 76.62, SD = 4.68; 66% women; 44% White, 40% Black, 11% Hispanic White, 3% Hispanic Black) from the Einstein Aging Study (EAS) and 14 days’ data from 260 participants aged 25 to 65 (M = 46.49, SD =11.09; 65% women; 8% White, 63% Black, 18% Hispanic White, 6% Hispanic Black) from the Effects of Stress on Cognitive Aging, Physiology, and Emotion Project (ESCAPE). For 4 or 5 times per day, participants reported whether they engaged in different social and cognitive activities (e.g., social interactions, TV watching) and completed smartphone cognitive assessments (i.e., processing speed, spatial working memory). Using hierarchical continuous-time dynamic modeling, we did not find any time-lagged associations between activity engagement and cognitive performance. Additionally, age, sex, and race-ethnicity did not moderate the time-lagged associations. Our results suggest that activity engagement did not have short-term effects on processing speed and spatial working memory in young and older populations with ethnic and racial diversity.
MOMENTARY INTERACTIONS WITH FRIENDS AND CARE RECIPIENTS AND CARDIOVASCULAR REACTIVITY IN DEMENTIA CAREGIVERS
Authors: Ng Yee To
Published: January 2025

Friends may serve as an important resource for dementia caregivers who often experience stress and heightened cardiovascular risk. This study examines momentary associations between friend interactions and cardiovascular reactivity, and tests whether friend interactions moderate the association between interaction with the care recipients (CRs; both positive and negative) and cardiovascular reactivity among Black and White dementia caregivers. Using Ecological Momentary Assessments (EMA), 159 dementia caregivers (Mean age: 62.24, 60% White) reported interactions with CRs (including time spent and levels of positivity and negativity) and indicated any friend interactions every 3 hours over five days. ECG monitors collected real-time physiological data (including heart rate [HR] and heart rate variability [HRV-RMSSD]). Findings revealed no racial differences in contact frequency with friends. Although Black caregivers spent less time with CRs, they reported similar levels of positive and negative interactions with CRs than White caregivers. While positive interactions with CRs were not associated with HR or HRV among caregivers, negative interactions with CRs were linked to momentary increases in HR, observed only among Black caregivers. Moreover, friend interactions were linked to momentary elevation in HR and reduction in HRV for both Black and White caregivers. However, friend interactions did not moderate the effect of negative interactions with CRs on cardiovascular reactivity. This study highlights racial disparities in the amount of time spent with the care recipients and its momentary effects on cardiovascular health. Friend interactions may not alleviate the impact of caregiving on cardiovascular burden but remain linked to momentary cardiovascular health.
EAST MEETS WEST: COLLABORATING INTERNATIONALLY TO MITIGATE SOCIAL ISOLATION
Authors: Inoue Megumi , Amano Takashi , Lubben Jim
Published: January 2025

Combatting social isolation in later life is a pressing global issue. This symposium assesses social isolation among older adults from various angles. Four presenters from North America and Japan examine the perception, disparities, and impact of social isolation within specific cultural contexts. The knowledge from diverse cultural backgrounds and policy frameworks of the different countries provides an opportunity to explore the intricate nuances and shared experiences of social isolation among older populations. Dr. Watanabe will introduce the status of social isolation among Japanese older adults who reside in a marginal community, where more than 50% of the population is 65 years or older. Dr. Murayama will describe the findings on different forms of social isolation and their impact on health outcomes, utilizing extensive cohort data from older adults living in the Tokyo metropolitan area. Dr. Taylor will examine disparities in loneliness among older adults in the U.S., with a particular focus on the mediation effects of socioeconomic factors on racial and ethnic differences in loneliness. Dr. Mair will discuss changing demographics of older adults and shifting cultural values from a global perspective, with implications for rethinking aging alone as a risk factor and traditional notions of successful aging in relation to limited family ties. These four presentations will provide a broad overview of social isolation in three countries and its implications for quality of life in later life. The symposium will help identify culturally-sensitive strategies for promoting the well-being of older adults in global communities.
SOCIAL ISOLATION OF OLDER ADULTS IN A MARGINALIZED COMMUNITY IN JAPAN
Authors: Watanabe Yuichi
Published: January 2025

Japan stands as one of the most aged societies globally, with approximately 29% of its population aged 65 or older as of 2022. Previous studies indicate that 10-30% of Japanese older adults experience social isolation, with 2-10% facing severe social isolation (Saito, 2009). This issue is particularly prevalent among those who have contact with others less than once a week, posing potential health risk (Saito et al., 2015). However, it’s crucial to acknowledge the existence of extremely aging communities in Japan, especially in rural areas, known as marginalized communities, where over 50% of the population is 65 years or older. This presentation offers insights obtained from surveys conducted in 2015, 2017, and 2019 within one such marginalized community. The findings reveal that out of 297 older adults surveyed, 72 were living alone. Among them, 4 reported meeting others less than once a week, while 18 met others less than four times a week. These results suggest that approximately 25% of older adults living alone may experience social isolation, with 5.6% facing severe social isolation. While these findings may not be generalizable to all marginalized communities in Japan, they highlight the heightened risk of social isolation within such contexts. Future research should conduct detailed analyses to inform discussions and develop solutions for addressing social isolation in marginalized communities.
DOCUMENTATION OF LIFE-SUSTAINING TREATMENT PREFERENCES IN A NATIONAL COHORT OF VETERAN DECEDENTS
Authors: Makaroun Lena , Li Yaming , Mor Maria , Morris Stephen , Rosland Ann-Marie , Rosen Tony , Kutney-Lee Ann , Thorpe Carolyn
Published: January 2025

In 2018, the Veterans Health Administration (VHA) introduced the Life-Sustaining Treatment (LST) Decisions Initiative to standardize documentation of Veterans’ goals and preferences in the electronic health record (EHR). The objective of this retrospective cohort study was to assess LST completion patterns and sociodemographic, clinical, and care utilization factors associated with completion in a cohort of 23,591 VHA-engaged Veterans aged ≥65 years who died in 2021. We used VHA EHR and Medicare claims data and multivariable logistic regression to examine factors associated with LST completion. Of the cohort, 6,684 (28%) completed an LST. LST documentation occurred a median of 142 days before death; 2,260 (34%) were completed by a surrogate. LST completion was markedly higher in those with an inpatient or VA nursing home (CLC) stay in the 2-years before death, so we estimated models stratified by the presence (n = 7,761) or absence (n = 15,830) of any inpatient/CLC stay. In both strata, older age, higher comorbidity, and frailty were associated with LST completion (p < 0.001). Among Veterans without an inpatient/CLC stay, being unmarried, having a child as next of kin, higher levels of VA financial benefits, and dementia diagnosis were also associated (p < 0.001). Race/ethnicity and gender were not associated with LST completion. LST completion before death is strongly tied to utilization of VHA acute and nursing home care, and generally occurs close to the time of death and often by a surrogate. Opportunities may exist to improve documentation of patient preferences in outpatient settings farther in advance of health declines.
PATTERNS OF RUSHED AND UNFINISHED CARE AMONG CARE AIDES IN NURSING HOMES: A LATENT CLASS ANALYSIS
Authors: Angel Cybele , Song Yuting , Duan Yinfei , Estabrooks Carole
Published: January 2025

Rushed care and unfinished care (also called missed care, care rationing) are common in nursing homes. Although the two phenomena are interrelated, most researchers have studied them separately and used a variable-centered approach. We took a person-focused approach and aimed to identify groups of care aides who rushed care and left care tasks unfinished in similar ways. This cross-sectional analysis used survey data from 3546 care aides working in a random sample of 87 urban nursing homes collected from September 2019 to February 2020 in three provinces in western Canada. We presented to care aides a list of physical and social care tasks (e.g., bathing, talking with residents). They answered whether or not they rushed or left a care task unfinished in their previous shift of work. We performed latent class analysis to identify patterns of rushed and unfinished care and verified the identified patterns with a different wave of data. A 4-class model emerged as the best-fit model for our data. Group 1 reported high levels of rushed and unfinished care, and Group 2 was low on both rushed and unfinished care. Group 3 reported high rushed care and Group 4 reported medium rushed care; both groups reported low unfinished physical care and medium unfinished social care. Our findings suggest the complexity of rushed and unfinished care among care aides. System-level support for this workforce is urgently needed to develop targeted interventions for sub-groups of care aides to reduce rushed and unfinished care in nursing homes.
THE NEED FOR PRAGMATIC PROGRAMMING FOR CAREGIVERS: EVIDENCE FROM MANAGING MONEY: A CAREGIVER’S GUIDE TO FINANCES
Authors: Grant Claire , Judge Katherine , Stratton Lauren , Moreno Monica , Fazio Sam
Published: January 2025

Several key issues remain in the caregiving intervention literature. Programs must seamlessly transition and scale into existing settings with plans for long-term implementation. Programs should be accessible, digestible, and efficient for caregivers while still delivering meaningful results. To address these issues, conceptualization and development should be guided by end-use scenarios. Managing Money: A Caregiver’s Guide to Finances was developed as an online program for caregivers to address the need for pragmatic and scalable programs focused on the financial impacts of caregiving. Synchronous (community educator-led) and asynchronous (self-paced) versions of the one-hour online program were offered. Topics include conversations about finances, assessing needs, and finding financial support. Printable tools were also provided. The synchronous program was evaluated as an RCT (N=179). The mean age was 55.03 (SD=15.34), 73.2% White; 48.6% cared for a parent/grandparent; and 36.3% cared for a spouse. Long-term effects were found in reducing unmet needs and distress around finances and increasing the likelihood to act to improve financial situations. The asynchronous version was evaluated in a one-arm study with 146 caregivers. The mean age was 45.85 (SD=5.65); 75% were white, and 91% cared for a parent/grandparent. Both versions were found to be acceptable and feasible. On a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree) participants reported the program identified financial challenges (M=4.09, SD=.75/M=3.81, SD=.79) and would recommend the program (M=4.50, SD=.86/M=3.91, SD=.84). Discussion will outline features of program development, rollout, and scalability. Ongoing need and recommendations for pragmatic programming will also be discussed.
PERSONALITY BYTES: CRACKING THE CODE OF OLDER ADULTS ENGAGEMENT WITH AI
Authors: Shade Marcia , Yan Changmin , Jones Valerie , Boron Julie
Published: January 2025

Despite stereotypes about older adults’ reluctance to embrace technology, smartphone and technological device adoption among this demographic is increasing, including the use of Artificial Intelligence (AI). However, perceptions about AI may hinder engagement in research among older adults. This study examined how older adults’ personalities influence their interaction with AI-driven interactive routines. Fifty community-dwelling older adults participated in a 12-week randomized pilot study, divided into standard and enhanced groups, interacting with conversational AI for intervention routines. Data collected included personality traits, usability, and routine initiations. Participants, averaging 72.4 years old, were mostly female (88%) and White (95%). Personality traits did not significantly affect routine initiations overall, but extraversion predicted engagement throughout the day and morning in both groups. Evening routines were unaffected by personality traits. Agreeableness and conscientiousness significantly predicted perceived usability. These findings emphasize the influence of older adults’ personality traits on AI technology interaction, with extraversion playing a significant role. Additionally, agreeableness and conscientiousness impact usability. Integrating personality traits into research protocols involving technology interactions is crucial for better understanding older adults’ engagement.
FROM THE NATHAN SHOCK CENTERS COORDINATING CENTER: BIOLOGY OF AGING FOR NONBIOLOGISTS
Authors: van der Willik Odette , Austad Steven
Published: January 2025

Advances in the biology of aging that promise to dramatically extend the healthy length of human life are now appearing at a breathtaking rate. At the same time, baseless claims of research breakthroughs in maintaining youth are everywhere in the news. It is often difficult for people outside basic aging research to keep track of what is real and what is not. This symposium brings together scientists working in some of the most exciting research areas to update attendees in terms that will be understandable to anyone. Our speakers were selected both for their scientific achievements and for their outstanding skill as science communicators. Dr. Passos will discuss the rapidly expanding field of senotherapeutics to identify drugs that can eliminate senescent cells (senolytics) and what is needed in the development of therapies that target cellular aging. Dr. Molina will review the development of promising biomarkers of human aging and will provide examples of how markers are being tested and applied in a range of clinical studies. Dr. Panda will provide insights from circadian rhythm science and how new lifestyle choices have the potential to be implemented on a population scale. And Dr. Espinoza will discuss the basic principles of geroscience and the use of such therapies toward the goal of improving healthspan (as opposed to the traditional single disease approach). Dr. Valenzano will update us on how important the microbes that live in and on us are turning out to be to our later life health.
BIOMARKERS OF AGING AND PRECISION HEALTH CARE FOR OLDER ADULTS
Authors: Molina Anthony
Published: January 2025

Efforts to develop objective and quantifiable biomarkers of human aging are ongoing and have been accelerated by advances in technical and analytical approaches for biomedical research. Beyond predicting one’s chronological age, this research is being increasingly applied to measure biological age, which captures the heterogeneity of the aging process. Such markers may be able to predict one’s risk for developing a variety of age-related conditions and diseases and are recognized to have potential applications for advancing precision healthcare for older adults. This presentation will review the development of promising biomarkers of human aging and will provide examples of how markers are being tested and applied in a range of clinical studies. As approaches for promoting healthy longevity are being developed and evaluated, biomarkers of human aging may serve as important study outcomes. Modifiable biomarkers of human aging may reflect effects on healthspan and longevity, which would otherwise take many decades to monitor. Finally, this presentation will review national and international cooperative efforts to evaluate and compare biomarkers of human aging, Such efforts are also applying biomarker development approaches to complementary topics, such as the assessment of human resilience.
THE CONTRIBUTION OF THE MICROBIOME TO THE AGING PROCESS
Authors: Valenzano Dario Riccardo
Published: January 2025

The human microbiome, a complex ecosystem of microorganisms residing in our bodies, is emerging as a critical contributor to our overall health and the aging process. With a total number of genes that vastly outnumbers our own—approximately 100 to 1—the microbiome influences virtually all biological processes, from nutrient absorption and immune system development to protection against pathogens. This diverse and dynamic community, acting as a polypharmacy, produces a plethora of compounds that affect our metabolism and are linked to various health outcomes. Recent findings have highlighted that numerous diseases, including metabolic disorders, immune-related conditions, and even neurodegenerative diseases are associated with the disruptions of the microbiome-host balance. Given its extensive involvement in health and disease, the microbiome has become highly relevant in aging research. Scientists are now investigating how changes in the microbiome composition throughout our lives can lead to new anti-aging interventions. One of the most promising areas of research is microbiome transplantations, which offer a novel strategy to potentially slow down or reverse aspects of the aging process by modifying our internal microbial landscape. Moreover, the discovery that rapamycin, a powerful anti-aging drug, originates from microbes underscores the microbiome’s potential as a treasure trove for developing new anti-aging compounds. By understanding and harnessing our microbiome, we stand on the brink of revolutionizing anti-aging strategies, transforming our approach to disease prevention in our later years. This rapidly expanding research field promises to unlock new possibilities for enhancing longevity and improving the quality of life as we age.
GENERATIVE AI IN GERONTOLOGY: CENTERING STAKEHOLDERS’ VOICES
Authors: Demiris George , Thompson Hilaire
Published: January 2025

The rise of Generative Artificial Intelligence (AI) tools such as Large Language Models (e.g., ChatGPT) has highlighted many potential application areas in gerontology, ranging from tools to support clinical decision support, facilitate communication, provide supportive services to older adults and family members and even address issues of social isolation and loneliness. Often technological solutions are developed without early and ongoing feedback by end users and other stakeholders. This symposium includes the presentation of distinct studies that examine the use of Generative AI for various gerontological areas based on experiences of the NIA funded Artificial Intelligence and Technology Collaboratories for Aging and other initiatives, and highlights ways to engage stakeholders in all design and implementation phases in order to facilitate co-creation of meaningful generative AI solutions. We provide a comprehensive discussion of both opportunities and challenges associated with the growth of Generative AI in gerontology and discuss clinical, ethical and practical implications. Additionally, we present ways to integrate Generative AI into traditional research and clinical practice in way that supplements rather than replaces traditional care, and minimizes the risk of bias.
STAKEHOLDER ENGAGEMENT FOR THE DESIGN OF GENERATIVE AI TOOLS: INCLUSIVE DESIGN APPROACHES
Authors: Demiris George
Published: January 2025

We present an approach to active and ongoing stakeholder engagement throughout the design lifecycle of generative AI applications. We highlight case studies from the Penn Artificial Intelligence and Technology Collaboratory for Healthy Aging (PennnAITech) of active involvement of older adults, family members, clinicians and social services coordinators as stakeholders in the early phases of design and prototype testing and demonstrate how this participatory approach can address not only usability challenges, but maximize the accessibility and relevance of Generative AI for older adult users. One example includes an NSF funded study using Large Language Model (LLM) tools to address social isolation and loneliness for community dwelling older adults living alone. In this project, older adults were invited to serve as co-designers of the LLM blueprint, its functionalities and purposes. Discussions around transparency and disclosure informed the implementation approach. The second example explores the use of Generative AI for a fall prevention program that captures fall risk scores using depth sensing. This project targets community dwelling older adults with mild cognitive impairment who live in low resource settings. The use of Generative AI is meant to make the fall risk information more accessible and actionable for older adults and their families. Co-design sessions provided system specifications for a chatbot that serves as a fall risk coach. As Generative AI applications continue to expand, assuring that we center older adults’ voices as part of an inclusive design effort will become critical for these systems to be accessible and relevant for their end users.
TIMELY PERSPECTIVES FROM DIVERSE STAKEHOLDERS ON GENERATIVE AI
Authors: Cudjoe Thomas , Schoenborn Nancy , Ashida Sato
Published: January 2025

A core mission of the Johns Hopkins Artificial Intelligence (AI) and Technology Collaboratory for Aging Research is to engage diverse stakeholders. To better understand the perspectives of stakeholders on research priorities and decision-making considerations regarding the development and adoption of AI, we conducted in-depth interviews with stakeholders recruited nationally. We interviewed a total of 49 participants, including older adults/caregivers (n=15) and clinicians (n=15) from urban and rural areas to understand user perspectives. We also interviewed entrepreneurs (n=6), investors (n=5), and payers (n=8)to gain a broader understanding of how generative AI may be integrated into current health service systems. Themes included: 1) Shared and distinct priorities among the stakeholders; most frequently identified priority areas that AI can help address included facilitating social engagement, coordination of care, supporting independence, and treating or preventing common geriatric syndromes like dementia and falls. Older adults and caregivers focused on daily function and caregiving; clinicians focused on monitoring and adherence; health system leaders and payers focused on access, staff burnout, and satisfaction. 2) Participants envisioned multiple roles for AI, including taking over burdensome tasks, making existing tasks more efficient, addressing unmet needs, and performing tasks beyond what is humanly possible. 3) Although perceived benefits outweighed concerns, there were concerns including unintended consequences and suggestions for guardrails. 4) Decisions about AI adoption focused on ease of use, implementation, and cost. Our findings highlight important priorities and considerations from stakeholders for the use of generative AI and opportunities for future research and development.
HEALTH CARE RESEARCH AND PROVISION AMONG OLDER ADULT GROUPS HISTORICALLY UNDERREPRESENTED IN RESEARCH
Authors: Ratnayake Aneeka , Brennan-Ing Mark
Published: January 2025

In this symposium we will discuss research focusing on minority populations who are often under-represented in research. We will focus on research among three groups broadly: racial and ethnic minority groups, sexual and gender minority groups, and patients in low- and middle-income countries. Our first presentation will discuss enrollment of racial and ethnic minority groups in the All of Us Research Program—a program aimed at oversampling those under-represented in research in the United States. The generalizability of those living with HIV captured in the All of Us database will be ascertained as compared to the overall population living with HIV in the United States. The second presentation will discuss whether issues of potentially inappropriate medication prescriptions are different for sexual and gender minority older adults compared to cisgender heterosexual older adults. In this presentation, disparities in potentially inappropriate medication prescriptions among this population will be highlighted. The final presentation will discuss correlates of physical activity among older adults with and without HIV in Uganda. In this presentation the contextual differences for studying physical activity among older adults in the Global South will be discussed. Together, these presentations highlight the need to consider vulnerabilities of populations under-represented in research and especially in older adults. Though specific emphasis will be placed on three under-represented groups, the overarching goal of this symposium is to emphasize the impact of prioritizing representation, intersectionality, and identity when conducting gerontological research and providing healthcare to older adults. HIV, AIDS and Older Adults Interest Group Sponsored Symposium
TESTING ERADAR: A NEW EHR-BASED ALGORITHM TO INCREASE DEMENTIA RECOGNITION IN HEALTH CARE SYSTEMS
Authors: Dublin Sascha , Karliner Leah , Coley Yates , King Deborah , Hsu Clarissa , Lee Sei , Walsh Judith , Barnes Deborah
Published: January 2025

Electronic health records (EHRs) hold potential for identifying individuals with undiagnosed dementia. Using machine learning, our team developed and externally validated a predictive algorithm called the EHR Risk of Alzheimers and Dementia Assessment Rule (eRADAR) that estimates the likelihood an individual has undiagnosed dementia with high accuracy (C statistics of 0.79 to 0.84). Through two embedded pragmatic trials, we are implementing eRADAR in 11 primary care clinics within Kaiser Permanente Washington and University of California, San Francisco. The target population is older adults age 65+ without a documented dementia diagnosis or medication. Primary care providers (PCPs) are randomized to intervention or usual care. The eRADAR algorithm is used to identify individuals with eRADAR scores in the top 15-20%, who are invited to a “brain health” visit that includes assessment of instrumental activities of daily living, depressive symptoms, and cognitive function (Montreal Cognitive Assessment). Results are shared with the patient and PCP, and the PCP is responsible for making the final diagnosis (with decision support provided through the EHR). To date, we have implemented the intervention in 9 clinics and conducted over 590 brain health visits. About 31% (658/2137) of high-risk individuals accept a brain health visit. Of these, about 18% have results suggesting dementia and another 30% mild cognitive impairment. Post-visit surveys show high acceptance of and satisfaction with the intervention. The primary study outcome is rate of dementia diagnosis over 12-month follow-up (completed by April 2025). We are also conducting semi-structured interviews to illuminate benefits and harms.
LEVERAGING THE NIH TOOLBOX FOR EARLY DETECTION OF COGNITIVE IMPAIRMENT IN PRIMARY CARE: THE TOOLBOX DETECT TRIAL
Authors: Wolf Michael , Nowinski Cindy
Published: January 2025

The NIH Toolbox comprises practice standard, cognitive and neurological functional assessments that can be deployed via iPad for research purposes. Our Northwestern team previously validated two of these brief measures of episodic memory and executive function to have clinical utility. Combined, these scored tests can be mobilized as a primary care-based screening tool for detecting cognitive impairment and dementia. To address common time and workflow constraints in these often-busy clinical settings, our derived assessment, known as Toolbox Detect, was adapted accordingly to be self-administered, and to be tethered to the electronic health record thereby removing manual data entry, followed by clear, ‘turnkey’ recommendations to address any suspected impairment. The effectiveness of Toolbox Detect to improve the timely detection, diagnosis, and referral for cognitive impairment is now being evaluated in a large, pragmatic trial conducted across 40 primary care sites within one academic health system, with real-time findings informing an embedded dissemination and implementation study at 20 federally qualified health centers. Early evidence of the fidelity of the Toolbox Detect strategy’s implementation, in terms of feasibility and acceptability and learnings of how it best might be adapted to community centers serving diverse patient populations will be explored in this presentation. Specific attention will be paid to the challenges and opportunities of introducing new technologies into primary care workflows, and healthcare provider, patient and care partner unmet needs in terms of cognitive screening.
UNDERSTANDING THE NEEDS OF INFORMAL CAREGIVERS OF PEOPLE EXPERIENCING DEMENTIA AS IDENTIFIED ON SOCIAL MEDIA
Authors: Flanagan Jane , connolly Maureen , Coakley Amanada , Fugate Matthew (Brent) , Prud’hommeaux Emily , Young Colin
Published: January 2025

Social media has the potential to reach informal caregivers of people experiencing dementia and provide them with supportive and accurate strategies. This study aimed to understand the caregivers’ concerns posted on social media and determine if the responses were supportive and accurate. This study utilized a human-centered machine learning (HCML) framework, natural language processing (NLP), and information retrieval (IR) techniques to extract posts from a dementia caregiver group with the largest number of members (N = 59,954). Using a qualitative descriptive design, we thematically analyzed a sample of 500 initial posts. In a subset of 100 posts and responses to those posts, we used a Delphi method to determine if the responses were supportive and accurate. Five themes were identified: 1) Seeking information about unusual problem behaviors of dementia with nowhere to turn for help; 2) Grief, a sense of loss, and loneliness are profound; 3) Support from others is challenged by relationship issues and distance from caregiving; 4) Financial and legal issues present unexpected challenges; and 5) The need to celebrate caregiving is not recognized. The team found that 73% of the responses to initial posts were supportive, 10% were not, and 10%; did not address the concern; 73% of the responses were accurate, 1% were not and 10% did not address the concern. These findings highlight multifaceted concerns dementia caregivers face. The information is foundational to developing an interdisciplinary HCML interactive question-answering tool using NLP and IR to provide supportive and accurate information to dementia caregivers.