bluuebunny/crossref_metadata_2025 huggingface dataset:
FINANCIAL FORTITUDE: IMPACT OF CAREGIVING ACROSS GENERATIONS
Authors: Vo Quynh , Bhurtel Shikha , Bell Janice , Martinez Pauline DeLange , Whitney Robin , Young Heather
Published: January 2025

There is growing evidence of the economic impact of unpaid family caregiving on physical, mental, social and financial wellbeing. The financial burden of caregiving has not however been fully examined nationally by generation. To address this gap, we examined relationships between generation and selected measures of financial fortitude among caregivers. This cross-sectional study used the 2020 Caregiving in the U.S. Survey to examine any reported impact of caregiving on savings, debt, and bills among adult caregivers who cared for an older adult. The primary independent variable was generation categorized as millennial, Gen X, and Baby Boomer. Survey-weighted logistic regression was used to model outcomes as functions of generation, controlling for socio-demographic and caregiving variables. Compared to Baby Boomers, millennials had higher odds of reporting impact on savings (OR=1.8; p=.006; 95%CI [1.17, 2.70]), debt (OR=2.2; p< 0.01; 95%CI [1.45, 3.40]), and bills (OR=2.6; < 0.01; 95%CI [1.69, 4.24]). Generation X also had higher odds of reporting impact on savings (OR=1.6; p=.006; 95%CI [1.15, 2.3]) and debt (OR=1.4; p=.03; 95%CI [1.02, 2.17]). Caregivers with higher incomes reported lower odds of impacts on all outcomes while those supporting more activities of daily living and caregiving for longer hours had higher odds. Additionally, caregivers with college degrees reported lower odds of impacts on bills. These findings highlight the role of generational status, socio-demographic and caregiving factors on financial outcomes, emphasizing the need for targeted interventions and policies that provide financial support to younger caregivers.
FROM POLICY TO PRACTICE: EVALUATING THE EFFECTIVENESS AND EXECUTION GAPS OF TLTCP 2.0 IN TAIWAN
Authors: Chou Yu-Ting , Yao Kaichen , Wang Hsiu-Jung , Chen Ya-Mei
Published: January 2025

Taiwan has implemented The Ten-Year Long-term Care Plan version 2.0 (TLTCP 2.0) for 7 years, focusing on integrated long-term care (LTC) services. Case managers at Community Integrated Service Center is the key and responsible for proposing managing service plan. However, gaps persist between policy and execution. To understand these gaps, related challenges, and outcomes, we conducted mixed-method study, including qualitative interviews with care managers and analysis of case managements outcomes using data from one a major center in northern Taiwan. Paired T-tests assessed differences between the Case Management Level (CML) scores at discharge and the first re-evaluation. Interviews revealed that the biggest gap and challenge is to become “one-stop shop.” TLTCP 2.0 users still face confusion due to multiple contacts during their service period. Case managers coordinated at least 140 cases monthly, yet the governments’ Care Services Management Information Platform is poorly designed to facilitate this coordination. Additionally, policy design flaws have led to service misuse, such as unclear requirement for range of motion services. Quantitative findings showed that while case mangers handle a higher caseload than in advanced countries, users demonstrate significant improvements in activities of daily living, primary caregivers’ burden, and CML scores after receiving integrated services. However, instrumental activities of daily living scores declined, likely due to reliance on service like house chores, leading to disuse these skills. Overall, the TLTCP 2.0 seems to be effective, but addressing policies and platform design and the issue of skill disuse is crucial for future improvement.
GERIATRICS EDUCATION MENTOR (GEM) PROGRAM: OUTCOMES FROM PAIRING STUDENTS AND OLDER ADULTS DURING MEDICAL SCHOOL
Authors: Griffin Hannah , Wihry David , Gugliucci Marilyn , Wehry Susan
Published: January 2025

Currently, only 15% of medical schools have mentor programs that educate students to work with older adults and their health. The University of New England College of Osteopathic Medicine Geriatrics Education Mentor (GEM) program is an experiential education component within the 1st and 2nd year curriculum whereby students and older adults are paired to conduct five “home-visit” GEM assignments. A pre/post survey design assessed students’ competence and confidence with older people (assigned GEMs). The survey was emailed to first-year medical students before they began GEMs and was sent again upon completion of the program at the end of their second year. This process was carried out through academic years 2020-2021 through 2023-2024 with an average of 174 first-year students per class, and this data was analyzed in RStudio. Results had a 26% response rate that included overall data (N= 133/Pre & N=138/ post), 24 responses were matched assessments. No significant change in students’ interest (p > 0.4), perceived readiness and competence (p > 0.07), or confidence in working with older adults (p > 0.5) was revealed. However, perceived readiness and confidence increased from pre- to post-test, indicating that a larger sample size might reveal significance. Self-reported knowledge of older adult healthcare needs increased, pre- to post-test, with the paired subset showing a significant increase (p< 0.015). Although a small sample, these findings provide a foundation for medical schools to consider implementing a mentor type program to augment medical student skill/knowledge in older adult health care to advance age-friendly health care.
HEALTHY DIETARY PRACTICE AND SELF-RATED HEALTH AMONG KOREAN OLDER ADULTS: THE MEDIATING ROLE OF PHYSICAL ACTIVITY
Authors: Chae Joosuk , Kim Hyunmi , Lim In-Taek
Published: January 2025

This study explored the relationship between healthy eating habits, physical activity, and self-rated health perception among older Korean adults, with a specific focus on whether physical activity level, as measured by the Global Physical Activity Questionnaire (GPAQ), serves as a mediating factor. We examined whether healthy eating habits influenced self-rated health perceptions through increased physical activity using Process Macro 4.3. The analysis included 1,468 older adults aged ≥65 years from the first year (2022) of the 9th Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative panel survey conducted in Korea from 2022 to 2024. The findings confirmed that healthy eating habits affected self-rated health perceptions via increased physical activity. This suggests that healthy eating habits positively help increase physical activity, which in turn enhances self-rated health status. These results highlight the importance of an integrated approach that incorporates healthy eating education and physical activity promotion when developing future care service plans for older adults in Korea. Based on these findings, more comprehensive guidelines can be established for social workers to design individualized programs within the older adults’ care service delivery system.
HOSPITAL AT HOME PROGRAMS: CAREGIVER INSIGHTS ON SUCCESSES AND ENHANCEMENTS
Authors: Hart Julia , Howard Brittni , Nnemnbeng Jeannys , Levine David , Gorbenko Ksenia , Leff Bruce , Siu Albert , Baim-Lance Abigail
Published: January 2025

Hospital at Home (HaH), an alternative to hospital-based care, continues to expand across the US. While the caregiver role is of great interest, little is known about their experiences. This is the first qualitative study, to our knowledge, examining caregiver experiences with HaH in a national sample. Beginning October 2023 (and ongoing), we conducted semi-structured interviews with caregivers via Zoom lasting 30-60 minutes, recruited through the HaH User’s Group, a national collaborative focused on implementation. This analysis uses rapid strategies including: systematic development of analysis templates, their synthesis to identify preliminary themes, and group consensus to ascertain meaning. To date, we completed 13 interviews with spouses, adult children, and grandchildren representing 5 programs (5 NE, 7 MW, 1 SE). 92% were female and 85% white. The mean age is 68 (range: 57-83). Program duration ranged from 3 days to 1 month. Overall, participants felt positive about HaH, reporting they would repeat the experience. Main benefits include: convenience, patient goal alignment, high quality care, and improved patient outcomes compared to brick and mortar experiences. Caregivers reported that providers were responsive, reliable and communicative. Yet, participants described lacking communication about caregiver roles and expectations, and desired additional information. Caregivers also reported needing more clarity about the timing of visits, tasks and procedures. They suggested that HaH may be more challenging to implement in contexts of greater caregiver strain or higher patient acuity. While caregivers generally reported positive HaH experiences, clearer and more explicit communication about the caregiver role could improve their experiences.
HOW DO KOREANS PERCEIVE THE EXPERIENCE OF CAREGIVING? A SYSTEMATIC REVIEW OF THE OUTCOMES OF INFORMAL CAREGIVING
Authors: Koh YoungBin , Ko Sunghyun , Lee Yeonjung
Published: January 2025

Globally, several research have been conducted to show the evidence of caregiving impact. In general, caregiving responsibilities have negative impacts on caregivers’ well-being, and further research has investigated the differences in the outcomes in terms of gender, race, and socioeconomic status. However, there exists not enough efforts to explain these differences at a macro level. For example, how countries differ in the extent to which they rely on informal care services and whether there are differences in caregiving impact among countries. These differences might be related to differences in cultural and policy background. Specifically, South Korea promotes formal long-term care through its national insurance. However, the support for informal caregivers is somewhat weaker compared to other countries, and there is limited research. The purpose of this study is to evaluate the research evidence in Korean contexts and summarize current findings on the outcomes of informal caregiving. A systematic review was performed with a structured literature search following PRISMA guidelines in five Korean databases. Our systematic search yielded 1,143 articles, of which 31 were included for synthesis. Findings show evidence of a negative impact of caregiving including caregivers’ deteriorating physical and mental health as well as reduced employability, especially for female caregivers. However, there are also some positive aspects such as having more satisfied relationship with caregiver recipient. The findings underscore the need for interventions to reduce the negative impact, particularly among female caregivers. We also suggest further research to investigate the cultural contexts to make caregiving experience positive.
IMPACT OF ORGANIZATIONAL FACTORS ON HEALTH ACROSS FRAILTY LEVELS IN TAIWAN’S DISABILITY PROGRAM
Authors: Chiu Wan-Yu , Mao Hui-Fen , Chang Ling-Hui , Chen Ya-Mei
Published: January 2025

Taiwan’s nationwide Prevention and Delay of Disability (PDD) program aims to maintain the physical and mental health of older adults through community-engaged partnerships. This study explored key organizational factors within the PDD program and their impact on health outcomes across different frailty levels. A cross-sectional study (2019-2020) involved 392 administrators from PDD service centers and 13,213 participants, categorized into frail (563), pre-frail (2,397), and healthy (10,253) groups. Over a 12-week period, multiple centers provided a consistent, multi-domain intervention across service centers, universities, and communities. This intervention included physical exercise, nutrition guidance, cognitive training, and social participation, all uniformly applied to the participants. Data were analyzed using multilevel and regression models, employing a tool with twenty items and six dimensions: internal efficiency, responsiveness, professionalism, community cooperation, environmental factors, and sustainability. Results showed that organizational professionalism significantly benefited pre-frail participants by reducing depression (β = 0.347, p < 0.001), fall risk (β = 0.010, p = 0.007), and improving overall health (β = 0.625, p = 0.005). Universities enhanced independent function for both frail (β = 1.215, p = 0.024) and pre-frail (β = 1.287, p = 0.006) participants. Additionally, organizations with favorable environmental factors and strong professionalism had the most positive impact on pre-frail participants, while providing limited benefits to frail participants and minimal impact on healthy participants. It is recommended that healthy participants engage in community activities better aligned with their health status, while frail participants may require more intensive and personalized interventions to maintain functionality and support health improvements.
INFECTIOUS DISEASE CONTROL REGULATIONS IN ASSISTED LIVING COMMUNITIES: BEFORE AND AFTER COVID-19
Authors: Gerken Danielle , Smith Lindsey , Carder Paula , Hua Cassandra , Jutkowitz Eric , Thomas Kali
Published: January 2025

Assisted living (AL) residents are at high risk for adverse health outcomes due to infection, particularly those living in memory care. Despite this, at the outset of the COVID-19 pandemic, most states had minimal or no regulations regarding infectious disease control within AL communities. In this study, we sought to determine if state agencies responded to the COVID-19 pandemic by increasing infectious disease control regulations for AL. We systematically sourced AL regulations for all 50 states and Washington D.C. from the legal policy database Westlaw. We then used search-term driven text retrieval to identify sections of policy relevant to infection control to determine the applicability and scope of each policy. In 2019, there were 13 regulations from 9 states regarding how AL providers should respond to pandemics and epidemics. In 2020, 13 regulations from 10 different states were found. In 2023, this number increased to 18 regulations from 11 different states. The majority of regulations required AL providers to inform a local health department or official about any disease outbreak occurring within the facility. In 2019, 7 of the 9 states (77.8%) had regulations requiring reporting. In 2020, that number decreased to 6 out of the 10 states (60%), and in 2023 the number of states requiring reporting was 8 out of the 11 (72.7%). Our analysis revealed that while a few states have made improvements, there is still a gap in regulatory protection that could result in poor health outcomes for AL residents.
INNOVATIVE PERSON-CENTERED SERVICES THROUGH THE KŪPUNA SUPPORT NAVIGATORS
Authors: Lee Jenny Jinyoung , Nishita Christy
Published: January 2025

The Kūpuna Support Navigator Program in Hawai’i employs Community Health Workers, known as Kūpuna Support Navigators, to connect kūpuna (older adults in Hawaiian) with essential community resources tailored to their specific needs. This innovative, person-centered approach significantly enhances the aging support network in Hawai’i through comprehensive education, seamless integration of care services with advanced tracking software, and rigorous impact evaluation. Its strategic design offers scalable, replicable, and sustainable solutions that enhance the ability of older adults across diverse communities to age-in-place. This program increases the availability of trained Community Health Workers embedded in the aging support network, fostering a supportive environment that enhances the well-being and independence of older adults, ensuring they receive better support and care. The program encompasses a holistic framework that addresses immediate health and social needs while focusing on long-term sustainability and community empowerment. In this presentation, we will detail the setup, structure, and processes of the Kūpuna Support Navigator Program. We will leverage data visualization to present specific outcomes that illustrate the program’s effectiveness in meeting the complex needs of its target population. Additionally, we will discuss the lessons learned and best practices developed, emphasizing the program’s potential as a model for similar initiatives. This overview aims to highlight the significant role of the Kūpuna Support Navigator Program in promoting and enhancing the well-being and independence of older adults.
INTERGENERATIONAL TUTORING: HEALTH BENEFITS FOR OLDER ADULTS IN A TWO-YEAR QUASI-EXPERIMENTAL STUDY
Authors: Sun Peter , Morrow-Howell Nancy , Click Mary , Minch Kendra
Published: January 2025

The COVID-19 pandemic has significantly impacted older adult volunteering. It is important to understand if prior relationships between volunteering and health remain consistent in a post-pandemic context. We surveyed Oasis tutors aged 51 and over before and after two years of volunteering and used three matching algorithms—nearest-neighbor matching, optimal full matching, and subclassification—to match them with a comparison group of non-volunteers in the 2016 and 2018 waves of the Health and Retirement Study. G-computation was then used on the merged sample (N = 518) to estimate the effect of volunteering on depression, functional limitations, and self-rated health. With all three matching algorithms, Oasis tutors experienced lower levels of depression and fewer functional limitations, compared to the HRS group of non-volunteers. When using nearest-neighbor matching, Oasis tutors had better self-rated health than the HRS comparison group. Volunteering in the Oasis Intergenerational Tutoring Program positively impacts older adults’ health, supporting the social model of health promotion.
LEADERSHIP EXCELLENCE AND ADVANCEMENT OF DIRECTORS (LEAD) PROGRAM: FIRST INSIGHTS FROM A NEW MENTORSHIP MODEL
Authors: Bacsu Juanita , Buck Harleah
Published: January 2025

Mentorship is critical to advancing leadership skills and building confidence in academia. However, there is a paucity of programs focused on supporting new center directors in the field of aging. Working with the Gerontological Society of America, we created the Leadership Excellence and Advancement of Directors (LEAD) Program as a mentorship model to provide peer support, networking opportunities, professional growth, and skill development for new center directors. This presentation aims to: 1) identify critical planning steps and strategies to develop high quality mentorship programs to support new center directors in the field of aging; and 2) recognize the LEAD Program as an emerging prototype to elevate leadership skills, build confidence, and advance research excellence to support new directors of gerontological research centers. The Lead Program is a groundbreaking GSA model that is geared towards new directors by providing peer support, leadership development, mentorship, and a dynamic network of fellow directors. The need for the LEAD Program was identified during a recent GSA Center Directors meeting where several directors shared that they were retiring and new directors were looking for mentorship support. The development of the LEAD Program was cultivated by: i) identifying priority topic areas and needs; ii) establishing meeting forma and frequency; iii) addressing potential program barriers and obstacles; and iv) exploring opportunities for peer support and collaboration to advance new directors in the field of aging. The next steps are to implement and evaluate the LEAD Program to strengthen the mentorship model for future cohorts of center directors.
LONELINESS AND DEPRESSION AMONG SEXUAL AND GENDER MINORITY OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Kim Hyun-Jun , Haitsuka Kilohana , Jung Hailey , Fredriksen-Goldsen Karen
Published: January 2025

Sexual and gender minority (SGM) older adults are at elevated risks of cognitive impairment (CI). High rates of loneliness and depression are particularly concerning for SGM older adults living with CI as they are linked to decreased physical health, lower life satisfaction, and accelerated cognitive decline. Yet little is known about the risk and protective factors of loneliness and depression for SGM older adults with CI. This study, utilizing the Health Equity Promotion Model, analyzes the Aging with Pride: National Health, Aging, and Sexuality/Gender Study to examine socioeconomic status, adverse life course experiences, and psychological and social factors that predict depressive symptomatology and the mediating role of loneliness. Data were a sub-sample of 160 participants with CI assessed by the Montreal Cognitive Assessment. Approximately 50% reported feeling isolated from others, 33% were experiencing depression, 40% reported physical or sexual child abuse, 70% were single, and 25% had a network size of 3 or less. A bootstrapped mediation analysis using Mplus revealed that child abuse, day-to-day discrimination, perceived stress, not being partnered, reduced network size, and lack of social support and community engagement were indirectly associated with depressive symptomatology via loneliness. Those with adverse childhood experiences, ongoing distressing stigma, and social isolation are of major concern. Improving support networks may reduce the risk of loneliness and depression. These findings can be utilized to develop culturally tailored interventions to enhance the mental health and overall quality of life of this understudied and underserved population.
LONGITUDINAL ASSOCIATIONS OF HEARING PROBLEM AND DEMENTIA IN COMMUNITY-DWELLING OLDER ADULTS IN THE UNITED STATES
Authors: Chu Jun , Mair Christine , Boudreaux Michel
Published: January 2025

There is evidence linking hearing problem to greater risk of dementia among older adults. However, no study has assessed such association longitudinally using nationally representative survey data. In addition, studies examining racial/ethnic differences in the association are limited. Using data from 2011-2022 National Health and Aging Trends Study and cox proportional hazards model, we examined the longitudinal association between having hearing trouble and dementia among older adults, and whether this association varied by race the ethnicity. Adjusting for demographics characteristics, number of chronic conditions, hearing aid status and social isolation status, we found that having hearing trouble was significant associated with a 2.29 (Hazard ratio=2.29, p< 0.001) higher risk of developing dementia over 11 years. After interacting race/ethnicity and hearing problem in a separate model, we did not find any statistically significant difference in the association by race and ethnicity. The findings suggest that older adults with hearing problem may be at a greater risk of developing dementia. Future studies should assess the effects of policies that promotes hearing tests and hearing aid usage among older adults on dementia delay and prevention.
MOVING BEYOND DISCRIMINATION: BUILDING A COALITION FOR LGBTQ+ OLDER PERSONS LIVING IN EAST TENNESSEE
Authors: Winberry Joseph , Bowland Sharon , Smith Jennifer , Mukherjee Namrata
Published: January 2025

Aims

Research with 50+ older members of the LGBTQIA+ community, conducted by Winberry (Forthcoming), aimed to identify important needs and healthcare gaps in services in East Tennessee. This poster describes establishing a coalition to address their complex needs and gaps.

Methods

As part of a larger community-based participatory research project, a strategic plan created through interviews and focus groups with LGBTQIA+ older persons identified the type of partners needed to accomplish what this population wanted around aging services.

Results

The coalition was formed in a three-step process. First, the earliest members identified organizations and individuals who could address participants’ needs: Culturally competent healthcare, services specifically for LGBTQIA+ people, social support, life planning, and caregiver services. Second, potential members who could address those needs were engaged. Those with personal ties or compelled by a social justice ethos around the LGBTQIA+ community were particularly interested in joining. Last, the role of the coalition members had to be negotiated, given limitations around staff, money, and time. Understanding exactly how members will contribute and when this needs to be renegotiated is essential to coalition success.

Conclusion

The Aging Rainbow Coalition (ARC)—consisting of older members from the LGBTQIA+ community, the local Pride agency, the state flagship land grant university, and other aging services organizations—was established at the county Office on Aging. This poster on the coalition creation process provides details across the three steps of the creation process and highlights insights useful for researchers and practitioners.
MULTIGENERATIONAL DYNAMICS AND FUTURE CARE PLANNING: A QUALITATIVE STUDY OF THREE-GENERATION FAMILIES IN HONG KONG
Authors: Bai Xue , Kang Rui , Ma Ke , Tian Kun , Hu Jing
Published: January 2025

Numerous ageing adults need to provide care for older and/or younger generations while also facing life challenges associated with the transition to old age. However, no systematic investigation has examined aging sandwich carers’ future care planning, nor the impacts of intergenerational care provision on their care planning. A purposive sample of 120 individuals from 40 multigenerational families in Hong Kong was recruited through various channels. The families all filled the following inclusion criteria: (a) had at least one adult aged 50–69 years with both surviving parents and children, (b) all three generations were willing to participate, and (c) the participants spoke Chinese and lived in Hong Kong. For each eligible family, an older parent from the oldest generation, an adult from the sandwiched, and a child from the youngest generation were interviewed separately. Both inductive and deductive coding approaches were used for data analysis. The findings reveal that lifelong multigenerational care transfer and intergenerational relationships shaped the future care planning and preparation processes and experiences. The upward care provision and substantial investment in child-rearing often lead to delayed and indirect reciprocity expectations from the sandwich generation. Moreover, the experience of caring for aging parents prompts sandwich generation to make financial, health, and social life-related care plans. However, traditional family communication patterns often obstruct open discussions about care plans between sandwich generation and their children. Anticipated future circumstances of both aging parents and children further shape the intended care arrangements of the sandwich generation.
NURSES’ PERSPECTIVES ON MEDICATION ADMINISTRATION SAFETY FOR RESIDENTS IN NURSING HOMES: A QUALITATIVE STUDY
Authors: Shieu Bianca , Wang Mei-Chen , Harris John , Lee Ya-Wen
Published: January 2025

Medication administration (MA) in nursing homes (NH) offers several key benefits to residents. However, the complexity of MA often overwhelms existing systems and individual capacities, leading to dissatisfaction among NH residents and staff. Enhancing safety and efficacy requires a robust, user-centered evaluation of the NH MA system, focusing on safety, efficiency, and staff satisfaction issues and opportunities. This qualitative study examined NH staff nurse perspectives regarding MA safety concerns and potential solutions for NH residents, including those with Alzheimer’s Disease and Related Dementias (ADRD). We used purposeful sampling to recruit 12 nurses employed at two NHs in the northeastern United States to participate in phone interviews. The Systems Engineering Initiative for Patient Safety (SEIPS) constructs informed the question guide, coding, and qualitative theme identification. We audio-recorded and transcribed the interviews verbatim. We organized the themes based on SEIPS components, which include (1) Technology-related concerns (non-user-friendly charting systems). (2) Organization-related concerns (teamwork, communication, and leadership). (3) Person-related concerns (variability in staff training and backgrounds). (4) Task-related concerns (different care approaches for ADRD residents, extreme workload variation throughout the day, task prioritization). (5) Environment-related concerns (staff shortages). Overall, the key themes identified by participants included the significance of user-friendly charting systems, customizing MA to accommodate diverse nursing backgrounds, and appropriate nurse-to-patient staffing ratios.
OLDER ADULT ACCESS TO SELF-DIRECTED SERVICES THROUGH MEDICAID HOME AND COMMUNITY BASED SERVICE WAIVERS
Authors: Turner Natalie
Published: January 2025

Self-Direction (SD) is an underused service delivery model shown to improve health outcomes and increase care satisfaction for older adults. Rooted in choice, empowerment, and control over long-term services and supports (LTSS), SD epitomizes person-centeredness. And, because of its ability to provide LTSS in a culturally responsive manner, has the potential to enhance racial equity in LTSS provision. Since each state determines what services can be self-directed and how many beneficiaries can self-direct, state policy impacts access to and use of SD. This mixed-method study identified state differences in access to SD among 1915(c) waivers that serve older adults using Framework Analysis approach and descriptive statistics. Findings indicate potential access barriers to SD provided through 1915(c) waivers. Of the 60 waivers serving older adults in the U.S., 35 allowed SD (58%), representing 26 states and DC. While states described the benefits of SD within waiver applications and highlighted its alignment with person-centeredness, most set very low goals for the number of beneficiaries expected to use SD. Seventy-five percent of waivers set goals for participation in SD at less than 25% of beneficiaries. Furthermore, states acknowledged SD’s flexibility and ability to tailor services to participant needs, while limiting the types of services individuals could self-direct. In light of the established benefits of SD, these findings raise questions about potential underutilization of SD among older adults. Further research is needed to better understand apparent discrepancies between state descriptions of SD and perceived and actual access to these services.
OUTCOMES OF A PILOT WELLNESS PROGRAM FOR LOW-INCOME OLDER ADULTS IN INDEPENDENT LIVING: A MIXED METHODS STUDY
Authors: Yusuf Khalid , Erb Isabelle , Tunningley Joan , Ronis-Tobin Victor
Published: January 2025

By 2030, one-fifth of U.S. residents will be of retirement age, leading to increased demand for residential services for older adults (OAs). Effective wellness programming is crucial to support the physical and psychological well-being of low-income residents, yet there is limited evidence to guide such program development and evaluation. This pilot study details the first phase of a program development initiative in two independent living communities in Southwest Ohio managed by Episcopal Retirement Services (ERS). A mixed-methods approach was used to inform program design. Participants were 57 residents, with an average age of 75.71 years (SD = 7.75); 89.5% were female, and 59.6% were Black or African American. Most participants (86%) reported incomes below $25,000, and 52.6% were divorced. Baseline engagement levels were low (M = 19.82, SD = 6.92), as measured by the Social Engagement and Activities Questionnaire (SEAQ). SEAQ scores did not correlate with program attendance; however, significant positive correlations were observed between going outside the home and both the number of friends (r(55) =.380, p =.004) and having friends within the residence (r(55) =.314, p =.018). Focus group analysis (n = 13) identified eight themes: Holistic Engagement, Activities for Social Connection, Participation Challenges, Personalization Desires, Impact of Isolation, Male Engagement Issues, Strategies for Boosting Engagement, and Self-Improvement Aspirations. These findings emphasize the need for wellness programs that address physical health, foster social connections, and promote personal growth. Active resident-staff collaboration in the development and maintenance of such programming is crucial for success.
PREPARING THE NEXT GENERATION OF THE DEMENTIA CARE WORKFORCE VIA SERVICE LEARNING: A SCOPING REVIEW
Authors: Green Makenna , Mayer Jamie , White Laura , Kouame Gail
Published: January 2025

The prevalence of Alzheimer’s Disease and Related Dementia’s (ADRD) is rising rapidly with the aging of the baby boomer generation. A large workforce gap in dementia providers is widening with education as a frequently cited barrier to entry into the ADRD workforce (Mayer et al, 2023). This scoping review aimed to explore the extant literature on the use of service learning (SL) pedagogy related to ADRD in higher education settings for students in health-related majors. A systematic search was conducted using seven databases. Sources were included if participants were undergraduate/graduate students in any health-related discipline and if SL was utilized in conjunction with specific instructional paradigms (e.g., coursework, on-site workshops). SL, though individually defined by authors of included studies, was required to include community engagement with adults with ADRD; studies specific to clinical rotations were excluded. Included sources (n=32) were systematically extracted for characteristics including student demographics, SL components (learning instruction methods/training, experiences, reflection), and outcomes. Analysis of training revealed most ADRD SL paradigms relied on setting-specific training (n=15) over didactic academic instruction (n=7) or a combination (n=7). SL experiences ranged in type with informal activities (n=13) and creative arts (n=9) most commonly utilized to engage participants. The reflection component most commonly included open-ended reflective journals (n=15). Analysis revealed variability in how SL is represented in the literature. Despite this variability, sources frequently report SL as a viable option for educating the next generation of dementia service providers, with observed improvements in student attitudes and knowledge related to ADRD.
REFRAMING AGING: THROUGH THE LENS OF ETHICAL ARTIFICIAL INTELLIGENCE
Authors: McNellis Cynthia
Published: January 2025

Artificial Intelligence (AI) technology is advancing at a rapid pace. In addition, our older adult cohort is growing at an unprecedented rate. The purpose of my research is to address the ethical concerns when AI intersects with this population, offering policy recommendations to bridge this ethical digital divide. To address this AI ethical dilemma, my research did not reach back prior to 2019 in order to provide a concise policy analysis that includes existing AI ethical policies/recommendations from the European Union, United States, and U.S. States, key differences, and how ethical AI policies are central to Area Agencies on Aging’s development of aging services. My findings indicated gaps in ethical AI design with developed policy recommendations. These gaps include inclusive data collection, user-centric design, algorithmic biases and understanding, digital literacy, New Jersey AI Task Force membership, and a need for a New Jersey AI Ethical Framework. With my five policy recommendations, New Jersey will be better positioned in assuring AI systems will be equitable, ethical, and effective in addressing the present and future needs of older adults. With this ethical AI framework, New Jersey will help to better older adults’ quality of life, as well as save valuable time and resources through the new industrial revolution that is Artificial Intelligence. Keywords: Artificial Intelligence, ethics, older adults, algorithmic bias, AI ageism
ROLE OF MACHINE LEARNING (ML) IN AGING IN PLACE RESEARCH: A SCOPING REVIEW
Authors: Park Sojung , Ahn Eunhye , Ahn Tae-Hyuk , Ahn SangNam , Park Soobin , Kwon Eunsun , Ahn Seoyeon , Yang Yuanyuan
Published: January 2025

As global aging accelerates, Aging in Place (AIP) is increasingly central to improving older adults’ quality of life. Machine Learning (ML) is widely used in aging research, particularly in health monitoring and personalized care. However, most studies focus on clinical settings, leaving a gap in understanding ML’s application in non-clinical AIP contexts. This review addresses this gap by exploring the themes, policy implications, and ethical concerns of AIP-ML studies, including AI bias and fairness. The review examined 32 peer-reviewed studies sourced from databases like PsycINFO, MEDLINE, and PubMed. Through thematic analysis, three main themes emerged: successful aging, managing depressive symptoms, and fostering social connectedness. The studies employed various ML techniques, including classification algorithms, random forest, SVM, and LASSO, to predict health outcomes such as depression, cognitive decline, and functional disabilities in older adults. They also identified key risk factors and examined disparities in healthcare access and digital inclusion.However, the studies often lacked validation across diverse populations, which limits their policy impact. Most research focused on healthy, community-dwelling older adults, excluding those with dementia or disabilities, thereby introducing biases that could disproportionately affect marginalized groups The review highlights that while ML models are useful for prediction, they may overlook the needs of less healthy older adults, reducing their accuracy and fairness. These findings emphasize the need for transparency and participant involvement in data usage, suggesting that despite its limitations, the current literature offers valuable insights for advancing AIP research and guiding the development of more inclusive AIP policies.
TECHNOLOGY THAT SUPPORTS EXTENDING DEMENTIA-FRIENDLY COMMUNITY BASED CARE: A SCOPING REVIEW
Authors: Buckley Nina , Hewitt Elizabeth , Chen Limei , Choi Sang
Published: January 2025

With global aging on the rise, there is increasing interest in technological interventions that support persons living with dementia (PLwD) to age in place. This scoping review identifies and examines technologies specifically designed for dementia care, explores their usage contexts, and assesses their potential for implementation in community settings. A systematic search was conducted across nine electronic databases—APA PsycInfo, AgeLine, MEDLINE, SocINDEX, Global Health, Web of Science, Google Scholar, and CINAHL—following the WHO (2023) framework for the classification of digital health interventions. The review included peer-reviewed articles published between 2014 and 2024, using search terms related to “dementia,” “digital technology,” “quality of life,” and “community.” Articles were screened for eligibility based on predefined criteria, such as being peer-reviewed and written in English. Out of 1,009 articles originally identified, 54 met the inclusion criteria and were included in the review. The findings reveal a range of technologies aimed at keeping PLwD safe and supported at home. However, the majority of studies highlighted a significant reluctance among PLwD to adopt these technologies, often due to a lack of familiarity and comfort with digital tools. This hesitancy, particularly among family caregivers, emerged as a major barrier to the successful implementation of technological interventions in community settings. To enhance the effectiveness of technology in dementia care, there is a need for strategies that address caregiver concerns and improve digital literacy. Future research should focus on developing user-centered interventions that are adaptable to the diverse needs and preferences of both PLwD and their caregivers.
THE ROLE OF HOUSING IN LONG-TERM NURSING HOME UTILIZATION IN THE UNITED STATES: AN INTEGRATIVE REVIEW
Authors: Bergh Marissa , Travers Jasmine
Published: January 2025

Given the growing housing crisis, researchers increasingly point to housing as a possible risk factor for nursing home (NH) utilization, yet the exact pathways from housing to NH utilization are unclear. The purpose of this integrative review was to develop an understanding of how housing acts as a mechanism that impacts NH utilization in the United States. Five databases were searched in April 2024 and 16 total articles were included. This review highlights four pathways for this relationship: 1) Financial Asset vs. Burden, represents how some leverage home equity to help finance necessary NH placements, while for others the cost-burden of housing may lead to early nursing home placements; 2) Access to Affordable Housing, represents how the supply of affordable housing impacts the ability of NH residents to return to community living; 3) (Mis)match Between Needs and Housing, represents how functional needs rapidly evolve, leading to housing transitions and NH placements; and 4) Compounding Systemic Inequities, represents how systemic inequities in access to affordable, quality housing lead to disparities in NH placement for socio-economically marginalized older adults. The results from this review provide evidence of the relationship between housing and NH utilization across these four pathways; however, due to weak quality of evidence, and limited methodological diversity, more research is needed to strengthen this evidence. Clinicians, researchers, and policymakers should still recognize the importance of housing in NH utilization and seek to target policies and interventions towards improving housing conditions for those at risk for NH placement.
THE SENIOR COMPANION JOURNEYS PROJECT: A TRAINING TO ENHANCE VOLUNTEERS’ KNOWLEDGE OF AD/ADRD
Authors: Fields Noelle , Xu Ling , Li Pingnan , Stringfellow Mary , Gomez Melissa
Published: January 2025

Research suggests that trained volunteers may be equipped to serve as interventionists for family care partners (CPs) of persons living with dementia (PLWD). The Senior Companion Journeys Project (SCP-J) was developed to help bridge gaps in knowledge of AD/ADRD and CP support. The purpose of this study was to evaluate the SCP-J training (n = 49) as part of a volunteer-led intervention for CPs of PLWD. The Alzheimer’s Disease Knowledge Scale (ADKS) and open-ended questions were used to examine the SCs’ knowledge before and after the SCP-J training. Non-parametric McNemar tests were conducted for each item and the overall correct response rate of the ADKS scale, respectively. Qualitative interview data were analyzed using RaDAR analysis. The results of the quantitative data indicated overall significant improvements in the overall correct response rate of ADKS after the SCP-J training (p <.001). Some specific ADKS items showed a significant increase after the training including items related to early responses to AD/ADRD behaviors (p <.001), high cholesterol and risk for developing AD/ADRD (p <.01), and high blood pressure and risk for developing AD/ADRD (p <.01). Qualitative findings revealed three themes: improved knowledge or reinforced knowledge of AD/ADRD, improved coping skills for problematic behaviors associated with AD/ADRD, and improved confidence in providing CP support. Overall findings suggest that the SCP-J Training is a promising intervention for enhancing knowledge about AD/ADRD for SC volunteers. Recommendations for future research and strategies for other volunteer-led AD/ADRD interventions in community-based settings are offered.
THE WHO INTEGRATED CARE FOR OLDER PEOPLE (ICOPE) FRAMEWORK AND THE ASSOCIATION WITH FRAILTY IN OLDER ADULTS
Authors: Chou Wan Yun , Hou Su-I
Published: January 2025

The World Health Organization (WHO) introduced the Integrated Care for Older People (ICOPE) framework, designed to enhance the intrinsic capacity (IC) of older adults, focusing on their physical and mental health. This shift in care approach, from disease-centered to person-centered, reflects the rapid increase in the global aging population. The objective of the current study was to explore how IC relates to frailty in older adults. In a medical center in Taiwan in 2021, this cross-sectional study involved patients aged 65 and older admitted to the geriatric ward. Participants completed a questionnaire that included an IC assessment based on the six domains of ICOPE (cognition, mobility, nutrition, visual, hearing, and depressive symptoms), Fried’s frailty scale, and demographic information. Fried’s frailty scale categorized participants into robust (score=0), prefrail (score=1-2), or frail (score ≥3) groups. Logistic regression analysis was employed to examine the association between individual ICOPE domains and frailty, adjusting for age, gender, and number of comorbidities. Of the 210 participants, 39.0% were categorized as prefrail and 28.6% as frail. Notably, mobility loss and depressive symptoms were strongly linked to prefrail and frail conditions, with significant adjusted odds ratios (aOR) indicating higher risks. Additionally, malnutrition and hearing loss were significantly associated with frailty. These findings underscore the critical need for attention to IC and frailty in older adults and advocate for regular implementation of the WHO ICOPE screening pathway. While the convenience sampling method may limit generalizability, further research is necessary better to understand the utility of ICOPE in frailty identification.
TOWARDS AN AGE-FRIENDLY UNIVERSITY: INSIGHTS FROM CULTURALLY DIVERSE COMMUNITY-DWELLING OLDER ADULTS
Authors: Wong Joey , Gregorio Mario , Santaella Paulina , Soni Albin , Fu Jason , Meghelli Ilan , Hung Lillian
Published: January 2025

Lifelong learning is essential for enhancing older adults’ self-esteem and social connections and expanding their capabilities. Including older adults on university campuses fosters intergenerational learning, where younger students benefit from their experiences and mentorship. This project addresses the growing emphasis on creating age-friendly universities by improving inclusiveness, diversity and equity at the University of British Columbia (UBC) Vancouver campus. The study, conducted in June and July 2024, engaged 25 community-dwelling older adults from diverse backgrounds—including Indigenous groups, multi-ethnic groups and people of color, LGBTQIA2+, and individuals with various physical and mental capacities—in audit walks with younger students across the campus. These walks assessed features related to “age-friendliness.” Group conversations before and after the walks provided valuable insights into participants’ perceptions of age-friendliness and feedback on current age-friendly university principles. Findings revealed a strong interest among older adults in continued learning, research collaboration, and mentorship opportunities. However, significant barriers were also identified regarding campus navigation, course registration, affordability, and communication. Additional concerns included safety issues, more accessible features, and improved transportation infrastructure. Participants also highlighted the importance of cultural inclusivity, such as multilingual resources and diverse art representations. This study not only reaffirms established age-friendly principles but also underscores the need to address environmental safety and accessibility from the perspectives of older adults. It advocates for a collaborative approach to developing an age-friendly university campus that effectively meets the needs of all its members, ensuring an inclusive environment for learners of all ages.