bluuebunny/crossref_metadata_2025 huggingface dataset:
GENTLE MOVES: AN INNOVATIVE IN-HOME PHYSICAL ACTIVITY PROGRAM INCLUSIVE OF OLDER ADULTS WITH ADRD
Authors: Hu Elise , Yin Lijuan , Song Woojin , Skowronski Jordan , Stocks Jane , Bing-Canar Hanaan , Caceres Maria , Muramatsu Naoko
Published: January 2025

While regular physical activity (PA) is vital for older adults’ health, older adults with Alzheimer’s disease and related dementias (ADRD) often find regular PA unattainable due to prolonged inactivity, functional limitations, and/or lack of motivation. Pro-Home(TM) Gentle Moves for Healthy Aging (GM) is an in-home PA program inclusive of inactive/frail older adults with ADRD, adapted from an evidence-based PA program. GM is innovative because (1) GM applies behavioral learning theory to guide learning, managing, and reinforcing regular PA; (2) GM features PA goalsetting to enhance motivation and builds PA into participants’ daily routine; (3) the in-home PA moves are appropriate for inactive/frail older adults with ADRD; and (4) participants receive a personalized tablet to remind and support daily completion of GM. We remotely pilot-tested GM with 8 participants and their caregivers. Participants had a mean age of 79.3 (SD=9.67), 5 were female, and caregivers were participants’ children (n=4), spouses (n=3), or grandchildren (n=1). Despite varying degrees of ADRD, all dyads actively engaged with our interventionist to set PA goals, learn GM, and incorporate GM into their daily routines. Additionally, all dyads completed the 3-month program (100% retention). Participants felt safe doing GM at home and found GM’s intensity appropriate for their abilities. While most participants with mild ADRD independently completed the 3-month intervention with daily tablet use after initial instruction, participants with moderate ADRD required greater caregiver support using the tablet and reminding and motivating participants daily. Future directions include implementing GM into healthcare settings and investigating further motivational strategies.
GENTRIFICATION AND COGNITIVE DECLINE IN OLDER ADULTS: MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS
Authors: Hirsch Jana , Moore Kari , Yazdi Reyhaneh Akbar Nejad , Besser Lilah , Hughes Timothy , Michael Yvonne
Published: January 2025

Gentrification, transition of neighborhoods from a state of disinvestment to reinvestment, introduces new amenities potentially beneficial for health of residents who are able to remain. However, the displacement of existing residents may result in stress and diminished social connection. These disparate influences of gentrification may positively or negatively influence older adults’ brain health. We used a sample of 1,292 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) to examine associations between gentrification from 2000 to 2010 and cognitive function change between Exams 5 (2010-2012) and 6 (2016-2018). Neighborhoods were categorized as continually advantaged (ineligible to gentrify), continually disadvantaged (eligible to gentrify but not gentrified), and gentrified. We categorized three continuous cognitive measures as maintained/improved score versus decline in score from Exam 5 to 6: CASI (version 2), global cognitive function; Digit Symbol Coding (DSC) task, processing speed; and Digit Span (DS), short term memory. Compared to those living in continually disadvantaged neighborhoods, participants residing in gentrified neighborhoods had 5% lower risk of CASI decline and 2% lower risk of DSC decline. More pronounced, those residing in continually advantaged neighborhoods had 10% lower risk of CASI decline, 6% lower risk of DS decline, and 8% lower risk of DSC decline. After adjustment for age, gender, race/ethnicity, language of administration, education, income, working status, and APOE4, only DSC declines remained statistically significant. Among a multi-ethnic and geographically diverse population, we observed a linear relationship through which risk of cognitive decline decreased with higher level and improvement of neighborhood socioeconomic conditions.
HEIGHTENED STRESS IN FOOD CHOICES: HOW ACUTE EXERCISE IMPACTS OLDER ADULTS’ DECISION-MAKING
Authors: Heselton Hyeon Jung (Judith) , Persson Annelie , Boron Julie Blaskewicz
Published: January 2025

Both habitual and acute exercise have a subjective stress-reducing effect in young and older adults. Exercise is associated with improved cognitive performance related to decision-making, while stress correlates with poorer decision-making regarding food intake in some individuals. Previous research with young adults found that acute exercise reduced perceived stress, as well as increased the amount selected for consumption both immediately after and 30 minutes post exercise. The current study assessed the impact of acute exercise on perceived stress in older adults while making hypothetical choices related to the amount and timing of food intake. Thirty-one healthy older (Mage=68.67; SD=3.08; Range=64-75) participants (54.8% female; Mean BMI=26.16kg/m2; SD=2.82kg/m2) completed 45-minutes of aerobic exercise and a resting control condition in randomized order. Perceived stress was surveyed (scale 0-10) before the exercise bout, immediately after, and 30-minutes post-condition. Food amount and intertemporal food preferences (e.g., immediate vs. delayed consumption) were assessed. Repeated-measures of analysis of variance (SPSS version 29) indicated no main effect on food amount preference, preferred timing of consumption, or stress; however, an interaction of condition and time on stress (p=0.013) showed when compared to rest, exercise resulted in increased stress from pre-to-post+30 min (F=7.58; p=0.02). Results suggest that acute exercise may transiently increase perceived stress in the context of decision-making around food choices in older adults highlighting the importance of available food options for this population. After replication, future studies should seek to elucidate the etiology and duration of increased stress, and the source of stress, in older adults.
HELP THAT HURTS: HOW BENEVOLENT AGEISM AND ABLEISM INTERSECT
Authors: Thompson Devin , Strickland-Hughes Carla
Published: January 2025

Older adults and people with disabilities are common victims of overaccommodative and unwanted help, partially due to their shared stereotypes of incompetence. This research replicated past work on perceptions of benevolent ageism (Chasteen et al., 2021), extending with examination of ableism and ratings of need for help. We aimed to test how younger and older persons’ impressions of an older woman (e.g., warmth) were affected by her reaction to benevolent ageism, depending on her physical disability. Younger (n=205; 18-35 years old) and older (n=216; 55+ years old) participants were recruited via MTurk, CloudResearch, and participant pools. Participants were randomly assigned to read a benevolent ageism scenario where an older woman had a cane or not and reacted by politely confronting or reluctantly accepting unnecessary help. Participants rated the older woman before and after her reaction. Consistent with preregistered hypotheses and past research, ratings of warmth, competence, and overall impression increased whereas ratings of perceived need for help decreased when the older women moderately confronted the offer of help. These effects were more pronounced for older participants than younger participants. However, the presence of the cane influenced impressions by younger, but not older, participants, who rated the older women as more warm after confronting ageism only when she had a cane. This age difference in perception based on the cane might be explained by experience with mobility aids. Implications of results for understanding how ableism and ageism interact for perceivers of different ages and abilities will be discussed.
HELPING BEHAVIORS AND COGNITIVE FUNCTIONING: IMPLICATIONS FOR INDIVIDUALS WITH COGNITIVE IMPAIRMENT AND DEMENTIA
Authors: Zhang Shiyang , Jang HaeJin , Han Sae Hwang
Published: January 2025

Formal volunteering is widely recognized for its health benefits, including improved cognitive functioning and delayed onset of cognitive impairment and dementia. However, the extent to which these cognitive benefits vary across individuals with different levels of cognitive functioning remains unclear, and the impact of informal helping (e.g., helping friends, neighbors) on cognition is even less well understood. To address these gaps, we analyze data from the U.S. Health and Retirement Study (1998–2020; 199,126 observations from 35,004 individuals) using unconditional quantile regression models. This allowed for investigating the heterogeneous effects of two forms of helping behaviors–formal volunteering and informal helping–on cognitive functioning, measured with the Telephone Interview for Cognitive Status (TICS; range 0–27), across the cognitive functioning distribution. Our findings reveal that the cognitive benefits of both helping behaviors become progressively more pronounced for individuals experiencing worse cognitive functioning, including those with cognitive impairment (TICS score: 7–11) and dementia (score: 0–6). These unique results challenge the prevailing assumption that healthier individuals are more likely to engage in helping behaviors and thus accrue more benefits. Instead, this study highlights that helping behaviors may be particularly beneficial for individuals at the lower end of the cognitive functioning distribution, and shed a positive light on many older adults who continue to help others despite having health challenges. Our findings support recommendations for healthcare practitioners to devise and implement innovative strategies that integrate helping behaviors as part of healthcare to promote cognitive health and well-being among older adults, especially those at risk of cognitive impairment.
HOME MAINTENANCE STRESS AND BURDEN IN A SAMPLE OF INFORMAL CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Griffiths Patricia , Tennenbaum Louis , Turner Seymour , Kimmel Susan , Sanford Jon
Published: January 2025

Home maintenance (HM) as it relates to stress, burden and aging in place (AiP) of informal caregivers (ICGs) of persons with dementia (PwD) is undervalued and understudied, yet a crucial component of a safe and reliable home environment. Homes Renewed Ventures surveyed a convenience sample of 14 ICGs caring for PwDs to assess stress and burden associated to HM and the relationship between HM, disruptions to, and AIP. HM Stress and burden were rated on a 5-point scale (none to a great deal) and were highly correlated (r=.92). ICGs reported high stress (mean = 3.9 + 1.4) and burden (3.6 + 1.5) in relation to HM (median and mode stress = 5, burden 4 and 5). Almost three-quarters (73%) had HM problems that disrupted daily routines with five instances resulting in relocations. ICGs rated the likelihood of doing more HM if provided with information (a) customized to their home or (b) on who to call and financing. The means, modes and medians were four or more indicating a high likelihood to do more HM if provided with helpful, personalized information. A Fisher’s exact test indicated a significant association (p=.027) between HM Stress and the likelihood of doing more if provided with option a) customized information about what needs to be done. Although a small convenience sample, these preliminary findings provide strong evidence that HMI are disruptive and stressful, suggesting that enhancing caregiver mastery of these issues is a potential mechanism for reducing ICG stress and burden.
HOW DOES SOCIAL INTEGRATION SHAPE HEALTHCARE USE AMONG OLDER ADULTS IMMIGRANTS?
Authors: Patel Aditi , Hong Sungjae , Mejia Shannon
Published: January 2025

Immigrant populations often face significant health challenges due to language or financial barriers, creating unique vulnerabilities that impact community health. This study focuses on social integration among immigrant older adults, which indicates how a relationship between an individual and their community is built and maintained. The aim is to understand how social integration, which has shown varying support for healthcare access, affects immigrant older adults and their use of novel healthcare measures like telehealth. We interviewed 22 Korean immigrant older adults living in the Chicago Metropolitan Area. The interviews covered respondents’ life experiences, focusing on affiliated communities and healthcare experiences. We conducted a content analysis to explore approaches to developing social integration and its implications for the healthcare experience. Our analysis compared the healthcare and telehealth experiences by the types of communities they belonged to and to what extent they felt affiliated with it. The analysis revealed three findings. First, strong affiliations in Korean communities, such as the Korean church, led to access to healthcare information, like available healthcare resources. Second, telehealth services were not associated with the social integration of immigrant older adults because they adopted telehealth during the COVID-19 pandemic based on healthcare providers’ recommendations. Third, strong affiliations with adult children supported the continued utilization of telehealth services in the years that followed the COVID-19 pandemic. These findings highlight the critical role of social networks and social integration in shaping healthcare decisions, offering valuable insights for developing strategies to improve telehealth accessibility and support services for immigrant populations.
I FOLLOW THROUGH: CONSCIENTIOUSNESS IS ASSOCIATED WITH ADHERENCE
Authors: Lakshmanan Sarada , Flynn Sheryl , Reyes Joel , Rubinstein Stephanie , Zelinski Elizabeth
Published: January 2025

Conscientiousness has been linked to positive health benefits, as conscientious individuals have high self-control and are determined to follow a plan (Roberts et al., 2009). Therefore, we tested a sample of 44 older adults aged 57-95, to see whether conscientious individuals were more likely to adhere to a time-intensive, self-guided, digital, home-based fall prevention program. The fall efficacy program contained 11 lessons with 60 5-10-minute-long classes and an avatar-guided program based on the Otago Exercise Program consisting of lower extremity strengthening and balance exercises. Participants completed up to three lessons and exercised up to three days per week. Conscientiousness was assessed using the Big 5 Personality Test. Lesson adherence reflects the number of lessons completed and exercise adherence was measured from baseline to 3 months and from 3 months to 6 months, creating a 3-month and 6-month adherence statistic. We then used Pearson’s r-correlation coefficients to assess the relationships between personality traits and exercise and lesson adherence. None of the traits were significantly related to lesson adherence. Intellect/imagination and extraversion were significant for 3-month exercise adherence (p<.05) while emotional stability was significant for 6-month exercise adherence (p<.05). Conscientiousness was significant for both 3-month (p<.05) and 6-month exercise adherence (p<.05). Conscientious individuals appear to have a stronger tendency to adhere to exercise programs over both 3 and 6 months, suggesting a potential link between conscientiousness and sustained habits. Further analysis is needed to make more definitive and directional conclusions regarding this relationship.
ILLNESS INTRUSIVENESS AND PERCEIVED CONTROL ON QUALITY OF LIFE IN OLDER ADULTS WITH ARTHRITIS AND MULTIMORBIDITY
Authors: Joshi Sama , Reid M Carrington , Mindlis Irina
Published: January 2025

Arthritis is independently associated with diminished quality of life (QOL) among older adults; and QOL is even worse among those with arthritis and multimorbidity (MM). Illness intrusiveness—i.e., the perception that diseases and their treatments interfere with valued roles and activities—leads to poor QOL among those with chronic illnesses. Further, the perceived control individuals have over their illnesses has been proposed as a mechanism underlying the relationship between illness intrusiveness and QOL. While illness intrusiveness and perceived control are amenable to change, they are understudied among older adults with arthritis and MM. We investigated the role of perceived control as a potential mediator or moderator in the relationship between illness intrusiveness and QOL among older adults with arthritis and MM. We conducted a secondary analysis on a cross-sectional sample of older adults with MM (N=228) using PROCESS macro for SPSS. Participants were on average 72.0 years (SD=5.5), largely women (66.1%), with 2.8 chronic illnesses (SD=0.4), and high levels of pain intensity (M =7.92, SD=2.29) and illness intrusiveness (M=38.86, SD=16.55). Perceived control was a significant mediator in the relationship between illness intrusiveness and QOL, even after adjustment for pain intensity [β = -0.16, 95% CI (-0.13, -0.06)]. Perceived control did not moderate the relationship. In this sample of older adults with arthritis and MM, with high levels of illness intrusiveness and pain intensity, perceived control mediated the relationship between illness intrusiveness and QOL. Perceived control may be a target for future behavioral interventions to improve QOL in this population.
IMPACT OF COGNITION AND DEPRESSION ON PHYSICAL ACTIVITY IN OLDER ADULTS WITH CVD: NHANES 2011-2014
Authors: Kim Hyun Jung , Gore Shweta
Published: January 2025

Cardiovascular disease (CVD) is a major cause of morbidity and mortality. Physical activity (PA) is crucial for its prevention and management. Cognitive impairment and depression, common in older adults with CVD, impact PA and sedentary behaviors (SB). This study explores the associations between cognitive function, depression, PA, and SB in 632 older adults with CVD, using data from the NHANES 2011-2014. PA was assessed using the Global Physical Activity Questionnaire – meeting PA guideline as ≥ 500 MET-min/wk and SB as spending ≥ 7 hr/day in sedentary time. Cognitive function was measured as a composite z-score from four standardized tests (CERAD Word List Learning and Recall, Animal Fluency Test, and Digit Symbol Substitution Test). Depression was measured using the Patient Health Questionnaire (PHQ-9) and categorized into none (score: 0), minimal (1-9), moderate (10-14), and severe depression (15-27). Survey design methods were used to adjust for the complex sample design. Significant predictors from preliminary bivariate analyses were included in logistic regression models. When adjusting for covariates, higher cognitive function increased the odds of meeting PA guidelines by 79% (OR = 1.79, 95% CI = 1.01-3.17, p =.047) and moderate depression by 79% (OR = 0.21, 95% CI = 0.08-0.56, p =.003). Self-perceived general health was also a significant predictor of PA. On the contrary, cognitive function and depression were not significantly associated with SB. These results highlight the importance of considering cognitive and mental health to promote adherence of PA in this population.
IMPACT OF PROJECT ECHO ON SELF-ASSESSED KNOWLEDGE IN LONG-TERM CARE AND PRIMARY CARE WORKFORCES
Authors: Telonidis Jacqueline , Brunker Cherie , Hernandez Christopher , Dassel Kara , Edelman Linda S
Published: January 2025

Project ECHO is a widely accepted method for transforming care through education. The Utah Geriatric Education Consortium (UGEC), a Health Resources and Services Administration funded Geriatric Workforce Enhancement Program, developed a monthly Age-Friendly ECHO series to educated clinicians about the Institute for Healthcare Improvement Age-Friendly Health Systems Initiative 4M’s Framework. The purpose of this program evaluation was to measure knowledge gained over the 12-month series ending in June 2024.

Methods

We used retrospective pre-post testing via Zoom polling to measure knowledge gained for each ECHO topic. This approach measures participants’ learning after the session by asking them to assess their knowledge from two viewpoints – BEFORE and AFTER participating.

Results

The UGEC hosted 11 ECHOs with a total of 461 participants: Allied Health (3.04%), Behavioral Health (20.61%), Medicine (10.63%), Nursing (20.17%), Paraprofessionals (6.07%), and other professions including facility administrators, informal caregivers, etc. (39.48%); students made up 3.08% across all disciplines. Overall, results revealed significant improvements in knowledge gained (t = -12.5273, df = 208, p < 0.001). The greatest changes were observed for presentations about Advanced Treatment Options for Parkinson’s Disease (t = -5.9847, df = 18, p < 0.001), Helping Patients Age Well (t = -5.4349, df = 20, p < 0.001), and Keys to Addressing Ageism (t = -4.8190, df = 18, p < 0.001). Conclusions: Retrospective pre-post is a valid method to measure learning compared to a traditional pre-post approach. Project ECHO is an effective learning model for best-practice dissemination to increase knowledge about the 4Ms Framework.
INDIVIDUAL AND SOCIAL FACILITATORS OF PHYSICAL ACTIVITY IN STROKE SURVIVORS: EVIDENCE FROM DAILY LIFE ASSESSMENTS
Authors: Garza Elizabeth Zambrano , Pauly Theresa , Murphy Rachel , Ashe Maureen , Madden Kenneth , Linden Wolfgang , Gerstorf Denis , Hoppmann Christiane
Published: January 2025

Physical activity is a means through which stroke survivors can reduce their future stroke risk. Individual intentions (purposeful aims to engage in a behavior) and self-efficacy (beliefs about their capacity to successfully perform the behavior) have been associated with more physical activity. Spouses are underrecognized resources that may facilitate physical activity engagement. We specifically examined dyadic intentions (shared aims to engage in a behavior) and dyadic self-efficacy (beliefs about the capacity to engage in a behavior with a partner) to explore the important role of spouses in facilitating physical activity. 88 Canadian stroke survivors (Mage = 67.84, SD = 10.79; 73% male; 35% with college degrees; 82% White) wore physical activity monitors for up to 14 consecutive days and completed morning and evening questionnaires including daily individual and dyadic intentions and self-efficacy. Results reveal positive associations between individual morning intentions and physical activity (self-report and accelerometer based) but not for individual self-efficacy. Dyadic variables (intentions and self-efficacy) were positively associated with self-reported physical activity but not with accelerometer assessed physical activity. Notably, associations differed by analytical level: within-person effects were significant for individual intentions and dyadic self-efficacy, whereas between-person effects were significant for both individual and dyadic intentions. This project highlights and discusses the importance of considering within and between person effect to provide more granular insights on the complexity of the targeted phenomenon as well as issues of physical activity measurement (self-report, device-derived) to light on avenues for increasing physical activity engagement in stroke survivors.
INTERGENERATIONAL SILENT DISCO PARTIES FOR OLDER ADULTS LIVING IN LONG-TERM CARE
Authors: Meghelli Ilan , Son Rynnie Cin Ee , Banco Julia , Yu Oliver Hang Kin , Arora Shambhavi , Mondol Swastika , Hung Lillian
Published: January 2025

Silent disco headphone parties in long-term care (LTC) settings offer a unique way to bring residents together to dance and share musical experiences through wireless, multichannel headphones. Unlike traditional group activities, these parties allow residents to choose their music, creating a personalized yet communal experience. Older adults living in LTC often experience loneliness and social isolation. Silent disco parties can offer a unique opportunity for socialization and enjoyment. This study explored the experiences of 22 older adults in silent disco parties with an intergenerational group of volunteers on the dance floor. Over six weeks, data were collected through video ethnography, including video recordings, conversational interviews, observations, and focus groups with 40 staff members. Thematic analysis identified three themes: intergenerational togetherness, social capacity, and inclusivity. Findings suggest that intergenerational silent disco parties hold promising potential to address loneliness and social isolation in LTC settings. Future research should investigate how these parties can influence residents’ social health and quality of life.
INTERIM ANALYSIS: VALIDATION OF THE AGITATION IN ALZHEIMER’S SCREENER FOR CAREGIVERS (AASC®)
Authors: Jackson W Clay , Stroud Jared , Brubaker Malaak , Patel Mehul , Fehnel Sheri , Peschin Sue , Grossberg George , Clevenger Carolyn
Published: January 2025

Agitation in Alzheimer’s dementia often goes unrecognized or underreported, contributing to delayed diagnosis and treatment. The International Psychogeriatric Association (IPA) set a standard for defining agitation in cognitive disorders. The Agitation in Alzheimer’s Screener for Caregivers (AASC®), the first clinical tool based on IPA criteria, was developed to support caregiver-healthcare professional (HCP) discussion and timely recognition of agitation in Alzheimer’s dementia. It has 2 questions assessing presence and impact of agitation behaviors. This ongoing, prospective, multisite, single-visit observational study will calculate predictive metrics for recognizing agitation by the AASC® versus IPA criteria. Interim (n=50 caregiver-HCP dyads) and final (n=150 dyads) analyses will determine agreement rates (yes/no) and sensitivity/specificity. This ongoing interim analysis included 44 dyads (caregivers completed AASC®; HCPs completed IPA criteria). Most patients/caregivers were female (70%/50%) and 74 (±7.3)/58 (±18.9) years old. Most caregivers were White (57%), a spouse/partner (43%) or child (23%), and spent a mean (SD) of 40.8 (44.3) hours/week providing care. Percentage agreement between AASC® and IPA was 70.45%; Cohen’s kappa coefficient (level of agreement) was 0.35 (95% CI: 0.08, 0.62). The number of false positives/negatives using AASC® was 3/10; positive/negative predictive values (95% CI) were 0.727 (0.464, 0.991)/0.697 (0.540, 0.854). The strongest contributor to false negatives on the AASC® was caregivers’ minimization of the impact of agitation behaviors on patient functioning, underscoring a key educational gap. These results suggest that the AASC® can improve caregiver-HCP communication and awareness of agitation behaviors and their impact, thereby advancing early recognition of agitation in Alzheimer’s dementia.
LGBTQIA+ AD/ADRD CAREGIVERS’ PERCEPTIONS OF THE ACCEPTABILITY OF A LEGAL AND FINANCIAL PLANNING TRAINING TOOL
Authors: Caldwell Clover , Chunga Richard , Hoel Sydney , Schwartz Heather , Slowey A J , Werner Nicole , Pickett Andrew
Published: January 2025

LGBTQIA+ identifying informal caregivers for people living with Alzheimer’s Disease (AD) and AD-related dementias (AD/ADRD) face multiple, overlapping stressors related to identity stigmatization and role-based burden. This includes legal/financial planning, as the legal landscape surrounding LGBTQIA+ identity is inconsistent and ever-changing. Part of a larger project, this study examined LGBTQIA+ identifying caregivers’ perceptions of the acceptability of CareVirtue Planner, a web-based legal and financial planning support tool for AD/ADRD caregivers. Semi-structured interviews with LGBTQIA+ caregivers (n=9) were conducted after three months of use. We conducted an inductive content analysis using the following process: open coding, collaborative generation of the initial codebook, dual coding with the codebook, consensus discussion on refinements to finalize codebook. Our analysis resulted in four overarching themes among users: sense of commonality and personal validation related to legal and financial challenges of caregiving, Planner features promoting caregiver preparedness, inclusive language and need for LGBTQIA+ specific tailoring, and individual characteristics and personal histories impacting relative usefulness of the Planner. Participants broadly found Planner material to be well organized and its features useful (e.g., document storage ‘vault’), with content best suited for those early in the caregiving journey. Users provided specific recommendations to increase LGBTQIA+ appropriateness, including creation of additional content to specifically address unique legal challenges facing LGBTQIA+ caregivers, inclusion of diverse families in materials (e.g., vignettes), and vetting of externally linked resources for LGBTQIA+ inclusiveness. Further research is needed to support LGBTQIA+ AD/ADRD caregivers navigating complex legal and financial situations.
LONG-TERM EFFECTS OF LOCAL AREA NEW DEAL WORK RELIEF IN CHILDHOOD ON LATE LIFE DEPRESSION
Authors: Modrek Sepideh , Rehkopf David
Published: January 2025

Objective To investigate whether childhood exposure to local area New Deal emergency employment work relief activity was associated with lower depressive symptoms in late life. Methods This study utilized individual-level data from the Wisconsin Longitudinal Study (WLS) linked to the full count 1940 census. New Deal emergency employment programs were the largest non-wartime expansion in government led infrastructure, services, and employment policy in U.S. history. We used within county variation in WLS participants’ exposure to emergency employment work relief activity during childhood (ages 0-3) to examine its association with depressive symptoms in late life. We examined depressive symptoms at three ages, 53-55, 65-67, and 72-74 but with a focus on depressive symptoms at ages 72-74 as a marker for late-life depression. Results Children who lived in neighborhoods with moderate or high levels of emergency employment work relief activity exhibited 14-18% lower depressive symptom scores at ages 72-74 compared to those from neighborhoods with low activity. These findings were consistent across various measures of late-life depressive symptoms, different model specifications, and after accounting for prior depressive symptoms. Discussion The study highlights the long-term mental health benefits of economic policies aimed at mitigating concentrated economic downturns among the most impacted individuals. Childhood exposure to New Deal work relief reduced depressive symptoms in older age, particularly new onsets of depressive symptoms at ages 72-74. These results suggest social policies aimed at maintaining economic activity in downturns can have long-term positive impacts on population mental health.
OLDER ADULTS WHO PLAY VIDEO GAMES: WHO ARE THEY AND HOW DO THEY FARE?
Authors: Sonnega Amanda , Sonnega John
Published: January 2025

Video games for leisure are often considered the purview of younger adults. When older adults are the focus of video game use it is often for rehabilitation or prevention. Growing literature explores the potential of video games to improve cognition and health in older adults but very little that is population-based. Available literature shows that fewer older adults engage in gaming when compared to younger adults but that the older adults play with a similar frequency to younger populations. Internet use provides psychosocial benefits to older adults, and we propose that gaming for leisure does so as well. We use data from the Health and Retirement Study (HRS), a biennial survey of a nationally representative sample of adults over age 50 in the United States begun in 1992. HRS, in an add-on module, asked respondents if they played video games such as X-box or PlayStation (n=1,734). We describe the socio-demographics and other individual differences of respondents who report playing video games. We find that those who report using video games are more likely to be male (64%) and younger than those who do not report using these games (mean age of gamers compared to nongamers is 62 year v. 74 years; p<.01). The gender gap shrinks as adults age. We subsequently examine the relationships between gaming and psychosocial outcomes, and find no difference between gamers and nongamers in depressive symptoms (p=.12). Interestingly, gamers have slightly higher cognitive scores (p<.02) longitudinally. We discuss the potential role of gaming in retirement.
ORAL HEALTH, PERCEIVED STRESS, AND SUBJECTIVE MEMORY COMPLAINTS ACCORDING TO DIABETES STATUS
Authors: Kim Min Jung
Published: January 2025

Oral health status has been linked to cognitive impairment. People with diabetes often experience more oral health issues and higher emotional stress than those without, that may increase the risk of cognitive impairment. This study explored the relationship between oral health, perceived stress, and subjective memory complaints (SMC), and whether these relationships differed by diabetes status, using data from the 2021 Korean National Health and Nutrition Examination Survey. Perceived oral health, stress levels, and SMC were assessed via questionnaires, and the number of natural teeth was counted during exams. Tobit regression models were used, with subgroup analyses by diabetes status. Among 1,444 adults, after controlling for demographic factors, perceived oral health (r = 0.16, p <.05) and stress levels (r = 0.16, p <.05) significantly increased SMC in healthy adults (n = 504). However, only stress levels increased SMC in those with prediabetes (n = 602, r = 0.29, p <.001) and diabetes (n = 260, r = 0.19, p <.05). The number of natural teeth did not affect SMC in any group. These findings suggest perceived oral health may indicate early cognitive decline in healthy adults, while psychological status is a more critical factor in those with prediabetes or diabetes. These results suggest that perceived oral health may be an early indicator of cognitive decline in healthy adults, while psychological health plays a more dominant role in cognitive decline in adults with prediabetes or diabetes. Tailored interventions to prevent cognitive decline should consider diabetes status.
PROTEASOME DYSFUNCTION A KEY PATHOLOGIC FEATURE OF ALZHEIMER’S DISEASE MITIGATED BY PROTEASOME ACTIVATORS
Authors: Pickering Andrew
Published: January 2025

Alzheimer’s Disease (AD) is the leading cause of dementia worldwide, affecting nearly 50 million people and characterized by cognitive decline, β-amyloid plaques, and hyperphosphorylated tau. The failure of numerous clinical trials targeting β-amyloid (Aβ) underscores the need for novel therapeutic strategies. A consistent feature of AD, particularly in the hippocampus, is reduced proteasome activity. This impairment is thought to result from direct inhibition by Aβ or hyperphosphorylated tau, disrupting essential neuronal processes like memory and synaptic plasticity. This study explores the hypothesis that AD-related deficits are driven, in part, by Aβ-induced proteasome dysfunction. We demonstrate that oligomeric Aβ inhibits 20S proteasome activity while destabilizing the 26S proteasome into free 20S units. Treatment with proteasome activators enhances 20S and 26S function, reducing Aβ42-induced toxicity in SK-N-SH cells. In Drosophila overexpressing Aβ42, oral administration of proteasome agonists delayed mortality and restored cognitive function. Similarly, in mouse models, chronic treatment with proteasome activators protected against Aβ42-induced working memory deficits, and acute treatment significantly improved spatial learning deficits in hAPP(J20) mice. Our findings reveal that Aβ exerts dual inhibitory effects on 20S and 26S proteasomes, contributing to AD pathology. Proteasome activation mitigates these deficits, suggesting that enhancing proteasome activity could be a promising therapeutic approach for AD.
RACE DIFFERENCES IN WALK SPEED, CARDIORESPIRATORY FITNESS, AND MUSCLE MITOCHONDRIAL RESPIRATION
Authors: Coen Paul , Distefano Giovanna , Ramos Sofhia , Cawthon Peggy , Cummings Steven R , Newman Anne B , DeLany James
Published: January 2025

Older adults who self-identify as Black have a disproportionately higher incidence of mobility disability. Whether older adults who are Black also have lower fitness and mitochondrial energetics compared to those who are White has not been adequately investigated. The Study of Muscle, Mobility and Aging (SOMMA) examined 879 older adults (≥70 years old), including 116 who self-identified as Black, who could complete a 400m walk within 15 minutes. Mitochondrial respiration (MaxOXPHOS) was measured in permeabilized fibers from biopsies of the vastus lateralis. A cardiopulmonary exercise test assessed maximum oxygen consumption (VO2peak). Education, income, financial resources, race, sex and age were determined by self-report. Propensity score matching was used to match Blacks with Whites with a 1:1 ratio. Black (n=90) and White (n=90) groups were well matched for age, sex, SOMMA multimorbidity index, BMI, muscle mass, physical activity, marital status, educational achievement, and whether financial needs were met (all p>0.05). Despite being well matched, those who identified as Black had a slower 400m walking speed (0.97 vs. 1.03 m/s, p=0.014), lower MaxOXPHOS (50.8 vs. 60.9 (pmol/(s*mg)), p< 0.001), and lower cardiorespiratory fitness (1391 vs 1566 ml/min, p=0.007), when compared to those who identified as White. Multivariate regression showed that VO2peak and MaxOXPHOS, but not socioeconomic factors, attenuated the race difference in 400m walking speed. In conclusion, while the etiology of race differences in mobility is multifactorial, our data indicate that muscle mitochondrial respiration and cardiorespiratory fitness may contribute to slower walking speed of individuals who identify as Black compared to White.
RURAL OLDER ADULT CARE TRANSITIONS: A SCOPING REVIEW
Authors: Kumar Amiritha , Liebzeit Daniel
Published: January 2025

Older adult (age 65 and older) care transitions are frequent and complex, particularly in rural areas lacking equitable access to health and other services. This scoping review: 1) evaluates research on older adult rural care transitions and 2) synthesizes types of transitions studied, challenges and opportunities in rural health care, and gaps in the literature. Of a total of 6,976 articles retrieved in July 2024 from PubMed, CINAHL, PsycINFO, Dissertations and Theses, AgeLine, and Embas, 91 articles were included. Eligible articles focused on older adults, rural setting, a care transition, and provided empirical data. Findings revealed a primary focus on acute care transitions; care transitions involving long-term care and assisted living were vastly underrepresented. Most were observational, with few interventions to address the specific challenges faced by rural older adults. The evidence base on acute care transitions reveals disparities in readmission rates between rural and other populations, with limited focus on patient-centered outcomes. Limited literature on long-term care and assisted living transitions primarily focused on losses experienced, such as loss of independence. Although improved outcomes are often associated with collaborative, individualized planning, significant gaps remain in application of effective models of transitional care. Follow-up or post-acute care appears key for rural older adults, offering benefits comparable to urban settings; however, rural access barriers underscore the need for intervention development to reduce health disparities. Developing patient-centered interventions for rural older adults during care transitions is crucial, and addressing research gaps will create opportunities to further reduce disparities and improve outcomes.
IMPLEMENTING AND EVALUATING MULTILINGUAL, COMPETENCY-BASED DEMENTIA TRAINING FOR IHSS CAREGIVERS IN CALIFORNIA
Authors: Yeh Jarmin , Beld Matthew , Pond Brittney , Neri Mel , Martinez Suzanna , Garcia Andrea , Castaneda Moraima , Eldridge Corinne
Published: January 2025

The rising prevalence of Alzheimer’s dementia in California’s aging population underscores the urgent need for a well-trained direct care workforce to help older adults age in place. This study implemented and evaluated competency-based dementia training for caregivers in California’s Medicaid-Funded In-Home Supportive Services (IHSS) program from 2019 to 2024. The program, offered in English, Spanish, Cantonese, and Mandarin, transitioned from in-person to online delivery due to COVID-19, providing an opportunity to assess this novel online approach. Using a quasi-experimental, mixed-methods design guided by the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance), we evaluated training outcomes, curriculum, staff roles, and delivery logistics. Of 722 caregivers who completed the training, 488 were included in the analytic sample, and 50 participated in interviews. Additionally, 11 key informant stakeholders were interviewed. Mean scores from validated instruments evaluating caregivers’ dementia knowledge (Toye et al., 2014) and self-efficacy (Fortinsky et al., 2002) showed statistically significant increases between pre-post-training and pre-3-month follow-up (p< 0.001). Thematic analysis of caregiver interviews revealed diverse pathways into caregiving, emotional rewards, enhanced advocacy skills, and improved interactions with medical providers. Stakeholder interviews uncovered implementation barriers and facilitators to intervention fidelity, and strategies for addressing the critical need for a skilled dementia direct care workforce. The training’s adaptability to online formats and multiple languages demonstrates its real-world efficacy and potential readiness for trial design. This study highlights the importance of evidence-informed, culturally and linguistically appropriate training for IHSS caregivers in managing the health and well-being of older adults living with Alzheimer’s dementia.
SEE SOMETHING, SAY SOMETHING: A QUALITATIVE STUDY OF NEIGHBORHOOD PERCEPTIONS AND BRAIN HEALTH
Authors: Heuer Sierra , Besser Lilah , Dominguez Briana , Huynh Stephanie , Le Bao Ngoc , Nguyen Boi-san , Pham Jason , Meyer Oanh
Published: January 2025

Studies have shown the importance of neighborhood factors, such as residential segregation and green spaces, to older adult brain health. In this qualitative study, we examine older adults’ perceptions of their neighborhood, with a particular focus on segregation. We recruited participants from the University of California Davis Alzheimer’s Disease Research Center and the local Northern California community to participate in semi-structured interviews over Zoom or telephone. They answered questions such as, “What kinds of activities do you do in your neighborhood?” and “Are neighbors segregated or separated based on age, race/ethnicity, SES, or language?” On average, interviews lasted 22.5 minutes, and were audiotaped, transcribed verbatim, and analyzed for recurring themes. Among the 32 participants, 62.5% were female, 59.4% non-Hispanic White, and 40.6% Black/African American. Mean age was 79.0 years (SD=8.3). The most prominent themes were (1) Accessibility to public stores and similar third spaces (e.g., churches, libraries, coffee shops); (2) Accessibility to green space, including parks, trees, etc.; (3) Staying active in the community, both physically and socially; (4) Neighborhood awareness/cohesion; and (5) Stereotypes, discrimination, and segregation, a sample quote being, “I’m happy with the diversity of the neighborhood…a lot of people would say it’s not very diverse, it’s…segregated, mostly economically,” (Male, 73 years-old). These findings highlight the social and built environment factors that are salient for older adults and may potentially affect brain health. Future research will examine how these themes might differ depending on older adults’ cognition and with objective measures of the neighborhood.
ENHANCING AGE-FRIENDLY CARE IN VALUE-BASED HEALTH SYSTEMS: CMS DELIRIUM ASSESSMENT AND POLICY STRATEGY
Authors: McMullen Tara , Ling Shari , Cummings-Vaughn Lenise
Published: January 2025

Delirium is a clinical syndrome characterized by alteration in consciousness and cognitive function, frequently observed in older adults. This condition is associated with a risk of mortality and can lead to severe and persistent functional impairments in survivors. The incidence of delirium is notably high, affecting up to 80% of older adults in intensive care units (ICUs) and up to 35% of those with general inpatient admissions. Routine and standardized cognitive assessments are essential for optimizing patient management and implementing delirium prevention strategies aimed at mitigating risk factors. To enhance person-centered care in delirium management, it is crucial to adopt age-friendly care frameworks that emphasize evidence-based approaches to assessment and management. In this presentation, Federal officials from the Centers for Medicare & Medicaid Services (CMS) will address the ongoing clinical and policy initiatives aimed at developing a comprehensive strategy for the screening and assessment of delirium, integrated within the framework of high-quality, age-friendly healthcare. This presentation will explore the essential attributes that health systems must possess to effectively translate age-friendly principles into improved health outcomes for patients with delirium. Officials will also discuss the development of age-friendly measures that address the specific needs of older adults to enhance both individual outcomes and population-level health. Additionally, the discussion will focus on policy levers that should be considered to promote age-friendly, value-based care, thereby improving the screening and prevention of delirium.
AWARENESS AND ATTITUDES ABOUT MEDICAL AID IN DYING IN THE U.S
Authors: Kozlov Elissa , Nemeth Samuel , Luth Elizabeth
Published: January 2025

Medical Aid in Dying (MAID) allows terminally ill patients to seek a prescription for medication to end their lives. Despite being legal in 10 states and Washington DC, public awareness of and attitudes towards MAID remain unclear. This study aims to assess the level of awareness of MAID laws and attitudes about MAID in the United States. Using mTurk and Prime Panels, we collected a purposive national sample of n= 2,343 people living in states where MAID is legal and n=1151 living in states where MAID is not legal. The sample was normally distributed for income, education, political affiliation, and had diverse religious representation. We over sampled for adults living in MAID states and adults over 60 because this is the population most likely to use MAID. In states where MAID is legal, 14.4% of respondents knew that MAID was legal in their state. In the full sample, 30% knew that MAID was legal anywhere in the United States. In the full sample, 20% reported that MAID was not morally acceptable, and 25% reported that they would probably or definitely not pursue MAID personally if they were faced with a terminal illness. This study revealed a significant gap in public awareness, with many residents unawares that they live in states where MAID is legal. However, attitudes towards MAID are mostly favorable with a 44% expressing support for MAID personally. These findings suggest the increased need for public education on MAID laws to ensure that residents are informed about their end-of-life-options.