bluuebunny/crossref_metadata_2025_split huggingface dataset:
INTEGRATING A FRAILTY INDEX INTO THE CMS HIERARCHICAL CONDITION CATEGORY MODEL FOR PREDICTING HEALTH CARE COSTS
Authors: Jang Jieun , McCarthy Ellen , Olivieri-Mui Brianne , Shi Sandra , Park Chan Mi , Sison Stephanie Denise , Kim Dae Hyun 
Published: January 2025

Abstract
The Centers for Medicare and Medicaid Services Hierarchical Condition Category (CMS-HCC) score is a standard risk adjustment tool to predict total Medicare costs. We examined whether a claims-based frailty index (CFI) could enhance the predictive capability of the CMS-HCC score. We utilized electronic health records linked with Medicare data, focusing on patients over 65, including surgical inpatients and outpatients from January 2017 to December 2018. Analyzing 1,855 surgical inpatients using logistic regression, we estimated the likelihood of incurring top 20% Medicare costs for 30 days, 90 days, and 1 year after surgery, comparing 1) the CMS-HCC score alone with 2) the CMS-HCC score combined with the CFI. Similarly, for 58,492 outpatients, we employed generalized estimating equations to estimate the likelihood of being in the top 20% of total Medicare costs for 1 year after an outpatient visit, comparing the same two models. The added value of CFI was assessed using net reclassification improvement (NRI) with 3 risk categories (0 to &lt;10%, 10 to &lt;20%, ≥20%) to compare the two prediction models. Including CFI with CMS-HCC score improved NRI by 7.3% for 30-day costs, 10.1% for 90-day costs, 9.8% for one-year costs in surgical inpatients, and 12.3% for annual costs in outpatients. The added contribution of CFI to CMS-HCC significantly improves the model’s ability to identify patients at high risk of incurring substantial medical costs (top 20%). Accounting for patient frailty may enable healthcare systems to more effectively allocate resources and implement targeted interventions, ultimately reducing healthcare expenditures.
ADAPTATIONS AND OUTCOMES OF A WALKING AND REMINISCENCE BRAIN HEALTH INTERVENTION FOR CAREGIVERS
Authors: Fuller Patrice , Fennell Charles , Mattek Nora , Gothard Sarah , Kaye Jeffrey , Croff Raina 
Published: January 2025

Abstract
The SHARP-Caregiver (SHARP-CG) study evaluated the feasibility of adapting SHARP to family caregivers of care partners with mild cognitive impairment or early-stage dementia. SHARP-CG assigned 7 triads (n=21) to Group A or B. Triads had a family caregiver (age &gt;40), their care partner (age &gt;40), and a support person (age &gt;18). Caregivers and support persons were healthy or mildly cognitively impaired. Triads walked 1-mile routes with images to prompt conversational reminiscence 3x a week for 16 weeks using the SHARP walking application. Caregivers and care partners contributed weekly health update data, and (optionally) sleep and step-count data. Group A participants walked immediately. Group B participants first completed 16-weeks of observation. Ages were 35-90 (mean 69.8); most were female (52%). Mean Montreal Cognitive Assessment score for caregivers and care partners was 21.7 (SD+4.6). Eighty-six percent (n=6) of caregivers and 71% of care partners (n=5) opted to engage in digital biomarker data collection (actigraphy watch and sleep sensor). Caregivers had greater mean total daily steps (2055; SD+686) than care partners (1684; SD+979). Mean sleep hours were similar for caregivers and care partners at 6.1 (SD+1.1) and 6.5 (SD+2.5). Recruiting caregivers was difficult because many family members did not recognize what they were doing as caregiving. To improve study accessibility for caregivers, adapted eligibility criteria included reducing minimum age, allowing mobility aids, and making some components optional. Increasing accessibility, while improving enrollment, did not necessarily impact adherence. Caregiver demands and sporadic health concerns limited participation.
EFFECTIVENESS OF A TECHNOLOGICAL PLATFORM TO MANAGE FRAILTY: RESULTS FROM THE POSITIVE AND INTEGRACAM STUDIES
Authors: Rodriguez-Manas Leocadio , Grille Alba Maria Costa , Hermosilla Irene Molina , Lopez Irene Alfonso , Perez-Rodriguez Rodrigo , Peinado-Martinez Ignacio , Villalba-Mora Elena 
Published: January 2025

Abstract
Technologies can assist in managing frailty through home monitoring and intervention systems, though evidence of their clinical benefit is lacking. Our study had two components. A) A two-arm (Intervention vs. Control) RCT named POSITIVE (NCT04592146) with a 6-month follow-up, recruiting prefrail or frail people aged ≥70 years living at home from three European countries (N=83), and B) a validation study in usual clinical practice called INTEGRACAM, conducted in Madrid, Spain, under a quasi-experimental before-after design that mirrors the criteria of POSITIVE. Both components utilized a technological platform for comprehensive patient assessment and functional status monitoring, delivering personalized interventions including VIVIFRAIL physical exercise programs, nutritional recommendations, and medication adjustments according to STOPP-START criteria. Usability and user experience were measured using the System Usability Scale (SUS) and the User Experience Questionnaire (UEQ-S), alongside frailty (Fried criteria and FTS-5 score) and functional status (SPPB and WHODAS). Results from POSITIVE (average age 76.7 years; 76.8% female) indicated significant improvements after six months in frailty status (FTS-5: -5.43 points in the intervention group vs. usual care; p=0.008; Fried´s criteria-FFP: -0.4 in IG vs UC p=0.087), SPPB (+1.07 points; p= 0.022) and WHODAS (0.22, p= 0.09). INTEGRACAM showed similar findings with participants (n=51; mean age 78.1±5.3 years) demonstrating improvements in SPPB (+1.03±1.38; p-value &lt;0.001), FTS5 (-3.4±4.11; p-value &lt;0.001), and FFP (-0.4±1.03; p-value 0.028) after 6 months. Patients rated usability as 87/100, surpassing the optimal threshold value (68/100). Regarding the UEQ-S, hedonic quality improved throughout the project (2.44 vs 2.02, p=0.031), both in patients and professionals.
THE POTENTIAL FOR MIND–BODY THERAPIES AS FRAILTY INTERVENTIONS
Authors: Loewenthal Julia 
Published: January 2025

Abstract
Strategies to prevent and manage frailty are priorities in clinical medicine and public health. Current evidence-based interventions for frailty are multimodal in nature, with physical activity as a key element. Mind-body therapies, especially those that incorporate movement such as yoga and tai chi, include physical postures, breathing practices, meditation, and other elements. In our recent systematic review of 33 randomized controlled trials of yoga interventions in older adults (2384 participants), there was moderate-certainty evidence that yoga improved gait speed and lower extremity strength when compared to inactive control groups. Both yoga and tai chi are known to improve physical function, even in already frail populations. Emerging evidence suggests they may modulate cellular and molecular hallmarks of aging, especially inflammation. Mind-body therapies have additional benefits for cognition, mood, and sleep. They likely confer resilience by positively impacting core systems for maintaining homeostasis, including musculoskeletal, metabolic, and stress-response systems. They are not only highly adaptable for older populations, but also increasingly popular: among US adults, use of yoga alone increased from 5% in 2012 to 15.8% in 2022. They may be delivered in a group format to reduce social isolation, and are increasingly accessible via telehealth, senior centers, and other community-based organizations. In addition, there is evidence that mind-body therapies are an entry point to other types of physical activity, especially for women. They are promising frailty interventions, though more work is needed to understand optimal dose, duration, and effectiveness.
IMMUNOLOGICAL ASPECTS OF AGING
Authors: Yousefzadeh Matt 
Published: January 2025

Abstract
Aging is an intricate and multifaceted phenomenon that impacts every aspect of our bodies, including the immune system. As we age, there’s a gradual decline in immune function known as immunosenescence, which reduces the body’s ability to combat pathogens effectively. Moreover, this decline in immune function plays a pivotal role in the development of various age-related chronic conditions. One significant contributor to aging is inflammaging or the production of low-grade chronic inflammation that occurs in the absence of pathogens that can drive aging. Despite significant research efforts, the intricate mechanisms behind immunosenescence and the communication of aging between the immune system and other bodily systems remain largely elusive. The aim of the symposium is to delve into recent breakthroughs in this field across different levels of research, spanning from basic science, translational studies, and potential therapeutic interventions.
PREDICTING OLDER ADULTS’ RESIDENTIAL CARE RELOCATION RISKS BASED ON CAREGIVER NETWORK CHARACTERISTICS
Authors: Nemmers Natasha , Lai Wenhua , Haldar Srabani , Tsuker Sophia , Freedman Vicki , Leggett Amanda 
Published: January 2025

Abstract
When older adults face increasing care needs or limited support, remaining safely and comfortably at home becomes challenging. Extant research has primarily concentrated on characteristics of the older adult or their primary caregiver on nursing home admission. This study examines the risk of older adults transitioning to residential care (e.g., assisted living, nursing home), focusing on the influence of their caregiver network or involvement of multiple caregivers. Using the National Health and Aging Trends Study, we conducted competing risk regressions following 7,085 community-dwelling older adults moving to residential care, accounting for death, across rounds 1-9 (2011 – 2019). We assessed network composition, size, shared tasks, and the number of in-network specialists or generalists, while controlling for individual sociodemographic and health factors. Individuals with caregiver networks that shared medical tasks had the highest risk of moving, followed by those sharing household tasks. Conversely, shared mobility or self-care and transportation responsibilities were associated with lower risks. Having more generalists increased the risk, while any number of specialists was non-significant. Larger networks were associated with heightened risk, though having close family like a spouse was protective. The findings underscore that caregiver network characteristics are critical to older adults’ ability to age in place. Specifically, older adults with larger caregiver networks, lacking a spouse or child, and providing complex care are at greater risk for relocating. Understanding caregiver networks can guide interventions related to care network coordination and resource allocation to help avoid or postpone a residential care move.
RELATIONSHIP CHANGES ACROSS THE CAREGIVING TRANSITION
Authors: Joiner Raquael , Nelson Niccole , Liu Qimin , Niemiec Stacey Schepens 
Published: January 2025

Abstract
The majority of aging individuals’ care needs are met by family caregivers (CGs), often at great costs to CGs’ well-being. There is, however, significant heterogeneity in CG outcomes, and social capital, or the quality of marital, family, and friend relationships, is widely recognized as an im-portant factor underlying individual differences in CG outcomes. Because empirical work to date largely focuses on either cross-sectional differences or changes in social capital post-caregiving on-set, it is unclear, however, whether social capital disparities across different populations are a func-tion of the transition to CG or whether such disparities exist prior to taking on a CG role. Thus, we used data from the Health and Retirement Study (N=366; 8-waves) and Bayesian multi-phase latent growth curve models to examine social capital changes across the caregiving transition. Results sug-gested that CGs, on average, do not show significant changes in their social capital across the transi-tion to caregiving. Yet, there were significant individual differences, and individual differences in pre-caregiving social capital were significantly associated with social capital changes following tak-ing on a caregiving role: CGs with higher initial levels of social capital showed less declines in rela-tionship quality leading up to caregiving onset, but steeper declines in relationship quality at caregiv-ing onset and smaller relationship quality increases in the years following caregiving onset. This suggests that the social capital of individuals with initially satisfying relationships are most impacted by caregiving. We discuss the implications of these findings for refining and developing personal-ized social support interventions for CG populations.
BUILDING COMMUNITY IN PRACTICE AND RESEARCH OF HEALTHY LONG-TERM CARE ENVIRONMENTS
Authors: Chi Peggy , Hunter Sarah , Berta Whitney 
Published: January 2025

Abstract
This presentation will describe an initiative based at the Institute of Health Policy, Management and Evaluation in Toronto, Canada, that aims to dismantle silos and build a community in the practice and research of aging environments. The goals and objectives are to share, synthesize, advance, and mobilize knowledge on long-term care homes—the influence of living environments on older adults and working environments on workers and their work. Three knowledge mobilization activities are the means by which our aims are achieved: 1) A series of seminars are curated for experts to disseminate knowledge to a broad audience (industry and academic leaders, decision-makers, and end-users) to connect research to practice. 2) Informal, practical discussions are created for practitioners to share current key challenges in long-term care homes with researchers to connect practice to research. 3) A Design Charrette is organized to translate knowledge to address key challenges within interdisciplinary teams comprising practitioners/ care providers, team leads, and trainees. These activities bring together individuals from industry and academia who represent diverse disciplines that have generated knowledge about these linkages based on different and complementary conceptualizations of long-term care environments but for whom there is no pre-existing forum in which to engage in integrative, synthetic discussion and application. The open-forum nature of the activities is intended to foment public discourse on the role of physical and psychosocial environments in the health of older adults and workers in long-term care homes and to demonstrate the value of evidence-based design founded on multidisciplinary knowledge.
UNDERSTANDING CAREGIVER BURDEN IN DECISION-MAKING IN ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Ginn Brandi , Arteaga Ignacia , de Jesús Alma Hernández , Abramson Corey , Dohan Daniel 
Published: January 2025

Abstract
Alzheimer’s disease and related dementias (ADRD) are chronic conditions that involve changes or loss of cognitive and social function. People living with dementia (PLWD) undergo a gradual expansion in caregiving needs, and many ultimately spend a portion of their lives in institutional settings, including nursing homes or assisted living facilities. This study uses a comparative ethnographic approach to examine how PLWD and their caregivers make sense of and navigate transitions from home to institutional care. It combines three years of detailed field observations and 84 in-depth interviews in California and Maine. Our data illustrate how socioeconomic inequality, disparate neighborhood contexts, and shared understandings of aging shape tensions caregivers experience as they navigate whether, how, and when to relocate PLWD for whom they care. Our results show cultural narratives encouraging independence and non-institutionalization of older adults intersect with caregivers’ desires, structural positions, and local institutional resources – creating tensions and are mentioned alongside the feeling of being burdened. These experiences and feelings emerge gradually as the health of PLWD declines and caregivers become aware of unmet needs and their own resource constraints. We unpack how diverse caregivers make sense of the burden they feel, define the thresholds to make decisions, map community resources, and experience a range of emotions such as frustration, guilt, and grief throughout the process. This contextualized analysis of how caregivers navigate ADRD decision-making offers insights into the affective nature of the process and the caregivers’ fortitude.
EXAMINING THE IMPACT OF RIDE-HAILING ON THE TRAVEL BEHAVIOR OF OLDER ADULTS ACROSS THREE CITIES
Authors: Song Minju 
Published: January 2025

Abstract
Due to age-related physical and cognitive changes, older drivers may eventually find themselves unable to continue driving, when finding alternative transportation modes becomes a major concern. Ride-hailing services like Uber and Lyft have emerged as potential solutions to this issue. Nevertheless, given the dearth of available data and the recently introduced transportation systems, limited research exists on ride-hailing usage of older adults. This paper aims to examine the factors influencing ride-hailing adoption among older adults by comparing different age groups across three metropolitan areas: Chicago, Minneapolis, and Seattle area. Using regional survey data collected in 2019, we estimate logistic regression models by age groups to examine notable characteristics of older adults utilizing ride-hailing. In follow-up, we use a multilevel logistic regression model to explore the hierarchical relationships between regional, household, and individual levels. Findings show that ride-hailing services are more used by younger adults (18-64) compared to individuals over 65 years, indicating a potential technological familiarity gap between age groups. The built environment has a significant association with ride-hailing adoption, particularly in urban areas with transit infrastructure and higher population density. While ride-hailing has the potential to enhance the social inclusion and independence of older people who stop driving, ride-hailing is not accessible for older people as much as other age groups. Thus, this study underscores the importance of continued investment and research in ride-hailing services, advocating for policymakers and service providers to consider older adults’ needs in transportation planning.
SIBLING-TO-SIBLING DEMENTIA CARE: UNDERSTANDING MOTIVATIONS, CHALLENGES, AND EXPERIENCES
Authors: Savla Jyoti , Roberto Karen 
Published: January 2025

Abstract
Caregiving research has traditionally focused on older adult siblings’ involvement in shared social activities and emotional support, while offering limited exploration of instrumental help provided by siblings when their brothers/sisters face a health-related event or long-term illness. Moreover, there is a notable gap in understanding how siblings navigate the complexities of caring for their community-dwelling sibling living with dementia (SLwD). We begin to address this gap by examining determinants of sibling dementia caregiving roles, individual and family challenges older adult sibling caregivers encounter, and factors that facilitate their provision of care. From a mixed-methods analysis of interviews with 25 sibling caregivers, comprised of 12 sisters caring for sisters, 10 sisters caring for brothers, and 2 brothers caring for brothers (Mage = 68.03 years, R = 52-83; 48% African American; 52% co-residing), several key insights emerged. Motivations for assuming the caregiving role included shared life experiences, availability due to non-employment, personal or professional caregiving experience, and the absence or limited involvement of the SLwD immediate family. Early-life relationship conflicts, challenges in managing dementia-related symptoms, and divided family loyalties added complexity to the caregiving role. Sibling caregivers who received support from other family members and paid caregivers in caring for SLwD reported lower role captivity and caregiver burden. Caregiving experiences intersected with birth order, race, and socioeconomic status. Discussion focuses on when and why siblings take on the caregiving role for their SLwD, nuanced differences on how they manage their caregiving responsibilities, and implications for extended family caregiving practices and support.
OPPORTUNITIES FOR INTEGRATING A GSA STUDENT CHAPTER WITH A SIGMA PHI OMEGA HONOR SOCIETY CHAPTER
Authors: Friberg-Felsted Katarina 
Published: January 2025

Abstract
The University of Utah Gerontology Interdisciplinary Program (GIP) has had an active Sigma Phi Omega chapter, Alpha Chi, for decades. Students are enrolled in one of our five programs: 1) Master of Science in Gerontology (MSG), 2) MSG/ Master in Physician Assistant Studies (MPAS) dual degree, 3) Graduate Certificate in Gerontology, 4) Undergraduate Certificate in Gerontology, and 5) Minor in Gerontology. Students are invited to join Alpha Chi in the second semester of their program. Alpha Chi’s Executive Committee ideally contains a student President, a student Secretary, and a student Treasurer; sometimes these positions are held by one or two students. The Alpha Chi Executive Committee is supported by a faculty advisor, who holds the position for several years. To integrate a GSA Student Chapter with our SPO local chapter, we began by following the guidelines in the GSA Student Chapter Handbook. Our process included application for a student group recognition on campus, verifying that our current Executive Committee members were student members of GSA, spreading the word through a variety of pathways, and ensuring that our events and projects were co-sponsored by Alpha Chi Chapter and GSA Student Chapter. This presentation will discuss both process and outcomes of the integration, including more students being involved earlier and more students being introduced to GSA student benefits, including ESPOs offerings.
EXPLORING FACTORS INFLUENCING WALKING ACTIVITY IN PEOPLE WITH DEMENTIA: A SPATIAL ANALYSIS IN METRO VANCOUVER
Authors: Nouri Mohammadjavad , Chaudhury Habib 
Published: January 2025

Abstract
As the number of people living with dementia (PLWD) increases in Canada, the significance of the neighborhood built environment grows, as most PLWD live at home rather than in long-term care facilities. This study investigates how built environment variables predict the overall outdoor walking activity of PLWD in Metro Vancouver. Twenty-five participants living with dementia from various cities in Metro Vancouver participated. We used exploratory factor analysis and multiple linear regression to analyze the relationship between built environment factors and outdoor walking activity. Our results revealed three significant factors: “Macro environment: accessibility to public transportation and street network,” “Micro environment: Pedestrian-oriented design,” and “General characteristics: Mixed land use and sidewalk suitability,” constructed from 14 built environment variables. These factors significantly influenced the outdoor walking activity of PLWD. The multiple linear regression results indicated that “Macro environment – accessibility to public transportation and street network” had a substantial positive effect (p =.007, β = 0.469), “Micro-environment: Pedestrian-oriented design” showed a moderately positive impact (p =.065, β = 0.305), and “General characteristics: mixed land use and sidewalk suitability” exhibited a significant positive influence (p =.015, β = 0.414) on outdoor walking activity. Our findings provide valuable insights for policymakers, urban planners, designers, landscape designers, and transportation planners, emphasizing the crucial collaboration needed to develop dementia-friendly neighborhood plans that cater to the diverse needs of individuals living with dementia, ensuring safe and accessible environments.