bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXAMINING PREDICTORS OF POOR SLEEP AMONG CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Authors: Petrovsky Darina , Luth Elizabeth 
Published: January 2025

Abstract
Caregivers who struggle with sleep face increased stress and worse mental health outcomes. This study explored the connection between caregivers’ perceived caregiving burden and benefits and their sleep quality. Using data from the 2017 National Study of Caregiving and National Health and Aging Trends Study, we examined 790 caregivers of individuals with possible and probable dementia. Using time diary interviews, sleep quality was categorized as either “excellent/very good” or “good/fair/poor.” Predictors included caregiver perceived burden and benefit scales, each the summed responses to four questions (burden Cronbach alpha=0.75; benefit Cronbach alpha=0.70). We used multi-variable logistic regression, controlling for the sociodemographic characteristics of caregivers and persons with dementia, as well as relationship quality and sleep disturbance due to caregiving responsibilities. Caregivers’ mean age was 62.5 years old (SD=13). Approximately 69% were women and more than half were non-Hispanic White (58.6%). Fifty-five percent (55%) of caregivers were children and 44% reported “excellent/very good” sleep quality. In the multi-variable logistic regression model, a higher benefit of caregiving was associated with significantly higher odds of reporting “excellent/very good” sleep quality (AOR: 1.09, 95%CI: 1.01-1.17, p=0.02). Conversely, a higher burden of caregiving was associated with lower odds of reporting “excellent/very good” sleep quality (AOR: 0.88, 95%CI: 0.81-0.95, p=0.002). These relationships persisted independent of caregiver and care recipient demographic characteristics and interrupted sleep due to caregiving. Our findings highlight potential modifiable targets for future interventions—specifically, addressing perceived caregiver burden and maximizing benefits—to enhance sleep quality among caregivers of individuals living with dementia.
DYSPHAGIA MANAGEMENT CONTRIBUTES TO BURDEN IN CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Shune Samantha , Namasivayam-MacDonald Ashwini 
Published: January 2025

Abstract
Providing care for persons with Alzheimer’s disease and related dementias (ADRD) comes with significant physical and psychosocial costs. Crucially underexplored in its contribution to caregiver burden is dysphagia (swallowing impairment), which occurs in up to 93% of persons with ADRD and contributes to increased morbidity and mortality. The current study aimed to quantify dysphagia’s contribution to general burden among family caregivers of individuals with ADRD. A total of 110, predominately female (79.1%), family caregivers were recruited (mean age 55.8±15.9). Multiple measures of dysphagia severity were considered, including caregiver-reported dysphagia severity (Eating Assessment Tool [EAT-10]) and degree of diet modification (International Dysphagia Diet Standardisation Initiative – Functional Diet Scale [IDDSI-FDS]). General caregiver burden was measured via the Zarit Burden Interview (ZBI). To examine which variables were unique predictors of burden, dysphagia-related variables as well as demographic (caregiver age, sex, employment status, education; care recipient relationship, age, sex) and disease variables (caregiver-reported diagnosis, severity, duration) were all entered simultaneously in a multiple regression analysis. Preliminary regression results indicated that higher ZBI scores were associated with caregivers who reported higher IDDSI-FDS scores (β =.26, p =.0364), identified as female (β =.25, p =.0450), were the spouse of the care recipient (β =.45, p =.0125), and reported shorter disease duration (β =.29, p =.0072). Findings highlight that aspects of managing dysphagia may independently contribute to caregiver burden, particularly in the context of continued oral intake. Thus, inquiry about dysphagia status should be considered in disease management.
COGNITIVE FUNCTION AND ORAL HEALTH MEASURES AMONG OLDER ADULTS IN INDIA: EVIDENCE FROM THE LASI, 2017–2018
Authors: Kelekar Uma , Pan Xi , T Muhammad , Turner Sidney , Heyn Patricia , Wu Bei 
Published: January 2025

Abstract
Given the rising older adult population and related increase in the prevalence of cognitive impairment in India, the present study aimed to examine the association between cognitive function and oral health measures among the middle-aged and older adults in India. Data for the study were selected from the Longitudinal Aging Study in India (LASI, 2017-2018) and 56,723 respondents&gt;=45 years were included. Oral health was measured by self-reported oral health problems including number of oral diseases, edentulism (i.e., losing some or all natural teeth), and dental care utilization (e.g., dental visit in the past 12 months). Our outcome measure was a composite score of cognitive function measured across five broad domains, specifically memory, orientation, arithmetic function, executive function, and object naming. Negative binomial regression models were used to analyze the relationship between the oral health and cognitive function. Our results showed that complete edentulism was associated with 3% lower cognitive scores [IRR=0.97, 95% CI 0.96, 0.99], while dental care utilization was positively associated with cognitive function. Those who had visited a dentist in the past 12 months reported 6% [IRR=1.06, 95% CI 1.03, 1.08] higher cognition scores than those who had not visited a dentist. The unadjusted univariate regressions demonstrated a negative association between the number of oral diseases and cognitive function. Our findings suggest an urgency for improving the existing oral health infrastructure, including expanding access to dental care and promoting oral health education in India, especially for adults at higher risk for cognitive impairment.
DRUG DEVELOPMENT AND EVALUATION: AGE, SEX, AND FRAILTY CONSIDERATIONS TO FACILITATE THE FORTITUDE FACTOR
Authors: Hilmer Sarah 
Published: January 2025

Abstract
Development and evaluation of drugs used by older adults must consider the effects of ageing, of lifelong factors including sex, and of other characteristics common in geriatric patients that affect pharmacokinetics and pharmacodynamics and outcomes, such as frailty. These factors interact within older people, resulting in major inter-individual variability. In some cases, the intersection of age, sex, frailty and other factors act in the same direction, e.g, age, female sex and frailty may all reduce renal drug clearance. In others they may act in opposite directions, e.g. age may decrease pharmacodynamic sensitivity to a drug, male sex may increase it, and frailty may reduce reserve to tolerate drug effects. Interactions with the older person’s other drugs in the presence of polypharmacy, their other diseases with multimorbidity, their genetics and environmental exposures further complicate prediction of drug effects in older adults. The International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee’s position statement on ‘Measurement of Frailty in Drug Development and Evaluation’ outlines key principles relevant to all phases of translational research. These include measurement of frailty, testing drug exposures and outcomes that are clinically relevant for older adults, use of physiologically based pharmacokinetic-pharmacodynamic modelling and artificial intelligence. In all phases of drug development and evaluation, the pre-clinical models used and clinical trial populations studied should be representative of the people who will use the drugs in age, sex, frailty, and other determinants of drug response. This will inform drug use that facilitates the fortitude factor in older adults.
TRANSLATIONAL BIOMARKERS FOR AGING AND FRAILTY: IMPORTANT SEX DIFFERENCES
Authors: Kane Alice 
Published: January 2025

Abstract
Frailty can be measured using a frailty index, which quantifies the accumulation of health-related deficits. Frailty increases the risk of adverse outcomes including hospitalization and mortality, but there are no validated frailty biomarkers and the underlying mechanisms of frailty remain unknown. Additionally, women are more frail than men at all ages, despite having a lower risk of mortality, but sex differences in frailty are poorly understood. We have assessed health outcomes, including frailty, in male and female C57BL/6 mice from middle age to natural death. We collected blood and stool samples at each timepoint, for untargeted plasma metabolomics, blood DNA methylation assessment and gut microbiome analysis. As in humans, female mice have higher frailty scores than males in middle-to-late life. Sex explains more variability than age or frailty in our DNA methylation data, and preliminary analysis identifies 100s of sex-specific differentially methylated regions with frailty. Metabolomics analysis identifies a set of 104 metabolites (enriched for amino acid and lipid pathways) associated with frailty, independent of sex and age. Additionally, we identify many sex-specific metabolomic markers for frailty, including creatine for females and FAD for males. Analysis of the microbiome data identifies microbes that are both positively and negatively associated with frailty across sexes including A. colihominis. Integrated analysis across data-types is ongoing. Overall, we see clear sex differences in the association of frailty with molecular outcomes in mice. Further investigation of these factors, and validation in human cohorts, will identify determinants and biomarkers of frailty in both sexes.
POLYPHARMACY: TRANSLATIONAL RESEARCH TO UNDERSTAND EFFECTS OF AGE, SEX, AND FRAILTY ON KEY OUTCOMES FOR FORTITUDE
Authors: Mach John 
Published: January 2025

Abstract
Chronic medication use is common in older men and women. Older people, particularly those with polypharmacy (use of 5 or more drugs) for multi-morbidity, are rarely included in clinical trials to establish efficacy and safety of therapeutic drugs. Based on clinical observational studies, polypharmacy is associated with impaired physical function and exacerbates frailty in older adults, particularly women, who make up the majority of this age group. In addition, there is evidence that women are at greater risk of drug-related harm than men. Preclinical models would be useful to screen for adverse geriatric outcomes and understand the impact of age, sex and frailty. This presentation will cover our advancements in the development and use of preclinical models to understand the effects of polypharmacy on geriatric outcomes that are important contributors to the ‘fortitude factor’ in both sexes and old age. We will present recent data from studies in our preclinical models that: (1) describe how chronic polypharmacy use impairs translatable functional outcomes in ageing; (2) demonstrate differences in outcome response for different sex, age and frailty.
WORK EXPECTATION AND PSYCHOLOGICAL STRESS DURING THE GREAT RECESSION: THE ROLE OF LATE-LIFE EMPLOYMENT TRANSITIONS
Authors: Dang Linh , Antonucci Toni , Gonzalez Richard , Clarke Philippa , de Leon Carlos Mendes , Mezuk Briana 
Published: January 2025

Abstract
Perceived uncertainty about future employment during economic crises negatively affects the mental health of older adults. Moreover, such health impact varies across countries and employment contexts. This study examined the longitudinal association between work expectation and psychological stress among Baby Boomers in the US and South Korea and how employment transitions moderated this association during the Great Recession (2008-2009) and its recovery (2010-2018). Data came from 2006-2018 Health and Retirement Study (n=2,647) and Korean Longitudinal Study of Aging (n=1,454). Perceived expectation of working in the next five years was reported on a probability scale (0-100%). Psychological stress was assessed by the Center for Epidemiologic Studies Depression Scale. Six distinct employment transitions were constructed based on labor force status: entrance to full-time employment, precarious employment, stable full-time employment, self-employment, exit labor force, and being out of labor force. Multivariate mixed-effects logistic regressions were fit, adjusting for sociodemographic and health characteristics. Effect modification by employment transitions was examined via stratification. Higher work expectations were associated with lower odds of psychological stress during recession (OR=0.93 [0.89, 0.98]) and recovery (OR=0.95 [0.92, 0.98]) in US respondents; this association was more pronounced during the recovery in Korea (OR=0.83 [0.79, 0.87]). Among those who transitioned to self-employment, higher expectations were associated with higher odds of stress in US (OR=1.22 [1.02, 1.46]) but lower odds in Korea (OR=0.90 [0.77, 1.05]). Findings suggest opportunities for country-specific workplace policies to support mental health of older adults transitioning to different employment paths, particularly during the uncertain period of economic crisis.
DIFFERENCES IN PROTECTIVE MENTAL HEALTH RESOURCES AMONG WIDOWED IN THE UNITED STATES AND INDIA
Authors: Chauhan Shekhar , Carr Dawn , Taylor Miles , Sonnega Amanda 
Published: January 2025

Abstract
Widowhood is among the most consequential stressful events for mental health. Although social support is protective for mental health at widowhood, most of widowhood studies are based on US populations. This study uses a harmonized dataset we created to evaluate differences in depressive symptoms among recently widowed individuals (i.e., within the last 2 years) in the United States and India using the first (2017-18) wave of the Longitudinal Ageing Study in India (LASI; n=1571) and the 2016-2018 waves of the Health and Retirement Study (n=202). Using OLS regression, we evaluate depressive symptoms based on a four-item depression instrument (CESD; mean=1.19), by country status and we use interaction effects to evaluate differences by country. Results show that mean depressive symptoms are lower among US widows (0.95 vs 1.22). Having children and higher relative socioeconomic status are both associated with protective effects for US and Indian widowed people, but having friends and rural status are only associated with lower depressive symptoms among US widows. Rural status is associated with higher symptoms in India. Gender is not significant in either sample. Self-rated health is associated with protective effects for depressive symptoms for both groups, but the effect is greater for US widows. Findings suggest there are certain protective resources that are consistent across contexts, especially self-rated health, socioeconomic status and having children. Mental health interventions for widows that focus on non-family social engagement, however, may only benefit recent widows in the US.
RESIDENTIAL PREFERENCES FOR CURRENT AND FUTURE RESIDENTIAL ENVIRONMENTS AMONG KOREAN MIDDLE-AGED ADULTS
Authors: Lee Eunju , Kim Kyungmin 
Published: January 2025

Abstract
Midlife adults often plan for life after retirement, forming their own preferences for where to live after retirement. Their residential preferences for life after retirement may be different from the past as they consider their well-being in later life. This study compared middle-aged adults’ preferences for residential features between current and future residential environments (i.e., past and current residential preferences) and examined how differences in preferences for current and future residential features were associated with health and social characteristics. A sample of 1,651 Korean middle-aged adults (aged 49–64) rated their preferences for each of 12 residential features (e.g., proximity to family/relatives, low living expenses, accessibility to health services) regarding their current and future residential environments, separately. Respondents considered “house price” and “safe and clean environments” most important for both current and future residential environments, while “accessibility to health services” and “opportunity for leisure activities” were more important for future residential environments. Regression results showed that respondents with poorer health considered features that help them compensate for health decline more important, while those who contacted friends/neighbors more frequently and participated in more cultural activities considered features that help them maintain their social interactions more important for future residential environments than the past. Across residential features, respondents with poorer health showed lower similarity in overall preferences between current and future residential environments. Our findings suggest the importance of identifying various demands for residential features after retirement to support successful adaptation in later years.
PSYCHOMETRICS OF THE PHYSICAL RESILIENCE SCALE IN OLDER ADULTS LIVING WITH DEMENTIA: PROXY RESPONSES
Authors: Resnick Barbara 
Published: January 2025

Abstract
Physical resilience is defined as the ability to recover or optimize function in the face of physical challenges. Physical resilience has been conceptualized as a trait focusing on the way individuals respond to stressors versus an outcome of the stressor(s) or physically challenging experience. Due to cognitive changes, including decreased ability to recall new information or aphasia, it is difficult for individuals living with dementia to respond to questionnaires. Consequently, a family member or identified proxy is often asked to respond. The purpose of this study was to determine if proxies can complete the Physical Resilience Scale for older adults living with dementia. This was a descriptive study using Rasch analysis and baseline data from the Function Focused Care for Acute Care Using the Evidence Integration Triangle trial. The first 240 patients living with dementia were included. There was evidence of reliability based on person and item separation index. There was no evidence of Differential Item Functioning (DIF) between genders although there was evidence of DIF by race on Item 7 (He/she accepted help from others). Validity was supported based on items fitting the model except for Item 10 (He/She found it difficult to ask for help from others). Controlling for age, gender, race and comorbidities there was a significant relationship between resilience and function (R2 =.08, F=.4.75, p=.001) and resilience and pain (R2 =.08, F=3.95, p.002). The Physical Resilience Scale is reliable and valid when completed by proxy reports. Future use should remove Item 10 due to redundancy.
PROMOTING LIFELONG LEARNING AT OREGON’S AGE-FRIENDLY UNIVERSITIES
Authors: Cannon Melissa , Toyokawa Noriko , Guest M Aaron 
Published: January 2025

Abstract
The Age-Friendly University (AFU) global network “aims to shape how we live and work by increasing educational opportunities across the life span” (https://www.afugn.org/). In Oregon, USA, Portland State University (PSU), Western Oregon University (WOU), and Southern Oregon University (SOU) have endorsed and adopted the AFU Principles to become part of the network of age-friendly higher education institutions. Although each institution has implemented different initiatives as part of this work, a common thread across the three has been promoting lifelong learning. Melissa Cannon will present findings from preliminary research that identified several strengths, weaknesses, and opportunities for WOU becoming age-friendly, including those detailed in their own AFU campus report. Participants will learn some of the recent initiatives that have advanced the university’s age-friendly and lifelong learning efforts. Noriko Toyokawa will guide a discussion on the distinct challenges small-sized universities face when initiating and maintaining age-friendly university initiatives. The presentation will explore potential strategies for effectively managing these situations, using the case of SOU as an illustrative example. Serena Hasworth and Lauren Bouchard will highlight findings from PSU’s “Age-Friendly University Campus Report” and provide an overview of activities to improve age-friendliness through the Better with Age Initiative. They will describe efforts to develop an age-inclusive micro-credential program for students and faculty at PSU. The concluding discussion fosters a dynamic exchange of creative ideas between the audience and presenters, aiming to optimize existing resources for mobilizing and sustaining age-friendly university initiatives across diverse contexts.
ENHANCING AND SUSTAINING THE MEMORY CARE NAVIGATOR MODEL IN HAWAII
Authors: Nishita Christy 
Published: January 2025

Abstract
Hawaii’s memory care navigator model aims to educate, support, and connect local families to the resources that they need. The Kupuna Collective, a cross-sector coalition led by the University of Hawaii Center on Aging and Hawaii Public Health Institute, has taken steps to enhance the model. First, community health workers, given their close ties and relationship with local communities were targeted and trained to provide person-centered, dementia support in a culturally tailored manner. To ensure quality and explore collective impact, community health workers, who were embedded within local organizations, use a standardized, electronic platform to collect assessment and care planning data. In addition, the model has been sustained by integrating the model within Hawaii’s workforce development efforts. Trainings are widely disseminated as part of Hawaii’s Building Our Largest Dementia Infrastructure initiative, funded by the Centers for Disease Control. Trainings are stored in an online library for ongoing continuing education and training and available for use by community college CHW training programs. Taken together, the memory care navigator model has supported the development of a more coordinated system of dementia care in Hawaii.
LATENT CLASSES AND PROGRESSION OF MMSE IN YOUNG-ONSET DEMENTIA: DATA FROM THE SWEDISH DEMENTIA REGISTER
Authors: Finkel Deborah , Kårelind Fanny , Zarit Steven , Bielsten Therése , Wijk Helle , Johansson Linda 
Published: January 2025

Abstract
Studies have shown significant heterogeneity in the longitudinal progression of dementia. Growth mixture models have detected up to 4 classes that differ in both baseline Mini-Mental State Exam (MMSE) and rate of decline over time. Most analyses focus on adults over age 65 and investigate group differences in demographic and health variables. The current analysis focused on adults with young onset dementia (YOD) and examined the role of demographic and support variables. Sample included 1025 adults (55% women) registered in the Swedish Dementia Register prior to age 65 with at least 3 registrations. Age at baseline was 38 to 64 (mean=59.3, SD=4.1); follow-up ranged from 1 to 12 years (mean=4.6, SD=2.0). Growth mixture models identified 4 classes: high baseline MMSE and moderate decline over time (56.1%), intermediate baseline MMSE and somewhat faster decline (39.2%), low baseline and stable MMSE over time (3.5%), and high baseline with steep decline (1.2%). Group 2 had the highest proportion Alzheimer’s Disease (AD) diagnosis and Group 4 had the lowest. Group 3 was more likely to have vascular or unspecified dementia and Group 4 was more likely to have vascular or frontotemporal dementia. Groups differed in age at diagnosis (Group 2 youngest), participation in adult daycare (Group 4 most likely), and having home health assistance (Group 2 most likely). Results highlight that YOD is just as heterogeneous as later onset dementia; therefore, it is vital that people with YOD get early diagnosis and a case manager to help identity and meet their individual needs.