bluuebunny/crossref_metadata_2025_split huggingface dataset:
NAVIGATING AND ENHANCING HEALTHCARE COMMUNICATION: CHALLENGES AND STRATEGIES FOR LATE-DEAFENED OLDER ADULTS
Authors: Kohl Gianna , Heniff Erin , Dye Maya , Rogers Wendy 
Published: January 2025

Abstract
Effective communication in healthcare is crucial, especially for older adults with complex health issues. Late-deafened older adults, who develop severe to profound bilateral hearing loss post-lingually, face unique challenges in communicating their health needs. This issue is not well understood, and research describing strategies to manage these communication challenges in clinical settings is lacking. Understanding these challenges and responses for healthcare activities is essential to support late-deafened older adults and health professionals, ensuring quality care. Data were collected through the Aging Concerns, Challenges, and Everyday Solutions (ACCESS) study wherein questionnaires and interviews were completed by 56 late-deafened participants aged 60 to 80 (M = 69.4, SD = 6.0), living with a diagnosis of hearing loss for at least ten years (age of onset: M = 31.8, SD = 19.9). We conducted a detailed content analysis of interview data about challenges and response strategies in healthcare settings. The most difficult activity was participating in healthcare appointments (n = 38), followed by managing health, diet, and nutrition (n = 13). Communication barriers included conversational partners using verbal communication and insufficient visual cues, lack of support, and unclear speech. Response strategies included using external assistive technology, adaptive communication strategies (e.g., lip-reading), and educating healthcare providers about their needs. Our findings highlight the need for health professionals in clinical practice to understand and adapt to the specific communication challenges faced by late-deafened older adults. Implementing effective communication strategies and providing tailored support can lead to more accurate diagnosis and treatment, ultimately enhancing patient care.
TECHNOLOGY FOR HEALTHCARE WORKFORCE FOR OLDER ADULTS: CHATGPT-ASSISTED QUALITATIVE ANALYSIS
Authors: Han Soojeong , Alexander Gregory 
Published: January 2025

Abstract
Rigorous guidance on ChatGPT use in qualitative research is not available. Here we examine the quality of ChatGPT versus human analysis. The International Summit on Innovation and Technology in Care of Older People (IS-ITCOP) was held on June 6-7, 2024 in New York. 47 experts in care of older adults attended IS-ITCOP. Attendees participated in structured roundtable discussions about long-term care workforce readiness to use technology in care of older adults. Each roundtable discussion included a lead facilitator and support staff who recorded discussions lasting approximately 2 hours. We used 10 roundtable discussions in our analysis. We followed the methodology established by Goyanes, Lopezosa, and Jordá(2024) for ChatGPT. Our human analysis was based on Braun and Clarke’s(2006) approach. Emerging themes included data privacy and security, informed consent, balancing autonomy and safety, role of the informatics workforce, technological advancements and ethical use, and policy and regulation. Compared to human analysis, 14 out of 79 sub-themes (18%) were missing in ChatGPT analysis. Findings suggest that ChatGPT has several strengths. ChatGPT completed the qualitative analysis in a few minutes, while humans took several days. ChatGPT provided clear definitions and explanations of words and concepts. It efficiently calculated convergence and divergence rates for each theme. ChatGPT also has weak points. ChatGPT cannot create a hierarchical coding scheme. It may not be able to capture all prompts from discussions. ChatGPT’s answers were derived from its training data, which may not be current. Also, ChatGPT appeared to miss some nuances or keywords, such as EHR.
DEMENTIA RISK FACTORS PREDICT ALTERED WHITE MATTER MICROSTRUCTURE IN A RURAL AGING COHORT
Authors: Bender Andrew , Giriprakash Pavithran Pattiam , Cordes Dietmar , Caldwell Jessica , Miller Justin 
Published: January 2025

Abstract
Diffusion-weighted magnetic resonance imaging (dMRI) studies of older adults reveal associations between dementia risk factors and altered cerebral white matter microstructure. However, these findings are based almost exclusively on residents of metropolitan areas. Older residents of rural areas face increased risk for Alzheimer’s disease and related dementias, but there are few neuroimaging studies of dementia risk in this population. The present study investigated associations between dementia risk factors and white matter alterations in rural-dwelling older adults (n=76) without dementia, recruited from the Nevada Exploratory Alzheimer’s Disease Research Center. We applied voxel-based analysis (VBA) to separately evaluate established risk factors (APOE e4 carriage, family history of dementia, body mass index [BMI], and diagnosed hypertension, hypercholesterolemia, and sleep apnea) as predictors of differences in dMRI measures of white matter microstructure (fiber density, crossing fiber entropy, fractional anisotropy, and mean diffusivity), while accounting for differences in age, sex, and handedness. VBA results (familywise error corrected p&lt;.05) showed APOE e4 allele carriage, family history of dementia, higher BMI, and self-reported diagnoses of hypertension and sleep apnea are independently associated with widespread patterns of lower white matter fiber density. Moreover, we observed similar patterns of results in subsidiary analyses that also accounted for diagnosed mild cognitive impairment. These are the first findings to characterize associations between elevated dementia risk factors and altered white matter microstructure in rural-dwelling older adults. Future studies should evaluate whether the effects of elevated risk factors on cerebral microstructure differ between rural- and metropolitan-dwelling older adults.
ADDRESSING THE LONG-TERM CARE POLICIES IN HAWAII: AN APPLICATION OF BARDACH’S MODEL
Authors: Hossain Mohammad 
Published: January 2025

Abstract
In this policy analysis paper, I utilized Bardach’s (1977) model to evaluate three alternative policy options addressing the crucial needs of long-term care in Hawaii. The policy options included the Long-Term Care Insurance (LTCI), the Kupuna Caregivers Program (KCP), and the Long-Term Care Insurance Partnership Program (LTCIPP). These policies were analyzed based on Bardach’s (1977) eight-step model. Further, the evaluation justified the selected policies against several criteria such as financial feasibility, effectiveness, political acceptability, policy sustainability, an overall impact to support older adults towards age in place, effects on employers, and sustainability. The findings of this policy analysis included that the LTCIPP, as a 3rd policy alternative in the list, has more potential to address the service gaps of LTC in the long run compared to the remaining policies. Though the LTCIPP has been progressively growing as a promising LTC initiative, and currently, most U.S. states are entitled to this program, it might not be affordable for potential care recipients from marginal communities such as low-income, homeless, Indigenous communities, etc. Further, this paper acknowledges that addressing the needs for long-term care necessitates comprehensive efforts. Aside from the enrollment in LTCIPP for Hawaii, this analysis recommends promoting and advocating for appropriate funding for the Kupuna Caregiver Program, which is unique even in the U.S., to support low-income families and their care-needed elderly members. The paper suggests that partnering with private entities enhances the government’s chances of avoiding cost-shifting challenges.
EXAMINE QUALITY OF CARE AMONG OLDER ADULTS IN MEDICARE ADVANTAGE COMPARED WITH TRADITIONAL MEDICARE
Authors: Mahmoudi Elham 
Published: January 2025

Abstract
About 50% of Medicare beneficiaries are enrolled in Medicare Advantage (MA), incentivized to offer more efficient and coordinated care than traditional Medicare (TM). Evidence suggests timely access to coordinated and high-quality ambulatory care is critical to preventing adverse health events (e.g., hospitalization and long-term institutionalization). In this study, we used 2017-2021 (latest available) Medicare Current Beneficiary Survey (MCBS) data to examine the effect of MA vs. TM on 10 quality metrics among older adults with and without dementia. We applied inverse propensity weighting to balance the characteristics of MA and TM enrollees and used the Average Treatment Effect method, adjusting for sociodemographic, rurality, and health-related variables. Among people without dementia, MA was associated with greater challenges receiving needed care [TM=5.06%; MA=6.50%; (diff=1.4 percentage point (PP); 95% CI:0.9%,1.9%)] and accessing specialty care [TM=5.25%; MA=6.02%; (diff=.73 PP; 95% CI:.21%,.1.26%)]. However, TM was associated with more dissatisfaction with out-of-pocket costs [TM: 13.78%; MA=12.18%; (diff=1.6PP; CI: -2.32%, -.87%)] and distance/location of different health services [TM=8.67%; MA=7.49%; (diff=1.18 pp; CI: -1.81, -.55)]. Among beneficiaries with dementia, except for dissatisfaction with ease of access to care with better results in MA (TM=7.53%; MA=5.09%; diff=2.45pp; 95%CI: -4.6%, -.26%), we did not find any significant differences in quality metrics between MA and TM. In conclusion, TM performed better in receiving the needed care and specialty care. MA was superior in lowering out-of-pocket costs and better care coordination. Dissatisfaction with care was substantially higher among enrollees with dementia than among those without, regardless of MA or TM.
A PILOT AND FEASIBILITY STUDY OF THE AGING TOGETHER ANTI-AGEISM PEER SUPPORT PROGRAM
Authors: Steward Andrew , Keane Connor Thomas Francisco , Lee Yura , Cho Young 
Published: January 2025

Abstract
Ageism is internalized from an early age, with accumulating, negative health impacts across the life course. Although the theory of relational ageism describes how ageism is reinforced through interpersonal interactions, few ageism-related intervention studies have actively engaged older adults at personal and relational levels. We conducted a pilot and feasibility study of a manualized, anti-ageism peer support program facilitated by trained older adults called “Aging Together.” Key components of the program include peer support, education about ageism and health, and “tell your story of aging.” Participants received a 30-page workbook providing education and journaling/discussion prompts. Six small groups of five-to-eight participants (N=48 total) met for ten, weekly, in-person (60-90 minute) sessions in a medium-sized city of the U.S. Midwest. Results indicate the program was feasible and acceptable overall (attendance rate=88.91%, attrition rate=6.25%, Mean acceptability score=4.23/5). Based on 30-minute pre/post phone surveys, Mann-Whitney U tests (N=28) indicated a significant decrease in relational ageism (M=2.73/6 to 2.19/6; p&lt;.01), decrease in internalized ageism (M=1.91/6 to 1.66/6), significant decrease in depressive symptoms (M=8.61/30 to 6.57/30; p&lt;=.01), increase in social connectedness (M=4.19/5 to 4.26/5), increase in self-efficacy (M=3.29/4 to 3.36/4), and decrease in cognitive function (M=29.67/40 to 29.5/40). By incorporating education about ageism and storytelling within a small, peer support group setting, the Aging Together program may be particularly effective in reducing depressive symptoms and relational ageism, which is an understudied aspect of ageism. Future research should scale this program across diverse geographical settings and explore potential mediating relationships between internalized/relational ageism and psychosocial well-being.
FRAMING AGE AND IMMIGRATION: OLDER IMMIGRANT WOMEN AND WELL-BEING IN A TIME OF SOCIAL INTOLERANCE
Authors: Tahmaseb Jasmin 
Published: January 2025

Abstract
In today’s contemporary troubling social climate, discourse against immigration is on the rise. In the U.S. older immigrants make up 13 % of the older adult population. The media often portrays both older adults and immigrants in biased and stereotypical ways, such portrayal can have a negative impact on the well-being of older immigrants and increase late life isolation and loneliness. This presentation examines the impact of how immigration and age are framed during the 2024 political campaign and the ways that those messages influence the lives of older immigrant women. Life history interviews exploring the goals, concerns, and supports of 18 older immigrant women (70+) indicate that the current political discourse on immigration has a negative influence on their lives, particularly as they navigate late life challenges. Media messages addressing the intersection of immigration and age are often negative increasing psychological distress among the women interviewed. We present examples and discuss the results of a content analysis of 10 news articles appearing over a 2-month period in several prominent newspapers, an analysis that illustrates the discriminatory nature of the ways that content is framed. We discuss the concerns, stressors, and resilience of participants as they struggle to manage late life challenges in a time of social intolerance and discrimination. The lives of older immigrants are often marked by cultural and economic challenges. Discriminatory framing of messages relating to both aging and immigration can increase life-course cumulative disadvantage negatively impact the well-being of an already vulnerable and socially marginalized group.
IMPACTS OF INTERGENERATIONAL CARE ON FUTURE CARE EXPECTATIONS: A SURVEY-EXPERIMENT STUDY OF AGING SANDWICH CARERS
Authors: Bai Xue , Zhou Shuai 
Published: January 2025

Abstract

Abstract background
An increasing number of people in their 50s and 60s are sandwiched between surviving parents and children. Numerous ageing adults often provide support for older and/or younger generations while also facing their own challenges and stereotypes associated with the transition to old age.

Objectives
This study examined the effects of multi-dimensional, multi-directional care provision on future care expectation among sandwich carers.

Design and methods
We implemented three factorial survey experiments within a large-scale representative survey of 1,500 sandwiched carers aged 50 and 69 (Mean age = 58.86±5.47) in Hong Kong. Care expectation was assessed in hypothetical scenarios across three key domains: financial, instrumental, and emotional care. Ordered logistic regression and multi-nominal logistic regression models were used.

Results
Downward support to children was positively associated with filial care expectations, especially emotional support (OR = 1.45; 95% CI = [1.21, 1.73], p&lt; 0.001). Sandwiched carers’ SES was negatively associated with expectations for financial (OR = 0.75; 95% CI = [0.62, 0.89], p&lt; 0.01) and instrumental care (OR = 0.85; 95% CI = [0.71, 1.01], p=0.068) from children. Providing instrumental support to both parents and children reduced the expectation for future instrumental care. Having sons and greater socioeconomic resources increased the preference for self-care, while downward support reduced it.

Discussion
Downward support to children strengthens filial care expectations among sandwich carers, especially mothers. However, providing instrumental support to both parents and children, along with SES, promotes the pursuit for self-care. It is crucial to enhancing sandwich carers’ image, caregiving capabilities and later-life preparations.
ASSOCIATION OF HAVING DOMESTIC WORKERS WITH ELDERLY’S SOCIAL PARTICIPATION, VOLUNTEERING, AND LIFELONG LEARNING
Authors: Zhang Youjuan , Bai Xue 
Published: January 2025

Abstract
Due to the family caregiver shortage and life expectancy increase, there has been an emerging worldwide trend of migrant domestic workers (MDWs) providing elderly care. However, the association of having MDWs at home with older adults’ psychosocial wellbeing has been under investigated. This study used data from the Panel Study of Active Ageing and Society (PAAS, conducted from June to November 2022) among 5007 Cantonese-speaking residents aged ≥50 years (64.2 ± 8.4 years, women: 53.5%) in Hong Kong. Participants self-rated their social participation frequency on a 20-item four-point scale, from “1.=never” to “4.=almost every day”. Moreover, participants reported their volunteering experience by rating their monthly volunteering time (from “0.=none” to “5.≥20 hours”), and their learning activities over the past two years using a simple yes/no response. On average, participants scored 29.32 (SD: 5.01) out of 80 on social participation, 17.6% engaged in volunteering, and 4.4% had learning activities. After adjusting age, sex, living status, education level, family income, and physical status, results from linear and logistic regression models showed that having an MDW at home was associated with enhanced social participation (β=1.24, p&lt; 0.001), and increased odds of participating in volunteering (OR=1.38, 95% CI: 1.05-1.81, p=0.02) and learning activities (OR=2.38, 95% CI: 1.60-3.53, p&lt; 0.001) among older adults. Social participation, volunteering, and lifelong learning are crucial for fostering community engagement and quality of life. Our findings imply that integrating MDWs into elderly care not only supports older adults’ psychosocial well-being but also could contribute to community development as a whole.
COMMUNITY-BASED GARDENING INTERVENTIONS FOR ASIAN AMERICAN IMMIGRANTS AND REFUGEES: A SCOPING REVIEW
Authors: Doan Lan , Chen Casandra , Tran My Duyen , Yi Stella , Kwon Simona 
Published: January 2025

Abstract
Gardening and horticultural therapy have been shown to increase overall sense of a community, social engagement and quality of life, and increase physical activity. Gardening interventions are innovative means to address social isolation and loneliness by engaging adults in a meaningful way and building supportive communities that integrate informative and respectful interactions around stigmatized topics like social isolation and loneliness and culturally specific contexts and experiences way (e.g., combining gardening interests with culturally relevant foods). However, few interventions have been developed for diverse cultural communities with limited English ability and there are no known interventions targeting isolation and loneliness among older Asian American adults who face severe economic and language challenges that limit health access. This scoping review examines gardening-based interventions for Asian American populations, specifically older adults. Following PRISMA guidelines, we searched PubMed, CINAHL, PsycINFO, and Embase in June 2024 for peer-reviewed articles related to gardening, health interventions and Asian American people in the US. Of the 1419 studies identified, 25 were reviewed in full and 6 studies were included. Key themes include cultural tailoring of garden-based nutrition programs; physical and mental health benefits of community gardens for refugees and immigrants; and that role of community gardens in fostering community social support and individual sense of belonging. Studies focused on adults and older adults and Bhutanese, Karen, Nepali, and Southeast Asian communities. These findings highlight the limited studies available for Asian American communities and urgent need for developing culturally relevant healthy aging interventions for diverse refugee and immigrant populations.
A META-ANALYSIS OF EXTRACELLULAR VESICLES BIOMARKERS IN THE DIAGNOSIS OF ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Taha Hash Brown 
Published: January 2025

Abstract
Accurate differential diagnosis of dementia disorders including Alzheimer’s disease (AD), frontotemporal dementia (FTD), dementia with Lewy bodies (DLB), Parkinson’s disease dementia (PDD), and vascular cognitive impairment and dementia (VCID), along with conditions like prodromal mild cognitive impairment (MCI) or negative controls (NCs), continues to challenge neurologists. Extracellular vesicles (EVs) have emerged as a popular tool for their capacity to encapsulate disease-specific signatures, particularly in neurodegenerative and neurological disorders. To this end, we have performed a comprehensive, PRISMA-guided systematic review and meta-analysis, utilizing sophisticated statistical modeling to determine the diagnostic accuracy, explore between-study variance and heterogeneity (I2), and investigate potential publication bias using biomarkers derived from general EVs (n = 44) or speculative CNS-enriched EVs (n = 18). For all comparative analyses, biomarkers derived from general EVs demonstrated superior diagnostic accuracy, less between-study variance, heterogeneity, and publication bias than those from speculative CNS-enriched EVs. The diagnostic accuracy was low in differentiating among different dementia disorders or from NCs. However, the analysis for diagnosing persons with AD vs. VCID achieved the highest diagnostic accuracy, suggesting that further studies may focus on this comparison. Meta-regressions revealed that studies using cerebrospinal fluid, employing citrate instead of EDTA for blood collection, using thrombin for coagulation factor depletion, isolating EVs with purer methods such as combined UC and SEC, not freezing EVs post-isolation, and quantifying miRNA biomarkers instead of proteins, achieved better diagnostic accuracy and less heterogeneity.
EXPLORING THE MODERATING ROLE OF COGNITIVE FUNCTION IN SCREEN TIME AND STRESS
Authors: Roque Nelson , McGill Robert 
Published: January 2025

Abstract
Understanding the interplay between brain health and digital media use is crucial in our current technological era. Prior research has shown that stress influences screen time usage and that screen time can impact cognitive function and brain structure (Neophytou, E., Manwell, L.A., & Eikelboom, R., 2021). This online survey study, conducted on Prolific, examines the relationship between screen time and stress, as moderated by momentary cognitive functioning, in a sample of 319 participants (mean age = 40.5 years, age range 19-77, 61% female). Momentary cognitive processing speed was assessed using a web-based cognitive assessment developed by M2C2 (NIA #U2CAG060408), stress via the Perceived Stress Scale, and screen time through self-reported data (yesterday’s screen time reported on cell phone). The bootstrapped SEM moderation analysis found that stress significantly increases screen time (stress_effect = 0.169, p = 0.004, 95% CI [0.051, 0.287]). The interaction effect (interaction_effect = 0.153, p = 0.011, 95% CI [0.031, 0.278]) indicates that faster processing speed (better cognition) amplifies the impact of stress on screen time. For example, in moments when one has faster processing speed, stress may lead to increased screen use as a way to cope with heightened awareness of stressors. Cognition alone does not significantly affect screen time (cognition_effect = 0.022, p = 0.740, 95% CI [-0.102, 0.162]). These findings underscore the need to consider cognitive dynamics when studying the relationship between digital media use and well-being. Future research should employ real-time data collection to explore how cognitive changes (across domains), affect screen time behaviors.