bluuebunny/crossref_metadata_2025_split huggingface dataset:
UNVEILING THE ASSOCIATION BETWEEN SOCIAL ISOLATION AND SLEEP DISTURBANCES AMONG LATINX OLDER WOMEN AND MEN
Authors: Giorgio Luciana , da Scherf Erick Luz , Ruggiano Nicole 
Published: January 2025

Abstract

Background
Sleep disturbances are associated with an increased risk of cardiovascular, cardiometabolic, and neurodegenerative conditions. Aging involves physiologic changes associated with increased sleep disturbances, however, sociocultural stressors, such as social isolation, can exacerbate these disturbances. Although Latinx older adults are more likely to experience social isolation and poorer sleep than their non-Latinx White counterparts, they remain underrepresented in sleep health research. We examined the association between social isolation and sleep disturbances and explored gender differences in this relationship.

Methods
We used data from Latinx older adults participating in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (n=323). We conducted weighted linear regression analyses adjusted for sociodemographics and selected health conditions to examine the relationship between social isolation and sleep disturbances. Sleep disturbances were measured using the Women’s Health Initiative Insomnia Rating Scale(WHIIRS). Social isolation was assessed using validated loneliness and social support scales. Gender differences were examined using cross-products.

Results
Most participants were women (54.30%), immigrants (97.56%), Cuban (40.33%), and Spanish-speaking (86.00%). Participants reported mean loneliness of 1.44(SD=1.66) and social support of 26.40(SD=6.68). Average WHIIRS scores were 7.53(SD=5.68). Increasing loneliness was associated with a 0.48-point increase in WHIIRS (β=0.48, SE=0.24, p=0.04) in adjusted models. Gender was not a significant moderator in this relationship. Social support was not significantly associated with WHIIRS.

Conclusions
Loneliness was a robust predictor of sleep disturbances among Latinx older adults. Psychological and community-level interventions aimed at increasing social connection may improve sleep, thus reducing the burden of health conditions in this population.
USING COMPANION CARE TO ADDRESS THE DUAL BURDEN OF LONELINESS AND CHRONIC ILLNESS
Authors: McNamara Kelsey , Meadows Jill Bongiorni , Smith Brian 
Published: January 2025

Abstract
Chronic illness is a risk factor for loneliness. Concurrently, loneliness can increase the risk of and exacerbate chronic conditions, especially among older adults. Special Supplemental Benefits for the Chronically Ill (SSBCI) are benefits that can be offered to qualifying Medicare Advantage members to improve health and function. This study’s objective was to evaluate the impact of a companion care program, designed to address loneliness and lack of social support, on SSBCI recipients’ quality of life. Members received companion care through their health plan and were paired with “Papa Pals” for companionship and assistance with instrumental activities of daily living. Members were assessed at enrollment and ≥8 weeks later for loneliness (UCLA Three-Item Loneliness Scale, Range: 3-9, =3 “not lonely”, 4-6 “lonely”, 7-9 “severely lonely”) and health-related quality of life (CDC’s Healthy Days Measure, Range: 0-30 days). Change in outcomes were analyzed using the one-sample t-test. Analysis included 531 SSBCI recipients who were lonely at baseline, used companion care any time between 2021-2023, and completed a reassessment. Average age was 74, 63% were female. Average baseline values: 5.7 loneliness score, 9.6 mentally unhealthy days, 14.1 physically unhealthy days. On average, outcomes improved: -0.99 loneliness score, -1.4 mentally unhealthy days, -1.6 physically unhealthy days. In regards to loneliness score, 66% of members improved, 13% maintained, 22% regressed. Our results indicate companion care can significantly improve loneliness among a population experiencing a high burden of physical and emotional stress; research should continue to evaluate scalable interventions to address loneliness among this population.
1. ENGAGEMENT: A PRIORITY NEED IN CARE TRANSITIONS EXPERIENCED BY OLDER ADULTS AND CAREGIVERS
Authors: Regan Claire , Hirschman Karen , Harding Rachel , McHugh Molly , Osokpo Onome , McCauley Kathleen , Shaid Elizabeth , Naylor Mary 
Published: January 2025

Abstract
Care transitions are a vulnerable time for older adults, particularly transitions from hospital to home. The Transitional Care Model (TCM) is designed to support older adults and their informal caregivers during this period, consistently demonstrating improvements in health outcomes while lowering care costs. This multi-component, advanced practice registered nurse (APRN)-led, team-based care intervention was recently implemented in a large-scale RCT in three U.S. healthcare systems (9/2020-3/2023). Content analysis of APRN intervention documentation for 480 patients revealed key barriers to delivering the TCM as designed. The lack of patient and/or informal caregiver engagement theme was the most common documented challenge (231/480, 48.1%), higher than issues of complexity of care (166/480, 34.6%) and social determinants of health (SDOH, 138/480, 22.8%). The lack of engagement theme was most often identified as a patient issue (197/231, 85.3%) or patient and caregiver issue (23/231, 10.0%). Subcategories included limited participation in care, patient refusal of services, and lack of adherence to plan of care (e.g. lifestyle changes, medication management and motivation). Lack of engagement was complicated by the complexity of care and/or SDOH (101/231, 43.7%). These findings demonstrate the challenges of patient engagement in the presence of complexity of care and SDOH within transitional care and how difficult engagement of patients and caregivers can be to achieve. Future research is needed to understand the factors contributing to and mediating lack of engagement as well as this challenge’s impact on health outcomes. Addressing this knowledge gap will inform the design of more effective transitional care interventions.
A LONGITUDINAL ANALYSIS OF DOMAIN-SPECIFIC CHANGES IN PROMIS® SELF-EFFICACY AND PREDICTORS IN PARKINSON’S DISEASE
Authors: Kim Haesung , Shulman Lisa , Magder Laurence , Schumacher John , Unick George , Shakya Sunita , Gruber-Baldini Ann 
Published: January 2025

Abstract

Background
There is limited research on the magnitude and predictors of longitudinal changes in Self-Efficacy (SE) among Parkinson’s disease (PD) patients. OBJECTIVE: To describe longitudinal changes in Patient-Related Outcomes Measurement Information System -SE (PROMIS-SE®): managing daily activities (SEM-DA), emotions (SEM-E), medications and treatments (SEM-MT), social interactions (SEM-SO), and symptoms (SEM-S) and examine predictors of changes in PD.

Methods
A longitudinal analysis was conducted on 239 PD patients using two-time points (3years±180days). Baseline predictors included age, sex, race, education, PD duration, PD severity, medical comorbidities, and cognitive ability. Student T-tests and Pearson’s correlation coefficient examined the relationship between PROMIS-SE domains and predictors of changes.

Results
SE decreased by more than 5 T-score units (0.5SD) across all domains [Mean±SD: SEM-DA (-6.13±8.66), SEM-E (-5.32±10.49), SEM-MT (-7.2±10.11), SEM-SO (-5.69±9.96), and SEM-S (-5.18±10.25)]. Significant larger mean declines (p&lt;.05) were associated among older age (age&lt; 65 vs. 65+) in SEM-E (-3.84 vs. -6.53) and SEM-MT (-5.63 vs. -8.47), higher cognition (MoCA&lt; 26 vs.26+) in SEM-E (-1.54 vs. -7.30), SEM-SO (-3.22 vs. -7.03), and SEM-S (-3.17 vs. -6.58), and higher education (no college vs. college) in SEM-SO (-2.10 vs. -6.00). Change in UPDRS total score correlated with change in SEM-S (r=-0.26, p&lt;.05).

Conclusions
Over three years, PD patients experienced significant SE changes across all domains, with the greatest decline in SE for managing medical treatments. Greater declines in SE were associated with older age, higher cognition, and higher education. This may indicate a higher sensitivity of the SE measure to change among those with higher cognition and education.
A SYSTEMATIC REVIEW OF RESILIENCE IN FAMILY CAREGIVERS OF AUTISTIC ADULTS: IMPLICATIONS FOR RESEARCH AND PRACTICE
Authors: Chakurian Daphne , Popejoy Lori 
Published: January 2025

Abstract
Family caregivers (FCGs) of autistic adults provide lifelong care and experience chronic stress, stigma, and social isolation, placing them at risk of poor health, quality of life, and well-being. Resilience, stress, and coping research have primarily been limited to FCGs of autistic children with inconsistent use of theory, definition, and measurement. This systematic review aimed to examine resilience in FCGs of autistic adults. Guided by the Transactional Model of Stress and Coping, this review followed PRISMA guidelines, and the protocol was registered with PROSPERO. Comprehensive searches of 10 databases identified 1,935 records. Risk of bias was appraised using the Johns Hopkins Evidence-Based Practice Model and Guide. Nineteen studies meeting inclusion criteria were included in the narrative analysis and were mapped to the conceptual model. Designs were cross-sectional and phenomenological. We found that higher FCG quality of life and well-being was associated with increased problem and meaning-focused coping, social support, future planning, and less perceived burden and stigma. A variety of FCG and autistic adult person and environment factors provided context for the stress and coping process. Social support and coping strategies were key to FCG resilience outcomes and may inform clinical guidelines and policy development. Research is warranted to examine social support, coping strategy, future planning, and perceived burden and stigma as modifiable factors to enhance FCG resilience. The use of well-defined theoretical constructs and measures could facilitate future systematic reviews, as well as contribute to clinical guidelines and policy development.
AGE-FRIENDLY HEALTHCARE: AN EVOLUTIONARY CONCEPT ANALYSIS
Authors: Zisberg Anna , Fraiman Paule Sarah , Rayan-Gharra Nosaiba , Danial-Saad Alexandra , Segel-Karpas Dikla , Ost-Mor Sharon , Keisari Shoshi 
Published: January 2025

Abstract
Current global aging trends emphasize the need to adapt healthcare systems to address older adults’ specific needs. Numerous age-friendly healthcare initiatives and approaches have emerged, but the field lacks a unified framework. The current study used Rodger’s evolutionary concept analysis model to explore ‘age-friendly healthcare’, examining the concept’s characteristics, components and structure. An initial literature search in multiple databases to identify articles relevant to age-friendly healthcare retrieved 1,407 articles. After screening for duplicates and relevance, 140 articles were examined for eligibility based on inclusion criteria related to age-friendly care, language, and full-text availability. Following full-text screening, 65 articles were included for data extraction by multiple researchers to synthesize theoretical, methodological and design elements. We identified similar terms, related cases, antecedents and consequences of age-friendly healthcare, as well as distinguishing attributes: Respect for older adults’ autonomy and needs; Leadership and organizational knowledge and support; Proactive policies and processes of care; Holistic care environments; and Communication and follow-up with awareness of challenges and barriers as well as prioritization of continuity-of-care. An overarching definition was crafted based on these findings. The concept of age-friendly healthcare is still in development, with much research focused on development and implementation but not yet on real-world patient and health-system outcomes. However, our proposed definition and analysis of the concept may help unify the field, clarify future research directions, and identify areas requiring further study. It may also enable development of improved practices and policies for the implementation of age-friendly healthcare in a variety of settings.
ARE STATINS THAT GOOD? ASSESSING THE PROTECTIVE EFFECT OF STATINS AMONG OLDER ADULTS WITH SERIOUS ILLNESS OR INJURY
Authors: Sanchez-Reilly Sandra , Yarrarapu Siva Naga Srinivas , Sidle Erin , Khalikov Marla , LaCoss Jennifer , Reilly Elizabeth , Crenshaw Shannon , McGinity Ashley 
Published: January 2025

Abstract

Background
Older Adults (OA) constitute the majority of Emergency Department (ED) visits, largely due to fall-related injuries and acute serious illnesses (ASI). OA’s ED visits lead to potentially extended hospitalizations and increased healthcare costs. Statins, commonly prescribed for cholesterol-lowering effects/cardiovascular benefits, are widely used among OA. Few inconclusive studies have explored the relationship between statins and OA falls/ASI. Objective: To investigate the relationship between statins and its protective effects among OA who visit ED due to injury/ASI.

Methods
OA ED visits (age&gt;65) were collected for seven weeks (summer 2024) at level-1 trauma center. Variables included acuity score (1-4, 1 being worse), diagnosis, ICU admission need, death and statins usage prior to event.

Results
1771 OA-ED. Median age 73 (68-80), 52% female (923), 34% White, 55% Hispanic. Acuity: 1(3%), 2(33%), 3(59%), 4(5%). OA statins usage was 50%. 25% visits were falls, followed by infections (13%), GI complaints (11%) among others. 50% OA went home, 43% admitted. 12% became ICU admissions, 2% died. Among statin-takers, 13.2% were admitted to ICU vs.11.4% not-on-statins (p=0.27,NS). Interestingly, 1.3% statin-takers died because of the injury/ASI that brought them to ED, vs. 2.6% not-on-statins (p=0.04). Falling was the most common reason for seeking ED: 21.6% statin-takers vs. 27.9% not-on-statins (p=0.002), suggesting a protective effect.

Conclusions
Statins appear to have a significant protective effect on falls/ASI among OA, specifically pertaining to decreasing their fall risk and in-hospital mortality rate. Further studies should explore prophylactic ways to use statins in improving hospital-related outcomes and decreasing risk of geriatric syndromes.
ASSESSMENT OF A U.S. NURSING STUDENT EXCHANGE PROGRAM FOCUSED ON JAPANESE OLDER ADULTS
Authors: Ono Keiko 
Published: January 2025

Abstract
From May 13 to 15, 2024, undergraduate nursing students from the U.S. participated in an international exchange at a university in Japan. A one-day program explicitly focused on learning about services for older adults in Japan: this study aimed to evaluate that program. On May 14, 2024, an intervention program was conducted in Japan, featuring lectures on Long-Term Care Insurance and other issues concerning older adults, including visits to nursing care facilities for older adults. The study involved seven undergraduate American nursing students. A qualitative descriptive research design was employed to assess the program’s impact. Before the intervention, participants individually responded to several questions via QR Codes using Microsoft Forms. These responses served as the basis for a group discussion, during which students summarized their thoughts on a sheet. After the intervention, the group discussed and revised their initial thoughts on the same questions. Finally, participants answered several questions using QR codes. The survey results indicated that none of the students were familiar with services for older Japanese adults before the program. However, after the program, the percentage of students interested in nursing care services for older adults in Japan increased from 57.1% to 71.4%. Additionally, the program positively influenced the student’s perception of older adults. They described older adults with terms such as “sociable,” “active,” “happy,” “willing to live,” and “well cared for.” This program may have made students perceive older adults in Japan as positive and content.
ASSOCIATION BETWEEN SARCOPENIA AND NEUROPSYCHIATRIC SYMPTOMS IN OLDER ADULTS WITH ALZHEIMER’S DISEASE
Authors: Zeng Derong , Zhang Nan , Qi Bingbing , Kawasaki Teruaki , Akiguchi Ichiro , Kinoshita Ayae 
Published: January 2025

Abstract
Sarcopenia is a vulnerability state that increases the risk of many adverse health outcomes, but little is known about the effects of sarcopenia on neuropsychiatric health. To explore the association between sarcopenia and neuropsychiatric symptoms in older adults with Alzheimer’s Disease, data from 110 participants were assessed using the Asian Working Group for Sarcopenia criteria. The participants had a mean age of 83.15 years (SD = 5.49), a mean MMSE score of 20.69 (SD = 5.03). The study focused on the relationship between sarcopenia and 12 neuropsychiatric inventory items, including delusions, hallucinations, aggression, depression, anxiety, elation, indifference, disinhibition, lability, aberrant motor behaviors, nighttime disturbances, and eating disturbances. The relationships between sarcopenia and these neuropsychiatric symptoms were explored using logistic regression models. Logistic regression analyses revealed significant associations between sarcopenia and both aberrant motor behaviors (Estimate=-1.5612, p=0.0141) and nighttime disturbances (Estimate= -1.2096, p=0.0194). Further analysis incorporating age, sex, MMSE, and grip strength showed that while the association between sarcopenia and eating disturbances was not significant (Estimate=1.51272, p=0.1248), age emerged as a significant predictor (Estimate = 0.18272, p = 0.00869), suggesting that age may be a more critical factor in the development of eating disturbances in this population. These findings suggest that sarcopenia may play a role in the development or exacerbation of specific neuropsychiatric symptoms in AD patients. Further research is needed to understand the underlying mechanisms and to develop targeted interventions to improve the quality of life for this population.
ASSOCIATION OF HEALTHCARE ACCESS AND DUAL ELIGIBILITY STATUS BASED ON ENROLLMENT IN MANAGED CARE
Authors: Dharia Aastha , Tarraf Wassim , Homayouni Ramin , Toseef Mohammad Usama 
Published: January 2025

Abstract
Dual-eligible beneficiaries (enrolled in both Medicare and Medicaid) remain a growing population with complex care needs. However, there are limited studies evaluating self-reported access to healthcare among these individuals. Using six key outcomes that describe the characteristics of beneficiaries’ usual source of care from the 2021 Medical Expenditure Panel Survey, we retrospectively analyzed self-assessment questionnaire data among individuals age 18 and older (N = 12,924) to evaluate the association between healthcare access and dual-eligibility status based on enrollment in managed care. A series of survey-weighted multivariable logistic regression models were estimated. After adjusting the models for demographic factors, socioeconomic factors, and interaction term between dual-eligible and managed care status, we calculated marginal effects of managed care and dual-eligibility on healthcare access outcomes and used analysis of variance contrast tests to estimate the difference in the probability of outcomes based on managed care and dual-eligibility status. The results demonstrate non-dual managed care beneficiaries were significantly less likely to seek care [4.1% versus 2.5%, p-value = 0.0338] and experienced greater delays in care [6.6% versus 4.9%, p-value = 0.0398] due to cost. We also noted no significant impact on established and regular care access independently based on dual-eligibility status or managed care status. These findings suggest managed care may not significantly influence dual-eligibles’ access to healthcare but should be analyzed further for associations with healthcare disparities before making policy recommendations. Future research should also examine associations between quality of care measures and dual-eligibility status to continue holistically evaluating healthcare equity.
BARRIERS AND FACILITATORS TO PHYSICAL ACTIVITY OF OLDER ADULTS IN KOREAN NURSING HOMES: A QUALITATIVE STUDY
Authors: Ko Young , Yun Seon Kyung , Yook Geun Sil , Kim Seo Young 
Published: January 2025

Abstract
Various factors can either reduce or improve the physical activity level of older people living in nursing homes. Although it is critical to manage the risk of inactivity, only a few studies have investigated the multifaceted factors associated with physical activity among nursing home residents. The purpose of this study was to investigate directors’ and care workers’ perceptions of barriers and facilitators to physical activity for older adults in Korean nursing homes. This was a qualitative descriptive study. We collected data from January 13 to February 14, 2023. We used thematic analyses to analyze data from 4 directors and 22 long-term care workers in nursing homes in South Korea. We extracted 4 themes and 11 sub-themes reflecting the factors related to older adults in nursing homes: (a) “safety is more important than activity,” (b) “encourage activities tailored to their preference,” (c) “activities in harmony,” and (d) “meaning of living at a nursing home.” Individual, interpersonal, environmental, and policy factors influence older adults’ physical activity in nursing homes. These factors guide policymakers, healthcare providers, and care workers in developing and implementing activity planning to help improve recipients’ physical activity level in nursing homes. This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Korean government (MSIT) (No. 2022R1F1A1074082).
BEHIND THE WALLS: THE IMPLICATIONS OF ASSISTED LIVING BUILDING CODES ON RESIDENT SAFETY
Authors: Pennavaria Adam , Smith Lindsey , Hua Cassandra , Carder Paula , Jutkowitz Eric , Thomas Kali 
Published: January 2025

Abstract
As the US population collectively ages, issues related to assisted living (AL) resident safety have become an increasingly pressing issue for the general public, reflected by major media reporting in the last year. The building codes that govern ALs play an important role in mitigating the risks associated with falls, wandering, and other hazards, especially for residents living with Alzheimer’s disease and related dementias. We sought to understand how states vary in their approaches to building code regulations that might impact resident safety. We used search term-based text retrieval to identify areas of text relevant to locks, alarms, and egress restriction. A preliminary analysis of 2023 AL policy text by state suggests that a majority of states’ AL policy regulations contain some kind of reference to requirements for locks, alarms, or other type of egress restriction, with a few outliers – regulations in Nebraska, Minnesota, South Carolina, and Tennessee appear to make no mention of any of these subjects, while New Mexico, Texas, Washington, and others include multiple references to each. For instance in NM, residents must have the ability to safely leave the building, so memory care units rely on alarms and provide access to secure outdoor environments. 38 states’ regulations (75%) refer to locks, 40 states (78%) refer to alarms, and 27 states (53%) refer to limiting/restricting egress. This research has implications for understanding the relationships between building code requirements and resident safety. It provides insight for those who seek to improve safety standards in AL communities.