bluuebunny/crossref_metadata_2025_split huggingface dataset:
BLACK-WHITE RACIAL DISPARITIES IN MORTALITY: FINDINGS FROM THE SAINT LOUIS PERSONALITY AND AGING NETWORK (SPAN)
Authors: Spears Isaiah , Wolk Megan , Gorelik Aaron , Siudzinski Jayne , Norton Sara , Esposito Michael , Oltmanns Thomas , Bogdan Ryan 
Published: January 2025

Abstract
Black-White racial health disparities in America are striking. Black Americans have worse physical health and lower life expectancy than White Americans. However, the potential factors contributing to increased mortality in later life among Black Americans are rarely investigated. Here, we examined Black-White racial mortality disparities in the longitudinal St. Louis Personality and Aging Network (SPAN) Study of older adults (n=1,630; aged 55-65 at baseline; 67.4% White; 32.6% Black), with mortality data collected from the National Death Index. Black SPAN participants had greater mortality over the course of the study than White participants(χ² = 47.667, p = &lt;.0001). Specifically, 26.9% of Black participants (n = 142) passed away relative to 12.7% of White participants (n = 139). Indices of socioeconomic status (i.e., annual household income; educational attainment) partially accounted for this difference. Additional planned analyses will examine whether environmental (e.g., discrimination, stress exposure), biological (e.g., inflammation), and psychological/behavioral (e.g., health behaviors, personality) factors may also contribute to these Black-White mortality disparities. These findings replicate prior studies documenting racial health disparities, the potential contributions of socioeconomic status, and position the SPAN study to evaluate plausible environmental, behavioral, and biological mechanisms. Ultimately, better understanding the environmental, psychological/behavioral, and biological mechanisms that may contribute to Black-White racial health disparities may help facilitate interventions and policy to improve racial health equity.
BUILDING AN EVALUATION FRAMEWORK FOR THE OREGON CENTER OF EXCELLENCE FOR BEHAVIORAL HEALTH AND AGING
Authors: Smith Lindsey , Unsworth Julia , Stodola Allyson , Himes Dani , Brandis Leah , Cellarius Karen , Carder Paula , Dawson Walter 
Published: January 2025

Abstract
The Oregon Center of Excellence for Behavioral Health and Aging (OCEBHA) was established in 2024 with the mission to serve as a backbone organization, coordinating efforts to improve behavioral health services for older adults in Oregon. Housed at Portland State University and Oregon Health & Science University, the Center is focused on enhancing workforce training, supporting community partner organizations, advancing research, and promoting policies that improve access to care. We created an evaluation plan aligned with the Collective Impact model. The evaluation framework was developed to assess OCEBHA’s effectiveness in growing workforce capabilities, coordinating partnerships, promoting health equity, and driving systemic change. By constructing the Center’s role as a backbone organization, the evaluation plan was designed to measure both the process and impact of the Center’s efforts across multiple sectors. Key elements of the plan include the integration of community feedback, collaboration metrics, and health equity outcomes. This approach ensures that the evaluation reflects the complex, collaborative nature of the Center’s work and provides actionable insights for continuous improvement.
CAREGIVING IMPACT ON MEDICARE OLDER ADULTS: RESULTS OF THE US HEALTH AND WELLNESS SURVEY
Authors: Neumann Lycia Tramujas Vasconcellos , Annunziata Kathy , Stratton Lauren 
Published: January 2025

Abstract
As the number of older adults caring for someone with a serious illness increases, there is a growing need to understand better the impact of caregiving on older adults’ health and finances. Based on responses from older Medicare recipients (65+) to the US 2022 National Health and Wellness Survey, an internet-based, cross-sectional survey, this study investigated differences in self-reported health status, healthcare utilization, and out-of-pocket costs between (1) older adults who are caregivers (n = 1,159) and those who are not (n = 11,443), and (2) older caregivers of individuals living with Alzheimer’s disease or other dementias - ADRD (n = 255) and those caring for an adult with other conditions (n = 904). Results were weighted to the population by sex, age, and race/ethnicity. Caregiver and non-caregiver cohorts had comparable median and mean ages. Compared with older non-caregivers, older caregivers had significantly higher comorbidities and significantly lower global health, physical health, and mental health T scores (p&lt; 0.05). There were no significant differences in reported use of ER, hospitalizations, and median number of medical visits in the six months before the survey. However, older caregivers reported higher mean out-of-pocket Rx expenses than non-caregivers ($44.51 vs. $34.02). Comparative analyses of older dementia caregivers with non-dementia caregivers did not indicate significant differences in health and financial impact. In conclusion, caregiving impacts older adults’ health in various ways, and health plans and providers should acknowledge and consider the impact of caregiving when assessing older adults’ health conditions, managing and coordinating their care.
DEVELOPMENT AND ASSESSMENT OF THE VIRTUAL INTERGENERATIONAL COMPARATIVE GLOBAL AGING CURRICULUM
Authors: Zurek Grzegorz , Zurek Alina , Holley Lyn 
Published: January 2025

Abstract
This presentation describes didactic process in the international, experimental, hybrid course, Comparative Global Aging. Created by the University of Nebraska at Omaha and two Polish universities – the University of Wroclaw and the University School of Physical Education in Wroclaw, it was structured to nurture intra- and intergenerational relationships and understanding between students and older adults on different continents. Classes are conducted in a “real time” audiovisual format designed to accommodate geographical and temporal distance and cultural diversity of professors and students. Methods to track independent learning and conscious self-improvement of students were custom-fitted to the course and to the requirements of information/communication technology. The course has been conducted each year from 2018 to 2023. Qualitative data from students’ courses in each edition of the Post-Class Reflections and Learning Journals were used to evaluate and improve a series of planned and systematic teaching methods inspired by both teachers and students. Data are from 44 UNO students, 23 students from Poland and 35 students from European universities in 9 European countries participating in the ERASMUS academic student exchange program.. Although courses were conducted in English, student teams were intentionally multinational and multicultural. Qualitative evaluation of data from students informed continuous improvement of methods and resources in subsequent editions of the course, and indicate it meets accepted standards for international, intergenerational, comparative, gerontological, service-learning university and virtually synchronous pedagogies, and could provide a template for courses that give learners the opportunity to work collaboratively international teams and communicate effectively.
EARLY CHILDHOOD EXPERIENCES AND LATE LIFE COGNITIVE FUNCTION AMONG OLDER CHINESE ADULTS
Authors: Nguyen Duy , Liu Rui , Chen Limei , Lee Yookyong 
Published: January 2025

Abstract
Extensive research has documented the negative impacts of adverse childhood experiences on individual well-being, yet Asian older adults have been overlooking. For the current study, we used the China Health and Retirement Longitudinal Study (CHARLS), a national, longitudinal study of representative residents and applied the Life Course Perspective to test how childhood conditions and social relationship indicators affect cognitive health at later life. This study combined data from three datasets: Wave 1 (2011), The Life History Survey Data (2014), and Wave 5 (2020). The study sample (N=9,941) included respondents 50 and over at baseline, without cognitive impairment in the baseline, and still living at Wave 5. Women constituted 52.4% of the sample, and the mean age was 60.2 (SD=6.77). Two outcome variables (self-rated memory and cognitive health status) were used in data analyses. The multivariate analyses results showed that weak neighborhood quality and social cohesion, poor social relationships, poor childhood health status were associated with worse cognitive function. The study findings demonstrate the effects of early childhood conditions on late-life cognitive function. As aging in China accounts for most global aging, public health approaches that stimulate positive childhood memories can have a meaningful protective effect for older adult well-being. Our findings underscore the global importance of childhood health, childhood experiences, and social relationships, which are not only those older adults in China but globally. Further cross-national research is needed to understand the diversity in sociohistorical experiences across global aging populations.
ETHNIC AND RACIAL DIFFERENCES IN END-OF-LIFE CARE IN TEXAN COLORECTAL CANCER DECEDENTS
Authors: Leach Bethany , Polychronopoulou Efstathia , Kuo Yong-Fang , Raji Mukaila , Serna Myrna 
Published: January 2025

Abstract
There are known racial and ethnic disparities in advance care planning (ACP) and downstream outcomes. We hypothesized that among Texan Medicare decedents with colorectal cancer (CRC), there would be racial and ethnic disparities in ACP, palliative care (PC) consultation and hospice enrollment. Data from the Texas Cancer Registry linked with Medicare claims records for patients age ≥66 years who died 6 months to 5 years after a primary CRC diagnosis between 2010 and 2018 was analyzed. Number (proportion) of Non-Hispanic Black (NHB), Non-Hispanic White (NHW) and Hispanic decedents with ACP, PC consultation and hospice enrollment in the last 30 days of life are reported and chi-square tests used to assess statistically significant differences. A multivariable logistic regression model was used to assess racial/ethnic differences in odds of hospice enrollment, adjusting for CRC stage and other demographic variables. Among 5,757 Medicare decedents, ≤2.2% had ACP with no significant racial/ethnic differences noted. While NHBs were most likely to receive PC consultation (106 (18%), p=0.017), they were least likely to be hospice enrolled (369 (62%), p&lt; 0.001). The multivariable logistic regression model showed NHBs had decreased odds of hospice enrollment when compared to NHWs (OR 0.67, 95% CI 0.55-0.81). Among Medicare decedents with CRC, there are low rates of ACP and racial/ethnic disparities in PC consultation and hospice care. More and earlier ACP is needed to provide patient-centered care. While more NHBs received PC consultation in the last 30 days of life, it is unclear if PC consultations were provided earlier in life course.
FACILITATORS OF AND BARRIERS TO ADULT DAY SERVICES PROVISION: PROVIDERS’ PERSPECTIVES
Authors: Udeh Kingsley , Noble Molly , Menne Heather , Hamill Randi , McLaughlin Sara 
Published: January 2025

Abstract
Adult day services (ADS) can help people living with various chronic conditions remain in their community, and may improve well-being among participants and their family caregivers. Despite the potential benefits, knowledge of the ADS landscape is underdeveloped, especially as it pertains to the experiences of ADS providers since the COVID-19 pandemic. This study aimed to understand the facilitators and barriers experienced by ADS providers. We conducted two focus groups with seventeen ADS providers in Ohio. Thematic analysis was used to identify themes in the data. Several facilitators for providing ADS were identified, including dedicated, consistent, and committed staff; partnerships with local organizations; sufficient reimbursement; and diverse funding sources. Barriers included: staffing issues (e.g., recruitment and retention); referral and recruitment of ADS participants; limited knowledge, awareness, and misconceptions about ADS among families and case managers; transportation services (e.g., inadequate and safe escort of participants to and from ADS centers); and insufficient or delayed reimbursement. Providers identified the following solutions with the potential to mitigate perceived barriers: educational initiatives to foster understanding of ADS among key stakeholders (e.g., regulators, case managers, community members) and additional funding and media publicity support from local, state, and federal authorities. As one of the only studies that seeks to understand the landscape of ADS in Ohio, this research is uniquely situated to provide crucial insights for tailoring interventions that consider ADS providers’ unique challenges. It also informs future research focusing on improving the quality of ADS.
NARRATIVES OF WARTIME VOLUNTEERING AMONG OLDER ADULTS IN ISRAEL
Authors: Sun Peter , Ayalon Liat 
Published: January 2025

Abstract
Volunteering is an important vehicle for the health promotion of older adults, yet research on its role during times of war remain limited. This research aimed to explore the representation and rhetoric of older adult volunteers in the Israeli media during Operation Swords of Iron. Using the LexisNexis database, four Israeli newspapers were searched for English-language articles published between October 7, 2023 and August 7, 2024: Haaretz, The Times of Israel, Yediot Achronot, and The Jerusalem Post. After removing duplicates and articles that were not relevant to older adult volunteering, a total of 23 articles were retained for thematic analysis. To probe the sentiments of these narratives, sentences containing keywords about older adult volunteers were compared against a preexisting lexicon of semantic orientations. Thematic analysis revealed three themes: (1) Older adult volunteers as heroic and self-sacrificial amid the risks of war, (2) the virtue of being productive versus unproductive, and (3) older adults as agile first responders in situations of distress. Sentiment analysis further uncovered both positive and negative feelings that were collocated with the rhetoric on volunteering, such as the juxtaposition of older volunteers with the lack of supervision or training. The rhetoric of heroism, sacrifice, and productivity suggest the need to attend to age-related stereotypes of older adults. This research not only has implications for the health of older adults, but also for supporting older adult volunteers contributing towards large-scale public health challenges.
THE EFFECT OF SOCIAL PARTICIPATION OF OLDER ADULTS ON DEPRESSION: FOCUSED ON THE MODERATING EFFECT OF HOUSEHOLD TYPE
Authors: Baek Sehyun , Lee Sungkyu 
Published: January 2025

Abstract
Previous studies have found that the social participation of older adults is positively associated with perceived health, happiness, and life satisfaction (Kim et al., 2018). However, as they age, their social activities tend to decrease, leading to increased depression (Choi & Kim, 2023; Kim & Jung, 2017). Given that older adults living alone show a gradual decline in social activities as they age (Shin, 2022), the household type may intervene in the relationship between social participation and depression among older adults. However, little is known about the structural associations of these variables. Therefore, we examined the extent to which household type (i.e., living alone vs. not living alone) moderates the relationship between social participation and depression among older adults. We utilized data from the 2022 Korean Longitudinal Study of Aging (n=6,055) and conducted moderated regression analysis using Process Macro. The study found a negative relationship between social participation and depression of older adults (b=-.136, p&lt;.01), and a moderating effect of household types on this relationship was statistically significant (p &lt;.05). More specifically, the effect of social participation on depression was greater for older adults living alone than for those who do not live alone. These results highlight the need for policy efforts aimed at increasing the social participation of older adults to reduce their depression. Also, considering that the negative association between social participation and depression is more pronounced among older adults living alone, the interventions targeting the growing number of older adults living alone should be prioritized in policy planning.
THE INTERSECTION OF OLDER ADULTS, DISABILITIES, AND MENTAL HEALTH
Authors: Mbanefo Onyinye , Teaster Pamela 
Published: January 2025

Abstract
The number of individuals aged 65 and older is projected to reach 82 million by 2050. This demographic shift is accompanied by an increase in the prevalence of disabilities and mental health issues among older adults. Nearly 46% of adults aged 75 and older report having a disability, and 25% of those aged 65 and older are living with a mental health condition such as anxiety or depression. These challenges are exacerbated by cumulative disadvantage, ageism, and a shortage of mental health providers trained to work with this population. To address these issues, we apply a strengths-based approach to explore the intersection of aging, disability, and mental health. Our approach emphasizes the resilience and potential of older adults, challenging the dominant narratives of decline and loss. Utilizing the Socio-Ecological Model, we examine how individual, relational, community, and societal factors influence the mental health of older adults, highlighting the need for integrated and holistic care strategies. We explore key concepts such as cumulative advantage and disadvantage, ageism, and intersectionality, which are critical in understanding the complexities faced by older adults. Our work advocates for comprehensive mental health care that addresses both the physical and psychological well-being of older adults, promoting dignity, equity, and quality of life. Our findings suggest that a strengths-based approach can effectively enhance mental health outcomes for older adults, providing a framework for mental health practitioners and policymakers alike.
THE LIFE STAGE AT MIGRATION MATTERS: A STUDY OF OLDER IMMIGRANTS’ SOCIAL WELLBEING BASED ON THE CLSA
Authors: Lee Yeonjung , Li Lun , Kim Boah 
Published: January 2025

Abstract
Based on life course theory, this study examines the different social wellbeing trajectories among older immigrants in Canada based on their life stage at migration. The study applies Linear Mixed Models (LMM) to three waves of data from the Canadian Longitudinal Study on Aging (2011 to 2021). Among the sample of 4,248 older immigrants, most of them (two-thirds) migrated before the age of 30 (young adults), one-fifth migrated between 30 and 45 years old (adulthood), and about five percent of them migrated after 45 years and older (middle and older age). Results from LMM reveal that older immigrants who migrated during middle and older age reported the lowest level of social wellbeing, measured by social participation, social support, and social network size. This group of older immigrants also experienced the greatest decline in social participation, social support, and network size over ten years compared to those who migrated before 45 years old. Older adults who migrated to Canada before the age of 30 reported the best situation with higher levels of social wellbeing, and well-maintained social connection over time. In addition, employment, income level, education, and family responsibilities are significant factors related to the changes in social wellbeing over time among older immigrants. The findings from this study highlight the need to support older immigrants who come to Canada in a later life stage (i.e., after a middle-aged period), and who lack the social resources and capabilities to accumulate social capital and enhance social wellbeing.
TOO SICK TO BE TRUE? EVALUATING PROBLEMATIC CODING PRACTICES IN MEDICARE’S PATIENT DRIVEN PAYMENT MODEL
Authors: Amaravadi Harsha , Prusynski Rachel , Fishman Paul , Mroz Tracy 
Published: January 2025

Abstract
The 2019 Patient Driven Payment Model (PDPM) aimed to promote budget neutral, patient-centered care by adequately reimbursing skilled nursing facilities (SNFs) for patient clinical complexity. Though PDPM mitigated financial incentives to provide excessive care, it may have introduced new incentives to falsely inflate or “upcode” clinical complexity. We hypothesize that upcoding may occur for common, chronic conditions associated with high reimbursement under PDPM. High reimbursement encompasses both diagnosis codes and services for complex conditions (e.g., diabetic wound care or IV use for severe anemia). Example conditions include complicated diabetes, blood loss anemia, and obesity. We sought to quantify the degree of documentation changes for conditions likely to be upcoded. Using a difference-in-difference design, we analyzed Traditional Medicare claims from 2018-2021 for all patients with a hospital-SNF care episode (n = 5.43 million), comparing diagnoses on the index hospital claim to the corresponding SNF claim for each patient. By using hospital claims, which are not subject to PDPM, as a control, we mitigate all patient-level confounding. We detected increased documentation for the selected conditions, representing an additional 32.18% [95%CI: 31.55, 32.82] in SNF coding for complicated diabetes, 54.59% [95%CI: 52.33, 56.95] for severe anemia, and 83.08% [95%CI: 82.00, 84.15] for obesity. PDPM sought to improve payment adequacy for caring for clinically complex patients, but Medicare’s financial sustainability also depends on accurate documentation of clinical factors that influence resource utilization and care provision. Our investigation of potential upcoding may inform future policy refinement to support sustainable, patient-centered care delivery for older adults.
UNCERTAINTY IN HOME HEALTH CARE FOR OLDER VETERANS: VA PERSPECTIVES ON AGENCY SELECTION AND CONTRACTING
Authors: Leonard Chelsea , Magid Kate , De Motta Lexus Ujano- , Daus Marguerite , Levy Cari , Jones Christine 
Published: January 2025

Abstract
Older Veterans discharged from the hospital with skilled home health care (HHC) have their HHC delivered by community home health agencies (HHA) and financed primarily through the Department of Veteran’s Affairs (VA) or Medicare. We sought to understand perspectives of VA personnel on the process of HHC agency selection and financing for Veterans referred for HHC. We used a sequential mixed methods study design and conducted in-person and virtual site visits at three VA Medical Centers (VAMCs) in the highest decile of VA-paid HHC services (3 in-person) and three VAMCs in the highest decile of Medicare-paid HHC services (1 in-person, 2 virtual). We observed processes related to HHC referrals and conducted interviews with key informants. Interviews were recorded, transcribed, and analyzed using inductive-deductive content analysis to identify themes related to referral processes, agency selection, and financing. We conducted 29 interviews with 39 personnel at 6 VAMCs. We identified 4 themes related to uncertainty around agency and payor selection: 1) VA roles are siloed and next steps are a “black box;” 2) VA personnel are uncertain how HHAs are selected for local networks; 3) Local VAMCs develop strategies to determine HHA quality and reputation; and 4) Veterans’ role in selecting HHA or financing is unclear. Understanding points of uncertainty has implications for VA’s ability to provide high-quality HHC for older Veterans. Our findings suggest that providing accessible information on HHA quality and clear guidance around Veterans’ role in HHA and payor selection may streamline the process of providing HHC to Veterans.