bluuebunny/crossref_metadata_2025_split huggingface dataset:
RACIAL/ETHNIC DISPARITIES IN TRAJECTORIES OF HOSPITALIZATIONS AMONG PATIENTS WITH HEART FAILURE
Authors: Dhingra Radha , Xu Hanzhang , Hammill Bradley , Lynch Scott , West Jessica , Green Michael , Dupre Matthew 
Published: January 2025

Abstract
Little is known about racial/ethnic differences in the long-term patterns of hospitalization following the diagnosis of heart failure (HF). We examined racial/ethnic differences in trajectories of hospital admissions following a diagnosis of HF and assessed the factors contributing to the long-term risks of hospitalization. We included 5,606 patients with newly-diagnosed HF between January 2015 and July 2018 in the Duke University Health System and followed them for up to five years. Group-based trajectory models were used to identify trajectories of all-cause admissions following the diagnosis of HF. Multinomial logistic regression models were used to identify patient characteristics associated with the trajectories of admissions. Approximately 45.6% (N=2,556) of HF patients had low risks of hospitalization, 36.6% (N=2,052) had elevated risks of admission shortly after diagnosis (early risk), 9.9% (N=553) had elevated risks at later stages of illness (late risk), and 7.9% (N=445) had consistently high risks of hospitalization. Non-Hispanic Black patients were more likely to exhibit early risks of hospitalization (odds ratio, [95% CI]: OR=1.33, [1.16-1.52]; P&lt;.001), late risks of hospitalization (OR=1.92, [1.58-2.34]; P&lt;.001), or consistently high risks of hospitalization (OR=1.89, [1.52-2.35]; P&lt;.001) compared with non-Hispanic White patients. Diabetes, chronic kidney disease, and residence in a disadvantaged neighborhood significantly contributed to the excess risks of admissions among non-Hispanic Black patients. Overall, these findings have important implications for identifying the social and clinical factors associated with racial disparities in the timing and frequency of hospital admissions in HF patients.
A SCOPING REVIEW OF MACHINE LEARNING STUDIES ON DEMENTIA RISK FOR ETHNORACIAL MINORITIES
Authors: Hong Michin , Ji Soo-Yeon , Kim Seon , Kim Kyeongmo 
Published: January 2025

Abstract
This study aims to provide an integrated review about dementia risk for ethnoracial minorities from machine learning (ML) based-studies. While ML methods are widely used in dementia research, their benefit for ethnoracial minorities remains unclear. We located prior research using combinations of the key words related to ML (e.g., neural network, deep learning, artificial intelligence), dementia and ethnoracial minorities from major electronic databases. Out of 599 initially searched articles, 389 remained after removing duplicates, and finally, 14 met the inclusion criteria. The interdisciplinary research team employed reiterative data analysis to identify key themes. All included studies, published since 2020, aimed to identify essential risk factors and generate predictive models for cognitive impairments. Most studies and treated race as a predictor after aggregating it into two or three categories, finding a lower risk of dementia among non-Hispanic Whites compared to Hispanics or Non-Hispanic Blacks. One study aimed to develop a predictive model of cognitive impairment applicable across non-Hispanic White, no-Hispanic Black, and Hispanic groups. Various ML techniques were used, such as neural network, random forest, support vector machine, and gradient boosting with some adopting Synthetic Minority Over-sampling Technique to oversample minority groups. Our review indicated that ML-based studies have made limited progress in understanding dementia risk among ethnoracial minorities. National data sets used in most reviewed studies, have lacked minority samples, and this seems to persist with the ML approaches, possibly contributing to deteriorating the existing racial gap. Proactive efforts should focus on ethnoracial variations in dementia risk in ML-based studies.
ACTING WITH AWARENESS AND VISUOSPATIAL LEARNING IN MILD COGNITIVE IMPAIRMENT
Authors: Zammitti Melissa , Bower Emily , Tremont Geoffrey 
Published: January 2025

Abstract
Mindfulness practice is a potentially low-risk intervention for mild cognitive impairment (MCI), with numerous studies indicating its robustness in addressing modifiable risk factors associated with the progression of MCI. Evidence suggests a positive association between mindfulness and cognitive ability, including within the visuospatial processing domain; however, which facets of mindfulness are associated with aspects of visuospatial processing are not well understood. We aimed to assess the relationship between the five facets of mindfulness and visuospatial learning and memory (VSLM). We hypothesized that stronger endorsement of the acting with awareness facet would correlate with improved VSLM, as present-mindedness could enhance the processing of one’s physical surroundings. In this secondary analysis, we conducted a hierarchical linear regression using baseline data from a pilot intervention study involving older adults with MCI. 46 participants with amnestic MCI (65% female, mean age 71.6 years) completed the Five Facet Mindfulness Questionnaire (FFMQ) and the Brief Visuospatial Memory Test-Revised (BVMT-R). We controlled for age, race, gender, education, and depression. The analyses revealed a negative relationship between BVMT-R learning scores and FFMQ Acting with Awareness subscale scores (FFMQ-A) such that higher learning was related to lower awareness (β= -.540, p=.021. Associations between BVMT-R scores and other mindfulness facets were not significant (p’s&gt;.05). Findings suggest that the specific domain of mindfulness, acting with awareness, may be associated with poorer visuospatial learning over repeated trials in individuals with MCI. The findings encourage further investigation of the acting with awareness facet and its role in interventions for older adults with MCI.
CO-CREATING RESOURCES TO RAISE AWARENESS OF RISKS OF GOING MISSING AMONG PERSONS WITH DEMENTIA
Authors: Daum Christine , Vahedi Vanessa , Chawrun Isabella , Neubauer Noelannah , Rutledge Emily , Adekoya Adebusola , Miguel-Cruz Antonio , Liu Lili 
Published: January 2025

Abstract
Persons living with dementia are at risk of getting lost and going missing due to wayfinding challenges. Yet, there are few accessible resources available that raise awareness of the risks of going missing and strategies to manage these risks. The purpose of this project was to develop engaging and informative learning resources for first responders, search and rescue personnel, persons living with dementia, care partners, and health and social care providers. Co-design and co-production approaches guided the development of these resources and were informed by reviews of the academic and grey literature, dialogue with persons with lived experiences, and content analysis of missing person cases. We produced three sets of resources: 1) nine dementia-friendly first responder videos for police and search and rescue personnel to enhance their awareness of dementia and risks of going missing; 2) a toolkit of strategies and resources for persons living with dementia and care partners to reduce the risks associated with getting lost and going missing; 3) eight personas and scenarios that depict contextual factors within missing events that can be utilized by service providers and the public in their interactions with persons living with dementia and care partners. All resources were reviewed by participants through interviews, focus groups, and written feedback to identify essential content and ensure accuracy, relevance, and comprehensibility. These sets of learning resources can elevate awareness and offer practical strategies to support persons living with dementia, care partners, first responders, and service providers.
DIFFERENCES IN ADVANCED CARE PLANNING BY LEVEL OF COGNITIVE IMPAIRMENT
Authors: Arellanes Isabella , Jacobson Mireille 
Published: January 2025

Abstract
Advance Care Planning (ACP) allows patients to make decisions regarding their health care while they still have the ability to do so. ACP may be particularly important for individuals experiencing cognitive decline who are likely to become unable to make decisions for themselves. This study identifies differences in advance care planning based on cognitive impairment status. This sample includes 6,650 older adults between the age of 65-90 years from the 2018 wave of the Health and Retirement Study. Cognition was categorized based on the Langa-Weir cognition classifications, with normal cognition classified by scores of 12-27 (n= 5,313), “cognitive impairment, not dementia” by scores of 7-11 (n= 1,085), and dementia by scores between 0-6 (n= 252). Among respondents with a normal cognition score, 65% reported having either a living will or power of attorney. Among those categorized as having “cognitive impairment, not dementia” and dementia, the percentages of ACP completion were lower, 59% and 54%, respectively. In a regression model controlling for race/ethnicity, gender, years of education, marital status, AD or dementia diagnosis, income, and healthcare utilization, all but diagnosis were significant predictors of ACP. There was a significant difference in ACP between those with normal cognition as those classified as having “cognitive impairment, not dementia” (p&lt; 0.05). Compared to those in the normal cognition group, those in the “cognitive impairment, not dementia” group are 1.3 times more likely to engage in ACP (p &lt; 0.05). These findings suggest differences in significant predictors of ACP based on level of cognitive impairment.
EFFECTS OF FRAILTY AND FUNCTIONAL IMPAIRMENT ON THE ASSOCIATIONS OF COGNITIVE IMPAIRMENT AND DEMENTIA WITH HEALTHCARE COSTS
Authors: Fink Howard , Sheets Kerry , Langsetmo Lisa , Schousboe John , Kats Allyson , Ensrud Kristine 
Published: January 2025

Abstract
Dementia and cognitive impairment (DCI) are associated with higher total healthcare costs (THC). We sought to determine the fraction of incremental THC of DCI accounted for by frailty and/or functional impairment. We utilized a multi-cohort dataset of 8165 community-dwelling, fee-for-service Medicare beneficiaries (53% women, 79% non-Hispanic White, mean age 79 years) who had index exams in 1 of 4 prospective cohort studies linked with Medicare claims. Cohort-based DCI was defined by self-or-proxy report of a dementia diagnosis or abnormal cognitive test results. Multimorbidity was count of chronic conditions. Frailty was a claims-based deficit accumulation index (CFI) or the Cardiovascular Health Study phenotype (3+ components of shrinking, slowness, weakness, poor energy, low physical activity). Functional impairment was self-reported difficulty performing 4 ADLs (with none, 1, 2, 3 or 4 of walking, climbing steps, transferring, bathing/showering). Annualized THC were ascertained for 36 months following index exams. After adjustment for age, race, geographic region, and multimorbidity, those with cohort-based DCI vs. no DCI had higher incremental THC ($6883 in women and $7276 in men). Respectively, 40%, 31%, 33% and 63% of incremental THC in women and 28%, 29%, 40% and 58% of incremental THC in men were attributable to CFI, phenotypic frailty, functional impairments or a combination of all 3 measures. In conclusion, in both men and women, most of the incremental THC of DCI were attributable to frailty and functional impairment. Further attention should be given to assessment of these geriatric syndromes and potential mitigation of their impact among those with DCI.
A QUICK NOVEL MOBILE HEARING IMPAIRMENT ASSESSMENT FOR DIGITAL SPEECH HEARING SCREENING
Authors: Banks Russell , Greene Barry , Morrow Isaiah , Ciesla Marissa , Woolever David , Tobyne Sean , Jannati Ali , Pascual-Leone Alvaro 
Published: January 2025

Abstract
It is estimated that 1 in 4 people worldwide will be living with hearing impairment by 2050. We propose a digital Speech Hearing Screener (dSHS) using short nonsense word recognition to measure speech-hearing ability. We compare dSHS outcomes with standardized pure-tone averages (PTA) and speech-recognition thresholds (SRT). 50 participants aged 55 or older underwent PTA and SRT measurement. One-way ANOVA was used to compare differences between hearing impaired and hearing not-impaired groups, by the dSHS, with a clinical threshold of moderately impaired hearing at 35dB and severe hearing impairment at 50 dB. dSHS results significantly correlated with PTAs/SRTs. ANOVA results revealed the dSHS was significantly different (F(1,47)=38.1, p&lt; 0.001) between hearing impaired and unimpaired groups. Classification analysis using a 35dB threshold, yielded accuracy of 85.7% for PTA-based impairment and 81.6% for SR-based impairment. At a 50dB threshold, dSHS classification accuracy was 79.6% for PTA-based impairment (NPV-93%) and 83.7% (NPV-100%) for SRT-based impairment. The dSHS successfully differentiates between hearing-impaired and unimpaired individuals in under 3 minutes. This hearing screener offers a time-saving, in-clinic hearing screening to streamline the triage of those with likely hearing impairment to the appropriate follow-up assessment, thereby improving the quality of services. Additionally, this tool can help to rule out hearing impairment as a cause or confounder of cognitive impairment.
RELATIONAL COLLABORATION BEYOND PROFESSIONAL TEAMS: NEGOTIATING HYBRID EXPERTISE WITH INFORMAL CAREGIVERS
Authors: Ginoux Laura , McAllum Kirstie 
Published: January 2025

Abstract
When conceptualizing collaboration in the context of health and social care, most definitions privilege interactions among members of the interprofessional team. To achieve joint goals and solve problems more effectively, these professionals must combine and integrate their disciplinary knowledge with that of others, including those outside the immediate healthcare team. Over the last three decades, the health communication literature has insisted on the need for patient-centered healthcare practices. Patient-centeredness includes appreciation for and inclusion of patients’ experiential knowledge (based on their daily experiences with health conditions). We note that the literature neglects the idea of experiential expertise of informal caregivers (ICG). Yet, ICGs are precious aids and mediators between the older adults they care for and healthcare workers (HW). Unfortunately, ICGs are not always included in decision-making processes, and hierarchies of knowledge remain within relationships with HWs. Following a literature review, our research highlights the need to develop a relational vision of collaboration that would enable interprofessional teams to consider ICGs as part of the team, enhance the quality of interactions, and, therefore, improve the quality of care provided to older adults. The objectives of this paper are threefold. First, we define our theoretical model of relational collaboration. Second, we explain why developing relational collaboration between ICGs and HWs benefits teams as well as older adults. Third, we contend that nurturing the relational dimensions of collaboration (respect, cultural humility, empathy, compassion, and trust) enables ICGs and HWs to negotiate a hybrid form of expertise that integrates medical and experiential knowledge.
A PARTICIPATORY STUDY TO CO-DESIGN SOCIAL NORM NUDGES FOR IMPROVING MENTAL HEALTH HELP-SEEKING IN OLDER PEOPLE
Authors: Liu Tianyin , Wang Jia 
Published: January 2025

Abstract
Mental health help-seeking is often delayed in older people, and different theories have hypothesized diverse mechanisms to improve help-seeking. The theory of planned behavior (TPB) and nudge theory (NT) converge on social norms as promising targets for intervention. Despite accumulating evidence of social norm nudges in promoting health behaviors, no intervention has utilized social norms to promote mental health help-seeking in older adults. This study aims to (a) co-design social norm-nudges with different stakeholders and (b) pilot their feasibility and effects in improving mental health help-seeking intention in older people. The participatory study recruited ten older people, two social workers, and two experienced researchers to co-design the social norm nudges. All participants received three-hour training on TPB and NT principles, followed by ten interactive co-design workshops over three months. A set of 14 social norm nudges was designed and piloted among 20 older people for feasibility and effects. The participants completed a self-administered baseline questionnaire, received 14 social norm nudges over smartphones in two weeks (one message per day), completed the post-intervention questionnaire and provided feedback to the nudges afterwards. The primary outcomes were changes in subjective norms and help-seeking intention assessed using a revised Chinese version of the TPB questionnaire (C-TPB); secondary outcomes included perceived behavioral control, help-seeking attitude, perceived barriers to help-seeking (C-TPB subscales), and mental health assessed by PHQ-9, GAD-7 and UCLA-3. Preliminary results suggested the feasibility of the social norms to be delivered digitally and the effects in increasing help-seeking intention and attitude.
EFFECT OF ACTIVITY-BASED INTERVENTION ON QUALITY OF LIFE AMONG OLDER ADULTS LIVING IN COMMUNITY
Authors: Seo Jisu , Song Rhayun , Li Yuelin , Oh Eunna 
Published: January 2025

Abstract
With age, older people experience reduced participation in activities. According to the Activity theory of aging, older adults can age successfully by engaged in their favorite activities. This study was conducted to systematically review RCTs that applied activity-based interventions (ABIs) to older adults living in community, and was to classify the ABIs into interaction-based social activities, exercise-based physical activities and self-directed individual activities, as well as compare and analyze the size of the effect on quality of life based on three types of activities. The analysis included 76 randomized studies from 6 Korean databases as well as 5 English databases. Cochrane’s Risk of Bias tool was used to assess the quality of the risk of bias. A CMA version 4 was used to calculate the effect size and a 95% confidence interval using a random effect model and to assess heterogeneity and publication bias. A network meta-analysis was conducted using R version 4.3.1 software’s “netmeta” package. Using GRADE, we assessed the quality of the evidence. ABIs applied to older adults living in community significantly improved their quality of life (SMD=0.56), and all three types of activity-based interventions significantly improved their quality of life. According to the result of ranking of network meta-analysis, self-directed individual activities was found to have the highest probability of being selected at 91.7%. As older people spend more time alone as aging, it is important to enhance their quality of life by encourage them to choose and participate in activities according to their own interests.
IMPROVING AWARENESS OF FOOD RESOURCES FOR OLDER ADULTS THROUGH REGIONAL COLLABORATIVE EFFORT
Authors: Ilardo Joan , Zell Angela 
Published: January 2025

Abstract
The Successful Nutrition Programs Across the Lifespan (SNP-AL) created a roadmap with recommendations for selecting sustainable, successful, evidence-informed nutrition programs that meet the community’s needs and foster cross-sector collaboration; implementing interventions; and gathering data to measure program outcomes. The Capital Area Coalition (CAC) addressed lack of communication around its regional food resources. The pandemic changed many community resources, so residents weren’t aware of current food resources or how to access emergency food. 2-1-1 coordinates with regional resources and provides information about local health and human services resources. CAC’s strategy included a media campaign, implemented in Spring and Summer 2023, directing residents with food insecurity to contact 2-1-1 for available resources, using local TV and radio spots and including 1400 leaflets containing information about food resources in produce boxes delivered to income-eligible residents. They provided 2-1-1 information to appropriate agencies. We used the Collaborative Effectiveness Assessment from the Prevention Institute to measure cohesiveness. Results demonstrated CAC was highly motivated with trust, strong communication, and conflict resolution skills. They perceived their mission was simultaneously overarching and comprehensive, aligning with their overall objective. CAC’s sustainability plan for 2-1-1 is helping local agencies recognize the importance of providing current information to 2-1-1. Calls to 2-1-1 was the indicator of impact of their media campaign. We compared data from 2-1-1 for 4/2022-6/2022 and 4/2023-6/2023. Food Lines referrals increased from 32 to 37. Food Stamps/SNAP decreased to 49 from 55. Food Pantries referrals increased the most, increasing 29% from 342 in 2022 to 479 in 2023.
THE CONTRIBUTION OF NIGROSTRIATAL DOPAMINERGIC TRANSMISSION ON APATHY IN OLDER ADULTS
Authors: Song Yixiao , Cawthon Peggy , Butters Meryl , Chahine Lana , Rosano Caterina 
Published: January 2025

Abstract
Apathy is a common and impairing symptom in neurological disorders and its connection with striatal dopamine levels has been examined in Parkinson’s and Alzheimer’s disease. Little is known about the nature of this relationship in older adults free from neurological diseases. This study explores the link between apathy and nigrostriatal dopaminergic neurotransmission in community-dwelling older adults without overt neurological symptoms. This was a cross-sectional study of community-dwelling older adults (N=230, mean age 75.3yrs; 60% female) from Monongahela-Youghiogheny Healthy Aging Team (MYHAT) and Study of Muscle, Mobility and Aging (SOMMA) studies. The nigrostriatal dopamine binding site density of VMAT2 was quantified via (+)-[11C]DTBZ PET imaging. Apathy was assessed with Apathy Evaluation Scale, an 18-item questionnaire using a 4-point Likert scale (range 18-72; higher score indicates greater apathy). Latent class analysis was used to identify latent subtypes of apathy. Multinomial logistic regression was used to investigate the relationship between dopaminergic transmission and latent classes. Three latent classes were identified, namely, low apathy (mean 20.7; SD 2.36; N=110), moderate apathy (mean 25.5; SD 2.83; N=89), and high apathy (mean 32; SD 4.82; N=31). Each SD decrement in nigrostriatal dopaminergic transmission corresponded to 39% and 42% lower odds of having high apathy compared to low apathy (OR=0.61; 95%CI: 0.39-0.95; p-value=0.028) and moderate apathy (OR=0.58; 95%CI: 0.36-0.90; p-value=0.015), respectively, after adjusting for age at the time of MRPET scan, gender, and race. Our study highlights apathy’s inverse relationship with dopaminergic neurotransmission, which underscores the importance of considering dopaminergic pathways in managing apathy in older adults.