bluuebunny/crossref_metadata_2025_split huggingface dataset:
SMARTPHONE OVERUSE AMONG OLDER ADULTS: A SCOPING REVIEW
Authors: Choi Jeongeun , Lee Hyangkyu , Yoon Seolah , Cho Hyeonmi 
Published: January 2025

Abstract
The rapid advancement of technology and widespread adoption of smartphones have led to increased smartphone usage among older adults. While smartphones offer many benefits, excessive use can lead to health issues, especially for older adults who may experience reduced social interactions and higher levels of anxiety or depressive symptoms. However, most existing research has focused primarily on adolescents and younger adults. This scoping review aimed to investigate the terms and definitions, factors associated with smartphone overuse, and its outcomes in older adults. We searched seven databases, including PubMed, PsycINFO, Embase, Cochrane Library, Web of Science, Scopus, and CINAHL, covering studies published from 2007 to 2024. We followed the Joanna Briggs Institute scoping review methodology, and sixteen studies were selected. Smartphone overuse was characterized by various terms and definitions, including ‘smartphone overdependence’, ‘smartphone addiction’, and ‘problematic smartphone usage’. According to the biopsychosocial model, factors related to smartphone overuse were classified into biological, behavioral, psychological, and social categories. Most commonly reported factors included biological aspects such as age, sex, and BMI; behavioral factors like types of smartphone activities; psychological factors including loneliness, anxiety, and depressive symptoms; and social factors such as income and educational level. Smartphone overuse can negatively affect physical, psychological, and social health, resulting in pain in the musculoskeletal system, sleep disturbances, anxiety, depressive symptoms, and loneliness. Future research should focus on developing standardized definitions and exploring effective interventions to mitigate the negative effects of smartphone overuse in older adults.
SOCIAL CONNECTIONS AND FALLS AMONG OLDER WOMEN WITH AND WITHOUT HIV IN THE UNITED STATE
Authors: Quach Lien , Lloyd Patricia , Erlandson Kristine M , Wilson Tracey , Rubtsova Anna , Sharma Anjali , Burr Jeffrey , Siedner Mark 
Published: January 2025

Abstract
Falls affect one in four older adults annually and are linked to biological and environmental risk factors. Women with HIV (WWH) may be particularly vulnerable due to lower social support and higher loneliness but their relationship with falls is not well understood. We analyzed data from 1,068 women aged 50 and older in the 2017 Women’s Interagency HIV Study (WIHS). Social connections were evaluated using the Multidimensional Social Support Scale, which queries respondents about issues such as support for sharing private worries and help with medical appointments. Loneliness was defined as a score of 6-9 on the UCLA Loneliness Scale (range 0-9). Logistic regression models estimated associations between social connections and loneliness with falls, adjusting for age, education, alcohol use, smoking, and total of comorbidities. Falls were reported by 31.5% of participants, with similar rates between WWH and women without HIV (WWoH) (adjusted odds ratio [aOR]=1.08; 95%CI 0.79,1.49). Loneliness was associated with a higher likelihood of falls (aOR=1.28; 95%CI 1.04,1.82). Some social connection aspects, such as having someone with whom to provide information or share worries (aOR=0.90; 95%CI 0.81, 0.996), or to receive assistance with medical appointments (aOR=0.89; 95%CI 0.80, 0.989), was associated with a lower odd of falls. WWH experience falls at rates similar to WWoH. However, loneliness and lack of social connections are key contributors to falls in older women in the US. Future research should explore whether interventions to mitigate loneliness and enhance social connections impact falls in older women in the US.
SOCIOECONOMIC INEQUALITIES IN HEALTHY AGING OF OLDER KOREAN ADULTS: AN AGE-PERIOD-COHORT ANALYSIS
Authors: Lee Yunhwan , Kim Eunsaem , Kim Jinhee , Kim Sukyung , Shin YooGyung , Han Jimin 
Published: January 2025

Abstract
As South Korea’s healthy life expectancy continues to increase, reaching 73 years in 2021 and ranking third in the world, there is growing interest in assessing functional ability as well as its disparity across various older population segments. The study aimed to investigate healthy aging trends by socioeconomic status in the recent decade among Koreans aged 65 years or older and to analyze the age, period, and cohort effects. Data were from the four waves, about 10,000 people in each wave, of the National Survey of Older Koreans conducted every three years from 2011 to 2020. The physiological, physical, cognitive, psychological, and social dimensions were combined to create the healthy aging index (HAI), with higher scores indicating a healthier state. Socioeconomic status included education, household income, and wealth. A multilevel analysis with a cross-classified random effects model was performed. An overall trend of healthy aging in the past decade was evident, but the gap between the highest and lowest levels of education has widened. The 1935-1944 birth cohort showed a significant decrease in HAI, suggesting a long-lasting negative effect of early life adversity in the latter years of colonial rule. There was a strong age effect, demonstrating a quadratic decline in HAI over the life course. Even though the last ten years have shown a general trend toward healthy aging, socioeconomic disparity persists. The study’s findings underscore the need for policies on healthy aging to consider the life-long vulnerability of certain aging population segments characterized by adverse early life experiences.
THE IMPACT OF PARTICIPATION IN AN IMMERSIVE VIRTUAL REALITY TAI CHI PROGRAM ON THE BALANCE OF OLDER ADULTS
Authors: Kim Jaehyun , Lobos Marcos Ardon , Park Serim , Oh Seungjun , Kim Jay , Kim Junhyoung 
Published: January 2025

Abstract
Falls are the leading cause of injury-related mortality in older adults aged over 65 years, with ~36 million older adults suffering from falls each year that result in more than 34,000 deaths. Tai Chi, an ancient Chinese martial art, is shown to reduce the risk of falls by improving physical functioning (e.g., balance, flexibility, muscle strength). Despite the well-recognized health benefits of Tai Chi instruction, older adults often encounter barriers including limited access to programs, a lack of instructors, and environmental distractions. To address these barriers, this study examined the impact of an immersive virtual reality Tai Chi intervention (IVTC) on the balance of older adults. Eighteen older adults from senior centers in North Carolina participated in eight 15-minute IVTC sessions over a month and completed the Berg Balance (BB) test before and after the IVTC intervention program. The results showed significant improvement in BB scale scores after the IVTC sessions (p &lt;.001) with a large effect size (d = -2.75). Holden’s System Usability Scale indicated that participants were very favorable towards using the program. Our findings suggest that the IVTC program is a very usable intervention that could effectively improve the balance of older adults, highlighting its potential as an innovative intervention to reduce fall risks for older adults.
THE RELATIONSHIP BETWEEN CREATININE-TO-CYSTATIN C RATIO AND FRAILTY: THE MEDIATING ROLE OF MUSCLE STRENGTH
Authors: Jia Shuli , Ge Mei-Ling , Xue Qian-Li , Dong Bigrong 
Published: January 2025

Abstract

Background
The creatinine to cystatin C ratio (CCR) has recently been suggested as a predictor for many adverse clinical outcomes. This study aimed to investigate the association between CCR and frailty, as well as the mediating role of muscle strength.

Methods
Cross-sectional and longitudinal analyses with 4-year follow-up of community-dwelling adults aged ≥60 years were conducted. Frailty was assessed using the physical frailty phenotype, which includes five binary criteria (weakness, slowness, exhaustion, low activity level and weight loss). Participants with three or more criteria were defined as frail. Muscle strength was measured by the maximum handgrip strength (HGS) of two hands. Logistic regression was used to analyze the associations between baseline CCR and prevalent and incident frailty. Mediation analyses were performed to examine the mediating role of HGS in the relationship between baseline CCR and incident frailty.

Results
Higher CCR was associated with lower risk of frailty (OR 0.41(0.18,0.92), p=0.030) in cross-sectional analysis, but this relationship was not significant when adding HGS in the regression model. After excluding participants who were frail at baseline and during the mid-follow-up, and those met the criteria for weakness at baseline, a total of 2428 participants were included in the longitudinal analysis. The association between baseline CCR and incident frailty was partially mediated by the mid-follow-up HGS (mediation proportion: 14%, p &lt; 0.001). Conclusions: HGS partially mediated the associations between CCR and frailty in Chinese populations. The findings reveal a novel biomarker for frailty, which may also facilitate the identification of frailty subtypes.
TIME-OF-DAY MOVEMENT AMOUNT AND VARIABILITY BY COGNITIVE STATUS IN A SAMPLE OF BLACK OLDER ADULTS
Authors: Wanigatunga Amal , Marino Francesca , Liu Fangyu , Shen Nicola , Karas Marta , Parker Lauren , Albert Marilyn , Schrack Jennifer 
Published: January 2025

Abstract
Reduced daily movement, particularly in the mornings, is linked with elevated Alzheimer’s disease risk, yet prior studies have consisted of primarily non-Hispanic White participants. Whether this association exists in Black older adults, who often are underrepresented in research and experience delays in cognitive impairment diagnosis, remains unexplored. Wrist-worn accelerometry was analyzed from 21 Black participants (median age: 73 years, 83% women) referred from the Johns Hopkins Alzheimer’s Disease Research Center who evaluate each participant for mild cognitive impairment (MCI). Separate age and sex adjusted linear regression models estimated movement differences by MCI status in mean: 1) total physical activity amount or variability (counts/d) over 24-hrs and 2) amount or variability of activity (counts/d) from 12am-6am, 6am-12pm, 12pm-6pm, and 6pm-12am. Variability measures were calculated as the SD of minute-level activity during each time period. Thirteen participants (62%) were identified with MCI. Participants with MCI averaged 1,700,927 (SD=721,021.9) counts/d compared to cognitively unimpaired participants who averaged 1,727,588 (SD=841,627.9) counts/d. Amount of activity counts/d did not differ between those living with and without MCI overall or by time-of-day (p for all&gt;0.56). However, there was a significant difference in physical activity variability between 6am-12pm, where variability was higher among those with MCI by 66,451 (95% CI: 883, 132,020) counts/d. Our findings warrant further investigation into whether variability, rather than amount, in everyday movement occurring during early morning hours could serve as a digital biomarker to enhance cognitive impairment screening for Black older adults living independently.
“IT’S NOT THE AGE, IT’S THE APTITUDE: FACTORS INFLUENCING ADOPTION OF DIGITAL HEALTH APP AMONG OLDER ADULTS”
Authors: Birati Yosefa , Orkibi Hod , Kolpina Lola , Zisberg Anna 
Published: January 2025

Abstract
The rapid growth of digital health services has established mobile health (mHealth) apps as a key communication channel between healthcare providers and patients in primary care. These apps offer features such as appointment scheduling, access to medical records, and administrative task management. This study examines how digital health literacy, perceived ease of use, and perceived usefulness of mHealth apps explain mHealth apps and online services usage among older adults. Our study involved 179 community-dwelling older adults (mean age 73.5±5.05). The sample was relatively well-educated, with 33.2% holding a bachelor’s degree and 31.5% having a master’s or higher degree. Notably, 80% of participants reported high to very high confidence in using mHealth apps. Multiple regression analysis showed that age and health status alone explained only 4% of the variance in mHealth app use. However, when accounting for digital health literacy (β =.228, p &lt;.001), ease of use (β =.369, p &lt;.001), and usefulness (β =.283, p &lt;.001) the model accounted for 58.7% of the variance (ΔR² =.493, p &lt;.001). These findings underscore the critical importance of addressing digital health literacy and usability challenges among older adults. By focusing on these factors over age alone, we can enhance the design and personalization of mHealth apps and facilitate independent engagement with digital health services among the older adult population.
ACCEPTABILITY AMONG DEMENTIA CAREGIVERS OF THE ONLINE SELF-GUIDED ACT FOR CAREGIVERS PROGRAM
Authors: Green Gavin , Batura Josey , Kelley Heather , Gossner Jacob , Aller Ty , Levin Michael , Fauth Elizabeth 
Published: January 2025

Abstract
Acceptance and Commitment Therapy (ACT) is an effective therapeutic intervention for stress and mental health concerns across various populations. Our study evaluates the acceptability of an online self-guided ACT program tailored specifically for dementia caregivers via a longitudinal mixed-method design. The study was advertised to community programs (e.g. Area Agencies on Aging, Alzheimer’s Association), and N = 83 caregivers completed the post-intervention survey (Mean age = 62.6; 82% female; 89% White, 57% spouse caregivers). The system usability scale averaged 86.1/100, indicating high acceptability, with the majority of participants reporting they would like to use the program again (76%), that the information was helpful (86%), and that they would refer the program to other caregivers (85%). We used a team-based approach to thematic analysis of in-depth interviews from 28 participants at both post-intervention and follow-up. Qualitative data supported the quantitative findings as participants expressed a high level of satisfaction with the program’s online asynchronous structure and content. Participants emphasized the practical skill-building exercises and emotional education as particularly helpful. Further, many participants reported continued engagement with the program by revisiting notes, reviewing session summaries, and reflecting on specific analogies or information. Those who maintained engagement away from the program reported increased motivation to apply skills taught in the program in their daily lives. The online self-guided ACT for Caregivers program demonstrates the potential for broader implementation of ACT in community and healthcare settings through its mobile and cost-effective nature.
ACTIVITY ENGAGEMENT FOR OLDER ADULTS WITH COGNITIVE IMPAIRMENT: UNDERSTANDING NEEDS AND SUPPORTS
Authors: Lydon Elizabeth , Keeler Carlyn Ellison , Mudar Raksha , Czaja Sara , Boot Walter , Charness Neil , Rogers Wendy 
Published: January 2025

Abstract
Understanding the daily challenges experienced by older adults living with cognitive impairment is essential for developing strategies to support their health and quality of life. These impairments involve cognitive changes that can pose barriers to daily activities, especially complex tasks such as managing medications. However, the specific difficulties faced by this population are not well understood. The Everyday Needs Assessment for Cognitive Tasks (ENACT) Study examines these challenges in community-dwelling older adults with probable cognitive impairment determined by reporting recent changes in their cognition and scoring as mildly impaired on global cognitive screening. Participants were aged 60 and older (N = 91). We used a mixed methods needs assessment approach to identify difficulties across five activity domains: Health, Social Engagement, Transportation, Domestic Life, and Leisure and Recreation. Participants rated the level of difficulty they experienced with activities within these domains using a Likert scale and then participated in in-depth interviews to explore the underlying causes, focusing on memory, planning, organizing, and communication challenges. We examined participants’ response strategies to challenges, such as using visual reminders, technology, personal habits, and seeking assistance from others. Difficulties related to memory and executive functioning were key contributors to the participants’ challenges. Details from the interview data provide insights about the context of the challenges. Their most common response strategy was utilizing support from others. Interventions and technology solutions designed to support this population should prioritize features that aid memory recall and task organization and facilitate functional independence.
AGE AND EMOTION: AGE MODERATES THE RELATIONSHIP BETWEEN MIXED EMOTIONAL EXPERIENCES AND PSYCHOLOGICAL WELL-BEING
Authors: Whitman Kathrine , Chen Enna , Stephenson Jane , Carstensen Laura 
Published: January 2025

Abstract
Aging is associated with higher levels of emotional well-being, with older adults experiencing more positive emotions, fewer negative emotions, and more mixed emotions in daily life. Mixed emotional experiences (reporting more than one type of emotion during the same period) may indicate more emotional complexity and adaptive functioning. Alternatively, it may indicate degraded emotional experience. Here, we examined the relationship between everyday positive, negative, and mixed emotional experiences with life satisfaction, trait-level positive emotion, psychological well-being, and depression. Participants in an experience sampling study (n =180, aged 18 to 93, M = 56.9) reported their emotions at five randomly selected times each day for seven days. As expected, reports of positive emotions were associated with life satisfaction and trait-level positive emotion, while negative emotions were associated with depression and inversely correlated with psychological well-being. Interestingly, the association of negative emotions with depression was weaker in older participants, suggesting that older people may be more resistant to clinical depression even in the face of negative emotions. Most interestingly, we found that mixed emotional states were associated with increased psychological well-being among older adults but decreased psychological well-being in younger adults. Older adults’ increased psychological well-being in relation to mixed emotions and their resilience to the effects of negative emotion are consistent with adaptive, age-related changes in emotional experience and well-being. These findings highlight the differential effects of experiential positive, negative, and mixed emotions on various measures of well-being, with younger and older adults experiencing key differences in emotional drivers of well-being.
AGE DIFFERENCES IN DECISION SUPPORT NETWORK SIZE: A STUDY OF TOTAL JOINT REPLACEMENT CANDIDATES
Authors: Wild Tess , Riffin Catherine , Löckenhoff Corinna 
Published: January 2025

Abstract
Arthritis, which affects tens of millions of middle-aged and older adults, is one of the most common causes of activity limitation, disability, and chronic pain. Despite evidence that total joint replacement (TJR) can improve quality of life and physical functioning in arthritis patients, many eligible TJR candidates hesitate to pursue surgical intervention, and this reluctance is higher among older patients. Research shows that willingness to undergo TJR is influenced by a variety of psychosocial factors. Social relationships in particular can be an important source of support and information for patients when considering surgery. It is well documented that people’s social networks tend to be smaller and more close-knit as they age, and recent research suggests that decision support networks for hypothetical healthcare decisions show the same trend. The present study examined whether this pattern extends to realistic decisions about TJR. Using a name-elicitation approach, we collected information on the size of patients’ decision support networks (Msize = 3.30; rangesize = 0-8) in a sample of potential TJR candidates (N = 98; Mage = 67.88; rangeage = 40-93 years). As predicted, linear regression revealed that, compared to younger potential TJR candidates, older potential TJR candidates identified fewer members in their decision support networks (B= -0.033; p =.048). Additional analyses examined the role of potential covariates including demographics (e.g., gender, marital status), health (e.g., pain, functional status), and psychosocial variables (e.g., personality, health literacy). Theoretical implications and ramifications for clinical practice are discussed.
AGING AND RADICAL ENVIRONMENTAL CHANGE: “WHY DON’T THEY JUST LEAVE?”
Authors: Friis Marlene , Gustat Jeanette , Cherry Katie , Cronin James , Bertrand William 
Published: January 2025

Abstract
Coastal Louisiana has experienced extensive land loss due to oil and gas extraction, flood protection measures, and repeated exposure to hurricanes, flooding, and other severe weather events. Radical socioeconomic changes further negatively impact older residents. Projected relative sea-level rise, increased intensity of weather events, and large infrastructure projects may further alter the ecosystem, leaving residents with the option to either adapt or retreat. Governmental agencies are working towards reducing population vulnerability through risk reduction measures, disincentivizing further population growth, or promoting outmigration to higher ground. Critically, older adults may be uniquely vulnerable to the hazards associated with coastal living as they are both overrepresented in population statistics yet may also be less sensitive to policies designed to move people out of harm’s way. Regarding migration decisions, older adults are often deeply embedded in the socioecological systems of historic communities and typically value the benefits of continuity over disruption. Using the Environmental Distress Scale on a sample of geographically vulnerable adult residents in lower Plaquemines Parish, Louisiana (n=161) and in-depth interviews with older adults (n=45), results indicate that Place Attachment, Solastalgia, Threat Perception, Felt Impact, and Action may undergird decisions to stay put in the face of radical environmental change. Results show that most adults ages 55 and over (75%) intend to stay in the area. Although some older adult may qualify as trapped (involuntarily immobile), this research supports older adults’ agency in choosing to be voluntarily immobile in the face of slow-onset environmental changes. This distinction has policy implications.