bluuebunny/crossref_metadata_2025_split huggingface dataset:
DAILY ASSOCIATIONS OF ACTIGRAPHIC SLEEP AND NEXT-DAY WORKING MEMORY IN MIDLIFE AND OLDER ADULTS
Authors: Master Lindsay , Buxton Orfeu , Allan Alexa , Fine Courtney , Mogle Jacqueline , Zonderman Alan , Evans Michele , Gamaldo Alyssa 
Published: January 2025

Abstract
This study evaluates the day-to-day associations between actigraphic nighttime sleep and next day working memory in a sample of diverse midlife and older adults. The study used a subsample of the HANDLSleep Study which provided complete information of the variables of interest. Preliminary data from wave 5 (2022-current, n=104, 72% female, 55% Black adults, mean age: 62) were collected via a wrist-worn accelerometer and daily mobile phone cognitive tasks over one week, from which nighttime sleep measures and next-day working memory outcomes were derived. Multilevel linear models tested within-person associations of nightly sleep duration, timing, and quality with next-day mean reaction time calculated from the Multiple Object Tracking (MOT) Task via a mobile device, which evaluates working memory. Analyses were stratified by poverty status (above/below 125% federal poverty line) and adjusted for age, sex, race, WRAT3 literacy scores, average sleep measures, and weekend/weekday. Within individuals who live below the poverty line (n=47), on nights when participants fell asleep earlier (p=.013) and slept longer (p=.021) but had more minutes of wake (p=.0013) and less efficient sleep (p=.018) than their average, next-day mean reaction time was faster. Sleep measures were not associated with next-day working memory for individuals who live equal/above the poverty line. Our results demonstrate that within-person improvements to nightly sleep timing and duration may help next-day reaction time on working memory in adults who live below the poverty line.
ASSOCIATIONS OF MEAN AND VARIABILITY OF ACTIGRAPHIC SLEEP AND GENERAL COGNITIVE PERFORMANCE
Authors: Ji Linying , Shen Yuqi , Buxton Orfeu , Beydoun May , Zonderman Alan , Evans Michele , Gamaldo Alyssa 
Published: January 2025

Abstract
Sleep health is associated with cognitive function in midlife and older adults. Little research investigated the relationship between cognitive performance and variability, in addition to mean sleep measures. Using a subsample HANDLSleep study (n=81; 72% female, 52% Black adults; age range: 46-81), this study examined the cross-sectional relationship between cognitive function and both variability and mean sleep with a Bayesian variability model. Cognitive function was measured using Montreal Cognitive Assessment (MoCA). Sleep measures were estimated using one week of wrist actigraphy (mean ± SD = 6.8 ± 0.4 day), including nighttime sleep time (TST), wake after sleep onset (WASO), nighttime sleep midpoint (Timing), Sleep maintenance efficiency (SMEff), and nap minutes (NAP). All models controlled for age, race, sex, WRAT3 literacy scores, and poverty status. Results showed that more variability in sleep Timing (b = -2.75, CI [-5.18, -0.45], p = 0.02) and longer mean nap minutes (b = -3.58, CI [-6.52, -0.93], p = 0.006) were associated with worse cognitive performance (lower MoCA score). No significant associations were observed for TST, WASO, SMEff and MoCA. Findings suggest the importance of considering both variability and mean sleep measures in understanding how sleep relates to cognitive function in middle-age and older adults.
SUSTAINABLE DEMENTIA CARE: CLINICAL, PROGRAMMATIC, AND PUBLIC HEALTH PERSPECTIVES
Authors: Gaugler Joseph , Johnson Elma , Gitlin Laura 
Published: January 2025

Abstract
When considering the dissemination and implementation of evidence-based innovations in aging, sustainability is a driving concern but understudied outcome. Sustainability refers to “is the extent to which a newly implemented intervention is maintained or institutionalized within a service setting’s ongoing, stable operations” (Lewis et al., 2017). Although attention in dementia care is beginning to pivot to issues related to successful dissemination and implementation of a growing number of evidence-based innovations, concerns related to the maintenance of long-term care adoption of dementia care interventions in clinical, community, and public health contexts remain pressing. Beyond dementia care and in the broader field of implementation science, available research on sustainability is limited with challenges ranging from heterogeneity in definitions, measurement, follow-up periods and similar issues. The objective of this symposium is to initiate a scientific and practice agenda as it relates to sustainability for dementia care interventions. We will feature presentations on dementia care sustainability from public health, community, clinical, and scientific perspectives. Following this symposium, we aim to establish a framework to better achieve sustainability of evidence-based and evidence-informed dementia care innovations across key settings and communities.
SUSTAINABILITY OF COMPREHENSIVE DEMENTIA CARE INTERVENTIONS FROM A CLINICAL PERSPECTIVE
Authors: Epstein-Lubow Gary , Tambor Ellen , Johnson Maddie , Haggerty Kristin Lees , Stoeckle Rebecca 
Published: January 2025

Abstract
Multiple evidence-based comprehensive dementia care programs are currently available for adoption by healthcare systems and providers. However, barriers to adoption and long-term sustainability remain. The need for effective payment policies to incentivize implementation of comprehensive dementia care has long been recognized and the recently announced Center for Medicare and Medicaid (CMS) Guiding an Improved Dementia Care Experience (GUIDE) Model is an important step forward in improving access to comprehensive dementia care for Medicare beneficiaries and family caregivers. The GUIDE Model seeks to confirm that comprehensive dementia care can be widely implemented without raising health care costs. Similar work is needed under Medicare Advantage and other health plans. The National Dementia Care Collaborative (NDCC) seeks to accelerate dissemination of six effective comprehensive dementia care programs. The NDCC provides a forum for addressing barriers to adopting and sustaining comprehensive dementia care and seeks to promote that GUIDE Model participants use at least one evidence-based program. Existing evidence-based dementia care models, developed and tested within large health systems and academic medical centers, are now demonstrating ability to adapt to the characteristics of diverse service-delivery organizations leading to widespread adoption and sustainability. To succeed, one high priority is expanding the dementia care workforce to deliver high quality, comprehensive dementia care. Also essential is consensus on a core set of metrics for monitoring the quality and fidelity of comprehensive dementia care.
STROKE PREVENTION EDUCATION IN AFRICAN AMERICANS: A COMMUNITY-BASED PARTICIPATORY FEASIBILITY STUDY
Authors: Hadidi Niloufar , Jones Clarence , Taylor Zachary , Gorzycki Emily , Pasdo Allison , Gurvich Olga , Everson-Rose Susan 
Published: January 2025

Abstract

Research aim
To assess the feasibility and acceptability of a Stroke Champion “train-the-trainer” program to support implementation of stroke prevention education among African Americans (AA) residing in the Minneapolis-St. Paul metropolitan area. Significance: AAs are fifty percent more likely to experience stroke than Whites. This disparity is partially attributed to higher prevalence of modifiable stroke risk factors such as hypertension, diabetes, and obesity among AA communities. Training community members to disseminate health information is an evidence-based, community-specific health promotion strategy. Stroke Champions - individuals from the community with a desire to help improve the health of their community – could be trained and empowered to deliver stroke recognition and prevention education to peers.

Methods
Twelve AA Stroke Champions were recruited to assess the feasibility of educating community on 1) stroke warning signs and risk factors; and 2) strategies to mitigate stroke risk factors. A one arm pre-post-test design was used. Findings: We successfully developed and implemented a stroke education website for community education. Stroke Champions reported the website was helpful, easy to use, and a valuable health information resource They stated that they needed more support from the research team to deliver the education to peers in the community.

Conclusion
Engaging Stroke Champions is potentially beneficial in increasing stroke prevention knowledge. However, Stroke Champions need more knowledge and facilitation support from the research team to effectively engage and educate peers. Implication: Community engagement is an important way to empower individuals to take charge of their health and reduce stroke burden.
A PUBLIC AWARENESS MESSAGE TO DISRUPT AGEISM AND PREVENT ELDER ABUSE
Authors: Marrs Sarah 
Published: January 2025

Abstract
To date, much of the research on elder mistreatment has focused on achieving improved skills for recognizing, screening for, and reporting abuse that has already occurred, typically considered secondary prevention. Knowing how to recognize when abuse has occurred is indeed critical for effective and timely intervention. However, engaging in efforts that challenge how we as a society perceive aging and older adults is an important and necessary primary prevention strategy, which targets stopping abuse from occurring in the first place by focusing on the source of abuse, such as underlying beliefs or attitudes. Given the linkages between ageism and abuse, our team has engaged in public education and awareness campaigns aimed at changing the narrative we as individuals associate with aging and older adults. In this multimedia presentation, we will begin by briefly discussing the link between ageism (both individual and structural) and elder abuse, citing current scientific literature as well as our own research, and how this led to our receipt of funding from the Administration for Community Living (ACL) to conduct innovative elder justice training and research. Then, we will briefly discuss the methods and evaluation feedback for one small component of this work, an ageism and abuse public awareness video. Specifically, we will highlight the methods (i.e., qualitative data collected, literature reviewed) that informed the creation of the video, present the video, and then share the feedback we have collected as part of our overall project evaluation activities.
THE STARTING A TESTOSTERONE AND EXERCISE PROGRAM AFTER HIP INJURY (STEP-HI) TRIAL: STUDY RESULTS AND IMPLICATIONS
Authors: Binder Ellen , Kiel Douglas 
Published: January 2025

Abstract
Hip fractures are common among older women and can have a devastating impact on their ability to remain independent. Many women who were high functioning before the hip fracture do not return to their pre-fracture level of function, have persistent weakness and mobility impairments, and may require ongoing supportive services. Age-associated androgen deficiency may contribute to deficits in muscle mass, strength and power that are common in older female hip fracture patients. The typical approach to hip fracture rehabilitation routinely includes a limited course of physical therapy but the precise role of exercise and the use of an anabolic therapy like testosterone has not been determined. The Starting a Testosterone and Exercise Program after Hip Injury (STEP-HI) Study is a three-group, randomized, double-blinded, placebo-controlled Phase III clinical trial that was conducted at 8 clinical sites in the USA. The trial was designed to evaluate a multi-modal intervention aimed at improving functional outcomes in older female hip fracture patients with persistent mobility impairment. 129 female hip fracture patients, age 65 yrs. and older were randomly assigned to one of three groups: supervised exercise plus 1% testosterone topical gel (EX+T); supervised exercise plus placebo gel (EX+P); or Enhanced Usual Care (EUC). This symposium will present the results of the trial, including recruitment and retention, primary and secondary outcome measures. The program will also address strategies to ensure fidelity with exercise in a multicenter study like STEP-HI. Implications of study findings for future research and clinical practice will be discussed.
SOCIAL ISOLATION, LONELINESS, AND DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS: THE MODERATING EFFECT OF RESILIENCE
Authors: Li Ke , Tang Fengyan , Albert Steven , Rauktis Mary , Ohmer Mary 
Published: January 2025

Abstract
Social isolation has been recognized as a social problem with negative health consequences. Using data from three waves of the Health and Retirement Study, this study aimed to examine the long-term impact of social isolation on loneliness and depressive symptoms and to explore the moderating effect of resilience. This study comprised 3,681 U.S. adults aged 60 and older at the baseline wave. Social isolation index was constructed using five indicators, including not married or cohabitating with a partner, no social participation, and less than monthly contacts with children, family members, or friends. Loneliness was measured by the UCLA loneliness scale and depressive symptoms were measured by the Center for Epidemiological Studies-Depression scale (CES-D). The moderator of resilience was assessed by the simplified resilience score (SRS). Latent growth curve models with robust standard errors were estimated. The results of latent growth curve models showed that social isolation was significantly associated with more initial loneliness and depressive symptoms. However, social isolation was associated with a slower increasing rate of loneliness, but no significant relationship with the change rate of depressive symptoms. Furthermore, resilience significantly buffered the negative effect of social isolation on the initial level of depressive symptoms. The findings underscore the importance of enacting strategies and interventions targeting resilience to address social isolation and its negative consequences among older adults.
ENHANCING DIGNITY IN DEMENTIA CARE IN BRAZIL: A CAREGIVER REMOTE 4MS FRAMEWORK APPLICATION FOR MOBILITY SOLUTIONS
Authors: Heyn Patricia 
Published: January 2025

Abstract
This abstract describes a case study based on the personal experience of an Alzheimer’s researcher who unexpectedly turned into a caregiver and crafted a novel care paradigm for her father with dementia living in a nursing home in Brazil. Confronting Brazil’s traditional care models, which often exacerbate frailty by confining older adults to wheelchairs, she championed the Age-Friendly Health Systems movement and its core 4Ms framework—Medication, Mobility, Mentation, and What Matters the Most. This personalized approach, advocating for autonomy rather than restraint, sparked a systemic shift toward recognizing and nurturing the functional capabilities of older adults with dementia. Implementing this framework virtually, we are capable of training a caregiver remotely through WhatsApp to deliver tailored physical and cognitive exercises for a physically restrained person with dementia, demonstrating the feasibility of technology-facilitated caregiving. This intervention led to significant functional improvements: the transition from wheelchair to walker, then to cane, and finally, to unassisted ambulation, and improved strength and walking speed within a year. Highlighting this success, the presentation will discuss the transformative influence of the Aging Friendly 4Ms framework on person-centered geriatric care in an international context and the potent role of technology in maintaining family engagement and oversight in caregiving quality from afar. This case underscores the necessity of personalized care that regenerates and maintains active mobility, ultimately preserving the dignity, independence, and quality of life for older adults with dementia in underdeveloped institutional settings.
CHANGES IN THE AGING POLICY LANDSCAPE SINCE 2020: HITS AND MISSES
Authors: Lipson Debra , Bishop Christine 
Published: January 2025

Abstract
Despite deep political divisions after the 2020 election, Congress passed several major statutes to address the acute economic and health fallout of the COVID-19 pandemic, including provisions that helped older adults cover large and unexpected health care costs and expanded access to home and community-based care (HCBS). States used federal funds disbursed under these statutes to strengthen the long-term services and supports (LTSS) system and respond to the COVID-19 health emergency. But as the pandemic faded into the distance, so did the impetus to address the fundamental problems that pose the greatest long-term risk to the health and economic security of older adults. This paper reviews major legislative and regulatory initiatives adopted at the federal and state level since 2020 to improve the economic security of low-income older adults, expand Medicare and Medicaid coverage, strengthen nursing home quality and the direct care workforce, increase access to HCBS, and provide greater support to family caregivers. Despite these achievements, progress has been incremental. Little has been done to fix flaws in Medicare and Social Security financing, and policymakers have yet to address LTSS financing, all of which pose major threats to the long-term financial wellbeing of older adults and their families. These issues belong at the top of the aging policy agenda and urgently call for action by the next Administration, Congress, and state and local governments.
RACE, NEIGHBORHOOD DYNAMICS, AND MORTALITY PATTERNS IN OLDER PUERTO RICANS
Authors: García Catherine , Aranda Maria , Crowe Michael 
Published: January 2025

Abstract
This study explores the relationships between race, neighborhoods, and mortality among older Puerto Ricans, drawing upon theoretical frameworks in sociology, gerontology, and public health. We combined data from the longitudinal Puerto Rican Elderly Health Conditions Project (PREHCO; 2002-2021) and the Puerto Rico Contextual Data Resource (PR-CDR) to examine how the relationships between racial identity, neighborhood-level racial density, and neighborhood-level socioeconomic status are related to the probability of experiencing all-cause mortality among island-dwelling Puerto Ricans aged 60 and older (n=4,243). Findings show that young-old Black Puerto Ricans residing in high socioeconomic neighborhoods have a lower risk of mortality relative to their same aged Black counterparts residing in low socioeconomic neighborhoods, and White Puerto Ricans who reside in either high or low socioeconomic neighborhoods. However, this mortality advantage diminishes when they reach the age of 75 years and over. We hypothesize that in Puerto Rico, Black communities with access to economic capital are especially beneficial for its residents as they are in spaces where they feel welcomed and are surrounded by amenities that are essential for healthy aging or survival into old age. As Puerto Ricans in these communities age, this advantage may diminish, due to a ceiling effect, meaning that for older Puerto Ricans who survive to age 60 in these communities, there are fewer advantages to accumulate. Our research provides a foundation for informed policy decisions and targeted interventions to promote aging in place in Puerto Rico and offers a framework for understanding similar dynamics in diverse Latin American contexts.
REFRAMING GEROSCIENCE TO IMPROVE OUTCOMES IN PEOPLE LIVING WITH CHRONIC INFECTION
Authors: Montano Monty 
Published: January 2025

Abstract
This talk will highlight recent advancements in aging science as applied to individuals living with chronic conditions associated with infections, such as HIV-1 and SARS-CoV-2. The discussion will focus on aging biomarkers and health trajectories in individuals with chronic morbidities related to infection. Additionally, the talk will address the importance of considering both physiological and holistic outcomes, taking into account allostatic load and the life history of stressors, both biological and psychosocial in strategies designed to improve quality of life.
CELEBRATING 50 YEARS OF AGING RESEARCH: A CHAT WITH NIA SENIOR LEADERSHIP
Authors: Kelley Amy , Kelley Amy 
Published: January 2025

Abstract
The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, is the federally designated lead agency on aging research and supports research to understand the nature of aging and to extend the healthy, active years of life. 2024 marks NIA’s 50th anniversary, a milestone which prompts reflection on both past and present discoveries resulting from NIA-funded research. In the decades since its establishment, NIA has propelled advances across multiple domains of aging research, including basic, clinical, neuroscience, and behavioral and social research. Looking to the future, NIA seeks to drive further advances in these areas – with input on strategic priorities from investigators, advocates, and the public – to enable healthier aging for all. This symposium will provide a forum for exploration of NIA-funded research advances, as well as current and future research priorities of NIA’s scientific divisions, and review of the NIA budget and its implications for the research community. A question-and-answer session with NIA senior staff will follow these remarks.
FEASIBILITY AND MECHANISM ENGAGEMENT OF A MINDFULNESS MOBILE APP FOR CAREGIVERS: FINDINGS FROM AN NIH STAGE 1B TRIAL
Authors: Plys Evan , Woodworth Emily , Seward Morgan , Allen Elizabeth , Carroll Isabella , Huberty Jen , Vranceanu Ana-Maria 
Published: January 2025

Abstract
A large body of research has tested psychological interventions with dementia caregivers. Yet, this literature still lacks clear understanding of mechanisms of action for psychological outcomes. This NIH Stage 1B study tested the feasibility and mechanism engagement of a theory-based mindfulness mobile-app (Healthy Minds Program [HMP]) for stress, depression, and anxiety among caregivers; mindfulness skill was the proposed mechanism for each outcome. Stressed caregivers were randomized to HMP (n=40) or a podcast control (n=40). Groups did not vary by age, gender, race, or caregiver type. Among all participants (N=80), benchmarks were met for recruitment (90% eligible caregivers enrolled), data collection (98% with no questionnaires fully missing), and attrition (95% completed post-tests). For caregivers completing HMP, benchmarks were met for treatment satisfaction and credibility, but not for expectancy or adherence (63% completed 52.5 minutes weekly). Using Wilcoxon signed-rank/paired-samples t-tests, caregivers receiving HMP evidenced significant within-group improvements in mindfulness (Applied Mindfulness Process Scale; Cohen’s d=1.16). Significant within-group differences were observed for stress (Perceived Stress Scale; Cohen’s d=.91), depression (Hospital Anxiety and Depression Scale [HADS]; Cliff’s delta=.34), and anxiety (HADS; Cohen’s d=.78). Change in mindfulness significantly related with change in stress (r=.38), depression (r=.42), anxiety (r=.33). Findings suggest the HMP mobile-app was feasible and led to moderate to large within-group effects for mindfulness and clinical outcomes among caregivers. Moderate correlations between change scores confirmed the conceptual model with mindfulness as a proposed mechanism of action. We discuss protocol refinements (e.g., changes to dose for mobile-app) and preparation for a Stage 2 efficacy trial.