bluuebunny/crossref_metadata_2025_split huggingface dataset:
CAN OLDER INPATIENTS WITH MOBILITY LIMITATION BENEFIT FROM MULTIDISCIPLINARY INTERVENTIONS: M-MOBILE STUDY
Authors: Ma Lina 
Published: January 2025

Abstract

Objective
Mobility limitation, the loss of exercise capacity or independent living ability, is a common geriatric syndrome. As a reversible precursor to disability, it is crucial to comprehensively assess the factors of mobility limitation and administer individualized multidisciplinary team (MDT) treatment. We hypothesized that MDT can improve mobility in older adults with mobility limitation methods: We conducted a study titled “A Multidisciplinary-team approach for management of Mobility Limitation in Elderly (M-MobiLE)”, which is a multicenter, randomized, and controlled trial. A total of 442 older inpatients with mobility limitation from five hospitals were recruited. Mobility limitation was defined as Short-Physical Performance Battery (SPPB) ≤9. Activities of Daily Living (ADL) and intrinsic capacity were assessed. The intervention group received an exercise-centered individualized MDT treatment, including exercise, educational, nutritional, and medical interventions; while the control group received routine medical treatment. All patients were followed up for six months. Adverse events such as falls, fracture, stroke, cardiovascular events and death were recorded.

Results
Preliminary data analysis showed that compared to the routine medical treatment, the exercise-centered individualized MDT treatment reduces adverse events at 6 months (6.3% vs 13.0%, p=0.036). However, there was no statistical difference in ADL, length of stay, and hospital costs between the two groups at 6 months after discharge.

Conclusion
This study developed a multidisciplinary decision-making clinical pathway for older inpatients with mobility limitation, which had potential clinical benefits such as reducing short-term adverse events in older inpatients with mobility limitation in preliminary data analysis. Further analysis is ongoing.
LENGTH OF STAY IN REHABILITATION HOSPITALS AS WELL AS HOSPITAL ADMISSION IS ASSOCIATED WITH SACRAL ULCER DEVELOPMENT
Authors: Yin Cheng , Mpofu Elias , Brock Kaye 
Published: January 2025

Abstract

Introduction
Sacral ulcers (SUs) pose a significant risk of mortality for older adults when admitted to rehabilitation hospitals. Previous research has underscored the influence of various factors including comorbidities, lifestyle, and personal factors on sacral ulcer development (SUD) in these settings. However, the impact of hospital admission and the mediating role of length of stay (LoS) on SUD remains unclear. Thus, this study aimed to determine the association between hospital admission and SUD in older adult patients in rehabilitation hospitals, and whether LoS mediated this association.

Methods
Cross-sectional data were obtained from the Texas Inpatient Discharge Database (2021; N = 38,916 patients aged over 60 years in rehabilitation hospitals). Binary logistic regression was used to determine the association between hospital admission and SUD, mediation was then investigated.

Results
Hospital admission increased the likelihood of SUD through mediation by LoS (b=0.30, 95% CI 0.26, 0.35). Accounting for covariates revealed hospital admission was associated with 1.58 times the odds of SUD (AOR = 1.58; 95% CI = 1.38-1.81), while LoS was linked to 1.06 times the odds of SUD (AOR = 1.06; 95% CI = 1.05-1.06).

Conclusion
Our study extends previous findings, demonstrating hospital admission’s connection to increased odds of SUD, through prolonged LoS in rehabilitation hospitals. The results highlight the importance of categorizing the source of admission in vulnerable populations to mitigate potential risks of hospital-acquired infections and excessive mortality associated with SUs.
PHYSIOLOGICAL AGING AND ITS USE AS A MARKER OF INEQUALITIES IN HEALTH: CROSS-NATIONAL PERSPECTIVES
Authors: Bloomberg Mikaela 
Published: January 2025

Abstract
Given substantial heterogeneity in health status between older adults, there have been many efforts to develop metrics of biological and physiological ageing that explain variability in health outcomes better than chronological age alone. Physiological age based on clinical indicators may explain variation in health outcomes better than epigenetic or telomere-based biological clocks because clinical indicators capture downstream physiological changes more closely related to health outcomes. In this symposium, we examine physiological age as a holistic marker of ageing and how we can use different measures of physiological age to examine disparities in health across the UK, US, and Ireland. The first and second abstracts examine physiological ageing in different organ systems and associations with health outcomes in the US-based Health and Retirement Study (HRS) and the Irish Longitudinal Study on Ageing (TILDA). The third abstract explores gender and educational inequalities in physiological ageing in the English Longitudinal Study of Ageing (ELSA). The fourth examines racial differences in the returns to education for physiological ageing. Finally, the fifth abstract investigates associations of cumulative stress exposure and neighbourhood context with inflammation in HRS. We demonstrate physiological age as a powerful tool for revealing inequalities in health during ageing across national contexts.
CUMULATIVE STRESS EXPOSURE, NEIGHBORHOOD ENVIRONMENTS, AND INFLAMMATION IN ADULTHOOD
Authors: Choi Jean , Farina Mateo , Munoz Elizabeth 
Published: January 2025

Abstract
Cumulative stress exposure, or the total stress exposure occurring across childhood and adulthood, is related to elevated inflammation, a key factor underlying physiological aging. Neighborhood contexts represent important sources of risk or resilience that may interact with stress to influence inflammation. Using data from the Health and Retirement Study, we assessed whether cumulative stress exposure would be associated with greater inflammation, and if this link is shaped by adult neighborhood cohesion and disorder (n = 5,625; age: 56 – 107). We constructed a continuous latent variable of systemic inflammation from six measured indicators (CRP, IL6, IL10, IL-1Ra, sTNFR1, IGF-1). Higher cumulative stress exposure was associated with elevated inflammation (b = 0.02, SE = 0.01, p =.032), but neighborhood contexts did not moderate this link. Sensitivity analyses revealed a significant interaction effect whereby greater neighborhood cohesion buffered the negative effect of cumulative stress exposure on IL-1Ra (b = -8.01, SE = 2.76, p =.004), and IGF-1 (b = -0.49, SE = 0.20, p =.014). Additionally, higher cumulative stress exposure was associated with elevated IL-1Ra in the context of greater neighborhood disorder (b = 4.43, SE = 2.24, p =.047). Results indicate that neighborhood cohesion and disorder are integral dimensions of the neighborhood environment that may modify the impact of cumulative stress exposure on markers of inflammation. These findings emphasize the need for additional research to consider an integrated multi-level approach to understand the effects of cumulative stress on inflammation.
STRENGTHENING BRAIN HEALTH AND DEMENTIA RESOURCES FOR OUR RELATIVES OF NORTHWEST TRIBES
Authors: Wilson Chandra 
Published: January 2025

Abstract
The Northwest Tribal Elders Project (NTEP) will manage the resources and provide space for the current tribal dementia relatives to gather and share intertribal stories of our traditional ways of health and wellness to address Alzheimer’s disease and related dementia (ADRD) among I/T/U (Indian Health Services, Tribal and Urban Indian) clinics. The aim of the project is to provide technical assistance, training, and resources within our 43-member tribes’ elder programs and tribal programs supporting older adults. NTEP collaborates with all 43-member tribes and provides ADRD resources that may be tailored to the health and wellness practices within each tribal community. A tribal coalition will provide input on the implementation of our ADRD Strategic plan to promote risk reduction and intervention priorities, early detection screenings and assessments and education and awareness of ADRD. Through this relationship powerful and impactful things are going to happen, the hope is there will be an increase of discussions happening with our member tribes to discuss ADRD, mild cognitive impairment, memory care and caregiving. The tribe’s input on training and technical assistance needs is the medicine for our loved ones whom are being cared for.
DEMENTIA CAREGIVER SUPPORT IN THE RURAL, FRONTIER, AND TRIBAL AREAS OF UTAH
Authors: Nederostek Kate , Russell Kristy 
Published: January 2025

Abstract
More than three million people call the Beehive state home. Rapid growth (40% in the last 20 years) and Utah’s unique landscape present challenges when it comes to coordination of services. Made up of 29 counties covering 84,000 square miles, Utah is the 13th largest state by area. Approximately three-fourths of Utah’s population lives in five contiguous counties, often referred to as the Wasatch Front. However, 12 of Utah’s counties are considered rural (six to 100 persons per square mile) and 12 counties are considered frontier (six or fewer persons per square mile). Utah’s statewide dementia efforts are funded by the state legislature (~$430,000/year) and currently receive no additional federal funds. Historically, the federally supported organizations that serve frontier and rural communities in Utah receive less funding due to their lower population density. To better serve their communities, the Alzheimer’s Disease and Related Dementias (ADRD) Program and Family Caregiver Support Program, offered through the Area Agencies on Aging (AAAs), have combined forces. The ADRD Program assists each AAA in providing education, support, materials, and programming to those living with dementia and their caregivers. This collaboration has allowed an extension of programs statewide, providing an opportunity for those in rural and frontier areas to participate. Relationships and collaborative interest are growing with the Utah Indian Health Advisory Board. Utah’s ADRD Program continues to work through barriers and to tailor educational opportunities to the needs of each tribal area.
STRENGTHENING CAREGIVER SUPPORT: ASSESSING AND ADDRESSING CAREGIVERS’ MENTAL HEALTH NEEDS
Authors: Gould Christine , Humber Marika , Trivedi Ranak 
Published: January 2025

Abstract
Family caregivers (typically patients’ unpaid relatives/friends) are vital to patient care, but their mental health needs are often overlooked. This may be exacerbated by the fact that the caregiving role can be isolating, stressful, and time-consuming. This symposium highlights promising findings related to the identification of caregiver mental health and well-being needs and potential interventions in the community and Veterans’ Health Administration (VHA). First, Dr. Moo will present findings from a national survey of caregivers of older Veterans that shows the impact of care responsibilities, health care navigation, and environment on caregiver quality of life. Second, Dr. Van Orden will describe her investigation of suicide ideation, perceived burden, and social connection among caregivers of persons with dementia. Third, Dr. Humber will describe the impact of a tele-geriatric psychiatry service in two VHA regions on caregivers of rural-dwelling older Veterans with neurocognitive and or psychiatric disorders. Last, Dr. VanPutten will discuss adaptations of Dialectical Behavior Therapy (DBT) for caregivers in high-conflict caregiving situations with persons with neurocognitive disorders. She will describe adaptations made to a DBT skills training group related to the influence of caregiver physical health problems on detecting and applying core DBT skills. Dr. Ranak Trivedi, the national Training Director of the Elizabeth Dole National Center of Excellence for Veteran and Caregiver Research and member of the Research Collaborative of the National Alliance of Caregiving, will close with discussion of the presentations and will highlight opportunities for future caregiver mental health research.
INFLUENCES ON CAREGIVERS OF OLDER VETERANS’ PERCEPTIONS OF THEIR QUALITY OF LIFE: A NATIONAL SURVEY
Authors: Moo Lauren , Chamberlin Elizabeth , Ngo Victoria , Shirk Steven 
Published: January 2025

Abstract
Being a family caregiver can negatively impact an individual’s physical and mental health, leading to caregiver burden, burnout, and lower quality of life (QoL). We explored caregiver and care recipient factors that influence caregiver QoL via a national web-based survey of 511 informal caregivers of older Veterans. We found that greater dependence of the Veteran on the caregiver for Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (iADLs) was associated with poorer QoL (p&lt;0.001). Caregivers’ cohabitation with the Veteran was also associated with poorer QoL (p&lt;0.001), while caring for an additional person was not. However, our results also suggest that caregivers making time for their own medical care and social needs were unique important predictors of higher caregiver QoL, and this positive benefit remains even when considering the negative impact of Veteran ADL and iADL support needs. In fact, our results suggest that making time for social activities is the strongest predictor of QoL. Thus, making time to receive medical attention and participating in social activities are important factors when considering the caregivers’ overall QoL. Cohabitating with the care recipient may be required for various reasons (e.g., amount of care needed, financial limitations) and, therefore, may be challenging to address. However, improving and supporting the amount of self-care the caregiver receives may be a feasible area to address and can still have a substantive impact on their overall QoL.
THE CANNABIS AND OLDER PERSONS STUDY: CAN WE AT LEAST DEFINE IT AS A FORM OF COMPLEMENTARY AND ALTERNATIVE MEDICINE?
Authors: Kaskie Brian 
Published: January 2025

Abstract
The Cannabis and Older Persons Study has examined the increasing use of cannabis among older persons since 2016. This year’s COPS symposium features panelists trained in community health, gerontology, medicine, psychology and public health, each offering latest research findings and considering cannabis as a form of complementary and alternative medicine. Annie Nguyen and her colleagues from the University of California, San Diego present a qualitative analysis of interviews completed with physicians and other clinicians affiliated with a geriatric medical clinic, focusing on their perspectives about cannabis as a form of complementary and alternative medicine. Angela Bryan and her team from the University of Colorado, Boulder identify more than 200 older persons who completed the “Cannabis and Your Health” survey and compare those who use cannabis for purposes of self-care and contrasts outcomes related to balance, mood and memory with those who do not use cannabis. Julie Bobitt from University of Illinois Chicago uses a socio-ecological framework to identify multi-level factors associated with cannabis use among 30 older women with HIV. Fadi Martinos examines more than 12,000 persons over 50 who completed the California Health Interview Survey, and compares cannabis use among those who identify as informal care givers and those who do not. Together, these studies reflect how scientific understanding of cannabis use among older persons has been informed by varied disciplinary perspectives, and whether researchers consider cannabis use among older adults as a complementary and alternative form of medicine.
THE IMPACT OF ENVIRONMENTAL EXPOSURES ON DEMENTIA, PHYSICAL, COGNITIVE, AND MENTAL HEALTH OF OLDER ADULTS
Authors: Zaninotto Paola , Prina Matthew 
Published: January 2025

Abstract
The proposed symposium will delve into crucial environmental factors affecting physical health, cognitive and mental health, in older populations. The first talk will explore urban environments’ impact on cognitive health, highlighting evidence gaps and concentrated areas of existing research, such as air pollution and social environment influences on dementia and Alzheimer’s disease. Another presentation will examine the association between long-term air pollution exposure and dementia risk in Denmark, identifying the most vulnerable groups based on socioeconomic status and comorbidities. The third talk will focus on the relationship between air pollution exposure over a decade and cognitive performance in older individuals in England, emphasizing the detrimental effects of industry emissions on cognition. A different study will discuss the findings on outdoor light at night and its lack of association with depressive symptoms in older adults in England. Lastly, the symposium will present research on extreme heat exposure’s effects on epigenetic aging and its potential to increase morbidity and mortality risks, underscoring the need for mitigating these biological changes.
EFFICACY OF THE RESIDENTIAL CARE TRANSITION MODULE
Authors: Gaugler Joseph , Birkeland Robyn , Albers Elizabeth , Peterson Colleen , Louwagie Katie , Baker Zachary , Mittelman Mary , Roth David 
Published: January 2025

Abstract
“This study aimed to evaluate the efficacy of The Residential Care Transition Module (RCTM), a six-session, psychosocial, and psychoeducational telehealth intervention for family caregivers of cognitively impaired relatives living in a residential long-term care (RLTC) setting. Eligible participants (including care recipients, regardless of time since admission) were randomized to treatment or usual care control conditions. Survey data were collected at baseline, four months, eight months, and 12 months (N = 240). Primary analytic outcomes included caregiver subjective stress (a stress process mechanism) and depressive symptoms (a measure of global well-being). Secondary analytic outcomes included secondary role strains, residential care stress, caregiver sense of competence, and self-efficacy (additional mechanisms of action). General linear models tested for the main effects of the intervention at four months and longitudinal mixed models examined the 12-month effects of the intervention. Post hoc analyses also examined the influence of moderators. There were no significant differences between the treatment and control groups for any primary analytic outcome. Caregivers in the treatment group whose relatives were admitted to RLTC in the prior three months were more likely to indicate reductions in depressive symptoms over the first four months of participation. Over the 12-month study period, caregivers in the treatment group who were employed reported increased self-efficacy over time. The heterogeneity of dementia care requires a broader consideration of key contextual factors. Aligning measures with the preferences, goals, and values of dementia caregivers may further demonstrate the benefits of interventions such as the RCTM” (Gaugler et al., in press).
PROCESS EVALUATION OF THE RESIDENTIAL CARE TRANSITION MODULE
Authors: Urbanski Dana , Birkeland Robyn , Louwagie Katie , Bailey Dionne , Baker Zachary , Gustavson Allison , Mitchell Lauren , Gaugler Joseph 
Published: January 2025

Abstract
Although still relatively uncommon in dementia care science and gerontology, process evaluations can offer substantial insight when considering the dissemination and implementation of evidence-based innovations, particularly when utilizing various types of data to examine causal assumptions of an intervention as well as pre-specified contextual moderators or mediators that may influence intervention effects. This process evaluation leveraged the extensive quantitative and qualitative data collected during the 12-month, mixed methods evaluation of the Residential Care Transition Module (RCTM), a psychoeducational telehealth (via phone or video conference) intervention. Of 120 treatment participants, 107 completed the six session intervention. Session duration averaged 81 minutes (range 18-130 minutes, SD=20.9). The 13 participants who did not finish the intervention were bereaved during the intervention. As such, intervention delivery was discontinued. One hundred and fourteen treatment group participants engaged in varied amounts and means of ad hoc communications throughout their time in the study, including 9 of the 13 aforementioned bereaved participants who chose to continue to work with their transition coach after their relative passed. Eighty-one of the 114 participants engaged in ad hoc coaching sessions via phone or video conference, averaging six ad hoc sessions (range 1-38 sessions, SD=5.7). Ad hoc session duration averaged 41 minutes (range 5-120 minutes, SD=18.4). Emotional support was the most frequently delivered content, occurring in 91% of intervention sessions and 53% of ad hoc contacts. Participants overwhelmingly valued the RCTM program via a treatment review checklist administered quarterly, indicating high perceptions of utility, acceptability, and satisfaction with the RCTM.
AN EMBEDDED MIXED METHODS EVALUATION OF THE RESIDENTIAL CARE TRANSITION MODULE
Authors: Birkeland Robyn , Gaugler Joseph , Albers Elizabeth , Peterson Colleen , Louwagie Katie , Baker Zachary , Mittelman Mary 
Published: January 2025

Abstract
Mixed methods designs refer to those research strategies that integrate or “mix” qualitative and quantitative research questions, sampling and data collection approaches, and analyses, so that one component builds upon and expands the inferences of the other. The Residential Care Transition Module (RCTM) evaluation relied on an “embedded” mixed methods design. In the RCTM embedded design, qualitative data collection was integrated during and following intervention delivery to ascertain components or contextual factors that may have influenced participant benefit. We relied on the robust qualitative data available from quarterly review checklists as well as purposive, post-intervention semi-structured interviews administered to RCTM treatment participants to identify and empirically test three mediators and moderators in a series of post-hoc, longitudinal quantitative analyses: unemployment, time in residential care, and bereavement status. In this presentation, we will highlight our findings for whom and under what circumstances a telehealth dementia care support intervention such as the RCTM may exert positive benefits.