bluuebunny/crossref_metadata_2025_split huggingface dataset:
HEALTH AND SOCIAL CARE TRAINEES’ ATTITUDES ABOUT AGING AND OLDER ADULTS
Authors: Park Min-Kyoung , Martin Diane 
Published: December 2023

Abstract
Ageism is pervasive in healthcare. It costs billions of healthcare dollars and results in earlier patient mortality and decreased quality of life. Existing research highlights the prevalence of ageist attitudes among health and social care practitioners, but there is a dearth of research regarding attitudes of trainees toward older adults. The present study utilized the Fraboni Scale of Ageism to examine attitudes of health and social care trainees participating in geriatric interprofessional training programs. Participants completed an electronic survey prior to the didactic portion of the program. Seventy-seven surveys were completed between November 2022 and June 2023. Results revealed a nuanced understanding of older adults’ contributions, particularly regarding creativity, social and political engagement, and the richness of their accumulated life experiences. Positive sentiments were evident regarding interactions and participants acknowledged the self-management capacities of older adults, encompassing personal hygiene and other aspects of independent living. Notably, findings underscore substantial support for creation of inclusive spaces. Overall, a person-centric understanding of older adulthood was evident in the results; less than 20% of trainees expressed a negative perception of older adults/later life to any given question. Recognizing the significance of bridging intergenerational perception disparities to counter ageism, this research contributes to a foundational understanding of younger generations’ awareness of aging. Given the contrast to existing research regarding attitudes of practitioners toward older adults, these results emphasize the importance of fostering opportunities for intergenerational dialogue and activities to maintain an attitude of inclusivity and empathy that underscores a person-centered approach to healthcare.
HEALTH SYSTEM LEADERSHIP PERSPECTIVES AND PRIORITIES ON CARE FOR OLDER ADULTS
Authors: Franzosa Emily , Kelley Lynette , Dryden Eileen , Moo Lauren , Hung William 
Published: December 2023

Abstract
Innovative care models for older adults such as non-institutional and home-based care have the potential to improve quality and efficiency of healthcare, but adoption of these models requires resources from health systems. Health systems leaders can influence the relative priority of geriatric care and associated resource allocation. This influence is especially important for areas with limited resources such as in rural areas. We interviewed recently retired health system leaders about their experience and how priorities in health systems can be aligned to improve the quality and reach of geriatric care. We conducted qualitative interviews with 10 participants (40% female) using a snowball sampling strategy of geographically diverse, retired hospital, regional, and national leaders in the Veteran Healthcare system, the largest single-payer system in the US. Participants described how they managed myriad competing health system priorities by weighing and devoting attention and time to tackle the crises of the day, the numerous national mandates and directives, and the goals for the local hospital or system, as seen from their own perspectives. Alignment with performance metrics provides strong impetus for some health system leaders to determine their priorities. Incentives to encourage health systems leaders to prioritize and allocate resources aimed at long-term improvements in care could be important. Additionally, building relationships and maintaining trust amongst partners across facilities and offices is critical to initiating and growing geriatrics programs. This work highlights that influence must work on multiple levels to effect change in prioritization of care for older adults.
HEALTHCARE SERVICES UTILIZATION IN ELDERLY RESIDENTS OF A PERUVIAN HIGHLAND COMMUNITIES: AUNQUI-ANDES STUDY
Authors: Cahuapaza-Gutierrez Nelson Luis , Olazo-Cárdenas Kamyla M , Urrunaga-Pastor Diego , Runzer-Colmenares Fernando M 
Published: December 2023

Abstract
It is estimated that approximately one out of every three Peruvians does not utilize healthcare services when facing an ailment. Nevertheless, this frequency could be higher in highland regions, given the limited availability of healthcare services. The aim was to estimate the prevalence of non-utilization of healthcare services among elderly residents of a Peruvian highland community during 2022. We conducted an analytical cross-sectional study in the district of Totos (average altitude of 3286 meters above sea level) in the Ayacucho region of Peru during 2022. A census sampling method was employed, including residents aged 60 and older in Totos. Non-utilization of healthcare services was defined as a participant not seeking healthcare services when facing a health issue. The current study was approved by the Institutional Research Ethics Committee of Universidad Científica del Sur. We evaluated 272 elderly adults with an average age of 74 years, of which 60.3% were female, 62.5% were cohabiting or married, 82.3% had not completed primary education, and 65.4% reported being beneficiaries of a social program for economic support. We found that 28.3% did not use healthcare services, while 44.9% reported using traditional medicine, and 13.2% practiced self-medication. Participants reported that the nearest health center to their residence was, on average, 55 minutes away. We found that approximately one out of every five elderly adults did not use healthcare services. It is necessary to reduce cultural barriers to increase healthcare service utilization, as well as to enhance their availability for elderly individuals living at high altitudes.
HEALTHY AGING AND OLDER ADULTS WITH AUTISM: A SCOPING REVIEW
Authors: Stringfellow Mary , Fields Noelle , Lee Kathy , Anderson Keith 
Published: December 2023

Abstract
Autism Spectrum Disorder (ASD) is a lifelong diagnosis. While several studies have examined the effects of this disorder throughout childhood, few have considered older adulthood and the differences between allistic (i.e., persons who are not affected by autism) and autistic older adults. Moreover, an examination of the intersections of healthy aging in older adulthood and autism are largely absent from extant research. The purpose of this scoping review was to examine the state of literature regarding autistic older adults and the domains of healthy aging, utilizing the framework developed by Arksey and O’Malley (2005). After developing the research question, the researchers followed following the PRISM-ScR guidelines. The specific domains of healthy aging considered included physical health, mobility, mental health, cognition and memory, and social connectedness. A total of 35 articles were selected for final review. There was no definitive age group for autistic older adulthood, therefore the studies’ selection of ages for the older adult population were not homogenous. Fifty-seven percent of these studies considered only one domain of healthy aging, 23% studied two domains, while 14% measured three domains and 6% assessed four domains. No study considered all five domains. Of the five domains considered for this scoping review, mental health and cognition and memory were the most represented domains in the studies. Overall, healthy aging among autistic older adults is largely understudied. More research is needed to better identify and tailor interventions and services for autistic older adults and their families to support healthy aging.
HEARING LOSS AND HOSPITALIZATION IN OLDER ADULTS: EVIDENCE FROM THE ATHEROSCLEROSIS RISK IN COMMUNITIES STUDY
Authors: Zhang Wuyang , Morales Emmanuel Garcia , Reed Nicholas 
Published: December 2023

Abstract
Hearing loss is highly prevalent among older adults and is associated with increased healthcare utilization. However, the majority of evidence relies upon self-report measures of hearing and hospitalization which are subjective to validity concerns. Using cross-sectional data from the Atherosclerosis Risk in Communities Study and linked Centers for Medicare and Medicaid Services (CMS) records (2016), we aim to investigate the association between objectively measured hearing loss and record-based hospitalization in a population-based sample. Among 1,330 older adults (Mean age: 79.3 years; Female: 57.8%; Black: 17.4%), hearing loss was measured using pure-tone audiometry and hospitalization outcomes, including occurrence of any hospital stays (yes/no); number of hospital stays; and duration of hospital stays, were ascertained from CMS records. In models adjusted for demographic, socioeconomic, and health characteristics, those with mild and moderate/greater hearing loss had 1.71 (95% CI: 1.13-2.58) and 1.87 (95% CI: 1.18-2.98) times higher prevalence of any hospital stay over 12 months; 2.23 (95% CI: 1.47-3.37) and 1.68 (95% CI: 1.04-2.71) times higher Incident Rate of multiple hospital stays, relative to those without hearing loss. Moreover, both groups had significantly longer durations of hospital stay (mild: Incident Rate Ratio [IRR]=2.41; 95% CI: 1.46-3.98; moderate/greater: IRR=2.32; 95% CI: 1.32-4.07). Using criterion exposure and outcome measures, these findings confirm previous work and provide the first insight into the association of hearing loss with increased inpatient service use. Future work should focus on accommodations for hearing to reduce healthcare utilization and design equitable healthcare systems that meet the needs of all older adults.
HOLISTIC ASSESSMENT OF NURSING HOME RESIDENTS PREDICTS QUALITY OF LIFE AND PERCEPTION OF CARE
Authors: Ertle Emilee , Simon Darby , Mast Benjamin , Meeks Suzanne 
Published: December 2023

Abstract
The traditional medical model employs a problem-focused approach to assessment and care, but recent research emphasizes holistic assessment to facilitate person-centered care. The current study examines whether holistic assessment of problems and strengths can predict quality of life (QoL) and perception of care (PoC) of long-term nursing home residents. Sixty-six long-term nursing home residents were tested at time of admission, and at three and six month follow-up. Problem-focused measures were cognition, illness severity, depression, frailty, and anxiety. Strength-focused measures were hope, optimism, and social support. QoL at three months was correlated with anxiety (r=-.47, p=.001) and social support (r=.33, p=.047). At six months, QoL was correlated with anxiety (r=-.53, p&lt;.001) and illness severity (r=-.30, p=.042). PoC at three months was not correlated with any problem-focused measures; it was correlated with optimism (r=-.38, p=.014), hope (r=.416, p=.008), and social support (r=.37, p=.036). PoC at six months was correlated with hope (r=.41, p=.009). Variables with significant correlations were selected for regression analysis; hope and optimism were combined into a single positive outlook variable. Anxiety was the only significant predictor in the regression model for QoL at three months. Anxiety and positive outlook were significant predictors of QoL at six months and PoC at three months. Positive outlook was the only significant predictor in the model for PoC at six months. Traditional problem-focused measures alone may provide insufficient information to predict well-being. Older adults’ strengths, particularly hope and optimism, may predict QoL and PoC in the months following nursing home admission.
HOSPITALIZED AFTER A FALL: EXAMINING THE IMPACT OF INPATIENT GERIATRIC POLYPHARMACY REVIEW AND DEPRESCRIBING
Authors: Gangupantula Pratima , Cooney Alissa 
Published: December 2023

Abstract
Falls are reported in 1 out of 3 older adults (≥65 years old) annually. While there are many modifiable factors contributing to falls in OA, polypharmacy increases risk of falling as well as recurrent falls by 1.5-2x. In an acute inpatient setting, geriatricians can evaluate an OA’s medications to ensure these medications are indicated and potential benefits outweigh potential risks. Little is known regarding the impacts of deprescribing (including discontinuing, holding, or tapering medications) in the inpatient setting for OA admitted for falls. A retrospective chart review was conducted at a single academic institution from January 1st to June 30th 2023 to examine associated polypharmacy and deprescribing in OA hospitalized after a fall. The OA’s complete home medication list was obtained, geriatric consultation notes were reviewed to determine if deprescribing was recommended, and commonly deprescribed drugs were noted. Of the 283 OA meeting inclusion criteria, 238 (84.45%) OA experienced polypharmacy. Deprescribing recommendations were given to 203 (84.94%) of OA experiencing polypharmacy. 54.39% of OA had ≥1 medications discontinued, 71.13% of OA had ≥1 medications held, and 23.85% of OA had ≥1 medications tapered. Commonly deprescribed drug classes included antihypertensives, non-steroidal anti-inflammatory drugs, proton pump inhibitors, and opioids. Pantoprazole, aspirin, omeprazole, and zolpidem were the most commonly deprescribed Beers criteria medications. Polypharmacy is associated with deprescribing in older adults admitted for falls. Future studies should examine whether deprescribing recommendations were followed by healthcare providers when given in an inpatient setting and whether deprescribing contributes to decreased fall risk over time.
HOW DOES EXECUTIVE FUNCTION IMPACT ADHERENCE AND COMPLIANCE TO NOVEL PHYSICAL THERAPY INTERVENTION AMONG VETERANS?
Authors: Ogawa Elisa , Harris Rebekah , Ward Rachel , Palleschi Mary-Kate , Milberg William , Gagnon David , Halasz Ildiko , Bean Jonathan 
Published: December 2023

Abstract
Executive function problems may make it difficult for a person to adhere to and comply with Physical Therapy (PT) treatment. This study examined adherence and compliance to a novel PT intervention among Veterans with and without executive function deficits (EFD+/EFD-). This study was a preplanned secondary analysis of an ongoing Randomized Controlled Trial among middle to older Veterans (≥50yrs) with slow walking speed. Participants’ adherence (dropouts) and compliance (attendance, post-treatment exercise) to 8-week PT treatment were evaluated based on their baseline EFD status. Seventy-two participants were included in this study (mean age 72) and 22% (n=16) were EFD+. Veterans with EFD+ at baseline had worse mobility both objectively (Short Physical Performance Battery, 7.7 ± 1.9 vs. 9.5 ± 2.2, p&lt; 0.01) and subjectively (Activity Measure for Post-Acute Care (AM-PAC), 57.6 ± 4.7 vs. 62.2 ± 5.7, p&lt; 0.01). Dropout rates for EFD+ and EFD- were 44% and 25%, respectively. In the multivariable logistic regression, dropouts were associated with pain interference, depressive symptoms, mobility, and living alone. There were no differences in treatment attendance or post-treatment exercise compliance based on EFD status measured by number of attended sessions or number of post-treatment exercise days. In conclusion, EFD+ was associated with poor mobility and higher rates of dropping out. Screening for EFD is critical and may assist in predicting individuals who will need more support to enhance mobility.
HOW REAL IS THIS DEAL? EVALUATING AI ACCURACY IN PROVIDING SUPPORT TO DEMENTIA CAREGIVERS
Authors: Ross Jeanette , Reilly Elizabeth , Sanchez-Reilly Sandra , Arevalo-Flechas Lyda , Dentchev Alexander 
Published: December 2023

Abstract

Background
Dementia, a devastating and incurable disease, affects millions of older Americans, placing astronomical levels of burden on caregivers, who usually lack resources to learn to provide their loved ones with high-quality care. Artificial Intelligence (AI), a programmed pioneering resource to generate immediate automated responses, is universally available when one looks for potentially accurate answers. Objective: To evaluate accuracy of AI sites pertaining to questions related to dementia caregiving

Methods
AI sites (ChatGPT and Textero.ai) were asked questions about dementia caregiving aspects such as self-care, patient symptoms/complications, stress control and managing expectations. Dementia caregiving experts reviewed and classified responses using the validated Zarit Caregiver Burden Scale (ZCBS) as framework. Inter-reliability scores were calculated among reviewers’ responses.

Results
AI sites responded in paragraph and list formats. Common themes identified by reviewers from both AI sites included self-care suggestions and seeking/accepting help. Several ZCBS aspects were not addressed by both sites such as guilt, exhaustion, negative emotions, and patient’s dependence. Textero.ai obtained lower scores addressing ZCBS, specifically not addressing potential caregiver’s unreasonable expectations. Inter-reliability score (reviewers) was 0.91 (highly significant).

Conclusions
In evaluating varied aspects of caregiving, results showed that AI sites, as it pertains to dementia caregiving are promising resources for accurately emphasizing caregiver’s self-help encouraging positive thoughts. However, validation and exploration of negative feelings and emotions within AI sites might not be properly addressed for dementia caregivers. Further studies need to further explore the use of AI in combination with hands-on dementia interventions to validate all aspects of caregiving.
HYPERTENSION SELF-CARE AMONG MEDICARE BENEFICIARIES WITH SELF-REPORTED HEARING TROUBLE
Authors: Wallace Laura , Reed Nicholas 
Published: December 2023

Abstract
Hearing loss is common in older adults and frequently comorbid with chronic illnesses like hypertension, which requires self-care practices learned through patient-provider health communication. However, hearing loss is a barrier to communication. This cross-sectional analysis used the 2020 Medicare Current Beneficiary Survey of (N=11,587; weighted estimate, 51.8 million) to characterize hypertension self-care outcomes (measuring blood pressure, taking blood pressure medications, reducing alcohol, and confidence in blood pressure control) by hearing status among Medicare beneficiaries ages &gt;65. In the sample, 39% reported a little and 6% reported a lot of trouble hearing while 66% reported having received a hypertension diagnosis. In models adjusted for sociodemographic and health variables, Medicare beneficiaries with a little trouble hearing (OR=0.84 95% CI=0.72-0.97; P=0.02) and a lot of trouble hearing (OR=0.74; CI 0.57-0.95; P=0.02) had 16% and 26% reduced odds of reporting confidence in hypertension control compared to beneficiaries with no hearing trouble. Similar results were found when excluding hearing aid users (a little trouble hearing OR=0.85; CI=0.72-1.01; P=0.06; a lot of trouble hearing OR=0.69; 95% CI=0.52-0.91; P=0.01). No significant difference was found for other self-care outcomes. To the authors’ knowledge, this is the first characterization of hearing difficulty and hypertension self-care and findings align with previous work suggesting hearing loss may be a barrier to vital health communication. Future work should focus on examining self-care activities across chronic illnesses, temporal relationships, and designing population-appropriate interventions to improve self-care understanding among adults with hearing loss.
IDENTIFYING THE RELATIONSHIP BETWEEN ALZHEIMER’S DISEASE PREVALENCE AND CURRENT SERVICE USE IN OHIO’S 88 COUNTIES
Authors: Nelson Matt , Menne Dr Heather 
Published: December 2023

Abstract
Recently released data reveals that over 235,000 people over the age of 65 have Alzheimer’s disease and related dementia (ADRD) in Ohio. Using 2020 data from the National Center for Health Statistics, county-level specific ADRD prevalence estimates for Ohio’s 88 counties were also prepared (Range: 9.4-13.4 per 1000 individuals 65+). Researchers, practitioners, and policy-makers can use these estimates to better understand the reach and impact of ADRD in local communities. Nationally and in Ohio, care and support for older adults and specifically older adults with ADRD typically falls to family caregivers, home- and community-based service (HCBS) providers, and residential care providers such as nursing homes. This study pairs the county-level ADRD prevalence data with county-level data on available services (e.g., Memory Care Units, nursing home beds) and service users (e.g., HCBS users). The 10 counties in Ohio with the highest prevalence rates are home to nearly 60% of the 65+ population statewide. Additionally, these counties had a significantly higher proportion of older Black/Hispanic individuals than the other counties (10.8 versus 2.9). When looking at capacity, the top 10 counties contained just 12% of all nursing home beds, but 54% of nursing homes memory care units for the entire state. When considering service use, these 10 counties served a smaller percentage of the state’s HCBS users (13%). For Ohio and other states, it is important to explore available services and current service usage when faced with the increasing estimates of people living with ADRD.
IMPACT OF HEALTHY LIFESTYLE FACTORS ON LIFE EXPECTANCY AND LIFETIME HEALTHCARE COST: A NATIONWIDE COHORT STUDY
Authors: Lo Wei-Cheng , Hu Tsuey-Hwa , Shih Cheng-Yu , Lin Hsien-Ho , Hwang Jing-Shiang 
Published: December 2023

Abstract
In an aging society with increasing life expectancy, the significance of healthy behaviors has garnered considerable attention. Research indicates that adopting healthy behaviors not only contributes to a longer life expectancy but also leads to reduced healthcare expenditure. Our study aims to investigate the impact of individual and combined healthy lifestyle factors on life expectancy and lifetime healthcare expenditure in Taiwan. Analyzing data from the National Health Interview Survey cohort, we examined five healthy lifestyle behaviors: nonsmoking, avoiding excessive alcohol consumption, regular physical activity, sufficient fruit and vegetable intake, and maintaining a normal weight. By employing a rolling extrapolation algorithm, we estimated the lifetime survival function of the study cohorts and calculated the life expectancy and lifetime healthcare expenditure of populations with and without healthy lifestyle factors. Our analysis of 19,893 participants aged 30 and above revealed that adopting a healthy lifestyle is associated with longer life expectancy and reduced healthcare expenditure in Taiwanese adults. Participants adhering to all five behaviors gained 11.93 years in life expectancy compared to those with none, with an annual average healthcare expenditure reduction of $7,308. Smoking and diet were the most significant risk factors for shorter life expectancy, with current and former smokers experiencing a 4.02-year reduction and individuals with sufficient fruit and vegetable intake gaining 3.69 years compared to those with insufficient intake. These findings offer a comprehensive understanding of the impact of healthy lifestyle factors on overall health and economic burden, providing evidence-based guidance for policymakers and stakeholders in promoting healthy aging.