bluuebunny/crossref_metadata_2025_split huggingface dataset:
TRANSITIONS IN MEDICATION MANAGEMENT AMONG PATIENTS WITH DEMENTIA: PATIENT-CAREGIVER PERSPECTIVES
Authors: O’Conor Rachel , Russell Andrea , Oladejo Dianne , Filec Sarah , Morhardt Darby , Rogalski Emily , Lindquist Lee A , Wolf Michael 
Published: December 2023

Abstract
Older adults with Alzheimer’s disease and related dementias (ADRD) have higher rates of multimorbidity and polypharmacy. Medication adherence is critical to maintain health but is difficult with complex regimens. Little is known about how older adults with varying levels of cognitive impairment self-manage medications, and how responsibilities transition to caregivers. We conducted qualitative interviews with patient-caregiver dyads exploring how they managed multidrug regimens. Patients were eligible if they had 1) mild cognitive impairment (MCI), mild ADRD or moderate ADRD, 2) ≥3 chronic conditions, 3) ≥5 medicines and 4) a caregiver. Three coders applied a priori codes to transcripts and analyses followed the framework method. We interviewed 60 participants (Patients: mean age 78 years, 63% female, 50% white, 33% Black; Caregivers: mean age 65 years, 73% female, 60% spouse, 33% child). Patients took 9 medicines on average; cognitively, 36% had MCI, 40% mild ADRD and 23% moderate ADRD. Interviews revealed a tension between preservation of patient independence with early caregiver involvement. Patients and caregivers reported a strong preference towards patient autonomy in medication management, and patients with MCI and mild ADRD managed their medications independently. Among patients with moderate ADRD, caregivers assumed all medication responsibilities except when living separately. In those scenarios, caregivers set up organizers and made reminder calls, but did not observe medication intake. Transitions in medication management followed patient-driven medication errors that resulted in adverse events. These findings have important implications; clinicians should initiate conversations with caregivers and patients about early medication assistance and work to simplify regimens.
UNDERSTANDING CHALLENGES AND SOLUTIONS FOR DEAF OLDER ADULTS
Authors: Shende Shraddha , Koon Lyndsie , Singleton Jenny , Rogers Wendy 
Published: December 2023

Abstract
The Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) project explores everyday activity challenges and solutions experienced by U.S. older adults as they age with a lifelong disability involving vision, motor, or hearing. Here, we report our findings from our community-engaged research with older adults who self-identify as members of the U.S. Deaf Community and who use American Sign Language (ASL) as their primary language. Using trained Deaf interviewers, we conducted semi-structured interviews in ASL with 60 Deaf participants (age 60-79 years) to understand their challenges performing various everyday activities (e.g., doing things around the home, activities outside the home, transportation, and managing health). Overall, our thematic analyses revealed that Deaf older adults navigate everyday tasks quite well. However, they experience particular challenges with technology, communication, and accessibility; specifically, fragile or inaccessible technology systems. For instance, technology alerting systems at home (e.g., smoke alarms) or airports (e.g., gate change announcements) are typically auditory. Accessibility is also poor when healthcare or wellness providers fail to provide an ASL interpreter. When probed about their responses to these challenges, Deaf older adults often reported frustration or resignation when experiencing barriers; the need for constant vigilance and self-advocacy; or reliance on hearing family members when systems fail them. Improving communication access and technologies that Deaf older adults rely on is critical and requires the inclusion of individuals from the Deaf community to identify the challenges and potential avenues for solutions.
USE OF THE EXERCISE FEATURE OF A HEALTHCARE APP AND CHANGE IN THE PREVALENCE OF LOWER BACK PAIN
Authors: Takase Mai , Odagami Kishimori , Eguchi Hisashi , Mori Koji , Itabashi Masako , Kono Sei , Shimizu Yosuke , Iijima Katsuya 
Published: December 2023

Abstract
Lower back pain among older adults has been associated with serious conditions, such as depleted cognitive function, and can accordingly limit the degree to which older adults can live independently. Therefore, it is extremely important to engage in exercise and conditioning activities from an early age. We developed a healthcare app with an AI engine that recommends personalized stretch, muscle training, and aerobic exercise programs. These programs were constructed by care prevention exercise experts and are personalized based on the user’s physical balance and the locations of their body pain. This study examined the association between the use of the exercise feature of this app and the change in the prevalence of lower back pain among users. A three-month longitudinal survey with three model companies in Japan (n=730) was conducted from the fall of 2022 to the winter of 2023. Online questionnaire surveys were administered to track the participants’ levels of lower back pain and app logs were retrieved to assess the users’ exercise records. Use of the exercise feature (not used vs. used) was the independent variable and change in the level of lower back pain (none to mild vs. mild to severe) was the dependent variable. A binary logistic regression analysis (n=331, female=34.1%, over 50 years old=43.5%) revealed that the use of the exercise feature led to lower level of back pain (OR = 0.37, 95%CI = 0.29-0.67). This result suggests that the use of this kind of exercise app may help alleviate lower back pain.
USER-CENTERED DESIGN FOR SOCIALLY ASSISTIVE ROBOTIC ACTIVITIES WITH OLDER ADULTS IN LONG TERM CARE
Authors: Maxwell Cathy , Ghosh Ritam , Khan Nibraas , Migovich Miroslava , Tate Judith , Latshaw Emily , Mion Lorraine , Sarkar Nilanjan 
Published: December 2023

Abstract
Apathy is common among older adults (OAs) in long term care (LTC) and associated with adverse outcomes. Engaging residents in socially interactive multimodal activities is resource intensive. Socially assistive robots (SARs) may supplement LTC staff resources. However, few studies have involved OAs in the design of SAR activity. We conducted a multi-step user-centered design process to design and evaluate SAR activities that a) used different robots (humanoid, puppy), b) a virtual reality interface, and c) required dyadic interaction between residents. Phase 1 (system design) focused on prototype development with input from literature and an advisory panel of LTC adults and staff. Phase 2 focused on determining usability measures. Phase 3 (iterative testing) focused on field testing at two LTC sites. Multiple sessions were conducted that required looping back to earlier stages of prototype development for refinement and improvement of both the activity and the system until end users deemed them usable.
Results: 12 residents (ages 72-92, 9 women) and 5 LTC staff participated in the design of four SAR activities (music, fishing, painting, and spelling). Perceived comfort and confidence improved from baseline (d=0.708). Interaction between pairs increased from 0.16/min to 1.14/min. LTC staff were able to administer the system.
Conclusion: Older LTC adults are pivotal in informing technology development and capable of providing essential information in use and acceptance of technology. Next steps include large scale feasibility and effectiveness testing in a clinical trial among diverse older adults residing in LTC facilities.
UTILIZING ADVANCED DRIVER ASSISTANCE SYSTEMS IN LATER LIFE: INSIGHTS FROM A LONGITUDINAL STUDY ON AGING DRIVERS
Authors: Louis Renee St , Eby David , Kostyniuk Lidia , Molnar Lisa , Zakrajsek Jennifer , Zanier Nicole , Nyquist Linda , Yung Raymond 
Published: December 2023

Abstract
Level 1 and 2 Advanced Driver Assistance System (ADAS) technologies (e.g., adaptive cruise control, blind spot warning, lane keep assist) are predicted to be available in approximately three-fourths of all vehicles worldwide by 2025. To realize the potential of these systems in extending safe mobility for aging adults, it is critical that the driver understands the functionality of the technology and uses the system appropriately. The current study examined demographic and vehicle technology questionnaire data from the Longitudinal Research on Aging Drivers (LongROAD) cohort study which concluded in December 2022. A total of 1,417 participants changed their vehicle throughout the study. There were statistically significant increases in the prevalence of all 15 ADAS technologies examined. Despite increases in prevalence, frequency of using the technologies remained unchanged across 5 years. Frequency of use also varied by functionality of the technology whereby participants reported higher frequency of using technologies that provide alerts, such as blind spot warning, than technologies that take action to assist drivers with vehicle operations, such as adaptive cruise control. Results showed differences in prevalence and use of technologies by income and education, suggesting disparities in access to vehicles with technologies that could help to create a safer driving experience. In consideration of the rapid proliferation of ADAS into the vehicle fleet, increased research into how older drivers learn about and use ADAS technologies will assist in efforts to develop tailored and accessible programs for training older adults to properly utilize ADAS available in their own vehicles.
WALKING CADENCE AS A MEASURE OF ACTIVITY INTENSITY AND THE IMPACT ON FUNCTIONAL CAPACITY FOR OLDER ADULTS WITH FRAILTY
Authors: Rubin Daniel , Hung Anthony , Hedeker Donald , Conroy David , Huisingh-Scheetz Megan , Brach Jennifer , Glynn Nancy , Danilovich Margaret 
Published: December 2023

Abstract

Background
Walking cadence has been suggested as a measure of activity intensity; however, it remains uncertain if prefrail and frail older adults can increase their walking cadence and if doing so leads to improvements in functional capacity. We aimed to determine if cadence can be increased and if this leads to improvement in functional capacity in prefrail and frail older adults.

Methods
We performed a secondary data analysis of a walking intervention in prefrail and frail older adults living in retirement communities. Patients were randomized to Casual Speed Walking (CSW) and High-Intensity Walking (HIW) groups. Our primary outcome was improvement in 6-minute walk test (6MWT) distance above the minimally clinical important difference (MCID). We performed linear and logistic mixed-effects regressions to analyze our aims.

Results
102 participants were included in the final analysis with 56 in the CSW group and 46 in the HIW group. Participants in the HIW group increased their walking cadence as compared to the CSW group during the intervention (HIW 100[88, 111] steps/min vs. CSW 77[65, 86] steps/min; P &lt; 0.001). Participants that increased their walking cadence demonstrated an increased odds of improvement in their 6MWT MCID (OR: 0.11, 95% CI: 0.033, 0.18; p=0.005).

Conclusions
Older adults can increase their walking cadence and walking cadence can serve as a surrogate measure of activity intensity during walking interventions. An increase of 14 steps/minute from their comfortable walking cadence increased the odds of improvement in 6MWT MCID.
EXTREME WEATHER AND HEALTH AMONG OLDER POPULATIONS: INDIVIDUAL AND CONTEXTUAL-LEVEL VULNERABILITY AND RESILIENCE
Authors: Choi Eunyoung , Wu Bei , Ailshire Jennifer 
Published: December 2023

Abstract
Intense, frequent extreme weather events pose a significant public health threat, particularly for middle-aged and older adults who may be at elevated health risk. Yet, the social and environmental factors that determine their vulnerability and resilience remain largely unexplored. This study investigates individual and contextual determinants associated with exposure to and the health effects of extreme weather. Data were from the 2021 California Health Interview Survey of adults aged 50+ (N=14,726). Respondents were asked whether they had experienced any hazardous weather events such as heat waves, floods, and wildfires in the past two years and whether mental or physical health was harmed by these events. About 53% were exposed to extreme weather events. Among the exposed group, 18% and 17% reported harm to mental and physical health, respectively. Logistic regression analysis revealed increased exposure risk among middle-aged adults (age 50-64), those with chronic conditions, people living alone, and residents of rural and unsafe neighborhoods. Similarly, mental and physical health harms were more prevalent among these groups, along with females and those with unstable housing conditions. Conversely, living in cohesive neighborhoods was identified as a resilient factor, associated with reduced mental (OR=0.78, p&lt; 0.05) and physical health risks (OR=0.70, p&lt; 0.01). This study reveals pronounced vulnerabilities to climate change risks among populations identified as socioeconomically disadvantaged. Moreover, the findings emphasize the role of contextual conditions in shaping vulnerability and resilience. Our study contributes valuable insights to develop targeted climate change mitigation strategies, fostering resilience among older populations and supportive communities.
EXPLORING PERCEPTIONS OF A SOCIALLY ASSISTIVE ROBOT IN ASSISTED LIVING: RECOMMENDATIONS FROM FAMILY CARE PARTNERS
Authors: Power Shannon , Smith Kasey , Burton Lydia , Abedine Reuben , Beer Jenay , Adams Anne 
Published: December 2023

Abstract
Research has shown that socially assistive robots are effective in delivering health and behavioral interventions to persons with and at-risk for dementia living in assisted living facilities. However, to gain a more comprehensive understanding on the potential benefits of socially assistive robots, family care partners should also be consulted for design recommendations. Thus, we conducted semi-structured virtual focus groups to investigate family care partners’ (N=10) perceived benefits, concerns, and design recommendations of a socially assistive robot for their loved ones with or at-risk for dementia. Robot interactions (e.g., activity reminders, trivia entertainment, health prompts) were presented to participants via video, followed by in-depth questions and discussion. Thematic qualitative analysis (intercoder agreement = 87.5%) resulted in most recommendations on usefulness and function (30%), followed by engagement and entertainment (18%), social attributes (15%), customization (14%), health promotion, education, and behavior (9%), appearance (7%), and other (7%). Family care partners recommended improvements to build interactivity, social connection, and usefulness, such as improvements to robot appearance, customization and adaptability in robot capability that matches disease progression, and considerations for ethical implementation (i.e., the robot as supplement, not replacement, of human caregiving). Our findings represent the personal perspective of care partners intimately acquainted with dementia and caregiving, and from this perspective, yield specific recommendations for useful design of socially assistive robots.
UNLOCKING PAIN MANAGEMENT FOR PEOPLE LIVING WITH DEMENTIA: AN INTERVENTION TO BE TAILORED
Authors: Na Annalisa , Sefcik Justine , Kwok Amy , Drazon Molly , Gitlin Laura 
Published: December 2023

Abstract
Effective pain management for persons living with dementia (PLWD) is critical to quality of life and could be achieve through rehabilitative care. However, it’s not well understood how physical therapists (PTs) and occupational therapists (OTs) develop and deliver treatment plans for PLWD, as most pain studies and evidence-based guidelines explicitly exclude those with cognitive impairment. In this qualitative descriptive study, we explored clinicians’ perceptions of pain management in PLWD as recommended by available guidelines. Semi-structured virtual interviews of 6 PTs and 4 OTs from 4 outpatient facilities were all female, with an average age of 36.7 (SD 8.78) years and an average clinical experience of 7.01 (SD 4.81) years. We analyzed transcripts using conventional content analysis and identified a consistent theme that rehabilitative-based interventions for pain management among PLWD need to be “carefully tailored.” Clinicians explained that the plan of care they designed for PLWD need to be tailored to the patient’s underlying pain mechanism, physical function, and comorbidities that can affect their participation in therapy, to avoid activities that exacerbate pain symptoms, and take into consideration the extent of memory loss that the person is experiencing and their preferences. This study highlights the important factors practicing clinicians take into consideration when developing rehabilitative programs to manage pain among PLWD. These findings can guide the updating of current pain management guidelines so they are more inclusive and tailored to PLWD.
IS EDUCATION ENOUGH? SEATED YOGA AND FALLS PREVENTION FOR OLDER ADULTS
Authors: Kemeny Betsy , Bright Heather , Digman Leanne , McCormack Krista , Page Riley , Setto Madison 
Published: December 2023

Abstract
Falls impact 25% of older adults 65+ annually (Bergen et al., 2016) with 1 in 5 falls resulting in trauma (CDC, 2020). Standing yoga can reduce falls by 48% (Hamrick et al., 2017), but some older adults cannot participate in these poses/inversions due to pain, lack of balance, and endurance. Seated yoga can reduce pain, fear of falling, mobility, and balance ( Yao & Tseng, 2019). Ong et al. (2021) found that falls education improves intention to engage in prevention. Although CDC (2022) suggests multi-modal interventions , no known research compares a combination of falls prevention education and seated yoga intervention with an education-only control group. This controlled study compared fifteen older adults living in HUD housing who received both an 8-week “Get Fit While You Sit” seated yoga (LVSY, 2021) and falls prevention education to those who only received falls prevention education. Physical testing (Timed Up and Go (TUG), chair stand test, 4-point balance test) and attitude/participation measures were measured in both groups. Wilcoxon signed rank and Kruskal-Wallis were used to compare pre-to-post and between groups. Results suggest that the multi-modal intervention (combined education and chair yoga) resulted in improvements in TUG and chair stand test but other measures (e.g. self-efficacy for falls) did not change over time. The education-alone group did not improve over time. Between groups, a sig. difference was found in TUG and Chair stand. More research is needed but older adults in LTC settings may benefit from combining seated yoga with prevention education.
THE MULTI-DIMENSIONAL ROLE OF GRATITUDE IN FAMILY MEMBERS OF PEOPLE WITH EARLY-STAGE ALZHEIMER’S
Authors: McGee Jocelyn , Morgan Davie , Meraz Rebecca 
Published: December 2023

Abstract
The interest in and scientific understanding of the multifaceted construct of gratitude has grown in recent years. However, research on the role gratitude plays in the lives of family members of persons with early-stage Alzheimer’s disease is limited. The purpose of this study, therefore, was to uncover the ways gratitude is experienced and expressed in family members of persons with early-stage Alzheimer’s. Interpretative phenomenological analysis, a qualitative methodology, was employed to analyze the narratives of 27 family members. Expressions of gratitude were universal in the study but varied in the dispositional gratitude factors of frequency, intensity, span, and density. Relational conceptions of gratitude were expressed across three subthemes: (1) intrapersonal (e.g., family member grateful for how their own personal strengths and resources had aided them and allowed for growth while caring for their loved one with early-stage Alzheimer’s; family member grateful for the individual strengths their family member with early-stage Alzheimer’s had retained); (2) interpersonal (e.g., family member expressed gratitude for people who had positively influenced them such as prior role models for giving care to a person with Alzheimer’s and people who had shown the family compassion); and 3) transpersonal (e.g., gratitude for God or a divine entity or force that was deemed benevolent and helpful when it came to the experience of living with Alzheimer’s). Findings indicate that professionals should attend to gratitude in family members of persons with Alzheimer’s and leverage this multifaceted resource to improve health and well-being.
ADVANCING POSITIVE SOCIAL CONNECTIONS FOR OLDER ADULTS IN SUBSIDIZED HOUSING: A HUMAN-CENTERED DESIGN APPROACH
Authors: Pubien Sheena , Slogeris Becky , Bazurto Elizabeth , McDaniel Kennedy , Ulset Vilde , Latkin Carl , Boyd Cynthia , Cudjoe Thomas 
Published: December 2023

Abstract
Social isolation is a complex problem that impacts many community-dwelling older adults and has detrimental impacts on mental and physical wellbeing of older adults. This research aims to utilize Human-Centered Design (HCD) to develop and implement tools and design ideas that advance positive social connections of older adults residing in subsidized housing. HCD is a collaborative process used to understand and define social problems, identify opportunities, generate ideas, and design interventions to support positive change. We sought to capture the perspectives and insights from older adults living in two federally subsidized housing communities in Baltimore, Maryland. During a five-month period, we held listening and brainstorming sessions with over 50 residents, service coordinators and members of management. Valuable insights and ideas were recorded during each of these facilitated engagements and synthesized. Through our engagements we identified six themes that influence the social connections of older adults living in subsidized housing: feelings of exclusion, lack of community connections, burdensome transitions to communal living, changes to building policies, and concerns about the physical environment. These themes led to the creation of interventions such as providing physical materials to residents, facilitating cultural inclusion and connections, implementing effective engagement strategies for community coordinators and promoting resident leadership. HCD can be employed to develop tools and innovative opportunities that specifically target and address social isolation in older adults living in subsidized housing. HCD can be utilized to drive changes to policies that impact older adults in subsidized housing leading to social transformations to improve health.