bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLUTTER AS A BARRIER TO MAINTAINING FUNCTIONAL INDEPENDENCE
Authors: Dozier Mary , Nix Caitlyn 
Published: December 2023

Abstract
Excessive levels of household clutter can increase fall risk and subsequently prevent older adults from living independently. This may be a particular concern for rural-dwelling older adults, who are likely to have a stronger sense of connection with their physical location. This talk will present data from a comprehensive baseline assessment administered to older adults enrolled in treatment studies for hoarding disorder in rural Mississippi (n = 25; mean age: 67). The majority of participants described themselves as “collectors,” (79%) and individuals who considered themselves to be collectors were more likely to have experienced at least one intervention from friends, family, or the community (42% vs. 20%). Thirty-two percent of participants reported they had experienced at least one fall in their home in the previous year and 60% reported they were at least “a little bit” concerned about falling in their home, with 20% indicating that they or someone else had expressed concern specifically about clutter increasing their risk of falling. In addition to fall risk, 28% of participants indicated having at least one health hazard in the home (e.g., mold, insect infestation). Forty-three percent of the sample reported low physical functioning and 50% of the sample indicated a high degree of loneliness. These results highlight the impairment experienced by rural-dwelling older adults with high amounts of clutter. Interventions that target de-cluttering may provide additional utility by also increasing the ability of these older adults to age in place.
PATIENT-FOCUSED TELEHEALTH 101: CONTENT, RESULTS, FEEDBACK, AND PLANS FOR REVISION AND EXPANSION
Authors: Freddolino Paul , Kim Ha Neul , Sun Fei , Bentley Megan , Macomber Catherine 
Published: December 2023

Abstract
A five-part patient-focused Telehealth 101 mini-course was offered one-to-one as part of a technology literacy program for older adults in a rural Midwest community who received home-delivered meals. Participants had already received content on basic digital skills including safety and security, email, internet browsing, videoconferencing, and photo tools. Topics included an overview of material to be covered, types of telehealth (real time encounters, remote patient monitoring, and patient portals), what to expect from providers, how to prepare for telehealth encounters, and a live simulation of a telehealth visit. Subjects rated the sessions positively, and patient engagement in health care (Patient Activation Measure scores) significantly increased after the training. The mini course was also offered virtually on Zoom to groups of older adults at five urban senior centers. Feedback from both settings suggest the need to reduce repetition in the material presented and to include more diversity in the personnel presenting the content, both live and through YouTube videos accessed as part of the content. Revision will also add content on mental health and substance abuse services available through telehealth.
RACIAL/ETHNIC DISPARITIES IN HELP-SEEKING BEHAVIORS IN OLDER AMERICANS WITH SUBJECTIVE COGNITIVE DECLINE
Authors: Qi Xiang , Pei Yaolin , Zhu Zheng , Wu Bei 
Published: December 2023

Abstract
Subjective cognitive decline (SCD) refers to individuals’ perceived decline in memory that negatively impacts the daily activities or work. Seeking help for SCD and/or related functional limitations may be beneficial as it can prompts screening and intervention for cognitive impairment. However, racial/ethnic minorities may face disadvantages in help-seeking behaviors due to healthcare access disparities, dementia-related stigma, and cultural differences. To investigate the racial/ethnic differences in help-seeking for cognitive problems among middle-aged and older adults with SCD and/or related functional limitation, we used data from the Behavioral Risk Factor Surveillance System (BRFSS) 2015-2021. The sample included 41,115 adults aged ≥45 with SCD and 20,227 (45.4%) with SCD-related functional limitation. We estimated the prevalence of help-seeking behaviors and conducted a logistic regression analysis accounting for BRFSS survey weights, missing data, state-level clustering, and covariates. Among those with SCD and/or related functional limitation, Asian American and Pacific Islanders (AAPIs) are least likely to initiate communication with their healthcare provider with their cognitive problems. In the multivariate logistic model, AAPIs (OR, 0.45; 95% CI, 0.33-0.61) and non-Hispanic blacks (OR, 0.76; 95% CI, 0.63-0.91) with SCD-related functional limitation were less likely to discuss cognitive problems compared to non-Hispanic whites. Our findings were consistent with studies suggesting that AAPIs with cognitive impairment were less likely to seek for dementia care due to their lower health literacy, limited English proficiency, and dementia-related stigma. Our study emphasizes the need for tailored interventions that promote early patient-provider communication to address racial/ethnic disparities in help-seeking for cognitive problems.
TRANSLATING SCIENCE INTO PRACTICE: APPLYING IMPLEMENTATION SCIENCE TO STREAMLINE FUTURE HIH ROLL-OUT
Authors: Nooraie Reza Yousefi , Sullivan Jennifer , Zimmerman Lindsey , Shin Marlena , Franzosa Emily , Dadgostar Porooshat , Levine Adele , Darcy Derek 
Published: December 2023

Abstract
The delay between establishing evidence-based practice and translating effective practices is well documented. This presentation will focus on the application of implementation science principles to the Department of Veterans Affairs (VA) Hospital-In-Home program using a staged approach. The stages are: 1) assessing current program implementation, 2) measuring organizational readiness with new sites, 3) developing tools and resources to assist new HIH sites, and 4) working with new sites interested in adopting the HIH program using a participatory implementation planning process guided by system dynamics. In this session we will profile our use of theories, models and frameworks including the Consolidated Framework for Implementation Research (CFIR) and Reach Effectiveness Adoption Implementation Maintenance (REAIM) framework. The CFIR Expert Recommendation for Implementing Change (ERIC) Mapping Tool will be introduced as useful to identifying strategies to overcome barriers to implementation. We will apply the participatory approaches for implementation planning, including Implementation Mapping, development of Implementation Logic Models, and Group Model Building to plan for the implementation of HIH in prospective sites. Key implementation science concepts and techniques will be introduced, along with a description of how participatory approaches will facilitate informed planning and stakeholder engagement in future implementation, adaptation, and roll-out of an evidence-based systemic program. Key anticipated outputs include a framework for the core components of HIH intervention, a catalog of important determinants of HIH implementation success, a profile of existing strategies to enhance implementation and sustainability, and a roadmap for the participatory planning of HIH implementation in future contexts.
EXPANDING INSIGHTS INTO LATE-LIFE DISABILITY USING OBJECTIVE ASSESSMENTS IN NHATS
Authors: Schrack Jennifer , Fazio Elena 
Published: December 2023

Abstract
The National Health and Aging Trends Study (NHATS) is a NIA-funded national panel study that conducts annual in-home interviews with a representative sample of US Medicare beneficiaries ages 65 years and older. Designed as a platform for the scientific study of late life disability trends and trajectories, NHATS fosters research to guide efforts to maximize health, promote independent functioning, and enhance quality of life at older ages. NHATS has collected performance-based measures of physical function since its inception (2011). In 2021 NHATS responded to expanded interest in objective measures of sensory loss and physical activity, by adding measures of vision (visual acuity, contrast sensitivity), hearing (pure tone audiometry), and physical activity (accelerometry). This symposium will introduce these measures and demonstrate their scientific application to answer key research questions related to physical and cognitive health. Dr. Schrack will present an overview of the accelerometry data collection procedures, as well as results by key demographic and health-related features. Dr. Twardzik will examine the association between features of participants’ social and physical environments and patterns of accelerometry-based physical activity. Dr. Martinez-Amezcua will examine the association between hearing and phenotypic frailty. Dr. Davoudi will present evidence on the links among sensory and motor function and risk of dementia. Finally, Dr. Wanigatunga will describe the association between measures of hand and leg strength and dementia incidence. Collectively, these presentations will highlight population-level associations of objective measures of health and function with physical and cognitive outcomes to advance the science of disability in older adults.
POLICY SERIES: AGING AND HEALTH POLICY UPDATE: A VIEW FROM WASHINGTON
Authors: Lindberg Brian , D’Antonio Patricia 
Published: December 2023

Abstract
Leading aging and health policy advocates will present their findings and viewpoints regarding aging and health care policy during a divided Congress. Issues will include behavioral health, social isolation, health care workforce, telehealth, hospice policy, elder justice and nursing home care, home and community-based services, and Medicare and Medicaid. The group will discuss what progress has been made during the 118th Congress and what is still possible in the election year ahead.
THERAPEUTIC CANNABIS USE: UNIQUE CONTEXTS FOR OLDER ADULTS
Authors: Cohen Pinchas 
Published: December 2023

Abstract
Nationwide cannabis use prompts new questions about its therapeutic use. Self-administered cannabis among older adults demands careful study on their treatment outcomes and consumption patterns, in light of a more accessible, legalized cannabis market. Changing sentiments toward the illicit drug urges new research into its viability as a treatment for conditions in older adults. Ailshire uses the 2018-2021 Behavioral Risk Factor Surveillance System (BRFSS) surveys to compare cannabis use by age group. The data, which is representative of 39 U.S. states, indicate that medical marijuana use increases with age. Furthermore, Kaskie’s Cannabis and Older Persons Study (COPS) uncovers the influence of age on cannabis use and motives for consumption. The study is grounded in three core objectives: distinguishing senior consumers from other age groups, distinguishing therapeutic and recreational use, and distinguishing life-time and naive cannabis consumers. With the support of the National Cancer Institute, Fahey conducts a cross-sectional study on consumption patterns of cancer patients over the age of 65, analyzing patient reported outcomes of symptom management through cannabis. Finally, Bluthenthal and Cohen perform quantitative, health surveys among 429 community-recruited people who inject drugs (PWID) to understand the potential benefit of a legal cannabis as a substitution for criminalized substances and alcohol. The papers in this symposium provide updated insights into widespread cannabis use among older adults. These findings may help forward conversations about the political and clinical changes that must be made in order to protect the therapeutic needs of older adults amidst a rapidly expanding cannabis industry.
THE LTSS STATE SCORECARD AND MULTISECTOR PLANS FOR AGING
Authors: Ipakchi Narda 
Published: December 2023

Abstract
Strong, comprehensive plans are crucial to secure lasting success in state LTSS systems. State Multisector Plans for Aging meet this need and are present and/or under development in more than a dozen states and DC. A Multisector Plan for Aging, a concept led by The SCAN Foundation, is a blueprint that: a) includes planning for 10 or more years; b) is often led by a governor with other executive and legislative leaders; and c) is developed to guide the restructuring of state and local policy, programs, and funding toward aging well in the community. For the first time, the LTSS State Scorecard credits states for having these plans. This portion of the symposium will describe Scorecard findings on Multisector Plans for Aging and address more broadly the important role of these plans to state leadership.
METABOLISM AND AGING
Authors: Baur Joseph 
Published: December 2023

Abstract
Reducing energy intake in the absence of malnutrition (caloric restriction) has long been known as the most robust and reproducible way to experimentally increase lifespan in laboratory models. However, our understanding of which metabolites and nutrient-sensing pathways interact with longevity and where they act remains rudimentary, and in many cases, controversial. This session will explore recent findings linking changes in metabolites to the aging process and to organismal health.
TRACING THE COORDINATED CONTROL OF NAD+ HOMEOSTASIS USING C. ELEGANS
Authors: McReynolds Melanie 
Published: December 2023

Abstract
Nicotinamide adenine dinucleotide (NAD+) is a vital coenzyme involved in redox reactions and cellular signaling. Its levels decline with age in humans, mice, and worms, leading to metabolic disturbances associated with age-related diseases. Interestingly, our studies in aged mice indicate that the rate of NAD+ synthesis remains unchanged, ruling out a lack of precursors as the cause of NAD+ decline. Instead, we found that tissues with lower NAD+ concentrations in aged mice exhibit higher fractional turnover, suggesting increased consumption as the primary driver of NAD+ decline during aging. This led us to hypothesize that the loss of NAD+ metabolic robustness and resiliency with age is linked to the hyper-activation and competition of NAD+-consuming enzymes. To investigate the physiological impact of NAD+ consuming enzymes on metabolic robustness, we used genetic tools and mass spectrometry in C. elegans. Surprisingly, we identified novel reproductive and aging phenotypes in mutant animals lacking specific NAD+ consuming enzymes, including Poly ADP-Ribose Polymerase (parp-1 and parp-2), TANKyrase (tank-1), and Toll and Interleukin 1 Receptor (tir-1). These mutants displayed significant reductions in fecundity and extensions in longevity. Additionally, employing High-Performance Liquid Chromatography coupled with Mass Spectrometry (HP-LC-MS), we examined the NAD+ metabolome across different developmental stages in our mutant strains, revealing notable metabolic disruptions associated with the loss of NAD+ consumers. In summary, our findings establish a novel connection between the hyper-activation of NAD+ degradation and the onset of reproductive aging. This research provides valuable insights into the role of NAD+ metabolism and its impact on aging-related processes.
INTERDISCIPLINARY WELLNESS CLINICS IN LOW-INCOME SENIOR HOUSING COMMUNITIES
Authors: Holmes Sarah 
Published: December 2023

Abstract
Low-income older adults may qualify to live in subsidized housing via the Housing and Urban Development (HUD) Section 202 program. Established in 1959, Section 202 is the only HUD program that provides housing exclusively for older adults. More than 1.8 million older adults receive this type of federal housing assistance. Older adults living in low-income senior housing communities are mostly people of color, socioeconomically disadvantaged, and at risk for poor physical and mental health and adverse health outcomes. Additionally, they have limited access to healthcare services and other resources such as internet use, healthy food options, opportunities for physical activity, and safe indoor and outdoor physical environments. Further they are at increased risk of high emergency room utilization and transfer to nursing home settings. The purpose of this project was to develop Interdisciplinary Wellness Clinics for older adults living in low-income senior housing communities and provide direct services including such things as blood pressure monitoring, medication management, hearing evaluation and cerumen removal, foot and nail care, pain management, management of acute medical problems, immunizations, and Medicare Annual Wellness Visits. Interdisciplinary Wellness Clinics are provided monthly to four low-income senior housing communities and serve approximately 500 residents living in these communities. This symposium will provide a review of residents seen and services provided with a focus on findings identified and interventions implemented; a description of the Medicare Annual Wellness services; and a review of approaches used to engage residents in using these services.
EFFECTIVE STRATEGIES FOR PREPARING STRONG CAREER DEVELOPMENT AWARD (“K”) APPLICATIONS
Authors: Lahvic Jamie 
Published: December 2023

Abstract
In this presentation, Dr. Lahvic will present critical policies, best practices, and resources to consider when preparing mentored career development award (“K”) applications. Dr. Lahvic will emphasize 1) Starting the process early; 2) Developing an application strategy, including reaching out to relevant program officials, identifying appropriate mentors and collaborators, and evaluating if the career development award will add value to your professional development trajectory; and 3) Understanding the application requirements. Using real, successful and unsuccessful career development applications as examples, Dr. Lahvic will highlight best practices in planning the research and career development strategy, including avoiding proposing an overly ambitious project and ensuring the project is a vehicle towards future independence and is distinct from mentor’s research. Knowledge of these practices and available resources to implement them will optimize the application process for individuals.
RISK FACTORS FOR DISABLEMENT WITH AGING IN CENTRAL MEXICO
Authors: Caudillo-Ortega Lucia , Blozis Shelley , Blanco-Arroyo Nancy , Harrison Tracie 
Published: December 2023

Abstract
Health, function, and social participation (e.g., disablement) were studied among community living men and women with mobility limitations living in central Mexico. Psychological (i.e., depression and activity effort), cultural (i.e., attitudes toward assistive devices) and social (i.e., personal resources) variables were tested with the goal to identify differential risk for worse health (Charlson Comorbidity Index) outcomes. We hypothesized significant differences based on psychological, social, and cultural influences. Data was collected using in-person, Spanish language surveys from 2019-2020. Measures were reliable and valid. The sample (N=257) were an average of 70.98 years (std 7.72) with an education of 6.97 years (std 7.22) and onset of functional limitation at 62.5 (std 15.07). Most reported female sex (51%). Using machine learning regression technique, statistically significant interactions were found: (1) Age was an important predictor of health; individuals clustered according to different age groups; those below 65 years had the best health; followed by those between 65 and 70 years, followed next by those between 70 and 75 years, and those over 75 years having the worst health, on average. (2) Age, biological sex, and depression were important predictors of function. Further, for those below 83 years, depression was related to function; specifically, for these individuals, those with depression levels above 18.3 had worse functioning relative to those who depression score was below 18.3. (3) age was an important predictor of social participation. For those with mobility limitations, age, sex, and depression were risks factors for disablement in Mexico.
POLICY SERIES: BUILDING TRUST, ADDRESSING BURNOUT AND EXPANDING THE DIRECT CARE WORKFORCE; THE 2022 REPORT TO DHSS AND CONGRESS
Authors: Pandya Naushira , Lindberg Brian 
Published: December 2023

Abstract
This symposium will review the key points and recommendations of the 2022 report to the Secretary of DHSS and Congress, prepared by the federally appointed Advisory Committee on Interdisciplinary and Community-Based Linkages in a blended didactic and interactive format. Clinician burnout following the Covid-19 pandemic is examined and root causes identified. Erosion of the patient trust in the public healthcare system and the consequences thereof are discussed, enhanced role of Community Health workers as the future primary care workforce is explored to prepare the system to prepare for future challenges.
BLUEPRINT TO TARGET THE SPINAL CORD MOTOR CIRCUITRY TO PRESERVE AND RESTORE MOBILITY IN OLD AGE
Authors: Valdez Gregorio 
Published: December 2023

Abstract
Spinal motor neurons are central for the initiation and modulation of all voluntary movements. Within the spinal cord, motor neurons form tens of thousands of excitatory (glutamatergic and cholinergic) and inhibitory (GABAergic and glycinergic) synapses along their dendritic arbor and soma. These synapses contain the information required to execute fine and complex motor commands and are together referred to as the motor circuitry. Once activated, motor neurons drive muscle contraction by releasing neurotransmitters from their axon terminals at neuromuscular junctions (NMJs). Thus, either the death of motor neurons or their disconnection from other neurons are skeletal muscles during aging would undoubtedly compromise motor function. We will show that motor neurons do not die in old female and male mice, rhesus monkeys, and humans. Instead, these neurons selectively and progressively shed excitatory synaptic inputs throughout the soma and dendritic arbor during aging. Thus, aged motor neurons contain a motor circuitry with a reduced ratio of excitatory to inhibitory synapses that may be responsible for the diminished ability to activate motor neurons to commence movements. Additionally, we will show that aged motor neurons present with aberrant changes in genes and molecular pathways with roles in glia-mediated synaptic pruning, inflammation, axonal regeneration, and oxidative stress. I will bring these findings together to suggest that motor neurons at a minimum contribute to the loss of their own synapses with advancing age and discuss possible avenues for therapeutic intervention.