bluuebunny/crossref_metadata_2025_split huggingface dataset:
A NEW METHOD TO IDENTIFY MEDICARE CLAIMS-BASED FACTORS ASSOCIATED WITH POST-ACUTE RECOVERY IN OLDER ADULTS WITH ADRD
Authors: Chen Chixiang , Shen Biyi , Falvey Jason , Shardell Michelle , Ren Haoyu 
Published: December 2023

Abstract
Nearly 300,000 older adults experience a hip fracture every year, the majority of which occur following a fall. Unfortunately, recovery from hip fracture is poor, where older adults diagnosed with Alzheimer’s Disease and Related Dementia (ADRD) spend a particularly long time in hospitals or rehabilitation facilities during the post-operative recuperation period. Because older adults value functional recovery and spending time at home versus facilities as key outcomes after hospitalization, identifying factors that influence days spent at home after hospitalization is imperative. However, few rigorous analytical approaches are available to help overcome potential sources of analysis bias such as hospital-level unmeasured confounders, informative hospital size, and loss to follow-up due to death. To overcome these challenges, we developed a new data science approach equipped with unsupervised learning to simultaneously handle statistical complexities that are often encountered in research using large administrative claims databases. The proposed approach is accessible and performs well in simulation studies. Analysis of 16562 Medicare beneficiaries diagnosed with ADRD who were aged 65 or older and experienced a hip fracture between 2017 and 2019 demonstrated that older age, longer length of stay in the hospital, more chronic health conditions, and less days at home before fracture are significantly associated less days spent at home in the 12-month period after hip fracture (p&lt;.05), while existing methods fail to detect some effects. Findings demonstrate that the proposed method can overcome bias in health services research using Medicare data and can lead to findings that may inform care and resource allocation.
A REVIEW OF PAIN MANAGEMENT FOR PEOPLE WITH DEMENTIA: A GENERAL SURGICAL PERSPECTIVE
Authors: Neville Emily , Wagstaff Ruth , Stolic Snezana , Neville Christine 
Published: December 2023

Abstract
As the global population ages and the prevalence of dementia increases, more people with dementia will present for surgery. Perioperative pain management, particularly for people who are not able to communicate effectively, is challenging for clinicians. Poor surgical outcomes may result if pain is not managed appropriately. The objective of this review was to synthesize the existing research about how pain is managed for people with dementia in the perioperative setting, discuss the implications for general surgery so clinical practice and surgical outcomes are improved. After an extensive database search, the themes identified were pain assessment including commonly used rating scales, the types and amount of pain relief, that people with dementia received less analgesia than people without dementia and the challenges for effective pain management. Findings determined that pain management needs a stronger evidence base, challenges are due to the impaired ability of the person with dementia to communicate pain and that clinicians have difficulty understanding pain behavior in people with dementia. Adequate pain management for people with dementia in the perioperative setting is important for a faster and better recovery and this matter will only become a bigger issue as the ageing population increases.
A SCOPING REVIEW ON BARRIERS AND FACILITATORS OF COMMUNITY ENGAGEMENT IN LEARNING HEALTH SYSTEMS
Authors: Hung Lillian , Wong Karen Lok Yi , Berndt Annette , Windsor Tracy , Vasarhelyi Krisztina 
Published: December 2023

Abstract
This scoping review identifies the challenges and enablers of community engagement in Learning Health Systems (LHS), an area where elder and health care have growing interests on. LHS aims to improve healthcare delivery, translate knowledge into clinical practice, and emphasize patient-centred outcomes. We followed the Joanna Briggs Institute’s (JBI) scoping review methodology. First, keywords and index terms were identified from MEDLINE and CINAHL databases. Second, using the keywords and index terms identified in the first step, other databases like Web of Science, PsycINFO, and Google were searched. Third, the reference lists of the chosen literature were searched. The results include 25 papers. The Assessing Community Engagement (ACE) Conceptual Model by Aguilar-Gaxiola et al. was utilized to inform the analysis. Active community engagement enhances the relevancy and applicability of health research and fosters trust and rapport between healthcare providers and their communities. It is essential to have appropriate support, mutual respect, culturally sensitive and locally relevant processes with common-ground language. We identified several barriers to engagement: 1) meaningful motivations, 2) logistical challenges in processes, 3) disparities in power dynamics, 4) cultural misunderstanding, and 5) lack of knowledge and skills. The review underscores the need to move beyond tokenistic engagement towards genuine community collaborations. Future research should investigate the facilitators that enhance such meaningful partnerships.
A SYSTEMS APPROACH TO PRACTICE TRANSFORMATION FOR BRAIN HEALTH INTEGRATION INTO COMMUNITY HEALTH CENTER SERVICES
Authors: Lindholm Cassie , Modica Cheryl 
Published: December 2023

Abstract
Community Health Centers are America’s largest and most successful primary care system, providing access to quality healthcare services to more than 30 million Americans through more than 14,000 service delivery locations regardless of patients’ ability to pay. The National Association of Community Health Centers (NACHC) provides the training and education that health centers need to advance practice transformation and improve care delivery models to succeed in value-based care and meet the needs of patient populations. Through the Value Transformation Framework (VTF), NACHC provides an approach to support health center systems change, organizes and distills evidence-based interventions, provides knowledge, tools and resources, and links performance to the Quintuple Aim – improved health outcomes, patient and staff experience, reduced costs, and equity. NACHC guides health centers in the application of the VTF through a nation-wide learning community, Elevate. Health center participation in Elevate is linked to improved performance on clinical quality measures, improved patient and staff experiences, and reduced costs. Within the Elevate, NACHC successfully implemented a learning track focused on brain health, offering health center-specific guidance on a clinical introduction to Dementia early detection/risk reduction; incorporating Dementia early detection/risk reduction into care management workflows and leveraging reimbursement opportunities; and strengthening community linkages and partnerships to support Dementia early detection/risk reduction. Evaluation data from this learning track indicates health center interest in continuing education related to brain health integration into health center services. This topic is especially relevant considering the increasing population segment of older adult patients that health centers serve.
ADVANCING GERONTOLOGY THROUGH EXCEPTIONAL SCHOLARSHIP (AGES): FIRST INSIGHTS FROM A NEW MENTORSHIP MODEL
Authors: Bacsu Juanita-Dawne , Baker Zachary , Petrovsky Darina , Rahemi Zahra , Sefcik Justine , Ma Kris Pui Kwan , Smith Matthew 
Published: December 2023

Abstract
Mentorship is vital to supporting professional growth among early career faculty members. Working with the Gerontological Society of America, the Advancing Gerontology through Exceptional Scholarship (AGES) Program was created as a mentorship model to promote productivity and peer support for early career faculty members. This presentation will: 1) describe the AGES Program as a prototype to facilitate peer support, collective learning, productivity, and co-authorship opportunities to advance early career faculty members; and 2) identify effective strategies to facilitate other groups looking to develop high-quality mentorship and training programs to support early career faculty members. After a competitive process, a cohort of 7 AGES members (including 2 program co-leads and 5 participants who all studied dementia) partook in monthly workshops from November 2022 to June 2023. Drawing on our experience with the AGES Program, we identified four strategies that cultivated our AGES Program: 1) being adaptable to address mentorship needs; 2) establishing accountability measures to enhance productivity; 3) fostering collective learning and peer support; and 4) delivering inspirational and educational activities. Following on the completion of the AGES Program, an open discussion was held with the cohort to assess and critically reflect on the program. Discussion results indicate the AGES Program was valuable in supporting early career faculty members. Specifically, findings demonstrate that the program was perceived as successfully supporting team science, collaborative opportunities, and enhancing productivity. Next steps are to conduct an anonymous evaluation survey to identify specific areas to strengthen and enhance the program for future cohorts.
AGE AS A FACTOR IN DIVERSITY, EQUITY, AND INCLUSION INITIATIVES IN HIGHER EDUCATION
Authors: Galucia Natalie , Morrow-Howell Nancy 
Published: December 2023

Abstract
At institutions of higher education, demographic shifts in the population and the growth of diversity, equity, and inclusion (DEI) initiatives are occurring simultaneously. This study seeks to understand their intersection by focusing on age as a diversity factor in DEI initiatives on college campuses. Six focus groups with a total of 42 DEI staff members were convened, including 36 colleges/universities across the country. Thematic data analysis was conducted by three members of the research team who reached consensus on themes, subthemes, and representative quotes. Focus group participants suggest that age as an identity factor is not given much attention in DEI initiatives. Participants acknowledge the issue of age; but in general, they strive to keep other identities, like race and gender, in the forefront, especially in the face of low resources. These findings can be understood in the context of the current political environment around social justice issues and the pervasive ageism at the society level, especially in age-segregated institutions of higher education. While it may be difficult to elevate age in DEI initiatives on campuses, interventions were identified; and advocacy efforts may move us toward advancing age diversity, equity, and inclusion in higher education as well as other organizations.
AGING AND WELL-BEING: TESTING MINDFULNESS AS A MEDIATOR AND RESILIENCE AS A MODERATOR IN A NIGERIAN SAMPLE
Authors: Amanambu Peace , Chukwuorji JohnBosco , Allard Eric 
Published: December 2023

Abstract
The mediating role of mindfulness on the relationship between age and affect (both positive and negative) has been established in Western samples. However, these associations have not been well considered within additional cultural contexts. The present study examined whether mindfulness mediates the relationship between increased age and both positive (PA) and negative (NA) affect. We also took an exploratory approach to assess the strength and direction of the age-affect relationship as a function of resilience. Participants were 242 (95 women, age range = 18-75 years, Mage = 41.79; SDage = 13.58) adults, affiliated with the University of Nigeria-Nsukka, who completed the Positive and Negative Affect Scale, Brief Resilience Scale, and the Mindful Attention Awareness Scale through Qualtrics. Separate moderated-mediation analyses were conducted for PA and NA. For the PA model, the only significant association was between age and mindfulness, with higher age predicting increased self-reported mindfulness. For the NA model, higher self-reported mindfulness predicted lower levels of NA. When NA was simultaneously regressed on age and mindfulness, the direct effect between age and NA was non-significant, but the indirect effect of age on NA through mindfulness was significant, suggesting that the association between age and negative affect was mediated by mindfulness. Resilience did not provide a significant moderating influence in the PA and NA models. The present findings suggest that older adults may experience diminished levels of negative affect due to an increased capacity for mindfulness. Hence, mindfulness-based interventions may be helpful in improving the well-being of older populations.
AGING MODULATION WITH EXERCISE AND MIMETICS
Authors: Lox Dennis 
Published: December 2023

Abstract
Understanding the molecular and cellular processes of the Longevity Pathway AMPK-SIRT1, and its activation by exercise and mimetics, plays a vital role in a series of molecular and cellular processes which stimulates optimal healthy cellular efficiency and functioning, ending with improved exercise tolerance. Knowledge of the role of exercise induced activation of the AMPK-SIRT1 pathway, and altering it towards dysfunctional processes and drivers of aging and disease propagation is important to understand to also understand. Cellular dysfunction unfortunately is the norm. This leads to molecular increase of P53 in a binding state not of DNA repair, but upregulation of gene transcription of NF-kB, which increases inflammatory cytokines, over activation of MTOR, and cellular senescence with secretion of the SASP. All these dysfunctions create feedback loops, which makes the process self propagating, resulting in progressive aging, and disease states. The most optimal state is regulation of the optimal molecular and cellular environment, via exercise or a mimetic stimulator of AMPK-SIRT1. Knowledge of the optimal body state for health, and enhancing this AMPK-SIRT process, is low body fat releasing beneficial adiponectin, and no inflammatory cytokines or adipokines. Training muscle releases positive myokines. Various mimetics can stimulate AMPK-SIRT1, such as Metformin, the mitochondrial derived peptide MOTS-C, AICAR, and other compounds intended for people with medical issues that prevents exercise. Some display a synergistic effect with exercise. Understanding, the benefits of exercise and modulation of aging, by encouraging healthy processes, and reducing the deleterious patterns is important to understand.
AGING SUSTAINABLY: A PILOT STUDY OF OLDER MIDWESTERN ADULT PERSPECTIVES ON ENVIRONMENTAL BEHAVIOR
Authors: Pedersen Megan , Walden Justin , O’Connor Melissa 
Published: December 2023

Abstract
Given their life experience and significant political power, the perspectives of older adults on environmental issues are crucial to addressing the climate crisis. Although unsupported by research, the general public tends to believe that older adults do not care about climate change. In seeking to overturn this belief, a qualitative responsive interview study was conducted. With a sample of 5 adults between 50 and 70 from North Dakota and Minnesota, this study is small, but can serve as a pilot study for more intensive research. Interview questions focused on older adults’ attitudes, personal behavior, and motivations for engaging (or not) in sustainable behavior. Although the sample size was small, findings showed that most older adults understand the need for sustainability and try to care for the climate in their own ways. Religion, financial incentive, and generativity can be strong motivators for sustainable behavior, but misinformation and distrust can act as de-motivators. Investigating older adults’ motivation to engage in sustainable behavior is a necessary step to involving more older adults in environmental advocacy. These interviews demonstrate that many older adults are willing to act on behalf of our shared planet, and future research may uncover more motivations and bring us closer to that goal.
ALLEVIATING WORRIES OF DEMENTIA AMONG OLDER ADULTS WHO ATTEND AN AGING BRAIN SEMINAR
Authors: Simonson Grace , Wehry Susan 
Published: December 2023

Abstract
Dementia worry is prevalent among older adults, and these concerns are often not addressed. Research demonstrates the public lacks accurate knowledge of dementia, which contributes to its negative perception. We hypothesized participation in an aging brain seminar would significantly alleviate dementia worry in older adults. The 45-minute in-person talk covered normal and abnormal aging brain changes, and research-based strategies for healthy brain aging. Attendees completed surveys immediately before and after the seminar. Both surveys included the 12-item Dementia Worry Scale (DWS), which uses Likert scales to assess dementia worry. Two additional Likert questions in the post-survey determined the immediate effect on dementia worry and intent to adopt new strategies. 7 sessions garnered 61 viable pre-post surveys from 160 attendees. 69% reported their dementia worry was somewhat or significantly improved; 68% reported they were very likely or definitely going to take action. Collectively, the Dementia Worry scale was reduced (median pre=19, median post=16, range= 12 - 41), but results were insignificant (p=0.058) likely due to the long-term nature of the questions. The aging brain seminar was successful. It resulted in an immediate reduction of dementia worry and intent to change behavior, and it can be effectively delivered by a medical student. Further research is warranted to determine if the seminar has a long-term effect on dementia worry and sustained adoption of healthy behaviors.
ASSOCIATION BETWEEN FRAILTY AND FIVE-YEAR MORTALITY AFTER HIP FRACTURE SURGERY IN OLDER PATIENTS
Authors: Choi Jung-Yeon , Kim Kwang-il 
Published: December 2023

Abstract
We aimed to identify the association between frailty and 5-year mortality after hip fracture surgery. The Hip-Multidimensional Frailty Score (Hip-MFS) was calculated using the Comprehensive Geriatric Assessment (CGA). The primary outcome was 5-year mortality. Among 1,363 patients who underwent HF surgery, 598 (44%) patients underwent CGA, and 536 patients were included in the final analysis. The mean age was 80.5 years and 71.3% were females. A total of 223 (41.6%) patients experienced postoperative complications. The median observation time was 1999.5 days, and the overall mortality rate was 60.4% (n = 324), whereas the 1-year mortality and the 5-year mortality rate after HF surgery were 13.8% (n = 74) and 42.8% (n = 235), respectively. In the multivariate regression analysis, after accounting for clinical and demographic factors, the high-risk Hip-MFS group and the group with postoperative complications had hazard ratios of 1.49 (95% confidence interval [CI] 1.090–2.037, p = 0.012) and 1.498 (95% CI 1.139–1.970, p = 0.004), respectively. Patients with postoperative complications with low Hip-MFS showed better 5-year survival than those without postoperative complications with high hip-MFS in the Kaplan-Meier curve (p = 0.013). Compared with the occurrence of postoperative complications, the frailty status evaluated with the Hip-MFS had a more significant impact on long-term mortality after hip fracture surgery.
ASSOCIATION BETWEEN LATE LIFE EDUCATION AND COGNITIVE FUNCTION AMONG U.S. OLDER ADULTS
Authors: Wang Nan , Dupre Matthew , Xu Hanzhang 
Published: December 2023

Abstract
This study assessed whether late-life education (LLE) was associated with better cognitive function and whether the benefits of LLE on cognitive decline differed by gender, race/ethnicity, and education level in a nationally-representative sample of U.S. older adults. We conducted a retrospective cohort study using six waves of data from the Health and Retirement Study ([HRS] 2008-2018) that included adults aged ≥ 65 with no baseline diagnosis of Alzheimer’s disease and related dementias (ADRD). Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7’s test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range=0-35). LLE was measured at every wave and was categorized as “once a month or more,” and “not in the last month [or never].” Covariates included participants’ demographic background, socioeconomic status, psychosocial and behavioral factors, and health-related factors. Of 12,099 participants (median age 71 [IQR=10]), engaging in LLE at least once a month or more was associated with better cognitive function and was equivalent to a 2-4 year delay in cognitive decline than non-participation in LLE. The association was only partially attenuated after adjusting for a wide range of covariates. In addition, the benefits of LLE on cognitive function did not significantly differ by gender, race/ethnicity, or prior educational attainment. This study provides new insights into the protective role of LLE on cognitive function and underscores the importance of continued learning among older adults.
ASSOCIATION BETWEEN SCHOOL DESEGREGATION AND THE COGNITION OF OLDER BLACK MEN: A CITY-LEVEL ANALYSIS
Authors: Perryman Collin , Anderson Taharka , Thorpe Roland J , Whitfield Keith 
Published: December 2023

Abstract

Objective
We sought to understand the relationship between school setting attendance (desegregated or segregated) and the cognition among older Black men.

Methods
Data from older Black men (n=153; age range: 50 to 89 years) from the Baltimore Study of Black Aging—Patterns of Cognitive Aging (BSBA-PCA) was used to explore the relationship between type of schooling and cognitive functioning. We conducted ANOVA and OLS regression analyses to find associations between schooling and various cognitive domains. The independent variable, school type, was measured using a variable assessing if participants attended a racially-mixed school in their youth. The outcome variable, cognition, was measured using global cognition, reasoning, memory, immediate recall, working memory, language, and perceptual speed.

Results
ANOVA analyses found that Black men who attended desegregated schools reported significantly better reasoning and global cognition. OLS regression analyses found that global cognition, reasoning, language, and working memory were significantly better performance in the OLS regression results. The multivariate analysis found that global cognition and reasoning yielded statistically better performance.

Conclusion
Our study provides insights to how cognition varies in Black men depending on the school settings in which they were educated. Additionally, our study finds evidence that past educational policies represent risk for poor cognitive health of older Black men populations.