bluuebunny/crossref_metadata_2025_split huggingface dataset:
NAVIGATING THE DIGITAL DIVIDE: FACTORS INFLUENCING PATIENT PORTAL ADOPTION BY OLDER ADULTS DURING THE PANDEMIC
Authors: Jeong Chung Hyeon , Kim BoRin 
Published: December 2023

Abstract
The pandemic rapidly accelerated the adoption of digital healthcare technologies, including patient portals. The patient portals enhance patient-provider communication, streamline medical records management, and provides tailored education materials. Nevertheless, older patients, known as heavy healthcare users, often encounter challenges when adopting patient portals. This digital divide could lead to worsening health and healthcare disparities. Guided by the Senior Technology Acceptance and Adoption Model (STAM), this study explored the factors influencing the adoption of patient portals by older adults during the pandemic. We conducted semi-structured virtual interviews in 2021 with 31 older adults aged 60 or older with healthcare needs. Interviews were thematically coded and analyzed using constant comparative methods. The STAM proposes an orderly phase of technology acceptance among older adults, comprising three phases: 1) objectification, 2) incorporation, and 3) conversion. Our findings showed that some older patients felt compelled to use patient portals during the pandemic, bypassing the objectification phase, which is crucial for building an intention to use the new technology. Older patients who lack a strong intention to use patient portals tended to report challenges in the incorporation phase, rather than focusing on the usefulness of patient portals. From the interviews, we identified three overarching themes: 1) perceived concerns or limited benefits, 2) aging-related and system-related barriers, and 3) limited training opportunities. These themes could pose obstacles to the adoption of patient portals during the conversion phase. The findings of this study suggest areas for improvement to increase the adoption of patient portals among older patients.
ONE MINUTE TO RECOGNITION: THE AGITATION IN ALZHEIMER’S SCREENER FOR CAREGIVERS (AASC™)
Authors: Clevenger Carolyn , Brubaker Malaak , Patel Mehul , Cummings Jeffrey , Jackson W Clay , Stroud Jared , Pechin Sue , Grossberg George 
Published: December 2023

Abstract
Agitation is a common neuropsychiatric symptom of Alzheimer’s dementia (AD) and both a complex and burdensome aspect of patient care. Caregivers are often first to encounter agitation-associated behaviors and play a pivotal role in communicating these symptoms to healthcare providers (HCPs). However, most caregivers do not identify the breadth of signs/symptoms of agitation and are hesitant to discuss these behaviors with HCPs. There is, therefore, an unmet need for an easy, pragmatic screener to facilitate caregiver recognition of agitation associated with AD (AAD) and HCP discussions. Here, we report on the development of the Agitation in Alzheimer’s Screener for Caregivers (AASC™), a brief screening tool based on the International Psychogeriatric Association (IPA) consensus definition for agitation in cognitive disorders, designed to assist caregivers in recognizing agitation-associated behaviors in patients with AD. Initial draft development involved identification of specific behaviors that were discriminative for AD with/without agitation and representative of the full range of IPA-defined agitation behaviors (i.e., excessive motor activity, verbal aggression, physical aggression) based on current literature and input from 6 opinion leaders. An initial draft was then refined across 2 rounds of cognitive debriefing with caregivers (n=12; mean age=62 years) who described the screening tool as comprehensive yet easy to complete, and perceived it to be valuable, relevant, and easily understood. The AASC™ is a brief, easy-to-use tool supporting the identification and assessment of impact of agitation-associated behaviors. The screener can be completed by a caregiver in &lt; 1 minute at home or in an HCP’s office setting.
PATHOGEN APATHY RESULTING FROM SKN-1 ACTIVATION: A MARK OF RESILIENCE OR A RATTLED GUT FEELING?
Authors: Nair Tripti , Weathers Brandy , Stuhr Nicole , Nhan James , Gorla Vandita , Curran Sean 
Published: December 2023

Abstract
Innate immunity is a key driver in promoting survival against xenobiotic stressors and hostile environments and an appropriate immune response is essential to organismal health across lifespan. Caenorhabditis elegans encounter pathogens in their natural environment and initiate cytoprotective and immune responses that can have long-lasting effects on health, even after the pathogen has been neutralized. Pseudomonas aeruginosa (PA14) is an opportunistic pathogen that is lethal to C. elegans with prolonged exposure. C. elegans employ multiple defense mechanisms to ensure survival upon exposure to pathogens to defend against the current infection and to avoid continued exposure, including activation of the key cytoprotective transcription factor SKN-1 (mammalian homologue Nrf2). Although wild type C. elegans quickly learn to avoid pathogens, our current work documents a peculiar apathy to pathogen in animals with constitutive activation of SKN-1. The outcome is surprising as the role of SKN-1 is to protect an animal from intracellular and environmental insults. This behavior is mediated by tissue specific actions of SKN-1 that initiate cell non-autonomous responses for pathogen avoidance, survival, and metabolic adaptation. Based on transcriptional signature of animals with SKN-1 activation upon exposure to PA14 we observed that the apathy behavior is independent of somatic lipid depletion, thus uncoupling these two exceptional physiological responses. Further, we define the role of neurosignalling molecules in the gut-brain axis that drive the apathy response to pathogens. Our work reveals new insights into how animals perceive pathogens in the environment and subsequently alter behavior and cellular programs to promote survival.
RACIAL AND ETHNIC DISPARITIES IN SOCIAL ISOLATION AND 11-YEAR DEMENTIA RISK AMONG OLDER ADULTS IN THE UNITED STATES
Authors: Grullon Jason , Soong Daniel , Wong Roger 
Published: December 2023

Abstract
Social isolation has been linked to cognitive impairment. Research on this relationship, however, remains limited because validated social isolation measures have been underutilized when examining dementia risk, while also considering differences among racial-ethnic groups. To address this gap, we analyzed 11 years of data (2011–2021) from the National Health and Aging Trends Study to examine the interplay between social isolation, race-ethnicity, and dementia. We constructed a longitudinal score using a validated social isolation variable for our sample of 6,155 community-dwelling U.S. adults aged 65 years and older. After applying sampling weights and imputing missing data, our analysis revealed a higher average longitudinal frequency of social isolation among Black (27.6%), Hispanic (26.6%), and Asian (21.0%) older adults compared to non-Hispanic White (19.1%) respondents during the 11-year period (t=-7.35, p&lt;.001). Cox regression models indicated higher frequency of social isolation was significantly associated with a 45% increased dementia risk after adjusting for sociodemographic covariates (adjusted Hazard Ratio [aHR]=1.45, 95% CI=1.14-1.84, p&lt;.01), but this association was non-significant after further adjusting for health covariates (aHR=1.16, 95% CI=0.92-1.46, p=.20). Race-ethnicity was also not a significant moderator in the association between social isolation and dementia. Our results suggest older adults of color experience higher longitudinal frequency of social isolation. Despite the elevated dementia risk we observed among older adults with higher social isolation, race-ethnicity did not moderate this relationship. Future research is needed to investigate the underlying mechanisms contributing to racial-ethnic disparities for social isolation, and develop targeted interventions to mitigate the associated risk for dementia.
THE RELATIONSHIP BETWEEN SEDENTARY BEHAVIOR AND COGNITIVE DOMAINS AMONG PEOPLE LIVING WITH DEMENTIA
Authors: Patel Charmi , Lewis Stevie , Jehu Deborah 
Published: December 2023

Abstract
Greater sedentary behavior negatively impacts cognition among older adults without dementia; however, the relationship between sedentary behavior and cognitive domains among people living with dementia (PWD) is unclear. Our aim was to explore the association between sedentary behavior and cognitive domains in PWD in residential care facilities. The testing took place at one nursing home (n=15/23), one memory care unit (n=4/23), and one assisted living facility (n=4/23). Participants completed a battery of cognitive tests (global cognition: Montreal Cognitive Assessment; executive function: Trail Making test, Digit Span Backwards Test; perception and orientation: Benton Judgment of Line Orientation Test; language: Boston Naming Test; learning and memory: Rey Auditory Verbal Learning Test; complex attention: Digit Symbol Substitution Test). We used the Morse Fall Scale to measure fall risk. Participants wore an actigraphy monitor on their wrist over seven days to measure sedentary behavior. Most participants were male (74%), white (87%), and had unspecified dementia (48%). Participants were sedentary for 8.0±2.7 hours/day. The regression model for sedentary behavior was significant (R2=0.82, F(10, 12)=5.39, RMSE=92.47, p&lt; 0.05). Greater sedentary behavior was associated with poorer language function (β=-0.82, p=0.02), poorer learning and memory (β=-0.82, p=0.002), and greater fall risk (β=-0.43, p=0.03). Sedentary behavior was not associated with the other cognitive domains. Greater sedentary behavior may indicate a decline in language function, learning and memory, and increase fall risk in PWD. Sedentary behavior should be considered in routine assessments, as it may play an important role in monitoring cognitive decline in PWD in residential care facilities.
THE RELEVANCE OF COGNITIVE ABILITIES IN FRAUD DETECTION
Authors: Zhang Shenghao , Charness Neil , Boot Walter 
Published: December 2023

Abstract
Some previous studies suggest that cognitive decline might be responsible for older adults being susceptible to phishing attempts and frauds, but results are not consistent. The current study utilized a structural equation modeling approach to examine the role of different cognitive abilities in fraud detection. We used data from the baseline of the Intervention Comparative Effectiveness for Adult Cognitive Training (ICE-ACT, NCT03141281) Trial. The sample included 230 cognitively normal community-dwelling older adults (Mean age = 72). Reasoning was measured by Raven’s Advanced Progressive Matrices and letter sets. Memory was measured by Hopkins Verbal Learning Test and Rey Auditory Verbal Learning Test. Processing speed was measured by Digit Symbol Substitution Test and Useful Field of View. Fraud detection was represented by d-prime score calculated from rating of fraudulence in 10 vignettes describing fraud and non-fraud scenarios. Latent factors were created for reasoning, memory, and processing speed. Results showed that reasoning, memory, and processing speed explained 14% of variance in fraud detection, however, none of those cognitive factors uniquely predicted fraud detection. A higher-order general cognitive factor indicated by the reasoning, memory, and processing speed factors significantly predicted fraud detection and explained 13 % of variance. These results showed that general cognitive abilities have a medium effect in fraud detection in cognitively normal community-dwelling older adults. Discussion will focus on implications of those results on training and interventions aiming to prevent fraud in older adults.
THE USABILITY AND ACCEPTABILITY OF THE AUGMENTED REALITY HOME ASSESSMENT TOOL (ARHAT)
Authors: Fields Beth , Skrove Zachary , Tredinnick Ross , Sprecher Bryce , Lee Jenny , Shields Rachael , Ponto Kevin , Shin Jung-hye 
Published: December 2023

Abstract
Gaining access to reliable home assessments for aging in place can be challenging and expensive for urban residents and particularly those living in rural areas. Evidence has shown that there is a substantial increase in the number of older adults nationally and globally, making the availability of home assessments scarce. As individuals continue to age and become more susceptible to disabilities it is important that they have a home that allows them to age in place and is compliant with housing standards. Technology has the potential to make home assessments more accessible to older adults who want to age in place. The aim of this study was to determine the usability and acceptability of a mobile-based app, the Augmented Reality Home Assessment Tool (ARHAT), across different groups interested in home assessment (occupational therapists (OTs), older adults/family caregivers, and housing professionals) (N=16). Participants were mailed an iPhone with the ARHAT installed. After participants reviewed the ARHAT, they were emailed an electronic survey with closed and open-ended demographic, usability and acceptability questions. The majority of participants were White (94%), female (75%), from the Midwest (63%), and had a Bachelor’s degree or higher (81%). Participants reported that the ARHAT is easy to use and acceptable for measuring features of the home environment and can support aging in place. Future research should test the impact of the ARHAT on improving health service utilization (e.g., delaying institutionalization, reducing emergency department visits) rates among older adults.
VOICES OF LOW-INCOME LATINO OLDER ADULTS: WHAT ARE THEIR PERCEIVED LEARNING IMPEDIMENTS?
Authors: Rodriguez Tania , Wu Rachel 
Published: December 2023

Abstract
Cognitive and functional health disparities between Latino and White older adults show that Latinos have a higher risk for developing Alzheimer’s and related dementias (ADRD) in the United States. Such risk compromises Latino’s likelihood of becoming healthy agers, which is of high concern as they are one of the largest and fastest-growing minoritized groups in the United States. Nonetheless, there is a lack of research aiming to understand how to increase their cognitive and functional abilities. One way of stimulating cognitive and functional growth is through learning of new skills. However, learning is a privilege, and this population may face unique barriers to learning that other racial/ethnic groups may not, especially if they have a low income. This qualitative study focused on identifying the barriers to novel skill learning engagement of low-income Latino older adults. A total of 20 low-income, Latino older adults were interviewed in Spanish over the phone utilizing a semi-structured interview protocol. Themes were derived from the data using a thematic analysis approach. Our results showed that the following barriers were most common among our participants: health problems (80%), lack of money (75%), lack of awareness/knowledge of learning opportunities (75%), lack of technology access/literacy (75%), lack of proficiency in the English language (65%), lack of reliable transportation (55%), and lack of motivation due to being “old” (50%). These findings help inform learning program leaders, policymakers, and future learning interventions on the barriers that should be addressed for minoritized populations.
INTEROCEPTIVE ACCURACY ENHANCES DECEPTION DETECTION WITH GREATER AGE
Authors: Ebner Natalie , Heemskerk Amber , Lin Tian 
Published: December 2023

Abstract
Financial exploitation of older adults is a growing concern, with millions of seniors scammed annually, costing billions, and resulting in devastating consequences for health, independence, and well-being. Exploitation risk is exacerbated in Alzheimer’s disease and related dementias (AD/ADRD). Detecting deception is challenging, especially for older adults who tend to believe others are truthful. Understanding the neurobiological mechanisms underlying this susceptibility is essential to design effective intervention toward reducing exploitation in aging. In this research we demonstrate the importance of interoceptive awareness─the ability to interpret body signals─in deception detection in older adults. Seventy-six young (18-34 years) and 74 older (53-82 years) adults completed a heartbeat counting task to assess their interoceptive awareness. They also engaged in deception detection paradigms across two distinct, ecologically valid tasks: i) a lie detection task in which they made veracity judgments of genuine and deceptive individuals, and ii) a phishing email detection task to capture accuracy in online deception detection. Greater interoceptive awareness was associated with greater lie detection accuracy. Furthermore, with greater chronological age among older adults, greater interoceptive awareness was associated with better accuracy in both detecting deceptive individuals and phishing emails. These findings support interoceptive awareness as a relevant factor for interventions aimed at enhancing deception detection abilities in aging. Project results will advance insight into the neurobiology of deception detection to inform effective translation into intervention in mitigating exploitation risk in aging and eventually ADRD.
OLDER LGBTQ+ PEOPLE’S PERSPECTIVES ON DISCRIMINATION AND AGEING IN THE UK: EMERGING FINDINGS FROM A TIMELINE STUDY
Authors: Thomas Michael , Prescott Amy , Victor Christina 
Published: December 2023

Abstract
This paper presents emerging findings from a United Kingdom study of socially inclusive ageing, reporting on timeline interviews with a sample of 25 LGBTQ+ people aged forty years and above, carried out during summer and fall of 2023. The research interrogates older LGBTQ+ people’s understanding of the impact of minority sexuality and gender identity on their lived experience and the ways in which this impacts their approach to challenges and opportunities linked to ageing. We draw on an innovative methodological approach, adapting Adriansen’s (2012) timeline interview method to fit the needs of older participants. Timeline interviews provide an approach to life-story research that structures a conversation around a written timeline, produced on paper during unstructured qualitative interviews. During the paper presentation we share anonymised timeline and narrative data highlighting milestones in individual biographies. We focus on moments and periods where sexuality and gender identity may have been a positive factor in individual life stories (romantic relationships, community membership) or have been seen as more problematic (discrimination, stigma and marginalisation). The timelines and associated interview data also provide opportunities to ground the biographies of older LGBTQ+ people in the context of social, cultural, political and policy contexts. The timelines reveal compelling data about ageing and identity, belonging and exclusion. Our emerging findings reflect C. Wright Mills’s concept of the sociological imagination, placing personal troubles and histories in the context of public issues. We gratefully acknowledge the funding this study has received from the United Kingdom Economic and Social Research Council.
EVALUATING MHEALTH APPLICATIONS FOR OLDER ADULTS WITH DIABETES: SYSTEMATIC META-ANALYSIS OF CLINICAL TRIALS
Authors: Azevedo Renato Ferreira Leitao , Varzino Michael , Steinman Erika , Rogers Wendy 
Published: December 2023

Abstract
Diabetes is a common chronic condition among older adults and health technology interventions for diabetes management have the potential to support their self-management. However there is no systematic review and meta-analysis of the effects of mobile health applications (mHealth apps) for older adults. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effectiveness of mHealth apps for improving older adults’ diabetes outcomes. We searched the EBSCO, Clinical Trials, Cochrane Library, ProQuest, PubMed, ScienceDirect, Scopus, and Web of Science databases for relevant studies. We retrieved 4247 papers and two reviewers completed a full screen review of 257. We excluded papers if the study was not a RCT, did not examine the effect of mHealth apps, or was not conducted with older adults, resulting in 7 papers included in the final analysis. Our results indicate that mHealth apps can be effective for older adults managing diabetes, with significant reductions in glycated hemoglobin (HbA1C) (Hedge’s g: -0.40, 95% CI [-0.75 to -0.06]), and fasting blood sugar (FBS) levels (g: -0.29, 95% CI [-1.52 to 0.42]), as well as improvements in medication adherence (g: 0.93, 95% CI [0.53 to 1.28]). These effect sizes are comparable with other meta-analysis conducted across different aging groups. We describe each intervention and evaluate the risk of bias and the app components that could relate to effectiveness to inform the design of other diabetes management RCTs, and more broadly, the design of other mHealth tools for older adults. Pre-registration: http://doi.org/10.17605/OSF.IO/AWVCX
BRIDGING RESEARCH AND POLICY TO EXPAND SUPPORTS TO OLDER ADULTS LIVING ALONE WITH COGNITIVE IMPAIRMENT IN THE US
Authors: Portacolone Elena , Stone Robyn 
Published: December 2023

Abstract
Bridging research and policy allows research findings to have a lasting impact in the wellbeing of vulnerable population such as the estimated 4.3 million older adults living alone with cognitive impairment in the United States. For example, a lasting impact comes from healthcare and social services provided by Medicare and Medicaid tailored to address unmet needs of these populations identified via rigorous research. Despite the importance of bridging research with policy, researchers seldom collaborate with policy makers, thus missing the opportunity of influencing policies. Reasons for these limited collaborations include limited knowledge on methods for researchers to collaborate with policy makers. This session will draw from the expertise gained by the research team of the 5-year Living Alone with Cognitive Impairment Project to involve policy experts in the design of their mixed-method study. Regular interactions between the research team and the Policy Advisory Group led to: 1) a mixed-method design aligned with policy priorities; 2) a report highlighting the priorities of PAG members with regard to policies to enhance the wellbeing of older adults living alone in the US; 3) a series of policy briefs highlighting key findings and related policy recommendations. The oversight of a Policy Advisory Group allowed the Living Alone with Cognitive Impairment Project to focus research activities that are likely to be translated into policy solutions, thus likely to mostly benefit older adults living alone with cognitive impairment, with emphasis on communities of color. These practices can be replicated by researchers in studies supporting underserved populations.