bluuebunny/crossref_metadata_2025_split huggingface dataset:
EMERGING PALLIATIVE CARE INTERVENTIONS FOR HOMELESS ADULTS IN 10 US CITIES
Authors: ODonnell Arden 
Published: December 2023

Abstract
America’s adult homeless population is growing older; its median age is now 50 years of age. Due to harsh living conditions of chronic homelessness, these individuals often experience geriatric conditions in their 50s and 60s and face premature mortality. Yet, little is known about palliative care for this population. A 2017 systematic review of scientific journals revealed only six palliative care intervention studies for homeless adults. Anecdotal evidence, however, suggests community responses are emerging. Focusing on the 10 U.S. cities with the largest adult homeless populations, this exploratory study had two objectives: 1) through a web-based search of the “grey literature,” the identification of organizations developing or adapting programs to serve the palliative care needs of homeless adults; and 2) through in-depth zoom interviews with directors, gaining an understanding of the programs’ core aspects as well as their successes and challenges in development, implementation, and sustainability. The 18 interviewed agencies fell into two distinct service categories, healthcare/palliative organizations and homelessness/housing organizations. Identified modifications included targeted advanced care planning (ACP) groups, the development of an ACP repository for unhoused persons, rapid re-housing for terminally ill patients, harm reduction strategies, and hospice options in shelters. Common themes were the challenges of working across multiple systems and the lack of dedicated resources and funding for initiatives to support the population’s multiple and complex needs. The discussion highlights the need for greater organizational resources and flexibility in both the healthcare and homeless systems to promote value-based-goal concordant care for homeless adults.
OPPORTUNITIES AND BARRIERS IN INTEGRATING PALLIATIVE CARE SERVICES INTO PERMANENT SUPPORTIVE HOUSING
Authors: Johnson Ian , Traver Anthony , Light Michael 
Published: December 2023

Abstract
Despite well-known inequities in rates of serious illness and premature mortality among people experiencing homelessness, as well as the unique biopsychosocial and spiritual care needs of people with homelessness histories, there is a lack of translational research focused on palliative care service delivery within permanent supportive housing. This presentation will present data from the Research, Action, & Supportive Care at Later-life for Unhoused People (RASCAL-UP study) to describe the current practices, perceived barriers, and recommendations in providing support to older permanent supportive housing residents during serious illness and end-of-life. Through a thematic analysis of interviews with direct care providers (n=30) across multiple care settings, themes were identified: 1) the importance of on-site relationships; 2) cross-sector collaboration barriers; 3) interdisciplinary communication barriers within permanent supportive housing teams; 4) environmental and spatial considerations; and 5) missing levels of care between supportive housing and higher levels of medical care. From these results, we put forth recommendations for translational research, supportive housing policy, and capacity-building efforts for interdisciplinary and cross-sector healthcare and housing teams.
GAIT PARAMETERS IN OLDER BREAST CANCER SURVIVORS WITH PERSISTENT CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY
Authors: Visovsky Constance 
Published: December 2023

Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) results from chemotherapy for breast cancer treatment. CIPN symptoms persist causing significant loss of functional abilities and increased risk of falls. This study aimed to assess the spatiotemporal gait parameters in breast cancer survivors with CIPIN using an IMU system. We hypothesized that spatiotemporal gait parameters will differ between patients with persistent CIPN as compared to normative values. Thirty-two women who completed taxane-based chemotherapy for breast cancer and who have symptomatic neuropathy &gt;6 months following completion of chemotherapy. Gait was assessed using seven Inertial Measurement Unit (IMU) sensors positioned at the sacrum, upper and lower leg, and foot. Participants completed a 2-minute walk at a comfortable walking pace. The outcome variables assessed included gait speed, single limb support, stride length, gait cycle time, stance percent, swing percent, double support percent, and cadence. Mean age 65(10) years, gait speed was 0.95(0.2) meters/second, single limb support 37.9(2.2) % of gait cycle, stride length 1.1(0.2) meters, gait cycle time 1.2(0.1) seconds, stance percent 62.1(2.2)% GC, swing percent 37.9(2.2)% GC, double support percent 23.9(4.3)% GC, and cadence 104.6(12.3) steps/min. Gait parameters assessed in this study showed an excellent test-retest reliability (r &gt;0.86; ICC &gt; 0.90). This is the first study to assess gait parameters in older breast cancer survivors with CIPN. Breast cancer survivors with CIPN showed reductions in all gait parameters. Reduced gait speed and stride length are critical indicators of fall risk for women with CIPN. Our study confirmed differences in spatiotemporal parameters between patients with persistent CIPN.
THE “GOOD” CAREGIVER: DOES FILIAL PIETY NECESSITATE SELF-SACRIFICE?
Authors: Maulod Ad , Rouse Sasha , Lee Nur ’Atiqah , Malhotra Rahul 
Published: December 2023

Abstract
Family caregiving policies that amplify the enactment of ‘filial piety’ – respect and care towards parents, grandparents and older persons – are especially pronounced in Asian societies, where caring for older family members is culturally expected and appraised yet is associated with stress and burden. Numerous studies have shown that fulfilment of filial piety contributes to better psychological outcomes for caregivers while mismatched filial expectations contribute to poorer psychological outcomes. However, few studies acknowledge how filial care varies according to individual resources and socio-cultural contexts. We seek to understand how family caregivers negotiate their self-determination through filial care, which contributes to positive and negative caregiving experiences. We conducted in-depth interviews with 34 caregivers of older persons with functional limitations in Singapore, purposefully selected based on varying positive and negative caregiving experiences. For caregivers with predominantly negative caregiving experiences, filial care was seen as an act of sacrifice and expectation of duty, with low autonomy to exercise self-determination. In comparison, caregivers with predominantly positive caregiving experiences described filial care as an act of sincere love cultivated through close relationships with their care-recipient, and aligned to their self-determination. Strong family support was also evident in the latter. Treating filial piety as a ‘natural desire to care for parents’ obscures efforts required to amplify positive caregiving experiences while normalisation of self-sacrifice and suffering hinders caregivers from expressing burden and accessing support. A nuanced understanding of how caregivers negotiate filial care can inform policy interventions to empower caregivers and care-recipients and enhance intergenerational relationships.
WORKING THROUGH IT: EMPLOYMENT DISCRIMINATION, LABOR FORCE OUTCOMES, AND MENTAL HEALTH AMONG OLDER BLACK AMERICANS
Authors: Brown Lauren , Abrams Leah , Zhang Yuan 
Published: December 2023

Abstract
We examine lifetime experiences of employment discrimination as one pathway by which racism impacts Black older adults’ well-being. We use data from the Health and Retirement Study’s (HRS) leave behind questionnaire to characterize lifetime experiences of being unfairly fired, not hired, or not promoted among Black older adults (N=2,948) and test associations of employment discrimination with labor force status at age 62, job satisfaction among those working, and depressive symptoms. Employment discrimination was commonly reported by Black older adults, especially among men and those with any college education. Employment discrimination was not associated with employment status but was associated with job dissatisfaction (OR=2.00, p=0.001) and depressive symptoms (Beta=0.34, p&lt; 0.001). Findings demonstrate the detrimental impact of employment discrimination on Black older adults’ work experiences and mental health, while highlighting the limitations of HRS’s discrimination items. This research points to racism in the workplace as an obstacle to healthy aging for Black adults in America.
ACCEPTANCE AND COMMITMENT THERAPY INTERVENTION FOR PARENT CAREGIVERS: A STRENGTH-BASED APPROACH
Authors: Frederick Miranda , Lee Jeong Eun , Zarling Amie 
Published: December 2023

Abstract
ACT has emerged as a behavioral change approach that has been applied to address a wide range of challenges. Empirical research has shown that ACT can deliver positive long-term effects across various populations, including caregivers. Using six core principles of ACT, we have revised an acceptance and commitment therapy program (ACT) for custodial grandparents and their grandchildren. Our intervention program emphasized the importance of acceptance and promoting resilience among participants. This approach is particularly valuable for this population as the focus of the program is to strengthen their competencies, life skills and emotional resilience. The program consists of a web based ACT program with online coaching meetings across four sessions delivered for each age group. This program is unique in the sense that it utilizes both individual and group session techniques to facilitate the learning process. The main purpose of the program is to promote effective coping strategies, to reduce parenting stress among grandparents and to increase life skills (i.e., decision-making, proactivity) among children. Preliminary findings suggest that participating in ACT programs could help custodial, foster and biological parents improve self-efficacy, emotional well-being, higher self-confidence, social competence, lower depressive symptoms, and parenting distress, thereby leading to positive outcomes such as improved mental health and higher resilience.
BUILDING INTERDISCIPLINARY COLLABORATIONS ACROSS THE AGING CONTINUUM: ROLE OF CENTERS ON AGING
Authors: Shippee Tetyana 
Published: December 2023

Abstract
Interdisciplinary collaborations and team science are essential in advancing research across the aging continuum. This involves bringing together experts from different disciplines to work together to address complex topics related to aging. Yet, despite the value of building interdisciplinary collaborations, multiple barriers often exist, that include finding the time to connect, developing shared goals by faculty dispersed across different departments, and developing a commitment to learning from each other and having open communication. This symposium will review multi-pronged strategies to build interdisciplinary collaboration in aging as part of the Center for Healthy Aging and Innovation at the University of Minnesota. In particular, we will discuss the formation of Special Interest groups (SIGs), which have become one key way to encourage interdisciplinary collaborations. SIGs are member driven and are meant to encourage collaboration via joint publications, presentations and grant applications as well as other shared initiatives agreed upon by the group (e.g., resource identifications, book club). Each special group has its own sense of community and draws on members from different disciplines. The symposium will include presentations from four of the seven SIG chairs, focused on the Financial Decision Making SIG, Alzheimer’s Disease and Related Dementias SIG, Transportation SIG, and Aging and Chronic Disease Management SIG. Importantly, the symposium includes perspectives from faculty at different career ranks as well as PhD students.
EARLY-LIFE ORIGINS OF LATER-LIFE HEALTH AMONG OLDER BRAZILIANS: DIFFERENCES IN ASSOCIATIONS BY HEALTH CONDITION
Authors: Farina Mateo 
Published: December 2023

Abstract

Background
A rich body of literature has linked poor childhood health to adverse adult health outcomes in later life. This association, however, has largely been studied in high-income countries. Less attention has been given to other country contexts where childhood exposures and adulthood socioeconomic conditions are vastly different. Brazil represents an important context due to the significant growth in older adult population, significant rise in life expectancy, and rapid industrialization that occurred since the 20th century. Method. Data come from the ELSI-Brazil Study, a nationally representative sample of older Brazilians. Logistic regression was used to predict the association between childhood conditions (socioeconomic adversity and poor health) and adult health conditions (heart conditions, heart failure, diabetes, and stroke).

Results
Poor child health was positively associated with stroke, heart disease, and heart failure, but was not associated with diabetes or high blood pressure. Poor child socioeconomic status was associated with diabetes and stroke but not associated with heart conditions, heart failure, or high blood pressure.

Discussion
The importance of childhood conditions for later life remained important in Brazil, but questions remain as to why certain conditions were found to be significant while others were not. Differences may stem from larger contextual changes such as the impact of globalization on food choices during adulthood for these cohorts. This study highlights the significance of contextual and conditional factors in comprehending the multifaceted dynamics underlying the association between early life conditions and later life health.
MID-LIFE FINANCIAL STRESS AND COGNITIVE AND PHYSICAL PROBLEMS IN OLDER AGE: THE ROLE OF POTENTIALLY MODIFYING FACTORS
Authors: Kåreholt Ingemar , Nilsen Charlotta , Finkel Deborah , Sindi Shireen 
Published: December 2023

Abstract
Financial stress is an important source of chronic stress and has been associated with cognitive and physical impairments. This study investigates whether midlife financial stress is associated with the combination of cognitive and physical impairment, the role of potentially modifiable factors, and sex differences.
Methods: The Cardiovascular Risk Factors, Aging, and Dementia population-based cohort study from Finland was used (n=1497) (baseline collected 1972-1987, mean age 50 years). There were two late-life re-examinations (mean total follow-up 25 years). Midlife financial stress was measured using two questions on financial situation. Cognitive impairment was based on six cognitive domains. Physical impairment was self-reported. Potential modifying factors investigated were smoking, alcohol, physical activity, cohabiting/not, non-manual work, and sleep disturbances. Sex differences were investigated. We used path analyses with full information maximum likelihood estimation.
Results: Among women and men, midlife financial stress associated with cognitive impairment, physical impairment and their combination. Smoking and sleep disturbances mediated associations between financial stress, physical impairment, and combined impairments. Among men: manual/non-manual work mediated the association to cognitive impairments; cohabitation mediated to cognitive impairment; financial stress was associated with cognitive impairment only among smokers and stress had a stronger association to physical and combined impairments among non-drinkers. Among women, sleep seems to have role in the association between financial stress and cognitive impairment.
Conclusions: Midlife financial stress associates with late-life impairments, and lifestyle/sociodemographic factors may modify these associations. Sex differences were observed. Interventions promoting healthier lifestyle and psychosocial factors may buffer against the deleterious role of financial stress.
REVOLUTIONIZING COGNITIVE ASSESSMENT: THE POWER OF DIGITAL BIOMARKERS AND ECOLOGICALLY VALID METHODS
Authors: Roque Nelson , Sliwinski Martin , Katz Mindy , Anderson-Hanley Cay 
Published: December 2023

Abstract
Digital technologies have allowed neuropsychologists to utilize process-based approaches to assess cognitive function and change. Traditional methods of neuropsychological assessment involve obtaining single scores (often composites) to represent cognitive function. However, modern process-based techniques involve the use of digital data collection to acquire insights into both the manner and reasoning behind an individual’s performance. The present study will share insights into the task development and validation of active and passive digital cognitive assessments from two longitudinal studies of aging: (1) a study of non-dementia participants (N=322), ultra-brief mobile cognitive tests were administered up to six times per day for two weeks; and (2) a neuro-exergaming study (N=31) enrolling patients with MCI and their co-residing study partner, where participants used a study-provided tablet to complete a neuro-exergaming protocol and digital cognitive assessments (e.g., digital trailmaking and eStroop). We analyzed both traditional and process-based metrics in two studies, including mean response time and patterns of inaccuracy. Study one found significant correlations between MCI status and metrics for survey completion time, working memory, and processing speed. Study two found weak to moderate correlations between cognitive function measures from digital and paper-based neuropsychology. Our findings suggest that remote self-administered digital measures can detect subtle cognitive changes. The event-level data, which is collected through a process-based approach, has enormous untapped potential for discovering and confirming novel digital biomarkers of cognitive health and progression that can be monitored beyond clinical settings.
CATCHU: A NOVEL VISUAL-SOMATOSENSORY INTEGRATION TOOL FOR PREDICTING FALLS
Authors: Mahoney Jeannette , George Claudene , Verghese Joe 
Published: December 2023

Abstract
Ability to integrate information across sensory systems is a vital aspect of human functioning in the real world. While multisensory integration effects are measured across a wide array of populations using various sensory pairings and different neuroscience techniques, a gold standard for quantifying multisensory integration was seemingly lacking. We recently established a standardized protocol for administering and calculating behavioral multisensory integration effects across diverse clinical populations and age-ranges. Our previous work has linked the magnitude of visual-somatosensory integration (measured behaviorally using simple reaction time tasks) to important cognitive (attention) and motor (balance, gait, and falls) outcomes in healthy and cognitively impaired older adults. Given the paucity of extant translational multisensory integration tools in clinical settings, we recently developed a novel digital health app grounded in over 15 years of multisensory research. CatchU® (Before You Fall…) quantitatively measures visual-somatosensory integration performance, while considering medical comorbidities, to detect one’s fall propensity. Our goal is to facilitate the identification of patients who are at increased risk of falls and promote physician-initiated falls counseling in routine practice (e.g., annual wellness, sick, or follow-up visits). This will thereby raise awareness of falls and foster physician efforts to alleviate disability, promote independence, and improve the well-being of older adults, all while aiming to reduce the significant societal cost of falls in older adults and others at high risk.
AN INTEGRATIVE LITERATURE REVIEW ON SPIRITUAL NEEDS FROM THE PERSPECTIVE OF OLDER ADULTS LIVING WITH DEMENTIA
Authors: Zhao Hui , Boateng Augustine , Ezeokonkwo Francesca , Federwitz Chad , Epps Fayron , Britt Katherine 
Published: December 2023

Abstract
Spirituality is a part of successful aging, promoting better sleep, well-being, and cognitive function. Persons living with dementia (PLWD) are reported to have greater needs related to their spirituality (spiritual needs) compared to persons without dementia; however, support for spiritual needs is minimally present or absent in dementia care. Unmet spiritual needs may lead to depression, anxiety, and greater physical pain; thus, addressing the spiritual needs of PLWD is essential to support well-being and inform personalized care. Our integrative literature review explored characteristics of spiritual needs of PLWD and how to support them. ATLA Religion, CINAHL, PsychInfo, PubMed, and SocIndex were searched between 2000 and 2022, resulting in five original research articles meeting inclusion criteria focusing on spiritual needs of PLWD, including PLWDs’ perspectives. Most studies (n=4) were qualitative design, conducted worldwide in various settings, and included mild to moderate stage dementia. Components of spiritual needs covered the importance of connection and meaning for a sense of peace to support their identity and values. Connection to elements of spirituality included religion, meaningful relationships, nature, art, and self. Meaning was connected to past sources and experiences, supported by spiritual and religious activities. A sense of peace is supported through meaningful activities and religious rituals to help them rely on their faith through fear and memory loss. Support for spiritual needs may facilitate meaningful engagement for PLWD, leading to a sense of peace. Healthcare providers may utilize complementary, low-cost holistic care to promote personhood, values, and well-being among PLWD.
RELATIONSHIP BETWEEN CEREBRAL MICROINFARCTS AND DEMENTIA BY GENDER AMONG COMMUNITY-BASED OLDER ADULTS
Authors: Sin Mo-kyung , Cheng Yan , Roseman Jeffrey , Zamrini Edward , Ahmed Ali 
Published: December 2023

Abstract
Cerebral microinfarcts are common in older adults and associated with cognitive impairment. Less is known about sex-related variation in the relationship between microinfarcts and dementia in older adults, the examination of which was the objective of this study. This case-control study was based on 727 participants (308 men, 419 women) in the Adult Changes in Thought (ACT) autopsy data. Microinfarcts (presence, number, and location) were ascertained by blinded board-certified neuropathologists, and dementia diagnoses (yes, no) were made by the ACT Consensus Diagnosis Conference per DSM-IV criteria. Multivariable logistic regression analyses were conducted to examine the relationship. Microinfarcts were present in 356 (49%) participants (144 had one; 211 ≥2, 257 cortical, 216 subcortical), and 381 (52.4%) had dementia. More participants with dementia had ≥2 microinfarcts, although there was no difference in the distribution of a single microinfarct. Adjusted OR (95% CI) for dementia associated with any microinfarct was 1.36 (0.97–1.91). Respective ORs (95% CIs) in women and men were 1.45 (0.91–2.30) and 1.24 (0.75–2.06; p for interaction, 0.34). Adjusted OR (95% CI) for dementia associated with cortical and subcortical microinfarcts were 1.19 (0.83–1.69) and 1.65 (1.14–2.38), respectively, without any evidence of heterogeneity (p for interaction, 0.96 and 0.55, respectively). The presence of subcortical microinfarcts, but not cortical, had a significant association with dementia in older adults, but there was no evidence of a sex-related heterogeneity in that association. Future studies need to examine strategies to delay and manage vascular risk factors contributing to subcortical microinfarcts.