bluuebunny/crossref_metadata_2025_split huggingface dataset:
CAREGIVER AND VETERAN PERCEPTIONS OF THE REFINING ELDER CARE IN AMERICA PROGRAM (RECAP)
Authors: Haverhals Leah , Magid Kate , Nunnery Mary , Manheim Chelsea , Young Jessica , Levy Cari 
Published: December 2023

Abstract
In 2021, the Veterans Health Administration (VHA) piloted the Redefining Elder Care in America Program (RECAP) at two Department of Veterans Affairs (VA) health care centers. RECAP identifies Veterans at risk for nursing home placement, and coordinators conduct a phone assessment with Veterans or their caregivers to link Veterans to VA services. To identify benefits and challenges of RECAP from Veterans’ and caregivers’ perspectives, we conducted phone interviews (N=32) from October 2021- May 2022. We analyzed data using a thematic approach, finding that participants appreciated the proactive nature of RECAP, felt supported by RECAP coordinators, and felt the VA cared about them. Caregivers cited RECAP’s benefits, such as learning about VA services and having the RECAP coordinator as a point of contact to help them navigate the VA. Caregivers of Veterans who received services reported improvements in caregiver mental health, decreases in caregiver burden, and improvements in Veterans’ abilities to remain at home. A few caregivers were uncertain if they could trust the RECAP phone assessment, thinking it was a scam, and two reported challenges contacting the coordinator after the assessment. Several caregivers expressed uncertainty about the timeline for service delivery and next steps to obtain services following the assessment. Caregivers described challenges related to receiving services including Veterans not being eligible for the chosen service and receiving fewer hours of home health care than desired. Overall, participants were satisfied with RECAP. Challenges identified should be addressed to best meet the needs of Veterans and Caregivers.
FUNCTIONAL LIMITATIONS AND ABSENCE OF CARE AMONG OLDER ADULTS LIVING WITH DEMENTIA IN CHINA, ENGLAND, THE EUROPEAN UNION, AND THE UNITED STATES
Authors: Lin Zhuoer , Qian Yuting , Gill Thomas , Hou Xiaohui , Chen Shanquan , Chen Xi 
Published: December 2023

Abstract
Assistance with daily living is essential for people living with dementia (PLWD) who also have functional limitations. Despite the growing demands for caregiving, the absence of care for PLWD with functional limitations can be large and concerning. Using harmonized longitudinal survey data (2012-2018) on community-dwelling adults aged 50+ from the US, England, Europe (covering 28 countries), and China, we provided the first comparative evidence on the global trends in functional limitations and absence of caregiving for PLWD. We demonstrated three alarming facts in both developing and developed countries: there was an overall increasing trend in the extent of functional limitations defined as difficulty with basic or instrumental activities of daily living (ADL/IADL) among PLWD; besides, about 1 in 5 PLWD received no care for their ADL/IADL limitations; and most importantly, the above absence of care has not improved over time in all studied countries, regardless of the stages of development. The patterns were evident for both ADL and IADL limitations and for informal and formal care. Our subgroup analysis showed consistency of these three facts, but also highlighted more worrying situations that about 2 in 5 PLWD received no care for their ADL limitations and at least 3 in 5 PLWD received no formal care. We also reported the greater absence of care for more vulnerable populations with less education and living alone. Our estimates highlight the urgency to ensure basic provision of care for PLWD with functional limitations, especially among those who are less educated or live alone.
MULTIPLE CHRONIC CONDITIONS AND DISABILITY IN VIETNAMESE OLDER ADULTS IN THE UNITED STATES
Authors: Miyawaki Christina , Garcia Joshua , Nguyen Kim , Park Van , Markides Kyriakos 
Published: December 2023

Abstract
Asian Americans recorded the highest life expectancy in the U.S. possibly due to selective migration as 86% of them are immigrants. However, the health of refugees such as older Vietnamese has been understudied. Using data from the Vietnamese Aging and Care Survey (VACS) collected in Houston, Texas, the 2nd-largest Vietnamese-populated metropolitan area in the nation, we assessed their chronic conditions, disability, depressive symptoms, and cognitive impairment, and examined the associations between their chronic conditions and disability by comorbidity clusters. Multivariable logistic regression models were used to answer the research questions. The respondents (N=177) were 76 years old (mean), married (62%), and female (58%). They lived in the U.S. for 24 years (mean) and spoke Vietnamese only (92%) in multi-generation (88%) low-income households (90% ≤$25K). They were in fair/poor health (84%) with 2 ADL/4 IADL disability (mean) and ≥3 chronic conditions (60%). Hypertension (79%) and arthritis (54%) were the most common chronic diseases. Respondents with ≥3 chronic conditions had significantly higher ADL (OR=2.77)/IADL (OR=2.33) disability and cognitive impairment (50%). However, cognitive impairment had the most significant impact on their disability (ADL:2.94-3.75; IADL:5.41-5.79) when combined with most common chronic conditions. Healthcare providers should pay special attention to older Vietnamese’ cognitive impairment due to their high prevalence and negative impact on their disability. Culturally and linguistically tailored healthcare services created by policymakers, healthcare professionals, and local social service agencies are recommended for the well-being of refugees who could not come as selected immigrants but migrated to the U.S. for a better life.
WHAT MATTERS MOST? REACTIONS TO THE RAISE ADVISORY COUNCIL’S NATIONAL STRATEGY TO SUPPORT FAMILY CAREGIVERS
Authors: Nadash Pamela , Tell Eileen , Qu Shan , Pallis Maryssa 
Published: December 2023

Abstract
This presentation reports on feedback from advocates and researchers, those working in organizations serving family caregivers, and family caregivers themselves regarding the 2022 National Strategy to Support Family Caregivers. The Strategy was issued by the RAISE Family Caregiving Advisory Council, created under the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (2018). A Request for Information (RFI) published in the Federal Register garnered nearly 600 responses from a wide range of individuals and organizations, providing feedback about top priorities for action, topics or populations that were not adequately addressed, and recommendations for actions that could help meet stated objectives; these comments will prove critical in implementing the National Strategy, as well as in updating and revising it. This presentation sets the progress of the National Strategy in context, reports on the RFI analysis, and describes next steps, highlighting key areas of focus for the federal government, states, and other entities. Priorities included expanding the direct care workforce and increasing access to caregiver training and supports, particularly respite. Other top comments pertained to financial and workplace security for family caregivers - encouraging caregiver-friendly workplaces, paying family members to provide care, and strengthening the Family and Medical Leave Act. Respondents broadly endorsed the Strategy and noted the need for campaigns promoting greater awareness of family caregiving. The findings suggest that there is strong consensus among caregiver advocates regarding the most critical areas for action and the most favored strategies to achieve caregivers’ priority goals.
LGBTQ-RELATED DISCRIMINATION REDUCES SLEEP QUALITY IN OLDER ADULTS: EVIDENCE FROM VUSNAPS AND UCNETS
Authors: McKay Tara , Tran Nathaniel , Trautman Lana , Clark Kirsty 
Published: December 2023

Abstract
Sleep is a critical protective factor for health outcomes with low-quality sleep linked to increased risk of diabetes, cardiovascular disease, and cognitive decline. Theoretical work proposes that minority stress may negatively affect sleep quality for LGBTQ and other minoritized populations. We examine differences in sleep quality across sexual orientation and gender identity and test the relationship between minority stress and sleep quality for LGBTQ adults. Data come from 1) UC Berkeley Social Networks Study (UCNets), a panel study of 50–70-year-olds with an oversample of older LGBTQ adults and 2) the Vanderbilt University Social Networks, Aging, and Policy Study (VUSNAPS), a panel study of older LGBTQ adults aged 50-76. LGBTQ identity includes participants who are transgender and/or gay, lesbian, bisexual, or something else. We estimate Poisson models predicting sleep quality as a function of LGBTQ identity and exposure to LGBTQ-related discrimination. Sleep quality is measured using three items available in both studies: 1) the number of nights per week trouble falling asleep, 2) number of nights per week trouble staying asleep, and 3) number of mornings per week waking well rested. Experiences of LGBTQ-related discrimination in the last year were measured using the Daily Heterosexist Experiences Questionnaire. We find that LGBTQ identity is significantly associated with poorer sleep quality compared to non-LGBTQ peers. Among LGBTQ adults, sleep quality declines as the number and intensity of recent experiences of LGBTQ-related discrimination increases. Poorer sleep quality may be an underlying mechanism exacerbating health disparities across sexual orientation and gender identity.
NEIGHBORHOOD SOCIAL TIES AND LONELINESS IN RETIRED AND CURRENTLY WORKING OLDER ADULTS
Authors: Keenoy Jaclyn , Ermer Ashley 
Published: December 2023

Abstract
Peripheral social ties such as coworkers and neighbors have been identified as helpful to protect against loneliness, considering their convenient geographic proximity and ability to contribute diversity into one’s social network (Sandstrom & Dunn, 2014). However, the importance of neighborhood social ties for older adults has rarely been investigated by employment status. We anticipated that with an absence of coworkers to serve as peripheral social ties, retirees will rely more heavily on neighborhood social ties to alleviate feelings of loneliness. Using Wave 3 of the National Social Life, Health, and Aging Project, 1,088 currently working and 1,594 retired older adults were compared using path modeling in Mplus (v. 8). We first ran an overall model and found that there was a significant negative association between neighborhood social ties and loneliness among all participants (p=.000). Next, we ran a multigroup model between working and retired older adults. In this model, neighborhood social ties and loneliness were negatively associated for both retired (p=.000) and working (p=.047) respondents. A Wald test revealed that these groups were not significantly different (p=.100). Our results suggest that neighborhood social ties help to alleviate loneliness similarly in both working and retired older adults. This is despite those currently working likely having a network of coworkers as peripheral social ties from their workplaces. These findings contribute to the broader literature on social networks, and particularly advance the social convoy model’s understanding of the importance of peripheral social ties, even in older age (Huxhold et al., 2020).
INSIGHTS ON THE CLINICAL NURSE ROLE IN IMPLEMENTING WHAT MATTERS FOR OLDER ADULTS IN ACUTE CARE
Authors: Taani Murad , Hook Mary 
Published: December 2023

Abstract
The Age-Friendly Health System (AFHS) evidence-based 4Ms framework (What Matters, Medication, Mentation, & Mobility) is designed to be implemented in clinical settings to reliably provide high-quality age-friendly care to older adults and reduce harm and hospital-associated complications. The 4M concept of ‘What Matters to You’ (WMTY) refers to assessing and aligning an individual’s specific health outcome goals and care preferences to ensure patient-centered care with a measurable impact on patient experience. While published toolkits support the implementation of WMTY for all disciplines, there is limited guidance and empirical evidence about the implementation and impact of this concept when used by clinical nurses in acute care. Some researchers have identified issues with implementing WMTY with patients who are not able to articulate their wishes or when the question is posed in a granular way. A large healthcare system in the Midwest supported five hospitals to implement the AFHS 4Ms including the WMTY concept but did not observe an improvement in nurse-sensitive patient experience measures. A qualitative study is in progress aimed at gaining an in-depth understanding of the knowledge, perceptions, and experiences of leaders and clinical nurses who have implemented the WMTY concept for older adults in their hospital to evaluate the implementation and impact on patient care. The results gathered by this study will lay the foundation for designing clinical nurse-targeted interventions to successfully implement WMTY and identifying supportive strategies for partnering with patients and their caregivers to ensure that their goals/preferences are fully integrated into care.
MOVIN PAST OBSTACLES: BUILDING A CULTURE OF MOBILITY
Authors: Glowinski Sarah , Hook Mary , King Barbara 
Published: December 2023

Abstract
Older adults are at risk for losing their ability to ambulate independently during hospitalization. The “MOVIN” (Mobilizing Older adult patients Via a systems-based Intervention) Study is a cluster-randomized control trial aimed to implement a nursing-led mobility model and monitor the change in nurse behaviors and unit culture before, during and after the 14-week intervention period. The model includes psychomotor training, mobility resources (equipment and ambulation aide), communication tools, ambulation pathways, and support for developing a “culture of mobility” led by nurses. It was launched on two inpatient nursing units at large urban Magnet quaternary medical center in Wisconsin in July 2021 (Unit 1) and March 2022 (Unit 2). Electronic reports based on documentation were generated to monitor patient ambulation and distances for feedback and celebration. The researchers and unit teams met often to implement and ensure intervention integrity despite increasing care demands and staffing shortages. Unit leaders navigated pandemic-induced obstacles including turnover, shortages, and high patient volumes by refining staff training, streamlining communication, promoting in-room walking, and finding creative ways to celebrate and build a culture within the COVID-19 restrictions. Unit 1 ambulated 75% of patients (20% increase) with distances averaging 47 miles/month (540% increase). Unit 2, with less ambulatory patients, ambulated 73% of patients (18% increase) with distances averaging 23.4 miles/month (680% increase). MOVIN is a promising system-based intervention that supports culture change and promotes nurse-led patient ambulation. Units were able to increase and sustain the quantity and quality of patient walking despite the obstacles imposed by the pandemic.
THE LONG LIVES OF PRIMATES AND THE ‘INVARIANT RATE OF AGING’ HYPOTHESIS
Authors: Alberts Susan 
Published: December 2023

Abstract
Can we slow the rate of human aging? A decades-long trend toward increasing life expectancy and greater lifespan equality in human populations raises the possibility that we can. But the rate of aging is closely correlated with other traits and may be highly constrained or even relatively fixed within species, according to the ‘invariant rate of aging’ hypothesis. To gain insight into biological constraints on aging, we use an unprecedented collection of datasets from 39 human and nonhuman primate populations, representing 7 genera distributed across the order Primates. We show that the highly regular linear relationship between life expectancy and lifespan equality reported in humans is recapitulated in other primate genera, and that variation in the rate of aging is several orders of magnitude smaller than pre-adult and age-independent mortality, which are highly variable within genera. Thus, within primate genera, longer life expectancies are associated with fewer early deaths, but not with a lower rate of aging. We also demonstrate that changes in the rate of aging, but not other ageing parameters, can produce striking, species-atypical changes in mortality patterns. Our results support the invariant rate of aging hypothesis, suggesting biological constraints on how much we can slow the human rate of aging.
EXAMINING COVID-19 VACCINE–RELATED AGEISM IN TWITTER DATA
Authors: Bacsu Juanita-Dawne , O’Connell Megan , Cammer Allison , Chasteen Alison , Fraser Sarah , Azizi Mehrnoosh , Grewal Karl , Spiteri Raymond 
Published: December 2023

Abstract
During the pandemic, many high-income countries prioritized older adults for COVID-19 vaccination in an attempt to reduce mortality. This prioritization may have exacerbated ageism and intergenerational conflict, especially with the limited quantity of COVID-19 vaccines. This presentation examines vaccine-related ageism during COVID-19 on social media to inform future vaccination campaigns and policies. Using Twitter, we gathered 1,369 relevant tweets using the Twint application in Python from December 8, 2020 to December 31, 2021. Tweets were assessed using inductive thematic analysis and steps were taken to ensure rigor and trustworthiness. Based on our analysis, four main themes were identified including: i) Blame and aggression; ii) Misinformation and mocking content; iii) Ageist political insults; and iv) Challenging ageism. Our study identified issues of false information, hate speech, and ageist political insults that are contributing to intergenerational conflict. Although some tweets challenged this derogatory messaging and demonstrated intergenerational unity, our findings suggest ageism contributed to COVID-19 vaccine hesitancy among older adults. Accordingly, urgent action is required to challenge vaccine misinformation, counter aggressive ageist content, and support intergenerational unity during the pandemic.
ASSISTED LIVING ADMINISTRATORS’ UNDERSTANDING OF REGULATORY REQUIREMENTS IN SEVEN STATES
Authors: Carder Paula , Thomas Kali , Smith Lindsey , Reed David , Sloane Philip , Zimmerman Sheryl 
Published: December 2023

Abstract
Each state requires assisted living (AL) residences to employ an administrator whose job responsibilities include oversight of resident care, managing staff, and regulatory compliance. This study surveyed administrators of 151 AL residences in 7 states. These AL residences reflect 28 license types (e.g., based on level of care, dementia care services). Administrators were asked whether there were any regulations, policies or procedures that required their AL to do any of 11 health-related activities (e.g., staff able to check vital signs, advance directive on file, reporting change in condition to resident’s healthcare provider). Using health services regulatory analysis, we documented the applicable regulations for each of the 151 AL residences, then assessed whether administrator responses were congruent with the licensed requirements. Almost all (95%) administrators of AL residences governed by a licensure requirement regarding change in condition reported this policy in their residence. In contrast, less than half (48%) of administrators who work in an AL in our sample that state law requires to keep an advance directive on file for residents reported that they did not have a policy to do so. Over one-third (37%) of administrators who work in an AL required to have a policy of non-pharmaceutical treatment for residents with dementia said that they did not have this policy in place. Some administrators reported the presence of policies in the absence of state requirements, suggesting that these AL residences exceed minimum requirements. These results vary by AL license type both within and across states.
THE AGING BRAIN: A NEUROVISCERAL INTEGRATION PERSPECTIVE
Authors: Thayer Julian 
Published: December 2023

Abstract
Healthy aging is associated with significant changes in both the brain and the heart. The changes between these, the two most important organs of the body, are linked via the vagus nerve. Using a model of Neurovisceral Integration I will describe how autonomic imbalance and decreased parasympathetic tone in particular may be the final common pathway linking negative affective states and conditions to ill health. The central nervous system network that regulates autonomic balance is closely related and partially overlaps with networks serving executive, social, affective, cognitive, and motivated behavior. This inhibitory cortico-subcortical circuit may structurally as well as functionally, link psychological processes with health-related physiology. When the prefrontal cortex is taken “offline” for whatever reason, parasympathetic inhibitory action is withdrawn and a relative sympathetic dominance associated with disinhibited defensive circuits is released, which can be pathogenic when sustained for long periods. This state is indicated by low heart rate variability (HRV), which is a marker for low parasympathetic activation and prefrontal hypoactivity. In this presentation, I examine the normative changes with aging and the effect that stress may have on how the brain–heart connection changes with age. I will present data linking peripheral physiology to brain structure and function. I conclude by noting that significant sex and ethnic differences exist but that future studies are needed to more fully explicate how they may influence the aging brain and its association with the cardiovascular system.
TOWARD A BETTER UNDERSTANDING OF SOCIAL EXCLUSION IN LATER LIFE
Authors: Aartsen Marja , Myck Michal 
Published: December 2023

Abstract
Social exclusion (SE) – or the separation of individuals and groups from mainstream society - is a serious problem with adverse health and well-being outcomes and increased societal costs. Older adults form a vulnerable group as they tend to be excluded for longer periods than younger people. A growing body of knowledge suggests that SE is multidimensional, including social, cultural, economic, material, and geographical aspects. There are however noticeable knowledge gaps, of which some are addressed in this symposium. Three presentations are based on large cross-national data sets, the final is a qualitative study on a rarely investigated but relevant social group, i.e., older Roma people. The first presenter shows how childless older adults in Europe feel more excluded than older adults with children and discusses how normative pressures can exclude people from society (data from the European Social Survey, wave 1 and 10). The second presenter explains how depopulation of geographical areas can act as driver of SE through material hardship, low social integration and lacking public infrastructure in the depopulated areas (data derived from SHARE, wave 4 and 6). Based on unique data from Poland and Germany, the third presenter shows how associations between markers of SE and well-being are modified by the macro-social context and characteristics of the individual. By using an intersectional life course perspective, the last presentation indicates how pathways in- and out SE are linked to social and societal processes and the political history of a country in a socially deprived group.