bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF CLINICAL BIOMARKER AND DNAM-DERIVED BIOLOGICAL AGE MEASURES IN AN ELECTIVE SURGERY COHORT
Authors: Parker Daniel , McDonald Shelley , Starr Kathryn Porter , Blazer, III Dan , Hwang E Shelley , Kirk Allan , Lagoo-Deenadayalan Sandhya 
Published: December 2023

Abstract
Older adults face greater post-operative morbidity due to decreasing biological aging (BA)-associated physical resilience. BA measures may quantify these vulnerabilities. Common BA quantification approaches include measures derived from clinical biomarkers and whole blood DNA methylation. The Duke Surgery One Thousand Patient Cohort is a prospective biospecimen and data repository of patients undergoing elective surgery. Using a subset of this cohort (n=119; 61±13 years of age; 50% female; 21% African American), we sought to determine: 1) the inter-relationship of BA measures; 2) associations of race, sex, BMI, and surgery type with BA; and 3) associations of BA with American Society of Anesthesia (ASA) Classification Score . Clinical biomarker BA measures included Klemera-Doubal method (KDM), homeostatic dysregulation (HD), and PhenoAge. DNAm measures included the DNAm PhenoAge, Hannum Age, and GrimAge. We calculated BA advancement (BAA) as BA minus Chronological Age (CA). We calculated Pearson correlation coefficients and fitted regression models, adjusting for CA, sex, race, and BMI. Overall, participants were biologically older than their CA. Male sex and African American race were associated with greater BAA by most measures . Associations of surgery type with BAA were consistent across measures . Greater BAA by most measures was associated with a higher ASA Score, reflecting higher baseline surgical risk. In conclusion, BA measures using different quantitative approaches showed anticipated associations with demographic factors, surgery type, and surgical risk. Ongoing work will identify BA measures that predict adverse surgical outcomes, and that could be used to identify patients for perioperative prehabilitation.
EXPLORING MODELS OF CARE INTEGRATION TO ADDRESS THE NEEDS OF PERSONS AGING WITH HIV
Authors: Baim-Lance Abigail , Fix Gemmae , Laskow Thomas 
Published: December 2023

Abstract
By 2035, the majority of persons living with HIV will be 50 and older. The clinical and social needs of this population have been well documented, including the negative impacts of persistent stigma on quality of life and health outcomes. Responding to such needs requires integrated, patient-centered approaches to care and supportive services. Care integration is defined as the bringing together of two or more previously unlinked services. Care integration is used within and outside of the HIV care settings, but how such models should be designed or adapted for older persons with HIV (OPWH) is less certain given their unique needs. This symposium will explore case studies representing different models of care integration developed within and outside of HIV care settings, their relevance to OPWH, evidence of implementation including known barriers and facilitators, and opportunities to advance such models. Our first presentation describes an embedded geriatrics outpatient consultation service within an HIV care setting in New York City (Condo). Our second presentation focuses on the barriers and facilitators to the integration of substance use treatment into HIV care in Georgia (Bender). Our third and fourth presentations will describe service models developed outside of HIV care, which are now being applied to support OPWH including the Veterans Affairs patient-centered Whole Health approach (Fix) and the CAPABLE program to support aging in place (Smith). With our discussant, we will reflect on these models of integration to enhance care and support systems for this population.
BRINGING GERIATRIC CARE INTO THE HIV PRIMARY CARE CLINIC: A COMBINED HIV/GERIATRIC MULTIDISCIPLINARY CLINIC MODEL
Authors: Condo Angela , Baim-Lance Abigail , Golstein Nathan 
Published: December 2023

Abstract
Persons living with HIV (PLWH) experience accelerated and accentuated aging, developing co-morbidities at earlier ages and with higher frequencies than those without HIV. Older persons with HIV (OPWH) also experience geriatric syndromes. In 2020 we developed a combined HIV/geriatrics multidisciplinary clinic at Mount Sinai Hospital in New York where a geriatrician and multidisciplinary team including a nurse, pharmacist, and social worker are embedded in an HIV primary care clinic. Patients are referred for comprehensive geriatric assessments. We conducted a retrospective chart review after the first 15 months of the program to describe this population of OPWH living in NYC who are referred to a geriatrician. From 9/2020-11/2021, there were 183 appointments scheduled of which 112 (61%) were new patient visits. Sixty-two percent of patients came to their appointment. The average age of patients was 67 years. Fifty-seven percent identified as male. The majority of referrals (50%) were for cognitive assessment followed by mobility assessment (25%), polypharmacy (14%), multimorbidity (8%), advance care planning (1%), and other (2%). Based on this data, we identified a need to improve the show rate to our clinic and implement cognitive screening in OPWH. We have incorporated a community health worker into our interdisciplinary team to assist in this goal and continue to educate patients and providers on geriatric syndromes. A geriatric approach to care is crucial to incorporate into existing HIV clinical practices and we hope to optimize this integration based on the needs of patients and providers.
HOW CAN DYING, DEATH, LOSS AND BEREAVEMENT BE INCORPORATED IN THE POLICY AND PRACTICE OF AGING IN PLACE?
Authors: Dury Sarah , Smetcoren An-Sofie 
Published: December 2023

Abstract
‘Aging in place’ has been one of the key goals for policymakers in the last 20 years, often translated into policies of deinstitutionalization. Due to the high costs of residential care, the home has re-emerged as a key site for the provision and consumption of care and support. Several critiques of this evolution have been formulated, including the challenges ageing in place might represent for older people, leading to reduced quality of life, and the need to consider low quality of older people’s houses, meaning that older people’s homes might not be the “best” places to age. However, what has received too little attention in the whole “aging in place” discourse is the end-of-life. This symposium addresses this by illustrating that we cannot talk about ageing in place without talking about dying in place. The authors present research on how dying, death, loss and bereavement might be included in the ageing-in-place policy and practice: Doran sets the stage with a critical reflection of ageing in place and the need to reflect on joining up ageing in place and end-of-life theory and practice. Smetcoren reports on the development of a ‘maison de mourance’ in a ‘co-housing and co-caring’ project in Brussels. Dury discusses consolation spaces in Flanders and how they decrease the taboo on death, grief and loss in the neighborhood. And Stegen reports on the caring neighbourhood-movement in Belgium and how some orient themselves to becoming part of a worldwide network of ‘compassionate communities’.
EXPLORING THE ROLE OF THE COMMUNITY AT THE END OF LIFE: EXPERIENCES FROM A SMALL COMMUNITY-LED END-OF-LIFE PROJECT
Authors: Smetcoren An-Sofie 
Published: December 2023

Abstract
‘Care and living in community’ (CALICO) is an intergenerational co-housing and co-caring project in Brussels. Within this larger project, a small community-based initiative for palliative and end-of-life care was founded, called Maison Mourance. This initiative aims to mobilize capacity in the broader community to make ‘dying-in-place’ possible. Given the innovative and grassroots nature of Maison Mourance, the present study wants to understand its vision, functioning, roles of stakeholders involved and the challenges it faces. Therefore a qualitative study was conducted consisting of 10 in-depth interview with several stakeholders and 1 focus group with the steering committee. Their vision centers on creating a homelike environment where people at the end of their lives still feel part of the community. As organisation they want to be nonhierarchical in which each member, formal and informal, is valued and assigned a certain role. Attention is given to the central role of the patient and breaking taboos about dying and death by making it part of the (broader) community. Creating a supportive network of informal and formal actors in palliative care, and thus embedding care in the neighbourhood, is seen as a great added value. Future challenges are financing the project, expanding and keeping the network of volunteers motivated, designing an evaluation plan and selecting evaluation tools. Although this is a promising initiative in terms of community-led palliative care and for making ‘dying-in-place’ possible, the initiative faces several challenges and threats and thus it will be important to monitor future developments.
EXAMINING RELATIONS BETWEEN OLDER ADULTS’ HEALTH, WISDOM, AND WELL-BEING DURING TIMES OF HARDSHIP
Authors: Ardelt Monika , Aldwin Carolyn 
Published: December 2023

Abstract
This symposium investigates the roles of health and wisdom characteristics as older adults’ resources during difficult times and whether ill health might explain lower wisdom during the later years of life. The first two presentations explored COVID-related changes in mental health. Utilizing a national sample of 1258 adults, Park found that acceptance of negative emotions, emotion regulation, and perceived social support at the beginning of the COVID pandemic (mid-April of 2020) predicted middle-aged (36-60 years, Mage=52) and older adults’ (61-88 years, Mage=70) lower distress five weeks later. Feng and colleagues analyzed well-being changes in 69 older adults (50-77 years, Mage=59) from before COVID (Time1) to the summer of 2020 (Time2) and 18 months later (Time3). Multiple logistic regressions revealed that greater wisdom and better health at Time2 and higher self-transcendence and better health at Time3 increased the likelihood of being well-adapted across time. Cogdill-Richardson and Bluck examined grief adaptation among 54 older widowed adults (Mage=81). Regression analyses showed that greater wisdom and better physical functioning predicted better grief-related mental health. Whereas good health and wisdom are consistent predictors of well-being in old age, ill health itself is a stressor. Analyzing data of 976 older adults (51-99 years, Mage = 77), Ardelt and Jeste found that the negative association between age and wisdom might be due to ill health that reduces older adults’ sense of mastery, which might lessen their motivation for wisdom development. Overall, this symposium demonstrates how health, wisdom, and well-being are interrelated, particularly during times of hardship.
HIV KNOWLEDGE AND INFORMATION ACCESS AMONG FEMALE CANCER SURVIVORS IN NIGERIA
Authors: Nwakasi Candidus , Esiaka Darlingtina , Nweke Chizobam 
Published: December 2023

Abstract
While Nigeria remains heavily burdened by HIV, especially among Nigerian women, there is also a rapidly increasing incidence and prevalence of cancer among aging women in Nigeria. growing. A body of research posits that HIV can be detrimental to cancer survivorship experiences including a worsened health outcome for cancer survivors. Further, HIV-relevant healthy behaviors such as sexual and reproductive health may be limited by a knowledge gap in the relationship between HIV and cancer, thus, increasing the risk of negative health outcomes among cancer survivors. This stresses the importance of HIV prevention and health promotion among cancer survivors in Nigeria, and one of such prevention strategy is the use of HIV health information. This study employed a qualitative descriptive method to assess HIV knowledge and information access among female cancer survivors in Nigeria. Thirty female cancer survivors in Nigeria were recruited and interviewed using a semi-structured interviewing format. Findings based on their responses indicated their knowledge about the connection between HIV and cancer. The themes are comparing HIV and cancer, views on the effect of HIV on cancer, and seeking HIV health information. Our findings highlight the need to utilize tailored public health education interventions for the growing number of cancer survivors in Nigeria to reduce the risk of poor health outcomes in this population.
PSYCHOMETRIC EVALUATION OF A SWAHILI-TRANSLATED KESSLER 6 AMONG OLDER KENYANS
Authors: Muruthi James , Maina Lucy , Mwega Elijah , Kagai Violet , Muruthi Ndungu , Nwakasi Candidus 
Published: December 2023

Abstract
The six-item Kessler Psychological Distress Scale (K6) has successfully been used to screen psychological distress, albeit among primarily Western dwelling adults. A major advantage of the K6 scale is the capacity to measure a variety of mental health disorders, such as depression and anxiety. However, limited studies have investigated the applicability of the K6 scale to assess psychological distress among aging individuals in Africa. The purpose of the present study is to evaluate the psychometric properties of a culturally adapted (Swahili version) of the K6 in a sample of aging Kenyans. A sample of 376 participants (N = 376; mean age =69.56 years; 73.7% women) was obtained from three regions in Kenya. Factor analyses were used to examine the properties of the translated K6 in aging Kenyans. The correlation between the scale and other health measures were also estimated using structural equation modeling. Factor analyses revealed a single factor model. CFA demonstrated excellent fit (CFI = 0.950; RMSEA = 0.109). Internal consistency was good (alpha =.83) and the scale had acceptable correlations with chronic (r = .15) and physical health (r = .16). Results underlined that the K6 is a one-factor scale that can be used to measure psychological distress in aging Kenyans. These are promising results for health professionals who seek to conduct population studies on psychological health using a brief scale. Future studies should refine these results to maximize the utility of the K6 scale among aging Kenyans.
FACTORS CONTRIBUTING TO GROWING DEPRESSION AMONG ELDERS IN SUB-SAHARAN AFRICA
Authors: Adamek Margaret , Kotecho Messay 
Published: December 2023

Abstract
While growing research has addressed physical ailments and communicable diseases in the older adult population in Sub-Saharan Africa, little research has investigated mental health conditions such as depression and anxiety among older Africans. In many African nations, mental health diagnoses are not acknowledged let alone well understood by the general public. Little has been documented about the extent of depression among older adults in Sub-Saharan Africa and the factors contributing to depression among older African adults. This study used secondary sources and a synthesis of recent empirical literature to examine and document the extent of depression among older adults in Sub-Saharan Africa and the contributing factors to geriatric depression. Sources indicate that mental health symptoms of Africans are often considered the work of evil spirits or may be overlooked by families. Available studies report rates of geriatric depression ranging from 37.8% in Ghana, 40% in South Africa, 41.2% in Ethiopia, and up to 44% in Tanzania. Older women in Sub-Saharan Africa have higher rates of depression than older men. Contributing factors to depression include lack of formal education, chronic illness, unstable income, and waning social supports. With an estimated 2 out of 5 older adults in Sub-Saharan Africa experiencing depression, interventions are needed to address the factors contributing to depression among older adults as well as culturally relevant interventions to ameliorate current symptoms. Interventions common in Global North nations such as anti-depressant medication or private therapy may not be appropriate for older African adults struggling with depression.
POLICY SERIES: A SECURE RETIREMENT FOR OLDER WOMEN
Authors: Lindberg Brian , Hounsell Cindy 
Published: December 2023

Abstract
This session will address policy development related to women and their financial well-being in later life. Panelists will discuss the recently passed SECURE 2.0, the latest programs providing financial literacy to older adults, healthcare workforce related issues, and the role of the Consumer Financial Protection Bureau is protecting older adults from fraud and elder exploitation.
FEASIBILITY AND EFFICACY OF THE LEAD DEMENTIA ADVANCE CARE PLANNING INTERVENTION
Authors: Dassel Kara , Iacob Eli , Clayton Jordana , Aruscavage Nancy , Supiano Katherine , Utz Rebecca 
Published: December 2023

Abstract
Using our dementia-focused advance care planning tool (ACP), the LEAD Guide (Life-Planning in Early Alzheimer’s and Other Dementias), we implemented a 9-month NIH Stage-1 behavioral intervention to promote ACP concordance in community-based dementia dyads. Baseline concordance was assessed using individual responses on the LEAD Guide (patient for themselves, care partner as if they were the patient). Dyads compared responses, discussed discrepancies, and the patient revised their responses. Concordance for values (quality of life, burden) and preferences (care location and life-sustaining treatments) across the disease trajectory was calculated using cross-tabs. At baseline, dyadic discordance was less than 10% on quality-of-life measures except for whether the patient would prefer a longer but less satisfying life (23.8%); however, post-conversation, 5.9% of patients changed their responses. About a fifth of the dyads showed discordance regarding financial, emotional, and physical burden (19.0%, 19.1%, and 16.7%, respectively); however, post-conversation, a few patients changed their responses (14.6%, 8.8%, and 5.9%). At baseline, discordance on questions for life-sustaining treatments across the disease trajectory varied; ventilator (now 14.3%, future 26.2%), brain dead (16.7% now and future), feeding tube (30.1% now, 28.6% future), and severe pain (23.8% now, 21.4% future). Following conversations, a few patients’ changed their responses on these items (8.8%, 12.1%, 8.8%, and 12.1%). Higher discordance on value questions on burden compared to the quality of life may result from care partners’ bias. Fluctuations in concordance regarding life-sustaining treatments in the present versus future states of advanced dementia demonstrate the need to engage in more in-depth care conversations.
MOVING TOGETHER: IMPACT OF LIVESTREAM GROUP PROGRAM FOR PEOPLE LIVING WITH COGNITIVE IMPAIRMENT AND CARE PARTNERS
Authors: Barnes Deborah , Lee Jennifer , Chesney Margaret , Mehling Wolf , Nicosia Francesca , Sudore Rebecca , Chao Linda , Benjamin Cynthia 
Published: December 2023

Abstract
Moving Together is an online, mind-body, group movement program for people living with cognitive impairment or mild dementia (PLCI/D) and care partners (CPs). We performed a randomized, controlled trial to test the impact of Moving Together on quality of life (primary) or physical, cognitive, social or emotional (secondary) outcomes in PLCI/D or CPs. Study participants were enrolled as dyads and randomly assigned to intervention or waitlist control groups. Participants joined live-streaming classes for 1 hour, 2 days/week, for 12 weeks. Intention-to-treat analyses compared 12-week change between groups. We assessed 603 dyads for eligibility: 382 (63%) declined to participate, primarily due to lack of interest; 123 (20%) were ineligible, primarily due to lack of CP or moderate/severe dementia; and 98 (16%) were eligible and enrolled. Of these, 77 (79%) completed the 12-week assessment and 21 (21%) withdrew, primarily due to health or scheduling issues. PLCI/D were 77±11 years old, 44% women, 22% non-White/Hispanic, 32% Alzheimer’s disease, 26% unspecified/mixed dementia, 14% mild cognitive impairment, 10% vascular dementia, and 19% other/unknown causes. CPs were 66±12 years old, 78% women, 31% non-White/Hispanic, 71% spouses, 25% adult children, and 3% paid. Baseline characteristics were similar between groups. Participants who completed the program reported high satisfaction (98% good/excellent). There were no serious adverse events related to study participation. We conclude that Moving Together is a safe program with good retention and high satisfaction. Data collection will be completed in May 2023, and we will present efficacy outcomes at the meeting.
PROVIDER PERCEPTIONS OF FACTORS IMPACTING COUPLES’ EMOTIONAL DISTRESS AND ADJUSTMENT TO DEMENTIA DIAGNOSES
Authors: Bannon Sarah , Brewer Julie , Ahmad Nina , Cornelius Talea , Parker Robert , Dickerson Bradford , Ritchie Christine , Vranceanu Ana-Maria 
Published: December 2023

Abstract
Alzheimer’s disease and related dementias (ADRD) are increasingly common conditions that disrupt the lives of persons living with dementia and their spousal care-partners. At the time of ADRD diagnoses, many couples experience challenges that produce emotional distress and relationship strain. At present there are no interventions to address these challenges early after diagnosis to promote positive dyadic adjustment. As the first phase of a larger study, we conducted a qualitative study to elicit and systematically summarize the perspectives of ADRD medical stakeholders (e.g., neurologists, geriatricians, social workers, neuropsychologists, care coordinators) surrounding common factors impacting distress following ADRD diagnoses. Participants (n=15) were recruited from two U.S. academic medical centers and completed a 60-minute focus group or individual interview that was transcribed, deidentified, and analyzed using a rapid data analysis approach to thematic analysis. We identified findings within 3 overarching themes: reactions to diagnosis, changes in relationship roles/dynamics, and insufficient resources. Participants described couples’ distress surrounding one partner’s denial or lack of insight into the diagnosis and symptoms, experiences of loss and hopelessness, and uncertainty surrounding illness trajectory. They noticed changes in couples’ historic roles, social determinants of health, and divergent understandings and reactions to diagnosis as contributors to couples’ distress. Finally, providers observed unmet needs surrounding embedded counseling, care-planning, and financial support for current and future care needs. Most providers felt insufficiently prepared to help couples experiencing distress. Our findings underscore the importance of improving resources to address individual, interpersonal, and system-level factors that contribute to couples’ adjustment to ADRD diagnoses.