bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECTS OF SOCIAL ENGAGEMENT ON WELL-BEING AND COGNITIVE FUNCTIONING IN OLDER HISPANICS
Authors: Liao Hsiao-Wen , Kang Hyewon 
Published: December 2023

Abstract
Research on engaged lifestyles demonstrates the importance of social engagement for aging well. The present study examined this thesis in the context of minority aging. With the theoretical lens that Hispanic cultures value social relationships, we tested whether social engagement was particularly important for maintaining well-being and cognitive functioning in Foreign-born (FB-H) and U.S.-born Hispanics (USB-H) relative to non-Hispanic Whites (NHW). Participants (N = 2677) was drawn from older adults in the Health and Retirement Study who completed the 2008, 2012, 2016, and 2020 module at least once. Two types of social engagement were assessed. Social interactions were based on the frequency of interactions with close partners (i.e., children, family members, and friends). Social activity participation was measured by the frequency of volunteering, doing charity, joining clubs, and attending meetings of non-religious organizations. Results of random intercept linear models controlling for covariates showed that, consistent with the literature, social interactions predicted better life satisfaction and that both aspects of social engagement predicted better immediate and delayed recall. Unexpected patterns emerged when interaction effects of race/nativity and social engagement were tested. While the general pattern held for NHWs, we found that greater social interactions predicted lower life satisfaction in USB-H. For FB-H, greater participation in social activities correlated with lower performance on immediate recall. Echoing a recent study that reveals mixed evidence for the well-documented paradox that Hispanic immigrants hold health advantages (Tarraf et al., 2020), we call for more research on lifestyle factors and aging trajectories in racially diverse populations.
STAYING SINGLE INTO VERY LATE LIFE: LONGITUDINAL ANALYSIS OF NEVER-MARRIED ADULTS
Authors: Nemmers Natasha , Martin Peter , Brottman Barbra 
Published: December 2023

Abstract
With the rise in life expectancy, the phenomenon of singlehood has also increased. However, most studies group unmarried individuals together (i.e., divorced, separated, widowed, never-married), and less is known about lifelong singlehood. This study aims to understand gender and never-married/married status differences in cognition, difficulty in activities of daily living (ADLs), and survival rates. Using the Health and Retirement Study (HRS) of older adults 69 years and older, we conducted longitudinal analyses of health from waves 2-5 and a survival analysis with waves 2-14. The never-married group (n=243) had a higher proportion of racial/ethnic minorities and women than the married group (n=7328) at baseline. Survivorship trajectories by marital group were significantly different: χ2(1) =13.26, p &lt; .001, such that married persons had a better chance of survival than never-married persons. We found significant gender differences in physical activities of daily living (PADLs, F=6.75, p&lt;.001) and instrumental activities of daily living (IADLs, F=9.03, p&lt;.001), indicating that women had greater functional difficulty than men. Regarding marital status, never-married persons had significantly more difficulty in ADLs than married persons only in waves 4 (F=10.22, p&lt;.01) and 5 (F=4.66, p&lt;.05). No cognition differences were found by gender or marital status. Consistent with prior work, these findings demonstrate the protective effect of marriage on mortality, though IADL-difficulty and cognition did not differ. This study will add to the sparse literature on lifelong singlehood. Future studies should consider other relevant covariates, like social network and personality, to inform tailored health interventions and policies for this subpopulation.
ASSOCIATION BETWEEN MOTOR ACTIVITY AND TOTAL NEUROPSYCHIATRIC INVENTORY NURSING HOME VERSION SCORES
Authors: Guseva Elena , Iaboni Andrea , Herrmann Nathan , Ismail Zahinoor , Lanctot Krista , Seitz Dallas , Burhan Amer , Wilchesky Machelle 
Published: December 2023

Abstract
Accurate neuropsychiatric symptoms (NPS) assessment monitoring is crucial for person-centered dementia care management. Doing so, however, is challenging, since current assessment tools rely on clinical observations, are time consuming, and are somewhat subjective in nature. The Neuropsychiatric Inventory Nursing Home Version (NPI-NH) is an informant-based assessment of 10 sub-domains of behavioral functioning where total NPI-NH score represents an overall behavioral disturbance level. We investigated the evidence pertaining to the diagnostic test accuracy (DTA) of motor activity tracking obtained via wearable sensor technology (WST) using total NPI-NH score as the gold standard in persons living with dementia (PLWD). This was part of a larger systematic review assessing the use of WST for NPS detection and monitoring carried out from inception until September 2022 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=219917). A systematic literature search carried out in 7 library databases produced 12,928 articles from which 84 titles were retained for analysis. In total, 8 articles examined the validity of WST for assessing and monitoring of overall behavioral disturbance in PLWD, among which 5 studies used motor activity trackers. Dementia participants predominantly had Alzheimer’s, vascular or mixed dementia (40%, 20%, and 40% respectively), with mild-moderate severity. Three studies reported correlations between motor activity and total NPI score that ranged from 0.35 to 0.38. A random effects model indicated that the pooled correlation across studies was 0.37 (0.22-0.51), with no heterogeneity (I2=0%). While our sample reveals WST test accuracy as being consistently moderate, more research is necessary for confirmation.
MIXED-METHODS EVALUATION OF A NOVEL MULTIMODAL COGNITIVE TRAINING “COGMUSE” IN OLDER ADULTS WITH INSOMNIA
Authors: Curtis Ashley , Costa Amy , Musich Madison , Rzeppa Chloe , Zemon Kevin , Schroeder Isaac , Sielert Charles , Wang Fang 
Published: December 2023

Abstract
Lack of pharmacological agents to improve cognition has prompted research on behavioral interventions, such as cognitive training (CT). CT benefit is inconsistent across non-patient populations. However, our recent work reveals multimodal commercialized CT shows promise for improving cognition and sleep in older adults with insomnia. Evaluation of non-commercialized CT allows for easy implementation of test scenarios/variables, monitoring and iterative optimization. This study: 1) created a novel non-commercialized CT for older adults with insomnia (“COGMUSE”) and 2) conducted usability testing/feature evaluation. COGMUSE is a computerized multimodal CT (Star Snatcher: targets spatial attention, perceptual motor skill, processing speed; Worse for Wire: targets spatial attention, inhibition). Ten older adults with insomnia complaints (Mage=69.3±3.3) completed 20 minutes of COGMUSE and the Game User Experience Satisfaction Scale (GUESS-18; rating 1-strongly disagree-7-strongly agree across game features). Open-ended feedback was solicited. Compiled transcripts were analyzed independently (A.F.C./F.W.) through deductive content analysis. Frequent topics/themes were identified. GUESS-18 average scores ranged from 3.5/7.0 (enjoyment) to 5.9/7.0 (personal gratification) for Star Snatcher, and from 3.1/7.0 (audio aesthetics) to 5.5/7 (play engrossment) for Worse for Wire. Feedback themes were largely positive (Star Snatcher: good graphics/sounds, easy/enjoyable; Worse for Wire: enjoyable, good instructions). Negative themes included quick movement and lackluster graphics/gameplay “story” (Worse for Wire) and lack of error consequences and practice trials (both games). Older adults with insomnia evaluated COGMUSE as easy and enjoyable to use with acceptable aesthetics. Improvement themes largely focused on instructions and navigation. Next steps include updating COGMUSE and evaluating its preliminary efficacy on cognition and sleep.
OTC SENIOR STATION: CONSUMER-FACING TECHNOLOGY TO PROMOTE MEDICATION SAFETY
Authors: Hill Jordan , Ganci Aaron , Patel Himalaya , Campbell Noll , Chui Michelle , Abebe Ephrem , Holden Richard 
Published: December 2023

Abstract
Over-the-counter (OTC) medications with anticholinergic effects (e.g. doxylamine, diphenhydramine) are widely used by older adults, despite their association with an increased risk of Alzheimer’s disease and related dementias (ADRD). Authoritative bodies, such as the American Geriatrics Society and National Academy of Medicine, recommend discouraging the use of both prescription and OTC anticholinergics. However, most interventions previously developed and tested have targeted only prescription anticholinergics despite the use rate of OTC anticholinergics being higher in older adult populations. Consumer-facing technology may be ideal for addressing OTC anticholinergic use as it is cost effective, scalable, and can address the constraints of relying on busy pharmacists to intervene during older adult OTC medication purchases; this has become especially relevant as pharmacies face staffing shortages, increasing pharmacist workload and requiring pharmacies adjust their hours of operation. Our interdisciplinary team of pharmacists, engineers, and designers engaged both older adults and pharmacy staff in the co-design of “OTC Senior Station”: a user-centered, consumer-facing kiosk to be placed in community pharmacies to promote reduced anticholinergic use by older adults. Kiosk users are prompted to input brief information, which is used to present safer alternatives to OTC anticholinergics (e.g., for insomnia management). This poster will present OTC Senior Station--what we believe to be the first consumer-facing technology to target OTC anticholinergic use—the participatory design methods used to create it, and the results of studies to assess its usability with older adults.
AN INTERSECTIONAL APPROACH TO UNDERSTANDING COMBINING WORK AND CAREGIVING ON MENTAL HEALTH
Authors: Brady Samantha , Patskanick Taylor , Coughlin Joseph 
Published: December 2023

Abstract
While an increasing number of Americans are providing unpaid care to an adult family member, the majority are balancing family care needs with employment responsibilities. Role conflict theory suggests the experience of combining family caregiving and paid work can detrimentally impact mental health, while role enhancement theory suggests that occupying both social roles can alleviate the burden of caregiving. Prior work finds support for both theories, however, there is currently a lack of causal evidence examining how mental health is affected by combining caregiving and employment roles. Additionally, while gendered differences and differences across racial identities in the family caregiving experience are well-documented, even fewer studies have taken an intersectional approach in understanding shifts in mental health when caregiving while employed. The current study uses a causal methodology to examine how the mental health of working adults is impacted when they transition into a family caregiving role and how these impacts vary at the intersections of racial and gender identity. Data are from the Health and Retirement Study (2004-2018), a nationally representative survey of U.S. adults aged 50+. Results from fixed effects models support role conflict theory, suggesting when working adults begin family caregiving they experience an increase in depressive symptoms. Additional analysis using an intersectional lens finds this result applied only to White working women who transitioned into a parental caregiving role. Combining care with paid work did not appear to impact depressive symptoms for employed Black women, Black men, and White men when they began caregiving.
APPLYING TIME-VARYING EFFECT MODELING TO EXAMINE DAILY VARIATION IN SUICIDAL IDEATION AMONG DEMENTIA CAREGIVERS
Authors: Puga Frank , Poe Abigail , Wang Danny 
Published: December 2023

Abstract
Emerging evidence suggests that caregivers may experience high rates of suicidal ideation. However, relatively little is known about daily contextual factors, including day-to-day depression and anxiety-related symptoms, that increase the severity of suicidal ideation over time. The purpose of this study was to apply time-varying effect modeling (TVEM) to examine daily depression and anxiety symptoms leading up to an individual’s highest suicidal ideation score within a span of 14 days in a sample of community-dwelling ADRD caregivers. The intercept-only model revealed an increase in the mean scores of daily suicidal ideation four days leading up to an individual’s highest score. Additionally, there was a significant decrease four days after the highest suicidal ideation point. The relationship between depression and daily suicidal ideation was significant 1-day leading up to the highest suicidal ideation score. Similar relationships were observed with daily anxiety as a time-varying predictor in a separate model. The results from this study suggest that suicidal ideation can vary between days, with depression and anxiety influencing the intensity of the slope leading to and following an individual’s highest suicidal ideation score. Examining suicidal ideation trajectories over time and factors associated with varying severity can help inform targeted interventions to support dementia caregivers and mitigate the risk of severe psychological distress associated with dementia caregiving.
ENGAGING OLDER ADULTS TO GUIDE LOW-COST NONWEARABLE SENSOR TECHNOLOGY DEVELOPMENT TO AGE IN PLACE: SURVEY FINDINGS
Authors: Schoenfeld Elinor , Trimboli Tracy , Finnerty Kaylyn , Ayisi-Boahene Givenchy , Bruckenthal Patricia , Zadok Erez , Horwitz Shelley , Ye Fan 
Published: December 2023

Abstract
As Americans live longer, a dynamic opportunity has arisen to provide enhanced resources to sustain their well-being. Cost-conscious, convenient in-home sensing will assist with chronic disease management, and become part of a long-term plan to support our aging population and shrinking healthcare workforce. The purpose of this study was to obtain input from older adults about (i) their comfort level and willingness to adopt different sensor technologies, and (ii) opinions on data sharing, security, and privacy to guide our sensor development. Over 4 different survey timeframes (2018-2022), adults aged 60 and older (N=112) completed our survey either in-person (n=77) or via a REDCap online survey (n=35) (53% female; 30% age &gt;80; 78% college graduates; 19% living alone). Though there were significant differences (p&lt; 0.05) in demographics based upon recruitment source, no differences in attitudes towards sensor use were found by age, gender, education, or marital status. Opinions and preferences for sensor type/number/install location, and data sharing preferences significantly differed (p&lt; 0.05) by home living arrangements (independent, 55+ or continuous care communities). Similar to national surveys, changes in technology use were observed pre- versus post COVID. Respondents living in 55+ and continuous-care housing were more comfortable with having sensors installed in their homes than those in community dwelling independent housing. This study highlights the need to include end users throughout the lifecycle of product development and provides insights into preferences by older adults for sensor use and data sharing.
IMPLEMENTING REABLEMENT IN COMMUNITY CARE: HOW DO WE SUCCEED?
Authors: Mouchaers Ines , Buma Lise , Verbeek Hilde , Zwakhalen Sandra , Vlaeyen Ellen , Goderis Geert , Metzelthin Silke 
Published: December 2023

Abstract
In the Netherlands, reablement is high on the agenda for inclusion in future health care policy, resulting in more and more care providers wanting to implement reablement into their everyday practice. So far, it has been implemented, resourced and organized in multiple ways. To support the implementation on an (inter)national level, insight is needed into what preconditions and influencing factors are regarding the successful implementation of reablement. Within a qualitative exploratory research design, four focus group interviews were conducted with stakeholders from three Dutch care organizations that have been providing reablement services for at least 6 months prior. Care staff, as well as project leaders, managers, directors, policymakers, and health insurance company representatives, were represented in the interviews. Data were analyzed using the framework method guided by the Consolidated Framework for Implementation Research. In total, 34 stakeholders, distributed over the four focus group interviews, participated in the study. Facilitators included interdisciplinary collaboration, organizational support in terms of leadership engagement and implementation climate, innovation design, and adaptability of the innovation. Barriers included costs and funding of the innovation, time investment (i.e. reporting, number of care visits), and communication. Some factors were listed as both hindering and facilitating such as knowledge and beliefs of care staff, staff’s and clients’ self-efficacy to change, and motivation of clients and family caregivers. These results enhance the understanding of factors influencing the implementation of reablement in community care. The next step is to identify strategies to overcome the identified barriers.
GLP-1 AGONISTS: EFFECT IN MANAGEMENT OF DIABETES AND WEIGHT LOSS IN OLDER ADULTS WITH OVERWEIGHT AND OBESITY
Authors: Pendrey Anna 
Published: December 2023

Abstract
Prevalence of Diabetes Mellitus Type 2 in older adults in the US is 33%, incidence of newly diagnosed diabetes is highest among those aged 65-79 years. Obesity in older adults impacts not only the morbidity and mortality, but importantly impacts quality of life and risk of institutionalization. Treatment for diabetes with glucagon like peptide 1 (GLP-1) agonists have demonstrated to reduce weight, control glucose, and reduce major adverse cardiovascular events in older adults. This study aims to describe outcomes in the management of older adults with diabetes and obesity with GLP-1 agonists. A retrospective study of 30 older adults with uncontrolled diabetes, overweight and obesity at a local practice that were started on treatment with GLP-1 agonists, since 2022, with ages 65-84 with diabetes mellitus type 2 with initial HbA1C 9.6%-12.6%, and BMI 27-48.2 that were started on GLP-1 agonists with improved results during treatment with current reduction of HbA1C 5.8%-7.7% and BMI reduction 23-39.8. In conclusion GLP-1 agonists have demonstrated significantly improved management of uncontrolled Diabetes Mellitus in older adults as well as a significant reduction in weight improving outcomes.
THE PICTURE WITHOUT THE THOUSAND WORDS—PHYSICIAN AND JUDGE COMMUNICATION IN GUARDIANSHIP CASES
Authors: Factora Ronan , Pawlicki Matthew 
Published: December 2023

Abstract
In Ohio, physicians conducting capacity evaluations in guardianship cases are also asked to complete a Statement of Expert Evaluation (SEE) used by Probate Court to aid in decisions determining that person’s competence. In a prior survey, physicians voiced reluctance to conduct such evaluations because they were time consuming and judges stated that information provided by physicians in guardianship cases was inadequate or incomplete. Communication between the two groups of what information would be most useful in this process would help optimize the time required by physicians to complete their evaluation and improve the quality of information judges receive when making their decision. A survey was conducted of legal professionals (at an Ohio Probate Court Pre-conference session specifically focused on capacity evaluation and SEE completion) which sought to identify elements these legal professionals felt were most and least useful from SEEs provided by completing physicians. With 52 attendees (including judges (active and retired), magistrates, court personnel, and public attendees), 38-42 persons answered the questions that were provided. By far the least valuable information was identified as the medication list, but the most useful was any detailed information/opinion provided by the completing physician explaining the other information included on the form (e.g. cognitive testing, diagnosis). Though potentially more time consuming, highlighting the importance of this information to completing physicians may help them communicate more effectively to legal authorities and facilitate greater understanding of the physician’s opinion in guardianship cases.
ADDRESSING BENZODIAZEPINE PRESCRIBING PRACTICES AMONGST ELDERLY PTSD VETERANS DURING THE COVID-19 PANDEMIC
Authors: Fernandes Deanna , Cheong Josepha 
Published: December 2023

Abstract
Psychotropic medication prescribing amongst elderly veterans has increased over the course of the COVID-19 pandemic despite the fact that psychotropics such as benzodiazepines, when being prescribed for a period over 2 weeks, are considered as relatively contraindicated amongst such patients with an additional Post-Traumatic Stress Disorder (PTSD) diagnosis due to a worsening of disease state symptoms. The objectives of my study are to inform clinicians and healthcare providers regarding the true extent of current benzodiazepine prescribing practices amongst elderly Veterans with PTSD and to provide a clinical aid/tool for education and improvement of such practices within the setting of the Veterans Affairs Medical Center. A one-page summarized aid will be drafted based upon provider feedback as well as from current Pharmacy Benefits Management Network resources to improve clinical practices with regards to the topics of benzodiazepine recommended length of use, risks of use amongst elderly Veterans, and risks amongst PTSD populations. While benzodiazepine prescribing practices have increased recently during the time of the COVID-10 pandemic, clinical tools may be drafted to improve such practices. Further studies are needed to determine the true impacts of such a tool on the national level as well as upon direct patient care.
EMOTIONAL RESPONSE TO THE COVID-19 PANDEMIC: NURSING HOME RESIDENTS’ PERSPECTIVES
Authors: Woods Ashley , Vogelsmeier Amy , Popejoy Lori , Miller Steven , Johnson Alisha , Thompson Roy , Trueblood Amy 
Published: December 2023

Abstract
Nursing home residents were at the forefront of challenges imposed by the COVID-19 pandemic, including being forced into extended periods of isolation, yet little is known about their emotional response. Therefore, the purpose of this study is to describe residents’ emotional responses to the COVID-19 pandemic, including their response to isolation. Twenty-eight residents residing in 22 Missouri nursing homes during the pandemic participated in semi-structured interviews as part of a larger mixed-methods study to understand nursing homes’ response to COVID-19. Interviews were transcribed and analyzed by a team of PhD researchers and doctoral students using a qualitative content analysis approach. Of the 28 resident interviews, most were more concerned about their families, other residents, and staff becoming infected rather than themselves. Many cited their lack of concern was due to trust in nursing home staff to keep them safe. Regarding isolation, a few described being angry about separation from family and friends. Nevertheless, most understood that the restrictions were about “doing what had to be done” and that isolation was “for the greater good.” The majority also responded positively about their relationships with staff during isolation and happiness at the return of visitors after isolation restrictions were lifted. Overall, residents’ emotional responses during the COVID-19 pandemic varied but primarily reflected their concern for others rather than themselves. Their concern for themselves may have been allayed because of their trust in nursing home staff. Their response to isolation seemed rooted in their understanding of the need to protect themselves and others.