bluuebunny/crossref_metadata_2025_split huggingface dataset:
INCOME AND WELL-BEING IN OLD AGE—SYSTEMIC AND REGIONAL FACTORS IN A COMPARISON BETWEEN GERMANY AND POLAND
Authors: Oczkowska Monika , Kulati Ellam , Myck Michal 
Published: December 2023

Abstract
We examine the responsiveness of later-life well-being measures to income using unique data, matching regional and individual level information from Germany and Poland. These two neighboring countries still strongly differ both in their welfare system designs, as seen in contrasting public social support as well as the quality of services, and in outcomes among older individuals. For example, the proportion of individuals aged 50+ who declare significant difficulties in making ends meet is only 3% in Germany, and as high as 16% in Poland. While up to 13% of individuals aged 65+ are classified as materially and socially deprived in Poland, the proportion in Germany is only 6%. Granted the importance of contextual factors in determining individual welfare, income is expected to matter less for the well-being of those enjoying higher quality local environments. Our preliminary findings confirm a much stronger relationship between income and well-being in Poland. The relationship is also found to be highly heterogeneous – for instance, it is substantially greater among those in poor health. Individual resources are thus shown to be more strongly related to well-being in conditions wherein individuals cannot rely on support through public services. Surprisingly, in both countries the effect of income on well-being does not significantly change when we control for the different local conditions expected to mediate the relationship. This suggests that the country-wide systemic context matters more for the examined relationship than specific regional environment.
THE ASSOCIATIONS OF SOCIOECONOMIC POSITION WITH STRUCTURAL BRAIN DAMAGE AND CONNECTIVITY AND COGNITION
Authors: Geraets Anouk , Schram Miranda , Koehler Sebastian , Jansen Jacobus , van Boxtel Martin , Koster Annemarie , Stehouwer Coen , Bosma Hans 
Published: December 2023

Abstract
Socioeconomic inequalities in the risk for cognitive impairment have been reported, which might partly act through structural brain damage and connectivity. This study investigated the extent to which the association of early-life socioeconomic position (SEP) with later-life cognitive performance is mediated by later-life SEP, and whether the association of SEP with later-life cognitive performance can be explained by structural brain damage and connectivity. We used cross-sectional data from the population-based Maastricht study (n=4,839; mean age 59.2±8.7 years, 49.8% women). Early-life SEP was assessed retrospectively by self-reported poverty and parental education. Later-life SEP included education, occupation, and household income. Participants underwent cognitive testing and 3 T magnetic resonance imaging to measure volumes of white matter hyperintensities, gray matter, white matter, cerebrospinal fluid, and structural connectivity. Multiple linear regression analyses tested the associations between SEP, MRI brain markers and cognition. Structural equation modeling tested mediation. Results indicated that higher SEP was associated with higher grey matter volume, lower white matter volume, and higher structural connectivity. Structural brain damage and lower structural connectivity were associated with lower cognition. Both higher early-life and later-life SEP were associated with higher cognition. The association of early-life SEP with later-life cognition was partly mediated by later-life SES (73.8%). However, the extent to which the association of SEP with cognition could be explained by structural brain damage or connectivity was marginal (up to 5.9%). More research is needed to investigate alternative pathways that can explain the associations between SEP with later-life cognition.
ASSOCIATION BETWEEN PATIENT PORTAL ACTIVITIES AND END-OF-LIFE OUTCOMES
Authors: Portz Jennifer , Wan Shaowei , Powers John , Palen Ted 
Published: December 2023

Abstract
Examining end-of-life (EOL) patient outcomes associated with patient portal use will help identify benefits and barriers of portal use during EOL care. The primary objective of this retrospective cohort study was to assess the association between EOL outcomes and patient portal use among a cohort (N=6,517) of deceased patients (18+ years old) in the last 12 months of life within Kaiser Permanente Colorado (KPCO). Outcomes including 1) number of hospitalizations in the last 30 days of life, 2) having documented advance directive before death, and 3) dying in hospice were investigated by levels of patient portal use (no use, non-active use, active use without provider, and active use with a provider) for the first six months of the last year of life. A generalized linear model with Poisson distribution, a log link and an offset to account for person-days of follow-up was used to estimate rates of hospitalizations in the last 30 days. Logistic regression was used to estimate advance directive and death in hospice outcomes. Patient portal use appeared to be associated with beneficial EOL outcomes such as advance care planning (P = 0.0226) and dying in hospice (P = 0.0070). Hospitalizations were greater with higher levels of patient portal use (P = 0.0492), suggesting that patients/caregivers may have used patient portals for disease related information and accessing health services during times of need. More research is needed to leverage patient portal use to intentionally engage, educate and guide patients with serious illness and approaching EOL.
ALONE TOGETHER: SOCIAL ISOLATION AND LONELINESS ACROSS COVID-19
Authors: Beck Emorie , Ong Anthony , Graham Eileen 
Published: December 2023

Abstract
The COVID-19 pandemic has resulted in a worldwide increase in the number of adults who are socially isolated and experiencing high levels of loneliness. Although research has focused on social isolation (the lack of social contact) and loneliness (the perception of being alone), few longitudinal studies have examined isolation and loneliness together in the context of the COVID-19 pandemic. We introduce a novel index of resilience to loneliness (social asymmetry), which captures the degree of congruence or discordance between subjective feelings of loneliness and objective social contact (social isolation). Using seven longitudinal samples (Total N &gt; 75,000) across three continents, we examined trajectories of social asymmetry across the onset of the pandemic using Bayesian multilevel discontinuous growth models. These allowed us to demonstrate differences in level and change of social asymmetry across the onset of the pandemic. Levels and change tended toward resilience over time but did not show significant changes across the onset of the pandemic. However, these results were not consistent across samples, indicating heterogeneity across countries, age groups, and more. We discuss how examining COVID-related changes in social asymmetry advances our understanding of (1) the extent to which broad societal challenges can induce short- and long-term impacts on trajectories of resilience and (2) what factors account for heterogeneity in adaptive responses to adversity.
SOCIAL DETERMINANTS OF HEALTH AND THE RISK FOR DEMENTIA
Authors: Baumgart Matthew , Hampton Kischa , Kline Chelsea 
Published: December 2023

Abstract
Social determinants of health (SDOH) play a role in the risk for dementia in two ways. First, certain SDOH may be direct risk factors for dementia. Second, SDOH contribute to the prevalence of many modifiable risk factors that in turn may elevate dementia risk – and act as barriers to addressing individually modifiable risk factors for dementia. To better understand how SDOH affect the risk for dementia and the role public health has in addressing dementia-related SDOH, the Public Health Center of Excellence on Dementia Risk Reduction (PHCOE-RR), in partnership with Wake Forest School of Medicine, recently synthesized the current state of the evidence. Following that synthesis, the PHCOE-RR conducted (1) a workshop where researchers and public health officials reviewed the science, and (2) a Public Health Roundtable where the public health community discussed the role of public health agencies in addressing dementia-related SDOH. This presentation will review the results of the evidence synthesis and discuss the work of the PHCOE-RR in helping state, local, and tribal public health agencies take action in their communities.
DELIVERING BRAIN HEALTH EQUITY TO COMMUNITIES CHALLENGED BY SDOH
Authors: Monroe Stephanie , Delgado Daphne , Mudrazija Stipica 
Published: December 2023

Abstract
Growing evidence suggests that dementia risk can be modified by brain healthy behaviors, including effective management of hypertension, diabetes, and obesity. In fact, the Lancet Commission released new research showing that managing a dozen risk factors could prevent or delay approximately 40 percent of worldwide dementia cases. Under-resourced communities are at a disadvantage in managing these risk factors however, due to systemic inequities in health and education, access to exercise opportunities, and to nutritious food. Social determinants of health (SDOH)—and policies that address them—must be part of the solution to ensuring better brain health for all American families. Ensuring that this hope and opportunity reaches all families regardless of zip code, income, race, or ethnicity will take greater commitment, investment, and strategies centered in health equity in public health and community-based initiatives. UsAgainstAlzheimer’s will share what they have done to a) identify, adapt, and disseminate tailored messages to minority-serving communities and b) better equip providers to establish trust and reach those they seek to serve by: 1) better understanding the barriers, opportunities and challenges to reach and build trust in historically underrepresented populations; (2) developing tools, strategies and messages that resonate with these populations; and (3) showing how place matters when it comes to implementing effective public health strategies.
CHALLENGES OF CONDUCTING COMMUNITY-ENGAGED RESEARCH AMONG JUSTICE-INVOLVED MID- AND LATE-LIFE ADULTS
Authors: Sneed Rodlescia 
Published: December 2023

Abstract
Formerly incarcerated mid and late-life adults exhibit high rates of chronic disease and disability; however, there is little attention to chronic physical health within programs designed to provide community reentry support. Healthy eating and physical activity are known to reduce chronic disease risk; yet existing physical activity and nutrition programs fail to address the needs of formerly incarcerated mid and late-life adults, who often experience housing insecurity, unemployment, low literacy, and limited access to healthy food. Through a partnership with a community-based reentry program, we designed a health and wellness program tailored to the needs of formerly incarcerated mid and late-adults that included group fitness instructor training, weekly nutrition/fitness classes, and peer coaching. Our team experienced numerous challenges in implementing this program, including low willingness of local community agencies to engage with justice-involved mid and late-life adults, competition with other reentry program activities, individual-level social factors that inhibited participation, and parole/probation restrictions that negatively impacted program attendance. In our session, we will describe how we engaged with a diverse range of partners to address these challenges to ensure program success. There are a number of barriers associated with conducting community-engaged research among formerly incarcerated mid and late-life adults. Our work to date will inform future engagement with this population.
SENSOR-ENHANCED CARE COORDINATION TO ADDRESS OLDER ADULT HEALTH: LESSONS FROM AN INTERDISCIPLINARY RESEARCH TEAM
Authors: Robinson Erin , Washington Karla 
Published: December 2023

Abstract
Researchers at the University of Missouri have a history of developing and testing aging in place (AIP) care coordination models for clinical translation. Vital to this work are in-home, residentially installed sensors to detect early illness and functional decline over time. While much smart home research is focused on older adults living in continuing care retirement communities, our team developed a novel sensor-enhanced care coordination approach for community-dwelling and disabled older adults as part of two ongoing, federally funded projects. For this symposium, we will highlight the Age-friendly Sustainable Smart and Equitable Technologies for Aging in Place (ASSETs for AIP) demonstration program, funded by the Department of Health and Human Services. Our first presentation will overview our interdisciplinary approach to creating this novel care coordination model, with specifics about research team composition, population focus, and methods. Our second presentation will highlight recruitment strategies and share lessons learned from reaching and enrolling this population that often experience residential transitions. Our third presentation will overview the open-source smart home and consumer-grade technologies deployed in this work, and practical considerations for technology installation, support, and sustainability and clinical team training. Our symposium will close with a presentation of selected client case studies that illustrate how clinical care coordinators use sensor data to remotely monitor and empower older adults for behavior change via telehealth consultations. This symposium will help inform other care coordination research, particularly that which uses sensor technologies and telehealth to facilitate aging in place.
ADVANCING ADOPTION AND SUSTAINABILITY OF AGE-FRIENDLY INITIATIVES THROUGH SYNERGIES AND IMPLEMENTATION SCIENCE
Authors: Kennedy Teri 
Published: December 2023

Abstract
For communities interested in adopting age-friendly principles, the plethora of age-friendly initiatives (i.e., age-, disability-, and dementia-friendly cities and communities; age-friendly universities, health systems, and public health systems) can be overwhelming. For rural, frontier, underserved, and under-resourced communities, it can be challenging to consider tackling even one such initiative. A major barrier to implementation is the know-do gap between what is known and what gets accomplished in practice. This gap is widened as a result of overly complex models and practices that are difficult to disseminate and scale, difficult to reproduce, or do not apply across settings. The know-do gap can be effectively bridged by focusing on core features common across age-friendly ecosystem initiatives. To successfully advance this work, it is important to consider strategies to maximize the collective impact of age-friendly initiatives and explore opportunities to tailor these initiatives so they can be successfully adapted for and adopted by various settings, contexts, and populations. Using an implementation science approach, three models will be introduced (Strengths-Based Interprofessional Practice and Education (SB-IPE); Micro-, Meso-, Macro- M3: Aligning Your Nexus Through a Systems Lens; and Kennedy Model of Sustainability) to facilitate the adoption and sustainability of evidence-based age-friendly principles, programs, and policies.
DETERMINANTS OF ALZHEIMER’S DISEASE AND RELATED DEMENTIA RISK IN OLDER BLACK MEN
Authors: Esiaka Darlingtina 
Published: December 2023

Abstract
Beyond biological determinants of Alzheimer’s disease and related dementias (ADRD), extensive literature also suggests a role for sociocultural determinants—including race, ethnicity, education, neighborhood, and economic environment—in modulating cognitive outcomes. In recent years, research examining sociodemographic disparities in ADRD incidence points to modifiable mechanisms. Important for more personalized dementia prevention is the focus on how social determinants of health interact with lifestyle factors to put people at risk of developing ADRD. However, a historical challenge to research on dementia disparities and prevention relates to stark underrepresentation of Black individuals, particularly Black men. Therefore, this within-group study utilizes data from older Black men to examine social determinants (e.g., neighborhood, home environment, social cohesion), lifestyle factors (e.g., sleep, diet, drinking), and their impact on neurocognitive domains linked to ADRD. Results from 178 Black men, age 70+, from the 2021 National Health and Aging Trends Study show lower presence of neighborhood physical disorders such as vandalism (B=.064, p=0.035) and better sleep quality (B=.022, p=0.036) were associated with better performance on executive functioning tasks. Additionally, ongoing primary data collection (N=100 Black men, age 60+) supports these findings and provides additional insights toward identifying and validating risk/protective factors that predict cognitive outcomes very early in the cognitive aging process among Black men. This work represents a necessary step toward a better understanding of heightened ADRD risk in this understudied group. Results can be used to guide tailored interventions likely to be most effective for mitigating risk and slowing progression in Black men.
ADVANCING DIVERSITY IN AGING: THE AGE-ADAR SCHOLARS PROGRAM AT WVU
Authors: Patrick Julie Hicks , Rusch Amber , Pullen Carly 
Published: December 2023

Abstract
As the number and racial/ethnic diversity of older Americans, ages 65+ years increases, recruiting, training, and retaining a diverse workforce to support aging-related fields is essential. Supported by an R25 grant from the NIA, the goals of the Appalachian Gerontology Experiences: Advancing Diversity in Aging Research (AGE-ADAR) Scholars Program include training undergraduate MSTEM majors in aging and health disparities research, especially as these topics interact in Appalachia. In this brief presentation, we will review the goals and mechanisms through which these aims are accomplished. We will review both hard outcomes (i.e., conference presentations, publications) and soft outcomes (attitude change, career specialization) among our first two cohorts of Scholars. For example, each Scholar prepares two empirical abstracts, presents a poster on campus, presents one or more posters off-campus, produces a public-facing infographic about health disparities and aging, conducts a literature review, and composes an integrated essay related to how their MSTEM major can help to solve issues of health disparities among older adults in Appalachia. About half of our Scholars have co-authored published manuscripts, as well. Finally, other funding mechanisms to support training the next generation of researchers, scholars, and applied workers in aging will be discussed.
ESPO AND BUTLER-WILLIAMS SCIENTIFIC SYMPOSIUM: CAREER DEVELOPMENT TO PROMOTE DIVERSITY, DISCOVERY, AND AGING
Authors: Davis Jamaine , Morgan Brianna , Jones Patricia 
Published: December 2023

Abstract
The NIA’s Butler-Williams Scholars Program and GSA’s ESPO Section are united in providing career development opportunities in a manner that promotes leadership, diversity, and inclusivity. This year’s theme challenges our emerging scholars to embrace diversity and discovery while thinking—or rethinking—about the perspectives of older adults. Disparities in health associated with race/ethnicity, lived experience, sociocultural and socioeconomic factors, as well as access to and provision of health care are chief concerns of our aging population. GSA’s early career professionals and 2022 alumni of the prestigious NIA Butler-Williams Scholars Program address these issues. Dr. Shekinah Fashaw-Walters will discuss her work examining how high-quality providers influence high quality of healthcare, particularly for Black patients. Dr. Sara LaHue will discuss how biological age can be a measure associated with delirium or neuronal inury markers in a cohort of hip fracture patients. Dr. Imilce Rodrigues-Fernandez will present on the importance of identifying pathways that can lead to improvements in stem cell function that can improve age-related tissue degeneration. how both demographics and genetic factors contribute to cognitive performance. The final speaker, Dr. Helena Zomer will present findings on the mechanism by which a hormone can extend healthspan and longevity. The featured talks by rising stars deepen our understanding of the influence of diversity and key discoveries so we can reimagine aging research.
PROTECTIVE EFFECT OF SHINGLES VACCINE ON ALZHEIMER’S DISEASE CAN BE MODULATED BY RISK VARIANT OF NECTIN2 GENE
Authors: Ukraintseva Svetlana , Duan Hongzhe , Holmes Rachel , Wu Deqing , Akushevich Igor , Yashkin Arseniy , Arbeev Konstantin , Yashin Anatoliy 
Published: December 2023

Abstract
The aging-related decline in immune surveillance was suggested to play a major role in Alzheimer’s disease (AD). Adult vaccinations may support the aging immune system beyond prevention of the target disease, and through this provide a protection against AD. Such off-target effects of vaccines may potentially be affected by genetic risk factors for AD. To explore this possibility, we estimated association of the vaccination against shingles (reactivated herpes zoster virus infection) received between ages 65-75 with AD onset at ages 75+ in the Health and Retirement Study (HRS) survey participants, comparing the carriers and non-carriers of rs6859 A allele of NECTIN2 gene (AD risk factor that is also involved in vulnerability to viral infections). We used logistic regression model with covariates including sex, race, education, and smoking status. We found that shingles vaccine was significantly associated with lower odds of AD onset later in life, in the total sample (p-value=0.021; OR=0.55 (0.33, 0.92)). After stratification by genotype, the protective effect of vaccine became stronger in rs6859 A carriers (p-value=0.016; OR=0.44 (0.22, 0.86)), but disappeared in the non-carriers, for both significance and size (p-value=0.81; OR=0.90). We conclude that adult shingles vaccine may reduce chances of AD at older ages, and this effect appears more beneficial for carriers of rs6859 A allele of NECTIN2 gene. Repurposing of existing vaccines may benefit the aging immune system, and be a promising approach to personalized genotype-tailored prevention of AD.