bluuebunny/crossref_metadata_2025_split huggingface dataset:
TWO NATIVE SOUTH AMERICAN MALE POPULATIONS EXHIBIT CROSS-SECTIONAL INCREASE IN REGIONAL BRAIN VOLUME WITH AGE
Authors: Imms Phoebe , Chaudhari Nikhil , Chowdhury Nahian , Gatz Margaret , Gurven Michael D , Finch Caleb , Irimia Andrei ,   The Tsimane Health and Life History Project
Published: December 2023

Abstract
Features of industrialized environments such as consumption of processed foods and sedentarism are associated with faster brain atrophy. Studying brain volume trends with age in non-industrialized populations can elucidate environmental correlates of brain health. Indigenous to the Bolivian Amazon, the Tsimane and Moseten (T&M) are highly active forager-horticulturalists with some of the lowest rates of dementia. Tsimane have minimal interaction with mainstream Bolivians; Moseten are semi-acculturated. Age-related trends in regional brain volumes were estimated from T&M’s (N = 1,024; age range: 46-83) computed tomography and compared to trends estimated from Britons’ magnetic resonance images (UK Biobank, N = 19,973; same age range). In T&M males, parietal and occipital structures mediating visuospatial abilities exhibit small but significant rates of volume increase with age. Structures recruited during visuospatial navigation are important for survival in Amazonian rainforests. Frontal and temporal structures whose volumes decrease with age in Britons do not trend negatively with age in T&M males. T&M females, however, exhibit steeper cross-sectional rates of volume decrease with age compared to their industrialized counterparts. This suggests that brain volume trajectories, which can reflect dementia risk, are impacted by sex-specific aspects of non-industrialization. Despite T&M females’ higher rates of regional brain volume decrease with age compared to UK females, dementia rates in T&M females remain extremely low. Trends demonstrating increases in brain volume with age, such as those observed in T&M males, have not been reported in industrialized populations, suggesting that factors associated with being a male forager-horticulturalist may constrain regional brain atrophy.
UNDERSTANDING THE IMPACT OF AGEISM AMONG HEALTHCARE PROFESSIONALS AND STUDENTS
Authors: Finn Laura , Sukumar Kavitha , Fasola Serena , Phan Dennis , Bautista Kirsten , Hon Michelle , Oswald Catherine 
Published: December 2023

Abstract
With our population aging, the need for healthcare practitioners trained in caring for older adults is urgent. The anticipated shortage of geriatric-trained providers may further the impact of age-related discrimination. Little data is published about the understanding of ageism by healthcare professionals and students. The comparison of these different groups became the focus of the conducted survey, and the presenting research analyzed a total of 467 respondents including dental, nursing, pharmacy, occupational therapy, and physical therapy professions across 2 universities. When comparing demographic differences in studied populations, 69% of faculty/preceptors and 12% of students were over 35 years old. Overall, 33.8% reported being unable to define ageism with 27.7% of all students unable to do so. In looking specifically at pharmacy, 34.3% of students and 37.9% of faculty were unable to define ageism. Understanding ageism and its effects on healthcare for older adults is important for pharmacists as 82.1% of pharmacy faculty reported regularly interacting with older adults and 67% said that primarily occurred at work; yet only 37.5% had taken a class or course in geriatrics. Among pharmacy students, 71.4% interacted regularly with older adults with 41.4% saying this occurred primarily at work. Differences were noted in student education with 50% of pharmacy and 86.9% of physical therapy students having taken a geriatric course. Analysis and conclusions interpret the impact of ageism and emphasize a need for education to address age-related disparities and potential for bias in healthcare.
UNMET NEEDS OF OLDER FEMALE VETERANS AND GENDER DIFFERENCES USING THE PROSPECTIVE HERO CARE SURVEY DATA
Authors: Dang Stuti , Tyagi Pranjal , Garcia Sandra , Bouldin Erin , Trivedi Ranak , Intrator Orna , Pugh Mary Jo , Leykum Luci 
Published: December 2023

Abstract
Aging female Veterans face unique healthcare needs which are yet to be well-described. We analyzed round one data from HERO CARE, a prospective survey, to describe the medical, psychological, and social unmet needs of female Veterans and compare them with those of male Veterans. We received survey responses from 8,056 community-dwelling Veterans (227 (2.8%) females and 7,829 (97.2%) males) from San Antonio, Palo Alto, Miami, Salt Lake City Veterans Affairs (VA) Medical Centers, and Veteran Integrated Service Network 8 in July 2021. We compared difference in needs between the female and male respondents using chi-square tests and difference in age in years using t-tests. Respondents were classified as having an unmet need if they responded that they needed “a little” or “a lot more help” for specific needs. Female respondents were 74.3 (SD: 14.5) years-old on average, and 7.9% Hispanic, 15.4% non-Hispanic Black, 72.7% non-Hispanic White. Male respondents were older 80.3 (SD: 9.8) years-old on average (p&lt; 0.01), with no significant difference in race/ethnicity. Female Veterans reported unmet needs in ADLs (14.1%), IADLs (40.1%), nursing tasks (7.1%), pain management (17.6%), communicating with the healthcare team (10.6%), and social needs like legal or housing (16.3%). All unmet needs were like those of male Veterans (all p&gt;0.05). Among female Veterans, 20.1% screened positive for anxiety (GAD-2 score &gt;2) and 22.8% for depression (PHQ-2 score &gt;2), compared to male Veterans: 15.2% (p&lt; 0.01) and 21.6% (p=0.41), respectively. Routine assessment of aging female Veterans, specifically focusing on mental health and IADLs, may better address their needs.
UNVEILING THE COMPLEX REALITIES: UNDERSTANDING SLEEP AND FATIGUE CHARACTERISTICS OF END-OF-LIFE CAREGIVERS
Authors: Park Hyeyoung , Lee Sunghoon , Bailey Amelia , Liu Yunda , Jacelon Cynthia 
Published: December 2023

Abstract
This mixed methods multi-case study explores sleep and fatigue characteristics among end-of-life caregivers. The research sample encompasses cases aiding individuals with advanced (n=4) and chronic illnesses (n=1), including various caregiver demographics such as gender, age groups (19-64 and 65+), and health conditions. Data collection involves comprehensive surveys capturing demographics, care recipient symptom intensity, caregiver depressive symptoms, caregiving stress, caregiver sleep quality, and caregiver fatigue level. The study integrates data from a 30-day Personal Sleep Monitoring Device (PSMD) and a 14-day sleep journal, enriched by insights from semi-structured interviews and field notes. The outcomes indicate a PSQI (Pittsburgh Sleep Quality Index) score of 6.1, accompanied by 7.44 hours of sleep recorded by the PSMD. There were approximately 20.5 nocturnal awakenings within 30 days, with average fatigue at 55.28 and daily fatigue at 49.66. Objective sleep outcomes were consistent among caregivers, while their own sleep ratings ranged from “Fairly Bad” to “Very Good.” Themes for each case were formulated to delve into the context of these sleep and fatigue characteristics. These themes encompass adaptive leadership, linchpin roles, emotional labor management, self-reliance, and vigilance. A prevailing overarching theme is the perception of “Not having control.” A significant finding underscores the dynamic influence of care recipients’ daily statuses on caregivers’ sleep quality and fatigue levels, leading to unpredictable outcomes. This study offers profound insights into end-of-life caregivers’ intricate journeys, highlighting individual differences and the dynamic nature of caregiving roles, while recognizing the importance of tailored interventions for enhancing caregiver’s well-being and caregiving effectiveness.
USING MULTI-LEVEL MODELING TO EXAMINE RACIAL DISPARITIES IN PALLIATIVE CARE AMONG OLDER ADULTS WITH HEART FAILURE
Authors: Han Ling , Abel Erica , Zhan Yan , Akgün Kathleen , Feder Shelli 
Published: December 2023

Abstract
Studies have found persistent disparities in guideline-concordant cares for heart failure among patients who self-identify as Black. We investigated how the guideline-concordant specialist palliative care (SPC) varied with race among older adults with advanced heart failure (AHF). We identified 16,464 older adults aged ≥65y (median: 74y) with AHF by ICD-9/10 codes seen between 1/1/2018-7/1/2020 in 83 Veterans Affairs Medical Centers (VAMC). In conventional logistic regression without accounting for between-VAMC variation, Black (28%) race was less likely to receive SPC services than White (70%) race [adjusted odds ratio (aOR) of 0.91 (95% Confidence Intervals (CI): 0.84,0.99); predicted probability: 27.6% vs. 29.5%], independent of age, sex and comorbidity. This association diminished to null [aOR: 0.99 (95% CI: 0.90,1.08)] after adding a random intercept for VAMCs (multi-level model (MLM)). Expanding the MLM with specific VAMC characteristics (SPC team staffing (p&lt; 0.05), facility complexity and urbanicity) as fixed effects improved overall model fit (area under ROC: 0.68 vs 0.61, p&lt; 0.05), and accounted for 17% of the VAMC-level variance (intraclass correlation coefficient: 0.069 vs 0.083). There were no cross-level interactions between race and VAMC characteristics. These findings suggest that variation in the individual probability of receiving SPC between Black and White race in this older AHF cohort may be partially explained by between-VAMC differences in SPC staffing and other facility characteristics. To promote equitable access to SPC for older adults with AHF, further research is needed to examine service delivery characteristics and broader contextual determinants of health, such as area socioeconomic disparity of healthcare facilities
UTILIZING VALID, RELIABLE, AND PRACTICAL MEASURES OF HEALTH STATUS IN PRIMARY GERIATRIC CARE: TRANSLATING RESEARCH INTO USUAL CARE WITH THE SENIOR’S HEALTH ASSESSMENT REPORT AND PLAN (SHARP™)
Authors: Rosenberg Ted 
Published: December 2023

Abstract

Introduction
To better support evidenced-based care, we combined 9 valid, reliable, and clinically useful tests into a single health status and risk assessment tool, performed by a Team nurse, called the Seniors Health Assessment, Report and Plan (SHARP™). These tests include: CFS, EQ5D-5L, EQ-VAS, MoCA, GDS, Months of the Year Backwards, Gait Speed, Grip Strength, Water Swallow Test, and MNA-6. A published study, with 18 months of follow-up for a primary geriatric home-based practice demonstrated that these tests were stronger predictors of death, nursing home transfer (NHT), or hospital admission(HA) compared to any medical diagnosis, multiple comorbidities, or polypharmacy. Hazard Ratios for SHARP™ vs medical diagnoses were: Death (median HR 5.9 vs. 1.6), NHT (median HR 4.6 vs.1.4), and HA (median HR 6.0 vs. 1.6). The research presented here will provide several case-based studies to demonstrate how we have translated this research into “usual care” for a primary home-based interdisciplinary geriatric medical practice. Specifically, we will demonstrate how we: 1. share this data with patients and caregivers to motivate them for Team interventions, 2. share a summary report of an individual’s health with the hospital and other community care providers, 3. use these tests to guide and evaluate Team interventions for individual patients (e.g. changes in gait speed), 4. Track changes in health status and risk, and 5. use aggregated data at a program level for benchmarking, defining population needs, and for planning and evaluation.

Conclusions
Standardized testing is acceptable to patients, efficient, supports evidenced-based care, and is useful for program planning and evaluation.
WHAT DO NURSING HOMES RECEIVING HIGH COMPLAINTS GOT TO DO WITH RESIDENTS’ QUALITY OF LIFE?
Authors: Kwon Jenny , Qiu Xiao 
Published: December 2023

Abstract
Residents’ quality of life is important to understand nursing home (NH) quality. Official complaints are another NH quality indicator. However, little research has examined the two quality measures together. To fill this gap, this study aims to investigate the association between resident satisfaction and NH complaints. 2018–2019 complaints data from the Ohio Department of Health, 2017 Ohio Biennial Survey of Long-Term Care Facilities, and 2017 Ohio Nursing Home Resident Satisfaction Survey were merged (N=629). Eight outcome variables were used: overall resident satisfaction score and seven individual domain scores. They range from 0 (low) to 100 (high). For independent variables, we labeled NHs received 6 or more complaints per 100 residents in both 2018 and 2019 as ‘high complaint repeaters.’ Multiple linear regression was conducted. There is a statistically significant relationship between official complaints and resident satisfaction. High complaint repeaters had lower overall satisfaction score by 1.48 (p &lt; .01); lower moving in score by 2.16 (p &lt; .01); lower spending time score by 1.30 (p &lt; .05); lower caregivers score by 1.20 (p &lt; .05); lower meals and dining score by 2.18 (p &lt; .05); lower environment score by 1.13 (p &lt; .05); and lower facility culture score by 2.14 (p &lt; .01) than non-high complaint repeaters. However, there is no association between complaints and care and services domain score. State policy makers need to consistently monitor high complaint repeaters and support them to reduce complaints. Also, providers should allocate resources and design strategies to improve residents’ experiences.
WHO’S ON YOUR TEAM? DEMENTIA FAMILY NETWORKS AND CAREGIVER WELL-BEING
Authors: Leggett Amanda , Haldar Srabani , Tsuker Sophia , Choi HwaJung 
Published: December 2023

Abstract
While caregivers are typically enmeshed in broad networks of family and friends assisting with care, this network is largely neglected, in favor of examining a “primary” caregiver. This study examines types of family/unpaid friend networks for persons living with dementia and how one’s network type relates to caregiver well-being. Data are drawn from the nationally representative 2017 National Health and Aging Trends Study and associated National Study of Caregiving. The sample includes 336 dementia care networks (Network size mean=2.9). We first identified network types using Latent Class Analysis and then examined the extent to which network type is associated with outcomes of caregiver well-being (emotional difficulty, overload) and support (social/care-related support from family and friends) using ANOVA and linear regressions adjusting for caregiver demographics. The three network types identified were: “Specialists”- small networks with little task sharing between members (29.8% of networks), “Small but mighty”- small networks with high task sharing (23.0% of networks), and “Sharers”- large networks with diverse membership and members who share and who specialize in task assistance (47.2%). “Small but mighty” network membership was associated with significantly greater emotional difficulty of caregiving (F=4.0, p&lt;.05) and marginally greater overload (F=2.8, p=.06) than “Specialist” and “Sharer” membership. However, in regressions, only social support significantly differed, with “Sharers” (B=-0.1, p&lt;.01) and “Small but mighty” (B=-.2, p&lt;.05) networks receiving significantly more support than “Specialists”. Networks with more task sharing may require more social support, yet smaller network size, while carrying complex caregiving responsibilities, may take a greater emotional toll.
CONTEXTUALIZING ATTITUDES TOWARD MEDICAL AID IN DYING IN A NATIONAL SAMPLE OF HOSPICE CLINICIANS
Authors: Becker Todd , Cagle John , Davitt Joan , Sacco Paul , Kusmaul Nancy , Cain Cindy 
Published: December 2023

Abstract
Research on the contextual characteristics informing the care that hospice professionals offer patients interested in medical aid in dying (MAID) is lacking. Thus, we aimed to explore MAID attitudes vis-à-vis hospice values and state law. This cross-sectional study recruited a convenience sample of 450 hospice-based physicians, nurses, social workers, and chaplains from national hospice and palliative care membership associations. Controlling for covariates, we fit a partial proportional odds model with clustered standard errors to examine the associations between participants’ professional experience working in a MAID-legal state, orientation toward patient-centered care, and commitment to the hospice philosophy of care, and their MAID attitudes (0 = “oppose,” 1 = “neither support nor oppose,” 2 = “support”). Results indicated that experience working in MAID-legal states (vs. not; OR = 2.42, p = .002) and increased orientation toward patient-centered care (OR = 1.38, p &lt; .001) were significantly associated with higher odds of greater MAID support across thresholds. Conversely, the direction and statistical significance of commitment to the hospice philosophy of care depended on the threshold of the dependent variable (odds of MAID support higher than “oppose”: OR = 0.98, p = .326; odds of MAID support higher than “neither support nor oppose”: OR = 1.05, p = .043). Findings provide the first quantitative evaluation of a predominantly theoretical debate concerning perceptions of MAID’s concordance with hospice values. Noting legal protections for conscientious objection, higher support from clinicians in states where MAID is legal may suggest training opportunities as levers to improve patient access.
ENABLING AGING IN PLACE: THE IMPACT OF HOME MODIFICATIONS ON NURSING HOME ADMISSION RISK
Authors: Levchenko Yuliana 
Published: December 2023

Abstract
In an era where the built environment profoundly shapes the ability to age in place, this study aims to investigate the relationship between home modifications and the risk of nursing home admission. Using data from the 2000-2018 Health and Retirement Study, Cox proportional hazard models are employed to analyze the impact of various modifications on admission risk for older adults in the United States (N = 31,133). The home modifications considered include the presence of ramps, railings, wheelchair modifications, grab bars/shower seats, and an emergency call system. The results indicate that having a grab bar/shower seat in one’s home is consistently associated with a decreased risk of nursing home admission (HR = 0.42, CI = 0.34, 0.52). However, there is mixed evidence for the remaining modification. These findings underscore the potential significance of incorporating grab bars and shower seats into building codes and promoting their installation in homes. Such modifications may play a vital role in promoting independent living and reducing reliance on institutional care. Further research is needed to explore the underlying mechanisms by which home modifications influence the risk of nursing home admission.
SOCIALIZING CARE FOR OLDER PEOPLE ACROSS THE COUNTRIES: A COMPARATIVE STUDY OF THE LOCATION OF CARE
Authors: Jang Aeji , Lee Yeonjung , Choi Young 
Published: December 2023

Abstract
As more people are likely to prefer to age in their own place, where and how the care in later life is provided become more important. This paper aims to compare the degree of socialization in care for older people among different countries, especially focusing on the location of care (i.e., home care and institutional care). We applied the Fuzzy-set Ideal Type Analysis to classify the countries depending on how the formal care is provided between home and institutional settings. Measures of socialization in home care include the national expenditure on home care and the number of formal care workers at home, whereas formal care workers and the number of beds in residential LTC facilities are indicators for socialization in institutional care. The four different types of formal care will be classified: HI where both home and institutional cares are highly socialized; Hi where home care is highly socialized but institutional care is not; hI where institutional care is highly socialized but not home care; and hi where neither are socialized. Results show that Denmark, Australia, and the Netherlands belongs to HI; Japan to Hi, New Zealand, Switzerland, and Germany to hI; and Korea and the United States to hi. Findings suggest that countries with high level of socialization of home care are likely to have a care management system for coordinating and monitoring services. This study provides implications for considering the unique cultural, institutional, and policy contexts among the countries in regards to the degree of socialization of care.
MUSIC CREATIVITY INTERVENTION FOR OLDER ADULTS WITH AND WITHOUT MCI: COGNITIVE BENEFITS AND NEURAL MECHANISMS
Authors: Fagundes Christopher , Wu-Chung Lydia , Brandt Anthony , Bonomo Melia , Denny Bryan , Frazier Jefferson , Blench Karl 
Published: December 2023

Abstract
Alzheimer’s and related dementias are debilitating conditions, and at this time, no cure has been identified. Older age is associated with cognitive decline and dementia. Developing and testing innovative non-pharmacological interventions to delay the loss of functional ability and understand the neurobiological mechanisms underlying the intervention’s efficacy is imperative. We conducted a semi-randomized clinical trial evaluating the effects of a novel music creativity curriculum on cognitive and neurological outcomes. Eighty older adults with and without a mild cognitive impairment (MCI) diagnosis were randomized to a 6-week music creativity intervention or a 6-week no-treatment control condition. Before and after the six weeks, both groups participated in a series of self-report and cognitive assessments; they also participated in resting-state fMRI scans to quantify whole-brain network patterns of modularity and flexibility. Those randomized to the music group exhibited improved overall cognitive function and working memory relative to the control group (assessed using standard clinical neuropsychological assessments). The association between being randomized to the music group and increased cognitive function was more robust among those who exhibited greater neural flexibility at baseline. The study shows that music creativity interventions may positively affect cognition, especially among those whose neural network structure is more dynamic or flexible. This study is innovative as it is among the first to identify possible neural mechanisms underlying why music creativity interventions confer a more significant cognitive benefit for some older adults than others.