bluuebunny/crossref_metadata_2025_split huggingface dataset:
NON-COVID-19 UPPER RESPIRATORY INFECTION DECREASES DURING THE COVID-19 PANDEMIC
Authors: Pruchnicki Alec 
Published: December 2023

Abstract
During the Covid 19 pandemic, the Vista on 5th Assisted Living Facility in New York City instituted a wide variety of pharmacological and non-pharmacological interventions (NPIs) to control the spread of the disease. Before and after vaccines were available for Covid 19, this combination of approaches reduced the usual seasonal variation of non-Covid upper respiratory infections (URIs). Almost all residents of the 127-bed facility were seen by the on-site physician with the onset of URI symptoms. Almost all those with symptoms were give an anti-histamine and cough syrup for relief. The single off-site pharmacy which supplied these medications tabulated the total amount of medications dispensed over the four years of 2019 to 2022. During December of 2019, normally the peak month for URIs at the facility, and the last month before significant Covid infections occurred, 67 prescriptions of these two types were dispensed. During 2020 NPIs and these medications kept new Covid 19 infections to about one dozen over the year. Medications being dispensed for all URIs in December of 2020 decreased by 69% to 21. Similar low rates of URI symptoms were seen in December 2021 and 2022 with only 18 prescriptions written in both months. Although some variation from month to month occurred because of other syndromes, the overall burden of URIs during the normally peak respiratory infection season was greatly reduced probably from the strict imposition of NPIs.
BENZODIAZEPINE/Z-DRUG DEPRESCRIBING DEFINITIONS AND FALLS OUTCOMES IN ELECTRONIC HEALTH RECORDS
Authors: Schindler Nicole , Zepel Lindsay , Maciejewski Matthew , Hastings Susan , Clark Amy , Pavon Juliessa 
Published: December 2023

Abstract
Benzodiazepines and Z-drugs contribute to the burden of falls in older adults; however, there is a lack of data examining the association between deprescribing and falls in real-world settings. We explored this association in a retrospective cohort study of adults aged 65+ with chronic benzodiazepine/z-drug use who received care at an academic health system from January 2017-December 2020. Chronic use of benzodiazepine/z-drugs was defined as ≥ 3 medication dispensings and cumulative days’ supply ≥ 45 days within 100 days in 2018 based on electronic health records. Medication deprescribing was defined as having a dispensing gap of either ≥180 days or 90 days within one year of index. Non-deprescribers were matched 4:1 using propensity score methods (180-day gap sample=655; 90-day gap sample=1395). Primary outcome was time until first fall resulting in ED, inpatient, or outpatient visit during 2-year follow-up after meeting deprescriber/non-deprescriber status, modeled using a cox proportional hazards model adjusted for age, gender, and number of comorbidities and chronic medications. Using the 180-day gap deprescribing definition (n=131 deprescribers, and n=524 non-deprescribers), the cumulative incidence of falls-related acute events was 6.9% for deprescribers and 9.7% for non-deprescribers (HR 0.65 [95% CI 0.31, 1.31]). Using the 90-day-gap definition (n=279 deprescribers and n=1116 non-deprescribers), the cumulative incidence was 9.3% for deprescribers and 8.5% for non-deprescribers (HR 1.12 [0.70, 1.77]). In this small single-site sample, neither deprescribing gap definition was associated with falls. There is a need to standardize deprescribing definitions and validate them in larger studies in the context of relevant clinical outcomes.
PREDICTING FALLS IN OLDER ADULTS
Authors: Brown Colleen , Feiler Marina Oktapodas , Simonsick Eleanor 
Published: December 2023

Abstract
Falls are detrimental to older adults causing injury and mortality. Although clinical assessments of balance deficits exist, it is not well understood how well they predict falls. Longitudinal analysis utilized data from 688 men and women aged 60-97 enrolled in the Baltimore Longitudinal Study of Aging with index and subsequent visits approximately 1.7 years apart. Inclusion criteria included objective balance assessment at index visit and answering the question “Have you fallen in the past 12 months?” at both visits. Predictors of interest included thigh muscle strength, progressive static balance test performance, narrow walk, and sway reference with eyes closed/feet together. Tests were parameterized using validated methods. Adjusted logistic regression was modeled to estimate the association between objective measures of balance and fall risk. Adjustment variables included age, sex, race, height, and weight. Results reported those who failed the eyes closed/feet together position had 3.6 (95% CI 1.03, 12.81) times the odds of future falls compared with those who passed. Those who failed the semi-tandem, tandem, and single leg stance, had respectively 3.1 (1.44, 6.75), 3.6 (1.59, 8.06) and 4.8 (1.93, 12.09) times greater odds of history of falls compared with those who did not fail. Progressive standing balance performance did not predict future falls. The eyes closed/feet together test is easily administered, requires no equipment, and takes less than 30 seconds to complete. Failure of eyes closed/feet together may predict future falls, which is clinically relevant as this may suggest shifting the momentum towards proactively preventing an initial fall.
COMPARING THE OUTCOMES OF VIRTUAL VERSUS IN-PERSON DELIVERY OF AN EVIDENCE-BASED FALLS PREVENTION PROGRAM
Authors: Herrick Tamara , Dorsey Kirsten , Hallen Sarah , Wierman Heidi 
Published: December 2023

Abstract
Each year one in four older adults has a fall1 and only about half tell their doctor or healthcare provider2. One way to prevent falls is to provide older adults with the evidence-based tools to prevent them. A Matter of Balance: Managing Concerns about Falls (MOB), is a top tier program for grant funding from the Administration for Community Living Falls Prevention Program. MOB has been shown to reduce the fear of falling and increase activity levels among older adults through cognitive restructuring and balance exercises.8 Prior to 2020, MOB was only offered as an in-person, small group (8-12 participants), community based intervention over 8 two-hour sessions led by 2 volunteer facilitators. In response to the global COVID-19 pandemic, MaineHealth’s Partnership for Healthy Aging adapted the Lay Leader model of MOB for virtual delivery (MOB-V). Review of MOB-V pilot data suggested that it was also effective in reducing the fear of falling and increasing the activity levels of older adults. Based on this success, the MOB-V was more widely disseminated during 2021 and 2022, but to date no comprehensive program evaluation of the MOB-V has been completed. We will present the preliminary results of our evaluation of participant data collected from the National Falls Prevention database between 2021 through 2022.
APATHY IN NURSING HOME RESIDENTS WITH DEMENTIA: ANALYSIS OF WITHIN- AND BETWEEN-PERSON DIFFERENCES
Authors: Jao Ying-Ling , Liao Yo-Jen , Berish Diane , Mogle Jacqueline , Kales Helen , Boltz Marie 
Published: December 2023

Abstract
Apathy commonly occurs in persons with dementia, yet it is often overlooked in nursing homes. It is unclear how apathy symptoms differ within- and between-individuals. This observational study examined the differences in apathy among nursing home residents with dementia. Three videos, 3-10 minutes each, were recorded for each resident to capture caregiving interactions between caregivers and residents with dementia and apathy. Apathy levels were rated second-by-second by trained researchers via video observations using the Person-Environment Apathy Rating-Apathy subscale (PEAR-Apathy). The total PEAR-Apathy score ranges from 6-24, with higher scores indicating higher apathy levels. A total of 17 residents were enrolled from three nursing homes in Pennsylvania. Correlations and multilevel modeling were used for analyses. PEAR-Apathy score was 16.2 on average. Within-video average variability in apathy was 2.28 (range=0.47-4.24). Across-video within-person results showed average variability was 2.27, and the range between people was 1.36 to 3.31. Residents’ baseline apathy and depression, caregiver age, dementia care experience, and experience with the resident were not significantly correlated with apathy variability. Results from multilevel modeling showed that 11.2% of the within-person variance in apathy was accounted for by resident differences. After accounting for the clustering at the resident level, age was significantly associated with apathy variability (t=3.31, p=0.002). Results suggest that residents with dementia have moderate differences in apathy variability. Additionally, variability in apathy tended to increase with age. Future research may further examine factors contributing to individual differences in apathy and develop interventions to minimize apathy in nursing home residents with dementia.
COGNITIVE CHANGE AMONG NURSING HOME RESIDENTS; COGRISK-NH SCALE DEVELOPMENT TO PREDICT DECLINE
Authors: Howard Elizabeth , Morris John 
Published: December 2023

Abstract

Objectives
Chronicle cognitive changes in nursing home residents; develop risk model identifying predictors of decline.

Methods
Using secondary analysis design with MDS data, cognitive status and change measures were calculated based on Cognitive Performance Scale (CPS). Baseline and quarterly follow-up analyses of US and Canadian interRAI data (n=1,257,832) were completed. Risk model from logistic regression analyses identified predictors of decline.

Results
Baseline 15% of residents were cognitively intact (CPS = 0); 11.2% borderline intact (CPS=1), 15% mild impairment (CPS = 2). 58.8% of residents fell into more severe CPS categories (3-6). Over time, increased proportion of residents declined – 17.1% at 6 months, 21.6% at 9 months, at 21 months, 34.0%. Over same time, more residents remained stable than declined. Baseline CPS score was strong predictor of decline. CPS categories 0-2 had 3-month decline rates in mid-teens, categories 3-5 had average decline rate of 9%. Two strata risk model construction was employed – one for CPS categories 0-2, second categories 3-5 and both were integrated into 6-category risk scale (CogRisk-NH). Mean decline rates at 3-month assessment ranged from 4.4% to 28.3%. Over time, distinction among risk categories continued – 6.9% to 38.4.% at 6 months, 16.2% to 61.4% at 21 months. Case distribution had 15.9% in category 1, 26.84% category 2, and 36.7% category 3. Three higher risk categories (4-6) represented 20.6% of residents.

Conclusion
CogRisk-NH scale differentiates among residents and likelihood of decline. Knowledge of risk for cognitive decline enables allocation of resources targeting amenable factors contributing to decline.
ENGAGEMENT OF FAMILY/CARE PARTNERS OF OLDER ADULT LONG-TERM CARE RESIDENTS WITH PHYSIOTHERAPISTS: A SCOPING REVIEW
Authors: Connelly Denise , Stephen Alexander , Guitar Nicole 
Published: December 2023

Abstract
The aim of this scoping review was to summarize and critically evaluate literature describing the relationship between physical therapists and family/care partners of older adults living in long-term care homes. A librarian-informed search strategy was applied to Medline, EMBASE, Proquest, PsychINFO, SCOPUS and CINAHL databases. Papers were included if they addressed rehabilitation, physical therapists, family/care partners, and long-term care (LTC) setting or equivalent. Five papers were retrieved; quality was mid-to high. Challenges included minimal integration of family/care partners into the long-term care home ’team’, inconsistent resident-centred health goals across staff, and lack of awareness about availability of physical therapy services within long-term care homes. Value for family/care partners as members of the health care team included their historical knowledge of their loved one, ability to perceive and manage behaviour change, signs/symptoms of pain by their loved ones with impaired communication (e.g., dementia diagnosis), and the resource of time and availability to engage in rehabilitation-related care activity. There is little information about partnership with family/care partners of older adults living in long-term care homes. The timing is optimal to explore the engagement of family/care partners in providing care and building rehabilitation capacity within the context of increasing nursing workloads, nurses’ experience of burnout, difficulty in attraction and retention of care staff in long-term care homes, and challenges in funding for and standards in provision of optimal rehabilitation for older adult residents of long-term care homes.
EXAMINING VETERANS’ CHOICES OF HIGH-QUALITY MEDICARE SKILLED HOME HEALTH CARE AGENCIES
Authors: Kennedy Katherine , DeVone Frank , Corneau Emily , Cornell Portia , Gozalo Pedro , Magid Kate , Jones Christine , Thomas Kali 
Published: December 2023

Abstract
Medicare-certified skilled home health helps Veterans restore function post-hospitalization. Our objective was to understand the quality of VA contracted home health agencies (HHAs) available to Veterans (i.e., had at least 1 VA-paid episode of care in the 12 months) relative to the local market. For comparison, about one-third (30.4%) of traditional Medicare beneficiaries received care from high-quality HHAs (4- or 5-stars on quality of care) in 2015 (Schwartz et al., 2019). We used the Home Health CAHPS (Consumer Assessment of Healthcare Providers and Systems) 2016-2019 quarterly patient experience of care overall ratings (possible values: 1-5) to define a high-quality agency as those with 4- or 5-star ratings. We matched the quarterly ratings with the discharge date from a VA Medical Center to create HHA choice sets per eligible Veteran discharge. A choice set contains all contracted and non-contracted HHAs that serve a Veteran’s Zip Code. Among HHAs proximal to Veterans’ homes across all years (N= 10,507 unique HHAs), 54.8% were high-quality (n=12,449 HHA-years), 30.1% were 3-star quality (n=6,835 HHA-years), and 15.1% were low-quality (1- or 2- stars) (n=3,444 HHA-years). Among discharges, 53.2% (n=28,081) of the discharges went to high-quality HHAs and 15.7% (n=8,294) went to low-quality HHAs. Veterans tended to live in areas with access to high-quality home health care, and most discharges mapped to high-quality HHAs. However, there is room to improve Veterans’ access to high-quality skilled home health and more to understand about VA contracting practices and the HHA selection process.
TOOLS FOR MEASURING PERSON-CENTERED CARE FOR OLDER ADULTS IN LONG-TERM SERVICES: A SCOPING REVIEW
Authors: Akter Nahida , VanHaitsma Kimberly 
Published: December 2023

Abstract
Person-Centered Care (PCC) involves individuals in their care planning and decision-making. Measuring PCC is crucial in identifying the adequacy of PCC dimensions, which can then be used to promote quality of care and life, yet a comprehensive review of evidence on PCC measurement tools in long-term service and support settings (LTSS) is lacking. Our study aims to identify and evaluate available tools for measuring PCC for older adults in LTSS. This review followed the Arksey and O’Malley (2005) five-stage approach for scoping reviews and search was conducted in PubMed and CINAHL using selected keywords. The inclusion criteria were peer-reviewed journal articles written in English, reporting on PCC measurement tools for older adults (≥ 65 years) living in LTSS. Tools intended for use by family members and gray literature were excluded. Articles (n=23) were chosen from 914 studies after reviewing titles, abstracts, and full texts by two reviewers. They revealed 10 distinct tools for measuring PCC in LTSS, categorized as non-observational (e.g., interview, self-report) and observational (e.g., structured observation). The psychometric properties (reliability and validity) of the tools were reported, and their applicability in different cultural contexts was discussed. Many tools (n=8) demonstrated good reliability and validity, and their applicability was evident in multiple countries (e.g., Spain, Japan, Sweden, China, Italy and Norway). Our study adds to the discussion on PCC measurement tool development as it identifies gaps (e.g., lack of harmony between tools) for future researchers and potential areas for development by policy makers and administrators.
ENGAGING OLDER ADULTS AND CAREGIVERS AS STAKEHOLDERS IN THE ARTIFICIAL INTELLIGENCE AND TECHNOLOGY COLLABORATORY
Authors: Jain Paavani , Schoenborn Nancy , Cudjoe Thomas 
Published: December 2023

Abstract
Artificial Intelligence (AI) holds the unique potential to capture older adult functional and behavioral diversity and improve geriatric care. Yet a gap exists between new technologies and the real-world needs of their target populations. Currently in the United States, three Collaboratories support novel AI projects in Aging Research. As the Stakeholder Engagement Core of the Johns Hopkins AI Collaboratory, in this poster, we share early lessons of forming a ‘Council’ of stakeholders – a group with the charge of informing pilot AI projects longitudinally. The Council was envisioned to include 10-15 persons: older adults, caregivers, and clinicians. We adopted different outreach techniques for clinicians versus non-clinicians; leveraged existing relationships with affiliated Memory and Social Clinics; individually approached community dwelling older adults and caregivers including homebound older adults and older adults with disabilities; and reached out to clinicians and advocates known to be committed to geriatric care. We developed plain language materials and explained the meaning of ’AI’ and ’Stakeholder Engagement’. Five out of 5 outreached clinicians, and 10 out of 20 older adults/caregivers agreed to serve on the Council. Many older adults on our Council had difficulty using their email and computer and required support. Several caregivers declined due to high caregiving demands and many older adults with multiple chronic conditions declined due to high personal needs; all reiterated their interest in the topic area despite declining participation. Future novel-technology projects should ensure inclusion of diverse stakeholders; incorporating a flexible plan of engaging high-needs older adults and caregivers is required.
SOCIOCULTURAL BARRIERS TO EQUITY IN SOCIAL SUPPORT FOR DEMENTIA CAREGIVING IN MINORITY WOMEN
Authors: Kim Heejung , Kim Hyein , Brewster Glenna , Chee Wonshik , Im Eun-Ok 
Published: December 2023

Abstract
Racial and ethnic minority is growing in dementia caregiving population. This study aimed to identify racial/ethnic differences in social support and sociocultural factors related to caregiving among minority midlife women who were family caregivers of persons living with Alzheimer’s disease (MWPLAD). A secondary data analysis was conducted using the data from a cross-sectional online survey of 172 MWPLADs. Self-report questionnaires were used to collect the data on the caregivers’ sociodemographic and caregiving-related characteristics, social support for caregiving, and sociocultural factors for caregiving. Descriptive statistics, one-way analysis of variance, and hierarchical linear regression were adopted for the data analysis. Non-Hispanic Asian caregivers reported lower social support and greater perceived barrier during dementia caregiving than non-Hispanic African-American and Hispanic caregivers (p ≦ .001). Furthermore, non-Hispanic Asian caregivers reported a higher level of discrimination during caregiving, a lower level of cultural justification for reciprocity, and a lower level of cultural justification for duty than non-Hispanic African-American caregivers (p &lt; .001). After controlling for race/ethnicity and sociodemographic factors, those who received more social support were younger, experienced a lower level of discrimination, and had a higher level of cultural justification for caregiving duties (p &lt; .05). Our study findings support that racial/ethnic differences exist in caregivers’ social support. When enhancing social support among racial/ethnic minority caregivers for dementia, it is necessary to develop specific strategies for encouraging each race/ethnicity group in further large-scale studies and clinical practice in the future.
Fall Prevention Model at Local Non-Profit Equipment Exchange Program Utilizing the STEADI: a Compilation of Two Pilot Studies
Authors: Lewis Constance , Probst Karen , Tanilli Rachel , Schoenfeld Alix 
Published: December 2023

Abstract
Individuals picking up gently used durable medical equipment (DME) from a local non-profit equipment exchange program in Erie, Pennsylvania were prompted with the CDC’s Stopping Elderly Accidents, Deaths & Injuries (STEADI) 3-item abbreviated questionnaire and contacted by telephone 6 months later to assess if this survey tool can accurately predict falls. Individuals were also given a STEADI pamphlet upon equipment pickup to educate community members on fall risk. Ninety individuals, who ranged from caregivers to the individual themselves, chose to participate in the follow-up research phone call. Our researchers found that while the abbreviated 3-item STEADI suggested that 80% of community members (in need of DME by way of an equipment exchange program) were predicted to be at risk for a fall, only 22.5% suffered a fall within a six-month follow-up period. This questions the validity of the 3-item abbreviated STEADI, though additional studies are recommended to improve the participant percentage (only 90 out of 255 individuals, or 35%, answered the follow-up call questions) as well as increasing the length of wait time to assess for subsequent fall incident beyond six months. Additionally, only 34% of individuals recalled receiving a pamphlet when picking up equipment, and of those 31 individuals, only 10 of them (32%) remembered what the pamphlet said. This suggests that the simple use of a brochure handout to decrease fall risk amongst community-dwelling adults does not seem to be an effective educational strategy within the Erie, PA community.
RECRUITMENT AND RETENTION AMONG A LONGITUDINAL COHORT OF AGING ADULTS: EXPERIENCES OF THE WOODLAWN STUDY
Authors: Bugbee Brittany , Doherty Elaine , Green Kerry 
Published: December 2023

Abstract
Minimizing participant attrition is critical to the success of longitudinal studies, but locating and retention is challenging when assessments occur decades apart. This poster will describe efforts to locate participants from the Woodlawn Study, a longitudinal cohort of 1,242 Black Americans followed since 1966 who were assessed at ages 6, 16, 32, and 42. In 2021-2023, two decades since the last assessment, we attempted to locate 1038 participants still thought to be alive to complete an Age 62 interview. Key sources for locating were online contact information databases, genealogical records, and public property records. Deceased participants were identified via National Death Index records. Strategies to encourage participation included monetary incentives, flexible scheduling options, and sharing results from previous assessments. To date, 90.8% have been located, 2.5% are unlocatable, and 6.6% have been identified as newly deceased. Although the cohort originated in Chicago, participants were located in more than 25 states. Interviews were completed with 45.7% of located participants. Approximately one-third (37.7%) did not respond to contact attempts, 6.4% were hard refusals, and 10.3% were soft refusals. Mailed letters and phone calls were the most successful contact methods; social media and email were not fruitful. Interview completion rates were highest for participants who participated at Age 42 (51.4%) and lowest among participants not reached since Age 6 (5.3%). Recruitment challenges included non-response to phone calls, suspicion about scams, and unknown accuracy of locating information. Implications for locating and maintaining aging cohort members will be presented.