bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE INTERSECTION OF INSOMNIA AND CENTRALIZED PAIN IN OLDER ADULTS
Authors: Smith Michael , Dean Meagan , Irwin Madison 
Published: December 2023

Abstract
The intersection of insomnia and pain with age has been broadly studied but has not been evaluated specifically in centralized pain. The objective of this study was to estimate the effect of age on rates of centralized pain and insomnia in older adults. This was a single center, retrospective, observational cohort study consisting of older adults (≥55 years old) with a diagnosis of centralized pain, insomnia, or both seen at University of Michigan Health from January 1, 2016 – January 1, 2022. The primary outcome was the proportion of older adults with both insomnia and centralized pain, defined as least one centralized pain diagnosis coded in the subject’s electronic health record within one year of insomnia diagnosis. A total of 26,804 patients were included in the analysis. Mean age was 66.84 years (SD 8.79); 66% of patients (n=17,687) were female. Overall, 92.1% of patients (n=24,683) carried ≥1 centralized pain diagnosis, 5.6% of patients (n=1,505) carried a diagnosis of insomnia, and 2.3% (n=616) had both [95% CI 2.1,2.5]. Of older adults with insomnia, 29% (95% CI 27, 31) also carried a centralized pain diagnosis. Of older adults with centralized pain, 2.4% (95% CI 2.3, 2.6) also carried an insomnia diagnosis. Compared to older adults with insomnia alone, those with both insomnia and centralized pain were more likely to be female (p=&lt; 0.001) and older (p=0.014). Insomnia and centralized pain are highly prevalent in older adults and co-occur frequently in those with insomnia. Older adults with insomnia should be screened for centralized pain.
ACCEPTABILITY OF PODCASTS TO ENHANCE WELLNESS SKILLS AMONG OLDER ADULTS IN AN UNDERSERVED COMMUNITY
Authors: Janevic Mary , Lindsay Rebecca , Brewer Robin , Hill-Ashford Yolanda , Guzman Rebeca , Robinson-Lane Sheria , Hassett Afton , Murphy Susan 
Published: December 2023

Abstract
Podcasts convey information in an accessible, engaging, and memorable way, yet are seldom incorporated into behavioral interventions for older adults. We developed a podcast series as a component of the RESET intervention (Re-Engaging in Self-care, Enjoying Today), the subject of an ongoing NIH-funded randomized controlled trial in Detroit, Michigan. In RESET, community health workers teach self-management and resilience-building skills to small groups of primarily African American older adults, to address challenges to well-being and functioning caused by the COVID-19 pandemic. Participants listen to six podcast episodes, accessible by website, app, or IVR/dial-in, which feature an older-adult host from the community interviewing other community members and topic experts. Each episode is then discussed in the corresponding intervention session. The goal of the current study was to evaluate the first three podcast episodes (Power of Positivity, Eating for Well-being, and Stability in Strength) in a convenience sample of 8 older adults and agency staff from our trial’s Community Advisory Board. Using 5-point Likert scales, all respondents strongly agreed or agreed that the episodes were enjoyable, relevant, and effectively taught key wellness skills. Podcast strengths identified by respondents included: warm interactions between host and guests, motivational tone, and compelling personal stories. Areas for improvement included the need to represent additional perspectives. These data suggest that podcasts are an acceptable way to provide health information to older adults. The ongoing RESET trial will allow us to determine the extent to which podcasts can help bring about behavior change and functional improvement.
EARLY DEVELOPMENT OF BIO-EXPERIENTIAL TECHNOLOGY TO SUPPORT PERSONS WITH DEMENTIA AND CARE PARTNERS AT HOME
Authors: Rochon Elizabeth , Sy Maimouna , Phillips Mirelle , Anderson Erik , Plys Evan , Ritchie Christine , Vranceanu Ana-Maria 
Published: December 2023

Abstract
Bio-experiential approaches offer an interactive, multisensory, immersive environmental experience using technology and physical design to promote mind-body wellness. These designs have the potential to provide an in-home solution to help persons living with dementia and their care-partners manage challenges including agitation, conflict, stress, and difficult emotions (e.g., grief). This presentation discusses a partnership between an interdisciplinary academic team and a creative design and technology studio that has pioneered bio-experiential designs. This partnership’s mission is to develop a free interactive, immersive bio-experiential platform that offers a positive and engaging experience for both persons living with dementia and their care-partner(s). Our team iteratively developed an initial prototype using multiple strategies rooted in user-centered design, including a literature review, design thinking workshop with the full team, and two focus groups with clinicians (N=10; neurologists, geriatric psychiatrists, geriatricians, neuropsychologists, social workers, occupational therapists). Early development emphasized safety to minimize risk of increased agitation or other neuropsychiatric symptoms (e.g., hallucinations, sleep impairments). Key recommendations to enhance safety and usability included simple calming visuals and sounds, personalized experiences, familiar stimuli, and multisensory engagement (e.g., music, tactile stimuli). Increasing accessibility was also discussed related to ease of use and availability of platforms (e.g., laptop, television). We are now preparing for “live” iterative usability testing of our prototype (i.e., beta testing) with a diverse group of persons living with dementia and care-partner(s) before efficacy testing. The larger goal is implementation and wide dissemination as well as adaptations for other neurodegenerative conditions. *Dr. Vranceanu and Ritchie are co-senior authors.
ENGAGING OLDER ADULTS VIA SOCIAL MEDIA DURING A PANDEMIC: SUCCESSFUL LEARNING EXPERIENCES FOR STUDENTS AND ADULTS
Authors: Cox Krista , Zeiner Tracey , Moore Jennifer , Traywick LaVona , McAtee Robin 
Published: December 2023

Abstract
The Arkansas Colleges of Health Education and the Arkansas Geriatric Education Collaborative collaborated on a project to educate senior adults about the use of assistive technologies (AT) for self-care, home management, community engagement, and leisure participation to help them live safely and independently. Occupational and physical therapy students collaborated with 10 community dwelling senior adults to research, develop, and disseminate 27 video vignettes shared via Facebook. These vignettes were developed and shown during a time when senior adults were encouraged to isolate during the pandemic. As of January 2023, the outcomes of sharing the 27 video vignettes on Facebook included: a total of 17,204 views, the most viewed was “Lighting and Magnification” at 1,000+ views, followed by “Sewing” at 992 views, the least viewed was “Fishing” at 147 views. Older adult viewers feedback included: contact with ACHE to ask how to purchase the assistive devices; sharing the information gained with their family members and others; purchase of devices; providing a resource for AT assistance for OA. Additionally, the senior adults that participated in the project reported a better understanding of the AT after presenting in the videos. In conclusion, these results indicate that creating the video vignettes and sharing them on Facebook had an extensive reach beyond the 27 individual sessions. This also demonstrated that the viewers were actively engaged as noted by their questions and comments.
FEASIBILITY OF CONTINUOUS PASSIVE MONITORING OF DAILY FUNCTION AND SYMPTOMS IN OLDER ADULTS WITH MULTIPLE MYELOMA
Authors: Tibbitts Deanne , Silbermann Rebecca , Roeland Eric , Webb Jason , Meyers Gabrielle , Shannon Jackilen , Kaye Jeffrey , Winters-Stone Kerri 
Published: December 2023

Abstract
The impact of cancer and cancer treatment on older adults’ day-to-day health and functioning remains poorly characterized. Therefore, we evaluated the feasibility of using home-based, continuous passive monitoring of daily life functioning plus symptom surveys in older adults with multiple myeloma (MM). We assessed accrual, uptake of passive monitoring, retention, survey completion, and data completeness. Passive monitoring included infrared motion sensors (activity), door contact sensors (time out-of-home), watch (activity/sleep), bed mat (sleep), biometric scale (weight), electronic pillbox (medication-taking habits), and computer-use software (computer habits). A weekly online survey assessed health events (i.e., falls, hospitalization/ED visits, pain) and treatment-related symptoms (PRO-CTCAE). We enrolled 20 patients with MM of 55 referred (36% accrual) with a median age of 71 years (35% female); 8 patients enrolled with a care partner. Half of patients agreed to passive monitoring and weekly surveys; half completed surveys only. Refusal of passive monitoring was primarily due to concerns about privacy/intrusiveness. Retention over 17 months was 85% (3 dropouts from the survey-only group). Survey completion was 82% (missing reasons included “poor health” and “too busy”) with a median completion time of 4.6 minutes. Data completeness for passive monitoring ranged from 66% for watch-based sleep (n=9 patients) to 93% for home-based activity (n=14 homes). In sum, passive monitoring of daily life functioning plus symptom surveys is feasible among older adults with MM. Future research will integrate daily functioning with symptom data to examine longitudinal variations in health and develop digital biomarkers to inform optimal timing of future interventional studies.
SMOOTHING SPLINE ANOVA MONITORING PHYSICAL ACTIVITY AND FALL RISK IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Xie Rui , Chen Lulu , Park Joon-Hyuk , Stout Jeffrey , Thiamwong Ladda 
Published: December 2023

Abstract
Emerging sensing techniques, which are easily transportable, user-friendly, and cost-effective, may reveal new possibilities in monitoring daily objectively measured physical activity (PA) and fall risk appraisal (FRA) identification. We used a Smoothing Spline Analysis of Variance (SS-ANOVA) to profile the daily PA using accelerometer-based device across FRA groups. Using the BTrackS system (static balance assessment) and a short Fall-Efficacy Scale-International, 124 participants (mean age 75, range 60-96, 77% female, 72% no history of falls) were categorized into four different FRA groups: rational (46.8%, low fear of falling (FOF) and normal balance), irrational (17.7%, high FOF and normal balance), incongruent (19.4%, low FOF and poor balance), and congruent (16.1%, high FOF and poor balance). The vector magnitude (VM) and the number of steps were extracted per second from an average 10 (SD=4.89) consecutive days of PA recording. Daily (0-24h) temporal trend was analyzed from 1.7 million records. Groupwise, PA of the congruent group was significantly lower than other three groups, while the rational group had the highest PA based on 95% Bayesian C.I. It is evident that there is a periodic trend in PA; in particular, inactive during night (12-5am), increasing trend in the morning (5am-noon) and peak at noon, moderately decrease in the afternoon (noon-6pm), and significantly decline in the evening. No significant gender differences in PA were found. These results indicate that FOF associated with poor balance contributes to low PA, highlighting the necessity of balance enhancing intervention and cognitive reframing to promote PA in older populations.
SOCIAL ISOLATION IN OLDER ADULTS POST HIP SURGERY IS CORRELATED WITH MOBILITY AND PHYSIOLOGICAL INDICATORS
Authors: Dayyani Faranak , Chu Charlene , Abedi Ali , Khan Shehroz 
Published: December 2023

Abstract
Hip fracture affect approximately 30,000 people in Canada and more than 300,000 people in U.S., annually. Older adults post hip-fracture surgery experience social isolation along with reduced physical mobility, changes in sleeping patterns, reduced indoor and outdoor activities, and other physiological changes once they are discharged form inpatient rehabilitation. Our team has developed MAISON (Multimodal AI-based Sensor platform for Older iNdividuals), a cloud-based multimodal sensor system that supports the collection of physiological, ambient and contextual data from various smart devices. Currently, MAISON consists of a smart watch, a smart phone, a motion sensor and a sleep mattress. Using MAISON, we have collected 24 weeks of raw acceleration data, heartrate, step count, frequency of indoor motion, GPS and sleep metrics from three older adults post-hip surgery living in the community. Statistical and domain-specific features were extracted from the collected data with a time window of one day, including average heartrate, maximum acceleration, total sleep time, total steps taken, and average number of exits. Additionally, clinical data is collected from the participants on a biweekly basis consisting of three questionnaires (i.e., Social Isolation Scale (SIS)) and two physical tests. The correlation between features from sensor data and clinical data was performed using Spearman coefficient, which showed a strong positive correlation (&gt;0.5) between the SIS and number of exits, variance of acceleration, total sleep time, and heartrate variance. Various correlation values were found between features from all the sensors and SIS, indicating the usefulness of multimodal sensors for this application.
THEORETICAL FRAMEWORK FOR AN ARTIFICIAL INTELLIGENCE–BASED COMPREHENSIVE GERIATRIC ASSESSMENT
Authors: Golden Adam 
Published: December 2023

Abstract
Comprehensive Geriatric Assessment (CGA) is a process where healthcare professionals evaluate and develop a management strategy for older adults who may have multiple multifactorial illnesses and geriatric syndromes. CGA has traditionally been a labor-intensive process that assesses many factors at a specific point in time. Its availability and feasibility in busy clinical settings is remains limited. Artificial Intelligence (AI) can potentially expand the accessibility and effectiveness of this currently limited resource. By integrating large numbers of longitudinal data sets, AI can evaluate in real time a broad array of ever-changing factors that include medical assessments, diagnostic testing/imaging, laboratory analysis, nursing evaluations, behavioral health interventions, social determinants, electronic monitoring, wearables, community resources, and caregiver support. A geriatric AI framework will need develop computational models that integrate changing biologic, sociodemographic, and mental health factors. The framework could also account for the changing availability of local resources and plan eligibility. The integration of large longitudinal datasets would allow for prediction modeling related to diagnosis, management strategies, and outcomes. Treatment protocols can be automated too. Machine learning will allow for the adjustment of medical alert thresholds to minimize alert fatigue that plaques current electronic health record systems. Just-in-time information can identify appropriate home technology equipment and referrals for community services. An AI framework potentially offers a more comprehensive and longitudinal geriatric evaluation that avoids delays in care while waiting for a single physician to “get to see the patient.”
UNDERSTANDING THE COMPLEXITY AND USE CHALLENGES OF MEDICARE PLAN FINDER FOR OLDER ADULTS
Authors: Lee Hye Soo , Harris Maurita , Rogers Wendy 
Published: December 2023

Abstract
It is critical for older adults to find an affordable health plan that meets their needs. The Medicare.gov site provides a Medicare plan finder (MPF), which is an online tool designed to assist individuals to find a Medicare plan that is most suitable for them. The MPF was updated in 2021 but remains complex and may be especially difficult for older adults to use, given age-related changes in cognitive abilities. To identify potential use challenges for MFP, we documented the complexity of the steps required for accomplishing the goal of finding a plan. We completed a task analysis using two use-case scenarios to illustrate potential paths one could take in using MPF. Both use cases were set to enroll in the same plan to explore how and why their paths could differ, focusing on whether they have prior information and experience with Medicare and MPF. The number of steps taken by these two use cases ranged from 10 steps (experienced user) to 32 steps (novice user), due to the different needs they had for using MPF. The results imply that the one-for-all design of MPF may not be optimal for meeting the different needs of users. We propose two solutions to reduce the number of steps for using MPF. First, users need to be able to access the functions they want from the start (e.g., using quick links from the initial page). Second, users would benefit from learning what they need to know and prepare before they start using MPF.
WHAT DO OLDER ADULTS THINK ABOUT ELECTRONIC PAIN APPS? USING A HEALTH LITERACY FRAMEWORK TO MEASURE QUALITY
Authors: Milidonis Mary , Rupp Hayley , McGinty Patrick , Kopiera-Frye Karen 
Published: December 2023

Abstract
Mobile pain applications (apps) may improve health communication. Mobile health apps do not always consider the needs of older adults. This project examines perceptions of pain apps on smartphones among older adults. The sample consisted of 23 older adults (M age = 64 years), with majority female (83%), predominantly Caucasian (91%), and majority some college education (65%). Respondents answered questions about 5 free pain apps using the Mobile Application Rating Scale (MARS). The MARS assesses descriptive and technical aspects of an eHealth apps using five categories including four quality scales: engagement, functionality, aesthetics, and information and one subjective quality scale. Participants currently had pain with range of 3 months to 12 years. The Single Item Health Literacy Screener identified 17 people have never asked for help reading health information; all participants scored 100% on the Rapid Estimate of Adult Literacy in Medicine Short Form. Participants self-reported an average of 2.6 comorbidities on the Functional Comorbidity Scale. The participants overall MARS rating ranged from 1-5; 11 participants rated pain apps very high (4-5). Important app characteristics identified by the older adults as critical for useable app included: Clear instructions, good navigation, and easy functionality. The elders reported that difficulty with loading the app and slow times would deter their use of the app. In terms of frequency of use, participants felt using the app was important weekly only if they experienced pain. These are important considerations in designing age-friendly technology for use with the frequent condition of pain among older adults.
A SYSTEMATIC REVIEW OF EFFECTIVE STRATEGIES OR INTERVENTIONS TO SUPPORT DRIVING CESSATION AMONG OLDER ADULTS
Authors: Dickerson Anne , Stapleton Tadhg , Margot-Cattin Isabel , Harries Priscilla , Gélinas Isabelle , Choi Moon , Swanepoel Lizette , Unsworth Carolyn 
Published: December 2023

Abstract
Driving remains the primary mode of transportation and often the only mode for rural and suburban areas. However, research is clear we all outlive our ability to drive. Nevertheless, as community mobility is essential to health and quality of life, we need to study and invest in understanding how to use and learn alternative means of transportation, especially for the vulnerable aging. A systematic review was designed to examine the literature for evidence-based strategies or interventions to support driving cessation among older adults while maintaining community mobility. The team of 13 international researchers from seven countries used the Covidence software with support of an expert health sciences librarian. Using multiple search terms (e.g., driving retirement; driving cessation; driving transition; interventions; strategies; older adults), 7317 studies were imported for screening with 7059 eliminated; 205 full texts were assessed for eligibility by 2-3 members. With 187 excluded, 19 studies were included and examined by the two primary authors. Results demonstrate low evidence of effectiveness of programmatic interventions, although multiple strategies have been identified. Overwhelmingly, the evidence supports starting very early with discussions about the process of transitioning from driving to being a passenger; particularly true with progressive diagnoses such as dementia. This presentation will highlight the programs currently available, strategies that appear to be successful, and review current toolkits for supporting driving cessation as well as emerging interventions and strategies.
CAREGIVING PUBLIC HEALTH SURVEILLANCE: EXPERT-GUIDED COLLABORATION FOR BRFSS MODULE REVISION
Authors: Shean John , Olivari Benjamin 
Published: December 2023

Abstract
The Behavioral Risk Factor Surveillance System (BRFSS) Caregiver Optional Module collects population-level data on caregiving prevalence, burdens faced by caregivers, and demographic information about care recipients. Developed in 2009, periodic reviews ensure the module remains current, data collected remain actionable, and encourage uptake of the module by state health agencies. In 2022, the Alzheimer’s Association and the Centers for Disease Control and Prevention’s Alzheimer’s Disease Program formed an expert workgroup to examine the ongoing value and relevance of the module and to propose improvements. The thirteen-member workgroup included academic researchers, caregiving experts, health promotion directors, epidemiologists, survey methodologists, policy analysts, and BRFSS coordinators. Over four months, the workgroup used a consensus-building process to identify areas of agreement and disagreement which informed discussion. Among many factors, the workgroup assessed the existing module for accuracy and utility. Discussion centered on utilizing plain language in the module’s questions, streamlining response options, and ensuring collection of a full scope of burden faced by caregivers, including caregivers of persons with dementia. Persons living with cognitive impairment and their caregivers were consulted during the process to ensure phrasing reflected their lived experience. The result was consensus on suggested revisions to the Caregiver Module, which was submitted to CDC for review and approval in April 2023. The revised module will be featured in this session. The robust process, involving a variety of stakeholders and perspectives, can serve as an efficient and effective model for ensuring sustainability and data-informed action using population health surveillance.