bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EYE OF THE STORM: END-OF-LIFE CARE IN NEW YORK CITY DURING THE COVID-19 PANDEMIC: LESSONS FOR THE FUTURE OF HOSPICE
Authors: David Daniel , Franzosa Emily , Brody Abraham 
Published: December 2023

Abstract
Public health containment and mitigation policies in response to the COVID-19 pandemic, including social distancing, infection control, and self-quarantine led to a substantial reduction in transmission of COVID-19. Yet they also brought about significant disruptions in healthcare, particularly care at the end of life. These challenges were amplified in older adults of color and those who contend with differing social determinants of health that impact care outcomes. Hospices played a key role in supporting patients at home throughout the pandemic and yet concomitant with the surge in demand for hospice, there was a gap in hospice delivery, exposing latent vulnerabilities in the capacity to respond to a crisis that demanded a coordinated, synchronized approach. We present the findings of an innovative, mixed methods study funded by the National Institute of Nursing Research that combines qualitative content analysis of linked electronic health records with qualitative stakeholder interviews to gain an in-depth understanding of the challenges of delivering hospice care in NYC during the pandemic. Interviews include the perspectives of nurses, managers, administrators, physicians, medical directors, social workers, and clergy from several healthcare practices. Our presenters address 4 key areas: a) Provider experiences and organizational challenges and successes, b) Challenges in transitioning from primary care to hospice, c) Efforts to provide equity-focused hospice care, and d) The central role of home health aides in end-of-life care. Together, these experiences provide insights into lessons learned and point to new opportunities to design and deliver high-quality hospice care in the future.
DIVERSIFYING THE PIPELINE OF GERONTOLOGISTS AT THE UNIVERSITY OF MASSACHUSETTS BOSTON
Authors: Miller Edward , Stokes Jeffrey E , Nadash Pamela , Boerner Kathrin , Birchander ellen 
Published: December 2023

Abstract
The University of Massachusetts (UMass) Boston is a public research university serving approximately 16,000 students. It is the most diverse university in New England and third most diverse university in the nation. UMass Boston prioritizes fostering an anti-racist and health-promoting institutional culture. Consistent with this priority, the Gerontology Department is committed to growing the size and diversity of the professional pipeline in aging services, policy, practice, and research. This presentation describes the multi-pronged approach taken to achieve this objective, while identifying associated facilitators and challenges. Department-wide initiatives include prioritizing work in disparities and a commitment to diversity, equity and inclusion in faculty hiring and implementing curriculum self-assessment and climate survey tools. Doctoral program initiatives include establishing a scholarship in Social Justice and Aging and submitting a training grant application in Health Equity Research. Undergraduate program initiatives include changing the name of the major to “Aging Studies” to make the content clearer and more accessible, proposing a minor in Aging Studies to make it possible for students from across the University to earn a valuable credential, having all courses meet Social and Behavioral requirements in general education (including, in select cases, the Diversity requirement as well), and expanding the number and attractiveness of course offerings (including “Diversity and Aging”). The Department is also implementing an initiative where undergraduates receive paid internships at local-area aging agencies with potential for continued employment post-graduation. Enhancing diversity goes hand-in-hand with growing program enrollment with positive benefits for older adults and their families, caregivers, and communities.
STUDY METHODOLOGY AND SAMPLE SELECTION TO DEVELOP AGE-INCLUSIVE STRATEGIES
Authors: Lin Yan , Xu Shu 
Published: December 2023

Abstract
Practical, feasible, and impactful age-friendly campus strategies to advance age inclusivity were identified through focus group and Delphi panel methodologies. Sixteen virtual focus groups with 78 participants (41 faculty, 16 students, and 21 staff/administrators; 44% ages 45-64 and 12% 65 and older) were conducted to assess age inclusivity in three institutional functions defined as high impact: teaching and learning, personnel, and student affairs. Facilitators presented participants with questions based on strategies and challenges identified from open-ended survey responses to our previous study. Following similar scripts for each of the three groups, facilitators asked 5 to 6 questions regarding potential strategies to address challenges such as those related to teaching older, age-diverse students; intergenerational tensions and biases; student support services; and incentives for faculty to integrate aging content into their courses. Next, the strategies yielded from this analysis were presented in online surveys to the Delphi panelists to assess their feasibility and impact. These 18 panelists had been selected based on their broad experience in higher education and upper-level administrative knowledge, professional connections, and/or expertise in diversity/inclusion/equity initiatives. In the first round, they evaluated the relative importance of 21 challenges to age inclusivity and their appropriateness, feasibility, and likelihood of implementation. The second-round survey narrowed the list of strategies to those rated as most viable (feasible and appropriate) in the first round and identified priorities among the selected strategies.
PREDICTIONS FOR DEMENTIA BURDEN AND POLICY RESPONSES IN CHINA AND UK BY 2050
Authors: Liao Jing , Brunner Eric 
Published: December 2023

Abstract
The goal of this symposium is to provide a forum to interact with the principal communities, who are developing research on the projection of dementia burden to ageing society and policy responses. It is driven by the UK-China Health and Social Challenges Ageing Project (UKCHASCAP). China’s rapid ageing process is occurring at an earlier stage of economic development than many other countries including UK, posing great demands on families, communities and health and care services. Thoughtful comparison of health and social care policy across the contrasting countries will be scientifically illuminating and valuable to policy makers. Preliminary results from four studies will be presented. Two studies based on large ageing cohorts of China and the UK, using multi-state Markov modelling (IMPACT-CAM, IMPACT-BAM) to construct predictions of dementia and related health status (e.g. CVD and physical disability) to 2050. The British model will highlight calculation of dementia incidence trend over time. The following study further used IMPACT-CAM to predict socioeconomic cost of medical, informal and formal care, and quality adjusted life years associated with dementia in China in corresponding years. The fourth study systematically evaluates the effects of implementing long-term care insurance in pilot cities in China, and analyses the main challenges in establishing a nationwide equitable long-term care system for older people. Through this symposium, the panel will provide state-of-art modelling and latest data on the innovative, interdisciplinary and international collaboration for predicting dementia, and provide scientific advices for policy making on healthy ageing in China, the UK and globally.
MOBILIZING INTERDISCIPLINARY RESEARCH TO ILLUMINATE DIVERSITY ACROSS THE CANCER CARE CONTINUUM
Authors: Halpin Sean , Krok-Schoen Jessica 
Published: December 2023

Abstract
Cancer diagnoses increase precipitously with age, impacting diverse populations who have different experiences, needs, and resources. In our symposium, we bring together researchers from multiple disciplines to present on the diversity of older adults living with cancer and the ways that health care providers, systems, and researchers are innovating to support them. Carrion presents the knowledge of gender-specific types of cancer among older Latinos/as. Seaman presents research on the use of comprehensive geriatric assessments by oncology and primary care providers who work with older adults. Blackberry discusses the use of age-friendly models of care within cancer care. Halpin discusses the results from a scoping review of cancer therapy decision-making among patients with co-morbid dementia and cancer and their caregivers. Ultimately, we discuss the need for multiple methods to understand the experience of patients from diverse populations and with various cancer diagnoses and innovate in cancer care research.
THE ROLE OF AGE-FRIENDLY HEALTH CARE IN OLDER ADULTS WITH CANCER
Authors: Blackberry Irene Darmadi , Rich Stacey , Hodge Oliver , Rasekaba Tshepo , Webb Nicole , Steer Christopher 
Published: December 2023

Abstract
It is estimated that 51% of cancer incidence worldwide occurs among adults aged 65 years and older. The care of older adults diagnosed with cancer is complex due to an interplay of biopsychosocial factors, including comorbidities, geriatric syndromes, functional status, nutritional health and socioeconomic characteristics. Working within an age-friendly model of care is important in ensuring the complexity of ageing is taken into consideration, while understanding what matters most to the patient undergoing cancer treatment. Age-friendly models of care such as the 4Ms framework (Mentation, Mobility, Medications, and (what) Matters) are gaining support across the globe, but little is known of the use of age-friendly models of care in cancer care. This scoping review aimed to understand the current state of age-friendly care in cancer care and to highlight how age-friendly models can be implemented in cancer care to improve the experience of treatment for older adults.
SOMATIC COMORBIDITY PATTERNS IN PEOPLE WITH DEPRESSION: A POPULATION-BASED COHORT STUDY
Authors: Luo Hao , Vetrano Davide , Triolo Federico , Zucchelli Alberto , Zhang Yingyang , Wang Pengcheng , Man Kenneth , Lai Francisco 
Published: December 2023

Abstract
People with depression often present with co-existing somatic conditions, which impact survival and steer patients’ clinical management. This study aimed to identify unique patterns of somatic comorbidity in people with depression and examine their associated mortality. We used population-based electronic health records from the Clinical Data Analysis and Reporting System in Hong Kong. People aged 40+ who had an incident depression diagnosis between 2001 and 2015 were included and followed up until 31 December 2018. Latent class analysis was applied, separately by decades, to individuals with depression and at least one comorbid somatic condition. Cox proportional hazard models were used to examine the risk of mortality associated with specific comorbidity patterns, adjusting for sociodemographic and clinical characteristics. We identified 38,889 eligible individuals (mean age: 62.8; 68.7% women). Latent class analysis identified an increasing number of patterns with age (two to seven). Compared with the unspecific pattern, the following patterns were associated with the highest mortality risk in different age groups: cardiometabolic and cerebrovascular diseases in individuals aged 40-49 (hazard ratio [HR] 2.5 [95% CI 1.7-3.7]), cardiometabolic diseases and anemia in those aged 50-59 (HR 3.4 [2.6-4.5]) and 70-79 (2.7 [2.3-3.3]), cardiometabolic, cerebrovascular diseases, and anemia in those aged 60-69 (HR 2.5 [2.0-3.2]), and cardiorespiratory disease in those aged 80+ (HR 2.0 [1.8-2.3]). Specific somatic comorbidity patterns were independently and substantially associated with the risk of mortality. This highlights the importance of taking combinations of somatic conditions into account when tailoring the clinical and care approach to people with depression.
PHYSICAL ACTIVITY AND IMPACT ON PSYCHOLOGICAL AND BEHAVIOR SYMPTOMS ASSOCIATED WITH DEMENTIA
Authors: Drazich Brittany 
Published: December 2023

Abstract
The aim of this study was to examine the impact of physical activity during hospitalization on behavioral and psychological symptoms of dementia among older adults, after controlling for covariates (age, gender, race, comorbidities, care interactions, and treatment group) and examine the association of physical and behavioral and psychological symptoms of dementia among hospitalized older adults living with dementia. Data from the first 365 participants in the FFC-AC-EIT study was used. Physical activity was measured over 24 hours and was based on the Physical Activity Survey which included the following activities: walking, wheeling, bathing, dressing, feeding, grooming, and toileting. Behavioral and psychological symptoms associated with dementia were based on the Neuropsychiatric Inventory (NPI). The mean age of participants was 83.18 years, the majority was female (63.6%) and White (69.4%), the mean NPI was 1.28(SD=1.85) and mean activities was 8(SD=5). A total of 16% of individuals performed no activity. The most common activity was eating and the least commonly performed was self-propelling in a wheelchair. A total of 40% engaged in walking and 60% performed some bathing and dressing while hospitalized. After controlling for covariates, physical activity explained an additional 2% of the variance in NPI scores (beta=-.13., p=.05). There was no evidence that engaging patients in physical activity resulted in behavioral symptoms and activity may help to decrease these symptoms. Continued focus is needed to engage older adults living with dementia when hospitalized to engage in routine physical activity by performing activities of daily living.
ADVANCING HEALTH EQUITY AMONG OLDER ADULTS THROUGH COMMUNITY ENGAGED RESEARCH
Authors: O’Conor Rachel , Lewis-Thames Marquita 
Published: December 2023

Abstract
Health equity, the absence of unfair and avoidable differences in health among social groups, has garnered mainstream attention due to recent civil unrest in communities, yet remains an elusive goal for aging health researchers. Community-engaged research is one approach to improve older adult health equity. Community-engaged research involves partnerships between researchers and community organizations, community health centers, and community members to pursue a common goal. To shift the traditional paradigm of investigator-led and -implemented research, community-engaged principles emphasize the co-production and ownership of knowledge. While community-engaged research has a successful track record in facilitating health disparities research, far fewer partnerships have been formed to 1) elevate the voices of older adults and 2) investigate and act on root causes of health disparities in older adults. To advance the practice of community-engaged research focused on older adult health, this symposium presents five community-academic partnerships elevating older adult voices from diverse groups and health conditions while simultaneously describing engagement strategies across the research process. First, Grant outlines processes for leveraging community representatives as partners in developing multilevel interventions for older cancer survivors. Second, Filec describes a multi-year community-engaged research journey that culminated with a study investigating the health impacts of a home repair program. Third, Singh details a user-centered design approach through a community advisory board to develop a telehealth navigation tool. Fourth, Lewis-Thames describes a community-based qualitative assessment capturing telehealth utilization among rural older cancer survivors. Lastly, Oladejo presents the community-driven development of a culturally-tailored dementia caregiving program for Black caregivers. This is a Community-Engaged Research Interest Group Sponsored Symposium.
TELEHEALTH UTILIZATION BY RURAL OLDER CANCER SURVIVORS: A COMMUNITY-BASED QUALITATIVE ASSESSMENT
Authors: Lewis-Thames Marquita , Trimble Shawn , Rosen Francesca 
Published: December 2023

Abstract
In a nationwide survey, rural clinic uptake of telehealth utilization increased by 70% compared to pre-pandemic utilization. Despite advancements in tele-delivered cancer care for rural residents, older adults are slower to engage the technology; yet examinations of the challenges rural older cancer survivors face when incorporating telehealth into complex cancer care are limited. Guided by the Andersen Healthcare Utilization Model, we qualitatively examined barriers and facilitators of telehealth utilization for rural older cancer survivors. Ongoing interviews began in March 2022. We purposively sampled telehealth-using rural older cancer survivors, caregivers of rural older cancer survivors, and healthcare professionals that served this population. The interview guide probed participants regarding telehealth utilization for cancer and survivorship care. We used thematic analysis and deductively coded to the Andersen Model constructs. Preliminary findings are based on six rural older cancer survivors, caregivers, and healthcare professionals. Most participants were Non-Hispanic White, had at least some college, traveled greater than 31 minutes to an oncologist, and used their cell phone or computer to access telehealth. We coded similar perceptions between survivors, caregivers, and healthcare providers. Emergent themes included (1) Telehealth provided critical and necessary services, (2) Existing technological literacy and infrastructure enabled telehealth uptake, (3) Geographic isolation related to the rural environment impaired participant’s ability to access telehealth-delivered care, and (4) Real-time provider-patient communication at critical points in participants’ care facilitated telehealth utilization. Overall, participants reported that telehealth was useful for overcoming barriers common to rurality and often a suitable strategy to deliver cancer care.
IT’S A FAMILY AFFAIR: ADDRESSING THE NEEDS OF BLACK DEMENTIA CAREGIVERS THROUGH COMMUNITY-BASED RESEARCH
Authors: Oladejo Dianne , Chapman Joyce , Roberson Tonya , O’Conor Rachel 
Published: December 2023

Abstract
Racial disparities exist in dementia diagnosis, co-morbid health conditions, and socioeconomic characteristics between older Black and White adults, compounding caregiving responsibilities for Black families; yet few dementia caregiving programs offer culturally competent, family-centered dementia caregiving programs for Black individuals. In a collaboration between two community-based organizations (CBO) and an academic medical center, a culturally tailored, family-centered, dementia caregiving program for Black individuals on Chicago’s Far South Side was proposed. Local CBOs convened community members to co-design a key informant interview guide and conducted 30 interviews among Black dementia caregivers. The caregivers interviewed were primarily caring for parents or grandparents and shared caregiving responsibilities with other family members. Caregivers recommended the program focus on five top concerns related to their caregiving experience: 1) feelings of stress and burden while being committed to their family member with dementia, 2) education on the progression of dementia and discussion of cultural beliefs, 3) personal experiences with racism and intersectional identities, 4) kinship responsibilities and managing dementia-specific changes that occur with loved ones, and 5) a need for respite and local medical and community-based resources. Anticipated barriers to participation in this program included time, an accessible location to members of the far south, and care for family members during participation. Though a community-directed approach, we elevated Black dementia caregiver experiences to better understand the influence that race and culture has on Black caregivers, which will provide the foundation for a Black family-centered dementia caregiving program to build capacity in routine caregiving and reduce caregiver stress.
PERSONALIZED AND TYPICAL CONCURRENT RISK: JOINT MODELS OF RECURRENT OUTCOMES AND MORTALITY BY RACE/ETHNICITY
Authors: Allore Heather , McAvay Gail , Wyk Brent Vander , Han Ling , Quiñones Ana 
Published: December 2023

Abstract
The growing burden of multiple chronic conditions documented by a U.S. Department of Health and Human Services initiative noted the importance of studies that 1) “Develop tools to identify and target population subgroups of individuals with multiple chronic conditions who are at high risk for poor health outcomes”, and 2) “Improve knowledge about patient trajectories temporally in relation to changes in health status, functional status, and health services use”. Expanding upon our methods for jointly modeling multiple outcomes, where each person’s shared influence on concurrent outcomes can be captured by using a random intercept term, we demonstrate how to model additional heterogeneity. Based on the estimates from the joint model, the typical concurrent risk (TCR) of each outcome (i.e., probability) can be estimated at the cohort level, providing a method for identifying average longitudinal effects of risk factors useful for healthcare system policies. In contrast, a person-specific effect reflects the probability of each outcome within a defined interval of time, while currently at risk for another non-mutually exclusive outcome (i.e., personalized concurrent risk [PCR]). Chronic conditions and sociodemographic risk factors may partially account for the heterogeneity of a cohort. However, differences in the occurrences and associations among these may differ for minoritized groups. These methods identify persons above (or below) average risk. We expanded these joint models to address truncation of measurement due to death and the interdependence of outcomes at the person-level, while maintaining the Type I error rate. We have made the code publicly available.
EMERGING COHORT DISPARITIES IN MULTIMORBIDITY IN US ADULTS ENTERING EARLY OLDER ADULTHOOD
Authors: Bishop Nicholas , Haas Steven , Quiñones Ana 
Published: December 2023

Abstract
Recent evidence of generational disparities in multimorbidity risk among older adults indicates earlier transitions into multimorbidity and greater disease burden for those born to later cohorts. As costs of managing chronic disease will rise with population aging, it is imperative to identify whether cohort effects in multimorbidity extend to cohorts just entering early older adulthood. We use representative data from the Panel Study of Income Dynamics to model cohort trends in multimorbidity from 1999–2019 in adults who were 50 years of age or older at any observational period (n = 4,975; 40,822 person-observations). Multimorbidity was assessed as a count of nine chronic conditions (stroke, hypertension, diabetes, cancer, lung disease, heart problems, emotional problems, arthritis, mental loss). Weighted Poisson mixed models were used to estimate multimorbidity trajectories adjusted for fixed effects of cohort, linear and quadratic age, and sociodemographic covariates. The model accounted for repeated measures though inclusion of a random effect for within-person error covariance across wave. After adjustment, those born to the Early and Late Baby Boom cohorts (b. 1946–1955 and b. 1956–1964, respectively), as well as those born to the early Gen X cohort (b. 1965–1972), reported significantly greater multimorbidity burden than those born to the late depression-era (b. 1931–1942). These findings extend evidence of cohort effects in multimorbidity in U.S. older adults, indicate these problematic trends apply to U.S. adults entering early older adulthood, and suggest practitioners and policymakers should prepare for an aging population with expanding disease burden.