bluuebunny/crossref_metadata_2025_split huggingface dataset:
EMBRACING CULTURE AND DESIGNING AN INTERGENERATIONAL TRAINING PROGRAM TO SUPPORT LATINE ELDERS
Authors: Cotton Quinton , Kissell Paul , Johnson Elma , Chambers Yolima , Nkimbeng Manka , Gaugler Joseph 
Published: December 2023

Abstract
Although there have been efforts to promote health equity and increase representational diversity in research, there is a gap in our understanding on how to integrate cultural considerations into the intervention design process. Dementia caregiving interventions too frequently lack prioritization and integration of community-directed and culturally appropriate inputs during intervention planning. Consequently, intervention fit among racial and ethnic populations is sometimes culturally incongruent and intervention acceptability in community settings is weakened. We conducted a formative analysis drawing from research team member memos, document review, World Cafes with Latine community residents, and group interviews with Latine organizational staff to understand the intervention development process of an intergenerational dementia training program to support elders within the Latine community. The design process integrated iterative periods of listening through data gathering, informing by applying learned information to the developing program, and affirming through validation. Our analysis demonstrates the need for a broad range of skills and capacity to facilitate effective intervention design (language mastery among key research team members, program design skills, listening, relationship building).
WHO WORKS LONGER IN LATER LIFE? KEY VARIATIONS IN WORKING LIFE EXPECTANCY IN INTERNATIONAL PERSPECTIVE
Authors: Beach Brian , Westerlund Hugo 
Published: December 2023

Abstract
In the context of population aging, policymakers are eager to encourage and enable longer working lives, assuming this will lead to increased tax revenue and reduced demand on social security and health care systems. Simultaneously, individuals who work longer will gain additional income and may experience the psychosocial benefits that come from workplace engagement. However, many factors drive early labor market exit, and blanket policy strategies to extend working lives often ignore the nuances that shape the length of real working lives. Such policies have emerged partly from increased life expectancies, although these measures fail to capture subgroup differences in the capacity to continue working. They also do not account for often discontinuous labor market trajectories, particularly around retirement. As such, scholars have turned to more refined methodologies and concepts like working life expectancy (WLE) to better inform policies that actively aim to increase retirement ages. This symposium highlights an ongoing program of work by the IDEAR network, which examines WLE using longitudinal studies of aging in Europe. The symposium features results from Sweden and England, estimating WLE using multi-state models. Unlike other approaches to estimate life expectancy employing the Sullivan method, this approach allows for reversible transitions between work and non-work, reflecting the dynamic and complex nature of modern labor market transitions and exits. The symposium further presents how WLE varies according to key determinants, including socioeconomic status, healthy lifestyles, and unpaid caregiving, highlighting the policy implications that emerge from recognizing inequalities and variations in WLE across vulnerable subgroups.
VIRTUAL REALITY FOR PALLIATIVE CARE COMMUNICATION TRAINING: A NOVEL DISSEMINATION STRATEGY
Authors: Ouchi Kei 
Published: December 2023

Abstract
Towards the end of life, 75% of older adults visit the emergency department (ED). During acute health decompensation, most older adults with serious illness (predicted survival of less than one year) do not have advance directives and are at risk of receiving care inconsistent with their goals. To deliver patient-centered care, palliative care communication skills are essential, especially during the shared decision-making for cardiopulmonary resuscitation (i.e., code status conversations). Facilitated by skilled faculty and trained actors playing the role of a seriously ill older adult in acute health decompensation, the traditional palliative care communication training combines role play and individual feedback to practice communication skills. These evidence-based, palliative care trainings have demonstrated to improve communication skills in trained clinicians with enduring skills 12-15 months later. However, these trainings take a minimum of four hours with highly trained faculty and professional actors to role play, which hinders wider dissemination. To improve nationwide dissemination of evidence-based practices in code status conversations, we have leveraged virtual reality technology to allow clinicians to experience in-person, palliative care communication training. In collaboration with a virtual reality company, a 360-degree view, virtual reality training content has been filmed in a real hospital environment. Using the same evidence-based, palliative care communication contents, clinicians in training can now experience the role play in a virtual reality environment in one hour instead of four. By leveraging virtual reality technology, evidence-based palliative care communication training can now be disseminated with much less institutional investment (e.g., training time, faculty resources, etc.).
EXAMINING THE PRELIMINARY EFFECTIVENESS OF THE SENIOR COMPANION PROGRAM PLUS FOR AFRICAN AMERICAN CAREGIVERS
Authors: Xu Ling , Fields Noelle , Williams Ishan , Gaugler Joseph , Lomelin Alan Kunz , Cipher Daisha , Feinhals Gretchen 
Published: December 2023

Abstract

Objectives
A culturally informed, peer-led, lay provider model, the Senior Companion Program (SCP) Plus, was implemented to decrease caregiving burden/stress and improve coping skills, and social support for African American ADRD caregivers. This study reported the preliminary effectiveness of this intervention.

Methods
An explanatory sequential mixed methods design was used in this study and a randomized control trial was conducted for the SCP Plus intervention among participants in three sites (N = 20). A sub-sample of participants (n = 7) consented to a qualitative interview about their experiences with the intervention. The Wilcoxon signed-rank tests, Friedman tests, and one-way repeated measures ANOVA were conducted for quantitative analyses. Thematic analysis was used for the qualitative interviews.

Results
Results demonstrated that knowledge of AD/dementia (KAD) and preparedness for caregiving were significantly improved for all senior companions in the intervention group. Results also showed that caregivers in the intervention group reported significantly decreased caregiving burden, as well as increased KAD, satisfaction with social support, and positive aspects of caregiving. Themes from the qualitative interviews included: learning new skills about caregiving, gaining knowledge about ADRD, and benefits for the dyad. Discussions: Findings from this study implied that SCP Plus was a promising model for African American family caregivers as it benefits both the SC volunteers and the African American ADRD family caregivers.
HOW DO FORMER DEMENTIA CAREGIVERS STRUCTURE HIGH- AND LOW-POINT NARRATIVES?
Authors: Matta-Singh Tara , Sharma Shubam , Ali Talha , Piechota Amanda , Abboud Anissa , Fried Terri , Monin Joan , Mroz Emily 
Published: December 2023

Abstract
Former caregivers of people living with dementia often develop and structure narratives of their lived experiences as caregivers in terms of subjective high and low points. We utilized thematic analysis to examine narratives of these high and low points in interviews with 32 former caregivers of a parent living with dementia. Across both high and low points, caregivers often structured their narratives using three types of “elaboration,” that is, points not necessary to recall a factual event, but which help convey deeper meaning. Caregivers who utilized comparisons contrasted their caregiving experiences with other individuals or caregiving situations to help make sense of their own experience. When participants made connections to earlier life, they linked caregiving to prior experiences such as growing up with their parents. Shifting the focal point occurred where caregivers moved the narrative towards or away from a certain positive or negative storyline, unprompted. We discuss how caregivers who utilize elaborations adaptively (e.g., to tell a fuller story that reinforces how their caregiving relationship is beneficial) may come to better make sense of their experience which can alleviate some distress. We also discuss how elaborations that emphasize incompetency or promote focus on difficult moments may threaten the caregivers’ sense of well-being, leading to psychological harm. We conclude by introducing concrete narrative strategies that can help former caregivers use elaborations in adaptive ways, such as comparing difficult caregiving experiences to other difficulties that they have overcome to re-write narratives surrounding personal incompetency in caregiving.
COMPARING COVID-19 CASES AND MORTALITY RATES: THE GREEN HOUSE VERSUS THE TRADITIONAL NURSING HOME IN THE UNITED STATES
Authors: Young Yuchi , Barnes Virgile , Perre Taylor , Hsu Wan-Hsiang , Shayya Ashley , O’Grady Thomas 
Published: December 2023

Abstract

Introduction
The COVID-19 pandemic has posed significant challenges to nursing home (NH) care. However, Green Houses (GH), with their small size and unique care model, may offer a solution for infection control and COVID-19 prevention. This study aims to compare COVID-19 case and mortality rates between GHs and traditional NHs in the United States.

Methods
Secondary data were used to compare COVID-19 case and mortality rates among three groups: GHs (n=19), traditional small NHs (n=266), and traditional large NHs (n=2932) located in 10 US states from June 2020 to September 2022. Poisson regressions using generalized estimating equations (GEE) were utilized to quantify differences in COVID-19 case and mortality rates while controlling for average age, gender, and ADL score.

Results
The study population had a mean age of 73.38 and was primarily female (57.8%) and white (78.2%). The GEE results indicated that small and large NHs have significantly higher relative risks (RR) of COVID-19 cases (RR = 1.61; 95% CI 1.25-2.08 and RR = 1.75; 95% CI 1.36-2.24, respectively) compared to GHs. For COVID-19 mortality rates, there is an increased risk in large NHs compared to GHs (RR = 1.67; 95% CI 1.01-2.77), but no difference between GHs and small NHs.

Conclusion
After adjusting for age, gender, and ADL disability, GHs have lower COVID-19 incidence and mortality rates than traditional NHs. These differences may be attributable to GHs having fewer beds, offering more resident privacy, and having a higher certified nursing assistant-to-resident ratio compared to traditional NHs.
FINANCIAL OUTCOMES ASSOCIATED WITH COVID-19 IN NURSING HOMES
Authors: Orewa Gregory , Weech-Maldonado Robert , Feldman Sue , Becker David , Davlyatov Ganisher , Lord Justin 
Published: December 2023

Abstract
Financial stability and well-being are critical for the success of any organization. COVID-19 put nursing homes (NH) in a financial bind, affecting their costs and revenues and mounting pressure on them despite government intervention. NHs have been one of the weak links in our care continuum for the U.S. healthcare system, and the pandemic caused havoc in the industry. Given the pandemic impact on NH operating cost and revenue, this study examined the level to which financial performance in NHs deteriorated. Six different datasets were merged for 2018–2021: Medicare cost reports, Payroll-Based Journal, NH Compare, Area Health Resource File, HHS Provider Relief Fund, and CDC COVID-19 Data Tracker. The data was modeled using random-effects regression. Dependent variables were operating revenue per patient day, operating cost per patient day, and operating margin. Independent variable was pre- and post-COVID-19. Organizational, community-level, and COVID-19-related variables were used as controls. Results suggest that the impact of COVID-19 was associated with an increase in operating cost per patient day (β=56.64, p&lt; 0.05), and a decrease in operating margin (β=-8.04, p&lt; 0.05), but the associated operating revenue per patient day (β=26.78, p&lt; 0.05), did not increase at the rate at which the operating cost increased. The increase in operating cost per patient day compared to the operating revenue per patient day was double. Given the negative impact of the COVID-19 pandemic on NH’s financial performance, policymakers should monitor the financial health of NH. Further deterioration in financial performance may result in NH closures and reduced access to long-term care.
PALLIATIVE AND END-OF-LIFE CARE FOR OLDER ADULTS WITH EXPERIENCES OF HOMELESSNESS
Authors: Melekis Kelly , Melekis Kelly 
Published: December 2023

Abstract
Although palliative and end-of-life (PEOL) care offers many benefits to those with life-limiting illness, unhoused older adults face significant barriers in accessing these types of care. This symposium examines disparities in PEOL care, emerging services for disadvantaged older adults, and recommendations for capacity-building within healthcare, housing, and aging services. The first paper is an exploratory study of programs serving the PEOL care needs of unhoused adults with serious illnesses. The second paper is a mixed methods study that explores provider perspectives on approaches and challenges to addressing the PEOL care needs among unhoused individuals. The third paper uses the CBPR method photovoice to highlight the experiences of terminally ill patients accessing social model hospice care, a free option to facilitate access to hospice for unhoused older adults. In addition to well-established disparities in the prevalence of serious illness and access to palliative care among people with experiences of homelessness, limits and barriers to holistic support remain once housed. The fourth paper uses secondary data analysis of the Research and Supportive Care at Later-life for Unhoused People (RASCAL-UP) study to describe current practices, perceived barriers, and recommendations in permanent supportive housing for older residents with complex comorbidities. The final paper, also using secondary data analysis of the RASCAL-UP study, addresses the role of skilled nursing for palliative care patients with histories of homelessness. Together, findings illuminate challenges to providing PEOL care for unhoused older adults and those with prior experiences of homelessness, as well as opportunities to improve access to care. This is a Hospice, Palliative and End-of-Life Care Interest Group Sponsored Symposium.
COGNITIVE TRAINING APPROACHES TO IMPROVE COGNITION AND ASSOCIATED FUNCTIONS IN MID TO LATE LIFE
Authors: Curtis Ashley , Costa Amy , Musich Madison , Rzeppa Chloe , McCrae Christina 
Published: December 2023

Abstract
Cognitive Training (CT) has yielded inconsistent benefits in non-patient populations. Despite known cognition/sleep associations, limited studies have investigated CT’s impact on sleep. We examined cognitive and associated outcomes across three CT programs in older adult (OA) insomnia patients [with/without mild cognitive impairment (MCI)] and middle-aged adults (MA) with generalized anxiety disorder (GAD). In Study 1, OAs with insomnia (Mage=67.9±8.0; 16 women/8 men) completed 6-week CT (Nintendo DS-Big Brain Academy; 60 mins/day, 3x/week) and waitlist control (WLC) in a cross-over design. At baseline and post-CT/post-WLC, participants completed NIH toolbox-cognitive tasks. In Study 2, MAs with GAD (Mage=49.8±4.0; 29 women) underwent 8-week CT (Cognifit, n=14) or Trivia Training (TT, n=15), 45 mins/day, 3x/week and completed pre/post Inquisit-cognitive assessments. In Study 3, OAs with insomnia and MCI (Mage=67.6±8.0; 10 women/3 men) completed 8-week CT (Cognifit; 45 mins/day, 3x/week) and pre/post Cambridge Brain Sciences-cognitive and polysomnography-sleep assessments. In Study 1, proportional RAVLT-verbal memory improvement was larger [t(23)=2.01, p=.028] following CT(17%) versus WLC(9%). Similarly, proportional Flanker-inhibition improvement was larger [t(23)=1.71, p=.05] following CT(2%) versus WLC(-.3%). In Study 2, CT improved Posner-attention orienting more than TT [F(1,27)=5.25, p=.03]. In Study 3, CT improved Digit-span-working memory [t(12)=-1.84, p=.045], reduced number of awakenings [t(12)=2.70, p=.01), increased %REM [(t(12)=-1.77,p=.05], and showed trending improvement for spatial planning/reasoning [t(12)=1.70, p=.057] and %Lighter-sleep [t(12)=1.62,p=.066]. CT benefits non-trained cognition (transfer effects) in mid-to-late life individuals with insomnia, GAD and MCI, and shows promise for improving sleep in MCI. Follow-up in larger samples investigating mechanisms underlying CT effects (domain-specific training, sleep improvement) is warranted.
AGHE Faculty Award Presentations and Lectures
Authors: Bradley Dana 
Published: December 2023

Abstract
The AGHE Faculty Award Presentations and Lectures will feature an address by the 2023 recipient Lisa Borrero, PhD, FAGHE of the University of Indianapolis. The Distinguished Faculty Award recognizes persons whose teaching stands out as exemplary, innovative, of impact, or any combination thereof. The Rising Star Early-Career Faculty Award Lecture will feature an address by 2023 co-recipient Nasreen Sadeq, PhD of the University of Southern Florida. Co-recipient Berenice Benayoun, PhD, of the University Southern California will present their lecture at a later date. The Rising Star Early-Career Faculty Award acknowledges new faculty whose teaching and leadership stand out as influential and innovative.
SELF-REPORTED VERSUS DIAGNOSIS-BASED DISEASED LIFE EXPECTANCY AMONG OLDER COLOMBIANS
Authors: Osuna Margarita Maria , Crimmins Eileen , Ailshire Jennifer 
Published: December 2023

Abstract
The number of older adults in Colombia will soon double and it is essential to understand the disease burden in this population. Disease prevalence is often estimated from medical diagnoses, which can underestimate disease in populations with less health care access and low health literacy. We compare differences in diseased life expectancy (DLE) using self-reported vs. measured markers for diabetes and hypertension using data from the 2015 health and wellbeing survey of older adults in Colombia (SABE-Col), a nationally representative survey of Colombians ages 60+. Respondents reported whether they had ever been told by a doctor that they had either diabetes or hypertension. Using direct measures of glucose and blood pressure and clinical cut-points, we determined which respondents were considered to have diabetes or hypertension. We used the Sullivan method to estimate life expectancy with and without disease. Data from self-reports alone generally suggest lower DLE than from both self-reported and measured disease statuses. At age 60, women have a total life expectancy of 20.56 years. We find a lower DLE for hypertension using self-reported data (12.66 years) than measured (13.24 years). Conversely, reported diabetes is similar (4.18 years) to the measured (4.28 years) DLE. Men, at age 60, have a total life expectancy of 18.04 years. DLE for hypertension using self-reports is lower (8.78 years) than measured (9.61 years). Similarly, DLE for diabetes is lower for self-report (2.98 years) than measured (3.04). Our findings show the burden of disease in this rapidly aging population.
NONINVASIVE INTERVENTIONS IN HEALTHY AND AT-RISK OLDER ADULTS: THE CASE FOR SOCIAL DANCING
Authors: Blumen Helena 
Published: December 2023

Abstract
Physical and cognitive activities can induce neuroplasticity and lead to modest improvements on cognition in healthy and at-risk older adults. Yet, many unanswered questions remain – including what type of physical, cognitive, or combination of physical and cognitive activities, are most beneficial, and to whom (e.g., healthy, or at-risk older adults). This single-blind randomized clinical trial (RCT; NCT03475316) contrasted 6 months of social ballroom dancing with 6 months of treadmill-walking. Twenty-five dementia-at-risk older adults (mean age = 76.45 years; 66% women; 48% White/Caucasian; 24% Black/African American; 20% Hispanic/Latino) were randomized between June 2019 and March 2020. Sixteen participants completed this RCT prior to early study termination due to COVID-19 (8 in each study arm). Dementia-at-risk was defined as a memory impairment screen score of ≥3 to ≤6, and/or and AD-dementia screening interview of ≥1. A composite measure of executive function – generated from digit-symbol-substitution, flanker interference, and walking-while-talking tasks – improved following both social dancing and treadmill-walking. Yet, social dancing generated greater improvements than treadmill-walking on the digit symbol substitution task. No intervention-related differences were observed in brain activation. Less hippocampal atrophy, however, was observed in the social dancing arm than in the treadmill-walking arm. These preliminary findings partly support the hypothesis that social dancing may promote neuroplasticity and benefit cognition to a greater extent than traditional physical activities. This is presumably because social dancing is not only a physical demanding activity, but also a socially and cognitively challenging activity. Yet, these findings need to be confirmed in larger-scale RCTs
SARCOPENIA AND MOBILITY DYSFUNCTION AS INDICATORS OF INCREASED ADRD RISK IN ASYMPTOMATIC DISEASE
Authors: Tolea Magdalena , Besser Lilah , Galvin James 
Published: December 2023

Abstract
Sarcopenia, the age-related loss of muscle mass and function, affects up to 30% of older adults. In addition to being an established component of frailty and predictor of mobility dysfunction, sarcopenia is associated with cognitive decline and increased risk of cognitive impairment, with ~70% individuals with late-stage dementia having sarcopenia. In this study, we investigated whether sarcopenia differentiates high- vs low- ADRD risk among 141 community-dwelling, older adults who were healthy controls (HC) or had mild cognitive impairment (MCI) (65% female; mean Age=70±11yr; mean Educ=16±3yr). Using the Brain Health Platform (BHP) developed at the Comprehensive Center for Brain Health, we categorized participants based on measures of resilience, vulnerability, cognitive performance as: Low-risk HC (36.9%); High-risk HC (12.8%), and MCI (50.4%). Amyloid positivity increased across risk groups (20% in Low-risk HC; 33.3% in High-risk HC; 39.1% in MCI). Prevalence of sarcopenia was 26.7% and increased by ADRD risk (12.2% vs 18.8% vs 39.1%, p=0.004). The MCI group had lower flexibility compared to both the low-risk (p=0.024) and high-risk HC (p=0.039) groups. Timed Up and Go (TUG) score increased with risk group (p&lt; 0.001MCI vs Low-risk HC; p=0.005MCI vs High-risk HC). Both mobility measures (i.e., flexibility, TUG) showed good discrimination for MCI vs Low-risk HC [AUC=0.77flexibility; AUC=0.78TUG] as well as for MCI vs High-risk HC [AUC=0.71flexibility; AUC=0.73TUG). Findings suggest that sarcopenia and other markers of mobility dysfunction have the potential to identify asymptomatic individuals at increased risk of ADRD, who could benefit from early intervention.