bluuebunny/crossref_metadata_2025_split huggingface dataset:
GOAL ATTAINMENT SCALING IN CAPABLE: A COMPARISON OF CARE PARTNER AND OLDER ADULT PARTICIPATION
Authors: Perepezko Kate , Toto Pamela 
Published: December 2023

Abstract
Aging in place is an optimal outcome for our maturing population as health systems become increasingly overburdened. One program that facilitates aging in place is the Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program. CAPABLE improves older adult performance in everyday activities and reduces inpatient and long-term service use. Although CAPABLE is designed as a person-centered program aiming to help older adults set and achieve goals, research demonstrates that care partners (i.e. family or friends providing unpaid support) are frequently involved in healthcare decisions and can reinforce intervention goals. This presentation will report findings from the trial stage of a Hybrid Type 1 Study of CAPABLE involving care partners for which recruitment is ongoing (N=100). We aim to describe how older adults and their care partners engage in goal setting using Goal Attainment Scaling, share the frequency of their goal attainment, and present the types of goals that they set. For example, older adult participant goals for our current sample focus on reduced fear when showering, improved mobility, and more efficient dressing. For our care partner participants, goals include finding respite and preventing older adult injury. All participants who have completed CAPABLE were able to achieve their goals by the end of the program. Findings from this study support care partner involvement in interventions to promote aging in place, aligning with the RAISE Act’s goal to engage family caregivers as key partners in the delivery of services and support.
EFFECTIVE CLINICIAN BEHAVIORS FOR INCLUDING FAMILY CAREGIVERS IN THE GERIATRIC MENTAL HEALTH SETTING
Authors: Wyman Mary , Raj Hayley , Perzynski Joseph , Gleason Carey , Trivedi Ranak , Byers Amy , Voils Corrine 
Published: December 2023

Abstract
To improve patient and caregiver outcomes, the 2022 National Strategy to Support Family Caregivers recommends training for professionals on caregiver inclusion and provision of person- and family-centered care. Caregiver inclusion is especially important for older adults with dementia, who experience high rates of comorbid mental health (MH) disorders but are disadvantaged by disparities in care access and quality. Current training options are limited. Our VA-funded project seeks to develop caregiver inclusion training for MH clinicians working with older adults with dementia. We present preliminary findings from in-depth, 45-min qualitative interviews with 9 multidisciplinary MH clinicians (psychiatry, social work, psychology, and clinical pharmacy) on their experiences with engaging family caregivers in MH treatment. A multidisciplinary coding team conducted content analysis to identify facilitators and barriers to effective communication and collaboration with caregivers, with a focus on clinician behaviors. Facilitators of effective caregiver involvement include clinician attention to developing rapport with the caregiver, addressing knowledge gaps about dementia and mental health interventions, and helping to address the challenges of caregiving with supportive resources. Barriers included not tailoring clinician approach to caregiver needs, failing to clarify the caregiver role in healthcare, and failing to address one own’s defensiveness or labeling of caregivers in distress. The importance of system factors (e.g., technology, clinic scheduling, and care team dynamics) was noted. Findings will be used to inform the development of strategies to increase clinician skills for caregiver inclusion, supporting improved patient and caregiver outcomes and the goals of the RAISE Act and the National Strategy.
PARTICIPATORY DESIGN OF A WEB-BASED COMMUNITY AND RESOURCE CONNECTION TOOL FOR RURAL DEMENTIA FAMILY CAREGIVERS
Authors: Werner Nicole 
Published: December 2023

Abstract
Rural family caregivers of people living with dementia have higher caregiver burden and experience lower social support than their urban counterparts. Technology has potential to address rural caregiver health disparities, but only if designed to their specific needs. Available technology interventions lack focus on rural caregivers and community influence. This represents a gap in rural caregivers’ ability to leverage technology for community supports to overcome their unique barriers. Thus, we are engaging rural caregivers and community resources in a participatory co-design process to design CareVirtue Family Connection, an online community and personalized resource connection tool specific to rural dementia caregivers. We conducted N=19 interviews with dementia caregivers self-identified as living in a rural area. We analyzed transcripts using team-based affinity diagramming to create meaningful clusters related to how rural caregivers get the help they need. We used consensus discussion to refine clusters and applied resulting categories to transcripts to identify confirming/disconfirming evidence. We identified seven dimensions influencing rural caregivers’ ability to get the help they need including community attributes, caregiving challenges, community connection, experience with community supports, caregiving goals, attitudes on caregiving and community, and information behavior. Results will guide subsequent co-design in which we will engage rural caregivers and related community organizations to co-design the CareVirtue Family Connection tool. Our participatory approach is aligned with the National Strategy to Support Family Caregivers’ goal to advance caregiver engagement, and CareVirtue Family Connection will support the Strategy’s vision to “expand access to programs, services, supports, and products to family caregivers.”
CONCERNED AND LONELY AMIDST COVID-19: FINANCIAL STRAIN AND LATER-LIFE PSYCHOLOGICAL WELL-BEING IN NEVADA
Authors: Bhatta Tirth , Miller Dante , Lekhak Nirmala 
Published: December 2023

Abstract

Objectives
Nevada has some of the nation’s highest suicide rates among older adults, which are linked to social isolation, loneliness, and mental health. The COVID-19 pandemic is likely to have exacerbated the loneliness and financial insecurity that older Nevadans have already been experiencing to a greater extent since the 2008 financial crisis. Prior research based on national data has documented the relationship between financial strain and mental health in later life. However, the social and psychological mechanisms that underlie such relationships have not been investigated, particularly in light of the devastating economic and health effects of the pandemic on older adults in Nevada.

Methods
Based on our web-based survey of adults aged 50 years and older (n=313), we examined the roles of loneliness and concerns about the pandemic in explaining the impact of financial strain on depressive symptoms and anxiety.

Results
We documented a statistically significant effect of financial strain on depressive symptoms (b=2.41, p-value&lt; 0.001) and anxiety (b=1.74, p-value&lt; 0.001). The inclusion of loneliness and concerns about the pandemic in our regression models led to substantial reduction in the impact of financial strain on depressive symptoms, whereas such impact on anxiety became statistically not significant. We also found significantly higher levels of depressive symptoms and anxiety among our respondents who reported greater feeling loneliness and concerns about the pandemic.

Discussion
Our findings underscore the need for mental health resources and financial support programs for economically disadvantaged older adults to alleviate their feelings of loneliness and improve mental health in Nevada.
NETWORK ANALYSIS OF OBJECTIVE AND SUBJECTIVE INDICATORS OF SOCIAL ISOLATION AND FUNCTIONAL LIMITATIONS
Authors: Zhong Chuwen , Dang Linh , Ananthasubramaniam Aparna , Mezuk Briana 
Published: December 2023

Abstract
Functional limitations, including decreased physical performance and increased limitations in daily activities, are common among older adults and associated with both objective and subjective social isolation. However, the dynamic interactions between and within different indicators of functional limitations and social isolation are unclear. This study employed network analysis to graphically depict and explore the relationships between various objective and subjective indicators of functional limitations and social isolation. Data came from the 2014/2016 waves of the Health and Retirement Study (n=9,076, mean age =67.25,52.32% female, 80.17% non-Hispanic White). Functional limitations were measured by objective physical performance (grip strength, tandem balance test) and self-reported limitations in daily activities. Objective social isolation was based on marital status, living arrangement, and network composition (children, other family members, and friends); subjective social isolation was indicated by the UCLA loneliness scale. Separate networks were constructed for men and women. Centrality indices, including strength, betweenness centrality, and eigenvector centrality, were computed to quantify the influence of each item. Subjective functioning and isolation items were strongly correlated but had weaker interconnections with one another. Strength and eigenvector centrality indicated that subjective functioning items had high degrees of influential interactions. Subjective social isolation items had high values of betweenness centrality, suggesting important bridging roles of these constructs. Subjective social isolation items had a more influential role in the network of women than men. Findings suggest opportunities for interdisciplinary interventions to address the multifactorial relationship between functional limitations and social isolation among older adults.
EXPLORATORY FACTOR ANALYSIS OF THE COMFORT ASSESSMENT IN DYING WITH DEMENTIA SCALE
Authors: Zhang Peiyuan , Stump Timothy , Tu Wanzhu , Becker Todd , Orth Jessica , Floyd Alexander , Unroe Kathleen , Cagle John 
Published: December 2023

Abstract
The 14-item Comfort Assessment in Dying with Dementia (CAD-EOLD) scale is a widely used instrument measuring end-of-life care for people with dementia (PWD). The instrument has been used to evaluate symptom burden among PWD in nursing homes, but the measurement properties are less studied for symptoms reported by family and staff caregivers. We conducted an exploratory factor analysis to evaluate the psychometric properties of the scale using staff and family (N=476) responses to CAD-EOLD at the baseline of an NIH-funded clinical trial. Subjects were long-stay nursing home residents with moderate-to-severe cognitive impairment in Indiana and Maryland. Staff (n=368) and family members (n=108) completed the CAD-EOLD, describing participating residents. We performed separate exploratory factor analyses on family and staff responses. Family and staff data showed similar clustering patterns. Restlessness, anxiety, fear, crying, and moaning had high factor loadings in the first cluster, interpreted as “Physical and Psychological Distress” (loading range = 0.47–0.91). Choking, gurgling, and difficulty swallowing had high loadings in the second cluster that depicted “Dying Symptoms” (loading range = 0.62–1.15). Serenity, calm, and peace had high loadings in the third factor on “Well-Being” (loading range = 0.72–0.93). Three “Physical Distress” items (i.e., discomfort, pain, and shortness of breath) cross-loaded with “Dying Symptoms.” Accordingly, “Physical and Psychological Distress,” “Dying Symptoms,” and “Well-Being” represented important but separate dimensions for measuring end-of-life experiences of PWD. Findings demonstrated favorable construct validity of CAD-EOLD in PWD with moderate-to-severe cognitive impairment in nursing homes, as reported by staff and family caregivers.
GRAVES’ DISEASE IS ASSOCIATED WITH INCREASED RISK OF CLINICAL ALZHEIMER’S DISEASE
Authors: Yashkin Arseniy , Nikitin Stanislav Kolpakov , Gorbunova Galina , Kravchenko Julia , Yashin Anatoliy , Akushevich Igor 
Published: December 2023

Abstract
Identification of modifiable risk factors for Alzheimer’s Disease (AD) onset is an important aspect of controlling the burden imposed by this disease on an increasing number of older U.S. adults. Graves’ disease (GD), the most common cause of hyperthyroidism in the U.S., has been hypothesized to be associated with increased AD risk, but there is no consensus. In this study, we explore the link between GD and risk of clinical AD. Cox and Fine-Grey models were applied to a retrospective propensity-score-matched cohort of 15,505 individuals with GD drawn from a nationally representative 5% sample of U.S. Medicare beneficiaries age 65+ over the 1991-2017 period. Results showed that the presence of GD was associated with a higher risk of AD (Hazard Ratio [HR]:1.15; 95% Confidence Interval [CI]:1.07-1.23). Magnitude of associated risk varied across subgroups: Males (HR:1.19; CI:1.01-1.41), Females (HR:1.09; CI:1.02-1.18), Whites (HR:1.13; CI:1.04-1.20), Blacks (HR:1.33; CI:1.04-1.20). Competing risk estimates were consistent with these findings. A potential mechanism connecting GD and AD may involve shared etiological factors between the two diseases. Although replication of our findings is needed, they suggest that GD prevention and treatment may contribute to reducing the burden of AD in U.S. older adults.
SUPPORTING PERSONS LIVING ALONE WITH DEMENTIA: FINDINGS FROM A PILOT STUDY
Authors: Gibson Allison , Pope Natalie , Hossain Mohammad 
Published: December 2023

Abstract
Older adults living alone with suspected cognitive impairment often have little-to-no support for conducting daily activities and may be more isolated from formal sources of support and healthcare services. As a result, many individuals living alone may receive delayed diagnosis of dementia compared to those that reside with others. The purpose of this study was to explore an innovative pilot program of case management services, Services to Age in Your Home (STAY Home), with local paramedicine services (interdisciplinary team of social work, law enforcement, and paramedics) that links this population to healthcare and social services through case management services in an urban area. While many participants were willing to engage in the pilot program, access to healthcare and social services remained challenging due to social service program waitlists, discomfort using formal services, distrust of losing autonomy, and limited financial resources contributed to barriers in pilot implementation. A biopsychosocial survey identified individuals needing cognitive testing (88.9%), support in managing medications and medication adherence (88.9%), unmet financial needs (77.8%), unmet healthcare needs (77.8%), difficulty managing finances (66.7%), challenges accessing transportation (55.6%), and unmet assistance needs for their ADLs (44.4%). Most individuals also reported limited social supports (i.e., neighbors, out-of-town relatives) with most relying on local formal services to address emergency needs. This presentation will include a discussion of ethical challenges for both conducting research as well as providing services to this low-resource population.
ENGAGEMENT OF NURSING HOME COMMUNITY EXPERTS TO MODIFY THE DIGNITY INTERVENTION
Authors: Behrens Liza , Kowalchik Kalei , Boltz Marie , Kraschnewski Jennifer 
Published: December 2023

Abstract
Voices of Nursing Home (NH) residents, family caregivers, staff and leaders (community experts) are underrepresented in research development but integral when developing interventions for implementation these complex organizations. This study aimed to explore opinions of NH community experts in the development of a novel person-centered risk management intervention for residents with dementia. Community engagement studios (CES) engaged 62 community experts to gain their perspectives on the DIGNITY (Decision-making in aging and dementia for autonomy) study procedures and instruments. CESs (N=4) were led by an experienced moderator and co-moderator, recorded, and transcribed verbatim. Content analysis was used to summarize responses in a rapid feedback loop. Descriptive statistics of standard measures describe community experts’ ratings of acceptability, appropriateness, and feasibility of DIGNITY intervention. Most community experts identified as female (85%), ranging from 22 - 86 years. Participants were residents with dementia (n=4); family caregivers (n=4); NH administrators (n=16), care manager/ supervisors (n=10), direct-care workers (n=6) licensed healthcare providers (n=6), other NH staff (n=8), ombudsman (n=4) and state surveyors (n=4). Community experts provided suggestions to adapt the study instruments and delivery methods. The study team made changes to all six intervention elements based on expert feedback. Most experts agreed that the DIGNITY intervention was acceptable (M=17.7, SD= 2.08), appropriate (M= 17.24, SD= 2), and feasible (M=16.91, SD= 2.22) to implement in the NH community. Results support practical modifications to the DIGNITY intervention to make it feasible to implement in an upcoming pilot clinical trial.
DAILY WORRY, RUMINATION, AND SLEEP IN LATE LIFE
Authors: Zhou Zexi , Birditt Kira , Leger Kate , Fingerman Karen 
Published: December 2023

Abstract
Perseverative thinking, including worry and rumination, is a common response induced by stress, and can be detrimental to well-being and health especially for older adults. Sleep may represent an important mechanism by which preservative thoughts affect health. Yet, limited research has investigated links between worry and rumination and their implications for sleep in late life. This study examines the associations between older adults’ everyday worry, rumination, and sleep. We leveraged the daily diary data over 5 to 6 days from the Daily Experiences and Well-being Study (N = 271, Mage = 73.62). Every evening, older adults reported worry and rumination they experienced that day. Every morning, they indicated how worried they were about something that might happen that day, and sleep the prior night (e.g., duration, quality, disturbances). Multilevel models showed that greater evening rumination was associated with fewer sleep disturbances. More hours of sleep, higher sleep quality, and fewer sleep disturbances were associated with less worry the next morning. Greater evening worry and rumination were both associated with greater next morning’s worry, but more hours of sleep buffered the lingering of worry over the night. These results suggest that worry and rumination may tend to persist in older adults’ daily life, and highlight the protective role that better sleep may play in reducing older adults’ everyday perseverative thinking.
RECOMMENDATIONS REGARDING THE DESIGN OF PAIN ASSESSMENT AND MANAGEMENT TOOL FOR OLDER ADULTS WITH HEART FAILURE
Authors: Kang Youjeong , Choi Yong Kyung , Oh Seung-Eun 
Published: December 2023

Abstract
Nearly 80% of all patients with heart failure (HF) are older adults (≥65 years of age) who are at high risk for frequent hospitalizations. Older adults with HF may delay in responses to pain that could trigger the burden of HF symptoms such as dyspnea due to the increased cardiovascular workload and oxygen demands. However, there is a concern that healthcare providers may be poorly prepared to assess and manage pain when reported by specific populations. This qualitative secondary analysis examined the design recommendations of HF providers for a comprehensive home-based pain assessment and management tool for older adults with HF. The study used in-depth interviews with 20 healthcare providers specializing in HF across different states. Participants provided various recommendations, including a checklist of questions about the patient’s past experience with pain, their living environment, and any activities that trigger pain. While some participants preferred electronic tools, such as an mHealth app, for data collection and analysis, they acknowledged the limitations of using technology for older adults. The tool should be straightforward, easy to navigate, and involve patients in the design process to ensure their motivation and buy-in. The tool should also consider the caregiver’s input. In conclusion, this study highlights the importance of a comprehensive assessment of pain symptoms and daily activities to provide personalized care for older adults with HF. The design recommendations provided by healthcare providers can aid in the development of a unique home-based pain assessment and management tool for older adults with HF.
BS GSA AND AGE JOINT SYMPOSIUM
Authors: Rogina Blanka , Anderson Rozalyn 
Published: December 2023

Abstract
Since 2020, BS GSA and American Aging Association (AGE) recognized the opportunity to present a joint session regularly at each organization’s national meeting. Given our unique positions in the field of aging research, we recognize the opportunity to advance each other’s missions and strengthen the ecosystem to advance translation of aging research into practice and policy. This symposium has been a resounding success and an ideal forum for early-stage investigators who seek to develop a program at the interface of basic and clinical research.
THE CELL “SURFACEOME”: A STRATEGY TO TARGET SENESCENT CELLS IN VIVO
Authors: Banarjee Reema , Dey Amit , Nyunt Thedoe , Gregg Jordan , Tsitsipatis Dimitrios , Herman Allison , Gorospe Myriam , Basisty Nathan 
Published: December 2023

Abstract
Senescent cell accumulation drives aging and related pathologies including metabolic disorders and neurodegeneration, and their selective elimination is a promising therapeutic approach to treat multiple diseases of aging in humans. However, developing drugs to eliminate senescent cells requires specific biomarkers to selectively identify and target these cells in vivo. In this study, we have performed a comprehensive and quantitative proteomic profiling of surface proteomes (surfaceomes) of senescent cells to identify potential senescence biomarker candidates in human tissues. We induced senescence using ionizing radiation in a variety of cell types including lung fibroblasts, monocytes, vascular smooth muscle cells, aortic endothelial cells and preadipocytes. Senescence was validated using a panel of canonical markers including reduced proliferation, increased senescence-associated β-galactosidase activity, and increased expression of p21, p16, IL6, and others. The cell surface proteome was enriched using an optimized surface biotinylation approach (Glyco-cell surface capture) followed by data-independent acquisition (DIA) LC-MS/MS analysis on a Q-Exactive HF Orbitrap mass spectrometer. Our analysis revealed novel cell surface targets that were further validated by flow cytometry and immunohistochemistry. These results provide clinically useful information for establishing biomarkers and therapeutic targets to aid in the translation of senescence-targeted therapies to treat age-associated diseases.