bluuebunny/crossref_metadata_2025_split huggingface dataset:
RURAL OLDER ADULTS’ VIEWS OF DEPRESCRIBING AND NONPHARMACOLOGICAL METHODS IN PAIN TREATMENT
Authors: Noh Hyunjin , Jeong Haelim , Kan Denise , Lee Lewis 
Published: December 2023

Abstract
Proper pain management is essential to quality of life. Due to the risks of harmful drug interactions, there has been an increasing effort to reduce medication that may be harmful or ineffective (i.e., deprescribing) and to promote non-medication based (i.e., non-pharmacological) strategies in pain management. The purpose of this qualitative study is to understand the views of deprescribing and non-pharmacological methods in pain management among community-dwelling older adults with multiple chronic health conditions. Eligibility criteria included: 65+, Alabama resident living outside of nursing homes, cognitively intact, have two or more chronic health conditions and chronic pain, and take medications for their health conditions including pain medications. Participants were recruited through the Area Agency on Aging across the state of Alabama as well as other community venues serving older adults. Individual, open-ended interviews were conducted by phone to explore their concerns about medications, their views of deprescribing and using non-pharmacological pain management as well as their needs in doing so. Thematic analysis of the interview data revealed various barriers and needs: concerns about various side effects while also worrying about missing out benefits from the medications if reduced or stopped, uncertainty or skepticism toward non-pharmacological pain treatment, lacking financial and logistical access to non-pharmacological options, and lack of knowledge about available non-pharmacological options and their benefits. These findings have implications for future education and advocacy efforts to promote older adults’ knowledge and self-efficacy so that they can consider deprescribing and non-pharmacological methods in managing their pain.
UTILIZING TECHNOLOGY AND INTEGRATED SERVICES TO SUPPORT FAMILY CAREGIVERS IN RURAL COMMUNITIES
Authors: Satz Skye , White Quinn , Watkin Laura Gallagher 
Published: December 2023

Abstract
CRIS Healthy Aging is a non-profit organization in East Central Illinois that serves older adults who are often lower-income and/or living in a rural community. CRIS’ mission is to keep older adults safe, healthy, and independent in their own homes for as long as possible. CRIS’ Memory Care Program (MCP) expanded upon the evidence-based STAR-Caregivers (STAR-C) program. In addition to administering traditional STAR-C training, CRIS provides caregiving dyads with more integrated services, including (1) implementation of technology like the Amazon Alexa Echo Show devices and OneClick video conferencing for older adults, (2) peer support and education opportunities including Memory Café, Stress-Busting Program for Family Caregivers, and the NCOA Aging Mastery Program, as well as (3) providing financial assistance, respite, and additional aging services. In the past 4 years, the CRIS MCP, funded by a federal ADPI grant through ACL, has served approximately 200 caregiving dyads, and collected pre- and post-treatment survey data from a cohort of 52. Those served consistently reported that the STAR-C program was extremely helpful for them. Most importantly, caregivers reported significant decreases in behavior frequency (t=14.75, p&lt;0.01) and severity of personal stress response (t-21.51, p&lt;0.01). Compared to baseline, caregivers also reported feeling less resentful (p=0.005), less socially isolated (p&gt;0.05, however qualitative data supports downward trend), and saw improvements to quality of life (t=-1.77, p&lt;0.042). Ongoing barriers to service in these rural and low-income communities include a global pandemic, misinformation, fear of the unknown, family unwillingness to participate, and financial concerns.
LEVERAGING PROJECT ECHO FOR EVIDENCE-BASED INFECTION CONTROL IN NURSING HOMES: A RANDOMIZED CONTROLLED TRIAL
Authors: Kraschnewski Jennifer , Kong Lan , Lehman Erik , Heilbrunn Emily , Behrens Liza , Calo William 
Published: December 2023

Abstract
Nursing homes were ill-equipped for the pandemic; though facilities are required to have infection control staff, only 3% have taken a basic infection control course. Significant research has focused on infection control in the acute care setting; however, little is known about the implementation of practices and effective interventions. We proposed an intervention utilizing Project ECHO to connect Penn State University experts with remote nursing home staff and administrators to support evidence-based infection control guideline implementation. This study sought to answer the critical research question of how evidence-based infection control guidelines can be implemented effectively in nursing homes. A stratified cluster randomized design was used to randomize nursing homes from the Northeast and Midwest to either: 1) AHRQ-funded COVID-19 ECHO that included 16 weekly tele-mentoring sessions addressing COVID-19 guidelines and best practices plus 9 optional, weekly 60-minute office hour sessions, or 2) AHRQ-funded COVID-19 ECHO+, which included 16 weekly tele-mentoring sessions addressing COVID-19 guidelines and best practices, plus 17 weekly 60-minute sessions with a focus on stakeholder-identified needs and CDC infection control training. A total of 136 nursing homes were recruited. There were no statistically significant differences in COVID-19 infection rate, hospitalization, deaths, or flu-like illness. A multipronged approach to improving infection control and emergency preparedness in nursing homes is important. The ECHO model has significant strengths when compared to traditional training, as it allows for remote learning delivered by a multidisciplinary team of experts and utilizes case discussions that match the context and capacity of nursing homes.
IMPROVING KNOWLEDGE OF LGBTQ+ AGING THROUGH A QUEERING GERONTOLOGY CAMPAIGN
Authors: Oswald Austin , Cooper Lujira , O’Driscoll Leo , Giunta Nancy 
Published: December 2023

Abstract
The marginalization of lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) content in health and human services education is well documented and varies considerably due to instructors’ attitudes as well as government and institutional policies intended to censor conversations about sexual orientation and gender identity. Lack of LGBTQ+ content in the curriculum may require creative solutions to fill the gaps in mainstream education which often goes unchallenged due to dominant heteronormative theory, literature, and teaching. Without adequate training, service providers may not have sufficient knowledge and skills for competent practice with LGBTQ+ older adults. This presentation bridges critical pedagogy with emancipatory gerontology to reflect upon a student led “queering gerontology” campaign to raise awareness about LGBTQ+ aging. Applying principles from participatory action research, the presenters analyze personal narratives in combination with program evaluation data to describe our process conceptualizing, implementing, and evaluating the campaign. We found that students are eager to learn about LGBTQ+ aging experiences and have innovative ideas to close the gaps in knowledge caused by heteronormative educational contexts. Supporting student led learning, intersectional coalition building, and intergenerational wisdom sharing were central to combatting programmatic and institutional constraints that limit LGBTQ+ content in the curriculum. The presentation concludes by highlighting future teaching and research directions that support students in their pursuit of knowledge while challenging heteronormative structures of higher education.
PERCENT TIME SPENT IN AN IMPAIRED GLUCOSE STATE AND ADVERSE MUSCLE OUTCOMES: THE SWAN STUDY
Authors: Leis Aleda , Kilpatrick Sidonie , Strotmeyer Elsa , Karvonen-Gutierrez Carrie 
Published: December 2023

Abstract
Sarcopenia is common among older adults, but associations of sarcopenia and diabetes are mixed. Beyond sarcopenia, relationships between glucose levels and muscle quality and power are understudied. We examined the association of time spent in an impaired glucose state and muscle outcomes. Muscle quality and power were assessed in 2015-2016 in 1,614 women (aged 66 + 2.7 years) without diabetes at baseline. Muscle quality was the average grip strength (measured in three trials using a Jamar dynamometer) per kilogram whole-body skeletal muscle mass (measured using bioelectrical-impedance analysis). Muscle power (Watts/kilogram body weight) was assessed using a 3-cycle timed stair climb: [(body weight (N)*stair height (m))/average ascent time (sec)]/body weight (kg). Fasting blood was collected at 11 visits; glucose ≥100mg/dL was considered impaired, with percent time spent in an impaired glucose state (%IGS) calculated as:(number visits with impaired glucose)/(number visits with glucose)*100 and categorized as ≤24%(n=1,203), 25-49%(n=184), 50-74%(n=136), ≥75%(n=91). Cross-sectional multivariable linear regression models were constructed for muscle outcomes with the independent predictor %IGS, adjusting for age, menopausal status, race/ethnicity, hormone use, and height. Compared to the lowest %IGS, all other groups had significantly lower mean muscle quality (β range: -0.091, -0.110 and -0.135, respectively) with the largest difference vs. highest %IGS (β= -0.135, 95%CI:-0.192,-0.077). Similar results were observed for muscle power (β range: -0.022, -0.024 and -0.020, respectively), though the highest %IGS was not significantly different. Results suggest that a longer time in an impaired glucose state from middle to older age may be associated with lower muscle function in older women.
SOCIAL ISOLATION, UNMET NEEDS, AND LONG-TERM SERVICES AND SUPPORTS IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Pomeroy Mary Louise , Jopson Andrew , Reiff Jenni , Wu M J , Ornstein Katherine , Cudjoe Thomas , Fabius Chanee 
Published: December 2023

Abstract
Social isolation is associated with adverse health outcomes among older adults but can be attenuated through increased social contact and support. Long-term services and supports (LTSS) are a potential mechanism to increase social contact and provide socially isolated older adults with the help needed to perform routine activities. Using a nationally representative sample of 6,705 community-dwelling older adults from the 2015 National Health and Aging Trends Study (NHATS), we examined associations between social isolation, functional difficulty, adverse consequences due to unmet needs, and indicators of the LTSS environment (e.g., Meals on Wheels). About 22% of older adults were socially isolated. Socially isolated older adults had greater functional difficulty compared to those who were not socially isolated (45.3% vs 38.3%; p&lt;0.0001). Socially isolated older adults were more likely to be Medicaid enrollees (17.5% vs 8.4%; p&lt;0.0001) and use LTSS including SNAP benefits (12.7% vs 5.5%; p&lt;0.0001), Meals on Wheels (4.1% vs 1.6%; p&lt;0.0001), energy/gas financial assistance (7.5% vs 4.2%; p&lt;0.0001), and transportation services for older adults or people with disabilities (4.6% vs 2.7%; p=0.001). Despite greater LTSS use, socially isolated older adults more often experienced adverse consequences due to unmet needs compared to those who were not socially isolated (12.5% vs 7.7%; p&lt;0.0001). Findings suggest that LTSS in the form of social and senior services are critical in supporting those lacking social connection, but they may not be adequate to support aging in place in the absence of informal support.
AGE-VARIANT PATTERNS OF WITHIN-PERSON VARIATION IN SELF-REGULATORY CAPACITY REVEALED VIA AMBULATORY ASSESSMENTS
Authors: Hakun Jonathan , Elbich Daniel , Alwerdt Jessie , Benson Lizbeth , Fleming Allison 
Published: December 2023

Abstract
Stressful experiences often evoke changes in experienced negative affect. Individual differences in the degree of stressor-related reactivity may reflect the action of self-regulatory strategies that evolve over the adult lifespan. The executive hypothesis of self-regulation suggests that our ability to exert control over information processing (i.e. cognitive executive control) plays an important role in determining our effective capacity to regulate our emotions and behavior. We recently found evidence in younger adults that stressor reactivity is greater during moments when working memory capacity is lower than usual. Critically, aging is associated with normative declines in executive control and it remains unknown whether this impacts self-regulation in older adults. We’ll present the results of a recent ambulatory assessment study involving a sample of older adults (N = 80; 65-87 yrs; 79% female) where we sampled ratings of negative affect, exposure to everyday stressors, and working memory capacity up to 6 times per day for a period of 14 days. Results related to frequency of stressor exposures, mean levels of negative affect, and degree of negative affect reactivity to stressor exposures in this sample were largely consistent previous findings. However, when modeling stressor reactivity as a function of momentary variation in performance on ambulatory assessments of working memory capacity, we found evidence suggesting that older adults may react more to everyday stressors during moments with higher than average working memory capacity. We interpret these findings in terms of the limits of the executive hypothesis and other well-established theories of cognitive and psychological aging.
THE ROLE OF LEADERSHIP IN DISASTER DECISION-MAKING IN ASSISTED LIVING
Authors: Peterson Lindsay , Dobbs Debra , Dosa David 
Published: December 2023

Abstract
Assisted Living Communities (ALCs) make up a growing segment in long-term care for adults with impairments. Research indicates that functional and cognitively impaired older adults who are evacuated for hurricanes are more vulnerable to harm than those who shelter in place. A high proportion of assisted living residents require help with bathing (63.6%), dressing (48.2%), and other activities of daily living. At least 40% have Alzheimer’s disease or other dementias. Despite residents’ vulnerabilities, we know little about ALC disaster preparedness. In this study, we conducted a secondary analysis of data from interviews with ALC administrative staff after Hurricane Irma to better understand factors influencing the decision to evacuate or shelter in place. Initially we conducted individual interviews and focus groups with stakeholders of 70 Florida-based ALCs concerning a range of preparedness and response issues. We analyzed transcripts using a deductive approach, with research team members meeting regularly to resolve differences, develop/update codes, and identify themes and subthemes. Next, we separately analyzed codes concerning the decision to evacuate or shelter in place. Three overall themes were identified: 1) response to evacuation orders; 2) differing views of how to ensure safety; and 3) characteristics of ALC buildings. Examining our results overall, an overarching theme of leadership emerged, with effective leadership being preparedness based on comprehensive knowledge of residents’ needs, the nature of the threat at hand, and the ALC’s strengths and vulnerabilities. Our finding show the need for training incorporating “lessons learned” concerning both evacuation and sheltering in place for disasters.
GRIEF SYMPTOM PROFILES OF OLDER SPOUSES BEREAVED BY COVID-19
Authors: Stahl Sarah , Kazan Joseph , Krafty Robert , Reynolds Charles , Rollman Bruce , Smagula Stephen , Gebara Marie Anne 
Published: December 2023

Abstract
Many older adults lost their spouse or life partner to COVID-19. Despite the anticipated rise in the prevalence of prolonged grief disorder, the association between COVID-19 bereavement and symptoms of complicated (or pathological) grief in community-dwelling older adults remains unclear. This study compared six clinically meaningful complicated grief symptom profiles between older spouses who were and were not bereaved by COVID-19. Participants included 80 adults aged 60+ years (20% men, 10% Black/minority status) who lost their spouse or life partner within the previous 12 months (M time since loss=6.6 months [SD=3.4 months]) and were enrolled in a randomized controlled trial for depression prevention. Grief symptom profiles were assessed with the Inventory of Complicated Grief. At the time of enrollment, older spouses bereaved by COVID-19 (n=18) reported more shock and disbelief (M = 7.11 [SD=3.16] versus M=3.83 [SD3.30], F=13.84, p&lt;.001) and more hallucinations (M=1.56 [SD=1.29] versus M=0.45 [SD=0.88], F=17.12, p&lt;.001) compared to older spouses bereaved by other causes of death (n=62). The two groups were similar in terms of yearning, anger and bitterness, estrangement from others, and avoidance behaviors. In addition, older spouses bereaved by COVID-19 had over 3 and a half times the odds of screening positive for probable prolonged grief disorder (OR=3.84 (95% CI = 1.28 -11.53, p = 0.016). These symptom clusters, particularly hallucinations, map to the highest level of prolonged grief disorder severity. These findings suggest that clinical treatment for prolonged grief disorder may be warranted for surviving spouses who lost their loved one to COVID-19.
METABOLOMICS OF LONGEVITY AND LIFESPAN
Authors: Sebastiani Paola , Raghavachari Nalini 
Published: December 2023

Abstract
Serum metabolomics has been an important source of biomarkers of aging and longevity for years. This symposium will bring together investigators from large studies of human longevity to provide an overview of recent discoveries on serum metabolomics of aging and extreme human longevity, their connections to genetic variations, and highlight the challenges of correlating metabolomic profiles of aging in human studies and across multiple species. Dr. Sebastiani will describe results from analyses of serum metabolomics of participants enrolled in the Long Life Family Study, highlight similarities and differences between metabolomic profiles of old age and extreme old age, and some connections with genetics of extreme human longevity. Dr. Rappaport will connect specific variations of the APOE alleles to metabolomic profiles and describe a possible role of bioenergetics pathways in mediating the effect of APOE to longevity and resistance to Alzheimer’s disease. Dr. Monti will expand the characterization of metabolomics of aging and extreme human longevity in a large metabolomic study of very old centenarians by using traditional statistical analyses and novel machine learning techniques. His analysis identifies rich signatures of aging and longevity that include well known metabolites and point to bile acids and several classes of steroids as important marker of longevity. Analytical innovations will be taken further by Dr. Schork who will introduce a novel approach based on distance of profiles to analyze multiple metabolites simultaneously and show the value of this approach to analyze metabolomic profiles of maximum lifespan across multiple species. This is a Geroscience Interest Group Sponsored Symposium.
WHAT IT MEANS TO ENGAGE IN FALL PREVENTION: QUALITATIVE ANALYSIS OF MOTIVATIONAL INTERVIEWING SESSIONS
Authors: Kiyoshi-Teo Hiroko , McMahon Siobhan , Northrup-Snyder Kathlynn 
Published: December 2023

Abstract
Evidence-based strategies to decrease fall risks and rates are well established. However, little is understood about how older people engage in fall prevention strategies. Participants’ statements in the motivational interviewing (MI) sessions conducted as part of Motivational Interviewing for Fall Prevention (MI-FP) study were analyzed. The goal was to describe what it means for older adults to engage in fall prevention; specifically, what and how they engage. Participants (n = 16) were purposefully selected from the MI-FP study for maximum variation in age, sex, fall risks, and assigned MI specialist. Participants were community-dwelling, ≥ 65 years old, and high fall risk for which they received fall prevention recommendations from their primary care provider. Baseline MI sessions were recorded, transcribed and analyzed using qualitative content analysis by three researchers. We first coded fall prevention strategies that participants described. Second, we analyzed the characteristics of these strategies and identified themes. Third, we examined how participants engaged in these strategies. Theoretical frameworks were not used for analysis; however, we did use the Capability, Opportunity, and Motivation Behavior model to organize findings. We found participants 1) used evidence-based and personal strategies; 2) engaged in multiple, personally meaningful strategies and engaged at intensities that worked for them; and 3) were influenced by factors such as their capability to engage in fall prevention, their motivation to engage, and access to opportunities. This study identified what matters for older people to engage in fall prevention.
DECONSTRUCTING MULTIMORBIDITY AND MUSCLE MITOCHONDRIAL RESPIRATION AND ENERGETICS IN OLDER ADULTS
Authors: Mau Theresa , Ramos Sofhia , Kramer Philip , Newman Anne , Cummings Steven , Hepple Russell , Coen Paul , Cawthon Peggy 
Published: December 2023

Abstract
Lower cardiorespiratory fitness among older adults is associated with greater multimorbidity burden, including cardiovascular disease, cancer, and dementia. Those with poorer muscle mitochondrial energetics also have lower cardiorespiratory fitness. We have previously shown lower mitochondrial respiration and energetics (OXPHOS and ATPmax) have higher morbidity burden using a summary measure, but the associations among specific conditions have not been examined. We leverage data from the SOMMA cohort (N=856, 76.4yrs, 59% women, 85.5% white); participants self-reported physician diagnosis of 11 age-related conditions (i.e., cancer, cardiac arrhythmia, chronic kidney disease (CKD), chronic obstructive pulmonary disease, coronary heart disease (CHD), depression, diabetes). Mitochondrial respiration was assessed by high-resolution respirometry of vastus lateralis using permeabilized fiber bundles. 31P magnetic resonance spectroscopy of the quadriceps measured ATPmax. In adjusted logistic models with beta-coefficients reported per SD decrement in each mitochondrial measure, fatty-acid-supported Leak respiration was associated with CKD (OR: 2.3(95%CI=1.2,4.3)), fatty acid and complex I&II supported oxidative phosphorylation (OXPHOS) with depression (OR: 1.8(95%CI=1.1,2.7)). Many respirometry measures and ATPmax associated with diabetes, with maximal electron transport system (ETS) capacity having the highest odds (OR: 1.5(95%CI=1.1,2.0)). No other associations were statistically significant for conditions listed above. These results indicate that mitochondrial respiration and energetics are more impaired in depression, kidney disease, and diabetes. This raises new questions about the role of mitochondrial respiration and energetics as cause or consequences of these conditions. Overall, our analyses suggest compromised mitochondrial function may have implications for specific aging-related conditions, and global measures of morbidity burden may not reflect these distinctions.