bluuebunny/crossref_metadata_2025_split huggingface dataset:
MAGNIFYING THE VOICE OF A COMMUNITY: ATTITUDES AND BELIEFS AMONG AFRICAN AMERICANS ABOUT DEMENTIA
Authors: Simmons Jabrina , Frager Victoria , Broussard Jia , Greenwood-Hickman Mikael Anne , Barrett Tyler , Barnes Deborah 
Published: December 2023

Abstract
By 2060, the prevalence of Alzheimer’s disease and related dementias (ADRD) in the U.S. is predicted to more than double to 14 million. African Americans (A.A.) 65 and older are 2.5 times more likely to develop Alzheimer’s than same-aged White Americans. Furthermore, A.A. are twice as likely to be underdiagnosed, leaving the A.A. community underserved with respect to ADRD. To gain insight into the key drivers of this underdiagnosis, we performed a scoping review of research on attitudes and perceptions held within the A.A. community regarding ADRD, which may impact diagnosis and screening. We searched PubMed, CINAHL, Web of Science, and Black Studies Periodicals Database for studies from 2002 to 2022 using keywords: “Dementia” or “Alzheimer’s” and “African Americans,” “Ethnicity,” “Racial Groups,” “Blacks,” or “Ethnic and Racial Minorities,” and “Health Knowledge, Attitudes, Practice,” “Health Services Needs and Demand,” or “Perception.” We identified 318 studies; 49 met inclusion criteria after title and abstract review and were selected for full manuscript review. We discussed all included manuscripts and identified pertinent themes, noting potential method bias. An identified “knowledge gap” among A.A. about dementia, particularly a belief that dementia is part of normal aging or God’s will, was prominent. Other themes included mistrust of the medical community, a desire to maintain everyday family life, the need for culturally appropriate resources, and cultural expectations to provide care despite institutional support obstacles (John Henryism/Superwoman schema). Understanding differences in attitudes and beliefs toward dementia among African Americans may support developing effective strategies to address disparities.
POLICY SERIES: HEALTH AND AGING POLICY FELLOWS: LINKING POLICY AND PRACTICE TO BENEFIT OLDER PEOPLE
Authors: Henry Maureen , Franzosa Emily 
Published: December 2023

Abstract
The Health and Aging Policy Fellows program was founded in 2008 after its founders observed a dearth of experts with overlapping experience in policy and aging. The program is creating a growing cadre of leaders to improve the health of older adults by influencing policy at the state and national levels that is joined through an alumni network of more than 150 fellows. The fellowship’s goal is to improve the lives of older people across life domains. Past fellows serve as staff members in Congress, in State and Federal Agencies, and in the private sector. The fellowship has helped to launch many policy-focused careers. In this seminar, current and past fellows from medicine, research, social work, and law will share their experiences before, during, and after their fellowship. They will describe what they learned through the training and a placement in a full- or part-time policy role, how viewing health and aging through a policy perspective changed their understanding of systems, and how they think the fellowship will enable them to influence policy to improve the lives of older people in the future. Fellows will also highlight ongoing policy challenges that stop or slow progress toward achieving the goal.
CARE PLAN INVENTORY AND ASSESSMENT—A MEANS TO LEARN MORE ABOUT CMS
Authors: Carney Maria 
Published: December 2023

Abstract
The Health and Aging Policy Fellowship (HAPF) provides an orientation on the federal government organization and an introduction to aging policy foundations and agencies. The goal of this orientation is to lead to a growth of a professional network as well as a policy placement opportunity. I will explain the process for choosing a HAPF placement with the Centers for Medicare and Medicaid Services (CMS) and Agency for Health Research and Quality (AHRQ). Using my HAPF experience as an example of how my interest in Age-Friendly Health System work at a large health system led to my placement and personal growth. I will discuss my reasoning in taking part in the Fellowship and the creation of CMS Care Plan Inventory and Assessment. Achieving goal-concordant care is the bedrock of Age-Friendly care. Creating care plans is a means for teams and insurance providers use to create goal concordant care. Measuring goal concordant care is a challenge, but development of care plans would be a potential start. CMS utilizes care planning in programs and in billing codes. My Health and Aging Policy Fellowship placement assessed how care planning is defined and what are the elements in CMS programs and billing codes and if these are aligned with care plan research from AHRQ. My experience, current interests and project development will be the example of how HAPF provided me with a better understanding of CMS programs and how billing code creation affects clinician behaviors and , in turn, patients.
THE CANNABIS AND OLDER PERSONS STUDY: MOVING ALONG A ROAD FROM ANIMAL MODELS TO STATE CAPITOLS
Authors: Kaskie Brian 
Published: December 2023

Abstract
The Cannabis and Older Persons Study has examined the increasing use of cannabis among Americans over 60 years old since 2016. This year’s symposium presents varied methodological approaches researchers have used to better understand the relationship between age and cannabis use. Barry Setlow examines how cannabis use corresponds with age-associated synaptic dysfunction, neuroinflammation, and tau pathology in animal models (younger v older rats), and how such association may contribute to cognitive aging. Nicole Ennis examines the association between cannabis use and simulated driving performance among adults aged 50 and older focusing on response time, attention, and executive functioning tasks that predict on-road performance. Yan Wang examines short and long-term effects of medical marijuana use among older adults using ecological momentary assessments. Divya Bhagianadh analyzes responses provided by 1398 older persons who completed a special module concerning cannabis use as part of the Health and Retirement Survey and applies a multi-level framework to better understand how cannabis use is shaped by individual attitudes and health status. Fadi Martinos considers how state medical cannabis program eligibility criteria and provider qualifications contribute to cannabis access and use among older adults. Together, these studies reflect how scientific understanding of cannabis use and aging has been informed by the application of multiple disciplinary perspectives, and how researchers use different methodological approaches to identify both desirable and undesirable outcomes associated with cannabis use among older adults. This symposium offers policy makers, program administrators and clinicians empirically-based insights concerning how cannabis use affects older adults.
EXAMINING CAREGIVER NETWORK STRUCTURE, COMPOSITION, AND COORDINATION FOR OLDER ADULTS WITH ALZHEIMER’S DISEASE
Authors: McConnell William , Haggar Katherine , Hernández María Ortega 
Published: December 2023

Abstract
Over half of the older adults with Alzheimer’s disease and related dementias (ADRD) live in the community with informal caregivers whose unpaid assistance constitutes the majority of their care. Research and interventions targeting caregivers typically limit their focus to one primary caregiver, but many older adults with ADRD rely on a variety of interconnected kin, non-kin, and professional supporters. Little is known about the structure, composition, or consequences of these caregiver networks. To address this gap, we conducted a social network analysis (SNA) of the caregiver networks of 23 older adults with ADRD receiving outpatient services at a Memory Disorder Clinic. SNA data was obtained through detailed social network interviews conducted one-on-one with self-identified primary caregivers. We find that adults with ADRD have an average of 7.7 caregivers in their networks. Quantitative analyses demonstrate that caregiver network properties (including size, density, composition, and care coordination) vary with the context of caregiving (including living situation, level of functional impairment, and use of formal services). An average network includes a roughly even mix of informal caregivers (3.2 members) and professional caregivers (3.5), but they occupy different network positions and fill distinct supportive roles. For example, informal caregivers engage in frequent care coordination, but coordination is comparatively uncommon between formal caregivers. This interdisciplinary research advances beyond the dyadic level of analysis typical of most caregiving research to comprehensively measure caregiver networks. Further, we identify variations in caregiver networks and quantify network-based task-sharing and care coordination among informal and professional caregivers.
AGE DIFFERENCES IN SUNK COST DECISIONS FOR ONESELF VERSUS A LOVED ONE
Authors: Strough JoNell , de Bruin Wändi Bruine , Parker Andrew 
Published: December 2023

Abstract
Previous research has established that older adults are less biased by irretrievable prior investments or ‘sunk costs’ when making a decisions about continuing a failing project. Such decisions often have implications for other people, but most research to date has focused on individuals making decisions for themselves. Here, we investigated whether age differences in willingness to discontinue a failing project and start over depended upon the intended beneficiary (self or loved one) as well as the type of investment (money or time). Participants (N=1075, Mage=53.49 yrs; 56.2% Women) from the American Life Panel responded to an online survey and made hypothetical decisions about a failing project. At all ages, when the project was for oneself, individuals were less willing to discontinue it and start over when money (versus time) had been invested, whereas when the project was for a loved one, willingness to start over did not depend on whether money or time had been invested. The association between older age and greater willingness to discontinue a failing project and start over was stronger when projects were for oneself compared to a loved one. Implications of the findings for understanding aging and decision making in a social context, and strategies for reducing sunk-cost bias in people of all ages are discussed.
SOCIAL SERVICE DIRECTOR PRIORITIES IN RESOLVING CONFLICTS IN NURSING HOMES
Authors: Kusmaul Nancy , Roberts Amy , Bern-Klug Mercedes 
Published: December 2023

Abstract
Social workers in nursing homes serve many critical roles such as assessing for residents’ unmet psychosocial needs, providing support to residents and families at end of life, and resolving conflicts between residents, families, and staff. In their roles, they often need to balance conflicting priorities and determine whose rights or needs should take priority. Little is known about how these conflicts affect the social workers in their jobs. This presentation will report the results of a content analysis of the answers to two open ended questions, “What do you like about your job?” and “What would you change about your job?” in a nationally representative sample of nursing home social service directors. The results illustrate directors’ views of what they value in terms of helping residents, families, and staff navigate change, difficult conversations, and conflicting interests. Social service directors report that their priorities are residents and their families, specifically advocating for resident needs. They also report needing to advocate for the role of social work on the interdisciplinary team. They report that family dynamics are messy, but do not discuss how they prioritize within and between residents, their family members, and nursing home staff. More research is needed to understand the decision making process that social workers employ in decision-making about priorities.
REPRESENTATION LEARNING OF PROTEOME DYNAMICS TO CHARACTERIZE ORGANISMIC COMMUNICATION AND INTRINSIC HEALTH
Authors: Liu Molei , Xu Bowen , Honfo Sewanou , Cohen Alan , Picard Martin 
Published: December 2023

Abstract
Co-regulation and interactions among organ systems are crucial to maintain health. Therefore, understanding patterns of such organismic communication using proteome dynamics could be an innovative and effective strategy for quantifying intrinsic human health. In this preliminary study, we conducted a case-control study involving six participants with severe genetic mitochondrial disease and six age- and sex-matched healthy subjects. We measured and recorded the salivary proteome of each participant (n=2922 proteins) at 0-, 30-, and 45-minutes post-awakening as well as bedtime (pm), over two days, representing a natural physiological challenge known to involve systems-wide physiological recalibrations. We then analyzed the changes in protein levels across successive time points using a high-dimensional two-sample testing approach (Cai, Liu, and Xia 2013). The protein co-regulation pattern (captured by the covariance matrix of their changes in expression) was significantly different between the healthy and mitochondrial disease participants (p=0.01), thereby linking proteome dynamics with health status. We then implemented Weighted Correlation Network Analysis to identify representative features showing a significant correlation with the subject’s health status between pairs of successive time points (0-30, 30-45, 45-pm). The correlation between the extracted feature and the self-rated health was as high as 0.39 (p-value=0.03) for the 30-45 time period. This finding reveals an association between health status and salivary protein co-regulation patterns, and suggests a promising representation learning strategy to quantify the manifestation of health into accessible proteome dynamics.
BUILDING CLINICAL JUDGMENT IN THE HEALTH CARE WORKFORCE BY ADDRESSING THE 4MS AND MULTICOMPLEXITY
Authors: Avallone Margaret , Perweiler Elyse , DeGennaro Jennifer , Mock Marilyn 
Published: December 2023

Abstract
Since 2019, NJGWEP, Rutgers School of Nursing-Camden and Fair Share Support Services, Inc. partnered in an affordable housing site in an underserved, disadvantaged community to support aging in place. Senior nursing students conduct Resident Health Risk Assessments (RHRAs) using the 4Ms framework to build assessment skills, sharpen clinical judgment, and address the Geriatric 5th M in a multi-complex resident population. Nursing students, working in teams with social service and community health workers, completed 92 RHRAs incorporating the 4Ms (What Matters, Mind, Medication, Mobility). On average, residents had &gt; 3 risk factors related to the 4Ms (M=3.31); 25% +screen for depression, 25% +screen for cognitive impairment, 64% w/mobility deficits, 83% w/polypharmacy, and 80% on 1 or more high-risk medications. There were 53% w/diabetes, 65% w/hypertension and other biopsychosocial factors related to social determinants of health; 91% could be characterized as multi-complex (the Geriatric 5th M) and in need of services/supports to age in place. The 4Ms framework, with the addition of the 5th M, provides curricular structure for development of clinical judgment through focused assessment, analysis, flagging of key assessment data, prioritization of problems, and developing person-centered plans of care. Interprofessional (IP) case studies of increasing levels of difficulty experienced by affordable housing residents build cultural competence, foster development of critical thinking, clinical reasoning, and, when supplemented by weekly IP case reviews, facilitate shared decision-making and care planning. The process is further supported by a customized electronic database that permits monitoring person-centered recommendations and outcomes over time, gauging impact.
DEVELOPMENT OF A COMMUNITY-ENGAGED DEMENTIA EDUCATION PROGRAM FOR THE VIETNAMESE AMERICAN COMMUNITY
Authors: Miyawaki Christina , Nguyen Kim , McClellan Angela , Ho Tuong-Vi 
Published: December 2023

Abstract
Despite the life-threatening escape from Vietnam, Vietnamese refugees’ health data are scarce. To fill this knowledge gap, we developed the Vietnamese Aging and Care Survey (VACS) and examined the health of community-dwelling older Vietnamese (≥65 years) in Houston, Texas, the 2nd largest Vietnamese-populated metropolitan area in the U.S. The data revealed their adverse health conditions including a high prevalence of cognitive impairment. We proposed a Community-Engaged Dementia Education Program to improve the community’s dementia literacy based on the Cultural Exchange Model as a conceptual framework. Using Edwards’ 9-stage Community Readiness Model, 14 Vietnamese key informants assessed their current literacy level (Aim 1). To develop dementia educational materials (Aim 2), the informants formed focus-group discussions. We used thematic analysis to analyze the community’s understanding of dementia and developed educational materials. Key informants were aged 58 years (mean), Vietnam-born (93%), married (79%), college-educated (72%), women (86%), and full-time employees (79%). They lived in the U.S. for 39 years and in Houston for 30 years. Themes such as the Vietnamese community’s low dementia literacy, their perception of dementia as a normal part of aging, and suggestions for introducing dementia conversations to the community emerged. We considered a one-pager as appropriate educational material, and included culturally- and linguistically-appropriate content and its translation, a target population’s image, and dementia warning signs encouraging them to see their doctors for cognitive check-ups. Our next steps include utilizing local ethnic social media, disseminating the one-pager, and offering a “Brain Booth” at various Vietnamese health fairs.
ASSOCIATION OF SECOND GENERATION EPIGENETIC CLOCKS AND DISCRIMINATION WITH TRAJECTORIES OF CHRONIC HEALTH CONDITIONS
Authors: Mutambudzi Miriam , Brown Maria , Chen Nai-Wei 
Published: December 2023

Abstract
This study aimed to examine whether 2nd generation epigenetic clocks and perceived discrimination as measured by the Everyday Discrimination Scale are associated with differential classification into trajectories of chronic health conditions (CHCs). We used 2014-2020 data from the Health and Retirement Study (HRS) and biological clock data from the 2016 HRS Venous Blood Study (N=3,177). CHC trajectories were constructed using latent class growth models. Multinomial logistic regression analysis examined the association between PhenoAge and GrimAge epigenetic clocks respectively, perceived discrimination, and the constructed trajectories. Participants (≥ 50 years) were classified into 4 CHC trajectory classes, graded by risk of increasing mean CHCs, with trajectory class 1 indicating the lowest mean number of CHCs (most favorable) and class 4 the highest (worst), over 3 study waves. Approximately 35.5% Black, 24.9% Hispanic, and 25% White participants reported high discrimination (p&lt; 0.01). Compared to Whites, Blacks had increased risk of classification into trajectory class 4 (RRR=1.91, p=0.02 GrimAge and RRR=2.31, p&lt; 0.01 PhenoAge). PhenoAge was associated with increased risk of classification into trajectory class 4 for Hispanics (RRR=1.17, 95%CI=1.06-1.28), and modest increases in risk for Blacks (RRR=1.07, 95%CI=1.01-1.15) and Whites (RRR=1.06, 95%CI=1.03-1.09). GrimAge was associated with increased risk of classification into trajectory class 4 for Hispanics (RRR=1.21, 95%CI=1.06-1.38), Blacks (RRR=1.19, 95%CI=1.06-1.33) and Whites (RRR=1.14, 95%CI=1.08-1.20). Despite higher observed rates of discrimination in Blacks, experiences of discrimination increased risk of classification into trajectory class 4 for whites only (RRR=1.59, 95%CI=1.06-2.38). Discrimination findings should be interpreted with caution and future work should account for coping strategies.
PATHWAYS TO OR WITHIN SOCIAL EXCLUSION? AN INTERSECTIONAL LIFE COURSE PERSPECTIVE ON OLDER ROMANIAN ROMA
Authors: Tufă Laura , Precupetu Iuliana , Anghel Ionut , Aartsen Marja 
Published: December 2023

Abstract
Social exclusion is considered a dynamic process as people can move in and out of exclusion while also experiencing different types of exclusion over their life course. In this paper we set out to understand pathways to social exclusion of older Romanian Roma, a particular population that received little attention in the literature. We aim to understand the lived experiences of social exclusion of Roma with the use of life histories and events calendars and we employ an intersectional life course perspective by looking at the nexus of structural, individual, and relational factors that impacted the pathways of older Roma across their life course. The intersection between ethnicity, gender, education, work, residence/segregation and income is employed in order to understand how disadvantage unfolded across the life course and into late life. The data come from 15 biographical interviews with older Roma living in rural and urban Romania, collected in 2021. Results illustrate how specific structural processes like sedentarization of nomad communities, the fall of the communist regime in 1989 and the retrocession of gold unevenly affected Roma across the intersectional characteristics and transformed into turning points in their lives, while interposing to a little extent with their pathways to social exclusion. De-institutionalized life courses and fast transitions had an important bearing on the ways disadvantage unfolded for older Roma living in segregated communities. Finally, super-linked lives at family and community level, when deprived of outside support, contributed to deep exclusion in later life.
USING THE MOCA-SA WITH SPANISH-SPEAKING OLDER ADULTS: STRENGTHS, LIMITATIONS, AND CORRECTIONS
Authors: Piedra Lissette , Iveniuk James , Pudelek Kelly , Howe Melissa , Marquez David 
Published: December 2023

Abstract
Exploratory factor analyses using Round 2 and 3 data reveal discrepancies in the MoCA scores of English and Spanish speakers. In this paper, we describe the strengths and limitations of using NSHAP’s state-of-art MoCA measure with Spanish speakers and propose a solution to the discrepancies observed between the two linguistic groups. To arrive at our remedy, we calculated modification indexes of Spanish language MoCA items to identify items that remained consistent across ethnoracial language groups. From these items, we constructed an abbreviated MoCA-SAA (Spanish version) that compared favorably with the long form MoCA-SA across the different grouping and showed predicative validity with consequential outcomes associated with cognitive decline.