bluuebunny/crossref_metadata_2025_split huggingface dataset:
ENGAGING OLDER ADULTS IN HEALTH PROMOTION: PILOT STUDY OF TEAM GAMEPLAY OF AN EDUCATIONAL EXERGAME IN A SENIOR CENTER
Authors: Ruggiero Laurie , Orsega-Smith Elizabeth , Nichols Amy , Varghese Joshua , Getchell Nancy , DeLauder Rachel , Koiler Reza , Barmaki Roghayeh 
Published: December 2022

Abstract
Digital health games offer one innovative approach to engage older adults to support healthy aging. Multiple reviews have described the positive impact of health games. Limited research has examined multi-focus health games implemented in senior centers. Informed by healthy aging theory and community-engaged methods, our multi-disciplinary team developed/refined an educational exergame with a combined focus on educating about healthy lifestyle behaviors (i.e., physical activity, healthy eating), stimulating cognitive functioning, and engaging movement to support healthy aging. A pilot study (Nf13; mean age = 78, 100% female) examined team gameplay (4 sessions in two weeks) in a senior center. Teams (2–3 members) worked together to answer knowledge, trivia, and cognitive challenge questions and competed for the highest score. A post-gameplay survey asked about acceptability, usability (i.e., adapted System Usability Scale), and perceived game impact. Preliminary results suggest team gameplay was engaging and nearly all (&gt;90%) agreed/strongly agreed that they enjoyed playing with others (i.e., on teams); were comfortable doing the physical movements during gameplay; were satisfied with game educational, trivia, and cognitive questions; enjoyed the social part of team gameplay; would recommend the game to others; and the game increased their knowledge and motivation regarding physical activity and healthy eating. The System Usability Scale was above 70, on average, suggesting above average usability for the game. Findings support use of this educational exergame as an innovative way to engage older adults in health promotion. Presentation will describe game development/refinement, senior center pilot, and implications for future research and senior center translation.
DEPLOYING IN-HOME SENSORS TO COMMUNITY-DWELLING OLDER ADULTS: ADOPTION OF TECHNOLOGY AND LESSONS LEARNED
Authors: Robinson Erin , Tefera Gashaye Melaku , Park Geunhye , Skubic Marjorie , Marchal Noah , Popescu Mihail , Keller James , Marilyn Rantz 
Published: December 2022

Abstract
In-home, sensor technologies can promote chronic disease self-management and independence among older adults. However, the translation of these technologies from assistive living/long-term care to community-dwelling older adults is lacking. This study aimed to tailor such technologies for private use by older adults, and gather feedback about adoption/interpretation of sensor-generated health information to make informed health decisions. Participants (Nf33; 72.7% female) aged 60+ (Mean=79.5) had three types of sensors installed: 1) depth sensors that track gait parameters and falls; 2) passive infrared motion sensors that track room activity; and 3) hydraulic bed mats that track sleep, respiration, and heart rate. Participants were also offered a Garmin smartwatch/fitness tracker. A health app was developed for participants to retrieve their sensor-generated health information via an Amazon Echo Show device with touch display and voice-activated capabilities, and a web-based interface. Data were collected over two years, and feedback was solicited during four quarterly interviews and one exit interview. Thematic analysis revealed participants used the Echo Show to retrieve their health information, set medication/health appointment reminders, and for non-health related purposes (e.g. music, weather). Regular retrieval of health information was low, partly due to technology skills, lack of interest, health issues, and technical/internet issues. Despite this, participants reported a sense of security in having the sensors installed and valued the depth sensor’s fall detection abilities. This study yielded many additional findings that will be presented, such as participant recommendations to facilitate greater adoption. Implications can inform technological solutions for older adult health self-management and aging-in-place.
USING HUMAN CENTERED DESIGN TO DEVELOP TWO NEW MEASURES OF LIVING WELL WITH DEMENTIA
Authors: Molony Sheila , Fazio Sam , Zimmerman Sheryl , Sanchez Ricci , Montminy Joe , Barrere Cindy , Montesano Rachel , Van Haitsma Kimberly 
Published: December 2022

Abstract

Background
New measures are needed that can provide a holistic approach to capturing salient outcomes contributing to quality of life in dementia. Purpose: To use human centered design to develop, prototype and evaluate new positive psychosocial measures for persons living with dementia

Methods
This project used a conceptual framework of human centered design to obtain and analyze data from multiple sources, including individual and focus group interviews, observations in the field and related methods to enhance empathy for the lived experience of dementia, and to design prototypes for two new measures.

Results
Qualitative analysis of interview data, integration of data from the theoretical and empirical literature and human centered design techniques including brainstorming and ideation were used to define constructs and create prototypes for a new Living Well with Dementia Inventory and Good Day-Bad Day assessment tool. Results of qualitative analysis, item development, and initial validity assessment will be presented.

Conclusion
Human centered design is a useful method for development of person-centered measures. This method may complement traditional methods of instrument development and CBPR.
FEELING VS BEING CONNECTED: DIFFERENTIATING LONELINESS AND ISOLATION IN NEAR- AND CENTENARIANS
Authors: Ying Lian , Pat Chun , Hi Bobo , Lau Po , Martin Peter , Chung Joey , Siu Yue , Siu Karen , Cheung Lan , Lai Cecilia , Chan Wan , Man Grace , Chan Yee , Ka James , Luk Hay 
Published: December 2022

Abstract
While gerotranscendence theories postulate that older adults tend to orient themselves toward solitude, activity theories highlight the importance of continuing social and meaningful engagement for well-being across lifespan. The distinction between loneliness and social isolation is particularly observable in older adults of advanced age who are often facing accelerated decline in physical and functional health, therefore restricting their opportunities to interact with others. This has been particularly disturbing during the previous two years under COVID. This study utilized data from the 2nd Hong Kong Centenarian Study which interviewed 120 family caregivers of older adults aged 95 or above in 2021–2022 when the city experienced almost an entire year of the outbreak. Using family or friend proxy information as well as caregiver ratings of whether older adults expressed feelings of social isolation and loneliness, we found that 10.7% of older adults reported high levels of loneliness and isolation; 26.7% feeling low in both; 11.5% were isolated but not lonely, and 38.2% were lonely but not isolated. Loneliness ratings were more strongly associated with psychological well-being (Patient Health Questionnaire-4), autonomy, happiness, perceived usefulness, worries, and death anxiety than did isolation, with the latter negatively correlated with optimism. Participants rated in the low isolation/loneliness group were least (death) anxious than the other three groups. Our findings underscore the divergence of isolation and loneliness for adults of advanced age and call for psychological support for oldest-old adults who continue to face social isolation, especially when society gradually recovers from COVID.
CHALLENGING AGEISM IN HEALTHCARE THROUGH INTERPROFESSIONAL EDUCATION
Authors: Park Min Kyoung , Martin Diane 
Published: December 2022

Abstract
Broadly defined as prejudice, discrimination, or stereotyping of older adults, ageism is prevalent in the healthcare system. It is implicated in the over- or under-diagnosis and/or treatments provided to older persons, resulting in decreased quality of life and increased costs of care. In Fall 2021, we developed a virtual interprofessional education (IPE) activity to increase professional health and social care trainees’ awareness of ageism and to biases they may hold. During the asynchronous portion of the training, participants complete the Harvard Implicit Association Test (age), watch a video, and respond to related threads on Blackboard, which provides an opportunity to discuss experiences prior to participating in a synchronous training activity incorporating a presentation on ageism in healthcare. To date, 98 trainees have provided qualitative data on the impact of the ageism training components. Overwhelmingly, trainees indicated the value of information provided; many of whom responded that the test revealed their own biases. Participants commented that the training was an opportunity to open their eyes to ageism and that it made them more aware of the importance of understanding older adults’ capabilities and limitations in a respectful way. More than half (55.86%) of threaded discussions noted that the ageism training helped them to realize their biases against older adults and understand older people’s challenges. Quantitative data from pre/post IPE surveys indicated increased interest in working with older adults. Responses illustrate the need to and value of incorporating anti-ageism content into educational programs of our future health and social care workforce.
SUPPORTING AGING IN PLACE WITH MOBILITY IMPAIRMENTS THROUGH ANNOTATED TELEPRESENCE TECHNOLOGY
Authors: Thompson Ben , Gandy Maribeth , Jordan Kala , Levy Laura 
Published: December 2022

Abstract
Most smarthome and smartphone technologies are designed with younger adults in mind, even though many older adults can benefit greatly from their use. Through our examination of how to make these technologies more accessible to adults aging in place with mobility impairments, we have found remote troubleshooting to be a possible solution to many problems. However, we have found most current teleconferencing solutions to be lacking in the limited perspectives of a single webcam, as well as from a lack of ability to point out specific items and locations within a camera view. As such, Our team developed a prototype system that used multiple desk space and room space views, as well as on screen annotations, to facilitate remote troubleshooting and social interactions through a teleconferencing service. This prototype was then evaluated with adults aging in place with mobility impairments, as well as accessibility experts, in order to see what parts of the system could be utilized for troubleshooting, as well as to see where the system was lacking. The studies tested the system’s ability to be used for troubleshooting, as well as their uses in games and social interactions. We have gathered positive feedback for these prototypes in the areas of troubleshooting, socialization, games, and for use in other accessibility studies. From these results, we have begun development of a mobile deployment kit for use of our teleconferencing solution in other accessibility studies.
USER PERSONAS TO GUIDE TECHNOLOGY INTERVENTION DESIGN TO SUPPORT CAREGIVER-ASSISTED MEDICATION MANAGEMENT
Authors: Linden Anna , Loganathar Priya , Holden Richard , Boustani Malaz , Campbell Noll , Ganci Aaron , Werner Nicole 
Published: December 2022

Abstract
Informal caregivers often help manage medications for people with ADRD. Caregiver-assisted medication management has the potential to optimize outcomes for caregivers and people with ADRD, but is often associated with suboptimal outcomes. We used the user-centered design persona method to represent the needs of ADRD caregivers who manage medications for people with ADRD to guide future design decisions for technology interventions. Data were collected through virtual contextual inquiry in which caregivers (Nf24) sent daily multimedia text messages depicting medication management activities for seven days each, followed by an interview that used the messages as prompts to understand medication management needs. We applied the persona development method to the data to identify distinct caregiver personas, i.e., evidence-derived groups of prospective users of a future intervention. We used team-based affinity diagramming to organize information about participants based on intragroup (dis)similarities, to create meaningful clusters representing intervention-relevant attributes. We then used group consensus discussion to create personas based on attribute clusters. The six identified attributes differentiating personas were: 1. medication acquisition, 2. medication organization, 3. medication administration, 4. monitoring symptoms, 5. care network, 6. technology preferences. Three personas were identified based on differences on those attributes: Regimented Ruth (independent, proactive, tech savvy, controls all medications), Intuitive Ian (collaborative, uses own judgment, some technology, provides some medication autonomy), Passive Pamela (reactive, easy going, technology novice, provides full medication autonomy). These personas can be used to guide technology intervention design by evaluating how well intervention designs support each of them.
CAREGIVER USABILITY TESTING OF WEB-BASED AND VIRTUAL REALITY REMINISCENCE THERAPY FOR PERSONS WITH DEMENTIA
Authors: Sun Winnie , Quevedo Alvaro 
Published: December 2022

Abstract
Reminiscence therapy (RT) is a multi-sensory treatment that uses a combination of sight, touch, taste, smell and sound to help persons with dementia (PWD) remember events, people and places from their past lives. Currently, digital technologies such as mobile applications and immersive solutions including virtual and augmented reality, are gaining momentum as supplementary tools for RT. This paper presents a usability study of a web-based and virtual reality application to understand the limitations and opportunities of digital platforms for facilitating engaging experiences for PWD towards recalling memories, while easing the therapy process for the caregivers. A total of ten healthcare caregivers were recruited from the Geriatric Dementia Unit and Geriatric Transitional Unit in Ontario Shores Center for Mental Health Sciences, Ontario Canada. Usability feedback from the caregivers were collected from the interviews after the completion of the System Usability Scale (SUS) questionnaire. Institutional caregivers found both web-based and virtual reality (VRRT) usable with SUS score above average (68/100), but required improvements related to the onboarding training of caregivers. The interview revealed four overarching themes related to the VRRT: (1) Ease of use; (2) Positive impact on caregiving; (3) Potential of reduction in responsive behaviors; (4) Feasibility for promoting social connection during COVID-19 pandemic. Next steps will focus on improving the user experience and expanding the application for immersive VR supporting head-mounted displays, hand tracking, and physiological measures, as well as conducting an usability study with PWD to expand our understanding of using RT digital tools with various levels of immersion.
WHITE MATTER CHANGE NEAR CEREBRAL MICROBLEEDS AFTER MTBI INVOLVES AGE AND SEX DEPENDENT COGNITIVE DECLINE
Authors: Irimia Andrei , Ngo Van , Chaudhari Nikhil , Zhang Fan , Joshi Shantanu , O’Donnell Lauren , Sheikh-Bahaei Nasim , Chui Helena 
Published: December 2022

Abstract
We tested the null hypothesis that, after mild traumatic brain injury (mTBI), white matter changes near cerebral microbleeds (CMBs) are associated with cognitive decline. Magnetic resonance images were acquired from 62 adults with mTBI and from 203 matched healthy controls. A week post-injury, mTBI participants had 2.7±2.6 traumatic CMBs in WM, located 6.1±4.4 mm from the cortical mantle. About 6 months later, 97% of CMBs were associated with significant reductions (34%±11%, q &lt; 0.05) in the fractional anisotropy (FA) of WM streamlines within ~1 cm of CMBs. Male sex and older age were significant risk factors for larger reductions (q &lt; 0.05). CMBs in the corpus callosum, cingulum bundle, inferior and middle longitudinal fasciculi were associated with FA changes that were significantly and positively associated with changes in cognitive functions mediated by these structures (q &lt; 0.05). These findings distinguish non-traumatic from traumatic CMBs according to CMB-related changes in surrounding WM. Our findings also challenge the assumption that traumatic CMBs are cognitively silent and identify older age and male sex as risk factors for mTBI-related cognitive decline in the presence of CMBs. In conclusion, mTBI with CMB findings on MRI can be described as a clinical endophenotype that warrants longitudinal mapping and quantification of cognitive function.
SOCIAL ENGAGEMENT IN LATER LIFE: INTERDEPENDENCE OF MARRIED COUPLE’S MENTAL HEALTH WELL-BEING
Authors: Kim Yulri 
Published: December 2022

Abstract
Social engagement in later life often provides a sense of belongings and social identity. Given its salient meanings for older adults in Korea where social ties play important roles on the mental health and well-being, different conceptualizations of social engagement have been examined, such as formal and informal social activities. As numerous studies have suggested, informal activities are associated with better well-being, however, it is unclear whether formal social engagement of husbands and wives influence the other partner’s mental health outcomes. Based on the Interdependence Theory (Rusbult & Van Range, 2008), we expect that formal and informal social engagement of husbands and wives are associated with their own depressive symptoms and further those of their spouses. Using a sample of 1,195 couples (Nf 2,390) of married older adults aged 65 and above from the 8th wave of Korean Longitudinal Study of Aging (KLoSA), we tested the relationship between social engagement and depressive symptoms using actor partner interdependence model (APIM). The findings indicated that for both husbands and wives, there was a negatively significant association between one’s informal social activity on their own depressive symptoms (actor effect) and their spouse’s depressive symptoms (partner effect). No significant findings were observed for formal social activities. Overall, this study suggests the importance of informal social activity compared to formal social activity to lower depressive symptoms for themselves and their spouses in later life. Moving forward, incorporating a partner’s informal social activity can provide useful information in predicting one’s own mental health well-being.
RESILIENCY AS A PROCESS: A QUALITATIVE INVESTIGATION INTO U.S. VETERANS’ EXPERIENCES AGING WITH HIV
Authors: Chan Kiera , Bender Alexis , Marconi Vincent , Justice Amy , Johnson Theodore , McInnes Keith , Perkins Molly 
Published: December 2022

Abstract
U.S. military Veterans aging with HIV represent a unique special population. The aim of this qualitative study was to investigate risk and protective factors associated with Veterans’ ability to age well with HIV. Participants included 25 Veterans (≥ age 50) participating in the Veterans Aging Cohort Study who were recruited from the Atlanta Veterans Affairs (VA) Medical Center. This study conducted semi-structured interviews, social network mapping, and sociodemographic and health surveys. Participants ranged in age from 50 to 72, with a mean age of 59. Most (80%) were male, and more than half (60%) were African American. Findings showed that many participants experienced adversity in childhood or early adulthood, including military sexual violence, childhood abuse, and non-military domestic violence, as well as harassment based on sexual identity. Many also had histories of substance abuse. Although military life provided stability for some, most experienced some form of instability after leaving the service, including financial difficulties and loss of valued military ties. Timing of diagnosis, whether in the military or after the military, impacted resiliency. Receiving an HIV diagnosis was an important turning point in participants’ lives characterized by either maladaptive (e.g., suicide ideation) or therapeutic (e.g., health promoting behaviors) coping strategies. Positive social support, including close relationships many developed with providers at the VA HIV clinic, was an important protective factor. The sample experienced cumulative life events that shaped their ability to age with HIV. Findings have important implications for interventions to promote Veterans’ ability to age well with HIV.
RACIAL-ETHNIC VARIATION IN MULTIMORBIDITY PATTERNS AND HEALTHCARE SERVICES AMONG OLDEST-OLD PATIENTS
Authors: Cho Jinmyoung , Rahimighazikalayeh Gelareh , Allore Heather 
Published: December 2022

Abstract
Adults aged 85 years and older (“oldest-old”) are perceived as survivors resilient to age-related risk factors. Although considerable heterogeneity has been often observed in this population, less is known about the unmet needs in health and healthcare service utilization for diverse patients in healthcare systems. We examined racial-ethnic variation in patterns of multimorbidity associated with emergency department (ED) and clinic visits among oldest-old patients with multiple chronic conditions (MCCs). Administrative and clinical data from an integrated healthcare system for five years included 25,801 oldest-old patients with MCCs. Hierarchical cluster analysis identified patterns of MCCs by four racial-ethnic groups (White, Black, Hispanic, & Other). Clusters associated with ED and clinic visits were analyzed using generalized estimation equations. The average of 5.79 (±2.79) MCCs ranging from 5.36 (±2.61) for Other to 5.82 (±2.79) for Hispanic patients at baseline decreased over time. Hypothyroidism, Alzheimer’s Disease and related dementia, bone-and-joint, metabolism syndrome, and pulmonary-vascular clusters were commonly observed across the groups. Unique cluster patterns were identified among Black patients (e.g., renal diseases were grouped with metabolic syndrome cluster). While almost all clusters were significantly associated with ED and clinic visits among White patients, distinctive clusters were significantly related to ED and clinic visits among Hispanic patients (e.g., bone–and-joint cluster grouped with renal diseases was significantly associated with ED [RR=1.36, p &lt; .0001] and clinic [RR=1.39, p &lt; .0001] visits, respectively). Patterns of multimorbidity and its significant association with healthcare service utilization varied by race-ethnicity. Findings suggest a need for culturally tailored care management within integrated healthcare systems.