bluuebunny/crossref_metadata_2025_split huggingface dataset:
COGNITION AND HEALTH: PRELIMINARY RESULTS OF A MUSIC CREATIVITY INTERVENTION FOR ADULTS AT RISK OF MCI
Authors: Wu-Chung E Lim Lydia , Brandt Anthony , Bonomo Melia , Denny Bryan , Karmonik Christof , Frazier Jefferson , Blench Karl , Fagundes Christopher 
Published: December 2022

Abstract
As the number of people with dementia is projected to rise to 13.8 million by 2050, there is a growing need to develop interventions that prevent or slow down disease progression in at-risk individuals. Older adults are particularly vulnerable, given that increasing age is the strongest predictor of dementia. Music interventions are promising, non-pharmaceutical treatment options for slowing down cognitive decline and enhancing psychological health. However, more music-related clinical trials are needed to evaluate treatment efficacy and to identify biobehavioral mechanisms of change. Project Chroma is a Stage 1 semi-randomized clinical trial, developed to assess the effects of a novel, music creativity curriculum on cognitive, socio-emotional, neurobiological, and immunological outcomes. In this study of 58 older adults with or without MCI, we demonstrate that Project Chroma has good feasibility and acceptability: participation, retention and satisfaction rates were comparable to other similarly designed clinical trials. Preliminary analyses revealed that participants in the music condition, relative to those in the control condition, showed marked improvements in cognitive functioning. Slight changes in socioemotional well-being were observed, which may be attributed to a minimally distressed sample. This study contributes to a growing literature substantiating music interventions as effective options for curtailing cognitive decline. Forthcoming work will examine the effects of music creativity on neural and immune outcomes.
CHARACTERISTICS OF HOSPITALS AND PROVIDER MARKETS ASSOCIATED WITH INCREASES IN HOME HEALTH CARE USE
Authors: Watts Elizabeth , Bucy Taylor , McHugh John , Cross Dori 
Published: December 2022

Abstract
Many older adults require post-acute care from a nursing home or home health agency following hospitalization. Recent trends show providers are increasingly relying on home health agencies rather than institutionalized settings, with home health volume surpassing skilled nursing facility (SNF) volume since 2017. Using MedPAR patient encounter data from 2016–2019 and provider data from CMS, we analyze changes in the profile of patients receiving home health over time, showing that individuals discharged to home health are increasing in complexity based on hospital length of stay, comorbidities, and use of critical care services. Mixed effects models additionally suggest that grouping patients at the hospital and market level helps to account for unexplained variation in whether a patient is likely to receive home health versus SNF services. Examining the characteristics of hospitals and provider markets with increasing rates of home health referrals over time, we found that hospitals with increasing rates of discharge to home health were more likely to be for-profit facilities in urban areas with higher operating margins. However, this increase was not consistently tied to a corresponding decrease in rates of discharge to SNF, suggesting that hospitals are experiencing a combination of both patient-shifting across post-acute settings as well as an overall increase in baseline complexity of hospitalized patients over this time period. These results have implications for understanding the how policies currently being considered to improve value in the post-acute sector filter through heterogeneous market structures and complex organizational environments to impact patient care decisions.
EXPLORING INTERSECTIONS OF NURSING HOME CULTURE, IMPROVEMENT, AND DOCUMENTATION-RELATED ATTITUDES
Authors: Baker Hannah 
Published: December 2022

Abstract
Documentation of patient care and characteristics is an important part of nursing home (NH) operations, affecting financial aspects, quality improvement (QI) efforts, inter-provider communication, and potential for medical errors. However, relationships among NH culture, QI, and documentation-related attitudes are unclear. This study explored Wisconsin NH staff and administrator perspectives on these variables (n = 10 in 8 NHs), using interviews structured on a composite of Schein’s organizational culture typology and Shortell’s Quality Improvement Implementation Survey concepts. Interview questions related to perspectives and emotions about NHs’ documentation quality, OC, QI efforts, and nursing staff turnover. Verbatim transcription, member checks, and team-based transcript coding and analysis ensured good data quality. Thematic analysis was used to construct a “storyline” and refine the original theoretical model. Sample data fit the model well, supporting the perception of pairwise relationships between NH OC, QI, and documentation. One of Schein’s culture types was not represented in the sample. Attitudes and perceived influences on documentation-related quality were mostly negative. This research contributes to knowledge on long-term care and could point future research toward (1) similar work in dissimilar NHs to replicate results, (2) closer examination of staffing variability, (3) quantitative work on effects of education and auditing on documentation-related attitudes, and (4) strategies to improve attitudes without increasing staff stress levels.
FEASIBILITY OF REMOTELY SUPERVISED ONLINE CHAIR YOGA INTERVENTION FOR OLDER ADULTS WITH DEMENTIA
Authors: Park JuYoung , Sullivan Marlysa , Heilman Keri , Surage Jayshree , Levine Hannah , Hung Lillian , Ortega María 
Published: December 2022

Abstract
This study assessed the feasibility of a remotely supervised online chair yoga (CY) intervention for older adults with dementia, exploring preliminary effects of CY on chronic pain, mobility, risk of falling, sleep disturbance, autonomic reactivity, cardiac rhythms (using IOM2 biofeedback device), and loneliness in this population. Using a one-group pretest/posttest design, a home-based CY intervention was delivered remotely to a group of 10 older adults with dementia who were socially isolated due to COVID-19. The online intervention was conducted twice weekly in 60-minute sessions for 8 weeks; data were collected virtually at baseline, mid-intervention, and post-intervention. Results indicated that online CY is a feasible approach for managing physical and psychological symptoms in older adults with dementia, based on retention (70%) and adherence (87.5%) with no injuries or other adverse events during the intervention. Senior-friendly videoconferencing should be available so that more older adults can gain access to the online intervention
TECHNOLOGY TO PROTECT HIPS IN SERIOUS FALLS - PRELIMINARY EVIDENCE
Authors: Tarbert Rebecca , Stefanacci Richard 
Published: December 2022

Abstract
Major injuries from falling in the older adult population is a tragic outcome that is growing in number. There is limited evidence of methodology to avoid major injuries from falls for those most at risk. Hip fractures are a catastrophic outcome from falls that incur cost to the individual, family and healthcare system. A study is currently underway in older adult living settings designed to demonstrate the efficacy and safety of a wearable smartbelt that deploys a protective airbag around the hips prior to landing on the ground as a mitigation for fall-related major hip injuries. The smartbelt technology includes embedded sensors and WiFi connection for data sharing. The primary endpoint of the study is to examine the efficacy and safety of the smartbelt in a population of older adults with high-risk profile of falls and major hip injuries. The study will be a comparative analysis of rate of major hip injuries from falls between a retrospective control group and a selected intervention group wearing the smartbelt for 6 months with all subjects continuing to receive standard of care for fall injury mitigation. Implementation methodology of clinical study performance in the care settings and integration into plan of care will be outlined. Outcomes from the enrolled subjects to date in the study will be shared including fall risk factors, fall events and injuries from falls reported.
AI AND AGING: IDENTIFYING IMPORTANT LIVING ACTIVITIES FOR HEALTHY AGING IN SINGAPORE LONGITUDINAL AGING COHORT
Authors: Zhong Xin , Yang Feng , Hu Wangyang , Gwee Xinyi , Chua Denise , Ling Qian , Ng Tze Pin 
Published: December 2022

Abstract
Population aging in Singapore has encouraged the development of ambient smart communities to support healthy aging. Poor understanding of the living activities that address both clinical and biological concerns may plague efficient aging service designs and community health programs. We have designed a new computational workflow to identify important living activities for older adults in Singapore. We investigated innovatively three pillars of human life aspects: activities, clinical health, and biological health to identify living activities that are significantly associated with both clinical health and biological health. Cross-sectional data analyses were performed on 1356 community-living Chinese older adults of 65–80 years old in the Singapore Longitudinal Aging Study II (SLASII) cohort. 7 out of 29 living activities were found significantly associated with clinically healthy aging and showed improved prediction accuracy towards health status in machining learning schemes. Furthermore, biological age has been computed by screening and modeling 66 biomarkers. 15 out of the 29 living activities were found significantly associated with biologically healthy aging. Checking the overlapping living activities, we have found that physical exercise and cognitive-simulating activities are the most important activities for healthy aging: such as jogging regularly and reading, writing, and doing puzzles often. We regroup participants into active and non-active groups according to these two activities. The Keplan-Meier survival analysis showed statistically significant differences in survival time between the active and non-active groups (p &lt; 0.001) in an 8-year longitudinal study. The workflow, results and biomarkers may provide references for future health program design improvement.
NEEDS FOR SUPPORTING PEOPLE AGING WITH HIV: RESULTS FROM A CBPR COMMUNITY-NEEDS ASSESSMENT
Authors: Rapoport Andy , Guasco Rick , Musolino Teresa , Reese Melanie , Teasley Kenneth , Danilovich Margaret 
Published: December 2022

Abstract
Nearly half of people living with HIV in the U.S. are over age 50 and are navigating age-related changes while managing the complexities and challenges of HIV. People aging with HIV are an emerging community—it is imperative to understand the key issues faced by this community so to improve health outcomes and eliminate health disparities. This paper presents a CBPR approach by the SHARE board (a community advisory group comprised of older people living with HIV) and academic researchers. SHARE members conducted a mixed-methods needs assessment using a semi-structured interview guide they had developed, as well as a survey to determine community priorities for research, healthcare, and social services for people aging with HIV. SHARE members conducted 32 semi-structured interviews with individuals from across the country. From the 216 survey responses (mean age 55 years), 35% were Black, 30% were Hispanic, 50% were male, and 43% had been living with HIV for 11–15 years. 44% were fearful that long-term HIV medications will adversely affect them with aging. Triangulating interviews and surveys, financial strains and caregiving were primary age-related concerns. Affording medication and transportation were primary barriers to accessing healthcare. Most respondents had experienced stigma due to both age and HIV status. Respondents felt the most important areas for future research were optimizing management of multiple co-morbidities including HIV, and cognitive changes with HIV. Results from this community-led needs assessment identified key areas for interventions and research to address conditions disproportionately affecting the health of those aging with HIV.
OVERCOMING OLDER ADULT RESISTANCE TO TECHNOLOGY TO SUPPORT DIGITAL HEALTH LITERACY: A CBPR APPROACH
Authors: Freddolino Paul , Sun Fei , Kim Ha-Neul , Wishart Dona , Godek Eileen , Bentley Megan 
Published: December 2022

Abstract
Overall low digital use by older adults creates a barrier to tools that enable them access to basic and specialty healthcare through telehealth and address their isolation and loneliness. In particular, older adults with low-income, like low-income isolated Home Delivered Meal (HDM) program recipients, can be most vulnerable to this barrier. A university team and a local Commission on Aging jointly secured funding to pilot the Virtual Table (VT) model which builds on relationships between HDM drivers and meal recipients to overcome lack of interest and skepticism of technology like the internet and video chatting. For the pilot, 25 recipients were recruited to learn basic technology skills (e.g., email, video chat) from trusted peer tutors through weekly one-to-one sessions, in-person or by video, leading to knowledge and skills to support telehealth utilization. Twenty recipients (80%) are completing the pilot. Results to date show increased technology use and comfort, together with confidence to use telehealth. Participants valued the interactions with tutors as well as what they learned. Feedback from tutors, agency staff, and participants has been used to refine the pilot during implementation. Building on the lessons learned and feedback, the goal for the next stage of collaboration is developing a set of effective tools to implement VT in several diverse communities. Four VT ‘graduates’ will be actively involved as co-producers of these revised tools. In addition, older adult home-delivered-meal (HDM) recipients, agency staff, tutors, and other older adult volunteers will directly participate in ongoing evaluation of the new resources.
INTERPROFESSIONAL COLLABORATIVE RESEARCH ASSESSING OLDER ADULT TECHNOLOGY USE (OR NONUSE)
Authors: Case Donna , Groden Sheryl , Sahli Michelle , Tremaine Wendy 
Published: December 2022

Abstract
This interprofessional study conducted by faculty in Occupational Therapy, Social Work and Public Health explored older adult technology use (or nonuse) by 216 Genesee County Michigan residents. Three professional lenses informed survey development, implementation and data analysis. Occupational therapy emphasized accessibility, how physical or cognitive impairments hinder technology use, and role of technology to complete daily living activities. Social work focused on technology use to facilitate social connectivity, decrease risks for mental health problems, and resource access. Public health explored if technology use or nonuse impacts health. Results indicated that 14% of participants want to learn to obtain transportation (social, health) via the internet, 13% stated they wanted to learn how to use technology to access medical records, 12.5% to attend on-line appointments, 11% reported they would engage in additional technology-based social activities (e.g. communicating with family/friends), 10% to order/refill medications, and 9% of older adults surveyed had difficulty accessing technology due to a physical, cognitive or sensory impairment. Researchers found the questions provided an integrated view of factors influencing older adult use or nonuse of technology and provided a guide for designing collaborative interventions to facilitate older adult access and use of technology to result in positive holistic health outcomes.
REMOTELY MEASURED IN-HOME DISTANCE FROM CARE RECIPIENT PREDICTS DEMENTIA CAREGIVERS’ LONELINESS
Authors: Chen Kuan-Hua , Chen Yuxuan , Levan Darius Tran , Yee Claire , Merrilees Jennifer , Scheffer Julian A , Chen Samson , Levenson Robert W 
Published: December 2022

Abstract
Caregivers (CGs) of a family member with dementia often experience increased loneliness, which can result from reduced social interactions and increased physical distancing associated with care recipient’s (CR) disease progression. Through a university-industry collaboration, we developed new technology for measuring physical distance remotely. CGs and CRs wore watches that monitored their location in the home using low-energy Bluetooth technology that enabled long battery life (up to four months). Using measures of proximity of the watches to three plug-in Bluetooth receivers located in the home, we assessed CG-CR physical distance on a second-by-second basis over a six-month period. Participants were 27 CRs diagnosed with dementia or mild cognitive impairment and their co-residing familial CGs. CG loneliness was measured by questionnaire at the beginning and end of the study. Both watches and receivers were remotely installed (by CGs). Results indicated that CG-CR physical distance increased from the first three months to the last three months of the study (t = 20.67, p &lt; 0.001). In addition, greater increases in CG-CR physical distance over the six-month period were associated with greater increases in CG loneliness (r = 0.46, p = 0.03). These results advance our understanding of how increases in physical distancing between CGs and CRs contribute to increased CG loneliness (a well-established risk factor for depression and other mental health symptoms). The study also underscores the value of remote technologies that allow for in-home long-term monitoring for research on interpersonal distance and other social behaviors in CG-CR and other aging dyads.
LONGITUDINAL ASSOCIATIONS BETWEEN FALLS AND DEPRESSIVE SYMPTOMS AMONG CHINESE OLDER ADULTS
Authors: Zuoting Nie , Tracy Eunjin Lee , Du Yan , Li Sha , Yang Rumei 
Published: December 2022

Abstract
Falls and depressive symptoms are prevalent and costly to Chinese older adults. Although falls and depressive symptoms are frequently interrelated, previous studies were mainly based on cross-sectional data, and the nature of interrelationships between them were not well understood. In this study, we aimed to examine the longitudinal bidirectional relationship between falls and depressive symptoms among Chinese older adults, and whether this bidirectional relationship is different for males and females, given that females are found to suffer from falls and depressive symptoms significantly more than males. Older adults aged 60 years+ who completed all three waves of data from the China Health and Retirement Longitudinal Study on falls and depressive symptoms between 2011 (wave 1), 2013 (wave 2), and 2015 (wave 3) were included in the current analysis (Nf2,203). Data were analyzed using random intercept multilevel models that adjusted for demographic information (e.g., age, education, and marital status). Overall, there is a relatively stable rates of comorbid falls and depression (about 10%) over time among Chinese older adults. Significant bidirectional associations at between-person and within-person levels were observed between depressive symptoms and falls over time, with greater depressive symptoms associated with higher risk for falls and vice versa. However, such associations were not different between males and females. Taken together, these findings indicate the importance of addressing both depression and falls at the same time to prevent falls in the clinical practice for both males and females.
EFFECT OF CHANGE IN BODY SIZE ON MORTALITY IN THE INITIALLY HEALTHY COMMUNITY-DWELLING OLDER ADULTS
Authors: Hussain Sultana Monira , Newman Anne , Beilin Lawrence , Tonkin Andrew , Woods Robyn , Neumann Johannes , Nelson Mark , McNeil John 
Published: December 2022

Abstract
Utilising data from the ASPirin in Reducing Events in the Elderly trial participants [aged &gt;70-years (Australians), &gt;65-years (US)], we estimated percent change in body size (BMI: body mass index, WC: waist circumference) from baseline and the second annual visits. Both BMI and WC changes were categorised as 1) change within 5% (stable), 2) decrease by 5–10%, 3) decrease by &gt;10%, 4) increase by 5–10%, and 5) increase by &gt;10%. Mortality events were classified according to the underlying cause by adjudicators. Hazard ratios were calculated to compare mortality between body size change categories. Amongst 16,773 participants, 1,269 mortality were observed over an average 4.4±1.7 years. In men compared to stable BMI, a 5–10% decrease in BMI had a 35% higher (HR 1.35, 95% CI 1.08–1.67), and a &gt;10% decrease in BMI had a 3.84-fold higher (HR 2.99, 95% CI 2.44–3.68) risk in all-cause mortality. A decrease in BMI was associated with a higher cause-specific (cancer, cardiovascular disease [CVD], and non-cancer non-CVD) mortality. A decrease in BMI was associated with higher mortality risk in women, however, the magnitude of association was weaker than men. A decrease in WC was predictive of mortality but with a much weaker relationship than a decrease in BMI. Weight gain was not predictive of mortality except for non-cancer non-CVD mortality in women. Physicians should be aware of the ominous consequence of weight loss, especially amongst older men. The risk extends beyond an increased risk of cancer, extending to CVD and a range of other life-limiting conditions.
AN OLDER ADULT FRACTURE PROGRAM EMPLOYING AGE-FRIENDLY CARE CAN BE IMPLEMENTED AT YOUR HOSPITAL AND IMPROVE OUTCOMES
Authors: Breda Kathleen , Keller Michelle , Gotanda Hiroshi , McKelvey Karma , Lin Carol , Rosen Sonja 
Published: December 2022

Abstract
Older adult fractures are expected to increase dramatically over the next several decades, with hip fractures reaching an estimated 6.26 million worldwide by 2050. A combined approach to the care of older adult fracture patients was first reported in the early 1990s, emphasizing geriatric and orthopedic co-management. Early studies showed significant improvements in complications, function, and discharge rates to nursing homes. Subsequent studies demonstrated shorter time-to-surgery, lengths of stay (LOS), lower readmission rates, reduced in-hospital mortality, and lower cost of care. The studies are from large academic centers whose physicians are employed faculty or have dedicated geriatric units. Less studied is whether similar models could be implemented in community health systems/mixed practice settings like Cedars-Sinai. Cedars-Sinai’s older adult fracture program integrates inpatient and outpatient care and uses best practices of the 4Ms Framework of an Age-Friendly Health System, including What Matters Most, Mentation, Medications, and Mobility. The program was designed through the consensus of interprofessional champions and empirical evidence. Results showed enrolled patients with all fracture types had significantly lower LOS (marginal effect [ME]: -2.12, 95%CI: -2.61, -1.63), LOS index (ME: -0.33, 95%CI: -0.42, -0.25), and total direct costs (ME: -$5316.4, 95%CI: -6806.31, -3826.5). There was no significant difference in time-to-surgery. Of the 746 enrolled patients, 170 (23%) had a post-discharge visit with a participating geriatrician within 6 months. Findings indicate a systematic approach to improving care for older adults with fractures improves inpatient outcomes in a mixed practice setting. Future studies will examine the effectiveness of Cedar-Sinai’s outpatient program.