bluuebunny/crossref_metadata_2025_split huggingface dataset:
WHO CAN BENEFIT FROM HOME-BASED MEDICAL CARE?
Authors: Ornstein Katherine , Leff Bruce , Reckrey Jennifer , Bollens-Lund Evan , Salinger Margaret , Wang Yihan , Ritchie Christine 
Published: December 2022

Abstract
Leaving the home to access medical care may result in undue burden for patients with dementia and other serious illnesses and their caregivers. While home-based medical care (HBMC) may be beneficial for many older adults, it is not clear how to best identify individuals who could benefit from such services. Using the 2015 NHATS linked to Medicare claims we estimated prevalence across multiple overlapping subtypes: Individuals who have moderate/severe dementia; are homebound; have serious illness; are frail; rely on assistive devices; have high caregiving needs; those with minimal primary care and high ED use; and those who met previously established criteria for Independence at home. Using these criteria, more than half of community-dwelling older adults could benefit from HBMC and more than 25% meet multiple criteria. Medicare and other payers can benefit from targeted identification of patients who could benefit from HBMC.
SPECTRUM OF DEMENTIA IN OLDER HOSPICE RECIPIENTS
Authors: Hunt Lauren , Cenzer Irena , Smith Alexander , Kelley Amy , Aldridge Melissa , Covinsky Kenneth , Harrison Krista 
Published: December 2022

Abstract
We know little about differences between hospice enrollees with dementia co-existing with another terminal illness (like cancer), those dying from dementia (as principal hospice diagnosis), and those dying with no dementia. We used the National Health Aging and Trends Study linked to Medicare claims to compare characteristics, hospice use patterns, and care quality ratings. Among 1,105 decedent hospice-enrollees age 70+, we found 39% were dying with coexisting dementia, 17% from dementia, and 44% without dementia. In adjusted analyses, those dying with dementia had similarly high rates of functional impairment, higher rates of clinical needs, and worse measures of care quality compared to elders dying from dementia. Hospice use patterns were different for elders dying with dementia compared to elders without dementia. In summary, 56% of older hospice enrollees have dementia, mostly in addition to another terminal illness. Their differing hospice experience implies changes are needed to hospice care and policy.
UTILIZING PHYSICAL THERAPY RESIDENTS' AS HEALTH PROMOTION EXPERTS TO IMPROVE QOL FOR OLDER VETERANS
Authors: Patel Susan 
Published: December 2022

Abstract
Gerofit, an evidence-based supervised exercise and health promotion program for older Veterans, has demonstrated success with its best practice model through the improved health, physical function, and well-being of participants. In 2017, Cincinnati VA Medical Center (CVAMC) launched an innovative approach to address the staffing needs of this wellness program by utilizing a Physical Therapy (PT) resident model for Gerofit group supervision/functional testing. As licensed PTs, residents engage in year-long advanced training in geriatrics across a variety of settings. They encounter adults who have unhealthy behaviors (lack of physical activity, smoking, poor nutrition, inadequate sleep, and stress), and demonstrate the knowledge/skills to reduce risk factors, prevent/treat chronic disease, prescribe physical activity/exercise, perform interventions consistent with the biopsychosocial paradigm, design/deliver individualized exercise prescriptions, and lead telehealth group exercises classes for Veterans. This presentation will explore how PT residents are in an ideal position to promote health/wellness in the Gerofit Program.
FUNCTIONAL IMPROVEMENTS AMONG OLDER VETERANS WITH PAD FOLLOWING 12 MONTHS OF EXERCISE TRAINING
Authors: Gutierrez J Antonio , Pearson Megan , Gu Lin , Hall Katherine , Rao Sunil , Morey Miriam 
Published: December 2022

Abstract
The prevalence of peripheral artery disease (PAD) increases exponentially with age and is associated with heightened risk of functional impairment. We assessed baseline function and compared changes in mobility among older Veterans with PAD participating in Gerofit, a clinical exercise program. A total of 545 Veterans (mean age: 79 years) completed baseline, 3-, 6-, and 12-month mobility assessments and were divided into the following cohorts: PAD (n=99) and no PAD (n=446). Assessments included 10-m walk speed, 6-min walk distance, 30-s chair stands, and 8-ft up-and-go time. Veterans with PAD performed worse on all measures than non-PAD Veterans at baseline. Veterans with PAD demonstrated significant improvements (p &lt; 0.05) in all measures from baseline at 3, 6 and 12 months. There were no significant differences in change scores between PAD and non PAD across all time points, controlling for age, except for 8-ft up-and go. PAD Veterans benefit from function-based exercise.
SOCIAL DIFFERENCES IN ALLOSTATIC LOAD TRAJECTORIES ACROSS ADULTHOOD
Authors: Walsh Christine , Yang Yang , Belsky Daniel , Mills Sarah , Hall Marissa , Golden Shelley 
Published: December 2022

Abstract
Chronic psychosocial stress has been indicated as a potentially important driver of U.S. health disparities. Allostatic load (AL) is an indicator of cumulative biological risk or “wear and tear” on the body resulting from repeated adaptations to life stressors. A population-level examination of AL may be particularly useful in understanding the intermediate physiological dysregulation that underlies social inequalities in health. No study has yet documented changes in allostatic load over a wide range of ages and intersecting sociodemographic groups. To address this gap, we pooled biomarker data from three U.S. longitudinal cohort studies (National Longitudinal Study of Adolescent to Adult Health, Midlife Development in the U.S., and the Health and Retirement Survey) to create an integrated dataset covering individuals ages 24 to over 95 from several birth cohorts. We conducted growth curve models to examine associations of AL trajectories with cohort and multiple dimensions of social identity. We found more recently born cohorts were associated with higher mean levels in AL as compared to earlier-born cohorts. Net of cohort, education, and other covariates, Black men and women and Hispanic men had significantly higher AL than their White counterparts. These differences were present in early adulthood and persisted at all ages. Hispanic women experienced the largest increases in AL with age, surpassing nearly all other groups at older ages. These findings contribute new knowledge about the temporal dynamics and social patterning of AL as individuals age, particularly intersecting stress exposures as an underlying and enduring source of health inequity.
EXPERIENCES OF LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND/OR QUEER (LGBTQ) OLDER ADULTS WITH SERVICE PROVIDERS
Authors: Moone Rajean , Gordon Barbara , Moone Rajean 
Published: December 2022

Abstract
Many lesbian, gay, bisexual, transgender, and/or queer (LGBTQ) older adults have experienced a lifetime of oppression and discrimination that often results in significant health, economic, and social disparities in comparison to their peers. Historically labeled as illegal, immoral, and/or sick, LGBTQ older adults often fear, hide, and distrust health care and other social services providers. This symposium will highlight contemporary research on the experiences and perceptions of LGBTQ older adults in relation to service providers. The first presentation will contextual factors that influence the healthcare utilization of LGBTQ middle-aged and older adults. The second presentation will explore older adult couples’ experiences of minority stress with service providers and effects on their relationships. The third presentation will explore explore the beliefs, experiences, and needs related to housing and housing discrimination in LGBTQ older adults living in coastal North Carolina. The fourth presentation will explore panel data of older LGBTQ adults residing in the U.S South and examine the effects of access to an LGBTQ affirming provider on health service utilization and aging outcomes.. The final presentation will explore the association between increased awareness, understanding, and belief in the Undetectable equals Unstransmittable campaign and having an LGBTQ affirming care provider. The symposium will conclude with a discussion on policy and practice impacts for aging services and health care providers.
THE ROLE OF FAMILY CAREGIVING CONFIGURATIONS AND SUPPORTS IN OLDER ADULT OUTCOMES
Authors: Chong Natalie 
Published: December 2022

Abstract
This study uses data from the 2017-2018 National Health and Aging Trends Study and the 2017 National Study of Caregiving to examine whether caregiving network configuration factors (e.g., if and how multiple caregivers of the same care recipient distribute tasks, responsibility and disagreement among caregivers, involvement of paid caregivers) and caregiver supports (e.g., emotional support, skills training, respite services) are associated with consequences of unmet needs among older adults. Findings from this study will provide greater understanding of how caregiving contexts shape the quality of care and health of older adults who rely on help from family caregivers.
THE ROLE OF FAMILIES IN FACILITATING USE OF HOME-BASED SERVICES
Authors: Reckrey Jennifer , Zhao Duzhi , Ritche Christine , Ornstein Katherine 
Published: December 2022

Abstract
Homebound older adults rely on home-based clinical services (e.g., home based medical care) and long-term services and supports (e.g., caregiving support, environmental modifications) to remain living at home, however patterns of service use are unknown. Using data from the 2015 National Health and Aging Trends Study linked to Medicare Claims Data, we identified a population of homebound older adults enrolled in fee-for-service Medicare (n=1066). Latent class analysis identified 3 distinct patterns of home-based service use: low (36%), medium (51%), and high (13%) service use. High family caregiving support was particularly prevalent in the medium service group (35% with over 40 hours of family care per week), but receipt of home-based medical care was minimal in this group. Additional support to connect family caregivers with other home-based services may improve care and outcomes for older adults living at home.
EMANCIPATORY VISIONS: USING VISUAL METHODS TO CO-CONSTRUCT KNOWLEDGE WITH OLDER ADULTS
Authors: Yeh Jarmin , Reyes Laurent , Versey H Shellae 
Published: December 2022

Abstract
Research is a political activity. Researchers are responsible for theories and methods used to explore, explain, or ignore injustices. A need exists for developing new tools and pathways of knowledge based on experiences, language, and intellect of older adults from Black, Indigenous, and People of Color communities. This presentation argues for the utility of visual methods in critical qualitative research as a medium that allows researchers and participants to co-construct knowledge. Lessons learned about implementing projects using visual methods from the intersectional standpoint of the authors – three younger women of color – will be discussed. Promises and complexities of navigating interpersonal dynamics, decolonizing knowledge-production, and scaling visual methods on multiple levels will be elucidated. Collectively, we argue that visual methods are rigorous for subverting power dynamics rooted in extractive research practices, and provide a vehicle for community-engaged participatory action research that has potential to advance social justice in gerontology.
EXPLORING HOUSING AND HOUSING DISCRIMINATION FOR LGBT OLDER ADULTS IN COASTAL NORTH CAROLINA
Authors: Rowan Noell , Norris Haley 
Published: December 2022

Abstract
This study explored the beliefs, experiences, and needs related to housing and housing discrimination in LGBT older adults living in coastal North Carolina. Surveys were administered to staff (N = 138) of various types of older adult living communities (including long term care, public housing, and specific units of care including memory care and skilled nursing) to understand the status of discrimination, any integrative activities and human diversity/cultural sensitivity training offerings for staff. Findings indicate that nearly 80% of the participants received no training in the specific needs of LGBT communities and less than 10% provided inclusionary marketing/advertisement. No prior studies to date have been conducted on housing needs or discrimination of LGBT older adults within this coastal region. Implications include extensive need for cultural sensitivity education to plan for and improve housing experiences for LGBT older adults.
DUAL ELIGIBILITY AND INJURY-RELATED EMERGENCY DEPARTMENT VISITS AMONG ASSISTED LIVING RESIDENTS
Authors: Hua Cassandra , Cornell Portia , White Elizabeth , Kennedy Katherine , Nelson Ian , Thomas Kali 
Published: December 2022

Abstract
Using 2018 Medicare data, we examined the relationship between dual eligibility and injury-related emergency department use among a cohort of assisted living residents (n=116,754). We fit multilevel models with random intercepts at the assisted living community and license type levels. The baseline rate of injury-related emergency department emergency department use was 0.17. After controlling for resident characteristics (i.e., age, sex, race, and chronic conditions), license type characteristics (i.e., dementia care licensure, staffing regulations), and assisted living community characteristics (i.e., size and percentage of residents with dementia), being dually eligible for Medicare and Medicaid was associated with a 12% increase in the probability of having an injury-related emergency department visit (b=.02; p&lt;.001). Assisted living communities that serve duals may have fewer resources and staff to provide personal care, potentially leading to increased rates of injuries.
URBAN AGING RESIDENTS COALITION (UARC): A HYBRID MODEL TO BRIDGE THE TECHNOLOGY GAP
Authors: Wright Kathy , Moss Karen , Tate Judith , Rose Karen , Shields Pamela 
Published: December 2022

Abstract
The COVID-19 pandemic spotlighted technology barriers for urban Black/African American older adults that lead to chronic stress, social isolation, and inability to fully engage with the world. In partnership with an African American older adult community leader, the Urban Aging Residents Coalition was founded in May 2020 to address engaging older adults with technology. A primary goal of UARC is to prevent social isolation and promote mental wellness through education. Using a hybrid model of videoconferencing and socially-distanced meetings, volunteer health professionals and community members (e.g., Information Technology Technician, Psychologist, and Nurse) delivered education to older adults. Participants also met for computer training to build confidence by sharing technology accomplishments with others (e.g., online bill paying). UARC has 75 active members and conducted over 12 videoconferences and in-person programming. The UARC project serves as a model for community/academic partnerships to support mental wellness and technology use in urban older adults.
INTERPLAY BETWEEN LOSS OF PROTEOSTASIS AND CELLULAR SENESCENCE: A SPOTLIGHT ON MISFOLDED PROTEIN QUALITY CONTROL
Authors: Samant Rahul 
Published: December 2022

Abstract
Loss of protein homeostasis (‘proteostasis’) and onset of cellular senescence are two conserved hallmarks of ageing. Healthy proteostasis relies on tightly-regulated intracellular quality control circuits that co-ordinate clearance of potentially toxic misfolded proteins arising from various internal or external stresses throughout an organism’s lifespan. Proteostasis imbalances are mechanistically linked to a broad range of ageing-associated diseases, and are also characteristic of cellular senescence—a permanent cell cycle arrest that prevents uncontrolled proliferation during development, injury repair, and tumorigenesis, but drives ageing-associated frailty, degeneration, and therapy resistance. Across a range of replicative and stress-induced senescence models in primary human cells, we have discovered differences in how misfolded proteins are triaged when compared with proliferating, quiescent, or immortalised cells—especially at the level of ubiquitin-mediated protein clearance systems. Given recent findings that proteostasis modulators act as senolytics with geroprotective properties, our work highlights the need for an improved fundamental understanding of how different ageing hallmarks are inter-connected in order to drive advances in human healthspan.
LGBTQ+ OLDER ADULT COUPLES' EXPERIENCES OF MINORITY STRESS BY SERVICE PROVIDERS
Authors: Bybee Sara , Cloyes Kristin , Mooney Kathi , Supiano Katherine , Baucom Brian , Ellington Lee 
Published: December 2022

Abstract
This study explored LGBTQ+ older adult couples’ experiences of minority stress with service providers and effects on their relationships. Twelve LGBTQ+ cancer patient-partner couples (N = 24) completed surveys assessing demographics, stress, and health, and participated in dyadic semi-structured interviews. Descriptive statistics summarized demographic characteristics. Interview data were content analyzed to identify sources of minority stress. Participants were aged 50.9 years on average (SD = 9.9, R =32-70), mostly white (21, 87.5%), and had been together for 19.1 years (SD = 9.9, R = 9-44). Common minority stress sources included derogatory language, belittling comments, heteronormativity, and cisnormativity in routine healthcare, cancer care, and legal services. Couples attributed relationship strength and durability as mitigating negative effects of stress; they described feeling closer, stronger, and more confident in their relationships. Some couples denied experiences of minority stress by service providers and these couples ascribed their equitable care to their geographic location.
BARRIERS TO REDUCING AND PREVENTING INVOLUNTARY TREATMENT: THE PERSPECTIVE OF PROFESSIONAL CAREGIVERS
Authors: Bleijlevens Michel , Willems Jules , Passos Valeria Lima , Hamers Jan 
Published: December 2022

Abstract
Measures to which a person resits and/or does not provide consent for are defined as involuntary treatment. The use of involuntary treatment violates the autonomy of (older) persons and causes more harm than benefit. Moreover, it contradicts the values of person-centred care. Nevertheless, its use among Persons Living with Dementia (PLWD) is still common practice and remains difficult to prevent and/or reduce. The aim of this study was to gain insights into the barriers towards the prevention and/or reduction of involuntary treatment in long-term geriatric care. We conducted a cross-sectional, mixed-methods study, including an online survey for professional caregivers, and a semi-structured focus group interview with professional caregivers. A total of 218 participants completed the questionnaire. The percentage of participants that experienced barriers in one of the twenty-two survey items ranged from 15% to 42%. Lack of time; the experienced need to use involuntary treatment; uncertainty about responsibilities of stakeholders; and a lack of knowledge on methods to prevent and/or reduce its use were most seen as barriers. Nursing staff experienced a lack of time more often than other professional caregivers. Working in home care and having no former experience with involuntary treatment usage increased perceived barriers. Participants of the focus group interview confirmed these findings. One out of four professional caregivers experience barriers hindering prevention and/or reduction of involuntary treatment. More research is needed to gain better understanding on how professional caregivers can be supported aiming to, remove barriers and consequently prevent and/or reduce the use of involuntary treatment.
LIFETIME CLOSE TO THE END: EFFECTS ON PERCEIVED TIME AND AGING IN OLDER ADULTS WITH ADVANCED CANCER
Authors: Wahl Hans-Werner , Laryionava Katsiaryna , Schönstein Anton , Heussner Pia , Hiddemann Wolfgang , Winkler Eva 
Published: December 2022

Abstract
This study addressed two questions: (1) Does advanced cancer in later life affect a person’s awareness of time and their subjective age? (2) Are awareness of time and subjective age associated with distress, perceived quality of life, and depression? We assessed patients with terminal cancer (OAC, n = 91) and older adults with no life-threatening disease (OA, n = 89). All participants were age 50 or older. OAC perceived time as being a more finite resource and felt significantly older than OA controls. Feeling younger was significantly related with better quality of life and lower levels of distress. In the OA group, feeling younger was also associated with reduced depression. Perceiving time as a finite resource was related to higher quality of life in the OA group. Indicators of an older person’s awareness of time and subjective aging differ between those with advanced cancer versus controls without a terminal disease.
GAIN- BUT NOT LOSS-RELATED VIEWS ON AGING PREDICT MORTALITY OVER A PERIOD OF 23 YEARS
Authors: Wurm Susanne , Schaefer Sarah 
Published: December 2022

Abstract
Some 2 decades ago, Levy et al. (2002) published their seminal study on the impact of SPA on mortality over a period of 23 years. Our study aimed at replicating and extending these findings. Based on a large German population-based sample of individuals aged 40+ (N = 2,400), for whom mortality was also documented over 23 years (1996–2019), we investigated the impact of gain- and loss-related SPA and SA on mortality. Data were analyzed with hierarchical Cox proportional hazard regressions. For individuals who perceived aging as ongoing development risk of death was half that of individuals with less gain-related SPA. Viewing aging as associated with physical or social losses could not predict mortality after controlling for covariates (age, gender, education, health-related variables, and psychological variables). Neither could SA predict mortality. The results suggest that mainly gain-related SPA explain differences in mortality and should thus be addressed in intervention studies.
INSIDE-OUTSIDE COMMUNITY ADVISORY BOARDS: ONE MODEL FOR ENGAGING OLDER BIPOC AND WOMEN IN CLINICAL RESEARCH
Authors: James Jennifer 
Published: December 2022

Abstract
Historical legacies of unethical research performed on people in prison, coupled with stringent policies intended to protect those who are incarcerated from exploitation, has meant that much clinical research about the health of people who are incarcerated is conducted at a distance, without directly engaging those who are incarcerated in the formulation of studies. As a result, research conducted about correctional healthcare and the healthcare needs of incarcerated persons may not reflect specific stakeholder values or priorities. In this session, we will describe barriers in engaging incarnated older women and BIPOC patients, their healthcare providers, and their loved ones in the research process and new models for the development of research questions that center stakeholder perspectives. We will describe identified priority areas for future research, insight on the ethics of research consent and participation with this population, and methodological considerations for clinical, social, and behavioral research with this vulnerable population.