bluuebunny/crossref_metadata_2025_split huggingface dataset:
PROTEASOME DYSFUNCTION A KEY PATHOLOGIC FEATURE OF ALZHEIMER’S DISEASE MITIGATED BY PROTEASOME ACTIVATORS
Authors: Pickering Andrew 
Published: January 2025

Abstract
Alzheimer’s Disease (AD) is the leading cause of dementia worldwide, affecting nearly 50 million people and characterized by cognitive decline, β-amyloid plaques, and hyperphosphorylated tau. The failure of numerous clinical trials targeting β-amyloid (Aβ) underscores the need for novel therapeutic strategies. A consistent feature of AD, particularly in the hippocampus, is reduced proteasome activity. This impairment is thought to result from direct inhibition by Aβ or hyperphosphorylated tau, disrupting essential neuronal processes like memory and synaptic plasticity. This study explores the hypothesis that AD-related deficits are driven, in part, by Aβ-induced proteasome dysfunction. We demonstrate that oligomeric Aβ inhibits 20S proteasome activity while destabilizing the 26S proteasome into free 20S units. Treatment with proteasome activators enhances 20S and 26S function, reducing Aβ42-induced toxicity in SK-N-SH cells. In Drosophila overexpressing Aβ42, oral administration of proteasome agonists delayed mortality and restored cognitive function. Similarly, in mouse models, chronic treatment with proteasome activators protected against Aβ42-induced working memory deficits, and acute treatment significantly improved spatial learning deficits in hAPP(J20) mice. Our findings reveal that Aβ exerts dual inhibitory effects on 20S and 26S proteasomes, contributing to AD pathology. Proteasome activation mitigates these deficits, suggesting that enhancing proteasome activity could be a promising therapeutic approach for AD.
RACE DIFFERENCES IN WALK SPEED, CARDIORESPIRATORY FITNESS, AND MUSCLE MITOCHONDRIAL RESPIRATION
Authors: Coen Paul , Distefano Giovanna , Ramos Sofhia , Cawthon Peggy , Cummings Steven R , Newman Anne B , DeLany James 
Published: January 2025

Abstract
Older adults who self-identify as Black have a disproportionately higher incidence of mobility disability. Whether older adults who are Black also have lower fitness and mitochondrial energetics compared to those who are White has not been adequately investigated. The Study of Muscle, Mobility and Aging (SOMMA) examined 879 older adults (≥70 years old), including 116 who self-identified as Black, who could complete a 400m walk within 15 minutes. Mitochondrial respiration (MaxOXPHOS) was measured in permeabilized fibers from biopsies of the vastus lateralis. A cardiopulmonary exercise test assessed maximum oxygen consumption (VO2peak). Education, income, financial resources, race, sex and age were determined by self-report. Propensity score matching was used to match Blacks with Whites with a 1:1 ratio. Black (n=90) and White (n=90) groups were well matched for age, sex, SOMMA multimorbidity index, BMI, muscle mass, physical activity, marital status, educational achievement, and whether financial needs were met (all p&gt;0.05). Despite being well matched, those who identified as Black had a slower 400m walking speed (0.97 vs. 1.03 m/s, p=0.014), lower MaxOXPHOS (50.8 vs. 60.9 (pmol/(s*mg)), p&lt; 0.001), and lower cardiorespiratory fitness (1391 vs 1566 ml/min, p=0.007), when compared to those who identified as White. Multivariate regression showed that VO2peak and MaxOXPHOS, but not socioeconomic factors, attenuated the race difference in 400m walking speed. In conclusion, while the etiology of race differences in mobility is multifactorial, our data indicate that muscle mitochondrial respiration and cardiorespiratory fitness may contribute to slower walking speed of individuals who identify as Black compared to White.
RURAL OLDER ADULT CARE TRANSITIONS: A SCOPING REVIEW
Authors: Kumar Amiritha , Liebzeit Daniel 
Published: January 2025

Abstract
Older adult (age 65 and older) care transitions are frequent and complex, particularly in rural areas lacking equitable access to health and other services. This scoping review: 1) evaluates research on older adult rural care transitions and 2) synthesizes types of transitions studied, challenges and opportunities in rural health care, and gaps in the literature. Of a total of 6,976 articles retrieved in July 2024 from PubMed, CINAHL, PsycINFO, Dissertations and Theses, AgeLine, and Embas, 91 articles were included. Eligible articles focused on older adults, rural setting, a care transition, and provided empirical data. Findings revealed a primary focus on acute care transitions; care transitions involving long-term care and assisted living were vastly underrepresented. Most were observational, with few interventions to address the specific challenges faced by rural older adults. The evidence base on acute care transitions reveals disparities in readmission rates between rural and other populations, with limited focus on patient-centered outcomes. Limited literature on long-term care and assisted living transitions primarily focused on losses experienced, such as loss of independence. Although improved outcomes are often associated with collaborative, individualized planning, significant gaps remain in application of effective models of transitional care. Follow-up or post-acute care appears key for rural older adults, offering benefits comparable to urban settings; however, rural access barriers underscore the need for intervention development to reduce health disparities. Developing patient-centered interventions for rural older adults during care transitions is crucial, and addressing research gaps will create opportunities to further reduce disparities and improve outcomes.
IMPLEMENTING AND EVALUATING MULTILINGUAL, COMPETENCY-BASED DEMENTIA TRAINING FOR IHSS CAREGIVERS IN CALIFORNIA
Authors: Yeh Jarmin , Beld Matthew , Pond Brittney , Neri Mel , Martinez Suzanna , Garcia Andrea , Castaneda Moraima , Eldridge Corinne 
Published: January 2025

Abstract
The rising prevalence of Alzheimer’s dementia in California’s aging population underscores the urgent need for a well-trained direct care workforce to help older adults age in place. This study implemented and evaluated competency-based dementia training for caregivers in California’s Medicaid-Funded In-Home Supportive Services (IHSS) program from 2019 to 2024. The program, offered in English, Spanish, Cantonese, and Mandarin, transitioned from in-person to online delivery due to COVID-19, providing an opportunity to assess this novel online approach. Using a quasi-experimental, mixed-methods design guided by the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance), we evaluated training outcomes, curriculum, staff roles, and delivery logistics. Of 722 caregivers who completed the training, 488 were included in the analytic sample, and 50 participated in interviews. Additionally, 11 key informant stakeholders were interviewed. Mean scores from validated instruments evaluating caregivers’ dementia knowledge (Toye et al., 2014) and self-efficacy (Fortinsky et al., 2002) showed statistically significant increases between pre-post-training and pre-3-month follow-up (p&lt; 0.001). Thematic analysis of caregiver interviews revealed diverse pathways into caregiving, emotional rewards, enhanced advocacy skills, and improved interactions with medical providers. Stakeholder interviews uncovered implementation barriers and facilitators to intervention fidelity, and strategies for addressing the critical need for a skilled dementia direct care workforce. The training’s adaptability to online formats and multiple languages demonstrates its real-world efficacy and potential readiness for trial design. This study highlights the importance of evidence-informed, culturally and linguistically appropriate training for IHSS caregivers in managing the health and well-being of older adults living with Alzheimer’s dementia.
SEE SOMETHING, SAY SOMETHING: A QUALITATIVE STUDY OF NEIGHBORHOOD PERCEPTIONS AND BRAIN HEALTH
Authors: Heuer Sierra , Besser Lilah , Dominguez Briana , Huynh Stephanie , Le Bao Ngoc , Nguyen Boi-san , Pham Jason , Meyer Oanh 
Published: January 2025

Abstract
Studies have shown the importance of neighborhood factors, such as residential segregation and green spaces, to older adult brain health. In this qualitative study, we examine older adults’ perceptions of their neighborhood, with a particular focus on segregation. We recruited participants from the University of California Davis Alzheimer’s Disease Research Center and the local Northern California community to participate in semi-structured interviews over Zoom or telephone. They answered questions such as, “What kinds of activities do you do in your neighborhood?” and “Are neighbors segregated or separated based on age, race/ethnicity, SES, or language?” On average, interviews lasted 22.5 minutes, and were audiotaped, transcribed verbatim, and analyzed for recurring themes. Among the 32 participants, 62.5% were female, 59.4% non-Hispanic White, and 40.6% Black/African American. Mean age was 79.0 years (SD=8.3). The most prominent themes were (1) Accessibility to public stores and similar third spaces (e.g., churches, libraries, coffee shops); (2) Accessibility to green space, including parks, trees, etc.; (3) Staying active in the community, both physically and socially; (4) Neighborhood awareness/cohesion; and (5) Stereotypes, discrimination, and segregation, a sample quote being, “I’m happy with the diversity of the neighborhood…a lot of people would say it’s not very diverse, it’s…segregated, mostly economically,” (Male, 73 years-old). These findings highlight the social and built environment factors that are salient for older adults and may potentially affect brain health. Future research will examine how these themes might differ depending on older adults’ cognition and with objective measures of the neighborhood.
ENHANCING AGE-FRIENDLY CARE IN VALUE-BASED HEALTH SYSTEMS: CMS DELIRIUM ASSESSMENT AND POLICY STRATEGY
Authors: McMullen Tara , Ling Shari , Cummings-Vaughn Lenise 
Published: January 2025

Abstract
Delirium is a clinical syndrome characterized by alteration in consciousness and cognitive function, frequently observed in older adults. This condition is associated with a risk of mortality and can lead to severe and persistent functional impairments in survivors. The incidence of delirium is notably high, affecting up to 80% of older adults in intensive care units (ICUs) and up to 35% of those with general inpatient admissions. Routine and standardized cognitive assessments are essential for optimizing patient management and implementing delirium prevention strategies aimed at mitigating risk factors. To enhance person-centered care in delirium management, it is crucial to adopt age-friendly care frameworks that emphasize evidence-based approaches to assessment and management. In this presentation, Federal officials from the Centers for Medicare & Medicaid Services (CMS) will address the ongoing clinical and policy initiatives aimed at developing a comprehensive strategy for the screening and assessment of delirium, integrated within the framework of high-quality, age-friendly healthcare. This presentation will explore the essential attributes that health systems must possess to effectively translate age-friendly principles into improved health outcomes for patients with delirium. Officials will also discuss the development of age-friendly measures that address the specific needs of older adults to enhance both individual outcomes and population-level health. Additionally, the discussion will focus on policy levers that should be considered to promote age-friendly, value-based care, thereby improving the screening and prevention of delirium.
AWARENESS AND ATTITUDES ABOUT MEDICAL AID IN DYING IN THE U.S
Authors: Kozlov Elissa , Nemeth Samuel , Luth Elizabeth 
Published: January 2025

Abstract
Medical Aid in Dying (MAID) allows terminally ill patients to seek a prescription for medication to end their lives. Despite being legal in 10 states and Washington DC, public awareness of and attitudes towards MAID remain unclear. This study aims to assess the level of awareness of MAID laws and attitudes about MAID in the United States. Using mTurk and Prime Panels, we collected a purposive national sample of n= 2,343 people living in states where MAID is legal and n=1151 living in states where MAID is not legal. The sample was normally distributed for income, education, political affiliation, and had diverse religious representation. We over sampled for adults living in MAID states and adults over 60 because this is the population most likely to use MAID. In states where MAID is legal, 14.4% of respondents knew that MAID was legal in their state. In the full sample, 30% knew that MAID was legal anywhere in the United States. In the full sample, 20% reported that MAID was not morally acceptable, and 25% reported that they would probably or definitely not pursue MAID personally if they were faced with a terminal illness. This study revealed a significant gap in public awareness, with many residents unawares that they live in states where MAID is legal. However, attitudes towards MAID are mostly favorable with a 44% expressing support for MAID personally. These findings suggest the increased need for public education on MAID laws to ensure that residents are informed about their end-of-life-options.
FEASIBILITY AND ACCEPTABILITY OF IMPLEMENTING DEPRESCRIBING IN POST-ACUTE HOME HEALTH CARE
Authors: Wang Jinjiao , Shen Jenny , Yu Fang , Nathan Kobi , Conwell Yeates , Simmons Sandra , Mixon Amanda , Caprio Thomas 
Published: January 2025

Abstract
Polypharmacy is common in home health care (HHC), but no deprescribing intervention has been tested in HHC. In a prior study, we identified essential components of deprescribing by interviewing patients, primary, acute and post-acute care providers, pharmacists, and HHC nurses in 12 U.S. states. This study assessed the feasibility and acceptability of deprescribing in HHC through the collaboration of an HHC nurse and a pharmacist to conduct home medication review, deprescribing assessment, primary care provider discussion, patient education, deprescribing implementation, and safety monitoring. In 11 patients who received HHC following hospital discharge, we assessed feasibility and acceptability of deprescribing through surveys and qualitative interviews with patients, providers, and study interventionists. Patients received deprescribing components over 3-4 home visits. On average, the HHC nurse spent 1 hour/home visit/patient, the pharmacist spent 1 hour on deprescribing assessment/patient, and the provider spent 5 minutes / patient to review and implement deprescribing recommendations. Over 70% of deprescribing recommendations were accepted by providers, with 30% not accepted mostly due to patient preference. Providers found deprescribing “very feasible,” but noted barriers such as time constraints and patient preferences. The HHC nurse found deprescribing components “very feasible,” citing the multidisciplinary approach as a facilitator but noting communication challenges with providers. Providers and patients both generally reported that deprescribing components were helpful and led to patients feeling empowered. In conclusion, deprescribing components were feasible in HHC and highly acceptable to patients and providers. Effective communication between patients, HHC nurses, and providers is crucial for deprescribing in HHC.
INTEGRATING CERTIFIED NURSING ASSISTANTS INTO INTERDISCIPLINARY CARE TEAM AND RESIDENT CARE PLANNING
Authors: Raval Aasha , Ermolenko Mia , Jimenez Andreina , Balaji Anisha , Shenoy Shivani , Bergh Marissa , Travers Jasmine 
Published: January 2025

Abstract
Integrating certified nursing assistants (CNAs) into interdisciplinary care team (IDT) and resident care planning is essential for delivering person-centered care in nursing homes. In 2016, the Centers for Medicare and Medicaid Services mandated this integration, but the lack of clear guidelines made implementation challenging. As a result, a specific road map is needed for nursing homes to optimize how best to integrate CNAs into IDT and resident care planning. This qualitative study, guided by Donabedian’s Quality of Care Model, explored the barriers and facilitators in integrating CNAs into IDT and resident care planning. Seventeen participants including CNAs, directors of nursing, social workers, nursing home surveyors, ombudsmen, and physicians were recruited from across the United States using the State Survey Agency Directory, LinkedIn, and a referral program initiated by our research team. One-on-one, 30-minute virtual Zoom interviews were conducted between June-2022 and June-2023. Interview data were analyzed using directed content and thematic analyses. Five key themes emerged from the data and included: recognition of challenges for CNA Integration, nursing home leadership and structure, integration of CNAs, care coordination and communication, and care integrity. The findings led to the development of two INTEGRATE guides in August 2024: one for nursing home executive leadership which offers strategies for effectively integrating CNAs into IDT and resident care planning, and another for CNAs, which provides practical guidance on contributing to IDT meetings and care planning processes. The next steps of this work involve testing the efficacy and acceptability of the INTEGRATE guides in nursing homes.
MEALTIME EXPERIENCES DURING AML/MDS TREATMENT: LONGITUDINAL QUALITATIVE STUDY PRELIMINARY RESULTS
Authors: Crowder Victoria , Cho Youngmin , Teng Chiao-Hsin , Batchelor Melissa , Beeber Anna , Coombs Lorinda , Richardson Daniel , Bryant Ashley 
Published: January 2025

Abstract
Older adults (aged ≥60) with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) face varied experiences related to eating and mealtimes during treatment with hypomethylating agents and Venetoclax (HMA+VEN). Family/friend carepartners may provide extensive support to patients during this time and undergo challenges of their own. A gap exists in our understanding of eating and mealtime experiences over time, and how this affects quality of life (QOL); further information is crucial to guide patients, clinicians and carepartners in their management. We aimed to understand patient’s eating and mealtime experiences with AML/MDS and their carepartners during Cycles 1 and 2 of HMA+VEN treatment, the efforts made to address challenges, and the impacts on QOL. We conducted semi-structured interviews with 11 older adult patients and ten carepartners at Cycles 1 and 2 and conducted directed content analysis with the Adaptive Leadership Framework for Chronic Illness. We identified five preliminary categories: (1) adaptive challenges for patients in eating and mealtimes, (2) changes with eating and mealtimes over Cycles 1 and 2, (3) adaptive challenges for carepartners in care of patients, (4) how they collaboratively address challenges, and (5) the impact of experiences or changes in eating and mealtimes on QOL. Findings highlight and expand our knowledge of eating/mealtime experiences during chemotherapy for patients with AML/MDS and carepartners, including their experiences with appetite loss, adaptations of meals, and the extensive involvement of carepartners. These findings may guide future intervention development to support symptom management, enhance support and services, and maintain QOL.
UNDERSTANDING AND ADDRESSING COMMUNITY-BASED PALLIATIVE CARE REFUSALS: A MULTI-PERSPECTIVE STUDY
Authors: Sheldon Kira , Luth Elizabeth 
Published: January 2025

Abstract
More than half of older adults have multimorbid chronic conditions, resulting in disability, functional limitations, and reduced quality of life. Community-based palliative care, increasingly part of Medicare Advantage value-based care plans, supports seriously ill individuals and their caregivers to improve symptom management and satisfaction and reduce acute care use. Yet, many potentially eligible individuals decline free services when offered. To understand why eligible individuals refuse palliative care, we conducted semi-structured interviews and focus groups with 22 Medicare Advantage plan members and caregivers who refused palliative care and five palliative care team members at a non-profit healthcare agency. Transcripts were analyzed to identify reasons for refusal. We identified three overarching reasons plan members and caregivers declined palliative care: (mis)associating it with end of life, unclear benefit of palliative care, and not wanting to change current care. Palliative care team members confirmed these findings and contributed additional insights. Medicare Advantage plan members and families who refused palliative care represent a key resource for understanding how to better explain services and increase acceptance of palliative care. Palliative care team members’ perspectives provide insights from interactions with seriously ill individuals who may be disinclined or unable to engage in research. In clinical practice, clearly differentiating palliative care from hospice, providing an individualized explanation for how it will address an individual’s particular needs, and emphasizing integration of palliative care with existing care teams may improve engagement in palliative care among seriously ill older adults.
IN-HOME ASSISTIVE TECHNOLOGY PROTECTS DEMENTIA CAREGIVERS FROM WORSENING SLEEP EFFICIENCY
Authors: Scheffer Julian , Levan Darius , Wells Jenna , Gallagher-Thompson Dolores , Grimm Kevin , Chen Kuan-Hua , Wang Gene , Levenson Robert 
Published: January 2025

Abstract
Caregivers for people with dementia or mild cognitive impairment often report sleep problems due to heightened vigilance concerning worrisome behaviors (e.g., falls, wandering) by their care recipients (CRs). Interventions are needed to help alleviate these issues and the associated sleep troubles for caregivers. One promising approach is to utilize scalable and affordable in-home technologies that monitor CR behaviors round-the-clock and alert caregivers to potentially dangerous situations. We conducted two randomized controlled trials with independent samples to determine whether People Power Caregiver (PPCg), a newly developed in-home monitoring and alerting system, benefitted caregivers’ sleep over a six-month period. Combining the two studies, a total of 162 primary caregivers of the CRs were randomly assigned to either an active condition (PPCg system fully activated) or a control condition (Study 1: water leak detection only; Study 2: waitlist control procedure). Caregivers self-reported their sleep quality using the Pittsburgh Sleep Quality Index at baseline, three-months, and six-months. Using latent growth modeling, caregivers in the control conditions reported significantly worsening sleep efficiency compared to caregivers in the active condition (Active: B = -0.30, SE(B) = 0.14; Control: B = 0.74, SE(B) = 0.12; Condition Effect on Linear Slope: p =.038). We observed a similar pattern with PPCg benefitting caregivers’ sleep duration; however, this result was not statistically significant (Condition Effect on Linear Slope: p =.105). These results suggest that in-home technologies such as PPCg may offer an effective way to help caregivers achieve healthy sleep as they contend with the demands of caregiving.