bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSESSING RACIAL DISPARITIES IN UTILIZATION OF HEALTHCARE SERVICES, 2010-2020
Authors: Dong Yanjun , Wang Kun , Rizzo Victoria 
Published: January 2025

Abstract

Objectives
Little is known about the intersectional effects of race, gender, income, and education on healthcare service utilization among BIPOC (Black, Indigenous, and People of Color) older adults. This study fills this gap by analyzing longitudinal data of older adults in the U.S. from 2010 to 2020.

Methods
Using six waves of longitudinal data from the Rand Health and Retirement Study (n= 26,304), this study employed random-effect Poisson and logistic models to examine disparities across seven healthcare services, focusing on the interactions of BIPOC with gender, education, and income.

Results
The findings show disparities in healthcare utilization, with BIPOC older adults consistently reporting lower utilization across different types of services, including hospital stays, prescription drug use, outpatient surgery, home healthcare, physician visits, and dental care. For the interactions, the results indicate that, compared with others, low-income BIPOC older adults are less likely to access prescription drugs (β = -1.10, p &lt; 0.01) but more likely to use home healthcare (β = 0.52, p &lt; 0.05) and physician services (β = 0.75, p &lt; 0.05). BIPOC women were less likely to utilize nursing home services (β = -0.84, p &lt; 0.05).

Discussion
This study underscores the effects of socioeconomic factors and systemic inequities on healthcare utilization. Policy implications include the need for targeted interventions to reduce financial barriers, culturally competent care models, and enhanced health literacy programs. The findings highlight the urgent need for systemic changes to create an equitable healthcare system that addresses the needs of marginalized populations.
ASSOCIATION OF IMMUNE CELLS AND INFLAMMATORY BIOMARKERS WITH DEPRESSIVE SYMPTOMS IN THE FRAMINGHAM HEART STUDY
Authors: Iyer Sandhya , Cao Yumeng , Lunetta Kathryn , Liebegott Ryan , Doyle Margaret , Chen Jiachen , Ragab Ahmed , Murabito Joanne 
Published: January 2025

Abstract
Depression is a common mental health disorder with substantial impact on older adults. Immune dysfunction has been studied as a mechanism for depressive symptoms, providing the opportunity for new targeted treatment approaches. This study investigated the associations between immune cell phenotypes, determined by flow cytometry, and peripheral inflammatory biomarkers, measured using the OLINK Inflammation panel, with Center for Epidemiologic Studies Depression Scale (CES-D) scores, indicative of depressive symptoms, in the Framingham Heart Study Offspring Cohort. Participants (n=996) had a mean age 62, were 52% female, and had a mean CES-D score 5 (SD=7) with 8% having a CES-D score &gt;/=16. A linear mixed-effects model was used (generalized estimating equation model for the dichotomous CES-D) with the proteins and immune cells as predictors and CES-D scores as the outcome, adjusting for age, sex, BMI, smoking status, CVD, depression medication use, NSAID use, and cytomegalovirus (CMV) status (immune cells only). We used Bonferroni adjusted p&lt; 0.005 to declare significance. Effect estimates (beta) are reported in standard deviation units. Our results suggested a positive association between FGF-19 and CES-D score (beta=0.11, p=0.0004), as well as a suggestive negative trend between the CD8+IL17+:CD8+CD25+FoxP3+ ratio (Tc17/CD8+Tregs) and CES-D score (beta=-0.1, p=0.03). In addition, we observed a positive suggestive trend between IL-17C and depressive symptoms (CES-D &gt;/= 16) (beta=0.35 p=0.009), that strengthened with higher levels of symptoms (p&lt; 0.005). This study helps to expand our understanding of the role of inflammation in the pathophysiology of depression.
ASSOCIATIONS OF SOCIAL RELATIONSHIPS WITH INFLAMMATORY, CARDIOVASCULAR AND IMMUNE CELL BIOMARKERS
Authors: Ragab Ahmed , Chen Jiachen , Cao Yumeng , Doyle Margaret , Murabito Joanne , Lunetta Kathryn 
Published: January 2025

Abstract
Social relationships are essential for health, as social isolation and loneliness are linked to higher risks of morbidity and mortality. These associations may result from behavioral changes, physiological alterations, increased inflammation, and a weakened immune system. Community-based cohorts investigating the association between social isolation and inflammation have not included immune cell phenotypes and have been limited to a small number of inflammatory and cardiovascular biomarkers. We investigated the relationship between the Social Network Index (SNI), and 3 biomarker datasets: 1) 68 inflammatory biomarkers (N=875), 2) 71 cardiovascular biomarkers (N=3295), and 3) 28 immune cell phenotypes(N=996), among Framingham Heart Study Offspring participants (mean age 61). SNI was calculated as the sum of four components: marital status, the presence of close friends or relatives, attendance at religious services, and participation in social groups and treated as an ordinal predictor (1=lowest level of connections, 4= highest). We used Linear Mixed Effects models with SNI as the predictor and biomarkers/immune phenotypes as the outcomes, adjusting for age and sex and CMV (immune phenotypes). We used FDR≤0.05 to declare significance within each biomarker dataset. SNI was positively associated with inflammatory biomarkers HGF, IL-6, OSM, and IL-10RB. SNI was also positively associated with cardiovascular proteins CNTN1, IGFBP3, FGF23, CD56, sRAGE, and IGF1, and negatively associated with GDF15, MMP9, FBN, MCP1, CD14, A1M, IGFBP2, CRP, EFEMP1, and PPBP. SNI was not significantly associated with any of the immune cell phenotypes in the full sample. We conclude that social isolation is associated with multiple inflammatory and cardiovascular biomarkers.
BRICKS FOR BETTER BRAINS©: STRATEGIES TO ENHANCE ENGAGEMENT IN PERSONS LIVING WITH DEMENTIA
Authors: Kasperovich Natalia , Sasser Jennifer 
Published: January 2025

Abstract
The Bricks for Better Brains© activity is an intervention to slow down the progression of cognitive decline for persons living with dementia. The activity utilizes various carefully selected, interlocking bricks (LEGO®) in bright colors as an innovative medium for stimulating participants’ creative capacities, using visual perception and motor sensory skills, as well as strengthening social engagement. Cognitive impairments can present unique challenges for effectively engaging this population in meaningful activities. An in-person observational study was conducted as a preliminary exploration of strategies to increase engagement of persons living with dementia in activities with viable therapeutic potential using The Bricks for Better Brains© protocol. The study consisted of two groups (five males and fifteen females total) of people 75 years of age and older living with moderate-to-severe dementia and residing in an institutional care setting. Four activity modification strategies were tested – modification to objects and property; modification to space demands; modification to social demands; and modification to sequence and timing. All modifications in space demands increased engagement. Modification in objects and property, sequence and timing, and social demands were positive for the group but showed mixed efficacy for individual. These results support the person-centered care model and highlighted the importance of creating stimulating environments by understanding how people living with dementia interact with their surroundings. By identifying efficient activity modification strategies we can increase activity engagement and improve the quality of life of the people living with dementia. Future studies will need to include the reliability of observational measures.
CARDIOVASCULAR RISK FACTORS AND MENTAL HEALTH OUTCOMES AMONG LGB+ OLDER ADULTS
Authors: Smith Jennifer , Rodriguez Robert , Anderson Joel 
Published: January 2025

Abstract
Emerging evidence highlights that sexual and gender minority (SGM) adults exhibit a higher prevalence of cardiovascular disease (CVD) and its risk factors compared with their non-SGM peers. This increased susceptibility underscores a critical intersection with cognitive health given the link between CVD and cognitive decline and early-onset dementia. Additionally, mental health challenges such as depression and anxiety not only heighten CVD risk but also predict severe cardiovascular complications. Utilizing cross-sectional data from the National Health Interview Survey (NHIS), this study examined these interconnected health issues among older adult LGB+ populations to inform comprehensive interventions aimed at addressing both cardiovascular and cognitive health. This cross-sectional study analyzed data from the 2022 NHIS data to describe cardiovascular and cognitive health characteristics among LGB+ and non-LGB+ older adults using chi-squared tests. The sample was limited to adults who self-reported being age 50 years or older. A CVD risk variable was created based on Framingham criteria. Data from 13,426 participants, including 341 LGB+ individuals, revealed significant differences in demographic characteristics, health, and lifestyle. LGB+ older adults were younger and more frequently formally educated. They exhibited lower rates of CVD risk factors and increased physical activity and preventative health behaviors, yet higher incidence of depression and anxiety and higher rates of smoking and alcohol use. These preliminary findings highlight the unique characteristics of LGB+ older adults in terms of cardiovascular health, offering potential targets for culturally tailored interventions.
CARE MANAGER PERCEPTIONS OF A CARE COORDINATION INTERVENTION IN THE ED FOR RESIDENTS IN ASSISTED LIVING COMMUNITIES
Authors: Wittenberg Grace , Serina Peter , Stetten Nichole , Reddy Ann , McCreedy Ellen 
Published: January 2025

Abstract
Of the 800,000 residents in US assisted living communities, nearly half are transferred to the Emergency Department (ED) each year, often without a support person or up-to-date medical information. This lack of information can lead to more testing in the ED, increased ED length of stay, and unnecessary hospitalizations. To address this problem, Bluestone Physician Services, providing care to ALC residents in Florida, Minnesota, and Wisconsin, developed the ED Early Response Program for patients in its accountable care organization. In the program, a complex care manager (CCM) is notified when one of Bluestone’s ALC patients registers at an ED. Bluestone staff then provide standardized, clinical information to the ED via phone and fax. To analyze the feasibility and acceptability of the program, we conducted semi-structured interviews with 12 CCMs involved in the program. Using directed content analysis, we identified five overarching themes: populations most likely to benefit from the program (e.g. people living with dementia, hospice), key components of the program, program strengths, areas of opportunity, and impact on patient care. CCMs described that the program positively impacted care transitions to the ED by providing added clinical information and fostering interprofessional communication. However, they also noted areas for improvement, including enhancing ED provider receptivity by increasing awareness of the program in the ED. Overall, by using CCM insights gained during implementation, this program can be used as a model to address key communication gaps for ALC residents during transitions of care, including ED visits.
CAREGIVING STRESS IN ADRD CAREGIVERS: THE INFLUENCE OF SOCIAL DETERMINANTS OF HEALTH AND SOCIAL SUPPORT
Authors: Lee Kyungmi , Xiao Chunhong 
Published: January 2025

Abstract
Alzheimer’s disease and related dementias (ADRD) caregivers face significant physical, emotional, and financial challenges. These stressors are influenced by social determinants of health (SDOH), such as income and service accessibility, as well as caregiver-specific factors like health status and caregiving burden. Social support can help mitigate caregiving stress. This study aimed to examine the relationships among SDOH, caregiver-specific factors, social support, and caregiving stress in ADRD caregivers. Utilizing data from the Caregiving in the U.S. 2020 study (n = 357 ADRD caregivers), we conducted a multiple regression analysis (F = 15.236, p &lt; 0.001). Results show that social support significantly reduces caregiving stress (β = -0.261, p = 0.004). Caregiver health status (β = -0.592, p &lt; 0.001), difficulty accessing services (β = 0.770, p &lt; 0.001), and caregiving burden (β = 0.511, p &lt; 0.001) are also significant predictors of stress. Although age did not directly impact caregiving stress, it significantly influenced service access (β = -0.010, p = 0.036), which in turn affected stress levels. Financial strain (β = 0.270, p &lt; 0.001) and physical strain (β = 0.171, p = 0.005) were also associated with service accessibility issues. These findings suggest that enhancing social support and improving service access could effectively reduce caregiving stress. Future research should further investigate these areas to develop targeted interventions for ADRD caregivers.
CARING FOR NURSING HOME RESIDENTS WITH DEMENTIA AND SERIOUS MENTAL ILLNESS: A QUALITATIVE STUDY
Authors: Block Laura , Gilmore-Bykovskyi Andrea , Maust Donovan , Roberts Tonya 
Published: January 2025

Abstract
Over half of nursing home (NH) residents are living with dementia, and a growing number also experience serious mental illness (SMI) and/or comorbid dementia and SMI. Despite the heightened vulnerability of this population, studies indicate NHs struggle to meet their needs, yet little research has documented specific challenges or strategies for their care. By employing a qualitative descriptive design, this study aims to describe NH staff perspectives on caring for residents with dementia and SMI. Partnerships were developed with NH and provider networks servicing rural and urban areas of a Midwest state, with purposive sampling of not-for-profit, county-run and for-profit facilities. Staff completed semi-structured interviews, which were analyzed applying thematic analysis. Ten individuals from three facilities have participated. While all participants identified dementia as common among residents, recognition of SMI as prevalent varied by staff and facility type. Participants described an interaction whereby a resident’s past (e.g., trauma) interacts with their mental health, functional, behavioral, and cognitive needs, which then influences selection of care and symptom management strategies. Staff described person-centered care as a universal best practice, while prescribing clinicians were attuned to appropriate pharmacology that reflected the resident diagnosis. Staff in some facilities described developing tailored behavioral and crisis plans. Findings suggest potential best practices to support residents with dementia and SMI, yet ongoing challenges caring for individuals with more complex behaviors and/or comorbid SMI. Future research should integrate further frontline nurse and nursing assistant perspectives, as additional strategies and challenges translating care plans to practice may exist.
CHALLENGES FACING PRIMARY CARE NURSE PRACTITIONERS CARING FOR PERSONS LIVING WITH DEMENTIA
Authors: Featherston Kyle , Dougherty Maura , Wang Siqing , Poghosyan Lusine 
Published: January 2025

Abstract
The nurse practitioner (NP) workforce plays a vital role in caring for the growing population of persons living with dementia (PLWD). However, organizational and structural barriers hinder their contribution to patient care. This study presents results from a national sample of 968 primary care NPs who care for PLWD. NPs were asked to report on the organizational support and resources available in their practices to care for PLWD. NPs also reported on the relationships between NPs and administration, as well as NP job satisfaction, burnout, and intentions of leaving their jobs. NPs reported their organizations lacked the resources to care for PLWD that they had for patients with other chronic diseases. Specifically, only 14.67% reported a registry of PLWD overdue for services and fewer than 60% had tools, templates, and reminders for PLWD that were largely available for chronic conditions like hypertension and dementia. Crucially, these deficits in the organizational context of care resulted in NPs rating the quality of the care provided to PLWD at their organization lower than the overall quality of care the organization delivered. Although NPs were largely satisfied with their jobs, over one-third reported being burned out, and over one-fifth reported they intended to leave their jobs within the next year. Addressing these barriers to care and creating work environments conducive to NP practice are necessary to fully utilize the capacity of the NP workforce to improve care of the older adult population living with dementia.
CHARTING NEW PATHS: LGBTQIA+ GERIATRICS FELLOWSHIPS
Authors: Noy Roy , Javier Noelle Marie Coloma 
Published: January 2025

Abstract

Background
As the global population aged 65 and older continues to grow, so does the number of individuals identifying as LGBTQIA+. Despite this increase LGBTQIA+ health content are often overlooked in medical education, leading to significant disparities in care. Recognizing this gap, the American Geriatrics Society emphasized addressing LGBTQIA+ health disparities as early as 2015.

Methods
Our pilot program, a collaboration between the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai in New York and the Tel Aviv Medical Center (TAMC), is designed to address disparities in LGBTQIA+ healthcare. As part of this initiative, a geriatric resident from TAMC completed a four-month observership at Mount Sinai, receiving specialized training tailored to LGBTQIA+ healthcare for older adults. The hands-on curriculum allowed the resident to shadow various services, including geriatric and palliative care, rehabilitation, and specialized clinics such as the Institute for Advanced Medicine and the Center for Transgender Medicine. In addition, the resident engaged in one-on-one educational sessions focused on LGBTQIA+ care.

Results
The outcomes of this pilot program include the creation of a tailored and replicable curriculum for geriatric residency that can be applied to other programs, scholarly peer-reviewed publications, sustainable collaborations, partnerships with advocacy organizations, and the establishment of Tel Aviv’s first LGBTQIA+ geriatric clinic.

Conclusions
Pilot programs like ours hold significant promise for advancing LGBTQIA+ health education and improve the quality of care for older LGBTQIA+ adults, as evidenced by the establishment of Tel Aviv’s first LGBTQIA+ geriatric clinic.
CHATGPT ANALYSIS OF AGEISM IN THE 2024 PRESIDENTIAL ELECTION: RESEARCH, POLITICS, AND POLICY IMPLICATIONS
Authors: Hopp Faith 
Published: January 2025

Abstract
Gerontologist Robert Butler introduced the concept of Ageism, described as “the great sleeper in American life” in a 1968 interview with journalist Carl Bernstein. Ageism refers to discrimination based on age and has been particularly evident during the 2024 election season. To further examine this relevant phenomenon, we used ChatGPT to analyze instances of ageism related to President Biden’s campaign. We instructed ChatGPT to collect a sample of articles from mainstream media mentioning President Biden (N=23), asking the program to score the frequency and type of ageist language during the month before and after the June 27 2024 Biden-Trump debate. Ageist themes included statements about Biden being a bad leader, not trustworthy, not mentally and/or physically fit, and not competent and/or relevant as a candidate. The number of ageist statements about Biden increased in the month following the debate compared with the pre-debate month. We found fewer ageist-related statements about Biden in the African American press both before and following the debate, but access to these articles was limited due to paywall restrictions. These findings suggest that ageism continues to be relevant and will continue to drive age-related discourse, impacting policy, practice, and older adult life experiences. Future researchers should consider the role of internet paywalls in limiting public access to news sources and the breadth of content available for ChatGPT analysis. We recommend that researchers obtain full-text articles using newspaper databases rather than relying on ChatGPT internet scans to ensure comprehensiveness and analytical depth.
CREATING DIGITAL STORIES ON AGING EXPERIENCES: A RAPID METHODOLOGICAL REVIEW OF DEVELOPMENT PROCEDURES
Authors: Gopalakrishnan Nisha , Mellett Katlyn , Mirza Noeman , Hulko Wendy , Gan Daniel , Wong Karen Lok Yi , Kupferschmidt Anthony L , Lee Heather 
Published: January 2025

Abstract
Digital storytelling is increasingly used to showcase the life histories of older adults and their communities. The Mobilizing Aging in Place (MAP) project team was tasked to engage older adults in the creation of five digital stories as a means of sharing the findings of two studies on aging in place with municipal and regional planners and health care policy/decisionmakers. While there were numerous examples of digital stories on aging experiences, the best way to develop digital stories with older adults was unclear. To create clarity in effective methods, we conducted a rapid methodological review of existing literature on digital storytelling involving older adults and experiences of aging. After searching in the Discovery search engine, we reviewed 61 abstracts and articles based on specific inclusion and exclusion criteria. This yielded 18 articles that we included in the review. The included literature discussed digital stories on various health and intergenerational knowledge transfer topics. Researchers used a variety of software, editing tools, and recording methods to combine images, videos, and sounds. Digital stories were developed both in collaboration with older adults and by the older adult participants themselves. The review showed that there are no set criteria or best practices for creating digital stories, and that workshops and interviews are commonly used to engage older adults in digital storytelling. We recommend a more comprehensive and broader review be undertaken with a focus on all forms of digital storytelling regardless of type of population and context.