bluuebunny/crossref_metadata_2025_split huggingface dataset:
UNDERSTANDING BARRIERS TO PARTICIPATE IN DEMENTIA RESEARCH AMONG OLDER ADULTS IN THE BRONX, NEW YORK
Authors: Jayakody Oshadi , Ceide Mirnova , Grabanski Morgan , George Claudene 
Published: January 2025

Abstract
The Bronx County in New York (NY) has the highest prevalence of dementia in the state and is considered the least healthy of NY counties. This study aims to identify the barriers to participation in dementia research among older adults in the Bronx and explore strategies for improving their research readiness. We are distributing a brief survey to 100 older adults (aged ≥60) visiting ambulatory practice and memory clinics at Montefiore Medical Center and community-based older adult centers in the Bronx. This survey, which will be completed in September 2024, assesses participants’ knowledge of dementia research, awareness of local dementia research studies, willingness to participate in different types of research and barriers for participation. Currently, we have collected survey data from 15 older adults (n=46% White,15% Black, 30% Hispanic). Our preliminary results show that 50% of older adults were aware of available local dementia research studies. Only 17% reported prior participation while 80% reported willingness to participate in future research. Most respondents (81%) were interested in studies investigating cognitive function and healthy aging, whereas 36% were interested in research involving brain imaging, drug trials or lifestyle interventions and genetic studies. The main barrier to participation was limited access to our study centers (55%) followed by lack of time (27%). Interestingly, 82% indicated that free transportation or parking would incentivize their participation. These findings highlight the knowledge gaps and what barriers to address (i.e. enhance accessibility) to improve readiness to participate in future dementia research among older adults in the Bronx.
USER-CENTRED DIGITAL TRANSFORMATION: JAPANESE OLDER ADULTS’ PERSPECTIVES ON DIGITIZATION
Authors: Wada Mineko , Takeda Kazuya 
Published: January 2025

Abstract
This community-based study aimed to explore how Japanese community-dwelling older adults perceived the use of digital technologies in daily life. Although the importance of including older adults in aging and technology research and development has been increasingly emphasized in recent years and the Japanese government has been using the slogan “No One Left Behind” to promote user-centred digital transformation, older adults’ perspectives on a digitized society have not been explored in depth to date. In this qualitative study, 18 Japanese older adults participated in either semi-structured individual interviews (10 participants) or focus groups (8), depending on their preferences. Both the interviews and focus groups elicited participants’ experiences of adapting to digitization in their daily lives and their related perceptions of this shift (i.e., challenges, benefits, and concerns). All the interviews and focus group discussions were digitally recorded, transcribed verbatim, and analyzed thematically. Our analysis generated five themes that illustrate Japanese older adults’ negative and positive perspectives on digital transformation: 1) disapproval of dehumanization, 2) concerns about being monitored and controlled through the digitizing of personal information, 3) increasing risks of scams and fraud, 4) lack of access to immediate support for issues relating to digital adaptation, and 5) potential for expanding social connection and entertainment. We discuss strategies for addressing negative perspectives among older adults that are related to low digital literacy, including, for example, increasing and improving the accessibility of immediate support to help with challenges relating to digitization.
VALIDATION OF DEMENTIA CARE-RELATED SCALES AMONG INFORMAL CAREGIVERS OF LATINOS WITH DEMENTIA OR MCI
Authors: Perales-Puchalt Jaime , Cabrera Monica Fracachan , Baker Christina , Mantilla Mariana Ramirez , Burns Jeffrey 
Published: January 2025

Abstract
We aimed to test the psychometric properties of several dementia care-related scales among Latinos. We leveraged secondary baseline data from a one-arm mHealth trial on dementia caregiver support. We included 100 responses for caregiver-focused scales and 88 responses for care recipient-focused scales. Scales included the Neuropsychiatric Inventory Questionnaire Severity and Distress scales, six-item Zarit Burden Inventory, Ten-item Center for Epidemiologic Studies Depression Scale, Geriatric Depression Inventory, Quality of Life in Alzheimer’s Disease, and Single-item Satisfaction With Life Scale. We calculated concurrent validity using Pearson and Spearman correlations and expected correlations amongst all variables in line with the Stress Process Framework. We calculated internal consistency reliability using Cronbach’s alpha. All concurrent validity correlations followed the expected directionality, with 19/21 inter-scale correlations in the total sample reaching statistical significance (p&lt; 0.05), and 17/21 reaching at least a low correlation (0.3). Cronbach’s alpha ranged from 0.832 and 0.879 in all scales in the total sample. Findings suggest that these English and Spanish caregiver-administered scales have good psychometric properties.
WEALTH, DEBT, AND COGNITIVE AND SELF-CARE DIFFICULTY AMONG AMERICANS AGED 65+
Authors: Sheehan Connor , Jang Jiwon , Saenz Joseph , Connor Dylan 
Published: January 2025

Abstract
As the American population ages, the number of individuals with cognitive and self-care challenges is projected to increase substantially, stressing the importance of understanding their social determinants. Previous research has connected socioeconomic status, specifically educational attainment and income, to cognitive and self-care problems. However, considerably less research has examined the role of wealth in older adulthood. This is an oversight, as wealth reflects cumulative life course exposure and accumulation of socioeconomic resources, and debt may be a unique stressor. We use novel geographic machine learning-based estimates of wealth for every American household to predict cognitive and self-care difficulties among Americans aged 65+. We linked GEOWEALTH data, a machine learning estimate of household wealth, to the 2019-2021 American Community Survey (n=742,348) to create one of the largest data sources of wealth and health heretofore analyzed. Regression models predict cognitive and self-care difficulties adjusting for demographic and socioeconomic characteristics, including income and education. Cognitive and self-care difficulties decreased with increasing wealth, while being in debt nearly doubled the probability of these difficulties at every age. This pattern is amplified among White Americans and those in areas with concentrated debt. Wealth consistently shows stronger associations with cognitive and self-care difficulties than educational attainment or income. Our findings emphasize the importance of wealth and debt for well-being in older adulthood. Future research should explore the directionality of this association and the impact of different sources of wealth and debt.
WHEN I’M 64 – LONGITUDINAL OBSERVATIONS FROM AN INTERDISCIPLINARY COURSE ON AGING FOR FIRST-YEAR STUDENTS
Authors: Thomas Karuna , Picchiello Matthew , Morrow-Howell Nancy , Stark Susan , Carpenter Brian 
Published: January 2025

Abstract
Research has highlighted the value of education for college students on the aging process. Curricula have the potential to address misconceptions about aging and draw students toward further coursework and experiences with older adults. This study explored the impact of participation in an interdisciplinary course on aging across one year for the Fall 2023 cohort (N = 50) with a control group that did not participate in the course (N = 33), and after five years for the Fall 2017 cohort (N = 59) and control group (N = 57). The course was offered to first-year undergraduate students. Weekly classes included older adults from the community. Surveys assessing attitudes towards aging and participation in aging-related activities were administered prior to and at the end of the academic year, and an annual follow-up. Group-by-time analyses showed that participants from the class had significantly more positive attitudes towards aging [F(1, 82) = 13.67, p &lt;.05, ηp2 =.03], and significantly fewer ageist beliefs [F(1, 82) = 9.21, p &lt;.05, ηp2 =.02] at the end of the academic year compared to the control group. In the 5-year follow-up, students in the course also reported more engagement in aging-related fields compared to the control group [t(114) = 4.65, p &lt;.05]. The course content was reported to be relevant to 45.8% of former students in their professional life, and 57.6% in their personal lives. These results substantiate the short and long-term positive impact of engaging undergraduate students in curriculum on aging.
48 HOUR HOSPICE HOME IMMERSION RESEARCH KEY MEDICAL STUDENT LEARNING OUTCOMES: UNE COM 2019-20 STUDENT COHORT
Authors: Okpoebo Amanda , Berkowitz Jennifer , Gugliucci Marilyn 
Published: January 2025

Abstract
Traditional palliative and end-of-life care education in US medical schools is often inadequate in preparing students to care for patients. To address this, the University of New England College of Osteopathic Medicine (UNE COM) introduced the Learning by Living 48-Hour Hospice Home Immersion (HHI) Project. This innovative program immerses students into an 18-bed acute care (ICU) hospice home for 48 hours, where they provide care to patients, support families, and engage in postmortem care while working with an interprofessional staff team and independently. Utilizing qualitative ethnographic/autobiographic research designs, two key research questions included: (1) What significant lessons were learned from the 48-hour home hospice immersion?; and (2) What skills will they apply in their future practice? Students documented their experiences in journals. Eleven second-year medical student journals from the 2019-20 cohort were selected for analysis; 300+ pages of data. During each of three stages: pre-fieldwork, fieldwork, and post-fieldwork, qualitative analysis included content review, creating a codebook, and conducting a final analysis with NVIVO 14 software. Three key themes emerged for question one: (a) Holistic comfort care/medicine, (b) Subjectivity of suffering, and (c) Religion/spirituality. For question two, students reported: (a) Increased confidence in caring for dying patients and their families, (b) Improved ability to discuss death, and (c) Enhanced understanding of the physician’s role in curing versus caring. Each student’s experience at Gosnell Hospice Home was unique, yet all gained critical insights that will shape their development into compassionate and skilled physicians in palliative and end-of-life care.
A CHALLENGE HONORING SELF-DETERMINATION OF NURSING HOME RESIDENTS WITH DEMENTIA; WHICH SELF -- THEN SELF OR NOW SELF?
Authors: Bern-Klug Mercedes , Levine Meredith 
Published: January 2025

Abstract
Medicare and/or Medicaid certified nursing homes (NHs) are required to inform residents they have a right to an advance directive. The government’s Resident Rights requires staff to honor resident self-determination. What happens when instructions in an advance directive are in opposition to the current expressed requests of a person with advanced dementia? Using qualitative descriptive methodology, in this pilot study, 12 NH staff members in various roles engaged in individual interviews and responded to questions that speculated they had a resident with dementia who, when they had decisional capacity, indicated in a written advance directive they did not want to be fed, once they lost the ability to feed themselves. Staff were unanimous in declaring the need to honor the resident’s self-determination, and yet could foresee instances in which a person with said advance directive, and unable to self-feed, would indicate through words or gestures, the desire to eat. Many staff indicated they would go ahead and feed the person; others worried that would dishonor the advance directive. Staff also expressed other challenges including how “self-feed” is operationalized, the fluctuating nature of functional capacity in dementia, and the potential conflict that could result with families and NH surveyors. Some staff indicated it would be against their religion or sense of morality to not feed a person who expressed an interest in eating. We conclude that although such advance directive templates are readily available online, the potential for logistical and moral challenges in the NH context are real and serious.
A FRAMEWORK FOR UNDERSTANDING PALLIATIVE CARE PREFERENCES AMONG AFRICAN AMERICAN PATIENTS WITH CANCER: THE 6S MODEL
Authors: Oduro Elisha , Carpenter Joan 
Published: January 2025

Abstract
African American (AA) patients with cancer have the highest mortality rates and poorest outcomes among all racial groups in the US, yet they are almost one-third less likely to receive palliative care (PC) than their White counterparts. AAs are less likely to receive PC due to systemic racism, discrimination, provider bias, and culturally insensitive healthcare services. Additionally, research has primarily focused on highlighting the disparities in PC access among AA patients with cancer rather than understanding the experiences and preferences of those who do receive PC services. Grounded in 6S-Model for Person-Centered Palliative Care, this presentation aims to illustrate a theoretically derived approach for clinicians and researchers to develop culturally sensitive PC for AA patients with cancer. The model comprises six concepts elucidating different aspects of patient care to ensure sensitive care and overcome disparities: self-image, symptom relief, social relations, self-determination, synthesis, and strategies. Self-image is the model’s central concept, reflecting the patient’s personal experiences and identity. To preserve self-image, it is crucial to alleviate the patient’s symptoms and physical suffering while maintaining their social connections. Self-determination ensures patient involvement in their care, and synthesis and strategies address their care preferences, spiritual and existential needs. Utilizing the 6S Model for Person-Centered Palliative Care in studies and clinical care, will allow AA patients with cancer to share their PC experiences and collaborate in creating culturally sensitive PC, thereby integrating AA patients with cancer preferences and needs into PC, improving quality of life, care outcomes, and promoting equity in PC services.
ACCURACY OF MINIMUM DATA SET FALL ASSESSMENTS IN LONG-TERM CARE RESIDENTS
Authors: Graham Laura , Li Yongmei , Dave Chintan , Odden Michelle 
Published: January 2025

Abstract
The Minimum Data Set (MDS) is commonly used to ascertain falls among long-term care residents for research and quality improvement. However, studies have shown that MDS may underreport falls compared to chart abstraction. Natural Language Processing (NLP) algorithms to detect falls are limited but have demonstrated effectiveness in identifying falls in medical records. Thus, we aimed to develop and validate a rule-based NLP algorithm to identify falls in Veterans Health Administration (VA) long-term care residents and compare it to MDS. To do so, we identified a national cohort of patients receiving care at 114 VA long-term care facilities (10/1/2006-9/30/2019). Using text mining in VA clinic notes, we developed a rule-based NLP algorithm to identify falls. The algorithm was validated using manual chart abstraction on 200 patients (positive predictive value [PPV] 0.99). We then compared the results of the NLP algorithm to the MDS assessment, which identifies a fall within the past 30 days at the time of the assessment, using sensitivity, specificity, and PPV. In our cohort of 45,183 patients, we identified 154,165 falls (7.8 per 1,000 days) among 22,331 residents using NLP compared to 16,356 falls (0.8 per 1,000 days) among 8,859 residents using MDS. Compared to NLP, the MDS had a sensitivity of 0.30, a specificity of 0.91, and a PPV of 0.77. Our findings suggest that MDS may dramatically undercount falls among long-term care residents, potentially leading to misclassification in research studies. Future studies should focus on alternative methods of fall detection in retrospective cohorts.
ADVANCES IN GERONTOLOGY CURRICULUM DESIGN: CENTRING LIVED EXPERIENCES OF LGBTQ+ OLDER ADULTS
Authors: Wilson Kimberley , Pevie Noah , Hofstra Emma 
Published: January 2025

Abstract
While research on LGBTQ+ aging in Canada has increased, post-secondary educators have identified gaps in pedagogical aids to facilitate their teaching in this area. Older LGBTQ+ individuals have unique social/historical contexts compared to their majority peers, often involving minority stress experiences (e.g., stigma, discrimination, physical violence) that contribute to inequalities during late life. To create a future workforce that understands and appreciates the unique needs and social/historical contexts of aging LGBTQ+ individuals, our team prioritized developing curriculum resources that center the voices of LGBTQ+ older adults. We interviewed 26 LGBTQ+ older adults (M = 65.9, Range = 51-89). Participants shared stories about their own life courses and how they reflected the landscape of current curricula. They offered strategies for enhancing curriculum to ensure that post-secondary education include diverse LGBTQ+ narratives. Through conventional content analysis we identified topics that LGBTQ+ older adults named as requirements for students to understand the experiences of LGBTQ+ aging within hetero- and cis-normative health/social contexts. Through our analysis we articulated the importance of co-construction of educational materials with LGBTQ+ communities. Participants also identified the development of tools to be used within classrooms to challenge instructors to unpack their own assumptions about LGBTQ+ aging. They shared the importance of highlighting unique experiences of aging within these communities including the histories of queer/trans discrimination and the experiences of survivors of the HIV/AIDs crisis. Findings from this project will inform curriculum design and resources that move beyond normativity and include narratives of the lived/living experiences of LGBTQ+ older adults.
AGING IN AMERICA: CARE AND COMMUNICATION ACROSS THE FIELD
Authors: Margulis Brianna , Garcia Alexandra , Matarazzo Richelle , Tepper Lynn , Kunzel Carol , Whalen Stacey 
Published: January 2025

Abstract
Northern Manhattan has the largest population of individuals over 65. Students within the graduate programs of Columbia University electively participated in the workshop “Aging in America: Care and Communication Across the Field.” The workshop aimed to provide future professionals with communication techniques and best practices when caring for the aging population. Before and after participating in the workshop, participants completed a survey asking them to self-assess their readiness to communicate with the aging population. The workshop also taught participants how to recognize at-risk-for lower health literacy individuals and diminish barriers whenever possible. The workshop randomized participants into small groups composed of different participating programs (College of Dental Medicine, Programs in Physical Therapy, Programs in Occupational Therapy, School of Nursing, MD Program, Clinical Pastoral Education Program, Program in Genetic Counseling, Institute of Human Nutrition, Mailman School of Public Health, and School of Social Work). Participants facilitated discussions about how they would utilize the tools provided to navigate scenarios concerning older adults. The pre and post-surveys indicated that our efforts impacted participants by making them feel more prepared to communicate with an older adult who has experienced sensory, cognitive, physical, and/or behavioral changes. Participants reported that they learned more about their future colleagues’ scope of practice, which promotes better communication. The limitations of our workshop were within the smaller sample size of responses we received. Graduate programs should implement this workshop among health professional students in the future.
AGING WITH DISABILITY AND AGING INTO DISABILITY: HOW INCOME AND MISTREATMENT EXPERIENCE ALTER SELF-PERCEIVED AGE?
Authors: Zhang Yalu , Chen Ziyan 
Published: January 2025

Abstract
Individuals who experience early-onset disability (aging with disability) might have a lifetime of adaptation and resilience that shapes their views on aging differently from those who encounter disability in later life (aging into disability). Conversely, older adults with late-onset disability might maintain higher financial stabilities which could significantly impact their aging experience. It remains understudied if these contrasting effects tend to offset each other or if one has a more significant impact. Using 2018 China Longitudinal Aging Social Survey data, this study examined whether the onset timing of disability shapes attitudes towards aging differently, and how the experience of elder abuse could alter this association. Attitudes toward aging were measured both in subjective age and an index of self-perceived capabilities and values. Consistent with previous findings, this study found that the majority of older adults with impairments in (instrumental) activities of daily living had the onset of disabilities after the age of 65 (n=660, 91%). This study uniquely identified that, compared to older adults with early-onset disabilities, those who had later-onset disabilities perceived their aging, capabilities, and social values more negatively (O.R.=2.56, p=0.003). The odds drastically increased to 9.03 times if limiting the analytical sample to those who experienced elder abuse in the last 12 months (p=0.013). This study provides valuable insights into how the timing of disability onset influences older adults’ attitudes toward aging. The marked impact of elder abuse on these perceptions highlights an urgent need for targeted prevention and interventions among those who have disabilities with aging.
ALZHEIMER’S DIAGNOSIS AND CARE BY RACIAL AND ETHNIC GROUP IN THE MEDICARE POPULATION
Authors: Hoyt Margaret , Bailey-Taylor Melissa , Chandler Julie , Johnston Joseph 
Published: January 2025

Abstract
Little is known about differences in healthcare resource utilization (HCRU) among racial/ethnic groups with Alzheimer’s disease (AD). Our study aims to address this gap with an incident AD cohort in Medicare claims data. We identified Medicare patients ≥65 years old with a first (index) AD code (ICD-10 G30*) or medication (galantamine, rivastigmine, donepezil, or memantine) in 2018 or 2019 who were continuously enrolled (gap &lt; 45 days) one year pre- and post-index. Descriptive analyses of HCRU and cost data were stratified by race/ethnicity. Our analysis included 887,984 patients, the majority female (64.2%), with mean (sd) age 80.6 (7.5) years. 72.0% identified as non-Hispanic White, 9.9% non-Hispanic Black, 12.8% Hispanic, and 3.8% Asian. In the 2018-2019 Medicare population, the incidence of Alzheimer’s disease per 100,000 person-years was 1,349 for White, 1,649 Black, 2,003 Hispanic, and 1,500 for Asian patients. Fewer White patients (18.8%) were dual-Medicare/Medicaid eligible than non-White patients (46.0-64.4%), and non-White patients had higher rates of many chronic comorbid illnesses. More White patients had at least one neurologist visit in the year pre-index (39.0%) compared to Black (35.1%), Hispanic (37.5%), and Asian (33.1%) patients. More Black patients had an inpatient admission with AD as the primary diagnosis post-index (11.0%) than White (9.5%), Hispanic (7.6%), and Asian (5.8%) groups, and costs for long-term care and hospice were highest for Black and Hispanic patients, respectively, which could indicate more severe disease. These statistically significant results suggest discrepancies between racial/ethnic groups in the Medicare AD population; further research is needed to understand the differences.