bluuebunny/crossref_metadata_2025_split huggingface dataset:
TESTING ERADAR: A NEW EHR-BASED ALGORITHM TO INCREASE DEMENTIA RECOGNITION IN HEALTH CARE SYSTEMS
Authors: Dublin Sascha , Karliner Leah , Coley Yates , King Deborah , Hsu Clarissa , Lee Sei , Walsh Judith , Barnes Deborah 
Published: January 2025

Abstract
Electronic health records (EHRs) hold potential for identifying individuals with undiagnosed dementia. Using machine learning, our team developed and externally validated a predictive algorithm called the EHR Risk of Alzheimers and Dementia Assessment Rule (eRADAR) that estimates the likelihood an individual has undiagnosed dementia with high accuracy (C statistics of 0.79 to 0.84). Through two embedded pragmatic trials, we are implementing eRADAR in 11 primary care clinics within Kaiser Permanente Washington and University of California, San Francisco. The target population is older adults age 65+ without a documented dementia diagnosis or medication. Primary care providers (PCPs) are randomized to intervention or usual care. The eRADAR algorithm is used to identify individuals with eRADAR scores in the top 15-20%, who are invited to a “brain health” visit that includes assessment of instrumental activities of daily living, depressive symptoms, and cognitive function (Montreal Cognitive Assessment). Results are shared with the patient and PCP, and the PCP is responsible for making the final diagnosis (with decision support provided through the EHR). To date, we have implemented the intervention in 9 clinics and conducted over 590 brain health visits. About 31% (658/2137) of high-risk individuals accept a brain health visit. Of these, about 18% have results suggesting dementia and another 30% mild cognitive impairment. Post-visit surveys show high acceptance of and satisfaction with the intervention. The primary study outcome is rate of dementia diagnosis over 12-month follow-up (completed by April 2025). We are also conducting semi-structured interviews to illuminate benefits and harms.
LEVERAGING THE NIH TOOLBOX FOR EARLY DETECTION OF COGNITIVE IMPAIRMENT IN PRIMARY CARE: THE TOOLBOX DETECT TRIAL
Authors: Wolf Michael , Nowinski Cindy 
Published: January 2025

Abstract
The NIH Toolbox comprises practice standard, cognitive and neurological functional assessments that can be deployed via iPad for research purposes. Our Northwestern team previously validated two of these brief measures of episodic memory and executive function to have clinical utility. Combined, these scored tests can be mobilized as a primary care-based screening tool for detecting cognitive impairment and dementia. To address common time and workflow constraints in these often-busy clinical settings, our derived assessment, known as Toolbox Detect, was adapted accordingly to be self-administered, and to be tethered to the electronic health record thereby removing manual data entry, followed by clear, ‘turnkey’ recommendations to address any suspected impairment. The effectiveness of Toolbox Detect to improve the timely detection, diagnosis, and referral for cognitive impairment is now being evaluated in a large, pragmatic trial conducted across 40 primary care sites within one academic health system, with real-time findings informing an embedded dissemination and implementation study at 20 federally qualified health centers. Early evidence of the fidelity of the Toolbox Detect strategy’s implementation, in terms of feasibility and acceptability and learnings of how it best might be adapted to community centers serving diverse patient populations will be explored in this presentation. Specific attention will be paid to the challenges and opportunities of introducing new technologies into primary care workflows, and healthcare provider, patient and care partner unmet needs in terms of cognitive screening.
UNDERSTANDING THE NEEDS OF INFORMAL CAREGIVERS OF PEOPLE EXPERIENCING DEMENTIA AS IDENTIFIED ON SOCIAL MEDIA
Authors: Flanagan Jane , connolly Maureen , Coakley Amanada , Fugate Matthew (Brent) , Prud’hommeaux Emily , Young Colin 
Published: January 2025

Abstract
Social media has the potential to reach informal caregivers of people experiencing dementia and provide them with supportive and accurate strategies. This study aimed to understand the caregivers’ concerns posted on social media and determine if the responses were supportive and accurate. This study utilized a human-centered machine learning (HCML) framework, natural language processing (NLP), and information retrieval (IR) techniques to extract posts from a dementia caregiver group with the largest number of members (N = 59,954). Using a qualitative descriptive design, we thematically analyzed a sample of 500 initial posts. In a subset of 100 posts and responses to those posts, we used a Delphi method to determine if the responses were supportive and accurate. Five themes were identified: 1) Seeking information about unusual problem behaviors of dementia with nowhere to turn for help; 2) Grief, a sense of loss, and loneliness are profound; 3) Support from others is challenged by relationship issues and distance from caregiving; 4) Financial and legal issues present unexpected challenges; and 5) The need to celebrate caregiving is not recognized. The team found that 73% of the responses to initial posts were supportive, 10% were not, and 10%; did not address the concern; 73% of the responses were accurate, 1% were not and 10% did not address the concern. These findings highlight multifaceted concerns dementia caregivers face. The information is foundational to developing an interdisciplinary HCML interactive question-answering tool using NLP and IR to provide supportive and accurate information to dementia caregivers.
THE PUBLIC HEALTH IMPLICATIONS OF DEMENTIA CAREGIVING: NATIONAL AND STATE-LEVEL VARIATIONS
Authors: Gaugler Joseph , Johnson Elma , Koffski Maya , Denno Benjamin , Baumgart Matthew , Belza Basia , McGuire Lisa 
Published: January 2025

Abstract
Unpaid dementia care has emerged as a public health priority. Specifically, dementia caregiving influences the health of those providing assistance (e.g., family members, friends) and recipients of care. However, the intensity of care provision and its health implications are often disproportionate within the population. Public health can engage in various initiatives to address such disparities, including improving surveillance of dementia caregivers with greater precision; engaging in outreach and education about the potential health risks of dementia care; and coordinating initiatives across traditional silos (e.g., public health, aging service providers, healthcare systems) to result in more available, accessible, and ultimately effective dementia care. Relying on 2021-2022 data from the Behavioral Risk Factor Surveillance System data from 47 states, we conducted a series of three-way cross-tabulations between dementia caregivers, non-dementia caregivers, and non-caregivers to ascertain key disparities and contextual factors that could serve as subsequent health targets. Nationally, although dementia caregivers provided more extensive help to care recipients for longer periods, variations in other domains (e.g., lifestyle behaviors) were less apparent nor consistent. More crucially, those patterns of statistical differences that emerged in the national analysis were far more variable and diverse when considering specific states, suggesting the urgent need for granular, more local data sources to better inform services, supports, and public health action to support dementia caregivers.
SOME WHOS, WHYS, AND HOWS OF BEING MORE DEMENTIA-INCLUSIVE IN AND BEYOND THE CLASSROOM
Authors: Montepare Joann 
Published: January 2025

Abstract
Demographic statistics predict a dramatic rise in the incidence of dementia (D) and Alzheimer’s disease (AD) as populations age. An estimated 5.3 million Americans were diagnosed with D/AD in 2015, and national predictions are that the number of adults diagnosed with D/AD will rapidly grow each year as the size of the population aged 65 years and older continues to increase (CDC, 2018). As such, researchers, practitioners, and policy makers have called for examining more broadly how we can develop interventions that target stigma, knowledge, diagnosis, resilience, caregiving, and related issues. An important, although overlooked, component of this call is developing educational opportunities for young adults. To this end, this presentation will describe research that aimed to gather information about undergraduate students’ dementia experience, knowledge, and concern. Specifically, a survey of 106 students distributed in diverse classes found that more than 50% of students had experience with someone with D/AD, showed low levels of knowledge, expressed strong concern about developing D/AD, and had an interest in educational activities. As well, this presentation will argue why efforts to be more dementia-inclusive should be incorporated into contemporary age-inclusive initiatives in higher education (Age-Friendly University/AFU, Age Inclusivity Domains of Higher Education/AIDHE). Finally, several activities in (TimeSlips) and beyond the classroom (Dementia Friends) will be described to show how experiential learning opportunities about dementia can be mounted.
USING NCI-AD FOR LONG-TERM SERVICES AND SUPPORTS AGING AND DISABILITY SYSTEM IMPROVEMENT
Authors: Giordano Stephanie , Plasencia Rosa 
Published: January 2025

Abstract
National Core Indicators Aging and Disabilities (NCI-AD™), survey data support State Medicaid, aging, and disability agencies to conduct surveys with individuals receiving publicly-funded long-term services and supports and measure and track their own outcomes and performance using reliable data collection methods and tools. Established in 2015, NCI-AD is now in use by 23 states nationwide. The NCI-AD portfolio includes the flagship survey – the Adult Consumer Survey (ACS) and the State of the Workforce—Aging and Disabilities (SotW-AD) survey. The ACS collects data directly from older adults and people with physical disabilities to assess the outcomes of services provided to individuals. Indicators address key areas of concern including service planning, rights, community inclusion, choice, health and care coordination, safety and relationships. In 2022, NCI-AD piloted the SotW-AD is a first of its kind for the aging and disabilities field, this new effort collects and aggregates statewide information about wages, benefits, and turnover of the direct service workforce—as reported by the agencies that employ them. This session will provide an overview of the NCI-AD program, the type of data collected from each survey, and how state-level and research partners have utilized the data sets. Additionally, 18 NCI-AD measures are included in the newly released CMS HCBS Quality Measure Set. We will discuss how this impacts states, and potential ways that these and other measures will be implemented and used to support important aspects of services access and equity.
PRINCIPLES OF QUEER GERONTOLOGY
Authors: Fabbre Vanessa , Oswald Austin , Jen Sarah 
Published: January 2025

Abstract
Gerontology has advanced greatly in recent decades in its attention to the lives of LGBTQ+ people. To this end, an increasing number of scholars have argued for a queering of gerontologists’ understanding of the human life course, as well as a queering of the field of gerontology itself. Yet, to date there exists no clear articulation, in practical terms, of what queer gerontology is and how it could be applied to scholarship and activism. Coming from a first-person, reflexive position, we argue that a clear vision of queer gerontology should be based on scholars’ historical use of queer theory to challenge normative ideas about the self and social life. In this presentation we will briefly present the historical landscape of LGBTQ+ aging studies, with an emphasis on recent conceptual and methodological advances, followed by a description of the iterative process through which we (as both early and mid-career scholars) developed the following five principles of queer gerontology: 1) Deeping Visibility and Awareness, whereby the identities and lives of LGBTQ+ and all oppressed peoples are elevated and illuminated; 2) Developing and Applying Critical Perspectives, whereby concepts and theories that challenge the status quo are engaged; 3) Challenging Oppression and Injustice, whereby critical theories are explicitly used to guide social change efforts; 4) Engaging Multiple Epistemologies and Modes of Inquiry, whereby scholars actively promote and use various approaches to scientific and social inquiry; and 5) Fostering Transdisciplinary Advancement, whereby scholars seek out and develop relationships that transcend traditional disciplinary boundaries.
RESHAPING LONG-TERM CARE SYSTEM INTO A SUSTAINABLE AND HIGH-QUALITY HEALTHCARE FIELD GLOBALLY: IT IS POSSIBLE!
Authors: McGilton Katherine , Spilsbury Karen , Thompson Carl 
Published: January 2025

Abstract
Years of investigation have revealed that despite compelling evidence, long-term care (LTC) home policies and procedures remain resistant to change. Globally, LTC homes grapple with subpar labor conditions stemming from structural and institutional elements, resulting in precarious work environments for its workforce. The revitalization of the LTC necessitates immediate attention to adequate staff and skill mix and innovative models of care to enable effective and person-centered care of residents. In this symposium, we will present an interactive overview and discussion of the work from international researchers exploring sustainable recruitment and retention of the LTC workforce, optimal staff and skill mix and initiatives for the intricate care requirements of residents and to mitigate precarious work conditions for the workforce. Specifically,: 1. Dr. Devi’s team presents findings from a Realist Review called the REACH including an explanatory framework to implement strategies to attract, recruit and retain LTC staff. 2. Dr. Montse and team highlight findings from a narrative review of measures taken by national European administrations to optimize working conditions for the LTC workforce including during the COVID-19 pandemic. 3. Dr. Bleijlevens and colleagues present the successful implementation of DAIly NURSE Intervention that transformed breakfast time for LTC residents. 4. Dr. McGilton and team implemented and evaluated the impact of nurse practitioner-led huddles that helped reduce moral distress amongst staff. 5. Prof. Zúñiga’s team prepares the scale-up of a registered nurse-led care model strengthening their geriatric expertise to reduce unplanned hospitalization for LTC residents.
REQUIREMENTS FOR POLICY MEASURES THAT FAVOR BETTER WORKING CONDITIONS FOR THE LONG-TERM CARE WORKFORCE IN EUROPE
Authors: Gea-Sánchez Montserrat , Mateos Jose 
Published: January 2025

Abstract
There is a need to improve key working conditions, such as low wages, high rates of part-time employment, and insufficient autonomy and support for workers. In addition, the pandemic has highlighted the need for better coordination between the long-term care sector and the wider health system, and recruitment and training policies must be accompanied by strategies to improve management within the sector. A narrative review of the main measures carried out by several national European administrations to improve working conditions in long-term care was conducted. Documentation was retrieved from a scientific literature review, grey literature and key informants (n = 9). The results of the review suggest that the long-term care sector suffers from structural deficiencies that were accentuated during the COVID-19 pandemic. Among these deficiencies the following were highlighted: the lack of professionals in long-term care mainly due to poor working conditions and gaps in training and role definition, especially for nurses. Measures to reverse this situation, such as the integration of new technologies or the replacement of nurses by other professionals who have acquired some of their competencies have been implemented in some European countries. These measures, in addition to being insufficient, may lead to a decline in the quality of care. Persistent problems of high turnover and low retention pose a threat to both accessibility and quality of services.
“KEEP AN EYE ON MY PLACE”: THE DYNAMICS OF SOCIAL CONNECTION FOR OLDER ADULTS LIVING IN SUBSIDIZED HOUSING
Authors: Cudjoe Thomas 
Published: January 2025

Abstract
Social isolation is a burdensome problem for low-income older adults. Many low-income older adults live in subsidized housing. However, few studies have examined this problem in this context. We sought to understand processes that may facilitate, or are barriers to social connections in older adults who live in this setting. We conducted in-depth semi-structured interviews with a purposeful sample of older adults living in subsidized housing communities in Baltimore City. Many residents had a small but meaningful residential network, facilitated by housing characteristics that support connection. Overall, though, residents were cordial but not connected. Challenges related to aging, the undesirable behaviors of others, and a desire for privacy limited social connections or hindered meaningful connection and led to social isolation within the housing communities.
THE LONG-TERM RELATIONSHIP BETWEEN SENIOR HOUSING, SOCIAL ISOLATION, AND COGNITIVE DECLINE
Authors: Park Sojung , Jeon Gyeahyung , Kwon Eunsun , Kang Ji young 
Published: January 2025

Abstract
Community-based senior housing has been advocated as an alternative living environment that promotes a sense of community. This study explores the long-term relationship between living in senior housing, social connection, and cognitive decline. Data came from the 12 waves (year 2010-2022) of the National Health and Aging Trends Study (NHATS) in the U.S. to compare two groups (Traditional Housing and Senior Housing) of older individuals aged 70 and over (Obs=50,128 in TH & 6078 in SH). We analyzed a long-term pattern of social isolation and cognitive function and examined the impacts of social isolation on changes in cognitive function by income groups. Weighted propensity score matching to ensure comparability between the two groups. To focus on the relations during the pandemic, we conducted a Synthetic Difference in Difference (SDID) analysis. In both housings, social isolation increased, and cognitive function decreased over a 12-year period. The regression analysis showed a clear pattern of drastic drops and recovery in the level of social isolation and cognitive function. Compared to senior housing, residents in traditional housing were likely to experience increased social isolation [coef: 0.20, p&lt;0.001] and decreased cognitive function [coef: -0.79, p&lt;0.01]. A series of subgroup analyses showed the protective effect of senior housing was pronounced for low-income older adults. With the long-term evidence about the protective effects of senior housing within the context of the COVID-19 pandemic, our study provides a rigorous basis for much-needed future research to identify core factors and mechanisms for healthy aging among low-income senior housing residents
THE ASSOCIATION BETWEEN LONELINESS AND CHILDLESSNESS IN MIDDLE TO LATE LIFE: DOES FRIENDSHIP AND GENDER PLAY A ROLE?
Authors: Rataj Alison , Alberth Andrew , Su Yan-Jhu , Stam Elisabeth , Stokes Jeffrey 
Published: January 2025

Abstract

Objective
Loneliness is a risk factor for negative health outcomes; however, little attention has been paid to the role of parental status as a contributor to loneliness in later life. Limited research has explored how this association may vary based on levels of friend support, friend strain, and gender. This study addresses these gaps by exploring whether those who are childless, have less friend support or friend strain, and are female are at a higher risk of loneliness.

Methods
This cross-sectional study used pooled data from 11,900 older adults 50 years and older from the 2016 and 2018 waves of the Health and Retirement Study. Loneliness was assessed across parental status groups, friendship support and friendship strain scales, and gender using ordinary least squares regression. Multiple imputation was conducted to address missing data.

Results
Those who did not have children (n=1,444, 13.0%) were substantially lonelier than those with children in adjusted models. Friend support was associated with reduced loneliness, particularly for childless adults when compared to parents. Midlife and older men were lonelier than women overall, and interaction effects show that childlessness played a larger role in shaping loneliness among women than men. Loneliness did not differ across levels of friendship strain.

Discussion
Parental status and gender are intertwined concerning their effects on loneliness. With the changing demographics of “family”, future research should identify specific categories of parental status (i.e., did not want children, blended families) and how the mechanics of friend support (i.e., how much, what types) impact loneliness.
SHIFTING SOCIAL PARTICIPATION AND LEISURE PATTERNS AMONG CHINESE OLDER ADULTS: EVIDENCE FROM NATIONAL SURVEYS
Authors: Fang Yu , Ouyang Zheng 
Published: January 2025

Abstract
Based on the data of “The National Survey on Older Persons in Urban and Rural China” conducted in 2000, 2006, 2010 and 2015, the paper examines the changing dynamics of social participation and leisure activities among Chinese older adults. Findings from the 2015 survey indicate a notable increase in the participation rate of public welfare activities among the older adults, with nearly half actively involved in various community endeavors. Particularly, urban areas showed enhanced participation, contributing to individual fulfillment and societal harmony. Moreover, a significant proportion of older adults expressed willingness to assist peers in need, underscoring the prevalence of mutual support networks within communities. Additionally, the development of Older Person’s Associations (OPA) has gained momentum, serving as vital platforms for older people self-management and social engagement. However, challenges persist, with disparities in participation rates between urban and rural areas. While static leisure activities remain prevalent, there is a notable rise in Internet usage among the older adults, offering avenues for social interaction and information dissemination. Despite advancements in spiritual and cultural engagement, attention to mental health among the older adults remains crucial, especially in addressing issues like suicide and mental health concerns among the rural older people population. The paper emphasizes the importance of bolstering support systems and services to promote holistic well-being among the aging population.