bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIGITAL MOBILITY MONITORING FOR HEALTHY AGING: RESULTS FROM LARGE AGING COHORTS IN EUROPE AND CANADA
Authors: Jansen Carl-Philipp , Beauchamp Marla 
Published: January 2025

Abstract
Mobility has been deemed the ‘sixth vital sign’ because of its ability to predict critical health outcomes in later adulthood. Up to now, there is no consensus on the ideal measurement of mobility, but previous findings and experiences with movement sensors have led to regular application of digital technology. Important but unanswered questions remain around the potential of digital mobility outcomes (DMOs) to monitor individuals’ health status, to serve as markers for physical or functional decline, and to predict clinically meaningful events such as falls and hospitalisations. This could provide a better understanding of older adults’ and patients’ general health based on recurrent monitoring of their mobility. Against this background, data from major cohort studies in Europe and Canada are presented. Marla Beauchamp will present a recently proposed unified framework for mobility measurement, outlining three distinct aspects of mobility and investigating their relationship in a cohort of 1,200 older adults. Carl-Philipp Jansen will complement this data by looking at the same three aspects in a clinical cohort of 566 hip fracture patients, however, comparing their trajectories over one year. Laura Delgado-Ortiz will explore sensor-derived real-world walking in 550 older adults with COPD with healthy older counterparts, thereby capturing different characteristics of walking activity and gait from a single device worn at subjects’ lower back for one week. Karen Van Ooteghem will provide a look beyond single-sensor approaches, highlighting the large potential and presenting principles of multi-sensor approaches to provide comprehensive and meaningful information on mobility in older adults.
UNIFIED FRAMEWORK FOR MEASURING MOBILITY IN OLDER PEOPLE: EMERGING DATA FROM A CANADIAN AGING COHORT
Authors: Beauchamp Marla 
Published: January 2025

Abstract
In the 2015 World Health Organization (WHO) World Report on Aging and Health, mobility is described as movement in all its forms either powered by the body or by a vehicle. Mobility thus encompasses basic movements such as standing up from a chair to more complex activities such as walking or using transportation. Many outcome measures have been developed to assess mobility, however, the variability in constructs being assessed and lack of standardisation in terminology present challenges to advance research and practice in this area. We propose a unified framework for mobility measurement in older populations consistent with the latest language and terminology endorsed by the WHO. The framework outlines three distinct constructs: perceived mobility (“what can you do?”), locomotor capacity for mobility (“what could you do?”), and actual mobility (“what do you do in daily life?”). The latter construct, actual mobility, has been less well studied until recently. Wearable devices offer the unique advantage of comprehensively monitoring the real-world actual mobility of older people in their homes and communities. In this talk, we will present emerging data from the McMaster Monitoring My Mobility (MacM3) study, a digital mobility cohort of over 1200 community-dwelling older adults with detailed mobility measurements spanning all three aspects of mobility and examine their relationships with clinically important health outcomes. In this way, we will be able to test the suitability of our framework and highlight the potential of digitally derived measures of actual mobility for informing aging research and practice.
HOW DOES THE USE OF HIGH-COST TREATMENTS IMPACT UTILIZATION OF THE MEDICARE HOSPICE BENEFIT?
Authors: Plotzke Michael , Christian Thomas 
Published: January 2025

Abstract
Medicare patients who may benefit from palliative chemotherapy, radiation, or blood transfusions for symptom management (hereafter called “high-cost treatments”) may face difficulties accessing those treatments while electing hospice. The Medicare hospice benefit allows these high-cost treatments, but the treatments’ cost may exceed hospice agencies’ Medicare payments, limiting hospices’ ability to cover high-cost treatments. Lack of access to high-cost treatments may discourage transitions to hospice, resulting in costly and less patient-centered care. Using 100% Fee-for-Service (FFS) Medicare Part A/B claims, we examine how frequently these high-cost treatments are used at the end of life and how hospice use varies by the receipt of high-cost treatments. 7,631,620 FFS Medicare beneficiaries died from FY 2017-2021 and roughly 19.8% of those received at least one high-cost treatment in the 180 days before death (8.3% used chemotherapy, 3.73% used radiation, 12.8% used transfusions) and 47.1% used hospice in the 180 days before death. Of the 786,402 beneficiaries that used both hospice and at least one high-cost treatment in the 180 days before death, only 16,478 (2.1%) used hospice and a high-cost treatment simultaneously. We also found that the average hospice length of stay for those using high-cost treatments in the last 180 days of life is substantially shorter than for beneficiaries electing hospice without using those services (chemotherapy recipients - 22.9 days, radiation recipients – 23.2 days, transfusion recipients -25.5 days, non-recipients – 105.6 days). These findings may indicate barriers to receiving hospice for beneficiaries who may benefit from high-cost palliative treatments.
INPATIENT AND OUTPATIENT PALLIATIVE CARE AMONG VETERANS: THE NATIONAL LANDSCAPE
Authors: Kaufman Brystana , Woolson Sandra , Burns Madison , Ma Jessica , Thorpe Joshua M , Hastings Susan , Bekelman David , Van Houtven Courtney 
Published: January 2025

Abstract
Palliative care (PC) improves quality of life for people with life-limiting conditions (LLC), which is common among older adults. In the United States, use of PC in the outpatient setting has expanded over the past decade; yet, most research has focused on inpatient PC. This study compared characteristics and use for veterans with inpatient or outpatient PC care nationally. The sample included veterans with specialty VA PC encounters, identified using VA and Medicare administrative data (2014-2017). Specialty PC encounters were identified using clinic stop codes (353, 351) and current procedural terminology codes (99242-99245). Of 120,249 unique veterans with specialty PC, 67.8% had PC only in the inpatient setting (n=81,523) and 32.2% had at least one PC encounter in the outpatient setting (n=38,726). One third experienced the first PC encounter within 2 years of meeting LLC criteria. Outpatient versus inpatient PC users were more likely to have cancer and less likely to have high frailty, but sociodemographic factors including rurality and housing instability were similar. Duration of hospice use was similar between inpatient (median = 37 days; interquartile range, IQR =11, 112) and outpatient (median=44 days; IQR=14, 118) PC users, and shorter among those with only one PC encounter (median =18 days; IQR=5, 64). Among veterans with PC use, one third received at least some PC in the outpatient care setting. Differences between veterans with inpatient and outpatient use motivates the need for further research to understand how care setting and timing of PC impacts outcomes for veterans and older adults.
THE ROLE OF HEALTH CARE STEREOTYPE THREAT IN END-OF-LIFE PLANNING AMONG OLDER SEXUAL MINORITY ADULTS
Authors: Singleton Meki 
Published: January 2025

Abstract
Healthcare stereotype threat (HCST), defined as “the threat of being reduced to group stereotypes within healthcare encounters”, may occur when social identities negatively impact healthcare experiences. Prior research has shown that individuals report experiencing HCST related to age, gender, weight, race/ethnicity, HIV status, and sexual orientation. However, little is known about how HCST may be associated with end-of-life care planning. The aim of this study was to examine the association between comfort with medical decision making and advance care planning (ACP) activities and HCST related to sexual orientation and race. We conducted an online survey from 2022—2023 to collect information about older sexual minority (SM) adults’ ACP activities and perceptions of HCST. Respondents (N=281) included Black (n=133) and White (n=148) SM adults. Logistic regression revealed that those with higher levels of HCST–sexual orientation had 13% lower odds of being very comfortable with medical decision-making (p&lt; 0.001) and 6% higher odds of having ACP discussions (p&lt; 0.05). Higher rates of HCST–race was associated with 8% lower odds of being very comfortable with medical decision-making (p&lt; 0.05) and 10% higher odds of having ACP discussions (p&lt; 0.001), 7% higher odds of having completed a living will (p&lt; 0.05), and 10% higher odds of having designated a healthcare proxy (p&lt; 0.001). Findings demonstrate that HCST may negatively impact comfort in healthcare decision-making while also potentially motivating older SM adults to formally engage in ACP. Research is needed to investigate the barriers and challenges to engaging in ACP among older SM adults and interventions to reduce HCST.
DISASTER AND EMERGENCY SUPPORT NETWORKS OF FAMILIES PROVIDING CARE TO PERSONS LIVING WITH DEMENTIA
Authors: Ashida Sato , Lynn Freda , Donohoe Maria , Killian Emily 
Published: January 2025

Abstract
Persons living with dementia (PLWD) and their caregivers are especially vulnerable in disaster situations. Research describes the composition and function of caregiving support networks, but not how these networks support families in terms of disaster preparedness. Currently, a study is underway to investigate disaster and emergency support networks and caregiver resilience. The baseline data collected thus far show that caregivers (N=59) identified 633 support members in total (M=10.4 members per respondent) via four prompts: family members important to PLWD (25%), others important to PLWD (37%), others important to themselves (25%), and additional members who would support them in disaster situations (12%). Of all named members, respondents identified 44% (M=4.5 members per respondent) as those who would provide assistance in emergency situations. However, respondents shared emergency preparedness information with only 9% (M=1 member) and discussed disaster plans with only 16% (M=1.7 members). Respondents’ perceived preparedness to provide care in general was higher compared to their perceived preparedness to provide care in emergency situations (p&lt;.001 for difference in means). Respondents with a greater number of assistance providers in their network reported higher caregiving preparedness in disaster situations (b=0.09, p=0.02) but not higher caregiving preparedness in general. Results suggest that caregivers may mobilize their support networks differently in the context of general caregiving versus caregiving in emergency situations. Efforts to increase discussions about disaster preparedness and management plans with support network members will be beneficial. Future research should focus on identifying strategies to strengthen caregiving support networks to be resilient in disaster situations.
AGE DISPARITIES IN EXPOSURE TO HEAT WAVES, EXTREME WEATHER, AND WILDFIRES IN A NATIONAL UNITED STATES SAMPLE
Authors: Wong Roger 
Published: January 2025

Abstract
Severe climate events have become increasingly frequent. Extensive research has shown that older adults are more adversely impacted by these climate events, often due to more prevalent health conditions contributing to functional impairment. There is, however, no existing research that has examined whether age disparities may exist across exposures to different types of climate events, especially with a national sample. To address this gap, the 2022 American Trends Panel data were analyzed to examine age group differences in exposure to heat waves, extreme weather (flood or intense storm), and wildfires in a nationally representative U.S. sample of 10,282 adults aged 18 and older. In a multiple logistic regression model, adults aged 65+ had 42% significantly lower odds of exposure to heat waves compared to adults aged 18-29 (adjusted odds ratio [aOR]=0.58, 95% CI=0.45-0.76, p&lt;.001), after applying survey sampling weights and adjusting for a variety of sociodemographic covariates. For extreme weather exposure, adults aged 65+ had 44% significantly lower odds compared to adults aged 18-29 (aOR=0.56, 95% CI=0.43-0.72, p&lt;.001). The odds of wildfire exposure was 45% significantly lower among adults aged 65+ compared to adults aged 18-29 (aOR=0.55, 95% CI=0.38-0.79, p&lt;.01). Across all age groups, our results indicate older adults are the least likely to be exposed to climate events related to heat, extreme weather, and wildfire despite the higher strain placed on this populations. Future research is warranted to understand factors contributing to lower climate event exposures, and degree of burden when these different climate events occur among older populations.
A QUALITATIVE STUDY IN COGNITIVE CARE PLANNING: THE ROLE OF FAMILY CAREGIVERS
Authors: Britt Katherine , Xaio Xaviera , Sun Kevin , Ge Shaoqing , Huang Bin 
Published: January 2025

Abstract
Patients with cognitive impairment and dementia may benefit from cognitive care planning, a process of routinely and systematically evaluating patient needs and making lifestyle recommendations (i.e., physical exercise, healthier eating, medication recommendations, and advance care planning). Though dementia is progressive, tailored lifestyle recommendations and planning can improve emotional health, quality of life, and resource utilization to alleviate the disease burden. However, cognitive care planning is underutilized, and barriers to optimizing the process remain. We conducted a qualitative descriptive study with family care providers (N=9) who provide care for older adults, including patients with cognitive impairment and dementia, to explore the role of family caregivers in cognitive care planning with patients. Conventional content analysis was used. Several facilitators and barriers around family caregivers in cognitive care planning implementation were identified across four categories: uncertainty, burden, absence, and priority. Family caregivers were often older, experiencing their own health challenges, and uncertain how to get help and navigate the healthcare system. Family and caregivers’ presence during cognitive care planning was reported as a critical facilitator as it’s essential for gathering patient context, documenting changes in daily abilities, and facilitating provider communication. Our study has important implications for stakeholders. Family caregivers indicated education needs for steps to take in cognitive planning when noticing cognitive changes in a loved one. Healthcare systems (i.e., providers, schedulers, clinical staff) need to make provisions for encouraging family companionship in cognitively impaired older adults’ checkups, offering support and resources for navigation.
RECEIVED SOCIAL SUPPORT SATISFACTION MAY INFLUENCE THE PERCEIVED STRESS-COGNITION ASSOCIATION IN BLACK AMERICANS
Authors: Byrd DeAnnah , Coon David , Thorpe, Jr. Roland , Whitfield Keith E 
Published: January 2025

Abstract
Previous research suggests that perceptions of stress shape cognitive health. Social support has been shown to be protective. Yet, it is not clear whether satisfaction with support is also beneficial. The aim of this study was to determine whether perceived stress is associated with cognitive changes over time and if satisfaction with receipt of emotional or instrumental support acts as a moderator in a sample of older Blacks 48 to 95 years of age, who were enrolled in the Baltimore Study of Black Aging—Patterns of Cognitive Aging and interviewed at two time points, approximately 3 years apart (N = 450). Cognition included 5 domains: working memory, processing speed, verbal memory, vocabulary, and inductive reasoning. Social support satisfaction was measured by asking participants “How satisfied are you with the emotional or instrumental support that you get from your family and friends in terms of how they make you feel and how much it helps you?” Results from the linear regression model showed no direct effect of stress on cognitive decline. Satisfaction with instrumental support marginally (p &lt;.10) modified the relationship between stress and working memory at follow-up but was not related to any other cognitive domains, adjusting for age, sex, education, depressive symptoms, comorbidities, and baseline cognition. Findings demonstrate the joint effects of stress and social support satisfaction on cognition, highlighting the need for more research documenting protective factors for domain-specific cognitive decline. This approach provides a basis for developing cognitive interventions and support networks for this population of Black Americans.
EMERGENCY PREPAREDNESS COMMUNICATION PREFERENCES OF OLDER IMMIGRANTS AND REFUGEES
Authors: Dabelko-Schoeny Holly , Rao Smitha , Sheldon Marisa , Traver Anthony , Doherty Fiona , Acharya Jhuma 
Published: January 2025

Abstract
Older immigrants and refugees in the U.S. face unique challenges with transportation, service access, and social integration, all critical risk factors for negative outcomes from extreme weather. This study aimed to: (1) Identify where older immigrants and refugees get information about weather-related emergencies; (2) Explore the role trusted information sources play in weather-related emergency-preparedness; and (3) Understand what supports older immigrants and refugees need to prepare for weather-related emergencies. Eleven focus groups were conducted (in English, Nepali, Tigrinya, Kinyarwanda, Somali, Amharic, Mandarin Chinese, Russian, and Khmer) with adults aged 62 and older (N = 56) in a large metropolitan Midwestern U.S. city. Most participants were immigrants and refugees, had annual incomes below $15,000, and lived alone. Preliminary analyses reveal television, radio, phone alerts, and school notifications were predominant information sources. Participants emphasized the importance of receiving communication in their native language, translation services, and simple visuals conveying preparedness information. Participants stressed the importance of reliable information sources and personal judgment in determining information trustworthiness. When asked about motivation to prepare for extreme weather, participants underscored the desire to avoid getting hurt or sick. Specifically, participants identified the need for better access to air quality information during pollution events. Participants suggested the government provide safe spaces for those without secure homes. Participants also emphasized the importance of home visits to address isolation and assistance with medication pick-up during emergencies. Findings lend insights into unique communication needs and priorities among older refugees and immigrants related to increasing extreme weather events.
SOCIOECONOMIC STATUS AND COGNITIVE DIFFICULTY: DIMINISHED RETURNS AMONG OLDER BHUTANESE REFUGEES IN THE US
Authors: Kitchens Katherine , Kirsch Jaclyn 
Published: January 2025

Abstract
Refugee populations report cognitive difficulties at a rate significantly higher than observed among older immigrants and native-born U.S. adults. There is evidence that socioeconomic status acts as a buffer against mild cognitive impairment. This study aimed to examine how socioeconomic status is differentially associated with cognitive difficulties between older Bhutanese refugees and other refugee groups in the United States (N = 5,666), using the 2021 American Community Survey five-year estimates and the official refugee counts from the Department of Homeland Security. Binary logistic regression analyses examined the moderating effect of Bhutanese refugee status on the association of income level and high school completion with self-reported cognitive difficulty, controlling for demographic and integration variables. High school completion was associated with a 43% decrease in the odds of cognitive difficulty among older refugees (AOR = 0.57, p&lt;.001, 95% CI [0.43,0.75]), yet educational attainment was not a significant protective factor for older Bhutanese refugees, who had almost three times the odds of experiencing a cognitive difficulty compared to other refugee groups (AOR = 2.86, p&lt;.001, 95% CI [1.86,4.40]). Interactions with income level indicated that living above 138% of the federal poverty level significantly increased the odds of reporting a cognitive difficulty (AOR = 2.86, p&lt;.001 95% CI [1.86,4.40], suggesting that higher income does not serve as a protective factor against cognitive difficulty for older refugees from Bhutan, giving evidence of diminished returns. Findings suggest a need for policies that enable Bhutanese refugees to convert their resources more effectively into concrete cognitive health outcomes.
FACES OF FORTITUDE: DIVERSE CAREGIVERS PROVIDING COMPLEX CARE
Authors: Young Heather , Bell Janice , Kelly Kathleen 
Published: January 2025

Abstract
Last year, more than 56 million family caregivers provided unpaid care to a family member, a number that will grow along population aging and increased prevalence of chronic and serious illness. The demands, resources and outcomes of family caregiving are shaped by the social and environmental context and the particular demands associated with the condition of the care recipient. In 2021, California adopted a Master Plan on Aging, including two investments to strengthen community-based supports for caregivers: Improving caregiver resource centers and adult day programs. This mixed method symposium highlights the fortitude of family caregivers and community-based organizations. We focus on specific health conditions in understudied family caregiver populations as well as the interface with formal services. The first paper examines experiences of caregiving and home care among caregivers of persons with Amyotrophic Lateral Sclerosis. The second paper compares caregiving activities and outcomes among caregivers of individuals with Parkinson’s Disease/Lewy Body Dementia to those with Alzheimer’s Disease and related dementia and other chronic conditions. The third paper examines building family capacity through family and nurse collaboration during acute illness. The fourth presentation describes the impact of adult day care services from the perspectives of family caregivers of persons with dementia. The final presentation, using a large statewide database, describes caregiving demands, unmet needs and resource gaps of diverse family caregivers to inform a caregiving equity plan for the State of California. Together, these papers reflect complexity, diversity and fortitude in family caregiving.