bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEMENTIA AND LONG-RUN CHANGES IN FINANCIAL HEALTH AMONG US HOUSEHOLDS
Authors: Li Jing , Kelley Amy , McGarry Kathleen , Nicholas Lauren , Skinner Jonathan 
Published: January 2025

Abstract
We use two decades of the U.S. Health and Retirement Study data to compare long-run trajectories in household finances between individuals who eventually developed dementia and those who did not. In prior work, we find large and steady divergence in household wealth that starts 6-8 years prior to dementia onset. In the current paper, we investigate several possible hypotheses for these changes. By examining detailed categories of household income and spending, we find that long-run divergence in wealth between dementia and non-dementia groups are not explained by higher out-of-pocket healthcare expenses or intentional “spend-down” to qualify for Medicare coverage of nursing home residence. Rather, our findings suggest that they are driven by earlier exit from the labor force and potentially suboptimal investment decisions, which negatively affect long-term income in multiple areas among the dementia cohort relative to their counterparts. We also find that these patterns are more prominent among individuals with higher socioeconomic status.
ADVANCEMENTS IN FRAILTY INTERVENTION RESEARCH: CURRENT TRENDS AND FUTURE DIRECTIONS
Authors: Xue Qian-Li , Xue Qian-Li 
Published: January 2025

Abstract
Frailty, a complex, syndromic condition primarily affecting older adults, faces a lack of evidence-based management strategies due to scarce randomized controlled trials. So far, frailty interventions have employed a spectrum of strategies, including health behavior interventions (e.g., diet and exercise), pharmacological interventions targeting specific biological pathways, and personalized geriatric care models. However, the field faces significant challenges that hinder its progress. A notable issue is that there is a noticeable lack of comprehensive management strategies for frailty patients, supported by robust evidence. Moreover, trials examining the impact of physical activity and dietary interventions have largely focused on the clinical manifestations of frailty (e.g., strength) with little evidence of addressing its biological underpinnings. Further complicating these issues is the inconsistent validation of research findings across various studies and demographic groups, casting doubt on their broader relevance and efficacy. The symposium presents four talks: the first evaluates a values-based digital literacy intervention for prefrail and frail individuals with chronic disease; the next two discuss integrating technologies, including sensors with AI and voice-activated devices, for in-home frailty monitoring and intervention; the fourth considers mind-body practices’ (e.g., yoga and tai chi) potential to influence frailty’s biological underpinnings. Collectively, this symposium aims to: (a) differentiate between interventions tailored specifically to address frailty as a unique clinical entity and interventions aimed at improving care for frail older adults; (b) explore innovative approaches for tailoring frailty interventions to patient-specific goals; (c) tackle the inherent research and implementation challenges in frailty care.
EMPOWERING FRAIL OLDER ADULTS THROUGH DIGITAL LITERACY: A THEORY AND VALUES-BASED INTERVENTION
Authors: Hladek Melissa , Rubio Olivia , Curriero Samantha , Crews Deidra , DeMarco Mara McAdams , Brennan Daniel , Xue Qian-Li , Szanton Sarah 
Published: January 2025

Abstract
Frailty is an age-associated syndrome heightening vulnerability to stressors. Mobility limitations common among individuals with frailty can impede access to physical resources and can lead to social isolation, detrimentally affecting mental and physical health. Digital literacy offers access to health information access, assistive and remote monitoring technologies and social engagement. Each are vital for people with frailty because they can enhance independence, cognition and quality of life. Despite the potential of digital literacy, internet access and digital health resources remain underutilized with older adults, especially among older adults with lower incomes and education levels. We designed a theory and values-based person-directed intervention to address digital literacy for older adults, aiming to recognize and leverage the motivational factors driving their desire to learn new skills. This is a 20 person one-arm feasibility and acceptability pilot trial enrolling participants with varying levels of frailty and digital literacy. The study is comprised of 4-6 in-home biweekly visits over the course of 8-12 weeks that use the older adults’ own values and goals to co-develop action plans that matter to the participant with the primary outcome of improvements in digital literacy. We hypothesize creating a digital literacy intervention that is person-directed will be feasible and acceptable to older adults and will lead to improvements in digital literacy, self-efficacy and quality of life.
AGING IN LONG-TERM CARE FACILITIES IN BRAZIL: NEW CHALLENGES FOR INSTITUTIONAL ENVIRONMENTS
Authors: Tomasini Sergio Luiz 
Published: January 2025

Abstract
This contribution sheds light on the planning of outdoor spaces within Long-Term Care Facilities (LTCFs) for older person as a means to enhance the quality of life for their residents. It presents one of the few empirical studies conducted on this topic in Brazil to date. The study follows an action research approach, focusing on the participatory design of a garden for a LTCF situated in the southern region of the country. The project unfolded in three stages: 1) Initial interviews were conducted with residents to explore their utilization of the institution’s external areas, their past experiences with gardens and their perceptions of the “ideal garden.”. Additionally, systematic observations were made regarding how residents interacted with the open spaces within the LTCF; 2) Subsequent collaborative meetings aimed to actively involve residents in selecting the garden site and defining project requirements; 3) Finally, interviews were held with participating residents to assess the effectiveness of the project methodology. The analysis of these interviews utilized the meaning condensation method, leading to the identification of several themes related to the participatory project approach: a) possibility of creating a territory in the facility; b) opportunity to develop an active role in the facility; c) acquisition of new knowledge; d) promotion of social relations. Overall, the residents’ feedback suggests that employing participatory planning methods can positively impact the adaptive outcomes of older adults in institutional settings.
WHERE DOES EDUCATION COME INTO AGING IN PLACE IN BRAZIL TODAY?
Authors: Kohlrausch Estela , Doll Johannes 
Published: January 2025

Abstract
Environmental Gerontology has involved a wide range of science, but until now, educational aspects are rarely found. In this paper, we argue that educational theory could give important contributions to the understanding and development of the aging person-environment-relation. There are three fundamental contributions: A) In Environmental Gerontology, there is a lot of thinking about adaptation, stimulation, and orientation processes in dealing with changes in the environment or changes in the person during aging process. These processes can be understood as learning processes, and Education Science could contribute by appointing conditions and obstacles for those processes, as for example Peter Jarvis’ existential learning theory for adults. B) Educational theory points out that learning processes happens in social and cultural contexts by social interaction, as Paulo Freire stated: Nobody educates anyone, nobody educates themselves, men (and women) educate each other, mediated by the world. C) Educational processes are intentional, by respecting the other in a dialogical relation. This might be an interesting form for gerontological intervention and is in line with actual discussion about participatory approaches in aging research. Within the major changes in society such as globalization, urbanization, digitalization and climate change, a critical educational perspective, as for example Paulo Freire’s liberation pedagogy can help to understand environment in a broader context, not only to guarantee safety and comfort for older people, but by “reading the world” (Paulo Freire) people can start to get aware of one´s own role within the larger context of community, society and the human world.
CHILDREN’S RESIDENTIAL PROXIMITY, SPOUSAL PRESENCE, AND MODIFIABLE RISK FACTORS FOR DEMENTIA
Authors: Lin Zhuoer , Yin Xuecheng , Levy Becca , Yuan Yue , Chen Xi 
Published: January 2025

Abstract

Objectives
Cognitive impairment poses considerable challenges among older adults, with the role of family support becoming increasingly crucial. This study examines the association of children’s residential proximity and spousal presence with key modifiable risk factors for dementia in cognitively impaired older adults.

Methods
We analyzed 14,731 persons (35,840 person-waves) aged 50 and older with cognitive impairment from the Health and Retirement Study (1995-2018). Family support was categorized by spousal presence and children’s residential proximity. Modifiable risk factors, including smoking, depressive symptoms, and social isolation, were assessed. Associations between family support and the modifiable risk factors were determined using mixed-effects logistic regressions.

Results
A significant proportion of older adults with cognitive impairment lacked access to family support, with either no spouse (47.0%) or all children living over 10 miles away (25.2%). Those with less available family support, characterized by distant-residing children and the absence of a spouse, had a significantly higher prevalence of smoking, depressive symptoms, and social isolation. Moreover, we revealed a consistent gradient in the prevalence of the risk factors by the degree of family support. Relative to older adults with a spouse and co-resident children, those without a spouse and with all children residing further than 10 miles displayed the highest prevalence of the risk factors. These findings were robust to various sensitivity analyses. Conclusions: Family support from spouses and nearby children serves as a protective factor against modifiable dementia risk factors in cognitively impaired older adults. Strengthening family and social support is paramount for this vulnerable population.
COMMUNITY ENGAGEMENT IN DIFFERENT NATIONAL CONTEXTS: BUILDING BRIDGES AND AGE-FRIENDLY ENVIRONMENTS
Authors: Jonsson Oskar , Chi Peggy , Johnson Ian 
Published: January 2025

Abstract
To bridge the gap between research and practice, initiatives to facilitate knowledge mobilization in tandem with community engagement have become increasingly important. This symposium will advance the understanding about knowledge mobilization processes and community engagement efforts by offering insight from scholars from established research centers with long-standing community engagement as well as new initiatives connecting disparate disciplines and sectors. Representing different national contexts, the speakers will share their experiences regarding the complexities of partnership and engagement approaches, processes, and activities. Benefits (research quality, relevance, utilization, transgressing boundaries, addressing complex problems) as well as barriers (diverse conditions/cultures, lack of time/resources, multiple levels of terminology, hard-to-reach groups, projectification, boundaries of traditional science systems) will be addressed. The first speaker will describe the development and establishment of a pool of interested parties in Sweden to systematize and facilitate communication, entryways to research studies, and user involvement in aging research. The second speaker will describe the work of a center serving older African Americans from Detroit, Michigan, including innovative leadership opportunities created for its members. The third speaker will describe new initiatives in the Canadian context that purposefully choreograph knowledge mobilization activities to disrupt disciplinary and industry silos in the practice and research of salutogenic/healthy long-term care environments. The last speaker will describe an engagement effort towards age-friendly infrastructures in rural municipalities in Canada. Finally, discussant Ian Johnson from the University of Texas San Antonio will identify, compare, and discuss underlying themes, commonalities, differences, and lessons learned generated from the presentations.
LEADERS AND CONSULTANTS FROM AN AGING CENTER IN MICHIGAN: PRODUCTIVE AND TAILORED ENGAGEMENT WITH AFRICAN AMERICANS
Authors: Perry Tam , Stringer Wilma , Howell Cynthia , Rorai Vanessa , Horn Amanda , Mitchell Jamie , Key Kent 
Published: January 2025

Abstract
The Healthier Black Elders Center (HBEC) is the community outreach core for the Michigan Center for Urban African American Aging Research. Established in 1997, this center offers health education to older adults in Detroit and expanded to Flint, Michigan in 2021 and maintains a research registry of over 1100 older Detroiters and over 200 older Flint residents. HBEC Detroit launched a consulting program in 2020 with the Community Advisory Board (CAB) members to offer personal and professional perspectives regarding research. Through this program, CAB members have 1) disseminated knowledge about community engaged research approaches 2) offered feedback on comprehensibility and ease of use to individual researchers on instrument content and research design as well as 3) offered insights beyond the academy (technology and philanthropic sectors). This program has created opportunities for older Black adults to provide direct feedback on product, funding initiatives and research design. This presentation will provide an overview of the initiatives, recruitment, and retention strategies of a long-established center. This presentation will showcase the Consulting program as a way to engage leaders in its center’s work as well as provide learning and growth for its Detroit members. This presentation will also highlight the process of tailoring, adapting, and launching the HBEC program for the Flint community.
QUALITATIVE STUDY IDENTIFIES DEMENTIA TRAINING NEEDS OF CARE WORKERS IN ASSISTED LIVING AND PERSONAL CARE AGENCIES
Authors: Andersen Troy , Kaplan Daniel , Foster Norman , Stefanucci Jeanine , Moffitt Chad , Dremann Andrea , Bechek Bonnie 
Published: January 2025

Abstract
Caring for individuals with dementia can be overwhelming, especially when direct care workers lack knowledge and skills to respond to changing needs of those with dementia. Burnout and turnover are common problems. To better understand wishes for dementia training, we interviewed direct care workers, supervisors and administrators in 4 assisted living facilities (ALFs) and personal care agencies (PCAs). Funded by the NIA, we collected data from 23 direct care workers, 7 supervisors, 8 administrators. Questions focused on needs for dementia training topics and solutions for delivering content. Interviews were recorded, transcribed, and evaluated by two independent raters to identify all topics discussed. These topics were then further analyzed by a second group of raters who specialize in training of direct care providers. Commonalities and thematic differences across direct care workers, supervisors, and administrators were reviewed qualitatively to identify highest priorities. For both ALFs and PCAs, priority topics for training overlapped between administrators, supervisors, and direct care workers and included skill development (e.g., de-escalation strategies), knowledge areas (e.g., bathing, distress), and workforce goals (e.g., training certifications). Direct care workers further mentioned that training should be interactive, fit into their work schedules, and give solutions in real time. PCAs added that greater effort is needed to assure that training is relevant (e.g., current topics often are too pedantic and not practical to daily activities). Real-time, flexible, content meeting identified needs, and individualized to caregiving settings, learner knowledge and experience should be the focus of future improvements in dementia training.
STRUCTURAL STRESSORS, PERCEIVED NEIGHBORHOOD CONTEXT, AND COGNITIVE FUNCTION IN BLACK MIDLIFE AND OLDER ADULTS
Authors: Thierry Amy , Tsuchiya Kazumi , Taylor Harry 
Published: January 2025

Abstract
Racial disparities in Alzheimer’s disease and related dementias have been established in the US, with higher rates in Black compared to White older adults. Because Black populations are disproportionately exposed to greater neighborhood disadvantage, chronic stress via the neighborhood context may contribute to worse cognitive health among Black older adults. However, the role of neighborhood-based stressors on cognitive function within the Black population is less understood. This study aims to examine how lifetime exposure to structural stressors (e.g., discrimination in housing, unemployment, and policing) and current perceived neighborhood stressors (e.g., high disorder and social discohesion) independently and interactively are associated with cognitive function in Black adults &gt;50 years of age (n=1,663) using 2010-2016 Health and Retirement Study data. Linear regression models tested associations between structural stressors, perceived neighborhood stressors, and interaction terms of total number of structural stressors, neighborhood disorder (including safety and cleanliness), and social discohesion with cognitive function measured using the Langa-Weir 27-point scale. Black adults reported exposure to structural stressors as 15.69% in policing, 14.25% in hiring, and 7.88% in housing. In unadjusted models, greater total structural stressors were associated with greater cognitive function, while worse ratings of social cohesion, safety and cleanliness were associated with lower cognitive function. A statistically significant interaction term (b= -.221, SE=0.10, p&lt;0.05) indicated that high social discohesion and greater total structural stressors was associated with lower cognitive function. Thus, life course exposure to multiple domains of neighborhood-based stressors may be important for Black adults’ cognitive function in later life.
SELF-REPORTED EVERYDAY DISCRIMINATION AND CARDIOMETABOLIC RISK IN OLDER BLACK AND WHITE ADULTS
Authors: Cobb Ryon 
Published: January 2025

Abstract
This study investigates the relationship between self-reported instances of everyday discrimination and cardiometabolic risk among older, focusing on potential variations by racial classification. This analysis draws on a subsample of older Black and White respondents from the 2010/2012 Health and Retirement Study (N=8,924), a biennial nationally representative survey of older adults across the United States. Cardiometabolic risk is assessed using a count of high-risk cardiometabolic biomarkers while we self-reported everyday discrimination and racial identification. We included an interaction term (self-reported everyday discrimination x race) to test whether the relationship between everyday discrimination and cardiometabolic risk varied by racial classification. We used negative binomial regression to estimate incidence rate ratios (IRRs) and corresponding 95% confidence intervals (CI) of self-reported everyday discrimination, racial classification, and cardiometabolic risk, controlling for potential confounders. Respondents with higher levels of self-reported everyday discrimination scores had higher levels of cardiometabolic risk after adjusting for demographic characteristics (IRR: 1.08, 95% C.I. 1.05-1.11), and while attenuated, remained significant (IRR: 1.08, 95% C.I. 1.01-1.07) after further adjustments for smoking status, physical activity, alcohol consumption, educational attainment, and household wealth. The relationship between self-reported instances of everyday discrimination and cardiometabolic risk was significantly weaker for older Black adults than their White counterparts. The present study confirms that self-reported instances of everyday discrimination are a psychosocial factor associated with higher levels of cardiometabolic risk among older adults; this association is especially pronounced among older White adults. Future studies among this population must examine whether the relationship changes over time.
MIDLIFE CHRONIC STRESS, PHYSIOLOGICAL DYSREGULATION, AND COGNITION: A LONGITUDINAL MEDIATION ANALYSIS
Authors: Mitchell Uchechi 
Published: January 2025

Abstract
The current study investigates how exposure to chronic stressors during mid-life indirectly affects cognitive function through changes in physiological dysregulation. Data come from 4,684 adults ages 51-64 at baseline who participated in the Health and Retirement Study between 2006 and 2018. Mid-life stressors include experiences of everyday discrimination and financial strain, both of which were assessed at baseline only. Physiological dysregulation was assessed as a count of high-risk inflammatory, cardiovascular, and metabolic biomarkers and was assessed every four years. Cognitive function assessed every two years using a modified version of the TICS. A longitudinal mediation analysis was conducted using R and MPLUS. Unadjusted analyses showed that cognitive function decreased over time, while physiological dysregulation significantly increased. The indirect effects of financial strain on cognitive decline were mediated by baseline dysregulation levels and increases in physiological dysregulation over time. On the other hand, the effect of everyday discrimination on cognitive decline was only mediated by its effect on baseline physiological dysregulation. These findings suggest that 1) physiologic vulnerability to financial strain and everyday discrimination may be more salient earlier in the life course setting the stage for changes in cognition later in life, and 2) financial strain in mid-life continues to adversely affect physiological functioning and cognition over time. That said, adjusting for age, gender, race/ethnicity and education fully accounted for the significant direct and indirect effects of financial strain and discrimination on changes in cognition, suggesting a more complex and nuanced relationship between chronic stress, physiological function and cognition.