bluuebunny/crossref_metadata_2025_split huggingface dataset:
ARE UNDERSERVED GROUPS INCLUDED IN AGING RESEARCH? RESULTS ACROSS MANY CLINICAL RESEARCH STUDIES
Authors: Neiberg Rebecca , Leng Xiaoyan , Houston Denise , Miller Michael , Beavers Kristen , Rejeski W Jack , Kritchevsky Stephen , Nicklas Barbara 
Published: January 2025

Abstract
Research can be inherently biased when results cannot be generalized across different subsets of a population that differ from those enrolled in the study. Thus, it is critical to recruit a diverse range of individuals who represent the entire population and who represent the disease or health condition being studied. The purpose of this study was to examine the demographics of 3,454 individuals enrolled in 11 clinical studies conducted from 2002-2023 and supported by the Wake Forest Older Americans Independence Center. Studies included recruited &gt;80 participants and had a minimum age eligibility of 55 years with no upper age exclusion. The total number of individuals phone screened for participation was 19,937. The characteristics of those enrolled were compared to those who were initially screened for participation to assess whether eligibility criteria enabled participants to approximately match the characteristics of those who inquired about participation. The demographics of the screened participants were: Age (mean±SD), 69.8±7.0 yrs; 69% female; 76.4% non-Hispanic white/23.6% black; and 79.3% with at least some college education. The enrolled participants were: Age, 69.8±6.6 yrs; 64% female; 76.1% non-Hispanic white/23.9% black; and 80.5% with some college education. The age distribution of those screened ranged from 23-98 years with 43.7% being &gt;70 yrs, 19.9%&gt; 75 yrs, and 6.8%&gt; 80 yrs while the distribution of those enrolled ranged from 55-92 years with 45.2% being &gt;70 yrs, 20.7%&gt; 75 yrs, and 7.6%&gt; 80 yrs. Further analyses will compare these demographics to those of the 5 counties surrounding the research center.
ADVOCATING FOR AN AGE-INCLUSIVE WORKFORCE AND WORKSPACES: THE COLORADO EXPERIENCE
Authors: Waterhouse Jodi 
Published: January 2025

Abstract
This session will focus on the advocacy work that is required at the state level to ensure that older adult worker rights are protected, both as they are looking for meaningful work with a livable wage or once in the workplace. We will describe a step-by-step process to advocate for and successfully implement policies to promote an age-inclusive workforce in Colorado – a state with one of the fastest-growing older adult populations and one of the most robust age-friendly community movements in the US. To help drive change within our state, we started by building community consortiums focused on education, advocacy, and sponsoring legislation to address identified workforce needs and opportunities. We will highlight the importance of a comprehensive needs assessment process in which community consortiums engaged as the basis for their advocacy work. Examples of consortiums, created by the Colorado Governor’s Office, will be shared as a model for symposium participants to create similar working groups to engage key constituents in their own states. We will also share our experience of crafting bills and seeing them through the legislative process, highlighting bills that we have sponsored and that have been passed in Colorado. Attendees will leave this session with more insights about how to work with their state’s elected officials to drive more support for an age-inclusive workforce and workplaces.
RESTORING GLUTATHIONE HAS BENEFITS FOR OLDER ADULTS AND MICE
Authors: Taffet George 
Published: January 2025

Abstract
The role and importance of mitochondrial function and glutathione is not well recognized by clinicians Glutathione is the most abundant intracellular anti-oxidant and is responsible for detoxifying many reactive, potentially harmful molecules and is most older adults are glutathione deficient because of low free Cysteine and especially Glycine. Supplementation with Glycine and N-Acetyl Cysteine is able to restore cellular glutathione. This symposium will fill these gaps by providing knowledge about glutathione, its role in defending anti-oxidant status, the deficient precursors, and the results when glutathione is restored by providing the precursors and the potential sex differences in these effects.
GLYNAC AND THE AGING MOUSE HEART: SEX-RELATED DIFFERENCES AND OUTCOMES
Authors: Cieslik Katarzyna , Angellini Aude , Marquez Grecia Garcia , Fiorotto Marta , Taffet George 
Published: January 2025

Abstract
Aging is associated with increased reactive oxygen species (ROS) resulting from an imbalance in antioxidant defenses and a rise in proinflammatory milieu. Glutathione (GSH) is a naturally occurring antioxidant which concentration is reduced in aging. Studying hearts of 21 month old male and female mice, we found that the enzymes of the GSH pathway synthesis were not downregulated however, supplementing a diet with GSH precursors (termed GlyNAC) for 3 months, improved cardiac diastolic function (measured longitudinally) and exercise performance in males. A much smaller GlyNAC effect on cardiac function and exercise was seen in females. Unbiased cardiac proteome mass spectrometry (MS) analysis validated by protein expression and functional assays demonstrated that a GlyNAC-supplemented diet led to an increase of Ndufb8 expression (a subunit of the mitochondrial respiratory chain complex), and higher enzymatic activities for CPT1b and CrAT, two carnitine acyltransferases, critical to cardiomyocyte fatty acid metabolism. Crosslinking and expression of fibrillar collagens is directly linked with extracellular matrix (ECM) stiffness, and although diastolic function was improved with GlyNAC, no significant change in fibrillar collagen was detected in the hearts of GlyNAC-fed old males. MS analysis determined that GlyNAC increased fibromodulin (Fmod) expression, which can inhibit collagen fibril formation. In summary, these data suggest that there are phenotypic sex-dimorphism differences in old mice and that these differences may affect the response to pharmacological and diet interventions, including GlyNAC. Furthermore, a simple diet intervention has been proven to ameliorate age-related cardiac diastolic dysfunction in old males.
FINANCIAL HORIZONS: EXAMINING RURAL AND URBAN NURSING HOME FINANCIAL PERFORMANCE
Authors: Orewa Gregory , Ghiasi Akbar , Gupta Shivani , Pradhan Rohit , Weech-Maldonado Robert 
Published: January 2025

Abstract
Rural nursing homes (NH) struggle with financial sustainability due to sparse populations, high costs, and scarce healthcare resources. Urban counterparts face increased operational costs and resource competition, despite larger populations and better infrastructure. Addressing these distinct challenges is essential for the sector’s financial health and strategic relevance. This study examines financial performance differences between rural and urban nursing homes. The study utilized secondary data from 2017 to 2022 from the Medicare Cost Report, LTC Focus, Care Compare, and Area Health Resource File. The data were modeled using hierarchical linear regression controlling for year and state fixed effects. The dependent variable was operating margin, and the independent variable was nursing home location (Rural vs. Urban). Two models were run, the first controlling for organizational factors (size, quality, ownership, occupancy rate, payer mix, and percent minorities) and the second for organizational and environmental factors (population 65 and older, competition, and Medicare Advantage) that may be associated with financial performance. Results suggest that urban nursing homes had significantly higher operating margins compared to rural facilities (β=1.95, p&lt; 0.01) after controlling for organizational factors. After controlling for environmental factors, urban nursing homes still had higher operating margins (β=0.90, p&lt; 0.01) than rural facilities, but to a lesser extent. As such, rural nursing homes have lower financial performance than urban, even after accounting for organizational and environmental differences. To the extent that lower financial performance may affect quality and access to long-term care, policymakers should explore reimbursement strategies to address these financial disparities.
A STATEWIDE PROGRAM FOR SCREENING FOR DEMENTIA IN MEDI-CAL PRIMARY CARE IN CALIFORNIA: DEMENTIA CARE AWARE
Authors: Chodos Anna 
Published: January 2025

Abstract
In California, the Department of Health Care Services (Medi-Cal) expanded benefits for older beneficiaries to include screening for dementia by trained primary providers starting in July 2022. In addition, they created a program to promote this screening and provide the training called Dementia Care Aware. The University of California, San Francisco was awarded the contract to realize this program through the end of September 2024 and brought together 4 other University of California campuses and statewide Alzheimer’s organizations to stand up the program. During the symposium, attendees will hear about the key accomplishments from creating and disseminating this program. These include: the development of the screening approach, called the cognitive health assessment, with state and national experts; the creation of interactive on-line learning and live trainings; success in dissemination to California’s 58 counties and overall uptake among providers and progress to the program’s goals of 4000 trained in two years; and lessons learned. Implementation of dementia screening based on the cognitive health assessment in two public health systems (in San Francisco and Los Angeles) provide evidence of how screening is possible in safety net primary care. Finally, a summary of key challenges will show how common barriers in primary care nationwide can be considered before implementing dementia screening programs.
HOSPITALIZATION-ASSOCIATED FUNCTIONAL DECLINE IN OLDER ADULTS: CLASSIFYING THE RISK USING THE “TIMED UP AND GO” TEST
Authors: Tzemah-Shahar Roy , Gatenio-Hefling Orly , Asraf Kfir , Dilian Omer , Gil Efrat , Agmon Maayan 
Published: January 2025

Abstract
Hospitalization Associated Functional Decline (HAFD) in older adults has been recognized as a major phenomenon with crucial consequences such as slower recovery increased morbidity, and higher mortality; it is linked with reduced mobility levels during hospitalization. To date, there is no objective test that can directly estimate personal risk for HAFD. The aim of this study was to examine the contribution of the Timed Up and Go (TUG) test in predicting HAFD among older adults. We used a cross-sectional study design; a total of 310 older adults (age≥65) hospitalized between December 2018 and August 2020 were included; the Modified Barthel Index was used to assess HAFD; it was administered at admission to evaluate patients’ independence in activities of daily living two weeks prior hospitalization, and at discharge. The TUG test was performed on admission; a cut-score of 12 seconds was used to predict functional decline, while accounting for demographics, length of hospitalization, comorbidity burden (Charlson’s comorbidity index), and Adult Lifestyles and Function Interview (ALFI-MMSE). Participants able to complete the TUG test in less than 12 seconds showed no significant change in the Modified Barthel Index; TUG test completion in 12 seconds and over or inability to complete it was associated with significant reduction in function, defined by a reduction of three points or more in the Modified Barthel Index (a reduction of 4 and 8.8 points respectively). The risk for HAFD is currently underestimated in clinical settings, the TUG test could be used to identify those at risk of HAFD.
MITO-MODULATORY MEDICATION USE AND SKELETAL MUSCLE BIOENERGETICS IN OLDER ADULTS
Authors: Phang Howard , Bergstrom Jaclyn , Atayee Rabia , Hart Laura , Cawthon Peggy , Cummings Steve , Molina Anthony 
Published: January 2025

Abstract
Drug-induced changes in mitochondrial function have been described for many medications, including those commonly prescribed for older adults such as statins, NSAIDs, and metformin; however, the clinical impact of “mito-modulatory medication” use remains unclear. Given the high rate of prescription medication use among older adults, it is imperative to understand the consequences of mito-modulatory medication use. Further, mitochondrial dysfunction in skeletal muscle has been linked to declining physical performance and fitness in older adults, highlighting the importance of understanding how drug-induced mitochondrial modulation impacts skeletal muscle. We sought to assess how mito-modulatory medication use is related to skeletal muscle bioenergetics in older adults using data from the Study of Muscle, Mobility and Aging (SOMMA). We hypothesized that mito-modulatory medication use would be associated with lower skeletal muscle ex vivo (MAX ETS) and in vivo (ATPMax) bioenergetic measures. In unadjusted models, MAX ETS was lower in mito-modulatory medication users (mean= 82.4 [77.7-87.0]) compared to non-users (mean= 92.7 [87.5-97.9]) for men (p=0.0021) but not for women (p&gt;0.05). Similarly, ATP-Max was lower in mito-modulatory medication users (mean= 0.54 [0.50-0.57]) compared to non-users (mean= 0.62 [0.58-0.66]) for men (p=0.0004). Adjustments for potential confounders attenuated some, but not all, of the associations. These results suggest that mito-modulatory medication use is related to lower skeletal muscle bioenergetics in older men but not women. Further investigation will provide greater clarity for the apparent sex differences in the impact of mito-modulatory medication use on muscle bioenergetics.
EFFECT MODIFICATION OF AGE AND SEX BETWEEN AORTIC CALCIFICATION AND MORTALITY IN A COMMUNITY SAMPLE OF OLDER PATIENTS
Authors: Horbal Steven , Leis Aleda , Holcombe Sven , Karvonen-Gutierrez Carrie 
Published: January 2025

Abstract
Abdominal aortic calcification (AAC) is a useful cardiovascular risk assessor in opportunistic screening. As cardiovascular risk changes with increasing age, effective AAC use depends on understanding influential factors on AAC and mortality. This study evaluated modification of age and sex on the relationship between aortic calcification and mortality. This sample includes 6647 Michigan Medicine patients age ≥ 65 years, without cardiovascular disease, and who received an abdominal computed tomography scan between 1999-2022. AAC was elevated if calcification exceeded 19.26% of the aortic wall at the L3 vertebral level. Cox regression was used to assess AAC and mortality (adjusted for body mass index and Charlson Comorbidity Index) and stratified by age group (65-79, 80+ years) and sex. In the sample, 18.3% (n=1219) were 80+ years and the mortality rate was 38.0%. Those with elevated AAC had 99% higher mortality hazard than those with unelevated AAC [HR 1.99 (95% CI 1.66, 2.41)]. A statistically significant interaction was observed between age category, sex, and AAC status. Among patients 80+ years, elevated AAC was protective for mortality [HR 0.79 (95% CI 0.62, 0.98)]. Further, elevated AAC was associated with 35% lower mortality hazard in females age 80+ [HR 0.65 (95% CI 0.46, 0.92)] but was not significant in males age 80+. Important effect modification by age and sex exists on the relationship between AAC and mortality. This suggests the impact of AAC as a risk factor for mortality may decrease with age and be less important in 80+ year old females relative to males.
ADVANCING AFFORDABLE, ACCESSIBLE HEARING CARE FOR OLDER ADULTS: FINDINGS FROM THE HEARS RCT AND ASSOCIATED STUDIES
Authors: Nieman Carrie , Han Hae-Ra , Lin Frank 
Published: January 2025

Abstract
Age-related hearing loss is independently associated with adverse health outcomes, but the use of hearing aids by older adults is low and disparities exist. The incorporation of community health worker (CHW)-partnered models can reduce barriers and address disparities. The HEARS (Hearing health Equity through Accessible Research & Solutions) intervention is a hearing care intervention delivered by CHWs that incorporates a low-cost amplification device and education on age-related hearing loss. The efficacy of the HEARS intervention was assessed through a randomized controlled trial (RCT) (JAMA, 2022) that demonstrated the intervention significantly improved communication function. The RCT was the first of a CHW-delivered hearing care intervention designed for older adults that included provision of amplification. As a community-engaged trial, the trial was also one of the largest hearing-related trials in the U.S. of African American older adults and low-income older adults with hearing loss and provides a unique opportunity to advance understanding of hearing care among communities not traditionally represented within research. This symposium presents secondary analyses from the HEARS RCT that inform the continued expansion of hearing care, including among individuals with cognitive impairment and those with limited technology use. The symposium also shares findings from community-engaged hearing screening efforts (K-HEARS Screen) in partnership with Korean American ethnic churches and provides the first estimates of hearing health behaviors among older Korean Americans. Together, the symposium shares lessons in partnering with CHWs and community organizations to optimize the development and testing of interventions to advance hearing health equity across diverse communities.
PRIOR TECHNOLOGY USE AND INTERVENTION OUTCOMES: INSIGHTS FROM A HEARING CARE TRIAL WITH AMPLIFICATION DEVICES
Authors: Suen Jonathan , Wang Ethan , Betz Joshua , Morales Emmanuel Garcia , Trumbo Jami , Marrone Nicole , Han Hae-Ra , Nieman Carrie 
Published: January 2025

Abstract
The total number of older adults in the U.S. with clinically significant hearing loss is projected to grow by an estimated 70% by the year 2060. Nevertheless, the adoption of hearing care strategies such as amplification technologies remains low nationally. Evidence of population disparities in accessing respective care along with adverse health outcomes linked to untreated hearing loss are also increasing, warranting a public health response. The Hearing health Equity through Accessible Research and Solutions (HEARS) intervention offers a novel care model leveraging OTC technologies for community-dwelling older adults with hearing loss and low income. A secondary analysis of data from a community-based RCT investigated the effect modification of self-reported prior use of technologies such as smartphones and computers on intervention outcomes across 151 participants. Participants classified as “tech-connected” showed a -14.1 point decrease (95% CI: -17.6, -9.9) on a standardized measure of hearing-related communication impairments when compared to a control group while “not tech-connected” participants demonstrated a -12.5 point decrease (95% CI: -16.2, -5.2), with a greater decrease indicating more favorable outcomes. The estimated difference in treatment effects of -1.55 points (95% CI: -7.8, 4.1) however was not statistically significant, revealing that prior technology use did not modify intervention outcomes among the RCT’s cohort. Nonetheless, technology literacy remains an important factor for hearing care intervention research to consider when designing outreach to underserved older populations. Key considerations related to prior technology use will be outlined and described for programs reliant upon OTC amplification technologies in addressing age-related hearing loss.
K-HEARS SCREEN: ETHNIC CHURCH-BASED HEARING SCREENING FOR KOREAN IMMIGRANT OLDER ADULTS IN THE UNITED STATES
Authors: Han Hae-Ra , Betz Joshua , Kwak Jacqueline , Park Joanne , Trumbo Jami , Nieman Carrie 
Published: January 2025

Abstract
Age-related hearing loss is highly prevalent in the United States (US), yet there is limited information on the magnitude of hearing loss in certain racial/ethnic minority groups, particularly those with limited English proficiency, due, in large part, to limited accessibility to hearing screening programs and national cohorts of older adults primarily focused on English-proficient communities. Older Korean Americans (KAs)—one of the fastest-growing aging populations in the US—are predominantly monolingual first-generation immigrants. We investigated the prevalence of hearing loss in community-dwelling KA older adults (60+ years) residing in the Baltimore-Washington metropolitan area. Faith-based organizations, such as ethnic churches, serve as epicenters for health promotion activities across diverse immigrant communities. To this end, we mobilized 18 Korean ethnic churches in the target area and screened 514 older KAs (mean=72.6 years, 61.5% women, 54.1% &lt;$50K annual household income, and 97.8% limited English). We found that more than half (55.4% or n=285) had a clinically significant hearing loss and 56% of individuals reported never having their hearing screened. Of those with hearing loss, 61% had a mild degree of hearing loss and 39% with moderate or greater degree of hearing loss. Despite the high rates of hearing loss, prevalence of current hearing aid use was low (12%), similar to findings in other under-resourced communities. To the authors’ knowledge, these findings represent the first estimates regarding hearing health among older KAs. Our findings suggest the urgent need for addressing hearing care disparities in this linguistically and socially disadvantaged group of immigrant older adults.
COMMUNITY-ENGAGED RECRUITMENT IN PARTNERSHIP WITH FAITH-BASED ORGANIZATIONS: FINDINGS FROM K-HEARS SCREEN
Authors: Trumbo Jami , Betz Joshua , Kwak Jacqueline , Park Joanne , Nieman Carrie , Han Hae-Ra 
Published: January 2025

Abstract
Hearing loss is highly prevalent, yet few older adults use hearing aids and disparities based on race, ethnicity, and socioeconomic position exist. With limitations in nationally representative data, little is known regarding the hearing health of older Asian Americans, much less among specific ethnic communities. Older Korean Americans (KAs) are predominantly monolingual first-generation immigrants and have some of the highest rates of poverty among Asian Americans as well as high rates of limited English proficiency and poor health literacy, which may contribute to hearing care disparities. The prevalence of hearing loss and hearing aid use among older KAs is not well understood. An observational study was conducted to recruit participants aged 60 and older from KA churches in a metropolitan area to examine the prevalence of hearing loss and hearing care behaviors. A total of 34 recruitment events occurred over 7 months in 16 Korean churches in the Maryland, DC, and Virginia metropolitan area. Screenings occurred in churches of varying congregation size. At least 2 staff members were present at every event (2-4 hour duration). The recruitment efforts resulted in screening 514 KA participants. 13 staff members contributed 414 hours, equating to 0.8 hours of staff effort per individual screened. The KHEARS Screening study represents one of the largest cohorts of KA older adults with hearing loss. Community-engaged research, partnered with faith-based organizations, may offer critical approaches to increasing representation within hearing-related trials and, ultimately, the development of interventions responsive to the needs of a wider population of older adults.