bluuebunny/crossref_metadata_2025_split huggingface dataset:
CALLING OUT AGEISM: HOW INTERSECTING IDENTITIES AND CONFRONTATION TONE AFFECT PERCEPTIONS OF OLDER CONFRONTERS
Authors: Gans Hannah , Chasteen Alison , Horhota Michelle 
Published: January 2025

Abstract
The few studies that have examined confrontations of ageism have shown that older adults are viewed differently after challenging the behavior. What remains unclear is how older people’s intersecting identities, as well as their confrontation tone, might influence reactions to their countering ageism. To address this question, we surveyed 500 young and older adults regarding their perceptions of warmth and competence towards older adult confronters who varied by race (Black, White) and gender (man, woman). Participants evaluated the older individuals both before and after they either moderately or strongly confronted an ageist backhanded compliment (“You don’t look that old”). The older confronter’s race and their response to the ageist comment moderated how they were perceived by participants. Specifically, both young and older adult participants rated older Black confronters as warmer when they used a moderate compared to a strong confrontation tone but did not make that distinction for White confronters. However, when the tone of the confrontation was not considered, young, and older participants generally differed in their perceptions of confronters. Older adult participants rated White confronters lower on warmth and competence after confronting compared to Black confronters. This pattern was not observed among young adult participants, underscoring the significance of intersectional identities in shaping perceptions among older adult perceivers. This study shows that older adult confronters’ intersecting identities influence how they are perceived when they challenge ageist comments. This suggests that customized confrontation techniques may be needed for older adults whose gender and racial identities vary.
LIMITATIONS OF POLYGENIC RISK SCORES FOR DEMENTIA IN FAMILIAL EXCEPTIONAL AGING: IMPACT OF SAMPLING
Authors: Xicota Laura , Cheng Rong , Rodriguez Sandra Barral , Honig Lawrence , Lee Joseph 
Published: January 2025

Abstract
Genetic risk factors for late-onset Alzheimer’s disease (LOAD) have been extensively studied in the general population of European background. Indeed, significant genetic variants with low to moderate contributions to LOAD have been used to calculate Polygenic Risk Scores (PRS) to identify individuals with a higher genetic risk of LOAD. The Long Life Family Study (LLFS) is characterized by having exceptionally long-lived individuals at lower risk of LOAD. With this study, we will uncover whether the described genetic risk factors for LOAD impact AD risk in LLFS, limited to US sites. In LLFS, PRS based on two large GWASs in the general population did not predict clinical AD status. The LLFS population did not have lower allele frequencies of risk alleles, but rather lacked putative effects in these risk alleles, with only 6.7% of SNPs from GWAS 1 and 7.7% from GWAS 2 were associated with AD. We then examine the relations between PRS and endophenotype, namely AD biomarkers (Aβ40, Aβ42, Aβ42/Aβ40, NfL, and GFAP). Levels of AD biomarkers were not positively associated with PRS, which can be explained by the low frequencies of SNPs associated with biomarker concentrations (3.3%-6.7% for GWAS 1; 2.6%-6.5% for GWAS 2). Here, we show that genetic risk factors for AD in the general population do not necessarily explain AD risk in a cohort of long-lived individuals; therefore, genetic risk factors based on large-scale GWASs ascertained from the general population need to be examined with caution when applied to a cohort ascertained for exceptional longevity.
BEST PROGRAMS FOR CAREGIVING: NEW PUBLIC VERSION FOR FAMILY AND FRIEND CAREGIVERS
Authors: Cannon Rachel 
Published: January 2025

Abstract
A new public version of Best Programs for Caregiving (BPC) launched in 2024 for family and friend caregivers to find and compare evidence-based, dementia caregiving programs available to them in their communities. Over 200 organizations were verified to be delivering one or more of the 47 programs in BPC. Data collected from surveys of developers of BPC programs and the organizations delivering BPC programs were used to understand the reach and characteristics of programs being delivered to caregivers, including information on how caregivers can enroll, types of help and support provided, cost and eligibility requirements, how they are delivered, and adaptations made for diverse communities. Survey results suggest there are more BPC programs available, and these programs have wider reach, than expected, with 25 programs offered to caregivers living anywhere in the US via remote delivery. Additionally, nearly one-fourth of programs (23.2%) were adapted for diverse communities. Along with demonstrating the new version of BPC for caregivers, discussion focuses on how caregivers can use BPC to find programs available to them, challenges encountered with verifying delivery organizations, the importance of developing culturally adapted programs, and how BPC can be used by healthcare systems, medical providers, and community organizations to strengthen implementations of comprehensive dementia care required by the Center for Medicare and Medicaid Innovation’s new payment model “Guiding an Improved Dementia Experience” (GUIDE Model).
SOCIAL RESOURCES ARE ASSOCIATED WITH COGNITIVE FUNCTION ACROSS BLACK AND WHITE OLDER ADULTS AND NEIGHBORHOOD TYPES
Authors: Sol Ketlyne , Antonucci Toni , Clarke Philippa , Zahodne Laura 
Published: January 2025

Abstract
Few studies examine neighborhood resources in healthy cognitive aging despite evidence that living in neighborhoods with lower socioeconomic status (NSES) is associated with increased risk for Alzheimer’s Disease and Related Diseases (ADRD) with persistent race disparities in ADRD and NSES. Fewer studies examine which social resources buffer against the detrimental effects of living in lower-resourced neighborhoods. In this cross-sectional study, multiple linear regressions examined associations between structural and functional social resources and cognition stratified by intersectional groups of participant self-reported race and neighborhood type. Participants were drawn from the Michigan Cognitive Aging Project, a longitudinal epidemiological study of cognitive aging in southeastern Michigan (Mage=64). Global cognition was a composite of five comprehensively-assessed cognitive domains. Participant addresses were linked to year 2017 measures of neighborhood resources from the National Neighborhood Data Archive. Latent class analysis of 2,813 Michigan census tracts identified that most participants lived in tracts characterized as low-resourced (Bn=162=Wn=128) or moderately-resourced (Wn=80&gt;Bn=64). Only among White residents of low-resourced neighborhoods, a larger social network (β=.257, p=.001) was associated with better cognition. Among Black residents of low-resourced neighborhoods, more support in their closest relationship (β=.150, p=.044) was associated with better cognition. Among Black residents of moderately-resourced neighborhoods, more strain from friends (β=-.255, p=.087) was associated with worse cognition. Support from relatives of Black, but not White, residents in both neighborhood types was associated with better cognition. Nuanced, culturally-sensitive interventions may support racially diverse older adults to foster and broaden desired relationships to buffer against adverse cognitive outcomes of neighborhood stressors.
HEALTH CARE COST DIFFERENCES BY GEOGRAPHIC CONTEXT AND DEMENTIA STATUS FOR MEXICANS AND MEXICAN AMERICANS
Authors: Anuarbe Mónika López , Gutierrez Angela 
Published: January 2025

Abstract
Research documents geographic differences in healthcare costs among Latinés living in the U.S. Yet healthcare costs by geographic context and dementia status for Latiné subpopulations residing in different countries, such as Mexicans in the U.S. and in México, have been overlooked. Utilizing pooled cross-sectional and weighted data of Mexicans ages 50+ from the 2012-2015 Mexican Health and Aging Study (n=15,723) and the 2012-2016 Health and Retirement Study (n=5,136), we investigated: 1) Associations between geographic context and healthcare costs; 2) Whether dementia status moderates the geographic context-healthcare costs relationship. We hypothesized that persons with dementia incurred higher healthcare costs in both countries, and that residents in less populated areas had higher healthcare costs. Preliminary findings from our two-part model (logit; GLM), which accounted for personal and healthcare characteristics, propose that persons with dementia in México had 60.3% higher average healthcare costs than individuals without dementia. Respondents with dementia also had higher odds (b=0.12; p=0.04) of incurring any healthcare costs in less densely populated areas (under 15,000 persons). However, their U.S. counterparts with dementia had lower, but insignificant, odds of incurring healthcare costs, with the dementia-rural interaction suggesting that individuals with dementia in areas with at 250,000-1 million persons were less likely to incur healthcare costs compared to areas with at least 1 million inhabitants (p&lt;0.001), and that their healthcare costs were lower (p=0.05).These results underscore how geographical context varies across countries and how dementia status leaves some individuals more financially vulnerable than others, affecting healthcare access and overall health.
STUDY DESIGN OF THE AGING AND COGNITIVE HEALTH EVALUATION IN ELDERS (ACHIEVE) AND ACHIEVE-MRI STUDY
Authors: Huang Alison 
Published: January 2025

Abstract
This presentation describes the study design of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study and the ACHIEVE-MRI sub-study. The ACHIEVE study (n=977) is a multicenter, randomized controlled trial testing the effect of a best-practice hearing intervention vs. health education control on the primary outcome of cognitive decline over 3 years. Participants in the ACHIEVE study were 977 community-dwelling adults aged 70-84 years with untreated hearing loss and without substantial cognitive impairment. The ACHIEVE study was partially nested within the Atherosclerosis Risk in Communities [ARIC] study; participants were recruited from the ARIC study (n=238) and de novo (n=739) from the surrounding communities of four U.S. sites. Participants were randomized 1:1 to hearing intervention or health education control and followed for 3 years. ACHIEVE study participants (n=977) were median age 76.4 years, 53.5% female, 87.8% White, and 53.3% held a Bachelor’s degree or higher. The ACHIEVE-MRI study is a sub-study testing the effects of hearing intervention on 3-year change in brain MRI characteristics and cognitive function with speech-in-noise performance. The ACHIEVE-MRI study included a subset of ACHIEVE study participants (n=445) who received three-dimensional magnetic resonance imaging at baseline and at 3-year follow-up. Participants were slightly younger and had higher income and greater memory function compared to ACHIEVE study participants. The ACHIEVE-MRI study also had a larger proportion of participants recruited de novo (83%). This presentation provides important background for contextualization of ACHIEVE study and ACHIEVE-MRI study findings on brain structure and function and speech-in-noise performance presented in this symposium.
EFFECT OF A HEARING INTERVENTION ON THREE-YEAR CHANGE IN BRAIN MORPHOLOGY: ACHIEVE RANDOMIZED TRIAL
Authors: Pike James 
Published: January 2025

Abstract
Prior studies among older adults have documented associations between hearing loss and changes in brain morphology. Whether interventions involving hearing aids can reduce age-related atrophy is unknown. A substudy within the Aging and Cognitive Health Evaluation in Elders (ACHIEVE, Clinicaltrials.gov Identifier: NCT03243422) randomized controlled trial tested the effect of a best-practices hearing intervention versus health education control on three-year change in cortical thickness among older adults with hearing loss. The study enrolled 977 community-dwelling adults aged 70-84 years at baseline (2018-2019) with untreated hearing loss (better ear pure tone average [0.5-4 kHz] ≥30 and &lt;70 dB HL) and without substantial cognitive impairment. Participants were randomized to a hearing intervention (provision of hearing aids and related technologies, counseling, and education) or a health education control (individual sessions with an educator covering health-related topics). Three-dimensional magnetic resonance imaging was performed on 3 Tesla Siemens scanners in a subsample of 445 participants (50.3% women, 11.7% Black) at the baseline and three-year follow-up. Mixed effects models were used in intention-to-treat analyses to estimate three-year change in cortical thickness. Compared to the health education control, the hearing intervention exhibited a nominally protective effect on three-year change in average cortical thickness. The greatest effect size was observed in the occipital lobe, while the smallest effect size was detected in the temporal lobe. Statistically significant effects were detected in the pars orbitalis, rostral anterior cingulate, posterior cingulate, and isthmus cingulate. The results suggest that a hearing intervention may reduce cortical thinning among older adults.
HEARING AID USE, COGNITIVE MEASURES, AND SPEECH-IN-NOISE PERFORMANCE: FINDINGS FROM THE ACHIEVE STUDY
Authors: Reed Nicholas , Jiang Kening , Huang Alison , Morales Emmanuel Garcia 
Published: January 2025

Abstract
There is a paucity of information on how measures of cognition, brain structure, audition, and sociodemographic (e.g., education) affect changes in speech-in-noise performance, a priority for communication, with hearing aids over time. The ACHIEVE study is a randomized control trial of older adults with hearing loss enrolled to a hearing intervention or health education control over 3-years. Self-report demographic and health measures, social participation, hearing (pure-tone audiometry, Hearing Handicap Inventory for The Elderly[HHIE]), and a cognitive test battery (global and domain-specific [language; memory; executive function]) were collected at baseline. In addition, a subsample completed Magnetic Resonance Imaging (MRI) as part of an ancillary. Speech-in-noise performance (Quick Speech-in-Noise test; scores range 0-30 with higher being better) was measured at baseline without hearing aids and at 2-months and 3-years with hearing aids. Among 220 participants (median age=75.5; 50.9% Female) in the intervention arm, median unaided speech-in-noise scores were 19.0 (IQR=16.0-22.5) at baseline. At ~2-months and 3-years, aided scores were 21.3 (18.0-23.5) and 20.0 (16.0-22.5), respectively. Using linear mixed-effects models, age, education, martial status, social network, depressive symptoms, hypertension, hearing loss, HHIE, global, language domain and executive cognitive domains, temporal lobe volume, white matter hyperintensities, white matter integrity (fractional anisotropy, and mean diffusivity) were associated with baseline speech-in-noise performance. However, 2-month change was only associated with baseline hearing loss (B=0.28;95%CI=0.19-0.36), HHIE (B=0.12;95%CI=0.05-0.18), temporal lobe volume (B=0.93;95%CI=0.40-1.45), white matter hyperintensities (B=1.09;95%CI=0.43-1.76), fractional anisotrophy (B=-0.72;95%CI=-1.40--0.05), and mean diffusivity (B=0.70;95%CI=0.03-1.37) while 3-year change was only associated with baseline hearing (B=0.15;95%CI=0.04-0.26), HHIE (B=0.09;95%CI=0.01-0.19), and fractional anisotrophy (B=-1.14;95%CI=-2.08--0.20).
ENGAGING DEMENTIA CARE PARTNERS IN FALL RISK MANAGEMENT: HEALTH PROFESSIONALS’ PERSPECTIVES
Authors: Zhou Yuanjin , Kilcrease Amanda , Phelan Elizabeth 
Published: January 2025

Abstract
Older people with dementia are at higher risk of falls than those without dementia. Informal care partners are well-positioned to assist them in reducing their fall risk. However, little is known about what support care partners may need to accomplish this. Health professionals with experience working with older people with dementia and their care partners may have important insights. This study thus aimed to characterize barriers for care partners to engage in fall risk management (FRM) from health professionals’ perspectives and identify strategies to overcome these barriers. Using snowball sampling, we conducted semi-structured, qualitative interviews via Zoom with 22 health professionals from six disciplines (geriatric medicine, nursing, occupational therapy, physical therapy, social work, and pharmacy). These health professionals had an average of 22 (range: 5-44) years of clinical experience in dementia care. Thematic analysis identified the following themes related to barriers: care partners’ care burden, a low perceived need for FRM, a tendency to prioritize the preferences of older people, resistance to making changes, disagreement about care arrangement, and challenges accessing needed resources (e.g., food, home safety evaluation, mobility devices). Suggested strategies included addressing care partners’ primary concerns first (e.g., behavioral issues of older people with dementia), assessing care partners’ motivation, existing strategies, and potential support for FRM, linking recommendations to priorities and goals of the dyads, and connecting them with appropriate resources. This study offers new perspectives on challenges dementia care partners may face in managing fall risk. These perspectives warrant further exploration with dementia care partners.
EVIDENCE-BASED FALL PREVENTION TRAINING FOR OLDER ADULTS IN RURAL COMMUNITIES
Authors: Murphy Sara , Crocker Andrew , Luk-Jones Susanna , Lemack Bergen 
Published: January 2025

Abstract
Falls among older adults is a public health issue affecting one-fourth of adults aged 65 and older annually and is a leading cause of unintentional injury death. Nearly 22% of older Texans live in one of the 199 rural counties, many without easy healthcare access. Texas has 71 counties with no hospital access, and only 83 rural counties have hospitals that provide 24/7 emergency care services. In response to these challenges, the University of North Texas Health Science Center Geriatric Workforce Enhancement Program (GWEP) partnered with Texas A&M Agrilife Extension Services (AgriLife) to expand A Matter of Balance (AMOB) fall prevention program for older adults in rural communities throughout Texas. Delivered as eight sessions, AMOB is designed to improve participant confidence, physical activity, and awareness through group activities in exercise, safety, assertiveness training, and problem-solving. Pre and post-surveys were administered to rate participant knowledge and confidence in managing fall-related situations on a scale from 1 (not sure at all) to 4 (absolutely sure). In 2023, AMOB sessions were held in 11 rural communities. Participants (n=182) were predominantly female (90.1%) aged 35 to 96 (average age: 75.88). A paired t-test comparing pre- and post-intervention scores revealed significant enhancements in knowledge about fall prevention strategies, improved ability to protect themselves during falls, enhanced physical strength, steadier balance, and better fall recovery skills. Evidence-based programs, like AMOB can be broadly disseminated to address challenges of falls among older adults at the individual and community level.
COMMUNITY MOBILITY IN OLDER ADULTS RECOVERING FROM DISABILITY IN DISINVESTED NEIGHBORHOODS: A QUALITATIVE STUDY
Authors: Falvey Jason , Mathis Lindsey , Cooper-Williams Jasmine 
Published: January 2025

Abstract
In socioeconomically disadvantaged areas, crumbling infrastructure and perceptions of limited safety can reduce opportunities for older adults to safely get around outside and engage meaningfully in social activities. This study seeks to understand how older adults in disinvested communities meaningfully recover community mobility after disabling injuries, and evaluates how recent payment reforms have challenged individualized rehabilitation delivery in home and outpatient settings. We recruited 13 adults over the age of 55, residing in neighborhoods with an Area Deprivation Index (ADI) of ≥9/10. Participants engaged in one-hour semi-structured interviews, coded by two independent researchers. The reliability between coders was verified using a kappa statistic. Five critical themes describe these mobility experiences: 1) exacerbating impact of chronic diseases and physical limitations on community mobility 2) environmental and infrastructural barriers restricting access to community resources; 3) influence of perceived safety and violent crime on participation in outdoor activities; 4) essential role of social support networks in enhancing mobility and 5) power of individual and community resilience in mitigating mobility challenges. One participant noted: “I never know when they going to start shooting and stuff. So when it start getting dark, I get up pretty early and get out early, try to get my stuff done [before dark].” –a vivid illustration of modifications in mobility forced by the fear of gun violence, complicating the recovery process Our study suggests new care pathways are needed to enhance the support for older adults navigating the challenges of recovery within socioeconomically disadvantaged neighborhoods.
PAYMENT POLICY IMPACT ON HOME HEALTH ACCESS FOR PEOPLE LIVING WITH DEMENTIA
Authors: Knox Sara , Brinton Daniel , Johnson Jada , Simpson Kit 
Published: January 2025

Abstract
Home health has been recommended as a strategy to prevent institutionalizations and promote aging in place for people living with dementia (PLWD). Longer home health episodes have been shown to optimize home health outcomes for PLWD. Recent payment policy reforms threaten the viability of this approach. The Patient-Driven Grouping Model (PDGM) uses patient characteristics to determine payment. Concerns have been raised that this model disincentivizes home health agencies from admitting patients, such as PLWD, who are admitted from the community and require longer episodes of care. We applied the PDGM to 100% home health files from 2019 to examine differences in PDGM components for PLWD and their peers before PDGM implementation. Two propensity score-matched groups of 153,957 individuals with and without dementia were created based on patient demographics, caregiver support, cognitive status, prior functional status, prior health care utilization, and Charlson comorbidity scores. Multivariate regression was used to examine the relationship between dementia and admission source/episode timing, functional limitations, and comorbidity level controlling for age, sex, and race. PLWD had greater odds of early community admissions (1.2 p&lt;.0001), high functional limitation (1.09 p&lt;.001), and of having a high comorbidity adjustment (1.49, p&lt;.001). The primary clinical grouping for both groups was cardiac and circulatory. However, people with ADRD had twice as many Behavioral Health clinical group records. These findings indicate that people living with dementia did access and use home health differently before the implementation of the PDGM and may be experiencing negative repercussions of the new payment model.