bluuebunny/crossref_metadata_2025_split huggingface dataset:
INSIGHTS ON THE AGING EXPERIENCE WITHIN REMOTE CARIBBEAN ENVIRONMENTS THROUGH THE LENS OF GUANAJA, HONDURAS
Authors: Ferguson Lee Ann 
Published: January 2025

Abstract
This qualitative study examined the aging experience of older adults residing on Bonacca Cay, a 100-acre island that serves as the central municipality of Guanaja, Honduras. Utilizing focused ethnographic methods and drawing upon the Old-Age Exclusion and Age-Space Exclusion Frameworks, the research explored socio-environmental considerations thought to influence the aging experience. The analysis of data collected through direct fieldwork, interviews, observations, and photographic journaling while on Bonacca Cay identifies eight themes elucidating the intricate interplay between sociocultural dynamics and environmental factors impacting the island’s aging population. These influential themes include (1) personal habitus of older adults, (2) vital family support and changing family structures, (3) community and social bonding, (4) cultural heritage and history, (5) built environment and service infrastructure, (6) geographic/environmental influences, (7) government, economy, and policy, and (8) access to instrumental personal care services and safety. This research also results in the recognition of both the strengths and limitations when attempting to apply either the Old-Age Exclusion or Age-Space Exclusion Frameworks to populations of older adults living on island municipalities governed by distant mainland countries. By presenting the lived realities of older adults within this remote island context, the results of this study may contribute to a more comprehensive understanding of the aging experience within low-resource Caribbean environments. It also offers valuable insights for future research and the development of tailored frameworks for studying aging in similar unique settings.
EXAMINING THE ASSOCIATION BETWEEN MULTIMORBIDITY PATTERNS AND MORTALITY RISK AMONG PEOPLE WITH DEMENTIA
Authors: Luo Hao , Zhou Jiayi 
Published: January 2025

Abstract
People living with dementia often live with other diseases. Understanding how other diseases co-occur (‘multimorbidity’, concurrence of two or more diseases) in a person with dementia is important as it can inform a tailored approach to care. This study aimed to identify multimorbidity patterns among patients with and without dementia and examine how these patterns were associated with mortality. We identified dementia patients diagnosed at 65+ between 2007 and 2017 from electronic medical records from all public hospitals in Hong Kong. Each patient was 1:1 matched with patients without dementia by age, sex and index date and followed until death or 31 Dec 2018, whichever was earlier. A total of 156,710 individuals (mean age [SD]: 83.26 [7.28]; 59.6% females) were included. Seven multimorbidity patterns were identified from latent class analysis in the total sample, and similar patterns were identified separately for patients with and without dementia. The pattern characterized by “dyslipidemia and neurological diseases” was most likely to coexist with dementia. Among patients with dementia, compared to the “unspecific” pattern (characterized by the lack of defining diseases), all other patterns were associated with an increased risk of mortality. The highest risk was observed in the “clinically complex” pattern [HR 1.65 (95% CI: 1.60, 1.70)], followed by the “respiratory disease” [HR 1.51 (95% CI: 1.45, 1.57)] and “heart disease” patterns [HR 1.40 (95% CI: 1.36, 1.45)]. The results highlight the importance of taking specific combinations of chronic conditions into account when tailoring the clinical and care approach to people with dementia.
METFORMIN AS A POTENTIAL PHARMACOLOGIC INTERVENTION TO IMPROVE HEALTHSPAN
Authors: Espinoza Sara 
Published: January 2025

Abstract
Metformin is the most widely used oral antidiabetic drug, generally recommended as first-line treatment for type 2 diabetes as well as for diabetes prevention. Metformin extends lifespan in preclinical models, and several observational studies in humans suggest that metformin reduces cancer, cardiovascular disease, dementia, frailty, and all-cause mortality. Therefore, given that it is well-tolerated, safe, and widely used, there is high interest in testing its role as a potential agent to reduce age-related diseases and geriatric syndromes. The exact mechanisms by which metformin exerts these benefits are still being elucidated, but in addition to activating AMPK emerging evidence demonstrates metformin modulates several hallmarks of aging, such as epigenetic modifications, mitochondrial function, cellular senescence and the gut microbiome. Thus, metformin has pleiotropic effects which may contribute, perhaps collectively, to its aging-modulating properties. To date there are few clinical trials of metformin to directly examine metformin’s effects on human healthspan. We are currently conducting a randomized placebo-controlled clinical trial of metformin to prevent frailty in older adults with glucose intolerance, which will also examine the effects of metformin on several hallmarks of aging. Metformin is also being examined in a separate ongoing randomized placebo-controlled trial as a potential therapy to prevent Alzheimer’s disease in older adults without diabetes (including those who have prediabetes). Given its tolerability and safety profile, metformin could be quickly translated to clinical use if ongoing and future clinical trials demonstrate its efficacy in promoting healthspan.
REPURPOSING SODIUM-GLUCOSE CO-TRANSPORTER-2 INHIBITORS FOR GEROTHERAPY
Authors: Solis-Herrera Carolina , Venna Venugopal , Lee Juneyoung 
Published: January 2025

Abstract
Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are drugs used to treat T2DM, offering benefits such as reduced HbA1c, weight loss, and improved insulin sensitivity/β-cell function. Additionally, they provide significant cardio-renal benefits, although the exact mechanisms are not fully understood. The ketone hypothesis suggests that SGLT2i may shift metabolism towards utilizing ketone bodies instead of fatty acids, contributing to their therapeutic effects. Previous research has shown that SGLT2i can increase plasma ketones 2-4-fold. One intriguing area of research is the potential use of SGLT2i as agents for late-aging and longevity. T2DM exacerbates aging-related biomarkers such as senescence, chronic inflammation, oxidative stress, DNA damage, and mitochondrial dysfunction. Preclinical studies have demonstrated that SGLT2i possess anti-inflammatory, anti-oxidative, and anti-senolytic properties, suggesting they may improve health span and lifespan, particularly in patients with chronic inflammatory diseases like T2DM and obesity. However, clinical research in this area is still limited. Preliminary data from our group suggests that in older, obese subjects with prediabetes, treatment with an SGLT2 inhibitor for 12 weeks led to a significant decrease in global and adipose senescent and inflammatory profiles. This effect, correlated with increased plasma ketones, indicates a potential mechanism by which SGLT2i may modulate aging processes and improve symptoms of age-related diseases. Here, we will discuss this and other current studies that support the notion that SGLT2i may contribute to the increase of both healthspan and lifespan.
DASH DIET WITH CULTURALLY TAILORED RECIPES: A PSYCHOEDUCATIONAL SESSION FOR BLACK WOMEN WITH HYPERTENSION
Authors: Groves Angela , Hamann Kate , Roche-Dean Maria 
Published: January 2025

Abstract
The prevalence of hypertension among non-Hispanic Black women in the United States is alarming because they develop hypertension at an earlier age and have higher blood pressures when compared to White women. Approximately 55.3% of Black women have hypertension, which puts them at significant risk of developing heart disease, kidney disease, and cerebral vascular accidents. The Dietary Approaches to Stop Hypertension (DASH) diet, when combined with lower sodium intake, has been associated with a reduction in systolic blood pressure by 10 mm Hg in a four-week intervention study that included 50% African American women with pre-hypertension or stage 1 hypertension. Although, the DASH diet does not consider cultural food preferences. Studies among Black adults have shown that when the DASH diet incorporated culturally traditional foods, adherence to the DASH diet improved, which lowered blood pressure. A key factor in understanding the health behavior of Black women is their general knowledge of hypertension and low-sodium diets. This psychoeducation session was part of an 8-week peer (dyadic) support mixed methods study that included the DASH diet and culturally tailored recipes to improve diet adherence and reduce systolic blood pressure. Purposive sampling was used to secure a sample of 34 older Black women from local churches and one senior center to participate in a one-hour DASH diet education session. Psychoeducation was reinforced with weekly newsletters and opportunities for one-on-one discussions via email or phone. Study results indicated that participants were able to successfully reduce systolic pressure. We discuss the implications for hypertension management.
THE CULTURE OF FAMILY CAREGIVING OF OLDER ADULTS AMONG AFRICAN AND AFRO-CARIBBEAN IMMIGRANTS TO THE US AND CANADA
Authors: Kum Cleopatra , Phillips Casey , Warner Lynn , Banisalman Islam , Roche-Dean Maria 
Published: January 2025

Abstract
An increasing number of African and Afro-Caribbean immigrants to the United States and Canada are aging. Older adults are dealing with various health conditions, which makes them increasingly dependent on family members and friends for their health and social needs. The assistance they receive includes help with physical care, transportation, medication assistance, and emotional and social support, amongst others. Caregivers play a pivotal role in maintaining the health of older adults of African and Afro-Caribbean immigrants in the United States and Canada. However, very little is understood about the expectations and culture of family caregiving within this group. This study explores the culture of family caregiving of older adults amongst African and Afro-Caribbean immigrants in the United States and Canada. We conducted a scoping review of the literature with the assistance of two experienced health science librarians using CINAHL, PubMed, Embase, and OVID MEDLINE. Preliminary findings show that while some articles discussed aspects of family caregiving on the African continent, none were specific to family caregivers of older adults living in the United States and Canada. While it is important to understand the cultural implications of family caregiving within African communities, there are nuances of the African and Caribbean diaspora that have serious implications for the health of older adults. This study adds to our understanding of family caregiving among African and Afro-Caribbean immigrants. It points to a need for tailored intervention for supporting family caregivers within African and Afro-Caribbean immigrant communities.
EQUITABLE ACCESS TO LATE-LIFE DEPRESSION CARE: A STEPPED WEDGE RCT WITH COMMUNITY ORGANIZATIONS
Authors: Andres Lanvin , Steinman Lesley , Mitchell Mary , Haruo Emy 
Published: January 2025

Abstract
For the past several years, our community-academic partnership has been collaborating with community-based social service and mental health organizations in Washington and California on the PEARLS Equity Study. The goal of this five-year study is to improve equitable access to late-life depression care (PEARLS) among older adults experiencing poverty who are linguistically diverse, BIPOC, and/or rural dwelling, recognizing many older adults are multiply marginalized by intersecting identities. In phase one (2020), we conducted formative research (39 interviews) with both current and potential PEARLS adopters that reach priority populations. Using a social marketing framework, our guide explored barriers, benefits and process for PEARLS adoption; organization capacities and needs; PEARLS acceptability and adaptations; and preferred communication channels. We conducted thematic analysis using the rapid framework method to develop strategies, collaborations, and adaptations to integrate depression care in ways that aligned with these contexts. In phase two (2021-2023), we evaluated these new dissemination and implementation strategies and tools in a stepped wedge Randomized Controlled Trial (swRCT) to test improvement in equitable access to mental health care. Our primary and secondary outcomes are new PEARLS adopters and reach of priority populations, respectively. We randomized counties into three waves or steps, choosing a stepped wedge design as more feasible for community-engaged research with all organizations ultimately receiving the intervention. We engaged over 500 organizations and 700 providers in outreach, webinars, community conversations, 1:1 support, and training. We are currently analyzing RCT, process and cost evaluation data to present findings and lessons learned at GSA.
BEST PRACTICES FOR COMMUNITY-ENGAGED RESEARCH AND PRACTICE WITH CBOS THAT ENGAGE DIVERSE OLDER ADULTS
Authors: Haruo Emy , Mitchell Mary , Andres Lanvin , Steinman Lesley 
Published: January 2025

Abstract
PEARLS partner organizations will share best practices on integrating PEARLS into routine service delivery to reach historically marginalized older adults, and how they have partnered with researchers to strengthen study feasibility, equity and sustainability to translated learnings into practice. The PEARLS Equity Study guided new dissemination and implementation strategies that aligned with the strengths, priorities, and needs of community-based social service organizations (CBOs) including cultural organizations, area agencies on aging, senior centers, and family and human services agencies. New communication approaches included proactive group and 1:1 outreach to organizations; a new peer-to-peer video with PEARLS organizations sharing how they have reached underserved communities; and updated PEARLS messaging that resonated with values of CBO leadership, staff and clients. For example, new messaging included downplaying “evidence-based program” which has often been used to promote programs that were not designed with diverse older adults, and instead amplifying stories of impact that highlight both quantitative and qualitative changes in outcomes that mattered. New supports for program adoption included 1:1 support calls for tailored guidance for different CBO, staff, and community contexts; distance on-demand training with trainers from diverse CBOs to improve accessibility and sustainability; and Zoom webinars and community conversations co-led by PEARLS partners (including local partners featured during this GSA Symposium) and our research center that targeted what CBOs are looking for to address depression and disconnectedness in their communities. Our community-academic partnership and PEARLS community of practice continues to engage regularly to share adaptations as an implementation strategy for health equity.
LONG-TERM CARE INSURANCE AND OVERLOOKED LONG-TERM CARE EXPENSES AMONG OLDER ADULTS WITH COGNITIVE IMPAIRMENTS
Authors: Long Chengxu , Yang Wei , Glaser Karen 
Published: January 2025

Abstract
We investigate catastrophic health and long-term care expenditures (CHLTCE) among older adults with cognitive impairments in China and the role played by long-term care insurance (LTCI). Drawing on data from the 2013, 2015, 2018, and 2020 waves of the China Health and Retirement Longitudinal Study, we exploit the rollout of LTCI pilots across different cities and employ a difference-in-differences approach. Our findings indicate that a significant proportion of CHLTCE among older adults with cognitive impairment is attributed to long-term care costs (i.e., both formal and informal). After considering long-term care expenditure, both the incidence and intensity of CHLTCE increase significantly compared to when only healthcare expenditures are taken into account. Our research underscores the importance of considering long-term care costs when examining catastrophic expenditures due to both health and long-term care expenditures among older adults with cognitive impairment. We also find that the implementation of LTCI reduces both the incidence and the intensity of CHLTCE among older adults with cognitive impairment. Moreover, this effect is more pronounced among individuals with more severe cognitive impairment and those who live alone. These findings suggest that the introduction of LTCI, may, to some extent, alleviate CHLTCE among older adults with cognitive impairments. Our findings support the extension of the LTCI pilot as well as the broadening of the insurance’s scope to ensure adequate protection for older adults with cognitive impairments.
COHORT DIFFERENCES IN PENSION AND JOB SECURITY OF OLDER UNION WORKERS: EVIDENCE FROM HRS
Authors: Oh Yun taek 
Published: January 2025

Abstract
The influence of the declining number of unions and their bargaining power on older workers’ quality of work lives, such as pension eligibility and job security, is an understudied field. I use the first six waves of the initial HRS cohort (born 1931-1936, recruited in 1992, N = 3,134) and Mid Baby Boomers (MBB, born 1954-1959, recruited in 2010, N = 2,886) from the Health and Retirement Study (HRS) from 1992 to 2020. I examine the changes in the association between union membership and the quality of later work lives by using the interaction terms between birth cohorts, union membership, and employment sector (private or public). The results from logistic regressions show that the proportion of pension eligibility from current jobs declined over time while the expectation of job loss at ages 57-62 is stable for union members. Furthermore, the predicted probability of actual job loss increased among non-union workers in the private sector while that for union workers was unchanged. These results suggest that the union’s declining bargaining power may influenced pension eligibility although expectations and actual job security remain unchanged for union workers. The results from competing risk analysis show that MBB union workers are more likely to change job titles while less likely to move to different employers or to directly exit the workforce than the previous cohort. This result suggests the prevalence of bridge employment among union workers as well as the preference changes in the type of bridge employment.
THE DYNAMICS OF ECONOMIC INSECURITY THROUGHOUT LATER LIFE: DISPARITIES BY GENDER AND RACE/ETHNICITY
Authors: Kim Seokmin , Park Sung , Mutchler Jan 
Published: January 2025

Abstract
Older Americans face significant economic hardships, and their risk of poverty increases with age. But it remains unclear whether the 65+ population, which includes a sizable number with incomes too high to qualify for means-tested public assistance programs, has the resources to meet an adequate standard of living. Using 2010-2020 data from the Health and Retirement Study linked to the corresponding years of the Elder Index (EI), this project investigates heterogeneity in economic insecurity among older adults aged 65+ as they age, by gender and race/ethnicity. We examine transitions in living above/below the EI and time spent living below the EI. We also study the dynamic relationship between respondents’ employment activity and their trajectories of economic insecurity. Results suggest that at least half of respondents live below the EI at some point in later life, and a quarter of them experience sustained economic insecurity throughout the entire observation period. Individuals in these economically insecure categories are more likely to be female, non-White, and have limited or no work experience. These disparities grow over time as individuals approach their 80s, driven partly by the intensity of work experience prior to age 60, despite increasing employment activity in later life. The findings illustrate the growing disadvantage in economic well-being for older females and racial/ethnic minorities, and the influence of earlier life economic activity on financial insecurity and instability in later life.
IMPLEMENTATION BOOSTER: REFLECTION AND ACTION AT THE FRONTLINE
Authors: Dolansky Mary , Little Kevin , Pino Lilia , Nabong Jennifer , Bender Anna 
Published: January 2025

Abstract
Frontline feedback during the implementation of the Age-Friendly Health System (AFHS) 4Ms Framework at MinuteClinic, indicated some providers faced barriers and challenges in delivering 4Ms care. In response, an interdisciplinary team of educators, providers, and other quality improvement experts devised the Reflection and Action strategy, aimed to enhance both competency and confidence among providers in delivering the 4Ms—namely, Mobility, Medications, Mentation, and What Matters Most. Leveraging the well-established “Plan, Do, Study, Act” model for improvement, the team conducted three small-scale experiments to test the Reflection and Action strategy. Each experimental cycle sought to clarify provider expectations, raise awareness of current performance, and catalyze actions for performance improvement during weekly tests of change (inspired by Juran’s Model for Improvement, 1961). Cycle 1 demonstrated a notable 12.5% increase in eligible visits with comprehensive documentation of all 4Ms. Cycle 2 built upon this progress, yielding a further 9.8% increase. Cycle 3 achieved a substantial 27.7% increase in adherence to the 4Ms. Between cycles, the implementation team dynamically adjusted strategies, refined targets, and fine-tuned educational materials and coaching messages to optimize effectiveness. Providers actively participated by completing weekly surveys, providing valuable feedback that informed strategic adjustments. Across all cycles, providers reported heightened confidence in completing the 4Ms assessment, coupled with a reduction in the time required for documentation.
FUELING SCIENTIFIC INNOVATION: NIA’S ENTREPRENEURIAL DEVELOPMENT PROGRAMS FOR AGING RESEARCHERS
Authors: Haim Todd 
Published: January 2025

Abstract
The symposium panel will offer a comprehensive overview of National Institute on Aging (NIA) programs designed to foster entrepreneurship and facilitate the commercialization of aging-related innovations. Central to the discussion are initiatives such as NIA Startup Challenge and Accelerator which has been demonstrated to provide first-time entrepreneurs with essential training in evidence-based technology development and position them for success. Additionally, the panel will highlight the NIA Research and Entrepreneurial Development Immersion (REDI) funding opportunities, which aim to expose researchers in gerontology and related fields to entrepreneurship.
A key focus of the panel is the pivotal role of Small Business Innovation Research (SBIR) funding as a primary source of early-stage seed funding in aging research. Panelists will elucidate how SBIR funding empowers startups to reach critical value inflection points by supporting data collection and validation processes.
Moderated by NIA entrepreneurial program leadership, the panel features representatives from Challenge finalists, SBIR-funded startups, and key stakeholders in the Aging Research-related startup ecosystem. Through diverse perspectives and real-world experiences, attendees will gain valuable insights into navigating the entrepreneurial journey, leveraging NIA resources, and harnessing the power of collaboration to enable the impactful commercialization of innovations that would enhance the health and/or care of older adults.
In summary, the panel will provide a dynamic exchange of ideas, strategies, and success stories, as we illuminate the path from research innovation to market transformation in the realm of aging research. Business and Aging Interest Group Sponsored Symposium