bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXAMINING AND ADDRESSING BARRIERS TO MENTAL HEALTH CARE FOR OLDER ADULTS IN PERMANENT SUPPORTIVE HOUSING
Authors: Robinson Randee 
Published: January 2025

Abstract
Permanent supportive housing is an evidence-based intervention to support individuals exiting from chronic homelessness. Increasingly, the demographic of adults prioritized for PSH are over the age of 50. Despite the higher prevalence of mental health concerns amongst older PSH residents their engagement with mental health services remains limited. The purpose of this investigation was to examine barriers to mental health care for older adults living in PSH and provide suggestions to address the identified barriers. A one-hour semi-structured focus group protocol was developed. Question sets focused on individual and system level barriers to mental health services. The focus group was digitally recorded, and responses were transcribed. Eight PSH residents from one housing provider participated in the focus group session. Thematic analysis utilizing inductive and deductive approaches was completed by two individuals. Themes of case manager role and limitations, stigma, service navigation, and trustworthiness emerged from the data. The mean age of participants was 63.8 years (SD 9.78). The mean length of tenancy was 6.6 years (SD 3.29). Addressing mental health access is critically important for older adults in PSH. Interventions to improve mental health care access at both the individual and systems level should target building trust, reinforcing available services, clarifying the care manager’s role, and supporting staff consistency. Future research should target effective interventions to address these barriers.
HEALTH CARE UTILIZATION OF AGING INDIVIDUALS EXPERIENCING CHRONIC HOMELESSNESS: A CASE STUDY APPROACH
Authors: Berg Russell 
Published: January 2025

Abstract
The population of individuals experiencing homelessness in the United States is both growing and aging. Late baby boomers are overrepresented amongst those experiencing chronic homelessness and this cohort is now of geriatric age. Many challenges interfere with providing medical care to this group including mental health, substance use disorders, carceral history, lack of surrogate decision makers and dementia. In some cities, the COVID 19 pandemic led to transition of congregate emergency homeless shelters to hotels, providing an opportunity to co-localize enhanced services such as embedded medical services. This session will present three medical cases from a low barrier, harm reduction focused hotel shelter for chronically homeless individuals. The cases focus on selected individuals with high hospital utilization and demonstrate how the hotel shelter model with embedded medical clinic can function as a “medical home” reducing unnecessary service utilization while pursuing placement for those requiring a higher level of care. While residing at the shelter, important medical conditions such as dementia and Parkinson’s disease can be diagnosed that qualify residents for additional benefits. For some patients with severely limited life expectancy, the hotel shelter space can provide a setting for patient centered palliative care and even home hospice services. The challenges to providing care for an aging population experiencing homelessness require novel models for the provision of health care and hotel shelters with embedded medical care can fill the role of “medical home”.
THE STUDY OF MUSCLE, MOBILITY AND AGING (SOMMA): LESSONS LEARNED RECRUITING OLDER ADULTS
Authors: Kennedy Kimberly , Kritchevsky Stephen , Nicklas Barbara , Newman Anne , Glynn Nancy , Strotmeyer Elsa , Danielson Michelle 
Published: January 2025

Abstract
SOMMA is a two-site (Wake Forest University School of Medicine [Wake] and University of Pittsburgh [Pitt]) ongoing observational study of 879 participants ≥70 years investigating the role of muscle biology in age-related mobility decline. Those eligible were free from any life-threatening disease, able to walk ≥0.6 m/s (4m) and complete a 400m walk, and safely undergo muscle tissue biopsies and magnetic resonance imaging. Recruitment was from April 2018 to December 2021 and, despite partially spanning the COVID-19 pandemic, exceeded its goal of 875 (Total enrollment: Wake=440; Pitt=439). SOMMA phone screened 4225 persons (Wake=1887; Pitt=2338) with 33.1% (n=1398) eligible for further screening. Advertisement strategies for SOMMA were evaluated and direct mail postcards were most successful and cost-effective; 75% of those phone screened were from direct mailings. At Wake, advertising costs totaled $52k or ~$28/phone screen and $118/enrolled participant. At Pitt, advertising costs totaled $41k or ~$17/phone screen and $93/enrolled participant. Participants eligible after phone screening were invited to attend an in-person information session in which the comprehensive multi-day exam and detailed consent form were reviewed and 4m gait speed was assessed. Sessions were held virtually during pandemic, at which point the gait speed screening was discontinued. A total of 210 information sessions took place (Wake=90; Pitt=120), with an average attendance of ~15 individuals/session and ~80% of those who attended the session were eligible and 63% were ultimately enrolled. SOMMA demonstrated the successful recruitment of a large older adult cohort study for an exam-intensive protocol which included tissue sampling and MR measures.
SUCCESSFUL APPROACHES TO ENHANCING OLDER ADULT REPRESENTATION IN MOTRPAC TRIAL
Authors: Espinoza Sara , Coen Paul , Talton Jennifer , Houmard Joseph , Moreau Kerrie , Nicklas Barbara 
Published: January 2025

Abstract
NIH mandates that clinical research include participants of all ages (or specify a reason for excluding based on age); yet, older adults (OAs) are often underrepresented even in studies without an age exclusion. Barriers to their inclusion are multi-factorial and include lack of recruitment strategies targeted to this demographic and eligibility criteria associated with age that reduce representation. Supported by multiple NIH Institutes, including NIA, the purpose of MoTrPAC is to characterize the molecular changes that underlie the benefits of exercise in humans. The goal is to randomize approximately 1980 sedentary, healthy participants (across 10 sites) to a 12-week control group or a supervised, moderate-intensity resistance or aerobic exercise intervention. The target is to balance enrollment across three groups (18-39, 40-59, and 60+ years). Recruitment is ongoing; as of 3/1/24, the number randomized is n=1043 with 20.6% OAs, compared to 40.5% younger and 38.9% middle-aged. Recruitment is monitored regularly, and early in recruitment a large age differential in eligibility yields was discovered, with only 4.5% of screened OAs being randomized, compared to 13.8% of middle-aged and 18.3% of younger individuals. Since the use of lipid-lowering medication was the single largest reason OAs did not qualify (36% of exclusions involved statin use in those &gt;60 yrs), the protocol was altered to drop this exclusion to enhance OA representation. Also, successful recruitment marketing approaches are tracked closely and vary across age groups. This presentation will discuss the strategies which provide the most success for attracting OAs to inquire about the study.
REIMAGINING WORK: TAPPING INTO THE STRENGTHS OF OLDER ADULTS
Authors: Nearing Kathryn , Terveer Katy , Rooks Ronica 
Published: January 2025

Abstract
This session will focus on inspiring and informing the audience about how we can reimagine the way we work in order to benefit from the experience, skills, and wisdom of older workers. We will explore the modern trends that are enabling us to work longer and the history of ageism in the workplace. We will help aging advocates to understand and promote the benefits of working longer from an individual, employer, and societal level. Finally, we will look at some of the strategies that organizations can leverage in order to recruit and retain older workers as well as leverage the full potential of an age-diverse workforce.
OLDER ADULTS PURSUE ENCORE CAREERS IN RESEARCH TO PROMOTE INCLUSION OF OLDER ADULT PEERS IN CLINICAL TRIALS
Authors: Nearing Kathryn , Wright Leslie , Williamson Christin , Sedey-Seitz Cory 
Published: January 2025

Abstract
We created an innovative pathway to encore careers in research for older adults at the University of Colorado Anschutz Medical Campus. Our program trains older adults from the community (average age 68; range: 56-82) for specialized community-facing and participant-centered roles on clinical trial teams to increase the recruitment and retention of older adult peers, as well as other underrepresented populations, in clinical trials. Older Adult Research Specialists’ roles include: 1) developing effective communication and outreach strategies to engage older adults from diverse backgrounds in research; 2) recruiting and consenting participants for trials; 3) supporting retention by identifying barriers to study participation and connecting study participants with needed resources to address social needs; 4) educating research teams regarding key considerations for including older adults in research, anchored by the Geriatric 5Ms, to inform trial design and implementation; and, 5) catalyzing research innovations to increase representation in, and the relevance and translational potential of, research. OARS prepare for their essential roles on clinical trial teams by completing a 14-week, 140-hour, virtual, competency-based training program. Health Navigation training is the foundation. To date, we have trained four cohorts (43 graduates). OARS are making the research workforce and associated teams more age-inclusive in the Division of Geriatric Medicine, Department of Neurology, Department of Physical Medicine and Rehabilitation Sciences, Center for Inclusive Design and Engineering, and at our healthcare affiliate, the Rocky Mountain Regional VA Medical Center. By promoting intergenerational learning, encore careers and research innovation, OARS are advancing our priorities as an Age-Friendly University.
SHAPING, AND BEING SHAPED BY, POLICIES AND PROGRAMS THAT PROMOTE AN AGE-INCLUSIVE WORKFORCE: A PERSONAL JOURNEY
Authors: Westcott James 
Published: January 2025

Abstract
In this session, I will share my personal journey as someone who has both shaped and been shaped by the innovative age-inclusive workforce policies and programming in Colorado. I will describe my state-wide leadership role as part of the Colorado Older Worker Policy Collaborative successfully advocating for the elimination of graduation dates and other age-identifying sections of job applications, which disadvantaged older adults in the job application process. I will also share my experience as an Older Adult Research Specialist who completed a novel pathway to encore careers in research program at the University of Colorado Anschutz Medical Campus. I will share how I apply my dual training as a health navigator and research navigator to recruit and retain older Veterans in clinical trials for the VA Eastern Colorado Geriatric Research Education and Clinical Center – one of 20 centers of excellence focused on aging in the Department of Veterans Affairs. I will describe the meaning of this work to me personally and professionally, as a culmination of many work and life experiences. I will also share the difference I make as an older adult peer for the Veterans with whom I engage in research and on a multi-disciplinary and intergenerational team comprised of an early career investigator and research assistant. My personal and professional journey highlights the importance of a multi-pronged approach, encompassing research, policy and action/application (e.g., education/training and hiring) to promoting the longevity dividend through meaningful work and gainful employment.
BRAIN GLUTATHIONE, MITOCHONDRIA, GLUCOSE METABOLISM, AND COGNITION IN AGED MICE: IMPACT OF GLYNAC SUPPLEMENTATION
Authors: Kumar Premranjan , Sekhar Rajagopal 
Published: January 2025

Abstract
Alzheimer’s disease (AD) remains unsolved, and is associated with brain defects including impaired glucose uptake, mitochondrial dysfunction, inflammation and glutathione deficiency. These defects also occur in age-related cognitive decline (ACD). Because mice do not naturally develop AD, mouse models of AD have been developed and studied. However, such mouse models are highly artificial because defects do not occur naturally and are artificially induced in mice. To understand the mechanistic basis of cognitive decline in aging, it is important to investigate these defects directly in the brain, which is only possible in animal models as performing brain biopsies in humans is not practical. To overcome these challenges, we studied glutathione deficiency, oxidative stress, glucose uptake, mitochondrial function, inflammation, genomic damage and neurotropic factors directly in the brains of old-mice (OM, 90-weeks)) and young-mice (YM, 20-weeks), and also measured cognition (maze-running). Compared to YM, OM had the following defects in the brain: (a) lower glutathione concentrations; (b) elevated oxidative stress (TBARS); (c) lower immunoblot expressions of: GLUT1 and GLUT3 (brain and neuronal glucose uptake); PGC1a; electron-chain complexes and PINK1 (mitochondria), TSPO (inflammation), pH2AX (genomic damage), and BDNF, GDNF and NGF (neurotrophic factors); (d) impaired mitochondrial respiration (high-resolution respirometry); (e) poor cognition (maze-running time). After 8-weeks of supplementation with GlyNAC (combination of glutathione precursors glycine and N-acetylcysteine), all of these defects improved/corrected in the brains of OM and cognitive performance improved significantly. The results of this study have important implications for improving brain health and cognition in human aging and in AD.
MORE THAN JUST A RIDE: TRANSPORTATION PROGRAMS TO MEET THE NEEDS OF OLDER ADULTS IN RURAL COMMUNITIES
Authors: Bayne Alycia , Siegfried Alexa , Chitwood Skyla , Valdivia Nathaly 
Published: January 2025

Abstract
Most older adults (age 65+) living in rural areas rely on personal vehicles for transportation. However, transportation is a significant challenge for older adults who need alternative forms of transportation, including those who do not drive or lack access to a vehicle. Fixed route transportation is limited in rural communities and may not meet the needs of older adults, particularly those who require assistance. Transportation barriers affect older adults’ health, mobility, independence, and quality of life. Recognizing these challenges, the Health Resources and Services Administration Federal Office of Rural Health Policy funded the NORC Walsh Center for Rural Health Analysis and the Rural Health Information Hub to develop the Rural Transportation Toolkit. The toolkit includes 15 promising program models to increase access to transportation, overcome barriers, and improve safety. To develop the toolkit, NORC conducted an environmental scan to identify programs and resources and interviewed representatives from nine rural transportation programs and four experts in rural transportation. The toolkit was first released in 2019, updated in 2024, and has had over 50,000 page views. This session describes toolkit findings, including transportation needs and challenges for rural older adults, and features program models practitioners can adapt. Program models include the Ride Sharing Model, Volunteer Driver Model, Voucher Model, and Coordinated Services Model. This session also describes how technology can improve rural transportation for older adults. This toolkit has the potential to help rural communities meet the transportation needs of older adults.
RURAL–URBAN RESIDENCE, EDUCATION, AND SUBJECTIVE COGNITIVE DECLINE AMONG MIDDLE AGED AND OLDER ADULTS IN THE US
Authors: Wong Roger , Mansour Amer 
Published: January 2025

Abstract
Subjective cognitive decline (SCD) is defined as an individual’s self-reported experience of increased confusion or memory loss, and it is a known risk factor for dementia. There is no existing research on SCD disparities by rural-urban residence, and how education may play a role in this relationship. To address this gap, the 2022 Behavioral Risk Factor Surveillance System data was analyzed to elucidate the interplay between rurality, education, and SCD. The SCD measure was only collected from respondents aged 45 years and older, resulting in a sample size of 63,948 U.S. adults. SCD was significantly more common among rural (12.0%) compared to urban (10.7%) residents [X2(1)=15.5, p&lt;.001]. In a multiple logistic regression model, rural residents had a 16% significantly higher odds of SCD compared to urban residents after adjusting for sociodemographic and health covariates (adjusted odds ratio [aOR]=1.16, 95% CI=1.01-1.33, p&lt;.05). There was a negative relationship between education level and SCD, but insignificant. For example, a college degree was associated with 12.4% lower odds of SCD compared to those with less than high school education (aOR=0.88, 95% CI=0.70-1.09, p=.24). Education did not significantly moderate the association between rurality and SCD. Our results suggest rural residents have higher odds of experiencing SCD, but no level of education may buffer this relationship despite extensive research on the benefits of education on cognitive health. Future research is needed to examine the mechanisms contributing to higher levels of SCD among rural residents, and effective interventions that may be used to mitigate further cognitive decline.
A STATEWIDE PROGRAM FOR EARLY AND ACCURATE DIAGNOSIS OF MEMORY LOSS
Authors: Johnson Theodore 
Published: January 2025

Abstract
Georgia Memory Net (GMN) provides clarity, care, and community connection for Georgians. GMN provides Primary Care Providers the educational resources local infrastructure they need to help Georgians experiencing memory loss or cognitive impairment get timely and accurate diagnoses. Georgia Memory Net also provides initial support and education while linking Georgians dealing with Alzheimer’s and related dementias and their care partners with community resources that can provide ongoing support. Primary Care Providers who have detected memory concerns can refer to one of seven Georgia Memory Net Memory Assessment Clinics or one of the rural telemedicine sites co-located in Department of Public Health clinics. Georgia Memory Net is made possible by a mandate from the Georgia State Legislature as a way to support Georgians all around our state who are dealing with memory issues. GMN is administered by experts at the Goizueta Alzheimer’s Disease Research Center at Emory University.
A REAL-WORLD PHARMACOVIGILANCE STUDY OF SACUBITRIL\VALSARTAN IN OLDER PEOPLE
Authors: Kuai Zheng , Hu Yu 
Published: January 2025

Abstract

Background
Sacubitril\valsartan is the first-in-class angiotensin receptor neprilysin inhibitor which is utilized clinically in the treatment of heart failure with reduced ejection fraction and hypertension patients. However, Systematic studies of sacubitril\valsartan-related adverse events (AEs) signals in older people based on real-world and international databases are still lacking.

Methods
Disproportionality analyses, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the Bayesian confidence propagation neural network (BCPNN), and the multi- item gamma Poisson shrinker (MGPS) algorithms, were employed to quantify the signals of Sacubitril\valsartan-associated AEs in older people.

Results
The search retrieved 94,210 sacubitril\valsartan-associated cases within the reporting period; 86 PTs with significant disproportionality were retained in 65+. Angioedema, hypotension, renal impairment, hyperkalemia, cough, dizziness, and seasonal allergies were found at a similar rate to those reported in trials. Reports emerged for several cognitive-related AEs and several fragility acceleration AEs, which were rare. Unexpected safety signals such as ‘Injury, poisoning, and procedural complications’ were only detected in 65+. Most of the cases occurred within the first month after sacubitril\valsartan initiation, and this was consistent across age groups.

Conclusions
Our study found potential new AEs signals and might provide important support for clinical monitoring and risk identification of Sacubitril\valsartan in older people.
AGE-RELATED DEFICITS IN MOBILITY RESILIENCE WITH CLIMATE CHANGE: A CASE STUDY OF HURRICANE IAN
Authors: Manini Todd , gao Shangde , Wang Yan 
Published: January 2025

Abstract
Resilience is the capacity of a system to respond and recover from extreme events. We aimed to test the feasibility of a new metric of mobility resilience in the context of an extreme hurricane event. We used the concept of the resilience triangle — an engineering framework to conceptualize the resilience of physical infrastructure systems in the public domain. Mobility measures originate from point of interest (POI) visit data using geolocations of 47 million smartphone devices across the U.S.— about 10% of the population in the nation. These data were linked to 4,749 exposed neighborhoods (i.e. census tracts) within Florida who were impacted by Hurricane Ian in 2022. POI data were tracked 1 month prior, and 12 months following hurricane Ian to quantify the impact (ratio of pre-event mobility to maximal loss of mobility), recovery (ratio of post-event to pre-event mobility equilibrium), and duration of recovery (length of time from nadir of mobility lost to a new mobility equilibrium). In multiple regression models, older neighborhood median age was associated with worse recovery and longer duration of recovery. Additionally, neighborhoods with a higher percentage of adults 65+ years had a higher impact, worse recovery, and longer duration of recovery. Adjustments for wind speed, socioeconomic status (poverty, group housing, house cost/structure, uninsured rates), physical/mental limitations, mobile home dwellings, and racial/ethnic minorities had little effect on associations. This study underscores the potential of resilience triangle framework for measuring mobility resilience, although more research across diverse climate events and locations is necessary.
TEMPORAL DYNAMICS OF UNMET LONG-TERM CARE NEEDS IN CHINA: AN AGE PERIOD COHORT ANALYSIS
Authors: Zhang Jingwen 
Published: January 2025

Abstract
The rapid demographic changes, combined with heavy reliance on informal care, pose significant challenges to meeting long-term care (LTC) needs in China. However, research has yet to comprehensively appraise how and to what extent the unmet need has changed during the past two decades. Drawing on data from 6,030 urban and 5,070 rural residents in the Chinese Longitudinal Health Longevity Survey (CLHLS), 2005-2017/18, this study investigates the temporal changes in unmet LTC needs among Chinese older adults. We applied the newly developed age-period-cohort interaction (APC-I) model to disentangle the three temporal processes and their place-based rural-urban variation. The study found that, overall, rural older adults experienced a higher risk of unmet needs for LTC, yet the age, period and cohort effects on unmet needs among rural older people differed from their urban counterparts. Although ‘younger’ older adults had fewer care needs than older adults, they had a higher risk of experiencing unmet needs. The variation in the age effects was larger among rural older adults. The risk of having unmet needs did not change significantly over the 12 years. The unmet needs for LTC were more pronounced among more recent cohorts than previous generations, especially in urban areas. The findings provide crucial policy insights, underscoring the necessity for targeted interventions to address the care needs of ‘younger’ older adults, whose demands may not be perceived as severe enough for immediate attention. The escalating care gap among recent cohorts emphasises the need for increased investment in the formal LTC system.