bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSESSING THE COMPLEXITIES OF LONG-TERM SERVICES AND SUPPORTS FOR OLDER ADULTS OF TEXAS
Authors: Murphy Sara , Anaab Esme , Severance Jennifer , Yockey Robert 
Published: January 2025

Abstract

Background
Long-term services and supports (LTSS) encompass a broad range of medical and personal care assistance needed by individuals who are unable to perform self-care tasks due to aging, chronic illness, or disability. The No Wrong Door (NWD) System is a statewide network that coordinates the system of access to long-term services and supports. As an offshoot of the person-centered planning movement, the NWD System is premised on ensuring that no matter where individuals first interact with the system, they are guaranteed comprehensive information, assessment, and services. This work will help the Texas Health and Human Services Commission create a consumer-driven, cost-effective, and efficient system.

Methods
A mixed methods approach was constructed to understand the challenges and barriers to accessing LTSS, assess NWD System performance based on stakeholder perspectives, and identify community needs.

Results
Of 4,153 respondents, 56% identified as an adult 50 years or older and 53% older adults reported a LTSS need in the past year. The top three problems faced when trying to get services include a confusing system, long service wait times, and not knowing where to get help. Unpaid informal caregiver respite services, caregiver education, and caregiver support groups were among the services and supports that inadequately met people’s needs. Conclusions: Our results form the blueprint for facilitating access to care throughout Texas to ensure vulnerable populations obtain a high quality of life. Recommendations for the NWD system include effective community outreach and streamlined application processes for services and supports.
EHEALTH INTERVENTIONS TO PROMOTE PHYSICAL ACTIVITY AMONG OLDER ADULTS WITH MCI: A SYSTEMATIC REVIEW
Authors: Shin Jinhee , Konlan Kennedy Diema , Park Chang Gi 
Published: January 2025

Abstract
Physical activity positively influences and improves motor ability, increases desirable behavior, promotes brain activity, and increases marginal memory and thinking among older adults with mild cognitive impairments. This systematic review explored current trends and the effectiveness of digital health (eHealth) interventions to promote physical activity among older adults with mild cognitive impairment. We used the PRISMA guidelines and the PICO framework to search for literature in five electronic databases (PubMed, Embase, CINAHL, and Web of Sciences). The search outcome was transferred to Endnotes software and independently screened based on title, abstract, and full text using predetermined eligibility criteria. The screening resulted in 10 articles for extraction using a self-developed matrix. The JBI quality appraisal tool was used for quality appraisals and the conventional thematic data synthesis method of analysis was used. The strategy used was diverse and multiple technological platforms for the implementation of digital interventions, and included hardware technology like tablets, smartphones, smartwatches, Bluetooth devices, earpieces, computers, or durable covers, while, software techniques like promoting, customization, multimedia, multisensory, hands-on practice, demonstration, cueing, tech support, user manual or in the training of care practitioners were used. The use of digital-based health interventions for people with mild cognitive impairment to improve physical activity is still rudimentary even though the potential influence of such interventions is enormous. Interventions that use digital methods focusing on promoting physical activity among older adults with mild cognitive impairments should provide detailed information on the types of interventions, implementation, development process, and the resultant improvements.
HEALTH CARE COST BURDEN AND SELF-REPORTED FREQUENCY OF DEPRESSIVE/ANXIOUS FEELINGS IN OLDER ADULTS
Authors: Choi Namkee 
Published: January 2025

Abstract
Many older adults are burdened by out-of-pocket healthcare costs. Using the 2018-2021 National Health Interview Survey data, we examined: (1) healthcare cost burden and its associations with depressive/anxious feelings; and (2) whether during the pandemic (2020-2021), COVID infection and COVID-related healthcare access problems would also be associated with a higher likelihood of reporting healthcare cost burden and depression/anxiety. Nearly 12% of older adults (age 65+) reported healthcare cost burden, and a little over 18% reported daily/weekly depressive/anxious feelings. In generalized linear modeling analyses, the risk of healthcare cost burden was higher among women, racial/ethnic minorities (Blacks: incident risk ratio or IRR=1.49, 95% CI=1.35-1.65; Hispanics: IRR=1.27, 95% CI=1.12-1.44), those with chronic illnesses, mobility impairment, and those with Medicare Part D (IRR=1.14, 95% CI=1.04-1.20), but lower among individuals with Medicare-Medicaid dual eligibility, Medicare Advantage, VA/military insurance, and private insurance. The risk of daily/weekly depressive/anxious feelings was higher among healthcare cost burden reporters (IRR=1.76, 95% CI=1.64-1.88), controlling for sociodemographic and health status characteristics. The COVID-19 pandemic-related delay of or lack of access to medical care was also associated with a higher risk of reporting healthcare cost burden (IRR=1.67, 95% CI=1.52-1.84) and depression/anxiety (IRR=1.40, 95% CI=1.29-1.52). In sum, healthcare cost burden reporters were 1.8 times more likely to report high-frequency depressive/anxious feelings. Healthcare and social service providers should recognize the interconnection between financial strain associated with physical health problems and mental health in older adults. Policies and programs are needed to alleviate healthcare cost burden and ensure adequate access to healthcare services.
HYPERTENSION CONTROL AND ISCHEMIC STROKE RISK: REAL-WORLD DATA IN HISPANIC MEDICARE BENEFICIARIES IN SOUTH FLORIDA
Authors: Chaves Paulo , Desoria Maureen , Roque Leslye , Mas Rafael 
Published: January 2025

Abstract
The extent to which the magnitude of stroke risk reduction associated with blood pressure (BP) control in highly controlled trial research settings is translated to real world clinical settings remains to be better characterized, particularly in understudied populations. We examined the odds of hospitalization for acute stroke as a function of BP control in the previous year in Medicare Beneficiaries of Hispanic origin in south Florida. We analyzed de-identified electronic health records (2015-2019) from outpatients ≥65 years old receiving care at Leon Medical Centers (LMC), a major integrated healthcare services provider to Medicare and Medicare/Medicaid dually eligible (DE) Beneficiaries in Miami-Dade County, FL. In each year, within-person average systolic (SBP)&lt; 140 mmHg and diastolic (DBP)&lt; 90 mmHg were used to define controlled BP. Acute ischemic strokes were identified from hospital claims (ICD-CM-10 codes). Pooled longitudinal logistic regression with 1-year lagged time (n=36,519) with adjustment for age, sex, and DE status. Mean age (76.1±7.2 to 77.5±7.2), proportion of Hispanics (&gt;90%), and annual BP control rates (&gt;90%) remained constant throughout 2015-2019. Patients with controlled BP in a specific year had 39% lower (OR.61; 95%CI: 0.51, 0.73) odds of hospitalization for acute stroke in the subsequent year than those with uncontrolled BP. Neither sex, nor DE status modified the BP control–stroke risk relationship. In a large healthcare system in south Florida, we observed very high BP control levels, and, in line with published trial data, documented a substantially lower risk of ischemic stroke 1 year later in both Medicare and DE patients of Hispanic origin.
INTERNET AND HEALTH INFORMATION TECHNOLOGY USE AMONG MIDDLE-AGED AND OLDER ADULTS WITH ARTHRITIS
Authors: Lieber Sarah , Moxley Jerad , Reid M Carrington , Czaja Sara 
Published: January 2025

Abstract
Arthritis is a leading cause of healthcare utilization in older adults. Healthcare delivery increasingly occurs virtually. We assessed health information technology (HIT) use in middle-aged/older adults with and without self-reported arthritis by analyzing 2022 National Health Interview Survey data. Prevalence of internet access and internet use for health information, communication with doctor’s office, and review of test results was compared between adults ≥50 years of age with (versus without) arthritis (i.e., arthritis, rheumatoid arthritis, gout, lupus, fibromyalgia). Logistic regression was used to examine the relationship between arthritis and internet access and HIT behaviors. Among adults with arthritis (N=6371) for whom relevant survey data were available, 2640 (83%) reported internet access, and 1617 (61%), 1180 (45%), and 1359 (52%) used the internet for health information, communication with doctor’s office, and review of test results. Among adults without arthritis (N=9268) for whom relevant survey data were available, 4150 (88%) reported internet access, and 2367 (57%), 1687 (41%), and 2023 (49%) used the internet for health information, communication with doctor’s office, and review of test results. Arthritis was significantly associated with internet access and internet use for health information, communication with doctor’s office, and review of test results (all p&lt; 0.01); the relationship between arthritis and internet use for health information, communication with doctor’s office, and review of test results remained significant after adjustment for age and sociodemographic characteristics (all p&lt; 0.01). Further study of factors impacting HIT use in middle-aged/older adults with arthritis is needed to improve healthcare delivery in this population.
MICROBIOTA COULD REDUCE THE BRACHIAL-ANKLE PULSE WAVE VELOCITY TO PROTECT FROM CARDIOVASCULAR DISEASE
Authors: Zeng Shengyin , Li Yaxin , Chen Bangwei , Ruan Lei , Zhang Jianguo , Zhu Shida , Zhang Cuntai , Li Tao 
Published: January 2025

Abstract
Brachial-ankle pulse wave velocity (baPWV) is a risk factor for cardiovascular disease (CVD), and is associated with blood pressure and lipoprotein. However, research on the microbiota associated with baPWV has been limited. Here, we used two-sample bidirectional mendelian randomization (MR) analysis to assess the causality between gut microbiotas and baPWV. The exposure instrumental variables (IVs) were selected as significant independent variants (Linkage Disequilibrium (LD) R2 &lt; 0.01; P-value &lt; 5×10-8) from 1,521 gut microbiota genome-wide association studies (GWAS) summary data including class to species in the IEU OpenGWAS project. We performed baPWV GWAS analysis in Tongji-BGI research cardiovascular health (TORCH) cohort to obtain baPWV-related variants (rs141045630, rs11138617, rs77947040 and etc.) and selected suggestive variants (LD R2&lt; 0.01; P-value &lt; 1×10-5) as outcome IVs. The inverse variance weighted (IVW) was used as the primary MR analysis. In addition, we adjusted sex, age and other Framingham risk score factors. The sensitivity analysis involved changing the covariates, altering MR method and heterogeneity test. The analysis results showed higher abundance of Bifidobacterium adolescentis (P-value:1.81×10-4) and Lachnospiraceae (P-value:2.88×10-5) associated with lower baPWV. Moreover, MR evidence suggested a causal relationship between higher abundance of 3 microbiotas (Lactobacillales, P-value:1.72×10-3;Citrobacter, P-value:1.46×10-2; Ruminococcus, P-value:1.36×10-4) and higher baPWV. On the other hand, baPWV didn`t have potential causal effects on the abundance of B. adolescentis and Lachnospiraceae. In conclusion, a higher abundance of butyric acid-producing bacteria decreases baPWV and reduces arterial stiffness. We are currently performing more analyses with the metabolic pathway to explore more details in these results.
PATIENT PERCEPTIONS OF A PERSONALIZED MUSIC PLAYLIST PROGRAM FOR HOSPITALIZED OLDER ADULTS
Authors: Wong Kayla , Nandigam Maanasa , Nguyen Victor , Morka Angela , Kiwak Eliza , Li Judy , Sharninghausen Jody , Marottoli Richard 
Published: January 2025

Abstract
Personalized music playlists may be therapeutic for hospitalized older adults. As part of the “Creativity in Aging” project at Yale Geriatrics, this study aims to bring personalized music to hospitalized older adults and explore their perceptions of its effect on emotional and physical health. Patients (N = 57) hospitalized in an inpatient geriatrics unit participated in the program from October 2023 to February 2024. Qualitative data were collected from 19 patients. Trained undergraduate volunteers took detailed “music histories” from patients and, when appropriate, their family caregivers (e.g. patients with dementia), and created personalized playlists using iPads. Patients could listen to their playlists during volunteer shifts throughout their hospital stay. Pre and post-listening surveys were conducted to elicit patient perceptions through brief semi-structured interviews and ratings on a Likert mood scale. A qualitative thematic analysis using the principles of grounded theory was performed to create thematic categories of patients’ perceptions. Two coders open-coded separately then came together to agree on codes and themes. Saturation was reached, as no new themes were generated at the end of the thematic analysis. Five core themes emerged from the analysis: patients expressed feeling 1) calmer and more relaxed, 2) generally more positive, 3) reminiscent, 4) a want to sing and dance, and 5) physically and emotionally healed after listening to music. Constructive feedback included technical issues with iPads and wanting to listen to playlists more often. We aim to increase accessibility and expand the program to older adults in other areas of the hospital. The first two listed authors (MN and KW) contributed equally.
VACCINATION MOTIVATORS AND DETERRENTS AMONG UNDERVACCINATED OLDER ADULTS IN NORTH DAKOTA
Authors: Huseth-Zosel Andrea , Fuller Heather , Carson Paul 
Published: January 2025

Abstract
Despite increased risk of morbidity and mortality among older adults due to preventable infectious diseases such as influenza, shingles, pneumonia, and COVID-19, many older individuals forego receiving some, if not all, of these vaccinations. This study examines vaccination motivators and deterrents for undervaccinated older adults in North Dakota (ND). Adults aged 65+ in ND were mailed a survey (n=901) with questions gauging vaccination behaviors and perceptions. Of these participants, 132 indicating not receiving influenza, shingles, pneumonia, or COVID-19 vaccinations. Further questions assessed reasons they had not been vaccinated against each specific disease (e.g., “Concerned about side effects”, “Vaccines are dangerous”, “I’m healthy and I do not need it”) and what would make it more likely to get a vaccine (e.g., “More information”, “Doctor recommendation”, “Easy access to vaccines”). Reasons for remaining unvaccinated varied by vaccine type. For influenza and pneumococcal vaccines, respondents were more likely to indicate they are healthy and do not need the vaccine. For shingles and COVID-19, respondents were more likely to indicate concerns about side effects. Factors reported to motivate increasing the likelihood of getting any vaccine were receiving a doctor recommendation, receiving more information, and having a vaccine provided at no cost. These results contribute to our understanding of vaccination behaviors among older adults and underscore specific issues around which to frame interventions tailored to increase vaccine uptake for this population.
ADULT CHILDREN‘S SINGLEHOOD AND AGING PARENTS’ PSYCHOLOGICAL WELL-BEING IN SOUTH KOREA
Authors: Lim Mihye , Lee Hyo Jung 
Published: January 2025

Abstract
Guided by a life course perspective, this study aims to examine the linkages between the marital status of adult children as an indicator of the transition to adulthood and their parents’ psychological well-being, considering how parental socioeconomic resources play a role in this association. We conducted a series of regression models using data from the 2018 Korean Longitudinal Study of Ageing (KLOSA, n=3112 aging parents who had at least one child over 35 years old). Consistent with the exposure model, having an unmarried son was associated with poorer parental psychological well-being, irrespective of parental income and education. However, parental education partially explained the association between daughter’s marital status and parental psychological well-being, suggesting that parental well-being regarding adult children’s marital status may depend on child’s gender and parental education level. This study has implications for the intergenerational relationships in collectivist and patrilineal Eastern cultural context. Aging parents’ psychological well-being ties to their adult children’s marital status based on the social norm regarding the transition to adulthood, and particularly sons’ marital status than that of daughters’. Also, aging parents may have different views on daughter’s marital status depending on their educational attainment. In sum, based on the concept of ‘linked-lives’ and stress process model, this study provides an extended understanding of intergenerational relations in later life in Korea. Clinicians and family professionals should consider well-being in old age associated with adult children’s life transitions and gender in the cultural context.
BURDEN AMONG INFORMAL CAREGIVERS OF OLDER ADULTS IN GHANA: A SCOPING REVIEW
Authors: Okine Joana , Ruggiano Nicole 
Published: January 2025

Abstract
The aging population in Ghana has experienced a significant increase, expanding tenfold from 213,477 in 1960 to 1,991,736 in 2021 during the last population census. Projections indicate that by 2030, the population of persons aged 60 and above will hit 2.8 million (Mba, 2010). In Ghana, as in many African countries, kinship-based system of care is predominant as caregiving is viewed as a filial responsibility and an expression of love. There are empirical studies done in advanced countries like the USA that have documented the burden associated with caregiving for older adults. However, literature on burden among informal caregivers of older adults in Ghana in sparse. This study aimed to review available studies exploring caregiver burden experienced by informal caregivers in Ghana. We searched for studies published since 2013 across various databases, including Ebscohost (APA PsychInfo, CINAHL, Abstract in Social Gerontology, SocIndex, APA PsychArticles, Eric Ebscohost), Web of Science, Social Services Abstracts, Sociological Abstracts, Taylor and Francis, PubMed, and Google Scholar. Out of 505 identified studies, 9 met the inclusion criteria for this review. Findings suggest that caregivers of older adults in Ghana, irrespective of the care-recipient’s condition, face various burdens, including economic, physical, and psychological challenges. However, there is a noticeable gap in research addressing the burdens faced by informal Ghanian caregivers. It is crucial to focus on understanding and mitigating the burden on this group of caregivers to inform the development of culturally relevant interventions tailored to the needs of older adults and their caregivers.
COGNITIVE FRAILTY IN RURAL KOREAN OLDER ADULTS: A GENDER-BASED EXAMINATION
Authors: Jang Ah Ram , Sagong Hae 
Published: January 2025

Abstract
Cognitive frailty, characterized by the simultaneous presence of physical frailty and cognitive impairment, is strongly associated with dementia and mortality, with prevalence among community-dwelling older adults ranging from 0.9% to 12.0%. Rural residents exhibit a higher risk, underlining vulnerability to health issues. However, there is a significant research gap regarding factors influencing cognitive frailty, especially in rural areas. Our cross-sectional survey conducted from May to September 2020 in rural areas of South Korea aimed to address this gap. Participants (n=376) aged 65 or older were recruited from 60 primary health care posts. Incomplete data excluded 32 participants from analysis. Cardiovascular Health Study frailty index and Korean Mini-Mental State Examination were used to categorize cognitive frailty.T-tests, Chi-squared tests, and logistic regression analysis were employed for statistical analysis. The results indicate that among males, higher nutritional scores were associated with a reduced likelihood of cognitive frailty. Conversely, in females, older age heightened the risk. Further, factors such as education, higher nutritional scores, and active social participation were linked to a decreased likelihood of cognitive frailty in females. Recognizing these gender-specific influences, tailored interventions are paramount. Strategies should aim at enhancing nutritional status for both genders while placing a specific emphasis on promoting increased social participation among females. This study enhances our understanding of cognitive frailty in rural older adults and provides valuable insights for the development of targeted interventions.
EXPLORING CURRENT CHARACTERISTICS OF GEROTRANSCENDENCE: A QUALITATIVE STUDY OF OLD PERSONS LIVING IN TOKYO SUBURBS
Authors: Kitayama Jun , Igawa Hitoshi 
Published: January 2025

Abstract
Tornstam (2005) proposed the concept of “gerotranscendence.” He identifies the phenomenon that the boundary between the self and the outer world is loosened in old age as gerotranscendence. The purpose of this study is to explore the experience of gerotranscendence among older people today living in the suburbs of central Tokyo. The participants, three men and five women who averaged 73.9 years old, attended a community association for older adults. The WHO-5-J scale was used to measure the participant’s mental health, and the overall score (21.4 out of 25 points) indicates that the eight participants were in good health. A semi-structured interview based on Tornstam’s gerotranscendence interview guide was conducted individually. The authors reviewed the collected narrative data and analyzed its individual and universal features. Unlike Tornstam’s idea, the results demonstrated that the participants are mainly living in actual life, in a preliminary state of gerotranscendence. The realization of psychological changes associated with aging were not often experienced. Most of them had not yet considered their views on death. They did not experience changes in their personality traits or personality integration. Interestingly, some participants mentioned that they reminisced about family members who had passed away or tried not to purchase new goods. It seemed that these usual expressions contained faint but significant indications of transformation in their views of life. This may suggest that clear phenomena of gerotranscendence seldom occur in healthy older adults. Therefore a better understanding of psychological transcendence may be achieved by focusing on individual small stories.