bluuebunny/crossref_metadata_2025_split huggingface dataset:
COST EFFECTIVENESS ANALYSIS OF IMPLEMENTING A SCREENING PROGRAM FOR EARLY-STAGE ALZHEIMER’S DISEASE DETECTION
Authors: Jung Yeongin , Wu Kaili , Alnufeay Mashael , Jin Xiaotong , Ballreich Jeromie , Drabo Emmanuel 
Published: January 2025

Abstract
Recent advancements in Alzheimer’s Disease(AD) diagnosis have been propelled by the advent of disease-modifying therapies and the emergence of plasma-based biomarkers, notably P-tau217, which offers diagnostic accuracy comparable to cerebrospinal fluid assays and enables early disease detection. This study evaluates the cost-effectiveness of two AD early detection strategies for individuals aged 65 and above showing early-stage neuropathological abnormalities: solely using blood biomarker testing(P-tau217) and a sequential approach starting with plasma biomarker followed by confirmation via Aβ-PET scan. The cost-effectiveness of two early screening methods in a representative cohort of older adults in the US aged 65 and above with early-stage brain abnormalities(n=1000) is evaluated: 1) P-tau217 blood biomarker testing alone(Strategy 1); and 2) P-tau217 blood biomarker testing followed by confirmatory Aβ-PET scan(Strategy 2). Employing a hybrid model combining a decision tree and a Markov model, we simulated screening decisions, outcomes, costs, and quality-adjusted-life-years(QALYs) across AD progression stages(preclinical, mild, moderate, severe) and death over 35 years. Results suggest that Strategy 1(blood biomarker testing alone) dominates Strategy 2, producing 891 incremental QALYs at the additional cost of $49.2million translating to an incremental cost-effectiveness ratio(ICER) of $55,194/QALY gained and an incremental net monetary benefit of $39.9million at the decision threshold of $100,000/QALY gained. These results were attributable to the direct medical costs from delayed AD identification by false-negative misclassifications, and the avoided disutility from Aβ-PET. The findings were robust to uncertainties in model input parameters and highlight the utility of blood biomarkers as a cost-effective preclinical AD screening option in US older adults.
IMPLEMENTATION OF DEMENTIA FRIENDS IN WASHINGTON STATE
Authors: Zeitler Katie 
Published: January 2025

Abstract
Dementia Friends (DF) is a global movement whose mission is to raise awareness about dementia and the challenges associated with its stigma. The purpose of this presentation is to trace the journey including the evidence supporting the implementation of DF in Washington State and describe next steps. The movement has 13.5 million participants worldwide and utilizes a train-the-trainer model to deliver information sessions to members of the community that discuss what dementia is, five key messages, and communication tips. From 2018-2019, DF was piloted in Washington with the support of the Dementia Action Collaborative. Data showed that Dementia Attitudes Scale scores improved after a DF session and that this improvement was maintained through the one-month follow up. The results from the pilot program led to the approval of funding from Washington state for the implementation of the program in 2022. The state lead for DF Washington, the UW Memory and Brain Wellness Center, implemented the program by partnering with Regional Lead Organizations to assist in deploying the train-the-trainer model to expand DF in their regions. Each Regional Lead Organization nominated a Regional Coordinator to oversee the DF program in their region and train new volunteer “DF Champions” to lead information sessions. Funding from the state and partnerships with Regional Lead Organizations have facilitated the expansion of DF program from 214 participants in 3 counties in 2019 to 2,170 participants in 24 counties in 2024. A key challenge for DF will be cultivating community partnerships in rural areas and underserved populations.
A REFLECTION OF A STUDENT-LED VIRTUAL REALITY ADOPTION PROGRAM FOR PEOPLE LIVING WITH DEMENTIA IN LONG-TERM CARE
Authors: Wong Joey , Wong Karen Lok Yi , Van Mary , Hayat Yumna , Wallsworth Christine , Mann Jim , Wong Lily , Hung Lillian 
Published: January 2025

Abstract
Previous research suggests that virtual reality (VR) holds promise in improving residents’ well-being in long-term care (LTC). With ongoing staff shortages, there is a critical need to explore, evaluate and share learnings on innovative approaches for adopting technologies, including VR, in LTC. In our research study conducted at two LTC homes in Vancouver, Canada, undergraduate students supported staff members in VR adoption. This study reflects on the opportunities and challenges of VR adoption from the students’ perspectives. Utilizing a critical reflection framework, our interdisciplinary team engaged in extensive discussions and reflections via Zoom meetings, resulting in the following five themes: (1) Challenging the stigma towards dementia in LTC, (2) Addressing ageism in older adults’ technology usage, (3) Building relationships through consistent and repeated visits to facilitate technology adoption, (4) Recognizing students’ value in technology implementation and their potential impact on LTC’s future workforce, and (5) Recognizing the importance of emotional and organizational support. Based on these reflections, our team devised the “ENRICH” framework, offering six practical tips to support student involvement in enhancing technology adoption in LTC. The team’s insights highlight the potential of engaging university students in promoting technology adoption in LTC settings. The “ENRICH” framework provides a practical approach to fostering technology uptake while offering valuable learning experiences for students. This study encourages further exploration of student participation in LTC research to advance future initiatives in this field.
A SYSTEMATIC REVIEW OF QUANTITATIVE STUDIES OF LONELINESS AND SOCIAL ISOLATION IN LONG-TERM CARE
Authors: Smith LaTonya , Theeke Laurie 
Published: January 2025

Abstract
Loneliness and social isolation, though conceptually different, are both prevalent conditions for adults in long-term care facilities. These individuals, often separated from their previous lives, communities, and families, can experience a significant disconnect, leading to a pervasive sense of isolation and abandonment. Both conditions elicit a stress response, exacerbate physical health issues, lead to anxiety and depression, and significantly decrease quality of life and longevity; making it critical to understand these conditions in this population. The purpose of this paper is to present a systematic review of quantitative studies that operationalized loneliness or social isolation in samples of older adults in long-term care. The literature search used EbscoHost and included MEDLINE Complete, CINAHL complete, APA PsycArticles, and APA PsycINFO and resulted in 20 articles for inclusion. The synthesis of study findings makes it clear that loneliness and social isolation are associated with harmful health outcomes with up to 56% of residents reporting loneliness. Older adults with more functional ability and higher resilience scores were less lonely. Those with pain and those with rumination, deterministic thinking and confabulation reported increased loneliness. Intervention programs that included gardening, music, videoconferencing with families, laughter yoga, and peer mentor programs were effective for diminishing loneliness. Future studies are needed for comparative effectiveness of current interventions and for the testing of new interventions designed for this setting that are more precise to each condition. Clinical protocols for assessment and treatment of loneliness and social isolation in long-term care could enhance resident experience and potentially, longevity.
THE CONTINUOUS LEARNING NEEDS OF PERSONAL SUPPORT WORKERS WHO CARE FOR PEOPLE LIVING WITH DEMENTIA IN LONG-TERM CARE
Authors: Norris Grace , Savundranayagam Marie , Vafaei Afshin , Teachman Gail 
Published: January 2025

Abstract
Personal support workers (PSWs) in long-term care (LTC) homes comprise over half of the workforce responsible for providing care to people living with dementia. Compared to other healthcare professionals, PSWs receive the least education, which fails to equip them with the necessary competencies for quality dementia care. To provide optimal care to people living with dementia, PSWs need to be offered opportunities for continuous education that addresses their specific learning needs. Therefore, this study identified and examined the dementia-specific learning needs of PSWs in LTC. Interpretive description guided the secondary qualitative analysis of 22 focus groups with ‘mid-career’ PSWs (n = 39) in LTC. The analysis identified specific learning needs along with ways in which those needs are best met. The learning needs include: 1) addressing responsive behaviours, 2) person-centered communication and attitudes, 3) delirium, and 4) dementia as a chronic condition. Learning needs were most commonly attributed to limited preparation during formal PSW education and a lack of continuous training opportunities throughout their career. Learning needs are best met through experiential methods involving peer learning, feedback, and evaluation within a supportive environment. For the learning needs to mediate practical outcomes, there needs to be an openness to dementia education and a good teamwork culture within LTC. The data generated from this research study will be essential to developing future continuing education for PSWs, contributing to knowledge about dementia care within LTC settings, and improving the quality of care provided to people living with dementia.
THE USE OF MINDFULNESS-BASED INTERVENTION FOR LONG-TERM CARE RESIDENTS: A REVIEW OF THE LITERATURE
Authors: Raciti Audrieanna , Chang Yu-Ping 
Published: January 2025

Abstract
Physiological and psychological health is a significant concern among people residing in long term care. Researchers have begun to design and test mindfulness-based interventions (MBIs) as a strategy to lessen the burden of these impacts on long-term care residents as well as our already strained healthcare system. The purpose of this review is to synthesize the use of MBIs and their impact on health-related outcomes and quality of life among long term care residents. Six databases: CINAHL, PUBMED, Cochrane, Web of Science, Psychinfo, and Embase were searched to identify original studies leveraging the use of mindfulness to improve health-related outcomes for long term care residents. Multiple keywords were used including mindfulness-based stress reduction, meditation, mindfulness intervention, long-term care, nursing home, residential care, older adult, elderly, and aged. Nine studies meeting the selection criteria were included in this systematic review. Most of the studies have a small to medium sample size. The types of MBIs include mindfulness-based cognitive therapy, silent meditations, mountain meditations, loving-kindness meditations, awareness exercises, breathing exercises, visualization, and guided imagery. The majority of those MBIs demonstrate a significant improvement in alleviating symptoms of stress, depression, anxiety, relocation anxiety, worsening dementia, and other mental health concerns, while one study also showed significant improvement in A1C levels among residents with type 2 diabetes. However, some studies have a high attrition rate. Future research is needed to utilize a more rigorous design with a large sample size and longitudinal studies. Participant engagement should be considered as part of the intervention activities.
CLINICAL PRESENTATION OF INTERSTITIAL LUNG DISEASE AS AN INITIAL MANIFESTATION OF ANTISYNTHETASE SYNDROME
Authors: De Pablo Pamela Salcido , Encarnación Carolina Escorcia , Olvera Alfredo 
Published: January 2025

Abstract
Antisynthetase syndrome (ASS) is an autoimmune disease, categorized as a type of idiopathic inflammatory myopathy, where interstitial lung disease is the most common manifestation, presenting in up to 80% of cases. It is related to antibodies and aminoacyl-transfer RNA (tRNA) and the most common one, anti-Jo. It has an incidence of 0.56 per 100,000 inhabitants, commonly in adults with an average age of 45 to 70 years old. A 72-year-old female, with a medical history of dyslipidemia, depression, and gonarthrosis, presents with dyspnea, hypoxemia, wheezings, asthenia, arthralgias, and myalgias. A chest radiograph showed abnormal parenchyma, with bilateral opacities in peripheral and subpleural zones, diagnosis was compatible with pneumonitis, treated with quinolones, steroids, and short-acting bronchodilators. With partial recovery, TC scan showed patchy ground-glass-like pattern, bronchi ecstasies, and honeycomb zones, spirometry showed restrictive pattern and rheumatology tests reports were negative for antibody anti-Jo-1 and positive in antinuclear antibodies (ANAs). After several differential diagnoses and studies; a diagnosis of antisynthetase syndrome was reached. Although its low prevalence in the general population, the importance of knowing about antisynthetase syndrome lies in understanding the pathology and encouraging research on it, thus achieving a good diagnosis and adequate interdisciplinary management that these patients should require in a syndrome that still exists. For this reason, this case report intends to mention some of the most used tools currently in use, which helped to diagnose this interesting and uncommon case.
PERCEPTION OF NEIGHBORHOOD WALKABILITY INFLUENCES PHYSICAL THERAPISTS’ WALKING RECOMMENDATIONS FOR OLDER ADULTS
Authors: Blackwood Jennifer , Karczewski Hannah 
Published: January 2025

Abstract

Background/objectives
Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults’ participation in outdoor walking. Physical therapists (PTs) may identify factors that influence decisions about outdoor participation in walking. Current understanding of PTs’ knowledge and perceptions of walkability, and utilization of walkability assessments is not described and serves as the purpose of this study.

Methods
A cross-sectional survey was sent via email to 5000 PTs nationwide with IRB approval. The 40-item survey covered the following: walking and walkability perceptions and assessments, perception of responsibilities, and demographics. Categorical variables were compared using Chi-square analyses.

Results
After inclusion and exclusion criteria, a total of 122 outpatient PTs who worked in geriatrics were used for analysis. A significant difference was found between perceptions of whether PTs should assess walkability and whether they assess walkability (x2=78.7, p&lt; 0.001). Components that influenced decisions to prescribe outdoor walking were prioritized in this order: availability (n=79, 64.8%) and maintenance (n=11, 9.0%) of sidewalks, crime (n=9, 7.4%), hills (n=7, 5.7%), aesthetics (n=6, 4.9%), and other (n=10, 8.2%). Objective measures were not used to assess walkability.

Conclusion
Respondents had a significant difference between perceptions of their responsibility to assess walkability and whether they do assess walkability in older adults before prescribing walking. Built environment constructs were prioritized over the social environment. Significance/Implications: Assessment of walkability may allow PTs to identify barriers and make more informed recommendations concerning outdoor walking for older adults. Objective measures are available for PTs when prescribing outdoor walking.
RISK FACTORS FOR NINE-YEAR MORTALITY OF OLDER PATIENTS WITH COGNITIVE IMPAIRMENT AT ADMISSION
Authors: Yamamoto Hiroshi , Ogawa Kenichi , Hisamatstu Yasushi , Ishitake Tatsuya 
Published: January 2025

Abstract

Background
Dementia can be a major cause of mortality and morbidity in geriatric patients. So, it would be essential to assess their mental state in the early. Aims: We aim to appraise the impact on mortality and hospital outcomes by revised simplified short-term memory recall test (STMT-R) and collecting clinical data simultaneous.

Methods
The subjects were 612 acute inpatients ≥65 from December 2014 to September 2015. Following the collection of clinical data, survival was subsequently measured for 8-9years until December 2023. An STMT-R score of ≤4 were considered to indicate cognitive dysfunction. To explore the association between the risk factors and mortality in cognitive impairment subjects, Kaplan-Meier method and Cox’s proportional hazards regression models were used to examine mortality and survival rates.

Results
The mean age of the subjects was 82.1 (±7.94), and 55.9% were female. Cognitive function was classified into three categories according to severity respectively; Incomplete Testing Group (Incomplete), Cognitive dysfunction (Abnormal) and Non-Cognitive dysfunction Group (Normal). 349 patients (57.0%) died during follow-up. Kaplan-Meier and the log-rank tests showed the negative prognostic effect of cognitive impairment, malnutrition, pneumonia and cancer-bearing state (p &lt; 0.01). After adjustment for potential covariates the Cox regression showed that mortality hazard is increased with “Incomplete” (HR 3.526 CI 95% 2.388-5.206 p&lt; 0.0001) and “Abnormal” (HR 1.676 1.210-2.321 p=0.0019).

Conclusion
Malnutrition, pneumonia and cancer-bearing state can significantly decrease the survival rate in patients with cognitive impairment at admission. Cognitive impairment also has independently an impact on survival rate in acutely ill geriatric patients.
FINANCIAL TRANSFERS BETWEEN OLDER FILIPINOS AND THEIR ADULT CHILDREN: THE ROLE OF EDUCATION AND PUBLIC PENSIONS
Authors: Cheng Kent Jason 
Published: January 2025

Abstract

Objectives
The Philippines is expected to transition to an aging society in less than two decades. Provision of resources and safety nets largely befalls family members since government support is limited. This study examines how education and public pensions shape older Filipinos’ financial transfers to and from their adult children.

Methods
Data on Filipinos aged 60+ with at least one living child came from the 2018 Longitudinal Study of Ageing and Health in the Philippines (n=5,645). Logistic regressions interacting educational attainment and public pension receipt (no pensions, have contribution-based pensions, have social pensions, have both) were ran, controlling for relevant sociodemographic factors, average characteristics of children, and living arrangements. Predicted probabilities were generated and pairwise comparisons were conducted.

Results
Higher educational attainment and having contribution-based public pensions were associated with higher (decreased) odds of giving (receiving) transfers. Interactive models suggest a modest moderating effect of education and public pension types on giving and receiving financial transfers. Within education level, public pension receivers, especially those with contribution-based pensions, tend to have the highest probability of transferring to children and lowest probability of being exclusively on the receiving end of money transfers.

Discussion
Public pension receivers being more likely to give downward financial transfer across all educational levels suggests that public transfers for older adults benefit both the intended beneficiaries and their descendants. Additionally, older parents having contribution-based pensions as an income source spares their adult children from providing upward transfers. Results support crowding in – that public transfers facilitate private transfers.
HEALTH CARE UTILIZATION AND COSTS FOR HOSPITALIZED DEMENTIA PATIENTS IN CHINA
Authors: Lin Zhuoer , Ba Fang , Allore Heather , Chen Xi 
Published: January 2025

Abstract

Background
Dementia poses challenges to patients and healthcare systems; yet little is known about the healthcare utilization and costs for dementia patients in China and their major contributors.

Methods
We identified 51,530 inpatient records of Chinese older adults who were admitted to 1,917 hospitals during 2017-2019 with a primary diagnosis of dementia. Multivariable logistic regressions estimated associations for emergency room (ER) admission and tertiary hospital admission; and linear regressions were performed to examine the determinants of length of stay (LOS), daily and total costs in Chinese Yuan (CNY). The potential contributors included age, sex, insurance type, working status, comorbidity, admission type and hospital level.

Results
The sample had a median age 78 (IQR: 72-84), of whom 46.2% were females, 20.2% were admitted through an ER, and 69.0% were admitted to tertiary hospitals. LOS, daily and total costs per admission were 21 days, 948 CNY and 12,602 CNY, respectively. Increased adjusted odds of ER admission were associated with having lung diseases or lower insurance coverage. LOS was longer for older patients, females, retirees, or those with more insurance coverage or admitted to lower-level hospitals. The total costs were higher among older patients, males, patients with lung diseases, more insurance coverage, and patients admitted to ER or tertiary hospitals.

Conclusion
There are large variations in inpatient care utilization and costs across dementia patients of different demographics, insurance types, and comorbidities. Our findings highlighted the importance of promoting chronic disease management and insurance coverage, as well as providing affordable and equitable dementia care.
NEIGHBORHOOD ENVIRONMENT AND COGNITIVE FUNCTION AMONG OLDER ADULTS IN BRAZIL
Authors: Álvarez Lourdes Romañach , Farina Mateo , Muñoz Elizabeth 
Published: January 2025

Abstract
Neighborhood characteristics, such as social cohesion and community resources, are linked to better cognitive functioning in older adulthood. However, little is known about the significance of neighborhoods for cognitive function in lower- and middle-income countries where this association may be augmented by limited resources and higher economic inequality. The present study used data from the 2016 Brazilian Longitudinal Study of Aging (ELSI-Brazil) to examine the association between self-reported neighborhood characteristics and cognitive functioning. ELSI-Brazil is a nationally representative sample of community-residing adults in Brazil aged 50 years and older (n = 9,412). We fit a series of linear regression models to test the hypothesis that more favorable neighborhood characteristics are associated with better cognitive functioning. Participants completed self-reported questionnaires of their neighborhood’s social cohesion and availability of healthy foods. A global cognitive score was calculated with a latent variable (g) that was created with confirmatory factor analysis. Adjusted models showed that social cohesion, specifically appraising their neighborhood as a good place to live and trusting most people in their neighborhood, was associated with higher cognitive functioning. Likewise, those who reported greater availability of fresh fruits and vegetables within their neighborhood displayed better cognitive function. Findings provide support for the protective role of neighborhood social cohesion and availability of healthy foods on cognitive function among adults in Brazil. Further research is needed to elucidate what mechanisms may explain this association in the Brazilian context.