bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION BETWEEN PARTNER IDENTIFICATION AND EDUCATION WITH HOSPITAL LENGTH OF STAY FOR PATIENTS WITH DEMENTIA
Authors: Werner Nicole , Medlin Austin , Fields Beth 
Published: January 2025

Abstract
Despite overwhelming reliance on care partners to care for people living with dementia (PLWD) after a hospitalization, care partners rarely receive adequate education to meet post-hospitalization caregiving demands, which is associated with health consequences including adverse clinical outcomes for PLWD, and increased levels of stress, depression, and morbidity for care partners. The present study aimed to explore associations between care partner identification as documented in the electronic health record (EHR), documented care partner education, and PLWD length of stay (LOS). We extracted EHR data from a large academic medical center in the Midwest between 1/1/2019 and 8/1/2022 (N = 8038). To assess association between care partner identification and PLWD LOS, encounters were coded dichotomously, either ‘lacking a care partner’ or ‘care partner present’, depending on EHR documentation. Similarly, encounters received designations of increased education if care partners received more education on post-discharge care than the education sample median. Independent t-tests analyzed mean differences on LOS for care partner identification. The same approach was used on a subsample of encounters with care partner identification (n=1644) to analyze associations between care partner education and LOS. We found no significant difference in LOS based on care partner identification status (p=.072). Among PLWD with identified care partners, significant differences in LOS were found between education groups (p=.017), where longer hospitalizations were associated with more care partner education (less education M=5.9 days, more education M=6.9). These results suggest that targeted education could better support care partners when a shorter LOS is expected for PLWD.
LEVERAGING ELECTRONIC MEDICAL RECORD DATA TO IDENTIFY MODIFIABLE CONTRIBUTORS TO ACUTE CARE USE IN DEMENTIA
Authors: Nothelle Stephanie , Ahmidouch Mohamed , Loosen Julia , Boyd Cynthia , Wolff Jennifer 
Published: January 2025

Abstract
Persons living with dementia (PLWD) are at increased risk of potentially preventable acute care visits (hospitalizations and emergency department visits), but modifiable contributors are poorly understood. We aimed to identify potentially modifiable factors from patient secure portal messages and outpatient clinical notes in the 30 days leading up to a potentially preventable acute care visit. We examined data from the Johns Hopkins Health System electronic medical record from 2017-2022. We included adults &gt;64 years with dementia diagnosis, 1+ advanced chronic illness (advanced liver disease, chronic obstructive pulmonary disease, congestive heart failure, diabetes with complications, chronic kidney disease), 2+ primary care visits who had a potentially preventable acute care visit. Two coders coded each message or note using a qualitative content analysis approach. We included 128 PLWD of whom 75 (69%) were female, and 68 (53%) were white. Approximately 47 (37%) had at least one patient/caregiver initiated portal message. Topics identified were similar across patient portal message and clinical notes. The most commonly mentioned needs related to care coordination, health systems navigation, medication management, access to and timeliness of care, and new physical symptoms. Cognitive concerns or symptoms were more commonly mentioned in clinical notes than portal messages. Portal messages and outpatient clinical notes prior to a potentially preventable acute care visit contain information about unmet care needs, predominantly related to coordinating and accessing care. Needs identified in this analysis may be addressable by a care manager to prevent unnecessary acute care use.
FAMILY CAREGIVER PERSPECTIVES ON THE PALLIATIVE CARE NEEDS OF HOSPITALIZED PERSONS LIVING WITH DEMENTIA
Authors: Kwak Jung , Kvale Elizabeth , Mills Sarah , Oppong Kwaku Duah 
Published: January 2025

Abstract
The progressive nature of dementia results in significant symptom burden, functional decline, and frequent hospitalizations, underscoring the need for specialized palliative care for persons living with dementia (PLWDs) and their caregivers. Existing studies, primarily retrospective analyses of health records or provider interviews, lack information on the critical psychosocial and social support contexts that significantly influence the palliative care needs of PLWDs. Addressing this gap, our study explored the perspectives of family caregivers on the palliative care needs of hospitalized PLWDs, informed by the Adapted Conceptual Model Integrating Palliative Care in Serious Illness and Multiple Chronic Conditions. We interviewed 37 caregivers of hospitalized PLWDs who were referred for palliative care. Caregivers identified primarily as female (66%) and caring for parents (58%), and as White (46%), Black (17%), Asian (5%), and Latino (31%). Most common challenges caregivers reported were about addressing health issues (58%), managing emotional difficulties (53%), and making care plan decisions (42%). Three related themes emerged from in-depth qualitative interviews: the complex care needs of PLWDs, including pain and symptom management; caregivers’ needs for support in discharge preparation; and challenges in making care transition decisions into facilities. These insights underscore the caregivers’ critical role in managing care and making decisions during critical care transitions for hospitalized PLWDs. The findings provide implications for practice and research including enhanced care coordination between primary, palliative, and discharge planning services in acute settings and future research on the impact of psychosocial and social support factors on palliative care outcomes for this vulnerable population.
THE PARADOX OF CONNECTION: MUTUAL FOLLOWING’S IMPACT ON LONELINESS AMONG OLDER ADULTS IN ONLINE NETWORKS
Authors: Kim Nahyun , Katagiri Keiko 
Published: January 2025

Abstract
Online communities serve as a resource for many older adults to create new connections, such as friendships and acquaintanceships that can help alleviate loneliness. Despite the many advantages, there is a lack of research on the network size in online communities tailored for older adults and its effects on loneliness reduction. This study examines mutual following on online platforms as an indicator of new connections, focusing on its relationship with the perceived formation of new connections and their subsequent effect on loneliness reduction among community members. In February 2023, we conducted an online survey within an online community for older adults in Japan, involving participants aged 60–79 (n=819). The platform provided features such as photo sharing, group participation, and user following. Data collected included group participation, mutual following, perceived establishment of new online connections, and loneliness. A path analysis revealed that a greater number of mutual followers was positively related to the perception of establishing new online connections, leading to a reduction in loneliness. However, we also found a direct positive association between mutual following and loneliness, indicating a paradoxical finding: the mere increase in mutual followers, devoid of meaningful engagement, may exacerbate loneliness. This suggests that the effectiveness of online connections in reducing loneliness is contingent upon the quality of relationships formed. These findings highlight the importance of fostering quality interactions within online communities, to enhance older adults’ well-being in digital environments.
PERSPECTIVES OF PERSON-CENTEREDNESS ACROSS LONG-TERM CARE AND COMMUNITY-BASED SETTINGS
Authors: Stratton Lauren , Zimmerman Sheryl , Efird-Green Lea , Fazio Sam 
Published: January 2025

Abstract
Within long-term care, person-centeredness is key to providing quality care to people living with dementia. However, there are discrepancies on how long-term and community-based organizations provide care that is person-centered and how it is integrated within their organizations and among staff. To better understand the concept of person-centeredness within long-term and community-based services, we conducted three focus groups with members of the Alzheimer’s Association Dementia Care Provider Roundtable, which consists of leadership of long-term and community-based care organizations. Prompts asked questions on person-centeredness in relation to current organizational systems, care, and workforce. Overall, themes emerged on types of care that are delivered in a person-centered way, challenges in delivering care in a person-centered care, the integration of person-centeredness into staff training, and if person-centered is the correct term to use. Additionally, discussion included integrating technology in a more person-centered way to benefit both the staff and the person living with dementia. Understanding these themes may help to provide recommendations on how to create guidelines for training staff and integrate person-centered care with the long-term care workforce more effectively.
USC ALZHEIMER’S DISEASE AND ALZHEIMER’S DISEASE-RELATED DEMENTIAS (RCMAR) CENTER: LESSONS LEARNED
Authors: Ailshire Jennifer 
Published: January 2025

Abstract
The National Institute on Aging has awarded another five-year, $3.6M grant to fund the University of Southern California Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias Resource Center for Minority Aging Research. The Center is led by the multidisciplinary team of Julie Zissimopoulos, Jennifer Ailshire, and Emma Aguila. The USC AD/ADRD RCMAR supports junior scientists exploring health and economic disparities associated with dementia. The RCMAR – housed within the USC Schaeffer Center for Health Policy & Economics – focuses on pathways by which social, behavioral, and economic factors – as well as policies and health systems – affect disparities in risk of dementia and disparities in the health, health care and economic outcomes of persons living with dementia. The center also helps launch the careers of underrepresented junior investigators, providing funding, mentorship, and tools to support their pilot research projects. The Center was established in 2012 and has supported 34 scholars from USC and 14 other institutions. Alumni of the program have received more than $11.2 million in research funding and have published more than 268 peer-reviewed articles. Many scientists have received academic promotions and met career goals. The Center has an extensive network of supporters and collaborators including Howard University, Spelman College, Cal State Fullerton and other NIA-funded centers at USC including: Roybal Center for Behavioral Interventions of Aging, Alzheimer Disease Research Center, Center for Economic and Sociodemographic Study of AD/ADRD, and USC/UCLA Center on Biodemography and Population Health. The Center also supports the annual Science of AD/ADRD for Social Scientists.
GEOGRAPHIC DISPARITIES IN ALZHEIMER’S DISEASE AND RELATED DEMENTIAS USING BAYESIAN MULTISTATE LIFE TABLE METHODS
Authors: Wong Jason , Zang Emma 
Published: January 2025

Abstract
Research has documented persistent regional disparities in the risk of Alzheimer’s disease and related dementias (ADRD) in the United States based on individuals’ current residence. However, it remains unclear how childhood region and current region jointly shape later ADRD outcomes. This obscurity conceals significant variations among older adults who reside in the same current region. Using data from the 1998-2020 waves of the Health and Retirement Study, we employ an innovative Bayesian multistate life table method to estimate how ADRD-related life expectancies vary across combinations of birth regions and current regions. Our results show that ADRD-related life expectancies are more strongly associated with regions of birth than with current regions of residence. Especially, at age 50, individuals born in the South, regardless of current residence, were expected to have shorter years (Men: 13.8-15.2 years; Women: 17.3-18.4 years) of life living without ADRD and longer years (Men: 2.7-3.0 years; Women: 3.6-3.9 years) of life with dementia, compared to those born in other regions. Our findings offer new evidence of the Southern disadvantage of ADRD by demonstrating that growing up in the South during the critical period of childhood may have long-lasting impacts on cognitive functioning later in life.
HOW DO PLACES OF RESIDENCE OVER THE LIFE COURSE SHAPE THE DYNAMICS OF HEALTH DISPARITIES IN LATER LIFE?
Authors: Lin Zhuoer , Chen Xi 
Published: January 2025

Abstract

Background
Significant geographical disparities persist in cognitive and health outcomes. According to life course theory, these disparities may stem from a history of place-based exposures throughout lifespan. However, due to data limitations, no study has explored how residential history impacts later-life health inequalities.

Methods
We addressed this gap by constructing an exceptionally comprehensive residential history dataset. Drawing from the Health and Retirement Study, we identified state-level places of residence for each individual from birth to age 60, and subsequently linked this information to a broad range of cognitive and health outcomes in later life (N=10,124). Employing regression-based Shapley value decomposition, we quantified the contribution of place of residence at each age to cognitive and health outcomes, thereby delineating the trajectories of place effects on cognition and health.

Results
Our analysis revealed distinct contributions of place of residence at various ages, particularly in relation to cognitive health compared to other health outcomes. Notably, place of residence exerted the most significant influence on cognition at birth, with this contribution decreasing linearly and rapidly during the initial 20 years of life (from age 0 to age 20), before stabilizing during adulthood. In contrast, we observed an overall upward trend in the contribution of place of residence to other health outcomes such as disability and depression.

Discussion
Our findings underscore the dynamic nature of the contribution of place of residence to health inequalities over the life course, emphasizing substantial disparities in the effects of location on cognitive health compared to other health outcomes.
SUPPORTING FAMILY CAREGIVING IN MULTICULTURAL CONTEXTS
Authors: Yuwen Weichao , Ramirez Maggie , Xie Serena Jinchen 
Published: January 2025

Abstract
There are 53 million family caregivers providing an estimated $470 billion in unpaid care services in the U.S. annually. Over 40% of them self-identify as having a racial or ethnic minority background, and at least one-third speak a language other than English at home. Caregivers from racial and ethnic minority groups experience significantly more physical and emotional stress than their white counterparts. This session focuses on supporting family caregiving in multicultural contexts. Berridge will discuss cultural values as they relate to technology intervention considerations for caregivers of older adults. Li and Liang will discuss a study exploring the needs of Chinese American families caring for older adults and their perceptions of using technologies such as chatbots. Specifically, Li will discuss results from four focus groups with community-based organizations’ staff supporting these families, and Liang will discuss results from family caregivers. Cardoso-Arias will discuss structural barriers to accessing supportive services among Latino family caregivers. Finally, Aguilar will describe a conceptual model of family caregiving and health equity. To conclude, our discussant Ms. Xie will discuss cross-cutting implications across studies and offer insights on how to incorporate cultural considerations in developing technologies to support family caregivers.
CULTURAL CONTEXTS AND BEYOND: THE NEED FOR VALUE SENSITIVE DESIGN IN TECHNOLOGIES TO SUPPORT CARE
Authors: Berridge Clara 
Published: January 2025

Abstract
It has long been understood in fields such as science and technology studies that technologies and data are not value-neutral, but digital technology interventions to support care partners of older adults are often treated as such. Understanding that values are cultural commitments that are not universally prioritized is critical for effective and non-harmful interventions. This presentation will describe ways in which values, assumptions, and priorities are embedded in digital interventions, drawing on findings from multiple studies of families’ experiences with care technologies. The importance of attention to norms, values, and expectations in care relationships, as well as contextual factors such as trauma history and intergenerational family cultural conflict will be discussed. Practical questions will be offered to guide the broader application of Value Sensitive Design in technology design and research to make all stakeholders’ values explicit, understand value tensions, and center and operationalize the values and needs of intended users.
STRUCTURAL BARRIERS TO UTILIZATION OF SUPPORTIVE SERVICES AMONG LATINO CAREGIVERS OF PEOPLE LIVING WITH DEMENTIA
Authors: Cardoso-Arias Rafael , Ramirez Maggie 
Published: January 2025

Abstract
Underutilization of supportive healthcare and social services may contribute to Latino caregivers’ higher risk of experiencing adverse health outcomes. The study objective was to understand structural barriers to utilization of supportive services among Latino caregivers of people living with dementia (PLWD). In Washington State, we interviewed 30 Latino caregivers of PLWD and 14 healthcare and social service providers. We applied deductive coding to the interview transcripts—relying on predefined codes representing the Cultural Treatment Adaptation Framework. We then examined excerpts coded under “Treatment Access/Entry.” Lastly, we inductively derived themes representing structural barriers to Latino caregivers’ utilization of supportive services. We identified structural barriers within the following three themes: 1) ethnic and language discordance between providers and Latino caregivers, 2) limited coordination between health systems and the broader network of providers in the community, and 3) digital health inequities.These interconnected themes underscore the importance of culturally competent, linguistically accessible care and technologically innovative approaches for Latino families. Healthcare systems often adhere to standards of care primarily designed for a majority population, which may fall short in meeting the unique needs and preferences of Latino communities and lead to disparities in access to and utilization of supportive services. Overall, the study findings can inform decision makers to adapt and adopt targeted interventions, policies, and practices, to increase and improve utilization of supportive services for Latino PLWD and their family caregivers.
TECHNOLOGY AND TRADITIONAL TOOLS FOR INTERGENERATIONAL CONNECTIONS IN HIGHER EDUCATION
Authors: Fassi Janelle , Rickenbach Elizabeth , Newsham Tina 
Published: January 2025

Abstract
While the benefits of connecting older adults with college-aged students are well-documented in literature, the practical application of connecting these individuals together in intergenerational learning spaces is more challenging. This session focuses on the challenges and strategies for successfully implementing and sustaining intergenerational connections in higher education using technology or traditional tools like board games. Each presentation outlines an innovative way for connecting college-aged students with older adults both inside and outside the classroom. The first presentation focuses on the factors that impact the implementation and sustainability of the Cyber-Seniors program through an implementation science framework. The second presentation describes the use of a waitlist control design for examining and identifying the strengths of the Cyber-Seniors Program. The third presentation identifies the feasibility and reflections from an in-person intergenerational game collaboration with Saint Anselm College undergraduate students and community partners. The fourth presentation examines the benefits and challenges of Tellegacy, an intergenerational story-telling project facilitated by university students via in-person, phone or virtual one-on-one visits with older adults in retirement communities. Aligning with the Annual Scientific Meeting 2024 theme, these presentations demonstrate fortitude in refining processes to ensure we are building optimal experiences to connect students and older adults.
GAMES ARE FOR EVERYONE: A PILOT PROJECT TO FACILITATE INTERGENERATIONAL ENGAGEMENT THROUGH GAMES
Authors: Rickenbach Elizabeth , Brady Loretta , Clifford Adeline , Gamache Seana 
Published: January 2025

Abstract
Undergraduate students and faculty participated in a pilot project to facilitate intergenerational engagement with older adults in the community through games. Each age group shared “their generation’s” games and learned games together by playing new games curated by a game designer that are specific to an intergenerational audience. Previous research has demonstrated that intergenerational activities are beneficial to physical and mental health, mood, age-related biases, and reduced loneliness. Intergenerational activities that involve games can add an element of play, collaboration, and cognitive enrichment across all participants that may extend the benefits across all participants and encourage co-learning. Intergenerational research has often included life-interviews (older teaching younger) and when games are considered, they are often video games (younger teaching older); this project is novel in that it includes socialization, play, and cognitive engagement with traditional games with an “equal playing field” (both younger and older adults will teach and learn games). The specific purpose of the project was to demonstrate the feasibility of a facilitated game collaboration as an intergenerational activity through participant feedback. Results showed that the experience provided collaboration, joy, learning, and an opportunity for facilitated exposure to challenging topics (e.g., political discourse across generations, sharing life stories during play, expressing grief and loss during or prompted by play, experiencing frustration and satisfaction due to play experiences). Students reported that the games provide an opportunity for engagement with older adults that felt comfortable, and at times, the experience was “more about the conversation, and less about the games.”