bluuebunny/crossref_metadata_2025_split huggingface dataset:
INSIGHTS ON OLDER ADULTS WITH COGNITIVE IMPAIRMENT AND HEARING LOSS: EXPERT PERSPECTIVES
Authors: Blinka Marcela , Oh Esther , Hope Peter , Lee Paul , Tu Xueting , wang Natalie , Yasar Sevil , Nieman Carrie 
Published: January 2025

Abstract
Although hearing loss is highly prevalent among older adults, especially among older adults aging with cognitive impairment, few use hearing aids. Older adults with co-morbid cognitive impairment and hearing loss experience multiple barriers to hearing care, including hearing loss often going unrecognized by clinicians and deprioritizing hearing care among competing health priorities. To understand the barriers and facilitators to hearing care among persons living with dementia and inform the development of a hearing care intervention, we conducted semi-structured interviews with 10 experts. Experts included professionals with expertise in dementia, hearing loss, neuropsychiatric symptoms, behavioral intervention development, implementation science, and technology adoption. We used purposive sampling and snowball recruitment to recruit experts with demonstrated experience and diverse backgrounds. Qualitative content analysis was used to identify themes. Among the experts, 56% self-identified as male, and 78% self-identified as white. Experts highlighted the importance of a multi-component approach to hearing care, including education on hearing and dementia, management of neuropsychiatric symptoms, and employing effective communication strategies. Experts prioritized the need for interdisciplinary collaboration and dedicated training for clinicians. Experts emphasized the need to engage stakeholders throughout intervention development and testing, including the key role care partners play in prioritizing hearing care and supporting the ongoing use of assistive technologies. Experts also identified the need to integrate practical strategies to support communication needs and hearing technology that is affordable. Our findings support the importance of hearing care within dementia care and identify tangible opportunities to support hearing health among persons aging with cognitive impairment.
ASSESSING MEDICAID PAYMENT RATES AND COSTS OF CARING FOR THE MEDICAID POPULATION RESIDING IN NURSING HOMES
Authors: Miller Edward , Simpson Elizabeth , Karon Sara 
Published: January 2025

Abstract
This symposium reports findings from an analysis of the relationship between Medicaid payment rates and costs for caring for the Medicaid population residing in nursing homes (NHs). Prior to the COVID-19 pandemic, there were about 1.37 million Americans using one of the nation’s 15,000+ NHs. Medicaid is the primary and largest single payer for NH care, covering approximately two-thirds of NH residents. The residents paid for by Medicaid’s nursing facility benefit are typically long-stay residents who often require custodial-type care due to cognitive or physical impairments that must be provided on a long-term basis. Until recently, there has been limited information examining the relationship between Medicaid payment rates and the costs of caring for Medicaid NH residents. Such information is essential to support discussion of policy reforms that aim to improve the safety and quality of NH care. This study used Medicaid payment and cost report data for freestanding NHs in 44 states collected during the latest pre-pandemic period (2019). The national average and median per diem Medicaid payment rates and costs and Medicaid payment-to-cost ratios were calculated for the nation as a whole and by NH characteristics and state Medicaid payment policies. The first presentation establishes the context for the study (Miller). The second presentation describes the study methodology (Simpson). The third presentation reports study findings (Cohen). The last presentation delineates implications of the study findings for policy and practice (Bowblis). Sara Karon will serve as discussant.
FEDERAL AND STATE POLICIES AND STAKEHOLDER VIEWS ON MEDICAID NURSING HOME PAYMENT
Authors: Miller Edward , Bowblis John , Simpson Elizabeth , Karon Sara , Oliveira Iara , Dey Judith , Squillace Marie , Cohen Marc 
Published: January 2025

Abstract
How much nursing homes (NHs) are paid by Medicaid is determined at the state level. Medicaid coverage of NH care is a significant expenditure for states. Consequently, states design Medicaid payment models to achieve desired policy objectives related to NH costs and quality, access to care, payment equity, service capacity, and budgetary control. Setting Medicaid payment rates too high can lead to excess profits at the expense of taxpayers with unknown implications to improvements in quality and staffing levels. At the same time, NHs need financial resources to pay nursing staff and invest in other quality improvement efforts to assure proper care. The industry claims that NH costs are not fully covered by their Medicaid payments. Consumer advocates argue that NHs are already adequately paid, and profit incentives potentially divert funds away from resident care. There is no federal requirement that Medicaid payments cover the full cost of care.
IMPLICATIONS OF MEDICAID NURSING HOME PAYMENT AND COSTS FOR POLICY AND PRACTICE
Authors: Bowblis John , Miller Edward , Simpson Elizabeth , Karon Sara , Oliveira Iara , Dey Judith , Squillace Marie , Cohen Marc 
Published: January 2025

Abstract
This study is the most comprehensive analysis to date on the relationship between state Medicaid payment rates and nursing home (NH) reported costs of caring for Medicaid residents. The findings provide insight into how, on average, Medicaid payments compare to reported costs, and how that differs by different types of NHs. It does not address the adequacy of Medicaid payment, whether NHs were operating efficiently or were adequately staffed based on the acuity of their residents; nor does it address the quality of the data from the cost reports. Nonetheless, it does provide important information on state Medicaid payment rates and reported costs that can inform current discussions assessing potential Medicaid payment policy reforms. Findings from this study also can be used to examine the impact of potential changes in Medicaid payment on financial performance and disparities across NHs. Study limitations and directions for further investigation are discussed.
BIOLOGICAL RESOURCES FOR AGING RESEARCH AT THE NATIONAL INSITUTE ON AGING
Authors: Moro Manuel , Cogliati Tiziana , Fox Jennifer , Wang Fei 
Published: January 2025

Abstract
Research on aging, by its nature, requires the acquisition of data over an organism’s lifespan or at later stages in life. For animals with medium to long lifespans such as rodents and nonhuman primates (NHPs), time is a limiting factor for the acquisition of data and samples. One of the missions of the National Institute on Aging (NIA) is to maintain and manage biological resources needed to support aging research that would be otherwise less accessible or excessively costly or time consuming to the investigators. The resources made available to publicly funded investigators comprise: 1) live rodents (Aging Mouse and Rat Colonies); 2) cells from different species including human, NHP, rodent, and domestic companion animals (Aging Cell Repository); 3) tissues from aged rodents (Rodent Tissue Bank) and NHPs (NHP Tissue Bank); and 4) a database of NHP vital parameters (Primate Aging Database). The NIA also supports two multi-institutional programs investigating interventions with the potential to extend lifespan and delay disease/dysfunction in worms (Caenorhabditis Intervention Testing Program, CITP) and in mice (Interventions Testing Program, ITP). The NIA values feedback to continue to provide valuable resources that will help the field move forward.
ADVERSE MUSCLE COMPOSITION IS LINKED TO LOWER MITOCHONDRIAL RESPIRATION AND SLOWER WALKING SPEED
Authors: Ramos Sofhia , Glockner Katherine , Distefano Giovanna , Cawthon Peggy , Linge Jennifer , Leinhard Olof Dahlqvist , Goodpaster Bret , Coen Paul 
Published: January 2025

Abstract
Low muscle mass and fat infiltration are core features of sarcopenic obesity. We examined skeletal muscle mitochondrial respiration and walking speed in older adults with normal muscle composition (NMC), only low muscle volume (LMV), only high fat infiltration (HFI) and the combination of LMV and HFI, (adverse muscle composition (AMC)). Muscle composition was determined by whole body MRI and high resolution respirometry was performed on muscle biopsies from N=828 participants (76.3 ± 5.0 years old, 59.4% female) in the Study of Muscle, Mobility and Aging (SOMMA). We found that mitochondrial respiration was significantly lower in individuals with LMV (-10%), HFI (-9%) and AMC (-8%), compared to those with NMC. In multivariate regression models, 4m and 400m walking speeds were significantly slower in LMV (400m: β=-0.10 4m: β=-0.07, both p&lt; 0.05), HFI (400m: β=-0.14, 4m: β=-0.13, both p&lt; 0.01) and AMC (400m: β=-0.19, 4m: β=-0.16, both, p&lt; 0.01) groups, compared to NMC (400m: 1.11m/s, 4m:1.10m/s). Compared to NMC, mitochondrial respiration explained ~20% of the variance in 400m walking speed in LMV, ~64% in HFI, and ~47% in AMC, while all three groups remained significantly slower. Compared to those with NMC, mitochondrial respiration explained ~29%, and ~77% of the variance in 4m walking speed in LMV and HFI respectively, abolishing group differences in 4m walking speed, while mitochondrial respiration explained ~50% of the variance in ACM. In conclusion, low muscle volume, high fat infiltration and AMC phenotypes are linked to lower mitochondrial respiration and slower walking speed in older adults.
MENOPAUSE HISTORY AND COGNITIVE FUNCTION IN THE IGNITE TRIAL
Authors: Watts Amber , Donofry Shannon , Ripperger Hayley , Eklund Nicole , Wan Lu , Kang Chaeryon , Erickson Kirk 
Published: January 2025

Abstract
Lifetime exposure to estrogen, a neuroprotectant, is associated with cognitive aging and dementia. Surgically induced menopause (ovariectomy) is associated with poorer cognitive performance, while use of hormone therapy (e.g., birth control, menopausal hormone therapy) has shown mixed associations with cognitive performance. We investigated these associations in IGNITE, a 12-month, multi-site, randomized exercise trial. We measured cognition via the Montreal Cognitive Assessment (MoCA), and factor analysis-derived composite scores for episodic memory, processing speed, working memory, attentional control, and visuospatial processing. In 461 female participants, we estimated relationships between ovariectomy, hormone-use, and baseline cognitive performance accounting for age, education, APOE ε4 carrier status, and race. Ovariectomy predicted worse MoCA scores (B=0.22, p=.038), but was unrelated to cognitive composite scores. African American race accounted for the largest proportion of variance in this model (R2Change=.09). Menopausal hormone therapy was associated with better performance on episodic memory (B=.109, p=.018) and working memory (B=.101, p=.021). Birth control use predicted better performance on MoCA (B=.090, p=.033), working memory (B=.094, p=.017), and attentional control (B=.099, p=.015). The association of ovariectomy with MoCA and not with other domains may indicate an association with dementia, not with typical cognitive aging. Meanwhile menopausal hormone therapy was associated with higher order cognitive performance, not the dementia screener. Birth control was associated with both. Our results validate prior evidence that lifetime exposure to estrogen is an important predictor of older women’s cognitive health and indicate further investigation is needed to clarify differential associations of menopause history and cognitive performance in African American women.
DYNAMIC BALANCE PERFORMANCE WAS ASSOCIATED WITH BETTER COGNITION IN COMMUNITY-DWELLING LOW-INCOME OLDER ADULTS
Authors: Thiamwong Ladda , Komalasari Renata 
Published: January 2025

Abstract

Objectives
We cross-sectionally examined the relationships of dynamic and static balance performance, and handgrip strength, with cognitive performance in community-dwelling low-income older adults in Orlando, Florida.

Methods
This study was drawn from a sample of 92 older adults (90.2% females, Mage = 72.63, SD±6.82). Dynamic balance was measured by the Short Physical Performance Battery, static balance by BTrackS scores, handgrips by three handgrip trials, and cognitive performance by the Rowland Universal Dementia Assessment Scale.

Results
Across the participants, 71.7% were African American, 62% completed high school, and 57.6% were just enough financially. The multiple regression analysis indicated that the model explained 10.2% of the variance (R2=.319, F (3,88) = 3.33, p =.023). Dynamic balance (B =.075, p-value =.047) was significantly associated with cognitive performance, but static balance (B =-.023, p-value =.081) and handgrip strength were not (B =.002, p-value =.855), accounting for current depressive symptoms (B =.057, p-value =.374). Independent t-test showed that older adults with normal cognition (RUDAS scores ≥23) scored higher in dynamic balance (Mdifference= 27.845, p=.018) than those with possible cognitive impairment (RUDAS scores &lt; 23). Older adults who are cognitively healthy performed better than those with possible cognitive impairment in dynamic balance performance.

Discussion
Simple dynamic balance performance tests, comprising balance, gait speed, and chair stand tests, could serve as a valuable cognitive assessment tool in community-dwelling low-income older adults. Keywords: dynamic balance performance, static balance performance, handgrip strength, cognitive performance, Rowland Universal Dementia Assessment Scale, aging
CULTIVATING TRUST IN RESEARCH PARTNERSHIPS WITH OLDER ADULTS ACROSS THE COMMUNITY ENGAGEMENT CONTINUUM
Authors: Brothers Allyson , Behrens LIza , Leach Carrie 
Published: January 2025

Abstract
Community-engaged research is essential for identifying and supporting the needs of an aging society and ensuring effective translation of research findings. While not a new idea to the field of gerontology, engaged research models and frameworks are expanding, and researchers are seeing increased access to initiatives for building and sustaining community-engaged research programs. This symposium will feature emerging and established projects across multiple levels of the continuum of engagement, from informing, consulting, involving, collaborating, and ultimately to co-creating. Kim et al. will describe efforts to co-create programming and educational materials with and for Alaska Native caregivers, focusing on decolonizing methodologies. Halvorsen will showcase an ongoing academic-organizational partnership created to increase the research and evaluation capacity of a national nonprofit organization and its grantees. Gan will describe how diverse community members were engaged to understand and meet gaps in cognitive health promotion, resulting in the pilot of a mindful discussion program. Guest et al. will present on the formation and fruitful efforts of a resident advisory board at the University Based Retirement Community, sharing best practices for sustaining engagement. Mahmood et al. will report on a community-based participatory effort evaluating the role of built environment on mobility access across five cities in the Vancouver area. These exemplars will launch the symposium into a discussion about the utility of engaging older adults across the continuum, illustrating effective strategies for establishing trusted academic-community partnerships. We invite attendees to consider the value of this heuristic framework to plan and design fit-for-purpose community-engaged research projects. Community Engaged Research Interest Group Sponsored Symposium
CO-CREATING EVIDENCE-BASED PROGRAMMING AND EDUCATIONAL MATERIALS FOR ALASKA NATIVE CAREGIVERS
Authors: Kim Steffi , Lewis Jordan , Thompson Lena 
Published: January 2025

Abstract
Alaska Native Elders are rarely involved in creating educational and outreach materials. Over and over, Elders share that available educational and informative materials do not include their cultural understandings, programs do not meet their needs, and resource developers rarely attend to incorporate the specific and unique Alaska Native context. We will share our expereinces about outreach, recruitment, and establishment of an Alaska Native Community-engaged Aging Collaborative to engage community members, caregivers, and local organizations to create culturally appropriate and context-specific educational materials and programming that support Alaska Native Elders. Establishing this collaboration is the foundation for implementing research and programs driven by community needs and cultural understandings in conjunction with Western evidence-based approaches. Decolonizing strategies such as community member involvement, building trust, and sustainable relationships are not just steps but integral components of conducting Indigenous-driven research that benefits communities. These approaches not only sustain Elder participation in research related to aging well and dementia but also underscore the value and importance of their contributions. Indigenous research paradigms are gaining traction and hold immense potential in involving Indigenous older adults in research endeavors. Building these collaborations not only gives Elders a voice but also offers researchers a promising direction and invaluable insight into the specific needs of these communities, fostering a sense of hope and optimism for the future of research.
OLDER ADULTS WITH DISABILITIES AS CORESEARCHERS IN COMMUNITY-ENGAGED RESEARCH ON MOBILITY AND ACCESS
Authors: Mahmood Atiya , Hedayati Niloofar , Nasiri Rojan , Hosseini Sogol Haji , Pandsheno Sepehr 
Published: January 2025

Abstract
Neighbourhood access and participation opportunity significantly impacts the health, social inclusion, and overall wellbeing of older adults especially those with mobility, sensory and cognitive disabilities. Stakeholders Walkability/Wheelability Audit in Neighbourhoods (SWAN) is a community engaged mixed method project where user-led audits are conducted in neighbourhoods complemented by semi-structured interviews to evaluate the role of built environment on mobility, access and participation of older adults and people with disabilities across five cities within Metro Vancouver, Canada. Using a community engaged lens starting from initial engagement to more advanced collaboration, this project involves various community stakeholders in different capacities fostering a two-way exchange of information between researchers and community members. Study participants as coresearchers participate in research tool adaptation, data collection, analysis and knowledge mobilization. Additionally, city staff members partner with the research team to identify key areas in cities for data collection, collaborate in knowledge mobilization activities and the development of complementary implementation projects. The SWAN project is part of a larger partnership project titled, “Mobility, Access and Participation” (MAP). Preliminary findings from this project underscores neighbourhood accessibility as it relates to functionality, safety, appearance, supportive features and social engagement opportunities for older adults with disabilities while highlighting some distinct challenges across different types of disabilities. Insights from the SWAN project has the potential inform both academic scholarship and local government policy around mobility, access and social. Findings underscores the importance of community engaged research in informing programmatic and policy changes using a social equity lens.
GLOBAL ASSESSMENTS OF END-OF-LIFE CARE: HOW ARE THESE CARE MEASURES PATTERNED BY PROXY RELATIONSHIP TO DECEDENT?
Authors: Mahmoud Kafayat , Carr Deborah , Ekerdt David 
Published: January 2025

Abstract
A “good death” is one in which the patient’s physical, emotional, and spiritual needs are met, they are treated with dignity and respect by health care providers, and treatment preferences are honored. Despite policies to help improve death quality, including support for doctor-patient end-of-life consultations as part of the Affordable Care Act, it is unclear whether death quality has improved, nor whether particular people are vulnerable to poor quality deaths. Researchers rely heavily on proxy-reported measures of end-of-life, however it is unclear whether these reports differ by one’s relationship to the decedent. We use 13 waves of the National Health and Aging Trends Study (NHATS), and polychoric factor analysis and multinomial and logistic regressions to identify the contributions of 10 specific dimensions of end-of-life care to overall quality of care evaluations, and how these assessments are affected by the proxy’s relationship to the decedent, after controlling for socio-demographic and health characteristics of decedents. Overall care ratings are highly correlated with perceptions of personal care needs met, respectful treatment, being informed about care, and care coordination. Physical and emotional symptoms, care wantedness, and decisions made without patient input have weaker associations with the overall care assessment. Paid caregiver proxies give more positive assessments of care relative to spouses and children of decedents. Adult children proxies offer more positive assessments of care decisions and wantedness, whereas spouse proxies report better management of physical and emotional symptoms. We discuss the implications for data collection as well as health care practice.
OLDER AGE PREDICTS POSITIVITY IN HOSPICE FAMILY CAREGIVER AUDIO DIARIES: IMPLICATIONS FOR ASSESSMENT INNOVATION
Authors: Cloyes Kristin , Hebdon Megan Thomas , Ellington Lee 
Published: January 2025

Abstract
The likelihood of becoming a caregiver of someone with a serious illness increases with age, and those 55 years of age and older are more likely to be end-of-life caregivers of family and friends. Older adults may also use more emotional coping skills, which can have a protective effect depending on perceived stress and gender. We asked in-home hospice family caregivers of cancer patients (n=58) to record daily, open-ended audio diaries about their experiences. We examined whether age and gender predicted the amount of affect-related content and overall emotional tone (positivity/negativity). Caregivers recorded audio diaries up to 5 minutes via an IVR system (n=984 entries). We transcribed diaries and used LIWC software to quantify the proportion of affect-related content and positive/negative tone, and mixed-effects regression modeling to analyze the effects of age and gender on these indicators. Our sample (M age=60.72, SD=13.12, range=30-86) was mostly white (84.5%) non-Hispanic (86.2%) women (74.1%) caring for their spouse (44.8%). Age predicted positivity, with each additional year of age predicting a slight increase (β=0.426, p=0.028). Age did not predict affect (β=0.032, p=0.251). Gender did not predict tone (β=2.622, p=0.619), but trended towards predicting less affect expression in men (β= -1.482, p=0.062). Hospice family caregiving is challenging and often isolating, affording few opportunities for processing experiences. Our findings suggest an interplay of age and gender in caregiver self-expression. Understanding how caregivers’ self-expression aligns with underlying coping and unmet needs is important for developing audio diaries as a low-cost assessment of coping and well-being.