bluuebunny/crossref_metadata_2025_split huggingface dataset:
BARRIERS AND FACILITATORS OF THE INNOVATION PROCESS IN LONG-TERM CARE HOMES DURING COVID-19
Authors: Santos Suzanne , Duan Yanjun , Rabello Gilciney Andrade , Bhatti Sumaya , Chu Charlene , Lepore Michael , Zuniga Franziska , Melo Ruth 
Published: January 2025

Abstract
The innovation process is complex and multidimensional regardless of the context in which it is applied. However, innovation sustainability can be even more challenging when applied in the Long-Term Care (LTC) sector. So, understanding the barriers and facilitators associated with innovation adoption can be essential to innovation sustainability in LTC homes. In the qualitative studies incorporated within the scoping review (n =18), an in-depth analysis was conducted to discern barriers and facilitators related to innovation in LTC homes during COVID-19. Barriers to innovation identified were related to residents (e.g., safety, privacy, and appropriateness), staff (e.g., workload and tight routine), LTC homes (e.g., infrastructure and material/human resources), and innovation itself (e.g., cost, technical and connectivity problems). Concerns about the inclusiveness of the residents, especially those with some health-related issues (e.g., dementia and macular degeneration) were also pointed out. Conversely, innovations are likelier to be adopted if they prove to be useful and convenient, align with the needs of both LTC homes and residents, and exhibit user-friendly features. From an organizational standpoint, facilitating innovation during COVID-19 involves preparing the LTC home, providing necessary equipment, and offering training and support to staff. Familiar members/caregivers also point as a positive factor the ability of innovation in relief of care burden. Codesign approaches, involving different stakeholders, might be essential to identifying barriers and facilitators and, therefore, contribute to the sustainability of the innovations inside LTC homes.
INNOVATIVE GERIATRICS EDUCATION FOR STUDENTS AND PROFESSIONALS
Authors: Emery-Tiburcio Erin 
Published: January 2025

Abstract
Training in working with older adults is lacking across health care disciplines, and in interprofessional education, both at the student and licensed professional levels. This symposium will describe five unique and highly diverse programs to educate students and professionals about elements of providing optimal health care to older adults. The Extension for Community Healthcare Outcomes (ECHO) Geriatrics program at the University of Washington engaged interprofessional health professions students to participate in monthly learning sessions about age-friendly care and post-session debriefs. The University of Louisville engaged social work students in their highly successful FlourishCare curriculum (FCC), which includes online modules, workshops, interprofessional case management experiences, case conceptualization meetings, Project ECHO, and more. The 4Ms STOP and WATCH Program at St. Louis University provides education and experiential learning for Certified Nursing Assistants (CNAs) in nursing homes. Virginia Commonwealth University trained Emergency Medical Services (EMS) providers on foundational knowledge and skills in care of older adults living with dementia, including advance care planning needs. Finally, the 4Ms framework of an Age-Friendly Health System (What Matters, Medication, Mentation, Mobility) was adapted by Rush University for use by behavioral health providers, who provided training to interprofessional Community Mental Health Center clinicians. Each of these programs has demonstrated significant positive impact and serve as models for training in geriatrics.
LONGITUDINAL ASSOCIATIONS BETWEEN MULTIMORBIDITIES AND PATIENT-REPORTED QUALITY OF LIFE
Authors: Graham Eileen , Atherton Olivia , Mroczek Daniel , Thames Marquita Lewis , Wolf Michael 
Published: January 2025

Abstract
The global prevalence of multimorbidity is increasing as the population ages. Older adults are very likely to develop multiple chronic conditions, and nearly two-thirds of the older adult population in the U.S. are estimated to be experiencing two or more chronic conditions. The current study examined whether multimorbidity was associated with longitudinal patterns in health-related quality of life (i.e., anxiety, depression, physical function) and whether these associations were moderated by sociodemographic factors (i.e., sex, race, marital status, income, insurance, education). The present pre-registered study used data from the Health Literacy and Cognitive Function Among Older Adults Longitudinal Study (LitCog), a prospective cohort study of English-speaking older adults (N=900). At each measurement occasion, participants reported anxiety, depression, and physical function using the Patient Reported Outcomes Information System (PROMIS), current chronic conditions, and socio-demographic characteristics. We employed multilevel growth models to estimate changes in health-related quality of life, with multimorbidities as a predictor and socio-demographics as covariates. Results indicated that individuals with multiple chronic conditions reported persistently high levels of anxiety and depression, and worse physical function. We found evidence for racial health disparities, such that individuals who identified as non-white experienced worsening health-related quality of life as multimorbidities increased, relative to white participants. These results contribute to the current conversation about the long term impacts of structural and systemic barriers experienced by minoritized groups. We further discuss the public health implications of multimorbidity in older adulthood.
“MY LIFE WAS EASY; HIS LIFE TAKES ALL OF MY TIME”: THE INTERPLAY OF SUPPORT STRUCTURES AND DEMENTIA CARE NEEDS IN THE HOME
Authors: Allison Theresa , Smith Alexander , Gubner Jennie , Covinsky Kenneth 
Published: January 2025

Abstract
We have limited literature about the lived realities of in-home dementia care. Using data from two ethnographic studies of music and everyday life in the homes of people living with dementia, we investigated the relationship between care support resources and multimorbidity care needs. Data included demographics, measures, fieldnotes and semi-structured interview transcripts. We inductively coded transcripts using ATLAS.ti and triangulated findings across data sources. N=83 (38 people living with dementia, 34 family care partners, 11 professionals). Participation varied from a single phone interview to 8 in-home visits over two years. Participants identified complex mismatches between resources and care needs, particularly in ambulatory stages of dementia or with care partner multimorbidity. In contrast, participants identified spirituality as a powerful motivator for providing care. Participants identified adequate social support and financial resources as critical. The findings underscore the need for nuanced approaches to interventions, acknowledging both positive and negative aspects of caregiving.
HARMONIZATION OF MEDICARE BENEFICIARIES’ COGNITIVE FUNCTION DATA
Authors: Zafar Anum , Kobylarz Fred , Zaritsky Rebecca , Kim Hyosin , Lopez Maria , Xia Weiyi , Lin Haiqun , Jarrín Olga 
Published: January 2025

Abstract
This study explains the methodology to harmonize data from healthcare claims and clinical assessments across various post-acute and long-term care settings for Medicare beneficiaries who died in 2019, age 50 or older at death, with at least five years of continuous Medicare enrollment. The cognitive function trajectory file was constructed from 2014-2019 Medicare and Medicaid claims and encounter files (ICD-9 and ICD-10 codes), and cognitive assessments from post-acute and long-term care settings (BIMS scores and other relevant items from MDS, MDS-SB, OASIS, and IRF-PAI assessments). Cognitive function data were harmonized to create a four-category variable: no impairment, memory loss, mild cognitive impairment (MCI), and dementia/severe cognitive impairment. Data were summarized for each quarter (3-month period) of the last five years of life (20 timepoints). Of the nearly two million beneficiaries in our study population, 19.4% had no evidence of cognitive impairment at any point. Five years before death, 3.2% of the sample population had mild cognitive impairment (MCI) and 7.7% had dementia or severe cognitive impairment. At the time of death, 14.8% of the sample had MCI and 50.6% had severe cognitive impairment/dementia. Among beneficiaries with any cognitive impairment, claims or assessment data contributing new information to the trajectory file were available for an average of 7 (out of 20), s.d. 5.7 quarters, median=5, inter-quartile range: 2-11. The harmonized longitudinal dataset allows for tracking change in cognitive function and identifying risk factors for cognitive decline.
MAXIMIZING COGNITIVE TRAINING OUTCOMES WITH SIMULTANEOUS BRAIN STIMULATION
Authors: Jaeggi Susanne 
Published: January 2025

Abstract
Cognitive health is a fundamental issue facing everyone across their lifespan, however, while there is accumulating evidence for the efficacy of targeted interventions to improve cognition, the outcomes have been inconsistent. This contrasts the vast basic science literature suggesting that brain circuits are highly malleable, even in older age. Non-invasive transcranial direct current stimulation (tDCS) has shown to facilitate brain plasticity, especially when administered during a learning event. Here, I will summarize the results of several randomized controlled trials as well as a meta-analysis conducted by my group focusing on cognitive training that is paired with tDCS. Across 4 separate studies involving 257 younger and older adults, we found evidence for improved learning trajectories as a function of tDCS, and in addition, we observed improvements in measures of long-term memory, some of which remained significant several months after training completion. The effects on working memory outcomes appear to be more mixed and dependent on baseline ability, i.e., those with initial lower performance typically benefit more from brain stimulation. Our primary findings are supported meta-analytically in that we found a small positive net effect of tDCS on transfer measures after working memory training, both, in the short- and long-term. However, the effects were most pronounced for measures that were similar to the trained tasks. Collectively, our studies illustrate the potential of tDCS to support cognitive training outcomes, but at the same time, there are boundary conditions and important individual differences that moderate training efficacy.
EFFECTS OF ATTENTIONAL CONTROL DEMANDS IN PROCESSING SPEED TRAINING ACROSS THE ADULT LIFESPAN: FIRST FINDINGS
Authors: von Bastian Claudia , Reinhartz Alice , Hyde Eleanor , Jiang Shuangke , Loranger Elisabeth , Ferreri Jeff , Belleville Sylvie , Strobach Tilo 
Published: January 2025

Abstract
Evidence for cognitive training-induced far transfer of improvements to untrained cognitive abilities is mixed. One notable exception appears to be training interventions that target speed of processing. However, the mechanisms underpinning these training effects are yet unclear. In this pre-registered, multi-site training study, we tested the hypotheses that (a) training tasks with stronger attentional control demands will induce larger transfer effects, and that (b) gains in the rate of information accumulation (i.e., drift rate) will be positively associated with these effects. For this purpose, we recruited 476 healthy participants spanning the adult lifespan (18-85 years) from three sites in the United Kingdom, Germany, and Canada, who were randomly allocated to one of four groups practising tasks with increasing attentional control demands. Transfer to working memory, executive functions, reasoning, and everyday cognitive functioning was assessed before, immediately after, and 3 months after 10 training sessions. N = 388 participants (age in years M = 48.61, SD = 18.28, range 18 – 85; 218 women, 168 men, 2 participants with undisclosed gender; education in years M = 16.68, SD = 3.68) completed the study. The first results from this study will be presented in this talk.
NOVEL FINDINGS AND LESSONS LEARNED FROM CROSS-NATIONAL LONGITUDINAL RESEARCH ON MIDLIFE DEVELOPMENT AND AGING
Authors: Infurna Frank , Gerstorf Denis , Nielsen Lisbeth 
Published: January 2025

Abstract
The goal of this symposium is to bring together a collection of papers that shed light on opportunities gained and challenges encountered in cross-national comparisons of development in midlife and aging and lessons learned. Infurna and colleagues used longitudinal panel data from 16 nations to examine historical changes in midlife pain and report historical increases in pain in the U.S., and Continental and Nordic Europe, whereas Mediterranean Europe, South Korea, and Mexico experienced historical declines. Wettstein and colleagues studied historical changes in midlife memory and explanatory factors in longitudinal panel data from 16 nations; the U.S. was the only nation/region to exhibit historical declines in memory, whereas historical improvements were observed in the European nations. Women, higher educational attainment, better grip strength, and fewer chronic diseases were associated with better memory across cohorts. Steptoe and Brocklebank used data from England and China to examine how physical activity and sleep patterns relate to cognitive decline and highlight challenges related to data collection and instrumentation and approaches to carry out robust cross-national comparisons. Wong provides an overview of research on cross-national comparisons using the Mexico Health and Aging Study by illustrating various examples and discussing gaps in knowledge pertaining to how low and middle-income nations could be supported by cross-national data. The discussion by Nielsen will integrate the four papers by highlighting novel findings that can arise from conducting cross-national research (e.g., historical change, comparisons of explanatory factors) and insights gained through the increasing availability of comparable data that can be harmonized.
EMPOWERMENT IN MOTION: ANALYZING THE EXPERIENCE OF WOMEN HIP-HOP DANCE CREW
Authors: Lee Kyung Eun , Min Hae Youn , Heo Jinmoo 
Published: January 2025

Abstract
Hip-hop dance is known as one of the dance genres, primarily associated with the younger generation. However, it has gained popularity among not only the youth but also the older generations worldwide. Participants in this study have formed hip-hop dance crews targeting middle and old-aged women, engaging in regular practices and performances to create and enjoy their leisure activities. According to the innovation theory (Nimrod & Kleiber 2007), individuals can achieve successful aging by actively engaging in leisure activities. This theory emphasizes the importance of continuously seeking new experiences and challenges, even in later stages of life. Therefore, this study aimed to explore the experiences of participation in the women’s dance crew based on the innovation theory. In-depth interviews were conducted with 16 middle and old-aged women regarding their motivations, identity as members, and outcomes. The interview results confirmed that participants initially began their activities for various reasons (e.g., family recommendations, maintaining health), but continued their activities due to intrinsic motivation. Interestingly, it was found that both self-preservation innovation (leisure activities related to previous life experiences) and self-reinvention innovation (completely new leisure activities) were simultaneously discovered among the participants. Furthermore, participants were able to enhance psychological, physical, and social well-being through dance activities. These findings align with the key factors proposed in the innovation theory. Consequently, it was observed that middle and old-aged women preserve their past identities and explore new aspects of themselves by enjoying hip-hop dance, highlighting the significance of leisure activities in later life.
MULTISECTOR PLANS FOR AGING: OPPORTUNITIES FOR AGING RESEARCH TO INFORM STATE POLICY
Authors: Flores Valerie , Graham Carrie 
Published: January 2025

Abstract
State Multisector Plans for Aging (MPA) are state-led, cross-department, stakeholder- and evidence-informed plans through which states set goals and priorities to transform their state and improve care, services and support for their diverse aging populations. Often these plans are led by the Governors’ offices, Departments of Aging or Medicaid agencies, but also engage across departments of public health, social services, emergency preparedness, housing, transportation, labor, and more. They are also informed by meaningful stakeholder engagement, including advocates, consumers, aging services providers and employers in the state. By far one of the most important MPA stakeholders are universities and researchers who can provide cutting edge data to inform MPAs. Currently, almost half of all U.S. states are engaged in either the development process or implementing an MPA. Evidence and data are important at every stage, from building the case for the necessity of an MPA, to the identification of unmet needs in the state, to development of strategies, and ultimately defining benchmarks and measuring progress. Many states have partnered with gerontological researchers to inform their plans. This offers the mutual benefit of informing the state, as well as providing an opportunity for researchers to learn how to better formulate their research questions to help the state build actionable and timely policy. This session will include an overview of how researchers have contributed to MPAs in many states and how the relationships forged through that process has opened more opportunities for continued collaboration and the translation of research into policy.
PRODUCING “QUALITY”: ASSISTED LIVING ADMINISTRATORS’ EXPERIENCE OF THE LICENSING AND SURVEY PROCESS IN OREGON
Authors: Tunalilar Ozcan , Kohon Jacklyn , Carder Paula 
Published: January 2025

Abstract
Assisted living (AL) communities in the United States are home to a steadily growing population of over 900,000 individuals and provide assistance with daily activities, medical treatments, and social and recreational activities in a congregate residence. States license AL and oversee regulatory compliance. Studies have examined states’ regulations in terms of stringency and specificity, though they did not address survey processes, especially administrators’ perspective. We conducted semi-structured interviews with 37 AL administrators in Oregon to examine AL administrators’ experiences of the licensing and survey process. Using thematic analysis, we identified three major themes: emotional reactions, practical considerations, and relational assessments. First, administrators expressed feelings of high-level stress related to the survey process. Second, administrators discussed drawing on multiple practical approaches to become “survey ready,” including reviewing prior survey results, having support during a new administrator’s first survey process, and setting up other types of partner or mentor support systems for administrators. Third, administrators defined the survey process through their relationship with surveyors, in terms of tone (adversarial vs. collaborative), hierarchical/power structure (“negotiating the evidence”), and the extent of collaboration (“surveyor as mentor”). We interpret these findings using elements from the Resource Dependency Theory by situating “substantial compliance” as a vital resource for the successful operation of AL and regulatory authorities as key resource providers for AL administrators. These results also emphasize a potential mismatch between how AL administrators view their setting and how regulators do.
FILLING GAPS FOR OLDER OHIOANS WITH LOCALLY RAISED FUNDS
Authors: Brekke Bailee , Janssen Leah , Dikhtyar Oksana , Nelson Matt , Applebaum Robert 
Published: January 2025

Abstract
Most older Americans aging in place at home do not financially qualify for support through the Medicaid program, and funding provided through the Older Americans Act is insufficient. As a result, 15 states have turned to local revenue sources to fill service gaps for individuals living in the community, who require social care to support independence. Ohio has a long history of utilizing such funds, generating over $200 million, more than the other 14 states combined. Despite the demonstrated success of these programs, local levy programs in Ohio do experience an array of implementation challenges. This study conducted 15 qualitative descriptive interviews with 20 program officials from various locally funded levy programs across Ohio. Thematic analysis revealed barriers, including increasing state and federal eligibility requirements, staffing issues, rural access to resources, and challenges in setting reimbursement rates. These barriers are coupled with added pressure from county officials to move individuals onto state funded programs (e.g., Medicaid HCBS Waiver programs), rather than keeping them on locally funded programs. The aim of this paper is to examine challenges that local programs are facing and provide program and policy recommendations. Findings reveal the important role local levy programs play in addressing gaps in service and the importance of local advocacy and education to continue passing these levies. Increasing communication between levy staff across the state, integration of cross-funding streams allocated by the state and increasing reimbursement rates are needed to ensure the success of the local levy programs for the future.
DIGITAL APPROACHES TO ROUTINE COGNITIVE SCREENING FOR OLDER ADULTS IN PRIMARY CARE SETTINGS
Authors: Thompson Louisa , Lawrence Molly , Eaton Charles 
Published: January 2025

Abstract
Cognitive screening remains under-utilized for older adults in primary care due to time constraints and limitations of existing measures. Well-validated digital assessments could potentially increase screening efficiency and accuracy. We compared two new digital cognitive tools with the Montreal Cognitive Assessment (MoCA) in a sample of 32 dementia-free older adults (ages 55-85) completing annual follow-up visits with a primary care provider (PCP). Participants self-administered the Boston Online Cognitive Assessment (BOCA), an online measure with alternate forms, twice prior to (1-4 weeks before and day of) an upcoming PCP follow-up visit. At their visit, they completed the Digital Clock and Recall (Linus Health DCRTM), a 5-minute, provider-administered tablet-based measure. Finally, they completed the MoCA with a research coordinator or behavioral health staff at the clinic. Five PCPs aided in protocol development and participated in data collection. The sample is currently 54% female and 81% White. Test-retest reliability for the BOCA was excellent (r =.81). BOCA score (time 1) was correlated with scores for the DCR and MoCA at the p &lt;.05 level. The association between the DCR and MoCA approached significance. On an exit survey, 79% of participants said that they would prefer to do cognitive screening at home before their appointment, compared to in the clinic (21%). These preliminary data replicate excellent test re-test reliability for the BOCA and demonstrate good convergent validity between the BOCA and two provider-administered screening measures. Next, we will compare test accuracies to detect impairment and their associations with demographics variables.