bluuebunny/crossref_metadata_2025_split huggingface dataset:
TRENDS AND SOCIOECONOMIC INEQUALITIES IN DEMENTIA RISK IN CHINA, 2011–2020
Authors: Luo Liying , Liu Liyun 
Published: January 2025

Abstract
China faces a rapidly aging population. However, there lacks evidence about if the prevalence of dementia risk increased over the past decade and what biopsychosocial factors may have contributed to the trends. Using the 2011-2020 data from the China Health and Retirement Longitudinal Study (CHARLS), this study finds the first evidence of significant decreases in the prevalence of high dementia risk—determined as scoring 4 or lower on 25 items of the Telephone Interview for Cognitive Status—in China between 2011 and 2020. The decrease was more pronounced among older Chinese women. We then use the Kitagawa-Oaxaca-Blinder method to quantify the contributions of a set of socioeconomic and health variables to the differences in the prevalence of high dementia risk between the periods 2011-2013 and 2018-2020. The decomposition results suggest that for both Chinese men and women, the compositional reductions in illiteracy and low education are a major driver of the decline in dementia risk between the two time points. Changes in other socioeconomic and health risk factors play a relatively smaller role, although for males, the heightened risk of dementia due to smoking exerts an upward pressure on dementia risk trends. Our findings extend the literature by providing evidence that increasing education is an effective strategy for reducing dementia risk at the population level.
STATE POLICY AND POLITICAL LANDSCAPES: IMPLICATIONS FOR COGNITIVE AND FUNCTIONAL HEALTH
Authors: Garcia Marc , Kemp Blakelee , Tarraf Wassim 
Published: January 2025

Abstract
There is considerable state-level variation in the percent of adults with cognitive and functional limitations. However, it is unclear how state policy contexts and changes in these contexts are associated with cognitive and functional health. We used BRFSS data (2015/16 and 2019/20) linked to the State Policy & Politics Data (SPPD) from the Center for Aging and Policy Studies (CAPS) at Syracuse University to examine how overall political ideology, Medicaid generosity, and three health behavior (Tobacco excise taxes, opioid laws, and clean-air indoor laws) policies and change in those policies over time (2000-2014) are linked to levels of perceived cognitive decline and functional limitations among individuals 45-years and older. We found considerable variability in both levels of perceived cognitive decline and functional limitations, as well as policy adoption and change in adoptions over time across states. Adjusting for individual-level sociodemographic indicators and change in state ideology/policy over time, higher levels of political liberalism, Medicaid generosity, Tobacco taxes, and more restrictive clean indoor air policies in 2014 were largely associated with lower levels of perceived cognitive decline and lower levels of functional limitations. However, greater change in political ideological and policy measures was inconsistently linked to higher prevalence of the considered impairment outcomes. As the U.S. ages and the landscape of state policies continues to diversify, policymakers are increasingly urged to conscientiously consider the cognitive and functional health implications associated with these varied policy environments.
PROMOTING DIGITAL HEALTH EQUITY THROUGH COLLABORATIVE PARTNERSHIPS WITH CHINESE AMERICAN COMMUNITIES
Authors: Li Jingyi , Xie Jinchen , Liang Yanjing , Dong Jingyi , Yuwen Weichao 
Published: January 2025

Abstract
Despite overwhelming and disparate needs, the use of supportive healthcare programs is lower among Chinese American caregivers, in large part due to the lack of accessible and culturally and linguistically appropriate care. Digital health tools have the potential to support caregivers’ needs. In collaboration with community partners, we conducted a qualitative study to identify opportunities using digital health tools to address caregiving needs among families caring for Chinese American older adults. Four focus groups with 21 staff from four local community-based organizations serving Chinese American families were conducted to explore staff’s experience supporting Chinese American families and discuss their perspectives on opportunities to use digital health tools to support caregiving needs. Inductive thematic analysis revealed that digital health tools have the potential to support Chinese American families caring for older adults by (1) offering real-time and trustworthy informational support on caregiving, (2) guiding caregivers through system navigation and service discovery, (3) sharing caregiving stories for scenario-based learning, (4) suggesting communication strategies for adult children caregivers, and (5) enabling family check-ins before or between case manager consultations. Additionally, staff raised concerns regarding digital health tools’ capacity to offer culturally sensitive emotional support, alongside skepticism about its potential to substitute valuable human social interactions. The findings from this study lay the foundation for future research on culturally adapting digital health tools for promoting the mental health and well-being of Chinese American family caregivers.
RECOGNIZING CAREGIVING NEEDS OF CHINESE AMERICAN OLDER ADULTS AND EXPLORING CHATBOTS UTILIZATION
Authors: Liang Yanjing , Xie Serena Jinchen , Li Jingyi , Xu Jingjing , Yuwen Weichao 
Published: January 2025

Abstract
Asian Americans encounter unique challenges in caring for older adult family members due to language barriers, cultural preferences, and difficulty in accessing healthcare resources. Family caregivers of Chinese-speaking older adults in the U.S. reported high levels of emotional stress more often compared to English-speaking caregivers. Digital health tools such as chatbots have the potential to offer affordable and accessible support. This qualitative study examined data from 12 in-depth interviews of families caring for Chinese American older adults and provided insights into caregiving challenges, self-care practices, cultural values, and perceptions of using chatbots for support. Participants faced challenges, including barriers to accessing resources due to language, limited understanding of social support, and stigma. The high-power distance of Chinese culture (Hofstede cultural value theory) alongside ‘familism’ and ‘filial piety’ exacerbated challenges in intergenerational communication. We discovered that the psychological aspect of self-care among Chinese American caregivers is often undervalued, influenced by the culture of self-restraint and endurance. Participants anticipated chatbots providing lifelike support and comprehensive caregiving resources by integrating functions such as health information guides. While caregivers appreciated chatbots as a judgment-free channel for seeking help, they had reservations about chatbots’ capacity to comprehend users’ emotions and embody cultural nuances such as sayings and references, which would make chatbots relatable and encourage engagement. The effectiveness of chatbots may be limited by constraints in empathy and cultural sensitivity. The findings reveal both the promise and challenges of developing culturally sensitive chatbots to address emotional needs and offer comprehensive support.
MIXED METHODS INTERVENTION DEVELOPMENT OF A TELEREHABILITATION PROGRAM FOR OLDER VETERANS
Authors: Rauzi Michelle , Stevens-Lapsley Jennifer 
Published: January 2025

Abstract
Mixed methods approaches add value during the development of complex interventions, increasing chances of program success. As such, we employed multi-stage mixed methods study designs to develop a MultiComponent TeleRehabilitation (MCTR) program for older Veterans with multiple chronic conditions. The four stages included 1) exploratory sequential, 2) explanatory sequential, 3) embedded convergent, and 4) exploratory sequential designs. Results from stage 1 provided valuable information to support the program’s initial implementation and evaluation. Stage 2 results supported the program’s feasibility for Veterans ≥50 years with at least 3 medical conditions. Stage 2 also provided key insights to improve recruitment and enrollment procedures, adapt the intervention, and modify technology integration. The resulting adaptations were implemented and evaluated during a randomized feasibility study, which involved stage 3. The primary results supported the MCTR program’s feasibility and safety in an older (≥60 years) and physically impaired population. Secondary results demonstrated some improvement of patient level outcomes including physical function. The mixed methods findings identified salient participant differences related to how and why participants chose to engage or not engage with the technological supports used during the MCTR program. These technology engagement findings were important because the higher technology engagement group showed greater improvements in physical activity. Thus, by understanding reasons why people did not engage with the technology, we can adapt the MCTR program during stage 4 to address engagement barriers and improve patient outcomes. In conclusion, using mixed methods approaches for intervention development accelerated our research and will help enhance future implementation efforts.
REMOTE MONITORING IN MULTISITE CLINICAL TRIALS: USING VIRTUAL TECHNOLOGY FOR RELIABILITY AND FIDELITY
Authors: Stevens-Lapsley Jennifer , Hinrichs-Kinney Lauren , Pontiff Mattie , Tran Melissa , Westlake Frances 
Published: January 2025

Abstract
Multi-site clinical studies often involve time consuming and resource intensive in-person monitoring of reliability and fidelity. An innovative solution provided by Swivl technologies holds tremendous potential to enhance remote monitoring options to reduce the need for costly in-person, onsite monitoring. The technology has enabled seamless and dynamic tracking of individuals undergoing Short Physical Performance Battery (SPPB) assessments, as well as specific rehabilitation interventions that are part of an ongoing 34 site clinical trial (NCT05492240) in skilled nursing facilities. The Swivl camera’s ability to video moving subjects while also using capturing conversations within a busy clinic environment uniquely enhances the quality of remote monitoring. Our team has used this technology to perform 190 SPPB reliability assessments and 65 rehabilitation fidelity assessments at 34 skilled nursing facility (SNF) clinics. This approach has allowed for real-time, remote observation of participants as they perform sit-to-stand, walking speed, and balance assessments within the SPPB. Similarly, the research team can remotely monitor fidelity of a high-intensity rehabilitation program focusing on dosing of specific rehabilitation exercises to ensure prescribed interventions are executed as intended. This virtual monitoring not only enhances the capacity to conduct remote reliability and fidelity assessments, but it also provides a valuable tool for continuous feedback and adjustment, optimizing the overall effectiveness of rehabilitation protocol fidelity. In essence, the Swivl camera brings forth a new era of remote monitoring that overcomes previous barriers (e.g. storage and transfer of large video files, inability to hear audio from an individual in a busy clinic setting).
THE GERMAN TRANSFER CLUSTER OF ACADEMIC NURSING INSTITUTIONS IN LONG-TERM CARE (TCALL)
Authors: Wolf-Ostermann Karin , Preuss Benedikt , Rothgang Heinz , Darmann-Finck Ingrid , Wolf Karsten , Stolle-Wahl Claudia , Zuendel Matthias 
Published: January 2025

Abstract
Considering the demographic shift, ensuring high-quality care emerges as a central future challenge in Germany. This can only be overcome by enhancing the attractiveness of the nursing profession through improved working conditions, introducing technological innovations comprehensively into long-term care, and adapting internal workflows through personnel and organizational development, as well as evolving educational content and structures accordingly. Currently in Germany such transfer and innovation structures are lacking. Therefore, TCALL establishes a sustainable framework to enable the implementation of technical and organizational innovations in regular operations similar to the Living Lab in Ageing and Long-Term Care (Netherlands) or Teaching Nursing Homes (US). This approach facilitates a direct pathway for research findings to transfer from academia through education into healthcare practice, with reciprocal influences from healthcare practice back into research and education. We will present the concept of TCALL which is up to now implemented in three nursing homes in the federal state of Bremen, Germany and will be further developed into a cluster of academic nursing institutions through the addition of personnel and the establishment of a decentralized learning infrastructure. TCALL thus constitutes a conceptual space for innovative transfer activities and simultaneously provides a permanent physical environment for recursive innovation development, testing, and implementation. This structure enables the close integration of research, education, and practice, contributing directly to the rapid and process-oriented development of the state-of-the-art through innovative insights and products.
BRIDGING THE GAP BETWEEN ACADEMIA AND PRACTICE: THE DUTCH LIVING LAB IN AGEING AND LONG-TERM CARE
Authors: Hamers Jan , Verbeek Hilde 
Published: January 2025

Abstract
There is a strong need in long-term care for scientific research, so older people and their families, health care professionals, policy makers, and educators can benefit from new advancements and best available evidence in everyday care practice. The model of a sustainable and successful interdisciplinary collaboration between scientists, care providers and educators in long-term care will be presented: the ‘Limburg Living Lab in Ageing and Long-Term Care’. It is a structural collaboration between academia, educational institutions, long-term care providers and clients. It covers approximately 185 long-term care facilities (e.g., nursing homes, assisted and group living facilities) as well as professional home care, and includes about 50,000 clients and more than 27,000 staff. Their mission is to contribute with scientific research to improving i) quality of life of older people and their families; ii) quality of care and iii) quality of work of those working in long-term care. Key working mechanisms are the scientific and practice-based Linking Pins and interdisciplinary partnership using a team science approach, with great scientific and societal impact. For more than 25 years this structural collaboration has served as an infrastructure that drives scientific research in long-term care in co-creation with end-users, including older people and their relatives, health care professionals, policy makers and educators. This model was established by Maastricht University in the Netherlands, and more recently, the model of the living lab is replicated in other countries such as the United Kingdom, Germany and Austria.
BED ALARMS FOR THE PREVENTION OF FALLS IN HOSPITALS: A THREE-ARM, DISINVESTMENT NONINFERIORITY TRIAL
Authors: Haines Terry , Pu Debbie , Stephen Kelly , Shorr Ronald 
Published: January 2025

Abstract
Bed alarms are commonly used to prevent falls in hospitals. However, the evidence supporting their effectiveness indicates they may be ineffective. Disinvestment from routine but low-value care is important, however carries the risk that unanticipated harms to patients may arise with this change of practice. We undertook a 3-arm, non-inferiority, stepped-wedge randomised trial with concurrent parallel cluster randomised trial to investigate whether reducing the frequency of bed alarm use from &gt;6% of beds to between 3% and 1%, or completely eliminating use of bed alarms had an impact on rates of in-hospital falls. We recruited n=18 wards at hospitals in Melbourne, Australia, and collected data over 10 calendar months. Wards were paired based on type and randomly allocated to month of transition in the stepped-wedge design, and then allocated to either “reduced” or “eliminated” conditions in a two-stage process. Alarm use was monitored through 3x weekly visual audits. Hospital falls data were collected through hospital incident reporting and administrative data systems with weekly auditing from site research assistants. A non-inferiority margin of an increase in rate of falls by 2 falls per 1000 patient days was set in pre-trial stakeholder consultation. The difference between “control (high use of alarms)” and “reduced” conditions was 0.29 falls/1000 patient-days (95%CI: -2.41 to 3.00) favouring the control. The difference between “control” and “eliminated” conditions was 1.13 falls/1000 patient-days (95%CI: -1.58 to 3.83) favouring the control. Non-inferiority of the “reduced” and “eliminated” conditions was not shown, though use of bed alarms was not superior.
THE ROLE OF APPRAISAL IN CAREGIVER CHARACTERISTICS ASSOCIATED WITH ELDER NEGLECT
Authors: Batista-Malat Eleanor , Gassoumis Zachary , Wilber Kathleen , Olsen Bonnie , Mosqueda Laura 
Published: January 2025

Abstract
Elder neglect occurs when a caregiver fails to meet a need, compared to elder abuse which involves specific abusive actions. Despite this, neglect and abuse are typically studied together as elder mistreatment. We investigated the characteristics associated with neglectful behaviors of caregivers of people living with dementia (PLWD). California dementia caregivers (N=92) completed a cross-sectional anonymous online survey about their caregiving experience and mistreatment of the PLWD from any source. 44.6% of caregivers were caring for a parent, 51.1% were Hispanic/Latino, and 68.1% were female. Eighteen (19.6%) caregivers reported at least one neglectful behavior in the last year, defined as leaving the PLWD alone inappropriately, not providing them with needed medical care, food, or water, or being impaired in caregiving due to alcohol or drugs. Of these, 11 (61.1%) also reported abuse in the last year: nine psychological, five financial, and five physical abuse. Bivariate tests comparing characteristics of caregivers with and without neglectful behaviors showed no difference in time spent caregiving, outside caregiving help, or social support and loneliness. Those who reported neglectful behaviors were significantly more likely to live with the PLWD (X2 =7.2, p=.028), believe the PLWD could “do better if they tried” (X2 =9.0, p=.029), and have higher burden scores (t=-2.61, p=.011). Our findings suggest that caregiver neglect may be associated with the caregivers’ perceived experiences rather than objective measures. Service providers should be attentive to caregivers’ understandings of their experiences, which may be related to neglectful behaviors, and reducing neglectful behavior may reduce overall mistreatment.
LIPID METABOLISM CONTROLS CELL FATE DECISIONS BETWEEN CELLULAR SENESCENCE AND FERROPTOSIS
Authors: Wiley Christopher 
Published: January 2025

Abstract
Recent advances have identified cellular senescence as a bona fide driver of aging and several age-associated pathologies in response to various forms of stress or damage. Primary phenotypes associated with cellular senescence include a stable proliferative arrest and secretion of a mélange of biologically active molecules collectively known as the senescence-associated secretory phenotype (SASP), but senescent cells also display other key phenotypic alterations. Key among these is survival in the face of stress and damage. We recently identified multiple alterations in lipid metabolism, especially those associated with polyunsaturated fatty acids, that favor survival of senescent cells over a form of cell lytic death known as ferroptosis. Interventions that target these pathways, including inhibition of the lipid peroxidation antagonist Gpx4 or elevation of dihomo-gamma-linolenic acid (DGLA), result in lytic death of senescent cells. Elimination of senescent cells using these pathways improves phenotypic outcomes in aged mice. Finally, obese human males carrying a genetic variant with low DGLA desaturation rates are protected from accumulation of senescent cells in adipose tissue, suggesting that these interventions could be translatable to patients. Together, our results provide a new set of targets for intervening in senescence and its associated outcomes.
N6-METHYLDEOXYADENOSINE (N6MEDA) IS ASSOCIATED WITH AGING
Authors: Tretyakova Natalia 
Published: January 2025

Abstract
N6-methyldeoxyadenosine (N6medA) is a recently discovered DNA mark that has been proposed to be involved in epigenetic regulation, DNA repair, and memory formation. N6medA is dynamically regulated in the mouse brain following environmental stress and plays a role in the formation of fear extinction memories, immune response, and in neuroblastoma. However, the biological roles of N6medA as an epigenetic mark have been questioned due to it extremely low abundance in the genome and conflicting information regarding its origins. We have developed an ultrasensitive isotope dilution nanoLC-methodology for N6medA in genomic DNA and investigated the potential roles of N6medA in human aging and in Alzheimer’s Disease (AD). We found that the global genomic N6medA in prefrontal cortex is positively correlated with human’s chronological age, and there is an increasing trend for N6medA levels in mild cognitive impairment and Alzheimer’s Disease. Genome wide mapping of N6medA in DNA isolated from human prefrontal cortex indicated that increased adenine methylation in AD was preferentially found in genes associated with neurological function and neurological diseases. Mass spectrometry-based affinity proteomics experiments identified several protein readers of N6medA as well as proteins that are prevented from binding to DNA in the presence of methylated adenine. Taken together, our results suggest that N6medA mediates protein binding to DNA, accumulates in genomic DNA of the brain during aging and could contribute to the development of Alzheimer’s Disease
MEASURING AND MANIPULATING YOUTHFUL FACTORS IN EXTRACELLULAR VESICLES THROUGH ENGINEERING AND EXERCISE
Authors: Ambrosio Fabrisia 
Published: January 2025

Abstract
Numerous studies employing heterochronic blood exchange have demonstrated the crucial age-dependent role of circulating factors in regulating the function of multiple tissues. To date, investigations into the mechanisms underlying the beneficial effect of young blood on healing cascades have primarily focused on circulating proteins. However, accumulating evidence suggests that circulating extracellular vesicles (EVs) may play a previously unappreciated role in the regulation of tissue health. EVs are membrane-enclosed paracrine mediators that traffic between anatomically remote sites to regulate physiological function and pathologic processes in target cells. A better understanding of the molecular mechanisms guiding age-related alterations in EV cargoes may pave the way towards the development of novel therapeutics that can promote a more youthful phenotype in older individuals. In her presentation, Dr. Ambrosio will summarize recent work from her laboratory identifying an age-related disruption in the transfer of information from circulating EVs to target cells and the impact of this this disrupted communication flow on tissue maintenance and regenerative potential over time. Towards the development of novel EV-based therapeutic strategies to counteract these declines, Dr. Ambrosio will share ongoing studies employing engineering and rehabilitative strategies designed to promote tissue function in an elderly population.