bluuebunny/crossref_metadata_2025_split huggingface dataset:
PCP PRACTICES AND ATTITUDES AROUND COGNITIVE SCREENING IN RHODE ISLAND
Authors: Lawrence Molly , Howe Matthew , De Vito Alyssa , Eaton Charles , Thompson Louisa 
Published: January 2025

Abstract
Primary care physicians (PCPs) are on the front lines for detecting cognitive changes in older adults but often have significant time constraints and are tasked with managing multiple conditions. For this reason, cognitive screening and follow up referrals need to be more efficient and effective. This study aims to evaluate how PCPs in Rhode Island (RI) manage memory concerns and cognitive screening. We created a 14-question, 5-minute survey which assessed several domains including level of familiarity, frequency of use and confidence with types of cognitive screening as well as barriers to screening and follow up. The survey was programed in Qualtrics and distributed through the RI Academy of Family Physicians. We received 48 responses and 26 of those were at least 50% complete. The MMSE (36.4%), MoCA (25.3%) and MiniCog (31.3%) were the top three screening assessments used. 77.3% of PCPs reported being “Very confident” or “Fairly confident” in conducting cognitive assessments, while only 2.3% were not at all confident. The three most frequently reported barriers to administering cognitive screening were: not have enough time for testing during appointments (23%), managing higher acuity conditions (13.2%) and not have enough time for counseling (13.2%). The top three barriers to referral to a memory specialist were: long wait times (31.5%), not enough resources (18.5%), and patient refusal (13.9%). Data collection is ongoing, but these preliminary findings provide insight into the current practices among RI PCPs and highlights time as a key limitation at multiples stages of memory screening and management by PCPs.
STARTING FROM STRENGTH: BUILDING PARTNERSHIPS IN COMMUNITY ENGAGED INTERVENTION RESEARCH FOR DEMENTIA INCLUSION
Authors: Novek Sheila , Furneaux Heather Neale , Macnaughton Eric , Malcolm Paulina , Monteiro Andréa , Phinney Alison 
Published: January 2025

Abstract
The majority of people with dementia live at home, often disconnected and isolated from their community. Canada’s Public Health Agency recognizes that community-based organizations are well positioned to address this issue, and through its Dementia Community Investment is advancing social innovation as a strategy for increasing inclusion, well-being, and quality of life for this growing population. The Building Capacity Project (2019-23) used asset-based community development to foster dementia inclusion through community programs and activities. Using developmental evaluation with community partners in Vancouver Canada, we identified a core set of guiding principles and promising practices for supporting dementia inclusive innovations in community programming: addressing stigma; including lived experience; organizational coaching; and social networking. Now in Phase 2 (2023-25), we are doing community-engaged intervention research, using the Evidence Based System for Innovation Support as a theoretical framework to scale out impacts with new partners in urban and rural communities across the region. As a first step, we conducted semi-structured interviews with 12 representatives from seven community organizations. Based on a thematic analysis of the interview data, we identified three areas for further capacity building for dementia inclusion: (1) reframing dementia as a shared experience; (2) growing confidence; (3) centering joy; and (4) making connections. These findings set the stage for further work as organizations identify strategies for reaching out to people with lived experience at the local level, expand opportunities for more diverse program offerings in multiple languages, and leverage opportunities for integration across municipalities, health systems, and the social services sector.
STATE-LEVEL EDUCATION QUALITY AND DEMENTIA INCIDENCE IN THE UNITED STATES
Authors: Cha Hyungmin , Farina Mateo , Jackson Heide , Ailshire Jennifer , Walsemann Katrina 
Published: January 2025

Abstract
Despite the robust link between education and dementia risk, less is known about how state education quality relates to dementia, particularly regarding how it differs by race. Drawing on data from the Health and Retirement Study (2000-2018) of adults aged 55 years and older, linked to historical state school investment records from 1914 to 1959, we employed hazard models to examine the association between state-level education quality and dementia onset. Our findings reveal a significant association between state education quality and dementia risk, and this association remains consistent across both White and Black adults. These results suggest that state investment in public education may have long-ranging influences on dementia onset, with consistent effects observed across racial subpopulations.
TESTING THE ASSOCIATION BETWEEN PSYCHOTROPICS AND OPIOIDS WITH FUNCTION IN HOSPITALIZED OLDER ADULTS WITH DEMENTIA
Authors: Kim Nayeon , Resnick Barbara 
Published: January 2025

Abstract
The aim of this study was to test if the use of psychotropic medications (antipsychotics, sedatives, antiseizure, antidepressants, and anxiolytics) and opioids were associated with physical function in hospitalized older adults living with dementia. This study was a secondary data analysis using baseline data from the Function Focused Care for Acute Care Using the Evidence Integration Triangle (FFC-AC-EIT) study, which is an ongoing randomized controlled trial. The first 369 participants were included. It was hypothesized that controlling for age, gender, race, comorbidities, cognitive function, and pain, the use of psychotropic medications and opioids would be negatively associated with physical function in the first 48 hours of admission. A path analysis was done to test this model using the AMOS statistical program. Overall, 72.5% (n=230) of the sample was on at least one psychotropic medication, and 18.8% (n=69) of the sample was on at least one opioid. Neither being on an opioid nor psychotropic medications was associated with function. Comorbidities, cognition, and pain were, however, significantly associated with physical function, such that those who had more comorbidities, better cognition, and less pain were more functionally independent. The findings support prior research showing a lack of association between psychotropic medication use and opioid use with physical function for hospitalized older adults. These drugs may be used appropriately to manage symptoms that allow for functional engagement of patients. Additional research is needed to continue to investigate the association of these medications with function and potential benefit versus harm.
“WE CAN BE PART OF YOUR PLAN”: ADAPTING AND PILOTING A VA EMERGENCY PREPAREDNESS TOWN HALL FOR HOME HEALTH AGENCIES
Authors: Hall Lauren , Wyte-Lake Tamar , Franzosa Emily , Solorzano Emily , Dobalian Aram 
Published: January 2025

Abstract
Home health agencies (HHAs) provide vital community-based care that helps older adults age in place. As climate-related disasters increase in frequency and intensity, HHA services become more critical. However, research shows HHAs are often under-resourced and disconnected from community-wide emergency planning efforts, threatening the continuity of services. As the nation’s largest integrated health system, the Veterans Health Administration (VHA) is uniquely positioned to support community HHAs serving veterans during disasters. We interviewed 19 key stakeholders (VA emergency managers, VA primary and community care staff, and administrators of contracted HHAs) from six VHA Medical Centers (VAMC) in a northeastern region (VISN 2) to generate strategies for VA to better support contracted home health providers. Participants offered innovative ideas including relatively low-resource suggestions and higher-level interventions (email groups, pocket emergency guides, staff training). Based on one site’s successful training for community providers of Medical Foster Home services, we worked with stakeholders to adapt and pilot a town hall and “resource fair” for home health agencies, scheduled for July 2024. Core sessions include guidance preparing emergency plans, an overview of VA benefits, and links to community resources. Stakeholders can also access 1-to-1 support on specific issues and offer suggestions for trainings VA can offer home health aides. Stakeholders identified potential challenges of town halls, including HHAs’ need to balance emergency preparedness with other priorities, and the broad geographical area which could limit attendance. This presentation will cover successes, challenges and lessons learned as we plan for scaling this effort at other sites.
AGE DIFFERENCES IN DEATH ATTITUDES IN THE CONTEXT OF MULTIDIMENSIONAL TORNADO IMPACTS
Authors: Chen Zhirui , Cong Zhen 
Published: January 2025

Abstract
This study examined the age differences in various attitudes towards death following tornado exposures, as well as the moderating effect of multidimensional tornado impacts. Data used was from the first wave of longitudinal study “Vulnerability and Resilience to Disasters” (N = 1,067). Latent class analysis was conducted to explore the underlying patterns of negative tornado impacts based on 15 indicators. Three latent classes were identified: low overall impacts with high power outage rate (Low-PO), moderate overall impacts with high emotional distress (Moderate-ED), and severe overall impacts. Subsequently, the results of linear regressions showed that relative to young-old adults aged 65-74, those aged 18-34 were more likely to have an intense fear of death and those aged 75+ were less likely to have an intense fear of death (Death Fear); people aged 18-34 were more likely to avoid thought of death when it entered mind (Death Avoidance); and those aged 18-34 and 35-49 were less likely to agree that death is an entrance to a place of ultimate satisfaction (Approach Acceptance). However, compared to younger and middle-aged adults, young-old adults were more likely to avoid thought of death when it entered mind and were less likely to agree that death is a natural aspect of life (Neutral Acceptance) if they belonged to the Moderate-ED class. These findings highlighted the resilience and death anxiety of older adults after experiencing multidimensional tornado impacts, which can provide important implications for the development of age-responsible mental health programs in post-disaster recovery.
BALANCING WORK AND HEALTH IN AGING: EMPLOYMENT AND ARTHRITIS DEVELOPMENT AMONG MIDLIFE AND OLDER WOMEN
Authors: Tan Micah , Straughan Paulin 
Published: January 2025

Abstract
With population aging, many countries have opted to delay mandatory retirement ages and to encourage workers to continue working into mid- and late-life. However, the implications of such policies for the health of older workers are still understudied. Existing research has demonstrated that women tend to experience greater negative effects on their physical health from working due to having to also shoulder a greater responsibility for household chores and caregiving. Yet, there is a paucity of research examining if such effects are present for older workers, as well as in East-Asian contexts where additional responsibilities at home are greater for women. As such, utilizing two waves of data from the Singapore Life Panel collected in January 2018 and January 2023, the current research aims to understand the physical health effects of work among middle-aged and older-adult women relative to men in Singapore. With a final sample size of 4225 respondents (mean age at baseline = 60.38 years) that had not yet been diagnosed with arthritis at baseline and in fully-adjusted models controlling for marital status, having children, and levels of social support available, we find that women who were working at baseline had a greater likelihood of being diagnosed with arthritis at follow-up relative to women who were not working. In comparison, working at baseline is not found to have any effect on the likelihood of being diagnosed with arthritis among men in the sample. The implications of these findings for health and labor policies in aging populations are discussed.
RELATIONSHIP BETWEEN JOB STRESS AND SELF-CARE ON MIDDLE-AGED AND OLDER ADULT EMPLOYEE WELL-BEING
Authors: Mertz Laurel , Smith Jennifer 
Published: January 2025

Abstract
Given that workplace stress and burnout are related to numerous adverse well-being outcomes, identifying strategies to decrease workplace stress or mitigate its effects is vital. Self-care may be a resource to protect against the negative impact of job stress on employees’ health and well-being, but self-care research is limited in non-healthcare fields. Additionally, as the number of older adults in the workforce rises, there is an increasing need to understand and enhance older adult employees’ well-being. The purpose of this study was to assess whether members of the middle-age and older adult workforce are able to engage in as much self-care as they need, and to determine whether the ability to engage in enough self-care attenuates the relationship between job stress and well-being outcomes. A total of 2,112 full-time employees, ages 43 to 77, were recruited via an online research panel (mean age = 54.0 years, 59.0% male, 64.2% White). Participants completed a survey that assessed job stress, ability to engage in self-care, and well-being (i.e. life satisfaction, job satisfaction, mental and physical health). Multiple regression analyses indicated that engaging in enough self-care attenuated the negative relationship between job stress and satisfaction with one’s life and job, but not health. These results provide evidence that self-care may be effective in protecting against the negative impact of workplace stress in the middle-age to older adult workforce. Further research is needed to examine the effectiveness of formal workplace self-care interventions, as formal interventions may supplement employees’ personal levels of self-care.
INCLUSIVE CROSS-CULTURAL LEARNING: END-OF-LIFE CRITICAL CARE ACROSS KOREAN AND AMERICAN LITERATURE
Authors: Kim Soo Hyun , Wright Rebecca 
Published: January 2025

Abstract

Background
Korean Americans are the fastest growing racial-ethnic population in the US, however, demographic reporting often groups by race, prohibiting exploration of ethnic and cultural needs. This represents a challenge for clinicians tailoring end-of-life care in critical care environments.

Objectives
Report the state of the science from a scoping review of Korean and American end-of-life critical care literature.

Methods
A comprehensive scoping review of the literature was performed in 2024 following the Joanna Briggs methodology, across seven databases: PubMed, CINAHL, EMBASE, Web of Science, KCI, Global Index Medicus, and KoreanMed. Articles were included in English and Korean with no time limit.

Results
Exploration of end-of-life critical care was limited: all studies were descriptive. Korean articles (N=23) highlighted minimal advanced care planning, physician-led care, and an absence of direct patient perspectives. US (N=26) literature revealed a gap in critical care content but included older adult’s hypothetical perspectives of palliative care. Differences were noted in preferences for end-of-life interventions between Korean Americans and other racial-ethnic groups. Some contradictions were noted in Korean American perspectives where life-sustaining treatments were viewed positively but not wanted, yet with an expectation that all treatment options should be pursued out of filial piety.

Conclusion
There is substantial need for research into end-of-life care needs in critical care environments to improve inclusion and equity for Korean Americans. Korean literature provides some insights into cultural norms the US could draw from. However, Korean Americans may have different needs to Koreans, requiring further exploration and intervention development.
NAVIGATING COMMUNITY-BASED HOSPICE TRANSITIONS: PALLIATIVE CARE TEAM PROCESSES TO SUPPORT PATIENT-CENTERED CARE
Authors: Mann Catherine , Masella Norine , Sullivan Suzanne 
Published: January 2025

Abstract
Palliative care systems provide a bridge to hospice as goals of care change during chronic, progressive, serious illness management. However, research is lacking on the role of palliative care teams in promoting care transitions outside of the hospital. The aim of this study is to understand the process palliative care teams use to support care transitions in the community to improve earlier acceptance and admission to hospice care by patients and families. Using a Straussian grounded theory approach, we explored processes palliative care teams use to support patient and caregiver transitions in homecare settings. Data were collected through eight recorded and transcribed interviews of palliative care team members (nurses and social workers, n=28) using the constant comparative method. Participants were recruited from three hospice and palliative care agencies serving three counties in New York state. A theory grounded in a process of building trust (e.g., creating safe spaces, listening and learning, building a rapport, meeting patients where they are at), watching and waiting (e.g., deciding if hospice criteria is met, determining readiness for transition, advance care planning), maximizing facilitators (e.g., personalizing care, involving the interdisciplinary team and caregivers, accessing resources), minimizing barriers (e.g., advocating for patient, addressing social determinants of health, navigating regulatory limitations), and getting them over the hill (e.g., educating to reduce stigma, normalizing hospice, reaching the tipping point) was developed. The process identified in the study reveals important mechanistic targets for the development of interventions that promote patient-centered hospice care transitions in the home.
USING LIFE REVIEW TO EXPLORE DEATH EXPERIENCES AND SELF-MANAGEMENT AMONG HEALTHY OLDER ADULTS IN TAIWAN
Authors: Tsou Hsin-Ying , Ten Pan Yu- , Kuo Tsuann 
Published: January 2025

Abstract

Background
Discussing death is considered a culturally sensitive topic in Eastern societies, as it may evoke concerns related to inheritance, filial piety, and mortality. Avoiding conversation about death can result in family members guessing the wishes of the deceased and may cause disputes and conflicts within the family. Purpose This study aims to explore the changing process of understanding death and self-arrangement among 11 healthy older adults in Taiwan through the use of life review program.

Method
This paper examines participation, dialogue, changes, and reflection in ten life review group sessions with 11 healthy older adults through participant observations and document text analysis. The sessions took place weekly for two hours between April to June in 2023.

Result & discussion
The process to reflect deaths and their self-management included four stages. 1) The “resistance” stage: participants expressed uncertainty by stating “I don’t know how to talk about it”. 2) In “promotion” stage: participants were encouraged to share their experiences in managing funeral arrangements for family members, leading them to realize that “there is no standard answer for funerals, only respect for the deceased”. 3) During the “change” stage: participants were willing to make arrangements regarding properties, medical decisions, funeral arrangements of their own. 4) In the “sharing” stage: an act was performed to summarize the course and to recognize that everyone was unique.

Conclusion
The life review group can effectively guide older adults to discuss their death experience and self-arrangement.
ASSOCIATION BETWEEN MULTIMORBIDITY AND KIDNEY FUNCTION DECLINE IN OLD AGE: A SWEDISH POPULATION-BASED COHORT STUDY
Authors: Beridze Giorgi , Dai Lu , Carrero Juan-Jesús , Marengoni Alessandra , Vetrano Davide Liborio , Calderón-Larrañaga Amaia 
Published: January 2025

Abstract
We aimed to study the associations between multimorbidity (the presence of ≥2 conditions) and multimorbidity patterns, and the risk of kidney function decline in older adults. 3094 individuals from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were followed between 2001 and 2016. Multimorbidity was operationalised as the number of chronic conditions and multimorbidity patterns identified using latent class analysis. Joint models and Cox regression models were used to explore the associations between multimorbidity, and absolute and relative (≥25% decline from baseline) changes, respectively, in the estimated glomerular filtration rate (eGFR) calculated using the creatinine-based Berlin Initiative Study equation. Mean age of the sample was 73.9 and 87% had multimorbidity. There was a dose-response relationship between the number of chronic conditions, and absolute (β [95% CI] = -0.05 [-0.07;-0.03]) and relative (HR [95% CI] = 1.23 [1.17;1.29]) declines in eGFR. Five patterns of multimorbidity were identified. The Unspecific, low burden pattern had the lowest morbidity burden and was used as the reference category. The Unspecific, high burden and Cardiometabolic patterns showed accelerated absolute (β [95% CI] = -0.15 [-0.26;-0.05] and -0.77 [-0.98;-0.55], respectively) and relative (HR [95% CI] = 1.45 [1.09;1.92] and 3.45 [2.27;5.23], respectively) declines. Additionally, the Cognitive and Sensory pattern showed accelerated relative decline (HR [95% CI] = 1.53 [1.02;2.31]). No associations were found for the Psychiatric and Respiratory pattern. Multimorbidity is strongly associated with accelerated kidney function decline in older age. Individuals with cardiometabolic multimorbidity exhibit a particularly increased risk.
DETERMINANTS AND TRAJECTORIES OF HEALTHY AGING IN OLDER AMERICANS
Authors: Sahab Lujain 
Published: January 2025

Abstract

Background
As the proportion of ageing individuals in the population increases, there is an increase in the burden of age-related chronic conditions. Therefore, it is essential to identify determinants of healthy ageing through extensive research and implement strategies to address challenges in society.

Methods
This analysis included an average of 8,340 participants, aged 50+ years, who participated in 6 waves (2006-2016) of the Health and Retirement Study. Healthy ageing measurement included freedom from cognitive impairment, freedom from disability, and high physical functioning. The study examined socioeconomic and ethnic inequality in healthy ageing over 10 years. Multilevel analysis was used to assess education, wealth, income and ethnic inequality in health ageing while accounting for demographic and behavioural factors.

Results
The analysis found that Females had lower odds for healthy ageing (OR: 0.64, 95% CI: 0.61–0.67). Black individuals had statistically significant lower odds of ageing healthily (OR: 0.87, 95% CI: 0.81–0.93) while hispanics had higher odds. The higher the educational degree the more likely you are to age healthily. Former smokers have a higher chance of healthy ageing (OR: 0.84, 95% CI: 0.80–0.88). The higher an individual’s wealth and income the more likely they are to age healthily. People who reported their health as poor were more likely to age negatively (OR: 0.22, 95% CI: 0.20–0.23).

Conclusion
This study showed that Being male, white, wealthy, with a high income were associated with a higher chance of achieving healthy ageing.