bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION BETWEEN SERUM BIOMARKERS OF ALZHEIMER’S DISEASE AND “DUAL DECLINE” IN COGNITIVE AND MOTOR FUNCTIONS
Authors: Pinardi Elena , Ornago Alice , Grande Giulia , Valletta Martina , Rizzuto Debora , Laukka Erika Jonsson , Bellelli Giuseppe , Vetrano Davide Liborio 
Published: January 2025

Abstract
Individuals experiencing simultaneous decline in cognitive and motor performances (i.e., dual decliners) face an increased risk of dementia and other adverse health outcomes. While the underlying pathophysiology remains largely unknown, this study aims to explore the association between serum biomarkers of Alzheimer’s disease (AD) and various patterns of cognitive/motor decline. Data are drawn from the Swedish National Study on Aging and Care in Kungsholmen. The rates of cognitive and motor decline were assessed over a 15-year period using linear mixed models, with Mini-Mental State Examination and gait speed as the respective measures. Participants were categorized into slow/non-decliners (reference group, n=1115), fast motor decliners (n=162), fast cognitive decliners (n=162), and dual decliners (n=264). The association between serum AD markers levels and the four decline patterns was analyzed using multinomial logistic regressions. Phosphorylated tau181 (OR = 1.77, 95% CI: 1.60;1.97), neurofilament light chain (OR = 1.44, 95% CI: 1.31;1.57) and phosphorylated tau181/amyloid-β42 ratio (OR = 1.18, 95% CI: 1.12;1.25) were associated with the highest risk of a dual decline pattern among study participants. In isolated cognitive decliners, robust associations were observed for amyloid-β42, amyloid-β42/40 ratio and glial fibrillary acidic protein, whereas no significant association emerged for those exhibiting only motor decline. Dual decliners present distinct profiles of serum AD biomarkers. The extensive involvement of tau pathology and neurodegeneration suggests an intrinsic biological complexity that necessitates further research, encompassing vascular and neuroinflammatory pathways.
DESIGNING FUTURE HEALTH CARE ENVIRONMENTS FOR AN AGING SOCIETY: TRANSDISCIPLINARY PERSPECTIVES
Authors: Kabo Felix , Contreras Cameron 
Published: January 2025

Abstract
As our society grapples with demographic aging, it is imperative that we design healthcare environments that better support the well-being of older adults in the context of critical staffing shortages in the healthcare sector. Beyond aesthetics and visual appeal, thoughtful healthcare design significantly and directly impacts patient outcomes, staff well-being, and the overall quality of care. This symposium brings together four complementary presentations from the design and research fields that employ transdisciplinary perspectives to examine the issue of designing healthcare environments for an aging society. Kabo, Morrison, and Ritsema discuss how digital twins, virtual representations of real-world objects, can be used to transform the future of healthcare design, thus delivering quality care experiences that sufficiently support the needs of older adults. Calkins provides an overview of evaluative research on healthcare design outcomes by focusing on the post-occupancy evaluation process by the SAGE Federation and links the research to the holistic design of age-friendly healthcare environments. Perreault and Kaminski use two innovative case studies to discuss and illustrate best practices in healthcare design for older adults, and how the built environment can be designed as an active aid for patient recovery. Kim will discuss how smart technologies and machine learning can facilitate successful aging-in-place and the design of home environments that better support healthcare for older adults. Collectively, this symposium brings together speakers from different fields (design and research) and disciplines (e.g., gerontology, architecture, interior design, engineering, etc.) to discuss the convergence of design and healthcare for our aging society.
END-OF-LIFE DECISION-MAKING: INFORMATION PRACTICES OF UCHINANCHU OLDER ADULTS
Authors: Shiroma Kristina 
Published: January 2025

Abstract
End-of-life (EOL) decision making encompasses sensitive, yet pivotal decisions requiring nuanced information. Understanding how diverse populations understand and make EOL decisions is crucial as diverse information practices can inform policies to enhance value-centered care for a broader range of patients at end-of-life. This study aims to better understand diverse approaches to EOL decision-making from older adults’ who come from an underrepresented ethnic minority group in the United States. Reflexive thematic analysis of in-depth, semi-structured interviews with 18 Uchinanchu American older adults. Recruitment through convenience and snowball sampling for in-person and telephone interviews. Three themes were identified in Uchinanchu American older adults’ approaches to EOL decision making: Prioritizing Mitigation of Burden for Adult Children; Keeping Customs of Filial Responsibility; and Maintaining a Shoganai Mindset. Uchinanchu participants were thinking about EOL decision making both down the familial lineage as they prioritized mitigating burden for their adult children, but also up the familial lineage as they kept customs of filial responsibility for their parents. Participants’ cultural approach to shoganai (the Japanese word associated with accepting one’s fate) helped them to balance a cultural acceptance of death as a fated part of life to either make or defer from EOL decision making. This study extends our understanding of diverse approaches to end-of-life decision making for underrepresented ethnic minority older adults in the United States. Future work in EOL decision making should include hard-to-reach, underrepresented populations to provide for inclusive and representative understandings of death and dying.
DEVELOPMENT AND CONTENT OF THE STUDY ABROAD COURSE
Authors: Fauth Elizabeth 
Published: January 2025

Abstract
Pedagogy of faculty-led short study abroad programs posits that these programs offer unique opportunities to build cross-cultural adaptability and global citizenship, expand disciplinary and interdisciplinary content knowledge beyond the traditional classroom, foster experiential learning opportunities, and facilitate personal and professional identity. This presentation on the Aging in a Welfare State covers the how course design, content selection, site visits, assignment, and excursions map onto these objectives. Optimizing three credits (which is ideal for most students’ programs) necessitates reading and assignments before, during and after “in-country” portion of the course. In-country content is delivered by US faculty and Swedish faculty, who purposefully are chosen (or select lecture content) based on their own discipline and expertise. With lecture content in nursing, social work, developmental psychology, gerontology, and more, students from diverse majors often connect closely to at least some of the content within their discipline, but expand learning into new topics. The addition of content on family and child policies is attractive to students outside of gerontology programs. Days are organized around themes, with three lectures in the morning broken up by the Swedish coffee tradition of FIka, a lunch break, and site visits to hospitals, adult day programs, child care programs, senior centers, assisted living facilities, and rehabilitation programs. Site visits offer applied learning experiences, where students can interact with professionals and clients/residents/users. Excursions are used to expose students to Swedish culture, and the historical perspectives that inform their social care policies. Assignments bridge academic application and personal/professional self-reflection.
ESTABLISHING A SHORT-TERM STUDY ABROAD COURSE ON AGING AND HEALTH CARE: FACILITATORS AND BARRIERS
Authors: Hermann Carla 
Published: January 2025

Abstract
The population of older persons is growing in every country in the world. In the United States (US), the older population is increasing at an unprecedented rate and is becoming significantly more diverse. Population aging is one of the most significant social transformations of the twenty-first century. Every occupation will be impacted by this transformation; therefore, education of individuals across disciplines about aging is imperative. To address the demand for aging-related professionals, Indiana University Southeast developed and implemented an interdisciplinary short-term study abroad course on healthcare and gerontology for students of any major. Although this course was previously offered by other US universities in collaboration with the College of Health and Welfare at Jönköping University in Sweden, the course offered in May 2023 was the first time Indiana University Southeast was involved. There were multiple facilitators and barriers to establishing this short-term study abroad course. Facilitators included: collaboration with an established course and international experts; institutional support from the host university in Sweden; high interest in an international learning experience by the students; the course available to students of any discipline; offered over a short-term (2 week) period. Barriers to offering this course included: lack of institutional infra-structure to support study abroad; post-pandemic traveling concerns; lack of student knowledge regarding basic concepts of aging and healthcare. High impact educational practices such as study abroad can help meet the demand for professionals that are prepared to promote the well-being of the aging and diverse population.
HISTORY OF A SUSTAINED AND SUCCESSFUL MODEL OF INTERNATIONAL GERONTOLOGICAL EDUCATION
Authors: Zarit Steven 
Published: January 2025

Abstract
A successful and sustained study abroad program depends on a foundation built in advance by the faculty of the participating institutions. Three foundational elements contributed to the success of the program, Aging in a Welfare State: What We Can Learn from Sweden, that has been ongoing since 1995. The first and most important foundational element is the relationship between the faculty at participating institutions. In this program faculty of the two initial participating institutions (Jönköping University and Penn State) had worked together for several years prior to developing and offering the program. Another foundational element was long-standing relationships between our Swedish partners and personnel at social and care facilities serving older people in Jönköping. A central goal of the program was that students would learn how care is organized and delivered in Sweden by visiting programs that served older people. Because our Swedish partners had long-established relationships with local care facilities, they were able to arrange visits for students at a range of programs for older persons. Staff at these facilities welcomed us, were open and informative and even invited us to Swedish Fika (coffee and a snack). We were also able to talk with the people using these programs. The visits were the most inspiring part of the class for students because they demonstrated innovative ways of providing care compared to the US. An obvious but important foundational element was having housing, transportation, and other comfort issues in place. These foundational elements were the key to our ongoing success.
WECAREADVISOR: CAREGIVER USE OF A DIGITAL PLATFORM TO MANAGE DEMENTIA-RELATED BEHAVIORAL SYMPTOMS
Authors: Gitlin Laura , Davis Vincent , Bouranis Nicole , McClure Leslie , Kales Helen , Webster Melinda 
Published: January 2025

Abstract
Dementia-related behavioral and psychological symptoms are undertreated and have negative consequences for people with dementia and their caregivers. Families typically do not have access to dementia education and effective management strategies. WeCareAdvisor is an online platform providing caregivers with dementia information, daily tips, and a 4-step systematic approach for describing behaviors, investigating underlying causes, creating a list of tailored strategies (prescriptions), and evaluating their effectiveness (DICE). It is being tested in a randomized trial to evaluate effects on caregiver wellbeing and behavioral symptoms. This paper reports utilization patterns of 240 caregivers under two “prompting” conditions to use the platform: high-intensity (telephone plus email reminders) and low-intensity (email reminders only). A total of 999 DICE sessions were started of which 347 (35%) sessions were evaluated. Caregivers sought strategies for all 13 behaviors included in the platform ranging from 141 DICE sessions for Anxiety (14%) to 31 sessions for Hallucinations (3%). Caregivers in the high-intensity prompt group (n=46) had more DICE sessions (296, mean=6.4, SD=4.5) compared to 163 sessions in the low-intensity prompt group (n=41, mean=4.0, SD=3.5), generated 82% more prescriptions, and requested close to 3 times more additional strategies. Of 171 study completers, an average of 4.5 (SD=3.8) DICE sessions were conducted over 6-months (range 1-19). Caregivers engaged with WeCareAdvisor to obtain strategies for managing common behavioral symptoms; however, only 1/3 evaluated their effectiveness. Caregivers used the online platform more when prompted by telephone/email than by email alone. This utilization pattern has significant implications for cost and scaling of the WeCareAdvisor.
EXPLORING THE ACTIVATING EFFECT OF THE CARE ENVIRONMENT OF GREEN CARE FARMS FOR PEOPLE WITH DEMENTIA
Authors: Rosteius Katharina , Frissen Laura , de Boer Bram , Gabrio Andrea , Verbeek Hilde 
Published: January 2025

Abstract
Engagement and activity is important for people with dementia for their sense of purpose, and for cognitive and physical stimulation. Aiming to increase engagement and activity, innovative long-term care environments like Green Care Farms (GCFs) reorganize care by including nature, animals and a more home-like environment into daily care. Previous studies have shown that GCF-residents are more active than those of regular care facilities. This study explored the role of the GCF-environment in this activation. Ecological Momentary Assessments were conducted with 152 participants from four Dutch GCFs, combined with cognitive and physical assessments. Residents were observed during mornings, afternoons and evenings, with a total of 4,600 valid observations. Each observation combines activity-, engagement-, as well as place scores, which are mapped on a ground plan of the facility. Analyses showed that residents were actively engaged in an activity in 67.9% of the observations. Residents spent most of their time in inside common areas (54.0%), followed by their own room (24.6%), outside (10.6%) and in communal inside areas outside of their ward (e.g. a café) (7.7%). In relation to passive behavior, active engagement was highest outside (87.1%), as well as in communal areas outside of the ward (81.7%) and inside the ward (81.3%). These results show that areas where residents spend time together have most activating potential and call for a more communal organization of care. Further research should explore what in the environment triggered residents’ engagement in order to react to needs arising in a tailored way.
UNDERSTANDING ACTIVITY ENGAGEMENT EXPERIENCE AMONG RESIDENTS WITH DEMENTIA IN LONG-TERM CARE HOMES
Authors: Zhang Ziying , Chaudhury Habib 
Published: January 2025

Abstract
Recreational and meaningful activities in long-term care homes are crucial in promoting well-being among residents with dementia. While existing research primarily focuses on planned activities facilitated by staff, little attention has been given to self-directed activities initiated by residents themselves, reflecting their intrinsic motivation, lifestyle, and lifelong interests such as walking, gardening, meal preparation and other household activities. In this study, activity is defined as personally meaningful behavior, including both programmed and self-directed activities, and supported by social and/or physical environmental stimuli. Utilizing critical ethnography in a long-term care home in Canada, our research aims to: 1) gather descriptive data on the types, diversity and process of residents’ activity engagement, and 2) examine the care home setting in its natural context to uncover the social practices, built environmental features and underlying organizational discourses that influence activity engagement. Observations will focus on residents’ engagement in various activities and their interactions with staff and the physical environment. Interviews will be conducted with activity staff and non-activity staff (e.g., care aides, nurses) to explore their perspectives on activity engagement, person-centered approach, and their respective roles in promoting engagement. This study offers insights into residents’ experiences with both structured and self-directed activities, and the influence of the care home’s social and physical environments on engagement. The study addresses the knowledge gap in meaningful engagement through self-directed activities and the role of social and physical environments. Fieldwork will be completed in summer and preliminary findings based on interviews and initial observations will be presented.
TARGETING BIOLOGICAL AGING MECHANISMS OF LOWER URINARY TRACT SYMPTOMS IN OLDER MEN WITH AN EXERCISE INTERVENTION
Authors: Bauer Scott 
Published: January 2025

Abstract
Physical frailty is associated with lower urinary tract symptoms (LUTS) severity and progression among older men with suspected benign prostatic hyperplasia (BPH). Prospective cohort studies have consistently demonstrated that both physically inactive and frail men are more likely to develop BPH or experience LUTS progression. The combination of aerobic plus resistance exercise has been demonstrated in clinical trials to have pleotropic effects that delay, prevent, or treat many frailty-related conditions that often co-occur with LUTS and BPH, including cardiovascular disease, diabetes, and erectile dysfunction. Although it has never been tested in humans, pre-clinical mouse models of BPH demonstrate improved voiding behaviors after exposure to exercise and exercise is known to improve several mechanisms that are implicated in human LUTS/BPH pathophysiology, including insulin resistance, endocrine dysregulation, and mitochondrial dysfunction. The recently launched PROUD study (NCT06225479; MPIs: Bauer, Kenfield) is a 2-arm pilot randomized controlled trial among physically inactive older men with LUTS/BPH testing the effect of a 12-week remote exercise intervention versus health education control. Outcomes include: 1) feasibility, acceptability, fidelity, and safety; 2) changes in LUTS, urologic and physical function, and physical activity; and 3) feasibility of detecting exercise-induced change in novel frailty-related mechanistic measures. This symposium session will review the scientific rationale, key study design and analytic decisions, enrollment progress thus far, and collaborative opportunities using stored biobank specimens.
CLINICAL TRIALS OF GEROTHERAPEUTICS FOR TARGETING LOWER URINARY TRACT SYMPTOMS
Authors: Al-Naggar Iman 
Published: January 2025

Abstract
Aging and the metabolic syndrome, a condition that accelerates biological aging, are both risk factors for lower urinary tract symptoms (LUTS). Storage LUTS, including urinary frequency, urgency, incontinence and nocturia, greatly impact quality of life and contribute to social isolation, depression, increased risk of falls and fractures, and loss of independence in older adults. Dysregulated mechanisms along the brain-to-bladder pathway can lead to LUTS, as the body becomes less resilient and its ability to maintain normal function declines. Although dysfunctional detrusor muscle can be targeted with anticholinergics, these drugs have had little success in alleviating LUTS and are often abandoned due to undesirable side effects. Identifying novel targets would allow the development of more effective drugs to alleviate LUTS. Biological mechanisms of aging that play a role in multiple age-related diseases have recently been implicated in metabolic syndrome-associated LUTS, including inflammation, mitochondrial dysfunction and oxidative stress. Furthermore, studies using mouse models of aging and metabolic syndrome show increased bladder dysfunction in these model organisms. Targeting biological hallmarks of aging to alleviate LUTS in humans represents a promising new direction that our group is exploring. This can be safely done using repurposed drugs or supplements with gerotherapeutic properties, such as MitoQ. This symposium session will describe the rationale and study design for on-going pilot and feasibility studies targeting the biology of aging for LUTS alleviation in older women.
EVIDENCE TO SUPPORT A NOVEL CLINICAL CARE PATHWAY FOR GERIATRIC INCONTINENCE SYNDROME IN OLDER WOMEN
Authors: Parker-Autry Candace 
Published: January 2025

Abstract
Geriatric syndromes define complex health conditions that result from the concomitant presence of multiple geriatric impairments in an older adult. Urinary incontinence (UI), an established geriatric syndrome, is unique in that it is present among younger women due to pelvic floor dysfunction, most commonly due to birth trauma or obesity, as well as older women with aging-related changes in skeletal muscle and cognitive health. The latter is a distinct phenotype of UI called female geriatric incontinence syndrome (GIS). Like other geriatric syndromes, GIS is bidirectionally associated with frailty and commonly occurs with concurrent multimorbidity. The combined impact of pelvic floor dysfunction, aging-related impairments in skeletal muscle and/or cognition, and multimorbidity make defining, diagnosing, and treating GIS a complex task. There is a significant body of work describing non-procedure-based treatments for UI with focus on physical therapy/exercise and medications. However, with unhealthy aging skeletal muscles become smaller and weaker, thus pelvic floor muscle function diminishes. This limits the clinical success of physical exercise to treat geriatric UI. Further, multimorbidity and cognitive impairment may limit the efficacy and safety of pharmacologic UI treatments. Based on our teams qualitative studies, women with GIS desire significant improvement in their symptoms; this may be only possible through multi-modal therapy. During this session, we will review the evidence above in more detail and describe the rationale and proposed approach to a multi-modal clinical care pathway, including both conservative and procedure-based treatments, that we are currently implementing for women with GIS at our tertiary care referral center.