bluuebunny/crossref_metadata_2025_split huggingface dataset:
REHOSPITALIZATION RISK AMONG VETERANS RECEIVING POST-ACUTE HOME HEALTH SERVICES: DIFFERENCES BY PAYOR SOURCE
Authors: McCreedy Ellen , Devone Frank , Gozalo Pedro , Gravenstein Stefan , Daus Marguerite , Jones Christine , Magid Kate , Thomas Kali 
Published: January 2025

Abstract
Medicare-eligible Veterans who require post-acute skilled home health (HH) after a hospitalization can have HH paid for by the Veterans’ Administration (VA) or Medicare. Our prior work showed Veterans enrolled in Medicare Advantage (MA) are more likely to have the VA pay for HH than MA. In this analysis, we look at differences in 90-day rehospitalization among MA-enrolled Veterans receiving VA-paid post-acute HH versus MA-paid post-acute HH. All Veterans enrolled in MA and receiving HH after an index hospitalization at a VA medical center between October 1, 2016 and September 30, 2019 were included. Data were extracted from the VA electronic medical record. We used inverse probability weighting to address baseline differences in age, patient complexity, and past utilization. We used cox proportional hazards models to estimate the effect of VA- versus MA-paid HH on the risk of 90-day rehospitalization. There were 14,501 eligible hospitalizations requiring HH; 8,753 (60.4%) received VA-paid HH, and 5,748 (39.6%) received MA-paid HH. On average, Veterans receiving VA-paid HH waited 3.7 days (SD: 3.2) to start HH, compared to 4.8 days (SD: 3.8) for Veterans receiving MA-paid HH. After preliminary weighting, Veterans who received VA-paid HH had a lower risk of 90-day rehospitalization, compared to Veterans who received MA-paid HH (adjusted hazard ratio=0.88; 95% CI: 0.83,0.93). Veterans whose HH was paid for by MA received services one day later, on average, and had higher risk of 90-day rehospitalization compared to Veterans receiving VA-paid HH. Potential implications on quality of post-acute care for MA-enrolled Veterans discussed.
SOCIAL SUPPORT NETWORKS AND LONELINESS: DIFFERENCES ACROSS RACIAL/ETHNIC GROUPS
Authors: Burack Orah , Mak Wingyun 
Published: January 2025

Abstract
Higher levels of social support (SS) has been associated with a number of positive health and well-being outcomes including lower levels of loneliness. Additionally, SS networks have been found to vary across race/ethnicity. Researchers have therefore begun to examine how specific aspects of SS differentially impact outcomes among racial/ethnic groups. In this study we examined whether visits with different types of SS providers (children, siblings, friends), impact loneliness differentially across race/ethnicity. Data were drawn from the AARP Loneliness and Social Connections Survey with a national sample of community dwelling adults age 45+ years (M=61.84, SD=10.12; N=4040). Participants self-identified as White non-Hispanic (N=3149), Black non-Hispanic (N=420), or Hispanic (N=472). A series of hierarchical linear regressions (one for each racial/ethnic group) examined the relationship between loneliness and frequency of in-person visits from: children, siblings, or friends, after controlling for age, gender, marital status, and perceived health. While older, married, healthier adults reported less loneliness across all groups, differences were found by SS provider type. Less loneliness was significantly related to more visits from: siblings (β=.05, p&lt;.001) and friends (β=.11, p&lt;.001) for Whites (ΔR2=.03, p&lt;.001); friends (β=.09, p=.008) for Hispanics (ΔR2=.02., p=.01); while for Black subjects there were similar size trends for children (β=.08, p=.08), siblings (β=.07, p=.03., p=.001), and friends (β=.07, p=.09). These results highlight that SS providers are not interchangeable, with differing impacts on loneliness across ethnicity/race. Implications and reasons for these findings will be discussed.
STATE-LEVEL OPPORTUNITIES TO ADDRESS BEHAVIORAL HEALTH NEEDS OF OLDER ADULTS: A NEW CENTER OF EXCELLENCE FOR OREGON
Authors: Dawson Walter , Stodola Allyson , Cellarius Karen , Himes Dani , Smith Lindsey , Brandis Leah , Dhar Nirmala , Carder Paula 
Published: January 2025

Abstract
Serious mental illness and substance use disorders among older adults frequently intersect with neurocognitive changes and complex physical health issues. At the same time, access to behavioral health services is often poor for many older adults. Multiple underserved populations such as older adults from communities of color and individuals living in rural/remote communities experience substantial barriers to access and use of behavioral health services. There is a need for enhanced program and policy actions to ensure access to behavioral health for these populations of older adults. This session describes the state of behavioral health and aging services for older adults in Oregon and efforts to address local and statewide needs. This includes the impetus for establishing the Oregon Center of Excellence for Behavioral Health and Aging (OCEBHA), the goals of OCEBHA, and the long-term vision of the Center to address behavioral health disparities.
THAT’S ANTHROPOLOGY: CONFRONTING AGEISM AND STUDENT DISCOMFORT IN SERVICE LEARNING
Authors: Cho S M , Williams Cara , Freidus Andrea , Shenk Dena 
Published: January 2025

Abstract
Undergraduate anthropology majors participated in a 15-hour, semester-long service-learning project at an adult day and health care center during Spring 2024. While a research-based model of intergenerational service-learning has been incorporated in the undergraduate gerontology program curriculum at UNC Charlotte for 25 years, this was the first time anthropology undergraduates engaged in intergenerational research as part of their senior seminar. With no prior coursework in gerontology, and limited intergenerational experiences, anthropology senior seminar students began the semester with uncertainty and ageist biases. The founding director of the gerontology program, a professor emerita of anthropology, guided students’ practical development by providing lectures, leading exercises, and facilitating discussions throughout the semester. During the course, the students learned about and confronted complex presentations of ageism. Their time at the day center involved socializing with participants, assisting staff, creating and tending a therapeutic garden, working with participants to create memory boxes, and building rapport. These steps were essential for building a reciprocal, collaborative intergenerational research relationship that integrates anthropological pedagogy. We suggest their initial resistance to this work is the result of age segregation and internalized sociocultural narratives of ageism, as well as misguided expectations of the frustrating, messy, challenging reality of undertaking anthropological research using participant observation. Consistent narrative themes of unprecedented gratitude, personal growth, and learning about ageism emerged from student field notes, class discussions, and written reflections. This program evaluation presents novel insights for future integration of intergenerational programming and gerontological knowledge into anthropological pedagogy.
THE ASSOCIATION BETWEEN DIGITAL TECHNOLOGY ACTIVITIES AND COGNITIVE DOMAINS OF COMMUNITY DWELLING OLDER ADULTS
Authors: Hsu Erh-Chi , Jutkowitz Eric , Thomas Kali 
Published: January 2025

Abstract
While prior research has established a relationship between digital technology use and improved cognitive function among older adults, the impacts of different technology activities on specific cognitive domains remain underexplored. This study examines associations between various technology activities and cognitive trajectories in community-dwelling older adults without dementia. We utilized repeated cross-sectional data from 5,596 participants in the National Health and Aging Trends Study (2015-2022). Technology activities included online shopping, banking, medication refills, social network site visits, and checking health conditions online. Cognitive domains assessed were episodic memory, executive function, and orientation. Covariates included sex, age, race, education, living arrangement, income, daily and instrumental activity difficulties, self-rated health, rurality, and device ownership. Survey-weighted mixed-effect models with random intercepts evaluated the associations between technology activities and cognitive trajectories, with descriptive stratification by sex. In 2015, online banking (28%) and visiting social network sites (25%) were the most popular activities, with females generally showing lower usage except for social network visits (F: 27%; M: 23%). Social engagement online had the strongest positive association with episodic memory (β=0.50, 95% CI: 0.33-0.67, p&lt; 0.001) and orientation (β=0.15, 95% CI: 0.10-0.21, p&lt; 0.001) independent of time. Online banking showed the strongest positive association with executive function (β=0.12, 95% CI: 0.06-0.18, p&lt; 0.001) independent of time. Notably, all five activities were more beneficial for females regarding episodic memory (p&lt; 0.001). These findings suggest that interventions promoting online instrumental activities (shopping, banking, medication refills) and social engagement online could enhance cognitive function in older adults, particularly females.
THE FORTITUDE FACTOR FOR CAREGIVERS: UNDERSTANDING THE EFFECT OF EMPLOYMENT AND CAREGIVING ON CAREGIVER WELLBEING
Authors: Clem Sarah , Davitt Joan , McCorvey Stephanie , Becker Todd , Eastman Jennifer , Sesek Greg 
Published: January 2025

Abstract
Shifting support services from community-based facilities to home-based settings has highlighted the dual roles of family/friend caregivers. This study investigated challenges experienced by caregivers of vulnerable adults in one east coast state. A convenience sample (N= 2,129) of caregivers, recruited through state and local agencies, completed an anonymous online survey to enhance understanding of caregiving experiences, challenges, and service utilization patterns. This paper focused on employed caregivers who reported greater service utilization than caregivers who were not employed. Within employed caregivers, we found they made workplace compromises to balance caregiving responsibilities including: going in late, taking a less demanding job, taking a leave of absence, and going from full to part-time work. There were positive associations between the number of compromises made in the workplace with caregiver-reported stress levels, financial strain, and service utilization. To address these challenges, employed caregivers reported using various coping strategies including exercise, mental health support, spiritual practice, hobbies, and support groups. Employer support to caregivers included: flexible hours, remote work options, paid sick days, paid family leave, referral/counseling supports, and unpaid family leave. Mixed results were found for relationships between employer supports and caregiver compromises, stress levels and financial strain. Research shows that multiple demands on employees can reduce worker productivity and efficiency. Responding to trends indicating an increase of informal caregivers in the workforce, this study highlights the needed support to promote caregiver resilience and their ability to remain employed. Implications for employers, community agencies, and government systems will be discussed.
THE ROLE OF HEALTH IN RETIREMENT PLANNING TOWARDS EXTENDED WORKING LIVES
Authors: Crossdale Rachel , Penning Nehle 
Published: January 2025

Abstract
Decades of research have shown that health is a key determinant of labour force participation in later life. As the ageing global population necessitates extended working lives (EWLs) for broader economic sustainability, the importance of the older population for the labour market is emphasised. Understanding the role of health and health inequality across the life course is crucial for impactful policy development to protect the health of the older workforce and encourage participation in EWLs. Using 100 interviews on risks and turning points in working life with older workers in Germany, Poland, Sweden, and the UK, this research explores the role of health as a barrier and facilitator of EWLs across the working life course. Drawing on policy and literature to contextualise our findings, this research reveals the role of health in retirement planning, including assumptions about health decline, impact on work, and the importance of partner’s health. Health as a ‘push and pull’ factor is also explored, with good health both fostering labour market engagement and encouraging early retirement, while physical and mental health can be both positively and negatively impacted by work. Inequalities by sector of employment, gender, and education level are also explored, with all four countries facing a ‘double bind’ whereby the most vulnerable must work longer for financial security but are limited by poor health. For future older populations to be healthier and more productive the current treatment-based model of health care needs to be challenged with preventative policy interventions throughout the life course.
TRAJECTORIES OF CHRONIC PAIN AMONG OLDER VETERANS: IDENTIFYING PAIN-WORSENING PREDICTORS VIA MACHINE LEARNING
Authors: Lee Chiyoung , Kim Yeri , Kim Seoyoung , Cohen Beth , Kwoh kent , Ahn Hyochol , Park Juyoung , Kim Heewon 
Published: January 2025

Abstract
Chronic pain is a major public health problem affecting approximately 100 million Americans and United States military Veterans, who constitute a particularly vulnerable group. While pain research in Veterans is actively underway, information on the longitudinal course of pain in this population is limited. This study aimed to 1) identify the various longitudinal pain status trajectories among older Veterans over a 10-year period and 2) detect factors predicting membership in the worsening trajectory of chronic pain. We analyzed data from 619 Veterans (mean age: 58.5 years) participating in the Mind Your Heart Study, an ongoing prospective cohort study examining diverse health outcomes among Veterans. Initially, we employed a generalized mixture model to identify pain trajectory classes using Brief Pain Inventory (BPI) pain intensity subscale score collected at 2-, 5-, and 10-year intervals. Two distinct trajectories were identified—low and high—both of which remained relatively stable. Subsequently, several feature selection methods extracted the predominant features from participants’ baseline characteristics that predicted membership in the high vs. low pain trajectory. These included: prior arthritis diagnosis; prior post-traumatic stress disorder (PTSD) diagnosis; depression symptoms; PTSD symptoms of avoidance, hyperarousal, and negative mood alterations; physical functioning; sleep quality; and overall health. The scikit-learn RandomForestClassifier, utilizing the refined feature set, achieved a classification accuracy of 0.79, yielding results nearly identical to those obtained using all 261 features. These findings are clinically informative and pertinent, highlighting potential intervention targets warranting intensive pain care plans based on probable long-term prognosis and discussing early treatment strategies among older Veterans.
TREATMENT BURDEN AMONG DIVERSE MIDDLE-AGED AND OLDER ADULTS WITH MULTIMORBIDITY
Authors: Quiñones Ana , Markwardt Sheila , Botoseneanu Anda , Tran Viet-Thi , Montori Victor 
Published: January 2025

Abstract
The demands associated with ongoing disease management may overwhelm middle aged and older adults living with two or more chronic conditions. Treatment burden refers to both (a) the numerous demands—such as the time and costs of travel to clinical appointment, administrative burden, and coordinating fragmented care—healthcare makes on patients and (b) the negative impact on the patient’s wellbeing. We evaluated data from respondents of the treatment burden experimental module included in the 2022 Health and Retirement Study data collection wave (N=1,888). We analyzed responses to the 15-item Treatment Burden Questionnaire (TBQ; 15 questions scored 0-10; total sum 0-150; &gt;59 considered unsustainable burden). We compared mean total TBQ score by sociodemographic and multimorbidity combination groups using either a t-test (among 2 groups) or ANOVA (among &gt;2 groups). We compared sustainability across groups using a chi-square test. Respondents (mean 69 years; 62% female, 71% living with 2+ chronic conditions) had a mean TBQ score of 20.3/150 (SD 22.7) with 125 (6.6%) reporting unsustainable burden. Administrative and financial tasks and lifestyle changes were the most burdensome activities. Unsustainable burden was significantly more likely among younger (51-64 vs. older), lower educated (&lt; high school vs. ≥high school), and Black and Latino (vs. non-Latino White) respondents, and in those living with 2+ chronic conditions. In this nationally-representative sample of US adults, participants reported less treatment burden than previously reported in international studies. Certain sociodemographic groups reported high and unsustainable burden of treatment, informing future interventions to reduce treatment burden in mid and late life.
TRENDS AND CHARACTERISTICS OF WORKING CAREGIVERS USING PAID FAMILY LEAVE PROGRAMS IN RHODE ISLAND AND WASHINGTON
Authors: Im Jennifer , Wong Edwin , Fishman Paul , Hill Heather , Weiner Bryan 
Published: January 2025

Abstract
Many family caregivers are part of the workforce and integral to older adults’ care. State Paid Family Leave (PFL) programs offer partial wage replacement to working caregivers. However, data on caregiving leave use is limited. This study examines trends and characteristics of workers who sought caregiving leave in Rhode Island (RI) and Washington (WA) using PFL program administrative data. Outcomes were application and approval for caregiving leave. Covariates included age, sex, ethnicity (WA only), income, primary language, and industry. Logit models with average marginal effects were used. In RI, 14,323 claims were recorded between 2015-22; 82.3% were approved. In WA, 75,739 claims were recorded between 2020-23; 76.7% were approved. Overall, caregiving applications increased annually. Applicants’ mean ages were mid-to-late 40s (RI=48.3; WA=46.9). Most applicants were female (RI=68.3%; WA=61.5%) and English-speaking (RI=95.1%; WA=89.2%). WA applicants were predominantly White (57.5%), Hispanic (13.8%), and mixed race (8.3%). Applications for spousal caregiving was most common in RI (36.3%); caregiving for children was most common in WA (39.1%). The lowest-earning workers had the highest percentage of denied claims (RI=35.5%; WA=29.8%). In both states, older age and higher income were significantly associated with claim approval. In RI, worker caring for spouse, parent, or grandparent had significantly lower probabilities of claim approval, compared to children; In WA, the opposite was observed. The results suggest caregiving PFL is rising among workers, with claim approval more likely for older workers. Higher income was associated with claim approval suggesting programs may not benefit workers that need it the most.
UNDERSTANDING COMMUNITY RESOURCES FOR OLDER ADULTS WITH DISABILITIES
Authors: Han Sunghei , Park Sojung , Park Soobin , Shin Esther , Kang Sarah , Kwon Eunsun , Ahn Seoyeon , Kim BoRin 
Published: January 2025

Abstract
For older adults with various disabilities—physical, mental, cognitive, and others—diverse community resources are essential for daily functioning and their Aging in Place (AIP). This scoping review analyzed 21 peer-reviewed studies from databases like PsycINFO, CINAHL, MEDLINE, Scopus, and PubMed to identify gaps in research on community resources for this population. Thematic analysis revealed four main themes: 1) the development of partnerships among local governments, service providers, and stakeholders to coordinate resources; 2) evaluation of community-level interventions such as telerehabilitation and mental health programs; 3) factors affecting access to and use of community resources; and 4) the impact of these resources on health and well-being. The studies primarily focused on home and community-based services (HCBS), but while some addressed specific care aspects like fall prevention and dementia care, broader research often overlooked the comprehensive needs of older adults with disabilities. Only two studies focused on resources for mental health and substance use disorders, highlighting significant gaps, particularly in primary care. Additionally, many studies lacked clear definitions of disabilities, leading to a fragmented understanding of community resources. This lack of clarity hinders efforts to address the unmet needs of older adults with disabilities, including diverse subgroups like LGBTQ individuals and ethnic minorities. The study highlights the need for more systematic research into the availability and accessibility of community resources to support older adults with varying disabilities better, ensuring no critical needs are left unmet in this vulnerable population.
USE OF REHABILITATION SERVICES AMONG OLDER CANCER SURVIVORS IN THE NATIONAL HEALTH AND AGING TRENDS STUDY
Authors: Huang Min-Hui , Chung Thomas 
Published: January 2025

Abstract
Older cancer survivors (OC) have higher risks of physical impairments than non-cancer older adults (NC). Cancer rehabilitation utilization remains a challenge. This study examined rehabilitation usage in OC using the National Health and Aging Trends Study (NHATS) round 12 (2022) dataset. Objectives were: 1) estimate rehabilitation prevalence in OC and NC; 2) identify factors associated with rehabilitation in each group; 3) compare rehabilitation duration, areas, and outcome between OC and NC. Community-dwelling adults ≥65 years with rehabilitation and cancer diagnosis responses were included (OC: N=653, age=78.7±7.33 years; NC: N=5168, age=79.9±7.63 years). General linear models (Objectives 1 and 2), Chi-square tests and t-tests (Objective 3) were conducted in IBM-SPSS version 28. Rehabilitation prevalence in the past year was similar between groups (OC: 26%; NC: 23%). Pain (OC: p=0.037; NC: p=0.004), higher education (OC: p&lt; 0.001; NC: p&lt; 0.001), and lower physical function (OC: p&lt; 0.001; NC: p&lt; 0.01) were linked to rehabilitation use in both groups. Unique factors linked to rehabilitation included low energy (p=0.030) for OC, and impaired lower-body strength (p=0.037) and balance (p=0.050) for NC. OC had longer rehabilitation durations (2.2±0.94 vs. 2.1±0.80 months, p&lt; 0.001) and were more likely to rehabilitate for low energy (p=0.004), falls (p=0.040), walking inside (p=0.035) and outside the home (p=0.027). More OC (81.1%) reported meeting rehabilitation goals than NC (70.1%)(p=0.010). Despite similar rehabilitation prevalence between groups, distinct factors linked to rehabilitation usage in OC highlight the need for tailored programs. Positive rehabilitation outcomes in OC support more rehabilitation referrals to improve physical function.