bluuebunny/crossref_metadata_2025_split huggingface dataset:
EAST MEETS WEST: COLLABORATING INTERNATIONALLY TO MITIGATE SOCIAL ISOLATION
Authors: Inoue Megumi , Amano Takashi , Lubben Jim 
Published: January 2025

Abstract
Combatting social isolation in later life is a pressing global issue. This symposium assesses social isolation among older adults from various angles. Four presenters from North America and Japan examine the perception, disparities, and impact of social isolation within specific cultural contexts. The knowledge from diverse cultural backgrounds and policy frameworks of the different countries provides an opportunity to explore the intricate nuances and shared experiences of social isolation among older populations. Dr. Watanabe will introduce the status of social isolation among Japanese older adults who reside in a marginal community, where more than 50% of the population is 65 years or older. Dr. Murayama will describe the findings on different forms of social isolation and their impact on health outcomes, utilizing extensive cohort data from older adults living in the Tokyo metropolitan area. Dr. Taylor will examine disparities in loneliness among older adults in the U.S., with a particular focus on the mediation effects of socioeconomic factors on racial and ethnic differences in loneliness. Dr. Mair will discuss changing demographics of older adults and shifting cultural values from a global perspective, with implications for rethinking aging alone as a risk factor and traditional notions of successful aging in relation to limited family ties. These four presentations will provide a broad overview of social isolation in three countries and its implications for quality of life in later life. The symposium will help identify culturally-sensitive strategies for promoting the well-being of older adults in global communities.
SOCIAL ISOLATION OF OLDER ADULTS IN A MARGINALIZED COMMUNITY IN JAPAN
Authors: Watanabe Yuichi 
Published: January 2025

Abstract
Japan stands as one of the most aged societies globally, with approximately 29% of its population aged 65 or older as of 2022. Previous studies indicate that 10-30% of Japanese older adults experience social isolation, with 2-10% facing severe social isolation (Saito, 2009). This issue is particularly prevalent among those who have contact with others less than once a week, posing potential health risk (Saito et al., 2015). However, it’s crucial to acknowledge the existence of extremely aging communities in Japan, especially in rural areas, known as marginalized communities, where over 50% of the population is 65 years or older. This presentation offers insights obtained from surveys conducted in 2015, 2017, and 2019 within one such marginalized community. The findings reveal that out of 297 older adults surveyed, 72 were living alone. Among them, 4 reported meeting others less than once a week, while 18 met others less than four times a week. These results suggest that approximately 25% of older adults living alone may experience social isolation, with 5.6% facing severe social isolation. While these findings may not be generalizable to all marginalized communities in Japan, they highlight the heightened risk of social isolation within such contexts. Future research should conduct detailed analyses to inform discussions and develop solutions for addressing social isolation in marginalized communities.
DOCUMENTATION OF LIFE-SUSTAINING TREATMENT PREFERENCES IN A NATIONAL COHORT OF VETERAN DECEDENTS
Authors: Makaroun Lena , Li Yaming , Mor Maria , Morris Stephen , Rosland Ann-Marie , Rosen Tony , Kutney-Lee Ann , Thorpe Carolyn 
Published: January 2025

Abstract
In 2018, the Veterans Health Administration (VHA) introduced the Life-Sustaining Treatment (LST) Decisions Initiative to standardize documentation of Veterans’ goals and preferences in the electronic health record (EHR). The objective of this retrospective cohort study was to assess LST completion patterns and sociodemographic, clinical, and care utilization factors associated with completion in a cohort of 23,591 VHA-engaged Veterans aged ≥65 years who died in 2021. We used VHA EHR and Medicare claims data and multivariable logistic regression to examine factors associated with LST completion. Of the cohort, 6,684 (28%) completed an LST. LST documentation occurred a median of 142 days before death; 2,260 (34%) were completed by a surrogate. LST completion was markedly higher in those with an inpatient or VA nursing home (CLC) stay in the 2-years before death, so we estimated models stratified by the presence (n = 7,761) or absence (n = 15,830) of any inpatient/CLC stay. In both strata, older age, higher comorbidity, and frailty were associated with LST completion (p &lt; 0.001). Among Veterans without an inpatient/CLC stay, being unmarried, having a child as next of kin, higher levels of VA financial benefits, and dementia diagnosis were also associated (p &lt; 0.001). Race/ethnicity and gender were not associated with LST completion. LST completion before death is strongly tied to utilization of VHA acute and nursing home care, and generally occurs close to the time of death and often by a surrogate. Opportunities may exist to improve documentation of patient preferences in outpatient settings farther in advance of health declines.
PATTERNS OF RUSHED AND UNFINISHED CARE AMONG CARE AIDES IN NURSING HOMES: A LATENT CLASS ANALYSIS
Authors: Angel Cybele , Song Yuting , Duan Yinfei , Estabrooks Carole 
Published: January 2025

Abstract
Rushed care and unfinished care (also called missed care, care rationing) are common in nursing homes. Although the two phenomena are interrelated, most researchers have studied them separately and used a variable-centered approach. We took a person-focused approach and aimed to identify groups of care aides who rushed care and left care tasks unfinished in similar ways. This cross-sectional analysis used survey data from 3546 care aides working in a random sample of 87 urban nursing homes collected from September 2019 to February 2020 in three provinces in western Canada. We presented to care aides a list of physical and social care tasks (e.g., bathing, talking with residents). They answered whether or not they rushed or left a care task unfinished in their previous shift of work. We performed latent class analysis to identify patterns of rushed and unfinished care and verified the identified patterns with a different wave of data. A 4-class model emerged as the best-fit model for our data. Group 1 reported high levels of rushed and unfinished care, and Group 2 was low on both rushed and unfinished care. Group 3 reported high rushed care and Group 4 reported medium rushed care; both groups reported low unfinished physical care and medium unfinished social care. Our findings suggest the complexity of rushed and unfinished care among care aides. System-level support for this workforce is urgently needed to develop targeted interventions for sub-groups of care aides to reduce rushed and unfinished care in nursing homes.
THE NEED FOR PRAGMATIC PROGRAMMING FOR CAREGIVERS: EVIDENCE FROM MANAGING MONEY: A CAREGIVER’S GUIDE TO FINANCES
Authors: Grant Claire , Judge Katherine , Stratton Lauren , Moreno Monica , Fazio Sam 
Published: January 2025

Abstract
Several key issues remain in the caregiving intervention literature. Programs must seamlessly transition and scale into existing settings with plans for long-term implementation. Programs should be accessible, digestible, and efficient for caregivers while still delivering meaningful results. To address these issues, conceptualization and development should be guided by end-use scenarios. Managing Money: A Caregiver’s Guide to Finances was developed as an online program for caregivers to address the need for pragmatic and scalable programs focused on the financial impacts of caregiving. Synchronous (community educator-led) and asynchronous (self-paced) versions of the one-hour online program were offered. Topics include conversations about finances, assessing needs, and finding financial support. Printable tools were also provided. The synchronous program was evaluated as an RCT (N=179). The mean age was 55.03 (SD=15.34), 73.2% White; 48.6% cared for a parent/grandparent; and 36.3% cared for a spouse. Long-term effects were found in reducing unmet needs and distress around finances and increasing the likelihood to act to improve financial situations. The asynchronous version was evaluated in a one-arm study with 146 caregivers. The mean age was 45.85 (SD=5.65); 75% were white, and 91% cared for a parent/grandparent. Both versions were found to be acceptable and feasible. On a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree) participants reported the program identified financial challenges (M=4.09, SD=.75/M=3.81, SD=.79) and would recommend the program (M=4.50, SD=.86/M=3.91, SD=.84). Discussion will outline features of program development, rollout, and scalability. Ongoing need and recommendations for pragmatic programming will also be discussed.
PERSONALITY BYTES: CRACKING THE CODE OF OLDER ADULTS ENGAGEMENT WITH AI
Authors: Shade Marcia , Yan Changmin , Jones Valerie , Boron Julie 
Published: January 2025

Abstract
Despite stereotypes about older adults’ reluctance to embrace technology, smartphone and technological device adoption among this demographic is increasing, including the use of Artificial Intelligence (AI). However, perceptions about AI may hinder engagement in research among older adults. This study examined how older adults’ personalities influence their interaction with AI-driven interactive routines. Fifty community-dwelling older adults participated in a 12-week randomized pilot study, divided into standard and enhanced groups, interacting with conversational AI for intervention routines. Data collected included personality traits, usability, and routine initiations. Participants, averaging 72.4 years old, were mostly female (88%) and White (95%). Personality traits did not significantly affect routine initiations overall, but extraversion predicted engagement throughout the day and morning in both groups. Evening routines were unaffected by personality traits. Agreeableness and conscientiousness significantly predicted perceived usability. These findings emphasize the influence of older adults’ personality traits on AI technology interaction, with extraversion playing a significant role. Additionally, agreeableness and conscientiousness impact usability. Integrating personality traits into research protocols involving technology interactions is crucial for better understanding older adults’ engagement.
FROM THE NATHAN SHOCK CENTERS COORDINATING CENTER: BIOLOGY OF AGING FOR NONBIOLOGISTS
Authors: van der Willik Odette , Austad Steven 
Published: January 2025

Abstract
Advances in the biology of aging that promise to dramatically extend the healthy length of human life are now appearing at a breathtaking rate. At the same time, baseless claims of research breakthroughs in maintaining youth are everywhere in the news. It is often difficult for people outside basic aging research to keep track of what is real and what is not. This symposium brings together scientists working in some of the most exciting research areas to update attendees in terms that will be understandable to anyone. Our speakers were selected both for their scientific achievements and for their outstanding skill as science communicators. Dr. Passos will discuss the rapidly expanding field of senotherapeutics to identify drugs that can eliminate senescent cells (senolytics) and what is needed in the development of therapies that target cellular aging. Dr. Molina will review the development of promising biomarkers of human aging and will provide examples of how markers are being tested and applied in a range of clinical studies. Dr. Panda will provide insights from circadian rhythm science and how new lifestyle choices have the potential to be implemented on a population scale. And Dr. Espinoza will discuss the basic principles of geroscience and the use of such therapies toward the goal of improving healthspan (as opposed to the traditional single disease approach). Dr. Valenzano will update us on how important the microbes that live in and on us are turning out to be to our later life health.
BIOMARKERS OF AGING AND PRECISION HEALTH CARE FOR OLDER ADULTS
Authors: Molina Anthony 
Published: January 2025

Abstract
Efforts to develop objective and quantifiable biomarkers of human aging are ongoing and have been accelerated by advances in technical and analytical approaches for biomedical research. Beyond predicting one’s chronological age, this research is being increasingly applied to measure biological age, which captures the heterogeneity of the aging process. Such markers may be able to predict one’s risk for developing a variety of age-related conditions and diseases and are recognized to have potential applications for advancing precision healthcare for older adults. This presentation will review the development of promising biomarkers of human aging and will provide examples of how markers are being tested and applied in a range of clinical studies. As approaches for promoting healthy longevity are being developed and evaluated, biomarkers of human aging may serve as important study outcomes. Modifiable biomarkers of human aging may reflect effects on healthspan and longevity, which would otherwise take many decades to monitor. Finally, this presentation will review national and international cooperative efforts to evaluate and compare biomarkers of human aging, Such efforts are also applying biomarker development approaches to complementary topics, such as the assessment of human resilience.
THE CONTRIBUTION OF THE MICROBIOME TO THE AGING PROCESS
Authors: Valenzano Dario Riccardo 
Published: January 2025

Abstract
The human microbiome, a complex ecosystem of microorganisms residing in our bodies, is emerging as a critical contributor to our overall health and the aging process. With a total number of genes that vastly outnumbers our own—approximately 100 to 1—the microbiome influences virtually all biological processes, from nutrient absorption and immune system development to protection against pathogens. This diverse and dynamic community, acting as a polypharmacy, produces a plethora of compounds that affect our metabolism and are linked to various health outcomes. Recent findings have highlighted that numerous diseases, including metabolic disorders, immune-related conditions, and even neurodegenerative diseases are associated with the disruptions of the microbiome-host balance. Given its extensive involvement in health and disease, the microbiome has become highly relevant in aging research. Scientists are now investigating how changes in the microbiome composition throughout our lives can lead to new anti-aging interventions. One of the most promising areas of research is microbiome transplantations, which offer a novel strategy to potentially slow down or reverse aspects of the aging process by modifying our internal microbial landscape. Moreover, the discovery that rapamycin, a powerful anti-aging drug, originates from microbes underscores the microbiome’s potential as a treasure trove for developing new anti-aging compounds. By understanding and harnessing our microbiome, we stand on the brink of revolutionizing anti-aging strategies, transforming our approach to disease prevention in our later years. This rapidly expanding research field promises to unlock new possibilities for enhancing longevity and improving the quality of life as we age.
GENERATIVE AI IN GERONTOLOGY: CENTERING STAKEHOLDERS’ VOICES
Authors: Demiris George , Thompson Hilaire 
Published: January 2025

Abstract
The rise of Generative Artificial Intelligence (AI) tools such as Large Language Models (e.g., ChatGPT) has highlighted many potential application areas in gerontology, ranging from tools to support clinical decision support, facilitate communication, provide supportive services to older adults and family members and even address issues of social isolation and loneliness. Often technological solutions are developed without early and ongoing feedback by end users and other stakeholders. This symposium includes the presentation of distinct studies that examine the use of Generative AI for various gerontological areas based on experiences of the NIA funded Artificial Intelligence and Technology Collaboratories for Aging and other initiatives, and highlights ways to engage stakeholders in all design and implementation phases in order to facilitate co-creation of meaningful generative AI solutions. We provide a comprehensive discussion of both opportunities and challenges associated with the growth of Generative AI in gerontology and discuss clinical, ethical and practical implications. Additionally, we present ways to integrate Generative AI into traditional research and clinical practice in way that supplements rather than replaces traditional care, and minimizes the risk of bias.
STAKEHOLDER ENGAGEMENT FOR THE DESIGN OF GENERATIVE AI TOOLS: INCLUSIVE DESIGN APPROACHES
Authors: Demiris George 
Published: January 2025

Abstract
We present an approach to active and ongoing stakeholder engagement throughout the design lifecycle of generative AI applications. We highlight case studies from the Penn Artificial Intelligence and Technology Collaboratory for Healthy Aging (PennnAITech) of active involvement of older adults, family members, clinicians and social services coordinators as stakeholders in the early phases of design and prototype testing and demonstrate how this participatory approach can address not only usability challenges, but maximize the accessibility and relevance of Generative AI for older adult users. One example includes an NSF funded study using Large Language Model (LLM) tools to address social isolation and loneliness for community dwelling older adults living alone. In this project, older adults were invited to serve as co-designers of the LLM blueprint, its functionalities and purposes. Discussions around transparency and disclosure informed the implementation approach. The second example explores the use of Generative AI for a fall prevention program that captures fall risk scores using depth sensing. This project targets community dwelling older adults with mild cognitive impairment who live in low resource settings. The use of Generative AI is meant to make the fall risk information more accessible and actionable for older adults and their families. Co-design sessions provided system specifications for a chatbot that serves as a fall risk coach. As Generative AI applications continue to expand, assuring that we center older adults’ voices as part of an inclusive design effort will become critical for these systems to be accessible and relevant for their end users.
TIMELY PERSPECTIVES FROM DIVERSE STAKEHOLDERS ON GENERATIVE AI
Authors: Cudjoe Thomas , Schoenborn Nancy , Ashida Sato 
Published: January 2025

Abstract
A core mission of the Johns Hopkins Artificial Intelligence (AI) and Technology Collaboratory for Aging Research is to engage diverse stakeholders. To better understand the perspectives of stakeholders on research priorities and decision-making considerations regarding the development and adoption of AI, we conducted in-depth interviews with stakeholders recruited nationally. We interviewed a total of 49 participants, including older adults/caregivers (n=15) and clinicians (n=15) from urban and rural areas to understand user perspectives. We also interviewed entrepreneurs (n=6), investors (n=5), and payers (n=8)to gain a broader understanding of how generative AI may be integrated into current health service systems. Themes included: 1) Shared and distinct priorities among the stakeholders; most frequently identified priority areas that AI can help address included facilitating social engagement, coordination of care, supporting independence, and treating or preventing common geriatric syndromes like dementia and falls. Older adults and caregivers focused on daily function and caregiving; clinicians focused on monitoring and adherence; health system leaders and payers focused on access, staff burnout, and satisfaction. 2) Participants envisioned multiple roles for AI, including taking over burdensome tasks, making existing tasks more efficient, addressing unmet needs, and performing tasks beyond what is humanly possible. 3) Although perceived benefits outweighed concerns, there were concerns including unintended consequences and suggestions for guardrails. 4) Decisions about AI adoption focused on ease of use, implementation, and cost. Our findings highlight important priorities and considerations from stakeholders for the use of generative AI and opportunities for future research and development.
HEALTH CARE RESEARCH AND PROVISION AMONG OLDER ADULT GROUPS HISTORICALLY UNDERREPRESENTED IN RESEARCH
Authors: Ratnayake Aneeka , Brennan-Ing Mark 
Published: January 2025

Abstract
In this symposium we will discuss research focusing on minority populations who are often under-represented in research. We will focus on research among three groups broadly: racial and ethnic minority groups, sexual and gender minority groups, and patients in low- and middle-income countries. Our first presentation will discuss enrollment of racial and ethnic minority groups in the All of Us Research Program—a program aimed at oversampling those under-represented in research in the United States. The generalizability of those living with HIV captured in the All of Us database will be ascertained as compared to the overall population living with HIV in the United States. The second presentation will discuss whether issues of potentially inappropriate medication prescriptions are different for sexual and gender minority older adults compared to cisgender heterosexual older adults. In this presentation, disparities in potentially inappropriate medication prescriptions among this population will be highlighted. The final presentation will discuss correlates of physical activity among older adults with and without HIV in Uganda. In this presentation the contextual differences for studying physical activity among older adults in the Global South will be discussed. Together, these presentations highlight the need to consider vulnerabilities of populations under-represented in research and especially in older adults. Though specific emphasis will be placed on three under-represented groups, the overarching goal of this symposium is to emphasize the impact of prioritizing representation, intersectionality, and identity when conducting gerontological research and providing healthcare to older adults. HIV, AIDS and Older Adults Interest Group Sponsored Symposium