bluuebunny/crossref_metadata_2025_split huggingface dataset:
TRAUMA-INFORMED CARE IN LONG-TERM CARE SETTINGS
Authors: O’Malley Kelly , Sullivan Jennifer , Mills Whitney , Driver Jane “Jenny” , Moye Jennifer 
Published: January 2025

Abstract
By older adulthood, most older adults will have been exposed to at least one potentially traumatic event. Older veterans are likely to experience three traumatic events during their lifetime, with 93% reporting exposure to at least one event. The prevalence of posttraumatic stress disorder (PTSD) among older adults is lower. Nevertheless, the long-lasting psychological effects of trauma can manifest in later life, exacerbated by the normative experiences of aging (e.g., medical illness, loss of loved ones, retirement) and encounters with medical settings. Receiving care in skilled nursing settings, may trigger traumatic memories or exacerbate PTSD of symptoms. As the population ages, more individuals will receive care in long-term care environments, leading to increased risk of worsening PTSD and re-engagement with past traumatic memories and experiences. Staff in long-term care facilities may not have skills or knowledge needed to address symptoms or reduce re-traumatization (i.e., utilize a trauma-informed care approach). Trauma-informed care is an approach that utilizes knowledge of the effects of trauma to meet survivors’ healthcare needs, through collaborative care and recognition of patient strengths in managing their health. This approach is mandated in skilled nursing facilities; however, no models of trauma-informed care practice in long-term care exist. This symposium will review the effects trauma and PTSD in later life, the effects of medical settings on PTSD, and provide a framework for implementing trauma-informed care in long-term care settings.
BRFSS DATA ON COGNITIVE DECLINE AND CAREGIVING: NATIONAL AND STATE IMPLICATIONS
Authors: Bouldin Erin 
Published: January 2025

Abstract
The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based annual telephone survey conducted in all US states and three territories. BRFSS includes two optional modules that jurisdictions can use to understand cognitive decline and family caregiving. The Cognitive Decline Module collects information on self-reported changes in memory and thinking. This module offers value in understanding prevalence, with data from the 2016-2021 BRFSS suggesting that 1 in 9 people aged 50 years and older are experiencing subjective cognitive decline nationally. The module also offers the ability to analyze risk factors and health behavior related to detection of cognitive decline. The Caregiver Module collects information on prevalence of caregiving, relationship to the care recipient, the care recipient’s health condition, the duration and intensity of care, and caregiving tasks. Data from the 2016-2021 BRFSS show that 1 in 4 caregivers aged 50 years and older in the United States are caregivers for someone with dementia. This module offers value in understanding of caregiver health and health behaviors across a variety of demographics. This session will highlight recent publications and resources, including the Centers for Disease Control and Prevention’s publicly available Healthy Aging Data Portal from which these and other data can be analyzed and visualized. Data from these modules has also been used in innovative studies exploring risk factors for cognitive decline, cognitive changes among caregivers, and other findings. The session will demonstrate ways these data can advance the field at the national and state levels.
ADVANCING BRAIN HEALTH THROUGH THE DATA FOR ACTION PROJECT
Authors: Fadel Meghan , Bethune Tyrone , Sands Talyah , Roberts Shelby , Bouldin Erin , Cheney Amanda 
Published: January 2025

Abstract
The Healthy Brain Initiative (HBI) Data for Action Project is a nationwide effort to support the integration of data on brain health and caregiving into public health planning efforts. Data about cognitive health, dementia, and family caregiving are increasingly available at the state level, in part due to HBI efforts to support the implementation of the Behavioral Risk Factor Surveillance System (BRFSS) optional modules on Cognitive Decline and Caregiving. This effort has increased state implementation of the Cognitive Decline Module from 5 states in 2009 to 49 states and territories in 2019-2020. Similarly, the Caregiver Module implementation grew from 4 states in 2009 to 49 states and territories in the years 2021-2022. The Alzheimer’s Association, alongside partners at the Association for State and Territorial Health Officials (ASTHO), developed the Data for Action Project in 2023 to support state health departments as they use public health data to advance brain health in their communities. In its first year, 4 states participated in the Data for Action pilot by conducting data analyses, producing dissemination tools of the findings, and creating a strategic plan to share the results. States participated in regular cohort calls, provided one another feedback, received individualized technical assistance, and had opportunities to connect through an asynchronous platform. The Data for Action Project created a community of practice with education, peer support and technical assistance for participating health departments.
ARE SOCIAL VULNERABILITY INDEX AND COGNITIVE DECLINE RELATED?
Authors: Sutphin Brandy , Adolph Sharada Sarah , Simon Bala 
Published: January 2025

Abstract
Alzheimer’s disease and related dementias (ADRD) prevalence is demonstrably increasing as more people live to advanced age. ADRD was Arkansas’s 7th leading cause of death in 2021 and an estimated 67,000 Arkansans will be living with ADRD by 2025. While known ADRD risk factors hypertension, obesity, smoking, heavy metal exposure, and familial inheritance are well studied, there is minimal research examining the influence of social vulnerability on ADRD patients. We sought to study population-level associations between the Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry (ATSDR) Social Vulnerability Index (SVI) and cognitive decline, the earliest symptom of ADRD, to identify high-risk areas for interventions. An ecological study design at county-level was utilized. CDC/ATSDR SVI scores &lt;0.5 indicate low-to-medium risk and scores ≥0.5 indicate medium-high-to-high risk of social vulnerability. Associations were tested between SVI composite and four component themed indices as predictor variables and Behavioral Risk Factor Surveillance System (BRFSS) cognitive decline prevalence as the outcome variable. Arkansas has 26 high-risk counties out of 75 (34.7%) with combined SVI ≥0.5 and high cognitive decline prevalence (µ ≥12.1%). Regression showed unit increases in SVI ≥0.5 resulted in significant increases in cognitive decline prevalence for composite SVI (β=7.67, p=0.0185), and corresponding component SVIs socioeconomic status (β=6.75, p=0.0494), household characteristics (β=9.28, p=0.0032), and racial and ethnic minority status (β=8.98, p=0.0458). Significant ecological associations indicate potential reciprocal influences between SVI and cognitive decline and the need for targeted interventions in high-risk counties.
GROWING STATE ACTION THROUGH A COMMUNITY OF PRACTICE
Authors: Cheney Amanda , Shean John , Bouldin Erin , Fadel Meghan 
Published: January 2025

Abstract
Building a community of practice is a key feature of the Data for Action Project. Working alongside a cohort of peers from other states, teams conduct data analysis related to brain health, dementia, and/or caregiving to produce tools for strategic dissemination of resulting data. Arkansas, Connecticut, Illinois, and New Jersey all participated in, and made important contributions to, the pilot cohort. State projects included analysis and dissemination of data on risk factors, dementia service use, and family caregivers. In several states, teams produced estimates among specific sub-populations or regions in the states to identify at-risk populations. Participating state teams also identified ways the data would most help their efforts, including public health planning, budgeting decisions, and public awareness and information efforts. Having data analysts and representatives from the offices in which data were housed (e.g., BRFSS coordinator) were critical to success, as was including diverse perspectives (e.g., aging, disability, and chronic disease) in developing public-facing products and strategies for dissemination, encouraging collaboration, and maintaining future sustainability of the project. Participants in the program reported increased knowledge of the BRFSS optional modules and of the use of data for health improvement planning. 85% of participants agreed that the program positively impacted their health department’s ability to collaborate on integrating brain health and caregiving into public health planning efforts. The second Data for Action cohort launched in 2024, with ongoing efforts to advance brain health in new states.
USING FRAILTY SCREENING TO INFORM PREOPERATIVE MANAGEMENT OF HIGH-RISK SURGICAL PATIENTS
Authors: Ko Fred , Ritchey Katherine 
Published: January 2025

Abstract
Frailty is a clinical syndrome of age-related decline in physiologic reserve and increased vulnerability to stressors. Frail older adults undergoing surgery are at higher risks for postoperative complications and mortality and increased health care costs. Thus, frailty has emerged as a robust predictor of poor surgical outcomes in vulnerable older patients. There have been immense interest and research for bench-to-bedside translation and integration of preoperative frailty screening into clinical practice. These efforts have centered on the development of preoperative frailty screening as a surgical risk-stratification tool and its application to guide preoperative management aimed to mitigate surgical risk in older adults. The Veterans Health Administration (VHA) has been recognized for its Surgical Pause initiative in which: (1) routine frailty screening is ascertained in surgical patients using the Risk Analysis Index (RAI) in order to identify those at the highest risk of postoperative complications, loss of independence, and mortality; and (2) multidisciplinary care strategies are implemented to reduce frailty-associated risks to enable reduction of potential complications before surgery in those identified as frail. In this symposium, we will provide a state-of-the-art look at the VHA experiences in: (1) validation of RAI as a preoperative risk-stratification tool in older adults; (2) implementation and integration of RAI screening in clinical practice; and (3) evaluation of RAI screening and multidisciplinary optimization board prior to surgery.
THE PAUSE TRIAL: LESSONS ABOUT SURGICAL PAUSE FROM AN RCT
Authors: Arya Shipra 
Published: January 2025

Abstract
Effective clinical care pathways that integrate preoperative frailty assessment and management to optimize high-risk older adults undergoing surgery are urgently needed to improve their outcomes. We designed a hybrid1 effectiveness implementation step-wedge cluster randomized trial called the Patient-Centered mUltidiSciplinary care for vEterans undergoing surgery (PAUSE) to test frailty screening and referral to a multidisciplinary member board to guide optimization of surgical patients prior to surgery. The PAUSE trial includes Veterans scheduled for elective surgery at 3 tertiary care VAMCs (Palo Alto, Houston, Nashville) and 7 specialties in each center (general, vascular, orthopedics, cardiothoracic, urology, neurosurgery and plastics/ENT). The intervention is referral to a “multidisciplinary PAUSE board” (e.g., surgery, anesthesia, geriatrics, palliative care, case management, rehabilitation and nutrition) for recommendations after frailty screening. Each ‘step’ was a randomly chosen specialty group transitioning from usual care to the PAUSE intervention. The Consolidated Framework for Implementation Research was used to guide mixed methods formative evaluation and analysis of factors that influence implementation. Key stakeholders identified champions, potential barriers and facilitators, possible intervention adaptations, and indicated limited time, staff shortage, and the concern that the PAUSE board may delay surgery as main barriers to implementation. Nurses were identified as partners in intervention execution. Surgical and nursing leadership engagement was indicated as crucial to adopting this new healthcare model. In conclusion, formative evaluation delivers timely and actionable findings to inform the intervention and identify implementation modifications to optimize opportunities for success. Multistakeholder involvement and accounting for clusters and sites variations is important for successful implementation.
SOCIAL DISCONNECTEDNESS, PERCEIVED LONELINESS, AND COGNITIVE FUNCTIONING: THE ROLE OF NEIGHBORHOOD ENVIRONMENT
Authors: Tang Fengyan , Jiang Yanping 
Published: January 2025

Abstract
Social disconnectedness and loneliness pose significant challenges for older Chinese immigrants. This study aimed to investigate the association of social disconnectedness and loneliness with cognitive functioning and examine the moderation role of neighborhood contexts. This longitudinal analysis examined a sample of individuals aged 60 years and older from the Population Study of Chinese Elderly in Chicago (N=2,044). Global cognition was assessed using the averaged z-scores of cognitive performance tests. Social disconnectedness was constructed using five indicators about structural aspects of social relationships. Loneliness was assessed with the R-UCLA loneliness scale. Neighborhood socioeconomic status (NSES) and neighborhood segregation index (NSI) were constructed using 2010-2014 American Community Survey data at the census tract level. Individual perceptions about neighborhood environments were used to construct neighborhood cohesion index (NCI) and neighborhood disorder index (NDI). Latent growth curve models showed that more loneliness was associated with a higher level of initial cognitive functioning (B= 0.030, p&lt;.01), but also with a faster decline rate over time (B= -0.007, p&lt;.01) after adjusting for covariates. High NSES and less neighborhood segregation buffered the negative effects of loneliness on cognitive decline, respectively. High NDI amplified the positive relationship between loneliness and initial functioning, but accelerated the rate of cognitive decline associated with loneliness. The study revealed that perceived loneliness, but not social disconnectedness, is a risk factor for cognitive decline among older Chinese immigrants. Living in a neighborhood with low socioeconomic status, more segregation, and high disorder elevated the detrimental effect of loneliness on long-term cognitive decline.
FAMILY TYPOLOGY AND MENTAL HEALTH IN OLDER KOREAN AMERICANS
Authors: Jang Yuri , Park Nan Sook , Park Juyoung , Chiriboga David 
Published: January 2025

Abstract
Challenging the notion that older adults of Asian origin are universally well protected by family support systems, we examined the heterogeneity of family types, considering both structural and qualitative aspects and addressing both positive and negative functions. The aims of the study were (1) to identify types of family relationships and (2) to examine their impact on mental health. Data came from 2,070 participants in the Study of Older Korean Americans (SOKA), a multi-state survey of Korean immigrants aged 60 and older (Mean Age = 73.3). To identify family types, latent profile analysis (LPA) was performed with marital status, living arrangement, family network, positive and negative interactions with family members, and family mistreatment. Linear regression models examined how mental distress was associated with family typology. LPA identified five family types: close-knit, intimate but distant, detached, connected but dysfunctional, and dysfunctional. Greater distress was associated with belonging to the detached, connected but dysfunctional, and dysfunctional family types in comparison to the close-knit type. Findings not only confirmed the value of a close-knit family but also demonstrated the heterogeneity of family typology. For example, the connected but dysfunctional group is uniquely characterized by those who are structurally embedded in a family system with marriage, co-residence, and contacts but had experienced negative interactions and even mistreatment within the family. This group demonstrates that obligated family ties in the absence of emotional bonding could be harmful. Our findings called renewed attention to older immigrants’ family relationships and their mental health implications.
SOCIAL ISOLATION AND DEPRESSIVE SYMPTOMS OF OLDER CHINESE AMERICANS: THE MEDIATION EFFECT OF ACTIVITY ENGAGEMENT
Authors: Li Ke , Tang Fengyan , Kwon Soonhyung , Jiang Yanping 
Published: January 2025

Abstract
Older Chinese Americans are particularly vulnerable to social isolation and its negative consequences on mental health. However, little is known about the intermediate processes through which social isolation contributes to depressive symptoms among this population. The aims of the study were (1) to examine the differential impacts of two forms of social isolation (social disconnectedness and perceived isolation) on depressive symptoms and (2) to investigate the mediating role of activity engagement. Data came from 2,075 participants in four waves of the Population Study of Chinese Elderly in Chicago Study (PINE). Social disconnectedness was measured by social network size and range, living arrangement, and marital status. Perceived isolation was measured by the perception of loneliness and lack of social support. Activity engagement was assessed by engagement with various social and cognitive activities. Results from the latent growth curve models indicated that social disconnectedness and perceived isolation were positively associated with the initial level of depressive symptoms. However, perceived isolation predicted a faster decline in depressive symptoms. The findings suggested the significant mediating effect of activity engagement. Social disconnectedness was associated with greater activity engagement, which in turn was associated with a lower initial level of depressive symptoms. Perceived isolation was associated with lower activity engagement, subsequently resulting in a higher initial level of depressive symptoms and a faster decline of depressive symptoms across waves. Intervention targeting depression among older Chinese Americans should make efforts on providing more opportunities for culturally sensitive activity engagement and social interaction and promoting social support system.
A COMPARISON OF DIRECT AND INDIRECT STUDENT CAREGIVERS ON OUTLOOKS RELATED TO CAREGIVING AND SELF
Authors: Graf Allyson , Baker Shelby , Bartlett Robin 
Published: January 2025

Abstract
Studies have recently demonstrated the impact of caregiving on college students. Caregiving, however, is transitional and dynamic and this complexity is rarely represented. The current study sought to compare caregiving experiences (direct-current, direct-former, and indirect care support) on the perceived impact on views of caregiving, relationships, well-being, and aging. Among the sample of 230 students (78.7% undergraduates) with caregiving experience, 28.3% were current caregivers, 53.5% were former caregivers, and 78.6% provided indirect care support. Compared to those with indirect experience, those with direct experience more strongly agree that caregiving impacted their views of caregiving (p &lt;.001) and their relationship with care recipient (p &lt;.001). There was no difference between current and former caregivers. Participants were also asked about perceived positive and negative influences independently. Results were similar for positive influences with direct caregivers perceiving a more positive influence on their relationship with the care recipient than indirect caregivers (p =.001) but only current caregivers differed significantly from indirect caregivers in the positive influence on views of caregiving (p =.023). Trends did not hold for perceived negative influence; however, there was a significant difference between current and former caregivers on the negative influence on health (p =.042) such that current caregivers indicated a greater negative influence. These results indicate the importance of investigating diverse caregiving experiences among students and differentiating positive and negative influences with implications for how universities may support the different life circumstances of student caregivers.
SUPPORTING AGING IN PLACE THROUGH NEW MOBILITY SOLUTIONS
Authors: Hatami Fatemeh , Siren Anu , O’Hern Steve 
Published: January 2025

Abstract
Aging in place is among the most widespread contemporary policy concepts. However, an important prerequisite for aging in place is the possibility to attend out-of-home activities, which requires satisfactory mobility options. Previous research has indicated that new transportation solutions and technologies may hold promise for older people’s mobility needs. To investigate these promising opportunities and how they may support aging in place, a critical literature review was conducted. Using Web of Science, Scopus, and PubMed as electronic journal databases, we searched keywords representing the user group (older adults), the solution (transport systems), and its qualities (novel), limiting the search to publications between 1990-2023. The search was complemented by hand-searching of reference lists and selected project homepages. The initial search yielded more than 3000 publications. After screening for title, abstract and contents, around 110 publications were included for review. To create a conceptual model, we synthetized major findings, and identified common themes, trends, and disparities in the existing literature. We analyzed whether proposed solutions are evidence based and whether the literature focuses on implementation processes. We also analyzed which mobility needs the solutions are explicitly targeting, and which groups of older adults are thought to be the main users of these solutions. Our conclusion is that while literature addresses many novel solutions that have potential for supporting older adults’ mobility, there are significant knowledge gaps related to assessing the feasibility of these solutions.
FACTORS RELATED TO THE LIKELIHOOD OF AN ELECTRIC VEHICLE PURCHASE AMONG OLDER US ADULTS
Authors: Vivoda Jonathon , Louis Renée St 
Published: January 2025

Abstract
Widespread acceptance of electric vehicles (EVs) is important to meet global energy and pollution goals. Previous studies established that older adults are less likely than younger people to consider purchasing an EV, and common barriers to EV uptake among this group have been identified, but little else is known. The current study used two waves of data from the Pew Research Center’s American Trends Panel (April, 2021 and May, 2022), which contained EV-related questions. Only older adults who responded to both waves were included (n=2,016). Two ordinal logistic regression models were utilized to identify factors related to older adults’ likelihood of purchasing an EV (measured on a four-point scale), and to a change in likelihood between waves. Odds of higher likelihood of a future EV purchase were related to more education; Asian and Hispanic race (vs White); more liberal political ideology; stating that scientists understand causes of global climate change well; favoring the phase-out of gasoline vehicles; as well as stating that EVs are more fun to drive, more reliable, or better for the environment. Stating that EVs cost more was related to a lower likelihood, as were the reverse of the EV factors above. Only three factors were related to a change between waves in likelihood of purchasing an EV. Higher odds were related to identifying as a Democrat (vs Republican), high income, and having heard ‘a little’ about EVs vs ‘a lot.’ Findings, implications, and future research suggestions will also be discussed.