bluuebunny/crossref_metadata_2025_split huggingface dataset:
PSYCHIATRIC DISORDERS IN EARLY-ONSET VS. LATE-ONSET DEMENTIA: AN ANALYSIS OF THE ALL OF US RESEARCH PROGRAM
Authors: Qi Xiang , Vranceanu Ana-Maria , Wu Bei 
Published: January 2025

Abstract
Early-onset dementia (EOD), defined as being diagnosed with dementia before age 65, affects approximately 200,000 Americans. While EOD is characterized by an earlier and more severe onset, late-onset dementia (LOD) patients have longer exposure to potential risk factors for psychiatric disorders. This study investigates the relationship between EOD and psychiatric disorders, comparing it to LOD and individuals without dementia. We conducted a retrospective cohort study using electronic health records of 286,826 participants from the NIH All of Us Research Program. This diverse cohort included 59.7% women (mean age 52.3). Using multivariable logistic regression models, we found that compared to LOD, individuals with EOD showed increased risks of depression (OR 1.47, 95% CI 1.23-1.76), anxiety (OR 1.47, 95% CI 1.23-1.75), bipolar disorder (OR 2.63, 95% CI 2.04-3.38), schizophrenia (OR 2.76, 95% CI 1.96-3.88), and substance use and addiction (OR 1.86, 95% CI 1.96-3.88). The differences were more pronounced when comparing EOD to the no dementia group, with notably higher odds for depression (OR 4.82, 95% CI 4.37-5.33), anxiety (OR 3.79, 95% CI 3.30-4.36), bipolar disorder (OR 3.42, 95% CI 2.90-4.03), schizophrenia (OR 3.48, 95% CI 3.03-4.00), and substance use and addiction (OR 2.92, 95% CI 2.64-3.22). These findings persisted after controlling for sociodemographic characteristics, lifestyle factors, functional ability, and chronic conditions. Our results highlight the need for comprehensive mental health screening and targeted interventions for individuals with EOD. This study emphasizes the importance of early detection and specialized care for this vulnerable population, potentially informing healthcare policies and improving patient outcomes.
SOCIAL NETWORK BRIDGING AND COGNITIVE RESERVE IN SPECIFIC DOMAINS: BENCHMARKING TO EDUCATIONAL ATTAINMENT
Authors: Sun Haosen , Perry Brea 
Published: January 2025

Abstract
Cognitive reserve helps delay and slow cognitive decline despite neuropathology, with diverse social networks that have rich bridging potential enhancing this reserve. However, the benefits to different cognitive domains from such networks and the relative impact compared to other known resiliency factors are unclear. This study aims to identify which domain-specific cognitive reserve benefits most from social networks with higher bridging capital, with a comparison with education. Data from 217 participants in the Social Networks in Alzheimer’s Disease (SNAD) project were analyzed. Cognitive reserve was assessed using the residual approach, comparing cognitive domain performance against brain structure metrics from MRI. Social network bridging capital was measured through network characteristics such as structural holes, diversity, weak ties, and network size. Linear regressions examined the association between bridging capital and cognitive reserve across cognitive domains, comparing the effect size to educational attainment. Network bridging capital was significantly associated with general cognitive reserve and cognitive domains such as executive function, visuospatial skills, language, and episodic memory. The impact of bridging capital was comparable to or greater than that of educational attainment in these domains. However, it did not significantly enhance cognitive reserve in attention and processing speed, where education had a stronger influence. Overall, social networks with high bridging potential are particularly beneficial for enhancing cognitive reserve in certain domains. Interventions aimed at slowing cognitive decline in these areas could leverage diverse networks, especially early in disease trajectories, constituting a late-life modifiable protective factor.
WORK TOLL: AN INTERSECTIONAL ANALYSIS ON ABSENTEEISM AND PRESENTEEISM AMONG FAMILY CAREGIVERS FOR PLWD
Authors: Milnamow Mary 
Published: January 2025

Abstract
Working family caregivers for PLwD experience higher rates of work productivity loss—absenteeism and presenteeism—compared to their non-caregiving counterparts. Accessible workplace supports remain out of reach for many caregivers making them vulnerable for compensation loss. Only recently has an intersectionality approach been used in quantitative research to address persistent inequalities across disciplines. This cross-sectional study examined 1) relationship between caregivers’ intersecting social identities and access to flexible hours; and 2) extent caregivers’ intersecting social identities impact experiences of absenteeism and presenteeism. Dyads (n=891) from 2017 wave of National Health and Aging Trends Study (NHATS) and National Survey of Caregivers (NSOC) were analyzed using the validated WPAI-CG measure. Mixed-effect logistic regression models and generalized linear models were conducted. Findings suggest caregivers with one full-time job were less likely to have flexible hours compared to caregivers with part-time or multiple jobs (p&lt;.05). Black female caregivers were more likely to have flexible hours compared to Black male caregivers (OR=9.3, p=.024), but the opposite relationship was found for White caregivers (OR=0.19, p=.002). Caregivers who were female, post-HS education, with flexible hours, and multiple health conditions had greater presenteeism (p&lt;.05). Caring for someone with dementia was associated with greater presenteeism (p&lt;.05). Caregiving situations vary drastically. Flexible hours are popular but may not adequately address work productivity loss; furthermore, findings suggest disparate access to them. As the number of PLwD is expected to rise over the next 25 years, policies and workplaces need to consider inclusive solutions to meet the needs of working family caregivers.
CMS AND ASTP: FEDERAL PARTNERSHIPS FORGED TO SUPPORT THE DEVELOPMENT OF INTEROPERABLE E-CARE PLANS
Authors: Hall Elizabeth Palena , Wittie Michael 
Published: January 2025

Abstract
Across the United States, more than 25% of Americans have multiple chronic conditions that often impact quality of life, mortality, complexity of care and cost. The need for seamless interdisciplinary communication and data driven decision-making continues to grow, however, health care often remains fragmented, poorly coordinated and inefficient. A comprehensive, shared, interoperable e-care plan has the potential to improve patient outcomes, satisfaction, and quality of care by making comprehensive health data available across providers and settings when and where it is needed most. At the Federal level, the Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT (ASTP) are engaged in efforts to improve interoperable e-care plans. This session will describe the current state of e-care plans and challenges, promising practices from the field, and opportunities for advancement. This presentation will discuss how ASTP programs interact with CMS’ work to support an e-care plan environment where patients’ care plan information is securely and readily available to support patient outcomes. The session will include an overview of updates and proposals to ASTP’s Health IT Certification Program, a description of how the United States Core Data for Interoperability (USCDI) and USCDI+ Program can support the collection and exchange of e-care plans with the care team and patients, support quality measurement and quality reporting programs, and highlight how interested parties can engage in ongoing standards and policy development.
ENHANCING HEALTHCARE VALUE THROUGH INTEROPERABLE E-CARE PLANS: A FRAMEWORK FOR QUALITY IMPROVEMENT
Authors: Bierman Arlene , Ling Shari , Nebeker Johanthan 
Published: January 2025

Abstract
Patient-centered data is critical for providing high-value care and assessing quality including functional and cognitive status, goals, and outcomes that matter most to people; these are often missing in Electronic Health Records (EHRs). Furthermore, lack of interoperability makes it challenging to share and aggregate data across clinicians and care settings, leading to fragmented and/or duplicative care. E-care plans (eCP) and data standards that focus on goal setting and outcome management are in development, and hold promise to support person- centered care planning across sites and settings of care. E-Care Plans support care coordination and quality improvement and inform future healthcare value-focused policies—such as those related to equitable coverage, quality improvement, measurement, payment, and innovation model planning. Interoperable eCPs could be integrated into clinical care and across the healthcare ecosystem. This integration will enhance care coordination and facilitate seamless information exchange. In this session, Federal officials from the CMS, VA, and AHRQ will explore the benefits of eCPs and discuss the work underway to support the implementation of these plans in clinical care. This presentation will also discuss efforts to develop value sets and FHIR mappings to enable bidirectional information exchange and the concurrent pilot testing of applications with patient data. E-care plans have the potential improve patient safety, reduce burden, support the efficient exchange of patient data such as cognitive function, physical function, and individual goals to support improving person-centered outcomes, advancing health equity, conducting economic analysis, and tailored program development.
SCAMMED BY LOVE: THE ROLE OF LONELINESS, TRUST, AND AGE IN FINANCIAL LOSSES FROM U.S. ONLINE ROMANCE SCAMS
Authors: Cole Rebecca 
Published: January 2025

Abstract
Online romance scam (ORS) victims are popularly characterized as lonely, overly trusting older adults targeted by scammers seeking gifts and money through fake romantic relationships. However, research focuses on middle-aged women, overlooking risks to older adults using social networking, online dating and Internet technologies. The present exploratory research aims to identify these risks by examining the associations among age, feelings of loneliness and trust, and ORS money loss from data collected in a nationwide online survey about U.S. ORS victimization. Male (n = 4) and female (n = 27) participants who were victimized in an ORS and lost any amount of money were identified through community partners and social media. Most participants reported their race as White (n = 17) or Black or African American (n = 10) and had a college degree (n = 22). Their average age was 52 years. The mean reported money lost to the ORS was $133,647. Pearson’s product-moment correlation was used to identify the variables’ associations, and Cohen’s D was used to determine the effect size of the relationships. The only statistically significant result identified a medium-strength relationship between age and ORS money loss r(28) =.584, p &lt;.01. This finding contributes to the limited knowledge in the U.S. of ORS by giving some foundational insight into the role of age and ORS victimization. Technology continues to be a constant in most adults’ lives, and more support is needed to create a safe online Internet experience for all adults.
“SURVIVING AGING” - LOW-INCOME OLDER ADULTS AND THEIR PERSPECTIVES ON THE MEANING OF LIFE: A QUALITATIVE ANALYSIS
Authors: David Daniel , Hadson Kim , Brody Abraham 
Published: January 2025

Abstract

Introduction
Low-income older adults often face challenging life circumstances, making it essential to explore how they derive meaning in life. This study examines the perspectives of residents in Medicaid-supported assisted living facilities on what gives their lives meaning, shedding light on their psychosocial needs and well-being.

Methods
Qualitative interviews were conducted with 60 residents across three Medicaid-supported assisted living facilities in New York City. Participants responded to the question, “What gives your life meaning?” The sample was diverse, including individuals navigating aging, illness, and limited resources. Data were analyzed using content analysis to identify common themes.

Results
Five key themes emerged: 1) Overcoming Challenges, 2) Seeking Meaningful Relationships with Family and Aides, 3) Focusing on and Accepting the Present, 4) Personal Growth and Community Contribution, and 5) Maintaining Autonomy. A subset expressed an existential view, stating, “There is no meaning.” Despite numerous challenges, most residents sought meaning late in life by focusing on strengths rather than barriers.

Discussion
The findings highlight the complexity of meaning-making in later life, particularly among low-income older adults in under-resourced settings. While challenges are significant, the ability to find meaning through relationships, personal growth, and autonomy suggests critical avenues for intervention. Existential concerns raised by some participants indicate a need to address these perspectives within psychosocial support frameworks.

Conclusion
This study offers insights into how low-income older adults in assisted living derive meaning. Emphasizing strengths over barriers underscores the importance of targeted interventions to support their psychosocial needs and enhance their quality of life.
THE HEALTH TRAJECTORY OF OLDER IMMIGRANTS IN CANADA: FINDINGS FROM THE CANADIAN LONGITUDINAL STUDY ON AGING
Authors: Li Lun , Wister Andrew , Lee Yeonjung 
Published: January 2025

Abstract
In Canada, older immigrants constitute about one-third of aging Canadians, and the population size of older immigrants is projected to keep growing. The health and wellbeing of older immigrants are critical to Canada’s healthcare and social services systems. This study intends to examine the health trajectory of older immigrants in Canada over ten years (2011 to 2021) using three waves of data from the Canadian Longitudinal Study on Aging based on Linear Mixed Models. The data analysis unit contains a total of 21,480 older adults (aged 65 years and older), including 4,248 immigrants and 17,232 Canada-born. The results indicate that older immigrants report better physical health (fewer chronic diseases and better physical capability) than Canada-born older adults but experience a greater decline in physical health over ten years. When it comes to mental health, older immigrants and Canada-born older adults report similar levels of depression and loneliness, and the change of mental health is parallel over time. In addition, older immigrants report significantly lower levels of social wellbeing (e.g., social support and social participation), and a greater decline in perceived social support and social participation. The findings from this study enrich the “healthy immigrant effect” with older immigrants’ health situation in Canada over ten years. The findings also emphasize the need to support older immigrants in Canada to maintain social wellbeing and enhance the positive impacts of social determinants of health during the aging process.
A SENIOR CENTER-BASED MULTILEVEL LIFESTYLE INTERVENTION IN OLDER ADULTS WITH TYPE 2 DIABETES
Authors: Du Yan , Song Lixin , Volpi Elena , Hazuda Helen , Yin Zenong , Finley Erin , Jaen Carlos , Mireles Josh 
Published: January 2025

Abstract
Approximately 30% of adults aged 65 and over in the U.S. have Type 2 diabetes (T2D), leading to impaired physical function and reduced quality of life. This ongoing pilot project aims to assess the feasibility and acceptability of a multilevel lifestyle intervention at a day-activity senior center, examine preliminary effects, and explore implementation strategies. The study employs a 6-month, single-arm, pre- and post- test design (3 and 6 months). In collaboration with key stakeholders, including senior center staff and individuals with T2D, we are adapting the Diabetes Prevention Program curriculum and the Look AHEAD lifestyle intervention into a multilevel lifestyle intervention, targeting individual, interpersonal, and organizational levels. Nineteen older adults (mean age=68.5±5.5, Latinos/Hispanics=94.7%, female=89.5%) were enrolled. Fourteen digital lessons, facilitated by trained community health workers, are being provided separately in English and Spanish in a group format. Semi-structured interviews with key stakeholders will be conducted at 6 months to explore study acceptability and intervention adoption, implementation and sustainability. Baseline data showed that 83.3% of participants were obese, with 42.1% meeting physical activity recommendations. Self-efficacy scores for physical activity and diabetes management were 63.4±11.9 and 54.6±21.0. The mean HbA1c, extended short physical performance battery, and quality of life was 6.5±0.8, 15.7±3.8, and 40.8±7.8, respectively. The baseline data reveal significant challenges, such as high obesity rates and low self-efficacy in physical activity and diabetes management. We are leveraging these insights to tailor the multilevel lifestyle intervention to improve diabetes management, physical function, and quality of life in older adults with T2D.
AGREEMENT OF MEDICARE PART D VS. MINIMUM DATA SET REPORTED MENTAL HEALTH DRUGS USE IN NURSING HOMES
Authors: Huan Tianwen , Intrator Orna , Simning Adam , Boockvar Kenneth , Grabowski David C , Cai Shubing 
Published: January 2025

Abstract
Researchers have often used the nursing home Minimum Data Set (MDS) data to measure the rate of medication use, but little evidence exists on the accuracy of the MDS-based medication items. We compared quarterly rates of antipsychotic, antidepressant, and hypnotic use between the MDS and Part D Event file (PDE) in 2018 among long-stay nursing home residents enrolled in Medicare Part D who were ≥ 65 years old with psychiatric disorders or dementia identified in the MDS data. We used Cohen kappa to assess agreement in the share of residents using mental health medications during the quarter and used PDE data as a reference to calculate validity parameters. A total of 34.0%/73.4% of study participants were identified using antipsychotic/antidepressant medications in MDS assessments vs 34.3%/71.3% identified in PDE records (kappa value: 0.90/0.83). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MDS data compared to PDE were 96.7%/84.5%, 92.8% /96.7%, 96.3%/91.1%, and 93.6%/94.0%. Only 3.7% of study participants identified in the MDS data, vs 32.6% PDE-based users (kappa value: 0.1), used hypnotics. By combining anxiety medications with hypnotics, the rates of MDS hypnotic or anxiety users increased to 35.0% (kappa value: 0.74). The sensitivity, specificity, PPV, and NPV were 89.5%, 85.6%, 92.8%, and 79.8%, respectively. Agreement between the MDS and PDE in antipsychotic and antidepressant use was high, suggesting that the MDS is a valid tool to measure antipsychotic and antidepressant use. Additional work is needed to understand the disagreements between MDS and PDE in hypnotic use.
DNA METHYLATION AGE ACCELERATION MEDIATES THE ASSOCIATIONS BETWEEN EARLY-LIFE CIRCUMSTANCES AND DEMENTIA RISK
Authors: Pu Fan , Lin Zhuoer , Yu Jiao , Liu Zuyun , Chen Xi 
Published: January 2025

Abstract
Dementia represents critical public health challenges and exerts an immense economic burden. While mounting evidence has linked early-life circumstances to dementia risk, prior research mainly focused on single factors, failing to capture the complex interplay of comprehensive early-life circumstances and the underlying biological pathways. This study aims to fill the gap by exploring how multidimensional early-life circumstances, spanning family education, relationships, financial status, regional context, and school experiences, contribute to dementia risk in later life. Particularly, we investigate the role of DNA methylation age acceleration (DNAmAgeAccel) as a strong mediator of the associations. Using data from 4,018 American adults aged 50 and older from the Health and Retirement Study, we assessed dementia using the Langa-Weir Classification of Cognitive Function and DNAmAgeAccel through the residuals of 11 DNAm clocks. Our multivariate regression analyses demonstrated significant associations between early-life circumstances and dementia risk. Notably, adverse family education environments, such as mother’s low educational attainment and absence of time/attention from mother, along with poor family relationships, were associated with an increased risk of dementia. In contrast, positive school experiences, like engagement in creative arts in high school, were protective. Importantly, DNAmAgeAccel showed significant mediation effects, especially in education-related factors. For instance, DNAmAgeAccel mediated 15.1% to 32.8% of the association between maternal education and dementia risk. These findings highlight the enduring impact of multidimensional early-life circumstances on late-life cognitive health and suggest DNAmAgeAccel as a key biological pathway linking early adversity to dementia risk.
EMPOWERING COLLABORATION: ENHANCING GERIATRIC CARE WITH AGE-FRIENDLY CNA TRAINING BY LTC OMBUDSMEN
Authors: Sivers-Teixeira Theresa , Thayer Erin , Chang E-Shien , Chen Stella , Cherry Debra , Tate Rachel , Olsen Bonnie 
Published: January 2025

Abstract
Long-Term Care (LTC) Certified Nursing Assistants (CNAs) who provide direct care to residents often face significant challenges in supporting daily activities and the well-being of residents with functional decline. Frequent difficult behaviors can lead to negative experiences, reducing residents’ quality of life and diminishing CNAs’ job satisfaction. LTC Ombudsmen (LTCO) assist residents with issues related to day-to-day care, health, safety, personal preferences, rights violations, poor quality of care, and elder abuse. The USC Geriatric Workforce Enhancement Program (GWEP) developed an innovative program to train LTCO to deliver the Age-Friendly (AF) Nursing Home curriculum to improve CNAs’ geriatric competencies. A four-lesson curriculum, developed collaboratively by the Los Angeles LTCO Program administered by WISE & Healthy Aging, Alzheimer’s Los Angeles, Dr. Shien Chang, and the USC GWEP team, addresses: 1) AF principles of nursing home care, 2) evidence-based strategies for managing behavior issues related to dementia, and 3) strategies for increasing culturally appropriate communication with patients and caregivers. Using a train-the-trainer model, 5 LTCOmbudsmen were trained and delivered the curriculum to 133 CNAs in eight local nursing homes. A pre-post training survey administered to CNA participants showed a statistically significant increase in confidence in applying the training topics. Focus groups with LTCO trainers revealed a positive bidirectional impact on ombudsmen and CNAs. This training model introduced AF care strategies and strengthened the shared purpose between LTCO and CNAs. The study provides a foundation for ongoing collaboration and dissemination of this scalable and sustainable model to improve care for older adult LTC residents.