bluuebunny/crossref_metadata_2025_split huggingface dataset:
HOW DO PRIMARY CARE PHYSICIANS NAVIGATE MEDICAL CANNABIS DISCUSSIONS WITH OLDER ADULT PATIENTS
Authors: Nguyen Annie , O’Malley Pearse , Osae-Oppong Edward , Foo Jamie , Abu-Baker Dania , Tibirica Lize , Diaz Joseph , Moore Alison 
Published: January 2025

Abstract
We interviewed 20 physicians who provide primary care in California and have patients ages 65+ in their practice. Interviews lasted 30 minutes and followed a semi-structured guide. The majority of physicians said that older patients were most likely to use cannabis for pain and sleep issues while younger patients used it for mental health-related conditions. Older patients often seek physicians’ advice about doses, forms, and efficacy, but most physicians were unsure on how to advise patients, with many defaulting to the strategy of starting with low doses and titrating up if needed; inhalation was universally discouraged. Many physicians were unsure about the strength of evidence, because while the evidence for sleep and pain appear to be supportive, there are not enough studies and large-scale clinical trials to develop a strong opinion. All agreed that physicians would benefit from training to increase confidence and be informed when discussing cannabis with patients.
ACUTE EFFECTS OF EDIBLE CANNABIS FOR OLDER ADULTS: THE GOOD, THE BAD, AND THE NEUTRAL
Authors: Bryan Angela , Skrzynski Carillon , Stanger Madeline , Giordano Gregory , Lervick Dana , Broyhill Tatum , Tracy Brian 
Published: January 2025

Abstract
Many older adults use cannabis to alleviate pain, increase sleep quality, and mitigate symptoms of anxiety and/or depression. Yet few studies assess co-occurring effects of cannabis use that may be more salient to older adults. We recruited 234 participants (average age 70.46 (sd=5.83) who either did (n=175) or did not (n=59) want to use edible cannabis for pain, sleep disturbance or negative affect. We compared acute effects on balance, mood, and memory before and after consumption of edible cannabis products differing in cannabinoid ratio (CBD dominant, THC dominant, CBD+THC). Among older adults who used cannabis, we observed balance impairment from pre to 60-minutes post use (p&lt;.01). Those who used cannabis experienced improvement in pain from pre to 60-minutes post use (p=.001) and higher concentrations of THC in blood (measured at time of use) were associated with greater decreases in pain (p&lt;.05). Older adults who used cannabis also experienced increases in subjective intoxication (p&lt;.001); higher THC in blood was associated with greater intoxication (p&lt;.001) while higher CBD in blood was associated with lower intoxication (p&lt;.05). There were few significant differences between those who did versus did not use cannabis on memory and cognitive tasks. We add to the growing literature examining cannabis use among older persons and identify significant outcomes experienced by those who use edible cannabis products. Disseminating this work among clinicians may facilitate more informed conversations with older persons who may consider cannabis as a therapeutic alternative.
CANNABIS USE AMONG INFORMAL CAREGIVERS OVER 50: FINDINGS FROM THE CALIFORNIA HEALTH INTERVIEW SURVEY
Authors: Martinos Fadi , Bhagianadh Divya 
Published: January 2025

Abstract
Despite the availability of evidence-based therapeutics and supports, informal primary care partners of older adults are using cannabis as an unproven, potentially harmful, alternative for reducing physical burden and psychological distress. Using the 2019 California Health Interview Survey, we identified 2,278 respondents over 50 years old who indicated providing care to someone also over 50 in the past year. We determined 23.0% of these survey respondents between 50 to 64 years and 18.0% of those over 65 years older used cannabis in the past year, and older caregivers were more likely to use cannabis than non-caregivers. Cannabis use among older caregivers was associated with smoking and self-reported feelings of depression (AOR 1.76) and/or nervousness (AOR 2.06). Cannabis use among older caregivers was not associated with the burden of caregiving or the condition of the care recipient. Caregivers who use cannabis were more likely to experience a delay in accessing health care services relative to caregivers who do not use (AOR1.54).However, they were no more or less likely to use emergency department or outpatient medical care. These findings illuminate how cannabis is being used as a understudied form of self-care among informal care partners.
WE GOT THE MOVES LIKE JAGGER: REFLECTIONS ON AGING RESEARCH, EDUCATION, AND COMMUNITY
Authors: Montepare Joann 
Published: January 2025

Abstract
Over the last 50 years, tremendous advances have been made in our understanding of aging and its many components through lifespan developmental research. As well, educators in the field of aging have designed creative and impactful strategies for teaching about aging and dismantling ageist thinking. Together, scholars and educators have made age matter in meaningful ways in our contemporary world. This presentation uses examples from my professional experiences to reflect on several key aspects of aging research and education – and how community connections are necessary to sustain this work, with special attention to the need to advance age inclusivity in higher education.
HIGH-FIVE! – DISCOVERING THE POWER OF MENTORSHIP
Authors: Bradley Dana 
Published: January 2025

Abstract
There is an art and a science to mentorship that transforms lives – for the mentor and the mentee. Often, this mystique of mentoring can be intimidating, creating a misperception of one’s abilities to serve as a mentor. While every mentoring opportunity is unique, generally accepted principles have been delineated in the rich mentorship literature that undergirds a productive and positive mentorship experience. In this view, mentoring is a hidden superpower that lies within each person, waiting to be discovered, shared – and celebrated. Reflecting on my career, I will share five observations from the mentor-mentee relationships that have shaped my life – and, in gratitude, give a virtual “high-five” across the room – and miles – to colleagues who have joined me on this journey.
LONG-TERM EXPOSURE TO OUTDOOR LIGHT AT NIGHT, AIR POLLUTION, AND DEPRESSIVE SYMPTOMS AMONG OLDER PEOPLE IN ENGLAND
Authors: So Rina , Gessa Giorgio Di , Scholes Shaun , Kim Su-Hwan , Park Yujin , Lee Jinkook , Adar Sara , Zaninotto Paola 
Published: January 2025

Abstract
Air pollution and light at night (LAN) are environmental stressors that may lead to depression, but the epidemiological evidence is inconsistent and scarce, especially for LAN. We used data from 8,583 participants (25,151 observations), aged ≥ 50 years, of the English Longitudinal Study of Ageing from waves 6-9 (2012-2019). Annual levels of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and LAN were assessed at participants’ residential addresses for each interview year. Having depressive symptoms was defined as reporting ≥3 items of the 8-item Center for Epidemiologic Studies Depression Scale. We used mixed effects generalized linear models (binomial distribution) to examine associations of air pollutants and LAN (in quartiles) with depressive symptoms, adjusting first for age and sex and then adding control for individual lifestyle and socio-demographic factors, and area-level deprivation index. In models minimally-adjusted, increased odds of having depressive symptoms were observed for PM2.5, NO2, and LAN with odds ratio (OR) (95% confidence interval) of 1.15 (1.05, 1.25) and 1.20 (1.10, 1.32) per interquartile range of PM2.5 (2.2 µg/m3) and NO2 (4.2 ppb), respectively, and 2.47 (1.96, 3.12) in the highest quantile of LAN compared to the lowest. These associations were attenuated in fully-adjusted models to 0.97 (0.90, 1.05) for NO2 and 0.91 (0.84, 0.99) for LAN, while the association with PM2.5 remained positive [OR: 1.05 (0.97, 1.14)]. Higher residential PM2.5 levels might be associated with an increased risk of having depressive symptoms, but associations with NO2 and LAN were explained by confounding by individual- and area-level characteristics.
THE UTILITY AND POTENTIALS OF CLAIMS-BASED FRAILTY INDEX IN CLINICAL CARE AND RESEARCH: NEW DEVELOPMENTS IN 2024
Authors: Kim Dae Hyun 
Published: January 2025

Abstract
The development of a claims-based frailty index (CFI) for Medicare claims (Kim et al., Journals of Gerontology: Medical Sciences, 2018) has empowered researchers to integrate frailty into pharmacoepidemiology and health services research. This symposium aims to overview the CFI’s development and validation process and spotlight its recent applications in studies utilizing Medicare claims and electronic health records (EHR). The CFI, estimating a deficit accumulation frailty index (range: 0 to 1, with higher values indicating greater frailty) based on the previous year’s claims, demonstrates 60% sensitivity and 86% specificity for a deficit accumulation frailty index ≥0.25, and 62% sensitivity and 78% specificity for the Fried Frailty Phenotype. Additionally, a crosswalk between CFI and clinical frailty measures is available, aiding the translation of research findings into clinical practice. Featured presentations will explore the CFI’s application to EHR data, its role in assessing dementia severity, its contribution to the CMS Hierarchical Condition Category model in predicting healthcare costs, its predictive value for outcomes following post-acute care in skilled nursing facilities, and its association with opioid discontinuation rates in older adults hospitalized with fractures. These examples will highlight the benefits and challenges of using CFI in research.
CLAIMS-BASED FRAILTY INDEX AS A PREDICTOR OF POSTACUTE SKILLED NURSING FACILITY CARE OUTCOMES
Authors: Shi Sandra , Oh Gahee , Park Chan Mi , McCarthy Ellen , Kim Dae Hyun 
Published: January 2025

Abstract
How claims-based frailty index (CFI) predicts post-acute skilled nursing facility (SNF) care outcomes is unknown. We used the National Health and Aging Trends Study 2011-2017 survey data linked to Medicare claims. CFI and comprehensive geriatric assessment-based frailty index (CGA-FI) were calculated at each survey and categorized into non-frail (&lt;0.25), mild frailty (0.25-0.34), moderate frailty (0.35-0.44), and severe frailty (≥0.45). We examined the first post-acute SNF admission within 6 months after survey assessment. The primary outcome was home time in the 6 months following SNF admission defined as days not in hospital or nursing home. We estimated the effects of frailty on home time using linear regression for each frailty measure. The secondary outcome was total healthcare costs in the 6 months following SNF admission estimated using a generalized linear model with a gamma distribution and identity link. Analyses adjusted for age, sex, and income. In our sample of 643 Medicare beneficiaries (representing 2.7 Million beneficiaries nationally), increasing frailty was associated with greater home time loss and healthcare costs by both measures. The mean difference (95% CI) of home time loss for severe frailty compared with non-frailty was -39.2 [-66.8, -11.5] days by CFI and -43.2 [-60.0, -26.4] days by CGA-FI. The mean healthcare cost increase (95% CI) for severe frailty compared with non-frailty was $21,583 [$13,132, $30,033] by CFI and $11,110 [$6,236, $15,983] by CGA-FI, respectively. Pearson correlation between CFI and costs was higher than CGA-FI (0.1885 vs 0.0804). CFI up to 6 months before SNF admission predicts healthcare utilization.
OPIOID DISCONTINUATION RATES: RISK STRATIFICATION USING A CLAIMS-BASED FRAILTY INDEX (2013–2018 MEDICARE)
Authors: Pritchard Kevin , Yang Chun-Ting , Chen Qiaoxi , Zhang Yichi , Wilkins James , Kim Dae Hyun , Lin Kueiyu Joshua 
Published: January 2025

Abstract
We aimed to determine if the severity of frailty influences the duration of opioid use following an emergent pain event. This retrospective cohort study included 21,728 fee-for-service Medicare beneficiaries (2013-2018). We included opioid-naïve individuals aged ≥65 years who initiated opioids within 30 days of a hospitalized fracture. Our index date was the opioid prescription fill date. We excluded those with prior opioid use, chronic pain, or contraindications to opioids in the preceding year. Frailty severity was defined using a claims-based index. We estimated opioid discontinuation rates using Nelson-Aalen cumulative hazard functions, stratified by frailty severity. Discontinuation during the follow-up year was defined as a gap in continuous prescription refills exceeding 15 days. We used Cox proportional hazards regression to assess the association between frailty severity and the number of days until discontinuing opioids while controlling for sociodemographic factors, health status, healthcare utilization, and calendar year. Our sample was on average age 80 [SD=9] years old, 77% female, and 91% White. The 30-day discontinuation rate was 85% (95% CI, 83-87%) in the moderate/severe frail group, 84% (83%-84%) in the mildly frail group, 87% (87%-88%) in the pre-frail group, and 90% (89-91%) in the non-frail group. After multivariable adjustment, the likelihood to discontinue opioids depended on frailty status. Compared to adults without frailty, discontinuation was less likely among those who were moderately/severely frail (Hazard Ratio [HR]: 0.88, 95% CI, 0.83-0.94), mildly frail (HR: 0.87, 95% CI, 0.83-0.92), and pre-frail (HR: 0.96, 95% CI, 0.91-1.00). Greater frailty decreased the likelihood of discontinuing opioids.
USING BLACK HISTORY FOR BRAIN HEALTH: APPROACH, OUTCOMES, AND PUBLIC APPLICATIONS IN THE SHARP STUDY
Authors: Croff Raina 
Published: January 2025

Abstract
This symposium focuses on the Sharing History through Active Reminiscence and Photo-imagery (SHARP) study that centers Black history to engage older Black adults in the brain-healthy behaviors of walking, social engagement, and reminiscence within gentrifying areas of Portland and Seattle. Presentations span the study’s theoretical underpinnings to operationalizing results for public awareness of brain health. Dr. Raina Croff introduces the SHARP study, discussing the gap in brain health interventions that it seeks to fill, its culturally celebratory framework, and why such approaches matter for participant engagement. Anthony Cryer and Stephanie Johnson-Toliver discuss the collaborative process in Seattle from the community partner perspective, including recruitment challenges amidst gentrification, creating meaningful walking routes centered on local Black history, and participant feedback. Boeun Kim reports on health outcomes from the SHARP Seattle study and themes from evaluative focus groups, including barriers and motivators to engagement. Charles Fennell discusses the SHARP Caregiver Study in Portland, including adaptations to meet dementia family caregivers’ needs, and health outcomes around sleep and activity levels as captured by wearable digital biomarker technology. Taryn Gordon discusses preparing SHARP’s recorded walking narratives for a public digital oral history archive in a way that preserves participant integrity, and how SHARP concepts are operationalized in the SHARP website by integrating Black oral history from walking narratives with brain health information to educate and empower older Black adults to learn about and practice brain healthy behaviors.
HONORING OUR HEALTH AND HISTORY: FRAMING BRAIN HEALTH THROUGH A CULTURALLY CELEBRATORY LENS
Authors: Croff Raina , Fuller Patrice , Fennell Charles , Gordon Taryn 
Published: January 2025

Abstract
Asset-based, culturally celebratory frameworks center community strengths, history, culture, and community resilience. Applying such frameworks to Black American brain health engenders agency over individual and community health, and empowers older Black adults to engage in aging research. Amidst gentrification, such frameworks become especially salient. The Sharing History through Active Reminiscence and Photo-imagery (SHARP) Study uses Black history to engage older Black adults in walking social reminiscence for brain health within gentrifying neighborhoods in Portland and Seattle. Since 2016, SHARP has engaged 82 healthy and cognitively impaired walkers, including dementia family caregivers. Triads walked 1-mile routes 3x/week for 1, 4, or 6 months using the SHARP walking application on a group tablet. GPS-linked images of local Black history and culture prompted social reminiscence during walking. Walking narratives were recorded for an oral history archive. This presentation explores SHARP’s culturally celebratory framework informed by Black Lives Matter principles applied to health, Asset-Based Community Development, and Africana Worldview. We examine how centering Black history over Black health deficits, community memory over individual memory loss, and group participation over individual research participation produced high retention, re-enrollment rates, and recommendations. We apply theoretical concepts and study design to understand participant experiences, including how impromptu neighborhood encounters during walks mimicked social patterns from younger years, recalling joyful community memories despite gentrification, improved coping with change, and decreased psychological burden of exercise. Finally, we highlight challenges to the SHARP approach, including balancing a culturally celebratory framework with duly addressing the heavy burden of Alzheimer’s and gentrification.
SHARP SEATTLE: A COMMUNITY COLLABORATION TO CREATE BLACK HISTORY WALKING ROUTES AND ENGAGE WALKERS
Authors: Cryer Anthony , Johnson-Toliver Stephanie , Ferguson Dian , Towns Juell 
Published: January 2025

Abstract
The Sharing History through Active Reminiscence and Photo-Imagery (SHARP) program honors Black health and history through creating culturally celebratory walking routes. Nine community and academic partners implemented SHARP Seattle in the gentrifying Central District. Key to success was partners with established community relationships and expertise aligned with the SHARP approach, including in walking programs, archival images, local Black history, cognitive health, and the needs, concerns, and preferences of older Black adults regarding programming. Study activities were based at and coordinated by a senior center serving primarily African Americans. Student interns led informant focus groups with 10 older Black adults to gather themes and topics for inclusion in twelve 1-mile walking routes. Interns worked with an archivist on selecting local historical images to illustrate community-identified walk themes and solicit stimulating conversational reminiscence among walkers. Themed routes with images were programmed into the SHARP walking application, tested, and revised. After a kick-off celebration, thirty-one older Black adults, grouped into triads, engaged 3 times a week for 4 weeks to walk the 12 routes. In this talk, community partners discuss their experience, including learning the research process, exerting their preference for an adapted, more relaxed study design for less burden and greater inclusion of people with cognitive impairment, creating routes with different generations whose local geo-historical knowledge differed greatly, strategies for curating community buy-in, gentrification and displacement-related recruitment challenges, and learning from participant feedback. Finally, self-reflections explore the meaningfulness of walking and social reminiscence amidst aging and gentrification.
EVALUATION OF A REMINISCENCE AND PHOTO-IMAGERY WALKING PROGRAM FOR BLACK OLDER ADULTS
Authors: Kim Boeun , Kaluna Lia , Otewa Meshack , Belza Basia , Croff Raina 
Published: January 2025

Abstract
The purpose of this study was to pilot the Sharing History through Active Reminiscence and Photo-Imagery (SHARP) program which honors Black history and health through culturally celebratory walking routes in the Puget Sound area. Participants were recruited from a senior center. Thirty-one healthy and mildly cognitively impaired Black Americans completed triadic walking three times a week for 4 weeks. Participants used the SHARP walking application on a group tablet device, and back-up paper routes, to navigate twelve themed, 1-mile looped routes with GPS-triggered local historical images of Black life and culture to prompt conversational reminiscence during walks. Route themes were Childhood Health, Black Advocacy, Community Ties, Building Community, Arts, Entertainment, and Education. Focus groups at the end of the study captured participant experiences, challenges, and preferences. Pre/post measures captured blood pressure, self-rated health, and depressive symptoms. Paired t-tests were performed on pre/post outcomes, and thematic coding was applied to focus group data. Mean age was 71.8 years and the majority (93%) were female. Mean self-rated health improved and depression symptoms decreased, but not statistically significant. Blood pressure had little to no change. End-study focus groups revealed that participants were motivated by and benefited from social engagement with their walking groups. Walks simultaneously motivated people to exercise and facilitated reminisce about lived experiences in the neighborhood, including gentrification. Participants identified confusing prompts, local construction, terrain, and technology as barriers to the current application of the program. Participants made suggestions for future route themes and to improve program accessibility and clarity.
WEALTH LOSS, DEMENTIA, AND COGNITIVE DECLINE: SURFACING NEW CONNECTIONS AND UPSTREAM INTERVENTIONS
Authors: Miller Julie , Yoquinto Lucas 
Published: January 2025

Abstract
Nearly one in ten adults in the United States over age 65 has dementia. Another two in ten have mild cognitive impairment: an early, symptomatic period of memory or cognitive decline experienced by those who do not yet meet the full diagnostic criteria for dementia. It has long been a matter of anecdote that serious personal finance losses can coincide with, and arise in the wake of, a dementia diagnosis. This symposium brings together leading researchers to explore financial losses than can occur both before and after formal dementia diagnosis. The first presentation compares household financial trajectories of individuals who ultimately developed dementia with those who did not. The second presentation explores financial status of older adults prior to and following the onset of dementia. The third and final presentation explores changes in marital and health status (including but not limited to transitions from normal cognition to cognitive impairment or dementia) as risk factors for negative wealth shocks in older age. Combined, the presentations surface new insights and questions about connections between financial health and cognitive health. The presentations will be synthesized and brought together by a discussion of possible cross-sector, cross-industry intervention strategies that can be undertaken to protect individuals and families at risk of financial losses associated with dementia, especially in the pre-diagnosis period.