bluuebunny/crossref_metadata_2025_split huggingface dataset:
ESTABLISHING SHORT-TERM STUDY ABROAD OPPORTUNITIES IN GERONTOLOGY
Authors: Johansson Linda 
Published: January 2025

Abstract
Beginning in 1995, the College of Health and Welfare at Jönköping University has hosted college and university students from the United States in a short-term (10-14 days) study abroad experience in “Healthcare and Social Services across the Lifespan.” Students from multiple U.S. universities have participated, including Pennsylvania State University, Utah State University, and Indiana University Southeast. U.S. students participate with Swedish students in the campus week experiences of an existing course offered by the College of Health and Welfare as part of the primarily online course: “Aging in a Welfare State.” Students from other countries (Finland, Scotland, Spain, Turkey, UK, and Vietnam) have also participated, allowing for comparison of experiences of aging and support for older adults across countries. Symposium presentations will address: Development and content of the study abroad course (Elizabeth Fauth), Facilitators and barriers to establishing a study abroad course at a U.S. university (Carla Hermann), Challenges and benefits of hosting U.S. study abroad students at the College of Health and Welfare (Therése Bielsten), and History of a sustained and successful model of international gerontological education (Steven Zarit). Course outcomes and measures of student satisfaction and success will be presented, as well as feedback from students and faculty and how that shaped the development of the course over time. Plans for future iterations will be addressed. This course model can be replicated by others aiming to promote engaging gerontological education experiences for both U.S. and international students, as well as international research collaborations.
UPDATED SYSTEMATIC REVIEW TO IDENTIFY INTERVENTIONS TO COMBAT ELDER NEGLECT TARGETING CAREGIVERS
Authors: Park Sophie , Costantini Helena , Shaw Amy , Elman Alyssa , Rosen Tony , Czaja Sara 
Published: January 2025

Abstract
Elder neglect is a subtype of elder mistreatment that is associated with serious medical and social consequences including mortality. Elder neglect by a caregiver is common among older adults receiving assistance from informal caregivers. Few interventions that target informal caregivers have focused on mitigating elder neglect. We updated an existing 2018 systematic review of elder mistreatment interventions, focusing specifically on interventions addressing elder neglect and targeting caregivers. The goal was to examine methods of intervention strategies to guide the development of a new caregiver intervention. The existing and updated review followed PRISMA guidelines and included 6 databases. Across both reviews, only 20 programs focused on elder neglect and targeted informal caregivers. Most programs used psychoeducation/therapy/counseling (65%) and/or education (30%), and 25% were multi-component interventions. Only one program was found to be very likely and two programs likely to be implementable in a low-resource environment. A formal program evaluation was included in 70% of the programs; only 15% were rated as having a high-quality study design. These findings suggest that few programs have been developed to address the important issue of caregiver elder neglect. The design of future interventions should focus on programs that are feasible to implement in low-resource environments and that contain rigorous evaluation strategies. The study findings also suggest that important areas of intervention focus include enhancing caregiver preparedness and reducing caregiver burden. Overall, there is a clear need for caregiver elder neglect interventions, especially those that can be implemented in low resource environments.
INNOVATING FOR EQUITABLE HOME HEALTH CARE: REDUCING BARRIERS TO SOCIAL AND END-OF-LIFE CARE FOR OLDER ADULTS
Authors: Murali Komal , Burgdorf Julia , Mroz Tracy 
Published: January 2025

Abstract
This symposium will focus on equity in home healthcare (HHC), operationalized as equitable access to, and receipt of, high quality HHC that is attuned to the unique needs of specific social and clinical subgroups, including minoritized racial/ethnic groups, those with chronic and serious illness such as dementia, and those at end-of-life. Topics include racial and ethnic disparities in hospice use and barriers to care, factors that impact individuals’ access to social work services, reasons for why palliative care is declined among individuals with lower levels of education, and disparities in access to high quality HHC for people living with dementia and their care partners. Abstracts present analyses from varied methodological and theoretical perspectives that all aim to better understand existing disparities and offer foundational evidence to support development of innovative models of care. The researchers and studies convened by this symposium are dedicated to equitable improvements in home health access and quality for the millions of diverse older adults who receive HHC each year in the United States. In sum, the robust findings of these impactful studies, each conducted in an interdisciplinary fashion and rooted in health-equity principles, present informative evidence for future work endeavoring to improve equitable access to and receipt of the full gamut of HHC services from early stages of illness and social care to end-of-life care. Hospice, Palliative and End-of-Life Care Interest Group Sponsored Symposium
PALLIATIVE CARE KNOWLEDGE, HEALTH CONCERNS, AND EDUCATIONAL STATUS IN DECLINING COMMUNITY-BASED PALLIATIVE CARE
Authors: Luth Elizabeth , Amponsah Abigail 
Published: January 2025

Abstract
Palliative care in community settings can support seriously ill individuals to reduce symptoms and maintain quality of life. However, many individuals decline palliative care, even when they are concerned about their health. Differences in understanding how palliative care can help manage serious illness may contribute to individuals declining. This study explores the relationship between individuals’ understanding of palliative care, their health concerns, and education levels (a proxy for health literacy). We use survey responses from a validated instrument assessing palliative care knowledge and information from semi-structured interviews for 21 seriously ill individuals (n=3) and family caregivers (n=18) who were eligible for community-based palliative care services and declined. We explore the relationship between respondents’ education, understanding of palliative care, and their concerns about their or their loved one’s health. Among participants, twelve had a bachelor’s degree or higher; nine had some college or less. A higher percentage of participants with some college or less were concerned about psychological issues, stress, and managing medication side effects (67% vs 42%). All participants who did not understand palliative care could help with stress and medication side effects and were concerned about these had some college or less. One of three participants who did not understand palliative care could help with psychological issues and were concerned about these had some college or less. Assessing health concerns and explaining how palliative care can address those concerns may reduce barriers to accepting palliative care, particularly among individuals with lower levels of education.
LESSONS LEARNED AND NEXT STEPS FOR USER-CENTERED DESIGN WITH OLDER ADULTS AND CAREGIVERS
Authors: Portz Jennifer , Czaja Sara 
Published: January 2025

Abstract
Digital health can uniquely address various healthcare challenges, yet its’ effectiveness relies heavily on factors such as usability, acceptability, and inclusivity. In this symposium, we present findings from three pioneering projects aimed at developing and refining digital health interventions for older adults and their care partners, tailored to specific populations and healthcare needs. Each project employs a user-centered design (UCD) approach to address unique challenges and opportunities in digital health intervention development. From designing dyadic interventions for advanced dementia to improving care coordination for rural older adults and integrating social support in palliative care, these projects offer valuable insights into developing meaningful, accessible, and person-centered digital health solutions across diverse healthcare landscapes. The final presentation outlines lessons learned from four remote co-design processes for dementia care partner interventions. Co-design, involving an active contribution from older adults and partners, fosters usable, relevant solutions, yet challenges in implementing co-design warrant guidance. Lastly, our Discussant, Dr. Sara Czaja, a world-renown expert in aging-related technology, will lead a conversation highlighting the benefits of UCD, the challenges and limitations of the approach, and innovative solutions for fostering the engagement of older adults and their care partners in the digital health design process.
DESIGNING A BIOEXPERIENTIAL PROGRAM FOR SAFETY, USABILITY, AND ACCEPTABILITY WITH DYADS WITH ADVANCED DEMENTIA
Authors: Plys Evan , Rochon Elizabeth , Thacker Ayush , Sy Maimouna , Phillips Mirelle , Kuma Mischa , Ritchie Christine , Vranceanu Ana-Maria 
Published: January 2025

Abstract
Dyadic psychosocial interventions that engage both persons living with dementia (PLWD) and care partners (CPs) are increasingly popular. Yet, designing dyadic interventions for advanced dementia is challenging due to mismatched abilities. Here, we describe the initial development and refinement of the Toolkit for Experiential well-beiNg in Dementia (TEND) intervention with a focus on design considerations for safety, usability, and acceptability. TEND is an online bioexperiential program (e.g., storytelling, digital art, and relaxing sounds and imagery) designed to engage PLWD and CPs together, to support positive affect, relationship satisfaction, and emotional well-being. Using a multi-phasic approach consistent with user-centered design, we conducted two focus groups with clinicians (N=10), two with PLWD-CP dyads (N=7), and one with CPs only (N=4) to inform an initial prototype. Then, we conducted eight rounds of workshops with 10 PLWD-CP dyads to inform intervention refinements. Rapid data analysis was used to analyze findings and quickly inform iterative design. Focus group participants highlighted design considerations to avoid inadvertently exacerbating behavioral and psychiatric symptoms; matching the context of use; and promoting individualization, familiar stimuli, immersion, and visual clarity of the online program. After development of an initial prototype, workshop participants informed refinements to include mixed methods of engagement (i.e., voice recognition, typing, and interactive movement); instructions, tutorials, and navigation guides; directive prompts; simplified language; and pleasant sounds. Overall, the program was perceived as safe and user feedback informed refinements to promote usability and acceptability. We highlight design elements of the TEND program that were responsive to iterative user feedback.
LESSONS LEARNED FROM A USER-CENTERED DESIGN APPROACH RURAL OLDER ADULTS USING DIGITAL HEALTH TOOLS
Authors: Lewis-Thames Marquita , Trimble Shawn , Rosen Francesca Cejtin , Seigel Zachary , Toll Kara , Horne Kensley 
Published: January 2025

Abstract
Increasing age and rurality are associated with decreased care coordination. There is a growing interest in the role of digital tools in improving care across the care continuum for rural and older adult groups. Still, little is known about the best practices of rural older adults and digital health tool usability. Guided by a user-centered design approach, we 1) describe multiple strategies to meaningfully engage rural older adults in the development of a digital health tool to improve telehealth navigation and 2) report best practices assessed from our multi-modal iterative design approach. We engaged key informants, including rural older adults, their caregivers, providers, healthcare administrators, and an advisory board. Our mixed methods user-centered design approach triangulated findings through semi-structured interviews, a systematic literature review, tool usability testing, and a MyChart usability analysis using eye-tracking technology. Lessons learned from our analysis reveal that rural older adults readily engage with digital technology and often sustain use after their introduction. Digital health technologies were most commonly associated with relieving access to care and transportation barriers. Reduced internet access and challenges with using the equipment were common usability barriers. Useful strategies to overcome usability barriers include in-person or telephone tutorials and knowledgeable caregivers. Tools to assist rural older adults with technology barriers were limited. As digital health technologies increasingly integrate into rural care coordination, barriers faced by rural older adults must be considered. Research that aims to elevate the voices of rural older adults in digital health tool design is imperative.
LESSONS LEARNED ENGAGING CARE PARTNERS OF PEOPLE LIVING WITH DEMENTIA IN CO-DESIGN OF DIGITAL HEALTH INTERVENTIONS
Authors: Werner Nicole 
Published: January 2025

Abstract
Per the NIH Stage Model of Behavioral Intervention Development, once a scientific mechanism for a possible behavioral intervention is established, the next critical step is to systematically design the intervention with the target population. If digital health intervention researchers bypass this stage, their interventions may work in ideal but not “real world” settings. Moreover, partnerships between user-centered design/engineering experts and health sciences researchers are believed to “increase the likelihood for impactful outcomes from the use of the engineering design process.” However, more work is needed to translate user-centered design approaches to digital health intervention design for older adults and care partners. Co-design in particular promotes strengths-based (vs. deficit-based) treatment of older adults and care partners. That is, rather than being the focus of a study on what is wrong, older adults and their care partners actively contribute to design and are therefore more likely to produce digital health solutions that are usable, useful, relevant, acceptable, and adaptable to current routines. However, co-design approaches can be challenging to implement, and guidance for engaging older adults and care partners in co-design is lacking. Dr. Werner will present lessons learned across four projects that implemented a remote, five-phase co-design process to co-design digital health interventions with care partners of people living with dementia. Lessons learned span co-design activities, co-design quality, and co-designer outcomes that were identified from research team and care partner interviews conducted at the end of the design process and feedback surveys conducted with care partners after each co-design session.
LIFESPAN SOCIOECONOMIC STATUS AND MORTALITY USING 1900–1940 CENSUSES: FINDINGS FROM THE NORMATIVE AGING STUDY
Authors: Marino Victoria , Ferrie Joseph , Dorame Ashley N , Graham Eileen , III Avron Spiro , Mroczek Daniel , Lee Lewina 
Published: January 2025

Abstract
Early and midlife socioeconomic status (SES) are linked to all-cause mortality, but few studies have examined their independent and joint associations using multidimensional, prospective SES measures and track mortality over extended periods. As described in the Dorame et al. presentation in this symposium, the Boston Early Adversity and Mortality Study (BEAMS) acquired prospective data on the early-life circumstances of three well-characterized male cohorts via linkage to the 1900-1940 US Federal Censuses. This study leverages BEAMS data to test the independent and joint associations of early and midlife SES with all-cause mortality in 1,303 men from a BEAMS cohort, the Normative Aging Study. Early SES, assessed at baseline (earliest available Census before age 18), was a composite combining paternal literacy (1=yes, 0=no) and z-standardized paternal occupational income. Midlife SES was a z-score composite of men’s occupational standing, education, and income at study entry (mean age=42). Mortality status was followed through December 2020 (mean follow-up since baseline: 77 years). Early SES was weakly and positively correlated with midlife SES (r=.17, p&lt;.0001). In Cox regression, each 1-SD higher early SES was associated with 8% lower mortality risk (95%CI: 0.84, 1.00). Each 1-SD higher midlife SES was associated with 3% lower mortality risk (95%CI: 0.95,0.99), adjusted for early SES. The main effect of midlife SES weakened the association of early SES with mortality by only 2%. Early SES did not moderate the association of midlife SES with mortality. Our findings support largely independent contributions of early and midlife SES to all-cause mortality risk.
STABILITY OF COGNITIVE ABILITY AND EFFECT OF EDUCATION ACROSS 58 YEARS: A PROJECT TALENT AGING STUDY
Authors: Arpawong Thalida Em , Huh Jimi , Gruenewald Tara , Fisher Gwenith , Manly Jennifer , Seblova Dominika , Peters Kelly , Gatz Margaret 
Published: January 2025

Abstract
We assessed the degree to which individuals retain cognitive abilities from adolescence through older adulthood, and whether more education associates with better retention in some more than others, after adjusting for adolescent cognitive ability. We also evaluated whether benefits associated with education differ for those with lower or higher cognitive scores in adolescence, or women or men. Data came from the Project Talent Aging Study, and included measures of abstract reasoning, mathematics, visualization in two dimensions, and recognition memory in 1960 and 2018 (n=2,032; age range 71 to 79). Confirmatory factor analysis was used to fit one-factor (cognitive ability factor, CAF) at each timepoint. We then used a structural equation model to test whether the 1960 CAF predicted the 2018 CAF, with an interaction term between 1960 CAF and years of education. Multiple group models tested invariance by sex. We found high stability in CAFs assessed 58 years apart. Education predicted higher 2018 CAF (p&lt;.001), although a significant interaction (1960 CAF*education; p&lt;.05) showed that effects were diminished for those with higher 1960 CAF. Sex-specific analyses showed that the diminishing effect of education was evident for both women (p&lt;.05) and men (p&lt;.05). Additionally, the simple effect of education on 2018 CAF was significant for women (p&lt;.001) but not for men (p=.37). Findings indicate high stability in cognitive abilities from adolescence to older adulthood, and that exposure to more education differentially benefits later age abilities depending on adolescent levels and sex.
VALIDATION OF COGNITIVE AND PSYCHOSOCIAL INSTRUMENTS FOR THE KENYAN CONTEXT: RESULTS FROM LOSHAK
Authors: Mani Sneha , Ehrlich Joshua , Ngugi Anthony , Nagarajan Niranjani , Riang’a Roselyter , Mwangi Eunice , Gross Alden 
Published: January 2025

Abstract
Adaptation of cognitive tests to culturally diverse and low-resource settings is essential for expanding knowledge of cognitive health in older adults beyond high-income countries. However, contextual differences in novel settings can affect reliability and validity. A significant knowledge gap remains in Sub-Saharan Africa, a region projected to be home to over 158 million older adults by 2050. The Longitudinal Study of Health and Ageing in Kenya (LOSHAK) aims to address this measurement gap. The LOSHAK pilot collected neuropsychological and psychosocial assessment data, adapted from the US Health and Retirement Survey to be relevant to the Kenyan context. For four cognitive constructs (orientation, memory, executive functioning, language/fluency) and four psychosocial constructs (depressive symptoms, loneliness, subjective well-being, and life satisfaction), internal consistency reliability was evaluated using McDonald’s omega (ω) and factor structures were evaluated using confirmatory factor analysis. McDonald’s omegas ranged from ω=0.78 to 0.95 for cognitive domains and were above 0.83 for each psychosocial domain, suggesting high reliability. Factor analyses revealed good to excellent fit for most domains (RMSEA&lt;0.095; CFI&gt;0.93; SRMR&lt;0.11); patterns of factor loadings were mostly acceptable (ranging from 0.5 to 0.9), and will be used to refine instruments further. This examination reveals a successful adaptation of neuropsychological and psychosocial assessments in Kenya and provides a reference for other studies seeking to assess the efficacy of adapted instruments.
HARMONIZING COGNITIVE SCORES ACROSS WAVES IN THE CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY
Authors: Wu Yingyan , Mayeda Elizabeth Rose , Kobayashi Lindsay , Gross Alden , Zhang Yuan 
Published: January 2025

Abstract
The China Health and Retirement Longitudinal Study (CHARLS) administered a word recall test to assess memory function across five study waves from 2011 to 2020. Since 2018, the word recall test has differed from prior waves in the difficulty of word lists used and number of immediate recall trials given, posing challenges for longitudinal analyses of cognitive change. We thus leveraged weighted equipercentile equating for immediate and delayed recall scores to address nonequivalence in the test across study waves. We created a calibration sample that balanced age, gender, and education to ensure the same underlying test ability across waves. Within the calibration sample, we used equipercentile equating to crosswalk percentile ranks between the scores in the 2015 and 2018 waves and 2015 and 2020 waves, then applied the crosswalk to the full study sample. In the full study sample, the mean original delayed word recall scores were higher in 2018 (4.3 words) and 2020 (5.1 words) versus 2015 (3.2 words). Within the 2018 and 2020 waves, mean original delayed scores were higher than mean original immediate scores (2018: 4.3 vs 3.2, 2020: 5.1 vs. 3.6 words). After applying equipercentile equating, the mean 2018 and 2020 wave immediate and delayed word recall scores were comparable to previous waves (immediate: 2015: 4.1, 2018: 3.7, 2020: 3.8; delayed: 2015: 3.2, 2018: 2.5, 2020: 2.8 words). Equipercentile equating can be used to generate comparable scores to facilitate longitudinal analysis when cognitive test administration procedures change over time.