bluuebunny/crossref_metadata_2025_split huggingface dataset:
HOME HEALTH CLINICIAN PERSPECTIVES ON ASSESSING AND SUPPORTING DEMENTIA CAREGIVERS
Authors: Burgdorf Julia , McDonald Margaret , Bowles Kathryn 
Published: January 2025

Abstract
Home Health Care (HHC) delivers skilled services via visits to patients’ homes. One-third of HHC patients have dementia and caregivers play a critical role in their care. Yet, it is difficult to assess caregivers’ training/support needs during HHC. As part of ongoing formative research aimed at developing a dementia caregiver assessment intervention for HHC, we convened semi-structured group interviews with 16 frontline staff from a large, urban HHC agency—Registered Nurses (n=5), Physical Therapists (n=5), and Social Workers (n=6). Staff shared their perspectives on current communication with caregivers and reacted to a proposed health information technology (HIT) solution for assessing caregiver needs. Participants highlighted social work’s critical role in connecting caregivers with community resources to bridge the gap of “a short-term benefit trying to meet long-term needs”. Staff emphasized the importance of gathering information regarding dementia patients’ complex caregiving networks (encompassing family, paid attendants, and HHC aides with varying schedules and task loads) but noted there were few options for storing and sharing this information in the patient record. Respondents expressed enthusiasm for an HIT-driven assessment tool linked to the patient record and requested that such a tool (1) come with a repository of community resources, (2) support information sharing among the care team and between episodes, and (3) include education for caregivers on dementia symptoms and the scope of HHC. Findings shed light on current barriers and opportunities for supporting dementia caregivers in HHC and reveal practical considerations for designing an intervention that will integrate with existing HHC workflows.
UNMET CAREGIVING NEEDS AMONG HOME HEALTH PATIENTS WITH DEMENTIA: FRONTLINE CLINICIAN REPORTS
Authors: Burgdorf Julia 
Published: January 2025

Abstract
One-third of Medicare home health care (HHC) patients have diagnosed dementia and rely heavily on support from family caregivers to implement the plan of care, but no prior work has examined unmet caregiving needs among these patients. Drawing on clinician reports in 2018 Medicare HHC assessment data for a national sample of 426,606 HHC patients with diagnosed dementia, we define unmet caregiving needs stemming from lack of availability (i.e., no caregiver is present) or lack of capacity (i.e., caregiver requires clinician supervision and training). Given the progressive nature of the disease, we compare across 3 levels of dementia symptom severity, determined by clinician-reported cognitive and behavioral symptoms. Comparing those with mild, moderate, and severe dementia symptoms, unmet needs due to lack of caregiver availability were present for 9.1%, 6.9%, and 5.3% of patients, respectively; unmet needs due to lack of caregiver capacity were present for 70.6%, 71.1%, and 74.9% of patients, respectively. In adjusted multilevel models controlling for patient and HHC agency characteristics and clustering at the agency level, individuals with more severe dementia symptoms were less likely to have an unmet need for caregiver assistance due to a lack of caregiver availability (aOR: 0.63; 95% CI: 0.60-0.66), but more likely to have an unmet need due to a lack of caregiver capacity (aOR: 1.15; 95% CI: 1.12-1.17). Findings suggest the need for varied approaches to caregiving-related support based on dementia disease stage and highlight widespread needs for clinicians to provide caregiver training during HHC episodes for those with dementia.
EXPLORING THE IMPACT OF TELE-GERIATRIC MENTAL HEALTH SERVICES ON RURAL CAREGIVERS’ WELL-BEING
Authors: Humber Marika , Carlson Chalise , Brodrick Marisa-Francesca , VanPutten Rachel , Peeples Amanda , Trivedi Ranak , Lloyd Althea , Gould Christine 
Published: January 2025

Abstract
Rural caregivers may experience unique barriers to support including lack of services, transportation, and internet access. Within the Veterans Health Administration (VHA), a virtual geriatric psychiatry consultation service evolved to increase specialty mental health care access for rural older Veterans. Although the Veteran and their neurocognitive disorder (e.g., Alzheimer’s disease) and/or mental health condition (e.g., depression, PTSD) were the focus of the service, caregivers were also present at appointments. This study explored the impact of the service on rural caregivers in two VHA regions. The median age of patients was 77; caregivers were a spouse or adult child. Semi-structured interviews with caregivers (n=13) inquiring about overall experience and satisfaction with the service, changes to patient care and symptoms resulting from visits, and the service’s impact on the caregiver were conducted from September 2022-November 2023. Using rapid qualitative analysis, interview transcripts were summarized and compared to identify themes. Caregivers reported working with the geriatrics providers normalized the caregiving experience and provided helpful techniques and resources for managing challenging patient behaviors. Rural caregivers appreciated that visits were done at home alleviating the time and effort required to travel to distant VHA facilities and that providers could spend more time focusing on patient and caregiver needs. The direct access to specialty providers via follow-up appointments or by telephone to ask questions and address emergent problems was particularly valuable. These findings indicate that integrating caregivers into specialty tele-geriatric mental health services may decrease burden and improve well-being for caregivers of rural older Veterans.
ADAPTING DIALECTICAL BEHAVIOR THERAPY TO ADDRESS CAREGIVER HEALTH IN HIGH-CONFLICT CAREGIVING SITUATIONS
Authors: VanPutten Rachel , Drossel Claudia , Waltz Thomas 
Published: January 2025

Abstract
Family caregivers of older adults with neurocognitive disorders (NCDs) are invisible patients in the U.S. healthcare system. This is especially concerning because poor caregiver mental or physical health predicts coercive care practices (e.g., yelling or threatening the older adult). When older adults with NCD come to providers’ attention for emotional and behavioral changes, systematic strategies for assessing and intervening on caregiver health and potential coercive caregiving patterns are lacking. The present study consisted of a retrospective chart review of clinical records from family caregivers who participated in dialectical behavior therapy (DBT) skills training groups adapted for high-conflict situations involving older adults with NCDs (Drossel, Fisher, & Mercer, 2011) in a doctoral-level psychology training clinic in the Midwest. Data from 32 family caregivers enrolled across eight 8-week DBT groups showed that caregivers whose medical records indicated significant health problems tended to describe themselves as healthy when completing the RAND 36-Item Health Survey (SF-36; Hayes et al., 1993). Attrition from the groups was mainly due to acute medical crises, and caregivers required significant individual support to address their medical concerns, prompting modifications to the DBT mindfulness and interpersonal effectiveness modules (e.g., developing DEAR MAN scripts to delegate care tasks to third-party providers). These findings suggest the need for routine, systematic, and direct assessments of caregiver health and skills-based approaches targeting health promotion and disease prevention to address coercive caregiving practices.
LIFETIME AND CURRENT CANNABIS USE BY OLDER WOMEN WITH HIV PARTICIPATING IN THE MACS/WIHS COMBINED COHORT STUDY
Authors: Bobitt Julie 
Published: January 2025

Abstract
The proportion of persons living with HIV who use cannabis is 2-3 times higher than the general population with past-year use rates ranging from 23%-56% in persons with HIV compared to 13% in persons without. A Women’s Interagency HIV Study (WIHS) found cannabis use by women to be 27%. We will present findings from interviews with 30 women aged 60+ enrolled in the MWCCS Cook County site. Guided by the socioecological framework, the interviews explore the multi-level influences on cannabis use decision-making and health outcomes. Our thematic analysis focuses on the following influences: 1) individual (attitudes, knowledge, health conditions); 2) Relationship (social connections/responsibilities); 3) Community (medical), and 4) Societal (legalization). We also explore cannabis use drivers on HIV-related pain relief, anxiety, and stress. As cannabis use among chronically ill persons continues to rise, it is important to understand the factors that influence use and health outcomes.
THE CLARK TIBBITTS AWARD AND HIRAM J. FRIEDSAM AWARD LECTURES AND PRESENTATIONS
Authors: Montepare Joann 
Published: January 2025

Abstract
The Clark Tibbitts Award Lecture will feature an address by the 2024 award recipient Joann M. Motepare, PhD, FGSA, FAGHE, of Lasell University. The Hiram J. Friedsam Award Lecture will feature an address by the 2024 award recipient Dana Burr Bradley, PhD, FGSA, FAGHE, of the University of Maryland Baltimore County. AGHE’s Clark Tibbitts Award was established in 1980 and named for an architect of the field of gerontological education. The award is given each year to an individual or organization that has made an outstanding contribution to the advancement of gerontology and geriatrics education. Hiram J. Friedsam was the professor, co-founder, and director of the Center for Studies in Aging and dean of the School of Community Service at the University of Northern Texas. Dr. Friedsam was an outstanding teacher, researcher, colleague, and mentor to students, faculty, and administrators, as well as a past president of AGHE. The purpose of this award is to recognize those who emulate Dr. Friedsam’s excellence in mentorship.
LONG-TERM OUTDOOR AIR POLLUTION CONCENTRATIONS AND COGNITION: FINDINGS FROM THE HCAP SUBSTUDY OF ELSA
Authors: Gessa Giorgio Di 
Published: January 2025

Abstract

Background
Although air pollution has been associated with cognitive impairment, several key details of these relationships remain unknown. This includes understanding how different pollutants and their emission sources impact the brain as well as the particular aspects of cognition that are susceptible to pollution. In this study, we consider the associations between 8 years of exposure to different air pollutants (including total PM2.5 and PM2.5 from different emission sources, and NO2) with different domains of cognitive performance among older people.

Methods
We used data from the Harmonized Cognitive Assessment Protocol (HCAP) sub-study of the English Longitudinal Study of Ageing (2018, N~1,200). This study measured a range of key cognitive domains affected by cognitive ageing, including attention, memory, executive function, language, and visuospatial function. Outdoor concentrations of each pollutant for all HCAP respondents’ residences were assessed since 2010. Averages and group-based trajectory modelling were then used to summarise long-term air pollution exposures and their relationships with cognition After adjustment for key personal and neighbourhood confounders.

Results
Preliminary results suggest that respondents with higher residential levels of air pollution reported poorer cognitive function, especially for verbal fluency and executive function. Particularly, we found sustained high levels of NO2 to be associated with poorer cognition, even when baseline levels of cognition were accounted for (B=-1.75, 95%CI=-3.43;-0.06). Regarding PM2.5, our results suggest that emissions from industry are particularly detrimental to cognition.

Conclusions
Efforts to reduce levels of exposure to air pollution should continue as this is a risk factor for poorer cognitive performance.
LONG-TERM EXPOSURE TO AIR POLLUTION AND RISK OF DEMENTIA AMONG OLDER INDIVIDUALS OF A DANISH NATIONWIDE ANALYSES
Authors: So Rina , Andersen Zorana , Lim Youn-Hee , Zhang Jiawei , Tuffier Stéphane , Cole-Hunter Thomas 
Published: January 2025

Abstract
The evidence linking air pollution with dementia has been fast growing over the last decade, but who is most susceptible remains rarely explored. Therefore, we aimed to examine the association between long-term exposure air pollution and incidence of dementia and identify the most susceptible groups by age, sex, socioeconomic status (SES), and comorbidities with major chronic diseases. We followed all Danish residents aged 60 years or older on January 1st, 2000 until December 31st, 2018. Annual mean concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in 2010 (100x100m) were estimated using European-wide hybrid land-use regression models and assigned to the baseline residential address. We used Cox proportional hazard models to evaluate the association between air pollution and dementia incidence, accounting for individual and area-level SES, and introduced an interaction term to test for effect modification by age, sex, income, education, employment, and co-morbidity with cardio-metabolic, respiratory diseases and depression. Of 934,792 subjects, 81,731 developed dementia. We detected statistically significant associations of all three pollutants with incidence of dementia, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.14 (1.12-1.16) per 1.9 μg/m3 increase in PM2.5, 1.25 (122-1.28) per 10.2 μg/m3 increase in NO2, and 1.23 (1.20-1.26) per 0.5×10-5/m increase in BC. Associations were stronger in the elderly (≥75 years), stroke patients, unemployed, and those with the lower income or education. In this nationwide analysis in a low-exposure setting in Demark, long-term exposure to air pollution contributes to the development of dementia.
EXTREME HEAT EXPOSURE AND EPIGENETIC AGING ACCELERATION AMONG OLDER ADULTS IN THE US
Authors: Choi Eunyoung , Ailshire Jennifer 
Published: January 2025

Abstract
Extreme heat exposure is a major risk factor for cardiovascular diseases and mortality. However, knowledge about the biological ramifications of extreme heat exposure is limited, particularly among older adults who face elevated vulnerability. This study examines the association between heat exposure and epigenetic aging, a key molecular marker of biological aging based on DNA methylation (DNAm) levels throughout the genome. We used data on 3,414 US adults aged 50 or above from the 2016 Health and Retirement Study Venous Blood Study with measured DNAm. To assess heat exposure, we calculated daily heat index values at the census tract level using high-resolution meteorological data from gridMet and linked them to each respondent’s geocoded residential location. We considered both acute (on the day of blood collection) and chronic (1-year moving average) exposure windows. Multilevel regression models with natural cubic splines were used to assess the effects of heat exposure on epigenetic aging acceleration (i.e., Horvath, Hannum, PhenoAge, GrimAge, and DunedinPACE). Acute exposure to high heat index values (90th percentile compared to room temperature of 68F) was significantly associated with increased Horvath (0.77, p&lt;.05), Hannum (0.73, p&lt;.05), and PhenoAge (1.09, p&lt;.001) acceleration. For long-term exposure, high heat index values were associated with increased PhenoAge (0.78, p&lt;.05), GrimAge (0.52, p&lt;.01), and DunedinPACE (0.02, p&lt;.01). These findings provide insights into the biological underpinnings linking heat exposure to a broader spectrum of morbidity and mortality risks. Our study adds to the evidence highlighting the strong need to mitigate the adverse biological modifications induced by extreme heat.
THE RESIDENTIAL CARE TRANSITION MODULE: SUPPORTING DEMENTIA CAREGIVERS FOLLOWING INSTITUTIONALIZATION
Authors: Gaugler Joseph , Boltz Marie 
Published: January 2025

Abstract
Families often continue to engage in various care activities following relatives’ entry to residential long-term (RLTC) care settings such as nursing homes. Dementia caregivers’ emotional and psychological adaptation to this transition is variable. We conducted rigorous, mixed methods randomized controlled evaluation to ascertain the efficacy of a remotely delivered, psychosocial/psychoeducational intervention when helping caregivers navigate the placement transition of relatives living with Alzheimer’s disease and Alzheimer’s disease-related dementias. The Residential Care Transition Module (RCTM) provided six formal sessions of consultation (one-to-one and family sessions) over a 4-month period to family caregivers who have admitted a relative living with dementia to an RLTC setting as well as ongoing, “ad hoc” consultation over an additional eight months. This symposium presents the quantitative, qualitative, and mixed methods findings of this dementia care intervention.
A QUALITATIVE ANALYSIS OF MECHANISMS OF BENEFIT IN THE RESIDENTIAL CARE TRANSITION MODULE
Authors: Albers Elizabeth , Birkeland Robyn , Louwagie Katie , Yam Hawking , Baker Zachary , Mittelman Mary , Gaugler Joseph 
Published: January 2025

Abstract
This study aimed to determine the perceived benefits of the Residential Care Transition Module (RCTM), a multi-component, psychoeducational/psychosocial, telehealth intervention for caregivers of cognitively impaired relatives living in residential long-term care (RLTC). We conducted semi-structured exit interviews with 30 purposively selected participants who had been randomly assigned to receive the RCTM. An open-ended survey question solicited feedback from all RCTM participants at four (n=90), eight (n=79) and 12 months (n=77). Available qualitative data were analyzed for thematic content. Participants mentioned nine mechanisms of benefit: six strategies or educational content for caregiving and three aspects of counselor support. Common benefits attributed to RCTM included improved mood, caregiving confidence and communication. Through this analysis we achieved a more comprehensive understanding of the RCTM’s mechanisms of benefit which we will explore more in the presentation.
CLAIMS-BASED FRAILTY INDEX FOR IDENTIFYING MODERATE-TO-SEVERE DEMENTIA IN MEDICARE BENEFICIARIES
Authors: Park Chan Mi , Sison Stephanie Denise , McCarthy Ellen , Shi Sandra , Kim Dae Hyun 
Published: January 2025

Abstract
Identifying dementia severity from administrative claims poses challenges. This abstract discusses developing and validating a claims-based frailty index (CFI) cut-point for identifying moderate-to-severe dementia among Medicare beneficiaries, using data from the National Health and Aging Trends Study (NHATS) and Medicare Current Beneficiary Survey (MCBS). We used 2015 data from NHATS linked to Medicare claims to calculate CFI and determine the optimal cut-point that maximizes sensitivity and specificity in identifying moderate-to-severe dementia based on the Functional Assessment Staging. We validated this measure on an independent sample of community-dwelling Medicare beneficiaries with dementia from MCBS. Performance metrics included sensitivity, specificity, and positive and negative predictive values. From the NHATS development cohort (n=814), the CFI cut-point of 0.280 demonstrated strong performance (C-statistic of 0.78) in differentiating moderate-to-severe dementia cases, achieving the maximum sensitivity of 76.9% and specificity of 62.8%. This cut-point correlated significantly with dementia indicators, including higher rates of functional disability, dementia medication use, mortality, and nursing home admissions. Subsequent validation using the MCBS cohort (n=658) supported the cut-point’s utility in identifying moderate-to-severe dementia, with modest sensitivity of 0.49 and high specificity of 0.80. These two pivotal studies suggest that the CFI, with a cut-point of 0.28, is a robust tool for identifying moderate-to-severe dementia in Medicare claims data. By offering an evidence-based metric, this research facilitates a more targeted approach to allocating healthcare resources and planning care interventions for dementia patients, bridging a critical gap in the absence of direct clinical measures of dementia severity.
HONORING OUR HEALTH AND HISTORY: OPERATIONALIZING CONCEPTS AND RESULTS FROM THE SHARP STUDY
Authors: Gordon Taryn , Newby Launa , Fuller Patrice , Fennell Charles , Croff Raina 
Published: January 2025

Abstract
Accessibility of mental and brain health education remains a challenge for older Black adults, hindered by cultural insensitivities within the field and discriminatory historical context. Operationalizing Black-centered theoretical concepts and narratives from the Sharing History through Active Reminiscence and Photo-imagery (SHARP) study on our website aims to leave older Black adults not only educated but empowered to address cognitive decline and engage in behaviors to mitigate it. Since 2016, 82 SHARP walkers in gentrifying areas of Portland and Seattle have generated over 400 narratives by walking 3x/week for 1, 4, or 6 months and reminiscing together, aided by image prompts about local Black history and culture. Reminiscence is audio recorded for an oral history archive. Transcribed narratives are vetted for content that may compromise participant integrity, then participant-checked. Next, narratives are coded to create a topical index for public users of the archive. SHARP researchers are now operationalizing SHARP theoretical concepts on our website and applying narratives to reach the wider Black public about brain health. The website integrates oral history from walks with tangible, culturally engaging educational content about aging, cognitive decline, and mental health. Asset-based and culturally celebratory messaging, tone, and Black history images counter the often fear- and deficit-based messaging around these topics. Framing Black health within the richness and vitality of Black history, culture, and community resilience, and through memories from other older Black adults taking agency over their health, can inspire learning and action to give readers agency in their mental and brain health.
CHANGES IN MARITAL AND HEALTH STATUS AS RISK FACTORS FOR A SUBSEQUENT NEGATIVE WEALTH SHOCK IN THE US, 1996–2020
Authors: Cho Tsai-Chin , Adar Sara , Choi HwaJung , Langa Kenneth , Kobayashi Lindsay 
Published: January 2025

Abstract
Negative wealth shocks, defined as a loss of ≥75% of one’s wealth over a short time-period, may decrease material living standards in later-life. However, the risk factors for negative wealth shocks are unclear. We aimed to examine the association of four risk factors, 1) separation from or loss of a spouse/partner; 2) diagnosis of a new chronic condition; 3) transition from low to high depressive symptoms; and 4) transition from normal cognition to cognitive impairment or dementia, with the subsequent experience of a negative wealth shock in mid-to-later life. We included respondents aged ≥55 in the US Health and Retirement Study between 1996-2020 (N=128,213 observations from 25,265 persons). Study participants were classified at each time-point as either having experienced a negative wealth shock between each biennial survey interview, or not. The risk factors were assessed over two years preceding negative wealth shocks. We performed multivariable logistic mixed effects models accounting for complex survey design to examine how each risk factor may trigger negative wealth shocks and evaluate effect modification by retirement status at the baseline of study intervals. Separation from or loss of a spouse/partner increased the odds of a negative wealth shock (AOR= 1.44; 95% CI: 1.24, 1.67). Compared to those not retired, retirees who became depressed had higher odds of a negative wealth shock (AOR= 1.23; 95% CI: 1.04, 1.47). This population-based prospective study suggests that changes in marital status and in mental health, for retired adults, may signal future negative wealth shocks, although further investigation is required.