bluuebunny/crossref_metadata_2025_split huggingface dataset:
MULTIDOMAIN INTERVENTION TO IMPROVE COGNITION IN OLDER ADULTS: NEW RESULTS AND FUTURE CHALLENGES
Authors: Bherer Louis 
Published: January 2025

Abstract
Decades of research have supported the notion that physical exercise and cognitive training can both help enhance cognitive performances in older adults. More recent studies have investigated whether these two domains of intervention could have synergistic effects, however results are equivocal. Moreover, there is an important heterogeneity among studies with regards to intervention modality within domain (e.g., memory or attention training as cognitive intervention; aerobic, resistance or combined physical exercise) and studied population (MCI vs. healthy aging). This symposium will discuss recent findings from innovative interventions ranging from within-domain attention training to multi-domain interventions that combine cognitive training or cognitive stimulation with or without physical exercise components. Issue of interindividual differences and the need to better individualized intervention as well as diversity in targeted population will also be discussed. Presentations will also address future challenges in combined intervention studies.
EFFECTS OF HOME-BASED COGNITIVE AND PHYSICAL EXERCISE TRAINING ON COGNITION IN OLDER ADULTS: THE COVEPIC TRIAL
Authors: Bherer Louis , Blanchette Caroll-Ann , Besnier Florent , Gayda Mathieu , Gagnon Christine , Vincent Thomas , Vrinceanu Tudor , Dupuy Emma 
Published: January 2025

Abstract

Background
Studies suggest that cognitive training and physical exercise can independently help improve cognition in older adults. This randomized clinical trial (COVEPIC study) aimed to compare the effects of 6 months of home-based physical exercise alone and combined with cognitive training on the cognition of older adults.

Methods
127 adults (50 years and older) were randomly assigned to one of the two following intervention arms (1:1): 1/ home-based physical exercise alone or 2/ combined home-based physical exercise and cognitive training. Participants completed videoconference neuropsychological assessments targeting episodic and working memory, processing speed and executive functions, prior to the intervention (T0), mid-intervention (T1) (3 months), and post-intervention (T2) (6 months). Clinicaltrials.gov (NCT04635462).

Results
Participation in the combined intervention showed a larger improvement than the exercise alone group on the MoCA from T0 to T1, and a change in executive functions which was not observed in the physical exercise only group. Effects of exercise dose were also observed, as participants who went through a higher dose of exercise showed larger improvement in episodic and working memory.

Discussion
Results suggest that a home-based intervention combining cognitive and physical training can help improve cognition in older adults.
EFFECTS OF A ONE-YEAR PIANO PRACTICE INTERVENTION ON COGNITIVE FLEXIBILITY IN HEALTHY OLDER ADULTS
Authors: Mack Melanie , Marie Damien , Worschech Florian , Krueger Tillmann , Sinke Christopher , Altenmueller Eckart , James Clara , Kliegel Matthias 
Published: January 2025

Abstract
We analyzed data of a randomized controlled trial to examine the effects of piano practice on cognitive flexibility in healthy older adults. Participants (N = 153, 69.5 ± 3.5 years of age, 57.5% females) were randomly assigned to a piano practice group (PP) or a control group engaged in active music listening (MC). Both groups underwent a year-long intervention with weekly 60-minute lessons and daily homework. We assessed switch and mixing costs in terms of speed (mean RTs) and variability (standard deviation of RTs) with a number switch and a perceptual switch task. We employed MIDI-based Scale Analysis to assess pianistic performance. Tests were conducted at baseline, after 6 months, post-intervention (12 months), and at follow-up (18 months). Results revealed more pronounced improvements in pianistic performance in the PP compared to the MC group over the course of the intervention. Both groups exhibited gains in several cognitive flexibility outcomes, which originated primarily in the latter half of the intervention. For mixing costs, the PP group showed partly greater improvements compared to the MC group. Additionally, the findings indicated a compensation account in both groups, which was partially more pronounced in the PP group. This study suggests that both piano practice and active music listening – with piano practice to a slightly higher degree - enhance cognitive flexibility, particularly in sustained control mechanisms linked to mixing costs. Both interventions potentially require longer than 6 months to induce behavioral transfer effects and are especially beneficial for individuals with lower cognitive flexibility levels.
INTERSECTING IDENTITIES AND HEALTH-RELATED QUALITY OF LIFE AMONG LGBTQ+ OLDER ADULTS
Authors: Kim Hyun-Jun , Jung Hailey , Oswald Austin , Fredriksen-Goldsen Karen 
Published: January 2025

Abstract
LGBTQ+ older adults remain understudied in terms of the intersectionality of their identities and its impact on health. It is unclear how certain aspects of identity are perceived as central and how the intersection of multiple identities influences experiences of discrimination. This study identifies intersectional profiles of identity centrality and attributions for day-to-day discrimination, focusing on gender, sexual and gender identity, age, and race/ethnicity among LGBTQ+ older adults. It also examines the associations between profile membership, key psychological and social factors, and physical and mental health-related quality of life (HRQOL). Utilizing data from the National Health, Aging, and Sexuality/Gender Study, the first national longitudinal study of 2,450 LGBTQ+ older adults, we unveiled five latent profiles using Latent Class Analysis, which depict heterogeneous patterns in individuals’ perception of their identities in terms of centrality and as the basis of their discrimination experiences. The most prevalent was the moderate centrality and discrimination profile (C1; 31%), followed by high centrality and discrimination (C2; 26%), low centrality and discrimination (C3; 17%), high centrality and low discrimination (C4; 15%), and low centrality and high discrimination (C5; 11%). C2 and C5 exhibited lower physical and mental HRQOL compared to other profiles, suggesting that multiple discrimination attributes may contribute to compromised health, regardless of identity centrality. C2 and C4 showed high identity centrality across all identities, which was linked to greater critical awareness and activism. This study highlights the significance of incorporating an intersectional lens to better understand the distinct needs and strengths within LGBTQ+ aging communities.
PAIN DURING MIDLIFE: A CROSS-NATIONAL ANALYSIS OF COHORT DIFFERENCES IN PAIN IN THE US, EUROPE, SOUTH KOREA, AND MEXICO
Authors: Infurna Frank , Syed Orchee , Cruz-Carrillo Yesenia , Dey Nutifafa , Wettstein Markus , Grimm Kevin , Lachman Margie , Gerstorf Denis 
Published: January 2025

Abstract
Over the past several decades, middle-aged Americans have exhibited troubling trends of declining mental and physical health over successive cohorts. However, this trend has not been consistently observed in peer nations. It is an open question whether pain shows similar national disparities. We thus examine how self-reports of pain have historically changed in the U.S. during midlife, and how this compares to peer nations. We used harmonized data on pain from nationally representative longitudinal panel surveys from the U.S., 13 European nations, South Korea, and Mexico to directly quantify national similarities and differences in historical change in midlife pain. Our results corroborate earlier reports that midlife pain is higher amongst later-born cohorts in the U.S. Of note is that these historical increases emerged at earlier stages of midlife for later-born cohorts. A similar pattern of historical increases in pain was observed in Continental and Nordic Europe. In contrast, historical declines in pain were observed in England, Mediterranean Europe, South Korea, and Mexico. These results suggest there could be aspects of American midlife today that are exacerbating feelings of pain, and these aspects may be shared in some European nations but absent or less influential in other peer nations. Our discussion focuses on potential explanations for this pattern, such as population level discrepancies in health, differential use of health care services, and the inter/intrapersonal costs of westernization, as well as how pain is conceptualized across nations.
TRAJECTORIES OF EPISODIC MEMORY IN MIDLIFE: HISTORICAL CHANGE FROM A CROSS-COUNTRY PERSPECTIVE
Authors: Wettstein Markus , Infurna Frank , Dey Nutifafa , Cruz-Carrillo Yesenia , Grimm Kevin , Lachman Margie , Gerstorf Denis 
Published: January 2025

Abstract
According to the Flynn effect, cognitive abilities have improved across the past decades. However, we know little about whether such historical improvements generalize to middle-aged adults and differ across nations. In this study, we used harmonized data on episodic memory from nationally representative longitudinal panel surveys including the U.S., Europe, Mexico, and China to compare historical change in age-related trajectories of episodic memory among middle-aged adults. Our sample included 89,775 participants aged 45 to 65 years who provided 272,876 observations over up to 20 years. Longitudinal multilevel regression models revealed that today’s middle-aged adults in the U.S. perform worse on episodic memory tests than their age peers in the past. In contrast, today’s middle-aged adults in most other countries perform better than did their peers in the past. At the same time, later-born cohorts of U.S. middle-aged adults exhibited a more favorable episodic memory trajectory than earlier-born cohorts, whereas this trend was not observed in most other countries. Cohort trends remained significant when controlling for socio-demographic indicators (gender, education) and health measures (grip strength, number of chronic diseases). Women and individuals with higher levels of education, higher grip strength and fewer chronic diseases exhibited better episodic memory performance, and the association of grip strength with episodic memory was stronger in later-born cohorts. Our findings suggest that countries differ in the extent and direction of historical change in episodic memory scores and trajectories. More research is needed to better understand why the Flynn effect in the U.S. seems to be reversed.
TRAINING CAREGIVERS TO BE INFECTION PREVENTION SUPERHEROES WITH PROJECT FIRSTLINE
Authors: Ham Carolyn , Schuh Madyson , Rogers Megan , Ellis Erica 
Published: January 2025

Abstract
Facility-acquired infections in long-term care facilities (LTCF) significantly affect resident’s safety and quality of life. Caregiving staff in LTCF are uniquely positioned to prevent infections by completing infection prevention and control (IPC) activities, including hand hygiene and using personal protective equipment. An IPC Needs Assessment (NA) survey was conducted in 2021 by the Washington State Department of Health (DOH) and University of Washington (UW) with 3,308 frontline healthcare respondents. Respondents from LTCF caregivers indicated a preference for self-paced, asynchronous learning experiences and ranked COVID-19 as the most interesting IPC topic. DOH partnered with UW and the Centers for Disease Control and Prevention to develop six Project Firstline Modules (PFM) on IPC topics. Drawing on adult learning theory principles, training content was developed with a focus on the needs and lived experience of caregivers. Each module was offered in English and Spanish and incorporated an instructional video, interactive scenario, job aid, and evaluation. Between February and December 2023, 589 LTCF caregivers completed modules, comprising 62.93% of all users, with the majority (97.3%) reporting that the information was easily understandable and 88.2% reporting they would be able to apply what they learned to their job. PFM completers reported the highest satisfaction for the module on respiratory droplets, consistent with the NA results. The delivery of PFM successfully provided actionable and accessible IPC training for LTCF caregivers. Future efforts to educate caregivers on IPC should consider their preferences in training modes and topics, and further explore public health and academic partnerships.
CONTEXT MATTERS: THE IMPACT OF ENVIRONMENT, MOOD, AND FATIGUE ON MOBILE COGNITIVE ASSESSMENTS
Authors: Wilks Hannah , Welhaf Matthew , Aschenbrenner Andrew , Morris John , Hassenstab Jason 
Published: January 2025

Abstract
To better understand the aging process and the subtle cognitive changes that occur in preclinical Alzheimer disease (AD), researchers are using technology to remotely measure cognition. We examined how concurrent environmental context, mood, and fatigue are associated with cognition in older adults at risk for AD. Participants (N = 288) were recruited from the Knight Alzheimer Disease Research Center (Mage = 75, RangeAge= 61-97). Cognition (e.g., associate memory and processing speed), context (e.g., with whom, where, activities prior to assessment), and current affect (e.g., mood, and fatigue) were measured contemporaneously on a smartphone-based application up to 28 times over a week in naturalistic environments. Clinical status was determined using the Clinical Dementia Rating □ (CDR□). Cognition at each assessment was predicted by contextual- and affect-related factors, and their interaction with CDR, while controlling for age, gender, education, and time in study. Associate memory and processing speed were worse in the presence of others, when assessed in locations other than home, and after engaging in sedentary behavior. Affective states were not associated with cognition. These effects were magnified in participants with very mild dementia symptoms, particularly for processing speed. Environmental and affective factors can influence memory and processing speed in older adults at risk for AD. Distracting environments were particularly problematic for individuals currently experiencing mild dementia symptoms. Studies of AD risk that rely on remote, unsupervised cognitive assessments should carefully assess and consider concurrent contextual factors when examining cognition.
UNREPRESENTED TO FLUSH-WITH-FAMILY: THE ROLE OF FAMILY STRUCTURE ON DEMENTIA CARE BY RURALITY
Authors: Utz Rebecca , Iacob Eli , Hollingshaus Mike , Bouldin Erin , Cudjoe Thomas , Miller Katherine , Farrell Tim , Ornstein Katherine 
Published: January 2025

Abstract
U.S. policy and clinical practice increasingly recognize the value and essential role that family caregivers play in planning and delivering long-term care, especially in the context of dementia where cognitive decline leads to practical and legal needs to rely on others (most often family) to serve as caregivers and surrogate decision makers. Given the preference of older adults to age-in-place and that younger generations commonly move away from rural areas, access to family support may characteristically differ across those living in urban versus rural areas. This study uses the Utah Caregiving Population Study (C-PopS), a unique population-based data resource that links administrative and health records with genealogical data, to describe the size and structure of first-degree family (FDF) members (spouse, child, sibling) associated with a cohort of persons aged 65+ who died with dementia in Utah, stratified by rural (n=11,105) vs. urban (n=38,099) geographic small-areas. Compared to those in urban areas, persons with dementia in rural settings were more likely to be married (39.3% versus 35.2%), but less likely to have adult children in the state (61.9% versus 67.9%). About one in five rural older adults with dementia (20.1%) were unrepresented (defined as no FDF present in the state), compared to about 17% of those in urban areas. Understanding rural-urban differences in how family structure characteristics are associated with distinct patterns of dementia care, including use of hospice and care transitions at end-of-life, will help inform health policy and future interventions targeting the unique needs of this vulnerable population.
LATE-LIFE SINGLEHOOD AND WELL-BEING: THE ROLE OF MARITAL STATUS AND SOCIAL RESOURCES
Authors: Ghose Urmimala , Park Rinseo , Smith Jacqui , Ram Nilam , Gerstorf Denis 
Published: January 2025

Abstract
Singlehood has long been identified as a potential risk factor for undermining well-being across adulthood, particularly in older ages. However, it is an open question what role other social resources may play. In the current study, we examine whether and how older adults experiencing marital transitions through divorce and spousal bereavement differ from their never married and continuously married peers in their well-being trajectories and in the roles that social support and strain play. We used six waves (2008 – 2018) of longitudinal data from 7,670 participants (Mage = 66 years, 56% women, 75% White) of the Health and Retirement Study (HRS). We also employed synthetic cohort matching to equate the groups on relevant background factors. First results of multi-level models revealed that bereavement trajectories were characterized by a steeper transition-related rise in depressive symptoms than the divorce trajectories, but also by a sharper drop in subsequent years. Both transition groups showed declines in depressive symptoms in the years after the event, yet those who had experienced divorce reached average levels of their continuously married peers after about three years, whereas the bereaved group continued to lag behind even after six years post-spousal loss. Overall, we found little evidence that the relevance of social resources for well-being trajectories differs across marital status groups. As one exception, we found that the predictive effects of strain from family and friends for elevated depressive symptoms was particularly pronounced among those who had experienced spousal loss.
STRATEGIES AND TOOLS TO MAKE THE INVISIBLE VISIBLE IN HOSPITAL CARE
Authors: Golden Blair , Fields Beth , Berian Julia 
Published: January 2025

Abstract
Family caregivers (relatives, partners, or other support persons) provide critical support during hospitalization events for older adults, ranging from providing companionship and emotional support to coordinating discharge planning. Despite their essential role in hospital care delivery, family caregivers often feel invisible and poorly integrated into hospital care teams. Recognizing this gap, the 2022 National Strategy to Support Family Caregivers was created by federally mandated advisory councils with public input. Goal 2 of this National Strategy consists of advancing partnership and engagement with family caregivers, including recognition of family caregivers as essential care team partners and inclusion of family caregivers within care plans. In response to Goal 2, this symposium will present innovative strategies and tools to advance partnerships and engagement with family caregivers within hospital-based care. Dr. Vick will present findings from a qualitative systematic review of family caregiver involvement during hospitalizations of older adults, leading to development of a conceptual model of family caregiver roles within hospital settings to guide future interventions. Ms. Hoel will discuss findings from a qualitative study identifying organizational barriers to family caregiver inclusion in the hospital care of people living with dementia. Dr. Scheunemann will discuss development of the ICU Family Workbook (a publicly available resource for family caregivers navigating critical illness), including results from content validity and user testing. Dr. Golden will present research findings on current practices and gaps with regards to caregiver and patient discharge education about delirium, a common condition affecting hospitalized adults.
REDUCING SERIOUS FALL INJURIES IN OLDER ADULTS: RESULTS OF A MULTICENTER WEARABLE TECHNOLOGY STUDY
Authors: Kinosian Bruce , Stefanacci Richard 
Published: January 2025

Abstract
Falls remain an immense public health concern for our growing aging population, causing over 3 million ER visits annually. With falls that result in hip fractures having devastating consequences for older adult health and independence, new solutions are urgently needed. This study evaluated the real-world effectiveness of the Tango® Belt, an innovative wearable device aimed at preventing serious fall injuries. In this six-month, comparative, adaptive study with historical controls conducted across 10 communities located in PA and CA, older adults used sensor-embedded belts alongside standard fall mitigation protocols. When worn during a potentially harmful fall, the belt deploys an airbag to cushion impact. We compared fall outcomes in the belt users (N=134) to propensity score matched historical controls (N=264). Analysis of fall events between the matched groups demonstrated similar rates of falls (p=0.081), but a significant reduction in the proportion of major hip injuries in the intervention versus the control group (1.1% vs 12.1% p=0.004) demonstrating a protective effect of 90.9% against hip fractures/dislocations due to serious hip-impacting falls. Further analysis reveals that the proportion of hospitalizations (8.2% vs 18.9% p=0.004) and ED visits (6.0% vs 17.8% p=0.0001) were also significantly reduced in the intervention vs control group. With compliance recorded at 67% across subjects and no serious AE’s noted related to the device, such “smart garments” address known compliance barriers with passive hip protectors. With serious fall injuries expected to exponentially rise with population aging, the study provides promising evidence for future use of disruptive innovations like Tango Belt.
CHARACTERIZING MUSIC PARTICIPATION FOR ADULTS WITH DOWN SYNDROME
Authors: Dorris Jennifer 
Published: January 2025

Abstract
Adults with Down syndrome (Ds) are living longer and have high risk of experiencing cognitive decline as they age. Unfortunately, few services are available to support aging adults with Ds and their care partners. Music is a safe, engaging intervention modality that has shown promising results for older adults experiencing cognitive decline. This study reported on adults with Ds’ frequency and type of music participation and described support provided by care partners. Additionally, the study explored associations of age, race, or level of intellectual disability associated with music participation. Care partners of adults with Ds (n =27) completed a survey that measured “listening” and “playing music” using the Guernsey Community Participation and Leisure Assessment. 92.6% of adults with Ds listened to music weekly or daily. 74.1% of care partners listened to music as an unaccompanied activity. 33.3% of adults with Ds played music either weekly or daily, and 48.2% of care partners described playing music as an unaccompanied activity. A significant association was found between race and playing music, but there were no significant associations between age, intellectual disability level, and music participation for adults with Ds. Knowing that racially minoritized adults with Ds had a higher frequency in playing music, those developing services and supports could consider utilizing music as a meaningful activity. Additionally, due to the lack of associations between age and intellectual disability, music programs could be developed equitably for changes in age and intellectual disability level, creating inclusive activities for this growing population of older adults.