bluuebunny/crossref_metadata_2025_split huggingface dataset:
USING INFORMATICS AND GENERATIVE AI TO SUPPORT OLDER ADULTS’ UNDERSTANDING OF LAB TEST RESULTS
Authors: He Zhe , Bhasuran Balu , Jin Qiao , Tian Shubo , Hanna Karim , Lu Zhiyong 
Published: January 2025

Abstract
Viewing laboratory test results is the most frequently used function of patient portals, but lab results can be confusing for patients. In this project, we aim to gain insights into older adults’ challenges in understanding lab test results. To achieve the goals, we first conducted an online survey with 276 patients with one or more chronic conditions. We found that younger adults and patients who had never used patient portals had significantly lower lab test comprehension scores compared to older adults, and those with higher numeracy or with no multiple chronic conditions. Even though older adults performed better on lab test comprehension tests, most reported they have difficulty understanding lab results online and prefer that their doctors explain these to them. In the second study, we selected 53 lab results-related questions from a community Q&A website, Yahoo! Answers, and evaluated the answers to these questions from four generative large language models. We utilized a ChatGPT-based evaluator Win Rate to judge whether a target model has higher quality in terms of relevance, correctness, helpfulness, and safety than the baseline model. Then, we performed a manual evaluation with medical experts for all the responses to seven selected questions on the same four aspects. The results of Win Rate and medical expert evaluation both showed that GPT-4’s responses achieved better scores than all the other LLM responses from LLaMa 2, ORCA_mini, and MedAlpaca and human responses on all four aspects. However, LLM responses occasionally suffer from incorrect statements.
MANAGEMENT OF NEURODEGENERATIVE DISEASES: APPLICATION OF MULTIMODAL, EXPERT-INTERACTIVE AI VERTICAL MODELS
Authors: Mao Junyan , Tong Jialiang , Huang Weidong , Li Hongyu 
Published: January 2025

Abstract
This study proposes a comprehensive management model for neurodegenerative diseases, leveraging multimodal, expert-interactive AI vertical models to tackle the challenges of environmental dependency, temporal constraints, and data singularity. The model aims to enhance patient prognosis, quality of life, and survival. Our research methodology unfolds in three phases: The first step involves conducting a bibliometric analysis to integrate findings from existing studies. The second phase “Early Detection and Prediction,” leverages computer vision (CV) and natural language processing to gather multimodal biomarker data, including voice, gait, vision, hearing, and PET scans. Data is analyzed using machine learning (such as SustaIn, Random Forests, and Support Vector Machines) and deep learning techniques for robust data modeling. The final step, “Effectiveness Verification,” entails executing randomized controlled trials (RCTs) with a triple-blind setup—ensuring blindness among participants, researchers, and assessors—to rigorously evaluate the developed model’s effectiveness. The research involved five-year data from 304 individuals aged 65 and older with neurodegenerative diseases. Objective biomarker data were collected through CV and sensors to facilitate early identification and diagnosis of neurodegenerative diseases. A sophisticated platform facilitated real-time monitoring of mental and behavioral symptoms and activities of daily living at disease onset, integrating both pharmacological and non-pharmacological interventions via advanced language models for holistic disease management. Utilizing dynamic video analysis and machine learning evaluations, the model significantly mitigated the progression of cognitive and physical impairments, enhanced quality of life, and decreased mortality rates, affirming the preliminary efficacy of the comprehensive management model.
THE MEDIATING ROLE OF SOCIAL ISOLATION BETWEEN FALLS AND COGNITIVE FUNCTION AMONG OLDER ADULTS IN THE UNITED STATES
Authors: Jung Wonkyung , Taylor Janiece 
Published: January 2025

Abstract
Social isolation and falls are significant concerns affecting the cognitive health of older adults. However, little is known about the interrelationships between social isolation, falls, and cognitive function among older adults in the United States (U.S.). This study aims to investigate the interrelationships between these factors and the mediating role of social isolation on the relationship between fall experiences in the past 12 months and cognitive function among older adults in the U.S. Utilizing Round 5 data from the National Health and Aging Trends Study (NHATS), we employed linear regression models using Hayes’s PROCESS macro with 5,000 bootstrapped mediation analyses in SPSS. Of the 947 participants, 60.8% were younger than 75 years, 38.6% were women, and most (77.1%) were White. Our findings revealed that social isolation did not mediate the relationship between falls and cognitive function. Additionally, we found no significant association between fall experiences and both social isolation and cognitive function. However, our analysis identified that socially isolated older adults were more likely to experience cognitive impairments (β =.84, P &lt;.001). These results highlight the complex nature of the relationships among social isolation, falls, and cognitive function in older adults. Further research is warranted to explore potential mechanisms underlying the observed associations and to develop targeted interventions to address cognitive impairments among socially isolated individuals. Strategies targeting social connectedness may have promising implications for promoting cognitive health in older adults in the U.S.
PILOT OUTCOMES OF A FALL PREVENTION PROGRAM “LIVE-LIFE” FOR COMMUNITY-DWELLING OLDER ADULTS IN CHINA
Authors: Luo Yuqian , Mo Cen , Peng Wenting , Szanton Sarah , Liu Minhui 
Published: January 2025

Abstract
More than 70 million older adults fall at least once each year in China, which may lead to disability, fear of falling, social isolation and even death. We conducted a pilot randomized controlled trial to evaluate the preliminary effects of the multi-component LIVE-LiFE program on health-related outcomes among community-dwelling older adults in China. Thirty-Eight participants, average 70.32 years old, 76.3% of female, were randomized to either the intervention group (n=20) or the control group (n=18) for 11 weeks. In the intervention group, participants received the LIVE-LiFE program (individualized strength and balance training, vision screening, medication review, and home hazards assessment and modification), whereas the control group received equal amounts of health education on fall prevention. To compare the differences of pre-post scores between two groups, we employed two independent sample t-test and independent sample Wilcoxon signed-rank test. Results indicated significant differences and moderate effect sizes on 3-meter walking speed (P&lt; 0.001, d =-0.603) and home hazards (P=0.043, d=-0.504). The paired t-test and paired Wilcoxon signed-rank test were used to examine the paired LiFE assessment data of the intervention group. Significant improvements were observed on the total scores (P&lt; 0.001, d=1.260), balance function dimension scores (P&lt; 0.001, d=0.962), and strength function dimension scores (P=0.002, d=0.776). Our study showed positive preliminary effects of the LIVE-LiFE program on improving both personal function and environmental safety. Future research should consider both internal and external factors to prevent falls among community-dwelling older adults with larger sample sizes and longer follow-up.
EMOTIONALLY MEANINGFUL GOALS IN LATE ADULTHOOD
Authors: Fung Nicole , Fung Helene H 
Published: January 2025

Abstract
Our perception of time greatly affects what kinds of goals we value and pursue. The socioemotional selectivity theory (SST; Carstensen, 1992; Carstensen et al., 1999) posits that people rearrange their goals in response to a limited future time perspective as they become older. Rather than investing in a limited and uncertain future, older adults will value and prioritize present-oriented emotionally meaningful goals over future-oriented goals. The SST literature thrived in the past three decades and emotionally meaningful goals were operationalized in various ways under different contexts. To better understand the changes in motivation when future time perspective becomes limited, we reviewed the empirical articles that formulated hypotheses according to the SST framework published since 1992. We identified different types of emotionally meaningful goals in the literature. The most prevalent type of emotionally meaningful goal in the literature is the pro-hedonic goal (preference towards positivity over negativity). Other types of emotionally meaningful goals include the pro-closeness goal (preference towards emotional closeness in social relationships), the prosocial and generativity goal (increased motivation to contribute to others), the social goal (increased importance in the social domain), the emotional goal (increased importance in the emotional domain), the self-maintenance goal (increased motivation for the intrinsic and self-concordant goal) and the meaningfulness goal (increased importance in meaningfulness). The empirical evidence of each goal will be reviewed and their relations to SST and a limited future time perspective will be discussed.
LONGITUDINAL ASSOCIATIONS BETWEEN TIME PERSPECTIVE AND LIFE SATISFACTION ACROSS ADULTHOOD
Authors: Wirth Maria , Wettstein Markus , Rothermund Klaus 
Published: January 2025

Abstract
Subjective representations of time are an important predictor of well-being. How time is structured and represented in individual behavior and experience, is itself subject to developmental change. Young adults focus on preparing for their future, whereas during midlife, shifts towards a more present-oriented time perspective should arise. Realizing that important life goals may no longer be achievable should lead older adults to detach themselves from these goals and focus more on present and past experiences. These age-related changes in time perspective supposedly are associated with greater well-being. Previous studies, however, yielded heterogeneous results. However, these studies mostly investigated only one dimension of time perspective and did not include younger and/or middle-aged adults. To overcome these limitations, we investigated how changes in four facets of time perspective (orientation towards the past, concreteness of the future, obsolescence, and finitude of life) are related to changes in life satisfaction and whether these associations are moderated by chronological age. We used data from an age-diverse sample comprising 459 participants (30 – 80 years) of the “Aging as Future” (AAF) study comprising three measurement occasion over 10 years. Longitudinal multilevel regressions indicated that individuals with overall higher concreteness and lower obsolescence reported higher life satisfaction. Additionally, individuals reported higher life satisfaction on measurement occasions when they scored higher on concreteness. These associations were not moderated by age, which questions the idea of age-differential associations between time perspective and well-being. Our study provides a deeper understanding of the relation between time perspective and well-being across adulthood.
INVESTIGATING SOCIAL DETERMINANTS OF HEALTH IN ASIAN AMERICANS AND PACIFIC ISLANDERS
Authors: Zheng Yaguang , Jiang Yanping , Wu Bei 
Published: January 2025

Abstract
Asian Americans and Pacific Islanders (AAPI) are one of the fastest-growing racial minority groups in the United States, who disproportionately experience some unfavorable social determinants of health (SDoH), such as limited English proficiency, unemployment, lack of health insurance, low health literacy, lack of culturally and linguistically sensitive healthcare providers and programs, and reduced healthcare access. However, limited research has explored the impacts of SDoH on health outcomes among this population. The objective of this symposium is to address knowledge gaps by examining the association of SDoH with various health outcomes in AAPI. Jiang and colleagues explore the immigration stressors and sleep health among older Chinese immigrants using the longitudinal data from the Population Study of Chinese Elderly in Chicago. Qi and colleagues examine the prospective associations of multiple SDoH with premature all-cause mortality and investigate their respective contributions among a nationally representative cohort of Asian Americans. Further, Wang et al. discuss the challenges and successes in recruiting Chinese and Korean American dementia caregivers living in minority and underrepresented communities for a large health intervention study. Lastly, Kim & colleagues examine the end-of-life care disparities for AAPI Medicare beneficiaries with dementia using Medicare data. Following the paper presentations, Dr. Wu will lead a discussion. The novel findings from this symposium will provide a comprehensive understanding of how SDoH impacts health outcomes in AAPI and how unique SDoH can be particularly targeted to improve health equity for this underserved ethnic minority group.
ENGAGING CHINESE AND KOREAN AMERICAN COMMUNITIES IN DEMENTIA RESEARCH: A JOURNEY OF INCLUSIVITY AND PARTNERSHIP
Authors: Wang Jing , Mittelman Mary , Leong I Tek , Park Sung Ji , Qi Xiang , Pei Yaolin , Epstein Cynthia , Wu Bei 
Published: January 2025

Abstract
The NYUCI-ES Project, designed to deliver a family-based psychosocial intervention to enhance social support and reduce cardiometabolic disease risk for Chinese and Korean American dementia caregivers, has developed and undertaken a culturally sensitive recruitment strategy. Our navigation through the journey has shed light on the challenges and successes faced when recruiting in these minority and underrepresented communities. Common challenges include reluctance of involving other family members, stigma towards dementia and the concept of family counseling. Encountered challenges prompted us towards multiple efforts to engage the communities, including leveraging online communities, building strategic partnerships with local community organizations, participate in local events and make presentations at local service agencies, and working with community partners to adapt recruitment messages and methods to better align with cultural norms and preferences. For example, we replaced the term “counseling” with “family meetings” and used “memory issues” rather than “dementia” and emphasized the practical benefits and the opportunity for children to practice filial piety. For the Chinese community, our strategies focused on initiating the conversations with practical skills rather than directly discussing emotions. For the Korean community, framing the intervention in terms of discussing caregiving strategies while highlighting the personal and social benefits of participating in the study has helped lower the rejection rate. Our journey highlights the importance of culturally sensitive recruitment strategies in dementia research and demonstrates the potential for greater engagement and participation when communities are approached with respect, sensitivity, and an understanding of their unique cultural dynamics.
LONGEVITY IN CULTURAL CONTEXT: FINDINGS FROM FOUR CENTENARIAN STUDIES
Authors: Martin Peter , Poon Leonard 
Published: January 2025

Abstract
Life expectancy varies across cultural and international groups, but each culture contains long-lived individuals. To what extent survivors in different cultural groups have common or divergent characteristics is still being determined. The purpose of the symposium is to compare and contrast physical, functional, and mental health characteristics among four different cultural groups of centenarians: African American centenarians from the Health and Retirement Study, Hawaii centenarians of Japanese ancestry from the Kuakini Hawaii Centenarian Study, Japanese centenarians, and Native Americans from the Oklahoma Centenarian Study. The first study showcases longevity predictors for African Americans in the Health and Retirement Study, highlighting family longevity, individual and family resources, health behaviors, and physical, functional, and mental health. The second study utilizes centenarian data from the Kuakini Hawaii Centenarian Study, featuring their unique survivorship characteristics as participants age from 70 to 100 years. The third presentation highlights Japanese centenarians and reveals the diversity of physical and mental well-being of centenarians in Japan. Findings highlight the high bed-bound ratio among centenarians in Japan. Finally, the Oklahoma Centenarian Study identifies themes pertaining to underlying cultural influences using oral narratives of centenarian descendants of indigenous ancestry. The themes of “transmission of historical trauma,” “shared collectivism,” “leisure and sporting,” and “educational attainment“signify themes of adaptation and survival. The four centenarian studies suggest similarities and essential differences when comparing these exceptional cultural groups of survivors. Practitioners and policymakers should be responsive to the diverse needs of centenarians who provide cultural individuality to their communities.
UNVEILING LONGEVITY INSIGHTS: AFRICAN AMERICAN OLDER ADULTS IN THE HEALTH AND RETIREMENT STUDY
Authors: Nicholson Meneka Johnson , Martin Peter 
Published: January 2025

Abstract
Although there is considerable longevity literature, few studies have focused on African American older adults. The current study assessed different domains of longevity predictors for African American participants in the Health and Retirement Study. A total of 723 African Americans (Mage = 68.2) who participated in wave 2 of the HRS were included in this study. Family longevity, individual and social resources, health behaviors and health were used to predict their age at death (Mage = 79.5). A blockwise multiple regression was used for the analyses. Results indicate that father’s and mother’s age at death did not predict longevity. Education and number of children were significant predictors when added as a second block (β = -.24, p &lt;.05 and β =-.13, p &lt;.05, respectively). Of the next block, body-mass index and smoking (β = -.10, p &lt;.05 and β =-.26, p &lt;.05, respectively), but not alcohol intake, added significantly to explaining longevity. Four specific health markers (i.e., self-rated health, high blood pressure, diabetes, and multimorbidity, β = -.08, p &lt;.05, β =.30, p &lt;.05, β = -.26, p &lt;.05, β =-.29, p &lt;.05, respectively) all added significantly to the explanation of longevity. The two final blocks (ADL functioning and level of depression), did not add significantly to the equation. On the whole, the model explained 35 percent of the variance. The results are important for African Americans, policymakers and practitioners as they can help identify risk and resilience factors of longevity.
NAVIGATING PAYMENT, POLICY, AND HEALTH SYSTEMS: HOW THE ORGANIZATION OF PAID CARE AFFECTS WORKERS AND FAMILIES
Authors: Franzosa Emily 
Published: January 2025

Abstract
The complex structure of paid personal and home care services can cause confusion and frustration for families as they navigate multiple payers and providers to get the care they need. At the same time, the fragmented industry structure, combined with low reimbursement for paid care services, leads to poor quality jobs and high workforce turnover for paid caregivers themselves. While the COVID-19 pandemic laid bare existing fault lines in paid care delivery, it also suggested promising avenues for intervention. This symposium explores organizational factors that may improve stability of the paid care workforce. First, we explore the impact of wages. Miller et al describe the impact of state policies such as hazard pay in stabilizing the workforce shortage during COVID-19, while Jiyeon Kim’s innovative analysis examines whether holding multiple direct care jobs, which is common given the often part-time nature of paid care work, can lift workers out of poverty. Next, Patricia Kim and colleagues use integrated electronic medical record and interview data to explore the organization of paid care at end of life through the experience of patients receiving hospice care during the pandemic. Finally, Walkner et al share a promising pilot in the Veterans Health Administration to integrate paid caregivers into health systems by hiring them directly into health care teams. Together, this research highlights innovative avenues to improve pay, job stability and other key measures that may stabilize the workforce and reduce complexity in the paid care system.
THE COMBINED EFFECTS OF SMOKING, DRINKING, AND PHYSICAL ACTIVITIES ON THE COGNITIVE HEALTH OF OLDER ADULTS
Authors: Su Yan-Jhu , Dugan Elizabeth , Avila Jaqueline 
Published: January 2025

Abstract

Background
Poor health behaviors such as smoking tobacco, alcohol consumption, and limited physical activity may be associated with poor cognitive health. Unhealthy behaviors often co-occur, and little research has examined the combined or cumulative effects of unhealthy behaviors on cognitive health. This examines how common health behaviors may co-occur and their associations with cognitive health among older U.S. adults.

Methods
This cross-sectional study used 2018’s Health and Retirement Study (HRS) data, including 7,467 respondents aged 65 and older. Cognitive function scores were assessed with the Telephone Interview of Cognitive Status-Modified. Health behavior combinations were assessed, including smoking status, drinking amount, and frequency of physical activities. Linear regression was used to examine the association between different health behavior combinations and cognitive function.

Results
The most common combinations were healthy ones: never smoking, no drinking, and high-level physical activity (15.47%; reference group). All combinations with a prevalence of less than 2% were combined as “other” combinations. Compared to the reference group, respondents who never smoked, had no drinking, and had no physical activities had lower cognitive function (b = -1.13, 95% CI: -1.56, -0.71). Other unhealthy combinations that impacted cognition were never-smoked, had no drink, and low physical activities; and former smokers had no drink and low physical activities.

Conclusions
This cross-sectional study found that high levels of physical activity and some drinking are associated with better cognitive health, while smoking was associated with poorer cognitive health. Policies to promote physical activity across the lifespan may be promising avenues to pursue.