bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXAMINING COGNITIVE FUNCTION IN BEREAVED OLDER PARENTS: THE MEDIATING ROLE OF DEPRESSIVE SYMPTOMS
Authors: Rubinstein Stephanie , Zelinski Elizabeth 
Published: January 2025

Abstract
Losing a child is a unique and exceptionally traumatic experience, often resulting in chronic and severe depressive symptoms. This is of increasing concern as the loss of adult children has become increasingly more common since 2010. Bereaved parents represent a psychologically vulnerable group about whom we know relatively little. In this study, we use data from a nationally representative sample of 5,265 community-dwelling older adults over age 50 from the Health and Retirement Study (HRS) to examine the relationship between child loss, depressive symptoms, and cognitive function. We hypothesize that being bereaved is significantly associated with worse cognitive scores and that this relationship will be mediated by the number of reported depressive symptoms. We conducted a cluster-adjusted path analysis on repeated cross-sectional data from 1995-2020. Controlling for sociodemographic and health factors, our findings confirmed these expectations. Both bereaved individuals and those with depressive symptoms exhibited significantly worse cognitive scores, respectively (β=-0.20, p&lt;.001; β=-0.15, p&lt;.001). Bereaved individuals were also significantly more likely to report depressive symptoms (β=0.09, p=.001). Depressive symptomology was found to partially mediate the relationship between bereavement and cognitive function, explaining approximately 7% of the variance. These results suggest that losing a child is associated with poorer cognitive function in older adults. This relationship is partially explained by the presence of depressive symptoms, likely associated with said loss. Our findings highlight the importance of addressing mental health concerns, such as depressive symptoms, within the context of bereavement to mitigate potential adverse effects of cognitive well-being in later life.
PROLONGED GRIEF DISORDER IN ADULTS OVER 65: A REVIEW IN LIGHT OF POST-COVID-19 LOSSES
Authors: Friedland Hannah , Stripling Ashley , Crocker Jillian 
Published: January 2025

Abstract
Prolonged Grief Disorder (PGD) entered the DSM-5-TR in 2022, standardizing criteria and research. As COVID-19 continues to disproportionately affect adults over 65, both directly and by disrupting traditional grieving rituals, understanding PGD in this group is essential. The review seeks to synthesize existing research on PGD in adults over 65 to guide research and practice. A PRISMA review utilizing “older adults” and “prolonged grief disorder” was conducted within APA PsychInfo and Google Scholar from 2013 to 2023. All English-language journal articles relating to the area of study were read, and relevant exclusion criteria were applied (i.e., empirical, mean age &gt;65, prolonged grief symptoms for &gt;1 year). Among the 15 articles meeting inclusion, PGD prevalence rates ranged between 0.5% and 21%. Participants were predominantly White women recruited from community and hospice samples. PGD risk factors included preexisting depression and type of relationship with the deceased, with the highest incidence rates following partner or child deaths. Co-occurring symptoms included sleep disturbances, lower quality of life, loneliness, and dysregulated cortisol. Given PGD’s addition to the DSM and inconsistent prevalence rates, accurate diagnosis and effective treatment are imperative, particularly for more impacted groups. Notably, death rates from COVID-19 are disproportionate among age, race, and ethnicity. As a true understanding of how PGD manifests in adults over 65, future research is warranted following the COVID-19 pandemic. Implications of the current presentation include translating findings into recommendations focused on the provision of adapted PGD interventions and assessments for adults over 65.
PUBLIC ATTITUDES TOWARD PHYSICIAN-ASSISTED DYING: A CROSS-SECTIONAL SURVEY IN TAIWAN
Authors: Chen Duan-Rung , Wu Kevin Chien-Chang , Kuo Chun-Tung 
Published: January 2025

Abstract

Purpose
This study aims to assess public attitudes towards Physician-Assisted Dying (PAD) in Taiwan, where legal support for PAD is notably absent despite its public endorsement in broader Asia, including Japan, South Korea, and China. Method: Utilizing an online survey, we gathered data from 3,922 Taiwanese adults from August to November 2022 to evaluate their support for PAD across different contexts: terminal illnesses, unbearable non-terminal pain, and severe cognitive impairments.

Results
The findings revealed substantial support for PAD, with 86.2% in favor of terminal illnesses, 79.2% for unbearable non-terminal pain, and 72.6% for severe cognitive impairments. Support for PAD correlated with younger age, male gender, lower levels of religiosity, non-medical professional background, and a positive attitude towards advance directives.

Conclusion
The public attitudes towards Physician-Assisted Dying (PAD) in Taiwan reveal a significant cultural transition towards valuing individual autonomy in end-of-life decisions. The study indicates a cultural shift towards valuing individual autonomy in end-of-life decisions among the Taiwanese public. It underscores the need for policymakers to align legal frameworks with public opinion on PAD, emphasizing the prioritization of individual rights in end-of-life care.
“UKE CAN DO IT”: A REFLECTION ON A UKULELE CLASS INITIATIVE FOR OLDER ADULTS LIVING WITH DEMENTIA AND CARE PARTNERS
Authors: Wong Joey , Fu Jason , Gregorio Mario , Hung Lillian 
Published: January 2025

Abstract
Individuals with different stages of neurocognitive disorder or dementia respond to music even at later stages of the diagnosis. Music can offer collective experiences for people from diverse cultural backgrounds who have dementia. However, limited studies explore the journey of learning musical instruments by people living with dementia. Our team, co-led by a person living with dementia, initiated a 12-week basic ukulele program to explore the potentials of music and learning to foster social connections, alleviate loneliness and bring joy to older adults living with dementia and their care partners in Vancouver, British Columbia. Eighteen older adults from diverse backgrounds (15 individuals living with different stages of dementia and three care partners) participated in the classes facilitated by a ukulele instructor. Our team critically reflected on the ukulele program based on the in-class observations and summaries from the instructor through multiple in-person and Zoom meetings. The reflection resulted in five themes: 1) Social connections through music, 2) Respite for care partners, 3) Peer support and empowerment to contribute to collective learning experiences, 4) An emphasis on enjoyment over skills, and 5) Inclusiveness in creating programs for people living with dementia. This innovative ukulele program shows the positive impact of music and collective learning. The team reflections highlight the potential of offering musical instrument programs for older adults living with dementia and their care partners to alleviate loneliness and foster social connections. Future research can investigate the long-term impact of group musical learning on individuals living with dementia and care partners.
ACCEPTABILITY AND FEASIBILITY OF IMPLEMENTING THE DEMENTIA CARE PRACTICE RECOMMENDATIONS IN CARE COMMUNITIES
Authors: Kim Boeun , Belza Basia , Prophater Lorna , Waddington Emily , Johnson Shawn , Fazio Sam 
Published: January 2025

Abstract
With growing numbers of residents living with dementia in care communities, providing quality care is challenging. Alzheimer’s Association developed an intervention to increase the adoption of person-centered care in care communities using a coaching approach based on the Dementia Care Practice Recommendations (DCPR). A cluster randomized-controlled study has been implemented to evaluate the intervention since December 2022. This study aims to report interim findings. Care communities in an intervention group met with a coach monthly over 6 months to assess the level of adoption of DCPR and increase and maintain person-centered care practices. Care communities in a control group received monthly emails not relevant to person-centered care. Employee satisfaction (job satisfaction, team building and communication, scheduling and staffing, training, management and leadership), person-centered practices (workplace practices, individualized care and services, caregiver-resident relationships), and confidence in dementia scale were assessed pre-intervention (time1), post-intervention (time2), and 3-month follow-up after completion of the intervention (time3). As of February 2024, 292 care providers from 53 care communities enrolled, 164 care providers from 35 care communities completed the 6-month intervention, and 113 care providers from 25 care communities filled out 3-month follow-up assessments. We found that scheduling and staffing satisfaction (time3), management and leadership satisfaction (time3), overall employee satisfaction (time3), and person-centered practices in individualized care and services (time2 and 3) were significantly higher in intervention groups than control groups according to generalized estimating equation estimates. This study provides preliminary evidence of the efficacy of the DCPR intervention in promoting employee satisfaction and person-centered practices.
CHALLENGES IN SUPPORTIVE CARE DECISION-MAKING IN THE CONTEXT OF ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Taylor Jean , Turner Anne 
Published: January 2025

Abstract
In the United States, persons with ADRD face multiple decisions regarding supportive care transitions; however, their involvement in decision-making often declines as their condition progresses. The aim of the Decision Making in Alzheimer’s Research (DMAR) study is to center the voice of persons with dementia by understanding preferences and key factors influencing supportive care decisions. We conducted in-depth online interviews (n=79) with 24 older adults with dementia (aged 65 years and older), 37 informal caregivers, and 18 professionals who work with individuals with dementia. Interviews focused on decision making and identifying factors that related to supportive care decisions. Qualitative analysis of interview transcripts revealed that persons with dementia and caregivers were often not ready to think about or plan for supportive care changes. Challenges participants described in moving forward in planning supportive care included lack of understanding or acceptance of the diagnosis, inability to imagine future scenarios, and lack of openness to planning for the future. Tailored information about the course of dementia and potential future care options are needed. Suggestions by professionals for the best timing for provision of a decision tool ranged from “as soon as possible” to “soon after diagnosis”. Some professionals emphasized the need for ongoing conversations with trusted medical professionals as the disease progresses. Our study highlights the importance of early, tailored, and ongoing support in transition planning. We will share specific suggestions for how and when to implement a decision-making tool to assist with decisions about possible future needs.
COMMUNITY-BASED DEMENTIA SCREENING AND SUPPORTIVE SERVICES
Authors: Wilson Traci , Ek Mary 
Published: January 2025

Abstract
Early detection of dementia is important to help consumers and caregivers access information, treatment and supportive services. The majority of people living with dementia (PLWD) live at home and in the community. Community-based aging services providers, such as Area Agencies on Aging (AAAs), are positioned to play a critical role in screening for cognitive impairment or dementia and referring individuals for medical cognitive assessments. Past surveys have shown that AAAs provide specialized services for PLWD and caregivers, but little is known about the prevalence of screenings and the process for referrals. This poster shares findings from a 2024 survey of AAAs about their dementia screening and supports (n=180, response rate 28%) describing the formal and informal cognitive screening, assessment, and referral services that AAAs provide, the feedback available to consumers and the agency after referrals are made, and the types of services and supports available that are tailored specifically for PLWD. The most common screening or assessment service is referrals to external sources of information (84%), followed by agency and provider staff observing for signs and symptoms of dementia (55%), referring individuals to medical cognitive assessments (43%), and conducting screenings (31%). The results demonstrate that AAAs are involved in a variety of dementia-related screenings, services, and interventions.
DEMENTIA SEVERITY AND QUALITY OF LIFE OF CARE PARTNERS OF OLDER ADULTS WITH DIABETES AND DEMENTIA
Authors: Adeyemi Oluwaseun , Blaum Caroline , Tarpey Thaddeus , Dickson Victoria , Chodosh Joshua 
Published: January 2025

Abstract
Caring for persons living with dementia (PLWD) is known to adversely affect care partner health. Health impacts specific to care partners of PLWD who also have diabetes is unknown. To examine this issue further, we assessed the association between dementia severity and care partner quality of life when caring for PLWD with diabetes. We extracted cross-sectional care partner survey responses enrolled in the Enhanced Quality in Primary Care for Elders with Diabetes and Dementia study (N=311). We defined dementia severity as a three-level categorical variable (mild, moderate, severe) using the Dementia Severity Rating Scale. Quality-of-life outcome measures were treatment burden score (scored 0 to 15; higher score = higher burden) and physical and mental health state (scored 0 to 20; higher score = better health). We controlled for both care partner and PLWD’s relationship, age, sex, race/ethnicity, and educational level. We performed multivariable quantile regression analyses and reported adjusted median difference (aMD) in quality-of-life measures (plus 95% confidence interval (CI)). Mean (standard deviation) ages of PLWD and their care partners were 81.5 (7.4) and 55.2 (12.4) years, respectively. Care partners were predominantly women (77.5%) and non-Hispanic Whites (38.9%). Compared to care partners of those with mild dementia, care partners of persons with severe dementia had more treatment burden (aMD: 1.41; 95% CI: 0.49, 2.32), and poorer mental health (aMD: -2.34; 95% CI: -3.60, -1.08). Caring for PLWD with diabetes exerts substantial burden on care partners especially when dementia is more severe and may benefit from more diabetes-focused education and support.
EATING EXPERIENCES IN PEOPLE LIVING WITH DEMENTIA: A CONCEPT ANALYSIS USING RODGERS’S METHODOLOGY
Authors: Wang Zih-Ling , McHale Jenna , Belza Basia , Sonney Jennifer 
Published: January 2025

Abstract
In people living with dementia, eating has often been portrayed in the literature as a time-consuming process or task-centered activity. However, it is important to distinguish the experience of eating from the process and task-centered approach of feeding. This study clarifies the concept of eating experience by using Rodgers’ evolutionary approach to analyzing factors associated with eating experiences in people living with dementia present in the literature. Twenty-two articles met the inclusion criteria, identifying three key attributes of eating experiences (self-connection, the special journey of life, and self-interpretation). Antecedents, as framed by the socio-ecological model, were categorized to represent Intrapersonal (personal preferences, individual culture, mealtime routines), Interpersonal (social interaction), and Environmental (dining room environment, policies) factors. Consequences were divided into external (quality of life, nutritional health, and physical health) and internal (personhood, autonomy and independence, dignity and feeling valued, and mental well-being) domains. The identified attributes, antecedents, and consequences can be utilized in healthcare education, research, and intervention approaches. This presentation allows nurses and other health care professionals to understand better people living with dementia through the relationship between eating and interpersonal, intrapersonal, and environmental aspects to develop personalized interventions and care strategies to achieve an optimal quality of life.
EFFECTS OF DEMENTIA DIAGNOSIS ON HOSPITAL READMISSION AFTER DISCHARGE FROM A SKILLED NURSING HOME
Authors: Carnahan Jennifer , Slaven James , Ludden Emily Fox , Bowditch Corinne , Ryan Healey , Jiangqiong Li , Tu Wanzhu , Torke Alexia 
Published: January 2025

Abstract
High acute care utilization has been associated with dementia, but the risk of repeat acute care use following a skilled nursing home (SNH) to home transition is not well understood. We examined the association of dementia with 30-day hospital readmission after leaving a SNH. Data from the Health and Retirement Study from 2000-2018 was linked to Medicare and SNH claims. We analyzed the events of hospital readmission following SNH discharge using logistic regression while controlling for repeated within-subject readmissions. There were 5,912 discharges to the community from an SNH and 941 hospital readmissions. ICD codes for dementia were present with 1,754 of the SNH-to-home transitions and 314 of the hospital readmissions. In bivariate analysis, people with dementia were more likely to be readmitted (p=0.0074). Post-SNH readmissions were also more likely among people who were Black, male, dual eligible beneficiaries, longer pre-SNH hospital stays, higher Charlson Comorbidity Index, and greater activities of daily living deficits. In the multivariable logistic regression model, the odds of readmissions were still greater among persons with dementia, but significance was attenuated (OR 1.09; 0.90, 1.32; p=0.4065). Significant associations with readmissions include the Charlson Comorbidity Index (OR 1.07; 1.04, 1.09; p&lt; 0.0001) and activities of daily living deficits (OR 1.11 (1.04, 1.17; p=0.0005). People with dementia may be at greater risk of readmission after SNH discharge but not when controlling for factors such as socioeconomic status, activities of daily living, and other comorbidities.
HOME-BASED REMINISCENCE INTERVENTION IN DEMENTIA: QUALITATIVE THEMATIC ANALYSIS
Authors: Jin Xianglan , Wu Kuan-Ching , Chien Shao-Yun , Zaslavsky Oleg 
Published: January 2025

Abstract
Reminiscence intervention has shown promising potential in alleviating dementia-related morbidities, thanks to the relatively intact remote memories of persons living with dementia (PLWDs). However, reminiscence interventions have been primarily delivered in group settings by healthcare professionals, which is costly and hard to scale up. One innovative solution is training family caregivers to carry out reminiscence conversations with their loved ones in their homes at their convenience. This thematic analysis aims to examine the participants’ perspectives of a home-based reminiscence intervention to inform future research on dyadic reminiscence interventions. A pilot study on a home-based reminiscence intervention was conducted between November 2022 and May 2023. Qualitative data were collected through semi-structured individual interviews with nine dyad participants at the end of the intervention. The interviews were audio-recorded and transcribed verbatim. Initial codes and categories were developed inductively, and queries on Atlas.ti were used for theme identification and recontextualization. Peer debriefing and external review were utilized to ensure rigor. Participants reported positive experiences of the home-based intervention. Centering on and engaging the PLWD in conversations was perceived as positive brain stimulation. Participants highly appreciated that it was conducted in home settings and acknowledged that the intervention content, duration (1-1.5 hours for 24 weeks), frequency (biweekly), and logistics were acceptable. PLWDs expressed willingness to share stories with their families. Most caregivers showed great interest in training on reminiscence conversations. Future studies should empower family caregivers to initiate and lead reminiscence conversations at home along with the provision of adequate caregiving support.
P. GINGIVALIS-LPS PROMOTES AD/ADRD VIA CASPASE-4-MEDIATED NONCANONICAL INFLAMMASOME PATHWAY
Authors: Verma Ambika , Azhar Gohar , Patyal Pankaj , Zhang Xiaomin , Wei Jeanne Y 
Published: January 2025

Abstract
Alzheimer’s disease (AD) and related dementias (ADRD) are significant contributors to illness and death in the older adult population worldwide. Chronic periodontitis and its keystone pathogen, Porphyromonas gingivalis, have increasingly been linked with AD/ADRD. P. gingivalis releases various virulence factors, including lipopolysaccharide (LPS), which have been shown to trigger systemic inflammatory events responsible for neuroinflammation and AD/ADRD. Caspase-4 directly senses and binds cytosolic LPS, promoting its oligomerization and activation, leading to the formation of the non-canonical inflammasome. However, the role of caspase-4 in P. gingivalis- LPS mediated AD-related neuropathology remains poorly defined. We hypothesized that P. gingivalis- LPS may be responsible for neuroinflammation via activation of caspase-4 mediated non-canonical inflammasome pathway through activation of its downstream NOD-like receptor family pyrin domain containing 3 (NLRP3) and caspase-1 inflammasome dependent cell signaling. Our overall hypothesis is exploring the cell signaling pathway by which P. gingivalis- LPS are able to affect the microglial/neuronal cells via activating caspase-4, that might be responsible for neuroinflammation and lead to AD/ADRD. Our results suggest that P. gingivalis- LPS activated caspase-4 and cleaved gasdermin D (GSDMD) to form the GSDMD pores to trigger pyroptosis, a form of programmed lytic cell death. The GSDMD pores in the plasma membrane also promoted K+ influx, sensed by the NLRP3 inflammasome to activate caspase-1, resulting in IL-1β maturation and secretion, as well as pyroptosis. This P. gingivalis- LPS induced caspase-4-mediated NLRP3/caspase-1 activation and associated IL-1β secretion, promotes neuroinflammatory environment that drives AD/ADRD pathogenesis.