bluuebunny/crossref_metadata_2025_split huggingface dataset:
WEALTH DISPARITIES IN LATER LIFE: SENSE OF MEANING AND PURPOSE IN LIFE
Authors: Choi Shinae 
Published: January 2025

Abstract
This study examined the extent to which racial/ethnic, gender, and age disparities in wealth persist among U.S. older adults, focusing on housing wealth (non-liquid assets) and non-housing wealth (liquid assets), alongside income, and further evaluated whether sense of meaning and purpose in life mitigates these wealth disparities in later life. Data were from the Leave-Behind Questionnaire in the 2018 Health and Retirement Study (N=4,472). I estimated ordinary least squares regression models with interaction terms to evaluate moderation effects, adjusting for health and sociodemographic characteristics. Results showed that wealth disparities across race/ethnicity, gender, and age groups exist in older Americans. Non-Hispanic Black, non-Hispanic Asian/other races, and Hispanic older adults compared to non-Hispanic Whites, as well as women (vs. men), reported significantly lower wealth and income. The age groups of 65-79 and 80+ reported higher wealth than those aged 50-64. Multiple moderation analyses revealed evidence of racial/ethnic and age disparities in wealth, but not gender, were mitigated by sense of meaning and purpose in life. Specifically, non-housing wealth increased among non-Hispanic Asian/other and Hispanic older adults as their purpose in life increased. A notable increase in both housing and non-housing wealth, as well as income, was observed among those aged 50-64 as their purpose in life increased. Findings suggest the protective effect of sense of meaning and purpose in life in mitigating wealth disparities in later life. Through further research and interventions aimed at bolstering sense of meaning and purpose in life, there is potential to alleviate wealth disparities in later life.
OCCUPATIONAL PHYSICAL HAZARDS AND RISK FOR DEMENTIA AND MILD COGNITIVE IMPAIRMENT IN THE HUNT 70+ STUDY
Authors: Tom Sarah , Bratsberg Bernt , Engdahl Bo , Stern Yaakov , Kohler Hans-Peter , Håberg Asta , Strand Bjørn Heine , Skirbekk Vegard 
Published: January 2025

Abstract

Background
While occupational physical hazards are related to physical decline in older adulthood, less is known about cognitive outcomes. We hypothesize that greater life course occupational physical hazards would be associated with higher mild cognitive impairment (MCI) and dementia risk.

Methods
Data were from the Trøndelag Health Study, a population-based study of one Norwegian county beginning in 1984, with follow-up every decade. In 2017-2019 participants age ≥ 70 had cognitive assessments, used to diagnose MCI or dementia. Occupations from age 30-65 were from decennial censuses (1960 - 1980) and the national employer-employee register, from 1995. Occupations were assigned to International Standard Classification of Occupation-88 codes, linked to the Occupational Information Network. Occupational physical hazards score is the mean of 10 characteristics describing exposures to hazardous and adverse occupational environmental conditions. Age, sex, marital status at age 30, and education were from registers. Ordered logistic regression models assessed the relationship between occupational physical hazards and later-life cognitive status.

Results
In 9344 participants median occupational physical hazards score was 1.82 (range: 1.0-3.3 (greater hazard)). The mean age was 78, and 35% and 15% of participants had MCI and dementia diagnoses, respectively. Adjusting for age and sex, one standard deviation greater occupational physical hazards were related to 1.32 times the risk of worse cognitive level (OR 1.32, 95% CI 1.26-1.36). Adjusting for education and marital status attenuated this association (OR 1.16, 95% CI 1.11-1.22).

Conclusions
Those exposed to occupational physical hazards may need greater support with later life MCI and dementia risk.
ADVANCING RURAL GERIATRIC SERVICES: LESSONS FROM THE VETERANS HEALTH ADMINISTRATION
Authors: Franzosa Emily , Hung William , Hicken Bret 
Published: January 2025

Abstract
Almost 3 million rural Veterans receive care from the Veterans Health Administration (VHA) and more than half are 65 and older. But, rural older Veterans may have limited access to specialized, interdisciplinary geriatric care services. VHA’s nationwide system is tasked with supporting Veterans wherever they live, a mission that comes with unique access challenges for Veterans far from VA hospitals or clinics. In a system responsible for managing many priorities and needs, prioritizing rural geriatrics services can be challenging. Our symposium highlights efforts to develop successful strategies for expanding rural geriatrics nationally. First, Dadgostar et al. share results from a project to understand geriatric service needs across VA, with the goal of leveraging data to map areas that could benefit from service expansions. Next, Kelley and colleagues discuss findings from interviews with VHA leaders on how priorities are determined at the local, regional and national level, and how rural geriatrics services fit with leaders’ visions. Franzosa et al. share a rural geriatrics “advocacy field guide” to support geriatrics champions in the field to gain support for local resources. Finally, Dryden et al. share an example from a successful rural geriatrics program, GRECC Connect, and discuss how these implementation lessons can inform the development and scale of new programs. Through the lens of rural geriatrics, this symposium highlights effective strategies for health care leaders to move their priorities ahead within their own systems.
THE RIGHT STRATEGY, THE RIGHT PERSON, THE RIGHT TIME: DEVELOPING AN ADVOCACY FIELD GUIDE FOR RURAL GERIATRICS
Authors: Franzosa Emily , Kelley Lynette , Dryden Eileen , Hall Lauren , Moo Lauren , Hung William 
Published: January 2025

Abstract
The need to expand rural geriatric services has received increasing attention within and outside the VHA, yet medical center leaders are often challenged to prioritize expanding these services among myriad competing needs. To better understand potential levers to move rural geriatrics up the priority ladder, we conducted semi-structured interviews with 11 former leaders in the Veterans Health Administration. We explored perspectives on how health system priorities can be aligned to improve the quality and reach of rural geriatric care and solicited best practices for advocating for rural geriatric care at the local, regional and national level. Leaders shared that there was no ‘best way’ to advocate, prompting the development of an advocacy field guide to advance rural geriatric services. The guide draws from our interview data, policy analysis, and best practices in communication and advocacy to help local leaders and champions make a case for expanding rural geriatric resources. The guide describes multiple avenues to purposefully employ “the right strategy, for the right person, at the right time”, including data from mapping local and regional gaps and needs for services, storytelling, relationship building, building a business case, aligning rural geriatrics with regional and national goals, and making geriatrics “personal”. Providing actionable, easy-to-use resources to local champions can support efforts to expand rural geriatric services locally and nationally.
A FACILITATED APPROACH TO SUSTAINMENT PLANNING FOR A RURAL GERIATRICS PROGRAM
Authors: Dryden Eileen , Riley Jessica , Moo Lauren , Kennedy Meaghan , Pimentel Camilla , Hung William 
Published: January 2025

Abstract
Continual adaptations enhance health care program sustainability amid ongoing health system changes, yet implementation research lacks descriptions of processes to facilitate needed adaptions, particularly for programs implemented in heterogenous settings We employed a three-phase participatory method to explore potential program sustainment strategies for a 19-site Veterans Health Administration program (GRECC Connect) that uses a hub-and-spoke model to expand rural access to geriatric specialty care through telemedicine. First, hub site clinicians and staff completed the Program Sustainment Assessment Tool (PSAT), a publicly available online tool. All sites then participated in a virtual retreat at which potential sustainment strategies, barriers and facilitators to each strategy, the capacity to enact each proposed strategy, and data needed to move forward in choosing a sustainment path were discussed. And finally, sites engaged in a participatory process with their local GRECC Connect teams to draft a site-specific sustainment plan. Proposed sustainment paths included integrating with local or regional clinical services, or mentoring other groups wanting to provide geriatrics telehealth specialty care. Sites varied in their perceived confidence to sustain program activities. Barriers and facilitators to sustainment strategies related to the current level of integration into and relationships with existing clinical services, existing relationships with local and regional VA leadership, knowledge of facility priorities, and perceived capacity to develop their program’s business case. This participatory approach enabled sites to plan the most feasible sustainment strategy for their own site, while using the support, knowledge, and experience of the national GRECC Connect team to do so.
BIOMARKERS OF AGING
Authors: Dutta Chhanda 
Published: January 2025

Abstract
It may be possible to prevent or ameliorate multiple adverse age-related outcomes through interventions targeted at fundamental mechanisms of aging, such as cell senescence, proteostasis, autophagy, mitochondrial dysfunction, macromolecular damage, and epigenetic regulation. Understanding the relationships between aging mechanisms and aging conditions as a basis for identifying targets for interventions to extend healthy life span has been a long-standing goal of biomedical aging research. The identification of sufficiently valid, reliable, and accurate aging mechanistic markers in humans would greatly facilitate the ability of observational studies to clarify the relationships of aging markers to aging-related phenotypes and enhance geroscience-based therapeutics development. To take full advantage of such aging mechanistic markers in future translational aging research, it will be important to clarify the degree of correlation between a) circulating levels and their activity in tissues/organs, b) their activity in laboratory animals and in humans, and c) whether they can capture the status of a specific mechanism across the life span, as part of the development and validation process. This session will feature presentations which highlight advances in the development of aging mechanistic markers, as well as challenges and limitations. Dr. Birgit Schilling will discuss the utility of specific markers of cellular senescence and multi-omics biomarkers. Dr. Nathan LeBrasseur will talk about the use of aging mechanistic markers for predicting clinical outcomes and selection of patient populations for clinical interventions. Dr. Anthony Molina will present on the application of blood-based bioenergetic profiling to elucidate the role of mitochondrial dysfunction in different aging conditions.
BIOMARKERS AND DRIVERS OF MITOCHONDRIAL HEALTH AND AGING
Authors: Molina Anthony 
Published: January 2025

Abstract
In line with the principles of Geroscience, age-associated alterations in mitochondrial function have been shown to underlie a wide array of age-related diseases and conditions. This presentation will review mitochondrial bioenergetic profiling approaches that are being implemented in human/clinical studies. These include tissue and blood-based approaches that can serve as reliable biomarkers of mitochondrial health and have enabled researchers to examine the role of mitochondria in the physical and cognitive abilities of older adults. Importantly, we are also beginning to understand the factors that influence human mitochondrial bioenergetic capacity. These include intrinsic factors such as age and sex, as well as behavioral factors such as diet, exercise, and activity. We will also discuss ongoing efforts to identify circulating factors (e.g. proteins and metabolites) that drive differences in mitochondrial function associated with dementia and aging. Building upon our previous work demonstrating that blood-borne factors mediate age-related bioenergetic differences, our recent studies indicate that non-cellular factors present in serum can mediate bioenergetic differences associated with age and cognitive performance. Combining mitochondrial respirometry with multi-omic approaches, we are now able to identify circulating molecules that drive changes mitochondrial bioenergetics.
THE SENESCENCE-ASSOCIATED SECRETOME AS A BIOMARKER OF AGING
Authors: LeBrasseur Nathan 
Published: January 2025

Abstract
Senescent cells accumulate in nearly all organs with advancing age. A defining characteristic of senescent cells is a robust and heterogenous senescence-associated secretory phenotype (SASP). The SASP influences tissue health and function locally and systemically, hence, circulating components of the SASP may be informative of senescent cell burden. We established a candidate panel of senescence biomarkers based on common cytokines, chemokines, matrix remodeling proteins, growth factors and other proteins components of the SASP. In this seminar, the associations between senescence biomarkers and clinical manifestations of biological age, including frailty, functional limitations, and chronic disease, in humans will be presented. Moreover, the responsiveness of senescence biomarkers to interventions that counter the biology of aging, including exercise and caloric restriction, will be highlighted. Finally, the strengths and limitations of this approach and new directions will be discussed.
BUILDING MORE AGE-INCLUSIVE CAMPUSES BY ENGAGING WITH RETIRED FACULTY
Authors: June Andrea , Cicero Caroline 
Published: January 2025

Abstract
Identified in the Age-Friendly University (AFU) principles and in the Age Inclusivity Domains in Higher Education model, initiatives that support the campus retired and emeriti community are important elements to promoting age inclusivity and intergenerational connection. Such initiatives may be found in a myriad of forms and may include campus-specific efforts as well as organizational efforts. This symposium features campus leaders representing institutional partners of the Age-Friendly University global network who will discuss their recent efforts to understand the needs of and to engage with retired and emeriti faculty. June, Andreoletti, and Swanson (Central Connecticut State University) describe findings from an initial survey of retired and emeriti faculty that sought to understand their desire to remain engaged in intergenerational teaching, research, and service at the university. Similarly, Porter (University of Manitoba) and colleagues conducted an exploratory study at their university regarding retired academics who have specific positions as Senior Scholars and Professors Emeriti, with the goal to enhance their experiences and overall benefits for the university. Gautam (UMass Lowell) discuss their campus journey in engaging emeriti professors over the past several years and present student feedback from an “intergenerational team talk” activity which engages a retired professor and students in a Gerontology course. Finally, Montepare (Lasell University) reports on data collected from the American Psychological Association’s late career stage/retired faculty and addresses how professional organizations could support age-inclusive campus practices with more age-inclusive member practices. Cicero (University of Southern California) will share insights and pose future directions as the discussant.
FORTIFYING HOPE: OLDER LATINA IMMIGRANTS WITH CANCER
Authors: Carrion Iraida , Neelamegam Malinee , Estapé Tania , Estapé Jorge 
Published: January 2025

Abstract
Given the growing population of Latina immigrants aged 60 years and older in Central Florida, United States, and the current lack of relevant data, understanding this population’s cancer experiences is crucial to ensure effective interventions, psychosocial care, and policies. This study assessed 200 responses to a survey developed and administered in Spanish, with questions focused on cancer knowledge, attitudes, prevention, early diagnosis, and treatment. The survey included a qualitative component of open-ended questions regarding the perspectives and experiences of 23 older immigrant Latina women with cancer. Recruitment occurred in community-based settings and the interviews were transcribed in Spanish and English. Utilizing a grounded theory approach and thematic analysis, codes were developed. The survey data highlight the lack of initial information regarding available cancer treatments, a minimal understanding of the causes of cancer, and insufficient knowledge regarding cancer diagnoses that delayed early treatment. Within this sample, 52% had breast cancer, 22% had skin cancer, 13% had uterine cancer, 4% had colon cancer, and 4% had uterine and ovarian cancer. Latina cancer rates are expected to rise in the next 20 years. Promoting cancer screenings and modifying health-related behaviors among diverse older immigrant Latinas is imperative and requires the development of culturally appropriate interventions to overcome health disparities and treatment barriers.
CELEBRATING 30 YEARS OF ENHANCE FITNESS: REACHING NEW POPULATIONS OF OLDER ADULTS WITH EVIDENCE-BASED EXERCISE
Authors: Patel Kushang , Denison Paige , Albert Steven 
Published: January 2025

Abstract
EnhanceFitness® (EF) is an evidence-based, group exercise program for older adults involving strength, aerobic, and balance training that is recommended for arthritis management and falls prevention. Classes are held for 1 hour, 3 days a week and are led by exercise instructors trained in the EF protocol, which accommodates people with different levels of physical capacity. In the past 30 years, more than 150,000 older adults have participated in EF at &gt;800 community sites in the United States. Over 75 peer-reviewed studies have evaluated EF’s effectiveness, implementation, and dissemination. In the proposed symposium, we will report new findings on efforts to expand EF’s reach. First, Paige Denison (who directs EF nationally) will present a brief overview of the program. Second, Kushang Patel will present the adaptation of EF for remote delivery (Tele-EF) and report the comparative effectiveness of Tele-EF versus in-person EF on several functional outcomes. Third, Nancy Gell will present a qualitative study on the experience of older rural cancer survivors with participation in Tele-EF. Fourth, Elise Hoffman will report the feasibility of Tele-EF in rural older adults with chronic pain and the results of co-designing a referral pathway to reach this population. Fifth, Basia Belza will present a pilot study on the feasibility of EF for people living with cognitive impairment and their caregivers. Lastly, Steven Albert (Editor of GSA’s Innovation in Aging) will deliver a critical discussion of the research findings and provide recommendations on expanding access of exercise programs to underserved, hard-to-reach populations of older adults. Fitness, Exercise and Wellness Interest Group Sponsored Symposium
PERSPECTIVES OF OLDER RURAL CANCER SURVIVORS ON REMOTELY DELIVERED ENHANCE FITNESS
Authors: Gell Nancy , Caefer Jacqueline , Patel Kushang 
Published: January 2025

Abstract
Exercise is recommended for healthy aging and to counteract long term effects of cancer and cancer treatment. Older cancer survivors living in rural communities face unique challenges to accessing exercise opportunities including fewer in-person program options, transportation barriers, and lack of safe, outdoor infrastructure. Remotely delivered exercise provides opportunities to overcome many of the documented barriers to exercise for this underserved population. The purpose of this study was to examine perspectives from older rural cancer survivors after participating in remotely delivered Enhance Fitness group exercise (Tele-EF). We conducted semi-structured interviews with 27 older cancer survivors living in rural communities (mean age 70.8 ±5.7, 81% female) after they completed 16-weeks of Tele-EF. All interviews were audio-recorded and transcribed. Transcripts from the interviews were coded using inductive thematic analysis. Analysis and discussion of the codes resulted in iterative mapping of key themes to the Capability Opportunity and Motivation Behavioral (COM-B) framework. Emergent themes related to Tele-EF included: 1. Capability: Improvements in psychological and physical capacity to exercise resulted from supportive instruction, experiential learning, and exercise modifications by trained instructors. 2. Opportunity: Barriers of transportation and weather were eliminated while technology, when functioning, afforded accessibility at home; comradery prompted consistent attendance. 3. Motivation for exercise was enhanced through improved capability, opportunity, and functional improvement. Tele-EF facilitates exercise engagement for older rural cancer survivors through constructs identified in the COM-B framework. Future work should examine how to optimize technology for engaging older rural cancer survivors in synchronous, remote exercise.
EXPANDING RURAL ACCESS TO TELE-ENHANCEFITNESS THROUGH COMMUNITY-ENGAGED DESIGN OF A REFERRAL PATHWAY
Authors: Hoffman Elise , Rensema Elspeth , Adams Leah , Jajko Shannon , Gell Nancy , Belza Basia , Patel Kushang 
Published: January 2025

Abstract
Rural older adults experience a high burden of chronic pain from osteoarthritis and other chronic conditions. Exercise is a first-line treatment for many painful conditions, but access to evidence-based programs is limited in rural areas. Remotely delivered programs, including Enhance®Fitness (Tele-EF), has high potential to expand access. Therefore, we conducted a series of studies to assess feasibility of delivering Tele-EF to rural older adults with chronic pain. First, we partnered with a rural-serving healthcare system to pilot 12 weeks of Tele-EF in 15 rural older adults with knee osteoarthritis. Median attendance was 91%, 100% of participants were very satisfied with tele-EF, 87% completed the program, and pain and physical functioning improved significantly. Next, we piloted implementation of an exercise prescription and Tele-EF referral pathway for older adults with knee osteoarthritis in a rural-serving primary care clinic. Adoption was low, with 4 patients referred, screened, and enrolled in Tele-EF over 16 weeks. In an effort to improve the referral pathway for a NIH-funded pragmatic trial on rural pain management, we conducted 20 interviews with EF instructors and leaders of rural-serving YMCAs. Preliminary results suggest referral pathways are effective when built into existing clinic and community systems and involve sustained provider outreach. Ongoing community engagement will include focus groups to assess usability of the pathway, prior to its implementation in a pilot of the pragmatic trial. Taken together, current results indicate that delivering EF to rural older adults is feasible, but engaging with rural healthcare systems is critical to reaching this population.