bluuebunny/crossref_metadata_2025_split huggingface dataset:
SUPPORTIVE CARE NEEDS AND INTERVENTIONS IN PANCREATIC CANCER PATIENTS AND THEIR CAREGIVERS: A SCOPING REVIEW
Authors: Fu Liang , Kim Su Hyun , Hayward Matt , Vieira Candice , Parikh Alexander , Song Lixin 
Published: January 2025

Abstract
Pancreatic cancer remains one of the most lethal cancers and predominantly affects older adults. This scoping review aims to provide a comprehensive review of the literature regarding supportive care needs and corresponding interventions in patients with pancreatic cancer and their family caregivers. We conducted this scoping review following the Joanna Briggs Institute Manual for Evidence Synthesis. We searched five English databases using ‘pancreatic cancer,’ ‘patients/caregivers,’ ‘supportive care,’ and ‘needs’ in January 2024. We summarized the data employing the Supportive Care Framework. Of the 4,342 references identified, 41 were included. Among the 31 descriptive studies, the top four highest supportive care needs were informational (n = 24), physical (n = 10), emotional (n = 9), and practical needs (n = 8). In the 10 experimental studies, most of the interventions in involved pain/symptom management (n = 8), following by adjustment/supportive counselling (n = 6), psycho-educational service or activity (n = 4), and orientation/ongoing patient and family education (n = 4). Four studies demonstrated statistically significant improvements in outcomes for intervention groups compared to control groups. Patients with pancreatic cancer and their family caregivers experienced a spectrum of supportive care needs, particularly informational needs. Several intervention strategies were applied to address these supportive care needs, but only a few demonstrated statistically significant improvements in outcomes. These findings enhance our understanding of the supportive care needs and appropriate interventions for patients with pancreatic cancer and their family caregivers, providing a foundation for further research to address these needs through a health equity lens.
CONTRIBUTING FACTORS TO POST-RETIREMENT EMPLOYMENT AND LIFE SATISFACTION
Authors: Wang Zhong 
Published: January 2025

Abstract
This study explores the factors influencing post-retirement employment and its impact on retirement satisfaction, aiming to provide insights to improve older adults’ productivity and well-being, thereby enhancing their life satisfaction and contributing to the cohesion of families, communities, and society at large. Utilizing secondary data from the RAND HRS Longitudinal File 2020, this quantitative research examines a sample of 1,561 individuals born in 1948 and 1949. The longitudinal data tracks changes in retirement trajectories and self-reported well-being over time. Logistic regression analysis revealed several key findings: African American and Hispanic individuals were less likely to intend to work beyond age 65 but more likely to engage in post-retirement employment. Higher household wealth correlated with a decreased intention to work past 65 but an increased likelihood of continued labor market participation. The health and employment status of a spouse significantly impacted older adults’ work intentions, retirement decisions, and satisfaction. Additionally, there were significant reciprocal relationships between respondents’ work plans and their retirement decisions. The findings highlight the need to address the diverse job-related needs of older adults in gerontological social work practice. Advocating for employment as a human right, the study highlights the importance of age-friendly policies, such as flexible work arrangements and phased retirement options. Social work practice can enhance opportunities for older adults through financial literacy programs, job training, and career counseling, particularly in underserved communities. Additionally, acknowledging the correlation between family dynamics and retirement experiences, gerontological social work can better support older adults in navigating their retirement transitions.
USING SOCIAL MEDIA POSTS TO UNDERSTAND THE HEALTH INFORMATION NEEDS FOR OLDER ADULTS WITH DEMENTIA
Authors: Larnyo Ebenezer , Benyassine Karim , Preece Natasha 
Published: January 2025

Abstract
Older adults with dementia and their caregivers face significant challenges, necessitating innovative approaches to support their evolving health information needs. This study leverages the power of social media to explore these needs, analyzing 664 posts from Reddit communities dedicated to dementia and Alzheimer’s disease. Thematic analysis and sentiment analysis were employed to identify key themes and emotional undertones. Additionally, deep learning models (convolutional neural network (CNN), transformers, bidirectional long short-term memory (BI-LSTM), and gated recurrent unit (GRU)) were compared for sentiment prediction accuracy, with CNN demonstrating superior performance. Our findings reveal that caregivers constitute the majority of contributors, sharing experiences related to caregiving burden, dementia symptoms, and emotional challenges. Despite the inherent difficulties, a predominantly positive sentiment prevailed, highlighting the importance of social connection and support. This research underscores the potential of social media as a valuable resource for understanding the experiences of dementia caregivers. By harnessing these insights, healthcare providers and policymakers can develop more effective interventions and support systems to improve the quality of life for both patients and caregivers.
GENDER-SPECIFIC EFFECTS OF IL-6 AND DECLINES IN PROCESSING SPEED AND EXECUTIVE FUNCTIONING IN OLDER ADULTS
Authors: Gloger Elana , Smith Patrick , Segerstrom Suzanne 
Published: January 2025

Abstract
Elevated peripheral inflammatory markers among older adults associate with cognitive decline, particularly for women, for whom cognitive decline is more prevalent and rapid. Few prospective studies have examined gender-specific associations between inflammation and cognitive decline or examined stable differences vs. fluctuations in inflammation. Participants (N = 235) were older adults (Mage = 75.1, range = 60-92) from a longitudinal study of neuropsychological assessments and blood draws every six months across up to 12 years. Systemic inflammation was operationalized as serum IL-6. The Trail Making Test provided assessment of psychomotor processing speed (A) and executive functioning (B and B-A). Multilevel models tested associations between cognition and inflammation and moderation by gender. Higher stable differences and fluctuations over time in IL-6 were significantly associated with slower TMT-A performance for women and men (between-person: g = -.06, p =.04; within-person: g = -.02, p =.049). Higher IL-6 was more strongly associated with slower TMT-B and B-A performance for men (TMT-B: g =.006, p =.02; TMT-B-A: g =.008, p =.01). Older participants demonstrated slower TMT-A performance at higher IL-6 (g =.026, p =.01). Women experience higher rates of Alzheimer’s disease diagnosis and faster age-related cognitive decline, suggesting gender-specific factors related to cognition yet to be uncovered. In the present study, executive function was sensitive to changes in systemic inflammation in a gender-specific way. Gender-specific differences in neurological aging remains a critical target for future intervention research aimed at addressing preclinical AD and accelerated aging.
PAIN MANAGEMENT IN DEMENTIA: A NEED FOR SPECIFICITY AND SUSTAINABILITY IN EXERCISE-BASED PROGRAMS
Authors: Na Annalisa , Bradt Joke , Fritz Julie , Gliebus Gediminas , Gitlin Laura 
Published: January 2025

Abstract
Over 50% of people living with dementia (PLWD) experience pain associated with functional decline. Pain and dementia are heterogeneous and complex, making the development of effective nonpharmacological interventions challenging. Hence, we used Intervention Mapping (IM), an evidence-based process for designing complex behavioral interventions. This study focuses on completing Step 1 of IM (needs assessment) to define population and intervention priorities. We conducted and synthesized the findings of three studies: (1) a scoping review of 81 studies summarizing current literature, (2) an analysis of the National Health and Aging Trends Study (NHATS) database (n=9,974) to characterize pain among community-dwelling PLWD, (3) qualitative interviews with clinicians (n=19) and PLWD/caregivers (n=17) to assess perspectives on current care. The scoping review revealed that most research focuses on passive interventions in long-term care facilities and lacks specificity in reporting pain diagnosis and dementia severity. From the NHATS database, low back and knee osteoarthritis were the most prevalent pain conditions among community-dwelling PLWD. Qualitative analysis of interviews confirmed scoping review findings of an overall lack of exercise-based interventions for pain despite being standard care among cognitively intact individuals. While there was a shared interest in exercise-based interventions, clinicians expressed concerns about adapting and sustaining these programs. Triangulating data (epidemiological and qualitative sources) and following IM provides foundational support to design clinical interventions for pain in PLWD. Specifically, intervention development should prioritize community-dwelling PLWD with knee and/or low back pain using therapeutic exercises tailored to the individual’s interests and abilities; however, research is needed to address sustainability.
MEDIATING PROTEINS UNDERLYING THE RELATIONSHIP BETWEEN MITOCHONDRIAL DNA COPY NUMBER AND DEMENTIA FROM TWO COHORTS
Authors: Tian Teresa , Zweibaum David , Qian Yong , Pilling Luke , Ding Jun , Ferrucci Luigi 
Published: January 2025

Abstract
Recent reports have shown that blood mitochondrial DNA copy number (mtDNAcn) is associated with dementia risk, but the biological underpinnings remain unclear. Identifying proteins that mediate this relationship may provide mechanistic insights. In the UK Biobank, we performed mediation analyses of 2,917 proteins via Olink platform in the association between mtDNAcn estimated using fastMitoCalc and future dementia diagnosis among 33,852 participants initially free of dementia (mean age=57 years). Over an average 13.2 years of follow-up, 891 participants (2.6%) developed all-cause dementia. We found 57 mediating proteins for all-cause dementia (FDR-p&lt; 0.05), mostly from inflammation and cardiometabolic function panels and implicated in 24 pathways with top ranked pathways being TNFs binding to physiological receptors, coagulation system, plasma lipoprotein assembly/remodeling/clearance, degradation of the extracellular matrix, and activation of matrix metalloproteinases (p&lt; 0.05). Three protein networks with more than 10 significant proteins were related to organismal injury and abnormality, hereditary disorders, cellular function and maintenance, post-translational modification, cell death and survival, and lipid metabolism. Of 57 mediating proteins for all-cause dementia, 4 proteins (TNFRSF11B, SMOC1, Fibronectin, and SMAD1) also mediated the relationship between mtDNAcn and cognitive impairment or dementia in the validation cohort of 593 Baltimore Longitudinal Study of Aging participants with available cross-sectional data (mean age=76.8 years, SomaScan, p&lt; 0.05). These findings may suggest that proteins important for energy metabolism, neurotransmitter synthesis, lipid and glucose homeostasis, and immunity may underlie the relationship between mitochondrial dysfunction and dementia risk. Future longitudinal studies should further validate these findings and investigate longitudinal changes in proteins.
PREDICTING THE ONSET OF DEMENTIA WITH LONGITUDINAL OBJECTIVE MEASURES OF PHYSICAL FUNCTION
Authors: Schaefer Sydney , Peterson Daniel , Bravell Marie Ernsth , Finkel Deborah 
Published: January 2025

Abstract
Older adults with dementia have reduced physical function; however, whether physical function decline accelerates prior to dementia onset remains unclear. This study compared changes in three objective physical function measures for up to 26 years in 518 older adults who did or did not develop dementia: Time to complete a three-meter walk (Gait), grip dynamometry (Grip strength), and time to complete five functional tasks (e.g., putting coins into a slot) (Fine motor). Data from three longitudinal Swedish datasets of older adults (OCTO-Twin, GENDER, SATSA) were analyzed. During the studies, 259 participants were diagnosed with dementia (through clinical consensus); only data prior to the age of dementia onset were included. Propensity matching identified 259 participants who did not develop dementia and whose age at last observation matched the age of diagnosis in the dementia group. Linear latent growth curve models captured longitudinal changes in each measure prior to the onset of disability; thus, intercepts reflect an estimate of physical function at dementia onset or the last timepoint in the study. After controlling for sex, the fine motor test declined faster in the dementia onset group, with differences emerging 9 years prior to dementia onset. Gait and grip strength showed no differences between groups in the rate of change. Fine motor decline also occurred at the same rate as cognitive decline (measured with the Mini-mental status exam). These findings suggest that functional fine motor tasks may identify elevated risk for developing dementia, particularly in cases where memory tests may not be reliable.
SHRINKING WORLDS: SOCIAL NETWORK OVERLAP FOR OLDER ADULTS WITH AND WITHOUT ADRD AND THEIR CLOSE TIES
Authors: Hamilton Lucas , Perry Brea 
Published: January 2025

Abstract
Alzheimer’s disease and related dementias (ADRD) are an urgent public health issue with psychosocial consequences that reverberate through family systems, weakening key social bonds for diagnosed individuals and caregivers. Feelings of social isolation are associated with worse clinical outcomes for people with ADRD and elevated dementia risk in caregivers. Data from 124 focal-informant dyads were used to examine the characteristics and consequences of shared ties between older adults and their informants – typically a spouse or child. Focal participants were diagnosed as cognitively normal (n = 73) or experiencing ADRD-related cognitive impairment (n = 51). All participants completed separate social network interviews, naming people with whom they discuss important or health-related matters. Using multilevel logistic regression, we found that family members and individuals offering psychosocial support were significantly more likely to be shared ties (all odds ratios &gt; 1.26, all p-values &lt;.05). People who provided instrumental support were more likely to be shared ties only in the networks of ADRD informants (OR = 2.11, p &lt;.01), suggesting they may mediate caregiving tasks on behalf of the person with ADRD. More network overlap was associated (p &lt;.05) with worse general cognition and episodic memory (β = -.261; β = -.323, respectively) among ADRD focals, indicating that loss of social independence is associated with poorer cognition (or vice versa). Higher overlap was also associated with greater loneliness in ADRD informants (β =.282, p =.05), suggesting that lacking social ties outside the caregiving system may threaten caregiver wellbeing.
THE ASSOCIATION OF EARLY LIFE ADVERSITY AND LIFE COURSE RELATIONSHIP QUALITY WITH LATE-LIFE COGNITIVE HEALTH
Authors: Walters Monica , Wong Roger , Scambray Kiana , Antonucci Toni , Tarraf Wassim 
Published: January 2025

Abstract
Early life adversity (ELA) relates negatively to cognition, yet how particular ELA experiences may differentially relate to cognition and whether associations may be attenuated by life course relationship quality (LCRQ) is unclear. We aimed to assess how ELA subgroups related to cognition and whether associations may be buffered by LCRQ. Adults (ages 50-64 at baseline) from the Health and Retirement Study participated (n=4,193; 2006/2008=baseline; 2018/2020=follow-up). Latent class and profile analyses identified ELA and LCRQ subgroups, respectively. We related ELA and LCRQ subgroups to global cognition (linear regression) as well as risk of cognitive impairment, not dementia (CIND) and dementia (multinomial logistic regression) at follow-up. We included sociodemographic and health-related covariates. We identified 4 ELA (High Adversity, Family Disruptions, Elevated Household Trauma, Low Adversity) and 3 LCRQ (Strong Ties, Mixed Ties, Weak Ties) classes. Of note, racially/ethnically minoritized adults were more likely to belong to Family Disruptions and Weak Ties classes than White adults. Participants with Family Disruptions (vs. Low Adversity) had worse cognition (global: b=-0.84, 95% CI[-1.25;-0.43]; CIND: RRR=1.54, 95% CI[1.16;2.03]; dementia: RRR=1.64, 95% CI[1.02;2.64]); controlling for LCRQ and sociodemographics attenuated associations. Participants with Weak Ties (vs. Strong) had worse cognition (b=-2.70, 95% CI[-3.40;-2.01]) and higher risk of CIND (RRR=3.22, 95% CI[2.11;4.89]) and dementia (RRR=4.10, 95% CI[2.16;7.81]); associations were not explained by covariates. Family Disruptions negatively impacted cognition, but associations were explained by sociodemographics, indicating potential resilience from ELA. However, negative LCRQ, particularly Weak Ties, was consistently harmful to cognition. Therefore, targeting midlife and late-life social relationships may benefit cognition.
FLEXIBILITY IN PRACTICE: CASE EXAMPLES OF THE ROLE OF A BRAIN HEALTH INTERVENTIONIST IN THE AGEWISE-AP PROGRAM
Authors: McLaren Jaye , Moo Lauren , Nguyen Andrew , O’Connor Maureen 
Published: January 2025

Abstract
Healthy brain aging and reducing the risk of dementia is important to older adults. The Aging Well through Interaction and Scientific Education program (AgeWISE) provides group education (12 sessions) on lifestyle factors and techniques to manage age-related cognitive change. Participants who completed AgeWISE reported feeling that they had more control over their brain health, but many requested additional supports to help them make lifestyle changes important to them. We added an 8-session one-on-one action plan component to the AgeWISE program (AgeWISE-AP) to help participants make personalized lifestyle modifications that support healthy brain aging. AgeWISE-AP utilizes a Brain Health Interventionist (BHI) to guide participants in the creation and implementation of individualized, client-centered goals while adhering to a manualized scaffolding. Fifteen participants have engaged in AgeWISE-AP to date. We will provide case examples illustrating the flexibility required from the BHI to manage individual needs in goal setting, adapt goals as needed, and successfully guide participants in behavior change within a manualized program. The AgeWISE-AP program requires the BHI to have strong clinical skills and content-specific training to support goal setting and implementation that is client-centered while also ensuring the sessions are operating within the structure of the manualized program. Walking this fine line is imperative for the success of the program as well as for its replicability in other settings.
OPIOID DEPRESCRIBING: QUALITATIVE INSIGHTS INTO REDUCING MOTIVATION FOR UNHEALTHY SUBSTANCE USE
Authors: LaRowe Lisa , Stone Sarah , Granados Heily Chavez , Ritchie Christine 
Published: January 2025

Abstract
Nearly 38% of older adults in the United States have chronic pain, and opioids continue to be used frequently for chronic pain management in this population. While recommendations suggest limiting opioids in older adults, given limited effectiveness and associated harms, one potential consequence of deprescribing opioids is that patients may turn to non-prescribed opioids or nonopioid (e.g., alcohol, cannabis, nicotine) substances to self-medicate pain. We conducted 3 focus groups of older adults with chronic pain who were prescribed opioids (N = 10, 65-92 years old) to explore perspectives regarding factors that may influence motivation to use substances during opioid deprescribing. We also aimed to elicit preferences for an opioid deprescribing intervention that reduces risk for adverse substance use-related outcomes. Qualitative data were analyzed using rapid data analysis. Participants identified the following factors that may increase motivation to use substances during opioid deprescribing: intolerable pain, lack of access to alternative pain treatments, psychological distress, and history of substance use/abuse. Factors that may decrease motivation to use substances include: having access to alternative pain treatments, having access to psychosocial treatment, having adequate social support, and being aware of the risks/consequences of substance use. To mitigate risk that patients will use non-prescribed opioids and/or nonopioid substances to cope with pain during opioid deprescribing, participants highlighted the importance of having a clear plan for deprescribing, ensuring access to effective alternatives to opioids, utilizing psychosocial and other nonpharmacologic pain treatment strategies, and providing psychoeducation about the risks of substance use.
LONG-TERM CARE IN-HOME: LIVED EXPERIENCES OF INDIVIDUALS IN VA MEDICAL FOSTER HOMES
Authors: Manheim Chelsea , Fix Rachel , Haverhals Leah 
Published: January 2025

Abstract
The Department of Veterans Affairs (VA) Medical Foster Home (MFH) program provides long-term care for Veterans who are nursing home eligible but desire to reside in home-like environments. In MFHs, Veterans are matched with non-VA caregivers to live in the caregiver’s home and become part of their family. As the Veteran population rapidly ages, the VA is proactively expanding the MFH program to all VA Medical Centers (VAMCs) by 2026. This work describes lived experiences of Veterans in MFHs, their caregivers, and their family members. From February-April 2024, we conducted N=23 phone interviews with these individuals from 10 sites across eight states. Sites are part of a current VA Office of Rural Health (ORH) MFH expansion program. Veterans described living fulfilling lives in MFHs and taking advantage of activities in home and in the community through assistance from their caregivers. Veterans who lived previously in nursing homes shared that their lives improved greatly once they moved into MFHs. Many caregivers found their work highly rewarding, but also shared that caregiving can be isolating and that the VA provides them with limited respite options. Therefore, those who serve as caregivers must have a great desire to do this work. Some family members described that placing their Veteran family member in a MFH allowed them to return to work and expressed deep appreciation of the program. VAMCs starting and expanding MFH programs can apply findings from this work to better design and implement MFH programs in coming years.