bluuebunny/crossref_metadata_2025_split huggingface dataset:
DISPARITIES AMONG LONG-TERM AND SHORT-TERM USERS OF MEALS ON WHEELS SERVICES
Authors: Weaver France , Chubinski Jennifer , Walsh Sarah 
Published: January 2025

Abstract
Home-delivered meal programs for older adults, commonly known as Meals on Wheels (MOW) services, provide nutritional benefits and are valued by clients, but most studies capture use over a short period of time, typically a few months. This study is the first to focus on duration of use and identify disparities in the long-term and short-term MOW users. It uses 35,756 observations from the 2013-2022 National Health and Aging Trends Study (NHATS), an annual survey of Medicare enrollees aged 65+. A fixed effect multinomial logit model, with complex survey design, predicts the probabilities of being a short-term or long-term MOW user across lagged sociodemographic and health characteristics. Short-term users are defined as reporting MOW use once (12.4% of the sample) and the long-term users indicate use for 2+ years (8.6%). Persons who are Black are statistically more likely to be long-term MOW users (13.7%) than non-Black (8.0%), similarly for those on Medicaid (15.7%), having 2+ instrumental activity of daily living limitations (10.9%), and pre-frail (9.5%). In contrast, no racial or health differences are found for short-term MOW users, except for those on Medicaid (18.7%). These results identify the populations more likely to be long-term MOW users, but further research is needed to determine if prolonged MOW use is an indicator of sustained independence or a consequence of barriers to additional services. This study helps to better understand the role played by MOW and the federal Older Americans Act Nutrition Program, which funds those services, at serving diverse populations.
REVIEWING DATA DISAGGREGATION IN AGING HEALTH RESEARCH: NIA GRANTS AND RECOMMENDATIONS FOR EQUITY
Authors: Cajavilca Moroni Fernandez , Lee Matthew , Doan Lan 
Published: January 2025

Abstract
Current federal minimum standards for collecting and reporting race and ethnicity data often group diverse individuals into broad, monolithic categories. Despite advances in policy and practice and calls for inclusive research, data equity remains a significant issue in aging-related health research. Racially and ethnically diverse older adults are underrepresented in health research and rarely disaggregated by ethnicity in data collection, analysis, and reporting of aging-related health outcomes. Data disaggregation offers a promising approach to advancing data equity in aging research. We reviewed the National Institutes of Health Research Portfolio Online Reporting Tools Expenditures and Results (NIH RePORTER) database to identify extramural National Institute on Aging (NIA) grants from 1985 to 2024 that proposed disaggregating race and ethnicity data for aging research. We found only 12 NIH-funded awards, demonstrating the limited focus on this issue. Most grants that explicitly mentioned data disaggregation were awarded from 2015 onwards (n=11, 92%). Proposed data disaggregation by ethnicity in NIA-funded grants included Latino and Hispanic, Asian, Pacific Islander, and Arab ethnic groups. Grant funding mechanisms included investigator-initiated grants such as R01 grants (n=5, 42%) and predoctoral training grants/awards such as the F31 and R36 (n=3, 25%). Enhancing cultural congruence and methodological rigor in data collection and reporting that is reflective of the diversifying aging population is crucial for meaningfully addressing health equity. We provide recommendations to advance aging-related health research and highlight data disaggregation considerations for racially and ethnically minoritized communities that are historically under-engaged and underrepresented in aging health research.
THE RELATIONSHIP BETWEEN RETIREMENT AND CARDIOVASCULAR DISEASE: A MEDIATION ANALYSIS IN THE U.S. AND SOUTH KOREA
Authors: Choi Gayoung , Chen Ruijia , Park Hee Man , Lee Harold 
Published: January 2025

Abstract
Retirement has been linked to increased risk for cardiovascular disease (CVD), but little is known about the pathways underlying the association. Moreover, most studies have been conducted in Western countries, and their findings might be less generalizable to Eastern countries due to different social contexts and labor and employment environment. We examined 1) whether retirement status is associated with a higher risk of CVD in South Korea and the U.S., and 2) whether health (e.g., hypertension, diabetes, and obesity), behavioral (e.g., physical activity, alcohol consumption, and smoking), and psychological factors (e.g., loneliness, depressive symptoms, and quality of life) mediate these associations. Data were drawn from the Health and Retirement Study (HRS, 2002–2014; n=11,855) and the Korean Longitudinal Study of Aging (KLoSA, 2006–2018; n=4,908). We analyzed the data using cox proportional hazard model, controlling for socio-demographic factors, health conditions, health behavior, and social isolation. We also performed causal mediation analyses based on counterfactual framework. After adjusting for all covariates, retirement (vs. employment) was associated with an increased likelihood of developing CVD (Hazard Ratio (HR): 1.22, 95% CI: 1.00-1.49) in Korea but not in the U.S. Regarding potential mediators, several physical health factors accounted for a proportion of the association in KLoSA: hypertension (17.7%, p&lt; 0.01), diabetes (12.1%, p&lt; 0.05), and obesity (3.7%, p=0.01). The psychological pathway, specifically quality of life, also mediated the association (4.8%, p&lt; 0.05). Our findings highlight that public health interventions targeting physical and mental health could be an important strategy for preventing CVD among retirees, especially in Korea.
IGESS: A CO-CREATIVE INTERGENERATIONAL STRATEGY FOR ENHANCING POSITIVE INTERGENERATIONAL OUTCOMES
Authors: Wong Alice C , Lai Daniel W L , Ou Alison Y T , Bai Xue 
Published: January 2025

Abstract
Intergenerational interaction is crucial for promoting social cohesion and mutual understanding. The Inter-Generational Engagement in Secondary Schools (i-GESS) program was created to engage older adults and university students in co-creating learning activities for students in secondary schools to enhance positive intergenerational interactions, attitude, knowledge, and skills. This study examined the changes using a quasi-experimental pre-post survey design in 129 older adults (age 60+), 110 university students (age 18 to 22), and 470 secondary school students (age 13 - 16). The results demonstrated substantial improvements in attitudes towards different age groups, as measured by the 34-item Kogan’s scale. Secondary school students showed a significant 13.7% improvement in attitudes towards older adults, while university students and older adults noted increases of 4.2% and 5%, respectively, in their views towards youth. Additionally, self-rated communication skills saw notable gains, with secondary school students and university students recording increases of 7.9% and 9.5%, respectively. Trust in communication also increased substantially, evidenced by a 12.1% rise among secondary school students and a 5% improvement among older adults. The most pronounced enhancements were in the attitudes of secondary school students towards older adults and the communication skills of university students, indicating major impacts in these areas. The i-GESS initiative successfully bridged generational divides, fostering meaningful relationships across age groups via the application of the co-creation strategy. The positive outcomes further reinforce the benefits of this intergenerational approach for enhancing mutual cooperation and respect.
INTERGENERATIONAL SOLIDARITY AND MENTAL HEALTH IN CHINESE AMERICAN FAMILIES: A DYADIC APPROACH
Authors: Li Mengting , Le Qun , Guo Man , Peng Changmin , Tang Fengyan , Da Wendi , Jiang Yanping 
Published: January 2025

Abstract
Existing family and caregiving studies have focused on mental health of either older adults or adult children, while less is known about the effect of intergenerational relations on mental outcomes for both generations using a dyadic approach. This study examined the association between intergenerational solidarity and mental health among older Chinese Americans and their middle-aged adult children with dyadic analysis, while considering the gendered nature of these relationships. This study included 216 father-child and 337 mother-child dyads. Three indicators of intergenerational solidarity (emotional closeness, contact frequency, and upward support) were assessed by both parents and children. Mental health of both generations was assessed with anxiety, depression, and loneliness. Actor–Partner Interdependence Models were used for dyadic analysis. In father-child dyads, lower contact frequency perceived by children and greater upward support perceived by older fathers were associated with older fathers’ lower levels of anxiety and loneliness; and higher emotional closeness perceived by adult children was associated with adult children’s lower levels of anxiety. In mother-child dyads, higher emotional closeness and upward support perceived by older mothers were associated with older mothers’ lower levels of anxiety, depression, and loneliness, while higher emotional closeness and upward support perceived by adult children were associated with adult children’s lower levels of loneliness. The findings suggest that dyadic intervention promoting emotional closeness and upward support may benefit mental health for both generations and achieve optimal caregiving outcomes. The gendered pattern in intergenerational relations should also be considered in dyadic interventions.
SOCIAL NETWORK TYPES TRANSITIONS, HEALTH AND WELL-BEING-A PERSON-CENTERED APPROACH AMONG CHINESE OLDER ADULTS
Authors: Dai Shuting 
Published: January 2025

Abstract
The social networks of older individuals reﬂect personal life history and cultural factors. However, little is known about stability and change in social network types over time in China. The purposes of this study were to (1) investigate transitions in social network types of Chinese older adults; and (2) examine the transitions of the relationship of the social network types to the measures of health and well-being. Data were drawn from ﬁve waves of the China Health and Retirement Longitudinal Study to examine the changes in social network heterogeneity in old Chinese cohort. Data from 19395 observations of 7321 older adults (65 years and older) were considered. Latent transition analysis (LTA) was conducted using seven social network-related variables. The identified typologies were then regressed on the indicators of health and well-being. We found 5 social network types at both waves, representing the most to the least diverse types–diverse, unmarried and diverse, extended family, immediate family, and restricted. About 68% of respondents between waves retained their social network type, whereas 19% transitioned into more diverse types and 13% into less diverse types. Compared with the restricted network, older adults in all other networks were more likely to report higher self-rated health, higher life satisfaction, and lower depressive symptoms at both waves. The findings capture the dynamics in social network composition among older adults in China. A person-centered approach is recommended for policymakers to understand social network transitions, and promoting social network diversity in later life may contribute to healthy aging.
A NOVEL DNA METHYLATION-BASED SURROGATE BIOMARKER FOR LATENT SYSTEMIC INFLAMMATION
Authors: Meier Helen , Klopack Eric , Farina Mateo , Hernández Belinda , Mitchell Colter , Faul Jessica , McCrory Cathal , Crimmins Eileen 
Published: January 2025

Abstract
Chronic low-grade systemic inflammation is a risk factor for chronic diseases and mortality and is an important biomarker in health research. DNA methylation (DNAm) surrogate biomarkers are valuable exposure, risk factor and health outcome predictors in population studies. We generated a DNAm surrogate biomarker for chronic, systemic inflammation from a previously identified systemic inflammation latent variable derived from seven inflammatory markers and evaluated its performance relative to measured inflammatory biomarkers in predicting several age-associated outcomes of interest, including mortality, activities of daily living and multimorbidity in the Health and Retirement Study. The DNAm surrogate, Inflammation Latent Variable Methylation Surrogate (InfLaMeS), strongly correlated with individual inflammation markers and performed similarly to the latent systemic inflammation when predicting multimorbidity, disability, and 4-year mortality. These results suggest that InfLaMeS provides a robust alternative to blood-chemistry measures of inflammation that can be used for further scientific insight into understanding the role of inflammation in aging and health.
THE IMPACT OF HIIT ON MUSCULAR, ENDURANCE, AND QUALITY OF LIFE METRICS IN OLDER ADULTS
Authors: Hoffman Rashelle , Murphy Blake , Krywe April , Stoffel Devon , Magrini Mitchel 
Published: January 2025

Abstract
High-intensity interval training (HIIT) can mitigate age-related declines in muscle mass and strength that lead to decreased functional ability and loss of independence. However, previous HIIT protocols are often treadmill or recumbent bike-based with limited whole-body functional exercises and often do not include older adults (OA) beyond 70 years of age. The aim of this study was to examine the effects of a 12-week, Total Body HIIT (TB-HIIT) protocol on muscle size (cross-sectional area [CSA] of the rectus femoris [RF], vastus lateralis [VL], and vastus medialis [VM]), muscle strength (peak toque [pT] and rate of torque development [pRTD]), muscle activation (peak electromyography [pEMG] and rate of EMG rise [pRER]), cardiovascular endurance (6-minute walk test [6MWT]), and quality of life (QOL, 36-Item Short Form [SF-36]) in OA. Older adults, 65-95 years of age, were recruited and completed all outcomes at baseline and following the 12-weeks of TB-HIIT. The TB-HIIT protocol progressively increased the exercise-to-rest ratio every four weeks (20sec:40sec, 30sec:30sec, 40sec:20sec) with target intensity being 85-95% of participants’ heart rate max. Twenty-four OA (74.8□6.37 years, range=65-89) completed this study. Results showed significant increases in VL-CSA (p=0.02, g=-0.77), VM-CSA (p&lt; 0.001, g=-1.03), cardiovascular endurance (p&lt; 0.001, g=-0.95), and health-related QOL (p=0.012, g=-0.47). No significance was revealed in RF-CSA (p=0.068, g=-0.4), pT (p=0.78, g=-0.17), pRTD: p=0.91, g=-0.07), pEMG (p=0.77, g=-0.17) or pRER (p=0.51, g=-0.39). Future research should continue to explore the benefits of TB-HIIT with consideration towards OA subpopulations with comorbidities and greater physical impairment to advance exercise prescription and function for this population.
COMPARISON OF MULTIDIMENSIONAL AGING TRAJECTORIES BETWEEN PEOPLE AGING WITH AND WITHOUT DISABILITIES
Authors: Park Seeun , Bratzke Lisa 
Published: January 2025

Abstract

Background
The aging trajectories of people aging with disabilities (PAwD) may involve distinct life experiences compared to those of people without disabilities (PWoD). However, the extent to which aging trajectories vary between the two groups remains unclear. This study investigates these differences, analyzing the impact of long-term disability at phenotypic and functional levels, and examining social disparities across various demographic factors using data from the 2006-2020 waves of the Health and Retirement Study.

Methods
Phenotypic aging was measured by the metabolic dysfunction risk score (MDRS), and functional aging was assessed through limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Growth-curve modeling was used.

Results
A total of 7,234 participants were included. PAwD exhibited significantly higher baseline MDRS and ADLs/IADLs scores, with more rapid escalation over time, indicating premature and accelerated aging. Significant social disparities in aging were observed across cohort, gender, race/ethnicity, and educational attainment. Recent cohorts of PAwD showed more rapid increases in MDRS. Women and racial minorities, especially non-Hispanic Blacks and Hispanics, had higher MDRS. Across all race/ethnicity groups, PAwD exhibited higher MDRS and functional limitations. Lower educational attainment was associated with both higher MDRS and ADLs/IADLs.

Conclusion
PAwD experience an accelerated and unequal aging process compared to PWoD, with significant social disparities. These findings suggest the need for tailored health interventions and policies that address the distinct aging trajectories and vulnerabilities of PAwD, emphasizing early detection and targeted support to mitigate the compounded effects of disability and sociodemographic factors.
COGNITIVE DECLINE AMONG OLDER ADULTS FOLLOWING TRAUMATIC BRAIN INJURY
Authors: Albrecht Jennifer 
Published: January 2025

Abstract
Traumatic brain injury (TBI) is a risk factor for Alzheimer’s disease and related dementias. However, evidence for this association among older adults is less robust, and further studies are needed to better understand cognitive recovery following TBI in this population. Retro-TBI is an ongoing prospective cohort study of adults aged 65+ diagnosed with TBI at a Level 1 trauma center. In the current study, we assessed four cognitive domains (memory, language, attention, and visuospatial/constructional) at 2 weeks, 3 and 6 months post-TBI using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). We calculated the slope of the RBANS total age-adjusted scaled scores for each participant with ≥2 assessments (n=42) over days since TBI. Participants with a negative slope were considered to have cognitive decline. We compared participant characteristics between those with and without cognitive decline using Student’s t-test or Fisher’s exact test. Average age was 73.9 (standard deviation 7.8) years and 47.6% were female. Findings indicated that 31.0% (13/42) of participants had cognitive decline and were more likely to report a history of depression (61.5% vs. 13.8%, p=.003) and live alone (76.9% vs 34.5%, p=.02) than those without cognitive decline. The cognitive decline group was also more likely to experience decline in visuospatial/constructional (61.5% vs. 24.1%, p=.04) and immediate memory skills (61.5% vs. 27.6%, p=.047) compared to those without cognitive decline. Preliminary findings from this ongoing study suggest that one-third of older adults experience cognitive decline over 6 months post-TBI, with immediate memory and visuospatial skills particularly impacted.
SELF-FUNDED PERSONAL CARE IS COMMON AND COSTLY FOR PEOPLE WITH DEMENTIA ACROSS THE INCOME SPECTRUM
Authors: Reckrey Jennifer , Shen Karen , Yang Yang 
Published: January 2025

Abstract
remain in the community; those without Medicaid coverage or long-term care insurance must self-fund this care (i.e., pay for privately or out-of-pocket). Using data from the Health and Retirement Study (2002-2018), we identified the prevalence and financial burden of self-funded paid care among community-dwelling people ≥65 who received help with ≥1 activity of daily living (n=4666). Dementia status, receipt of paid care, and financial information (income, cost of self-funded paid care) were determined by survey responses. One-quarter of PLWD (versus 14% without dementia) used self-funded care. Among PLWD, the probability of self-funding care increased with income, but was significant for all income groups: 15%, 23%, 32%, and 48% of those with incomes 100%, 100-200%, 200-400%, and ≥400 of the federal poverty level respectively self-funded paid care. The amount and cost of this self-funded care was high, particularly for PLWD: 45% of PLWD (versus 22% without dementia) received ≥40 hours/week of self-funded care and nearly half spent ≥$1000/month self-funding paid care. The median PLWD that self-funded care spent 45% of their monthly income on self-funded care; in the lowest-income group, the median PLWD spent nearly 75% of their monthly income on self-funded paid care. Given self-funded paid care is common and costly throughout the income spectrum, programs and policies aimed at easing the financial burden of self-funded paid care (e.g., expanded access to Medicaid home and community-based services) are essential, particularly for low-income individuals and families.
UNMET NEEDS & AVOIDABLE NURSING HOME PLACEMENTS AMONG BLACK, LATINO, AND WHITE PEOPLE LIVING WITH DEMENTIA
Authors: Travers Jasmine , Shenoy Shivani , Bergh Marissa , Raval Aasha , Jimenez Andreina 
Published: January 2025

Abstract
Many nursing home (NH) placements are avoidable considering equivalent care can be provided in the community setting. Preventing avoidable NH placements and enabling aging in the home and community has been prioritized by federal, state, and local entities. Guided by Diwan and Moriarty’s conceptual frame for Identifying Unmet Healthcare Needs of Community Dwelling Older Adults, this qualitative descriptive study explored the unmet needs and related barriers that drive avoidable NH placements among Black, Hispanic/Latino, and White people living with dementia (PLWD). One-on-one semi-structured interviews were conducted March-November 2022. Participants including PLWD, family care partners (FCP), and NH staff, were recruited from two New York NHs. Policy experts were recruited from aging organizations across the country. Data were analyzed using a directed content and thematic analysis approach. Sixty-one individuals were interviewed, 19 PLWD, 17 FCP, 15 NH staff, and 10 aging policy experts. Seven distinct themes specific to unmet needs emerged from the data and included 1) support with activities of daily living and basic home maintenance; 2) resources and services; 3) treatment; 4) socialization; 5) individual preferences; 6) function of the home; and 7) equipped, available, and supported family. Related barriers that contribute to unmet needs defined within our guiding framework included awareness, knowledge, availability, affordability, and acceptability of resources and services. Participants described multifaceted factors that contribute to the unmet needs driving avoidable NH placements. Strategies to address these unmet needs and improve the understanding of the complex home and community-based services landscape may help reduce these placements.