bluuebunny/crossref_metadata_2025_split huggingface dataset:
VIRTUAL IMPLEMENTATION OF MOBILITY PROGRAMS IN MEDICALLY COMPLEX POPULATIONS
Authors: Garbin Alexander , Stevens-Lapsley Jennifer 
Published: January 2025

Abstract
Utilization of virtual platforms (e.g., Zoom, Teams, VA Video Connect) has rapidly expanded in both clinical and research settings since the onset of the COVID-19 pandemic. Within research, the use of virtual platforms affords numerous advantages including access to a broader geographical range of older adults, lack of dependency on transportation, and ability to monitor fidelity remotely. However, there also exist numerous considerations to ensure success when using virtual platforms as part of a research study. This symposium will detail four research projects utilizing virtual platforms. The research projects discussed share the overarching theme of improving mobility in older adults with medical complexity while varying in their stages of research, methodologies used, and how they use virtual platforms. The first speaker (Ritchey) will detail implementation of a virtual fall prevention clinical trial, MOVing FREEly. The second speaker (Garbin) will present on the use of a virtual platform to 1) determine the prevalence of fall risk factors in older Veterans using virtual fall risk factor assessments and 2) examine Veterans’ and providers’ perceptions of virtual fall prevention strategies. The third speaker (Rauzi) will discuss the development and refinement of a multicomponent telerehabilitation intervention delivered via virtual platform to older Veterans, using mixed-methods approaches. The fourth speaker (Stevens-Lapsley) will discuss challenges and successes of using virtual platforms and technologies to remotely monitor fidelity in a large-scale pragmatic clinical trial. These talks will provide a comprehensive understanding of barriers, solutions, and considerations for employing virtual platforms across a range of studies.
IMPLEMENTATION OF A VIRTUAL FALL PREVENTION PROGRAM IN OLDER VETERANS
Authors: Ritchey Katherine 
Published: January 2025

Abstract
Though virtual platforms have increased in popularity few studies have explored the implementation and benefit of a virtually-based fall prevention program. MOVing FREEly (Multicomponent Otago Virtual Falls Reduction Exercise and Education program) is a VA-based fall prevention program delivered entirely over a virtual care platform. The MOVing FREEly program is six-weeks long and includes both education in fall-risk reduction and evidence-based fall prevention exercises. Process measures captured implementation considerations, feasibility and effectiveness of the program. 27 participants who were older (mean 75 years), mostly male (89.0%), white (85.2%) and moderate or high risk of falling completed the program. 70% were new to the virtual platform. Attendance for education and exercise classes was &gt; 80% with little attrition. There was improvement in the Falls Efficacy Scale-International short form and statistically significant improvement in 30 second sit-to-stand and single leg balance tests. Process measures indicated that 40% of participants needed extra help at the start of each class to sign-on to the virtual visit, which was provided by program facilitators. By the fourth class, all participants were self-sufficient in their ability to navigate the virtual platform. Additional considerations such as electronic health record documentation and coding; clinic setup, referral management and virtual appointment scheduling; patient privacy and health emergency planning were necessary for the start-up and sustainability of the program. Virtual fall prevention programs are feasible and effective but require careful logistical planning and considerations. Implementation considerations from this program can guide future telerehabilitation research and clinical efforts.
CURRICULUM FOR PRACTICE AND LEADERSHIP IN NURSING HOMES: THE US RESPONSE
Authors: Kolanowski Ann , Reifsnyder JoAnne , Dunbar-Jacob Jacqueline 
Published: January 2025

Abstract
The Teaching Nursing Home (TNH), which began in the 1980s under the leadership of Dr. Mathy Mezey, was a visionary approach to improving the lives of older adults in nursing homes through the efforts of the interdisciplinary healthcare team. The project had extraordinary outcomes, but for a host of political and economic reasons was never brought to full realization. Forty years and a pandemic later, the need for improving quality care in our nations’ nursing homes took center stage. Dr. Terry Fulmer (John A Hartford Foundation) and Nancy Zionts (Jewish Healthcare Foundation) provided extraordinary leadership to address what is now widely regarded as a devastating gap in the US healthcare system. With over $5 million in funding, academic/practice partnerships were revisited in a pilot project with renewed energy, creativity, and resolve by three major universities in Pennsylvania and four affiliated nursing homes. Early on, the lack of curriculum models for faculty educating pre-licensure students in the delivery of quality care in nursing home settings was identified as a barrier to progress in the TNH project. The authors of this paper present the groundbreaking work that was done by an interdisciplinary panel of over 40 expert healthcare practitioners and academicians who came to consensus in the identification and qualitative development of a curriculum that prepares healthcare professionals and their faculty through academic/practice partnerships. Competencies include: creating a culture of care; improving diversity, equity and inclusion; person/family-centered care; models of care delivery; geriatric syndromes; interdisciplinary practice; regulation and finance; and information technology.
NURSE STAFFING AND PRN PSYCHOTROPIC DRUG USE IN VA HOSPITALS
Authors: Shorr Ronald , Lo-Ciganic Wei-Hsuan , Hahm Bridget , Gamble Julia , Powell-Cope Gail , Luther Stephen , Yang Seonkyeong 
Published: January 2025

Abstract
Reducing physical and chemical restraint use in hospitals is vital for patient safety. Studies have linked excessive physical restraint use to nurse shortages and increased risks (e.g., deaths). PRN (as needed) psychotropic drugs are used in hospitals for behavioral disturbances, yet their safety remains debatable. The impact of nurse staffing on PRN psychotropic use is unclear. Using data from 166 nursing units in Veterans Affairs (VA) hospitals from October 1, 2012, to September 30, 2017, we examined the relationship between PRN psychotropic use (i.e., antipsychotics or benzodiazepines) and two nursing staffing indicators: total nursing hours per patient day (TNHPPD) and the skill mix of registered nurses (RN), namely the proportion of nursing hours provided by RNs. Of 9,770 unit months (average 565.4 person-days of care), 25.8% involved veterans aged ≥75, 95.3% were male, and 31.6% had high Nosos risk scores. We categorized each unit into one of four quantiles based on their monthly TNHPPD, with mean and standard deviation ranging from 7.0 (1.5) in the lowest group to 15.2 (3.0) in the highest group. RN skill mix decreased as TNHPPD increased, from 71.5% to 63.1%. PRN psychotropic was 1.4%, consistent across TNHPPD levels. Multivariable mixed modeling showed PRN psychotropic use was not associated with TNHPPD levels (p=0.27) or RN skill mix (p=0.07). Our findings indicate that nurse staffing levels were not associated with PRN psychotropic use in VA hospitals.
SELF-NEGLECT CO-OCCURS WITH AND IS A RISK FACTOR FOR ELDER MISTREATMENT
Authors: Lewis Stuart , Connolly M T , Kimball Patricia , Rogers Geoff , Salvo Erin , Burnes David 
Published: January 2025

Abstract
Elder mistreatment is abuse, neglect, or exploitation occurring in a relationship involving an expectation of trust.1 Yearly, 10%–14% of community dwelling older adults experience mistreatment, with only 15% of cases being reported to Adult Protective Services (APS) for investigation.2 Self-neglect (not defined as elder mistreat- ment) comprises 50% of APS investigations and 65% of substantiated APS cases.3 How self-neglect relates to other forms of mistreatment is not well understood. Maine APS data was analyzed to delineate the relationship between self-neglect and elder mistreatment. Self-neglect as a risk factor for elder mistreatment has important implications for policy, practice, and the prevention of future harms. Our analysis demonstrates that Self-neglect frequently co-occurs with elder mistreatment. A first allegation of self-neglect, substantiated or not, is associated with a shorter time to elder mistreatment and an estimated 33% of all cases of elder mistreatment could be attributed to self-neglect. These findings have important implications for prevention, policy, and practice. While causality cannot be presumed—a limitation in all retrospective analyses—elder mistreatment and self-neglect share risk factors: cognitive impairment, physical disability, lack of social support, and social isolation. Our analysis suggests that early intervention, even in unsubstantiated allegations of self-neglect, may prevent subsequent mistreatment.
ADVANCING EQUITY AND COMMUNITY ENGAGEMENT IN AGING IN CENTERS ON AGING
Authors: Gaugler Joseph , Frazier Robbin , Mahoney Jane 
Published: January 2025

Abstract
The ultimate goal of much gerontological scholarship is to improve the lives of older people. To meet the needs and preferences of our rapidly diversifying communities of older persons, creating equitable partnerships with older adults, families, neighborhoods, and organizations is often necessary, if not essential. This symposium aims to highlight centers/institutes on aging across the U.S. that have adopted various strategies and approaches to build partnerships with aging communities, co-create innovative scholarship, culturally adapt evidence-based/evidence-informed programs, and effectively disseminate knowledge to achieve health equity in aging. Our symposium will feature equity and community engagement missions, activities, opportunities, and challenges for four centers on aging, representing different types of institutions and areas of the country. Featured centers/institutes include the University of Texas-Austin’s Texas Aging & Longevity Consortium, Wayne State University’s Institute of Gerontology, Johns Hopkins University’s Center for Equity and Aging, and the University of Minnesota’s Center for Healthy Aging and Innovation. Jane Mahoney, MD, Director of the Community-Academic Aging Resource Network (CAARN) of the University of Wisconsin-Madison, will synthesize equity and community engagement efforts in centers/institutes on aging and will provide a roadmap for future initiatives to sustain this critical work.
I NEED HELP: AN EXPERIMENT IN COMMUNITY OUTREACH
Authors: Angel Jacqueline 
Published: January 2025

Abstract
This paper describes community outreach activities by faculty affiliated with The UT Austin Texas Aging & Longevity Consortium. Communities across the country like Austin are aging rapidly, while they are becoming more racially diverse and facing an ever-growing need for assistance to older citizens. The City of Austin is a vibrant and cosmopolitan metropolis comprising multiple communities of color—African American, Latino, and Asian which require affordable and culturally-appropriate services and supports. Often these are difficult to find or are simply not available. Many older adults suffer from multiple chronic conditions which increases their need for assistance. As a consequence, community outreach is desperately needed, and investigations in to the most cost-effective and efficient ways of informing clients about available services from which they might benefit is vital. This presentation lays out proposed solutions to confronting these challenges. Specifically, the presentation highlights one award-winning community-based policy research initiative that investigates important possibilities for building an age-friendly Austin that might be applied elsewhere. The public-private initiative uses a multimethod approach to establish an intergenerational community-based resource and activity center (IDC) to optimize space in public places. The IDC model would expand current public health services, including child and adult day care aging, service coordination, and tele-behavioral health in one location. We end with a discussion of lessons learned regarding research-based strategies that encompass three domains: community outreach, co-production, and building partnerships inside and outside the UT campus.
THE CENTER FOR EQUITY IN AGING AT JOHNS HOPKINS UNIVERSITY
Authors: Ornstein Katherine , Allgood Sarah , Thomas Kali , Samus Quincy 
Published: January 2025

Abstract
The Center for Equity in Aging was launched in 2022 Johns Hopkins University to advance scholarship, research and advocacy focused on aging and serious illness care. The Center seeks to transform the diverse experiences of aging and serious illness to enhance equity and well-being across the life course. Hosted by the School of Nursing, the Center includes 2 dozen principal faculty and draws upon a variety of disciplines including nursing, epidemiology, gerontology, health services, and health policy. In this presentation we will discuss how the Center advances equity in aging by engaging in research, training and scholarship that supports diverse individuals and populations, identifies health disparities in aging throughout the life course, and develops interventions, policies, and models of care to reduce inequities in the opportunities and resources needed to grow and age as healthily as possible. We will discuss the Center’s collaborations and partnerships with a diverse set of stakeholder groups to promote community-engaged research practices that inform research across all stages and describe new initiatives focused on advancing equity within the Center and how the Center collaborates with other centers/institutes both within and outside of the Johns Hopkins community. Center leadership will discuss their visions for promoting equity in aging research and reflect on key challenges in the field.
THE ASSOCIATIONS OF LATE-LIFE BLOOD PRESSURE WITH CERAD AND BRAAK STAGES: FINDINGS FROM THE NACC DATASET
Authors: Sin Mo-kyung , Dowling N Maritza , Roseman Jeffrey , Ahmed Ali , Zamrini Edward 
Published: January 2025

Abstract
CERAD and Braak staging are two major scoring systems for quantifying neuropathological features of Alzheimer’s disease (AD). Midlife hypertension is a risk factor for AD, but less is known about the relationships between late-life systolic blood pressure (SBP) with CERAD and Braak staging, the examination of which was the objective of the current study. This study analyzed data from 5,160 participants in the National Alzheimer’s Coordinating Center dataset which had data on 4 longitudinal SBP measurements before death and on CERAD (n=2,600) and Braak (n=2,560) autopsy data. CERAD score was dichotomized into moderate/severe versus none/sparse; Braak stage was dichotomized into groups: III-VI vs 0-II. Logistic regression models were used to examine odds of higher CERAD or Braak staging associated with SBP ≥130mmHg (mean of 4 late-life measures). In a model that controlled for age at death, last BP to death (in years), and sex, a late-life mean SBP ≥130mmHg compared to SBP &lt; 130mmHg was associated with an estimated odds ratio for a more severe CERAD score of 1.13 (95% CI: 1.00, 1.26). In a model that also controlled for antihypertensive medications and APOE ε4 status, SBP ≥130mmHg was associated with a slightly increased estimated odd for a more severe CERAD score of 1.15 (95% CI: 1.02, 1.30). We found a direct association between late-life mean SBP with CERAD score, but not with Braak stage. This analysis supports the importance of maintaining control of BP into late life as a strategy to slow the rate of progression of AD pathology.
THE INTERPLAY AMONG IMMUNITY, INFLAMMATION, AND FRIED FRAILTY ON ALZHEIMER’S DISEASE
Authors: Chen Jiachen , Doyle Margaret , Cao Yumeng , Ragab Ahmed , Murabito Joanne , Lunetta Kathryn 
Published: January 2025

Abstract
Unraveling shared mechanisms for both frailty and Alzheimer’s Disease (AD) including immunity and inflammation is crucial for understanding the link between these two complex multifactorial conditions. This study aimed to characterize the interplay among circulating immune cells, inflammatory biomarkers, and frailty phenotypes on AD onset in the Framingham Heart Study Offspring cohort. A sample of 519 participants (52% female, mean age 66 years), had extensive profiling of immune cells from peripheral blood mononuclear cells and inflammatory protein biomarkers (OLINK Proteomics) at Exam 7 and were dementia-free at the time of Fried frailty measurement (Exam 8). Data from 146 immune cells, 68 proteins, and 5 frailty phenotype components were integrated using sparse multiple Canonical Correlation Analysis (SmCCA) adjusted for relevant covariates. SmCCA seeks linear combinations of variables maximizing inter-correlated canonical scores for all three datasets, yielding signatures of immunity, inflammation, and frailty for each participant that screened variables contributing to the establishment of signatures and inter-datasets pathways. Full follow-up for up to 13.8 years (median 12.1 years) identified 24 incident AD cases. Cox proportional hazard models, accounting for covariates including age, sex, education, and APOE genotype, were employed to assess signatures as risk factors for AD incidence. The inflammation and immunity signatures were correlated (r2=0.32, p-value&lt; 0.001). Both immunity and frailty signatures were significantly associated with AD incidence (immunity: HR=1.1, p-value=0.03; frailty: HR=3.14, p-value=0.02). This study disentangles potential pathways among immune cells and inflammatory biomarkers that contributed to associations with frailty and AD. We will extend to larger studies for replication.
EFFECTIVENESS OF A DEMENTIA CARE INTELLIGENT RECOMMENDER SYSTEM ON CARE PROBLEMS: A RANDOMIZED CONTROLLED TRIAL
Authors: Sun Yue , Wang Zhi-wen 
Published: January 2025

Abstract

Background
The complexity and diversity of problems encountered in dementia care varies from the individual, and the health recommender system provides a pathway for realizing solutions for universal access to professional guidance.

Objectives
To examine the effectiveness of dementia care intelligent recommender system (DCIRS) for dementia care on improving the number of care problems and their level of distress.

Methods
250 caregivers of dementia patients were included and randomly assigned them to either the intervention group receiving the intervention of DCIRS or a waiting-list control group with 12 weeks of intervention length. The number of care problems and their level of distress was measured using the care problems evaluation sheet for people with dementia. The outcomes were compared between groups by using generalized estimating equations (GEE) based on intention-to-treat principle.

Results
A total of 250 participants were included in the analysis. The dietary, dressing, and excretory care problems of the patients with dementia in the control group significantly increased at T2, while there was no significant change in the number of care problems in the intervention group. GEE results showed that participants in the intervention group revealed significantly greater reductions on the level of distress related to care problems than the control group at T1 (β = −3.01, p = 0.026) and T2 (β = −5.80, p = 0.006). Conclusions: The DCIRS was effective in improving the number of care problems and their level of distress. Longer follow-up study is needed to uncover its long-term benefits on clinical outcomes.
EMERGING STRATEGIES FOR AGING
Authors: Ambrosio Fabrisia 
Published: January 2025

Abstract
This session on Emerging Strategies for Aging focuses on the potential of therapeutically targeting specific pathways/hallmarks of aging for extending healthspan. These targets include increasing mitophagy as a way to improve mitochondrial function, the use of extracellular vesicles from young serum to improve tissue homeostasis, modulating lipid metabolism to reduce the number of senescent cells through induction of ferroptosis and targeting the N6-methyldeoxyadenosine epigenetic mark regulated by DNA damage and stress. The session also will include discussion of approaches to target these different pathways in mice, C. elegans and human cell types derived from iPSCs as well as human brain tissue and provide evidence that genetic variants in lipid metabolism indeed affects the level of senescence in humans. Overall, the goal of the session is to provide examples of the types of novel approaches that could be used to target different pathways important for aging and disease.
SHIELDS OF CHIFFON: THE FORTITUDE/RESILIENCE OF AGING DRAG ARTISTS
Authors: Chapman Brian , Brenick Alaina , Donorfio Laura 
Published: January 2025

Abstract
This presentation discusses findings from a mixed methods study examining the intersection of aging, drag artistry, and individual wellbeing. Drag artists remain an understudied and underrepresented population in scholarship (Knutson et al., 2020; O’Brien, 2018). More specifically, older drag artists have yet to be studied in social science literature (Henneberry et al., 2022). Participants completed a semi-structured interview and a self-administered survey to understand the perspectives of drag artists over the age of 50 (n=22; ages 50-94). Qualitative analysis of the interviews revealed themes related to personhood, family impact, coping, resilience, generativity, community advocacy, activism, and performance. Participant interviews were augmented through an electronic survey that validated themes and provided a greater understanding of personality characteristics illuminated in the interviews. The survey assessed resilience (CD-RISC; Connor & Davidson, 2003), depression (CES-D; Radloff, 1977), personality (TIPI; Gosling et al, 2003), and coping (Brief COPE, Carter, 1997) of 20 drag artists (51-94 years). Descriptive analyses reveal high levels of resiliency (M =80.32/100) and low levels of depression (80% of participants reported below threshold rates/symptomatology). The sample is significantly more extraverted, conscientious, and open than population comparison means (51+ years) (t-tests; p’s=0.01-0.001). Repeated measures ANOVA Additionally, results showed that participants used healthier coping methods (i.e., problem-focused&gt;emotion-focused&gt;avoidant (Repeated Measures ANOVA, p’s&lt;0.001). The lived experiences revealed in this study also provides data about the unifying impact of shared episodic events. The session will close with a discussion of potential future research including intergenerational approaches.