bluuebunny/crossref_metadata_2025_split huggingface dataset:
PHYSICAL ACTIVITY AMONG OLDER ADULTS WITH AND WITHOUT HIV IN UGANDA: COHORT STUDY IN RURAL UGANDA
Authors: Ratnayake Aneeka , Tong Yao , Reynolds Zahra , Chamut Steffany , Paul Robert , Tanner Jeremy , Olivieri-Mui Brianne , Siedner Mark 
Published: January 2025

Abstract
Studies from high-income countries have established the benefits of physical activity (PA) for health among older people. Yet, PA and its links to frailty and quality of life (QOL) in older rural African populations living with HIV remain under-explored. We analyzed data from the first three annual assessments in a cohort of older people living with HIV (PLWH) and age- and sex-similar, community-based people not living with HIV. PA was measured through self-reported minutes of moderate and vigorous PA, converted into metabolic equivalent of task (METs). PA adherence to World Health Organization (WHO) guidelines was defined as a minimum of 150 minutes of moderate PA or 75 minutes of vigorous PA weekly. Linear and logistic generalized estimating equations (GEE) regression models were employed to estimate the association between HIV status and PA, adjusting for frailty, QOL, comorbidities, and age. At enrollment there were 297 PLWH and 302 people not living with HIV, 304 men and 295 women, with a median age of 58 years (IQR:54-63); 96% met PA guidance. After multivariable adjustment, PA in METs was associated with younger age (b=-187.18 per year, p&lt;0.0001), HIV infection (b=-1039.12, p=0.041), higher health-related QOL (b=38.05 per point on a 0-100 scale, p=0.034), frailty (b=-2661.24, p=0.028), and medical comorbidity (b=-2208.07, p&lt;0.0001). Guideline-concordant PA was inversely associated with frailty (OR:0.27, p=0.0076) and medical comorbidity (OR:0.43, p=0.0069). Correlates of lower PA were older age, living with HIV, frailty, and medical comorbidity. Those with frailty and medical comorbidity may not be benefitting from recommended levels of PA.
INCREASING DEMENTIA DETECTION IN HEALTH CARE SYSTEMS: LEARNINGS FROM THREE PRAGMATIC CLINICAL TRIALS
Authors: Dublin Sascha , Barnes Deborah , Ling Shari 
Published: January 2025

Abstract
In the US, an estimated 6.7 million older adults have dementia, yet only about half have received a diagnosis. Earlier detection has potential to improve health and quality of life for people living with dementia and their caregivers by improving access to education, supportive services, and emerging treatments. The National Institute on Aging has funded pragmatic clinical trials of innovative, low-cost approaches aimed at increasing recognition of dementia within healthcare systems. In this symposium, we will present methods and early results from 3 such trials. The eRADAR study is applying a machine learning-based algorithm that draws on electronic health records (EHR) data to identify high-risk individuals. The intervention involves inviting high-risk individuals in the intervention arm for a “brain health” assessment visit within primary care. The D Cubed Study is testing two approaches: an EHR-based algorithm, the Passive Digital Marker, and a brief patient-reported questionnaire, alone and in combination. Results are shared with primary care providers via the EHR together with next steps for evaluation. The Toolbox Detect study is examining whether self-administered, brief cognitive screening tests given via tablet computers as part of annual wellness visits can increase dementia detection. Investigators leading these trials will describe their interventions and study methods and present early results related to uptake, feasibility and acceptability. They will also discuss challenges encountered, potential solutions, and lessons learned. A major goal will be to engage audience members to consider how they might apply these methods to increase detection of dementia in their own settings.
DIGITAL DETECTION OF DEMENTIA (D CUBED) TRIALS
Authors: Boustani Malaz , Fowler Nicole 
Published: January 2025

Abstract
At Indiana University, we leveraged electronic health record (EHR) data and Machine Learning algorithms to develop a Passive Digital Marker (PDM) for dementia detection with 80% accuracy. At the University of Miami, we developed the Quick Dementia Rating Scale (QDRS) as a 2-3 minute patient-reported outcome tool with 85% accuracy for dementia diagnosis. Two pragmatic cluster-randomized controlled comparative effectiveness trials randomized primary care clinics to Usual care, PDM alone, and both the PDM and the QDRS. Trials recruited diverse rural, suburban and urban primary care practices located in central Indiana and south Florida. The positive results are communicated via the EHR only to clinicians within the PDM and PDM + QDRS clinics during an ambulatory primary care visit. The primary outcome measure is the annual rate of new documented dementia diagnosis. In the first year, the Indiana trial enrolled 5960 older patients with a mean age of 71.9 years and SD of 6.50, 61% were female and 51% were African American. In the clinics that were randomized to PDM + QDRS, there were 827 patients who completed at least one question on the QDRS. The Indiana trial used a non-interruptive Best Practice Alert (BPA) for the first year of operation. For the second year of operation, the trial coupled the BPA with an InBasket message to primary care physicians to overcome the shortcoming of the Non-interruptive nature of the BPA. We have created an IT implementation manual to deploy the PDM with minimum expertise.
INTEGRATING VIRTUAL REALITY DEMENTIA SENSITIVITY TRAINING INTO THE UNDERGRADUATE CURRICULUM
Authors: Shovali Tamar 
Published: January 2025

Abstract
There is a need for Age-Friendly endeavors to include dementia-inclusive educational opportunities in higher education. Given the rising aging population, undergraduate students increasingly will (a) have personal experiences with loved ones diagnosed with dementia or Alzheimer’s disease, (b) pursue careers in the field of aging and directly work with individuals with dementia or Alzheimer’s disease, or (c) indirectly work with individuals with dementia or Alzheimer’s disease and their caregivers through roles in various professions such as finance or law. Undergraduate students in a gerontology course at an Age-Friendly University engaged in a dementia inclusive virtual reality training intended to sensitize individuals to the needs of people living with dementia. Virtual reality experiences related to dementia can help build empathy towards daily challenges faced by people living with dementia. Prior to and after engagement in the session students were asked questions about their understanding and empathy for people with dementia and their caregivers. Small group discussions followed the session to prompt reflection, encourage critical thinking, and facilitate discussion on the impact and lessons learned from the training. This experiential learning was preceded by an interactive lecture about the basics of Alzheimer’s disease and dementia delivered by a Community Educator from the Alzheimer’s Association. Age-Friendly University principles provide a guideline for the many ways higher education can shape age inclusive teaching and learning environments that promote greater empathy and understanding for people living with dementia or Alzheimer’s disease and their caregivers.
IMPACT OF STATE-LEVEL FACTORS ON CONSUMER-REPORTED UNMET NEEDS IN HOME AND COMMUNITY-BASED SERVICES
Authors: Parikh Romil , Shippee Tetyana , Langworthy Benjamin , Wang Zheng , Jutkowitz Eric , Giordano Stephanie 
Published: January 2025

Abstract
In the value-based purchasing framework, provider-specific quality indicators are often compared with national average estimates to measure performance. Hence, it is important to elucidate the impact of state-level administrative factors on consumer-level quality indicators for their national use. Therefore, we evaluated associations of state-level factors (from publicly reported data) with consumer-reported service-specific unmet needs for six commonly used home and community-based services (HCBS) from the NCI-AD data (2015-2019, n=23,333 community-dwelling older respondents; age, ≥65 years). We fit a mixed-effects logistic regression model for unmet needs in each of six HCBS; adjusting for state ID random effect, consumer-level health and demographic fixed effects, and four state-level fixed effects including HCBS spending relative to institutional care spending, percent managed care population, HCBS spending per client, and Medicaid expansion. To evaluate whether addition of these 4 state-level fixed effects improved model fit, we evaluated improvement in the Akaike Information Criterion, for each of six HCBS. A 10% increase in the proportion of managed care population in state was significantly associated with greater odds of consumer-reported unmet needs in personal care (Odds Ratio [OR], 1.37, p&lt;0.01), homemaker services (OR, 1.74, p&lt;0.001), and transportation services (OR, 1.22. p&lt;0.05). There were no significant associations between other state-level factors and service-specific unmet needs. Addition of the four state-level factors improved model fit for personal care, homemaker, meal delivery, and transportation services, and worsened model fit for adult day and caregiver-respite services. State-level factors likely have very little impact on consumer-reported unmet needs as an HCBS quality indicator.
WORKING THE SCHOLAR-ACTIVIST HYPHEN: QUEER GERONTOLOGY PERSPECTIVES FROM OLDER BLACK LESBIANS
Authors: Oswald Austin 
Published: January 2025

Abstract
The LGBTQ+ aging population is growing increasingly racially and ethnically diverse; however, older adults of color are underrepresented in LGBTQ+ aging research. This significant gap in the field constitutes a critical ethical issue that future scholarship must address. Advancing LGBTQ+ aging research necessitates a heightened focus and specificity on subgroups, particularly those with intersecting marginalized identities, while generating knowledge that challenges structural oppression. This presentation sheds light on insights gleaned from an ongoing, multi-year participatory action research project aimed at addressing gaps within contemporary LGBTQ+ aging research by highlighting the needs and experiences of LGBTQ+ older adults of color within an age-friendly city. Five older Black lesbian women, aged between 65 and 75, actively participated in designing, implementing, and evaluating a research project that analyzed data from public records and focus groups. Findings emphasize three fundamental principles of queer gerontology, providing tangible examples of community-engaged scholarship that researchers can utilize to advance the field of LGBTQ+ aging. This includes strategies aimed at deepening visibility and awareness of underrepresented subgroups through an intersectional lens, applying critical perspectives to challenge dominant frameworks that narrowly define old age and aging through heterosexual and gender norms, and combating oppression and injustice through activist-scholarship committed to real-world change. The insights from this presentation underscore the imperative for inclusive, community-engaged scholarship to advance our understanding of LGBTQ+ aging, promote social justice, and effect meaningful change in the lives of older LGBTQ+ adults with multiple intersecting identities.
USING CREATIVE NARRATIVES AND VISIONS OF LATER LIFE TO QUEER GERONTOLOGICAL SCHOLARSHIP
Authors: Jen Sarah 
Published: January 2025

Abstract
Queering gerontology calls for more diverse and inclusive visions of old age, including those that resist normative ways of being. LGBTQ people have particular contributions to make to this project given their experiences of non-normative life events, sequences, and desires. This study presents a secondary qualitative data analysis, drawing from two existing datasets (13 life reviews with older bisexual-identified women and 40 creative narratives published in Bi Women Quarterly). The analysis examines queer and non-normative visions and experiences of aging from the perspective of queer and trans individuals across the life course. The findings are examined through the lens of three principles of queer gerontology, illustrating the potential of queer and creative visions of aging to reimagine the potential of gerontological scholarship. Notably, the creation and dissemination of queer narratives of aging and later life deepen visibility and awareness of diverse and marginalized experiences while also offering new and creative ways of imagining later life for all populations. The examined narratives engage critical perspectives, often dispelling normative ways of being through camping up, resisting, or queering notions of self, kinship, life and death, and the narrative form. Narratives also illustrate the engagement of multiple epistemologies, creating potential for more creative modes of inquiry, including creative writing and imagery, in envisioning later lives. These findings indicate the potential of revisiting existing data through the lens of queer gerontology principles to illuminate the possible forms queer gerontological scholarship could take, both empirical and conceptual.
OPTIMIZING STAFF RECRUITMENT AND RETENTION IN CARE HOMES: WHAT WORKS? THE REACH REALIST REVIEW
Authors: Devi Reena , Haunch Kirsty , Spilsbury Karen , Dalkin Sonia , Bate Angela , Jones Liz , Goodman Claire , King Natalie 
Published: January 2025

Abstract
Solutions for sustaining the social care workforce need to a) consider the different factors which influence staff experiences, b) recognize the nuances between different care settings, and c) differentiate between staff groups (e.g. age, levels of experience). At the University of Leeds, we led research which uses a realist synthesis approach to reviewing international academic and grey literature and contributions from sector stakeholders to develop theories. The results identified strategies used in care homes to attract, recruit, and retain Registered Nurses and care workers, e.g., effective job interviews, opportunities for career development, rewards and recognition, flexible working options, and caring conversations. The strategies used to attract, recruit, and retain staff do not operate independently, they interact and work together. We brought the evidence-based programme theories together into an explanatory framework to explain how and why these strategies work, for which staff, the conditions needed for strategies to work, and the outcomes to be expected. The framework summarizes the different ways the strategies help with attracting, recruiting and retaining staff. For example, empowering staff through caring conversations and opportunities for career development; building and fulfilling a psychological contract to set accurate expectations of care work; and reciprocating positive experiences (when providing staff with positive experiences staff will reciprocate and respond positively (i.e. commitment and loyalty at work). We will summarize the full findings during the symposium. To the best of our knowledge, this is the first time a realist synthesis approach has been used to review the literature in this area.
IMPACT OF A NURSING INTERVENTION ON PHYSICAL ACTIVITY AND INDEPENDENCE IN NURSING HOME RESIDENTS
Authors: Bleijlevens Michel , den Ouden Mirre , Meijers Judith , Zwakhalen Sandra , De Vries Erica , Hamers Jan 
Published: January 2025

Abstract
DAILy nurse is a complex intervention that was used in changing the breakfast routine for nursing home residents. It was expected that nursing home residents would be more engaged and would perform more activities independently; furthermore, it was expected that nursing staff behavior would change towards encouraging residents and taking over fewer activities. A quasi-experimental design with a pre- and posttest in four nursing homes was utilized. Participants were 104 residents and 134 staff. Video recordings were used to observe primary outcomes: engagement and independence in breakfast activities, and nursing staff activities. Results showed that staff succeeded in changing the breakfast routine dramatically. Departing from a standardized breakfast moment (with sandwiches fully prepared, no choice for residents) in a rather sterile environment (e.g., no ambiance, empty tables, almost no interactions), the routine was changed into a breakfast moment where tables were set with breadbaskets, different types of sandwich filling and pots of coffee and tea. This enabled residents to prepare their own sandwich and to be engaged in this activity, which led to interactions between residents; and residents and staff. Video recordings, and perceptions of nursing home staff, indicated statistically significant improvement of the daily lives of residents during the breakfast moment. However, no effect was found in nursing staff behavior. In conclusion, this study showed that applying DAILy NURSE, led to more engagement and independence of residents. It should be emphasized that this was feasible without increasing the number of staff or the allocation of extra budgets.
INTRODUCING NURSES IN EXPANDED ROLES IN LONG-TERM CARE FACILITIES
Authors: Zúñiga Franziska , Kotkowski Kornelia , Guerbaai Raphaelle-Ashley , Brunkert Thekla 
Published: January 2025

Abstract
INTERCARE is a nurse-led care model introducing registered nurses in expanded roles (nurses with advanced education and training beyond the traditional scope of practice for registered nurses) into long-term care facilities (LTCFs) to strengthen geriatric expertise and reduce unplanned hospitalizations. INTERCARE nurses promote the core components of INTERCARE, such as interprofessional collaboration. INTERCARE was implemented in 11 LTCFs in Switzerland from 2018 to 2020 and tested in an effectiveness-implementation hybrid-type II design. Six months post-implementation, care staff (n=108) were interviewed about their perception of the INTERCARE nurse’s role. INTERCARE nurses (n=18) were interviewed at the end of the study to explore the content of their work and the factors supporting their role adoption. Staff reported high acceptability of INTERCARE nurses, feeling supported in daily practice and experiencing increased confidence in skills, such as responding to acute situations. INTERCARE nurses provided regular coaching to care teams in complex resident situations and guided interprofessional collaboration by supporting phone calls with physicians. They considered the ongoing training during the study as important to expand their clinical and leadership skills. Bi-weekly one-to-one coaching sessions, where they practiced analyzing and solving problems and additional exchanges with peers, were crucial in sustaining them in their challenging role. In conclusion, nurses in expanded roles provide a supportive environment for care staff to enhance their skills and provide quality care. Peer support and coaching are pivotal in sustaining these expanded roles in the demanding low-resource LTC environment.
SARCOPENIA: NO CONSENSUS, NO DIAGNOSTIC CRITERIA, AND NO APPROVED INDICATION HOW DID WE GET HERE?
Authors: Evans William , Cawthon Peggy 
Published: January 2025

Abstract
In addition to the role of skeletal muscle in movement and locomotion, muscle plays a critical role in a broad array of metabolic processes that can contribute to improved health or risk of disease. The age-associated loss of muscle has been termed sarcopenia. Muscle is the primary site of insulin-stimulated glucose disposal and the largest component of basal metabolic rate, directly and indirectly affects bone density, produces myokines with pleiotropic effect on muscle and other tissues including the brain, stores essential amino acids essential for the maintenance of protein synthesis during periods of reduced food intake and stress. As such, not surprisingly deterioration of skeletal muscle health, typically operationalized as decline of muscle mass and muscle strength is both a powerful risk factor and main consequence of chronic diseases, disability, and loss of independence, and it is one of the strongest risk factors for mortality. As a result, the development of pharmacological therapies to increase muscle mass (or prevent loss) an important goal for decades. However, while remarkable advances in the understanding of molecular and cellular regulation of muscle protein metabolism have occurred recently, there are no approved drugs for the treatment of sarcopenia, the loss of skeletal muscle affecting millions of older people The goal of this symposium is to describe the possible reasons for the lack of new and effective pharmacotherapies to treat one of the most important risk factors for age-associated disease and loss of independence.
SARCOPENIA: NO CONSENSUS, NO DIAGNOSTIC CRITERIA, AND NO APPROVED INDICATION HOW DID WE GET HERE?
Authors: Evans William 
Published: January 2025

Abstract
In addition to the role of skeletal muscle in movement and locomotion, muscle plays a critical role in a broad array of metabolic processes that can contribute to improved health or risk of disease. The age-associated loss of muscle has been termed sarcopenia. Muscle is the primary site of insulin-stimulated glucose disposal and the largest component of basal metabolic rate, directly and indirectly affects bone density, produces myokines with pleiotropic effect on muscle and other tissues including the brain, stores essential amino acids essential for the maintenance of protein synthesis during periods of reduced food intake and stress. As such, not surprisingly deterioration of skeletal muscle health, typically operationalized as decline of muscle mass and muscle strength is both a powerful risk factor and main consequence of chronic diseases, disability, and loss of independence, and it is one of the strongest risk factors for mortality. As a result, the development of pharmacological therapies to increase muscle mass (or prevent loss) an important goal for decades. However, while remarkable advances in the understanding of molecular and cellular regulation of muscle protein metabolism have occurred recently, there are no approved drugs for the treatment of sarcopenia, the loss of skeletal muscle affecting millions of older people The goal of this symposium is to describe the possible reasons for the lack of new and effective pharmacotherapies to treat one of the most important risk factors for age-associated disease and loss of independence.
WHO’S SARCOPENIC? AN ANALYSIS USING THE CANADIAN LONGITUDINAL STUDY ON AGING DATA
Authors: Phillips Stuart 
Published: January 2025

Abstract
A limitation of the sarcopenia definitions used in our analyses is the use of DXA measured ALM to approximate muscle mass. Although many consider ALM to be the reference standard for measuring muscle mass for sarcopenia, it is actually a measure of lean mass that includes organ tissue, water, and all other non-bone and non-fat soft tissues in addition to muscle mass. The results may be substantially altered if more accurate measures of muscle mass such as the D3-creatine method were used. We have reported that there is generally slight to moderate agreement (Cohen’s κ values of.00–.60) between most of the combinations of variables used to ascertain sarcopenia status recommended by the expert group definitions. For definitions using lean mass, the agreement between different adjustment techniques for lean mass ranged from slight to substantial. These findings were consistent across the range of cutoffs for each variable that are either observed in the literature or recommended by the expert group definitions for sarcopenia. The general lack of agreement between sarcopenia definitions observed in our study underscores the importance of the sarcopenia research community identifying a unified ascertainment method for sarcopenia. Having multiple definitions of sarcopenia identifying different groups of individuals as sarcopenic may hinder vital research developing clinical management strategies for sarcopenia by decreasing the comparability between studies.