bluuebunny/crossref_metadata_2025_split huggingface dataset:
CONCEPTUALIZING THE HEALTH CARE WORKFORCE AS A SOCIAL DETERMINANT OF HEALTH IN LONG-TERM CARE SETTINGS
Authors: Thompson Roy , Olanrewaju Sherif , Squires Allison 
Published: January 2025

Abstract
The social determinants of health include environmental conditions where: individuals reside and age that affect their health, functioning, quality of life, and risks. We propose a conceptual model of how the health workforce becomes a social determinant of health resulting from the sustained person-clinician relationship. To illustrate the application of this proposed model, we examine the case of long-stay residents in long-term care settings. These residents spend ≥101 days, oftentimes until death in these facilities and have prolonged healthcare staff interactions which impact their health outcomes. Evidence suggests that sustained contact between residents and the healthcare workforce does impact their quality of life, health outcomes, and risks. We posit that the health workforce can be a contributing factor in inequitable outcomes in long-term care settings, thus becomes a social determinant of health. Their interactions and practices with residents may explain disparities in Black and Hispanic residents who typically have significantly higher rates of pain, falls, antipsychotic use, and pressure injuries relative to their Non-Hispanic White counterparts. Additionally, Black and Hispanic residents receive care in geographically segregated nursing homes. Through multi-level exemplars, we will illustrate how as a social determinant the workforce characteristics like racial and ethnic concordance, skill mix, and hours per resident impact health outcomes. Therefore, studies that conceptualize and operationalize the healthcare workforce as a social determinant of health at the individual, interpersonal and organizational levels are needed to improve staffing interventions to mitigate health disparities across in long-term care settings.
HETEROGENEOUS EFFECTS OF CHILDHOOD ADVERSITY ON LATE-LIFE BRAIN HEALTH: A CAUSAL FOREST APPLICATION
Authors: Hayes-Larson Eleanor , Ikesu Ryo , Inoue Kosuke , Gilsanz Paola , Whitmer Rachel , Glymour M Maria , Mungas Dan , Mayeda Elizabeth Rose 
Published: January 2025

Abstract
Effect heterogeneity across individuals may help explain inconsistent evidence regarding effects of childhood adversity on brain health. We used harmonized Kaiser Healthy Aging and Diverse Life Experiences and Study of Healthy Aging in African Americans (n=617) data to evaluate heterogeneity in effect estimates of childhood adversity (z-score of 7 adverse childhood events factor score, dichotomized at median) on brain white matter hyperintensity volume (WMH, log transformed). We used an honest causal forest with augmented inverse probability weighting and 10-fold cross-validation to estimate conditional average treatment effects (CATEs); this approach captures complex heterogeneity better than traditional regression models. Candidate sources of heterogeneity included age at MRI, demographics, US southern birth, childhood SES measures and interactions between variables. Overall, exposure to at least median childhood adversity was associated with 0.14 higher log units of WMH (95% CI -0.06, 0.35) after covariate adjustment. The best linear fit model for the observed treatment effect had an out-of-bag predicted treatment effect coefficient of 0.81 (P-value=0.02), indicating the heterogeneity in the association. Individuals with estimated CATEs below the median estimated CATE were older (mean age 76.4y vs. 72.5y), more likely to be male (56% vs 63%), and more likely to report low childhood SES (55% vs. 74% average/well-off, 16% vs 7% ever went hungry). This is preliminary work in a relatively small sample; more work is needed to understand the impact of childhood adversity on late-life brain health, including differences across individual characteristics.
INCOME INEQUALITY, INCOME, AND HEALTH OVER THE LATER LIFE COURSE IN EUROPE: A LONGITUDINAL AND CROSS-NATIONAL STUDY
Authors: Cheng Mengling , Sommet Nicolas , Spini Dario 
Published: January 2025

Abstract
Evidence from the U.S., UK, and Europe documented that income inequality has modest effects on the social gradient of health. However, few studies investigate how the effect of income inequality on the social gradient of health evolves over the life course. This study aims to examine to what extent, and in what ways, does the effect of income on later-life health trajectory vary across more unequal and less unequal societies. This study used data from the Standardized World Income Inequality Database (SWIID, 2004-2020) and the Survey of Health, Ageing and Retirement in Europe (SHARE, 2004-2010). We used national-level Gini index to measure income inequality. We used life satisfaction as the health outcome. We performed multilevel modelling to analyze the data in which observations (level 1) are nested in participants (level 2), country-years (level 3), and countries (level 4). Our analysis revealed three findings. First, the effect of income on life satisfaction among older adults is more pronounced in unequal countries. Second, the effect of income inequality on life satisfaction weakens as individuals age. Third, the importance of income on life satisfaction across societies of varying levels of income inequality decreases over the life course of an individual. Findings from this study show that contextual-level income inequality can modify the effects of individual income on health as individuals age. This can help the policy makers and practitioners to target the vulnerable population and offer more effective intervention.
LIFETIME TRAUMA AND ALLOSTATIC LOAD: PSYCHOSOCIAL RESOURCES AS BUFFERS?
Authors: Bell Mallory , Zhang Wencheng , Ferraro Kenneth 
Published: January 2025

Abstract
Although past studies report a relationship between stress and allostatic load, less research examines whether psychosocial resources buffer this relationship. Further, most studies examine allostatic load cross-sectionally. The current study uses sixes waves (2006-2016) of the Health and Retirement Study to examine the relationship between lifetime traumas and allostatic load over time. We also examine whether a variety of psychosocial resources, such as neighborhood cohesion, social support, and volunteering, help protect against the deleterious consequences of trauma on physiological dysregulation. Results indicate that higher lifetime trauma is associated with higher allostatic load. Allostatic load did not change over time Further, we found little evidence that psychosocial resources moderate the relationship between lifetime traumas and allostatic load.
MODERATING THE EFFECTS OF COGNITIVE DECLINE ON DAILY FUNCTIONING IN OLDER ADULTS: THE ROLE OF SOCIAL SUPPORT
Authors: Cho Youngmin , Wu Bei , Zou Baiming , Song Lixin , Anderson Ruth , Beeber Anna 
Published: January 2025

Abstract
As cognitive impairments increasingly affect community-dwelling older adults (CDOA), it becomes significant to understand the longitudinal impact of social support factors—such as living arrangements, social network size, and participation in social activities—on the relationship between cognitive status and daily functioning. Daily functioning includes activities of daily living (ADL), instrumental activities of daily living (IADL), physical capacity, and mobility. This study aims to determine whether social support factors moderate the relationship between cognitive status and daily functioning. We analyzed data from the National Health and Aging Trends Study (NHATS), a longitudinal survey of a nationally representative cohort of Medicare beneficiaries aged 65 and over in the US. Our analysis included eight years of data from 6,238 community-dwelling participants. Using linear mixed-effects models, we explored the interaction effect between cognitive status and social support factors on trajectories of daily functioning. Overall, all areas of daily functioning significantly declined over time, with faster decreases observed as cognitive status worsened. Living arrangements moderated the relationship between cognitive status and IADL, specifically mitigating the negative impact of cognitive decline on IADL. Increased participation in social activities eased the decline in ADL for individuals with probable dementia and in physical capacity for those with mild cognitive impairment (MCI); however, the size of the social network had no significant impact. Our findings highlight the importance of incorporating social support factors into tailored interventions to mitigate declines in daily functioning among CDOA, tailored to their specific cognitive status.
NEIGHBORHOOD POLLUTING INFRASTRUCTURE AND COGNITIVE HEALTH IN OLDER ADULTS
Authors: Ku Vivian , Sol Ketlyne , Zahodne Laura 
Published: January 2025

Abstract
Air pollution is known to be associated with poorer brain and cognitive health. Modifiable sources of pollution in neighborhoods such as industrial and hazardous waste facilities may serve as intervention targets. However, less is known about how polluting infrastructure relates to different cognitive domains. This study examines the relationship between polluting infrastructure and cognition within older adults. 475 adults aged 55+ from the Michigan Cognitive Aging Project (MCAP) completed a comprehensive neuropsychological battery measuring cognition across five domains (episodic memory, executive function, processing speed, language, visuospatial function). Participant geocoded addresses were linked to data on polluting infrastructure in the National Neighborhood Data Archive. Polluting infrastructure was operationalized as the presence of Toxic Release Inventory sites and the proportion of highway length to the total length of streets in a census tract. Generalized estimating equations accounting for geographic clustering modeled relationships between polluting infrastructure and cognitive health, controlling for age, sex, education, income, population density, and neighborhood disadvantage. Higher proportions of highways were related to poorer episodic memory (β= -0.660, p= 0.040). A trend was also found between the presence of at least one toxic site and poorer language (β= -0.121, p= 0.056). Both highways and toxic sites represent polluting infrastructure that could reduce cognitive health among older adults. Differential associations between pollution sources and cognitive domains may indicate that different types of pollutants (e.g., airborne fine particulates versus others) influence unique brain pathways.
PARTNER CORRESPONDENCE IN SOCIAL INTERACTION TIME AND WELL-BEING: EVERYDAY EVIDENCE FROM OLDER DYADS
Authors: Grünjes Carlotta , Garza Elizabeth Zambrano , Murphy Rachel , Madden Kenneth , Gerstorf Denis , Hueluer Gizem , Hoppmann Christiane 
Published: January 2025

Abstract
Social interactions play an important role in older adults’ daily well-being. Longer duration of interaction has been associated with higher well-being at the individual level. However, less is known about the extent to which partners differ in their convergence in interaction reports and whether such differences might be associated with daily well-being. Positive Illusion theory states that individuals are more content in relationships if they idealize their partner leading to the assumption that overreporting interaction time may benefit well-being. Based on the literature, we expect that longer social interaction time is associated with higher well-being at the individual level. At the partner level, we look at discrepancies and similarities. We assess whether individuals report higher well-being on days when they overreport the interaction time with their partner. We further test whether partners who are more similar in evaluating the time spent together are also more similar in their well-being reports. This study uses dyadic end-of-day diary data from 136 Canadian older adults (M = 66.68 years, SD = 13.11 range: 18-87 years, 60% women) and a close other of their choice. Preliminary analyses indicate that longer duration of interaction was associated with higher well-being. Correlations show differences in interaction time reports between partners. Multilevel models will examine whether overreporting interaction time may be associated with well-being. Further analyses will investigate how synchrony in interaction time reports shape joint well-being. As data collection is completed, these results will be ready to be presented by the time of GSA conference in November.
SOCIAL DETERMINANTS OF HEALTH AMONG CUSTODIAL GRANDMOTHERS: ADVANCING AN INTERSECTIONAL APPROACH
Authors: Littleton Tenesha 
Published: January 2025

Abstract
Racial disparities in custodial grandparenting, as well as disparities in the physical and mental health outcomes of custodial grandparents, are well-documented. As a result of long-standing socio-structural inequalities across the life course, custodial grandparents are disproportionately single, Black women with low socio-economic status. These categories of difference and the process of racialization contribute both to the need for grandparent caregiving in the Black community and the negative health consequences of caregiving for Black custodial grandmothers. Macro level structures and systems of oppression impact access to the social determinants of health shaping the life trajectories of racialized groups and contributing to unequal aging which suggests the importance of an intersectional lens when understanding the lived experiences of Black custodial grandmothers. A scoping review was conducted to determine the extent to which an intersectional framework is utilized in research examining the experiences of Black custodial grandmothers. A search of relevant databases (PsychINFO, SociINDEX, PubMed, and Web of Science) was performed using the following search terms and Boolean logic: (“grandparent” OR “grandmother” OR “grandfather” OR “custodial grandparent”) AND (“intersectionality”). Quantitative, qualitative, and mixed-methods peer-reviewed journal articles published in English through January 2024 were included. Findings suggest that research integrating intersectionality with large representative samples is limited. This presentation will propose a conceptual framework that integrates the social determinants of health with an intersectional life course perspective as proposed by Ferrer and colleagues (2017). Recommendations for future research using intersectional approaches will be offered.
THE INTERPLAY OF SOCIAL DETERMINANTS, DIGITAL TECHNOLOGY, AND DEPRESSIVE SYMPTOMS IN KOREAN OLDER ADULTS
Authors: Shin Donghee , Kim Giyeon 
Published: January 2025

Abstract
The purpose of this study was to address the mechanisms between digital inequality and mental health disparities among Korean older adults, recognizing that social determinants of health (SDH) also contribute to the digital divide. We investigate whether older adults’ digital capacity exacerbates or mitigates health inequalities in later life. Drawn from the 2020 National Survey of Older Koreans, a nationally representative sample of 9,885 adults aged 65 and older was analyzed. We employed hierarchical multiple regression, moderation, and mediation analyses. SDH factors including sex, income, education and geographic location (rural-urban residence) were examined. Results showed that capacity to use digital technology significantly moderates and mediates the relationship between income, education, geographic location and depressive symptoms. Notably, digital technology use buffers against the negative effects of low income (B=.021, p&lt;.05) and living in metropolitan areas (B=.095, p&lt;.001, B=.067, p&lt;.01) on depressive symptoms, while it also amplifies the negative effect of low educational attainment on depressive symptoms (B=-.030, p&lt;.001). Specifically, heightened digital technology use among older adults augments the detrimental effects of education on depressive symptoms. Findings suggest that the importance of developing diverse support programs to improve digital literacy among Korean older adults, offering possible ways for reducing the digital divide and addressing mental health disparities.
FAMILISM MODERATES RELATIONS BETWEEN SOCIAL NETWORK AND COGNITION IN MIDLIFE LATINE ADULTS
Authors: Grudzien Adrienne , Gonzales Samantha , Burke Shanna , Cambara Celine , Briceno Alexandra , Jimenez Daniel , Scott Stephanie , Martinez Sabrina Sales 
Published: January 2025

Abstract
Larger social network size, a measure of social isolation, has been linked to better cognitive function in older adults. Research indicates that stress-related immune and endocrine pathways may activate in socially isolated adults and negatively impact brain tissue. This study examined whether Latine adults reporting poorer social network quality but holding familial cultural values that prioritize closeness and loyalty in the family group experienced worse cognitive function. Cross-sectional multiple regression and moderation analyses were used to evaluate the influence of familism (via MACVS Obligations and Support scale) on relations between Lubben Social Network Scale score and National Alzheimer’s Coordinating Center cognitive domains in midlife Latine adults (n=51). Participants were predominantly female (92.16%), white (80.39%), and married or partnered (62.75%). The mean age of this sample was 52.84 (SD=4.89) years. Differential interaction effects were identified after adjusting for age, sex, race, income, and education level: familism strengthened relations between social network and episodic memory (β =.112, p = 0.019), and semantic memory (β =.059, p = 0.022) and weakened those with visuospatial (β =-.017, p = 0.044), executive function (β =-.04, p = 0.05), and verbal fluency (β = -.075, p = 0.046). These findings suggest that familism may be protective of visuospatial, executive function, and fluency domains, while semantic and episodic memory are more vulnerable in familism-aligned but socially isolated, aging Latine adults. Further evidence is necessary, however, to support the development of targeted interventions and support systems addressing cognitive health disparities in Latine adults.
GENDER DIFFERENCES IN COVID-19’S EFFECTS ON LONELINESS, ISOLATION, AND COGNITIVE HEALTH AMONG TAIWANESE RETIREES
Authors: Hsu Wan-Chen , Huang Nuan-Ching , Hu Susan C 
Published: January 2025

Abstract

Objectives
This study investigates the impacts of lock-down policies during the COVID-19 pandemic on the loneliness, social isolation, and cognitive function of retirees in Taiwan, focusing on the differences between men and women. Method: We conducted a two-stage stratified sampling survey to collect 1,115 valid retirees aged 50-74 in Taiwan in early 2023. A mixed-methods approach, combining focus groups and quantitative analysis, was employed. Loneliness was evaluated using the UCLA Loneliness Scale, and social isolation was measured through interaction with family members and social participation. Cognitive function was assessed using the Saint Louis University Mental Status. The statistical analysis included network analysis and multinomial logistic regression.

Results
This study revealed that approximately 30% of participants experienced loneliness during the COVID-19 pandemic, and about 20% of men and women reported less time allocated to volunteering and group activities. Although regression analysis showed no gender differences in loneliness scores and cognitive functions, network analysis found gender-specific relationships among related factors and sub-item of cognitive tests. For example, women’s feelings of loneliness negatively correlated with geometric judgment performance, while men showed a positive correlation between orientation test scores and volunteer involvement. Qualitative research further underscored the crucial role of community support in facilitating recovery from the pandemic, particularly for individuals who were less engaged in community activities.

Discussion
This study highlights the need to explore gender-specific correlates of loneliness and isolation across different cognitive items and emphasizes strengthening community support for post-pandemic recovery.
LONELY AND SOCIALLY DISCONNECTED OLDER ADULTS ARE AT HIGHER RISK FOR PREVALENT AND INCIDENT DEMENTIA
Authors: Chek Carmen , Knauft Katherine , Stickel Ariana , Araujo-Menendez Carlos , Gonzalez Hector , Tarraf Wassim 
Published: January 2025

Abstract
A 2020 report from the National Academies indicates that nearly one in four adults over age 65 are lonely. Loneliness has important health implications, including for cognitive aging. However, loneliness might not manifest uniformly in the population. Herein, we address a gap in the existing literature by examining the link between heterogeneities in the risk of loneliness and dementia outcomes. We used data from n = 8,805 adults aged 65+ from the Health and Retirement Study (average age 74.7; 56.3% women) to estimate latent classifications of loneliness (11 items from the UCLA loneliness index) and tested, using generalized linear regression models, whether different manifestations of loneliness were differentially associated with dementia (Langa-Weir criteria) prevalence and incidence (over 3-waves of data). A four-class solution best fits the data: “No/Low loneliness” (NL; 51.6%); “Socially disconnected” (SD; 18.0%); “Lonely but not socially disconnected” (LNSD; 12.6%), and “Lonely and socially disconnected” (LSD; 17.8%). Notably, these classifications and their prevalence rates were largely consistent across waves. Adjusting for sociodemographic covariates, compared to individuals in the NL group, the LNSD (OR = 1.68; 95%CI = 1.22;2.32) and LSD (OR = 1.71; 95%CI = 1.33;2.20) groups were more likely to meet criteria for prevalent dementia at baseline. The LSD group was also more likely to meet criteria for incident dementia at follow-ups (within 2 and 4 years from baseline). Loneliness is not uniformly distributed in the population and its subtypes confer differential risk for dementia outcomes. Focusing on the subtypes can potentially pinpoint targetable groups for interventions.
ASSOCIATIONS BETWEEN NURSING HOME WORKPLACE SAFETY CULTURE AND PATIENT SAFETY CULTURE
Authors: Hesgrove Brandon , Tyler Emily , Yount Naomi , Sorra Joann , Hassell Susan 
Published: January 2025

Abstract
An influential report from the Institute for Healthcare Improvement purports that a strong workplace safety culture is a precondition of a strong culture of safety in healthcare. However, existing empirical evidence is limited. We used data from a 2023 pilot test of the Workplace Safety Supplemental Item Set administered with the Surveys on Patient Safety Culture (SOPS) Nursing Home Survey to examine associations between all 9 workplace safety culture and all 14 resident safety culture measures. Data were obtained from 2,515 staff (40% response rate) in 48 nursing homes across 20 states. Associations were estimated using multiple linear regressions, where, because of strong multicollinearity, the dependent variable for each regression was one patient safety culture measure and the independent variables were one workplace safety culture measure, nursing home bed size, and ownership. The analysis was at the nursing home level and nursing home percent positive scores were calculated as the percentage of staff that answered with the two most positive response options (out of five). 123 out of 126 associations were statistically significant (p &lt; 0.05). The two workplace safety culture measures most highly associated with resident safety culture were Management Support for Workplace Safety (mean β = 0.78) and the Overall Rating on Workplace Safety for Staff (mean β = 0.73). The very strong associations between resident and workplace safety culture measures imply that the two are interconnected and improving a culture of safety for nursing home staff will also improve safety for residents.