bluuebunny/crossref_metadata_2025_split huggingface dataset:
DECODING EHR DATA: THE ROLE OF SOCIAL SUPPORT IN PRESSURE INJURIES AMONG HOMEBOUND OLDER ADULTS
Authors: Chow Christine , Kim Yijung , Bangerter Lauren , De Jonge Karl 
Published: January 2025

Abstract
Homebound older adults are increasingly susceptible to acquiring pressure injuries (PIs) due to a variety of pathological and physiological changes associated with aging. However, the impact of social risk factors of PIs among homebound older adults remains largely understudied. This research was conducted to explore how unstructured data via House Call clinical notes can provide insights of psychosocial factors that influence pressure ulcer conditions compared to formal diagnoses via ICD-10 codes. Using electronic health records and clinical notes (N= 1,770) from patients enrolled in a home-based primary care program (04/01/2021-03/31/2024), we evaluate the impact of a novel natural language process (NLP) algorithm to identify PIs among older adults (N= 664 patients, Mean age= 86.55, 78% female, 84% Black or African American). These clinical notes were analyzed using bigram analysis to identify patterns of psychosocial and other factors that influence documentation of pressure ulcers. Themes included known common risk factors for PIs (functional impairment, malnutrition, co-morbidities, frailty, and poor tissue perfusion). However, social support was a unique category identified with multiple associated bigram phrases, suggesting a strong relationship with PIs and underscores a need for further investigation. This study highlights the emerging potential of NLP methodology in clinical research for the systematic analysis of large volumes of clinical narratives, offering valuable insights from these interpersonal relationships. Furthermore, understanding social risk factors can contribute to the early identification of PIs, inform clinical practices, and help reduce the incidence of PIs in homebound older adults.
DEMENTIA CARE SHARED BY MULTIPLE CHINESE FAMILY CAREGIVERS: EXPLORING FAMILY-LEVEL PREPAREDNESS FOR CAREGIVING
Authors: Choy Jacky C P , Wong Dipsy H S 
Published: January 2025

Abstract
Involvement of multiple family members as caregivers is commonly observed and often essential in families living with dementia. While preparedness for caregiving was found to be associated with better caregiver outcomes, previous studies centred on one primary caregiver and rarely enquired their preparedness at a family level. This qualitative study aims to explore the preparedness of family as a unit for dementia care. Participants were 30 caregivers (12 spousal caregivers; 31 to 86 years old) who took care of a person living with dementia (PLwD) in the community and reported having more than one family members involved (3.8 caregivers involved in average). We conducted semi-structured in-depth interviews to understand the care needs of PLwD, their care arrangements, family dynamics, and perceived family preparedness. Thematic analysis with an inductive approach was adopted. Seven themes suggesting 7 components of family preparedness emerged: 1) Common understanding of PLwD care needs, 2) Aligned caregiving roles and expectations, 3) Identification of primary caregiver, 4) Flexibility for care task sharing and substitution, 5) Conflict resolution in care arrangement decision making, 6) Exchange of caregiving resources and information, and 7) Sharing of feelings and emotional support. Proximity, composition, family values, and prior communication patterns among members substantially shape their preparedness for caregiving. These components largely resonate with the dimensions of communication, roles, problem solving and affective exchange in McMaster model of family functioning and resemble concepts in models of team effectiveness. Family-centered interventions targeting family preparedness for caregiving can potentially improve caregiver as well as family outcomes.
DETECTION OF AI-GENERATED IMAGES: A MIXED METHODS STUDY ON AGE-RELATED DIFFERENCES
Authors: Velazquez Enilda , Flores-Cruz Gabriela , Roque Nelson 
Published: January 2025

Abstract
Generative artificial intelligence (AI) content has become widely accessible but continues to face misuse for spreading misinformation that often targets older adults. This is concerning considering that AI generated content is projected to occupy 10% of the internet by 2025 (Gartner, 2024). Previous research has implicated age and analytical thinking as potential predictors in how well individuals identify misinformation (Pehlivanoglu et al., 2022; see CISDA model, Frazier et al., 2019). This study uses a mixed methods approach to examine the vulnerability of individuals across age groups (young adulthood: 18-39, middle adulthood: 40-59, old adulthood: 60-89; within-subjects) to discern AI manipulated images (AI-generated, non-AI generated; between-subjects) by using (1) signal detection analyses (i.e., hit, miss, false alarm, correct rejection) and (2) response time measures while controlling for analytical thinking (Cognitive Reflection Test score, Frederick, 2005) as an external variable (N = 190). A mixed methods ANOVA suggests that older adults (M = 0.426, SD = 0.150) exhibited significantly higher false alarms than younger adults (M = 0.306, SD = 0.180, p = 0.007, n2p = 0.053). However, there were no differences of age cohort on the rate of hits, misses, or correct rejections, nor on image discernment reaction time while controlling for analytical thinking. The increased false alarm rate among older adults may reflect AI sensitivity toward images, potentially indicating that AI sensitivity acts as a protective factor in the AI interactions of older adult’s AI interactions. Future research should explore this sensitivity as a safeguard against misinformation exploitation.
DETERMINANTS OF SLEEP HEALTH IN THE CONTEXT OF THE COVID-19 PANDEMIC AMONG OLDER CHINESE IMMIGRANTS IN THE U.S
Authors: Marquez Stephanie Lyn , Da Wendi , Tang Fengyan , Jiang Yanping 
Published: January 2025

Abstract
Good sleep is crucial for healthy aging. While recent studies have examined psychosocial factors related to sleep health, their impact on older Asian immigrants is not well understood. Notably, few studies have examined how psychosocial factors and immigration factors may intensify the COVID-19 pandemic’s effect on sleep among this population. This study investigated how these factors, assessed prior to the pandemic, affected sleep health during COVID-19 among older Chinese immigrants. Data were drawn from the Population Study of Chinese Elderly (PINE), focusing on participants who completed the Pittsburgh Sleep Quality Index and Women’s Health Initiative Insomnia Rating Scale in wave 6 (2021-2023) and at least one prior wave between wave 4 (2017-2019) and wave 5 (2019-2021). A mixed-effects linear spline model analyzed predictors across five domains: individual characteristics (age, sex, marital status, education, income, health literacy, chronic conditions), psychological distress (depressive symptoms, anxiety, perceived loneliness), immigration factors (years living in the U.S., acculturation), interpersonal factors (social support, social strain, filial piety receipt and expectations), and perceived neighborhood environment (disorder and cohesion), all adjusted in the context of COVID-19. Results were stratified by residential environment (living in Chinatown versus living outside of Chinatown). The findings revealed that the pandemic worsened sleep health, with depressive symptoms being significantly related to a faster decline in sleep quality and faster increase in insomnia, regardless of residential environment. These findings suggest that the pandemic intensified the influence of psychosocial and immigration factors on sleep health among older Chinese immigrants, highlighting the need for targeted interventions.
DIGITAL AGEISM PERSISTS IN ARTIFICIAL INTELLIGENCE-GENERATED IMAGES
Authors: Derenne Nicole , Martens Lindsey , Virgin Nicole , Hoffarth Phillip , Van Eck Richard , Klug Marilyn , Manocha Gunjan , Jurivich Donald 
Published: January 2025

Abstract
Artificial intelligence systems (AI), including text-to-image models, often reflect and amplify societal age-related biases, a phenomenon known as digital ageism. This study examines if instances of digital ageism in AI-generated representations of older adults lessen over time. Examining how digital ageism evolves in AI-image generation can provide insight into the interplay between technology advancements, societal attitudes toward aging, and the well-being of older adults interacting with the dynamic digital landscape. This mixed methods project compared 164 images generated by Open AI’s DALL-E 2 image generator at two points, one year apart. Text prompts, identical at both points of inquiry, included terms from the geriatric lexicon (e.g., frail older adult, dementia, successful aging). Images were qualitatively evaluated to identify perceived gender, race, socioeconomic status, and emotional expression. Quantitative analysis of the frequency with which each category was represented found significant differences in gender and socioeconomic representation at both points of inquiry but no difference between the two points. The number of white racialized representations of older adults was 5-fold higher than other racialized representations at both points, with an increase of Asian racialized representations at the second point of inquiry. There was no significant difference between emotional expressions between the inquiry points. Despite the increased social emphasis on positive views on aging, AI text-to-image generators persistently generated predominantly white racialized middle-class male figures. A limitation of this study is that it focuses only on AI text-to-image generation and no other AI-generated content.
DOMAINS OF PERSON-CENTERED CARE IN LONG-TERM CARE COMMUNITIES
Authors: Seidel Elizabeth , Lin Shih-Yin , Cortes Tara 
Published: January 2025

Abstract
Person-centered care (PCC) in long-term care (LTC) has been integrated in a patchwork fashion. No standard nomenclature or quality indicators exist for PCC culture, policy, training, or practice. As part of the 2nd phase of a large study to establish the standards of care for PCC, we conducted 8 resident (n=56, age 65-102) and 9 staff (n=66) in-person focus groups, at 5 LTC communities in NY, PA, IL, AZ, and CA to validate essential PCC domains and concepts. Deductive content analysis was applied to validate person-centered domains previously established by the University of Maine during phase 1 of the study: personhood; resident care, choice, and empowerment; food and dining; enrichment and socialization; staff empowerment; physical environment, and family engagement. Phase 2 focused on populations that are more inclusive of residents from historically marginalized groups. We successfully validated all domains previously proposed with minor revisions to the domain definitions and a clearer understanding of the elements within them. For instance, consistent quality across all levels of care was added to the resident, care, choice, and empowerment domain, and the personhood domain was expanded to include staff advocating for the residents when their care preferences differ from their family. The top three domains discussed across the focus groups were resident care, choice and empowerment; personhood; and enrichment and socialization. By identifying elements that drive PCC, measures can be developed to ensure standards are in place to guide excellence in PCC in LTC communities.
EXAMINING THE CHARACTERISTICS OF UNIVERSITY EMPLOYEES AND STUDENTS PROVIDING CARE TO ADULTS WITH ADRD
Authors: Southerland Jodi L , Mauck Erin , Zheng Shimin , Smith Matthew 
Published: January 2025

Abstract
University employee and student caregivers face challenges balancing caregiving with employment and educational responsibilities. With over 4,000 degree-granting institutions in the United States, this represents a growing need for intervention. Data were collected via a Qualtrics survey from university employees and students (n=350) who provided unpaid care to a relative or friend 18 years or older. Participants completed assessments including the Zarit Burden Index, Center for Epidemiologic Studies 4-item Depression Scale, Generalized Anxiety Disorder 2-item scale, and Connor-Davidson Resilience Scale. Chi-square and independent t-tests were employed to compare personal, socio-emotional, and caregiving characteristics between caregivers to people with Alzheimer’s Disease and related dementias (ADRD) and non-ADRD caregivers. Compared to non-ADRD caregivers, the care recipients of ADRD caregivers were older and had more health conditions. ADRD caregivers also had been caregivers for fewer years than non-ADRD caregivers. Although ADRD caregivers were more likely to provide personal care, they also had more caregiving support (e.g., unpaid and paid) than non-ADRD caregivers. Compared to non-ADRD caregivers, ADRD caregivers reported significantly higher caregiver burden (t=-2.39, P=0.02). ADRD caregivers reported a greater need for caregiving resources and were more likely to disclose their caregiving status to university personnel compared to non-ADRD caregivers. Findings highlight the need for university-based resources to support the unique challenges of employee and student ADRD and non-ADRD caregivers. Opportunities exist to introduce programs and services (e.g., respite care, flexible scheduling, problem-solving interventions) to help employees and students succeed in their work/studies, manage caregiver burden, and provide high-quality care to care recipients.
EXAMINING THE IMPACT OF TRAUMA-INFORMED CARE ON NEUROPSYCHIATRIC SYMPTOMS IN THE LONG-TERM CARE SETTING
Authors: Saiyed Sahebi , Bender Alexis 
Published: January 2025

Abstract
Major life changes, such as transitioning into skilled nursing care, can trigger a traumatic stress response in older adults. In 2019, CMS released the requirement for trauma-informed care (TIC) in Skilled Nursing Facilities (SNF). This exploratory project aimed to assess the effectiveness of TIC on reducing neuropsychiatric symptoms, assessed using the NPI-NH, among patients with a history of trauma in one SNF. We conducted a retrospective chart review and trauma screening of 59 patients; primarily female (n=51, 86%), white (n=35, 59%) and ranged in age from 67-102 (Mean=82.97). 43 (73%) patients reported trauma and 27 (46%) patients were defined as “high risk” (i.e., history of trauma and either an NPI-NH score (≥ 20) or ≥2 psychotropic medications). 12 (44%) “high-risk” patients received a targeted care plan intervention (i.e., consistent staffing, music therapy, spiritual support, and specialized nursing care) based on the trauma reported and input from patients or their care partners. NPI-NH scores we reassessed one month after the intervention initiation. The NPI-NH score for the intervention group was 36.00 (SD=19.34) at baseline and 24.56 (SD=19.68) at follow-up. We conducted a paired samples t-test (pre- to post-intervention) with a more lenient p-value of 0.10 due to the exploratory nature of this intervention. We found there was a significant difference with a moderate effect between the mean NPI-NH scores from pre- to post-intervention, t(11) = 1.95, p=.08, Cohen’s d = 0.59, indicating promise for TIC interventions to improve the quality of life for patients admitted into SNF with a trauma history.
EXERCISE IN RURAL COMMUNITIES: A QUALITATIVE STUDY OF HOW PAST EXPERIENCES IMPACT CURRENT EXERCISE PRACTICES
Authors: O’Leary Bryant , Shaffer Tasha , Routh Brianna , Whitten Justin , Tarabochia Dawn 
Published: January 2025

Abstract
As the aging population continually grows, understanding how to keep older adults engaged in exercise is of increasing importance. This is critical as exercise trends show that engagement dramatically decreases with age. Moreover, older adults are more likely to live in rural communities as compared to urban communities (Cohen & Greaney, 2023). Previous studies explored barriers related to the overall decrease in exercise engagement, yet few have focused on older adults’ motivation to maintain exercise practices. The purpose of this project was to explore how past experiences with exercise influence current exercise participation among rural, older adults. Residents engaging in exercise and aged 55+ (n=42) from a western state were recruited using convenience sampling (partnership with local Extension agents and social media outlets). As part of a larger online survey, participants completed an open-ended questionnaire specific to past experiences with exercise. Participant results were analyzed using Van Manen’s (1990) hermeneutical approach with three members of the research team developing themes from participant responses. Trustworthiness was established by a peer reviewer to assess the themes for accuracy. Researchers identified five themes associated with how past experiences influenced current exercise practices. These included health and wellness (18), accessible instruction/resources (17), friends and family (13), community programming (10), and youth activity (4). By understanding past experiences, outreach professionals may find more impactful early or later life supports to promote exercise across the lifespan.
EXPLORING DELIBERATE PRACTICE TO REDUCE AGE-RELATED PERFORMANCE DIFFERENCES IN A COMPLEX TASK
Authors: Prevratil Michael , Charness Neil , Boot Walter 
Published: January 2025

Abstract
Can age-related differences in complex task performance be overcome with simple behavioral interventions? We monitored differences between older and younger adults’ performance in a complex psychomotor task with the intent of developing a behavioral intervention grounded in principles of deliberate practice. An older (N = 24, M age = 71) and younger (N = 28, M age = 19.1) sample were taught to play a complex videogame called Space Fortress Participants also completed several cognitive tests and a semi-structured interview. The older adults performed significantly worse on Total score (Cohen’s d = 1.45) and three of four subscore metrics (Control, Points, and Speed). Like the differences between men and women (Harwell, Boot, and Ericsson, 2018), score differences between younger and older adults appeared to be driven by strategic and potentially modifiable behaviors. For example, older adults held control inputs for twice as long compared to the younger sample (Cohen’s d = 0.98), a common strategic error. Older adults primarily implemented variants of the “drifter” strategy, letting their ship float uncontrolled through the game environment, while most younger adults implemented the optimal “orbiter” strategy, piloting their ship in a clockwise path around the central fortress. These differences demonstrate likely modifiable aspects of performance that can be improved with targeted behavioral interventions. Findings will be used to develop practice environments and instructions anticipated to greatly reduce or eliminate age-related performance differences.
EXPLORING EPIGENETIC CLOCKS AND COGNITIVE CHANGE IN MIDDLE ADULTHOOD
Authors: Zavala Daisy , Oravecz Zita , Graham-Engeland Jennifer , Engeland Christopher , Sliwinski Martin , Veeramah Krishna , Scott Stacey 
Published: January 2025

Abstract
Positive age acceleration, in which a person’s epigenetic age is older than their chronological age, was associated with worse mean-level cognitive performance and higher moment-to-moment intraindividual variability in our prior work utilizing only a single burst of data. The present study extends this work by utilizing a Bayesian Double Exponential Model (BDEM) to examine longitudinal changes in cognition while accounting for practice effects. In a diverse sample of 142 midlife adults, baseline age acceleration was derived from five DNA methylation epigenetic clocks (Horvath 1, Horvath 2, Hannum, PhenoAge, GrimAge). Across four annual bursts of data, ambulatory processing speed and working memory was determined through the symbol search and n-back task, respectively. Using the BDEM framework, for both tasks we found that peak performance (at burst 1) was slower for individuals with greater age acceleration and those who were chronologically older. However, we found no longitudinal changes in peak performance on average, and neither age acceleration nor chronological age were predictive of differences in longitudinal change. Interestingly, greater age acceleration (but not chronological age) was associated with more fluctuations in scores across the study period, but greater chronological age (not age acceleration) was linked with more forgetting between bursts in the symbol search task. Although it is unclear what is driving opposing findings, these results reveal that even in an age heterogeneous sample spanning midlife (prior to expected cognitive declines, or onset of impairment) differences in age acceleration predict differences in peak performance and variability.
EXPLORING THE EFFECTIVENESS OF COGNITIVE STIMULATION THERAPY FOR DEMENTIA IN UNITED STATES, BRAZIL, AND HONG KONG
Authors: Nketsiah Ebow 
Published: January 2025

Abstract
Cognitive Stimulation Therapy (CST) is a cost-effective non-pharmacological intervention for dementia developed in the United Kingdom. Though CST has been adopted and implemented all over the world, there has not been a study to evaluate its effectiveness across multiple counties. This study analyzes existing data from CST groups in USA, Hong Kong, and Brazil to evaluate the primary outcomes CST for persons with dementia. Paired sample t-tests were conducted to evaluate the effect of CST on cognition, quality of life, physical function, and depression across the countries. Among the USA CST groups (N=288), significant t-test were calculated for cognition, t(261) = -7.412, p&lt; 0.01, quality of life, t(199) = -8.707, p&lt; 0.01, and depression, t(254) = 6.347, p&lt; 0.01. A non-significant t-test was calculated for physical function, t(103) = 1.262, p=0.21. Among the Hong Kong CST groups (N=408), significant t-tests were calculated for cognition, t(204) = 3.125, p&lt; 0.01, depression, t(236) = 3.084, p&lt; 0.01. However, non-significant t-tests were calculated for quality of life, t(376) = -0.614, p=0.539, physical function, t(84) = -0.888, p=0.377. On the other hand, among Brazil CST groups (N=47), significant t-test was calculated for cognition, t(46) = -2.961, p&lt; 0.01. However, non-significant t-tests were calculated for quality of life, t(46) = -1.760, p=0.085, physical function, t(46) = -0.250, p=0.804, and depression, t(46) = 0.345, p=0.690. There are cultural and demographic factors that influence the effectiveness of interventions like CST. As CST is being implemented as a cost-effective non-pharmacological intervention for dementia and Alzheimer’s worldwide, its cultural applicability is worth exploring.