bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMPROVING ELDER MISTREATMENT SCREENING AND INTERVENTION IN DEMENTIA: EARLY NIA RESEARCH FINDINGS
Authors: Haggerty Kristin Lees , Fulmer Terry 
Published: January 2025

Abstract
Elder mistreatment (EM) poses a significant public health concern for older adults, particularly those with mild cognitive impairment and Alzheimer’s Disease and Related Dementias (MCI/ADRD). This symposium presents innovative NIA-funded research aimed at assessing risk factors for EM and developing interventions to address these risks, focusing on caregivers and older adults with MCI/ADRD. The first presentation describes the development of a Screening, Brief Intervention, and Referral to Treatment model based on Medicare outpatient data and interviews with stakeholders. Preliminary findings highlight social determinants of health, caregiver stress, and education gaps as key contributors to EM risk. The second presentation introduces a caregiver risk assessment tool linked to an abuse prevention intervention for persons living with dementia (PLWD). The study demonstrates strong predictive capabilities in identifying modifiable caregiver risk factors associated with abuse. The third presentation describes adapting an evidence-based EM screening tool for home-based primary care providers. Qualitative data from seven sites inform the adaptation of the DETECT tool, addressing policy implications, barriers to recognition, and necessary adaptations for effective implementation. The fourth presentation highlights the development of a strategy to screen for caregiver neglect in PLWD. By evaluating existing tools and creating an item bank, this study aims to enhance measurement precision in elder mistreatment interventions. The final presentation reviews interventions targeting elder neglect by informal caregivers. Findings emphasize the need for feasible programs with rigorous evaluation strategies to address caregiver neglect effectively. This symposium presents projects aimed at improving EM risk assessment, identification, and interventions.
BARRIERS TO HOSPICE CARE TRANSITIONS AMONG PEOPLE WITH DEMENTIA IN HOME HEALTH CARE: VIEWS OF DIVERSE CARE PARTNERS
Authors: Murali Komal , Wang Gwenneth , Vergez Sasha , McDonald Margaret , Schulman-Green Dena , Brody Abraham , Bullock Karen 
Published: January 2025

Abstract
Racially and ethnically minoritized persons living with dementia (PLWD) use hospice at disparately low rates and home healthcare (HHC), a preferred setting of end-of-life care, is a key intervention point for increasing hospice transitions. We conducted qualitative interviews with diverse care partners of PLWD to explore views about barriers to hospice care and experiences with dementia care and end-of-life decision-making in HHC. Conceptually rooted in the NIMHD Health Disparities and Equity-Focus Implementation Research Frameworks, we conducted directed content analysis. Participants (n=20) were mostly female adult children of PLWD identifying as Black, Hispanic/Latino, Asian, or White. Six main concepts emerged: 1) Despite general openness to hospice, there was variable knowledge including misconceptions that it could not be received in the home; 2) Limited knowledge of dementia illness trajectories and end-of-life care options including hospice; 3) Communication challenges and conflicts associated with family-decision making; 4) Difficulty with care coordination and limitations of health insurance coverage and access to dementia caregiving support and resources; 5) Unmet cultural aspects of care and language barriers (language discordance between aides and PLWD) led to conflict between care partners and HHC staff); 6) Desire to honor and balance prior stated wishes of PLWD (e.g., prioritizing care at home, avoiding hospitalizations and nursing home) with end-of-life dementia care and decision-making. Findings shed light on views related to hospice care barriers and decision-making experiences of diverse care partners of PLWD that are key for the development of equity-focused culturally sensitive end-of-life care in HHC.
PROVISION OF SOCIAL WORK SERVICES DURING HOME HEALTH CARE: INDIVIDUAL- AND AGENCY-LEVEL DETERMINANTS OF ACCESS
Authors: Burgdorf Julia , Barron-Vaya Yolanda , Goodman Jeri , McDonald Margaret 
Published: January 2025

Abstract
Medicare-funded Home Health (HH) delivers skilled health care services via visits to patients’ homes. Social work (SW) services are included within the HH benefit, and qualitative research suggests SW positively impacts outcomes for HH patients with complex needs. However, no prior work has quantitatively assessed SW provision during HH. We examined 2018 linked HH claims, assessment, and HH agency data for a national sample of 1,372,563 Medicare HH patients. Just 11.3% of HH patients received SW; those who received SW had a mean of 1.3 (SD=0.6) SW visits and a mean of 8.8 days (SD=6.6) from HH admission until the first SW visit. We modeled odds of receiving SW using a multilevel logistic model clustering at the HH agency level and adjusting for patient sociodemographic characteristics and clinical status and HH agency characteristics. The patient-level factors most significantly associated with receiving SW included being Black compared to White (aOR: 1.66; 95% CI: 1.62-1.71), being Medicaid-enrolled (aOR: 1.24; 95% CI: 1.19-1.30), having no family caregiver (aOR: 3.83; 95% CI: 3.62-4.07), and having depression (aOR: 2.26; 95% CI: 2.20-2.33). HH agency-level factors associated with receiving SW were non-profit ownership (aOR: 1.40; 95% CI: 1.29-1.52), urban service area (aOR: 1.48; 95% CI: 1.33-1.64), 60 or more full-time employees (aOR: 1.89; 95% CI: 1.70-2.09), and having social workers on staff, compared to providing SW via contract (aOR:2.23; 95% CI: 2.05-2.41). Findings indicate that SW access remains rare during HH and is driven by both demand-side (i.e., patient needs) and supply-side (i.e., agency capacity) factors.
UNDERSTANDING SEVERITY OF ELDER MISTREATMENT: FINDINGS FROM THE CANADIAN LONGITUDINAL STUDY ON AGING
Authors: Burnes David , Lachs Mark , Pillemer Karl 
Published: January 2025

Abstract
Basic elder mistreatment knowledge on risk factors and prevalence has advanced substantially over the past two decades. However, research in this area has predominantly framed our understanding of elder mistreatment in binary (no/yes) terms. While a binary understanding of elder mistreatment is necessary to determine prevalence/incidence, this conventional framing obscures the variation in lived experiences across cases and provides limited clinical insights for response interventions seeking to reduce harm. Building on prior research examining elder mistreatment through a lens of severity, this study analyzed data from the population-based Canadian Longitudinal Study on Aging to both describe the range of elder mistreatment severity across cases and identify longitudinal risk/protective factors associated with severity levels. An ecological-systems perspective organized potential risk/protective factors from several levels of influence. Drawing on a nationally stratified, random sample (n=23,468) of community-dwelling adults aged 65 or older interviewed over a three-year period, the current study analyzed a subsample (n=2368) of older adults identifying as victims of emotional, physical, or financial mistreatment. Severity was operationalized according to past-year frequency and multiplicity of mistreatment behaviors experienced. Ordinal/multinomial logistic regression was used to examine static and change risk/protective factors for elder mistreatment in general and for separate subtypes. Older adults with lower physical, cognitive and mental health, higher levels of child maltreatment, who lived with their perpetrator, and identified as female were more likely to experience severe forms of mistreatment. Findings from this study advance our basic knowledge on elder mistreatment phenomena and inform practice in community-based response programs.
LONELINESS AND RISK OF ELDER ABUSE: DOES SIZE OF SOCIAL NETWORK MAKE A DIFFERENCE?
Authors: To Louis , He Jasmin , Leung Lok Man , Tsui Ronald , Wan Debby , Yan Elsie 
Published: January 2025

Abstract
Elder abuse is a serious public health issue. Research demonstrated that loneliness is a risk factor for abuse. The present study examined the association between loneliness and elder abuse in a convenient sample of 686 community dwelling older persons in Hong Kong. Participants were recruited from senior community centers across the territory. They provided information on their demographic characteristics, sense of loneliness (DJGLS-6), social network (LSNS-6), and risk of elder abuse (EASI and VASS-10). 37.4% of the participants were screened positive on EASI or VASS-10. Results of logistical regression show that participants who were female (OR=-.505), married (OR=-.951), of a younger age (OR=-.044), reported greater sense of loneliness (OR=.266) were more likely to report risk of being abused. Co-residence with a family member and size of social network was not significant in the model (p&gt;.05). Multiple regression analysis was conducted to identify factor associated with sense of loneliness. Participants of a younger age (Beta=-.019), living alone (Beta=-.170), and had a smaller social network (Beta=.-085) reported greater sense of loneliness. Findings from the present study adds to the larger literature on the impact of various demographic factors and sense of loneliness on elder abuse. Prevention and intervention efforts should focus on female young-olds in a marital relationship. Efforts to mitigate sense of loneliness could potentially help tackle elder abuse. Although increasing social network size does not have a direct impact on risk of elder abuse, it could potentially mitigate sense of loneliness thereby decrease risk of abuse.
ENHANCING PALLIATIVE CARE THROUGH THE INTEGRATION OF THE SOCIAL CONVOY: A USER-CENTERED DESIGN APPROACH
Authors: DeGroot Lyndsay 
Published: January 2025

Abstract
Digital health offers considerable potential for enhancing palliative care but often neglects to integrate the patient’s caregiving “social convoy”, i.e. partners, family, and friends. The Social Convoy Palliative Care (Convoy-Pal) mobile intervention was developed using a user-centered design approach involving interprofessional healthcare providers, older adults with serious illness, and their social convoy (N=81). Convoy-Pal, a 12-week intervention, provides a tablet, smartwatch, and options for mobile phone access, with shared access among participants and their convoy. It facilitates assessment, symptom tracking, and provision of palliative care resources based on user responses. Initial usability feedback among 26 participants (16 older adults/10 social convoys) was favorable, particularly regarding the information provided (User Mobile Application Rating Scale-uMARS: 4.22±.8/5). Based on feedback, final iterations were made to improve goal setting, monitoring tools, and convoy assessment. We then conducted a single-site waitlist randomized control trial among N=46 (31 older adults/14 social convoys) to pilot-test the feasibility of delivering Convoy-Pal. Participants were 76.3 years of age, and social convoys 71.6, primarily White, but not all had access to a mobile device/computer. Recruitment of multiple caregivers was challenging; when enrolled the study maintained a 67.4% retention rate with 4.6% missing subscales on surveys. Intervention participants reported improvements in social functioning (SF-36: 64.6±25.8 vs. 73.2±31.3) and social convoys reported increased perceptions of positive aspects of caregiving (29.5±5.28 vs. 35.0±5.35). Usability scores for information provided were again well-rated (uMARS: 3.96±.57/5). This research underscores the importance of incorporating diverse key informant perspectives to develop meaningful and relevant digital palliative care interventions.
IN THE PALM OF OUR HAND: HUMAN-LED ADMINISTRATIVE DATA LINKAGE TO AUGMENT LONGITUDINAL AGING STUDIES
Authors: Dorame Ashley N , Antic Mina , Ferrie Joseph , Waldinger Robert , III Avron Spiro , Mroczek Daniel , Lee Lewina 
Published: January 2025

Abstract
A robust literature has documented associations of adverse early experiences with poor lifespan health (Hughes et al., 2017). The evidence with respect to aging-related outcomes has been largely derived from population-based longitudinal studies, which predominantly rely on retrospective assessments of childhood experiences. Given the modest agreement between prospective and retrospective measures of early life exposures (Baldwin et al., 2019), it is unknown whether the well-established associations of early adversity with later-life health may replicate in prospective designs. This presentation uses the Boston Early Adversity and Mortality Study (BEAMS) to illustrate a novel approach leveraging recently-digitalized, full-count U.S. Censuses from 1900 to 1940 to obtain prospective data on the early-life family and neighborhood conditions for participants in three, all-male longitudinal aging studies (Normative Aging Study, 1961+, n=2280; Harvard Study of Adult Development, 1938+: Grant cohort, n=458, Glueck cohort, n=267). The authors will describe key steps of the human-led data linkage (“hand-linkage”) process, and present results on linkage performance and value added to the longitudinal studies. Hand-linkage identified 10,146 female and male siblings of the original cohort members. Among original cohort members born prior to each Census, hand-linkage identified 68.6% (1900), 76.3% (1910), 88.5% (1920), 88.0% (1930), and 87.9% (1940) participants, compared to match rates of 24%-36% via a commonly used algorithm (Abramitzky et al., 2021 with Jaro-Winkler adjustment). Relative to hand-linkage, the sensitivity and specificity of the algorithmic approach was 31.2% and 98.2%, respectively. Findings support human-led linkage as an effective strategy to augment the scientific value of longitudinal aging studies.
THE UNEXPECTED FAMILY CAREGIVER: UNVEILING THE CHARACTERISTICS OF YOUNGER ADULT CAREGIVERS
Authors: Spears Katie , Gore Janelle , Bouldin Erin , Ali Akilah , Walker Jenny , Olivari Benjamin , McGuire Lisa 
Published: January 2025

Abstract
With the growing proportion of older adults in the US population, both the number of persons who will need care and the need for family caregivers will increase. Previous studies have found most caregivers to be middle-aged or older adults, but due to a widening gap in care needs and caregivers available, the importance of younger adult caregivers is growing. This analysis uses Behavioral Risk Factor Surveillance System data from the optional Caregiver Module administered in 2021-2022 in 47 states and Puerto Rico. We described the health characteristics of young adults aged 18-34 (n=45,627), who we classified as current caregivers, anticipated caregivers (expected to provide care in the next 2 years), and non-caregivers. We calculated weighted estimates and made comparisons using chi-square tests. Caregivers reported significantly higher prevalence of obesity (34.3%), depression (35.2%), and current cigarette smoking (17.2%) compared to anticipated caregivers and non-caregivers. Caregivers also reported a higher prevalence of frequent mental distress (14 days or more of poor mental health in the past month) (32.5%) compared to anticipated caregivers and non-caregivers. Most caregivers provided less than 9 hours of care a week (57.8%, 95% CI=54.7-60.9) and helped with personal care tasks (51%, 95% CI=47.9-54.1). Caregivers had more risk factors for chronic disease and poorer mental health than those not currently or anticipated to provide care. Public health efforts can recognize and include younger caregivers in their efforts to maximize physical and mental health for all caregivers to assure care recipients are well-supported.
EFFECTS OF POSTRETIREMENT ACTIVITIES ON RETIREES’ WELL-BEING: THE MODERATING ROLE OF CHILDLESSNESS
Authors: Lin Gloria , Chung Edwin Ka Hung , Yeung Dannii Y , Ho Alvin , Ng Amy 
Published: January 2025

Abstract
According to role theory, retirees’ work roles are likely diminished upon retirement, but their family and community roles are strengthened. Such pattern however may be different among childless retirees as their family roles are comparatively fewer than retirees with children. Postretirement activities, such as volunteering (Filges et al, 2020) and postretirement employment (Wang, 2007), have been shown to contribute to retirees’ well-being as they compensate for the absence of important roles after retirement. Thereby, this cross-sectional study aimed to investigate whether the relationship between postretirement activities and well-being would be moderated by childlessness. Retirees’ number of children, participation in postretirement activities (volunteering, postretirement employment, both activities, or none), life satisfaction, positive affect, depressive symptoms, and cognitive functioning were measured among 942 older Hong Kong Chinese retirees aged 65 and above (Mage = 71.76, SD = 5.28). The results of two-way ANCOVAs demonstrated significant main effects of postretirement activities and childlessness on most of well-being outcomes. A significant interaction effect of postretirement activities and childlessness on depressive symptoms was found, even after controlling for demographic variables. Specifically, childless retirees participated in volunteering (adj. Mdiff = –2.33, p =.001), postretirement employment (adj. Mdiff = –3.56, p =.001), or both activities (adj. Mdiff = –2.77, p =.010) showed fewer depressive symptoms than those with children. Our findings suggest that beneficial effects of postretirement activities are more salient among childless retirees than those with children, implying that participation in postretirement activities would be a protective factor in maintaining well-being after retirement.
STRENGTHENING RETIREMENT PLANNING: A LONGITUDINAL EXAMINATION OF CONNECTEDNESS TO THE AGED FUTURE-SELF
Authors: Yeung Dannii Y , Lin Gloria , Ho Alvin 
Published: January 2025

Abstract
The overall level of pre-retirement planning among working adults remains low. This study aims to identify effective strategies to strengthen younger and older workers’ preparation for retirement. A total of 401 Hong Kong Chinese workers (170 younger and 231 middle-aged; M=42.34, SD=11.15) were randomly allocated to one of four experimental conditions: future-self with a writing task (FSW), future-self only (FS), current-self with a writing task (CSW), and current-self only (CS). In the experiment, participants in FSW and FS conditions were presented with an aged-morphed photo of their future-self, while those in CSW and CS conditions were presented with a photo of their current-self. The experiment was followed by a 5-day diary study, in which the participants in FSW and CSW wrote down their plans to improve well-being of their future-selves in old age or in three months, respectively. Retirement planning in financial, health and psychosocial domains were assessed at two weeks (T1) and at six months (T2) after the experiment. Preliminary analyses show that participants in FS and FSW reported more negative emotions after viewing the future-self photo (F(3,396)=10.42, p&lt;.001). A significant age group by condition interaction effect (F(3,317)=2.82, p=.039) was found in T1 retirement planning activities, with older workers in FSW reported more preparatory activities than younger workers in FSW, while such age effect was not observed in FS, suggesting that the 5-day writing task could strengthen one’s preparation for retirement. However, such age discrepancy effect diminished in T2. Implications on promotion of retirement planning will be discussed.
HIGH IMPACT ACTIVITIES: ASSESSING THE ASSOCIATION BETWEEN SOCIAL PARTICIPATION FREQUENCY AND COGNITION
Authors: Vogelsang Eric , Moorman Sara 
Published: January 2025

Abstract
There is growing recognition that social participation may help attenuate cognitive decline in older ages. Unfortunately, previous empirical research often relies on social participation “summary indexes”, which may obfuscate associations between cognition and specific social activities. Moreover, there has been little consideration as to whether increased social participation frequency is associated with greater cognitive functioning. We utilize two nationally representative longitudinal surveys of older adults: the Health and Retirement Study (21,705 observations across six waves) and the National Social Life, Health & Aging Project (5,317 observations across two waves). Regression models test how associations between social participation frequency and three cognition measures (a) differ by summary indexes; and (b) differ among specific social activities. We also compare and contrast the ways in which social participation is evaluated in these studies. When using summary participation indexes, for both datasets, each additional social activity and each increase in activity frequency was associated with greater cognitive functioning. However, when segregating social activities, we found disparate associations with cognition. Specifically, volunteering (in one dataset) and social/club membership (in the other) were the only activities whose frequency was positively associated with each cognition measure. Committing to regular social and community activity in older ages may help mitigate the risk of cognitive decline. However, caution is advised when interpreting the health effects of social activity counts or aggregate frequency measures. Surveys would benefit by establishing consistent social participation measurement standards.
ENGLISH PROFICIENCY, IMMIGRATION STATUS, AND COGNITIVE ASSESSMENT VARIABILITY IN OLDER ADULTS
Authors: Kitchens Katherine 
Published: January 2025

Abstract
Recent studies provide evidence that immigration status is a risk factor for developing dementia among older adults and that English proficiency moderates this relationship. This study aimed to analyze the factor structure of the National Health and Aging Trends Study’s (NHATS) cognitive battery to investigate whether this structure varies by English proficiency among the Medicare population and to assess the association between English proficiency, immigration status, and cognition. Utilizing the 2021 NHATS data from a nationally representative sample of Medicare beneficiaries (N = 5,628), a multi-group confirmatory factor analysis (CFA) was used to examine the factor structure of the cognition battery by English proficiency. Three multivariable linear regression models tested the relationship between English proficiency, immigration status, and a standardized cognition score weighted by factor loadings. The multi-group CFA revealed variations in factor loadings and error variances, suggesting differences in how cognition is captured among individuals with varying English proficiency. English proficiency emerged as a significant predictor of better cognitive z-scores, independent of immigration status (b = 0.70, p &lt;.001). Variance in latent cognition construct scores across groups suggests that English proficiency impacts cognitive assessment accuracy, possibly underestimating the cognitive abilities of those with lower English proficiency due to language or cultural barriers. The association between English proficiency, detached from immigration status, counters the perception of immigration status as a cognitive risk factor and calls for cognitive assessments that are culturally and linguistically appropriate and nuanced public health strategies that address diverse immigration experiences and social determinants.