bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE RELATIONSHIP BETWEEN SPIRITUALITY AND COGNITION WITHIN BLACK AND WHITE ADULT IN THE HANDLSLEEP STUDY
Authors: Hampton Marsha , Allan Alexa , Ji Linying , Ross Lesley , Thorpe Roland , Zonderman Alan , Evans Michele , Gamaldo Alyssa 
Published: January 2025

Abstract
This study explored associations between spirituality and cognitive performance within Black and White adults in the HANDLS Sleep Study (n=85; 52% Black adults; age range: 46-82). The Spirituality Transcendence Scale-Short Form measured overall spiritual transcendence orientation and three subscale scores (Prayer Fulfillment, Universality, and Connectedness). Cognitive performance was measured by several tests (MoCA, Trails Making Test, AVLT, Digit Span, Clock Drawing, Verbal Fluency). Race-stratified regression analyses explored the association between each spirituality score and cognitive test after covariate adjustment (age, sex, poverty status, depression severity and health conditions). Within Black adults, the spiritual subscale (universality and connectedness) and total scores were significantly associated with better delayed AVLT (memory; b = -.409, p = 0.014), phonemic verbal fluency (executive function; b = 1.312, p =.044) and clock drawing (visuospatial skill; b = 0.092, p = 0.040). However, these findings became non-significant after covariate adjustment. Within White adults, results indicated that higher spiritual personal fulfillment (b = -.281, p = 0.014) was significantly associated with worse performance on digit span forward (executive function); however, higher connectedness (b =.442, p = 0.014) was significantly associated with better performance on the same test after covariate adjustment. Higher connectedness was significantly associated with faster performance on Trials B (b = -4.452, p = 0.015; executive function), but was non-significant after covariate adjustment. Findings illustrate differential associations between the spirituality and cognitive performance within Black and White adults, which suggest further exploring psychosocial factors culturally relevant to each racial group to understand current findings.
LONGITUDINAL TRENDS OF FAMILY CAREGIVERS’ FINANCIAL WELL-BEING AND SUPPORTIVE CARE SERVICE USE
Authors: Liu Yin , Kim Kyungmin , Ferguson Melissa , Li Niying , Batura Josey 
Published: January 2025

Abstract
The stress process model denotes financial well-being and caregiving support as two important resources for family caregivers. Financial well-being can be a critical factor in securing paid/formal care services at home and in community settings. When care-related out-of-pocket expenses are high, however, it can also become a secondary strain (i.e., financial burden) for caregivers. We conducted a longitudinal trend analysis, utilizing four waves of cross-sectional data collected over time from caregivers enrolled in the National Study of Caregiving study (i.e., family/unpaid caregivers of participants in the National Health and Aging Trends Study 1, 2, 11, and 12 rounds). The findings suggested that across waves, subjective financial difficulty was associated with income, and there were disparities in financial well-being (i.e., defined as subjective financial difficulty and income) by care recipients’ chronic health conditions as well as caregivers’ race/ethnic minority status and levels of education. Further, financial well-being (including subjective financial difficulty and income) was associated with using community-based care services such as respite programs (e.g., adult day care services) and paid help for personal care at home. Caregiving policy needs to consider caregiver financial well-being and financial disparities as factors affecting care service use.
KEEPING THE FAITH IN ADVERSITY: UNPACKING THE PARADOX OF INTENSIVE CAREGIVING
Authors: Maulod Ad , Farhan Nur ‘Atiqah Mohd , Rouse Sasha , Malhotra Rahul 
Published: January 2025

Abstract
Striving to live an authentic life while fulfilling caregiving duties is a common challenge among family caregivers. Previously, based on the distribution of the burden and benefits of caregiving, we identified four distinct archetypes – balanced (40%), satisfied (33%), intensive (17%) and dissatisfied (10%) – among family caregivers of older adults in Singapore. “Intensive” caregivers were most burdened in terms of poor health and financial strain yet continued to express caregiving as a highly rewarding endeavor, reporting benefits which were similar or greater than the other archetypes. In this paper, we interrogate this paradox by exploring the experiences of “intensive” caregivers through a one-year longitudinal qualitative study (Quali-T, N=39) conducted with caregivers across the different archetypes. Study findings reveal complex narratives of “intensive” caregivers seeking rewards to justify their burden. A karmic belief in intangible spiritual benefits seems to be the key explanation for this phenomenon. While the supportive effects of spirituality in overcoming caregiving challenges have been studied at length, we identify the intricate processes that occur when highly stressed caregivers negotiate meaning out of their circumstances, in relation to their personal need for spiritual well-being and authenticity. While spiritual support can be profoundly comforting for many caregivers, it is not a panacea to address all the challenges they face. By addressing the spiritual dimension of care in parallel to other aspects of caregiver support, healthcare and social service providers can offer more comprehensive person-centered care that supports caregivers’ holistically.
OLDER AMERICANS ACT: TARGETING OLDER ADULTS WITH GREATEST SOCIAL AND ECONOMIC NEEDS
Authors: Robinson Kristen 
Published: January 2025

Abstract
The overall purpose of the Older Americans Act (OAA) is to help older adults remain in their communities through the provision of long-term services and supports. The Administration for Community Living administers the National Survey of OAA Participants (NSOAAP) to collect data on OAA clients in six service areas (home-delivered meals, congregate meals, homemaker services, transportation services, case management services, and caregiver support services). The annual survey includes questions on consumer assessment of service quality as well as client characteristics such as health status, physical and social functioning, and demographics. The OAA targets older adults with the greatest social and economic need. Older adults who receive in-home services (home-delivered meals, case management, and homemaker services) are often the ones with the highest level of need. For example, between one-half and three-quarters of in-home service clients live alone, more than half report mobility limitations, and one-third report limitations in 3+ activities of daily living (ADLs). In 2022, a module on emergency preparedness was added to the 16th NSOAAP. Findings show that one-third of in-home service clients experienced severe weather events such as a tornado, hurricane, or wildfire. Living alone and having medical devices that require electricity can be an added complication during emergencies. Among OAA clients, 41% of home-delivered meal, 60% of case management, and 42% homemaker clients reported having 3+ ADLs and rely on medical devices that require electricity. This presentation will discuss uses of the annual survey, findings from the rotating modules, and how researchers can access the data.
DEMONSTRATION OF COMMUNITY-ENGAGED RESEARCH CONTINUUM THROUGH A UNIVERSITY AND AREA AGENCY ON AGING PARTNERSHIP
Authors: Sheldon Marisa , Calhoun Katie , Rao Smitha , Happel Christine , Dabelko-Schoeny Holly , Traver Anthony 
Published: January 2025

Abstract
Area Agencies on Aging (AAA), which were originally established to support the planning and delivery of community-based support, are well-positioned to build knowledge and develop innovative responses to community needs through community-engaged research partnerships. This presentation illustrates a relationship between the Age-Friendly Innovation Center (AFIC) at The Ohio State University College of Social Work and the Central Ohio Area Agency on Aging (COAAA), focused on advancing community-engaged research in response to multiple aspects of aging in the community. This presentation will explore the continuum of community-engaged research, to build meaningful collaborations between two entities that shared similar values and identified shared concerns, as demonstrated through three research projects. The projects address three different critical needs among older adults and reflect different levels of engagement, 1) Low-income housing residents, especially older adults with disabilities, face heightened risks during weather-related disasters, 2) The increasing rate of older adult renters that are considered extremely housing cost burdened, and 3) The unique needs of an increasingly diverse population of older adults, in particular the rising number of older adults that are LGBTQ+. The three projects represent different methodological approaches and levels of engagement, illustrating unique funding, staffing, and project implementation activities. Preliminary findings from interviews, focus groups, and survey activities for each research project will be presented. The primary focus will be understanding the development and design of the projects, ranging from consultation, collaboration, to partnership, emphasizing challenges and points of success experienced by AAA and by AFIC.
PATIENT PRIORITIES CARE FOR HISPANICS WITH DEMENTIA (PPC-HD)
Authors: Samper-Ternent Rafael 
Published: January 2025

Abstract
Persons living with dementia frequently experience difficulty managing multiple chronic conditions (MCC) and have poorer outcomes. Managing MCC typically involves adhering to single-disease clinical practice guidelines. This approach results in burdensome care with outcomes that may not reflect what matters most to patients. Studies using the Patient Priorities Care (PPC) approach have demonstrated feasibility and effectiveness of PPC in different clinical settings. Physical, emotional, and cognitive impairments related to dementia interfere with disease self-management. Care partners, therefore, play an essential role in the care and decision-making of PlwD. Care partners are essential in translating ‘what matters most’ for PlwD into healthcare decisions. Patient and care partner involvement should include identifying outcome goals and care preferences (health priorities) as well as aligning care to meet those priorities. PlwD from minority groups face more barriers and have poorer outcomes compared to Non-Hispanic Whites. Hispanics are the fastest growing underrepresented population in the USA, and have higher risk of dementia compared to Non-Hispanic Whites. Hispanics rely heavily on their families and there is a cultural expectation of families to provide care to members in need. Cultural differences and language barriers shape healthcare priorities and how priorities impact outcomes among Hispanics. We recently completed a feasibility study among older Hispanics with cognitive impairment and their care partners. Results from this study confirm Hispanics with dementia and their care partners are willing and able to identify health priorities, and clinicians can align care to achieve these priorities when placed in the electronic health record (EHR).
JGMS EDITOR’S CHOICE ARTICLES OF 2023: RISK AND RECOVERY OF FUNCTIONAL DECLINE AND FRAILTY
Authors: Lipsitz Lewis , Kim Dae 
Published: January 2025

Abstract
This symposium will present four 2023 “Editor’s Choice” articles from the Journal of Gerontology Medical Sciences that focus on the risk and recovery of functional decline and frailty. Courtney Millar and her colleagues, in their article “Association of Proinflammatory Diet With Frailty Onset Among Adults With and Without Depressive Symptoms: Results From the Framingham Offspring Study” examine the association between an inflammatory diet and increased odds of frailty in those with depressive symptoms. Nicholas Rowan and his coauthors, in “The Association of Peripheral and Central Olfaction With Frailty in Older Adults” examine olfactory impairment, specifically olfactory identification and sensitivity, as a potential biomarker and risk factor for frailty. “Supplementing Glycine and N-Acetylcysteine (GlyNAC) in Older Adults Improves Glutathione Deficiency, Oxidative Stress, Mitochondrial Dysfunction, Inflammation, Physical Function, and Aging Hallmarks: A Randomized Clinical Trial”, written by Sekhar Rajagopal and colleagues, studies the effects of GlyNAC (combination of glycine and N-acetylcysteine [NAC]) supplementation on hallmarks of aging in older adults. Theresa Mau and coauthors, in their article, “Mitochondrial Energetics in Skeletal Muscle Are Associated With Leg Power and Cardiorespiratory Fitness in the Study of Muscle, Mobility and Aging,” examine the associations between mitochondrial energetics and functional outcomes, including leg power and cardiorespiratory fitness. Our discussant, Roger Fielding, will highlight commonalities and lessons learned from these studies.
ASSOCIATION OF PRO-INFLAMMATORY DIET WITH FRAILTY ONSET AMONG ADULTS WITH AND WITHOUT DEPRESSIVE SYMPTOMS
Authors: Millar Courtney , Dufour Alyssa , Hebert James , Shivappa Nitin , Okereke Olivia , Kiel Douglas , Hannan Marian , Sahni Shivani 
Published: January 2025

Abstract
Dietary inflammation is associated with increased risk of frailty. Those with depressive symptoms may be at higher risk of frailty onset since they typically have higher levels of inflammation. The study objective was to determine the association between a pro-inflammatory diet and frailty onset in those with and without clinically relevant depressive symptoms. This prospective study included 1,701 non-frail individuals with self-reported baseline (1998-2001) data available for the evaluation of energy-adjusted dietary inflammatory index (E-DIITM) (calculated from food frequency questionnaires), depressive symptoms (from the Center for Epidemiologic Studies Depression; CES-D), and follow-up frailty measurements (2011-2014). Frailty was defined as fulfilling ≥3 Fried frailty criteria. Results are presented by baseline CES-D scores &lt;16 or ≥16 points, which denotes the absence or presence of clinically relevant depressive symptoms, respectively. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (95% CI) between E-DII and frailty onset, adjusting for confounders. In all study participants, mean (standard deviation; SD) age was 58(8) years and E-DII was -1.95 (2.20; range: -6.71 to +5.40, higher scores denote a more pro-inflammatory diet), and 45% were male. In those without clinically relevant depressive symptoms, one-unit higher E-DII score was associated with 14% increased odds (95% CI:1.05-1.24) of frailty. In those with depressive symptoms, one-unit higher E-DII score was associated with 55% increased odds of frailty (95% CI: 1.13-2.13). The association between inflammatory diet and increased odds of frailty appeared somewhat stronger among those with depressive symptoms. This preliminary finding warrants further investigation.
THE ASSOCIATION OF PERIPHERAL AND CENTRAL OLFACTION WITH FRAILTY IN OLDER ADULTS
Authors: Rowan Nicholas , Nagururu Nimesh , Bernstein Isaac , Voegtline Kristin , Olson Sarah , Agrawal Yuri 
Published: January 2025

Abstract
Olfactory impairment is increasingly recognized as a biomarker of frailty, but the relationship between olfactory subdomains that describe peripheral or central dysfunction and frailty remains unexplored. In this study, we examined 1,160 older adults from the National Social Life, Health, and Aging Project Wave 3. Olfactory identification (OI): the ability to identify an odorant; and olfactory sensitivity (OS): the ability to detect the presence of an odorant, were assessed using 5 and 6-point measures respectively. Frailty was operationalized as both a 37-item Frailty Index (FI) and the 5-item Physical Frailty Phenotype (PFP). Mixed models were fit to examine the association between OI, OS, FI and PFP, while adjusting for demographic and clinical covariates. Subjects in the most-frail PFP category had lower OI and OS scores (OI: 3.88 vs 4.19, p= 0.016; OS: 3.15 vs 3.47, p= 0.031), whereas, subjects in the most-frail FI category exhibited lower OI scores but not OS scores when compared to non-frail subjects (OI: 3.72 vs 4.27, p= 0.014; OS: 3.19 vs 3.43, p= 0.476). Adjusted mixed models showed that a point increase in OI was associated with a lower PFP score (β= -0.107, p= 0.006) and FI score (β= -0.009, p= 0.010). A point increase in OS was associated with a lower PFP score (β= -0.058, p= 0.016), but not FI score (β= -0.004, p= 0.064. These finding reveal distinct associations between peripheral and central measures of olfaction and frailty, highlighting the potential use of olfaction assessment as a biomarker and risk factor for frailty.
MITOCHONDRIAL ENERGETICS IN SKELETAL MUSCLE ARE ASSOCIATED WITH LEG POWER AND CARDIORESPIRATORY FITNESS IN SOMMA
Authors: Mau Theresa , Kramer Philip , Coen Paul , Hepple Russell , Kritchevsky Stephen , Newman Anne , Cawthon Peggy , Cummings Steven 
Published: January 2025

Abstract
Mitochondrial energetics are an important property of aging muscle, as generation of energy is pivotal to the execution of muscle contraction. However, its association with functional outcomes, including leg power and cardiorespiratory fitness, is largely understudied. In the Study of Muscle, Mobility and Aging, we collected vastus lateralis biopsies from older adults (n = 879, 70–94 years, 59.2% women). Maximal State 3 respiration (Max OXPHOS) was assessed in permeabilized fiber bundles by high-resolution respirometry. Capacity for maximal adenosine triphosphate production (ATPmax) was measured in vivo by 31 P magnetic resonance spectroscopy. Leg extension power was measured with a Keiser press system, and VO2peak was determined using a standardized cardiopulmonary exercise test. Gender-stratified multivariate linear regression models were adjusted for age, race, technician/site, adiposity, and physical activity with beta coefficients expressed per 1-SD increment in the independent variable. Max OXPHOS was associated with leg power for both women (β = 0.12 Watts/kg, p &lt;.001) and men (β = 0.11 Watts/kg, p &lt;.050). ATPmax was associated with leg power for men (β = 0.09 Watts/kg, p &lt;.05) but was not significant for women (β = 0.03 Watts/kg, p =.11).
LEVERAGING PATIENT PORTALS TO IDENTIFY AND INTERVENE IN DEMENTIA CARE: CAREGIVING, MEDICATION, AND ACUTE CARE
Authors: Portz Jennifer , Demiris George 
Published: January 2025

Abstract
Care partners play a pivotal role in supporting people living with dementia (PLWD), yet their systematic identification and involvement in clinical care are often lacking. This symposium presents four studies highlighting ground-breaking care partner identification methods to inform patient portal-based interventions targeting care partners to enhance dementia care. The first study, a retrospective cohort analysis focuses on automating care partner identification via structured patient contact data and unstructured portal notes in the electronic health record to better deliver evidence-based caregiving interventions through patient portals. The second study explores the associations between the documentation of a care partner and documentation of care partner education in the electronic health record and hospital length of stay. The third study presents an analysis of patient secure portal messages and clinical notes that identified modifiable contributors to potentially preventable acute care visits among PLWD including unmet care needs, particularly in care coordination, health systems navigation, and medication management that contribute. The final study describes the content of patient portal messages relating to medications among PLWD, care partners, and clinicians in a single health system, to inform the development of a portal-based intervention to reduce the use of potentially inappropriate medications among PLWD Our Discussant, Dr. George Demiris, PhD, an informatics and caregiving technology expert, will lead a conversation emphasizing the importance of systematic care partner identification and integrating care partner engagement tools with patient portals to enhance support for PLWD and their care partners, ultimately improving dementia care delivery and outcomes.
IDENTIFICATION OF PATIENT PORTAL MESSAGES SENT FROM NON–PROXY ACCOUNT CARE PARTNERS AND THEIR PORTAL USE PATTERNS
Authors: Portz Jennifer , Martin Daniel , Gleason Kelly , Washington Karla , Daddato Andrea , Powers Dave , Lyons Jason , Bayliss Elizabeth 
Published: January 2025

Abstract
Automating care partner identification via the electronic health record (EHR) can streamline the delivery of evidence-based caregiving interventions through patient portals and is vital for supporting care partners of people living with dementia (PLWD). This retrospective cohort study focused on identifying patient portal messages from non-proxy care partners and exploring associated portal usage. Conducted at Kaiser Permanente Colorado, it analyzed data from 789 PLWD aged ≥60, utilizing the EHR and Virtual Data Warehouse. Structured patient contact data (e.g., emergency contact, family contact) and unstructured portal notes were used to match contact names with caregiver terms, employing a rule-based algorithm to identify care partner messages. Results showed that 95% of PLWD had at least one care partner listed, with an average of 2.1. A majority (77%) engaged with the patient portal, and 57% had messages sent by care partners, predominantly non-proxy (7% were from proxy accounts). Non-proxy care partners sent an average of six messages during the study period. Additionally, 54% of PLWD had portal activity on days when care partners sent messages, showing their involvement in healthcare management. Care partners mainly accessed clinical visit information, medication details, lab scheduling/results, and primary care provider information on these days. This study underscores the importance of automated care partner identification and non-proxy engagement via patient portals, facilitating better support for PLWD and enhancing their care partners’ involvement.