bluuebunny/crossref_metadata_2025_split huggingface dataset:
ENGAGING ASIAN AMERICAN FAMILY CAREGIVERS IN CLINICAL TRIALS: FINDINGS FROM A NATIONWIDE STUDY
Authors: Rubovits Eve , Yedavalli Anjali , Sadruddin Sabeen , Lavari Kavin , Mudar Raksha , Leung Vania , Raj Minakshi 
Published: January 2025

Abstract
Ensuring representation of older racial and ethnic minority participants in clinical trials requires considering the family, community, and sociocultural context within which older adults make decisions about their healthcare and participation in trials. This study sought to evaluate Asian American caregivers’ (a) knowledge and experiences with clinical trials; (b) trusted and utilized sources of clinical trial information, (c) perceptions of ideal types of information to receive before enrolling their older relative in a clinical trial, and (d) concerns about their relative’s participation in clinical trials. We conducted a cross-sectional, online nationwide survey with Asian American family caregivers supporting an older relative between July 2022 and April 2023. Of all respondents (n=98), 62.2% reported knowing a little about clinical trials and 11.2% supported a relative who had been invited to participate in a clinical trial. Over one-third of respondents reported they most trust their relative’s healthcare provider as a source of information, and over half said they would use information from health organizations/groups or their relative’s provider for information. Respondents expressed wanting information about (a) the purpose, design, and components of the trial; (b) trial research ethics and safety; and (c) their responsibilities as the caregiver. Greater engagement between clinicians and family caregivers of culturally diverse older adults could help address concerns related to sociocultural barriers to participating in clinical trials. Providing key information to family caregivers in a comprehensive and accessible way without adding burden could help caregivers understand their responsibilities through the clinical trial process.
PROBLEM-SOLVING THERAPY FOR HOSPICE FAMILY CAREGIVERS: DOES TIMING MATTER?
Authors: Oh Oonjee , Washington Karla , Oliver Debra Parker , Demiris George 
Published: January 2025

Abstract
Although problem-solving therapy (PST) shows promise in alleviating hospice caregivers’ distress, the best timing for its implementation (e.g., closer to admission or later) is unknown. Our aim was to compare changes in hospice caregivers’ depressive and anxiety symptoms based on whether they received PST during or after their transition to hospice. We conducted a secondary analysis using pre- and post-intervention data from a PST intervention labeled PISCES (Problem-solving Intervention to Support Caregivers in End-of-life care Settings). Among 218 hospice family caregivers who were actively caring for their loved one at baseline, 79 caregivers received PISCES face-to-face (F2F), 72 caregivers received PISCES via both F2F and videoconferencing (Hybrid), and 67 received an enhanced hybrid version of PISCES (PISCESplus), which additionally focused on recognizing positive aspects of caregiving following a positive reappraisal approach. The timing of the intervention was dichotomized into starting either during recent transition to hospice (within 14 days of hospice admission) or later. Caregivers who received PISCES F2F, whether during or after hospice transition, demonstrated improved depressive symptoms (p value 0.013 and &lt; 0.001, respectively). PISCES Hybrid group did not show a significant change in their depressive symptoms at either timing. Within the PISCESplus group, only those who received the intervention later demonstrated a significant decrease in depressive symptoms (p value=0.043). Regarding anxiety symptoms, all caregivers experienced significant decrease, irrespective of the intervention type and its timing. Further efforts are needed to optimize the timing of PST in real-world hospice settings to increase its translatability and effectiveness.
PERCEIVED STRESS AS A MEDIATOR OF THE ASSOCIATION BETWEEN PSYCHOLOGICAL RESILIENCE AND FUNCTIONAL DECLINES
Authors: Kim Eunsaem , Lee Yunhwan , Kim Miji , Kim Sukyung , Shin YooGyung , Han Jimin 
Published: January 2025

Abstract
Because older adults are highly likely to experience physical and functional losses during the aging process, resilience, the ability to cope with age-related stress and navigate adversities, is key to healthy aging. Although a growing number of studies have acknowledged the protective effects of psychological resilience on the onset of frailty, cognitive impairment, and physical disability, little is known about underlying mechanisms explaining the association between psychological resilience and functional declines in later life. To explore mediators that account for the path between psychological resilience and frailty, we used data from the 2023 Korean Frailty and Aging Cohort Study (KFACS), with 1397 aged 72-90 (Mean = 82.2). Mediating effects of perceived stress, cognitive function, and physical functioning were examined by a parallel-serial mediation model using PROCESS macro. Older adults with high psychological resilience were less likely to develop frailty (β = -.093, p &lt;.05) after controlling for socio-demographic covariates and health-related factors. Psychological resilience influenced levels of frailty indirectly through perceived stress (β = -.04, 95% CI = -.078, -.002) and physical functioning (β = -.031, 95% CI = -.056, -.009). Also, there were simultaneous indirect effects of cognitive appraisal of stress through both cognitive function (β =-.01, 95% CI = -.019, -.003) and physical functioning (β = -.034, 95% CI = -.05, -.021) in the association between psychological resilience and frailty. These findings suggest that stress-coping abilities of older adults play a crucial role in promoting favorable stressor appraisals, which may mitigate functional declines.
RISK FACTORS ASSOCIATED WITH FRAILTY STATUS CHANGE: A PROSPECTIVE STUDY IN A GERIATRIC OUTPATIENT SETTING
Authors: Wen Chiung-Jung , Lee Chung-Sheng , Huang Wei-Jia , Lin Ching-Huang , Chan Ding-Cheng (Derrick) 
Published: January 2025

Abstract

Background
There has been limited research on the factors that predispose individuals to changes in frailty status. This study aims to identify the risk factors that lead to changes in frailty status among older adults.

Methods
Participants were recruited from a prospective geriatric outpatient cohort at a medical center. Frailty status was evaluated at baseline and during a 1-year follow-up using a modified version of Fried’s criteria. Additionally, demographic characteristics, health status, and geriatric assessments were collected.

Results
The mean age of the 140 participants was 79.5 ± 7.3 years. During the one-year follow-up period, 47.1% of participants experienced a worsening of frailty status, while 12.9% showed improvement, and 40% remained at the same frailty status. After adjusting for confounding variables, individuals who experienced more than one fall in the past year tended to exhibit deteriorating frailty status (□ □= -0.226, p = 0.005). The absence of teeth, which affects eating habits, also correlated with deteriorating frailty status (□ = -0.144, p = 0.061). Conversely, individuals with higher scores on the Mini-Mental State Examination tended to show improvements in frailty status □ = 0.198, p = 0.027).

Conclusion
Our findings could contribute to the development of interventions and strategies designed to prevent and manage frailty in older adults.
STAYING WITH A POSITIVE MIND: STEPPING AWAY FROM ACCELERATED AGING
Authors: Liu Yuchen , Cai Wenjie , Wittenberg Eve , Kim Dae Hyun , Bloom David , Kubzansky Laura , Seligman Benjamin 
Published: January 2025

Abstract
Subjective wellbeing (SWB) is a crucial measure of life quality in older adults. Understanding its relationship with frailty may inform strategies to promote healthy aging. We analyzed data for older adults aged ≥ 60 years old from Waves 3 and 4 of the China Health and Retirement Longitudinal Study. SWB was measured based on participants’ self-reported overall satisfaction with life. A frailty index was developed using the deficit accumulation approach. We conducted a cross-sectional Poisson regression to investigate the relationship between SWB and counts of frailty deficits. Additionally, we conducted a longitudinal analysis to determine the three-year relative risk of clinically significant frailty progression or mortality for different levels of SWB. The analyses were adjusted for individual weights, including adjustments for household nonresponse. The cross-sectional analysis included 9,702 individuals. After adjusting for covariates, lower baseline life satisfaction was associated with higher counts of frailty deficits (mean deficit counts ratio [95% confidence interval]: 1.66 [1.54, 1.78] for “not satisfied” and 1.06 [1.02, 1.10] for “somewhat satisfied” relative to the reference “very satisfied”). The longitudinal analysis included 8,599 individuals. Participants who were “not satisfied” with life at baseline were at a greater risk of frailty progression compared with those who were “very satisfied” (risk ratio: 1.16 [1.00, 1.35]). Our study finds that a lower level of SWB is associated with more severe frailty. It is also associated with frailty progression or death. These results emphasize that both psychological wellbeing and physical health are essential components of healthy aging.
COGNITIVE INTRAINDIVIDUAL VARIABILITY IN ADULTS WITH AND WITHOUT HIV-ASSOCIATED NEUROCOGNITIVE DISORDER
Authors: Vance David , Blake Jason , Li Wei , Wheeler Pariya , Collette Christopher , Jacob Alexandra , Kamath Vidyulata , Bene Victor Del 
Published: January 2025

Abstract
Cognitive intra-individual variability (IIV) is a sensitive marker of reduced top-down cognitive control related to neuropathology and increases with age. Prior work has shown increased cognitive IIV in people living with HIV (PLWH). For those with HIV-Associated Neurocognitive Disorder (HAND), it is likely that cognitive IIV is greater compared to PLWH without HAND (Non-HAND). In a sample of older PLWH from the Deep South of the United States, we examined differences in cognitive IIV in those with and without HAND, and the relationship of IIV with clinical and demographic factors. HAND (n=108) and Non-HAND (n=23) participants completed a neuropsychological assessment as part of a larger cognitive training protocol. Our primary outcome measure was the coefficient of variation (CoV), a widely used measure of IIV that corrects for mean-performance. Group differences were examined with analysis of covariance, followed by correlations of CoV with clinical and demographic variables. Cognitive IIV was greater in the HAND than the Non-HAND Group, consistent with our hypothesis. When exploring demographic variables included as covariates, we found race was statistically significant. Specifically, Black individuals with HAND had greater cognitive IIV than White individuals with HAND. However, these observed race differences in cognitive IIV were no longer significant after including reading ability and years of education in the model. Relative to PLWH without HAND, those with a HAND diagnosis have greater cognitive IIV attributable to more advanced HIV and cerebral dysfunction. Race-related differences in cognitive variability are best explained by historical disparities in education and reading levels.
EXPLORING THE PERSPECTIVES OF NURSING STUDENTS ABOUT WORKING IN THE LONG-TERM CARE SECTOR
Authors: Sun Winnie , McCabe Janet , Rudoler David 
Published: January 2025

Abstract

Background
The purpose of this study was to understand the perceptions of prospective registered nurses about working in the long-term care sector and identify workplace attributes that attract prospective nurses to the sector.

Methods
A sequential mixed methods study was conducted with nursing students at Ontario Tech University. Focus groups (n=14) asked students to comment on views about working in the long-term care sector, and job attributes that may attract them to the sector. A cross-sectional survey asked students to respond to elicited choice job scenarios, informed by the thematic analysis of focus group interviews. The survey data (n=139) was analysed using least absolute deviations estimator. Willingness-to-pay (WTP) values of wages gained or forgone were generated for each job attribute.

Results
Focus group interviews suggested fair compensation, optimal client-to-staff ratios, unionized work environments, comprehensive benefits packages, and flexible work arrangements were important job attributes. In survey results, 18.0% expressed interest in working in long-term care sector compared to 75.5% in acute care. Regression analysis suggested that higher amounts of paid vacation (WTP: -5.983; 95% CI: -13.749, -0.037) and higher risk of injury (WTP: 0.684; 95% CI: 0.124, 1.208) were associated with work in the long-term care sector.

Conclusion
Long-term care can attract nurses by offering flexible options such as part-time positions and paid vacation, and by actions that potentially mitigate the risk of workplace injury, violence, and abuse. Nursing students should be shown the positive aspects of working with older adults and dispel negative perceptions about the long-term care sector.
FACTORS ASSOCIATED WITH HAND HYGIENE COMPLIANCE OF NURSING STAFF IN LONG-TERM CARE FACILITIES
Authors: Kim EunKyo , Cho Eunhee , Kim Gwang Suk , Lee Kyung Hee 
Published: January 2025

Abstract
This study was performed to identify hand hygiene compliance factors of registered nurses (RN) and nurse aids (NA) in long-term care facilities. This cross-sectional study surveyed 78 RNs and 50 NAs who worked at long-term care facilities. Data were collected from October 1st to December 30th, 2020. The hand hygiene knowledge, perception, and infrastructure were measured by translated versions of the World Health Organization(WHO)’s hand hygiene knowledge, perception, and infrastructure tool(2009). Hand hygiene compliance was calculated as ‘number of conducted WHO’s hand hygiene at five moments’ out of ‘number of chances to conduct WHO’s hand hygiene at five moments’ multiplied by 100, which participants wrote. Data were analyzed using Spearman’s rank correlation coefficient and multiple linear regression. The hand hygiene compliance rate was 78.85%. The mean score of hand hygiene knowledge was 13.55±2.21 out of 25 points, the perception mean score was 73.41±11.65 out of 96 points, and the infrastructure mean score was 32.42±5.18 out of 40 points. Hand hygiene compliance positively correlated with the perception (r=0.177, p=0.045) and the infrastructure(r=0.194, p=0.028). Factors influencing hand hygiene compliance were the infrastructure (β=0.223, p=0.042) and working in a specialized unit (β=0.221, p=0.013) for residents who need nursing treatments (e.g., indwelling catheter exchange and wound management) and with mandating minimum registered nurse staffing level. Hand hygiene compliance was affected by infrastructure and working units with different nursing staffing levels. The results suggest expanding the infrastructure and ensuring adequate nursing staffing in long-term care facilities to improve hand hygiene compliance.
IDENTIFYING IMPORTANT AND FEASIBLE ITEMS FROM THE PREFERENCES FOR EVERYDAY LIVING INVENTORY-KOREAN (PELI-K)
Authors: Shin So Young , Kwon Jenny 
Published: January 2025

Abstract

Purpose
As a follow-up study for the translation and cultural adaptation of the Preferences for Everyday Living Inventory-Korean (PELI-K), this pilot study identified the ranking of the PELI-K items selected as most important/feasible from the original PELI-K 72 items in the Korean nursing home (NH) context.

Methods
A purposive snowball sampling strategy were used. The NH stakeholder advisory panel was recruited from five unique sites in one metropolitan city in Korea: two NHs, one general hospital, one teaching hospital, and one university. A total of 34 stakeholder advisory panel, including 22 experts and 12 care consumers, conducted a self-administered, in-person survey asking to score the importance and feasibility of the 72 PELI-K items. Four answer choices were available, ranging from 0 (low) to 3 (high). The sum of the scores, which adds all the scores received from participants, was calculated to rank items. The score ranges from 3 to 102 and the higher the score, the higher the importance/feasibility.

Results
The top 12 important and top 11 feasible items are reported. Items related to human basic needs such as sleeping, bathroom needs, safety, and privacy were selected as important priorities. Having regular contact with family and using electronic devices to communicate with others were the most feasible preferences.

Conclusion
The results from this study will help NH providers plan and deliver care that is geared toward residents’ most salient preferences and play a huge role in creating a short version of the PELI-K.
THE USE OF INVOLUNTARY TREATMENT AMONG NURSING HOME RESIDENTS IN THE NETHERLANDS: A CROSS-SECTIONAL STUDY
Authors: Biesmans Guido , Hameleers Niels , Hamers Jan , Bleijlevens Michel 
Published: January 2025

Abstract
Several studies indicate that care-dependent older adults with cognitive impairments, living in a nursing home, are at risk of care without their consent, referred to as ‘involuntary treatment’. This includes the use of physical restraints (e.g. belt restraint or bedrails), off-label use of psychotropic medication (e.g. anti-depressants, sedatives) and non-consensual care (e.g. forced hygiene, hiding medication). To explore the prevalence and associated factors of involuntary treatment in nursing home residents with cognitive or functional impairment we conducted a cross-sectional study in the southern part of the Netherlands using association analyses. Involuntary treatment was measured using the International Prevalence Measurement of Care Quality (LPZ). In addition, sociodemographic data were collected from residents, including gender, age, functional or cognitive impairment, diagnosis of dementia, confusion, aggression and dependency in activities of daily living. Involuntary treatment was used in 30% of the total sample. Among the residents who received at least one form of involuntary treatment, physical restraint was most commonly used (92%), followed by off-label use of psychotropic medications (20%) and non-consensual care (10%). Involuntary treatment was most common among residents with cognitive impairments (38%). Within the group of residents with functional impairment, the prevalence was 20%. Cognitive impairment and dependency in activities of daily living were strongly associated with involuntary treatment. Involuntary treatment is often used among nursing home residents with cognitive impairment. It also shows that residents with functional impairments are at risk. Future research should focus on understanding and preventing inappropriate involuntary treatment in nursing homes.
LONG-TERM MOBILITY DEVICE USE AND SOCIAL WELL-BEING AMONG COMMUNITY-DWELLING OLDER ADULTS IN THE UNITED STATES
Authors: Liu Xinran , Baumann Sara , Rosso Andrea , Venditti Elizabeth , Yao Yao , Albert Steven 
Published: January 2025

Abstract
The prevalent use of mobility devices among older adults is largely driven by the increased incidence of mobility disability in later life. While these devices are designed to enhance activities and participation for individuals with mobility disability, their long-term effects on social well-being remain unclear. This study assesses whether mobility device use contributes to improved activities, participation, and life satisfaction among community-dwelling older adults over time, comparing users with their non-user counterparts. We utilized data from the National Health and Aging Trends Study (NHATS) waves 1-9 (2010-2019) to identify incident mobility device users with over two years of experience. These users were matched on a 1:1 basis with non-users by age (±5 years), gender, race, and baseline Short Physical Performance Battery scores (±1 point). Follow-up assessments were conducted at the time of incident use, and 1- and 2-year later. Guided by the NHATS late-life disability framework, we applied mixed-effects models, adjusting for personal and environmental factors, health status, body impairments, functional capacity, and accommodations. The results indicate that mobility device users have overall significantly lower participation in paid work compared to non-users (p&lt; 0.05). Over time, mobility device use was associated with decreased driving but increased reliance on rides from others, and more frequent visits with family and friends (ps&lt; 0.05). Notably, older mobility device users exhibited lower life satisfaction in the long term (p&lt; 0.05). These findings underscore the critical need to address the social well-being of older adults who use mobility devices in communities to improve their overall quality of life.
PAIN AND LOWER EXTREMITY FUNCTIONAL LIMITATION IN AMERICAN OLDER ADULTS: A SIX-YEAR FOLLOW-UP STUDY
Authors: Sodhi Jaspreet , Snih Soham Al 
Published: January 2025

Abstract
The objective of this study was to examine the relationship between pain and lower extremity functional limitation (LEFL) among American older adults without LEFL at baseline over 6-years of follow-up. Participants (N=1,717) aged ≥ 65 years were from the National Health and Aging Trends Study (2011-2016). Measures included pain, socio-demographics (age, gender, race/ethnicity, and education), depressive symptoms, obesity, and comorbidities. LEFL was defined as limitation in ≥ one of the following five activities (walking 6 blocks, walking 3 blocks, walking up 20 stairs, walking up 10 stairs, or able to get down on knees). General estimation equation model was fitted to estimate the odds ratio (OR) and 95% Confidence Interval (CI) of any LEFL as a function of pain. All variables were treated as time varying except for gender, education, and race and ethnicity. Participants with pain had greater odds (OR=1.52, 95% CI=1.42-1.63) of reporting any LEFL over time than those without pain after controlling for all covariates. Older age and comorbidities were associated with greater odds of any LEFL while married status and high level of education were factors associated with lower odds of reporting any LEFL. In conclusion, pain was a significant predictor of limitations in lower extremity function. Therefore, early assessment of pain and appropriate treatment could prevent future disability and maintain independence in this population.
SOCIAL DETERMINANTS AND THE VULNERABILITY TO LOSS OF INDEPENDENCE IN OLDER ADULTS
Authors: Lee Young-Shin , Jun Hee-jin , Lee Jung-Ah 
Published: January 2025

Abstract
Over 41% of Americans with disabilities are aged 65 and older, with two in five seniors experiencing at least one disability, such as mobility limitations or depending on others for daily activities. As life expectancy increases, the prevalence of disability in later life is also expected to increase. Vulnerability of independence and unmet needs in daily activities present a significant personal burden and a growing concern for public health. While mMobility disabilities contribute significantly to this vulnerability, yet a comprehensive understanding is still lacking. This study aims to explore the impact of social determinants on functional vulnerability of older adults, utilizing data from the 2017 National Health Aging Trends Study (NHATS). It evaluates functional vulnerability with the Vulnerable Elders Survey tool and applies logistic regression analysis to assess the effects of age, gender, race/ethnicity, income, and living arrangements on this vulnerability. The analysis included 6,312 individuals aged 65 years and above, revealing that 30% have an income under the poverty level and 35% live alone. The results show that 43.6% of older adults are at a high risk of functional vulnerability. Significant risk factors identified include being of ‘old’ age, female, NH Black, living with others, and having an income at the poverty level. These findings underscore the urgency of developing targeted interventions for these at-risk groups.