bluuebunny/crossref_metadata_2025_split huggingface dataset:
EVIDENCE-INFORMED ONLINE PLATFORMS FOR DEMENTIA CAREGIVERS
Authors: Stevens Alan , Czaja Sara 
Published: January 2025

Abstract
Online platforms for dementia care have emerged in response to the expressed desire of family caregivers for on-demand, self-paced education and dementia care skills training. Given the wealth of evidence-based dementia caregiver interventions, there is a unique opportunity to provide evidence-informed online services for family caregivers. Four online platforms for dementia caregivers will be discussed. Dr. Stevens will present an overview of two online platforms, GamePlan4Care (GP4C) and Resoures4Care (R4C). Preliminary findings suggest positive benefits to caregivers who engaged in either platform. The GP4C online platform has been modified to address the needs of family caregivers who experience the hospitalization of a Veteran living with dementia by Dr. Horstman. Preliminary findings from Dr. Horstman’s pilot study of GP4-Hospital in a VA hospital will be presented. Dr. Laura Gitlin’s presentation will focus on WeCareAdvisor, an online platform that provides daily tips to caregivers. Dr. Gitlin will present findings on the impact of multiple techniques used to engage family caregivers in using WeCareAdvisor. Dr. Eric Jutkowitz will provide an overview of Plans4Care, a translation of therapeutic strategies that address caregiver challenges from multiple in-person evidence-based dementia caregiver interventions into a single digital format. His presentation will focus on innovative online methods of tailoring therapeutic content to family caregivers. Dr. Sara Czaja, an international leader in developing, implementing, and evaluating technology-based solutions to late-life autonomy and caregiving support, will frame the findings of the four presentations within the US landscape of online support services for dementia caregivers.
GAMEPLAN4CARE AND RESOURCES4CARE: PRELIMINARY OUTCOMES ASSOCIATED WITH TWO ONLINE DEMENTIA CAREGIVING PROGRAMS
Authors: Stevens Alan , Cho Jinmyoung , Reese Jordan , Han Gang , Ory Marcia 
Published: January 2025

Abstract
GamePlan4Care (GP4C) and Resources4Care (R4C) are online dementia caregiver programs. GP4C consists of rules-based conditional logic algorithms and real-time assessments of caregiving risks to tailor and prioritize educational and skills content. R4C provides a searchable database of vetted online educational and resources focused on dementia and family caregiving. The content of R4C was chosen to parallel GP4C educational content but does not include tailoring of content based on real-time caregiver assessments. Other program similarities were the self-paced format for caregivers’ engagement with brief educational videos and skill-building exercises and access to a Dementia Care Specialist to further support caregivers’ engagement. Two hundred forty family caregivers of persons living with dementia (PLWD) were randomly assigned to either GP4C or R4C. Nearly 70% of enrolled caregivers lived with a PLWD. Half were adult child/child-in-law caregivers (52%) and 39% were spousal caregivers. Preliminary results are reported on three standardized assessments conducted at baseline and a 6-month follow: Zarit Caregiver Burden Interview (ZBI), Positive Aspects of Caregiving (PAC), and Social Provision Scale (SPS). Caregivers assigned to either GP4C or R4C reported a significant (P&lt;.05) reduction in ZBI and improvement in PAC after 6 months of self-paced engagement in GP4C and R4C. Caregivers in GP4C also reported a significant increase in perception of receiving guidance support from family or friends (SPS). Both GP4C and R4C show promise as online platforms for dementia caregivers. Feedback from participants of this study suggest the need for improved functionality and revision of content to better meet diverse caregiver needs.
ADAPTATION OF GAMEPLAN4CARE FOR HOSPITAL CARE AND CARE TRANSITIONS
Authors: Horstman Molly , Evans Tracy , Guo Crystal , Sonnenfeld Mandi , Naik Aanand , Stevens Alan , Kunik Mark 
Published: January 2025

Abstract
Adults with dementia rely on family caregivers after hospital discharge. Increased caregiver stress following discharge may lead to worse outcomes for caregivers and adults with dementia. Our aim was to adapt GamePlan4Care, a community-based caregiver support intervention, to support caregivers of hospitalized adults with dementia. GamePlan4Care combines online, self-directed skills training with four phone calls from a dementia care specialist. Potential adaptations were identified through a literature review and semi-structured interviews with health professionals and caregivers. Adaptation prototypes were presented to caregiving research consultants, a stakeholder panel with a caregiver and health professionals, and individuals who implemented GamePlan4Care in the community. All adaptations were reviewed with the GamePlane4Care developer. We used the Framework for Modification and Adaptations-Expanded (FRAME) to describe the adaptations. Initial adaptations were planned and made during the pre-implementation stage. Adaptations included: 1) adding training content for care transitions (medication review, clinical red flags, delirium, functional decline, and medical tasks), 2) modifying the intervention content to improve caregiver engagement, and 3) modifying the context of intervention delivery. Additional adaptations will be made based on caregiver feedback from an ongoing feasibility and acceptability pilot. The recruitment target of 30 caregivers should be reached in June 2024. Preliminary results will be presented at the symposium. Evidence-based interventions designed for outpatient and community settings need to be adapted before they can be implemented as part of hospital care. Using insights from multiple sources, we developed HospitalGamePlan4Care, a new intervention that combines care transitions training with an evidence-based dementia caregiver support intervention.
HOW DOES THE NEIGHBORHOOD-BUILT ENVIRONMENT CONTRIBUTE TO SOCIAL HEALTH FOR PEOPLE LIVING WITH DEMENTIA?
Authors: Altona Janissa , Mena Emily , Schüz Benjamin , Wolf-Ostermann Karin 
Published: January 2025

Abstract
Several studies point to the importance of the neighbourhood-built environment (NBE) for the social health of community-dwelling people living with dementia (PlwD). Indicators of dementia-friendly urban planning can be identified in the literature, but little is known about which specific factors of the NBE are important for PlwD and family carers. In order to examine relevant indicators, the following questions were analyzed by a qualitative research approach in the German DEN-HB study: 1. Which places in the residential and living environment are subjectively perceived as positive or negative by PlwD and their carers, and how satisfied are they with the dementia-friendliness of their social space? 2. What is the role of social aspects of the NBE and which aspects are conducive to social health? Based on a systematic review of NBE factors and a subsequent empirical study on evaluating existing wayfinding structures in the federal state of Bremen, Germany, we will conduct individual interviews with PlwD and their informal carers to discuss the relevance of these factors. Additionally, a focus group with dementia coordination centres and responsible persons from ministerial institutions in Bremen, Germany, will be conducted to discuss possible actions in urban planning. Results of both qualitative research approaches will be presented and discussed to promote participatory approaches to the design of the NBE for PlwD and, in particular, to focus more strongly on social health factors.
FEASIBILITY OF A VIRTUAL CARE FARM FOR OLDER ADULTS WITH COGNITIVE AND PHYSICAL LIMITATIONS
Authors: Anderson Keith , Mauldin Rebecca , Westmore Megan , Tulloh Anna 
Published: January 2025

Abstract
Nature-based activities provide an array of physical, emotional, social, and spiritual benefits for people of all ages. Older adults with cognitive and physical limitations, however, are often excluded from these activities due to environmental, functional, and financial barriers. In this study, the researchers evaluated the feasibility of delivering a virtual (online), nature-based, group activity to older adults with physical and cognitive limitations in assisted living. Days at Dunrovin (D@D) is a “virtual care farm” featuring live web-cameras, recorded content, and online discussion boards that focus on life on a rural Montana ranch. Qualitative data from 18 interviews with participants, staff, and interventionists and 40 days of field notes were analyzed for themes related to feasibility. Themes were organized using an established framework of feasibility domains and outcomes. Results indicated that D@D was well-received by participants (Demand/Acceptability). Results also illuminated the process by which the researchers delivered and subsequently modified the activity (Implementation/Adaptation) in response to challenges presented by the assisted living environment, including the cognitive functioning of participants, the physical structure of the facility, and staffing issues (Practicality/Integration). A range of benefits (Effectiveness) were associated with D@D, such as gains in emotional well-being, increased socialization, enhanced engagement with nature, and stimulation of reminiscence. These findings suggest that it is feasible to deliver virtual, nature-based group activities to older adults with cognitive and physical limitations in long-term care. In doing so, we may be able to provide expanded access to the wonders of nature to this all too often excluded population.
DEVELOPING A STRATEGY TO SCREEN FOR CAREGIVER NEGLECT: EXAMINING EXISTING PUBLISHED TOOLS
Authors: Chang E-Shien , Elman Alyssa , Baek Daniel , Rosen Tony 
Published: January 2025

Abstract
Screening for elder mistreatment among older adults with dementia may be helpful, but the value of existing tools is not supported by evidence. Shifting the focus to individual sub-types of mistreatment may provide improved approaches to screening and ultimately to intervention. We have chosen to focus on caregiver neglect, the subtype associated with highest mortality and particularly common in dementia. As a preliminary step to develop a novel strategy to screen for caregiver neglect, we identified all existing published elder mistreatment screening tools to find items assessing for the presence of or risk for caregiver neglect. We identified 31 screening tools, which were all reviewed by 3 team members with complementary expertise (gerontology, social work, emergency medicine). Overall, none of the tools screened only for caregiver neglect. Among them, 22 (71%) included neglect-related items consisting of patient questions, caregiver questions, and provider observations. The total percent of items within each tool assessing for neglect ranged from 18-96%. After removing identical or very similar items, a final of list 202 was created, the majority of which (67.8%) were provider observations. These items were further grouped into 42 discrete categories: 11 categories of patient questions, 10 of caregiver questions, and 21 of provider observations. These serve as a clear starting point for development of caregiver neglect screening.
NOVEL METHODS, MODELS, AND METRICS FOR MEDICARE DATA TO UNDERSTAND RECOVERY AFTER HOSPITALIZATION FOR INJURY
Authors: Shardell Michelle , Ensrud Kristine 
Published: January 2025

Abstract
Medicare is the U.S. federal health insurance program for adults aged ≥65 years and some younger persons with specific conditions. The Medicare Minimum Data Set (MDS) is a standardized clinical assessment tool administered by the Centers for Medicare and Medicaid Services to facilitate care management for residents in Medicare and Medicaid certified nursing homes. Medicare administrative claims and MDS databases provide opportunity to generate novel and impactful real-world evidence, but deriving accurate conclusions can be difficult due to measurement and research design challenges. In this symposium, we illustrate four methods to overcome these challenges in the context of understanding mechanisms of post-hospitalization recovery among older adults, consistent with meeting theme “The Fortitude Factor”. First, we describe a new data science method to overcome unmeasured confounding when identifying factors associated with post-hospitalization monthly days at home (DAH), a person-centered metric that reflects aging in place, among older adults with Alzheimer’s Disease and Related Dementia (ADRD) who experience a hip fracture. We next examine the role of contextual socioeconomic disadvantage in recovery from hip fracture using weighting estimation to mitigate survival bias. To overcome bias from informative observation times in the MDS, we apply a flexible joint model to examine time-varying factors associated with post-fracture physical function among older adults with ADRD. Lastly, we innovatively apply latent variable analysis to identify post-hospitalization DAH trajectories among older adults with traumatic brain injury. We discuss how the gerontology community can use these bias-reducing approaches for policy-relevant health research with Medicare data.
TRAJECTORIES OF DAYS AT HOME FOLLOWING TRAUMATIC BRAIN INJURY AMONG OLDER ADULTS
Authors: Albrecht Jennifer , Chen Chixiang , Falvey Jason 
Published: January 2025

Abstract
Traumatic brain injury (TBI) is a common fall-related injury among older adults that results in over 123,000 hospitalizations and 485,000 emergency department visits annually. While older adults have poorer recovery following TBI relative to younger adults, most older adults recover well from TBI. Identifying those at increased risk of poor recovery could inform appropriate management pathways, facilitate discussions about palliative care or unmet needs and permit targeted intervention to optimize quality of life or recovery. Time spent at home and not in a hospital or other health care facility each month is a patient-centered measure associated with improved outcomes. We identified unique trajectories of monthly home time following hospitalization for TBI among Medicare beneficiaries aged ≥65 using group-based trajectory modelling and identified characteristics associated with poor recovery. Among 20,350 Medicare beneficiaries who sustained TBI between 2010-2018, four unique trajectories of home time were identified: poor recovery (9.5%), improving recovery (13.7%), good recovery (66.4%), and declining recovery (10.4%). Recovery of monthly home time was complete for most by three months post injury. The strongest predictors of membership in the poor relative to the good recovery trajectory group were diagnosis of ADRD (odd ratio (OR) 2.42; 95% confidence interval (CI) 2.16, 2.72) and dual eligibility for Medicaid, a proxy for socioeconomic vulnerability (OR 5.13; 95% CI 4.59, 5.74). Future studies should seek to further characterize and investigate identified recovery groups to inform management and development of interventions to improve recovery.
PRESIDENTIAL SYMPOSIUM: PRESIDENTIAL POLITICS AND THE FORTITUDE FACTOR: EMPOWERING OLDER ADULTS IN TODAY’S POLITICAL LANDSCAPE
Authors: Shippee Tetyana , Kaskie Brian 
Published: January 2025

Abstract
In the backdrop of a presidential election, the United States faces a critical issue: a diminishing unity within the advocacy community dedicated to addressing the needs of an aging population. While acknowledging past successes in securing significant public investments for older adults, there is a noticeable decline in advocacy cohesion as the older adults demographic continue to grow. Presenters highlight the need for renewed advocacy efforts, emphasizing intergenerational collaboration, to compel presidential candidates to address aging policy agendas. Presenters also challenge the reliance on individual fortitude in aging policies, arguing that systemic supports are essential to equitable outcomes. They advocate for rethinking aging policies, emphasizing collective action and alternative organizing principles, especially in light of the complex challenges faced by older adults.
WHERE HAVE ALL THE ADVOCATES GONE?
Authors: Stone Robyn 
Published: January 2025

Abstract
We face a serious challenge as we enter this presidential election season: the lack of a unified advocacy community to support a coherent national political platform that needs to be addressed around the aging of the U.S. population over the next 15 years and into the future. This presentation briefly summarizes the history of the modern advocacy movement to improve the lives of older adults who were more likely than any other age group to be living in poverty in the 1960s and 1970s. The advocacy organizations were strong and united, helping to secure huge public investments including Medicare and Medicaid, affordable senior housing and the establishment of an aging network. Strong champions on Capitol Hill and in the executive branch supported these policies and investments. Ironically, as the older adult population is living longer, and the baby boomer population has grown larger than those under age 18, the advocacy voice has either disappeared or has become diffuse and less powerful. We need new advocacy efforts that bring younger and older generations together to advocate for an aging policy agenda that both presidential candidates are forced to acknowledge and address. The climate change advocacy approach that calls for short and long-term solutions to benefit current and future generations may provide a good framework for an intergenerational aging movement. When generations across age, racial/ethnic identity and other diverse groups (including class) see they are all in this together, a collective fortitude can emerge.
THE LIMITS OF FORTITUDE: PRINCIPLES FOR ADVANCING EQUITABLE AGING POLICY
Authors: Lowers Jane 
Published: January 2025

Abstract
Fortitude – an individual’s ability to endure difficulty or adversity – is an implicit premise in U.S. aging policies, which require individuals and families to shoulder the financial, physical, and emotional costs of aging. Emphasizing fortitude in any discussion of aging obscures the assumption that it works best when accompanied by a lifetime accumulation of wealth and other tangible and intangible supports. When systemic supports for aging are fractured and inadequate, no amount of individual fortitude can adequately bolster older adults challenged by fixed incomes, decreased availability of family caregivers, and lengthening years with chronic and progressive illness. Using examples of adults aging solo with dementia, this presentation will propose alternatives to fortitude as organizing principles for rethinking U.S. aging policy.
PRESIDENTIAL POLITICS AND THE FORTITUDE FACTOR
Authors: Lindberg Brian 
Published: January 2025

Abstract
Education, engagement, advocacy, and coalition building are key elements of GSA’s ongoing work in the nation’s capital. Election years provide both opportunities and challenges for working in the legislative and regulatory processes, and GSA staff and our members across the country have become effective in sharing the research, policy development, and practice experiences with policymakers in DC. Although the field may face challenges in “advocacy cohesion,” this presentation will include examples of the continued strength of aging advocates in the face of ageism and generational competition for resources. GSA’s intergenerational approach to engagement and our recent policy initiatives will be discussed. The presentation will include examples of the strength of aging advocacy organizations and their ability to successfully protect federal programs facing proposed cuts or elimination and securing billions of dollars in additional resources during the COVID-19 pandemic. While the timing is not good for large new entitlement programs, coalitions have been successful in improving benefits such as home delivered meals, tackling the social isolation crisis, providing resources for caregivers, and reducing the cost of Medicare prescription drugs and more. GSA is often providing the evidence to support these positive steps.
ENRICHING EARLY-LIFE ACTIVITIES AND LATER-LIFE COGNITION: THE MODERATING ROLE OF MULTIPLE SOCIAL POSITIONS
Authors: Reynolds Addam 
Published: January 2025

Abstract
Mounting evidence suggests that associations between early life factors and later life cognition are not universal across racialized populations. While evidence suggests that enriching early life activities (EELA) are protective for cognitive aging, no study has evaluated if this association is equally salient for older Black adults across the socioeconomic gradient. Using data from the Life History Mail Survey in the Health and Retirement study, we employ a growth curve analysis to estimate the association between EELA and later life cognition among non-Hispanic White and Black older adults. We also test for moderating effects to assess the relative importance of race and childhood socioeconomic status (cSES) in this association. I found evidence of a three-way interaction between, EELA, cSES and race (b = 0.26, p &lt;.05). Among non-Hispanic White older adults, we observed a stronger relationship between EELA and baseline cognition among those with lower levels of cSES. Among Black participants, we observed the opposite effect. Among Black participants with one standard deviation below the mean of cSES, there was no effect of EELA on baseline cognition. This study suggests that associations between EELA and later life cognition are conditional on multiple social positions, rather than being universal across populations. While White individuals with lower cSES have the most to gain from EELA, Black individuals from similar backgrounds do not benefit from EELA. The implication of this finding suggests that EELA may buffer against the negative effects of lower cSES among White, but not Black participants.
TECHNOLOGY-BASED PHYSIO-FEEDBACK EXERCISE PROGRAM (PEER) TO PREVENT FALLS AND ENHANCE HEALTH EQUITY
Authors: Thiamwong Ladda , Xie Rui , Lighthall Nichole , Loerzel Victoria , Park Joon-Hyuk , Stout Jeffrey 
Published: January 2025

Abstract
Only a few studies have focused on low-income older adults with a mismatch between perceived fall risk and physiological fall risk. We developed a Physio-fEedback Exercise pRogram (PEER) which includes a) physio-feedback using a real-time portable innovative technology—the BTrackS Balance System: BBS; b) cognitive reframing based on a novel fall risk appraisal matrix; and c) peer-led exercise by focusing on balance and strength training. This NIH-funded clustered randomized control trial is led by an interdisciplinary team representing nursing, kinesiology, cognitive psychology, engineering, and data science. We aim to prevent falls and reduce health disparities by facilitating shifts from maladaptive to adaptive fall risk appraisal (i.e., moving from irrational, incongruent, or congruent to the rational quadrant) The 8-week PEER intervention is offered at low-income independent living communities/units in Central Florida through our partnership with community-based and public health organizations. We collected data at baseline and measured outcomes after program completion and found that 17.78 % of the participants in the PEER group (n=45) had adaptive shifting compared to 13.46 % in the control group (n=52). Up to 24.99% of the control group had maladaptive shifting compared to only 12.73% of the PEER group. The PEER intervention results in a shift from maladaptive to adaptive as a way of preventing falls, which is novel, and PEER may slow down the maladaptive shifting process. Integrating technology into fall risk assessments could increase engagement in fall interventions in low-income settings due to barriers faced by older adults regarding accessibility, knowledge, and healthcare costs.