bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-Efficacy as a Mediator Between Lifestyle and Self-Perceptions of Aging
Authors: Steward Andrew , Hasche Leslie
Published: December 2020

A growing body of literature demonstrates the public health impacts of negative self-perceptions of aging (SPA). However, minimal research has explored mediating mechanisms as well as which lifestyle activities may influence SPA. Based on theory and prior research in successful aging, this study explored the impact of lifestyle activities on SPA and tested self-efficacy as a mediator between lifestyle activities and SPA. This study analyzed cross-sectional data from the psychosocial module in the 2018 wave of the Health and Retirement study (N = 2,675; mean age = 65.67/ SD = 9.95). Eight SPA items (e.g., “Things keep getting worse as I get older”) were derived from the Attitudes Toward Own Aging subscale of the Philadelphia Geriatric Center Morale Scale. 10 items measure self-efficacy on a 6-point Likert-type scale from strongly disagree to strongly agree. 21 lifestyle activities covering physical, intellectual, social, and spiritual domains were dichotomized into whether respondents participate at least monthly. Multiple regression analyses were utilized. Results indicate that self-efficacy explained 23% of the variance in SPA while holding constant age, gender, and functional ability. Sobel’s test showed that self-efficacy mediated the relationship between lifestyle activities and SPA. Exercise explained the most variance in SPA, followed by computer use and volunteering. Building upon successful aging literature, this study demonstrates the impact of self-efficacy and helps distinguish which lifestyle activities may be most effective in improving SPA. In addition to individual-level lifestyle activities, the impact of structural interventions on SPA should be tested in future research.
The Relationship Between Activity Participation and Cognitive Functioning
Authors: Jeon Sangha , Charles Susan
Published: December 2020

Researchers are growing increasingly interested in how the diversity of daily activities are related to well-being. The current study examined how both frequency and diversity in daily activities are associated with cognitive functioning. Participants from the third wave (2013-2016) of the Midlife Development in the U.S (MIDUS) survey (N=1281) completed both a telephone-based cognitive assessment and a mailed survey asking about participation in three different types of activities: cognitive (e.g., doing word games, attending educational lectures or courses), physical (e.g,. exercise, home chores), and social (volunteer work, attending sports or social groups). Frequency of activity participation was assessed with items asking how often they engaged in these activities, and diversity of activity participation was calculated by summing the number of activities they reported doing in each category. All analyses included sociodemographic variables, health status, and openness to experience as covariates. Findings from multiple regression indicated that greater frequency in all activities (cognitive, physical, and social) was related to higher levels of cognitive functioning. Greater diversity of social activity was also related to higher cognitive functioning. Education mediated the association between diversity in cognitive activities and cognitive functioning, suggesting that the link between higher levels of cognitive functioning and education may be partly attributed to people with higher levels of education engaging in greater diversity of cognitive activity.
Daily Association Between Sleep and Stressors: Role of Personality Traits
Authors: Venetto Angelina , Vigoureux Taylor , Lee Soomi
Published: December 2020

Poor sleep is associated with more stress across adult populations. The sleep—stress relationship is particularly important in nurses who are vulnerable to daily work-related stressors and poor sleep. Nurses with certain personality traits may be more vulnerable, however, the role that personality plays in the sleep-stress relationship has not previously been examined with lack of research in nurses. We examined how personality moderated the association between sleep characteristics and the perception of daily stressors in nurses. Participants were 61 oncology nurses who responded to a background survey that included a personality measure and completed 14 days of ecological momentary assessments. Each morning, participants reported sleep characteristics (i.e., perceived sleep sufficiency, sleep duration). Three times daily, participants reported their stressor experiences. We used multilevel models adjusting for sociodemographic characteristics, work shift, and work day. Results showed that on average across 2 weeks, participants with higher sleep sufficiency (β=-21.06, p<.05) and longer sleep duration (β=-11.80, p<.05) reported lower stressor severity. Agreeableness moderated the sleep duration—stressor severity association (β=25.07, p<.01), such that longer sleep duration was associated with lower stressor severity for participants with lower agreeableness (β =-17.39, p<.01), but not those with higher agreeableness (β=5.66, p>.05). These findings indicate that the protective nature of longer sleep duration on stressful experiences may not occur in nurses high in agreeableness. Nurses high in agreeableness may take on more responsibilities, exposing themselves to more daily stress. Thus, nurses who are high in agreeableness may be a good target population for stress-reduction interventions.
Overlap of Pain and Depression Among Nursing Home Residents With Advanced Alzheimer’s Disease and Related Dementia
Authors: Belanger Emmanuelle , Jones Richard , Epstein-Lubow Gary , Lapane Kate
Published: December 2020

Physical and psychological suffering are interrelated and should be assessed together as part of palliative care delivery. We aimed to describe the overlap of pain and depressive symptoms among long-stay nursing home (NH) residents with advanced Alzheimer’s disease and related dementia (ADRD), and to determine the incidence of pain and depressive symptoms. We conducted a retrospective study of a US national sample of fee-for-Service Medicare beneficiaries who became long-stay NH residents in 2014-2015, had two consecutive quarterly Minimum Dataset assessments (90 and 180 days +/- 30 days), and had a diagnosis of ADRD in the Chronic Condition Warehouse and moderate to severe cognitive impairment (N= 92,682). We used descriptive statistics and Poisson regression models to examine the incidence of each symptom controlling for age, sex, and concurrent hospice care. Sub-groups with self-reported and observer-rated symptoms (pain/PHQ-9) were modelled separately, as were those switching between the two. The prevalence of depressive symptoms was low (5.7%), while pain was more common (18.2%). Across various subgroups, 2% to 4% had both pain and depression, but between 20% and 25% were treated with both antidepressants and scheduled analgesia. Depressed residents at baseline had an incidence rate ratio (IRR) of pain of 1.2 at the second assessment, while the residents with pain at baseline had an IRR of depressive symptoms of 1.3 at the second assessment. Our results support the expected relationship between pain and depressive symptoms in a national sample of long-stay NH residents with advanced ADRD, suggesting the need for simultaneous clinical management.
Multidimensional Sleep Health and Physical Functioning in Older Adults
Authors: Tighe Caitlan , Brindle Ryan , Stahl Sarah , Wallace Meredith , Bramoweth Adam , Forman Daniel , Buysse Daniel
Published: December 2020

Prior studies link specific sleep parameters to physical functioning in older adults. Recent work suggests the utility of examining sleep health from a multidimensional perspective, enabling consideration of an individual’s experience across multiple different sleep parameters (e.g., quality, duration, timing). We examined the associations of multidimensional sleep health with objective, performance-based measures of physical functioning in older adults. We conducted a secondary analysis of 158 adults (Mage=71.8 years; 51.9% female) who participated in the Midlife in the United States (MIDUS) 2 and MIDUS Refresher studies. We used data from daily diaries, wrist actigraphy, and self-report measures to derive a composite multidimensional sleep health score ranging from 0-6, with higher scores indicating better sleep health. Physical function was assessed using gait speed during a 50-foot timed walk, lower extremity strength as measured by a chair stand test, and grip strength assessed with dynamometers. We used hierarchical regression to examine the associations between sleep health and gait speed, lower extremity strength, and grip strength. Age, sex, race, education, depression symptoms, medical comorbidity, and body mass index were covariates in each model. In adjusted analyses, better multidimensional sleep health was significantly associated with faster gait speed (B=.03, p=.01). Multidimensional sleep health was not significantly associated with lower limb strength (B=-.12, p=.89) or grip strength (B=.45, p=.40). Gait speed is a key indicator of functional capacity as well as morbidity and mortality in older adults. Multidimensional sleep health may be a therapeutic target for improving physical functioning and health in older adults.
Relationships Among Types of Activity Engagement and Sleep Quality Among Older Adults
Authors: Kim Da Eun , Roberts Tonya
Published: December 2020

There is increasing awareness that lack of activity engagement is associated with poor sleep quality. However, the majority of studies have focused on the effect of a single type of activity engagement on sleep quality. Little is known about the combined effect of multiple types of activity engagement on sleep quality. The aim of this study is to identify relationships among different types of activity engagement and sleep quality among older adults. This study is a secondary data analysis using the Health and Retirement Study data. The participants included 3,357 persons who were age 65 or older and who responded to survey modules on activity engagement and sleep quality in 2016. Before we conducted primary analysis, factor analyses and calculating coefficient omega were conducted to identify factor structure, construct validity and reliability of the activity engagement questionnaire. Then, regression was conducted to examine the relationships among multiple types of activity engagement and sleep quality after adjusting for covariates based on the senescent sleep model. Exploratory and confirmatory factor analysis showed the 14-item questionnaire was comprised of three factors; social, cognitive, and physical activity and the three-factor model showed adequate validity and reliability. In the regression model social (β=0.25, p=0.033) and cognitive (β=0.36, p=0.001) activity engagement were positively related to better sleep quality. Based on these results, future research is needed to identify the mechanisms in which social and cognitive activities influence sleep quality positively and to develop targeted activity interventions for older adults.
Medication Management Among Older Adults With Multiple Chronic Conditions: What Role Do Caregivers Play?
Authors: O’Conor Rachel , Eifler Morgan , Russell Andrea , Opsasnick Lauren , Benavente Julia Yoshino , Curtis Laura , Wolf Michael
Published: December 2020

Many older adults manage multiple chronic conditions (MCC) that require adherence to complex medication regimens. Few studies have investigated the degree to which caregivers support medication-related behaviors. We conducted semi-structured qualitative interviews with 25 caregivers of older adults with MCC to characterize caregiver medication assistance. Two coders used content and constant comparative analysis to analyze transcripts. The mean age of caregivers was 61 years; the majority were female (68%) and identified as non-white (Black, 52%; Hispanic, 8%). Caregivers were predominantly spouses (n=10), or children (n=11). Older adults were on average 73 years old, managing 5 chronic conditions and prescribed 7 medications. Caregivers acknowledged the importance of medications to the older adult’s health, but their involvement in daily medication management was limited. Some caregivers preferred that the older adult continue these tasks to maintain autonomy, especially when caring for older adults who valued maintaining independence. Caregivers assumed medication responsibilities after older adults experienced sudden changes in health or upon observing non-adherence (e.g. full pill bottles). Older adults with higher medication burden (12+ medicines) adopted inefficient, cumbersome medication management practices; caregivers suggested simplified strategies, but the older adults refused to adopt recommended strategies. To combat resistance from the older adult, caregivers disguised assistance and deployed workaround strategies to monitor medication-taking behaviors. These findings suggest older adults and caregivers share a value of promoting independence of medication management, up until safety is seriously questioned. Additionally, there is a breakdown in communication at the time when older adults may benefit from increased caregiver involvement.
Pain Acceptance Predicts Expansive Outlooks on the Future in Older Chronic Pain Patients
Authors: Fennell Gillian , Yip Abby Pui Wang , Reid M Cary , Enguidanos Susan , Zelinski Elizabeth , Loeckenhoff Corinna
Published: December 2020

As chronic conditions continue to rise in the US, associated pain symptoms are rising as well, affecting 65% of those 65 and older. In an attempt to help patients lessen the burdensome physical/psychological effects of chronic pain, researchers have investigated the effectiveness of therapeutic interventions with pain acceptance-based models yielding the most promising effect sizes. However, these interventions do not explicitly account for how patients perceive their future. Qualitative work has shown that chronic pain patients with positive and expansive views of their futures report fewer pain-related anxiety and depression symptoms, and are more likely to engage in long-term (and often more effective) treatment regiments. This study aims to investigate whether pain acceptance scores predict future time perspective to enhance treatment effects of chronic pain interventions. Multivariate linear regression analyses were conducted with a sample of 148 non-cancer patients age 45 and older with chronic pain, i.e. pain lasting three or more months. Pain duration, neuroticism, sex, race, income, and age were included in the model to explore potential mediating or moderating effects. A significant positive association was found between pain acceptance and future time perspective (r=.42, p<.001, r2=.17). Additionally, with the inclusion of all covariates, our model significantly explained 24.1% of the variance in future time perspective in the sample, F(7,132)=5.99, p<.001. With an established association between these two psychological constructs, strategies to bolster future time perspective can easily be integrated into pain acceptance interventions for older chronic pain patients, hopefully pushing effect sizes past the ‘moderate’ level.
Emergent Business Models for Homecare in England
Authors: Zimpel-Leal Karla
Published: December 2020

The purpose of this study is to examine how emergent homecare business models are shaping the care market in England. Homecare providers for older people are facing a rise in demand for their services which is driven not only by an ageing population but also from a market demand for personalised care, choice, continuity of care, and real time availability. Combined with a turbulent political and policy environment, the current care landscape presented an opportunity for innovative and emergent homecare models to establish themselves and in some occasions disrupt the market by offering a more inducing service design and value propositions that better match customers’ needs. Utilizing the Business Model Canvas, this study investigated various emergent models of homecare by using semi-ethnographic methods that included field observation and data collection, a narrative summary review and interviews. It has shown that homecare providers for an ageing customer base are becoming increasingly aware of emerging customer needs and expectations. Disruptive and emergent models such as uberisation, community-based, live-in and preventative models are becoming more pervasive in the current landscape. These models offer major shifts related to their value proposition, partnerships and customer segments. The value propositions are focused on several dimensions of wellbeing outcomes, choice and personalisation, whilst their care workforce is perceived as a major customer segments and their network of partners provides access to complementary services, investments and specialist knowledge. These changes are promoting more flexibility and responsiveness in the care market, enhancing service users’ experience and encouraging workforce development.
Investigating the Factors That Influence Self-Efficacy Among Home Care Workers Providing Dementia Care
Authors: Savundranayagam Marie , Ahmad Anaya , Basque Shalane
Published: December 2020

The self-efficacy beliefs of home care personal support workers (PSWs) play a crucial role in their professional competence and subsequent provision of quality care. Understanding the factors that influence self-efficacy of PSWs is critical to ensuring their job satisfaction and retention, and ultimately improving the quality of care provided to home care clients. Currently, there is a lack of literature exploring the factors influencing self-efficacy among home care PSWs who care for clients with dementia. Accordingly, the purpose of this study was to investigate the sources of self-efficacy for home care PSWs. Conventional content analysis of interviews with 15 home care PSWs yielded six categories of sources influencing self-efficacy: insufficient client information provided by employers, lack of supportive communication by employers, restriction of PSWs’ discretion and autonomy by employers, insufficient practical dementia-specific training, sufficient work experience with clients with dementia, and feedback from family caregivers. These findings call for a multi-pronged approach to enhance the self-efficacy of PSWs. In particular, these findings offer specific areas of improvement for employers on how to best support their PSWs. They also highlight the significant role of dementia-specific education and training for PSWs regardless of their experience in the field. Finally, the findings emphasize the importance of family caregivers in the home care context. Taken together, the study’s findings offer insights on how to best support PSWs and ensure stability in the dementia care workforce.
Low-Income Cooperative Living Environments: An Analysis of Universal Design Features That Support Aging in Place
Authors: Kaup Migette , Richardson Hannah , Adkins Mikayla , LaFleur Brett , Tucker Sydney , Tines Lauren
Published: December 2020

Affordable housing for low-income older adults is in significant demand in the United States. Housing options available, however may not recognize how design can support social infrastructure in addition to basic physical accessibility. The aim of this research was to provide an analysis of the efficacy of the planning and design principles applied to a recently constructed cooperative living home. The goal was assess the universal design (UD) of features that supported aging in place, and, to inform the planning of future projects for the community. A post-occupancy evaluation process was conducted at the home, and all five residents consented to structured focus group discussions as well as individual interviews regarding their specific experiences living in the home. An environmental assessment was completed through detailed field notes, measurements, and photo documentation. An analysis of specific features of each room of the home was then assessed by the seven UD principles. Results revealed the specific features of each space that contributed to the completion (or the limitations) of basic activities of daily living as well as instrumental activities of daily living. These assessments were validated through feedback provided by the users. Many features of the home were found to be positive and supportive of equitable use by all residents. Other design attributes that could be improved were related to size and space for approach and use, and providing flexibility in use. Specific design changes based on resident input, such as kitchen function, storage safety, and lighting details, are highlighted and discussed.
Safety or Autonomy in Dementia Care at Home, a Qualitative Study on Family Caregivers’ Experiences
Authors: Moermans Vincent , Bleijlevens Michel , Verbeek Hilde , Milisen Koen , de Casterlé Bernadette Dierckx , Hamers Jan
Published: December 2020

Persons with Dementia (PwD) living in their own home become increasingly dependent on support from especially family caregivers who often are confronted with dilemmas. Family caregivers feel responsible for PwD and predominantly want to ensure their safety, whereas PwD wants to engage in meaningful activity and make decisions autonomously. This study aims to identify how family caregivers caring for PwD at home deal with these dilemmas. Using a grounded theory approach, this study conducted in-depth interviews with 8 family caregivers. Results show that dealing with the dilemma of safety versus autonomy is considered as a calculated risk. By timely entering into dialogue with their loved one, family caregivers try to create a safe environment taking into account the needs and preferences of PwD. However, when situations evolve to such an extent that family caregivers think unsafety will occur, they take over control and overrule the autonomy of the PwD. This often results in resistance to care in PwD. Dealing with the dilemma is a continuous and exhausting learning process due to the ever-changing behaviour of PwD. Family caregivers said that they are in need of support of professional caregivers, but that this need is met insufficiently. As a result, family caregivers have to rely mostly on their own intuition and earlier experiences. The conclusion is that family caregivers experience serious dilemmas in the care of PwD living at home. Professional support in making adequate decisions related to safety and autonomy is warranted.
Adult Age Differences in Coping Strategies After the 2016 Flood
Authors: Cherry Katie E , Calamia Matthew , Elliott Emily M , Nguyen Quyen P
Published: December 2020

The 2005 Hurricanes Katrina and Rita had a devastating impact on south Louisiana, as did the more recent flooding in 2016. Multiple disaster exposures are associated with distress which may be lessened through adaptive coping behaviors, although prior disaster losses may affect current coping responses. In this study, we assessed self-reported coping strategies, resilience, and mental health outcomes after the 2016 flood. The sample was comprised of mostly middle-aged and older adults (N = 223, age range: 18-89 years). Three groups were compared: (1) non-flooded adults as controls, (2) once-flooded adults with structural damage to homes and property in 2016, and (3) twice-flooded adults who had relocated to Baton Rouge because of catastrophic losses in Hurricanes Katrina and Rita and they experienced damage in the 2016 flood. Analyses of variance confirmed that the three groups differed in coping responses, with non-flooded controls using significantly fewer strategies than their once and twice flooded counterparts. Correlation analyses demonstrated that age was positively associated with adaptive forms of coping (acceptance, religiosity) and negatively correlated with maladaptive coping (self-blame). These data suggest that awareness of prior severe weather experiences and catastrophic losses, which are likely for older adults living in hurricane prone areas, are an important consideration for disaster planning and the development of age-sensitive interventions to mitigate adversity.
Applying the Push-Pull Framework to Downsizing in Late Life
Authors: Costlow Kyrsten , Yeager Leona , Choi Shinae , Roskos Beverly , Parmelee Patricia
Published: December 2020

One of the most frequently cited theoretical models of relocation decision-making is Wiseman’s Behavioral Model of Elderly Migration. Based on this model, the present study used a push-pull framework to describe older adults’ reasons for downsizing to a smaller home. A sample of 68 older adults who had downsized in the past year provided reasons for moving from their previous residence (push factors) and reasons for moving specifically to their new residence (pull factors). Participants rated the importance of each push/pull factor using a (1) not at all important to (4) extremely important scale. On average, participants rated pull factors (M = 3.63, SD = .31) as slightly more important than push factors (M = 3.54, SD = .40) in their decision to move. The most frequently reported push factors were declining health (n = 47, 22%), having too much space or maintenance (n = 40, 19%), and disliking the location of their previous residence (n = 30, 14%). The most commonly reported pull factors were the attractive location of the new residence (n = 60, 28%), social factors (e.g., being closer to family and friends; n = 36, 17%), and services or amenities available in the new residence (n = 32, 15%). Qualitative responses will be presented to illustrate the interaction between push and pull factors in participants’ relocation decision-making. Findings are consistent with those identified in other studies on late-life relocation, establishing Wiseman’s behavioral model as a useful framework for investigating downsizing in late life.
Comparison of Three Wayfinding Assessment Tools
Authors: Calkins Margaret , Davis Rebecca
Published: December 2020

An early, problematic symptom of aging, exacerbated by cognitive problems such as Alzheimer’s disease, is difficulty finding one’s way. Long term care (LTC) communities are especially challenging for wayfinding. This study compares three different tools to evaluate spatial complexity within eight LTC communities. The tools included computation of space syntax integration values using axial lines to determine how connected wayfinding routes are within the community. The Wayfinding Checklist tool (revised) rates the quality of signage, complexity of a building floor plan, and use of decorative elements. The Calkins Route Assessment tool evaluates route complexity using both plan and vertical visual field information (e.g. presence, location, clarity of signage and cues). The results of the analysis showed that the buildings varied with respect to integration, with some very well integrated floorplans and routes, and some that were very complex, with multiple jogs, turns, and limited integration. The Wayfinding Checklist echoed the variety of complexity of floorplans, but lowered scores for poor existence and design of signage and mostly substandard lighting for visibility. The Calkins Route Assessment tool added greater specificity to the space syntax analysis and Wayfinding Checklist, showing how visual elements (versus just visual access) can compensate for plans with low-integration. These study findings indicate that each tool was valuable for measuring wayfinding complexity, but measured different aspects of building and route complexity. Tools like these can be used to identify challenging wayfinding routes and buildings so that designers and clinicians can improve the overall design for wayfinding.
Adverse Consequences of Unmet In-Home Mobility Care Needs and Risk of Hospital Stay Among Older Adults in the United States
Authors: Sahoo Shalini
Published: December 2020

Mobility limitations are the most prevalent late life disability and are strongly associated with negative health outcomes. Research suggests that 1 in 5 older adults with limitations in activities of daily living report needing more help than is received. The objective of this study is to address a gap in the literature by directly examining the relationship between adverse consequences (e.g. home-bound, bedridden) of unmet in-home mobility care needs and hospital stay for a national sample of community-dwelling older adults. Data was analyzed from round eight (2018) of the National Health and Aging Trends Study (NHATS), an epidemiologic panel study of nationally representative Medicare beneficiaries ages 65 and older living in the communities (n = 4,344). Community dwelling adults with one or more adverse consequence due to in-home mobility limitation had 1.931 times odds of hospital stay in the last 12 months, compared to the counterpart with no in-home mobility limitation (OR = 1.931, SE = 0.153, p < 0.05), after adjusting for the covariates. Community-dwelling older adults who have adverse consequence due to unmet in-home mobility care needs are more likely to be immobile and are more likely to have hospital stays. By addressing the needs of this population, the rate of hospitalization can be decreased resulting in fewer stressful events and better quality of life. Policies to improve long-term services and supports and reduce unmet need could benefit both older adults and those who care for them.
Characterization of Skilled Nursing Facility Residents Admitted With Substance Use Disorders
Authors: Sindvani Rhea , Barry Lisa
Published: December 2020

For reasons including the opioid epidemic and more widespread substance use across all ages, the prevalence of individuals meeting preadmission criteria for skilled nursing facility (SNF)-level care and who have substance use disorders (SUDs) is growing. However, little is known about this population. We characterized a sample of residents with SUDs in two SNFs that target admission of difficult-to-place individuals in Hartford, Connecticut. Residents admitted between June 1, 2018 and May 31, 2019 and had an SUD per Pre-Admission Screening and Resident Review (PASRR) were included. Using retrospective chart review, we collected data including demographics, physical and mental health conditions, psychiatric medications, and participation in SNF-provided SUD counseling. Of 163 residents admitted with an SUD, all were admitted following an acute hospitalization. Residents’ average age was 49.9(SD=11.7) years (range 21-79). They were 61% male and racially diverse; 56% Caucasian, 27% Hispanic, 16% Black. SUDs on admission included opioid use disorder (48%), alcohol use disorder (33%), unspecified psychoactive SUD (26%), cocaine use disorder (25%), and Other (20%). Of these, 18% and 16% were taking methadone or suboxone, respectively and 25% were taking an antipsychotic medication. Comorbidities such as bipolar disorder (15%) and viral hepatitis (26%) were prevalent. A total of 40 (25%) residents participated in SUD counseling; none of the aforementioned factors was associated with participation. This is the first study to characterize a sample of residents from SNFs that target individuals with SUDs. Improved understanding of this unique and growing subset of the SNF population may help optimize their treatment.
Season’s Cheatings: Beware of Holiday Scams
Authors: Choi-Allum Lona , Williams Alicia
Published: December 2020

‘Tis the season…to be on the lookout for possible scams and fraud. It’s during this time of year that individuals are more focused on the spirit of the holidays and less focused on what may be happening with their pocketbook. AARP conducted a survey of 2,842 U.S. adults ages 18 and older to understand people’s awareness of and experience with a variety of scams that are common around the holidays. The study explored experiences with purchasing gift cards, shipping/receiving packages, and charitable giving. In addition, the survey tested the knowledge of adults about several specific scams with a ‘quiz’ of five true or false statements. Results showed that one in six (17%) U.S. adults failed the quiz. When making gift card purchases, one in five U.S. adults have given and/or received a gift card that had no funds on it. And only about half of U.S. adults conduct research before making a monetary donation to charitable causes or organizations. Of those who do check out a charity first, over half (54%) did not make a donation based on what they found on charity rating sites. Also, U.S. adults say that packages are left outside of their home without requiring a signature. Half (50%) of U.S. adults say they never require a signature when shipping packages to home addresses while about one in seven (15%) always require a signature. More education is needed to raise awareness of scams that are common during the holidays.
Validation of the MEDSAIL Tool to Screen for Capacity to Live Safely and Independently in Nursing Home Residents
Authors: Mills Whitney , Kunik Mark , Kelly P Adam , Wilson Nancy , Starks Steven , Asghar-Ali Ali , Naik Aanand
Published: December 2020

Capacity for safe and independent living (SAIL) refers to an individual’s ability to solve problems associated with everyday life and perform activities necessary to live independently. Little guidance exists on the assessment of capacity for SAIL among nursing home residents. As a result, capacity for SAIL is not fully considered in the development of discharge plans to ensure safety and independence in the community. The Making and Executing Decisions for Safe and Independent Living (MEDSAIL) tool was developed to screen for capacity for SAIL among community-dwelling older adults. In this cross sectional pilot study, we tested the validity of MEDSAIL for use with nursing home residents. Participants were twenty-four residents of a Veterans Health Affairs nursing home. Exclusion criteria were cognitive impairment too severe to complete the protocol, diagnosis of serious mental illness or developmental disability, inability to hear, and inability to communicate verbally. Participants completed two assessments: the MEDSAIL interview administered by a research assistant and the criterion standard capacity interview administered by a geriatric psychiatrist. We examined internal consistency, convergent validity, divergent validity, and criterion-based validity. Five of seven MEDSAIL scenarios approximated acceptable levels of internal consistency (α>0.70). MEDSAIL scores were positively correlated with the criterion standard (0.88, p=0.001), and the Wilcoxon Rank Sum Test statistic was also statistically significant (p=0.001). MEDSAIL has promise as a user-friendly brief screening tool in nursing homes to understand resident capacity for SAIL and to inform development of discharge plans to keep the resident safe and independent in the community.
Step Up: An Evaluation of Question-Behavior Effects in Diabetes Footcare in Middle-Aged and Older Adults
Authors: Robertson Anna , Johanson Katherine , Walden Allison , Ingram Rebecca , Schneider Lauren , Feliciano Leilani
Published: December 2020

Type 2 diabetes mellitus (T2DM) is a major public health concern requiring engagement with specific self-care activities for improvement. Due to the increased risk for neuropathy, foot ulcers, and infections, engagement with certain footcare practices (e.g., inspecting feet and inside shoes, washing and drying between toes) is an important part of overall diabetes self-care. However, interventions targeting blood glucose monitoring, medication management, nutrition, and/or physical activity often precede footcare interventions. Question-Behavior Effects (QBEs), which describe the effects of behavior questioning on future engagement in that behavior, provide a unique framework for studying diabetes self-care. Although clinicians may not administer footcare interventions for people with T2DM, footcare behaviors are often still assessed (e.g., through questionnaires) in session and, consistent with QBEs, may improve through the repetition of questioning. The present study evaluated footcare QBEs (specifically, the number of days of foot inspection and cleaning in the past week) across 7 sessions of an at-home diabetes management program without intentional footcare intervention. Paired-samples t-tests (N = 78, ages 40-88 years) revealed significant improvements in the number of days of foot inspection and cleaning from intake to session 1 and intake to session 5. However, from intake to session 7, only significant improvements in foot inspection were detected. These findings reflect the potency of footcare QBEs in the absence of specific footcare interventions. They also reveal differential engagement in foot inspection and cleaning after an extended period of questioning, suggesting certain diabetes self-care behaviors may taper without the intentional introduction of intervention.
An Orphan Needing a Champion–Barriers to Evaluations of Decision-Making Capacity
Authors: Factora Ronan , Saxena Saket
Published: December 2020

Impaired decision making capacity is common in medical and community settings, often coexistent with functional impairment and dementia. Though the legal system determines competence, deciding if guardianship is appropriate often relies on a medical assessment of decision making capacity. Physicians conduct cognitive evaluations but are often unaware of a person’s functional impairments and are unfamiliar with their role in pursuing guardianship. Despite the individual roles of the legal system, medical system, and community agencies (e.g. Adult Protective Services (APS)) in such cases, no agency claims responsibility for ensuring this process’s fidelity. As numbers of older citizens in the US increase along with associated increasing numbers of cases involving impaired decision making capacity, ensuring this processes’ fidelity is essential. We sought to identify the barriers (recognized by each of these parties) in determining decision making capacity of persons for whom guardianship is being considered. Surveys were conducted with professionals in the legal, medical, and APS arenas, to identify barriers to obtaining capacity determinations. Common themes identified amongst these entities included needing to include functional status in this evaluation, and the need for clear communication between the legal system, medical system, and APS. Unique concerns identified in the survey included APS caseworkers challenges in finding physicians willing to complete capacity evaluations, judges’ concerns about evaluations’ failure to address safety issues and need for immediate action , and physician’s concerns about liability and compromising the physician-patient relationship. Continued collaboration between these systems could overcome these barriers.
Age Differences in the Affective Experience of State Curiosity
Authors: Chu Li , Fung Helene
Published: December 2020

Is feeling curious a pleasant, anxious or mixed feeling experience? Dual process theory posits that curiosity results from an optimal level of knowledge gap anxiety. Yet, personal growth facilitation model suggests that people are intrinsically curious, which is associated with positive affects. While curiosity may be pleasant or anxious, it may also be both. In fact, compared with younger adults, older adults were more likely to experience mixed emotions. However, very few studies investigated age differences in affective experience of curiosity, so the present study utilized a time-sampling dataset to address this question. This 14-day time-sampling study included 85 younger (43 females, age 18-30) and 83 older adults (40 females, age 60-85) who recorded momentary curiosity and affective experiences three times per day. Linear mixed-effects analysis revealed a significant 3-way interaction between age group, happiness and anxiousness on state curiosity (□=.20, SE=.05, p<.001). For younger adults, results suggested that curiosity was higher when they felt either happy or anxious but not when feeling both. Conversely, for older adults, curiosity was higher when they felt both happy and anxious concurrently. In other words, older adults were more likely to experience curiosity as a mixed emotional state, whereas younger adults were more likely to experience curiosity as a pure emotional state. This finding adds to the current mixed emotion and aging literature and has important implications for future interventions to enhance curiosity towards novelties for people from different age groups.
Age Similarity in Emotion Perception Based on Eye Gaze Manipulation
Authors: Abualula Yosra , Allard Eric
Published: December 2020

The purpose of this study was to examine age differences in emotion perception as a function of emotion type and gaze direction. Old and young adult participants were presented with facial images showing happiness, sadness, fear, anger and disgust while having their eyes tracked. The image stimuli included a manipulation of eye gaze. Half of the facial expressions had a directed eye gaze while the other half showed an averted gaze. A 2 (age) x 2 (gaze) x 5 (emotion) repeated measures ANOVA was used to analyze emotion perception scores and fixation to eye and mouth regions of the face. The manipulation of eye gaze yielded more age similarities than differences in emotion perception. Overall, we did not detect age differences in recognition ability. However, we found that certain emotion categories differentially impacted emotion perception. Interestingly, we observed that an averted gaze led to beneficial performance for fear and disgust faces. Additionally, participants spent more time fixating on the eye regions of sad facial expressions. We discuss how naturalistic manipulations of various facial features could impact age-related differences (or similarities) in emotion perception.
Disruption as Antecedent to New Business Startup: A Study of Entrepreneurship Using the Understanding America Study
Authors: Kabo Felichism , Thornhill Stewart , Isele Elizabeth
Published: December 2020

We use data from a nationally representative study to examine antecedents of entrepreneurial activity in the US among younger (< age 50) and older (≥ age 50) adults using Shapero’s and Sokol’s Model of the “Entrepreneurial Event” (hereafter SEE). The “entrepreneurial event” here refers to the initiation of entrepreneurial behavior. The SEE approach assumes that individuals default to inertia until their lives are disrupted by exogenous factors such as life-changing events (Shapero & Sokol, 1982). The disruptor could be either positive or negative, and has the net effect of driving the individual to reconsider entrepreneurship as a viable opportunity (Krueger & Brazeal, 1994; Krueger & Day, 2010). We examine the correlation between negative disruptions and a person initiating entrepreneurial behavior (starting a new business), including whether the process is similar across younger and older adults. Using data collected in 2014 and 2019 from 3,586 individuals in the Understanding America Study panel, we run survey Cox proportional hazards models to analyze the effects of negative disruptions (getting separated or divorced) on starting a new business over a five-year period starting in 2014. We found that negative disruptions have a significant, positive effect but only among older adults. Further, the magnitude of that effect is about 3-7 times that of younger adults. Our findings support the validity of the SEE approach in advancing our understanding of the transition of individuals from potential to actual entrepreneurs. However, the findings suggest the SEE approach better explains this process in older rather than younger adults.
Gene-Environment Covariance as a Mechanism of Declines in Openness in Late Adulthood
Authors: Beam Christopher , Sharp Emily
Published: December 2020

We previously demonstrated that openness to experience declines with age and these declines correlate with mortality risk. We posited that decline in openness was related to change in behavior in relation to a change in future time perspective, defined here as dynamic changes in scope of time that influence persons’ behavior. This idea, based on Baltes’ selection, optimization, and compensation theory of lifespan development, suggests that with foreshortened time horizons individuals adapt their behavior leading to lesser engagement in novel experiences and relationships. The current study examined the genetically informed mechanisms underpinning the relationship between openness and mortality. Using identical and fraternal twins from the Swedish Adoption Twin Study of Aging (SATSA), we examined whether twins further from death nonrandomly select environments that maintain their openness scores while their co-twins nearer to death nonrandomly select environments that contribute to declines in openness. Using a sample of 822 twin pairs, we estimated a genetically-informed longitudinal model that quantified time-varying effects of twins’ openness scores at time t-1 on latent nonshared environmental scores at time t. The model generates within-family gene-environment correlation, a statistical coefficient that quantifies the genetic basis for nonrandom exposure to environments. Results suggest significant time-varying correlations between twins’ openness scores and their unique environments as well as increasing gene-environment correlation over time. Findings are consistent with the view that environments can support and reinforce maintenance of or declines in openness depending on the length of persons’ time horizons.
Generativity Development Across Adulthood: A Longitudinal Investigation
Authors: Nelson Niccole , Bergeman Cindy
Published: December 2020

The developmental trajectory of Generativity, or investment in the next generation, has been theorized about for decades. Although Generativity is widely hypothesized to peak in midlife, and thus, follow a nonlinear change trajectory across adulthood, extant studies have been too limited in scope to formally test this hypothesis. Indeed, most existing studies on Generativity development have been cross-sectional, with the few longitudinal studies either only examining the first half of adulthood or using too few measurement points. The current study, therefore, aimed to address these limitations by investigating Generativity development in the context of an accelerated longitudinal design. Accelerated longitudinal designs capitalize on both cross-sectional and longitudinal data, combining age-heterogenous individuals’ overlapping trajectories to estimate developmental change across the sample’s age range. If cohort effects are not present in the estimated trajectory, this trajectory can be interpreted as developmental change. Participants included 876 age-heterogenous individuals from The Notre Dame Study of Health & Well-being (Mean age = 58.89; SD age = 9.42), a 10-year, longitudinal study of adult development and aging. Capitalizing on the age-heterogeneity of the sample at Time 1, two-level, multilevel modeling was employed to estimate Generativity development across ages 37 to 96. Results indicate that Generativity follows an age-graded cubic trend, with no apparent cohort effects. Specifically, Generativity peaks in early midlife, declines slightly before stabilizing across ages 47-77, and then declines sharply thereafter. Implications for lifespan developmental research, as well as health and well-being, will be discussed.