bluuebunny/crossref_metadata_2025 huggingface dataset:
ANNUALIZED AND CUMULATIVE MEASURES OF ANTICHOLINERGIC EXPOSURE FOR RESEARCH AND CLINICAL APPLICATIONS
Authors: Khalil Hussein , Stachler Eva , Alamer Khalid , Ludlow Jared , Campbell Noll
Published: December 2022

Medications with anticholinergic properties are commonly used by older adults despite being associated with dementia.The anticholinergic total standardized daily dose (TSDD) is a continuous measure of exposure that has been associated with an increased risk of dementia at values >1095 over ten years in epidemiologic studies. We sought to determine a cumulative (cTSDD) and annualized (aTSDD) in a sample of community-dwelling older adults enrolled in the ongoing Reducing Risk of Dementia Through Deprescribing (R2D2) trial (NCT04270474). Participants were 65 years or older without dementia, attended at least one primary care visit within 12 months prior to enrollment, and were current users of strong anticholinergics according to the 2012 Anticholinergic Cognitive Burden Scale. Prescribed and over-the-counter medication details were collected during the baseline visit through self-report and included strength, frequency, units/dose and duration. The aTSDD was calculated for each participant assuming continuous use patterns throughout the year. The cTSDD was calculated by summing the aTSDD across the number of years since initiation. Of 66 participants, the median cTSDD was 2425 (IQR 5131), and 48 (72%) exceeded the threshold of dementia risk (>1095). Additionally, the aTSDD had a median of 730 (IQR 547), with 60 (90%) exceeding the threshold of dementia risk (109.5, one-tenth of the ten-year risk) while 11 (17%) exceeded dementia risk threshold of 1095 considering 1 year of exposure. Both measures identified the majority of anticholinergic users exceeding dementia risk thresholds despite some disagreement between the two approaches. However, both methods have potential for research and clinical applications.
HEALTH-RELATED QUALITY OF LIFE OF OLDER PEOPLE WITH DIABETES DEPENDING ON WHETHER THEY LIVE IN FAMILIES OR NOT
Authors: Choi Gi Won , Chang Sun Ju
Published: December 2022

Diabetes requires self-management, such as the use of insulin, oral antidiabetic drugs, diet, and exercise, for maintaining blood glucose. To promote self-management of older people with diabetes, family support is considered an important factor. However, older people living alone lack family support and have a lower health-related quality of life (HRQOL) than those living in families. The purpose of this study was to assess HRQOL and the factors that affect it between older people with diabetes living alone and those living in families. We performed secondary data analysis using the data of Korea National Health and Nutrition Examination Survey (KNHANES) 2017–2019. In total, 973 people with diabetes aged 65 years or older answered all questions about HRQOL. Complex sample analysis was performed. Each dimension of HRQOL was significantly lower in people living alone than those living in families. Restricted activity, bedridden, number of comorbidities, and perceived health status significantly predicted HRQOL in patients living alone. Health insurance, age, economic activity, unmet medical service needs, restricted activity, bedridden, number of comorbidities, perceived health status, and suicidal ideation significantly predicted HRQOL in patients living in families. This study indicated how differences in HRQOL exist between older patients with diabetes living alone and those living in families. This data will be useful in developing educational programs in the future, and it will be helpful when dealing with people living alone who have diabetes.
ASSOCIATION BETWEEN DUAL TASK FUNCTION AND NEUROPSYCHOLOGICAL TESTING IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Petrillo Kelsi , Toosizadeh Nima
Published: December 2022

Cognitive impairment is an increasingly relevant health concern, as demonstrated through data estimates that by 2040 the number of older adults with dementia will surpass nine million in the United States. Despite this high prevalence, more than half of patients with dementia never receive an evaluation. This indicates that a quick and objective routine test for screening cognitive decline in older adults is needed. Poor dual-task gait performance has been associated with decreased executive and neuropsychological function. However, gait tests are not always viable for clinics or older patients. The aim of this study was to assess the relationship between a novel upper-extremity function (UEF) dual-task performance and neuropsychological test results in older adults. We recruited older adults at three stages: cognitively normal (n=33), mild cognitively impaired (n=34), and Alzheimer’s disease (n=22). For UEF tasks, participants performed a consistent elbow flexion, while counting backwards in by threes. Wearable motion sensors were attached to forearm and upper-arm to measure accuracy and speed of elbow flexion kinematics and the UEF cognitive score. The results demonstrate a strong correlation between UEF cognitive score and MMSE, Mini-Cog, Category fluency, Benson complex figure copy, Trail making test, and MOCA (r values between -0.2355 and -0.6037 and p< 0.0288). UEF dual-task was associated with executive function, orientation, repetition, abstraction, verbal recall, attention and calculation, language and visual construction. The results from this study convey a promising future for the use of dual task UEF as a safe and convenient cognitive impairment screening.
ASSOCIATION BETWEEN VISUOSPATIAL ABILITY, GAIT, AND FUNCTION IN OLDER SURVIVORS OF BREAST CANCER
Authors: Blackwood Jennifer , Simone Abigail
Published: December 2022

Research has highlighted the relationship between impaired cognitive function and physical mobility measures in older adults. This relationship may also exist in older survivors of breast cancer, however, specific cognitive domains like executive function or visuospatial ability may influence physical mobility. The purpose of this study is to describe associations between cognitive function and mobility in a group of community-dwelling older females with a history of breast cancer. Cross-sectional data of performance on cognitive and physical mobility measures from 38 older adults with a history of breast cancer were analyzed. Pearson’s correlation coefficient was used to examine relationships between measures. Significant inverse relationships were found between TMT-A and usual gait speed (r = -.662, p<.001), fast gait speed (r = -.409, p = .012), and dual-task gait speed (r = -.631, p<.001), suggesting that as visuospatial ability became more impaired, gait speed decreased. Significant relationships were found between TMT-A and performance on the TUG (r = .664, p<.001), TUG-cognitive (r = .635, p<.001), and TUG-manual (r = .653, p<.001). Results indicate that visuospatial ability, as measured with the TMT-A, is associated with physical mobility measures in older survivors of breast cancer. While previous research has reported impairments in executive function in this population, impaired visuospatial ability may also play a role, suggesting that clinicians should include a visuospatial task when working on improving gait in older survivors of breast cancer.
STEP EXECUTION TIME: EXAMINING ITS RELIABILITY AND ASSOCIATION WITH PARTICIPATION IN OLDER ADULTS
Authors: Tiernan Chad , Kolodziejczyk Ida , Talley Susan , Goldberg Allon
Published: December 2022

The projected rise in the number of older adults warrants increased attention to selecting reliable and meaningful clinical assessments. Compared to more frequently used balance measures, step execution time (SET) has not been studied extensively. The purpose of the current study was twofold. First, we investigated the association of several balance measures [SET, Activities-specific Balance Confidence Scale (ABC-6), Five-times-sit-to-stand (5TSTS), Four-square step test (4SST), and maximum step length (MSL)] with participation (LIFE-H). Second, reliability of SET was investigated. The study included 32 community-dwelling older adults between the ages of 65 and 83 years (88% White, 66% female). Results indicated that SET was the only balance measure associated with both participation accomplishment (r = -.54, p = .001) and participation satisfaction (r = -.55, p = .001); 5TSTS (r = -.64, p < .001) and 4SST (r = .37, p = .039) were also significantly correlated with participation accomplishment while MSL (r = .37, p = .040) showed a significant association with participation satisfaction. SET demonstrated excellent test-retest reliability (ICC = .92). Bland-Altman analysis determined the 95% Limits of Agreement to be -258.5 ms to +271.5 ms (mean difference = 6.5 ms; 95% CI of difference = -43.1 to 56.1), suggesting that bias was not a concern. SEM (100.5 ms) and MDC95 (278.5 ms) for SET represented 9.3% and 25.8% of the mean, respectively. Collectively, findings suggest that SET may have clinical utility as a reliable assessment in older adults that relates to meaningful constructs, such as participation.
ASSOCIATIONS BETWEEN MEASURES OF SLEEP QUALITY, PHYSICAL ACTIVITY, ANXIETY, AND STRESS AMONG ADULTS
Authors: Paulson Sally , Gray Michelle , Campitelli Anthony , Gills Joshua , Jones Megan , Madero Erica , Myers Jennifer , Glenn Jordan
Published: December 2022

Good quality sleep is important for physical and mental well-being and plays a vital role in healthy aging. Additionally, sleep quality is influenced by multiple factors associated with aging, such as lifestyle, depression, and physical activity levels. Therefore, the purpose of this study was to explore the relationship between self-reported measures of physical activity levels, anxiety, stress, and sleep quality among adults aged 45-75 years. Adults (N = 204) completed the short form International Physical Activity Questionnaire (IPAQ), Generalized Anxiety Disorder 7-Item Scale (GAD-7), Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI). Participants were classified as either good quality sleepers (GQS, n = 65, 67.7% female, M±SD: age: 61.7±8.9 yrs; mass: 82.8±16.7 kg, height: 169.6±10.2 cm, education: 17.3 yrs) or poor quality sleepers (PQS, n = 139, 77.7% female, M±SD: age: 61.9±8.0 yrs; mass: 83.1±16.2 kg, height: 166.4±8.5 cm, education: 18.0 yrs) using their PSQI global score. A score of ≥5 denoted PQS. Data were analyzed using descriptive statistics, Spearman correlation, and Chi-square (p ≤ .05). Sleep quality was negatively associated with the PSS (r = -.17, p = .02) and GAD-7 (r = -.19, p < .01). Adults reporting PQS presented with higher levels of perceived stress and generalized anxiety. The relation between sleep quality and IPAQ was significant (X2 = 8.47, p = .01). These results suggest there was a greater tendency for PQS to report lower levels of physical activity and higher levels of stress and generalized anxiety.
CARDIOVASCULAR DISEASE AND PHYSICAL ACTIVITY PHENOTYPES WITH FALLS: BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM
Authors: Oh Minsuk , Ylitalo Kelly
Published: December 2022

Cardiovascular disease (CVD) is associated with a higher risk of falls and physical activity (PA) can prevent falls. However, the role of PA in the association between CVD and falls is unknown. We examined the associations of four CVD–PA phenotypes (no CVD–PA, no CVD–no PA, CVD–PA, CVD–no PA) with any, recurrent, and injurious falls. Middle-aged and older adults ≥ 45 years (n=295,282; N=130,103,093) from the 2018 Behavioral Risk Factor Surveillance System who self-reported CVD, leisure-time PA, and falls in the previous 12 months were examined. The weighted prevalence ratio (PR) of any (≥ 1 fall), recurrent (≥ 2 falls), and injurious (≥ 1 injurious fall) falls across CVD–PA phenotypes was estimated using Poisson regression models with adjustment for sociodemographics and major health characteristics. The likelihood of any, recurrent, and injurious falls was greater across the unhealthier CVD–PA phenotypes in fully adjusted models. In the total sample, no CVD–no PA (PR: 1.19; 95% confidence interval (CI): 1.14, 1.24), CVD– PA (PR: 1.22; 95% CI: 1.15, 1.29), and CVD–no PA (PR: 1.29; 95% CI: 1.23, 1.35) phenotypes were more likely to report injurious falls, than no CVD– PA phenotype. Engaging in leisure-time PA may be an important lifestyle strategy for fall prevention in midlife and older adults, particularly those with CVD. Our findings could be useful for primary and/or secondary fall prevention efforts by healthcare providers who treat midlife and older adults with CVD.
INTERGENERATIONAL PERCEPTIONS OF FAMILY DYNAMICS AMONG OLDER PARENTS AND ADULT CHILDREN ON THE FACES IV AND SFI II
Authors: Hahne Jessica , Skemp Eleanor A , Carpenter Brian
Published: December 2022

Standardized measures of family dynamics are rarely used with late-life families in either research or clinical contexts. The purpose of this study was to examine perceptions of family dynamics from the perspective of older parents and their adult children on two widely used family assessment measures. To our knowledge, no previous studies have reported data on these measures with late-life families. Within a larger project examining decision-making in late life, 34 older parents and two of their adult children (total N= 102) completed the Family Adaptability and Cohesion Evaluation Scale (FACES) IV and the Self-Report Family Inventory (SFI) II. Parents were mostly mothers (94.1%; M age= 75), but adult children included both daughters (67.6%; M age= 46) and sons (32.4%; M age= 46). For comparison with published norms, we report subscale scores on both family measures for parents and adult children. The mean intrafamily ICC (two-way, mixed effects, single rater, absolute agreement) for individual items for the FACES IV was .561 (SD= .164, Min= .128, Max= .827), and the mean intrafamily ICC on the SFI II was .422 (SD= .178, Min= .014, Max= .750). Overall, family consistency was in the poor to moderate range, but with a high degree of variability across families. Moreover, within families, parents and children had highly variable inconsistency in their perception of family dynamics. Findings from this study provide insight as to how established measures function in late-life families, and they highlight the importance of assessing multiple family members in order to understand family dynamics.
DYADIC APPRAISALS OF FAMILY DECISIONS AND HEALTH TASKS IN MIDDLE-AGED AND OLDER COUPLES
Authors: Lyons Karen , Han Sae Hwang , Kim Kyungmin , Miller Lyndsey
Published: December 2022

Dyadic theories, including the Theory of Dyadic Illness Management, emphasize the important protective roles of shared appraisals and collaborative tasks within the couple for optimizing health and well-being. Within illness contexts, research has also focused on shared decision-making and collaborative illness management within couples. However, less is known about how concordant middle-aged and older couples are regarding how they make decisions (e.g., one partner has final say, both have equal say) and how they complete health-related tasks (e.g., one partner does it, they do it together), factors associated with being more concordant as a couple, and implications of concordance for health and well-being of both members. Data from 2,761 couples (Mage = 64.94 for wives and 68.04 for husbands) from the Health and Retirement Study (2014/16–2016/18) were examined. The majority of couples were congruent regarding who makes family decisions (69.7%) and who completes medical forms (64.4%) within the couple; further, 62% agreed they make family decisions collaboratively versus 25.5% completing medical forms collaboratively. Greater concordance in these appraisals was significantly associated with greater marital support and length of marriage. While concordance in appraisals was not significantly associated with depressive symptoms 2 years later, the link between congruence in making major family decisions and self-rated health differed by age and gender— suggesting that the intersection of age and gender may shape how decisions within couples lead to potential health benefits.
UNDERSTANDING STROKE SURVIVOR–CARER DYNAMICS USING THE ACTOR-PARTNER INTERDEPENDENCE MODEL: A SYSTEMATIC REVIEW
Authors: Chow Esther , Fung Sai-fu
Published: December 2022

Background

Family members often take on the caregiver roles to stroke survivors due to kinships and cultural responsibilities. Yet, little is known about the the impact of survivor-caregiver dynamics on stroke rehabilitation. To understand the dyadic relationships between the dyads, a systematic review was conducted to examine studies which have adopted Actor–Partner Interdependence Model (APIM) analysis.

Methods

A systematic review and meta-analysis were conducted using the following electronic databases: PubMed, SAGE Journals, MEDLINE, PsycINFO and Cochrane Review to identify eligible studies published from their inception to December 2021, following the PRISMA guidelines.

Results

Nine studies involving 1183 stroke survivors (male = 57%) and 1181 caregivers (male = 37%) had met the inclusion criteria and were identified in this review. The interaction among the following outcomes were self-esteem, optimism, stress, depression, emotional distress, quality of life, and life satisfaction. The review provided evidence that (1) APIM is valuable tool in analyzing dyadic interactions; (2) support from caregivers has a significant impact on the stroke survivor’s recovery; (3) the mental health status of caregivers can influence that of stroke survivors and vice versa; (4) Due to the interconnected nature of dyadic interaction, providing dyadic intervention have positive impact on dyads.

Conclusion

These findings highlight the interdependence nature between survivor-caregiver dyads in the context of stroke rehabilitation. The APIM provides conclusive evidence on the effectiveness of survivor-caregiver dyadic interactions, with significant theoretical and practice implications for both health and social care professions. More research is needed to support dyadic strategies for stroke survivors.
ASIAN AMERICAN FAMILY CAREGIVING EXPERIENCES COMPARED TO CAREGIVERS OF OTHER RACIAL/ETHNIC GROUPS
Authors: Miyawaki Christina , Bouldin Erin
Published: December 2022

Asian Americans (AAs) are the fastest-growing immigrant group in the U.S. While otherwise highly heterogeneous, AAs value filial piety and eldercare. This study compared the prevalence, health, and caregiving experiences of AA caregivers (18+ years) to AA non-caregivers and caregivers in other racial/ethnic groups. Data from the 2015-2019 Behavioral Risk Factor Surveillance System were used (N=252,602). Caregivers were classified as those who provided care/assistance to a parent/parent-in-law/grandparent with a long-term illness/disability. Chi-square tests were used to compare weighted estimates. Among 4,564 AAs, 4.1% (n=321) were caregivers. They were single (55.6%), college-educated (84.2%), working (64.7%), young (< 45 years)(68.2%), male (60.0%), and in excellent/very good/good health (86.3%). Compared to non-caregivers, caregivers were more often unmarried with more chronic health conditions. They assisted a parent/parent-in-law (73.4%) with personal care (52.7%) and household tasks (77.9%). Although overall caregiving experiences were similar across racial/ethnic groups, the prevalence of caregivers was higher among other racial/ethnic groups than AAs (8.3%, Hispanic to 14.8%, American Indian/Alaska Native, p< 0.001), which was a surprise due to their caregiving culture. Because caregiving is expected, they may not identify themselves as caregivers. The data were collected in English and Spanish but 44% of AAs had limited English proficiency. Those limitations may have affected the sample size. Despite the limitations, this study was unique because of the comparison among different racial/ethnic groups of caregivers across the nation. However, to examine a full picture of AA caregivers, we need to administer surveys for each AA ethnic group in various languages.
NEUROPSYCHIATRIC SYMPTOMS IN PRIMARY CARE PATIENTS WITH DEMENTIA
Authors: Paul Constanca , Teixeira Laetitia , Sousa Susana
Published: December 2022

Neuropsychiatric Symptoms of dementia are mostly valued within care and burden of formal and informal caregivers and less considered as diagnosis predictors. Diagnosis of dementia in Primary Care Service (PCS) is frequently late and based mostly in general clinic assessment, and patient/family subjective complaints. We study the association of Neuropsychiatric Symptoms (NPI-Q) and existing diagnosis of dementia in PCS. The objectives are to know 1) the prevalence of symptoms identified by familial caregivers in people with a diagnosis of dementia and 2) if there is an association of symptoms with the existence of a diagnosis.Method: we randomly select a community based sample of a pool (N=2734) of primary care users with mental health concerns referred by General Physicians, (N=154), mean age 76 years (sd 7.8), 57% women. Caregivers (N=39) were interviewed and fulfil NPI-Q. Results of descriptive and logistic regression analysis showed that 39% (60) had a formal diagnosis of dementia not differentiating men and women. The neuropsychological symptoms frequency varied between 3.1% (hallucinations) and 16.3% (apathy/indifference), and the symptoms’ mean was 4.5(sd 2.1). The amount of symptoms was not associated with the diagnosis. The symptoms that predict the diagnosis were Apathy/ Indifference OR 5.24(1.25-22.0),p.024 and Motor Disturbance OR 5.70(1.17-27.6), p.031. Qualitative data from caregivers interview show that they are not very comfortable with the terminology of NPI-Q, which may limit the accuracy of assessment.

Conclusion some neuropsychological symptoms identified by caregivers seems to be relevant as predictors of diagnosis of dementia in Primary Care.
SOCIAL INTERACTIONS BETWEEN CERTIFIED NURSING ASSISTANTS AND CLIENTS WITH DEMENTIA: A QUALITATIVE STUDY
Authors: Fauth Elizabeth Braungart , Gossner Jacob , Dokos Malinda , Schultz Rebecka
Published: December 2022

Certified nursing assistants (CNAs) provide direct care for persons with dementia in formal settings and are therefore positioned to engage socially with clients during care. Our prior published observational study in memory care (7000 minutes of observation over 1 year) identified infrequent negative interactions of CNAs with clients, but many opportunities where CNAs did not socially engage a client, including ignoring attempts for engagement. This followup study seeks to understand CNAs experiences and attitudes towards social interaction with clients with dementia. Through semi-structured interviews with 11 CNAs at two care facilities (not included in the prior study), we examined the perceived role that CNAs have towards engaging socially with clients with dementia, barriers to interactions, and behaviors and attitudes that promote quality social interactions. Thematic analyses with multiple trained coders identified that all CNA participants reported feeling personally responsible for engaging with clients socially, having learned this through observation and trial and error, rather than formal training. Barriers to social interaction were lack of time, training, and managing symptoms of dementia. In describing quality social interactions, CNAs highlighted multiple verbal and nonverbal behaviors, including touch, eye contact, body posture, and volume and tone of voice. CNAs emphasized that quality social interactions were facilitated by internal attitudes of valuing personhood, getting on the client’s level, and being a friend. Our findings highlight that CNAs identify the importance of social interactions in their work in memory care, and they identify needing training in effective interaction techniques, specifically with their clients with dementia.
THE EFFECT OF ACTIGRAPHY MEASURED PHYSICAL ACTIVITY ON EXECUTIVE FUNCTION IN OLDER ADULTS
Authors: Thangwaritorn Pilar , Hicks Hilary , Laffer Alex , Losinski Genna , Meyer Kayla , Tran Elizabeth , Cox Keri , Watts Amber
Published: December 2022

Executive function (i.e., decision making, self-control, planning) is important for facilitating independent living in older adults. Physical activity may preserve executive function, but previous research has demonstrated sex differences in both physical activity and executive function among older adults. Few studies have investigated sex differences in the association between the two. We examined associations between objectively measured physical activity and executive function with attention to sex differences. We recruited N = 204 participants (Mage =71, SD=6.36; 57% women) with (n=47) and without (n=157) Alzheimer’s disease from the University of Kansas Alzheimer’s Disease Research Center. We used wrist-worn accelerometers (Actigraph GT9X) to measure physical activity 24 hours a day for 7 days in a free-living environment. We categorized physical activity as moderate to vigorous (MVPA) based on the Montoye (2020) Adult Vector Magnitude cut-points. We evaluated sex differences in the association between executive function and MVPA using multiple regression with an interaction term, adjusting for age, education, and dementia status. We used a composite score to combine tests of executive function (Digit Symbol Substitution, Stroop Interference, Trail making Part B, and Verbal Fluency). Results indicated, older age and lower education were associated with lower executive function scores (β=-2.12, p < 0.001; B=2.13, p < .05). In contrast to previous research, we did not find evidence for sex differences in the MVPA, executive function, nor the association between the two in our sample. Future research should investigate whether individualized exercise-based interventions and treatment between men and women may differentially benefit cognitive function.
IMPROVEMENTS IN HEALTH-RELATED QUALITY OF LIFE FOR BINGOCIZE CLINICAL TRIAL PARTICIPANTS
Authors: Smith Emily , Shake Matthew , Hamm Callie , Crandall Jason
Published: December 2022

With the number of older adults increasing rapidly, researchers have increasingly focused on designing interventions to improve health-related quality of life (HRQOL) in older adulthood. However, many interventions struggle with adherence because older adults often perceive them as unenjoyable, condescending, or painful. Here, we report results from a clinical trial of Bingocize®, a community-based “in vivo” exercise and health education intervention for older adults, to determine if participation impacts participants’ HRQOL. One-hundred and forty-three older adults ages 60+ were randomly assigned to one of four conditions that contrasted exercise and health education to non-intervention control groups. All conditions were matched on social engagement and met in group sessions twice weekly for 12 weeks. The CDC HRQOL measure was administered before and after the intervention. Session adherence was >90% across all sessions. Results from 2 (Time: Pre/Post) x 4 (Condition: Bingo-only Control vs. Bingo+Health Education vs. Bingo+Exercise vs. Bingo+Health Education+Exercise) ANOVAs found that all participants reported better sleep quality, reduced pain, and increased energy after completing the program (p-values <.05). Results from 2 (Time: Pre/Post) x 2 (Exercise/No Exercise) ANOVAs revealed interactions showing that exercise participants experienced greater decreases in days with anxiety and physically unhealthy days as compared to non-exercise participants (p-values <.05). These findings suggest that elements of Bingocize can contribute to improvements in older adults’ mental and physical quality of life. The current research can help researchers and professionals further elucidate which intervention mechanisms play a role in determining older adults’ health-related quality of life.
COPING STRATEGIES AND THEIR INFLUENCE ON DEPRESSIVE SYMPTOMS DURING THE SECOND COVID-19 PANDEMIC WAVE IN SWITZERLAND
Authors: Lampraki Charikleia , Jopp Daniela , Hoffman Adar , Roquet Angélique , Uittenhove Kim , Sieber Stefan
Published: December 2022

Coping strategies help individuals face stressful events and adapt to them. During the second wave of the COVID19 pandemic, individuals were confronted with increased governmental restrictions that aimed in impeding the propagation of the virus, but affected, at the same time, the life as we knew it, with negative consequences for mental health. This study aims at identifying the coping strategies that individuals used during this period, whether they changed over time and how they affected depressive symptoms in a life span sample in Switzerland. Our sample consisted of 736 individuals with age ranging between 18 and 81 years. The study was conducted in three waves with one-month intervals during the second pandemic-wave (i.e., October, November, December 2020). We used multilevel modelling to identify within-subject change and between-subject differences in depressive symptoms, with coping strategies and sociodemographic variables included as predictors. Older age, male gender, cohabiting with others, and being employed protected from feeling depressed. Results also indicated that seeking functional support, seeking emotional support, positive reappraisal and acceptance decreased, while self-distraction and depressive symptoms increased. When positive reappraisal decreased or/and when self-distraction increased, depressive symptoms also increased. This protective effect of positive reappraisal on depression differed in magnitude for younger and older individuals: Reduction in positive reappraisal was more strongly related to increases in depression for younger individuals. In sum, to adapt to the pandemic stress individuals changed the frequency of coping strategy use, but only changes in positive reappraisal and in self-distracting had an influence on depressive symptoms.
GIVING BACK TO FEEL GOOD? SOCIAL RESPONSIBILITY, AGE, AND NEGATIVE AFFECT
Authors: Nichols Madeline , Witzel Dakota , Stawski Robert
Published: December 2022

Developmental theories suggest that midlife and older adulthood are stages in which individuals may begin to focus their time on contributing to society (Erikson, 1969). During these stages, individuals may engage in socially responsible behaviors that protect against negative affect resulting from a lower sense of purpose in later life (Greenfield & Marks, 2004). Social responsibility includes both subjective measures of an individual’s felt contribution to society (i.e., generativity) and objective measures reporting actual time volunteering in different settings (Rossi, 2001). We utilized data from the Midlife in the United States Refresher survey study and Biomarker Project (N=735, Mage=51.56, SD=13.59, 50.20% Male) to explore how self-perceptions of generativity and time spent volunteering predicted negative affect for individuals in midlife and older adulthood. Preliminary analyses indicate that higher generativity (p<.001) and older age (p<.001), but not average time spent volunteering, were associated with higher negative affect. Further, we considered age as a potential moderator for the associations between generativity, volunteering, and negative affect. Age significantly interacted with generativity (p<.01), such that the effects of generativity on reducing negative affect decrease with age. Age did not significantly interact with time spent volunteering. Discussion will focus on how actual engagement in socially responsible behaviors and perceived societal contributions might yield different outcomes regarding protection against negative affect in mid- and later-life. Future directions may include exploring daily indicators of time spent volunteering, generative beliefs, and affect.
HOW GOAL REPRESENTATIONS MODULATE ASSOCIATIONS BETWEEN EVERYDAY AFFECT AND GOAL PURSUIT AMONG OLDER ADULTS
Authors: Choi Yoonseok , Gerstorf Denis , Ashe Maureen , Madden Kenneth , Hoppmann Christiane
Published: December 2022

Individuals differ in the extent to which they represent their goals as hoped-for versus feared states. We examined the role of such goal representations for how everyday affective experiences and goal pursuit are intertwined. When goals are represented as hoped-for states, we expected stronger associations between daily positive affect and goal pursuit. In contrast, when goals are represented as feared states, we expected stronger associations between daily negative affect (particularly fear) and goal pursuit. We used seven days of repeated daily life assessments from 238 older individuals (Age: M = 70.5 years, SD = 5.99, 59-87 years; N = 119 couples). At baseline, participants reported three goals they planned to pursue over the study period and the extent to which each goal referred to something they hoped-for or feared. During the daily life assessments, participants reported their current affective states and momentary goal pursuit (goal engagement and goal progress) three times per day (11 AM, 4 PM, 9 PM). Multilevel analyses regarding participants’ most salient goal provide initial evidence supporting the expected interactions of goal representations on everyday affect–goal pursuit links. Specifically, individuals with a strong hope-focus in their goals engaged in more goal pursuit when positive affect was up than individuals whose goals were low in hope-focus. In contrast, those with feared goals engaged in more goal pursuit when reporting increased fear. Findings are discussed in the context of the possible selves literature. Future analyses will examine lead-lag effects to address the temporal order underlying affect-goal pursuit associations.
PROFILES OF PERSONAL DETERMINANTS OF HEALTH AND ASSOCIATED HEALTH OUTCOMES IN OLDER ADULTS: A LATENT CLASS ANALYSIS
Authors: Hill Melanie Serrao , Barnes Timothy , Wu Lizi , Tkatch Rifky , Kraemer Sandra , Schaeffer James , Yeh Charlotte
Published: December 2022

Personal Determinants of Health (PDOH) are considered personal resources that contribute to successful aging. Positive PDOH factors have been associated with better health outcomes in older adults; however, research in this area is still limited. Using survey and claims data among adults age 65+ (N=2,866), profiles were identified based on five key PDOH factors (resilience, purpose in life, optimism, self-perception of aging, and social connection via loneliness) utilizing Latent Class Analysis (LCA). Differences in socio-demographics and healthcare outcomes were then explored utilizing multivariate regression models. Outcomes included emergency room (ER) visits, inpatient (IP) admissions, total medical cost, and quality of life (physical and mental health component scores). LCA models yielded three main classes within our sample: high PDOH (56%, n=1,150), moderate PDOH (40%, n=1,611), and low PDOH (4%, n=125). Those within the high PDOH class were significantly younger (Mage=75.6) compared to those within the moderate (Mage=78.2) and low (Mage=78.9) PDOH classes. In addition, the high PDOH class was significantly less likely to have an ER visit (OR=1.81, 95% CI:1.23-2.66) and had 28% better physical health and 52% better mental health components scores as compared to the low PDOH class. Results demonstrate support for the PDOH model as a potential successful aging model. Combinations used to create classes using resilience, purpose in life, optimism, self-perception of aging, and social connection via loneliness indicates that those who are positive in all five aspects show the most promising health outcomes. Future implications include targeting interventions at improving these variables for at-risk older adults.
VISION IMPAIRMENT AND SOCIAL ISOLATION IN OLDER AFRICAN AMERICANS: THE IMPACT ON COGNITIVE DECLINE
Authors: Hayes Emily , White Avalon , Tanner Corinna Trujillo , Yorgason Jeremy
Published: December 2022

Evidence suggests a consistent correlation between vision impairments, social isolation, and cognitive decline. The National Eye Institute reports that African Americans have an increased risk of developing certain vision impairments such as cataracts, glaucoma, and diabetic retinopathy. At the same time, older African Americans often receive care from family members and this family care may act as a buffer against social isolation and resulting cognitive decline. Using data from 737 African Americans that participated in waves 5, 6, and 7 of the National Health and Aging Trends Study (NHATS), we explored associations between vision impairment, social isolation, and cognitive functioning. Results showed that vision impairment at round 5 was related to increased social isolation, and higher social isolation at round 5 was related to decreased delayed word recall scores at the same wave. No significant longitudinal associations were found between these constructs. Findings suggest that concurrent associations exist between sensory impairments, social isolation, and cognitive functioning, but that these relationships are not robust across time. Despite support provided by unpaid family caregivers, African American older adults with vision impairment are at an increased risk for concurrent social and cognitive challenges. It may be that family support of those with sensory impairments helps so that these impairments aren’t related to social isolation or cognitive functioning across time. Researchers and clinicians could benefit older African Americans with sensory impairments by providing and encouraging support during early stages of vision loss.
DISSOCIATING RETEST EFFECTS FROM DEVELOPMENTAL CHANGE FOR PREDICTING COGNITIVE STATUS
Authors: Tamburri Nicholas , McDowell Cynthia , MacDonald Stuart
Published: December 2022

In longitudinal designs, unadjusted retest effects can confound developmental change estimates. This study utilized a measurement burst design and three-level multilevel modeling to a) independently parameterize short-term retest and long-term developmental change and b) employ these estimates as predictors of cognitive status at long-term follow-ups. Using data from Project MIND , participants (N=304; aged 64-92 years) were assessed across biweekly sessions nested within annual bursts (spanning up to 17 total assessments over four years). Cognitive impairment no dementia (CIND) status was classified at Years 4 (the final burst assessment) and 8 (the study end date). Response time inconsistencies (RTI) were computed to index intraindividual variability across RT trials of a one-back response time (BRT) task. Three-level multilevel models simultaneously yet independently estimated BRT RTI change across weeks and years, indexing short-term retest and long-term developmental change, respectively. Individual slope estimates were extracted and utilized in multinomial logistic regression models contrasting short- vs. long-term RTI change as predictors of long-term cognitive status. Results from the three-level models indicated that retest and developmental slopes yielded non-redundant sources of variance, providing unique estimates of change that would otherwise be confounded. Further, short- and long-term RTI differentially predicted cognitive status at Years 4 and 8; failing to benefit from retest effects on the BRT task was associated with increased likelihood of cognitive impairment. This innovative approach to parameterizing retest effects can reduce systematic bias in estimates of long-term developmental change, as well as highlight the utility of retest effects as predictors of cognitive health.
WORKING AROUND THE CLOCK: THE EFFECT OF SHIFT WORK AND SLEEP ON DEPRESSIVE SYMPTOMS
Authors: Frazier Cleothia
Published: December 2022

Shift work is increasingly prevalent in a 24-hour society where there is increased demand for round the clock service. However, shift work can disrupt circadian rhythms, which can negatively impact sleep. In turn, diminished sleep is associated with poor mental health. To expand prior research that reveal the independent effects of shift work and sleep on mental health, this study focuses on the interconnection between shift work, sleep, and depressive symptoms. Guided by the Stress Process Model (SPM), I examine the association between shift work and depressive symptoms and investigate whether sleep duration, sleep quality (insomnia symptoms), and sleep latency (the time it takes to fall asleep) mediate this relationship. Data was drawn from the age 50 health module of the National Longitudinal Survey of Youth 1979 cohort. The sample consisted of noninstitutionalized adults aged 51-60 (N=5,386). Findings show that shift workers had increased odds of short sleep, insomnia symptoms, and increased sleep latency compared to non-shift workers. Moreover, shift work was associated with increased depressive symptoms. However, part of the effect of shift work on depressive symptoms was indirect, operating through sleep. Specifically, short sleep during the week and on the weekend as well as insomnia symptoms mediated the relationship between shift work and depressive symptoms. The findings suggest that while engaging in shift work can negatively affect mental health, improving sleep duration and sleep quality can be effective in reducing the harmful effects of engaging in shift work during late midlife.
CAREGIVER OUTCOMES RELATED TO SLEEP DISTURBANCES IN PEOPLE LIVING WITH COGNITIVE IMPAIRMENT
Authors: McPhillips Miranda , Petrovsky Darina , Sefcik Justine , Li Junxin , Brewster Glenna , Gooneratne Nalaka , Aryal Subhash , Hodgson Nancy
Published: December 2022

Sleep disturbances in people living with cognitive impairment (CI) may impose a great burden on caregivers. We examined the relationship between objective and subjective sleep measures in people living with CI and caregiver depression and mastery via a secondary analysis of The Healthy Patterns Clinical Trial (NCT03682185) baseline data (n=170). Objective sleep variables included total sleep time and sleep efficiency derived from 3 nights of actigraphy. Subjective sleep measures included PROMIS Sleep Related Impairment, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale. Caregiver measures included Center for Epidemiological Studies Depression Scale and Caregiver Mastery Scale. People living with CI were female (67%), Black (80%), with mean age 73.4 ± 8.7. Caregivers were female (81%), family caregivers (80%) with mean age 56.5 ± 14.7. We used multiple regression analysis, adjusting for cognition, and examined if there were differences by caregiver gender. Poorer subjective sleep quality was significantly associated with more caregiver depression (B=0.407, SE= 0.198, p = 0.042). There were no significant sleep predictors for caregiver mastery; however, there was a moderating effect of gender on the association between subjective sleep quality and caregiver mastery. Female caregivers had increased caregiver mastery compared to males when the person living with CI had better sleep quality (B=0.555, SE= 0.218, p = 0.012). This study found that people living with CI sleep characteristics differentially influence caregiver outcomes. Sleep should be assessed using a combination of objective and subjective sleep measures in people living with CI to inform providers when interventions are needed.
GOLDILOCKS AT WORK: JUST THE RIGHT AMOUNT OF JOB DEMANDS MAY BE NEEDED FOR YOUR SLEEP HEALTH
Authors: Nelson Monica , Lee Soomi , Allen Tammy , Buxton Orfeu , Almeida David , Andel Ross
Published: December 2022

Objectives

It has been reported that job demands affect sleep, but how different levels of job demands affect sleep remains unclear. We examined whether curvilinear relationships exist between job demands and multiple sleep health outcomes. Design: Cross-sectional analyses with linear and quadratic effects, using self-administered survey data. Setting: A national sample of U.S. adults. Participants: Workers from Midlife in the United States Study (MIDUS2; n=2,927). Measurements: The Job Content Questionnaire assessed overall and five specific aspects of job demands (intensity, role conflict, work overload, time pressure, and interruptions). Habitual sleep health patterns across five dimensions (regularity, satisfaction/quality, daytime alertness, efficiency, and duration) were assessed. Age, sex, race/ethnicity, marital/partnered status, education, job tenure, work hours, body mass index, smoking status, and study sample were covariates.

Results

There were significant linear and quadratic relationships between job demands and sleep outcomes. Specifically, the linear effects indicated that higher job demands were associated with degraded sleep health, such as shorter duration, greater irregularity, greater inefficiency, and more dissatisfaction. The quadratic effects, however, indicated that the rate of degrade was decelerated in terms of sleep regularity and efficiency, such that these sleep outcomes were best with moderate levels of job demands. These effects were found for overall job demands as well as specific aspects of job demands. Stratified analyses further revealed that these curvilinear associations were mainly driven by participants with low job control.

Conclusions

Moderate levels of job demands, especially if combined with adequate job control, are related to better sleep health.
HOSPITALIZATION AT HOME MAY ADDRESS SOCIAL DETERMINANTS OF HEALTH: RESULTS FROM A QUALITATIVE STUDY
Authors: Schiller Gabrielle , Wurtz Heather , Masse Sybil , Baim-Lance Abigail , Federman Alex , Franzosa Emily , Gorbenko Ksenia , DeCherrie Linda
Published: December 2022

This project evaluated implementation of the Acute Hospital Care at Home (AHCaH) waiver from the U.S. Center for Medicare & Medicaid Services (CMS), launched in November 2020 to ensure availability of acute care as COVID-19 cases overwhelmed hospitals. We interviewed 18 HaH program leaders of 14 programs, from both existing and newly launched HaH programs, about their experiences applying for and implementing HaH under the CMS waiver. A thematic analysis of the interviews was completed. Informants described HaH programs as an opportunity for healthcare professionals to have “eyes in the home,” referring to ways in which the HaH team was able to observe and intervene in aspects of the patient’s life not accessible from traditional in-patient care. Informants described various ways that HaH programs addressed Social Determinants of Health (SDoH) including assessing patients’ ability to obtain healthy foods, reducing potential safety hazards in the home, and providing education and support to patients’ caregivers. Informants also suggested that HaH may reduce anxiety associated with hospital stay and separation from loved ones, helping people already contending with social inequities. Addressing SDoH is important for ensuring quality care and long-term positive changes in the patient’s lifestyle and environment. As CMS shifts their aims to further address the SDoH, our findings suggest that the interdisciplinary care approach of HaH programs may be a model of addressing both social and medical needs.