bluuebunny/crossref_metadata_2025 huggingface dataset:
Caregiver Neurotic Personality Trait and Elder Abuse—The Moderating Role of Change in the Level of Caregiver Burden
Authors: Fang Boye , Yan Elsie , Pei Yaolin , Yang Xiaozhao
Published: December 2020

Objectives: To investigate whether caregiver neuroticism has an effect on subsequent occurrence of elder abuse and whether change in the level of caregiver perceived burden alters this relationship. Methods: Using two-year longitudinal data, we analyzed a consecutive sample of 800 Chinese family caregivers and their care recipients with dementia recruited from the geriatric and neurological departments of three Grade-A hospitals in People’s Republic of China (PRC). All the participatory dyads were assessed between September 2015 and February 2016 and followed for two years. Results: Significant increase in the prevalence was found for physical and psychological abuse, caregiver neglect, and financial exploitation. Caregivers high in neuroticism were more likely to engage in subsequent physical and psychological abuse, however, change in the level of caregiver perceived burden altered this association. Specifically, absence and alleviation of care burden during the two-year observation prevented the subsequent occurrence of physical and psychological abuse. Although caregiver neuroticism was also associated with subsequent caregiver neglect, caregiver perceived burden did not appear to have an impact on this relationship. Discussion: This study provided evidence that caregiver neuroticism was associated with subsequent physical and psychological abuse, while change in the level of caregiver perceived burden may alter this trajectory. These findings suggest the importance of implementing caregiver-centered intervention and prevention programs for elder abuse by specifically targeting at caregivers’ behaviors related to their neurotic personality trait and cognitive appraisal of caregiving stressors associated with such personality trait.
A Peacock That Does Not Show Its Feathers Is Not Much Different From a Turkey: On Being a Physician Executive for 25 Years
Authors: Battar Saraswathy
Published: December 2020

Compelling common threads in the fabric of being an academic and clinical geriatrician, VA health care executive and physician champion for VIONE – a national medication deprescribing project that was launched at 59 VA programs across the nation will be presented in a thought provoking, objective, evidence based and legacy oriented format. Highlights include a)success factors b)networking c) effective presentations d) lessons learned e)implementing elements of High Performance Delivery Model (HPDM), f)transforming ideas into actions that help rise and shine g) creating a legacy h)survey readiness h) keeping the main thing the main thing i) understanding others and helping others understand you. Making significant contributions in career is important. How the work is captured, projected, made visible as a viable, actionable solution to a critical and significant mission critical problem, strategic engagement with stakeholders, implementation with measurable outcomes, passionate engagement while being an affirmative, non-controversial leader who is eager, willing, available, capable and knowledgeable etc., are some of the other non-negotiable aspects of getting work recognized. Experiences shared include creating VIONE – a medication deprescribing project that won VA USH Shark Tank competition as a Gold Status Fellow with outcomes such as over 95,000 veterans impacted, over 194,000 non-essential medications deprescribed with accomplished cost savings of over 9.6 million US dollars in 4 years. This profound journey taught me the importance of effectively displaying worthy work with global relevance with dignity, credibility, pride, persuasion, leadership, efficiency, teamwork, art of persuasion, ponder, recharge, rejuvenate and start fresh – time and again.
Personality and High Blood Pressure Among Older Adults: State Anxiety as a Mediator
Authors: Stone Lisa , Koh Deborah , Weber Kendall
Published: December 2020

High blood pressure (BP) is a prevalent medical condition among older adults, and previous research has consistently found that the Five Factor Model (FFM) of personality relates to elevated BP. However, variables that affect this relationship have been unexamined. Given the strong association between personality and state anxiety in later life, this study examined state anxiety as a mediator between the FFM and elevated BP. Participants consisted of respondents in the 2018 wave of the Health and Retirement Study (N=5225) who completed FFM and state anxiety questionnaires and had their BP measured. First, correlations were computed between the FFM and systolic and diastolic BP. Relationships were insignificant between systolic BP and the FFM. Conscientiousness (r = -.04) and Neuroticism (r = .03) were significantly correlated with diastolic BP. Next, a series of mediation models were computed. Controlling for sex, the test of indirect effects found that the connection from Conscientiousness to diastolic BP was significantly mediated by anxiety, Sobel Z test = -2.44, p = .01. Additionally, controlling for sex, the connection from Neuroticism to diastolic BP was significantly and fully mediated by anxiety, Sobel Z test = 2.02, p = .04. Although small effect sizes, Conscientiousness and Neuroticism were related to diastolic BP but not systolic BP, indicating personality differentially affects types of BP. The mediating role of state anxiety suggests that it can be used as a point of intervention to lessen the negative impact of low Conscientiousness and high Neuroticism on high diastolic BP among older adults.
A City Too Busy to Remember? Aging, Structural Violence, and the Politics of Forgetting in Atlanta’s Gentrification
Authors: Pothen John , Yip Keland , Idler Ellen
Published: December 2020

Can forgotten stories from the past inform a city’s future? As older adults continue to live longer and comprise more of the population than ever before, the suitability of gentrifying spaces for older adults aging in place is increasingly important. Critical theories of gentrification argue that remembering the experiences of older adults in this context - experiences of suffering, resilience, and structural violence - is essential to promote changes in support aging in place. In this study, we tell a story of individual experiences, structural violence, and aging in the ongoing gentrification of one neighborhood in southwest Atlanta. We construct this narrative through a qualitative analysis of 1,500 local newspaper articles from 1950 to the present day and 10 in-depth interviews with ex-residents of the neighborhood aged 65-87. Drawing on the theory of planetary rent gaps, we frame gentrification as a class struggle between property-owners and working class residents. We highlight the city government’s role as a facilitator for property-owners through projects including the Model City initiative, preparation for the 1996 Olympics, and ongoing development surrounding the Atlanta BeltLine. We show how these projects have affected the prospects for aging in place in general and, specifically, by affecting access to healthcare services. We share this story in an effort to combat the politics of forgetting and to inform a richer, more inclusive, and more equitable future for gentrifying spaces.
Chronic Stress and Risks for Myocardial Infarction in U.S. Adults
Authors: Farmer Heather , Xu Hanzhang , Navar Ann Marie , Nanna Michael , George Linda , Dupre Matthew
Published: December 2020

Long-term exposure to stress has been linked to multiple behavioral and biological responses that are detrimental to cardiovascular health, but the association between chronic stress and risks for acute myocardial infarction (MI) remains unknown. We examined the association between exposure to chronic stress and MI incidence from 2006 to 2016 using data from a nationally-representative prospective cohort study of adults aged 45 and older (n=15,109). Chronic stressors included ongoing issues related to personal health, social relationships, financial strain, housing, and caregiving responsibilities. Cox proportional hazards models were used to examine the association between the number of chronic stressors and MI while adjusting for confounding risk factors. More than half of the respondents reported ≥2 chronic stressors at baseline. Risks for MI increased incrementally from 1 chronic stressor (HR=1.28; 95% CI, 1.20-1.37) to ≥4 chronic stressors (HR = 2.71; 95% CI, 2.08-3.53) compared with those who reported no stressors. These risks were partly attenuated after adjustments for socioeconomic, psychosocial, behavioral, and clinical risk factors. The impact of chronic stressors was especially pronounced among adults with a history of MI (P value for interaction=.032). In adults with a prior MI, risks for a recurrent MI increased substantially from 1 chronic stressor (HR=1.31; 95% CI, 1.10-1.55) to ≥4 chronic stressors (HR = 2.92; 95% CI, 1.47-5.82) compared to those with no stressors. Chronic stress is a significant risk factor for acute coronary events in U.S. adults. More research is required to further understand the psychosocial, behavioral, and biological mechanisms underlying this association.
Financial Strain, Self-Rated Health, and the Mediating Role of Health Behaviors During the Great Recession
Authors: Wilkinson Lindsay
Published: December 2020

Previous research has revealed the physical and mental health consequences of the economic recession that began in 2007 and ended in 2009. Despite accumulating evidence of the harmful health effects of the economic downturn on older adults, relatively little research has examined the mechanisms involved in this relationship. Moreover, most research on the financial crisis has relied on objective indicators of the recession, despite evidence demonstrating the predictive utility of subjective measures such as financial strain. Drawing on a subsample of respondents age 50 or older from the Health and Retirement Study (N = 2040), this research (1) examines whether initial financial strain and that due to the recession independently contribute to worsening self-rated health over the period of the recession and (2) investigates the role of health behaviors as mechanisms in this relationship. Using longitudinal lagged dependent variable models that adjust for pre-recession self-rated health, the results reveal that both initial and increased financial strain due to the recession were associated with worsening self-rated health between 2006 and 2009. In addition, increased financial strain during the recession was found to be associated with skipped or postponed health care visits and change in prescription drug use, such as pill splitting and reduced or skipped doses, which, in turn, were associated with decreased health ratings. The results from this study suggest two important pathways in the recession-health relationship and have implications for policies aimed at supporting older adults during future financial crises.
Religion and Voting Behavior of Older Adults With Disabilities in Ghana
Authors: Yale Kodwo-Nyameazea
Published: December 2020

Voting is a necessary and inherent right of citizens in democracies to select public office holders who decide how public goods and resources are distributed and maintained. It is therefore critical that all citizens who are eligible are able to participate in one of the key aspects of political participation – voting. This study focused on the factors that influence the ability of older adult Ghanaians with disabilities to vote in local and national elections. The study sample of 923 respondents was drawn from the second wave of WHO SAGE study on Global Aging and Adult Health. The results of the logistic regression analyses showed that religion influenced the voting behaviors of all the three people with disabilities groups included in the study. But certain groups are also influenced by interaction with community leaders and personal political interests and characteristics, including gender. Given these findings, it is suggested that an impact community be established around the meaning and ethics associated with the religious activities people with disabilities participate in, and engage them through civic engagement, and personal and community development activities that empower them to live meaningful lives.
Aging With Autism Spectrum Disorder: An Exploration of Physical Activity Engagement
Authors: Waldron Danielle , Dugan Beth , Stokes Jeffrey , Coyle Caitlin , Kramer John
Published: December 2020

Adults with Autism Spectrum Disorder (ASD) participate in physical activity (PA) infrequently compared to adults in the general population. This is problematic as individuals with ASD suffer from disproportionate physical and mental health co-morbidities as well as diminished life expectancy, but do not reap the physical and mental health benefits of PA. This study used data from the National Core Indicators-In Person Consumer Survey (n=4,370; age: 18-78) to analyze factors associated with both aerobic PA and muscle strengthening (MS) activity in adults with ASD receiving state Developmental Disability Services. This research used multilevel logistic regression modeling, with mediation and moderation analyses to explore personal and environmental factors associated with PA/MS in this population. Findings indicated the following significant associations between community engagement and PA and MS: community contact (OR=1.17; p<0.001; OR=1.07; p<0.001), community group participation (OR=1.83; p<0.001; OR=1.91; p<0.001), and employment/day program participation (OR=1.32; p<0.05; OR=1.32; p<0.001). Additionally, at older ages, participants were less likely to engage in PA and MS three or more times a week (OR=0.99; p<0.05; OR=0.99; p<0.05). These findings indicate that increasing age is associated with decreased PA and MS activity in this group, while community engagement may facilitate their PA and MS activity. While much remains unknown about the population aging with ASD, it is evident that they suffer from poorer health than the general population and have experienced lifelong difficulties with socialization and communication. Greater access to community engagement opportunities may promote this population’s healthy aging, as well as support their unique social needs.
Benefits of Volunteering for Middle-Aged and Older Adults: Comparison Between Types of Volunteering Activities
Authors: Chung Edwin K H , Lam Alfred H K , Yeung Dannii , Chung Ka Hung Edwin
Published: December 2020

More middle-aged and older adults are often encouraged to volunteer (Gray et al., 2012). However, the effects of various volunteering activities on physical, psychological and cognitive health remain unknown. This study thereby aims to investigate such effects and the moderating effect of age in such associations. Data of 501 middle-aged and older Hong Kong Chinese adults (Mage = 53.06, SD = 4.55; and Mage = 70.46, SD = 7.34, respectively; range = 45 – 96) from a survey on Adult Development and Aging were analysed. Engagements in instrumental (e.g., food preparation, fundraising) and cognitively demanding volunteering (e.g., counselling, mentoring), hand-grip strength, life satisfaction, depressive symptoms, and cognitive functioning were measured. Factorial ANOVA revealed significant main effects of age group and volunteering type (F = 29.71, and F = 3.96, respectively, ps < .001), and an interaction effect of age and volunteering type (F =1.80, p = .03) on health outcomes. Comparisons among the four volunteering types (no volunteering, instrumental volunteering, cognitively demanding volunteering, and both types) revealed that individuals engaging in cognitively demanding volunteering had better hand-grip strength, life satisfaction, and cognitive functioning, and lower depressive symptoms than those who engaged in instrumental volunteering (all ps < .05). The health outcomes of instrumental volunteering were even worse than those who did not volunteer at all. These patterns were more prevalent in the middle-aged adults than in the older adults. Findings of this study indicated the beneficial effects of cognitively demanding volunteering, providing valuable directions for future programs on volunteering.
Addressing the Role of Smart Robotic Health Assistants Within the Human-Machine Frontier of Geriatric Healthcare
Authors: Firdausya Nadia , Bishop Alex , Carlson Barbara , Sheng Weihua
Published: December 2020

Data for this study was acquired from three separate stakeholder focus group sessions involving nurse case managers (n = 5), social agency caseworkers (n = 5), and rural outreach providers (n = 5). Participants across all groups were asked to address the question: “When it comes to your work, what would you want a smart robot assistant to do for you?” Data from the three sessions were combined, transcribed verbatim, coded, and analyzed for thematic content. Three shared themes emerged, including health monitoring, behavioral intervention, and healthcare literacy. Relative to health monitoring, participants desired a robot that possessed functions in the form of “taking vital signs,” and “tracking water and food intake.” There was also a thematic agreement regarding behavioral intervention capabilities. Most notably, advisory stakeholders acknowledged a need for a smart robotic assistant to provide geriatric care recipients with “an alert or reminder to take medication.” This was viewed as an essential intervention for improving medication adherence. Healthcare literacy emerged as a final theme among advisory groups. In particular, participants noted that a smart robot should assist with bi-directional communication and translation of health care information and instructions as a way to “minimize impediments of care due to language barriers.” Findings will be further used to highlight how future integration of robotic health assistants represents a viable solution in helping geriatric healthcare workers work effectively alongside machines to meet the diverse care needs of older adults in both urban and rural settings.
Age-Cohort Differences in Longitudinal Associations Between the Rate of Internet Use and Memory Functioning
Authors: Raichur Vineet , Ryan Lindsay , Gonzalez Richard , Smith Jacqui
Published: December 2020

Cross-sectional analyses of internet use patterns among older adults find that the rate of internet use is less with greater physical and memory difficulties. It is not clear, however, how age-cohorts differ in their internet use as physical and memory difficulties increase over time. In addition to factors such as increasing accessibility (cost) and social influences, the expansion and cognitive complexity of functions performed by the internet-enabled devices over time could influence internet use patterns. In this study, we investigate how the association between internet use and episodic memory difficulties over time varies between cohorts. We analyzed longitudinal data from the Health and Retirement Study (N = 15,703 in 2002; Aged 51 and older) between years 2002-2016 using mixed effects logistic regression models. Immediate and delayed word recall measures were used to assess episodic memory. Rate of internet use in the sample increased from 30% in 2002 to 53% in 2016. Rate of internet use among younger age groups was significantly higher in the baseline year. Younger age groups also showed a significantly higher rate of increase in internet use over time. In general, internet use decreased with episodic memory impairment. In addition to these effects, the effect of episodic memory on the rate of increase in internet use over time is lower in younger cohorts. These results indicate that younger cohorts of older adults are more likely to maintain internet use as they continue to age and therefore could better utilize technology for communication, social interactions and health interventions.
Beyond Religiosity: A Model to Explain Spirituality Among Middle-Aged and Older Adults
Authors: Vogel Carlyn , Dobbs Debra , Small Brent
Published: December 2020

Spirituality is difficult to define as researchers assign it different meanings and individuals’ perceptions can vary. For example, spirituality may connect to religiosity, while others consider religiosity a less significant part of spirituality. This study investigates factors outside of religiosity that are significantly associated with spirituality to inform the characteristics of the concept. Webster’s (2004) existential framework of spirituality was used to guide variable selection. The National Survey of Midlife in the United States wave three (MIDUS 3; 2013-2014; n = 2,594; Mage = 63.5, SD = 11, range = 39–92) was used to examine individuals’ reported levels of spirituality. Multinomial logistic regression was conducted to examine factors related to low and high levels of spirituality compared to a moderate level. Participants with low spirituality were more likely to be male, less likely to be mindful, mediate/chant, feel a strong connection to all life, to indicate that they cannot make sense of the world, and to be religious. Participants with high spirituality were more likely to be female, have at least some college experience, be mindful, meditate/chant, feel deep inner peace, have a sense of deep appreciation, think that a sense of purpose is important for a good life, and have a high level of religiosity. Framed by Webster’s conceptual model, the current study observed that religiosity is significantly associated with spirituality and that other mindfulness-based aspects are also present within this concept. Incorporating mindfulness with religious efforts will more accurately and holistically address spirituality.
What Predicts Advance Care Planning Among Older Adults: Perceived Health or the Number of Chronic Conditions?
Authors: Wang YuHsuan (Olivia) , Enguidanos Susan , Wang Olivia
Published: December 2020

Advance care planning (ACP) is associated with improved quality of death and better end-of-life care. Studies have found that both health status and chronic illness influence rates of ACP. However, little is known about the relative association of each factor with engaging in ACP. This study aims to identify the extent to which the number of chronic conditions and self-rated health predict engaging in ACP. We used data from the Health and Retirement Study, a nationally-representative longitudinal survey of older adults. The sample consisted of 2016 core interview respondents. We conducted logistic regression models to examine the association between self-rated health and the number of self-reported chronic conditions with three dependent variables: (1) ACP engagement (n=687), (2) AD completion (n=1671), and (3) assignment of health care proxy (n=1668), while controlling for demographic characteristics,. Samples were weighted. Analysis revealed that reporting more chronic conditions was associated with higher odds of advance directive completion (OR:1.21, p<.001), ACP engagement (OR: 1.26, p<.05), and assigning medical proxies (OR: 1.32, p<.001). However, better self-reported health was associated with higher odds of having an AD (OR: 1.20, p<.05) and assigning medical proxies (OR: 1.27, p<.01). These findings suggest that greater number of chronic conditions increased the odds of having an AD, engaging in ACP and in assigning medical proxies; however, those reporting better health were more likely to have an AD and a medical proxy. Findings from this study point suggest that individuals with multi-morbidities may be more open to engaging in ACP discussions and activities.
Meaning of Aging, Gerotranscendence, and Successful Aging in Older Adults With Chronic Health Conditions
Authors: Troutman-Jordan Meredith
Published: December 2020

Aging presents change in the form of opportunities and challenges, from common physical alterations, to major life events. Perception of such events is greatly shaped by one’s mental health, and is a major influence on gerotranscendence, a positive kind of aging involving redefinition of self, relationships, and proposed to be a precursor to successful aging. A mixed-methods cross-sectional descriptive design was used to study 50 older adults. Life Events Checklist, Gerotranscendence Scale, Herth Hope Index, and Successful Aging Inventory were administered. Mean participant age was 70.78 years; there were 9 males (18%), 41 females (82%), 13 were Black (26%), and 37 were White (74%). Participants reported a number of stressful events, most frequently transportation accidents, followed by other very stressful events or experiences, and sudden unexpected death of someone close. Gerotranscendence scores ranged from 0-10 (µ 6.88, a moderate score). Successful aging scores ranged from 40-79 (µ 62.33, a moderate score). A sub-sample of 6 participants engaged in semi-structured interviews, which were transcribed verbatim and subject to content analysis. Faith, displaced longing, temporal anticipation, proactive problem-solving/coping, and concern for future generations were emergent qualitative themes. Findings highlight opportunities for providers from multiple disciplines to target risks and possibilities for aging successfully and to promote hope, optimism, problem-solving skills, and gerotranscendence in all older adults, regardless of physical or functional health status.
Resilience in Young and Older Adults: Eudaimonic Well-Being Despite Life Challenges
Authors: Sharma Shubam , Bluck Susan , Liao Hsiao-Wen
Published: December 2020

Although the types of events that occur across life phases may vary, experiencing multiple life challenges in a short time-frame can disrupt mental health (Zepinic, 2016). Maintaining self-continuity (i.e., sense of being the same person over time) when experiencing challenges may, however, foster resilience (Masten, 2001). This study investigated, in both young and older adults, whether: (1) experiencing multiple recent negative life challenges relates to lower current eudaimonic wellbeing, and (2) self-continuity acts as an internal resource for resilience. That is, whether having greater self-continuity ameliorates the negative association between frequent life challenges and well-being. Participants (N = 99 young, 87 older adults) reported all challenging events experienced in the last six years (Sarason et al., 1978). They also completed measures of eudaimonic Well-being (Ryff, 1989) and Sense of Self-continuity (past six years; e.g., Habermas & Köber, 2015). Older adults reported higher eudaimonic well-being than young adults (p < .001). Young adults reported experiencing more challenges (p < .001). Regardless, for both age groups, more frequently experiencing life challenges was associated with lower eudaimonic well-being (p < .001). Self-continuity mediated the association between more frequent experience of challenge and lower eudaimonic well-being: β = .258, SE = .061, 95% CI [.138, .378] (p < .001). Classic risk models focus on the negative effects of life’s inevitable challenges. Our findings, grounded in a resilient aging framework, support the idea that individuals of any age can use internal resources (i.e., strong sense of self-continuity) to maintain or re-establish well-being.
Binge Drinking, Depressive Symptoms, and Sleep Health in Middle-Aged and Older Adults
Authors: Lorenz Rebecca , Auerbach Samantha , Chang Yu-Ping
Published: December 2020

Unhealthy alcohol consumption such as binge drinking and depression are common problems among adults. The combined effect of binge drinking and depression might contribute to negative health outcomes, such as accidents, addiction, or sleep problems. Previous evidence has indicated that alcohol consumption differs by age. However, little is known about the association between binge drinking, depression, and sleep health, and how age might play a role in this association. This study aimed to examine the association between binge drinking, depressive symptoms, and sleep health in middle-aged and older adults and characterize any age differences. A total of 5191 middle-aged and older adults from the 2014 Core Survey of the Health and Retirement Survey (HRS) data aged 50 to 80 were included for this study. Binge drinking was defined as the consumption of 5 or more drinks (men) and 4 or more drinks (women) per drinking day. Depressive symptoms were measured using a validated 8-item Center for Epidemiologic Studies Depression Scale. Sleep health was assessed using a composite measure. Age was grouped into middle-aged (50-64.9 years) and older (65-79.9 years) adults. Multiple linear regression analysis was used to examine the associations between variables of interest. Our findings indicated that binge drinking and depressive symptoms negatively influenced sleep health among middle-aged adults, however this relationship was not found in older adults. Clinicians should simultaneously assess problematic alcohol consumption, depressive symptoms, and sleep health. Future research can develop and test age-specific interventions to reduce unhealthy drinking behaviors in middle-aged adults.
Daily Association Between Sleep and Stressors: Role of Caregiving at Work and Home
Authors: Harris Taylor , Vigoureux Taylor , Lee Soomi
Published: December 2020

Previous research shows that adults with children experience poor sleep. We know that poor sleep is associated with experiencing more frequent and severe stressors (i.e, subjective feelings of believing his/her life is uncontrollable, unpredictable and overloading) the following day. This study examined whether the sleep—stressor relationship is stronger for individuals with children than those without. Participants were 61 oncology nurses (92% female). Participants completed a background survey that assessed sociodemographic and work characteristics. Using 14 days of ecological momentary assessments, participants reported their sleep characteristics daily upon waking. Three times daily, they also reported whether they experienced any stressors and how severe those stressors were. Multilevel modeling was used to assess whether the sleep—stressor relationship was stronger in nurses with children than those without. After controlling for sociodemographic covariates, poorer sleep quality was associated with more severe stressors. This daily association was moderated by the presence of children (B=-16.89, p<.01); the association was apparent for individuals with children (B=-5.74, p<.05), but not for those without. The daily association for sleep quality and stressor frequency also differed by the presence of children (B=-0.22, p<.01), although the slope for individuals without children did not reach the statistical significance. These findings suggest that individuals with children are at risk for experiencing a stronger linkage between poorer sleep and greater stressor severity. Improving sleep health among adults with children is critical for stress management. Future studies should examine whether age of children or number of children further influences the sleep—stressor relationship.
Cardiometabolic Risk and Biomarker Trajectories Among Older Adults: Findings From the Health and Retirement Study
Authors: Wu Qiao , Crimmins Eileen , Ailshire Jennifer , Kim Jung Ki , Zhao Erfei
Published: December 2020

The deterioration of the cardiovascular system is a process associated with aging. Most of the prior works have examined changes in cardiometabolic risk (CMR) while aging at the population level using cross-sectional data, but we study within-person changes for total CMR and separate risk factors, including pulse pressure, resting heart rate, C-reactive protein, glycosylated hemoglobin (HbA1c), high-density lipoprotein cholesterol, total cholesterol, waist circumference, and obesity. We examine 8-year changes (from 2006 to 2014) among respondents from the Health and Retirement Study biomarker sample (n=19,776). We use growth curve models to identify differences at baseline and the changes while aging, by age, gender, race/ethnicity, and education. Blacks, the old-old, the less educated, and current smokers have higher baseline CMR. The total CMR increases while people age over 8 years. HbA1c, waist circumference, and pulse pressure increase significantly with age. A reduction in total cholesterol can be observed and is likely due to medication. The CMR increase is no longer significant after accounting for socioeconomic status. The next step of this study is to focus on the disparity of risk distribution, in order to identify the individuals that are most in need of specific care and support.
Someone at Home: How Kinship Support Influences Aging-in-Place Decisions Among Childless Older Adults in Rural China
Authors: Hongzhou Chen , Lou Vivian , Chen Hongzhou
Published: December 2020

Background and aim: 80% of childless older adults in rural China choose to ageing-in-place (AIP) rather than moving to residential facilities, regardless the fact that they were financially constrained, scarily supported and some were physically disabled. This research explores the reason why AIP were prevailing preferred. Research design and Method: A qualitative method adopting constructive grounded theory approach was utilized in this research. 20 in-depth interviews were conducted among childless rural residents (aged 60 to 83 years old, 8 of them were over 75 years old) in Yunnan, one of the most economically disadvantaged provinces in China. Data was transcript and coded line-by-line, a in Vivo coding strategy was engaged to capture local language and meanings. Results: A phrase - ‘there’s someone at home’ - was used by rural childless older adults to explain their AIP decision, which demonstrating the role of kinship relations. Three sub-themes were emerged regarding to the phrase: 1) reciprocity, as the support were mutual and predictable; 2) justified conflicts, as older adults and ‘someone’ managing the support relation with subtle conflict; 3) unspoken agreement, as childless older adults being constrained by filial piety when negotiating for further support. All of sub-themes were related with sense of certainty. For participants who were over 75, growing old were “naturally” related with decreased social support. The daily-based kinship support and sense of certainty was particularly important among childless older adults who would like to choose AIP but still questioning the sustainability of self-reliance at an uncertain rural place.
Living Through Decline: Resident Perceptions of Change Within Cleveland’s Urban Neighborhoods
Authors: Langendoerfer Kaitlyn
Published: December 2020

Despite the vast amount of research focused on neighborhoods within the environmental gerontology, very little attention has been paid to learning how older residents make sense of and describe the changes that have occurred within their communities over the course of their lives. The purpose of this study was to provide a space for residents to tell their stories of what it was like to live through neighborhood decline within Cleveland. Older adults are an ideal group for examining perceptions of neighborhood decline as they have the perspective to address both the historical changes of their neighborhood and the biographical changes of their lives. This study utilized data from 4 years of ethnographic observations with over 30 older (age 60+), African-American adults who have aged in place within Cleveland since their childhood. Additionally, multiple in-depth life history interviews were conducted with 13 long-term residents. Data was analyzed using grounded theory techniques for emergent themes. While each resident had their own unique perspective of neighborhood change, common themes emerged related to 1) institutional decline, 2) changes in safety and crime and 3) changes to the people living in their communities. The findings suggest that resident perceptions can help us better understand how neighborhood dynamics work their way into the lives of long-term residents. The results are particularly important as they provide the foundation for exploring how residents responded to neighborhood decline and why residents remained within their neighborhoods when so many others left.
When Less Is More: Downsizing, Sense of Place, and Well-Being in Late Life
Authors: Costlow Kyrsten , Choi Shinae , Roskos Beverly , Parmelee Patricia
Published: December 2020

The present study aimed to investigate the decision-making process and outcomes associated with downsizing to a smaller home in late life. Older adults who had downsized in the past year (n = 68) completed self-report measures of push-pull factors driving the decision to move, relocation controllability, sense of place (SOP), move satisfaction, and psychological well-being. It was hypothesized that the relation between push-pull factors and relocation outcomes (i.e., move satisfaction and psychological well-being) would be serially mediated by control and SOP. Haye’s PROCESS macro was used to test serial multiple mediator models for each of the relocation outcomes. Placing greater importance on push relative to pull factors was associated with lower levels of well-being in three domains: environmental mastery (b = -5.52, p = .002), purpose in life (b = -3.94, p = .01), and self-acceptance (b = -3.61, p = .007). Results of serial mediation analyses suggested that older adults whose downsizing decisions were more strongly influenced by push factors felt less control over relocation, found it more difficult to develop SOP in the new home, and, in turn, experienced lower levels of psychological well-being and move satisfaction. These findings can be used to inform older adults’ downsizing decisions and develop supports for relocating older adults.
Predictors of Motivation to Learn Among Middle-Aged and Older Men in the United States
Authors: Yamashita Taka , Millar Roberto , Sahoo Shalini , Smith Thomas , Cummins Phyllis
Published: December 2020

Middle-aged and older men are less likely than women to participate in adult education and training (AET) outside of their work. AET is known to provide psychological, social and economic (e.g., job-related skills) benefits throughout the life course. Research has shown that motivation to learn (MtL) is the key to promoting AET. The objective of this study is to identify MtL predictors among middle-aged and older men in the U.S. Nationally representative data (n = 1,450) of men aged 45 years and older were obtained from the 2012/2014 Program for International Assessment of Adult Competencies (PIAAC). Structural equation models were constructed to examine how a latent MtL construct measured by four 5-point Likert-type itemsMtL might be predicted by participant characteristics. Results showed that having a postsecondary degree (vs. high school or less; b = 0.19, p < 0.05), higher literacy skills (0-500 points; b = 0.01, p < 0.05), at least one parent/guardian with a postsecondary degree (vs. those without; b = 0.08, p < 0.05) and better self-rated health (b = 0.14, p < 0.05) were associated with greater MtL. Additionally, Black (b = 0.22, p < 0.05) and Hispanic (b = 0.19, p < 0.05) men showed greater MtL than White men. Overall, socioeconomic status indicators and race/ethnicity were linked to MtL. Given the known challenges involved in middle-aged and older men’s participationin AET (e.g., low and short-term participation), enhancing MtL may have long-term implications. Theoretical explanations and possible policy implications are evaluated.
The Feasibility and Acceptability of Training Dietitians to Hand Feed People Living With Dementia
Authors: Ferguson Christine , Douglas Joy , Nolan Beth
Published: December 2020

The purpose of this study was to evaluate the feasibility and acceptability of a training program using the interactive Positive Approach to Care□ dementia care curriculum to Registered Dietitians (RDs). To recruit RDs, the Alabama Dietetic Association emailed its member twice about the training opportunity, and a maximum of 25 potential participants could register online. Of those who registered, 80% (20/25) attended the training, and all attendees agreed to the informed consent. The total cost for the two training sessions, including travel, supplies, and labor hours, was approximately $800. The primary challenge for the facilitator was accurately following the script due to time constraints. Two weeks after completing the training, participants answered open ended questions, and many shared how they enjoyed the hands-on activities and watching videos of people living with dementia being fed using the Hand-Under-Hand□ technique. Some participants would have preferred a longer workshop at a location that was more convenient for them. All participants shared how this training may impact their professional practice, such as how it changed the way they approach and communicate with people living with dementia. Since receiving the training, many shared how they have either already started or are interested in sharing the information with interdisciplinary healthcare professionals and/or caregivers. Overall, the training session is considered a feasible, acceptable, and low-cost approach to training RDs on providing hands-on care to people living with dementia. Lengthening the training may improve the replicability of the script in addition to providing opportunities for more hands-on activities.
Awareness of Aging Mediates the Relationship Between Health and Control Beliefs: A Micro-Longitudinal Study
Authors: Zhang Shenghao , Neupert Shevaun
Published: December 2020

Objective: Control beliefs are bidirectionally related to physical and cognitive health, but it is unclear how health influences control beliefs. Health-related experiences (physical symptoms and memory failures) on a particular day can make older adults more aware of their aging, and may subsequently lead to lower control beliefs. We propose that awareness of aging constructs (subjective age and awareness of age-related change [AARC]) could function as mediating mechanisms between health and control beliefs, and examine this relationship from both between- and within-person perspectives separately for domain-general and domain-specific control beliefs. Methods: Older adults (n=116) ranging in age from 60 to 90 (M=64.71) completed a nine-day daily diary study online, resulting in 743 total days. Participants reported their physical symptoms, memory failures, felt age, daily AARC gain and loss experiences, and control beliefs on Days 2-9. Results: Multilevel mediation results showed that between-person AARC losses mediated the relationship between physical symptoms and both domain-general and domain-specific control over physical symptoms. Between-person AARC losses also mediated the relationship between memory failures and both domain-general and domain-specific control over memory. AARC gains and subjective age did not mediate the relationship between health and control beliefs. Discussion: Our findings suggest that between-person differences in AARC losses function as underlying mechanisms linking health and control beliefs. Efforts to reduce AARC losses may lessen the negative impact of health problems on control beliefs for older adults.
Philippine Older Adults’ Attitudes to Love and Remarriage
Authors: Kim Ju Young , Xu Hanzhang , Ostbye Truls , Cruz Grace
Published: December 2020

Attitudes to love in older adults, often operationalized as acceptance of love and re-marriage in their 60s and 70s, is a key yet understudied component of aging in Southeast Asia. Using data from the 2007 Philippine Study on Aging that included 3105 older adults 60+, this study aimed to 1)describe the level of acceptance of love in older adults in the Philippines, 2)assess factors associated with acceptance of love, and 3)assess how acceptance of love is associated with social activity, life satisfaction, and health behaviors. Multivariate logistic regression was used to examine these associations while adjusting for age, gender, urban or rural residence, education, religion, marital status, self-reported health, comorbidity, and physical functioning). Only 1-in-5 older adults in the Philippines reported acceptance of love in older ages. Men and those with good health were more likely to report such acceptance, after adjustment for covariates (P<0.05). Although marital status alone had no association with acceptance of love, marital status interacting with gender showed significant associations with acceptance: unmarried men were more likely than married men to report acceptance. Individuals with lower acceptance of love were more likely to smoke (P<0.01). Attitude towards love was not significantly associated with social activity or life satisfaction after accounting for confounders. By evaluating the health and social outcomes associated with acceptance of love in older adults, this paper provided a better understanding of the utility of attitudes to love in older adults as a metric of elderly health in the Philippines.
The Association Between Recent Family Death and Self-Perceptions of Aging Among Middle-Aged and Older Adults
Authors: Xu Shu
Published: December 2020

The loss of a family member may have a significant influence on one’s aging experience in life. Self-perceptions of aging, which are an individual’s beliefs or evaluation of their experiences of aging, have been described as an important factor for one’s health and daily life. However, there is little research on the association between family death and self-perceptions of aging. This study examines the relationships between recent family death, self-perceptions of aging, and gender of the bereaved among middle-aged and older adults. Using nationally representative data from the Health and Retirement Study (HRS), we conducted cross-sectional analysis on adults age 50 years and older (n=1,839). Self-perceptions of aging were accessed by 8 items derived from the Attitudes Toward Own Aging subscale of the Philadelphia Geriatric Center Morale Scale and the Berlin Aging Study, and we considered recent family death (i.e., parental death, spousal death, sibling death and child death), as well as gender of the bereaved. Multiple linear regression analyses revealed that respondents who experienced recent family death report less positive self-perceptions of aging compared to those who did not experience recent family death (t = 12.40, p < .01). Recent parental death was more negatively related with self-perceptions of aging for bereaved women than for bereaved men (χ2 = 4.28, p < .05). Findings suggest that middle-aged and older adults experiencing recent family loss have less positive self-perceptions of aging, and gender of the bereaved plays an important role in the relationship between parental death and self-perceptions of aging.