bluuebunny/crossref_metadata_2025 huggingface dataset:
Shining a Light Inside the “Black Box” of NIH Application Submission and Review
Authors: Ortenberg Elia , Bynum Shalanda
Published: December 2021

What happens to applications after they are submitted to the National Institutes of Health, and how can you better prepare yourself and your application for the process of peer review? The Center for Scientific Review (CSR) works closely with the 24 funding institutes and centers at the National Institutes of Health that provide funding support for projects of high scientific merit and high potential impact. CSR conducts the first level of review for the majority of grant applications submitted to the NIH, which includes 90% of R01s, 85% of Fellowships, and 95% of Small Business Innovation Research (SBIR) applications as well as many other research and training opportunity activities. In this capacity, CSR helps to identify the most meritorious projects, cutting-edge research, and future scientists who will advance the mission of the NIH: to enhance health, lengthen life, and reduce illness and disability. The purpose of this project is to provide an overview of 1) what happens to NIH applications before, during, and after peer review at CSR; 2) a summary of new and current peer review policies and practices that impact investigators and their submitted applications; and 3) strategies for developing a strong NIH grant application. Peer review is the cornerstone of the NIH grant supporting process, and an insider’s view can shine a light inside the “Black Box” of how the most meritorious projects are identified.
Older Men's Participation in Cognitive Training: A Review.
Authors: González Estela , Requena Carmen , Alvarez Paula
Published: December 2021

Background: Cognitive training for healthy older adults living in a community is an essential resource that allows them to live at home for as long as possible. Objective: The purpose of the review is to examine the degree of participation of males and females in longitudinal studies of cognitive training. Moreover, we want to identify if these studies include the gender variable in their analyzes or reflect on its importance. Method: This review considered longitudinal cognitive training studies were published in English and Spanish and conducted with healthy older adults living in a community. Results: The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (in English) and the Memoria Mejor (MM) Longitudinal Study (in Spanish), both illustrate the trend of sex/gender treatment of the studies reviewed: a) high participation of older people seventy and more years b) recruiting stratified by age and sex; c) males are disproportionately underrepresented in cognitive training studies [24% - 14%]; d) the evaluation measures (baseline, follow-up, and final) and dropout data are provided but not stratified by age and sex/gender. Conclusions: Researchers demonstrate awareness about the impact of sex/gender differences but do not focus on it. Understanding sex/gender differences are necessary for understanding not only that these differences occur, but also why they occur; this will allow policies or intervention programs with approaches that are more equitable for both sexes/genders to be formulated.
Effect of Exchange Through Kendo on the Image of the elderly of Junior High School Kendo Club Members
Authors: Matsumoto Daisuke , Uchida Hayato
Published: December 2021

This study targeted junior high school kendo club members who have practice experience with elderly kendo practitioners and examined the image of the elderly and the related factors that intergenerational exchange through kendo brings to the junior high school members. Kendo is one of the traditional Japanese martial arts. The subjects in this research were 193 players who practiced with the elderly kendo practitioners in Osaka prefecture. As a result of factor analysis to clarify the structure of the image, the "evaluation" factor and the "activity / competence" factor were extracted as in the previous research, and it was suggested that the junior high school players generally had positive image regarding the elderly practitioners. As a result of logistic regression analysis to clarify the factors related to the high/ low scores in the image of elderly kendo practitioners, "evaluation" factor showed a significant relationship between "intimacy with elderly practitioners" and "empathic interest", and "activity / competence" factor indicated a significant relationship between "gender" and "intimacy with elderly kendo practitioners." Although it is pointed out that the traditional style of kendo and the image of elderly kendo practitioners have a negative impact on children, it may be possible to control these factors through an appropriate guidance and approach depending on the children's stage of growth .
Characteristics of Financial Exploitation in a Sample of Israeli Older Adults
Authors: Weissberger Gali , Han S Duke , Shrira Amit
Published: December 2021

Financial exploitation (FE) negatively affects wellbeing in older adulthood. However, characteristics of FE and its health correlates remain poorly understood. In this study, 138 Israeli older adults answered questions regarding FE history, and completed physical and mental health questionnaires. Of 138 participants, 23 reported a history of FE. FE participants were older (M birth year = 1950.35; sd = 9.65) than non-FE participants (M birth year = 1953.79; sd = 6.06; p = 0.028) and reported lower household income (p=0.001). Groups did not differ in education level or sex breakdown. The FE group reported older subjective age (p = 0.022), worse subjective cognition (p = 0.007), more depressive symptoms (p=0.002), and marginally higher anxiety symptoms (p = 0.099) than the non-FE group. Groups did not differ in reported levels of social support or number of medical conditions. When covarying for age, differences between groups in subjective cognition and depressive symptoms remained significant (ps ≤0.022), while subjective age differences became marginal (p = 0.07). The FE group responded to follow-up questions regarding FE experiences. Reported perpetrators included companies/businesses (most commonly reported, 30%), strangers, friends/neighbors, service providers, and family. Eleven reported losing 100 NIS to 10,000 NIS, and 10 reported losing 10,001 to over 100,000 NIS. Additionally, six FE participants reported that the FE is ongoing, and two reported additional FE experiences. Findings suggest that FE is related to mental and physical health of older adults. Findings also provide preliminary information regarding characteristics of FE in a sample of Israeli older adults.
The psychological health consequences of elder abuse and neglect in sheltered homes
Authors: Alraddadi Khulood
Published: December 2021

Background: Psychological health effects of elder abuse and neglect in sheltered homes are unknown. Objectives:The objective of the present study was to determine if several types of elder abuse were related to an increased likelihood of negative psychological health. Methods: Data were derived from the elder mistreatment in sheltered homes project, a cross-sectional study conducted in 2018 that included 446 older adults living in 43 sheltered homes.A face-to-face interview was carried out to complete structured questionnaires for participants to assess the psychological health effects of different subtypes of elder abuse. Results:All subtypes of elder abuse were significantly associated with increased prevalence rates of depressive symptoms and sleep problems. Similarly, all subtypes except physical abuse were associated with higher rates of anxiety symptoms. In multivariate regression analysis, Older adults who reported physical mistreatment were three times more likely to experience suicidal ideation(OR=3.28, 95% CI=1.14 to 9.44), while no other subtypes were significantly associated with suicidal ideation.Older adults who report at least one type of abuse were eight times more likely to have depressive symptoms (OR=7.99, 95% CI=4.43 to 14.41), twice as likely to screen positive for anxiety symptoms(OR=2.05, 95% CI=1.20 to 3.49), three times more likely to have sleep problems (OR=3.20, 95% (CI=1.78 to 5.75). All subtypes of abuse were significantly associated with the presence of depressive symptoms, sleep problems, and anxiety symptoms except physical mistreatment. Conclusion: Abuse is common among older adults living in sheltered homes and is associated with negative impacts on psychological health.
Childhood Exposure to Family Violence and Later-Life Sibling Relationships
Authors: Kong Jooyoung , Goldberg Jaime
Published: December 2021

There has been a growth in research examining the long-term effects of childhood adversity on later life outcomes; however, only a few studies have examined the impact that childhood adversity has on sibling relationships in late adulthood. To address this gap in the literature, the current study examines the latent class structure of childhood exposure to family violence and investigates whether a latent class membership is associated with aspects of later-life sibling relationships, including geographical proximity, frequency of contact, perceived closeness, similarity in outlook, and exchange of support. Using data from 3,921 adult participants in the Wisconsin Longitudinal Study and the Bolck, Croon, and Hagenaars (BCH) approach of latent class analysis (LCA), we identified five latent classes (prevalence rate noted): “Never experienced violence (75%),” “experienced sibling violence (7%),” “experienced parental abuse & witnessed domestic violence (4%),” “experienced father’s abuse & witnessed domestic violence (10%),” “experienced mother’s abuse & witnessed domestic violence (5%)”. Childhood exposure to family violence was a significant predictor of later-life sibling relationships. Specifically, adults who experienced sibling violence and their mother’s and/or father’s abuse in childhood showed significantly lower perceived closeness and similarity in outlook with their siblings in adulthood than those who did not experience violence. Our findings suggest that childhood exposure to family violence may have a long-term negative impact on the emotional aspect of sibling relationships. Future research may explore how the impact of childhood adversity on sibling relationships affects other aspects of adult lives, such as individual well-being or caregiving for aging parents.
Patient Portal Use Near the End-of-Life
Authors: Portz Jennifer , Powers John David , Baldwin Megan , Bekelman David , Casillas Alejandra , Kutner Jean , Bayliss Elizabeth
Published: December 2021

Use of patient portals, personal health information websites linked to electronic health records, in seriously ill populations is unknown, as is use by caregivers. We described portal use patterns among adults with serious illness nearing end-of-life and their caregivers within Kaiser Permanente Colorado. Inclusion criteria were: 1) seriously ill patients (defined by KP’s “Care Group”), □18 years of age, who were registered for the portal, and died between 1/1/2016-6/30/2019; and 2) caregivers of these patients, □18 years of age, registered for a proxy account. Data included user characteristics and portal use metrics summarized monthly over the 12-month period prior to death. Models included an unadjusted linear trend of the days used by month using a generalized estimating equation Poisson model with a log link and an autoregressive correlation structure of order 1. We identified 6,517 seriously ill patients with portal registrations; 163 of these patients had proxy caregivers. Patient users were 77 years old, mostly frail and White, and caregivers were predominantly female. Average days of use among patients was 42.4 days and <1 day among their caregivers. Number of days used significantly increased by 0.7% per month from twelve months to one month prior to death (95% CI: 0.4%-1.0%; p-value <.0001) and peaked 3 months prior to the patient’s death. Average use was high in comparison to previous portal research and suggests that as the patient approaches death portal use increases. Future research should explore how portals may serve as indicators for identifying and addressing end-of-life care needs.
Predictors of ACP competency among Chaplains by Service Line
Authors: Cho Soyeon , Kwak Jung , Hughes Brian , Hands George , Lee Moon
Published: December 2021

Healthcare chaplains have key roles in palliative care including facilitating advance care planning (ACP). However, little is known about chaplains’ competency in ACP. We conducted an online survey with board-certified healthcare chaplains recruited from three major professional chaplains’ organizations. We explored correlates of chaplains’ competency in ACP facilitation among two groups of chaplains, general and special care (SC) chaplains (chaplains in oncology, intensive care, or palliative units) because SC chaplains are generally more involved in palliative care. The final sample included 481 chaplains with 89.8% reporting ACP as an important part of their work and 71.3% reporting to help patients complete advance directives. There was no significant difference in ACP competency between general chaplain group (n=240; M=39.61, SD=7.0) and SC chaplain group (n=241; M=40.65, SD=5.87). Hierarchical regression analyses revealed differences between the groups. General chaplains who practiced longer as a chaplain (b=1.02, p<.000), were more engaged in ACP facilitation (b=1.06, p<.05), had more positive attitude toward ACP (b=4.04, p<.000), and reported a higher level of participation in shared decision-making with other team members (b=.75, p<.000) were more competent in ACP facilitation. In the SC chaplain group, higher competency was associated with more positive attitude towards ACP (b=2.58, p <.05), and a higher level of participation in shared decision-making (b=1.05, p <.000). Overall, these findings suggest that healthcare chaplains, both general and special care, are competent and actively involved in ACP facilitation. Further systematic studies are warranted to examine the effects of chaplains facilitating ACP on patient and healthcare system outcomes.
Till Death Do Us Part?: Exploring the Influence of Deceased Romantic Partners on the Lives of Older Women
Authors: Hackett Sara
Published: December 2021

Recent research integrating the hierarchical mapping technique (HMT) and the continuing bonds framework has suggested that deceased individuals may be influential social convoy members. Building off this pilot work, the current qualitative descriptive study focused on how older women viewed the role of a longstanding deceased romantic partner in their current social network. Twenty women (Mean age = 78 years), recruited via social media and snowball sampling, participated in one 90-minute semi-structured interview. Each discussed their bereavement journey and completed a HMT diagram to comment on their social network and the presence or absence of the deceased within it. Nineteen participants described the deceased as being an active member of their convoy. Interestingly, 15 women placed them within the innermost circle of the diagram, separate from their other network members. Thematic analysis of interview transcripts expanded upon the HMT diagram exercise to reveal five major themes: “We’re part of each other,” “I think he supports me,” “He would want me to be happy,” “I just feel so grateful,” and “I think about him every day but I don’t talk about him every day". Perceptions that deceased romantic partners continue to play a key role in participants' lives offers researchers and practitioners with a unique opportunity to examine how losses are experienced and carried into old age. Further, this study may assist with the development of interventions that help support bereaved individuals, specifically, interventions that focus on destigmatizing continuing bond expressions and provide assistance with communicating memorialization preferences.
Decreasing Barriers to Care: Voices of Riders, Drivers, and Staff of a Rural Transportation Program
Authors: Schwartz Abby , Richman Alice , Scott Mallary , Liu Haiyong , White Weyling , Doherty Caroline
Published: December 2021

Eastern North Carolina (eNC) is a rural, poor, and underserved region of the state with 1 in 5 adults living below the poverty level. Residents experience health disparities driven by limited access to healthcare and inequitable distribution of social determinants of health. Project TRIP (Transporting Residents with Innovative Practices) is a potential solution to barriers in accessing care in eNC. Results presented include the first phase of a multi-phase study evaluating and replicating TRIP’s effectiveness. Data from qualitative interviews with TRIP riders, drivers, and staff (e.g., case managers) will be presented (n= 20). As a result of the COVID-19 pandemic, interviews were conducted by telephone with the goal of understanding both strengths and weaknesses of the transportation program from riders, drivers, and staff to gain a holistic understanding of TRIP. Of the riders interviewed, the majority (91%) were age 50 and over and African American. Themes that emerged from the data that highlighted strengths of the program included: improved health outcomes, no wait times for pick up or drop offs, cost free, and accommodating service. Themes related to areas of weaknesses or improvement included: needing more transportation vendors and a dedicated TRIP case manager and scheduling concerns. The presentation will conclude with considerations in translating the findings into a pilot and expansion of TRIP in another eNC county (study phases 2 & 3), and how the data can inform the development of transportation interventions in other states, with the goal of increasing access to healthcare for vulnerable rural populations.
Cognition and Subjective Age Predict Physical Activity Engagement: A Longitudinal Study of Impaired Older Adults
Authors: Growney Claire , Zhu Xianghe , Neupert Shevaun
Published: December 2021

Physical activity is an important factor in preventing or slowing cognitive decline. However, the predictors of fluctuations in physical activity in a population that is already experiencing cognitive impairment is not well understood. Subjective age, such as how old one feels, has been tied to many health indicators in cognitively intact populations. Thus, we focused on the within-person associations between subjective age and physical activity as they unfold over time within a sample of cognitively impaired participants. The current study examined 400 reports from measurement burst data consisting of 5 weekly surveys conducted twice across 6 months from 68 cognitively impaired participants (M age = 70.14 (6.63), range = 60-92). Participants completed a battery of cognitive tests at baseline. At each weekly assessment, participants reported on their physical activity (e.g., exercise, outdoor, flexibility, and strength activities; Yes/No) and subjective age with respect to how old they feel overall and how old they feel mentally. There were longitudinal decreases in physical activity across the bursts, but on occasions when participants felt younger overall or younger mentally there were increases in physical activity. In addition, the effects of mental subjective age depended on cognitive ability, with those scoring lower in cognitive ability appearing to benefit the most from decreases (feeling younger) in mental subjective age. These findings suggest that perceptions of aging, especially within the domain of mental age, are tied to physical activity engagement for older adults with cognitive impairment.
The Inventory of Physical Activity Barriers for Adults 50 Years and Older: Refinement and Validation
Authors: Wingood Mariana , Jones Salene , Gell Nancy , Peters Denise , Brach Jennifer
Published: December 2021

Addressing physical activity (PA) barriers is an essential component of increasing PA among the 56-73% of community-dwelling adults 50 years and older who are not performing the recommended 150 minutes of moderate-to-vigorous PA. As there is no feasible, multi-factorial tool to assess PA barriers among this population, we developed and validated a PA barrier assessment tool called the Inventory of Physical Activity Barriers (IPAB). We collected cross-sectional data on 503 adults (mean age 70.1), with 79 participants completing the scale twice for test-retest reliability and 64 completing a cross-over design examining the ability to use two administration formats interchangeably. Our analyses consisted of exploratory and confirmatory factor analysis, Cronbach alpha, intraclass correlation coefficient, Bland-Altman Plot, and t-tests. Using factor analysis, we identified and confirmed an eight-factor solution consisting of 27 items. The 27-item IPAB is internally consistent (alpha= 0.91), has a high test-retest reliability (intraclass correlation coefficient=0.99), and can differentiate between individuals who meet the recommended levels of PA and those who do not (p < 0.001). The IPAB scores ranged between 1.00-3.11 for the paper format (mean=1.78) and 1.07-3.48 for the electronic format (mean=1.78), with no statistical difference between the paper and electronic administration formats (p=0.94), resulting in the conclusion that the two administration formats can be used interchangeably. Participant feedback illustrates that the IPAB is easy to use, has clear instruction, and is an appropriate length. The newly validated IPAB scale can be used to develop individualized PA interventions that address PA barriers among patients 50 years and older.
Descriptive Epidemiology of Fall-Related Injuries Among Older Adults in Ontario, Canada
Authors: Lappan Nicolette , Zecevic Aleksandra , Ming Yu , Hunter Susan , Johnson Andrew
Published: December 2021

The number of older adults is growing rapidly in the province of Ontario meaning there will be more fall-related injuries (FRIs) in coming decades. Falls are the leading cause of injury-related hospitalizations in Canada. The purpose of this study was to describe the prevalence, circumstances, types, and locations of FRIs among older adults in Ontario. Using a population-based retrospective design, we analyzed secondary data from three health administrative databases (NACRS, DAD, RPDB) for 2010-2014. Older adults (≥ 65 years) admitted to an emergency department (ED) with a combined diagnosis of ICD-10-CA codes for a fall (W00-W19) and injury (S00-S99 or T00-T14) were selected. Descriptive statistics were performed in R and rates were reported per 100,000 population. There were 304,610 FRI ED admissions (3,089/100,000) and 143,210 patients (47.0%) were subsequently hospitalized (1,452/100,000). Females accounted for 63.0% ED and 61.2% hospital admissions. Age-specific rates increased with age at both ED (2,208/100,000 in 65-69 group, 6,552/100,000 in 90+ years old) and hospital (698/100,000 in 65-69 group, 4,364/100,000 in 90+ years old). Females had higher rates of ED (3,503 vs. 2,572/100,000) and hospital (1,598 vs. 1,270/100,000) admissions than males. The most common injury types at the ED were fractures (1,234/100,000), superficial injuries (719/100,000), other or unspecified injuries (572/100,000), open wounds (498/100,000), and sprains, strains, and tears (162/100,000). FRIs are a considerable problem for older adults and better injury prevention strategies are needed for all female age groups, the 90+ year age group of both genders, and fractures.
Depressive Cognitions Impact On A Latent Growth Curve Model Of Depressive Symptoms In Caregiving Grandmothers
Authors: Burant Christopher , Musil Carol , Zauszniewski Jaclene , Jeanblanc Alexandra
Published: December 2021

Grandmothers caring for grandchildren have elevated levels of depressive symptoms compared to grandmothers who do not provide care. While the CES-D measures the somatic, positive and negative affect, and interpersonal strain symptoms experienced with depression, the Depressive CognitionScale © captures the change in cognitive thinking that often precedes depression. Depressive symptoms, on the other hand, are state like in nature and describe depressive symptoms that have happened recently. While depressive cognitions, according to Beck’s theory of depression, are the first negative thought processes to appear, these typically lead to other, more serious symptoms of depression. Specifically, depressive cognitions reflect negative thinking patterns and not depression. Data were collected on 343 participants in a longitudinal nationwide online research study of caregiving grandmothers. A latent growth curve model was used to track the trajectory of depressive symptoms at four time points (baseline, 2 weeks, 12 weeks, and 24 weeks). As depressive cognitions are the precursor to the development of depressive symptoms, a latent growth curve model was tested to gain an understanding of how depressive cognitions impacts the trajectory of depressive symptoms over time. The model fit the data well (Chi Square=21.025; df=9; p=.013; TLI=.976; CFI=.985; RMSEA=.063). Baseline depressive cognitions had a strong impact on the intercept (Standardized Beta=.76, p<.001) and the slope of depressive symptoms (Standardized Beta=-.67, p<.001). The continued impact of depressive cognitions over 24 weeks indicates the need for potential interventions to further address depressive cognitions as a way to decrease depressive symptoms in grandmother caregivers.
Development of a New Measure of Intergenerational Contact
Authors: Hooker Karen , Turner Shelbie , Jarrott Shannon , Geldhof John
Published: December 2021

Intergenerational relationships are a predictor of greater physical, mental, and emotional well-being; they can reduce ageism and facilitate feelings of purpose and meaning, shown to be important for health and mortality. Surprisingly there are no measures of intergenerational contact (IGC) shown to be reliable and valid across age groups. Therefore, we aimed to develop a psychometrically sound survey measure of IGC. We utilized a three-phase development process, which included a Delphi-style expert panel review of items, focus groups, and validation of the survey via Amazon MTurk. The resulting 18-item survey captures details on and comparisons between both familial and non-familial contact and is appropriate for adults of all ages. We conducted confirmatory factor analyses with the 9-item family and 9-item non-family subscales for 380 young and 256 middle-aged adults reporting on contact with older adults, and 348 older adults reporting on contact with younger adults. The family scale had good model fit across all three groups (χ2 (78) = 245.74, p<.0001; RMSEA = 0.08, 90% CI = [0.07, 0.10]; CFI = .94; TLI = .92). After covarying for 2 pairs of items among the middle-age group, the non-family scale had good model fit across all groups (χ2(75) = 217.21, p<.0001; RMSEA = 0.08, 90% CI = [0.07, 0.09]; CFI = .95; TLI = .93), indicating construct equivalence across age groups. The new IGC measure can be used in all adult age groups, making it useful for scientific projects as well as program evaluations. Funded by the RRF Foundation on Aging
Intergenerational Strain and Subjective Well-being: The Role of Leisure Activity Engagement
Authors: Collins Amanda , Stokes Jeffrey , Dugan Elizabeth
Published: December 2021

Family strain is associated with higher numbers of depressive symptoms and lower levels of life satisfaction. Leisure activities are observed to buffer the negative effects of family strain among younger adults, however, this phenomenon is understudied among older adults. This study examines the relationship between intergenerational strain and depressive symptoms and life satisfaction among persons aged 50 and older. The study also examines the moderating effects of gender and leisure activities. The analysis uses the Health and Retirement Study to addresses these questions. The results suggest that intergenerational strain (p=.000) and being female (p.=000), are associated with more depressive symptoms, while engagement in social leisure activities (p.=04) is associated with fewer. Intergenerational strain (p=.000) and being female (p=.03) are associated with lower levels of life satisfaction, while engagement in solitary (p=.000) and social leisure activities (p=.000) are associated with higher levels. Results from moderation models suggest that as intergenerational strain increases, women have lower life satisfaction and more depressive symptoms as compared to men (p=.000). Also, the association between intergenerational strain and life satisfaction is reduced among respondents who engaged in leisure activities (p=.002-social and p=.000-solitary). Further, the positive relationship between intergeneration strain and depressive symptoms is lower for persons who engage in leisure activities (p=.027-solitary and p=.013-social). Finally, women who engage in social and solitary leisure activities have fewer depressive symptoms than men (p=.037). The study findings imply that the subjective well-being of older persons may be improved in terms of intergeneration strain if they engage in leisure activities.
The Costs of Concern: Health Implications of Worries about Aging Parents and Adult Children
Authors: Cichy Kelly , Koumoutzis Athena
Published: December 2021

As their parents age and their children enter adulthood, midlife adults need to manage their worries and concerns about both generations. In midlife, worries about aging parents’ health and emerging needs for support co-occur alongside worries about adult children’s relationships and prolonged need for support. Research reveals links between midlife adults’ worry and sleep quality, underscoring how worries compromise health and well-being. In addition to compromising sleep, worries may also contribute to poor health behaviors, such as emotional eating. Emotional eating, where individuals eat in response to stressors and negative emotions, is a significant risk factor for overeating and obesity. Less is known; however, about how midlife adults’ worries contribute to poor health behaviors. To address this gap, the current study considers how midlife adults’ concurrent and previous day’s daily worries about aging parents and adult children are associated with daily well-being and health behaviors. Respondents are midlife adults (40-60 years) from Wave II of the Family Exchanges Study (Fingerman et al., 2009). During 7 days of daily telephone interviews, respondents indicated if they worried about their adult children and their aging parent(s), if they ate food for comfort, and their daily negative mood. Controlling for demographics, on days when midlife adults worried about their adult child(ren), they reported more negative emotions than on days without these worries (p <.05). Respondents engaged in more eating for comfort the day after they reported worrying about their mother (p < .05). Implications for aging families will be discussed.
The Impact of Living Arrangements and Intergenerational Support on the Health Status of Older People in China
Authors: Yang Yazhen , Evandrou Maria , Vlachantoni Athina
Published: December 2021

Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people’s living arrangements and intergenerational support provision/ receipt on their physical and psychological wellbeing, focusing on rural/ urban differences. The results show that receiving economic support from one’s adult children was a stronger predictor for higher life satisfaction among older rural residents compared to those in urban areas, while grandchild care provision was an important determinant for poor life satisfaction only for older urban residents. Receiving informal care from one’s adult children was associated with a poor (I)ADL functional status and with depressive symptoms among older rural people. Meanwhile, having weekly in-person and distant contact reduced the risk of depression among older people in both rural and urban areas. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological well-being of urban older residents, such as with the early diagnosis of depression.
Role-reversals in Caregiving: Case Studies of Two Women Living With Late Stage Cancer
Authors: Reel Candice , Williams J Hunter , Brennan Emma , Williams Jonna , Payne Kristen , Allen Rebecca
Published: December 2021

Many studies have examined the effects of caregiving burden and many others have focused on the effects of having a caregiver (Haynes-Lewis et al., 2018; Trevino, Prigerson, & Maciejewski, 2018; Semere et al., 2020). However, there is little data on the experience of role reversal, once responsible for caring for others and now being cared for while living with cancer. This project aims to identify ways in which women living with cancer cope with the internal struggles of receiving care. The current project is a case study of two females, one age 67, NHW, with a breast cancer diagnosis and one age 60, Black, with an ovarian cancer diagnosis, who once were caregivers and are now being cared for by family. Two semi-structured interviews were conducted that were approximately 60 minutes each. The study data are from a larger project focused on the self-perception of older women with late-stage cancer. Four independent researchers used thematic analysis to uncover common themes of coping between the two women receiving care. The themes uncovered were acceptance of the loss of autonomy, positive death attitudes, good relationships with their caregivers, and religiosity were identified and coded as coping strategies. The qualitative data showed that the use of these coping strategies helped the women be more accepting to care with less internal conflict. Future research should focus on generalizing these findings on a larger sample and use the data to help cancer patients better accept care from others.
Exhausted and trapped in isolation. Caring for a spouse with dementia during the Covid-19 pandemic
Authors: Hammar Lena , Johansson Marcus , Dahlberg Lena , McKee Kevin J , Summer-Meranius Martina
Published: December 2021

Even before the Covid-19 pandemic, spouse carers of persons with dementia (PwDs) found their care responsibilities overwhelming and had little time to focus on their own lives. To minimize the risk of being infected with Covid-19, older persons are recommended to self-isolate in their homes, while formal support such as respite care and day care centers are withdrawn. This study involved semi-structured interviews with 24 spouse carers of community-living PwDs, with the aim of describing their situation during the pandemic. The interviews were analyzed with qualitative content analysis. Results revealed that they commonly declined help because of the perceived risk of their spouse being infected with Covid-19 and thus also possibly causing their death. They described feelings of being trapped in their situation, as they experienced having no choice than take all responsibility for the care of their partner themselves, with cost of being unable to take necessary breaks. This was described as making an already strained situation almost unbearable, which led to conflicts with their partner. However, the spouses also described positive aspects due to strategic changes in health and social care provision to prevent the spread of the virus, such as greater staff continuity in home care services, and patient transportation service. These made the PwD less stressed and influenced their everyday life positively. It could be concluded that the extent burden during the Covid-19 pandemic calls for extensive development of tailored support to better tackle the rapid changes that can occur in a society.
Patient and Caregiver Symptom Trajectory: The Last 2 Months of Cancer Home Hospice
Authors: Reblin Maija , Iacob Eli , Tay Djin , Jones Miranda , Cloyes Kristin , Beck Anna , Mooney Kathi , Ellington Lee
Published: December 2021

Patient symptom management is a fundamental goal of cancer home hospice care. However, informal family caregivers, who are primarily responsible for daily patient care, also experience negative symptoms, especially at the end of the patient’s life. While research has attended to patient symptom progression in home hospice, little research focuses on caregiver symptoms. To address this, we examined the frequency of both patient and caregiver symptoms to determine how these symptoms change in the last two months of the patient’s life. Sixty-three cancer hospice caregivers from 4 US states prospectively reported daily patient and caregiver symptoms via an Interactive Voice Response phone system. We analyzed data from up to the last 60 days of the patient’s life. Most caregivers were female (71.4%), Caucasian (88.9%), spouses of the patient (46%); average age was 59 years old (SD=13). Patients were mostly female (54%), with diverse solid tumor cancer diagnoses, and 72 years old (SD=11) on average. Most commonly reported moderate-to-severe patient symptoms were fatigue (67%), pain (47.5%), and loss in appetite (42.3%). Most common moderate-to-severe caregiver symptoms were fatigue (57.8%), trouble sleeping (45.1%), anxiety (52%), and depression (40.4%). Patient and caregiver symptoms were significantly correlated (Pearson r = .51, p<.001). Mixed-effects models found that both patient and caregiver symptoms (collapsed by week) worsened as patient death approached (ps <.01). Researchers and clinicians who are aware of the strong relationship between patient and caregiver symptoms are best able to address caregiver symptoms as part of hospice care, particularly as patient death approaches.
Testing Predictive Factors of Depressive Symptoms among Grandparents under the COVID-19 Pandemic
Authors: Jiao Yuqin , Fruhauf Christine
Published: December 2021

An estimated 69.5 million Americans are reported to be grandparents. Among them, about 10% are raising grandchildren and the number of grandparents who are raising grandchildren (GRG) is increasing. Previous research on GRG suggests that the unexpected caregiving duties may lead to negative physical and mental health including more depressive symptoms when compared to non-caregiving grandparents (NGRG). Additionally, grandparent-grandchild relationships determined by emotional availability (EA) of the grandparent may be impacted. These factors might further be complicated, especially as it relates to the health and well-being of GRG, as a result of the COVID-19 pandemic. Thus, the overarching goal of this presentation is to use the biopsychosocial model to present a conceptual framework to test the mental well-being of GRG during the COVID-19 pandemic. In this presentation, we will 1) summarize appropriate literature on GRG; 2) share a COVID-19 health and well-being assessment survey designated for GRG in order to assess their health before and since the COVID pandemic; and 3) propose a conceptual model to investigate and test the protective role of physical activity and GRG’s EA in the grandparent-grandchild relationship for the mental health of GRG. In our model, we argue that GRG experience more COVID-19 pandemic-related stress and more depressive symptoms when compared to NGRG. This proposed conceptual model offers one way to test the predictors of depressive symptoms on GRG. Future testing has the potential to shed new light on the development of appropriate intervention programs tailored to maintain the mental health of GRG.
Use of Actigraphy on sleep outcomes for dementia family caregivers: an integrative review
Authors: Ju Eunae , Pinto Melissa , Lee Jung-Ah
Published: December 2021

Sleep difficulties are one of the foremost health problems that affect family caregivers of dementia patients increasing their risk for a host of mental health problems and hastening dementia patients’ transitions to long-term care facilities. This integrative review aims to describe the objective measurement of sleep quality parameters of family caregivers using actigraphy and how well they are associated with self-reported subjective measures of sleep outcomes and psychological states. A search was performed using PubMed, CINAHL, and PsycInfo including articles from 2011 to 2020. Twenty studies met the inclusion criteria. Five sleep interventions (2 RCTs and 3 pre-post design) were found, including multi-component interventions (e.g., sleep hygiene, walking, day-time light therapy) that used actigraphy and other self-report measures. Duration of wearing actigraphy (wrist band/watch) varied in studies (3-days to 8-weeks). Most studies reported high accuracy and sensitivity of actigraphy. Sleep parameters measured by actigraphy included ‘total sleep time’, ‘sleep efficiency’, ‘deep/light sleep’, or ‘wake time after sleep onset’. In eight studies, sleep parameters measured by actigraphy were significantly associated with sleep outcomes measured by sleep related self-reported scales (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, all Ps<.05). Eleven studies used actigraphy to examine sleep measures associated with various mental health states (depression, burden, stress, positive/negative affect) and found significant relationships (All Ps <.05). Findings support that use of actigraphy for dementia family caregivers is a valid measure of sleep parameters when compared with their sleep self-reports. Furthermore, it was found that actigraphy sleep measures were significantly associated with psychological outcomes.
Examining Physical and Social Environments of Korean American Family Caregivers of Persons Living with Dementia
Authors: Lee Kathy , Shuffler Jon , Shin Hye-Won , Grill Joshua , Seo Chang Hyun , Miyawaki Christina
Published: December 2021

Introduction: East Asian Americans are considered a hard-to-reach population in the field. Existing resources are not inclusive of Korean family caregivers, and therefore, a community support system may be required for this ethnic group. Methods: We conducted a telephone-based survey and in-depth interview with Korean family caregivers of persons with dementia (N=36; Mean age: 63.3) to examine their physical and social environments. Results: Most caregivers (58%) co-resided with their care recipients. Those providing care with limited assistance from others showed greater financial hardship (p=0.03) and interference with employment (p=0.03). Job interference was further related to higher levels of caregiving burdens (p=0.01). The services used most were senior center services (25%) and in-home care services (17%), while desired services included health promotion and disease prevention services (50%) and culturally appropriate or medically tailored home-delivered meals services (31%). Caregivers socialized with others using a multi-messaging app (i.e., KakaoTalk) with others. About 74% of them addressed they used KakaoTalk always (52%) or often (22%), and nearly half of them (47%) said they searched for caregiving information online. Findings from our qualitative interviews confirmed positive attitude toward the use of technology. Korean family caregivers showed a lack of knowledge of not only existing community-based resources but also the disease-related information, particularly regarding early-stage support and home safety. Conclusion: It is critical to develop a community education program that reflects their unique physical and social environment conditions, potentially through technologically delivered interventions, for outreach and engagement for Korean family caregivers of persons with dementia.
Family Caregiving and Depression among Older Adults in Japan: A Cross-Sectional Study during the COVID-19 Pandemic
Authors: Noguchi Taiji , Hayashi Takahiro , Kubo Yuta , Tomiyama Naoki , Ochi Akira , Hayashi Hiroyuki
Published: December 2021

COVID-19 infections are particularly lethal in older adults; thus, social activities of older adults and their families in the community have been restricted. The threat of infection, restrictions on social activities, and limitations on the provision of care services for older adults could increase family caregivers’ burden and impact their mental health. This cross-sectional study examined the association between family caregiving and change in depression during the COVID-19 pandemic. In October 2020, we conducted a mailed questionnaire survey on a random sample of functionally independent community-dwelling older adults in a semi-urban area of Japan. Based on the depression status between March and October 2020, participants were classified into four groups: “consistently non-depressed,” “depression onset,” “recovering from depression,” and “remained depressed.” Participants were assessed for providing care for their family members or not. Caregiver participants were also assessed on their caregiving role (primary or secondary), the severity of their care-recipient’s needs, and an increased caregiver burden. Data from 957 older adults were analyzed. The participants’ mean age (SD) was 80.8 (4.8) years, and 53.5% were female. Multivariable multinomial logistic regression analysis revealed that family caregiving was associated with depression onset (OR=3.17 [95%CI=1.57-6.40], p=0.001) and remaining depressed (2.53 [1.36-4.71], p=0.004). Particularly, primary caregivers, those providing care for family members with severer care need-levels, and those with an increased caregiver burden had a higher risk of depression onset and remaining depressed. Family caregivers could have severe mental health conditions during the pandemic. Developing a support system is essential to protect their mental health.
Pivoting during the pandemic: A case study of the Senior Companion Program Plus
Authors: Fields Noelle , Xu Ling , Roark Erin , Sundar Sruthi , Williams Ishan , Gaugler Joseph
Published: December 2021

Introduction: Growing research supports the use of older volunteers to provide respite and community-based assistance to persons with ADRD and their caregivers. This study explores the impact of COVID-19 on a face-to-face, peer-led psychoeducational intervention for African American ADRD family caregivers, the Senior Companion Program Plus (SCP-Plus), and its subsequent need to ‘pivot’ during the pandemic. Method: The SCP-Plus was a randomized control trial across three states that assessed program impact on ADRD family caregiver stress/burden, coping, and social support. In spring 2020, the SCP-Plus intervention was halted because of the potential risk to participants due to COVID-19 (n = 20 enrolled dyads). In an effort to maintain rapport and trust, critical to retention in research studies, team members began weekly (March-April) and then bi-weekly calls (May-December) for the purpose of providing a social check-in and to provide updates on the status of the intervention. Results: A total of 396 calls lasting approximately 10 minutes each were completed. Participants shared concerns around safety, access to food/supplies/masks/testing, feelings of stress and loss, concern for others, and the importance of technology as a means of social connection. Although the intervention aspect of the SCP-Plus ultimately ended due to COVID-19, information gleaned from these check-ins were used to pivot the study. The study moved forward by using a descriptive phenomenological approach to capture dyads’ lived experiences during COVID-19. Discussion: Overall, purposeful participant engagement through weekly/bi-weekly phone calls suggests that this is a promising strategy for participant retention as well as for pivoting research.