bluuebunny/crossref_metadata_2025 huggingface dataset:
INVOLVING COMMUNITY GOVERNMENTAL ORGANIZATIONS IN THE ESTABLISHMENT OF DEMENTIA-FRIENDLY COMMUNITIES IN BEIJING
Authors: Liu Yu , Zhao Hexin , Guo Hong
Published: November 2019

China has about 20% of the world’s total dementia population. Since most elders with dementia are living at home with care by family members, communities are fundamental support resources for families as well as patients. Dementia-friendly community initiatives aim to empower families with dementia and increase their social inclusion. Within the Chinese political context, the community level governmental organization called Ju-wei-hui has played a key role in community engagement. Within this context, a Community Based Participatory Action Research (CBPAR) process is utilized to increase public awareness on dementia and caring strategies. Our team collaborated with 15 Ju-wei-hui offices across Beijing to design a series of courses and teaching modules together. Five hundred community residents participated and positively evaluated the project. A major finding is that CBPAR could be an effective strategy to develop dementia-friendly communities across China.
PAIN, PAIN MANAGEMENT, AND CONSEQUENCES OF PAIN AMONG HOSPITALIZED PERSONS WITH DEMENTIA
Authors: Arendacs Rachel , Boltz Marie , Kuzmik Ashley , Resnick Barbara
Published: November 2019

The purpose of this study was to describe the incidence, management and impact of pain on behavior and delirium in hospitalized older adults living with dementia. This was a descriptive study using baseline data from patients in the first cohort of the Fam-FFC study which evaluates the impact of a family-engaged function-focused care intervention in hospitalized patients with dementia. The majority of the sample was female (70%) and black (80%) with a mean age of 82.5 (SD=8.9). Pain (PAINAD) was reported by 36% of the patients; 42% of those demonstrating pain were prescribed analgesics. Controlling for age, gender and baseline cognition, pain was significantly associated with behavioral and psychiatric symptoms of dementia ( t =2.1, p= .034) and delirium severity (t = 4.9, p<.0001). Results suggest the need for pain assessment and individualized treatment plans to promote comfort and decrease behavioral and delirium symptoms in hospitalized persons with dementia.
GERIATRICS MICU CO-MANAGEMENT: INTEGRATING GERIATRIC ASSESSMENTS FOR CRITICALLY ILL PATIENTS
Authors: Gnanasekaran Gowrishankar , Mireles-Cabodevila Eduardo
Published: November 2019

Programs like orthogeriatrics, geriatric cardiology have shown to improve outcomes in hospitalized geriatric patients. Our Geriatrics MICU Co-management program is a quality improvement initiative that instigates a partnership approach with critical care medicine in integrating geriatric assessments and build foundation for interdisciplinary care of critically ill patients. MICU (Medical Intensive Care Unit) protocols do not have standard geriatrics assessments integrated in clinical care. An electronic dash-board identifies high risk elderly (HRE) patients admitted at a MICU in a large teaching hospital in Northeast Ohio based on nursing specific screening triggers. A geriatrics co-management team engages in a comprehensive geriatric assessments and care transition. 386 patient were identified using HRE screening triggers in a period of 100 days. 33 % (n=131) were generated as consults for co-management. A pilot review on 131 HRE patients was conducted. 70% (n=93) patients had incident frailty. 93% (n=87) of patients with frailty were diagnosed with incident delirium. 56% (n=74) of patients were newly diagnosed with cognitive impairment. 56 % (N=74) of patients had a medication reduction. An average of 1.23 medication was changed. 85% (n =112) of patients had a warm hand off to the next level of provider on discharge. 90% (n=119) of patients notified improved self-management skills and better understanding of discharge process. The Geri-MICU program demonstrates a patient -centered approach in integrating geriatric assessments for critically ill patients and build foundation of a geriatrics-critical care task force. The program would be a mile stone in optimizing elderly care in critical care units.
THE PRICE OF DEMENTIA: POLICY STRATEGIES TO NARROW HEALTH DISPARITY GAPS, REDUCE COSTS, AND IMPROVE QUALITY OF LIFE
Authors: Super Nora , Ahuja Rajiv , Proff Kevin
Published: November 2019

Historically, a diagnosis of Alzheimer’s disease and related dementias (ADRDs) created a sense of hopelessness among those diagnosed, their families, and physicians. The misperception that there is no available medical treatment or interventions inhibited patients from receiving cognitive assessments or exploring home- and community-based interventions that could improve quality of life. Today, researchers have developed evidence-based pathways to improve brain health, reduce dementia risk, and enhance lifelong cognitive function. This report highlights recent scientific advancements focused on medical and lifestyle interventions that reduce the risk of ADRDs and slow the disease progression. To improve the current system and reduce the risk of dementia and improve brain health, the following policy areas are recommended: 1) promote brain health strategies to delay onset and reduce the stigma associated with cognitive decline; 2) increase early detection and cognitive screening efforts; 3) build a dementia-capable workforce; 4) create seamless transitions from health systems to community-based services to better support those with dementia; 5) improve caregiver training and support; and 6) increase funding for research related to ADRDs. Understanding that ADRDs disproportionately impact certain populations, these policy recommendations include strategies to narrow health disparities. Previous Milken Institute research highlighted the disproportionate health impacts of dementia on women, which costs the economy trillions of dollars. This report expands on that analyses and stratifies the data by race and income as well. Ensuring that these policy recommendations address disproportionately impacted groups will benefit the broader healthcare system and alleviate the burden felt by all patients and families.
A PILOT STUDY TO TEST METHODS FOR DATA COLLECTION ON NURSES CARING FOR RESIDENTS WITH DEMENTIA IN THE NURSING HOME
Authors: Perkins Rebekah , Cashdan Elizabeth , Supiano Katherine
Published: November 2019

Nurses draw from their experiences and intuition to detect changes in patient condition, patterns of patient behaviors, and evidence of distress. In the nursing home setting, nurses care for residents with dementia and manage challenging behavioral and psychological symptoms of dementia (BPSD), and may rely on informed intuition to assess and capably respond to such behaviors. To date, no observational method has been developed to discern nurse-resident interactions that identify expert nurses who effectively address BPSD. It is not known if or how nurses in this setting use intuition to make clinical judgments and decisions to manage BPSD events. Using an ethogram approach, we developed an observational tool and spot interview method to discern BPSD events, background and proximal factors and nurse responses to BPSD. Pilot observations took place over three nursing shifts to identify nurse-resident interactions during BPSD events using the observation tool. Nurse-resident interactions were followed by spot interviews with each nurse to clarify their responses to BPSD. Semi-structured interviews were conducted with nurse participants to further develop an interview guide and identify elements of nurse intuition. The pilot study affirmed the feasibility of gaining access to facilities with residents with BPSD, of nurse comfort with field observation and interviews, and established preliminary construct validity of the “expert nurse.” Verification of the utility of this observation and interview method permit further examination of effective nurse engagement with nursing home residents with BPSD, informs our understanding of nurse intuition and permits further exploration of the broader context of BPSD.
MOVING PICTURES: RAISING AWARENESS OF DEMENTIA IN CALD COMMUNITIES THROUGH MULTIMEDIA
Authors: Brijnath Bianca , Antoniades Josefine , Adams Jon , Browning Collette , Goeman Dianne , Ellis Katie , Kent Mike
Published: November 2019

Limited awareness of dementia in people from culturally and linguistically diverse (CALD) backgrounds often results in delayed diagnosis, poorer prognosis, and a higher burden of care on families and health systems. Given the rapidly ageing and multicultural populations in migrant-receiving countries such as Australia and the United States, this disparity needs to be addressed urgently. This project aimed to inform and educate people from five linguistically diverse backgrounds – Hindi, Tamil, Mandarin, Cantonese, and Arabic – about dementia. A mixed methods, multimedia design comprising video-interviews with 76 participants including carers from the five language groups and key service providers was employed. Data were gathered nationally across Australia in 2018 and thematically analysed. Data were used to co-produce 15 short films, comics, and a mobile-optimised website from which data analytics were measured. The films and comics focused on dementia detection and timely diagnosis, how to navigate the aged care system, and the importance of self-care. Analytics data is currently being collected online and via community forums. In conclusion, co-production methods in tandem with digital multimedia are fundamental to developing culturally salient interventions to address dementia disparities in CALD populations in Australia and internationally.
SKILLS AND STRATEGIES OF FACILITATORS WHO CO-CREATE DIGITAL STORIES WITH PERSONS WITH DEMENTIA
Authors: Daum Christine H , Liu Lili , Hollinda Kara , Kaufman David , Astell Arlene
Published: November 2019

Digital storytelling combines storytelling and digital tools to create brief video clips in which narrative, images, and music are embedded, in order to share personal stories. Digital storytelling facilitators can be health and social care providers as well as care partners who collaborate with persons living with dementia to co-create their stories. These facilitators elicit people’s stories and use the technology to create the digital story. Despite their important role, there is a paucity of information on facilitators’ specific skills and strategies used in working with persons living with dementia. The purpose of this project was to examine skills and strategies used by facilitators who co-create digital stories with persons living with mild dementia. Audio recordings of 70 digital storytelling co-creation sessions conducted in three Canadian cities (Edmonton, Vancouver, Toronto) were transcribed and subjected to qualitative content analysis. Regardless of their disciplinary background, facilitators acted as weavers, bringing together narrative threads to co-construct a digital story with participants. Essential communication skills and strategies included active listening, strategic questioning, being comfortable with silence, and therapeutic responding. Building relationships and collaboration were achieved through flexibility, empathy, and encouraging autonomy. To be an effective facilitator of the digital storytelling process with older adults living with dementia, facilitators must adapt their communication strategies and relational skills to the strengths and needs of the older adults with whom they are collaborating.
ATTITUDES TOWARDS AGING PERCEPTIONS OF AGING AND HEALTH OF OLDER ADULT SPOUSES
Authors: Smith Jennifer L , Bihary Joseph G , O’Connor Dugan , Basic Ajla , O'Brien Cate
Published: November 2019

Evidence suggests that negative perceptions of aging are associated with worse health outcomes. Research also shows that marital partners can mutually influence each other’s health; however, limited research has explored perceptions of aging within couples. The purpose of the current study was to examine the association between self and partner perceptions of aging and health among married older adult couples. Both members of 452 couples (average age: wives = 80.6 years, husbands = 82.7 years) completed a survey that measured perceptions of aging and health (i.e., self-reported health, healthy diet, physical functioning, stress, and physical activity). Data were analyzed using actor-partner interdependence models, and analyses were conducted separately for positive and negative perceptions of aging, controlling for self and partner’s age, depression, and chronic health conditions as well as gender and income. Consistent with previous research, analyses revealed that one’s own positive perceptions of aging were related to better health across all measures, and the opposite pattern was found for negative perceptions of aging. An examination of partner effects revealed that people reported better physical functioning and greater physical activity when their spouses had more positive perceptions of aging. Similarly, husbands reported less stress when wives had more positive perceptions of aging, but there was not a partner effect for wives. In contrast, people reported lower subjective health and less healthy diets when their spouses had more negative perceptions of aging. These findings suggest that health-promotion efforts should consider partners’ perceptions of aging as a potential resource or risk factor.
BOSTON AGING TOGETHER STUDY: ATTITUDES TOWARD OWN AGING AMONG OLDEST-OLD PARENTS AND CHILDREN
Authors: Kim Yijung K , Boerner Kathrin , Kim Kyungmin , Jopp Daniela
Published: November 2019

One consequence of modern longevity is the growing number of older adults with very old parents. While family members are often interdependent in their development and aging, less is known about how intergenerational relationships may influence individuals’ attitudes toward their own aging in later life. Using 70 dyads of oldest-old parents (Mage = 93) and their children (Mage = 67) from the Boston Aging Together Study, we examined the dyadic concordance in positive attitudes toward own aging, and how perceptions of giving and receiving care are associated with attitudes toward own aging for parents and children. On average, parents reported more negative attitudes toward own aging than did children. In less than half of all dyads (46%), both parents and children reported positive (i.e., score three or higher on a scale that ranged from one to five) attitudes toward own aging. T-test results showed that the dyads with positive attitudes toward own aging had more within-dyad age difference, better average self-rated health, fewer depressive symptoms and less loneliness than others. For children, higher level of caregiver’s burden was associated with more negative attitudes toward own aging. For parents, perception of received support was not associated with their attitudes toward own aging. This study sheds light on how both individual and family characteristics may influence individuals’ aging perceptions. Findings suggest the context of parent-child ties may particularly be relevant to those older adults who may have to deal with their own aging- related challenges as well as those of their parents.
COGNITIVE HEALTH STATUS AND GENDER DIFFERENCES IN ATTITUDES AND EMOTIONS TOWARD OLDER ADULTS
Authors: Caskie Grace , Voelkner Abigail R , Bashian Hannah M
Published: November 2019

The health and gender of older adults can elicit differing attitudes and emotions within young and middle-aged adults (Bergman & Bodner, 2015); one’s own gender may also influence these differences (Bergman & Cohen-Fridel, 2012). In this study, 287 participants (173 males, 114 females), aged 19-55 years (M=32.8), were randomly assigned to read one description of an older adult that varied cognitive health status (healthy/Alzheimer’s) and gender (male/female). Factorial MANOVAs examined differences by gender, health, and participant gender for participants’ (a) emotions about the older adult (compassion and emotional distance) and (b) negative perceptions about aging (ageist attitudes and aging anxiety). The first MANOVA found a significant main effect for health status; participants expressed more compassion (p=.013) and less emotional distance (p<.001) for the older adult with Alzheimer’s than for the healthy older adult. Also, the Target Gender X Participant Gender interaction was significant for emotional distance (p=.032), but not for compassion (p=.616); men reported more emotional distance than women for the female older adult, regardless of target health status, but men and women’s emotional distance were very similar for the male older adult. The second MANOVA showed only a significant health status main effect; ageist attitudes (p=.021), but not aging anxiety (p=.062), differed by health status of the older adult, with more ageist attitudes expressed for the healthy older adult than the older adult with Alzheimer’s. Overall, these results show that individual factors can influence young and middle-aged adults’ negative attitudes and emotions towards older adults. Implications will be discussed.
WORRIES OF OLD-AGE SUPPORT FOR PARENTS AND THEMSELVES: VIEWS FROM OLDER BACHELORS IN RURAL CHINA
Authors: Wang Ying , Liu Huijun , Wu Bei , Pei Yaolin
Published: November 2019

Due to China’s gender imbalance, it is estimated that more than 30 million adult males were unable to get married. The old-age support for older unmarried sons (so-called forced bachelors) and their parents faces a significant challenge. Using data from a survey in Central and Western rural China, the present study examined the impact of family structure and health status on the worries about old-age support for themselves and their parents from the perspective of older unmarried sons. The sample included 359 older unmarried sons with rural Hukou (housing registration) status. The age of he sample ranges from 28 to 51. The results showed that 52.64% and 54.8% of respondents were worried about their own and their parents’ old-age support, respectively. Ordered logistic regression showed that having a sister(s) was negatively related to worries about their own and parents’ old-age support. Those with living mothers had less worries than their counterparts, and those who had a brother(s) had less worries about their parents’ old age support. Moreover, having any brothers who were also older unmarried sons was positively related to worries about their own and parents’ old-age support. Older unmarried sons who had two frail old parents had more worries for their parents’ old-age support than those whose parents were physically independent. The study highlights the importance of family structure and parental health status as important factors in worries over old-age support in China.
OPTIMISM AND EXPECTATIONS REGARDING AGING AMONG YOUNG ADULTS AND OLDER ADULTS
Authors: Vleet Samuel C Van , Moore Jenna M , Edzards Sarah , Smith Leah N , Sawyer Jennifer , Coldiron Allyson M , Sandlin Allie M , Barnett Michael D
Published: November 2019

A large body of research has found that individuals’ attitudes toward aging may influence their future health. Previous research has found that age is associated with more negative expectations toward aging. However, it is possible that optimism, or generalized positive expectancies regarding future outcomes may play a role in expectations regarding aging. Optimism has been identified as a key component of successful aging. The purpose of this study was to compare expectations regarding aging among young adult and older adult age cohorts, controlling for optimism, and to investigate the differential relationships between optimism and expectations regarding aging by age cohort. Young adults (n = 130) and older adults (n = 335) completed a survey containing the Expectations Regarding Aging – 12 and the Optimism-Pessimism Scale. Results found that, after controlling for optimism, older adults endorsed more negative expectations regarding aging. Comparison of the correlation coefficients between optimism and expectations regarding aging among age cohorts found that optimism was significantly associated with expectations regarding aging among older adults but not young adults and that this difference was significant. Taken together, the results suggest that older adults have more negative expectations for aging and that optimism may play a key role in older adults’ expectations regarding aging.
ADOLESCENTS’ ATTITUDES ON GRANDPARENT INVOLVEMENT IN CHILD CARE
Authors: del Rosario Katherine E , Ferrer Raphael
Published: November 2019

This descriptive associative study focused on the attitudes of selected adolescents toward the involvement of grandparents (maternal grandmother, maternal grandfather, paternal grandmother, paternal grandfather) in childcare. Specifically, it aimed at determining the rate of closeness of these adolescents toward their own grandparents; their attitudes toward the involvement of their grandparents; and the relationship between the students’ closeness with their grandparents and their attitudes toward grandparents’ involvement. A survey was administered to 185 adolescents aged 16 to 22 from the University of the Philippines. Results showed that most of the respondents (43.38%) are either very close or close to their grandparents, especially their maternal grandmother (n = 126). The attitudes of the respondents toward grandparents’ involvement were measured by looking at their rate of agreeableness on 17 statements. Results showed that most of the respondents either agree or neither agree nor disagree (M = 2.60) on grandparents’ involvement. The correlation analysis showed a moderate to high positive linear association between MGM closeness and MGM involvement (r=.72); MGF closeness and MGF involvement (r=.74); PGM closeness and PGM involvement (r=.63); and PGF closeness and PGF involvement. This implies that perceived closeness increases with perceived involvement. The findings of this study emphasized on the role grandparents play in the lives of adolescent grandchildren. Some implications of this study with regards to future research in this field are described.
IMPACT OF FAMILY FUNCTION ON THE RELATIONSHIP BETWEEN SELF-PERCEPTION OF AGING AND STRESS IN MIDLIFE
Authors: Yeom Hyun-E , Park Eunyoung , Jung Misook
Published: November 2019

Midlife is a transitional period with considerable stress related to health changes and interpersonal responsibilities. Understanding how self-perception of aging and family function affect stress is essential to improve quality of life in midlife and beyond. The purpose of this study was to examine the association among self-perception of aging, family function, and stress with a specific focus on the interaction between self-perception of aging and family function, which affect stress in midlife Koreans. This is a cross-sectional study. Data on a convenience sample of 249 midlife Koreans (age mean= 50.6, 50.1% male) were collected through a self-administered survey and analyzed using the PROCESS macro for SPSS. Self-perception of aging was significantly related to family function (r= -.121, p=.045), and family function was related to stress (r= -.402, p<.000). Self-perception of aging was a significant predictor for stress (β= -.130, p=.008) after adjusting for age, gender, subjective health status, and chronic health problems. A significant interaction between family function and self-perception of aging on stress was found (β= -.261, p=.006), indicating that the influence of self-perception of aging on stress was different depending on family function. Self-perception of aging was a strong predictor of stress in individuals who reported poorer support from family members, but not in those who reported better support. Our findings emphasize the importance of supportive family function, which could regulate the impact of self-perception of aging on stress in midlife. Developing psycho-cognitive interventions to improve self-perception of aging and supportive interaction between family members is warranted.
IMPACT OF SELF-PERCEPTION OF AGING ON THE RELATIONSHIP BETWEEN HEALTHY BEHAVIOR, STRESS, AND HEALTH IN MIDLIFE
Authors: Yeom Hyun-E , Park Eunyoung , Jung Misook
Published: November 2019

Self-perception of aging may affect the interpretation of health-related changes that influence behaviors. Understanding how self-perception of aging is associated with healthy behavior, stress, and health is essential to prepare healthy aging. The purposes of this study are to examine the influence of healthy behavior on stress and subjective health status and to investigate whether self-perception of aging affects the association in midlife Koreans. This is a cross-sectional study. Data were collected through a self-administered survey using a convenience sampling of 466 midlife Koreans (mean age = 50.7, 52.4% male). The PROCESS macro for SPSS was applied for data analysis. Self-perception of aging was significantly related to stress (r= .20, p<.00), and subjective health was related to healthy behavior (r= .22, p<.00) and stress (r= -.38, p<.00). Healthy behavior predicted stress, which, in turn, affected subjective health status (index=.05, 95% CI [.01, .10]). A significant interaction between healthy behavior and self-perception of aging was found (β= -.22, p=.002), indicating that the influence of healthy behavior on stress was different depending on the individual’s self-perception of aging. It means that the impact of healthy behavior on stress was stronger in individuals with a more negative self-perception of aging. The findings demonstrate the critical role of self-perception of aging, which affects the benefits of healthy behavior on stress and subjective health status. This study highlights the importance of assessing self-perception of aging and developing cognitive behavioral interventions that contribute to modifying stereotyped beliefs about aging for better quality of life in midlife.
I CAN'T SLEEP IN MY BED: THE RELATIONSHIP BETWEEN SLEEP AND LATE-LIFE HOARDING
Authors: Davidson Eliza J , Dozier Mary E , Nadorff Michael , Ayers Catherine R
Published: November 2019

Hoarding disorder in late life has been associated with increased risk for medical conditions and decreased ability to perform activities of daily living in the home; however, no studies have yet examined the relationship between geriatric hoarding and sleep. This study represents a secondary data analysis of older adults who received 26 sessions of group behavioral treatment for hoarding disorder (n = 41; mean age 64, range 55-85). Baseline sleep disturbance was significantly associated with hoarding severity, even when controlling for inability to sleep in a bed due to household clutter level. However, no significant change in sleep disturbance was reported following completion of treatment and baseline sleep disturbance was not significantly predictive of change in hoarding symptom severity. Findings suggest that disturbed sleep quality is associated with greater hoarding symptom severity but does not preclude positive symptom change in treatment.
COMBINED EFFECT OF CMV SEROPOSITIVITY AND SYSTEMIC INFLAMMATION ON DEMENTIA PREVALENCE IN CANCER SURVIVORS
Authors: Vivek Sithara , Thyagarajan Bharat , Nelson Heather , Prizment Anna , Crimmins Eileen , Faul Jessica
Published: November 2019

Though cancer patients treated with multi-modal therapies demonstrate higher levels of systemic inflammation, which is associated with dementia, cancer survivors have not shown a consistent association with dementia. Since several studies reported an independent association between cytomegalovirus (CMV) infection, inflammation and dementia in non-cancer populations, we have evaluated whether CMV infection and systemic inflammation were associated with increased prevalence of dementia in cancer survivors in Health and Retirement Study (HRS). We evaluated prevalence of dementia (using score ≤7 on the 27-point scale) among 1607 cancer survivors, in whom we measured CMV seropositivity and two biomarkers of systemic inflammation: C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR). The prevalence of CMV seropositivity was 68.26% (n=1097), while prevalence of increased systemic inflammation [CRP >5mg/L and NLR >4] was 4.23% (n=68). Using survey logistic regression, adjusted for age, race, gender, BMI (Body Mass Index) and sampling design, cancer survivors who were both CMV seropositive and had increased systemic inflammation had the highest odds of dementia compared to those who were CMV seronegative and had low levels of systemic inflammation (OR=6.59; 95% CI [2.81, 15.44]; p<.0001). Cancer survivors who were CMV seropositive without evidence of systemic inflammation had a lower but increased odds of dementia (OR=2.02; 95% CI [1.17, 3.47]; p=0.01). Odds of dementia among those who were CMV seronegative with elevated systemic inflammation was not significant (p=0.09). Our study demonstrates a possible role for ongoing CMV induced inflammation in determining dementia prevalence among cancer survivors that needs further confirmation.
SOCIAL NETWORK BY ENVIRONMENTAL DESIGN: FACILITATING THERAPEUTIC EFFECT IN LTCF FOR PEOPLE EXPERIENCING DEMENTIA
Authors: Ferdous Farhana
Published: November 2019

The relationship between the physical environment and the prevalence of social interaction have been a core topic of inquiry in environmental gerontology. It has been estimated that around 25 million people worldwide have dementia, and the number will exceed 80 million by 2040. A growing body of literature in the areas of environment-behavior studies shows that the physical environment affects positive behavioral changes, in turn, affecting individual, group and organizational outcomes, but little research has focused on older adults especially those with cognitive impairment by targeting the Dementia Enabling Environment of care facilities. By using non-pharmacological interventions, the purpose of this study is to initiate positive social network among dementia residents and staff by analyzing the spatial configuration of the physical environment and layout in long-term care facilities (LTCF). The findings may give evidence-based design guidelines for future research and design of memory care facilities to promote therapeutic experience for older people experiencing early to moderate stage dementia. Using a 3-stage, multi-method research design such as space syntax, behavior mapping techniques and direct observations, this study objectively measured the spatial configuration of LTCF (physical environment) to evaluate the provision of social interactions (among dementia residents and staff), promote positive health outcomes and healthy living for people experiencing early to moderate stage dementia. This study was able to establish that the architectural layout and environmental design could have a positive and protective effect against dementia in environmental gerontology and geriatrics.
PREDICTORS OF INSOMNIA IN INDIVIDUALS WITH MILD COGNITIVE IMPAIRMENT
Authors: Mattos Meghan , Davis Eric M , Manning Carol
Published: November 2019

Insomnia is a common disorder that affects up to 40% of people age 65 and older. Untreated insomnia can decrease quality of life, increase healthcare use, and exacerbate cognitive problems. Individuals with cognitive impairment experience more sleep disorders than those without cognitive concerns, yet little is known about insomnia and mild cognitive impairment (MCI). Our objective was to examine predictors of insomnia in persons with MCI (PwMCI). Using data from the National Alzheimer’s Coordinating Center Uniform Data Set, a cross-sectional study of older PwMCI was conducted. Independent sample t-tests and contingency tables with chi-square tests of independence were used to examine differences between PwMCI with and without insomnia. Multivariate binary logistic modeling was performed. The total sample (N=1543) was comprised of 234 (15.1%) with clinician-reported insomnia and 1309 (84.9%) without insomnia. PwMCI and insomnia were more likely to be younger, take more medications, and smoke cigarettes (p.05). Three variables significantly predicted insomnia in PwMCI subjects in a multivariate model: active depression (OR 1.66, 95%CI 1.21, 2.27), active anxiety (OR 2.16, 95%CI 1.57, 2.99) and arthritis (OR 1.78, 95%CI 1.33, 2.39). Differences in predictors of insomnia in PwMCI highlight the need for geriatric and mental health specialists to provide specialized care to this population. Future studies should examine conversion of PwMCI with insomnia to dementia and the compounding effects of insomnia on cognition.
AGE AND ADVANCE CARE PLANNING PREDICTS SELF-PERCEIVED RISK FOR DEMENTIA
Authors: Yun Stacy W , Maxfield Molly
Published: November 2019

Self-perceived Alzheimer’s disease and related disorders (ADRD) risk may be highly influenced by the sense of control which one has over the prevention and negative impact of such diagnoses (Kessler et al., 2012). This study examined whether age, advance care planning (ACP), and experimentally manipulated dementia salience (DS) are related to self-perceived risk of dementia. Participants (N = 122, 40 to 88 years old, M = 65.66, SD = 9.71) completed the computerized study using Qualtrics software. Participants completed questionnaires assessing individual differences, self-perceived risk, and demographics. Multiple regression was calculated to predict self-perceived ADRD risk based on age, ACP, and DS induction. The set of predictors explained 15.3% of variance in participants’ self-perceived risk of dementia, F(3, 118) = 7.08, p < 0.001. Specifically, being older (β = -0.40, p < 0.001) and having less ACP items completed (β = 0.26, p < 0.01) uniquely predicted lower perceived risk. DS condition (β = -0.01) did not attain significance in the model. Younger age might be associated with less ADRD exposure and understanding, which may influence perceived risk. It is possible that older adults are less worried about developing dementia as they may (erroneously) believe they have “passed” the time to develop ADRD. Additionally, high levels of self-perceived ADRD risk may have resulted in motivation for greater levels of planning for the future among those with greater ACP. Future studies will investigate the level or point in which perceived risk changes from being beneficial and health-promoting to problematic and anxiety-provoking.
USE OF FDA-APPROVED ALZHEIMER’S DISEASE MEDICATIONS AMONG NON-INSTITUTIONALIZED U.S. ADULTS AGE 60 YEARS AND OLDER
Authors: Frenk Steven , Sautter Jessica M
Published: November 2019

This study examined the use of Alzheimer’s Disease medications (ADMs) among non-institutionalized U.S. adults aged 60 years and older. It described the characteristics of ADM users, compared them to adults who were not currently using ADMs, and examined how demographic characteristics, living arrangements, healthcare utilization, and self-perceived cognition are associated with use of ADMs. It also identified the duration of ADM use and the most commonly used ADMs. Data come from the National Health and Nutrition Examination Survey, a nationally representative study of the non-institutionalized U.S. population (2009-2014). Respondents were classified as ADM users if they reported using one or more of the following prescription ADMs in the past 30 days: donepezil, rivastigmine, memantine, galantamine, or a drug combination of donepezil and memantine. During the study period, 1.9% of non-institutionalized U.S. adults aged 60 years and older reported using an ADM in the past 30 days. Use of ADMs was associated with concurrent use of antidepressant medications and also frequent or worsening memory loss and confusion. Most ADM users (82.3%) reported using ADMs for more than one year and the most frequently used ADM was donepezil. In 2009-2014, about 1.1 million non-institutionalized adults aged 60 years and older used an ADM in the past 30 days. They reported relatively poor cognitive abilities, frequent healthcare utilization, and concurrent use of antidepressant medications compared to non-users. Newly released public survey data will be useful to provide updated estimates of ADM use in the community.
A WEB-BASED MOBILE APPLICATION TO SUPPORT SOCIAL ENGAGEMENT IN PERSONS WITH DEMENTIA
Authors: McCarron Hayley R , Zmora Rachel , Gaugler Joseph E
Published: November 2019

Assistive technology has been recognized as a promising tool to improve the lives of persons living with dementia and their caregivers. The use of assistive technology in dementia care is expanding, although it is most often applied to manage care and promote safety. There is a lack of assistive technology designed to aid persons with dementia to participate in meaningful activities. The present study utilizes a pilot randomized controlled trial (RCT) design to evaluate the feasibility, acceptability, and effects of an assistive technology device, the Social Support Aid (SSA), designed to assist persons with dementia engage in social interaction. Quantitative data were collected initially and three and six months later, and participants in the technology group participated in qualitative interviews. Feasibility and utility scores indicated that participants felt neutral about the technology. Use of the SSA was not significantly associated with changes in quality of social interactions or quality of life measures over the six months of follow-up (P > .05). The qualitative analysis revealed three themes that described how and why the SSA worked or did not: (1) outcomes (2) reasons why (not) useful and (3) recommendations. There is a need to develop effective assistive technology that improves the quality of life of persons with dementia. Assistive technology that allows persons living with dementia to maintain some level of autonomy should be a priority for future research. Results provide recommendations for future assistive technology development and evaluation.
MILD BEHAVIORAL IMPAIRMENT AS A PREDICTOR OF COGNITIVE FUNCTIONING IN OLDER ADULTS
Authors: Rouse Hillary J , Small Brent J , Schinka John
Published: November 2019

Background: Mild behavioral impairment (MBI) is considered to be a late life transitional state between normal aging and dementia that describes individuals who have persistent behavioral changes and/or psychiatric symptoms. Individuals with MBI are found to be at greater risk of dementia compared to those without these symptoms. Identifying how MBI might relate to different domains of cognition is of key importance, as it could be an early indicator of a future dementia diagnoses. Method: Secondary data analysis of a sample (n=512) of older adults from the Florida Alzheimer’s Disease Research Center who were either cognitively healthy or presenting with mild cognitive impairment (MCI). Some individuals presented with MBI, as defined by decreased motivation, affective dysregulation, impulse dyscontrol, social inappropriateness, or abnormal perception/thought content. Executive function, attention, short-term memory, and episodic memory, were compared using a battery of neuropsychological assessments. Results: Individuals with MCI performed worse on all tasks across all cognitive domains, where individuals with MBI performed worse on several tasks associated with executive function, attention, and episodic memory. Compared to individuals with only MCI, individuals with MCI and MBI performed significantly worse on tasks associated with executive function and episodic memory. Conclusion: The present study found evidence that individuals with MBI will perform worse on tasks of executive function, attention, and episodic memory. Further, those with MCI and MBI will perform significantly worse on executive function and episodic memory tasks. Future research should explore if these findings can help to predict specific dementia diagnoses.
TASKS AND EDUCATION RESOURCES OF ADOLESCENTS WHO ASSIST WITH CAREGIVING FOR A FAMILY MEMBER WITH DEMENTIA
Authors: Perion Jennifer , Ames April , Steiner Victoria
Published: November 2019

An abundance of research involving adults who care for family members with dementia has guided the creation of supportive programs/services. Much less is known about adolescents who are dementia caregivers. This descriptive secondary analysis utilized data collected during a qualitative examination into the psychological well-being of adolescent dementia caregivers. Eleven adolescent/adult dyads who provided dementia care for a family member completed surveys prior to the adolescents’ participation in focus groups. Five male and six female adolescents ages 12 to 17 and eleven female adults were asked similar questions about caregiving tasks, education resources, and demographic information. Using descriptive statistics, the results of the surveys provide a snapshot of caregiving among a group of adolescents living in northwest Ohio and highlight differences reported by the dyads. Adult accounts of adolescent preparatory education were incongruent with the adolescents’ and did not report their use of books or online caregiving resources. Conversely, three adults (27%), but no adolescents, identified hands-on and observational opportunities as education resources. Adults reported greater adolescent involvement in ten activities of daily living (71%), especially related to bathing, shopping, transportation, and managing medication and finances. Adolescents reported helping with tasks such as eating and laundry more often than adults. While the sample size was small, these findings suggest a need for triangulation when seeking knowledge about adolescent caregiving. These results may inform researchers wishing to investigate the role of adolescent caregivers, as well as guide supportive agencies who provide education materials to families caring for individuals with dementia.
DEVELOPING A CONCEPTUAL MODEL OF FAMILY PREPAREDNESS FOR FUTURE DEMENTIA CAREGIVING IN CHINESE FAMILIES
Authors: Choy Jacky C P
Published: November 2019

Dementia is a growing health challenge that demands better public preparedness. Persons with dementia often lack the capacity to make and execute plans such that family involvement in care preparation becomes necessary. It is commonly observed in Chinese societies that there are more than one family members involved in the taking care of the person with dementia. The current qualitative study aims to understand preparedness for dementia caregiving of a family as unit in a Chinese society. In-depth interviews with 10 family units of dementia caregivers were conducted. Participants (4 spousal caregivers; 44 to 80 years old; mean years of caregiving: 3.3) reflected on how prepared their families were before the caregiving began. Thematic analysis was applied to examine the family preparedness and the family dynamics throughout the caregiving journey. As opposed to a crisis-driven involvement, involvement of more family members before crisis was helpful for reducing the damage brought to the family. Furthermore, families that could align their expectation and understanding of the situation, share knowledge and resources, negotiate the allocation of caregiving duties, and provide emotional support among family members were more likely to provide proper care with minimal sacrifice in family wellbeing. Chinese families often worked as a caregiving team, yet, with uneven distribution of caregiving duties and a lack of proper communication to sustain their caregiving role healthily. Timing and quality of family involvement were more influential factors than family resources to successful adaptation to caregiving.
LIFESTYLE BEHAVIORS AND RACIAL DIFFERENCES IN ALZHEIMER’S DISEASE RISK
Authors: Wong Roger
Published: November 2019

There is substantial evidence indicating that among all racial groups, Blacks have the highest Alzheimer’s disease (AD) risk. Despite the wide support for this disparity, the reasons for these racial differences in AD risk remain unclear. The purpose of this study was to examine how lifestyle behaviors (physical activity, smoking, and social contacts) mediate and moderate the relationship between race and AD risk among Black and White older adults. This study used seven annual waves (2011-2017) of prospective data from the National Health and Aging Trends Study (NHATS), a large nationally representative U.S. sample of older adults. At each wave, physical activity was measured as whether they engaged in vigorous physical activities; smoking was measured as whether they were cigarette smokers; and social contacts was measured as whether they visited friends/family outside of their home. The dependent variable was age of AD diagnosis. Multivariate analyses were conducted using the Cox proportional hazards model. Blacks had a 1.3 times significantly higher risk for AD compared to Whites (Hazard Ratio [HR]=1.31, p=.03). After controlling for lifestyle behaviors as a mediator, racial differences in AD risk were attenuated and no longer significantly different between Blacks and Whites (HR=1.05, p=.74). For the moderation model, interactions between race and each lifestyle behavior generated no statistically significant results. Our findings indicate lifestyle behaviors contribute to racial differences in AD risk between Blacks and Whites. Future research is needed among Black populations to identify specific lifestyle behaviors that are especially protective against AD as targets of intervention.
PROXIMAL DETERMINANTS OF FALLS IN OLDER ADULTS: THE MOBILIZE BOSTON STUDY
Authors: Kang Hyun Gu , Hsu Jonathan
Published: November 2019

Objectives: To study risk factors for falling, we examined risk factors for falls among older people according to the proximal determinants present at the time of the fall. Methods: Data came from MOBILIZE Boston, a prospective cohort study of 765 community-dwelling women and men, mainly aged 70 years or older. Over 4.3 years, 1737 falls were recorded, along with narrative reports describing proximal determinants at the time of the fall. Proximal determinants were identified from narrative reports and falls were classified into categories. Categorization was verified using three raters. Results: 14 categories of proximal determinants were identified. Of these, environmental determinants were the largest contributor to falls (74%). Participants with poor mobility and executive function were more likely to fall while performing activities of daily living, specifically while trying to stand and bending over. However, participants with poor mobility also had lower likelihood of falling to environmental hazards and dual-tasking cognition. In contrast, high-functioning older adults with naturally fast movement speed tend to fall to environmental factors while engaging in complex motor activities. Conclusions: Our results suggest there may be two populations of fallers, the healthy and the disabled, each with their own set of distinct risk factors and triggers. Cognitively functional older adults who choose to engage in vigorous activities in hazardous environments may increase their chances of falling to dual-task cognition. Community fall prevention efforts may benefit from examining the needs of specific subpopulations.