bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complementary and Integrated Studies of Longevity and Healthy Aging
Authors: Cummings Steven , Perls Thomas , Hadley Evan 
Published: December 2020

Abstract
Five NIH-funded studies, the Long Life Family Study (LLFS, U19), the Longevity Consortium (LC, U19), Longevity Genomics (U24), and Protective Omics Profiles in Centenarians (UH2) work together to triangulate on mechanisms of extreme longevity and healthy aging with the ultimate goal of discovering predictors and targetable pathways. Linkage analyses by LLFS identified extremely strong genetic linkage peaks for cross-sectional as well as longitudinal trajectory rates-of-change phenotypes. Deep sequencing suggests these peaks are driven by rare, protective variants in selected pedigrees. In cross-species studies (UH2, LC), genomics, metabolomics and proteomics are used to exploit many-fold variances in natural life spans to discover protective mechanisms that explain some of these differences. Proteome analysis reveal several longevity-related proteins such as Cip1/p21, FOXO3, TOP2A, AKT1, RICTOR, INSR and SIRT6 harboring post translational modification sites that preferentially appear in short- versus long-lived species. The U24 effort developed a tool using genetically-mediated gene expression to prioritize genes for longevity translational efforts. We found that BLOC1S1 was associated with longevity and protection from atrial fibrillation and hearing loss without being associated with adverse events. This novel target is undergoing functional characterization. A proteomic assay (4,131 proteins, Somascan) annotated by genome-wide association study results in a total of 1,797 centenarians and 3,685 controls divided into independent discovery and replication sets, discovered significant and replicated over-expression (thus, pro-longevity) of BIRC2 and under-expression of APOB in carriers of the APOE ɛ-2 allele. A novel protein signature of rs2184061 (CDKN2a/CDKN2B in chromosome 9) was also associated with slower aging.
Interprofessional Education Through Case Study: Learners’ Attitudes on Interprofessional Education
Authors: Halli-Tierney Anne , Allen Rebecca , Carroll Dana , McKinney Robert 
Published: December 2020

Abstract
Interprofessional education case sessions allow learners to apply discipline-specific knowledge to real-life scenarios through thorough facilitated discussion of a patient case. Our interprofessional case discussion was implemented for learners to develop care plans for complex geriatric patients; learners have intentional time to learn with, from and about each other’s roles in geriatric care. All learners receive the case and work through it from their discipline’s perspective, then join a facilitated group discussion to develop collaborative care plans. Participants were surveyed using the ICAS and qualitative comments about perceptions of interprofessional learning, and most interprofessional (medicine, pharmacy, psychology and social work) learners found the sessions to be educational. Themes emerging from qualitative analysis about what was most educational were “different professional approaches”, “professional roles”, “collaboration” and “problem solving”. Typically, learners were unable to identify “least educational” components to the activity. Overall feedback from learners aligns with the goals of interprofessional education. Part of a symposium sponsored by the Mental Health Practice and Aging Interest Group.
Health Among Sexual Minority Older Adults: Individual Differences and Implications for Improving Health
Authors: Wardecker Britney , Exten Cara 
Published: December 2020

Abstract
The number of sexual minority (SM) older adults is increasing rapidly, yet this population continues to be underrepresented in research (Fredriksen-Goldsen & Kim, 2017) and experiences significant disparities in health and health care access (Fredriksen-Goldsen, 2016; Wallace et al., 2011). In the current symposium, we analyze data from U.S. national probability samples of middle-aged and older adults (MIDUS, HRS, NESARC-III) to consider how age-related concerns and challenges may be experienced differently by SM individuals compared to their heterosexual counterparts. This symposium includes novel methods and statistical tools, such as daily diary assessments, multilevel modeling, and time-varying effects models. Individual presentations evaluate how: (1) SM women, compared to heterosexual women, may respond differently to menopause through norms and values surrounding womanhood; (2) midlife and older SM individuals use alcohol and cigarettes more frequently across a typical week than their heterosexual counterparts, though their substance use may not be tied to common triggers (e.g., negative mood, stress); (3) despite bisexual older adults reporting more health problems compared to lesbian and gay counterparts, they are less prepared for health concerns and crises (e.g., reporting a lower number of valid wills); and (4) the prevalence of depression and anxiety varies across age, such that older SM adults—especially women—are particularly vulnerable to psychological health problems. These presentations collectively examine complex issues facing older SM adults while emphasizing individual differences (i.e., women’s concerns, bisexual people’s issues). We discuss challenges in researching this growing at-risk population, and we highlight areas of future research and intervention.
The price of privilege: helping mom die at home
Authors: Beard Renee 
Published: December 2020

Abstract
Americans overwhelmingly wish to age in place and many explicitly want to die at home. Yet, the anemic welfare state means that only the most fortunate among us are able to achieve that goal. A disproportionate burden of care falls squarely to families, which are smaller and more geographically spread out than ever before. Carers too often wind up in environments that are far from conducive, namely being older and perhaps frail themselves or younger and perhaps with small children of their own. Drawing on an autoethnographic study of my mother’s final years and a case study analysis of one innovative home care agency, this project examines the individual and organizational factors that allow one family to grant their family member’s wish to die at home. Grounded theory methods revealed facilitators including presence of a home-based long term care insurance policy, geographic mobility, and access to a democratically-oriented home care organization. Barriers, of course, include lack of access to long term care insurance and a daughter who lives in a progressive state with a waiver for Home and Community Based Services. While the privilege of access underscores the social determinants of aging, this case study reveals some important features that suggest how senior social services could be. Even for the “ideal type” presented here, the many trials and tribulations of aiding a loved one to die at home relate to the untenable nature of doing it all in a context whereby social services are fragmented and driven by financial incentives.
Healthcare Affordability and Associated Concerns Among Older Adults in Florida
Authors: Wiltshire Jacqueline , Orban Barbara , Conner Kyaien , Colato Edlin Garcia , Anderson Erica , Carrion Iraida 
Published: December 2020

Abstract
Rising healthcare costs create significant financial burden for Americans and is a threat to the well-being of our growing, racially/ethnically diverse, older population. In a mixed method study, we assessed ability to afford care and ascertain concerns about healthcare cost in a racially diverse sample of Floridians ages ≥ 65. We surveyed 170 adults (40.4% White, 27.6% African Americans/Black and 31.8% Latino/Hispanic) and conducted three race-stratified focus groups (n=27). Most participants had Medicare coverage (97.1%) and 27% also had Medicaid. Approximately 11.6% of Whites had problems paying medical bills in the past 12 months versus 14.9% of African Americans/Blacks and 24.1% of Latino/Hispanics. Additionally, 13% of Whites, 19.2% of African Americans/Blacks and 20.4% of Hispanics reported not getting needed prescription drugs because they could not afford them. Approximately 45.7% either perceived that their doctor “never” takes into account costs for treatment or did not know whether costs were considered. Multiple regression analyses showed no statistically significant racial/ethnic differences in affordability problems. From the focus groups, healthcare cost concerns most frequently identified by participants were the high cost of prescriptions drug, rising co-pays and out of pocket expenses, and medical billing. Participants’ concerns about medical billing included understanding their bills, transparency in billing, timely posting of charges, and uncertainty about who to talk to about billing problems. Our findings suggest that routine discussions about healthcare costs with doctors or designated healthcare personnel should help ease financial burden and healthcare costs concerns among older adults.
Estimating Risk of Elder Abuse: Intergenerational Communication/Empathy, Census-Based Assessment
Authors: Wu Heng , Holley Lyn 
Published: December 2020

Abstract
COVID highlights the importance of accurate estimates of the risk of elder abuse to guide prevention. Reliability of data is problematic; reports have issues with consistency of definitions, time periods, and stigma. This paper demonstrates the use of US Census data to estimate risk of elder abuse by mapping generational incongruities between care-givers and care-receivers that invite dissonance (Cohen, 2011). Using the 2014-2018 Nebraska Public Use Microdata and 5-year American Community Survey, this research identifies and profiles personal care aides/nursing aides for institutionalized persons (65+). Data reveal generation gaps in age, education, and race between care-receivers and care-givers that are geographically comparable in the three most populous counties (the Big-3), but different for the 90 rural counties. In Nebraska’s Big-3 Counties the difference in education between care-givers (ages 25+) and care-receivers (65+) is considerable; 42.9% of Big-3 care-givers have some college, while 43.6% of care-receivers have only high school. Intergenerational differences in education are greater in Nebraska’s 90 rural counties than in the Big-3; 41.2% of rural care-givers have some college; 46.1% of rural care-receivers have only high school. Racial intergenerational differences are greater in Big-3 than in rural counties; 90.3% of care-receivers and only 62.3% of care-givers are non-Hispanic White. For rural Nebraskans, intergenerational differences in race are smaller, 97.2% of care-receivers and 79.4% of care-givers are non-Hispanic White. This type of analysis can be used to identify geographic settings where elder abuse is most likely to happen and guide the development of preventive measures that mitigate elder abuse.
Perceived Social Support and Help-seeking among U.S. Chinese Older Adults with Elder Mistreatment
Authors: Chao Ying-Yu , Kong Dexia , Dong XinQi 
Published: December 2020

Abstract
Background/Purpose: Older immigrants are at risk of experiencing marginalization and social exclusion. Traditional Chinese culture values could deeply influence the older Chinese immigrants’ perceptions regarding mistreatment and motivating them to seek help. This study aimed to examine the associations between perceived social support and informal/formal help-seeking intentions and behaviors among U.S. Chinese older adults experiencing elder mistreatment. Methods: Data derived from the Population Study of Chinese Elderly in Chicago (PINE). Independent variables were positive and negative perceived social support. Dependent variables were informal/formal help-seeking intentions and behaviors. Descriptive statistics and logistic regression analyses were performed. Results: A total of 423 participants experienced elder mistreatment (mean age: 72.4 ±7.88 years old). The most common informal help-seeking sources were adult children, followed by partner, and friends/neighbors/colleagues. The most common sources of formal help-seeking were community social services organizations and the legal criminal justice system. After controlling for covariates, positive perceived social support was associated with informal help-seeking intentions (OR=1.14, 95% CI: 1.05-1.24, p &lt; .01) and behaviors (OR=1.12, 95% CI: 1.04-1.22, p &lt; .01). However, the associations between perceived social support and formal help-seeking intentions and behaviors were not significant. Conclusions & Implications: Further research is needed to examine the mediating effects of cultural values on the relationship between perceived social support and help-seeking among mistreated older Chinese immigrants. In addition, additional studies are needed to identify impede or facilitate factors of informal/formal elder mistreatment help-seeking. Prevention and intervention programs should incorporate valuable cultural insight to improve help-seeking among this population.
Asking Young Adults about Their Attitudes toward and Knowledge of Sex in Later Life
Authors: Fratila Iulia , Berdychevsky Liza 
Published: December 2020

Abstract
Sexual expression is a lifelong need related to health and wellbeing. However, older adults’ sexuality is often neglected and stigmatized due to societal ageist stereotypes portraying them as asexual. Although baby boomers’ generation resists such portrayals, societal acceptance of sexuality in later life is slow to materialize. The purpose of this study was to explore this acceptance among young adults while focusing on three research questions: (1) How much do young adults know about older adults’ sexuality and how do they feel about it? (2) Do young adults’ knowledge and views of later-life sexuality vary by gender? (3) Do young adults’ views of later-life sexuality vary based on their general attitudes toward sexuality? Data collection included online and intercept survey methods. The sample (N=270) was young (M=21.58 years, SD=4.32) and included 149 women and 113 men. Results revealed that young adults had medium levels of knowledge, yet rather permissive/open-minded attitudes regarding later-life sexuality. Higher levels of knowledge were unrelated to more permissive attitudes. Independent samples t-test revealed no differences by gender in young adults’ knowledge and attitudes. However, multiple regression results indicated that general liberal attitudes toward sexuality (β=.772, t=17.867, p=.000) and viewing sex as leisure activity (β=.147, t=3.338, p=.001) are significant predictors of having more permissive/open-minded attitudes toward older adults’ sexuality (R2=.557, F(3,266)=111.390, p=.000). These findings suggest that socio-psychological (rather than cognitive and demographic) factors drive the acceptance of later-life sexuality among young adults. This study offers valuable insights for knowledge, practice, and advocacy concerning older adults’ sexuality.
Perceived Everyday Age Discrimination and Depressive Symptoms:The Moderating Effect of Social Environment
Authors: Park Min Kyoung , Mair Christine 
Published: December 2020

Abstract
Approximately 30% of men and women in the United States have experienced age discrimination (Rippon, Zaninotto, & Steptoe, 2015). Experiencing age discrimination may lead to increased risk of depressive symptoms among older adults. Although positive social environments are known to buffer depressive symptoms, it is unknown to what extent a positive social environment may buffer the association between age discrimination and depressive symptoms for older adults in the US. The purpose of this study is to examine the association between perceived age discrimination and depressive symptoms among older adults, and to explore whether this association varies by two aspects of the social environment: social support and neighborhood environment. We explore this topic with data on 5,439 adults aged 50 and older in a sample drawn from the Psychosocial Module of the Health and Retirement Study (HRS, 2016 wave). Our results show a clear association between age discrimination and increased risk of depressive symptoms, net of a range of covariates. Older adults who receive more positive social support and rate their neighborhood environment more positively also report lower depressive symptoms. Finally, we find statistically significant interactions between age discrimination and both measures of the social environment, which suggest that social support and a positive neighborhood environment may buffer the negative impact of age discrimination on depressive symptoms. We discuss these findings in light of the prevalence of age discrimination in the US and cross-nationally, and consider potential mechanisms for improving the social environment of older adults, particularly in the post-COVID era.
How Does Adult Children Migration Effects Older Adults Aging in Place? Community and Individual Level Interventions
Authors: Balaswamy Shantha , Singh Rufus 
Published: December 2020

Abstract
In India, the increasing emigration by adult children for job opportunity and socio-economic betterment has left vulnerable older adults (OA) to age in place. Almost ‘one of out of ten households in Tamil Nadu state has one or more (e) migrants’ (TN Migration Survey 2015), leaving behind OA who traditionally depend on family as a major source of support. There are few studies on impact of immigration of male adult on wife and children who are left behind, but hardly any research on OA who stay behind. This study aims to understand the social, emotional, economic, and health experiences of OA in one of the districts that has the highest rates of out migration. Data was collected using in-person interviews with 304 randomly selected OA whose adult child had migrated to another country. Nearly half of OA live alone (49.7%), have one or more chronic diseases (60%), require support for meeting their ADLs (90%), and half receive no financial support from adult child (50%) contrary to expectations of providing care for OA in this culture. Findings also reveal that persons over the age of 70 exhibit greater coping skills despite lower functional health, smaller social network, and less financial resources. A significant relationship exists between frequency of visits by adult child and reported levels of anxiety and depression. Implication discussions explore solutions at individual, community and policy levels to address vulnerabilities of the older population who are left behind in villages and towns of India due the globalization related mobility.
Not All Home Care is Created Equal: The Relationship Between Sources of Care and Recipients’ Perceived Control
Authors: Wylie Molly 
Published: December 2020

Abstract
Perceived control is an important psychological resource for middle-aged and older adults. Aging in place may help foster feelings of control and autonomy, yet many community-dwelling older adults must rely on others for physical assistance. Little is known about psychological reactions to receiving this support. This study investigated how receiving home care from different sources was associated with two facets of perceived control (mastery and perceived constraints) among adults with varying levels of physical disability. Data was drawn from the 2012 and 2014 waves of the Health and Retirement Study. Community-dwelling adults aged 50 years and older receiving help for at least one activity of daily living (ADL) impairment (N = 884) reported their relationship to each respective caregiver (formal professional and/or informal family or friend), level of ADL impairment, and ratings of perceived control. Ordinary least squares (OLS) regression was used to examine the association between type of support and perceived control and the moderating effect of physical disability on that relationship. Receiving formal or a combination of formal and informal support was related to perceptions of greater control over one’s life, but only in terms of mastery. The level of one’s ADL impairment did not have a moderating effect on the relationship between support type and perceived control. Findings suggested that the type of instrumental support adults receive in their home has implications for specific facets of perceived control. Those receiving formal or mixed support had perceptions of greater mastery than those only receiving informal support.
Racial and Ethnic Differences in Preventive Services Use After the Affordable Care Act’s Enhancement of Medicare Benefits
Authors: Toseef Mohammad Usama , Tarraf Wassim 
Published: December 2020

Abstract
As a consequence of the Affordable Care Act’s enhancements of Medicare benefits, certain recommended clinical preventive services became available to Medicare beneficiaries without cost-sharing. We study the impact of these mandates on racial/ethnic disparities in the use of preventive services among traditional Medicare beneficiaries. We analyze nationally representative data on non-institutionalized Medicare seniors from the 2006-2016 Medical Expenditure Panel Survey (N=27,124). Our preventive services of interest include yearly receipt of cholesterol check, blood pressure test, flu shot, endoscopy, blood stool test, clinical breast examination, mammography and prostate exam. We estimate propensity score weighted difference-in-difference (DID) models to test for differences in preventive services utilization by race/ethnicity. Among traditional Medicare beneficiaries, we do not observe significant change in the use of most preventive services for Blacks and Hispanics compared to their White counterparts. However, Hispanics have significantly increased their use of blood stool tests relative to whites. Overall, we do not find major evidence to support a differential effect of reforms on race/ethnic minorities’ uptake of preventive services following the mandates. Our results suggest that despite an overall benefit trough services expansion and cost-sharing elimination race/ethnic group differences persist. As such, disparities might continue and would require additional interventions. Reduction in disparities is a stated goal of US policy for many decades and achieving equity might require additional work and more varied and targeted interventions.
Demystifying Grief in the Dementia Divide: A Case for Grief Therapy in Dementia Care
Authors: Ione Adrienne 
Published: December 2020

Abstract
The results of emotional and psychological losses overlap with behavioral and psychological symptoms of dementia (BPSD) in the neuronal and structural changes in the brain. The aim of this current study was to explore the magnifying effects of COVID-19 on exacerbating residual losses, illuminating a case for using grief therapy to moderate BPSD. A case control study was conducted with people ages 65 and greater, with an established diagnosis of dementia prior to March 2020. Compared with an active control group - participants without a current dementia diagnosis who self-reported mild cognitive shifts and who also received active grief-informed therapies – offer supporting evidence of a strong factor of efficacy for including grief therapy in services offered to people living with dementia. Evidence of a continued point improvement on both the brief grief questionnaire and inventory of complicated grief, as well as decreased severity of items on NPI-Q corroborate this therapeutic recommendation. Now more than ever – as people across the globe who are diagnosed with dementia face uncertain ramifications of previous grief episodes, ones that have potentially been reignited by the flames of COVID-19 – therapists must foster safe spaces informed by novel therapeutic grief approaches. In any just society, emphasis on therapeutic techniques that allow participants to ventilate their feelings and fears, as well as promote movement along a continuum from isolation to intimacy, must prevail. People exhibiting BPSD should not be excluded from such treatments.