bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Me Cuido Activo Manizales”: A Community Care Model Based on an Active Aging Framework for Elderly People in Colombia
Authors: Ballesteros Lina Gonzalez , Zuluaga Santiago López , Hoyos Ana María Ortiz , Gómez Oscar , GonzalezBallesteros Lina 
Published: December 2020

Abstract
Colombia, as other countries in the Latin American region has aged at a higher rate than countries from developed ones. This challenges the way these countries decide how to attend the ageing of their population. “Me cuido activo Manizales” is a community care model based on an active ageing framework developed in Manizales, Colombia in 2017. It is based on collaborative and experiential learning activities for elderly people and their caregivers in the areas of care and self-care, writing and memory, healthy habits, physical activity, resilience and rights, and economic productivity. A before and after analysis of the 88% of enrolled subjects that participated through 2017-2019 (Median age = 70; IQR = 76 years) show stable results in independency (Barthel before = 97,23 Vs Barthel after = 94,68; t = 1,48; p = 0,14), instrumental activities of daily living (Lawton-Brody before = 3,63 Vs Lawton-Brody after = 3,58; t = 0,748; p = 0,47), resilience (CD-RISC10 before = 28,61 Vs CD-RISC10 after = 28,28; t = 0,40; p = 0,69) and MMSE scores (before = 25,72 Vs after = 24,62; t = 1,67; p = 0,10). Qualitative analysis evidenced increased awareness of self-care lifestyles and active ageing, and the need for institutional presence providing logistic and personnel support and better ways to engage groups rather than the individual. We believe this is a holistic approach that focuses on key aspects of the current perception of elderly functionality and that it engages individuals and communities along in a self-aware healthy ageing.
Adult Children’s Migration and Health-Related Quality of Life Among Older Nepalese Adults
Authors: Ghimire Ghimire , Singh Devendra , McLaughlin Sara , Nath Dhirendra , McCarren Hannah , Subedi Janardan , Ghimire Saruna 
Published: December 2020

Abstract
Traditionally, adult children have served as primary caretakers and providers for older Nepalese adults. However, out-migration of adult children for employment and other opportunities is increasing. Health-related quality of life (HRQOL) in older Nepalese adults in general and in the context of adult children’s migration is poorly understood. This study aims to assess HRQOL of older Nepali adults and its relationship with adult children’s migration. We used existing cross-sectional survey data on 260 older adults from the Krishnapur municipality, which has witnessed a high rate of adult migration. HRQOL was assessed using the SF-12, which provides a physical (PCS) and mental (MCS) health component. Scores for PCS and MCS range from 0-100; a higher score indicates better HRQOL. Simple and multiple linear regression were used to assess correlates of HRQOL. Participants had suboptimal HRQOL [mean (±SD): PCS =40.4±9.2 and MCS=45.2±7.7]. After adjusting for covariates, adult children’s migration was associated with lower MCS scores (β: -2.33, 95%CI: -4.21, -0.44). Individuals with more than one child had higher MCS scores (β: 2.14, 95%CI: 0.19, 4.09). Females (β: -3.64, 95%CI: -7.21, -0.06) and those with a history of unemployment (β: -6.36, 95%CI: -10.57, -2.15) had lower PCS scores than their respective counterparts. The presence of one or more chronic conditions was associated with significantly lower PCS and MCS. Our findings suggest that out-migration of adult children may negatively effect HRQOL among older Nepali adults, specifically their psychological well-being. Additional research is needed to investigate potential moderating factors that may serve as important buffers.
Cross-Lagged Panel Analyses of Reciprocal Effects of Social Isolation, Perceived Loneliness, and Solitary Activity
Authors: Li Ke , Tang Fengyan 
Published: December 2020

Abstract
Social isolation and perceived loneliness are major issues as they may place older adults at greater risks for health problems. The objective status of social isolation and the subjective perception of loneliness may have distinct meanings, and their longitudinal reciprocal relationship remains unclear. The purposes of this study were to examine the reciprocal effects of social isolation and loneliness among U.S. adults aged 50 and above and to explore the moderating effect of solitary activities by using the data from three waves of the Health and Retirement Study (HRS) collected in the year 2008, 2012 and 2016. The index of social isolation was created by summing five commonly used indicators, including marital status, living arrangement, and three types of social contact. Loneliness was assessed by a summary score of 11 items. Solitary activities included 13 activities with limited or no social interaction. The results estimated by the cross-lagged effects model showed positive reciprocal relationship of social isolation and perceived loneliness across waves: respondents with a higher level of social isolation were predicted to have increased loneliness, and more perceived loneliness was significantly associated with a higher level of social isolation in the following waves. The results also indicated that solitary activity had a direct effect on decreasing loneliness. This study improves the understanding of reciprocal effects of social isolation and perceived loneliness over years and indicates that practice needs to address the issues of social isolation and perceived loneliness at the early stage and provide more opportunities of solitary activities.
The Association Between Health, Social Engagement, and Psychological Well-Being Among Older Adults in China
Authors: Li Yuekang 
Published: December 2020

Abstract
Psychological health and health-related quality of life of older adults have been long minimized by caregivers, service providers and the society in developing countries, such as China. According to the Stress Process Model, the stress of physical disadvantages influences mental health outcomes directly and indirectly. However, being socially engaged has the potential to reduce disease burden and improve psychological wellbeing of older adults. The purpose of this study is to examine the role played by social engagement in the pathway through which physical health predicts mental health. Using the WHO Study on Global AGEing and Adult Health China wave 2010, 6,276 individuals ages 60 years and older were included for analyses. Structural equation modeling was used to construct a directional path leading from the functioning and chronic disease, impacting the social engagement, in turn impacting the psychological wellbeing. All variables in this model are latent constructs. Functioning and chronic diseases in later life were associated with social engagement and psychological wellbeing, and the link between social engagement and psychological wellbeing was also significant. The effect of function was greater than that of chronic diseases. Though the significant indirect effect of physical health on psychological wellbeing was not supported in this study, this study suggests the multiple roles of social engagement as coping resources in the stress process of physical impairment and illness of older adults. This present study also adds to the existing literature by exploring how SEM methods can be applied to studies of social engagement.
#Dementia: An Evaluation of the Worldwide Dementia Twitter Network
Authors: Ayyaswami Varun , Padmanabhan Divya , Prabhu Arpan 
Published: December 2020

Abstract
Social media engages an international network of healthcare stakeholders. Our study characterized the #dementia community on Twitter, which we hypothesized has increased substantially in the last six years. Symplur Signals, a healthcare social media analytics platform, was used to analyze public #dementia tweets between 1/1/2014 and 12/31/2019. Spam or users unclassified by the platform were excluded. Tweet activity, content, user characteristics, engagement, associated hashtags, sentiment, and network analysis metrics were obtained. Exactly 2,149,494 tweets made by 105,938 users resulted in 21,460,413,770 impressions. There was a 44.6% and 29.1% compound annual growth rate of tweets and users, respectively. The five most frequently tweeted words were people, care, help, living, and support. Among users with identifiable locations, the United Kingdom, United States, and Canada had the greatest number of users. Healthcare associated individuals (17.8%), health advocacy organizations (17.6%), non-healthcare associated individuals (17.0%), and non-healthcare associated organizations (13.8%) were among the top 500 influencers based on tweet number. Hashtags related to caregiving (#Caregiving, #carers, #care, #caregivers, #caregiver, #dementiacare) and Alzheimer’s disease (#alzheimers, #Alzheimer, #Alz, #EndAlz) were among the top 15 associated hashtags. Analysis of the 1,000 most recent tweets shows more tweets with positive (71.0%) than negative (29.0%) sentiments. Network analysis mapping connections between users shows advocacy organizations (i.e. @ASAging) and other health individuals (i.e. @LEAD_Coalition) were central conversation hubs in 2019. The #dementia network discusses themes important to older adults. The network’s rapid growth has enabled increased dissemination of dementia-related information by both healthcare and non-healthcare associated individuals and organizations.
Care Me Too: A Mobile App for Engaging Chinese Immigrant Caregivers in Self-Care and Its User-Experience Testing
Authors: Liu Mandong , Jiang Tongge , Yu Kexin , Wu Shinyi , Jordan-Marsh Maryalice , Chi Iris 
Published: December 2020

Abstract
Caregiving and self-care are challenging for Chinese immigrants in the U.S. due to limited accessible support and resources. The team developed a Care Me Too app for engaging Chinese immigrant caregivers in self-care and conducted a user-experience test to assess its usability and acceptability. The aims of this paper are to report the testing results and develop guidelines to support mHealth app design for immigrant caregiver populations. Twenty-two Chinese caregivers participated in the test, which consisted of two parts: in-lab testing and one-week at-home testing. In-depth face-to-face interviews and follow-up phone interviews were used to test the app’s usability and acceptability and solicit participants’ feedback for app design and functions. Directed content analysis was used to analyze testing transcripts. Participants reported uniformly positive ratings of usability and acceptability of the app and provided detailed suggestions for app improvement. We generated some mHealth app design guidelines, including weighing flexibility vs. targeting majority preferences, increasing text sizes, using colors effectively, providing engaging and playful visual designs and functions, simplifying navigation, simplifying login process, design functions to cater to the population’s context, etc. We concluded that culturally and linguistically appropriate mHealth apps are appealing to immigrant caregivers for health promotion.
Role of Health Information Technology in the Engagement Process of Older Adults’ Cancer Treatment Decision Making
Authors: Zaidi Maryum , Gazarian Priscilla , Mattie Heather , Sheldon Lisa Kennedy , Gakumo C Ann 
Published: December 2020

Abstract
This study investigates the role of Health Information Technology (HIT) in the process of patient engagement in treatment decision making in older adults in cancer care. Despite the role of HIT in patient engagement processes and government incentives for HIT development, research regarding HIT is lacking among older adults. The following study is a secondary data analysis of a subset of the Health Information National Trend Survey (HINTS 4, Cycle 3), including individuals 65 years old and above. Chi-square tests, logistic regression, and linear regression models were fit to study several sociodemographic, socioeconomic, and psychosocial variables in this study. The results show that education, poverty status, and self-management domain of the patient activation (which is a precursor of the engagement process) were significantly associated with access to and utilization of HIT. No significant differences between access to and utilization of HIT and the diagnosis of cancer were found. However, fatalistic beliefs about the diagnosis of cancer significantly impacted the use of HIT in all models, including those controlling for cancer diagnosis and access to HIT. Specifically, a one-point increase in cancer fatalism score is associated with a 59% decrease in the utilization of HIT, giving evidence that fatalistic beliefs about cancer can drive engagement behaviors regardless of a diagnosis of cancer. Our study provides vital information for providers and policy researchers to take into account for future implementation and development strategies of HIT in cancer care for older adults.
Bridging the digital divide for vulnerable patient telehealth
Authors: Ali Diab , Gillie Monica , Carstarphen Kathy Jo 
Published: December 2020

Abstract
In New Orleans, Louisiana, 61% of advanced age patients have low health literacy, 50% report financial insecurity, and more than one-third have high hospital readmission rates and medical complexity scores. This population has been disproportionately impacted by the COVID-19 pandemic and the system-wide transition to remote, virtual visits. While COVID-19 has accelerated needs for impactful remote care and research, this has been impeded by low telehealth literacy and structural barriers, such as lack of internet and devices. There are major gaps in the literature regarding telemedicine services in geriatric and complex populations and efficacy rates are variable in these populations. There is currently no telehealth literacy screening tool designed for identifying patients with barriers requiring additional interventions to succeed, no uniform understanding of the factors affecting use or how to increase engagement, and telehealth models requiring fluent use of technology for older adults have been met with poor rates of completed visits and associated harm. Following a dedicated 358.5 hours to training 309 geriatric, complex patients in telemedicine using our pre-existing telehealth model, averaging 4.78 hours per patient, only 18.8% of these patients were subsequently able to connect to the provider virtually. Here we describe lessons learned and tools developed from the Ochsner MedVantage Network Innovation project, including the development of a telehealth literacy screening tool, the adaptation and provision of simplified, user-friendly tablets, and a randomized control trial to determine if increased accessibility to telehealth leads to improved healthcare outcomes, such as decreased hospital admissions and emergency department utilization.
Intergenerational connections through technology: Insights from the Technology Use in Later Life multi-site study
Authors: Freeman Shannon , Marston Hannah R , Musselwhite Charles , Olynick Janna , Genoe Rebecca , Kulczycki Cory , Xiong Beibei 
Published: December 2020

Abstract
With enhanced challenges to maintain social connections especially during times of social distancing due to the COVID-19 pandemic, the need for technology solutions grow. Technologies have become interwoven into the daily lives for many older adults. The Technology Use in Later Life (TILL) study investigated how the perceptions and use of technology both can foster new and leverage existing intergenerational relationships. Through a mixed methods study engaging older adults aged 70 years of age and greater across rural and urban sites in Canada and the UK (N=37), participants described how the interconnection between technology and intergenerational relationships was an integral component to social connectedness with others. Through a qualitative descriptive approach, it was noted that older adults leveraged intergenerational relationships with family and friends to adjust to new technologies and to remain connected to adult children and grandchildren especially when there is high geographic separation between them. Especially during times of COVID-19, younger family members can play an important role to introduce and teach older adults how to use, technologies such as digital devices, computers, and social networking sites. Participants emphasized the benefits of intergenerational connections to adopt and use technology in later life noting flexibility and willingness to overcome barriers to technology adoption and remain connected across the generations. The adoption and uptake of technologies may continue as viable options during times of social distancing to support older persons to remain independent, age in place, in both age-friendly cities and across rural geographies during and post COVID-19.
#BoomerRemover: COVID-19, Ageism, and the Intergenerational Twitter Response
Authors: Skipper Antonius , Rose Daniel 
Published: December 2020

Abstract
In March 2020, COVID-19 was declared a pandemic and frequently presented as a virus primarily affecting older adults. News headlines led with statements such as, “Coronavirus deaths are so far mostly older men” (Ramzy, 2020). Although later determined inaccurate, this perspective contributed to openly ageist views and exchanges from people around the world. On the social media platform of Twitter, #BoomerRemover was used as a hashtag to express views related to older adults, and particularly baby boomers, as the primary targets of COVID-19. This study uses qualitative methods to analyze the messages of Twitter users that discuss COVID-19 with the use of the hashtag #BoomerRemover. A total of 1,875 tweets posted in English and including the hashtag “#BoomerRemover” from March 16, 2020 to March 30, 2020 were analyzed. Analytic methods employed an open coding procedure consistent with grounded theory and Numeric Content Analysis (Marks, 2015). Salient themes include: (1) COVID-19 is Politically Driven (2) There’s a Real Intergenerational Divide, (3) Young People are Dying Too, and (4) #BoomerRemover is Simply Disrespectful. Findings suggest that only about a fourth of #BoomerRemover tweets could be considered ageist, and the large majority of tweets using the hashtag were related to politics and elections. Further, several of those using the #BoomerRemover hashtag to defend older adults were inadvertently causing it to remain relevant (trend) as a Twitter topic. This study recognizes the importance of considering Twitter – primarily composed of young adults – as a place where intergenerational attitudes vis-à-vis COVID-19 may be expressed.
Community environment and COVID-19 related stress among older adults with disabilities in Taiwan
Authors: Yu Meng-Hsuan , Chao Shiau-Fang 
Published: December 2020

Abstract
The outbreak of the COVID-19 pandemic at the beginning of 2020 forced many countries to implement social distancing policies such as the suspension of activities and gathering. Taiwan is the leading country which took active epidemic prevention measures in local communities, including closing the community centers and programs for older adults. Older adults with chronic health conditions are particularly vulnerable to the COVID-19 pandemic because they have disproportionally been affected by it. This study examined the associations between community environment and COVID-19 related stress of community-dwelling older adults with disabilities. Data were collected from a sample of 547 community-dwelling older adults aged 65 and over with disabilities in Taiwan between April and July, 2020. Multiple Regression Analysis was applied to test the hypothesized relationships. The analytic results suggested that: First, participants who were younger and with better cognitive functioning had higher levels of COVID-19 related stress. Second, as the confirmed case number dropped by month, participants interviewed in the later months expressed lower levels of COVID-19 related stress. Third, older adults who perceived more obstacles in their environment reported higher levels of COVID-19 related stress. In conclusion, although restrictions during the pandemic is inevitable to secure the safety of the public, programs should be designed for older adults with disabilities to remove the obstacles and to make information, policies and services more accessible in the communities to mitigate their COVID-19 related stress.
Comparing the Protective Value of Human and Pet Social Support on Well-Being of Older Adults During COVID-19
Authors: Sobering Juliet , Brown Lisa 
Published: December 2020

Abstract
Older adults are vulnerable to particular risk factors that contribute to lower well-being and poorer functioning. With the COVID-19 pandemic, the importance of social support has been highlighted in media reports because of its well-known beneficial effects on overall well-being. However, as adults age, social networks, contacts, and activities naturally decrease. These age-related losses are often difficult, if not impossible, to replace. Pets have recently been recognized as a valuable source of social support for many older adults, providing both physical and psychological benefits through mutual connection and behavioral activation. Previous studies have examined how human social support or pet social support enhance older adults’ well-being (i.e., positive emotions, engagement, relationships, accomplishment, and meaning). However, there is a gap in our scientific knowledge as previous research has not evaluated if pet social support can serve as a protective factor in the absence of adequate human social support. Current analyses, with 141 older adult participants, suggests that pet owners with a positive attachment to their pet experience higher well-being as pets serve as a coping resource that protects against common life stressors. Similar to human social support, pet social support appears to be a protective factor that also promotes and fosters a sense of well-being in older adults. Support in late life is especially important for families and agencies to be attuned to, especially during a global pandemic.
COVID-19-Related Changes in Potential Risk Factors for Elder Mistreatment Reported by Caregivers of Older Adults
Authors: Makaroun Lena , Beach Scott , Rosen Tony , Rosland Ann-Marie 
Published: December 2020

Abstract
In previous studies, caregiver (CG) stress, substance use, poor physical health, poor mental health, financial problems, and social isolation have been associated with increased risk of elder mistreatment (EM) for older care recipients (CR). This study aimed to assess how the COVID-19 pandemic has impacted these CG-related risk factors for EM in a community sample of CGs. A non-probability sample of 433 CGs caring for adult CRs age ≥60 years with physical (76%), cognitive (34%) and mental health (14%) conditions completed a survey on COVID-19 impacts in April-May 2020. CGs had mean age 61 (range 21 – 91), were 75% female and 92% non-Hispanic White. Over 40% of CGs reported doing worse financially since COVID-19. Compared to before COVID-19, 15% reported drinking more alcohol and 64% reported somewhat or greatly increased feelings of social isolation and loneliness. CGs reported that COVID-19 had made caregiving more physically (18.7%), emotionally (48.5%) and financially (14.5%) difficult, interfered with their own healthcare (19%), and led to family conflict over caring for CR (13.2%). Younger CGs (age &lt;65) and those with annual income &lt;$50,000 were more likely to report negative COVID-19 impacts. This study suggests CGs of older adults may be experiencing increased stress, alcohol use, social isolation and negative impacts on their own health and financial situation. Healthcare and social service providers should assess for these EM risk-factors in caregivers and connect them and their care recipients with resources and services to address these stressors to reduce risk of EM during the COVID-19 pandemic.