bluuebunny/crossref_metadata_2025_split huggingface dataset:
Change in Cognitive Performance by Race or Ethnicity and Multimorbidity Among Older Americans
Authors: Quinones Ana , Chen Siting , Botoseneanu Anda , Allore Heather , Newsom Jason , Thielke Stephen , Kaye Jeffrey 
Published: December 2020

Abstract
Understanding factors that influence cognitive performance remain critical priorities, particularly among racial/ethnic groups that have higher prevalence of dementia. This study assesses race/ethnic (non-Hispanic white, non-Hispanic black, Hispanic) differences in cognitive performance in adjusted models accounting for co-existing self-reported chronic conditions (arthritis, diabetes, cancer, depressive symptoms, cardiovascular disease, hypertension, lung disease, osteoporosis, stroke), age, sex, education, and income. Data from the 2011-2017 National Health and Aging Trends Study (NHATS), a nationally-representative sample of Medicare beneficiaries (N=7,041, mean age=77.5), were used to estimate a series of cross-sectional multivariable linear regressions to evaluate race/ethnic differences in cognitive performance scores on the NHATS cognitive composite test of memory, orientation, and executive function domains (range 0-33) over seven years. In adjusted models, black participants had lower cognitive scores relative to white participants in 2011 (b=-2.25, 95% CI[-2.52, -1.98]) and by the end of the observation period in 2017 (b=-3.24, 95% CI[-3.72, -2.76]). Similarly, Hispanic participants experienced lower cognitive scores relative to white participants in 2011 (b=-2.31, 95% CI[-2.77, -1.84]) which persisted to the end of the observation window (b=-2.77, 95% CI[-3.66, -1.89]). Racial/ethnic groups had significantly lower cognitive scores relative to white Medicare beneficiaries over seven years of assessment. These analyses build toward longitudinal analyses of repeated observations of cognitive performance. Given the broad clinical and policy implications involved in caring for persons with dementia, it will be important to intervene earlier on modifiable risk factors to postpone cognitive declines among older minority ethnic adults.
Prevalence of Heavy Alcohol Use by Caregivers of Persons With Alzheimer’s Disease or Related Dementia
Authors: Kunicki Zachary , Jones Richard 
Published: December 2020

Abstract
Some caregivers of persons with Alzheimer’s Disease and related dementias (ADRD) are known to be under high levels of burden, which is associated with higher levels of anxiety, depression, and stress. Previous research has established anxiety, depression, and stress are associated with heavy alcohol use, but little research has examined heavy alcohol use among ADRD caregivers. Heavy alcohol use could influence the ability of ADRD caregivers to provide care. The purpose of this study was to explore the prevalence and prevalence correlates of heavy alcohol use among ADRD caregivers using the 2016 Behavior Risk Factor Surveillance Survey (BRFSS). We identified 2,028 persons among the 486,303 BRFSS respondents who were the primary informal caregivers of a person with ADRD. Among them, the prevalence of heavy alcohol use was 6.3 per 100 persons. Adult child caregiver relationship, positive smoking status, and fewer hours of providing care per day were all positively and significantly associated with heavy alcohol use. Notably, sex was not. Future research should examine if heavy alcohol use by ADRD caregivers is related to personally and clinically relevant outcomes of care provided to the persons with ADRD.
Shared Decision Making Between Older Adult Home Health Patients and Their Caregivers: A Dyadic Coping Perspective
Authors: Tay Djin , Ellington Lee , Towsley Gail , Supiano Katherine , Berg Cynthia 
Published: December 2020

Abstract
Older adult Home health (HH) patients comprise a medically frail population with increased inpatient and emergency department utilization. Despite the need for advance care planning among this population, rates are suboptimal. Patients rely increasingly on caregivers to advocate and coordinate their care particularly at the end of life; however surrogate decision makers are often underprepared for their roles in end-of-life decision making. This study examined shared decision making processes among older adult HH patients and caregivers during a shared decision making intervention guided by the Developmental-Contextual Model of dyadic coping (DCM). Purposive recruitment of N=18 HH patient-caregiver dyads was conducted. Patients were 55 years and above and participated with a family or non-family caregiver they nominated to the study. A 10-41 minute long video-recorded advance care planning intervention was conducted in patients’ homes and analyzed for non-verbal and verbal interactions using Noldus Observer XT 14.0. Theoretically-derived codes were applied deductively in a content analysis to examine dyadic processes associated with interactions suggesting agreement (convergent interactions) and disagreement (divergent interactions). Convergent interactions demonstrated greater alignment in illness representations and shared appraisals, and processes involving support, negotiation, and confirmation of preferences were noted. Convergent interactions also facilitated joint planning for future decisions. Disagreement on illness representations and/or shared appraisals, and overriding another’s preference was observed with divergent interactions. This study builds the groundwork for intervention refinement to promote constructive decision making and address non-constructive decision making among patient and caregivers for advance care planning.
Spousal Caregiving and Cognitive Trajectories: Does Care Recipient Dementia Status Matter?
Authors: Atkinson Taylor , Jester Dylan , Haley William 
Published: December 2020

Abstract
Caregiving is often considered stressful, even more so if the care recipient has been diagnosed with dementia. The current study examines the rate of cognitive decline of spousal caregivers of persons with dementia (CG-D) when compared to spousal caregivers of persons without dementia (CG) before and after the death of the care recipient. Health and Retirement Study (HRS) data from 1998-2016 were used to examine cognitive trajectories of CG-D (n=364) and CG (n=1,649) before and after the care recipient death. Cognition was measured through the HRS’s shortened Telephone Interview of Cognitive Status and separated into measures of total cognition and memory. Covariates included age, education, sex, race, ethnicity, care hours, frailty, socioeconomic status, nursing home placement of the recipient, and whether the death was expected. Piecewise mixed models were constructed to examine two two-year periods of decline leading up to the death of the care recipient, and two two-year periods of decline after the death of the care recipient. CG-D and CG declined at equivalent rates on measures of total cognition and memory (ps &gt; .05). In all caregivers, total cognition and memory declined at a stable rate before the death of the care recipient. However, an accelerated decline was evident after the death of the care recipient (ps &lt; .001). Our results suggest that cognitive decline is not differentially affected by care recipient dementia diagnosis. We find evidence that the death of a spousal care recipient is accompanied by hastened cognitive decline in our population-based sample.
Wellness Coaching: Practices and Preferences Among Life Plan Community Residents and Staff
Authors: Fullen Matthew , Smith Jennifer , Sayer Janis , Clarke Philip , Tomlin Connie 
Published: December 2020

Abstract
Wellness coaching, a process in which a coach and client partner together to address the client’s wellness goals, can increase motivation and develop skills to enhance wellness and lifestyle balance among older adults. To understand wellness preferences among Life Plan Community residents, we surveyed a total of 447 residents from 10 Life Plan Communities. Participants were asked about perceptions of wellness, wellness activity preferences, motivators and barriers to participation in wellness activities, and wellness coaching program preferences. Twenty employees in wellness-related or leadership roles also completed a survey. To enhance our understanding of these perspectives on wellness coaching, nine residents and four employees participated in follow-up interviews. Among the study findings, the majority of resident respondents expressed an interest in improving almost all domains of wellness. Forty percent (40%) of participants said they were extremely or moderately likely to try wellness coaching, and about one-half (51%) said they believed they would benefit from wellness coaching. Staff indicated interest in implementing a wellness coaching program in their community, with 74% reporting at least a moderate likelihood of implementing a program if led by a staff member. Results indicated that emotional and vocational wellness programs were offered and attended less frequently than other types of wellness programs, which suggests that wellness coaching could help to address the need for more programming in these areas. In addition, findings suggested that implementation requires resident input to ensure buy-in. The survey results informed the development of recommendations for a resident wellness coaching program.
Examining Satisfaction With Assisted Living Among Residents With and Without Dementia
Authors: Holmes Sarah , Galik Elizabeth , Resnick Barbara 
Published: December 2020

Abstract
Understanding residents’ satisfaction with assisted living (AL) is essential for creating supportive environments that are focused on residents’ needs and preferences. Nearly half of AL residents experience some level of cognitive impairment, although limited research has examined residents’ satisfaction with AL particularly among those with cognitive impairment. The purpose of this study was to compare satisfaction with AL between residents with and without dementia. Baseline data from the Dissemination and Implementation of Function Focused Care in AL study was used in this analysis. A total of 481 AL residents were included in the sample. Measures included demographic information, Saint Louis University Mental Status Exam (SLUMS), and the Resident Satisfaction Index. Controlling for age, gender, and comorbidities, multivariate analyses of variance was performed to consider the impact of cognitive status on residents’ satisfaction with health care services, physical environment, relationships with staff, and social activities. The majority of participants were female (71%), White (97%), mean age was 89 years old (SD=7.43), and mean SLUMS score was 15.90 (SD=4.74). On average, residents were highly satisfied with AL reporting a mean score of 19.17 (SD=3.15). There were no significant differences in residents’ satisfaction scores (p&gt;.05) between residents with dementia and without dementia across all subdomains of satisfaction: health care services, physical environment, relationships with staff, and social activities. There may have been some bias in results due to social desirability. Further research should explore additional aspects of residents’ satisfaction with staff such as whether or not person-centered care is provided.
Thinking Outside the (Enrollment) Box: “Who, disguised as a Public Educator, . . .”
Authors: Anunsen Roger 
Published: December 2020

Abstract
“Thank you, I really enjoyed your talk. I understand you teach college classes and I’m wondering how . . .” That’s what can happen when a “College Educator” steps off campus, steps into the community. That’s the enrollment superpower of a “Public Educator.” We’ll track a decade of innovative off-campus educational presentations strategically positioned to target new students, lead to cognitive-enhancing programs with adult residential living communities, and, importantly, help reset the role and relevancy of today’s gerontology faculty. Examples will include service club meetings, public agency, business and non-profit training retreats, and residential community staff training. Examples include “This is Your Brain on . . .” events such as Music, Loneliness, Sleep, Volunteering, Sports Fandom, Quilting, Golf and, of course, TasteAerobics featuring Brain-Healthy Chocolate. We’ll conclude with an innovative enrollment and awareness-raising project in a small city west of Portland that kicked off with a 6-part Aging Education Series. Part of a symposium sponsored by the Community College Interest Group.
Implementing a Positive Learning Experience Related to Older Adults for Undergraduates: A Toolkit
Authors: Scheve Ann , Bruderle Elizabeth 
Published: December 2020

Abstract
Undergraduate nursing students are frequently exposed to older adults in the clinical setting, where they assess and manage their diseases and its consequences. But that is not enough! To support healthy aging, students need positive intergenerational learning experiences with older adults to discover the gifts of aging early in their curriculum. The goal of these experiences is to help students reflect on their thoughts about aging and reframe how they view older adults. During this presentation we will provide a tool kit based on our experience incorporating positive intergenerational learning early in our curriculum, offer practical guidelines and share constructive feedback.
Dementia Caregiving, Care Recipient Health, and Financial Burdens
Authors: Basu Rashmita 
Published: December 2020

Abstract
Objective: While about 75% of people with ADRD receive care informally by their family members, relatively little is known about the effect of the quality of caregiving on maintaining carerecipient’s health and financial burden of out-of-pocket (OOP) healthcare costs. The goal of this study is to examine the quality of caregiving on the out-of-pocket healthcare costs among ADRD patients and if caregiving prevents deterioration of physical health of carerecipients. Data and Sample: We used a nationally representative sample of people diagnosed with ADRD from the Aging Demographic and Memory Study, subsample of the Health and Retirement Study. The study sample includes carerecipients whose caregivers participated in the survey (N=261). Outcome measures: Primary outcomes were deterioration of carerecipients’ health (1=yes, 0=no) and annual OOP healthcare costs. The quality of caregiving is captured by if caregiving made them feel good, feel useful and fee closer to carerecipients. More than 70% caregivers reported that caregiving make them feel good or useful. About 60% of carerecipients’ physical health was maintained, and average out-of-pocket costs was $3,701/year ($0-$31,051). Multivariable logit for binary health outcome and OLS regression for OOP cost were estimated. Results: The likelihood of health deterioration was significantly lower for carerecipients whose caregivers reported that caregiving made them feel useful (AOR=5.1, 95% CI: 1.9- 14.5) and lower OOP remained significantly associated with presence of usefulness of caregiving (cost decrease, $3000 [95% CI: $6309-$918). Positive feeling of caregiving is independently associated with lower OOP cost and deterioration of physical health among ADRD patients.
Aging and Decision Making: Socio-Emotional and Contextual Factors
Authors: Strough JoNell , Loeckenhoff Corinna , Charles Susan 
Published: December 2020

Abstract
Maintaining sound decision-making skills in later life is a key concern in the face of population aging. The four presentations in this symposium highlight the importance of considering socio-emotional and contextual factors when investigating adult age differences in decision making. Together, they show that features of decision contexts such as the way information is presented, along with social relationships and emotional responses, have distinct implications for understanding age effects in decision-related processing and outcomes. Drawing from fuzzy trace theory, Nolte, Löckenhoff and Reyna showed that gist-based (“good,” “extremely poor”) versus verbatim information (exact numbers) was differentially appealing to younger and older adults, with older adults seeking more gist information than verbatim information. Young and Mikels investigated older and younger adults’ integral emotional responses to a behavioral risk-taking task. Younger adults experienced more anger and less contentment than older adults. These emotions differentially predicted risk taking in the two groups. Seaman, Christensen, Senn, Cooper, and Cassidy found age differences in learning about the trustworthiness of social partners. Older adults showed less learning relative to younger adults and invested less with trustworthy partners and more with untrustworthy partners. Smith, Strough, Parker and Bruine de Bruin found that older age, perceiving better decision-making ability than age peers, and perceiving declines in ability over time, were associated with lesser preferences for making decisions with others. In her discussion, Charles will integrate these findings with existing research on aging and decision making and offers directions for future research.
Health-Related Support and Control on Poor Diet in Mixed-Weight, Older Gay Married Couples
Authors: Novak Joshua , Wilson Stephanie , Peak Terry , Gast Julie , Miyairi-Steel Maya 
Published: December 2020

Abstract
The health support and control literature in same sex couples suggests partners take turns (known as health behavior work). However, research has not accounted for mixed-weight (lighter partner (LP) and heavier partner (HP)) status in these relationships nor investigated domain-specific health behavior work (i.e., dietary habits) on outcomes. We examined an actor-partner interdependence mediation model of 224 mixed-weight, older gay married couples (mean age: 52) and controlled for education, relationship satisfaction and length, frequency of eating meals together, and income. Nutrition-specific eating encouragement and discouragement was not associated with poor dietary behaviors for either partner. More frequent couples’ reports of disagreements about nutrition was associated poorer diet for both the HP and LP (through their own higher depressive symptoms). Interestingly, the higher LP’s health support was associated with better LP’s diet (through lower depressive symptoms), and higher HP’s health control was associated with poorer LP’s diet (through lower depressive symptoms).
Establishing the Replicability and Generalizability of Multi-Study Longitudinal Research
Authors: Hofer Scott 
Published: December 2020

Abstract
Replication and cross-validation of research findings across independent longitudinal studies is essential for a cumulative science. However, the interplay between harmonization, replication, and generalizability of results across interdisciplinary longitudinal studies can present remarkable challenges. Careful interpretation of multistudy results must include consideration of the age, birth cohort, health, and education of individuals in the sample, measurements, the number and spacing of assessments, and rates of response and attrition. Placed in a broader historical (or future) context, we must consider the representativeness of population sampling, historical period, and analytic method in understanding the replicability and generalizability of findings. In a multistudy context, harmonization can be considered at levels of research question, statistical models, and measurements and can minimize some sources of cross-study variability. I will discuss the challenges and benefits of harmonization and the coordinated analysis approach used by the IALSA research network to achieve results from multi-study integrative research.
Psychological Pathways Linking Parent-Child Relationships to Subjective and Objective Sleep Among Older Adults
Authors: Wang Haowei , Kim Kyungmin , Burr Jeffrey , Wu Bei 
Published: December 2020

Abstract
This study investigated whether older adults’ relationships with their children were associated with their self-reported subjective sleep quality and actigraphy-measured objective sleep characteristics, as well as whether depressive symptoms and loneliness mediated the association between these parent-child relationships and sleep. Data were taken from the second wave of the National Social life, Health, and Aging Project, in which 569 respondents (age 57-85) participated in the sleep module, along with the social network module that provided relationship information for participants and their children. Results from structural equation modeling showed that (1) parents’ closeness with children was associated with better objective sleep (i.e., fragmentation of sleep and percent sleep), (2) more frequent contact with children was related to better subjective sleep quality, (3) depressive symptoms and loneliness were associated with worse subjective sleep quality, and (4) less closeness with children were related to worse subjective sleep quality via older adults’ depressive symptoms. Part of a symposium sponsored by the Sleep, Circadian Rhythms and Aging Interest Group.
Aging in High-Risk Coastal Regions: Examining Social Infrastructure Needs of Older Adults Living in the Gulf Coast
Authors: Merdjanoff Alexis 
Published: December 2020

Abstract
This study examines how coastal erosion, flooding susceptibility, and extreme hazard risk in Louisiana communities shape decisions to age in place. The decision to age in place is not only related to one’s physical health and cognitive capabilities but strongly connected to neighborhood cohesion, sociocultural contexts, economic resources, familiarity with surroundings, and a sense of security. However, research on the types of individual and community resources that older adults need in order to successfully age in environmentally vulnerable communities is exceptionally sparse. Using in-depth interview data collected from older adults (n=20) living in coastal Louisiana parishes, this research aims: 1) to gain a deeper understanding of how coastal erosion and frequent flooding influence the decision to age in place; 2) to compile evidence as to how coastal communities can create resources that promote resilience, despite environmental risk; and 3) to use this evidence to increase awareness and enhance policy discussions on coastal adaptation.
Gender, Cognitive Status, and Depressive Symptoms: Findings From the National Social Life, Health, and Aging Project
Authors: Cheung Ethan Siu Leung , Mui Ada 
Published: December 2020

Abstract
This secondary research is based on the Wave 3 National Social Life, Health and Aging Project (n = 3,104). The association between cognition, gender, and depressive symptomatology were examined. Findings indicate that 54% of the sample were women and the mean age was 72.95 (SD=8.29). Bivariate analyses suggest that there were no gender differences in cognitive status (Mean of MoCA Short Form = 9.73; SD = 3.26), age, and stress (Mean of PSS = 7.69; SD = 3.90). There were significant gender differences in terms of marital status, income, education, stressors, social participation, and social support. Compared to older men, older women reported a significantly lower level of both education and income. Multiple regression results show that gender has an independent effect and a joint effect with stressors in explaining depressive symptoms. Parallel regression analyses for each gender group were conducted and models were significant (P &lt; .0001). The only common predictor for depressive symptoms was ADL impairment, and the impact of this was stronger for males (b=.32) than for females (b=.17). For older men, unique correlates of depressive symptoms were being not married, more ADL and cognitive impairments, and higher stress. For older women, a higher level of depressive symptoms was associated with being younger, lower-income, a higher level of ADL and IADL impairments. In addition, white elderly women reported a higher level of depressive symptoms than Asian elderly women. Findings suggest gender and racial differences in depressive symptoms experienced among older Americans living in the community.