bluuebunny/crossref_metadata_2025_split huggingface dataset:
PILOTING AN INTERPROFESSIONAL GERIATRICS COURSE FOCUSED ON SYSTEMS-BASED PRACTICE
Authors: Severance Jennifer J , Ross Sarah 
Published: November 2019

Abstract
Health professionals must be able to work together in the care of older adults to provide competent, value-based care within dynamic healthcare systems. Previous studies cite the need for health professions education addressing systems-based competencies and the interconnected components of health and aging services. With an aim to provide a foundation for systems-based interprofessional practice in the care of older adults, an academic medical center piloted a competency-based curriculum introducing different settings of care for older adults and exploring special topics in geriatric patient care and gerontology. Applying a framework of health and aging services, interprofessional faculty developed a curriculum delivered over six one-hour sessions during the Spring 2019 semester. Session topics included dementia care, end-of-life care, medication safety, activity, and financial and regulatory considerations across the continuum of care. Teaching strategies included didactics, case-based discussions, online reflection questions, shadowing of geriatric encounters in clinic and long-term care settings, and student presentations of a patient case. Post-session evaluation surveys were administered electronically to measure knowledge, skills and confidence using Likert-scale and open-ended questions. Eleven health professions students (medical [n=6], physician assistant [n=3], physical therapy [n=2]) participated. Preliminary findings show improved knowledge about healthcare and community-based options for older adults, value-based care, and the driving forces affecting health care delivery. Analysis of qualitative feedback identified key themes related to teaching methods, course materials, and course improvement opportunities. Interprofessional faculty collaboration can lead to quality health professions student training and increase competency in systems-based practice in the care of older adults.
AN INTERDISCIPLINARY PEDAGOGICAL APPROACH THAT HARNESSES COLLABORATIVE NETWORKS
Authors: Abramson Tobi A , Siegel Martha 
Published: November 2019

Abstract
Opportunities abound in healthcare and non-healthcare for innovative pedagogy, products, and services to address the growth of the aging population and ageism. ‘Aging-in-place’ homes and healthcare settings, often ill-prepared to meet aging needs, require redesign to incorporate designs that are responsive to an older or disabled person’s needs. This pedagogical approach used interprofessional/cross-disciplinary collaborative learning to incorporate a person-centered approach to developing evidence-based interior design solutions to transform homes, healthcare environments, and communities. This pedagogical collaboration built networks across disciplines, provided a unique learning environment by focusing on student learning through engagement of cross-discipline undergraduate and graduate students and external collaborators (older adults, healthcare systems). All students participated in the live project within and outside of the classroom utilizing print materials, didactic learning, experiential activities, research, technology, site visits, client interviewing, recording data, team meetings, and designing and presenting a solution to a panel of judges. Assessments indicated students’ appreciation of the project for their professional development and an enhanced understanding of teamwork strategies and cross-disciplinary classrooms for interprofessional learning. This pedagogical approach broke down academic silos and deserves more attention in academia to prepare students with the skills to work with an aging population. As the population ages, it is essential that college courses include approaches to decrease ageism and lead to the building of the workforce. Collaborative learning builds the foundation and networks that will help emerging professionals meet the needs of an aging population.
ADULT CHILDREN AND THEIR BOOMER PARENTS: THE DYNAMICS OF INTERGENERATIONAL LIVING ARRANGEMENT AND LIFE EVENTS
Authors: Huang Chiu-hua , Lin Ju-ping 
Published: November 2019

Abstract
Taiwan became an aged society in 2018. As Baby Boomers enter late life, relationships with family members gain importance.This research aimed to examine the intergenerational living arrangement between adult children and their baby boomer parents. Taking the perspectives of adult children, five waves of data (2008, 2009, 2010, 2011, and 2012) from the Panel Study of Family Dynamics (PSFD) were analyzed. Latent class growth analysis (LCGA) was used to develop changes types of intergenerational living arrangements. Focus on the life events of the two generations, this research examined the effect on intergenerational living arrangements changes pattern. The main findings are as follow. First, The proportion of intergenerational co-residence is high, especially between adult sons and their parents. There are different types of changes of intergenerational living arrangements. The four types of changes of intergenerational living arrangements for adult sons and daughters are the same: “continuous co-residence,” “continuous non-co-residence,” “from co-residence to non-co-residence,” and “from non-co-residence to co-residence.” Second, Adult children’s life events such as getting married and having children affect changes of intergenerational living arrangements. After marrying, the intergenerational living arrangement between adult children and their parents is inclined to be the “continuous non- co-residence” type. When adult sons have newborn babies, the living arrangement is inclined to be “from co-residence to non-co-residence.”
THE ROLE OF POLICY CONTEXT IN INDIVIDUAL LONG-TERM CARE DECISIONS IN OECD COUNTRIES
Authors: Caldera Selena 
Published: November 2019

Abstract
While family caregiving of the elderly has long been part of the cultural life of most OECD countries, longer life expectancy combined with low fertility rates has increased the share of the population dependent on current workers and minimized the available population of informal caregivers. The demand for expanded public provision of long-term care (LTC) resulting from this demographic shift prompted reforms in many OECD countries in the 1990s and 2000s. Differences in these reforms provide an opportunity to examine how individual choices between formal and informal care types are shaped by the policy context. I use longitudinal data on elders in three OECD countries, Sweden, Germany, and Japan, to examine LTC decisions under three varied approaches to population aging. The direction of LTC reforms in each country has been shaped by the existing model of care provision and financial constraints. In response to cost pressures, Sweden introduced need-based provision, financial devolution, and market-based approaches to its universal care model. Germany and Japan, in contrast, widely expanded restricted LTC coverage through public LTC insurance models. I use three multinomial logistic models of the LTC decision to test how differing policy schemes influence choices between formal and informal care. Using longitudinal Global Gateway to Aging data for each country, I model the LTC decision in each country as a factor of demographic and need characteristics of the elder experiencing limitations, characteristics of their family, and eligibility for publicly-provided LTC.
LOOKING UPSTREAM: THE ASSOCIATION BETWEEN AFFORDABLE HOUSING, NURSING HOME USE, AND UNMET CARE NEEDS IN THE COMMUNITY
Authors: Morales Meghan Jenkins , Robert Stephanie 
Published: November 2019

Abstract
In the U.S., population aging is coinciding with a growing affordable housing crisis. Evidence suggests that housing security contributes to health, but less is known about how affordable housing affects aging in place. We use a nationally representative sample (n=5,117) of older community-dwelling Medicare beneficiaries from the 2015 National Health and Aging Trends Study to test the association between housing cost burden (HCB) and moving to a nursing home, death, or remaining in the community by 2017. Among 2017 community-stayers (n=4,836), we also test the association between HCB and unmet care need, defined as experiencing a consequence related to 12 mobility (e.g., stayed in bed), self-care (e.g., skipped meals) and household (e.g., no clean laundry) activities. HCB is the proportion of income spent on rent or mortgage: low (&lt;30%), moderate (30-50%), severe (≥50%), or home paid off (referent). Among nursing home movers, 26% had moderate or severe HCB in 2015 compared to 16% of community-stayers. Informed by the person-environment fit perspective, weighted stepwise regression models (multinomial and logistic) adjust for race, age, sex (Model 1), self-rated health, probable dementia (Model 2), living with others and high income (Model 3). Severe HCB is significantly associated with nursing home entry (RRR=2.66, SE=0.89) and this association is only partially mediated by health factors (RRR=2.16, SE=0.72) and resources (RRR=1.95, SE=0.64). Among community-stayers, severe HCB is significantly associated with unmet care need across all models. This study suggests that affordable housing is an important protective factor for older adults to age well in the community.
THE DOCTOR-PATIENT RELATIONSHIP, PERSONALITY, MOOD, AND FUNCTIONING IN OLDER ADULTS
Authors: Atlas Lauren S , Zweig Richard 
Published: November 2019

Abstract
Personality pathology has been tied to mental and physical health in older adulthood. Less is known regarding the combined impact of personality and the doctor-patient relationship on mental health outcomes. This study examined relationships between personality, mood, and trust in physicians. Participants (N=170) were a sample of primary care older adults ages 60-99 (M = 70.73, SD = 7.054) who completed self-report measures of personality traits (NEO-FFI), processes (IIP-PD-25), depression (GDS-30; PHQ-9), social adjustment (SAS-SR) and trust in one’s physician (GTIP). Medical burden data (CIRS) were retrieved from medical records. After adjusting for relevant covariates such as age, perceived health, cumulative illness burden, and income security there were several significant predictive relationships. In combined models more neuroticism (NEO-N, ß = .082, p &lt; .000) and lower trust (GTIP, ß = -.025, p = .014) but not agreeableness (NEO-A, ß = -.006) or interpersonal problems (IIP-25, ß = .254) predicted depression. In combined models, higher neuroticism (NEO-N, ß = .018, p &lt; .000) and interpersonal problems (IIP-25, ß = .186, p = .002) but not agreeableness (NEO-A, ß = -.003) or trust (GTIP, ß = -.002) predicted social adjustment. The results are consistent with previous findings that neuroticism predicts both depression and social adjustment in older adults. In addition, lower trust augmented neuroticism to predict depression. Results suggest that apart from general personality risk factors, situational personality processes such as trust in physicians may affect mood state, whereas personality processes such as interpersonal problems contribute to longer term functional impairment.
INDIVIDUAL PREDICTORS OF VOLUNTEERING IN OLDER ADULTS USING STRUCTURAL EQUATION MODELING
Authors: Baumel Zolana J , Kelly Christopher M 
Published: November 2019

Abstract
Why do some older Americans volunteer while others do not? Personality theory is used to explain volunteering behavior. This study used the Big 5 personality domains. Volunteering is also explained by resource theory, which includes personal, social, and cultural capital. Personal capital was measured by age, sex, race, marital status, health, and education (a proxy for socioeconomic status). Social capital was measured by frequency of email/write interactions and interactions with friends. Cultural capital was measured as church attendance. The purpose was to measure the extent to which social and cultural capital mediates between personality and personal capital, and volunteering outcomes. Participants were the 2010 Core Health and Retirement Study who also completed the leave-behind self-administered questionnaire (N=4,299). Structural equation modeling (SEM) tested personality and resource theory in one model. Exploratory factor analysis, followed by confirmatory factor analysis supported development of the final SEM. Extraversion directly predicted volunteering. Age was inversely correlated with volunteering. Health and education directly predicted volunteering. Church attendance and interactions with friends directly predicted volunteering. Conscientiousness predicted church attendance. Open to new experience was inversely related to church attendance and directly predicted frequency of email/write interactions. Extraversion predicted interactions with friends. Measuring direct, indirect, and total effects of predictors on volunteering showed that personality influences volunteering both directly and indirectly. Future applied research could test whether extraversion, which directly influences interactions with friends, would directly predict recruiting outcomes. It could also test whether open to new experience, which directly influences email/write interactions, would directly predict retention outcomes.
IMPROVING MOOD THROUGH PHYSICAL ACTIVITY FOR CARERS AND CARE RECIPIENTS TRIAL (IMPACCT): RESULTS OF A RCT
Authors: Dow Briony , Malta Susan (Sue) , Gaffy Ellen , Russell Melissa , Williams Sue , Moore Kirsten J , Lautenschlager Nicola , Loi Samantha 
Published: November 2019

Abstract
The aim of this Australian study was to investigate effects on depression of a 6-month individually tailored home-based exercise program for caregivers, designed to be done with the person they care for. Ninety-one caregiver-care recipient dyads and 30 caregiver-only participants (caregivers scoring ≥4 on the 15 item Geriatric Depression Scale (GDS-15)) were randomized into one of three groups: exercise intervention (n=50, 34 dyads and 16 caregiver only), social support control (n= 50, 42 dyads and 8 caregiver only) or usual care control (n= 21, 15 dyads and 6 caregiver only). The exercise group completed an individualised program based on the Otago-plus. The primary outcome was the proportion of participants with GDS-15 ≤4. Outcome assessors were blinded to group assignment. There were no significant difference in depression between the physical activity intervention group and the social control (OR 1.06, 95% Confidence Interval (CI) 0.44, 2.56) and the physical activity intervention group and the usual care control (OR 1.51 95% CI 0.46, 4.94) at six months or at 12-months. However, more than 50% of caregivers in all three groups no longer had a GDS-15 score &gt;4 at 6 months. Sub-group analysis revealed that after 6 months caregivers in the exercise group caring for someone with an MMSE ≥24 were significantly less depressed than those caring for someone with an MMSE score of &lt;24 compared with social (p value &lt;0.02) and usual care groups (p value &lt; 0.02). A dyad exercise intervention may be beneficial for those caring for someone without cognitive decline.
DON’T WORRY, BE HAPPY NOW, PET OWNERS: THE RELATION BETWEEN PET OWNERSHIP AND ANXIETY AND DEPRESSION IN LATE LIFE
Authors: Bolstad Courtney J , Adams-Price Carolyn E , Nadorff Michael R 
Published: November 2019

Abstract
Pets can provide older adults a means of social support, which can combat problems faced in later life including loneliness, anxiety, and depression. However, current research findings in this area are mixed. The current study explored the differences in anxiety and depression between pet owners and non-pet owners and how pet ownership was associated with these symptoms after accounting for other established correlates. We hypothesized pet owners would endorse fewer symptoms of anxiety and depression than non-pet owners and owning a pet would be associated with these symptoms even after accounting for other common correlates. Participants included 608 older adults aged 70 to 95 that were included in the University of Alabama at Birmingham Study of Aging. As hypothesized, results indicated that pet owners endorsed significantly fewer symptoms of anxiety and depression than non-pet owners. Hierarchical regressions indicated that owning a pet explained a significant amount of variance in anxiety symptoms even after controlling for depression, self-reported health, and demographics. However, owning a pet did not have a significant association with depressive symptoms after accounting for anxiety, self-reported health, and demographics. These results suggest that lower rates of anxiety and depression are related to owning a pet and that pet ownership is associated with fewer anxiety symptoms, but not depressive symptoms, independent of several established correlates of anxiety. Future research is needed to determine the specific mechanisms of pet ownership that comprise this relationship as well as whether pet ownership may longitudinally reduce or buffer against anxiety in late life.
SELF-RATED HEALTH AS A PREDICTOR OF DEPRESSION AND ANXIETY IN OLDER ADULT INMATES
Authors: Vogel Carlyn E , Barry Lisa C 
Published: November 2019

Abstract
Inmates age ≥50 years (older inmates) are a rapidly growing population within the U.S. correctional system with the highest suicide rate among adult prisoners. Although depression and anxiety are strong precursors of subsequent suicide, little is known regarding factors associated with these outcomes in older inmates. To inform suicide prevention efforts in this high-risk population, we evaluated the role of older inmates’ self-rated health (SRH) in relation to depression and anxiety. We utilized data from the ongoing Aging Inmates Suicidal Ideation and Depression study (Aging INSIDE). Participants (N=175) included men age ≥50 (M=56.5, SD=6.3, range=50-79 years) from eight correctional facilities in Connecticut who completed face-to-face interviews. The outcomes, depression and anxiety, were assessed using the PHQ-9 (range 0-27) and GAD-7 (range 0-21); higher scores on each scale indicated worsening severity. SRH, operationalized as a pseudo-continuous variable (1=excellent; 5=Poor), was correlated with depression (r=0.379; p &lt;.001) and anxiety (r=0.260; p =.001) in unadjusted analyses. Two linear regression models were conducted to determine if SRH was associated with depression and/or anxiety after controlling for age, race (white versus non-white), years of education, visitors (yes versus no), and number of chronic conditions. Increasingly worse SRH was significantly associated with more depressive symptoms (β=1.92, SE=.43, p &lt;.001) and higher anxiety scores (β=1.41, SE=.41, p=.001). SRH explained 10.0% and 6.2% of the variance in depression and anxiety scores, respectively. SRH may be useful for identifying older inmates who are more likely to have depression or anxiety, and thus may be at higher risk for suicide.
RACIAL DIFFERENCES IN PHYSICAL ACTIVITY IN NURSING HOME RESIDENTS WITH COGNITIVE IMPAIRMENT
Authors: Viviano Nicole A , Galik Elizabeth , Resnick Barbara 
Published: November 2019

Abstract
INTRODUCTION: Nursing home residents with moderate to severe cognitive impairment are mostly sedentary. It is more likely that African-American (AA) older adults tend to be more sedentary than their white counterparts. The purpose of this study was to examine racial differences in overall time spent in physical activity (PA), time in sedentary, light intensity, and moderate levels of PA, and participation in activities of daily living (ADLs) among cognitively impaired nursing home residents. METHODS: This was a secondary data analysis from the Function and Behavior Focused Care Intervention study. The sample included 336 cognitively impaired residents from 12 nursing homes. RESULTS: The mean age of the residents was 86.2 (SD=10.1) with an average MMSE score of 7.8 (SD=5.0) where 41% were AA and 59% white. White and AA participants engaged in only 51.2 and 46.1 minutes of light and 1.5 and 1.1 minutes of moderate level PA, respectively. There was a significant difference in time spent in light-intensity PA with whites spending more time in this level of activity [F(4, 242) = 3.360, p = .01]. Conversely, AAs had better functional ability than white residents [F(4, 242) = 4.754, p &lt; .001]. There were no significant racial differences in time in sedentary, or moderate level PA. DISCUSSION: These findings are consistent with prior research showing that AAs had lower PA levels compared to their white counterparts. Future research should focus on increasing PA among nursing home residents and consider specific interventions to increase activity among AA residents.
GENDER DIFFERENCES IN THE EFFECT OF DIFFERENT EXERCISE DOSES ON PREVENTING DEPRESSIVE SYMPTOMS IN OLDER ADULTS
Authors: Chen Mei-Lan , Chang Yu-Chen , Chao Ying-Yu , Gardenhire Douglas S , Burgess Elisabeth O 
Published: November 2019

Abstract
Regular exercise is potentially an effective way to prevent or reduce depressive symptoms for older adults. However, little research has focused on gender differences in exercise dose effects on depressive symptoms in older people. The purpose of this study was to test gender differences in the preventive effects of different exercise doses on depressive symptoms among community-dwelling older adults in Taiwan. This study was a secondary analysis of a longitudinal cohort study in a sample of older Taiwanese adults (N = 2,673; mean age 74.2 ± 5.7 years). Four different doses of moderate-intensity exercise were examined including three 15-min sessions/week, three 30-min sessions/week, six 15-min sessions/week, and six 30-min sessions/week. Descriptive statistics and generalized linear mixed models were used to analyze characteristics of the sample and hypotheses testing. All analysis models were adjusted according to age, gender, education, marital status, smoking, social participation, and chronic conditions. The results indicated that regular exercise with at least 15 min per session, 3 times a week of moderate intensity was significantly associated with lower levels of depressive symptoms for women, but there were no significant preventive effects on depressive symptoms for men. This study suggests that moderate-intensity exercise may play a protective role in depression prevention for older women, even with a very low dose (three 15-min sessions/week). Gender differences should be considered for future research and clinical practice when designing exercise interventions on preventing depression for older adults.