bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disparities in Opioid Use for Pain Control Among Older Adults: The Role of Social Factors
Authors: Jansen Taylor 
Published: December 2020

Abstract
Over 50% of older adults (65+ years old) suffer from pain, and an estimated 25% of older adults use prescription opioids to treat their pain. Older adults are physiologically vulnerable to the effects of opioids; yet, they are prescribed more than all other age groups. This study used the Health and Retirement Study 2016 Core dataset (N=3,916) to analyze the moderation effect of social support on the association between pain and prescription opioid use in people aged 65+ using logistical regression analysis. Results show that older adults with severe pain were more likely to use prescription opioids (OR= 4.84) after considering covariates. Higher perceived social support was associated with higher likelihood of prescription opioid use for severe pain (OR=1.53). Older adults are at greater risk of pain and social isolation compared to younger age groups, making them a vulnerable group to consider as policy makers tackle this nationwide epidemic.
Bridging the Past and the Future: Why Age Matters in Behavioral Health Training
Authors: Allen Rebecca , Carden Keisha 
Published: December 2020

Abstract
This symposium presents data from three applied clinical research projects that involve intergenerational interaction as one component of effective treatment. The first paper describes learner outcomes in an intergenerational art therapy and reminiscence program provided in an adult day service facility. Results show that, in comparison with students in a didactic psychology of aging course or an introductory psychology course, learners in the experiential learning course demonstrated increased empathy, as well as better attitudes toward and increased interest in working with persons with dementia (PWD). The second paper focuses on observed outcomes for older PWD participants in this art therapy and reminiscence program, showing that intergenerational communication engagements exceed engagements with art. Mixed method data across time indicated that PWD benefitted from the treatment, facilitated by undergraduate student learners. The third paper focuses on cultural humility and the importance of racial diversity in providers conducting behavioral health screening in an integrated geriatric primary care clinic. Training issues and behavioral health outcomes regarding assessment of cognitive status, cultural mistrust, and test validity are considered. The fourth and final paper considers how intergenerational dynamics facilitated group cohesion and allowed for increased normalization of common challenges in mindfulness practice. Training issues for graduate student therapists are described. Consideration of level of behavioral health integration in each site, treatment efficacy, and the impact of intergenerational relationships are the foci of discussion. This symposium will show why age matters in behavioral health training.
Assessing and Harnessing the Power of Intergenerational Interactions in Mindfulness-Based Treatment Groups
Authors: Dragan Deanna , Newman Andrea , Torres Calia , Carden Keisha , Letang Sarah , McDuffie Danielle , Bontemps Andrew , Allen Rebecca 
Published: December 2020

Abstract
Mindfulness-based interventions (MBIs) in individual and group formats, have been shown to be effective for a variety of psychological disorders. Due to the promising evidence supporting the wide applicability of mindfulness skills, graduate student therapists were trained to deliver groups that attracted diverse individuals across the lifespan. In these groups, therapists noted how intergenerational dynamics facilitated group cohesion and allowed for increased normalization of common challenges related to practicing mindfulness skills. Therapists’ prior training on cohort differences and treatment recommendations for older adults served as an important foundation to navigating these group interactions. Barriers to simultaneously collecting data and delivering intervention components were noted by the student therapists. Future research and therapist training gaps in knowledge related to effectively facilitating intergenerational groups were identified.
Risky Preferences: Nursing Staff Perceptions of Risks May Impede Delivery of Person-Centered Care
Authors: Behrens Liza , Van Haitsma Kimberly , Kolanowski Ann , Boltz Marie , Sciegaj Mark , Abbott Katherine , Madrigal Caroline 
Published: December 2020

Abstract
Nursing home (NH) staff perceptions of risks to residents’ health and safety is a major barrier to honoring resident preferences, the cornerstone of person-centered care delivery. This study examined direct-care nursing staff perceptions of risk (possibilities for harm or loss) associated with honoring residents’ preferences for everyday living and care activities. Participants (N=27) were mostly female (85%), had more than 3 years of experience (74%), and worked in NHs experiencing 6-12 health citations. Content analysis of 12 focus groups indicated nursing staff perceptions of risks may impede delivery of PCC. This is supported by the overarching theme: pervasive risk avoidance; and sub-themes of: staff values, supports for risk-taking, and challenges to honoring preferences. Findings will be discussed considering a newly modified risk engagement framework meant to understand and inform the clinical management of older adult preferences perceived to carry risks. Opportunities for future research will be discussed (e.g. measurement development). Part of a symposium sponsored by the Research in Quality of Care Interest Group.
Staff Barriers to Fulfilling Assisted Living Resident Daily Care and Activity Preferences
Authors: Roberts Tonya , Parks Jillian , Greenhalgh Ella , Hansen Josephine , Wheelis Olivia , Wilke Sara 
Published: December 2020

Abstract
Person-centered care (PCC), or delivery of care consistent with preferences, has been associated with improved care and quality of life for residents in long-term care (LTC). However, research has shown PCC has not been universally adopted. While general implementation barriers have been identified, little research has focused on barriers to meeting specific types of resident daily care and activity preferences. The purpose of this study was to describe LTC staff barriers to fulfilling specific types of resident preferences. A descriptive, qualitative study with 19 assisted living staff from nursing, dietary, and activities was conducted. Semi-structured interviews focused on identifying work system barriers to meeting specific types of resident preferences were analyzed using thematic analysis. Findings suggest shift assignments, staffing challenges, and facility schedules influence staff ability to meet certain types of preferences. The results suggest innovative design of shift schedules and assignments may help staff meet certain types of preferences. Part of a symposium sponsored by the Research in Quality of Care Interest Group.
Meaningful Aging in the Face of Vulnerability: Perspectives From the Humanities and Arts
Authors: de Medeiros Kate , O’Neill Desmond 
Published: December 2020

Abstract
This symposium interprets GSA’s 2020 leading conference theme, “Why Age Matters”, as touching upon fundamental existential questions about the meaning of old age. Although meanings of aging have always been implicitly present in a variety of disciplinary gerontological studies, scholars from the humanities and arts have traditionally taken the lead in the field to provide thorough reflections and analyses about what makes later life meaningful. In this symposium, we aim to present a selection of perspectives from the humanities and arts that explore how meaningful aging can be realized in circumstances of the increasing vulnerability that inevitably accompanies old age. First, Hanne Laceulle uses a practice-theoretical philosophical framework to argue that the common assumption that vulnerability constitutes a threat to meaningfulness deserves to be nuanced, because meaning can also occur in the process of integrating vulnerability in one’s life. Second, Theresa Allison, Jennie Gubner and Alexander Smith show how vulnerable older adults living with dementia and their caregivers seek meaning in daily life, adapting meaningful activities to circumstances of increasing vulnerability. Third, Kate de Medeiros and Ulla Kriebernegg discuss how a dialogue between facts and fictions, narrative and literary gerontology, can contribute in seeing vulnerability as a form of resistance. Fourth, Margaret Perkinson illustrates the power of visual images as elicitors of reflections on meaning among the older inhabitants of a Guatemalan village. Documenting villagers’ own perspectives through PhotoVoice methodology underscores the fundamental importance of taking first-person perspectives into account when studying meaning.
Building and Sustaining a Community Advisory Board of African American Older Adults for Volunteer Research
Authors: Mitchell Jamie , Perry Tam , Johnson-Lawrence Vicki , Rorai Vanessa 
Published: December 2020

Abstract
Older African Americans’ (AA) participation in health-related research is severely limited; they are not involved in sufficient numbers and for sufficient duration to ensure the applicability of advancements in medical and behavioral health. This research participation gap exacerbates older AAs vulnerability to poor health outcomes and disparities. The Michigan Center for Urban African American Aging Research employs a progressive community-based participatory model that utilizes a structured community advisory board (CAB) of older AAs in metro Detroit to oversee the research recruitment and retention of fellow AA older adult research participants. CAB members are provided ongoing training on social and behavioral health research, supported in acting as a consultancy to outside researchers where they can be compensated for their expertise and engagement, and empowered as gatekeepers of a participant research registry of over 1000 AA older adults. This model has broad potential for advancing community engaged research with AA older adults.
Working With Communities to Support Minority Caregivers: The PRISMA Health REACH Expansion Project
Authors: Spencer Mindi , Miller Maggi , Jahries Diana , Davis James 
Published: December 2020

Abstract
In 2019, the NIH presented the results of its two-year visioning process to advance the science of minority health and health disparities. The PRISMA Health REACH Expansion (PH-REACH E) is an innovative, community-academic partnership between a hospital memory clinic, meal delivery service, research university, and low-income health clinic. The purpose is to: 1) increase the dementia capability of community-based programs, 2) offer caregivers of persons with dementia the REACH intervention, and 3) identify and connect racial minority and/or rural residents with services to promote health and well-being in older adulthood. This presentation will detail the PH-REACH E framework and present program results, which include improved caregiver outcomes (e.g., reduced burden, increased self-efficacy, reduced depression) and enhanced dementia capability (e.g., increased dementia knowledge) of partner organizations. This program illustrates some key recommendations of the NIH – community engagement in intervention adaptation, multisectoral collaboration, and promoting systems-level change to reduce health disparities.
Nutrient Intake Patterns Predict Homeostatic Dysregulation in an Older Quebec Population
Authors: Cohen Alan , Senior Alistair , Legault Véronique , Raubenheimer David , Simpson Stephen , Presse Nancy , Gaudreau Pierrette , Couteur David Le 
Published: December 2020

Abstract
The geometric framework for nutrition has largely been applied to macronutrients in experimental settings. Here, we utilize the framework to examine both macro and micronutrient intake patterns in observational human data. We used nutritional intake patterns (3x 24h recall per visit) of 1754 older Quebecers from the NuAge cohort to predict multi-system homeostatic dysregulation scores calculated from 30 biomarkers. Intermediate intake of both macro- and micronutrients was generally associated with lower dysregulation scores (i.e., better health). Furthermore, there were often nutrient-nutrient interactions, such that the optimal level of one nutrient depends on the intake level of others. However, higher protein intake was generally associated with better health, and results varied substantially across different dysregulation systems. Accordingly, even though nutrition does have important effects on health trajectories during aging, it will be challenging to arrive at population-level recommendations to fine-tune nutrient intake patterns to optimize health beyond “everything in moderation.” Part of a symposium sponsored by the Nutrition Interest Group.
Partitioning Analysis of Disparities and Time Trends in Alzheimer’s Disease and Related Dementia
Authors: Akushevich Igor 
Published: December 2020

Abstract
This study uses Medicare data to i) identify age patterns, time trends, and race/geography-related disparities in prevalence and mortality of AD/ADRD; ii) apply partitioning methodology to separate out trends in causal components including incidence and survival, and iii) expand the method for analysis of disparities to identify the magnitude and trends in causal components of race-related disparities in AD/ADRD. Analysis shows that the trend in AD/ADRD incidence explains up to 70% of the observed changes in AD prevalence and mortality and is the main contributor to the differences in race-specific prevalence (higher for African Americans (AA)). Differences in race-specific incidence explain up to 80% of the disparity while 20% are due to difference in survival. This indicates that for AAs, incidence is worse but survival is better. This is confirmed by direct evaluations of hazard ratios: AD incidence HR for AA is 1.50(1.46,1.54) and 0.93(0.91,0.96) for survival after AD diagnosis.
REGARDS: A Case Study in Aging and Disparities Research, Mentoring, and Data Sharing
Authors: Howard Virginia , Manly Jennifer , Glymour Maria 
Published: December 2020

Abstract
Investigators in the NIH-funded REGARDS (REasons for Geographic and Racial Differences in Stroke) project have taken a novel approach to break the paradigm of epidemiologic studies limited to clinic-based convenience samples, by developing a national cohort of 30,239 black and white participants recruited from communities across all lower 48 US states, including 1,855 of the 3,033 counties. Mean age at enrollment (Jan 2003-Oct 2007) was 65.3 years. The four initial aims were to further understanding of: 1) geographic and racial differences in stroke risk factors; 2) geographic and racial differences in stroke incidence and mortality; 3) association of stroke risk factors and stroke risk (incidence and mortality) focusing on effect modification by race or region; and 4) establishment of a repository of serum, plasma, urine and DNA for use in future studies. When the grant was awarded, the study goals were broadened to include longitudinal remote assessment of cognitive function. A second in-home visit was completed May 2013-Dec 2016 including measures of functional status. The cohort is in its 17th year of follow-up. We will detail recruitment and enrollment methods, characteristics of the cohort and status, with brief overview of the biological, medical, psychosocial, environmental, and contextual data collected in the parent study. Speakers will discuss in more detail the stroke and cognitive data, ancillary studies focused on caregiver and heart disease outcomes, and provide examples of national and international mentoring that has leveraged REGARDS data. Finally, we will describe opportunities for additional data sharing and new ancillary studies.
REGARDS Cognitive Assessment and Approaches to Defining Cognitive Impairment and Change in Cognitive Function
Authors: Manly Jennifer , Unverzagt Frederick , McClure Leslie , Judd Suzanne , Rhodes J David , Howard George 
Published: December 2020

Abstract
Since 2003, REGARDS participants have taken part in telephone-based cognitive assessments. Global cognitive status is assessed annually with the Six-item Screener. Between 2006 and 2009, measures of learning and memory (CERAD Word List) and language/executive function (Animal and Letter Fluency) were implemented, and are administered biennially. A Brain Health Substudy, conducting in-home clinical examinations of neuropsychological, neurological, and functional status among 1000 participants, is underway to validate telephone assessments and estimate prevalence of VCID in REGARDS. Approaches to defining incident cognitive impairment and cognitive change, including definitions employed for case/cohort studies using stored blood samples, will be described. We will discuss psychometric and methodological considerations for characterization of risks for cognitive impairment across race and region, as well as longitudinal trajectories of cognitive function.
Opportunities for More Aging and Disparities Research, Mentoring, and Data Sharing With REGARDS
Authors: Judd Suzanne , Howard Virginia , Cushman Mary , Manly Jennifer , Howard George 
Published: December 2020

Abstract
One of the benefits of this large, national cohort study with black and white participants is the opportunity to involve a breadth of researchers in the science. REGARDS actively solicits and engages early career and minority investigators to lead or participate in manuscripts as well as ancillary studies. REGARDS has provided opportunities for &gt;175 ancillary studies, including those that enrich existing outcomes, provide new outcomes, assess new exposures, link with other national data, support extended analyses, and assess genetic associations. Over 70% of the 500+ publications to date have a lead author who was not a funded REGARDS investigator. In this presentation, we will discuss some of the innovative ancillary studies and high-impact manuscripts that have grown out of REGARDS, the processes for developing an ancillary study/manuscript, and the procedures for obtaining REGARDS data. We will describe opportunities for mentored research for junior investigators, as well as independent research projects.
Reversing Cognitive Decline in Aging: Reversible Mechanistic Defects and a Novel Nutritional Intervention
Authors: Sekhar Rajagopal , Taffet George 
Published: December 2020

Abstract
Aging is the biggest risk factor for cognitive-decline and Alzheimer’s disease (AD), but underlying mechanisms are not well-understood and interventions are lacking. Cognitive-decline in AD has been associated with deficiency of glutathione, (the most abundant, intracellular, antioxidant protein), elevated oxidative-stress, insulin-resistance and increased inflammation. We identified and reported that glutathione-deficiency and oxidative-stress in older-adults occur due to decreased availability of precursor amino-acids glycine and cysteine, and can be corrected with GlyNAC (a combination of glycine and the cysteine precursor N-acetylcysteine). We hypothesized that cognitive decline in older-adults is linked to glutathione-deficiency, mitochondrial-dysfunction, oxidative-stress, insulin-resistance, and inflammation. The first abstract discusses the rationale and findings of an open-label clinical trial: compared to young-humans, older-adults had cognitive-decline, glutathione-deficiency, mitochondrial-dysfunction, abnormal glucose-metabolism and insulin-resistance, oxidative-stress, endothelial-dysfunction and inflammation. These defects were improved/reversed by supplementing GlyNAC for 24-weeks, but benefits receded on stopping GlyNAC for 12-weeks. The second abstract presents a study in 8 young (20-weeks old) and 16 aged (90-weeks old) wild-type male C57BL/6J mice where we found that aged-mice had naturally-occurring cognitive-impairment, and brain defects in glutathione-deficiency, oxidative-stress, glucose-transport, mitochondrial glucose-oxidation, insulin-resistance, endoplasmic-reticulum stress, autophagy, mitophagy, inflammation, senescence, genomic and telomere damage. Aged-mice received either GlyNAC or isonitrogenous-placebo supplementation for 8-weeks, and only GlyNAC-fed mice improved cognition and brain defects. Collectively these data highlights the discovery of novel and reversible mechanistic defects in older-adults and aged-mice with naturally-occurring cognitive-decline, and identifies that supplementing GlyNAC can improve brain-health and cognition. These findings could have important implications for reversing cognitive-decline in older-adults, and AD.
Reversing Mitochondrial, Metabolic and Molecular Defects in the Brain Improves Cognition in Aged Mice
Authors: Sekhar Rajagopal , Kumar Premranjan 
Published: December 2020

Abstract
Age-associated cognitive-decline is a risk factor for Alzheimer’s disease (AD), but mechanisms are not well understood, and interventions are lacking. Rodent studies on AD have not led to therapeutic breakthroughs for cognitively-impaired humans. In an open-label trial in older-adults we found that supplementing GlyNAC (glutathione precursors glycine and N-acetylcysteine) improved cognitive-decline, defects in whole-body mitochondrial-function, and systemic insulin-resistance, oxidative-stress, and inflammation. We hypothesized that aged-mice will have similar defects in the brain, and studied male C57BL/6J mice as follows: young-mice (20w) were compared to two-groups of aged-mice (90-weeks) receiving either GlyNAC or isonitrogenous-placebo diets for 8-weeks. GlyNAC-supplementation improved cognition, and the following measures in the brain: glutathione-concentrations, glucose-transporters in blood-brain-barrier and neurons, mitochondrial glucose-oxidation, oxidative-stress, endoplasmic-reticulum stress, autophagy, mitophagy, inflammation, senescence, genomic and telomere damage. These data provide mechanistic insights into the novel and beneficial role of GlyNAC supplementation to reverse cognitive-decline in aging, and holds promise for human AD.
Health-Related Quality of Life Factors in African American Caregivers of Persons With Dementia
Authors: Brewster Glenna 
Published: December 2020

Abstract
African American caregivers of persons living with dementia have a high prevalence of caregiving compared to other caregiving groups. The goal of this study was to explore health-related quality of life factors in a sample (n=25) of African American caregivers with a body mass index of more than Caregivers were female (87%). Caregivers were an average age of 63.2 (±6) years, had 16.6 (±2) years of education, and were providing care for 4.3 (±4) years. Care-recipients were on average 79.1 (±11) years and mothers (52.2%). 74% of the caregivers reported good-to-excellent quality of life. Caregivers reported low anxiety and depression but high perceived stress and strain. Higher anxiety and depression were correlated with greater strain and lower quality of life. Healthcare providers need to examine specific situational caregiving factors that can affect African American caregiver outcomes; since, their stress and strain may not reflect in their response to psychological questionnaires.