bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Acculturation Experiences of Korean Immigrant Older Adults Through Expressive Writing
Authors: Rhee Stephanie 
Published: December 2020

Abstract
Korean immigrant older adults residing in areas without well-established Korean ethnic enclaves experience acculturative stress and depressive symptoms due to their lingual and cultural barriers. Expressive writing can be used as a culturally sensitive intervention to help those immigrants disclose their deepest thoughts and feelings related to their immigration and acculturation experiences. This study gathered qualitative data from the author’s experimental study using expressive writing for first-generation Korean immigrant adults 60 to 88 years of age residing in Midwestern cities. Participants were instructed to write for 15-20 minutes per day in three consecutive days at their convenience in a comfortable and private setting and asked to return their writings by mail. A total of 22 participants returned their writings: 14 wrote about their past and current stressful experiences related to their immigration and acculturation, while eight wrote about their daily lives. Eight themes emerged from thematic coding processes guided by the grounded theory approach: (1) survival, resilience, hardiness, tenacity, pride; (2) lingual barriers; (3) religious faith; (4) gender difference in roles and values; (5) racial discrimination; (6) traditional strategies of acculturation; (7) family and intergenerational gap; and (8) aging. The themes illustrate the participants’ lifelong efforts to shape their unique voices through heart-wrenching struggles, haunting wounds, and ethnic pride and resilience. The study findings suggest that culturally relevant programs and services are needed to facilitate social relationships and reduce lingual and cultural barriers for Korean immigrant older adults residing in non-ethnic enclaves.
Sex Differences in the Prevalence of Pain Trajectories Over a 14-Year Period in the Mexican Health and Aging Study
Authors: Milani Sadaf , Rodriguez Martin , Ternent Rafael Samper , Wong Rebeca 
Published: December 2020

Abstract
Pain increases with age, disproportionately affects females, and is a major contributor to decreased quality of life. Because pain is dynamic, trajectories are important to consider. However, few studies have looked at longitudinal trajectories of pain, by sex, using population data. We used data from the 2001, 2003, 2012, and 2015 waves of the Mexican Health and Aging Study, a nationally representative sample of Mexicans aged 50 and older. Individuals who had direct interviews at each time point and complete information on analytical variables were included (n=5,135). Pain reported at these time points was used to define pain trajectories as persistent pain, development of pain, diminishing pain, fluctuating pain, and never pain, by sex. Multinomial logistic regression was used to assess the association of sex with pain trajectories, adjusting for baseline demographic, behavioral, and health factors. Females had a higher prevalence of persistent pain (25.1% vs. 11.5%) while males had a higher prevalence of never pain (35.8% vs. 22.2%). Development of pain, diminishing pain, and fluctuating pain was similar between males and females (14.4% and 14.6%; 14.8% and 15.8%; 23.9% and 22.4%, respectively). Females had higher odds of persistent pain (OR: 2.13; 95%CI 1.67-2.70) and development of pain (OR: 1.40; 95%CI 1.11-1.75) compared to males. Overall, females had a much higher burden of persistent pain compared to males. Understanding trajectories of pain in later life and life course mechanisms for this large sex difference observed is crucial to improve quality of life.
Health Behaviors Among Family Caregivers Participating in the Paid Workforce
Authors: Keller Abiola , Garnier-Villarreal Mauricio 
Published: December 2020

Abstract
Up to 20% of family caregivers are also working full-time or part-time. The competing demands of caregiving and working may adversely affect the health of caregivers. In this study, we use data from the 2015 Behavioral Risk Factor Surveillance System Questionnaire-Caregiver module to examine the relationships between participation in the paid workforce and health behaviors among caregivers. Individuals with a positive response to the survey question, “During the past 30 days, did you provide regular care or assistance to a friend or family member who has a health problem or disability?” were identified as caregivers. Participation in the paid workforce was defined as being employed for wages or self-employed. We conducted separate survey-weighted multivariate regression analyses to examine the relationship between participation in the paid workforce and drinking, exercise, and smoking controlling for sociodemographic characteristics. For each outcome, all sociodemographic characteristic variables were entered into the model simultaneously. 55.6% of the 24,034 caregivers participated in the paid workforce. The survey-adjusted multivariate regression analyses showed that those in the paid workforce had an increased likelihood of binge drinking (OR = 1.39, 95% CI [1.14-1.69]) and decreased likelihood of engaging in leisure-time physical activity (OR = 0.83, 95% CI [0.73-0.95]) compared to those who were not in the paid workforce. The odds of smoking less frequently did not differ between the two groups (OR = 0.96, 95% CI [0.85-1.07]). Our findings underscore the need for workplace-based interventions aimed at promoting healthy behaviors among caregivers.
Recognizing Decline and Supporting Care Transitions in Older Adults: Homecare Nurse Perspectives
Authors: Sullivan Suzanne , Mann Catherine , Mullen Samantha , Chang Yu-Ping 
Published: December 2020

Abstract
Older adults with serious illness residing in the community are at risk for decline and death. Homecare Registered Nurses (RNs) are in an ideal position to recognize serious illness and engage older adults and their caregivers in discussions about goals for care, while guiding transitions to supportive care services such as palliative or hospice care. However, little is known about this process, or how homecare RNs act upon this information. Using a grounded theory approach, data were collected through focus group interviews with 35 RNs working in homecare. A social process rooted in relationship-based care over time was identified using the constant comparative method. RNs recognize serious illness and support care transitions by identifying changes in illness trajectories and assessing the impact of such changes on quality-of-life, adapting and accommodating care to support older adults in the home for as long as possible, communicating with the care team, engaging stakeholders, and maneuvering through complex systems of care; ultimately relinquishing care to other providers and settings. Our findings also reveal that RNs feel inadequately prepared and frustrated with a fragmented healthcare system and lack of collaboration among the team in supporting the best care transition for older adults and their caregivers. Our findings reinforce the importance of promoting care continuity in homecare settings whenever possible, suggesting a critical need to develop training and team processes that support and empower RNs, so that they may lead care transitions as changing needs emerge during serious illness management of older adults.
Allostatic Load and Biological Aging Indicators in the MIDUS National Survey
Authors: Hastings Waylon , Shalev Idan , Almeida David 
Published: December 2020

Abstract
Indices quantifying allostatic load (AL) and biological aging (BA) have received widespread use in epidemiological and health science literature. However, little attention has been paid to the conceptual and quantitative overlap between these indicators. By reviewing literature utilizing measures of AL and BA, we highlight differences with respect to biological markers employed and approach toward scale construction. Further, we outline opportunities where AL indices might be improved by adopting analytical features of BA measures. We demonstrate the utility of this approach using data from The MIDUS National Survey, constructing three indices of allostatic load: one standard approach modeled after Gruenewald et al, 2012, and two alternative formulations informed by BA procedures. The performance of AL indices are juxtaposed against two commonly employed indices of biological aging: Klemera-Doubal Method Biological Age and Homeostatic Dysregulation. All measures were significantly associated with chronological age. Alternative AL formulations were more strongly associated with biological aging measures than with the standard approach. MIDUS participants with increased allostatic load and older biological ages performed worse on tests of physical, cognitive, perceptual, and subjective functioning. Further, MIDUS participants with history of childhood-trauma and mental-health problems were measured as having increased AL and BA. Alternative AL formulations tended to have effect-sizes equivalent to or larger than those observed for BA measures. In conclusion, indices of allostatic load and biological age approximate similar processes when constructed with comparable biomarkers and rigor, in line with their conceptual overlap as proxies of cumulative wear and tear.
Applying Innovative Qualitative Methods to Understand the Perspective of Vulnerable and Diverse Populations
Authors: Roes Martina , Koren Chaya 
Published: December 2020

Abstract
The application of a variety of innovative qualitative research methods and analysis as well as the possibilities it offers for the selected population to share their personal experience is the main focus of this symposium. We present the relationships between design, methodological approaches and themes of interest for the people who participate in research. The presenters used designs such as ethnographic field research or phenomenological designs. The used photos taken and analyzed by the participants; using photo-voice and tabletop exercise. All speakers will present their designs and methods linked to a specific research theme. Using examples of recent and highly innovative research practices which meaningfully challenge taken-for-granted assumptions in social science and care research, to open new ground for other ways of thinking about doing research in these fields. Goal for the discussion is a critical reflection of the designs and methods used and to provide take away messages
A Diary-Based Study of Language Use During Cognitive Decline
Authors: Pabst Katharina , Tagliamonte Sali 
Published: December 2020

Abstract
Although the effects of dementia on language have been examined in a variety of ways, there is relatively little data available showing longitudinal effects. In the present study, we examined the effect of cognitive decline on an individual’s language use over time (from age 60-91) by assessing daily diary entries. We focused on a linguistic phenomenon commonly associated with diaries and other informal registers, i.e. subject omission, as in “∅ Made cranberry muffins.” Quantitative analysis revealed a drastic decline in the use of this feature, which is correlated with the stages of the individual’s cognitive decline. We argue that the patterns reflect a systematic reduction in complexity that affects a writing style based on literacy and acquired at a later stage than more basic writing. This corroborates previous findings, showing later-acquired linguistic features are disproportionately affected in cognitive decline and highlights the importance of linguistic analysis in aging research.
Sociolinguistic Markers of Friendship Among Persons With Dementia in Long-Term Care
Authors: Saunders Pamela 
Published: December 2020

Abstract
Sociolinguistics and discourse analysis provide tools through which to examine how friendship is socially constructed through language and communication. Research on social isolation and loneliness reveals the importance of social interaction on the psychological and physical health of older adults. Given that linguistic, communicative, and functional abilities decline as dementia progresses, it is challenging to identify markers of friendship. The Friendship Project is an ethnographic study of social interaction among persons with dementia living in a long-term care setting. The data are from transcripts and field-notes of social interactions among residents with a range of cognitive impairments over a six-month time period. Results reveal that persons with dementia employ specific linguistic features such as narrative, evaluation, evidentials, and pronominal reference to make meaning and create relationships over time. Practical implications will be discussed.
Linking Negative Views of Aging to Cognitive Function: The Dopaminergic Theory
Authors: Robertson Deidre , Bokde Arun 
Published: December 2020

Abstract
Negative views on aging are known to impair cognition, in both the short and long term, but it is not fully understood why. This paper proposes that negative views impair cognition through dysregulation of reward-seeking behaviours and downregulation of the dopaminergic system. In a preliminary study to test this, 70 older adults were exposed to implicit positive and negative views on aging in a within-subject design carried out over 2 weeks, and then played a computerised game that involved deciding whether to expend effort to gain a reward. Over 216 trials, when participants were exposed to negative views, they were less likely to choose the effort-for-reward option. This effect was amplified at higher levels of effort. The paper will discuss how the dopaminergic theory ties into stereotype embodiment and other theories, and why it may explain previous findings that negative views of aging impair specific cognitive functions more than others.
Improving Detection of Cognitive Decline and Impairment Using Everyday Behavioral and Social Markers
Authors: Zhaoyang Ruixue , Cerino Eric , Scott Stacey 
Published: December 2020

Abstract
Early detection of cognitive decline and mild cognitive impairment (MCI) during the pre-symptomatic phase of Alzheimer’s disease is particularly important for maximizing effectiveness of clinical trials and efficiency of resource allocation. However, it is difficult to distinguish early signs of decline and impairment from normative aging, especially with biomarkers and clinical-based assessments that are expensive and challenging to apply widely. Ambulatory assessments in naturalistic settings provide opportunities to capture everyday markers of cognitive decline and offer cost-effective tools for sensitive, early detection of transitions to MCI in community-dwelling older adults. In this symposium, we present four studies that use ecological momentary assessment (EMA) data from the Einstein Aging Study to showcase how everyday markers of behavioral and social functioning assessed up to six times a day for 14 consecutive days can facilitate early detection of cognitive difficulties. Zhaoyang et al. examine whether older adults with intact cognition versus MCI differ in patterns of daily social interactions. Hyun et al. investigate how the diversity of daily activities is associated with ambulatory cognitive deficits. Cerino et al. compare the sensitivity of everyday markers of stress versus global trait-based stress measures to detect MCI. Roque et al. use completion time from EMA surveys as a reliable and unobtrusive way to measure cognition and distinguish those with and without MCI. Stacey Scott will integrate insights gained from these four papers, and discuss the opportunities and challenges faced when combining ambulatory assessments of everyday markers with traditional methods to better detect cognitive decline and impairment.
Advancing Adult Day Services Research: The 2016 and 2018 National Study of Long-Term Care Providers
Authors: Lendon Jessica , Rome Vincent , Caffrey Christine , Singh Priyanka , Sengupta Manisha 
Published: December 2020

Abstract
This presentation demonstrates how researchers can leverage data from the 2018 redesign and new content from the forthcoming NSLTCP survey of adult day services centers (ADSC) conducted by National Center for Health Statistics. For the first time, NSLTCP data will allow analyses at the services-user level. New policy-relevant topics about centers and ADSC participants include reasons for hospitalization, medication use, patient-centered and end-of-life care, staffing turnover, and unmet needs. Additionally, the presentation highlights latest findings from the 2016 survey. About 53% of centers were primarily medical model. Almost 79% of participants in medical model centers used Medicaid, compared to 51% in social model centers. About 4% of participants had at least one 90-day hospitalization. 40% of participants had difficulty bathing. The most prevalent chronic conditions were hypertension (50%), arthritis (38%), and diabetes (31%). Nearly 40% of participants had an advance directive. Findings are contextualized within the broader understanding of ADSCs.
Neurobiology Informed, Mobile Technology Augmented Interventions for Late-Life Depression and Suicidality
Authors: Alexopoulos George 
Published: December 2020

Abstract
Depression is a major risk factor of suicide in late life. Evidence based psychotherapies for late-life depression are underutilized, mainly because of their complexity. In response, we created “Engage”, an innovative streamlined psychotherapy that relies on neurobiology findings to identify core behavioral pathology of late-life depression and targets it with simple cognitive-behavioral strategies of known efficacy, co-designed with community therapists so that its interventions can be mastered my community based clinicians. We demonstrated that “Engage” is non-inferior to the evidence based Problem Solving Therapy and documented that behavioral activation precedes improvement of depression. We have also shown that activities with important others have the strongest behavioral activation value. “Engage” served as a model for three novel, mobile technology augmented psychotherapies that address the clinical and psychosocial context of distinct populations of depressed older adults. Our interventions and mobile apps provide interventions for emotion regulation as a way of reducing suicidality.
Loneliness and Social Engagement: The Unique Roles of State and Trait Loneliness for Daily Prosocial Behaviors
Authors: Lee Yeeun , Lay Jennifer , Mahmood Atiya , Graf Peter , Hoppmann Christiane 
Published: December 2020

Abstract
Loneliness is a distressing yet adaptive emotional experience that alerts us to socially re-engage. However, loneliness can also lead to social withdrawal and isolation. To reconcile the seemingly contradictory consequences of loneliness, we unpack the timing of the underlying processes by distinguishing between the roles of state loneliness (i.e., daily variations in loneliness) and trait loneliness (i.e., person-average loneliness) in predicting social re-engagement. Using ten days of electronic daily assessments from 95 older adults (M age = 67.0 years; 64.2% women), initial findings indicate that trait loneliness moderates time-varying associations between state loneliness and prosocial behavior: On days of elevated state loneliness, older adults low in trait loneliness report increases in prosocial behavior, whereas older adults high in trait loneliness show decreases in prosocial behavior. Findings suggest that transient loneliness may motivate older adults to actively re-engage with others; chronic loneliness may undermine such adaptive responses.
Empathic Accuracy: Helpful to Avoid Negative Affect in Old Age?
Authors: Wieck Cornelia , Katzorreck Martin , Gerstorf Denis , Schilling Oliver , Lücke Anna Jori , Kunzmann Ute 
Published: December 2020

Abstract
Past work suggests age-related declines in empathic accuracy and that these declines may put older people at risk for heightened stress reactivity and low affective well-being. We addressed these questions using data from the fourth wave of the Interdisciplinary Longitudinal Study of Aging (ILSE). To assess empathic accuracy, the young-old (N=115, Mage=63.4, SDage=1.13) and old-old (N=31, Mage=82.3, SDage=.87) participants of ILSE watched six film clips of individuals, who thought-aloud about an emotional autobiographical event, and were asked to rate each individual’s emotions. Subsequently, participants watched a film about Alzheimer’s disease and their subjective and cardiovascular stress reactions were assessed. Empathic accuracy was lower in old-old, as compared with young-old, individuals. Furthermore, empathic accuracy was only associated with low levels of stress reactivity among young-old but not old-old individuals. This suggests that empathic accuracy is not only compromised in very old age, but also appears to be of lower adaptive utility.
Loneliness and Social Isolation Among Older People in Northern Ireland
Authors: Neville Charlotte , Devine Paula 
Published: December 2020

Abstract
Loneliness and social isolation are increasingly recognised as being public health concernsparticularly in older people. Social isolation can be defined as the lack of social connections, whilst loneliness is a more subjective concept and relates to negative feelings about a lack of connections. This research explores the patterns of loneliness and social isolation of over 5,000 people aged 50 years or over living in Northern Ireland who participated in the first wave of the NICOLA study (Northern Ireland Cohort for the Longitudinal Study of Ageing). Data were obtained by computer-assisted personal interviews and self-completion questionnaires. We focused on loneliness and social interaction, in relation to key demographic and socio-economic variables including age, gender and marital status. Key findings were that loneliness patterns varied according to gender, age, income, health and living circumstances. Future waves of NICOLA will help to longitudinally explore the effects of transition on loneliness and social isolation.
The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers
Authors: Eaton Jacqueline , Cloyes Kristin , Paulsen Brooke , Madden Connie , Ellington Lee 
Published: December 2020

Abstract
Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.