bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Poor Sleep Quality Predict Functional Limitations?
Authors: Friedman Elliot , Teas Elizabeth 
Published: December 2020

Abstract
Previous work from our group (Friedman, 2016) linked sleep complaints to declines in mobility and risk of incident limitations over a 9-10 year follow-up among middle-aged and older adults. While these results suggest that poor sleep might undermine functional capacity, the self-report nature of the data leaves the robustness of this association unclear. The current study addressed this uncertainty by examining links between sleep and mobility limitations using subjective and objective assessments of both. Data were from the Midlife in the United States (MIDUS) study: the biomarker sub-sample (N = 664) from the original cohort (collected 2004-2006) and the Refresher cohort (collected 2011-2013). Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI; subjective) and 7 consecutive days of actigraphy (objective). Functional capacity was assessed by self-report of limitations and measured gait speed, grip strength, and chair stands. In linear regression models adjusting for demographic and health factors, lower PSQI scores (better sleep quality) predicted fewer reported limitations, stronger grip, quicker gait, and faster chair stands (all p&lt;.01). Of the objective sleep metrics, time to fall asleep and time spent awake during the night predicted more self-report limitations, weaker grip (latency only), and slower gait speed and chair stands. These results extend our prior work by showing a) subjective sleep is linked to measured as well as self-reported physical function, and b) objective assessments of sleep predict reduced physical function, albeit to a lesser extent. They also brighten the spotlight on sleep as a key health determinant in older adults.
The Evaluation of a Modified Decision Aid for Older Women With Low Health Literacy
Authors: Cadet Tamara , Schonberg Mara 
Published: December 2020

Abstract
Given the lack of evidence recommending mammography for women &gt;75 years, guidelines recommend that older women be informed of the uncertainty of benefits and of potential harms. The objective for this study was to evaluate the effect of a mammography decision aid (DA) designed for older women with low health literacy (LHL) on their decisional conflict and knowledge of mammography’s benefits and harms in a pretest-posttest trial. Women, 75-89 years were eligible for this study if they had not had a screening mammogram in six months, a history of breast cancer/dementia and had LHL (defined as reporting difficulty completing medical forms on one’s own or obtaining &lt; college education). Forty-four women participated. their mean age was 78, 74% had a high school degree or less, and 53% were non-Hispanic White. Overall, women reported that the DA helped them prepare to talk with their clinician quite a bit (Mean =3.6/5.0 on preparation for decision making scale) and 97% found the DA helpful. Using McNemar’s test, decisional conflict did not change and knowledge on a 10 item true/false test on mammography screening did not change; however, after receiving the DA women were correctly less likely to think that having a mammogram would prevent cancer. With the shift toward shared decision-making for women &gt; 75 years, there is a need to engage women of all literacy levels to make these decisions and we have developed a DA on mammography screening for older women with LHL that these women perceive to be helpful.
Cultivating Generative Connection Through Agricultural Leadership
Authors: Bower Kyle 
Published: December 2020

Abstract
Adult agricultural leadership programs (ALP) address the needs of a diversifying society with pressing social, economic, environmental, and political challenges. Additionally, these programs offer transformative learning experiences that lead to a greater capacity of current and prospective leaders to become change agents in their communities. Our aging society generates a novel opportunity to reframe experiences of professional succession and retirement within the agricultural sector. In a profession where vitality, strength, and perseverance are fundamental, the agricultural industry needs leaders who remain aware of the foundational knowledge contributed by their predecessors. At the same time, it also necessitates innovation that may revolutionize the farming industry for decades to come. In this mixed-method study, we asked participants of an ALP in the Southeastern region of the U.S. to complete the Loyola Generativity Scale (N=45). Survey results (N=45; 60% response rate) indicated average overall generative (40.3; 40-41 scale average) concern. However, there was a considerable variation among participants, scores ranging from 25-57 (scale range 20-55). To understand the range of attitudes, we conducted interviews (N=10) to represent the distribution of scores by varying ages (M=38), gender, and educational background. Generativity Theory provided the foundation of our thematic qualitative analysis. We discuss the findings in terms of generative desire (motivational), beliefs (thoughts and plans), and actions (behaviors and applied meaning). Our quantitative and qualitative findings advance the conversation of the importance of maintaining social capital throughout one’s career and identifying generative connections that assist with difficult transitions, such as retirement, in later life.
Predictors of Change in Osteoporosis Knowledge, Health Beliefs, and Self-Efficacy After an Education Intervention
Authors: Labrias Philippe Ronel , Feinn Richard , Johnson Shanthi , McLeod Katherine 
Published: December 2020

Abstract
Education interventions that increase osteoporosis knowledge and address health beliefs and self-efficacy help older adults make informed decisions to prevent and manage the disease. The aim of this study was to determine if clinical risk factors for osteoporosis moderate the effect of a multifaceted education intervention on osteoporosis knowledge, health beliefs, and self-efficacy. Patients 50 years and older with no prior diagnosis of or treatment for osteoporosis were referred by their primary care provider for bone mineral density testing by DXA and randomized to an osteoporosis education intervention group (n = 102) or usual care group (n = 101). Demographic and health history questionnaires, and validated tools to assess osteoporosis knowledge, health beliefs and self-efficacy were completed at baseline and 6-month follow-up. Results of the linear mixed-effects model showed a significant interaction with younger age (p=.024) on self-efficacy among patients in the intervention group compared to the usual care group. Patients with higher BMI had greater perceived health motivation (p=.026) in the intervention group. Compared to the usual care group, patients in the intervention group with higher vitamin D intake had greater perceived exercise (p=.020) and calcium benefits (p=.012) and those with a family history of osteoporosis had greater perceived susceptibility to osteoporosis (p=.045). By understanding the key factors that predict change in knowledge, health beliefs and self-efficacy after an education intervention compared to usual care, we can better tailor interventions to enhance prevention and management of osteoporosis.
Who Benefits in Vitality After Retirement? Findings From a 3-Year Panel Study
Authors: Vanajan Anushiya , Bültmann Ute , Henkens Kène 
Published: December 2020

Abstract
Background. Past studies have revealed the effect of retirement on various health measures. None, however, have studied retirement’s effect on vitality, a holistic measure of physical and mental health. To boot, very few studies have addressed the heterogeneity in the health consequences of retirement. This study investigates the effect of retirement on vitality, and how this effect is influenced by 1) manual work and 2) baseline vitality. Methods. The analyses were based on two waves of the NIDI Pension Panel Survey, collected in the Netherlands in 2015 and 2018. Data from 4,156 older workers (N=4,156), of whom 1,934 (46.5%) retired between waves, were analysed. Vitality is assessed in three ways, as: 1) a composite measure of vitality, and its sub-components 2) energy and 3) fatigue. Results. Conditional Change OLS Regression Models demonstrate that retirement improves vitality and decreases fatigue. These effects were heterogeneous. Retirement was more advantageous for older workers who experienced poor vitality and increased fatigue before retirement. Likewise, older workers who were employed in manual work before retirement, experienced the largest gains in vitality and deepest declines in fatigue post-retirement. No such effects were found for energy. Conclusions. Older workers experiencing low baseline vitality and high baseline fatigue and those in manual labor may benefit from early retirement. Since early retirement is financially unfavorable, it is essential to provide these groups of workers with workplace vitality interventions that may not only improve their vitality and quality of working life, but also extend their participation in the labor market.
Language and Memory Reserve Mediate Protective Effects of Social Support on MCI or Dementia Risk in Older Women
Authors: Petkus Andrew , Gruenewald Tara , Youan Diana , Wang Xinhui , Gatz Margaret , Espeland Mark , Chen Jiu-Chiuan 
Published: December 2020

Abstract
More supportive social relationships are protective of cognitive decline in older adulthood. Although supportive social relationships are hypothesized to promote cognitive reserve (CR; the cognitive adaption to neuropathology), it is unknown whether CR mediates associations between social support and risk of developing mild cognitive impairment or dementia (MCI/dementia). Data from 815 women (aged 73-87 years) participating in the Women’s Health Initiative Memory Study-MRI cohort (WHIMS-MRI) and Women’s Health Initiative Study of Cognitive Aging (WHISCA) were analyzed to examine whether domain-specific estimates of CR mediate associations between social support and incident MCI/dementia risk. Women completed the Medical Outcomes Study Social Support Scale (MOS-SS) in 2004-2005, a structural MRI (sMRI) of the brain in 2005-06, and annual extensive neuropsychological examinations till 2018. CR (6-months after completing the MOS-SS) was estimated across different domains (e.g. verbal memory, figural memory, language, visuospatial, and attention) as the residual variance after regressing out effects of sMRI variables, sociodemographic factors, and measurement error. Structural equation models were constructed to examine whether CR mediate associations between social support and MCI/dementia risk while adjusting for covariates. Higher social support was associated with lower MCI/dementia risk (hazard ratio=0.85 per 1-SD;p=0.037), higher language reserve (standardized β=0.09;p=0.008) and verbal memory reserve (standardized β=0.08;p=0.025). Language and verbal memory reserve each significantly explained approximately 14% of the protective effect of social support. Findings illustrate the heterogeneous effect of social support on CR, highlighting the importance of language and verbal memory reserve as mediators of the association between social support and MCI/dementia risk.
Pandemic Preparedness of Care Homes Serving Older Adults in the Wake of COVID-19: An Exploratory Study
Authors: Amin Iftekhar 
Published: December 2020

Abstract
Recent COVID-19 pandemic has disproportionately affected the older adult population worldwide. According to CDC, among older adults over 60 years the risk increases with age, with the highest risk of serious illness and death among those over 80 years. While public has been receiving messages about the risks and how to take preventive measures, it is not clear how the care homes serving older adults have been preparing. Data have been collected as part of an ongoing study from 30 independent living, assisted living, and memory care facilities across the United States. The centers were selected with a snowball sampling technique. Administrators of the centers were interviewed with a semi-structured questionnaire. It was apparent that although awareness of risks was high, preparation appears to be inadequate with little resources available at the time of the survey. Variation of preparedness based on the sociodemographic characteristics of the residents suggests that homes that serve predominantly minority and economically disadvantaged have greater likelihood of lacking preventive resources. It is critical that facilities serving older adults be prepared to ensure an effective healthcare response in the wake of novel viruses, such as COVID-19.
Surviving Together by Staying Apart: How Older Adults Experienced the COVID-19 Crisis
Authors: Miller Julie , D’Ambrosio Lisa , Balmuth Alexa , Brady Samantha , Raue Martina , Patskanick Taylor , Rudnik John , Coughlin Joseph 
Published: December 2020

Abstract
The repercussions of novel coronavirus (COVID-19) within the United States and across the globe are vast. Researchers at the MIT AgeLab conducted a national online survey (N=1200) related to COVID-19 in March 2020 with the goal of exploring participants’ COVID-19-related attitudes, hygiene and consumer behaviors, and their use of technology to work, make purchases, stay informed, and stay socially connected. In this presentation, AgeLab researchers will describe findings among a sub-population of study participants deemed to be at highest health risks for the virus: adults ages 60 and over. Findings demonstrate that the largest group of participants stayed informed about COVID-19 primarily through online sources. As a result of the virus, most had made changes to their health and hygiene practices, including implementing social distancing measures, and the majority had changed at least one of their purchasing behaviors, most often buying more products than usual online. Second only to participants’ physical health concerns related to COVID-19 were their financial health concerns, both related to near-term finances and longer-term financial goals. From this study, policy and practice implications emerge across public, private, and non-profit sectors that, taken together, can prepare older adults and their loved ones to survive and thrive during global emergencies.
Creating a Novel Physical Resilience Measure among Older Adults: The Health, Aging, and Body Composition Study
Authors: Wu Chenkai , Li Ya-Xi , Odden Michelle , Marron Megan 
Published: December 2020

Abstract
The concept of resilience has gained increasing attention in aging research; however, current literature lacks consensus on how to measure resilience. We constructed a novel resilience measure based on the degree of mismatch between persons’ frailty level and disease burden and examined its predictive validity. We also sought to explore the physiological correlates of resilience. Participants were 2,457 older adults from the Health, Aging, and Body Composition Study. We constructed the resilience measure as the residual taken from the linear model regressing frailty on age, sex, race/ethnicity, 14 diseases, self-reported health, and number of medications. Participants were classified into three groups—adapters, expected agers, and premature frailers—based on residuals (less than, within, or above one standard deviation of the mean). Validation outcomes included years of able life (YAL), years of healthy life (YHL), years of healthy and able life (YHAL), disability, hospitalization, and survival. The average YHAL was 5.1, 7.7, and 9.1 years among premature frailers, expected agers, and adapters, respectively. Compared with premature frailers and expected agers, adapters had significantly lower rates of disability, hospitalization, and mortality and higher proportion surviving to 90 years. The likelihood of surviving to 90 years was 20.4%, 30.6%, and 39.7% among premature frailers, expected agers, and adapters. We developed and validated a novel approach for quantifying and classifying physical resilience in a cohort of well-functioning white and black older adults. Persons with high physical resilience level had longer healthy life span and lower rates of adverse outcomes.
Patterns of Weight Change in Aging and Dying
Authors: Thielke Stephen 
Published: December 2020

Abstract
Little research has characterized the natural history of weight change in older adults. Different changes may occur during aging and dying. We analyzed 18 years of weight measures from a cohort of 736,361 Veterans, all of whom had died at age 70 or older. We produced summary measures that accounted for both chronological age and number of years before death. Several clear population-level trends appeared. (1) The average weight of the sample declined across all ages at a rate of about 0.18 BMI points per year. (2) Starting about seven years before death, the amount of loss began to accelerate, reaching a decline of 0.75 BMI points in the year before death. (3) Changes in weight relative to years of remaining life were independent of chronologic age. People who died at age 70 experienced, on average, the same type and duration of terminal decline as did those who died at age 95. (4) The dying process involved a cumulative loss of about 1.3 BMI points. (5) The distribution of weights during advancing age both declined and narrowed. (6) Disproportionate deaths occurred at the lower BMI ranges (below a BMI of 24), and especially below 18, regardless of age. (7) The finding in #5 is explained by the entire cohort losing weight, with death of the thinnest members. These findings argue for examining survival time in studies of weight change. They indicate that weight loss may be a natural part of dying, rather than a risk factor for it.
The Need to See the World: Outings and Meaningful Engagement Among Assisted Living Residents With Dementia
Authors: Ciofi Joy , Kemp Candace , Duong Stephen , Hill Andrea , Baidoo Anna Lisa , Wood AprilSpring , Manley Pamela , Bender Alexis 
Published: December 2020

Abstract
Meaningful engagement is a promising avenue for enhancing the lives of persons with dementia. Yet, engagement can prove challenging across care settings. Here, we report on our ongoing 5-year NIA-funded study (R01AG062310) aimed at identifying best practices for promoting meaningful engagement opportunities among assisted living residents with dementia. Guided by grounded theory method, the study involves multiple modes of qualitative data collection, including: participant observation; resident record review; and in-depth interviews with residents (when possible), assisted living staff, residents’ family and friends, volunteers, and others involved in residents’ daily lives. We present analysis of data collected in 4 diverse care settings studied in-depth over a one-year period and focus on “outings” or instances when residents leave the assisted living setting. Findings show the variable nature, content, and frequency of outings and demonstrate the advantages, disadvantages, and challenges associated with taking persons living with dementia out of their living environments. Outings represent an opportunity “to get out,” “see the world,” and “not be stuck inside.” Yet, outings are not universally successful and sometimes create frustration, distress or confusion. Multiple factors intersect to influence residents’ opportunities to participate in and derive benefit from outings, including residents’ cognitive and physical function, and personal preferences, and formal and informal care partners’ knowledge, attitudes, behaviors, and resources. Care setting practices and policies, resources, size and location, and community connections also shape opportunities for and experiences with outings among residents living with dementia. We discuss the implications of our findings for research, policy, and practice.
Intergenerational Relationships, Social Support, and Psychological Well-Being Among Korean Older Adults
Authors: Lee Yooumi , Wilmoth Janet 
Published: December 2020

Abstract
This study investigates whether intergenerational relationships and social support improve the psychological well-being of Korean older adults. We examine whether intergenerational relationships and social support directly influence psychological well-being and the extent to which they mediate the distressing consequences of life events such as declining health and recent widowhood. Using longitudinal data from the 2006 to 2016 Korean Longitudinal Study of Aging, we explore depression trajectories among individuals who are 60 or older with at least one living adult child at baseline. Specifically, we converted data from 5,383 older adults into a person-period file with 24,726 observations over a ten-year period. Then we estimated linear growth curve models of depression trajectories separately for men and women using the Center for Epidemiologic Studies Depression Scale (CES-D). Results from the hierarchical linear models indicate that declining health and recent widowhood are positively related to depressive symptoms. Satisfactory intergenerational relationships and social support in the form of personal interactions and proximate living arrangements with adult children decrease depressive symptoms of older parents, especially among women. We conclude that the psychological benefits of intergenerational relationships and social support are contingent upon the vulnerability of older adults and discuss the implications for public policy.
Social Isolation and Cognitive Function: Evidence From Older Chinese Americans
Authors: Kong Dexia , Chao Ying-Yu , Tang Fengyan , Dong XinQi 
Published: December 2020

Abstract
Chinese older adults are particularly vulnerable to social isolation due to various barriers they face in developing/maintaining social networks (i.e. limited English proficiency and transportation barriers) in the U.S. However, the prevalence of social isolation and its potential health consequences in this rapidly growing minority aging population remain poorly understood. To address this knowledge gap, the current study examines the prevalence of social isolation, and the relationship between social isolation and cognitive function among U.S. Chinese older adults. Data were obtained from the Population-based Study of Chinese Elderly in Chicago collected between 2011 and 2013 (N=3,157). A four-item index (including living alone, not married, lack of confidant, and low participation in social activities) was constructed to assess social isolation (range: 0 to 4, a score of ≥2 was used to identify individuals who were most isolated). Cognitive function was measured by five validated instruments (range: -2.8 to 2.0). Nearly 22% of the sample were socially isolated. Multivariable linear regression analysis showed that social isolation accounted for 44% of variance in global cognitive functioning. Chinese older adults with greater levels of social isolation had poorer overall cognitive function (B= -0.05, SE=0.01, p=0.001). Study findings highlight the importance of addressing social isolation in cognitive aging among older Chinese Americans. Culturally tailored interventions facilitating the development of supportive social networks/ support have the potential to mitigate cognitive decline in this population. Future longitudinal studies need to elucidate potential mechanisms underlying the relationship between social isolation and cognitive function. Practice implications will be discussed.