bluuebunny/crossref_metadata_2025_split huggingface dataset:
NON-FAMILIAL INTERGENERATIONAL NETWORK TIES: MOVING THE NEEDLE ON MEASUREMENT
Authors: Jarrott Shannon E 
Published: November 2019

Abstract
GSA and other professional organizations recognize the threat that ageism poses to the country’s health and welfare, from its youngest to oldest citizens. Reframing Aging involves communication and outreach strategies to inform the conversation about aging and its implications. Non-familial intergenerational relationships can support the Reframing Aging initiative. By fostering positive, intentional, and mutually beneficial interactions, intergenerational exchange can achieve a variety of individual, relational, and community goals. Measures of their impact should reflect these goals; unfortunately, intergenerational network ties are typically represented by measures of young people’s attitudes towards older adults. Practitioners, researchers, policy makers, and funders need additional indicators to document the best practices and potential impact of non-familial intergenerational programs. Reflecting recent systematic surveys of measurements and 20 years of intergenerational research, the current paper addresses challenges of measuring non-familial intergenerational relationships and presents select measures appropriate for common network ties.
EVALUATING THE IMPACT OF STAR-VA ON VETERANS’ PSYCHOTROPIC MEDICATION USE IN CLCS
Authors: McConeghy Kevin , Curyto Kim , Jedele Jenefer M , Mach Jennifer , Intrator Orna , Wiechers Ilse R 
Published: November 2019

Abstract
The impact of STAR-VA on psychotropic drug use among residents with behavioral symptoms of dementia was evaluated through a difference-in-differences framework. STAR-VA residents enrolled 2013-2017 were evaluated longitudinally pre-post intervention. The primary outcome was the number of as needed administrations with an indication of ‘anxiety’ or ‘agitation’. The analytical cohort included 214 training cases and 1,870 controls from untrained sites meeting eligibility criteria. STAR-VA cases were less white (48% vs. 54%), less black (11% vs. 14%), and had significantly longer median length of stay (830 vs. 261 days), respectively. STAR-VA cases had on average 3.5 as needed doses/month of psychotropic medication before the intervention and 1.7 after, controls averaged 1.8 doses/month. After adjustment for person-time-fixed effects, enrollment was associated with 55% (95% CI:30, 68) reduction or an average 0.8 as needed psychotropic doses/month. Findings demonstrate effectiveness in decreasing as-needed psychotropic drug use among CLC residents, supporting continued implementation of STAR-VA.
THE ASPREE STUDY: DISABILITY-FREE SURVIVAL, UPDATED RESULTS, SUB-STUDIES, AND IMPLICATIONS FOR ASPIRIN USE
Authors: Murray Anne M , McNeil John , Eldadah Basil 
Published: November 2019

Abstract
The NIA/NCI ASPREE (ASPirin in Reducing Events in the Elderly) Study was a landmark RCT of 19,114 healthy adults aged 70 (whites) and 65 (US minorities) in Australia and the US that demonstrated lack of effect of low dose aspirin (LDA:100 mg/d) on the novel primary end point of Disability- Free Survival (life free of disability and dementia) over a mean treatment of 4.7 years. Surprisingly, LDA was associated with a trend toward increased all cause mortality, driven by cancer deaths (results published NEJM September 2018). After the LDA intervention was halted in June 2017, ASPREE was extended as an observational cohort follow-on study, ASPREE-XT, to measure potential delayed LDA effects on ASPREE outcomes. The ASPREE study primary results will be summarized, and the rationale for and performance of the novel DFS geriatric outcome discussed. New results of the analysis of dementia as a secondary outcome will also be presented (both for overall dementia and Alzheimer’s disease). We will also examine the unexpected increased all-cause mortality attributed to cancer deaths, despite no significant difference between groups for all incident cancer, and effects of LDA on incident metastatic disease. The important implications of the ASPREE results for prescribing LDA for primary prevention in health elderly will be discussed, and the ASPREE-XT study design and progress described. Lastly, the breadth of the ASPREE sub-studies including the Biobank, Brain Imaging studies and Genomics, and opportunities to access the rich ASPREE data and collaborate with ASPREE investigators will be reviewed.
EFFECT OF INITIATING ASPIRIN ON CANCER EVENTS IN THE HEALTHY ELDERLY
Authors: Chan Andrew T , Gibbs Peter , Lockery Jessica E , Polekhina Galina , Orchard Suzanne G , Ford Leslie , Umar Asad , McNeil john J 
Published: November 2019

Abstract
In ASPREE, we previously reported a surprising increase in cancer-related deaths associated with initiating aspirin. We now report primary incident cancer events. Aspirin was not associated with risk of incident cancer (HR=1.04, 95% CI 0.95-1.14), including non-metastatic cancer (HR=0.99, 95% CI, 0.89-1.11) and colorectal cancer (HR=1.02; 95% CI, 0.81-1.30). However, risk of incident metastatic cancer was elevated with aspirin (HR=1.18; 95% CI,0.96-1.46), although this could be attributable to chance. In ASPREE, the increase in cancer deaths associated with initiation of aspirin was not accompanied by a significant increase in overall incident cancer after 4.7 years. However, there did appear to be an increase in the incidence of advanced cancer in the aspirin arm. These data support the possibility that aspirin may adversely affect short-term outcomes among elderly participants with undiagnosed cancers (e.g. prevalent tumors at enrollment or early incident tumors) and/or may have differential effects according to age.
THE ASPREE STUDY: DEMENTIA DUE TO ALZHEIMER’S DISEASE OUTCOMES
Authors: Shah Raj C 
Published: November 2019

Abstract
In the ASPREE clinical trial, aspirin 100mg daily in health older adults did not delay onset of dementia, a pre-specified secondary outcome over a period of 5 years. We examine whether low-dose aspirin versus placebo is related to incident dementia due to Alzheimer’s disease. Older community-dwelling participants free of dementia, physical disability, and conditions requiring aspirin treatment were recruited (n=19,114). Participants were administered a cognitive test battery during follow-up and participants with suspected dementia underwent a more extensive dementia assessment. An expert international panel adjudicated dementia according to DSM-IV criteria, with sub-classification according to NIA-AA criteria. Over a median 4.7 years, 575 participants had a confirmed dementia diagnosis. In analysis of the 41% of cases classified as dementia probably due to Alzheimer’s disease, no difference in the incidence between the treatment arms was found (HR=0.96, 95% CI =0.74, 1.24). Plans for continued assessment of cognition in ASPREE-XT will be presented.
POTENTIAL IMPLICATIONS OF ASPREE ON ASPIRIN PRIMARY PREVENTION GUIDELINES
Authors: Murray Anne M 
Published: November 2019

Abstract
The 2016 USPSTF guidelines for aspirin to prevent CVD and colorectal cancer noted insufficient evidence to assess the balance of benefit and harm in those 70 and older. The long-awaited ASPREE trial, conducted in healthy elderly aged 70 and older (65 for US minorities), evaluated aspirin’s effect on disability-free survival, a composite of death, dementia, or persistent physical disability. CVD and cancer were pre-specified secondary endpoints, positioning ASPREE’s results to substantially inform the evidence gap noted in the USPSTF guidelines. Low-dose aspirin over 5 years did not lower CVD events or colorectal risk, but significantly increased bleeding. The ASPREE-XT observational follow-up study over the next 5-7 years will observe for potential legacy effects of aspirin on the primary and secondary outcomes of ASPREE, thus adding further evidence to define the risk-benefit profile of aspirin for primary prevention in healthy elderly.
FOOD INSECURITY AND COST-RELATED MEDICATION NON-ADHERENCE IN OLDER ADULTS: A SYSTEMATIC REVIEW
Authors: Boss Lisa L , Caouette Shaunna 
Published: November 2019

Abstract
Food insecurity (FI) is defined as having limited access to nutritional and safe foods due to lack of financial resources and is believed to negatively influence health outcomes. Older adults, in particular, face rising healthcare costs and may be forced to choose between purchasing prescribed medications and using their limited financial resources for basic needs, such as food. The purpose of this systematic review was to examine the relationship of food insecurity (FI) and cost-related medication non-adherence (CRN) in older adults living in the community setting. A comprehensive, electronic review of the literature was performed. Criteria for inclusion were original quantitative or qualitative research, written in English, human participants ≥60 years, and published from January 2000 through January 2019. The total number of studies included was six. Main findings from the studies largely indicate that FI and CRN are significantly and positively correlated in older adults living in American communities. Further, CRN increases with the severity of FI. Most participants in these six studies were female, non-Hispanic white, with an annual household income &lt;20k, and with less than a high school education. Although preliminary evidence is promising, research with more rigorous design is warranted to better understand the relationship of FI and CRN in older adults, and to develop appropriate interventions and programs for this growing public health concern.
INNOVATIONS IN HOME MODIFICATION RESEARCH: THE STATE OF THE ART
Authors: Nabors Emily , Renfro Mindy , Pynoos Jon , Szanton Sarah L , Sanford Jon , Stark Susan 
Published: November 2019

Abstract
The overwhelming preference of older adults is to stay in their homes for as long as possible (AARP). However, most housing lacks supportive features and presents barriers that jeopardize residents’ ability to successfully age in place. Only 1% of houses have five key features to ensure accessibility: no-step entry, single-floor living, lever door handles, accessible electrical controls, and extra-wide doors and hallways (Harvard Joint Center for Housing Studies), making the vast majority unsuitable for persons who use wheelchairs and problematic for the growing number of people with activity limitations. Persons least likely to have such features in their homes need them the most: old-old, low income, frail, and residents in older housing stock. Although home modification can support people as their needs change and preclude the need to move, often to institutional settings, the majority of older adults lack these supports. Recent studies have demonstrated the role of home modification in health, safety, and cost effectiveness. This symposium will convene a panel of researchers to share evidence-base in home modification, recent cost-saving innovations including the CAPABLE Program, and policy change to improve service delivery.
GERONTOLOGICAL EDUCATION: APPLIED PERSPECTIVES AND PEDAGOGICAL APPROACHES
Authors: Niles-Yokum Kelly 
Published: November 2019

Abstract
The art and science of gerontological pedagogy is a balance of multidisciplinary paradigms that provide students with a pathway to the depth and breadth of the field of gerontology. This session will explore a variety of issues, including possibilities and challenges within the context of pedagogical approaches to gerontology education both in and out of the classroom. Topics include applied and theoretical perspectives and the what, why, and how gerontological educators do what they do and how it can impact the learning environment not only for students but for the community at large.
THAT’S MY CREATOR’S REALM: UNDERSTANDING AFRICAN AMERICAN ASSISTED LIVING RESIDENTS’ END-OF-LIFE PREFERENCES
Authors: Kemp Candace L , Bender Alexis A , Quest Tammie , Coyle Mary H , Perkins Molly M 
Published: November 2019

Abstract
Assisted living, one of the fastest growing formal long-term care options for older adults in the U.S., increasingly is a site for end-of-life care.. Most residents are non-Hispanic and white, yet African Americans reside in these settings and relatively little is known about their end-of-life preferences. In this paper, we present an analysis of data collected as part of a larger five-year mixed-methods NIA-funded study (R01AG047048) examining end of life in assisted living. We analyze longitudinal qualitative data collected over two years in a large (&gt;90 beds) care community catering to African American older adults. Drawing on 850 hours of participant observation, in-depth interviews with 25 residents, and record review data, we seek to: (a) understand residents’ end-of-life preferences; and b) identify how and why preferences vary. Guided by principles of grounded theory, our analysis shows that most preferred a death where “you go to sleep and never wake up.” Yet, residents varied in their preferences for the timing and location of death, nature of end-of-life care, and use of advanced directives. Age, health, health literacy, perceived quality of life, and not wanting to be a burden all influenced preferences. For most, religious beliefs were a key factor shaping these preferences. Perceiving that end of life, including how, when, where one dies, and the nature of suffering and care, ultimately is their “creator’s realm,” led to the near universal conclusion: “I got no control over it.” We discuss implications of these findings for improving end-of-life care for African American residents.
DEVELOPING AND TESTING AN ASSISTED LIVING ENVIRONMENT MODEL
Authors: Holmes Sarah D , Galik Elizabeth , Resnick Barbara 
Published: November 2019

Abstract
The assisted living (AL) environment plays an important role in supporting residents’ life satisfaction and helping them to age in place. Guided by ecological theory, the AL environment is multidimensional and has many interrelated components including staffing (e.g. direct care workers, nursing, activity staff), services provided (e.g. medical, mental health, pharmacy), amenities offered at the setting (e.g. beauty salon, computer room, exercise facilities), and built environment features (e.g. walkability). Moreover, evidence suggests that aspects of the AL environment can enhance or detract from the physical function, well-being, social engagement, and behavioral outcomes among residents. The purpose of this study was to develop and test an integrative AL environment measurement model that includes indicators of staffing, services, amenities, and the built environment. Baseline data was used from a study testing the Dissemination and Implementation of Function Focused Care in AL. A total of 54 AL facilities across three states were included in the sample. Settings ranged in size from 31 to 164 beds with an average size of 82.2 (SD=26.2) beds and the majority were for profit facilities (n=41, 74.5%). Structural equation modeling was used to test the proposed model. Results showed that the model fit the data (chi-squared/df=1.86, p&lt;.05; CFI=.858, RMSEA=.126). Having an integrative AL environment measurement model will advance future research that explores the impact of the environment on resident outcomes. In addition, findings from this study can inform interventions and programs designed to modify AL environments to optimize residents’ ability to age in place.
RURAL RETIREMENT MIGRATION AND ACTIVE CITIZENSHIP: MOTIVATIONS, PRACTICES, AND PROCESSES
Authors: Winterton Rachel 
Published: November 2019

Abstract
Within rural settings, older adults play a significant role in ensuring community age-friendliness through their engagement as active citizens. However, the increasing heterogeneity of rural older adults is challenging expectations around how, and in what circumstances, this cohort will engage as active citizens. Given that rural retirement migration is a key contributor to this increasing heterogeneity, there is a need to understand the motivations for, and practices associated with active citizenship among older in-migrants. Drawing on qualitative data from two rural regions in Victoria, Australia, this paper draws on concepts from the rural citizenship literature to investigate how active citizenship practices of rural retirement migrants align with traditional rural codes of conduct. Semi-structured interviews were conducted with 39 rural retirement migrants (aged 56-76 years), which explored engagement in, and motivations for, active citizenship. Findings indicate that in line with traditional expectations around rural citizenship, most rural retirement migrants had assumed responsibilities associated with community governance, and engaged in protest aimed at defending the rights of rural people. However, conflict with traditional codes of conduct was observed in relation to both how active citizenship was enacted, and motivations for engagement. Additionally, rural retirement migrants highlighted barriers that had precluded their involvement as active citizens. These findings are discussed in relation to their implications for both the capacity of rural settings to meet the needs and expectations of older in-migrants, and the experience of ageing in place for resident older adults.
INVESTIGATING THE RELATIONSHIP BETWEEN SOCIAL SUPPORT AND COGNITION AS MEDIATED BY HEALTH AND POSITIVE AFFECT
Authors: Falzarano Francesca , Siedlecki Karen L , Salthouse Timothy 
Published: November 2019

Abstract
Decreased social networks are common in old age after major life events such as retirement, loss of loved ones, and declining health (Shankar et al., 2013). Diminished social ties are associated with increased feelings of loneliness and perceived isolation, which can have negative effects on cognition and physical health. The current study examines the relationship between social support (assessed via the Social Network Questionnaire) and overall cognitive performance (assessed as a latent construct comprising indicators that represent mean verbal episodic memory, processing speed, reasoning, and spatial visualization), and investigates positive affect and self-rated health as mediators of this relationship. The current study included 5,125 participants between the ages of 18-99 years from the Virginia Cognitive Aging Project (VCAP). Cross-sectional analyses were conducted using structural equation modeling. After controlling for age and education, results showed that a social support construct (comprising indicators representing each social network subscale) significantly and positively predicted cognitive performance (.59, p&lt; .001). This relationship was reduced to .22 (p &lt;.001) when positive affect was included as a mediator, and to .14 (p&lt; .001) when self-rated health was included as a mediator. When the variables were included in a joint mediation model the relationship between social support and cognition was .20 (p &lt; .001). Thus, health and positive affect are partial mediators of the relationship between social support and cognition and may help explain the relationship between social support and cognition. Furthermore, these findings provide additional evidence that social networks may play an important role in successful aging.
DOES CHANGE IN COGSTATE MONTHLY COGNITIVE MONITORING OF OLDER ADULTS TRACK WITH 2-YEAR CHANGE IN GLOBAL COGNITION?
Authors: Atkinson Taylor J , Andel Ross 
Published: November 2019

Abstract
CogState is a repeatable, accessible online cognitive testing suite with evidence of low practice effects that could be used as a monitoring tool to detect cognitive decline early. We compared participants’ change in CogState to change in the Telephone Interview for Cognitive Status (TICS). Participants (N = 41, age M = 75.5, 66% female) completed monthly CogState and two TICS assessments over two years. Reaction time on a psychomotor speed task, attention task, and working memory task, and accuracy on a memory task were assessed. A TICS difference score was calculated to measure change. Standardized scores were used. Covariates were age, sex, and education. Paired t-tests indicated that participants performed worse on the TICS the second time, p = .02, Cohen’s d = 0.39, but better on their last working memory task, p = .007, Cohen’s d = 0.45, and their last memory task, p = .001, Cohen’s d = 0.56. Growth curve models indicated CogState memory and working memory scores improved over time, ps &lt; .05, by 0.17 SD accuracy units and 0.16 SD speed units, respectively. There were no significant TICS difference score by time interactions, indicating that changes in CogState were not related to change in TICS. CogState monthly repeat assessment did not track with change in the TICS, indicating that participants may become more proficient in task performance with repeated testing even while global cognition worsens. Despite prior evidence of low practice effects, less frequent assessment may still be warranted to avoid losing sensitivity to change.
EFFECTS OF MINDFUL FELDENKRAIS EXERCISES AND STRENGTH TRAINING ON COGNITIVE EXECUTIVE FUNCTION IN OLDER ADULTS
Authors: Ullmann Gerhild , Li Yuhua , Ray Meredith A 
Published: November 2019

Abstract
Decline in cognitive function associated with aging is one of the greatest concerns of older adults and often leads to significant burden for individuals, families, and the health care system. This 3-arm randomized controlled trial (RCT) responds to the urgent need to identify strategies which can enhance and/or maintain cognitive vitality in older adults. The study is funded by the National Institute on Aging, and aims to examine the effects of both the mind-body exercise Feldenkrais and strength training on cognitive executive function in independent living older adults (N=90) age 65 to 85. Participants of the first wave (n=45) were randomized to a (1) Feldenkrais group, (2) strength training and (3) no-intervention control group. Intervention groups met twice a week for 12 weeks. Cognitive and physical performance measures of the NIH-Toolbox were used at baseline, post-intervention and at a 3-month follow-up. Results of changes in cognitive executive functions within and across groups will be presented. The findings will suggest if such interventions would be a viable low-cost option for older adults to maintain cognitive vitality and thereby impact the development of programs and guidelines for combatting decline in cognitive function.
CHANGES IN COGNITIVE FUNCTION AMONG SENIOR AMERICANS: TRENDS AND DIFFERENCES BY RACE
Authors: Zhang Keqing , Zhang Wei , Wu Yanyan 
Published: November 2019

Abstract
Improvements in health and increase in life expectancy have contributed to the increasing proportion of older population over the past century. It is estimated that by 2050, the number of older adults with cognitive impairments in the United States will increase by 2.5-4 fold, while age-specific rates remain constant. This paper uses data from 10 waves (1996-2014) of the Health and Retirement Study (N= 33213) to crystalize the trends in cognitive function changes and cognitive impairment rates in a nationally representative sample of older adults. OLS and logistic regressions are used to estimate the trends and determine the contribution of sociodemographic variables to decreasing trends in the prevalence of cognitive impairment over time. Results show that with the increase of age, the cognitive function of older adults decline in all races, after adjustment for age, gender, education, and other sociodemographic factors. Also, the annual decline rate of cognitive function is larger for African Americans and Hispanic Americans, while smaller for white and other races. A further investigation of the possibility of cognitive impairment reveals a different scenario: as individual ages, the Hispanic are the least likely to suffer from cognitive impairment, followed by the white, other and black. Improvements in educational level contribute to declines in cognitive impairment across all races, particular the Hispanic Americans. Race-specific findings suggest that future research need to take into account the racial diversity and possibly cultural influences when examining the cognitive functions of older adults.