bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE SIGNIFICANT ROLE OF HOUSING COORDINATION IN CONNECTICUT’S MONEY FOLLOWS THE PERSON PROGRAM
Authors: Kellett Kathy G , Lambert Dawn , Lopez Tamara , Robison Julie 
Published: November 2019

Abstract
Housing coordination, a central component of the Money Follows the Person program, allows older adults and people with disabilities to experience greater independence and sense of well-being (Butler & Cabello, 2018; Koenig, 2015). This study was part of the 2017 Money Follows the Person (MFP) Process Evaluation involving 26 key informants (KIs) who completed telephone interviews sharing their experiences about program implementation. Of these, 13 KIs providing housing coordination services to the MFP transition team were asked about the housing coordination training they received and suggestions to improve the training. They were also asked about housing resources, how they develop their housing inventory, and recommendations for a “Housing Best Practices Report.” Interviews were audio-taped and transcribed. Data were analyzed using ATLAS.ti. Results demonstrate a need for more training and assistance to enable housing coordinators to expand their knowledge of housing alternatives, increase their awareness of housing policy/process changes, and further inform consumers about housing choices. Suggestions to improve housing coordination included offering more creative solutions during monthly housing coordination phone calls. Housing inventory challenges mentioned by KIs included time constraints, limited staff, administrative delays, and lack of affordable housing. Suggestions for housing inventory development focused on improving the management/maintenance of housing inventories. Best housing practices underscored the importance of communicating, teaming, building relationships with landlords and management companies, and standardizing housing policies and procedures. Overall recommendations included strengthening collaboration among housing coordinators to identify and implement best practices and improving housing inventory development to widen housing options for consumers.
PLANNING FOR AGING IN PLACE IN RURAL AREAS: PERCEPTIONS AND NEEDS OF OLDER ADULTS
Authors: Weaver Raven H , Bolkan Cory 
Published: November 2019

Abstract
Most individuals prefer to live independently in their homes, but will need support to age-in-place safely. Rural-dwelling individuals historically have worse health, limited income, and restricted access to adequate services/supports compared to their urban counterparts. Community-based aging services organizations (i.e., Area Agency on Aging; AAA) offer in-home health, social support, and information/referral to community resources that support older adults in both urban and rural communities. A representative sample of adults aged 60+ (N=253, mean age=74) were surveyed via computer-assisted-telephone interviews about their health status, needs, and service utilization. Over half (54%) lived in rural counties, which was significantly associated with receiving insufficient health care services (X2=9.227, p=.002). Insufficient service access was also associated with experiencing a fall (X2=7.315, p=.007). While 53% reported having chronic conditions, most individuals still reported good health and their top reported needs included: yard work, interior/exterior house repairs, and housework. Content analysis of open-ended survey responses regarding future care needs revealed participants anticipate help from family/friends or neighbors; reliance on physicians for referrals; and expect insurance to cover their needs. Participants had varying awareness levels of available community resources and identified concerns about adequacy of services (e.g., mental health; transportation) and health insurance barriers (e.g., reimbursement; vision/dental coverage). Preparing for future needs and anticipating changing functional capacity is critical, especially among rural-dwelling older adults with chronic conditions. To improve ability for adults with diverse needs to age-in-place, preventive services/supports that span the continuum of care needs and that complement informal family care are necessary.
INSTABILITY OVER THE LIFE COURSE AND POVERTY IN OLDER ADULTHOOD: A MIXED-METHODS STUDY
Authors: Dys Sarah , Steeves-Reece Anna , Carder Paula 
Published: November 2019

Abstract
Over half of older adults (age 65+) who rent their home are cost burdened, paying more than one-third of their income on rent (JCHS). Government programs are in short supply, and most who qualify for housing assistance will wait months or years to receive a voucher or unit. This mixed methods (QUANT to qual) study explored housing instability among older adults wait-listed for housing assistance. Analysis of surveys (n=268) and in-depth interviews (n=29) examined how financial instability influences participants’ perceived risk of future homelessness. Perceived financial instability is associated with perceived risk of homelessness (p&lt;.001). Compared to those whose current perceived financial status was now much worse from when they applied for assistance, those who were stable had lower perceived risk of homelessness. Thematic analysis of interview data provided insights into patterns of life-long experiences with various forms of instability, which are reproduced over the life course and met with little societal response or restrictive eligibility criteria. Major events (e.g., relationship changes, job loss, injury/illness) contributed to financial instability and housing instability among participants. Interviews wove together current status with individual histories, while the survey provided a cross-sectional perspective. An iterative analytic approach allowed us to conceptualize the relationships between health, employment, relationships, financial instability, food insecurity, and perceived risk of homelessness. Overall, this project describes how older Americans experience poverty and provides further evidence for how social determinants of health throughout the life course result in differential access to material resources, including income, food, health care, and housing.
ASSESSING THE RELATIONSHIP BETWEEN SERUM IGF-1 AND ADIPOSITY BY AGE IN THE LONG LIFE FAMILY STUDY
Authors: Sherlala Rehab A , Kammerer Candace M , Kuipers Allison L , Wojczynski Mary K , Ukraintseva Svetlana , Feitosa Mary , Mengel-From Jonas , Minster Ryan 
Published: November 2019

Abstract
Serum levels of insulin-like growth factor 1 (IGF-1) and measures of adiposity, such as body mass index (BMI), are associated with susceptibility to age-related diseases. Previous reports of the relationship between IGF-1 and BMI ranged from positive to negative to no relationship, perhaps because previous reports studied different age cohorts. Using data on 4270 participants (aged 24-110 years) from the Long Life Family Study, we investigated the relationship between IGF-1 and BMI overall and by age groups. IGF-1 and BMI were positively correlated in the total sample (β=0.161, r2= 0.0038, p=1.8-05). However, further analyses revealed that the relationship between IGF-1 and BMI varied by age quartile: in the 1st quartile (24-58yo) the relationship was negative (β=−0.204, r2= 0.011, p=0.0008); in the 2nd quartile (59-66yo) the relationship was negative but non-significant (β=−0.069, r2= 0.0012, p=0.28); in the 3rd quartile (67-86yo) the relationship was positive but non-significant (β=0.106, r2= 0.002, p=0.13); and in the 4th quartile (87-110yo) the relationship was positive (β=0.388, r2= 0.019, p=1.2−05). This pattern did not differ by sex. We also detected a similar age-related pattern between IGF-1 and BMI using an independent dataset (NHANES III), comprising 2550 men and women aged 20-90 years. Our results may clarify some of the inconsistency in previous literature about the relationship between IGF-1 and BMI. Additional studies of IGF-1 and adiposity measures are needed to better understand the underlying mechanisms involved.
MEASURING QUALITY OF LIFE IN OLDER ADULTS LIVING WITH T2DM: A COMPARISON WITH YOUNGER ADULTS USING 2015 BRFSS DATA
Authors: Smalls Brittany , Moody Myles , Rutledge Matthew , Cowley Amy 
Published: November 2019

Abstract
Challenges due to burden of disease can affect adherence to self-care behaviors and optimal health outcomes in those living with T2DM. This study utilized state- and national-level data from the 2015 BRFSS to compare QoL measured by the prevalence of physical and mental burden days among older adults (OAs) compared to younger adults living with T2DM. The results of our analysis showed that OAs living in the US were significantly less likely to experience at least one mental burden day when compared to their younger counterparts (OR =0.61, 95% CI: 0.58, 0.64), while gender, education, race, BMI, and depression, CVD, or another chronic condition were significantly associated with the odds of experiencing at least one mental burden day. Whereas, in Kentucky OAs were less likely to experience at least one mental burden day when compared to their younger counterparts (OR= 0.48, 95% CI: 0.35, 0.66). Gender, education, BMI, and depression were significantly associated with the odds of experiencing at least one mental burden day or one physical burden day. The findings of this study suggests that the questions used by BRFSS to measure QoL may not be the most suitable for OAs who likely have different criteria for self-reported mental or physical burden days. When assessing QoL or burden of disease among the aging at a population level, considerable thought should be given into the questions asked and if they appropriately examine patient-level QoL in this population.
COGNITIVE FUNCTION IN COUPLES AND COLLABORATIVE INVOLVEMENT IN TYPE 1 DIABETES MANAGEMENT
Authors: Berg Cynthia , Suchy Yana , Allen Nancy , de Grey Rob Kent , Campbell MaryJane , Helgeson Vicki 
Published: November 2019

Abstract
Managing type 1 diabetes involves coordinating complex daily behaviors that benefit from higher cognitive function. One’s spouse’s cognitive function may also be beneficial as spouses may collaborate in daily adherence behaviors and may be especially beneficial for older adults who may be experiencing poorer cognitive function. We examined: 1) whether one’s own and one’s spouse’s cognitive function predicted lower (better) HbA1c, 2) whether collaborating with a more cognitively capable spouse was especially beneficial, and 3) whether the benefit of partners’ cognitive ability occurred through better adherence. 199 couples were recruited where one member was diagnosed with type 1 diabetes for at least one year (52% females, average age 46.8 years, range 25.9-74.9, average duration of diabetes 27 years). Both patients and spouses completed the information subtest from the Wechsler Adult Intelligence Scale-Fourth Addition as a measure of general intelligence. Patients rated the collaborative involvement of their spouse in their diabetes and their adherence to their medical regimen. Multiple regressions revealed that spouse’ higher intelligence uniquely and solely predicted better HbA1c over patient’s intelligence. Collaborating with a spouse of lower intelligence was associated with higher HbA1c for older adults; collaborating with a spouse of higher intelligence was associated with somewhat lower HbA1c. Mediational analyses indicated that spouse’s intelligence was associated with higher HbA1c through better adherence behaviors. The results suggest that individuals with type 1 diabetes who have a spouse of lower cognitive function may benefit from support from others in their network to manage their diabetes.
DOES ONSET OF CHRONIC CONDITIONS MODERATE THE IMPACT OF RELATIONAL LIFE EVENTS ON DEPRESSED MOOD?
Authors: Ogletree Aaron M , Blieszner Rosemary , Pruchno Rachel , Savla Jyoti , Sands Laura P 
Published: November 2019

Abstract
More than 62% of adults aged 65+ have more than one chronic condition; this number increases to more than 82% for those 85+. Older adults simultaneously experience changes in their relationships due to negative relational life events, including illness, injury, or death of a loved one. Stressors occurring in tandem can overload psychological resources and increase risk for poor mental health. Informed by the stress process model, we assessed the influence of relational life events on depressive symptoms over time and evaluated the moderating effects of chronic condition onset. Self-reports of four stressful life events, five chronic conditions, and depressive symptoms as measured by the CES-D came from 2,948 older adults participating in the ORANJ BOWL panel. Using longitudinal multilevel mixed effect modeling, we examined trajectories of depressive symptoms across three waves. While depressive symptoms increased over time, they were greater for people who experienced more relational life events and the onset of more chronic conditions. Participants who reported experiencing all four relational life events but no chronic conditions had an average CES-D score of 5.28 (p&lt;.0001); average CES-D score increased to 12.72 (p&lt;.0001) for those who reported four life events and the onset of four or more new chronic conditions during the study period. In summary, chronic condition onset moderated the relationship between life events and depressive symptoms. Findings highlight the need for practitioner awareness of increased mental health risks for people experiencing stressors in multiple domains of life.
ASSOCIATION BETWEEN SEEKING HEALTH INFORMATION ON THE INTERNET AND PALLIATIVE CARE KNOWLEDGE
Authors: Zhu YuJun , Enguidanos Susan 
Published: November 2019

Abstract
Background: National and state surveys have found that only 8% - 17% of people know what palliative care (PC) is. Anecdotal reports also suggest many of those knowledgeable have misconceptions about PC. This lack of knowledge or misconceptions about PC can serve as barriers to accessing palliative care for seriously ill patients. Additionally, individuals often use the internet to seek health information, but it is unclear if this improves palliative care health literacy. Methods: We used the Health Information National Trends Survey 5, Cycle 2 (2018), a nationally representative dataset (n=3,504) to compare self-rated PC knowledge level with actual knowledge. We conducted chi-square and logistic regression to examine the association between PC knowledge and seeking health information on the internet. Results: About 33% of participants self-reported having PC knowledge. When these individuals were queried about specific PC knowledge, 58% failed to answer three basic questions correctly. After controlling for demographic and socioeconomic status, using the Internet to seek health information was positively associated with being knowledge about PC (P=0.006, OR=1.64), while having less than high school education was associated with lower PC knowledge. Implications: We found that self-reported PC knowledge may not reflect actual PC knowledge and thus clinicians should be sure to define the service when introducing it to patients. In addition, since use of internet in seeking health information is significantly associated with PC knowledge, it is important to ensure that internet PC information is valid, reliable, easy to access, and presented in simple language.
THE ASSOCIATION OF PAIN LOCUS OF CONTROL WITH PAIN OUTCOMES AMONG OLDER ADULTS
Authors: Musich Shirley , Wang Shaohung , Slindee Luke , Kraemer Sandra , Yeh Charlotte 
Published: November 2019

Abstract
Pain locus of control (LOC) refers to perceived control over health and pain. LOC has ramifications on pain severity, disability and treatment. Our objective was to determine prevalence of 3 subscales of LOC among older adults with pain; and examine associations of scales on pain severity, opioids and physical function. The sample was identified from adults age≥65 with back pain, osteoarthritis or rheumatoid arthritis and minimum of 12-months medical and drug plan enrollment. Members were mailed a survey in May 2018 assessing positive resources, negative attributes and pain outcomes of pain. Opioid and other medications were determined from drug claims. The population was propensity weighted to adjust for survey non-response bias; weighted to generalize to those with diagnosed pain. Multivariate logistic regression was used to determine protective associations of positive resources with negative attributes on outcomes. Among respondents, 30% were internal LOC; 34% powerful other; 36% chance. In multivariate models, demographics, socioeconomics, health status, pain medications, resilience and social network, internal LOC was associated with lower pain severity, reduced opioid use and increased physical function. Magnitude of impact was comparable to resilience and diverse social networks. Powerful other LOC was partially protective with improved psychosocial attributes but poorer pain outcomes; chance LOC was associated with poor psychosocial/pain outcomes. Despite positive resources, depression and poor sleep maintained associations with pain outcomes. Internal LOC is a strong positive resource associated with improved pain. Multidimensional programs should include enhancing positive resources, including LOC, and focus on improving negative attributes to maximize pain management.
PREDICTORS OF SHORTNESS OF BREATH DURING STAIR CLIMB IN COMMUNITY-DWELLING INDIVIDUALS WITH COPD
Authors: Gore Shweta 
Published: November 2019

Abstract
Dyspnea is the primary and most disabling symptoms seen in chronic obstructive pulmonary disease (COPD). Primary pathophysiological changes such as dynamic hyperinflation have been associated with the etiology of dyspnea in chronic obstructive pulmonary disease (COPD). However, since the experience of dyspnea “derives from interactions among multiple physiological, psychosocial and environmental factors”, a single correlate to accurately predict dyspnea has not been established. The purpose of this study was to identify factors that could predict shortness of breath during stair climb (SOB-SC) in community dwelling adults with COPD. We hypothesized that physical activity and muscle strength would significantly predict SOB-SC. Individuals with COPD who participated in the National Health and Nutrition Examination Survey (NHANES) between years 1999-2002 were selected for this study. Participants were excluded if they had significant mobility limitations. Socioeconomic, demographic variables, and clinical variables including BMI, physical activity, comorbidities, muscle strength, ankle brachial index, waist circumference and inflammatory markers were extracted. Logistic regression models were plotted with SOB-SC as the categorical dependent variable after assessing for collinearity using the forced-entry method. Individuals with COPD had a significantly greater proportion of SOB-SC (χ = 134.87, p &lt; 0.001). Larger waist circumference (p = 0.002, CI = 0.04 -0.13), presence of cardiovascular disease (p = 0.001, CI = 0.76 -2.37) and Caucasian race were found to significantly predict SOB-SC after controlling for covariates. This study reinforces the importance of screening for cardiovascular disease and lifestyle modification in this population subgroup. Future studies examining differences in COPD severity are needed.
CHANGES IN DEPRESSIVE SYMPTOMS IN EAST ASIA: A COORDINATED ANALYSIS OF THREE LONGITUDINAL STUDIES
Authors: Nakagawa Takeshi , Cho Jinmyoung , Yeung Dannii 
Published: November 2019

Abstract
Evidence for changes in depressive symptoms is relatively sparse in Asian populations. We examined changes in depressive symptoms in China, Korea, and Japan. Data were derived from three longitudinal studies with three measurement waves: the China Health and Retirement Longitudinal Study (CHARLS between 2011—2015), the Korean Longitudinal Study of Aging (KLoSA between 2006—2010), and the Japanese Study of Aging and Retirement (JSTAR between 2007—2011). Participants aged 50—75 years were included in the analysis (CHARLS: n = 10,385; KLoSA: n = 6,683; JSTAR: n = 3,004). Multilevel analyses were conducted separately for each country to examine trajectories of depressive symptoms, controlling for age, age squared, gender, education, marital status, activities of daily living, and morbidity as covariates. Depressive symptoms were measured by the 10-item CES—D. The CES—D score was scaled to a T score metric (M = 50, SD =10) using the score at wave 1 in each country as a reference. Trends in depressive symptoms varied across countries, with stability in China but increase in Korea and Japan (Estimate = —0.05, 0.69, 0.40, respectively). Older Koreans reported higher levels of depressive symptoms than younger adults, whereas a reverse pattern was shown in China. Age differences were not found in Japan. Higher levels of education were associated with lower levels of depressive symptoms in China and Korea, whereas the opposite association emerged in Japan. These country differences will be discussed through the lens of societal and economic factors (e.g., welfare systems and economic recession).
DETERMINANTS OF DEPRESSION AMONG AGING LGBT IN TEXAS
Authors: Moore Ami 
Published: November 2019

Abstract
Introduction: Aging LGBT experience significant health disparities compared to their heterosexual counterparts. As a sexual minority, they have a high likelihood of acquiring physical and mental illnesses. Methods: This study investigated factors that are associated with reports of depression among LGBT. Data came from Project Gray Pride, a study of aging gay, lesbian, bisexual, and transgender men and women living in a metropolitan area in Texas (N=126). Linear regression analysis was used. Results: Results show a negative association between respondents who self-identified as cisgender female and depression compared to those who self-identified as transgender. However, social vigilance and reports of health symptoms positively correlate with depression. Additionally, the interaction term of gender and race showed that respondents who were non-Whites and female reported higher levels of depression relative to their counterparts who were White males or White transgender. Other factors such as HIV status, age, education were not statistically significant. Conclusion: This study shows that being socially vigilant increases depression among aging LGBT. Also, aging female LGBT who are non-White may have an increased burden of negative social experiences leading to high levels of depression. As the population of older LGBT is increasing, intervention efforts must take into account these important findings in order to devise sound policies and programs to improve mental health among LGBT.
MEANING IN LIFE AND REASONS FOR LIVING IN OLDER ADULTS WITH SUICIDAL IDEATION: AN INTEGRATIVE REVIEW
Authors: Sagna Atami 
Published: November 2019

Abstract
Suicide has ranked as the 10th leading cause of death for all ages in the United States. Although Healthy People 2020’s target is to reduce suicide rates by 10.2 per 100,000 by 2020, it remains that suicide rates continue to increase, with suicide in older adults contributing substantially to this rise. Older adults have a higher risk for suicide, yet research in the area on positive psychological factors such as meaning in life and reasons for living is lacking. The purpose of this review is to investigate the associations among meaning in life, reasons for living and suicidal ideation in older adults (55+ years). Based on PRISMA guidelines, the PubMed, PsycINFO, PsycARTICLES, and CINAHL databases were systematically searched for relevant publications without date restrictions. Nine studies, qualitative and quantitative, are included in the review, showing a relationship among meaning in life, reasons for living and suicidal ideation in older adults. All the studies found that meaning in life and reasons for living were negatively associated with suicidal ideation in older adults. The findings of this review highlight the importance of including positive psychological factors in assessing suicide risk in older adults and in planning preventative measures and services for this high-risk group.