bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family Caregiver Mental Health: Linking Family Care Regime, Intersectionality, and Stress Process Frameworks
Authors: Browning Sean , Penning Margaret 
Published: December 2020

Abstract
Although the implications of family care regime, social location, and stress process factors for the mental health of family caregivers have been well-documented individually, there is a lack of research that integrates these factors. Yet, linking family care regime and intersectionality approaches to stress process theorizing provides us with one possible explanation of the mechanisms potentially linking family care regime and intersecting structural inequalities to mental health outcomes. This paper draws on pooled data from the 2012 and 2016 European Quality of Life Surveys (EQLS - N=6,007) to assess direct and indirect associations between family care regime and the self-reported mental health (SRMH) of family caregivers, together with the additive and interactive associations involving social location (gender, age, socio-economic status, and marital status), and stress process factors (stressors and resources). The results of a series of weighted least squares regression analyses reveal that family care regime has a direct association with SRMH and that social location and stress process factors partially mediate this association. Additionally, the results suggest that additive and interactive social location factors have direct associations with SRMH and that stress process factors also partially mediate the association. Lastly, stress process factors are associated with SRMH as expected. Overall, our findings provide initial support for the value of linking family care regime, intersectionality and stress process frameworks for an understanding of the mental health implications of family caregiving.
The Effects of the BAILAMOS Dance Program on Brain Functional Connectivity of Older Latinos: An Exploratory Study
Authors: Balbim Guilherme Moraes , Ajilore Olusola , Lamar Melissa , Erickson Kirk , Aguiñaga Susan , Bustamante Eduardo , Marquez David 
Published: December 2020

Abstract
Compared to non-Latinos whites, older Latinos are at higher risk of cognitive impairment and engage in less leisure-time physical activity (PA). Resting-state brain functional connectivity (FC) is a putative biomarker for age-related cognitive decline. PA plays a role in FC of brain networks associated with cognitive decline. Objective: Investigate the effects of the BAILAMOS™ dance program on FC in three brain networks associated with age-related cognitive decline (Default Mode [DMN], Frontoparietal [FPN], and Salience [SAL] networks). Methods: Single-group pre-post design. Ten cognitively intact older Latinos participated in the four-month (2x/week for 60min) BAILAMOS™ dance program with four Latin dance styles. MRI was obtained pre- and post-intervention. FC was analyzed using the resting-state fMRI toolbox (CONN) via pairwise BOLD signal correlations and then converted into z-scores. We performed dependent t-tests, computed Cohen’s d and 95%CI for p &lt; 0.05. Results: Within-FPN FC significantly increased (t(9) = 2.35, p = 0.043, d = 0.70) from pre (M=0.49±0.15) to post-intervention (M=0.59±0.13). In the DMN, we observed moderate effect size changes in the ratio of the FC between-networks by the FC within-networks (Mdiff = 0.10; 95%CI = -0.01; 0.21, p = 0.08, d = 0.64). Conclusions: The BAILAMOS™ program increased within-FPN FC, which is a cognitive-control network related to adaptive control and flexibility. Moderate changes between- vs. within-DMN FC suggest BAILAMOS™ also increased whole-brain DMN integration. Taken together, results might signal that Latin dance can combat the disruption of FC between the DMN and other networks, and within-FPN, which are associated with cognitive decline.
Co-Designing and Evaluating a Self-Care Curriculum of an App for Chinese Immigrant Caregivers
Authors: Wang Ying , Liu Mandong , Chi Iris 
Published: December 2020

Abstract
Chinese immigrant caregivers face unique self-care difficulties in the United States due to language barriers, cultural isolation, and occupational stress. This study aimed to conduct a formative evaluation on a caregiver self-care curriculum of an app designed for Chinese immigrants in the United States. Using a co-design approach in 2019, 22 Chinese immigrant caregivers in Los Angeles county were recruited through purposive sampling method. The directed content analysis was adopted to analyze the qualitative data using NVivo 12.1.0 software. We organized the findings under two main contents: self-care and caregiving. Three categories were identified under the self-care content: physical health, emotional and mental health, and support resources. Sixteen subcategories under physical health (e.g., dietary supplements), five subcategories under emotional and mental health (e.g., depression) and eight subcategories under support resources (e.g., support and networking group, senior center) are suggested. Two categories were identified under the caregiving content: caregiving knowledge and skills, and community resources. Fourteen subcategories under caregiving knowledge and skills (e.g., care assessment) and six subcategories under community resources (e.g., medical emergency call) were mentioned. With this useful information, we could further refine the self-care curriculum to be more linguistically, culturally and occupationally sensitive for Chinese immigrant caregivers. Empowerment approach for enhancing the ability to caregiving and self-care should be emphasized in content design for immigrant caregivers. The co-design approach is crucial for planning of the program and intervention curriculum to improve understanding of the users’ needs and better cater them.
Informal Volunteering Helps Older Adults Stay Put Too! But, Does Gender Matter?
Authors: Shen Huei-wern , Perry Tam 
Published: December 2020

Abstract
Many older adults desire to remain in one’s home for as long as possible, and many factors have been identified to be helpful, such as formal volunteering (doing unpaid work for religious, educational, health-related or other charitable organizations). While many older adults volunteer formally, many others volunteer informally (providing unpaid help to friends, neighbors, or relatives who did not co-reside). However, less is known about the relationship between informal volunteering and relocation. Guided by the social and material convoy framework, the present study explores the intersection of gender, informal volunteering, and relocation (no move, move within area, and move out of area). Utilizing data from 2008 and 2010 Health and Retirement Study, 8,361 older adults who were 65 and above in 2008 were included. When older people’s financial resources, health, environment, and demographics were controlled, findings from multinomial logistic regression showed that older adults who volunteered informally were less likely to move within area two years later. When stratified by gender, it was found that female (n=4,832) volunteered informally in 2008 were less likely to move within area within two years, too; whereas for male (n=3,529), those who informal volunteered in 2008 were less likely to move out of area in 2010. According to the findings, informal volunteering helps older adults stay put. Future research is needed to understand why informal volunteering helps reduce short distance moves for women but helps reduce long distance moves for men.
There at Any Distance? Geographic Proximity and the Presence of Adult Children in Older People’s’ Confidant Networks
Authors: Schafer Markus , Sun Haosen 
Published: December 2020

Abstract
Adult children are key members of their aging parents’ close social network, often providing emotional and advisory supports. Still, adult children are not a guaranteed presence in older people’s core discussion networks. Geographical distance is a leading explanation for why some children are excluded from the confidant network, but we hypothesize that certain parent- and dyadic-level factors make these intergenerational ties more resilient to distance. Using wave six of the Survey of Health, Ageing, and Retirement in Europe, we identified whether a living adult child was also a member of the parent’s egocentric confidant network. We modeled the effect of the child (Level 1) and parent (Level 2) characteristics on the exclusion of a child from the core network using hierarchical logit models. We found that fifty-eight percent of children were excluded from a parent’s network. Parents were more likely to exclude those who lived more than 25 km compared to children who lived within 5 km. The impact of distance was exacerbated among parents who were older, partnered, or had four or more children. Parents with higher education and good computer skills were less sensitive to longer distances when listing a child as a confidant. Finally, parents who had confidants outside of the nuclear family and who lived in Northern Europe were less likely to exclude a child over 100 km from their confidant network. Together, results indicate that a number of demographic factors and personal and social resources contribute to the elasticity of parent-child ties across long distances.
Body Mass Index Instability and Incident Mild Cognitive Impairment Among Black Older Adults
Authors: Aiken-Morgan Adrienne , Capuano Ana , Arvanitakis Zoe , Barnes Lisa 
Published: December 2020

Abstract
Despite general negative health effects, elevated body mass index (BMI) can be “protective” against poor health outcomes, including cognitive decline and mild cognitive impairment (MCI), in old age. However, few studies have examined the effects of BMI fluctuations (BMI instability) over time. The purpose of this study was to examine how BMI level at baseline and BMI instability is related to incident MCI in Black participants from the Minority Aging Research Study (MARS; N = 522, mean age = 73.5, mean education = 15.0; 76.5% women). Participants without cognitive impairment at baseline underwent annual clinical evaluations, including measurement of BMI and 19 neuropsychological tests for up to 15 years of follow-up to document MCI. 192 of 522 persons developed MCI. In Cox models adjusted for age, sex, and education, 1) higher baseline BMI, across the range of all values (mean=30.5; SD=6.5), was related to a decreased risk of MCI (Hazard Ratio = 0.97; 95% CI = 0.94-1.00); and 2) BMI instability (with a maximal range of 0-15.7; mean=3.2; SD=2.5) was related to an increased risk of MCI (Hazard Ratio = 1.09; 95% CI = 1.03-1.15). The present findings suggest that while late-life higher BMI level may protect against MCI, BMI instability over the years is detrimental to cognition in Black persons without dementia. Future research should investigate underlying mechanisms.
Dealing With Loneliness Among LGBT Older Adults: Different Coping Strategies
Authors: Peterson Natasha , Lee Jeongeun , Russell Daniel 
Published: December 2020

Abstract
Older lesbian, gay, bisexual, transgender (LGBT) adults may be at risk for high levels of loneliness—a risk factor for worse health behaviors—as a result of historical and social discrimination. Some LGBT older adults may have estranged relationships with family members or have toxic relationships, consequently leaving them without adequate social support. The 2018 Loneliness and Social Connections survey by the AARP Foundation consists of a national sample of non-institutionalized individuals 45 and older, including 2905 individuals who identify as heterosexual and 318 who identify as LGBT. The study indicated individuals had similar levels of loneliness regardless of sexual orientation. However, significant differences between heterosexuals and LGBT participants were found in their communication and time usage when they are lonely. For example, heterosexual individuals socialize with friends in person more than homosexuals (t=-2.393, p&lt;.05), whereas LGBT older adults use technology more to socialize with friends (t=3.749), p&lt;.001. Further, findings revealed that older LGBT adults tend to engage in more risky or unhealthy behaviors when lonely than do heterosexual older adults (t=3.907, p&lt;.001). Overall, the results indicate that while LGBT older adults may spend more time alone (t=7.350, p&lt;.001), they are engaging in different types of activities, particularly involving technology to communicate with friends, suggesting compensation for their lack of in-person contact. By understanding how LGBT older adults cope with loneliness along with the risks and resources that have influences on their health disparities can be useful for developing interventions to improve the health and well-being in these communities.
Association Between Living Arrangement and Acute Care Use in Older Medicare Home Health Patients
Authors: Wang Jinjiao , Ying Meiling , Cai Xueya , Caprio Thomas , Temkin-Greener Helena , Li Yue 
Published: December 2020

Abstract
This secondary analysis used a 10% random sample from the national Outcome and Assessment Information Set (OASIS) of Medicare beneficiaries ≥ 65 years old who received home health (HH) care in 2017 (N=646,109). We examined the risk of hospital admission during a 60-day HH episode among Medicare home health patients in different living arrangements, including living alone at home (23.8%), living with other at home (64.8%), and residing in assisted facility (AL) facilities (11.4%). At the start of the HH episode, AL residents were older, more likely to have cognitive impairment, depressive symptoms, and limitations in activities of daily living (ADL) than those living at home at home (alone/with others). In the multivariable logistic regression model of hospital admission adjusting for demographic status (age, sex, race/ethnicity, Medicaid status), cognitive impairment, depressive symptoms, and ADL limitations, when compared to HH patients living with others at home (reference), AL residents were 15% less likely to have hospital admission (Odds Ratio [OR]=0.85, 95% Confidence Interval [CI]: 0.84, 0.88, p&lt;0.001). HH patients living at home alone were not statistically significantly different from the reference (OR=0.99, 95% CI: 0.98, 1.01, p=0.47). HH patients in AL, despite having worse cognitive, mental, and physical function at baseline, had better outcomes than those living at home. This suggests 1) older adults living at home may have unmet health or personal care needs, and 2) synergies may exist between post-acute care through HH care and long-term care and support at AL that are critical to patient welfare.
The Harmonization of Four Delirium Instruments
Authors: Helfand Benjamin , Detroyer Elke , Milisen Koen , Adamis Dimitrios , Jones Richard 
Published: December 2020

Abstract
Delirium is a clinical syndrome characterized by acute cognitive dysfunction, which is pervasive in older persons. Delirium affects over 2.6 million Americans over age 65 annually. One major problem in detection of delirium is that over 40 different instruments have been created to identify delirium in different clinical settings. There is no single agreed upon reference standard instrument. In previous work, we performed a systematic review to identify the four most commonly cited and well-validated instruments for delirium identification. The aim of this study is to harmonize these four commonly used instruments: Confusion Assessment Method (CAM), Delirium Observation Screening Scale (DOSS), Delirium Rating Scale-Revised-98 (DRS-R-98), and Memorial Delirium Assessment Scale (MDAS). We used data from three separate sources (N = 1623). Participants were rated by multiple and overlapping instruments across studies, allowing us to apply item response theory linking procedures. We fit generalized structural equation models, and found unidimensional factor models fit well. We found the instruments were highly correlated (all r &gt; 0.9) and kappa statistics for delirium case identification were high (range: 0.89 to 0.95). We generated crosswalks to map sum scores on one instrument to another. Our results suggest the same underlying construct, propensity to delirium, is measured across the four instruments. The crosswalks facilitate comparison and combination for immediate clinical use or for future meta-analyses. In future steps, we will use our results to find the optimal cut-points for use across all instruments to identify delirium.
Hyposmia and Neuroimaging Signature in Community-Dwelling Older Adults
Authors: Felix Cynthia , Chahine Lana , Chen Honglei , Cao Zichun , Rosano Caterina 
Published: December 2020

Abstract
Olfaction declines with aging, and hyposmia, or impaired sense of smell, is associated with neurodegenerative disorders including Alzheimer’s Disease (AD) and Parkinson’s Disease (PD). Neuroimaging studies of hyposmia in AD/PD patients have often examined pathology-specific brain regions. Our knowledge of neural correlates in regions that mediate olfaction in community-dwelling older adults, is limited. We quantified mean diffusivity (MD) of the gray matter (GM) using diffusion tensor imaging in a community-dwelling sample of 308 older adults (mean age: 82.9 years, 58% women, 40% black). We focused on total brain and these regions involved in olfaction- olfactory bulb, amygdala, entorhinal cortex, orbitofrontal cortex, and hippocampus. Smell was tested with a scratch-and-sniff validated odor identification test, the Brief Smell Identification Test (BSIT). Hyposmia was defined as BSIT score of ≤8, assessed about 7 years prior to neuroimaging. In our sample, 23% had hyposmia, more in in men (30%) than in women (19%). Hyposmia was not significantly associated with cardiovascular risk factors such as hypertension; diseases such as stroke; age; race; cognitive or mobility functions (all p&gt;0.1). In linear regression models adjusted for demographics and brain atrophy (total brain gray matter volume divided by intracranial volume), hyposmia was significantly associated with higher GM MD (lower microstructural integrity) of the left orbitofrontal cortex (standardized beta: 0.142, t=2.56, p=0.011). Understanding the neural substrates involved in hyposmia in aging is an important step towards advancing research on hyposmia in non-clinic-based, community-dwelling populations.
Olfaction and Physical Function in Older Adults: Findings From Health ABC
Authors: Yuan Yaqun , Luo Zhehui , Li Chenxi , Simonsick Eleanor , Shiroma Eric , Chen Honglei 
Published: December 2020

Abstract
The present study aims to investigate poor olfaction in relation to physical functioning in community-dwelling older adults and potential sex and race disparities. The analysis included 2511 participants aged 71-82 years (51.7% women and 38.4% blacks) from the Health Aging, and Body Composition (Health ABC) study. Olfaction was tested with the 12-item Brief Smell Identification Test (BSIT). Physical function measures included the Short Physical Performance Battery (SPPB), the Health ABC Physical Performance Battery (HABCPPB), gait speed of 20-meter walk, fast 400-meter walking time, grip strength, and knee extensor strength, repeatedly assessed annually or biennially for a follow-up of seven years. We analyzed each of these physical function measures using mixed models, adjusting for demographics, lifestyle, and comorbidities. For all measures except grip and knee extensor strength, poor olfaction was clearly associated with poorer physical performance at baseline and a faster decline over time. For example, at baseline, the multivariate adjusted SPPB was 8.23 ± 0.09 for participants with poor olfaction and 8.55 ± 0.09 for those with good olfaction (P = 0.02), after seven years of follow-up, the corresponding scores decreased to 6.46 ± 0.12 and 7.36 ± 0.10 respectively (cross-sectional P&lt;0.001, and P for olfaction-by-year interaction &lt; 0.001). For grip and knee extensor strength, similar differences were suggested but didn’t reach statistical significance. The overall results were similar by sex and race. In summary, poor olfaction is clearly associated with faster decline in physical functioning in older adults and future studies should investigate its potential health implications.
Age as an Element of Diversity: Intergenerational Discussion to Improve Age-Related Attitudes
Authors: Wagner Lisa , Luger Tana 
Published: December 2020

Abstract
All generations must work together solving societal problems, yet age-related stereotypes are used to divide generations. Age derogation motivates younger people to vote by creating fear of an older White voting generation (Dear young people, don’t vote; 2018), and to belittle older people (“Okay, Boomer…”). Demonizing older people creates prejudice within families asking that people target loved ones, for example, by pitting educational funding for young against health funding for older adults. Neither group wins when divisiveness occurs. Generation to Generation, an intergenerational course for older and younger adults, promotes intergenerational contact. Students discuss topical issues (e.g., racism) in multi-generational groups. Using pretest-posttest design, all students were invited to complete questionnaires at beginning and end of term. Younger adults reported significant increases in affection, comfort, kinship, engagement and enthusiasm for older adults, whereas older adults showed stability over time. Intergenerational discussion may facilitate improved connections between generations.
Living and Learning Partnerships on Age-Friendly University Campuses
Authors: Montepare Joann , Farah Kimberly 
Published: December 2020

Abstract
Campuses and communities have a long and varied history of partnerships around educational efforts. In response to current shifts in age demographics and the number of adults aged 65+ increasing dramatically, new partnerships around living and learning are emerging. In particular, university-based retirement communities (UBRCs) associated with institutions of higher education are growing as housing options for older adults in the United States. The establishment of the Age-friendly University (AFU) initiative offers a guiding framework for how UBRC partnerships may be effectively mounted. This presentation will use the case example of the Lasell University – Lasell Village partnership to demonstrate how AFU principles can be implemented through age-friendly curricular programming and intergenerational exchange. Logistical considerations such as individualized learning plans for UBRC residents, an on-campus location, shared resources, and governance policies will be also be discussed as components of successful partnerships.
AGHE Program of Merit for Health Professions Education
Authors: Weinreich Donna 
Published: December 2020

Abstract
In 2015, the Program of Merit was expanded and adapted to implement a voluntary evaluation process for health professions programs that are choosing to integrate gerontology/geriatrics competencies in order to prepare students for working with older adults as well as their informal care partners. These programs are now eligible to apply for the Program of Merit designation. The Program of Merit for Health Professions Programs is based on the AGHE Standards and Guidelines for Gerontology/ Geriatrics in Higher Education, Sixth Edition (2015), specifically Chapters 11 and 12. This session will provide an overview of the process, review the application content, and provide technical support for interested participants.