bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care Managers Have Few Options for Home Modification Because They Are Not Specified in Architecture
Authors: Yoshida Kazunori , Harazono Yoritaka , Funaki Toko , Nishino Akiko 
Published: December 2020

Abstract
In this paper, we aim to clarify the cause of the difficulty in home modification. The aging society becomes larger where older people have difficulty in living home because of weakened body functions. To maintain quality of life, it is important to modify houses. In Japan, home modification is conducted by care managers, who are originally from nurses, helpers, and so on. However, to modify houses, we hypothesized that it is needed to have knowledge about not only body function but also architecture. Because of this, home modification should be difficult for care managers. For this problem, we aim to clarify the difficulty in home modification. In November 2018, we took part in the teaching course for care managers about home modification and asked care managers the number of home modification they conducted and what they have difficulty in. As a result, we asked for 57 care managers, who have experience as care managers for 39 months in average. Home modification was mainly conducted for setting handrails (four for a care manager in average). It was also revealed that experience of modification for handrails and doors are larger when the experience of care manager becomes longer, but other modification is not the case. The care managers told us that they cannot understand architecture. This result indicates that care managers cannot think of many options for modification because of their little knowledge about architecture. Therefore, it should be needed to combine the architects and care managers for appropriate home modification.
Urban-Rural Differences in Geodetic Distance Between Home and the Nearest Pharmacy Among Older Pennsylvania Adults
Authors: Khan Shivani , Heller Debra , Latty Leroy , LaSure Michelle , Brown Theresa 
Published: December 2020

Abstract
Aim: We examined differences in geodetic or straight line distance between home and the nearest community pharmacy among rural and urban older adults in Pennsylvania. Method: The addresses of 241,398 older adults (≥65 years) and 2,880 community pharmacies enrolled in Pennsylvania’s Pharmaceutical Assistance Contract for the Elderly (PACE) program in 2018 were geocoded. We identified pharmacies in the same or adjacent counties for each enrollee and measured the geodetic distance between home and those pharmacies. The pharmacy with the shortest distance from home was identified as the nearest pharmacy for each enrollee. Enrollees’ home addresses were categorized as urban or rural at the county level, based on the Center for Rural Pennsylvania’s definitions. T-tests and chi-squared tests were used for analyses. Results: Overall, 37% were rural older adults and the mean distance between home and the nearest pharmacy was 1.60 ± 2.21 miles. The mean distance between home and the nearest pharmacy was significantly greater in rural compared to urban older adults (2.78 ± 2.93 versus 0.91 ± 1.19; p&lt;.0001). A higher proportion of rural older adults resided &gt;5 miles away from the nearest pharmacy compared to urban older adults (19.19% versus 1.80%; p&lt;.0001). Moreover, 2.96% of rural older adults resided &gt;10 miles away from the nearest pharmacy compared to 0.08% of urban older adults (p&lt;.0001). Conclusion: Older patients in rural counties need to travel longer distances for pharmacy access than in urban counties. Efforts to provide convenient access to medications and pharmacy services for rural older patients are necessary.
Examination of Advanced Function and Its Correlates in a Cohort of Community-Dwelling Older Adults
Authors: Liebzeit Daniel , Kuo Wan-chin , Carlson Beverly , Mueller Kimberly , Bratzke Lisa 
Published: December 2020

Abstract
Function in older adults includes multiple domains, from basic to “advanced,” but we remain limited in detection of advanced function (engagement in social, leisure, and productive activities). The objective is to describe advanced function and examine relationships with basic function and health outcomes in community-dwelling older adults aged 55-65 years. This is an analysis of existing data from a large, ongoing cohort study, The Wisconsin Registry for Alzheimer’s Prevention (WRAP R01 AG027161). We used a 1:1 prospective case–control design to examine whether older adults with lower advanced function (lower functioning group) at wave 3 showed lower IADLs and poorer health outcomes in wave 4, compared to those with higher advanced function (higher functioning group). The lower functioning group had a mean advanced function score of 74.4 (SD = 10.1), compared to 98.7 (SD = 11.1) in the higher functioning group. The mean IADL scores were similar in the two groups (p = 0.123). The lower functioning group had significantly lower self-rated health (mean = 3.52; SD = .79) than higher functioning group (3.70; 0.79) and a significantly lower proportion of individuals with unimpaired, stable cognition (77%) than the higher functioning group (85%). The lower functioning group had higher rates of comorbidities (4.25 vs. 3.96), mortality (4 vs. 1), and depressive symptoms (CES-D: 7.17 vs. 6.09), although results were not significant at α=0.05. This study provides a foundation for examining advanced function, which may be an early indicator of poor health outcomes in older adults.
Developing an RAI-MDS Behavior-Based Pain Scale for Long-Term Care Residents With Advanced Dementia
Authors: Knopp-Sihota Jennifer , Hoben Matthias , Poss Jeff , Estabrooks Carole 
Published: December 2020

Abstract
In Canadian and many international long-term care (LTC) facilities, pain assessment frequently relies on data from the Resident Assessment Instrument – Minimum Data Set 2.0 (RAI-MDS). The RAI-MDS produces a two-item scale, measuring both pain frequency and pain intensity. This scale correlates well with self-reported pain in cognitively intact LTC residents, but despite repeated testing, is less valid for use in residents with more advanced cognitive impairment who are unable to self-report their pain. In this study we aimed to develop and validate a behaviour-based pain assessment scale for long-term care residents using data available in the RAI-MDS. To construct our initial scale, we reviewed the literature and compiled a list of observable indicators of pain (e.g., grimacing) and linked these with 28 similar items available in the RAI-MDS. Using Delphi techniques, we further refined this to 20 items. We then evaluated the psychometric properties of our scale using two independent, representative samples, of urban LTC residents in Western Canada. Exploratory factor analyses were conducted in sample one (n=16,282) and confirmatory factor analyses (CFA) were then conducted in sample two (n=15,785) in order to test, and confirm, our model. A two-factor solution was identified grouping RAI-MDS items into subscales 1) change in status (e.g., new onset restlessness) and 2) behaviours (e.g., crying). Commonly recognized model fit indices were acceptable suggesting the adequacy of the two-factor solution. Results provide preliminary support for the use of behavioural-based pain assessment scale using RAI-MDS data. Further evaluation and validation of our scale is warranted.
Ideal Cardiovascular Health Is Associated With Slowness Among Community-Dwelling Older Adults
Authors: Jung Heeeun , Kim Miji , Shim Hayoung , Seo Yuri , Lee Seoyoon Jane , Won Chang Won 
Published: December 2020

Abstract
Slowness is associated with increased disability and mortality in older people. However, the relation between ideal cardiovascular health (CVH) and slowness in community-dwelling older adults is uncertain. We examined the prevalence of ideal CVH in Korean older adults and its association with slowness in community-dwelling older adults. We analyzed 2,597 participants (mean age 76.0±3.9 years, 54.4% women) without cardiovascular disease from the Korean Frailty and Aging Cohort Study. The usual gait speed over a distance of 4 m was measured using an automatic timer, and slowness was defined as a speed &lt;1.0 m/s. Ideal CVH was described as attainment of ideal health behaviors (no smoking, regular physical activity, ideal body mass index, and healthy diet) and optimal health factors (blood pressure, HDL-cholesterol, and glycated hemoglobin). Multiple logistic regression analysis was used to examine the association between the CVH score and slowness. Ideal CVH was present in 785(30.2%) subjects. Considering those with poor level of CVH were as the reference group, the odds ratios [OR] for slowness were 0.55 (95% confidence interval [CI], 0.39-0.77) for those with intermediate level of CVH, and 0.28 (95% CI, 0.17-0.45) for those with ideal level of CVH after adjustment for potential confounders. Among ideal CVH components, behavioral CVH score (OR 0.65, 95% CI 0.58-0.74) was significantly associated with slowness vs. the biological CVH score (OR 0.95, 95% CI 0.84-1.07). This study indicates that ideal CVH is significantly associated with a lower risk of slowness in community-dwelling older adults. A better CVH may help prevent slowness.
Modeling Hearing Loss Progression and Asymmetry in the Older Old: A National Population-Based Survey
Authors: Sharma Rahul , Lalwani Anil , Golub Justin 
Published: December 2020

Abstract
The progression and asymmetry of age-related hearing loss has not been well characterized in those 80 years of age and older because public datasets mask upper extremes of age to protect anonymity. We aimed to model the progression and asymmetry of hearing loss in the older old using a representative, national database. This was a cross-sectional, multicentered US epidemiologic analysis using the National Health and Nutrition Examination Study (NHANES) 2005-2006, 2009-2010, and 2011-2012 cycles. Subjects included non-institutionalized, civilian adults 80 years and older (n=621). Federal security clearance was granted to access publicly-restricted age data. Outcome measures included pure-tone average air conduction thresholds and the 4-frequency pure tone average (PTA). 621 subjects were 80 years old or older (mean=84.2 years, range=80-104 years), representing 10,600,197 Americans. Hearing loss exhibited constant acceleration across the adult lifespan at a rate of 0.0052 dB/year2 (95% CI = 0.0049, 0.0055). Compounded over a lifetime, the velocity of hearing loss would increase five-fold, from 0.2 dB loss/year at age 20 to 1 dB loss/year at age 100. This model predicted mean PTA within 2 dB of accuracy for most ages between 20 and 100 years. There was no change in the asymmetry of hearing loss with increasing age over 80 years (linear regression coefficient of asymmetry over age=0.07 (95% CI=-0.01, 0.24). In conclusion, hearing loss steadily and predictably accelerates across the adult lifespan to at least age 100, becoming near-universal. These population-level statistics will guide treatment and policy recommendations for hearing health in the older old.
Self-Reported Uptake of Clinical Preventive Services by Vision Impairment Status
Authors: Assi Lama , Shakarchi Ahmed , Sheehan Orla , Reed Nicholas , Swenor Bonnielin 
Published: December 2020

Abstract
Disease prevention is central to healthy aging. People with vision impairment are more likely than those without to report barriers to accessing health care and have unmet health care needs. We examined the association between functional vision impairment and preventive care uptake among adults aged 65 years and older in the 2016 and 2018 Behavioral Risk Factor Surveillance System (BRFSS) survey. The outcome of interest was being up-to-date with the recommended core clinical preventive services, as defined by Healthy People 2020: influenza and pneumococcal vaccination, and colorectal cancer screening for men, with the addition of breast cancer screening for women. Self-reported vision impairment was defined as blindness or serious difficulty seeing, even when wearing glasses. In models adjusted for sociodemographic characteristics (including age), access to care, and health/functional status, there was no difference in the odds of reporting being up-to-date with the recommended core preventive services among men with vision impairment compared to those without (odds ratio [OR]=0.90, 95% confidence interval [CI]=0.8-1.01); however, men with vision impairment were 0.82 times (95% CI=0.71-0.94) less likely than those without to report being up-to-date with colorectal cancer screening. Women with vision impairment were less likely than those without to report being up-to-date with the recommended core preventive services (OR=0.77, 95% CI=0.69-0.87); among the different services, the odds were lowest for reporting breast and colorectal cancer screening. These findings suggest that to achieve higher rates of preventive care uptake, especially cancer screening, older adults with vision impairment may be a special group to target.
The Association of Sensory Impairment With Incident Disability-Related Cessation of Employment in Older Adults
Authors: Shakarchi Ahmed , Morales Emmanuel Garcia , Reed Nicholas , Swenor Bonnielin 
Published: December 2020

Abstract
Sensory impairment (SI) is common among older adults, and it is an increasingly important public health challenge as the population ages. We evaluated the association between SI and incident disability-related cessation of employment in older adults using the population-based Health and Retirement Study. Participants employed in 2006 completed biennial interviews until self-reported incident disability-related cessation of employment. Participants were censored at loss to follow-up, retirement, or 2018. Participants rated their vision and hearing, using eyeglasses or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, excellent). SI was defined as poor or fair ability, and SI was categorized as neither SI (NSI), vision impairment alone (VI), hearing impairment alone (HI), and dual SI (DSI). Cox proportional hazard regression assessed the association between SI and incident disability-related cessation of employment, adjusting for demographic and health covariates. Overall, 4726 participants were included: 421 (8.9%) were with VI, 487 (10.3) with HI, and 203 (4.3%) with DSI. Mean age was 61.0 ± 6.8 years, 2488 (52.6%) were women, and 918 (19.4) were non-White. In the fully adjusted model, incident disability-related cessation of employment over the 12-year follow-up period was higher in VI (Hazard Ratio (HR)=1.30, 95% confidence interval (CI)=0.92, 1.85), HI (HR=1.60, CI=1.16, 2.22), and DSI (HR=2.02, CI=1.38, 2.96). These findings indicate that employed older adults with SI are at increased risk of incident disability-related cessation of employment, and that older adults with DSI are particularly vulnerable. Addressing SI in older adults may lengthen their contribution to the workforce.
Attitudes and Intention to Work With Older Adults by USA and Israeli Nursing Students: Measure Adaptation and Testing
Authors: Van Son Catherine , Zisberg Anna , Shulyaev Ksenya 
Published: December 2020

Abstract
More nurses are needed to meet the healthcare needs of older adults. Valid and reliable measures are lacking that assess attitudes and intentions of nursing students to select a career in geriatrics. This paper discusses the applicability of the Carolina Opinions on Care of Older Adults (COCOA) instrument on attitudes towards and intention to work with older adults among nursing students. A cross-sectional survey design was used with samples of nursing students from the United States (N=122) and Israel (N=109). Students completed the COCOA instrument and the measure’s dimensionality, construct validity, reliability and equivalence among the nursing students was tested. Exploratory Factor Analysis (EFA) produced 5 factors explaining 59% of the variation with most of the items (17, 71%) loading above 0.40 on subscales according to the instrument’s original structure. Four items loaded on different subscales than originally described. One original subscale was eliminated (Value of Older Adults), and one new subscale was created (Older versus Younger Adults). The reliability scores were good to acceptable for all subscales (.60 - .80). Confirmatory FA supported the data’s fit to the modified COCOA instrument (CMIN/DF=1.55, CFI=.93, IFI=.93, RMSEA=.05). The analysis of model equivalence for USA and Israeli samples revealed significant differences attributed to Experience in Caring for Older Adults subscale. The modified COCOA instrument demonstrated good construct validity and reliability and can serve as estimation of nursing students’ attitudes towards older adults and intention to choose geriatrics as a career. Further studies are needed to test its predictive validity.
Leveraging Prehospital Care to Address Elder Mistreatment: Development of an Online Training for EMS
Authors: Haggerty Kristin Lees , Miller Melanie , Wardlaw Dana , Myint-U Athi , Campetti Randi , Cannell Brad , Lees Kristin 
Published: December 2020

Abstract
Elder abuse affects an estimated 1 in 10 older adults in the US and has devastating consequences for their health and well-being yet is widely under-recognized. Prehospital emergency medical service (EMS) providers are particularly well-positioned to identify older adults who are at risk of or experiencing mistreatment, and to report and intervene as appropriate. However, many EMS providers across the country lack the training and tools required to facilitate consistent identification and intervention. Recognizing the critical need for easily accessible, comprehensive, and relevant training, Education Development Center received funding from RRF Foundation for Aging to develop and pilot test the Elder Mistreatment EMS Training Curriculum (EM-ETC). The EM-ETC aims to improve identification, referral, and linkage to coordinated care and support services for older adults who are at risk of mistreatment. In this presentation, we will describe our iterative and collaborative process for developing an interactive online training program for EMS providers. The training leverages the unique circumstances of prehospital care to prepare EMS providers to recognize and respond effectively to elder abuse and help them to fulfill state licensing requirements. We will present findings from our formative research comprising consultation with subject matter experts and state offices of EMS education, focus groups with EMS and Adult Protective Services providers, and user testing with EMS providers.
Activity and Cognition in Older Adults With and Without Sleep Apnea
Authors: Mattek Nora , Kaye Jeffrey , Beattie Zachary 
Published: December 2020

Abstract
Many older adults have sleep apnea. It often goes undiagnosed. Sleep apnea is associated with decreased oxygen to the brain, fragmented sleep, shorter sleep duration, impaired cognition, increased risk for dementia, and less clearance of amyloid and tau. Little longitudinal data are available identifying objective measures of sleep apnea over time that may facilitate improved identification of affected persons. One hundred ninety-five participants age 57 or older were enrolled as part of Collaborative Aging Research using Technology (CART) initiative, a national study examining the feasibility of unobtrusive remote sensing and monitoring of cognitive, behavioral, physiological, and health-related activities. Nightly hours of sleep and total daily step count were acquired using a wrist worn device. Sixty (31%) reported having sleep apnea. Those with sleep apnea had a significantly lower MoCA total score than those without (22.9 vs. 24.2, p&lt;0.01) and were more likely to be classified as MCI by MoCA cutoff &lt;23 (49% vs. 24%, p&lt;0.001). Volunteers who live alone were less likely to be diagnosed with sleep apnea (p&lt;0.01). Males were much more likely to report having sleep apnea than females (p&lt;0.0001). Of those with watch-derived activity data, sleep apnea cases had shorter mean sleep duration (7.2 vs. 7.8 hours, p=0.05) and fewer total daily steps than those without sleep apnea (2384 vs 3327, p=0.04). Sleep apnea may be identified by its association with mildly impaired cognition, with shorter sleep duration, and less total daily activity as measured at home via remote continuous monitoring techniques.
Moderating Effect of Age on the Relationship Between Patient Activation and Diabetes Self-Care Activities
Authors: Kim Suhyun 
Published: December 2020

Abstract
Purpose: The purpose of the study was to identify the moderating effect of age on the relationship between patient activation and diabetes self-care activities among Korean patients with type 2 diabetes mellitus. Methods: For the cross-sectional correlational study utilizing secondary data analysis, 155 patients diagnosed with type 2 diabetes were divided into two age groups: &lt; 65 and ≥ 65 years. Original data were collected in ambulatory endocrinology units of two tertiary hospitals in South Korea from September 2016 to July 2017. Multivariate regression analyses were used, including interaction variable to detect a moderating effect of age group. Results: The level of diabetes self-care activities was similar between patients aged 65 or over and those aged less than 65 (with the possible range from 0 to 7) (3.71±1.22 vs. 3.53±1.20, t = -0.58, p = .561). Patient activation level was lower for patients aged 65 or over than those aged less than 65 (with the possible range from 0 to 100), but there was no statistical difference (61.54±4.01 vs. 68.66±16.45, t =1.68, p = .095). In multiple linear regression analysis, there was a significant interaction effect of age group (≥ 65 vs. &lt; 65 years) and patient activation on diabetes self-care activities, controlling for the demographic and clinical variables (standardized beta = -.69, p = .021, 95% CI [-.08, -.01]). Conclusion: To encourage diabetes self-care activities, it is necessary to consider the limited effect of patient activation level for patients with type 2 diabetes aged 65 or over.
The Acceptability of Technology in Health Care Among Older Korean Adults With Multiple Chronic Conditions
Authors: Ha Ji Yeon , Park Hyeyoung 
Published: December 2020

Abstract
Background: Although there are benefits in utilizing ICT in health care, older adults have challenges in employ technologies in their health care management due to the changes in cognitive and physical functions, low motivation to use technology, and low computer/internet literacy (Adebayo et al, 2017; Wildenbos et al, 2018). The purpose of this study is to investigate the acceptance of technology among older Korean adults with multiple chronic conditions and examine factors associating with the acceptance of the technology. Method: The participants were 226 community-dwelling older adults who have more than two chronic conditions. Directed by the senior technology acceptance model (Chen & Chan, 2014), demographics, gerontechnology self-efficacy, gerontechnology anxiety, facilitating conditions, self-reported health conditions, cognitive ability, social relationship, attitude to life and satisfaction, physical functioning, and acceptance of technology were surveyed using a self-reported questionnaire. Findings: Older Korean adults with multiple chronic conditions showed a moderately high technology acceptance score (M = 25.35, SD = 5.28). There were significant differences in the acceptance of technology depending on age (r=-0.241, p&lt;.01), cognitive ability (r=0.225, p&lt;.01), gerontechnology self-efficacy (r=0.323, p&lt;.0001), and facilitating conditions (r=0.288, p&lt;.0001). Conclusion: While older age were associated to the acceptance of technology, gerontechnology self-efficacy which is one’s judgment of their ability to perform a task successfully using gerontechnology and facilitating conditions which are environmental factors that help older adults use gerontechnology easier were positively associated with the acceptance of technology among older Korean adults with multiple chronic conditions.