bluuebunny/crossref_metadata_2025_split huggingface dataset:
OLD-AGE DEPRESSIVE SYMPTOMS: THE ROLE OF EARLY-LIFE FINANCIAL STRAIN AND LATE-LIFE SOCIAL ENGAGEMENT
Authors: Triolo Federico , Sjöberg Linnea , Vetrano Davide , Darin-Mattsson Alexander , Bertolotti Marco , Fratiglioni Laura , Dekhtyar Serhiy 
Published: November 2019

Abstract
It remains unclear if childhood socioeconomic disadvantage is associated with depression in old age. This study aims to investigate the effect of childhood financial strain on depressive symptoms in old age, and to examine whether late-life social engagement modifies this association. Data from the Swedish National study of Aging and Care in Kungsholmen, a community-based longitudinal study of aging, spanning clinical assessments over 15 years of follow-up were used. Information on financial strain in childhood was collected at baseline. Repeated measures of the Montgomery–Åsberg Depression Rating Scale were used to define depressive trajectories. A social engagement index comprised information on baseline social network and leisure activities. Linear mixed models were used to estimate depressive trajectories. Childhood financial strain was associated with a higher level of depressive symptoms (β = 0.36; p&lt;0.05), but not the rate of symptom accumulation over time. Relative to those with a combination of no financial strain and active social engagement, the level of depressive symptoms was progressively increased in those without financial strain but with inactive social engagement (β = 0.29; p&lt;0.05), as well as in those with both financial strain and inactive engagement (β= 0.83; p&lt;0.05). Individuals with financial strain who had active social engagement exhibited a similar burden of symptoms as those without financial strain and with rich social engagement. Early-life financial strain may have a lasting effect on old age depressive symptoms, although its detrimental consequences may be modified by active social engagement in late life.
THE POWER OF LOOKING AHEAD? A FIXED-EFFECTS MODEL OF FUTURE ASPIRATIONS OVER THE LIFE COURSE AND INCOME
Authors: Sendroiu Ioana , Upenieks Laura 
Published: November 2019

Abstract
Perceived life trajectories are rooted in structural systems of advantage and disadvantage, but individuals also shape their futures through setting goals and expectations. “Future aspirations” have typically been used in life course research to refer to one’s conception of their chances of success across life domains and can serve as a resource to help individuals persevere in the face of hardship. Taking a life course approach and using three waves of data from the MIDUS study, we utilize hybrid fixed effects models to assess the relationship between future aspirations and income. We find that, net of age, health, and a host of other time-varying factors, more positive future aspirations are indeed related to higher income over time, but that this relationship takes different shapes in different contexts. In particular, in lower quality neighborhoods, higher future aspirations lead to worse economic outcomes over the life course, while in higher quality neighborhoods, higher aspirations are indeed related to higher incomes. We thus argue that aspirations are only helpful in some contexts, and are inherently contextual not just in their sources but also in their effects.
HARNESSING THE POWER OF OLDER AMERICANS: INDEPENDENCE CENTER NETWORKS TO DEVELOP TECHNOLOGIES PROMOTING MOBILITY
Authors: Hall Katherine S , Caves Kevin , Alexander Neil 
Published: November 2019

Abstract
Information communication technology (ICT) refers to various technologies encompassing software, networking, the Internet, telecommunications, information systems, and more. As healthcare organizations adopt ICT devices and platforms, patients and providers will have more tools available to improve access to monitoring, telehealth, and timely interventions. The use of alternative methods of collecting, recording, and displaying data (e.g., smart speakers, chat bots, wearables) promise to improve health outcomes for the older adult population. As the U.S. population ages, opportunities for development designed specifically for older adults should be a focus for healthcare organizations. While there are challenges and barriers to enabling new technology within this population, research shows that older adults are adopting new technology. This symposium is focused on these emerging technologies and will showcase diverse examples of ICT implemented across various older adult populations and clinical application areas. The first paper describes the validation of Gaitbox, a walking speed measurement device. The second paper describes using multiple sensors to capture real-world loss of balance and recovery responses. The third paper reports the feasibility of using fitness gamification with a Virtual Reality Treadmill in older adults. The fourth paper describes a smartphone-based assessment of dual task standing and walking. The fifth paper describes wearable sensor-based assessment of falls risk of Timed Up-and-Go test. The Claude D. Pepper Centers maintain year-round coordination and collaboration through a national coordinating center. This powerful network, working towards the common goal of improving the lives of older Americans, has sparked technologic advances that will be highlighted here.
SENSOR-BASED ASSESSMENT OF FALLS RISK OF THE TIMED UP AND GO IN REAL-WORLD SETTINGS
Authors: Quinn Charlene C , Greene Barry R , McManus Killian , Redmond Stephen J , Caulfield Brian 
Published: November 2019

Abstract
Falls are the leading cause of older adult injury and cost $50bn annually. New digital technologies can quantitatively measure falls risk. Objective is to report on a validated wearable sensor-based Timed Up and Go (QTUG) assessment detailing 11 measures of falls risk, frailty and mobility impairment in older adults in six countries in 38 clinical and community settings. Second objective is to generate individual targeted falls prevention programs. 14,611 QTUG records from 8,521 participants (63% female) (72.7±10.7 years) available for analysis. QTUG time was 13.9±7.4 s; gait velocity was 101.9±32.5 cm/s. 25.8% of patients reported falling in previous 12 months; 26.2% of patients were at high fall risk. 21.5% not reporting a fall, were high fall risk. Participants had slow walking speed (29.8%); high gait variability (19.8%); problems with transfers (17.5%). Easily captured and interpreted sensor data is useful in a population-based approach to quantify falls risk stratification.
MENTORSHIP AND CAREER PATHS IN GEROPSYCHOLOGY
Authors: Jacobs Lindsey , Allen Rebecca S , Strong Jessica , Shumaker Elizabeth 
Published: November 2019

Abstract
Mentoring is a critical process for guiding the next generation of geropsychologists into career paths that fit their goals and needs. However, the context and content of mentorship in geropsychology is not well-documented. Understanding geropsychologists’ experiences may provide some insight into how mentorship is executed in academia versus clinical settings and which factors are relevant to career decision-making. We conducted a qualitative analysis of 28 transcripts from individual telephone interviews with geropsychologists and geropsychology trainees, focusing on mentorship and how it influenced their career path. Themes were differences in the focus of mentorship (e.g., immediate projects versus career goals), frequency of career-focused mentorship, length of mentorship (years versus months), and mentors’ openness to share opinions and experiences (e.g., academic mentors are more open about negative aspects of academia, while clinical mentors “guard” trainees from the negative aspects of clinical work). Subthemes and recommendations will be discussed.
HEALTH INSURANCE LITERACY, HEALTH STATUS, AND CONCERNS ABOUT AFFORDABILITY OF HEALTH INSURANCE NEAR RETIREMENT
Authors: Scherer Aaron M , Solway Erica , Malani Preeti , Luster Jamie , Kullgren Jeffrey , Kirch Matthias A , Singer Dianne , Tipirneni Renuka 
Published: November 2019

Abstract
Results from the NPHA highlight the link between health insurance affordability concerns and delaying/forgoing health care near retirement. We sought to determine factors associated with health insurance affordability concerns for US adults age 50-64. We regressed little/no confidence in health insurance affordability in retirement/within the next year on health insurance literacy, age, gender, race/ethnicity, income, employment, education, and health status. Factors associated with greater health insurance affordability concerns included lower health insurance literacy—measured via confidence knowing health insurance terms (aOR=1.78, p=0.035), identifying covered services (aOR=1.81, p=0.038), and finding out service costs (aOR=2.69, p&lt;0.001)—female gender (aOR=1.73, p=0.001), and fair/poor health (aOR=1.88, p=0.020). Factors associated with fewer health insurance affordability concerns included African-American race (aOR=0.55, p=0.038) and higher income (aOR=0.34, p&lt;0.001). These results suggest that it may be possible to reduce health insurance affordability concerns and delayed/forgone care by improving adults’ confidence in understanding and using health insurance.
CHANGES IN HEALTH CARE UTILIZATION FOR LOW-SES ADULTS NEAR RETIREMENT AFTER THE ACA MEDICAID EXPANSION
Authors: Tipirneni Renuka , Langa Kenneth M , McCammon Ryan J , Zivin Kara , Luster Jamie , Ayanian John Z 
Published: November 2019

Abstract
Low-SES Americans approaching retirement are experiencing rising morbidity and mortality. We examined longitudinal changes in health care access, utilization, and health for low-SES adults age 55-64 before (2010-2012) and after (2014-2016) ACA Medicaid expansion using the HRS. With a longitudinal difference-in-differences (DID) approach adjusting for demographics and the complex survey design, we found that low-SES adults age 55-64 had increased rates of Medicaid coverage (+10.7 percentage points [pp] in expansion states, +3.4 pp in non-expansion states, DID +7.3 pp) and increased likelihood of hospitalizations (+9.9 pp in expansion states, -1.2 pp in non-expansion states, DID +11.1 pp) in Medicaid expansion compared with non-expansion states. There were no other significant differences in access, utilization or health trends between expansion and non-expansion states. After Medicaid expansion, low-SES adults age 55-64 were more likely to be hospitalized, suggesting poorer baseline access to chronic disease management and associated pent-up demand for health care services.
STRUCTURAL DISCRIMINATION AND MRI-ASSESSED BRAIN ENDPOINTS: HANDLS BRAINCHILD
Authors: Beatty Moody Danielle L , Gullapalli Rao P , Davatzikos Christos , Sun Shuyan , Katzel Lesile , Zonderman Alan , Evans Michele , Waldstein Shari R 
Published: November 2019

Abstract
Emerging evidence demonstrates that exposure to race-related adversity, specifically, individual-level discrimination, in middle-age is adversely linked with white matter lesion volume, a prospective marker of future cerebrovascular disease as indicated on Magnetic Resonance Imaging (MRI). It remains unclear whether exposure to indices of neighborhood-level structural discrimination (e.g., residential segregation, % of population employed & with high school diploma/equivalency), are linked to MRI-assessed brain pathology and how these linkages may be patterned by key sociodemographic characteristics (e.g., race, age, sex, class). Knowledge of this linkage may help us further understand well-documented racial disparities in multiple clinical brain health endpoints including stroke, dementia, cognitive decline, functional disability, and subclinical brain pathology in adulthood. Thusly, this talk will focus on work that examines whether neighborhood-level structural discrimination is associated with MRI-brain assessed indicators of subclinical brain pathology and the role of key sociodemographic factors, with emphasis on the role of race.
INDIVIDUAL AND DYADIC PREDICTORS OF TECHNOLOGY ADOPTION: IMPLICATIONS FOR HEALTH AND WELL-BEING
Authors: Chopik William J , Cotten Shelia R 
Published: November 2019

Abstract
Technology has the ability to enhance and enrich the lives of older adults by facilitating better relationships, health, and well-being. However, older adults vary in how often—and even whether—they use information and communication technologies (ICTs). Further, interactions and relationships with people in their immediate social networks might have implications for whether or not older adults adopt ICTs. In two studies of individuals (N=595 participants; Mage=67.09; 56% Female; 69.2% White) and couples (N=542 couples; Mage=63.65; 50% Female; 83.9% White), I examined individual and dyadic predictors of technology adoption among older adults. Among a wide array of individual difference constructs, the most reliable predictor of technology adoption in both individuals and their spouses was need for cognition (.08 ≤ r ≤ .23). The results will be discussed in the context of how individual differences modulate adoption and the benefits accrued from ICTs across the lifespan.
THE IMPLICATIONS OF DIGITAL SOCIAL INTERACTIONS FOR OLDER ADULTS’ EXPERIENCES OF WELL-BEING IN DAILY LIFE
Authors: Mejia Shannon T , Turner Shelbie , Hooker Karen 
Published: November 2019

Abstract
Digital communication technologies expand opportunities for social interactions and as a result have the potential to either amplify or dampen the coupling of social interactions with well-being in daily life. We use data from the 100-day Personal Understanding of Life and Social Experiences project (n = 99, age = 50 – 88) to examine variation in the sensitivity of older adults’ daily reports of well-being to the quality of social interactions with their five closest social partners across digital (email/social media) and analogue (in person/by phone) interactions. Digital interactions were more common among less-close social partners. Multilevel random coefficient models showed days with more digital interactions than normal to be characterized by a) lower well-being and b) less sensitivity in well-being to the quality of social interactions with close social partners on that day. The implications of our findings are discussed within a life-span perspective of social relationships and well-being.
TRAJECTORIES OF HEALTH SYSTEM USE AND TRANSITIONS IN OLDER ADULTS WITH DEMENTIA
Authors: Bronskill Susan E , Maclagan Laura C , Walker Jennifer , Guan Jun , Wang Xuesong , Ng Ryan , Vermeulen Marian J , Maxwell Colleen J 
Published: November 2019

Abstract
Health systems strive to enable persons with Alzheimer’s and related dementias to remain at home to maximize their quality of life. There is limited evidence describing long-term trajectories of health system use by persons with dementia as they remain in the community over time. A cohort of 62,622 community-dwelling older adults was followed for seven years and matched to persons without dementia (controls) based on age, sex and comorbidities. Overall, persons with dementia were more likely than controls to use health services, particularly home care and hospitalizations with discharge delay; and were more likely to be admitted to a nursing home. As they remained in the community over time, persons with dementia used home care at an increasingly intensive rate. Our approach to examine trajectories of health system use among persons with dementia is of particular value to capacity planning initiatives to anticipate future health service needs of this population.
CHRONIC PAIN, FEAR OF FALLING, AND RESTRICTED ACTIVITY DAYS IN AN OLDER POPULATION
Authors: Leveille Suzanne 
Published: November 2019

Abstract
Both chronic pain and fear of falling can lead to activity restriction and increased fall risk among vulnerable elders. Little is known about pain characteristics that may be associated with fear of falling, contributing to restricted activity. We studied 765 adults aged ≥65y (mean=78.9y) in the MOBILIZE Boston Study, to evaluate the cross-sectional relationship between pain characteristics and fear of falling measured using the Falls Efficacy Scale (FES). In addition, we examined the impact of pain and fear of falling on restricted activity. We measured 3 domains of global pain: pain distribution (none, single site or multisite pain), and Brief Pain Inventory subscales of pain severity and pain interference. Restricted activity days (RADs) refer to the count of self-reported days of reduced activity due to illness or injury in the previous 12 months. We performed multivariable logistic regressions predicting fear of falling (FES&lt;90/100) adjusted for sociodemographics, fall history and fall risk factors. Participants with multisite pain or moderate-to-high pain interference ratings were more likely to have fear of falling (adj.OR 1.97, 95%CI 1.05-3.67; adj.OR 4.02, 95%CI 2.0-8.06, respectively). Pain severity was not associated with FES. Older adults with multisite pain and fear of falling reported significantly more RADs than those with multisite pain without fear of falling (79±135 and 26±74 RADs, respectively; test for pain x FES interaction, p=0.01). Older adults with chronic pain have greater fear of falling which may contribute to restricted activity. Efforts are needed to increase activity and falls efficacy among older adults with chronic pain.
CROSS-SECTIONAL ASSOCIATION OF FALLS AND POST-TRAUMATIC STRESS IN CANADIANS ACROSS LEVELS OF FRAILTY
Authors: Theou Olga , Pérez-Zepeda Mario Ulises , Armstrong Joshua , Godin Judith , Andrew Melissa , Kirkland Susan , Rockwood Kenneth 
Published: November 2019

Abstract
Frail older adults are vulnerable to stressors and are more likely to experience adverse outcomes. Post-traumatic stress is common in older adults, and can be related to common adverse outcomes, such as falls. We examined whether falls are associated with post-traumatic stress in middle-aged and older Canadians, by levels of frailty. We conducted cross-sectional analysis of the baseline assessment of the Canadian Longitudinal Study on Aging’s tracking cohort, comprising 21,241 individuals, aged 45 to 85 years. We constructed a 60-item frailty index (FI) and defined post-traumatic stress using the primary care post-traumatic stress disorder four-item tool (score 3 as the cut-point). Logistic regressions with post-traumatic stress as the dependent variable and at least one fall in the past year as the independent variable, were adjusted for socio-demographic variables and stratified according to FI 0.1 groups. Prevalence of post-traumatic stress and falls was of 6.5% and 5.0%, respectively for the whole sample. Among those who did not fall prevalence of post-traumatic stress ranged across frailty levels from 3.2% (FI&lt;0.1) to 24.5% (FI≥0.3). Among those who fell, post-traumatic stress ranged from 3.4% (FI&lt;0.1) to 36.9% (FI≥0.3). Falls were not significantly associated with post-traumatic stress among people who had an FI&lt;0.3, but among those with an FI≥0.3 the odds ratio for having post-traumatic stress for those who fell was 2.25 (95% CI 1.2-4.23, p=0.011) compared to non-fallers. In conclusion, high levels of frailty can impact how a stressor, such as a fall, can be associated with an adverse psychological outcome.
EFFECT OF A HOME-BASED EXERCISE PROGRAM ON SUBSEQUENT FALLS IN SENIORS AFTER A FALL: A RANDOMIZED CLINICAL TRIAL
Authors: Liu-Ambrose Teresa , Davis Jennifer C , Best John R , Dian Larry , Cook Wendy , Madden Kenneth , Hsu Chun Liang , Khan Karim M 
Published: November 2019

Abstract
We assessed the efficacy of the home-based Otago Exercise Program (OEP) as a secondary falls prevention strategy in seniors referred to a falls prevention clinic after an index fall. We conducted a 12-month randomized controlled trial of 344 adults, aged 70 years and older, with = or &gt; 1 fall resulting in medical attention in the prior 12 months. Participants were randomized to OEP or standard of care (CON). The OEP is a home-based strength and balance training program delivered by a physical therapist. All participants received AGS Guideline Care for falls prevention from a geriatrician. Differences in falls rate was tested with a negative binomial regression model. The rate of falls was lower in the OEP group vs the CON group (incident rate ratio [IRR] = 0.64, 95% CI 0.46 to 0.90). The estimated incidence rate of falls per person-year was 1.4 (95% CI 0.1 to 2.0) in the OEP group and 2.1 (95% CI 0.1 to 3.2) in the CON group, with an absolute incidence rate difference of 0.74 (95% CI 0.04 to 1.78) falls per person-year. DSST performance also increased in the OEP group by a mean change of 1.1 points (95% CI 0.02 to 2.1) vs the CON group. Improved DSST was associated with fewer falls (IRR = 0.80, 95% CI 0.68 to 0.95). These findings support the use of the OEP for secondary falls prevention.
SEDENTARY BEHAVIOR AND PHYSICAL ACTIVITY IN THE ADULT CHANGES IN THOUGHT (ACT) STUDY
Authors: Rosenberg Dori E , LaCroix Andrea Z , Guralnik Jack 
Published: November 2019

Abstract
Few epidemiologic studies have examined device-measured sitting patterns and health outcomes. Furthermore, there is a need to continue understanding the role of prospectively measured physical activity in relation to older adult health. The Adult Changes in Thought (ACT) study is an on-going epidemiologic study of adults age ≥65 years that began in 1994. Participants complete biennial assessments including a self-reported measure of physical activity. Starting in 2016, ACT participants could enroll in a physical activity sub-study that involved wearing a thigh-worn activPAL device and maintaining sleep logs for 7 days. Of those approached to participate in the sub-study, 64% agreed (N = 1139). A total of 961 had valid wear time (≥4 days with 10-20 hours of data per day) and completed survey collecting measures on pain and built environments (56% female, 57% &gt; age 75, 89% non-Hispanic white). Participants who consented to the sub-study were generally younger and had fewer chronic conditions than those who did not consent. After removing sleep time, mean daily activPAL measures calculated included hours sitting and standing, number of sitting bouts lasting 30 minutes or more, number of breaks from sitting, and steps walked. The first session in this symposium will present historical self-reported physical activity trajectories in relation to cognitive function. The subsequent sessions will present novel cross-sectional data examining activPAL variables with measures of physical function, pain, and perceived built environments. This symposium will provide new insights on the roles of sedentary behavior and physical activity in aging and health.
AGENCY IN LATE-CAREER TRANSITIONS: THE IMPACT ON ADJUSTMENT AND SATISFACTION
Authors: Solinge van 
Published: November 2019

Abstract
In research on late career transitions agency is implicitly assumed. The extent to which older adults are able to shape their late career in the face of external constraints, such as a rising state pension age, may however be limited. Constraint agency may have impact on well-being. Using data from a panel study among 5,300 older workers in the Netherlands, we examined the impact of agency in the work-retirement transition on adjustment and life satisfaction. Results show that adjustment to a the higher retirement age is more challenging than adjustment to retirement. Life satisfaction increased among those who retired, but not among those who remained working. One third experienced constrained agency (involuntary retirement or non-retirement). The negative association between constrained agency and life satisfaction was stronger for participants still in the labor force than for retirees. Our findings demonstrate that involuntary non-retirement has stronger implications for well-being than involuntary retirement.