bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening for Cognitive Impairment in African American Congregations
Authors: Epps Fayron 
Published: December 2020

Abstract
Having access to memory screenings is pivotal to early detection in the African American (AA) community. The purpose of this report is to describe the willingness and perceived barriers of AA congregants to participate in memory screenings. Out of 283 attendees to dementia-related church forums, 26% (n = 73) of the attendees participated in private memory screenings. The majority of the participants were female (88%, n = 64). Under half of the participants (37%, n = 27) scored below normal with 81% (n =22) being female. Several attendees declined the opportunity to have their memory screened for various reasons. These results support how women are disproportionately affected by cognitive impairment. Another alarming point was the low participation in memory screenings of event attendees. This report is important because it raises awareness of the need within the AA community, who are at a higher risk for memory loss, to receive screening. Part of a symposium sponsored by the Alzheimer’s Disease Research Interest Group.
Differential Association of Geographical Region of Birth With Dementia Risk Across Black Women and Men
Authors: Avila-Rieger Justina , Murchland Audrey , Seblova Nika , Glymour Maria , Brickman Adam , Schupf Nicole , Mayeux Richard , Manly Jennifer 
Published: December 2020

Abstract
Risk of dementia is both racially and spatially patterned. Less is known about sex/gender differences in pathways linking birth place to late-life cognitive outcomes in older non-Latino Blacks. The 1464 Black men and women included in these analyses were Northern Manhattan residents. Cox regressions revealed that Stroke-Belt South (SB) and Non-Stroke-Belt South (NSB) birth was associated with a higher dementia risk, adjusted for birth year, childhood SES, and risk of death. Compared to Northern-born (NB) men, SB men had the highest risk, followed by NSB women and SB women, while NSB men and NB women had a similar risk to NB men. The higher risk for SB men and NSB women remained after adjusting for education, adult income, and CVD burden. Future work should identify why birth in the SB is uniquely detrimental for cognitive health among Black men, while birth in NSB has the strongest impact on Black women.
Adult Children’s Support and Trajectory of Depressive Symptoms Among Disabled Chinese Older Adults
Authors: Wang Jianyun , Zhong Renyao , Pei Yaolin , Wu Bei 
Published: December 2020

Abstract
This study aimed to examine the trajectory of depressive symptoms among Chinese older adults with disabilities and the role of adult children’s support in predicting trajectory classes of depressive symptoms. Data were drawn from three waves of the China Health and Retirement Longitudinal Study (2011-2015). The sample included 1420 disabled older adults age 60+ at the baseline and completed all three waves of the data. Growth mixture model shows two-class depressive symptoms trajectories: the higher risk group (25.49%) and the lower risk group (74.51%). Logistic regression results showed that respondents who received a longer term of adult children’s instrumental support were more likely to be classified in a higher risk group after controlling the covariates (OR=1.184, p&lt;0.05), while financial support and the frequency of contacts were not associated with the increased level of depressive symptoms. The policy implications were also discussed in this study.
Creating Inclusive Advance Care Planning Tools
Authors: Beringer Robert , Gutman Gloria , de Vries Brian , Kwan Helen , Jang Katrina , Vashisht Avantika , Kaur Taranjot 
Published: December 2020

Abstract
The cultural appropriateness of two ACP tools, My Wishes, My Care, and Conversation Starter Kit, are examined. In development by the BC Centre for Palliative Care, My Wishes, My Care was reviewed with: LGBT Non-Metropolitan Older Adults (6 focus groups, N=32); English/Chinese Speaking Older Adults (1 focus group, N=9); and English/Punjabi or Hindi Speaking South Asian Older Adults (1 focus group, N=5). The Conversation Starter Kit, developed by Ariadne Labs, was reviewed with focus groups of people whose loved one was/is in a Care Home: one LGBT group (N = 5); one South Asian group (N = 5). General feedback on both tools included: concerns over level of understanding required to use the tool; the role of family in ACP planning; cultural inclusivity (e.g., images and text) and design elements. The feedback will inform revision of these tools and assist organizations in developing inclusive ACP planning guides or educational materials.
Deprescribing and Polypharmacy for Medicare Beneficiaries Under Guardianship in Long-Term Care Facilities
Authors: Swenson Tami 
Published: December 2020

Abstract
Local judicial courts vary in the amount of supervision they provide guardians, which makes the practice of guardianship uneven. To begin to address the evidence gap to inform best practices for persons under guardianship care, this study examines the issues of polypharmacy and prescribing patterns for four therapeutic classes most commonly targeted for deprescribing for older adults. The Medicare Current Beneficiary Survey (MCBS) for 2015 and 2016 is used to examine facility-dwelling Medicare beneficiaries under guardianship compared with those that are not. Logistic regression is used to examine association of polypharmacy outcomes and guardianship care controlling for patient and facility characteristics. Statistical models are adjusted using Fay’s Method with replicate weights for the MCBS complex survey design. Approximately 12% of the facility-dwelling Medicare population in 2015 and 2016 are persons under guardianship care. Persons under guardianship were more likely to have polypharmacy or to be prescribed 5 or more medications (Odd Ratio (OR)=1.168, 95% Confidence Interval (CI)=1.156 to 1.180, p&lt;0.001) than facility-dwelling Medicare beneficiaries not under guardianship care. Medicare beneficiaries under guardianship were more likely to be prescribed PPIs (OR=1.229, 95% CI=1.222 to 1.237, p&lt;0.001) or antipsychotic medications (OR=1.240, 95% CI=1.232 to 1.247, p&lt;0.001) but less likely to be prescribed benzodiazepines (OR=0.920, 95% CI=0.913 to 0.927, p&lt;0.001) or antihyperglycemics (OR-0.726, 95% CI=0.721 to 0.731, p&lt;0.001). Medical decision support services, such as guardianship care, are increasing in importance as shared decision making between patients and physicians evolves to address polypharmacy and deprescribing for older adults.
Does Long-Term Care Substitute for Hospital Care? Evidence From the China Health and Retirement Longitudinal Survey
Authors: Yang Wei 
Published: December 2020

Abstract
Publicly funded long-term care (LTC) support is shrinking in many countries despite continuing increases in the number of older people who need care. Evidence has shown that the LTC services have an impact on the efficient use of the resources in the health care sector by reducing rates of admission and associated costs through assisting older people with daily living. This paper seeks to examine whether and to what extent these services are substitutes. We use a fixed-effect instrumental variable GMM model to predict the effect of long-term care services on the utilisation of outpatient and inpatient care services. Data are drawn from China Health and Retirement Longitudinal Survey 2011, 2013 and 2015. Our findings suggest that LTC significantly reduces the use of outpatient care but not inpatient care. We have also found LTC use is concentrated among the rich, but the substitution effects are stronger among the poor compared to the rich. This indicates that the poor would benefit more from subsided LTC services. We urge the Chinese government to take action to develop its formal LTC system and to channel more resources to its LTC system, which will benefit the older population in general, and the poor in particular.
A Comparison of Symptoms in Hospitalized African American and White Persons With Dementia
Authors: Galik Elizabeth , Marie Boltz , Arendacs Rachel , Kuzmik Ashley 
Published: December 2020

Abstract
There exist significant race disparities in the prevalence of dementia, with black persons with dementia (PWD) showing higher co-morbidity and more frequent hospitalizations, yet little is known how clinical presentations compare. This study compared physical function, delirium, depressive symptoms, and behavioral and psychological symptoms of distress (BPSD) in black and white PWDs when hospitalized. A multivariate analysis of covariance showed that, controlling for age, gender, cognitive status, and comorbidities, black PWD had more delirium (mean= 3.8, SD= 2.9) as compared to white PWDs (mean=2.4, SD= 2.2, F=4.8, p =.029). Additionally, black PWD had more depressive symptoms (mean= 11.7, SD= 6.7) as compared to white PWD (mean = 9.0, SD= 5.2, F=6.6, p =.011), and less improvement in functional status admission to discharge (mean =12.4, SD= 18.9) as compared to white PWD (mean=17.8, SD=18.8, F=12.3, p=.001). There were no differences in BPSD. Continued research examining factors influencing differences in race cohorts is warranted.
Large-Scale Measurements of Physical Activity With Wearable Devices: An International Perspective
Authors: Urbanek Jacek , Schrack Jennifer , Roth David 
Published: December 2020

Abstract
In recent years the popularity and application of both research- and consumer-grade wearable physical (PA) activity monitors have witnessed substantial growth in large observational studies and clinical trials. For example, the NHANES and UKBiobank, have collected accelerometry data on thousands of participants contributing to the reputation of wearable technology overall as well as in aging-oriented research. As a result, more aging-focused studies including the Baltimore Longitudinal Study of Aging, Maastricht Study, Finnish Retirement and Aging study, and the National Health and Aging Trends Study, along with clinical trials have introduced accelerometry protocols into their design. The symposium focuses on challenges in the implementation of the objective measurements of PA into large studies on older adults. We will discuss the design of successful projects held and/or completed in the United States and Europe including: (1) types of devices, (2) size of datasets, (3) steps necessary for the successful device implementation, (4) data management and (5) statistical analyses. We will also present primary, PA-related findings in each study, together with funded or planned follow-up work. Collectively, these presentations will improve understanding of the technology and effort necessary for the successful application of objective PA monitoring and the resulting data analysis, providing a better context for investigators in the field of aging who want to introduce wearable devices into existing and upcoming research. The discussion will focus on the future of these technologies in the context of geriatric medicine and gerontology and the consequent steps essential for their best utilization and further expansion.
Supporting People With Dementia in the Community: Occupational Therapy Service and Reimbursement Innovations
Authors: Lepore Michael , Long Erin , Fortinsky Richard 
Published: December 2020

Abstract
The wide range of services needed to support a safe and quality life among people living with dementia at home is growing and extends beyond the bounds of traditional reimbursement models. Within the context of a health care system that is not designed to reimburse for these types of services, federal grants from the Alzheimer’s Disease Programs Initiative (ADPI) funded by the Administration for Community Living (ACL) have supported the delivery of home- and community-based services (HCBS) for people with dementia and their care partners with a pragmatic emphasis on sustainability, such as establishing successful reimbursement pathways. Drawing lessons from ACL’s ADPI program and from the Health Resources & Services Administration Geriatric Workforce Enhancement Program and Geriatrics Academic Career Award program, this symposium examines opportunities and strategies for providing services to people living with dementia in the community and highlights occupational therapy as a valuable dementia care service that has potential for sustainable delivery and opportunities for professional expansion. Papers address needed workforce development for delivering HCBS to diverse populations living with dementia and examine occupational therapy roles in delivering HCBS to persons with dementia and their care partners. Additionally, papers examine the implementation and outcomes of evidence-based occupational therapy and interprofessional interventions for persons living with dementia in the community. Reimbursement mechanisms for occupational therapy services delivered to people with dementia in the community are described. Discussion addresses how these innovative interventions and reimbursement mechanisms align with the recent surge of National Institute on Aging funding for pragmatic trials.
FIGS Study Outcomes: Disentangling Relationships Between Vision Loss, the Environment, Physical Activity, and Falls
Authors: Ramulu Pradeep , Gitlin Laura , Schrack Jennifer 
Published: December 2020

Abstract
The longitudinal relationships between various aspects of mobility (with each other and with vision loss) are important to understand for healthy aging. The Falls in Glaucoma Study (FIGS) was a three-year longitudinal study conducted in persons with a range of visual field damage from glaucoma (from normal visual fields to severe visual field damage) and evaluated several aspects of mobility: physical function (gait and balance), physical activity (annual accelerometer trials), fall rates (prospectively-collected falls calendars), environmental features (an in-home assessment), and fear of falling. In this symposium, we present data demonstrating that: (1) physical activity is altered by visual field damage - lowering the overall amount of physical activity, and also resulting in more fragmented activity (i.e. shorter activity bouts); (2) specific home environmental features, such as better lighting, are associated with lower rates of falls within the home; (3) specific gait and balance features increase the risk of falling, but do not explain the association between visual field damage and a higher rate of falls; (4) injurious falls, but not non-injurious falls, lead to future reductions in physical activity; and (5) worsening of fear of falling (FoF) leads to either a higher rate of falls (at low FoF levels) or decreases in physical activity (at higher FoF levels). Study findings will educate the audience about the types of mobility problems found in persons with visual field damage, potential methods to prevent falls in older adults, and factors likely to predict future mobility deficits in older adults.
The Relationship Between the Home Environment and Falls for Older Adults With Visual Impairments
Authors: Swenor Bonnielin , Mihailovic Aleksandra , Ramulu Pradeep 
Published: December 2020

Abstract
The home environment and features of the home have been identified as important risk factors for falls, and may pose particular risk for older adults with visual impairments given difficulty with hazard perception. We used data from 245 participants in the Falls in Glaucoma Study [mean age: 71 years, mean follow-up: 31 months] with homes graded using our previously validated Home Environment Assessment for the Visually Impaired (HEAVI), which quantifies the number of in-home fall-related hazards and found that neither the number of hazards nor the percentage of hazardous items were associated falls/year. However, each 10-fold increase in lighting was associated with a 35% lower rate of falls/year (RR=0.65, 95%CI=0.46 to 0.92) and there was a 50% reduction in falls/year when lighting was at or above 30 footcandles (minimum lighting level recommended by the Engineering Society of North America) compared to lighting &lt;30 footcandles (RR=0.50, 95%CI=0.26 to 0.96).
Facilitators and Barriers to the Implementation of Function and Behavior Focused Care
Authors: Vigne Erin , Galik Elizabeth , Resnick Barbara 
Published: December 2020

Abstract
Function and Behavior Focused Care (FBFC) is a two tiered intervention based on the Social Ecological Model and Social Cognitive Theory that focuses on training long term care staff to cue, model, and assist residents with dementia to engage in physical activity and perform functional tasks. FBFC was implemented by a Research Nurse and a facility based Champion for 12 months and involved a four step approach: (1) Environment and Policy Assessments; (2) Staff Education; (3) Establishing Resident Care Plans; and (4) Mentoring and Motivating of Staff and Residents. Facilitators of implementation included administrative support, an identified champion, and supportive environments and policies. Challenges and barriers included the fear of falls, fear of behavioral symptom exacerbation, competing priorities, and lack of facility specific goals. Innovative approaches to overcoming these barriers will be reviewed.
ESPO/ Health Sciences Section Symposium: Leveraging Older Adults’ Perceptions of Chronic Illness to Improve Care
Authors: Prasad Anyah , Morgan Brianna , Naylor Mary 
Published: December 2020

Abstract
In advanced years of life comorbidity of chronic illnesses is a common phenomenon. While chronic illnesses have been documented to impact overall quality of life, morbidity, and mortality, older adults may develop psychological resources in the years of coping and managing their illnesses. These psychological resources can be influenced by individual perceptions and context as people age, and include concepts such as psychological resilience, inner strength, subjective age, and illness perception. This symposium brings together emerging health science scholars’ work on exploring and leveraging these psychological resources to improve care. Amy Ketcham will present a systematic review of psychological resilience and depression in adults with cardiac disease. Brianna Morgan will present a concept analysis exploring the nature of inner strength in people aging with serious illness and cognitive impairment. Anyah Prasad will present results examining the association between chronic illnesses and subjective age and discuss its clinical relevance. Eleanor Rivera will explore illness perception phenotypes in a longitudinal cohort study of older adults with chronic kidney disease. Together, the perspectives shared in this symposium improve understanding of and indicate ways to move toward person-centered and contextual clinical models of care in the management of chronic illnesses among older adults. In addition, the discussant will engage in a dynamic conversation about psychological resources in later life and the role these projects have played in advancing the presenters along their academic trajectories.
Characterizing Illness Perception Phenotypes in Older Adults With Chronic Kidney Disease
Authors: Rivera Eleanor , Hirschman Karen , Townsend Raymond 
Published: December 2020

Abstract
An individual’s understanding of their chronic illness (illness perception) is a psychological resource that has an impact on coping and self-management behaviors. Our previous study identified illness perception phenotypes (overall patterns of illness perceptions) in a sample of older adults with heart failure, COPD, and chronic kidney disease. These phenotypes were associated with perceived self-management ability (patient activation) and recent hospitalizations. To further characterize the illness perception phenotypes we focused on older adults with chronic kidney disease, analyzing illness perception data along with potential covariates from the multi-center longitudinal Chronic Renal Insufficiency Cohort study (CRIC). Covariates include sociodemographics, disease parameters, personality type, disease knowledge, and treatment adherence. While personality type was associated with illness perception phenotype, disease knowledge and treatment adherence were not. We have also conducted qualitative analyses of in-depth interviews. These results will inform the development of a pilot intervention incorporating illness perception information into the clinical setting.
Socioeconomic and Psychosocial Mechanisms Underlying Racial and Ethnic Disparities in Cognition Among Older Adults
Authors: Zahodne Laura , Sharifian Neika , Kraal A Zarina , Morris Emily , Zaheed Afsara , Sol Ketlyne , Manly Jennifer , Brickman Adam 
Published: December 2020

Abstract
Racial/ethnic disparities in cognitive aging are only partly attributable to socioeconomic indicators. Emerging literature highlights psychosocial factors, such as related constructs of discrimination and perceived control. Using data from 1,463 older adults (51% Hispanic, 27% non-Hispanic Black, 22% non-Hispanic White) in the Washington Heights-Inwood Columbia Aging Project, cross-sectional mediation models quantified separate indirect effects of Black race and Hispanic ethnicity on global cognitive composite scores. Socioeconomic status explained approximately 50% of Black-White and Hispanic-White disparities in cognition. Perceived control explained an additional 5-8%. Discrimination was not associated with cognition. Significant racial/ethnic disparities remained after accounting for the included socioeconomic and psychosocial factors, indicating that future studies should consider additional potential mediators. Lower perceived control, which likely reflects chronic exposure to interpersonal and institutional marginalization, may be a particularly salient psychosocial risk factor for poorer cognitive aging among certain racial/ethnic minority groups.
More Energy and Less Fatigue: Implications for Successful Brain Aging
Authors: Rosano Caterina , Glynn Nancy 
Published: December 2020

Abstract
Higher energy and lower fatigue are intuitively important to live independent, active lives. However, little is known about the relation between brain health, energy, and fatigue in older adults. From a neurobiological standpoint, energy and fatigue appear to rely on distinct, albeit overlapping brain networks, but most evidence is from patients with neurodegenerative conditions. These relations have not been fully examined in community older adults. In this symposium, we first present an overview of the neurobiology underlying fatigability and energy states. We will then present original unpublished data on brain health, fatigability, and energy from four well-established epidemiological studies of aging: Osteoporotic Fractures in Men Study (MrOS), Long Life Family Study (LLFS), Baltimore Longitudinal Study of Aging (BLSA), and the Health Aging Body Composition Study (Health ABC). Specifically, Ms. Allen will explore whether personality traits are related to perceived mental fatigability in MrOS. Using LLFS data, Ms. Gmelin will examine whether perceived physical fatigability is associated with global cognition, verbal fluency, memory and psychomotor speed. Dr. Schrack will share BLSA data showing cross-sectional and longitudinal associations between lower walking efficiency and reduced brain volumes. Dr. Tian will evaluate the neuroimaging signature of perceived energy levels in Health ABC. Taken together, our data indicate that higher energy and lower fatigability likely reflect overlapping but distinct aspects of brain health. The long-term effects of promoting energy and lowering fatigability on dementia should be further studied.