bluuebunny/crossref_metadata_2025_split huggingface dataset:
EPIGENETIC AGING IN THE HRS
Authors: Faul Jessica 
Published: November 2019

Abstract
Biological aging can be characterized by molecular, cellular, and epigenetic changes that in addition to being related to chronologic age, are also associated with social disadvantage and associated morbidity and mortality. These biological markers can help explain at a biological level why socially disadvantaged individuals are at greater risk of aging-related disease and premature death. From DNA extracted from venous blood collected from over 4,000 HRS participants we measured array based DNA methylation. These assessments were made from unsorted cells, but are adjusted for individual cell composition measured from flow cytometry. We present genome-wide methylation differentials by age, race/ethnicity and SES using the largest, nationally representative sample with these data available to date. Understanding basic biological changes related to age and social disadvantage is essential for identifying translational opportunities to improve health.
NOVEL FINDINGS TWO DECADES FOLLOWING COGNITIVE TRAINING: FINDINGS FROM THE ACTIVE TRIAL
Authors: Gross Alden L , Rebok George W , Boot Walter 
Published: November 2019

Abstract
Although the only demonstrated panacea against cognitive decline, behavioral cognitive training usually fails to demonstrate transfer either to untrained cognitive abilities or to distal outcomes like everyday functioning. No such trials, however, have leveraged more than a decade of follow-up to adapt life-course perspectives. The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study remains the largest NIA-funded clinical trial of cognitively normal older adults. Efforts to re-invigorate the cohort after 20 years with external data linkages have coalesced around renewed interests in how training-related cognitive improvements affect long-term dementia risk, health care utilization and costs, credit scores, and active years in later life. The first presentation by Rebok overviews ACTIVE and its 20-year follow-up plans. Next, Gross and colleagues tested whether cognitive training attenuates the relationship between IADL difficulty and mortality; negative findings suggest proposed relationships between cognition and IADL difficulty are correlational, not causal, which has implications for transfer and trial outcomes. Third, Thomas tests a novel algorithm for classifying MCI, ushering opportunities to examine training effects on incidence of MCI after up to 20 years post-training. Marsiske then evaluates temporal transfer of training in reasoning ability, concluding that reasoning training and age, but not other baseline demographics, predict maintained alterations in reasoning abilities. Finally, Felix evaluates the stifling role of depressive symptoms on ability to benefit from training. Dr. Wally Boot, a recognized thought leader in transfer of cognitive training, will provide an illuminating discussion of promises and pitfalls of these lines of research.
ADDRESSING THE NEEDS OF INCARCERATED INMATES WITH DEMENTIA: CREATING DEMENTIA-FRIENDLY PRISONS
Authors: Gruss Valerie , Hasnain Memoona 
Published: November 2019

Abstract
U.S. prisons are experiencing a graying of their population, with many older inmates experiencing chronic conditions, including dementia. Older prisoners now represent 10% of the U.S. prison population and 18% of Illinois’ prison population. Aging inmates cost more to incarcerate due to their medical needs. Bureau of Prisons data estimate $881 million (19%) of its budget was spent to incarcerate aging inmates. Prisons are seeking solutions to address the unmet needs of older inmates, especially those with dementia. These older inmates with dementia face discrimination and exploitation within the prison population, and Correction Officers and clinicians lack training to understand and address their complex needs. Utilizing the Alzheimer’s Association’s, ACT on Alzheimer’s Toolkit we implemented four phases guiding communities’ adoption of dementia-friendly practices: we convened meetings with Illinois Department of Correction leaders, assessed community strengths and gaps by surveying prison wardens, analyzed findings and created an action plan to provide dementia training of prison staff to create a dementia friendly community. Our “Dementia-Friendly Prisons” program trains prison staff on understanding and providing supportive care and management to inmates with dementia, enabling staff to meet inmates’ needs, thereby creating an environment where inmates with dementia are safe and treated respectfully. Our program used an Appreciative Inquiry Four-D cycle approach (Discover-Dream-Design-Destiny) to engage and empower learners from a highly diverse workforce to develop into collaborative teams. Our program remedies a problem in the delivery of prison healthcare, serving a particularly vulnerable population and creates an adaptable model for other prisons and communities.
CARING FOR OLDER INDIGENOUS PEOPLE WITH DEMENTIA: ATTENDING TO THE PERSONALITY
Authors: Mason Kathleen R , Moeke-Maxwell Tess H , Gott Merryn 
Published: November 2019

Abstract
Māori, the indigenous people of New Zealand, are living longer and dying older. The prevalence of conditions associated with older people, such as Dementia are expected to increase amongst the Māori population. Pae Herenga, a qualitative research project investigating traditional Māori end-of-life care customs, identified an indigenous narrative of Dementia care, as carried out by their families. Sixty participants took part in face-to-face interviews to systematically record the traditional care customs employed by Māori families. Of these families, five experienced caring for someone with dementia. A traditional Māori family values approach based on biological connections, relationships, empathy, love, patience and inclusiveness aimed to care for the individual with Dementia as an important member of the family, and sought to maintain as much of the person’s autonomy as possible, for as long as possible. Sharing care roles between family members and maintaining connections to Māori communities helped to prevent isolation of the person with Dementia and their family members caring for them. Involvement in family and community activities, and attending to the individual’s personality and their spiritual needs were just as important as tending to their physical care needs. These findings emphasize the importance of a holistic approach to caring for indigenous people with Dementia.
INSIGHTS FROM AFRICAN AMERICAN OLDER ADULTS ON BRAIN HEALTH RESEARCH ENGAGEMENT: NEED TO SEE THE NEED
Authors: Bardach Shani H , Yarbrough Markeda , Walker Charlene , Alfred Doris L , Ighodaro Eseosa , Jicha Gregory A 
Published: November 2019

Abstract
Recruitment of African American (AA) participants into clinical research trials in the area of aging and dementia is a major problem facing the field. Although AAs are at a significantly elevated risk of developing Alzheimer’s disease (AD), they are underrepresented in clinical trials and research studies. While previous research has identified a number of barriers to participation, relatively little is known about how to overcome these barriers and engage AA individuals in research. Photovoice may provide a novel approach to advance our understanding of AA perceptions in regards to barriers and strategies to increase AA engagement in brain aging research. The purpose of this project is to add to existing understanding of barriers and facilitators and identify strategies to enhance engagement. Three AA research advocates served as community facilitators to identify and guide groups of AA adults though an 8-10 session photovoice project. Group sessions involved discussions and sharing of images pertaining to various prompts in the area of brain health and research participation. Sessions were audio-taped and transcribed verbatim and photos were uploaded. Participants identified four categories of barriers to AA research participation: Mistrust, the belief that all research involves medication, avoidance and fear of acknowledging problems, and seeing the risks of research but not the need. Participants had various suggestions and approaches for ameliorating each of these barriers. This photovoice community engagement process revealed unique insights into barriers and opportunities for increasing AA engagement in brain aging research.
SYSTEMATIC REVIEW AND META-ANALYSIS OF RACIAL AND ETHNIC DIFFERENCES IN DEMENTIA CAREGIVER WELL-BEING
Authors: Liu Chelsea , Badana Adrian , Burgdorf Julia , Fabius Chanee D , Haley William E , Roth David L 
Published: November 2019

Abstract
Studies comparing racial/ethnic differences on psychological and physical outcomes of dementia caregivers have often reported differences in well-being for minority groups compared to Whites. However, due to issues with enrolling minorities into studies, recruitment methods often differ for minority and White participants and may lead to biased comparisons. We conducted a systematic review and meta-analysis to examine racial/ethnic differences in dementia caregiver outcomes and to determine whether any differences vary among studies with population-based samples compared to convenience samples. We systematically reviewed articles with primary data from PubMed, Google Scholar and PsycINFO, and included studies comparing either African American (AA) or Hispanic/Latino dementia caregivers to White caregivers on measures of psychological health (e.g. depression, anxiety, burden) and physical health (e.g. self-rated health, cardiovascular measures, stress biomarkers). Reviewers screened titles and abstracts, reviewed full texts and conducted risk-of-bias assessments. A total of 207 effects were extracted from 40 studies. Random-effects models showed that Hispanics/Latinos reported significantly lower levels of well-being than Whites (ps &lt; .05) for both psychological outcomes (37 effects) and physical outcomes (15 effects), while AAs were not significantly different from Whites in either domain. No differences were observed for population-based studies (N=3; 23 effects) or convenience-sample studies (N=37; 184 effects). Although some previous studies with convenience samples found better psychological well-being in AA caregivers, that pattern was not confirmed in our meta-analysis. Additional analyses for the different indicators of well-being and the relationship of quality ratings to effect sizes will be discussed along with implications for future research.
NUMBER OF FRIENDS AND THE RISK OF DEVELOPING DIABETES: A REPLICATION USING NSHAP AND HRS
Authors: Hawkley Louise , Schumm Phil , Huang Elbert , McClintock Martha 
Published: November 2019

Abstract
The epidemic increase in diabetes prevalence (primarily type 2) is a public health crisis. We hypothesized that the rates of movement among diabetic states depend in part on one’s social relationships and environment. Using population-based samples from both NSHAP and HRS, collected in 2005–15, we found that having more friends was associated with a lower risk for acquiring diabetes over the next 4-5 years. As an independent replication, separate logistic models for NSHAP and HRS data yielded similar odds-ratios for the protective effect of having friends (OR = 0.82 and 0.92 respectively), adjusting for gender, age, race/ethnicity, and BMI. This effect was concentrated entirely between 0–4 friends; differences in the number of friends above 4 were not associated with differences in diabetes risk.
FOR BETTER AND WORSE? THE IMPORTANCE OF CLOSENESS AND AGE FOR SPOUSES’ CARDIOMETABOLIC SIMILARITY
Authors: Wilson Stephanie J , Peng Juan , Andridge Rebecca , Jaremka Lisa M , Fagundes Christopher P , Malarkey William B , Belury Martha A , Kiecolt-Glaser Janice K 
Published: November 2019

Abstract
Spouses share age-related disease risks: a person’s diabetes or hypertension raises the partner’s odds for the same condition. To probe the importance of partners’ closeness, marital satisfaction, and age for spouses’ similarity in cardiometabolic health, 43 disease-free couples ages 24-61 provided fasting glucose, fat and carbohydrate oxidation, and blood pressure at two study visits. Couples who felt closer had more similar rates of carbohydrate oxidation compared to those who felt less close. Likewise, happier couples had more similar carbohydrate and fat oxidation. Fasting glucose and blood pressure were more similar within middle-aged couples compared to younger pairs. In follow-up analyses, partners’ health behavior concordance did not explain these effects. In sum, closer, happier, and older couples shared more similar cardiometabolic profiles, perhaps driven by joint stress and emotional spillover. Findings suggest that closer, happier relationships may confer both larger health risks and benefits, and increasing age may raise the stakes.
RACE-ETHNICITY AND HOPELESSNESS IN OLDER AMERICANS: WHO’S AT GREATEST RISK AND WHY?
Authors: Mitchell Uchechi 
Published: November 2019

Abstract
Racial and ethnic minorities are more likely to experience adversity throughout their lives, which puts them at greater risk feelings of despair and powerlessness. This study uses data from 5,500 respondents from the Health and Retirement Study to assess racial/ethnic differences in hopelessness and test whether older blacks and Hispanics experience greater increases in hopelessness as they age. Hopelessness was assessed using 4-items that capture the extent to which a person has a negative outlook towards the future and believes they are powerlessness to overcome the obstacles they face; it is measured at three time points: 2006/2008, 2010/2012 and 2014/2016. Linear regression models were used to assess differences in hopelessness by race/ethnicity and linear mixed models were used to assess racial/ethnic differences in trajectories of hopelessness over time. Older blacks and Hispanics were more likely to report feelings of hopelessness at each timepoint of the study. Differences between blacks and whites were completely explained by differences in education and poverty status, while differences between Hispanics and whites remained. Although minority elders had higher levels of hopelessness at each time point, older whites experienced steeper increases in hopelessness over time. These findings suggest that structural factors influence feelings of hopelessness among minority elders. However, older blacks and Hispanics may develop resilience to hopelessness as they age.
STRENGTH IN AGE: HARNESSING THE BENEFITS OF NIA’S 45 YEARS
Authors: Bernard Marie A , Hodes Richard , Barr Robin A 
Published: November 2019

Abstract
The National Institute on Aging at the National Institutes of Health was established in 1974 with a mission to support and conduct research on aging processes, age-related diseases, and special problems and needs of the aged. Shortly thereafter, the Institute was designated by Congress as the lead research agency in Alzheimer’s disease. During this symposium, NIA’s scientific leadership will reflect on major accomplishments to improve the health of older individuals over the past 45 years and look to the future of the NIA and aging research. This symposium will describe progress led by NIA’s extramural divisions, the intramural program, and the Office of Special Populations. A brief panel discussion will ensue, followed by an informal reception and opportunities for networking in celebration of NIA’s 45 years
STRENGTH IN AGE: INCREASING THE POWER OF FAMILY CAREGIVERS
Authors: Young Heather , Harvath Theresa , Cothran Fawn 
Published: November 2019

Abstract
This session addresses approaches to strengthening the capacity of family caregivers in the context of intense and complex care. Recognizing the increasing role that families play in delivering complex care at home to individuals with multiple conditions, this symposium highlights approaches to enhancing support and increasing the power of family caregivers. In the first half of the symposium, the papers elucidate characteristics of the caregiving situation that put caregivers at risk and suggest potential areas for intervention by health systems. The second half explores system level approaches to enhancing capacity for family caregivers. On the demand side, the first paper will examine the social network of family caregivers, highlighting effects of social isolation on caregiver health. The second paper uses national data to understand the relationship between higher demand caregiving situations and the strain and challenges that caregivers experience. On the potential solutions side, the third paper addresses a collaborative design of an intervention to enhance supports for family caregivers of persons with dementia at a critical time, during hospitalization. The last paper provides an overview of evidence-based technological solutions to support family caregiving. Taken together, these papers establish some of the demand characteristics of the caregiving situation and provide potential health system solutions to improve capacity of family caregivers. In the final segment, three discussants will reflect on the implications of these papers for clinical practice, education, research and policy.
AN ACADEMIC-HEALTH SYSTEM COLLABORATION TO DEVELOP A PROGRAM FOR FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Siegel Elena , Hinton Ladson , Rice Elizabeth , Shah Nilpa , McElroy Vanessa , Lacsamana Jasmine DeGuzman , Young Heather M , Maynard Gregory A 
Published: November 2019

Abstract
Hospitalization of persons with dementia can pose specific challenges for family caregivers, with post-discharge issues in managing acute clinical care needs coupled with dementia-related care that can exacerbate caregiver fatigue and capacity. We established an academic-practice collaboration to develop an evidence-based and innovative multi-component health system-level program to support family caregivers of persons with dementia in transition from hospital to community. Using an implementation science approach aimed to decrease the gap in translation of caregiver research into practice, we co-designed the program/implementation plan as a quality improvement initiative reflecting an integration of evidence from family caregiving literature and the health system’s unique context, workflows, stakeholder perspectives, resources, and values/priorities. This paper highlights insights gained and lessons learned in establishing a successful academic-practice collaboration, including time/investment to establish a shared project vision and identify/leverage existing organizational capacity to successfully deliver a program to improve the health and wellbeing of family caregivers.
WHY DO OLDER WORKERS WITH CHRONIC HEALTH CONDITIONS PREFER TO RETIRE EARLY?
Authors: Vanajan Anushiya , Bültmann Ute , Henkens Kène 
Published: November 2019

Abstract
Older workers experiencing chronic health conditions (CHCs) are more likely to retire early. Current literature, however, lacks knowledge on the different pathways through which CHCs stimulate retirement preference. Earlier research is highly fragmented. Some studies have found CHCs to impact vitality, work limitations, or subjective life expectancy. Others have found vitality, work limitations, or subjective life expectancy to predict retirement preferences. We present a comprehensive model in which we hypothesize that the effects of four CHCs - arthritis, cardiovascular disease, sleep disorders, and psychological disorders - on retirement preferences are differentially mediated by vitality, health-related work limitations, and subjective life expectancy. We analyzed data from 6,294 older workers (60 – 65 years) in the Netherlands. Effects of CHCs on older workers’ retirement preferences were mediated by vitality, health-related work limitations, and subjective life expectancy. The main mediation pathway differed for each CHC. Severe health-related work limitations among older workers with arthritis (65.6% mediated) and cardiovascular disease (44.0%) predominantly guided their retirement preferences. Lower vitality levels mainly mediated retirement preferences of older workers with sleep (59.1%) and psychological disorders (52.9%). Lower subjective life expectancy was a significant mediation pathway (13.7%) for older workers with cardiovascular diseases. Extending working lives is a key public health and policy challenge. We show that health-related work limitations and vitality play a major role in determining retirement preferences of older workers experiencing CHCs. Since both mediators are modifiable, targeted interventions may not only extend the working lives of older workers, but also improve its quality.
TWO TALES OF TRANSLATION: EVIDENCE-BASED CAREGIVER PROGRAMS THROUGH COMMUNITY-BASED ORGANIZATIONS
Authors: Coon David , Whitlatch Carol 
Published: November 2019

Abstract
This presentation reports findings from on different translation approaches that embedded into the community two evidence-based interventions for family caregivers of people with dementia. CarePRO was embedded into the community after completion of a clinical trial, whereas EPIC was embedded from the program’s inception. CarePRO is a group and telephone coach call intervention targeting family caregivers and EPIC is a group dyadic intervention for both early-stage people and their care partners. Available in English and Spanish, these programs are still being delivered across two states through community-based organizations. Findings from both CarePRO and EPIC demonstrate significant levels of participant benefit (e.g., reduced negative mood states, negative coping strategies, and negative network interactions as well as increased positive mood states, self-efficacy, care preparedness). Presenters will share lessons learned from the translation process regarding design modifications, training and supervision of interventionists, participant recruitment and retention, and adaptation of outcome assessments.
HOME AND COMMUNITY-BASED CARE FOR A DIVERSE AND GROWING POPULATION: WORKFORCE POLICY AND PRACTICE IMPLICATIONS
Authors: Scales Kezia , Sturgeon Jodi M , Iezzoni Lisa I , Espinoza Robert , Campbell Stephen , Cook Allison , Gallopyn Naomi I 
Published: November 2019

Abstract
Most Americans would prefer to continue living in their homes and communities as they age, even when they require support with daily activities due to illness or disability. Much of this support is provided by unpaid caregivers, but the paid home care workforce also plays an essential role. Due to demographic changes and poor job quality, however, the home and community-based services (HCBS) sector is struggling to attract and retain enough workers to meet demand. Drawing from an extensive analysis of HCBS in the United States, this paper examines key factors impacting the home care workforce, including: supply and demand trends; financing policies; service-delivery models; and policies and practices defining workers’ compensation, training, and career development. From these findings, we provide recommendations for addressing the home care workforce crisis and maximizing home care workers’ contribution to the delivery of high-quality supports for a growing and evolving population of HCBS consumers.