bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Mental Health of Older Veterans Ages 58-99 Years: 2016-2017 VE-HEROeS Findings
Authors: Cypel Yasmin , Schnurr Paula , Bossarte Robert , Culpepper William , Schneiderman Aaron , Akhtar Fatema , Morley Sybil , Davey Victoria 
Published: December 2020

Abstract
Mental health and its correlates were examined in U.S. Vietnam War veterans approximately fifty years after the War. The 2016-2017 VE-HEROeS (Vietnam Era Health Retrospective Observational Study) was a mail survey of the health of U.S. Vietnam War veterans who served between February 28, 1961 and May 7, 1975 and matched US non-veteran controls. ‘Veteran status’ represented wartime experience for three cohorts: ‘theater’ veterans with service in Vietnam, Cambodia, or Laos, non-theater veterans with service elsewhere, and non-veterans with no military service. Veterans and non-veterans, aged 58-99 years, were randomly selected from a veteran sampling frame (n=9.87 million) derived from the Department of Veterans Affairs’ USVETS dataset and a commercial address database, respectively. Questionnaires were mailed to 42,393 veterans and 6,885 non-veterans; the response rate for veterans was 45% (n=18,866) and 67% (n=4,530) for non-veterans. Weighted bivariate and multivariable analyses were conducted to examine poor overall mental health, via the SF-8TM Mental Health Component Summary score (MCS), and other mental health measures by veteran status and socioeconomic, health, and other military characteristics. Nearly 50% of all theater veterans reported poor overall mental health (MCS&lt;50). Prevalence of mental health measures was greatest for theater veterans and successively decreased for non-theater veterans and non-veterans. Key correlates significantly (P&lt; 0.02) associated with poor MCS included veteran status, race/ethnicity, income, physical health, health perception, trauma, distress, depression, posttraumatic stress disorder (Primary Care DSM-5 PTSD screen), and drug use. Results indicate a high burden of poor mental health among those who served in-theater.
Outpatient Physical Therapists Should be Competent in Care of Older Adults: A Total Population Register-Based Study
Authors: Arnadottir Solveig 
Published: December 2020

Abstract
In Iceland, outpatient physical therapy (OPT) is traditionally not focused on older clients. Yet, the Icelandic population is aging as other populations in the world, and national policies endorse aging in place. The objective of this study was to explore 17 years of demographic information on OPT clients and to identify if this information reflects the total population aging. The research was built on 17 years (1999-2015) of complete data from: the Icelandic Health Insurances register with information on the total population of OPT clients (N=172071), and the Statistics Iceland register with demographic information on the total general population. The results revealed that in 1999, older adults comprised 18.3% of all OPT clients, and in 2015 it had increased to 23.5% Therefore, OPTs were 23% more likely to treat an older adult in 2015, compared to 1999 (Risk Ratio [RR] 1.23; 95% Confidence Interval [CI] 1.19-1.27). In the same time period older people became 15% more prevalent in the general population (RR 1.15; 95%CI 1.10-1.21). Linear modelling revealed a yearly 3.45% (95%CI 3.05-3.85) increase from 1999 to 2015 in the overall proportion of older OPT clients. This yearly trend, however, varied depending on age group and sex with the highest yearly increase in the ≥ 85 years old men (9.1%; 95%CI 7.90-10.35). This case of Iceland presents 17 years of continuous growth in older adults seeking OPT service. These findings reinforce an urgent need to enhance the geriatric competence of OPTs, who in their clinical practice frequently encounter older adults.
Effectiveness of a 6-Month Multicomponent Training on Physical Frailty in Older Adults With Cognitive Impairment
Authors: Ribeiro Oscar , Borges-Machado Flavia , Barros Duarte , Carvalho Joana 
Published: December 2020

Abstract
Multicomponent training (MT) that combines aerobic, strength, postural, and balance exercises seems to be safe and effective to prevent and even reverse early stages of frailty, as well as counteract the physical consequences of cognitive impairment. This study analyzes the effectiveness of MT on physical frailty in older adults diagnosed with cognitive impairment. Forty-nine subjects (34 women) diagnosed with mild cognitive impairment (MCI) or dementia were allocated into exercise group (EG; 75.80±6.60 years; age range: 61-90) or a control group (CG; 82.56±5.45 years; age range: 73-90). EG was submitted to a 6-month MT intervention (2x/week, 50min). CG had a monthly recreational session. Sample mean of MMSE at baseline was 21.02 (±4.98). Participants were categorized as frail, pre-frail and robust according to a validated physical performance battery - Short Performance Physical Battery (SPPB). Overall, in baseline there were 12.5% frail and 37.5% pre-frail individuals in the EG group; in the CG there were 36% and 32%, respectively. Data from SPPB total score revealed that EG group increased the performance over time [t(23)=3,94; Δ=1.21 (±1.50); p&lt;0.001], as opposite to CG individuals [t(24)=-2.26; Δ=-0.92 (±2.04); p=0.034]; also, there were 8.3% frail and 29.2% pre-frail in EG, and 40% and 32% in CG after intervention. By improving lower extremity functionality of patients diagnosed with cognitive impairment, MT intervention may be an important non-pharmacological strategy to improve physical frailty status and modify subjects’ condition from frail to pre-frail or even robust. Supported by IPDJ & FCT: CIAFEL (FCT/UIDB/00617/2020), “Body and Brain” (POCI-01-0145-FEDER-031808), PhD Grant (SFRH/BD/136635/2018).
Frailty Change Scores Over Long-Term Follow Up in Patients With Coronary Artery Disease
Authors: Gharacholou Shahyar , Flock Carolyn , Lennon Ryan , Slusser Joshua , Cooper Leslie , Singh Mandeep 
Published: December 2020

Abstract
Background: Frailty assessment has often been performed only at baseline in cohort studies. Little is known regarding factors associated with changes in frailty indices over follow up in patients with coronary artery disease (CAD). Methods: Between 11/2008 - 8/2012, 142 community-dwelling adults ≥65 years of age with prior history of CAD (angina or revascularization) participated in a study of frailty assessment at Mayo Clinic Health System in La Crosse, WI. A sample of participants (n=45) were included for frailty re-assessment using the Fried frailty criteria approximately 5 years after their baseline measures. Frailty classification was based on absence of deficits (non-frail), 1-2 deficits (intermediately frail), or 3 or more deficits (frail). Factors associated with a change in frailty indices were studied. Results: There were 45 patients that had a second assessment of frailty indices. At baseline, 24 patients (60%) were not frail while 16 patients (40%) had at least 1 frail feature. At follow up, 20 patients (50%) were not frail while 20 patients (50%) had a frail feature. Those improving were more often being married, had prior revascularization, and were without angina. Interval development of slower gait speed (r = 0.46; p=0.004) and decreased grip strength (r = -0.39; p = 0.01) were associated with worsening frailty. Conclusions: Older adults with CAD are not often frail by standard criteria; however, incident deficits develop during long term follow-up. Spousal support, absence of angina, and change in functional indices are less often associated with frailty features.
Qigong Exercise in Frailty, Psychological Health, and Spiritual Well-Being of Middle-Aged and Older Blacks
Authors: Chang Pei-Shiun , Lu Yvonne , Ofner Susan , Nguyen Chi 
Published: December 2020

Abstract
Interventions are needed to address the frailty and psychological health in middle-aged and older African Americans. Qigong, a traditional medicine exercise, consists of gentle body movements, breathing exercise, and meditation. The benefits of Qigong exercise have been widely reported in Asian adults but there have been no known studies testing Qigong exercise in the African American population. The purpose of this pilot study was to evaluate the potential benefits of an 8-week Qigong exercise in physical and functional ability, balance, frailty, depression and anxiety, and spiritual well-being in community-dwelling middle-aged African Americans using a single group design. Fifteen African Americans aged 45 to 85 years were recruited to receive Qigong exercise over 16 bi-weekly, one-hour sessions. The Layers Module that unfolds the complex multidimensional benefits of Qigong exercise on physical, mental, and spiritual dimensions was used to guide the outcome measures. Data were collected at baseline and 14 days post intervention. Results showed positive trends in repeat chair stands, physical function, and spiritual well-being (p&lt;0.05) with effect sizes ranging from 0.45 to 0.87. Despite no significance, over 52% of the participants showed improved depression scores, fast gait speed, and standing balance than baseline. Nearly 42% demonstrated some levels of frailty improvement than the baseline. No adverse events related to Qigong exercise intervention was reported. Qigong exercise is a potentially promising intervention which needs further testing in a randomized clinical trial.
Mealtime Care for People With Dementia: What Do Nursing Home Staff Think?
Authors: Faraday James , Abley Clare , Exley Catherine , Patterson Joanne 
Published: December 2020

Abstract
More and more people with dementia are living in nursing homes (NH). Often, they depend on NH staff for help with eating and drinking. It is important that staff have the skills and support they need to provide good care at mealtimes. This qualitative study explores mealtime care for people with dementia, from the perspective of NH staff. Semi-structured interviews with NH staff (n=16) were carried out in two nursing homes. The homes were chosen to have diverse characteristics: one home had a large number of beds and was part of a small local organization; the other had a small number of beds and was part of a large national organization. Various staff members were interviewed, including direct care staff, senior carers, nurses, managers, and kitchen staff. Interviews were audio-recorded and transcribed verbatim. A constant comparison approach was taken, so that data from early interviews were explored in more depth subsequently. From the analysis, five themes emerged as important in mealtime care for people with dementia living in nursing homes: Setting the right tone; Working well as a team; Knowing the residents; Promoting autonomy and independence; Gently persevering. This work forms part of a larger ethnographic study on the topic, which includes data from residents with dementia, and family carers. Results will inform the development of a staff training intervention to optimize mealtime care for this population.
Measuring Adoption of Patient Priorities-Aligned Care Using Natural Language Processing
Authors: Razjouyan Javad , Freytag Jennifer , Odom Edward , Dindo Lilian , Naik Aanand 
Published: December 2020

Abstract
Patient Priorities Care (PPC) is a model of care that aligns health care recommendations with priorities of older adults with multiple chronic conditions. Social workers (SW), after online training, document PPC in the patient’s electronic health record (EHR). Our goal is to identify free-text notes with PPC language using a natural language processing (NLP) model and to measure PPC adoption and effect on long term services and support (LTSS) use. Free-text notes from the EHR produced by trained SWs passed through a hybrid NLP model that utilized rule-based and statistical machine learning. NLP accuracy was validated against chart review. Patients who received PPC were propensity matched with patients not receiving PPC (control) on age, gender, BMI, Charlson comorbidity index, facility and SW. The change in LTSS utilization 6-month intervals were compared by groups with univariate analysis. Chart review indicated that 491 notes out of 689 had PPC language and the NLP model reached to precision of 0.85, a recall of 0.90, an F1 of 0.87, and an accuracy of 0.91. Within group analysis shows that intervention group used LTSS 1.8 times more in the 6 months after the encounter compared to 6 months prior. Between group analysis shows that intervention group has significant higher number of LTSS utilization (p=0.012). An automated NLP model can be used to reliably measure the adaptation of PPC by SW. PPC seems to encourage use of LTSS that may delay time to long term care placement.
The Action Project Method Applied in Nursing Home Settings
Authors: Jensen Charlotte , Gruneir Andrea , Hoben Matthias , Tompalski Jaclyn , Easterbrook Adam , Keefe Janice , Estabrooks Carole , Marshall Sheila 
Published: December 2020

Abstract
The action-project method (APM), developed in counselling psychology and used in various disciplines, has been shown to be useful for understanding major life transitions in different contexts. We argue that the APM is beneficial for studying the impact of nursing home (NH) home admission and daily life of residents and their families/friends. The APM enables researchers to explore how residents and their families/friends experience NH-life at individual and supraindividual levels of analysis. We applied the APM to solicit the views of residents and individuals close to them to understand their priorities for quality care. The APM data collection consisted of three stages. First, a resident and family member or other caregiver met with the interviewer who initiated a conversation about their experience in the NH. The interviewer then left the room but video-recorded the conversation. Second, the interviewer met with each participant to review the video with each participant offering reflection on the original conversation. These sessions were also recorded. Following transcription and analysis of the conversations, 3 lay-language narratives were created: 1 for each individual and 1 for the pair. Third, participants reviewed their own and the pair’s narrative for additional comments. The APM offers a means to give a voice to NH residents and allows for people to talk about their experiences without the presence of a researcher. By using the APM, researchers can break down individual actions of participants and how these actions come together to form the project of navigating care in NHs.
The Columbia Behavior Scale for Dementia: Validity and Reliability in Long-Term Care Settings
Authors: Mansbach William , Mace Ryan 
Published: December 2020

Abstract
Numerous neuropsychiatric inventories have been created for behavioral and psychological symptoms of dementia (BPSD). These inventories are seldom used in long-term care (LTC) settings due to questionable psychometrics, lengthy administration, and reliance on knowledgeable informants. The Columbia Behavior Scale for Dementia (CBS) is a rapidly administered BPSD rating tool that was developed for LTC residents. The 11-item CBS can be completed in less &lt;5 minutes independently, with nursing staff, or in conjunction with interdisciplinary care teams. LTC residents (N = 350) participated in a validation study in Maryland, USA (M age = 78.38, SD = 10.82). Internal consistency (⍺ = 0.75) and inter-rater reliability (r = 0.99) for the CBS were strong. CBS scores were not biased by informant type (p &gt; 0.05): GNAs/CNSs (40.69%), nurses (36.10%), other facility staff (23.21%). Diagnostic validity was confirmed by significantly higher CBS scores (p &lt; 0.001; large effect, d = .63) for LTC residents with dementia (n = 197, M = 4.63, SD = 4.58) versus those without dementia (n = 145, M = 2.17, SD = 2.87). Higher CBS scores were significantly associated with greater impairment on cognitive instruments (r range = -0.25, -.36) and increased mood dysfunction (r range = 0.20, 0.26), indicating convergent validity. Principal components analysis produced three CBS factors, psychosis, aggression, and non-aggressive motor disinhibition, which significantly identified LTC residents with greater odds for antipsychotic use. Results will be discussed in terms of right-sizing antipsychotic utilization, improving nonpharmacological behavior management, and enhancing the dementia literacy of nursing staff.
Association Between Activity Diversity and Frailty in Community-Dwelling Older Japanese: A Cross-Sectional Study
Authors: Takahashi Junta , Obuchi Shuichi , Kawai Hisashi , Ishii Kaori , Oka Koichiro , Fujiwara Yoshinori , Hirano Hirohiko , Ihara Kazushige 
Published: December 2020

Abstract
In addition to intensity and quality, diversity of activity will be an important factor to explain health outcomes among older adults. Few studies, though, examined an association between activity diversity and health outcomes. This study aimed to examine the association between activity diversity and frailty among community-dwelling older Japanese. Participants were community-dwelling older adults who participated in a cohort study, the “Otassya-Kenshin” in 2018 . The participants were asked frequency of 20 daily activities, inside/outside chores, leisure activities with/without physically, direct/indirect contact with friends and so on, in a week and activity diversity score were calculated using the formula of Shannon’s entropy. Frailty was defined by the Japanese version of the Cardiovascular Health Study criteria. The difference in diversity score between frail and non frail were examined by t-test. Logistic regression analysis with covariates, age, sex, economic status, living alone, BMI, Mini-Mental State Examination, and IADL was adopted to find association between activity diversity score and presence of frailty. Of 652 participants (age: 72.8±6.3, women: 60.6%) analyzed, 27 (4.1%) were defined as frail. Frailty group revealed significantly lower activity diversity score than non-frailty group (0.66±0.11 vs 0.75±0.08, P&lt;0.01). 0.2 point of decrease in diversity score increase 5 times chance of frailty after controlling covariates. We found significant relationship between activity diversity and health outcome among older subjects. The activity diversity may provide additional information to number or intensity of activity.
Feasibility of a Group Version of the Lifestyle-Integrated Functional Exercise Program
Authors: Jansen Carl-Philipp , Nerz Corinna , Labudek Sarah , Klenk Jochen , Clemson Lindy , Becker Clemens , Schwenk Michael 
Published: December 2020

Abstract
In a randomised noninferiority trial, it is investigated whether a group version of the Lifestyle-integrated Functional Exercise program (gLiFE) is non-inferior to the individually delivered LiFE in terms of feasibility and effectiveness. While effectiveness evaluation is ongoing, feasibility results are already available. Participants (&gt;70 years; confirmed fall risk) were randomized in either LiFE or gLiFE and participated in the same strength and balance exercises, however, based on different approaches of delivery. LiFE participants received seven home visits; gLiFE was delivered in seven group sessions. Feasibility was defined as willingness to participate, adherence to group/home visits, and drop-outs. Predictors for intention to participate were calculated using regression. N=310 participants were randomized to LiFE (n=156) or gLiFE (n=154). n=51 (16%) of the participants dropped out after baseline. Attendance analyses showed that when excluding drop-outs, 100% (iLiFE) and 88% (gLiFE) took part in at least 5 of the 7 meetings. Self-efficacy and outcome expectancies, but not risk perception, were predictors of the intention to participate (F(3,193)=24.84, p&lt;.001). In this first study comparing a group-based LiFE format with the original LiFE, feasibility of both formats was shown in terms of high attendance and less drop-outs than expected in this target group. Compared to other studies involving group based training, compliance to intervention (defined as having absolved at least 5 sessions) was high in both formats. Lower attendance in gLiFE can be explained by inflexible scheduling as compared to making individual home visit appointments. Whether lower gLiFE adherence translates into lower effectiveness is currently analysed.
Satisfaction With Outdoor Activities Over Time Among Long-Term Services and Supports Recipients
Authors: Sefcik Justine , Hirschman Karen , Petrovsky Darina , Huang Liming , Hodgson Nancy , Behrens Liza , Naylor Mary 
Published: December 2020

Abstract
Approximately 85% of older adults have at least one chronic health condition. The onset of chronic health conditions and mobility issues can constrain activities, including outdoor recreation. There is limited knowledge of older adults receiving long-term services and supports (LTSS) and their satisfaction with outdoor activities over time after enrolling in services. This study examined predictors of change in ratings of satisfaction with outdoor activities. A secondary analysis was conducted of data involving structured interviews with older adults (N=470) over the first two years of receiving LTSS (Health-Related Quality of Life: Elders in Long-Term Care; R01AG025524). Participants lived in assisted living communities, nursing homes, or their home. A single item on satisfaction with outdoor activities (assessed using a 5-point Likert scale: not at all to extremely satisfied) was the primary outcome. Mixed effects linear regression modeling using a backward elimination process was used for building a final multivariable model. In the final model, older age (p&lt;0.001) and higher overall quality of life ratings (p&lt;0.001) at baseline were associated with slower rates of increase in outdoor satisfaction over time. Higher education level (p=0.035) at baseline was associated with a faster rate of increase in outdoor satisfaction over time. Additionally, those who moved into an assisted living community (p=0.024) or nursing home (p=0.016) at baseline were associated with faster rates of increase in outdoor satisfaction over time compared to those in the home. Knowledge of factors influencing satisfaction with outdoor activities can assist interdisciplinary teams implement interventions for individual or organizational changes.
Ambulatory Care Preferences of Older People Age 80 and Over: A Systematic Review of Qualitative Studies
Authors: Herrler Angélique , Kukla Helena , Vennedey Vera , Stock Stephanie 
Published: December 2020

Abstract
According to the United Nations, the number of people aged 80 and over is expected to treble by 2050 globally. But research on the preferences for care of this age group grows slowly. To achieve high-quality patient-centered care, we need to understand the oldest people’s specific living circumstances, care preferences and goals. The aim of the study was to synthesize findings about ambulatory care preferences, experiences and expectations of people aged 80 and over. We systematically searched Medline, CINAHL, PsycInfo, Web of Science Core Collection and Google Scholar for qualitative studies published until October 2019 and additionally conducted forward and backward citation search for included studies. Two independent reviewers assessed studies for eligibility criteria and quality. We performed a thematic synthesis of study findings as developed by Thomas and Harden using MAXQDA-20 content analysis software. Twenty-three studies were included. They were mainly conducted in Europe, used face-to-face interviews, reported on ambulatory home care and used qualitative content or thematic analysis. The meta-synthesis revealed two fundamental themes from the perspective of older people: feeling safe and feeling valued in their relationships with caregivers and in their care environment. This was shown, for instance, in preferences for coordinated care, high continuity of caregivers, personal attention and interactions based on trust and respect. In practice, the older persons’ preferences should be integrated into care planning and policies to ensure patient-centered care.