bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing Longevity Risk: How Best to Annuitize Defined Contribution Assets?
Authors: Munnell Alicia , Wettstein Gal , Hou Wenliang 
Published: December 2020

Abstract
Unlike defined benefit pensions, 401(k) plans provide little guidance on how to turn accumulated assets into income. The key risk that retirees face is outliving their assets. Insurance against such risk is available through several routes, including immediate annuities, deferred annuities, and additional Social Security through delayed claiming. Under this Social Security bridge option, participants would tap their 401(k) for payments equal to their Social Security to delay claiming. This paper compares these three options in simulations against a baseline in which no assets are used to obtain lifetime income. In each option, assets not allocated to purchasing lifetime income are consumed following the Required Minimum Distribution rules. The analysis finds that, when market and health shocks are included alongside longevity uncertainty, the Social Security bridge option is generally the best for households with median wealth. Wealthier households can benefit from combining the bridge option with a deferred annuity. Part of a symposium sponsored by the Economics of Aging Interest Group.
Unmet Needs of Families of Adults With Intellectual and Development Disabilities on Waiting Lists
Authors: Heller Tamar 
Published: December 2020

Abstract
Most adults with intellectual and developmental disabilities live at home with their aging parents. Given the large waiting lists for residential and home-based services, families face many unmet service and support needs. The author will present results of a study that examined the impact of a Medicaid waiver program that provided either home-based or residential placements to 444 families of adults with IDD who were living at home at baseline through surveys at baseline and two years later. Families who did not receive the waiver services still had high unmet needs for person-centered planning training, networking with other families, respite, advocacy services, assistive technology, and home modifications at follow up. Regardless of services received, class members from minority backgrounds had more unmet needs than white class members, indicating the need for more targeted efforts to reach minority families.
Effective Communications Techniques for Communities to Reach Older Adults in a Natural Disaster
Authors: Fletcher Patricia 
Published: December 2020

Abstract
Framing timely messages during an emergency is often underestimated but is vitally essential and necessary, especially for the older population. While there is existing research on disaster and older adults, there is a gap in the literature that focuses on a 21st-century communication model that reaches at-risk populations. This presentation explores how practitioners can inspire change in the delivery of an emergency message to communities. Appropriately designed health communications will provide extensive knowledge about the health crisis and improve public health literacy among older adults in disaster preparedness, response, and recovery, creating messages that influence necessary behavior change during the emergency. Additionally, recognizing how collaborative partnerships with Federal, Local, State government, trusted relief agencies, and community groups benefit from designing an organizational structure to disseminate information to the community. Part of a symposium sponsored by Disasters and Older Adults Interest Group.
The CoGenT3 Study: Examining Gender’s Impact on Education and Cognition Trends in Three American Generations
Authors: Stites Shana , Cao Hannah , Gill Jeanine , Harkins Kristin , Rubright Jonathan , Flatt Jason 
Published: December 2020

Abstract
How older adults protect their cognitive health, reduce their risk for cognitive decline, and manage cognitive changes vary for men and women. To advance what is known about these differences and to promote inclusion of sexual and gender minorities in research, we are developing an empirically-informed research framework for studying gender effects in aging and Alzheimer’s research. In this presentation, we describe the framework informing our approach and present results from analyses of gender effects in The Health and Retirement Study that examine gender differences in the associations observed between education and cognitive measures in older adults. Our findings show gender’s effects on education vary in direction and magnitude as gender norms changed over time. Although college education serves as a factor protective against cognitive decline, characteristics of who achieves a four-year college degree change over time. We discuss the implications of our results for aging and Alzheimer’s disease research.
Psychoactive Prescribing in Assisted Living
Authors: Zimmerman Sheryl , Sloane Philip 
Published: December 2020

Abstract
More than 800,000 older adults reside in almost 30,000 assisted living (AL) communities across the country, 42% of who have moderate or severe dementia. As many as 97% of persons with dementia display symptoms of distress such as agitation or anxiety, and 69% of AL communities provide medications to treat this distress. Unfortunately, the psychoactive medications that are prescribed are often ineffective, contraindicated, and may cause serious adverse events including mortality. Especially concerning is the use of antipsychotic medications, which carry a black-box warning for persons with dementia. This symposium will present data from a seven state study of 250 AL communities and the 13,600 individuals who reside there. The first speaker will discuss the prevalence of psychoactive prescribing in AL overall and by medication type, and community characteristics that relate to use (e.g., staffing, resident case-mix). The second presentation will focus on the use of pro re nata (PRN) psychotropic medications, to examine the extent to which use is situational. The third speaker will address the use of off-label antipsychotic medications, and typologies of AL communities that differentiate use. The fourth speaker will discuss the prevalence of potential antipsychotic side-effects and adverse events, and also family member knowledge of medication use. The final speaker will compare the use of antipsychotic and antianxiety prescribing in proximate AL communities and nursing homes, to examine the extent to which local prescribing patterns may influence use. All five presentations of this symposium convey important issues for practice, policy, and future research.
Pro Re Nata Use of Psychotropic Medications in Assisted Living
Authors: Carder Paula , Zimmerman Sheryl , Wretman Christopher , Dys Sarah , Sloane Philip 
Published: December 2020

Abstract
This study examined the use of pro re nata (PRN, or as needed) psychotropic medications among assisted living (AL) residents. We examined prescriptions and administrations, and compared use based on dementia diagnosis. Data sources included interviews with administrators of 250 AL communities in 7 states and medication administration record review for the prior 7 days; analyses were weighted to the entire state. The percent of all residents prescribed a PRN psychotropic medication was 10.3%. However, residents with a dementia diagnosis were twice as likely to have a PRN psychotropic prescription (15.2% versus 7.2%; p&lt;.001). The majority of psychotropic medications prescribed and administered were for anxiolytics/hypnotics rather than antipsychotics. Additional resident-level factors significantly associated with higher PRN prescribing included psychiatric diagnosis, incontinence, hospice use, confusion/disorientation, and agitation. We summarize these and other findings in the context of state regulatory requirements for staffing, chemical restraints, and dementia care.
Local Nursing Home Prescribing Patterns and Psychoactive Prescribing in Assisted Living
Authors: Thomas Kali , Wretman Christopher , Sloane Philip , Beeber Anna , Carder Paula , Schwartz Lindsay , Zimmerman Sheryl , Silbersack Johanna 
Published: December 2020

Abstract
Because prescribing practices in long-term care settings may reflect regional influences, we examined how potentially inappropriate antipsychotic and antianxiety medication prescribing in assisted living (AL) compared to prescribing in nursing homes (NHs) based on their proximity, using generalized linear models adjusting for facility characteristics and state fixed effects. Data were derived from a seven state sample of AL communities and data for the same seven states drawn from publicly available data reported on the Nursing Home Compare website. In adjusted analyses, AL rates of antipsychotic use were not associated with the rates in the nearest or farthest NHs. However, AL communities that were affiliated with a NH had lower rates of potentially inappropriate antipsychotic use (b=−0.27[95%CI=−0.50,−0.04]). In a separate model, antianxiety medication prescribing rates in AL were significantly associated with neighboring NHs’ rates of prescribing (b=2.65[95%CI=1.00,4.29]). Findings suggest efforts to change prescribing in NHs may influence prescribing in AL.
Social Isolation and Loneliness: The Pros and Cons of Technological Interventions
Authors: Demiris George 
Published: December 2020

Abstract
A variety of technologies have been proposed, tested, and used to reduce social isolation and loneliness [SIL]. Furthermore, information technology may offer a way to detect or predict patterns of SIL. In this paper, the range of technology tools for assessment (e.g., passive monitoring, tracking data patterns, electronic health records) and intervention (e.g., social robots, social media, virtual reality) are reviewed for evidence of impact, and consideration is given for related ethical issues. The role of technology in relation to the report’s recommendations is discussed, including assessment and testing of new technological interventions for their potential benefits and harms, consideration of contextual issues such as broadband access, and the role of technology in education and training. Finally, gap areas of research are explored, such as the impact of the use of technology among current younger adults as they age. Part of a symposium sponsored by Loneliness and Social Isolation Interest Group.
Title I: Modernizing Definitions and Programs Under the Administration on Aging
Authors: Gualtieri Marie 
Published: December 2020

Abstract
The recent reauthorization of the Older Americans Act adds language and definitions to current issues facing the aging population. Specifically, Title I includes definitions related to program adaptation and coordination, workforce and long-term care issues, nutrition and social isolation, as well as family caregivers. Different from the last authorization, these definitions span beyond the individual experience to include other entities impacted by an aging society, such as the workforce and families. Overall, the Title I reauthorization seeks to modernize policy to reflect the current influx of the older adult population and its consequences.
The Aging Enterprise: A 40-Year Retrospective
Authors: Polivka Larry , Estes Carroll 
Published: December 2020

Abstract
Dr. Carroll Estes has long been recognized as one of our most influential social gerontologists beginning with the publication of the Aging Enterprise over 40 years ago. This book quickly achieved iconic status among gerontologists and other social scientists as one of the founding texts in critical gerontology, which Dr. Estes has played a leading role in developing with numerous publications over the course of her illustrious career. The panelists will focus on Dr. Estes’ application of the theoretical frameworks offered by the social construction of reality and the political economy of aging to a critique of federal and state policies designed to improve the quality of life of older Americans. Many of the programs and policies included in Dr. Estes’ critique are still in place, including the Older Americans Act and the nonprofit aging network. On the other hand, much about the aging enterprise has changed since 1979. The panelists, Drs. Chris Phillipson, Pamela Herd and Larry Polivka, will discuss the value of and challenges to these theoretical and empirical perspectives within the current contemporary neoliberal political economy that has gradually displaced the welfare state capitalism of the postwar period. As this shift has occurred in the political economy, a neoliberal policy agenda featuring for-profit privatization of public services, including aging services, has become dominant at the federal and state levels. Dr. Estes will respond to the panelists’ presentations and discuss the future of critical gerontology. Women's Issues Interest Group Sponsored Symposium.
The BOLD Public Health Response to Alzheimer’s Disease and Related Dementias: Past, Present, and Future
Authors: McGuire Lisa , Reed Nia 
Published: December 2020

Abstract
Achieving meaningful progress against Alzheimer’s disease and related dementias (ADRD) requires an urgent public health response. Since 2005, the Alzheimer’s Association, Centers for Disease Control and Prevention (CDC), and other public health partners collaborated on the Healthy Brain Initiative (HBI). HBI seeks to advance public health awareness of and action on ADRD as a public health issue. The HBI Road Map Series, State and Local Public Health Partnerships to Address Dementia: The 2018–2023 Road Map (S&L RM) and Road Map for Indian Country, provide the public health with concrete steps to respond to the growing burden of ADRD in communities, consistent with the aim of the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act (P.L. 115-406). This series of RMs for state, local, and tribal public health provide flexible menus of actions to address cognitive health, including ADRD, and support for dementia caregivers with population-based approaches. The purpose of this session is to illustrate public health’s role with ADRD—past, present, and future. An overview of the evolution of HBI RM series will be provided (McGuire) and preliminary evaluation data of 24 actions from S&L RM will be presented (French, Shean, Beatty). Holt, Reed, & McGuire will share lessons learned and next steps from CDC’s Regional Action Institutes designed to facilitate implementation of the RM series across the US. The intersection between the RM series and Age-Friendly Public Health Systems will be described as a starting point for public health (Wolfe, French, Shean).
Start at the Center: Age-Friendly Public Health Systems and Healthy Brain Initiative Frameworks
Authors: Wolfe Megan , French Molly , Shean John 
Published: December 2020

Abstract
SIGNIFICANCE. Older adults can contribute wisdom, skills, and time to communities. The public health sector has unique capabilities for creating conditions that promote health, foster community connections, and quality of life. METHODS. Two frameworks provide public health (PH) with core strategies to improve outcomes for all older adults. The Framework for Creating an Age-Friendly Public Health System (AFPHS) supports the PH role, as demonstrated by 37 of Florida’s 67 county health departments that are piloting the AFPHS Framework. The Healthy Brain Initiative’s (HBI) State and Local Public Health Partnerships to Address Dementia is a framework for action used by PH to promote cognitive health, improve care for cognitive impairment, and increase caregiving supports. Both frameworks call for utilizing regional data and cross-sector partnerships. IMPLICATIONS. PH can contribute to community-wide initiatives to promote well-being and community connections for older adults. Cross-sector partnerships can start by using available tools and planning guides.
Policy Series: The Impact of Ageism on Health and Efforts to Address It Through Reframing Aging
Authors: Solway Erica 
Published: December 2020

Abstract
Ageism can manifest in a variety of ways including in institutional policies and practices, interpersonal interactions, older adults’ internalization of ageist stereotypes, and through the media. While major incidents of age-based discrimination and their negative effects on health are more recognized, older adults also experience less momentous, but still harmful ageism in their day-to-day lives. These types of everyday ageism are also harmful to health. This symposium will highlight recent research from the University of Michigan National Poll on Healthy Aging on self-reported experiences of everyday ageism among a nationally representative sample of U.S. adults age50-80 and its connections to physical and mental health outcomes. Next, another researcher also using data from the National Poll on Healthy Aging will explore the prevalence of positive attributes of aging, its relationships to health, and ways in which it may buffer older adults from the adverse health consequences of ageism. Then speakers will highlight the Reframing Aging initiative and the ways in which GSA and other organizations are leading a national effort to address ageism through education and dissemination of research-based resources. This session will feature research, education, and advocacy efforts and will focus on the policy implications of efforts to better understand the prevalence of and strategies to counter the effects of ageism.
Advance Care Planning Engagement and End-of-Life Preference Among Older Chinese Americans
Authors: Pei Yaolin , Zhang Wei , Wu Bei 
Published: December 2020

Abstract
The study aimed to examine how immigrant status and family relationships are associated with advanced care planning (ACP) engagement and end-of-life (EOL) preference over burial plan among older Chinese Americans, the largest subgroup of Asian Americans. Logistic regressions were used to analyze data from a survey of 430 older Chinese Americans aged 55 and older living in a Honolulu, Hawai’i. Results show that U.S.-born Chinese Americans were more likely to engage in ACP, including willingness thought of EOL care, and discussion about EOL care, and having preference over burial plan, than the foreign-born Chinese American. Family cohesion was not associated with ACP engagement and EOL preference over burial plan. Family conflict increased the possibility of ACP engagement, indicated by willingness thought of ACP, willingness discussion on ACP, and EOL preference over burial plan. The culturally sensitive educational intervention is needed to increase ACP engagement among older Chinese Americans.
Catechol-O-Methyltransferase Genotype, Frailty, and Gait Speed: The Cardiovascular Health Study
Authors: Mance Shannon , Rosso Andrea , Bis Joshua , Studenski Stephanie , Bohnen Nico , Rosano Caterina 
Published: December 2020

Abstract
The association of COMT with gait speed varies across studies; frailty, a condition increasing vulnerability to stressors, may influence this association. Cross-sectional data was obtained in 3,744 participants (71 years, 82% white, 39% male) for gait speed, frailty (Fried definition), and COMT. Multivariable regression models of COMT predicting gait were adjusted for demographics, chronic conditions, and locomotor factors. Interactions of COMT by frailty and by race predicting gait speed were p=0.03 and p=0.02, respectively. Compared to Met/Met, the Val/Val group walked marginally more slowly in the full cohort (0.87 vs 0.89 m/sec, p=0.2); differences were significant for those with frailty (n=220, 0.55 vs 0.63m/sec, p=0.03), but not for those with moderate (n=1691, 0.81 vs 0.81m/sec, p=0.9), or no frailty (n=1833, 0.98 vs 0.97 m/sec, p=0.7). Associations were similar by race, but significant for whites only. Studies should assess the influence of dopaminergic signaling on gait slowing due to frailty.
Nutritional Vulnerability: The Complexity of Preparing Older Veterans for Surgery
Authors: Starr Kathyrn , Loyack Nancy , McDonald Shelley , Heflin Mitchell , Lagoo-deenadayalan Sandhya , Bales Connie 
Published: December 2020

Abstract
Poor nutritional status leads to postoperative complications, infections, poor healing, and increased mortality, creating a high-risk situation for older adults undergoing surgery. Psychosocial and environmental factors, including socioeconomic disadvantage, disability, social isolation and depression, are known precipitators of nutritional risk. However, these potentially modifiable concerns are rarely taken into consideration preoperatively. In 736 older Veterans preparing for surgery, we found 42% reported it was hard/somewhat hard to pay for basic needs, 6% reported sometimes/often times not having enough to eat, 24% reported living along, 47% reported needing assistance with 1 or more IADLs, and 42% reported a history of depression. Findings from older, Veterans, illustrate the prevalence of psychosocial and environmental risk factors prior to surgery. Best practices for identifying these factors, the importance of an interprofessional team for intervening, and specific resources that can be utilized throughout the perioperative period to improve outcomes will be presented.
Brain Games for Dementia: Do They Help?
Authors: Heyn Patricia , Sood Pallavi , Devos Hannes , Negm Ahmed , Kletzel Sandra 
Published: December 2020

Abstract
Brain Gaming (BG) Interventions have been shown to improve the cognitive function of older adults with cognitive impairments (CIs). However, rigorous evaluation supporting BG effectiveness is needed. Thus, we used meta-analysis to evaluate the effectiveness of BG. Several search databases (i.e. Pubmed) were used to identify relevant randomized controlled trials (RCTs). Cochrane RoB tool evaluated risk of bias. The main outcome was the composite score of cognitive function. Inverse-variance random effects model was used to compare the pooled standardized mean difference (SMD) across studies. A total of 16 RCTs included 909 participants. The RCTs varied in sample size, gaming platform, training prescription, and cognition. The meta-analysis showed no significant effects of BG on overall cognitive function (pooled SMD = 0.08, 95% CI [-0.24 – 0.41], p = 0.61, I2 = 77%. However, due to high heterogeneity, we cannot confidently refute that BG is an effective cognitive training approach.
Risk and Protective Factors for Cognitive Reserve in Oldest-Old Japanese Americans
Authors: Willcox Bradley , Chen Randy , Donlon Tim , Willcox D Craig , Allsopp Richard , Masaki Kamal 
Published: December 2020

Abstract
3,734 Japanese-American male oldest-old (aged 85+ years), from the Kuakini Honolulu Asia Aging Study, were assessed for prevalent cognitive impairment (CI). CI was defined as scoring &lt;74 on the 100-point Cognitive Abilities Screening Instrument (CASI; 80% sensitivity, 90% specificity for dementia). CASI tests from 1991 (Exam 4) to 2012 (Exam 12) identified 1496 cases of CI (i.e. low cognitive reserve) and 1222 non-CI controls (mean diagnosis age: 85.7 ± 5.3; range 71-100 years). Baseline risk factors were compared between groups, adjusted for age at onset of CI or last CASI. Step-wise conditional logistic regression was used to assess risk for CI. Among other factors, education (0.88; 0.85-0.9, p&lt;0.0001), hand-grip strength (0.98; 0.97-0.99, p=0.03), and height (0.97; 0.96-0.99, p=0.002) had protective effects; whereas APOE4 carriage (1.31; 1.04-1.63, p=0.02) and depression (1.4; 1.06-1.96, p=0.02) were risk factors for CI. The implications of these data for cognitive and physical health will be discussed.