bluuebunny/crossref_metadata_2025_split huggingface dataset:
WEB-BASED PHYSICAL ACTIVITY INTERVENTION IN MIDDLE-AGED AND OLDER ADULT VETERANS WITH COPD
Authors: Robinson Stephanie A , Robinson Stephanie A , Mori Deanna L , Richardson Caroline R , Moy Marilyn L 
Published: November 2019

Abstract
Physical activity (PA) is recommended in all patients with chronic obstructive pulmonary disease (COPD). Technology-based interventions can deliver effective, scalable behavior-change techniques; though feasibility and acceptability among older adults is not established. Veterans with COPD (N=112, aged 49-89 years, median=68) were randomized to a 12-week web-based and pedometer intervention or a pedometer alone (control). Across groups, there was no significant difference between middle-aged (&lt;68 years) and older (≥68 years) adults in percentage of pedometer wear-days over the study period (83.6% vs. 89.9%). In the intervention, there were no significant differences between middle-aged and older adults in total number of website logons (15.04 vs. 16.31), or proportion who reported they recommended the intervention (96.4% vs. 96.7%), found it easy to use (93.1% vs. 90.0%), and would continue to walk (93.1% vs. 89.7%). We conclude that a web-based PA intervention with a pedometer is feasible and acceptable in an older COPD population.
OVERVIEW OF THE ACTIVE STUDY AT 20 YEARS
Authors: Willis Sherry , Rebok George 
Published: November 2019

Abstract
ACTIVE (1998-2019), the largest NIA-funded clinical trial of cognitively normal elderly, was designed to test if cognitive intervention maintains functional independence in older adults (N = 2,802, aged 65-94) by improving basic mental abilities. In this paper we overview major aims of ACTIVE to investigate 1) effectiveness and durability (through 1,2,3,5, and 10 years of follow-up) of three cognitive interventions (memory, reasoning, processing speed) in improving basic measures of cognition; 2) if training in specific cognitive abilities improves or maintains cognitively demanding daily living skills (e.g., medication use, driving); and 3) impact of intervention on everyday mobility, health-related quality of life, and health service utilization. We also review aims of a recent NIA-funded 20-year follow-up of ACTIVE to examine whether improved cognition and daily function results in long-term reduction in dementia risk, years of disability, health care utilization and costs, and increased active years of life in advanced old age.
DEPRESSIVE SYMPTOMS: HAMPERING MAINTENANCE OF COGNITIVE TRAINING GAINS
Authors: Felix Cynthia , Du Simo , Taylor Brad , Rebok George 
Published: November 2019

Abstract
To study the impact of depressive symptoms on the effectiveness of cognitive training interventions, the ACTIVE 10-year follow up data was analyzed for cognition and difficulty in everyday functioning outcomes. Because depression is treatable, this topic is of high public health significance. Analyses showed that females had greater prevalence of depressive symptoms. Reasoning, speed of processing and daily function change scores were significantly worse in the depressive symptom group, while memory change score was non-significantly worse, showing poor proximal and downstream primary (functional) outcomes. Depressive symptoms may lead to lower retention of cognitive training benefits.
MEASURING LOST-WORK OPPORTUNITY AT RETIREMENT AGE
Authors: Voss Maren Wright , Al Snih Soham , Li Wei , Hung Man , Richards lorie 
Published: November 2019

Abstract
There is uncertainty related to whether retirement negatively impacts health--possibly due to the complexity of retirement decisions. The role of lost work opportunity on retirement decisions may help clarify when retirement has a favorable or negative impact on health. Lost work opportunity can be defined as forced retirement or unemployment prompting an earlier than planned retirement. However, 17% of individuals retiring due to the loss of work opportunity (i.e., unemployment, temporary lay-offs, company buy-outs, forced relocations, etc.) do not report either unemployment or involuntary retirement in survey data. We propose a broader conceptualization of late-career unemployment. Using the Health and Retirement Study (HRS), a lost-work opportunity score (LOS) was computed from items indicating unemployment and forced or unplanned retirement. Correlations were computed between this LOS and all continuous variables in the RAND longitudinal compilation of the HRS to determine its convergent and discriminant validity. The LOS demonstrated a Chronbach’s alpha of α=0.82 and had convergent validity with constructs of employment (9 variables), finances (36 variables), and health (14 variables), as predicted by the literature on retirement timing. No other continuous variables in the HRS were identified with a moderate or strong correlation to LOS, demonstrating discriminant validity. Further research should explore whether a combination of variables in the HRS can improve the accuracy of measuring retirement voluntariness. Improved precision in measurement, through an expanded conceptualization of lost-work opportunity, may help explicate the retirement-related factors that impact health, to inform policy and support healthy aging decisions at a societal level.
REDUCING ANTIPSYCHOTIC USE IN LONG-TERM CARE: CONSIDERING THE ROLE OF CULTURE OF CARE AND INFORMAL COMMUNICATION
Authors: Smith Andre , Kurucz Sue , Erb Tara , Kampen Ruth 
Published: November 2019

Abstract
Persons living with dementia-related disorders (PwD) can experience challenging behavioural and psychological symptoms (BPSD) as their illness progresses. There is a continued reliance on antipsychotic drugs (APD) in long-term care to manage this issue despite the well-documented risks of adverse events and increased morbidity and mortality. This study examines the role of culture of care in relation to efforts at reducing inappropriate APD use in managing BPSD within long-term care. Culture of care consists of shared norms, beliefs, and cognitive frames which guide clinical practice and inform the development and implementation of care strategies. Findings were obtained from three Canadian long-term care facilities working on reducing inappropriate use of APD. Data came from interviews with 6 nurses, 18 licenced practical nurses, 14 health care assistants, 4 activity leaders, 4 directors of care, 1 chaplain, and 10 physicians. We found that direct care providers initially varied in their perceived ability to develop and use alternate care strategies with health care assistants being most concerned about safety and exposure to violence. Change involved detective work and innovative thinking in assessing possible causes of BPSD beyond psychosis, including pain and feelings of confusion. Informal reciprocal patterns of communication emerged among health care assistants to identify effective non-pharmaceutical strategies to manage BPSD. Overall, the study shows how shared beliefs in the need for and value of alternate care practices among direct care providers along with the existence of effective informal communication can contribute to successful reduction in APD use when managing BPSD in PwD.
PHYSIOLOGY OF SUCCESSFUL AGING: IMPLICATIONS FOR HEALTH AND WELL-BEING
Authors: Mantantzis Konstantinos , Gerstorf Denis , Hess Thomas M 
Published: November 2019

Abstract
Research into peripheral physiology and its association with cognition, emotionality, and social/physical functioning has received considerable attention over the years. However, many of the underlying mechanisms are not well understood. In this symposium, we have compiled a set of four empirical projects that showcase current and future endeavors to address some of the long-standing questions about when, how, and why physiology shapes and is shaped by key psychosocial resources. Hawkley et al. make use of data from the NSHAP and HRS longitudinal studies to investigate whether social relationships such as number of friends predicts risk of diabetes among older adults. Wilson et al. use dyadic data from young and middle-aged couples to examine cardiometabolic similarity among spouses, and how such concordance is shaped by key relationship factors such as emotional closeness. Pauly et al. use data from two daily-life studies of older couples to investigate how physiological synchrony in cortisol is modulated by partner interactions, empathy, and empathic accuracy. Finally, Mantantzis et al. make use of multi-year longitudinal data from the Berlin Aging Study II to examine the role of glucose regulation capacity for trajectories of subjective well-being among older adults. Thomas Hess will discuss the importance of these papers, discuss strengths and weaknesses of the approaches chosen, and consider implications for future research.
POOR GLUCOSE REGULATION IS ASSOCIATED WITH LOWER WELL-BEING AMONG OLDER MEN, BUT NOT WOMEN
Authors: Mantantzis Konstantinos , Drewelies Johanna , Wagner Gert G , Demuth Ilja , Steinhagen-Thiessen Elizabeth , Lindenberger Ulman , Düzel Sandra , Gerstorf Denis 
Published: November 2019

Abstract
Glucose regulation is a key aspect of healthy aging, but little is known about gluco-regulatory capacity and older adults’ well-being. In this study, we examine whether gluco-regulatory capacity is predictive of within-person age-related trajectories of three major well-being indicators. We applied growth models to multi-year longitudinal data obtained in the Berlin Aging Study II (N = 1437; age 60-89; 53% women) and used insulin resistance as an index of glucose regulation capacity. Poor glucose regulation was associated with lower levels of well-being in men, but not women. These associations among men emerged for two of the three well-being indicators, were maintained across old age, and were independent of the other cognitive and physical factors examined. We discuss how sexual dimorphism may have contributed to our findings, and conclude that our results provide initial evidence for the relevance of glucose regulation for quality of life among older men.
LINKS BETWEEN PARTNER INTERACTIONS, EMPATHY, AND EVERYDAY PHYSIOLOGICAL SYNCHRONY IN OLDER COUPLES
Authors: Pauly Theresa , Michalowski Victoria I , Drewelies Johanna , Gerstorf Denis , Ashe Maureen C , Madden Kenneth M , Hoppmann Christiane A 
Published: November 2019

Abstract
Romantic partners exhibit dyadic covariation (synchrony) in physiological parameters. This study aims to link everyday cortisol synchrony to daily partner interactions and empathy. We conducted coordinated multilevel analysis using data from two independently collected samples of older couples (Study 1: N = 85 couples, aged 60-87 years; Study 2: N = 77 couples, aged 66-85 years) who completed questionnaires and provided salivary cortisol samples 5 to 7 times daily for 7 days. Cortisol levels were significantly correlated among partners in both studies. Cortisol synchrony was higher when partners were present (Study 1), and when partner interactions involved feeling understood and valued (Study 1) and seeking help or closeness (Study 2). Higher cortisol synchrony was further related to greater empathic accuracy (Study 1) and greater empathy (Study 2). Thus, social bonding processes and the ability to consider other’s thoughts and feelings may be intertwined with physiological synchrony in everyday life.
RETIRING AND CAREGIVING IN THE AGE OF STUDENT LOANS: THE IMPACT OF STUDENT DEBT ON RETIREMENT AND LONGEVITY PLANNING
Authors: Brady Samantha , Miller Julie , Balmuth Alexa , D'Ambrosio Lisa , Coughlin Joseph 
Published: November 2019

Abstract
Saving for retirement and the ability to provide care for a loved one can be dramatically affected by student loan debt. Currently, approximately 44 million people of all ages in the United States carry the weight of over 1.4 trillion dollars of student loan debt. Student loan borrowers of all ages may experience lower financial preparedness for retirement as well as decreased ability to provide care for family members, including aging parents. While older adults hold a relatively small proportion of student loans, they are the fastest growing subset of student loan borrowers and have disproportionately high rates of student loan defaults. As a result of their defaults, the Social Security retirement benefits of Americans ages 65 and older experienced a 500% increase in offsets over the last decade. This presentation will spotlight an MIT AgeLab mixed methods study about how student loan borrowers between the ages of 51 and 75 experience student loans within family systems and perceive and prioritize longevity planning in light of their student loans. Data collected for this study include focus groups and a large national survey. Preliminary findings suggest that for older borrowers, student loans are generally one of several financial constraints that can inform spending and saving decisions. For most, student loan payments are regarded as stunting overall retirement savings while the minority regard the two separately. Older borrowers also tend to have increased financial and familial responsibilities, including caring for aging parents, that compete for borrowers’ limited financial and temporal resources.
RACIAL DISPARITIES IN HOSPICE USE AT THE END OF LIFE: FINDINGS FROM THE REGARDS STUDY
Authors: Ornstein Katherine , Sheehan Orla C , Huang Jin , Rhodes J David , Roth David L 
Published: November 2019

Abstract
Hospice supports patients and families through interdisciplinary care focused on symptom management and maximization of quality of life. Although hospice care confers well-documented benefits, it remains underutilized: many patients do not use it at all or enter care too late to receive any benefit. While racial disparities in hospice use have been documented, hospice utilization among non-white decedents remains understudied, particularly among those with non-cancer diagnoses. Therefore, we used the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a population-based investigation of stroke incidence with oversampling of Blacks and cause of death adjudication by expert panel review, linked to Medicare claims data to examine racial disparities in end-of-life care. We identified 1221 participants who died between 2013-2015 due to natural causes excluding sudden death. More than half (52.8%) used hospice during the last 6 months of life (median =15 days), with use among cancer decedents over 70%. Overall, Blacks were significantly less likely to use hospice (OR=0.570) compared to Whites in adjusted analyses. Among hospice users, Blacks did not significantly differ from Whites in length of stay. In analyses stratified by cause of death (dementia, cancer, CVD and other), Blacks were significantly less likely than Whites to use hospice for all causes of death other than dementia. Despite tremendous growth of hospice in recent decades, our findings suggest that this effective service remains highly underutilized among Blacks dying from cancer, CVD and other serious illnesses, suggesting a need for targeted intervention to eliminate disparities in quality end-of-life care.
RACIAL VARIATION IN THE RELATIONSHIP BETWEEN LIFE-COURSE TURNING POINTS AND LIFE SATISFACTION
Authors: Carr Dawn C , Kail Ben L , Calvo Rocio 
Published: November 2019

Abstract
According to many social gerontologist and life course scholars, major life course transitions, referred to as “turning points,” have a significant impact on well-being. Although the relationship between major later life turning points and general well-being is fairly well understood, it is unclear whether there is systematic racial/ethnic variation in response to turning points in general. Moreover, much of sparse research on racial/ethnic variation that does exits overlooks how Hispanic Americans may respond differently to turning points than do either white Americans or African Americans. To that end, in this paper, we draw on life course theory to assess whether the relationship between retirement and the death of a spouse (i.e. turning points) and life satisfaction (a measure of well-being) vary by race/ethnicity. We focus on differences between whites, Hispanics, and African Americans. Moreover, we draw on stress process theory to identify mechanisms that may explain any observed racial/ethnic variation in these relationships. Using the Health and Retirement Study, in preliminary results we find: 1) before adjusting for turning points, Hispanics appear to have higher life satisfaction than whites, and African Americans do not differ significantly from whites; 2) however, after adjusting for turning points, only Hispanics who make life course transitions have significantly higher life satisfaction than whites; and 3) this higher life satisfaction observed among Hispanics who experience turning points is largely not accounted for by several factors derived from stress process theory.
POLICY SERIES: RESEARCH, POLICY, AND PRACTICE: IMPACTS OF DISCRIMINATION
Authors: D’Antonio Patricia M 
Published: November 2019

Abstract
Discussant: John Feather Aging crosses all domestic and international borders and affects everyone regardless of religion, race, nationality, ethnicity, sexual orientation, or gender identity. The main purpose of The Gerontological Society of America is “to advance the scientific and scholarly study of aging and to promote human welfare by the encouragement of gerontology in all its areas.” Yet in 2019, policies remain in effect that impact individuals in a discriminatory manner. The program will highlight research in several areas that demonstrate the effects of these discriminatory practices.
DEFINING DIFFERENT FORMS OF DISCRIMINATION IMPACTING SOCIETY
Authors: D’Antonio Patricia M 
Published: November 2019

Abstract
Aging crosses all domestic and international borders. It’s an issue that affects everyone regardless of religion, race, nationality, ethnicity, sexual orientation, or gender identity. The main purpose of The Gerontological Society of America (GSA) is “to advance the scientific and scholarly study of aging and to promote human welfare by the encouragement of gerontology in all its areas.” Yet in 2019, policies remain in effect that impact individuals in a discriminatory manner. The program will highlight research in several areas that demonstrate the effects of these discriminatory practices.
THE IMPACT OF DISCRIMINATORY POLICIES AND PRACTICES ACROSS THE AGING CONTINUUM
Authors: Lindberg Brian W 
Published: November 2019

Abstract
Aging crosses all domestic and international borders. It’s an issue that affects everyone regardless of religion, race, nationality, ethnicity, sexual orientation, or gender identity. The main purpose of The Gerontological Society of America (GSA) is “to advance the scientific and scholarly study of aging and to promote human welfare by the encouragement of gerontology in all its areas.” Yet in 2019, policies remain in effect that impact individuals in a discriminatory manner. The program will highlight research in several areas that demonstrate the effects of these discriminatory practices.
SPOUSAL INFLUENCE ON EARLY RETIREMENT DECISIONS: ORIGINS AND MECHANISMS
Authors: Eismann Maria , Henkens Kène , Kalmijn Matthijs 
Published: November 2019

Abstract
The interdependence between partners raises considerable interest in the sociology of life course, work and families. Partner influences play a particularly important role in the work domain, because each partner’s work decisions have profound effects on the couple as a whole. In contrast to previous research, this study pays detailed attention to the role partners play in workers’ labor market decisions by using the case of early retirement decisions. We hypothesize that partners’ preferences for older workers’ retirement originate from altruism and self-interest. For example, partners might prefer workers to retire early because the worker’s job is highly stressful or partners might prefer workers to retire early to increase possibilities for joint leisure. Moreover, we expected that partners influence older workers’ early retirement behavior via persuasion and pressure. So, partners might either convince workers to change their preferences, or they might pressure workers to act according to the partners’ preferences, irrespective of workers’ own preferences. To adequately estimate partners’ and workers’ preferences for workers’ early retirement, we used an instrumental variable approach. This was possible due to the multi-actor longitudinal data available from a large representative sample of older workers and their partners in the Netherlands. The results support that partners’ preferences originate in altruism and self-interest and that partners influence workers through persuasion and pressure. Gender differences were marginal, with stronger signs for altruistic origins among female than male partners.
FAMILY CAREGIVER SOCIAL ISOLATION AND HEALTH: FINDINGS IN THE NATIONAL SURVEY OF CAREGIVING
Authors: Pohl Janet S , Bell Janice F , Woods Nancy , Tancredi Daniel J 
Published: November 2019

Abstract
Social relationships are important for family/informal caregiver health. Due to caregiving commitments caregivers are at risk for social isolation. Social isolation is associated with adverse health outcomes in the general population, but few studies have examined this association among caregivers. Employing the Convoy Model of social relations, we examined associations between caregiver self-reported health and social isolation—operationalized as a measure that included multiple domains and as specific domains modeled independently. Social isolation prevalence was 24.74% (n=2,175); mean health was 3.46 (SE=0.02) on a scale of 1 (poor) to 5 (excellent). In adjusted models, domain-inclusive social isolation was inversely associated with health (β=-.07; CI=-0.14,-0.02, p=0.01). In independent domain adjusted models, only participation in club activities was associated with health (β=-.22; CI=-0.35,-0.10, p&lt;0.01). Social isolation predicted caregiver health, with club participation explaining much of the variance. Domain inclusive social isolation measures can identify targets for intervention studies to improve caregiver health.
FAMILY CAREGIVING IN THE CONTEXT OF INTENSE AND COMPLEX CARE
Authors: Bell Janice , Whitney Robin L , Young Heather M 
Published: November 2019

Abstract
Approximately four in ten family caregivers experience high intensity care, based on the number of caregiving hours, activities of daily living (ADLs) and instrumental ADLs supported for the care recipient. Using the 2015 Caregiving in the U.S. Survey, we examined outcomes associated with high (compared to low or medium) intensity of care. High intensity was positively associated with emotional stress (OR=2.10; 95%CI: 1.52-2.91); financial strain (OR=1.69; 95% CI: 1.210-2.36); physical strain (OR=3.09; 95% CI: 2.21-4.34); and declines in caregiver health (OR=2.14; 95% CI: 1.56-2.93). High intensity was also associated with greater difficulty coordinating recipient care (OR=1.96; 95%CI: 1.42-2.71), higher odds of performing complex medical/nursing tasks (OR=6.85; 95% CI: 5.27-8.90) and, among task performers, greater difficulty performing tasks (OR=2.10; 95% CI: 1.43-3.08). High intensity of care impacts caregiver health and the caregiving role in multiple domains; new clinical and policy approaches are needed to mitigate risks and ensure adequate support.