bluuebunny/crossref_metadata_2025_split huggingface dataset:
RELATIONSHIPS BETWEEN INFORMAL CAREGIVERS’ MARITAL SATISFACTION, BURDEN, AND CAREGIVING STRESS
Authors: Ottmar Hannah , Houston Amy , Harfmann Elisabeth , Olzmann Amy , Brewster Glenna 
Published: November 2019

Abstract
Spouses often serve as the primary caregiver of individuals with dementia (Wright, 1991). As caregiving can be a stressful experience, marriage strains may occur. Researchers have found that caregiver spouses reporting low marital cohesion and satisfaction endorsed significant symptoms of depression (Rankin et al., 2001). Lower levels of marital intimacy have been found to be associated with higher levels of depression and strain among caregivers (Morris et al., 1998). The goal of the current study was to better understand the relationships between caregiver (N = 158) marital satisfaction, caregiving stress, and subjective and objective burden. Results indicated that marital satisfaction was a significant negative predictor of subjective burden as measured by the Zarit Burden Interview (F(1,134) = 93.51, p &lt; .001, R2 = .411), subjective burden as measured by the Revised Memory and Behavior Problems Checklist (RMBPC), Reaction Scale (F(1, 146) = 25.65, p &lt; .001, R2 = .149), and role captivity (F(1, 139), P &lt; .001, R2 = .380). Marital satisfaction was a significant positive predictor of caregiver competence (F(1,140) = 32.45, p &lt; .001, R2 = .188). It was also found that marital satisfaction was not a significant predictor of objective burden as measured by the RMBPC Frequency Scale (F(1, 146), p = .065, R2 = .023). The findings have implications for future interventions in that improving marital satisfaction of spouse caregivers may reduce subjective burden, decrease feeling trapped within the caregiving role, and increase caregivers’ sense of competence within the caregiving role.
IMPACT OF ELDER ABUSE ON SUBSEQUENT COGNITIVE DETERIORATION IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: FANG Boye , Yan Elsie 
Published: November 2019

Abstract
Objectives: Considering the rapidly increasing older population, elder abuse has become a major public health problem. Using longitudinal data, this study examines the impact of elder abuse on subsequent cognitive deterioration. Methods: At baseline, one-thousand-and-two older adults (aged≥55 years) with a clinically valid diagnosis of mild-to-moderate cognitive impairment were consecutively recruited from the geriatric and neurological departments of three Grade-A hospitals in Guangdong Province of People’s Republic of China from 2015 to 2016 and 958 of them have completed the present follow-up study after two years. The major independent variables were psychological abuse, physical abuse, caregiver neglect, and financial exploitation experienced at baseline. The outcome variable was cognitive deterioration defined by repeated measures using the Mini-Mental State Examination. Covariates included demographic characteristics, neuropsychiatric symptoms, depression, and IADL impairment. Results: According to the mixed-effect model, elder abuse at baseline did not have significant association with baseline cognitive impairment. However, experience of physical abuse (coefficient 0.11; 95% CI 0.06-0.15), psychological abuse (coefficient 0.28; 95% CI 0.09-0.47), and caregiver neglect (coefficient 0.03; 95% CI 0.01-0.05) at baseline predicted greater cognitive deterioration over the two-year observation period. Other contributing factors for greater cognitive deterioration included neuropsychiatric symptoms and depression. Discussion: Although no significant cross-sectional association between elder abuse and cognitive impairment was observed, physical abuse, psychological abuse, and caregiver neglect at baseline was found to have a long-term prominent effect on subsequent cognitive deterioration over the two-year observation period. The present results su
THE EFFECT OF YOGA ON FALL PREVENTION OUTCOMES IN ADULTS 50 YEARS AND OLDER: A SYSTEMATIC REVIEW OF THE LITERATURE
Authors: Nsobundu Chinelo K , Foster Margaret J , Hong Yan 
Published: November 2019

Abstract
Falls constitute a multitude of injuries irrespective of age. To combat these challenges, older adults are encouraged to engage in recreational activities. Yoga has been identified as an effective physical activity to promote mobility and balance for older adults. This study aims to systematically review the literature about yoga as a fall prevention intervention and synthesize the outcomes. Major databases (Ovid Medline & CINAHL) were searched for relevant articles. Studies were included if they met the criteria of 1) being a face to face yoga program, 2) aimed to recruit participants 50 years or older, and 3) reported at least one fall-related outcome (e.g., balance, mobility, fear of falling) as a result of the yoga program. 57 studies were identified: 32 from Ovid Medline and 25 from CINAHL. After removing the duplicates and applying a strict inclusion and exclusion criteria, 11 articles were included in the final analysis. A detailed synthesis of the results will be presented and quality assessment of included articles will be performed using the Modified Downs and Black checklist which appraises the methodological quality of both randomized and non-randomized studies. More research is needed to understand the impact of yoga in preventing falls among older adults at least 50 years of age. Additionally, research should establish a gold standard index that identifies which specific yoga programs ( based on type- individual vs. group; hatha, iyengar, kundalini, ashtanga, and etc.; frequency, and duration) have an enhanced effect on fall prevention.
FALLS AND MOTOR VEHICLE COLLISIONS: A LONGITUDINAL INVESTIGATION OF OLDER DRIVERS
Authors: Pope Caitlin N , Fazeli Pariya , Bell Tyler R , Gaini Meghana , Mrug Sylvie , Ball Karlene 
Published: November 2019

Abstract
Longitudinal research is needed to better understand mobility and aging, as falls and motor vehicle collisions (MVCs) are the top two leading causes of unintentional injury-related deaths for adults 65 and older in the United States. Using a longitudinal sample of older adults, prior falls were assessed as a predictor and moderator of the rate of subsequent MVCs over a 15 year time period. Using a 15-year longitudinal sample of 1,911 older adults recruited from three Maryland State Motor Vehicle Administration (MVA) sites, we conducted group differences and Generalized Estimating Equation (GEE) Poisson regressions. Individuals who reported a fall at baseline were more likely to be female, older, have poorer physical functioning, and reported more situational driving avoidance at baseline compared to those who did not report a fall. Females who reported a fall at baseline had a 2x greater risk rate of subsequently reporting a MVC over the 15 year time period than males. Furthermore, individuals, irrespective of gender, with a prior fall at baseline who drove more days per week over the 15-year time span had a 23% higher risk rate of a subsequent MVC. The current findings further the discussion on aging and mobility as it offers a longitudinal perspective on the association between falls and MVCS. These findings promote the utility of investigating non-traditional driver screening methods to identify drivers who may be at an increased rate for further driving difficulties.
LOWER BACK PAIN AFFECTS MOBILITY-RELATED INJURIES IN OLDER ADULTS
Authors: Bell Tyler R , Fazeli Pariya , Pope Caitlin N , Crowe Michael , Ball Karlene 
Published: November 2019

Abstract
Pain causes functional limitations and might elevate risk for mobility-related injuries in older adults. For this reason, we examined the longitudinal impact of lower back pain on the likelihood of MVCs and falls. Between 1998 and 1999, participants (ages &gt;55 years) completed cognitive and physical measures at three Motor Vehicle departments. Participants then completed a telephone interview (n=1,248) assessing yearly health complications and injuries, which continued annually for 14 years. Separate longitudinal models examined the relationship between lower back pain and MVC and fall likelihood while controlling for demographics and mobility. Overall, those with lower back pain were twice as likely to have a fall than unafflicted peers (95%CI:1.69-2.47) and odds of MVC was just beyond statistical significance (95%CI: 0.97-1.94). In persons with lower back pain, problems in lower-limb function, divided attention, and task-switching were associated with MVCs whereas problems in lower-limb function were related to falls. Addressing limitations from pain might reduce mobility-related injury in older adults.
THE FEASIBILITY OF USING COMMUNITY PHARMACISTS TO COUNSEL OLDER ADULTS ON FALL PREVENTION
Authors: Smith-Ray Renae L , Singh Tanya , Suwalski Michael W , Taitel Michael 
Published: November 2019

Abstract
Despite recognition as a serious public health problem, older adults falls increased 30% between 2007-2016. Numerous evidence-based fall prevention programs exist, but may have inadequate reach. Pharmacists are highly trained and accessible clinicians who have potential to counsel on fall prevention. This study describes the reach of a fall prevention outreach conducted by a large national pharmacy chain in partnership with local area agencies on aging (AAAs). On August 7, 2018, the pharmacy chain held an outreach during which older patients were incentivized to speak with pharmacists about their fall risk and prevention strategies. In Ohio, AAAs provided pharmacists additional support and availability of AAA fall prevention programs. A random sample of pharmacists was sent a follow-up survey to assess the program’s reach, except in Ohio where all pharmacists received the survey. Response rates were 41% (N=111) and 59% (N=160) in Ohio and non-Ohio states, respectively. We estimate that pharmacists discussed fall prevention with an additional 57,642 on 8/7/2018. The difference in older patients counseled on fall prevention on 8/7/2018 vs. a typical day was significantly greater (p=0.03) for Ohio pharmacists (µ=9.28) compared to non-Ohio pharmacists (µ=5.94). The majority of pharmacists in Ohio and non-Ohio states were moderately or extremely confident in their ability to discuss fall prevention with older patients (69.82% vs. 72.72%) and play an important role in fall prevention (59.75% vs. 54.54%). This study demonstrates the feasibility of utilizing community pharmacists, in partnership with AAAs, to reach large numbers of older adults to counsel on fall prevention.
FRAILTY MEDIATES SENILITY IN MEXICAN AMERICANS
Authors: Palmer Raymond F , Royall Donald R , Downer Brian , Markides Kyriakos 
Published: November 2019

Abstract
The latent construct “d” (for “dementia”) offers a continuously distributed transdiagnostic dementia severity metric. Age is significantly associated with “d”. We test whether frailty mediates age’s effect on 6 year prospective change in dementia severity in Mexican-Americans (MA), using data from the Hispanic Established Population for Epidemiological Studies in the Elderly (HEPESE). Age was regressed onto the 6yr prospective slope of change in “d” in N = 880 [mean age = 77.4 (6.1) at wave 3]. Change in “d” was estimated by a latent growth curve (LGC) indicated by latent cognitive measures across three HEPESE waves (i.e., 3, 5 and 6). “Frailty” was assessed by a modified version of Fried et al.’s construct observed at wave 5, and was tested as a mediator of age’s association with change in “d”. The mediation effect was estimated by MacKinnon’s method. “d” at each wave, and the LGC of change in “d” all had acceptable model fit (e.g. RMSEA &lt;.05). Age was significantly associated with change in “d”. 51% of their association was explained by frailty. Frailty mediates the majority of age’s association with dementia severity. Not only does this support the existence of a cognitive “frailty” syndrome in MA, it also implicates an effect of frailty on intelligence (as “d” is derived from Spearman’s general intelligence factor “g”). Their association may be mediated by blood-based serum biomarkers, including somatomedins, which may offer targets for the treatment and /or prevention of senility in frail elderly persons.
MEDIATING EFFECT OF GRIP STRENGTH TRAJECTORY ON THE ASSOCIATION BETWEEN EXERCISE AND WEAKNESS: A DYADIC APPROACH
Authors: Joo Susanna , Chai Hye Won , Jun Hey Jung 
Published: November 2019

Abstract
This study aimed to explore the mediating effect of grip strength trajectory on the longitudinal association between regular exercise and weakness in grip strength using a dyadic approach. We used six waves of the Korean Longitudinal Study of Aging (KLoSA) collected every two years from 2006 to 2016. The sample was middle and old-aged Korean couples who participated in all six waves of the survey (N=1,967). The outcome variables were husbands’ and wives’ grip strength at Wave 6, coded as a binary variable (0=clinically weak, 1=normal). The mediating variables were husbands’ and wives’ trajectories of grip strength across Waves 1 and 5. Independent variables were three dummy variables indicating couple’s participation in regular exercise (both engaged in regular exercise, only husband did, only wife did). Reference group was both not doing regular exercise. Results showed several significant mediational pathways. For husbands, engagement in regular exercise of both spouses and only husband were associated with higher grip strength at Wave 1, and slower decline in grip across waves was related to lower likelihood of having a clinically weak grip strength at Wave 6. As for wives, engagement in exercise of both spouses was associated with higher grip strength at Wave 1 which in turn was related to lower likelihood of having a clinically weak grip strength at Wave 6. These results suggest longitudinal dyadic processes through which engagement in regular exercise affects weakness in grip strength among older Korean couples.
MOTIVATIONAL INTERVIEWING TO ENGAGE OLDER INPATIENTS IN FALL PREVENTION: PILOT RANDOMIZED CONTROLLED TRIAL
Authors: Kiyoshi-Teo Hiroko , Northrup-Snyder Kathlynn , Eckstrom Elizabeth , Cohen Debbie , Dieckmann Nathan , Stoyles Sydnee 
Published: November 2019

Abstract
Motivational Interviewing (MI) is an evidence-based approach for fostering behavior change and holds potential to engage patients in behavior change related to fall prevention. A two-arm, unblinded, pilot randomized controlled trial was conducted in a hospital setting to determine the feasibility (recruitment and retention), establish suitable procedures for the intervention (duration and quality of MI), and to test study measurements (fear of falling, importance and confidence related to fall prevention, patient activation, fall prevention behaviors, and fall rates). Participants were high fall risk older inpatients (age ≥ 65). The intervention arm received MI at one time during hospitalization in addition to routine hospital fall prevention intervention. The control arm received the routine hospital care for fall prevention only. Measures were collected at baseline, 2-days, 1-week, 1-month, and 3-month. A total of 120 inpatients were contacted by the study team and 67 were randomized: intervention arm (n=36) and control arm (n=31). Approximately 66% of participants completed the study at the 3-month data collection and MI intervention took an average of 21 minutes and was of adequate quality. The intervention group reported less fear of falling after the MI intervention and maintained fall prevention behaviors over time (p&lt;.05). The study identified that MI for fall prevention at a hospital setting was feasible to deliver and provided insights into suitable study procedures and beginning evidence for a positive impact of MI.
EARLY FRAILTY PHENOTYPES AND PREDICTIONS OF COGNITIVE AGING: EVIDENCE FROM THE VICTORIA LONGITUDINAL STUDY
Authors: Bohn Linzy , Zheng Yao , McFall G Peggy , Dixon Roger A 
Published: November 2019

Abstract
Frailty is an aging condition that reflects multisystem decline. A prominent approach to frailty assessment is to create an index, whereby responses across multiple indicators of aging systems are summed to create a single score. These studies indicate that frailty is associated with adverse aging outcomes (e.g., mortality, dementia). We employ a data-driven approach to detecting and differentiating emerging frailty phenotypes and examine their associations with non-demented cognitive aging trajectories. Participants (n = 653; M age = 70.6, range 53-95) were community-dwelling older adults from the Victoria Longitudinal Study. Participants contributed (a) baseline data for 30 frailty-related items representing deficits across 7 domains (e.g., instrumental and cardiovascular health) and (b) longitudinal data for latent variables of executive function, speed, and memory. For each participant, we calculated the proportion of deficits present in each frailty-related domain and submitted these data to a latent profile analysis (LPA; Mplus 7.0). We used latent growth modeling (LGM) to test these frailty phenotypes for prediction of cognitive performance and decline. LPA results revealed three profiles, one large normal low-frailty profile and two emerging frailty phenotypes. Whereas the latter represented profiles of individuals with respiratory-type frailty (i.e., marked impairment in respiratory function; 7%) and mobility-type frailty (i.e., marked impairment in mobility function; 9%), the former featured limited impairment across frailty domains (83%). Findings from LGM indicated that these profiles were differentially related to cognitive performance and decline. Data-driven approaches can help detect early differentiation of frailty profiles and contribute to personalized intervention.
PROVIDER AND SYSTEM IMPACTS OF THE UW ECHO IN RURAL AND FRONTIER CARE TRANSITIONS
Authors: Carrico Catherine , Woods Tonja , Barry Robin A , Franke Kevin , McKibbin Christine 
Published: November 2019

Abstract
Background: The Project ECHO model utilizes a hub and spoke approach through which a team of experts co-mentors local providers in the management of complex cases while disseminating information about best practices and evidence-based care. Project ECHO is a promising model for improving patient care through transformation of the care delivery system. The UW ECHO in Rural and Frontier Care Transitions created an online community of practice comprised of local care coalitions dedicated to improving care transitions in Wyoming and Montana. This ECHO network provided a unique opportunity to support system- and provider-level implementation of best practices in care transitions. Methods: Semi-structured interviews were conducted with thirty ECHO attendees following participation in an ECHO session as either a participant or case presenter. Thematic analysis was used to analyze interview data. Results: Two overarching themes emerged 1) impact of the ECHO on the provider or healthcare team and 2) impact on the system. Participants indicated that the impact on the provider/healthcare team included an increased sense of community, increased awareness of community resources, increased knowledge of care transition strategies, and increased confidence in implementing best practices. Additionally, providers indicated increased utilization of community resources. Systemic impacts included increased involvement of interprofessional team members in patient care and utilization of ECHO recommendations to present systemic interventions and changes to colleagues, administration, and leadership. Conclusions: This ECHO network had a particularly strong impact on the provider and healthcare team as participants increased their knowledge, confidence, and use of best practices in care transitions.
HOW MEDICAL EDUCATION ALLEVIATED ETHICAL DILEMMAS IN RESIDENTS DURING END-OF-LIFE FAMILY MEETINGS IN THE SOUTH TEXAS
Authors: Martin Jessica G , Rivera-Burciaga Andrya , Gutierrez Cesar , Dentino Andrew 
Published: November 2019

Abstract
The UTRGV DHR Internal Medicine Program conducted a study addressing end of life (EOL) care focused on our Hispanic community in regards to communication and trust between patients, caregivers, and healthcare providers. Our residents train at a community hospital which cares for an 89% Hispanic population of 1.2 million, spanning over 4 counties of the Rio Grande Valley. Trainees are often involved in family meetings while treating hospitalized, terminally ill patients. Although family meetings are a standard approach in palliative care, Hispanic family meetings tend to occur more often and with a larger, extended family unit. Our intent was to educate our residents to initiate conversations about EOL care choices promoting delivery of patient-centered, family oriented care utilizing culturally appropriate information regarding EOL issues. Baseline surveys were provided to all 39 trainees which assessed anxiety, incompetence, and communication skills in delivering bad news during family meetings. An advanced care planning process was implemented over 3 months with a goal to engage patients in EOL conversations, initiation, and completion of advanced directives. Residents received weekly training on interactive methods and ethical concepts including group discussions, role-playing, and demonstrations which were culturally and linguistically appropriate. We found that physician competence in conducting Hispanic family meetings is vital. Residents completed a post-training survey resulting in 100% improved attitudes and behaviors such as confidence, satisfaction, caring and empathy. They felt more comfortable and prepared to speak to a larger family unit who was likely to ask a lot of questions and request multiple meetings.
EHEALTH PROGRAM BASED ON THE INFORMATION-MOTIVATION-BEHAVIORAL SKILLS MODEL FOR THE ELDERLY: A PILOT STUDY
Authors: Yang Eunjin , Chang Sun Ju , Lee Kyoung-eun , Ryu Hyunju 
Published: November 2019

Abstract
Although the internet is helpful and considered a preferred channel to get health information, some vulnerable populations such as the elderly have a digital divide. The purpose of this study was to test the development and intervention of the eHealth program based on the Information-Motivation-Behavioral Skills (IMB) model for improving internet health information seeking, understanding and utilization behaviors in the elderly. This study was a single group pretest-posttest design, and the eleven elderly aged 67-87 (mean74.6, SD 6.9) participated in 5 session program at a senior welfare center from 25 January to 22 February 2019. Each theory-based constructs of IMB model such as computer/web knowledge (p&lt;.01), attitude toward the internet health information usage (p&lt;.01), and eHealth literacy (p&lt;.01) was significantly improved at posttest than pretest. More than half of the participants (6 of 11) gave up on searching internet health information on pretest; however, all of the participants searched the internet health information accurately on the posttest. Regarding health information understanding, a significant difference was found (p=.03), and participants reported positive behavioral change after the program (6.54 ± 2.42). This pilot study indicated that the theory-based eHealth program might be an effective way to decrease a digital divide for the elderly. Therefore, the preliminary findings show promise for the use of the IMB model-based eHealth program as an intervention to improve internet health information seeking, understanding, and utilization behaviors in the elderly.