bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREMIGRATION, DISPLACEMENT, AND POSTMIGRATION EXPERIENCES OF LONELINESS AMONG HMONG OLDER ADULTS
Authors: Vang Cindy , Sieng Michael 
Published: November 2019

Abstract
Available evidence highlights the detrimental impact of loneliness on the mental and physiological health of older adults. While immigrant older adults report higher prevalence for experiencing loneliness compared to native born older adults, minimal research has simultaneously explored the premigration, displacement, and postmigration experiences of loneliness among older adults with a refugee history. This study aimed to explore loneliness in these three phases among Hmong older adults, an ethnic minority group resettled in the United States as refugees over 40 years ago. Drawing on data from a constructivist grounded theory study guided by an intersectionality framework, the first author interviewed 17 community-dwelling Hmong older adults age 65 and older residing in Fresno and Sacramento, California. Two coders coded and analyzed the transcribed interviews. Findings revealed negative, disruptive, and discriminatory experiences underscored by systems of oppression grounded on the social, political, psychological, and cultural context of each phase. Influencing factors that contributed to loneliness were identified as: trust, loss, aging-related issues, isolation, sense of community, access to cultural community, instability, violence, and cultural adjustments. In specific phases, particular influencing factors were more evident and persistent in producing loneliness. Some influencing factors remained a problem for participants across all phases. With the unprecedented growth of refugees all over the world, this study highlights the need for more research, practice, and policy focused on the context of the refugee experience to gain greater insight into their loneliness experiences and expand the notion of loneliness as an individual experience.
USE OF SERVICES BY PEOPLE LIVING ALONE WITH COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW
Authors: Rosenwohl-Mack Amy , Chodos Anna , Dulaney Sarah , Fang Min-Lin , Merrilees Jennifer , Dubbin Leslie , Portacolone Elena 
Published: November 2019

Abstract
At least one third of older adults with dementia live alone in the United States. Living alone may represent an opportunity to maintain independence and autonomy, while remaining in a familiar home environment. However, living alone with cognitive impairment is also associated with health risks and unmet needs. No systematic reviews on this population have been published. We systematically reviewed research on use of healthcare and long-term services and supports (LTSS) by people living alone with cognitive impairment. Following PRISMA guidelines, we searched six electronic databases for studies reporting quantitative findings on use of services by people living alone with cognitive impairment; 33 studies met inclusion criteria. Nine countries were represented, all high-income economies. Race/ethnicity data was reported in just five studies, and only one included a majority of racial/ethnic minorities. Overall, people living alone with cognitive impairment appear to use health services at similar or lower rates compared to those living with others; however, LTSS use is higher among people living alone. Representation of non-white participants was poor, but the evidence available suggests that among racial/ethnic minorities with cognitive impairment, there is no difference in LTSS use between those living alone and living with others. Findings highlight inconsistencies in access to and use of essential services by older adults living alone with cognitive impairment. As the populations of the US and other high-income countries become both older and more diverse, with increasing numbers living alone, researchers and service providers must consider the specific needs and preferences of this population.
CANCER: ARE OFFSPRING OF LONG-LIVED SIBLINGS BOTH ROBUST AND RESILIENT?
Authors: Galvin Angéline , Pedersen Jacob Krabbe , Ukraintseva Svetlana , Perls Thomas T , Wojczynski Mary K , Christensen Kaare 
Published: November 2019

Abstract
Background: The mechanisms underlying clustering of longevity in families are unclear. We have previously shown a low cancer incidence in offspring of long-lived siblings, i.e. cancer robustness. Here we test whether such offspring are also more resilient in terms of survival after cancer diagnosis. Methods: Identification of offspring from long-lived families was undertaken in three nationwide, consecutive Danish studies (DOS, GeHA, LLFS). Cancer cases were identified through linkage with the Danish Cancer Registry. Each offspring cancer case was matched with two control cancer cases from the 5% random sample of the Danish population. Matching criteria were birth year, sex, year of diagnosis and cancer site. The main outcome was overall survival. Factors studied were sociodemographic, health-related and cancer-related. Survival analyses were performed using stratified Cox proportional hazards models based on the matching data. Results: Among the 5,377 offspring of the 634 families, 465 offspring of long-lived siblings with first primary cancer were included, along with 930 controls. Offspring of long-lived siblings had a significantly better survival than controls (HR=0.64 95%CI=[0.52-0.78]). The association attenuated only slightly after adjustment of marital status, education, Charlson Comorbidity Index, and number of prescribed drugs (HR=0.66 95%CI=[0.54-0.81]). Conclusion: Our results suggest that in addition to being more robust to cancer risk, offspring of long-lived siblings are also more resilient to cancer after its diagnosis and show better overall survival compared to individuals with cancer from general Danish population. Funding: The LLFS study is funded by the US National Institute on Aging / National Institutes of Health.
PHYSICAL ACTIVITY ATTENUATES AGE DIFFERENCES IN CHANGE IN PERCEIVED PHYSICAL FATIGABILITY
Authors: Qiao Yujia (Susanna) , Gmelin Theresa , Boudreau Robert M , Andersen Stacy L , Cosentino Stephanie , Christensen Kaare , Wojczynski Mary K , Glynn Nancy W 
Published: November 2019

Abstract
Lower physical activity is cross-sectionally associated with greater fatigability; whether such a relationship holds for longitudinal changes in fatigability is under-studied. We examined this question in offspring (≥60 years, range 60-93y, 99.7% white; 53.2% female) enrolled in the Long Life Family Study, a two-generation cohort enriched for exceptional longevity and their spousal controls. At Visit 2 (2014-2017), we measured self-reported physical activity (PA) with the Framingham Physical Activity Index (dichotomized by median value: less active &lt;37 MET-hrs/wk and more active ≥37 MET-hrs/wk). Perceived physical fatigability was assessed using the Pittsburgh Fatigability Scale (PFS, 0-50) at Visit 2 and repeated during a follow-up contact 2.7±0.92 years later. We constructed a repeated-measures linear mixed-effect model to examine the effect of PA on longitudinal change in PFS by median age (younger &lt;70y; older ≥70y) adjusted for family structure, field center, follow-up time, sex, and self-rated health. We found a strong dose-response relationship of PFS scores across the four age/PA groups (ptrend&lt;0.001). Specifically, older/less active (N=310) participants had the highest annual PFS increases of 0.37 points/yr (p&lt;0.001) while those older/more active (N=340) had annual increases of 0.17 points/yr (p=0.03). Younger/less active (N=371) participants had annual PFS increases of 0.09 points/yr (p=0.008); those younger/more active (N=341) had annual decreases (improvement) of 0.18 points/yr (p&lt;0.001). Although annual PFS changes were modest, our findings indicate physical activity attenuated age differences in these trajectories. Physical activity is emerging as a potential target for intervention aimed at reducing fatigability - an important risk factor in the disability pathway.
PREVENTING FALLS AMONG OLDER FALLERS: LIVE-LIFE
Authors: Szanton Sarah L , Clemson Lindy , Liu Minhui , Gitlin Laura N , Roth David L , Hladek Melissa D , LaFave Sarah , Granbom Marianne 
Published: November 2019

Abstract
OBJECTIVES: To evaluate whether a fall prevention intervention, adapted from the LiFE program, reduces fall risk in older adults who have previously fallen. DESIGN: Randomized controlled pilot trial SETTING: Participants’ homes INTERVENTION: LIVE-LIFE is an occupational therapy delivered fall prevention intervention that integrates strength and balance training into daily habits in 8 visits over 12 weeks. The intervention also provides 1) up to $500 in home safety changes prioritized by the participants 2) vision contrast screening and referral, and 3) personalized fall risk medication recommendations to Primary Care Providers (PCP) from a Pharmacist. This multi-component intervention was compared to a control condition consisting of CDC fall prevention materials and an individualized fall risk summary. MEASUREMENT: Primary outcome: Fall risk measured by Timed Up and Go (TUG) and Tandem stand. Secondary outcomes: Falls efficacy, feasibility and acceptability of the intervention. RESULTS: The sample of 37 people was 65% female, 65% white and an average 77 years old. Two were lost to follow up (95% retention). Compared to the control group, the mean of each outcome improved in the intervention. The LIVE-LiFE intervention had a large effect size (1.1) for amount of time study participants could hold a tandem stand, a moderate effect (0.5) in falls efficacy, and a small effect (0.1) in the TUG. CONCLUSION: LIVE-LIFE was acceptable to participants, feasible to provide, and averaged large to small effect sizes. Simultaneously addressing preventable fall risk factors is feasible and should be investigated due to the growing population at risk for falls.
DIGITAL INEQUALITY IN OLDER ADULTS’ ONLINE SOCIAL ENGAGEMENT AND SOCIAL CAPITAL
Authors: Nguyen Minh Hao , Hunsaker Amanda E , Hargittai Eszter 
Published: November 2019

Abstract
The increasing popularity of social media and other online communities offers new possibilities for older adults to stay socially connected. This study examines the relationship of older adults’ online social engagement and bonding as well as bridging social capital based on a survey of over 1,000 adults aged 60 and over. Social bonding refers to support obtained from existing strong social ties while social bridging is creating connections across varied social networks. We estimated three multi-stage regression models to examine these relationships when controlling for sociodemographic factors, as well as Internet experiences and skills. We then extended the regression models with Internet skills as a moderator. Findings show that older adults who engage more often in specific online social activities (i.e., asking questions on social media, looking at photos of family members/others) enjoy greater bridging social capital (both in offline and online contexts) than those who do so less often. Furthermore, Internet skills moderate the relationship between online social engagement and social capital. Specifically, older adults with greater Internet skills benefit relatively more from engaging in specific online social activities more often with respect to online social bridging. These results imply that digital inequalities may put older adults who are less skilled in using the Internet at a disadvantage when it comes to building social capital from online social engagement. Thus, while social media has potential positive implications for well-being among older adults, the current manifestation of this does not suggest equitable distribution of those benefits across different older users.
INTEGRATING HEALTH IT INTO CLINICAL WORKFLOW FOR DEMENTIA CARE: PROVIDER AND CAREGIVER PERSPECTIVES
Authors: Ruggiano Nicole , Brown Ellen , Clarke Peter 
Published: November 2019

Abstract
Each year, more than 5.5 million people in the U.S. are affected by Alzheimer’s disease and related dementias (AD/RD), most of whom reside within the community, receive ongoing care from family caregivers, and medically managed by primary care providers. However, AD/RD caregiving and care is often compromised and costly, with medical costs projected to increase from $203 billion in 2013 to $1.2 trillion in 2050. A significant barrier to AD/RD care relates to collecting the health information needed for clinical decision making, due to patients’ communication problems associated with AD/RD, insufficient time to collect relevant patient information from caregivers during the medical visit, and lack of communication with in-home health and support providers. To address these issues, the research team has developed CareHeroes, a multi-functional web and mobile app designed to increase the quality of communication about patient symptoms between the caregivers and providers of people with dementia. This study integrates qualitative findings from two studies evaluating CareHeroes that involved: (a) interviews and a focus group with AD/RD caregivers and (b) focus groups with clinical staff at two memory clinics. Findings indicate that caregivers want technologies that can inform clinical decision making on a regular basis while providers emphasize the use of information technologies that prepare patients and caregivers for upcoming medical appointments. Implications for practice, research, and policy are discussed.
BINGE EATING AMONG OLDER WOMEN: PREVALENCE RATES AND HEALTH CORRELATES ACROSS THREE UNIQUE SAMPLES
Authors: Kilpela Lisa S , Becker Carolyn B , Gomez Francesca , Middlemass Keesha , Espinoza Sara E , Musi Nicolas 
Published: November 2019

Abstract
Emerging research indicates that older women struggle with disordered eating more frequently than once thought. Among older women, binge eating (BE; consuming unusually large amounts of food in one siting while feeling a loss of control) appears to be the most common form of disordered eating. Notably, BE is associated with significant medical morbidity, including metabolic dysfunction and chronic pain. Aging-related experiences, such as sleep disruptions following menopause, mood changes and psychosocial stressors, may increase risk for BE. This study comprises a 3-sample comparison of BE prevalence and health correlates among older women. We gathered self-reported frequencies of BE in three separate samples of older women, using three different methods and validated measures. Sample 1: N = 185 women aged 60-83; collected online via snowball sampling and Amazon MTurk; 86% White. Sample 2: N = 100 women aged 55-79; collected online via snowball sampling; 72% White; 50% Masters/Doctoral Degree; 72% married. Sample 3: N = 64 women aged 66+ living with food insecurity, collected in person at local food pantries; 65% Hispanic, 16% African American; 39% disabled status; 48% &lt; high school/GED; 47% household income &lt; $10,000/year. Per DSM-5 frequency criterion of BE at least weekly, we found prevalence rates ranging from 19%-26.5% across the samples; correlates included elevated negative mood, worry, and BMI, and less nutritious food consumption. Across three very different samples in terms of race/ethnicity, education, and food security status, we found consistent rates of self-reported BE at least weekly (roughly 1/5). Implications will be discussed.
LATINO HOSPICE PATIENTS’ INVOLVEMENT IN CARE DECISIONS AND PLANNING: FACTORS THAT SHAPE PARTICIPATION PREFERENCES
Authors: Beltran Susanny J 
Published: November 2019

Abstract
Patient participation in care decisions is a primary tenet of patient-centered care and has been emphasized in policies and programs shaping clinical practice. Patient self-determination and involvement is associated with improved outcomes, including patient satisfaction and compliance. However, studies exploring Latino patients’ care involvement preferences find a cultural preference for limited autonomy and shared or family-based decision-making. This study describes terminally-ill older Latinos and their proxies’ preferences regarding involvement in decision-making and care planning following a referral to hospice care. Semi-structured interviews were conducted with 13 hospice-enrolled Latinos 65 or older, or their proxies. The sample is predominantly female (54% of all patients; 80% of proxies) and Mexican (77%). The average age of all patients was 82 years, and of proxies 54. Patients interviewed had an average of 7 years of education and proxies an average of 11 years. Patients were receiving care in a variety of settings, including inpatient hospice units, nursing homes, and community. Interviews were transcribed verbatim in the original language and coded thematically using an inductive approach. A second coder was used to code a Spanish and an English transcript (15% of the data), and a high level of interrater reliability was obtained (k = 0.85). Findings elucidate the paths through which culture, religion, and trust in provider shape preferences for limited autonomy and planning, confirming previous findings. However, this was not replaced by a preference for family-based decision-making. Findings highlight the importance of Latinos having access to culturally-competent primary care providers and fostering lasting relationships.
INCIDENCE OF COGNITIVE IMPAIRMENT AMONG U.S. CHINESE OLDER ADULTS: DOES SOCIAL ENGAGEMENT MATTER?
Authors: Kong Dexia , Dong XinQi 
Published: November 2019

Abstract
The increasing diversity in U.S. aging population warrants improved understanding of risk factors of cognitive aging in minority populations. This study presents the prevalence of incident cognitive impairment (CI) among U.S. Chinese older adults; and the relationship between social engagement and incident CI. Data were obtained from the Population-based Study of Chinese Elderly in Chicago, a prospective cohort study of Chinese older adults. Baseline (collected between 2011 and 2013) and one subsequent wave of data (collected between 2013 and 2015) were used in analyses (N=2,713). Social engagement was measured by the frequency of participation in social and cognitive activities (range=0-65). Cognitive function was assessed by a battery of 5 validated instruments. Incidence of CI was defined as having a follow-up cognition score lower than 1.5 standard deviations below the mean baseline cognition score. Logistic regression analyses were conducted. Nearly 6% of the sample reported incident CI. Chinese older adults who are more socially-engaged had a lower likelihood of developing CI (odds ratio [OR] 0.94, 0.92-0.96). The relationship was consistent across cognitive domains, including episodic memory (OR 0.95, 0.92-0.97), working memory (OR 0.92, 0.88-0.95), and perceptual speed (OR 0.95, 0.92-0.98). Furthermore, older age (OR 1.12, 1.09-1.15), and lower education (OR 0.91, 0.87-0.96) were associated with incident CI. No significant association was observed between gender, income, marital status, household size, acculturation, medical morbidities, depressive symptoms, and incident CI. The findings highlight the importance of social engagement in cognitive aging. Discrepancies with prior literature and implications of these findings will be discussed.
BUILDING AN AGE-FRIENDLY UNIVERSITY: AN INTERGENERATIONAL CAREGIVER EDUCATION PROGRAM
Authors: Cordes Becky , Luz Clare C , Sun Fei , Lee Jaewon 
Published: November 2019

Abstract
A rapidly aging U.S. population means an increased need for supportive services that allows aging in place. Eighty percent of such support is provided by unpaid family caregivers, many of whom are juggling multiple obligations. There is clear evidence that mental health risks of caregiving include social isolation, depression and identity loss, and potentially “caregiver burnout”. This study focuses on the lesser known impact of caregiving on college students who care for older family members and if their experiences differ from older caregivers. Presumably, students face additional stressors related to their age and school demands. Further, we posited that learning more about the aging process and interfacing with older retirees who are family caregivers through an intergenerational educational program would benefit both populations. Hosted by a campus organization, AgeAlive, which is dedicated to building an Age-Friendly University, the team’s specific aims included: 1. Conducting focus groups to identify concerns among college student and retiree family caregivers related to aging, caregiving, dementia, and intergenerational relationships. 2. Developing and piloting an intergenerational, educational program with the objective of addressing these concerns, and 3. Evaluating the program’s impact on measurable outcomes such as perceptions of aging, caregiver stress, and knowledge of resources. Focus group findings indicate that there are both shared concerns and divergent perspectives that provide opportunities for cross-generational learning. All program participants reported improved knowledge of aging, communication skills, and resources that will have a direct, positive impact. Lessons learned can guide development of supportive services for student and retiree caregivers.
CHANGE IN PHYSICAL FUNCTION, SWALLOWING, AND NUTRITIONAL RISK IN PEOPLE WITH PARKINSON’S DISEASE OVER 4 YEARS
Authors: LoBuono Dara L , Dobiszewski Sarah Sarah , Tovar Alison , Leedahl Skye N , Delmonico Matthew J , Xu Furong , Leslie Mahler , Lofgren Ingrid E 
Published: November 2019

Abstract
Parkinson’s disease, a neurodegenerative disease, impacts physical function, swallowing, and nutritional risk, but research has not examined how these health markers change longitudinally in one study. This study was an observational, longitudinal study with assessments conducted every 6 months over 4 years. The assessments included: the short physical performance battery (SPPB) (scores 75)), and weight in pounds. A one-way repeated measures ANOVA compared outcomes variables at baseline, years 2 and 4. Partial eta square are reported for effect size. Eight participants, baseline mean age 67.1±4.0 years and time since diagnosis=8.1±7.5 years, were assessed. At baseline, 3 participants exhibited possible mobility issues (SPPB=9.9±1.8), 2 participants exhibited a possible swallow issue (swallow speed=15.7±9.8mL/s), and 7 were at possible or at nutrition risk (64.0±13.8). At year 4, 5 participants exhibited possible mobility issues (SPPB=8.1±3.2, (ηp2=0.5), 4 participants exhibited a possible swallow issue (swallow speed=13.4±10.4 ml/s, ηp2=0.3), and there was a decline in perceived swallow function (77.3±12.4 vs. 74.8±16.2, ηp2=0.5). Six participants were at possible or at nutrition risk. Participants experienced weight declines from baseline to year 4 (178.5±31.4 vs.168.8±24.9, ηp2=0.5). The demonstrated decline in physical and swallow functioning, presence of nutrition risk, and experienced weight loss suggests that interdisciplinary intervention strategies may need to be designed and tested in this population.