bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Road to Improved Assisted Living Quality: State Efforts and New Metrics
Authors: Shippee Tetyana , Schwartz Lindsay 
Published: December 2020

Abstract
Assisted living (AL), a senior housing option that combines housing, support services, and health care, is recognized as one of the fastest-growing components of the long term care industry. AL is also a relatively expensive service, whether it’s paid for privately or publicly. Also, an increasing proportion of AL residents have diagnoses of Alzheimer’s and related dementias. However, little is known about AL quality, in part due to lack of measures. Quality of AL matters to residents, their families, and policy makers because AL is not only about the experience of receiving specific services, but about a place that many will call home. Concerns have been surfacing regarding the quality of AL, including poor staffing, inadequate teamwork, and poor management, which can negatively impact resident well-being and result in abuse and neglect in some cases. This symposium will feature four presentations that will review efforts from two states that have been actively developing measures to address AL quality: Oregon and Minnesota. We focus on new legislation in both states to address AL quality, the new metrics being adopted, and preliminary results. Individual presentations will describe 1) Oregon’s new quality measures for AL ;2) Oregon’s use of Resident VIEW project, including measures of person-centered care from the perspectives of residents; 3) Minnesota’s development of AL report card, and 4) development and results from MN pilot surveys of resident quality of life and family satisfaction in all licensed ALs in the state. Policy implications for other states and researchers will be discussed.
Identifying Domains of Assisted Living Quality for Minnesota’s Assisted Living Report Card
Authors: Shippee Tetyana , Akosionu Odichinma , Skarphol Tricia , Beebe Timothy 
Published: December 2020

Abstract
Concerns around assisted living (AL) quality have prompted the 2019 passage of the MN legislature, which provided funding for the development of an Assisted Living Report Card. We present results from the first two phases of this project. The first phase involved a national literature review of quality measures and technical advisory panels to understand the types of domains and indicators for AL quality that are measured. Nine quality domains were identified. The second phase focused on state-wide stakeholder engagement to determine priority rankings for nine AL quality domains and indicators identified. Quality of life, staff quality and resident safety were the top three domains across all stakeholder groups. The state will implement surveys of AL resident quality of life and family satisfaction as mandated by the legislature, but findings indicate that other aspects of quality such as staff-related measures and resident safety, are also important to address.
Eliciting Care Management Preferences with Engaged Caregivers and Individuals With Mild Cognitive Impairment
Authors: Majid Tabassum 
Published: December 2020

Abstract
The goal of this study was to engage individuals with mild cognitive impairment (MCI) in developing a survey instrument that assists in the selection and prioritization of meaningful treatment outcomes in health care decision making. A multi-stakeholder advisory panel was engaged throughout the first qualitative phase of the study. 15 in-depth, guided interviews were conducted with caregiver-care recipient dyads who had been recently diagnosed with MCI. In addition to questions about meaningful outcomes, individuals were asked about quality of life and the severity of their symptoms using the Functional Attainment Staging Tool. 14 thematic concepts identified in an earlier, non-engagement-based caregiver study were all endorsed as relevant to the dyads interviewed. However, participants included 6 more thematic concepts, many of which were focused on social and community factors relevant to health care decision making. Engaging patients and caregivers allowed for focused dialogue within the interviews on shared treatment goals.
CATCH-ON Age-Friendly Health System Implementation Across Varied Geographic and System Settings
Authors: Emery-Tiburcio Erin , Golden Robyn , Newman Michelle 
Published: December 2020

Abstract
GWEP program goals include transformation of clinical training environments into integrated geriatrics and primary care systems to become Age-Friendly Health Systems. CATCH-ON, the collaborative GWEP led by Rush University Medical Center, is working with primary care health systems in four highly varied geographic and system settings to achieve this goal. Each of these clinic systems has unique successes and challenges in developing and implementing workflow protocols; engaging providers, patients, families, and community-based organizations in the development of Age-Friendly Health Communities; and modifying the electronic health record to document assessing and acting on 4Ms. Clinic team members participate in monthly Learning Community sessions to learn about and reinforce the 4Ms, along with practical recommendations for implementing with patients. This session will focus on CATCH-ON’s process for implementing the 4Ms in various practice settings, lessons learned in implementation across large and small health systems, and opportunities to bridge AFHS with the community.
Use of a Driving Simulator to Facilitate Older People to Return to Driving
Authors: Unsworth Carolyn , White Megan , Lannin Natasha 
Published: December 2020

Abstract
Driving simulators are a relatively underutilized therapy tool that provide an opportunity for older drivers with a range of health-related problems to participate in simulated driving scenarios in a low cost and safe environment. The aim of this paper is to (i) describe the use of a Forum 8 driving simulator prior to a driver assessment, (ii) detail the story-boarding technique used to develop and grade driving scenes to enable older drivers to increase confidence, practice using vehicle modifications such as a spinner knob (e.g. for one-handed driving following stroke), and train specific skills including visual scanning and attention, and (iii) present five case studies to identify the strengths and limitations of incorporating the simulator into therapy programs with older drivers. of simulator use. The establishment and use of a driving simulator in a rehabilitation unit highlights both the challenges and benefits of using this kind of technology in practice. Part of a symposium sponsored by Transportation and Aging Interest Group.
Implementation of Evidence-Based Practices in Intergenerational Programming: A Scoping Review
Authors: Jarrott Shannon , Scrivano Rachel , Mendoza Nancy , Park Cherrie 
Published: December 2020

Abstract
Intergenerational programs facilitate mutually beneficial interactions between youth and older adults, achieving an array of outcomes. With few exceptions, implementation factors rarely figure into outcome analyses, though researchers frequently gather data on factors influencing outcomes. The resulting practice-evidence gap may deter wide-spread adoption of intergenerational programming. We conducted a scoping review of 35 peer-reviewed articles (2000-2019) to map key concepts and evidence sources of empirically-supported practices impacting intergenerational program outcomes. A scoping review is appropriate when an area is complex, like intergenerational programs that incorporate diverse participants, content, and goals. Primarily qualitative studies involved programs equally likely to involve young, school-age, or post-secondary age youth and independent or frail older adults. Half had sample sizes under 50, frequently measuring both age groups. Implementation practices included co-learning and sharing personal stories. Program content (e.g., technology) and greater exposure amplified outcomes. Rigorous implementation research is needed to advance evidence-based intergenerational practice.
Types of Interpersonal Bias: Measurement and Their Association With Health Among LGBTQ Older Adults
Authors: Prasad Anyah , Goldsen Karen Fredriksen , Kim Hyun , Jung Hailey 
Published: December 2020

Abstract
Increasing diversity and rapidly evolving sociopolitical context is changing the face of bias experiences in contemporary America. Accordingly, literature has evolved into four unique ways of describing bias, namely lifetime discrimination and victimization, everyday discrimination, and microaggressions. However, there is less conceptual clarity on the way these constructs are operationalized, measured, and their relationship to one another and health outcomes. In this paper, we discuss the measurement of these four constructs and report their prevalence among a national sample of LGBTQ older adults (N=2,450). The correlation between these constructs varied between 0.36 to 0.63, which shows that despite considerable overlap they are measuring distinct aspects of bias experiences. Each of the constructs had a significant association with depression, general health and quality of life. When the four constructs were entered into a regression model, everyday discrimination (due to sexual and gender identity and other factors) emerged as the strongest predictor.
Epigenetics, Heredity, and Aging
Authors: Greer Eric 
Published: December 2020

Abstract
Longevity has long been shown to be regulated by genetic and environmental factors. We recently showed that longevity in the nematode Caenorhabditis elegans can also be regulated by the transmission of epigenetic information. We have shown that several chromatin modifying enzymes have a transgenerational non-Mendellian effect in worms on the longevity of their descendants. I will discuss some of our recent work attempting to decipher how epigenetic modifications can regulate complex phenotypes, including longevity, and how this non-genetic information can be transmitted across generations.
Neural Control of Healthy Aging in Drosophila Through Perceptive Experiences
Authors: Pletcher Scott 
Published: December 2020

Abstract
We will describe how neurosensory circuits relate information about nutrition, danger, and mates to initiate rapid changes health and aging, including evolutionarily conserved neural signaling pathways and molecules that extend organism lifespan. These findings provoke the notion that aging may be considered a complex behavior that is acutely malleable, susceptible to sensory influences, and strictly controlled by coordinated sets of neurons.
Physical Impairment, Insurance Coverage, and Healthcare Utilization Among U.S. Chinese Older Adults
Authors: Attilus Jonas , Li Mengting , Le Qun , Dong XinQi 
Published: December 2020

Abstract
The relationship between physical impairment and healthcare utilization is well studied. However, few studies examined this relationship among immigrant older adults whose health insurance status may represent a barrier to healthcare use. This study aims to examine the relationship between physical impairment, health insurance, and types of healthcare utilization. The PINE Study provided data of 3,157 Chinese older adults age 60 and over. Most (70.67%) of them had insurance. Physical function was assessed by Activities of Daily Living and Instrumental Activities of Daily Living. Healthcare utilization was evaluated by the times of physician visit (PV), ER, and hospitalization, separately, in the past two years. Logistic regression was used. After adjusting for covariates, among the insured patients, every one unit increase in ADL impairment was associated with higher odds of ER visit (OR:1.32 [95%CI 1.21-1.45]) and hospitalization (OR: 1.37, [95%CI 1.25-1.50]). Every one greater IADL impairment was associated with higher odds of PV (OR: 1.26, [95%CI 1.12-1.43]), ER visit (OR: 1.21, [95%CI 1.16-1.26]), and hospitalization (OR: 1.23, [95%CI 1.18-1.28]). Among the non-insured, every one unit increase in ADL impairment was associated with higher odds of ER visit (OR: 1.82, [95%CI 1.19-2.78]) and hospitalization (OR: 3.05, [95%CI 1.51-6.16]). Every one unit increase in IADL impairment was associated with higher odds of PV (OR: 1.24, [95% CI 1.09-1.42]), ER visit (OR: 1.33, [95% CI 1.17-1.52]), and hospitalization (OR: 1.53, [95%CI 1.32-1.76]). These findings highlight disparities in healthcare utilization. Longitudinal studies are needed to strengthen causality between physical impairment, health insurance, and healthcare utilization.
Community Health Educator’s Role on the 3D Team
Authors: Santiago Alba 
Published: December 2020

Abstract
As a member of the 3D Team, the bilingual, bicultural Community Health Educator (CHE) addresses needs expressed by study participants related to social determinants of health. Clinical triggers generated by nurse practitioners (NPs) that lead to CHE referral include: social isolation and loneliness; lack of transportation access; lack of resources to sustain nutritional adequacy, purchase medications, and purchase assistive devices; and cultural and linguistic barriers that lead to lack of knowledge about community resources. To date, 50% of study participants randomized to receive 3D Team care have triggered referral to the CHE. In this presentation, the team CHE will provide details on the frequency of different needs expressed by study participants, how she utilizes an ever-growing community resource directory, and specific types of information and guidance she provides to address their expressed needs. Case studies will help illustrate ways in which CHE services have successfully provided assistance to study participants.
Adverse Outcomes, Polysubstance Use, and Polypharmacy in Older Veterans
Authors: Byers Amy 
Published: December 2020

Abstract
This session will provide information about adverse health outcomes, including suicide, suicide attempts and unintended death, that may be related to polysubstance use and polypharmacy in older adults, particularly older veterans. It will further provide information that will help support late-life suicide prevention and intervention efforts. Older veterans (age50 and older) have the highest number of lives lost to suicide, make up majority of the veteran population, and are highly likely to experience conditions (e.g., chronic pain, sleep disorders, musculoskeletal) associated with commonly prescribed medications that are potential markers for suicide risk (hereafter referred to as “high-risk” drug categories), including benzodiazepines, sedative-hypnotics, opioids, antidepressants, antipsychotics, and antiepileptics. The research presented in this session will highlight important patterns in high-risk drug prescribing and use and related outcomes in late life. The presentations will underscore various groups of older veterans that may be important to consider and, yet, neglected in the polysubstance and polypharmacy and suicide prevention conversation, including those who recently attempted suicide, veterans with late-life posttraumatic stress disorder (PTSD), and older veterans transitioning from prison to community. Drs. Maust and Morin will present findings on prescribing and use of high-risk medications in late life, including an overview of trends in polypharmacy and associations with suicide attempts. Drs. Byers and Barry will speak about older veterans with PTSD and those with a history of incarceration, with information on suicide, unintended death by overdose, and substance use disorder-related emergency department visits and hospitalizations, emphasizing importance of care transition models for prevention. Aging, Alcohol and Addictions Interest Group Sponsored Symposium.
PTSD, Risk of Suicide, and Unintended Death by Overdose in Late Life
Authors: Byers Amy , Li Yixia , Maguen Shira , Neylan Thomas 
Published: December 2020

Abstract
Little is known about late-life posttraumatic stress disorder (PTSD) and risk of suicide and apparent accidental death by overdose. We studied 488,044 older veterans (50 and older) with PTSD and propensity-matched comparison group without PTSD (n=488,044), seen in VA 2012-2013 followed to 12/31/2016. There were 5,693 non-fatal and fatal suicide attempts for those with PTSD and 4,310 for those without PTSD (approximately 20% fatal for each group). Those with PTSD had nearly 2-fold increased risk of any attempt [HR=1.55 (95% CI=1.49-1.62)]. While results specific to death by suicide were non-significant, impact of PTSD on method of death (e.g., drug overdose, firearms, hanging) was significant only for drug overdose [HR=1.58 (95% CI=1.22-2.03)]. Intentional and unintentional death by narcotics and such drugs as non-opioid analgesics and autonomic nervous system drugs were most highly associated with late-life PTSD. This study provides important implications for late-life suicide prevention related to PTSD and cause-specific drugs. Part of a symposium sponsored by the Aging, Alcohol and Addictions Interest Group.
Best Practices in Implementing the VA’s Life-Sustaining Treatment Decisions Initiative
Authors: Haverhals Leah , Kononowech Jennifer , Bauers Courtney , Manheim Chelsea , Levy Cari 
Published: December 2020

Abstract
To study use and completion of Life Sustaining Treatment (LST) templates across the Department of Veterans Affairs (VA) healthcare system, we designed a qualitative study to interview VA sites we identified who had high rates of LST template completion between July 1, 2018 (the official implementation start date) and March 2019. We then conducted site visits with two VA sites and phone interviews with nine other VA site to better describe facilitators and barriers to implementation of this new practice and identified factors influencing high rates of LST documentation completion. Researchers who conducted the interviews analyzed interview data through applying the Consolidated Framework for Implementation Research. From these efforts, we identified best practices used, including the importance of a formally appointed implementation leader, gaining leadership support, and engaging staff through education. We will share these recommendations with VA sites across the healthcare system to improve LST documentation.
Availability of Audiology Services in Assisted Living Communities in Florida
Authors: Pupo Daniel , Rouse Hillary , Peterson Lindsay , Hyer Kathryn 
Published: December 2020

Abstract
Florida has one of the largest populations of older adults in the U.S., and as a result the state also has a high prevalence of hearing loss. Given the growth of assisted living as a housing option for older adults, the purpose of this study was to determine the availability of audiology services in assisted living communities (ALCs) across Florida. Data on ALC location, characteristics and audiology service availability were collected from the Florida Agency for Health Care Administration (AHCA). County socioeconomic data were collected from the U.S. Department of Labor. Logistic regression and chi2 tests were used to examine the relationship between county socioeconomics and whether an ALC provided audiology services. We found that of the 3090 ALCs in Florida, audiology services were present in only 57 (3.2%). ALCs with audiology services were significantly more likely to be located in counties with a higher education level and a higher average income. This suggests a shortage of ALCs with audiology services in counties where residents have fewer resources. The results are concerning, given that individuals with fewer resources are less able to pay for audiology services on their own and evidence showing that poor hearing health late in life impacts individuals’ health and quality of life. Policy implications will be discussed, including the need for more ALCs to provide audiology services in counties with fewer resources. One possible solution is tele-audiology, which would enable a single audiologist to diagnose and prescribe hearing aids to patients in underserved areas.
Who Cares for Whom and Is That important? A Typology of Dementia Care Dyads and Health-Related Support Measures
Authors: Wolf-Ostermann Karin , Wiegelmann Henrik , Schirra-Weirich Liane , Verhaert Lisa-Marie , Brannath Werner , Arzideh Farhad 
Published: December 2020

Abstract
In Germany, about 70% of all care-dependent persons are community dwelling. In dementia care arrangements you will commonly find a primary informal caregiver (IC) taking on the decisive role in providing care and support for the person with dementia (PwD). This study aimed to develop a typology of dyads based on typical characteristics of the PwD, the IC and their relationship and to gain a better understanding of home-based dementia care arrangements. A latent class analysis was used to detect different dyad types based on personal, social, care and disease characteristics of 551 dyads of CGs and PwD living at home. A 6-class model was identified. The classes could be differentiated based on IC-PwD key characteristics (gender, age, relationship, living situation, occupation). There are significant differences with regard to observed outcomes. The verification of different types of dyads strengthens the need to develop tailored dyad-centred interventions in dementia care
The Challenges of Recruiting and Retaining Dyads of Hospitalized Persons With Dementia and Their Family Carers
Authors: Boltz Marie , Kuzmik Ashley 
Published: December 2020

Abstract
Persons with dementia (PWD) have high rates of hospitalization, and along with their family caregivers (FCGs), commonly experience negative hospital experiences and outcomes. The recruitment and retention challenges encountered in an ongoing cluster randomized clinical trial in PWDs and FCGs are described. The trial tests the efficacy of a nurse-FCG partnership model that aims to improve: 1) the physical and cognitive recovery in hospitalized PWD, and 2) FCG preparedness and anxiety. Recruitment and retention challenges, identified in team meetings and extracted from team documentation,.include factors in the hospital environment, the PWD, and FCGs. Strategies that address these challenges include careful pre-planning and preparation with the site, strong communication with dyads, and honoring preferences for communication. The recruitment and retention of acutely ill older adults with dementia and FCGs can pose a challenge to investigators and threaten the validity of findings. Recruitment and retention strategies that help improve validity are described
Thigh-Worn Accelerometer Data in the Maastricht Study
Authors: Koster Annemarie 
Published: December 2020

Abstract
This study describes the use of thigh-worn accelerometers to collect high-quality data on sedentary time and physical activity in the Maastricht Study, a prospective cohort study in the Netherlands. Data have been collected in 9000 participants, aged 40-75 years, 49% women, and 25% has type 2 diabetes by design. All participants were asked to wear an activPAL accelerometer for 7 days. Percentage sedentary, standing and stepping time of waking time were calculated. Participants had on average 6.4 valid days (≥14h of monitoring) and 90% wore the device &gt;4 days. Men spent significantly more time sedentary than women (63.3±10.3% versus 57.0±10.1%); standing and stepping time were significantly higher in women (30.1±7.9%; 12.9±4.4%) than in men (24.7±7.4%; 12.1±4.6%). Sedentary time significantly increased with increasing age while standing time decreased; no clear age-gradient in stepping time was found.