bluuebunny/crossref_metadata_2025_split huggingface dataset:
TASKS AND EDUCATION RESOURCES OF ADOLESCENTS WHO ASSIST WITH CAREGIVING FOR A FAMILY MEMBER WITH DEMENTIA
Authors: Perion Jennifer , Ames April , Steiner Victoria 
Published: November 2019

Abstract
An abundance of research involving adults who care for family members with dementia has guided the creation of supportive programs/services. Much less is known about adolescents who are dementia caregivers. This descriptive secondary analysis utilized data collected during a qualitative examination into the psychological well-being of adolescent dementia caregivers. Eleven adolescent/adult dyads who provided dementia care for a family member completed surveys prior to the adolescents’ participation in focus groups. Five male and six female adolescents ages 12 to 17 and eleven female adults were asked similar questions about caregiving tasks, education resources, and demographic information. Using descriptive statistics, the results of the surveys provide a snapshot of caregiving among a group of adolescents living in northwest Ohio and highlight differences reported by the dyads. Adult accounts of adolescent preparatory education were incongruent with the adolescents’ and did not report their use of books or online caregiving resources. Conversely, three adults (27%), but no adolescents, identified hands-on and observational opportunities as education resources. Adults reported greater adolescent involvement in ten activities of daily living (71%), especially related to bathing, shopping, transportation, and managing medication and finances. Adolescents reported helping with tasks such as eating and laundry more often than adults. While the sample size was small, these findings suggest a need for triangulation when seeking knowledge about adolescent caregiving. These results may inform researchers wishing to investigate the role of adolescent caregivers, as well as guide supportive agencies who provide education materials to families caring for individuals with dementia.
DEVELOPING A CONCEPTUAL MODEL OF FAMILY PREPAREDNESS FOR FUTURE DEMENTIA CAREGIVING IN CHINESE FAMILIES
Authors: Choy Jacky C P 
Published: November 2019

Abstract
Dementia is a growing health challenge that demands better public preparedness. Persons with dementia often lack the capacity to make and execute plans such that family involvement in care preparation becomes necessary. It is commonly observed in Chinese societies that there are more than one family members involved in the taking care of the person with dementia. The current qualitative study aims to understand preparedness for dementia caregiving of a family as unit in a Chinese society. In-depth interviews with 10 family units of dementia caregivers were conducted. Participants (4 spousal caregivers; 44 to 80 years old; mean years of caregiving: 3.3) reflected on how prepared their families were before the caregiving began. Thematic analysis was applied to examine the family preparedness and the family dynamics throughout the caregiving journey. As opposed to a crisis-driven involvement, involvement of more family members before crisis was helpful for reducing the damage brought to the family. Furthermore, families that could align their expectation and understanding of the situation, share knowledge and resources, negotiate the allocation of caregiving duties, and provide emotional support among family members were more likely to provide proper care with minimal sacrifice in family wellbeing. Chinese families often worked as a caregiving team, yet, with uneven distribution of caregiving duties and a lack of proper communication to sustain their caregiving role healthily. Timing and quality of family involvement were more influential factors than family resources to successful adaptation to caregiving.
LIFESTYLE BEHAVIORS AND RACIAL DIFFERENCES IN ALZHEIMER’S DISEASE RISK
Authors: Wong Roger 
Published: November 2019

Abstract
There is substantial evidence indicating that among all racial groups, Blacks have the highest Alzheimer’s disease (AD) risk. Despite the wide support for this disparity, the reasons for these racial differences in AD risk remain unclear. The purpose of this study was to examine how lifestyle behaviors (physical activity, smoking, and social contacts) mediate and moderate the relationship between race and AD risk among Black and White older adults. This study used seven annual waves (2011-2017) of prospective data from the National Health and Aging Trends Study (NHATS), a large nationally representative U.S. sample of older adults. At each wave, physical activity was measured as whether they engaged in vigorous physical activities; smoking was measured as whether they were cigarette smokers; and social contacts was measured as whether they visited friends/family outside of their home. The dependent variable was age of AD diagnosis. Multivariate analyses were conducted using the Cox proportional hazards model. Blacks had a 1.3 times significantly higher risk for AD compared to Whites (Hazard Ratio [HR]=1.31, p=.03). After controlling for lifestyle behaviors as a mediator, racial differences in AD risk were attenuated and no longer significantly different between Blacks and Whites (HR=1.05, p=.74). For the moderation model, interactions between race and each lifestyle behavior generated no statistically significant results. Our findings indicate lifestyle behaviors contribute to racial differences in AD risk between Blacks and Whites. Future research is needed among Black populations to identify specific lifestyle behaviors that are especially protective against AD as targets of intervention.
PROXIMAL DETERMINANTS OF FALLS IN OLDER ADULTS: THE MOBILIZE BOSTON STUDY
Authors: Kang Hyun Gu , Hsu Jonathan 
Published: November 2019

Abstract
Objectives: To study risk factors for falling, we examined risk factors for falls among older people according to the proximal determinants present at the time of the fall. Methods: Data came from MOBILIZE Boston, a prospective cohort study of 765 community-dwelling women and men, mainly aged 70 years or older. Over 4.3 years, 1737 falls were recorded, along with narrative reports describing proximal determinants at the time of the fall. Proximal determinants were identified from narrative reports and falls were classified into categories. Categorization was verified using three raters. Results: 14 categories of proximal determinants were identified. Of these, environmental determinants were the largest contributor to falls (74%). Participants with poor mobility and executive function were more likely to fall while performing activities of daily living, specifically while trying to stand and bending over. However, participants with poor mobility also had lower likelihood of falling to environmental hazards and dual-tasking cognition. In contrast, high-functioning older adults with naturally fast movement speed tend to fall to environmental factors while engaging in complex motor activities. Conclusions: Our results suggest there may be two populations of fallers, the healthy and the disabled, each with their own set of distinct risk factors and triggers. Cognitively functional older adults who choose to engage in vigorous activities in hazardous environments may increase their chances of falling to dual-task cognition. Community fall prevention efforts may benefit from examining the needs of specific subpopulations.
ONE-LEGGED STANCE BALANCE OF OLDER ADULTS WITH AND WITHOUT FALLS
Authors: Vieira Edgar R , Oliveira Márcio , Gil Andre , Fernandes Karen , Teixeira Denilson , Amorim Cesar F , Silva Rubens da 
Published: November 2019

Abstract
Balance impairment is a common problem among older adults. Poor balance in older adults is often associated with mobility impairments, activity limitations and fear of falling in older adults. Thus, balance assessment is useful for early detection of postural control deficits to prevent mobility impairments and falls in older adults. The aim of this study was to assess if balance measures based in center of pressure (COP) parameters during one-legged stance could differentiate between older adults with and without falls in the past 12 months. One-hundred and seventy older adults (50 fallers and 120 non-fallers, age range: 63-72 years) performed three 30s one-legged stance trials with eyes open on a force platform with 30s of rest between each trial. The following variables were evaluated: COP 95% elliptical area, COP velocity in the anterior-posterior and medio-lateral directions, and test duration (how long the participant was able to stay in one-legged stance, up to 30s). Fallers had poorer balance than non-fallers (P ≤0.004). The COP parameters presented an area under the curve between 0.65-0.72, with sensitivity varying from 66 to 78% and specificity from 54 to 68%. There were no significant differences between fallers and non-fallers on test duration (17 vs. 18s, respectively). The findings showed that the fallers had similar duration time, but poorer balance than the non-fallers during one-legged stance. The COP parameters were able to differentiate the balance between fallers and non-fallers with acceptable area under curve, sensitivity and specificity.
CHARACTERISTICS OF MALADAPTIVE FALL RISK APPRAISAL AMONG OLDER ADULTS AGES 60 YEARS AND OLDER
Authors: Thiamwong Ladda , Ng Boon Peng 
Published: November 2019

Abstract
Even though one-third of older adults have maladaptive fall risk appraisal (FRA), no studies has examined this discrepancy between perceived fall risk and physical fall risk among older adults in Thailand. We examined the characteristics of fall risk appraisal (FRA). 433 community-dwelling older adults were randomly selected from two provinces in Southern Thailand. Physical fall risk was assessed by a full tandem stand test and perceived fall risk was assessed by the Fall-Efficacy Scale International. We classified FRA into: 1) Rational FRA means low physical fall risk and low perceived fall risk; 2) Irrational FRA means low physical fall risk but high-perceived fall risk; 3) Congruent FRA means high physical fall risk and high-perceived fall risk; and 4) Incongruent FRA means high physical fall risk but low perceived fall risk. Irrational FRA and Incongruent FRA are a maladaptive FRA. About 60% of the participants had maladaptive FRA, which consisted of irrational FRA (57.3%) and incongruent FRA (2.3%). 20.8% were in rational FRA and 19.6% in congruent FRA. Among those with rational FRA, incongruent FRA, irrational FRA, and congruent FRA, 27.8%, 60%, 41.1%, and 74.1% reported having at least one fall in the past year, respectively. After covariate adjustment, participants in the congruent FRA group were 3.29 times more likely (p=0.006) to fall than those in rational FRA. High proportion of participants had maladaptive FRA so screening individuals with maladaptive FRA and prevent them to transition into the congruent FRA group is important efforts to mitigate health and economic burdens.
FALL RISK BEHAVIORS AND INTRINSIC RISK FACTORS FOR FALLS IN INDIGENOUS AND NON-INDIGENOUS RURAL OLDER ADULTS
Authors: Bouweraerts Andre G , Ortega Justus 
Published: November 2019

Abstract
Within California, older adults living in rural counties have reported higher rates of falls than urban dwelling older adults. Although many Indigenous people live in rural areas, it is unclear whether the rate of falls among Indigenous older adults is similar to that of non-indigenous older adults living in rural areas. Thus, the purpose of this study was to examine fall risk behaviors and intrinsic risk factors for falls in rural dwelling Indigenous (N = 89), and non-Indigenous (N = 68) older adults 60-95 years of age living in California. Results showed that both Indigenous and non-Indigenous older adults share similarly high fall rates, but there are a much greater number of Indigenous older adults falling multiple times a year. Moreover, fall risk behaviors and intrinsic fall risk factors were significantly different between Indigenous and non-Indigenous rural-dwelling older adults. Future studies should investigate falls and fall risk factors in different tribes/locations of Indigenous older adults to better understand whether these risk factors differ among tribes. Moreover, it would be beneficial for future studies to assess the effectiveness of fall prevention exercises on fall risk in these communities. Information gained from this study helps to inform clinicians and researchers alike about the prevalence of falls and factors contributing to falls among Indigenous older adults living in rural communities; and helps to influence decisions in the future of programs for reducing fall risk in this often neglected population.
NEURAL CORRELATES OF COMPLEX WALKING TASKS IN OLDER ADULTS
Authors: Chen Nemin , Rosano Caterina , Karim Helmet , Studenski Stephanie , Aizenstein Howard , Rosso Andrea 
Published: November 2019

Abstract
Walking on a narrow path challenges attention and balance control but its neural correlates are unknown. We assessed the association between gray matter microstructural integrity and gait speed along a 6 m long and 20 cm wide path in participants from the Health, Aging, and Body Composition Study (n=155; mean age=83, 53% women, 35% black). Micro-structural integrity was measured by mean diffusivity (MD) in gray matter computed from diffusion weighted imaging (DWI); higher MD indicates lower integrity. We conducted general linear models to assess this association with gray matter microstructural integrity of regions of interest (based on known associations of usual pace gait speed): middle frontal gyrus; caudate; putamen; anterior, middle, and posterior cingulate; hippocampus; precentral gyrus; and supplementary motor area. We adjusted for total brain atrophy, usual pace gait speed, age, sex, race, and education. The average narrow-path gait speed was 0.97 m/s (standard deviation: 0.21). Average usual pace gait speed was 1.1 m/s (standard deviation: 0.21). After adjusting for covariates, we identified significant negative associations between narrow-path gait speed and gray matter MD of left posterior cingulate, left and right hippocampus, and left precentral gyrus (p&lt;0.05). Narrow-path gait speed is associated with lower microstructural integrity in gray matter related to network connectivity (posterior cingulate), spatial cognition (hippocampus), and motor function (precentral gyrus).
ACHIEVING THE TRIPLE AIM THROUGH A FALLS PREVENTION INNOVATION IN LONG-TERM CARE
Authors: Gray-Miceli Deanna L , Ratcliffe Sarah J , Smith Matthew L , Rogowski Jeannette 
Published: November 2019

Abstract
Falls disproportionately burden frail older adults in long-term care, which is evidenced by the 60% fall rate annually in this setting. Our health systems improvement model, framed by the Health Outcomes Model for falls prevention, is targeted to achieve the triple aim of better health, better care, and better value. Highlighting evidence from three inter-related studies, this presentation describes the impact of a practice change model and its impact on patient, unit/staff, and organizational level factors as related to facility-wide falls prevention. In study one, we used an evidenced-based practice approach and assessment tool to achieve total and recurrent falls reduction over one year by 32% and 25%, respectively (p&lt;0.001). In study two, the annual savings of using this approach was assessed and showed a total savings of $53,531.00, which equates to $700.00 per falling person. In pilot study three, a convenience sample of 15 older adults who were interviewed about their fall by nurses using this approach stated they felt valued and that the nurse cared about their story (n= 6; 40%). Purposive efforts to embed the model and effective strategies for adoption and implementation are presented.
STRATEGIES TO PREVENT FRAILTY: THE POWER OF EARLY DETECTION AND TRAINING OF PROFESSIONALS
Authors: Bleijenberg Nienke , de Wit Niek 
Published: November 2019

Abstract
Aging in place is an important goal for both older adults as well as many health policies worldwide, as it is in the Netherlands. Within an aging society, the number of frail older people with complex care needs living at home is increasing. Despite the various definitions of frailty, it is important to early identify who is at risk in clinical practice in order to prevent functional decline, enhance quality of life, and reduce health care costs. Furthermore, an important requirement is effective collaboration between primary care professionals. Various factors are associated with frailty. However, early detection of frailty and its risk factors such as oral health, nutrition and medication related problems is not part of routine care of professionals. To recognize frailty and its risk factors we started a large proactive integrated primary care program that successfully identified frail older people living at home based on routine care data in the Netherlands. After two-year follow-up, a reduction in acute visits at the emergency department was observed. Next, we performed additional studies focusing on early detection and prevention of risk factors of frailty such as oral health, nutrition, and medication related problems among older people living at home. During this symposium we will present the results of the program, followed by our studies that investigated frailty or frailty related risk factors. Additionally, we will show how we enhanced and evaluated the knowledge and skills of professionals working with frail older people in primary care.
NATIONAL IMPLEMENTATION OF A VHA DIFFUSION OF EXCELLENCE GOLD STATUS PRACTICE
Authors: Garner Kimberly K , Jensen Jamie , Nabholz Lisa , Harding Melissa , Taylor Laura 
Published: November 2019

Abstract
Advance care planning (ACP) is a health behavior that requires in-depth discussions support by trained professionals and motivational strategies to promote goal-setting and actions. Group visits in the healthcare setting can effectively increase an individual’s motivation and self-efficacy for ACP. The Department of Veterans Affairs (VA) has developed the Diffusion of Excellence Initiative to identify and spread innovative practices such as Advance Care Planning via Group Visits (ACP-GV), which uses an interactive group session to engage Veterans in thinking about and planning for their future medical decisions. In these sessions, social workers, nurses, psychologists, and chaplains, facilitate group discussions to increase the chance that a Veteran’s care preferences are known and reflect with their wishes. This also can relieve trusted others of having to make these tough decisions without much guidance. In addition, ACP-GV increases the effectiveness of advance care planning through allowing Veterans to discuss and process this complex topic with their peers. To date, 36 VA Medical Centers (VAMCs) are currently adopting, implementing or sustaining this practice and more than 15,250 Veterans have attended ACP-GV sessions. In addition, another 40 VAMCs are exploring participating this practice. Of those participants, approximately 18-20% develop a new advance directive and 86% set a smart goal to take steps toward advance care planning. Continued dissemination and implementation of this innovative practice is ongoing. After the session, attendees will have practical guidance for implementation of ACP-GV discussions in integrated (VA) or fee-for-service (Medicare) settings.
THE NATIONAL ELDER MISTREATMENT STUDY 8 YEARS LATER: VICTIM MENTAL HEALTH OUTCOMES AND PROTECTIVE FACTORS
Authors: Hernandez-Tejada Melba , Acierno Ron , Anetzberger Georgia , Loew Daniel , Muzzy Wendy 
Published: November 2019

Abstract
The purpose of this study was to conduct an 8-year follow-up of the National Elder Mistreatment Study (NEMS) and specify risk ratios for negative outcomes of elder abuse, including DSM-5 defined depression, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and poor self-reported health. Methodology: Attempts were made to re-contact, via Computer Assisted Telephone Interview, all 752 NEMS participants who reported mistreatment since age 60 at Wave I, as well as a randomly selected sample of non-mistreated NEMS participants Results: 183 NEMS Wave I elder abuse victims and 591 non-victims provided data. In bivariate analyses, elder mistreatment 8 years earlier increased risk of negative outcomes by 200-700%. However, multivariate analyses revealed that Current (Wave II) social support was highly protective against most negative outcomes (excepting PTSD), and even appeared to nullify effects of mistreatment on GAD and poor self-reported health. Conclusions: Outcomes of elder mistreatment have not been studied prospectively in a national sample. The NEMS 8-year follow-up findings indicate a strong relationship between elder mistreatment at Wave I and negative emotional and physical health 8 years later. Fortunately, current (Wave II) social support appears to be both consistently and powerfully protective against most negative outcomes.
A SYSTEMATIC REVIEW AND META-ANALYSIS OF AGE-RELATED DIFFERENCES IN TRUST
Authors: Bailey Phoebe E , Leon Tarren 
Published: November 2019

Abstract
This systematic review and meta-analysis quantifies the magnitude and breadth of age-related differences in trust. Thirty-eight independent data sets met criteria for inclusion. Overall, there was a moderate effect of age group on trust (g = 0.22), whereby older adults were more trusting than young adults. Three additional meta-analyses assessed age-related differences in trust in response to varying degrees of trustworthiness. This revealed that older adults were more trusting than young adults in response to neutral (g = 0.31) and negative (g = 0.33), but not positive (g = 0.15), indicators of trustworthiness. The effect of age group on trust in response to positive and neutral cues was moderated by type of trust (financial vs. non-financial) and type of responding (self-report vs. behavioral). Older adults were more trusting than young adults in response to positive and neutral indicators of trustworthiness when trust was expressed non-financially, but not financially. There was also an age-related increase in self-reported, but not behavioral, trust in response to neutral cues. Older adults were more trusting than young adults in response to negative indicators of trustworthiness regardless of the type of trust or type of responding. The reliability of information about trustworthiness (superficial vs. genuine cues) did not moderate any effects of age on trust. Implications of these findings and directions for future research are discussed.