bluuebunny/crossref_metadata_2025_split huggingface dataset:
RECRUITING OLDER ADULTS WITH DEMENTIA FOR NEUROIMAGING RESEARCH: BARRIERS AND SOLUTIONS
Authors: Atalla Sebastian , Wright Kathy , Anderson Alison , Moss Karen O , Cowan Ronald , McDaniel Ann , Monroe Todd 
Published: November 2019

Abstract
Recruiting participants with dementia for magnetic resonance imaging (MRI) research is prone to inherent barriers including caregiver schedules, mistrust, transportation, expertise of MRI technologists, claustrophobia, and MRI safety requirements. This pilot study aimed to identify barriers and develop strategies for increasing recruitment and retention of persons with dementia in neuroimaging studies and to gauge improvements in recruitment outcomes associated with dedicated recruitment staff. Over a period of five years of active recruitment, a dedicated recruitment specialist and a full-time research assistant screened and enrolled an average of eight participants with dementia per month (8.16), of which, approximately two participants (1.97) successfully completed the MRI testing. The most common barrier was difficulty obtaining surgical records for MRI safety clearance. The most common solutions were thorough prescreening and maintaining a positive rapport with MRI technologists. Our study findings will assist others with engaging persons with dementia and their caregivers in MRI research.
END-OF-LIFE DECISION SUPPORT NEEDS OF DEMENTIA FAMILY CAREGIVERS
Authors: Kwak Jung , Geshell Lisa 
Published: November 2019

Abstract
One third of older adults die with dementia. At the end of life (EOL), persons with dementia require surrogate decision-makers, often their family caregivers, to make important EOL decisions. However, only a handful of evidence-based interventions exist to guide dementia caregivers in surrogate-decision making. In order to examine the acceptability and appropriateness of a decision coaching intervention developed for dementia caregivers, we conducted cognitive interviews (n=4), and one focus group (n=9) with dementia caregivers, and two focus groups with healthcare professionals (n=14) from a large healthcare system and a managed long-term care organization. Guiding questions for interviews and focus groups included: (1) types of decisions (what), and circumstances or triggers (when and how) that call for decision-making support by healthcare professionals, (2) barriers to families receiving decision-making support, and (3) decision support needs of family caregivers. All face-to-face interviews were audio-recorded, transcribed verbatim, and verified for accuracy. Content analysis was conducted to identify and organize themes and patterns emerging from the interview transcripts. Two main themes and subthemes emerged: (1) decision-making challenges and barriers: lack of advance care planning, caregivers’ acquiescence with dementia progression and caregiving role, discontinuing life sustaining therapies, and lack of communication between providers; and (2) decision support for families: advance care planning at different stages of dementia, preparing caregivers for life after the patient’s death, and providing adequate information about benefits and harms of treatment options specific to the practical concerns of patient and family caregivers. These findings provide implications for practice and future research.
ETHNIC DIFFERENCES IN FACTORS INFLUENCING ATTITUDES TOWARD SUICIDE AND PHYSICIAN-ASSISTED SUICIDE AMONG ELDERS
Authors: Martinez Ruben 
Published: November 2019

Abstract
This study examines differences in attitudes toward suicide and physician-assisted suicide in chronic pain scenarios among Latino and White elders. Face-to-face interviews were conducted with 204 elders at four community-based, outpatient care sites in the metropolitan area of San Antonio, Texas. In addition to ethnicity and the suicide-related questions, the interviews collected data on age, gender, marital status, education, income level, acculturation (Latinos only), depression, self-reported health status, daily living functioning, and religiosity/spirituality. In general, there were no ethnic group differences in attitudes, however, the factors associated with those attitudes varied between ethnic groups. Among Whites, attitudes toward suicide and toward physician-assisted suicide were significantly and negatively associated with religiosity. Among Latinos, depression was significantly and positively associated with attitudes toward suicide in chronic pain scenarios, while acculturation was significantly and negatively associated with attitudes toward physician-assisted suicide in chronic pain scenarios. This study’s findings suggest that depression among Latino elders and religion among White elders are determinant factors of attitudes toward suicide in chronic pain scenarios. Future research is needed to confirm our findings with a more heterogeneous study sample, including Latinos from different countries of origin (e.g. Mexican Americans, Puerto Ricans, Cubans); and more heterogeneous ethnic groups in terms of socioeconomic status and educational level characteristics.
THE ART OF CARING: EXPLORING HOW DEMENTIA CARE PARTNERS MANAGE CARE CHALLENGES AND FIND RESILIENCE
Authors: Leggett Amanda N , Gitlin Laura N 
Published: November 2019

Abstract
Approximately 15 million Americans serve as family caregivers for a person with Alzheimer’s disease or another form of age-related dementia and this care can take a physical and emotional toll. Understudied is the process of how families actually provide care in response to care challenges, and how to find respite and resilience amidst care challenges. This symposium considers how caregivers handle daily challenges related to dementia including activities of daily living, behavioral and psychological symptoms of dementia, general health and medical comorbidities. In addition to characterizing care partner’s distinct styles of management (Leggett et al.) and knowledge and capacity to manage health care (Sadak et al.), the papers also provide perspective on positive aspects of care management such as the impact of respite on positive mood (Wylie et al.), the moderating role of relationship quality on responses to behavioral and psychological symptoms of dementia (Chunga et al.) and finally how caregivers’ problem-related, self-growth, and help-related behaviors compose their resilience to care challenges (Zhou et al.). To conclude, our discussant Dr. Laura Gitlin will offer insight on cross-cutting implications across studies and offer perspective on how research, intervention science, and clinical practice may better account for caregiver management styles to promote growth and resilience in caregivers and their care partners with dementia.
PRECISION IN HEALTH CARE FOR DEMENTIA: DO CARE PARTNERS KNOW WHAT THEY DON’T KNOW?
Authors: Sadak Tatiana , Ishado Emily , Borson Soo 
Published: November 2019

Abstract
Clinicians rely on care partners to provide health care at home for people with dementia, who typically have multiple chronic conditions in addition to progressive cognitive decline. We examined the accuracy of care partners’ knowledge of care recipients’ medical conditions and medications, using a benchmark of ≥ 80% match. Of 100 care partners of people with dementia who were recently hospitalized for a major medical illness, nearly all rated their knowledge as high, but about half did not correctly identify care recipients’ medical conditions or know medications, and one fourth did not understand the purpose for which medications were given. A key predictor of poor objective knowledge was care partners’ cognitive status. These findings highlight the importance of objective assessment of care partner knowledge and skills by clinicians who provide health care and advance care planning for people with dementia.
FAMILY CAREGIVERS’ RESPONSES TO DAILY BEHAVIORAL SYMPTOMS OF DEMENTIA: THE MODERATING ROLE OF RELATIONSHIP QUALITY
Authors: Chunga Richard E , Liu Yin , Kim Kyungmin , Zarit Steven H 
Published: November 2019

Abstract
Providing care for persons with dementia (PWD) is frequently regarded as highly stressful, but how caregivers perceive care-related stressors depends on a variety of contexts. Research has demonstrated that relationship quality between the caregiver and receiver – as an important dyadic context – can influence the magnitude of this perceived distress. Using 8-day diary data from 173 family caregivers of PWD (day N = 1,359), this study examined the moderating effect of relationship quality on caregivers’ stress responses to daily behavioral and psychological symptoms of dementia (BPSD), comparing within- and between-person effects. Multilevel models suggested differences in the association between BPSD occurrence and perceived distress of BPSD (i.e., negative within-person association, but positive between-person association). However, we found that both associations were moderated by relationship quality; that is, better dyadic relationship quality seemed to be protective against distress at both within- and between-person levels.
A SCOPING REVIEW OF KNOWLEDGE EVALUATION INSTRUMENTS FOR FORMAL AND INFORMAL DEMENTIA CAREGIVER PROGRAMS
Authors: Resciniti Nicholas V , Tang Weizhou , Tabassum Masroora , Al-Hasan Dana , Lohman Matthe C , Spencer Mindi , Friedman Daniela 
Published: November 2019

Abstract
With the increase in our older adult population there is a need for dementia training for informal and formal dementia caregivers. The objective of this scoping study was to assess dementia knowledge instruments utilized in educational programs and interventions intended for formal and informal dementia caregivers. Scoping review methodology was used to search PubMed, PsycInfo, CINAHL, and Web of Science with tailored database search terms. The search yielded 8,101 results, with 35 studies meeting inclusion criteria. Studies were conducted in eight countries, had varying study designs (RCTs=9, non-RCTs=6, one-group study design=20), and utilized previously published (19) and author-developed (16) instruments. Only two studies focused on minority populations. While author-developed instruments may be more relevant and time-saving, studies should strive to validate instruments or use previously published instruments to help standardize findings across studies and better understand the effects of education programs on caregiver knowledge.
THE TIPPING POINT STUDY: DIGITAL DETECTION AND DECISION SUPPORT FOR OLDER ADULTS AND FAMILIES
Authors: Shea Kimberly D , Shea Kimberly D 
Published: November 2019

Abstract
In 10 years, the United States will experience a “dependency” ratio of one working age adult (20-64 years old) to one non-working person (&gt; 65 or 85 years old will comprise 19 million of the non-working people (US Census Bureau, 2008). Busy working adults will have to be vigilant to determine when to make life-changing decisions about health and safety issues for people that depend on them. Older adults have gradual and cumulative physical and/or psychological aging changes or can experience significant events. Knowing when to make a life-changing decision, such as when to intervene with independent living due to safety risks, is difficult even when situations have constant vigilance. Eventually, older adults experience a seemingly abrupt, sudden and absolute point where a life changing decision must be made. This is the Tipping Point. Health data, derived from unobtrusive wearable sensors, are algorithmically synthesized to provide critical information on impending concerns via an electronic portal will help the busy working adult to predict and prevent the Tipping Point. This application of precision health care results in targeted and personalized education thus avoiding a potentially catastrophic Tipping Point. This symposium provides insight into five aspects of the Tipping Point: 1) significance of identification, 2) theoretical foundation for environmental and cultural sensitivity, 3) feasibility outcomes from a Mexican American population, 4) methodology for synthesizing quantitative metrics from multivariate streams of data, 5) creation of a culturally sensitive electronic portal to display predictive information and education about consequences
LAWTON’S THEORY OF PERSON-ENVIRONMENT FIT: THEORETICAL FOUNDATIONS FOR DETECTING TIPPING POINTS
Authors: Crist Janice D , Lacasse Cheryl , Phillips Linda R , Liu Jian 
Published: November 2019

Abstract
Caregiving families often experience “tipping points,” changes that forever alter their lives, such as a fall with a fractured femur. Tipping points for older adults can be conceptualized as an interaction between individuals and their environments. According to Lawton’s theory of person-environment fit (Lawton, 1983, 1985), physical and social environments and the person’s behavior are shaped by one another in a dynamic, ever-changing process. For older adults, the relationship between “environmental press,” or the mismatch between the person and his/her environment, and adaptation to that environment is mediated through one’s ability to cope. When stressors in health, cognition, or caregiver availability occur, environmental press may heighten, leading to a tipping point. In this paper the authors clarify how environmental press theory provides a foundation for studying early detection of impending tipping points and facilitating decisional support of families for choosing the right long-term support services at the right time.
TIPPING POINTS PILOT STUDY: WEARABLE DEVICES AND ALGORITHMS
Authors: Peterson Rachel L , Shea Kim , Luque Kayla , Powell Jessica , Liu Jian , crist Janice 
Published: November 2019

Abstract
Little is known about the use and acceptability of fitness watches (e.g. Fitbit) by diverse older adults, or how data from affordable (&lt;$40) devices could be triangulated with self-report data to predict adverse health outcomes. We investigated interest and acceptability of fitness watch technology among Mexican American older adults via a week-long trial. Participants were asked to consistently wear the watches and complete daily diaries of activity, questionnaires, and a semi-structured interview. The watch data was triangulated with data from the daily diaries and questionnaires to validate its usefulness in developing algorithms that could detect important physiological transitions that lead to tipping points. Interview data was qualitatively analyzed and coded for barriers and facilitators of watch use and acceptability. Preliminary results suggest that participants are eager and willing to wear a fitness device. Participants reported interest in monitoring their health and using the device to track and improve physical activity.
DEVELOPING COMPETENCE IN QUALITY IMPROVEMENT: A MODEL FOR GEROPSYCHOLOGY TRAINING
Authors: Jacobs Lindsey , Mlinac Michelle 
Published: November 2019

Abstract
Quality improvement (QI) efforts are imperative to ensuring patient-centered, safe, effective, timely, efficient, and equitable healthcare. QI training is well-established in the fields of geriatric medicine and nursing but is lacking in geropsychology. Clinical geropsychologists are in need of QI knowledge and skills, as the population they serve is often vulnerable to healthcare disparities due to complex medical, neurological, and/or psychiatric presentations, limited resources, and low social and/or instrumental support. This presentation will describe a developmental model of QI training, driven by initial pilot data from geropsychology trainees, analysis of geropsychology graduate program marketing materials, and expert opinion from geropsychologists who have QI implementation experience. Consistent with the Pikes Peak Competencies for Geropsychology Training, this model delineates aspirational QI knowledge and skills, as well as recommendations for incorporating QI training into geropsychology at progressing levels of competency from graduate school through independent clinical practice.
LONGITUDINAL HEALTH CONSEQUENCES OF CHILDHOOD ADVERSITY: THE MEDIATING ROLE OF PURPOSE IN LIFE
Authors: Homan Kristin J 
Published: November 2019

Abstract
Adverse childhood experiences have long-term detrimental effects on physical health. Although biological, behavioral, and social factors have been explored as intermediate mechanisms, little research has explored psychosocial factors as potential mediators. This study examined whether purpose in life longitudinally mediates the relationship between childhood adversity and two measures of adult health (self-rated health and functional limitations). Data were obtained from 3,871 participants in the Midlife in the United States (MIDUS) study. We tested a cross-lagged mediation model from childhood adversity to adult health via purpose in life, controlling for baseline measures of health and purpose in life. Good model fit was achieved indicating that childhood adversity is associated with poorer adult health through direct and mediated paths. Childhood adversity may restrict young people’s search for purpose in life, and reduced purpose in life is ultimately associated with poorer subjective health and increased functional limitations.
ESPO/BEHAVIORAL AND SOCIAL SCIENCES: SOCIAL RELATIONSHIPS, ISOLATION, AND WELL-BEING
Authors: Stokes Jeffrey E , Irani Elliane , Thomas Patricia A 
Published: November 2019

Abstract
The purpose of this symposium is twofold: (1) To present innovative research linking social relationships, isolation, and well-being among older adults, and (2) To highlight new and emerging scholars in the Behavioral and Social Sciences section of GSA. The papers in this symposium examine the repercussions of numerous relationships for well-being in later life. Huo and colleagues examine the impacts of contact with close and not-close social partners on physical activity, highlighting differences by gender. Polenick and colleagues focus on perhaps the closest of relationships in later life: marriage, analyzing longitudinal associations between discordant chronic conditions and depressive symptoms among older couples. Upenieks takes an intergenerational perspective, examining the embeddedness of adult children in older adults’ networks in the context of both depression onset and chronically high depressive symptomology. This paper also highlights the consequences of well-being for older adults’ social isolation, and not merely the reverse. Hladek and colleagues explore the subjective side of isolation among older adults with chronic disease, noting links between loneliness and self-efficacy that may have clinical and interventional significance. Lastly, Meinertz and Gilligan explore potential gaps in service provision that may increase rural older adults’ risk of isolation and abuse. Taken together, these five papers underscore the importance of various social relationships for older adults’ well-being, and suggest implications for how best to promote healthy aging. As discussant, Thomas will assess the strengths and limitations of these papers, and consider the contributions these studies – and new scholars – can make to the field.
AGING APPEARANCE AND ITS SIGNIFICANCE TO WELL-BEING
Authors: Woodspring Naomi 
Published: November 2019

Abstract
Ageing is a profoundly embodied process, yet elder’s concerns about appearance are perceived, by many, as trivial. Notions of appearance as a core human concern continues as a significant aspect throughout our lives. Self-presentation choices convey a sense of our identity. This paper is based on a qualitative study which aimed to explore current notions of beauty and age. A diverse group of postwar women (born between 1945 -1955) from the US and the UK were interviewed with a focus on their own self-presentation and the acts of seeing and being seen. This paper explores the some of the findings from this study. The majority of women, and the all women of colour, reported feeling more confident in their appearance and appreciative of other older women’s appearance. This led to a more robust sense of well-being and suggests that age and appearance may be significantly linked to well-being.
INTIMACY IN LATER LIFE: A POTENTIAL PATHWAY FOR IMPROVING WELL-BEING IN OLDER WOMEN
Authors: Flores Renee J 
Published: November 2019

Abstract
Despite benefits to overall health and well-being, healthcare professionals’ knowledge and research is limited in regards to older women’s sexuality and intimacy desires. There are barriers that impede fulfilling these desires and lack of understanding hinders ways to address this issue, which negatively affects the well-being of older women. A sexuality and intimacy survey of 29 women between the ages of 60-86 revealed that the majority were having sex at least once a month and expressed the desire to increase the frequency of sexual encounters. These data suggests that later-life sexuality and intimacy encounters are important for some women. Recognizing these desires could prompt responses that could greatly influence the quality of life in older women. A broader public health discussion needs to occur in order to promote awareness and optimize overall well-being.
THE QUALITY OF DENTAL CARE IN NURSING HOMES: VARIATION BY FACILITY AND MARKET CHARACTERISTICS
Authors: Ye Zhiqiu , Wu Bei 
Published: November 2019

Abstract
Nursing home (NH) residents are disproportionately affected by poor oral health. But little we known about the root causes. We analyzed the 2000-2016 national inspection survey data for all certified-NHs (n=248,975 facility-years). Dental care performance was measured by two designated deficiency citations. Generalized estimating equation models were used to predict if the NH facility and market characteristics were associated with low performance. The rates of deficiency citation tripled from 1.2% in 2000 to 3.4% in 2016 (p&lt;0.001) with substantial variation across states. NHs with more minority residents and poorer resources (higher share of Medicaid and lack of registered nurse), and NHs with high competing priorities (larger, for profit, chain-affiliated and urban locations) were more likely to receive deficiency citations. Residents in these facilities are at greater risks of poor oral health. This presentation will provide discussion on relevant policy and practice to improve dental care quality in nursing homes.
THE MODERATING ROLE OF BIRTHPLACE ON DENTAL CLEANING SERVICE AMONG CHINESE OLDER ADULTS IN HAWAII
Authors: Liu Sizhe , Zhang Wei , Zhang Keqing , Wu Bei 
Published: November 2019

Abstract
Regular dental cleaning is vital to maintaining good oral health. This study aims to identify socio-demographic characteristics that are associated with the use of dental cleaning services among Chinese older adults in Honolulu, Hawai’i. In addition, we examine if birth-place moderates these associations. The data for this study were collected from 398 Chinese older adults living in Honolulu. Results from multivariate logistic regressions showed that those who were married and with higher levels of education were more likely to have their teeth cleaned within the past year compared to those who were not married or with lower levels of education. These significant associations were only found salient for the foreign-born when the moderating role of birth place was accounted for in the model. These differences may be partially due to the impact of acculturation and the knowledge of oral health and dental services.