bluuebunny/crossref_metadata_2025_split huggingface dataset:
ELDER MISTREATMENT AND ANXIETY SYMPTOMS AMONG U.S. CHINESE OLDER ADULTS
Authors: Chao Ying-Yu , Chang Yu-Ping , Dong XinQi 
Published: November 2019

Abstract
Purpose: Elder mistreatment is a critical public health issue across all cultural backgrounds. However, we have limited understanding of the mental health outcomes of elder mistreatment among older Chinese Americans. This study aimed to examine the association between different types of elder mistreatment and anxiety symptoms among U.S. Chinese older adults. Methods: Data were from the Population Study of Chinese Elderly in Chicago (PINE), a community-based participatory research study of 3,157 Chinese older adults in the Greater Chicago area. Elder abuse was assessed with the overall abuse screening test and Modified Conflict Tactic Scale. Anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS-A). Multivariate logistic regression analyses were performed. Results: Participants had a mean age of 72.8 ± 8.3 years old (range 60-105). After controlling for potential covariates, participants with overall abuse (OR = 1.76, 95% CI: 1.57-1.98, p &lt; .001), psychological abuse (OR = 1.76, 95% CI: 1.53-2.02, p &lt; .001), physical abuse (OR = 1.56, 95% CI: 1.03-2.36, p &lt; .05), and financial exploitation (OR = 1.24, 95% CI: 1.06 – 1.44, p &lt; .001) were more likely to have anxiety symptoms. However, sexual abuse was not significantly associated with anxiety symptoms (p = 0.83). Conclusion & Implications: Our findings indicate that elder mistreatment may result in anxiety symptoms among Chinese older adults. Further studies can examine whether Chinese cultural traits (e.g., face, harmony) influence the relationships between elder mistreatment and anxiety symptoms.
AGING WITH SCHIZOPHRENIA: RACIAL DISPARITIES IN COGNITIVE IMPAIRMENT
Authors: Dobbins Sarah , Hubbard Erin , Leutwyler Heather C 
Published: November 2019

Abstract
Introduction: Cognitive impairment (CI) is a core feature of schizophrenia (SCZ). Comorbidities such as substances/smoking, metabolic syndrome, and medications contribute to CI. There are racial disparities in CI in the general US population. No study has evaluated CI racial disparities among people with schizophrenia (PWSCZ). The aims of this study were to describe the clinical/psychosocial correlates and racial disparities in CI. Methods: Cognitive performance in PWSCZ over 55 years old was measured using MATRICS Consensus Cognitive Battery (N=66). We calculated age- and gender-corrected scores for global cognitive performance, which represent number of standard deviations away from the mean of the MCCB normative sample. Clinical and sociodemographic data were collected. A counterfactual approach was used to explore mediation of CI through education. Results: Our “all-comer” convenience sample represented 57.6% white, 25.8% black, and 16.6% other non-white groups. There was a black/non-black disparity in cognitive score (-2.33 v.s. -1.68, t=2.843, p&lt;.01). This difference remained significant in a regression model adjusted for age, substance use, smoking, education, antipsychotic medication, and positive/negative symptoms (-.6611, [95%CI:-1.12,-.20], overall F8, 57=3.690, p=.0016). In the mediation analysis, education accounted for 19% of the disparity in CI. In the counterfactual scenario in which education was distributed equally, education accounted for 48% of the disparity. Conclusion: There are significant racial disparities in cognitive performance among older PWSCZ, and educational attainment may account for a sizable portion of the disparity.
FORMAL TRAINING IN TELEHEALTH UNIQUELY PREPARES AN INTERDISCIPLINARY WORKFORCE IN GERIATRICS AND GERONTOLOGY
Authors: Nearing Kathryn A , Lum Hillary D , Hardland Janna , Church Skotti , Hartz Stephanie 
Published: November 2019

Abstract
Geriatric Research Education and Clinical Centers (GRECCs) are centers of excellence funded by the Veterans Administration for the advancement and integration of research, education and clinical activities in geriatrics and gerontology to improve the health, and health care of, older Veterans. The GRECC Connect program expands access to care for rural-residing older Veterans and caregivers. Eastern Colorado GRECC Connect integrates Associated Health Trainees (Audiology, Psychology, Social Work, Pharmacy) and Geriatric Medicine Fellows into interdisciplinary tele-geriatric and tele-palliative care consultations provided to outlying community-based outpatient clinics. The formal telehealth training includes: (1) an initial didactic orientation to introduce skills, common challenges, and important tips when working with older patients and caregivers via telehealth; (2) direct observation and modeling by preceptors, followed by a structured opportunity to debrief what the trainee observed and address questions; and (3) opportunities to provide Geriatric telehealth services, supported by the interprofessional team and feedback and reflection. A formal competency assessment, standardized observation protocol and debriefing guide support the development and assessment of telehealth competencies. During exit interviews, trainees indicated that these experiences offered unique opportunities to develop their clinical skills, particularly related to active listening and communication. They identified their involvement with GRECC Connect as a highly valued aspect of their Geriatrics training. Rigorous training in telehealth is an essential aspect of workforce development in Geriatrics and Gerontology given the concentration of older adults in rural areas. During this session, we will highlight the value of telehealth training for workforce development in Geriatrics and Gerontology.
THE LAST MONTH OF LIFE: AN EXPLORATORY REVIEW OF THE NATIONAL HEALTH AND AGING TRENDS STUDY
Authors: Latimer Abigail , Montemuro-Rode Lauren , Garrison Brianna , Gibson Allison 
Published: November 2019

Abstract
Approximately 80% of Americans prefer to die at home. Hospice and palliative care services are associated with improved pain and symptom management, increasing capacity to meet preferences for end-of-life care at home. However, according to the NHPCO (2018) only 48% of Medicare beneficiaries were enrolled in hospice at the time of death. This poster presents trends in the last month of life for adult Medicare beneficiaries age 65 or older examining the influential factors contributing to the quality of end-of-life experiences. A cross-sectional survey design was utilized with the National Health and Aging Trends Study (NHATS). Descriptive and inferential statistics were generated to describe a sample of persons (n= 241) who died in 2017. The sample demographics are predominately white (77.6%) females (61.4%) over 90 years old (42.4%). 29.5% of individuals died at home, 29.5% at the hospital, and 27% at a nursing home. Only 32.2% had hospice care in the last month, with many experiencing pain (71.1%), shortness of breath (54.7%), and anxiety/sadness (56.9%). There were 33.6% of participants who lived alone at death and 70% did not receive hospice care. The majority of these individuals were widowed (70.4%) and 33.3% died in the hospital. The other 28.4% died at their home or someone else’s and 25.9% died in a nursing home. Many older adults face multiple barriers to experiencing a quality end-of-life experience. Future research should examine the challenges facing those living alone at time of death.
REGIONAL VARIATIONS IN ENGAGEMENT IN ADVANCE CARE PLANNING AMONG RACIALLY AND ETHNICALLY DIVERSE OLDER ADULTS
Authors: Kim Kyeongmo , Hong Michin , Kim Giyeon 
Published: November 2019

Abstract
Advance care planning (ACP) has positive effects on the quality of end-of-life of older adults. Given the influence of environmental factors on health and behavioral health behaviors among older adults, geographic variations may exist in engagement in ACP. This study examined whether 1) there was a regional variation in engagement in ACP and 2) there was a racial/ethnic difference in ACP across regions (Northeast, Midwest, South, and West). Drawn from the 2012 National Health and Aging Trends Study, 2,015 Medicare beneficiaries in the U.S. were included in analyses. Results from logistic regression analysis showed that older adults living in the West (OR=1.66, p=0.003) and the Midwest (OR=1.39, p=0.032) were more likely to be engaged in ACP compared to those living in the South. African Americans (OR=0.31, p&lt;0.001), Hispanics (OR=0.30, p&lt;0.001), and other races (OR=0.49, p=0.04) were less likely than their white counterparts to be engaged in ACP. We also conducted four separate logistic regression analyses by regions. In the Northeast, Midwest, and South, African Americans were less likely to be engaged in ACP compared to whites. In the West, Hispanics were less likely to be engaged in ACP compared to whites. Findings from this study provide a clear picture of racial/ethnic disparities in ACP across different regions in the U.S., suggesting where to target for future interventions to improve engagement in ACP among racial/ethnic minorities. Future research should be conducted at lower levels of geographic areas to find modifiable geographic factors to improve engagement in ACP among older adults.
VARIATION IN ADVANCE DIRECTIVES TIMING BETWEEN END-STAGE RENAL DISEASE PATIENTS AND CANCER PATIENTS
Authors: Wang Yu-Hsuan , Enguidanos Susan 
Published: November 2019

Abstract
The United States has the third highest prevalence and the second highest incidence of End-Stage Renal Disease (ESRD). ESRD is associated with high mortality and lower quality of end-of-life experiences. Having an advance directive (AD) is associated with better care at the end of life. Although past ACP completion rates in ESRD patients has been studied, little is known about its timing differences between ESRD and cancer patients. This study investigates the timing difference of AD completion between ESRD and cancer patients We conducted logistic regression to analyze data from the Health and Retirement Study, a nationally representative longitudinal survey of older adults. The analytic sample included exit interviews from 2012 to 2016 among 971 proxies of deceased with ESRD or cancer. Among the sample, 47% of decedents completed an AD; 44% of cancer patients and 48% of ESRD patients. Being a racial minority (OR=0.38, p&lt;0.001), and lower education (OR= 0.63, p=0.001) were associated with lower AD completion rates. No significant differences in AD completion rates were found between cancer patients and ESRD patients. Compared to cancer patients, ESRD patients were more likely to complete ADs more than one year before death (OR=3.15, p=0.001). However, there were no significant difference between cancer patients and ESRD patients in AD completion rates in the three months before death. Although both samples had comparable rates of AD completion, compared to cancer patients, ESRD patients tend to document care preferences earlier. Further studies are needed to investigate factors related to early documentation of ADs.
THE INTERACTIVE ASSOCIATION OF EDUCATION AND NEIGHBORHOOD ENVIRONMENTS ON COGNITIVE DECLINE
Authors: Esposito Michael H , Clarke Philippa , Sol Ketlyne , Finlay Jessica , Hicken Margaret , Judd Suzanne , Wadley Virginia 
Published: November 2019

Abstract
Education’s ambiguous association with cognitive decline may be due to unmeasured effect heterogeneity, including variation across environmental contexts. In areas with more social and physical resources, education may play less of a role in shaping cognitive trajectories. In areas with fewer resources, educational capital may be more important for slowing cognitive decline. Using multilevel models, this paper examines whether education’s impact on cognitive trajectories varies among neighborhoods defined by differential densities of social and physical resources. Findings suggest that education plays a consistent role in shaping cognition across contexts. Lower education is associated with lower cognitive function (High school vs College: b=-2.97; sd=0.16) and marginal differences in rates of decline (College vs High School: b=0.04; sd=0.03). However, these patterns are invariant across neighborhoods. Findings reiterate the importance of education for cognitive function in late life, and stimulate further research on other contextual factors that may affect rates of cognitive decline.
CHILDHOOD CONDITIONS AND ARTHRITIS AMONG MIDDLE-AGED AND OLDER ADULTS IN CHINA: THE MODERATING ROLES OF GENDER
Authors: Lu Nan , Wu Bei , Jiang Nan , Dong Tingyue 
Published: November 2019

Abstract
This study examined the moderating effect of gender on the relationship between childhood conditions and arthritis among middle-aged and older adults in China. The data were derived from the 2015 wave and the life history module of the China Health and Retirement Longitudinal study. The sample included 19800 respondents age 45 and over. Multiple imputation was used to handle the missing data. A multilevel logistic regression was used to test the proposed models. Childhood socioeconomic status, mother’s education, subjective health, access to health care and medical catastrophic event were found to be significant factors associated with arthritis in later life, after controlling for adulthood and older age conditions. Furthermore, the effects of childhood socioeconomic status on arthritis were found to be higher among men than women. The findings highlight the important role of childhood conditions that affect the onset of arthritis in later life. Policy and intervention implications are discussed.
DEATH NARRATIVE IN 19TH-CENTURY CHINA: HOW DID NEWSPAPERS FRAME DEATH AND DYING?
Authors: Lou Yifan 
Published: November 2019

Abstract
This study explored the death narrative in the late Qin dynasty as expressed in Chinese newspapers in the 19th century. Using textual analysis to analyze the 646 pieces of news containing death-related topics, this study revealed the discourse regarding death and dying during this period can be understood at three levels: (a) euphemism of death: the language of death and its relationship with power and social hierarchy; (b)definition of “good death”: including preferences for location, cause, and experiences of death and dying; and (c) Western influence on the death narrative: missionaries’ efforts to incorporate Catholic and Chinese traditions to attract more believers. This paper argues that the current Chinese people’s perception of death is inherited and evolved from those historical roots, which has practical implications for the systematic development of hospice care in China. Suggestions include changing the language used in the hospice policy, emphasizing the importance of confidentiality in home-based hospice programs, and building a hospice system based on public perceptions of so-called “good death” while advocating for individualized definitions of this concept.
FLOURISHCARE: HELPING OLDER ADULTS FLOURISH IN RURAL COMMUNITIES
Authors: Faul Anna , D’Ambrosio Joe , Yankeelov Pamela , Cotton Samantha G , Austin Megan , Huff Mona , Handy Darla 
Published: November 2019

Abstract
Flourishing represents living within an optimal range of human functioning. To foster older adults flourishing, our FlourishCare model of care coordination was developed as part of a HRSA Geriatric Workforce Enhancement Program (GWEP) to transform PC sites by delivering coordinated services in 6 rural KY counties. FlourishCare is unique in its integration of academic teams, community health teams and mental health specialists within age-friendly primary care health systems.FlourishCare recognizes that many of the largest drivers of health care costs fall outside the clinical care environment. One of the major components of Flourish is the involvement of community health navigators (CHNs), community education coordinators (CECs) and community coalitions working with the health teams to respond to the social determinants of health. For each patient that is referred and agrees to participation in the program, the CHN performs Flourish clinical and home assessments and obtains medical records. A repeated measure designed was used to assess the 60 patients who have baseline assessments results along with at least a 6-month assessment and in some cases a 12-month assessment (n= 20). Patients have demonstrated a significant increase in their flourishing across all determinants of health. There was also a significant improvement the total FI from pre to post-test at 6-month. These outcomes illustrate that it is important to operationalize the outcomes for older adults by evaluating the success as the ability of the older adult to flourish when they can maintain current functioning, access to resources have sufficient support systems in place.
NEIGHBORHOOD CONDITIONS AND SELF-NEGLECT IN LATER LIFE: LONGITUDINAL EVIDENCE FROM THE NSHAP
Authors: Upenieks Laura , Iveniuk James , Schafer Markus H 
Published: November 2019

Abstract
Self-neglect includes persistent inattention to personal hygiene and the conditions of one’s immediate living environment and is known to be associated with an increased risk of mortality among older adults. Although previous studies have shown that many individual factors predict self-neglect, neighborhood characteristics have received much less attention. Extant research has yet to consider connections between the conditions of one’s neighborhood and self care over time. Using nationally representative longitudinal data from the National Social Life, Health, and Aging Project (NSHAP), we consider several features of neighborhood context in later life, including self-reported perceptions of neighborhood cohesion and neighborhood danger, neighborhood disorder (measured by interviewer ratings), and concentrated neighborhood disadvantage (using census data). Adjusting for individual-level factors (including social connection, physical and cognitive health, and demographics), results from both lagged dependent variable and cross-lagged panel models find higher levels of neighborhood disorder to be associated with higher self-neglect scores (measured by interviewer ratings) over time. Social cohesion, perceived neighborhood danger, and collective efficacy were not associated with self-neglect when controlling for neighborhood disorder. These findings suggest that improving neighborhood disorder may be an effective approach for self-neglect prevention in later life
JOINING AND REMAINING: FACTORS THAT CONTRIBUTE TO MEMBERSHIP IN A VILLAGE
Authors: Dunkle Ruth E , Harlow-Rosentraub Karen , Pace Garrett T , Coppard Larry 
Published: November 2019

Abstract
Many older people want to age in place with one popular model of care being the Village Model. Understanding why people join and why they continue as members are important considerations for a Village to survive. Utilizing open-ended data from a representative sample of current members of a Village (N=100), we examined the reasons for people becoming members as well as continuing their membership. Twenty six percent of the sample were men, age ranged from 50-95, 30% lived alone and 58% believed that their health was very good. Data were coded by three researchers with discrepancies resolved by discussion to refine the codes. Three categories were identified: instrumental, social, and altruistic. The most frequent reason for joining was instrumental (35%) where the member wanted the services provided by the Village. It was also the most frequent reason for continuing membership (57%). An analysis was also conducted to examine predictors of reasons for joining and continuing membership in the Village. These included, age, gender, health, and living alone. Results indicate that men were less likely to join or continue their membership for instrumental reason compared to women, and members who live alone were more likely to become a member for social reasons. When age at entrance into the Village was examined, each increasing year of age was associated a .01 increase in the probability of continuing as a member for instrumental reasons. Findings provide guidance in issues related to sustaining membership in a Village.
EFFECTS OF AGE ON CONNECTION TO NATURE AND POSITIVE AFFECT
Authors: Carney Amy Knepple , Patrick Julie 
Published: November 2019

Abstract
Socioemotional selectivity theory positis that when we feel our time as limited, when a person ages, emotion based goals become a priority (Carstensen, Isaacowitz, & Charles, 1999). Although previous studies have shown that all age groups benefit from a connection to nature (CN; Bisceglia, Perlman, Schaack, & Jenkins, 2009; Han, 2008; Mayer et al., 2009), there have been no studies conducted to determine if there are age differences in CN and how that relation contributes to positive affect. Analyses were conducted with a sample size of 152 participants with an average age of 37.55 years (SD = 15.64; Range 18 -89). Age was significantly positively associated with CN, r(151)=.16, p&lt;.05. Additionally, an ANOVA showed that middle-aged to older adults reporting significantly higher CN than younger adults. The relation of positive affect to age and CN was then examined. In the analysis examining the effects of age and CN on positive affect, the model was significant, F(3, 146)=8.48, p&lt;.05, R2 = .15. Both, CN, and age, uniquely contributed to the variance accounted for on positive affect, although, the interaction of CN and age did not uniquely contribute to the variance. These results may be indicative of socioemotional selectively theory, in that older adults were choosing connection to nature because it fulfilled more emotional activities/goals than the younger adults in the study. Because previous research has all but ignored the association of CN and age and their relation to positive affect, it should be considered in future research.
FAST-FOOD RESTAURANTS: A NEIGHBORHOOD RESOURCE FOR COGNITIVE FUNCTION AMONG AGING AMERICANS?
Authors: Finlay Jessica M , Clarke Philippa , Esposito Mike , Gomez-Lopez Iris , Judd Suzanne , Wadley Virginia 
Published: November 2019

Abstract
In this exploratory mixed-methods sequential design study, interviews with 125 adults aged 55-92 (mean age 71) living in the Minneapolis (Minnesota) metropolitan area suggest that large-chain fast-food restaurants such as McDonald’s may serve as reservoirs of cognitive function. Thematic analysis revealed perceived benefits of fast-food settings for older adults including familiarity and comfort; affordability; sociability with friends, family, staff, and customers; and entertainment (e.g., newspapers, crosswords). To further test these observations, we analyzed data from urban and suburban REGARDS participants. Preliminary multilevel regression models found that participants residing within 5 kilometers of a McDonald’s restaurant exhibited higher cognitive function than similar individuals who live further from said organizations (b=0.31; se=0.12). The results complicate understanding of fast-food settings and prompt further research that tests whether restaurants can serve as community spaces for older adults to help buffer against cognitive decline by fostering social interaction and mental stimulation.