bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EFFECT OF COGNITIVE TESTING ON STATE ANXIETY AND CORTISOL REACTIVITY IN YOUNGER AND OLDER ADULTS
Authors: Hughes MacKenzie L , Pearman Ann , Neupert Shevaun D 
Published: November 2019

Abstract
Although it is well established that stress is negatively associated with cognitive functioning, less is known about age differences in the effects of stressors and anxiety on state anxiety and physiological reactivity (i.e., changes in cortisol). The current study examined state anxiety and cortisol reactivity during a series of cognitive tasks in a sample of younger (n=26) and older (n=29) adults. Participants completed the State-Trait Anxiety Inventory prior to cognitive testing and provided six salivary cortisol samples throughout one testing session: two cortisol samples prior to cognitive testing, three samples during testing, and one sample after testing. Six cognitive tasks were administered that measured attention span, declarative memory, and processing speed. Results indicated a significant interaction effect of age by time with younger adults’ cortisol linearly decreasing during the testing session and older adults’ cortisol showing a quadratic trend. A second interaction was found between age and state anxiety whereby older adults who reported more anxiety had higher cortisol levels during the cognitive testing session than both the older adults who reported low levels of anxiety and the younger adults. Only age (not cortisol or anxiety) was significantly related to cognitive performance. Results from this study suggest that standard cognitive testing could be anxiety producing for older adults, particularly for those who are already anxious. Future investigations should examine age-related differences in the processes linking anxiety and cortisol to specific types of performance, such as memory and attention.
THE OPIOID EPIDEMIC IN LONG-TERM CARE: A STAFF PERSPECTIVE
Authors: Hemmert Rachael , Dull Gabriella E , Edelman Linda S 
Published: November 2019

Abstract
Opioid-based analgesic therapy is a common treatment for moderate to severe pain among long term care (LTC) residents. It has been estimated that 60% of LTC residents have an opioid prescription. Of these, 14% use opioids as part of a long term pain management strategy. LTC residents are particularly vulnerable to opioid misuse, exhibiting higher rates of adverse drug events. However, addressing pain, polypharmacological needs and resident well-being in the LTC setting is challenging. More research and education regarding opioid use in LTC is needed. The Utah Geriatric Education Consortium conducted interprofessional focus groups with LTC partners to 1) determine educational needs of staff regarding opioid use, and 2) gather qualitative data about the pain management experiences of staff when working with residents and families. Staff identified the following training needs: pain manifestation and assessment; certified nurse assistant education on opioid use; non-pharmacological options for pain management. Review of staff’s perception of the intersection of opioids, family and staff in a LTC setting revealed that 1) family is concerned about opioid use; 2) conversely, staff may not see opioid use as a problem; and 3) non-pharmacological options for pain management are often costly and unavailable to those in LTC. Identifying educational needs of LTC staff will help guide the development of educational materials and provide baseline data for future assessments of the impact of opioid education on long-term care patient outcomes.
TRENDS IN OPIOID USE IN LONG-TERM CARE NURSING HOME RESIDENTS WITH DEMENTIA
Authors: Mehta Hemalkumar B , Kuo Yong-Fang , Westra Jordan , Raji Mukaila , Goodwin James S 
Published: November 2019

Abstract
We examined opioid use in long-term care nursing home residents with dementia. This retrospective cohort study used Minimum Data Set linked Medicare data, 2011-2016, and included long-term care episodes for residents 65+ years who survived 100+ days each year (592,211 episodes for 256,207 residents). Cognitive status at first annual assessment was classified as none/mild, moderate and severe impairment. Overall opioid use, prolonged opioid use (prescription supply 90+ days) and long-acting opioid use were identified from Medicare part D. Descriptive statistics were used to describe opioid use by cognitive impairment. Cochrane Armitage trends test was used to determine trends in opioid use. 114,622 (19%) patients had severe and 129,257 (22%) had moderate dementia. Overall opioid (none/mild=15.4%, moderate=13.9%, severe=9%), prolonged opioid (none/mild=5.2%, moderate=4.5%, severe=3.2%) and long-acting opioid use (none/mild=1.1%, moderate=0.9%, severe=0.3% ) were lower in patients with advanced dementia. Opioid use was significantly higher in females and Whites and varied by states. Substantial increase was found in overall opioid and prolonged opioid use from 2011 to 2016, with greater increase in none/mild and moderate dementia patients. For example, prolonged opioid use increased by 69% in none/mild and 71% in moderate dementia patients compared to 52% in severe dementia patients (p&lt;0.0001). Long-acting opioid use decreased, with a greater decline in none/mild (69%) and moderate (71%) dementia patients compared to severe dementia patients (58%) (p&lt;0.0001). Contrary to decreasing opioid use in community setting, overall and prolonged opioid use increased in nursing home residents. Future studies should identify the reasons behind increased use.
AN EXPLORATION OF HOME CARE NURSES’ EXPERIENCES IN DEPRESCRIBING OF MEDICATIONS FOR OLDER ADULTS IN THE COMMUNITY
Authors: Sun Winnie 
Published: November 2019

Abstract
The aim of this study is to explore the barriers and enablers of deprescribing from the perspectives of home care nurses, as well as to conduct a scalability assessment of an educational plan to address the learning needs of home care nurses about deprescribing. This study employed an exploratory qualitative descriptive research design, using scalability assessment from two focus groups with a total of eleven home care nurses in Ontario, Canada. Thematic analysis was used to derive themes about home care nurse’s perspectives about barriers and enablers of deprescribing, as well as learning needs in relation to deprescribing approaches. Home care nurse’s identified challenges for managing polypharmacy in older adults in home care settings, including a lack of open communication and inconsistent medication reconciliation practices. Additionally, inadequate partnership and ineffective collaboration between inter-professional healthcare providers were identified as major barriers to safe deprescribing. Further, home care nurses highlighted the importance of raising awareness about deprescribing in the community, and they emphasized the need for a consistent and standardized approach in educating healthcare providers, informal caregivers, and older adults about the best practices of safe deprescribing. Nurses in home care play a vital role in medication management and, therefore, educational programs must be developed to support their awareness and understanding of deprescribing. Study findings highlighted the need for the future improvement of existing programs about safer medication management through the development of a supportive and collaborative relationship among the home care team, frail older adults and their informal caregivers.
PATTERNS OF PSYCHOACTIVE MEDICATION USE IN COMMUNITY-DWELLING OLDER ADULTS IN THE UNITED STATES IN 2015
Authors: Bajracharya Rashmita , Qato Danya 
Published: November 2019

Abstract
Per the 2015 Beer’s Criteria, most psychoactive medications are identified as potentially inappropriate for use in older adults as this population is especially vulnerable to the potential adverse effects associated with psychoactive medications, including sedation, anticholinergic effects, and falls. Past studies found increasing use of psychoactive medications in community-dwelling older adults; however, patterns of use by other sociodemographic, socioeconomic, and clinical subgroups have not been explored. This is a cross-sectional analysis of 2015 Medical Expenditure Panel Survey in a sample of 6122 older adults (60-85 years). We utilized Andersen’s Behavioral Model of Health Services Utilization to guide logistic regression model development and estimated odds ratios (OR) with 95% confidence intervals (CI) to quantify the association between psychoactive use and predisposing(sex and race); enabling(marital status, education, poverty, insurance); and need-based[multi-morbidity and activities of daily living (ADL) limitations] factors. Over 30% of older adults in the U.S. reported taking a psychoactive medication in 2015. Prevalence of use was significantly higher in women (35.9%), the unmarried(34.1%), low-income(35.7%), white(34.0%), multimorbid (32.0%), and ADL limitation groups (45.9%) compared to men, married, high-income, other races, not multimorbid, and no ADL limitations groups, respectively. Female sex [OR=1.62(1.38-1.91)], low-income [OR=1.30(1.04-1.6)], multimorbidity [OR=3.2(2.6-3.9)], and ADL limitations [OR=2.2(1.7-2.8)] were identified as independent predictors of psychoactive use. There is differential use of psychoactive medications by sociodemographic, socioeconomic, and clinical factors. Given the increased complexity of pharmacotherapy regimens, especially in those with multimorbidity and ADL limitations, improved efforts aimed at prudent use of psychoactive medications should be intensified.
DIABETES, SELF-EFFICACY TOWARD DIABETES PREVENTIVE BEHAVIORS, AND DEPRESSIVE SYMPTOMS AMONG KOREAN AMERICANS
Authors: Cho Soyeon 
Published: November 2019

Abstract
Type 2 diabetes is a largely preventive chronic disease, which requires persevering self-management by maintaining healthy life style. Prevalence of Type 2 diabetes among Asian Americans are rapidly increasing, yet little is known about Asian Americans’ self-efficacy towards diabetes preventive behaviors. Thus, the present study examined self-efficacy on diabetes preventive behaviors (DPB) as a potential mediator in the association between diabetes and depressive symptoms among older Korean Americans. Data were driven from a cross-sectional study of 235 community-dwelling Korean American older adults (aged 60 and older) in 2013. The direct significant relation between diabetes and depressive symptoms became insignificant after self-efficacy on DPB was introduced, which demonstrates a full mediation effect of self-efficacy on DPB. Results suggest that even in the presence of diabetes, mental well-being such as depression of older adults can be maintained by having competence in self-management of their own health.
AGE, EXPERIENCE OF RACIAL MICROAGGRESSIONS, AND DISTRESS
Authors: Thompson Shayla , Sawyer Broderick , Meeks Suzanne 
Published: November 2019

Abstract
Racial microaggressions are a common form of racial discrimination consisting of subtle or interpersonal slights. Racial microaggressions are linked to various kinds of psychological distress in younger adults, but have not been studied across the lifespan. We examined the relationship of racial microaggressions with psychological distress and anger rumination among younger and older adults identified as racial or ethnic minorities. We hypothesized that age would moderate the relationship between racial microaggressions and psychological distress and anger rumination, that is, the relationship would be weaker for older than for younger adults. Participants were recruited from Amazon Mechanical Turk and were compensated $1 for their participation. Preliminary tests of the hypotheses (N=220), using multiple regression analyses to test for moderation, failed to support the hypothesis that age would mitigate the impact of microaggressions on symptom severity. Both age and microaggressions were related to psychological distress and anger rumination, but contrary to prediction, older adults showed more exacerbation of distress in the face of microaggressions than younger adults. The results also differed by gender and ethnic groups, suggesting the importance of examining intersectional experiences of race, gender, and age in response to discrimination. These cross-sectional findings lend support to the importance of considering both subtle and overt discriminatory experiences in understanding the mental health challenges for minority groups in the U.S., but more work is needed to examine the intersection of ethnicity with other demographic variables, and to understand how the lifelong experiences of discrimination may shape older adults’ vulnerability, well-being, and resilience.
A 20-YEAR COHORT STUDY OF LIVING ARRANGEMENTS AND COGNITIVE DECLINE IN THE MEXICAN AMERICAN POPULATION
Authors: Cantu Phillip A 
Published: November 2019

Abstract
Backgrounds/Objectives: The prevalence of dementia in the elderly Latino population is expected to significantly increase from around 200,000 cases in 2000 to as many as 1.3 million cases in 2050. This demographic trend has important consequences for options in care and living arrangements. Very little is known about how of cognitive impairment trajectories co-vary with support available to Mexican Americans. We examine the relationship between living arrangements and the social support of individuals with dementia. Methods: Using data from nine waves from the 23 years of the Hispanic EPESE (n=3,952), we examine trajectories of cognitive functioning and family and social support. We first describe the change in Mini Mental Status Examination (MMSE) scores for survivors from Wave 1 (1993/1994) to Wave 9 (2015/2016), n=255. Growth Mixture Modeling (GMM) is then used to assess how changes in MMSE scores are distributed among living arrangements for individuals living independently compared to household extension (living with others) using the full sample. Results: Analyses reveal different trajectories in MMSE score. 12% (n=27) of the sample had no decrease, while the remaining (88%) were split between moderate decline (60% n=136, 1-10 point decline in MMSE) and severe decline (28% n=62 &gt;10 point decline In MMSE). Changes in living arrangement over the same period show that 89% of individuals who move from independent living into extended household experienced cognitive decline. Conclusions: This study provides new information on how cognitive trajectories are associated with living arrangements. We discuss implications for improving community-based interventions for Latino family caregivers.
TóMALO SUAVE (TAKE IT EASY): HOW LATINO OLDER ADULTS PERCEIVE OF POSITIVE AGING
Authors: Piedra Lissette M , Howe Melissa , Ridings John , Montoya Yadira , Conrad Kendon 
Published: November 2019

Abstract
With the help of the Positive Aging of Latinos Study (PALS) steering committee (N = 20), we used concept-mapping methods to learn what Latino older adults (N = 101) consider important for aging well, positively, and successfully. We used data from nine focus groups (six Spanish, three English) to generate an unabridged list of 171 statements that described what positive and successful aging meant to participants. The PALS steering committee reviewed the statements, assisted with the translation and back translation of items in Spanish, eliminated vague and duplicate statements, and approved a final list of 85 statements. Next, Latino older adults thematically sorted (n = 35) and rated (n = 93) the 85 statements (using a 1-5 scale; higher values indicate greater importance). These data were used to produce a concept map for how participants conceptualized positive and successful aging. The final map consisted of 11 clusters nested within 4 overarching regions. Region 1 [Self-Sufficiency] contains clusters of items which address “Stability” and “Independence.” Region 2 [Healthy Behaviors] includes clusters with items related to “Staying Healthy” and “Avoiding Trouble.” Region 3 [Perspectives on Life] encompasses four clusters of items that address mindsets: “Tómalo Suave (Take it Easy),” “Outlook on Life/Self-Care,” “Emotional Well-being,” and “Maturing.” Region 4 [Convivir (To coexist)] features indictors of interrelatedness such as “Social & Community Engagement,” “Coping & Adjustment,” and “Family Relationships.” These findings provide insights into how Latino older adults conceive of positive aging, which could be useful when designing culturally sensitive programming for Latino seniors.
UNIMAGINED FUTURES: THE PARADOX OF FAMILISM AND ELDERCARE AMONG AGING LATINOS IN THE CHICAGOLAND AREA
Authors: Howe Melissa , Howard Alexis , Hsieh Wendy , Piedra Lissette M 
Published: November 2019

Abstract
Scholars of gerontology highlight the ways aging varies cross-culturally. Whereas North Americans tend to describe “successful aging” as the maintenance of social and physical independence, Latin Americans tend to view aging as a natural process of social transition. In this study, we conducted a content analysis of nine focus groups (N =101) and 20 interviews with Latino older adults in the Chicagoland area to examine how they characterize successful aging and view the health declines that accompany aging. We found that Latino older adults often used rhetoric associated with “successful aging,” which tended to emphasize the maintenance of independence and physical functioning. Even immigrant respondents employed this language, suggesting that descriptions of “good old age,” may be more culturally transferable than previously thought. At the same time, the cultural values of respeto and familismo also emerged. Regardless of the participant’s nativity status, centrality of family and the importance of respect represented constant sources of support. Still, adherence to these values came with considerable drawbacks for those intensely focused on self-sacrifice for the sake of their families. Taken together, “successful old age” was defined by the participants as one in which a person maintains physical independence in the context of an interdependent, kin-focused, social life. This paradoxical combination of valuing independence and familial interdependence produced a number of benefits and challenges for Latino adults as they transitioned into to older adulthood.
PAIN AND DEPRESSION AFFECT SELF-REPORTED STRESS RATINGS IN ADULTS WITH AND WITHOUT FIBROMYALGIA
Authors: Nguyen Ha M , Phillips Kristen , Cherry Barbara J , Zettel-Watson Laura 
Published: November 2019

Abstract
Fibromyalgia (FM) is a chronic pain condition characterized by tenderness, fatigue, stiffness, joint pain, and physical and emotional distress. Depression is common, as well, and stress may be perceived as more severe. The current study examines perceived stress in adults ages 50 and older with and without FM. It was hypothesized that individuals with FM and/or depression would subjectively rate stressors as more severe compared to those without. Ninety-four participants (53% with FM, 78% female) aged 50 to 93 (M = 67.72, SD = 9.26) were administered an updated version of the Social Readjustment Rating Scale (SRRS) to assess amount of stress experienced in the past year. The difference between the SRRS pre-determined values and participants’ subjective ratings was calculated. Lower difference scores indicated that self-reported severity exceeded standardized values. Hierarchical linear regression analyses revealed that older adults and men were less likely to report exaggerated stressor severity (p &lt; .05). Controlling for age and gender, individuals with FM were significantly more likely to report stressor severity far above standardized severity scores (p &lt; .05). Results also revealed that both depression and chronic pain impact stress ratings, but impact is significantly greater for depression (p &lt; .001). When controlling for depression, FM impact is no longer significant, suggesting that depression is a stronger predictor of subjective stress. The findings emphasize the importance of stress management and lifestyle changes to reduce the likelihood of depression and stress perception in individuals experiencing chronic pain.
NUTRITIONAL RISK IS ASSOCIATED WITH LOW BACK PAIN AMONG OLDER ADULTS: RESULTS FROM THE UAB STUDY OF AGING
Authors: Buys David R , Evans Marion W , Kennedy Richard E , Locher Julie , Buys Katie , Brown Cynthia J 
Published: November 2019

Abstract
Poor nutritional status is associated with adverse health outcomes across the life course, affecting older adults’ ability to maintain overall well-being, limiting physical strength, and affecting mobility. International research has demonstrated associations between nutritional risk and general musculoskeletal pain; however, no research has explored relationships between nutritional risk and low back pain. Using the University of Alabama-Birmingham Study of Aging, we examined this relationship among 1000 community-dwelling older Alabamians (65+years). We used the DETERMINE Checklist, a well-validated nutritional risk assessment and assessed presence and severity of low back pain over the past 4 weeks. We completed univariate and bivariate analysis and multivariate logistic regression, adjusting for factors significant in the bivariate analyses: sex, body mass index, depression, and co-morbidities. More than half of the participants were at nutritional risk (55.2%). In multivariate analyses, one point increases in nutritional risk were associated with a 14% increase in the likelihood of low back pain 95% CI (1.087,1.213); in categorical analyses, moderate nutritional risk and high nutritional risk were associated with an increase in likelihood of low back pain [46% (95% CI 1.07,2.02) and 164% (95% CI 1.80,3.94), respectively]. While this cross-sectional analysis should be interpreted cautiously, it further emphasizes the importance of nutritional health for older adults. Clinicians treating patients with low back pain or nutritional risk may consider assessing for the other condition. When nutritional risk is detected, clinicians should refer to services such as counseling with a registered dietitian or to a social worker for assistance identifying community-based nutritional supports.
NOVEL METHIONINE-RELATED INTERVENTIONS THAT CONFER HEALTHSPAN BENEFITS TO YEAST AND RODENTS
Authors: Johnson Jay E , Plummer Jason D , Postnikoff Spike D , Tyler Jessica K , Johnson Jay E 
Published: November 2019

Abstract
Methionine restriction (MR) is one of only a few dietary manipulations known to robustly extend healthspan in mammals. Methionine-restricted rodents are up to 45% longer-lived than control-fed littermates and a number of studies suggest that humans may also benefit from MR. While a methionine-restricted human diet is technically feasible, compliance to such a regimen might not be practical or desirable. Therefore, an important goal is to identify and/or develop more facile dietary interventions, or preferably, pharmacological agents that mimic MR. Towards this end, we have made use of the yeast chronological lifespan and replicative lifespan assays, which serve as models of aging in quiescent and mitotic cells, respectively. Importantly, our lab and others have demonstrated that MR dramatically extends yeast lifespan. Here we show work aimed at developing novel MR-like interventions that extend yeast lifespan, as well as preliminary data demonstrating that such interventions significantly improve the healthspan of mice.