bluuebunny/crossref_metadata_2025_split huggingface dataset:
BRIDGING THE GAP BETWEEN COGNITIVE HEALTH AND FINANCIAL CAPACITY IN OLDER ADULTS: A SCOPING REVIEW
Authors: McLaughlin Jessica B King , Taeckens Ashley , Greenfield Jennifer C , Chess Eric 
Published: November 2019

Abstract
Significant declines in everyday functioning are often indicators of cognitive impairment. Although researchers agree that a diminished ability to carry out a variety of instrumental activities of daily living (IADL) tasks is a harbinger of cognitive impairment (CI), studies have repeatedly found that a compromised ability to successfully complete financial management tasks may be one of the initial IADLs affected by prodromal CI. Due to the combination of compromised financial functioning and the increased prevalence of CI, older adults as group are, therefore, put at a greater risk for financial abuse and exploitation. The aims of this scoping review were two-fold: 1) to synthesize current literature on CI as it relates to financial decision-making (FDM) and 2) to analyze the measures and instruments used to assess FDM in older adults. In a review of four databases, 39 studies were identified that met inclusion criteria. These studies used 22 different instruments to measure and assess financial functioning. Across the 39 studies, consistent themes emerged relevant to factors that impacted cognitive impairment and financial functioning. These themes included participants’ education levels, premorbid financial literacy, and age. White participants were overrepresented in research samples from these studies. Future research should investigate how FDM and early signs of CI may interact in people of color. Additionally, research should be focused on how to make instrumentation more accessible and feasible for the general public to administer without extensive training. This would enable the lay population to more easily identify early signs of cognitive impairment.
THE RELATIONSHIP BETWEEN IMMIGRANT STATUS AND UNDIAGNOSED DEMENTIA
Authors: Franco Yujin , Choi Eun Young 
Published: November 2019

Abstract
In the U.S., the immigrant population is rising, and immigrants are more likely to develop dementia than the U.S.-born population. However, little is known about the rate of undiagnosed dementia among immigrants. This study investigates the relationship between immigrant status and undiagnosed dementia, using 2011 data from the National Health and Aging Trends Study. Data from 7,347 older adults aged 65 years and older (6,531 U.S.-born and 816 immigrants) were included in the analysis. Study participants were divided based on whether they had or had not been diagnosed with dementia, respectively. The results of binary logistic regression showed that being an immigrant was associated with two times higher odds (odds ratio [OR]: 2.00, 95% CI: 1.38-2.92) of undiagnosed dementia compared to US-born participants. Among immigrants, undiagnosed participants had significantly lower levels of depression (t(166)=-2.60, p=.01). Moreover, although marginally significant, the latter were younger (t(166)=-1.90, p=.06) and immigrated at an older age (t(159)=1.87, p=.06) than the diagnosed group. Thus, it is important to tailor dementia education and interventions to the immigrant population, as this may contribute to reducing health disparities in dementia outcomes within the older population.
ALZHEIMER’S DISEASE AND RELATED DEMENTIAS IN MEXICAN AMERICAN MEDICARE BENEFICIARIES
Authors: Snih Soham Al , Chou Lin-Na , Downer Brian , Raji Mukaila , Kuo Yong-fang , Markides Kyriakos , Ottenbacher Kenneth 
Published: November 2019

Abstract
Objective: To determine the prevalence and incidence of Alzheimer’s Disease and Related Dementias (ADRD), and to identify the socio-demographic and health characteristics of Mexican-American older adults with ADRD. Methods: Data are from wave 5 (2004/05) of the Hispanic Established Population for the Epidemiological Study of the Elderly linked with Centers for Medicare and Medicaid Services files. We studied 1166 participants of which 927 did not have an ADRD diagnosis before wave 5 interview and followed until 2016. Measures included socio-demographics, medical conditions, depression, physical function, Mini-Mental-State- Examination (MMSE), body mass index (BMI), disability, and ICD-9-CM codes for ADRD. Results: A total of 424 participants had an index diagnosis of ADRD during 11-years. The total prevalence rate ranged from 31.6% in 2006 to 72.8% in 2016, and the total incidence rate ranged from 9.3% in 2006 to 15.8% in 2016. The prevalence rate ranged from 30.3% to 69.7% in men and 32.5% to 74.1% in women. The incidence rate ranged from 8.5% to 12.9% in men and 9.8% to 12.9% in women. Those with ADRD were significantly more likely to be older (82.1 versus 81.6 years; p-value=0.024) and to have a lower score in the MMSE (21.1 versus 21.7; p-value=0.013) compared with whole sample (N=927). Non-significant differences were observed by sex, education, medical conditions, BMI, depression, physical function or disability compared with whole sample. Conclusions: The prevalence and incidence rates of ADRD in Mexican-American Beneficiaries is high. These findings underscore the need for clinical services and caregiving resources in this population.
IDENTIFYING PATIENTS WITH PROBABLE DELIRIUM AND DEMENTIA FROM ROUTINE HOME HEALTH CARE ASSESSMENTS
Authors: Jarrín Olga F , Nyandege Abner , Rosati Robert J , Videon Tami J 
Published: November 2019

Abstract
Timely education of patients and their family caregivers on dementia disease management and health behavior changes and referral to additional resources is an essential part of age-friendly and high quality care. Nearly one out-of-three home health care patients has been diagnosed with dementia, however, family members and front-line health care providers are frequently unaware that a diagnosis of dementia has made, and what to do. The aim of this study was to identify a small set of questions that are routinely collected during home health care assessment which can be used to rapidly identify patients with suspected dementia, who may benefit from additional screening and services. We developed the preliminary model from 100% national home health care assessment data from 2014 (4.1 million people). We validated the model with a sample of nearly 27,000 patients who received a new (start-of-care) home health assessment in 2016, from four home health agencies that share a common data warehouse. The final model consisting of five questions, performed well in national data (AUC 0.85) predicting any diagnosis of dementia contained in the Medicare Chronic Conditions warehouse or home health record. The final model performed similarly (AUC 0.87) in the validation sample, predicting a diagnosis of dementia or history of dementia medication during a 3-year window of time from clinical data warehouse. The potential applications of this model have the potential to accelerate timely identification of patients with probable dementia or delirium, patient and family caregiver education, and referral to rehabilitative and supportive services.
CHOOSE TO MOVE: IMPLEMENTATION OF A PHYSICAL ACTIVITY INTERVENTION AT SCALE ACROSS BRITISH COLUMBIA, CANADA
Authors: Gould Joanie Sims , McKay Heather , Gray Samantha , Bauman Adrian , Nettlefold Lindsay , Hoy Christa 
Published: November 2019

Abstract
Despite the many benefits of physical activity (PA), older adults remain among the least active Canadians. Regular PA effectively enhances social connectedness which in turn, is linked to positive health benefits. PA also promotes older adult’s physical mobility which is “the best guarantee of retaining independence and being able to cope” in later years. Although effective PA interventions exist, all but five were conducted at small scale. None were effectively scaled up and sustained over the longer term. To improve population health, effective interventions must be scaled-up. In 2015, BC Ministry of Health released a PA strategy and action plan--older adults were identified as one priority area. In partnership with government and community stakeholders we were entrusted to co-design, implement and evaluate a 6 month, evidence- and choice-based PA intervention (Choose to Move; CTM) across BC, Canada. Implementation and adaptation frameworks and processes we adopted were embedded within socioecological models. We evaluated CTM at scale-up in 26 communities with 458 low active older adults. Our implementation evaluation showed that relationships and infrastructure were key facilitators to delivering CTM at scale. Our impact evaluation showed that PA and social connectedness were enhanced; mental health (loneliness/happiness), grip strength and mobility all improved following participation in CTM. A flexible, adaptable PA model, designed with scalability in mind is key to enhance health indicators in low active older adults. Effectively engaging stakeholders at multiple levels in the implementation process is essential to success.
DEBT AMONG OLDER ADULTS: DATA FROM AN EXPLORING STUDY IN SOUTH BRAZIL
Authors: Doll Johannes , Conte Francieli , Lima Karen 
Published: November 2019

Abstract
In recent years, Brazil has experienced significant increase in indebtedness rates amongst older adults. This is partly due to prominent forms of credit such as credit cards and payroll deductible credit, a type of credit that accounts for up to 35% of pensions. In addition, indebtedness is aggravated by high interest rates which are charged in Brazil. Exploratory study on the propensity for indebtedness amongst older people in Rio Grande do Sul, Southern Brazil (n = 406; age 46-97 years old; average 68,7 years old) aims to analyze reasons and factors which interfere in the financial-related issue. In general, indebtedness is a complex process that is often triggered by critical life events such as illness, death, separation, accident and unemployment. And, it is mediated by a number of behavioral and sociodemographic factors. The present work aims to analyze the relation between financial problems, income, schooling, age, materialism, consuming habits as well as altruism in two different social groups: a middle class (SESC) and a lower middle-class (FASC). Concerning theoretical reference, data discussion is based on Ronald Inglehart’s theory on Materialism and Postmaterialism. Data analysis has shown differences in factors and relations among the two social groups. Consuming habits and altruism have a significant correlation with financial problems in both groups. However, income, education and materialism has shown a significant correlation only in the lower middle-class group. In the middle-class group, no relation between income, education, materialism and financial problems has been found.
HETEROGENEITY IN PROGRESSION OF COGNITIVE IMPAIRMENT AND VARIATIONS IN HEALTH EXPENDITURES AND HEALTH SERVICES USE
Authors: Tarraf Wassim , González Hector M 
Published: November 2019

Abstract
Cognitive aging and disease (e.g. dementia) are leading public health issues as longevity increases and the US population ages. We fit generalized linear models using data from the longitudinal Health and Retirement Study (2008-2014) on (Unweighted N=1,884) participants 70-years and older who met criteria for cognitive impairment not dementia (CIND), based on Aging, Demographics, and Memory Study specification, at baseline (2008) to test how impairment reversion, stability, and transition to dementia over 8-years affect change in biennial hospitalizations, nursing-home use, and out-of-pocket expenditures (OOP). Over 8-years, 13% reverted to normal cognition, 20% remained as CIND, 21% transitioned to dementia, and 46% died. In these groups, average OOP spending at baseline was $2311 (SE=$225), $2722 (SE=$278), $2180 (SE=$228), and $3653 (SE=$322), respectively. Average OOP spending increased to $3,095, $4,720, and $11,548 by the 8th year for those that reverted, stayed stable, and transitioned, respectively. Average OOP spending at the wave preceding death was $11,600. We observed substantial increases in nursing home use that were particularly pronounced among those that transitioned to dementia (Baseline Probability=0.04 increasing to 0.37 over 8-years) or died (0.09 increasing to 0.35 over 6-years), and similar but less pronounced differences in patterns of inpatient hospitalizations. Estimates were only slightly modified through adjustments to sociodemographic characteristics and comorbid conditions. We discuss how healthcare policy and clinical interventions focusing on early identification of impairment can potentially lead to improved and more efficient healthcare if better understanding of heterogeneities in impairment and cognitive disease progression is achieved.
WHO ANSWERS THE HOUSEHOLD FINANCIAL QUESTIONS: ANALYSIS OF STABILITY AND CHANGE
Authors: Curl Angela L , Mudzonga Chido 
Published: November 2019

Abstract
There is limited research on who acts as household financial respondents (FR) for couples who are responding to surveys. The purpose of this study was to determine the amount of stability and change in FR, as well as predictors of FR status and change of FR status. Methodology: This study analyzed data from Health Retirement Study from 2006 to 2014. The sample comprised of 6,755 households of couples over the age of 50. Data were analyzed using Hierarchical Linear Modeling (HLM). Results: The results indicated that 18.13% households experienced one or more transitions of the financial respondent. Black non-Hispanics, males, those with higher education, earning a greater percent of the household’s income and those with higher cognitive ability were more likely to be the financial respondent than their counterparts. Higher depression (OR=1.22, p&lt; .01) and lower cognitive ability (OR= 1.06, p&lt;.01) were factors that predicted changes in the household’s financial respondent. Health (number of chronic conditions, self-rated health) and percentage of the household earnings are not significant in the change of financial respondent. Discussion: Change of respondent may result in differences in reporting of household financial resources in longitudinal studies. Changes in respondent may also be indicative of a more Egalitarian household, or serve as an early sign of changes in family dynamics or roles. As changes in mental health and cognitive ability may prompt a change of financial respondent, this highlights the importance of both spouses being financially literate and aware of the family’s economic resources, investments and obligations.
PHASED RETIREMENT IN OLDER AMERICAN WORKERS
Authors: Choi Shinae , Smith Genevieve 
Published: November 2019

Abstract
Older workers are engaging in “phased retirement” in which they transition from full-time working status to part-time working and eventually retire at a later age. This study investigated whether phased retirement was financially and psychologically beneficial for middle-aged and older adults in the United States. The current study examined data on financial and psychological well-being and retirement transitions (i.e., immediate retirement and phased retirement) from the Health and Retirement Study (HRS) at two time points, four years apart. We analyzed 5,106 middle-aged and older adults from the 2010 and 2014 waves of the HRS data set using chi-square and one-way analysis of variance tests. Our results showed that 66.8% of respondents remained full-time working, while 12.7% of respondents chose phased retirement and 15.2% of respondents jumped straight into retirement. Our findings suggest that phased retirement is beneficial for older Americans financially and psychologically. Specifically, the level of total household financial wealth was significantly higher for those who chose phased retirement than immediate retirees from workforce. In terms of psychological perspectives, immediate retirees experienced more depressive symptoms than those who chose phased retirement. Our findings could help individuals and households to be better equipped when preparing for retirement. Our findings could also provide a basis for further research into phased retirement and its impact on well-being in middle-aged and older Americans. Furthermore, policymakers could be better informed about retirement trends and create policies based on our findings to better help older individuals and households be financially and psychologically prepared for retirement.
WORKING LONGER FOR ACADEMICS IN THE U.S. AND IRELAND: A GENDERED LIFECOURSE ANALYSIS
Authors: Leime Aine Ni 
Published: November 2019

Abstract
Many governments including the US and Ireland have been advocating longer working lives for all workers to ensure pension sustainability in the light of population ageing. Policy changes encouraging increased social security/state pensions age reflect this. However, there has been limited investigation of how the gender implications of these policy changes. While longer working lives may be attractive for some workers, there is evidence that women and men have profoundly different work-life trajectories and women may be more financially disadvantaged approaching retirement age. There is a need to explore how this affects their ability and/or desire to continue working past traditional retirement age and their financial security. This presentation is based on analysis of evidence from an EU-funded cross-national research project involving work-life history interviews conducted with forty older workers in academia in the US and Ireland in 2016 and 2017. A lifecourse approach is used to analyse interview data from ten male and ten female academics in Ireland and ten male and ten female academics in the US, aged 50 or over. Participants discussed early influences, work-life history and health concerns. The paper uses a cumulative disadvantage perspective to analyse how gender, family and health trajectories across the life course affect and can limit options around late work and retirement. It concludes that gender differences regarding norms of care-giving are important and that extending working life is more likely to be caused by financial necessity for women. The implications for future research and policy are discussed.
CONSEQUENCES OF AGE DISCRIMINATION IN THE WORKPLACE
Authors: Yeung Dannii 
Published: November 2019

Abstract
Despite a growing number of middle-aged employees in the workforce, Hong Kong still lags behind other developed countries in implementing age-friendly policies to protect older workers from being discriminated in recruitment, performance appraisal, and other personnel decisions. This paper therefore aims to investigate the effects of age discrimination on work-related outcomes and well-being. A total of 333 Hong Kong Chinese employees aged 40 years and above (Mage = 46.6 years, SD = 6.21, Range = 40-68; 60% female) completed an online survey on work experiences. Self-perceived age discrimination in the workplace (Furunes & Mykletun, 2010), perception of occupational future time (Ho & Yeung, 2017; Zacher & Frese, 2009), work engagement (Schaufeli et al., 2017), work stress (Cohen et al., 1983), and psychological distress (Shek, 1989) were measured. Almost 53% of the participants reported that older workers were less likely to get the same training opportunity for new technology as their younger peers, and 46.8% perceived that older workers did not get the same promotion opportunity as their younger peers. Regression analyses further revealed that employees’ perceived age discrimination in the workplace indirectly influenced their levels of work engagement (B = -.038, SE = .017), work stress (B = .016, SE = .005), and psychological distress (B = .008, SE = .005) through perception of occupational future time. The findings of this study unveil the severity of workplace age discrimination in Hong Kong and the negative impacts of age discrimination on work-related outcomes. Recommendations for organizational practices will be discussed.
A HOSPICE COLLABORATIVE NETWORK TO IMPROVE SERIOUS ILLNESS CARE IN A LARGE HEALTHCARE SYSTEM
Authors: Leiter Richard E , Pu Charles T , Mazzola Emanuele , Bernacki Rachelle E 
Published: November 2019

Abstract
The quality of hospice care in the United States varies significantly, yet healthcare systems lack methods to comprehensively evaluate and stimulate quality improvement in organizations that serve their patients. Partners HealthCare, an integrated healthcare system located in Eastern Massachusetts, sought to create a high-quality hospice collaborative network based on objective and quantitative criteria obtained from public reporting as well as the hospice itself. Through a modified Delphi procedure, clinicians, administrators, and data scientists developed a set of criteria and a scoring system focused on three areas: organizational information, clinical care quality indicators, and training and satisfaction. All Medicare-certified hospices in good-standing in Massachusetts were eligible to participate in a request for information (RFI) process. We blinded all hospice data prior to scoring and invited hospices scoring above the 15th percentile to join the collaborative for a 2-year initial term. Of 72 eligible hospices, the majority (53%) responded to the RFI, of which 60% submitted completed surveys. Hospices could receive up to 23.75 points with scores ranging from 2.25 to 19.5. The median score was 13.62 (IQR: 10.5-16.75). For the 19 hospices scoring above the 15th percentile, scores ranged from 10.0-19.5 (median: 14, IQR: 11.1-16.9). There was no association between quality score and continuous (Spearman’s correlation 0.24, p=0.27) or dichotomous (Wilcoxon rank sum test p=0.13) measures of hospice size. The hospice collaborative network is one healthcare system’s initial attempt to effectively leverage its influence and relationships to improve hospice quality for the benefit of its seriously ill patients and their families.
TRENDS AND FACTORS ASSOCIATED WITH PLACE OF DEATH AMONG INDIVIDUALS WITH CARDIOVASCULAR DISEASE IN THE UNITED STATES
Authors: Cross Sarah H , Kaufman Brystana G , Warraich Haider 
Published: November 2019

Abstract
While most patients prefer to die at home, trends and factors associated with place of death for patients dying of cardiovascular disease (CVD) remain unknown. Using data from the National Center for Health Statistics from 2003-2017, we described trends and conducted multivariable logistic regression to evaluate associations between demographic characteristics and place of death among CVD patients in the United States. From 2003-2017, the rate of CVD deaths occurring at home increased from 21.3% to 30.9%, and rate of hospice facility deaths increased from practically none to 6.0%. Over the same period, the rate of hospital deaths decreased from 36.5% to 27.3%, and nursing facility deaths decreased from 25.1% to 20.6%. With the exception of conduction disorders, temporal trends in place of death were consistent across CVD diagnosis subgroups: ischemic heart disease, hypertensive heart disease, heart failure/cardiomyopathy, cerebrovascular disease, aortic stenosis, and all other CVDs. Differences between demographic groups persisted over the study period, with reduced odds of home death among Hispanic versus non-Hispanic (OR=.942; 95% CI .929-.955) decedents, Black versus White (OR=.837; CI .809-.866) decedents and greater odds of home death among decedents with some college education or more (OR=1.08; CI 1.06-1.09) versus decedents with a high-school education or less. In 2014, home surpassed hospital as the most common place of death for CVD patients. CVD patients often have acute and intense needs at the end of life that are challenging to manage in the home and the quality of care these patients receive should be further investigated.