bluuebunny/crossref_metadata_2025_split huggingface dataset:
SHINGLES VACCINE UPTAKE AMONG OLDER ADULTS: IDENTIFYING EARLY, LATE, AND NON-ADOPTERS
Authors: Kang Hyewon , Crimmins Eileen , Ailshire Jennifer A 
Published: November 2019

Abstract
Although a shingles vaccine (Zostavax) has been available since 2006, vaccination uptake has been slow. As a newly approved shingles vaccine (Shingrix) became available in 2018, understanding factors affecting acceptance and timing of the original vaccine would be useful in establishing effective strategies for greater immunization. Using the Health and Retirement study, we examined individual-level and area-level characteristics of early and late vaccine adopters, and those who were not vaccinated between 2006 and 2016. Early adopters were those who got vaccinated during the four year window after the approval of the vaccine; late vaccine adopters were those who got vaccinated from 2010 to 2016. Early adopters (13.5%) and late adopters (18.5%) comprised 32% of the sample, leaving two-thirds unvaccinated. Regression results suggest that those who received the vaccine were more likely to be socioeconomically advantaged, covered by insurance, socially active, healthy, to use other preventive vaccines, and to live in a region with more vaccinated people. Early adopters were more likely to be highly educated, affluent, and more conscientious compared to late adopters. Utilization of influenza vaccine and living in the region with the highest level of vaccination were found to be significant factors predicting early vaccine uptake. Our findings highlight the importance of outreach efforts and health care access in increasing vaccination rates.
MODEL-BASED CLUSTER ANALYSES OF COGNITION FOR UNPACKING SUBGROUP DIFFERENCES IN PSYCHOSOCIAL OUTCOMES
Authors: Roque Nelson A , Sliwinski Martin J 
Published: November 2019

Abstract
We forward a methodological approach, using model-based cluster analyses, and ambulatory assessments of cognition (2 indicators from each task), to derive subgroups of interest for tailored clinical follow-up in a longitudinal framework. Community dwelling adults were asked to complete 14 consecutive days of ecological momentary assessments (EMAs) using smartphones, including measures of cognitive performance, and self-reported physical and mental health outcomes (e.g., stress, memory complaints, depression, pain). A stable four-cluster solution emerged, labelled as: (1) a high-risk cognitive group (13%; most memory complaints, slowest performing, more memory errors); (2) subjective risk group (42%; highest levels of somatic and cognitive complaints); (3) normative aging (28%; intermediate cognitive performance -- speed/accuracy); (4) super-cognitive agers (17%; fastest speed, best memory). In conclusion, these findings highlight the potential of a cluster-based approach for risk classification, uncovering different profiles of poor performance that may represent different etiologies.
MOTIVATION AS A MECHANISM: THE LONGITUDINAL RELATIONSHIP BETWEEN PERSONAL RESOURCES AND ACTIVITY ENGAGEMENT
Authors: Lothary Allura F , Queen Tara L , Hess Thomas M 
Published: November 2019

Abstract
Past research has demonstrated an association between health and cognitive resources, intrinsic motivation, and activity participation in older adulthood, both cross-sectionally and from a daily perspective (e.g., Queen & Hess, 2018; Hess et al., 2018). This highlights the potential importance of motivation as a mediator of the impact of changing personal resources on engagement in cognitively beneficial activities. This study expanded on prior research by examining these relationships longitudinally in a large representative sample of adults over 50. Specifically, we used data from the Health and Retirement Survey (N = 5600) to create two 4-year longitudinal assessments, with multi-level structural equation modeling used to test the mediating role of motivation on everyday activity engagement. Consistent with expectations from Selective Engagement Theory (Hess, 2014), motivation served as a partial mediator of the impact of changing resources on engagement, with the effect being selective based on the cognitive demands of the activity.
THE ASSOCIATION BETWEEN SENSE OF PURPOSE IN LIFE AND REPEATED MEASURES OF HEALTH BEHAVIORS OVER TIME
Authors: Kim Eric S , Shiba Koichiro , Kubzansky Laura 
Published: November 2019

Abstract
Although a stronger sense of purpose in life has been associated with reduced risk of chronic conditions and mortality, potential pathways underlying these associations remain understudied. In the present study, we tested if a higher baseline sense of purpose in life was associated with maintenance of recommended levels of five health behaviors. Prospective data included 13,771 adults from the Health and Retirement Study, who were assessed up to six times across an average of 9 years. In mixed models that adjusted for sociodemographic factors, those in the highest quartile of purpose, compared to those in the lowest quartile, had a higher likelihood of not smoking (RR=1.04; 95% CI: 1.03–1.06), remaining physically active (RR=1.42; 95% CI: 1.33–1.51), drinking moderate amounts of alcohol (RR=1.21; 95% CI: 1.13–1.29), not suffering from sleep problems (RR=1.29; 95% CI: 1.24–1.34), and maintaining healthy BMI (RR=1.09; 95% CI: 1.06–1.11) over follow-up.
COGNITIVE AGING IN OLDER MINORITY POPULATIONS: LONGITUDINAL EVIDENCE FROM U.S. CHINESE OLDER ADULTS
Authors: Dong XinQi , Simon Melissa 
Published: November 2019

Abstract
The increasing diversity in the aging population warrants systematic investigations regarding ethnic differences related to cognitive aging and ethnicity-unique risk factors. However, due to the great paucity of population-based longitudinal data on cognitive aging in racial/ethnic minority populations, our knowledge in this area remain limited. The purpose of this symposium is, therefore, to examine various psychological, socio-cultural, and physical factors associated with cognitive aging among U.S. Chinese older adults, representing one of the biggest and fastest growing older minority populations nationally. Using longitudinal data from a population-based prospective cohort study, namely The Population Study of ChINese Elderly in Chicago (PINE) with a sample size of 3,157, this symposium presents findings from five research projects. Session 1 investigates the relationship between psychological well-being and change of cognitive function over four years. Session 2 and 3 examine the relationships between two socio-cultural factors and cognitive function. Specifically, session 2 investigates the associations between immigration-related factors and the incidence of cognitive impairment. Session 3 explores the relationship between cognitive function and Tai-Chi practice. Session 4 and 5 examine the relationships between two physical health indicators and cognitive aging. Specifically, session 4 examines the relationship between physical function and change of cognitive function over two years. Session 5 explores the association between body mass index and cognitive function decline over two years. Taken together, this symposium aims to further our knowledge of cognitive aging among ethnically/culturally diverse populations. The research findings will identify unique factors related to cognitive aging in older minority populations.
EFFECTS OF SOCIAL SUPPORT ON PERSONS’ NEUROLOGICAL WELL-BEING:IMPLICATIONS FROM CROSS-CULTURAL STUDIES
Authors: Jiang Nan , Wang Jing 
Published: November 2019

Abstract
The impact of social determinants on health is well documented. Among them, social support has emerged as one of the most important old ideas being revisited from a new perspective. Social support refers to perceived supportive resources from an individual’s social engagement or social network. Recently, the concept of social support has become the subject of intense discussion, as it represents a mechanism by which interventions lead to health improvement. Neuropsychological disorders, on the other hand, represent a large burden on worldwide health. Research has shown that older adults with neurological conditions are embedded in social structures that may affect their outcomes, but not enough attention has been paid to the potential effect of social support on many neurological conditions. Using data collected from studies across cultures that have sought to understand neurological well-being worldwide, this symposium will present evidence of the relationship between social support and neurological conditions among older adults and explore how these mechanisms of social support extend the understanding of health disparities in old-age neurological wellbeing. A discussant will draw out common themes from these papers and connect them with the broader literature on the effect of social support on neurological well-being. We propose that social support constitutes an integral part of medical care for older adults with neurological conditions. This symposium will generate insights to help clinical practitioners more effectively design their social support interventions.
RISK AND RESILIENCY IN THE RELATIONSHIP BETWEEN WIDOWHOOD AND DEPRESSIVE SYMPTOMS AMONG OLDER MEXICAN AMERICANS
Authors: Cong Zhen , Pei Yaolin , Wu Bei 
Published: November 2019

Abstract
This study investigated the association between widowhood and depressive symptoms and the extent to which the association is contingent upon immigration status, functional limitations, financial strains, and intergenerational support, among older Mexican Americans. A sample of 344 parent-child dyads reported by 83 older adults in a city of West Taxes completed the measures for socioeconomic status and depressive symptoms. Clustered regression analysis showed that widowhood elevated the risk of depressive symptoms. Living with functional limitations, having more children and residing in the same city with children exacerbated the adverse effects of widowhood on depressive symptoms. Residing in the same city with children increased the detrimental effects of widowhood on the depressive symptoms among men, whereas this pattern did not appear among women. The findings highlight the heterogeneity of depressive symptoms among the widowed Mexican American older adults.
RACE-ETHNICITY, GENDER, AND DISABILITY: A TEST OF STRESS DISABLEMENT PROCESS MODEL AND INTERSECTIONALITY THEORY
Authors: Wray Linda A , Wray Linda A , Thierry Amy D 
Published: November 2019

Abstract
Decades of studies demonstrate that: physical disability differs widely by race/ethnicity, sex, and achieved social status in midlife and older adults; health conditions explain part or all of the differences by race/ethnicity and/or sex; but disparities by race/ethnicity and/or sex often persist beyond controls for health conditions. Using longitudinal HRS data on 16,280 adults and sequential logistic regression models, Wray and Thierry test if those links are additive or interactive and if achieved social status attenuates remaining disparities. Initial models support past studies indicating that impairments in strength, mobility, and ADLs are greater for females and race/ethnic minority adults. Fully adjusted models, including terms for the intersection of race/ethnicity, sex, and health conditions and controlling for other health and social status factors, reveal differential impacts on reported impairments; and that achieved social status only partly attenuates the disparities. More research is warranted to understand underlying mechanisms that produce health disparities.
HEALTH BEHAVIORS AND PSYCHOLOGICAL WELL-BEING ALLEVIATE DIABETES-RELATED DISABILITY DETERIORATION
Authors: Tsai Yi-Hsuan , Chiu Ching-Ju 
Published: November 2019

Abstract
Diabetes is known to increase the risk of disability, which may be buffered by health behaviors and psychological factors. However, few existing studies examine how these factors affect disability in diabetic patients over time. The present study assessed the extent to which diabetes affected disability with age and how that effects differed by health behaviors and psychological well-being in older Taiwanese. The data of 5131 adults aged 50 and older were drawn from the 1996-2007 Taiwan Longitudinal Study on Aging. A cohort sequential multilevel modeling was employed to explore the effects of sociodemographic, comorbidities, lifestyle, and psychosocial factors in mediating and moderating the link between diabetes and disability. Disability was measured by mobility limitation in 1999, 2003, and 2007, while health behaviors and psychological factors were measured in 1996, 1999, and 2003 to be lagged time-varying covariates in random effect model analyses. Our results showed that adults with diabetes had more mobility limitation (β(diabetes) =3.031, P&lt;.001) and progressed each year with ageing (β(diabetes*age) =0.061, P&lt;.005). Exercising more than four times a week reduced the risk of disability by 51 % in diabetic patients (β(diabetes*exercise≥4 times) =-1.220, P&lt;0.05). Social participation (β(social participation)=-0.631, P&lt;.005), stress (β(stress)=0.651, P&lt;.001) and depression (β(depression)=0.144, P&lt;.001) had independent effects on the risk of disability in adults, but the interaction with diabetes was not significant. To conclude, exercise is the most powerful factor to alleviate the risk of disability in diabetic patients.
PROBLEMS AND PROSPECTS FOR CURRENT POLICIES TO EXTEND WORKING LIVES
Authors: Street Debra A , Street Debra A 
Published: November 2019

Abstract
Current policy debates fluctuate between “extending working life” and “delaying retirement”—assuming policies that reflect different conceptual approaches are identical. This presentation uses a different analytic strategy, conceptualizing later life work policies as representing distinctive approaches to consideration of work conditions/income security for older workers. Using data from over 30 countries, I discuss main trends in extended working life policies (mainly in the EU) and the gender and health implications for current and future workers. We find that policies committed to “extending working life”—supporting adequate/meaningful employment for later life work—are enacted rarely, but with potentially positive effects for the health and wellbeing of older workers of either gender. However, “delaying retirement” policies, which dominate the political landscapes of most of the country-specific policies we consider, reproduce or exacerbate gender inequalities and health risks for vulnerable older workers.
NEIGHBORHOOD AND HEALTH AMONG CHINESE ADULTS: BEYOND THE URBAN AND RURAL DICHOTOMY
Authors: Li Yuekang , Wang Yi 
Published: November 2019

Abstract
The associations between physical frailty and depressive symptoms among older individuals were established in existing literature. Taking the person-environment perspective, we argue that neighborhood environment could either buffer the stress derived from being physically vulnerable or worsen it by adding another layer of stressors in the environmental context when physical health declined. The objectives of this study are to explore 1) to what extent the neighborhood-level characteristics moderate the relationship between physical frailty and depressive symptoms, 2) if there were rural-urban differences in the moderation effects, and 3) whether some of the environmental factors worked beyond the contextual influences of the rural-urban scope. Using the China Health and Retirement Longitudinal Study 2011 wave, 6,246 individuals ages 60 years and older were included for analyses. Multilevel mixed-effects models were fitted to examine the moderating effects of urbanicity and neighborhood-level socio-economic status (SES) on the relationship between frailty and depressive symptoms among older adults, controlling for individual-level characteristics. Results showed a stronger relationship between deterioration in physical health and depressive symptoms in rural neighborhoods and neighborhoods with lower SES, after controlling for individual-level SES. Also, the moderating effects of the neighborhood-level socioeconomic factors remained after controlling for urbanicity, indicating that neighborhood SES works beyond the rural-urban contexts. Findings from this study demonstrate the important roles of neighborhood socioeconomic characteristics in reshaping and the need to redefining China’s rural-urban dichotomy. The findings also identified neighborhoods with low SES as potential targets for policy and practice to reduce the stress associated with health decline.
CHANGES IN FUNCTIONAL DISABILITY AND SUICIDAL IDEATION ASSOCIATED WITH PSYCHOTHERAPY FOR DEPRESSION
Authors: Lutz Julie , Beaudreau Sherry , Morin Ruth , Bickford David , Nelson J Craig , Mackin Scott 
Published: November 2019

Abstract
Given the association between functional disability and suicidal ideation (SI) in late life (Lutz & Fiske, 2017), this study examined associations between functional disability and SI among older adults receiving problem solving therapy (PST) for depression. PST is a promising intervention for SI (e.g., Gustavson et al., 2016) and has been shown to be effective in reducing functional disability among older adults with depression (e.g., Choi et al., 2014). Regression analyses with adults age 65-91 (n=65) found that level of SI (Geriatric Suicide Ideation Scale) at baseline was not significantly associated with change in SI from pre- to post-treatment. However, lower baseline disability (WHODAS-II; ΔR2=.08, p=.022) and greater reduction in disability (ΔR2=.12, p=.004) were significantly associated with greater reduction in SI after controlling for age and baseline SI. These results suggest that treatments that decrease disability may be particularly advantageous for reducing SI in older depressed adults.
DEVELOPING EVIDENCE-BASED INSTRUMENTS TO TALK ABOUT LONELINESS
Authors: Schoenmakers Eric 
Published: November 2019

Abstract
People, professionals and non-professionals, lonely and non-lonely, experience difficulties in talking about loneliness. Yet, talking about loneliness is important. Without conversation about loneliness, it is impossible to identify lonely persons and to assist them in a tailor-made way. The aim of this research project is to create evidence-based instruments to make talking about loneliness easier. From 2016 to 2019 (ongoing) six researchers held about 60-70 interviews with lonely persons, discussing feelings of loneliness and coping behavior. After the first 23 interviews with lonely older adults, a qualitative analysis on how to discuss loneliness was performed, resulting in a format for talking about loneliness and a topic list to help in conversations. These instruments were tested in the remaining interviews with lonely older adults and students, after which the format and topic list were updated. The format for talking about loneliness discusses guidelines for the inter human relationship, how to bring up the topic of loneliness, and what to discuss, e.g. feelings, timing, coping, consequences and taboo. ‘What to discuss’ is also addressed in the topic list. It is important to not be eager to help. Often, lonely people have felt so for a long time and considered many coping options. This illustrates complexity. Trying to ‘solve’ loneliness with oversimplified suggestions makes people feel that their situation is not taken seriously. These instruments emphasize the importance of true listening. The instruments can be used to train professionals and volunteers who want to discuss loneliness with lonely people.
THE IMPACT OF MANDATED COGNITIVE ASSESSMENTS ON ALZHEIMER’S DISEASE AND RELATED DEMENTIA DIAGNOSIS RATES
Authors: Thunell Johanna , Zissimopoulos Julie 
Published: November 2019

Abstract
Although no cure for Alzheimer’s disease exists, early diagnosis allows clinicians to detect reversible causes of memory loss, inform pharmacologic treatment options that may delay cognitive decline, and inform patients about clinical trial opportunities. It allows patients to communicate medical, legal, financial, living, and end-of-life desires. Barriers to diagnosis include low public awareness of early symptoms, stigma and misconceptions about the disease that delay seeking medical assistance. Provider-related barriers include low recognition of cognitive impairment and/or insufficient training in dementia diagnosis, and reimbursement issues. The new annual wellness visit (AWV) benefit available to Medicare Part B beneficiaries may reduce some of these barriers. The Patient Protection and Affordable Care Act of 2010 mandated an AWV that, along with routine preventive services, included for the first time, a cognitive screen at each visit. In this study, we analyze the effect of the introduction of the AWV benefit on Alzheimer’s disease and related dementias (ADRD) diagnoses rates, average age at diagnosis and geographic dispersion of diagnoses. We use the 100% sample of Medicare claims and regression discontinuity to estimate the impact of the legislation enactment. Preliminary analyses show immediate and increasing take-up in AWV visits after the policy went into effect. The total number of preventative exams claims went from about 2,500 to 27,000 immediately after the policy and continued to grow in subsequent months. We also observe an increase in ADRD incidence in the months immediately following ACA, from about 14,000 claims in December 2010 to about 16,000 in January 2011.
SUCCESSFUL AGING A SELF-RELIANT UMBRELLA: DEFINING SUCCESSFUL AGING AMONG THE OLD-OLD (80+) IN SHANGHAI
Authors: Chen Lin , Ye Minzhi , Kahana Eva 
Published: November 2019

Abstract
The Chinese old-old (80+) population has steadily increased in recent years; however, limited studies have examined how they age. The purpose of this study is to explore how the old-old in urban China define successful aging. Guided by grounded theory, community-dwelling old-old individuals participated in semi-structured, in-depth interviews (N= 97). Participants identified self-reliance as the goal of successful aging, which was supported by four proactive behaviors, including physical activity, financial security, community connectedness, and willing acceptance of reality. These four proactive behaviors were conceptualized to constitute the ribs of an umbrella model offering a canopy to protect the pole of self-reliant successful aging. This study offers new insight in understanding dynamic and nuanced ways that the old-old in urban China age successfully and their valiant efforts to maintain an ideal status.