bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility Test of a Customizable Relationship Intervention for Stroke Survivor-Family Caregiver Dyads
Authors: McCarthy Michael , Garcia Yolanda Evie , Lyons Karen , Sanchez Angelica , Bakas Tamilyn 
Published: December 2020

Abstract
A strong interpersonal relationship after stroke is important for the well-being of survivors and family caregivers. However, few interventions are designed to strengthen the relationship between members of the care dyad in order to prevent depression and other poor outcomes. The aim of this study was to feasibility test a quality of relationship intervention for stroke dyads called Hand in Hand (HiH). Sixteen survivor-caregiver dyads were recruited and randomized into either the HiH intervention group (n=8) or the Information, Support, and Referral (ISR) control group (n=8). HiH dyads received up to 8 sessions with a social worker in-person, by telephone, or by Zoom web conference, prioritized according to a 17-item screening tool with 17 corresponding HiH content areas. ISR dyads received up to 8 sessions that included information, active listening, and referrals as needed. Process, satisfaction, and pre/post outcomes data were collected for both groups. Seventy-five percent of HiH dyads completed over half the sessions which lasted, on average, 55 minutes (range 26-76). Sixty-two percent of ISR dyads completed over half the sessions which lasted, on average, 21 minutes (range 15-33). Dyads in both groups reported being satisfied with the program materials and processes. Survivors and caregivers in both groups experienced improvements in outcomes, particularly caregivers in the HiH group who showed improvements in communication, coping, subjective relationship quality, and depressive symptoms. Findings suggest that HiH is feasible to implement with stroke dyads and has promise for improving outcomes for participants. Additional research is needed to determine program efficacy.
Factor Analysis of the Short Form Cohen Mansfield Agitation Inventory and Measurement Invariance by Gender
Authors: Paudel Anju , Resnick Barbara , Galik Elizabeth 
Published: December 2020

Abstract
Background: The Cohen-Mansfield Agitation Inventory (CMAI), available in both long and short versions, is a widely used measure to assess and evaluate agitation among older adults. There has been less psychometric testing of the short-form CMAI particularly with regard to the factor structure of this shorter measure. Purpose: The purpose of this study was to test the internal consistency, reliability and validity of short-form CMAI in a sample of nursing home residents and examine if it is invariant across gender. Specifically, it was hypothesized that consistent with the long form CMAI, the short-form CMAI would have three factors with acceptable internal consistency and item reliability. In addition, it was hypothesized that there would be no difference in factor structure and factor means across gender. Methods: This study utilized baseline data from a randomized trial including 553 residents from 55 nursing homes. Data was analyzed using structural equation modeling. Results: Confirmatory factory analysis supported the three-factor structure of short-form CMAI including aggressive (α= 0.794), physically non-aggressive (α= 0.617), and verbally agitated (α= 0.718) behaviors; three items loading on physically non-aggressive behaviors had R2 close to 0.3 suggesting low reliability. Invariance testing confirmed that the shortened measure is invariant across gender. Conclusions: Short-form CMAI is a valid and reliable scale to assess agitation and gender differences in agitation in nursing home population. However, it could benefit from rewording the items with low reliability or, merging them with other similar items. Future work could also consider a four-factor structure for this shortened measure.
Organizational Factors Associated With Retention of Certified Nursing Assistants and Direct Care Workers
Authors: Kennedy Katherine , Applebaum Robert , Bowblis John , Straker Jane 
Published: December 2020

Abstract
Low retention of certified nursing assistants (CNAs) and direct care workers (DCWs) continues to be an unresolved problem for nursing homes (NH) and assisted living (AL) settings. While numerous studies have examined predictors of CNA retention in NHs, little attention has been paid to differences between settings of long-term care. To inform practice and policy related to growth in the AL industry, this study compares the predictors of CNA and DCW retention rates. The 2017 Ohio Biennial Survey of Long-Term Care Facilities provides facility-level information from 968 NHs (91% response rate) and 708 ALs (88% response rate). Using regression analysis, we compare the factors that predict retention rates among providers with complete data on retention and controls. The same covariates relating to structural and financial characteristics, as well as staffing, management, and a number of retention best practices are used. Average DCW and CNA retention rates were 66% and 61% in ALs and NHs, respectively, with some settings reporting very low (and even 0%) retention over a year. AL and NH providers rated the problem’s severity highest (6 out of 10) compared to retaining other licensed nurses. Similar and different predictors were found across financial, environmental, and managerial practices supporting retention. CNA and DCW retention strategies may not be equivalently meaningful between settings, given differing working environments, resources, and regulations. Aging services managers should be attuned to practices supporting retention in their industry.
Personality Disorders and System Use Among Older Veterans Using the Veterans Health Administration
Authors: Jedele Jenefer , Griffin Cameron , Nelson Sharon 
Published: December 2020

Abstract
Personality disorders (PD) are defined by longstanding patterns of dysfunctional behavior and associated with higher risk for adverse outcomes, such as suicide and comorbid mental health (MH). Despite recognition that PDs manifest differently as individuals age, few studies have examined PDs in older adults. VHA serves a significant population of older Veterans, providing a valuable opportunity to explore PD in older ages. Using FY2019 administrative data, we compare documented PDs, MH, and VHA use in a cohort of recent Veteran VHA users 50 years and older, across six age groups. At least one PD was documented for 0.8% of the total cohort, decreasing with age from 1.8% (50-54) to 0.2% (75+). Among those with PD, 98% had a comorbid MH disorder with the greatest percent having a major depressive disorder (69.7%). Except for dementia, comorbid mental health disorders generally decreased with age. Suicide risk flags were documented for 8.2% of cohort Veterans with PD compared to 0.7% with MH only. Behavior risk flags were documented for 4.3% of cohort Veterans with PD compared to 0.3% with MH only. The presence of both flags decreased with age. Compared to cohort Veterans with MH only, those with PD had more than twice the number of outpatient MH encounters and 1.5 times more psychiatric hospitalizations and ED visits for MH. Differences in care were consistent across age. However, differences in use were greatest for Veterans ages 55-64. The need to address crises resulting in the use of inpatient and ED is discussed.
Neighborhood Socioeconomic Position and Social Support in a Clinical Population of Older Adults
Authors: Berg Kristen , Perzynski Adam , Krieger Nikolas I , Einstadter Douglas , Dalton Jarrod 
Published: December 2020

Abstract
Models of successful aging underscore the critical role of external social resources in older adults’ health and well-being. Neighborhood socioeconomic position is known to influence health, but little is known about the linkages between neighborhood conditions, social relationships and health among older adults. We identified a cohort of 12,434 adults (aged 65+) who attended a Medicare Annual Wellness Visit from the NEOCARE Learning Health Registry. NEOCARE includes electronic health record (EHR) and neighborhood data from 1999-2017 on over 3 million unique Northeast Ohio individuals. The study population was 60% White, 32% Black or African American, 64% female, and 90% non-Hispanic. Over 60% were ages 65-74, 29% 75-84, and 10% 85 years or older (range from 65 to 101). We used ANOVA and chi square tests to examine variation in social support by quintile of the census tract area deprivation index. Compared to those in less disadvantaged neighborhoods, older adults in more disadvantaged neighborhoods were more likely to report needing help with care needs (Bonferroni-corrected x2=95.21, df=4, n=8,967, p&lt;.001) but were less likely to report having help at home (x2=85.72, 4, n=12,354, p&lt;.001). Similarly, adults in more disadvantaged neighborhoods reported less help available to them compared to those in more advantaged communities (F=39.31, df=4, n=12,099, p&lt;.001). Furthermore, older adults living in more disadvantaged neighborhoods experienced significantly less functional independence (F=3.68, df=4 , n=8,571, p&lt;.01). Our results suggest that the pathway from neighborhood socioeconomic conditions to successful aging includes perceived social needs and social support.
Profile Groups Based on Lifestyle and Differences in Mental Health and Cognition
Authors: Kim Joseph , Kim Kyuree 
Published: December 2020

Abstract
The purpose of this study was to identify the profiles of older adults according to lifestyle. Data for the study were from the 2017 Consumption and Activities Mail Survey (CAMS). CAMS 2017 is a questionnaire mailed to a sub-sample of respondents from the Health and Retirement Study. Participants were limited to older adults 65 and older, and the final sample consisted of 1136 older adults. The sample included 443 men and 693 women. Caucasians comprised 82.0% of the participants. Lifestyle was measured through items assessing the amount of time spent on activities. Due to high skewness, the items were dichotomized, 0=no time spent on activity and 1=time spent on the activity. Latent class analysis (LCA) was performed to identify groups based on lifestyle. LCA is a person-centered approach for identifying unobserved subgroups based on similarity in responses to items. Three lifestyle groups were identified. Group 1 was “Outgoing” with 471 individuals. Group 2 was “Adequate” with 229 individuals. Group 3 was “Inactive” with 436 individuals. An ANOVA was then conducted to assess mean differences in self-rated health, cognition, depressive symptoms, and loneliness for the three lifestyle groups. The “Outgoing” and “Adequate” groups had significantly higher scores on self-rated health and cognition, and in addition, significantly lower scores on depressive symptoms and loneliness compared to the “Inactive” group. No significant differences were observed between the “Outgoing” and “Adequate” groups. An implication from this study is the importance of maintaining an active lifestyle in later life for better mental health and cognition.
Factors Related to Workplace Well-Being: Occupational Health and Safety of Older Workers in Hong Kong
Authors: Lee Vincent , Lai Daniel W L , Cheung Kin , Luk Calvin , Bai Xue , Li Jessica J , Wu Joan 
Published: December 2020

Abstract
As Hong Kong is undergoing rapid population ageing over the past few decades, and this trend is expected to persist due to low fertility rates and extended life expectancy. This trend has significant implications for Hong Kong’s labor market and workforce. This study aims to gain a better understanding of the experiences, needs, and definitions of older workers in Hong Kong. It helps to draw attention to issues of occupational safety and health (OSH) risks and help identifying and promoting strategies and interventions for effectively supporting the ageing workforce in the workplace. The major objective of this research is to identify the OSH problems and challenges perceived by the older workers, employers and other stakeholders. Both quantitative and qualitative research methods are applied. A qualitative study with focus groups and individual in-depth interviews have been conducted with a representative sample of 70 stakeholders, including employees, employers, representative of labour unions, policymakers, NGO representatives and researchers in the related disciplines. We obtained their views on age-related changes within the older workforce and how such changes would affect their work ability, the OSH issues facing the older workers in different industries, and the facilitators and barriers associated with remaining in or joining the labour force. Feasible intervention strategies for effectively supporting the ageing workforce in the workplace are also being identified.
Financial Resources and Later-Year Relocation From the Annuitized Assessment of Income and Assets
Authors: Chen Jun-Hong , Park Sojung 
Published: December 2020

Abstract
Solid evidence has shown financial resources play important roles in housing decisions among older adults. Despite the growing research on the joint assessment of income and assets as valid economic well-being, little attention is paid to its role in relocation in old age. Drawing from the Behavioral Model of Elderly Migration, this study examined to what extent financial resources are associated with the likelihood of moving in later years. The data came from the 2017 Panel Study of Income Dynamic (PSID). A sample of 1354 people, 65 years and older, was used in the analyses. We used the annuitized approach, which is different from conventional approaches that assume people draw down all available assets to satisfy daily needs and leave no assets for use in later years. We (1) assessed annuitized assets based on the 2019 IRS Mortality Table, (2) assessed yearly income using supplementary income (i.e. income plus non-discretionary expense). A final indicator of the summed score was used in a logistic regression to predict the likelihood of moving. A set of covariates known to affect later- year relocation at an individual level (e.g. health condition, living arrangement change), environmental level (e.g. rural, non-metro area) are controlled for. In clear conflict with previous studies, we found annual financial resources did not significantly influence relocation among older adults. The notable absence of the well-known role of the economic factor provides critical initial evidence about the importance of simultaneous assessment of financial resources for the literature on later year relocation.
Age-Friendly Initiatives at Arizona State University: Building Transformative Learning Systems for All
Authors: Knopf Richard , Talmage Craig , Baker Abby 
Published: December 2020

Abstract
The AFU global initiative begin with a collaborative agreement by Arizona State University (ASU), Dublin City University (DCU), and the University of Strathclyde in 2012. The vision was to spur other universities to be fully inclusive of all generations. In 2013, ASU and DCU created a Trans-Atlantic Catalyst Fund to spur AFU initiatives at each institution, with an early focus on research in on dementia, technologies for “aging in place,” challenges of caregiving, healthy and active aging, and retirement community design. Since then, ASU has embedded Age Friendly practices throughout the institution via creation of a new foundational charter (success is “measured not by whom ASU excludes, but by whom ASU includes”), creation of ASU-wide Center for Innovation in Healthy and Resilient Aging, a re-purposed Osher Lifelong Institute, construction of the Mirabella community (twenty-story gateway for older adults into ASU), new inter-generational learning platforms, and implementation of universal learning systems.
Increasing Outreach and Expanding Inclusion: Community-Based Educational Gerontology
Authors: Sasser Jennifer 
Published: December 2020

Abstract
Gerontologists have the opportunity to step into an increasingly significant role as public educators who convene gatherings focused on expanding aging awareness and literacy, inter-generational inquiry and collaboration, and age inclusion, equity and justice. The purpose of this presentation is to share creative design principles and keen take-aways from several ongoing community-based educational interventions connected to these themes. As well, we will discuss the role such public-facing initiatives might play in making a compelling case for the importance of supporting and participating in various kinds of formal educational pathways in the field of aging. Part of a symposium sponsored by the Community College Interest Group.
Age-Friendly Community Education: Fostering Health Behavior Change in a Medically Underserved Community
Authors: Thompson Katherine 
Published: December 2020

Abstract
The University of Chicago GWEP, SHARE Network (Supporting Healthy Aging Resources and Education), is located on the South Side of Chicago, an urban medically underserved community. SHARE Network partners with a variety of community based organizations (CBOs) to support Age Friendly care through an Age Friendly Community Education Curriculum. In a one year period, 28 events were held in 13 CBO sites. Each of these events addressed the 4Ms of Age Friendly care with a specific content focus on Mentation (5 events), Mobility (5), Medications (4), and What Matters (10), and 4 events focused on multiple domains. There were 458 attendees, 290 completed surveys (63% response rate). Eighty-eight percent of participants planned to make a healthy behavior change after participation. Age Friendly Community Education can complement health system transformation to lead to health behavior change for community-dwelling older adults in medically underserved communities.
Age Differences in Discrete Emotional States During Risk Taking
Authors: Young Nathaniel , Mikels Joseph 
Published: December 2020

Abstract
Emotions often guide risk-taking. For example, anger tends to lead to increased risk-taking. However, older and younger adults differ in their emotional experiences: older adults tend to report more positive emotions, fewer experiences of anger, and relatively similar or increased experiences of sadness relative to younger adults. As such, differences in emotional experience may manifest in the integral emotional responses of older and younger adults as they take risks. The current work examined the discrete integral emotional responses of older and younger adults as they completed the Balloon Analogue Risk Task (BART). For the BART, participants completed 40 trials. Prior to each trial, participants reported how much anger, sadness, contentment, and excitement they felt. The results indicate that younger adults experienced more anger and less contentment than older adults in response to the BART. Importantly though, age differences also emerged in how discrete emotions predicted subsequent risk-taking.
From Infantilizing to Collaborating: Interactions in an Adult Day Center in Taiwan
Authors: Lin Shumin 
Published: December 2020

Abstract
Many studies have found that interactions in long-term care settings are characterized by infantilizing speech towards older adults, which was principally interpreted as detrimental to older adults’ health and self-esteem. These studies, however, focused on how caregivers talked to older adults and were conducted primarily in Western countries. How older adults respond to and make sense of such speech has received little empirical investigation (Marsden & Holmes, 2014). In this paper, I re-examined issues related to infantilizing speech based on 6 months of fieldwork in an ADC in Taiwan, which serves 33 older adults (aged 66-94), including 16 diagnosed with dementia. My data (including observational fieldnotes, 72 hours of video-recordings of naturally-occurring interactions, and conversations/interviews with caregivers, older adults and their family members) show that the ADC was discursively co-constructed as a learning place with frequent didactic interactions that occurred both ways. Many older adults (those with dementia included), with little or no education before, cherished the opportunity to be “students” for the first time. Caregivers also appreciated learning various things from the older adults. Furthermore, didactic interactions co-occurred or were interspersed with relational interactions, including teasing, humor, and bodily interactions that show mutual friendliness and care. By taking into account the wide variety of interactions, attending to the contributions of all parties, and situating these interactions in the personal as well as social histories, this study demonstrated that even didactic or so-called infantilizing interactions were used by caregivers and older adults as they collaborated to create strong positive relationships.
Perceptions of Aging and Inflammation in the Context of Older Adult Married Couples
Authors: Ermer Ashley , Segel-Karpas Dikla 
Published: December 2020

Abstract
The current study takes a dyadic perspective to understand how self-perceptions of aging are associated with C-reactive protein, an inflammation marker, among older adult married couples. The potential moderating role of marital support and strain are also examined. Respondents include 668 married couples who participated in the 2014 wave of the Health and Retirement Study. Actor-Partner Interdependence Models were conducted in Mplus. Age, functional limitations, income, and race served as covariates. Husbands’ greater positive perceptions of aging were significantly associated with their own lower levels of inflammation. Husbands’ greater positive perceptions of aging were significantly associated with lower levels of inflammation for women who reported lower levels of marital strain; this was not the case for women who reported higher levels of marital negativity. This study exemplifies how relationship factors are necessary to consider when examining age perceptions and health among marrieds.
Health Justice as the Catalyst for Improving Health in Underserved Settings
Authors: Wiese Lisa , Williams Ishan 
Published: December 2020

Abstract
Older adults face an increased incidence of Alzheimer’s disease and related dementias (ADRD) due to higher prevalence of risk factors such as lack of awareness of ADRD and reduced access to care. Furthermore, African American and Hispanic communities, which often reside in rural areas, face 1.5-2 times the risk of ADRD. The purpose of this research was to address this disparity. We conducted three studies investigating stakeholder perceptions about screening and ADRD knowledge from six diverse rural sites. Survey results revealed that regardless of rurality and education, most rural (71%) older adults believed heart disease and poor diet increased ADRD risk and were willing to be screened. Yet only 15% had been tested for memory loss by their provider. Rurality was the only significant predictor of willingness to participate in screening. It is important to maintain a focus on pursuing health justice among rural older adults facing multiple health disparities.