bluuebunny/crossref_metadata_2025_split huggingface dataset:
STATE PERFORMANCE ON HOME- AND COMMUNITY-BASED SERVICES EXPENDITURES UNDER THE BALANCING INCENTIVES PROGRAM
Authors: Shih Regina A , Friedman Esther M , Ghosh-Dastidar Bonnie , Escarce Jose 
Published: November 2019

Abstract
Medicaid has been at the forefront of policy efforts to “rebalance” long-term services and supports (LTSS) from institutional toward home- and community-based services (HCBS). The Balancing Incentives Program (BIP), authorized under the Affordable Care Act, sought to increase spending on HCBS relative to total LTSS among states that were spending less than 50% of total Medicaid LTSS dollars on HCBS each year. BIP’s benchmark for states to spend more than 50% of LTSS on HCBS was meant to improve states’ infrastructure to ensure an equitable, consumer-friendly process to access HCBS. For the first time, we quantified how states performed on HCBS expenditures. We analyzed state-level HCBS expenditure data for states eligible for BIP (n=35) from 2008 to 2015, which includes several years both before and after BIP implementation. We examined the effect of BIP on HCBS expenditures as a percent of total LTSS spending using fixed-effects modeling which controls for stable characteristics of states and years. We find that BIP states increased HCBS spending relative to non-BIP states, and this effect continued to grow over our study period. In the first year after BIP implementation, BIP states increased spending by 1.8% relative to non-BIP states. The difference in spending between BIP and non-BIP states is even larger in subsequent years (4.8% in year 2, 5.3% in year 3, and 5.8% in year 4). Results indicate that BIP prompted increased state-level spending that continued to rise several years after initial implementation of BIP.
COMPOSITE MEASURES FOR MULTIDIMENSIONAL SOCIAL EXCLUSION: AN APPLICATION TO THE IRISH LONGITUDINAL STUDY ON AGEING
Authors: Keogh Sinead , Neill Stephen O’ , Walsh Kieran 
Published: November 2019

Abstract
The measurement of the complex, multidimensional and dynamic concept of old-age social exclusion has been constrained due to theoretical and methodological challenges as well as a reliance on secondary data sources not designed to collect social exclusion indicators. Limitations in measuring social exclusion in later life hinder the expansion of our empirical and conceptual understanding of social exclusion. In this paper, we seek to address these limitations by developing a composite measure of old-age social exclusion using three methods: 1) normalisation through re-scaling with linear aggregation, 2) a sum-of-scores approach with an applied threshold and, 3) classification and regression trees (CART), a machine learning approach. Using the conceptual framework of old-age exclusion presented by Walsh et al., (2017), these three approaches are applied empirically with data from Wave 1 of The Irish Longitudinal Study on Ageing (TILDA). The measures are assessed in terms of their ability to explain a validated measure of psychological well-being. Results suggest that despite the challenges associated with secondary data and measurement techniques that implicitly measure social exclusion, the newly proposed composite measure computed using CART performed better than the other two measures which are more prevalent in the literature.
HUMAN RESOURCES PROFESSIONALS’ PERCEPTIONS OF AGE-FRIENDLY EMPLOYMENT
Authors: Choi Mi Sun , Dabelko-Schoeny Holly , White Katie , Sheldon Marisa 
Published: November 2019

Abstract
Many researchers have attempted to find alternative ways to address the challenges of the aging workforce. Applying the concept of age-friendly to work settings may be a promising strategy to promote older adults’ well-being in the workplace. However, age-friendly employment is an abstract concept, and empirical research identifying its features is lacking. Also, few studies adequately represented the diverse characteristics of different industries and stakeholder’s perceptions of age-friendly work environments. This study used focus group data and the Delphi method, along with existing literature to create an instrument to measure age-friendliness in diverse work environments. In partnership with a senior employment organization serving central Ohio, six human resources (HR) professionals participated in a focus group discussion and 10 HR professionals participated in a two-round Delphi study. In the focus group discussion, HR professionals identified flexibility, mobility, ergonomics, health benefits, and respect as age-friendly aspects in the workplace. We developed 37 items within five subcategories: accommodation, development, maintenance, utilization, and inclusion. In the first round, HR professionals assessed the importance of each item, presenting training opportunities for employees of all ages as the most important practice; four weeks later they examined the revised 33 items in regard to the feasibility of their real-world implementation, showing 100% agreements among experts in career advice, opportunities for promotion, involving decision making, educating age discrimination, and formal acknowledgment. The second phase of this study will include scale evaluation to confirm its reliability and validity with a broader number of HR professionals and older adults.
PATHWAYS TO RESILIENCE: TRANSFORMING TRAUMA THROUGH THE POWER OF NETWORKS
Authors: Corley Connie , Feldman Maureen , Kaiser Scott 
Published: November 2019

Abstract
Resilience has been examined in various age groups, initially focused on vulnerable children and more recently in enhancement of resilience in various age groups and in response to trauma. Based on studies of resilience in Holocaust survivors and intergenerational engagement to promote resilience in former gang members and isolated older adults, Corley’s 3E model of Experience, Expression and Engagement is discussed in terms of multiple studies and the implications for forming and strengthening networks in communities at risk. This includes initiating creative coalition-building endeavors to address loneliness in residential settings for older adults evolving from a project funded to the Motion Picture and Television Fund in Los Angeles from the AARP Foundation.
DEVELOPING TRAUMA-INFORMED APPROACHES IN PUBLIC HOUSING COMMUNITIES FOR OLDER PERSONS
Authors: Bowland Sharon , Knight Becky 
Published: November 2019

Abstract
In a study using a grounded theory approach with trauma survivors living in a mixed-age public housing community in Louisville, KY, twenty-five older women (50+) identified their main concern as housing safety. The study underlined the importance of community-level effects on health and well-being. Additionally, almost all participants identified that they had multiple experiences of interpersonal trauma across the life course. There may be increased negative health effects for older women living in public housing based on a history of interpersonal trauma. First, we will examine how women living in the community coped with their safety concerns. Second, we will explore policy implications of older trauma survivors living in communities that may exacerbate their trauma histories due to an ongoing lack of safety. Finally, we will consider how implementing trauma-informed approaches in public housing can potentially lead to improved health and well-being for those living with complex trauma.
SHORT-TERM U.S. PATHS TOWARD RETIREMENT: SIMILARITIES AND DIFFERENCES ACROSS AGE-GENDER-CLASS INTERSECTIONS
Authors: Flood Sarah , Moen Phyllis , flood sarah , Wang Janet 
Published: November 2019

Abstract
Existing knowledge about retirement transitions comes from studies of cohorts living through demographic, technological, social and economic environments, and private sector and public policy regimes that are very different from those of today. The Boomer cohort now transitioning to retirement is more educated, healthier, and more engaged in paid work than their parents or grandparents at the same ages. How is the large, diverse Boomer cohort (in their 50s, 60s, and 70s) navigating leaving the labor force compared to the Silent Generation preceding them? How similar or different across cohorts are patterned yet heterogeneous short-term workforce pathways, in terms of the timing, sequencing, and voluntariness of working hours, work participation, and exits, including subjective retirement? We use linked Current Population Survey (CPS) panel data (over 16 months) to capture change, complexity, heterogeneity, and inequities in even short-term work/retirement dynamics across intersections of age, gender, and class.
INFLUENCES OF CAREWORK INTENSITY ON DAILY TIME USE PATTERNS OF CAREGIVERS
Authors: Sayer Liana C 
Published: November 2019

Abstract
With the aging of the Baby Boom generation, increasing numbers of older adults require assistance in their daily lives and most help comes from family members. Delays in childbearing mean many adult elder care providers are simultaneously raising children. Although past research has documented disparities in psychological distress and financial costs, less is known about the social costs resulting from elder caregiving and how this varies by parental status. We examine the social costs of elder caregiving by comparing elder and child care configurations to investigate three questions. First, do the daily time use patterns of elder caregivers differ by parental status? Second, do the daily time use patterns of elder caregivers differ by caregiving intensity? Third, does caregiving intensity moderate associations of elder caregiving and parental status on daily time use? We address these questions using nationally representative time diary data from the 2011-2017 American Time Use Survey (ATUS).
HOUSEHOLDS AND LIVING ARRANGEMENTS OF OLDER PERSONS AROUND THE WORLD
Authors: Kamiya Yumiko , Kamiya Yumiko , Hertog Sara 
Published: November 2019

Abstract
The household living arrangements of older persons – whether living alone, with a spouse or partner, with their children or in multi-generational households – can be an important factor associated with their health, economic status and overall well-being. Understanding the patterns and trends in older persons’ living arrangements is thus relevant for global efforts to achieve the sustainable development goals, in particular those targeting poverty, hunger and health. The United Nations Database on the Households and Living Arrangements of Older Persons 2018 presents evidence drawn from 672 unique data sources, including census and survey microdata samples archived at IPUMS-International and household rosters from Demographic and Health Surveys, among other sources. The resulting dataset describes older persons’ households across 147 countries or areas, representing approximately 97 per cent of persons aged 60 or over globally.
DISTRIBUTION, PREDICTORS, AND CLINICAL RELEVANCE OF 5-YEAR CHANGE IN FRAILTY MEASURES
Authors: Huisingh-Scheetz Megan , Wroblewski Kristen , Ferguson Mark , Huang Elbert , Waite Linda , Schumm L P 
Published: November 2019

Abstract
Implementing frailty assessment into routine clinical practice is a priority. Gait speed and performance on 5 repeated chair stands are two measures of frailty. We face a number of clinical implementation challenges: (1) We lack normative data for U.S. older adults and (2) The clinical relevance of change in frailty measures is unclear. The National Social Life, Health and Aging Project dataset allows an examination of the distribution of 3-meter gait and 5-repeated chair stands times as well as 5-year change in these measures in a nationally-representative, community-dwelling older adult sample. Dr. Huisingh-Scheetz will describe demographic predictors of change in these measures as well as determine whether baseline plus 5-year change in these measures predicts loss of independence in activities of daily living (ADLs).
FACTORS FACILITATING COLLABORATION AND ENGAGEMENT: BUILDING AND SUSTAINING STATEWIDE COALITIONS
Authors: Henage Cristine B , Schneider Ellen C , Roberts Ellen , Tilley Vicki , Busby-Whitehead Jan 
Published: November 2019

Abstract
Sustaining collaboration across multiple community-based organizations (CBOs) creates synergies and economies of scale to support age-friendly communities beyond the provision of direct services any single CBO can achieve. The Carolina Geriatrics Workforce Enhancement Program (CGWEP) created and sustained multiple statewide coalitions focused on geriatrics syndromes. More than 290 CBOs, including Area Health Education Centers, social services programs and nongovernmental organizations, meet quarterly to form linkages, promote education and build infrastructure to support rural and underserved older adults. Shared governance with pooled resources has been achieved because of a long history of partnership, mutually beneficial relationships, flexibility, and frequent communication. The strength of the partnership is evidenced by continued growth in number of CBOs, number of sponsored events, and number of referrals to CBOs. Two coalitions, focused on falls prevention and mental health respectively, have been adopted by partners and sustained beyond grant funding.
EVALUATION OF ART ON THE BRAIN, A HEALTH APP FOR OLDER ADULTS, IN LONG-TERM CARE
Authors: Howard Elizabeth P , Retalic Tammy , Rogan Jessica 
Published: November 2019

Abstract
ArtOn the Brain is a mobile application that incorporates art history education, play and socialization for older adults. This pilot project examined its health and social impact among long term care residents. A convenience sample of 48 residents, 60+ years, with borderline intact to moderate cognitive impairment were recruited. Residents with mild or better cognitive status used the app individually on a tablet while the remaining participated in therapist-led group sessions. One-hour intervention occurred twice weekly. Primary outcomes, health and well-being, were measured with 5Q-5D-5L and Warwick-Edinburgh Mental Well-being tools at baseline and after 6 weeks. Secondary outcomes were mood, cognition, function and overall satisfaction with activity options and personal relationships. Pre-post paired t-test analyses of data from EQ-5D-5L and Warwick tools did not show a significant difference. There were no notable declines with cognitive performance, functional ability and depression post-intervention. Four activity options and three personal relationship items had statistically significant improvements post-intervention. Activity options addressed engagement in enjoyable activities on weekends and evenings, and opportunity to, spend time with other like-minded residents and explore new skills, interests. Personal relationships items included engagement in activities helpful to others and having people to do things with. ArtOn the Brain is a novel application suitable for long term care residents. While 6 week intervention did not show improvement in overall health and well-being, there were significant improvements with residents’ reported engagement in activity options and improvement of personal relationships. Longitudinal evaluations are needed to examine changes in health status and well-being.
WHAT DETERMINES THE USE OF MEANING FOCUSED COPING IN DEMENTIA CAREGIVING?
Authors: Yu Doris , cheng Sheung Tak 
Published: November 2019

Abstract
Meaning-focused coping has been identified as an important factor contributing to more positive adjustment and health outcomes for family caregivers of persons with dementia. Yet, there is less evidence about what determines the use of this coping strategy. Based on the Meaning Making Model, this quantitative exploratory study identified the relationship between meaning focused coping and intrinsic motivation towards caregiving, quality of relationship between the care dyads and level of religiosity. Two hundreds and five family caregivers of PWD were recruited from a geriatric clinic from March 2018 – Feb 2019. A battery of questionnaires including the Meaning-Focused Coping Scale, Relationship Quality Scale, the Duke University Religion Index and Intrinsic Motivations to Care was administered in face-to-face interview. By using hierarchical regression analysis to control the effects of caregivers’ demographic profile, caregiving history, clinical severity of dementia, and level of neuro-psychiatric symptoms, the results indicated that a higher intrinsic motivation to caregiving (β = 1.457, p = 0.044), better dyadic relationship quality (β = 0.768, p = 0.004) and a higher level of religiosity (β = 0.969, p = 0.001) are independently related to a higher likelihood of using meaning-focused coping. The findings shift the paradigm of caregiver support from a deficit model to helping them to appraise the meaning of caregiving in dyadic relational, spiritual and motivational perspectives. The application of strength-based and person-centered approach to caregiver supportive program will be discussed.
USING MOBILE TECHNOLOGY TO ELUCIDATE PSYCHOSOCIAL AND COGNITIVE FUNCTION IN OLDER ADULTS
Authors: Roque Nelson A , Hyun Jinshil , Scott Stacey B 
Published: November 2019

Abstract
Ambulatory methods (AM) improve the reliability and ecological validity of cognitive assessments, and help to elucidate psychological influences through concurrent reports of pain, stress, and other psychosocial outcomes. Ecological momentary assessment (EMA) involves sampling of daily experiences in natural settings, including completing cognitive assessments, and answering questions related to, for example, social interactions and sleep. The purpose of this symposium is to present innovative methods and results, exploring questions at the intersection of intensive longitudinal data collection, cognition, and psychosocial influences, using data from two EMA studies, the Einstein Aging Study (EAS) and the Effects of Stress on Cognitive Aging, Physiology, and Emotion (ESCAPE) Study. The EAS (ages &gt;= 70) and ESCAPE (ages 25 - 65) protocols, ask participants to complete an annual 14-day EMA measurement burst. A unique value of these methods is the ability to explore effects from moment-to-moment (or day-to-day; within-person effects) as we will present. We will also contrast these with conventional analyses of between-person differences, typical of clinic and in-person studies. Dickens (using ESCAPE data) examines end-of-day perceived stress and anticipation of next-day stress in predicting sleep quality. Hyun and colleagues (using EAS data) discuss the effects of affectionate physical touch on mitigating pain and emotional distress. Using a model-based cluster analysis approach (with EAS data), Roque unpacks differences in psychosocial factors, as a function of cognitive status risk groups. Stacey Scott will discuss these papers in the context of using ambulatory methods to improve the characterization of risk status in older adults.
AFFECTIONATE PHYSICAL TOUCH MITIGATES PAIN AND EMOTIONAL DISTRESS IN OLDER ADULTS
Authors: Hyun Jinshil , Lipton Richard B , Zhaoyang Ruixue E , Graham-Engeland Jennifer E , Pavlovic Jelena M , Sliwinski Martin J 
Published: November 2019

Abstract
Although research suggests that social interactions can decrease pain and emotional distress, it is unclear what produces these salubrious effects. We examined whether older adults experienced lower pain and emotional distress after two types of social interactions (affectionate physical contact and non-physical pleasant interactions) using data from the Einstein Aging Study (N=193, age=70-92). Participants completed a 14-day ecological momentary assessment protocol via which they reported the quality of recent social interaction, types of physical touch, levels of current stress, negative affect, and pain intensity five times a day. Multilevel models indicated that, following affectionate physical contact, individuals reported low levels of current pain intensity, negative affect, and stress (ps&lt;.05). Following a pleasant non-physical interaction, individuals reported low negative affect (p&lt;.05); pleasant interactions did not predict current pain or stress. Results highlight the potential unique utility of affectionate physical contact versus mere pleasant social interactions in older adults’ daily lives.
DAILY EFFECTS OF PERCEIVED AND ANTICIPATED STRESS ON SUBJECTIVE SLEEP QUALITY
Authors: Dickens Chelsea N , Sliwinski Martin J 
Published: November 2019

Abstract
Prior studies of stress and sleep have postulated that anticipation of future stress may have a greater impact on sleep quality than stress experienced during the day. We examined this possibility using data collected over 14 consecutive days. Participants (Npersons=257, age=25-65) rated each evening how stressful the day was and how stressful they expected the next day would be. Each morning, participants rated their subjective sleep quality. After adjusting for the effect of the previous night’s sleep, on days when individuals reported feeling more stressed, they also reported not sleeping as well that night. However, expectations of stress the next day did not have an effect on sleep quality, suggesting that stress experienced during the day impacts sleep quality more so than anticipation of future stress. Despite previous findings that older age is associated with sleep complaints, age did not act as a moderator in our analysis.
AGING INTERVENTIONS GET HUMAN: CAN WE EXTEND HEALTHSPAN?
Authors: Kennedy Brian 
Published: November 2019

Abstract
Understanding biologic aging will afford opportunities for novel interventions to enhance human healthspan. If ageing can be slowed, the effect would be simultaneous protection from many of the chronic diseases. One strategy is to use animal model organisms to find common pathways that modulate ageing and then to seek methods for their human manipulation. The TOR pathway is one point of convergence and a clinically approved drug targeting the TOR kinase, rapamycin, extends murine lifespan and healthspan. Many more small molecules are being added to the list of anti-ageing compounds. Here, I use examples of interventions to conceptualize how agents extending healthspan might improve human health. We are entering a stage in aging research where it is imperative to test ageing interventions in humans and several strategies are contemplated. The potential to directly impact human healthspan is emerging from ageing research and this approach, if successful, will have global impact.