bluuebunny/crossref_metadata_2025_split huggingface dataset:
OLDER ADULT FALLS PREVENTION: THREE ADOPTED CLINICAL STRATEGIES FROM EVALUATION OF THE CDC STEADI INITIATIVE
Authors: Edwards Jennifer , Bickford Brittany , Johnston Yvonne , Alford Aaron 
Published: November 2019

Abstract
This evaluation examines patients’ barriers and facilitators to adopting an evidence-based fall prevention strategy. Twenty-one patients were telephone interviewed. The purposive sample includes patients over age 65, screened as at risk for falls, and who received a referral for falls risk intervention. Seven themes emerged from the qualitative analysis of interview transcripts: 1. Behavioral Facilitators, 2. Personal Fall Experiences, 3. Informed Decision-making, 4. Providers, 5. Friends and Family, 6. Home Setting Facilitators, and 7. Risk Perception. Three opportunities were identified: 1. Develop an outpatient follow-up protocol, 2. Develop a falls screening public service announcement, and 3. Partner with the local Office for Aging to connect patients at risk with community programs such as Tai Chi. A systems approach involving the CDC, National Network of Public Health Institutes (NNPHI), Broome County Health Department, and an Upstate New York hospital system’s outpatient practices was vital for the success of this evaluation.
TAKING THE HIGH (SCHOOL) ROAD: DEVELOPING INTERGENERATIONAL INTEREST FOR CAREERS IN AGING
Authors: Karasik Rona J , Greenberg Phyllis A 
Published: November 2019

Abstract
Invisibility and ageism are ever-present challenges to developing a work-force commensurate with the expanding older population (Augustin & Freshman, 2016). Intergenerational and experiential endeavors (e.g., Simulations, Service-Learning, Careers in Aging Week) can counter stereotypes while highlighting gerontology career opportunities. Focusing workforce development efforts on the oft-overlooked population of high school students (Zhang, 2015) has numerous advantages, including: (1) identifying aging-related career paths prior to college; (2) reaching students eligible to become CNAs/PCAs; (3) uncovering potential benefits (e.g., scholarships, tuition reimbursements) agencies may offer to student-employees and (4) countering aging stereotypes. This presentation reports on a multi-faceted undertaking which includes collaborating with local service agencies on a regional aging-workforce initiative, bringing high-school students to a college campus for CIAW events, participating in local/regional career events focused on high school students, and developing/implementing experientially-rich learning opportunities such as a college-credit bearing introductory course on aging to be taught at the high school.
TRAJECTORIES OF PHENOTYPIC MARKERS OF AGING AS PRECURSORS TO FUNCTIONAL CHANGE
Authors: Schrack Jennifer A , Kuo Pei-Lun , Simonsick Eleanor M , Resnick Susan M , Levine Morgan , Shardell Michelle 
Published: November 2019

Abstract
Delineating trajectories of aging phenotypes is essential to understanding mechanisms of clinical disease and disability. We investigated longitudinal changes in measures of body composition, energy expenditure, and brain volumes in &gt;900 participants (age 67.0 (IQR: 57-77) years, 48.1% male) of the Baltimore Longitudinal Study of Aging using mixed effects regression models. Computed tomography-derived thigh muscle cross-sectional area declined 754.2 cm2 per decade at age 60 years (p&lt;0.001) and 1294.3 cm2 at 75 years (p&lt;0.001). Energy reserves, defined as a ratio of energy-cost-to-energy-capacity measured using indirect calorimetry, decreased 11.2% per decade at 60 years (p&lt;0.001), and 16.8% at 75 years (p&lt;0.001). MRI-derived measures of total brain volumes declined 41.6 cm3 per decade at 60 years (p&lt;0.001) and 44.9 cm3 at 75 years (p&lt;0.001). Linking these findings to biological and clinical measures of aging may contribute to more accurate assessment of phenotypic age.
ASSESSING BRAIN VOLUMETRICS IN THE AGING BRAIN USING COMPUTED TOMOGRAPHY
Authors: Irimia Andrei , Maher Alexander , Rostowsky Kenneth 
Published: November 2019

Abstract
Although broadly utilized, computed tomography (CT) has been superseded by magnetic resonance imaging (MRI) for the volumetric assessment of white matter (WM), grey matter (GM) and cerebrospinal fluid (CSF) in the aging human brain. Nevertheless, many scenarios remain where MRI is unavailable or discouraged; furthermore, in developing countries, CT can often be the only accessible imaging method for assessing brain structure in older patients with mild cognitive impairment or Alzheimer’s disease. Thus, there is merit in developing effective approaches for the estimation of brain volumetrics using CT. Here, MRI and CT scans were acquired from 10 older adults [mean (µ) ± standard deviation (σ) of age = 65 ± 7 yrs; 5 females]. To demarcate WM, GM and CSF from head CT, we developed a brain segmentation method based upon probabilistic, atlas-dependent classification. MRI-only segmentation was compared to CT-only segmentation; similarity was calculated through the Dice coefficient (DC). A normal distribution of DCs was found after contrasting the methods [µ ± σ across participants: 85.5% ± 4.6% (WM), 86.7% ± 5.6% (GM) and 91.3% ± 2.8% (CSF)], suggesting a satisfactory capacity of CT to assess brain volumetrics. Sensitivity was adequate: WM, GM and CSF volumes were estimated within ~5%, ~4% and ~3% of their MRI-based values. There was no indication of volume over- or under-estimation with CT [t (9) = 0.89, p &gt; 0.80]. These results facilitate the integration of CT-based brain volumetrics with MRI, thereby offering a wider range of methods for quantifying macroscale brain changes in neurodegenerative diseases.
THE HIGH COST OF SOCIOECONOMICS ON RACIAL DISPARITIES IN HEALTHY AGING
Authors: Shaffer Nancy Chiles 
Published: November 2019

Abstract
Race-related differences in overall health across the age-span are well established; how differences manifest within a cohort selected for good functional status is unclear. Using data from Black and White older adults aged 70-79, in the Health, Aging and Body Composition (Health ABC) study, we created a healthy aging index (HAI) of mental health, fitness, lung capacity, bone mineral density, inflammation, and metabolic syndrome. We assessed if racial differences existed in HAI, the extent education, financial resources and stress attenuated any observed differences, and whether this varied by site (Memphis v. Pittsburgh). Blacks had lower HAI than whites, adjusted for age and site. Further adjustment for finances and education eliminated the effect of race in women and reduced the effect in men by 64%. A significant interaction between site and financial stress was observed. Future research should assess ways to reduce the harmful impact of low socioeconomic status on health.
RECRUITING LGBT OLDER ADULTS FOR RESEARCH
Authors: Prasad Anyah , Fisher Alice , Immel Michael , Boerner Kathrin , Jethwani Kamal , hale Timothy , Centi Amanda 
Published: November 2019

Abstract
LGBT older adults constitute a rare population and so are methodologically difficult to recruit. Due to stigma, many of them may not disclose their sexual/gender identity, which makes it challenging for researchers to reach out to them. Due to history of discrimination, LGBT older adults may not trust researchers. The purpose of this presentation is to discuss strategies used to recruit LGBT older adults to a study on exploring the idea of an online senior center for LGBT older adults in Massachusetts. Building a rapport with community stakeholders, developing trust and having LGBT older adults themselves as part of the research team were important tools to help overcome these challenges. LGBT older adults are very diverse and focused efforts should be made to recruit them from various racial/ethnic backgrounds, rural areas; also, those who are not publicly open about their identity, and who are home bound due to restricted mobility.
RECRUITING FAMILY CAREGIVERS OF PERSONS LIVING WITH DEMENTIA FOR PARTICIPATION IN AN ONLINE INTERVENTION
Authors: Brewster Glenna , Epps Fayron , Nash Rachel , Griffiths Patricia , Phillips Janice , Nocera Joe , Shah Raj , Hepburn Kenneth 
Published: November 2019

Abstract
Responsibilities of caregiving for persons living with dementia make it challenging to participate in in-person research studies. Caregivers may be more willing to participate in studies that are online. This presentation will highlight recruitment strategies of a 4-site telehealth caregiver intervention for caregivers of persons living with dementia. Thus far, we have recruited 596 participants over the period of 2 years: 76, 189, 164 and 167 from each of the sites, respectively. Community partnership strategies such as presentations at churches and events organized by the Alzheimer’s Association, and the Alzheimer’s Disease Research centers, using a handshake protocol, and using social media sites such as Facebook and Twitter have all been effective at recruiting participants. Ongoing communication among the staff at different sites is also an important aspect of successful recruitment. These strategies have enabled recruitment to continue at a consistent rate and enabled the maintenance of relationships within the community.
ASSESSMENT OF COMPARATIVE EFFECTIVENESS RESEARCH GAPS TO PROMOTE AGING IN PLACE: A STAKEHOLDER-DRIVEN APPROACH
Authors: Moscou-Jackson Gyasi , Gummi Sindhura , Clauser Steven B , Arora Neeraj K 
Published: November 2019

Abstract
A priority for many older adults is to remain in their homes and communities. This paper describes the Patient-Centered Outcomes Research Institute’s (PCORI) review of our investment in comparative effectiveness research (CER) that will advance the field of “aging in place.” To inform our systematic evaluation, we first engaged our multi-stakeholder advisory panel of patients/caregivers, clinicians, health systems leaders, and payers to develop and refine a conceptual framework for research focused on aging in place among older adults. Key themes from stakeholders were: aging in place interventions should be patient-centered and align with the patients’ needs and goals, studies should include individuals 55+ years who may be at risk for institutionalization, relevant interventions go beyond environmental modifications and include social support, healthcare (inclusive of palliative care), and personal care services. In addition, aging in place services should focus more on informal caregiver interventions and outcomes since informal caregivers play a major role in enabling older adults to age in place. We identified 14 PCORI-funded CER projects that will provide evidence on the most effective interventions to promote aging in place among older adults; the total investment is $113.4 million dollars. The portfolio is addressing decisional dilemmas faced by multiple stakeholders on a variety of topics including falls prevention, home-based palliative care, and community-based care models; however, several critical CER evidence gaps remain that need to be addressed in future funding investments and will be discussed during the presentation.
THE RELEASE OF TECHNICAL QUALITY AND PATIENT EXPERIENCE STAR-RATINGS FOR HOME HEALTH AGENCIES AND AGENCY SELECTION
Authors: Schwartz Margot L , Rahman Momotazur , Thomas Kali S , Konetzka R Tamara , Mor Vincent 
Published: November 2019

Abstract
To facilitate informed Home Health Agency (HHA) selection for the 3.5 million annual Medicare home health (HH) users, CMS introduced technical quality and patient experience summary star-ratings on the Home Health Compare website in July 2015 and January 2016. There is no information about the relationship between the introduction of these two unique sets of star-ratings and HHA selection. We utilized a conditional logit, discrete choice model, which accounts for all HHAs that each patient could have selected (their “choice-set”) based on ZIP codes, to assess this relationship. We selected a random 5% sample (203,966 admissions) of new Medicare Fee-for-Service HH admissions that occurred in the year before, or the year after star-ratings were released. Star-ratings were obtained from the HH Compare website and categorized as low (=4 stars). We found the introduction of HHA star-ratings was associated with an increased likelihood of selecting an HHA with a high technical quality star-rating, and a decreased likelihood of selecting an HHA with a high patient experience star-rating. After controlling for each patient’s choice-set, patients had 19% increased odds (OR 1.19, 95% CI:1.16,2.23) of selecting a high technical quality HHA and a 12% decreased odds (OR 0.88, 95% CI:0.84,0.92) of selecting a high patient experience HHA, compared to low quality HHAs. Findings suggest patients and referring providers may prioritize technical quality over patient experience. Policy-makers should provide resources to enable HH patients to utilize and interpret the two different HHA star-ratings.
DIGITAL MONITORING OF SLEEP, MEALS, AND EXERCISE AS A PREVENTIVE INTERVENTION FOR DEPRESSION IN BEREAVED SPOUSES
Authors: Stahl Sarah 
Published: November 2019

Abstract
The death of a spouse brings profound change to bereaved survivors’ lifestyle and daily routine. These changes disrupt circadian rhythms which, in turn, places individuals at high risk for depression. The purpose of this study is to examine the feasibility and acceptability of a 12-week behavioral intervention that targets the timing and regularity of sleep, meals, and physical activity via digital monitoring and motivational health coaching. Participants were 60+ years of age and assessed on intervention acceptability and adherence, depression symptoms (Hamilton Rating Scale for Depression) and the rest-activity rhythm, (a downstream indicator of the body’s circadian rhythm (via actigraphic technology). The intervention was rated highly by participants (n=55); 88% were compliant in digital monitoring and 95% were retained. Depression symptoms declined from pre-to post-intervention; and the regularity of circadian rhythms increased. An intervention that targets the regularity of day- and nighttime activities may reduce depression in older spousally-bereaved adults.
HARNESSING THE NETWORK OF GERONTOLOGY IN HIGHER EDUCATION TO IMPROVE RECRUITMENT STRATEGIES
Authors: Eaton Jacqueline , Neal Margaret B 
Published: November 2019

Abstract
While the workforce requires applicants trained to meet the needs of an aging population, many gerontology programs find recruiting students a challenge. Barriers to enrollment vary and are influenced by disciplinary silos, miscomprehension of terminology (such as “gerontology”), vague career paths, and limited resources. Program directors are challenged to identify innovative and new strategies that market training opportunities at a variety of levels and across colleges and departments. In an effort to harness the power of networks, it is our goal that this symposium fosters discussion in order to improve our communal approach to increase the number of individuals prepared for careers in aging. This symposium examines the recruitment experiences and challenges from the perspective of gerontology programs at four universities. Fruhauf (Colorado State University) explores the importance of university-community engagement in support of gerontology programs. Fauth and Liu (Utah State University) describe effective recruitment strategies for an interdisciplinary gerontology certificate housed within a department of Human Development and Family Studies. Eaton (University of Utah) presents the outcomes from a targeted initiative to increase early undergraduate enrollment in an interdisciplinary online gerontology minor. Finally, Yorgason (Brigham Young University) shares a systematic approach to leverage resources and fundraising that successfully increased program enrollment and faculty involvement throughout campus. Dr. Margaret B. Neal, an experienced educator and former director of the Institute on Aging at Portland State University, will facilitate discussion surrounding how we can mobilize our networks to strengthen, innovate, and expand approaches to recruitment in gerontology.
RE-IMAGINING LTC: QUANTITATIVE AND QUALITATIVE RESULTS OF A NATIONAL MODIFIED DELPHI STUDY, IMPLICATIONS AND NEXT STEPS
Authors: Kane Rosalie A , Degenholtz Howard 
Published: November 2019

Abstract
In 11/2016 Robert and Rosalie Kane began a 3-round Delphi study to re-imagine long-term care (LTC), , which took as a starting premise that LTSS in the United States fails to comport to the values and preferences of consumers. The Delphi study is “modified” from more typical Delphi designs because of 1) a sample sizes over 100, 2) an unusually broad topic--optimal LTC systems if not constrained by existing programs, financial arrangements and regulations; and 3) incorporation of new sample at each round. Round 1 asked respondents to rate and add to a list of values important to LTC&lt; but largely was an open-ended request for respondents’ ideas, Round 2 was fielded in 6/2018 with all data collection completed by 11/2018 (the delay partly due to Robert Kane’s sudden death on March 6, 2017 and also the time needed to analyze, summarize and present the complex and detailed responses to the first round). Round 3, to be fielded in 4/2019., will provide participants with the ratings of values, principles and programmatic building blocks at Round Two, and the open-ended comment of respondents in explanation of their ratings. Each Round is analyzed cross-sectionally and can be considered a separate “virtual town square.” Ellen McCreedy and Rosalie Kane, respectively, present quantitative and qualitative results from the first two rounds. Discussants will each comment briefly from their perspectives as 1) state LTC policy developer,2) LTC university-based researcher; 3) consumer advocate, followed by audience and presenter discussion of the implications of the findings.
GRANDPARENTING CHILDREN WITH DISABILITIES AND ITS IMPACT ON GRANDPARENT HEALTH
Authors: Abdul-Malak Ynesse , Meyer Madonna Harrington 
Published: November 2019

Abstract
Across the US, millions of grandparents are providing vital care for their grandchildren with disabilities when their adult children are in need of assistance and public programs do not provide needed supports. Research suggests the impact on grandparent physical health is mixed. This paper draws on in-depth interviews with 50 grandparents to explore how caring for grandchildren with disabilities shapes their physical wellbeing. We use life course perspective to assess the choices grandparents make from available resources and options at different stages of their lives and the effects on their health. We find in addition to providing routine care, helping with feeding, bathing, and dressing, some grandparents provide constant supervision and medically intense care, such as tending to feeding tubes, catheters, and oxygen lines. Many grandparents said care work has improved, or at least helped sustain, their overall level of fitness, while other grandparents find that care work has adverse impacts. Often there is too much chasing, bending, and lifting for their aging bodies. This paper suggests that stronger social programs for children with disabilities and the grandparents who step in to help them would decrease the negative effects of care work on grandparent health.
DOES PERCEIVED LONELINESS MATTER FOR DIVERSE OLDER MEN AND THEIR PROSTATE-SPECIFIC-ANTIGEN TESTING BEHAVIORS?
Authors: Cadet Tamara J , Burke Shanna L , Mitchel Jamie , Conner Kyaien , Nedjat-Haiem Frances 
Published: November 2019

Abstract
Evidence suggests loneliness is associated with poorer health practices and fewer health promoting behaviors, yet may be associated with greater use of the healthcare system. This dichotomy highlights the lack of understanding in the literature about the relationship between the experience of loneliness in early disease detection behaviors, such as prostate cancer screening and appropriate clinical interventions to support older men. Utilizing a series of logistic regression models, this investigation examined the relationship between loneliness and prostate cancer screening in 2008 and 2012 among White, Black, and non-Hispanic men, ages 50-74 years, (n= 4,875 for 2008 and 7.063 for 2012). The data source as the Health and Retirement Study. Findings indicate that White men were less likely to participate in PSA screening in 2008 if they felt left out or isolated. There was a reduced likelihood of screening among Black men who feel as though they have a lot in common with those around them in 2012. Utilizing approaches such as cognitive-behavioral therapy, motivational interviewing, and solution-focused practice, clinical social workers can have shared decision-making conversations to understand this phenomenon. Clinical social workers have unique training in the person-in-environment model that emphasizes the biological, psychological, social, and spiritual factors that influence behaviors such as cancer screening participation, that can help to understand men’s experiences, feelings or needs related to cancer screening participation. Given the lack of focus on men’s, this study provides formative data to test interventions to increase the well-being of older men.
RESTING HEART RATE MODERATES THE RELATIONSHIP BETWEEN NEUROPSYCHIATRIC SYMPTOMS, MCI, AND ALZHEIMER’S DISEASE
Authors: Burke Shanna L 
Published: November 2019

Abstract
Little is known about how resting heart rate moderates the relationship between neuropsychiatric symptoms and cognitive status. This study examined the relative risk of NPS on increasingly severe cognitive statuses and examined the extent to which resting heart rate moderates this relationship. A secondary analysis of the National Alzheimer’s Coordinating Center Uniform Data Set was undertaken, using observations from participants with normal cognition at baseline (13,470). The relative risk of diagnosis with a more severe cognitive status at a future visit was examined using log-binomial regression for each neuropsychiatric symptom. The moderating effect of resting heart rate among those who are later diagnosed with mild cognitive impairment (MCI) or Alzheimer’s disease (AD) was assessed. Delusions, hallucinations, agitation, depression, anxiety, elation, apathy, disinhibition, irritability, motor disturbance, nighttime behaviors, and appetite disturbance were all significantly associated (p&lt;.001) with an increased risk of AD, and a reduced risk of MCI. Resting heart rate increased the risk of AD but reduced the relative risk of MCI. Depression significantly interacted with resting heart rate to increase the relative risk of MCI (RR: 1.07 (95% CI: 1.00-1.01), p&lt;.001), but not AD. Neuropsychiatric symptoms increase the relative risk of AD but not MCI, which may mean that the deleterious effect of NPS is delayed until later and more severe stages of the disease course. Resting heart rate increases the relative risk of MCI among those with depression. Practitioners considering early intervention in neuropsychiatric symptomology may consider the downstream benefits of treatment considering the long-term effects of NPS.