bluuebunny/crossref_metadata_2025_split huggingface dataset:
FRAILTY AND THE COMPARATIVE EFFECTIVENESS AND SAFETY OF SGLT2I AND DPP4I IN OLDER ADULTS WITH TYPE 2 DIABETES
Authors: Kim Dae H , Pawar Ajinkya , Kim Seoyoung , Patorno Elisabetta 
Published: November 2019

Abstract
We conducted a 1:1 propensity score-matched retrospective cohort study of 83,432 patients with type 2 diabetes (mean age, 71.5 years [standard deviation, 5.0]) initiating a SGLT2i or a DPP4i in Medicare data. We estimated HRs (95% CIs) for a composite cardiovascular endpoint and severe hypoglycemia comparing the two treatments in the entire population and by the CFI-based frailty subgroups. Compared with DPP4i, SGLT2i were associated with a lower rate of the composite cardiovascular endpoint (HR, 0.70 [95% CI, 0.64-0.77]) and a similar rate of severe hypoglycemia (0.88 [0.71-1.07]) over a mean follow-up of 8.8 months. The rate of composite cardiovascular endpoint for SGLT2i vs DPP4i was consistently lower in pre-frail (0.71 [0.64-0.79]) and frail (0.67 [0.55-0.80]) subjects, but not in non-frail patients (0.98 [0.62-1.54]). The rate of severe hypoglycemia was not meaningfully different between SGLT2i and DPP4i (non-frail, 0.39 [0.12-1.16]; pre-frail, 0.83 [0.65-1.07]; frail, 1.13 [0.78-1.64]).
GETTING TO YES . . . I WILL RESPOND: CHALLENGES AND SUCCESSES SURVEYING AGING SERVICES PROVIDERS TO PRODUCE QUALITY DATA
Authors: Harris-Kojetin Lauren 
Published: November 2019

Abstract
Voluntary surveys of aging services providers are important data sources for research, quality improvement, and program evaluation efforts to inform evidence-based decision making. Ideally, provider surveys—a type of establishment survey—offer valuable information on providers and services users. However, decreasing survey response rates in recent years raise data quality concerns. This symposium highlights challenges leading to lower response rates (e.g., time constraints, skepticism, confidentiality concerns, getting to the correct respondent); specific data collection techniques tested, what did and did not work, and lessons learned. Although the surveys focus on long-term services and supports (LTSS) providers (e.g., assisted living) and services users (e.g., residents), the session is generalizable to other establishment surveys. Presenters bring extensive survey experience and diverse organizational perspectives—academic research center, national provider association, federal statistical agency, and research contractor. Over the years, the presenters have used their research network to share challenges and lessons learned with each other, which addresses the GSA conference theme, “Strength in Age: Harnessing the Power of Networks.” The first presentation describes test results of a state survey protocol to obtain sampled resident information from assisted living providers. The second presentation examines approaches to increase provider participation in a quality improvement initiative. The third presentation discusses efforts to address response challenges in an on-going national survey of providers in two LTSS sectors. The session allows time for and facilitates interaction with audience members to share their insights and lessons learned.
EVALUATING ENHANCEMENTS TO ADDRESS SAMPLE DIVERSITY, RESPONDENT BURDEN, AND DIFFICULTY REACHING RESPONDENTS
Authors: Hobbs Melissa , Hobbs Melissa , Greene Angela , Caffrey Christine , Sengupta Manisha , Harris-Kojetin Lauren 
Published: November 2019

Abstract
Every two years since 2012, the National Study of Long-Term Care Providers includes provider surveys with residential care communities (RCCs) and adult day services centers (ADSCs), via a multi-mode approach using Web, hard-copy questionnaires, and computer-assisted telephone interviewing. In each wave, we struggled to achieve target response rates. First, diversity among providers surveyed—e.g. RCC size, type of ADSC—presents unique challenges. For RCCs, small communities have lower response compared to larger ones. For ADSCs, how they define themselves (medically vs socially oriented) influenced their decision to participate. Second, respondents’ perceived burden, particularly the time required to complete the survey, is a recurring concern especially for directors of multiple RCCs and ADSCs. Finally, reaching target respondents—directors, administrators or operators—is problematic. These challenges affect data quality. In this presentation, we share results of our efforts to enhance contacting and interviewing protocols intended to address low participation associated with these challenges.
PRESIDENTIAL SYMPOSIUM: HARNESSING SOCIAL NETWORKS TO OPTIMIZE ENVIRONMENTAL CONTEXTS FOR DIVERSE AGING EXPERIENCES
Authors: Rozario Philip A , Greenfield Emily , Kusmaul Nancy 
Published: November 2019

Abstract
Social networks provide opportunities for engagement with others and structure the receipt and provision of emotional, instrumental, informational and appraisal support. Indeed scholars in this field have documented the importance of having strong social networks in influencing older adults’ well-being and quality of life. The three papers in this symposium draw on the convoy model of social relations and ecological model to examine and better understand the micro, mezzo, macro contexts that shape and influence how older people engage with and benefit from their networks in three areas: low-income senior housing communities, urban areas specifically targeting older Latinos with dementia, and disaster preparedness in micropolitan counties in eastern Iowa. The first paper, a cross-sectional study focusing on social connections in senior housing communities, examines levels of social networks, engagement, support and loneliness and their relationship with well-being outcomes. The second paper, a community-based participatory research project, reports an intervention that seeks to train natural helpers in a predominantly Latino urban neighborhood to identify and refer older Latinos with dementia to bilingual assessment services. The third paper, synthesizing findings from interventions targeting network building at the individual and state levels as well as a community-based network analysis, presents ways to strengthen networks at the mezzo and macro levels as well as environmental contexts that enable better disaster preparedness for community-based older adults. These papers will consider practice, policy and research implications in strengthening social networks and engagement to optimize older adults’ well-being in various settings.
STRENGTHENING PERSONAL AND COMMUNITY DISASTER SUPPORT NETWORKS OF OLDER ADULTS
Authors: Ashida Sato , Thompson Lena , Robinson Erin L 
Published: November 2019

Abstract
The Ecological Model posits a multilevel approach to understanding of and strengthening social networks of community based older adults. We present findings from our intervention, network analysis, and efforts at influencing policy making at the state level to better prepare them for pre and post disaster and emergency situations. At the individual-level, we implemented the Disaster PrepWise program to help community-based older adults develop personal disaster plans. We found increases in personal emergency network size by an average of three non-familial individuals. At the community-level, we evaluated two disaster management networks in Eastern Iowa counties. We found strong collaborations in disaster planning and response among 44 governmental and community-based organizations, but weaker collaborations in supporting older residents, suggesting a need in this area. At the policy-level, we are developing a state-level network of organizations to address policy barriers to effectively support older Iowans.
THE EFFECTS OF CHRONIC PAIN AND LONELINESS ON FUNCTIONING AMONG LATINO AND WHITE OLDER ADULTS
Authors: Camacho David , Aranda Maria P , Burnette Denise , Lukens Ellen 
Published: November 2019

Abstract
The detrimental effects of loneliness and chronic pain on functioning in later life are well documented, yet there is little evidence of whether these patterns hold across racially diverse older adults. Guided by the Biopsychosocial Model of Assessment, Prevention, and Treatment of Chronic Pain, we used data from Waves 2 and 3 of the National Social Life, Health, and Aging Project (NSHAP) to examine the additive and interactive effects of loneliness and chronic pain on Elemental and Instrumental Activities of Daily Living (ADLs & IADLs) among a sample of 1046 Latino and White adults aged 50 and over. Using linear regression analyses, our final models (Adjusted R-squares: .316 & .304) included demographic characteristics, physical and mental health, medication, health behaviors and social factors. In this sample, approximately 33% experienced chronic pain, 50% reported at least transitory loneliness and 22% experienced both. Neither loneliness nor chronic pain was independently associated with functioning impairment. However, these two factors in combination were associated with lower scores on ADLs and I-ADLs. In addition, Latinos who reported chronic pain were more likely to report lower scores on ADLs only. Results highlight variations in the detrimental effects of loneliness and chronic pain for white and Latino elders. Findings suggest the need for interventions that address chronic pain and loneliness simultaneously. Future studies should examine how culturally-grounded experiences of loneliness and chronic pain may contribute to worsening of functioning among diverse groups of Latino elders.
VITAMIN K ANTAGONISM AND CHONDROCALCINOSIS IN THE OSTEOARTHRITIS INITIATIVE
Authors: Shea M Kyla , Loeser Richard F , McAlindon Timothy E , Booth Sarah L 
Published: November 2019

Abstract
Calcification of articular cartilage, known as chondrocalcinosis, becomes more prevalent with age. Although chondrocalcinosis can be characteristic of osteoarthritis, it has been associated with more joint pain and disability independent of osteoarthritis severity. Identifying novel modifiable risk factors for chondrocalcinosis may help reduce joint pain and disability. One potential risk factor involves vitamin K because vitamin K-dependent proteins that inhibit calcification are present in articular cartilage. To test the hypothesis that vitamin K antagonism is associated with more chondrocalcinosis, we evaluated the cross-sectional association between warfarin use and chondrocalcinosis prevalence in the Osteoarthritis Initiative (n=1472, 60% female, mean age 64 years). Warfarin is a vitamin K antagonist that interferes with vitamin K-dependent protein function. In a secondary analysis we evaluated whether the prevalence of chondrocalcinosis differed according to dietary vitamin K intake. Chondrocalcinosis of the knee, evaluated using plain x-rays, was detected in 8% of participants. It was three times more prevalent in warfarin users (n=20) compared to non-users [prevalence ratio (95% confidence interval) (PR(95%CI)): 3.02(1.42-6.46); p=0.004, adjusted for age, sex, race, BMI]. Chondrocalcinosis prevalence did not differ according to vitamin K intake [PR(95%CI), compared to tertile 3 (≥189 mcg/d): tertile 1 (&lt;96 mcg/d) =1.30(0.82-2.07), tertile 2 (96-189 mcg/d) =1.17(0.76-1.81), p-trend=0.623, adjusted for age, sex, race, BMI, energy intake]. That chondrocalcinosis prevalence differed according to warfarin use, but not vitamin K intake, suggests vitamin K-dependent protein function may be involved in chondrocalcinosis development. Since warfarin was not commonly used in this cohort, additional studies are needed to substantiate our findings.
THE RELATIONSHIP OF APOE ε4 TO THE RELATIVE TIMES AND HAZARDS OF DEMENTIA
Authors: Powell Danielle , Kuo Pei-Lun , Deal Jennifer A , Gottesman Rebecca , Palta Priya , Knopman David , Gross Alden L 
Published: November 2019

Abstract
Although APOE ε4 is an established risk factor for dementia, it is unclear whether it is associated with elevated risk or earlier symptom onset. Longitudinal study of 10,400 white-race individuals in the ARIC cohort followed from age 60 to incident dementia diagnosis, death, or censoring. All-cause dementia was defined using standardized algorithms incorporating longitudinal cognitive change, proxy report, and hospital or death certificate dementia codes. Death was ascertained via the National Death Index and death certificates. We used a parametric mixture of generalized gamma distributions to simultaneously estimate the distribution of event times and the proportion of individuals who experience each outcome (i.e., dementia and its competing risk, dementia-free death) by APOE ε4 status (≥ 1 allele vs. no alleles). Age-adjustment was through use of age as the time scale. APOE ε4 carrier status was associated with a doubling of the overall frequency of dementia incidence to 25% compared to 13% (p &lt; 0.001) in non- ε4 carriers. The distributions of time to dementia was modified by APOE ε4 status (p=0.007): median time to dementia onset among APOE ε4 carriers was 81.9 years compared to 83.3 years in non-APOE ε4 carriers (p = 0.005). No differences in results were found by sex. APOE ε4 carrier status is associated with both elevated risk and earlier time to dementia onset. These findings clarify the causal role of APOE in dementia etiology, could help better identify at-risk subgroups, and may help facilitate better research recruitment.
MECHANISMS OF BRAIN REJUVENATION
Authors: Villeda Saul 
Published: November 2019

Abstract
A growing body of work has shown that systemic manipulations, such as heterochronic parabiosis and young blood administration, can partially reverse age-related cellular impairments and loss of cognitive faculties in the aged brain. These studies have revealed an age-dependent bi-directionality in the influence of the systemic environment indicating anti-aging factors in young blood elicit rejuvenation while pro-aging factors in old blood drive aging. It has been proposed that introducing anti-aging factors or mitigating the effect of pro-aging factors may provide effective strategies to rejuvenate aging phenotypes. Despite this potential, much is unknown as to the systemic and molecular mechanisms regulating anti-aging and pro-aging effects of blood-borne factors. I will discuss work from my research group that begins to provide mechanistic insight into the systemic and molecular drivers promoting rejuvenation in the aging brain.
EARLY-LIFE INFLUENCES ON LATER-LIFE HEALTH
Authors: Moorman Sara M , Smith Jacqui 
Published: November 2019

Abstract
This symposium identifies risk and protective factors in childhood and adolescence that continue to influence the physical and cognitive health of older adults. Dimensions of early life inequality include geographic location, educational opportunities, and total amount of adversity faced. Papers in the symposium use data from three major U.S. longitudinal studies: the Health and Retirement Study (HRS), the MacArthur Study of Midlife in the U.S. (MIDUS), and the Wisconsin Longitudinal Study (WLS). Each paper focuses on the mechanisms (i.e., mediators and moderators) linking well-being in childhood and adolescence to health in older adulthood. Greenfield, Akincigil, and Moorman find that net of IQ, college education boosts later life cognition, especially for men who had a low probability of college attendance. Kemp and Montez further find that state economic policy and adult health behavior explain later life disparities in health by educational attainment. Herd, Sicinski, and Asthana continue the theme of geographic place, finding that rural children who were raised on farms are at a cognitive disadvantage in later life. Both Ferraro and Sauerteig and Homan and Kong generate indices of total childhood misfortune. Ferraro and Sauerteig conclude that childhood misfortune affects obesity by way of adult health behavior, specifically, physical activity. Homan and Kong find that childhood misfortune affects subjective and functional health by way of the psychological mechanism of purpose in life. Together, these five papers begin to identify the ways in which experiences in childhood and adolescence have long-lasting consequences for a variety of health outcomes in later life.
GEO-LIFE COURSE DETERMINANTS OF EDUCATIONAL DISPARITIES IN U.S. ADULT HEALTH
Authors: Kemp Blakelee , Kemp Blakelee R , Montez Jennifer K 
Published: November 2019

Abstract
Educational attainment is one of the strongest social determinants of adult health. However, recent studies show that it is a stronger determinant in some areas of the country than others. This study investigates geographic and life course contexts that may explain the pattern. We merge data on adults aged 50+ in the Health and Retirement Study (1998-2014) with contextual data on their state(s) of birth and residence. We examine: (1) how the education-health association varies across regions, and (2) how childhood (e.g., poverty, compulsory schooling) and adulthood experiences (e.g., smoking, minimum wage) explain the variation. Findings reveal that the education-health association varies across regions and is more pronounced for outcomes further along in the disablement process. Poor childhood health, adult behaviors, and states’ economic policies partly explain why the association varies across regions. The findings underscore the importance of geographic and life course contexts for understanding educational disparities in health.
LONELINESS AND SUICIDE IDEATION IN OLDER ADULTS: A LONGITUDINAL INVESTIGATION
Authors: Heisel Marnin J 
Published: November 2019

Abstract
Older adults have the highest rates of suicide globally, necessitating theory and research investigating suicide and its prevention in later-life. The experience of loneliness is significantly associated with depression, hopelessness, negative health outcomes, and mortality among older adults. Yet, relatively little research has focused on the role of loneliness in conferring suicide risk in later life. The purpose of the present study was thus to investigate the potential associations between loneliness and suicide ideation and behavior in a sample of community-residing older adults recruited into a larger two-year longitudinal study of psychological risk and resiliency to later-life suicide ideation. We specifically recruited 173 adults, 65 years or older, from community locations in a medium-sized Canadian city, for a study on “healthy aging.” Participants completed measures of positive and negative psychological variables, including depression, loneliness, and suicide ideation at a baseline assessment, and again at 2-4 week, 6-12 month, and 1-2 year follow-up points. Findings indicated that loneliness (UCLA Loneliness Scale) was significantly positively associated with concurrent depression and suicide ideation, negatively associated with psychological well-being and perceived social support, and differentiated between participants who endorsed or denied having ever engaged in suicide behavior. Baseline loneliness also explained significant variability in the onset of suicide ideation over a 1-2 year period of follow-up, controlling for age, sex, and baseline depression and suicide ideation. These findings will be discussed in the context of the need for increased focus on psychosocial factors when assessing and intervening to reduce suicide risk in older adults.
BEHAVIORAL MARKERS OF RESILIENCE IN CARE PARTNERS OF PERSONS WITH DEMENTIA: A THEMATIC ANALYSIS FROM A SCOPING REVIEW
Authors: Zhou Yuanjin , O’Hara Avery , Ishado Emily , Borson Soo , Sadak Tatiana 
Published: November 2019

Abstract
Caring for a person with dementia (PWD) requires commitment, flexibility, and resilience - the ability to endure and recover from stressors that arise during the caring process. However, it is unknown what behaviors can indicate resilience in care partners (CPs) of PWDs. We examined 46 peer-reviewed articles (1990 to 2018) that included measures or definitions of resilience in CPs of PWDs. Our goal is to identify resilience-related behaviors and create a behavior-based model/framework for CPs of PWDs. Three major themes emerged: (1) Problem-response behaviors (problem-identifying, problem-solving, problem-distancing, learning, and reflection); (2) self-growth behaviors (self-care, creative/spiritual activities, and developing/maintaining meaningful social relationships); (3) help-related behaviors (help-seeking and help-receiving). These findings informed the development of a behavior-based Care Partner Resilience (CPR) measure. Future steps in this research include evaluating to what extent behaviors in the CPR framework are associated with CPs’ self-assessed resilience and can predict CPs’ resilience following specific caregiving-related stressors.
WALKABLE NEIGHBORHOODS AND BRAIN HEALTH IN LATER LIFE: A SCOPING REVIEW
Authors: Kim Boeun 
Published: November 2019

Abstract
Brain health is critical in independent living and well-being in later life. There have been growing interests in investigating the role of walkable neighborhoods in brain health. The purpose of this scoping review was to understand the influence of walkable neighborhoods on cognitive outcomes in older adults. The physical features of walkable neighborhoods and their measurements were examined. Database search identified 2957 peer-reviewed articles and eight studies (2012-2018) met inclusion criteria. Community facilities and land-use mix were consistently associated with cognitive outcomes across studies. The measures of walkable neighborhoods were under development and the measurement properties were not reported in most studies. Further research on the definition of walkable neighborhoods that accounts specifically for older adults with/without cognitive impairment is needed. Additionally, more rigorous, valid, reliable standardized instruments for measuring walkable neighborhoods, as well as a standard for evaluating the quality of instruments are warranted.
REDUCING THE IMPACT OF CHILDHOOD MISFORTUNE: THE ROLE OF ADULT PHYSICAL ACTIVITY ON LATER OBESITY
Authors: Ferraro Kenneth F , Sauerteig Madison R , Williams-Farrelly Monica M 
Published: November 2019

Abstract
This study investigates the effects of childhood misfortune and adult physical activity on later-life body mass index (BMI) and waist circumference. We use ordinary least squares regression to examine the impact of childhood misfortune (30 indicators), and adult physical activity (frequency and intensity) on waist circumference and BMI (kg/m²) using data from the Health and Retirement Study (N=5,732). Results emphasize that experiencing childhood misfortune is associated with a larger waist circumference and BMI in later life, while adjusting for social status and lifestyle variables. Adjusting for adult physical activity decreases the effect of childhood misfortune on waist circumference, suggesting mediation. The analysis reveals that the effects of childhood misfortune on BMI and abdominal adiposity are remediable. Although childhood misfortune is associated with larger waist circumference and BMI in later life, regular physical activity reduces the risk on both indicators of obesity.
CAREERS IN ACADEMIC GEROPSYCHOLOGY: STRENGTHENING THE PIPELINE
Authors: Strong Jessica , Wynn Matthew , Moye Jennifer , Carpenter Brian 
Published: November 2019

Abstract
The shortage of clinical geropsychologists is further imperiled by the shortage of geropsychologists entering academia. The current study analyzed data collected during the implementation of a national webinar series (Advancing your Confidence as an Educator in Geriatrics and Gerontology). The development and implementation of the series has been previously reported. In the current study, we report on n=66 psychologists’ and psychology trainees’ responses to academia. Results included quantitative ratings of feelings towards imaging oneself in an academic role. Feelings rated included Excitement (41%), Intimidated (18%), Overwhelmed (30%), and Enthusiastic (30%), among others. These results were triangulated with open-ended qualitative responses on the frustrations and rewards of being an educator. Results are discussed in the context of the geropsychology pipeline shortage and implications for the future of clinical geropsychology. Suggestions for how to remedy this concern will be discussed.