bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caregiving, Pain, and Dementia: Evaluating the Role of Coping and Adaptation
Authors: Robinson-Lane Sheria , Zhang Xingyu 
Published: December 2020

Abstract
Pain is a stressor that can negatively influence quality of life for caregivers. Dementia caregivers have an increased risk for stress-related health outcomes including death. Few studies have examined the relationships between pain and coping-related outcomes for dementia caregivers. In the present study, Black family caregivers (n=56) completed a survey inclusive multiple health and coping measures. In addition to descriptive statistics, Pearson’s correlation coefficients were completed. 33% of caregivers experienced moderate to severe pain. The majority of participants with pain (72%) also had hypertension and were obese (69%). Pain intensity was significantly correlated with anxiety (p=.001). Effective coping and adaptation was correlated with perceived social support (p=.002) and perceived positive aspects of caregiving (p=.0.027). The primary coping strategies used by caregivers with chronic pain included spiritual coping, information gathering, reliance on past experiences, and maximizing resource use. Improving pain outcomes for caregivers may benefit both caregivers and persons with dementia.
The Impact of Fragmented Physical Activity on Physical Function in European Older Adults in the SITLESS Study
Authors: Caserotti Paolo , Tully Mark , Skjodt Mathias , Blackburn Nicole , Gine-Garriga Maria , Planas Laura Coll , Denkinger Michael , Wilson Jason 
Published: December 2020

Abstract
Patterns of physical activity (PA) may be associated with physical function independently of total volume. The study aim was to explore associations of PA fragmentation (PAF) and function in ≥65-year-old European adults (SITLESS study: n=1360). The ActiGraph wGT3X+ accelerometer was worn for seven consecutive days at the dominant hip. PAF was assessed as the ratio of the number of ≥10-second PA bouts divided by an individual’s total minutes in PA. Physical function was assessed using the 2-minute maximum walk test (2MWT) and short physical performance battery test (SPPB). Multiple linear regression was utilized adjusting for relevant covariates. Lower PA fragmentation was significantly (p&lt;0.01) associated with longer 2MWT distances and better SPPB scores. The model explained 54% and 41% of the variance in the 2MWT distance and in SPPB score, respectively. Increased PAF seems associated with reduced physical function; independent of sedentary behavior and numerous important health and socio-demographic covariates.
Assessment of fNIRS Processing Methods on Active Walking Data: Findings and Implications for Future Research
Authors: Izzetoglu Meltem , Holtzer Roee 
Published: December 2020

Abstract
Functional near infrared spectroscopy (fNIRS) studies utilized a limited and inconsistent number of processing algorithms to assess the prefrontal activity during active walking. To address this critical limitation, we have reanalyzed our large dataset of older adults (n=83) who underwent single and dual-task walking (STW and DTW) protocol by applying different hemodynamic conversion parameters and movement and physiological artifact removal methods. Linear mixed effect model results indicated significant increases in oxygenated-hemoglobin (HbO2) with expected decline in deoxygenated-hemoglobin (Hb) from STW to DTW (range of effect sizes: 0.59 to 0.64 for HbO2, 0.18 to 0.32 for Hb) irrespective of the methods used. In addition, intraclass correlations suggested excellent reliability across methods and task conditions (HbO2 range=0.982 to 0.996; Hb range=0.883 to 0.984). These findings support fNIRS as a robust approach for measuring prefrontal activity in older adults during walking and emphasize the importance for establishing explicit guidelines/principles for fNIRS processing.
Patterns of Prefrontal Activation and Performance During Walking Tasks Among Older Adults
Authors: Chen Nemin , Huppert Theodore , Krafty Robert , Rosso Andrea 
Published: December 2020

Abstract
Differences in prefrontal cortex (PFC) control of walking in older age likely arise from changes in neural capacity and compensation. PFC activation by changes in oxygenated hemoglobin from functional near infra-red spectroscopy was examined in 29 older adults (mean age=76). Tasks included standing with cognitive challenge and walking with and without cognitive challenge on even and uneven surfaces. Three PFC activation-performance patterns were identified using K-means clustering: 1) low activation during walking tasks and high activation during standing cognitive task, with the best performance in terms of walking speed and cognitive performance (n=10); 2) low activation on all tasks, with the lowest performance (n=15); 3) high activation during walking and low activation during cognitive, with intermediate performance (n=5). Associations of patterns with cognitive function and structural neuroimaging were explored, with results informing interpretation of functional changes of PFC during aging process, including compensatory mechanisms for primary network impairment.
Overlap, Commonality, Disparity, and Variability of Frontal Lobe Activation in Aging and Neurodegeneration
Authors: Maidan Inbal , Bernad-Elazari Hagar , Hacham Roni , Hausdorff Jeffrey , Mirelman Anat 
Published: December 2020

Abstract
Recent work suggests that the prefrontal cortex is recruited during complex walking as a form of cognitive compensation to maintain performance in aging and neurodegenerative diseases. Evidence from fNIRS studies is accumulating on different patient groups demonstrating the utility of this method and its sensitivity to neural dysfunction. However a direct comparison that explores the specificity of prefrontal activation patterns has not been conducted. This process is essential towards implementing the use of fNIRS at the individual level. Data collected from four different cohorts; young adults, older adults, PD patients at different stages of the disease, and patients with Multiple-Sclerosis during challenging tasks will be presented. Overlap, commonality, disparity and variability between groups and conditions will be presented and modifiers and moderators that can affect individual performance will be discussed. Understanding individual differences in fNIRS response will enhance data interpretation and promote translation of this technology to clinical care applications.
Preventing and Managing Chronic Conditions In Older Adults: Lessons Learned From the NHATS and NSOC 2017
Authors: DiMaria-Ghalili Rose Ann , Monturo Cheryl 
Published: December 2020

Abstract
According to the Centers for Disease Control, 85% of older adults have at least one chronic health condition, and 60% percent have at least two chronic conditions. This symposium explores strategies to prevent and manage chronic conditions (nutritional status, medication management, wound care, and physical function) using data from the 2017 National Health and Aging Trends Study (NHATS) and corresponding National Study on Caregiving (NSOC). The datasets include a nationally representative sample of US older adults (NHATS) and their caregivers (NSOC). In addition to survey questions, the 2017 NHATS cohort submitted dried blood samples which include inflammatory biomarkers (hs-C reactive protein [hsCRP] and interleukin-6 [IL-6]). All individual presentations report on weighted data from the analysis to more accurately reflect the US population. In the first paper, DiMaria-Ghalili explores the prevalence of and factors related to malnutrition in community-dwelling and residential living older adults. In the second paper Coates examines the extent to which source of purchased medications impacts the occurrence of self-reported medication mistakes and hospitalizations in community-dwelling participants who managed medications independently. In the third paper, Hathaway compares the socio-demographic, nutrition, and inflammatory profile of older adults with and without wounds. In the fourth paper, Sefcik examines the relationship between the frequency of community-dwelling older adults going outside and physical function. Collectively, findings provide insight into the experiences of vulnerable older adults with chronic conditions informed from the NHATS and NSOC datasets. The symposium will conclude with a discussion by Monturo on implications for research, policy and practice.
Prevalence of Malnutrition in a National Sample of Older Adults Residing in Community or Residential Care: NHATS 2017
Authors: DiMaria-Ghalili Rose Ann , Granche Janeway , Coates Martha , Hathaway Zachary , Sefcik Justine 
Published: December 2020

Abstract
The national prevalence of malnutrition in older adults living in the community and residential care (non-nursing home) is not known. We determined the prevalence of malnutrition (Mini-Nutritional Assessment) in a representative sample (N=4472) living in the community (95%) or residential care (5%), and examined known nutrition risk factors (inflammation [hsCRP, IL-6], socio-demographic variables). The majority (68%) were nourished, 26% were at risk, and 6% were malnourished. Those living in residential care vs community were more likely to be malnourished (12% vs 5%, respectively p&lt;.01). Compared to nourished group, those with malnutrition were more likely to have hsCRP greater than median (1.36) (OR = 1.45 [95% CI 1.01-1.92]) and those at nutritional risk were more likely to have IL-6 greater than median (4.22) (OR=1.34 [95% CI 1.09-1.63]). Malnourished older adults were more likely to be older, female, live alone, report worse self-reported health, and use Meals on Wheels (p &lt;.05).
Hearing Loss and Help-Seeking Behavior
Authors: Reed Nicholas 
Published: December 2020

Abstract
Hearing Loss (HL) is common among older adults and is associated with poor health care quality outcomes include 30-day readmissions, length of stay, poorer satisfaction, and increased medical expenditures. These associations may manifest in changes in help-seeking behaviour. In the 2015 Current Medicare Beneficiary Study (MCBS) (n=10848; weighted sample=46.3 million), participants reported whether they knowingly had avoided seeking care in the past year and self-reported HL was measured as degree of trouble (none, a little, or a lot) hearing when using a hearing aid if applicable. In a model adjusted for demographic, socioeconomic, and health factors, those with a little trouble (OR= 1.612; 95% CI= 1.334-1.947; P&lt;0.001) and a lot of trouble hearing (OR= 2.011; 95% CI= 1.443-2.801; P&lt;0.001) had 61.2% and 101.1% higher odds of avoiding health care over the past year relative to participants with no trouble hearing. Future work should examine whether hearing care modifies this association.
The Temporal Relationship Between Ecological Pain and Life-Space Mobility in Older Adults With Knee Osteoarthritis
Authors: Mardini Mamoun , Nerella Subhash , Kheirkhahan Matin , Ranka Sanjay , Fillingim Roger , Cenko Erta , Rashidi Parisa , Manini Todd 
Published: December 2020

Abstract
Older adults who experience pain are thought to have lower life-space mobility (spatial size and frequency of interaction with the surrounding environment). However, there is significant day-to-day variability in pain experiences that offer insights into consequences on life-space mobility that aren't understood. This study examined the temporal association between ecological pain and metrics from Global Positioning System in older adults with symptomatic knee osteoarthritis. Participants (n=19, 73.1+/- 4.8 yrs, 68.4% female) wore a smartwatch for an average period of 13.16 (+/-2.94) days. Participants were prompted in their free-living environment about their pain intensity (range 0-10) at random times in the morning, afternoon and evening. Results suggest that higher level of knee pain in older adults was associated with a 6.4 (2.81, p=0.02) fewer miles traveled per day – indicating a lower life-space mobility. A custom designed smartwatch is effective at simultaneously collecting rich information about ecological pain and life-space mobility.
Early Life Conditions, Adulthood Experiences, and Edentulism at Older Ages
Authors: Lee Haena , Waite Linda 
Published: December 2020

Abstract
The role of childhood in shaping overall adult health has been well documented, especially for physical and mental health, but much less is known about the impact of early disadvantage on oral health in later life. Using data from the 2006 and 2012 Health and Retirement Study, we investigate the link between childhood financial and psychosocial adversity and edentulism over a six-year period among U.S. adults aged 51 and older. We find that those growing up with parents with fewer resources face higher risks of having lost all their tooth at baseline and during the follow-up. Adulthood socioeconomic status and health behaviors are strongly associated with the risk of edentulism, net of childhood conditions. However, the effect of low parental resources on the onset of edentulism persists when accounting for these life course factors. Part of a symposium sponsored by the Oral Health Interest Group.
Technology-Based Applications for the Assessment and Management of Alzheimer’s Disease and Related Disorders
Authors: Massimo Lauren , Demiris George 
Published: December 2020

Abstract
Over the last decade, technological advances have made it possible for people to access health information right at their fingertips. Indeed, technology-based applications (apps) have been developed to tackle a wide range of health-related issues, including Alzheimer’s disease and related disorders (ADRD). As such, there is a critical need to develop and test effective dementia apps that can ultimately be converted in to scalable programs. In this interdisciplinary symposium, we will discuss the development and testing of novel apps for the assessment and management of ADRD. The first session will discuss the development of an online money management credit card task to assess cognitively vulnerable older adults who are at risk for making poor financial decisions. The second session will describe the development and psychometric testing properties of a mobile app to detect the earliest features of preclinical Alzheimer’s disease. The third session will highlight findings from a study testing a smartphone-based prompting app to improve everyday task completion in persons with mild cognitive impairment and mild dementia. The last session will share findings from a study testing a mobile app to increase goal-directed behavior and reduce apathy in persons with dementia. Together, these presentations describe how technology-based applications can be used to assess and manage cognitive and behavioral symptoms of ADRD.
Deficiency Citations in Nursing Homes That Predominantly Serve Residents With Serious Mental Illness
Authors: Jester Dylan , Hyer Kathryn , Bowblis John 
Published: December 2020

Abstract
Studies suggest that nursing homes (NHs) that predominantly serve residents with serious mental illness (SMI) are of worse quality due to poor resources (i.e., high Medicaid-paying census) and lower staffing. We used national Certification and Survey Provider Enhanced Reports (CASPER) data to examine the deficiencies issued to NHs from 37,800 recertification inspections of 14,582 unique NHs from 2014 to 2017. NHs were categorized into “low-SMI” and “high-SMI” facilities using the lowest and highest quartiles, respectively, of the proportion of residents in the NH with SMI. Bivariate analyses were used to assess for differences between low-SMI and high-SMI NHs in the number of deficiencies, the deficiency score (a point-based metric developed by the Centers for Medicare & Medicaid Services), and the scope and severity of deficiencies. In total, there were 245,178 deficiencies issued. In comparison to low-SMI NHs, high-SMI NHs received a greater deficiency score and more deficiencies per survey (p&lt;.001). Deficiencies given to high-SMI NHs were associated with greater risk of harm (p&lt;.001) and were of wider scope (p&lt;.001). High-SMI NHs were cited 215% more often for resident abuse or neglect and 61% more often for the policies that prohibit and monitor for risk of abuse and neglect in comparison to low-SMI NHs. In conclusion, high-SMI NHs were documented for providing worse care to residents, with one particular area of concern being the heightened risk of resident abuse and neglect. Implications for policy and practice will be discussed.
Using Genetic Information to Explore Whether Preclinical Alzheimer’s Disease Affects Hearing Difficulty
Authors: Brenowitz Willa , Filshtein Teresa , Yaffe Kristine , Walter Stefan , Hoffmann Thomas , Jorgenson Eric , Whitmer Rachel , Glymour Maria 
Published: December 2020

Abstract
Underlying AD-related neurodegeneration or shared risk factors may influence hearing loss; in an innovative approach we tested whether genetic risk for AD also influences functional hearing loss. We studied 401,084 UK Biobank participants aged 40-70, with Caucasian genetic ancestry, and enrolled 2007-2010. Participants self-reported hearing difficulty and were followed for AD diagnosis until 2018. A genetic risk score for AD (AD-GRS) was calculated as a weighted sum of 23 AD risk variants. In age-, sex-, and genetic ancestry- adjusted models higher AD-GRS was associated with problem hearing in ages 60+(OR= 1.03; 95%CI:1.00, 1.05), but not ages &lt;60 (p&gt;0.05). Using the AD-GRS as an instrumental variable for AD diagnosis, we estimated that incipient AD increased probability of difficulty hearing at enrollment by 45% (95%CI: 1%, 93%). Higher AD-GRS was associated with slightly higher odds of hearing difficulty in older adults. Genetics that predispose for AD also influence late-life hearing difficulty.
Dementia Knowledge and Caregiving Skills Improvement From Using the PAC Model: A Pilot Comparative Evaluation
Authors: Brown Jerry , Reddy Pranay , Nwakasi Candidus , Nolan Beth , Snow Teepa , Ehlman Katie 
Published: December 2020

Abstract
The diverse needs of persons living with dementia in nursing home settings presents challenges for Certified Nursing Assistants (CNAs) to provide quality care. There is a lack of educational preparedness among nursing home CNAs regarding dementia knowledge and skills required to care for a person living with dementia. As direct caregivers for persons living with dementia, CNAs play an important role in long-term care. This pilot study evaluated the dementia knowledge and caregiving skills of newly trained CNA students. The students were trained by an instructor certified using Teepa Snow’s Positive Approach to Care (PAC) curriculum. Conducted in a rural southwestern Indiana community, this study evaluated CNA students’ knowledge and perception of dementia, as well as their skill performing the Positive Physical Approach™ (PPA™) technique to approach and connect. A 38-item knowledge and perception survey and a 12-step observed skills assessment using a standardized patient encounter were administered to CNA students. Data were analyzed using descriptive statistics and bivariate analysis. Preliminary results indicate that 100% of students correctly answered the survey item regarding non-confrontational body language, while 29% of students correctly performed the corresponding PPA skill. There is a statistically significant association between the knowledge that people find pressure in their palm comforting and the ability to perform the corresponding Hand-under-Hand® and PPA techniques. Incorporation of PAC into current CNA curriculum may equip CNAs with the knowledge and skills required to provide better care, with the potential to improve the overall quality of life for persons living with dementia.
The Importance of Bridge Jobs in America Today
Authors: Cahill Kevin 
Published: December 2020

Abstract
Gradual retirement, consisting of phased retirement, bridge employment, and reentry, has been a persistent feature of older Americans’ work decisions for decades. This persistence is remarkable in light of the many changes to the retirement landscape that have taken place since the mid-1980s, including changes to Social Security incentives, private-sector pensions, and macroeconomic volatility. Our paper addresses two topics related to these retirement transitions. First, using 26 years of data from the Health and Retirement Study (HRS), we quantify the prevalence of bridge employment among the initial group of HRS respondents. For the first time, bridge job prevalence can be calculated for a large cohort of older Americans who have completed their retirement transitions. Second, we comment on what these findings mean for policymakers, with respect to income inequality later in life, barriers to retirement pathways, and public-private sector differences, and what role public employers might be able to play.
Challenges of Implementing the 4Ms in Federally Qualified Health Centers and Private Academic Medical Centers
Authors: Olsen Bonnie , Sivers-Teixeira Theresa , Sadamitsu Kelly 
Published: December 2020

Abstract
As our country increases our capacity to provide quality interprofessional geriatric medical care to older adults, we find challenges that are unique to the setting. Many older adults receive care in Federally Qualified Healthcare Centers where implementing Age-Friendly Care is critical. Implementing the 4M’s in this setting has specific challenges including lack of geriatric trained staff, staff turnover, leadership engagement and financial sustainability. When implementing Age-Friendly Care within a large-scale complex academic health system, equally difficult challenges surface. With less nimble infrastructures, changes in one service area can have a domino effect and create larger barriers in other parts of the system. Instituting the 4M’s in an academic health system environment requires a careful strategic approach and support from many areas of organizational leadership. This talk will focus on strategies to anticipate and adapt implementation plans to best address barriers that are unique to the setting.
Mixed Methods Evaluation - A Chinese Cancer Screening Program
Authors: Hou Su-I 
Published: December 2020

Abstract
This paper introduces the rapidly growing modern mixed methods research (MMR) and its application in a Chinese cancer screening program. While some previous researchers have incorporated quantitative and qualitative data in research, recent mixed methods developments have provided significant clarity that can guide those new to the MMR field. Understanding the context for using MMR and examining a complex mixed methods evaluation study in Taiwan can help illustrate opportunities for and application of mixed methods in Asians. The Taiwan Cervical Cancer Screening Education Program is used as an exemplar of a multi-phase complex mixed methods evaluation study showcasing various MMR designs. These include an exploratory sequential design to develop culturally sensitive study instrument, iterative concurrent and sequential mixed methods for intervention mapping, and an embedded mixed methods evaluation design to assess impact. Visual diagrams are introduced to facilitate communication of mixed methods design procedures and products in each phase.