bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Psychosocial and Spiritual Components of a Good Death
Authors: Maynard Quentin , Csikai Ellen 
Published: December 2020

Abstract
Advances in medical care led to more older adults living longer, with at least one chronic illness. Correspondingly, the disease trajectory and dying process may be prolonged, providing more time to plan for a ‘good death.’ A ‘good death’ is typically described in the literature according to medical and biological aspects, with limited explicit discussion of psychosocial and spiritual elements. The purpose of this study was to explore older adults’ perceptions of psychosocial and spiritual factors that contribute to a death they would consider ‘good’. Using descriptive qualitative research methods, 12 community-dwelling older adults in central Alabama participated in two in-depth interviews. The findings suggested a range of physical, psychological, social, and spiritual components contributed to the conception of a ‘good death’ and were often interrelated. For example, the medical treatment desired at end of life was influenced by the perceived effects on the participants’ family/social network. Reflecting on previous experiences with death, along with motivations and values, guided what participants believed could help achieve their ‘good death.’ Most realized that preparation would allow for control over their experiences at end of life. The study findings emphasized the need to consider the holistic nature of advanced planning for the end of life according to what older adults and their families perceive as important to a ‘good death’. Efforts by professionals to maximize quality of life throughout serious illness and near the end of life are essential and can be accomplished through understanding what a ‘good death’ means to older adults.
Successful Aging: A Comprehensive Outcome Using Latent Profile Analysis
Authors: Longley Kasey , Grzywacz Joseph 
Published: December 2020

Abstract
Understanding “successful aging” is a primary goal of gerontology and adult development researchers that has been motivated by rapid the increases in life expectancy over the last 100 years. Successful aging, as it is understood by Rowe and Kahn, is conceptualized multidimensionally in terms of limited disease and disability, high physical, mental and cognitive functioning, and active engagement with life. “Success” in all three domains reflects the idealized manifestation of “successful aging.” Nevertheless, research on successful aging typically focuses on only one or two aspects of the model – most commonly physical disease or disability. The overall goal of this research is to advance understanding and subsequent attempts to promote holistic successful aging. Specifically, using key metrics from each domain of successful aging from the Midlife Development in the United States (MIDUS), this study characterizes distinct profiles of successful aging, and it describes the distribution of these profiles in the adult population. Results indicate 3 profiles. These are labeled as Successfully Aged, Somewhat Successfully Aged, and Least Successfully Aged. Approximately 82.1% of the population (mean age=50.5) is classified as Successfully Aged, whereas the remainder are classified in the Somewhat Successfully Aged (12.2%), and Least Successfully Aged (5.6%), respectively. As expected, those who were classified as Successfully Aged had the highest cognitive scores, sense of well-being, and self-rated health; and had the lowest number of age-related physical disabilities (i.e. cancer, stroke, osteoporosis, etc.) and mental health conditions (depression, anxiety disorder, and panic disorder). This outcome can be applied to multiple predictors.
Evaluating the Association Between Single Item Literacy Screener and Health Outcomes in Patients With Lung Cancer
Authors: Nguyen Julie , McNaughton Caitlyn , Sautter Jessica 
Published: December 2020

Abstract
Health literacy is becoming increasingly important in areas such as cancer care, where treatments are relatively difficult to navigate. This study aims to describe the how health literacy is associated with healthcare outcomes and health system usage among patients with lung cancer. Data include retrospective medical record data from 456 patients with lung cancer; half were age 70 and older. Patients were coded as having adequate or limited health literacy based on their response to their Single Item Literacy Screener (SILS). Data were collected from a 12 month period following diagnosis for each patient. One-third of patients had limited health literacy; this was significantly more common among adults age 70 and older. Patients with limited health literacy were more likely to have newly diagnosed lung cancers of stage 3B or higher (59.18% vs. 42.76%, p = 0.0011) compared to those with adequate health literacy. Patients with limited health literacy had higher median levels of depression based on the PHQ-9 questionnaire (4.0 vs. 3.0, p = 0.0082) and a higher median number of emergency department visits (1 vs. 0, p = 0.0156) and unplanned hospitalizations (1 vs. 0, p = 0.0044). Furthermore, patients with limited health literacy were more likely to have an emergency department visit or unplanned hospitalization sooner (p &lt; 0.0001). These data illustrate a lower quality of life and a higher dependency on healthcare services for patients with limited health literacy. Assessment and interventions may be necessary to ensure access to quality healthcare.
Is Pain Time Pattern Predictive of Future Time Perspective in Older Chronic Pain Patients?
Authors: Fennell Gillian , Yip Abby Pui Wang , Reid M Cary , Enguidanos Susan , Zelinski Elizabeth , Loeckenhoff Corinna 
Published: December 2020

Abstract
Chronic pain patients constitute 65% of those ages 65 and older in the US. Many affected older adults are challenged to manage physical and psychological consequences tied to the intensity, interference, and temporal pattern of their pain. However, little quantitative research highlights the psychological impact of constant versus intermittent or ever-present-yet-variable pain, even though temporal pain pattern may have meaningful predictive power for wellbeing and future time perspective (FTP). A positive and expansive view of the future is particularly adaptive for this population because it is positively associated with treatment adherence. In this study, we analyzed secondary data to determine whether pain temporal pattern and pain duration are associated with differences in participant scores on Carstensen & Lang’s Future Time Perspective scale. All participants (N=142) were 45 years old and older with non-cancer chronic pain lasting three months or more. There was no significant association between pain time pattern and FTP (p=.35). Additionally, controlling for pain duration, average FTP scores did not vary significantly as a function of time pattern (p=.07). Our analyses demonstrated no significant relationship between pain time pattern and FTP and no significant moderating effect of pain duration. However, in contrast to the previous literature, FTP was not significantly associated with age and negatively (rather than positively) associated with subjective health (r=-.08, p=.35; r=-.24, p&lt;.01), thus raising concerns about the generalizability of these findings. Implications for understanding time perceptions in older pain patients are discussed.
The Effect of Neighborhood Experiences on Positive Mental Health Among Community-Dwelling Older Adults
Authors: Gan Daniel R Y , Cheng Grand H-L , Ng Tze Pin , Fung John Chye , Cho Im Sik 
Published: December 2020

Abstract
Given reduced life spaces, the neighborhood often functions as a social venue for older adults. Yet how these everyday social spaces affect older adults’ psychosocial wellbeing remains largely unknown. Drawing on the GRP-CARE Survey data, this paper examined the relation between neighborhood experiences and positive mental health. Participants were 601 community-dwelling Singaporeans aged 50+ who lived in public housing neighborhoods. Neighborhood experiences were measured using the four-factorial, 16-item OpenX scale (Gan, Fung, Cho, 2019); positive mental health was measured using a six-factorial, 19-item scale (Vaingankar et al., 2011). Both scales have good psychometric properties and had been validated. Path analysis between relevant factors of both scales was conducted using Stata, within a theorized model of causation from neighborhood environment to social factors to psychosocial health. Age, education, ethnicity and sex were controlled for. Multiple linear regression analysis showed a strong, positive association between neighborhood experiences and mental health (p=0.000) even after controlling for personal traits (operationalized as depressive symptoms, GDS) in addition to sociodemographic variables. Path analysis showed that two distinct neighborhood health processes mediated this association. These were (1) the potential for a sense of community in the neighborhood improved emotional support, and (2) having better neighborly friendships improved interpersonal skills. These neighborhood health processes provide us with new lenses to understand older adults’ everyday experiences of their neighborhoods. Community-based interventions to improve older adults’ psychosocial wellbeing may be developed to facilitate these processes. Spatial and programmatic implications will be discussed in relation to age-friendly cities and communities (AFCC).
The Intersectionality of Person, Space, and Time for Understanding Aging in Place
Authors: Ramadhani Widya , Harris Maurita , Rogers Wendy 
Published: December 2020

Abstract
Aging in place is interpreted differently across times and disciplines in the literature. Multiple interpretations of aging in place can lead to differences in expectations and goals when planning products, services, and technologies for older adults. We conducted a historical review across databases in the fields of anthropology, architecture, gerontol-ogy, medicine, psychology, and sociology to explore the evolution of ‘aging in place’ term across time and disciplines. We included articles that used the terminology “aging in place” or “ageing in place” in titles, abstracts, keywords, or subject. From the aging in place definition excerpts collected, we identified the preliminary themes and grouped them into three main themes: people, space, and time. Although the narrative of aging in place is highly related to living spaces, the cause and influencing factors are tied beyond the space. Person and time-related factors that are related to the aging experience im-pact the way aging in place is defined. When designing products, services, and technolo-gies to support successful aging in place, designers, researchers, policymakers, and care-givers should be aware that aging in place is at the intersection of personal, spatial, and temporal elements of older adults’ lives. Based on the multiple perspectives of disci-plines, we concluded that aging in place is beyond the matter of location, but also takes into account the person’s capacity and the changes over the person’s lifespan. Founda-tional understanding of the multiple factors that influence aging in place is critical to support older adults to have a healthy and optimal aging experience.
The Impact of Changing the CMS Nursing Home Compare 5-Star Ratings on the Use of Antipsychotics
Authors: Fashaw Shekinah , Shireman Theresa , McCreedy Ellen , Ogarek Jessica 
Published: December 2020

Abstract
Due to their potential to increase falls and death in people with dementia, antipsychotic medications (APMs) have been the subject of several federal efforts to reduce their use in nursing homes (NHs). In 2015, the Centers for Medicare & Medicaid Services added inappropriate APM use to their NH 5-star quality ratings. We examined the impact of this policy decision on NH residents with dementia by race/ethnicity. Using a quasi-experimental study design and Minimum Data Set (MDS) 3.0 assessments, we examined long-stay NH residents with dementia. We examined changes in APM use quarterly (2013-2016) using interrupted time series analyses, stratified by race/ethnicity. There were about 1 million NH residents per quarter. Baseline use of APMs among persons with dementia was 29.1% for Whites, 29.2% for Blacks, and 33.7% for Hispanics. All three races experienced significant declines in APM use prior to the addition of AP use into the quality rating (p&lt;0.001). During the first quarter of rating system changes, there were significant declines in APM use for all three races: Blacks, 0.48%; Hispanics, 1.0%; Whites, 0.49%. Subsequent rates of decrease in APM use did not differ from the baseline rate of decline (p&gt; 0.5). The policy change did result in a one-time, significant drop in APM use, but did not alter the rate of decline already in place, presumably stemming from the National Partnership instituted in 2012. Hispanics started with the highest rate of APM use and experienced the greatest decreases over time and with the new star rating measure.
A Study on Community Formation Patterns Based on the Usage of Benches by Seniors
Authors: Lee Yunjeong , Nishino Akiko , Matsuda Yuji , Otsuki Toshio , Nishide Kazuhiko 
Published: December 2020

Abstract
In Japan, the rate of aging exceeds 27%, and the decline of communities has been an issue. Therefore, in this study we take the T housing complex as an example where the rate of aging is more than 40% and aim to understand the usage pattern of benches. An observational research was conducted for 19 days to examine the usage of a total of 23 benches, 17 existing ones and 6 newly installed ones, in the T housing complex. This investigation led to the findings. An average of 417 people used the benches in a day. Research determined that there are four different types of bench utilization, and they each present different ways of building relationships with other people. Bench use behavior was broken into four different categories. Sitting on a bench alone (without building relationships with others) was classified as “single use”. Sitting on a bench with another person but not engaging in any relationship-building behavior was classified as “sharing”. Sitting on a bench and exhibiting relationship-building behavior with others (such as through talking) was classified as “chatting”. Sitting with companions in groups of 3 or more people and exhibiting relationship-building behavior was classified as “group use”. Our findings provide evidence that a bench can be a device to foster the formation of diverse communities.
Barriers to Disaster Preparation When Older Adults Are Taking Care of Older Adults
Authors: Chen Zhirui , Cong Zhen 
Published: December 2020

Abstract
This study examined the association between age and barriers for disaster preparation in the U.S., including the moderating effect of caring for an elderly person. Using a sample of 1147 individuals from the 2017 FEMA National Household Survey, we tested age as the key predictor, which had four groups: 18-44 (young age), 45-64 (middle age), 65-74 (young-old), and 75+ (old-old). Binomial logistic regression was conducted to investigate how age and the responsibility to take care of an older adult affected the likelihood of having preparation barriers, controlling for respondents’ gender, education, race, home ownership, disability, and responsibility to take care of an older adult. The results showed that compared with other age groups, young-old were significantly less likely to have barriers for disaster preparation. In addition, taking care of an older adult increased the likelihood of having preparation barriers. Interestingly, relative to the young-old, caring for an older adult presented additional challenges for other age groups to have barriers for preparation. Our findings directed attention to age patterns in barriers for disaster preparation and heterogeneity among older adults, and also highlighted that caring for older adults could exacerbate barriers for disaster preparation. The life course perspective informed the discussion of results, which emphasized on life-span development and linked lives.
Perceived Neighborhood Environmental Factors Related to Sarcopenia in Urban-Dwelling Older Adults
Authors: Seo Yuri , Kim Miji , Shim Hayoung , Jung Heeeun , Lee Seoyoon Jane , Won Chang Won 
Published: December 2020

Abstract
Sarcopenia is common among older individuals and has adverse health outcomes. However, little is known about its association with neighborhood environmental factors. We explored the relationship between sarcopenia and neighborhood environmental factors among community-dwelling older adults aged 70–84 years in urban areas in the Korean Frailty and Aging Cohort Study. There were 1,776 participants in this cross-sectional study (mean age 75.9±3.8 years, 54.1% women). Sarcopenia was defined using the Asian Working Group for Sarcopenia guidelines. The neighborhood environmental factors were assessed using the 17-item Environmental Module of the International Physical Activity Questionnaire (IPAQ-E). The prevalence of sarcopenia was 22.5%. In the multivariate analysis adjusted for potential confounders, compared to the 5th quintile of the IPAQ-E score, the odds ratio (OR and 95% confidence interval [CI]) for sarcopenia in the 1st, 2nd, 3rd and 4th quintile were 2.14 (1.41-3.26), 1.70 (1.11-2.61), 1.76 (1.16-2.68) and 1.62 (1.07-2.47), respectively. Sarcopenia was associated with environmental factors including access to destinations (β = -0.015) and neighborhood safety (β = -0.008) (all p&lt;0.05). Furthermore, no access to public transportation (OR 2.05, 95% CI 1.20-3.50), poor access to recreational facilities (OR 1.40, 95% CI 1.02-1.92), no presence of destination (OR 1.53, 95% CI 1.07-2.21), hill hazard (OR 1.34, 95% CI 1.02-1.77), and lack of safety from traffic (OR 1.35, 95% CI 1.02-1.79) was associated with an increased risk of sarcopenia. Our study suggests that neighborhood environmental characteristics are associated with sarcopenia and better neighborhood environmental strategies can help prevent sarcopenia among older adults.
A Longitudinal Study of Retirement Transition and Advance Directive Completion
Authors: Koss Catheryn 
Published: December 2020

Abstract
Advance directives (AD) help to ensure patients’ wishes are honored and contribute to improved end-of-life care. According to normative life course theory, retirement is a significant role change that signals a transition into the third age and its socially prescribed activities. To the extent that ACP is viewed as something to do when one reaches a more advanced stage in life, retirement may spark recognition that planning for incapacity and the end of life is now personally relevant and appropriate. This study tested whether transitioning from work to retirement prompted AD completion. The sample included Health and Retirement Study participants 65 and older who, in 2012, had no ADs and were not completely retired (N = 919). Retirement was operationalized as both a categorical status and as a multistep process. Three waves of data were analyzed using multinomial logistic regression to test associations between retirement transition and advance directive completion. By 2014, 21% had completed ADs and another 17% completed them by 2016. Those who completely retired between 2012 and 2014 were almost twice as likely to complete ADs between 2014 and 2016. Graduated increase in level of retirement between 2012 and 2014 was associated with higher odds of new AD possession in 2016, but did not reach statistical significance at p &lt; .05. These results suggest the period following retirement may be an optimal time to encourage patients and clients who have not already done so to complete advance directives.
Linking Work-Life Occupational Exposures With Distress and Mortality Before and After Retirement
Authors: Laditka Sarah , Laditka James , Arif Ahmed 
Published: December 2020

Abstract
Mental health problems have surpassed musculoskeletal injuries as causes of work disability. Workers in certain occupations may have high risks for mental health problems and premature death even after retirement. People in high risk occupations for many years may be particularly vulnerable, along with groups with higher health risks such as rural residents. Little research examines their occupation-related risks. No research has examined how occupational exposures affect mental health in retirement. We studied these life course risks using the nationally representative Panel Study of Income Dynamics, following participants 36 years beginning 1981, with annual measures of occupation and distress (n=16,994; 129,880 occupation measures; 415 deaths). We estimated hazards of developing distress in occupations hypothesized to have high and low distress risks, adjusted for factors associated with occupational choice and mental health including age, education, income, race/ethnicity, sex, childhood and midlife health, and family trauma. Compared to low risk occupations, working in high risk occupations was associated with 20% elevated odds of distress (adjusted odds ratio, OR 1.20, 95% confidence interval, CI 1.13 1.28) and 55% elevated risk of death (hazard ratio 1.55, CI 1.11-2.16). Each additional year in a high risk occupation increased the odds by 5%. Rural residents had the highest occupation-related distress risk (adjusted OR 3.05, CI 2.39-3.97). At ages 70+ each additional past exposure year was associated with 2% higher distress risk (p&lt;0.05), and 4.6% higher mortality (p&lt;0.05). Workers in certain occupations have high risks of psychological distress and death, even after retirement.
A Short Screening Measure of Contextual Vulnerability for Financial Exploitation
Authors: Campbell Rebecca , Lichtenberg Peter 
Published: December 2020

Abstract
Financial exploitation (FE) among older adults is an expensive personal and societal problem. Many professionals who work with older adults need fast and reliable measures to detect FE, including: APS workers, financial professionals, and healthcare providers. Very few standardized measures exist to assess an older adult’s risk for FE, and fewer still that do not require extensive training to administer. Lichtenberg et al. (in press) presented the Financial Exploitation Vulnerability Scale (FEVS), which assesses the context (i.e. financial, social, and psychological) in which an older adult is making a financial decision. This 17-item scale differentiates between older adults who’ve experienced FE and those who have not. It has excellent psychometric properties and clinical utility to detect FE beyond demographic and neuropsychological variables. We utilized exploratory factor analysis to examine the factor structure of the FEVS and reduce the number of items. Participant data (n=243) were drawn from two samples: a community-based sample and a group of individuals who were seeking financial coaching services following a financial scam or theft. Examination of the eigenvalues yielded a unidimensional scale. An iterative process was used to remove items that did not load on the single factor or with low corrected item total correlations. The final scale contained nine items and retained its ability to detect financial exploitation (AUC=0.778) and good internal consistency (a=0.845). This short form scale (FEVS-SF) is a brief, standardized screening measure to assess contextual vulnerability for FE that is accessible to professionals who work with older adults.